Clinicians tend to have varying levels of trust for adhesive dentistry. Some clinicians still cut retention slots or grooves in their preps to mechanically retain composite restorations or build-ups. Others create tall build-ups to establish retention and resistance form for their full coverage crowns. And the outlier biomimetic restorative dentists create flat-top biobases trusting nothing but adhesion to retain the partial or full coverage crown come delivery day.
In the case of non-retentive preps, what you do between prep day and delivery can time-consuming and disruptive or quick and predictable. Traditional temporary crowns on non-retentive preps are difficult to keep retained and often result in multiple return visits by the patient when they fall off. In fact, creation of the non-retentive biobase via immediate dentin sealing, deep margin elevation, and/or any necessary “build-up,” can be viewed as the provisionalization step.
Temporary crowns do not just aid in function; they also help maintain the tooth position mesial-distally and occlusally. When traditional temporary crowns aren’t indicated, as with non-retentive preps, another method is necessary to maintain tooth position. When properly sealed with a solid biobase and positionally stable in all dimensions, the 2-3 week provisionalization period can be stress-free for both the patient and doctor. This is why clinicians favor the “liquid dam” technique.
OpalDam is a passively adhesive (sealing) methacrylate-based light-cured resin barrier. It is used primarily to protect the gingiva or adjacent teeth during whitening procedures but can also be used to protect the gingiva around a tooth during air-particle abrasion procedures, stabilize sectional matrices, or seal a leaky rubberdam. Since OpalDam was originally developed as a gingival barrier, the material is ideal for provisionalizing non-retentive preps as it is friendly to the soft tissue for hours up to 2-3 weeks. Let’s review a case to see this technique in practice.