case pres 3 Flashcards
materials for cores
composite - preferred
RMGIC - uptake of water
amalgam - 24 hours to set
when is a post indicated
if insufficient tooth structure to retain a core
implication of space between post and GP
compromises seal, predisposes to leakage and may lead to failure of the RCT
how can GP be removed
thermal - heat
mechanical - GG burs
Chemical - not recommended when removing for posts as cant control depth of softening
why do fibres posts need an adequate ferrule
if no tooth tissue core can debond and flexure can lead to post fracture
fibre posts are less resistant to fracture than metal posts
removal of anterior posts
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
why cuspal coverage for 24 after RCT
both marginal ridges lost and access cavity - significantly weakened tooth at increased risk of fracture
materials for an onlay
composite - either direct (technically demanding) or indirect (cheaper than ceramic)
ceramic - great aesthetics
what is emax
lithium disilicate, a glass ceramic
what makes up a metal ceramic crown
metal substructure (strength)
opaque ceramic layer (block metal shine through)
veneering ceramic layer (aesthetics)
labial prep for anterior crowns
should be done in 3 planes to achieve uniform reduction
cervical 1/3, middle 1/3 and coronal 1/3
palatal reduction for metal ceramic anterior crowns
0.7mm palatal chamfer
0.7mm cingulum reduction
what site has caused stage IV grade C diagnosis
47m vertical defect
is smoking still a risk factor for this patient
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
what did you do when code 4 BPE recorded
radiographic assessment - OPT or PAs
full mouth 6PPC
diagnostic statement
step one perio treatment
- explain disease, risks and benefits of treatment
- enforce importance of OH
- reduce risk factors (27d overhang)
- OHI including interdental cleaning
- PMPR of clinical crown
what did you do after step one of periodontitis
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
step 2 of periodontal treatment
- reinforce principles of step one (behaviour change, OHI, risk factor control)
- subgingival PMPR
what to be done after step 2 of periodontal treatment
reevaluate after 3 months to assess stability
stable: PPD <= 4, no BOP at 4mm sites, <10% BOP
unstable: PPD>=5mm or >=4mm with BOP
step 3 of periodontal treatment
reinforce OHI and behaviour change
4-5mm pockets - reperform subgingival PMPR
6mm+ pockets - specialist referral for pocket management or regenerative surgery (47)
surgical options for 47m defect
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
what can be used to calculte periodontal recall period
SDCEP risk assessment tool
step 4 perio treatment
maintenance
reinforce OHI, behaviour changes, risk factor control
regular, targeted PMPR
full 6PPC annually
