Final Revision Flashcards
(81 cards)
1
Q
What is Digital Dentistry?
A
=dental devices incorporating digital/computer controlled components for carrying out a dental procedure
2
Q
What is Digitial Dental Practice?
A
=practice using modern technologies and incorporating digital applications exclusively
3
Q
SOS
How do we do Digital Diagnosis and what are the tools?
A
Digital Xrays Digital Intraoral Camera Digital Impression Digital Photos Digital Spectrophotometers Facial Scanning
4
Q
What’s the use of Digital Photos?
A
Dentist: Diagnosis Planning Documentation Communication Backup info Evaluation extra/intraorally
Lab: Color Shape Textures Tooth Size Smile Line Facial form
improves visual communication
multidisciplinary team
legal standpoint
internal & external marketing
5
Q
Extraoral Marketing photos:
A
6 photos:
sides, 12 o’clock, smiley, occlusal, retracted
6
Q
Why do we use videos?
A
smile line, motion, gathering info
7
Q
What is the use of Digital Spectrophotometers?
A
determine the shade and color of dental tissues
8
Q
Digital consultation importance:
A
patient’s acceptance
9
Q
SOS
What is Cad Cam?
A
Cad=Computer Aided Design
-use of computer and software to create, modify and analyse a design
Cam=Computer Aided Manufacturing
-use of software to guide the machine to produce a design according to CAD design
10
Q
Cad Cam components
A
- Scanning Device -software and hardware
- CAD/CAM Software
- Milling machine
11
Q
SOS
Where does the efficiency of a Milling machine depend on?
A
of axes and burs
12
Q
Milling machines Chairside Vs Laboratory:
A
Chairside:
• 3-4 axes
• few teeth being trimmed together
• uncomplicated restorations
Laboratory: • 5 axes • larger, faster • complicated restorations • more precise
13
Q
What are the Systems of Cad Cam?
A
Chairside -CAD CAM
Laboratory -CAD CAM
Combination -chairside: CAD and lab: CAM
14
Q
What is the Cad Cam Workflow?
A
- same day delivery
- instead of weeks -> hours
- thorough treatment
- enhance patient involvement
- precise, predictable implant treatment
15
Q
SOS
Traditional Impression Vs Digital Impression
A
Traditional Impression: •voids or tears •need to capture margins •stability of impression material (unstable) •dimensional changes (shrinkage) •gagging reflex •materials are setting fast •beginners can hurt the gums
Digital Impression: better immediate feedback efficient 20 min faster no gagging reflex faster remake / repeat in sec if necessary no disinfection needed easier storage marketing tool good visualization of margins sometimes no provisional (1 visit) ability to add missing data fast; no need to retake
16
Q
On which factors you can have an Immediate Feedback?
A
- preparation
- margins
- undercuts
- inter-occlusal clearance
- path of insertion
- repeat in seconds if necessary
17
Q
What are the types of Digital scanners you know?
A
- Digital intraoral scanning (IOS)
- Benchtop scanning
18
Q
What are the contraindications of Digital Impression?
A
- inability to access
* lack of patient cooperation
19
Q
General benefits of Digital Impression?
A
- high precision
- patient comfort
- simple process
20
Q
Basic rules of Digital Impression technique:
A
- dry field
- gum retraction
- soft tissues retraction
- good visualization of margins
- good recording of tissues affecting
21
Q
Clinical guidelines for Digital Impression:
A
The accuracy of the final restoration can only be as good as the accuracy of the replica of the tooth preparation.
22
Q
Why is an attractive method to the dentist?
A
decreased delivery time
23
Q
What are the types of Direct Digital Manufacturing?
A
Subtractive
Additive
24
Q
File format in Digital Workflow:
A
DICOM and Stl file
25
What are the types of Subtractive Manufacturing Technologies?
Open System
| Closed System
26
Open System Vs Closed System
Open System: scan and send it anywhere to design the files
Closed System: send it to CAD CAM or to a lab working w/ the same company
27
What is the Subtractive Manufacturing Technology production process?
CAD -> CAM for CNC machine -> CNC process -> initiation
28
3-Axis Vs 4-AXIS Vs 5-AXIS
3-AXIS:
- faster
- cheaper
- simple restorations: crowns, small bridges, inlays and onlays
4-AXIS:
-crowns, veneers, inlays, onlays, frameworks, fixed partial dentures
5-AXIS:
-all previous, digital models, implant attachments and abutments, denture base, bars, splints (everything)
29
Milling process in our lab:
* WET & HARD
* pre-sintered zirconia, composites, metals
* in our lab
* DRY & SOFT
* unsintered zirconia, composites, wax
30
*SOS*
What are the ADV of Milling?
* high accuracy
* standardized manufacturing process -> doesn't depend to any factor
* efficient quality control
* fast production
* enable use of new materials (zirconia, ti)
* increased production capacity
* transforming labs from simple fabrication sites into computerized production centers
31
What are the DISADV of Milling?
* initial cost
* wasteful procedure
* accuracy dictated by smallest bur diameter
* limited CAD CAM uses by the software and digital scanners
* some restorations require lab process
32
What is Lazer Ablation and what is used for?
=process where material is removed from solid surface using lazer beam instead of cutting tools
used for: crowns, veneers, inlays, onlays, bridges
33
What are the 2 types of Additive Manufacturing?
3D Printing
| Lazer Melting
34
What's the procedure for 3D Printing production?
3D scanner -> design -> supports added + model is sliced as multilayers -> 3D objected printed
35
What is Stereolithography SLA?
=photopolymerization process building solid parts in multilayers from liquid based materials using UV light or Lazer for solidifying materials
36
What are the dental applications for Stereolithography SLA?
```
Dental models
Surgical guides
Custom trays
Complete dentures
Orthodontic appliances
Maxillofacial prostheses
Facial replacements
```
37
What's the most common application of CAD CAM in dentistry?
crowns and inlays
38
*SOS*
Workflow sequences?
1. record geometry
2. vol proposal
3. production
39
What are the computerized system categories?
digitial impression
| chair side CAD CAM
40
What system do you have if there's only IOS?
Combined system
41
What are the ADV of Chair Side Digital Application?
* No provisionals
* 1 visit
* No impressions/cast volumetric changes
* No distortion
* No abrasion/fracture of cast
* No shipment problems
42
What is the digital workflow of the office (direct closed file system)?
```
proper exam
diagnosis
treatment plan
agreement consultation
tooth shade selection
remove existing restoration
carries control
tooth prep
```
43
*SOS*
How do we evaluate a tooth?
- pulp condition
- linear margins
- margins placement (supra, sub, equi)
- gingival condition
- proper prep (10-24 degrees convergence, 4 mm axial wall height, rounded angle prep corners)
44
Why small # of units in case selection criteria?
b/c of 3 axes milling machine
45
*SOS*
Steps for CLOSED system in office method:
1. hello - hello, patient examination + info input, agreement
2. tooth perp + select type of restoration and material
3. dry (isolate)
4. scan antagonist, 2 adjacent teeth and buccal bite
5. model edit - remove, add and smooth tools
6. depends if manual alignment
7. model analysis - margins, insertion axis, prep analysis
8. design
9. milling phase - select block size, fast/slow milling mode, mill position, sprue and send to mill
10. di-sprue -> glazing, adjusting, sintering etc
11. delivery
46
*SOS*
Steps for stand-alone OPEN system:
1. hello - hello, patient examination + info input, agreement
2. tooth perp + select type of restoration and material
3. dry (isolate)
4. scan antagonist, 2 adjacent teeth and buccal bite
WE ONLY HAVE A SCANNER
5. send to lab for manufacturing
6. make a PROVISIONAL until lab does the CAD design and manufacture it
7. request an optional CAD preview to see what technician did
8. CAM manufacture
9. delivery
47
*SOS*
What are the ADV of in office CLOSED system?
- low total chair time
- no gagging reflex
- no aspiration/swallowing impression material
- increased refferals
- easy restoration reproduction
- no need to block out undercuts (b/c software does it)
- no removal of existing restorations or loose teeth by taking an impression
- same day delivery
- +ve patient experience
- less # of visits
- no provisionals necessary
- lab cost saving
48
*SOS*
What are the ADV of in office OPEN system?
- low total chair time
- no gagging reflex
- no aspiration/swallowing impression material
- increased refferals
- easy restoration reproduction
- no need to block out undercuts (b/c software does it)
- no removal of existing restorations or loose teeth by restorations or loose teeth by taking an impression
49
Long term survival of fixed dental prosthesis depends on:
1. Length of edentulous span
2. Abutment status
3. Prosthetic material
50
Total occlusal convergence (TOC):
=angle formed by two opposing axial walls of the abutment teeth
-10 -20 degrees
51
*SOS*
Which bur is most important for the CAD tooth prep and why?
Step Bur (NOT cylinder bur) b/c of:
- the width of the bur 10.5 mm
- prepares the inner crown surface
- greater role on prep guide lines
- mills the fitting restoration surface
- height of prep should not exceed 10.5 mm
52
*SOS*
Diameter of burs importance:
anterior teeth are smaller than posteriors, especially in mandible
-prep for anteriors: 1 mm (NOT less)
53
*SOS*
```
Min Thickness of:
shoulder:
under a cusp:
under a fissure:
axial wall:
```
shoulder: 1 mm
axial wall: 1.5 mm
under a fissure: 1.5 - 2 mm
under a cusp: ANT: 1.5 mm POST: 2 mm
54
The machine will not mill ceramic into an undercut except:
in interproximal area
55
*SOS*
Monolithic Vs Multilayered material selection:
Monolithic:
•Full metal
•Full contour zirconia restorations
•Full contour lithium disilicate restorations
```
Multilayered:
•Meta -ceramic restorations
•Zirconia -ceramic restorations
•Layered lithium disilicate restorations (e.max)
•Alumina -based restorations (in-ceram)
```
56
*SOS*
General factors for right material selection:
* Location of missing teeth: higher occlusal forces in posteriors, especially M2
* Interocclusal space: all ceramic materials require large connector size
* Parafunctional habits (bruxism/cleanching): NOT all ceramic
* Aesthetic demands: all ceramic
* Allergies: to metals, use all ceramic materials
57
*SOS mcq*
What's the diameter of cylinder bur?
8.7 mm
58
*SOS*
Give an example of subtractive system:
-milling machine we are using (3 axis)
59
Give an example of additive system:
- lazer melting
| - 3D printing
60
RPD Acquisition:
analogue impression
lab scans
gives us an Stl file
61
RPD Manipulation:
- determine automatically POI
- block out undesirable undercuts
- retentive areas for the retentive clasp tips are determined
62
RPD Fabrication:
Direct metal production:
laser sintering
laser melting
Indirect metal production:
stereolithography
direct light processing
milling resin or wax framework
1. framework
2. finished and polished
3. check fit and occlusion in mouth
3. return to lab
4. teeth setting, final wax up, acrylization
5. tried in mouth, adjust and polish
63
What are the RPD limitations?
* doesn't allow digitalized tooth set up
* expensive
* requires time and expertise
* special supports needed for 3D Printing
* staircase effect due to layering of 3D Printing
* some special designs cannot be produced due to software and manufacturing procedures limitations
64
In which conditions do we use CBCT for endo ?
1. Apical periodontitis detection
2. Periapical surgery
3. Radicular root resorption
4. Dentoalveolar traumatology
5. Complex endo anatomy
65
Differences b/w the 2 surgical templates:
Microguided access:
- address better calcified canals *SOS*
- used for implant placement
Endodontic surgery:
- accurate and reliable access to root apex
- min risks of damaging adjacent critical anatomical structures
- helps preserve cortical bone
- allows clinician to perform min invasive endo microsurgeries (max effective)
66
Procedure with template:
1. Stability and proper seating of fabricated template
2. Small portion of enamel is removed with a diamond bur to expose dentin
3. Guided access cavity prep
4. Irrigation to avoid tooth overheating
5. The apical target point reached when shaft drill end touches the sleeve
67
*SOS*
Where are ancor pins used?
Endo microsurgery
NOT microguided endo access
68
Use of radiographic analysis of CBCT:
- used for 3D location of vital anatomical structures needed to be avoided during implant drilling
- you know the amount of bone available
example: incisive canal, maxillary sinus, nasal floor, mandibular canal, mental foramina
69
*SOS*
Which 2 liner measurements do we use to determine the 3D location of implant placement?
-parasaggital images
Alveolar ridge height:
- extending from alveolar crest to closest anatomical to be avoided
- used to determine implant length
Alveolar ridge B-L width:
- done in level planned to insert the implant
- helps to choose appropriate implant diameter
70
*SOS*
What determines implant position?
PROSTHETIC REHABILITATION plan developed BEFOREHAND
71
*SOS*
What are the digital surgical guides?
=custom made templates for guided drilling and surgical plan to ensure highly accurate drilling and implant placement
- they allow:
1. highly predictable outcomes
2. better soft tissue management, emergence profile, final prostho morpho
72
Where should implants be placed:
away from adjacent implants:
away from adjacent anatomical structures:
away from adjacent teeth:
away from adjacent implants: 3 mm
away from adjacent anatomical structures: 2 mm
away from adjacent teeth: 1.5 mm
73
What are the types of surgical guides?
tooth supported guides
mucosa supported guides
bone supported guides
74
*SOS*
How to achieve superimposition accuracy?
use of transversal slice
75
*SOS*
CAD CAM chair side restorations:
cement retained
| screw retained
76
Cerec TiBase Kit:
Ti base, abutment screw, scanbody
77
When are we using the TiBase and when the Scanpost?
TiBase: if its not deep
Scanpost: if gums taller
-both of them subgingivally
78
*SOS*
Cerec Workflow:
Once the scanning is completed we design the customized abutment or crown with the desired emergence profile based on the size and shape of the tooth restoration, then they are milled from ceramic or composite blocks that have a predrilled hole for screw access. They can be milled with different materials like lithium disilicate, zirconia, enamic
79
What is an apex locator?
=electronic device which determines the position of apical constriction and detecting the root canal space
- R to electrical current
- measured using a pair of electrodes, lip, endodontic file
80
What are stereolithic models?
for planning exactly the jaw osteotomy and bone distraction for oral and maxillofacial surgery
81
What are the examples of Digital Application in Orthodontics?
- digital dental casts
- 3D CBCT
- 3D reconstruction
- digital lateral chephalometric analysis
- 3D CBCT airway assessment
- communication and educational materials for patients
- digital orthodontic treatment
