Posterior Fixed Project

A word of caution to those of you who aren't too familiar with dentistry. This post will most likely bore the living daylights out of you, however I feel it is necessary for you all to see what I've been working hard on and stressing out over about this past month and a half.

Note: At nearly every stage of this project; you mess up, you do over.

Purpose:

To prepare 2 natural teeth for gold restorations including provisional (temporaries) and complete die work-ups. Basically: Make some gold crowns for a "patient" who needs two teeth restored.

Step 1: Preparation (2-MOD onlays) and Diagnostic work-up

In this step, the patient has come in and I have cut their teeth in a way to get rid of all the cavities while trying to keep as much of their natural healthy teeth as possible. I also take impressions of the teeth so I can work on making them their gold crowns after they "leave the office".



Step 2 - Provisionalization

After I take the impression, I wax up what I would like the new restoration to look like. Since the patient came in with damaged carious (cavities) teeth, I had to wax up what I think the patients teeth looked like based on the other teeth in their mouth.



I use the new design to make a plastic template, called an elman, and make the patient a provisional (AKA a temporary crown) that will protect the teeth I just prepared from bacteria while I make their permanent crown.

Step 3 - Final Wax-up and Investment

After the patient leaves, I make another impression of their teeth in a different type of stone that is much stronger and cut it up into sections. This is done so that I can access all the hard to reach places between the teeth and make a perfect wax-up to use as a template for their final crown. Remember, it has to fit absolutely perfectly if I want this to last the rest of the patients life. If done properly, it can even last longer than the patient!





Now I take CAREFULLY take the wax-ups of the teeth and put them is cement-like mixture called investment. Once it hardens and the wax is trapped inside, I heat it up to over 700 degrees for an hour to burn out all the wax. Now there is a tooth shaped void where the wax used to be.




Step 4 - Casting

After melting a special type of dental gold until it becomes molten, I put it in a machine that spins the gold into the investment... and out comes this.



Sure it doesn't look like much now, but after I trim off the excess gold and polish it up, you'll soon have a beautiful looking restoration.

Step 5 - Polishing

See what a little TLC can do?

Wow, I never thought this day would arrive. What an experience. I need some sleep.
By the way, I'm all for "peace" - but that's actually the time I finished. 2 am the day the project was due.