6. Foundation Restorations for Vital Teeth I Flashcards
A crown is a failure when
- Doesn’t provide the benefit for which it was intended
- Doesn’t conform to existing occlusion
- Periodontal health is not maintained
- Esthetics are not satisfactory to the patient
- Pulp vitality is not preserved
- Patient is constantly aware of it
- Doesn’t remain secure after cementation
A crown is a success when it
- Provides the benefit for which is indicated
- Conforms to the existing occlusion
- Maintains perio health
- Esthetics are acceptable by patient
- Pulp vitality is preserved
- Not a source of awareness to the patient
- Remains in place
A crown will remain secure when the supporting structure has what
length and strength (need adequate tooth structure to retain and support a crown)
What are the qualities of a good foundation restoration
-Provide the patient with adequate function
-Contour and finished to facilitate oral hygiene
(Proximal contacts and occlusal anatomy!!)
What are the indications for placing a foundation restoration
- Remaining tooth structure is insufficient to support a crown (caries/fracture)
- Large existing restoration demonstrates leakage or will not be retained after tooth prep
- When 50% or greater of the coronal part of the tooth is missing
What is the function of the core
- Provides retention and resistance form for the crown
- Transitional restoration before crown prep
What is the difference between a core buildup and a restoration foundation
Core
- When 50% or more of the tooth structure remains
- Must be putting a crown on the tooth
Restoration foundation
- You are putting a crown on the tooth but the filling is small
- Significant coronal tooth structure still remains
Pre-assessment of a core restoration on a vital tooth to look for leakage and retention should involve what
- X-rays
- Intra-oral exam (transillumination)
What should be done with teeth with extensive or deep vertical root fractures
extraction
What are the 3 approaches to placing a foundation restoration
- Remove and restore the core to full contour. Prep next session
- Remove and buildup to prep. Contour and finish prep
- Prep tooth for crown, remove/replace to prep contour and finish prep
What two materials should never be used as core materials
- GI
- RMGI
What are the advantages of GI
- Rapid set
- Inherent adhesion
- Fluoride release
- CTE= CTE of the tooth (little microleakage)
What are the disadvantages of GI
- Low strength
- Moisture/ handling sensitive
What should GI be used for
Small defects (blockout/filer)
What are the advantages or RMGI
- Stronger than conventional GI
- Command set –> crown prep with no delay
- Inherent adhesion (simple bonding)
- Fluoride release
What are the disadvantages of RMGI
- Low strength
- Hydrophilic resin absorbs H2O
RMGI should be used for what
- Small defects (blockout and filler)
- Minor fillings
How can the adhesive propeerties of GI be enhanced
By removing the smear layer with the cavity conditioner (10 sec etch)
What are the advantages of composite resin
- Stronger than GI
- Can be placed in thin sections (unlike amalgam)
- Rapid set- same appointment tooth prep
- Dentinalbonding???
- Most current materials are radiopaque
- Suited for long term intrim restoration (unlike GI and RMGI)
What are the disadvantages of composite resin
- Technique sensitive (isolation, bonding, etc)
- Polymerization shrinkage can disrupt bond
- High CTE –> post-op sensitivity and microleakage
- Expensive
- Color match can be a chalange when prepping the crown
Light cure materials should be placed incrementally- why?
so the light can penetrate (will be too thick to penetrate if not placed incrementally
What are contraindications for resin
where isolation can’t be achieved
Fluorocore is recommended for how many appointments
One- should prep and temporize that same day
Fluorocore should be used with what kind of adhesive
dual cure- not optibond solo plus! (optibond is LC only)
