Fixed Exam 2 - Fixed Prosth Protocols Flashcards
What are the 4 crown/FDP appointments?
- Diagnosis + tx plan (1 or 2 appts)
- Crown prep
- Final impression
- Crown delivery
Which appt?
a. Preliminary impressions, facebow, mounted casts, x-rays, intraoral findings
b. Wax-up if needed
c.Tx Plan elaboration
d. Fabrication of vacuum form for provisional fabrication (coping material).
Diagnosis + tx plan for crown/FDP
Which appt?
a. Shade selection prior to crown prep (neighbor teeth can dehydrate throughout the appt.)
b. Anesthesia
c. Crown Preparation
d. Evaluate if tooth will need additional procedures after removing existing decay and old restorations (build-up, endo tx…)
e. Provisional restoration fabrication
f. Cementation with a provisional cement
Crown prep
Which appt?
a. Anesthesia
b. Try-in custom tray / stock tray, paint tray with adhesive, prepare impression material guns. (Remember to always bleed material!)
c. Place first retraction cord
d. Evaluate crown prep, refine if needed.
e. Place second retraction cord
f. Impress crown preparation
g. Interocclusal registration (Regisil)
Final impression for crown
What should always be obtained in order to mount the maxillary cast on the semi adjustable articulator?
Facebow
What should be created in order to mount the mandibular cast?
Interocclusal record
Which record should give good stability to the mandibular arch when articulated?
Interocclusal record
A distribution of contacts with what layout is desired to maximize stability?
Tripod
Where should you use bite registration material?
Only on the teeth being restored!!
Trim the interocclusal record so that only the most occlusal _______ digitates into the material
1 mm
What are the 2 types of interocclusal record material?
Regisil
Aluwax
Which interocclusal record material?
PVS
Regisil
Which interocclusal record material?
Sophisticated composite material
Aluwax
Which interocclusal record material?
Contains powdered aluminum to increase the integrity of the compound and provide heat retention for efficient modeling
Aluwax
Which part of the fabrication?
- Pour and fabricate master cast (working dies, pins, trim…)
- Mounted case with facebow and interocclusal record
- Laboratory Script write up.
- Faculty’s signature
- Turn in case to South Lab to be sent to respective laboratory.
Lab procedures for crown
What is the order you should follow when checking to make sure a crown or FDP fits?
- Margins
- Interproximal contacts
- Occlusion
Which appt?
a. Remove provisional restoration with hemostat
b. Clean crown prep from all cement excess with pumice (Preppies)
c. Try-in crown
d. Check margins clinically, should be closed. (if margins are opened, check for very heavy inter-proximal contacts, they might not be letting the restoration seat completely)
e .If margins are closed, take a BTW (posterior teeth) to verify closed margins.
f. If margins appeared open on X-Ray, check for very heavy interproximal contacts.
g. Once closed margins are confirmed, check interproximal contacts.
h. Adjust occlusal surface on MIP and eccentric movements.
i. Polish porcelain with the Dialite Porcelain Polisher Kit to minimize occlusal wear of opposing dentition.
j. Cement crown with appropriate cement and respective manipulation technique.
k. Remove all cement excess
l. Verify restoration was fully seated (closed margins), check occlusion, interproximal contacts…
m. Final x-ray: verify all margins are closed and there’s no cement excess
Crown delivery
Which appt?
a. Shade selection prior to crown preparation (teeth have not been dehydrated)
b. Anesthesia
c. Crown Preparation
d. Evaluate if tooth will need additional procedures (build-up, endo tx…)
e.Verify there’s a Path of insertion for the FDP
f. Provisional restoration fabrication
g. Cementation with a provisional cement
FDP prep
Which appt?
a. Anesthesia
b. Try-in custom tray / stock tray, paint tray with adhesive, prepare impression material
guns. (Remember to bleed material!)
c. Place first retraction cord
d. Evaluate FDP prep, refine if needed.
e. Place second retraction cord
f. Impress preparation for FDP
g. Interocclusal registration
h. Verify you have an opposing arch cast/facebow.
i. Cementation with a provisional cement
Final impression for FDP
Which part of the fabrication?
- Pour and fabricate master cast (working dies, pins, trim…)
- Fabricate a Solid cast.
- Mounted case with facebow and an interocclusal record.
- Laboratory Script write up.
- Faculty’s signature.
- Turn in case to South Lab to be sent to respective laboratory
Lab procedure for FDP
Which appt?
a. In case of an PFM or PFZ, a framework try-in is necessary before applying the feldspathic porcelain.
b. Sometimes, a Framework try-in can be made with out anesthesia. Ask patient if they would like to try with or without being numbed.
c. Try-in framwork
d. Check margins clinically. All margins should be closed.
e. Frameworks should NOT have inter-proximal and/or occlusal contacts, unless requested on the lab script. (ex: metal occlusion)
f. If margins are clinically closed, verify radiographically with a BTW
g. If margins are open, use Occlude to adjust framework and make it fully seat.
h.Cementation of provisional / clean cement excess / check occlusion
Framework try-in for FDP
Which appt?
a. Anesthesia
b.Remove provisional restoration with hemostat
c. Clean FDP preps from all cement excess with pumice (Preppies)
d. Try-in FDP
e. Verify if restoration fully seats. It should since the framework was verified on previous appt.
f. If not fully seated, check for very heavy interproximal contacts.
g.Once fully seated, check both interproximal contacts to be nicely tight.
h.Once interproximal contacts adjusted, check and adjust occlusion.
i.Check pontic design and soft tissues around it.
j.Verify shade match.
k.Let the patient see it with a mirror and get their esthetic approval.
l. Cement FDP with indicated cement following the manufacturer’s recommendations and protocols.
m. Remove all cement excess
n. Verify restoration was fully seated, interproximal contacts, check occlusion…
o. Final x-ray, all margins should be closed.
FDP delivery
What does the following describe?
1.Clean provisional from any previous cementation or debris.
2.Clean abutment from any previous cementation, saliva, blood
3.Cementation
4.Let cement fully set.
5.Gently remove cement excess with an explorer. Assistant helps with high suction.
6.Verify occlusion, provisional restoration could have not seated completely
Cementing a provisional
What does the dentist and assistant do when cementing a provisional?
Assistant: mixes and loads provisional with provisional cement.
Dentist: isolates tooth and lightly dries the tooth. Then, seat restoration after handled by assistant.
