Finishing and Polishing Fixed Restorations Flashcards
What are the steps of a crown try-in?
- Remove the Temporary.
- If tooth is sensitive, anesthetic may be required.
- Once, removed, clean the preparation with explorer or spoon to remove excess cement.
- Pumice clean the preparation
- Throat Pack
If tooth is super sensitive after taking off the temporary you may elect to delay the crown seat and instead…
Place two 1-minute coats of Gluma, and reseat the temporary with OTC pain meds in use. Then monitor for a week or two.
___________ is essential to prevent aspiration of a crown
Throat Pack
What are the steps for seating a crown?
- Check Proximal Contacts
- Check Internal Fit
- Check Marginal Integrity
- Check Stability and Retention
- Check Occlusion
- Check External Contours
- Check Surface Finish
- Check Shade
*If crown appears to fit marginally, and with floss snap on contacts, head to radiology to take…
BW x-ray to confirm radiographic proof of sealed interproximal margins.
If there is a gap between the crown and the finish line on your preparation what should you do…
continue with checking the other aspects of the crown seat checklist to see if the crown can still be delivered after an adjustment or two.
What are the next steps if the crown does not seat?
- Place Accufilm between crown prep and tooth intra-orally
- Then using finger pressure seat crown.
- Interproximal contacts will be highlighted and now you can see where the crown is hitting prematurely
How do you reduce the interproximals on a gold crown?
Use slow speed wheel to remove excess on contact area
How do you reduce the interproximals on a zirconia crown?
use fine diamond or slow speed wheel to remove excess on contact area
How do you reduce the interproximals on a ceramic crown?
use fine diamond or slow speed wheel to remove excess on contact area
In what direction do you reduce the interproximals?
Polish or grind from the inferior border of the mark and move occlusally.
What are the objecties of adjusting the proximal contacts?
- Adjust contact to lessen its tightness, but maintain size, shape and floss snap
- Can use Shimstock between crown and adjacent tooth to see if Shimstock pulls through with resistance.
- Most of the time, Floss tension when flossing is used to determine strength of contact.
How do you check the internal fit of a crown?
- Fitchecker is a material we have in the UMKC clinic
- Place a small amount in the crown, the crown is then seated and the patient bites on a cotton roll or you can hold the crown until the material sets.
- Remove the crown.
- Wherever there is show through, the crown needs to be adjusted to remove the area
How do you adjust the internal fit of an All-Ceramic Crown?
the internal surface of the crown is never adjusted. Instead, the preparation is adjusted
If there is no remaining temporary cement, contacts are light, and no issues are seen on internal of crown, and the crown still does not seat all the way what should you do?
a new impression should be made and the patient re-appointed
What do you do with an overextended margin?
- can be smoothed, burnished, or adjusted to bring the margin back into a smooth profile.
- use fine grit diamond disc or Blue course polishing wheel for this adjustmen
What do you do with an underextended margin?
- generally unacceptable due to plaque accumulation and possible sensitivity.
- a new impression should be taken if the seat in the mouth is different than the cast and die
What do you do with an open margin?
a new impression is needed if the open margin does not exist on the cast and die
Once Proximal Contacts, Internal impurities, and marginal adaptation have been deemed acceptable, check the…
Stability and Retention
If the crown rocks or rotates what should you do?
possibly new impression is needed
After you check proximal contacts, internal impurities, marginal adaptation, and stability you can check…
occlusion
What do you need to check occlusion?
- You will need Accufilm articulating paper
- Fine Diamonds, Green stone, White Stone, Brown Stone
How do you check occlusion?
- Check in MIP first by having patient “tap tap tap” their teeth together.
- If that occlusion is registering WNL, THEN ask patient to “close, squeeze, and grind side to side and forward and back” to analyze the excusive movements.
- Adjustments can be made with fine diamond.
Occlusal Contacts may cause mandible to ______ upon closing
deviate
