8. ACC III Flashcards
What factors influence the color of the final restoration
- Stump (ND) shade
- Restoration thickness
- Shade and translucency of ceramic
- Cement shade
When selecting the shade errors in selecting the correct (hue/chroma/value) are the most noticeable
value
If you have a few discolored tooth background what are your options
layered emax (opaque layer coping with more translucent layers (ceramic veneering) to give more lifelike restoration)
What are the different levels of emax translucency
- Mutli
- High translucency
- Medium translucency
- Low translucency
- Medium opacity
- High opacity
- Impulse
Is it important to know if the emax crown will be layered or not
yes because if it is layered you need more than 1mm facial reduction
How much facial reduction is needed for layered emax
1.3 mm
What factors need to be considered when determining if the restoration should be layered
- Stump shade
- Final desired shade
Outcome of the final restoration shade is more predictable with a (light/dark) stump shade
light
The opaque coping layer is how thick
0.7-0.8mm
Which bonds better to layering ceramic E.max of Zirconia opaque copings
E.max
T/F Major color corrections can be achieved with veneers
F-can’t
Most commonly used materials for veneers
- Empress
- Emax CAD and press
What restoration is indicated for anterior teeth requiring major color correction
full coverage
What is a more conservative adjunct to veneers to help whiten the teeth
bleaching
The effect of the cement shade on the final shade of the restoration is small because it is _ nm thick
70 microns
Another word for try in paste for a resin esthetic cement is
optical connector
Resin cements for veneers are (light/self/dual) cure
Light and dual cure
The more transparent the cement the (lighter/darker) the appearance of the restoration
darker (more of the stump shade will show)
The try in paste corresponds to the shade of the (polymerized/unpolymerized) cement
polymerized
Look at the chart on slide 28
ok
What restorative material is the gold standard in patients with parafunction and why
gold because it is strong and non-abbrasive to the opposing dentition
What is the only all-ceramic restoration indicated for bruxers
zirconia
What are the most common complications (in order of most to least common) of single crowns
- Need for endo
- Porcelain fracture
- Loss of retention
- Perio disease
- Caries
What are the most common complications (in order of most to least common) of all ceramic single crowns
- Facture (less of an issue today with the ceramic materials- this was more for feldspathic)
- Loss of retention
- Pulpal health
- Caries
- Perio disease
15 year survival rate of empress restorations
75%
15 year survival rate of leucite reinforced ACC
69-74%
T/F The 15 year survival rate of leucite reinforced ACC is similar to PFM
t
Main reason for failure of Leucite restorations
- Loss of retention** (result of bonding)
- Fracture
- Discoloration
- Sensitivity
What are the three significant predictors for failure of restorations
- Gender
- Parafunctional habits
- Non-vitality of the tooth
Which gender has more restoration failures and what are the causes of the failures
-Males with higher loss of retention and caries
Non-vital teeth often contribute to restoration failure by…
increasing the probability for bond failure
Before re-luting a ACC that debonded what should be done
diagnose the cause for the debonding
Higher success rates in ACC reztorations may be made by improving the quality of what
the cemented interface
Two most common reasons for fracture of ACC restorations are
- Prep guidelines weren’t followed
- Parafunctional habits
Discoloration may be caused by
mixing ferric sulfate and aluminum chloride
Contamination of ferric sulfate may lead to staining and
reduce the bond strength –> microleakage
The restoration should be cemented (before/after) the occlusal adjustements have been made and the restoration is polished
after
T/F the crown can be adjusted and polished intraorally
t
Centric contact on an anterior tooth with an ACC should be where
where the porcelain is supported by tooth structure (i.e in the middle third of the lingual wall)
Is leaving the opposing tooth out of occlusion a good idea? Why or why not?
no because it will lead to supra-eruption, protrusive interference , and precipitating fracture.
Why can’t veneers do significant color correction
because they are thin and translucent
Why don’t you want to use an opaque veneer
won’t look natural (chiclet white smile)
How much space is needed for a layered ACC
1.3-1.5mm
Try in pastes must be used for (translucent/opaque) restorations
translucent
