Resin-Bonded Fixed Partial Dentures
Fig 28-38 The coping margins are trimmed with a sandpaper disk. Fig 28-39 The resin toping is sft on the abulmcnl prepar
Framework Fabrication
Fig 28-40 The resin projerin > the edentulous Fig 28-41 The resin bar should be thick enough faciolingually so
space until they almust touch. llial il will not break without extending too far facially or lingually.
when the entire pattern has been completed. Place the Remove the pattern from the cast and check the thick-
copings back on their respective dies to insure that all of ness of the lingual surface of the retainer resin copings
the margins have been sufficiently relieved. with an Iwanson thickness gauge (Fig 28-43) The thick-
ness should be no less than 0.4 mm and preferably clos-
Lubricate the stone master cast with the same oily die er to 0.6 mm.
lubricant used on the dies. Transfer the copings to the
stone master cast (Fig 28-39). Build a small projection Wax Pattern
into the edentulous space from the proximal surface of
each coping, dipping a small brush first into monomer Add blue inlay wax to the bar of resin connecting the two
and then polymer (Fig 28-40). Do not build them into con- retainers. Build up the wax to the full contour of the final
tact at this time. Set trie cast aside for a while and allow pontic (Fig 28-44) Carve it flush on the lingual surface so
the resin to polymerize. This allows much of the shrink- that it blends with the milled lingual surface of the resin
age distortion to occur before the retainers are joined bar (Fig 28-45). If there are any voids in the resin, fill them
together into one piece, where the shrinkage could warp in with wax and carve them flush. Use a spoon excavator
the fixed partial denture framework. or a discoid carver to cut 1.0-mm-deep grooves into the
facial, lingual, and gingival surfaces of the pontic. The
Examine the lingual thickness of the resin copings and
adjoining bar (Fig 28-41). Check them in occlusion
against the opposing cast, and if they are too thick,
remove the excess with a large acrylic bur (Fig 28-42).
Resin-Bonded Fixed Partial Denture
Fig 28-44 The pontic
Fig 28-48 Because the cutback pontic slightly overlaps the facial Fig 28-49 From a gingivotarial viewpoint, space is visible under
aspert of the ridge, no space is visible. the cutback pontic.
grooves on the incisal edge should be 1.5 mm deep (Fig Investing and Casting Armamentarium
28-46) These grooves will insure an adequate thickness
of porcelain when it is added to the metal framework 1. Bunsen burner
later. Carve away the wax to the depth of the grooves (Fig 2. Cotton pliers, brush
28-47), duplicating the outer contours of the full-sized 3. Hollenbeck carver, PKT no 2 waxing instrument
pontic in the cutback version. 4. 8-gauge wax sprue, conical metal sprue former
5. 500-cc Vac-U-Mixer, vacuum tubing
To insure uniform space for porcelain under the pontic, 6. Investment, split casting ring
and to prevent overshortening of the supportive metal 7 Vibrator
framework in the gingival area, no space should be visi- 8. Water measure, spatula
ble under the pontic when it is viewed from the facial sur- 9. Modeling clay, 5-inch plastic square
face (Fig 28-48). However, when the cast is tilted, there 10. Bench knife
should be space under the pontic when it is viewed from 11. 8.0 dwt of casting alloy
a gingivofacial (Fig 28-49) or incisolingual direction
Investing and Casting
Retrieve the refractory cast and, without painting any
lubricant on the cast, transfer the pattern to it. Add blue Attach an 8-gauge wax sprue to the lingual surface of the
inlay wax around the entire periphery of both retainer pontic Cut it off over the hole in the palate that will
copings with a PKT no. 2 waxing instrument (Fig 28-50). accommodate the conical metal sprue former (Fig 28-
The wax pattern will not be removed from this cast, and
investing will take place directly on it. Carefully carve the
margins with a heated, dull-edged beavertail burnisher
on the facial (Fig 28-51) and lingual surfaces (Fig 28-52).
Resin-Bonded Fixed Partial Dentu
hole in the palate of the refractory c
the lingual surface of Ihe pat-
53). Then insert the sprue former through the hole until sides, place the molar end of the cast into the investment
the cone is completely seated (Fig 28-54). It should con- in the center of the ring. Wiggling the cast gently,
tact the end of the wax sprue, or come close to it. Attach immerse it compietely in the investment, rotating it 90
the wax sprue smoothly to the metal sprue former (Fig degrees to an inverted position with the base of the cast
28-55). parallel with the bottom of the ring. The teeth on the cast
are toward the table, and the metal sprue former should
Vacuum mix the investment material, and with a large protrude slightly from the investment.
brush flow the material onto the lingual surface of the pat-
tern, painting investment around all of the margins and When the investment has set completely, remove the
under the wax sprue (Fig 28-56). Be sure to paint invest- investment-filled ring from its base. Use a bench knife to
ment under the pontic so all of that space is completely bevel into the base of the metal sprue former. When there
filled with investment. The hand holding the brush is rest- is adequate access to grasp the sprue former, remove it
ed on the vibrator, but the cast itself is not vibrated. Turn from the investment. Burn out the invested pattern in a
the cast over and paint material on the facial surface of the burnout furnace, going from room temperature to 732°C
anterior portion of the refractory cast. Take care to paint (1,350°F) in 45 minutes. Heat soak the ring at that tem-
investment along all of the facial margins of the retainers. perature for 90 minutes. Transfer the ring to the crad!e of
an induction casting machine (Ticomatic 3001-C,
With modeling clay, seal a split casting ring to a 5-inch Ticonium Co) and cast the fixed partial denture with a
ceramic tile or plastic square. Then fill the split ring with sufficient weight of suitable casting alloy For the
investment flush with the top. Grasping the cast by its
Framework Fabrication
machine described here, the minimum amount of alloy is Delivery Armamentarium
8.0 dwt (Rexillium III, Jeneric/Penlron).
1 Rubber dam, clamp, snd frame
Allow the ring to cool to room temperature before 2. Low-speed contra-angle handpiece, rubber
breaking the casting out. After removing the large pieces
of investment with sharp instruments, remove the final cup, pumice
layer with aluminum oxide air abrasion (Fig 28-57). Using 3. Etchant, cotton pellets
the technique described in Chapter 22, finish the por- 4. Small brush, mixing well
tions of the framework on the lingual surface that will 5. Mixing pad, plastic spatula
remain unveneered. 6. Mylar strip, dental floss
7. Explorer, sealer
Porcelain can be added at this point, although the 8. Complete adhesive resin kit
novice operator would be well-advised to try the casting
in the mouth to insure its fit before proceeding. Even if the
metal framework is tried in, there will be a try-in after
porcelain has been added to insure the maximum esthet-
ic result. Unless the particle-roughened or cast mesh
technique has been employed in the fabrication of the
fixed partial denture, it is now ready for air abrading.
Resin-Bonded Fixed Partial D
Fig 28-60 The abraded FPD is placed in dishwashing detergent in Fig 28-61 Noble-metal alloy retainers are tin plated.
Fig 28-62 Abu1 Fig 28-63 Fichant h applied k
small rubber sponge.
Delivery Sequence washing liquid in an ultrasonic unit for 2 minutes (Fig 28-
60), and then rinse.
The delivery sequence is an important procedure that
must be accomplished efficiently because of the limited If the FPD is made of a high noble alloy, such as
working time of bonding resins. It is also critically impor- Olympia, the inner surfaces of the retainers should now
tant to the longevity of the prosthesis. Contamination or be plated with a layer of tin approximately 0.5 jim thick.
improper seating ol the fixed partial denture at this time Ground the tin plating instrument (Micro-tin, Danville
will adversely affect the success of the restoration. The Engineering) to the pontic metal. Rub the active tip with
technique described here is for Panavia 21 (Kuraray Co), a pellet soaked with plating solution over the inner sur-
faces of the retainers for 5 to 10 seconds each (Fig 28-
The process begins with the isolation of the abutment 61). The surface will become a slightly lighter shade of
teeth with a rubber dam (Fig 28-58).M ^ 1 0 G Refresh the gray.37 Rinse the restoration thoroughly in water and
tooth-facing surfaces of the retainers by air abrading again for 2 minutes in detergent in an ultrasonic cleaner.
them again just before inserting the restoration. Use 30 to Rinse, blow the FPD dry, and place it in an accessible but
50 urn aluminum oxide with a hand-held etcher (Micro- protected place.
etcher, Danville Engineering). Two to three seconds per
cm2 at 4.2 to 7 kg/cm^ (60 to 100 psi) pressure should be The next step is to clean the tooth preparations with
sufficient to restore the matte finish (Fig 28-59). Wash the unfavored, nonfluoridated pumice and a rubber prophy
casting in running water for 1 minute, place it in dish- cup (Fig 28-62). Wash off the pumice and apply a 40% to
50% phosphoric acid solution to the abutment prepara-
tions with a cotton pellet (Fig 28-63).107 Leave the etchant ing the material onto the mixing pad (Fig 28-68). Stop
on for 60 seconds, rinse, dry, and reapply for 15 sec- when it clicks. If you think you have too small a quantity
onds.97 Wash the abutment preparations thoroughly with for the restoration you are placing, turn the handle anoth-
water for 20 seconds (Fig 28-64), followed by drying (Fig er full turn until it clicks again. Mix the two stripes of paste
28-65) Play a light stream of air over the preparation. for 20 to 30 seconds over a wide area (Fig 28-69). The
Place a Mylar strip between each abutment and the material is anaerobic, so it will set only if oxygen is kept
neighboring tooth. from it. Therefore, spreading it out will keep it from setting
prematurely.
Now you are ready to mix the primer and the resin to
bond the prosthesis in place. Dispense one drop each of Apply a thin, bubble-free layer of paste to the retainers
ED Primer liquids A and B into a well in the mixing dish (Fig 28-70). Do no! place any on the tooth, as the primer
and mix for 4 seconds (Fig 28-66). Use a sponge pled- will accelerate it and the restoration will not seat com-
get to apply the mixture to the preparations (Fig 28-67). pletely. Seat the restoration with firm finger pressure (Fig
Allow it to set for 60 seconds and then apply a gentle 28-71) and hold it for 60 seconds. Use a small brush
stream of air to evaporate the volatile substances, leav- (Proxabrush, John O. Butler Co, Chicago, IL) to clean
ing a glossy surface. Do norapply primer lo the metal; do away excess resin.
not rinse
Use a disposable brush to apply Oxyguard II to the
Remove the cap from the dispenser and slowly rotate margins of the retainers to keep oxygen away from the
the rectangular "knob" clockwise one full turn, dispens- setting resin (Fig 28-72). The Mylar strips placed
Resin-Bonded Fixed Partial Dentures T
between each abutment tooth and the tooth ad|acent will X Denehy GE, Howe DF' A conservative approach to the miss-
insure that they do not bond together. A piece of floss ing anterior tooth. Quintessence Int 1979; 723-29
can also be positioned between the abutment tooth and
its neighbor when the fixed partial denture is placed. It is 5. Eshleman JR. Douglas HB, Barnes D: The acid etch bond-
pulled out through the contacts before the resin has set ed porcelain fused to metal fixed partial denture. Va Dent J
completely. After 5 minutes remove the Oxyguard II with 1979, 56:16-19.
cotton rolls and a water spray.
3. Livaditis GJ: Cast metal resin-bonded retainers for posterior
Before the resin has become too hard, the excess must teeth. J Am Dent Assoc 1980; 110:926-929.
be removed because it will become irritating to the gin-
gival tissue. An explorer or sealer can be used around '. Livaditis J, Thompson VP: Etched castings: An improved
the gingival margins and those exposed areas that can retentive mechanism for resin-bonded retainers J Prosthet
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contacts of the abutment teeth and of the adjacent teeth
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and its adjacent neighbor should be very carefully chromium cobalt structures. J Dent Res 1976, 55.328-332
cleaned and examined.
). Tanaka T, Atsuta M, Uchiyama Y, Kawashima I: Pitting cor-
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Index
Abrasives seating completeness, 392 crack-tip shielding, 434
definition of. 385 Agar. See Reversible hydrocol- secondary crystals, 435
forms of, 387 tooth preparations
loid. anterior vs posterior teeth, 437f
Knoop Hardness Numbers. 3861 Air brush. 398f armamentarium, 152
Abutments All-ceramic crowns depth-orientation grooves, 152,
contraindications, 89 alumina-reinforced, 436 153f
criteria for attributes, 79t incisal reduction, 152, 153f
casting, 435 labial reductions. 152. 153f
crown-root ratio, 89-90 cementation lingual reductions, 152, 153f
overview, 89 overview, 153f
periodontal ligament area, armamentarium, 413 radial shoulder, 152, 153f
cements shoulders, 151
91-93 All-metal hygienic pontic, fabrica-
root configuration, 90-91 removal of excess, 415
root surface areas, 91t, 91-93 selection of, 414 casting, 500, 502
definition of, 1 shade, 414-415
diagnostic casts of, 8 excess wax removal, 498, 499f
endodontically treated teeth, finishing of rough surfaces, investing, 500, 502
414,451 plaster matrix, 500, 501f
195 wax coping, 498
pier, 95-96. 96f proximal contacts, 414, 451 Ailoys
secondary, criteria for selecting, stone smoothing, 451 ADA classification, 366
contraindications for, 151-152 base metal
93 description of, 78
tilted molar, 97-100 Dicor system, 435 advantages, 365-366
tooth-supported fixed partial fabrication beryllium content, 366
casting of, 381-382
dentures coping, 439, 440f fluoride use, 509
conventional, 88 die preparation, 437-438 gold alloys and, differences,
resin-bonded, 88 finish line, 437
Acid etching, 537 porcelain addition, 441 366
Adjustments, for gold restorations sealants, 438 melting temperatures, 366
contours, 397 shade selection, 439 for metal-ceramic restorations,
esthetics, 397 sintering, 439
margin finishing, 392-394 456-457
marginal adaptation, 392 slip material, 438, 439f nickel-chromium, 366
occlusal tooth reduction, 437 soldering, 530
nonworking movement, 395, fracture susceptibility of, 151 casting of. See Casting.
historical origins, 434 factors that affect choice of, 367
396f illustration of, 80f gold
overcorrection, 394, 396f indications, 139 base metal alloys and, differ-
protrusive interferences, 395, longevity of, 80t, 80-81, 82t
occlusal reduction. 126 ences, 366
396f reinforcement methods investing of, 367
working movement, 395, 396f
proximal contacts. 391-392 coping, 434
crack bridging, 434
crack-tip interactions, 434
types II and III, casting of Anterior teeth advantages of. 28
armamentarium, 373 dowel cores, for endodonlically description of, 27
burnout, 373 treated teeth Articular disc, description of, 11
illustration of, 194f Articulators
cleaning the cast, 375-376 arcon, 27-28
common defects, 377f length determinations, I95f border movements duplicated
pickling, 375, 377f rationale for, 194
procedure, 373-375 retentive properties, 194-195 by, 25
gold-palladium guidance of mandible, 54, 60, condylar movements, 30, 32f
casting definition of, 25
67,70 Denar, 56
armamentarium, 381 metal-ceramic crowns fully adjustable, 26
procedure, 381 Hanau, 63-71
for metal-ceramic restorations, armamentarium, 142 nonadjustable, 25, 26f
axial reduction, 145, 146f nonarcon, 27-28
457 depth-orientation grooves, 144, principles of, 25, 26f
soldering semiad|ustable, 25
145f tooth-transverse horizontal axis
burnout, 528-529
casting, 528-529 finishing lines, 146 relationship, 29-30
indexing, 527 incisal reduction, 144, 145f Whip Mix, 47
investing, 527-528 labial reduction, 144, 145f Asbestos, 370
preparatory procedures, 526 lingual reduction, 145
recommended uses, 366 Aspiration of restorations, 412
Aluminous porcelain jacket crown occlusal reduction, 142, 143f Axial contours
fracture resistance, 434 overview, 148f
layers of, 434f proximal reduction, 145 full veneer crown, 340f
Aluminum oxide putty molds, 142, 143f wax patterns
radial shoulder, 146, I48f
abrasive use of, 385-386 bulges, 339, 340f
Alveolar bone loss, root resection shoulders, 146 emergence profile. 338-340
three-quarter crown, tooth faciolingual, 337-338
and, 214 proximal, 337
Amalgam preparations for Axis, hinge
for prefabricated dowels, 197 armamentarium, 162 arbitrary location of, 30
restorations axial reduction, 162, 163f and articulator hinge axis, effect
bevels, 162, 163f
complex flares, 162, 163f of dissimilarities,
attributes, 79t grooves, 162, 163f 25. 26f-27f
description of, 76 incisal reduction, 162, 163f
illustration of, 76f lingual reduction, 162, 163f trial and error method to deter-
longevity of, 80t. 80-81, 82t occlusal reduction. 162 mine, 29
offset, 162, 163f
cores for, 185 overview, 164f B
indications for, 73 74, 171 path of insertion, 161-162
longevity of, 80t, 80-81. 82t Ante's law, 92 Banthine, 259
plaque control, 73 Antiflux, 509 Base, 187, 188f
simple Antirotational devices, for die in Base metal alloys
attributes, 79t working casts advantages, 365-366
description of, 76 curved dowel pin, 318-320 beryllium content, 366
illustration of, 76f Di-Lok tray, 330-333 fluoride use, 509
longevity of, 80t, 80-81, 82t Pindex system, 321 gold alloys and, differences, 366
strength of, 197 straight dowel pin, 315-318 melting temperatures, 366
Andrews bridge system, 493 Antisialogogues, for fluid control, for metal-ceramic restorations,
Angle of convergence, 119
Angle of divergence, 119 258-260 456-457
Anterior guidance Appearance zone nickel-chromium, 366
Denar facebow and articulator, soldering, 530
definition of, 419 Base metal restorations
60-61, 62f incisors adjustments, 400
Hanau facebow and articulator finishing, preliminary
incisal lines, 423
custom settings, 67, 68f-70f interproximal contacts, 423 armamentarium, 399
mechanical, 70. 71f midline, 421 procedure, 399-400
Whip Mix facebow and articula- pontics, 487-488 polishing, 400
smile line, 419
tor, 54, 54f-55f Arcon articulators
try-in. 400 Canines Pindex system, 321-329
Beilby layer, 385 in appearance zone, 422 straight dowel pin, 315-318
Bennett angle, 14, I5f fixed partial dentures for requirements, 314
Beryllium configurations, one tooth, 109 requirements for, 309
description of, 100 wilh separate die
carcinogenic properties of, 366, resin-bonded, 543f armamentarium, 309
incisal lines, 423f description of, 309
457 die preparation, 311-314
description of, 366 Carat, 509 difficulties associated with, 309
Bevels Caries finish lines, 312, 313f
hardening agents, 313
contraindications for, 129-130 resin-bonded fixed partial den- impression pouring, 309-311
functional cusp ture and, 541 Catapres, 260
Cellulose liners, for casting rings,
description of, 127 restoration of, glass ionomer
for full veneer crown, 140 370
metal-ceramic crown, 149, use, 74, 75f Cementation
Casting
150f all-ceramic restorations
three-quarter partial veneer alloys, 365-366 armamentarium, 413
definition of, 365 cements
crowns, 156, 157f dowel-core patterns, 376, 378
indications for, 128-129 gold alloys, types II and II! removal of excess. 415
mesio-occluso-distal onlays, selection of. 414
armamentarium, 373 shade, 414-415
175-176, 176f-177f burnout, 373 finishing of rough surfaces,
proximo-occlusal inlays, 173, procedure, 373-375
gold-palladium alloys 414
173f armamentarium, 381 proximal contacts, 414
procedure, 381 ceramic crowns, 452
three-quarter crown, 162, 163f induction, 366 description of, 405
Bifurcational ridge, intermediate, inlay patterns, 376, 378 dowel cores, 412-413
voids, soldering repair of fixed partial dentures, 415
215 armamentarium, 520 gold inlays, 412
Bilateral balanced occlusion, 19, contraindications, 519 metal-ceramic crowns, 415
indications for, 519 with polycarboxylate cement,
355 Casting rings, for gypsum-bond-
Binangle chisel, 146, 147f ed investments, 370 409-410
Biologic width, 191 Casting temperature, 378 with resin cements, 410-412
Bis-acryl composite Casts, working vent holes for cement escape,
mounting of
characteristics of, 227t 406f
overimpression-fabricated Denar facebow and articulator with zinc phosphate cement
mandibular, 58-60
crowns maxillary, 56-58, 59f cement preparation, 407
description of, 243 mandibular isolation, 406, 407f
procedure for creating. Hanau iacebow and articulator pulp protection, 406-407
mandible, 66-67, 67f removal of excess cement,
243-246 maxillary, 64-65, 66f
Black triangles, 493 409
Blow holes, soldering repair of, Whip Mix facebow and articu- restoration seating, 408f, 409
lator vital tooth considerations. 406
519 Cemented restorations
Bonding, 441 mandibular, 50-52 external surface
Border movements. 25 maxillary, 49-50 finishing of, 385
Box form with removable die plaque accumulation on, 385,
advantages over separate die,
for extensively damaged teeth, 386f
314 indications for, 73-74
181-182, 183f antirotational devices, 314, internal surface. 385
substitution of. 123 plaque control. 73
Brazing, 509 315f provisional
methods of orienting die in
Bridge. See Fixed partial denture. armamentarium. 233
Brightness. SeeValue. cast procedure, 233-234
Bruxism, occlusion and, 16-17 curved dowel pin, 318-320 Cements
Burnout Di-Lok tray, 330-333
definition of, 365
gold alloys, types II and III. 373
high-temperature, 367
low-temperature, 367
Burs. 1341-135t. See also specific
procedure, armamentarium.
Busch Silent, 387
bonding mechanisms description of, 130 positioning of, 11
micromechanical bonding. full veneer crown, 141 Connectors
heavy, 130
400, 401f illustration of, 131f definition of. 1
molecular adhesion, 400-401 resin-bonded fixed partial den- nonrigid
nonadhesive luting, 400, 401 f
resin ture, 542 cross-pin and wing, 532-533
dovetail, 530-531
autopolymerizing, 404-405 Check bites, 27. 35 for pier abutments, 96, 97f,
tensile strength, 400 Chroma, 426
types of, 402t-403t 530-531
zinc phosphate, tensile strength, Clenching, occlusion and, 16-17 split pontic, 531-532
Clonidine hydrochloride, 260 for tilted molar abutments, 99f,
400 Colloid solutions. See
99-100
Central incisors, fixed partial den- Hydrocolloid. rigid, contraindications for,
tures for Color, for shade selection of
95-96
complex ceramic restorations soldering. See Soldering.
characteristics of, 426 Contacts, proximal
more than two teeth, 114 effect of daily functions, 426 adjustments for, 391-392
two teeth, 112 effect of light sources ail-ceramic restorations, 414,
pier abutments, 115
simple artificial, 426 451
natural, 426 metal-ceramic restorations, 458
one tooth, 106 factors that affect, 425 soldering
two teeth, 110 Color blindness, effect on shade
Centric occlusal interference, 16, armamentarium. 518-519
selection, 425 indications for. 518
17f Composite resin Coping
Centric relation, 11 for fabrication of wax patterns,
Centric relation record autopolymerizing, 402t
dual cure, 402t 335-336
armamentarium, 35 properties of, 402t metal-ceramic restorations
description of, 35 restorations
technique alloy used, melting range of,
attributes. 79t
anterior programming device, criteria for, 73-74 456
inlays, 75, 76f description of, 455
38. 39f longevity of, 80t, 80-81, 82t extent of veneered area,
baseplate wax adaptation to Condensation silicones
armamentarium, 297 458-461
maxillary teeth, 37-38 characteristics of, 282t facial margins, 461-462
bimanual manipulation, 35-36. costs of, 283t, 285f metal collar, 461
disadvantages, 297 occiusal contacts, 458
36f impression making, 297-299 overview, 457
manipulation of mandible. 36f, putty/reline, 297 proximal contacts, 458
reaction of, 297 thickness of metal, 457-458
37 viscosity, 283, 284f for reinforcement of all-ceramic
wettability, 281
patient positioning, 36-37 Condyles crowns, 434
registration base use, 39, 40f guidance Core
Ceramic liners, for casting rings,
on Denar facebow, 60, 61f composite resin, 185
370 effect on posterior teelh, 20, functional. See Functional core,
pin-retained, 185, 186f
Ceramic restorations 21f Crack bridging, 434
inlays Crack-tip interactions, 434
on Hanau facebow. 67, 68f-69f Crack-tip shielding, 434
attributes, 79t on Whip Mix facebow, 52f, Cross-pin and wing, 532-533
description of, 77 Crown-root ratio, for abutment
illustration of, 77f 53-54
longevity of, 80t, 80-81, 82t inclination of, on arcon and teeth. 89-90
veneer crowns Crowns
all. See All-ceramic crowns, nonarcon articulators. 27, 28f
attributes, 79t movements of all-ceramic, 414, 451
cementation, 452 definition of, 1
description of, 78 articulator reproduction of, 25, endodontic access preparation,
illustration of, 80f
longevity of, 80t, 80-81, 82t 30, 32f 194
shade selection, ractors that pantographic recordings, 30, full veneer crown, 78, 139
lengthening of, for gmgival
affect, 78 32f
Ceramming, 435
Chamfers. See also Finish lines.
exposure, 276-277 fabrication process, 234-238 crowns, 435
longevity of, 80i, 81, 82t visible light-cured Die, for working casts
metal-ceramic, 78, 142, 148.
armamentarium, 239 removable
152 fabrication process, 239-240 advantages over separate die,
partial veneer, 139, 164 templates, 226
pin placement, 183, 184f Custom resin trays 314
preformed analomic metal adhesives, 290 antirotational devices, 314.
armamentarium, 291
armamentarium, 251 composition of, 290-291 315f
procedure, 251-255 preparation, 291-293 methods of orienting die in
provisional, for endodontically stock trays and, comparison.
cast
treated tooth. 250, 251f 290 curved dowel pin. 318-320
retention and resistance, 119, uses of. 290 Di-Lok tray, 330-333
Cutback areas. 476, 477f Pindex system, 321
120f Cuttle, abrasive use of, 386 straight dowel pin, 315-318
tapering of, 120 requirements, 314
three-quarter, 162-168 Dam, rubber, 257, 557-560 separate
Crucible, 373 Damaged teeth, extensively
Curve of Spee. 347 armamentarium, 309
Curve of Wilson, 347 destruction areas, 181, 182f description of, 309
Cusp-fossa orthodontic adjuncts die preparation, 311-314
curve of Spee, 347 difficulties associated with. 309
curve of Wilson. 347 extrusion, 191-193 finish lines, 312, 313f
cusp placement and occlusal regaining interproximal space, hardening agents, 313
impression pouring, 309-311
contacts, 347f 189-190 Di-Lok tray, 330-333
definition of, 346 preparations for Disinfection, of impressions, 304
description of, 341t Disocclusion
illustration of, 341f bases, 185 definition of, 20
wax patterns of cores, 185 molar, 20
retention and space Distofacial root, of maxillary molar,
origins, 347 methods to avoid excessive
procedure, 347-350 resection of, 216-217
Cusp-marginal ridge destruction, 181 Dovetail connector, 530-531
cusp placement and occlusal substitutive methods for creat- Dowel cores
contacts, 342f ing aspiration during try-in, 412
description of, 340 box forms, 181-182, 183f cemented vs threaded, 197
wax patterns of overview, 181 classification of, 197
pins, 182-184 for damaged teeth, 194f
mandibular teeth, 344-346 vital teeth, modifications for, endodontically treated teeth
maxillary teeth, 343-344
Cusps 187, 188f for anterior teeth
Depth-orientation grooves illustration of, 194f
mandibular teeth, 3411 length determinations, 195f
maxillary teeth, 342t all-ceramic crowns, 152, 153f rationale for, 194
Custom provisional restorations full veneer crown, 139-140 retentive properties, 194-195
overimpression-fabricated laminate veneer, 443f-444f
metal-ceramic crowns, 144, 145f illustration of, 194f
alginate Devitrification, 481 insertion procedure, 199, 200f
Diabetic patients, considerations length determinations, 195f
armamentarium, 228 for posterior teeth, 195
cementation process for, 3 prefabricated, with amalgam or
Diagnostic casts, 7-8
armamentarium, 233 Diagnostic workup resin core, 197
procedure, 233-234 rationale for, 194
tooth preparation, 229-232 casts, 7-8 retentive properties. 194-195
bis-acryi composite crown, elements of, 1-2 tooth preparation for
full-mouth radiographs, 8
243-246 history taking, 2-4 armamentarium, 198
shell-fabricated intraoral examination, 6-7 custom cast
Diamond, abrasive use of, 385
armamentarium, 241 Diamond depth cutter, 442 armamentarium, 202
description of, 241 Dicor system, for all-ceramic canal preparation, 202-204
procedure, 241-243 finishing and cementation,
template-fabricated
fixed partial denture 204-206
armamentarium, 234
instrumentation, 202t tissue damage from, 269 interproximal contacts, 423
resin pattern fabrication, Emergence profile, 338-340 midline, 421
Emery, abrasive use of, 385 smile line, 419
204, 205f Endodontically treated teeth conversational, 424
occlusal reduction, 198 Etching
Peeso reamer use, 198, 199f abutment use, 195 acid, 537
pin placement, 198, 200f anterior teeth. 194
prefabricated with amalgam dowel cores electrochemical, 538
Examination, intraoral, 6-7
or composite resin core for anterior teeth Expansion methods, for shrinkage
armamentarium, 198 illustration of, 194f
diameter recommendations. length determinations, 195f during investing
rationale for, 194 hygroscopic, 367
198, 200f retentive properties, 194-195 setting, 367
occlusal reduction, 198 thermal, 367-368
Peeso reamer use, 198, insertion procedure, 199, 200f wax pattern, 367
for posterior teeth, 195 Extensively damaged teeth,
199* prefabricated, with amalgam or
pin placement, 198, 200f 181-185
for pulpless teeth, 194f resin core, 197 Extracoronal restorations, 77
wax patterns, investments for, tooth preparation for Extrusion, for damaged teeth
376, 378 arch wire, 192, 193f
Dowel inlays, 206 cast
Dowel pins, for orienting remov- biologic width, 191
able die in working cast armamentarium, 202 determination of amounl need-
curved, 318-321 canal preparation, 202-204
straight finishing and cementation, ed, 192f
armamentarium, 316 204-206 endodontic treatment, 192
location, 315 instrumentation, 202t ferrule effect, 191
procedure, 316-318 resin pattern fabrication, pin placement, 192. 193f
Dry mouth, 3
204, 205f Facebows
Edentulous ridge prefabricated with amalgam articulator use, 29-30
classification of, 491, 492f caliper-style, 30, 31f
deformities, 491, 492f or composite resin core Denar
pontic modification, 493 armamentarium, 198 anterior guidance settings,
surgical correction diameter recommendations,
Class I! and III defects, 495, 60-61, 62f
198, 200f armamentarium, 56
496f occlusal reduction, 198 cast mountings, 56-60
donor tissue, 495, 497 Peeso reamer use, 198, condylar guidance settings,
incisions, 494, 495f
Edentulous spaces, prosthetic 199* 60, 61f
treatment of pin placement, 198, 200f description of, 56
fixed partial denture, 86, 106 factors that affect, 194 interocclusal records, 56,
removable partial denture, 85, lack of coronal structure, 197
posterior teeth, 195 57f-58f
87 provisional crown, 250, 251f description of, 29
Electrochemical etching, 538 rationale for, 194-197 Hanau
Electrosurgery root resections, 212-222
subgingival collars, 195 anterior guidance
armamentarium, 273 Epileptic patients, considerations custom settings. 67, 68f-70f
contraindications, 272-273 mechanical, 70, 71f
crown lengthening, 276-277 for, 3
current types, 270, 271f Epimine resin, 226 armamentarium, 63
edentulous cuff removal, 276 Epinephrine, in gingival retraction cast mountings, 64-67
gingival sulcus enlargement, components of, 63f
absorption of, 261-262 condylar guidance, 67, 68f
274-276 contraindications, 261 interocclusal record, 63-64,
grounding, 271-272, 272f physiologic effects, 261
recommended uses, 269 studies of, 261t 64f-65f
technique, 273-274 Esthetics hinge axis points, arbitrary, 30
absolute, 424-425 transverse horizontal axis
appearance zone
recordings, 29
definition of, 419 Whip Mix
incisors
incisal lines, 423
anterior guidance, 54, 54f-55f procedure, 399-400 framework
armamentarium, 47 gold restorations
cast mountings, 49-52 configurations, 545f-546f
components of, 47f postcementation, 399 duplication, 548-550
condylar guidance, 52f, 53- 54 investing and casting,
intercondylar distance record- preliminary
armamentarium, 387 555-557
ings, 49 procedure, 387-388, 389f resin coping, 551-553
interocclusal records, 47, 48f, wax pattern, 550, 553-555
margins, for wax patterns, longevity uncertainties, 540,
49
Facial roots, of maxillary molar, 352-353 541t
Fixed partial dentures Maryland, 537-538
resection of, 219 Rochette, 537-538
Facial veneer, 441-449 abutment teeth tooth preparation
Ferrule effect, 191 crown-root ratio, 89-90
Fineness, 509 ideal types, 86 armamentarium, 547
Finish line exposure axial reduction, 548f
arch curvature, 93, 95f axial reductions, 542
chemicomechanical, 260-262 biomechanical considerations, countersinks. 547f
criteria for, 261 examples of, 543f
decongestants, 262 93, 94f-95f finish lines, 542
electrosurgery canine-replacement. 100 grooves, 542, 543f, 548f
cantilever, 100-102 lingual reduction, 547f
armamentarium, 273 casting of, single-piece. 510 occlusal reduction, 542, 547f
contraindications, 272-273 cementation, 415 proximal reduction, 547f
crown lengthening, 276-277 configurations rests, 545f
current types, 270, 271f sequence, 547-548
edentulous cuff removal, 276 complex vertical stops. 542
gingival sulcus enlargement. Virginia, 539
more than two teeth. 114-115 soldering
274-276 one tooth, 109
grounding, 271-272, 272f two teeth, 112-113 breaking of joint, 520
recommended uses, 269 simple distortions, 513
technique, 273-274 gold alloy
tissue damage from, 269 one tooth, 106-109
mechanical, 260 two teeth, 110-111 distortions, 513
retraction cord connectors, 95-97, 99-100, indexing, 510-513
armamentarium, 262 investing, 513-516
chemical types, 263t 530-533 procedure, 516518
epinephrine, 261-262 definition of, 1 single-piece casting, 510
placement of, 262, 264-267 deflection of, 93, 94f metal-ceramic alloys
rotary curettage, 268 faciolingual movement, 95, 97f indications for, 520-521
rubber dam, 260 illustration of, 3f methods, 521
Finish lines implant-supported, 88-89 postveneer, 526-529
bevels, 130 metal-ceramic preveneer, 521-525
bucco-occlusal, 132 methods of, 521
chamfer, 130, 13H coping wax pattern, 503-506 preveneer, 520-521
configurations for marginal incisal configuration. 502 proximal contacts, 518-519
metal coping, 502 repair of casting voids,
integrity, 130-132 rigidity, 503
heavy chamfer. 130, 131f soldering 519-520
knife edge, 132 requisites for. 509
placement of indications for, 520-521 single-piece casting, 510
methods, 521 tooth-supported
near alveolar crest. 133 postveneer, 526-529 conventional, 87-88
subgingival, 133 preveneer, 521-525 resin-bonded, 87-88
supragingival, 133 occlusal interferences, 86f wax patterns, 379
radial shoulder, 130, I31f pontics, 491 Fluid control methods
shoulder with a bevel. 131, 132f for posterior teeth, 105 antisialogogues, 258-260
Finishing provisional restorations, tem- high-volume vacuum, 258
rubber dam, 257
base metal restorations, prelimi- plate-fabricated, 234-238 saliva ejector, 258
nary resin-bonded
armamentarium, 399 advantages, 540
cast mesh, 538-539
cements, 539
contraindications, 541
delivery, 557-561
disadvantages, 540-541
Svedopter, 258, 259f Garnet, abrasive use of, 386 finishing
vacuum attachments, 257f Gingiva postcementation, 399
Fluorides, use on base metal preliminary, 387-388, 389f
examination of, 6 precementation polishing,
alloys, 509 finish line exposure 397-399
Flux, 509
Freedom of displacement, chemicomechanical, 260-262 try-in
criteria for. 261 anesthesia use, 388
121-122, 122f decongestants, 262 armamentarium, 389
Fritting, 433 electrosurgery, 269-276 precautionary procedures, 391
Full veneer crown importance of, 260 provisional crown
mechanical, 260 patient hypersensitivity, 389
axial contours, 340f retraction cord removal. 391
definition of, 1
esthetics, 73 armamentarium, 262 Golden rectangle, 422
illustration of, 2f, 78f chemical types, 263t Gold-palladium alloys
indications for, 78, 139 epinephrine, 261-262
longevity of, 80t, 80-81, 82t placement of, 262, 264-267 casting, 381
partial veneer crown and, com- rotary curettage, 268 for metal-ceramic restorations,
rubber dam, 260
parison, 139,155 sulcus, enlargement using elec- 457
prevalence of, 139 trosurgery, 269, 274-276 soldering
retention of, 73-74 Glass ionomer
tooth preparation for attributes of, 79t burnout, 528-529
bacteriostatic properties. 404 indexing, 527
armamentarium, 139 composition of. 404 investing, 527-528
axial reduction, 140f, 141 disadvantages, 404 preparatory procedures, 526
chamfer, 141 factors that affect, 404 Green stones, 387
depth-orientation grooves, hybrid, 403, 405 Grooves
indications for, 74, 75f depth-orientation
139-140 longevity of, 80t, 81, 82t all-ceramic crowns, 152, 153f
finishing lines, 141 properties, 402-404 full veneer crown, 139-140
functional cusp bevel, 140 pulp protection for extensively laminate veneer, 443f-444f
occlusal reduction, 139, 140f metal-ceramic crowns, 144,
overview, 139, 141f damaged teeth, 185
seating groove, 141 Glass-ceramics 145f
Functional core, for functionally retentive, 123
Dicor system, 435 Group function, 19, 355
generated path technique IPS-Empress system, 435
armamentarium, 355-356 Glenoid fossae, 11 H
fabrication process, 356-361 Gold alloys
Functional cusp bevel casting of, 373-375 Heatless stones, 387
description of, 127 Hemisection, 212, 219-221
for full veneer crown, 140 casting defects, 377f
for metal-ceramic crown, 149 cleaning the castings, 375-376 Hepatitis B, protective measures,
for MOD onlay, 176 pickling the castings, 375, 377f 8
for partial veneer crown, 156 investing of, 367
Functionally generated path tech- properties of, 366 Hinge axis
Gold restorations arbitrary location of, 30
nique adjustments and articulator hinge axis, effect
contours, 397 of dissimilarities, 25, 26f-27f
advantages, 355, 364 esthetics, 397 trial and error method to deter-
definition of, 355 margin finishing. 392-394 mine, 29
functional core, 355-361 marginal adaptation, 392
variations of, 364 occlusal, 395-396 History, patient, considerations
proximal contacts, 391-392
wax pattern, 362-364 seating completeness, 392 for, 3-4
Furcation cementation, 405-412 Horizontal symmetry, 421
Hue, 426
definition of, 212 Hybrid ionomer cements, 403,
effect on root resections
405
contraindications, 214 Hydrocolloid, reversible, 282-289
indications, 214
flutes, 212 irreversible and
preparation finish lines, 212, concomitant use, 286
disadvantages of, 286
213f
Fusing temperature, 433 origins of, 285
storage of impressions, 286 effect of disinfectant solu- cementation, 452
wettability, 281 tions, 304 description of, 77
Hygienic pontic, all-metal definition of, 1
casting, 500, 502 hydrophobic nature, 293 dowel-inlay, 206
die trimming, 497 impression making, 293-296 illustration of, 2f
excess wax removal, 498, 499f packaging of, 293 indications, 171
investing, 500, 502 viscosity, 284f metal, 77
plaster matrix, 500, 501f polyvinyl siloxane proximo-occlusal, preparations
wax coping, 498 armamentarium, 299
Hygroscopic expansion, 367 bonding strength of, 290 for
Hypoglycemia, considerations for, characteristics of, 282t armamentarium, 172
costs of, 283t, 285f bevel, 173, 173f
3 effect of disinfectant solu- flares, 172-173, 173f
gingivoaxial groove, 172, 173f
I tions, 304 marginal ridge, 172
formulations, 299 occlusal outline, 172
Implant-supported fixed partial hydrophobic nature, 299 overview, 174f
denture impression making, 299-302 proximal box, 172
overi impression -fabricated wax patterns, 335
characteristics of, 87t Interferences, occlusal, 16,
description of, 88 crowns, 243-246
retainers, 89 packaging of, 299 17f-18f
span length, S7t, 88 viscosity, 284f Intermediate bifurcational ridge,
Impressions for pin-retained restorations,
definition of. 281 215
disinfection of, 304 303-304 Interocclusal records
hydrophilic vs hydrophobic, 281 shear rate, 283
materials for In-Ceram articulator use of, 27
centric relation
condensation silicones description of, 435-436
armamentarium, 297 tooth preparation for, 437 armamentarium, 35
characteristics of, 282t Incisal curve, 419 description of. 35
costs of, 283t, 285f Incisal reduction technique
disadvantages, 297 all-ceramic crowns, 152, 153f
impression making, 297-299 laminate veneer, 443-444, 444f anterior programming device,
putty/reline, 297 metal-ceramic crowns, 144, 145f
reaction of, 297 three-quarter crown, 162, 163f 38, 39f
viscosity, 283, 284f Incisors baseplate wax adaptation to
wettability, 281
central, fixed partial dentures for maxillary teeth, 37-38
criteria, 281 complex bimanual manipulation,
factors in selecting
more than two teeth, 114 35-36, 36f
cost, 284-285 two teeth, 112 patient positioning, 36-37
viscosity, 283, 284f pier abutments, 115 registration base use, 39, 40f
wettability, 281, 283 simple definition of, 27
polyether
one tooth, 106 maximum intercuspation, 41-43
armamentarium. 302 two teeth, 110 Interproximal space
characteristics of, 282t esthetic length of, 419, 420f
costs of, 283t, 285f incisal edges, 423 loss from tooth migration, 189f
description of, 302 preparation for resin-bonded methods to regain, 189-190
effect of disinfectant solu- fixed partial denture, 543f Intracoronal restorations
Index, soldering amalgam, 73-82, 185, 197
tions, 304 armamentarium, 511 composite resin
function of, 510-511
impression making, 302-303 gap width, 513 attributes, 79t
wettability, 281 procedure, 511-513 criteria for, 73-74
polysulfide Infectious disease inlays, 75, 76f
armamentarium, 293 patient history taking for, 4 glass ionomer. 74-82, 185,
characteristics of, 282t protective measures, 8-9, 9f
costs of, 283t, 285f Inlays 402-404
in custom resin trays, cementation, 412
inlays. See Inlays,
290-291 retention and resistance. 119,
120f
stress concentrations, 171
Investing
for casting
base metal alloys, 381-383
crowns, gold alloy, 373-375 443f-444f 13-14
dowel-cores, 376, 378 facial reduction. 442, Mandibular teeth
expansion methods, 367, 378 cusp placement, 341t
fixed partial denture, gold 443f_444f cusp-marginal ridge, 344-346
finish line, 442 hemisection, 219-221
alloy, 513-516 finishing, 445 incisors
general procedure, 368-373 incisal reduction, 443-444,
gold-palladium alloys, 381 esthetic length of, 419, 420f
inlays, gold, 376. 378 444f preparation for resin-bonded
definition of, 365 lingual reduction, 444f,
for soldering fixed partial denture, 543f
metai-ceramic alloys, 523-525, 444-445 root surface areas, 91t
proximal reduction, 442-443. Margins
527-528 beveling vs not beveling,
type III gold, 513-516 443f
Investments, casting working casts, 445-446 128-130
gypsum-bonded, 368 Laminating, 442 finishing
phosphate-bonded,378f Lateral incisors, fixed partial den-
requirements of, 367 tures for for gold restorations. 392-394
IPS-Empress system, 435 complex, 112-113 for wax patterns, 351-353
Irreversible hydrocolloid, 281, 286 pier abutments, 115 Maryland bridge, 537-538
simple Masseter muscle, palpation of, 5f
Joining, 509 one tooth, 106-107 Maxillary teeth
Joints, solder. See Soldering. two teeth, 110 cusp placement, 342t
Lateral interocclusal record. 44 incisors
Keyway. 202, 204f, 530 Light sources
Knoop Hardness Numbers (KHN), artificial, 426 esthetic length of, 419, 420f
natural, 426 incisal edges, 423
386t Lingual reduction preparation for resin-bonded
all-ceramic crowns, 152, 153f
Laminate veneer laminate veneer, 444f, 444-445 fixed partial denture, 543!
composite resin, 441 metal-ceramic crowns, 145 root resections of
definition of, 1 resin-bonded fixed partial den-
porcelain distofacial root, 216-217
description of, 441 tures, 547f mesiofacial root, 217
developmental stages of, three-quarter crown, 162, 163f root surface areas, 911
441-442 Loops, for resin-bonded fixed Maximum intercuspation record,
dies
refractory, 446-448 partial dentures, 546f 4"M3
removable, 445 Lost salt technique, 539 MCR. See Metal-ceramic restora-
gingival retraction, 445
illustration of, 3f M tions
impression, 445 Mesiofacial root, of maxillary
indications, 442 Mandible
porcelain application movement molar, resection of, 217
color, 449 Bennett angle, 14, 15f Mesio-occluso-distal onlays
procedure for, 449-451 anterior guidance, 22-23 attributes, 79t
shade selection, 449 condylar guidance, 20, 21f description of, 77
preformed, 442 description of, 15-16 illustration of, 77f
provisional restorations, 445 molar disocclusion, 20 indications for, 175
silane coupling agent, 442 posterior. SeeTemporo- longevity of, 80t, 80-81, 821
tooth preparation stress concentrations, 175, 176f
depth-orientation grooves, mandibular joint. tooth preparations
effect of anterior teeth, 15-16 for mandibular molars, 178f
excursion, 14, 15E for maxillary teeth, 175-178
protrusive, 14, 15f Metal inlays
types of, 13, 14f attributes of, 79t
positioning of Class 1, 174, 175f
dysfunctional, 12f Class 3, 174, 175f
healthy, 13f Class 5, 174, 175f
methods to guide, 11 description of, 77
terminal hinge axis theory. illustration of, 77f
tooth preparations for, 174
Metal-ceramic restorations (MCR)
all-ceramic restorations and,
comparison, 455
alloy types, 456-458 selective use of. 148 N
bonding mechanisms, 456 thickness requirements, 142
cementation, 481-482 finishing, 481-482 Nickel-chromium alloys, 366, 541
composition of, 455 fixed partial dentures Noble alloys
coping design coping wax pattern. 503-506
incisal configuration, 502 ADA classification system, 365
extent of veneered area, metal coping, 502 gold content, 365
458-461 requirements, 502 heat treatment, 471
rigidity, 503 melting temperature, 456
facial margins, 461^562 soldering, 520-521 types of, 365
metal collar, 461 metal coping, 455 Nonadhesive luting, 400-401
occlusal contacts, 458 pontics, 485, 486f. 491 Nonarcon articulators, 27
overview, 457 porcelain addition Nonrigid connectors
proximal contacts, 458 all-porcelain margin fabrica- cross-pin and wing, 532-533
thickness of metal, 457-458 dovetail, 530-531
tion. 472-475 for pier abutments, 96, 97f.
anterior teeth, preparations for dentin and enamel porcelain,
530-531
axial reduction, 145, 146f 476-481 split pontic, 531-532
depth-orientation grooves, opaque application, 471 for tilted molar abutments, 99f,
soldering of, 520-521
144, 145f surface treatment, 481 99-100
finish lines, 146 wax pattern Nonworking occlusal interference,
incisal reduction, 144, 145f
labial reduction, 144, 145f all-wax technique, 462-464 395.396
lingual reduction, 145 heat treatment, 470^71
occlusal reduction, 142, 143f plastic shell technique, Occlusion
overview, 148f bilateral balanced, 19
proximal reduction, 145 464-468 diagnostic casts, 8
putty molds, 142, 143f treatment of alloy surface, evaluation of, 4-5
radial shoulder. 146, 148f interferences, 16
shoulders, 146 468-470 mandibular movement. See
attributes, 79t Metamerism, 426
cementation, 415 Methantheline bromide. 259 Mandible, movement.
description of, 78, 142 Micromechanical bonding, of mutually protected, 19-20
esthetics, 436 normal vs pathologic, 16-18
illustration of, 80f cements unilateral balanced, 19
indications, 139 description of, 400 wax patterns
longevity of, 80t, 80-81, 82t illustration of, 401f
path of insertion, 126f Missing teeth, treatment options cusp-fossa
on periodontally weakened cusp placement and occlusal
for
teeth. 211 case presentation, 89 contacts, 347f
plaque accumulation, 385, considerations, 85, 89 definition of, 346
removable partial denture, description of, 341t
386f illustration of, 341f
posterior teeth 85-86, 87t, 88 origins, 347
MOD onlay, 77-82. 175-178 procedure, 347-351
indications, 148 Molars cusp-marginal ridge
preparation for cusp placement and occlusal
fixed partial dentures
armamentarium, 149 cantilever, 102 contacts, 342f
axial reductions, 149, 150f description of, 340
depth-orientation grooves. sfoi for mandibular teeth,
one tooth, 108-109
149, 150f pier abutments, 117 344-346
facial reduction, 149, 150f two teeth, 111 for maxillary teeth, 343-344
functional cusp bevel, 149. resin-bonded, preparations for, Onlay
definition of, 1
150f 544f illustration of, 3f
gingival bevel, 150f, 151 reverse three-quarter crown, mesio-occluso-distal, 77-82,
occlusal reduction, 126, 175-178
160, 161f Organo-tin silicones, 281-285,
149, 150f Molecular adhesion, of cements.
overview, 152f
radial shoulder 151 400-401
Moore's discs, 387
Mutually protected occlusion,
19-20, 355
T
297-299 root resection armamentarium, 165
Overimpressions, for custom pro- capacity of resected roots, 214 axial reductions, 165, 166f
contraindications, 214 bevel, 167
visional restorations, alginate, description of, 212
228 effect of narrow furcations, 214 cutting holes, 164-167
Oxidation cycle, 470 failure rates, 222 flares, 166
indications, 214 grooves, 165, 166f
Palatal root, of maxillary molar, success rates, 222 offset, 166, 167f
resection of, 217, 218f, 219 technique, 214-215 overview, 168f
tooth preparation and crown Pins
Palladium alloys dowel
gold configurations
casting, 381 mandibular hemisection, curved, 318-321
for metal-ceramic restorations, straight
457 219-221
soldering, 526-239 maxillary distofacial root, armamentarium, 316
silver, 365 location, 315
216-217 procedure, 316-318
Pantograph for extensively damaged teeth,
air-activated, 32f maxillary facial roots, 219
condylar movement recordings, maxillary mesiofacial root. 182-184
in restorations, impressions for,
30, 32f 217
description of, 30 maxillary palatal root. 217, 303-304
fully adjustable articulator use uses of, 182-183
218f, 219 Pitting, 509
with, 30 skyfurcation, 221, 222f Polishing materials
Partial dentures Periodontium, finishing line effects abrasives, 385-387
description of, 385
fixed See Fixed partial den- on,132-133 Polycarbonate crown, anterior,
tures. Phosphate-bonded investments
247-249
removable, 85-87. 233 alloy types, 378 Polycarboxylate cements
Partial veneer crowns armamentarium, 378
casting cementation, 409-410
advantages of, 155 compressive strengih, 403t, 404
definition of, 1 base metal alloys, 381-383 indications, 404
gold-palladium alloys, 381 properties of, 403t
full veneer crown and, compari- expansion methods, 378 pulp protection for extensively
son, 139, 155 indications for, 378
investing procedure, 378-381 damaged teeth, 185
illustration of, 21, 78f sprue former, 378-379 tensile strength, 403t
indications, 78, 155 Pickling, 375, 377f Polyether
lingual grooves, 155, 156f Pier abutments
longevity of, SOt, 80-81, 821 description of, 95-96 armamentarium, 302
retention of, 155 fixed partial denture configura- characteristics of, 282t
seven-eighths crown, 160, 161f costs of, 283t, 285f
three-quarter, tooth preparations tions, 115-118 description of, 302
illustration of, 96f effect of disinfectant solutions,
for nonrigid connectors, 96, 97f
anterior teeth Pin hole 302
drilling of, 183 impression making, 302-303
overview, 164f placement areas, 184f wettability, 281
path of insertion, 161-162 substitution of, 123 Polyether urethane dimethacry-
tooth preparation. 162-163 Pindex system
pin-modified, 165-168 base to cast, process for late, 303
posterior teeth, 155-160 Poly(ethyl methacrylate), 227t
Path of insertion, 124, 125f adding, 326-327 Polymerization, 226
Periodontal ligament area, abut- components, 322f Polymerization shrinkage, 74
ment evaluation using, 91-93 description of, 321 Polyfmethyl methacrylate),
Periodontically weakened teeth pin holes, 324
finish line modifications pouring of impression, 321 226-227
furcation flutes, 212, 213f Pink stones, 387 Polysulfide
location, 211-212
nonresection methods, success Pin-modified three-quarter crown armamentarium, 293
rates of. 222t indications for, 164 characteristics of, 282t
retention, 164 costs of, 283t, 285f
tooth preparation for in custom resin trays, 290-291
effect of disinfectant solutions,
302 addition to metal-ceramic Posterior teeth
hydrophobic nature, 293 restorations contact with mandible, 20
impression making, 293-296 fixed partial dentures for, 105
packaging of, 293 all-porcelain margin fabrica- metal-ceramic crowns
viscosity, 284f tion, 472-475 indications, 148
Polyvinyl siloxane preparation for
armamentarium, 299 dentin and enamel porcelain, armamentarium. 149
bonding strength of, 290 axial reductions, 149, 150f
characteristics of, 282t 476-481 depth-orientation grooves.
costs of, 283t, 285f opaque application, 471
effect of disinfectant solutions, constituents, 433t 149. 150f
firing temperature classification, facial reduction, 149, 150f
302 functional cusp bevel, 149,
433
formulations, 299 fusing temperature, 433t 150f
hydrophobic nature, 299 glazed, 442 gingival bevel, 150f, 151
impression making, 299 302 laminate veneer occlusal reduction, 149, 150f
overimpression-fabricated overview, 152f
description of, 441 radial shoulder, 151
crowns, 243-246 developmental stages of. selective use of, 148
packaging of, 299 three-quarter crowns
viscosity, 284f 441-442 armamentarium, 155
Poly(vinylethyl methacrylate), dies axial reductions, 156, 157f
buccal bevel, 159
characteristics of, 227t refractory finishing lines. 156, 157f
Pontic fabrication of, 446-448 flares, 158-159, 159f
tooth preparation, 449 functional cusp bevel, 156,
in appearance zone, 487-488
cantilever, 101 removable, 445 157f
definition of, 1. 485 gingival retraction, 445 grooves, 156-157, 157f-158f
designs illustration of, 3f occlusal reduction, 155-156,
impression, 445
conical, 490 indications, 442 157f
considerations for, 485 porcelain application offsets, 159
hygienic, 489-490 overview, 160f
ovate, 490-491 color, 449 Precious metals. See Noble
ridge lap, modified, 489
saddle, 488 procedure for, 449-451 alloys.
fabrication shade selection, 449 Prefabricated provisional restora-
all-metal hygienic preformed, 442
provisional restorations, 445 tions
armamentarium, 497 silane coupling agent, 442
casting, 500, 502 tooth preparation anterior polycarbonate crown
die trimming, 497 depth-orientation grooves, armamentarium, 247
excess wax removal, 498, procedure, 247-249
443f-444f
499f facial reduction, 442, overview, 247
investing, 500, 502 preformed anatomic metal
plaster matrix, 500, 501f 443f-444f
wax coping, 498 finish line, 442 crown
metal-ceramic, 491 finishing. 445 armamentarium, 251
modifications incisal reduction, 443-444, procedure, 251-255
for edentulous ridge, 493 Premolars
of surfaces, 485, 486f 444f dowel cores, 206
postinsertion hygiene, 487-488 lingual reduction, 444f, fixed partial dentures
prefabricated facings, 491 configurations for
span length, deflection created 444-445
one tooth, 107-108
by, 93, 94f proximal reduction, 442-443. pier abutments, 116
split, 531-532 443f two teeth, 110-111
tissue contact with ridge, 485, resin-bonded, preparations for,
working casts, 445-446
487f metallic oxide additions, 433 543f-544f
modifiers, 433 Preparations, tooth. See Tooth
types of, 485. 486f properties necessary for dental
use of, 8 preparations.
Porcelain use, 433 Pro-Banthine (propantheline bro-
Porcelain jacket crown. See All-
mide), 259
ceramic crowns.
Porcelain release agent, 472
Porcelain-fused-to-metal restora-
tion. See Metal-ceramic
restorations, crown.
Protrusive incisal path, 22 Radial shoulder, 146, 148 primer, 559
Protrusive incisal path inclination, Radiating symmetry, 421 pumice cleaning, 558
Radiographs, full-mouth. 8 disadvantages, 540-541
22 Reduction. See specific reduc- framework
Protrusive occlusal interference configurations, 545f-546f
tion. duplication, 548-550
adjustments, for gold restora- investing and casting, 555-557
tions, 395, 396f Removable die, for working casts resin coping, 551-553
advantages over separate die, wax pattern, 550-555
definition of, 16 314 longevity uncertainties. 540,
illustration of, 18f antirotational devices, 314, 315f 5411
Provisional restorations methods of orienting die in cast Maryland bridge, 537-538
classifications curved dowel pin, 318-320 Rochette bridge. 537-538
Di-Lok tray, 330-333 tooth preparation
direct vs indirect, 225-226 Pindex system, 321-327 armamentarium, 547
prefabricated vs custom. 225 straight dowel pin, 315-318 axial reductions, 542. 548f
criteria for, 225 requirements. 314 countersinks. 547f
custom, techniques for examples of, 543f
overimpression-fabricated pro- Removable partial dentures finish lines, 542
abutment teeth requirements, grooves, 542, 543f, 548f
visional crowns, 228-234 lingual reduction, 547f
she11-fabricated, 241-243 85-86 occlusal reduction, 542, 547f
template-fabricated characteristics of, 87t proximal reduction, 547f
indications for, 85 rests, 545f
fixed partial denture, 234-238 provisional crown placement sequence, 547-548
visible light-cured, 239-240 vertical stops, 542
definition of, 225 under, 233 Virginia bridge, 539
endodontically treated teeth, Resin cements Resistance, 119-125
Restorations
250, 251f autopolymerizing, 404-405 base metal
prefabricated, techniques for cementation, 410-412 adjustments. 400
composite finishing, preliminary. 399-400
anterior polycarbonate crown, polishing, 400
247-249 autopolymerizing, 402t try-in, 400
dual cure, 402t ceramic. See Ceramic restora-
preformed anatomic metal properties of, 402t tions.
crown, 251-255 restorations considerations for, 73-74
gold
removal of, 391 attributes, 79t
resins, 226, 227t See also spe- criteria for, 73-74 contours, 397
inlays, 75, 76f esthetics, 397
cific resin. longevity of, 80t, 80-81, 82t margin finishing, 392-394
Proximal contacts dentinal bonding agent use with, marginal adaptation, 392
occlusal
adjustments for, 391-392 405
all-ceramic restorations, 414 description of, 404 nonworking movement, 395,
metal-ceramic restorations, 458 problems associated with, 405 396f
soldering, 518-519 zinc phosphate cement and,
Proximo-occlusal inlays, prepara- overcorrection, 394, 396f
comparison, 405 protrusive interferences,
tions for
Resin-bonded fixed partial den- 395, 396f
armamentarium. 172 working movement, 395,
bevel, 173, 173f advantages, 540
flares, 172-173, 173f 396f
gingivoaxial groove, 172, 173f cast mesh, 538-539 proximal contacts, 391-392
marginal ridge, 172 seating completeness, 392
occlusal outline, 172 cements, 539 finishing
overview, 174f
proximal box, 172 contraindications, 541 postcementation, 399
Pterygoid muscles, palpation of, preliminary, 387-389
armamentarium. 557
6f sequence
Pulpless tooth, restoration of. See
abutment teeth, 557f, 558
Endodontically treated teeth. air abrading, 557f, 558
bonding, 559
Quick Mount facebow, 47-50 excess removal, 561
Oxyguard II. 559, 560f
precementation polishing, implant-supported fixed partial configuration of, 90-91
397-399 denture, 89 crown-root ratio, 89-90
Root amputation, 212
try-in Retention and resistance, of Root canal. See Endodontically
restoration
anesthesia use. 388 treated teeth.
armamentarium, 389 extracoronal, 119, 120f Root caries. See Caries.
precautionary procedures, factors that affect Root resection
391 freedom of displacement, capacity of resected roots, 214
provisional crown contraindications, 214
121-122, 122f description of, 212
patient hypersensitivity, 389 internal feature substitution, effect of narrow furcations, 214
removal, 391 failure rates. 222
marginal integrity 123-124, 124f indications, 214
beveling vs not beveling, occlusogingival length, success rates, 222
technique, 214-215
128-130 122-123, 123f tooth preparation and crown
finish line configurations, path of insertion, 124, 125f
intracoronal. 119, 120f configurations
130-132 overview, 119 mandibular hemisection,
metal-ceramic. See Metal- small teeth vs large teeth, 120,
219-221
ceramic restorations, 121f maxillary distofacial root.
provisional. See Provisional Retraction cord
216-217
restorations. armamentarium, 262 maxillary facial roots, 219
retention and resistance chemical types, 263t maxillary mesiofacial root, 217
epinephrine, 261-262, 264-267 maxillary palatal root, 217,
extracoronal. 119, 120f placement of, 262, 264-267
factors that affect Reverse occlusion, 20 218f, 219
Reversible hydrocolloid skyfurcation, 221, 222f
freedom of displacement, agar content, 286 Rotary curettage, 268
armamentarium, 286 Rouge, abrasive use of, 386
121-122, 122f characteristics of, 282t RS-1, 146, 147f
internal feature substitution, conditioner for, 286, 287f Rubber base. See Polyether;
cooling of, 285
123-124, 124f costs of, 283t, 285f Polysulfide.
occlusogingival length, impression making, 286, Rubber dam
122-123, 123f 288-289 description of, 257
path of insertion, 124, 125f irreversible, 286 for gingival retraction. 260
intracoronal, 119, 120f origins of, 285 illustration of, 257
overview, 119 storage of impressions, 286 Rubber points, 387
small teeth vs large teeth. 120, wettability, 281 Rubber wheels, 387
Richwil Crown Remover, 391 RUM position, 11
121f Ridges
shade selection Saliva ejector, 258
cusp-marginal Sand, abrasive use of, 386
color cusp placement and occlusal Sandbiaster, 398f, 399
Separating discs, 387
characteristics of, 426 contacts, 342f Seven-eighths crown, 160, 161f
effect of daily functions, 426 description of, 340 Shade selection
effect of light source, 426 wax patterns of
factors that affect, 425 color
sequence mandibular teeth, 344-346
maxillary teeth, 343-344 characteristics of, 426
patient positioning, 428 edentulous effect of daily functions, 426
recording of findings, 430 effect of light sources
removal of distractions, 427 classification of, 491, 492f
shade guide, 427 deformities, 491, 492f artificial, 426
shade tabs, 428-430 pontic modification. 493 natural, 426
translucency, 426 surgical correction factors that affect, 425
structural durability, factors that metal-ceramic restorations,
Class II and III defects, 495, 481-482
affect
axial reduction, 128 496f
functional cusp bevel, 127 donor tissue, 495, 497
occlusal reduction, 126 incisions, 494, 495f
tooth preparation for. See Tooth Rochette bridge, 537
Root, tooth
preparation.
tooth structure preservation, 119
Retainers
definition of, 1
T
sequence attributes of, 79t Solders
patient positioning, 428 extracoronal. See Crowns. breaking of, 520
recording of findings, 430 mtracoronal characteristics of, 509-510
removal of distractions. 427 gold, 509
shade guide, 427 amalgam noble metal content, 509
shade tabs complex, 76
disinfection of, 430 simple, 76 Spratley knife, 393
use of. 428-429 Sprue former
composite resin. See
translucency, 426 for all-metal hygienic pontics,
Shade tabs, 428-430 Composite resin. 500
Shear thinning, 283 glass ionomer. See Glass
Shell-fabricated provisional description of, 368
ionomer. in gypsum-bonded investments,
restorations, 241-243 inlays. See Inlays.
Shoulder mesio-occfuso-distal onlays. 368-370
illustration of, 369f
all-ceramic crowns, 151-152, See Mesio-occluso-distal in phosphate-bonded invest-
onlays.
153f ments, 378-379
mesio-occluso-distal onlays. longevity of, 80-81 Sternocleidomastoid muscle, pal-
treatment planning, considera-
176f pation of, 6f
metal-ceramic crowns, 146, 148f tions for, 73-74 Stones, abrasive
Shrinkage, during investing Skyfurcation, 221, 222f
description of, 367 Slipcasting, 436 green, 387
expansion methods Smile line pink, 387
shapes of, 387f
hygroscopic. 367 effect of mouth on, 421f white, 387
setting, 367 illustration of, 419f
thermal, 367-368 Soldering Stress concentrations, in intra-
wax pattern, 367 definition of, 509 coronal restorations, effect of
Shrink-spot porosity, 368, 377f difficulty associated with. 510 metal covering, 175
Silane coupling agent, 442 fixed partial denture
Silicon carbide, abrasive use of, Structural durability, of restora-
gold alloy tions
385 distortions, 513
Silicones indexing, 510-513 axial reduction, 128
investing, 513-516 functional cusp bevel, 127
condensation single-piece casting, 510 occlusal reduction. 126
armamentarium, 297 soldering. 516-518 Subgingival margins, 133
characteristics of, 282t Supragingival margins, 133
costs of, 283t, 285t metal-ceramic alloys Svedopter, 258, 259f
disadvantages, 297 indications for, 520-521 Symmetry, of face
impression making, 297-299 methods, 521 horizontal, 421
putty/reline, 297 postveneer radiating, 421
reaction of, 297 burnout, 528-529 Syneresis, 286
viscosity, 283, 284f casting, 528-529
wettability, 281 indexing, 527 Taper
investing, 527-528 definition of, 119
polyvinyl siloxane preparatory procedures, optimum degree of, 120, 121t
armamentarium, 299 retention and, relationship
bonding strength of, 290 526 between, 121f
characteristics of, 282t preveneer
costs of, 283t, 285f Teeth
formulations, 299 burnout, 525 abutment use See Abutments,
hydrophobic nature, 299 indexing, 523 alignment of, 86f
impression making, 299-302 investing, 523-525 effect on mandibular movement,
overimpression-fabricated margin finishing. 525 15-16
postveneer and, compari- endodontically treated. See
crowns, 243-246 Endodontically treated teeth,
packaging of, 299 son, 521 extensively damaged. See
viscosity, 284f Damaged teeth, extensively.
Silver-palladium alloys, melting procedure, 521-523 missing. See Missing teeth.
methods of, 521
temperature, 365 preveneer, 520-521 Telescope crown, 99f, 99-100
Single-tooth restorations proximal contacts, 518-519
repair of casting voids,
519-520
requisites for, 509
Templates, for provisional restora- fixed partial dentures. 98-99 finish lines. 176, 177f
tions split pontics, 531-532 flares, 177, 178f
proximal half crown, 160, 161f isthmus, 177
fixed partial denture, 234-238 Tin oxide, abrasive use of, 386
visible light-cured, 239-240 Titanium alloy, 366 occlusal reduction, 175, 176F
Temporalis muscle, palpation of, TMJ. See Temporomandibular overview, 178f
proximal box, 177
5f joint. Shoulder, 176f
Temporomandibular joint Tooth preparations metal-ceramic crowns
anterior teeth
anatomy of, 11. 12f all-ceramic crowns armamentarium, 142
evaluation of, 4-5 armamentarium, 152 axial reduction, 145, 146f
mandibular movement and, 25 depth-orientation grooves. 152, depth-orientation grooves,
Terminal hinge axis theory, 13-14
Thiokol. See Polysulfide. 153f 144, 145f
Thixotropic, definition of, 283 incisal reduction, 152. 153f finish line, 146
Three-quarter crowns labial reduction, 152, 153f incisal reduction, 144, 145f
anterior teeth lingual reduction, 152, 153f labial reduction, 144, 145f
overview, 153f lingual reduction, 145
armamentarium, 162 radial shoulder, 152. 153f overview, 148f
axial reduction, 162, 163f shoulders, 151 proximal reduction, 145
bevels, 162, 163f putty molds, 142, 143f
flares, 162, 163f extensively damaged teeth. See radial shoulder, 146, 148f
grooves, 162, 163f Damaged teeth, extensively, shoulders, 146
incisal reduction, 162, 163f preparations for. posterior teeth
lingual reduction, 162, 163f armamentarium, 149
offset, 162, 163f full veneer crown axial reduction, 149, 150f
overview, 164f armamentarium, 139 depth-orientation grooves,
path of insertion, 161-162 axial reduction, 140f, 141
for mandibular molar, 160. 161f chamfer, 141 149, 150f
pin-modified depth-orientation grooves. facial reduction, 149, 150f
indications for, 164 functional cusp bevel, 149,
retention, 164 139-140
tooth preparation for finishi line, 141 150f
functional cusp bevel, 140 gingival bevel, 150f, 151
armamentarium, 165 occlusal reduction, 139, 140f occlusal reduction, 149, 150f
axial reductions. 165, 166f overview, 139, 141f overview, 152f
bevel, 167 seating groove, 141 radial shoulder, 151
instrumentation, 133, 134t-135t periodontium preservation.
cutting holes, 166, 167f laminate veneers, porcelain
flares, 166 depth-orientation grooves, 132-133
grooves, 165, 166f retention and resistance
offset, 166, 167f 443f-444f
overview, 168f facial reduction, 442, extracoronal, 119, 120f
posterior teeth factors that affect
armamentarium, 155 443f-444f
axial reduction, 156, 157f finish line, 442 freedom of displacement,
buccal bevel. 159 finishing, 445
finishing lines, 156, 157! incisal reduction, 443-444, 121-122, 122f
flares, 158-159, 159f internal feature substitution,
functional cusp bevel, 156, 444f
lingual reduction, 444f, 123-124, 124f
157f occlusogingival length,
444-445
grooves, 156-157. 157f-158f 122-123, 123f
occlusal reduction, 155-156, proximal reduction, 442-443, path of insertion, 124, 125f
443f intracoronal, 119, 120f
157f overview, 119
marginal integrity taper, 119-120
offsets, 159 beveling vs not beveling,
overview, 160f 128-130 small teeth vs large teeth, 123f
reverse, 160, 161f finish line configurations, structural durability, factors that
Tilted molar 130-132
abutments affect
mesio-occluso-distal onlays axial reduction, 128
corrective methods, 98-99 for mandibular molars, 178f functional cusp bevel, 127
description of, 97-98 for maxillary teeth occlusal reduction, 126
armamentarium, 175 tooth structure preservation, 119
bevel, 175-176, 176f-177f
Tooth structure preservation w methods of orienting die in
for extensively damaged teeth. cast
187 Wax interocclusal records See
overview, 119 Interocclusal records. curved dowel pin, 318 320
Di-Lok tray, 330-333
Total etching, 405 Wax patterns Pindex system. See Pmdex
Trapezius muscle, palpation of, 6f axial contours
Tripoli, abrasive use of, 386 bulges, 339, 340f system.
Try-in emergence profile, 338-340
faciolingual, 337-338 straight dowel pin, 315-318
base metal restorations, 400 proximal, 337 requirements, 314
gold alloy restorations fabrication requirements for, 309
armamentarium, 335 with separate die
anesthesia use, 388 coping, 335-336 armamentarium, 309
armamentarium, 389 methods of, 335 description of, 309
precautionary procedures, 391 margin finishing die preparation, 311-314
provisional crown common problems, 352-353 difficulties associated with, 309
occlusal grooves, 353 finish lines, 312, 313f
patient hypersensitivity, 389 occlusal scheme hardening agents, 313
removal, 391 classification of, 341t impression pouring, 309-311
cusp-fossa Working occlusal interference, 16.
u curve of Spee, 347
curve of Wilson, 347 17f
Undercuts cusp placement and occlusal adjustments, for gold restora-
box form to eliminate, 185
resin-bonded fixed partial den- contacts, 347f tions, 395, 396f
ture, 548 definition of, 346
visual examination for, 124, 125f description of, 341t Xerostomia I
illustration of, 341f carious activity and, 3
Unilateral balanced occlusion, 19, origins, 347 drug-induced, 3
355 procedure, 347-351
cusp-marginal ridge Zinc oxide-eugenol cement
Vac-U-Spat investor, 370-372 cusp placement and occlusal indications, 404
Value, 426 performance of, 404
Van der Waal's forces, 456 contacts, 342f
Veneer restorations. See Laminate description of, 340 provisional crowns, 233-234
for mandibular teeth, Zinc phosphate
veneer.
Vent holes, 406 344-346 cementation
Vertical stops, 542f for maxillary teeth, 343-344
Virginia bridge, 539 wax types, 335 cement preparation, 407
Visible light-cured provisional Wet field technique, 288 mandibular isolation, 406, 407f
White stones, 387 pulp protection, 406-407
restorations, template-fabricat- Working casts removal of excess cement, 409
ed, 239-240 mounting of restoration seating, 408f, 409
Visible light-cured urethane Denar facebow and articulator. vital tooth considerations, 406
dimethacrylate, 227t 56-60 compressive strength, 403t, 404
Vital teeth Hanau facebow and articulator. indications, 404
resin cements and, comparison,
abutment use of, 89 64-67
damaged, modifications for Whip Mix facebow and articu- 405
restorative procedures, 187, lator, 49-52 tensile strength, 403t
188f with removable die
Voids, casting, soldering repair of
armamentarium, 520 advantages over separate die,
contraindications, 519
indications for, 519 314
antirotational devices, 314,
315f
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