Procedure for placing a temporary crown on a type
Select a plastic crown form. Trim the form with
scissors to adapt it to the fractured crown.
Ensure that the entire fracture will be covered.
Also ensure the incisal edge in not in occlusion
with the opposing teeth, while fitting the plastic
Place two or three small holes in the incisal edge
of the crown form with a sharp explorer.
Fill the crown form with a thin mix of calcium
hydroxide or zinc oxide and eugenol.
Gently place the crown form over the fractured
crown. You will see any excess material
expressed from the holes of the incisal edge
while placing the crown.
Remove any excess material from and around
the crown with gauze and cotton pellets
Instruct the patient to eat a bland diet and avoid
extremely hot and cold foods or liquids and
Symptoms (Type IIIEnamel/Dentin Fracture
With Pulp Exposure)
A patient with a type III tooth fracture may
complain of the following:
Severe, throbbing pain
Very rough or sharp edges
Severe pain from heat, cold, or air
Inability to chew food
Upon examination of a type III fracture, you may
Extensive fracture with the pulp exposed
Most or all of the crown is fractured off
Bleeding from crown fracture
Perform emergency treatment guidelines. In
almost all cases of a fracture this severe, the dental
officer will treat the patient. Only in rare cases would
the Dental Technician treat the patient. The following
is a treatment plan that the dental officer might
authorize to treat a type III fracture.
1. Place a crown form over the affected tooth.
Refer back to this procedure under the treatment for
type II fractures. At times, it may be impossible to place
a crown form over a fractured tooth. The pressure of the
crown form against the pulp tissue may cause the patient
pain or there may not be enough tooth structure left for
retention of the crown. If this occurs, a splint rather than
a crown form is placed on the tooth as shown in figure
2. To make the splint, prepare a large mixture of
zinc oxide and eugenol as described in Dental
Technician, NAVEDTRA 12573, chapter 4,
Restorative Dentistry. Add cotton fibers from a
cotton pellet to the mixture for strength. The mixture
should have a dough-like consistency for molding the
3. Place the splint so it covers the affected tooth
and the teeth immediately adjacent to it (fig. 6-7).
Ensure that the mixture is placed well up on the lingual
and facial aspects of the gingival tissue. Gently
compress the splint between your finger and thumb to
lock it into the interproximal spaces.
4. Trim the splint from the incisal edges of the
teeth. Check the occlusion to see if the splint is
interfering with the patients bite.
5. Advise the patient to let the splint harden for
several hours before attempting to eat. Tell the
patient to return to sick call ASAP for more definitive
Symptoms (Type IVRoot
A patient with a type IV tooth fracture may
complain of the following:
Severe pain from heat, cold, air
Inability to eat anything without severe pain
A tooth that is moving or loose
Figure 6-7.Properly placed splint.