ABGD - Fixed Pros Board Review Flashcards
If you have a Distal Extension, what are 3 tx options to consider?
- Removable Dental Prosthesis
- Implant Retained FDP
- Removable Partial Overdenture
- Retained roots
- Implant assited RDP
What are 5 Disadvantages of RBDFP?
- Not “non-invasive”
- Anterior esthetics difficult
- Limited indications: Occlusion, restorative space
- Limited long-term data
- Debonding problems
The ratio of the occlusocervical/incisocervical dimension of a prepared tooth to the faciolingual dimension should be at least _____ or higher for all teeth
0.4 mm
For removable, what would you consider for an abutment if the crown-root ratio is less than 1:1?
Consider overdenture abutment
What happens when you have a B contact only?
Maxillary teeth move lingually, mandibular teeth move buccally
What are 4 advantages of Cusp to Fossa Occlusion?
- Forces in line with the long axis of teeth
- Eliminates the “plunger cusp” effect
- Greater stability to the dental arch
- Less tendency towards tooth mobility
Describe the Double String Retraction Technique…
- A small water or Hemodent dampened cord / 2.0 silk or 000 is placed
- A second Hemodent dampened cord is placed
- Only the second cord is removed during impression making
What are some characteristics of Cement Retained Implant Crowns?
- Not retrievable
- Better screw mechanics
- Better esthetics
- Easier to develop occlusion
- Correct implant malposition
- More passive fit
Regarding alginate properties, what is the best way to control the setting time?
Water Temp
not water : powder ratio
What happens when you remove alginate from an undercut?
It gets compressed
What is a Metamerism?
Seemlingly same color but appear different under a different light source
In CR, what position is the condyle braced in?
Superior and Anterior position
What do you have to be careful of when using Electrosurgical methods of tissue management?
Pacemaker!
What is the optimum crown-root ratio for implants? Minimal?
- Optimum 2:3
- Minimal 1:1
- Landmarks: Occlusal Surface to Available Bone Height
Regarding the first principle of prep design according to Shilingburg, how do you preserve Periodontal structures?
- Margin location
- Attached gingiva
- Biologic width
- Periodontal surgical timing
What is value?
Lightness or darkness of the hue
What 2 things increase with time regarding alginate?
- Tear strength
- Resistance to deformation
What should be used routinely when mandibular molars are prepped for an FDP?
Where do you place these?
Axial Grooves/Boxes
Proximal Surface (B/L)
In what order regarding value, chroma, and hue should you pick your shade match?
Value > Chroma > Hue
What are 2 advantges of RBFDP?
- Less invasive to tooth and pulp
- Reduced cost
Define Imbibition…
When alginate abosrbs water (swells) on immersion
What are some clinical tips when pouring/transfering an alginate impression to the lab?
- Pour as soon as possible
- Store in 100% humidity (plastic bag) until pouring
- Don’t wrap in wet towels or immerse
In an Implant Retained Fixed Complete Denture (Hybrid), how many implants would you use, and between what structures?
4-6 Implants
Between mental foramina
When you are programming a semi-adjustable articulator, what are you setting?
What records do you use to accomplish this?
Condylar inclination + Bennett angle
Eccentric interocclusal records (lateral/protrusive records) are ued to program this
What makes internal hex better than external hex?
- Developed to provide solutions to screw loosening
- Increased surface contact abutment-implant
- Geometric lock
- Better stress distribution
What happens when you have an A and C contact only?
Maxillary teeth move buccally, mandibular teeth move lingually
What kind of records does a Celenza Class 3b take?
What is an example?
- Accepts lateral records or protrusive records
- Whipmix
- Can be Arcon or Non-Arcon
What are 4 techniques you can record CR clinically?
- Chin Point Guidance
- Bimanual Manipulation
- Leaf Gauge
- Lucia Jig
What are 2 material considerations for RBFDP?
- Base metal allows: Sand Blasted
- High noble alloys: Tin Plating
Can a Hanau Articulator except lateral bite registrations?
No!
For the facebow record, what is traditionally the anatomic reference?
What are they for the Whip-Mix and the Hanau?
Transverse horizontal axis
What does a smooth/rough prep have to do with adhesive cements?
- The effect of preparation roughness has not been definitely determined for adhesive cements
- A resonable smooth preparation is therefore recommended
What are these prep designs getting ready for?
FBFDP
What type of records dos a Celenza Class 4a take?
Condylar paths are made by engravings made by patient
Functionally Generated Path…
What are some examples of Bis-Acryl provisional materials?
- Integrity
- Protemp
- Radica
What is the recommended axial wall heigh for incisors and premolars?
What is the recomended total occlusal convergence?
3.0 mm
10 - 20 °
How many points does each cusp contact on the opposing tooth?
3
When tx planning a distal extension, what is the tx of choice if the distal abutment is compromised?
- Implant Retained FDP
- Must have sufficient bone
- Know patient’s occlusion
- Evaluate restorative space
- 1.5 - 2 mm between implant and tooth
- 3 mm between implants
What wasn’t good about External Hex…
- 10-56% Loosening (Gold cylinder and screw)
- Better screw designs today
- Higher preloads
What are 4 chemicals that are NOT to be used in tissue management?
- Epinephrine
- Ferric Subsulfate (Monsel’s solution)
- Zinc Chloride
- Negatol (creosol sulfonic acid and formaldehyde)
In Cusp/Fossa Occlusion, what provides Mesial/Distal Stability?
Closer stoppers and equilizers
Define Syneresis…
Gel filaments contract and squeeze out water
When tooth conditions and estehtics permit, finish lines should be located…
Supragingivally
Subgingival margins increase potential for periodonatl problems…
What are the 2 purposes of Closure Stoppers (Mesiodistal Stability)?
- STOPS CLOSURE OF MANDIBLE as it relates to the maxilla
- NEUTRALIZES forces exerted by equalizers
For an FDP, an endodontically treated tooth is ____ more likely to fail…
2x
What it is the minimum space required for a screw-retained implant crown?
- Implant top to occlusal surface: 6 - 7 mm
Can you name the first 4 uses of a Diagnostic Mounting?
- Simulation of mandibular movement
- Analysis of occlusal plane
- Critical analysis of occlusion and disocclusion
- Visualization of anatomy and restorations
What are the 4 principles of preparation according to Shilingburg?
- Preservation of Tooth (& Tissues) Structure
- Retention and Resistance
- Structural Durability
- Marginal Integrity
What does an Articulator imitate?
Physiologic motion by substituting mechanical equivalents for anatomical parts
For implants, what is the required mesiodistal space?
- “Rule of 7”
- Mesial to Distal
What can happen minerals in the tap water do to setting algiante?
Accelerates it
What do you need to keep in mind when treatment planning a Cantilever?
- Lengthy root and favorable configuration
- Long clinical crown for good retention/resistance form
- Good crown:root ratio
- Healthy periodontium
When programing an articulator, would you use lateral AND protrusive records?
- Lateral OR protrusive records
- Protrusive record more shallow
- Can also use (match up) wear facets to program articulator
What are 2 Articulation Philosophies?
- Panky-Mann -Schuyler
- Gnathology
What happens when you leave the cast too long attached to alginate?
Degrades cast surface
What is Centric Occlusion?
OCCLUSION of opposing teeth with mandible IN CENTRIC RELATION may or may not coincide with MIP
Define Latero-Retrusion…
Lateral and backward movement of the condyle on the working side
Define Retention?
That which prevents removal of a restoration along its path of placement or long axis of the tooth preparation
Is there such thing as a perfect articulator?
No!
How do you choose the right articulator?
- Based on:
- Complexity of the restoration
- Complexity of mandibular movement
- Complexity of occlusal scheme
- Choose the articulator that fits the job
When programming the articualtor, which record is “Safer” to use…
Protrusive Record
What 5 factors contribute to RDP success?
- Proper survey & design
- Adequate abutments
- Broad Stress Distribution
- Well adapted bases
- Altered Cast Impression
What are 5 methods for tissue managment?
- Mechanical methods
- Rotary gingival currettage
- Mechanicocheical methods
- Electrosurgical
- Diode Laser
What is Hemodent?
Aluminum Chloride
Is connecting implants to natural teeth a good idea?
- All methods report intrusion of natural teeth
- Consensus: this restoration type should be avoided
- Recommendations: use two implants in edentuous space
What is Astringident?
Ferric Sulfate
What is an example of a Celenza’s Class 2 Articulator?
Galetti
Allows some vertical and horizontal
What types of records does a Celenza Class 4b take?
Condylar paths can be angled, or customized.
Usually acceps a pantograph (3 dimensional dynamic registration or tracings)
What is anterior guidance?
What is the equation for the Law of Beams?
Flex is related to cube of pontic length
Can you name 6 uses of Diagnostic Casts?
- Diagnosis and treatment planning
- Diagnostic waxing
- Provisional matrix fabrication
- Survey and design
- Radiographic guides and surgical templates
- Design and fabricate custom trays
If the length of the edentulous space is short/medium, what are you thinking?
- Short: Implants/Fixed
- Medium: Implants/Fixed
What are some considerations regarding shade selection?
- Surface texture
- Background: lip stick, make-up
- Reflective qualities: Translucency, opacity, craze lines
- Metamerism
- Light Source: 5500K
What is an ear-bow?
- An arbitrary facebow
- Based on an average anatomic distance between external auditory meatus and the transverse horitzontal axis of the mandible
What is an Articulator?
A mechanical instrument that represents the (1) temporomandibular joints and(2) jaws, to which (3)maxillary and mandibular casts may be attached to SIMULATE SOME OR ALL MANDIBULAR MOVEMENTS
Why would you not want to use Zinc chloride in managing soft tissue?
Causes tissue damage
What occlusal scheme is this?
- Mutually Protected Articulation
- Posterior teeth prevent excessive anterior contacts in MIP
- Anterior teeth disengage posterior teeth in all eccentric movements
- This can only happen if CO = MIP, not completely true if MIP does not = CO
What are 3 treatment options for Complete Edentulism?
- Conventional Complete Dentures
- Overdentures
- Fixed-Detachable (Hybrid)
What records do you use to mount the mandibular cast?
Centric relation interocclusal records
Crown-Root Ratio is a consderation for what 3 treatment choices?
- Fixed
- Removable
- Implants
Without anterior guidance in a case, it is difficult to avoid what?
What may be indicated?
Eccentric Interferences
High adjustable articulator may be indicated
Why would you not want to use Ferric Subsulfate (Monsel’s solution) for tissue management?
Causes tissue damage
What is this picture illustrating?
What occlusal scheme are they aiming for?
Functionally Generated Path
Group Function
What are 5 features of successful Cast Post and Cores?
- Adequate Legnth and Strength of Post
- Adequate Apical Seal
- Anti-Rotation Feature
- Vertical Stop
- FERRULE (Very difficult to achieve)
How many mm do you want for implant emergence profile?
- 3 mm
- Gingival bulk
- Hide implant and abutment connection
- Room for metal/porcelain labial to screw channel
What technique do you want to use when removing alginate?
Snap removal of tray