 Hello everybody, Andrea Maesky here with Dentalo Tutoring and the video today we will be going over a crown prep tray setup. This could be used for a bridge prep as well, but just to keep things simple because bridges are basically the same thing as doing a crown prep, but just on a larger scale. So we'll be talking about the bridge or sorry the crown prep tray setup today. I was just taking a quick peek. It looks like everything's here. I just took this picture from Pinterest. So these are not my pictures. I took this one from Pinterest, but I want to explain everything for you because when I was working as a full-time dental assistant, I found the crown prep probably one of the scariest procedures. I mean not scary, but it was just so easy to forget something because I felt you had to have so much with you and it was kind of hard to learn it all step by step. So it did take me a long time, but do not be afraid of the crown prep tray setup. Yes, it looks like a lot, but you would be surprised how quickly you will catch on. So initially what I would like to talk to you guys about is that for a crown, it takes usually two appointments. So the first appointment is the crown prep. So that is where the dentist will prep around the tooth. Do what they have to do to prepare the tooth for that final impression, and then they would put on a temporary crown after that. And then the patient usually comes back in about two weeks to have the temporary crown taken off, and then the permanent crown will be cemented in with a permanent cement. They will check to make sure that everything fits. Sometimes they take an X-ray at that second appointment just to make sure that the crown is seated properly, and then that's it. So typically this is not done in one appointment. It takes two, unless you have a CERAC machine in the office, which allows you to make the crown in the office, and some offices do have that. Some offices don't. But let's just say you do not, and this is for a two-appointment crown prep. So initially, like I said, what the dentist is going to do is the usual, you know, topical anesthetic, local anesthetic, they will put on the rubber dam. If you guys want to know more about the topical and the local, I do talk about that a little more in depth in my composite tray procedure. So have a look at that. But after the rubber dam is placed, then they will go to prep the tooth for the crown. And a lot of dentists like to use the rubber dam initially for the prep because it takes time, because you're pretty much shaving off a millimeter to two millimeters around the entire tooth. It doesn't sound like a lot, but it is a lot. So there's a lot of water with that high speed handpiece. So it's a lot easier even for you if the dentist does use a rubber dam, because if not, you'll be trying to retract the, you know, cheek tongue using the high speed suction. It can just be a little more annoying, I think. So I just find it so much easier if they're able to use the rubber dam. But they will likely take off the rubber dam for the rest of the prep because you can only prep so much because the rubber dam clamp will be in the way. So after the dentist does the majority of the prep, they will take off the rubber dam clamp and then do the rest of the prep from there. It might take 30 seconds. It might take a minute, but at least they have the majority of the prep done. I should mention to sometimes before a crown prep, if there's a large cavity in the tooth, they might have to actually fill the cavity with composite or composite or amalgam first. So if you want to know how that works, then watch my composite tray set up that I have on that because it depends if the patient needs a filling or not. So you might have to set up even more. But anyway, so to continue on, after the prep is done, the dentist will want you to cut a retraction cord, which is over here. Now, retraction cords do come in different thicknesses. So the dentist will tell you the thickness that they want. 00 I believe is the smallest thickness and every dentist is different. I have seen them use the tiniest one and then I've seen them use the largest one. So you just don't know what they want to use, but they will tell you. Some dentists also place this gingival retraction cord in a solution of it's called Hemosil. I couldn't find a picture of that, but that's just basically a vasoconstrictor in a liquid. And that will help to stop the bleeding around guns. Now they don't always put it in that Hemosil solution, which I'm sorry, I don't have that picture here because I couldn't find a picture of it. But sometimes they do. So if you happen to see that and you're thinking, what is this solution? Well, that is what it could be for. But again, they don't always use that. But you want to know how that works. So that's basically a vasoconstrictor in a liquid. And that will help to stop the bleeding around guns. Now they don't always put it in that Hemosil solution, which I'm sorry, I don't have that picture here because I couldn't find a picture of it. But sometimes they do. So if you happen to see that and you're thinking, what is this solution? Well, that is what it could be for. But again, they don't always use that. But you want to hand this retraction cord to the dentist using the compliers or the forceps depending on what they call it. And then they will either dip it in the Hemosil that I had just talked about, or they will place it into the sulcus. And then you want to pass them the gingival cord packer. And that's what this is here. So I did get a larger picture for you just so you could see because it was really hard to see kind of what it looks like from here. Now in my office, we just use the PFI, so the plastic filling instrument, because basically the same shape and it just sort of prevents us from using a different instrument. But most offices do have this gingival cord packer. But just in case you don't have that, if you see an instrument that has this kind of an end to it, that will work okay. And then just pass that to the dentist after they place the retraction cord into the sulcus. So the dentist takes a couple minutes to carefully pack this all the way around the tooth. This is not easy. It can take a couple minutes or it can happen right away. But they need to make sure to pack that all around the tooth so that the gum against the tooth is being pulled away. And that will make for a much better final impression. Once they're satisfied, they have to make sure that the gum is not bleeding at all because if it is, they will not be able to take a very good final impression. So that takes time, which is why usually the retraction cord is placed in a hemo seal type of solution to stop that from happening. But once they're happy with that, they will want you to pass them the light body impression material first. Now the light body impression material, you might not have this whole contraption in your office. Every office is different. Sometimes I've seen this type of thing that you leave on the counter and then you just have to load up the light body in there and then you push a button and then you would load it into the syringe that way. Or this is usually what I see, but depending on what your office is, hopefully the other dental assistant in the office will be able to show you. So if this is the case, these cartridges come separately and then you have to load it into the gun here. And the light body, you would want to load up into a syringe, which I do not see that here. Let me go find a picture quickly of what that would look like. So one moment. There everybody, sorry, sorry about that. So I did find a couple different images for you. So the light body you want to load into a syringe like this. So you would take the top off and then load it in. I wish there was a better way I could explain that but that's just kind of something that has to be shown to you. So hopefully you learned that in school or the dental assistant in the office will be able to show you that. So the light body is, you know, always going to be first because what the dentist does is you would pass them the syringe with the light body in it and then they would put the light body around that crown prep. So I just kind of found this picture here. So this is showing the lower arch. So they would put the light body with the syringe around the tooth. So inside the mouth that goes around the crown prep. And then quickly, so this has to be done fast. No pressure. You have to load up either the medium body or the, either the medium or the heavy impression material in the gun, but onto the entire tray. So this tray will be empty and then you have to load up and I say either medium body or the heavy because it depends on what the dentist wants to use. I've seen either or just in the picture here. It's not showing the medium. It's only showing the heavy. So what that is done is you would load up the entire tray quickly and then pass that to them and then they will put this impression tray with impression material inside the mouth. They let it sit there for a couple minutes and they take it out and then it looks like this. So the light body is always a different color. Now I quickly just wanted to mention. So sometimes for the light body, they would not use a syringe, but they would just use a different tip. I have seen it both ways. So that's why I just kind of showed you the syringes to like sometimes they just want to use the tip. But if they don't purchase those extra tips, then they'll need to put it in a syringe like this with a thin tip because they want that light body around the crown prep. So does that make sense. So after that, then they can make the temporary crown. So this is where this impression comes in handy. Actually, you know what you guys I forgot to mention something at the very start of the appointment. I apologize at the very start of the appointment. You will likely be taking alginate impressions, not always, but usually you will be taking alginate impressions of the top teeth and of the bottom teeth too. And that's because it just makes it easier to send that to the lab and the lab can see how the teeth, how the tooth and the teeth looked before the crown prep and also how the top teeth and the bottom teeth fit together. So that's why you will typically do that first. But another thing I completely forgot to mention was after you take the alginate impressions, you will want to take a bite impression of where that crown will be. And a bite registration as well, which I don't have a picture of that. So let me go find that. Okay, guys, sorry. So for the bite at the beginning, you want to use a tray like this. So before the dentist does the crown prep, you have to make sure to load up the bite registration will be in a similar cartridge like this. And it's usually clear. And it's just usually called bite registration. So there's no other name to it. You would load it into the gun, load it here on the top, and then you would load it on the bottom too. So this is either side, so the top and the bottom. And then you would put that into the patient's mouth of where that crown prep is supposed to be. Have them close for like 10 seconds. And then have them open and then you are all set because this will be then used to make the temporary crown at the end because you want to put on the temporary crown in the shape of obviously how the tooth was before. So if you don't remember to take this impression at the beginning, um, you're really, it's going to be a lot harder for the dentist to make a temporary crown because if you don't have how the teeth looked before. This just makes it a lot easier for them to put in that temporary crown material into this impression. Now, sorry, I'm going to stop the video again. Because I want to try to find what this looks like for you guys in case you haven't seen it before. So go take a break and I'll be right back. Okay, so this was the best one that I could find. So this would be the impression. So this impression here. And then this temporary crown material is in a cartridge like this to with a thin fine tip. So it is usually orange. So that would then be put here. This looks like actually it's a bridge prep that they're doing because you see it on three different teeth. So for a crown, let's say we're just doing the one crown, it would just be in the one area. Okay, so the dentist will usually put this in and then they will put this back inside the mouth in that area of where that to should be. Because then this will make a temporary crown in this in the shape of that tooth how it was before. I did try to find kind of a picture of a temporary crown just so I could show you guys but believe it or not I couldn't find one. So hopefully you had seen this in school. But if you're really confused, then just make sure to comment below so then I can help you guys out more with that. And I can always look a little bit harder to but I just couldn't find anything. Oh, you know what, I just found something. I was just kind of looking on my opposite monitor while I was doing that. So can you guys see this and sorry for all of the images here. So this is the final product so this is what it looks like after it's been set in the mouth and then the dentist takes it out of the mouth this is what it looks like. So, so then the dentist will take this will take this off and then load up their temporary cement also in a gun usually to sometimes not sometimes it's as a catalyst and a base and then you have to mix it up and then put it in here. Some Dennis like a thin amount some Dennis like a lot. So I would just ask them what they they want or they might mix up the cement themselves and then place it themselves so I don't know everybody's different but this is kind of what the final product looks like. And then they will cement this inside the mouth and that's it. They will cement it. They don't usually have to like hear it or anything. They'll cement it inside the mouth and then they will take off the extra cement usually with an explorer because you do have to clean up sort of around the tooth. They'll likely check the bite after that but it probably doesn't need too much to be changed. Sometimes it does sometimes it doesn't. But the dentist has to be careful because this is a temporary cement or sorry a temporary crown material so if you try to change it or if you try to adjust it too much. It might crack right because they're not supposed to last more than a couple weeks, a couple months at the most but they're meant to last the best answer a couple a couple weeks because then you assume that the patient will come back to have the permanent crown. Put inside the mouth. So yeah, so that's it for the crown prep procedure. If you guys have questions, please comment below. But I will quickly say for the second appointment when the patient comes back to get their permanent crown seated, the dentist has to take off obviously the temporary crown. Sometimes they're still stuck in there pretty good. So sometimes the dentist does have to cut into that temporary crown with with a high speed handpiece and a bird or they might use crown and bridge scissors to kind of trim around it and then try. But these are kind of hard because these aren't meant to go inside the mouth but I've seen dentists, you know, do that sometimes. But they take the temporary crown off. You can even ask them what they want to use to take off the temporary crown because there are temporary crown bridge removers I guess is the right word. So they might want to use that too and then they will wash and dry the tooth really quite well and then they will put the permanent cement into the permanent crown. Now they will likely though try in the crown first before they permanently cemented in because they want to make sure that the crown fits properly. So I should mention that too. But that's at the second appointment and then they'll obviously check the fight and then the patients all set. So usually the first appointment so the crown prep takes about an hour and a half to two hours depending on the dentist. The second appointment to bring the patient back takes about 20 minutes, maybe, maybe half an hour, maybe more, maybe less. It just depends on the dentist, but there are usually two appointments with that. Okay, guys, I think I have everything on here. I forgot to mention the shade guy, but that's kind of self explanatory anyway, you want to check the shade of the teeth. So that you can tell the lab what shade that crown is supposed to be. So I did forget to mention that. But if you guys have any questions, make sure to comment below. If you like this, make sure to also click like so that way I know that you guys are liking these and you would like me to do more. So thank you guys for watching and I will see you guys in the next one.