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Fixed Prostodontics > Finishing and Polishing Cast Gold & All Ceramic Restorations > Flashcards

Finishing and Polishing Cast Gold & All Ceramic Restorations Flashcards

1
Q

Steps after waxing up a gold crown
(2)

A

*Send it to the lab for casting it- they use the same technique I have showed
in my investing and casting lecture earlier.
*Lab returns a gold casted crown with sprue.

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2
Q

Patient Try-In (Lab Procedures – Use Typodont)
(3)

A

*(Anesthesia when necessary)
*Remove interim crown; clean with explorer / pumice
*Hypersensitivity

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3
Q

Hypersensitivity –

A

postpone cementation.
*Perfect the interim crown and cement with ZOE (TempBond).

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4
Q

Airway Protection –

A

Throat Pack
Gauze 4X4 / upright position (not more than 45o recline)

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5
Q

Sequence of Clinical Steps- VVV IMP
(7)

A
  1. Proximal contacts
  2. Internal fit
  3. Marginal integrity
  4. (Stability & Retention)
  5. Occlusion
  6. External contours
  7. Surface finish
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6
Q

Patient Try-In: Seating Crown
*Seat crown with finger pressure
*Observe relationship to other teeth and tissues
(2)

A

*Marginal ridges and proximal contacts
*Marginal closure

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7
Q

—- most often prevent crown from seating intraorally.

A

*Proximal contacts

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8
Q

Patient Try-In:
#1. Evaluate and adjust proximal contacts
*Proximal contacts most often prevent crown from seating intraorally.
*Mark with

A

Accufilm; adjust with abrasive wheel
*(Cuttle fine or blue disc; adjust from below and upward)
*Not with a finishing bur or diamond point
*DO THIS FIRST !!!

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9
Q

Craytex Wheel or Fine Sandpaper Disc

A

Grind from inferior border of heavy marking
Burlew Wheel Finish

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10
Q

Proximal Contacts
Objective:
(2)

A

*Adjust to correct size, shape, and tightness.
*Leave very slightly tight to allow for final polish.

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11
Q

Proximal Contacts
Procedure:
(3)

A

*Evaluate contacts visually, with floss, and with shimstock.
*Place articulating film between casting and adjacent tooth, seat crown.
*Selectively adjust region of binding

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12
Q

Selectively adjust region of binding:
(2)

A

*Inferior portion of mark
*Craytex wheel, Burlew wheel, Shofu Brownie polishing discs

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13
Q

Seating the Crown: Proximal Contacts
*Place the crown and check for appropriate proximal contacts using

A

shimstock and then Accufilm.
*Check the location and intensity of the proximal contacts:
*Place shimstock interproximally (should drag through with resistance)

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14
Q

Seating the Crown: Proximal Contacts
*Check the location and intensity of each of the proximal contacts:
*Place Accufilm interproximally to evaluate where the crown should be —
*Use the — disc if slight adjustment is necessary; the (2) may be used if more significant reduction is necessary.

A

adjusted, if necessary.

Blue
separating disc or
diamond disc

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15
Q

Seating the Crown: Internal Fit
*Fit crown to tooth using

A

Blue Fit Checker (any binding areas are more
easily visible than with White Fit Checker).

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16
Q

Internal Surface (intaglio)
Procedure:

A

binocular microscope or loupes
*Identify and remove “positive” contacts
*Fit Checker, disclosing wax
*Burn through – nodules, internal line and point angles
*Selective grinding – #1 round carbide
*Remove slight excess
*Indiscriminate removal is unacceptable
*Repeat steps
*Sandblast and steam clean as final step

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17
Q

Fit crown to tooth using Blue Fit Checker*Clinically, if adjustment is necessary, adjust the preparation using

A

a fine grit
diamond; not the intaglio of the all-ceramic crown.
*Why?

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18
Q

Using Accuflim IV as the fit checker
*Clinically, if adjustment is necessary, adjust the preparation using a fine grit diamond.
Accufilm IV can be used to mark the

A

intaglio of the crown, which will make a
corresponding mark on the prep.
*Is this normal?

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19
Q

Clean the Restoration
*Clean intaglio surface which has been contaminated with Accufilm IV
using
*In addition, the surface can also be cleaned with

A

Q-tips and solvent (rinse thoroughly and dry).
etchant gel and rinsed
thoroughly.

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20
Q

Sprue Removal
*Remove the sprue using the

A

separating disc mounted on the mandrel with the slow-speed handpiece (HP).
*Smooth the roughened surface with the Blue rubber abrasive disc.

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21
Q

Seating the Crown:
Evaluate Complete Seating / Margin Adaptation
*Evaluate the marginal integrity using the

A

cowhorn or perio explorer for
vertical closure, as well as the horizontal contour and extension.

22
Q

A small — can be corrected
by carefully adjusting the casting.

A

overhang

23
Q

Marginal Integrity
*Check for completeness of seating and marginal adaptation.
*Remove any
*Fine grit diamond disc
*Blue course polishing wheel

A

over-extension of ceramic material.

24
Q

Adjustment of long, thick margin
*Remove excess with
*Polish with fine rubber disc
*View from inside / outside casting as you go

A

Burlew wheel

25
Q

Margin Evaluation and Adaptation
A small ledge of enamel is generally unacceptable -

A

increases
the risk of recurrent caries (and sensitivity).

26
Q

An — margin requires
making a new casting.

A

open

27
Q

Open Margin???
(3)

A
  1. Heavy proximal contact:
  2. Internal binding due to distortion or undercut:
  3. Casting with open margin must be re-made
28
Q
  1. Heavy proximal contact:
A

Re-check it

29
Q
  1. Internal binding due to distortion or undercut:
    (4)
A

*Sandblast the internal surface
*Disclose with Fit-checker, aerosol, or disclosing wax
Adjust minimally with #330 or green stone
*Stay away from margin
*Avoid eliminating grooves (unless causing undercut)

30
Q
  1. Casting with open margin must be re-made
    (1)
A

*Determine cause and correct it first.

31
Q

Marginal Adaptation
Procedure:

A

binocular microscope and/or loupes
“Negative” defect – i.e., short or open margin
*One or two-way catch
*Remake
*Additional visit for new impression, ….
“Positive” defect - i.e., overextension
*One-way catch
*Stone or rubber wheel – slow speed handpiece
*Steady hands
*If margin damaged – remake

32
Q

Gold Margin Finishing (fully seated casting)
*Burnishing “softened” metal (type III or softer)

A

*Margin must fit.
*Surface is drawn or moved by rubbing w/ steel point
*Marginal improvement: 30 - 80 microns
*Subgingival (most FGC’s): burnish on die
*Supragingival: burnish & finish (white stone) on tooth
*No finishing on typodontteeth

33
Q

Occlusal Surface
Procedure:

A

*Mylar articulating film
*Mark occlusal contacts
*Shimstock
*Evaluate the precision
*Iwanson gauge
*Prevent perforation
*Maintain bulk of restoration
*Adjust premature contacts
*Green stone, white stone, brownie point
*Maintain anatomy of cusp or ridge

34
Q

Occlusal Adjustment (fully seated casting)
1. Check adjacent teeth without crown in place.
2. Check occlusion with crown in place.
*Use — to determine if the crown is in hyper-
occlusion or infra-occlusion.

A

shimstock

35
Q

Occlusal Adjustment
*Locate contacts without crown in place

A

*Mylar articulating film
*Shimstock
*Visual check amount of “opening” of adjacent teeth
*Use adjacent marginal ridges as guides
*MIP then lateral excursions

36
Q

Occlusal Adjustment*When complete seating has been verified, mark the occlusal contacts with
Accufilm, and slight adjustments can be made with the fine

A

grit football diamond
(low high-speed / water) and/or the blue diamond abrasive point (slow-speed /
contra-angle).

37
Q

Always check the — of the occlusal surface before adjustment.

A

thickness

38
Q

Anatomy can be accentuated with a — or diamond (low speed / water),
if necessary.

A

½ round bur

39
Q

Adjust heavy occlusal markings(triangular ridges / fossae / marginal ridges)
speed

A

SLOW-SPEED ONLY

40
Q

1) Evaluate centric occlusal contact

A

*Close and squeeze; mandible may deviate
*Shift to the buccal (toward side of restoration)
*Lingual inclines mn buccal cusps / mx lingual cusps
*Shift to the lingual (medial)
*B inclines mn lingual cusps / L inclines mx lingual cusps
*B inclines mn buccal cusps / L inclines mx buccal cusps

41
Q

2) Check / adjust lateral excursive contact

A

*“Working side” prematurity
*B inclines mn lingual cusps / L inclines mx lingual cusps
*“Group function” contact on working side
*“Non-working side” prematurity
*L inclines mn buccal cusps / L inclines mx lingual cusps

42
Q

3) Check and adjust protrusive contact
*Maxillary:
*Mandibular:

A

distal inclines
mesial inclines

43
Q
  1. External Contours
A

*Physiologic / esthetic contours
*Cervical areas – proper emergence profile
*Proper cusp angulation / contours
*Edge-edge occlusion: cheek biting
*Over-contour / long

44
Q

Pre-Cementation Finishing and Polishing
*Polish with

A

rubber abrasive points and discs.
*Brownie – Greenie – Super Greenie
*Avoid over-polishing occlusal contacts / proximal contacts
*Straight handpiece / slow speed

45
Q

Final Polish with Rouge
*Polish with rouge (Robinson brush / Chamois wheel)

A

*ABSOLUTELY NOT INTRAORALLY ON TEETH!!
*Clean with Polishing Compound Remover
*No remnant of polishing abrasive
*Prevents cement adhesion → de-bonding

46
Q

Pre-Cementation Finishing and Polishing

A

*Re-check the occlusal contacts
*Re-check the proximal contact and contours
Restoration must be CLEANFree of polishing compound, residue (internal), moisture or saliva contamination
*READY TO CEMENT!

47
Q

Pre-cement-Polish the Restoration
After using the blue coarse polishers on the axial and occlusal surface for adjustment and
shaping / finishing; use the

A

pink medium disc and point to polish the axial and occlusal
surfaces, respectively.

48
Q

Pre-cement-Polish the Restoration
*After using the pink medium polishers, use the gray fine disc and points to further polish
the
*The final polish can be obtained using diamond polishing paste and a felt wheel.
Alternatively, the clinical single use Ceramodot and disposable bristle brush can be used.

A

axial and occlusal surfaces.

49
Q

Evaluation
*Surface Topography (Intaglio)
(2)
*Tooth preparation is —;
*Ready for cementation (bonding)

A

*Smooth, no laminations or voids
*Snug, passive fit; clean

CLEAN

50
Q

Whatever type of crown it is- regardless of the material the steps in
finishing and polishing remain the same except the

A

burs/
armamentarium changes depending on the type/ material of the
restoration.

Fixed Prostodontics (19 decks)

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