10. Framework and Pontic Design Flashcards
• Framework
– Any metal or combination
of metals or ceramic material which provide ____ to a dental prosthesis
rigidity
Framework Design
• Main objective
– Support a relatively ____ thickness of ____
even
porcelain
Framework Design
• A properly designed framework can ONLY be achieved by waxing the restoration to ____ and then cutting back a ____ amount for the veneer
complete anatomic contour
consistent
Framework Design • Waxing to anatomic contour allows: – Even \_\_\_\_ of porcelain – Proper \_\_\_\_ interfaces – Good \_\_\_\_ design – Optimally placed \_\_\_\_ contacts
thickness
porcelain-metal
connector
occlusal
Framework Design
• Once completed, the area to be veneered can be demarcated and an even ____ of wax removed
thickness
Framework Design
• To avoid fracture, the thickness of the ceramic veneer must not exceed ____ mm
Minimum porcelain thickness of ____ mm is needed for esthetics
Porcelain fracture on implant prosthesis
2
1
Framework Design
• At the porcelain-metal interface, the ceramic material should be at least ____mm thick
0.5
Framework Design
• The ____ of the ceramic- metal interface varies, depending on the ____ chosen to contact adjacent and opposing teeth
location
material
Framework Design
• Occlusalanalysis
– Centric stops can be located in ____ or ____
• Must be ____mm away from junction
– to prevent porcelain fracture from deformation of the metal
• Minimize ____ contacts over porcelain-metal interface
porcelain
metal
1.5
sliding
Framework Design • Opposing restorations must be carefully planned so that contacting surfaces are of the same \_\_\_\_ – \_\_\_\_ opposing metal – \_\_\_\_ opposing porcelain
material
metal
porcelain
Framework Design
• Existing ____ in opposing arch can influence framework design
– A porcelain restoration cannot oppose a cast ____ restoration due to abrasion of gold by porcelain
• this may be an ____ problem depending on the location of the restoration intraorally
restorations
gold
esthetic
Framework Design
• Restorations with porcelain occlusal surfaces must be carefully planned
– Wear of opposing enamel
• ____ more abrasive than enamel
– Especially problem if not ____ or polished
– ____ strength than metal occlusal surfaces
– More difficult to obtain correct occlusal form
in ____ than metal
porcelain
glazed
lower
porcelain
Framework Design
Anterior Teeth
Different framework designs depend on ____ design
crown
Framework Design
Connectors
• Connector
– The portion of a fixed dental
prosthesis that \_\_\_\_ the retainer(s) and pontic(s)unites
Framework Design
- If FDP, connectors must have proper configuration and location
- Restoration must conform to the normal ____ of the tooth that is being replaced
anatomic configuration
Framework Design
Connectors
• Size, shape, and position of connectors all influence ____ success
• Connectors must be sufficiently large
– Prevent ____
– Prevent ____ during function
not too large -> interfere with ____ control -> periodontal problems
• Need correct shaping to avoid esthetic problem
– Should occupy normal anatomic interproximal contact
areas
• Most manufacturers recommend ____mm vertical height
prosthesis distortion fracture plaque 3-4
Framework Design
Connectors
• Optimal connectors are:
– \_\_\_\_ to clean
– \_\_\_\_
– \_\_\_\_ pleasingeasy
strong
esthetically
Framework Design
____ is used to aid in cutback of wax pattern
silicone putty matrix
Framework Design
Summary
• Framework design must be based on understanding of fundamental material properties
• Restorations should be waxed to ____ and cut back
• ____ size, shape, and position influence the success of a FDP
full contour
connector
• Pontic
– Artificial tooth of a partial FDP (fixed dental prosthesis)
• Restores function and appearance
• Must be ____ with continued oral health and comfort
• Frequently ____ during treatment planning
compatible
overlooked
• Proper preparation – Analysis of dimensions of edentulous areas • \_\_\_\_ width • Occlusocervical distance • \_\_\_\_ dimension • Location of residual ridge • Opposing \_\_\_\_ – Form and shape of gingival surface • Prevent \_\_\_\_
MD
BL
occlusion
irritation
Pontic design
Considerations
BIOLOGIC
____ tissue surface
Access to abutment teeth
No ____ on ridge
MECHANICAL
____ (resist deformation)
Strong connectors (prevent fracture)
____- ceramic framework (to resist porcelain fracture)
ESTHETIC
Shaped to look like tooth replacing
Appears to ____ out of edentulous ridge
Sufficient space for porcelain
cleansable pressure rigid metal grow
Pontic Design Pontic Space • When Tx planning, \_\_\_\_ and waxing procedures may help determine optimal pontic design – Consider \_\_\_\_ repositioning – \_\_\_\_ pontics often trap food • Difficult to clean – May need to increase proximal contours
diagnostic
orthodontic
undersized
Pontic Design
Residual Ridge Contour
• Ideally shaped ridge
– Smooth, regular surface of attached gingiva
• Facilitates maintenance of ____-free environment
– Height and width should allow placement of pontic which appears to ____ from ridge
• Mimic appearance of adjacent teeth
– Adequate facial height to sustain appearance of
interdental papilla
plaque
emerge
Pontic Design Residual Ridge Contour • Loss of residual ridge – may lead to unesthetic \_\_\_\_ gingival embrasures • \_\_\_\_ triangles – Food \_\_\_\_ – Saliva \_\_\_\_
open
black
impaction
percolation
Pontic Design
Residual Ridge Contour
Class 0 defect No \_\_\_\_ Class I defect Faciolingual loss of tissue \_\_\_\_ with normal ridge \_\_\_\_ Class II defect Loss of ridge \_\_\_\_ with normal ridge \_\_\_\_ Class III defect \_\_\_\_ of loss in both dimensions
defect width height height width combination
Due to esthetic problems from Class II and III defects, ____ surgery to augment ridges should be considered
preprosthetic
Pontic Classification
• No Mucosal Contact
– ____ (hygienic)
• Mucosal contact – \_\_\_\_ – Modified ridge lap – \_\_\_\_ – ovate – modified \_\_\_\_
Based on shape of ____side of pontic
sanitary ridge lap conical ovate gingival
Pontic Selection
•Primarily depends on ____ and oral hygiene
• Anterior region
– ____ concerns
• Well adapt to tissue to appear emerging from gingiva
• Posterior region
– Possibly less esthetic, but better ____
esthetics
esthetic
oral hygiene
Pontic Selection:
Sanitary or Hygienic Pontic
• Allows easy cleaning because tissue surface is clear of ____
• May ____ food
• Least ____
– Limited to ____ mandible
ridge
entrap
esthetic
posterior
Pontic Selection:
Saddle or Ridge Lap Pontic
• ____ surface that overlaps residual ridge bucco-lingually
– Simulating ____ and emergence profile
• AVOID because concave surface unable to ____
– Results in tissue ____
concave
contours
clean
inflammation
Pontic Selection: Modified Ridge Lap Pontic • Combines best featuresof hygienic and saddle pontic designs – \_\_\_\_ – Easy \_\_\_\_ • Overlaps \_\_\_\_ on facial – For proper emergence profile • Clears ridge on lingual – Optimal \_\_\_\_ control
esthetics
cleaning
residual ridge
plaque
Pontic Selection:
Modified Ridge Lap Pontic
• Should be as ____ as possible for hygiene
• Need ____ adaptation for esthetics
– Tissue contact on facial
• Most ____ pontic form used in areas of mouth visible during function
convex
facial
common
Pontic Selection:
Conical Pontic
• Also called: \_\_\_\_-shaped, bullet-shaped, heart-shaped • Easy to clean • One contact point in \_\_\_\_ of ridge (X) • Not in \_\_\_\_ areas – Facial and lingual contours depend on width of residual ridge • Not for \_\_\_\_ residual ridges – Poor \_\_\_\_ with point contact
egg center esthetic broad emergence profile
Pontic Selection:
Ovate Pontic
• Most ____ pleasing
• ____ tissue surface in soft tissue depression or hollow in ridge
– Tooth appears to emerge from gingiva
• Typically requires ____ surgical augmentation
esthetically
covex
soft tissue
Pontic Selection:
Ovate Pontic
• Advantages – Esthetics
• Appears identical to natural emergence profile
– ____
– No food ____
• Disadvantages – Meticulous \_\_\_\_ – Surgical management – Increased \_\_\_\_ – Not possible with \_\_\_\_ defects
Ovate pontic design eliminates potential for ____ porcelain cervically
strength impaction oral hygiene cost ridge unsupported
Soft tissue ____ indicates pressure
blanching
Pontic Selection:
Modified Ovate Pontic
- Ovate form with apex positioned more ____ on the residual ridge rather than ridge crest
- Allows use when ____ is not sufficient for conventional ovate pontic
- Cleansing is ____ of all pontic types
facially
horizontal ridge width
easiest
TAKE A LOOK AT THE TABLE!
yay
Pontic Selection
• Regardless of pontic design, patient must be instructed how to ____ gingival surface with floss
clean
Pontic Design
Summary
• Select design to allow for easy ____ control
– essential for ____ term success
• Minimize tissue contact by maximizing
____
• Special consideration for easy maintenance with natural appearance and strength
• Must accurately convey design to dental technician
plaque
long term
convexity
Introduction
• For the cast metal restoration, series of finishing procedures necessary to produce highly polished surfaces
– Limit ____ and plaque retention
• Facilitate maintenance of health and periodontal tissues
accumulation
Introduction • Different zones can aid in developing sequence to finishing restoration – Zone 1: \_\_\_\_ margin – Zone 2: \_\_\_\_ surface (intaglio) – Zone 3: \_\_\_\_ – Zone 4: \_\_\_\_ contacts – Zone 5: \_\_\_\_ surface – Zone 6: \_\_\_\_ walls – Zone 7: External \_\_\_\_
internal internal sprue proximal occlusal axial margins
Zone 1: Internal Margin • Defect in margin – \_\_\_\_ crown – New \_\_\_\_ • Small nodules may be \_\_\_\_ if far from margin – Ex. 1⁄4 round bur
remake
impression
removed
Zone 2: Internal Surface (intaglio) • Intaglio=internal surface • No contact between \_\_\_\_ and internal surface – Need space for \_\_\_\_ agent – Relieve any \_\_\_\_ • Remove any nodules – Do not \_\_\_\_ die
die
luting
contacts
abrade
Zone 2: Internal Surface
(intaglio)
• Marking agents facilitate identification of ____ between casting and die
– ____ soluble (paint on)
• ex.Liqua-Mark
– ____ based dyes • ex.AccuFilmIV
– ____ sprays
• ex. Occlude (spray)
• Do not indiscriminately remove material
– Results in excessive loss of retention and resistance form
interferences
water
solvent
powdered
Zone 3: The Sprue
• Once casting fits on die, sprue is removed
– Reestablish proper ____ tooth structure and function
• Carborundum separating disk to cut through the sprue
– Leave small area in center and ____ to separate
• Refine with stones and sandpaper disks
coronal
twist
Zone 4: Proximal Contacts • Adjust contact to be correct in mouth – Or slightly too \_\_\_\_ • Special care to avoid \_\_\_\_ contact • Articulating paper between adjacent castings and/or adjacent teeth helpful
tight
overreducing
Zone 4: Proximal Contacts
• Connectors
– Require special
attention
– Need to be highly ____
– Mesiodistally, properly finished connector has ____ configuration
– Rotary instruments (ex. rubber wheels) to finish
polished
parabolic
Zone 5: Occlusal Surface
• Reestablish ____ contacts
– Intercuspation and excursions
• Utilize flame shaped finishing burs or diamonds
– Redevelop ____ of entire ridge or cusp
– Define grooves with finishing or small round bur
occlusal
anatomy
Zone 5: Occlusal Surface
• Before adjustment, use thickness gauge on metal
– Minimum ____mm thick
• <1.0mm inadequate
• After contacts refined, do not excessively overpolish and remove contacts
1.0
Zone 6: Axial Walls
• Axial walls should be smoothly contoured and highly polished
– Optimum plaque control
• Utilize abrasives to remove
surface defects
• Finish using progressively ____ abrasives
– Do NOT progress to finer grade too ____
• Polish with tripoli and rouge
finer
rapidly
Zone 7: External Margins • Want highly polished margins without ledges or steps to unprepared tooth structure • If access, can finish directly on \_\_\_\_ • If limited access, finish on \_\_\_\_ • Excessive finishing creates problems – Do not compromise emergence profile
tooth
die
Review of Technique Pre-clinical Exercise • Abrasive disks, green stones and carborundum separating disks in straight handpiece – Refine and smooth contours – Coarser grit > finer grit \_\_\_\_ \_\_\_\_ \_\_\_\_
• Leave final finishing of margins until ____
• Once contours and smoothness acceptable, ____ wheels and points used
• Final polishing (ragwheel, Robinson bristle brush) – Tripoli
– Rouge
finishing bur green stone white stone try-in rubber
Introduction • Metal-ceramic restorations – Often, minimum of \_\_\_\_ evaluations (try- in) • \_\_\_\_ evaluation • Reevaluation following \_\_\_\_ addition
two
metal
porcelain
Introduction • Metal evaluation – Margin \_\_\_\_ – Stability – \_\_\_\_ – Substructure design • Assessment of cut- back area – Avoid metal in \_\_\_\_ areas
integrity
occlusion
esthetic
Introduction
• Solder transfer
– If ____
– For ____ units
– Tissue transfer
• ____ transfer
necessary
multiple
coping
Introduction • Bisque evaluation – \_\_\_\_ material before vitrification (glazing) – Reevaluate marginal integrity – Proximal contours – Stability – Shade – Texture – Glaze
ceramic
• For partialf ixed dental prosthesis
– Tissue ____ of pontic and location and shape of connectors need assessment
– Needs to be ____
• or tissue irritation
contact
passive
Restoration almost always
requires ____ adjustment
chairside
Evaluation • Remove provisional restoration – Hemostats or crown removing forceps • Remove remaining \_\_\_\_ from tooth • May clean tooth with \_\_\_\_ and water
cement
pumice
Evaluation Sequence • (1)\_\_\_\_ contacts • (2)Marginal \_\_\_\_ • (3)\_\_\_\_ • (4)\_\_\_\_ • (5)\_\_\_\_ • (6)\_\_\_\_ • (7)\_\_\_\_ or polishing
proximal integrity stability occlusion contour characterization glazing
(1)Proximal Contacts
• Evaluate first to allow seating • Location, size, contact should resemble \_\_\_\_ teeth • Unwaxed floss should \_\_\_\_ through – May use Shim stock • Pt may assess tight contact by \_\_\_\_ • Deficient contact results in food \_\_\_\_
natural
snap
feel
impaction
(1)Proximal Contacts • Excessive tightness – Mark and adjust carefully – If both are tight, adjust \_\_\_\_ basis – Leave slightly tight to polish – Repolish metal and or porcelain contact
alternating
(2)Marginal Integrity
• Marginal fit should be = on ____ and intraorally
• Different techniques to determine fit
– ____ soluble marking agent (ex. Liqua-Mark)
– ____
– ____ paste
• May also assess marginal fit
die
water
occlude
elastomeric
(2)Marginal Integrity
• Assessment
– Sharp explorer
• Margins should be ____
• May eliminate minor discrepancies through
adjustments
– If inaccurate, re-make with new impression
– CONFIRM WITH ____! (usually ____)
• Finishing margins
– Same as cast metal
– Cannot finish poorly ____ casting to be acceptable!
undetectable
radiograph
BW
fitting
(2)Marginal Integri
Small overhang can often be corrected by adjusting the ____
A small ledge may increase the risk of recurrent ____
An open margin requires a ____ casting
casting
decay
new
(2) Marginal Integrity
____ needed to confirm seating of crown
____ radiograph offers a better assessment than a periapical radiograph
radiograph
BW
2)Marginal Integrity • Deficient margin – All metal • May \_\_\_\_ (?) – Porcelain restorations • Requires additional porcelain \_\_\_\_ – \_\_\_\_ bake » Additional firing – Glaze » Lower \_\_\_\_ correction porcelain
____** due to excessive firings
**to change from glassy to a crystalline state and become ____ and ____
solder firing bisque fusing devitrified brittle opaque
(3) Stability
• Check for stability
• Should not rock or rotate when force applied
• Any instability will cause failure during function
– If nodule, remove – If ____, new
casting
• For partial FDP, check tissue contact of pontics
distortion
(4) Occlusion
• Check after correct proximal contacts, crown well-seated and sealed margins
• Should have ideal tooth contacts on natural teeth and restoration
– Natural teeth AND restoration should occlude ____
• Verify with ____
• ____ to identify contacts
simultaneously
shim stock
articulating paper
(4) Occlusion
- If supraoocclusion
– Adjust
– Check with ____
• If significant
discrepancy, ____
• If not inocclusion
– ____ if cast metal
– Additional porcelain ____
calipers
remount
re-make
firing
(5) Contour
• Verify contour of gingival 1/3 – Excessive bulk \_\_\_\_ disease • For anterior teeth – Establish proper \_\_\_\_ and shape of incisal edge • Mark \_\_\_\_ on restoration – Adjust as needed • \_\_\_\_ the teeth • Evaluate at normal conversational distance
periodontal
position
line angles
moisten
(6) Characterization
• Need to duplicate the surface detail of natural teeth (adjacent teeth)
• Generate textures of normal anatomic form
– ____ surfaces (no sharp grooves)
• Do NOT ____
curved
overcharacterize
(7) Glazing
- during glazing, surface layers of porcelain melt ____
- surface stains may be applied during ____
• A restoration that is not sufficiently glazed, will retain more ____ and be more liable to ____
• After glazing, metal surfaces are ____
slightly glazing plaque fracture polished
(7) Glazing
White stain to mimic ____
Stain with increased ____ for proximal coloration
Stain is dried to ____ consistency in front of furnace muffle
hypocalcification
chroma
chalky
(7)Polishing
- an alternative to ____
• Provides greater control of surface ____ and distribution than glazing
• Laboratory studies show polished porcelain no more ____ than glazed
• Unpolished porcelain much more ____ than polished or glazed
glazing
luster
abrasive
abrasive
Polishing Lithium Disilicate
• ____ used to
finish and polish lithium disilicate
dialite LD
Polishing Lithium Disilicate
• Intraoral and ____ burs are available
– ____ system
extraoral
2 step
Evaluation, Characterization
and Glazing
Summary
• For metal-ceramic restorations and all ceramic restorations
– Proper contouring of ____ is crucial
– Proper shaping of gingival and incisal embrasures, along with contouring and characterization significantly improves esthetics
– Small corrections and subtle changes can be made with surface ____
– Certain all ceramic restorations may be ____ before final adjustment and occlusion
cervical 1/3
stains
luted
