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Tooth Preparation for full veneer crown

  1. DR. NEHA PATIL
  2. COMPLETE CROWN FULL VENEER CROWN
  3. DEFINITION:  A restoration that covers all the coronal tooth surfaces (mesial, distal, facial, lingual and occlusal)(GPT8). ADVANTAGES: 1. Most effective retention and resistance. 2. Alteration in tooth form and occlusion is possible. DISADVANTAGES 1. Extensive tooth preparation. 2. Margins are close to gingivae and need meticulous maintenance.
  4.  INDICATION 1. Presence of extensive caries 2. Large defective restorations 3. Endodontically treated teeth 4. Fractured tooth  CONTRAINDICATION 1. Poor oral hygiene 2. Young patients where pulp chambers are large.
  5. ALL METAL FULLVENEER CROWN METAL CERAMIC FULL VENEER ALL CERAMIC CROWN
  6. ALL METAL FULL VENEER CROWN PREPARATION  Armamentarium: 1. Airotor handpiece 2. Round end tapered diamond 3. Short thin tapering/needle diamond 4. Chamfer diamond/ torpedo diamond/bur 5. Baseplate wax sheet 2mm thick
  7. Preparation of putty index  Purpose: to have a positive check on the amount and configuration of tooth preparation  Procedure: 1. Half a scoop of base of elastomeric putty impression material is kneaded with its catalyst paste or activator 2. Then it is adapted over the tooth to prepared and even the adjacent tooth 3. Once set, index is removed and it is cut into labial and lingual half with BP blade
  8. Adaptation of putty index Cut putty index along the occlusal/incisal edge Verification of preparation with the use of the index
  9. STEPS FOR ALL METAL FULL VENEER CROWN OCCLUSAL REDUCTION AXIAL REDUCTION PROXIMAL REDUCTION FINISHING BUCCAL SEATING GROOVE
  10. 1.OCCLUSAL REDUCTION  This prepares the occlusal surface  Depth of preparation: 1mm on non-functional cusp and 1.5mm on functional cusp  Rotary instruments used are: round-end tapering diamond
  11. Procedure: 1. The depth cuts of 1mm are first placed on the occlusal grooves following the anatomic contour of the occlusal surface. 2. Depth cuts are then placed on the triangular ridges from cusp tip to the base again following the anatomic contour 3. It should be 1mm on non functional cusp and 1.5mm on functional cusp 4. The remaining tooth structure between the depth cuts is then removed uniformly to complete the occlusal reduction
  12. Depth cuts are placed on the occlusal grooves Depth cuts should follow the anatomic contour of the tooth Depth cuts placed in the triangular ridges Complete occlusal reduction is checked with index
  13. FUNCTIONAL CUSP BEVEL  A wide bevel is then placed on the functional cusp using the round-end tapered diamond.  It is placed on the buccal cusp of the mandibular teeth and palatal cusp of the maxillary teeth.  Bevel at an angle of 45 degree and approximate width of 1.5mm on the functional cusp is given  Round-end tapering diamond is used
  14. CHECKING OCCLUSAL CLEARANCE  This is verified by asking the patient to bite on 2mm thick baseplate wax .  Thin spots in wax indicate inadequate clearance and the thickness is checked with a wax caliper.
  15. Functional cusp bevel at an angle of 45 degree is given Approximate width of 1.5mm Round end tapering diamond is used Checking occlusal clearance with a wax caliper
  16. AXIAL REDUCTION  In axial reduction facial, lingual/palatal surfaces are prepared. DEPTH of preparation: 0.8 – 1mm and 0.3 – 0.5mm cervically ROTARY instrument: Round end tapered diamond
  17. Depth cuts with round-end tapering diamond Depth cut 1mm occlusally and 0.5mm cervically Complete buccal reduction Facial reduction checked with putty index
  18. Depth orientation grooves on lingual surface Completed lingual preparation Completed facial and lingual preparation- occlusal view with putty index Completed axial reduction using round-end tapering diamond
  19. PROXIMAL REDUCTION  Prepares mesial and distal surfaces. DEPTH of preparation: 0.8 – 1mm and 0.3 – 0.5mm cervically. ROTARY instrument: short thin tapering diamond/ needle diamond followed round end tapering diamond.
  20. PROCEDURE:  A matrix band is used to protect the adjacent tooth or  Thin tapering diamond is used in a vertical sawing motion, from facial to lingual surface  Diamond is placed parallel to the long axis of the tooth and a lip of enamel is kept to protect the adjacent tooth.  This portion can be removed with a probe.
  21. Proximal tooth preparation using thin tapering diamond The lip of the enamel can be removed with a probe Completed proximal preparation Facial view Using short thin tapering diamond and round end tapering diamond
  22. FINISHING  The axial surfaces are finished using a torpedo diamond of fine grit or torpedo bur.  Occlusal finishing with a flat end tapering fissure bur.
  23. BUCCAL SITTING GROOVE  It prevents rotation of crown during cementation and acts as a guide during placement.  When opposing walls are exclusively tapered, in tipped teeth and long span fixed partial dentures, additional groove may be placed.  Depth of preparation : 1mm  Rotary instruments : Flat end tapering fissured bur
  24. Sitting groove parallel to the path of insertion. Prepared sitting groove – occlusal view Prepared sitting view- buccal view Using flat end tapering fissured bur
  25. METAL CERAMIC FULL VENEER CROWN PREPARATION  This restoration combines the strength of metal and the aesthetics of ceramics.  It maybe of two types: Metal with complete ceramic coverage Metal with ceramic facing
  26. ANTERIOR METAL WITH CERAMIC FACING CROWN  TOOTH PREPARATION ON MAXILLARY INCISOR  ARMAMENTARIUM: 1. Airotor handpiece 2. Flat-end tapered diamond 3. Round-end tapering diamond 4. No. 2 round bur 5. Small wheel diamond 6. long thin tapering diamond/ needle diamond 7. End cutting diamond 8. Chamfer diamond 9. Flat-end tapering fissure bur 10. Baseplate wax sheet- 1mm thick
  27. INCISAL REDUCTION  DEPTH OF PREPARATION: 2mm  ROTARY INSTRUMENT: flat-end tapering diamond
  28. Depth cuts are placed on incisal edge perpendicular to the direction of mandibular teeth Depth cuts placed at mid-incisal and at junction of each proximal surface Complete incisal reduction Incisal reduction with flat-end tapered diamond
  29. LABIAL REDUCTION  DEPTH OF PREPARATION: 1.2- 1.5 mm  ROTARY INSTRUMENT: flat-end tapering diamond Flat end tapering diamond of 1.2mm diameter is selected to prepare a depth of 1.5mm after finishing .
  30. A metal caliper is used to check the diameter of the diamond Depth orientation groove in 2 planes- first plane following gingival contour of labial surface Depth orientation groove 2nd plane following incisal contour of labial surface Completed depth orientation grooves
  31. Depth orientation groove in two planes prepared with flat end tapered diamond Preparation should follow the gingival contour to avoid the damage of interdental papilla and excessive extension into the gingival crevice The putty index is used to verify adequacy of the preparation Labial reduction using a flat end tapering diamond and subgingival margin should be at least 1.5mm away from the alveolar crest
  32. LINGUAL REDUCTION  This is divided into two parts: 1. LINGUAL AXIAL REDUCTION DEPTH of preparation: 0.3- 0.5mm ROTARY instrument: round end tapering diamond 2. LINGUAL FOSSA REDUCTION Depth of preparation: 0.8-1mm Rotary instrument: no.2 round bur and wheel diamond/football diamond
  33. LINGUALAXIAL REDUCTION  This prepares the cervical portion of the lingual surface.  It should be parallel to the path of insertion and produce a taper of 3-5 degree with cervical portion of the labial surface.  Around end tapering diamond is used to prepare the surface producing a chamfer finished line.  A chamfer finished line is recommended as the lingual surface is covered only by metal.
  34. LINGUAL AXIAL REDUCTION Lingualaxial reduction lingual view Lingual axial reduction occlusal view Lingual axial reduction using a chamfer or round end tapered diamond
  35. LINGUAL FOSSA REDUCTION  Depth cuts like potholes are placed on the lingual fossa with a number 2 round bur with diameter of 1 mm.  The remaining tooth structure is removed with a wheel diamond or a football diamond.  The clearance is checked using baseplate wax of 1mm thickness.
  36. LINGUAL FOSSA REDUCTION Depth cuts placed on lingual fossa with round bur Completed depth cuts of 0.5mm depth Removal of remaining tooth structure with small wheel diamond
  37. Football diamond bur can also be used for lingual reduction Completed facial and lingual reduction checked with putty index Lingual fossa reduction with round bur/ diamond and wheel diamond.
  38. PROXIMAL REDUCTION  DEPTH OF PREPARATION: varies with formation of wing  ROTARY INSTRUMENT: Long thin tapering diamond/ long needle diamond and round end tapering diamond
  39. Thin tapering diamond used to gain access to the proximal surface Round end tapering diamond used to provide a chamfer finish line Finished preparation with wing
  40. Labial axial finishing – flat end tapering fissure Shoulder finishing using end cutting diamond Shoulder finishing – end cutting diamond FINISHING
  41. ADVANTAGES :-  Combines the aesthetics of ceramics and less abrasive metal occlusal surface.  More conservative and less expensive than metal with complete ceramic coverage crown and all ceramic crown. DISADVANTAGES :-  More tooth preparation and more expensive than all metal crown.  Risk of ceramic fracture.
  42. ALL CERAMIC CROWN  Metal free ceramic crown  ARMAMENTARIUM 1. Handpiece 2. flat-end tapered diamond 3. No.6 round bur 4. Small wheel diamond 5. Flat-end tapering fissure bur 6. End cutting diamond 7. Binangle chisel 8. Baseplate wax sheet – 2mm thick.
  43. INCISAL REDUCTION  DEPTH OF PREPARATION: 2mm  ROTARY INSTRUMENT: flat end tapering diamond Depth cuts at mid-incisal and at junction of each proximal surface Complete incisal reduction Incisal reduction with flat-end tapering diamond
  44. LABIAL REDUCTION  DEPTH OF PREPARATION: 1.5mm  ROTARY INSTRUMENT: flat end tapering diamond LINGUAL REDUCTION: 1. LINGUAL AXIAL REDUCTION: Depth of preparation: 1.5mm Rotary instrument: flat end tapering diamond 2. LINGUAL FOSSA REDUCTION Depth of preparation: 1.5mm Rotary instrument: no. 6 round bur and wheel diamond/football diamond
  45. FINISHING The shoulder is finished with an end cutting diamond Completed preparation facial view Completed preparation incisal view Completed preparation using heavy chamfer
  46. REFERENCE  Textbook of PROSTHODONTICS:V RANGARAJAN.
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