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QUESTION
For Fixed
Prosthodontics, list the top ten ways a dentist can help the dental lab
technician produce a quality restoration.
ANSWER
| 1.
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Provide
a complete and comprehensive treatment plan, even if you only plan
to accomplish a small portion of the plan at this time. This allows
the technician to foresee where you and the patient are headed, and
by being part of the team, they may be able to forecast upcoming problems
or concerns.
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| 2. |
Send
pre-operative information, such as study models and photos of the
patient. Also list any expectations that the patient may have esthetically.
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| 3. |
Properly
prepare the tooth or teeth. The dental technician needs a clear margin
design and adequate reduction. For a porcelain-fused-to-metal restoration,
a minimum of .5 mm is needed for the metal coping and 1-1.5 mm is
necessary for the porcelain to prevent fracturing. If this occlusal
reduction is not possible, please state if you would then prefer a
metal island, reduction of the opposing tooth, or a call from the
technician to discuss the case.
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| 4. |
Before
impressioning, achieve total hemostasis. Pack a gingival retraction
cord for the appropriate length of time. If hemostasis cannot be accomplished,
it may be necessary to temporize the prepared tooth and have the patient
return another day for the final impression. Remember, quality always
supercedes convenience.
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| 5. |
Take
an accurate impression. For multiple units, a full arch impression
is preferred. For single units, aquad tray is acceptable, but be wary
of flimsy triple trays. If there is inadequate lateral support, distortion
will occur.
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| 6. |
Take
a passive bite registration. Most patients find it difficult to close
an anesthetized jaw into a true centric bite when encountering the
bulkiness of a triple tray loaded with impression material on both
sides. A separate bite registration using a small amount of material
will yield better results.
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| 7. |
Place
a well-fitting temporary restoration. Proximal contact should be closed,
gingival margins contoured and tight fitting, and proper occlusion
verified. A poor-fitting temporary will contribute to insertion problems
at the cement appointment.
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| 8.
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Shade,
shade, shade. Yes, take the shade three times. Once is for the hue
(color), twice, for the chroma (intensity of color), and finally,
for the value (grayness). Include any additional information such
as increased translucency at the incisal, craze lines, or areas of
hypoplasia. Diagrams and drawings are a great help. Also, remember
to choose the shade before you prepare the tooth. Air from the handpiece
will dehydrate adjacent teeth and they will appear lighter than their
true shade. Use multiple light sources and allow the patient to approve
of the selection.
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| 9.
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Return
the comment cards. The dental technician needs to know what worked
as well as what may need to be modified. Did it need little or no
adjustments to seat? Was the patient satisfied with the shade?
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| 10.
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Lastly,
and most importantly, TALK with your technician. Communication is
the key to unlocking many doors. Communication is the key to success.
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