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What is the clinical workflow for a lab-fabricated Full Cast Metal crown?

A Full Cast Metal restoration is lab-fabricated and completed over two patient visits, with approximately 5 days in the lab between them (shipping not included). The sequence below follows ROE's lab-fabricated crown workflow.

First appointment: preparation and records

Remove decay and damaged structure and shape the tooth to accommodate the crown, building up core material if needed for a stable foundation. Establish the margin and verify the conservative occlusal clearance (a minimum of 0.5 mm), then manage tissue and moisture so the margins are clean and dry. Capture impressions or scans including bite registration. No shade selection is needed for a metal restoration. Place a temporary crown to protect the preparation.

Between appointments

ROE casts and finishes the restoration in your chosen alloy. Use the case delivery calculator to schedule the patient's return around the 5-day in-lab window.

Second appointment: try-in, verification, and delivery

Remove the temporary crown and clean all temporary cement from the preparation. Sanitize the restoration (ROE recommends a 2-minute immersion in 0.12% chlorhexidine gluconate solution). Trial-fit the crown and check margins, contacts, and occlusion, having the patient bite firmly to confirm full seating. Before cementing, capture a post-operative radiograph to confirm the margins are fully sealed, using an explorer to confirm marginal fit in proximal areas where direct vision is limited.

Cementation and finishing

Cement the restoration following the seating protocol (see the seating and cementation article), remove excess cement while it is still rubbery, then check and adjust proximal contacts, emergence profile, and occlusal contacts in centric and excursive movements. Polish all adjusted surfaces thoroughly, since rough contacts and occlusal surfaces can abrade adjacent and opposing natural teeth over time.

Clinical rule of thumb: Verify complete seating radiographically before final cementation. An open or short margin caught at try-in is a quick fix; the same problem found after cementation is a remake.

 

Additional Resources

For more information concerning the Full Cast Metal:

Contact Information

For help with a Locator Fixed solution for your next case, contact ROE Dental Laboratory: