Checking and Verification

Pre-appointment Assessment
On working cast and dies

Pre-cementation Assessment
intra-orally

a)Pre-appointment assessment:……WHY??

i) Minimize chair time

ii) Detect and correct errors
iii) Send it back if not satisfied
Pre-appointment assessment should include the following:
1) Margin
2) Proximal contact
3) Occlusion
4) Embrasure and contours
5) Esthetic
6) Finish texture and polish
1) Margin:
 Visual inspection should be done
i) smooth / rough
ii) chipped / bent / discontinuities

 Accepted or rejected
 Margin inspection on the die:

under-extended (vertical / horizontal)

over-extended (vertical/ horizontal)

2) Proximal contact:
 The adjacent unprepared tooth should be examined if the technician during
sectioning injured the adjacent contact  therefor excessive proximal contact is
expected which prevent seating

 The tight contact can be detected by articulating paper and relieved.

3) Occlusion:
 Checked on articulators
 Using shim stocks
4) Embrassures and contour:
 Morphological/ non morphological
 Over contouring/under contouring
 Accepted /rejected

5) Esthetic:
 Shade
 Shape and size
 Position and alignment with adjacent teeth
Pre-cementation Assessment: (intra-orally)

1- Complete seating.
2- Marginal fit.
3- Retention and stability.
4- Occlusal adjustment.
5- pontic.
6- Contour and alignment.
7- Connectors.
8- Esthetics.
9- Radiographic checking.
■ N.B:
Be4 try in
i) The temporary restoration is removed.
ii) Removal of temporary cement
iii) Cleaning by water and pumice.

■ N.B:
Metal ceramic restoration restorations need separate metal
evaluation i.e coping design should be evaluated.
1) complete seating:
●Causes of resistance to complete seating:
a) Excessive proximal contact:
If too tight contact:► Therefore
i) Prevent seating
ii) Patient discomfort as pressure is felt on adjacent teeth.
iii) Flossing is difficult

►Solution:

i) In metallic restoration detected by→ a) Special quick drying liquid

b) Satin (matt) finish allow tight contact to appear shiny

Relief is done by→ rubber wheel
►If opened contact:
Allow food impaction→ gingival inflammation

●Solution:
i) In metallic restoration →solder may be added to the deficient area
ii) In porcelain restoration (unglazed)→ low fusing porcelain(add on
porcelain) may be added.→ TAKE CARE…….Tightness may occur again due
pyroplastic flow→ therefore further adjustment may needed followed by
polishing of porcelain
2) Presence of nodules on the fitting surface of the restoration
Causes:
i) Improper brush technique
ii) Inadequate vacuum during investing.
iii) ↓ of surfactant
• Detected by magnifying lens.
Treatment:
if small nodule not located if large nodule or located
in critical area on the margin
↓ ↓
Should be removed Remake
3) Over extended gingival margin
►Occur due to errors in→ i) Die preparation (ditching)
ii) Wax pattern carving.
►How to detect?
i) Blanching of the gingival
ii) Catch with tip of probe.
iii) X-ray

►Treatment → Remake
4) Tight casts:
Causes:
a) Improper expansion of the investment due to:
i) Improper w/p. (setting expansion)
ii) Improper spatulation time and rate (setting expansion)
iii) No ring liner. (hygroscopic expansion)
iv) Improper mold heating. (thermal expansion)
b) Delayed pouring of impression.

●Detected by → a special quick drying marking liquid.

→ sand blasting → matt finish.

TREATMENT
If small area If generalized tightness
↓ ↓
Removed by spot grinding electro-stripping i.e remove
Uniform thin layer from fitting
Surface (↓ FITTING)
5) Faulty assembling and soldering:
Causes:
Improper relationship between retainers and pontic
(improper soldering technique)
Treatment:
Dis-assembling → Resoldering.

6) Lack of parallelism of abutment teeth.

Causes→ i) No common path of insertion.
ii) Absence of temporary crown
Treatment→ Preparation, adjustment and remake.
2) Marginal integrity:
is evaluated using sharp explorer→ moved from restoration to tooth and from tooth to
restoration.
↓
If resistance occur in both direction
↓
Gap or open margin exist.

Treatment:
a) If the gap due to excessive proximal contact→ correction as be4
b) If the gap due to inaccurate restoration→ remake
c) If small ledge present at the margin→ finishing should be done??????? how
(3) Retention and stability:
●Restoration should be retained in position by tenso-frictional grip during initial seating.

●Stability is checked by placing one finger on one retainer → no rocking should occur on
the other retainer.
●Causes of ↓retention:
i) Over convergence
ii) Over occlusal reduction (↑ 1/3 occluso-gingival height)
●Treatment:
i) Extend preparation subgingival ii) Prepare parallel collar at cervical region.
iii) Added means of retention e.g grooves iv) Use added abutment
Causes of rocking:
a) Small nodule → can be corrected
b) Distortion of wax pattern→ remake
(4) occlusion:
● Checked by →
i) 2 thin articulating paper of different color to detect centric
and eccentric premature contacts
ii) Mylar shim stock strips
● Any high spots or centric interference should be removed.

● If true occlusal contact interference → Bull's eye.

If false contact→ smudge.
(5) Contour / aligment / & occlusal anatomy:
● Contour / aligment should be compared with the adjacent teeth & contra –lateral teeth.
●Emergence profile should be straight???????????
●Over contouring???????
●Under contouring??????

● Occlusal anatomy should represent the proper anatomical form as the contra –lateral
teeth.
(6) Pontic contour & its relation to mucosa of the
alveolar ridge:

●Pontic contour→ should be correct to allow sweeping of food over the mucosa→
massaging (i.e prevent food impinging).

● Pontic relationship to the ridge

→ Should be self-cleansing.
→ No pressure→ o.w blanching of mucosa.
7) Connectors:

Rigid Connector
● Checked for:
i) Adequate strength Non-Rigid Connector

ii) Proper inter-proximal relationship. ● Checked for:

i) Adequate retentive quality
ii) Proper inter-proximal relationship
(8) Esthetics:
● Ceramic restoration should be checked for:
a) Contour of the restoration.
b) Surface characterization.
c) Color match.
● Metal ceramic restoration
a) preparation????????
b) Marginal position???????
c) Alignment with the adjacent teeth
a) The lateral incisors should be 1mm shorter than upper centrals
b) The incisal edge of upper centrals and cusp tip of upper canine are on the same line
c) The incisal embrasure between upper central and upper lateral should be
prominent.
e) The gingival embrasure between upper lateral and upper canine (cuspid) should be
prominent.
e) Distal corner of the incisal edge of upper centrals should be more rounded
f) Slight difference should exist between the incisal edge of the natural central
and the restored one (e.g slight notch).

9) Radio-graphic checking:
To detect open margin exist inter-proximally