Full Gold Crown in 7 Steps | Technique for Preparing the FGC on A Mandibular Molar
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- čas přidán 26. 07. 2024
- Dr. Stevenson demonstrates his 7 step technique for preparing the FGC. He is going to talk about the Volkl crown preparation on a mandibular molar. I hope this will help you to learn. If you have any queries, Don't forget to share them in the comment box.
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Full Gold Crown in 7 Steps | Technique for Preparing the FGC on A Mandibular Molar
#StevensonDentalSolutions #fullgoldcrown #mandibularmolar
Thanks for watching! - Krátké a kreslené filmy
Dear Dr. Stevenson,
I'm studying dentistry in germany and your videos are helping me so much. In class we are usually just shown what it should look like in the end but never actually told much about the process or what to fokus on. Your explanations and demonstrations are so detailed and understandable that I learn ten times as much through your channel, as I do in class. And you can convey a symphathy and understanding that makes you a very unique teacher in this profession. Thank you so much for your great work! I as one of many really appreciate it!
Thank you Malte - so nice to learn that you find the videos helpful!
Hi Dr. Stevenson,
I wanted to thank you so much for your knowledge and ability to make these videos. These have helped me tremendously. I even bought some of your bur blocks and so far is been amazing. I wish nothing but blessings and lots of success with this channel and your career.
That's wonderful! Wishing you the best Doc, and Thank You!
You are having such a magic hand! So beautiful work as always! :) thank you so much, dear dr. Stevenson! :)
Thank you Faith!
Thank you for your videos! It's funny how these are more clear and we'll explaijdd than those videos my school has. U did a better job talking through the crown prep than my tutors! 😂 thanks again!
Oh, that's cool. Thank you!
I do not do these kinds of work but I always enjoy watching your videos and the fact that how much you enjoy doing it after all these years.
Thank you - I appreciate your comments. Best, Dr. S
Thank you very much Dr. Stevenson. I use your videos as a teaching tool to my students. I teach the Shillingburg way of prepping for crowns which uses the depth cuts. But you're right. Smoothing all those grooves then to result to overreduction. Your method looks better.
Thank you Doctor - after 26 years of teaching at UCLA - we have found this to be true as well. You are doing commendable work - very rewarding to help our profession through teaching.
I’m a patient about to get a crown for a molar with a hairline crack, now I see your work 😱😱 this is art🦷
Oh - that's nice of you to say!
Big fan of this video! Thank you for posting
Thank you for watching!
Masterpiece 👌👌❤
Hello, Dr. Stevenson!
I would like to begin by telling you that your videos on preparations have been extremely helpful for me. I find your plane reducing technique much more predictable then the grooves one.
I appreciate very much the fact that you have made these videos available for everyone. You are a wonderful teacher! In the world of dentistry, that seems to be dominated mostly by ego, your competent and warm presence is such a breath of fresh air…
Again, thank you!
Excellent!
Excellent Video Doctor!
Glad you enjoyed this!
Love love love videos. Thank you so much
Thank you!
Well done Dr. Stevenson
Thank you Doc!
This is definitely perfect
definitely perfect. Thank you
Thank you!
this is pure classy prep.
Thank you
Lovely explanation & work
Thank you Doctor!
Lovely! Thank you very much Dr. Stevenson.
Thank you.
I like it. Nice work.
Thanks!
Thanks so much Dr.stevenson Am Studying Dentistry from Uganda indeed it's a perfect crown
thank you!
looking good
HELLO DOCTOR STEVENSON ,THANK YOU SO MUCH ABOUT YOUR PROGRAM AND VIDIO EXACTLY THEY HAVE A COMPLET INFORMATION AND I JUST CAN TELL YOU THANK YOU SO MUCH ...
FIERS OF ALL HAPPY NEW YEAR I WISH YOU HAVE BEST LIFE.....FROME HASSAN
Thank you Doctor! All the best to you as well, Dr. S
Hassanrahimi445@yahoo.com Rahimi, [27.12.19 11:25]
facebook.com/groups/2234857640124662/permalink/2553933678217055/
Hassanrahimi445@yahoo.com Rahimi, [28.12.19 21:01]
YOUR WELCOME 🙏,,,again thank you so much exactly and really all have completely and enough information
I saved them ,...I’m 4th course of this faculty in armanian country Doctor
I very late started this faculty
11years ago I graduated of about master of management (financial management in Iran and about thT faculty took experience in to several subjects....suddenly and 4years ago took decision to study this faculty and when I searching several pages of CZcams
With me was so great your page
....
I wish you have best life in the new year ,,,,,,
God Dammnnn….what a prep!!
Dr Stevenson, thank you so much for your great video. I have learned a lot from it. You have mentioned that you spend around 15-20mins on one tooth preparation, how about the temporary crown?
The temporary will usually take about 10 minutes as well, unless it's in the anterior, where esthetics may dictate customization, taking twice as long. From start to finish for a molar crown, Including med hx review, pre-op instructions, anesthesia, build-up, prep , impression and temporary, shade and Rx, charting and post op instructions, I usually book 1.5 hours. This is a fairly common time schedule for experienced dentists, however, many will work faster - I'm not about increasing profits but I enjoy trying to be better every time I work on a case from a quality standpoint.
awesome!❤
Thank you!
Thank you doctor
My pleasure
Thank you very much for your videos Dr. They have helped me a lot :)! I wanted to ask you, which book do you recommend for studying and reading about this topic? Thank you again!! I subscribed :)!!
Shillingburg: Fundamentals of Fixed Prosthodontics. Thank you!
Thank you Dr. for these brilliant videos. What is your advice for the bench test exams practising ? Thanks in advance.
Take a good course, then engage in focused practice at home - perform at least 500 preps and have many of them objectively evaluated.
Good job 🌹
Thank you.
thanks very much Dr.Stevenson, any video for upper first molar for FGC please ?
For sure - will do!
Very useful
Great, thank you.
I can't thank you enough for all the videos I am watching on your channel and how much it really helped me and still helping. Do you mind if you can share a video for a Full Gold crown prep on Anterior Teeth also?
That sounds awesome - I'll put that in the queue!
Thank you for the videos Dr. Stevenson. How does one monitor the reduction depths? Preliminary measurements using Perio-probe from gingiva to cusp tips and groves?
Usually via comparing the adjacent marginal ridges, (using a probe or RGS instrument) and through periodic occlusal space checking. Also, each plane is verified as it is cut by looking at the unprepared area adjacent to the plane.
"Definitely not perfect". Lol. Yes it is
They wHat he a
Lways saY
Hi Dr. S,
Thank you for your video. I've learnt a great deal. I'd like to know if you are doing any CEREC or CAD/CAM materials? If you are,
would you show preparation guides for CEREC or CAD/CAM-based inlay/onlay/crowns? Also, could you show techniques/tips on anterior milled crowns/bridges/veneers shade selections? Thanks
Thank you Doc!
Beautiful as usual doc, could you please do a video about verti prep ? Is it actually a gold prep but with different material (zirconia )?
It's not a good design for several reasons and the proponents of this prep lack the understanding of the scientific literature and material demands of Zirconia. This prep will phase out as the failures start showing up - fractured zirconia, initiating at the knife edge margin. Zirconia is very poor in thin areas, less than 0.8 mm. Therefore, I will respectfully decline your request - hope you understand.
@@StevensonDentalSolutions I understand Dr Stevenson, thanks u for ur reply.
im drooling. shes gorgeous
Ahhh, too nice!
Great video! do you have any tips for creating the margin on the disto-palatal side of a molar when working on a patient? Not having direct vision and then the hand mirror getting wet every 2 seconds after drilling with water makes it seem impossible to get a clean continuous margin disto-palatally ?
I use electric and minimal water.
Hi. Thank you very much Dr. Stevenson for the great video. May I ask if it is the same preparation as full zirconia? Is it any different or it is the same exact prep? Thank you so much again.
Almost - the line angles are all rounded for zirconia and zirconia does best with a 0.6 mm marginal axial depth and a fillet shape, rather than a true chamfer.
Amazing prep thank you for the course !
do you have anything similar on veneers ?
Yes I do: czcams.com/video/_Fp3lsTOZkE/video.html
@@StevensonDentalSolutions thank you ! you're awesome
I have been watching and enjoying all your videos.
I would like to know if all your preps finish right at the gumline no matter what material you are using for your final crown or are you still packing cord
to be able to read the finishing line of the prep? Do you have a video that talks about that issue.
Thanks again.
For bonded restorations I typically will prep Supra-gingivally whenever possible, except as dictated by lesions, existing structural compromises or esthetics. For non-bonded I’ll use the above criteria PLUS the need to satisfy retention and resistance forms.
do you have a video on adjusting a night guard when it is delivered to the patient. I think these days with all that is happening in the world more people are using night guards due to stress. A video would be helpful. Thanks.
Tried this today, and it worked a lot better than making depth cuts!
Yes! Agreed. Glad this helped.
Hi thanks dr Stevenson. Just a question, are all the burs from Brassler?
Got it in the end of the video, thanks. Also how do you relate this prep to a full contour base metal crown in US,? Is it really done anywhere? And does the prep remain the same? Thanks again
Base metal crowns really aren't done much anymore - too many issues with Beryllium toxicity in labs and Nickel allergies with patients. Usually gold at 40% is the minimum for most crowns, and yes the FGC is still done, albeit much less than in the past. With all-ceramic materials, especially zirconia, the full gold crown is almost gone from many practices...
Great video doctor!
What type of typodont are you using in this case?
Columbia model 860 - thank you for watching!
Stevenson Dental Solutions
dr, thank you very much for sharing your video.
Very good yaraam
30 minutes for a FGC prep!!?? it takes me a full 2.5 hours... Then again i just started fixed pros this semester - going to challenge myself in preclinic sessions to cut that down to an hour and eventually like you Dr. Steveson!
Woohoo! You are on the path...keep at it!
@@StevensonDentalSolutions I re-reviewed your PFM premolar prep video after doing them today in preclinic and i was able to do 2 preps in two hours (second one was anatomically better)... but i seem to be over-tapering mesio-distally!!! i've made checkpoint drawings to visualize every step of the way and in my mind i have an end-goal picture of what i want to create, but it never turns out that way... is there any tip you could share in terms of not over-tapering, and thus, over-reducing the mesio-distal walls? (note: PFM upper premolar prep)
Wow - that's great! Try using a nearly parallel diamond, like an 877-009 and look from 9 O'clock to better visualize what the bur is doing.
@@StevensonDentalSolutions thank you. and very good points! will try to incorporate this into my next preclinical sessions. thanks very much again
@@KHgoalkeeper21 Great!
Video on PFM please
I have them in my channel - check it out - thank you!
Doctor please tell me that when you are doing occlusal reduction in beginning you made depth cut 1mm at that time did you cut it flat or maintained the inclination of cusp
Maintain the cusp inclination at all times with the A, B and C planes. Thank you!
wonderful as always. Can you guide m how too measure 1.5 mm occlusal clearance ? thanks in advance
You can use the RGS 4 instrument. If you don’t have one of these you can also use the shank of a friction grip but which measures 1.5 mm.
When you don’t have any instruments that can be used like on the lingual, simply use depth cuts or depth planes during your reduction. You can always look at the adjacent teeth in the area of the marginal ridge. You can easily see that you have reduced your preparation 1.5 mm more than the adjacent marginal ridge.
@@StevensonDentalSolutions thank you so much Dr. Stevenson that was new info to me
Would be very helpful if we can watch you demo block temporaries
Oh that is a cool idea! Will put this in the queue!
Thank you Dr for the video.
I just want to ask you, the instrument 23:22 is same as gingival margin trimmer?
Hi Doc - no, this is an off angle chisel and it has a right angle at the end, like a hatchet.
@@StevensonDentalSolutions Thank you for answering dental student like me
Of course! I appreciate your questions and interest.
at what speed are you running your electric micromotor when preping in all your videos, which I thoroughly enjoy. Thanks
I typically use 40,00 x 5 for the gross reduction and 5,000-10,000 x 5 for the refinement. Thank you Doc!
Hey Dr. Stevenson, thank you so much for making these videos. I've learned so much from you. What RPMs are you using throughout the procedure?
It's an air turbine - so it varies. Usually I use slower speed for finishing and a brush stroke. With electric, I use max speed until finishing and then reduce the speed to 5000
@@StevensonDentalSolutions Gotcha, thanks. So it's okay to use the electric high speed handpiece at 5000 rpm?
@@shockwave208 Yes, or even slower - as little as 500 for refining finish lines
@@StevensonDentalSolutions Okay thank you!
@@shockwave208 My pleasure!
Is it ok if i start with proximal wall reduction before axial wall reduction??? Or which is easier and gives better results???
This is perfectly acceptable as well - no matter what technique you choose, with focused practice and feedback, you'll achieve mastery! Thank you, Dr. S
Thank you very much Dr, please when we remove the interproximal contact, we work with a lower vitess ?
Usually I use high speed for this with a very steady hand and finger rest.
Thank you that was very helpful, you saved my life 8) , but is there a video of occlusal reduction with a diamant milling? In our school i am not allowed to use a cylindrical milling to make an occlusal reduction.
Sorry - don't have any others. I wish you the best.
Hello Dr. Stevenson, thanks for the video.
I want to know that are you using Air driven hand piece system or Electric motor hand system to perform the reduction in this video.
Air. I use electric in my practice.
@@StevensonDentalSolutions Thank you Dr. Stevenson 🙏🙏
@@StevensonDentalSolutions Dr. Stevenson, what are your views regarding use of Electric motor driven system for a dental student pursuing DDS.
I mean to say is it more easily adaptable as compared to air driven system for a dental student.
Secondly, can we use Electric motor system in WREB exam?
Kindly share your views.
Beautiful! But what’s wrong with having a gold feather edge margin on the lingual?
You can make a gold feather edge 360 degrees - it's just not taught this way in dental school, as it requires a very talented technician to pull the wax pattern off the die without distortion. Most technicians find that when more bulk exists at the finish line (via a modified chamfer) it is easier and more predictable when fabricating a casting. I perform all of my gold lab work and find that feather edge margins are not an issue, but they do require significant skills to pull off.
Hey Dr stevenson, thank you so much!!! I want to ask that should I always retract the free gingiva by placing retraction cord before preparing the crown???
Usually in the posterior I use rubber dam for most of the prep and then go without burs to finish the margins. For anterior teeth it depends - sometimes a small cord (the smallest or #3 silk suture) is placed when the phenotype is thin and recession is a concern, in this was I can control bur contact with the tissue and not disturb the delicate gingiva. In the latter case, I would not use a true retraction technique - we see these cases in about 13% of the patients, fortunately. In other anterior cases, where recession is less of a concern, thick phenotype, normal bone crest, I will place a small cord and prep to the top of the crowd, then pack another cord on top prior to the impression.
This is a great video... If the tooth is overtappered buccally, and lingualy when reducing bucal and lingual face, is there a way to 'rescue' this tooth? Thank you so much
The only way is to either deepen the axial walls at the gingival, or add a box on the mesial/distal. Clinically there are many other tricks including integral slots.
@@StevensonDentalSolutions Thank you so much for the reply..
Good day Dr stevenson for the functional cusp reduction do u recommend to reduce it to about 1.5mm or 2 mm
1.5 for gold, 2 mm for PFM
@@StevensonDentalSolutions thank u so much Dr stevenson always appreciate your help
@@StevensonDentalSolutions isn't 2 mm too much for a pfm? I prefer 1.5 mm with diamond burs with a medium grit for better retention with cementation. Let me know what you think about my technique and if it's good please.
@@no-dl4rm You need 0.5 mm minimum for the metal and 0.2-3 mm for the opaque layer, therefore 2 mm is the standard here in the US as taught by Shillingburg, etc. which will allow for beautiful groove replication and an aesthetic appearance.
As for the grit, the lab will use a wax-up and add die spacer which will leave space for the cement, which you will then fill the grooves with. A smoother prep actually increases retention due to more of the metal being in contact with the prepared surface, and also, less distortion when removing the wax pattern from the die. A rough prep has hundreds of micro undercuts. This is rare knowledge and is not taught in dental schools nor understood by even the most experienced dentists.
Can you please explain how a student can find the long axis of the tooth when doing a preparation (whether it be a crown or not). I find I always angle my burn incorrectly...thank you so much for your videos.
Good Question. Hold the bur perpendicular to the occlusal plane of the tooth. Keep the curves of Spee and Wilson in mind as well. The roots are not involved in the line of draw, just the clinical crown. All the best!
Hello Dr Stevenson,
For the 46, is the long axis of the tooth tilting lingually because of the curve of Wilson?
Thanks!@@StevensonDentalSolutions
Doctor how you know the amount of reduction with out makin guiding grooves?🤔
I have a question, how dependent are you on your dental assistant's ability to keep a clear view of teeth while you carryout a crown preparation? This video is amazing & your prep is good with a dry burr. But you do you prepare clinically while maintaining such an awesome view of your teeth (under all the water spray & saliva)? Thanks!
A few tips: use rubber dam whenever possible - even on full crown preps. Turn the water down. At the end, use the electric handpiece or stall-out mode on the high speed DRY with fine diamonds and refine with a light touch - very little heat is generated if at all. In fact, studies have shown that using the prophy cup causes significantly more heat that a dry bur! A good assistant will keep your mirror dry during the procedure.
Can you show me a picture of how you are holding your drill, i was showing some of my classmates this video and many are curious.
Modified pen grasp
anlamadığım sapasağlam dişi neden törpüleyip üzerine kaplama yapılıyor mantık nerede
Hi Dr. Stevenson! Is there a difference between an off angle-chisel and a hatchet?
yes, the OAC is rotate 45 degrees relative to the blade.
Dr stevenson did you reduce occlusal clearance when u make the functional bevel??
So when u where doing the occlusal reduction the occlusal clearance was not reduced?
The functional cusp bevel IS occlusal reduction. Occlusal reduction involves THREE planes not just two...
Stevenson Dental Solutions thank you for replying dr.
But what i mean is do u reduce the height when ur doing the functional bevel
@@alexjun5694 Yes, absolutely, but 1.5 mm
I have a question doc. How did you do chamfer margin for a gold crown??? Shouldn’t be a full shoulder
Gold always does better with a chamfer margin - the shoulder is only used for ceramics.
Hey Doctor, what bur are you using for the axial reduction?
878K-012 on facial and lingual, then 859-010 to break proximal contact, then back to the 878K-012 to improve the wall inter proximally. Finally, I use the 8877-009 to improve the chamfer.
Stevenson Dental Solutions thanks!!!
Dear Dr Stevenson,
To reduce the buccal wall of the lower molar, do we need to tilt the bur slightly lingually because of the curve of Wilson?
Thank you
Yes. Perpendicular to the occlusal table, hence tipped toward the lingual.
After breaking the proximal contact with a thin bur, my axial reduction bur still can’t pass through interproximally...
Correct, this is true, so now use the 878K-012 and remove axial tooth structure to allow it to fit...
Do you train for the clinical Dental Boards?
Yes - check our our site: stevensondentalsoutions.com
why do you do the functional cusp bevel in the beginning and not the end? is there a difference? is the beginning better?
No difference - it's just so important, we recommend completing this before axial reduction at the very least.
Hi, Doctor.
How do you remove contact area with severe root proximity.
It`s difficult to reduce contact area in that case.
Plus, there is a lot of gingival bleeding.
This is a tough situation. Sometimes, if I can't achieve adequate gingival clearance, I'll place a provisional and an ortho separator and move the tooth slightly. This requires a good understanding of the impact on occlusion but it is a viable technique.
@@StevensonDentalSolutions I got it. thanks a lot.
@@CR-uz8qq Great
Cracked a tooth now I’m looking at gold teeth, got to this video and made me want to become a dentist lol
Awesome!
I'm getting this done tommorow does it hurt
Oops.. Your comment's been a month ago... How was your experience 🙂
I wish i can meet you some day... !
Me too
I plan on traveling to India and the ME very soon!
Can I use low speed rather than high speed ?
Yes or an electric
Which but number you used for axial reduction?
878k-012 for axial taper and 877-010 for finish line
Dr: How many mm do you reduce on the buccal gingival surface for Gold crown?
0.5-0.7 mm ideally.
What rpm do you run your bur at for these videos?
I'm using a high speed turbine, so it will be over 100,00 rpm, but I use stall out mode for refinement, pressing partway on the rheostat pedal. Thank you!
What is the suggested speed ?
I use 36,000 electric with a 5x up gear for a speed of over 180,000 rpm for the gross cutting and then slow it to 5,000x5 = 25,000 fom for the refinement or even slower.
Hi doctor
How much reduction is required for gold crowns means in mm ?
1.5 mm occlusal is typical, and 0.5 mm axial at the chamfer finish line...
the problem I am facing.. is that the distal interproximal cutting through the mirror is horribly difficult..
Yes, it is the hardest part of the prep. When you face this challenge, just understand that we all know this to be difficult, hence, go slowly, keep your cool and realize that is is this way for everyone.
What handpiece is this?
High speed
Can't a gold crown be placed without taking away and 🦷 structure?
if the tooth touches the opposing tooth naturally, you will need to remove tooth structure to create space for the gold, otherwise, the gold cap would be the only thing touching.
im worried about damaging proximal tooth when you remove interproximal wall
Always a challenge!
im sorry doc i only have 10~15 minuets allowed for a single crown preparation...
allowed?
That's sad.
this crown was literally perfect. if all my crowns looked like this id be a millionaire.
Wow - thank you.
Thumbs up if you're watching to try to save money on dentistry 👍
You got that right!
does a dentist or a dental technician do this?
Dentist
Stevenson Dental Solutions thank you
There is no gold crown in the video tho :(.
As a jeweller I'm disappointed lol
I thought you didn't need to shave down alot of tooth for a Gold crown?
Full Crown , it's like this...onlay, much less.
huh?
Its only a shame that so many dentist, are able to become dentist even though they are not good enough to produce quality work. You watch these videos and think this is the work you will get. But for some reason, there are many dentists who do really bad work, and yet are still able to stay dentists doing bad work. Only if they all did good quality work like we see in these BS videos lol.
Lost count how many times he touched the adjacent teeth!
For the untrained eye, it looks like a lot, but i actuality the adjacent teeth were not touched one time during the filming of this video. I use 6x loupes and a microscope and can place the bur within 50 microns of the adjacent tooth with no touching. The powder generated may give you this impression. Thank you for your comment as it is hard to understand when just learning fine dentistry.