Coronal foundations Flashcards
Assessing tooth restorability
preservation of tooth structure
Function and longevity
Aesthetic considerations
Cost-effectiveness
Patient health
Tx planning
what To assess with regards to preservation of tooth tissue?
Assess if there is enough tooth stctire available to restore the tooth
- evidence of creep, micro leakage and secondary caries
- fracture or deterioration of restoration
- periodntium and perio health
- tooth wear
wat to assess with function and longevity?
Perform radiograph in assessment
Tooth vitality
Occlusion and occlusal factors that may affect long term success of tx
aesthetic considerations?
Very important form pt aspect
Consider tooth position, orthodontic intervention
Gingival position and smile line
Consider what arterial to use for our fixed prosthesis
cost- effectiveness considerations?
Consider early intervention to reduce costs - reduce need to do more extensive work
Save money and time
pateint health considerations?
If an infection occurs potentially spreading to the surrounding areas and affecting the pt overall health
Any allergies to certain materials e.g. metal allergies
Gastric disorders/vomiting tendencies/ eating disorders
Psychological condition e.g. anxiety, ADHD and hyperactivity disorders which may increase risk of bruxism
considerations for treatment planning for fix pros?
Condition of the tooth
Consider if teeth require elective root tx
Construct study models and. A diagnostic wax up to anticipate any potential complications
Examine occlusion
Record shade at the examination visit and reconfirm at later visits
Consider what material may Perot better in the area to be treated
why is it important to determine tooth restorability?
Help us anticipate any potential complications and how we can best approach restoring the pt back to a healthy and easthetic function
does age influence tooth restorability?
Affect pt prognosis
Younger pt better outcome
extra-oral clinical examination?
TMJ and musculature
Cervical lymph nodes and salivary glands
Facial features
- facial proportions
- symmetry
- facial shape
- profile and width
- lip morphology
- mobility
Range of movement
intra-oral clinical examination?
Soft tissue assessment
- clenching habits, dry mouth
Assessment of hard tissues
- condition of current restorations
- absence of teeth
- presence of dental caries
- tooth fracture/cracks
- wear of mechanical or chemical origin
- tooth malformations
- food traps should be notes
periodontal examination for fixed prosthesis pros?
Oral hygiene (good, moderate, poor)
Presence of any colour and morphological anomalies of the gingivae
Bleeding on probing
Exudate or any halitosis
Pt home care routine
BPE
Pocket chart
occlusal assessment - static occlusion?
Tooth rotation, tilting, drifting, supra-eruption
Crowding
Spacing
Overjet
Overbite
Occlusal vertical dimension
Free way space
Malocclusions
Categorise inter-occlusal relationships
Loss of posterior support
Lateral excursions
Occlusal interferences
assessment of the aesthetic zone?
Determine the appearance of smile
Smile line
Width of smile
Assessment of smile arch
Dental midline’s
Tooth colour, form, size/shape ad symmetry/position
Gingival aesthetics
low, medium and high smile line?
Low = no more than 75% ant teeth on show, no display of gingival tissue
Medium = 75-100% of ant teeth on show as well a s interdental papilla
High = exposes the teeth on show as well as interdental papilla’s, gingival margin, often referred to as the ‘gummy smile’
assessment of any edentulous spaces?
Rounded
Flat
Inverted
Knife edge
Mucosa firmly bundled or flabby
Hard or soft tissue undercuts
Examination of any current removable prostheses
what to consider when there isn’t ideal tooth structure available?
Core build up with adhesive material more commonly composite resin
Consider RCT and post/core or extraction
- this depends on the available ferrule
what is the purpose of the ferrule?
Provid additional strength and retention for the restoration helping to prevent fracture or failure of the tooth or the restoration itself
Particularly crucial when the tooth has lost a substantial amount of its crown structure due to decay, trauma or previous restorations
key characteristics of a ferrule?
Height of the ferrule
Thickness
Encircling the tooth
indications for ore build ups?
Root canal treated teeth
Teeth with significant structural loss
Teeth requiring crowns
Teeth that are abutments for bridges
Teeth with extensive structural loss
When using a post-and-core
materials for core build ups?
Core composite material s
Amalgam - nt great in pros - not good retention
GIC
RMGI
Pre-formed post-and-core system
Fibre post
what may affect the success of a core build up?
Amount of remaining tooth structure
Material selection
Adhesion
Proper post placement (if required)
complications of core build ups?
Core material fracture
Post failure
Insufficient bonding
process of core build ups?
Tooth prep
Post placement (if required)
Core material placement
Curing and shaping
Crown prep
