Index

DIAGNOSIS AND TREATMENT PLANNING

I. CHIEF COMPLAINTS

Comfort
Appearance

II. HISTORY

Medical History
Drug History
Dental History

III. EXAMINATION

a. General Examination
b. Temporomandibular Joint Examination
c. Extraoral Examination
d. Intraoral Examination
- Periodontal Examination
- Examination of Teeth
e. Occlusal Examination
f. Abutment Tooth Evaluation
- Evaluation of Abutment Teeth

IV. DIAGNOSTIC CASTS

V. RADIOGRAPHIC EXAMINATION

Periapical Radiographs
Bitewings
Panoramic Films

DESIGN AND MATERIAL CHOICE

Choice of Restoration
2. List the ideal requirements of an abutment tooth and describe the steps taken to maintain biological integrity while preparing teeth for Fixed Partial Denture.

FACTORS TO BE CONSIDERED IN ABUTMENT SELECTION

Crown-root Ratio
Root Configuration
- Root Shape and Angulation
Periodontal Surface Area
- Root Surface Area
- Bone Support
The Length of the Pontic Span
Forces
Oral Hygiene

A. BIOLOGIC CONSIDERATIONS

1. Prevention of Damage during Tooth Preparation to
2. Conservation of Tooth Structure
- Failures due to Improper Preparation of Tooth
3. Margin Placement
- Supragingival Margins
- Subgingival Margins
4. Finish Lines
- Types
5. Occlusal Considerations

B. MECHANICAL CONSIDERATIONS

1. Providing Retention Form
- Factors affecting Retention
2. Providing Resistance Form
3. Preventing Deformation of the Restoration

C. AESTHETIC CONSIDERATIONS

Partial-coverage Restorations
- Proximal Margin
- Facial Margin
Metal-ceramic Restorations
- Facial Tooth Reduction
- Labial Margin Placement
3. Describe various methods used for gingival retraction and add a note on the advantages of fluid control and tissue displacement.
Definition

ADVANTAGES OF FLUID CONTROL AND TISSUE MANAGEMENT

ADVANTAGES OF GINGIVAL RETRACTION

1. MECHANICAL METHODS

a. Rubber Dam
b. Cotton Rolls
c. High Vacuum
d. Saliva Ejector
e. Svedopter/Speejector
f. Vac-ejector
g. Moisture Absorbing Cords
h. Oversized Copper Bands

2. CHEMICAL METHODS

3. MECHANICAL-CHEMICAL METHODS

Method of Gingival Retraction
- Double Cord Technique

4. SURGICAL TISSUE DILATION

Electrosurgery/Surgical Diathermy
- Types of Electrode
- Types of Current
Rotary Curettage/Gingettage
4. Describe the methods used to classify fixed bridges. Add a note on types of retainers used in Fixed Partial Dentures.

CLASSIFICATIONS OF FIXED BRIDGES

1. Classification depending on Edentulous Spaces
2. Classification based on Type of Connector
3. Classification based on Type of Abutments
4. Classification based on Materials Used
5. Classification based on Temporary and Permanent Nature of Bridges
- Temporary
- Permanent
6. Classification based on Span Length

TYPES OF RETAINERS

A. Complete Crowns
- 1. All Metal Fixed Partial Dentures
- 2. All Ceramic Fixed Partial Dentures
Types of Ceramics
B. Partial Crowns
- Posterior Tooth
- Anterior Tooth
5. Define and classify retainers. List the advantages and disadvantages of partial veneer crown over other types of retainers. What are the factors that come into play in the selection of retainers?

CLASSIFICATION OF RETAINERS FOR FIXED PARTIAL DENTURE

Class I—Extracoronal Restorations
- A. Complete Crowns
- B. Partial Veneer Crowns
Class II—Intracoronal Restorations
Class III—Radicular Retainers

TYPES OF PARTIAL VENEER

Three-quarter Crowns
Advantages
Reverse Three-quarter Crown
Seven-eighths Partial Veneer Crown
Mesial Half Crown

SELECTION OF TYPES OF RETAINERS

Ideal Retainers
6. Define retention and resistance form in fixed partial denture. What are the factors affecting retention and resistance in posterior tooth preparation?

DEFINITIONS

Retention
Resistance

FACTORS AFFECTING RETENTION

1. Magnitude of the dislodging forces
2. Geometry of the tooth preparation
3. Roughness of the Surfaces
4. Materials being Cemented
5. Type of Luting Agent

FACTORS AFFECTING RESISTANCE FORM

1. Magnitude and Direction of the Dislodging Forces
2. Geometry of the Tooth Preparation
3. Physical Properties of the Luting Agent
- a. Compressive Strength
- b. Modulus of Elasticity
7. Classify finish lines. Enumerate the functions, indications, advantages and disadvantages of finish lines. Add a note on selection of type of finish line to be used.
Definition

CLASSIFICATION OF GINGIVAL FINISH LINES

Basic Types
Variations

FUNCTIONS OF FINISH LINES

Ideal Finish Line

FEATHEREDGE/CHISELEDGE FINISH LINE (FIGS 4 AND 5)

Definition

CHAMFER FINISH LINE (FIG. 6)

Definition
Variations

SHOULDER FINISH LINE (FIG. 7)

Definition
Variations

PRINCIPLES IN DETERMINING TYPE OF FINISH LINES

a. Type of restorative materials
b. Location of Finish Lines
- Supragingival
c. Configuration
d. Marginal Fit
8. Illustrate with diagrams, the tooth preparation on right upper central incisor for receiving porcelain jacket crown. Add a note on the advantages, indications and contraindications of all-porcelain jacket crown.
1. Placing of Depth Orientation Grooves (Fig. 9)
2. Incisal reduction (Fig. 10)
3. Facial Reduction
4. Lingual reduction (Fig. 13)
5. Axial Reduction
6. Lingual Axial Reduction (Fig. 14)
7. Marginal Development and Refinement
- Variation in Margin Preparation

ALL-CERAMIC CROWNS

9. Define a crown and mention the advantages, disadvantages and indications of a full metal crown. Describe in detail, with diagrams, the step-by-step procedure in the preparation of a full metal crown on a mandibular first molar.
Definition

FULL METAL CROWNS

PREPARATION OF A FULL METAL CROWN ON A MANDIBULAR FIRST MOLAR

Steps in Full Metal Crown Preparation
- a. Placement of Occlusal Guiding Grooves
b. Occlusal Reduction (Fig. 15)
10. Describe in detail, with diagrams, the step-by-step preparation of a maxillary canine to receive a three quarter crown. Explain and justify different impression techniques for fixed partial denture.
Definition

PREPARATION STEPS OF PARTIAL VENEER CROWNS

1. Incisal Reduction
2. Lingual Reduction (Fig. 20)
3. Interproximal Reduction (Fig. 21)
4. Proximal Grooves (Fig. 22)
5. Incisal Groove (Fig. 23)
6. Facial Bevel (Fig. 23)
7. Finishing the Preparation
8. Cingulum Modification if needed for Additional Retention

DIFFERENT IMPRESSION TECHNIQUES

1. Stock Tray/Putty Wash
- Single Mix Technique
- Double Mix Technique (PVS PS CS)
2. Custom Tray: PVS PE PS, CS
Technique
- Fabrication of Tray
- Making Final Impression
3. Closed Bite Double Arch Method
- Minimum conditions
- Procedure
4. Copper Band
11. Name the component parts of a bridge. Define and classify pontics. Add a note on selection of pontic design in anterior and posterior teeth. What are the requirements of a pontic?

PARTS OF A BRIDGE

DEFINITION OF PONTIC

CLASSIFICATION OF PONTICS

1. According to the shape of the surface contacting the ridge
2. According to the material used in construction of pontic
3. According to the type of fabrication
4. According to mucosal-contacting or nonmucosal-contacting

REQUIREMENTS OF A PONTIC

PONTIC DESIGN

Saddle/Ridge Lap Design (Fig. 24)
Definition
Modified Ridge Lap (Fig. 25)
Hygienic Pontic (Fig. 26)
Modified Sanitary Pontic (Fig. 27)
Spheroidal/Egg-shaped/Bullet-shaped Pontic
Modified Spheroidal Pontic (Fig. 28)
Conical Pontic (Fig. 29)
Ovate Pontic (Fig. 30)
Prefabricated Pontics

PONTIC SELECTION

Factors Determining Pontic Selection
12. What are the biological, mechanical and aesthetic considerations in designing a pontic? Add a note on fabrication of pontics.

PONTIC DESIGN

Prerequisites

BIOLOGIC CONSIDERATIONS

Factors affecting Biologic Considerations

MECHANICAL CONSIDERATIONS

Factors influencing Mechanical Aspects

AESTHETIC CONSIDERATIONS

Factors affecting Aesthetics

PONTIC FABRICATION

1. Metal-ceramic Pontics
2. Resin-Veneered Pontics
3. All-metal Pontics
4. Unidirectional Reinforced Composite
13. Describe different types of provisional restorations. Describe various techniques used for making provisional restoration for anterior and posterior tooth preparation.

TYPES OF PROVISIONAL RESTORATIONS

a. Cast Metal Treatment Restorations
b. Aluminum Shell Crowns (Aluminum and tin-silver)
c. Preformed Metal Crowns
d. Cellulose Acetate Crown Forms
e. Prefabricated Polycarbonate Crowns
f. Heat-Polymerised Resins

TECHNIQUES IN FABRICATION OF PROVISIONAL RESTORATIONS

1. Autopolymerizing Resin-alginate Impression Technique
- Direct Technique
2. Vacuum-formed Plastic Template Technique
3. Post-crown Technique
- Indirect-Direct Procedure
14. Describe various luting agents used in crown and bridge cementing. Explain the procedure and care to be taken to lute porcelain jacket crowns.

VARIOUS LUTING AGENTS

a. Zinc Phosphate Cement
b. Zinc Polycarboxylate Cement
c. Glass Ionomer Cement
- To reduce belated Sensitivity
d. Zinc Oxide-eugenol with and without EBA (Ortho ethoxybenzoic Acid)
- Zinc Oxide-Eugenol
- EBA Cement
e. Silico-phosphate Cement
f. Unfilled Resins
Other Cements

PROCEDURE TO LUTE PORCELAIN JACKET CROWNS

15. Classify adhesive bridges/resin bonded bridges. Cite the advantages, disadvantages, indications, contraindications and preparation steps. Add a note on types of bonding to metal and tooth.

DEFINITION

CLASSIFICATION

Advantages
Disadvantages
Indications
Contraindications
a. Rochette Bridge (1973) (Fig. 35)
b. Maryland Bridge (Fig. 36)
c. Virginia Bridges
d. Cast Mesh Fixed Partial Denture (Fig. 37)

STEPS IN THE FABRICATION/PREPARATION OF A RESIN BONDED FIXED PARTIAL DENTURE

Preparation of Abutment Teeth

TYPES OF BONDING TO PROVIDE RETENTION

A. Mechanical Bonding
- 1. Macroscopic Retention
- 2. Microscopic Retention
B. Chemical Bonding
16. What are the requirements of dies? Describe materials used in preparation of dies and different techniques used for preparing dies?

REQUIREMENTS OF DIES

MATERIALS USED IN DIE PREPARATION

1. Gypsum
2. Epoxy Resin
3. Electroplated die

METHODS OF DIE PREPARATION

1. Working Cast with Separate Die
2. Divestment Technique
3. Working Cast with a Removable Dies
17. Classify ceramics. Enumerate its advantages and disadvantages. Explain the mechanism of bonding and describe the laboratory steps involved in fabrication of different ceramics.

CLASSIFICATION

1. Depending on Use
2. Depending on Fusion Temperature
3. Based on Application
- Core Porcelain
- Dentine or Body Porcelain
4. All Ceramic Restorations
- Types

ADVANTAGES

DISADVANTAGES

ENAMEL-METAL BOND

1. Mechanical Bond
2. Compressive Stresses
3. Chemical Bond

FABRICATION OF A CERAMIC RESTORATION

a. Condensation
- Dense condensation provides
b. Firing
c. Glazing
- Application of over glaze/self glaze
d. Cooling

OTHER TYPES OF PORCELAIN FABRICATIONS

a. Cast Coping
b. Bonded Platinum Foil Coping
c. Swaged Gold Alloy Foil Coping

ALL CERAMIC MATERIALS

1. Conventional powder-slurry ceramics
- Duceram LFC
2. Castable Ceramic Systems
- a. Picon
- b. Dicor Plus
3. Machinable ceramics
4. Pressable ceramics
- IPS Empress
- Optec Pressable Ceramic
5. Infiltrated ceramics
- In-Ceram

RECENT ADVANCES IN METAL-CERAMICS

18. What are the types of veneering materials? Describe their advantages, disadvantages and indications. Add a note on the recent advances in veneering materials used in fixed partial denture.

TYPES OF VENEERING MATERIALS

COMPARISON OF VENEER SYSTEMS

Direct Composite Veneers
Indirect Resin Veneers
Porcelain Veneers

PORCELAIN LAMINATES

Resin Veneer Direct Technique
Resin Veneer Indirect Technique
Indirect Composite Veneers

RECENT ADVANCES IN VENEERING MATERIALS

Reinforced Composites

Chapter Notes