10. Framework and Pontic Design Flashcards by J L

• Framework
– Any metal or combination
of metals or ceramic material which provide ____ to a dental prosthesis

rigidity

How well did you know this?

Not at all

Perfectly

Framework Design

• Main objective
– Support a relatively ____ thickness of ____

even

porcelain

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Framework Design
• Waxing to anatomic contour allows:
– Even \_\_\_\_ of porcelain
– Proper \_\_\_\_ interfaces
– Good \_\_\_\_ design
– Optimally placed \_\_\_\_ contacts

thickness
porcelain-metal
connector
occlusal

How well did you know this?

Not at all

Perfectly

Framework Design

• Once completed, the area to be veneered can be demarcated and an even ____ of wax removed

thickness

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Framework Design

• At the porcelain-metal interface, the ceramic material should be at least ____mm thick

0.5

How well did you know this?

Not at all

Perfectly

Framework Design
• The ____ of the ceramic- metal interface varies, depending on the ____ chosen to contact adjacent and opposing teeth

location

material

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Framework Design
• Opposing restorations must be carefully planned so that contacting surfaces are of the same \_\_\_\_
– \_\_\_\_ opposing metal 
– \_\_\_\_ opposing
porcelain

material
metal
porcelain

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Framework Design
Anterior Teeth

Different framework designs depend on ____ design

crown

How well did you know this?

Not at all

Perfectly

Framework Design
Connectors
     • Connector
– The portion of a fixed dental
prosthesis that \_\_\_\_ the retainer(s) and pontic(s)

unites

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Framework Design
Connectors
     • Optimal connectors are:
– \_\_\_\_ to clean
– \_\_\_\_
– \_\_\_\_ pleasing

easy
strong
esthetically

How well did you know this?

Not at all

Perfectly

Framework Design

____ is used to aid in cutback of wax pattern

silicone putty matrix

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

• 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

How well did you know this?

Not at all

Perfectly

• 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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

``` 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