Extra-Coronal Full Coverage Tooth PDF (2024)

# Extra-Coronal Full Coverage Tooth ## Slide 1 of 23 **Dr. HALA M. ALHAWIJ. BDS. MSC** **UNIVERSITY OF TRIPOLI. 2024** - Full Metal Crowns - All Ceramic Crown - Metal Ceramic Crowns - Zarconia ## Slide 2 of 23 **TYPES OF CROWNS** * An image of various types of crowns, showing a full metal crown...

# Extra-Coronal Full Coverage Tooth ## Slide 1 of 23 **Dr. HALA M. ALHAWIJ. BDS. MSC** **UNIVERSITY OF TRIPOLI. 2024** - Full Metal Crowns - All Ceramic Crown - Metal Ceramic Crowns - Zarconia ## Slide 2 of 23 **TYPES OF CROWNS** * An image of various types of crowns, showing a full metal crown, a porcelain fused to metal crown, and an all-ceramic crown. * All crowns depicted have Zirconia. ## Slide 3 of 23 **Lecture outline:** - Introduction - Advantages - Disadvantages - Indication - Contraindication - Criteria of tooth preparation ## Slide 4 of 23 **Need for the crown?** There are several types of crowns used to: - Protect a weak tooth from breaking or to hold the cracked parts of the teeth together. - To cover misshaped and discolored tooth. - Restore or Reattach the broken tooth. - To cover the tooth and support it with a large filling. - Used to cover a tooth that is treated with a root canal. - Covers a dental implant. ## Slide 5 of 23 **All metal crown:** - **Definition**: is a metallic artificial restoration that restore the coronal portion of the tooth in function, contour and anatomy. - Old culture use gold crown as a type of wealth, luxury and Culture tradition. ## Slide 6 of 23 **Synonyms:** - Full cast crown - Complete cast crown - All metal crown - full veneer crown ## Slide 7 of 23 **Types of metal crown:** - 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 An illustration of different types of crowns with different levels of Precious metals. ## Slide 8 of 23 **Advantages of metal crowns:** 1. Unlike other crowns, it has tremendous strength. 2. It is completely made of very good quality. 3. Metal crowns last for a very long period and resist breaking or chipping compared to other types of crowns. 4. Has great retention. 5. Durable and used for the restoration of hidden teeth. ## Slide 9 of 23 **Disadvantages of metal crown:** 1. Extensive tooth structure removal as compared with partial crown such as 3/4crown. 2. Difficulty to test the vitality of the tooth especially by electrical pulp tester. 3. May interfere with taste. 4. Display of metal. ## Slide 10 of 23 **Indications of full metal crown:** - A tooth with extensive destruction due to caries or trauma in order to protect the remaining tooth structure from fracture. - A tooth with large amalgam restoration in order to protect the remaining tooth structure and amalgam from fracture. - Endodontically treated teeth. ## Slide 11 of 23 **Indications of full metal crown:** - When maximum retention and resistance needed as in a tooth with short crown. - Recontouring of the tooth as in a tooth receiving a clasp for removable partial denture. - As a bridge retainer. ## Slide 12 of 23 **Indications of full metal crown** - Correction of minor inclination. - A patient with high caries index. - Correction of the occlusal plane. ## Slide 13 of 23 **Contra-Indications of full metal crown** 1. If high esthetic need is demanded. 2. When less than maximum retention and resistance necessary. 3. When a more conservative crown could be used such as 3/4 crown as in a tooth with intact buccal surface and very short span bridge. 4. When caries index is low. ## Slide 14 of 23 **Tooth Preparation steps:** - Occlusal surface preparation. - Buccal surface preparation. - Lingual surface preparation. - Proximal surfaces preparation. ## Slide 15 of 23 **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. 17IL bur - red utility wax ## Slide 16 of 23 **Criteria of tooth preparation:** The clinical procedure to prepare a tooth for a complete cast crown consists of the following steps: >* **Occlusal reduction:** - Depth orientation - Grooves - Occlusal surface in configuration of geometric inclines - Functional cusp bevel >* **Axial reduction:** - Parallel to the long axis of the tooth - Recommended 6-degree taper or included convergence - Preparation margin : Chamfer - Location: supra- gingival ## Slide 17 of 23 **Occlusion reduction** An image depicts the occlusal reduction process using a handpiece. ## Slide 18 of 23 - **THE FUNCTIONAL CUSPS:** THE LINGUAL UPPER AND THE BUCCAL LOWER - **NON-FUNCTIONAL CUSPS:** THE BUCCAL UPPER AND THE LINGUAL LOWER An illustration of different types of cusps. ## Slide 19 of 23 **Guiding groove for occlusal reduction:** 1. Place depth holes approximately 1mm deep in the central, mesial and distal fossae and connect them. 2. Place guiding grooves in the buccal and lingual developmental grooves and each triangular ridge extending from cusp tip to the center of its base. 3. Because the centric or functional cusp is to be protected by an adequate thickness of metal place a functional cusp bevel. 4. Use the guiding grooves to ensure that occlusal reduction follows anatomic configuration. 5. A groove should be placed in the low point and high point of each cusp, low point are the central and development grooves, high point are the tips and triangular ridges. ## Slide 20 of 23 **Occlusion reduction** Use round-end tapered diamond to make depth orientation grooves on the triangular ridges and in the primary developmental groove. An Image depicts the occlusal reduction process using a round-end tapered diamond. ## Slide 21 of 23 **Occlusion reduction** 1.5 mm deep on functional cusp and 1 mm deep on the nonfunctional cusps. An Image depicts the occlusal reduction process focusing on the depth of the reduction. ## Slide 22 of 23 **Occlusion reduction** Enamel chisel used to precisely judge the depth of grooves. A black and white image depicting the use of the enamel chisel to judge the depth of grooves. ## Slide 23 of 23 **Occlusion reduction** Removal of tooth structure between the grooves in an inclined manner. A black and white image depicting the removal of tooth structure using an enamel chisel. ## Slide 24 of 23 **Occlusion reduction** Planar occlusal reduction round tapered diamond and no. 17 bur. A black and white illustration of a tooth highlighting the use of a round, tapered diamond with no. 17 bur for planar occlusal reduction. ## Slide 25 of 23 **Occlusion reduction** Functional cusp bevel: Round- end tapered diamond and no.17 bur A black and white illustration of a tooth highlighting the use of a round, tapered diamond with no. 17 bur for functional cusp bevel. ## Slide 26 of 23 A series of black and white images of tooth preparation after the occlusal and functional cusp preparation has occurred. ## Slide 27 of 23 **Checking the occlusal clearance with utility wax** A black and white image depicting the utility wax being used to check the occlusal clearance. ## Slide 28 of 23 **Examining the imprint of the occlusal surface** A black and white image depicting the imprint of the occlusal surface being examined. ## Slide 29 of 23 **Measure clearance with RGS 3** **Instrument fits loosely** A black and white image showing a tooth preparation. ## Slide 30 of 23 **Axial reduction:** A black and white image illustrating the axial reduction process using handpiece on a tooth. ## Slide 32 of 23 **Placement of depth orientation groove** A black and white image depicting the placement of the depth orientation groove while doing the axial reduction. ## Slide 33 of 23 **Axial Reduction** Grooves: One in center and one in each mesial and distal line angle. 1) When this guiding grooves are placed be sure the Shank of the diamond is parallel to proposed path of withdrawal of the restoration 2) Don't let the diamond cut into the tooth beyond its midpoint ## Slide 34 of 23 **Facial and lingual axial reduction torpedo diamond** A black and white image depicts the axial reduction of the buccal and lingual surfaces using a torpedo diamond. An illustration of a tooth being reduced by a torpedo diamond. ## Slide 35 of 23 **Axial Reduction** Buccal surface reduced with torpedo diamond the chamfer finish line is created at the same line. A black and white image depicting the axial reduction of the buccal surface using a torpedo diamond. ## Slide 36 of 23 **Axial Reduction** The facial axial reduction is carried as far as possible into interproximal embrasures without nicking the adjacent teeth. A black and white image depicting the axial reduction of the facial surface using a torpedo diamond. ## Slide 37 of 23 **Lingual axial reduction with the same diamond.** A black and white image depicting the axial reduction of the lingual surface using a torpedo diamond. **The lingual axial reduction also extends as far interproximally as can be easily accomplished** A black and white image depicting the axial reduction of the lingual surface using a torpedo diamond. ## Slide 38 of 23 **Occlusal view** An exclusive view of the tooth preparation at this stage reveals isolated area of undecked tooth structures surrounding each proximal contact. A black and white image depicting the occlusal view of a tooth preparation, revealing isolated area of undecked tooth structures surrounding each proximal contact. ## Slide 39 of 23 **Proximal reduction** Short thin needle diamond placed against the remaining Iceland of tooth structure and moved in a up and down motion A black and white image depicting the use of a thin needle diamond when doing the proximal reduction of a tooth. **In tight areas sometimes the tip may be used** A black and white image depicting the use of a thin needle diamond, focusing on using the tip in tight areas. ## Slide 40 of 23 **Gaining access by sweeping the short thin diamond** A black and white image depicting the gaining access using the short thin diamond on a tooth. **Repeating the process on the opposite proximal surface** A black and white image depicting the proximal reduction on the opposite surface. ## Slide 41 of 23 **Increasing the depth of reduction and producing a finish line with torpedo.** A black and white image depicting the use of a torpedo diamond to increase the depth of reduction and produce a finish line. **Critical area of preparation** A black and white image highlighting the critical area in crown preparation. ## Slide 42 of 23 **More reduction achieved in this area** A black and white image highlighting the area where more reduction was achieved. **Chamfer finishing: torpedo bur** An illustration showing a tooth with chamfer finishing. ## Slide 43 of 23 **Placement of seating groove 0.5mm above chamfer** A black and white image showing a tooth with the seating groove 0.5mm above the chamfer line. **The complete full veneer crown preparation** A black and white image showing a complete preparation for a full veneer crown. ## Slide 44 of 23 **Complete preparation** An illustration showing a complete preparation for a full veneer crown. **The features of full veneer crown preparation and the function served by each** A black and white illustration of the preparation steps with explanations of each step. ## Slide 45 of 23 **Review:** - **Occlusal guiding grooves** A black and white image depicting how to guide the occlusal grooves. - **Occlusal reduction** A black and white image depicting the occlusal reduction of a tooth. - **Alignment grooves for axial reduction** A black and white image depicting the alignment grooves for axial reduction - **Axial reduction** A black and white image depicting the axial reduction of a tooth. ## Slide 46 of 23 - **Breaking proximal contact** A black and white image showing the breaking of the proximal contact. - **Retentive grooves** A black and white image showing the retentive grooves in a tooth preparation. - **Finishing of the preparation** A black and white image showing the finishing of the preparation of a tooth.