Aesthetics Flashcards
why can colour issues occur in aesthetics ?
- wrong shade matching
- pt gets older so crown remains same white colour
list the problems that can occur with aesthetics ?
colour
surface texture
symmetry
spaces
shape
arrangment
why does surface texture occur?
- developmental enamel issue
how can asymmetry occur ?
drifting
what are the issues here?
erosion
staining
- if we did restore and close the gap teeth will look wide and if we make teeth longer = interferes with occlusion
least to most destructive aesthetics
what are some of the effects of whitening on enamel ?
- Enamel pores, depressions, and erosive surface alterations seen following two weeks of treatment
- Transient sensitivity is common
- All effects completely reversed at three months following
treatment - Recommendation that a fluoride mouth rinse/ varnish should be used to improve remineralisation of enamel
what are the effects on bonding in regards to whitening ?
bond strength to enamel decreases 2 weeks after whitening has happened
- advise pts to wait 2 weeks post bleaching for bonding, RRB, Venners, and buildups
when do we do non vital bleaching?
- root filled teeth often darken due to:
- Pulpal remnants breaking down (bilirubin / biliverdin)
- Pigmented bacteria
- Caries
what are the 2 different ways of treating non vital teeth?
- Internal bleaching
- Inside/outside bleaching
how do we do internal bleaching ?
- Remove coronal restoration
- Take GP down to 2mm below level of CEJ
- Clean walls with ultrasonic
- Place 1mm RMGIC over GP (not on walls)
- Acid etch for 30 seconds wash / dry
- Place pledget of cotton wool soaked in 10%
carbamide peroxide - Temporary restoration with high contrast
material such as Poly F or Chemfil Rock
Internal bleaching
Review each week and refresh or remove and restore
how do we do inside outside bleaching ?
Tooth prepared as per internal bleaching, but after RMGIC lining leave open and provide tray as per vital nightguard bleaching
micro abrasion? indications?
The use of acid etching and pumice to remove surface stains and superficial enamel defects
* Can be used in cases of mild flourosis
* Can be useful in conjunction with other regimens such as composite veneers or bleaching to get a better starting point.
how do we deal with severe fluorosis?
Severe cases such as this may not be treatable with micro-abrasion alone, but may reach a better starting point for subsequent whitening or veneers
steps for micro abrasion?
Rubber dam, Clean teeth to be treated with pumice and water, wash and dry.
Apply phosphoric acid 37% to enamel surface for 30 secs, wash and dry.
Clean teeth with a further pumice and water slurry in a slowly rotating rubber prophylaxis cup, and then wash again.
Repeat if necessary up to 3 applications in total
Review at one month and repeat above stages. Up to 3 visits for treatment.
how can we make comp restoration more realistic?
what are the properties of a luting cement ?
needs to be;
* BeDual-curing
– As light won’t properly penetrate the veneer to polymerise it enough
* Have matching shades
– As veneers are so thin the shade of the cement can affect the outcome
* Contain a Silane-coupling Agent
– This allows a chemical bond to the porcelain
how does the resin cement adhere ?
Rely-X Ultimate + Scotchbond Universal properties and indications
most to least transulcent crown material
most to least fracture resistance ?
pros and cons of dentine bonded crown
Alumina / Zirconia Core (Procera) pros and cons
what can emax lithium dictate be used for and pros and cons
what is monolithic translucent zirconia ?
