British Society of Restorative Dentistry Guidelines Flashcards
what is the decision to place fixed pros based on
motivation of patient
oral and general health
condition of remaining teeth and tissues
analysis of benefits/disadvantages
complications which limit the likelihood of success
skill of clinician
what are the alternatives to crowns and fixed pros
vital bleaching
composite
ceramic inlays and onlays
RBB
what restoration would be most appropriate if the patient had minimally or moderately restored teeth at time of presentation
adhesive options
definition of a fixed bridge
dental prosthesis which is luted/screwed/mechanically attached or otherwise securely retained to natural teeth/roots/implants
what is the rationale for using crowns
restore form, function and appearance of badly broken down teeth to the extent that other restorations are contraindicated/failed
to improve form and appearance of unsightly teeth unable to be managed by cosmetics
reduce risk of fractures occurring in extensively restored teeth (and RCT teeth)
alter shape, size and inclination of teeth for cosmetic purposes (rare)
restore dental implant
what is the rational for the use of fixed bridges
replace one or more teeth of functional or cosmetic important to the patient
prevent tooth movement and improve occlusal stability (rare)
what systemic conditions/medications would contraindicate implants
osteoporosis
bisphosphonates
uncontrolled diabetes
smoking
radiotherapy
what special tests may a clinician do
sensibility
radiographs
study casts
MP/MB
diet diary
diagnostic wax up
observe occlusal function
long-term monitoring against study casts
what should the design for tooth-supported fixed bridges be
simple and conservative
avoid using multiple linked abutments
consider implants
enhance occlusal relationships and function
encourage optimal tissue response and facilitate OH
be realistic
what should the choice of material for a bridge be based on
allow cosmetic expectations but do not involve excessive removal of sound tissue
facilitate tissue response
consider opposing materials
what makes treatment planning easier
demonstration models and illustrated case histories to discuss with patients
use of study casts to rehearse preparations and for diagnostic wax ups
liaising with the technician
audit and peer review processes
what do patients need to be made aware of before consenting
implications
sequelae
life expectancy of work
other options
they must understand that success relies on their maintenance
cost
what treatment comes before placement of fixed pros
pain relief
perio
re-evaluation after initial
placement of cores
endo
assessing for implants
necessary orthodontics
surgical perio treatment
definitive occlusal adjustment
placement of implants if part of treatment
if using implants to retain a bridge on an edentulous patient, how many implants are needed per arch
maxilla = 6
mandible = 4
if using implants to retain an overdenture on an edentulous patient, how many implants are needed per arch
maxilla = 4
mandible =2
after implant placement in upper and lower arches how long is the healing time for each arch
and what is this related to
maxilla = 3-4 months
mandible = 2-3 months
the time that the implant needs to osseointegrate into the jawbone
how do you decide the shade
in a neutral colour environment
using shade guide familiar to technician
assessment under different lighting conditions
when you are deciding the form and dimension of preparation what should you take account of
tooth morphology and anatomy
quantity and location of remaining tooth tissue responsible for retention
occlusal relationships
need for realignment
relationships with adjacent teeth and soft tissues
materials to be used
considerations of long-term sequelae
aesthetic requirements
purpose of master impressions
obtain an accurate, dimensionally stable, fully supported impression of the prepared teeth, any dental implants and associated soft tissue
what should the occlusal registration material be
readily and accurately record detail of occlusal and axio-occlusal tooth surfaces
exhibit limited flow following application
have a working time sufficient to allow correct positioning of the mandible
be dimensionally stable and capable of being adjusted without distortion when set or in the solid state
purpose of temporary restorations
restore, protect and maintain the position of prepared teeth between appointments and until the placement of the final restoration
qualities of a provisional restorations
improvements in tooth form/function
marginal adaptation and seal
minimal tissue response
favourable hygiene features
good marginal fit
fracture and wear resistance
functional comfort and control of sensitivity
aesthetics
purpose of a lab prescription
record and communicate precise details of all aspects of crown and bridgework required
what are the principles of a try in visit
inspect restorations with the master cast to confirm satisfactory completion
assessment of acceptability of restorations at time of try in
minor adjustments completed while patient present
identify issue if unsatisfactory
get the patient to confirm acceptance of appearance and comfort
what do you check during a review appointment
satisfaction and comfort
proximal contacts and relationships with adjacent and opposing teeth
note the hygiene
make suitable adjustments
further instructions and advice should be given regarding oral hygiene maintenance
