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Fixed Prosth 3rd year > zweig - digital > Flashcards

zweig - digital Flashcards

1
Q

broad - what is digital dentistry

A 
electronic recors 
photos
radiographs 
patent communication software
digital impressions
computer aided milling
music in office
telephone systems

software
x-rays

goes on to say everything

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2
Q

can someone tell me what a CEREC crown is?

A

basically doing ___ material crown with cad cam technology

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3
Q

procedural steps needed to complete a traditional fixed restoration

A

1-10

  1. decide material
  2. anesthetize
  3. prepa
    ration of tooth to meet requirements of material
  4. isolation
  5. retraction
  6. elastomeric impression
  7. temporaization
  8. send to lab
  9. 2nd visit to try in and adjust
  10. cement
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4
Q

procedural steps needed to complete a CAD/CAM fixed restoration?

A
  1. choose material
  2. anesthetize
  3. prepare tooth
  4. isolation
  5. retract
  6. digital scan of quadrant with the prepped tooth, the opposing quadrant
    . and the bite relationship
  7. mill f the restoration
  8. try in and adjust occlusion
  9. bond the restoration
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5
Q

digital scan of what with CAD/CAM fixed restoration

A

scan of the quadrant with the prepped tooth

the opposing quadrant

and of the bite relationship

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6
Q

the ‘only’ differences are

A

different prep design

digital scanning/ no elastomeric impression

ability to control the design of your restoration

in office milling - no lab fees

can be delivered in a single visit which would mean no temporizaton

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7
Q

materials available in school

A
  1. vita mark II
  2. enamic
  3. IPS e.max CAD
  4. celtra duo
  5. zirconia
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8
Q

flexural strength, indications, post milling processing, and appointment time for vita mark II

A

flexural strength, indications, post milling processing, and appointment time for

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9
Q

emax needs to be

A

glazed and fired all the time

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10
Q

flexural strength, indications, post milling processing, and appointment time for enamic

A

flexural strength
- 112.4 MPA
indications, post milling processing, and appointment time for

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11
Q

why using the material we are

A

EXPOSURE -

using a wide variety of material - more clinical experience and knowledge of the materials avaialble

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12
Q

flexural strength, indications, post milling processing, and appointment time for IPS e.max CAD

A

flexural strength, indications, post milling processing, and appointment time for

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13
Q

flexural strength, indications, post milling processing, and appointment time for celtra duo

A

flexural strength, indications, post milling processing, and appointment time for

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14
Q

flexural strength, indications, post milling processing, and appointment time for zirconia

A

flexural strength, indications, post milling processing, and appointment time

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15
Q

which materials do not require a sintering cycle in the oven? implication?

A

Enamic, vita mark II and celtra duo

cuts down on post-milling processing time in one visit restorative appointment

*also one of the reasons
at school why we use these

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16
Q

types of cerec optical scanner

A

blue cam

omni cam

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17
Q

blue cam

A

individual pictures that are stitched together
requires optical powder on tooth surface

most pictures taken in long axis of tooth only

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18
Q

omni cam

A

VIDEO - NO POWDER

- must capture all tooth and soft tissue data

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19
Q

sirona cerec details

A

the system we use in school

30+ years of CAD/CAM

integration of CBCT

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20
Q

optimal conditions for digital scanning

A
  1. ACCESS
  2. GINGIVAL HEALTH
  3. ability to completely isolate the area to be scanned especially if using BLUECAM
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21
Q

lute which materials

A

zirconia and emax

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22
Q

implication of location of the margin? enamel locatino?

A

supra-gingival

ideal for scanning
- but more related to bonding

enamel present on all margins – makes digital scanning more ideal condition
- but again it is more related to BONDING

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23
Q

implication of location of the margin? enamel locatino?

A

supra-gingival

ideal for scanning
- but more related to bonding

enamel present on all margins – makes digital scanning more ideal condition
- but again it is more related to BONDING

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24
Q

access with regard to optimal condition for digital scanning

A

access– the patient needs to be able to open wide enough to insert the camera in the correct position and the operator needs adequate access in order to accomplish a prep that can be scanned and milled

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25
gingival health with regard to optimal condition for digital scanning
required for all types of fixed restorations - if using blue cam- we need to use reflective powder, any bleeding from the gingiva will prevent us from powdering properly
26
have patient clench during a buccal bite registration
NO | - just bring the teeth together
27
have patient clench during a buccal bite registration
NO | - just bring the teeth together
28
isolation implication
CRITICAL FOR BOTH CAMERAS | - teeth must be kept dry during the scanning process, with or without the powder
29
reflection of the saliva?
bad - will cause the omnicam to stop taking pictures
30
if powder gets wet?
isolation problem - images will look like they are covered with 'mud'
31
scan looks like covered in mud
isolation problem | - likely due to saliva / moisture getting the powder wet
32
scan looks like covered in mud
isolation problem | - likely due to saliva / moisture getting the powder wet
33
soft tissue managemnt - WAYS MENTIONED WE USE
MANDATORY 1. scalpel 2. electrosurgery-- PACKING CORD 3. laser
34
linear scanning
recommended techniuque if well isolated should NOT take long do this then if see black areas then go back to those areas only to fill them in
35
scalpel for soft tissue management
cost efficient but poor hemorrhage control and visibility second appt. often required
36
double cord technique
place 0 or double 00 treated cord cut cord so do not have any cord hanging out of the sulcus second cord is next size up -- and leave a tag of cord out when ready to impress- remove top cord and be sure that the first cord did not pull out you NEED to be able to see the WHOLE margin without cord adjacent to the margin
37
bur size in CAD/CAM
1-1.5 so if angle less than 1mm -- bur does NOT cut it - cannot fit -- will over mill it - meaning thinner restoration
38
software will over mill where but not where
over mill irregularities less than 1 mm on axial walls and occlusa lsurface but will NOT compensate for irregularities all along the margins
39
over mill on margins?
NO | s- so margin needs to be perfect and crisp and totally smooth
40
Requirement for cad cam prep - general
ROUNDED no irregulariteis and spikes slightly more tappered 1. no sharp axial - occlusal angles 2. smooth surfaces 3. preserve as much enamel at margins as possible 4. VERY smooth margins
41
single important thing for great dentistry?
INEGRITY of the dentist in terms of procedure -- prep is most important
42
foundation for well fitting durable restoratino
PREPARATION - spend time required - use vision magnification to evaluate the prep prior to final optical impression
43
implction of saving more enamel / minimal prep
bonding!!! - better bonding to enamel
44
margin type
shoulder or deep shammfer
45
minimum occlusal reduction
2mm
46
depth of margin design
1mm
47
taper on cerec
6-8 is ideal
48
exit angles for inlays and onlays
90 degree
49
proximal box shape
1. rounded smooth box shape; avoid sharp corners 2. walls should taper 6-8 degrees 3. avoid undercuts in walls 4. smooth floor- rough areas may inhibit seating 5. avoid sharp internal angles
50
spike on margin?
will not cut / compensate and crown WILL NOT SEAT
51
onlays crown in cerec design
1 . desire 2-2.5 mm reduction over functional cusps and central fissure 2. at least 2 mm over non funcitnal 3. desire bulk of ceramic at the margin 4. avoid sharp internal angle- keep walls smoth
52
proximal box starting point
line angles outside - in design CENTRAL GROOVE
53
largest cause of ceramic failure
UNDER REDUCTION must have a minimum of 1.5 of PORCELAIN if unable to reduce 2mm occlusally, another material must be chosen note PFM's require at least 1.5mm reduction for success
54
if unable to reduce 2mm occlusally?
CHOOSE ANOTHER MATERIAL
55
EMAX full coverage on posterior reduction? at occlusal axial at margin
occlusal = 1.5 - 2mm axial = 1.5mm at margin = 1 mm rounded internal line angles flat ended tapered diamond bur is utilized to establish a butt joint margin
56
minimal ceramic thickness for crowns inlay/onlays
occlusal = 2 mm axial = 1-1.5 mm at margin = .8mm -- will approach 1 towards axial wall
57
how do we get the best initial proposal?
1. great preps
58
model axis
set model in the proper place in the horseshoe - molars in the dots - premolars in the stripes SET MIDLINE SET BOTH OCCLUSAL PLANES AS FLAT AS POSSIBLE Setting this accuratley Most important part of what kind of proposal we get initially
59
is model axis path of insertin?
NO --
60
T/F can use tools after design has been proposed
true
61
anatomical tool
two directional will move 1/3 of the restoration, keeping the anatomy, in the direction the arrow is pointed multiple areas can be chosen
62
circular tool
will move area of chosen size, as picked on the size wheel does NOT MAINTAIN anatomy and will just move selected area said one he uses the most
63
setting crown color contacts
blue - we want this
64
design tips
1-7
65
turn on or off the minimal thickness icon
TURN ON -- first point on the design tips
66
least 'important' step in the CAD/CAM process most important?
DESIGN = least most = prep and acquisition
67
re-calculate button
will bring you back to starting proposal
68
polishing and glazing with be sure?
ENAMIC can ONLY BE HAND POLISHED be sure - all adjustments have been made - hand polished using porcelain polishing kit use all three grits be very careful that you DO NOT remove proximal contacts finish with diamond polishing paste on a bristle brush place enamic glaze if available and light cure
69
enamic can be only
polished cannot be fired
70
mark II at the end
can be hand polished or fired in oven if needd to add stain then it has to be fired hand polishing done same as enamic -- but no enamic glaze
71
most natural look
hand polished porcelain
72
occlusal adjustment with marrk II
HAS TO BE BONDED FIRST THEN OCCLUSAL ADJUSTMENT
73
emax at end
has to be fired must be fired in oven in order to convert / crystallize block to go to lithium dislicate MUST BE fired in oven to glaze and stain
74
celtra duo at end
gains more strength is fire it but can be hand polished as well
75
luting requires a
retentive prep and intimate fit of crown to prep
76
concepts for cementation
we are BONDING all milled restorations we are using a dual cure resin cement we need to bonf the restoration to the cement we need to bond the tooth to the resin cement therefore -- we need to treat BOTH the intaglio of the restoration and the tooth surface
77
we are ____ all milled restorations
BONDING
78
what do we lute
PFM's and zirconia all else we are bonding?
79
etching of milled restorations for Enamic
60 seconds etch with 5% HF 30 seconds wih 9.6 % HF
80
etching of milled restorations for mark II blocks
(which is feldspathic porcelain) 30 seconds with 9.6% HF
81
etching of milled restorations for emax
20 seconds with 5% HF 10-15 seconds with 9.6% HF
82
etching of milled restorations for celtra duo
30 seconds with 5% HF 20 seconds with 9.6% HF almost same as emax except 5 seconds longer with HF
83
multi-link instruction he highlighted
NOT HF using PHOSPHORIC ACID
84
typical spacing of cement
100 micron space
85
complete kit of multi-link cement
ivoclean monobond self etching primer bottles A and B multi-link cement in auto mix syringe
86
have patient bite on bonded restoration
NO | apply pressure until the end
87
ivoclean use
part of the multi-link kit clean restoration with this if it has been previously etched
88
etch restoration with multi-link when
when it HAS NOT BEEN PREVIOUSLY ETCHED
89
use of monobond
aply this to the INTAGLIO of the restoration for 1 minute -- then air dry

Fixed Prosth 3rd year (17 decks)

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