Temporization Materials

[MustangSVC]

Hey everyone, I'm a D2 at Temple and we're currently doing a lot provisionals in the preclinic. I have been using the Jet acrylic they provided in our kits, yet I fit it difficult to use because of distortion. I have also tried SNAP but it is too brittle for my liking. For those of you practicing or in the clinic, what temporization material do you prefer?

Thanks!

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[docj1]

Hey everyone, I'm a D2 at Temple and we're currently doing a lot provisionals in the preclinic. I have been using the Jet acrylic they provided in our kits, yet I fit it difficult to use because of distortion. I have also tried SNAP but it is too brittle for my liking. For those of you practicing or in the clinic, what temporization material do you prefer?

Thanks!

Exactatemp. I've been using it for 6 years and it works great. You can add to it with flowable composite if needed but it's usually not needed.

If you are allowed to use whatever you want than I recommend it. 2.5 minute set in an alginate preop impression.

 

[Elipar]

If you're getting too much distortion, very likely you're not mixing it correctly, or in the right proportion, or for the right amount of time. One important step that just about everyone forgets is to READ THE INSTRUCTIONS. All temporary materials will give you an acceptable temporary, with some only slightly better than others.

Now, to answer your question the way you want to hear it. Luxatemp is a great temporary material. It's strong, esthetic, easy to trim, and comes in a mixing cartridge. Downside is that it's very expensive. I use SmartTemp from Parkell. It's like Luxatemp in that it comes in a cartridge, but not as nice. But it gets the job done.

Some important points to consider when making temporaries.

1. The more well-defined your crown prep, the better your margins are to read in the temporary.
2. Take a bite registration using a rigid impression material. Then take a diamond bur and grind 0.5-1mm off the cervical portion of the tooth all the way around it. This gives your temporary bulk in the cervical area. You'll trim off the excess later, but it helps to prevent cracking thin temps.
3. Use a timer. Seriously. Use a timer. Material handling characteristics are very time dependent.
4. Make sure to wash the acrylic off the tooth before impressing with PVS. The acrylic will affect the setting of the PVS. If you use Alumium Chloride (e.g. Viscostat), also make sure that is washed off very well.

 

[HuyetKiem]

Intergrity is my favorite one with variety of shades and easy to reline and polish with flowable composite. I had couple pts wore their temp 3 unit bridges for more than 6 months with not even a crack. 👍👍

 

[johntara04]

I agree with the above poster. If you are having that much distortion that consistently, then you aren't doing something right. I hated acrylic as well at first, but I called 3 or 4 different labs and asked them what other doctors were using and what they thought the best temp was. The all said acrylic (jet) was the best temp material out there, and brought up other materials that they didn't like as much. Exacta-temp works well, it is a bis-acrylic, but is expensive. Honestly, learn how to use the acrylic for nothing else than the fact that when you start up your own practice in 2-6 years, you probably won't be able to afford to by a tube of exacta-temp or 30+ bucks when jet is so much cheaper. Go back, read the instructions, and keep practicing at it.

 

[rocknightmare]

jet acrylic here.. but it is a pain in the ass.. but apparently it works great in patients..

 

[OceanDMD]

If you're getting too much distortion, very likely you're not mixing it correctly, or in the right proportion, or for the right amount of time. One important step that just about everyone forgets is to READ THE INSTRUCTIONS. All temporary materials will give you an acceptable temporary, with some only slightly better than others.

Now, to answer your question the way you want to hear it. Luxatemp is a great temporary material. It's strong, esthetic, easy to trim, and comes in a mixing cartridge. Downside is that it's very expensive. I use SmartTemp from Parkell. It's like Luxatemp in that it comes in a cartridge, but not as nice. But it gets the job done.

Some important points to consider when making temporaries.

1. The more well-defined your crown prep, the better your margins are to read in the temporary.
2. Take a bite registration using a rigid impression material. Then take a diamond bur and grind 0.5-1mm off the cervical portion of the tooth all the way around it. This gives your temporary bulk in the cervical area. You'll trim off the excess later, but it helps to prevent cracking thin temps.
3. Use a timer. Seriously. Use a timer. Material handling characteristics are very time dependent.
4. Make sure to wash the acrylic off the tooth before impressing with PVS. The acrylic will affect the setting of the PVS. If you use Alumium Chloride (e.g. Viscostat), also make sure that is washed off very well.

Why not just take the impression before making the temporary? And another thing, I think its crazy to hand mix your temporary material. What a pain in the ass. What if you are doing a 5 unit bridge, or 10 units of veneers/jackets. You have got to be crazy not to use a catridge system with good esthetics. Spend the extra bucks for the convenience. When your in practice, raise you fee that TINY LITTLE BIT to cover it. Luxatemp is solid. It also has a complementary flowable(luxaflow) to seal temporary margins or repair them.

There are some less expensive cartridge systems, but always remember you can adjust your fees.

 

[OceanDMD]

Intergrity is my favorite one with variety of shades and easy to reline and polish with flowable composite. I had couple pts wore their temp 3 unit bridges for more than 6 months with not even a crack. 👍👍

Integrity is good stuff, less expensive than luxatemp. In my opinion the only downsides are longer working time and a bit more brittle. Its also awfully viscous to squeeze through the tips. Still way easier than hand mixing that dental school stuff.

 

[Elipar]

Why not just take the impression before making the temporary?When your in practice, raise you fee that TINY LITTLE BIT to cover it.

I make the temp impression BEFORE impressing. That way, while the impression is setting, I can trim it, and have it ready to seat when the impression comes out of the mouth. Saves about 5 minutes (or more if you're slow at making temps).

As for raising fees, a lot of dentists are trapped by insurance. So it is not possible to raise fees. If you're FFS, go for it.

 

[johntara04]

There are some less expensive cartridge systems, but always remember you can adjust your fees.

Not if you accept insurance......

 

[docj1]

Not if you accept insurance......[/quote
Cartridge systems are not very expensive per unit. They do become expensive if you put way too much in the impression. The learning curve is about 3 crowns, than you will know how much to put in. No smell, less distortion, quicker, more esthetic, more user friendly.

It's a no brainer even in a ppo practice.

 

[johntara04]

..

 

[docj1]

That's fine, but my point still stands. You can't raise your fees on your insurance patients.

True, but anything that reduces the amount of time you spend with the patient increases your productivity. So if you can't raise your fee, simplifying the process will decrease the amount of time it takes to do the procedure thus increasing your productivity.

 

[johntara04]

True, but anything that reduces the amount of time you spend with the patient increases your productivity. So if you can't raise your fee, simplifying the process will decrease the amount of time it takes to do the procedure thus increasing your productivity.

Yeah, I was just in a stinkin mood at the time....I tried to erase my post cause it was a bit childish.....anyhow, you caught me..😎😳

 

[docj1]

Yeah, I was just in a stinkin mood at the time....I tried to erase my post cause it was a bit childish.....anyhow, you caught me..😎😳

Sorry about that.
Cold beer makes a stinkin mood much better🙂

 

[DrJeff]

Intergrity is my favorite one with variety of shades and easy to reline and polish with flowable composite. I had couple pts wore their temp 3 unit bridges for more than 6 months with not even a crack. 👍👍

It's all that I use in my office. Great product IMHO👍

The price factor isn't that big a deal in private practice. Basically it's a $100 a cartridge which will make you 50+ units of crown and bridge temporaries. With what you'll bill for a unit of crown and bridge, the price becomes a non issue.

Many of the other brands of auto mix temporary materials that I've tried (and I've tried just about all of them) just seem to come out of the curing phase with a greater amount of "slime"(basically unfilled resin) on them comapred to Integrity(or atleast that's how it handles for me)

 

[johntara04]

Okay, I still agree with my first post about learning how to use acrylic, but I got my hands on some exta-temp over the weekend and tried it out in pre-clinic today. I passed off 8, 5, and 3. So, the other stuff is a lot quicker. I don't think Schien has the exta-temp, but I bet they would order it for you or you could try some of the stuff these guys have suggested.

For the doctors, what is your opinion of exta-temp (bis-acrylic, light cured)? I love it so far, but I haven't looked into its durability, strength, etc. Any thoughts?

 

[OceanDMD]

Okay, I still agree with my first post about learning how to use acrylic, but I got my hands on some exta-temp over the weekend and tried it out in pre-clinic today. I passed off 8, 5, and 3. So, the other stuff is a lot quicker. I don't think Schien has the exta-temp, but I bet they would order it for you or you could try some of the stuff these guys have suggested.

For the doctors, what is your opinion of exta-temp (bis-acrylic, light cured)? I love it so far, but I haven't looked into its durability, strength, etc. Any thoughts?

Who cares about "durability, strength,etc". Its TEMPORARY. Believe me, regardless of cost, using a cartridge system makes life much easier. When you are prepping multiple units do you really want to measure out every thing and hand mix it, then thumb into the temp matrix? I cant see how you would ever light cure a temporary material. My PFM patient comes in and I take a preliminary impression, usually an alginate if its a single unit. If Im doing a cosmetic case or a multi unit bridge, I usually have a wax up and a pvs of the wax up for the temp. You cant light cure through these types of molds. If you are creating a suck-down clear temp mold you are wasting time. The pvs mold also requires much less adjusting then a suck down mold. Just my opinion.

 

[DrJeff]

If your using a autopolymerizing resin cartridge system it should take more than about 5 minutes total to make and finish a temporary.

Maybe 2 minutes for your pre-prep preliminary model

2 minutes to inject the temp material into the matrix and then insert into the mout and allow it to polymerize

Maybe a minute to trim the flash around the margins and make any minimal occlussal adjustments and/or contour adjustments. Done.

Or in private practice an even better way is have your assistant do all the above steps while your either work on another patient or check some hygiene patients or even better surf the web for a few minutes😀

 

[MustangSVC]

Thanks for all the replies. I started using Maxitemp, an autopolymerizing bis-acrylic, and couldn't be happier. In about 15 minutes, I have a nicely polished provisonal. One day, when I'm no longer a poor dental student, I'll give some of those more expensive materials a try...

 

[jaxdds]

If your using a autopolymerizing resin cartridge system it should take more than about 5 minutes total to make and finish a temporary.

Or in private practice an even better way is have your assistant do all the above steps while your either work on another patient or check some hygiene patients or even better surf the web for a few minutes😀

Exactly, take advantage of whatever your state's dental assistant rules allow you to, a GP from Colorado told me that he preps the tooth then the assistant places the cord, impresses and temps the tooth. he justs checks the impression. if that's legal then he's a smart man. Plus, most of the time an experienced dental assistant from the 'Jet' era of dentistry will make better temps than most dentists, save for anatomy and occlusion.

the only problem is when a pt chews up a temp and you don't have your prelim impression, then its time to break out the jet and think back to the days of 'temp camp' in dental school.

Dr. J

***I like to videotape the dentist down the street and see how he does his procedures while the assistants make the temps.
(had to get that in before OJ steals the spotlight - pun intended)

 

[1992Corolla]

Mustang SVC I feel your pain, since I sit close to you and hear you scream about once a day...😀 When can I drive your car?

Get my hands on whatever you use to give you a 15 minute provisional...I still block carve!!!!


/Doing it old school at seat E6...😎

PS I heard SNAP! is a breeze on a real patient - from a 4th year. Take it or leave it.

 

[DrJeff]

PS I heard SNAP! is a breeze on a real patient - from a 4th year. Take it or leave it.

Nah, they're justing joking with you since they're delerious from smelling the monomer during all the amount of time it takes to set up😀

 

[1992Corolla]

Nah, they're justing joking with you since they're delerious from smelling the monomer during all the amount of time it takes to set up😀

Never listen to upperclassman I guess...👍