Diagnostic Waxing and Provisional Restorations Flashcards
What are the elements used as part of a diganostic wax up?
-A full health history
-Intra-oral examination of patient
-Diagnostic Casts (mounted)
-Occlusal Evaluation
-Esthetic evaluation
— Primarily for anterior FPD work. However, should also be considered for posterior work as well
What are the steps following diagnostic waxing?
- diagnostic waxing
- interim restoration
- patient feedback/soft tissue management
- cast of interim/clincal photographs
- predictable definitive restoration
What are the steps of diagnostic waxing through final product?
STEP 1 -
Initial diagnostic casts are made along with discussion about patient restorative and esthetic goals
STEP 2 –
Diagnostic wax up of these goals is made and includes:
-Pontic shape, size, contour, and relation to the ridge
-Incorporate any changes to the current esthetics and function
** STEP 3 –**
This wax up then can be used with a putty matrix to make a temporary which incorporates these desired changes
** STEP 4 –**
Tooth preparation and temporization
** STEP 5 – **
Patient returns with temporaries in place and provides feedback on the shape, length, and overall esthetics and function.
STEP 6 –
Once temporaries are representing desired results, a new impression is made of the temporaries to provide to the lab. Photographs of the temporaries with measurements are provided for the lab.
** STEP 7 – **
FPD created from a final impression and using the models of your temporaries. Definitive prosthesis is tried in and seated.
** STEP 8 – **
Evaluation of final product after patient has had prosthesis for a period of time.
When do you make changes to the temporary if you or the patient desires it?
Step 5 - Patient returns with temporaries in place and provides feedback on the shape, length, and overall esthetics and function.
What is diagnostic waxing?
Using wax to create intended restorative contours on casts for the purpose of evaluation and planning the restorations. A wax replica of proposed treatment.
What are the different methods of doign a diagnostic wax up?
- literally create a wax tooth
- use a denture tooth
- use a polycarbonate shell
What is a provisional?
- A prosthesis designed to enhance esthetics, stabilization and/or function for a limited period of time after which it is to be replaced by a definitive prosthesis
- Used to assist in determination of the effectiveness of a specific treatment plans form and function
How do you know if you have reduced enough on this preparation?
- use a putty
- use a vacuum matrix
In addition to vacuum matrix viewing to assess reduction, _____________ can be used as well with properly placed cuts and removal to see visually or measure with a probe what your reduction is based on your diagnostic wax up
Putty matrixes
Steps to make a provisional restoration?
- mounted diagnostic casts (with facebow)
- diagnostic wax up
- alginate of wax up and cast made
- vacuum matrix or puttys made
- crown preps done
- provisional made
- check occlusion and protrusive
- patient tests them out at home
- changes can be made it needed
- definitive crowns will be made included any adjustments
What can cause gingival inflammation with crowns/provisionals?
- Creating gingival inflammation either by lack of patient ability to clean
- Or with ill fitting restorations with poor marginal adaptation that allow more bacteria to impact the tissue.
- Also, if restorations are over contoured
Based on a wax up, provisional FPD’s placed with _________ pontic to develop extraction site into excellent esthetic case during healing.
ovate
Ovate pontic site development can take _____________ to properly develop.
weeks to months
What are the challeneges of provisional restorations?
- Time is needed to make an adequate temporary
- Time the material is in the mouth is limited
- Provisional materials have limitations
What are the disadvantages of jet acrylic (poly methyl methacrylate)?
High Exothermia
Toxic Monomer
High Volumetric Shrinkage (8%)
Low Abrasion Resistance
