Dental Crowns Quiz

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Questions and Answers

Which of the following is a synonym for a full metal crown?

  • Three-quarter crown
  • Complete cast crown (correct)
  • Onlay
  • Partial veneer crown

What is a primary advantage of using a full metal crown compared to other crown types?

  • Superior aesthetics and natural appearance
  • Minimal tooth structure removal during preparation
  • Exceptional strength and durability (correct)
  • Ease of vitality testing

A patient has a tooth with extensive decay. Which type of restoration is most suitable to fully protect the remaining tooth structure from fracture?

  • Porcelain veneer
  • Full metal crown (correct)
  • Composite filling
  • Ceramic inlay

Which of the following is considered a disadvantage of using a full metal crown?

<p>Potential interference with taste (A)</p> Signup and view all the answers

A full metal crown is indicated in which situation?

<p>To cover a tooth with a large amalgam filling, protecting it and the tooth from fracture. (A)</p> Signup and view all the answers

What is the minimum percentage of noble elements required for a crown to be classified as a noble metal crown?

<p>25% (B)</p> Signup and view all the answers

Which of these characteristics is NOT one of the primary reasons for using a dental crown?

<p>To easily test the vitality of the tooth (D)</p> Signup and view all the answers

The use of a full metal crown will typically result in which of the following?

<p>More extensive tooth structure removal compared to a partial crown (A)</p> Signup and view all the answers

When is a full metal crown indicated for a tooth?

<p>When maximum retention and resistance are needed, or when recontouring is needed for a removable partial denture clasp. (C)</p> Signup and view all the answers

What is a contraindication for using a full metal crown?

<p>When there is a low need for retention and resistance, or when a more conservative crown could be used. (B)</p> Signup and view all the answers

Which of the following is NOT a step in tooth preparation for a complete cast crown?

<p>Gingival surface preparation. (C)</p> Signup and view all the answers

Which of the following burs is NOT listed in the armamentarium for tooth preparation?

<p>Fine-grit long needle diamond. (A)</p> Signup and view all the answers

During tooth preparation for a full metal crown, what is the recommended taper for axial reduction?

<p>6-degree taper. (C)</p> Signup and view all the answers

What is the location of the preparation margin for a full metal crown?

<p>Supra-gingival. (B)</p> Signup and view all the answers

Which of the following describes the functional cusps?

<p>Lingual cusps of the upper teeth and buccal cusps of the lower teeth. (A)</p> Signup and view all the answers

What is the purpose of placing a functional cusp bevel during occlusal reduction?

<p>To provide an adequate thickness of metal over the centric or functional cusp. (B)</p> Signup and view all the answers

When creating guiding grooves for occlusal reduction, where should a groove be placed?

<p>At the low points and high points of each cusp. (C)</p> Signup and view all the answers

What is the recommended depth of the orientation grooves on a nonfunctional cusp during occlusal reduction?

<p>1 mm (C)</p> Signup and view all the answers

Which instrument is best suited for initially creating the depth orientation grooves during occlusal reduction?

<p>Round-end tapered diamond bur (C)</p> Signup and view all the answers

After using the diamond bur and making the initial reductions. Which instrument is used to precisely judge the depth of the grooves?

<p>Enamel chisel (D)</p> Signup and view all the answers

When placing guiding grooves during axial reduction, to what should the shank of the diamond bur be parallel?

<p>The proposed path of withdrawal of the restoration (A)</p> Signup and view all the answers

How is tooth structure removed between the created grooves during occlusal reduction?

<p>In an inclined manner. (D)</p> Signup and view all the answers

What type of diamond bur is recommended for facial and lingual axial reduction?

<p>Torpedo diamond (D)</p> Signup and view all the answers

Where is the chamfer finish line created when reducing the buccal surface with a torpedo diamond?

<p>At the same line as the reduction (A)</p> Signup and view all the answers

What type of bur is primarily used for planar occlusal reduction?

<p>Round-end tapered diamond bur and no. 17 bur (B)</p> Signup and view all the answers

What is used to check the occlusal clearance after the occlusal and functional cusp preparation?

<p>Utility wax (A)</p> Signup and view all the answers

During facial axial reduction, how far should the reduction extend interproximally?

<p>As far as possible without nicking adjacent teeth (C)</p> Signup and view all the answers

When is an 'RGS 3' instrument used during the tooth preparation process?

<p>To measure the clearance of tooth reduction. (B)</p> Signup and view all the answers

What does an occlusal view of the tooth preparation reveal at this stage of axial reduction?

<p>Isolated areas of undecked tooth structure around proximal contacts (D)</p> Signup and view all the answers

What type of diamond bur is used for proximal reduction?

<p>Short, thin needle diamond (B)</p> Signup and view all the answers

How is the thin needle diamond used when performing proximal reduction?

<p>In an up-and-down motion against the remaining tooth structure (A)</p> Signup and view all the answers

What type of bur is typically used to increase the depth of reduction and create a finish line?

<p>Torpedo bur (D)</p> Signup and view all the answers

Where is the seating groove typically placed in relation to the chamfer?

<p>0.5mm above the chamfer (C)</p> Signup and view all the answers

In full veneer crown preparation, after the breaking of proximal contact, what is the next key step?

<p>Placement of retentive grooves (B)</p> Signup and view all the answers

Which of the following is a critical area to consider during crown preparation?

<p>The entire prepared tooth structure (B)</p> Signup and view all the answers

What is the purpose of using a torpedo bur in crown preparation?

<p>To refine the finish line and increase reduction depth (A)</p> Signup and view all the answers

What is the initial step in preparing the occlusal surface?

<p>Creation of occlusal guiding grooves (D)</p> Signup and view all the answers

What role do alignment grooves play in axial reduction?

<p>They guide the bur during axial reduction (D)</p> Signup and view all the answers

What is the final step in the preparation of a full veneer crown?

<p>Finishing the preparation (A)</p> Signup and view all the answers

Flashcards

Full Metal Crown

A type of dental crown that completely covers the tooth's visible portion, made entirely of metal. It's known for its durability and strength.

All Metal Crown

A dental crown made entirely of metal, offering high strength and durability. It's often used for restoring teeth with extensive damage or when strength is paramount.

Why do we use Full Metal Crowns?

Full metal crowns are designed to protect a tooth from breaking or to hold the cracked parts of the teeth together. They can also be used to cover misshaped or discolored teeth, restore broken teeth, support teeth with large fillings, cover teeth treated with root canals, and cover dental implants.

Types of Metal Crowns

Full metal crowns are made of different types of metals depending on their noble element content. High noble metal crowns contain at least 60% noble elements, noble metal crowns contain at least 25%, and base metal crowns contain less than 25%.

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What are the advantages of Full Metal Crowns?

Full metal crowns are exceptionally strong, resist breaking or chipping, last for a long time, have excellent retention, and are durable. This makes them suitable for restoring hidden teeth.

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What are the disadvantages of Full Metal Crowns?

Full metal crowns have some disadvantages, including the need to remove a significant amount of tooth structure, difficulty in testing the vitality of the tooth using an electrical pulp tester, potential interference with taste, and visibility of the metal.

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What are the indications for using Full Metal Crowns?

Full metal crowns are used for teeth with extensive damage due to decay or trauma to prevent fractures, and for teeth with large amalgam restorations to protect the tooth and filling from breaking.

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Base Metal Crown

A type of metal crown that contains less than 25% noble elements, making it less expensive than other types of crowns.

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Full Metal Crown Indications

A full metal crown is used when maximum retention and resistance are needed, for instance, in teeth with short crowns. It's also used for recontouring teeth to accommodate clasps for removable partial dentures or as a bridge retainer.

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Additional Full Metal Crown Indications

A full metal crown can be used to correct minor inclination, in patients with high caries index, and to correct the occlusal plane.

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Full Metal Crown Contraindications

Full metal crowns are not ideal when aesthetics are paramount. They are also not recommended when lower retention and resistance are sufficient, or when a more conservative crown like a 3/4 crown is suitable. Additionally, they are not the best option for patients with a low caries index.

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Tooth Preparation: Occlusal Reduction

The first step in tooth preparation for a full metal crown involves reducing the occlusal surface.

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Tooth Preparation: Buccal Reduction

This step involves shaping the buccal (cheek) surface of the tooth.

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Tooth Preparation: Lingual Reduction

This step involves shaping the lingual (tongue) surface of the tooth.

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Tooth Preparation: Proximal Reduction

This step involves shaping the proximal surfaces of the tooth, which are the surfaces next to adjacent teeth.

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Occlusal Reduction: Details

The reduction of the occlusal surface involves creating a specific shape with grooves and inclines, ensuring a functional cusp bevel for proper biting.

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Occlusal Reduction

The process of reducing the height of cusps to create proper occlusion. It ensures smooth and balanced biting.

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Guiding Grooves

Grooves placed at the highest and lowest points of a cusp, guiding the reduction process.

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Depth Orientation Grooves

These grooves are used to create a smooth, evenly contoured surface for better occlusion.

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Depth of Grooves

Depth orientation grooves should be 1.5 mm deep for functional cusps and 1 mm deep for non-functional cusps.

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Enamel Chisel

A tool used to accurately measure the depth of grooves during occlusal reduction.

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Inclined Removal of Tooth Structure

Tooth structure is removed in a slant or angled direction between the grooves, creating a smoother occlusal surface.

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Round Tapered Diamond & No. 17 Bur

A round, tapered shaping tool used for planar occlusal reduction.

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Round Tapered Diamond for Functional Cusp Bevel

A round shaping tool for beveling the functional cusp for optimal occlusion.

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Axial Reduction

The process of reducing the axial walls of a tooth to create the desired shape and thickness for a crown preparation.

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Torpedo Diamond

A diamond bur shaped like a torpedo, used for smoothly reducing the buccal and lingual surfaces of a tooth during axial reduction.

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Chamfer Finish Line

The line where the axial reduction meets the tooth's margin, creating a smooth, continuous transition.

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Proximal Reduction

The process of reducing the proximal surfaces of a tooth, located between adjacent teeth, during crown preparation.

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Short Thin Needle Diamond

A small, thin diamond bur used for precise reduction of the remaining tooth structure between the proximal surfaces during crown preparation.

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Gaining Access

The process of using the short thin needle diamond to access interproximal areas between teeth during crown preparation.

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Occlusal Preparation

The final stage of crown preparation where the occlusal surface of the tooth is prepared for the crown, creating a smooth, even platform.

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Critical area of preparation

The part of the tooth preparation where the most reduction occurs, usually at the cervical margin.

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Chamfer finishing

A type of tooth preparation where the finishing line is a smooth, rounded edge, creating a gradual transition from the tooth to the crown.

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Seating groove

A groove placed 0.5mm above the chamfer line to help the crown fit securely onto the tooth.

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Full veneer crown

A type of dental crown that covers the entire visible portion of the tooth, providing a strong and durable restoration.

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Occlusal guiding grooves

Grooves placed on the occlusal surface (chewing surface) of a tooth preparation to guide the crown's placement and contact with the opposing teeth.

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Alignment grooves

Narrow grooves placed on the tooth's sides to help create even reduction along the tooth's axis during crown preparation.

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Study Notes

Extra-Coronal Full Coverage Tooth

  • Various types of crowns exist: full metal, all-ceramic, metal-ceramic, and zirconia.
  • Crowns are used to protect weakened teeth, address misshapen or discolored teeth, and repair broken teeth.
  • Crowns are also used to cover teeth that have undergone root canal treatment or support large fillings.
  • Crowns can be used to cover dental implants.

Types of Crowns

  • Full metal crowns: metallic restorations for the coronal, contour, and anatomical part of the tooth.
  • Full metal crowns are a part of many cultures' traditions.
  • All-ceramic and all-porcelain crowns
  • Porcelain fused to metal.
  • Zirconia crowns.

Need for the Crowns

  • Prevent tooth breakage or hold together fractured teeth.
  • Address misshapen or discolored teeth.
  • Repair or reattach broken teeth.
  • Provide coverage over a large filling or a root canal.
  • Cover dental implants.

Synonyms

  • Full cast crown
  • Complete cast crown
  • All metal crown
  • Full veneer crown

Types of Metal Crowns

  • High noble metal crown: 60% noble elements, 40% gold.
  • Noble metal crown: at least 25% noble elements.
  • Base metal crown: less than 25% noble elements.

Advantages of Metal Crowns

  • Exceptional strength compared to other types of crowns.
  • Consist of high-quality materials.
  • Often last longer, resisting chipping and breakage.
  • Have good retention.
  • Used for restoring hidden teeth.

Disadvantages of Metal Crowns

  • Extensive tooth reduction compared to partial crowns (3/4 crowns).
  • May pose difficulty in assessing tooth vitality using electrical pulp testers.
  • May cause interference with taste.
  • Display of metal as a drawback.

Indications of Full Metal Crowns

  • Teeth with extensive damage from caries or trauma, needing to protect the remaining structure from further fracture.
  • Teeth with large amalgam restorations which requires additional protection from fracture.
  • Teeth that have undergone endodontic treatment (root canal).
  • Teeth requiring maximum retention and resistance (e.g., teeth with short crowns).
  • Teeth needing contouring (e.g., receiving a clasp for a removable partial denture).
  • Used as a bridge retainer.
  • Correction of minor inclination.
  • Patients with high caries index
  • Correction of the occlusal plane.

Contraindications of Full Metal Crowns

  • Patients with strong aesthetic concerns (when esthetics are paramount).
  • When the level of retention and resistance needed is below the minimum requirements.
  • Cases where ¾ crowns could serve as adequate treatment.
  • When caries index is low.

Tooth Preparation Steps

  • Occlusal, buccal, lingual, and proximal surface preparation.

Armamentarium

  • Handpiece
  • Coarse-grit round-end tapered diamond
  • Fine-grit round-end tapered diamond
  • Medium-grit short needle diamond
  • Coarse-grit tapered torpedo diamond
  • Fine-grit tapered torpedo diamond
  • No. 17L bur
  • Red utility wax

Criteria of Tooth Preparation

  • Occlusal reduction: Depth orientation, grooves, and proper configuration of geometric inclines. Functional cusp bevels. Depth of occlusal reduction is dependent on size and shape of functional cusp and non-functional.
  • Axial reduction: Parallel to the long axis of the tooth, employing a 6-degree taper, including convergence, a prepared margin, and chamfer location (supragingival). Avoid cutting beyond the midpoint of the tooth

Occlusion Reduction

  • 1.5mm deep for functional cusps and 1mm deep for non-functional.
  • Use round-end tapered diamond to make depth orientation grooves on the triangular ridges.
  • Removal of tooth structure between grooves, performed in an inclined fashion.
  • Functional cusp bevels and appropriate diamond bur sizes should be used.

Guiding Groove for Occlusal Reduction

  • Guiding/depth holes are placed in central, mesial, and distal fossae, and connected.
  • Guiding grooves are placed at buccal and lingual developmental and triangular ridge areas.
  • Bevel the functional cusp to protect it from the diamond.
  • Follow proper anatomical configuration when performing occlusal reduction.
  • Groove placement follows central and developmental grooves, high and low points, triangular ridge tips.

Proximal Reduction

  • Short thin needle diamonds are placed against the remaining island of tooth structure.
  • Used in difficult areas.
  • Moved in an up-and-down motion.
  • Access is gained by sweeping the short thin diamond in tight areas.
  • Process can be repeated on the opposite proximal surface.

Critical Area of Preparation

  • Increasing the depth of reduction to produce a finish line with a torpedo.
  • Chamfer finishing with a torpedo bur.

Complete Preparation

  • Seating groove placement (0.5mm above the chamfer).
  • Planar occlusal reduction, structural durability, retention, and resistance.

Review

  • Occlusal guiding grooves
  • Occlusal reduction
  • Alignment grooves for axial reduction
  • Axial reduction
  • Breaking proximal contact
  • Retentive grooves
  • Finishing of the preparation

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