Partial Veneer crown (including esthetic veneer), inlay and onlay Flashcards
Ex of when to use labial man or lingual max partial veneer crowns:
occlusion VD increase
inlay partial veneer crowns are traditionally made w :
metal alloys
Help w retention of partial veneer crown inlays:
pinholes small, thin holes, metal for strength in these regions
Partial veneer crown is aka:
Partial coverage crown
Surface usually not covered by partial coverage crown:
facial, ex: extracoronal metal resto
TF? 2 pin wedge is the most commonly used retention for PVCs:
F, but could be on boards
2 types of PVC to use in anterior:
3/4 crown, pinledge
2 types of PVC to use in pos:
3/4 crowns, 7/8 crowns
7/8 crown from where to where?
start from B groove toward D and around to MB cusp which should be intact for esthetics
Indications for 7/8 crown:
moderate tooth structure loss, retainer for fFDP, if B wall is intact and you don’t want to fully cover, inc VDO, establish new anterior guidance, perio involved teeth but want to keep, can splint instead of ortho
3/4 crown, retentive grooves or no?
yes, axial alignment retentive grooves
Placement of retentive grooves for 3/4 crown:
ML and DL (it looks like MB and DB on slide 4) check
PVC indications:
lost moderate tooth struc, intact B wall, retainer for FDP, for anterior, retainers to reestablish AG, to splint teeth where sufficient tooth struc present
PVC contraindications:
short cx crown (inadequate retention), retainers for long-span FDPs, endo treated teeth, active caries, pdd, poorly aligned teeth
Why are PVC contraindicated for misaligned teeth?
can’t align axial wall properly
Adv of PVCs;
conservation of tooth, red pulpal / perio insult, access to supra-gingival margins, access to margins for OH, easier cementation, seating and clean up, ability to pulp test on B surface
Disadv of PVC:
less retention/resistance than CCC, complicated prep bc of pinhole placement needing to be in proper POI, metal display
Reductions for 3/4 posterior crown:
same as CCC, Fun: 1.5mm, Non-Fun: 1mm, FunCB: 1.5mm, axial alignment grooves, chamfer margin
Molar 7/8 crown prep
Mesial 1/2 = 3/4 crown prep, D Complete crown prep
Groove placement molar 7/8 crown:
B groove, MB
Fxn of B groove being in the groove:
hide alloy, preserve MB cusp for esthetics
Materials that can be used for inlays:
metal alloy, ceramic, composite resin
form of onlay depends on:
amount of tooth loss, no sp way
Inlay-Onlay: Indications:
high esthetic demand (ceramic/ composite resin), replace moderate to large existing resto, fractures tooth/resto, mod to large 1’ caries
Less retentive, inlays/onlays or PVCs:
inlays/onlays
Can inlays/ onlays be used for FDP retainers?
no (what about #29?)
Direct composites, short term or long term restos?
short term
Why is there more retention for PVCs than inlays/ onlays?
PVCs have pinholes
if you are using metal FDP it is possible to use the only.
T. not inlay, because inlay creates a ledge that may break the cusp (don’t understand, check)
Inlay/ Onlay contraindications:
can’t isolate, bruxing, clenching, excessive wear, need for high R/R
Why are in / onays contraindicated for pt w parafunctional habits?
R/R form needed
Adv of in / onlay
gold: low creep and corrosion resistance, more esthetic than amalgam w material choice, onlay: cuspal support, reducing risk of cuspal fracture, more conservative that full coverage
Adv to metal alloy restos:
low creep and corrosion resistance
Disadv, in/ onlays:
less conservative than direct, metal display, if used, risk of cuspal fracture for inlay
Why is a direct resto more conservative than onlay?
must reduce more to get retention, more bulk is of material is needed for this, the walls must diverge to the occlusal as well for in / onlay for placement of indirect resto, leading to further reduction
when using metal alloy for an inlay, this effect is created and can lead to fracture:
wedge
Do we usually want to interproximal inlays on the lingual or labial side?
labial, to prevent discoloration, chipping, malformation
conservative method of restoring the appearance and fxn of discolored, chipped, malformed, misaligned, too short or diastema of anterior teeth:
Porcelain laminate veneer
Adv of PLV over full coverage Resto (FCR):
conservation of structure, marginal integrity of bonded enamel, gingival adaptation, esthetics
TF? PLV can be cemented to cementum.
T. highly prefered to be cemented to enamel bc the porcelain is very biocompatible
Diastemas under __mm can be closed via PLV:
6mm, ortho if larger
Why can’t we close diastemas larger than 6mm?
wouldn’t have proper emergence profile, food impaction, neither direct nor indirect can fix
Contraindications for PLV:
Bruxism, defective enamel (amelogenesis imperfecta), less than 50% remaining tooth structure or enamel, man incisors w steep overbite and ho horizontal overbite
Reductions for PLV:
Facial: 0.3-0.5, chamfer margin as close to gingiva as possible, I edge red: none, 1mm, or 2mm
Group 1 incisal edge reduction:
no reduction
Group 2 I edge red:
2mm
Group 3 I edge red:
1mm
Veneer seating direction on prepped tooth:
don’t understand, these don’t resemble the 3 Groups mentioned in previous slide check
Possible POI’s for PLV:
labial or incisal
Prep steps PLV:
shade selection, depth cut, gingival plane: (012 bur held parallel to emergence profile of tooth, in enamel at gingival margin, 0.3mm), labial plane:: (red parallel to mid plane of tooth and extend M-D, 0.3-0.5mm, not extended into interproximal contacts, proximal prep: break contacts, end finish line before interprox contact, I edge: bur 90’, 1-2mm
how can you end the finish line BEFORE the interproximal contact and still not be ablet o see the finish line from the M or D direction?
check? Slide 30
Shape of prox prep for PLV:
Elbow shpaed
Didn’t we, for FCC for incisors reduce the I edge at a 45’ angle to help create the halo of a nature tooth? WHy is iit different here?
check? slide 31
Diagnostic and Cx steps of PLV:
Eval and dx cast, wax-up, duplicate dx wax-up, make ESF, mock up (auto-cure composite resin temp),
What is a mock up?
autopolymerizing composite resin, to ESF, apply intraorally, show patients
Material type for mock up:
auto-cure composite resin temp
When to break contact when prepping PLVs:
diastema
Tooth prep for PLV:
double cord w AlCl
Should we be able tell which are which based on the image alone?
check slide 40
Steps to making mock up for PLV:
apply vaseline w 1st cord is still in, autopolymerizing composite resin temp, thin at margin, remove ESF, apply flowable composite before taking off or it will break, trim excess,
Steps to placing interim:
don’t etch tooth completely or else you won’t be able to remove, no adhesive, cement with flowable, remove excess, cure, modify for cleansability and esthetic form w carbide finishing burs, polish using resin polishing burs
When to record impression to submit w cast to lab:
fom interim, w hydrocolloid
Difference bw veneer and laminate veneer:
laminate - thinner layer, usually for esthetic improvement
Material veneers can be made of:
composite resin, Feldspathic porcelain, leucite reinforced (Empress I), LiDi (e.max)
How to select material type for veneer:
based on longevity, esthetics, strength, transparency of the material and the esthetics of the existing restoration (? why? check)
Material type for heavy biter, not bruxism:
LiDi (e.max), stronger
Veneer cements:
Total etch resin, Light cure, dual cur
Ex of light cure or dual cure veneer cement:
Variolink II
How to choose veneer cement:
Try-in pastes to observe shade BEFORE permanent cementation
adjustments to be made on veneers before cementation
only interproximal contacts, no others
How to adjust interproximal contacts of veneers:
porcelain polisher wheel
Etch veneer w:
Hydrofluoric acid, time depends on material
Steps to veneer cementation:
Try in paste to ensure proper color, adjust interproximal contacts if needed, etch veneer w hydrofluoric acid, silane coupling agent, etch tooth w phosphoric acid, adhesive resin to tooth, cement to veneer, interproximal strip in gingival embrasure to help with excess removal, seat, cure 2-3s each side, remove excess before completely curing, adjust as needed, polish, verify occlusion
QUIZ!!! When to adjust occlusion for veneer:
after cementation, otherwise you will damage
is using denture teeth in a PFD ever an option?
yes, but not esthetic, if space is minimal
