Hot Topics Fixed Final Flashcards by Tyler Brown

a dental prosthesis worn for varying periods of time, which maintains esthetics, provides masticating surfaces and protects the hard and soft tissues

provisional

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Ease of fabrication and alteration
Strength and resistance to wear abrasion
Inert to eugenol
Poor thermal conductivity
Esthetically acceptable- tooth colored
Color stable
Non-irritating to pulpal tissues

desirable characteristics of provisionals

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Establish occlusion and occlusal plane
Verify tooth prep reductions
size and position of missing teeth
determining path of insertion
evaluation of pontic design
evaluation of esthetic demands
establishment of proper tooth contour and form
Aid in determining condition of cracked tooth

diagnostic characteristics of provisionals

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Protection
Maintenance of healthy tissues
Facilitates impression
Patient evaluation
Evaluate pontic design
Maintains teeth in position
Provide tissue form for implants
Maintain tissue after crown lengthening

Benefits of fabricating accurate and esthetic provisional restorations

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Jet acrylic- Lang

Duralay temp- Reliance

Polymethyl methacrylates

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Bis-GMA composite

Light cured resins (PEM, urethane dimethacrylate)

Hybrid provisionals

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Best abrasion resistance
Best color stability
Good polishability
Good marginal finish

PMM advantages

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High heat polymerization (165)
High shrinkage
Monomer irritant to pulp
Eugenol deteriorates resin

PMM disadvantages

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Indirect techniques
Long-term provisionals
Conventional provisionals
Long span provisionals

PMM indications

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Split line- Lang
Trim- H. J. Bosworth
Snap- Parkell

Polyethylmethacrylate

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Low shrinkage
Rubber stage to set
Longer working time
Lower polymerization temp (125)

PEM advantages

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Poor hardness
Poor abrasion resistance
Poor color stability
Poor finishability
Eugenol deteriorates resin

PEM disadvantages

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Short-term provisionals (1-3 wks)
Direct technique
Short span

PEM indications

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Lowest shrinkage
Negligible heat of polymerization
Lowest pulpal irritability
Eugenol does not affect resin

Epimine advantages

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High cost/unit
Air bubbles
Poorest in color stability, hardness, abrasion resistance
Cannot be corrected by additions

Epimine disadvantages

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most biologically compatible when used in direct technique

Epimine advantages

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Low shrinkage
Corrected by additions
Can be radiopaque

Hybrid advantage

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Brittle
Repairs and mixing are more difficult
Expensive

Hybrid disadvantage

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Long span restorations

Long term provisionals

Hybrid indications

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Pink wax
ESF
PVS impression

all are matrices for provisionals

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Thickness of polypropylene or poly vinyl matrix

0.02”

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Diagnostic wax up
Duplicate cast: Plaster
ESF on cast with plaster index
Minimal preparation on plaster cast
Shell provisional by cast-ESF-index assembly
Abutment teeth preparation
Shell provisional reline intraorally
trim, finish and polish provisional

Indirect-Direct Reline Technique

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Artificial teeth of a partial fixed dental prosthesis that replaces missing natural teeth, restoring function and appearance

pontic

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Which mucosal contact should you never use?

Saddle ridge lap- impossible to clean

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Which mucosal contact do we use?

Modified ridge lap- pretty to clean but still esthetic, convex on lingual/palatal side

Which mucosal contact is egg-shaped?

Ovate- very esthetic but cannot be used for residual ridge with defects

What are the issues with conical pontics?

may create food entrapment on broad residual ridges

Which type of pontic design to use in the posterior?

-hygienic pontic

Minimum, pressure free contact with ridge No acute angles with ridge Occlusal table equal to the adjacent teeth Rigidity Open embrasures Convex, smooth, properly finished tissue surface

Pontic requirements

No tissue blanching Pass thin floss No visible space under contact with tissue on visually esthetic areas as possible

pontic contact requirements

What is the thickness of the pontic contact in metal?

2mm x 2mm

proxabrush floss threaders super floss

great oral hygiene products to clean pontic

To establish a 1mm wide band of metal closely adapted to the tooth, this minimizes dissolution of the luting agent

internal margin objective

What is the space for the luting agent?

25-35 micrometers

Proximal contact adjustment- should grip shim stock

1st step in delivery sequence

Shim stock

most accurate way to adjust proximal contacts

Sequence of using the round wheels

Blue, pink, gray

What should you not use to adjust metal proximal contacts?

Coarse diamonds- they leave rough surface that is difficult to finish

Marginal integrity- disclosing wax, rouge in turpentine, powdered spray (occlude) other detection pasts

2nd step in delivery sequence

Which bur is best used to adjust intaglio surface?

1/2 round or 330

Stability

3rd step in delivery sequence

These can all affect what part of the pontic? | Nodules, distortion during impression or cast, parallelism between abutments, undercuts

All can affect stabilty

Occlusal adjustment

4th step in delivery sequence

Which occlusal contacts are you assessing when adjusting the restoration for delivery?

-centric and eccentric occlusal contacts

Which burs can you use to adjust occlusal contacts

white stones fine diamonds fluted carbides

Lateral and protrusive contacts

eccentric occlusal contacts

metal crown occlusal surfaces are best finished with what kind of burs?

- carbide - white stone - green stone

which bur is best to enhance and maintain the anatomy of the crown?

-small football bur

What is the color progression of the gold polishing kit?

Abrasive silicone wheels: - coarse brown - dark green medium - light green fine

Contouring

5th step in delivery sequence

Adjust these during what step of delivery? Gingival third Embrasures Pontic design

contouring (5th step)

Flexible diamond disk porcelain grinding wheel Diamonds Porcelain adjustment kit, abrasive wheels and points

-Armamentarium for contouring porcelain

A fusible metal alloy used to unite the edges or surfaces of two pieces of metal

solder

This is a designation given to gold solders to indicate the proportion of pure gold contained in 1000 parts

Fineness

High fusing alloys that slightly melt beneath the softening point of the parent alloy to be joined; should flow well above the fusion range of the subsequent applied porcelain

pre-ceramic solders

What is the gap distance for soldering complete gold FPDs?

-0.25mm

``` Difficult (narrow melting range) Volatization of base metal Microporosity or pitting Not good bond with porcelain Color Corrosion ```

Disadvantages of Pre-Ceramic soldering

Low fusing alloys that melt bellow the pyroplastic range of the porcelain

post-ceramic solders

Less chance of sag or deformation of the framework Slightly weaker and more brittle solder joint since frame work cannot be quenched Small gap space for solder= incomplete joint Large gap space for solder = decreases strength, higher porosity, higher meniscus, more difficult to solder

disadvantages of post-ceramic soldering

This is used to limit the spreading of the solder It is placed in areas of the casting before the flux to prevent the flow of the molten solder Typically graphite or rouge (iron oxide) with turpentine as a solvent are used in this

Antiflux

``` This is a substance applied to the metal surface to be soldered to remove oxides or prevent their formation Borax Glass (Na2B4O7) with gold alloys comprise this substance ```

Soldering flux

Soldering investments contain what ?

Fused quartz

How do you restore fatigued color vision?

-view pale blue or gray surface between shade matching

This is the phenomenon of two objects appearing to match in color under one condition but showing apparent differences under another

Metamerism

What are the 3 components of color

Value- light/dark Hue- color Chroma- saturation

Vita shade guide color progression from left to right

A- red-brown B- red-yellow C- gray D- red-gray

First step in vita shade selection

Hue

2nd step in vita shade selection

Chroma

3rd step in vita shade selection

Value

What should you do to enhance your ability to distinguish value?

squint- decreases light --> diminish cone sensitivity, increase rod sensitivity

Steps in Vitapan - 3D shade guide

Value, Chroma, Hue

Which shade guide is better at reproducing value?

Vitapan 3D master shade guide

How do you trick the eye in to thinking teeth are wider/narrower?

Move line angles out/in

What are the disadvantages of the external color modification and characterization?

- causes a loss of fluorescence | - increases the effect of metamerism

How do you externally modify chroma?

-add yellow or orange

How do you externally modify hue?

- add pink/purple to move towards red | - add yellow to move away from red

Adding stains lowers the ____ of the restoration and increases the metameric effect

-Value

Degree of luster is dependent on what factors

Temp and time

This process strengthens a porcelain restoration similar to polishing

Glazing

Hot Topics Fixed Final Flashcards

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