Fixed Prosthodontics is typically offered during your D2 year. Fixed Prosthodontics involves restoration of the coronal portion of a tooth or the replacement of missing teeth by a non-removable (fixed) restoration. Mostly, you will focus on crowns and bridges. Fixed is a challenging course that requires fine-tuned hand skills. Like operative and endo, your fixed course will typically entail both a lecture and sim-lab component. Continue reading for my top 5 tips to ace fixed!
1. Make a Matrix
You know the adage, “Look before you leap?” In fixed, this translates to, “Make a matrix before you drill!” In other words, don’t be so hasty to begin prepping that you forget to make a matrix. You will use this matrix to fabricate a provisional crown/bridge. A matrix can be made using a variety of methods: putty, vacuum-formed “suck down,” triple tray, etc. Personally, I used a putty matrix in sim-lab, then transitioned to a triple tray in clinic. Experiment in sim-lab to see which method you prefer! To really get ahead of the curve, arrive to sim-lab early to make your matrix. This will allow you more time to focus on your prep and provisional.
2. Use a Stent
You will be required to complete a variety of fixed prosth procedures on your board licensure exam. During the board exam, you are encouraged to use a stent (and perio probe) to gauge how much you have drilled, or reduced, the tooth. Start using stents now, so you will be comfortable with them by the time boards roll around! Again, these can be made beforehand to maximize your time in sim-lab.
3. Know your Margins
I have to confess: It took me way too long to figure out the difference between a shoulder and a chamfer! Different margins are indicated for different crown materials. Take the time to learn the different margins early on in the course. This will allow you to select the appropriate burs with confidence! To save you some time, see below for illustrations of shoulder, chamfer, and feather margins.
4. Experiment with Materials
You will have the opportunity to create provisional crowns/bridges using a variety of materials in sim-lab. Experiment in sim-lab to see which material you prefer! Personally, I preferred bis-acryl composite resin. Likewise, you may have the opportunity to try retraction cord, retraction pastes and comprecaps. Again, experiment in sim-lab to see which material you prefer! This will make your transition to clinic smoother.
5. Understand your Grade
Your fixed prosthodontics grade is comprised of both the lecture component (exams) and the sim-lab component (practicals). You should carefully examine the course syllabus to identify exactly what portion of your grade each component is assigned, then allocate your efforts accordingly. For example, if the lecture component comprises 30% of your final grade and the sim-lab component comprises 70% of your final grade, you should focus your efforts more heavily on sim-lab.
This advice sounds simplistic, but dental students are notorious for being over-achievers! However, you will take ~51 credits your D2 year. There is simply not enough time in the day to study in the same manner as undergrad. Rather than working harder, you must learn to work smarter. Tackle your courses in a strategic manner to maximize your time.
What additional tips do you have to ace fixed? Comment below!
For a competitive edge in sim-lab, download my Fixed Quick Guide below. This comprehensive guide includes: recommended armamentarium, ideal prep dimensions for full metal, full ceramic, PFM, and crown prep procedures. Be sure to cross-reference your faculty’s guidelines as well (individual practitioners may differ).