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Fixed Pros II > Lecture 7 - Wax up Provisional and Lab Communication > Flashcards

Lecture 7 - Wax up Provisional and Lab Communication Flashcards

1
Q

what are the elements used as part of a diagnostic wax up

A
  • a full health history
  • intra oral exam
  • diagnostic casts mounted
  • occlusal evaluation
  • esthetic evaluation
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2
Q

what is the sequence in the diagnostic wax up

A
  • diagnostic waxing
  • interim restoration
  • patient feedback: soft tissue management
  • cast of interim- clinical photographs
  • predictable definitive restoration
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3
Q

what are the steps in the diagnostic waxing

A

1- initial diagnostic casts are made. discussion with patient about restorative and esthetic goals
2- diagnostic wax up includes: pontic shape, size, contour and relation to the ridge. incorporate any changes to the current esthetics and function
3- the wax up can be used with a putty matrix to make a temporary which incorporates these desired changes
4- tooth preparation and temporization
5- patient returns with temporaries in place and provides feedback on the shape, length and esthetics and function. any changes to the temporary desired made at this time
6- a new impression is made of the temporaries to provide to the lab. photographs of the temporaries with measurements are provided for the lab
7- FPD created from a final impression and using the models of temporaries. definitive prosthesis is tried in and seated
8- final evaluation after patient has had prosthesis for a period of time

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4
Q

wax is used to:

A

create intended restorative contours on casts for the purpose of evaluation and planning the restorations

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5
Q

what is the definition of a provisional

A

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

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6
Q

a provisional is used to assist in:

A

determination of the effectiveness of a specific treatment plans from and function

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7
Q

what can be used to assess reduction

A
  • vacuum matrix
  • putty matrices
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8
Q

when significant change is occurring are depth cuts beneficial

A

no

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9
Q

what can be evaluated on the diagnostic casts

A
  • can mount using facebow
  • custon incisal guide table records gathered incisal length and guidance requireemnts
  • mounted diagnostic wax up used with same mandibular to measure the length of the incisal edges and protrusive movements while also improving canine guidance and tooth contour
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10
Q

what is used for the impression of the diagnostic wax up

A

alginate

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11
Q

a vacuum matrix is made on______ of wax up

A

stone cast

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12
Q

patient will check ______ in the temporaries

A

smile, speech and occlusion

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13
Q

if provisionals are modified what happens?

A

a new impression of temps should be taken to mount for the case when sent to the lab

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14
Q

definitive crowns will incorporate the adjustments made and:

A

the input of family and friends

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15
Q

bite registration can be used to assess:

A
  • incisal guidance, length and angulation
  • establish the occlusal plane
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16
Q

cases are mounted in:

A

MI

17
Q

what can cause gingival inflammation from the provisionals

A
  • lack of patient ability to clean
  • ill fitting restorations with poor marginal adaptation that allow more bacteria to impact the tissue
  • if restorations are over contoured
18
Q

when is a final impression taken when there is gingival inflammation

A

after the inflammation has resolved

19
Q

what is an ovate pontic used for

A

the develop extraction site into excellent esthetic case during healing

20
Q

how long does ovate pontic site development take

A

weeks to months

21
Q

when are temporary bridges places in relation to crown lengthening surgery and why

A

right after crown lengthening surgery to allow for healing and patient cleaning

22
Q

what is the purpose of the provisional restoration

A
  • to verify adequate preparations
  • to determine if planned restoration will satisfy the functional, esthetic and phonetic requirements of the patient
  • to determine the response of the gingival tissues to the planned restoration
  • to facilitate transition during therapy: ortho, restorative and periodontal
23
Q

what are the challenges to provisional restorations

A
  • time is needed to make an adequate temporary
  • time the material is in the mouth is limited
  • provisional materials have limitations
24
Q

what are the disadvantages and advantages of PMMA

A
  • D: high exothermia, toxic monomer, high volumetric shrinkage (8%), low abrasion resistance
  • A: good marginal fit, not brittle, polishes well, durable, inexpensive
25
Q

what are the advantages and disadvantages of bis acryl

A

-D: difficult to polish, loses polish over time, more brittle, challenging to repair or reline, more expensive
-A: less shrinkage, low exothermia, no toxic odor, automix delivery, easy to trim and shape, radio opaque
- more biocompatible

26
Q

what are the lab processed materials used to make provisional restorations

A
  • heat cured PMMA: creates stronger temp material
  • lab processed PMMA: bio temps from glidewell lab
  • CAD-CAM
27
Q

how are eggshells made

A
  • vacuum matrix is made from wax up on duplicate case, minimal preparations done on duplicate cast, no preps started on patient yet
  • based on wax up lab fabricates temporary to fit the minimal preps done, no preps started on patient yet
  • prepare patients teeth to the ideal preps based on intra oral conditions
  • eggshell is relined with material, trimmed, polished and cemented in the patient
28
Q

what makes the eggshell fit over the patients prepped teeth

A

-because the preps are more reduced than the minimal preps done on the cast

29
Q

the eggshell must fit _____ and _____ over prepared teeth to allow for:

A

loosely and completely; room to reline the temporary with resin

30
Q

what is the advantage of eggshells

A
  • reduced chairside time
  • better esthetics, fit and polish
31
Q

what is the disadvantage of eggshells

A

cost

32
Q

how is CAD/CAM used to make provisionals

A
  • teeth are prepared and impression or scan sent to lab with the wax up
  • scan is made of wax up and tooth preps
  • temporary is milled and polished
33
Q

what is the downside of CAD/CAM provisional

A

cost of large enough block to create eggshell
- time to fire or glaze and stain and polish

34
Q

what needs to be sent to the lab to create a provisional

A
  • shade of desired restorations
  • stump shade
  • final impression
  • cast of provisional restorations that stimulate what you want to achieve
  • articulated casts
  • incisal guide table for anterior cases
35
Q

when is the stump shade really important

A

in anterior cases so they lab can blend emax or veneer better

Fixed Pros II (13 decks)

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