2.23 Fabricate Provisional Crown or Bridge
Protocol: The student will prepare temporary coverage for a tooth or teeth prepared to receive a crown or bridge.
Criteria:
| Student completed procedure protocol accurately | Successful (S) |
| Student did not complete procedure protocol accurately | Unsuccessful (U) |
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Procedure Protocol |
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Procedure Protocol |
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Gathered the appropriate materials |
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Fabricated a stent |
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Coated the tooth with separating medium |
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Dispensed adequate acrylic material to cover prepared teeth without excess waste |
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Placed the material in the stent without causing air bubbles |
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Placed the stent over the prepared tooth and held in place for two minutes. |
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Removed the stent and placed provisional back on prepared tooth |
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After curing was complete, removed all excess material with acrylic bur |
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Margins of provisional are tapered and smooth and meet the crown preparation margin |
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Provisional contacts the adjacent teeth (no open contacts) |
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Completed final polish with pumice to a smooth finish |
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Provided patient with post-operative instructions |
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Safety measures followed |
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Infection control protocols followed |
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Demonstrates professionalism and appropriate communication skills |
