Fixed Prosthodonics: Crown Preps

Now that Operative Dentistry is over, It's time to start Fixed Prosthodontics. We started with crown preps and here is my first:

Proximal & Height of Contour Reduction
Buccal & Lingual Reduction - 0.8-1.5mm
In the first plane I made the axial walls parallel
 then tapered in the second plane - approx. 3-6 degrees
-Ensured maxillary lingual cusps were tapered towards 
the central fossae of the opposing mandibular tooth
- Kept original form, outline and orientation of the tooth

Occlusal reduction- 1.5 - 2mm
- Reduced occlusal surface following the outline 
of the cusps and keeping the central groove

In Occlusion

In Occlusion: closer view

Occlusal View

Definitely not perfect but it is my first and will have to practice practice practice!

Setting Maxillary and Mandibular Posterior Teeth

Here goes the setting of the posterior teeth:

Maxillary Left Posteriors Set

Lateral View of Maxillary Left Posteriors
Ignore those gaping holes, I made them for adjusting the 2nd premolar and 1st molar.
Lateral View of Maxillary Right Posteriors

Mandibular Left Posteriors Set
Not complete because of constant adjustment
Mandibular Right Posteriors Set
Again, not complete because of constant adjustment
Complete Maxillary Teeth Set

Complete Mandibular Teeth Set

All done!!
except I have to reinforce and fix the wax around the teeth

More Adjusting...

Stay tuned for the FINAL set up after all adjustments and reinforcements are made.

Oral Myiasis

Warning: Graphic Content

Oral myiasis is a rare disease in humans associated with poor oral hygiene, suppurative oral lesions, alcoholism and senility, etc. It's caused by fly larvae! Though sterilized fly larvae is sometimes used to treat stubborn non-healing ulcers (by eating the necrotizing tissue while leaving viable tissue behind), this is not the case here:

A psychiatric (schizophrenic) patient presented to The University of The West Indies Dental School with this problem:

Yes! those are maggots in his palate

Other cases:

Treatment includes surgical exposure of the affected area, physical removal of the maggots and cleansing with either topical or systemic medications and, wound debridement. 
Suture him up, give him some antibiotics and he's as good as new! or close.

See related article here
I had to share this. Unbelievable!

Setting Mandibular Anterior Teeth

Now that midterm exams are over I can resume the posting of my complete denture fabrication.

This is where we left off:

Maxillary Anterior teeth set
First Mandibular Central Incisor Set

All Mandibular Incisors Set

Lateral View

Maxillary and Mandibular Anterior Teeth Set

Front View: Might need to adjust the mandibular canines just a bit

Stay tuned for setting of maxillary Posterior teeth!

Midterm Diet

This should get me through this grueling week of midterm exams

Similar to 5-hour energy. Got this for free around campus

*PS - I have not started the "diet." It will only be used as a last resort.

Setting Maxillary Anterior Teeth

I don't like to stay in school longer that I need to. I'm there from 8am to 5pm everyday, after which I've had enough! This is how the "Home Lab" was invented: 

Of course, I need all the tools of the trade:

I need the teeth for setting

Here we go! After midline has been established, start setting teeth on one side first

All maxillary anterior teeth Set:

PS: This is wrong on so many levels. I should have been setting teeth
in the articulator, NOT while it's in the dentoform.
This was before I knew better ;)
Something tells me I need to correct the position of the left canine 

lateral: Left View

Lateral: Right View
Finished Maxillary Anteriors (or so I thought...)
Front View

Turns out the above teeth were a bit lingually placed. After making the adjustments,
Finished Maxillary Anteriors:

Front View

Stay tuned for the setting of the Mandibular Anterior teeth!

Dentist License Revoked for Administering Botox

Helaine Smith, a well known Massachusetts cosmetic dentist, lecturer and author who has been practicing for ~ 20yrs, was disciplined and got her license revoked for unauthorized use and administration of Botox (Botulinum toxin).

Apparently, in an article written in The Boston Globe about the increased demand for Botox treatments, she told the paper she has been using them for quite some time. This piece of information caught the attention of the state's Board of Registration of Dentistry and they later launched an investigation. The investigation revealed the unauthorized administration of Botox to patients as well as other violations including; failure to conduct weekly  tests for sterilization, failure to correctly store dental instruments, administering sedation without a permit, etc.
According to the law, general dentists are not allowed to administer Botox to patients, this can only be done by a certified Oral and Maxillofacial Surgeon who has been trained in the use of Botox and dermal fillers and can only be used for the treatment of disease, disfigurement and dysfuntion.

The punishment is pretty harsh but it reminds us that we should keep abreast of state and federal law and regulatory changes as well good practice management.

See full article here and here.


Removable Prosthodontics: Mounting Casts

Last time I posted about Removable Prosthodontics I left off at Occlusal (wax) Rim:

Next step is to mount the maxillary cast.

After the articulator is put together and the condyles, incisal table etc is set at the right angle, the bite fork is wrapped in wax and seats the cast (with record base and wax rim). Mounting ring is screwed in place then it's time to mix, place and shape plaster, giving: 

Lateral View: Notice the notches in the wax, these are placed to hold the maxillary
and mandibular cast in occlusion while being mounted

Frontal View

For the mandibular portion, simply flip the articulator and repeat

Maxillary and mandibular casts mounted. Notches in the wax
 rim filled with aluwax to hold casts in occlusion. ~ Pretty messy

Cleaning up all the mess and making the plaster nice and neat.

Stay tuned setting of teeth! Don't you just love the suspense? 

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