Tips on Removing Your Temporary Crown And Bridge   

Do you get nervous when it is time to remove your temporary crown and bridge? Are you worried that you may not be able to remove it? Or that your tooth and core preparations will break upon removal?  Today, I want to talk about the techniques for removing temporary crown and bridge restorations. This is not a new concept and I don’t want to take credit for it, but I find that many of my students don’t know the proper technique for removing temporary restorations. 

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 during 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 there are some crown removal instruments that are shaped like a curved hemostat with tungsten-coated tips to provide better grip on the restoration. I think they work great and are worth the investment.

Do you get nervous when it is time to remove your temporary crown and bridge? Are you worried that you may not be able to remove it? Or that your tooth and core preparations will break upon removal?  Today, I want to talk about the techniques for removing temporary crown and bridge restorations. This is not a new concept and I don’t want to take credit for it, but I find that many of my students don’t know the proper technique for removing temporary restorations. 

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 during 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 there are some crown removal instruments that are shaped like a curved hemostat with tungsten-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 and 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. I find that it is more efficient that way and will be less likely to break my temporary bridge.

In summary, I squeeze the temporary restoration (crown and bridge) over the abutment/prepped tooth and wiggle slightly buccally lingually. Then I move the handle of the hemostat downward to help pull the temporary restoration in the occlusal 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 or mid-lingual groove on the abutment to help break the seal. Or as a 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 was to use them for my implant surgeries. Some of the seasoned practitioners told me they use these towel clamp forceps to remove the temporary restorations. If you have them in your office, you can try to see if they work well in your hands. Personally, I worry 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. I hope these tips will help with your everyday dentistry. Thanks for reading!

Dr. Beatrice Leung earned her dental degree from the University of Toronto Faculty of Dentistry. She completed a general practice residency at Boston Medical Center and a prosthodontics residency at the University of Pittsburgh. She is a fellow of the Royal College of Dentists of Canada and a diplomate of the American Board of Prosthodontics. Dr. Leung is an assistant professor at the University of Toronto and maintains a private practice in Toronto, Canada.

Dr. Beatrice Leung is presenting the courses “Tips and Tricks for Your Everyday Crown Restorations” (C05) and “Tips and Tricks to Your Everyday Implant Restorations” (C18) on Thursday, June 25, at the Florida Dental Convention in Orlando, FL. Learn more and register at: http://www.floridadentalconvention.com