Temporary restorations are an indispensable part of the complete crown and bridge restorative procedure, and the roles which a temporary restoration must fulfil have become more demanding over time. In the past, the functional aspects of temporary restoration predominated. However, with recent advancements in restorative dentistry, there is an ever increasing demand placed on aesthetics as well as structural strength.
3M™ ESPE™, with more than 40 years of experience in temporisation, meets this demand with the introduction of Protemp™ 4 Temporisation Material. This unique bis-acrylic composite material with a new generation of sophisticated fillers – a result of advances by 3M ESPE in filler technology – sets new industry standards with the following key features:
Excellent breaking fracture resistance and toughness.2
Highly aesthetic through natural gloss and fluorescence.3
Easy handling and fast procedure. No polishing or glazing.4
¹3M ESPE Internal Data. Protemp 4 clinical assessment. 2006. Claim number 03398.
²Farah, JW and Powers, JM. (2011). 3M ESPE Protemp 4 Temporisation Material one year clinical performance. The Dental Advisor
³3M ESPE Internal Data. Light conduct study of various temporisation materials. 2008. Claim number 03418 43M ESPE Internal Data. EU Field evaluation 12/2007 - 02/2008. Claim number 03626
Protemp™ 4 Temporisation Material is the latest development from 3M ESPE of bis-acrylic composite material for multiple-unit restorations in the 10:1 Garant™ Cartridge. In vitro tests show that Protemp 4 material ranks highest in important mechanical characteristics such as:
¹Farah, JW and Powers, JM. (2011). 3M ESPE Protemp 4 Temporisation Material one year clinical performance. The Dental Advisor
Source: 3M ESPE internal data – Atomic Force Microscopy (AFM) images by 3M Corporate Research Analytical Laboratory – (CRAL)
A faster procedure and brilliant results without polishing or glazing.
Compared to competitive temporary materials, Protemp™ 4 Temporisation material provides a much thinner smear layer that can easily be removed and therefore reduces your working time significantly.
3M ESPE- unique nanotechnology ensures a smooth surface right from the beginning. Just wiping off with ethanol will get the surface glossy and shiny immediately, making the whole procedure faster as the polishing and glaze working step is no longer required.
There are many challenges clinicians face when preparing provisional restorations. Among these challenges are strength, colour stability, gingival health, utility, and overall patient comfort. Long-span temporary bridges can be particularly challenging. Usually, temporaries consisting of four or more units are useful as an aesthetic replacement option during the interim treatment phase.
Protemp™ 4 Temporization Materials (3M ESPE) is a two-component composite with a new generation of fillers for fabrication of interim restorations. It is indicated for temporization of single- and multiple-unit crowns, bridges, implants, inlays/onlays, and veneers, including long-term provisional restorations. This material is purported to have high strength and aesthetics.
An 84 year-old female presented with a six-unit PFM bridge, spanning teeth #6 through #11. Teeth #6 and #11 were abutments with #6 exhibiting excessive mobility and severe inflammation of the gingival tissues. Radiographs revealed the need for endodontic treatment on both abutment teeth. The poor prognosis of the abutment teeth #6 and #11 necessitated the inclusion of #5 and #12 as additional abutments. Subsequently, #5 through #12 were prepared for a porcelain-fused-to-zirconia bridge and temporized with Protemp™ 4 Temporization Materials (3M ESPE), shade A2, and temporarily cemented with Durelon™ (3M ESPE).
One week after cementing the eight-unit provisional bridge, the patient called the office and requested keeping the temporary bridge for a longer period of time because she liked it and it was very comfortable. The patient was recalled at three months, at which time it was noted that the tissues were healthy and the mobility of #6 had decreased substantially. Further recalls at six months, 12 months, and 18 months reconfirmed these findings. The patient was so pleased with the provisional bridge that she did not want to try the permanent bridge. The bridge became loose and required re-cementation at 24 months. Prior to re-cementation with FujiCem Automix (GC America), minor stains were removed and the bridge was re-polished.
Clinical Case Report
At 27 months (Figure 1), the provisional bridge had resisted fracture and exhibited excellent aesthetics. The patient’s gingival tissues were pink and healthy (Figure 2). The provisional had picked up only minor stain despite the patient being a heavy coffee and tea drinker (Figure 3). Additionally, the patient stated she had “no problems at all.” The bridge was “smooth to her tongue and easy to keep clean.” She further reported that there were no issues with eating or chewing (Figure 4).
Figure 1: Eight-unit bridge at 27 months
Figure 2: Gingival health of tissue in bridge area
Figure 3: Close-up of eight-unit bridge and tissue
The patient presented with a complaint of poor aesthetics related to her existing maxillary right central incisor PFM crown. The crown was monochromatic with gingival recession exposing metal margins. In addition, the crown margins had been leaking causing decay around the margins.
Treatment plan: A treatment plan was formulated to replace the existing PFM with a Crown.
Figure 1: Pre-operative view. Insufficient single-unit crown on tooth UR1 with exposed mental margins.
Figure 2: Pre-operative view. The current crown (PFM) is monochromatic and shows very poor crown margins.
Figure 3: Completed tooth preparation showing the margin with gingival retraction in situ. Note the discolouration of the tooth due to leakage around the PFM crown margins.
Figure 4: Adjusting the occlusion and final polish.
Figure 5: Final view of Protemp™ 4 Temporary Crowns.
Dr. Rakesh Jivan, Royal Leamington Spa, Warwickshire, UK
Initial situation: Patient presented with an upper removable partial denture and was not interested in a bridge. There is recurrent decay on teeth UR1 and UL1 and patient chose to have those two teeth replaced with all porcelain crowns.
Treatment plan: A treatment plan was formulated to replace existing PFM crowns on teeth UR1 and UL1 with all porcelain crowns.
Figure 1: Pre-operative view.
Figure 2: : Initial situation: recurrent decay on teeth UR1 and UL1 from existing failed PFM crowns.
Figure 3: Initial pre-operative impression.
Figure 4: Completed preparations for all ceramic crowns on teeth UR1 and UL1.
Figure 5: Protemp™ 4 Temporisation Material filled into pre-operative impression.
Figure 6: Protemp™ 4 Temporisation Material and pre-operative impression removed from mouth.
Fig. 1: In a test measuring material toughness, Protemp™ 4 Temporization Material showed greater resistance to fracture than other tested temporization materials.
Source: V. Babcic, R. Perry and G. Kugel, Tufts University, Boston, MA, U.S.A., AADR 2008, #0371
Material toughness of Protemp™ Material toughness of Protemp 4 compared to other temporisation materials
Protemp™ 4 temporisation material is the best-in-class material in a test that indicates its durability under in vivo stress.
The higher this value the more likely the material will resist to fracture under stress. Compared with other leading temporisation materials (see below), Protemp™ 4 temporisation material has the best material toughness values, i. e. shows the greatest resistance to fracture.