Faculty Teaching Guide for Dental Materials

Module: Prosthodontics

Faculty Teaching Guide for Dental Materials

Module - Prosthodontics

Faculty Teaching Guide for Dental Materials

Module: Prosthodontics

Review of Previous Module

Review topics from the previous module to confirm understanding prior to presenting new material.

Module Overview

Prosthodontics is the specialty concerned with replacement of teeth and missing or deformed oral structures. The accuracy of crowns, inlays, bridges, or dentures, and therefore the dental health of the patient, depends on the physical properties of the materials involved. The success of these prosthesis also rests with dental personnel who manipulate the materials and equipment during the process of creating the prosthesis. Dental laboratory technicians are partners with dental office personnel in the endeavor for maximum service for the patient. Strict attention to detail, and knowledge of materials used, are essential for dental assistants in order to aid in this process of fabricating oral structures.

The Big Picture

Resources

This module utilizes the following learner resources:

Textbooks: Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3480-9.

Materials and Procedures for Today’s Dental Assistant, by Ellen Dietz, Delmar Learning, 2004. ISBN 1-4018-3733-6.

Workbook: Workbook to Accompany Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead, prepared by Karen L. Waide, Delmar Learning, 2004. ISBN 1-4018-3483-3.

Instructor’s Manual: Instructor’s Manual to Accompany Delmar’s Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3482-5.

Electronic CD-ROM: Delmar’s Dental Assisting Interactive Skills and Procedures CD-ROM, ISBN 1-4018-3485-X.

Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide the PowerPoint Presentation for Dental Materials.

Additional Resources

Safety Standards and Infection Control for Dental Assistants, by Ellen Dietz. Delmar Learning, 2002. ISBN 0-7668-2659-7.

Electronic Classroom Manager to Accompany Delamr’s Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN: 1-4018-3484-1.

Section 1: Fixed Prosthodontics

Section Overview

A fixed prosthesis is cemented permanently in place in the patient’s mouth, and if cared for properly by the patient, is designed to last a lifetime. It is a restoration that replaces missing tooth structure, improves mastication, prevents drifting of teeth, and promotes better oral health. The dental assistant’s meticulous responsibilities at each phase of the procedure contribute to the success of the final product. There are many steps involved and each one is vital to the ideal end result.

Outline of Section 1

Part A: Types of Fixed Prosthetics

Part B: Fixed Prostheses Procedures

Learning Objectives and Competencies

These learning activities directly address the Learning Objectives and competencies as stated.

Knowledge

1.  Define the Key Terms.

Comprehension

2.  Describe various types of fixed prostheses and their functions.

3.  Describe dental material used in fixed prostheses.

4.  Explain the role of the dental assistant in fixed prosthodontic treatment.

Application

5. Demonstrate the knowledge and ability to assist during a crown preparation appointment.

6. Demonstrate the knowledge and ability to assist during a crown cementation appointment.

Learning Activities

These learning activities directly address the Learning Objectives and Competencies as stated.

[Insert Homework Assignment icon] Key Term Glossary (Part A, All Objectives)

[Insert In-Class Activity icon] Porcelain Veneer Set Up (Part A, Objectives 2-5)

[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)

[Insert In-Class Activity icon] Crown Preparation (Part B, Objectives 2-5)

[Insert In-Class Activity icon] Crown Cementation (Part B, Objectives 2-4, and 6)

[Insert Homework Assignment icon] Interactive Skills and Procedures CD-ROM (Part B, Objective 5-6)

[Insert Homework Assignment icon] Workbook Assignment (Part B, All Objectives)

[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)

Part A: Types of Fixed Prosthetics

Overview

This part examines the various permanent fixed prostheses and materials used to restore missing tooth structure. Each requires a certain amount of tooth reduction by the dentist, and is an investment for the patient in their oral health. They are designed to provide maximum chewing efficiency and a lifetime of service. These restorations are prepared outside of the patient’s mouth, in a dental lab, and therefore are called indirect prosthetics. Dental assistants need to understand the various types of fixed prostheses and how they are fabricated, in order to support the dentist, as well as to be able to educate the patient regarding choices to improve the patient’s dentition.

Initial Questions and Activities

1. Is there anyone here who has a permanent crown or bridge? If not, what do you

think a patient might experience if they were to have a permanent crown or bridge?

There will be various answers depending on learners’ experiences. Ask what they remember about having impressions done and wearing a temporary restoration while the permanent prosthesis was being made. Remind learners that relating to the patient’s experience will help them be more caring dental assistants.

Key Concepts / References and Activities / Slides /
Introduction to Module / Slides 1-2
Introduction to Section 1 / Slides 3-4
Key Terms / [Insert Home Ass icon] Key Term Glossary / Slide 5
Types of Fixed Prosthetics / Chapter ___, pgs. ____ (Phinney & Halstead)
[Insert Group Activity icon] Porcelain Veneer Set Up
[Insert Home Ass icon] Textbook Assignment / Slides 6-15

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities

q  Porcelain Veneer Set Up (Part A, Objectives 2-5). Goal: To have learners set up for and understand Porcelain Veneer procedures. Instructor should ensure enough materials and supplies are available for learners and place them into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____(Phinney & Halstead). Learner workbooks contain check off sheets that can be utilized. Depending on supplies available, grading may include verbal explanation of certain steps, by the learners to the evaluator. Instructor should allow enough time for learners to practice steps before evaluating. The instructor should be the operator during testing and grading of this procedure.

[Insert In-Class Dis Ques icon] In-Class Discussion

1. Describe a good impression of a patient’s arch?

A good impression is an accurate negative reproduction of a persons teeth and surrounding tissues.

2. What would happen if not enough material is used for the impression?

The impression may not acquire enough of all oral structures necessary, if there isn’t enough material mixed, loaded into the tray, and then placed properly in the patient’s mouth.

3. What could happen if too much material is used for an impression?

This could cause the patient to gag.

[Insert Home Ass icon] Homework Assignments

Key Term Glossary. Learners will define key terms listed in the PowerPoint presentation. They are to enter this glossary on disk, in a dedicated notebook or in a designated part of a notebook. They are expected to augment information from text or lecture with other resources including any available in the school or public libraries or on the Internet and will be graded at the end of the module on completeness and presentation.

Textbook Assignment. Learners are to read Chapter ____ (Phinney & Halstead).

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

Slide 1 / [Insert DM 3-1]
DM – Stands for Dental Materials. The 1st number “3” indicates the Module called Prosthodontics. The 2nd number indicates the slide number. / Power Point Presentation for Dental Materials
Module: Prosthodontics
Prior to introducing this module. Ask learners if any questions remain from the previous module. If questions remain review the material as needed.
Introduce this Module.
Slide 2 / [Insert DM 3-2] / Module: Prosthodontics
Introduce the sections and each part.
Slide 3 / [Insert DM 3-3] / Section 1: Fixed Prosthodontics
Discuss each objective in detail. Learners need to know what they will be learning and why. Try to relate it back to their careers as dental assistants.
Slide 4 / [Insert DM 3-4] / Section 1: Fixed Prosthodontics (cont.)
Continue to discuss each objective in detail.
Slide 5 / [Insert DM 3-5] / Key Terms (cont.)
Continue to review each key term and discuss.
Homework Assignment: Stop here and go over the Key Term Glossary assignment.
Slide 6 / [Insert DM 3-6] / Part A: Types of Fixed Prosthodontics
Review the definition of prosthodontics and introduce the functions of these types of restorations.
Inform learners that these are the ideal replacements for lost tooth structure.
Slide 7 / [Insert DM 3-7] / Contraindications for a Fixed Prosthesis
Explain the reasons why the dentist and patient may decide against a fixed prosthesis.
Review the vital role DAs have in educating their patients towards making an informed decision regarding their dental health.
Explain that if a mouth shows habitual lack of care, and the patient does not respond to counsel for improvement, the effort, time, and expense may be wasted; or if the patient is unable to follow strict oral hygiene, due to a physical handicap, a fixed prosthesis is contraindicated.
Slide 8 / [Insert DM 3-8] / Cosmetic Dentistry
Explain how advances in technology and materials are continually expanding in this field of dentistry.
Discuss how rewarding it is to give patients an improved smile which often results in a boost of confidence and self esteem.
Review each procedure on the slide, explaining the meaning of each.
Point out that esthetics may also be spelled aesthetics.
Slide 9 / [Insert DM 3-9] / Types of Fixed Prostheses
Explain how full cast crowns, partial crowns, inlays, and onlays are made in the dental lab from elastomeric impressions taken of the patient in the dental chair.
Explain that the dental lab technician will construct a restoration that is an exact replica of the tooth, and made with precision to fit on or into the shape of the tooth preparation.
Point out that a full cast crown covers the entire coronal portion of a tooth and a partial crown covers the coronal surface but leaves the natural facial surface intact. Describe the difference between an inlay and an onlay. Explain that the tooth being replaced is called a pontic, and the tooth used to support or stabilize a bridge is called an abutment.
Describe a Maryland bridge as a resin-retained fixed bridge that replaces only one tooth.
Ensure learners understand that each tooth of a crown or a bridge is called a unit, and that is how insurance companies code the procedure, how the office will charge the patient, and how the lab will charge the doctor – per unit.
Explain that veneers improve the appearance of the patient by using a conservative preparation on the facial surface of the tooth and placing a thin layer of tooth-colored material.
Address the difference between direct and indirect veneers, as well as porcelain veneers.
Describe the reasons for these types of restorations.
Slide 10 / [Insert DM 3-10] / Materials Used for Fixed Prostheses
Discuss how pure gold would be too soft and that a precious metal alloy is a stronger material.
Explain that porcelain may be attached to the metal alloy, which adds strength to the ceramic material, or used alone where the forces of mastication shouldn’t fracture the restoration.
Point out that recent composite resin techniques are becoming popular due to continuous improvement in technology and materials.
Slide 11 / [Insert DM 3-11] / Retention of Restorations
Explain that core buildups and retention pins are used to help retain the filling material on badly broken down teeth, when not much tooth structure is left to restore. Describe how pins are screwed into the dentin so the amalgam, composite, or the silver alloy/glass ionomer material has something to adhere to.
Point out that a post, placed inside of the root canal is necessary to strengthen a tooth following endodontic treatment.
Refer to the figure in Chapter ___ (Phinney & Halstead) which illustrates a post and core with a pin.
Explain that dental implants are surgically inserted into the bone, and following the healing process, provide support for prostheses.
Point out that implants prevent resorption of the patient’s alveolar ridge, and must be routinely cleaned to remove plaque.
Discuss the use of devices used to clean under and around implants as well as fixed bridges, such as bridge threaders, proxi-floss, dental tape, and interproximal brushes.
Explain that dental hygienists will scale implants with plastic coated instruments so the precious metal won’t become scratched.
Refer to the figure in Chapter _____ (Phinney & Halstead) which illustrates the screw-retained implant prosthesis and the cement-retained implant prosthesis.
Slide 12 / [Insert DM 3-12] / The Dental Laboratory
Explain that the dental lab technician uses the impression and bite registration taken on the patient, and follows the dentist’s written instructions on the lab prescription in order to fabricate a prosthetic restoration.
Describe how the lab tech pours the elastomeric impression with die stone, and constructs an exact replica of the normal tooth in wax on the die.
Explain that this wax pattern is then invested and cast into a metal alloy duplicating normal tooth form, just as jewelers cast metal for jewelry. Point out that this is called a precision cast restoration because each step requires absolute accuracy.
Ensure learners understand that the lab can only work with what is sent to them and that errors such as distorted or inaccurate impressions will affect the final prosthesis, and may not fit the patient’s tooth preparation.
Slide 13 / [Insert DM 3-13] / Dental Assistant Responsibilities
Explain that the DA has many responsibilities during fixed prosthetic procedures, and that these duties vary depending on the dentist as well as state regulations.
Point out that DAs, highly skilled in restorative procedures, are always in demand.
In-Class Activity: Stop here for the Porcelain Veneer Set Up activity.
Homework Assignment: Stop here to assign and discuss the homework.

Part B: Fixed Prosthesis Procedures