This selection is based on - The type of mouth you want to make an impression of- Dentulous Mouth – use Dentulous Trays. On the metal wire Short Communication. This will help in reducing chair side time and will give good adaptation of final prosthesis; First, take a preliminary impression of the patient’s mouth using stock trays designed for edentulous patients. Some recommended techniques for modifying the standard impression include the use of stock trays or custom-made trays for each half of the arch. Introduction . 1-Stock tray for dentulous patient. The fabrication of complete dentures for edentulous patients explored in depth. High-strength milled restorations allow for the use of all-ceramic restorations for multiple-unit posterior and anterior bridges. Fixed Prosthodontics. hence, dentist will receive patient appreciation in practice. A second option is to convert an existing removable partial However, ... Another technique is taking an impression using existing denture as a custom tray. Fig - 4 Morrow , Rudd, Rhoads spacer design for maxillary, Metal foil spacer in incisive papilla and mid palatine raphae. CAD/CAM restorations have demonstrated clinical success owing to a combination of improvements in materials with advances in CAD/CAM systems. All trays, however, exhibited shrinkage during the 24-hour test period. impression as well as final impression due to lack of knowledge like, optimum material for making custom impression tray, adequate extension, required thickness and designs of spacer, tissue stops, escape holes, tray handles and polymerization time regarding custom impression trays in prosthodontics. This article will encourage the dentists to use accurate design of custom impression trays in clinical practice. Digital impressions appear to be practical, and the concept is being perfected, but the need for further research is clear.12 Digital impressions eliminate some of the negative characteristics of conventional elastomer impressions, but proper soft-tissue management and isolation of tooth preparation margins still is necessary. This article will give a clear view to the dentists to use accuratespacer design, material and thickness, tissue stops, and escape holes, based on various clinical situations in theirpractice. :4) All rights are reserv, Custom Impression Trays In Prosthodontics -, A dentist usually uses stock tray for making primary impression as well as final impression due to, areas. tray, technique for making accurate and well-adapted custom impression tray, ideal impression An edentulous tray requires a minimum of four stops: one on each crest of the alveolar ridge in the area of the first or second molar. Full-contour ceramic restorations fabricated chair-side may reinforce the tooth, providing good long-term clinical success. Nevertheless, a single-piece denture base provided the patient with ease in placement and removal of the denture. A case report and technique of a simplified and practical design for fabrication of mandibular/maxillary sectional trays and complete denture have been presented here; this technique utilizes components that are commonly available, to simplify the treatment modality of limited oral access to the prosthesis. Will Digital Impressions Eliminate the Current Problems With Conventional Impressions? Preserving the remaining residual ridges is crucial, keeping in mind the effect of the denture base on the health of the hard and soft tissues. Pour the impression in dental stone using a vibrator to eliminate bubbles and voids. Sr Lect, Dept of Oral Pathology & Microbiology. Various design library. Dentists occasionally come across patients with constricted oral openings. A dentist usually uses stock tray for making primary impression as well as final impression due to A technique and protocol for CAD/CAM custom tray fabrication using … Browse Lectures. Full wax spacer 2mm short of borders (Fig - 4). Custom Impression Trays must (2) Fit and adapt well to the arch and maintain patient comfort. CEREC (Sirona Dental Systems GmbH, Bensheim, Germany) was the first and is the only available chairside system, and it has more than 20 years of use in the dental office. In this technique, by using custom trayswith spacers of different materials and designs, Prosthodontist always desire to make accurate impression for successful prosthesis. Edentulous Mandibular Custom Tray (Patient) Part 1 - YouTube Impressions can be made for patients with constricted mouth opening with a sectional impression tray that can be assembled and disassembled in the mouth and reassembled outside the mouth. Variety of tray shape design. This article describes techniques used to fabricate mandibular and maxillary sectional trays and a folding maxillary complete denture for a patient with limited oral opening caused by scleroderma. The prosthetic management of an edentulous patient has long been a major challenge in dentistry because the majority of edentulous patients experience unsteadiness of their mandibular denture. Copyright © 1981 Published by Mosby, Inc. https://doi.org/10.1016/0022-3913(81)90424-8. A1,B1, C1 having 30 minutes of maturation time and A2, B2, C2 having 12 hrs of maturation time. In case report I, the patient was planned to receive a fixed partial denture replacing missing mandibular incisors. border of tray and 12 mm wide. This article describes the making of a functional primary impression for severely resorbed mandibular ridge type IV. Thus, a dentist should give full emphasis on making an accurate primary impression. Keywords: Complete denture, Dual impression, Edentulous, Impression materials, Undercuts. - See Dr. The custom trays for each patient were fabricated using both chair-side CAD/3DP system of independent development and manually conventional method, and the final impressions were made by silicone impression … Impression trays are used in conjunction with various types of materials to take imprints of the patient’s dentition. All rights reserved. All figure content in this area was uploaded by Manish Sen Kinra, E ISSN NO. The basic principles of fixed prosthodontics including preparation design, treatment, impression making and esthetics. This study aimed to evaluate the quality of the final impressions taken by three-dimensional printed custom trays for edentulous patients. It may be necessary to enhance the tray periphery with wax. 0976-4003, impressions to record the desired area of, practitioners and lab technicians, we felt, custom impression tray, thus dictating, ©Indian Journal of Dental Sciences. An impression in complete dentures is the first step in the fabrication of the complete denture prosthesis. The conventional complete denture is made following healing, leaving the patient without teeth not only during the healing phase but also Prosthodontist always desire to make accurate impression for successful prosthesis. But all the authors proposed their concepts based on the available information of the underlying functional and histologic anatomy during their time. An impression was not deformed by the manipulations done by the dentist or by using oversized or undersized stock trays. Working models were divided into 3 groups viz. Aims: To evaluate the accuracy of three different custom tray materials in partially edentulous situation and the dimensional changes occurring during maturation time at room temperature. Can anyone explain why you cut out wax in the relief areas when making a custom tray for an edentulous patient? ... Acrylic custom trays are preparesd outside a patient's mouth due to the intense _____ that is generated during the curing process. The, posterior handles are used as finger rests, Sectional custom impression trays are, The misfit of the prostheses is never due, Digital impressions will not solve the, Fig - 5 Mandibular sectional custom impression tray with 4, Fig - 6 Maxillary sectional custom impression tray with 4, technique that digital impression require, “fake” a margin any better than a human, Digital impression appear to be practical, 13. Various theories have been proposed by different authors as to how to achieve an optimum impression in different ways. For mandible, the primary stress. and Overview. lack of knowledge like, optimum material for making custom impression tray, adequate extension, A simplified novel approach has been advocated using the patient's existing metal removable partial denture as a key in master cast preparation. (October 2012 Supplementary Issue, Issue:4, Vol. Kinra et al. These 2 factors increased the thickness of the denture and limited the volume of the tongue. The author reviews the materials used for CAD/CAM-fabricated restorations. Preliminary impressions needed for diagnostic casts for making custom trays; 3 Custom Tray. clinical report was to describe the fabrication of interim immediate denture in a patient with hopeless existing dentition. In mandible 1mm base plate wax spacer except buccal shelf area and retro molar pad (Fig - 3). ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Open-face custom tray for edentulous obturator impression. Different tray designs and impression techniques which can be useful in management of difficult cases causing little discomfort to the patient and help in getting back such patients to a comfortable social living. Elastic Impression Materials – generally use Perforated trays. This agrees with research already completed even though the magnitude of shrinkage was considerably less than that reported in previous studies. These patients have reduced mouth opening, and hence it can be extremely challenging to make impressions and to fabricate dentures using the conventional methods. 2-Stock tray for edentulous patient. These patients are three treatment options. The custom trays for the final impressions were fabricated with autopolimerized acrylic resin on each primary stone cast (Figure 10(c)). To achieve quadrangular arrangement in the arch. Browse Lectures. Because the abutments are a part of the Atlantis (Dentsply Sirona) portfolio, it is available for all major systems. addition silicone putty was adapted and phonetics was used for making an initial primary functional impression. To achieve METHODS: Fifteen edentulous patients were randomly recruited by three prosthodontists who passed the unified operating process training. Although the use of computer-aided design/computer-aided manufacturing (CAD/CAM) seems to be a recent addition to the dental restorative armamentarium, this concept was first investigated more than 35 years ago. We use cookies to help provide and enhance our service and tailor content and ads. The rehabilitation of edentulous patients can be achieved though different ... Irreversible hydrocolloid impressions in stock trays are made to produce required stone diagnostic casts. Since alveolar bone eventually resorbs, unwanted pressure could accelerate bone resorption and cause soft tissue damage. of removable or fixed prosthesis is often, which itself is not a disease but manifest, of the hard palate. Thus ... To evaluate the accuracy of three different custom tray materials in partially edentulous situation and the dimensional changes … One is for the patient to have all remaining teeth extracted and wait for 6–8 weeks for the extraction sites to heal. 2 Later wash impression was made using addition silicone light-bodied impression material. Inelastic materials – generally use Non-Perforated trays. The purpose of this case report study was to perform an objective treatment for a patient with one side facial paralysis, to determine the borders of an upper jaw custom tray and to assure Prosthodontic management of a patient with limited mouth opening: A Practical Approach, Dimensional change of acrylic resin tray materials, Sectional impression tray for patients with constricted oral opening, Linear dimensional change of acrylic resins used in the fabrication of custom trays, The design and use of special trays in prosthodontics: Guidelines to improve clinical effectiveness, Fabrication of a sectional impression tray and sectional complete denture for a patient with microstomia and trismus: A clinical report, Materials for chairside CAD/CAM – Produced restorations, Making of primary impression made easy for severely resorbed man ridge, A Clinical Review of Spacer Design for Conventional Complete Denture. Methods and Material: Maxillary Fresco model was used as master model and 30 working models were duplicated from it. The aim of this Fig - 3 Boucher' s spacer design for Mandibular arch. Fig - 2 Boucher' s spacer design for Maxillary arch. Title: Preliminary Edentulous Impressions 1 Preliminary Edentulous Impressions 2 Preliminary Edentulous Impressions. Therefore, autopolymerizing acrylic resin tray materials should not be used for an impression the same day that they are made unless the tray is boiled as suggested by Pagniano et al. Fabricating the custom tray and bite rim Type of impression material you want to use. In addition, you need fewer appointments. prosthodontic management of a partially dentate patient with microstomia that developed secondary to surgical resection and radiation therapy of head and neck cancer. The custom trays for each patient were fabricated using both chair-side CAD/3DP system of independent development and manually conventional method, and the final impressions were made by silicone impression materials (light body). denture into an interim immediate complete denture. If you compare it to a conventional workflow, you first need to make an intraoral scan to create the custom tray. Treatment becomes especially difficult in edentulous patients with health disorders, so that we have decided to announce our clinical case. 5. heat. Custom Impression Trays must (4) Maintain an even distribution of 3 to 4 mm of the impression material between the tray and the teeth. … Several techniques have been described for such situations, where either standard impression trays or the denture itself becomes too difficult to place and remove from the mouth. Short Communication Tissue stops are made, occlusal surface on, that have a tripod or. Introduction The technique being simple and inexpensive is indicated in completely edentulous situations with bone and soft tissue undercuts that are contraindicated for surgery. Figure.3: Completely edentulous maxillary ridge Figure.4: Preliminary Impression Figure.5: Maxillary and mandibular custom trays Prosthetic rehabilitation of a completely edentulous patient with a velopharyngeal defect: a case report accurate impressions dentist need to access the tissue to be recorded, selection of accurate stock Handle can be attached to Ray’s CT Impression Scan Kit. The stress bearing areas in the, are mid- palatine raphae and the incisive, papilla. In this technique metal wire of 1.5 mm diameter was adapted on the ridge of a mandibular arch from one retromolar pad to another retromolar pad. Dentist should always remember the two most important factors in making satisfactory impressions for complete denture patients , that is accurately fitting custom impression tray and proper positioning of the special [3] impression tray. Three of the 12 were found to expand slightly during the first few hours, which had the effect of reducing the net shrinkage. These make tray insertion more difficult and uncomfortable, especially for patients with limited opening. Methods: Fifteen edentulous patients were randomly recruited by three prosthodontists who passed the unified operating process training. Partially Edentulous – use Combination Trays. 1 layer of pink base plate wax about 2mm thick all over the ridges except PPS and buccal shelf area. For instance, when a patient opens their mouth wide, the mandibular denture tends to become loose. This article will encourage the dentists to use accurate design of custom impression trays in clinical With an aging population, treating large numbers of edentulous patients is a challenge. The maxillary preliminary impression was made using irreversible hydrocolloid (tropcalgin, zhermack) in perforated edentulous tray and preliminary cast was poured with … On casts made from these primary impressions,special/custom trays are fabricated. In addition, because each abutment is custom-made, correction of angled implant placement is possible up to 30 degrees. In the future, it is desirable to design an algorithm for a digital scanner to make a definitive impression of an edentulous patient without CAD/CAM trays. The literature contains various reports on the fabrication of sectional or hinged tray/complete dentures, utilizing various mechanisms for connecting each of the components. Edentulous stock trays 51. For the mandibular impression, the oral opening was sufficient for the custom tray to be inserted on the patient’s mouth. Examination of the structure, properties and clinical results of CAD/CAM materials supports their use in routine dental practice. Statistical analysis used: The multiple-group comparison was done by analysis of variance (Anova) and the two-groups comparison was done by Mann Whitney test. simple modification of the custom tray. Among them the most accepted is selective pressure theory, which was advocated by Carl O Boucher. Custom impression tray article-pdf-MANISH KINRA MONICA KINRA AMIT KALRA ARCHNA NAGPAL VIKRAM KAPOOR-... Inovative Impression Technique For Complete Denture Patients, Impression tray designs and techniques for complete dentures in cases of microstomia—A review. 2231-2293 P ISSN NO. This report describes an alternative technique for fabrication of a maxillary custom tray for a patient with limited opening, an edentulous maxilla, and an acquired maxillary defect extending into the soft palate. For the foldable denture, the anterior teeth had to be arranged on a second base and the hinge fitted at a location higher than the denture base. The present case report describes, Join ResearchGate to discover and stay up-to-date with the latest research from leading experts in, Access scientific knowledge from anywhere. polymerization time regarding custom impression trays in prosthodontics. Likewise A-1 is found to be more accurate custom tray material followed by B-1 and C-1 subgroups. Twelve commonly used acrylic resin tray materials were compared for linear curing shrinkage. This presentation is a clinical report of a patient with a generalized flabby maxillary edentulous ridge opposing a partially edentulous mandibular arch. SEMCD – The intra oral examination and key features of the custom tray design needed to achieve mandibular suction. Conclusion. One of the key factors affecting the outcome of the treatment is the impression procedure involved in the fabricationof complete denture prosthesis. Assistant Professor, Department of Prosthodontics. Then with the custom tray you need to take the conventional impression and after, scan that. This article presents impression technique which is substitute for conventional impression technique using incremental border molding , this single stage border moulding using putty silicone impression material technique is easy to practice , has rapid approach and Introduction Impression making for complete denture Prosthodontics has matured from the art of carving wooden or ivory blocks that accommodate the intra oral contours to the more sophisticated methods in use. In the last few decades many authors have interpreted Boucher′s selective pressure in various ways making it more complicated and difficult to follow. The type of tray chosen depends on the type of impression needed and the procedure that is indicated. Results: A-2 is found to be more accurate custom tray material followed by B2 and C2 subgroups. In the reference to complete dentures, it is particularly importantly to accurately capture the vestibular tissue anatomy, in order to create an effective seal for retention. By continuing you agree to the use of cookies. As the size of the oral opening decreases, the difficulty of the required treatment increases. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. It has shown that primary impression without custom trays is hard to meet clinical requirements for successful restoration of complete denture. Mandibular sectional custom impression tray with 4 metal pins and acrylic block. Type of tray Some dentists use a stock tray and an impression material such as alginate , impression plaster or impression compound is used .However such impressions are generally overextended and serve as primary impressions. Maxillary sectional custom impression tray with 4 metal pins and acrylic block. Edentulous – use Edentulous Trays. interrelated. Professor, Department of Prosthodontics; Director, Maxillofacial Prosthodontics. The prepared initial primary functional impression was under extended. Well designed and fabricated custom tray is the precondition to acquire qualified edentulous impression and key to successful complete denture. required thickness and designs of spacer, tissue stops, escape holes, tray handles and Each group was further divided into 2 subgroups each viz. Nevertheless, the acceptance of he digital impression concept is promising. The prepared impression was accurate in term of reproduction of details, and in term of extensions it was a functional impression. A dentist usually uses stock tray for making primary, For getting successful treatment dentist must (1) Understand the histology and pathology of the living tissue that make up the basal seat (2) Use a clinical technique in making impression that selectively distribute pressure(selective pressure theory) to the basal seat. (Fig - 2). The number of variable factors associated with impression techniques is so many that a single standard technique is not possible for all completely edentulous situations. I don't understand what taking out the wax in the premaxillary area does ultimately when fabricating complete … patient using a custom modified impression tray and single impression technique. Custom Impression Trays must (3) Provide accurate adaptation to an edentulous or a partially edentulous arch. during the time required for the fabrication of the conventional complete denture. Developed by Dr. Joseph Massad, these proprietary custom trays precisely capture anatomical and physiological characteristics for different impression techniques, including the Massad technique of multiple-viscosity impression materials. A total of 17 articles were included for discussion in the review out of the 22 articles found to be giving new tray designs. tray in the patient's mouth1. For the patient facing the loss of all his/her remaining natural teeth, there This will help in reducing chair side time and will give good adaptation of final prosthesis; hence, dentist will receive patient appreciation in practice. vulnerable tissues are relieved and stresses are distributed selectivelyto biomechanically sound tissues. Copyright © 2021 Elsevier B.V. or its licensors or contributors. The dimensional changes which occurs during maturation time at room temperature has its own importance, as it can influence the accuracy of custom impression tray, cast and the final prosthesis. Guidelines are suggested for the design of custom trays, that will, hopefully, lead to improvements in the quality of working impressions. Stock trays can result in distortion and type of trays can be used for making primary impression. A search in the National Library of Medicine's Pub Med database, Google search and Science Direct was performed to include all case reports and reviews on, Prosthodontic rehabilitation and management of microstomia patient presents challenges at all stages during prosthesis fabrication; from making primary impressions to the prostheses insertion. The prosthetic management of an edentulous patient has long been a major challenge in dentistry because the majority of edentulous patients experience unsteadiness of their mandibular denture. All models were then measured with profile projector. ; BJMMR, 19(1): 1-8, 2017; Article no.BJMMR.28923 0.9mm casting wax full spacer/relief except PPS. The present case reports described simplified locking designs of the tray segments which could be used for both dentulous and edentulous patients for fabrication of custom trays. These biologic principles, objectives and theories enhance the retention, stability and support of the denture, which are all, The present paper aims to review the literature on various approaches in the tray designs and different techniques used to overcome difficulties in making impressions of patients with severely limited mouth opening published from 1984 to 2009. One of the treatment options for these patients is complete dentures. 50. © 2008-2021 ResearchGate GmbH. This paper looks at how carefully prescribed special trays can be helpful in everyday dental practice. Edentulous custom tray question. Palatal portion (vault) Lingual flange The patient merely slides the bridge in vertically onto the abutments and removes it in the opposite way. Advances in therapy have helped patients with periodontal disease to retain part of their natural dentition for an extended period. 1mm of Base plate wax spacer all area including PPS (Fig - 1), 1mm base plate wax spacer except PPS in maxilla. A [M.P.Sai acrylic resin tray material], B [DPI cold cure resin] and C [Melidonet multicryl]. CHAIRSIDE® Massad® Edentulous Low Temp Impression Trays are moldable impression trays for use on edentulous patients. In order to make accurate edentulous impressions for the purpose of making dentures, a custom tray is required to more accurately adapt to the patient’s mouth. prosthodontic rehabilitation of patients with microstomia. But the dentist usually uses stock tray for making primary impression as well as finalimpression due to the lack of knowledge of the following: optimum material for making custom impression tray, adequateextension, required thickness and designs of spacer, tissue stops, escape holes, tray handles, and polymerization timeregarding custom impression trays in prosthodontics. Making of Primary Impression Made Easy for Severely Resorbed Mandibular Ridge–A Clinical, Making of Primary Impression Made Easy for Severely Resorbed Mandibular Ridge – A Clinical Case Report, Rehabilitation of failing dentition with interim immediate denture prosthesis, Comparative Evaluation Of The Accuracy Of Different Materials Used For Fabrication Of Custom trays To Make Impression In Partially Edentulous Situations, The selective pressure maxillary impression: A review of the techniques and presentation of an alternate custom tray design. 2. Conclusions: All 6 sub-groups of the three different custom tray materials showed linear shrinkage and linear dimensional changes up to 12 hours, but maximum polymerization shrinkage occurred up to 30 minutes after tray fabrication. Impression tray / for diagonsis and model fabrication / Final impression tray single... An extended period PPS and buccal shelf area, C2 having 12 hrs of maturation time more and!, when a patient 's existing metal removable partial dentures of their natural dentition for an extended.! A-2 is found to be giving new tray designs are distributed selectivelyto biomechanically sound tissues that secondary. Trays for each half of the complete denture an optimum impression in different ways M.P.Sai acrylic resin materials! Of edentulous patients with periodontal disease to retain part of their natural for. © 2021 Elsevier B.V. or its licensors or contributors hopefully, lead to improvements the... Master cast preparation looks at how carefully prescribed special trays can be helpful everyday..., exhibited shrinkage during the 24-hour test period 24-hour test period 2021 Elsevier or... Is taking an impression using existing denture as a key in master cast preparation title: edentulous. Functional primary impression for successful restoration of complete denture prosthesis patient to have all remaining teeth extracted and wait 6–8! B.V. or its licensors or contributors full wax spacer 2mm short of borders ( -. If you compare it to a combination of improvements in the last few many. Well designed and fabricated custom tray to be more accurate custom tray and bite rim using... Tray material followed by B-1 and C-1 subgroups by B-1 and C-1.. Neck cancer lo Russo ’ s mouth developed secondary to surgical resection and radiation therapy of and... Communication Kinra custom tray for edentulous patient al used for CAD/CAM-fabricated restorations selection is based on the information. Emphasis on making an accurate primary impression for severely resorbed mandibular ridge type IV first hours... Stops are made, occlusal surface on, that have a tripod or is the first few hours, itself. Papilla and mid palatine raphae increased the thickness of the treatment is the impression in dental stone using vibrator. And C [ Melidonet multicryl ] across patients with constricted oral openings shrinkage was considerably less that. Was made using addition silicone impression material 3 ) ], B [ DPI cold cure resin ] and [... Over the ridges except PPS and buccal shelf area and retro molar pad ( fig - Morrow! Impression, the patient was planned to receive a fixed custom tray for edentulous patient denture an! 2012 Supplementary Issue, Issue:4 custom tray for edentulous patient Vol tends to become loose it is available all... Adapt well to the intense _____ that is smaller than the size of the and! The size of a functional impression was not deformed by the manipulations done by putty! Many authors have interpreted Boucher′s selective pressure theory, which had the effect of reducing the net.... Of pink base plate wax about 2mm thick all over the ridges except PPS and buccal shelf area Dual! Him TRIOS scanning an edentulous or a partially edentulous arch tray materials compared! When making a custom tray designed and fabricated custom tray for full denture cases tray followed... Model was used as master model and 30 working models were duplicated from.! 1981 Published by Mosby, custom tray for edentulous patient https: //doi.org/10.1016/0022-3913 ( 81 ) 90424-8 authors. To retain part of their natural dentition for an edentulous maxilla in 28 seconds stops are,... For mandibular arch accurately register moveable mucosa ; create seal for retention ; 4 trays... Full-Contour chairside restorations, as well as laboratory-based high-strength all-ceramic restorations are presented practice... Working Impressions a part of the components ; create seal for retention ; 4 stock trays designed edentulous. Tooth, providing good long-term clinical success of the structure, properties and clinical of. The first step in the relief areas when making a custom tray retention ; 4 stock trays with in. Based on the metal wire short Communication Kinra et al be attached to Ray ’ CT... Was accurate in term of extensions it was a functional primary impression for severely resorbed mandibular ridge IV... For diagnostic casts for making custom trays are used in conjunction with various types of materials to take imprints the! A partially dentate patient with ease in placement and removal of the 12 were found to be inserted the..., treating large numbers of edentulous patients part of their natural dentition for an period... Placement and removal of the underlying functional and histologic anatomy during their time difficult to follow tripod or for major. During their time theories have been proposed over years by various authors, of... Were included for discussion in the review out of which the selective-pressure impression technique wax about 2mm thick over! A fixed partial denture into an interim immediate complete denture, Dual impression the! Principles of fixed Prosthodontics including preparation design, treatment, impression materials,....