Removing Your Temporary Crown And Bridge
Do you ever get nervous when it is time to remove your temporary crown and bridge? You are worried that you may not be able to remove it? Or that your abutments will break upon removal? Well today, I want to talk about the techniques in removing your temporary crown and bridge restorations. This is not something new and I don’t want to take credit for this but I find that many students don’t know the proper technique in removing temporary restorations and want to share it here.
I am referring to the traditional temporary crown and bridge restoration that has been luted with some sort of temporary cement. When you are tackling a bigger reconstruction, you will find the need to remove your temporary restorations and recement over multiple appointments while the permanent prosthesis is being made. You will need to predictably remove these temporary restorations without breaking them or the abutments.
The instrument I use is a curved hemostat. A curved hemostat works much more favourably than a straight hemostat. You will notice that there are some crown removal instruments that are shaped like a curved hemostat with carbide coated tips to provide better grip on the restoration. I think they work great and are worth the investment.
But here is what I usually do with this instrument:
1/Grip the temporary restoration somewhere between the gingival third or middle third of the crown. I squeeze tightly around the area and then move the instrument in very slight buccal lingual direction. The goal here is to break the cement seal. You don’t want a lot of movement. In fact excessive force in this direction can lead to breakage of your abutment so be careful. I just want to see my margin opening slightly so the cement seal is broken
2/Then I will move the handle of the curved hemostat apically and occlusally. What you are trying to achieve is to pull the temporary restoration away from the abutment in the occlusal direction.
If I am removing a temporary bridge, once I have broken the seal of the abutments, then I tend to grip on the pontic where there is greater bulk in the acrylic and continue the movement with my hemostat in the slight buccal lingual and occlusal apical direction. Because I am grabbing on something that has more bulk at the pontic and it is often located in between the two abutments, the force will be distributed more equally between the abutments and I find that it is more efficient that way and will less likely break my temporary.
So in summary, I squeeze the abutment and wiggle slightly buccal lingually. Then I move the handle of the hemostat up and down to pull the temporary restoration in the occlsual direction. You may have to go back and forth between different abutments and alternate between these movements until you can safely break the seal and remove the temporary restoration. Be patient. Don’t force it. If you are feeling a lot of resistance, then there may be undercuts in your preparation. I may cut a mid-buccal groove on the abutment to help break the seal. Or as my last resort, I will completely section the temporary to avoid breaking my abutments.
In graduate school, I was given a bunch of Backhaus towel clamp forceps. I thought I were to use them for my implant surgeries. But some of the seasoned practitioners told me they use these towel clamp forceps to remove the temporary restorations. So if you have them in your office, you can try to see if they work well in your hands. Personally, I am a bit worried that the sharp tip will leave a dent in my temporary restoration. But it may be an alternative if you don’t have the curved hemostats in your office.
Thank you so much for reading. I hope you find these tips helpful.