Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Class of 2013/ 2014 Septemper22, 2013

Presented by Dr. Mohamed Hamed Ghazy

Professor of Fixed Prosthodontics Email mghazy@mans.edu.eg
mghazy2002@yahoo.com
mghazy@mans.edu.eg

Faculty of Dentistry Conservative Dentistry Department

Head of Department Dr. Salah Al danf
Fixed Prosthodontics Staff members

Crowns& Bridges Course 2013/ 2014

Will run over 2 semesters, including: A series of lectures Practical work including demos and Lab work in fixed prosthetics lab. No clinical work, yet! Final practical work Oral exam Half term exam + preclinical requirements A final end of the year qualifying paper 30 Degree 15 Degree 15 Degree 60 Degree

Dr. Mohamed Ghazy. Dr. Ahmed Attia. Dr. Manal Aboumadina. Dr Shymaa Aboualfarag
mghazy@mans.edu.eg

mghazy@mans.edu.eg

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Prosthodontics
The dental specialty concerned with the making of artificial replacements for missing parts of the mouth and jaw.
Called also Prosthetic dentistry or Prosthodontia.

Implant Prosthodontics
That phase of prosthodontics concerning the replacement of missing teeth and/ or associate structures by restorations that are attached to dental implants.

Fixed Prosthodontics
The branch of Prosthodontics that concerned with replacement and/ or restoration of teeth by artificial substitutes that are not readily removed by the patient from the mouth
mghazy@mans.edu.eg

mghazy@mamns.edu.eg

Clinical crown
The portion of tooth that

extended from the occlusal table or incisal edge to the free gingival margin.

Anatomical crown
The portion of tooth that

GINGIVA ENAMEL CEMENTUM

extended from the occlusal table or incisal edge to cemento - enamel junction.

Artificial crown
Artificial replacement that restore

missing tooth structure by surrounding part or all of the remaining tooth with a material such as metal, ceramic or combination.
mghazy@mans.edu.eg

an artificial replacement that restores missing tooth structure by surrounding most or all of the remaining structure with a material such as cast metal or ceramic or combination. It is intended to reproduce both the form and function of the tooth and in some instance to restore or enhance the appearance

A crown is

mghazy2002@yahoo.com

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Complete (Full) veneer crown

Temporary Crown:
It is a crown made and used temporarily for the protection of the prepared tooth till the final crown or bridge is completed and ready for cementation.
A restoration that covers all of the tooth clinical crown surfaces (mesial , distal, facial, lingual and occlusal). The restoration material may be metal, ceramic or combination

Metal ceramic crown

mghazy2002@yahoo.com mghazy@mans.edu.eg

Full veneer gold crown

Three Quarter Crowns:

Partial veneer crown:

Extra-coronal cast metallic restorations that covers portion of prepared clinical crown:
e.g. crowns 7/8 crowns crowns Pin ledge crowns
mghazy@mans.edu.eg

Restore the occlusal and three of the four axial surfaces not including the facial surface.

Reverse Three Quarter Crowns:

Restore all surfaces except the lingual surface.

Seven- Eights Crown:

Is a modified type of the three quarter crown extend to include a portion of the facial surface, except the mesial half of the buccal surface of maxillary molars
mghazy@mans.edu.eg

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

One half crown: Restore the occlusal and mesial

surface, as well as portion of the lingual and buccal surfaces. It is a modified form of the three quarter crown.

Laminates
Are veneer restoration that restore the facial surface of the tooth for esthetic purposes. They are fabricated from resin or dental ceramic. They are bonded to etched enamel with resin cement.

MacBoyle retainer :
Is a modified type of the three quarter crown, with its retention derived from grooves at the labio- proximal line angles usually used for mandibular anterior incisors.

Resin- bonded restoration :

it is a cast partial veneer restoration that are bonded to etched enamel.

Pinledge retainer:
Is a modified type of an anterior three quarter crown that obtain its retention from long parallel pins in the lingual or palatal surfaces of the clinical crown.
mghazy@mans.edu.eg

mghazy2002@yahoo.com

Inlay retainer:
It is a classical intracoronal restoration that restore the proximal and occlusal surfaces but does not protect or cover the cusps entirely.
Encircling the preparation

Classification of crowns
Full coverage Partial coverage
Grooves

Metallic

crown
One piece
Tow piece

1/2 crown 7/8 crown

MacBoyle crown

Combined

veneered

Pins, pin-ledge retainer Enclsping the preparation Combined

Full veneered

Onlay retainer:
It is a modification of the inlay with cusps overlays on the occlusal surface to protect the integrity of the remaining tooth structure.
mghazy@mans.edu.eg

Non metallic Porcelain

Acrylic
Combined

Posts in the root canal

Retained by posts or post &core Posterior post attached or detached mghazy2002@yahoo.com Materiall mettalic, ceramic or combined

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Classification of crowns
according to material

Classification of crowns
According to site
Anterior

According to material

Metallic

Non metallic

Posterior

Combined
mghazy@mans.edu.eg mghazy@mans.edu.eg

Abutment Is a natural tooth or portion of

Fixed dental prosthesis {bridge} A partial denture that is luted or otherwise securely retained to the natural teeth, tooth roots, and/ or dental implant abutments that furnish the primary support for the prosthesis.
Retainer

tooth, or dental implant that supports and/or retains a prosthesis. Fixed dental prosthesis {bridge} A partial denture that is luted or otherwise securely retained to the natural teeth, tooth roots, and/ or dental implant abutments that furnish the primary support for the prosthesis.
mghazy@mans.edu.eg

The part of Fixed dental prosthesis that units the abutment {s} to the remainder of the restoration.
Connector

A portion of Fixed dental prosthesis that units the retainer {s} to the pontic.
Pontic An artificial tooth on a Fixed dental prosthesis that replaces a missing natural tooth, restore its functions, and usually fill the space previously filled by the natural crown.

mghazy@mans.edu.eg

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Fixed dental prosthesis (FPD) = Bridge = Fixed prosthesis

Classification of Fixed dental prosthesis

According to site
Anterior

Posterior

Pontic = replaces lost tooth Retainers fit over prepared teeth

mghazy@mans.edu.eg

mghazy@mans.edu.eg

Complex

Classification of Fixed dental prosthesis

According to material

Classification of Fixed dental prosthesis

According to mode of retention
Fixed fixed Fixed- supported

Metallic

Removable bridge

Non metallic

Cantilever bridge Spring cantilever Resin bonded FPD

mghazy@mans.edu.eg

Combined

mghazy2002@yahoo.com

Implant supported

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

1- Fixed- Fixed bridge:

It is a bridge where the abutments and the pontics are all soldered together and the bridge is cemented at both ends to the abutments.

Removable bridge: It is a bridge where each retainer consists of two parts. One fixed to the abutment tooth. And one soldered to the pontic and the bridge can be removed at the will of and by the patient for cleansing purposes.

2- Fixed- supported bridge:

It is a bridge which is not actually joined to one of the terminal abutment teeth but is connected to it by means of a non rigid connector allowing some individual movement of the abutment tooth.

mghazy@mans.edu.eg

mghazy@mans.edu.eg

Cantilever bridge:
It is a bridge where the pontic is fixed to and derives its support from one or double retainers at one end only while the other end is unsupported.

Spring Cantilever Bridge:

It is a cantilever bridge where the pontic is at the end of resilient curved arm deriving its support from an abutment remote from the edentulous space

mghazy@mans.edu.eg

mghazy@mans.edu.eg

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Dental material used in fixed Prosthodontics

Direct restorative filling
Amalgam glass ionomer Composite Compomer

Material used for laboratory procedures

Gypsum product Wax Custom tray material

Impression materials
Placement of the implant. Gum tissue sutured over the implant. It will take 4 -6 months for the implant to fuse with the bone

Cements
Zinc phosphate Glass-ionomer Composite resin

Irreversible hydrocolloids (alginate) Reversible hydrocolloids (agar agar) Rubber base impression material
Polysulfide Polyvinylsiloxane Poly ether
mghazy@mans.edu.eg

Material used for extra coronal restoration

Direct casting alloys Ceramic Polymer acrylic

Temporary crown boned to adjacent teeth during the healing phase.

mghazy2002@yahoo.com

Extra coronal restorations

Full coverage Partial coverage

Intra coronal restoration

Direct filling materials Gold Amalgam Composite Glass ionomer Compomer Inlays and onlays Gold Ceramic

Porcelain laminate veneer

mghazy2002@yahoo.com mghazy@mans.edu.eg

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Prosthodontic Motto
I hear, I forget I see, I remember I touch, I understand
Chinese Proverb

Class of 2013/ 2014 September29,2013 Presented by Dr. Mohamed H. Ghazy

Professor of Fixed Prosthodontics Email mghazy@mans.edu.eg
mghazy2002@yahoo.com

ANY QUESTIONS about the last lecture?

Text Book and Readings

Contemporary Fixed Prosthodontics
SF Rosenstiel, MF Land , J Fujimoto

Fixed prosthodontics notes

Cairo university

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Student message

Please DR Mohamed .. can you tell me what is an inlay-onlay restoration? ... i read it consists of both inlay and onlay .. but i can't imagine it ... Thanks a lot Dr Mohamed

Inlays and Onlays

A tooth with a large filling (left) before preparation for onlay and a tooth with a slightly smaller filling (right) before preparation for an inlay.

A tooth with a large filling (left) after preparation for onlay and a tooth with a slightly smaller filling (right) after preparation for an inlay.

The onlay and inlay are prepared on a plaster model of the teeth.

The onlay and inlay have been fitted. The onlay covers more than the inlay.

10

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Crown Fabrication
Purpose of Prosthodontics

Improve appearance Improve speech Promote good oral hygiene Stabilize arch and occlusion
mghazy@mans.edu.eg

1. Tooth Preparation, Including Build-Up 2. Impression 3. Temporization 4. Model (Cast) and Die Fabrication 5. Wax-Up 6. Investing and Casting 7. Crown Adjusting and Polishing 8. Clinical Try-In and Cementation

mghazy@mans.edu.eg

11

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Tooth Preparations
mghazy@mans.edu.eg

Partial veneer crown Preparations

mghazy@mans.edu.eg

Build-Ups
Pin Retained Preformed Posts Custom Cast Post and Core
Teeth Preparations for fixed dental prosthesis
mghazy@mans.edu.eg mghazy@mans.edu.eg

12

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Build-Ups

Pin Retained

Build-Ups Preformed Posts

mghazy2002@yahoo.com

mghazy2ymans.edu.eg

Build-Ups Custom Cast Post and Core

Temporaries
Custom made acrylic Relined polycarbonate crowns

Preformed metal crowns

mghazy@mans.edu.eg mghazy@mans.edu.eg

13

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

Impressions
Full arch impressions

Model (Cast) and Die Fabrication

Double bite impressions

mghazy@mans.edu.eg mghazy2002@yahoo.com

Restorations

mghazy2002@yahoo.com

mghazy@mans.edu.eg

14

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

mghazy2002@yahoo.com

mghazy2002@yahoo.com

Pouring the impression with Gypsum Products

Microstone

GYPSUM PRODUCTS: Plaster Stone, Cast Stone Improved Stone, Die Stone

Specialty Stones Investment Materials

Proportion P and L Working Cast with Removable Dies

Transfer to impression Edentulous Cast Orthodontic Model Working Cast

Removable Die with Waxed Inlay

mghazy@mans.edu.eg

mghazy@mans.edu.eg

15

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

16

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy@mans.edu.eg

17

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

mghazy@mans.edu.eg

mghazy2002@yahoo.com

mghazy2002@yahoo.com

mghazy2002@yahoo.com

18

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

mghazy2002@yahoo.com

mghazy2002@yahoo.com

Overview of INDIRECT RESTORATIONS

Impressions Models/Casts

Waxing
Investing Casting Finishing/Polishing Cementing
mghazy2002@yahoo.com mghazy2002@yahoo.com

19

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

The metal ceramic restoration tried on the master cast

mghazy2002@yahoo.com mghazy@mans.edu.eg

PFM FABRICATION

mghazy@mans.edu.eg

mghazy@mans.edu.eg

20

Dr Mohamed Hamed Ghazy

Email:mghazy@mans.edu.eg

"Each time you are honest and

conduct yourself with honesty, a success force will drive you toward greater

success. Each time you

lie, even with a little white lie, there are strong forces pushing you toward failure."
mghazy2002@yahoo.com

21