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Fixed Prosth 3rd year > zweig - digital > Flashcards

zweig - digital Flashcards

1
Q

broad - what is digital dentistry

A 
electronic recors 
photos
radiographs 
patent communication software
digital impressions
computer aided milling
music in office
telephone systems

software
x-rays

goes on to say everything

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2
Q

can someone tell me what a CEREC crown is?

A

basically doing ___ material crown with cad cam technology

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3
Q

procedural steps needed to complete a traditional fixed restoration

A

1-10

  1. decide material
  2. anesthetize
  3. prepa
    ration of tooth to meet requirements of material
  4. isolation
  5. retraction
  6. elastomeric impression
  7. temporaization
  8. send to lab
  9. 2nd visit to try in and adjust
  10. cement
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4
Q

procedural steps needed to complete a CAD/CAM fixed restoration?

A
  1. choose material
  2. anesthetize
  3. prepare tooth
  4. isolation
  5. retract
  6. digital scan of quadrant with the prepped tooth, the opposing quadrant
    . and the bite relationship
  7. mill f the restoration
  8. try in and adjust occlusion
  9. bond the restoration
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5
Q

digital scan of what with CAD/CAM fixed restoration

A

scan of the quadrant with the prepped tooth

the opposing quadrant

and of the bite relationship

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6
Q

the ‘only’ differences are

A

different prep design

digital scanning/ no elastomeric impression

ability to control the design of your restoration

in office milling - no lab fees

can be delivered in a single visit which would mean no temporizaton

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7
Q

materials available in school

A
  1. vita mark II
  2. enamic
  3. IPS e.max CAD
  4. celtra duo
  5. zirconia
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8
Q

flexural strength, indications, post milling processing, and appointment time for vita mark II

A

flexural strength, indications, post milling processing, and appointment time for

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9
Q

emax needs to be

A

glazed and fired all the time

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10
Q

flexural strength, indications, post milling processing, and appointment time for enamic

A

flexural strength
- 112.4 MPA
indications, post milling processing, and appointment time for

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11
Q

why using the material we are

A

EXPOSURE -

using a wide variety of material - more clinical experience and knowledge of the materials avaialble

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12
Q

flexural strength, indications, post milling processing, and appointment time for IPS e.max CAD

A

flexural strength, indications, post milling processing, and appointment time for

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13
Q

flexural strength, indications, post milling processing, and appointment time for celtra duo

A

flexural strength, indications, post milling processing, and appointment time for

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14
Q

flexural strength, indications, post milling processing, and appointment time for zirconia

A

flexural strength, indications, post milling processing, and appointment time

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15
Q

which materials do not require a sintering cycle in the oven? implication?

A

Enamic, vita mark II and celtra duo

cuts down on post-milling processing time in one visit restorative appointment

*also one of the reasons
at school why we use these

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16
Q

types of cerec optical scanner

A

blue cam

omni cam

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17
Q

blue cam

A

individual pictures that are stitched together
requires optical powder on tooth surface

most pictures taken in long axis of tooth only

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18
Q

omni cam

A

VIDEO - NO POWDER

- must capture all tooth and soft tissue data

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19
Q

sirona cerec details

A

the system we use in school

30+ years of CAD/CAM

integration of CBCT

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20
Q

optimal conditions for digital scanning

A
  1. ACCESS
  2. GINGIVAL HEALTH
  3. ability to completely isolate the area to be scanned especially if using BLUECAM
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21
Q

lute which materials

A

zirconia and emax

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22
Q

implication of location of the margin? enamel locatino?

A

supra-gingival

ideal for scanning
- but more related to bonding

enamel present on all margins – makes digital scanning more ideal condition
- but again it is more related to BONDING

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23
Q

implication of location of the margin? enamel locatino?

A

supra-gingival

ideal for scanning
- but more related to bonding

enamel present on all margins – makes digital scanning more ideal condition
- but again it is more related to BONDING

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24
Q

access with regard to optimal condition for digital scanning

A

access– the patient needs to be able to open wide enough to insert the camera in the correct position and the operator needs adequate access in order to accomplish a prep that can be scanned and milled

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25
Q

gingival health with regard to optimal condition for digital scanning

A

required for all types of fixed restorations

  • if using blue cam- we need to use reflective powder, any bleeding from the gingiva will prevent us from powdering properly
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26
Q

have patient clench during a buccal bite registration

A

NO

- just bring the teeth together

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27
Q

have patient clench during a buccal bite registration

A

NO

- just bring the teeth together

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28
Q

isolation implication

A

CRITICAL FOR BOTH CAMERAS

- teeth must be kept dry during the scanning process, with or without the powder

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29
Q

reflection of the saliva?

A

bad - will cause the omnicam to stop taking pictures

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30
Q

if powder gets wet?

A

isolation problem - images will look like they are covered with ‘mud’

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31
Q

scan looks like covered in mud

A

isolation problem

- likely due to saliva / moisture getting the powder wet

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32
Q

scan looks like covered in mud

A

isolation problem

- likely due to saliva / moisture getting the powder wet

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33
Q

soft tissue managemnt

  • WAYS MENTIONED WE USE
A

MANDATORY

  1. scalpel
  2. electrosurgery– PACKING CORD
  3. laser
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34
Q

linear scanning

A

recommended techniuque

if well isolated
should NOT take long

do this then if see black areas then go back to those areas only to fill them in

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35
Q

scalpel for soft tissue management

A

cost efficient but poor hemorrhage control and visibility

second appt. often required

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36
Q

double cord technique

A

place 0 or double 00 treated cord

cut cord so do not have any cord hanging out of the sulcus

second cord is next size up – and leave a tag of cord out

when ready to impress- remove top cord and be sure that the first cord did not pull out

you NEED to be able to see the WHOLE margin without cord adjacent to the margin

37
Q

bur size in CAD/CAM

A

1-1.5

so if angle less than 1mm – bur does NOT cut it - cannot fit – will over mill it - meaning thinner restoration

38
Q

software will over mill where but not where

A

over mill irregularities less than 1 mm on axial walls and occlusa lsurface

but will NOT compensate for irregularities all along the margins

39
Q

over mill on margins?

A

NO

s- so margin needs to be perfect and crisp and totally smooth

40
Q

Requirement for cad cam prep - general

A

ROUNDED
no irregulariteis and spikes

slightly more tappered

  1. no sharp axial - occlusal angles
  2. smooth surfaces
  3. preserve as much enamel at margins as possible
  4. VERY smooth margins
41
Q

single important thing for great dentistry?

A

INEGRITY of the dentist

in terms of procedure – prep is most important

42
Q

foundation for well fitting durable restoratino

A

PREPARATION

  • spend time required
  • use vision magnification to evaluate the prep prior to final optical impression
43
Q

implction of saving more enamel / minimal prep

A

bonding!!! - better bonding to enamel

44
Q

margin type

A

shoulder or deep shammfer

45
Q

minimum occlusal reduction

A

2mm

46
Q

depth of margin design

A

1mm

47
Q

taper on cerec

A

6-8 is ideal

48
Q

exit angles for inlays and onlays

A

90 degree

49
Q

proximal box shape

A
  1. rounded smooth box shape; avoid sharp corners
  2. walls should taper 6-8 degrees
  3. avoid undercuts in walls
  4. smooth floor- rough areas may inhibit seating
  5. avoid sharp internal angles
50
Q

spike on margin?

A

will not cut / compensate and crown WILL NOT SEAT

51
Q

onlays crown in cerec design

A

1 . desire 2-2.5 mm reduction over functional cusps and central fissure

  1. at least 2 mm over non funcitnal
  2. desire bulk of ceramic at the margin
  3. avoid sharp internal angle- keep walls smoth
52
Q

proximal box starting point

A

line angles
outside - in design

CENTRAL GROOVE

53
Q

largest cause of ceramic failure

A

UNDER REDUCTION

must have a minimum of 1.5 of PORCELAIN

if unable to reduce 2mm occlusally, another material must be chosen

note PFM’s require at least 1.5mm reduction for success

54
Q

if unable to reduce 2mm occlusally?

A

CHOOSE ANOTHER MATERIAL

55
Q

EMAX full coverage on posterior reduction?
at occlusal
axial
at margin

A

occlusal = 1.5 - 2mm

axial = 1.5mm

at margin = 1 mm

rounded internal line angles

flat ended tapered diamond bur is utilized to establish a butt joint margin

56
Q

minimal ceramic thickness for crowns inlay/onlays

A

occlusal = 2 mm

axial = 1-1.5 mm

at margin = .8mm – will approach 1 towards axial wall

57
Q

how do we get the best initial proposal?

A
  1. great preps
58
Q

model axis

A

set model in the proper place in the horseshoe

  • molars in the dots
  • premolars in the stripes

SET MIDLINE

SET BOTH OCCLUSAL PLANES AS FLAT AS POSSIBLE

Setting this accuratley
Most important part of what kind of proposal we get initially

59
Q

is model axis path of insertin?

A

NO –

60
Q

T/F can use tools after design has been proposed

A

true

61
Q

anatomical tool

A

two directional
will move 1/3 of the restoration, keeping the anatomy, in the direction the arrow is pointed

multiple areas can be chosen

62
Q

circular tool

A

will move area of chosen size, as picked on the size wheel
does NOT MAINTAIN anatomy and will just move selected area

said one he uses the most

63
Q

setting crown color contacts

A

blue - we want this

64
Q

design tips

A

1-7

65
Q

turn on or off the minimal thickness icon

A

TURN ON – first point on the design tips

66
Q

least ‘important’ step in the CAD/CAM process

most important?

A

DESIGN = least

most = prep and acquisition

67
Q

re-calculate button

A

will bring you back to starting proposal

68
Q

polishing and glazing with

be sure?

A

ENAMIC can ONLY BE HAND POLISHED

be sure
- all adjustments have been made
- hand polished using porcelain polishing kit
use all three grits
be very careful that you DO NOT remove proximal contacts

finish with diamond polishing paste on a bristle brush

place enamic glaze if available and light cure

69
Q

enamic can be only

A

polished

cannot be fired

70
Q

mark II at the end

A

can be hand polished or fired in oven

if needd to add stain then it has to be fired

hand polishing done same as enamic – but no enamic glaze

71
Q

most natural look

A

hand polished porcelain

72
Q

occlusal adjustment with marrk II

A

HAS TO BE BONDED FIRST THEN OCCLUSAL ADJUSTMENT

73
Q

emax at end

A

has to be fired

must be fired in oven in order to convert / crystallize block to go to lithium dislicate

MUST BE fired in oven to glaze and stain

74
Q

celtra duo at end

A

gains more strength is fire it

but can be hand polished as well

75
Q

luting requires a

A

retentive prep and intimate fit of crown to prep

76
Q

concepts for cementation

A

we are BONDING all milled restorations

we are using a dual cure resin cement

we need to bonf the restoration to the cement

we need to bond the tooth to the resin cement

therefore – we need to treat BOTH the intaglio of the restoration and the tooth surface

77
Q

we are ____ all milled restorations

A

BONDING

78
Q

what do we lute

A

PFM’s and zirconia

all else we are bonding?

79
Q

etching of milled restorations for Enamic

A

60 seconds etch with 5% HF

30 seconds wih 9.6 % HF

80
Q

etching of milled restorations for mark II blocks

A

(which is feldspathic porcelain)

30 seconds with 9.6% HF

81
Q

etching of milled restorations for emax

A

20 seconds with 5% HF

10-15 seconds with 9.6% HF

82
Q

etching of milled restorations for celtra duo

A

30 seconds with 5% HF

20 seconds with 9.6% HF

almost same as emax except 5 seconds longer with HF

83
Q

multi-link instruction he highlighted

A

NOT HF

using PHOSPHORIC ACID

84
Q

typical spacing of cement

A

100 micron space

85
Q

complete kit of multi-link cement

A

ivoclean

monobond

self etching primer bottles A and B

multi-link cement in auto mix syringe

86
Q

have patient bite on bonded restoration

A

NO

apply pressure until the end

87
Q

ivoclean use

A

part of the multi-link kit

clean restoration with this if it has been previously etched

88
Q

etch restoration with multi-link when

A

when it HAS NOT BEEN PREVIOUSLY ETCHED

89
Q

use of monobond

A

aply this to the INTAGLIO of the restoration for 1 minute – then air dry

Fixed Prosth 3rd year (17 decks)

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