case pres 3

Question 1

materials for cores

Answer 1

composite - preferred
RMGIC - uptake of water
amalgam - 24 hours to set

Question 2

when is a post indicated

Answer 2

if insufficient tooth structure to retain a core

Question 3

implication of space between post and GP

Answer 3

compromises seal, predisposes to leakage and may lead to failure of the RCT

Question 4

how can GP be removed

Answer 4

thermal - heat
mechanical - GG burs
Chemical - not recommended when removing for posts as cant control depth of softening

Question 5

why do fibres posts need an adequate ferrule

Answer 5

if no tooth tissue core can debond and flexure can lead to post fracture
fibre posts are less resistant to fracture than metal posts

Question 6

removal of anterior posts

Answer 6

ultrasonics - vibrational energy directed down long axis of tooth, conservative
eggler device - uses residual root for anchorage has gripping forces, pulls along long axis so less risk of fracture

Question 7

why cuspal coverage for 24 after RCT

Answer 7

both marginal ridges lost and access cavity - significantly weakened tooth at increased risk of fracture

Question 8

materials for an onlay

Answer 8

composite - either direct (technically demanding) or indirect (cheaper than ceramic)
ceramic - great aesthetics

Question 9

what is emax

Answer 9

lithium disilicate, a glass ceramic

Question 10

what makes up a metal ceramic crown

Answer 10

metal substructure (strength)
opaque ceramic layer (block metal shine through)
veneering ceramic layer (aesthetics)

Question 11

labial prep for anterior crowns

Answer 11

should be done in 3 planes to achieve uniform reduction
cervical 1/3, middle 1/3 and coronal 1/3

Question 12

palatal reduction for metal ceramic anterior crowns

Answer 12

0.7mm palatal chamfer
0.7mm cingulum reduction

Question 13

what site has caused stage IV grade C diagnosis

Answer 13

47m vertical defect

Question 14

is smoking still a risk factor for this patient

Answer 14

exact time frame varies - various papers with differing amounts e.g 4/5/7/10/12
as this patient is 10 years risk is likely very minimal

Question 15

what did you do when code 4 BPE recorded

Answer 15

radiographic assessment - OPT or PAs
full mouth 6PPC
diagnostic statement

Question 16

step one perio treatment

Answer 16

• explain disease, risks and benefits of treatment
• enforce importance of OH
• reduce risk factors (27d overhang)
• OHI including interdental cleaning
• PMPR of clinical crown

Question 17

what did you do after step one of periodontitis

Answer 17

re-evaluate in around 2 weeks to assess engagement
engaging patient: <=20% plaque and <=30% bleeding OR >=50% improvement in plaque and bleeding OR personal targets met

Question 18

step 2 of periodontal treatment

Answer 18

• reinforce principles of step one (behaviour change, OHI, risk factor control)
• subgingival PMPR

Question 19

what to be done after step 2 of periodontal treatment

Answer 19

reevaluate after 3 months to assess stability
stable: PPD <= 4, no BOP at 4mm sites, <10% BOP
unstable: PPD>=5mm or >=4mm with BOP

Question 20

step 3 of periodontal treatment

Answer 20

reinforce OHI and behaviour change
4-5mm pockets - reperform subgingival PMPR
6mm+ pockets - specialist referral for pocket management or regenerative surgery (47)

Question 21

surgical options for 47m defect

Answer 21

regenerative periodontal surgery (intra bony defect >3mm)
Guided Tissue Regeneration - bone derived graft placed into defect to act for scaffold for patients bone to grow

Question 22

what can be used to calculte periodontal recall period

Answer 22

SDCEP risk assessment tool

Question 23

step 4 perio treatment

Answer 23

maintenance
reinforce OHI, behaviour changes, risk factor control
regular, targeted PMPR
full 6PPC annually