FIXED

PROSTHODONTI
CS
drg. Bertha E. Setio, SpPros
FINISHING & CEMENTATION

• The surface of the casting that is retrieved from investment is

too rough for use in the mouth
• Five preparatory procedures need to be performed on any type
of cemented restoration after it has been fabricated in the
laboratory: preliminary finishing, try-in and adjustment, pre-
cementation polishing, cementation, and post-cementation
finishing
PRELIMINARY FINISHING

• To minimize the expenditure of valuable chair

time, preliminary adjustment using the die and
master cast should be completed on internal and
external surfaces of the restoration prior to the
cementation appointment
ARMAMENTARIUM
1. High-speed handpiece
2. Straight handpiece
3. Separating disc on mandrel
4. No. 2F Craytex disc on mandrel
5. 5/8-inch Burlew wheel on mandrel
6. Sulci disc on small-head mandrel
7. No. 0 “bud” finishing bur
8. No. 330 friction-grip bur
9. Articulating paper
10. Green stone
• Remove any small nodules or “bubbles” with a no. 330 bur in a
high-speed handpiece
• Use a separating disc to cut the sprues from the casting
• Use a coarse rubber disc to smooth away the roughness left by
the separating disc
• Use the finer Burlew or Gold Lustre Blue disc in a similar
manner after the coarse disc
• The axial surface should be finished to the margin, the disc
should be rotated parallel with the margin, rather than
perpendicular to it.
• Use a no. 0 “bud” finishing bur to smooth
out the grooves on the occlusal surface
• Smooth the cusp ridges and blend them
into the groove on the occlusal surface with
a small rubber sulci disc
•Grooves are finished with a small “bud” finishing
bur
•Cusp ridges are finished with a small sulci disc
TRY-IN AND ADJUSTMENT

• If you are careful and gentle, the try-in procedure can be

accomplish on many patients without administering an
anesthetic
• Cementation should be postponed if the patient reports
that the tooth has been hypersensitive under provisional
crown
• Make sure the provisional restoration is not
hyperocclusion and that it covers all prepared tooth
surfaces
• Recement it for several days
ADJUSTMENT OF PROXIMAL CONTACTS

• The proximal contacts of a restoration must be neither too

tight nor too light
• If they are too tight, they will interfere with correct seating
of the restoration, produce discomfort, and make it
difficult for the patient to floss
• If they are too light, they will allow impaction of strands of
food, which is deleterious to the gingiva and annoying to
the patient.
• A frequent cause for failure of restoration to seat
completely is an overcontoured proximal surface.
Hold the restoration firmly in place and test both
proximal contacts with waxed floss
• If both proximal contacts feel too tight, adjust only
the tighter contact first
• Care must be taken not to remove too much material
from the contact area
• If the proximal contact is open or too light, this must
be corrected by adding solder before cementation
Proximal contacts are tested with dental floss
MARGINAL ADAPTION

• After the proximal contacts have been

corrected, seat the restoration and examine
the margins closely
• An acceptable margin is not overextended,
underextended, too thick, or open
Types of defective margins : overextended (A), underextended (B),
thick (C), and open (D)
MARGIN FINISHING

Two types of margins need to be considered

• Subgingival margins can be burnished on the die
with a beavertail burnisher or fine stone
• Supragingival margins of inlays, onlays, and partial
veneer crowns can be finished on the tooth.
• A burnisher, such as a dull Spratley knife,
can be used to press the margins against
the tooth surface
• The white stone should always rotate from
casting to tooth surface, under heavy
pressure and at low speed
•All accesible margins are burnished intraorally with a smooth, dull
instrument
•Margins are finished with a white stone rotating from alloy to
tooth
 OCCLUSAL ADJUSTMENT
• Insert the restoration and see, if the patient can still hold
the shim between the same pair of nearby teeth
• If not the crown is high in the intercuspal position.

If the patient can hold

shim stock on adjacent
teeth with the crown out,
but not with in it, the
crown is too high
• If the mandible shifts to the side where the restoration is
located, the buccal incline of the maxillary lingual cusp of the
lingual incline of the mandibular buccal cusp needs
adjustment
• If the mandible shifts to the side away from the restoration,
one of two deflective contacts requires correction, there is a
possibility of a heavy contact between the lingual incline of
the maxillary buccal cusp and the buccal incline of the
mandibular buccal cusp
• There may also be excessive contact between the lingual
incline of the maxillary lingual cusp and the buccal incline of
the mandibular lingual cusp that needs correction
• A premature contact on the buccal incline of the maxillary lingual cusp
produces a buccal shift of the mandible
• A premature contact on the lingual slope of the maxillary buccal cusp
produces a lingual shift of the mandible
• A premature contact on the lingual incline of the maxillary lingual cusp
produces a lingual shift of the mandible