When a tooth requiring a full coverage restoration has a very short clinical crown height, one of the first thing I asked myself is how to improve the retention and resistance form. There are many ways to do that and they include building up a core, using accessory grooves and boxes during tooth preparation or to consider restorative crown lengthening.
Sometimes you are in between phases of treatment and your temporary crown may not hold that well yet. So if I am worried that the temporary crown will come off, I would consider using a cement that is a little stronger than my temporary cement.
In my office I always keep a polycarboxylate cement (e.g. Durelon) for these situations. It is a very weak luting cement that has a weak chemical bond to the tooth structure. It comes in a powder and liquid form. The cement has a thixotropic property which means it flows under pressure. So when mixed properly it is thicker than your other cement but it will thin out when pressed under pressure. Some seasoned practitioners have taught me to add a bit of vaseline in the mix so it is easier to remove later on. The cement, being white in colour, has a great contrast to the tooth structure so it is easy during the clean up phase. Sometimes, I do have to section my temporary crown during removal. Sometimes I do have to use a scaler to flick the cement off the tooth structure. But it does a great job at protecting the tooth during the temporary phase. And it decreases the chances of my patients calling my front desk that their temporary crowns have come off.
I use this cement when my tooth does not have ideal retention and resistance form or I need to stabilize the temporary crown a little longer especially when the patient has to go away for an extended vacation.
I hope you find this tip helpful.
Thanks for reading.
