CSA restorations and periodontal health Flashcards
What is Biological width
natural distance between base of gingival sulcus & height of alveolar bone
Why do we have periodontal problems when we are doing restorative dentistry?
- plaque accumulation
2. Food impaction into periodontal tissues
How does plaque accumulation occur?
a. Shape of restoration/ overhangs at margins
b. Deficiencies/ voids formed within restoration
c. Roughness of restorative surfaces
What is food impaction into perio. tissues?
a. Poor/ no contact point
b. Incorrect 3D contour of supragingival bulge in restoration
c. Overbuilt or under-built embrasures (spillways)
What is the importance of tooth shape ?
- shape of tooth prevent food impaction on gingival tissue
- shape of crown protect gingival tissue
- shape of contact point & embrasure protect soft tissues
What to check with patient ?
• Will tissue permit us to carry out any restorative procedures? Direct sight, probing examinations
o If tissue isn’t healthy margins wont seal properly
Why do we get plaque retention ?
Crowns/amalgams/composite not made properly
• Big overhangs leave area patient can’t clean properly so ging. tis. inflamed//bleeding
How do we keep perio health to a good standard ?
- making restorations of good quality
- Telling patient to clean efficiently and where
- whether area will be kept clean after placement is where we place margin
Where can we place restoration for good aesthetics?
place a margin into sulcus
What are iatrogenic factors ?
- Tooth tissue loss may affect vital supporting structures of both hard & soft tissue
- matrix band can> when packing amalgam, material squeeze out and become a PRF> perio disease
What is Biological integration ?
When place restoration, shouldn’t have neg. response on oral cavity
What is placement of preparation finishing line ?
either supra gingival, equigingival, or subgingival
Why are Supra- & equi-gingival margins advantageous ?
preparation and impressions more easily accomplished
Why do most dentists place crown margins subgingivally ?
aesthetic to hide margin but newer ceramic materials allow placement of restorations supergingivally
What aspects to consider when gaining soft tissue contour ?
- Biotype
- Biological width/margin placement
- Precision of marginal fit
What is biotype?
- Square shaped teeth associated with THICK biotype
* Triangular shaped associated with THIN
What is thin scalloped biotype?
- Distinct disparity between height of gingival margin on direct facial and height of gingival margin interproximally
- Delicate/friable soft-tissue curtain
- small amount of attached masticatory mucosa
What is underlying osseous form like in thin biotype?
scalloped, dehiscences and fenestrations often present
- FLATTER/THICKER in thick
how does thin biotype react to insult?
by recession
, by pocket depth in THICK
Where are contact areas of adjacent teeth located in thin biotype
toward the incisal or occlusal thirds
, towards apical in THICK
What are contact areas of adjacent teeth like faciolingually and incisogingivally in THIN Biotype?
• Small contact areas
Why do we have thick and thin biotype?
- Due to thickness & contour of bone
- Soft tissue = top of the bone
- Thick biotype = thick bone vice versa
- thick biotype posteriorly & thin anteriorly
Where is it common to see thin biotype ?
in teens on lower incisors due to orthodontic treatment
What is probing like on thin biotype?
probe a couple of mm physiologically
- must know depth of sulcus when placing margin
