Diagnostic Waxing and Provisional Restorations Flashcards
(42 cards)
Diagnostic Waxing
Elements used as part of a Diagnostic Wax up:
(5)
-A full health history
-Intra-oral examination of patient
-Diagnostic Casts (mounted)
-Occlusal Evaluation
-Esthetic evaluation – Primarily for anterior
FPD work. However, should also be
considered for posterior work as well.
Diagnostic Waxing
steps (5)
Diagnostic Waxing
Interim Restoration
Patient Feedback
Soft tissue Management
Cast of Interim
Clinical Photographs
Predictable Definitive Restoration
Diagnostic Waxing – Systemic Approach
8 (long) steps
STEP 1 –
Initial diagnostic casts are made along with discussion about patient
restorative and esthetic goals
STEP 2 –
Diagnostic wax up of these goals is made and includes:
-Pontic shape, size, contour, and relation to the ridge
-Incorporate any changes to the current esthetics and function
STEP 3 –
This wax up then can be used with a putty matrix to make a temporary
which incorporates these desired changes
STEP 4 –
Tooth preparation and temporization
STEP 5 –
Patient returns with temporaries in place and provides feedback on the
shape, length, and overall esthetics and function. Any changes to
the temporary desired by you or the patient can then be made at
this time.
Diagnostic Waxing-Systemic Approach
STEP 5 –
Patient returns with temporaries in place and provides feedback on the
shape, length, and overall esthetics and function. Any changes to
the temporary desired by you or the patient can then be made at
this time.
STEP 6 –
Once temporaries are representing desired results, a new impression is
made of the temporaries to provide to the lab. Photographs of the
temporaries with measurements are provided for the lab.
STEP 7 –
FPD created from a final impression, and using the models of your
temporaries. Definitive prosthesis is tried in and seated.
STEP 8 –
Evaulation of final product after patient has had prosthesis for a period of time
Using wax to create intended restorative contours on casts for the
purpose of
evaluation and planning the restorations. A wax replica of
proposed treatment.
Using a Temporary Crown Former
(2)
Fit to space and waxed in and
secured
Once shaped, putty or vacuum
matrix made.
Provisional Restorations
Definition:
A prosthesis designed to enhance esthetics, stabilization and/or function for a limited
period of time after which it is to be replaced by a definitive prosthesis.
Provisional Restorations
Used to assist in
determination of the effectiveness of a specific treatment plans form and
function.
Provisional Restorations – Diagnostic Potential
Provisional restorations are used in a variety of ways to
accomplish your
treatment planning as you progress
Your — can be used to verify reduction both visually,
or with small holes in the matrix to use a perio probe.
vacuum matrix
In addition to vacuum matrix viewing to assess reduction, – can be used as well with properly placed cuts and
removal to see visually or measure with a probe what your
reduction is based on your diagnostic wax up
Putty
matrixes
When significant change is occurring, — are of little use
to you. Therefore, these alternate methods of checking
reduction are helpful.
depth cuts
Diagnostic casts were taken and mounted using a —.
facebow
Custom incisal guide table records gathered (2)
requirements
incisal length and guidance
Mounted Diagnostic wax up used with same mandibular to measure the
length of the — and — movements while also
improving (2)
incisal edges
protrusive
canine guidance and tooth contour.
An — is made of the diagnostic wax up.
A — matrix is made on stone cast of wax up
Preparations are started.
Reduction is checked with — matrix
Provisional is made as two —
In patient mouth, we can see that the incisal edges need to be reduced in
provisional due to the interferences seen in protrusive
alginate
vacuum
vacuum
3 unit temporaries
Patient is now sent home with provisionals to “test” them out.
Patient will check (3)
Changes can be made in the temporary for any areas patient is not
satisfied with.
If provisionals are modified, a new impression of temps should be
taken to mount for the case when sent to the lab.
Definitive crowns will incorporate the adjustments made and the input of family and friends.
smile, speech, and occlusion.
Using a bite registration, the study models for this case can be mounted to assess:
(2)
Incisal guidance, length, and angulation
Establish the occlusal plane
Mounted case with wax up to assess (2) for fixed
prosthesis.
In this case, we need atypical contours for the FPD.
Case is mounted with Facebow and in Maximum Intercuspation
contours and parameters
Here we see restorations that are:
Creating gingival inflammation either
by (2)
Also, if restorations are —,
they will also have a similar impact.
lack of patient ability to clean
Or with ill fitting restorations with poor
marginal adaptation that allow more
bacteria to impact the tissue.
over contoured
Using a provisional,
we can see if the
tissues respond well
to the new contour
and fit.
Reinforcing (2), we
observe in this
case, the patient
tissues responded
very well to the
provisional based
on a wax up.
A final impression
can now be taken
as tissue
inflammation has
resolved.
OH and
patient care
Based on a wax up, provisional FPD’s placed with — pontic to develop
extraction site into excellent esthetic case during healing.
Once tissue heals and contours established, a final impression can be made.
ovate
We want our provisional
to allow for optimum
gingival health prior to
—
cementation.
— pontic site development
can take weeks to months to
properly develop.
Ovate
Provisional Restorations – Allowing healing
Temporary bridge placed here after crown
lengthening surgery.
These provisionals allow for (2)
Once healed, new provisionals will be made
and used as a more definitive guide to final
restorations.
healing, patient
cleaning.
