Fixed Pros

Procera Crowns: Internal Binding Spot Modification

• If a Procera all-ceramic crown has an internal binding spot, the tooth preparation should be slightly adjusted, not the crown itself
• Incorrect: Remaking the impression, adjusting the crown, or adjusting occlusion with/without cementation

Procera FPD Contraindication

• A contraindication for a Procera all-ceramic fixed partial denture (FPD) on teeth #6-#8 is when the prepared tooth axial height is less than 4mm

Metal-Ceramic Crowns: Internal Binding Spot

• If a metal-ceramic crown has an internal binding spot, adjust the tooth preparation slightly, not the crown itself
• Incorrect: Proceeding with cementation, adjusting the crown, or remaking the impression

Implant Healing Abutment Torque

• An implant healing abutment should never be torqued to 20Ncm

Metal-Ceramic Crown Hyper-Occlusion

• If a metal-ceramic crown has hyper-occlusion in the mouth but proper occlusion on the articulator, it is likely due to improper execution of the final impression or improperly articulated casts

Biologic Width Re-Evaluation

• The "biologic width" of a prepared tooth should be re-evaluated after tooth preparation before making a final impression

Third Molars as Abutments

• Third molars are often poor abutments due to unpredictable bucco-lingual inclination, mesial inclination, and short clinical crown height

3-Unit FPD Seating Issues

• If a 3-unit FPD causes blanching in the pontic area and lifts off abutment teeth, section the FPD and evaluate individual copings

FPD Framework Sectioning and Soldering

• The ideal location for sectioning an FPD framework for soldering is through the pontic
• Sectioning should be done diagonally

Procera Crown Labial Axial Reduction

• Procera crown labial axial reduction requires 1.5-2.0mm

Implant Abutment Fit Confirmation

• Implant abutment should fit flush with the shoulder of the implant
• Fit can be confirmed with a radiograph

Coronal Restoration Prognosis

• Establishment of a ferrule ensures successful long-term prognosis
• If there's enough coronal tooth structure for a prefabricated dowel and core build up

Adequate Tooth Reduction

• Ensuring adequate tooth reduction involves evaluating provisional restoration thickness, using a PVS buccal index, and using a vacuum-formed matrix

Extensive Caries and Second Molars

• The first step in treating a second molar with extensive caries is to remove the caries and assess restorability

Implant Placement: Location and Angulation

• A CT scan with a radiographic stent best assures proper location and angulation in the surgical phase of implant placement

Timing of Fixed Prosthetics and Removable Partial Denture

• Fixed prosthetic treatment should be completed before designing a cast removable partial denture for the same patient

Premolar Full Ceramic Crown Occlusal Reduction

• When preparing a premolar tooth for a full all ceramic crown (Procera), the occlusal reduction should be 2.0mm

Choosing a Dowel System

• When deciding between pre-fabricated or cast post dowel system, consider the amount of remaining coronal tooth structure

Reduction Copings

• Reduction copings are used when the tooth preparation is over-tapered

Buccal Index

• Buccal index is a tool used to verify the adequate reduction of the tooth structure

Custom Implant Abutment Torque

• In the Nobel Biocare Replace Select system, a custom implant abutment should be torqued to 35 Ncm

Dowel Space Ideal Length

• The ideal length for dowel space preparation is generally ¾ of the length of the root

Buccal Index Significance

• A buccal index is an excellent tool for verifying adequate tooth structure reduction

Porcelain Fracture: PFM Crowns

• Excessive horizontal overlap is the likely reason for fracture
• If a patient has a porcelain fracture on PFM crown placed 3 weeks prior

Cast Dowel Failure

• Most common cause of cast dowel failure is root fracture

Diagnostic Wax-Up Uses

• Diagnostic wax up are utilized as provisional fabrication guides, depict treatment outcomes for patient education, aid communication, and serve as tooth preparation guides

Laminate Veneer Fracture Risk: Contact

• Fracture risk is reduced when there are optimally supported restoration with proper opposing occlusal contacts

Ideal Treatment Options: Single Tooth

• Ideal treatment is single tooth implant and crown #30, when #30 is non-restorable, the patient is not missing any other teeth and adjacent teeth are unrestored

Custom Implant Abutment: Torquing

• Before torquing a custom implant abutment, check height of abutment collar above soft tissues, occlusal clearance, and proximal contacts

All-Ceramic Crown: Prep Finish Line

• The preferred crown preparation finish line for an all ceramic Procera crown is a chamfer

Nobel Biocare Implant System: Blue Collar

• The blue collar corresponds to a 5.0mm implant diameter in the Nobel Biocare Replace Select implant system

Provisional Restoration: Mastication Pain

• Dull pain during mastication may imply improper occlusion
• Verify proper occlusion when a patient reports pain in a provisional restoration for tooth #3 the following week.

Provisional Restoration Material Application

• His-acrylic resin base (Luxatemp) provisional restoration material is appropriate for anterior multiple unit FPDs

Implant Placement Assessment

• If an implant has to be placed in the mandibular left first molar (#19) region, factors that should be considered when assessing the area for implant placement is location of the mental nerve and the mandibular canal

Crown-to-Root Ratio

• The ideal crown-to-root ratio 2:3

Final Impressions Procedures

• Enclose in lab for fabrication of contacts

Procera All-Ceramic Crowns: Material

• All Procera all-ceramic crowns are fabricated with CAD/CAM technology

Procera All-Ceramic FPD: Contraindications

• Contraindicated Procera all ceramic height is more than 6mm

Proper Treatment Sequence

• Restore tooth #3 and then fabricate the crown on #4

Sectioned FPD Framework

• Re-impression and new framework when coping incorrectly fits
• In a sectioned FPD framework the coping does not fit properly section is required after lab work