| |
|
| |
| Our Standard Practice of Crowns and Bridges |
| |
Listing of Standards By Task
1. Disinfect the impression and/or model
2. Assess the prescription for completeness
3. Determine the correct shading for the restoration
4. Document changes to the prescription and/or design requirements
5. Determine the quality of the impression and the bite registration
6. Fabricate a master model and separate dies
7. Mount the models on the articulator
8. Prepare dies
9. Wax- up the restoration
10. Select the alloy to be used in casting
11. Invest wax pattern
12. Burn-out the wax pattern
13. Cast and de-vest the restoration
14. Fit the restoration to the master die
15. Send the restoration to the Health Professional for try- in
16. Prepare the restoration for ceramic/composite application
17. Oxidize the restoration
18. Apply the veneering material to the restoration
19. Contour the veneer
20. Glaze and/or stain the restoration
21. Polish the exterior metal portions of the restoration and microblast the fitting surfaces
22. Determine the restorations quality
23. Prepare the restoration for shipping
Condition:
Given a shipment of an impression or model from a Health Professional
Task:
Disinfect the impression and/or model
Criteria:
Safety:
...So that gloves are worn at all times until disinfecting is completed
...So that the disinfectant used is compatible with the impression and/or model
...So that manufacturers specifications for disinfectant used, are followed
...So that the packaging material that was in direct contact with the impression or model, is discarded
...So that the impression and/or model is disinfected according to the Universal Precautions -- at the minimum -- low level.
Timing:
...Before proceeding any further
Condition:
Given a prescription from a Health Professional
Task:
Assess the prescription for completeness
Criteria:
Technical Quality:
...The prescription must include:
...the patients name or identification number
...the authorized Health Professionals name
...type and/or description of prosthesis or treatment objectives
...type of alloy to use (i.e. noble, high noble, non-precious)
...shade
...date sent and date required
...So that if in doubt, the dental technologist will consult the Health Professional before proceeding with the
Condition:
If the shading was not established by a Health Professional, and given that colour corrected lighting is used and that patient is present
Task:
Determine the correct shading for the restoration
Criteria:
Technical Quality:
...So that the shade blends with the shade of the adjacent teeth
...So that the shade selected is recorded
Interpersonal Quality:
...Ensuring that you explain to the patient what you are going to do and why
...Ensuring that you ask the patient for his/her expectations regarding the shading
...Ensuring that if the patients expectations cannot be met, you (the RDT) explain to the patient why
...So that while taking the shading, touching the patient only in the area around the mouth
...So that consent to take the shade is obtained from the patient
Safety:
...So that if the patient needs help, assist him/her onto the chair
...So that hands are washed prior to gloves being worn
...So that new examination gloves are worn at all times
...So that all colour matching tabs are disinfected
...So that all instruments used in the patients mouth are disinfected
Condition:
Given that clarification and/or changes are needed due to an incomplete or unclear prescription from a Health Professional
Task:
Document changes to the prescription and/or design requirements
Criteria:
Technical Quality:
...So that any changes or modifications to a prescription or design as a result of discussions with the Health Professional, are documented and dated
...Documentation must include:
...date of contact from the Health Professionals office
...changes and modifications agreed to
...signature of the RDT or that of the person designated by the RDT
Condition:
Given a completed impression and bite registration (provided by a prescribing Health Professional)
Task:
Determine the quality of the impression and the bite registration
Criteria:
Technical Quality:
...The impression must:
...not have any air bubbles, drags or visible distortions
...replicate the Health Professionals preparation entirely
...if impression copings are used, they must be secure in the impression material (i.e. must be locked into the impression)
...The bite registration must be accurate, i.e. not distorted
...If in doubt at any stage, the dental technologist should consult with the Health Professional
Condition:
Given an impression with no air bubbles, drags or visible distortions and the following equipment and materials: a vibration device, mixing container, vacuum mixer, die stone,
epoxy resins, and a removable die system
Task:
Fabricate a master model and separate dies
Criteria:
Technical Quality:
...So that the model is a true reproduction of the impression
...So that there is a clear outline of the prepared margins
...So that the space between opposing teeth is consistent with the manufacturers specifications for the restoration materials used
...So that the die system allows repeated removal and replacement of the die to its pre-cut position
Safety:
...Wearing gloves while pouring the model
Condition:
Given the requirement to articulate, and using an articulator
Task:
Mount the models on the articulator
Criteria:
Technical Quality:
.So that the models are mounted in the relationship required by the prescription
Condition:
Given a hand piece, burs, block-out material, marking pencil, die spacer, die hardener and dust extractor and a magnification device
Task:
Prepare dies
Criteria:
Technical Quality:
...So that all aspects of the margin are visible and accessible
...So that the dies are not over trimmed
...So that the preparation is parallel to the path of insertion
...So that minor undercuts and imperfections are blocked out
...So that the margins are marked visibly
...So that the spacer covers all preparation areas as per technique
Condition:
Given a Health Professionals prescription (for metal or veneered to metal crown & bridge), the articulated model, wax, die separator, and hand instruments
Task:
Wax- up the restoration
Criteria:
Technical Quality:
...So that if any of the occlusal contacting surfaces are in metal, functional and anatomical harmony must be achieved
...So that the margins are sealed with no under or over extensions as defined by the penciled markings except when otherwise required by the prescription
...So that copings are designed to support the veneer to the veneer manufacturers specifications
Condition:
Given a prescription from a Health Professional
Task:
Select the alloy to be used in casting
Criteria:
Technical Quality:
...So that the properties of the alloy are suitable for restoration
...So that the selected alloy complies with the requested alloy on the Health Professionals prescription
Safety:
...So that materials used are either ADA, CDA, Health Canada or FDA approved
..So that if materials do not have either ADA, CDA, Health Canada or FDA approvals, the RDT must inform the prescribing Health Professional and record the Health Professionals approval and materials used
Condition:
Given a casting ring, vacuum mixer, sprue form, debubbilizer, spatula, hand instruments, wax and investment system
Task:
Invest wax pattern
Criteria:
Technical Quality:
...So that manufacturers specifications are followed
Condition:
Given a mold, furnace and crucible
Task:
Burn-out the wax pattern
Criteria:
Technical Quality:
...So that the temperature used and time allowed for burn-out follows alloy manufacturers specifications
Condition:
Given a selected alloy for casting, mold that has been burnt out, a casting system, and a de-vesting system
Task:
Cast and de-vest the restoration
Criteria:
Technical Quality:
...So that porosity is not present in the restoration
...So that all details of the wax pattern are present in the casting
...So that all casting, de- vesting and cleaning procedures are followed according to the instructions of alloy and equipment manufacturers
Condition:
Given a cleaned restoration, a lathe and/or hand piece, trimming tools and a magnification device
Task:
Fit the restoration to the master die
Criteria:
Technical Quality:
...So that if any of the occlusal contacting surface are in metal, functional and anatomical harmony must be achieved
...So that the margins are seated with no under or over extensions as defined by the penciled markings except when otherwise required by the prescription
...So that copings are designed to support the veneer to the veneer manufacturers specifications
...So that there is no damage to the die
Condition:
Given a restoration fitted to the master model, a request specified in the prescription or the RDTs decision that try- in is required
Task:
Send the restoration to the Health Professional for try- in
Criteria
Technical Quality:
...So that the restoration will be received by the Health Professional without damage or visible distortions
Condition:
Using ceramic/composite compatible trimming tools
Task:
Prepare the metal restoration for ceramic/composite application
Criteria:
Technical Quality:
...So that the ceramic can bond to the metal
...So that the surface has a smooth and even finish, and has no sharp edges (if ceramic)
...So that retention is provided for composite bonding
Condition:
Using a ceramic furnace and a metal substructure
Task:
Oxidize the restoration
Criteria:
Technical Quality:
...According to the manufacturers specifications of the alloy used
Condition:
Given prepared metal restoration, the ceramic furnace, hand instruments, and veneering materials
Task:
Apply the veneering materials to the restoration
Criteria:
Technical Quality:
...So that the form, function and the desired shade of the restoration is achieved
Safety:
...So that materials used are either ADA, CDA, Health Canada or FDA approved
...So that if materials do not have either ADA, CDA, Health Canada or FDA approvals, the RDT must inform the prescribing Health Professional and record the Health Professionals approval and the materials used
Condition:
Given a veneered restoration, hand piece and trimming tools
Task:
Contour the veneer
Criteria:
Technical Quality:
...So that if any of the occlusal contacting surfaces are in the veneering material, functional and anatomical harmony are achieved
...So that the margins are sealed with no under or over extensions as defined by the penciled markings except when otherwise required by the prescription
...So that the fit, form and function are harmonious with the neighbouring teeth unless otherwise required by the prescription
Condition:
Given a ceramic furnace or curing unit, stains, hand instruments and the trimmed veneered restoration
Task:
Glaze and/or stain the restoration
Criteria:
Technical Quality:
...So that the prescribed shade and surface characteristics are achieved
Condition:
Given a completed restoration and using trimming tools
Task:
Polish the exterior metal portions of the restoration and microblast the fitting surfaces
Criteria:
Technical Quality:
...So that all oxide and debris is removed from the fitting surfaces
...So that the surface has a mirror- like finish
Condition:
Given the clean restoration and a Health Professionals prescription
Task:
Determine the restorations quality
Criteria:
Technical Quality:
...The restoration must be correct in accordance with the prescription
...The restoration must fulfill the required intra-oral function and intent of the prescription
Condition:
Given a completed (porcelain/composite), glazed and polished cast restoration, and shipping bag/container
Task:
Prepare the restoration for shipping
Criteria:
Technical Quality:
...Packing it so that it will be received by the Health Professional with no damage or distortion
|
|
|
|
|
|
|
|
