Dental Restoration: Complete Cast Crown
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Questions and Answers

Why is a larger diamond recommended for finishing and evaluation?

  • To eliminate any unwanted ripples created during axial reduction (correct)
  • To upright overtapered axial walls
  • To improve retention by adding grooves or pinholes
  • To create unwanted ripples during axial reduction
  • What is evaluated during the finishing and evaluation stage?

  • Occlusal clearance, margin width, smoothness, and continuity (correct)
  • Only margin width, smoothness, and continuity
  • Only path of placement and degree of axial taper
  • Only occlusal clearance
  • Why is it important to place the margin sufficiently apically?

  • To result in adequate proximal clearance (correct)
  • To reduce retention
  • To upright overtapered axial walls
  • To improve the path of placement
  • What can be added to improve retention?

    <p>Grooves, boxes, or pinholes</p> Signup and view all the answers

    What is the result of over tapering of opposing axial walls?

    <p>Reduced retention</p> Signup and view all the answers

    What must be corrected before fabrication of the interim restoration and the definitive impression?

    <p>Any noted deficiencies</p> Signup and view all the answers

    What is the purpose of using an end-cutting bur?

    <p>To ensure continuity of finishing line</p> Signup and view all the answers

    What is evaluated during the finishing and evaluation stage regarding the path of placement?

    <p>From the proximal, buccolingual, and occlusal aspects</p> Signup and view all the answers

    What is the purpose of rounding of all line angles?

    <p>To ensure smoothness and continuity</p> Signup and view all the answers

    What is the purpose of evaluating the margin?

    <p>To evaluate the width, smoothness, and continuity</p> Signup and view all the answers

    Study Notes

    Complete Cast Crown Preparation

    • A complete cast crown is a complete coverage restoration that restores the coronal portion of the tooth in function, contour, and anatomy.

    Advantages

    • Has greater retention than partial coverage
    • Has greater resistance form
    • Complete cast crown strength is superior to that of other restorations and resists deformation better than partial veneer restorations
    • Allows the dentist to modify axial tooth contour (e.g. malalignment) and occlusion (e.g. supra-eruption)

    Disadvantages

    • Less conservative than partial coverage
    • Unpleasant bad metal color
    • Does not allow electric pulp vitality test

    Indications

    • Single crown restoration
    • As a bridge retainer
    • Endodontically treated posterior teeth
    • Extensive coronal destruction by caries, restoration, or trauma
    • Correction of axial tooth contour (e.g. malalignment) or occlusion
    • To support a mandibular partial removable dental prosthesis
    • When maximum retention and resistance are needed (e.g. in posterior, high-load locations)
    • To improve access for oral hygiene in teeth with furcal involvement through alteration of buccal and lingual wall contours

    Contraindications

    • If the esthetic need is high as in anterior zone
    • If the buccal or lingual wall is intact, a partial-coverage restoration should be considered
    • If more conservation of tooth is indicated
    • If less than maximum retention and resistance are needed (e.g. short-span fixed dental prosthesis)
    • If a removable partial denture is planned and an adequate buccal contour exists or can be obtained through enamel modification (enameloplasty)

    Alloys Used in Complete Cast Restoration

    • High noble metal alloys (e.g. Au-PL-Pd, Au-Pd, Au-Ag-Pd)
    • Noble metal alloys (e.g. Ag-Pd)
    • Base metal alloys (e.g. Ni-Cr, Co-Cr, Ti)

    Preparation Steps

    • Occlusal depth grooves
    • Occlusal reduction and functional cusp bevel
    • Axial alignment grooves
    • Axial reduction
    • Finishing and evaluation

    Occlusal Reduction

    • Using a fissure bur or rounded end tapered diamond to create guiding orientation grooves
    • Reduction should be uniform to allow adequate thickness of metal
    • Check occlusal clearance using utility wax, reduction gauge, or registration material

    Axial Reduction

    • 6-10 degree taper between opposing walls
    • Even axial depth
    • Chamfer depth from 0.3-0.5 mm
    • Finish line 0.5 mm supragingival
    • Follow gingival contours

    Finishing Line

    • Type: Chamfer finishing line
    • Thickness: 0.3 mm in case of base metal alloy, 0.5 mm in case of noble metal alloy
    • Location: Supragingival, subgingival, or a replica of half the tip of round ended tapered diamond stone used

    Interproximal Reduction

    • Extend below adjacent tooth contact
    • Avoid adjacent tooth damage
    • Over tapering
    • Excessive axial reduction

    Functional Cusp Bevel

    • 1.5 mm clearance
    • Parallels opposing triangular ridges
    • Placed at an angle of approximately 45 degrees to the long axis of the prepared tooth

    Finishing and Evaluation

    • The larger diamond is recommended to eliminate any unwanted ripples
    • Evaluate margin width, smoothness, and continuity
    • Evaluate the path of placement and degree of axial taper from proximal, buccolingual, and occlusal aspects

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    Description

    Learn about the preparation and advantages of complete cast crowns, including their indications and contraindications in dental restoration.

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