tips and tricks

I had an interesting time trying to fit an upper partial chrome back into a patient who had left it out for a few weeks. The adjustments ended up being on a lonestanding upper molar on the mesial surface of the mesiobuccal cusp and the distal ridge of the distobuccal cusp. I had a few thoughts on this procedure: -Partial denture can stop fitting due to placement of overcontoured restorations, alterations in the denture (i.e bent clasp), shrinkage of acryllic or movement of teeth. -Overcontoured restorations should be noticed right after placement unless they haven't brought their denture along. -Acryllic shrinkage can occur when it is stored  dry but this will probably be noticed soon after construction as they are unlikely to change their storage habits long after construction. -Movement of teeth occurs over time and is the most common reason for a partial denture spontaneously not fitting. This may occur naturally or occur due to poor denture design i.e un-reciprocated clasps...

I performed a same day tooth addition the other day and thought of a few tips: -Take the shade and mould before anything else. Unfortunately I went ahead and took a pick up impression before this and after I had seated the tray I realised it wouldn't be possible t to chose which teeth would be placed as the denture was in the impression. Of course this can be left up to the technician but the more control you have over the procedure the better.  -If the denture is not stable, you should reline the denture at the same time. Take a reline impression and then a pickup. If no reline is needed, a pickup impression is sufficient. Before taking the pickup impression check the bite of the reline impression to ensure the denture has seated fully -I thought it would be a good idea to use polident to stabilise the denture while taking the pickup impression. It must be noted that adhesive doesn't increase stability but improves retention. For stability, the denture must adapt well to th...

Designing the shape of anterior teeth is more difficult than it sounds at first but does become easier after a study of dental anatomy and a systematic process that is followed. There are certain rules that must be followed to create anterior tooth shapes that are aesthetic and also mimic nature. Between these rules there is room for creativity in terms of tooth colour, textures and variations that can allow the operator to add a personal touch to the case. When designing anterior aesthetics, start with the central incisors. The position of the central incisors is paramount to the position of the entire dentition as they are the most aesthetically important teeth and all teeth posterior to them are designed based on the central incisor position. This is analogous to full denture design: The incisal length, midline and incisal angle is one of the first things we design into the wax rims and the occlusal plane is designed from this point backwards. When designing the position of the ...

http://dental-tidbits.blogspot.com/2016/08/pre-endo-restorative.html I remember this and the idiot who filled the whole pulp chamber with amalgam before the endo was complete. It took me about an hour and a half as a student to slowly dig all the amalgam out to reaccess the canals. Honestly, before an endo is committed to it is a good idea to remove all restorations to assess the restorability of the tooth. You'll look like a real fool if you get to the end of the treatment and the tooth can't be crowned because there's no ferrule to be gained. It is useful to check for cracks and to assess the restorative prognosis. Once the restorations are all removed you need to put one back. You can use a tofflemire or a metal band and bog the tooth up with GIC. In the past I have formed the proximal walls with composite resin and filled the central part of the tooth with GIC aiming eventually to replace the GIC in composite resin after the endo. Keep the end in mind, if you do this ...

Teeth are brittle materials. What works so well is the fact that the materials that make up a tooth work so well synergistically to give the best of all the materials. Enamel is extremely hard but extremely brittle which allows it to cut and grind through foods with not much damage to the tooth surface. Dentine on the other hand is still quite hard but due to its lower mineral content has some flexibility to it. Enamel and dentine are bonded together at the CEJ and the flexibility of dentine supports the enamel to avoid it cracking. As we age, the mineral content of dentine starts to increase, enamel becomes thinner due to wear and along with accumulation of chewing cycles cracks will start to appear in enamel and risk of tooth fracture becomes higher. It is inevitable that things eventually will wear and break. Our mission is to try and make this happen as slowly as possible. Everything is important in this regard from preparation design, material choice and occlusal design. One tre...