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Fixed Prosthodontics I > Diagnosis and Treatment Planning For Single Fixed Restorations > Flashcards

Diagnosis and Treatment Planning For Single Fixed Restorations Flashcards

1
Q

Treatment planning fro single tooth restorations begins with:

A
  1. Analysis of each individual tooth
  2. Analysis of the patient as a whole
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2
Q

What are some factors we should consider when treatment planning for single tooth restorations?

A
  • home care
  • tooth wear
  • existing restorations (a lot?)
  • pain
  • financial abilities for treatment
  • will treatment maintain the tooth
  • will treatment strengthen the tooth
  • Existing tooth treatment already
  • patient goals
  • esthetics
  • periodontal stability
  • will the tooth need additional treatment
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3
Q

What is the first step in treatment planning?

A

complete medical & dental history

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4
Q

When taking a complete medical and dental history we should be looking for:

A

contra-indications

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5
Q

What are some contra-indications to beginning dental treatment?

A
  • cardiac issues
  • patients stability with diabetes or other diseases
  • patients home care
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6
Q

After obtaining dental and medical history what is the second step in treatment planning?

A

gather further information about the tooth in question (radiographs and periodontal charting)

This step is after obtaining medical and dental history

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7
Q

What should we evaluate on the radiographs?

A
  • bone level
  • extend of decay or tooth destruction
  • endodontic condition
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8
Q

What are we evaluating when periodontal charting?

A
  • bone level
  • tissue condition (inflammation level, bleeding level, recession)
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9
Q

What is the third step in treatment planning following detailed medical/dental history and further tooth evaluation with radiographs and periodontal charting?

A

Look at the tooth in question to analyze what might be needed to restore it

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10
Q

What should you do immediately when you see a silver filling?

A

blow air to look for fracture lines

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11
Q

If you see fracture lines in an existing filling what should you do?

A

remove filling and restore the fracture lines

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12
Q

If the isthmus destruction is greater than 1/2 intercuspal width you would lean towards what treatment?

A

crown or onlay

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13
Q

More than 50% of tooth structure is gone and loss of cusp support you would do what treatment?

A

crown (an likely a core buildup)

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14
Q

Combined CENTRAL and PERIPHERAL destruction, treatment would involve:

A
  • core buildup and crown
  • possible RCT/Post/Core/Crown
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15
Q

Every time you cut a tooth you:

A

weak a tooth

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16
Q

The fourth step in treatment planning is asking:

A

What are the options for treatment for this particular patient and this particular tooth

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17
Q

The fifth step of treatment planning is to:

A

put the treatment options into ranked categories

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18
Q

During the 5th step of treatment planning what are the categories you should put the treatment options in?

A
  1. best
  2. better
  3. acceptable
  4. not recommended
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19
Q

List an examples/definitions of the best, better, acceptable, and not recommended:

A
  1. best- strengthen the tooth and provide excellent esthetics
  2. better- strengthen the tooth
  3. acceptable- repair the tooth, but not necessarily improve its strength
  4. not recommended- not an option for this patients tooth
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20
Q

During the 5th step of treatment planning present the options to your patient discussing the risks, benefits, and alternatives of each option including:

A

NO TREATMENT

21
Q

Loss of cuspal support = what treatment?

A

crown!

22
Q

What are types of materials used for fixed restorations?

A
  1. gold
  2. ceramic (E.Max, Empress)
  3. zirconia
  4. zirconia fused to porcelain (PFZ)
  5. composite formulations (CEREC)
  6. metal
  7. metal-ceramic (Porcelain Fused to Metal (PFM))
23
Q

The pros of gold (similar for non-gold metal crowns) include:

A
  1. gentle on gingiva
  2. low wear on opposing teeth
  3. longest lasting restoration we have in dentistry so far
  4. can be burnished to seal smallest of margins
  5. very low risk of crown fracture
  6. contacts can be added to
  7. easily polished
24
Q

The cons of gold (similar for non-gold metal crowns) include:

A
  1. non-esthetic
  2. labor intensive for lab tech
25
Q

The pros for ceramic crowns include:

A
  1. tooth colored
  2. still stronger than enamel by 2x
  3. most realistic and beautiful of all crown materials
26
Q

The cons for ceramic crown include:

A
  1. must use resin cements 90% of the time
  2. careful patient selection needed for molar crowns
  3. requires thicker margins as ceramic need a minimal amount of material to prevent fracture
  4. fracture risk
27
Q

The pros to zirconia crowns include:

A
  1. tooth colored
  2. some iterations are 4x as strong as enamel
  3. becoming more esthetic
  4. easy for lab technician to fabricate
28
Q

The cons to zirconia crowns include:

A
  1. not all zirconias are the same
  2. cannot easily add material to establish contacts
  3. crown prep design still key for longevity
  4. fracture risk with some formulations
29
Q

The pros to porcelain fused to zirconia crown include:

A
  1. tooth colored
  2. some iterations are 4x as strong as enamel
  3. becoming more esthetic
  4. no dark metal (like PFM) to cover
  5. white substructure enhances esthetics with porcelain providing high esthetics
30
Q

The cons to porcelain fused to zirconia crown include:

A
  1. not all zirconias are the same
  2. cannot easily add material to establish contacts
  3. crown prep design key for longevity
31
Q

The pros to CEREC composite formulation crown include:

A
  1. tooth colored
  2. easy for the lab to fabricate
  3. milled restorations
  4. mixture of composite and ceramic
32
Q

The cons to CEREC composite formulation crown include:

A
  1. longevity is still in research
  2. cannot easily add material to establish contacts
  3. crown preparation design still key for longevity
  4. esthetics is challenging
33
Q

The pros to PFM crowns include:

A
  1. tooth colored
  2. metal substructure adds strength
  3. metal substructure enables PFMs to be used in longer bridges
  4. can design where porcelain covers metal to provide excellent flexibility in design
  5. metal substructure protects tooth even if the porcelain fractures
34
Q

The cons to PFM crowns include:

A
  1. porcelain can fracture if not prepared correctly
  2. metal collars can be unesthetic
  3. porcelain can yellow over time
  4. preparation is technique sensitive due to metal and porcelain components
35
Q

Types of fixed prosthodontics include:

A
  1. crowns
  2. veneers
  3. other implant prosthesis (“all on 4”)
  4. inlay/onlay
36
Q

Types of crowns include:

A
  1. single crowns
  2. bridges (multiple crowns with Pontic)
  3. implant crowns
  4. partial crowns
37
Q

How long do single crowns last?

A

average single crown lasts 10-15 years (some materials have a longer life span than this)

38
Q

List the longevities on average of crowns, conservative amalgams, and conservative composite?

A

crowns: 10-15 years
conservative amalgam: 10-15 years
conservative composite: up to 10 years but average of 6 years

39
Q

Treatment planning a crown begins with:

A

patient history

40
Q

Prior to working on the patient what should be taken?

A

a global analysis of the patients overall health

41
Q

After taking a global analysis of the patients overall oral health what should be done?

A

analysis of the tooth to be treated

42
Q

What are two questions that should be asked in regards to the analysis of the tooth to be treated?

A
  1. how much of the tooth is compromised
  2. what is needed to restore the tooth?
43
Q

When Identifying options to restore the tooth the 1. best option=
2. better =
3. acceptable=
4. not an option =

A
  1. esthetics and strength
  2. strength
  3. repair the tooth but not necessarily stronger
  4. not a reasonable option for the patient
44
Q

Patient presents to your office with no pain or sensitivity. You notice decay on the buccal of #30 which compromises the integrity of the existing amalgam.

What information do you need to gather in order to treatment plan #30 for a new restoration?

What are the options available here for this patient?

Can you list the best, better, acceptable, and not an option for this patient?

A

x

45
Q

Patient presents to your office with no pain or sensitivity. You notice decay on the occlusal of #30 which compromises the integrity of the existing amalgam.

What information do you need to gather in order to treatment plan #30 for a new restoration?

What are the options available here for this patient?

Can you list the best, better, acceptable, and not an option for this patient?

A

x

46
Q

What type of damage is seen in this image? What would the treatment be?

A

combined central & peripheral destruction

core build up & crown, possible RCT/post/core/crown

47
Q
  • Patient presents to your office with a broke tooth
  • No significant medical/dental history
  • Bitewing radiograph taken
  • Patient reports no pain but tooth is sharp to his tongue
  • Patient home care is in stable condition

What additional information do you need?

A
  1. PA radiographs to see apex
  2. perio charting
48
Q
  • Patient presents to your office with a broke tooth
  • No significant medical/dental history
  • Bitewing radiograph taken
  • Patient reports no pain but tooth is sharp to his tongue
  • Patient home care is in stable condition

What does this image reveal?

A

Loss of cusp and greater than 50% of tooth structure compromised

49
Q
  • Patient presents to your office with a broke tooth
  • No significant medical/dental history
  • Bitewing radiograph taken
  • Patient reports no pain but tooth is sharp to his tongue
  • Patient home care is in stable condition

Upon examination it is noted that the tooth in question has loss of a cusp and greater than 50% tooth structure compromised.

What is the best/ideal choice for this patient?

A

Crown

Fixed Prosthodontics I (13 decks)

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