Shrink Wrap Provisional Technique for Predictable Veneers: Part 1

Of all the methods commonly used for veneer provisionalization, my favorite has to be the shrink wrap technique. I love it and use it all the time because in my opinion it is the easiest and most predictable method.

The term ‘shrink wrap’ comes from allowing polymerization shrinkage of the material to lock bisacryl onto the preparation. The main advantage of this approach is that it keeps veneer provisionals firmly secured until the final restoration can be placed.

Here’s my take on utilizing this technique in the dental practice:

Predictable Veneers with Shrink Wrap Provisionals

The first step of shrink wrap provisionals is to prepare the teeth. Let’s imagine you are dealing with a patient who experienced trauma such as breaking their teeth in a bicycle accident.

Before beginning the technique, make sure you have all the diagnostic records you need, including all prep records for the lab: facebow, opposing model, final impressions (maybe more than one) with good flash, etc. Once you provisionalize the teeth, it won’t be easy to get access to the preps again.

One of the essential parts of a shrink wrap provisional technique is fabrication of a silicone matrix with a silicone gasket to separate the excess. You should begin with a solid model either of the teeth before they are prepared or of the wax-up. You can carve a 1 mm deep trench into the wax-up by using the cleoid end of a cleoid/discoid.

Put the sharp pointy end right on the free gingival margin of the gingival of the tooth on the model to carve. You can even go a little deeper in the interproximals. Now take that model and fabricate a two stage silicone matrix.

First, create a putty matrix and trim it. Then, load the putty with the light body of the same impression system, reseat on the model, allow it to achieve a full set, and trim. Now you are ready to go to the patient and use lip retractors. Remember to add a little vaseline or lubricant to the lips for comfort.

At this point, I like to use the OptraGate from Ivoclar Vivadent for a latex free retraction device that can handle anything in the anterior. I will have it in during preparation and for impressions so I don’t have to hold the lip out of the way.

To be continued …

 

 

The Shrink Wrap Technique is taught in our hands on course Excellence in Bonded Porcelain.

Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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