RESD 527

Fixed Prosthodontics

Xavier Lepe

3 Credits / Quarter 7 (Spring, Second Year)

Course Description

This course is the third in a three course sequence of Preclinical Fixed Prosthodontics. The didactic course and laboratory exercises emphasize the esthetic aspects of the restoration of individual or multiple unit prostheses. An introduction to esthetic veneers is included. Greater ability in planning and critical thinking is expected compared to the previous two courses. Several guest lecturers introduce the students to the concept of continuing education and an introduction to a critical evaluation of the dental literature is presented with examples of evidence-based decisions regarding treatment planning in fixed prosthodontics.

Educational Objectives

The student will gain knowledge in the indications, materials selection, and fabrication of esthetic veneer restorations for fixed prostheses. The rationale is learned for different designs of resin-bonded ultraconservative prostheses and resin or ceramic veneered fixed prostheses. The student learns the science of color and its’ application to esthetic restorations. Tooth preparation design is related to the different types of esthetic veneer restorations and this ability is established by exercises on dentoform teeth and practical examinations of selected tooth preparation designs. The student will be able to rapidly review the periodic dental literature for new developments in fixed prosthodontics and evaluate such new developments by comparing them to the evidence-based decisions for current methods and materials.

Course Outline

Lecture Topics include: laboratory procedures for ceramometal restorations; casting ceramic alloys; CAD/CAM procedures, framework design for ceramometal restorations; ultraconservative retainers for resin-bonded fixed prostheses; dental ceramics; color in dentistry; procedures for porcelain application; ;; variations in design of EVCs and corresponding variations in tooth preparation; illusions, special effects, characterization, staining, glazing, post-ceramic soldering; resin veneers for crowns and bridges; evidenced based dentistry; treatment planning for fixed prosthodontics and maintenance of fixed prostheses; and Guest Lecture Topics may include: restoring the short clinical crown; matching the anterior tooth; graduate level complete ceramic restorations including porcelain laminate veneers; graduate level treatment planning and implant restorations; introduction to maxillofacial prosthodontics.

Assessment of Competency

To successfully meet the requirements of this course, the student is expected to attend lectures and laboratory sessions, complete all laboratory projects and to demonstrate her/his knowledge of the lecture and assigned reading material through quizzes, midterm and final written examinations as well as demonstrate skills through simulated clinical and laboratory projects and practical examinations. Students must pass all tooth preparation and provisional restoration practical examinations with 70% or greater. Tooth preparation and provisional restoration practical examinations include both faculty and student peer-evaluations with recognition for closeness between faculty and student marks.

Course Requirements

  • Attend nine, two-hour lectures, read selected references related to each topic and pass a midtermand final (multiple-choice format) written examinations.
  • Practice preparing dentoform teeth for  different designs of esthetic veneer restorations using evaluation criteria for reference, manual instructions and faculty instruction for guidance; subsequent to the skill development  of various preparation designs,  timed clinically simulated, competency practical examination must be successfully completed with a grade of 70% or greater; one of these practical examinations requires critical thinking by the student to design and prepare abutment teeth for a fixed partial denture based on a written clinical narrative and it involves fabricating a fixed partial denture provisional restoration.
  • Attend ten, four-hour laboratory sessions and complete several clinically simulated projects at a clinically satisfactory level; the projects include: waxing a resin-bonded ultraconservative fixed prosthesis and an anterior esthetic diagnostic waxing, two single tooth preparations for individual metal ceramic crowns with different margin designs and fabrication of  one ceramometal restoration, an anterior FPD project to include tooth preparation of two anterior PFM FPD abutments, impression, working mounted cast, waxing and cut back procedures; preparation of two complete ceramic crowns, and fabrication of three individual provisional restorations and one of these using a temporary post.

Effective Winter Quarter 2007, completion of on-line course evaluation is a requirement of this course. Failure to comply will result in an “Incomplete” grade being assigned.

Competencies Addressed

  • UWSOD Competency 2: Communicate the risks and benefits of proposed care and alternative treatment strategies available, then obtain expressed consent for treatment conveyed by a patient or legal guardian.
  • UWSOD Competency 3: Formulate a comprehensive treatment plan based on diagnostic findings, then implement treatment in a safe, properly sequenced and timely manner.
  • UWSOD Competency 5: Recognize the limits of their expertise and seek consultation with other health care providers to facilitate patient care.
  • UWSOD Competency 7: Manage pulpal and periradicular disease.
  • UWSOD Competency 14: Manage periodontal diseases.
  • UWSOD Competency 16: Manage diseases and conditions of the teeth.
  • UWSOD Competency 17: Manage replacement of teeth for the partially or completely edentulous patient.
  • UWSOD Competency 21: Recognize the role of lifelong learning and self-assessment in maintaining competency.
  • UWSOD Competency 22: Utilize critical thinking in assessing technical and scientific information for use in identifying patient needs and treatments.

Assurance of Competencies

Students are judged competent to proceed with the fixed prosthodontic clinical treatment of patients under faculty supervision when they have successfully completed the following:

  • two written examinations judging student’s knowledge of esthetics, fixed prosthodontics, and dental laboratory technology.
  • completion of various individual tooth preparations, one individual indirect PFM restoration, various single unit provisional restorations, one multiple unit provisional restoration, various PFM crown wax-up and cutback procedures, a resin bonded FPD waxing and an anterior esthetic diagnostic waxing; all at a clinically acceptable level.
  • two tooth preparation competency examinations.
  • one fixed partial denture provisional restoration competency examination.

Media

  • Preclinical Fixed Prosthodontics (Manual)
  • Contemporary Fixed Prosthodontics, Rosenstiel, Land, Fujimoto, 2006 (4th edition)

*last updated: 9/17/2013

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