There are a number of areas when dealing with the coronal aspect of the dentition that may be modified to produce an environment less favorable to plaque formation and retention and more amenable to plaque control. These include the removal of excessive contours on the buccal, lingual or interproximal surfaces that have shown themselves to be problematic, but should not be done prophylactically.
Often the crown of a tooth may be modified to eliminate plaque retentive areas and provide better access for oral hygiene procedures. Grooves that extend subgingivally can be removed by recontouring the surrounding tooth to provide better plaque control access. Enamel pearls complicating furcation involvement can be similarly treated. These procedures require judicious use of the bur and any area of odontoplasty should be left smooth and confluent with the surrounding tooth structure.
Inadequate restorations can create problem areas promoting plaque formation and retention and hampering plaque control.
Examples of such problems are:
In many instances the existing restoration can be modified by trimming, smoothing, relining, polishing or a combination of these. In other cases, a new restoration will need to be provided, either provisional or permanent. Provisional restorations allows the restorative dentist the opportunity to "test" the compatibility of his proposed final restorative plan with the patient's oral health.
Remember that by the time you reach your final provisional stage, the only difference between the provisional and permanent restorations should be the material from which they are made.