Zirconia Ceramics, Part 4: All-Ceramic Crown Preparation #2 Natural Tooth

Рет қаралды 81,508

4 жыл бұрын

In this video, Dr. Richard Stevenson demonstrates about Posterior Ceramic Full Crown Preparation #2 Natural Tooth for Monolithic Zirconia.
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Пікірлер: 102

@saiboli1938 4 жыл бұрын

The camerawork is amazing! Loving the amount of videos Dr!

@StevensonDentalSolutions 4 жыл бұрын

Thank you!

@rodrigocartens7563 4 жыл бұрын

It’s official, you are the best professor I have ever seen.

@StevensonDentalSolutions 4 жыл бұрын

Thank you Rodrigo!

@bbb6691 4 жыл бұрын

Dear dr I found some of your videos 2 years ago .. and you inspired me to be better in my daily practice .. so thanks alot 💐

@StevensonDentalSolutions 4 жыл бұрын

So nice to hear this! Thank you, Doctor!

@hebab6956 3 жыл бұрын

Great content dr. short, concise and to the point. Thank you

@StevensonDentalSolutions 3 жыл бұрын

Thank you!

@monaabdelmotelb8005 4 жыл бұрын

Your videos are always helpful 🙂 Thank you

@StevensonDentalSolutions 4 жыл бұрын

Thank you Doctor!

@muathalrababah1511 4 жыл бұрын

Love it , thank you sir

@drsubikashgorai5970 3 жыл бұрын

Excellent video.Great helpful.

@StevensonDentalSolutions 3 жыл бұрын

Thank you!

@thafseenafathima6624 2 жыл бұрын

Well demonstrated❤

@StevensonDentalSolutions 2 жыл бұрын

Thank you!

@eslammahdy3537 4 жыл бұрын

Great video and amazing prep as usual :D Regarding Verti prep I think it is useful in cases where limited tooth structure left like in root canal treated teeth. Creating a finish line will reduce the bulk of tooth structure at the neck thus reducing resistance to fracture. I would like to hear more from you about that. And I have a request for future video about Seating Problems and how to solve imperfect fit of restoration. Thank you Doctor for your effort I really appreciate what you are doing.

@StevensonDentalSolutions 4 жыл бұрын

I know what you are saying, however, in RCT cases with minimal axial walls, why perform a full crown at all? Save the tooth structure with an onlay or vonlay, but not this unproven vertiprep design. It's a design that stuns the prosthodontists and academics due to its failure of scientific analysis and clinical trials. Will proceed with cementation video in the future - thank you for your comments.

@successneedstime96 4 жыл бұрын

cool. As a dental student it's the first time I get to know about the requirement of prep for zirconia. Seems like the requirement for all metal crown. Shows how strong the zirconia is.nice

@StevensonDentalSolutions 4 жыл бұрын

Very similar indeed. Thank you!

@2kidsnosleep 3 жыл бұрын

Lovely preps and ideals to aspire towards. Second degree of difficulty is access into a real mouth, third is the attachment of a tooth to human being, fourth is the GD tongue!😉

@StevensonDentalSolutions 3 жыл бұрын

True! Interestingly, I find that working in the mouth is easier than the typodont.

@TheAskoulas 4 жыл бұрын

Hi Dr. Stevenson, I miss you! Your videos are always awesome. Hope you the fam, and the ucla dental fam, are well and healthy in this terrifying time. Do you remember when I suggested a website for these videos back in the day. Good memories. Questions: Is there any reason to ever use tetragonal zirconia in the posterior? Why would you choose zirconia over emax?

@StevensonDentalSolutions 4 жыл бұрын

when you have a thin crown - even as little as 0.8 mm, Y-TPZ is the best.

@warnerbros00 3 жыл бұрын

Hello, dr. Sveneson! I would like to see something like an introduction to different types of finish lines in fixed prosthodontics. Thanks!

@StevensonDentalSolutions 3 жыл бұрын

Coming this week! You must be a mind reader.

@warnerbros00 3 жыл бұрын

@@StevensonDentalSolutions Wow! Can't wait! 😍 Thank you!

@victorsanchez7554 4 жыл бұрын

Hello Dr. Stevenson. Great videos..I 'd like to see something about Direct facial composite veneers or bonding. Thank you.

@StevensonDentalSolutions 4 жыл бұрын

Will do! Thank you.

@muathalrababah1511 4 жыл бұрын

Yes indeed

@a1gle 4 жыл бұрын

wonderful and useful as always...please doc if you can make a video about the vertical preparation technique....CORDIALlY

@StevensonDentalSolutions 4 жыл бұрын

Okay - I really don't want to do this, but I will because so many people ask. Coming soon!

@user-qi5zs4lz4s 3 жыл бұрын

and what the amount of reduction for aspect of maxillary first premolar in all ceramic crown?

@hachmiyaali9931 3 жыл бұрын

The camera focusing is very clear 😌

@StevensonDentalSolutions 3 жыл бұрын

I work hard on this!

@Bordondental 4 жыл бұрын

Once again great video. May I ask whether rough polishing with a pumice brush is not a strategy worth considering ? I find it gives me a quicker route to bulk smoothing. Edges still need to be selectively finished but anything in my hands tends to help ?

@StevensonDentalSolutions 4 жыл бұрын

Yes, this is a good technique - I also use composite abrasive cusps which work well. Thank you!

@avesta1021 3 жыл бұрын

6831 diamond is perfect for caries removal 👌 Fuji 9 is an excellent build up material as well.

@StevensonDentalSolutions 3 жыл бұрын

Great!

@mohammedal-saeed1774 4 жыл бұрын

Hello Dr.Stevenson , you mentioned that the flowable composite can be used in this particular case to block out the cavities as it will be covered by the crown in any way but what about the free monomers in the composite which will irritate the pulp and can cause permanent pulp damage !?

@StevensonDentalSolutions 4 жыл бұрын

These are shallow block-outs with about 4 mm of wall thickness before the pulp. I also use a 4th gen bonding agent which creates a strong and protective hybrid layer barrier. If It was deeper, I'd use GI liner and RMGI material, and if I was near the pulp, I'd lay down Biodentin/MTA, then RMGI...

@El_mahdi313 4 жыл бұрын

Thanks Dr. Dr. What the difference between fillet finishing line and chamfer finishing line?

@StevensonDentalSolutions 4 жыл бұрын

A chamfer is a bevel, of at least 45 degrees declination - but optimally 60 degrees. A modified chamfer has the same declination angle, however has a rounded internal line angle. A chamfer does not provide enough bulk for the ceramics. A deep chamfer is not named properly - it is actually a FILLET, because it is definitely not a bevel, nor does it decline enough, nor is it a shoulder, which attempts to form a 90 degree butt joint - the Obtuse Fillet accomplishes four things: bulk of ceramics, marginal protection, edge support of ceramics and internal stress reduction of tooth and ceramics.

@El_mahdi313 4 жыл бұрын

@@StevensonDentalSolutions Thank you Dr You mean the deep chamfer is the fillet?

@dergoldyung5629 3 жыл бұрын

The preps

@StevensonDentalSolutions 3 жыл бұрын

Thanks!

@ritujashah5418 3 жыл бұрын

Great work, but was wondering why the margins weren't deeper to represent subgingival margins. It would also be great if you can demonstrate molar preparation in the patient's mouth

@StevensonDentalSolutions 3 жыл бұрын

I don't remember why - someone probably asked me to demo supragingival margins - I typically make the decision based on structural and esthetic parameters. Clinical vids coming

@karan5194 3 жыл бұрын

Do u prefer supra or equi gingival ?

@rh_BOSS 3 жыл бұрын

Sometimes you go through the pain of carefully preparing a second molar following all the guidelines only to find out that you've eliminated an occlusal interference, the condyle had moved a bit closer to CR and now your carefully reduced occlusal surface no longer has enough clearance.

@StevensonDentalSolutions 3 жыл бұрын

So true! Nice to perform a CR check with a leaf gauge before prepping any second molar.

@2kidsnosleep 3 жыл бұрын

Oh yes, this sucks

@tmdkns8986 3 жыл бұрын

hi doctor, what camera do you use to record this video? And do you use mouth mirror for indirect vision or does the camera give real time image?

@StevensonDentalSolutions 3 жыл бұрын

Canon Vixia 40 HD - yes, realtime and yes a mirror.

@ExtranjeroyPeregrino. 4 жыл бұрын

Hello Doc!... Could you do a tutorial for overlay prep next time?

@StevensonDentalSolutions 4 жыл бұрын

Okay - did you want an Ceramic Onlay? Please describe the details fo the prep you want to see. Happy to make a video.

@ExtranjeroyPeregrino. 4 жыл бұрын

@@StevensonDentalSolutions ...step by step overlay prep? Don't get me wrong is not onlay. For composite or ceramic rest. Either way. Thanks in advance. 👍

@anthonyvu6558 4 жыл бұрын

Dr Stevenson- what is that tool that you touched the 856 bur end to end with?

@StevensonDentalSolutions 4 жыл бұрын

RGS-3-4 stevensondentalsolutions.com/product/den-mat-rgs-3-4/

@user-xl7gk9si7r 4 жыл бұрын

Good job

@StevensonDentalSolutions 4 жыл бұрын

Thank you Doctor!

@alokpol3312 4 жыл бұрын

Hello Dr. Do you use rubber dam during crown prep in your clinical practice also?? Thanks

@StevensonDentalSolutions 4 жыл бұрын

Almost always! I even perform periodontal root planing with the dam on, following the Hunter Brinker technique. A friend of mine uses rubber dam during implant placement. Thank you.

@alokpol3312 4 жыл бұрын

@@StevensonDentalSolutions Your reply just showed me the things I still need to learn even more in depth. Thank you for the motivation. I really mean it.

@hamoudaFassad 2 жыл бұрын

Doctor, some other docters prefer chamfer finish line in mostly all crown preparation, do you agree with that?

@StevensonDentalSolutions 2 жыл бұрын

What is the definition of a chamfer, a modified chamfer? Most docs have very unclear answers. The desired finish line is a fillet for all ceramics.

@arberhajdini2617 2 жыл бұрын

Hi, i have a question. How do you prepare the tooth without watter, isn't the pulp tissue gona get hiperemeic and the patient will be in pain? Or we can prepare without watter if we slow down the RPM?

@StevensonDentalSolutions 2 жыл бұрын

These are on extracted teeth, but with an electric handpiece and slow speed, water may be avoided for finishing.

@Oscostaee 10 ай бұрын

hello Dr. I have a question.. why Shoulder finish line not recommendation for Pfm crown?

@StevensonDentalSolutions 10 ай бұрын

For PFM the facial finish line is a shoulder.

@user-vi2gy4do5h 3 жыл бұрын

Hello , how I know I am parallel with tooth during preparation to avoid undercut sometimes I am confuse if am parallel or not

@StevensonDentalSolutions 3 жыл бұрын

Global view, align handpick, finger rest, then oral view.

@someonesomeday1 2 жыл бұрын

Hey Dr Steven, may I ask what is your preferred bur to smoothen the edges of the margins?Also, what material do you prefer to cement thefinal crown( zirconia)?Ta

@StevensonDentalSolutions 2 жыл бұрын

8856-012 to 8856-16, or a KS0 of 8881-012

@StevensonDentalSolutions 2 жыл бұрын

Material choices are dependent on numerous factors, but if boding is not required for retention, I opt for 3Y TZP.

@Scarpkingsley 3 жыл бұрын

U R GREAT GREAT TEACHER A LEGEND

@StevensonDentalSolutions 3 жыл бұрын

So kind of you to say - all the best to you!

@ammarkouki2621 4 жыл бұрын

Hello doctor, Should not the tip of the 856 .016 be 1.6 mm?

@StevensonDentalSolutions 4 жыл бұрын

No - the 016 means that the widest part of the bur is 1.6 mm. The tip is approximately 1.1 mm

@ambertahseen7796 2 жыл бұрын

Sir am always concerned or bit confused either finish line should be below gingival line or not?

@StevensonDentalSolutions 2 жыл бұрын

On the typodont, keep it above to allow the graders to see your prep. Clinically, I will only create the finish line subgingivally in the following FOUR situations: 1. It is dictated by the structure or biology of the tooth (defects, existing restorations or caries), 2. If I need to consider gingival esthetics - in other words cover the area of the existing tooth to create a more pleasing result, 3. When the case has a low bone crest which would make the tissue more susceptible to recession, in which case I drop the margin to 1/2 the sulcus depth, and 4. To increase retention when the case will NOT be bonded. Hope this helps!

@user-qi5zs4lz4s 3 жыл бұрын

Hi doctor what's the bur used for all aspect of maxillary first premolar in all ceramic crown and what the size for all bur

@StevensonDentalSolutions 3 жыл бұрын

KS0 and KS0f. 1 mm round ended diamonds

@user-qi5zs4lz4s 3 жыл бұрын

Thank you ❤

@a.n3428 3 жыл бұрын

how long does the ceramic inlay/onlay place work?

@StevensonDentalSolutions 3 жыл бұрын

Research trials tell us that it ranges from a few years to over 10 years, but not much longer than 15 years or so.

@alexd15680 Жыл бұрын

I like your video, but how come you prep the tooth without water?

@StevensonDentalSolutions Жыл бұрын

Done on the bench-top. FWIW: water isn't the solution to pulpal trauma - sharp burs, light tough and air spray combined with a feather or brush stroke. The prophy cup/polishing point causes more damage to the pulp than a bur...

@sherafati Жыл бұрын

Is the secondary plane reduction necessary on lingual? We are not worried about the esthetics on lingual.

@StevensonDentalSolutions Жыл бұрын

It's only necessary when the thickness of the ceramic is too thin if the form of the upper half of the tooth is more bulbous. Usually, it is more subtle on the lingual. The key is to establish the retention ring along the gingival 1/3 of the axial walls and then allow the natural contour of the occlusal 1/3-2/3's to dictate the secondary plane. Great question!

@sherafati Жыл бұрын

@@StevensonDentalSolutions Thanks for your answer doctor, i've noticed that that secondary plane on lingual is more tangible in upper molars and in mandibular molars we mostly have a single plane from the gingival to the occlusal.

@dr.anjumsultana3606 Жыл бұрын

The round end bur is the one u always use for all ceramic????...what about chamfer bur..???...I am always confused can u clear my point ???

@StevensonDentalSolutions Жыл бұрын

Chamfer's are essentially bevels with downward inclinations and rounded internals - these are NOT appropriate for ceramic. The ideal design is a Fillet finish line. Round ended burs only.

@dr.anjumsultana3606 Жыл бұрын

@@StevensonDentalSolutions thank you soooooo very much

@dr.anjumsultana3606 Жыл бұрын

@@StevensonDentalSolutions I am using chamfers for zircon and I am highly disappointed with the finishing line I am getting i will use round end from now and I will see

@user-sm6vj4us4d 2 жыл бұрын

Hi) thank you for this kind video, i really like, it's one of useful information. Tell me please, when you preps in the mouth, finishing with red burs, 10 000 rpm. Which one you prefer, with low of water, normal amount water,or less water ( because when water off, better see margin)

@StevensonDentalSolutions 2 жыл бұрын

No water, just air spray. No damaging heat is generated. Thank yo!

@user-sm6vj4us4d 2 жыл бұрын

@@StevensonDentalSolutions thanks you for your answer)

@ahmadsollam3307 4 жыл бұрын

Kindly reply.. Why're you doing crown preparation without water cooling from handpiece? any corcerns about the pulpal health of the tooth! and thank you

@StevensonDentalSolutions 4 жыл бұрын

I'm making a video, not working on a patient. Better video quality without the water impeding your view...

@nmda9578 4 жыл бұрын

It's an extracted tooth, mounted in a typodont.