DIAGNOSIS AND TREATMENT PLAN IN FIXED 2019. pptx

Question 1

Emergency treatment : Symptomatic treatment :

Includes:

Answer 1

Treatment of emergencies to relief discomfort associated
with acute conditions as,
1-Fractured tooth or teeth,
2- Acute pulpitis
3- Acute exacerbation of chronic pulpitis,
4- Dental abscess,
5- Acute pericronitis or gingivitis and
6- Facial pain.

Question 2

Phase I: Stabilization Phase

Answer 2

The treatment involves stabilizing conditions such as
dental caries or periodontal disease by removing the
etiologic factors, increasing the patient’s resistance.
1- Scaling and root planning
The proper removal of plaque is possible only if the teeth
are smooth and their contours allow unimpeded access to
the gingival sulcus.
-Proper oral hygiene instruction
2- - Chronic periodontitis with continuing irreversible
bone loss should be treated as early as possible by
effective daily plaque control
3-Replacement of defective restorations.
4- Corrections of defective or over hanging restorations,
open inter proximal contacts.
5- Removal of carious lesions, (excavations of caries and
placement of temporary restoration)
with combination of dietary advice, oral hygiene measures,
and fluoride treatment.
6- Extraction of hopeless teeth grade 3 mobility severe
bone loss with resistant abscess
Teeth with a hope- less prognosis, and residual roots and root tips should be
removed early.

Question 3

cast restorations are avoided in

Answer 3

a patient with active
caries, because the results of such extensive treatment would
be jeopardized by recurrence of the disease.

Question 4

Phase II: Preparatory phase

includes:

Answer 4

Oral surgery
Periodontal surgery
Endodontic treatment
Orthodontic treatment

Question 5

Oral surgery

Answer 5

The treatment plan should allow time for healing and ridge
remodeling. should be undertaken during the early phase of
treatment.
Unerupted , impacted teeth, and residual roots and root tips should be removed..

Question 6

Periodontal surgery Any surgery, pocket elimination, mucogingival procedure,
guided tissue regeneration, or root resection is performed
at this time

Answer 6

Phase 2: Preparatory phase

Question 7

Elective endodontics may be needed to provide

Answer 7

1-Adequate space for a cast restoration or to
2- Provide retention for a badly damaged or worn tooth.
3- Tooth with doubtful pulpal health is to be
used as an abutment for an FPD.

Question 8

Occlusal adjustment

Answer 8

Occlusal adjustments are often necessary before the initiation of
fixed prosthodontics. When extensive fixed prosthodontics is to be
provided, an accurate and well-tolerated occlusal relationship may
be obtainable only if a discrepancy between maximal
intercuspation and centric relation is eliminated first , any supraeruption
or drifting should be corrected rather than be allowed to
compromise the patient’s occlusal scheme.

Question 9

The consequences may be

Answer 9

1- Suprerupion of the opposing tooth or teeth,
2- Tilting of the adjacent teeth, and
3- Loss of proximal contact
4- Disturbances in the health of the supporting structures and the
occlusion

Question 10

If both anterior and posterior teeth are to be restored, the

anterior teeth are usually restored first because

Answer 10

they
influence the border movements of the mandible and thus
the shape of the occlusal surfaces of the posterior teeth

Question 11

Restoring all four posterior segments at the same time
might lead to considerably more complications for the
patient and dentist, including

Answer 11

1-Fracture or breaking of interim restorations,
2-Discomfort with bilateral local anesthesia, and
3-Difficulties in confirming the accuracy of jaw relationship
recordings.

Question 12

Unless bone support has been weakened by
advanced periodontal disease, a single missing
tooth can almost always be replaced by

Answer 12

a threeunit
FDP that includes one mesial and one distal
abutment tooth.

Question 13

An abutment should be

Answer 13

1- A vital tooth.
2- The tooth must have some sound, surviving coronal tooth structure to
insure longevity.
Coronal tooth structure that has been lost. This can be corrected by the
use of a dowel core, or a pin-retained amalgam or composite resin core.
3-Teeth that have been pulp capped in the process of preparing should
not be used as FPD abutments unless they are endodontically treated.
4-The supporting tissues surrounding the abutment teeth must be healthy
and free from inflammation.
Normally, abutment teeth should not exhibit mobility, since they will be
carrying an extra load.

Question 14

Occlusal loads that surpass the PDL’s physiologic threshold cause

Answer 14

injuries to the PDL tissue. As a consequence the mobility of the
tooth increases.

Question 15

Potentially damaging lateral forces can be confined to

Answer 15

the anterior

teeth where they are reduced by the longer lever arm.

Question 16

After horizontal bone loss from periodontal disease, the periodontal
ligament–supported root surface area can be

Answer 16

dramatically reduced.
Because of the conical shape of most roots when one third of the
root length has been exposed, half the supporting area is lost. In
addition, the forces applied to the supporting bone are magnified
because of the greater leverage associated with the lengthened
clinical crown.

Question 17

longer spans are less rigid bending or deflection

varies directly with

Answer 17

the cube of the bridge length and inversely with the

cube of the occluso-gingival thickness of the pontic.

Question 18

Bending or deflection varies directly with

Answer 18

the cube of the bridge length

Question 19

Bending or deflection varies inversely with

Answer 19

the cube of the occluso-gingival thickness

of the pontic.

Question 20

The fixed partial denture can be expected to provide a long

life of function for the patient if.

Answer 20

1-The abutment teeth are periodontally sound
2- The edentulous span is short and straight
3- The retainers are well designed and executed,
4- No gross soft tissue defect in the edentulous ridge.
5- High motivation for the patient

Question 21

A secondary abutment must have at least

Answer 21

as much root surface area and

as favorable a crown-root ratio as the primary

Question 22

A telescope crown

The marginal adaptation for this restoration is provided by

Answer 22

the coping.

Question 23

The use of a nonrigid

connector has been recommended to reduce

Answer 23

causing failure

of the weaker retainer.

Question 24

The keyway of the connector should be placed
within the normal……
and the key should be placed on…..

Answer 24

distal contours of the pier
abutment,
the
mesial side of the distal pontic.

Question 25

Generally, cantilever fixed partial dentures should

replace only

Answer 25

one tooth and have at least two abutments.

Question 26

When pontics lie outside the inter-abutment axis line,

Answer 26

the

pontics act as a lever arm, which can produce a torquing movement.