10 - Tooth wear 3 Flashcards

Dental demolition and managing failure in tooth wear

1
Q

Why is dental demolition common in tooth wear cases?

A
  • previous failure
  • small teeth
  • high occlusal loads
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2
Q

What is involved in informed consent for dental demolition?

A
  • 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
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3
Q

What is involved with operator safety in dental demolition?

A
  • adequate eye protection
  • surgical glove wear
  • appropriate handling of sharp fragments
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4
Q

What is involved in patient safety in dental demolition?

A
  • eye protection
  • airway protection (super floss attached to bridge, throat pack, dental dam)
  • suction
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5
Q

What prevents radiographic assessment of crowns for caries?

A

Radiographic washout

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6
Q

What do you use to remove a porcelain restoration?

A

Coarse diamond bur

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7
Q

What do you use to remove a metal restoration?

A

Gold cutting bur

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8
Q

Describe the basic technique for the demolition of an indirect restoration.

A
  • cut up buccal surface
  • use chisel to prise apart
  • if struggling, cut up occlusal or lingual surfaces
  • section horizontally if required
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9
Q

What additional tools can be of assistance when demolishing indirect restorations?

A
  • sliding hammer
  • matrices
  • enamel chisel
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10
Q

What complication is common with a sliding hammer?

A

High risk of core fracture

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11
Q

What equipment is required for re-RCT?

A
  • conventional files
  • gates-glidden burs
  • rubber dam
  • eucalyptus oil
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12
Q

What can be used to remove posts from teeth?

A

Masseran kit or ultrasonic

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13
Q

How can extractions be managed to aid healing?

A
  • mattress suture
  • coe comfort lining immediate denture
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14
Q

Define a failing dentition.

A

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.

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15
Q

What are the keys to success when managing failure?

A
  • comprehensive history and exam
  • thorough planning and seek advice when necessary
  • prevention
  • avoid overambitious treatment plans
  • effective communication with patient
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16
Q

How can prevention be tailored to a failing dentition?

A
  • OHI
  • diet advice
  • fluoride regime
  • information provision and recording everything in the notes
  • assess response to prevention
17
Q

What simple treatment is recommended in a failing dentition?

A
  • OHI
  • caries management
  • simple endodontics
  • dentures
  • additive composite
18
Q

What makes up effective communication with a patient with a failing dentition?

A
  • honesty and transparency
  • taking into account patient’s wishes
  • address the difficult issues
  • give patient reality check
  • document all discussions
  • avoid patient led treatment
19
Q

What is the protocol for giving bad news?

A

SPIKES
- set up interview
- perception of what patient knows
- invitation of what patient wants to know
- knowledge, give patient facts
- emotion, respond to emotion
- summarise