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

What is evaluated during the finishing and evaluation stage?

Occlusal clearance, margin width, smoothness, and continuity

Why is it important to place the margin sufficiently apically?

To result in adequate proximal clearance

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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