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Back to last lecture, the last few slides I did not talk about
them, last lecture we talk about preservation
Of tooth structure, resistance and retention and structural
durability.
{Please refer to lecture slides}
Today, we will talk about marginal integrity and there will
be separate lecture for the last principle (preservation of
periodontium).
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its own inaccuracies ( يعني كل وحدة عندهاinaccuracy )تبعها
eventually, your restoration won’t seat perfectly in your
preparation. This imperfection in your work will express
itself as space between the restoration and the tooth
structure, which is called (D) and this (D) : is the vertical
discrepancy between the preparation seat and the
restoration margin , this D isn’t the closest distance
between the preparation and nearest point of restoration
) يعني هاي مش اقرب نقطة بينtooth structure and restoration )
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to zero like in picture (b) then D = d because m=0 so Sin
(0) = 1
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This vent is better in flatter preparation because when you
have flat prereration, the cement will be easier to flush out
than if you have sharp preparation.
If you lute restoration on C imagine distance of escape that
the cement will go out, this exit area is more horizontal and
big.
There are other factors later on; we will talk about them
and this which tells you what to choose. Other than fitting
of restoration .now, when you prepare your tooth, you end
up with finish line and this finish line is the area where the
restoration meets the tooth structure .
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If you look to a the white material is porcelain, the gray one
is metal.
We have 5-6 finish lines:-
1. knife edge (d in the picture) :-
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Easy to pick it up in your impression.
SO if you have full metal crown restoration your finish line
should be chamfer by default.
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Cross section must be flat otherwise porcelain will
break.
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PORCELAIN we cant make it at any finish line you need
flat top to seat at it , if its not flat top porcelain cant seat, its
become stress point, stress point will fracture this is applied
into two things :-
1- Finish line must be flat.
2- Internal angle should be rounded.
In porcelain we can do radial shoulder, conventional
shoulder, heavy chamfer (we can use it in metal ceramic
crowns as well) which is close to radial shoulder.
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Doctor doesn’t want to use the way of shillingburg,
shillingburg talk about finish line in complex way.
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BEVELIED SHOULDER:-it is standard shoulder with 45
ْbevel like what we make in composite we use it
somewhere(not important we don’t make them) ,its
problem like deep chamfer there is metal band beneath it
,so not accepted aesthetically.
Background: FVCs
• They have a high success rate and the reason because
they are surrounding the whole tooth structure, when
we talked about treatment planning when I make
plastic restoration or inlays or onlays or extracoronal
(crown) we choose according to tooth structure. Now
FVCs is surrounding the whole tooth structure then the
success rate definitely is higher than the rest.
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Second thing if someone calculates the finish line
mesiodistal, buccolingul then finish line distance less
than I make MOD onlay.
Finish line shorter ,the shorter the finish line the
less the chance of complication.
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• Heavily restored teeth.
• Primary trauma.
• Tooth wear.
• Hypoplastic condition.
• To alter shape, size, or tooth inclination.
• To alter occlusion.
• Appearance.
• Non vital teeth.
• Combined and others.
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{ last lecture please read it carefully}
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A.Aesthetics very important because you have
ceramics.
B.We use metal for strength.
If you use full ceramic you will scarify more tooth
structure.
Full metal crown the least preparation you need, the most
conservative one.
metal-ceramic crown a little bit more destructive than full
metal crowns ,it become more destructive in the area where
you need ceramic over metal ,if you have central incisor
you place your porcelain labially , in the incisal edge, and
slightly go into interproximal area all these areas need
shoulder, heavy chamfer ,or any modification could carry
porcelain .
The preparation usually about 1.2 mm then we start rising
up our destruction.
0.5-0.7 mm for metal. 1.2 For metal-ceramic crowns.
Advantages of MCCs:-
Strength because of metal.
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Durability because of metal.
Used as retainers (because its full coverage, it covered
with metal) for anterior (because of porcelain) and
posterior FPD.
Cheaper than all ceramic restoration. More expensive
than full metal crowns, cheaper than all ceramic
crowns, more cosmetic than FMCs.
Disadvantages of MCCs:-
• Destructive compare to FMCs (in porcelain areas
to avoid overcontouring).
• Less satisfactory in aesthetic point of view than
all ceramic crowns.
• Subgingival margin anteriorly.
What ever the skills you have, finish line when you
have metal and ceramic the porcelain wont reflect
light probably as porcelain by itself, porcelain is
glass ,if you put glass and put behind it curtain
black it wont reflect light as if glass by itself (matt
glass ) عملته حتى لو
Porcelain while metal behind it won’t reflect light
probably, so it won’t match the aesthetic perfectly.
The most obvious area you can see this is the margin
(cavosurface angle where crown meet tooth structure,
porcelain wont reflect light well) so it gives artificial look.
To overcome this problem we need to place our margin
subgingivally.
We need subgingival finish line in metal-ceramic crown
although we have porcelain top on the metal.
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We don’t need that at all ceramic crown.
Contraindication:-
a) Active caries: we don’t place fixed prosthesis in active
carious tooth.
b) Untreated periodontal diseases.
c) Highly aesthetic demand.
The first two contradictions applicable for all FVCs.
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Mechanical interlocking.
Van der waals forces: initial bonds.
Compressive forces: due to difference in the
coefficient of thermal expansion.
Chemical bonding: oxide layer, the most important.
Now, the most important is the Chemical bond, the bond
between metal and porcelain occur by something called
oxide layer, this oxide layer incorporate from the porcelain
and from the metal this is important, this is very strong
bond.
You can imagine if you try to fracture metal ceramic
crown, the porcelain will fracture at the middle before the
bond broken between metal and porcelain, in other word in
metal ceramic bonding the Chemical bonding is stronger
than the cohesive bond.
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thermal expansion of ceramic and metal and that could be
adjusted for METAL usually we use BASE METAL
ALLOYS.
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So it is combination between metal and porcelain, the metal
covers all around the preparation, but the porcelain covers
the metal substructure in the visible areas.
(When you make MCCs, all the preparation will be covered
by metal, but esthetic or visible areas will be covered by
porcelain).
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As you go posteriorly, the contact area will be more
lingually, that’s why you need to cross (pass) the contact
area anteriorly; while in posterior teeth, you don’t cross
contact point 1mm, but you have to stop; because it is
already away lingually.
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(roughly 0.5 mm for metal and 0.7mm for porcelain) ,so
the total 1.2mm , incisal reduction roughly 1.5 mm or
more about 2mm .
- Lingually less 0.5 – 0.7mm, the area of 1mm, you
will take details about it in (labs), this area is called
centric stop.
( بعض عليها فبنزيدها اكثر, ) لما المريض بعض
• The left hand sided, the top one is the labial side is
prepared by shoulder bur, so you have 1.2mm
reduction with flat finish line (shoulder finish line).
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Back to structural durability, we talked about something
called offset which connects 2 structures together; do
you think this area strengthening point or weakening
point? Strengthening point; because it is the junction
between thick and thin, so this one is going to be strong,
stronger than lingual, but weaker than labial, but it is
strong point, it is a reinforcing struts (trusses)
) 2 grooves ( رح تعمل كأنو رابطين
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When we talked about tooth preparation, we focus that
we prepare teeth for 2 reasons, First, preservation; we
don’t need to cut unnecessarily. Second, we need
structural durability.
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justify why resin cement enhance the strength of your
porcelain .
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The last thing is porcelain laminate veneers (PLVs)
(Indications ( الدكتور حكى ما بدنا ندخل بالتفاصيل المهم تعرفوا
• A thin layer of porcelain used in the anterior region
to correct :(indications ):-
A-Colour.
B- Mild mal- alignment.
C- Small teeth.
D-Chipped or traumatized teeth.
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Dr. Saied that there is a range differs between one book to
another; there is no significant difference between them.
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If you have
you cool it d
The metal w
what is goin
means that
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