capstone patient project

Question 1

anytime you tp a fixed unit

Answer 1

1) tp a buildup as well

Question 2

today

Answer 2

1) create patient
- extract 7,13,14 fracture
2) add putty 7 concave, 13 convex
3) fracture #14
4) make upper and lower alginates, pour stone for diagnostic casts
5) after alginates, start 14 BU

Question 3

Lab work

Answer 3

1) fabricate diagnostic casts and mount in MI
2) wax up 7, 13, 14
3) duplicate maxillary cast (soak cast for 5 mins)
4) fabricate putties for provisional bridge restorations
5) fabricate a maxillary custom tray or final impression 12-14

Question 4

wax up 7 and 13

Answer 4

1) line angles ivory
2) fill gray
*use sticky wax at base of cast

Question 5

provisional putties

Answer 5

1) make off of duplicate cast

Question 6

Maxillary custom tray

Answer 6

1) make it from duplicate cast

Question 7

should we always replace the amalgam?

Answer 7

1) durable
2) bacteriostatic
3) oxidation (corrosive) products between amalgam and tooth prevent leakage
4) class II composites bonding gingival margin is not reliable if margins are in dentin (root caries)

Question 8

other considerations

Answer 8

1) drilling it out will cause temp spike in exposure
2) dental exposed to mercury vapor
3) it is not ethical to scare them

Question 9

amalgam tattoos and staining

Answer 9

1) dentin under old amalgam may be stained due to seepage of corrosive products
2) stained areas may be removed or covered with opaque resin
- but will still be discolored
3) amalgam tattoos may be mistaken for melanoma

Question 10

amalgam prep design

Answer 10

1) equally sized amalgam and composite preps are similar
2) rounded line angles
3) 90 degree angles of exit
4) 0.25 – 0.5 mm clearance

Question 11

composite prep

Answer 11

1) rounded line angles
2) bevels
- occlusal if flat
- B, L, and gingival proximal (if there is enough)
3) no retention grooves necessary *unless it is a build up
4) occlusal prep can be minimally invasice

Question 12

removing old amalgam

Answer 12

1) rubber dam
2) high speed
3) water spray
4) HVE
5) amalgam is easily removed

Question 13

removing old composite

Answer 13

1) high speed handpiece
2) know diff from dentin
- dentin is smooth like wood

Question 14

create a fracture

Answer 14

by removing DL cusp and extend to the gingival level
- do this outside mouth and just make pencil marks

Question 15

remove amalgam from #14

Answer 15

1) use the transmetal bur
- 330 or 550
2) better to create chunks than paste

Question 16

14 prep

Answer 16

1) you can put retentive features
- optional for buildups
- but recommended
2) examples
- truncated walls
- potholes or trough axial to DEJ (ONLY ON TYPODONT not on people)

Question 17

review of buildup

Answer 17

1) before the tooth is prepped for a crown
2) lost tooth structure due to caries or fractured cusp
3) replace a large filling
4) for endodontically treated teeth
- if less than 50% coronal remaining, consider a post
5) INTERRIM ONLY!
-
margins and ferrule need to be on tooth structure
- check crown to root ratio as well

Question 18

what if parts on margin is still in resin

Answer 18

1) drop the margin where there is JUST buildup

Question 19

materials today

Answer 19

1) photocore
- translucent
2) anchor

Question 20

photocore

Answer 20

1) for aesthetic areas
2) indicated for tooth margins about tissue level which can be easily seen
3)a light cure bonding system
- placed in increments for shrinkage

Question 21

clearfil photo core

Answer 21

1) heavily filled micro hybrid particle size
2) cuts like dentin, radiopaque
3) allow tooth structure between photo core build up and your margin
- for ferrule
4) keep tooth out of occlusion or very light occlusion!!!

Question 22

when do we consider subgingival

Answer 22

1) increase prep length for short clinical crowns
- better ferrule
2) caries or pre-existing restoration is subgingival
3) fracture is there
4) esthetic reasons for anterior teeth
5) allow lab to give more ideal contacts

Question 23

things to consider with subgingival

Answer 23

1) biological width
2 )tissue management
3) be kind to soft tissue
4) verify clear margins, saliva and heme control, and tissue displacement

Question 24

crown preps on NCCLs

Answer 24

1) if small and shallow, prep all the way to the base of it
2) what if its deeper and bigger?
- do not hit the pulp
- prep occlusal to the NCCL and restore with composite separately
- or place the resin and make it part of the axial wall (but make the margin on tooth)