2. Tx Planning I Flashcards
Describe the sequence of flow for treating a patient
urgent need –> disease control –> rehabilitation –> maintenance
What should you do before referring someone to endo for RCT after making a dx?
determine if the tooth is restorable
If a patient is in pain and it is unclear as to whether or not the tooth is restorable and the patient wants to save the tooth what should happen
emergency endo to alleviate pain
What is the emergency endo treatment for a tooth with symptomatic irreversible pulpitis and no percussion sensitivity that is single/two rooted
clean and shape
What is the emergency treatment for a multi-rooted tooth with symptomatic irreversible pulpitis that is not percussion sensitive
pulpotomy
What is the emergency treatment for a tooth with symptomatic irreverxible pulpitis that is sensitive to percussion
Clean and shape
What is the emergency treatment for a necrotic tooth
Clean and shape
Identify the principles of treatment planning (in the correct sequence)
- ID all problems
- Establish treatment goals
- ID patient specific modifiers/risk factors
- Determine appropriate treatment procedures
- Organize all procedures into sequence
What are the Fixed prosthodontitis goals of treatment
- Prevention of future disease
- Correction of existing disease
- Restoration of function
- Improved esthetics
T/F People who brush 3x/day have significant’y less risk for caries than those who brush 2x/day
F but there is a significant difference in caries risk between those who brush 1x/day and 2x/day
Reading mentioned on slide 19- be sure to read
ok
What components make up prevention of future disease
- OHI
- Caries risk assessment
What components make up correction of existing disease
- Scaling and root planing
- Extraction of hopeless teeth
- Replacement of defective restorations
- Removal of carious lesion
- Recontour overcontoured restorations (esp near furcations)
- Therapeutic and/or surgical perio therapy
Considerations for foundations for fixed restoratiosn
- Retention of the foundation to the remaining tooth structure (need a post??)
- Strength of foundation
- Color of foundation (esthetic)
- Parafunctional habits (loss of VDO)
- Behavioral problems (bulemia/anorexia)
Fixed restorations on individual teeth are indicated when
- Extensive caries
- Heavily restored (> or equal to 50%)
- Following RCT (posterior teeth)
- Fractures
- Replace inadequate restorations (esthetic issue with previous crown- ie wrong shade match)
- RPD abutment (survey crown)
- Developmental problems (amelogenesis imperfecta)
What is the purpose of survey crowns
remaining teeth for a partial denture often lack optimal contours to retain an RPD- survey crowns give optimal contours
What are the indications for replacing missing teeth
- Functional deficit (chewing and speech)
- Esthetic issue
- Potential for problematic tooth movement (not an absolute indication)
Chewing ability is superior for an (RPD/FDP)
FDP
Chewing performance is proportional to
number of occluding units
Article on the shortened dental arch slide 43 read
ok
What is the shortened dental arch (SDA)
- Continuous (2nd PM to 2nd PM) with no intermediary missing teeth
- Functionally acceptable for most patients
- No significant predisposition to tooth wear or migration
- No significant alteration in diet
- Acceptability (psychologically and esthetically) acceptibility must be ascertained on an individual basis
What are the treatment options for replacing missing teeth
- Implant
- FDP
- RPD
- Nothing
What are the factors that influence the choice of treatment for the replacement of missing teeth
- Length of edentulous span
- Soft tissue defects
- Condition of abutment teeth
- Practical issues (medical health, money and time)
What is ante’s law
Says that the surface area of the abutment teeth should be greater than or equal to the root surface area of the teeth being replaced
What are the indications for an RDP
-Long edentulous span, absence of distal abutment tooth
(vertical support needed from the ridge)
-Where resistance to lateral movement is needed from the contralateral teeth and soft tissues
-Hard/soft tissue deficiency
-Money
-Need to replace a soft tissue/bony space with flange
Options for replacing teeth in a short edentulous span
- FDP
- Implant
- Adhesive (maryland) bridge
What are the indications of an adhesive bridge
Indications
- 1-2 missing teeth
- Abutment teeth present on either end
- Abutments have favorable alignment
- Abutments are un-restored
T/F: fixed prosthesis provides better comfort function and security
t
What is a cantilevered FDP
bridge with an abutment only on one side
Where is the only place in the mouth where a cantelievered bridge should be used
lateral incisors
What is the most common failure associated with Maryland bridges
debonding
What is todays most used alternative for restoring short edentulous span
implants
