Contemporary Fixed Prosthodontics

Front Cover
Contemporary Fixed Prosthodontics
Copyright Page
Contributors
Preface
Acknowledgments
Contents
I. Planning and Preparation
1 History Taking and Clinical Examination
History
Chief Complaint
Comfort
Function
Social Aspects
Appearance
Personal Details
Medical History
Dental History
Periodontal History
Restorative History
Endodontic History
Orthodontic History
Removable Prosthodontic History
Oral Surgical History
Radiographic History
Myofascial Pain and Temporomandibular Joint Dysfunction History
Examination
General Examination
Extraoral Examination
Temporomandibular Joints
Muscles of Mastication
Lips
Screening for Sleep-Disordered Breathing
James E. Metz
Intraoral Examination
Periodontal Examination
Robert F. Baima
Gingiva
Periodontium
Clinical Attachment Level
Dental Charting
Occlusal Examination
Initial tooth contact.
General alignment.
Lateral and Protrusive Contacts
Jaw Maneuverability
Radiographic Examination
Vitality Testing
Diagnosis and Prognosis
Differential Diagnosis
Prognosis
General Factors
Local Factors
Prosthodontic Diagnostic Index for Partially Edentulous and Completely Dentate Patients
Location and Extent of the Edentulous Areas
Condition of the Abutment Teeth (Tooth Condition for Completely Dentate Patients)
Occlusal Scheme
Residual Ridge
Classification System
Class I
Class II
Class III
Class IV
Guidelines for the Use of Prosthodontic Diagnostic Index Classification System for Partial Edentulism and Complete Dentitio ...
Summary
Study Questions
References
2 Diagnostic Procedures
Clinical Photography
Armamentarium
Extraoral Photographs
Intraoral Photographs
Dentofacial Analysis
Repose: The Starting Point
Lip Form
Lips in Smile
Smile Types
Esthetics in Speech
Cephalometric Analysis
Digital Smile Design and Esthetic Templates
Diagnostic Casts and Related Procedures
Impression Making for Diagnostic Casts
Irreversible Hydrocolloid
Diagnostic Impression Technique
Armamentarium
Tray Selection
Impression Making
Evaluation
Articulator Selection
Virtual articulators.
Traditional articulators.
Small nonadjustable articulators.
Semiadjustable articulators.
Fully adjustable articulators.
Facebows
Transverse Horizontal Axis
Kinematic Hinge Axis Facebow
Hinge Axis Recording
Kinematic Facebow Transfer
Average Axis Facebow
Anterior Reference Point
Facebow Transfer
Armamentarium
Step-by-step procedure
Kois Dento-Facial Analyzer.
Centric Relation Record
Jaw Manipulation
Anterior Deprogramming Device
Centric Relation Recording Technique
Reinforced Aluwax Record
Armamentarium
Step-by-step procedure
Anterior Deprogramming Device With Elastomeric or Zinc Oxide–Eugenol Record
Armamentarium
Step-by-step procedure
Recording Jaw Relationships in Partially Edentulous Dentitions
Articulating the Diagnostic Optical Scans and Casts
Virtual articulation.
Step by step process for digital mandibular movement video
Traditional maxillary cast.
Traditional mandibular cast.
Evaluation.
Traditional analog posterior articulator controls.
Average (arbitrary) values.
Traditional eccentric interocclusal recordings.
Armamentarium
Step-by-step technique
Simplified pantographs.
Pantographic recordings.
Electronic pantograph.
Stereograms.
Anterior guidance.
Mechanical anterior guide table.
Custom acrylic anterior guide table.
Custom Guide Table Fabrication
Armamentarium
Step-by-step procedure
Evaluation.
Patient-Specific Anatomical Articulator
Shereen S. Azer
Diagnostic Cast Modification
Summary
Study Questions
References
3 Treatment Planning
Patient Considerations in Treatment Planning
Patient’s Personality
Patient’s Systemic Health
Mouth Opening and Temporomandibular Joint Health
Bruxism
Oral Hygiene
Smoking
Dental Caries Status
Periodontal Status
Smile Line
Pre-Prosthetic Considerations in Treatment Planning
Oral Radiology
Dental Anesthesia
Restorative/Operative Dentistry
Endodontics
Orthodontics
Exodontia
Periodontics
Biomaterial Considerations in Treatment Planning
Complete-Metal
Metal-Ceramic
Ceramic
Other Materials
Types of Restorations in Treatment Planning
Inlays
Onlays
Veneer Restorations
Crowns
Fixed Partial Dentures
Implant-Supported Restorations
Removable Partial Dentures
Complete Dentures
Biomechanical Considerations in Treatment Planning
Root Angulation and Root Surface Area
Replacement of a Single Missing Tooth
Replacement of Multiple Missing Teeth
Span Length
Overloading of Abutment Teeth
Cantilever Fixed Partial Dentures
Nature of Occlusion and Opposing Dentition
Treatment Sequence
Follow-Up and Maintenance
Complex Prosthodontics
Summary
Study Questions
References
4 Principles of Occlusion
Anatomy
Temporomandibular Joints
Ligaments
Musculature
Muscular Function
Dentition
Centric Relation
Mandibular Movement
Reference Planes
Sagittal Plane
Horizontal Plane
Frontal Plane
Border Movements
Posterior and Anterior Determinants of Mandibular Movement
Functional Movements
Mastication
Speaking
Parafunctional Movements
Bruxism
Clenching
History of Occlusal Studies
Bilaterally Balanced Articulation
Unilaterally Balanced Articulation (Group Function)
Long Centric
Mutually Protected Articulation
Optimum Occlusion
Rationale.
Patient Adaptability
Lowered Threshold
Raised Threshold
Pathogenic Occlusion
Signs and Symptoms
Teeth
Periodontium
Musculature
Temporomandibular Joints
Temporomandibular Joint Disorders
Myofascial Pain Dysfunction
Occlusal Treatment
Occlusal Device Therapy
Fabrication of Device
Direct Procedure With a Vacuum-Formed Matrix
Indirect Procedure With Autopolymerizing Acrylic Resin
Indirect Procedure With Heat-Polymerized Acrylic Resin
3D Printed Occlusal Device
Optical Impression
Occlusal Device Digital Design
3D Printing Occlusal Device
Attention to Detail
Follow-Up
Digital Systems
Summary
Study Questions
References
5 Periodontal Considerations
Prevalence
Treatment of Periodontitis
Prognosis
Connective Tissue
Biologic Width
Margin Placement
Guidelines for Subgingival Margin Placement
Gingival Biotype/Phenotype
Correcting or Preventing Biologic Width Violations
Biologic Shaping
Papilla
Ovate Pontics
Implant Site Maintenance and Development
Extraction Sequelae
Orthodontic Extrusion
Summary
Study Questions
References
6 Mouth Preparation
Mouth Preparation
Oral Surgery
Pathosis
Hard Tissue Procedures
Orthognathic Surgery
Caries And Existing Restorations
Foundation Restorations
Selection Criteria
Composite Resin
Dental Amalgam
Resin-Modified Glass Ionomer Cement
Step-by-Step Procedures
Composite Resin Core
Placement.
Contouring and Finishing
Endodontic Treatment
Assessment
Treatment
Periodontal Treatment
Gingival Tissue
Mucosal Reparative Therapy
Crown-Lengthening Procedures
Surgical Crown Lengthening
Maintenance and Reconstruction of the Interdental Papilla
Implant-Supported Fixed Prostheses
Orthodontic Treatment
Assessment
Treatment in the Vertical Dimension
Treatment in the Horizontal Dimension
Definitive Occlusal Treatment And Occlusal Reshaping
Summary
Study Questions
References
II. Clinical Procedures: Section 1
7 Principles of Tooth Preparation
Indications and Contraindications for Indirect Restorations
Biologic Considerations
Prevention of Damage During Tooth Preparation
Adjacent Teeth
Soft Tissues
Pulp
Causes of Injury
Temperature.
Chemical action
Biomaterials in tissue engineering.
Bacterial action.
Conservation of Tooth Structure
Considerations Affecting Future Dental Health
Axial Reduction
Margin Placement
Margin Adaptation
Margin Geometry
Occlusal Considerations
Preventing Tooth Fracture
Restoration/Tooth Interface Considerations
Traditional Mechanical Geometric Shapes for Tooth Preparation
Retention Form and Vertical Forces
Magnitude of the Dislodging (Vertical) Forces
Geometry of the Tooth Preparation
Taper.
Surface area.
Stress concentration.
Type of preparation.
Roughness of the Surfaces Being Cemented
Materials Being Cemented
Luting Agent
Type.
Film thickness.
Resistance Form and Horizontal Forces
Magnitude and Direction of the Dislodging Forces
Geometry of the Tooth Preparation
Physical Properties of the Luting Agent (Cohesive Versus Adhesive Cements)
Preventing Deformation
Bonding
Adequate Tooth Reduction
Margin Design
Alloy Selection
Esthetic Considerations
Ceramic Restorations
Metal-Ceramic Restorations
Facial Tooth Reduction
Incisal Reduction
Proximal Reduction
Labial Margin Placement
Partial-Coverage Restorations
Proximal Margin
Facial Margin
Planning and Evaluating Tooth Preparations
Diagnostic Tooth Preparations
Diagnostic Waxing Procedures
Evaluative Procedures During Tooth Preparation
Patient and Operator Positioning
Summary
Study Questions
References
8 Tooth Preparation for Ceramic Restorations
Anterior and Posterior Tooth Preparation for Etchable Ceramic Restorations
Analysis of Type, Quality, and Quantity of Tooth Structure
Considerations for Anterior Tooth Preparation
Considerations for Posterior Tooth Preparation
Indications for Etchable Ceramic Restorations
Contraindications
Advantages of Etchable Ceramic Restorations
Disadvantages of Etchable Ceramic Restorations
Anterior Lithium Disilicate Preparation—Porcelain Laminate Veneers and Bonded Ceramic Crowns
Preparation
Armamentarium
Step-by-Step Procedure
Facial reduction
Incisal reduction.
Transitioning the veneer to a bonded ceramic crown—lingual reduction.
Transitioning to a complete ceramic crown.
Posterior Lithium Disilicate Preparation
Preparation
Armamentarium
Step-by-Step Procedure
Occlusal reduction.
Buccal reduction (esthetic veneer)
Modified chamfer margin preparation.
Finishing
Ceramic Inlays and Onlays
Indications
Contraindications
Advantages
Disadvantages
Preparation
Armamentarium
Step-by-Step Procedure
Outline form
Caries excavation
Margin design
Finishing
Occlusal clearance (for onlays)
Evaluation
Study Questions
Summary Chart
Summary Chart
Summary Chart
References
9 The Complete Crown Preparation
Advantages
Disadvantages
Indications
Contraindications
Criteria
Special Considerations
Functional (Centric) Cusp Bevel
Nonfunctional (Noncentric) Cusp Bevel
Chamfer Margin Width
Preparation
Step-by-Step Procedure
Guiding Grooves for Occlusal Reduction
Occlusal Reduction
Alignment Grooves for Axial Reduction
Axial Reduction
Finishing
Evaluation
Summary
Study Questions
Summary Chart
10 The Ceramic-Veneered Crown Preparation
Indications
Contraindications
Advantages
Disadvantages
Preparation
Armamentarium
Step-by-Step Procedure
Depth Grooves
Incisal (Occlusal) Reduction
Labial (Buccal) Reduction
Axial Reduction of the Proximal and Lingual Surfaces
Finishing.
Evaluation.
Study Questions
Summary Chart
11 The Cast Partial Veneer Crown, Inlay, and Onlay Preparations
Partial Veneer Crowns
Indications
Contraindications
Advantages
Disadvantages
Preparation
Armamentarium
Posterior Partial Veneer Crown Preparations
Maxillary Premolar Three-quarter Crown
Occlusal reduction.
Axial reduction
Groove placement.
Bucco-occlusal contrabevel
Finishing
Examples of Other Cast Partial Veneer Crowns
Inlays and Onlays
Indications
Contraindications
Advantages
Disadvantages
Preparation
Armamentarium
Mesio-occlusal or Distal-occlusal Inlay Preparation
Occlusal Analysis
Outline Form
Caries Excavation
Axiogingival Groove and Bevel Placement
Mesio-occlusal–distal Onlay Preparation
Outline Form
Caries Excavation
Occlusal Reduction
Margin Placement
Study Questions
Summary Chart
Summary Chart
Summary Chart
12 Restoration of the Endodontically Treated Tooth
Treatment Planning
Clinical Failure
Considerations for Anterior Teeth
Considerations for Posterior Teeth
Principles of Tooth Preparation
Conservation of Tooth Structure
Preparation of the Canal
Preparation of Coronal Tissue
Retention Form
Anterior Teeth
Preparation geometry.
Post length.
Post diameter.
Post surface texture.
Luting agent.
Posterior Teeth
Resistance Form
Stress Distribution
Rotational Resistance
Procedures
Tooth Preparation
Removal of the Endodontic Filling Material
Canal Enlargement
Prefabricated posts.
Custom-made posts
Preparation of the Coronal Tooth Structure
Post Fabrication
Prefabricated Posts
Available materials.
Corrosion resistance.
Custom-Made Posts
Direct pattern procedure
Pattern fabrication with thermoplastic resin
Indirect procedure.
CAD-CAM Post-and-Core Restorations
Core Fabrication
Plastic Filling Materials
Step-by-step procedure for amalgam.
Cast Metal
Direct procedure for single-root teeth.
Pattern fabrication with autopolymerizing resin.
Interim Restorations
Investing and Casting
Evaluation
Cementation
Removal of Existing Posts
Summary
Study Questions
References
13 Implant-Supported Fixed Prostheses
Implant Types
Plate Implants (Blades)
Root-Form Implants
Treatment Planning For The Implant Recipient
Clinical Evaluation
Radiographic Evaluation
Diagnostic Casts
Principles Of Implant Location
Anatomic Limitations
Anterior Part of the Maxilla
Posterior Part of the Maxilla
Anterior Part of the Mandible
Posterior Part of the Mandible
Restorative Considerations
Implant Placement
Implant and Restoration Size
Single Tooth Implant
Soft Tissue Contours
Surgical Guide
Implant Surgery
Surgical Access
Implant Placement
Postoperative Evaluation
Implant Uncovering
Implant Restorations
Clinical Implant Components
Implant Body
Healing Screw
Interim Endosteal Dental Implant Abutment (Interim Abutment)
Abutments
Impression Copings
Implant Analogs
Intraoral Scan Bodies
Waxing Sleeves
Prosthesis-Retaining Screws
Implant Restorative Options
Distal-Extension Implant-Supported Restoration
Restoration for a Long Edentulous Span
Single-Tooth Implant Restoration
Treatment Planning for Optimal Prosthetic Material-Soft Tissue Junction in High Smile Line Situations
Cement-Retained Versus Screw-Retained Implant Crowns
Biomechanical Factors Affecting Long-Term Implant Success
Occlusion
Connecting Implants to Natural Teeth
Implant and Framework Fit
CAD-CAM Abutments and Frameworks
Maintenance
Complications
Bone Loss
Prosthetic Failure
Summary
Study Questions
References
14 Tissue Management, Scanning, and Impression Making
Prerequisites
Tissue Health
Saliva Control
Displacement of Gingival Tissues
Displacement Cord
Step-by-Step Procedure
Evaluation
Hemorrhage Control With an Infuser Syringe
Step-by-step procedure
Evaluation.
Displacement Pastes
Occlusal Matrix Impression Technique
Electrosurgery
Soft Tissue Laser
Radiosurgery
Materials Science
Elastic Impression Materials
Reversible Hydrocolloid
Polysulfide Polymer
Condensation Silicone
Polyether
Addition Silicone
Vinyl Polyether Silicone
Scannable Elastomeric Impression Materials
Impression Trays
Custom Tray Fabrication
Armamentarium
Step-by-Step Procedure: Autopolymerizing Resin
Step-by-Step Procedure: Photopolymerized Resin
Evaluation
Impression Making
Elastomeric Materials
Step-by-Step Procedure
Heavy-bodied–light-bodied combination
Single-mix technique.
Automix technique.
Machine mixing technique.
Evaluation
Reversible Hydrocolloid
Step-by-Step Procedure
Evaluation
Closed-Mouth Impression Technique
Step-by-Step Procedure
Evaluation
Special Considerations
Evaluation
Disinfection
Digital SCANNING Techniques
Types of Scanning Systems
Light Reflection
Confocal Imaging
Parallel Confocal Scanning
iTero Principle
Architecture of Captured Data
Optical Impression Units
Summary
Study Questions
References
15 Interim Fixed Restorations
Requirements
Biologic Requirements
Pulpal Protection
Periodontal Health
Occlusal Compatibility and Tooth Position
Prevention of Enamel Fracture
Mechanical Requirements
Function
Displacement
Removal for Reuse
Diagnostic Requirements
Esthetic Requirements
Ideal Properties
Currently Available Materials
Materials and Forms
External Surface Form
Custom
Preformed
Polycarbonate.
Cellulose acetate.
Aluminum and tin-silver.
Stainless steel.
CAD-CAM PMMA or composite resin.
Materials Science
Free Radical Polymerization
Initiation
Propagation
Termination
Properties Associated With the Monomer
Filler
Techniques and Procedures
Preparation Surface Form
Indirect Procedure
Direct Procedure
Indirect-Direct Procedure
Procedures
Basic Clinical Armamentarium
Basic Laboratory Armamentarium
Interim Fixed Partial Dentures: Custom Indirect Method
Additions to Clinical Armamentarium
Step-by-Step Procedure
Additions to Laboratory Armamentarium
Step-by-Step Procedure
Interim Fixed Partial Dentures: Custom Direct Method
Step-by-Step Procedure
Evaluation
Interim Fixed Partial Denture: Custom Indirect-Direct Method
Additions to Laboratory Armamentarium
Step-by-Step Procedure
Addition to Clinical Armamentarium
Step-by-Step Procedure
Custom Single-Unit Interim Restorations
Complete Crowns
Onlays and Partial Veneer Crowns
Inlays
Additions to Clinical Armamentarium
Step-by-Step Procedure
Laminate Veneers
Additions to Clinical Armamentarium
Step-by-Step Procedure
Interim Crowns Mass Produced from External Surface Forms
Polycarbonate Crown Forms
Additions to Clinical Armamentarium
Step-by-Step Procedure
Aluminum Crown Forms
Additions to Clinical Armamentarium
Step-by-Step Procedure
Post-and-Core Interim Restorations
Additions to Clinical Armamentarium
Step-by-Step Procedure
Cementation
Ideal Properties
Available Materials
Armamentarium
Step-by-Step Procedure
Removal, Recementation, and Repair
Armamentarium
Step-by-Step Procedure
Esthetic Enhancement
Contour
Color
Translucency
Texture
Fiber-Reinforced Composite Fixed Prostheses
Available Materials
Summary
Study Questions
References
III. Laboratory Procedures
16 Communicating With the Dental Laboratory
Quality and Qualification
Mutual Responsibilities
The Dentist
The Dental Laboratory Technician
Responsibilities of the Dentist
Infection Control
Tooth Preparation
Preparation Margins
Work Authorization
Diagnostic Waxing
Mounting, Cross Mounting, and Verification of Occlusal Records
Cast of Interim Prosthesis and Its Use
Shade Selection
Appropriate Checks
Summary
Study Questions
References
17 Definitive Casts and Dies
Prerequisites
Materials Science
Gypsum
Resin
Digital
Flexible Die Materials
Selection Criteria
Available Methods for Traditional Stone Casts
Removable Dies
Solid Cast With Individual Die
Alternative Die Systems
Choice of Definitive Cast-and-Die System
Technique
Armamentarium
Step-by-Step Procedure
Mounting Casts on an Articulator
Definitive Casts versus Diagnostic Casts
Conformative Occlusion
Reorganized Occlusion
Verification of Mounting
Technique for Closed-Mouth Impressions
Step-by-Step Procedure
Digital Applications in Fixed Prosthodontics
Scanning accuracy.
Step-by-step procedure to create digital definitive cast and die.
Digital manufacturing options.
Additive manufacturing
Casts.
Wax patterns.
Metallic structures.
Interim restorations.
Subtractive manufacturing
Casts.
Wax patterns.
Metal structures.
Ceramic structures.
Interim restorations.
Special consideration for tooth preparation.
Summary
Study Questions
References
18 Restoration Design
Digital Design
The Evolution of Digital Design
The Digital Process
Digital Design and Fabrication
Digitally Designing Restorations
Cloning Existing Teeth and/or Restorations
Computer-aided Design Tooth Libraries
Digital 3D Smile Design
Maxillary Incisal Edge Position
Midline
Profile—For Tooth Form
Proximal Contacts and Facial Embrasure Form
Primary Facial Contours
Secondary Facial Contours
Tertiary Facial Contours
Traditional Restoration Design with Wax Patterns
Prerequisites
Correction of Defects
Provision of Adequate Space for the Luting Agent
Increasing the Space for the Luting Agent
Reduction of the Space for the Luting Agent
Die Spacer
Marking the Margins
Materials Science
Technique
Armamentarium
Waxing Instruments
Waxing Posterior Teeth
Internal Surface
Step-by-step procedure
Wax Pattern Removal
Evaluation.
Proximal Surfaces
Contact areas.
Step-by-step procedure
Evaluation.
Axial Surfaces
Step-by-step procedure
Axial contours
Evaluation.
Occlusal Surfaces
Occlusal scheme.
Cusp height and location
Evaluation.
Completion of axial contours
Evaluation.
Triangular ridges
Evaluation.
Secondary ridges
Evaluation.
Margin Finishing
Step-by-step procedure
Evaluation.
Waxing Inlays and Onlays
Waxing Anterior Teeth
Lingual and Incisal Surfaces
Labial Surfaces
Wax Cutback
Waxing Connectors
Printed Wax Patterns
Milling Wax Patterns
Review of Technique
Summary
Study Questions
References
19 Framework Design and Metal Selection for Metal-Ceramic Restorations
Prerequisites
Waxing to Anatomic Contour
Occlusal Analysis
Cutting Back
Armamentarium
Step-by-Step Procedure
Designing the Cutback
Troughing the Pattern
Finishing
Connector Design
Pontics
Evaluation
Printed Framework Patterns
Metal Selection
Dental Connotations of Mechanical and Physical Properties for Ceramic Alloys
Modulus of Elasticity
Proportional Limit and Yield Strength
Hardness
Elevated-Temperature Creep and Distortion
Ultimate Tensile Strength
Percentage Elongation
Toughness
Thermal Expansion/Contraction
Density
Available Alloy Systems
High-Noble Alloys
Gold-platinum-palladium.
Gold-palladium-silver.
Gold-palladium.
Discussion.
Noble Alloys
Palladium-Silver.
Palladium-copper-gallium.
Palladium-gallium.
Discussion.
Predominantly Base Metal Alloys
Nickel-chromium.
Beryllium.
Nickel.
Cobalt-chromium.
Titanium and titanium alloys.
New Technologies for Base Metal Alloys
Review of Technique
Summary
Study Questions
References
20 Pontic Design
Pretreatment Assessment
Pontic Space
Residual Ridge Contour
Surgical Modification
Class I Defects
Class II and Class III Defects
Gingival Architecture Preservation
Pontic Classification
Sanitary or Hygienic Pontic
Saddle and Ridge-Lap Pontics
Modified Ridge-Lap Pontic
Conical Pontic
Ovate Pontic
Modified Ovate Pontic
Biologic Considerations
Alveolar Ridge Mucosal Lesions
Ridge Contact
Oral Hygiene Considerations
Pontic Material
Occlusal Forces
Mechanical Considerations
Available Pontic Materials
Zirconia Pontics
Metal-Ceramic Pontics
Esthetic Considerations
The Gingival Interface
Incisogingival Length
Mesiodistal Width
Pontic Fabrication
Available Materials
Metal-Ceramic Pontics
Anatomic Contour Waxing
Armamentarium.
Step-by-step procedure
Evaluation.
Cutback
Armamentarium
Step-by-step procedure
Metal Preparation
Armamentarium
Step-by-step procedure
Evaluation.
Porcelain Application
Armamentarium.
Step-by-step procedure
Evaluation.
Armamentarium
Step-by-step procedure
Metal Pontics
Zirconia Pontics
Pontics in Fixed Implant Restorations
Summary
Study Questions
References
21 Retainers for Removable Partial Dentures
Treatment Planning
Prerequisites for Success
Design
Denture bases.
Occlusal rest seat.
Minor connectors.
Clasp Retention
Reciprocation
Tooth Preparation
Path of Placement
Rest Seats
Axial Contours
Impression Making
Occlusal Records
Wax Pattern Fabrication
Survey Line
Guide Planes
Occlusal Rest Seats
Special Finishing Procedures
Milling
Evaluation and Cementation
Fabrication of a Crown for an Existing Removable Partial Denture
Attachments
Extracoronal Attachments
Intracoronal Attachments
Prefabricated Attachments
Laboratory-made Attachments
Bars, Studs, and Magnets
Implant-Assisted RPD
Summary
Study Questions
References
22
Metal Restoration Fabrication
Prerequisites
Sprue
Diameter
Location
Attachment
Venting
Crucible Former
Casting Ring and Liner
Sprue Technique
Armamentarium
Step-by-Step Procedure for a Single Casting
Procedure for Multiple Castings
Materials Science
Gypsum-Bonded Investments
Expansion
Setting expansion.
Hygroscopic expansion.
Thermal expansion.
Phosphate-Bonded Investments
Expansion
Working Time
Selection of Materials
Selecting a Casting Alloy
Factors to Be Considered
Intended use.
Physical properties.
Color.
Composition.
Cost.
Clinical performance.
Laboratory performance.
Handling properties.
Biocompatibility.
Selecting an Investment Material
Ideal Properties
Gypsum-bonded investments.
Phosphate-bonded investments.
Investing
Armamentarium
Step-by-Step Procedure
Brush Technique
Wax Elimination
Step-by-Step Procedure
Accelerated Casting Method
Casting
Casting Machines
Casting Technique
Armamentarium
Procedure
Recovery of the casting.
Evaluation.
Defects in the casting.
Roughness.
Nodules.
Fins.
Incompleteness.
Voids or porosity.
Marginal discrepancies.
Dimensional inaccuracies.
Special Considerations for Titanium and Titanium Alloys
Review of Technique
Traditional Lost Wax Process Summary
Digital Workflows
Digital Data Acquisition
Computer-Aided Design
Computer-Aided Manufacturing
Subtractive Manufacturing Technologies for Metal
Additive Manufacturing Technologies for Metals
Powder Bed Fusion Technology
Selective Laser Melting
Electron Beam Melting
Properties of Additive Manufacturing Metals
Accuracy
Microstructure and Mechanical Properties
Ceramic Veneering
Summary
Study Questions
References
23 Color, the Color-Replication Process, and Esthetics
Description of Color
Munsell Color Order System
Hue
Chroma
Value
Color Difference Formulae
Color Replication Process
Shade-Matching Phase
Visual Shade Matching
Lighting
Description of light.
Quality of light source.
Quantity of light source.
Auxiliary light sources.
Shade-matching environment.
Human Vision
The eye.
Color adaptation.
Deceptive color perception.
Metamerism.
Fluorescence.
Opalescence.
Color blindness.
Shade Selection Systems
VITA classical (Lumin Vacuum) shade guide: Hue matching.
Chroma selection.
Value selection.
VITA Toothguide 3D-MASTER (VITA North America)
Extended-Range Shade Guides
Translucency
Dentin Shade Guides
Custom Shade Guide
Shade distribution chart or images.
Summary of Guidelines for Visual Shade Matching
Instrumental Color Analysis
Color-Measuring Instruments
Shade-Duplication Phase
Esthetics
Anatomy of a Smile
Proportion
Balance
Midline
Incisal Embrasure Form
Incisor Angulation
Virtual Patient
Summary
Study Questions
References
24 Metal-Ceramic Restorations
Historical Perspective
Overview
Metal Preparation
Shape
Investment Removal
Oxide Removal
Metal Finishing
Thickness
Finishing
Cleaning
Oxidizing
Materials Science
Porcelain Manufacture
Porcelain Technique
Types of Porcelain
Opaque Porcelain
Body Porcelain
Incisal Porcelain
Porcelain-Alloy Bonding
Factors Affecting the Bond
Selection Criteria
Opaque Porcelain
Body and Incisal Porcelains
Fabrication
Porcelain Application
Armamentarium
Step-by-Step Procedure
Opaque porcelain.
Body and incisal porcelains.
Internal Characterization
Contouring
Glazing and Surface Characterization
External Characterization
Porcelain Labial Margins
Advantages and Disadvantages
Indications and Contraindications
Framework Design for Labial Margin
Step-by-Step Procedure
Troubleshooting
Cracks
Bubbles
Unsatisfactory Appearance
Press-On-Metal Technique
Review of Technique
Summary
Study Questions
References
25 Ceramic Restorations
Historical Background
High-Strength Ceramics
Strengthening Mechanisms of Dental Ceramics
Control of Fabrication Defects
Crystalline Reinforcement
Stress-Induced Transformation
Glazing
Prevention of Stress Corrosion
Ceramic Systems
Aluminous Core Ceramics (Historical)
Heat-Pressed Ceramics
Leucite Based
Lithium Disilicate Based
Zirconia-Reinforced Lithium Silicate Ceramics
Fluorapatite Ceramic Ingots for Heat-pressing Onto Zirconia Frameworks
Fabrication Procedure for Heat-Pressed Restorations
Machined Ceramics
CEREC System
Interpenetrating Phase Composites
Fabrication Procedure
Machined and Sintered Ceramics
Zirconia Ceramics
Selection of Ceramic Systems
Fracture Resistance
Esthetics
Abrasiveness
Inlays and Onlays
Refractory Dies
Step-by-Step Procedure
Ceramic Partial Fixed Dental Prostheses
Ceramic Foundation Restorations
Resin-Bonded Ceramics
Etching and Silanating the Restoration
Summary
Study Questions
References
26 Resin-Bonded Fixed Partial Dentures
Overview
Development of Resin-Bonded Fixed PARTIAL DENTURES
Bonded Pontics
Cast Perforated Resin-Bonded Fixed Partial Dentures (Mechanical Retention)
Etched-Cast Resin-Bonded Fixed Partial Dentures (Micromechanical Retention: “Maryland Bridge”)
Ceramic Retainers (Zirconia Cantilever Resin-Bonded Fixed Partial Denture)
Chemical-Bonding Zirconia Resin-Bonded Fixed Partial Dentures
Design Concepts and Patient Selection
Advantages
Disadvantages
Indications
Contraindications
Fabrication
Abutment Preparation
John Locke
Step-by-Step Procedure
Posterior Tooth Preparation and Framework Design
Laboratory Procedures
Bonding the Restoration
Cements (Bonding Agents)
Conceptual Step-by-Step Bonding Procedures With Adhesive Cement
Occlusion
Postoperative Care
Review of Technique
Summary
Study Questions
References
27 Connectors for Fixed Partial Dentures
Rigid Connectors
Nonrigid Connectors
Connector Design
Types of Connectors
Rigid Connectors
Cast Connectors
Soldered Connectors
Soldering gap width.
Nonrigid Connectors
Materials Science
M.H. Reisbick
Solder
Soldering Flux and Antiflux
Soldering Flux
Soldering Antiflux
Soldering Investment
Joining Base Metals
Titanium and Titanium Alloys
Selection of Soldering Technique
Soldering Metal Fixed Partial Dentures
Soldering Metal-Ceramic Fixed Partial Dentures
Presoldering
Postsoldering
Heat Sources
Torch Soldering
Oven Soldering
Microwave Soldering
Laser Welding
Soldering Accuracy
Soldering Technique
Armamentarium
Step-by-Step Procedure
Occlusal Soldering Index
Investing
Autopolymerizing Resin Soldering Index
Investing
Wax Removal and Preheating
Torch Soldering (Low Heat)
Torch Soldering (High Heat)
Oven Soldering
Evaluation
Review of Technique
Summary
Study Questions
References
28 Finishing the Metal Restoration
Objectives and Procedures
Zone 1: Internal Margin
Objective
Procedure
Zone 2: Internal Surface (Intaglio)
Objective
Procedure
Marking agents.
Zone 1: The Sprue
Objective
Procedure
Zone 4: Proximal Contacts
Objective
Procedure
Connectors
Zone 5: Occlusal Surface
Objective
Procedure
Zone 6: Axial Walls
Objective
Procedure
Zone 7: External Margins
Objective
Procedure
Review of Technique
Study Questions
References
IV. Clinical Procedures: Section 2
29 Evaluation, Characterization, and Glazing
Quality Assessment Part 1: Extraoral Assessment
Stone Die Casts
Advantages
Disadvantages
Solutions
Digital Die Casts
Advantages
Disadvantages
Solutions
3D-Printed Casts
Advantages
Disadvantages
Ceramic Restoration
Metal-Ceramic and Metal Restorations
Quality Assessment Part 2: Intraoral Assessment
Interim Restoration and Luting Agent
Evaluation Sequence
Proximal Contacts
Excessive Tightness
Ceramic restorations.
Metal restorations.
Deficiency
Ceramic restorations.
Metal restorations.
Armamentarium.
Step-by-step procedure
Margin Integrity
Assessment
Finishing
Stability
Occlusion
Evaluation and Adjustment
Armamentarium
Step-by-step procedure.
Remount
Armamentarium.
Step-by-step procedure.
Ceramic Restorations
Fixed Partial Dentures
Dentofacial Analysis
Contouring
Armamentarium.
Step-by-step procedure
Surface Texture Characterization
Armamentarium
Step-by-step procedure
Characterization and Glazing
External Color Modification and Characterization
Stuart H. Jacobs
Armamentarium
Step-by-Step Procedure
Shade Modification
Chroma and hue adjustment.
Value adjustment.
Characterization.
Hypocalcified areas.
Proximal coloration.
Enamel cracks.
Stained crack line.
Exposed incisal dentin.
Incisal halo.
Translucency.
Special illusions.
Summary
Study Questions
References
30 Luting Agents and Cementation Procedures
Luting Agents And Cementation Procedures
Interim Cementation
Definitive Cementation
Bonding Versus Cementing
Conventional Cast Restorations
Dental Cements
Zinc Phosphate Cement
Zinc Polycarboxylate Cement
Glass Ionomer Cement
Zinc Oxide–Eugenol With and Without Ethoxybenzoic Acid
Resin-Modified Glass Ionomer Luting Agents
Resin Luting Agents
Choice of Luting Agent
Zinc Phosphate Cement
Zinc Polycarboxylate Cement
Glass Ionomer Cement
Resin-Modified Glass Ionomer Luting Agents
Adhesive Resins
Preparation of the Restoration and Tooth Surface for Cementation
Armamentarium
Step-by-Step Procedure
Resin Luting Agents
Bonding To Zirconia
Cementation For Cement-Retained Implant Crowns
Cementation Procedures For Ceramic Veneers And Inlays
Selection of Resin Luting Agent
Bonding the Restoration
Armamentarium
Step-by-Step Procedure
Removal Of A Bonded Ceramic Veneer
Review Of Technique
Summary
Study Questions
References
31 Postoperative Care
Post-Cementation Appointments
Routine Maintenance Appointments
History and Cancer Screening
Oral Hygiene, Diet, and Saliva
Dental Caries
Root Caries
Periodontal Disease
Peri-implantitis
Occlusal Dysfunction
Pulp and Periapical Health
Emergency Appointments
Pain
Loose Abutment Retainer
Fractured Connector
Debonded and Fractured Porcelain Veneer
Complications With Implant-Supported Restorations
ReTreatment
Planned Re-Treatment
Neglect
Treatment Presentations
Summary
Study Questions
References
Index