How Prosthodontic Procedures Are Done-Part I
Most prosthodontic procedures involve a number of tasks that are completed step by step and with great detail. Each step may in turn consist of multiple tasks and require multiple visits.
- The first visit is the pre-treatment visit, in which the dental assistant arranges and prepares for taking a preliminary impression.
- In the preparation visit, the dental assistant is required to prepare for certain tasks, including administration of topical as well as local anesthetic agents, selection of the shade, preparation of the crown, management of tissue, mixing and preparing materials for final impression, provisional restoration material fabrication, preparation of material for temporary cementation, and excessive cement removal.
- The final visit is known as the cementation visit and requires the removal of provisional restoration and excessive cement as well as cement preparation for final restoration. The dental assistant is responsible for all these tasks.
As mentioned earlier, the dental assistant carries out all these tasks and procedures with the exception of administration of local anesthesia and preparation of the restorative bridge or crown.
This is the first visit and the tasks performed during this visit include:
Taking Preliminary Impressions
The patient is examined and the treatment plan of a crown or a bridge is decided. Alginate impressions are taken to make study models. Then, working casts are made with the alginate impressions. These casts are used to create custom trays. The basic idea behind the creation of custom trays is to fabricate a final impression, which is comfortable and close fitting for the patient. Other aspects to consider are that the impression material should record the accurate details, costly material should not be wasted during the preparation, and the final result should be properly fitted inside the mouth.
Administration of Anaesthesia
The process of injecting local anesthetic agent is the most frightful event during regular dental visits. The pain of injections can be alleviated by the application of topical anesthetics on the mucosa before injecting.
Selection of the Shade
The selection of the shade is an important step and it can be done after administration of the local anesthetic injection while everyone is waiting for the anesthetic effect to begin. A shade guide is shown to the patient under good light and a shade that closely matches with the normal teeth is selected. The patient, dentist and dental assistants work together to find the best match.
Tooth Preparation and Cleaning
The dentist uses a special hand-held instrument for trimming and shaping the tooth. Simultaneously, the dental assistant uses the air/water syringe that is attached to a high-speed evacuation system to clear the working area of any debris so that the dentist can have a clear view while working. After the completion of this step, the dental assistant examines and cleans the oral cavity thoroughly to remove any leftover debris.