- Email: [email protected]
Making a fixed restoration contour guide
BOHNENKAMP
7. Carefully grind and fit the mandibular anterior acrylic resin denture teeth to fit the runner bar, vertical struts, and ridge (Fig. 6). 8. Wax the anterior segment so that the runner bar is wellconcealed with no additional bulk added to the labial or lingual surfaces (Fig. 7). 9. The denture base can be characterized and processed routinely by using standard laboratory procedures. 10. Seat the completed partial denture and make necessary occlusal and denture base adjustments (Fig. 8). It is extremely unlikely that the anterior denture base will break away from the partial denture with this type of runner bar.
Making
a fixed restoration
REFERENCES 1. Henderson D, Steffel VL. McCracken’s removable partial prosthcdontics. St Louis: The CV Mosby Co, 1981;18. 2. Dental laboratory technology. Air Force Manual 162-6. Washington: US Government Printing Office, 1982;370. 3. Rudd KD, Morrow RM, Rhoads JE. Dental laboratory procedures. Removable partial dentures. St Louis: The CV Mosby Co, 1986;451. 4. Steward KL, Rudd KD, Kuebker WA. Clinical removable partial prosthodontics. St Louis: The CV Mosby Co, 1982;81-8. 5. Rudd KD, Morrow RM, Strunk RR. Accurate alginate impressions. J PROSTHET DENT 1969;22:294-300. Reprint requests to: DR. DAVID M. BOHNENKAMP PSC Box 3779 APO SAN FRANCISCO, CA 96293
contour
guide
K. Fareed, B.D.S., M.S.,* and A. Solaihim, B.D.S.** King Saud University, College of Dentistry, Riyadh, Saudi Arabia A silicone matrix of the diagnostic wax-up of the abutment teeth serves as a guide during tooth preparation and final contouring of the restoration. A cast with the castings on it with surrounding gingival tissues formed in silicone is made. This cast, along with the silicone matrix, provides the technician with definite guides for the axial contouring of the tooth-colored portion of the fixed restoration. jJ PROSTHET D~~~1989;61:112-4.)
P
roperly contoured fixed restorations are necessary for gingival health. Periodontal disease can be directly related to poorly contoured restorations.1-4 It has been suggested that axial contours of fixed restorations should be harmonious with the gingival architecture.5 Overcontouring of fixed restorations is often the consequence of an underprepared abutment because the metal and porcelain must be made to a minimum thickness. When the dies are trimmed, the true relationship between the margin of the restoration and the gingival tissue is lost. The dental technician may overcontour the restoration for a properly prepared tooth if he is not aware of the original anatomy and its relationship to the gingival tissues.6 This article describes a device that can be made and used as a guide during preparation of the teeth and as an aid in establishing proper contours for the restorations.
PROCEDURE
Fig.
3.
1. Make a diagnostic wax-up of the abutment teeth to sim-
ulate the desired contour and occlusion. 2. Make a matrix of the wax-up and a few adjacent teeth by using Optosil Plus (Bayer Dental, Leverkusen,
4. 5.
*Lecturer, Department of Removable Proethodontic Sciences. **General Practice resident.
6.
112
1. Looking into silicone matrix of diagnostic wax-up.
Federal Republic Germany) silicone putty material (Fig. 1). Trim the silicone matrix as shown to serve as a guide during tooth preparation and final contouring of the restoration (Figs. 2 and 3). Make the castings, seat, and adjust them in the mouth. Make a pick-up impression in the patient’s mouth using light- and heavy-body Permlastic (Kerr GmbH, Karlsruhe, Federal Republic Germany) polysulfide rubber base impression material (Fig. 4). Remove the impression from the mouth and place the castings in the impression.
JANUARY1989
VOLUME61
NUMBER1
Fig. 2. Trimmed silicone matrix on cast, with diagnostic wax-up, overlaps incisal edges slightly. Matrix covers adjacent teeth on each side not involved in fixed restoration. Fig. 6. Polysulfide rubber base impression with light-body silicone impression material in and around castings. Paper clips inserted into each casting.
Fig. 3. Trimmed silicone matrix seated in mouth used as guide for preparation of abutment teeth.
Fig. 6. Cast with abutment castings and silicone impression material representing gingival tissues.
Fig. 4. Polysulfide rubber base impression material injected around the castings for pick-up impression. Inject a light-body silicone impression material such as President (Coltene AG, Alstatten, Switzerland) into and around the castings in the pick-up impression. Before the silicone sets, position bent paper clips through the silicone into each casting (Fig. 5). After the silicone impression material sets, pour the impression with dental gypsum. The paper clips hold the silicone material on the cast. Two different elastic impression materials are used because they separate easily from each other.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
Fig. 7. Same cast as in Fig. 6 with silicone matrix. 113
The resultant cast with the castings on it will have the surrounding gingival tissues formed in silicone (Fig. 6). This cast, along with the silicone matrix, provides the technician with definite guides for the axial contouring of the toothcolored portion of the fixed restoration (Fig. 7). The silicone matrix can be used for the application of porcelain to contour (Fig. 8). It reduces the time spent on porcelain contouring in the laboratory and at the chair. The matrix may also be used when contours are waxed in preparation for adding tooth-colored plastic. Only minor contour adjustments will be required before final staining, glazing, and final cementation (Fig. 9). Fig. 8. Silicone matrix serves as guide for porcelain application and contour.
REFERENCES 1. Perel ML. Axial crown contours. J PROSTHET DENT 1971; 25642-g. 2. Perel ML. Periodontal considerations of crown contours. J PR~STHET DENT 1971;26:627-30.
3. Burch JG. Ten rules for developing crown contours in restorations. Dent Clin North Am 1971;15:611-8. 4. Tjan AHL, Freed H, Miller GD. Current controversies in axial contour design. J PROSTHET DENT 1960@636-40. 5. Yuodelis RA, Weaver JD, Sapkus S. Facial and lingual contours of artificial complete crown restorations and their effects on the pericdontium. J PROSTBIIT DENT 1973;29:61-6. 6. Palomo F, Peden J. Periodontal considerations in restorative procedures. J PROSTHETDm 197636387-93. Reprint
Fig. 9. Completed maxillary anterior restorations in patient’s mouth.
Method
for denture
L. Brian
Toolson,
University
of Washington,
Steps
for using
School of Dentistry, chip
to:
identification
D.D.S., M.S.D.,* and Thomas D. Taylor,
a plastic
requests
DR. KAMAL FAREED KING SAUD UNIVERSITY COLLEGE OF DENTISTRY P.O. Box 60169 RNADH 11545 KINGDOWOF SAUDI ARABIA
to identify
D.D.S., M.S.D.*
Seattle, Wash. a removable
prosthesis
are described.
(J PROSTHET DENT 1989;61:114-5.)
R ecently, several states have passed legislation
requiring names of patients to be placed in new removable prostheses. Some patients object to this being done because of the visibility of the printing and having one’s name or social security number in an artificial device. Large printing on a denture can be unsightly and requires additional laboratory time and expense. This article describes a procedure for placing a name or social security number in a prosthesis that is simple to accomplish and is relatively invisible to the patient.
*Associate 114
Professor,
Department
of Prosthodontics.
PROCEINJRE 1. Type the name or social security number on a Min. LDent (Super Tooth Products, Minneapolis, Minn.) denture identification strip. Any manual, ribbon type typewriter is satisfactory (Fig. 1). 2. Preheat an oven to 325O F. 3. Place tbe typed name in the oven for 30 seconds to 1 minute to shrink the lettering or numbers. The strip becomes a chip. 4. Remove the plastic chip from the oven and immediately place it between two glass slabs to flatten the chip (Fig. a. 5. Trim the chip with a carbide bur to decrease the size. JANUARY
1989
VOLUME
61
NUMBER
1
7. Carefully grind and fit the mandibular anterior acrylic resin denture teeth to fit the runner bar, vertical struts, and ridge (Fig. 6). 8. Wax the anterior segment so that the runner bar is wellconcealed with no additional bulk added to the labial or lingual surfaces (Fig. 7). 9. The denture base can be characterized and processed routinely by using standard laboratory procedures. 10. Seat the completed partial denture and make necessary occlusal and denture base adjustments (Fig. 8). It is extremely unlikely that the anterior denture base will break away from the partial denture with this type of runner bar.
Making
a fixed restoration
REFERENCES 1. Henderson D, Steffel VL. McCracken’s removable partial prosthcdontics. St Louis: The CV Mosby Co, 1981;18. 2. Dental laboratory technology. Air Force Manual 162-6. Washington: US Government Printing Office, 1982;370. 3. Rudd KD, Morrow RM, Rhoads JE. Dental laboratory procedures. Removable partial dentures. St Louis: The CV Mosby Co, 1986;451. 4. Steward KL, Rudd KD, Kuebker WA. Clinical removable partial prosthodontics. St Louis: The CV Mosby Co, 1982;81-8. 5. Rudd KD, Morrow RM, Strunk RR. Accurate alginate impressions. J PROSTHET DENT 1969;22:294-300. Reprint requests to: DR. DAVID M. BOHNENKAMP PSC Box 3779 APO SAN FRANCISCO, CA 96293
contour
guide
K. Fareed, B.D.S., M.S.,* and A. Solaihim, B.D.S.** King Saud University, College of Dentistry, Riyadh, Saudi Arabia A silicone matrix of the diagnostic wax-up of the abutment teeth serves as a guide during tooth preparation and final contouring of the restoration. A cast with the castings on it with surrounding gingival tissues formed in silicone is made. This cast, along with the silicone matrix, provides the technician with definite guides for the axial contouring of the tooth-colored portion of the fixed restoration. jJ PROSTHET D~~~1989;61:112-4.)
P
roperly contoured fixed restorations are necessary for gingival health. Periodontal disease can be directly related to poorly contoured restorations.1-4 It has been suggested that axial contours of fixed restorations should be harmonious with the gingival architecture.5 Overcontouring of fixed restorations is often the consequence of an underprepared abutment because the metal and porcelain must be made to a minimum thickness. When the dies are trimmed, the true relationship between the margin of the restoration and the gingival tissue is lost. The dental technician may overcontour the restoration for a properly prepared tooth if he is not aware of the original anatomy and its relationship to the gingival tissues.6 This article describes a device that can be made and used as a guide during preparation of the teeth and as an aid in establishing proper contours for the restorations.
PROCEDURE
Fig.
3.
1. Make a diagnostic wax-up of the abutment teeth to sim-
ulate the desired contour and occlusion. 2. Make a matrix of the wax-up and a few adjacent teeth by using Optosil Plus (Bayer Dental, Leverkusen,
4. 5.
*Lecturer, Department of Removable Proethodontic Sciences. **General Practice resident.
6.
112
1. Looking into silicone matrix of diagnostic wax-up.
Federal Republic Germany) silicone putty material (Fig. 1). Trim the silicone matrix as shown to serve as a guide during tooth preparation and final contouring of the restoration (Figs. 2 and 3). Make the castings, seat, and adjust them in the mouth. Make a pick-up impression in the patient’s mouth using light- and heavy-body Permlastic (Kerr GmbH, Karlsruhe, Federal Republic Germany) polysulfide rubber base impression material (Fig. 4). Remove the impression from the mouth and place the castings in the impression.
JANUARY1989
VOLUME61
NUMBER1
Fig. 2. Trimmed silicone matrix on cast, with diagnostic wax-up, overlaps incisal edges slightly. Matrix covers adjacent teeth on each side not involved in fixed restoration. Fig. 6. Polysulfide rubber base impression with light-body silicone impression material in and around castings. Paper clips inserted into each casting.
Fig. 3. Trimmed silicone matrix seated in mouth used as guide for preparation of abutment teeth.
Fig. 6. Cast with abutment castings and silicone impression material representing gingival tissues.
Fig. 4. Polysulfide rubber base impression material injected around the castings for pick-up impression. Inject a light-body silicone impression material such as President (Coltene AG, Alstatten, Switzerland) into and around the castings in the pick-up impression. Before the silicone sets, position bent paper clips through the silicone into each casting (Fig. 5). After the silicone impression material sets, pour the impression with dental gypsum. The paper clips hold the silicone material on the cast. Two different elastic impression materials are used because they separate easily from each other.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
Fig. 7. Same cast as in Fig. 6 with silicone matrix. 113
The resultant cast with the castings on it will have the surrounding gingival tissues formed in silicone (Fig. 6). This cast, along with the silicone matrix, provides the technician with definite guides for the axial contouring of the toothcolored portion of the fixed restoration (Fig. 7). The silicone matrix can be used for the application of porcelain to contour (Fig. 8). It reduces the time spent on porcelain contouring in the laboratory and at the chair. The matrix may also be used when contours are waxed in preparation for adding tooth-colored plastic. Only minor contour adjustments will be required before final staining, glazing, and final cementation (Fig. 9). Fig. 8. Silicone matrix serves as guide for porcelain application and contour.
REFERENCES 1. Perel ML. Axial crown contours. J PROSTHET DENT 1971; 25642-g. 2. Perel ML. Periodontal considerations of crown contours. J PR~STHET DENT 1971;26:627-30.
3. Burch JG. Ten rules for developing crown contours in restorations. Dent Clin North Am 1971;15:611-8. 4. Tjan AHL, Freed H, Miller GD. Current controversies in axial contour design. J PROSTHET DENT 1960@636-40. 5. Yuodelis RA, Weaver JD, Sapkus S. Facial and lingual contours of artificial complete crown restorations and their effects on the pericdontium. J PROSTBIIT DENT 1973;29:61-6. 6. Palomo F, Peden J. Periodontal considerations in restorative procedures. J PROSTHETDm 197636387-93. Reprint
Fig. 9. Completed maxillary anterior restorations in patient’s mouth.
Method
for denture
L. Brian
Toolson,
University
of Washington,
Steps
for using
School of Dentistry, chip
to:
identification
D.D.S., M.S.D.,* and Thomas D. Taylor,
a plastic
requests
DR. KAMAL FAREED KING SAUD UNIVERSITY COLLEGE OF DENTISTRY P.O. Box 60169 RNADH 11545 KINGDOWOF SAUDI ARABIA
to identify
D.D.S., M.S.D.*
Seattle, Wash. a removable
prosthesis
are described.
(J PROSTHET DENT 1989;61:114-5.)
R ecently, several states have passed legislation
requiring names of patients to be placed in new removable prostheses. Some patients object to this being done because of the visibility of the printing and having one’s name or social security number in an artificial device. Large printing on a denture can be unsightly and requires additional laboratory time and expense. This article describes a procedure for placing a name or social security number in a prosthesis that is simple to accomplish and is relatively invisible to the patient.
*Associate 114
Professor,
Department
of Prosthodontics.
PROCEINJRE 1. Type the name or social security number on a Min. LDent (Super Tooth Products, Minneapolis, Minn.) denture identification strip. Any manual, ribbon type typewriter is satisfactory (Fig. 1). 2. Preheat an oven to 325O F. 3. Place tbe typed name in the oven for 30 seconds to 1 minute to shrink the lettering or numbers. The strip becomes a chip. 4. Remove the plastic chip from the oven and immediately place it between two glass slabs to flatten the chip (Fig. a. 5. Trim the chip with a carbide bur to decrease the size. JANUARY
1989
VOLUME
61
NUMBER
1