CLI NI CAL SCIENCES

i T
Mal col m D. Jendresen William F. R Mal one Thomas D. Tayl or
Laminate veneer provisional restorations: A clinical report
Maya Zalkind, DMD," and Nira Hochman, DDS ~
Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel
II I I
The popularity of porcelain laminate veneers has
increased since their i nt roduct i on in the early 1980s for
two reasons: a conservative t oot h preparation and im-
pressive esthetics with the ultrathin porcelain laminate
veneers retained with resinous cement. 1,2 The laminate
veneers can be used to restore stained, fractured, or mal-
formed and malpositioned teeth. 3,4 Reduced chair time,
increased patient compliance, economic feasibility, mini-
real discomfort or sensitivity after treatment, and esthet-
ics have all cont ri but ed to their increased use. >a,s
Glazed porcelain is a biocompatible and esthetic den-
tal restorative material and the material of choice for
laminate veneers. The porcelain etching t echni que with
bondi ng t o a composi t e cement has been confi rmed as
an acceptable treatment. 2&6 Some dentists routinely place
provisional restorations, whereas others do not , mainly
because of time constraints or concern about the dura-
bility of the interim restorations. 7
The need for provisional coverage can be justified
because of the patient' s appearance and occlusion. Pro-
visional restorations may be required t o prevent drifting
of the prepared t eet h and the extrusion of t eet h in the
opposi ng arch. ~,8 Patients with high expectations may
not be as willing to tolerate the appearance of the ante-
rior dent i t i on wi t hout provisionalization. Various pro-
cedures are available to facilitate short -t erm biologically
acceptable interim restorations. Direct and indirect ve-
neer t echni ques have been des cr i bed; t hey use
aut opol ymeri zi ng acrylic resin, 9 visible l i ght -curi ng
resin, ~ and composites2 ~
This clinical r epor t describes a t echni que for provi-
sional rest orat i on that uses a clear plastic vacuform ma-
trix or put t y matrix system and a preformed polycar-
bonate crown. The technique is less time consuming and
expensive and has a more esthetic result than ot her tech-
niques do.
CLI NI CAL REPORT
A 30-year-old woman complained of esthetic problems
caused by a space between a maxillary peg-shaped lateral
incisor and the crown on the adjacent central incisor. A
laminate veneer on the lateral incisor was suggested.
Toot h preparation i ncl uded the reduct i on of the in-
cisal edges by approximately 1.5 t o 2 mm, with an
aSenior Lecturer, Department of Prosthodontics.
bAssociate Professor, Department of Prosthodontics.
J Prosthet Dent 1997;77:109-10.
Fig. 1. Preformed pol ycarbonate crown and design for reduc-
ti on of lingual surface.
Fig. 2. Provisional laminate veneer adaptation based on tooth
morphol ogi c features and gingival finish lines,
incisolingual extension. Toot h preparation was dictated
by the enamel thickness of the t oot h because the reduc-
t i on of approximately 0.5 mm results in more esthetic
restorations.~
A preformed polycarbonate crown of suitable diameter
was selected and prepared in accordance with the height of
the gingival crest, free gingiva, and cavosurface angles of
the t oot h preparation (Figs. 1 and 2).
After lingual reduct i on the pr ef or med crown was
adapted to the prepared t oot h. The prepared shell was
relined with autopolymerizing or light-cured acrylic resin
(Fig. 3). Excess material that was t rapped in the inter-
proximal areas was discarded before final polymeriza-
tion. After pol ymeri zat i on the t emporary laminate ve-
neer was adjusted to a desirable shape, and the occlu-
FEBRUARY 1997 THE JOURNAL OF PROSTHETIC DENTISTRY 109
THE JOURNAL OF PROSTHETI C DENTISTRY ZALKI ND AND HOCHMAN
Fig. 3. Provisional laminate veneer relined with composite ce-
ment.
sion was tested in all excursions of the mandible. A hole
was creat ed at the poi nt of a mark drawn on t he t oot h
surface. A di mpl e was t hen made in the mi ddl e of t he
inner surface of t he provisional laminate veneer. This
mark was transferred to the provisional laminate veneer
so t hat the di mpl e was opposi t e to the spot (Fig. 4).
Bondi ng material was applied only in the dimple area,
so t here was no elevation of the provisional laminate
veneer, or gap between the laminate veneer and the tooth,
wi t hout excessive bondi ng material. The laminate ve-
neer was t hen bonded t o the t oot h with the use of tradi-
tional resinous cement s and bondi ng techniques.
When the pat i ent ret urned for t he definitive cemen-
tation, the provisional laminate veneer was easily dis-
l odged with a spoon excavator. The cement was removed
wi t h a scaler or finishing bur.
REFERENCES
1. Garber DA, Goldstein RE, Feinman RH. Porcelain laminate veneers. Chi-
cago: Quintessence, 1988:14-35.
2. Calamia JR. Etched porcelain veneers: the current state of the art. Quintes-
sence Int 1985;16:5-12.
3. Chiche G J, Pinault A. Esthetics of anterior fixed prosthodontics. Chicago:
Quintessence, 1994:442-4.
4. Berksun S, Kedici PS, Kalipcilar B. A matrix procedure for reproducing
natural or carved tooth contours in porcelain laminate veneers. J Prosthet
Dent 1994;71:203-5.
5. Jordan RE, Suzuki M, Croll TP. Conservative treatment of the discolored
dentition. In: Jordan RE, editor. Esthetic composite bonding techniques
and materials. 2nd ed. St. Louis: Mosby-Year Book, 1993:84-158.
Fig. 4. Provision for dimple by use of predetermined mark.
6. Calamia JR, Simonsen RJ. Effect of coupling agents on bond strength of
etched porcelain [abstract]. J Dent Res 1984;63:179.
7. Kurtz KS. Constructing direct porcelain laminate veneer provisionals. J Am
Dent Assoc 1995;126:653-6.
8. Feinman RA. Mandibular laminate provisionalization. Quintessence lnt
1989;20:771-3.
9. Rada RE, Jankowski BJ. Porcelain laminate veneer provisionalization using
visible light-curing acrylic resin. Quintessence lnt 1991 ;22:291-3.
10. E[ledge DA, Hart JK, Schorr BL. A provisional restoration technique for
laminate veneer preparations. J Prosthet Dent 1989;62:139-42.
11. Clyde JS, Gilmour A. Porcelain veneers: a preliminary review. Br Dent J
1989;164:9-14.
Reprint requests to:
DR. MAYA ZALKIND
DEPARTMENT OF PROSTHODONTICS
HADASSAH SCHOOL OF DENTAL MEDICINE
HEBREW UNLVERSITY
P.O. Box 12272
91120 JERUSALEM
ISRAEL
Copyright 1997 by The Editorial Council of The Journal of Prosthetic Den-
tistry.
0022-3913/97/$5.00 + 0. 10/1/78435
110 VOLUME 77 NUMBER2