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lecture for 2nd year students
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Dr Mohamed Hamed Ghazy
Email:[email protected]
1
Class of 2013/ 2014
Septemper22, 2013
Presented by
Dr. Mohamed Hamed Ghazy Professor of Fixed Prosthodontics
Email [email protected]
Faculty of Dentistry
Conservative Dentistry Department
Head of Department
Dr. Salah Al danf Fixed Prosthodontics Staff members
Dr. Mohamed Ghazy.
Dr. Ahmed Attia.
Dr. Manal Aboumadina.
Dr Shymaa Aboualfarag
Crowns& Bridges Course 2013/ 2014
Will run over 2 semesters, including:
A series of lectures
Practical work including demos and Lab work in fixed prosthetics lab.
No clinical work, yet!
Final practical work 30 Degree
Oral exam 15 Degree
Half term exam + preclinical requirements 15 Degree
A final end of the year qualifying paper 60 Degree
Dr Mohamed Hamed Ghazy
Email:[email protected]
2
Prosthodontics The dental specialty concerned with the making of artificial replacements for missing parts of the mouth and jaw. Called also Prosthetic dentistry or Prosthodontia.
Fixed Prosthodontics
The branch of Prosthodontics that concerned with replacement and/ or restoration of teeth by artificial substitutes that are not readily removed by the patient from the mouth
Implant Prosthodontics
That phase of
prosthodontics concerning
the replacement of missing
teeth and/ or associate
structures by restorations
that are attached to dental
implants.
Clinical crown The portion of tooth that
extended from the occlusal table or incisal edge to the free gingival margin.
Anatomical crown The portion of tooth that
extended from the occlusal table or incisal edge to cemento - enamel junction.
Artificial crown Artificial replacement that restore
missing tooth structure by surrounding part or all of the remaining tooth with a material such as metal, ceramic or combination.
CEMENTUM
GINGIVA
ENAMEL
A crown is an artificial replacement that
restores missing tooth structure by surrounding most or all of the remaining structure
with a material such as cast metal or ceramic or combination.
It is intended to reproduce both the form and function of the tooth and in some instance to restore
or enhance the appearance
Dr Mohamed Hamed Ghazy
Email:[email protected]
3
Temporary Crown: It is a crown made and used temporarily for the protection of the prepared tooth till the final crown or bridge is completed and ready for cementation.
The restoration material may be metal,
ceramic or combination
Complete (Full) veneer crown
A restoration that covers all of the tooth clinical crown surfaces (mesial , distal, facial, lingual and occlusal).
Full veneer gold crown Metal ceramic crown
Partial veneer crown: Extra-coronal cast metallic restorations that covers portion of prepared clinical crown: e.g. ¾ crowns 7/8 crowns ½ crowns Pin ledge crowns
Three Quarter Crowns:
Restore the occlusal and three
of the four axial surfaces not
including the facial surface.
Reverse Three Quarter
Crowns:
Restore all surfaces except the
lingual surface.
Seven- Eights Crown:
Is a modified type of the three
quarter crown extend to include a
portion of the facial surface,
except the mesial half of the
buccal surface of maxillary molars
Dr Mohamed Hamed Ghazy
Email:[email protected]
4
One – half crown:
Restore the occlusal and mesial
surface, as well as portion of the lingual
and buccal surfaces. It is a modified form
of the three quarter crown.
MacBoyle retainer : Is a modified type of the three quarter
crown, with its retention derived from
grooves at the labio- proximal line
angles usually used for mandibular
anterior incisors.
Pinledge retainer: Is a modified type of an anterior
three quarter crown that obtain its
retention from long parallel pins in the
lingual or palatal surfaces of the clinical
crown. [email protected]
Laminates Are veneer restoration that
restore the facial surface of the
tooth for esthetic purposes.
They are fabricated from resin or
dental ceramic. They are bonded
to etched enamel with resin
cement.
Resin- bonded restoration : it is a cast partial veneer
restoration that are bonded to
etched enamel.
Inlay retainer:
It is a classical
intracoronal restoration that
restore the proximal and
occlusal surfaces but does
not protect or cover the
cusps entirely.
Onlay retainer:
It is a modification of the
inlay with cusps overlays on
the occlusal surface to
protect the integrity of the
remaining tooth structure.
Classification of crowns Full coverage Partial coverage
Grooves
Pins, pin-ledge retainer
Enclsping the preparation
Encircling the preparation
Combined
Combined
Metallic
Combined
Non metallic
One piece
Tow piece
veneered
Full veneered
Porcelain
Acrylic
Posts in the root canal
Retained by posts or post &core
Posterior post attached or detached
Materiall mettalic, ceramic or combined
¾ crown
1/2 crown
7/8 crown
MacBoyle crown
Dr Mohamed Hamed Ghazy
Email:[email protected]
5
Classification of crowns according to material
According to material
Metallic
Non metallic
Combined [email protected]
According to site
Anterior
Posterior
Classification of crowns
Abutment
Is a natural tooth or portion of tooth, or dental implant that supports and/or retains a prosthesis.
Fixed dental prosthesis {bridge}
A partial denture that is luted or otherwise securely retained to the natural teeth, tooth roots, and/ or dental implant abutments that furnish the primary support for the prosthesis.
Fixed dental prosthesis {bridge} A partial denture that is luted or otherwise securely retained to the natural teeth, tooth roots, and/ or dental implant abutments that furnish the primary support for the prosthesis. Retainer
The part of Fixed dental prosthesis that units the abutment {s} to the remainder of the restoration.
Connector
A portion of Fixed dental prosthesis that units the retainer {s} to the pontic.
Pontic
An artificial tooth on a Fixed dental prosthesis that replaces a missing natural tooth, restore its functions, and usually fill the space previously filled by the natural crown.
Dr Mohamed Hamed Ghazy
Email:[email protected]
6
Fixed dental prosthesis (FPD)
= “Bridge” = “Fixed prosthesis”
Pontic = replaces lost tooth
Retainers fit over prepared teeth
Classification of Fixed dental prosthesis
According to site
Anterior
Posterior
Complex
Classification of Fixed dental prosthesis
According to material
Metallic
Non metallic
Combined [email protected]
Classification of Fixed dental prosthesis According to mode of retention Fixed – fixed
Fixed- supported
Removable bridge
Cantilever bridge
Spring cantilever
Resin bonded FPD
Implant supported
Dr Mohamed Hamed Ghazy
Email:[email protected]
7
1- Fixed- Fixed bridge:
It is a bridge where the
abutments and the pontics are all
soldered together and the bridge is cemented at both ends to the
abutments.
2- Fixed- supported
bridge:
It is a bridge which is not
actually joined to one of the
terminal abutment teeth but is connected to it by means of a
non rigid connector allowing
some individual movement of the abutment tooth.
Removable bridge:
It is a bridge where each retainer consists of two parts.
One fixed to the abutment tooth.
And one soldered to the pontic and the bridge can be
removed at the will of and by the patient for cleansing
purposes.
Cantilever bridge:
It is a bridge where the pontic is fixed to and derives its
support from one or double
retainers at one end only while the other end is
unsupported.
Spring Cantilever Bridge:
It is a cantilever bridge where
the pontic is at the end of resilient curved arm deriving
its support from an abutment
remote from the edentulous space
Dr Mohamed Hamed Ghazy
Email:[email protected]
8
Placement of the implant. Gum tissue sutured over the implant. It will take 4 -6
months for the implant to fuse with the bone
Temporary crown boned to adjacent teeth during the healing
phase.
Dental material used in fixed Prosthodontics
Direct restorative filling
– Amalgam
– glass ionomer
– Composite
– Compomer
Impression materials
– Irreversible hydrocolloids
(alginate)
– Reversible hydrocolloids (agar agar)
– Rubber base impression
material
Polysulfide
Polyvinylsiloxane
Poly ether
Material used for
laboratory procedures
– Gypsum product
– Wax
– Custom tray material
Cements
– Zinc phosphate
– Glass-ionomer
– Composite resin
Material used for extra
coronal restoration
– Direct casting alloys
– Ceramic
– Polymer acrylic
Extra coronal restorations
Full coverage
Partial coverage
Intra coronal restoration
Direct filling materials
Gold
Amalgam
Composite
Glass ionomer
Compomer
Inlays and onlays
Gold
Ceramic
Porcelain laminate veneer [email protected]
Dr Mohamed Hamed Ghazy
Email:[email protected]
9
Prosthodontic Motto
I hear, I forget
I see, I remember
I touch, I understand Chinese Proverb
Class of 2013/ 2014
September29,2013
Presented by
Dr. Mohamed H. Ghazy Professor of Fixed Prosthodontics
Email [email protected]
ANY QUESTIONS
about the last lecture? Text Book and Readings
•Contemporary Fixed Prosthodontics
–SF Rosenstiel, MF Land , J Fujimoto
•Fixed prosthodontics notes
–Cairo university
Dr Mohamed Hamed Ghazy
Email:[email protected]
10
Student message
• Please DR Mohamed .. can you tell me what is an inlay-onlay restoration? ... i read it consists of both inlay and onlay .. but i can't imagine it ... Thanks a lot Dr Mohamed
Inlays and Onlays
A tooth with a large filling (left)
before preparation for onlay and a
tooth with a slightly smaller filling
(right) before preparation for an
inlay.
A tooth with a large filling (left)
after preparation for onlay and a
tooth with a slightly smaller
filling (right) after preparation
for an inlay.
The onlay and inlay are
prepared on a plaster model
of the teeth.
The onlay and inlay have been fitted. The onlay covers more than the inlay.
Dr Mohamed Hamed Ghazy
Email:[email protected]
11
Purpose of Prosthodontics
Improve appearance
Improve speech
Promote good oral hygiene
Stabilize arch and occlusion
Crown Fabrication
1. Tooth Preparation, Including Build-Up
2. Impression
3. Temporization
4. Model (Cast) and Die Fabrication
5. Wax-Up
6. Investing and Casting
7. Crown Adjusting and Polishing
8. Clinical Try-In and Cementation
Dr Mohamed Hamed Ghazy
Email:[email protected]
12
Tooth Preparations [email protected]
Partial veneer crown Preparations
Teeth Preparations for fixed dental prosthesis [email protected]
Build-Ups
Pin Retained
Preformed Posts
Custom Cast Post and Core
Dr Mohamed Hamed Ghazy
Email:[email protected]
13
Build-Ups Pin Retained
mghazy2ymans.edu.eg
Build-Ups Preformed Posts
Build-Ups Custom Cast Post and Core
Temporaries Custom made
acrylic
Relined polycarbonate crowns
Preformed metal crowns
Dr Mohamed Hamed Ghazy
Email:[email protected]
14
Impressions Full arch
impressions
Double bite impressions
Model (Cast) and Die Fabrication
Restorations
Dr Mohamed Hamed Ghazy
Email:[email protected]
15
[email protected] [email protected]
Pouring the impression with Gypsum
Products
Proportion P and L
Transfer to impression
Microstone
GYPSUM PRODUCTS: • Plaster • Stone, Cast Stone
• Improved Stone, Die Stone
Specialty Stones
Investment Materials
Edentulous Cast
Orthodontic Model
Working Cast
Working Cast with Removable Dies
Removable Die with Waxed Inlay
Dr Mohamed Hamed Ghazy
Email:[email protected]
19
[email protected] [email protected]
[email protected] [email protected]
Overview of INDIRECT RESTORATIONS
• Impressions
• Models/Casts
• Waxing
• Investing
• Casting
• Finishing/Polishing
• Cementing
Dr Mohamed Hamed Ghazy
Email:[email protected]
20
[email protected] [email protected]
The metal ceramic restoration tried on the master cast
[email protected] [email protected]
PFM FABRICATION
Dr Mohamed Hamed Ghazy
Email:[email protected]
21
"Each time you are honest and conduct yourself with honesty, a success force will drive you toward greater
success. Each time you
lie, even with a little white lie, there are strong forces pushing you toward failure."
