Insight 81 — When the Patient's Old Crown Becomes Its Own Provisional

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Clinical Explanation

Sometimes a patient presents with an existing crown, and for one reason or another we have to modify the tooth preparation. If that crown is intact, meaning it has come off on its own or comes off the tooth easily without being sectioned, it can be used as a provisional crown. When removing the crown, we also need to be careful not to deliver an uncontrolled blow to the tooth, because instead of removing the crown we may end up fracturing the tooth itself.

After the preparation has been modified, the old crown no longer has retention on the tooth, and until the new crown is ready the patient needs a provisional. The usual approach is to make a provisional crown from scratch. But there is a simpler way: we reline that same old crown with resin. The intaglio surface of the crown is filled with resin, the crown is placed on the prepared tooth so it records the new form of the preparation, and after the resin has set, the excess is removed and the margins are cleaned. This same crown is then delivered to the patient as the provisional.

With this method, the patient leaves with a crown whose form and occlusion are familiar to them, and making the provisional crown effectively comes down to a few minutes of relining.

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