Temporary crown

How to make a temporary crown? What we need to do before the milling is what we call the silicone key. What we can see on the next picture is the negative of our preparation. There is two molars that are already milled for the last practice. This time we are going to do two premolars.  

After this key we are ready to do the milling. The mechanical requirements are: retention (vertical forces) and stability with horizontal or oblique forces. Retention involves parallel walls with at least 3 grades.

• Parallelism
• Conicity
• Narrow shaft of input/output
• Height
• Surface
• Auxiliary retention 

This picture shows the best form. If we chose too conicity, like the B, the crown will easily peel off. So what we want to do is to reduce the shaft of the input/output.

Next picture shows how parallel has to be our preparation. We prefer 3º at least. If it's more there is going to increase the shaft of the input/output. Otherwise if we make inverse, the crown will impossible not go inside.  

The problem comes when is a molar very small. If we don't put a retention the crown will turn around like in the case A. So if we mark some retentions we are going to reduce the shaft of the input/output, there is going to be an unique form to put and output the crown. 

We have to keep the anatomy of the teeth but reducing the preparation. We also have to think about the marginal  adaptation and the biologic space.  

The chamfer is very important. Is the end of the preparation at the marginal level.  

The first day we put our teeth in the plaster and we did the milling of two molars. 

The second day we did the key and the milling of two premolars. 

After this we put the material of the crown inside the silicone key and we introduce the milling. We have to wait 1 minute.   

Finally what we have to do is to polish the crowns and cementing in our preparation. 

CASE 4410.8

It's been a long time since my last post, I've been with exams but we restarted classes on monday so today I wanted to talk about one of our cases at the clinic. My partner and I we had this case as a first visit. The patient is a 38 years old women.

How do we start the first visit? What we usually do is the questions to the patient. We need to know:

• Visit reason: she wanted a revision.
• Personal medical history: no interest
• Family history: her father had angina pectoris, myocardial infarction and stomach ulcers. Her mother also had a heart desease.
• Medication: occasional medication for headaches - ibuporfen.
• Periodontal status: severe probing with <6mm of widespread
• Bad habits: smoking of 2 packs (40 units aprox.)
• Last dentist visit: 4 years ago.
• Oral higiene: 2 times a day, very suspicious.
• Alergies: no interest.

After all the history we have to determine a presumptive  diagnosis. We took some XR how we could:

1. Bitewing of the Right side:

2. Bitewing of the Left side:

3. Periapical of the antero-supeior sector:

4. As we observe a bad general status we decide to take a Orthopantomography (OPG) 

Presumptive Diagnosis:

• Severe generalised calculus 
• Root fragments: 1.8, 1.5, 2.8, 3.6 and 4.6 (International)
• Cavities: 3.7 and 2.2
• Fracture: crown fracture on 4.5
• partial edentulism: 1.6, 2.6 and 3.5
• Anterio-superior crowns on 1.2, 1.1, 2.1 and 2.2 in bad status.
• 2.2 has to be evaluated with all the anterior sector because the crown seems to be fractures and is not restorable.
• Occasional radiographic founds: radiopacity on 4.8 (posible cementoma). 

Treatment plan:

1. Hygienic phase: remove all the calculus
2. Surgical phase: extracting root remnants
3. Restorative phase: 4.5 and 3.7.
4. Master of aesthetic and prosthetic phase: antero-superior sector (2.2 is the most important). 

Actuality: We did the hygienic phase and I remove the cavity on 3.7. Now we just need the patient's effort for all the other treatment. I'm on 3rd year so here is where is our work: first visit and diagnosis, higiene and small cavities. 

  

Surgical instruments I

It's been a long time since the last time I posted, but never is late. All of this instruments are used in oral surgery and we normally dispose them like this: 

 Here is our new lab: 

So after the good equipment: medical gown, gloves, mask and goggles we proceed to do the incision with a scalpel. We practice with the needle holder and the tweezers. 
   

    

                         

                        

Here on the left we can see my practice.

     

All the different kinds of sutures: for example here we have the continued suture (right up), intertwined suture (left down), single points and finally horizontal mattress suture. 

Complete Denture

It's been a while without writing in my blog, I've been busy with classes but here is my new post. 

What is a complete Denture? is a prosthetic device that replace all the missing teeth and supported by soft and hard tissues. How do we do this denture?

First we have to take measures with alginate and zinquenolic.So we obtain thte models in plaster. Then we have to take the measure of the Fox plante to obtain the inclination of the mouth plus the intermaxilar measure with the facial arch. After all the measures we mount in the articulator with the deasirable measures. Second, with optosil, a yellow silicone or another kind of material, we take the Vertical Dimension of the patient, the height that we want. 

Once we finish with this, we prepare the occlusion rim for the next preparation. 

Final work before flasking:

Endodontic procedures 1

There is some steps to do in a endodoncy. 

1. Open the chamber with the abrasion drills and with endo-Z drill we. Find the direct access to the apical foramen with the drills. 
2. Expansion of the cavity to adjust for the posterior obturation. 
3. With SX we have to wear the dentine triangle, then it will be easier for the apical curvature. This step is optional.
4. Use the apical localization to find it.
5. Then we start with the limes of conformation:
1. S1 + irrigation + passenger lime
2. S2 + irrigation + passenger lime 
6. In the next picture we see the passenger lime that we have to pass in almost every step.
7. After this lines we pass the limes of finishing:
1. F1 + irrigation + passenger lime
2. F2 + irrigation + passenger lime
3. F3 + irrigation + passenger lime

Each lime has a different apical diameter that makes the apice bigger. Then we also have the Profile System.
The next picture is the apice localizator, there is a lot of kind of localizator. What we have to know is that they indicate you the length of the conduct. 



Protaper tecnique: 




Manual tecnique, befor Protaper: