Sep 1, 20202 min read

Emergency Temporary Crown

When a patient attends for an emergency appointment with a broken crown, they commonly expect for it to be stuck back together and put onto the tooth. But if they have lost their crown or broken it in a way where it cannot be recemented this can pose challenges for the operator and patient.

This week's tip is to showcase an alternative method of constructing a temporary crown in an efficient and functional manner.

This patient attended with a fractured crown on their upper left first molar. The tooth was temperature sensitive and so the patient wanted something to cover the exposed dentine. The patient's expectations, coupled with the time constraints of an emergency appointment, means providing a solution to this issue can be challenging. Therefore, it is good to have innovative methods up your sleeve!

To create a temporary crown chairside with only the prepared tooth we can do the following.

First roll some orthodontic wax into a ball (red ribbon wax can also work well here). Adapt the wax onto the crown preparation and remove the excess with a flat plastic. Ask the patient to bite into the wax (this will leave the imprint of the opposing dentition) therefore giving the correct static occlusion. Then ask the patient to grind left and right into the wax to appreciate the excursive movements. By doing this we have used the wax to create a functionally generated path for our temporary crown. Now the ICP and excursive movements have been recorded we are confident the occlusion is comfortable for our patient.

Now using a sectional tray take an impression of the wax on the preparation. This will act as our putty stent for the construction of our temporary crown.

Remove the wax from the impression tray.

Now pour some temporary crown material into the impression and transfer to the upper left first molar. Allow for the material to set.

Trim the temporary crown to remove the excess and cement with a retentive cement (in this case we used durelon).

Note for this example the temporary crown is extended interproximally to give it further retention and hold.

You can see the temporary crown material is thin - this is why the crown had fractured in the first place - there was insufficient clearance occlusally. Now this will act as an interim measure before the patient returns for the definitive preparation and new crown.