Podcast
Podcast
Podcast
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Questions and Answers
Questions and Answers
What does Category A in the decision-making process indicate?
What does Category A in the decision-making process indicate?
- Direct restorations clearly indicated. (correct)
- Indirect restorations clearly indicated.
- Uncertainty between direct and indirect restorations.
- Indications are based on patient preference.
In what situation would an indirect approach be preferred according to the decision-making categories?
In what situation would an indirect approach be preferred according to the decision-making categories?
- When the patient has strong preferences.
- When cuspal protection is required for endodontically treated teeth. (correct)
- When there is uncertainty over the appropriate approach.
- When direct restorations are clearly indicated.
Which factor can complicate adhesive techniques during the restoration process?
Which factor can complicate adhesive techniques during the restoration process?
- Usage of direct restorations.
- Selecting indirect restorations.
- A well-controlled dry field.
- Inability to maintain a dry field. (correct)
What potential issue can arise from insufficient thickness in ceramic restorations?
What potential issue can arise from insufficient thickness in ceramic restorations?
In which category is there uncertainty about the most appropriate restorative approach?
In which category is there uncertainty about the most appropriate restorative approach?
Why might indirect techniques be advantageous for large restorations?
Why might indirect techniques be advantageous for large restorations?
Which situation is most likely to indicate a direct restoration?
Which situation is most likely to indicate a direct restoration?
What are the modifying factors to consider when deciding between direct and indirect restorations?
What are the modifying factors to consider when deciding between direct and indirect restorations?
What is the primary advantage of using indirect esthetic restorations over direct restorations?
What is the primary advantage of using indirect esthetic restorations over direct restorations?
Which material is commonly used in the creation of indirect esthetic restorations?
Which material is commonly used in the creation of indirect esthetic restorations?
What is an important step in the preparation of a tooth for indirect esthetic restorations?
What is an important step in the preparation of a tooth for indirect esthetic restorations?
Which process is utilized to bond indirect esthetic restorations to the tooth?
Which process is utilized to bond indirect esthetic restorations to the tooth?
What aids in the fabrication of indirect esthetic restorations using modern technology?
What aids in the fabrication of indirect esthetic restorations using modern technology?
What is a common limitation of direct esthetic restorations?
What is a common limitation of direct esthetic restorations?
Which of the following methods is NOT typically used for the fabrication of indirect esthetic restorations?
Which of the following methods is NOT typically used for the fabrication of indirect esthetic restorations?
What technique precedes the cementation of indirect esthetic restorations?
What technique precedes the cementation of indirect esthetic restorations?
What is the minimum width required for any isthmus in most ceramic systems?
What is the minimum width required for any isthmus in most ceramic systems?
Which of the following is NOT a benefit of immediate dentin sealing (IDS)?
Which of the following is NOT a benefit of immediate dentin sealing (IDS)?
Why should the occlusal portion of the preparation be 2 mm deep during cusp coverage?
Why should the occlusal portion of the preparation be 2 mm deep during cusp coverage?
What should be done during photopolymerization of IDS to avoid the effect of oxygen inhibited layers?
What should be done during photopolymerization of IDS to avoid the effect of oxygen inhibited layers?
What is one purpose of deep margin elevation (DME)?
What is one purpose of deep margin elevation (DME)?
Which of the following is NOT considered a method for performing DME?
Which of the following is NOT considered a method for performing DME?
What are the aims of provisionalization in dental procedures?
What are the aims of provisionalization in dental procedures?
In which phase of the dental restoration process is the digitization of conventional models most relevant?
In which phase of the dental restoration process is the digitization of conventional models most relevant?
Why should deep subgingival preparations generally be avoided?
Why should deep subgingival preparations generally be avoided?
What is one of the primary benefits of anatomically driven tooth preparation?
What is one of the primary benefits of anatomically driven tooth preparation?
What should be the minimum thickness of restorative material in cavity preparations?
What should be the minimum thickness of restorative material in cavity preparations?
What type of angle should all margins have to ensure marginal strength of the restoration?
What type of angle should all margins have to ensure marginal strength of the restoration?
What should be the gingival-occlusal divergence of the preparation walls?
What should be the gingival-occlusal divergence of the preparation walls?
What is the primary purpose of occlusal adjustment in ceramic restorations?
What is the primary purpose of occlusal adjustment in ceramic restorations?
Which of the following statements about beveling the margins is true?
Which of the following statements about beveling the margins is true?
Which material is achieved by injecting a fast-setting vinyl polysiloxane into the impression?
Which material is achieved by injecting a fast-setting vinyl polysiloxane into the impression?
How can retention of the restoration be improved?
How can retention of the restoration be improved?
What enhances the smoothness of ceramic restorations during polishing?
What enhances the smoothness of ceramic restorations during polishing?
What is a crucial factor for the success of indirect esthetic restorations?
What is a crucial factor for the success of indirect esthetic restorations?
What is the purpose of using a tapered diamond for tooth preparation?
What is the purpose of using a tapered diamond for tooth preparation?
What technique is used for further smoothing of restorations after initial polishing?
What technique is used for further smoothing of restorations after initial polishing?
Which of the following is NOT a step in the process of indirect esthetic restorations?
Which of the following is NOT a step in the process of indirect esthetic restorations?
Which method can be used to remove excess resin cement during restoration procedures?
Which method can be used to remove excess resin cement during restoration procedures?
What type of restorations have been improved due to advances in ceramic, polymer, and adhesive technologies?
What type of restorations have been improved due to advances in ceramic, polymer, and adhesive technologies?
What is the main purpose of using Hydrofluoric acid in the bonding process of silica-based materials?
What is the main purpose of using Hydrofluoric acid in the bonding process of silica-based materials?
Which statement accurately describes the cementation materials used in dental restorations?
Which statement accurately describes the cementation materials used in dental restorations?
What is the recommended action to prepare the tooth surface when using resin cement?
What is the recommended action to prepare the tooth surface when using resin cement?
What is the role of a silane coupling agent in the bonding process?
What is the role of a silane coupling agent in the bonding process?
Which of the following is NOT part of the procedures for finishing and polishing dental restorations?
Which of the following is NOT part of the procedures for finishing and polishing dental restorations?
What should be monitored during the try-in phase of restoration?
What should be monitored during the try-in phase of restoration?
What is a common technique for preparing the fitting surface prior to cementation?
What is a common technique for preparing the fitting surface prior to cementation?
What is the function of light curing in cementation processes?
What is the function of light curing in cementation processes?
Questions and Answers
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Flashcards
Flashcards
Category A (Direct Restoration)
Category A (Direct Restoration)
A decision-making framework for choosing between direct and indirect restorations, where direct restorations are clearly the best option.
Category B (Uncertainty)
Category B (Uncertainty)
A situation where it's uncertain which restoration method is best - direct or indirect.
Category C (Indirect Restoration)
Category C (Indirect Restoration)
A decision-making framework for choosing between direct and indirect restorations, where indirect restorations are clearly the best option.
When to Use Indirect Restorations
When to Use Indirect Restorations
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Dry Field Requirement
Dry Field Requirement
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Occlusal and Parafunctional Habits
Occlusal and Parafunctional Habits
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Why avoid deep subgingival margins?
Why avoid deep subgingival margins?
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What is an anatomically driven preparation?
What is an anatomically driven preparation?
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How do anatomically driven preparations improve adhesion?
How do anatomically driven preparations improve adhesion?
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How do anatomically driven preparations minimize dentine exposure?
How do anatomically driven preparations minimize dentine exposure?
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What's the minimum thickness for restorative material?
What's the minimum thickness for restorative material?
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Why are rounded internal angles important?
Why are rounded internal angles important?
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What is a butt-joint cavosurface angle?
What is a butt-joint cavosurface angle?
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What is gingival-occlusal divergence?
What is gingival-occlusal divergence?
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Scalpel Blade
Scalpel Blade
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Flexible Model Technique
Flexible Model Technique
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Polishing Ceramic Restorations
Polishing Ceramic Restorations
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Indirect Esthetic Restoration
Indirect Esthetic Restoration
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Tooth Preparation
Tooth Preparation
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Bonding Indirect Restorations
Bonding Indirect Restorations
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Occlusal Adjustment
Occlusal Adjustment
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Ceramic Restoration Polishing Sequence
Ceramic Restoration Polishing Sequence
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What are Indirect Esthetic Restorations?
What are Indirect Esthetic Restorations?
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What are some examples of Indirect Esthetic Restorations?
What are some examples of Indirect Esthetic Restorations?
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How are Indirect Restorations made?
How are Indirect Restorations made?
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What types of materials are used to make Indirect Restorations?
What types of materials are used to make Indirect Restorations?
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What's an example of a common material used for Indirect Restorations?
What's an example of a common material used for Indirect Restorations?
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What is CAD/CAM used in Indirect Restoration fabrication?
What is CAD/CAM used in Indirect Restoration fabrication?
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What is cavity preparation in Indirect Restorations?
What is cavity preparation in Indirect Restorations?
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What is impression taking for Indirect Restorations?
What is impression taking for Indirect Restorations?
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Try-in
Try-in
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Cementation
Cementation
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Resin Cement
Resin Cement
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Tooth Surface Treatment
Tooth Surface Treatment
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Fitting Surface Treatment
Fitting Surface Treatment
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Light Curing
Light Curing
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Excess Removal and Polishing
Excess Removal and Polishing
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30-fluted carbide finishing burs
30-fluted carbide finishing burs
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Smooth Pulpal Floor
Smooth Pulpal Floor
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Isthmus Width
Isthmus Width
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Cusp Coverage Depth
Cusp Coverage Depth
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Shoulder for Cusp Capping
Shoulder for Cusp Capping
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Immediate Dentin Sealing (IDS)
Immediate Dentin Sealing (IDS)
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Glycerin for IDS
Glycerin for IDS
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Deep Margin Elevation (DME)
Deep Margin Elevation (DME)
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Impression Techniques
Impression Techniques
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Flashcards
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Study Notes
Study Notes
Course Title
- BDS11173 Indirect Esthetic Restorations
Course Aim
- Detail different types of indirect esthetic restorations, their indications, and materials used.
- Explain selecting the best restoration and preparing the tooth to receive it.
- Explain bonding indirect esthetic restorations.
Course Objectives
- Understanding the diverse indirect esthetic restorations and their indications.
- Understanding the steps and process in indirect esthetic restorations, including tooth preparation.
Outline
- Limitations of direct esthetic restorations and indications of indirect restorations.
- Materials and techniques of fabrication.
- Material selection.
- Advantages of indirect restorations.
- Indications of indirect restorations.
- Cavity preparation.
- IDS & DME.
- Impression techniques.
- Provisionalization and try-in.
- Cementation.
- Finishing and polishing.
Limitations of Direct Esthetic Restorations
- Marginal fracture.
- Inadequate bond.
- Shrinkage.
- Marginal adaptation.
- Shrinkage stress.
Indirect Esthetic Restorations
- Fabricated outside the patient's mouth.
- Made on a replica of the prepared tooth.
- Created in a lab or using CAD/CAM.
Indirect Esthetic Restorations: Popularity
- Driven by patient demand for aesthetics, durable restorative materials.
- Improvements in materials, fabrication techniques, adhesives, and resin-based cements.
Indirect Esthetic Materials and Fabrication Techniques
- Ceramics (feldspathic porcelain, castable ceramics, hot-pressed ceramics, infiltrated ceramics, machined ceramics).
- Hybrid Ceramic.
- Resin Composite. -CAD/CAM (Laboratory, flexi models, 3D printing)
Material Selection
- Modules of elasticity and surface luster and wear to the opposing and wear resistance.
Advantages of Indirect Restorations
- Higher physical and mechanical properties.
- Variety of materials and techniques.
- Wear resistance.
- Reduced polymerization shrinkage.
- Support of remaining tooth structure.
- More precise control of contours and contacts.
- Increased auxiliary support.
- Biocompatibility and good tissue response.
Indications of Indirect Restorations
- Lesion size, etiology, and number of involved surfaces.
- Number of teeth affected.
- Patient compliance, habits, and preferences.
- Dentist's competence.
Decision-Making Process: Direct vs. Indirect
- Category A: Direct restorations are suitable.
- Category B: Uncertainty over the best approach.
- Category C: Indirect restorations are better.
Additional Indirect Restoration Indications
- Replacement of large compromised existing restorations.
- Contour and occlusal contact ease of development.
- Endodontically treated posterior teeth where cuspal protection is needed.
Modifying Factors
- Inability to maintain a dry field. This impacts long-term success.
- Occlusion and para-functional habits (bruxing, clenching).
- Deep subgingival preparations (not an absolute contraindication but generally avoided).
Cavity Preparation
- Check occlusion.
- Field isolation.
- Tools.
- General criteria.
- Cusp reduction.
- Finish line.
- Recent modifications.
- Patient anesthetization
- Area isolation with rubber dam.
- Amalgam or exposure removal.
- Removal of caries.
- Using different tools.
Tools for Tooth Preparation
- Tapered diamond burs for occlusally divergent facial and lingual walls.
- Rounded-end cutting instruments.
- Finishing diamonds.
Anatomically Driven Preparation
- Maintains favorable stress distribution.
- Improves adhesion.
- Minimizes dentin exposure which supports hard tissue preservation
- Optimizes esthetic integration.
- Preparation design to be adequate thickness.
- Rounded internal angles.
- Well-defined margins.
- Facial and lingual extensions.
- Smooth curves around cusps.
Margins
- 90-degree butt-joint cavity surface angle (for strength).
- Avoid beveling.
- Surface increased for bonding with glass based materials.
- Gingival-occlusal divergence of >2-5 degrees per wall .
Resistance and Retention
- Resistance of the tooth structure.
- More surface area for bonding.
- Lateral displacement prevention and undercut blocking.
Pulpal Floor and Isthmus
- Smooth and relatively flat.
- Isthmus needs a minimum 2mm.
- Smooth transition for strength.
- 2mm deep for cusps.
Capping Cusps
- Shoulder preparation.
- Prevent accidental contact with opposite tooth.
Immediate Dentin Sealing (IDS)
- Better adhesive properties of freshly cut dentin.
- Less intra- and post-operative hypersensitivity.
- Better bond strength to dentin.
- Two-step adhesive or universal adhesive covered with flowable composite.
- Glycerin coverage during photopolymerization.
Deep Margin Elevation (DME)
- Placing the gingival margin of the restoration for cementation ease, better impressions, restoration seating, and excess removal.
- Usable composites are flowable, bulk fill, injectable.
Impression
- Conventional method.
- Digitization of conventional model.
- Digital method.
Fabrication
- Ceramics.
- Hybrid ceramics.
- Resin composite.
- CAD/CAM(lab, flexi, 3D printing).
Provisionalization
- Stabilizes both occlusal and proximal contacts.
- Protects soft tissue.
- Materials include light-cured temporary filling.
- Additional option is 3D printed restoration.
Try-in
- Checking the fit, and proximal contact.
- Assessing adaptation of margins.
- Materials including Wax, PMMA, or final materials.
Cementation
- Cement material selection.
- Tooth surface treatment.
- Fitting surface treatment.
- Light curing.
- Excess removal and polishing.
Resin Cement vs. Composite
- Comparison between resin cement and heated flowable composites.
Resin Cement
- Dual cure vs. light cure: (restoration thickness, translucency, and aesthetics.)
- Conventional vs. self-adhesive.
Tooth Surface Treatment and Cementation
- Material specific treatments based on structure and materials.
- Use of etching, primers, and adhesives.
- Acidity considerations.
Bonding of Silica Based Restorations
- Hydrofluoric acid: etches the internal surfaces.
- Acid-etching: enhances surface area for micromechanical bonding.
- Bonding generally done in office or lab.
Bonding to Tooth Structure
- Tooth surface refreshment using Alumina is key.
- Selective etching technique / self-etching technique.
Finishing and Polishing
- The use of 30-fluted carbide finishing burs for smoothing interproximal surfaces.
- Using a scalpel blade to eliminate resin cement.
- Polishing ceramic restorations using abrasive techniques.
Occlusal Adjustment and Re-polishing
- Occlusal adjustment tools and techniques.
Finishing Processes
- Smoothing with rubber abrasive points/cups.
- Diamond polishing using paste and tools.
Flexible Model Technique
- Fast-setting vinyl polysiloxane injection.
- Setting time.
- Dye separation.
- Silicon cast creation.
- Layer build up with different shades and curing.
Additional Information
- Reading materials are presented for further study.
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