A TEN STEP PROCESS FOR MAKING A DENTURE

A Ten Step Process For Making A Denture

By Sarfraz Ahmed

ms dental arts steps of making a denture 

Although dental implants are an increasingly popular means of tooth restoration for patients with complete edentulism, not everyone is ready or suited for this procedure. Traditional dentures always provide a predictable result or may be required to help patients transition from dentures to implant-supported dentures. 

1. Pouring the Model

Denture Fabrication - Pouring The Model

First take a first impression of the patient’s mouth with tablespoons for edentulous patients. It may be necessary to reinforce the circumference of the spoon with wax.

Take an impression of the tartar with a vibrator to remove bubbles and cavities.


2. Fabricating the custom tray and bite rim

Denture Fabrication - Fabrication of Custom Tray and Bite Rim

Your lab technician will fabricate a custom tray and occlusal wax margin The occlusal margins should be contoured to provide adequate labial support and to accommodate the future incisal position, occlusal plate, the vertical dimension and the center line. Select the most appropriate tooth mode and tooth shade for your patient, record these details and other information on your x-ray and send all parts back to the dental laboratory.

 

3. Articulating the models

Denture Fabrication - Articulating

Dental indexes and fixes master models created from an individual tray impression and occlusal measurements by the articulator to represent the patient’s jaw relationship.

 

4. Setting Up the Teeth

Denture Fabrication - Tooth Set-Up

Your dental technician positions the teeth according to the desired occlusal pattern. Ensure proper form and function.

 

5. Waxing

Denture Fabrication - Waxing

Once all teeth are properly aligned, the dental technician will apply additional wax around the teeth, gradually building up the correct gum line. Sufficient wax is added to properly support the gums of the facial muscles and give them a natural look. The wax can be slightly perforated to prevent the acrylic gum from feeling abnormally smooth after the denture is made.

 

6. Flasking

Denture Fabrication - Flasking

Once both the dentist and patient have accepted the dental adjustments, the denture is ready for treatment. The first step is to cast the prosthesis by placing the model with the prosthesis in the lower ampoule and fixing it with plaster. After the plaster has dried, the upper balloon is put on and filled with more plaster. The flask is then heated until the wax is sufficiently melted. Then the bottle is opened, the wax is thoroughly rinsed out and the teeth and the denture mold are filled with acrylic.

 

7. Acrylic Mixing

Denture Fabrication - Acrylic Mixing

The technician carefully weighs the monomer and polymer. He carefully mixes them to make the acrylic.

 

8. Acrylic Pressing

Denture Fabrication - Acrylic Pressing

Once the mold is prepared, the acrylic is packed into the bottle and the two halves are rejoined.

The prosthesis is then polymerized under pressure until it is sufficiently hard. The prosthesis is rinsed, plaster-free and ready for finishing.

 

9. Finishing

Denture Fabrication - Finishing

Each prosthesis is finished by hand using special burs to remove excess acrylic around the edges and in the area of the building. The joint is checked and adjusted if necessary.

 

10. Polishing

Denture Fabrication - Polishing

Finally, the prosthesis is polished and smoothed with a mop and polishing paste. For natural luminosity. 

Our licensed and skilled technicians are constantly to be had for case consultations and might help you with case planning. Get in touch now.

How to Prepare All Type Of Ceramic Crowns ?

How to Prepare All Type Of Ceramic Crowns ?

By Sarfraz Ahmed

 

All-ceramic crowns form one of the most aesthetic restorations available today. Crowns without metal frameworks allow light to pass through the crowns and exactly mimic the translucency of natural teeth. Other benefits include biocompatibility and less tooth loss than ceramic-to-metal restorations.

 

Limitations of all-ceramic restorations 

 

  • For all ceramic restorations include appropriate polishing techniques required after adjustment to minimize wear on opposing teeth.
  • All-ceramic crowns might not be the best option for stained teeth.
  • Carious teeth should be restored with appropriate materials to minimize gaps and reduce esthetic outcomes .

Ms Dental arts Soft-tissue response to well-fitting all-ceramic restorations in Dentistry

  • Titanium implants have established longevity. 

Tooth preparation guidelines

  • To be successful, all-ceramic crowns must have a relatively uniform circumferential thickness. This is directly related to the drills used during tooth preparation.

  • The preparation differences between various all-ceramic crown materials are minimal. They avoid unfavorable stress distribution and minimize the risk of crown fracture.

  • The preparation of the front teeth must ensure optimal ceramic support along the entire incisal edge. It consists of a reduction on 2 levels of the incisal edges.

  • The tooth should have sufficient crown structure for optimal strength and retention shape. Ideally, the thickness of this area should not exceed 2mm. Otherwise, all-ceramic restorations are likely to fail.

  • The preparation of the posterior teeth should include 2-plane reductions on the working cusps (lingual cusps of the maxilla; buccal cusps of the mandible).

  • Posterior restorations should distribute occlusal loads evenly in the ceramic and be supported by the tooth structure.

  • For IPS Empress® or e.max® crowns and zirconium crowns in the anterior region, the teeth should be reduced in the range of 1 mm to 1.5 mm to achieve aesthetic restorations. The reduction of the face must be between 1mm and 1mm.

  • 5mm, while the incisal margins should be reduced between 1.5mm and 2mm to ensure sufficient incisal translucency.

 
 
Laboratory cross-section of an anterior all-ceramic crown preparation
 

Prepration of Tooth

 

  • The optimal one Tooth preparation should begin with deep fissures of known diameter. This is done with milling cutters with a known diameter of approx. 1.
    0mm diameter. Doctors ensure sufficient bite reduction by combining the grooves.

  • This step is repeated on all surfaces of the tooth to ensure an even reduction.

  • During preparation, the sharp corners of the lines should be removed.

  • Margins should be carefully prepared with a 1 mm wide circumferential shoulder or bevel with rounded axial/gingival corners.

     

  • Take care around To create undercuts at the junction of the shoulder and axial walls.

  • Sharp edges and sharp transitions should be avoided and the shoulder should be as smooth as possible. This can be done with a fine-grain diamond drill.

  • The soccer drill can be used to reduce and contour the lingual surfaces.

 

Our licensed and skilled technicians are constantly to be had for case consultations and might help you with case planning. Get in touch now.

How to determine the best crown and bridge material for your patient’s implant case?

How to decide the first-class crown and bridge in your patient’s implant case?

By Sarfraz Ahmed

 

Dental crowns and bridges are varieties of dentistry used to restore broken enamel or update enamel which have been misplaced secondary to caries, trauma, periodontal disease, etc. For sufferers, regaining feature and enhancing aesthetics are regularly stipulations for dental implant remedy. Throughout the final fifty years, substances used for dental implants had been appreciably researched, and an know-how of the way the bodily and chemical residences have an effect on the scientific final results of the remedy has significantly improved.

These residences encompass the floor composition and the microstructure of dental implants. Ideally, implant substances ought to be biocompatible and immune to corrosion and fracture. Implants may be crafted from titanium or zirconia (ceramic).

At Ms Dental Arts Lab, the cloth we propose for crown restorations will depend upon numerous factors, which include which teeth the crown will restore, the presence or absence of parafunctional habits, and steel hypersensitive reactions. Before deciding on the cloth for crowns or constant prostheses, it’s crucial to speak about the advantages and obstacles of every choice

Titanium Dental Implants 

Titanium Dental Implants Ms dental arts

Titanium has been used to make dental implants for decades. It has extensively appeared as the “gold popular of implants.”

Commercially natural titanium is represented via way of means of 4 awesome grades, specially grade 1, grade 2, grade 3, and 4. Pure titanium degrees from grade 1, which has the best corrosion resistance, formability, and lowest power, to grade 4, which gives the best power and slight formability.

Titanium alloys are metals that incorporate a aggregate of titanium and different chemical elements. For maximum applications, it’s miles alloyed with small quantities of aluminum and vanadium, normally 6% and 4%, respectively, and for a few, it is also alloyed with palladium. Such alloys have very excessive tensile power and toughness, are mild in weight, have corrosion resistance, and might resist excessive temperatures.

The warmth resistance permits a warmth remedy method after the alloy has been labored into its very last form earlier than it’s miles placed to use, permitting lots less complicated fabrication of a excessivepower product. The maximum not unusualplace titanium alloy has 6% aluminum and 4% vanadium and is warmth handled to enhance its power, ensuing in a low-density cloth this is immune to corrosion and fatigue.

Implants crafted from titanium are biocompatible; thus, whilst the steel comes in touch with the bone, the bone grows subsequent to the steel with out disruption. 

There had been a few issues over titanium sensitivity, likely related to floor corrosion of implants, however maximum of the studies pertains to orthopedic implants. There is little proof to reveal hypersensitive reactions to titanium, even though a few human beings might also additionally have a sensitivity or an hypersensitivity to different metals utilized in titanium alloys. Also, a few sufferers decide on now no longer to have any shape of steel of their bodies. 

Benefits of Titanium

  • High established achievement charge of 95%. 

  • Titanium implants have established longevity. 

Limitations of Titanium

  • Potential allergies in a few sufferers

  • Some sufferers bitch of a metal flavor withinside the mouth.

Porcelain Fused to Metal (PFM) Dental Implant-Supported Restorations 

PFM Ms dental arts

 

As the call suggests, porcelain fused to steel (PFM) crowns combines porcelain and steel. The porcelain overlay is color-matched to the patient’s herbal enamel. Sometimes, the darkish steel margin ought to display on the gingival margin, in particular with gingival recession or excessive smile lines. Dentists might also additionally propose PFM restorations for sufferers who choice power and a herbal appearance.  

Benefits of PFM restorations

  • The cloth is durable. 

  • Matching a patient’s teeth coloring to PFM restorations can be incredibly easy.

Limitations of PFM restorations  

  • PFM restorations incorporate numerous styles of metals, which could purpose allergies in a few sufferers.  

  • The steel across the margins of PFM crowns can come to be seen on the gingival margin, that is taken into consideration unappealing for a few sufferers

Zirconia Dental Implants 

Zirconia dental implants are ceramic dental implants; they may be now no longer steel. They might also additionally wreck greater without problems than titanium implants. Zirconia, a steel withinside the periodic desk of elements, is located worldwide. Everyday family objects which include dinnerware, pipes, and electric furnishings are crafted from zirconia.

Because of its herbal power and durability, zirconia is good for dental crowns. Zirconia crowns are first-class for sufferers who want posterior crowns, which require lots power for masticating meals and parafunctional habits. 

Benefits of Zirconia  

  • Is well suited with human tissues

  • Implants have a low bacterial attraction

  • Have excessive power and respectable fracture resistance

  • They maintain up properly concerning put on and corrosion

  • Have splendid esthetics (no steel margins)

Limitations of Zirconia

  • Over time, the cloth might also additionally go to pot and result in microfractures. Implants are normally handiest to be had in one-piece implants; titanium implants are a higher choice if attitude correction is needed. 

  • Grinding zirconia can lower its fracture resistance.

  • Although proof is limited, zirconia implants might also additionally have better failure costs whilst in comparison to titanium implants.

  • Less scientific studies has been performed on zirconia implants than titanium and PFM restorations. 

  • Implant-supported zirconia crowns may be greater costly. 

The professional technicians at MS Dental arts Lab have in-intensity information approximately zirconia, titanium, and PFM substances used for restorations and are continually inclined to speak about unique instances with you. 

HOW TO IMPROVE YOUR MARGINS AND DIGITAL DENTAL SCANS

How to improve your margins and digital dental scans

By Sarfraz Ahmed

 

Excellent margins are vital for attaining a well-becoming healing requiring minimum chair-facet adjustments. It is essential to make certain the margins are designed and prepped correctly, and afterward, it’s miles first-class to shine your prep. Your preference of margin training relies upon at the kind of crown decided on for the affected person. The forms of margins and whilst to apply them are mentioned beneath.

 

Dental Margin ms dental arts

 

 

Knife-part or feather-part margins are appropriate for:

Full-solid crowns.

Full zirconia crowns.

Less teeth discount is needed with a knife-part or feather-part margin, however, this training is much less perfect for layered Zirconia restorations and can purpose becoming issues.

 

Dental Margin ms dental arts

 

 

Bevel-chamfer margins are appropriate for:

Full-solid crowns.

Full zirconia crowns.

PFMs.

Bevel-chamfer margins provide a higher marginal in shape, and there may be much less risk a darkish line may be seen on the margin. This margin training isn’t an premiere preference for layered zirconia or IPS e.max crowns.

 

 

Chamfer margins are appropriate for:

Full-solid crowns

Full zirconia crowns

Chamfer margins offer a greater passive and higher marginal in shape without a darkish margins. They are much less appropriate for layered zirconia and IPS e.max restorations.

 

 

 

Shoulder or butt-joint margins are appropriate for:

Full-solid crowns.

Full zirconia crowns.

Layered zirconia.

IPS e.max.

Shoulder or butt-joint margins offer a greater passive in shape and put off darkish margins. This training is suggested for LiS2 and layered zirconia. Care ought to be taken to make certain right isolation of the margin all through training.

 

 

Shoulder-bevel margins are appropriate for:

Full-solid crowns.

Full zirconia crowns.

Shoulder-bevel margins assist make certain a greater passive and right marginal in shape, getting rid of darkish margins. They aren’t a premiere preference for layered Zirconia crowns, and right margin isolation is vital all through training.

Isolating the margins is vital for a well-becoming crown. If your dental lab can not see the margins of a traditional influence or if a virtual scanner fails to choose up the margins satisfactorily, there may be a excessive hazard the case may be delayed,  in particular if the influence is rejected. Otherwise, if the case is going ahead, it may bring about open or quick margins. For those reasons, increasingly more clinicians are selecting to apply virtual impressions.
Digital generation permits records to be captured and visualized, offering the possibility to investigate tiny information which aren’t effortlessly seen on traditional tray impressions.

 

How to Get a Great Margin Scan on Your iOS

Although virtual impressions can offer precise images, there are numerous critical elements to consider.

 

Obtaining a Sub-Marginal Line of Sight with Accuracy

The picture displayed withinside the replicate is the picture so that it will be captured with the aid of using the scanner, and ideally, it have to display 0.5mm sub-marginally. Dental labs regularly obtain virtual impressions in which moisture and tissue had been inadequately controlled. Although the margin is seen, it isn’t truly defined. Keep in thoughts that virtual scanners best seize the picture this is seen; the conventional influence method can bodily pressure a few tender tissue out of the manner, as low viscosity fabric is injected into the sulcus. Your techniques, whilst making ready for a virtual influence, ought to will let you visualize the sub-marginal line of sight truly.

 

Retracting Soft Tissue

Retracting tender tissue is first-class completed with the aid of using packing a wire into the sulcus earlier than taking the influence, however this assignment is frequently less difficult stated than done. Inflamed gingival will regularly bleed, and setting apart the margins is difficult whilst area is limited. Supragingival margins provide a clearer visualization, however frequently enamel which might be being prepped for a crown can have formerly been restored with sub-gingival margins, and the fitness of the gingival tissues is regularly compromised.

Usually, as a minimum a part of the training is beneath the loose gingival margin. If your teeth training has subgingival margins, the tissue ought to be separated from the training part, permitting an awesome best virtual test. A excessive-readability test is completed with top notch best retraction, revealing a clean margin.

 

 

Exposing Margins with a Soft Tissue Laser and Retraction Paste

Using a tender tissue laser may be beneficial for exposing sub-gingival margins and for getting rid of dangerous and infected gingival tissue that can be masking the margin or growing immoderate bleeding. Removing infected tissue additionally allows to stimulate the regrowth of more healthy tissues. After treating regions with a dental laser, peroxide answer eliminates tissue debris. More fairly infected regions may be handled with a retraction paste that allows to offer hemostasis and bodily separation among the margin and tissue. The paste is injected into the sulcus, and a company cotton roll is located over the paste. The affected person bites down at the cotton for among and 5 mins, after which period the paste is rinsed away leaving a clean view of the margin.

 

Using a Retraction Cord

A retraction wire movements gingival tissue out of the manner of the margin arrangements and is inserted lightly beneath the gum line and into the gingival sulcus across the teeth. Using a retraction wire can displace gum tissue effectively,  but it’d additionally purpose bleeding. This bleeding can be complicated to control, making it awkward to seize the margins truly. Some forms of wire are already soaked in an answer of hemodent or may be soaked with the aid of using the clinician earlier than placement.

 

Using the Double Cord Method

It’s additionally feasible to apply the double wire method; the usage of a double wire can beautify tissue displacement, and margins are higher defined. One trouble with the usage of a unmarried wire is that frequently margin regions are extraordinarily skinny and impressions can greater without problems deform. If the affected person has an in particular deep sulcus, the usage of cords prevents tissue from collapsing over the pinnacle of the wire. When packing the cords, % a small wire at once beneath the margin of the teeth, and % a bigger wire at once on pinnacle of the small wire. The huge wire is left in region for as a minimum 5 mins earlier than being removed. You can then determine whether or not to get rid of the small wire earlier than the influence is taken or to go away it in region.

The accurate margin training and tissue control strategies are important to the whole system of fabricating and becoming a top notch restoration, whether or not the use of a traditional or virtual impression. MS Dental Arts Lab has an high-quality chart for enhancing your margins. This chart is to be had for download, and it’s far a brilliant reference tool.

 

 

Our licensed and skilled technicians are constantly to be had for case consultations and might help you with case planning. Get in touch now.

 

Suggested Intra-oral Scan Image Acceptance Standards

Suggested Intra-oral Scan Image Acceptance Standards

Requirements for prep For Oral Scan

ms dental arts, digital dentistry

The occlusal discount of the prepped enamel ought to comply with the product parameters of the cloth decided on for the restoration. 

Anterior Preps, incisal edge ≥ 1.5mm minimal discount, facial & lingual surface ≥ 1.0mm minimal discount, margin > 0.8mm. A shoulder or chamfer prep is recommended. 

Posterior Preps, occlusal fossa ≥ 1.5mm of minimal discount, occlusal cusp ≥2mm minimal discount, axial surfaces > 1.0 -1.5mm, margin > 0.8mm discount. A shoulder or chamfer prep is recommended.

Digital scan ms dental arts

Ideally, there should be no undercuts on the prepped tooth. If undercuts are present; they should be either blocked out or removed. For bridges; the preps need to be parallel, with the equal route of insertion among abutments. Convergent or divergent preps can prevent the bridge from seating and may be rejected at the design phase; or will require further adjusting at the seat appointment.

digital scan MS dental arts

The surface of prep tooth should be smooth. Sharp corners and edges should be avoided as they can cause ill-fitting restorations or fracture issues.

Prep a clear shoulder or deep chamfer margin, unless monolithic zirconia is being used. Use of gingival retraction or laser is highly recommended.

digital scan ms dental arts
digital scan ms dental arts

The margin line of the prepped teeth need to be smooth. A zig zag, or difficult margin line can motive in shape problems including open or quick margins.

digital scan ms dental arts

Ensure there are no undercuts on the tooth prep. Ideally, for a bridge; there should be no interference or draw issues caused by an adjacent tooth being convergent or impinging on the prepped tooth. When necessary; the adjacent tooth may have to be adjusted, or the path of insertion altered.

Digital scan MS dental arts

Tip: Keep the regions being scanned absolutely dry. Be certain to have more cotton rolls.

Clean up saliva and any debris in the scan area, in order to have a clear and accurate scan image.

For anterior scans; the contra-lateral teeth must be registered in the scan to provide a design reference. This is crucial to achieve symmetry with the adjacent teeth.

Margin 

Clean up any blood or debris to ensure the margin is easy to be read by the scanner

Tip: When scanning the arch, make sure contacts are included in arch scan, not with the prep scan.

The prep and margin should be clear. Use of gingival retraction cord, double gingival retraction cord, or laser is highly recommended for a successful scan image. If cord is used; it should be removed just prior to the scan.

Contact 

Ensure that the scan registers a clear and complete interproximal contact area.

Occlusion 

Have the patient close into normal centric during the occlusal relationship scan phase.

Scan the opposing occlusal surface, buccal & lingual surfaces completely. Register appropriate gingival tissue. The scan area should be the same as the working side.

If a number of teeth are missing; scan multiple occlusal contacts or scan the full arch in order to register an accurate occlusal relationship.

Tip: Make sure the wand is being used properly. If cord is used; it should be removed just prior to the scan.

Missing data 

Scan should be complete or a rescan will be necessary.

Distortion 

Scan should show clear, clean contrast with no fuzziness, pitting or debris on models.

Tip: Select the settings option and make sure the restorative box is selected. This will show any areas that have not been scanned and will allow you to re-scan those missed areas.

 

Digital dental scans and ideal clinical margins

By Sarfraz Ahmed

Digital Scanner
Digital Scanner

It is impossible to achieve well-fitting restorations without clearly defined margins. Making sure the margins are prepared and designed correctly is essential.

outstanding ending bursts

For shoulder preparations, fine finishing burs should be used; for axial and occlusal reductions, coarse diamond burs should be used. In general, rougher surfaces improve cement retention and adherence.

Dental BurImage, from left to right, bevels, chamfer margination, and coarse for axial and occlusal reduction.

To help physicians purchase diamond burs for all clinical needs, manufacturers offer bur kits.

The kind of crown restoration, the material, and the location will all influence your choice of margin preparation (aesthetics, periodontal). The following lists the many sorts of margins and when to utilise them.

varieties of margins

1.       Margin styles with a knife edge or a feather edge work well for:

·         Full-cast crowns

·         Veneers

Knife-edge or feather-edge margins require less tooth reduction than other types. For multilayer zirconia restorations, this preparatory design is inappropriate and may result in fitting or fracture problems.

2.       Margin bevel-chamfer is appropriate for:

·         Full-cast crowns

·         Full Zirconia crowns

·         PFMs

A 360-degree chamfer margin is appropriate for PFM, all-ceramic, and full-cast crowns.

When compared to knife-edged margins, bevel-chamfer margins give better marginal fit. When making crowns out of layered zirconia or IPS e.max®, this margin preparation is not ideal.

3.       Chamfer margins work well for:

·          Full-cast crowns

·         Full Zirconia crowns

·         PFMs

Options for High-Strength Dental Crowns

The marginal fit between the restoration and the tooth surface is improved by chamfer margins. For multilayer zirconia and IPS e.max restorations, they are less appropriate.

4.       It’s acceptable to use shoulder or butt-joint margins for:

·         Full zirconia crowns

·         Layered zirconia

·         IPS e.max

margin at the shoulder or butt-joint

The shape of the bur at the apical end determines the margins.

Shoulder-beveled margins minimise potential dark lines at the margin and offer a passive fit. LiS2 and layered zirconia are excellent materials for this preparation. Gingival retraction prior to preparation and the use of end-cutting burs can help ensure proper isolation of the margin during preparation.

5.       Shoulder-bevel margins work well with:

·         Full-cast crowns

·         PFM crowns with porcelain shoulders

Generally speaking, shoulder-bevel margins produce precise marginal adaptation and clinically acceptable marginal fit. Metal collars may be seen, hence they shouldn’t be utilised in situations where aesthetics are an issue. They are not the best option for zirconia crowns that are stacked.

For well-fitting crowns, it’s essential to isolate the preparation margins. Additionally required are gingival healthy tissues, which reduces the risk of blood contaminating the scan or impression. There is a considerable likelihood that the Quality Control person will reject the case if your dental laboratory technician cannot perceive the margins of a traditional impression or if a digital scanner fails to record the margins adequately.

It is unacceptable to move forward with scans or impressions that are subpar. In the event that the case proceeds, there will probably be open or short margins, necessitating a new impression or scan in order to finish the case.

Data can be recorded and shown using digital technology, giving researchers the chance to examine minute characteristics that are difficult to see on traditional fixed prosthodontic impressions. However, conventional rules still hold true because the margins must be distinct and obvious.

How to Get a Great Margin Scan on Your iOS

Digital impressions can produce precise images, but there are a number of critical things to take into account.

Tissues are ready for retraction after preparations with 0.5mm subgingival margins were finished.

Accurate sub-marginal line of sight acquisition

The image that will be captured by the scanner is the one that is seen in the mirror. The tooth structure should be visible 0.5 mm apical to the edges. Digital imprints that have been poorly managed for tissue and moisture are regularly sent to dental labs. The margins must be readable and distinct.

Digital scanners only record the structures that are visible on the teeth, just like traditional imprints. You must be able to see the tooth structure from the apex to the edges when using your digital impression procedures.

Bringing Soft Tissue Back

Ø  Packing cords into the sulcus before producing impressions is the greatest way to retract soft tissue.

Ø  The size, shape, and depth of sulci vary.

Ø  Retraction cables are offered in a variety of materials and sizes.

Ø  In most cases, packaging doesn’t cause braided cords to unravel.

Ø  Sulci typically start off narrower at the apex and gradually get wider as they approach the gingival crest. The majority of sulci have a V-shaped cross section.

Ø  Therefore, if necessary, the thinner cords should be positioned first (000), then a thicker cord (00), and ultimately the thickest cord (0).

Ø  The interproximal areas, where the sulcus depths are normally deeper, are where clinicians usually begin. During these processes, the least amount of pressure should be created.

The preparation is frequently at least somewhat apical to the free gingival edge. To get accurate scans or impressions, the tissue around any subgingival borders on the tooth preparation must be cut away. With exceptional quality retraction that displays clear margins, high-clarity scans can be produced.

It can be difficult to isolate the boundaries of inflamed gingival tissues due to continuous bleeding. It is crucial that there is no active bleeding present during scans or impressions, as well as no saliva.

Although teeth that are being prepared for crowns frequently had teeth that were previously treated with sub-gingival margins, supragingival margins allow a clear visibility of margins. The gingival tissues’ health has frequently been harmed in these situations.

Retraction cord usage

Cords for dental retraction

Gingival tissue is moved laterally away from the margin preparations by the retraction cord. Utilizing a thin packing device, it is delicately inserted into the sulcus. Retraction cord is an efficient way to remove gingival sulcular tissues.

However, haemorrhage could also result from it. There are hemostatic treatments that can be applied to the cords or the bleeding areas prior to the impressions or scans. Prior to continuing, bleeding must be stopped.

Retraction cords come in a variety of diameters, materials, and producers.

Double-Cord Method

Using numerous cords can improve tissue displacement and make it easier to capture margins. Using two cables prevents tissue from folding over the edges during scanning or imprints if the patient has a particularly deep sulcus.

Pack a cord with a smaller diameter first while bundling the cords. In most cases, the first chord will cover the edges. Next, stuff a cord with a bigger diameter; this usually reveals the margins.

To fully expose all edges, it could occasionally be necessary to use a third cord with a bigger diameter. Before being removed, the larger cables must remain in place for at least five minutes. Occasionally, the original, thinner chord is still present during the scan or impression.

exposing edges using a soft tissue laser and retraction paste

By removing unhealthy and inflamed gingival tissue that may be obscuring the subgingival margins or causing excessive bleeding, a soft tissue laser can help reveal the subgingival margins. Lasers have the potential to permanently alter gingival tissues, so extreme caution must be taken.

Ø  The rebuilding of healthier tissues is aided by the removal of inflammatory tissue.

Ø  Hydrogen peroxide solution eliminates tissue debris after areas have been treated with a dental laser.

Ø  After being injected into the sulcus, the paste is covered with a sturdy cotton roll.

Ø  The paste is rinsed away, allowing a clear view of the margins as the patient chews down on the cotton for two to five minutes.

Whether using a traditional or digital impression, the proper margin preparation and tissue management techniques are essential for producing and fitting high-quality restorations. A great chart from MS Dental Arts Lab can help you increase your margins. You can download this chart, which is a useful resource.

Our trained and knowledgeable technicians can help you with case preparation and are always accessible for case consultations.

How to make a dental crown fit properly

By Sarfraz Ahmed

Palo Malo with DMLS Crown
Palo Malo with DMLS Crown

The methods used in clinical and laboratory settings for crown fitting are widely known. It is necessary to transmit clinical data from the oral cavity to the laboratory and back again. Clinical and/or laboratory processes could have led to crowns that don’t fit properly. Both sides of the spectrum require a high level of quality control. Crown seating procedures must to be dependable and consistent.

The difficulty with loose-fitting crowns is typically locating the precise point of contact so that an adjustment can be made. Adjusting the crown by guesswork or eyeballing takes time and does not always result in a perfect fit. Unacceptable crowns that don’t fit properly shouldn’t be cemented.

In three sections, this article outlines the clinical and laboratory perspectives on crown procedures:

Part I: Seating Crowns as Recieved from MS Dental Arts Lab

Part II: Potential Roots of Poor Crown Fit

Part III: Clinical Treatments for Dislodged Crowns

Part I: Seating crowns as they were delivered by MS Dental Arts Lab

Lab procedures:

  • Check the crown both on the die by itself and on the mould. Magnification is advantageous. The die’s margins and the crown margin should line up perfectly.
  • Put the crown on the die and the die into the cast. It ought to be simple to slide into position. The interproximal connections are AREAS, not points, keep that in mind. The middle third of the axial walls and the middle to buccal thirds buccal/lingually should be the areas of contact. Contact Areas for Dental Crown Margins
  • Close the upper and lower articulator components to assess the occlusion. Articulating paper should fit snugly between each tooth.

Clinical actions

  • Clean the prep of cement and dirt after removing the temporary crown. Try it in the crown; if it doesn’t sit all the way down, test the interproximal contacts with floss. Adjust as necessary until the crown is properly seated. In order to verify seating, take a bitewing radiograph.
  • Examine the occlusion; the crown’s occlusal surface should not be “high.”
  • Permanent cement is polished into the crown.
  • Remove any extra cement:
  1. If unsure of whether all cement has been removed, another radiograph may be required.
  2. Check the occlusion once more.
  3. Present the patient with the crown.

Part II: Potential reasons why crowns don’t fit properly

Micro-leakage: When the luting cement used to secure the crown to the tooth structure dissolves, micro-leakage results. As a result, there is a small flaw between the preparation and the crown.

Cementation: Crowns that have not been properly cemented run the risk of coming loose if the manufacturer’s recommendations are not followed or the cement is improperly mixed.

Tooth Decay: If not kept clean, restored teeth are more prone to plaque buildup and caries. This may eventually result in tooth decay underneath the crown.

Bruxism: By dislodging or fracturing the cement, bruxism, or grinding your teeth, can loosen crowns.

Diet: Taffy and other sticky foods, such candies, can entirely dislodge crowns.

Note: Every effort is made to verify that all crowns fulfil laboratory requirements using MS Dental Arts Lab quality control methods. Before packaging, all crowns will fit the dies and/or casts appropriately. Crowns that don’t fulfil these requirements won’t be given back to doctors.

Part III: Medical solutions for loosened crowns

  • Analyze the preparation and the crown. With the aid of hand tools, steam cleaning, or air particle abrasion, remove any dirt that is inside the crown.
  • Reposition the crown onto the preparation and assess the integrity of the margin. To assess subgingival regions, do a bitewing radiograph. If everything is in order, just re-ceil the crown. It is recommended to get the dental crown made again if it is loose because of tooth decay apical to the borders.

Zirconia crowns being re-cemented

  • Change your cementation procedure if your zirconia crowns are debonding or coming loose. Before polishing the tooth with pumice, the majority of dentists test the zirconia crown’s comfort in the patient’s mouth.
  • If the cement does not include a built-in primer, proceed by decontaminating the intaglio surface of the zirconia restoration before preparing it with a priming agent or adhesive. Since light does not reliably penetrate zirconia, the cement should be dual-cured (light and chemical).
  • The crown should next be cemented and light-cured from various angles in accordance with the manufacturer’s recommendations. As above, scrape away any extra cement.

Patients who have poorly fitting crowns may become dissatisfied. Call our lab directly to speak with a member of our knowledgeable technical team about your unique situation if you have fit problems with MS Dental Arts Lab crowns. The technical team at MS Dental Arts Lab is prepared to assist in finding the best solution for problems involving ill-fitting restorations and will collaborate with your office to do so.

Make an appointment to speak with our technical staff. 

How to fix Zirconia (MS Zircraft) crown fitting problems

By Sarfraz Ahmed

GC Zircraft
GC Zircraft

The past ten years have seen an increase in the use of zirconia ( MS Zircraft) crowns. Because zirconia ( MS Zircraft)  restorations offer robustness and realistic aesthetics, patients today prefer them to metal-based crowns. Furthermore, zirconia ( MS Zircraft) is quite strong and can survive repeated, vigorous chewing and grinding. 

zirconia ( MS Zircraft) restorations can last a patient their entire lifetime if kept up to date. Some dentists choose not to utilise zirconia ( MS Zircraft) crowns or develop the skills necessary to place them in their patients’ mouths because of the material’s recent development. This inexperience might occasionally result in crowns that don’t fit properly.

You should not dismiss problems with the fit of your dental crown. For the patient’s safety, any issues with dental crowns must be fixed immediately.

It’s crucial that you understand how to properly place a crown and how to alter the fit of the crown should issues emerge because zirconia ( MS Zircraft) crowns are made to help seal and safeguard your patient’s teeth from additional harm.

Why might zirconia ( MS Zircraft) crowns not fit properly?

  • The dental crown was made in a hurry. Crowns that are hurried can have inappropriate margins. The infiltration or seepage of saliva and bacteria into crowns that have open margins in the cement can cause decay and periodontal problems.
  • The crown wasn’t properly anchored. To prevent mistakes during cementation, such as a gap in the crown, clinicians must carefully inspect the crown margins. This opening enables saliva and bacteria to enter the crown and cause tooth decay.
  • It was unclear what the impression was. The quality of the imprint will be impacted by air pockets, drag or pull marks, missing impression data, incorrect marginal impressions, and subpar impression material.
  • Preparation irregularities.

How to resolve issues with debonding

  • Try changing your cementation procedure if you notice that your zirconia ( MS Zircraft) crowns are debonding. Before polishing the tooth with pumice, the majority of clinicians check the zirconia ( MS Zircraft) crown’s fit in the patient’s mouth.
  • If the zirconia ( MS Zircraft) crown does not come with a built-in primer, proceed by cleaning the intaglio surface of the restoration before priming or adhering it.
  • The crown should then be cemented, the cure tacked, and any extra cement scraped off.

Even though these are all common practises, therapists occasionally neglect to fully clean the intaglio surface, which leads to bonding failure. For the zirconium oxide sites to successfully bond in the patient’s mouth, the phosphate groups must be carefully removed since they form a link with zirconium oxide.

Three strategies for eliminating phosphate groups

  1. Sandblasting. Most manufacturers advise lightly sandblasting the inside surface at low pressure, even if it’s occasionally not advised to use aluminium oxide with a 50-micron diameter. Always read the manufacturer’s instructions before using this technique.
  2. Hypochlorite of sodium. The intaglio of the crown is cleaned with gauze soaked in sodium hypochlorite or full hydrogen peroxide at a 5% concentration. The cleaning solution is then removed, and the restoration is allowed to air dry.
  3. Ivoclean. Use a specialised solution, such Ivoclean. Before rinsing, let the solution sit on the crown for 20 seconds. After air drying, the crown is prepared for bonding.

Preventing facial-lingual lingual rocking in restorations

Do you think zirconia ( MS Zircraft) crowns rock facial-lingually but the margins fit perfectly? zirconia ( MS Zircraft) crowns for patients must be fitted more carefully and take longer to correct this issue than you might imagine.

Any irregularities are removed when the digital image of the patient’s tooth is created because milled restorations have smooth internal surfaces and cannot fit over them or undercuts.

On conventional versions, a die-spacer is typically employed, which leaves a gap of about 50–100 microns. Have your clinician check that the computer programme when creating zirconia ( MS Zircraft) restorations is set to provide well-fitting margins while defining the size of the space between the fit surface and the prep site. This easy procedure will prevent zirconia ( MS Zircraft) crowns from swaying facial-lingually and serves as a functional equivalent of a traditional die-spacer.

Patients who have poorly fitting crowns may become dissatisfied. Call our lab immediately to speak with our technical staff about your unique case if you ever face fit concerns with a zirconia ( MS Zircraft) crown. The technical team at MS Dental Arts Lab is prepared to assist with any problems involving improperly fitted restorations and will collaborate with your office to find the best solution.

To arrange a meeting with our technical team, click here.

Guidelines for preparing Zirconia (GC Zircraft)

GC Zircraft
GC Zircraft

Since its introduction to the dentistry industry, zirconia has grown to be the material of preference for dentists who want to offer their patients the most cutting-edge metal-free restorations.

With the addition of a wider variety of milling pucks, zirconia has substantially improved, enabling greater shade variation and translucencies that nearly match natural dentition. Zirconia’s physical attributes enable precision-fitting restorations, durability, and strength in addition to better aesthetics. It is crucial to make sure adequate preparatory criteria are followed in order to enhance the outcome of seated Zirconia restorations and save chairtime.

The significance of tooth preparation design

  • Less stress is placed on the crown because of smooth edges. The likelihood of fractures happening is lower due to the lesser stress.
  • For ceramic repairs, a passive fit is necessary.
  • Ceramics with uniform reduction provide high strength.
  • The best aesthetic outcomes come from sufficient reduction.
  • Smoother preparations are read more precisely by digital scanners.

Guidelines for a front zirconia crown’s preparation

  • You must leave enough space while preparing a tooth for an anterior Zirconia crown so that the wall thickness has a minimum of 0.3 mm and is optimum between 1.0 mm and 1.5 mm, or 1.8 to 2.0 mm incisal reduction.
  • At the gingival margin, there should be at least a 0.5 mm decrease and a clear, continuous circumferential chamfer.
  • A 5° angle should be used for the tooth’s horizontal and vertical preparations; a bevel is not advised.
  • The lingual aspect of the anteriors should be reduced using a football diamond to generate a concave lingual, and all of the incisal edges should be rounded.

Guidelines for a posterior zirconia crown preparation

  • You must leave enough space while preparing a tooth for a posterior Zirconia crown so that the wall thickness is at least 0.5 mm thick and, ideally, between 1 mm and 1.5 mm or 1.5 to 2 mm occlusal reduction.
  • The pretreatment should taper from 4 to 8 degrees. A decrease of at least 0.5 mm is needed at the gingival margin, and it must have a clear and continuous circumferential chamfer.
  • A bevel is not advised, just like with the preparation for an anterior crown. Make sure that all of the occlusal edges are rounded.
  • For zirconia, shoulder and Chamfer preparations work best. Although they are not advised, feather edge preparations can be used for full-Zirconia crowns. Ask your dental laboratory if this prep form can be made using their fabrication procedure.

Reasons why a crown preparation might not be suitable for a zirconia restoration

  • The preparation must be free of gutter preparation and any undercuts in order to be suitable for a Zirconia crown restoration.
  • Both the preparation of a parallel wall and a 90° shoulder are unacceptable.
  • Zirconia restorations are not recommended for teeth with sharp incisal or occlusal edges.

completing zirconia restorations with cement

  • When assembling and glueing Zirconia restorations, marginal finishing is frequently necessary.
  • To prevent plaque buildup, which causes tooth sensitivity and periodontal disease, extra cement must be removed.
  • Using non-cutting, safe-end finishing burs for gingival margins will safeguard the soft tissues.
  • A Zirconia restoration’s surface may be slightly roughened by these modifications, but polishing should be simple and result in an incredibly smooth surface.

If changes are necessary, a fine diamond bur suited for a Zirconia restoration must be used. Zirconia will develop micro-fractures as a result of excessive heat or sparking from an aggressive reduction. In order to limit the quantity of heat created, it is imperative to utilise as little pressure as feasible.

Please remember that our knowledgeable technical team is there to help you if you would like to talk about a Zirconia implant case in more detail: Click the link to get in touch with us.

Major mistakes made when taking dental impressions and how to avoid them

3D DENTAL SCANNER
3D DENTAL SCANNER

A top-notch dental imprint is essential because without one, the dental lab cannot create precise, well-fitting restorations. Potential dental impression mistakes should be found before sending the impression to the lab. Otherwise, if the impression is turned down, work can be delayed.

If the project moves forward, there is a higher chance that you will need to spend valuable chairside time correcting it or that it will need to be completely redone.

The most typical dental impression mistakes are as follows:

  1. Poor choice of tray.
  2. Unsatisfactory Impression Material blending
  3. Surface pollution.
  4. Margin detail is poor.
  5. Internal turbulence
  6. minuscule tears
  7. Making the Wrong First Impression.
  8. Making a hasty impression.
  9. Failure to Maintain Patient Stillness.
  1. Poor choice of tray.

The chosen tray must accurately record the required data without distortion. All of the teeth should be covered by it, but it shouldn’t touch the soft tissues. After making an impression, the tray shouldn’t be visible.

Full arch trays come in a variety of sizes. Trays’ arch shapes vary depending on the manufacturer, with some being more square and others being more rounded. Make sure the tray you choose is long enough to encompass the entire arch and wide enough to accommodate the tray comfortably. Metal trays can be altered and their posterior parts can be widened, but altering the anterior part of metal trays is more difficult. An alcohol torch can be used to heat plastic trays and modify them.

It’s best to keep a variety of dual-arch trays (triple trays) in stock because they come in different widths. As the patient bites into the empty tray to determine the size of a dual-arch tray, look at the other side of the arch. You’ll have a clear notion of how the occlusion ought to appear while capturing the impression thanks to this. Additionally, it enables the patient to feel what is required of them and will guarantee that they bite properly when taking the impression. Due to the fact that wax bites are frequently less stable during transportation, it is beneficial to offer a separate occlusal registration using rigid vinyl polysiloxane (VPS) material.

  1. Unsatisfactory Impression Material blending

When imprint material is properly blended, the colour is smooth and streak-free. With hand-mixed putty materials, streaking is more likely to occur, so hand-mixed ingredients should be promptly kneaded to ensure consistent colour. When using cartridge materials, bleed the cartridge before affixing the automix tip. This will guarantee that the catalyst and the base flow uniformly, preventing mixing problems. Since the tray material and wash are chemically formulated to cooperate, it is essential to use products from the same manufacturer. When the impression is poured up in the dental lab, using different materials could increase the chance that the wash material will separate from the tray VPS.

  1. Surface pollution.

An imprint material layer that is sticky and unset might result from surface contamination. It can be because adhesives, composites, or core build-up materials left a greasy film on the tooth preparation. Any of these could stop the material from properly setting. Retraction cables and solutions containing ferric sulphate or aluminium chloride can deliver sulphur to vulnerable regions, preventing the marginal VPS material’s setting reaction. The same effect can be achieved through glove contact, rolling the retraction cord in gloved fingers, or using a rubber dam. When putty is mixed by hand, latex can get into it.

After removing the rubber dam, properly dry the area and rinse it with water or mouthwash to prevent surface contamination. Make sure to thoroughly wash the preparation after applying hemostatic agents to get rid of any remaining debris and hemostatic agent. Additional hemostatic can be burnished into the gingival sulcus to stop further bleeding if gingival bleeding resumes. The preparation is air-dried and prepared for an impression once the bleeding has ceased. If the putty is mixed by hand, wash your hands while wearing gloves to get rid of any remaining surface powder and sulfides. If not, pick vinyl or powder-free gloves.

  1. Margin detail is poor.

One of the most important features of a dental impression is the margin. Without a precise marginal impression, issues like overhanging or open margins or a restoration that doesn’t fit properly are more possible. Inadequate retraction or areas where fluid has gathered restrict the impression material from flowing around the margin, which is the usual cause of voids at the margin.

The best method to deal with this issue is to use retraction cords with syringeable hemostatics. Utilizing a double retraction cord is one method. Another method involves preparing the gingival sulcus and inserting retraction pastes there. When achieving hemostasis, a diode laser can help widen the sulcus and enhance visibility of the prepared margin.

  1. Internal turbulence

Bubbles may appear in the imprint if moisture, such as blood, water, or saliva, becomes entrapped in the impression substance. These bubbles might impact the luting agent and increase the amount of space that needs to be filled. The interaction between the restoration and the tooth is weaker when the luting substance is thicker. Additionally, if the prosthetic material is too thin, there is a greater chance it may fail; this is crucial when utilising all-ceramic materials, in which case a minimum thickness is essential. Hemostasis is the key to resolving this issue.

  1. minuscule tears

When the wash material lacks sufficient tear strength, marginal tears may happen. Low viscosity material is more likely to tear in the sulcus and varies in strength according on the manufacturer. The wash material is thinner and more likely to tear when being removed when the sulcus is extremely deep. Additionally, if the impression is taken out before the wash material is set, there may be some minor ripping. If you need to rebuild an impression due to minimal tearing, make sure any leftovers are taken out of the sulcus and think about pulling back more tissue to make the sulcus wider. Additionally, using a more viscous wash substance could enhance the impression’s quality.

  1. Making the Wrong First Impression.

For the impression to be precise and predictable, the best impression material must be used. For your patient’s comfort, a sort setting time is typically preferred; nonetheless, it is crucial to understand the working time for the substance you have selected. The working time must be used to insert the impression. If it is already set up, it might not seat all the way and won’t record the necessary information. Selecting a material that is more hydrophilic will make it easier for it to adhere to the prepared tooth, particularly sub-gingivally and where fluid may be present.

  1. Making a hasty impression.

It is essential to take your time and double-check the facts (for example, packing the retraction cord). Make that the cable is properly packed and that the tissue has been sufficiently retracted. Rushing could prevent the chord from having enough time to sit, which would just serve to traumatise the area surrounding the sulcus.

  1. Failure to Maintain Patient Stillness.

If the patient moves or starts to gag, dental impressions may get distorted. Engaging in conversation with the patient can assist keep them motionless by keeping them busy and preventing them from noticing any pain. Remind the patient to breathe in and out through their nostrils frequently. They can ease their discomfort by wriggling their toes.

If you have any questions, our knowledgeable technical team can provide guidance on obtaining more consistent and high-quality impressions.

To arrange a meeting with our technical team, click here.