Let’s face it, we have all played out the above scenario in our own practices. Recently, I did and soon after found myself wearing a nice layer of egg makeup. I contacted Dennis and relayed my frustration concerning consistently high second molar occlusion. Dennis assured me that he would get right on it, but not before asking if my temporaries were in occlusion. I confidently shared with him that my highly trained dental assistant, of 14 years, has made thousands of temporaries and the problem most certainly lies within a Becden system.

After our conversation Dennis immediately went to work researching my complaint and within a few days delivered a message that was hard to swallow. To make a long story short, what he discovered reminded me how important it is for every dentist to establish and then consistently reevaluate their clinical systems. Indeed my patients were leaving my office with carefully crafted second molar temporaries that were slightly out of occlusion. It seems that I had not clearly communicated a recent change in our second molar temporary protocal. My assistant had interpreted some new information I recently shared regarding the necessity for second molars to be completely free of functional contact as a directive to also remove occlusal contact. And now you have the rest of the story.

Prepared teeth will drift and super erupt within twenty-four hours if occlusion or contacts are left open.

Use my moment of crow eating to remind you of how important temporaries are in the success of our final product and our bottom line. Crowns that require little or no adjusting facilitate less seating time, better lab relations, and happier patients.

Use the following temporary tips and build upon your own temporary protocol.

1. Take a quality pre-treatment impression of the treatment area. I suggest using a triple tray filled with firm, fast-setting, polyvinyl impression material.
2. Wait until you complete your final impression before using a high quality temporary material to fill and then completely seat your preliminary impression in the treated area. Most temporary materials leave a residue on the prepared teeth that interferes with the accuracy of your final impression, therefore it is imperative to postpone fabrication until your final impression is successfully completed.
3. Carefully trim any flash from the margins of your temporaries but not before clearly marking the interproximal contact area with a pencil or Sharpie. Do not remove or smooth the marked areas.
4. Use articulating paper to mark and adjust occlusion. I suggest relieving all functional excursions that will create premature loss of the provisional appliance, but DO NOT RELIEVE THE OCCLUSAL CONTACT. ALSO, MULITPLE UNIT PROVISIONALS, LIKE BRIDGES, NEED TO HAVE ALL UNITS IN OCCLUSAL CONTACT.
5. Instruct patients to contact your office immediately if their temporary becomes loose or falls off.
6. Consistently review, inspect, and educate your team on your temporary expectations.

Published by BECDEN Dental Laboratory 131 E. 13065 S. Draper, UT 84020 888-344-9991 toll-free 801-576-9991 phone

The editor of this newsletter is Emily Webb of Becden Dental Laboratory, Inc. Please send any questions or comments about this newsletter, or suggestions for articles to: emilyw@becdendental.com ©2006 BECDEN Dental Laboratory, Inc.