Mounted Diagnostic Casts
● Vocab words
o Diagnostic cast: life size reproduction of a part or parts of oral cavity. For purpose of
study or treatment planning
o Primary impression: NEGATIVE LIKENESS or copy of the surface of an object. IMPRINT of
teeth and ADJACENT STRUCTURES
o Rim lock trays
o Stock trays
o Inter-occlusal record
o mounting jig= facebow
o land area
o porous cast
● Need to have correct LENGTH and WIDTH for tray
o 6mm space all around
● Primary impression: 1 to 1 H20 to alginate
● Maxillary impression landmarks
o Accurate detail of teeth
o Frenulum
o Full roll
o Hammular notch complete
o Palate and rugae reflect actual tissue
● Mandibular impression landmarks
o Full roll
o Labial frenulum
o Accurate detail of teeth
o Retromolar pad
● NEED TO TRIM INTER-OCCLUSAL RECORD
o Only need tip of cusps
● Microstone
o Expansion is .12%
o 140 g per 40mL water
● Land area: 1-2mm
o dense smooth surface with no positive nodules/voids
● Thickness: 10-15 mm
● Before mounting: make 3 slots using arbor band or stone cutter
Articulating
● Mounting stone
o Expansion is .08%
o 100g per 26 mL water
● use inter-occlusal records
● also use tongue depressor, hot glue/ sticky wax. Connect the two casts
Tooth Preparation
● Steps
o Occlusal reduction
o Buccal and lingual reduction
o Interproximal
o Finalize axial walls
o Finish prep
o Evaluate prep
● Mechanical considerations
o Retention
o Resistance form
o Preventing deformation of restoration
● Principles of tooth preparations
o Biologic
o Esthetic
o Mechanical
● Retention
o Prevents REMOVAL of the restoration along the PATH OF INSERTION or long axis of the
tooth preparation
o The essential element of retention is opposing vertical surfaces of the same prerpation
such as the buccal and lingual/ mesial and distal walls
● Resistance
o Prevents dislodgement of the restoration by forces directed in the APICAL or OBLIQUE
direction and prevents any movement of restoration under occlusal forces
● Geometry
o Diameter
▪ Higher diameter, higher retention
▪ Higher diameter, lower resistance
o Height
▪ HEIGHT ISNT A HUGE DEAL WITH RETENTION
o Taper
▪ Ideal: parallelism
▪ For teeth prepared for single crowns or fixed dental prosthesis
● Important to preserve facio-proximal and linguo-proximal corners of a tooth prep to provide
RESISTANCE
Definitive Impression
● Need to make sure finish line is exposed
● Tissue displacement
o Mechanical displacement
▪ 1) Non-impregnanted cord or 2) impregnated with epinephrine or aluminum
potassium sulfate OR with 3) alternative paste system (potassium sulfate)
▪ Steps
● Isolate the prepared teeth
● First cord is placed (thin-prep cord) PREPARATION CORD: loop the
cord around the tooth and gently push into the sulcus (its ends do not
overlap, avoid overpacking). Wet before putting in sulcus
▪ 00 or 000 size
o first step is always isolation!
o Start in interproximal cause it’s the thickest part of gingiva
there
● second cord (larger) IMPRESSION CORD: saturate with astringent, and
placed over first cord
o 0, 1,2,3 depending on sulcus size
o overpacking can lead to recession of soft tissue
o keep end of cord out
o Chemical
o Surgical
● Double cord technique
o Need to make sure finish line is exposed by retracting tissue !!!
o Put two cords, remove second cord. First cord stays in during recording impression.
Working Cast/Pindexing
● Vocab
o Base former (plastic)
o Plastic caps= base stopper
o Metal pins
o Die
o Ditching= die trimming
● Definition
o Replica of tooth surfaces, residual ridge areas and other parts of dental arch/ facial
structures used to fabricate dental restoration or prosthesis in the lab using indirect
technique. Also named final cast
● Artificial crowns and fixed partial dentures are fabricated in the lab using indirect technique
● Jade stone expansion is .18%
o Compensates shrinking of metal alloy
● Cast
o Full arch are poured to 20-25 mm thickness above cervical areas. Leaving palatal portion
exposed as possible.
o Taper walls with an arbor band so they taper 20 degrees
● Pin hole position
o 18, 22, 28,30,31
o make sure the cast is dry!!!
● Adhesive such as cyanoacrylate is applied to heads of pins
Interim Restorations
● Need
o ESF for single crown
o Correct interproximal contact
o Margin adaptation
o Occlusal contacts (closed/open margin)
o Ortho resin (clear acrylic)
o Selected shade of jet acrylic
o Monomer
o Intagliosurface
o Pumice + water
o Robinson wheel
● Techniques
o Direct
o Indirect
o Indirect-direct
● Interim restoration definition
o Fixed or removable dental prosthesis or maxillofacial prosthesis designed to enhance
esthetics, stabilization and/or function for a limited period of time, after which it is to
be replaced by a definitive dental or maxillofacial prosthesis. Often such prostheses are
used to assist in determination of the therapeutic effectiveness of a specific treatment
plan or the form and function of the planned for definitive prosthesis.
● PMMA= poly methyl meth acrylate
o Powder and liquid mixed together 3:1
o Addition polymerization takes place
o Hardening steps (SSDRS)
▪ Sandy
▪ Stringy
● Place into ESF during this phase
▪ Doughy
▪ Rubbery
▪ Stiff
● Composition of liquid
o MONOMER:
▪ Highly volatile
o Activator
▪ Organic amine (teritery amine)
o Inhibitor
▪ To prevent monomer from polymerizing during sevreal years of stoage
(hydroquinone)
o Cross linking agent
▪ Dimethacrylate
● Coposition of powder
o Polymer methyl methacrylate
▪ In the form of beads or pearls
o Initiator
▪ To initiate polymerization (benzoyl peroxide)
o Plasticizer
▪ Alters physical properties
o Opacifier
▪ To increase opacity
o Pigments
▪ To give required shades
● Process of polymerization
o initiator w double bond in powder (benzoyl peroxide) + activator in liquid (tertiary
amine) --> free radical which is combined with monomor in lquid which creates another
free radical that linkes two methyl methacrylate beads together. When theyre linked,
polymerization has taken place
● Autocured composite resin advantages over PMMA
o no taste/odor
o virtually no shrinkage
o very good fit
o color stiff
o shorter setting time
o good esthetics
o good strength and STIFFNESS-prone to shattering
o higher cost
o you can sandblast if it breaks
● Errors
o do not place pressure directly on prepared tooth
o locking in undercuts and hard to get off: not lifting ESF- mix before it sets
o short margin- cutting vertically
