indirect midterm l4 and on?

What are the functions of provisional?

occlusal function

pulpal protection

maintaing periodontal health

positional stability

esthetics

template for final restoration

Poor esthetics, reestablish function, mastication, speech are part of what function of provisional

occlusion function

How does provisionals protect pulp

helps cover exposure of dentin, dentinal tubules

prevents contamination of tubules by bacteria which can increase sensitivity

How does it maintain periodontal health

having a nicely contoured provisional will help maintain oral hygiene, plaque control and leakage of saliva and bacteria. a healthy periodontal tissue is crucial in deliverying final restoration

how do provisionals help with positional stability

inter and intra arch stability

What are some of the factors from hyper-occluded provisionals in inter-arch stability

2 for patient discomfort

2 for tooth movement

TMJ, occlusal trauma

extrusion of adjacent teeth, intrustion of prepared tooth (rarely)

What are a major outcome from hypo-occluded provisionals in inter-arch stability

open occlusal contact

Intra arch stability. open proximal contact from hypoocclusion can lead to _____ and ____

food impaction causing patient discomfort

tooth movement of prepared tooth and adjacent tooth

in intra-arch stability, if the proximal contact is too tight on the provisional, this can cause tooth movement on ___ and ___ teeth and this causes _____ with the actual definitive restoration

movement prepared and adjacent , open contact

if provisional is to tight, the teeth will move apart because of the pressure if you have tight proximal contact and teeth separate, when you place definitive restoration, the contacts will be open beacuse you moved teeth using provisionals not intentionally.

Template for final restoration. The provisional restorations wil allow us to evaluate multiple aspects of the proposed design. We can cahnage//modify before or after__ we move to the final restoration for which we will only need to ____ the provisional restoration

before, reproduce

How long should the provisionals last

2 weeks

For provisionals, evaluate at least _____. during this you can ___

once every month for long term provisionals

remove, evaluate, repair and recement

What are the three changes we can make on the provisional stage

shape and line angles: during provisonal stage we can change contours and line angles to acheive the desired morphology of teeth

Embrausres: gingival embrausres are essential as are able to modify the shpae of the papilla, promote gingivbal health, and cleanability by changing contours adaptation and margins

Shade-Translucency: we will be able to evaluate the shade with the patients to make sure the final restoration will look simliar to proposed treatment

if we make changes or revisions on the provisional, then what do we do

make another cast and base your final resotration based off the new cast

For the fabricated provisionla, once the provisionals are accepted, an _____ is taken to obtain a model with the shape of the provisionals

impressionthe

The final resotrations will be fabricated following the shpae of the provisionals. the purple putty is a fereference from the provisional restorations. the final restorations will be made following the putty.

the final restorations follow same shape as provisionals.

What are the types of prefabricated provisionals

aluminum shells,

acrylic shells

celluloid crown forms

polycarbonate crowns

stainless steel crowns

iso form crowns

What are the two types of custom made provisionals

composite resins

acrylic resins

What are the general charactertisitcs of provisional material

high strength and wear resisteance

ease of manipulation

dimension stability

polishability

color stability

non irritating

poor thermal conductivity

easy to modify/repair

cost

biocompatability

What is the composition of acrylic resins

Liquid: MMA monomer, hydroquinonenone (tertiary amine initiator)

Powder: PMMA polymer, benzoyl peroxide (activator

What is hydroquinonenone

tertiary amine initiator

What is the Benzoyl peroxid

activator

what is the initiator and activator in Acrylic resins

initiator : hydroquinenone

Activator; benzoyl peroxide

what type of provisional resin does this describe for disadvantages

exothermic reaction, polymerization shrinkage (7%), setting time 6-9 min, excessive free monomer (allergy), unpleasant odor

acrylic resinW

These are advantages of which provisional material ———

good physical properties, good esthetics, easy of manipulatino, easily repairablee, low cast

acrylic resin

Is acrylic resin exothermic or no

yes

what is the polymerization shrinkage percentage of acrylic resin

7

What is the setting time for acrylic resin

6-9 min

Acrylic resin has excessive _____ causing ____

free monomers, allergy

acrylic resin can be used the conventional way with ____ or through CADCAM which is _____ industrially processed

powder liquid jet

PMMA

When we say cadcam has higher polymerization rate, we mean they dont have as much ____ and will be stronger

free monomer

CADCAM has higher ____, fewer ____, and has ____ particles

Choices:

voids

fillers

polymerization

polymerizatoin, voids, filler (can add to make it stronger)

CAD CAM can be monochromatic or multilayered T or F

True

to reinforce fibers and metals and to decrease porosity, we can put long term provisionals in what

pressure pot

Sometimes, the material changes shape because of poluymeriation or because of the surface of material. if not too polished a lot of things can stick to provisionas. If there are voids, it would get stuck to the material and stain faster.

you want to avoid discoloration by curing in a )____ to decrease porosity

you can also do high polish or put surface ________

pressure pot

surface sealing materials like BisCover LV

to provide sealing materials to avoid discoloration in our provisional, what do we use

BisCover LV

What are the two types of composite resins for provisionals

Bis Acryl

Light cure resin

For Bisacryl, what is the composition for resin and filler

resin:
dimethacrylate polymer

bisGMA

filler

zirconia silica

Fune silica

pigement

silane

Does Bisacryl have high or low heat?

High or minimal pulpal irritation?

High or low polymerization shrinkage

low, minimal, low

What is the polymerization shrinkage of Bisacryl percentage

2-3%

Does bisacryl have high or low tensile strength and surface hardness

high

Bisacryl has ___ stability, minimal odor, and polishability

color

Does Bisacryl have an oxygenated inhibited layer

yes, very thick and this is bad

Is Bisacryl brittle? y or no

can you layer? yes or no

Is it easy to repair?

yes no no

one time or multiple time use provisional

one time. you mess up, you need to make another one

What are the advantages and disadvantages of Bisacryl

For light cure resin, what are the two types

Triad VLC

Fermit Fermit N Telio

What are the components of Triad VLC

THINK PMCA (like pimco)

PMMA Urethane dimetacyrlate

microfine silica

CQ

amine

What type of silica is in Triad VLC

microfine

What type of dimetacrylate does TRIAD VLC use

urethane

What are the components of fermit fermit n telio

polyester urethane dimethacrylate

silica

ethilriglycomethacrylate

Do light cure resin temporaries have direct or indirect technique?

low or high curing heat?

low or high polymerization shrinkage?

direct

low

low

is it easy to use and repair light cure resin

yes

Is ther e low or high strength and wear resistance for light cure resins for temporaries?

Does it have water absorption?

Is it short or long term use

low, yes and its ot good, short

T or F: light cure resins like traid vlc and fermit fermit prevent movenent of teeth

false

Is light cure resin radiolucent or opaque

after setting the material becomes,,….

lucent

plastic = disadvantage

Can you polish light cure resin

no

What are the advantrages and disadvantages of light cure resin

• Just like direct composite that youve been using for restorations, but its made for provisionals

• It has very low amount of filler so resin. Usually easy to manipulate, pretty sticky. Plac ematerial on top of tooth and light cure it. Easy to remove. Doesnt have a lot of filler so breaks easily too when you want to remove

• Not a lot of heat

• Less shrinkage, no mixing

• Only used for short term

• Can be expensive compared to other materials

  • Lot of water absorption, will degrade faster and the shade wont be stable, and physical properties of this material are pretty low

Techniques to fabricate a custom made provisoina'l

direct provisional is indicated for ____

indirect is indicated for _____

direct indirect technique (shell )indicated for

bisacryl bisacryl pmma

• Direct indirect

  • Shell provisional

  • Take impression of patient before prep

  • We make prep on the cast and we fabricate these provisionals/

  • Provisionals are ready _____ prep

  • Add material and realign the provisionals in the patients mouth and we need to use PMMA. so we can add material , repair the provisionals, and we can realign with pmma

before

what are the advantages and disadvantages for direct technique

advantages: fast

Disadvantages: possibility of getting lcoked on, less strength, onte time only, minimal repairs

What are the three different matrix that can be used for direct technique

thermal forming shell “ ellman technique”

putty matrix

alginate matrix

direct technique: thermal forming shell ellamn

plastic is heated, modelis placed on vaccum when lowered the heated plastic, the vaccum adapts to plastic on cast.

the repmlate is trimmed

template used for indirect or direct technique?

used for both indirect and indirect

for direct techniques, minor defects can be reapired using composite for provisionals. like adding -______ or to fill _____

proximal/occluszal contact

small voids

you can or can not repair margina repairs direct technique

can not

There si __% decrease in transverse strength after repair of bisacryl

make a new one rather than repair one

85

for direct technique we do not want interproximal ____ undercuts or ____walls

external parallel

for direct technique light cured materials, the patient will/will not be able to floss because it is locked in ____ into the interproximal space/undercut

will not

mechanically

What is the advantages of indirect technique

strenght and esthetics: cured in pressure pot

better fit: less polymerization shrinkage

biocompatability: less irritation to pulp and patient

no lock on (in the patients mouth)

can be delegated to auxilaries

best for using layering techniquje

for indirect technique you can use _____ or ______ to take impression of prep

ellman technique putty matrix

after making alginate impression, you pour up cast with no bubbles using quick set _____

plaster

You then inspect the plaster cast to see no nodules or voids, and add a ______, ___ or ___

separator

alcote, vaesline

after, you can mix the PMMA , load the matrix (ellman or putty), and seat and secure on the cast that was coated wtih vaseline.

after, u put the provisional in a ___-

use a pressure pot with PMMa

in pressure pot with PMMA, you use ___ or ____

hydraulic or air pressure

in pressure pot, you can

increase or decrease porosity in acrylic

can increase or decrease strength of acrylic

use hot water to lengthen or shorten sitting time

decrease

increase

shorten

does hot water in pressure pot increase strength of PMMA acrylic material?

no, just decrease sitting time

for direct indirect technique (shell), the shell provisional is made before or after the prepratation from a simulated preparation on the cast.

before

the shell provisional in direct indirect technique will be realigned in the patient mouth with ______

PMMA

direct indirect technique shell is done with_____ because we have to realign and repair the mateiral

PMMA

the direct indirect technique shell requires ____ if contours are to be changed

diagnostic wax up

what are the advantages and disadvantages of direct indirect technique

after taking the fabrication of a putty matrix from the original cast of wax up, a rought prep is made on the cast. ____ is applied to lubricate

Alcoat. The material is pressed on simulated prep after.

for direct indirect technique shell, what is the part thats actually getting put on the prep?

the PMMA, not the shell itself

you spray copious amounts of ____ to minimize the ______

water, minimize heat of exothermic reaction and create pulpal irritation

for direct indirect technique after u put shell, is this exothermic reaction?

yes so we spray water to cool down

L 6 Soft Tissue managemetn and impression materials and shade selection

impression materials ideal properities

accuracy, elastic recovery, dimensional stability, flow, flexibility, workability, hydrophilicity, long shelf life, patient comfort, economical

Topic: accuracy ideal property of impression material

for ideal impression material, we want fine details of ___ um

most modern impression materials meet this criteria and the limiting factor is the ____

25

ability of gypsum die material to replicate fina detail (~50um)

Topic: accuracy ideal property of impression material

is lower or higher viscosity impression material able to reproduce fine detail better

lowere

Topic: elastic recovery of impression material

Elastic recovery is the ability of a material to ___ back to its original shape when distorted

Elastic revoer occurs ______

think removal from undercut., you want easy removal

rebound, instant

when we take impression of teeth, it can be full of undercuts. when you place material and when you remove it, this material distorts just because u have to remove it and to go past the undercuts. After that it has to recover and go back to its og position and somtimes it doesnt, it gets distorted

Topic: dimensional stability of impressio material

Are you able to make change in dimesnions over time with impressions in the topic of dimensional stability

no

Topic: flow and flexibility of impression material

do you want flexible or nonflexible material?

When set, inflexible materials cause ___ of gypsum casts when on separation

flexible

fracture

Flexibility: ability to rebound and get to original position. when we try to remove from patient, it can break so we want flexibility

Topic: workability of impression

______ of material increases working time without sacrificing accuracy

refrigeration

Topic: hydrophilicity of impression material

moist/wet environment of the mouth means a hydrophlilic impression material flows into sulcus and captures details with ease

know already

ideally want material that allows u to have enough time and not too much time.

• Want material that sets faster so you don't have to wait and have patient in position that is not comfortable

• Working time important

• How to fix materials. Is it hand mixed to make it hard or outer mix? Do we need certain temperature or can we modify the work time or the the properties. Intraorally, we work with wet environment so we need material that works properly. Once we work w hydrophobic material, we have more problems with that too for fine details

  • Hydrophilicity: we need material that can work with hydrophilic wet environment in the mouth because its wet in the mouth

Topic: ideal properities

shelf life, you want no longer than ___ months for impression material

6

Ideal properties: patient comfort

you want impression material with least/most bulk, odor or no odor, taste or tasteless

least, odorless, tasteless

What are the three impression material types

water based impression materials

elastomeric impression materials

rigid impression materials

For lateral displacement of tissue with gingival dispalcement and retraction, the critical sulcular width is approximately ___ mm

0.2

the ideal properties of retraction include

vertical and lateral displacement

control of crevicular fluid

no systemic effects

not cause trauma to tissue

We need enough vertical and horizontal separation

Put tissue lower and to the side

We want Material that controls they moisture is important (cervicular fluid or blood)

No systemic effects. Sometimes we use materials that have active medication that can affect the patient. Do

We want materials that do not affect the tissues because we are at some cases doing trauma to tissuesand this can involve recession

What are the four methods of retraction

mechanical

chemical

alternative

surgical/electrosurgery/laser