Prosthetics II. Fixed dentures Inlay, root canal inlay Fixed dentures ØCemented (fixed) on/in pilots, abutment •teeth. Ø ØInlays (inlays, onlays, overlays, partial •crowns). ØCrowns ØBridges • lenka.roubalikova@tiscali.cz 3 Inlays • • •Composit, cermic • •Metal nekovovainlay hotoveinlkov1 hotovrinkov2 voskmodel lenka.roubalikova@tiscali.cz 5 Fixed dentures * Cemented on the teeth – crowns, bridges, inlays • * > Fixed bridge maxcem1 lenka.roubalikova@tiscali.cz 6 Fixed dentures * Material – metal alloy, ceramics lenka.roubalikova@tiscali.cz 7 Removable dentures * Partial * Complete (full) lenka.roubalikova@tiscali.cz 8 Procedures ØIn dental surgery ØIn dental laboratory ØSpecial instruments ØBasic (main) materials •(metal alloys, ceramics,polymers) ØAuxilliary (accessory) materials •(impression, carving, die, insulating •investing, grinding, polishing) lenka.roubalikova@tiscali.cz 9 Manufacturing of dentures •Model of gypsum (plaster) – model of a •denture (wax pattern). • •Model of a denture (wax pattern) directly in •the mouth – rarely. • •Denture is formed without a wax pattern in •the dental lab. • • lenka.roubalikova@tiscali.cz 10 Manufacturing of dentures •Model of gypsum (plaster) – model of a •denture (wax pattern). • • • lenka.roubalikova@tiscali.cz 11 Impressions of the jaw - negativ •The impression is filled with a casting •material (gypsum) – poured into • • •Model •(various purpose) • • lenka.roubalikova@tiscali.cz 12 Models ØWorking model – the denture is produced on • this model (special procedures) Ø ØOpposing model (antagonal) - necessary for • the recognition of intermaxillary relationship Ø ØBite regitration - wax Ø lenka.roubalikova@tiscali.cz 13 Manufactoring of dentures • ØThe denture (not the denture itself but the model of the denture) is produced on the working model. ØThe model of the denture is made of the carving wax. ØThe wax is replaced by the main (base) material. lenka.roubalikova@tiscali.cz 14 Fabrication of dentures • •The model (wax) of the denture is invested • •The wax is removed from the form and the base •material is placed into the form. • •Wax removal: •The wax is burned out (for metal alloys) •or removed by hot water (for polymers) • • lenka.roubalikova@tiscali.cz 15 * * * Impression material Tooth Impression lenka.roubalikova@tiscali.cz 16 * Gypsum Impression lenka.roubalikova@tiscali.cz 17 * Plaster lenka.roubalikova@tiscali.cz 18 * The model (wax pattern) lenka.roubalikova@tiscali.cz 19 * The model (wax pattern) The investing material lenka.roubalikova@tiscali.cz 20 * The form The melted alloy The investing material lenka.roubalikova@tiscali.cz 21 * The crown The melted alloy The investing material lenka.roubalikova@tiscali.cz 22 * The metal crown Plaster lenka.roubalikova@tiscali.cz 23 Manufacturing of dentures • • •The method described above = indirect •method lenka.roubalikova@tiscali.cz 24 Manufacturing of dentures • • • •Direct method lenka.roubalikova@tiscali.cz 25 Manufacturing of dentures • •Direct method • •No impression •The model of the denture is made directly in •the mouth •For inlays only • Inlays * Rigid fillings * * Manufactured in a dental lab * * Direct or indirect method -Direct method rarely -Indirect method most common * * Inlay * Crown inlay •- a part of a clinical crown is replaced * * * Root canal inlay •- The inlay is cemented into the root canal and replaces a crown (abutment tooth – stump, snag) * Crown inlay •Material ØComposit ØCeramics ØMetal Alloys inlayreciproke kotveni halasovasendvic Angle of convergence Ø0° - maximum Ø6° - very good Ø15°- acceptable Ø20° - insuficient Ø •Optimum 6° - 15°. Crown inlays • •Indikations • • lA big lost of dental tissues lBig interdental spaces lNext to the crowns and bridges made of metal alloy Crown inlays •Contra - indication • 1.Too small - shallow (flat) cavities 2.High caries risk 3.Frontal area (metallic) Inlay • • • inlaysadra inlayschema Onlay • onlaysadra onlayschema Overlay overlaysadra overlayschema Partial crown • schudkkorsadra schudkkorunkaschema Crown • • •Korunka • • korunka korunkaschema Retention of rigid fillings •Whitstand capability against axial forces: • •Geometry of the preparation (facilitating shape) •Quality of the luting material • retence01 retence02 retence2 retence3 Outer or inner conus Angle of the convergence Rau G. 1994 Retaining areal * Surface of contact • •Rigid filling •Inlay or crown (internal, outer, combined) inlaysadra korunka overlaysadra Stability of rigid fillings •Whitstand capability against horizontal •forces • •Angle of convergence •Axial length contact surface racek helgoland1 Basic rules of cavity preparation ØBox Ø Ø No undercuts • Ø Light divergence of the walls (facilitating shape) 1tridaschema Box Undercuts Simple box Facilitating form Inlay of metal alloy * Direct method * * * Indirect method Inlay of metal alloy ØDirect method Ø Ø * * • Direct modellation in the mouth Special wax – casting wax, (special polymers) Sprue pin Investment Method of the lost wax Inlay of metal alloy •Direct method Ø • ØCentral cavities (class I., classs V.) Ø ØRoot canal inlays Ø Ø * * • Inlay of metal alloy •Indirect method Ø •Taking of the impression •Model •Modellation of the casting wax, •(special polymers) •Sprue pin •Investment •Method of the lost wax • • * • otiskovani1 otiskovani2 otisk otisksilofl speedex medium kavita na modelu lakovanipahylu cementspacer voskmodel hotoveinlkov1 hotovrinkov2 voskmodel preparzub5 preparzub6 Dokončená preparace Nasazená rekonstrukce cementstet cementpritlac cementvasel skusdrevo cementdentnit Aesthetic inlays – composite materials, ceramics nekovovainlay Special procedure Indirect method always inl4 * DSC_0323 IMG_1788 onlay1 * DSC_0239 DSC_0238 maryland v ustech Root canal inlay Root post Core Crown Root canal filling Root rootcanalinlay01 Root canal inlay •Indication : •Restoration for teeth with lost crown •(cca 2/3 of the crown) •It is anchored in the root canal •(the tooth must be endodontically treated) •The coronal part is formed as a stump for the crown •It enables to treat this teeth with crown • Contraindication * Teeth that cannot be treated endodontically * Decay of the root or coronal part of the crown * Less than 1mm hard dental tissues supragingivally * Destruction of root canal walls circulary Root canal inlay - preparation * Removal of the root canal filling (2/3), 4 mm of the root canal filling must be left. * The third rule * * 0614203717_1 0614203717_5 0614203717_7 Gates, Peeso – Largo, Beutelrock – these burs has „flame form“ * 1/3 1/3 1/3 1- 2mm rootcanalinlay03 rootcanalinlay2 4mm at least 2/3 of the root canal length 1/4 of the total length rootcanalinlay04 Preparation rootcanalinlay05 Isolation Modellation – casting wax, heated, flowing Sprue pin with reservoir Sprue cone Investment Lost wax method (burntout in the special oven) rootcanalinlay06 Direct method Impression Model Modellation – casting wax, heated, flowing Sprue pin Investment Lost wax method (burntout in the special oven) Indirect method rotcanalinlay07 Impression Indirect method rotcanalinlay07 rootcaanalinlay08 rootcaanaal09 Impression material Impression tray Wire rootcanalinlay12 rootcanalinlay11 rootcanal13 Model Insulation Modellation Impression Model Modellation – casting wax, heated, flowing Sprue pin Investment Method of the lost wax (burntout in the special oven) Indirect method rotcanalinlay07 lenka.roubalikova@tiscali.cz 71 * * * Impression material Tooth Impression lenka.roubalikova@tiscali.cz 72 Plaster Model lenka.roubalikova@tiscali.cz 73 * The model (wax pattern) The investing material lenka.roubalikova@tiscali.cz 74 * The form The melted alloy The investing material lenka.roubalikova@tiscali.cz 75 * The model (wax pattern) The investing material lenka.roubalikova@tiscali.cz 76 * The model (wax pattern) The investing material lenka.roubalikova@tiscali.cz 77 * lenka.roubalikova@tiscali.cz 78 * Final product * Zinkoxid phosphate cement * Lentulo * Vaseline * Removal of access of the cement DSC_0121 Cementation