This document discusses common problems that can occur with dental impressions and stone models, and their potential causes and solutions. It describes issues such as voids, tears or pulls in impressions that could result in poor fitting restorations. Specific problems covered include inhibited or slow setting impressions, lack of detail, voids or tears at margins, facial-lingual pulls, tray-tooth contact, delamination, poor bonding to trays, and discrepancies in stone models. For each problem, potential causes such as expiration, contamination, inadequate technique, or material incompatibility are identified along with recommended solutions.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
The scope of fixed prosthodontics treatment can range from the restoration of a single tooth to the rehabilitation of the entire occlusion. Single teeth can be restored to full function, and improvement in
esthetics can be achieved. Missing teeth can be replaced with fixed prostheses that will improve patient comfort and masticatory ability, maintain the health and integrity of the dental arches, and, in many instances, elevate the patient’s self-image.
FPD failures/dental CROWN & BRIDGE courses by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
The scope of fixed prosthodontics treatment can range from the restoration of a single tooth to the rehabilitation of the entire occlusion. Single teeth can be restored to full function, and improvement in
esthetics can be achieved. Missing teeth can be replaced with fixed prostheses that will improve patient comfort and masticatory ability, maintain the health and integrity of the dental arches, and, in many instances, elevate the patient’s self-image.
FPD failures/dental CROWN & BRIDGE courses by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
Failures in fixed partial dentures /certified fixed orthodontic courses by In...Indian dental academy
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.
Post insertion complaints in cd patients/ orthodontic continuing educationIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Resin retained fpd/ oral surgery courses / oral surgery courses Indian dental academy
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.
13- Relining, rebasing and repair of removable dentures.pptxAmalKaddah1
COMPLETE DENTURE CONSTRUCTION
1- Diagnosis and Treatment Planning for Removable Prosthodontics
2- Preliminary Maxillary and mandibular impression procedures
3- Final Maxillary and mandibular impression procedures
4- Jaw Relation Registration
a. Introduction and the stomatognathic system
What 'occlusion' is and why it is important
b. Definitions.
c. Check denture foundation and Establishment of facial contour.
d. Establishment of the occlusal plane.
e. Importance of mounting the maxillary cast using Maxillary face-bow record and transfer.
f. Determination of vertical dimension of centric occluding relation.
g. Determination of centric and eccentric relations at the accepted vertical dimension.
5- Selection of Artificial Teeth
6- Prosthetic Problems and possible solutions in Setting –up of teeth for skeletal Class I, II and Class III arch relationship of completely edentulous patients.
7- Try-in of the wax trial complete denture.
8- Complete denture insertion (Delivery)
9- Occlusal corrections.
10- Managements of Post Insertion Problems and Complaints.
11- Single denture and Kelly's Syndrome
12- Denture Processing and Laboratory Errors.
13- Relining, rebasing and repair of removable dentures
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Finishing and cementation /certified fixed orthodontic courses by Indian dent...Indian dental academy
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: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Die and die materials/certified fixed orthodontic courses by Indian dental ac...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
Similar to Fixed prosthodontics problems and solutions in dentistry (20)
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Anti ulcer drugs and their Advance pharmacology ||
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||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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5. Porcelain fused to metal
Distortion of metal-ceramic framework
Inadequate metal support
Excessive porcelain thickness
Technical flaws
Normal function (occlusal forces)
Trauma
6. Failure of solder joints
Inclusion
Failure to bond
Small solder joint
15. Casting difficulties
External angles of crown
should be rounded
Sharp edges
Stone die
wax-up stage.
investment material flow
difficult to remove the investment material
Cement thickness
16. REPAIRMENT TIME…
Some things are really beautiful!
But nothing lasts forever!
HOW CAN WE REPAIR THESE C&B FAILURES?
17. Seriousness of the problem
1. Leave it alone if not causing any serious harm
2. Adjusting or repairing the fault
3. Replace the crown or bridge
19. Grinding and polishing in situ
Metal margins of crowns with positive ledges
Porcelain margin
Heatless stone
Diamond point
Followed by various composite finishing burs and discs.
20. Metal margins
1. Diamond stone
1. Green stones
2. Tungsten carbide stones
3. Metal and linen strips
2. Interdentally,
1. Triangular shaped diamond
2. Abrasive rubber instrument with special handpiece
3. Margins should be polished
21. Repairs by restoring in situ…….
Occlusal Repairs
1. Amalgam
2. gold inlay
3. composite material
22. Repairs at the Margins
margins of a poorly fitting bridge
Secondary caries/early erosion and abrasion
composite or GIC
Cavity prep at margins
poor access >>> remove part of the crown margin
raising a full gingival flap
good visibility
23. Repairs to porcelain
Ceramic restorations
Composite
Separate silane coupling agent
Limited to sites with minimal occlusal forces.
24.
25.
26.
27.
28.
29. Ceramic facings
Porcelain is lost and
composite repair is not
possible
Often better to replace
whole crown
Pontic.
Drilled through
New pin retained metal-
ceramic facing
Removing all the porcelain
Metal ceramic sleeve
crown
30. Removing c&b’s
1. Vibration of
ultrasonic scaler.
2. Good leverage at
margins
3. A slide hammer Bridge
remover
4. Crown can be cut off
31. Removing post & cores
Using extraction forceps and using sharp twists –
carefully…
Files
Ultrasonic
32. Removing PJC’s
Cannot be removed intact
and should be cut off.
A vertical groove is made
with a diamond bur in the
buccal surface just
through to cement.
Then Removed with
suitable heavy duty
instrument.
33. Removing Metal – Ceramic Crowns
Possible to remove with
normal devices
usually better to cut off.
cast metal
solid tungsten carbide bur
with very fine cross cuts
Eye protection!!!
Vertical groove cut on buccal
metal is usually thinner here
with better vision.
Diamond bur can cut
porcelain favourably !
35. Removing Bridges
(3 situations)
1. Abutment teeth need to be
extracted
Bridge is removed Intact
Dividing the bridge
2. abutment needed to be
retained
Retainers are cut and bridge
removed carefully
3. temporary measures
removing whole bridges and
making adjustments.
36.
37.
38.
39. Inhibited or Slow Setting
Visual Appearance:
Shiny, no detail
Result:
Inadequate surface detail on
cast, poor fitting restorations.
S ulfur inhibition For Vinyl
Polysiloxane Materials
latex gloves .
Residues
custom temporary
provisional cements
40.
41. Inhibited or
Slow Setting
CAUSE SOLUTION
For Vinyl Polysiloxane
Materials
Sulfur inhibition due to
contact of latex gloves with
tissue/tooth/retraction
material or impression
material.
Wear gloves proven not to
contain traces
of sulfur.
If contamination is
suspected, scrub affected
area with diluted hydrogen
peroxide.
42. Inhibited or Slow Setting
CAUSE SOLUTION
Residues from custom
temporary or
provisional cements (acrylics)
present.
Do not use impressions already
used to
fabricate the temporary
restoration.
Fabricate the temporary crown
or bridge
after final impression has been
made.
Remove air-inhibited layer on
the exposed
surface with an alcohol wipe
before making
final impression.
44. Lack of Impression Detail
Visual Appearance:
Muted detail
reproduction.
Result: Crowns may be
too tight, or loose, and
not fit correctly.
45. Lack of Impression Detail
CAUSE SOLUTION
Impression material stored at
elevated temperature.
Store impression material at
room temperature.
46. Lack of Impression Detail
CAUSE SOLUTION
Impression material stored at
too low a temperature
(prolongs the setting
reactions,
changes viscosity and
requires exceptionally
high extrusion forces for
automix materials).
Keep impression material at a
temperature of
18°C/64°F at least one day
prior use.
47. Lack of Impression Detail
CAUSE SOLUTION
Thick blood/saliva pooled
around prep.
Remove blood and saliva
prior to
making impression.
Use 2-step impression
technique.
48. Lack of Impression Detail
CAUSE SOLUTION
Inadequate retraction of
sulcus around prep.
Use good retraction
technique, with proper
moisture control.
49. Lack of Impression Detail
CAUSE SOLUTION
Exceeding the working time. Follow manufacturer’s
working
time specifications.
Choose material with longer
working time.
50. Lack of Impression Detail
CAUSE SOLUTION
Inadequate disinfection
effects
surface quality (detail
reproduction) and
dimensional stability.
Use water based disinfectants
according to
FDA guidelines.
Follow manufacturer’s
instructions for use.
51. Voids on the Margin
Visual Appearance:
Voids/holes on margin
of the prepared teeth.
Incomplete margin.
Result: The fit and
function of the final
restoration may be
compromised. Short
crown margins
and/or open margins.
52. Voids on the Margin
CAUSE SOLUTION
Improper syringe technique. Keep syringe tip immersed in
wash material to
avoid entrapping air.
Wiggle and stir while
syringing. Push
material forward.
53. Voids on the Margin
CAUSE SOLUTION
Inadequate coverage of
marginal area with light body
impression material.
Use wash material liberally
on preparation
and abutments.
54. Blood and saliva
contamination around prep.
Use good moisture control technique.
Rinse and dry prep area before taking
the impression.
Stop bleeding by using appropriate
retraction
technique and hemostatic agent.
Leave cord
in sulcus until no blood or saliva are
present
before syringing the light body
impression
material. Consider two-cord retraction
to
displace tissue and control fluids.
Voids on the Margin
CAUSE SOLUTION
56. Tearing at the Margin
Visual Appearance:
Rip, or visible tearing
on the margin of the
preparation.
Result: Short crown
margins and/or open
margins.
57. Tearing at the Margin
CAUSE SOLUTION
Check expiration date of
impression material.
Ensure mixing instructions
are followed and materials
have a streak-free appearance.
Expired impression material.
Inadequate mix.
58. Tearing at the Margin
CAUSE SOLUTION
Displace tissue to allow the
impression material to access
prepared area.
Consider two-cord retraction.
Leave pilot cord in the sulcus
when taking the impression.
Use impression material with
sufficient tear resistance.
Insufficient retraction.
59. Tearing at the Margin
CAUSE SOLUTION
Do not use impressions
already used to fabricate the
temporary restoration.
Fabricate the temporary
crown or bridge after final
impression has been made.
Remove air-inhibited layer on
the exposed surface with an
alcohol wipe before making
final impression.
Residues from custom
temporary or provisional
cements (acrylics) present.
60. Facial-Lingual Pulls
Visual Appearance: V-
shaped void, trough-
like.
Result: Failure to
capture complete and
accurate dentition.
61. Facial-Lingual Pulls
CAUSE SOLUTION
Follow manufacturer’s
working time specifications.
Choose material with longer
working time.
Exceeding the working time.
64. Facial-Lingual Pulls
CAUSE SOLUTION
Use lingual stops.
Use an impression tray that
supports the flow
of the material.
Impression tray does not
support flow of
impression material.
65. Tray-Tooth Contact
Result: Restoration
may have slight
distortion at marginal
area, or rocks.
Visual Appearance:
Show-through of tray.
Impression tray
exposed.
66. Tray-Tooth Contact
CAUSE SOLUTION
Use proper size tray.
Test various tray sizes to
ensure proper size.
Prepared teeth contact the
sides or bottom
of impression tray.
67. Tray-Tooth Contact
CAUSE SOLUTION
Carve out tray material
properly before
applying wash.
Tooth contact with the pre-
set tray material
when using the two-step
technique.
70. Delamination
CAUSE SOLUTION
Follow manufacturer’s
working time specifications.
Choose material with longer
working time.
Store impression material at
room temperature.
Exceeding the working time.
Impression material stored at
elevated temperature.
71. Delamination
CAUSE SOLUTION
Avoid contact with sulfur
contaminants:
Wear gloves proven not to
contain traces of sulfur.
Avoid contact with acrylic
and methacrylic
contaminants:
Ensure impression
materialdoes not come into
contact with methacrylate
residue from acrylate
temporary materials.
Sulfur or acrylic
contamination of pre-set
heavy body material in two-
step technique.
72. Poor Bond of Impression
Material to the Tray
Visual Appearance:
Impression pulling
away from the
sides/bottom of tray.
Result: Crown(s) may
be tight and not seat
fully, or require
excessive internal
adjustment.
73. No tray adhesive used. Use tray adhesive.
Poor Bond of Impression
Material to the Tray
CAUSE SOLUTION
74. Incompatible tray adhesive
used.
Use appropriate tray
adhesive.
VPS adhesive for VPS.
Polyether adhesive for
polyether materials.
Poor Bond of Impression
Material to the Tray
CAUSE SOLUTION
75. Inadequate drying time for
tray adhesive..
Follow manufacturer’s
instructions for application,
and drying time
Poor Bond of Impression
Material to the Tray
CAUSE SOLUTION
76. Thin plastic trays allow
deflection, which can cause
rebound upon removal.
Use a tray that fits better, and
is stiffer and more rigid.
Poor Bond of Impression
Material to the Tray
CAUSE SOLUTION
77. Stone Model
Discrepancies
Visual Appearance:
Voids on margin,
powdery cusp tips on
incisal edges on
prepared tooth. “Golf-
ball” appearance of
stone model.
Result: Incomplete
seating of indirect
restorations
79. Tooth contact with
impression tray, or gauze of
double bite tray causes water
to leach out of the tray,
dehydrating the stone.
Instruct patient to bite
passively in centric occlusion
when using dual arch trays.
Fill tray with sufficient
amount of material.
CAUSE SOLUTION
Stone Model
Discrepancies
80. Cast not made according to
model preparation guidelines
and lacks detail.
Provide as much information
as possible to the lab.
Indicate
type of impression material
(polyether or VPS) and
whether
or not the impression has
been disinfected.
CAUSE SOLUTION
Stone Model
Discrepancies
81. VPS
Hydrogen gas emission.
Follow manufacturer’s
instruction for casting time.
CAUSE SOLUTION
Stone Model
Discrepancies
Editor's Notes
Failure means, to be unsatisfactory, and in C&B, it’s the inevitable.
Repairment is the work that is done to get rid of the failure.
Distortion of metal-ceramic framework invariably results in the loss of porcelain
A flaw or inclusion in the solder itself
Failure to bond to the surface of the metal
The solder joint not being sufficiently large for the conditions in which it is placed.
Progression of perio disease
Abutment tooth may become non-vital (pulpal problems)
Recurrent caries occuring at margins of retainers:
- change in diet.
- lapsed oral hygiene.
- inadequate restoration
design
May occur to all-metal bridges
if pontics are too thin or
if a bridge is removed with too much force.
Framework distortion may occur during function or as a result of trauma.
Crowns tend to wear down substantially over a lifetime
All restorative materials wear in use
, and the rate is determined by the occlusion,
the diet and parafunctional (bruxing) habits
No cut back
Inadequate space for porcelain
Minor problems to be noted & monitored but where no other action is needed.
The type of inadequacies that can be corrected in situ.
Those that cannot.
Positive ledge (overhang)
excess of crown material protruding beyond the margin of the preparation.
Negative ledge
deficiency of crown material that leaves the margin exposed but with no major gaps between the crown and the tooth.
Often arises because the impression did not correct at the try-in stage.
“External angles of crown preps for metal castings should be rounded to prevent one of the faults that may occur in the following chain of events:”
Stone die may not flow into the impression adequately, trapping air bubbles in the sharp angles of the imp.
Sharp edges may be damaged at the wax-up stage.
Investment material may not flow adequately into the wax pattern to produce rounded internal angles on the casting, preventing the casting from seating fully.
It may be difficult to remove the investment material entirely from sharp internal angles without damaging the casting.
Cement will flow less rapidly around sharp angles, increasing the likelihood of an unnecessary thick cement layer at the margins.
Flower picture
In some situations, margins of crowns with good ledges can easily be adjusted.
If margin is porcelain (or specially designed), finishing instruments should be used, example, heatless stone or diamond point followed by various composite finishing burs and discs. Can also be modified in situ using the same instruments.
diamond stone followed by green stones, tungsten carbide stones or metal and linen strips may be used.
Interdentally, a triangular shaped diamond and an abrasive rubber instrument with special handpiece (esp overhangs).
Margins should be polished with prophylactic paste with brush/rubber cup, and interdentally with finishing strips.
Occlusal Repairs
Occlusal effects in metal retainers can be fixed by amalgam which usually gives good results.
A small gold inlay may also be preferred.
In metal-ceramic or porcelain restorations, composite material can be used but repair may need to be done periodically.
Should never try to repair margins of a poorly fitting bridge during insertion.
Secondary caries/early erosion and abrasion can be treated with composite or GIC.
Cavity prep at margins should not endanger strength although all caries should be removed. If poor access, then it is better to remove part of the crown margin rather than excessive amount of tooth structure.
In some cases, raising a full gingival flap may be justified.
Retainer margins can be adjusted and restored with good visibility.
Any necessary periodontal therapy or endodontic surgery can also be carried out.
Materials such as basic composite with a separate silane coupling agent for optimum bonding can be used to modify or shape ceramic restorations.
It is not an acid etch bond to enamel and is not strong. Therefore, the use of the material is limited to sites with minimal occlusal forces.
When porcelain is lost from a metal-ceramic unit and composite repair is not possible – often better to replace whole crown.
Sometimes possible with a pontic. A hole is drilled through the backing and an impression is taken with suitable pins for a new pin retained metal-ceramic facing.
- It could be a little bulkier than the original!
Sometimes possible to fix retainers or pontics by removing all the porcelain and reprepare the metal part using a “metal ceramic sleeve crown” which covers the skeleton of the old retainer or pontic.
Sometimes made with heat cured acrylic or laboratory light cured composite.
In removing any crown or bridge, in particular posts and caries, often helpful to break up the cement by vibration of ultrasconic scaler. It works best with zinc phosphate cement.
Metal crowns
Good leverage at margins for either complete or partial metal crowns.
Some instruments used are;
- cumine or mitchels trimmer
- even a slide hammer type crown
- bridge remover may be used
Crown can be cut off if all else fails.
Possible to remove with normal devices but are more rigid than gold and porcelain may break – usually better to cut off.
cast metal is best cut with a solid tungsten carbide bur with very fine cross cuts (beaver bur).
Eye protection is important for everyone
.
Vertical groove cut on buccal as metal is usually thinner here with better vision.
Diamond bur can cut porcelain favourably !
1 Abutment teeth need to be extracted
Bridge is removed with crown and bridge remover
Easy for cantilever
Others - Dividing the bridge through pontic or connector and remove teeth individually with retainers in place
2. When abutment teeth are needed to be retained either for support of partial denture or overdenture or for making a new crown. Retainers are cut and bridge removed carefully as preparations are protected.
3. Some temporary measures require removing whole bridges and making adjustments. Neither bridge nor preparation should be damaged.