Prosthetic III. Fixed dentures Fixed dentures Restore the shape (and function) Cemented on/in the prepared teeth Can not be removed Fixed dentures Inlays /onlays Crowns Bridges Inlay Onlay Overlay Partial crown Crown Korunka Preparation Reconstruction in oral cavity Aesthetic inlays – composite materials, ceramics Special procedure Indirect method always Root canal inlay Root post Stump, snag Crown Root canal filling Root Zinkoxid phosphate cement Lentulo Vaseline Removal of access of the cement Cementation Fixed bridge Replacement one or more teeth Crowns Restore the shape of a damaged tooth Most frequently - Replace the lost part of a tooth (caries, fracture) - Protect before damage - Anchoring of a bridge Indications 1. Badly broken down tooth (previously restored, secondary caries, loss of vitality) 2. Fracture (large) 3. Tooth wear- erosion (chemical) - attrition (mechanical) - abrasion (patological) - diseases of the hard dental tissues 4. Changes in position of teeth Types of crowns Full crowns One material (metal alloy, resin, ceramics) resin and ceramics - jacket crowns Facet crowns Combination of materials Metal alloy –resin Metal alloy – ceramics Partially / full covered The crown The crown The tooth For the crown the tooth must be prepared Basic rules for the crown preparation Reduction of the hard dental tissues – space for the arteficial material (restore the form as well as the function – strong enough) Conical form (5° - 7 ° optimal, max 15°), no undercuts!!!! No sharpe edges!!! Basic rules for the crown preparation Cervical border –must be clear. The location is: - Supragingival - Subgingival (0,5 mm) - Gingival Cervical border Shoulderless – the tooth is simply tapered, Preparation bordes can be seen Cervical border Round shoulder (chamfer) Cervical border Rectangle shoulder Full metal crown Posterior teeth Full metal crowns Preparation is less invasive Aesthetics is bad The price is low Full metal crown Occlusal reduction: 1 mm, following the anatomical form Reduction vestubulary and orally – 0,5 mm (max 1 mm) Round shoulder Preparation is shoulderless Preparation border can be seen Metall alloy - golden alloy, chromcobalt alloy Facet crown Tooth Metal allo Facet made of resin or composit Facet crown Anterior teeth Posterior teeth Facette crown Metal framework Made of golden alloy or chromcobalt alloy Facete made of the resin, composite, (ceramics) Metal framework with retention for the resin Facette of aesthetic materiál usually resin Combined crown – facet crown Metal construction + facet (made of acrylic or composit) Incisal or occlusal reduction 1,5 mm Vestibular reduction 1 - 1,5 mm Oral reduction 0,5 mm Round shoulder (vestib appr. 1 – 1,5 mm, oral 0,5 – 1 mm) Metalceramic crown The crown The tooth The metal alloy Metalceramic Posterior teeth Anterior teeth High aesthetics Good mechanical properties Metalceramic Occlusal (incisal reduction) – 1,5 Vestibular and oral reduction and other 1,5 mm Round shoulder Metal framework is fully covered with ceramic material Metalceramic crown Jacket crown Tooth Resin, ceramics Jackette crown Made completely of aesthetic materiál Resin or ceramics Jacket crown – ceramic, composit, acrylic Occlusal (incisal reduction) – 2 mm Vestibular and oral reduction and other 1,5 mm Sharp rectangle shoulder lenka.roubalikova@tiscali.cz 44 Full ceramic (jackette) crown lroubal@med.muni.cz 48 Cementation of the crown Fixed bridge Replacement one or more teeth Bridges Abutments Pontic Various size: 3 members bridges, 4 members bridges, 5 members… tce The member: abutment or pontic. Bridges Abutments Full metal crown Facet crown Metalceramic crown The axis must be parallel Bridges Pontic Full metal Facet Metalceramic Self cleaning bridge (sanitary bridge) Contact pontic Reduction - the area that is in contact with gingiva 1/3 of the occlusal size. Occlusal reduction depends og the magnitude from 10 – 30% reduction. Preparation Preparation grooves Occlusal reduction Vestibular reduction Oral reduction Proximal reduction Finishing and polishing Manufacturing procedure 1.st phase in dental ofice Taking impression – elastomers Antagonal impression alginate Occlusal impresion – bite registration (intermaxillary relationship) Provisional treatment Impression Elastomeric materials - Dual viscosity technique - in one phase or in two phases Registration of the intermaxillary relationship Wax or Special silicone) Antagonal impression - alginate Manufacturing procedure 1.st phase in dental lab Plaster model– the dental arch is made of ultrahard gypsum, the base of a stone. The model is divided after application of guide pins The antagonal model of stone Mounting to the articulator (simulator) Manufacturing procedure 1.st phase in dental lab The wax patern of the metal framework is manifactured Casted (the method of lost wax) Adapted on the model Manufacturing procedure 2.nd phase in dental ofice The framework is tried out The colour of veneering material is choosen Manufacturing procedure 2.nd phase in dental lab The veneering material is applied on the framework. Manufacturing procedure 3.rd phase in dental ofice The denture is tried out Cemented (zinkoxidphosphate cement, glasionomer or composite) lroubal@med.muni.cz 68 lenka.roubalikova@tiscali.cz 69 lroubalikova@gmail.com 70 71lroubalikova@gmail.com