4. Posterior Indirect Restorations Flashcards

1
Q

Definition of inlay or only (indirect restoration)

A

Partially or fully intracoronal indirect restoration retained using a cement or bonding system, normally made outside the mouth

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2
Q

Difference between inlay and only (2)

A

Inlay - usually covers just the occlusal surface

Onlay - usually covers one or more functional cusps

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3
Q

Types of indirect restoration materials (2)

A

Gold

Aesthetics - composite, ceromeric, ceramic

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4
Q

Advantages of gold indirect restorations (6)

A

Indirect nature allows for ideal contour and occlusion
Strength, support, protection
Wear and antagonist wear
Marginal adaptation can be improved at fit
Corrosion resistant
Extremely durable and long-lasting when fitted properly

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5
Q

Disadvantages of gold indirect restorations (5)

A

Costs (laboratory)
Extra visits
Need for placement of a provisional restoration
Aesthetics
Skill required for preparation/intra-oral waxing

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6
Q

Indications for gold use (4)

A

Small lesions leading to complete coronal breakdown
Occlusal protection
Production of ideal occlusal/morphological contours
Prevention of galvanism

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7
Q

Basic principles of tooth prep for gold indirect restorations (1)

A
Conservation of tooth structure
Consider cusps coverage
Retention and resistance form
Contours
Finish lines
No undercuts
Adequate strength of remaining tissue
Precise prep critical
Bases and liners
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8
Q

What does inlay prep involve (2)

A

Inlay prep

With partial or full occlusal coverage

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9
Q

Types of aesthetic indirect restorations (4)

A

Composite
Ceromeric
Ceramic
CAD-CAM

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10
Q

Advantages of indirect composite restorations (4)

A

Avoids common technical errors with direct composites
Avoids polymerisation contraction
Avoids polymerisation contraction stresses
Avoid cuspal flexture

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11
Q

Disadvantages of indirect composite restorations (4)

A

Secondary polymerisation
More destructive than direct composite (block out undercuts)
Bonding still technique sensitive
Lab stage required and provisional restoration required
Little evidence of any benefit over a well-placed direct composite

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12
Q

Features of indirect ceromeric restorations (7)

A

Ceramic optimised polymer
More destructive as undercuts must be removed
May be reinforced with fibre additions
Excellent aesthetics
Less suitable for inlays (retention)
Bonding still technique sensitive
Lab stage required and provisional restoration required

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13
Q

Features of indirect ceramic restorations (11)

A
High-strength porcelain
Bonding technique maximises strength
More destructive as undercuts must be removed
Best aesthetics
Less marginal leakage
Better wear resistance than ceromeric
Better retention than ceromeric
More suitable for onlays (retention)
Bonding is still technique sensitive
Lab stage required and provisional restoration required
Differential wear
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14
Q

Types of ceramic (3)

A

Hand modelled (refractory die technique)
Pressed (lost wax technique)
Milled (CAD-CAM)

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15
Q

Advantages of indirect CAD-CAM restorations (7)

A
Excellent marginal fit
Single visit
Optical impression
3D computer modelling if restoration
Antagonist and articulation functions
Correlation and replication functions
Pre-formed factory manufactured ceramic blocks
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16
Q

Gold finishing and occlusal adjustment (3)

A

Hand and rotary burnishing
Greenies and Brownies
ZnO and alcohol

17
Q

Aesthetic finishing and occlusal adjustment (4)

A

Composite finishing burs
Astropol
Soflex discs
Enhance polishers

18
Q

Advantages/disadvantages of gold indirect restorations (7)

A
Excellent durability and life
Demanding tooth preparation
Intra-oral or extra-oral wax up
Impression may be required
Provisional restoration required
Cuspal coverage required to add strength to tooth
Non-conservative
19
Q

Principles of preparation for indirect aesthetic restorations (8)

A
No bevels – shoulder and butt joints
No sharp internal or point angles
No sharp angle transitions
No undercuts
Minimal taper of axial walls
Smooth cavosurface margins and correct angles
Rounded internal anatomy
Consider bulk of restoration: strength