Indirect.txt

• • DIMENSIONAL ACCURACY
• • LONG TERM STABILITY
• • STRENGTH AND TOUGHNESS
• • FAST SETTING
• • SOME FLEXIBILITY
• • MUST NOT EXERT ANY INFLUENCE ON JAW POSITIONING
• • TEETH NOT PREPARED SHOULD BE IN CENTRIC OCCLUSION (ICP) WHENEVER POSSIBLE

• Soft at room temp
• Tenax, sheet wax, plaster, acrylic, silicon rubber, aluwax, An oxide eugenol, dead soft metal
• Filled PVS (polyviylsiloxane)

• No, trim to just cusp tips
• Remove axial and deep occlusal Vs

Wait til after in order to avoid errors of thickness (pooling)

• Approximate rotation center of the head of the condyle
• CLOSED BITE mounting in ICP, OK
• If the mounting is open bite use different technique to locate true terminal hinge or condylar rotation center?

• Set semi/fully adjustable articulators to approximate ange of CONDYLAR EMINENCE
• More accurate CUSP INCLINES for jaw movements of protrusion and lateral border positions

Eminence curve (bone contour and ligaments and muscles

ADDITION SILICON: Higher viscosity heavy body elastomerics

• 1-2 single crowns
• Pt w/ stable bilateral occlusion, w/ at least 1 vertical stop on preparation side
• Contra: multiple, FPD, abutments, unstable, changes in VDO, can’t close mouth with tray

• Prep, adj teeth and opposing in 1 impression
• Bite registration in impression
• Economic & efficient

45, smooth improved flow with less air entrapment

• Entered
• Margins 6-8mm from closed end
• Margins 2-4mm from open(top) end
• Sprue length 4-6mm

• 26ml / 75g
• Hand mix 15, vacuum 30 at 27psi
• Set 1 hour

1200 F

• REDUCING
• Ox, red, combustion, mixing

• Remove investment and dissolves surface oxides leaving higher noble content to surface metal
• Use rubber or plastic to remove from prevox

1.5%

• Gold shrinks 1.5%
• Die stone: expands when setting
• Investment: expands-> compressing ring liner, expands in oven
• Investment: setting & thermal expansion
• Net result, good fit

• Resists corrosion
• Tensile strength-> durable thin margins
• CTE = tooth
• Wear rates on restoration and opposing teeth similar to enamel
• High density & low oxide make predictable

Typically no, patient can evaluate better

• Backhaus towl clamp
• GC pliers
• Engage buccal/lingual and rotate

Angle of beam

Paraffin CnH(2n+2)

• Beeswax: pliability
• Carnuba: hardness, shine
• Candelilla: hardness, no m.p.
• Ceresin: reduce brittleness, increase hardness
• Gum dammar and Rosin: increase brittleness

• Pattern:inlay, casting, baseplate
• Processing: boxing, utility, stick
• Impression: low MP, Iowa wax, bite registration (Aluwax)

• Temperature
• Viscoelastic, modulus, proportional limit, strength, ductility

• Low thermal conductivity
• High heat capacity-> long working time
• High CTE
• Melting range dependent on composition

• Coefficient of thermal expansion
• = d(L)/L(0) * d(Temp)

Paraffin, beeswax, hard wax, carnauba

• Elastic deformation slope of linear stress(y) strain (x) curve
• TEMP DEPENDENT

• Uniform heat
• Immediate investing
• Store at low temp

Weight(wax) * 16.2

Gold shrinkage

• Heat resistant, SiO2 polymorphs
• Quartz, Tridymite, Cristobalite

• Refractory: heat resistant (SiO2)
• Binder: gypsum, phosphate, SiO2
• Modifiers: NaCl(regulate expansion), C, Cu reducing

• CaSO4 hemihydrate-> dehydrate & heat
• Ultimate Setting expansion(after initial contraction) due to multidirectional crystal growth
• Heat causes thermal expansion of wax

Increased expansion when investing setting under water -> uninterrupted crystal growth

• Breaks up crystal nuclei-> more growth, interation, setting expansion
• Decreases setting time

• Faster setting time
• Inc thermal expansion

• Increase setting time
• Decrease setting expansion, strength

Softening, viscosity reducing by rapid shear stress (vibrate)

• I: inlay, thermal
• II: inlay, hygroscoic
• III: partial denture, thermal-> less expansion, higher compressive strength

• Decomposition in presence of carbon
• Embrittle metal castings

• Phosphate-bonded: higher melting alloys (PFM), stronger than gypsum, harder to work with
• silica-bonded: flammable, expensive

Increase setting expansion and investment hardness

Reduced lung function from chronic SiO2 exposure, could be carcinogenic

• Hard: more heat, distortion (high when cooling, low when cooled), subject to fracture, easier to smooth and polish
• Soft: withdraw past small undercuts without fracture/distortion

Safety to patient, prevent damage to remaining tooth, pulp, periodontium

• Richwil: adhesion
• Posterior: Centric
• Anterior: protrusion

• No leave 2mm to prevent aspiration
• Then use T-bar

Intraoral crown fit checking

• Gold: 7404-012
• Porcelain: diamond stone

• I: single, dowel, FPD
• Plus(Resin enforced): single
• Not for ceramics

• 1. Medium garnet (enamel only)
• 2. Fine Sand
• 3. Fine Cuttle
• 4. Brownie points (grooves)
• 5. Pumice: rubber cup
• 6. Greenie points (grooves)
• 7. 15mu Al2O3
• 8. Super greenie
• 9. 1mu AlO2

• H34-010
• 330

• .7mm minimum
• 1.0 Ideal
• 2.0 Maximum

• Porcelain butt joint
• Metal collar
• “disappearing margin

1.0mm

40x

Thin porcelain or overcontour in final crown

5 mins from start of mix

• Bulk: strength
• Proximals: greater extension for finishing
• Internal angles: rounded
• Divergence: greater
• Bonded

Yes

• Easier to contour
• More durable
• More conservative than PFM

• Heavy occlusal forces (fracture)
• Cannot isolate (dry for adhesion)
• Deep subgingival: poor bonding to cementum and hard to impress/finish
• Uncontrolled caries

• Gold: 1-2mm occ clearance, sharp internal angeles, beveled shoulders in box and functional cusp, 6-10 occlusal divergence, minimal proximal, luted
• Ceramic: 2mm, rounded internal, 90 degree finish lines, 12-15 degree divergence, greater proximal, bonded

• Dam, remove caries/old rest, block out w ionomer
• Occlusal, boxes, covered cusps, margins

• Non-toxic
• Insoluble
• Good mechanics (compressive)
• Protective (thermal, electrical, chemical
• Adhere to tooth and restoration
• Bacteriostatic
• Obtundent to pulp

• More viscous
• Faster setting
• High strength
• Low solubility, acidity

• P/L ratio
• Rate of powder incorporation
• Mixing temp
• Spatulation
• Water contamination

• Zinc-oxide(powder)
• Eugenol(liquid)
• ->zinc eugenolate
• Some liner applications

• Bland and obtundent on pulp
• Mild irritant to CT

• Good for pulp, temporary seal
• Disadvantages:
• Low strength, abrasion resistance, anticariogenic action
• Soluble in oral fluids

• Natural/synthetic resins or AlO3
• Increases compressive strength, marginal use for permanent retention
• Can be used for temporary fillings

• Liquid is aromatic oil and organic acid NOT eugenol
• Used for temps where resin or resin ionomer luting will be used for permanent

• Glass ionomer
• Powder: aluminosilicate glass
• Acid: polyacylic(vs phosphoric)

• Zinc oxide & phosphoric acid
• Initial pulpal irritation from acidity, osmotic effects
• May permit marginal leakage

• easy handling
• durable
• moderate strength
• low film thickness
• DIADVANTAGES:
• Pulp irritation, poor adhesion to tooth, not anticariogenic, brittle, soluble long term

• Powder: Zn oxide
• Acid: polyacrylic
• Uses: luting temps, interim luting on sensitive teeth, luting restorations, base
• Decreased use for permanent and base

• Powder: Ca-F-Al-Si-ate glass
• Liquid:50% aqueous polyacrylic-itaconic acid
• ⇒ Calcium Aluminoacrylate gel
• High compressive strength for lining, luting, base
• Bonding: good w/clean enamel, dentin and stainless steel
• Good for luting metal, PFM, decreasing use as liner, base, restorative

• Adv:
• High strength, low solubility than ZnPO4
• Minimal pulpal rxn(technique dependent)
• Adhesion
• Fluoride release
• Disadvantages:
• Technique, proportion sensitive
• Moisture contamination

• similar to restoratives but less filler and LOW viscosity
• BisGMA or UDMA diluted
• Setting rxn: addition polymerization
• Curing: chemical, light, dual
• Applications: bonding ceramic or resin resorations, luting metal or PFM
• Types: adhesive (MDP phosphates, 4-Meta)or non-adhesive

• Sensitivity: polymer contraction, marginal leakage
• Pulp protection

• Adv: high strength, low solubility
• Disadv: moisture contamination, thick film, difficult handling, pulp irritation, high wear on occlusal margins

Resin Ionomer Luting cements

• Powder: F-Al-Si-ate glass, chemical or light initiator
• Liquid: polyacrylic acid with pendent methacrylate groups

• High compressive strength
• Lower solubility than GI
• F-release
• Inherently adhesive
• Disadvantages: rapid set, excess difficult, cause fracture

Pulpal floor and axial wall

• DO,MO,O inlays (15)
• FGC (15.5)
• 7/8, 2/4, MOD onlays (18)
• MOD inlays (18.5)

Allows ideal preparation, keeping internal conservative

• External Tucker 233 GMT
• Internal Tru-bal 232 GMT

• * Incisal Reduction-2 mm
• * Lingual Clearance-1.0-1.5 mm
• * Facial Reduction
• * Shoulder-1.0-1.2 mm wide
• * Axial-1.5 mm
• * Finish Lines
• * Facial-shoulder
• * Lingual-chamfer
• * Proximal-shoulder-beveled shoulder-chamfer

• • Minimum Clinical Experiences (all prescriptive procedures
• • 30 Direct, 4 sealants)
• • Skills Assessment Evaluations (need 3.0 average on each)
• • Student Teaching Experiences (2nd year/4th year operative and crown)
• • RVU’s totaling 1200 points

• A. Glass ceramic
• B. Etched intaglio surface
• C. Silane primer
• D. Unfilled resin
• E. Filled resin cement
• F. Bonding resin
• G. Etched enamel
• H. Hybrid layer

• Enamel: etch 30-60 secs, micromechanical, more stable
• Dentin: smear layer removal etch 10-15 secs, keep wet, primer, hybrid layer, less constistent, stable

• Self: ONLY sealed areas, less post-op sensitivity, faster, weaker
• Total: may penetrate non-sealed->post-op sensitivity, stronger, longer time

• • Auto cure
• • Appropriate for metal and opaque ceramic restorations
• • Dual cure
• • Allows accelerated clean up for posterior or full coverage ceramic restorations where light penetration is limited
• • Light cure
• • More color stable for thin translucent anterior porcelain veneers

• • Essentially low viscosity composite materials with similar properties to composite:
• • Good strength
• • Resistance to wear better than acid/base cements
• • Low solubility
• • Tooth colored
• • Can optically connect tooth & overlying ceramic
• • Compatible with enamel and dentin bonding techniques

• • Clean up can be very difficult
• • Can bond to unprotected adjacent tooth surface
• • Inhibition of set by oxygen means that proximal cement will set before cement on more accessible surfaces
• • Tooth color and adhesion make removal from root surfaces difficult
• • Contribution to periodontal disease
• • Post operative sensitivity from aggressive removal

Felspathic porcelain(60-120 secs, 7-10%), leucite reinforced glass ceramic, LiSiO4 (20 secs 4-5%)