Quartz 4

Coals 3. Definitive (Reconstructive phase treatment)

5 min read

NOTE

DMD3 is when definitive phase treatment starts, need to know for clinic

Crowns

  • Visit 1: Primary impressions -take preliminary impressions in alginate for custom special tray fabrication record putty key for preparation guide (if required and future temporary crown fabrication. )
  • Visit 2: Crown Preparation
    • administer LA
    • Prepare tooth
    • Use custom tray, take impression. Light body PVS injected around and on prepared tooth, and medium/heavy body in custom tray.
    • take alginate impression of the opposing arch for proper bite alignment, (if no t recorded at previous app)
    • bit registration with Regisil
    • record appropriate shade for the crown
    • Use putty key and luxatemp , fabricate a temporary crown to protect the prepared tooth while the permanent crown is being fabricated. Cement with Tempocem
    • Provide post-op instruction for managing the temporary crown
    • send impressions to the dental lab for fabrication of the permanent crown . The materials aren't static, they can vary in the real-world, these are OCHWA specific

DentalMaterials

  • Regisil for bite registration
  • Tempocem for cementing
    • Zinc Oxide
  • Luxatemp for temporary crown
  • Permenant cements
    • RelyX
    • Panavia
    • Variolink

Theres different shade guides for different materials (i.e. crowns, dentures and direct-restoratives) aesthetic

  • Visit 3
    • Remove the temp and clean the underlying tooth with pumic
    • try in permanent crown on the prepared tooth to check for fit, marings , shade and occlusion
    • using dental cement =(ex. RelyX;Panavia, Variolink etc)= to bond the permanent crown securely to the tooth, removing any excess cement once seated
    • check occlusion and make any adjustments if needed
    • advise the patient on crown care and oral hygiene

Complete Dentures dentures

  • Visit 1: Primary Impressions
    • Use stock trays with alginate material to take preliminary impressions of the upper and lowe edentulous arches
    • send the preliminary impression to the lab to fabricate custom impression tray
  • Visit 2: Secondary Impressions
    • check the fit and comfort of hte custom trays on the patient’s ridges.
    • adjust tray borders as needed to ensure proper extension and fit.
    • use putty to border mold, to capture functional extensions of the denture
    • take secondary/final impressions using heavy body
    • send final impressions to hte lab for creation of master casts and fabrication of baseplates and wax rims

Dental impression materials dentures DentalMaterials impressions

  • pvs
  • polyether
  • Visit 3: MMR
    • baseplate/wax rim to establish MMR
    • establish the correct horizontal vertical dimension (confirm wiht fox plane, Willy’s gauge)
    • Record the centric relation
    • if indicated, use a facebow to transfer the relationship of the maxilla to the tmj
    • mark midline, smile line, and canine lines on wax rims
    • select the appropriate shade and shape of acrylic teeth send records to Lab for Anterior Try -in
  • Visit 4: Anterior try- in
    • insert the baseplate/ wax dentures (anterior teeth et in wax) to check fit, aesthetics, and phonetics
    • evaluate aesthetics (lip support, midline, smile line) and phonetics (sound production)
    • confirm patient satisfaction with the appearance and alignment of the teeth
    • send to lab for posterior tooth setting
  • Visit 4: Posterior try in
    • insert the wax trial dentures (teeth set in wax) reassses; aesthetics, and phonetics
    • evalute aesthetics (lip support, midline, smile line ) and phonetics (soud production)
      • check and confirm the occluion in CR and make necssary adjustments
      • obtain patient consent and approval before processing the final dentures
      • send the approved wax dentures to the lab or final processing in acrylic.
  • Vist 6Denture insertion and adjustment
    • assess for fit and comfort
    • check retention and stability
    • use articulating paper to identify hihg spots and adjust the occlusion as needed
    • provide patient wiht instructions on denture care, cleaning and maintenance
    • Discuss expected adapation period and potential challenges
    • schedule follow-up appointments for adjustment and re-evaluation
  • Visit 7: review appointment

Partial Dentures

  • Visit 1:
    • take preliminary impression of upper and lower arches using alginate
    • send impressions to the lab for fabrication of custom trays and creation of study models . Survey models for design of the partial denture and potential tooth modifications (e.g. rest seats )
  • Visit 2:
    • prepare rest seats and other necessary tooth modifications (such as guide planes or undercut adjustments)
    • once rest seats are prepared, check the fit of the custom tray in the patient’s mouth
    • if required, border mould the custom trays using a material like aquasil putty tocapture functional extensions of the denture
    • use light body PVs around the prepared teeth to capture the rest seats and guide planes . And heavy body PVS in tray.
    • Take final impressions
    • send final impression to the lab for master casts and cobalt chrome framework, and base/wax rims if required

Aquasil

  • Visit 3:
    • try in the cobalt chrome framework check fit on the rest seats, guide planes, and that there is no interference with other teeth or soft tissues
  • Visit 4
    • mmr
    • select the appropriate shade and shape of acrylic teeth
    • send to the lab for teeth setup in wax on the framework
  • Visit 5:
    • wax try in
      • check aesthetics (lip support,midline,smile line)
      • phonetics (speech sounds
      • occlusion ensure bite is correct in Cr and check vertical dimension
    • Send to lab for processing

Form 26 form26

pros clinic

  • who can sign these?
    • pros (complex cases, VD concerns)
    • clinic coordinators
    • clinical tutors (single unit crowns, straightforward denture designs)
    • You should discuss clinical cases with clinical tutors, coordinators etc to get feedback on treatment planning and you designs etc before completing a From 26

Reflections

  1. What are some specific skills you feel more confident in this year?
  2. Can you recall la moment in clinic when you felt proud of what you accomplished
  3. how have you developed your communication skills with patients
  4. What feedback have you received from tutors or peers that made you feel good about your progoess
  5. In what way have you overcome challenges in the clinic, and how does that reflect your growth

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