Gold occlusal surfaces and organic occlusion in denture construction.
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Alternative approaches toward the resolution of difficulties associated with severe attrition are offered. A clinical approach is advocated which first proves the acceptance of an increase in the occlusal vertical dimension before initiating definitive treatment. The various aspects of removable treatment are considered. A sequential approach is suggested in fixed reconstruction which avoids inaccuracies of multiabutment registration and orientation associated with complete arch preparation.
This treatment of dentinogenesis imperfecta presented many problems because of the severe attrition of the existing teeth. An overdenture may be used in similar situations of extreme attrition.
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A study was conducted to develop a laboratory technique and to evaluate the clinical efficacy of a base metal casting alloy. Slight modification of recommended investing procedures is required to produce consistently well-fitting castings with the test alloy. After 12 months of clinical service, the test alloy did not differ from the control alloy in tarnish, untoward gingival response, resistance to abrasion, or tooth sensitivity.
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A technique has been presented to simplify the fabrication of multiple direct post and core patterns. When combined with techniques for indirect provisional restorations, this technique merely requires the fabrication of an additional plastic template to form the direct core patterns.
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To restore severely worn anterior teeth, adjunctive procedures are often needed to increase clinical crown length. The various methods to achieve this are discussed and the advantages of using pin retention and the method are described.
The potentially destructive nature of dental porcelain placed on the occluding surface of prosthodontic restorations is explored. Current restorative trends are addressed with presentation of multiple clinical examples. Emphasis is placed on working knowledge by the restorative dentist. First an indepth knowledge of physical properties of dental porcelains is a necessity. Comprehensive treatment planning that includes a total evaluation of the patient's occlusal function and dysfunction is critical. Finally, viable material and treatment options are presented along with methods to help control the effects of porcelain if its use is mandated. This article does not condemn or condone the use of porcelain on occluding surfaces, but graphically reveals its potentially destructive character and suggests possible options.
The treatment of excessive tooth wear with limited interocclusal space is complicated. Nonprecious alloys may be cast into thin sections and bonded to the tooth surface with an adhesive cement. The technique may be applied to the provision of veneers to restore and protect worn tooth surfaces. This article describes the conservative management of excessively worn maxillary anterior teeth by use of this technique.