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fixed 2 > final > Flashcards

final Flashcards

1
Q

what does an MCC crown combine elements of

A

CVC and ACC

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2
Q

where to reduce more or less for an MCC crown

A

more reduction where ceramic will be placed

less where metal only will be placed

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3
Q

how do you ensure good esthetics on a MCC

A

substantial tooth reduction

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4
Q

minimal metal thickness on a MCC anterior corwn

A

.5mm at edge
.3mm at facial
1mm at lingual

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5
Q

Minimal metal thickness on a MCC posterior crown

A

.3mm at buccal
.8-1.2 mm at central groove
1.3-1.7mm at functional tip
.6 mm at the lingual

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6
Q

what are the consequences of under prepping an MCC

A

Opaque looking crown

Over contoured gingival margin

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7
Q

Minimal porcelain thickness for an anterior crown

A
  1. 2mm facial

1. 5 mm incisally

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8
Q

Minimal porcelain thickness for a posterior crown

A
  1. 2mm facial

1. 3-1.7 at facial cusp tip

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9
Q

what happens if you don’t correctly shape the second facial plane

A

opaque looking crown
over contoured gingival margin
Bulls-eye opaque area on incisal 1/3

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10
Q

how thick overal should an MCC crown be

A

1.5mm for porcelain/metal areas
1.2mm for porcelain
.3mm for` metal

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11
Q

how should the cavosurface margin look on the facial for a MCC

A 
Porcelain Labial margin (90 degrees)
Slopped shoulder (120 degrees)
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12
Q

what should the cavosurface margin look on the lingual side of the cavosurface margin

A

Chamfer (.5mm)

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13
Q

why is the sloped shoulder important

A

Allows for metal to come right to the cavosurface margin

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14
Q

what finish line is used for metal crown

A

Knife (feather edge)

Chamfer

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15
Q

what finish line is used for MCC (PFM)

A

Sloped shoulder
Shoulder
Beveled shoulder

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16
Q

when is a knife (feather) edge useful

A

Very subgingival margins

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17
Q

what is a porcelain butt margin

A

A porcelain labial margin of 90 degrees

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18
Q

what is a conventional margin

A

Sloped shoulder (120 degrees)

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19
Q

what to use to achieve uniform tooth reduction

A

Guide groves
Depth grooves
Precision reduction indicators

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20
Q

how should the labia be reduced

A

two plane redction (1.3-1.5mm)

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21
Q

how should the lingual be reduced

A

1mm

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22
Q

chamfer on the lingual

A

.5mm

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23
Q

why does lipping occur

A

when the chamfer diamond is used at more than 1/2 depth

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24
Q

how to identify lipping

A

Visual and tactile

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25
Q

lingual concavities

A

Incisors: uniform slight concave
Canines: biconcave

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26
Q

layers at the margin for an MCC

A

metal framework
Opaque porcelain
Translucent porcelain

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27
Q

what is needed for determine margin location

A

Evaluation of the smile line

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28
Q

pros and cons of 90 degree butt joint

A

brittle

looks good

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29
Q

pros and cons of 120 degree sloped shoulder

A

gives more strength
supports margin
looks bad (Creates a shadow)

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30
Q

when are margins visible for a smile

A

With a high lip line (margins not visible if lip line is low

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31
Q

what happens if the margin is not placed deep enough under the tissue for a crown

A

risk for recession and potential exposure of the crown margin (esthetically unacceptable)

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32
Q

what happens if the margin is placed too deep

A

risk for possible biological width impingement

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33
Q

what is a greatetr problem too deep or not deep enough

A

Too deep due to biologic width impingement

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34
Q

what is the best biological response

A

Supra gingival

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35
Q

what is the best esthetic response

A

sub gingival

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36
Q

what to pay attention to for the best of both worlds when restoring a crown

A

Attention to details of the biologic width

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37
Q

why does a porcelin labial margin of 90 degrees look nicer

A

allows light to transmit down the root

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38
Q

why does a sloped shoulder cast a shadow

A

does not allow light to transmit to rooot (creating a shadow in the root)

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39
Q

what causes the darkline at the margin of an MCC

A

metal collar or conventional sloped shoulder designs

Dark underlying root structure from trauma or previous endo treatment

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40
Q

what determines where the restorative margin is placed relative to the tissue and the response of that tissue

A

Biology itself

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41
Q

what are biologic consideration

A

Prevention of damage during tooth preparation

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42
Q

what must be important for biologic considerations

A

Adjacent teeth
Pulpal response
Soft tissue (biologic width)

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43
Q

the empty space between gingiva and enamel

A

Sulcus

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44
Q

where the epithelium of the gums attaches to the tooth

A

Epithelail tissue

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45
Q

what is the biologic width

A

the amount of stuff between the deptth of gingival sulcus and the tip of the alveolar bone

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46
Q

what is the biological width made of

A

the PDL connective tissue and epithilium above the alveolar bone

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47
Q

what is the correct biologic width necessary for

A

for the existence of healthy bone and tissue from the most apical extent of a dental restoration

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48
Q

mean biological width

A

2.15-2.30mm (usually about 50:50 with maybe a bit more connective tissue)

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49
Q

range of biologic width

A

.2-6.73mm

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50
Q

average sulcus depth

A

1mm

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51
Q

what is the significance of biologic width

A

Its importance relative to the position of retorative margins and its impact on poastsurgical tissue position

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52
Q

what is the goal concerning biologic width

A

Bone is 3mm below the gingival margin of the prep

53
Q

what types of gingiva exist

A

Flat

Scalloped (more rounded)

54
Q

how common is the thin gingival biotype

A

1/3 of the population

more prominent in women

55
Q

how common is the thick gingival biotype

A

2/3 of the population

more prominent in men

56
Q

what size of crown is at the greatest risk of recession

A

Narrow crown is at greater risk than square wide incisors

57
Q

Periodontum thickness of scalloped and flat periodontum

A

Scalloped: Delicate thin perio
Flat: thick heavy perio

58
Q

location of gingiva in the scalloped and flat gingiva

A

Slight gingival receion in scalloped

coronal gingiva in flat gingiva

59
Q

how much keratine is there in scalloped and flat gingiva

A

Scalloped has minimum zones of keratinized gingiva

Flat has wide zones of keratinized

60
Q

contact are of scalloped and flat gingival area

A

small incisal contact area of scalloped gingiva

Broad apical contact area of flat gingiva

61
Q

anatomic crowns of scalloped and flat gingiva

A

Triangular anatomic crowns: scalloped

Square anatomic crowns: Flat

62
Q

what does insult do to scalloped and flat gingiva

A

Insult leads to recession in scalloped gingiva

insult leads to pocket depth or rebundnat tissue in flat gingiva

63
Q

convexities in the cervical 1/3 of the facial surface of scalloped and flat gingiva

A

Scalloped: subtle diminutive convexities
Flat: bulbous convexities

64
Q

bone thickness of flat and scalloped gingiva

A

Thick in flat gingiva

thin in scalloped gingiva

65
Q

what gingiva is easier to work on

A

Flat (less inflammation and change)

66
Q

why is having dark gingiva important

A

needed for esthetics to cover underlying materials (implant and restorative dentin)

67
Q

How to detemine the biotype of gingiva

A

Placement of a probe within the gingival sulcus and looking at prob visicibility

  • seen: thin
  • not seen: thick
68
Q

do deep or shallow sulcuses have more risk of recession

A

deep has more risk

69
Q

does thick or thin gingiva have deeper sulcuses

A

No relation sadly

70
Q

cord sizes for subgingival margins

A 
#00: thin tissue
#1: most tisuee
71
Q

where is cord placed for shallow sulcus patients

A

.5mm to .7mm apical to the prep margin

72
Q

what do you dampen the cord with for shallow sulcus patients

A

damp with aluminum chloride solution

73
Q

what does the first cord do when placed for shallow sulcus patients

A

retracts the tissue

represents the correct position for the final prep margin (.5 to .7mm subgingival

74
Q

how far should you prep subgingivally when using cord for shallow sulcus patients

A

prep to the top of the cord using a bur that provides adequate depth and shape for your finish line

75
Q

hw should a second cord be place for shallow sulcus patients

A

placed and pushed down apically so it sits at the level of the prepped margin
should be able to be visuallized around the tooth

76
Q

what is done after the impression istaken with the cord for shallow sulcus patients

A

Complete the restoration

77
Q

how far should probing be allowed to go (max) for subgingival crowns

A

max of 1.5mm

78
Q

how far deep should the prep be done with no cord for deep sulcus patients

A

prep to the existing gingival margin (leave only the subgingival margin to be done)

79
Q

how should the first round of cords be placed for deep sulcus

A

2 layers (ultrapack 1# first, followed by Ultrapack 2#)

80
Q

how high should the 1st round of cord be from the prepped margin for preps with deep sulcuses

A

top of cord is 1.5mm below the previously prepped margin (1.5mm below the gingival margin)

81
Q

roll of cord in subgingival preps

A

moves gingival out of the way

82
Q

using cord if margin is supra-gingival

A

No need

83
Q

how are cords easiest to put in

A

Dry

84
Q

what should happen if you do a good impression with cords

A

Come out with the impression

85
Q

what should be done in deep sulcus preps after the cords have been placed

A

prep the margin to the top of the cord 1,5mm below starting gingival margin

86
Q

what should be be done after you preped to the top of the second cord in a deep sulcular prep

A

place a 3rd cord (ultrapak 1) so it sits between the prep margin and gingiva (no deeper) and is easily seen around the tooth

87
Q

why would you want to keep cord dry

A

allows for the impression material can go in and around it so impression looks good

88
Q

how should the last cord always look

A

should be able to be seen from the top

89
Q

what is done before taking an impression witha deep sulcus

A

remove the 3rd cord, but should be able to see the 2 cords around the margin

90
Q

Good esthetics starts with what

A

Good gingival health

91
Q

what instrument is good to retract gingiva

A

8A(also good for cord)

92
Q

what is need to control final tissue level

A

need to start with healthy tissue

93
Q

how to control saliva in the max anterior

A

easy, usually cotton role isolation

94
Q

tissue displacement is done how for impressions

A

Cords and the 8A

95
Q

how to control hemorrhages

A

Chemicals
Lasers
Electrosurgery

96
Q

Types of trays

A

Custom
Disosable stock
Triple tray (Closed mouth

97
Q

when are tripple trays good to use

A

Good posterior

Anterior less good

98
Q

What are elastomeric materials

A

Polyvinylsiloxanes (OSU clinic)
Polyethers (OSU clinic)
Polysulfides

99
Q

when to use light and heavy body polyvinylsiloxanes

A

Light: injection type
Heavy: tray material

100
Q

benifit of polyvinyl siloxanes

A

dimensionally stable

101
Q

pros and cons of polyethers

A

Easier to use than polyvyniles but taste like shit

102
Q

what do we need to send to the lab for crown fabriaction

A

Final Impression
Interocclusal Record
Opposing Arch impression or cast

103
Q

are most preps supra-gingival

A

No, most are subgingival

104
Q

how are impressions poured for the lab

A

Poured in type 4 stone

105
Q

why is the cast marked in the working model in die

A

For location of pins

106
Q

what is sent to the lab exactly

A

Plaster model or impressions depending on the material used

107
Q

characteristics of type 4 stone

A

hardest and most accurate stone

108
Q

what keeps the working model and die from connecting to the type 3 stone poured under it

A

stone separator

109
Q

Roll of the pins

A

allow for the working die to be removed and reput back into the cast as to allow easier working

110
Q

what do you do once you remove the dies from the cast

A

Trim margins of the die so they can be clearly identified

111
Q

How is the final die shape determined

A

Done using a wax up

112
Q

when do you do a full contnour wax design

A

For all memtal or all cermaic crowns

113
Q

when do you do a facial cutback wax design

A

Facial porcelain coverage

114
Q

when do you do a cull cutback wax design

A

Full porcelain coverage

115
Q

when are crowns cast

A

Metal

116
Q

when are crowns pressed

A

Glass ceramics

117
Q

Analysis of dimensional changes for crown casting does what

A

goal to get the overal dimension change as close to zero as possible

118
Q

roll of the opaque later in a crown

A

Masks metal color

Bonds porcelain to metal

119
Q

steps of porcelain latering

A

Body porcelain
Incisal porcelain
Post-sinter contouring

120
Q

what is the most common digital path

A

Traditional Impression
Tradition working model
lab scanner

121
Q

Most modern digital path

A

Direct intraoral scan
Digital crown design via virtual waxup
Digital Manufacturing

122
Q

What are the types of Digital Manufacturing

A 
Subtractive manufacturing (CNC milling)
Additive Manufacturing (3D printing
123
Q

what is currently the most common manufacturing method for permanent restoration and prosthesis

A

CNC milling

124
Q

when is 3d printing used

A

Some items, mostly temporary items

125
Q

development of 3D printing

A

Many new devices under develofopment

126
Q

what are most anterior teeth made out

A

80% all ceramic

127
Q

what areposterior tooth made of

A

60% all ceramic

128
Q

are metal ceramic or all ceramic more expensive

A

MEtal ceramic are more expensive due to extra metal

129
Q

what bur should be used to establish uniform should width

A

702

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