Crowns and other extra-coronal restorations: Occlusal considerations and articulator selection

Key Points

• Clarification of some of the terminology and concepts relating to occlusion as it is used in everyday practice, making clear why these concepts matter

• Undertaking a simple pre-operative examination of the occlusion as a matter of routine

• Helping clinicians identify cases where articulated study casts will help plan treatment and design restorations

• Advice is provided about selecting an appropriate articulator and taking appropriate records at the treatment stage.

Key Points

Crowns and extra-coronal restorations:

• 1 Changing patterns and the need for quality

• 2 Materials considerations

• 3 Pre-operative assessment

• 4 Endodontic considerations

• 5 Jaw registration and articulator selection

• 6 Aesthetic control

• 7 Cores for teeth with vital pulps

• 8 Preparations for full veneer crowns

• 9 Provisional restorations

• 10 Impression materials and technique

• 11 Try-in and cementation of crowns

• 12 Porcelain veneers

• 13 Resin bonded metal restorations

Abstract

For many dentists, occlusion carries an air of mystique. It even seems sometimes that a perverse pleasure is derived in making the whole subject more complicated than it really is. As a clinician, you need to be able to decide what you expect from your proposed restoration, and to identify situations where you may need to alter the existing occlusal scheme. At a fundamental level, you also need to provide the laboratory with appropriate clinical records to ensure that when you fit them, adjustments to the expensively prepared restorations are minimal. This requires a sound understanding of the basics.

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