Sidenote: PFM bridges favored due to strength of connectors (metal connectors stronger than porcelain)
ALSO ALL STEPS ARE RECORDED AND SIGNED ON GREEN RESTORATIVE FORM
Prior to Appointment:
Take alginate impression of mouth
Create putty stent (or plastic if you have extra copies of the cast)
Drill ideal prep: (or slightly larger than ideal because will "reline" temp)
Occlusal clearance=1.5(lingual)-2.0 (buccal)mm
Lingual Chamfer: metal collars=0.3-0.7mm
0.5-1.0 lingual overall axial reduction
Buccal Shoulder: porcelain=1.0-1.2 mm
1.5mm facial overall axial reduction
Anterior: Lingual clearance: 1-1.5mm, 2mm incisal reduction
Gingival Extensions: 0.2-0.5mm above gingiva
Proximal clearance: 0.5mm minimum
6-10 degree taper, 3mm long axial walls
Create temp with bisacrylic or jet acrylic
Central:
T-bar (if previous crown)
Mach-2 silicone
Impression tray
alginate bag
Measuring cup
Restorative Cassette
Local anesthesia (Lidocaine)
Topical
Proper needle
Putty for stent
Retraction cords (size 0 and 00)
Bisacrylic and gun
PVS (light and heavy body) w/ gun and syringes for them (BFC syringe)
Double bite tray if not last tooth in arch
IF last tooth in the arch:
FUTAR and PVS
Student Kit
Hand pieces: High speed and Straight
Bur blocks: Black indirect, Purple acrylic, (Opt if need blockout: Green composite)
Vita Shade guide
Carts
Cotton rolls and gauze
Articulating paper
Vaseline and microbrush
If not using putty stent: matrix button
Tempbond and mixing pad
Floss
IF last tooth in the arch:
Full Arch trays
Removal of the Crown:
Local Anesthesia
If PFM, make a slot in the porcelain to the metal with 846 diamond bur above the buccal margin
Continue up the buccal surface to the occlusal, barely cutting through to the cement.
Continue from the occlusal surface onto the lingual surface until 1-2 mm of uncut crown remains near the lingual margin
Use a T-bar, a strong spoon excavator or other instrument and place it in the groove and gently separate the two parts of the crown.
Remove the crown w/ GC Haus backpliers
Preparation:
If previous crown, use carbide burs and T-bar to remove the crown
877 bur for lingual chamfer (0.3-0.7mm)
Line up bur in Line of Draw and move to second tooth without changing angle
850 bur for interproximal break
Use 856 bur on the buccal for shoulder (1-1.2mm)
Remove any lips on the margin
Make sure all preps have the same line of draw
Can inject Quickset plaster cast (or Mach-2 Silicone) of quadrant alginate impression and set on surveyor
Bite Registration for Cast Mounting:
Use Filled Polyvinylsiloxane and inject into ONLY the preps, you want just the cusp tips
Trim excess
Take provisional restoration made prior to appointment, and reline by adding tempbond
Take impression using double bite impression, submit it with bite registration
IF LAST TOOTH IN THE MOUTH:
Take full mouth impression
Send it to the lab for pour up
They will send it back to you, you will mount it with the cast mounting (PVS)
You will send the casts to the lab for final restoration