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Fixed Pros I > Finishing and Polishing Fixed Restorations > Flashcards

Finishing and Polishing Fixed Restorations Flashcards

1
Q

what are the try in steps

A
  • remove the temporary
  • if tooth is sensitive, anesthetic may be required
  • once removed clean the preparation with explorer or spoon to remove excess cement
  • pumice clean the prep
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2
Q

what should you do if the tooth is super sensitive prior to crown seating

A
  • may delay crown seat
  • place two 1- minute coats of gluma
  • reseat the temporary with OTC pain meds in use
  • monitor for a week or two
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3
Q

what is essential to prevent aspiraition

A

throat pack with 4x4 gauze with patient in a slightly upright position

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4
Q

what are the crown seating steps

A
  • check proximal contacts
  • check internal fit
  • check marginal integrity
  • check stability and retention
  • check occlusion
  • check external contours
  • check surface finish
  • check shade
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5
Q

when you try in crown and it appears to fit marginally and floss snaps contacts what do you do

A

take a BW xray to confirm radiographic proof of sealed interproximal margins

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6
Q

if there is a gap between the crown and finish line on your prep what is usually the cause

A

proximal contacts are too tight

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7
Q

what do you do when crown does not seat

A
  • place accufilm between crown prep and tooth intra orally
  • use finger pressure to seat crown
  • interproximal contacts will be highlighted and now you can see where crown is hitting prematurely
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8
Q

how do you remove excess on contact area on gold crowns

A

use slow speed wheel

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9
Q

how do you remove excess on contact area with zirconia crowns

A

fine diamond or slow speed wheel

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10
Q

how do you remove excess on contact area with ceramic crowns

A

fine diamond or slow speed wheel

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11
Q

what is the technique to polish interproximal contacts

A

polish or grind from the inferior border of the mark and move occlusally

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12
Q

what is the purpose of moving from inferior border of the proximal contact

A

you could end up removing the entire contact and crown would have to be remade

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13
Q

what are the objectives of proximal contact adjustments

A
  • adjust contact to lessen its tightness but maintain size, shape and floss snap
  • can use shimstock between crown and adjacent tooth to see if it pulls through with resistance
  • floss is used to determine strength of contact
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14
Q

what should you evaluate in interproximal contacts

A

correct location
-size
- intensity with film marking

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15
Q

what do you do if contacts are light with floss but are the correct size and location and the margin is still not sealed

A

move on to the next step

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16
Q

what is the material we have at UMKC to assess internal fit

A

fitchecker

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17
Q

how is fitchecker used

A
  • place a small amount in the crown, the crown is then seated and the patient bites on a cotton roll or hold crown until material sets
  • remove the crown
  • wherever there is show through the crown needs to be adjusted to remove the area
  • do not start grinding out any area of the crown internally
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18
Q

what bur do you use to adjust internal fit of crown

A

2 round bur

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19
Q

how is the internal fit adjusted when using the blue fit checker with an all ceramic crown

A

same technique but the internal surface of the crown is never adjusted, the preparation is adjusted instead

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20
Q

why do you not want to remove the internal surface of an all ceramic crown

A

it is specially treated by the lab and if you remove the surface treatment, retention of the crown is much more difficult

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21
Q

what do you do if there is no remaining temporary cement, contacts are light, and no issues are seen on internal fit of the crown and the crown does not seat all the way what do you do

A

new impression should be made and the patient re-appointed

22
Q

what do you do if there is no remaining temporary cement, contacts are light, no issues on internal crown and crown seats all the way

A

a BW x ray is taken to confirm interproximal fit

23
Q

how do you adjust the margin to a smooth profile when it is overextended

A

use fine grit diamond disc or blue course polishing wheel

24
Q

what do you do if the margin is under extended

A

a new impression should be taken if the seat in the mouth is different then the cast and die

25
Q

why are under extended margins unacceptable

A

due to plaque accumulation and possible sensitivity

26
Q

if there is not an open margin on the cast and die and there is an open margin clinically what do you do

A

make a new impression

27
Q

once proximal contacts, internal impurities, and marginal adaptation have been deemed acceptable, check the:

A

stability and retention

28
Q

what do you do if the crown rocks or rotates

A

new impression

29
Q

when the crown seats well what do you evaluate next

A

the occlusion

30
Q

what do you use to evaluate occlusion

A

accufillm articulating paper

31
Q

what burs do you use to adjust occlusion

A

fine diamonds
- green stone
- white stone
- brown stone

32
Q

since articulating paper doesnt mark well with crowns what do you do

A

place a thin layer of vaseline on the articulating paper and then check occlusion

33
Q

what directions do you give the patient to check occlusion

A
  • check in MIP first by having patient “tap,tap,tap” their teeth together
  • if that occlusion is registering then ask patient to “close, squeeze, and grind side to side and forward and back” to analyze excursive movements
34
Q

what do you need to make sure of before adjusting and polishing crown

A

make sure crown has enough thickness

35
Q

what do you adjust if the mandible shifts to the buccal

A

adjust lingual inclines of mandibular buccal cusps and/or maxillary lingual cusps

36
Q

what do you adjust if the mandible shifts to the lingual

A
  • adjust the buccal inclines of the mandibular lingual cusps and/or lingual inclines of maxillary lingual cusps
  • adjust the buccal inclines of mandibular buccal cusps and/or maxillary lingual inclines of buccal cusps
37
Q

occlusal contacts may cause ____ to deviate upon closing

A

mandible

38
Q

what are the non-working side prematurities

A

adjust buccal inclines of mandibular lingual cusps and/or lingual inclines of maxillary lingual cusps

39
Q

what are the working side prematurities

A

adjust lingual inclines of mandibular buccal cusps and/or lingual inclines of maxillary lingual cusps

40
Q

what do you adjust if there are maxillary protrusive prematurities

A

adjust the distal inclines

41
Q

what do you adjust if there are mandibular

A

adjust the mesial inclines

42
Q

what should be evaluated on the external contours

A
  • ensure the contours are esthetic and appropriate
  • check for proper emergence profile
  • proper cusp angulation and location
43
Q

what is the final step

A

ensure surface is smooth and polished

44
Q

how is gold polished

A

brown and green abrasive points and a shine is placed with robinson brush

45
Q

what are ceramics polished with

A

course blue polishers
- then medium pink disk
- finish with the fine white polishers
-last shine given with diamond pastes and bristle brush

46
Q

when is the crown cleaned

A

prior to cementation

47
Q

what is the crown cleaned with

A

rubbing alcohol for eMax ceramics or ivoclean for zirconia and metals to remove contaminants from saliva or from products used in crown seat appointment

48
Q

regardless of the crown material, the steps in finishing and polishing are similar except for:

A

the burs designed for the material you are using

49
Q

what is the last thing to check

A

shade

50
Q

when should adjusting occlusion and contacts be done in relation to cementation

A

prior to cementation

51
Q

do you need to make a new impression if there is a shade change

A

no

52
Q
A

Fixed Pros I (13 decks)

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