Making A Copper Band Temporarypdf
Making A Copper Band Temporarypdf
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  1. A Technique for Making Full Coverage Temporaries on Teeth with Insufficient Clinical Crowns By Edward Feinberg DMDFull coverage temporaries are not just interim coverings while permanent restorations are being made. The temporary is a blueprint for the final restoration, and prepares the patient for that restoration by fulfilling several criteria. First and foremost is patient comfort. Temporaries must cover and protect teeth, allow normal function, provide acceptable esthetics, encourage periodontal health and be easily removable by the dentist without being dislodged during function. In fulfilling all of these requirements, temporaries are tremendous practice builders. Patients appreciate walking out of the office looking and feeling better than when they walked in. In order to emphasize the importance of teeth, it is essential that patients always leave the office with teeth.Temporaries made from acrylic alone work well when there are preparations with adequate clinical crowns. Acrylic cannot easily be made thin enough to extend over the root surface and can insult the periodontal tissues when extended below the gingiva. In order to make a temporary with no clinical crown, it is essential to have a good grip on the root surface for adequate retention. Cement, by itself, is not enough to sustain temporaries that are not adequately retentive. In order to obtain adequate retention, good grip on the root surface is essential. This can be accomplished by starting with a full shoulder preparation and long apron. There are several important advantages that full shoulder preparations provide1: a definite finishing line, ease of parallelism and repeatable fit of restorations, less tooth sensitivity, greater area for proper embrasure spaces, adequate tooth reduction for restorations with ideal shape and form, distribution of forces closer to the supporting structures, and less likelihood of future erosion and decay. The ideal restoration has a flat ledge corresponding to the shoulder and an apron of 1.5 to 2.0mm that grips the root surface. This design is the same design as a mason jar cover, which is the best known method for preservation. A temporary made with a copper band that has this design fits just like a permanent restoration. Sometimes these temporaries are so retentive that little more than a thin rubber film (trial cement) is all that is necessary to hold them in place. When cemented with permanent cement, these temporaries can last for years without erosion or decay. It is therefore wise to use copper bands when fabricating temporaries when there is little or no clinical crown, when a tooth contains a weak post that could be easily dislodged from the action of temporaries, when a tooth is prone to fracture, and when temporaries must be worn for long periods of time. A perfect candidate for making a temporary with a copper band is the emergency visit for a fractured tooth at the gingival crest. The tooth is usually asymptomatic and often nonvital. Root canal treatment is necessary, but need not be done at the emergency visit. It is easier and better for the patient to make a temporary with a copper band that avoids the pitfalls which emergency root canal treatment might bring. Why create a post
  2. space just to make a temporary when there is a strong possibility that the tooth will flare up? A temporary made with a copper band and acrylic avoids creating symptoms for the patient at the emergency visit. Very little tooth preparation is necessary, and only infiltration anesthesia is required. Often, the only preparation performed is smoothing the root surface with a large flame-shaped diamond in a slow speed handpiece. This action clears away excess tissue and debris in order to facilitate fitting the copper band. Here’s the technique:1.Festoon and adapt a snug-fitting copper band with a plastic instrument to the tooth. The band should conform well to any furcations or root indentations and it should have smooth even margins. A rubber wheel in a slow speed handpiece can be used to smooth the margins.2.Trim the occlusal end of the band so that it does not interfere with the occlusion. The buccal and lingual aspects of the band should be bent or trimmed so that they are well within the temporary’s ideal contour.3.Make a series of retention slits or perforations in the occlusal end of the band. This action will create a series of tabs that can be pushed toward the center with a plugger. Be sure to hold the band securely while the plugger is being used. 4.Make a temporary over the band with any conventional technique. Painting the band with fusion (silane) increases the adhesion of acrylic to the band. Temporaries over bands can be made with a plastic shell (Omnivac or Ellman Pressform techniques), or with an acrylic shell (impression or ion crown form techniques). For single posterior teeth, the mix can be directly molded over the band. Vaseline the opposing teeth and have the patient close into the mix.5.Carve the temporary to ideal shape and form. Use a paint brush dipped with acrylic powder and liquid to restore any deficiencies around the margins or contact areas.6.Remove the temporary/copper band and dry it thoroughly. For added retention, rebase the temporary with a loose mix of acrylic or with a paint brush dipped in powder and lots of liquid. Let the rebased temporary harden in place.7.Carve and polish the temporary. If it is very retentive, only trial cement may be necessary, otherwise conventional temporary cement such as temerex is appropriate. The temporary can also be cemented with a permanent cement like Durelon if it is to worn for a long period of time. Time spent with temporaries is time well spent because a patient with a good temporary is comfortable and appreciative. The temporary acts as a blueprint for the final restoration by simulating it. Proper esthetics, comfort, and function provide direction as to how the
  3. final restoration should be made. It is critical in managing patients that the final restoration not be one that the patient has to “get used to”. With this technique even the most difficult teeth can be easily temporized. Illustration:Fig 1: A cantilever bridge Fig. 2: A tight-fitting Fig. 3: The band is placedIn the mouth for 30 years copper band with occlusal in the mouth and the flapsFractured off. slits creating flaps. Are folded over the occlusal Fig. 4: The bridge is prepared Fig 5: The bridge is to fit over the band. Acrylic cemented in the mouth is added to fuse the band to with temporary cement. the bridge. The band is also rebased with acrylic for a perfect fit.
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