Podcast
Questions and Answers
What is the primary purpose of using splints in dental treatment?
What is the primary purpose of using splints in dental treatment?
- To speed up the healing process
- To increase occlusal vertical dimension (correct)
- To strengthen enamel
- To improve tooth color
Which of the following is NOT a role of splints?
Which of the following is NOT a role of splints?
- Check for muscle origin pain
- Prevent toothwear
- Support root canal treatment (correct)
- Enable assessment of denture fit
What is a post in dental terminology?
What is a post in dental terminology?
- A type of dental cleaning technique
- A tooth filling material
- A patient follow-up procedure
- A metal or rigid restorative device in the root (correct)
What defines a core in dental restoration?
What defines a core in dental restoration?
What is commonly used to restore the upper anterior teeth?
What is commonly used to restore the upper anterior teeth?
Which procedure is used to create a mold for wax-ups?
Which procedure is used to create a mold for wax-ups?
What type of material is traditionally used for dowels in dental posts?
What type of material is traditionally used for dowels in dental posts?
What is the function of a putty index in dental procedures?
What is the function of a putty index in dental procedures?
What type of materials is Zinc Phosphate primarily used for?
What type of materials is Zinc Phosphate primarily used for?
Which property of Zinc Phosphate can affect its usage?
Which property of Zinc Phosphate can affect its usage?
What is a significant characteristic of Glass Ionomer cement?
What is a significant characteristic of Glass Ionomer cement?
For what type of restorations is Resin based cement particularly indicated?
For what type of restorations is Resin based cement particularly indicated?
What is a disadvantage of using Glass Ionomer cement?
What is a disadvantage of using Glass Ionomer cement?
Which cement type is less susceptible to early moisture exposure?
Which cement type is less susceptible to early moisture exposure?
What aspect can affect the performance of Resin based cement?
What aspect can affect the performance of Resin based cement?
What is the primary use of articulating papers in dentistry?
What is the primary use of articulating papers in dentistry?
What is a common clinical feature of attrition?
What is a common clinical feature of attrition?
Which of the following is the least conservative management for TSL?
Which of the following is the least conservative management for TSL?
What is an indication that splints should not be offered?
What is an indication that splints should not be offered?
What is a key feature seen with tooth erosion?
What is a key feature seen with tooth erosion?
Which method is recommended for maintaining tooth structure in a patient with erosion?
Which method is recommended for maintaining tooth structure in a patient with erosion?
What clinical sign is NOT typically associated with attrition?
What clinical sign is NOT typically associated with attrition?
Which of the following is a feature of erosion?
Which of the following is a feature of erosion?
What is the recommended first step in managing a patient experiencing erosion?
What is the recommended first step in managing a patient experiencing erosion?
What is the minimum height of ferrule required for dental posts?
What is the minimum height of ferrule required for dental posts?
For a ferrule height of 2-3 mm, which post type is preferred?
For a ferrule height of 2-3 mm, which post type is preferred?
What is the primary factor in determining whether to use a direct or indirect post?
What is the primary factor in determining whether to use a direct or indirect post?
What is the recommended core type for molar teeth instead of a post and core?
What is the recommended core type for molar teeth instead of a post and core?
What does the Tooth Restorability Index (TRI) assess?
What does the Tooth Restorability Index (TRI) assess?
How many sextants are used in the TRI assessment?
How many sextants are used in the TRI assessment?
What score indicates 'inadequate' remaining coronal dentine in the TRI?
What score indicates 'inadequate' remaining coronal dentine in the TRI?
What is the ideal method to create a representation of a post and core system for laboratory fabrication?
What is the ideal method to create a representation of a post and core system for laboratory fabrication?
What is the primary issue with adhesion in zirconia-based components?
What is the primary issue with adhesion in zirconia-based components?
Which acidic monomer is recommended for chemically bonding with zirconia?
Which acidic monomer is recommended for chemically bonding with zirconia?
What method is often required to increase the surface roughness of zirconia?
What method is often required to increase the surface roughness of zirconia?
Which type of materials differ in composition and properties from zirconia?
Which type of materials differ in composition and properties from zirconia?
What is a consequence of using aggressive mechanical abrasion on zirconia?
What is a consequence of using aggressive mechanical abrasion on zirconia?
Which of the following is NOT a recommended resin cement for zirconia ceramics?
Which of the following is NOT a recommended resin cement for zirconia ceramics?
What is the significance of chemically functionalizing the surface of zirconia?
What is the significance of chemically functionalizing the surface of zirconia?
Which of the following best describes the interaction between bonded cements and forces on restorations?
Which of the following best describes the interaction between bonded cements and forces on restorations?
What is the typical thickness range of normal articulating paper used for dentures?
What is the typical thickness range of normal articulating paper used for dentures?
During which phase would you stabilize periodontal disease in the treatment planning process?
During which phase would you stabilize periodontal disease in the treatment planning process?
Which of the following materials has the thinnest thickness among those listed?
Which of the following materials has the thinnest thickness among those listed?
What should be the primary focus during the Rehabilitation Phase?
What should be the primary focus during the Rehabilitation Phase?
Which error is not correctable and will require a new impression?
Which error is not correctable and will require a new impression?
What is the first step in managing a patient with irreversible pulpitis and multiple carious cavities?
What is the first step in managing a patient with irreversible pulpitis and multiple carious cavities?
Which of the following is a method for checking the fit of a crown?
Which of the following is a method for checking the fit of a crown?
What is the main purpose of GHM articulating paper in dentistry?
What is the main purpose of GHM articulating paper in dentistry?
Flashcards
Luting
Luting
A type of bonding where the force is concentrated at the interface, resulting in less retention.
Bonded Cements
Bonded Cements
Cements that distribute the force away from the interface, providing stronger bonding and retention.
Preparation Form
Preparation Form
The shape and form of a dental preparation. Taper refers to the angle of the walls, and length refers to the size of the preparation.
Zirconia
Zirconia
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Surface Modification
Surface Modification
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10-MDP
10-MDP
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MDP-Containing Cements
MDP-Containing Cements
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Examples of MDP-Containing Cements
Examples of MDP-Containing Cements
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Zinc Phosphate Cement
Zinc Phosphate Cement
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Polycarboxylate Cement
Polycarboxylate Cement
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Resin Modified Glass Ionomer Cement
Resin Modified Glass Ionomer Cement
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Resin-based Luting Cements
Resin-based Luting Cements
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Articulating Paper Technique
Articulating Paper Technique
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Glass Ionomer Cement
Glass Ionomer Cement
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Moisture Contamination
Moisture Contamination
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GHM articulating paper
GHM articulating paper
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Shimstock
Shimstock
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Emergency Phase of Treatment
Emergency Phase of Treatment
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Stabilization Phase of Treatment
Stabilization Phase of Treatment
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Rehabilitation Phase of Treatment
Rehabilitation Phase of Treatment
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Maintenance & Monitoring Phase
Maintenance & Monitoring Phase
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Common Errors Affecting Crown Fit
Common Errors Affecting Crown Fit
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Checking Crown Fit
Checking Crown Fit
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Erosion
Erosion
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Attrition
Attrition
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Onlay
Onlay
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Splint Therapy
Splint Therapy
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Indirect restorations
Indirect restorations
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Composite Build-ups
Composite Build-ups
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Fluoride containing toothpaste
Fluoride containing toothpaste
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Diet analysis
Diet analysis
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What is a dental post?
What is a dental post?
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What is a dental core?
What is a dental core?
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What is the purpose of a dental splint?
What is the purpose of a dental splint?
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What is a diagnostic wax-up used for?
What is a diagnostic wax-up used for?
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What is the purpose of a silicone index?
What is the purpose of a silicone index?
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What are articulated study casts?
What are articulated study casts?
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What was the final restorative step in the clinical case described?
What was the final restorative step in the clinical case described?
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What does the clinical case illustrate?
What does the clinical case illustrate?
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Ferrule
Ferrule
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Indirect Post and Core
Indirect Post and Core
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Direct Post and Core
Direct Post and Core
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Tooth Restorability Index (TRI)
Tooth Restorability Index (TRI)
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TRI Score 0
TRI Score 0
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TRI Score 1
TRI Score 1
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Apical Gutta-Percha Length
Apical Gutta-Percha Length
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Nayyar Core
Nayyar Core
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Study Notes
Course Information
- Course code: DES410
- Course title: Fixed & Removable Prosthodontics
- Lecturers: Dr. Christos Theocharides, Dr. Alexandros Panayiotou
- Institution: European University Cyprus, School of Dentistry, Department of Dentistry
Exam Format
- 20 multiple-choice questions (MCQs): 10 fixed, 10 removable; 1 mark each; 5 options per question; one correct answer
- 10 short-answer questions (SAQs): 5 fixed, 5 removable; 4 marks each
- Questions primarily based on clinical practice
- Review year 3 notes and clinical guidelines
- Read questions carefully before answering
Crowns
- Indications for a dental crown:
- Protect remaining tooth structure
- Improve aesthetics
- Alter crown form for removable partial dentures (abutments)
- Alter occlusal plane
- Most conservative to most destructive crowns:
- Zirconia (monolithic)
- All-metal crown
- All-ceramic crown
- Ceramo-metal crown
- Porcelain fused to zirconia
Tooth Reductions
- Table of biomaterials and their respective reduction levels for occlusal (posterior) and incisal (anterior) surfaces and axial. Different biomaterials are shown starting from least destructive to most destructive.
Crown Preparation (steps)
- Take shade of crown (for porcelain or zirconia)
- Take two or three putty indices
- Use local anesthetic if required
- Prepare the tooth properly (use indices as guides)
- Construct a temporary crown
- Place retraction cord with a haemostatic agent
- Take an impression
- Place a temporary crown
- Check occlusion and adjust if needed
- Complete records and laboratory card
One-Stage Impression Technique
- Choose appropriate tray
- Apply adhesive to tray (following manufacturer's recommendations)
- Block any undercut areas in the mouth (e.g., using wax)
- Load heavy-bodied material into the tray (using green/blue mixing tip)
- Simultaneously, syringe light-bodied material around the prepared tooth/teeth (using yellow mixing tip with intra-oral tip)
- Place loaded tray in the mouth
- Hold the tray firmly until impression sets
- Remove impression from mouth, rinse, and disinfect
- Follow manufacturer's instructions
Inspection of Impression Quality
- Rinse the impression with water to remove saliva and blood
- Dry the impression with 3-in-1 and examine under light magnification
- Disinfect the impression per manufacturer's recommendations
- Complete and sign the lab form, and send it to the lab
- Check preparation margins for visibility
- Ensure morphological features of teeth match the impression
- Verify no air bubbles or debris
- Check for detachment of impression material
Crown Cementation(steps)
- Check lab work (crown fit and shade)
- Remove temporary restorations
- Clean the prepared tooth
- Try in the restoration
- Check marginal fit, contacts, and occlusion
- Verify patient satisfaction with fit and appearance
- Remove the crown and clean both the crown and tooth surfaces (sandblast if indicated with Al2O3 50μm)
- Cement the crown using appropriate cement
- Check and remove excess cement
- Recheck occlusion
Cements or Luting Agents
- Temporary cements: Zinc Oxide (with/without eugenol)
- Permanent cements: Definitive cementation (conventional cements); acid-base reaction (resin cements); polymerization reaction (hybrid cements); combination of above reactions
Choosing the Right Cement
- Use stronger cement for weaker restoration materials
- Bonded cements spread forces away from the interface.
- Consider the amount of retention needed (preparation form, tapers, length of crown/walls)
Non-silicate Ceramics (especially Zirconia)
- Clinical challenge with zirconia-based components is difficulty in achieving suitable adhesion
- Traditional adhesive techniques do not work effectively with zirconia
- Current research focuses on surface modification of ceramics to achieve chemical functionalization of the surface to improve bonding
Other Important Concepts
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Tooth Reductions: Table provided details on reduction amounts for different biomaterials (e.g., Zirconia, All metal, All Ceramic crowns) for occlusal and incisal surfaces.
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Articulating Papers: Normal (70-200 microns), GHM (12-20 microns), and Shimstock (8 microns) are used to check occlusal contacts.
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Treatment Planning Process: Stages include: Emergency, Investigation/Stabilization, Rehabilitation, and Maintenance.
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Clinical Case Scenario: A patient case of tooth pain (tooth 46) is given; students need to design a management plan (including emergency, stabilization, rehabilitation, and maintenance phases).
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Common Errors in Crown Marginal Fit: Tight proximal contacts, casting blebs, over/under-extended margins, lack of die spacer, and impression distortion can lead to poor marginal fit
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Checking Crown Fit: Visual examination (margins, direct/mirror observation, magnification) and use of explorers (straight probe) are crucial for determining a crown's fit, especially for subgingival margins.
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Types of Defective Margins: Overextended (surplus wax or ceramic), Underextended, Over-Contoured (e.g., thicker crowns with over-waxing), and Open margins (castings not completely seated).
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Evaluating Crowns Before Cementation
- Assess proximal contacts (use floss)
- Evaluate marginal fit (use explorer)
- Check aesthetics (shape and shade)
- Evaluate occlusion (use articulating paper)
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Semi-precision Attachments
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Objectives of Modifying Abutment Tooth Contours (Advantages of Milled Crowns): Develop acceptable path of insertion, enhance biomechanics (retention, support, stability), improve aesthetics, and improve tooth's structural durability (especially if heavily restored).
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Options for Replacing Teeth: Removable (partial/complete acrylic, cobalt chrome, valplast) and fixed (resin-bonded bridge, implant, conventional bridge).
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Factors Affecting Prognosis of Teeth: Patient factors (restorative status, medical/dental history, expectations, finances/behaviour), and dentist factors (skills/expertise, available equipment/materials).
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Prognosis Factors (Structural, Endodontic, Periodontal Integrity): Tooth structure remaining (at least 1.5mm ferrule), endodontic outcome for successful root canal treatment, and periodontal health (amount of bone loss and mobility).
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Strategic Value of a tooth: Aesthetic considerations, medical concerns (related to lip line and soft tissues), prosthodontic factors (role as abutment), functional aspects, and financial constraints (e.g., NHS funding).
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RCP (Retruded Condylar Position), ICP (Intercuspal Position): Definitions and clinical relevance.
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Management of Teeth with Extensive Tooth Loss: Discussion of tooth restorability index (TRI) scoring system for evaluating tooth structure, including types of tooth surface loss and management strategies.
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Toothwear: Various causes (attrition, abrasion, erosion, abfraction) and management strategies (monitor, treatment planning, wax-ups, materials).
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Clinical Features of Erosion/Attrition: Presentation of symptoms or signs related to each condition are provided
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Management of TSL (Tooth Surface Loss): A workflow for addressing TSL cases with different restorative options (Most conservative—least conservative).
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Management of Erosion: Dietary modifications, fluoride toothpaste, composite resin restorations, and indirect lab restorations are recommended.
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How a Wear Case is Managed: Sequence of procedures, including creating articulated casts, constructing wax-ups, creating putty index or plastic retainer, and choosing composite resin to restore the anterior teeth.
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Role of Splints: Evaluation and treatment of TMD cases where pain arises as muscle origin that splint application can be used to resolve the problem, alongside prevention of tooth wear before/after treatment. The role of splints in managing toothwear (e.g., increasing occlusal vertical dimension, checking RCP, treatment of TMD), as well as managing partial/complete dentures or overdentures is addressed.
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Posts & Cores: Post (metal/rigid restorative in root canal of a non-vital tooth); and Core (replaces coronal structure to retain final restoration). Suitable post length and other specifics for indirect/direct method that is ideal.
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Tooth Restorability Index (TRI): Provides a structured assessment (scores and procedures) for evaluating remaining coronal/crown tissue (i.e., dentin) for stability and resistance.
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Clinical Guidelines needed for further review.
Additional Information
- Understand the clinical guidelines and pay specific attention to the topics mentioned in this revision lecture, as well as other lectures, to gain a strong understanding.
Studying That Suits You
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Description
Test your knowledge in fixed and removable prosthodontics with this quiz designed for the DES410 course. The quiz covers clinical practice, indications for dental crowns, and various crown types. Prepare using your third-year notes and clinical guidelines to succeed.