Post cementation /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Post cementation /certified fixed orthodontic courses by Indian dental academy

  1. 1. Post Cementation Instructions ,Home Care and Follow Up of Fixed Partial Dentures INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Contents Introduction Post cementation instructions Oral hygiene Follow up:  Dental caries  Periodontal health  Occlusal dysfunction  Pulpal Health  Periapical Health www.indiandentalacademy.com
  3. 3. Emergency Appointments  Pain  Fracture of tooth  Loosening of Retainers  Fractured Connectors  Fractured Porcelein Conclusion Refrences www.indiandentalacademy.com
  4. 4. Introduction www.indiandentalacademy.com
  5. 5. Post Cementation Instructions       Avoid loading or biting on the restoration for the first 24 hours Exercise all oral functions Avoid sudden impact forces Maintenance and oral hygiene procedures Regular recall Report immediately if there is pain www.indiandentalacademy.com
  6. 6. Home care Core of the home care program is plaque control. Use of a manual or a powered toothbrush Short flat headed brush with medium soft bristles Thoroughness rather than technique. Most popular is the sulcus cleansing technique or the BASS method www.indiandentalacademy.com
  7. 7. www.indiandentalacademy.com
  8. 8. Bass Method www.indiandentalacademy.com
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  12. 12. Modified Stillmans Method www.indiandentalacademy.com
  13. 13. Charters method www.indiandentalacademy.com
  14. 14. INTERDENTAL CLEANING AIDS Purpose To remove plaque, not to dislodge fibrous threads of food wedged between teeth. www.indiandentalacademy.com
  15. 15. Types of Embrasures www.indiandentalacademy.com
  16. 16. Dental floss Multifilament nylon yarn Twisted and non twisted Bonded and non bonded Waxed and non waxed Thick or thin Monofilament and multifilament www.indiandentalacademy.com
  17. 17. www.indiandentalacademy.com
  18. 18. Floss Holders www.indiandentalacademy.com
  19. 19. Super Floss www.indiandentalacademy.com
  20. 20. www.indiandentalacademy.com
  21. 21. Interdental Brushes www.indiandentalacademy.com
  22. 22. Wooden and rubber tips www.indiandentalacademy.com
  23. 23. Oral Irrigating Devices www.indiandentalacademy.com
  24. 24. Disclosing Solutions www.indiandentalacademy.com
  25. 25. Plaque Control Record www.indiandentalacademy.com
  26. 26. Dental Caries  Pain or sensitivity  Bad taste  Bad breath  Loose restorations  Fractured teeth  Discoloured teeth www.indiandentalacademy.com
  27. 27. Most common cause of failure of cast restorations as reported by Schwartz et al in 1970--- accounting for 36% of failure. Detection of caries1. Visual 2. Explorers 3. Radiographs www.indiandentalacademy.com
  28. 28. LocationOn abutment at the margin of restoration www.indiandentalacademy.com
  29. 29. Caries involving the furcation and root caries www.indiandentalacademy.com
  30. 30. Extensive Caries Requiring Removal Of the Retainer www.indiandentalacademy.com
  31. 31. Daily rinse of sodium flouride (0.05%) and a Flouridated dentifrice containing 1,100 ppm of flouride as sodium flouride Flouride varnishes. www.indiandentalacademy.com
  32. 32. Periodontal Disease          Looseness of teeth or bridgework Drifting teeth Bleeding tissues Change in colour of the gingiva Bad taste Bad breath Pain Abscess formation Poor aesthetics www.indiandentalacademy.com
  33. 33. thorough assessment of periodontal condition. 1. Evaluating patients plaque control efficiency 2. bleeding on probing, estimating pocket depth 3. Checking for mobility 4. Radiographic evaluation. www.indiandentalacademy.com
  34. 34. Acute conditions : abscess- incision and drainage.  Advanced periodontitis: around abutments or in case of furcation involvement. Debridement and removal of the soft tissue pocket. Subgingival irrigation with 1% chlorhexidine gel. Elevation of flap ,debridement Recontouring the tooth to provide access for maintenance Remaking of single crowns if possible Antibiotic therapy- doxycycline 200mg on day one followed by 100mg per day for 3 weeks.  www.indiandentalacademy.com
  35. 35. Advanced cases of furcation involvement – treated endodontically and root resected Absolutely unmaintainable site still persists –extraction www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37. Gingival facade www.indiandentalacademy.com
  38. 38. Subpontic inflammation  Pain  Swelling  Poor aesthetics  Poor plaque control www.indiandentalacademy.com
  39. 39. Occlusal dysfunction     Abnormal tooth mobility,muscle and joint pain. Wear facets on occlusal surfaces. Articulated diagnostic casts must be remade Correction by occlusal adjustments, occlusal devices. www.indiandentalacademy.com
  40. 40. Occlusal adjustment   Centric relation position must be verified Remove retrusive prematurities and eliminate the deflective shift from RCP to ICP. www.indiandentalacademy.com
  41. 41.  Adjust ICP to achieve stable, simultaneous, multipointed, widely distributed contacts. www.indiandentalacademy.com
  42. 42.  Test for excessive contact (fremitus) on the incisor teeth.  Remove posterior protrusive supracontacts and establish contacts that are bilateral.  Remove or lessen mediotrusive (balancing) interferences www.indiandentalacademy.com
  43. 43. • Reduce excessive cusp steepness on the laterotrusive (working) contacts. www.indiandentalacademy.com
  44. 44.  Eliminate gross occlusal disharmonies include, Extruded Teeth, Plunger Cusp, Uneven Adjacent Marginal Ridges, Rotated, Malposed Teeth, Flat Occlusal Wear. Recheck tooth contact relationships.  Polish all rough tooth surfaces.  www.indiandentalacademy.com
  45. 45. Occlusal Device  Repositioning of condyles / articular disk  Reduction in masticatory muscle activity  Modification of harmful oral behavior  Used as a night guard in cases of bruxism www.indiandentalacademy.com
  46. 46. Occlusal wear  Perforations of restorations  Leakage and caries  If detected earlysealed with amalgam restoration  Remaking of restoration www.indiandentalacademy.com
  47. 47. Pulpal and Periapical health Pain : spontaneous or related to hot ,cold or sweet stimuli Exacerbated on lying down Vitality of the tooth assessed – electric pulp testing, thermal www.indiandentalacademy.com
  48. 48. Periapical pain manifests as: Pain on biting Swelling Previous pain that subsided Radiographs provide the most useful information. Assessed every few years. Contradictary evidence where some studies show high incidence of periapical disease of teeth restored with fixed prostheses others show opposite results. Teeth with pulpal or periapical problems must be endontically treated www.indiandentalacademy.com
  49. 49. Access opening is made through the crown After the Biomechanical preparation and obturation is done The access opening is sealed with either an amalgam restoration or inlaywww.indiandentalacademy.com repair.
  50. 50. Emergency Appointments    Pain Tooth fracture- coronal or radicular Causes : Excessive tooth preparation. Interfering centric or eccentric contacts . Unseating of a prosthesis www.indiandentalacademy.com
  51. 51.    Small fractures- amalgam or resin Large fractures around partial coverage crownsfull coverage restorations or core and crown fabrication if pulpal exposure occurs –endodontic therapy ,post and core and crown Fracture under a full coverage restorationhorizontal at finish line- endodontic therapy ,post and core followed by a crown Little coronal structure with intact finish line. Use of existing crown .post and core fabricated to fit restoration and prepared tooth. www.indiandentalacademy.com
  52. 52. Root fractureDue to internally weakened tooth with short oversized posts. Usually extraction Complicates follow up treatment. www.indiandentalacademy.com
  53. 53. Loose Abutment Retainer Percieved as bad taste ,bad odour or sensitivity, May develop caries. www.indiandentalacademy.com
  54. 54. Prosthesis must be removed Abutment evaluated Recementation Intact removal difficult Hemostats Ultrasonic scalers Crown and bridge removal systems Adhesive resin-richwil system Sectioning of prosthesis www.indiandentalacademy.com
  55. 55. Crown and Bridge Removal Systems Coronaflex crown remover Metalift Crown and Bridge Removal System Roydent Bridge and Crown www.indiandentalacademy.com Back Action-Crown Remover remover
  56. 56. Richwil crown and Bridge Remover Removal by Sectioning www.indiandentalacademy.com
  57. 57. Fractured connector Fracture due to occlusal forces Failure of the cast or soldered connection due to internal porosity. Perceived as pain Repair : Stabilisation of the parts in the mouth,making an impression ,Removal from mouth and reassembling it on the casts, soldering and recementation. www.indiandentalacademy.com
  58. 58. Dovetails are prepared to a depth of 2mm on either side of the fractured connector ,an inlay like casting is fabricated and then cemented. Prosthesis must be removed and remade. www.indiandentalacademy.com
  59. 59. Fractured porcelain Veneer Fracture within the porcelain www.indiandentalacademy.com
  60. 60. Mixed porcelain / metal repair www.indiandentalacademy.com
  61. 61. www.indiandentalacademy.com
  62. 62. Metal repair Fabrication of an overcasting www.indiandentalacademy.com
  63. 63. Conclusion The responsibility of a dentist does not end with the cementation of the prosthesis . The success and longevity of the prosthesis depends upon 1. carefully structured sequence of post operative appointments, designed to monitor the patients dental health, 2. stimulate and motivate the patient to maintain meticulous plaque control. 3. Identify any incipient disease and introduce any corrective treatment before irreversible damage occurs. www.indiandentalacademy.com
  64. 64. Refrences     Carranza Newman:Clinical Periodontology, ed 8,1996, W B Saunders company Dykema-Goodacre –Philips: johnston’s modern practice in fixed prosthodontics, ed 4,1986,W.B. Saunders company. Micheal D. Wise: Failure in the restored dentition: management and treatment, 1995, Quintessence Publishing co. ltd. Rosenstiel-Land-Fujimoto: contemporary fixed prosthodontics, ed 3,2001,C V Mosby www.indiandentalacademy.com
  65. 65.      The Dental Clinics of North America: periodontal restorative interrelationships; apr 1980 Comprehensive fixed Prosthodontics:The Dental Clinics of North America, jul 1992 Antonio Carlos Cardoso. Clinical and Laboratory Techniquesfor Repair of Fractured Porcelein in fixed Prosthesis: A case Report. Quintessence int,1994;25:835-38 J W robbins. Intraoral Repair of Fractured Porcelein Restortion . Operative dentistry,1998;23:203-207 Karson A. Kupiec, Karen M. Wuertz. Evaluation of porcelein surface treatments and agents for composite –to –porcelein repair.Journal of Prosthetic Dentistry; 1996; 76:119-24 www.indiandentalacademy.com
  66. 66. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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