RCC 1003

Inlay vs Onlay

Inlay fits inside the cusp

Onlay is larger and restore cusp

Finish Line vs Margin

Finish line is most external of margin (Where tooth meet crown) (point of failure)

Margin is outer edge of crown

Facebow vs Centric Relation

Facebow: Transfer maxillary to articulator

Centric Relation: Maxillo-Mandible relationship independent of tooth contact

What is the impression material for bite registration

Polyvinyl Siloxane (PVS)

True or False: The path of insertion should encroach upon the pulp or adjacent teeth

False (it should not)

Taper is ______ of two opposing external walls of a tooth

convergence

Extension form angle of convergence

What is the ideal taper

6 degrees

A complete straight will have undercut (too much retention)

What must be resolved prior to treatment

Perio issues

Interocclusal record is a registration of the positional relationship of the ______ teeth or arches

opposing

Impression tray must have adequate _______ to avoid distortion

rigidity

Resin thickness of ______ is needed for adequate rigidity. Clearance between the tray and the teeth should also be ______.

Elastomeric impression materials are considered most stable when they have a uniform thickness of _______

2 to 3 mm

2 to 3 mm

What is tissue stop for?

Ensure impression seat at same place everytime

Uniform thickness

What is marginal percolation

Leakage of salviary and microbial products via the restorative margins

Which stress breaks most restoration

shear stress (not along straight line)

Galvanic reaction/shock: Pain sensation caused by the electrical current generated when two ______ metals are brought into contact in the oral environment

dissimilar

What is the minimally required clearance of following

Buccal cusp

Lingual cusp

Marginal ridges and fossae

1.5 mm

1.0 mm

1.0 mm

What type of gold alloy is for crown

Type 3 or 4

Type 1 and 2 is too soft

What metal ceramic alloy is similar to type IV gold

High Noble

What is the reduction of functional and nonfunctional cusp

Functional: 1.5 mm (lingual of maxillary) (buccal of mandibular)

Nonfunctional 1.0 mm

What is crown lengthening

cutting gingival tissue to expose more tooth

If the occlusal width of the preparation exceeds ______ to ______ the buccolingual intercuspal distance, a restoration offering more protection such as an onlay should be planned

1/3 to 1/2

Can you have convergent walls for indirect restoration?

No it has to be divergent for insertion

What kind of characteristic do gold restoration need

bevel so that gold can flow through

When is chamfer indicated and when is shoulder

Chamfer: FCG and Ligual of PFM (850 bur)

Shoulder: PFM and All ceramic (847 bur)

What burs are shoulder and what is chamfer

Chamfer 850

Shoulder 847 and 848

What does gold look like in radiograph?

What does porcelain look like?

Amalgam (zirconia look like metal)

Resembles normal tooth structure can see through

_______ cannot be used as Fixed partial denture (bridge)

Onlays

Porcelain is a ceramic that contains a _______ matrix

glass

Un-bonded restoration are _______

brittle

Try-in can result in fracture

Porcelain is etched with _______ acid

Increases micromechanical retention

hydrofluoric

Silane is a ________ agent

Contributes to covalent and hydrogen bond

coupling

Can you bond gold

No

Sharp angles in preparation lead to ________ in restoration

fracture

Onlay longevity can be enhanced if the preparation allows for at least _______ occlusal ceramic thickness and incorporates additional retentive features

2 mm (magic number)

Which should be made first: Interim restoration or Final impression

Interim Restoration

________ ________ is the contour of a tooth or restoration, such as a crown on a natural tooth or dental implant abutment

Emergence profile

Gingival health is better maintained if the crown is slightly ________ rather than ________

________ causes plaque trapping and gingival inflammation

undercontoured, overcontoured

Overcontoured

Luting agent (cement) does/does not provide significant help with retention

does not

PMMA and PEMA

PMMA: Strong material but come with powder and liquid and very exothermic (very hot will fry pulp)

PEMA: Similar to PMMA, but has a slower setting time and less heat generation, improving usability in dental applications. (liquid is carcinogen)

Smell Terrible

PEMA can be attacked by _______

eugenol

Atundant (make pulp tissue feel better)

What is the material of provisa plus

Bis-acrylics

Less exothermic

Less shrinkage

Less odorous

Higher cost

Tine of Explorer

The tip of explorer

What is iatrogenic damage

Damage occurred during treatment

Biological width is defined as the dimension of soft tissue which is attached to the portion of the tooth coronal to the crest of ________ ________

alveolar bone

2 mm

Over Contour causes ________ disease

Under Contour causes ________

periodontal

recession

________ gingival margin is preferred

Supragingival

The margin of a ________ crown is to be hidden behind the labiogingival crest

metal-ceramic

A smooth margin is considerable ______ than a jagged one

shorter

What happens if chamfer is wider than half the bur used to form it

It causes J margin

Margin should be smooth and distinct and allow for approximately _______ of metal thickness at the margin

0.5 mm

(in lab is 1mm)

________ crown is considered a all ceramic

Zirconia

Zirconia requires ________ for it to density to crown

sintering (require high heat)

Cost of Zirconia compared to Full Cast Noble

Zirconia is cheaper

Having increased taper reduces ________ of the tooth

retention

Glass-based ceramics are etched with ________ acid and bonded with _______ coupling agent

hydrofluoric, silane

Does not work with zirconia

________- modified ________ allows zirconia to act like glass based ciramic

Silica, alumina

Sandblasting the ________ surface of zirconia crown develops the bond

intaglio (inside)

Coupling agent of zirconia

MDP (increase bond strength)

APC Concept

Method enhance bond strength of Zirconia

Step A: Air-particle abraded with alumina or silica-coated alumina (50 to 60 micron)

Step P: MDP (Primer) on tooth

Step C: Resin cement used to ensure polymerization

Which crown causes the least opposing wear

Zirconia Crown especially when polished

What is a Z bur

Bur to cut zirconia

What restoration is the molar

Emax

What is a ferrule

A ferrule is a small metal band or ring used to reinforce a dental restoration, particularly at the cervical area of a crown, enhancing retention and stability.

Usually 1.5 to 2 mm

Multi-functional vs Mono-functional

Linear Branched Cross-linked

Multi-functional stronger

Cross-linked stronger

Polymer are _______

crosslinked

Are ceramic composites?

Yes

Methyl Methacrylate vs Higher Alkyl Methacrylate

Higher Alkyl (Ethyl and Isobutyl Methacrylate) overcome drawback of MMA (high level of monomer release and high exothermic)

_______ can break the bond of higher alkyl methacrylate

Eugenol (found in temporary cement and IRM)

What is Bis-Acryl

Composite based provisional material

Doughy vs Rubbery Stage of acrylic

Doughy: No more monomer on surface (take impression)

Rubbery: Polymerization continues

Fiber-reinforced Provisional

For longer-term bridges

Multiple layers of Ribbond “Fiberglass”

Very strong but Ribbond prevents failure

PMMA vs Bis-acryl

PMMA is stronger

Can PMMA be used directly on tooth?

No it has strong exothermic reaction

Which technique is better: Direct or Indirect

Indirect

Don’t heat pulp

Better restoration

Disadvantage is require a good stone cast

An impression is an imprint or ______ likeness

A ______ reproduction, or cast will be made from the impression

negative

positive

What is HIRD

Hemostasis (Control bleeding)

Isolation (No saliva)

Retraction (Retract Gingival tissue)

Directions

Local anesthesia may help with saliva control by blocking nerve impulses from the ______

PDL

Atropine, Dycyclomine, and propantheline are _________

anticholinergics

Inhibit parasympathetic innervation and reduce saliva

What is the caution of glaucoma pt

No anticholinergics or will cause permanent blindness

What is another drug to reduce saliva that is safer than anticholinergics?

Clonidine (Antihypertensive)

Avoid in pt taking other antihypertensive

Not recommended

Mechanical, Chemical, and Surgical Displacement of Gingival Tissue

Mechanical: Retraction Cord

Chemical: Astringent (aluminum or iron salt) cause transient ischemica shrinking gingival tissue

Double cord technique

Thin cord placed without overlap at bottom

Second cord placed to to for lateral tissue displacement

Latter is removed immediately before impression making and initial cord left in place

Astringent contain aluminum or iron salts and cause a ______ _____, shrinking the gingival tissue

transient ischemia

Impression must be taken immediately upon removal

Repeated use should be avoided (can cause gingival recession)

What is ferric sulfate gel

Viscostat for hemorrhage control

What is aluminum chloride

Hemostatic agent and promote tissue shrinkage

What material is needed to use reversible hydrocolloid

Water cooled trays

Inhibition of Reversible Hydrocolloid

Displacement of one fluid by another immiscible fluid

Polysulfide as Final Impression

Takes time to set

Smell bad

Need to mix (error)

Not dimensionally stable

Condensation Silicone as final impression

Poor wetting characteristics (need very dry)

Not as good

Polyether vs Polyether with silicone

Polyether is very stiff

Addition of silicone (poly vinyl siloxane)

What is the final impression material we use

Polyether with addition of silicone

Latex glove inhibit the setting of what impression material?

PVS with silicone

Vinyl Siloxane

Closed-Mouth Impression Technique is made at _______

MICP (Maximum intercuspation)

No eccentric relationships recorded so need to be adjusted

Retraction for Impression vs Digital Impression

Impression: Tissue retracted vertically and laterally

Digital: Laterally

What is the disadvantage of digital impression

Problematic in subgingival cases

Must have clear margin and finish line

PFM require _______ tooth reduction compared to FCM and Zirconia

More

Two material both need sufficient thickness

Sufficient thickness needed to mask color of metal

Clearance vs Reduction

Clearance is difference between opposing tooth

Reduction is how much tooth you actually cut off

You may have enough visual clearance but reduction is what matters to success of restoration

Which restoration can pt have nickel sensitivity

PFM with nickel (cause most allergy)

Can have dramatic gingival response

Pt that can’t have costume jewelry

What kind of margin is for periodontally involved cases where gingival health is important

Shoulder beveled

Beveled shoulder only works on what kind of crown?

Metal cermic crown

Do not work on ceramic