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Fixed Prosth Midterm (Fall) > 6. Foundation Restorations for Vital Teeth I > Flashcards

6. Foundation Restorations for Vital Teeth I Flashcards

1
Q

A crown is a failure when

A
  • Doesn’t provide the benefit for which it was intended
  • Doesn’t conform to existing occlusion
  • Periodontal health is not maintained
  • Esthetics are not satisfactory to the patient
  • Pulp vitality is not preserved
  • Patient is constantly aware of it
  • Doesn’t remain secure after cementation
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2
Q

A crown is a success when it

A
  • Provides the benefit for which is indicated
  • Conforms to the existing occlusion
  • Maintains perio health
  • Esthetics are acceptable by patient
  • Pulp vitality is preserved
  • Not a source of awareness to the patient
  • Remains in place
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3
Q

A crown will remain secure when the supporting structure has what

A

length and strength (need adequate tooth structure to retain and support a crown)

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4
Q

What are the qualities of a good foundation restoration

A

-Provide the patient with adequate function
-Contour and finished to facilitate oral hygiene
(Proximal contacts and occlusal anatomy!!)

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5
Q

What are the indications for placing a foundation restoration

A
  • Remaining tooth structure is insufficient to support a crown (caries/fracture)
  • Large existing restoration demonstrates leakage or will not be retained after tooth prep
  • When 50% or greater of the coronal part of the tooth is missing
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6
Q

What is the function of the core

A
  • Provides retention and resistance form for the crown

- Transitional restoration before crown prep

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7
Q

What is the difference between a core buildup and a restoration foundation

A

Core

  • When 50% or more of the tooth structure remains
  • Must be putting a crown on the tooth

Restoration foundation

  • You are putting a crown on the tooth but the filling is small
  • Significant coronal tooth structure still remains
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8
Q

Pre-assessment of a core restoration on a vital tooth to look for leakage and retention should involve what

A
  • X-rays

- Intra-oral exam (transillumination)

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9
Q

What should be done with teeth with extensive or deep vertical root fractures

A

extraction

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10
Q

What are the 3 approaches to placing a foundation restoration

A
  • Remove and restore the core to full contour. Prep next session
  • Remove and buildup to prep. Contour and finish prep
  • Prep tooth for crown, remove/replace to prep contour and finish prep
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11
Q

What two materials should never be used as core materials

A
  • GI

- RMGI

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12
Q

What are the advantages of GI

A
  • Rapid set
  • Inherent adhesion
  • Fluoride release
  • CTE= CTE of the tooth (little microleakage)
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13
Q

What are the disadvantages of GI

A
  • Low strength

- Moisture/ handling sensitive

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14
Q

What should GI be used for

A

Small defects (blockout/filer)

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15
Q

What are the advantages or RMGI

A
  • Stronger than conventional GI
  • Command set –> crown prep with no delay
  • Inherent adhesion (simple bonding)
  • Fluoride release
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16
Q

What are the disadvantages of RMGI

A
  • Low strength

- Hydrophilic resin absorbs H2O

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17
Q

RMGI should be used for what

A
  • Small defects (blockout and filler)

- Minor fillings

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18
Q

How can the adhesive propeerties of GI be enhanced

A

By removing the smear layer with the cavity conditioner (10 sec etch)

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19
Q

What are the advantages of composite resin

A
  • Stronger than GI
  • Can be placed in thin sections (unlike amalgam)
  • Rapid set- same appointment tooth prep
  • Dentinalbonding???
  • Most current materials are radiopaque
  • Suited for long term intrim restoration (unlike GI and RMGI)
20
Q

What are the disadvantages of composite resin

A
  • Technique sensitive (isolation, bonding, etc)
  • Polymerization shrinkage can disrupt bond
  • High CTE –> post-op sensitivity and microleakage
  • Expensive
  • Color match can be a chalange when prepping the crown
21
Q

Light cure materials should be placed incrementally- why?

A

so the light can penetrate (will be too thick to penetrate if not placed incrementally

22
Q

What are contraindications for resin

A

where isolation can’t be achieved

23
Q

Fluorocore is recommended for how many appointments

A

One- should prep and temporize that same day

24
Q

Fluorocore should be used with what kind of adhesive

A

dual cure- not optibond solo plus! (optibond is LC only)

25
Q

How is fluorocore placed

A

first increment 2-3 mm, light cure then bulk fill (improves bond strength and reduces shrinkage)

26
Q

Fluorocore can remain in the mouth as a core how long until the crown prep needs to be done

A

no later than 2 weeks

27
Q

What are the advantages of amalgam as a core

A
  • Not technique sensitive (moisture control= less critical)
  • Highest compressive strength (in bulk sections)
  • Seals by corrosion products –> decreased microleakage
  • Has a long record of clinical success as a core
  • Makes excellent intermediate/intrim restoration
28
Q

What are the the disadvantages of amalgam

A
  • Condensation is critical
  • Weak in thin sections
  • Hg is concern for some patients (galvanic reaction)
  • Prep delay (24 hr) because has a long setting time till it achieves max strength however high copper amalgam can be prepped in 30 min
29
Q

What must be used to achieve proper amalagam condensation

A

ridgid matrix

30
Q

What is the material of choice for posterior cores and why

A

Amalgam

  • Resists deformation and fracture
  • More equitable stress distribution
  • Decreased probability of tensile and compressive failure
  • High compressive strength (necessary to resist masticatory and parafunctional forces)
31
Q

Reasons to us a rubber dam

A
  • Moisture control
  • Infection control
  • Prevent aspiration
  • Optimal visibility
32
Q

During a core build up what must you do with thin cusps

A
  • Shorten them

- Cusp thickness should be equal to or greater than half its height (i.e 2 mm high wall should be at leat 1 mm thick)

33
Q

Cavity floors are flattened for what purpose

A

increase resistance

34
Q

Ideal ratio of height to thickness is what_ and should be no greater than _

A

1:1… 2:1

35
Q

Criterion reduce thin cusps til they are _ mm thick

A

1 mm

36
Q

Which provides more predicatable retention (dentinal bonding/pin retained cores)

A

pin retained

37
Q

T/F In vitro results are not always reliable predictors of clinical performance

A

t

38
Q

What is the issue with the only retentive feature of a core being dentinal bonding

A

the dentinal bonding will degrade over time- should never be the only method of retention. Also dentinal bonding alone is not enough to withstand high masticatory forces (conventional undercut retention also needed

39
Q

When are pins indicated

A
  • High occlusal forces (FDP abutment, survey crown, posterior tooth)
  • Minimal tooth structure (quality of adhesion to tertiary or sclerotic dentin is not great)
40
Q

Sloping waslls should be modified to _ and _ to improve retention and resistance

A

horizontal and vertical

41
Q

Retention and resistance features of amalgam cores are

A
  • Pins
  • Parallelism of the walls
  • Proximal boxes
  • Retention grooves in proximal line angles
  • Circumferential/ partial grooves “slots”
  • Amalgam pins
42
Q

Circumferential grooves or slots are placed with what burs

A

-Inverted cone or 1/2 round

43
Q

Amalgam pins are placed with what bur and to what dimensions

A

330

  • Depth= 1.5-2 mm
  • Diameter=0.8mm (diameter of he head of the 330)
44
Q

What is elective endodontics

A

the decision to devitalize a tooth to obtain retention

45
Q

When might you do elective endo

A
  • Stressed pulp (previous direct/indirect pulp cap_

- Need a post to retain the core (little coronal tooth structure left)

Fixed Prosth Midterm (Fall) (10 decks)

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