FIXED PARTIAL DENTURES.

(Crown & Bridges)

Click to edit Master subtitle style Definition.

The prosthesis which is cemented to the abutment and cannot be removed by the patient.

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FPDs
History

taking:

Collecting the information which are important in treatment planning and diagnosis of the disease.
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CHIEF COMPLAINT.
Chief complaint usually falls into one of the following four categories: a. Comfort( pain, sensitivity, swelling). b. Function(difficulty in mastication or speech) c. Social(bad taste or odor) d. Appearance( fractured or unattractive teeth or restorations, discoloration)

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EXAMINATION
It consists of clinical use of sight, touch, and hearing to detect conditions outside the normal range. It is critical to record what is actual observed rather than to make diagnostic comments about the condition. For example, swelling redness and bleeding on probing of gingival tissue should be recorded rather than gingival inflammation(which implies a diagnosis).

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EXAMINATION
General

Examination. Extra Oral Examination. a. TMJ b. Muscles of mastication c. Lips

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EXAMINATION
Intraoral

Examination: a. Periodontal information 1. Gingiva. 2. Periodontium. 3. Occlusal examination

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EXAMINATION

Radiographic

examination. (X-ray)
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DIAGNOSIS & PROGNOSIS

Approach

should be logical and systematic.

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DIFFERENTIAL DIAGNOSIS
After

completion of history and examination a differential diagnosis is made. A definitive diagnosis can usually be developed after such supporting evidence has been assembled.

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PROGNOSIS

Prognosis is an estimation of the likely course of a disease.

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PROGNOSIS
General

Factors a. Overall caries rate. b. Diabetes c. Bite force of the patient. d. others.

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PROGNOSIS
factors: a. Vertical overlap of the anterior teeth. b. Impaction adjacent to molar that will be crowned may pose a serious threat in a younger individual in whom additional growth can be anticipated but it may be of lesser concern in an older individual.
Local

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PROGNOSIS

c. Individual tooth mobility. d. Root angulation. e. Root morphology. f. Crown-root ratio. g. Others
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DIAGNOSTIC CAST.
Material

used Model making Articulation ( non-adjustable, semi-adjustable)

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TRETMENT PLAINING.
IDENTIFICATION

OF THE PATIENTS NEEDS. Successful treatment planning is based on proper identification of the patients needs Ideal treatment against the patient's needs is usually a failure.

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Ideal treatment against the patient's needs is usually a failure.

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TREATMENT PLANNING.
Correction

of Existing Disease. Prevention of Future Disease. Restoration of function. Improvement of Appearance.

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MATERIALS USED
All

existing restorative materials and techniques have limitations and cannot exactly match the properties of a natural tooth structure.

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SELECTION OF ABUTMENT TEETH.

Whenever

possible, FPDs should be design as simple as possible with a single well anchored retainer fixed rigidly at each end of the pontic. Teeth in which pulpal health is doubtful should be endodontic ally treated before the initiation fixed prosthodontics.

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SELECTION OF ABUTMENT
Unrestored

abutments: An unrestored caries free tooth is an ideal abutment. Mesially Tilted Second Molar: Overloading of the abutment teeth should be avoided.

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DIRECTION OF FORCES
The

occlusal forces should be directed along the long axis of the tooth. Root surface area. Antes law: Root surface area of the abutments supported by bone should be equal or more than the root surface area of the teeth which are being replaced.

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ROOT SURFACE AREA.

Nayman and Ericsson, however cast doubt on the validity of Antes law by demonstrating that teeth with considerably reduced bone support can be successfully used as fixed partial denture abutments.

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SEQUENCE OF TREATMENT
ORAL

SURGERY PERIODONTICS ENDODONTICS ORTHODONTICS FIXED PROSTHODONTICS REMOVABLE PROSTHODOTICS

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FOUNDATION RESTORATIONS
A foundation

restoration, or , core, is used to build a damaged tooth to ideal anatomic form before it is prepared for a crown.

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FOUNDATION RESTORATION
Materials used:
1. 2. 3. 4.

Dental Amalgam. Glass Ionomer. Composite Resin. Pin-retained cast metal core.

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PRINCIPLES OF TOOTH PREPARATION

1.

BIOLOGICAL CONSIDERATIONS. Affect the health of the oral tissues.

2.

MECANICAL CONSIDERATIONS. Affect the integrity and durability of the restoration. ESTHETIC CONSIDERATION. Affect the appearance of the patient.

3.

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BIOLOGICAL CONSIDERATIONS

PREVENTION OF DAMAGE DURING TOOTH PREPARATION:

1. Adjacent

teeth. 2. Soft tissues. 3. Pulp

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BIOLOGICAL CONSIDERATIONS
CAUSES

OF INJURIES: 1. Temperature. 2. Chemical Action. 3. Bacterial Action.

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BIOLOGICAL CONSIDERTION
Conservation

of Tooth Structure. Considerations Affecting Future Dental Health. 1. Axial reduction. 2. Margin Placement. 3. Margin Adaptation. 4. Margin Geometry. 5. Occlusal Consideration. 6. Preventing Tooth Fracture.

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MECHANICAL CONSIDERATIONS

Retention Form.

The quality of a preparation that prevents the restoration from becoming dislodged by such forces parallel to the path of withdrawal is known as retention.

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MECHANICAL CONSIDERATIONS.
Factors Affecting 1.

retention Form.

Magnitude of dislodging forces. 2. Geometry of the tooth preparation. 3. Roughness of the fitting surface of the restoration. 4. Material being cemented. 5. Film thickness of the luting agent.

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MECHANICAL CONSIDERATIONS. Resistance Form.

The quality of preparation that prevents the restoration from becoming dislodged by such forces as horizontal or oblique which is applied during mastication and par functional activities.

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MECHANICAL CONSIDERATIONS
Factors

affecting resistance form.

1.Magnitude

and direction of the dislodging forces. 2. Geometry of the tooth preparation. 3. Physical properties of the luting agent.

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ESTHETIC CONSIDERATIONS.
Factors 1.

affecting esthetic considerations.

Metal- Ceramic Restoration. 2. Facial Tooth Reduction. 3. Incisal Reduction. 4. Proximal Reduction. 5. Labial Margin Placement.

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Qualityisneveranaccident;itis alwaystheresultofhigh intention,sincereeffort,intelligent directionandskillfulexecution;it representsthewisechoiceofmany alternatives. - William Foster

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COMPLETE CAST CROWNS.

Advantages. 1.

Greater retention. 2. Greater resistance. 3. Superior strength. 4. Modification in tooth structure can be done.

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COMPLETE CAST CROWNS

Disadvantages. 1.

Extensive reduction of tooth structure. 2. Gingival inflammation. 3. Esthetics problems 4. Thermal/vitality test is difficult in complete crown.

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COMPLETE CROWNS
INDICATIONS: 1.

Extensive coronal destructive teeth( caries or trauma). 2. Where maximum retention and resistance are required. 3. Short clinical crowns. 4. Where high displacing forces are anticipated.

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COMPLETE CROWNS.
5.

Correction of axial contour of a tooth. 6. Endodontically treated teeth. 7. Congenitally malformed teeth. 8. Discolored teeth.

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COMPLETE CROWNS.
CONTRAINDICATIONS: 1.

In case where treatment objective can be achieved without crown. 2. Where light support is needed( cantilever bridge.) 3. If a high esthetic need exists as in anterior teeth.

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CROWN PREPARATION
STEPS

OF CROWN PREPARATION:

Occlusal

guiding grooves. Occlusal reduction. Axial alignment grooves. Axial reduction. Finishing and evaluation.

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THE PARTIAL VENEER CROWN

INDICATIONS. In

posterior teeth where moderate amount of tooth structure is lost, provided the buccal wall is intact. Used as a retainer for fixed partial denture(bridge). Where alteration in the occlusal surface is needed.

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THE PARTIAL VENEER CROWNS

CONTRAINDICATIONS. On

teeth that have short clinical crowns. As retainers for long span bridges. For endodontically treated teeth. In patients with active caries and periodontal diseases. In malshaped and poorly aligned teeth.

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ADVANTAGES
Conservation

of the tooth structure. Reduce the risk of pulpal and periodontal damage. Supragingival finishing lines are easily approached. Better oral hygiene can be maintained. As the margins of the restoration are usually away from the gum margins, less chances of gingivitis.

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ADVANTAGES
Cementation

is easy. Vitality test can be done after cementation.

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DISADVANTAGES
Less

retention. Less resistance. Preparation is difficult.

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COMPLETE CERAMIC CROWNS.

Complete

ceramic crowns should have even thickness circumfrentionaly. Usually about 1 to 1.5mm is needed to create an esthetically pleasing restoration. Incisally, a greater ceramic thickness may be required.

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COMPLETE CERAMIC CROWNS.

ADVANTAGES. Superior

in esthetics. Excellent translucency.(Natural look). Good tissue response. Slightly more conservative tooth reduction in preparation.

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COMPLETE CERAMIC CROWNS.

DISADVANTAGES. Reduced

strength due to absence of metal substructure. For shoulder preparation significant proximal tooth reduction is required. The preparation should provide support for the porcelain along its entire incisal edge. Thus a severely damage tooth should not be restored with a ceramic crown.

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DISADVANTAGES cont...
As

a retainer for FPDs, all ceramic crowns are not effective. Connectors require large cross section, as the material is brittle, this leads to gum impingement and periodontal failure.

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COMPLETE CERAMIC CROWNS.

INDICATIONS:

In areas with high esthetic requirements.

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COMPLETE CERAMIC CROWNS

CONTRAINDICATIONS:

When

more conservative restoration can be used. Rarely are they indicated for molar teeth. Increased occlusal load and decreased esthetic demand.

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RESTORATION OF ENDODONTICALLY TREATED TEETH

The

tooth should be assessed for the following points; 1. Apical seal. 2. Tenderness. 3. Exudate. 4. Fistula. 5. Active inflammation.

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Endodontically treated teeth cont.

SEVERELY DAMAGED TEETH. Post-and-core. In one piece. In separate pieces. One piece post crowns. (Not common) Two step technique, ( Post-and-core foundation and separate crown.)
IN

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Endodotically treated teeth cont. .

THE AMOUNT OF REMAINING TOOTH SRUCTURE IS PROBABLY THE SINGLE MOST IMPORTANT PREDICTOR OF CLINICAL SUCCESS.

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RETENTION FORM
TEETH. Dislodgement of a retained anterior crown is frequently seen clinically and results from inadequate retention form of prepared root. Post retention is affected by: 1. Preparation Geometry. 2. Post length. 3. Diameter
ANTERIOR

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Post retention affected by.

5. Surface Texture 6. Luting agent.

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POST FABRICATION
Prefabricated

Post.(available in different materials) Custom made posts.

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TERMS USED IN FPDs

CROWNS: Extracoronal

Restoration.

It protects the underlying tooth structure. restore the function. aesthetics.

It

Restore

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Types of Crowns
Clinical

Crown: It is intraoral visible tooth structure. Anatomical Crown: The area of tooth covered by enamel. Artificial Crown. a. Full veneer crown.(FVC) b. Partial veneer crown(PVC)

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TERMS USED IN FIXED PARTIAL DENTURES.

RETAINERS:

Part of FPD which is used as a support and cemented to the natural tooth or implant.

ABUTMENT: may be tooth, root or implant.

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TERMS USED IN FPDs.

PONTIC: The

artificial tooth that replaces a missing tooth in FPD.

CONNECTORS: It

is the connection that exists between the retainer and pontic.

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INDICATIONS FOR FPDs

SHORT

SPAN EDENTULOUS AREA. SUPPORT. PREFERANCE.

PROPER

PATIENTS PATIENTS

WHICH CANNOT MAINTAIN RPDs.

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CONTRAIDICATIONS FOR FPDs.

LARGE AMOUNT VERY YOUNG

OF BONE LOSS.

PATIENTS. COMPROMISED TEETH.

PERIODONTALLY LONG

SPAN EDENTULOUS AREAS.

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CONTRAINDICATIONS FOR FPDs.

UNCOPERATIVE MEDICALLY VERY Distal

PATIENTS.

COMPROMISED PATIENTS.

OLD PATIENTS. extension denture bases as in class I, II.

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CLASSIFICATION OF FPDs.
Three Each Each

major classes.

class is divided into three divisions.

division is further divided into four subdivisions.

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CLASSIFICATIONS OF FPDs.
CLASS: It identify the location of the edentulous space. CLASS I: Posterior edentulous space(Molar or premolar)

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CLASSIFICATIONS OF FPDs.
CLASS

II: edentulous spaces( Incisors or Canines are

Anterior

missing)
CLASS

III: edentulous spaces.

Antero-posterior

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CLASSIFICATIONS OF FPDs.
DIVISION: A division

gives information about the abutment

teeth.
DIVISION

I: Cantilever FPDs. Abutment on one side.

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CLASSIFICATIONS OF FPDs.
DIVISION

II: Conventional FPDs, abutments on both sides of the edentulous area.

DIVISION

III: Pier Abutments. A single tooth is surrounded by an edentulous space on either side.

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CLASSIFICATION OF FPDs.
Sub-division:
A sub-division

denotes the status of the tooth that is to be used as an abutment.

Sub-division I:
Ideal

abutments. Healthy teeth which provide good support.

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CLASSIFICATION OF FPDs.
Sub-division II:
Tilted Abutment.(Either

the design of the prosthesis is to be modified or the tilt should be corrected).

Sub-division III:
Periodontally

weak abutment.

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CLSSIFICATION OF FPDs.
Sub-division IV:

Extensively damaged abutment.

Sub-division V:
Implant

abutment.

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CLASSIFICATION OF FPDs.
DEPENDING Fixed Fixed

ON THE TYPE OF CONNECTOR:

fixed partial denture. movable partial denture. fixed partial denture.

Removable

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CLASSIFICATION OF FPDs.
DEPENDING All

ON MATERIAL USED.

metal Metal ceramic All ceramic All acrylic.

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CLASSIFICATION OF FPDs
LENGTH Short Long

OF SPAN:

span bridges. span bridges.

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CLASSIFICATION OF FPDs.
DURATION Permanent Interim

OF USE.

fixed PDs

bridges.

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CLASSIFICATION FOR FPDs.

TYPES

OF ABUTMENTS:

Normal/

Ideal abutment. Cantilever abutment. Pier abutment. Mesially tilted. Endodontically treated abutment. Implant abutment.

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RETAINERS
Retainer

is a crown or any part of FPD that is cemented to the abutment. Major retainers( FVC,PVC.) which covers the whole occlusal surface of the abutment. Minor retainers. It a small extension that is cemented on to the tooth.

1.

2.

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TYPES OF RETAINERS.
BASED Full

ON TOOTH COVERAGE:

veneer retainers. veneer retainers. retainers. ( Minimal preparation)

Partial

Conservative

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TYPES OF RETAINERS.
BASED All

ON THE MATERIAL BEING USED.

metal ceramic

Metal All All

ceramic acrylic.

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PONTIC.
It

is an artificial tooth on a fixed partial denture that replaces a missing tooth, restores its functions and usually fills the space.

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REQUIREMENTS OF A PONTIC
1.

It should restore the functions of a tooth it replaces. 2. It should provide good aesthetics. 3. It should be comfortable to the patient. 4. It should be biocompatible. 5. It should be easy to clean. It should preserve the underlying mucosa and bone.

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PONTIC DESIGN.
FACTORS AFFECTING

THE DESIGN OF A

PONTIC.
1.Space 2. 3.

available for the placement of pontic.

The contour of the residual alveolar ridge.

The amount of occlusal load that anticipated for that patient.

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RESIDUAL RIDGE CONTOUR

Sieberts CLASS

Classification of Ridge defects.

I defects: Normal faciolingual width with normal height. II defects: Loss of ridge height with normal width. II defects: Loss in both dimensions.

CLASS

CLASS

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CLASSIFICATION OF PONTICS.
A. B. C.

Based on Mucosal contact. Type of material used. Method of fabrication.

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PONTICS DESIGNS BASED ON THE MUCOSAL CONTACTS.

TISSUE

SURFACE IN CONTACT. 1.RIDGE LAP/Saddle 2. MODIFIED RIDGE LAP 3. OVATE 4. CONICAL TISSUE SURFACE NOT IN CONTACT. 1. SANITARY/Hygienic 2. MODIFIED SANITARY.

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TISSUE SURFACE IN CONTACT.

SADLE

OR RIDGE LAP: Concave fitting surface Overlap the residual ridge buccolingually.
SHOULD

BE AVOIDED Concave surface of the pontic is inaccessible. Cause tissue inflammation.

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TISSUE SURFACE IN CONTACT.

MODIFIED Combines

RIDGELAP PONTIC:

best features of the Hygienic and Saddle pontic designs. esthetics and easy cleaning.

Combining

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TISSUE SURFACE IN CONTACT.

CONICAL PONTIC: Also

called Egg-shaped, Bullet-shaped, or Heartshaped. It only touches the residual ridge at one point. Easy to clean. Recommended in posterior teeth where esthetics is a less concern.

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TISSUE SURFACE IN CONTACT.

OVATE

PONTIC: Esthetically superior. Its convex tissue surface reside in the soft tissue depression. Socket preservation techniques are necessary for successful results.

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REQUIREMENTS OF TISSUE SURFACE OF PONTICS.

Ridge

contact: The contact between the underlying tissues and pontic should be pressure free. Oral Hygiene Consideration: Pontic Material: It should provide good aesthetics. It should be biocompatible. It should withstand occlusal forces.

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TISSUE SURFACE NOT IN CONTACT

Sanitary or Hygienic Pontic. Tissue surface remains clear of the residual ridge. Easy plaque control. Only in posterior teeth.

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BASED ON MATERIAL
Metal-ceramic

Pontics All metal pontic All ceramic pontic Resin pontic

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BASED ON METHOD OF FABRICATION

Custom-made Prefabricated

pontics.

pontics

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CONNECTORS.

The portion of the Fixed Partial Dentures that unites the retainer(s) and pontic(s).

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TYPES OF CONNECTORS.
Rigid

connectors

Non-rigid

connectors.

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RIGID CONNECTORS.
Used

to unite the retainers with pontics in Fixedfixed partial dentures. connectors are used when the load is transferred directly from the pontics to the abutments.

These

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RIGID CONNECTORS
Cast

rigid connectors(conventional bridges) rigid connectors.

Soldered

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Non-Rigid Connectors.
Used

in situation where single path of insertion cannot be achieved due non parallel abutments. types of connectors allow limited movement between the retainer and pontics.

These

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Non-Rigid Connectors
Tenon

Mortise connectors(TMC) /Dovetail connectors. prepared within the connectors of

Mortise(female)

the retainers.
Tenon(male)

attached to the pontic.

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Loop Connectors.
Used The

to maintained an existing diastema.

connector consists of a loop on the lingual/palatal surface.

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Occlusion in Fixed Partial Dentures

Definition:

It is the static relationship of the opposing teeth.

Centric

occlusion: Occlusion of the opposing teeth when the mandible is in centric relation. This may or may not coincide with maximum intercuspation.

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OCCLUSION
Maximum The

intercuspation:

complete intrcuspation of the opposing teeth independent of the condyle position. occlusion:

Eccentric

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IMPRESSION MAKING IN FPDs

Ideal

requirements of the impression material used in fixed partial dentures. Dimensional stability and accuracy Elasticity after cure. Flow. Wettability. Compatibility.

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Putty wash impression

Elastomeric Two

impression material.

stage technique impression in putty. impression in wash.

Primary

Secondary

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Causes of Misfit/mismatch crowns and bridges

Treatment Case Case

planning.

selection design Law

Antes

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 Preparation Selection

of Impression material technique

Impression Recording

the fine details

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 Pouring Shade

the cast

selection with the laboratory.

Corresponding Demands

and specific details.

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 Proper

Wax up.

Investment Casting Recovery

and finishing. Porcelain work Firing Shade and glaze

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 Intraoral

adjustment

Cementation Follow

up and maintenance.

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 Tips

& Warnings

After

mixing, turn the rubber mixing bowl upside down. If the dental stone mixture does not drip to the ground, then you have the appropriate consistency. If the dental stone mixture drips to the ground, there is too much water in the mixture and more dental stone will need to be added.

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Tips of warnings.
Air

bubbles will distort the accuracy of the dental stones.

Avoid over-vibrating the dental stone mixture. Over-vibrating will create unnecessary air bubbles.

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Tips of warnings.
During

the setting time period, the stone undergoes an exothermic reaction, releasing heat. not separate the model from the impression until the model feels cold.

Do

Leave the dental stone model undisturbed for 45 to 60 minutes until the material completely sets

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 After

setting remove the cast carefully.

Check

the prepared surface for bubbles and deficiencies. the prepared margins.

Outline

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LABWORK OF CROWN & BRIDGE

Apply hardener on the prepared surfaces.( Dural)
Wax

up with blue/pink wax

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SPRUES
Definition:

Its a channel through which molten alloy can reach the mold in an invested ring after the wax has been eliminated. Role of a Sprue: Create a channel to allow the molten wax to escape from the mold. Enable the molten alloy to flow into the mold which was previously occupied by the wax pattern

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SPRUES
FUNCTIONS

OF SPRUE 1 . Forms a mount for the wax pattern . 2 . Creates a channel for elimination of wax . 3 .Forms a channel for entry of molten metal 4 . Provides a reservoir of molten metal to compensate for the alloy shrinkage

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SPRUES
SELECTION

OF SPRUE 1 . DIAMETER : It should be approximately the same size of the thickest portion of the wax pattern . Too small sprue diameter suck back, results porosity. 2 . SPRUE FORMER ATTACHMENT : Sprue should be attached to the thickest portion of the wax pattern . It should be Flared for high density alloys & Restricted for low density alloys
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SPRUES
3

. SPRUE FORMER POSITION Based on the 1 .Individual judgment . 2 .Shape & form of the wax pattern . Patterns may be sprued directly or indirectly .. Indirect method is commonly used Reservoir prevents localized shrinkage porosity . Reservoir And Its Location

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 Armamentarium 1.

Sprue . 2 . Sticky wax . 3 . Rubber crucible former . 4 . Casting ring . 5 . Pattern cleaner . 6 . Scalpel blade & Forceps . 7 . Bunsen burner

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SPRUES
TYPES

OF SPRUES I . - Wax . II . Solid Plastic . III. Hollow Metal.

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 WETTABILITY

To minimize the irregularities on the investment & the casting a wetting agent(SURFACTANT) can be used . FUNCTIONS OF A SURFACTANT. 1 . Reduce contact angle between liquid & wax surface . 2 .Remove any oily film left on wax pattern

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 PREREQUISITES Wax

pattern should be evaluated for smoothness , finish & contour . Pattern is inspected under magnification & residual flash is removed

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 CRUCIBLE It

FORMER

serves as a base for the casting ring during investing .Usually convex in shape. May be metal , plastic or rubber . Shape depends on casting machine used . Modern machines use tall crucible to enable the pattern to be positioned near the end of the casting machine .

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 CASTING

RING LINERS Most common way to provide investment expansion is by using a liner in the casting ring .Traditionally asbestose was used . Non asbestose ring liner used are : 1) Aluminosilicate ceramic liner . 2) Cellulose paper liner

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 Purpose

of Casting Ring Liner Ringer liner is he most commonly used technique to provide investment expansion. To ensure uniform expansion , liner is cut to fit the inside diameter of the casting ring with no overlap. Thickness of the liner should not be less than approximately 1mm. Place the liner somewhat short of the ends of the ring, 3mm, tends to produce a more uniform expansion, therefore less chance for distortion of the wax pattern & mold

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 CASTING

CRUCIBLES Four types are available ; 1) Clay . 2) Carbon . 3) Quartz . 4) Zirconia Alumina

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 Remove

the whole wax pattern along with the sprues very carefully.

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LABWORK OF CROWN & BRIDGE

Attach

the wax pattern and sprues on the crucible former in such a way that the whole complex should be accommodated in the casting ring. the insulating sheet within the casting ring so that heat loss is prevented during shifting of the ring from the furnace to the casting machine.

Put

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LABWORK OF CROWN & BRIDGE

After putting the casting ring over the wax pattern, the margins of the ring are properly sealed with modeling wax so that investment plaster should not come out of the ring. A SURFACTANT solution is applied to prevent bubble formation during pouring. The ring is then poured with investment plaster.

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LABWORK OF CROWN & BRIDGE

During Leave

the pouring vibrator is being used.

the plaster to cool at room temperature for about 45minutes to 1hour. the casting ring in the oven for about 1hour and 30minutes and raise the temperature up to 1100 degrees cent.

Put

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LABWORK OF CROWN & BRIDGE

Melt

the alloy in casting machine.

Take

out the RED HOT ring from the oven and put it in the Casting machine. the red hot ring is transferred from the oven to the casting machine.

Now

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LABWORK OF CROWN & BRIDGE

Centrifuge Now Cool

it in the casting machine.

the casting is completed. it down at room temperature. the framework from the investment plaster.

Recover

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LABWORK OF CROWN & BRIDGE

Cut

all the sprues. the plaster.

Remove Blast

the framework in the blasting machine. the metal with burs.

Finish

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LABWORK OF CROWN & BRIDGE

Do

the final blasting on all the surfaces except the inner surfaces of the retainers/crowns. layer of thin mix porcelain is applied with brush on all surfaces which will be covered with porcelain. is called wash core.

A thin

This

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LABWORK OF CROWN & BRIDGE

After

application of the wash core firing is done according to the specific programme. temperature of the wash core is raised up to 950 degrees instead of 930 degrees which is meant for porcelain body. firing the wash core in furnace the bridge is cool down.

The

After

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LABWORK OF CROWN & BRIDGE

Then

opaque layer is applied and the bridge is fired in furnace again. bridge is cool down at room temperature.

The

Apply

the body, cervical and incisal shades and put it in furnace for another required programme and raise the temperature up to 930 degrees.

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LABWORK OF CROWN & BRIDGE

Cool

down the bridge and finish the surfaces with burs, discs, wheels.

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LABWORK OF CROWN & BRIDGE

After

finishing , apply the glaze powder and put it in furnace . for three minutes, then increase the temperature up to 930 degrees in five minutes and hold at 930 degrees for 1 minute.

Preheat

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If

minor changes in shade are required, it can be done at this stage.

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Part A: Types of Fixed Prosthodontics

Purpose of Prosthodontics Restore masticatory function Improve appearance Improve speech Promote good oral hygiene Stabilize arch and occlusion
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Contraindications for a Fixed Prosthesis

Lack of supporting alveolar bone Presence of periodontal disease Excessive mobility of abutment teeth Lack of patient interest in oral hygiene Patient cannot afford treatment
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Types of Fixed Prostheses

Porcelain veneers Direct resin veneers Indirect resin veneers Full-cast crown Partial crown Inlays Onlays Bridge s
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Fixed prosthes es

Materials Used for Fixed Prostheses

Gold alloy Porcelain fused to metal

Porcelain Composite resin

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Retention of Restorations

Core buildup

Recreation of lost tooth structure Screwed into dentin Hold core filling material After root canal therapy Strengthens tooth

Retention pins

Post and core

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The Dental Laboratory

Dental lab technician

Fabricates restoration Makes die from impression Creates wax pattern on die Invests wax and casts invested material into metal Prepares metal for porcelain layers Finishes and polishes final restoration

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Selecting a Tooth Shade

Before preparation Moisten shade guide Match to natural teeth under natural light Record in patients chart Record on lab prescription

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Tissue Retraction

Placed in gingival sulcus Mechanical and chemical retraction Prevents bleeding Ensures impression of gingival margin

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Provisional Restorations
Temporary coverage to protect tooth between appointments Esthetics and patient comfort Stabilize contacts and occlusion Protect gingiva and interproximal areas Fit gingival margin snugly
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The Laboratory Prescription

Patients name Description of prosthesis Materials for prosthesis Tooth shade Dentists information Date requested

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Crown Cementation

Check fit Margin Contacts Occlusion Adjust if necessary Permanent cement

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Fixed Prostheses Maintenance

Crowns Bridges Dental implants

Toothbrus h Antimicro bial rinses Water irrigators Thread ing systems Dent al floss

Plaqu e remo val Interproxi mal bushes

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