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Restorative > Crown And Bridge Anterior Teeth > Flashcards

Crown And Bridge Anterior Teeth Flashcards

0
Q

What is a provisional crown?

A

Made to last for a longer period eg whilst periodontal treatment carried out

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1
Q

What is a temp crown?

A

Made to only last a short time

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2
Q

What are the biological requiements for temp crown?

A

BAM
Biological: protect prepared dentine, prevent gingival overgrowth, prevent over eruption and tilting of adjacent teeth
Aesthetics: good surface topography and shade
Mechanical: strong enough to withstand forces of occlusion and mastication

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3
Q

How can temp crowns be made?

A

Chair side or preformed crown

Preformed: polycarbonate for canine, incisor and premolar
Aluminium for molar teeth: aluplast
Tin alloy : ion

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4
Q

What are the advantages of tooth coloured crowns?

A

Aesthetics

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5
Q

What are the all tooth coloured crowns?

A

All porcelain
Lab constructed composite
Resin/detine bonded

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6
Q

What are the non all tooth coloured options for anterior crowns?

A

PFM

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7
Q

How can all porcelain crowns be made?

A

Conventional build up on platinum folk or refractory model

CAD/CAM coping with conventional build up
CAD/CA! Without coping eg Cerec

Pressed porcelain
Glass infused ceramics
Cast glass ceramic

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8
Q

Which technqie is commonly used for all ceramic crowns?

A

Conventional build up on platinum foil

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9
Q

Which technqie is commonly used for veneers?

A

Conventional buildup on refractory model

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10
Q

What is the purpose of the foil I the porcelain?

A

Platinum foil laid down and then alumina or porcelain core used for strength
Platinum foil removed after glazing and prior to cementation

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11
Q

What type of joint is used for the platinum foil?

A

Tinners

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12
Q

How can you build up the core for the porcelain crowns?

A

Using a paint birth or a le cron handle

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13
Q

What is the technique called when you leave the platinum foil on ?

A

Mac clean sced techqnie

The pt foil is tin plated and allows porcelain to bond to foil

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14
Q

What are the options for discoulored anterior teeth?

A 
Hydrochloric acid pumice microabrasion 
Non Vital bleaching
Vital bleaching
Localised composite 
veneers
Crown
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15
Q

What can be the cause of discoloured tooth?

A

Intrinsic or extrinsic
Intrinsic: caries, erosion ingestion, trauma, non vital, neonatal jaundice, genetic

Extrinsic: plaque, calculus, mouth wash, smoking,diet, restorations

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16
Q

What are the manamagemt aims for discoloured anterior teeth?

A 
Restore aesthetics
Restore function
Resolve sensitive t
Preserve tooth
Respect periodontal health
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17
Q

How does hydrochloric acid - pumice work?

A

This improves discolouration limited to outer enamel only

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18
Q

How much enamel is removed in microabrasion and pumice?

A

Less than 100 micrometers

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19
Q

What is the technique to microasbriaon?

A

Vitality test, x ray and photos
Clean dry and isolate
Protect soft tissues with sodium bicarbonate

18% HCL and pumice 5 sec application using slow rotary or wooden stick
Max of 10 times 5 secs

Fluoride drops for 3mins
Oldish for 1 min with soflex

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20
Q

When is micoabrsairon indicated?

A

Fluorisis
Idiopathic speckling
Post ortho demin
Well demarcated brown patch before veneer
White or brown surface staining eg turner teet

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21
Q

When shoud you see an improvement in colour with the microabrasion?

A

1/12

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22
Q

Which colour staining is more easily removed with microabrasion?

A

Brown

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23
Q

How do white stains improve?

A

Due to optical changes of aprismatic enamel

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24
Q

T/F there is an association between caries and prolonged thermal sensitive and microabrasion?

A

F

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25
Q

What kit do you need for microabrasion?

A 
Pumice 
Rubber am and copalite varnish 
Bicarbonate tsoda
18% HCL or 37% phosphoric acid
Non acid fluoride 
Fine soflex disk 
Fluoridated tooth paste
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26
Q

When is non vital bleaching indicated?

A

Non vital discoloured teeth

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27
Q

What causes the discolouration in non vital teeth?

A

Diffusion of Hb products from necrotic pulp tissue

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28
Q

What are the requirements for non vital bleaching?

A

Well condensed GP

No clinical evidence radiographic signs of Periapical disease

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29
Q

How do you perform non vital bleaching?

A

Pre op X-ray
Clean tooth and note shade
Access pulp chamber and remove filling to level of dento gingival
1mm zinc phosphate placed on top
Etch tooth with 37% phosphoric acid for 30-60secs

Mix bleaching agents and cover with GIC. For 1 week

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30
Q

WHen is non vital bleaching not effective?

A

Heavily restored teeth
Staining due to amalgam
21% failure rate

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31
Q

How often should you do the non vital bleaching?

A

Every week once a week until over bleached

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32
Q

How kong should you leave non setting CaOH in cavity for?

A

2 weeks

33
Q

How should you restore the cavity?

A

With white GP and composite

34
Q

When should you abandon non vital bleaching?

A

If no improvement after 3 times

35
Q

What kit do you need for non vital bleaching?

A 
Rubber dam 
Zinc phosphate 
37% phosphoric acid 
30 volume hydrogen peroxide 
Sodium perborate
Cotton wool and GIC
Composte resin
36
Q

What type of resorption can non vital bleaching lead to?

A

Cervical

37
Q

How do we prevent cervical resorption in non vital bleaching?

A

1mm zinc phosphate at neck of tooth

CaOH dressing to eradicate pulpal inflammation

38
Q

What are the options for vital bleaching?

A

Chair side or night time

39
Q

What percentage HP can be used for vital bleaching?

A

Up to 6%

40
Q

When is chair side bleaching implicated?

A

Mild fluorosis
Ageing
Sclerosed pulp chamber

41
Q

What happens to the hydrogen peroxide applied to the tooth in vital bleaching?

A

Activated with a light source of heat

42
Q

What is the legislation behind vital bleaching?

A

Before 2012 could only use 0.1% HP one can use up to 6%

43
Q

What is the process of home bleaching?

A

For each cycle,first cycle must be done by practitioner and for over 18 only
Can use 10% carbamine peroxide gel which breaks down to 3% HP and 7% urea which both diffuse through enamel and dentine

44
Q

What are the concerns with vital bleaching?

A
  • Trace amounts of phosphoric and citric acid might lead to low pH and demin
  • initial decrease in bond strength of composite which resolve over 7 days
  • possible cytotoxic
45
Q

Why is thre an initial decreases in composite bond strength?

A

Due to residual O2

46
Q

What is vital bleaching cytotoxic to?

A

Vascular endothelium

47
Q

What are the advantages and dis of localised resin based composite for discoloured anterior teeth?

A

AD
Useful for demarcated lesion
Dis: marginal staing, accurate colour match and reduce composite translucent and need good quality enamel

48
Q

When are veneers indicated?

A

Discolouration,
Diaestema
Mal positioned tooth
Large restoration a

49
Q

When are veneers contra indicated?

A

Poor quality tooth for bonding
Teeth to buccal in the arch
Heavy occlusal loading

50
Q

What is a good intermediate before placing porcelain veneers?

A

Composte resin
Good for children since have large pulp and immature gingival contour

For adults can be used as permanent but reversible and can be used a Dahl

51
Q

When are porcelain veneers indicated?

A

Adults

52
Q

T/F composite resins can be used directly ?

A

T

Lab made or direct

53
Q

What is the problem with composte veneers?

A

Increased labio Palatal bulk can be detrimental to gum health

54
Q

What are the disadvantages with porcelain veneers?

A

Hard to repair

Abrasive

55
Q

T/F porcelain veneers mask out gross discolouration?

A

T

56
Q

How much do you prepare porcelain veneers into teeth?

A

0.5mm

57
Q

How do you prepare the surface of the veneer?

A

Sand blast and the HF acid and then apply silane coupling agent

58
Q

What is a RRB?

A

A resin bonded bridge fixed to one or more unprepared or minimalist prepared natrual teeth

59
Q

What are the alternative names for RRb?

A

Adhesive
Minimum prep bridge
Maryland bridge

60
Q

What is the history begin RRB?

A

1973: Rochette used metsl wings to splint periodontal compromised teeth
Tags of resins were used to retain metal wing that had perforations on

61
Q

What are the advantages to RRb?

A 
Fixed
Conservative
No La
Short clinical time
Relatively inexpensive 
Reversible/diagnostic
62
Q

What are the disadvantages of RRB?

A

Aesthetic: greying of the abutment and metal showing over
Try in of bridge can be hard
Temporising can be difficult
Extensive restore teeth cannot be used
Risk of debond and failure rate higher than conventional bridge work
Risk of caries greater if partial de bond of fixed fixed design
Technqie sensitive

63
Q

What are the failure rates for RRB? Reference

A

Djemal 1999

92% debond
4% metal fracture
2% caries

64
Q

What are the indications for RRB?

A

Single tooth replacement ideally
Unrestored abutments
Teeth with sufficient good quality enamel
Intermediate prosthesis in young patient

65
Q

What are the contras indications to RRB?

A 
Heavily restored abutments
Teeth with lack of good quality enamel
Excessive occlusal loading
Poor OH
Diffuculty in isolation
Translucent incisal edge 
Disastomer
66
Q

What are the designs for a RRB?

A

Cantilever
Fixed fixed
Hybrid

67
Q

What are the features of a cantilever?

A

Eliminate problem of partial de bond
Less expensive
Limited to replacing only single tooth
Less stress on resin lute since no differential tooth movement

68
Q

What are the features of a fixed fixed?

A

Provide periodontal splinting
Orthodontic retention
Can restore multiple missing teeth
Needed for anything other than single premolar or anterior r

Differential movement of abutment

69
Q

What is a hybrid design?

A

Resin retained and conventional design
Needed when one or more of abutments to be restored with conventional crown
Two testiness maybe joined by a moveable joint

70
Q

What is the median survival rate for RRB? Reference

A

Fixed fixed 7.8 yrs
Cantilever 9.8 yrs

Djemal 1999

71
Q

What are the clinical stages to RRB prep?

A 
Sharp angles of tooth removed
Bulbosities removed
Guide planes
No finish lines 
Crete bevel for incisal anterior teeth 
Aim for max coverage 180 degrees
Consider crown lengthening
Retauner extends into incisal edge and cusps 
Posterior teeth need extensive occlusal coverage
Rigid framework
72
Q

How thin can the metal be finished to in RRB?

A

0.1-0.5mm

73
Q

How thick should the metal retainers in RRB. Be?

A

0.7mm minimum

74
Q

How can you create space for the retainer in the RRB?

A

Prepare abutment
Reduce oppsing teeth
Ortho
Dahl

75
Q

Which method of space creation is ideal for the Pontic? Except for which patients?

A

Dahl

Except: occlusally aware and periodontal compromised

76
Q

Which metal allot is used for the bridge?

A

Ni-Cr

77
Q

What tyke of cement must be used for RRB?

A

4-Meta or Phosohate groups

78
Q

What are the future options for RRB?

A

Metal free made from zirconia or ceramic

Good for premolar region

79
Q

What are the problems with the metal free RRB?

A

Need increase bulk for retainer and increased risk of fracture of Pontic

Restorative (45 decks)

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