Presentation by: Omar Saleeh Alageel Academic Number: _  The Kingdom Of Saudi Arabia King Saud University College of Applied Medical Sciences Dental Technology Department Armamentarium

Introduction This presentation I will talk about the case on the fixed partial denture, I will restore the missing teeth [Number :15,16,17] by porcelain fused to metal (PFM) as a bridge. I do that on the dental lab at the ALYAMAMA Hospital. Fixed partial denture is a prosthetic appliance, permanently attached to the prepared teeth (abutments), which replaces a missing tooth or teeth. Pontic Abutment Bridge

Objective  Restore the missing teeth.  Restore function : mastication and chewing.  Restore esthetic.  Restore phonetic and speech.

Armamentarium I.Equipment: II.Materials:

I. Equipment: 1- Model Trimmer. 2- Vibrator. 3- Drilling unit for pindex. 4-Vacuum mixer. (jelenko). 5-Micromotor (Hand piece)& Burs. ( W&H TECTORQUE).

I. Equipment: 6-Sandblaster. (Emeevi s 24 ) 7- furnace. (Jelekco accu-therm III 3000) 8-Casting machine. ( Jelenko thermotrol II) 9-Porcelain furnace (JELRUS VIP). 10-Steam or Ultrasonic cleaner (silfradent EV 4).

I. Equipment: 11- wax pot (wax path) (WM whip mix ). 12-Articulator. 13-Spatula & plaster knife. 14-Rubber bowel & rubber sleeve.

I. Equipment: 15-Wax instrument. 16-Calliper & tweezers. 17-Saw. 18-Metal ring for casting. 19-Brush & carver for porcelain & mixing slab.

II. Materials: 1- Dental Plaster, Stone (DENTSPLY). 2-Pin for pindex. 3-Glue. 4-Die spacer. 5-Separate medium.

II. Materials: 6-Wax & wax sprue ( BEGO COMPANY). 7-Investment materials. (whip mix company I cera-fina) 8-Metal alloy ( BEGO wirobond c--- cobalt – chrome). 9-Porcelain materials: opaque, dentine, enamel, glaze and liquids. Shade A3. (VITA COMPANY).

Procedure 1- Trimming : A- Reduce the dental arch at the back. B- Trim to correct height of the base. C-Trim the outer contour (anterior, posterior and heel) of the dental arch. D- Polish the dental arch ( maxillary and mandible ).

Procedure 2- Pinning or Pindex: A- Mark the position of the pin, every segment tow pin. B- Fix the model on the drilling unit and point the red beam on the marked point. C-Press the model down to drilled.

Procedure D- Clean the hole and apply separate on the base of model E- Fix the pin to hole with glue. F-Place the plastic on the pin, then place small pieces of wax on the pin tip.

Procedure 3-Basing: A-Mix the stone then pour to the rubber sleeve and apply amount of stone around the pin, place the cast to the rubber sleeve use vibrator. B- Remove the base from rubber sleeve, then trim the base.

Procedure C- Cut the dies by saw.

Procedure 4- Mounting : Mount the upper and lower cast on the articulator.

Procedure 5- Preparing the dies: A- Prepare the margins and the die. B- Mark the margin by red pencil. C- Apply die spacer on the die gold -silver tow surface. D- Apply separating medium on the die and adjustment surface.

Procedure 6- Waxing: A-Dip the die on the hot wax dipping, dipping quickly and remove slowly. B- Check the thickness and add wax if need to that. C- Trim the wax up and the margin, must be even thickness.

Procedure 6- Waxing: D- Add wax on the lingual surface from mesial to distal surface, that to form metal collar. E-Add pontic connect to coping of abutment teeth. F- The pontic con be hygienic or over lab design. G- The final step rewet the margin and smooth the bridge before connect the sprues.

Procedure 7- Sprueing: A- Attached sprue to the bridge as indirect sprues techniques.

Procedure 8- Investment: Fix the wax pattern to the ring, then mix the investment materials by vacuum mixer and pouring to the ring, use vibrator to avoid bubbles.

Procedure 9- Wax Elimination : After the investment material setting put the ring in the furnaces to get out the wax (wax elimination).

Procedure 10- Casting:. A- Take the ring from furnaces and put on the casting machine, to do casting. B- Get the ring out the machine after casting till the metal final set.

Procedure 11- De- spueing: A-Open the ring and get out the metal frame work. B- Clean the metal from investment materials by sandblaster. C-Cut sprue by disk.

Procedure 12- Metal Finishing: A- Fitting the restoration, remove any internal irregularities or nodules by bur. B- Finishing the metal substructure and adjusted it to the uniform thickness, smooth the surface, adjusted the metal collar, use caliper to measure it.

Procedure 13- Metal Cleaning: A- Use the sand plaster (air abraded ) to the metal substructure,then clean it by steam or ultrasonic cleaner.

Procedure 14- Oxidation: Place the substructure to the porcelain furnace for oxidize the metal substructure according to the manufacturer’s directions.

Procedure 15- opaque porcelain layer: A- Apply the wash opaque layer on the metal porcelain surface then place it to the porcelain furnace as the manufacturer’s directions. B- Apply the opaque layer on the metal porcelain surface then furnace.

Procedure 16- Dentin : A- After opaque layer finish build up the dentin porcelain to form the gingival tow thirds of the tooth.

Procedure 17- Enamel : A- Build up the enamel on the incisal or one third of buildup. B- Place it on furnace as the manufacturer’s directions.

Procedure 18- Finishing the porcelain: After get it from furnace place it on the cast and check the occlusal surface and adjusted the occlusal surface and finish the other surface by bur.

Procedure 19 – The external glaze: After porcelain finished apply glaze to the external surface and place it to furnace.

Procedure 20-Final step: get it from furnace polish the metal collar and clean it.

Result The result is restore the missing teeth by fixed partial denture as abridge- Porcelain Fused to Metal(PFM) on the 15,16,17.

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