CIMOE Flashcards
single crown delivery
1) cementation
2) final step of indirect procedure
proper cementation
1) retention
2) permanent
3) marginal seal
4) marginal leakage minimal
5) protect pulp
6) stable occlusion
7) esthetics and perio health
single crown restoration steps
1) extra oral assessment
- assessed on the working die and model from lab
2) intraoral assessment
- patients mouth
3) cementation
- PREVENT ASPIRATION!!!!
extraoral
1) restoration is checked on model
2) master cast and trimmed die
3) an untrimmed sectional stone
extra oral assessment (pre0cementation)
1) interproximal contacts
- location, size, tightness
2) internal fit
3) margin
4) occlusion
5) height of contours (F, L, prox)
6) embrasures
7) finish and polish
articulating pater
1) 0.04 slide in
- find strength of contact
- 0.2 and 0.1 may be too big
2) accufilm
- 0.021 mm
3) shimstock
0.008-0.012 mm
- to check if food will get in
pre cementation retention
1) stable, not rocking
2) no pitting, voids, or discrepancy
3) roughness
4) damaged or altered die
check margins precementation
1) use explorer
2) master cast and sectional cast
3) drag for no overhand and ledges
- or open margin
check occlusion
1) on the mastercast first
- then try it in the mouth (can have small changes)
check contours
1) within a quality lab, minimal adjustments necessary
- you can have it reglazed
benefits of not numbing patient
1) they will be able to tell if it is fitting right
2) however, they may be uncomfortable during cementation
CIMOE
C
- interproximal contact
I
- internal fit
M
- margin
O
- occlusion
E
- esthetics
C
1) visual
2) floss intensity
- may not be accurate
- silk, nylon, plastic
- twisted, non twisted, waxed, non waxed
3) articulating paper
- intensity, size, location
- usually contacts prevent seating
contact types
1) idea
- waxed floss passes with resistance
2) open
- no resistance with floss
- SEND BACK
3) light contact
- minimal resistance
- may need to send back
4) tight contact
- make adjustments
anterior teeth interproximal contact
1) usually centered in FL dimension
posterior teeth interproximal contact
2) centered or located buccal of center in BL dimension
finshing and polishing burs
1) various head sizes and various grids
2) we have a universal system kit
- porcelain, LDS, zirconia
- jiffy brand
3) with contacts
- use fine diamond for tight
- use polisher for slightly tight
* DO NOT OPEN YOUR FREAKING CONTACT!!!
4) never skip steps.
polishing steps
1) red to yellow disc
I
1) tactile
- rocking, not seating
- too tight or too loose
2) visual
- line angles: sharp or round
- blebs, damages, irregularities
- thickness
- perforations
- through coping
- finish: sandblasted, etched, residual debris
3) fit checker
- VPS which allows you to check where there is show through in the intaglio (PFM and gold)
- PVS is for ceramic crowns (ADJUST THE PREP TO NOT THIN THE RESTORATION)
M
1) any discrepancy in the junction of prep and restoration can lead to poor adaptation
- short, over or irregularities
- sensitivity leakage, decay, or perio issues
2) open margin can provide a shelter for microorganisms and responsible for inflammatory response
acceptable margins
1) contour is good, margin is closed
- 017 explorer says its good
2) if open unacceptable
- send to back to lab or reprep and get a new impression
3) if there is closed margin but under extended
- send back to lab
- if it is slight, might be ok to cement
4) if there is overhanging margin
- you can possibly adjust it after bonding
5) fat crown but closed
- can adjust but you might break the glaze
6) undercontour but closed
- send it back
O
1) shimstock is thin
- close mouth and pull
- make sure that it is holding
2) check other teeth and make sure clown isnt holding it up
3) check occlusion in MI
- remove marks on incline
- don’t tell them to grind
E
1) check contours, shade, translucency, polish ,glaze, incisal edges, embrasures, shape, symmetry, long axis
final cementation
1) dental material selection
2) decision making includes
3) type of restoration material
4) preparation
5) accessibility
6) handling
7) patient comfort
8) shade selection
