Fixed prosthodontics lesson 3

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  • 1. INTRODUCTION & Extra-coronal TERMINOLOGY restorations Part I: General Full coverage considerations restorations
  • 2.  Full coverage restorations as we said before, these are restorations used to restore the all surfaces of the clinical crown. And are classified according to the material used in their construction, as: 1. Metal crowns (or restorations) 2. Non-metal crowns (or restorations). Full veneer 3. Combination of both of the two above. crowns
  • 3.  Called also : - Full metal crowns, - Complete metal crowns, - Full cast crowns, - Complete cast crowns, - All metal crowns
  • 4. It is an artificial metallic restoration used tocover the all surfaces of the clinical crown.It is made only from metal, e.g. gold.
  • 5. Metal crowns •IndicationsThe metal crowns are used: 1. as single crown or as a bridge (retainer for FPD). 2. only for posterior teeth (where there is a sever occlusal stress). 3. in patient with high caries index. 4. for an endodontically treated tooth/or teeth (as protection). 5. for malalignment tooth/or teeth. 6. for teeth with a short occluso-gingival height. 7. for a badly broken clinical crown. 8. in a long span bridge.
  • 6. Metal • Contraindications crownsThe metal crowns are contraindicated: 1. in case of anterior teeth, for esthetic reasons. 2. in a situation where anther conservative preparation can be use (e.g. partial coverage). 3. when less than maximum resistance and retention is needed. 4. when caries extend gingivally, as that the finish line cannot be made. 5. in case of uncontrolled caries.
  • 7. Metal • Advantages crowns1. great resistance form.2. great retention.3. high strength.4. good protection for a tooth to be restored.5. can modify occlusion in case of overeruption.6. can modify tooth contour in case of open contact or in buccal or lingual contour in a tooth used as a retainer for FPD.7. Ideal restorations for teeth with developmental defects.
  • 8. Metal • Disadvantages crowns DISADVANTAGES : 1. bad esthetics (especially for anterior teeth). 2. pulp vitality can not be detected. 3. incipient* caries can not be detected. 4. extensive amount of tooth reduction. *Incipient: which is just beginning or which is in its early stage.
  • 9.  Called also : - Jacket crowns - all ceramic crowns It is an artificial non metallic restoration used to cover the all surfaces of the clinical crown. It is made only from porcelain or acryl.
  • 10. It is an artificial non metallic restoration made of porcelain, used to cover the all surfaces of the clinical crown.
  • 11. PJC •IndicationsThe PJC are used: 1. for anterior teeth (especially incisors). 2. for severely discolored anterior teeth. 3. over an existing post and core substructure.
  • 12. PJC • ContraindicationsThe PJC are contraindicated: 1. in Posterior teeth (when maximum resistance and retention is needed). 2. in case of tooth with short clinical crown (no enough tooth structure to support the porcelain). 3. in case of edge to edge or overbite* occlusion. 4. as a retainer for FPD. *Overbite: is the vertical overlap of the upper incisor teeth over the lower ones.
  • 13. PJC • Advantages The PJC:1. have the best cosmetic effect of all dental restorations.2. are very strong.3. are the best to use on the incisors. PJC • Disadvantage The PJC: Have high risk of fracture (because they are brittle)!
  • 14. Have 2 types: 1. Full veneered crowns, and 2. Veneered crowns.
  • 15. Known as : - Porcelain Fused to Metal crowns (PFM), or - Metal ceramic crowns.
  • 16. Full veneered crowns are full castcrowns having all surfaces faced withporcelain or acrylic fused to metal.
  • 17. Full veneered crowns are full cast crownshaving porcelain or acrylic facing on facial orlingual surface.
  • 18. Metal ceramic crowns •IndicationsThe metal ceramic crowns are used: 1. on teeth require esthetic. 2. in case of extensive tooth destruction as a result of caries, trauma, or existing previous restorations. 3. when there is a repeated failure of PJC. 4. when superior retention and resistance is needed. 5. in case of an endodontically treated tooth. 6. to recontour axial surfaces or correct minor malinclinations of teeth.
  • 19. Metal ceramic crowns • ContraindicationsThe metal ceramic crowns are contraindicated: 1. in patient with active caries or untreated periodontal disease. 2. in young patient with large pulp chamber because of the high risk of pulp exposure. 3. where a more conservative restoration can be made.
  • 20. Metal ceramic crowns • Advantages The metal ceramic crowns :1. have the strength of cast metal crownswith the esthetic of the all ceramiccrowns2. have good retention.3. permit easy correction of the axialwalls.
  • 21. Metal ceramic • Disadvantages crowns1. their preparation requires more tooth reduction to provide sufficient space for the restorative materials.2. their facial margins for anterior teeth, is often placed subgingivally which increase the risk for periodontal disease.3. the laboratory casts are expensive.4. a frequent problem is the difficulty of accurate shade selection.
  • 22. Define the following terms: - Porcelain Jacket crown - Full veneered crownWhat are the indications for metal crowns? What are the different types of fullcoverage restorations? Write the advantagesof one of the them.