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    Fixed Pros 4 - Tooth Preparation For Complete Cast Crown

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    Willan Jumbo
    This document provides instructions for preparing a tooth for a complete cast crown. It describes the indications, contraindications, advantages, and disadvantages of complete cast crowns. It then details the armamentarium, preparation steps including occlusal depth grooves and reduction, functional cusp bevel, proximal slice, axial reduction, and finishing. Evaluation criteria are provided to assess the quality of the preparation.

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    Fixed Pros 4 - Tooth Preparation For Complete Cast Crown

    Uploaded by

    Willan Jumbo
    430 views7 pages
    This document provides instructions for preparing a tooth for a complete cast crown. It describes the indications, contraindications, advantages, and disadvantages of complete cast crowns. It then details the armamentarium, preparation steps including occlusal depth grooves and reduction, functional cusp bevel, proximal slice, axial reduction, and finishing. Evaluation criteria are provided to assess the quality of the preparation.

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    Prosthodontics lecture notes

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    Fixed Pros 4 - Tooth Preparation for Complete Cast Crown

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    This document provides instructions for preparing a tooth for a complete cast crown. It describes the indications, contraindications, advantages, and disadvantages of complete cast crowns. It then details the armamentarium, preparation steps including occlusal depth grooves and reduction, functional cusp bevel, proximal slice, axial reduction, and finishing. Evaluation criteria are provided to assess the quality of the preparation.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    430 views7 pages

    Fixed Pros 4 - Tooth Preparation For Complete Cast Crown

    Uploaded by

    Willan Jumbo
    This document provides instructions for preparing a tooth for a complete cast crown. It describes the indications, contraindications, advantages, and disadvantages of complete cast crowns. It then details the armamentarium, preparation steps including occlusal depth grooves and reduction, functional cusp bevel, proximal slice, axial reduction, and finishing. Evaluation criteria are provided to assess the quality of the preparation.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    of 7

    Dr.

    Arteaga
    August 22, 2013

    Tooth Preparation for Complete Cast Crown


    Complete Case Crowns
    Indications
    Extensive coronal tooth destruction or existing restoration size
    Need for maximum retention (keeps tooth from being pulled off) and resistance form (keeps tooth from
    being pushed off)
    Endodontically treated tooth (extensive caries or large access)
    Correction of occlusal plane
    Correction of axial contours
    Support of RPD

    Contraindications
    High esthetic demands sometimes people dont want gold
    Treatment objectives met with a move conservative restoration
    Intact buccal and/or lingual walls
    No need for greater retention and/or resistance form
    Adequate buccal contour or contour achievable by enameloplasty
    Poor oral hygiene or maintenance

    Complete Cast crown


    Advantages
    Greater retention
    Greater resistance
    Can modify tooth contour
    Can modify occlusion
    Strength
    Disadvantages
    Extensive removal of tooth structure
    Adverse effect on tissue
    Vitality testing difficult
    Display of metal
    Expensive

    Armamentarium
    HIGH SPEED HANDPIECE Diamond Burs
    Description
    Diamond pieces electroplated to bur
    Shapes
    Cleaning and Care

    Preparation
    Occlusal Depth Grooves
    Occlusal Reduction
    Axial Alignment Grooves
    Axial Reduction

    Fixed Pros 4 Pages 1


    Depth grooves and occlusal reduction
    Occlusal depth grooves
    Round end taper bur 856-016 or 6856-016
    Do at angles of the inclines
    Depth helps estimate how thick or how much reduction you need
    Because it is tapered make sure to seat the bur but with lighter pressure
    Occlusal reduction
    Round end taper bur 856-016 or 6856-016
    1.5 mm on functional cusp
    For maxillary palatal cusp
    1.0 mm on non-functional cusp
    1.5 mm on both cusps are acceptable
    Connect the dots

    Functional Cusp Bevel


    Round end taper 856-016
    Reduction 1.5 mm
    Width 2 mm

    Fixed Pros 4 Pages 2


    Proximal Slice
    Leave a shell of tooth structure between adjacent tooth

    Adequate clearance (0.6 mm) between external surface chamfer and the adjacent tooth

    Fixed Pros 4 Pages 3


    Axial Reduction
    6 degrees is ideal
    Same distance between 12:00 and 12:01 on a clock

    699 carbide to open proximal contact


    Change to 878K-012 for proximal reduction
    Use chamfer bur (856-016) for axial reduction
    Reduction 0.8 to 1.0 mm
    Finish line of 0.5 to 1 mm above the gingiva
    Angle of convergence 6 to 10 degrees
    Buccal two-plane of reduction to follow the anatomy
    Path of withdrawal not blocked (Path of Draw - Hows the tooth is going to slide crown on and off 3-
    dimensionally. Need path of draw before drilling. Dictated by adjacent teeth)
    Adjacent teeth not mutilated

    Finishing
    Smooth uniform chamfer width 0.5 mm
    Roughly the edge of a perio probe
    Rounded line angles
    Overall smooth surface

    Fixed Pros 4 Pages 4


    Evaluation
    Soft-base plate wax placed between the preparation and opposing tooth
    Once set, can use caliber to measure

    Adequate clearance
    Greater than 0.6 mm between external surface and the adjacent teeth
    No lip of enamel at the margin
    Path of withdraw is not blocked by the adjacent teeth
    Taper within 6-16 degree total convergence angle

    Severe Errors
    Undercuts
    May not be able to freely move the crowns
    Excessive tape
    Damage adjacent teeth

    Evaluation
    Occlusal Reduction
    __ 3. Approximately 1.5 mm uniform reduction
    __ 2. Slightly under reduced or slightly over reduced
    __ 1. Unacceptable with severely under reduced and severely over reduced

    II. Functional Cusp Bevel..


    __ 3. Cusp summit opposing central fossa and plane is parallel to inner incline of opposing cusp; includes
    proximal line angles with approximate bevel 2.0 mm
    __ 2. Functional cusp bevel acceptable but not ideal
    __ 1. Unacceptable: Bevel missing, cusp summit misplaced B L M D, plane too long/ short/ flat/ steep,
    proximal line angle not included

    Fixed Pros 4 Pages 5


    III. Taper of Axial Surfaces..
    __ 3. Angle of convergence 6-10o between opposing axial surfaces
    __ 2. Under tapered (0-5o) or over tapered (10o -16o ) between one set or both sets of opposing axial surfaces
    or line angles
    __ 1. Unacceptable: Undercut or Over tapered ( >16o) between any set of opposing axial surfaces or line
    angles

    IV. Extent of Axial Reduction ( Buccal & Lingual)..


    __ 3. Axial reduction of 0.6-0.8 mm overall and two-plane reduction on the buccal follows the anatomy of the
    tooth
    __ 2. Under reduced or over reduced but with acceptable reduction and two-plane reduction on the buccal
    follows the anatomy of the tooth
    __ 1. Unacceptable: Overall severely under reduced or severely over reduced and no two-plane reduction on
    the buccal

    V. Treatment Management
    __ 3. Intact adjacent teeth and gingival shroud with no evidence of damage
    __ 2. Adjacent teeth and/or gingival shroud have evidence of slight damage (nicks or scrapes)
    __ 1. There is evidence of significant damage (small cut or tears) to adjacent teeth and/ or gingival shroud
    __ 0. Unacceptable: The wrong tooth is prepared and there is gross damage to the adjacent tooth/teeth and/or
    severe damage to gingival shroud; neighboring teeth block the path of withdrawal

    VI. Chamfer margin .


    __3. Chamfer margin with approximately 0.5 mm consistency
    __2. Slightly under reduced or over reduced on any location
    __1. Over reduced with resultant ledges or under reduced with resultant feather edge
    __0. Unacceptable: margin with undermined enamel

    Fixed Pros 4 Pages 6


    VII. Marginal Finishing..
    __3. Uniform, smooth, continuous chamfer on all surfaces
    __2. Slightly irregular in any location
    __1. Unacceptable: finish line is non-continuous or significantly irregular

    VIII. Location of Finish Lines


    __3. 0.5-1.0 mm coronal to gingival margin
    __2. less than 0.5 mm or even to the gingival margin OR more than 1.0 mm but not more than 1.5mm
    __1. Unacceptable: Over-extended below the gingival margin OR under-extended above the gingival margin
    more than 1.5 mm

    IX. Overall Finish.


    __3. Adequate overall smoothness, rounded line angles and point angles
    __2. Slightly rough
    __1. Unacceptable: Significant roughness and sharp angles overall

    X. Cleanliness.
    __3. Overall typodont is clean
    __2. Only ivorine tooth prep # 3 is clean
    __1. Unacceptable: Overall typodont is dirty

    TOTAL Any Unacceptable grading will affect the total failure.


    A total score of 20 or more without ANY Unacceptable grading is a PASS for tooth preparation.

    Fixed Pros 4 Pages 7

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