#CLUB100 || PROSTHODONTICS: PART 1 || MAKING A CROWN OF A BROKEN TOOTH STEP BY STEP || A VERY SPECIAL POST FOR ME ||
In a dental OPD you get various cases on daily basis. Lets talk about the Prosthodontics, which basically deals with the crowns, bridges, veneers, dentures and much more. A patient who usually comes in the Prosthodontics OPD is suffering a lot already. We see regular cases of some quacks fixing permanent dentures in such a terrible way in a patient's mouth that they develop an infection. Patients, who've had a recent root canal treatment and they still haven't got their cap(crown)
These are usual cases. We get to see these patients everyday. Another thing about being in the Prostho OPD is that work doesn't get done in a single day, but you have to call the patients for atleast a 3-4 follow-ups. Why is that? I'll explain everything in this Patient, with an example of a real patient that I dealt with.
CASE: UNCAPPED ROOT CANAL TREATMENT OF LOWER 6
Picture clicked with patient's consent
A patient headed into the OPD with a complain of uncapped Lower 6. By lower 6 here we mean the Mandibular Molar. She had her Root Canal Treatment recently and the dentist had left her tooth uncapped which means the crown wasn't fixed. Now in these situations, it is very important to set the cap on the untreated tooth to avoid and bacterial colonization and some serious infections.
The first prognosis is done by tapping the tooth with a tooth mirror to observe whether the patient has any pain or not. After that the patient is asked to have an X-ray of their tooth so that we can see if there's any infection which might have penetrated to the root or if the root is distorted in any way. If the X-ray looks fine then the on duty dentist is in charge of the ongoing case.
The first step in this process is to take the impression of the patient's teeth. Now there are multiple impression materials but the most commonly used is Alginate Silicone etc. The impression is taken for a couple of reasons.
so that we could build a perfect replica of the patient's tooth.
to get accurate dimensions, which include the size and shape of the tooth.
Now coming back to impression. Even though the tooth affected is of the Mandibular Arch but we have to take the impression of both arches, ie, Maxillary and Mandibular. One might ask why are we taking the impression of the Maxillary arch when we have to work on the Mandibular molar? This is to get perfect occlusion and to avoid abrasion and erosion of any kind. When you close your mouth your Maxillary and Mandibular teeth get in contact. Imagine if the Mandibular prosthetic tooth is bigger in size then that of the patient's natural tooth, the patient will not be able to close their mouth easily and will be in a lot of stress.
So, after diagnosis, a stock tray was chosen and on it Alginate was poured to take the impression of the Upper arch and on another stock tray, silicone was poured.
Alginate
Now, a really important thung concerning Alginate is that it sets very quickly and shrinks as well, so its important that as soon as it is poured, it should be inserted inside the patient's mouth. The stock tray is inserted in the mouth in such a way that the patient doesn't feel any discomfort and the impression is also carried out perfectly. The Alginate impression was taken on the upper arch and the silicone was taken on the lower arch. This is what it looked like after the impression was taken.
You see that blue area on that yellow tray? It's to indicate the technician that the crown is to be prepared for this tooth. The reason of taking impression of both the arches has been explained above.
Now the technician will, according to the dimensions, in the stock tray, will make a metal crown. As I mentioned above these processes take a couple of follow-ups.
The patient will now have to get a Bite Registration which is done on modelling wax. I'll show you the modelling wax with its rim and will leave the process of bite registration and the attachment of crown for another day as the patient will be called again.
This modelling wax is prepared in a lab that is connected to the OPD. Whilst the dentist works on the patient, the technician works on the models as specified by the dentist. The patient will be called again and the procedure will be completed in a day or two.
I am trying to get a GoPro...
I have been trying to collect some funds for the GoPro which is a camera that will allow me to make videos of my dental procedures without any hurdles and then I will be able to post complete videos on Steemit. The only issue is that it is very expensive (starting price is around $450) but I'll work towards it and hopefully in near future I'll be able to get one.
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Thank you.
@pennsif
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