Technique tips – constructing a provisional crown for a broken down tooth

Cuspal coverage restorations are indicated for teeth which have been endodontically treated,^1,2,3,4 or have been structurally compromised either due to large restorations⁴ being present within them or some traumatic incident. Such compromised teeth can benefit from cuspal coverage restorations as these can help to protect the tooth from further fractures which may render the tooth unrestorable.⁴ The destruction of marginal ridges, extensive restorations, or the presence of visible cracks can help to highlight the potentially structurally compromised tooth.^4,5

Provisional restorations are an essential part of the treatment pathway for teeth which have been prepared for a cuspal coverage restoration. They are indispensible as they can contribute to providing interim protection for the residual preparation,⁶ limit microbial leakage into the endodontic space via the dentinal tubules,⁷ prevent sensitivity and pulpal inflammation and prevent undesirable movement of adjacent and opposing teeth. Well-constructed provisional restorations can also be valuable in aiding resolution of inflamed periodontal tissues so that definitive impressions can be recorded with the tissues in a healthy and stable condition. It is not uncommon to have to prepare broken down teeth to receive a crown and the limited quantity of tooth structure initially can make it challenging to construct a well-fitting and contoured provisional restoration. This short article describes an effective way to construct a well-fitting, appropriately contoured provisional crown quickly and cost-effectively.