DOCSLIB.ORG

Chapter 24), Although the Color of the Ceramic Core Is Important Part of Contemporary Dental Practice

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Chapter 24), Although the Color of the Ceramic Core Is Important Part of Contemporary Dental Practice C H A P T E R 2 5 All-Ceramic Restorations Isabelle L. Denry, Contributing Author All-ceramic inlays, onlays, veneers, and crowns can be reduced the amount of porosity and therefore resulted in some of the most esthetically pleasing restorations cur- restorations that were denser, stronger, and more trans- rently available. They can be made to match natural lucent than could be achieved with air firing.7 tooth structure accurately in terms of color, surface texture, and translucency. Well-made all-ceramic restora- tions can be virtually indistinguishable from unrerestored HIGH-STRENGTH CERAMICS natural teeth (Fig. 25-1). Traditionally, ceramic crowns have been made on a The chief disadvantage of the early restorations was their platinum matrix and were referred to as porcelain jacket low strength, which limited their use to low-stress situa- crowns. More recently, improved materials and techniques tions, such as those encountered by anterior teeth. Thus have been introduced in an attempt to overcome disad- fracture was a fairly common occurrence, which prompted vantages inherent in that traditional method. These the development of higher strength materials.8,9 These improvements, particularly the use of higher strength developments have followed two paths. One approach is ceramics and adhesives for bonding the ceramic restora- to use two ceramic materials to fabricate the restoration. tion to tooth structure, have led to a resurgence of A high-strength but nonesthetic ceramic core material is interest in all-ceramic restorations, including the more veneered with a lower strength, esthetic porcelain. This conservative inlays and veneers (Fig. 25-2). With increas- approach is similar to the metal-ceramic technique (see ing esthetics demand, all-ceramic restorations are an Chapter 24), although the color of the ceramic core is important part of contemporary dental practice. more easily masked than that of a metal substructure. In this chapter, the historical background of all- The other approach is the development of a ceramic that ceramic restorations and more recent developments is combines good esthetics with high strength. This has the reviewed. The laboratory procedures necessary for the obvious attraction of not needing the additional thickness fabrication of all-ceramic inlays, veneers, and crowns are of material to mask a high-strength core. reviewed, and the alternatives are compared. Monolithic zirconia restorations10,11 provide a good The importance of the design of the tooth preparation compromise of outstanding strength and esthetics that to the success of ceramic restorations cannot be overem- are acceptable for posterior restorations. The restora- phasized (see Chapter 11). tions are generally colored by dipping of the presintered material in special colorants,12 although the process has drawbacks, including nonuniformity of the coloring13 and HISTORICAL BACKGROUND color change after adjustment.14 Because of their high strength, less tooth reduction is needed than for other The first attempt to use ceramics for making denture all-ceramic or metal-ceramic systems.15 Wear of oppos- teeth was made by Alexis Duchateau in 1774. More than ing enamel appears to be less with monolithic zirconia a hundred years later, C. H. Land made the first ceramic than other dental ceramics,16 although the restoration crowns and inlays with a platinum foil matrix technique must be carefully polished because a rough surface will in a gas-powered furnace and was granted a patent in lead to increased wear of the opposing tooth.17 1887.1 As this method was fraught with a number of risks, it did not become popular until electric furnaces were introduced a number of years later.2 The popularity of STRENGTHENING MECHANISMS ceramic restorations declined with the introduction of OF DENTAL CERAMICS acrylic resin in the 1940s and continued to be low until the disadvantages of resin veneering materials (increased In spite of their excellent esthetic qualities and outstand- wear, high permeability leading to discoloration and ing biocompatibility, dental ceramics, like all ceramic leakage) were realized.3-5 In 1962, Weinstein and materials, are brittle. They are susceptible to fracture at Weinstein6 patented a leucite-containing porcelain frit the time of placement and during function. Brittle mate- for use in metal-ceramic restorations. The presence of rials such as ceramics always contain at least two types of leucite, an aluminosilicate with high thermal expansion, flaws from which fracture can initiate: fabrication defects allowed a match between the thermal expansion of the and surface cracks. Methods used to improve the strength ceramic and that of the metal (see Chapter 24). The and clinical performance of dental ceramics include crys- appearance of ceramic restorations was improved by talline reinforcement, chemical strengthening, and stress- the introduction of vacuum firing, which considerably induced transformation. 674 25 All-Ceramic Restorations 675 A A B B C C FIGURE 25-1 ■ A, All-ceramic crown restoring the right maxillary FIGURE 25-2 ■ A, Mandibular molar prepared for conservative central incisor. B and C, Maxillary anterior teeth restored with ceramic onlay after cuspal fracture. B, Lithium disilicate evalu- facial veneers and an all-ceramic fixed dental prosthesis. (B and ated intraorally before firing. C, Completed restoration. C, Courtesy Dr. D.H. Ward.) Fabrication Defects analyze failure with a statistical approach, assessing flaw size and spatial distribution.24 Fabrication defects are created during processing and consist of voids or inclusions generated during sintering. Crystalline Reinforcement Condensation of a ceramic slurry by hand before sinter- ing may introduce porosity. Sintering under vacuum Strengthening by crystalline reinforcement involves the reduces the porosity in dental ceramics from 5.6 to 0.56 introduction of a high proportion of crystalline phase volume percent.18 Porosity on the internal side of clini- into the ceramic material to improve the resistance to cally failed glass-ceramic restorations has been shown to crack propagation. The crystals can deflect the advancing be a fracture initiation site.19 Also, microcracks develop crack front to increase the fracture resistance of two- within the ceramic upon cooling in leucite-containing phase materials. Microstructural features that typically ceramics and are caused by thermal contraction mismatch lead to crack deflection include (1) weakened interfaces between the crystals and the glassy matrix.20-22 between grains in single-phase materials that may be caused by incomplete sintering and (2) residual strains in 25 Surface Cracks two-phase materials. The latter constitutes a major issue in dental ceramics. Surface cracks are induced by machining or grinding. A crystalline phase whose thermal expansion coeffi- The average natural flaw size varies from 20 to 50 µm.23 cient is greater than that of the matrix produces tangential Usually, fracture of the ceramic material originates from compressive stress (and radial tension) near the crystal- the most severe flaw, which effectively determines the matrix interface. Such tangential stresses tend to divert fracture resistance of the restoration. Ceramic engineers the crack around the particle. Leucite particles have a 676 PART III Laboratory Procedures greater thermal expansion coefficient than does the between water and the ceramic at the tip of the strength- surrounding glassy matrix. Upon cooling, compressive controlling crack, which results in an increase in the crack stresses develop at the leucite crystal–matrix interface.21 size—a phenomenon called stress corrosion or static fatigue.35 According to Michalske and Freiman,36 the reaction steps Chemical Strengthening involve the following: 1. The adsorption of water to a strained silicon- Chemical strengthening is another method used to increase oxygen-silicon (Si-O-Si) bond the strength of glass and ceramics. Chemical strengthen- 2. A concerted reaction involving simultaneous proton ing relies on the exchange of small alkali ions for larger and electron transfer ions below the strain point of the ceramic material. Because 3. The formation of surface hydroxyls stress relaxation is not possible in this temperature range, Sherrill and O’Brien37 reported a reduction in fracture the exchange leads to the creation of a compressive layer strength of about 30% when dental porcelains were frac- at the surface of the ceramic.26 Finally, any applied load tured in water, and other authors38,39 have concluded that must first overcome this built-in compression layer before stress corrosion is important in the performance of dental the surface can be placed into tension; this results in an ceramic restorations. increase in fracture resistance. This technique involves the Ceramic systems such as Captek (The Argen Corpora- use of alkali salts with a melting point lower than the tion) that are baked on a metal foil may reduce fracture glass transition temperature of the ceramic material. Ion incidence by reducing moisture exposure to the internal exchange strengthening has been reported to increase the surface of the ceramic material, from where the fracture flexural strength of feldspathic dental porcelain up to 80%, is thought to initiate.19 In industry, coatings such as depending on the ionic species involved and the composi- optical fibers are used to reduce stress corrosion of glass tion of the porcelain.27,28 The depth of the ion-exchanged and ceramics. Similar
Load more

Recommended publications
  • Expanding Dimensions in Fixed Prosthodontics
    THE AMERICAN ACADEMY OF FIXED PROSTHODONTICS EXPANDING DIMENSIONS IN FIXED PROSTHODONTICS 68th ANNUAL SCIENTIFIC SESSION Friday, February 22, 2019 Saturday, February 23, 2019 CHICAGO MARRIOTT DOWNTOWN 7TH FLOOR BALLROOMS I, II, III TABLE OF CONTENTS MISSION AND GOALS ............................................................................................. 3 INTRODUCTION OF CORPORATE SPONSORS ..................................................... 4 ORIGIN AND HERITAGE ........................................................................................... 5 PAST PRESIDENTS ................................................................................................... 6 PRESIDENT’S MESSAGE ......................................................................................... 7 OFFICERS AND DIRECTORS .................................................................................8-9 COMMITTEES AND PRESIDENTIAL APPOINTMENTS ...............................10-13 PREVIOUS TYLMAN AWARD RECIPIENTS ......................................................... 14 PREVIOUS MOULTON, BAKER, GARVER-STAFFANOU AWARD RECIPIENTS AND HONORARY MEMBERS ......................................................... 15 ANNUAL MEMBERS FELLOWSHIP AND BUSINESS MEETING ..................... 16 PROGRAM CHAIRS ................................................................................................. 17 EXHIBITOR DIRECTORY ......................................................................................... 18 POSTER PROGRAM DIRECTORY .....................................................................19-25
    [Show full text]
  • Point of Care the “Point of Care” Section Answers Everyday Clinical Questions by Providing Practical Information That Aims to Be Useful at the Point of Patient Care
    Point of Care The “Point of Care” section answers everyday clinical questions by providing practical information that aims to be useful at the point of patient care. The responses reflect the opinions of the contributors and do not purport to set forth standards of care or clinical practice guidelines. Readers are encouraged to do more reading on the topics covered. If you would like to contribute to this section, contact editor-in-chief Dr. John O’Keefe at [email protected]. Q U E S T I O N 1 How can I limit the number of different dental cements available in my dental practice and still be able to address all prosthetic clinical situations? Background cements currently being used in our prosthodontic s a clinician’s repertoire expands to include group practice (Table 1). various indirect restorations, there is a ten- Adency to accumulate a large number of dif- �hoice of Dental Cements ferent dental cements in the office. As prosthetic Conventional Fixed Prosthodontics materials each demand specific luting agents, Provisional restorations can be cemented with logistic headaches arise for both the dentist and calcium hydroxide (Dycal, Dentsply International, staff. Regrettably, the “universal” dental cement is York, Penn.), as this material is easy to manipulate, still elusive. readily available and does not interfere with or Several types of dental cement are available, compromise the integrity of the permanent ce- each possessing unique properties and handling ment. One generally places it on the margins of an characteristics; no one product is ideal for every interim restoration, then seats the restoration.
    [Show full text]
  • Lec.1 Crown & Bridge ءلاا.د
    د.اﻻء Lec.1 Crown & Bridge An Introduction to Fixed Prosthodontics Prosthodontics: It is the dental specialty concerned with the making of artificial replacements for missing parts of the mouth and jaw. It is also named "Prosthetic Dentistry" or "Prosthodontia". Fixed Prosthodontics (Crown and Bridge Prosthodontics); It is a branch of dental science that deals with restoration of damaged teeth with artificial crown and replacing the missing natural teeth by a dental prosthesis permanently cemented in place [Fixed partial denture]. Fixed Prosthodontics includes: Inlays Onlays Veneers Crowns Fixed partial dentures Crown: It is a fixed extra-coronal artificial restoration of the coronal portion of a natural tooth. It must restore the morphology, contour and function of the tooth and should protect the remaining tooth structure from further damage. Types of crowns (Classification of crowns): I. According to coverage area 1. Complete crown : It is the crown that covers all the coronal portion of the tooth such as full metal crown, porcelain fused to metal crown and All Ceramic crown. 2. Partial crown : It is a crown that covers part of the coronal portion of the tooth such as 3/4 crown, 7/8Crown. 3. Complete replacement: It replaces the natural crown entirely. This type of crown retains itself by means of a dowel (post) extended inside the root canal space of the tooth such as a post crown. 1 Three-quarter crown which is a partial crown covering all tooth surfaces except the buccal surface. Post crown which replaces the natural crown entirely and retains itself by means of a dowel (post) extended inside the root canal space.
    [Show full text]
  • Contemporary Fixed Prosthodontics, Fifth Edition, Include the Following: • Practice Examination Questions for Each Chapter • The Glossary of Prosthodontic Terms
    YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK! Evolve Student Resources for Rosenstiel/Land/Fujimoto: Contemporary Fixed Prosthodontics, Fifth Edition, include the following: • Practice examination questions for each chapter • The Glossary of Prosthodontic Terms Activate the complete learning experience that comes with each textbook purchase by registering at http://evolve.elsevier.com/Rosenstiel/prosthodontics/ REGISTER TODAY! You can now purchase Elsevier products on Evolve! Go to evolve.elsevier.com/html/shop-promo.html to search and browse for products. CONTEMPORARY FIXED PROSTHODONTICS This page intentionally left blank CONTEMPORARY FIXED PROSTHODONTICS FIFTH EDITION Stephen F. Rosenstiel, BDS, MSD Professor Emeritus, Restorative and Prosthetic Dentistry College of Dentistry The Ohio State University Columbus, Ohio Martin F. Land, DDS, MSD Professor of Fixed Prosthodontics School of Dental Medicine Southern Illinois University, Edwardsville Alton, Illinois Junhei Fujimoto, DDS, MSD, DDSc Part-Time Lecturer, Tokyo Medical and Dental University Director, J.F. Occlusion and Prosthodontic Postgraduate Course; Private Practice Tokyo, Japan 3251 Riverport Lane St. Louis, Missouri 63043 CONTEMPORARY FIXED PROSTHODONTICS, ISBN: 978-0-323-08011-8 FIFTH EDITION Copyright © 2016 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the Publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
    [Show full text]
  • Fixed Partial Denture Failures: a Clinical Survey for Evaluation of the Factors Responsible 1Manjula B Chandranaik, 2Roopa K Thippanna
    CODSJOD 10.5005/jp-journals-10063-0031 ORIGINAL ARTICLE Fixed Partial Denture Failures: A Clinical Survey for Evaluation of the Factors Responsible 1Manjula B Chandranaik, 2Roopa K Thippanna ABSTRACT Source of support: Nil Aim: Most of the time, the failures are conditions that occur Conflict of interest: None during or after appropriately performed fixed prosthodontics treatment procedures. Reasons for failures in fixed prostho- dontics can be divided into biological, mechanical and esthetic INTRODUCTION factors. Replacement of missing teeth in partially edentulous The present study was conducted to assess biological, arch involves various treatment options like removable, mechanical, and esthetic failure factors among fixed partial fixed prosthesis, and implants. Fixed prosthodontic treat- dentures (FPDs). ment can offer exceptional satisfaction for both patient Materials and methods: A cross-sectional study was con- and dentist. ducted among patients who reported to the Department of Prosthodontics, College of Dental Sciences, Davangere, Restoring and replacing of teeth with FPDs represents Karnataka, India with complaints about fixed partial denture. an important treatment procedure in dental practice, A total of 450 fixed partial denture failures in subjects were mainly because of the continuing high prevalence of assessed. The fixed partial denture was examined for the caries and periodontal diseases in the adult and geriatric failure factors (biological, mechanical, and esthetic). The populations.1 selected subjects underwent a clinical examination and set of Failure to achieve the desired specifications of design a questionnaire about the complaint of the fixed partial denture and further detail clinical examination about the failure factor. for function and esthetics would fail the prosthesis.
    [Show full text]
  • Herbert T. Shillingburg, Jr
    Herbert T. Shillingburg, Jr, DDS David Ross Boyd Professor Emeritus Department of Fixed Prosthodontics University of Oklahoma College of Dentistry Oklahoma City, Oklahoma with David A. Sather, DDS Edwin L. Wilson, Jr, DDS, MEd Joseph R. Cain, DDS, MS Donald L. Mitchell, DDS, MS Luis J. Blanco, DMD, MS James C. Kessler, DDS Illustrations by Suzan E. Stone Quintessence Publishing Co, Inc Chicago, Berlin, Tokyo, London, Paris, Milan, Barcelona, Istanbul, Moscow, New Delhi, Prague, São Paulo, and Warsaw Cover design based on a photograph of Monument Valley on the Navajo Reservation in northern Arizona taken at sunrise by Dr Herbert T. Shillingburg, Jr. Contents Dedication vii Authors viii Preface ix Acknowledgments x 1 An Introduction to Fixed Prosthodontics 1 2 Fundamentals of Occlusion 13 3 Articulators 27 4 Interocclusal Records 35 5 Articulation of Casts 45 6 Treatment Planning for Single-Tooth Restorations 71 7 Treatment Planning for the Replacement of Missing Teeth 81 8 Fixed Partial Denture and Implant Con!gurations 99 9 Principles of Tooth Preparations 131 10 Preparations for Full Coverage Crowns 149 11 Preparations for Partial Coverage Crowns 165 12 Preparations for Intracoronal Restorations 193 13 Preparations for Severely Debilitated Teeth 203 14 Preparations for Periodontally Weakened Teeth 229 15 Provisional Restorations 241 16 Fluid Control and Soft Tissue Management 269 291 17 Impressions 325 18 Working Casts and Dies 343 19 Wax Patterns 363 20 Investing and Casting 383 21 Cementation and Bonding 413 22 Esthetic Considerations 425 23 All-Ceramic Restorations 447 24 Metal-Ceramic Restorations 471 25 Pontics and Edentulous Ridges 493 26 Solder Joints and Other Connectors 517 27 Restoration of Osseointegrated Dental Implants 531 28 Single-Tooth Implant Restoration 543 29 Multiple-Tooth Implant Restoration Index 555 Dedication In Memoriam Constance Murphy Shillingburg 1938–2008 This book is dedicated to the loving memory of Constance surgeries later in life, she was the most optimistic person I Murphy Shillingburg.
    [Show full text]
  • Application of Laser Technology in Fixed Prosthodontics —A Review of the Literature
    Open Journal of Stomatology, 2020, 10, 271-280 https://www.scirp.org/journal/ojst ISSN Online: 2160-8717 ISSN Print: 2160-8709 Application of Laser Technology in Fixed Prosthodontics —A Review of the Literature Al-Jallad Walid Arab American University, Jenin, Palestine How to cite this paper: Walid, A.-J. (2020) Abstract Application of Laser Technology in Fixed Prosthodontics. Open Journal of Stomatol- Introducing laser light in prosthetic dentistry opens a new era on the treat- ogy, 10, 271-280. ment modules with new impact in the quality of prosthodontics treatments, https://doi.org/10.4236/ojst.2020.1010026 with hope of overcoming some of the drawbacks posed by the conventional Received: January 22, 2020 methods of fixed prosthodontics procedures. Laser techniques cause less pain Accepted: October 10, 2020 than traditional methods and eliminate the noise of instrumentals that some Published: October 13, 2020 fearful patients who have long term neglected care and those have complex medical histories and required more specialized care, could use the advantage Copyright © 2020 by author(s) and Scientific Research Publishing Inc. of laser in their treatment plan. The aim of the articles review is to highlight This work is licensed under the Creative the current and emerging application of laser in fixed prosthodontics treat- Commons Attribution International ment to be used in conjunction or as replacement for traditional methods License (CC BY 4.0). based on the research that support the indication described. http://creativecommons.org/licenses/by/4.0/ Open Access Keywords Lasers, Fixed Prosthesis, Gingival Troughing, Esthetics, Crown Lengthening, Soft Tissue Management, Veneer Removal, Ovate Pontic 1.
    [Show full text]
  • Prosthodontics Courses (PROS) 1
    Prosthodontics Courses (PROS) 1 PROS:8122 Treatment of Dentulous Patients: Fixed Prosthodontics for Single Anterior Teeth Lecture 1 s.h. Prosthodontics Basic principles of fixed prosthodontics for single-unit anterior teeth; basic principles of tooth preparation, clinical steps, and Courses (PROS) digital procedures for fabrication of anterior single-tooth all- ceramic crowns and interim crowns. Prerequisites: PROS:8120 This is a list of all prosthodontics courses. For more and PROS:8121. information, see Prosthodontics. PROS:8123 Treatment of Dentulous Patients: Fixed PROS:5700 Advanced Clinical Prosthodontics 0,2 s.h. Prosthodontics for Single Anterior Teeth Lab 1 s.h. PROS:5710 Advanced Removable Prosthodontic Patient simulation exercises in single anterior tooth Technique 0,2 s.h. preparation, and fabrication of single-unit anterior all-ceramic and interim restorations. Prerequisites: PROS:8120 and PROS:5720 Advanced Instrument Technique 0,2 s.h. PROS:8121. PROS:5730 Advanced Implant Techniques 0-2 s.h. PROS:8124 Treatment of Dentulous Patients: Fixed PROS:5740 Advanced Fixed Prosthodontics Prosthodontics for Single Posterior Teeth Lecture 1 s.h. Technique 0,2 s.h. Basic biomechanical principles of fixed posterior single tooth prosthodontics; diagnosis and treatment planning for dentate PROS:5750 Clinical Issues and Treatment Planning in patients including occlusion. Prerequisites: PROS:8120 and Prosthodontics 0-1 s.h. PROS:8121 and PROS:8122 and PROS:8123. PROS:6220 Fixed Prosthodontics Literature Review PROS:8125 Treatment of Dentulous Patients: Fixed I 0-4 s.h. Prosthodontics for Single Posterior Teeth Lab 1 s.h. Fixed prosthodontic procedures; assigned readings, discussion Patient simulation exercises in single posterior tooth of related research.
    [Show full text]
  • Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses
    molecules Article Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses Anna Avetisyan 1, Marina Markaryan 1, Dinesh Rokaya 2,* , Marcos Roberto Tovani-Palone 3,*, Muhammad Sohail Zafar 4,5,* , Zohaib Khurshid 6 , Anna Vardanyan 7 and Artak Heboyan 7,* 1 Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia; [email protected] (A.A.); [email protected] (M.M.) 2 Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok 10400, Thailand 3 Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil 4 Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia 5 Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan 6 Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Hofuf, Al-Ahsa 31982, Saudi Arabia; [email protected] 7 Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia; [email protected] * Correspondence: [email protected] (D.R.); [email protected] (M.R.T.-P.); [email protected] (M.S.Z.); [email protected] (A.H.); Tel.: +374-9321-1221 (A.H.) Citation: Avetisyan, A.; Markaryan, Abstract: The objective of the present study was to investigate the effects of various types of fixed M.; Rokaya, D.; Tovani-Palone, M.R.; prostheses on periodontal tissues and explore the association of gingival biotype and gum recession Zafar, M.S.; Khurshid, Z.; Vardanyan, in relation to prosthesis types.
    [Show full text]
  • Removable Prosthodontics – Dental Coverage Guideline
    UnitedHealthcare® Dental Coverage Guideline Removable Prosthodontics Guideline Number: DCG020.10 Effective Date: June 1, 2021 Instructions for Use Table of Contents Page Related Dental Policy Coverage Rationale ....................................................................... 1 • Fixed Prosthodontics Definitions ...................................................................................... 3 Applicable Codes .......................................................................... 3 Description of Services ................................................................. 5 References ..................................................................................... 5 Guideline History/Revision Information ....................................... 6 Instructions for Use ....................................................................... 6 Coverage Rationale Complete and Partial Dentures Removable Complete or Partial Dentures are indicated for replacement of missing teeth lost due to disease, trauma or injury. Complete and Partial Dentures are not indicated for the following: Partial dentures are not indicated for members with chronic poor oral hygiene or abutment teeth that are in poor condition due to periodontal disease or extensive caries When there has been extensive bone atrophy resulting in an inadequate edentulous ridge Poor neuro-muscular control Unresolved soft tissue concerns (e.g., lack of vestibular depth, hypertrophy, hyperplasia, stomatitis) Coverage Limitations Limited to once per 60 months No additional
    [Show full text]
  • Contemporary Fixed Prosthodontics
    C H A P T E R 3 1 Postoperative Care After placement and cementation of a fixed dental pros- agent that may have been overlooked previously and that thesis (FDP), patient treatment continues with a care- all aspects of the occlusion remain satisfactory. fully structured sequence of postoperative appointments Radiolucent cements should be avoided because designed to monitor the patient’s dental health (Fig. detecting excess luting agent radiographically is impos- 31-1), ensure meticulous plaque control habits, identify sible if that material is effectively radiolucent. With luting any incipient disease, and introduce any corrective agents of greater radiopacity, excess cement is spotted treatment that may be needed before irreversible future more easily on routine radiographs; therefore, the dentist damage occurs. should choose a luting agent that is as radiopaque as Patients should be instructed in special plaque-control possible. In practice, luting agents are available in a measures, especially around pontics and connectors, and wide range of radiopacities.4-6 Figure 31-5 summarizes the use of special oral hygiene aids such as floss threaders data from these studies. (Fig. 31-2). If pontics are properly designed (see Chapter The presence of fremitus (see Chapter 1), or “pol- 20), floss can be looped through the embrasure spaces on ished” facets, on the occluding surfaces of cast restora- each side, and the loop can be pulled tightly against the tions at the postcementation appointment should prompt convex pontic tissue surface. A sliding motion is then a careful reassessment and correction of the occlusion. If used to remove dental plaque (Fig.
    [Show full text]
  • Chapter 1 Introduction
    CHAPTER 1 FIXED PROSTHODONTICS is the branch of prosthodontics concerned with the replacement and/or restoration of teeth by INTRODUCTION artificial substitutes that are not removable from the mouth.1 REMOVABLE PROSTHODONTICS DEFINITIONS is the branch of prosthodontics concerned with the replacement of teeth and contiguous PROSTHETICS is the art and science structures for edentulous or partially of supplying artificial replacements for edentulous patients by artificial substitutes missing parts of the human body and a that are removable from the mouth.1 PROSTHESIS is an artificial replacement for an absent part of the human body. MAXILLOFACIAL PROSTHETICS is the branch of prosthodontics concerned with By supply the suffix -DONTICS, the restoration and/or replacement of which connotes dentistry, the term somatognathic and associated facial structures prosthodontics is derived. by artificial substitutes that may be removed PROSTHODONTICS or PROSTHETIC on a regular or elective basis.1 DENTISTRY is defined as the branch of dentistry pertaining to the restoration and PROSTHODONTIC RESTORATIONS maintenance of oral function, comfort, appearance, and health of the patient by the RESTORATION is a broad term restoration of natural teeth and/or the applied to any material or prosthesis that replacement of missing teeth and contiguous restores or replaces lost tooth structure, teeth, oral and maxillofacial tissues with artificial or oral tissue.1 substitutes.1 More simply stated, prosthodontics is the restoration of natural Single tooth restorations include teeth and the replacement of missing teeth and amalgams, composite resins, inlays, onlays, associated structures with artificial substitutes. crowns, and veneers. The restoration of natural teeth with single tooth restorations is THE DIVISION OF PROSTHODONTICS frequently referred to as RESTORATIVE or OPERATIVE DENTISTRY although this Prosthodontics has three major treatment is included in the definition of divisions: (1) fixed prosthodontics, prosthodontics.
    [Show full text]