Trial fitting procedure2
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The document outlines the trial fitting procedure for dental restorations. It discusses adjusting the occlusion and proximal contacts without anesthesia if possible. It also notes to postpone cementing if the tooth is sensitive and never to cement over a symptomatic tooth. The key steps of the evaluation are to ensure proper proximal contacts, complete marginal adaptation, correct occlusal adjustment, proper contours, and esthetics from a conversational distance.
Trial fitting procedure2
- 1. TRIAL FITTING PROCEDURE Pre-Insertion Adjustment
- 2. The try-in procedure can be accomplished on many patients without administering an anesthetic. The patient’s unimpaired tactile sense can be valuable during the adjustment of the occlusion, and the annoyance of lingering anesthesia is avoided. However, if the patient is uncomfortable by the procedure, an anesthetic should be given.
- 3. Cementation should be postponed if the px reports of tooth sensitivity under the provisional/temporary crown. The tooth would be subjected to a greater chemical and thermal trauma upon placement of permanent restoration. ***Never cement a crown permanently over a symptomatic tooth.
- 4. Evaluation of a Restoration should be carried out in the following sequence: 1. Adjustment of Proximal Contacts Proximal contacts of the restoration must be neither too tight nor too light/loose. If too tight, they interfere with correct seating, produce discomfort and make it difficult for the px to floss If too light/loose, allows food impaction which is harmful to the gingival and annoying to the px
- 5. 2. Marginal Adaptation (Completeness of Seating) After the proximal contacts have been corrected, seat the restoration and examine the margins closely An acceptable margin should not be overextended, underextended, too thick, or open
- 6. Most common cause of poor margin adaptation is the failure of the restoration to seat completely If the proximal contacts are not too tight and the margins are still short or open, there may be some minute undercut, unseen defect or distortion preventing seating
- 7. 3. Occlusal Adjustment Only after the resto is seated completely can occlusal adjustments be performed Use articulating paper and instruct the px to open and close his mouth making sure that the teeth are in their correct intercuspation once occlusion is established
- 8. Make sure that the markings on the teeth exhibits evenness, if not, necessary adjustment should be made especially on those areas with darker markings Adjustment of the restoration in excursive movements is also essential in establishing the correct occlusion
- 9. 4. Contours Improper contours may impair gingival health and detract from the natural appearance, must be corrected prior to cementation Excessive convexity near the gingival margin promotes plaque accumulation
- 10. Surfaces directly occlusal to furcations are usually concave and the concavity should extend occlusally on the axial surface of the restoration to improve access for a toothbrush
- 11. 5. Esthetics Step back and view the restoration from a conversational distance to see if its contours harmonize with the rest of the px’s dentition Let the px look in a mirror so that any objections to the appearance can be dealt with prior to cementation
- 12. Looking at the teeth in a wall mirror shows a patient how the restored tooth will look to others at a normal conversa- tional distance.
- 13. Using a hand mirror held only inches from the mouth allows the patient to see the teeth as no one else will.