10 - Tooth wear 3 Flashcards
Dental demolition and managing failure in tooth wear
Why is dental demolition common in tooth wear cases?
- previous failure
- small teeth
- high occlusal loads
What is involved in informed consent for dental demolition?
- benefits and risks for health and appearance
- longevity of restoration and restorative cycle
- advise that assessment may not be possible until restoration removed, prepare for worst
- when to refer
What is involved with operator safety in dental demolition?
- adequate eye protection
- surgical glove wear
- appropriate handling of sharp fragments
What is involved in patient safety in dental demolition?
- eye protection
- airway protection (super floss attached to bridge, throat pack, dental dam)
- suction
What prevents radiographic assessment of crowns for caries?
Radiographic washout
What do you use to remove a porcelain restoration?
Coarse diamond bur
What do you use to remove a metal restoration?
Gold cutting bur
Describe the basic technique for the demolition of an indirect restoration.
- cut up buccal surface
- use chisel to prise apart
- if struggling, cut up occlusal or lingual surfaces
- section horizontally if required
What additional tools can be of assistance when demolishing indirect restorations?
- sliding hammer
- matrices
- enamel chisel
What complication is common with a sliding hammer?
High risk of core fracture
What equipment is required for re-RCT?
- conventional files
- gates-glidden burs
- rubber dam
- eucalyptus oil
What can be used to remove posts from teeth?
Masseran kit or ultrasonic
How can extractions be managed to aid healing?
- mattress suture
- coe comfort lining immediate denture
Define a failing dentition.
A dentition where deteriorating teeth, restorations or oral health means a loss of adequate basic oral functions such as mastication and acceptable aesthetics is inevitable if untreated.
What are the keys to success when managing failure?
- comprehensive history and exam
- thorough planning and seek advice when necessary
- prevention
- avoid overambitious treatment plans
- effective communication with patient