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Fabrication of Crowns Under Existing RPDs
Treatment Sequence
• Survey and design of Diagnostic casts
• Surveyed crowns are designed with ideal
contours and design parameters for the RPD
fabrication
• Fabrication of surveyed crown and
verification of design parameters
• Delivery of surveyed crown
• Fabrication of RPD framework
Ideally Surveyed crowns should be fabricated first!
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However !!!
• If an abutment tooth requires a crown
underneath an otherwise acceptable and
serviceable RPD, the abutment surveyed
crown will be fabricated to fit inside the clasp
assembly of the existing RPD.
Fabrication techniques
• Indirect: without the patient
• Direct: Principally intraoral (intraoral fabrication
of a crown pattern
• Combination ;Direct-indirect or indirect-direct:
intermediate intraoral steps
Indirect technique
• Impression of the prepared tooth with
simultaneous pick up impression of the RPD
• RPD is incorporated in the master cast
• The crown is waxed on the die and within the
clasp assembly of the RPD framework
• Disadvantage: Patient will be without the
RPD while surveyed crown is being fabricated
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Direct technique
• Acrylic resin and inlay wax are used
intraorally to adapt and form a crown
pattern directly to the tooth preparation
• The pattern is cast and the restoration is
cemented after ensuring an intimate fit to
the RPD frame work
• Patient is allowed to keep the RPD while the
crown is being casted and finished
Combination techniques A. Direct- indirect method • After tooth preparation impression is made without RPD in place • Resin coping is made intraorally and fit within the clasp assembly • Resin coping is transferred to master cast and final contours and margins are finished on master die in the lab
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B. Indirect- Direct method • Resin coping is made on the die in the laboratory • Coping is transferred to the mouth and refined intraorally and later finalized on the die • Most widely used since setting reaction of acrylic resin is exothermic • Takes one more clinical step since die has to be fabricated first
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Application of CAD/CAM ?????
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