The role of interim dental restorations used for indirect restorative and prosthodontic procedures has changed dramatically in the past several years. These restorations are no longer regarded as temporary restorations but rather as provisional restorations with distinct functions and purposes. Provisional restorations have become a vital diagnostic and assessment tool to evaluate function color, shape, contour, occlusion, periodontal response, implant healing, and overall esthetics. An accurate fit and margination is essential to insure and maintain pulpal health of the tooth. With increased demands being placed on provisional restorations, new materials and techniques are being developed and some existing protocols are being refined to accomplish the desired goals. Provisional restorations are often in the oral environment for several months, requiring a well-fabricated and stable restoration. This review is designed to report on current materials, techniques, and concepts in fabricating and maintaining long-term esthetic provisionals.