When Are Temporary Cements Used

When Are Temporary Cements Used? A Comprehensive Guide for Dental Professionals and Patients

Temporary cements play a crucial role in dentistry, providing a reliable and reversible method for securing restorations during various phases of dental treatment. Understanding their applications is vital for both dental professionals and patients. This article delves into the diverse scenarios where temporary cements are indispensable, exploring their properties, advantages, and limitations. We'll also address frequently asked questions to provide a comprehensive understanding of this essential dental material.

Introduction: The Versatile Role of Temporary Cements

Temporary cements are materials designed to hold dental restorations, such as crowns, bridges, inlays, onlays, and veneers, in place for a predetermined period. Unlike permanent cements, temporary cements are designed to be easily removed without damaging the underlying tooth structure or the restoration itself. This characteristic makes them essential in several key stages of dental procedures, allowing for precise fitting, assessment, and ultimately, secure and long-lasting permanent cementation. Their use significantly enhances the predictability and success rate of complex dental treatments.

Situations Where Temporary Cements are Used:

Temporary cements find applications in a wide range of dental procedures. Here's a detailed overview:

1. Pre-Permanent Cementation:

This is arguably the most common application. After a restoration is fabricated (e.g., a crown in a dental lab), it's temporarily cemented into place to allow the patient and dentist to assess:

• Fit and Function: The temporary cement allows for evaluation of the restoration's fit, occlusion (bite), and overall functionality. Any necessary adjustments can be made by the dentist before permanent cementation. This minimizes the risk of needing to remake the restoration later.
• Patient Comfort: The patient can assess the comfort and aesthetics of the temporary restoration, providing valuable feedback before the final cementation. Addressing concerns at this stage avoids potential complications and ensures patient satisfaction.
• Marginal Integrity: The temporary cementation allows for the evaluation of the marginal fit – the precise seal between the restoration and the tooth. This is crucial for preventing leakage and potential secondary caries (decay).

2. Provisional Restorations:

In situations requiring multiple appointments, temporary restorations secured with temporary cement are essential. These might include:

• Following Tooth Preparation: After a tooth is prepared for a crown or other restoration, a temporary crown is often placed to protect the prepared tooth from damage, sensitivity, and infection. The temporary crown maintains the tooth's shape and function until the permanent restoration is ready.
• Following Extraction: In certain cases, where a bridge or implant is planned, a temporary restoration might be used to close the extraction site, improve aesthetics, and maintain proper occlusion.
• During Orthodontic Treatment: Temporary restorations can be used during orthodontic treatment to temporarily protect teeth that have been prepared for bonding or other procedures.

3. Maintaining Space:

In specific circumstances, temporary cements are used to temporarily hold a restoration in place to maintain space until a more definitive solution can be implemented:

• After Endodontic Treatment: After root canal therapy, a temporary restoration may be cemented to seal the access cavity and prevent re-infection while awaiting a more permanent filling or crown.
• Missing Teeth: Temporary restorations can temporarily fill the space where a tooth is missing before more extensive treatment (like a bridge or implant) begins.

4. Treatment of Fractured Teeth:

Temporary cements can offer immediate stabilization and protection for fractured teeth awaiting more definitive treatment, such as:

• Temporary splinting: In cases of multiple fractured teeth, temporary cement can be used to splint them together until a more permanent solution can be made.
• Emergency Stabilization: In cases of trauma, a temporary cement can help stabilize a severely damaged tooth to prevent further complications while awaiting more complex treatment.

5. Cementing Orthodontic Appliances:

While not as common as other applications, specific temporary cements are sometimes used in orthodontics for temporary bonding of brackets or other appliances before the final placement of permanent adhesives.

Types of Temporary Cements and Their Properties:

Several types of temporary cements are available, each with unique properties suited for specific applications:

• Zinc Oxide Eugenol (ZOE) Cements: These are among the most commonly used temporary cements. They're relatively inexpensive, easy to use, and provide adequate retention. However, they have a long setting time and may inhibit the polymerization of some composite resins.
• Zinc Phosphate Cements: Stronger than ZOE cements, zinc phosphate cements provide excellent retention but require careful mixing to avoid exothermic reactions. They can also be irritating to the pulp (the soft inner tissue of the tooth).
• Polycarboxylate Cements: These cements offer good biocompatibility and adhere well to tooth structure, but they are not as strong as zinc phosphate cements.
• Resin-Modified Glass Ionomer Cements: Combining the advantages of glass ionomers and resins, these cements offer good biocompatibility, fluoride release, and moderate strength. They also require relatively short setting times.
• Temporary Resin Cements: These are increasingly popular due to their ease of use, short setting time, and relatively high strength.

Advantages and Limitations of Temporary Cements:

Advantages:

• Ease of Removal: They are easily removed without damaging the restoration or the underlying tooth structure.
• Reversibility: This allows for adjustments and corrections before permanent cementation.
• Protection: Temporary cements protect prepared teeth from damage, sensitivity, and infection.
• Maintain Function: They allow for the maintenance of normal chewing and speaking functions during the temporary phase.
• Aesthetics: Some temporary cements can provide acceptable aesthetics during the treatment period.

Limitations:

• Shorter lifespan: They are not designed for long-term use and may degrade or lose their retentive properties over time.
• Strength limitations: They generally have lower strength than permanent cements.
• Solubility: Some temporary cements are more soluble than others, leading to potential degradation over time.
• Potential for leakage: Imperfect margins can lead to leakage, which may cause sensitivity or secondary caries.
• Inhibition of Polymerization: Some temporary cements (like ZOE) can interfere with the setting of certain composite resins.

Frequently Asked Questions (FAQs):

Q: How long can a temporary cement last? A: This depends on the type of cement, the location, and the stresses placed on it. Generally, temporary cements are expected to last for a few weeks to a few months. It's crucial to follow the dentist's instructions regarding the lifespan of the temporary restoration.

Q: What should I do if my temporary crown falls off? A: Contact your dentist immediately. Leaving the tooth unprotected can lead to sensitivity, infection, or damage. Your dentist can re-cement the crown or provide alternative solutions.

Q: Can I eat anything I want with a temporary crown? A: Avoid extremely hard or sticky foods that could potentially dislodge the temporary crown. Chew on the opposite side of your mouth to minimize stress on the temporary restoration.

Q: Does temporary cement cause any side effects? A: Generally, temporary cements are biocompatible and well-tolerated. However, some individuals might experience temporary sensitivity or allergic reactions, particularly to ZOE cements. If you experience any unusual symptoms, contact your dentist.

Q: Is it painful to have a temporary crown cemented? A: The procedure is generally painless. Your dentist might apply a topical anesthetic to numb the area for increased comfort.

Conclusion:

Temporary cements are indispensable tools in modern dentistry, facilitating effective and predictable treatments. Their ability to provide temporary restorations, protect prepared teeth, and allow for assessments before permanent cementation significantly contributes to successful outcomes. Understanding the various applications, properties, and limitations of different temporary cements is crucial for both dental professionals and patients in ensuring optimal dental care. Always follow your dentist's instructions carefully regarding the care and maintenance of temporary restorations to maximize their effectiveness and minimize potential complications.