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indirect restoration > Lec 1/12 Partial FDP MCC & ACC I > Flashcards

Lec 1/12 Partial FDP MCC & ACC I Flashcards

1
Q

Indications for leucite based fixed prosthesis:

A

anterior crowns, veneers, inlays and onlays

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2
Q

Indications for lithium silicate based fixed prosthesis:

A

ant/ POST crowns, veneers, inlays, onlays, 3-UNIT ANT FDP

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3
Q

consequences of tooth loss:

A

M-D drift of adjacent teeth, supraeruption of opposing teeth, premature contacts created during protrusive movements, alterations in occlusion, bone loss, possible loss of VD

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4
Q

Options for replacing a missing tooth:

A

implant, PFD, RPD, Resin bonded FDP, no tx

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5
Q

Comparison of survival rates of implants and FPD after 10y

A

about same

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6
Q

Most common complication for conventional tooth-supported FDPs:

A

biological: caries, loss of pulp vitality

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7
Q

Most common complication for implant-supported reconstructions:

A

technical complications

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8
Q

caries under adjacent tooth for FP is considered a failure of:

A

the treatment

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9
Q

For teeth w/ endo treatment, how does extraction and replacement w PFD compare w replacement w an implant supported prosthesis?

A

FDP lower longterm (10y same) survival than implant

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10
Q

Aspects to eval when determining tx options for missing tooth:

A

edentulous area, perio health, caries on adjacent teeth, is occlusion stable?, root length and shape, bone support, divergent/ non-divergent roots (conical roots are the worst), quality and extension of caries/ restoration, H/W of edentulous area at MIP

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11
Q

What always come before treatment?

A

disease control

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12
Q

What needs to be eval if adj tooth to edentulous area has had an RCT and you are thinking about placing a FDP?

A

amount of ferrel

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13
Q

Ante’s Law:

A

combined pericemental area of all abutment teeth supporting a FDP should be equal to or greater in pericemental area than tooth or teeth to be replaced

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14
Q

Law of Beams:

A

deflection of force is proportional to the cube of its span

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15
Q

What to do after diagnostic work-up and tx plan and before appt to start prepping tooth:

A

make shell for interim FDP and custom tray

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16
Q

What to do after prepping adjacent teeth?

A

definitive impression, interocclusal record MCC/ACC shade and Interim restoration

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17
Q

What to do after definitive impression interocclusal record MCC/ACC shade and Interim restoration

A

pindex, trim, mount the working cast, wax up, sprue and invest

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18
Q

Metal alloy types that can be used for indirect:

A

III and IV

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19
Q

Metal alloy type that can be used for short-span FPD:

A

III

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20
Q

Type I alloy can be used for:

A

some, not all, inlays

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21
Q

Type II alloy can be used for:

A

inlays and onlays

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22
Q

Type IV alloys can be used for:

A

long span FPD, RPD

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23
Q

How are metal alloys categorized?

A

yield strength and elongation

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24
Q

Noble alloy:

A

25% noble, no stipulation for gold

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25
Q

Base metal alloy:

A

Less than 25% noble metal

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26
Q

Ti and TI alloy:

A

85%+ Ti

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27
Q

High noble:

A

at least 60% noble and at least 40% gold

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28
Q

3 types of porcelain:

A

opaque, body, incisal

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29
Q

Type of porcelain responsible fo rmetal-ceramic bond

A

opaque

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30
Q

Porcelain type that provides some translucency and contains metallic oxides that aide in shade matching:

A

body porceliain

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31
Q

Translucent porcelain type:

A

incisal porcelain

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32
Q

Factors affecting the bond:

A

oxide layer thickness, bonding agent, airborne particle abrasion, linear CTE

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33
Q

Higher flexure strength, metallic alloy or feldspatic porcelain?

A

metalic alloy

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34
Q

TF? Greater deflection leads to greater likelihood of breakage.

A

T

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35
Q

Is porcelain stronger in compressive or tensile strength?

A

compressive

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36
Q

CTE

A

Change in length per unit length of a material for every 1’ temp change

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37
Q

Ceramic CTE:

A

13 -14 X 10^-6/C’

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38
Q

metal alloy CTE:

A

13.5-14.5 X 10^-6/C’

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39
Q

CCC reductions:

A

margin: 0.5mm, Non-functional cusp: 1mm, Functional 1.5mm

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40
Q

MCC reductions:

A

Lingual: 1mm (metal only), Buccal: 1.5mm (1.2mm porcelain, 0.3mm metal), Incisal 2mm (1.5mm porcelain, 0.5? metal) Non-functional cusp: 1.5mm, Functional 2mm

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41
Q

ACC reductions for anterior tooth:

A

Incisal: 1.5mm, Lingual / Facial: 1mm shoulder margin

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42
Q

ACC reductions for posterior tooth

A

Margin: 1.5mm, occlusal: 1.5-2mm, 1mm shoulder margin

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43
Q

3 PFM margin types:

A

knife edge, metal collar, porcelain margin

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44
Q

4 PFM Occlusal Surfaces:

A

metal lingual (anterior), porcelain lingual (anterior), metal posterior, porcelain posterior (?don’t understand, check?)

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45
Q

PFM Ceramic Margin:

A

Gen only the labial area in esthetic zone, requires a smooth, 1.2mm finish line w round internal angle, slightly sub-gingival (equigingival), technique sensitive

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46
Q

Bur for PFM ceramic margin:

A

modified shoulder

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47
Q

Bur for metal collar PFM prep:

A

chamfer, 0.5 lingual reduction

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48
Q

Bur for knife edge PFM:

A

chamfer, right?

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49
Q

PFM metal ceramic margin:

A

mid-sulcus prep, acceptable result if fabricated properly, simplifies crown fabrication, many clinical problems

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50
Q

Clinical problems assoc w metal-ceramic margin PFM:

A

gingival over-contour, rough porcelain surface, non-esthetic after gingival recession NOT RECOMMENDED

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51
Q

When to use metal collar framework design for PFM

A

non-esthetic areas

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52
Q

Benefit of metal collar framework design for PFM

A

easier porcelain application

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53
Q

Issues with metal collar framework design for PFM

A

compromised appearance: shallow sulcus, thin gingival tissue, gingival recession

54
Q

Which surfaces are covered in ceramic w Metal-Lingual/ occlusal PFM?

A

Facial, proximal, and incisal (?check? why?)

55
Q

Benefit of Metal-Lingual/ occlusal PFM:

A

less tooth reduction (good for recovering bullics)

56
Q

MI contacts are in this material for Metal-Lingual/ occlusal PFM:

A

metal

57
Q

Which surfaces are covered in ceramic w Porcelain-Lingual/ occlusal PFM?

A

facial, incisal, lingual

58
Q

MI contacts are in this material for porcelain-Lingual/ occlusal PFM?

A

porcelain

59
Q

Disadvantage of Porcelain-Lingual/ occlusal PFM?

A

more reduction

60
Q

In which material are proximal contact typically placed?

A

in porcelain, esthetics, easier to clean

metal is a more conservative prep, but non-esthetic

61
Q

Proximal contacts must be this far from Metal-Porcelain junction:

A

1.5mm

62
Q

Adv of porcelain contact for Metal Ceramic Restoration:

A

easier to clean, if contact isn’t heavy enough you can add porcelain

63
Q

Incisal thickness must not exceed:

A

2mm

64
Q

Requirements of framework design for PFM:

A

no unsupported porcelain, proper metal contour

65
Q

*** Does this mean that if you over reduce we must add metal and porcelain in the same proportions so as not to decrease fracture resistance?

A

check

66
Q

***** Slides say that a pontic “usually fills the space previously occupied by the clinical crown” When would it not?

A

ask, check

67
Q

prep and design of abutment teeth for a PFD follow what design?

A

the same design as single crown restorations

68
Q

Ideal characteristics of tissue in space that will be taken by pontic:

A

smooth, regular, attached

69
Q

Class I Siebert Residual Ridge Classification:

A

dec ridge width, normal ridge height (hard and soft tissue)

70
Q

Class II Siebert Residual Ridge Classification:

A

loss of ridge height, normal ridge width

71
Q

Class III Siebert Residual Ridge Classification:

A

loss in both dimensions

72
Q

if a pt comes in with a high smile line, which Siebert Residual Ridge Classification is easiest to correct the problem?

A

Class I (bc pt will continue to lose ht?)

73
Q

Purpose of interim:

A

diagnose, assess tx plan chosen, can show pt what you are going for

74
Q

FDP pontic, mucosal contact:

A

Ridge lap, modified ridge lap, ovate, conical

75
Q

FDP pontic, no mucosal contact:

A

sanitary or modified sanitary (both hygienic)

76
Q

2 types of pontics:

A

contact residual ridge or not

77
Q

How to choose between the 4 types for mucosal contacts for FDP:

A

Bone loss

78
Q

anterior, loss of width, want to treat pt, replace width by portion that wraps around, choose:

A

modified ridge lap

79
Q

must have this for the ovate pontic to be an option

A

good amount of width

80
Q

If patient comes w Class III bone loss, is there a way you can hide the length of the tooth?

A

Yes, 1. Replace tissue w pink porcelain 2. change line angle, create illusion 3. surgical intervention (non-prosthetic)

81
Q

Saddle-ridge lap, recommended or not?

A

not

82
Q

Recommendation location for sanitary/hygienic:

A

posterior mandible

83
Q

Recommendation location for conical:

A

Molars w/o esthetic requirement

84
Q

Recommendation location for modified ridge la[p:

A

High esthetic requirements (ant, premolars, some max molars)

85
Q

Recommendation location for ovate:

A

very high esthetic requirements, max incisors, canines, and premolars

86
Q

Material options for conical PFD:

A

metal-ceramic, all-resin, all-metal (no all ceramic)

87
Q

Material options for modified ridge lap & ovate

A

metal-ceramic, all-resin, all ceramic (no all metal)

88
Q

ovate portion of FDP pontic has to go

A

2-3mm apical to margin of extraction site

89
Q

How to preserve gingival architecture at time of tooth removal:

A

Immediate resto and perio intervention, PFD pontic 2.5mm apical to facial free gingival margin

90
Q

Biological considerations regarding pontic:

A

cleansable tissue surface, access to abutment teeth, no pressure on ridge, pontic material, occlusal forces

91
Q

Most biocompatible pontic material:

A

glazed porcelain

92
Q

FDP mechanical considerations:

A

RIGID resist deformation, STRONG, prevent fracture, metal-ceramic framework, RESIST porcelain FRACTURE

93
Q

Differences bw rigid and non-rigid connectors:

A

rigid: can’t separate from one and other, non-rigid - key/ lock, usually graduate level

94
Q

3 types of rigid connectors for FDP’a

A

Cast, Soldered/Welded, Loop

95
Q

Aspects of the FDP connector that influence success of the prosthesis:

A

size, shape, and position

96
Q

Why connectors shouldn’t be too large or small:

A

impedes cleaning / may be visible, more prone to fracture

97
Q

Type of failure that will occur if connector is too large incisal/ cervically

A

periodontal failure

98
Q

May lead to the visibility of the connector:

A

too large, inappropriate shaping

99
Q

A properly shaped connector has a configuraion similar to:

A

a meniscus formed bw the 2 parts of the prosthesis

100
Q

Tissue surface of connector:

A

highly polished, curved F-L to facilitate cleansing

101
Q

Shape of connector M-D:

A

shaped to create a smooth transition from one partial FDP component to the other

102
Q

Shape of most connectors in B-L cross-section:

A

elliptical, strongest if major axis parallels direction of force, usually not possible due to space constraints, usually must be perp

103
Q

Crown types, best to worst mechanical retention of pontic:

A

porcelain only on B, por on B/occlusal = por on B/cervical margin, then all porcelain except M/D contacts/cervical lingual area

104
Q

An esthetic pontic should appear to:

A

emerge out of edentulous ridge

105
Q

Connector is always placed more towards the (B/L):

A

L

106
Q

Strongest connector is in this direction in relation to force:

A

major axis of ellipse parallels direction of force

107
Q

Space occupied by connectors:

A

normal anatomic interproximal contacts, ant more toward lingual embrasure for esthetics

108
Q

Limiting factors in design of non-rigid connectors:

A

pulp size and clinical crown height

109
Q

Most prefab patterns for connectors require:

A

the prep of a fairly large box to allow incorporation of mortise in the cast resto wo overcontouring interproximal emergence profile,

110
Q

Recommended vertical ht of clinical crown to ensure adequate strength of FDP:

A

3-4mm

111
Q

Indications for loop connectors:

A

to keep a diastoma

112
Q

Disadv of loop connector:

A

poor plaque control, lower strength

113
Q

Indications for non-rigid connector:

A

Intermediate (pier) abutment, no common POIt, complex man FDP’s

114
Q

Another name for intermediate abutment:

A

pier abutment

115
Q

how to deal w very M tilted abutment tooth when fabricating FDP:

A

non-rigid connector w crown on M tilted tooth: can’t correct tilt by having rigid abutment, don’t have a good POI, prefer to have a

116
Q

How are forces on teeth affected by a non-rigid connector?

A

They control amt of force applied to abutment

117
Q

Parts of non-rigid connector:

A

mortise (female, matrix), tenon (male, patrix)

118
Q

Patrix is w/in:

A

the contours of the retainer

119
Q

Patrix is attached to:

A

pontic, fits into matrix

120
Q

Limiting factors for non-rigid connectors:

A

edentulous span, pulp size (need receded pulp, can’t do on younger pts), crown ht: 3-4mm O-G ht recommended

121
Q

The less convergence of the prepped teeth for a FDP the:

A

greater the retention

122
Q

Retention def:

A

removal along POI or long axis

123
Q

Essential element of retention:

A

2 opposing vertical surfaces of the same prep

124
Q

Resistance def:

A

forces directed in apical or oblique direction

125
Q

TF? The addition of grooves or boxes to a prep w a limited POI greatly increases its retention.

A

F. bc the sa is not increased sig

126
Q

Boxes are good for increasing:

A

resistance form bc they interfere w rotational movement (tipping) of crown

127
Q

To increase retention/ resistance if we tapered too much:

A

buccal groove or other internal features

128
Q

Teeth that can often benefit from grooves and/or boxes:

A

M tipped molars, short premolars

129
Q

To inc retention/ resistance of an over reduced premolar”

A

grooves or boxes (are all grooves placed on B? if so, why?)

130
Q

List all pt positionings:

A

12: max occlusal, 10-11: pt facing you, 9: pt facing away from you, 8-9: man ant

indirect restoration (54 decks)

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