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DMD3 > Try in > Flashcards

Try in Flashcards

1
Q

What are the features of the ideal crown?

A

Easily seated

Stable

Accurate occlusal contact

Adequate proximal contacts

Accurate marginal fit (for longevity of restoration)

Aesthetic

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2
Q

What should be checked during the try in?

A

Seating

Fitting

Contact points

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3
Q

How is the tooth assessed systematically?

A

1) Evaluation of the crown on the die
2) Seating the crown on the prepared tooth
3) Assessment of the seated crown

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4
Q

What are the aims of evaluation of the crown on the die?

A

Detection of fabrication errors (laboratory related)
prior to the clinical appointment

Save critical chair time

Anticipation of problems before clinical appointment

Consider good lighting and magnification

In case of problem, consult with the dental laboratory

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5
Q

What issues can arise when evaluating the crown on the die?

A

Poor pouring

Overtrimming

Fracture

Scratches

Wear

Casting problems: air bubbles

Casting nodules or blebs

Ideally, the casting should touch the die at the margins only

Overall fit could potentially be loose and can have an excessive gap.

Marginal fit can be poor with open margins, overhangs or underextensions.

Occlusion (Centric contacts, eccentric contacts and interferences)

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6
Q

What features should be checked when evaluating the crown on the die?

A

Internal surface

External surface

Overall fit and resistance

Marginal fit

Occlusion

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7
Q

How should the crown be seated ideally?

A

Crown should seat on the prepared tooth without forcing it.

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8
Q

What can cause the crown not to sit properly?

A

Proximal contacts

Internal fit

Inaccurate margins / over extensions

Retained temporary cements

Trapped gingival tissue.

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9
Q

What can cause FPD to not sit properly?

A

Same as for single crown

Tissue contacts under pontics

Location and shape of connectors could produce another issue.

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10
Q

What kind of forces should be applied when removing a crown?

A

Only apply vertical forces when removing the crown do not use torsion movements as this can break the crown or the tooth structure.

If crown doesn’t come off easily, it is a good idea to section the crown.

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11
Q

What tools can be used for removal of a crown?

A

Excavator, sickle probe

Hemostat, backhaus forceps, and pliers

Crown remover: Back-action remover, automatic crown remover, and Richwill crown remover

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12
Q

How are proximal contacts checked when seating the crown?

A

Assess tightness with dental floss

Articulating paper, marking liquid, or spays can be used to determine contact points.

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13
Q

How should the crown feel when being seated on the tooth?

A

There should be some tightness with the dental floss but not too difficult.

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14
Q

What kind of contact point do we need in anterior and posterior teeth?

A

Anterior teeth need a small contact point. Posterior teeth need a larger contact area

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15
Q

How should the crown fit onto the tooth?

A

The restoration should seat completely without interference of the occlusal or axial surfaces

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16
Q

How can the internal fit be identified and fixed?

A

Using a disclosing medium or aerosol indicator. Then can be fixed with a diamond bur.

17
Q

What mistakes with impression taking can cause problems with the internal fit?

A

Early impression removal

Distortion of the impression

Latex contamination

Incorrect mixing tip

IF THIS HAPPENS USE A NEW IMPRESSION

18
Q

What are the features of poor marginal adaptation?

A

Overextension

Underextension

Overhanging

Open margin

19
Q

What are the potential effects of poor marginal fit?

A

Sensitivity (exposed dentin)

Dissolution of cement leading to plaque retention and caries as well as gingival inflammation

20
Q

What leads to poor marginal fit?

A

Can be due to inability to read the finish line by the technician.

21
Q

What should be done if the margin has overhangs/overextension, underextension, or gaps?

A

Can be adjusted

Underextension and Gap require remake

22
Q

What is checked when the seated crown is assessed?

A

Stability

Contour

Occlusion

Aesthetics

Confirming the crown is suitable for cementation

23
Q

How is the stability of a crown assessed?

A

Restoration should not rotate when the force is applied.

Instability causes failure in function.

24
Q

What causes internal surface misfit?

A

Disruption in impression or fabrication process

25
Q

Why should the crown’s contour be adequate?

A

Improper contour may impair gingival health and affects the natural appearance

They must be adjusted before cementation

26
Q

When should occlusal adjustments be done to the seated crown?

A

Crown should be fully seated

Major adjustments should be done prior to cementation

Minor adjustments can be completed after cementation

27
Q

What causes inadequate occlusal contacts?

A

Poor occlusal recording

Poor articulation

28
Q

What is a shim stock used for?

A

The shim stock will determine if an occlusal
contact is present

Assess the occlusion on all teeth with and
without the prosthesis

Assess the occlusion on the crown

29
Q

How is articulating paper used for occlusion assessment?

A

Mark heavy contacts or interferences in
centric and eccentric

Articulating paper will locate the contact area

Use different colors for different movements

30
Q

How should occlusion be adjusted if there is a premature contact in centric?

A

Adjust grooves or cusp
inclines

Never the tip of cusp

31
Q

How should occlusion be adjusted if there are interferences in eccentric movements?

A

Adjust cusp inclines

Tip of cusps if necessary

32
Q

How can the thickness of the prosthesis be measured?

A

Using a thickness gauge (Svensen gauge) to know how much you can adjust of the crown.

33
Q

What is the aim of occlusal distribution?

A

Completed adjustment

Well distributed occlusal contacts

Posterior teeth: the prosthesis and the remaining dentition should have the same occlusal contact and hold shim stock

Anterior teeth: the prosthesis should lightly hold the shim stock if other anterior teeth do

34
Q

How are the aesthetics of the crown assessed?

A

Patient approval should be obtained prior to
cementation

Shade and morphology
- Lighter shade: can be stained and glazed
- Darker shade: should be cut back and followed
by new ceramic application

Modify the morphology with diamond burs and
soflex discs
- Send back for glazing

Consider temporary cementation

35
Q

How is the crown finished?

A

Metal: rubber polishing wheels and points

Ceramic: Rough ceramic will wear the opposing teeth:

Composite finishing rubber burs should be used to smoothen it

  • Rubber cup and diamond polishing paste
  • Or send to laboratory for reglazing

DMD3 (53 decks)

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