17.05.

2020

Universitatea de Medicină și Farmacie „Gr. T. Popa” Iași

Facultatea de Medicină Dentară
Disciplina Proteza Unitară
I. Prepararea dinților

1. Incrustații (inlay)
2. Coroane parțiale (onlay)
3. Coroane de înveliș
4. Coroane de substituție
5. Fațete dentare

Conf. Dr. Oana Țănculescu

I. Definiții
I. Definiție Coroana de substituție este o restaurare unidentară care
înlocuiește (substituie) corona dintelui și se agregă printr-un
II. Clasificare dispozitiv radicular pe canalul / canalele dintelui.

III. Indicații și contra-indicații Se indică dinților tratați endodontic, cu distrucții coronare întinse
care nu oferă o retenție și rezistență suficiente pentru o restaurare
IV. Avantaje și dezavantaje protetică cu agregare coronară.

V. Preparații pentru inlay-uri

VI. Accidente și complicații

I. Definiții
I. Definiție
II. Clasificare
Această restaurare trebuie să
asigure: III. Indicații și contra-indicații
• sigilarea sistemului canalar
radicular – condiție primordială
IV. Avantaje și dezavantaje
pentru succesul tratamentului V. Preparații pentru inlay-uri
endodontic
• retenția restaurării protetice VI. Accidente și complicații
coronare,
• distribuția solicitprilor funcționale
în substanța dentară coronară și
radiculară remanentă

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II. Clasificare
1. După metodă:
a. indirect (laborator)
b. direct - indirect (cabinet
+ laborator)

https://www.youtube.com/watch?v=4LWt81p6NMo

https://www.youtube.com/watch?v=4LWt81p6NMo https://www.youtube.com/watch?v=4LWt81p6NMo

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http://www.endomontreal.com/wp-content/uploads/2015/11/24-
Post-Root-Canal-Therapy.jpg

II. Clasificare II. Clasificare

2. După tipul restaurării: 3. După tipul de materiale:
a. o singură piesă = Richmond crown a. un singur material:
b. piesă dublă = dispozitiv corono-radicular + coroană de • metal
înveliș • ceramica
b. două materiale: metalo-ceramic, metalo-compozit,
metalo-acrilic

II. Clasificare
4. După tehnica de realizare: I. Definitions
a. Turnare (metal, ceramică)
b. Pressare (ceramică) II. Classification
c. Frezare – CAD-CAM
III. Indications and contraindications
IV. Advantages and disadvantages
V. Preparations for substitution crowns
VI. Accidents and complications

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III. Indications and contraindications III. Indications and contraindications

• on single-root teeth, but can also be used on multi-root with technical
changes (CR);
• correct root fillings • on untreated or incompletely treated roots;
• long roots, permeable channels;
• straight or slightly curved roots ;
• chronic periapical lesions (when the apical resection does not
• major carious destruction; offer a satisfactory remaining length);
• on teeth with small mesial-distal index (RC); • coronal subgingival fractures;
• crown fractures with subgingival remaining portion (RC); • on short or curved roots;
• abnormal position (CPR; rotation - RC);
• discoloration, dental dysplasia;
• on roots with open apex;
• pathological abrasions; • root walls infiltrated by decay and non-resistant;
• as retainer (RC); • mobile teeth;
• in stabilizing the removable partial dentures;
• altered general condition.
• in splints in periodontal disease (RC);
• redone anterior guidance (RC);
• remade the occlusal plane (RC)

IV. Advantages and disadvantages

I. Definitions
• allows the realization of singular or plural in good aesthetic
II. Classification effect prosthetic restorations;

III. Indications and contraindications • provides a solid post aggregation;

• a good functional value;
IV. Advantages and disadvantages
• can be built in any material;
V. Preparations for substitution crowns • can be done singularly, but also as plural constructions
(several teeth) (PC)
VI. Accidents and complications
• allows the replacement of the crown cover (PC);
• strengthens the remaining tooth crown;
• protects the coronary remnant dental tissue (not completely
amputated crown) (PC)

IV. Advantages and disadvantages

• requires the devitalization of the tooth;

• requires the sacrifice of the tooth crown;
• commands the insertion axis;
• after cementing disinsertion is very difficult

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Custom made Prefabricated

Advantages: Advantages:
1-very well adapted to the size & shape 1-time saving.
of the different canals cross sections. 2-cheeper. I. Definitions
2-more conservative. 3-less technique sensitive.
3-better stress distribution. II. Classification
4-better support to the core because they
are casted from the same material as one
unit.
III. Indications and contraindications
Disadvantages: Disadvantages:
1-one extra visit. 1-not very well adapted to the size & IV. Advantages and disadvantages
2-more expensive. shape of the different canals cross
3-technique sensitive. sections. V. Preparations for substitution crowns
2-less conservative (need additional
operative procedures).
3-less support to the core because they
VI. Accidents and complications
are not from the same material.
Core material: Core material:(plastic filling materials)
-cast metal (noble or base metal). 1-amalgam (gives corrosion products
resulting in more weakening to the core-
post junction).
2-composite.
3-GIC.

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Effect of apical preparation on crown-to-root ratio. A, Schematic of extensively damaged premolar tooth.
Apical extension of the gingival margin would encroach on the biologic width. This preparation has no
ferrule. B, Creating a ferrule with orthodontic extrusion reduces root length (R) while crown length (C)
remains unchanged. C, Surgical crown lengthening also reduces root length (R) but increases crown
length (C). This results in a much less favorable crown-to-root ratio, which may not in fact strengthen the
restoration.

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I. Definitions
II. Classification
III. Indications and contraindications
IV. Advantages and disadvantages
V. Preparations for full coverage crowns
VI. Accidents and complications

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