fixed prosthodontics and orthodontics Flashcards
3 replacement options for missing teeth
3 roles of the dental hygienist
fixed prosthesis, removable prosthesis, implants
explain each choice to the pt, answer their questions, and prepare notes (medical history, dental history, EOE/IOE, etc
components of a fixed partial denture
fixed partial denture AKA =
what types of fixed partials dentures involve the natural teeth (3)
what type of fixed partial denture does not involve a real tooth
components: abutments, connectors, and pontics
AKA a bridge!
natural tooth: traditional (abutments + pontic), cantilever (pontic + 2 real teeth on ONE side), and maryland/resin supported (butterfly shape)
implants do not involve the natural tooth
IMPLANTS
what is the difference between a cemented and screw retained crown
advantages to a cemented crown
advantages to a screw retained crown
disadvantages to a cemented crown
disadvantages to a screw retained crown
a cemented crown requires a two piece assembly (implant + abutment; abutment + crown) a screw retained crown requires a one piece assembly (crown screws on implant)
cosmetics: looks like a natural tooth
easy to access the screw, no cement required
cement can cause inflammation and bone loss; limited removal options
crown may chip easier near the access hole (not common); not as aesthetic
parts of an endosteal/single implant supported crown; what does it do
crown, abutment, implant
replaces a SINGLE tooth, not multiple
THREE-UNIT IMPLANT-SUPPORTED BRIDGE
can be ____ or _____
can occur in a variety of designs to replace __ or more teeth
what isn’t recommended and why?
patient can not _____ to clean
can be cemented or screw retained
can occur in a varitety of designs to replace 3 or more teeth
not recommended to use both natural tooth AND implants within the same bridge (keep the abutments as two implants or two natural teeth because of even stress applied to the teeth (more failures)
pt can not remove to clean
T/F in a “full-arch implant-supported bridge”, if the patient has selected implants, each tooth is replaced by an implant
FALSE, only select teeth are replaced (2 on mandibular, 4 on maxillary)
IMPLANT-SUPPORTED DENTURES (Overdentures)
Ball-shaped abutments on the ______
Cup-shaped attachments on the ___
Denture snaps on and off
The patient or clinician can remove it for cleaning of both the ________ and ______
amount of implants for best long term success:
_ on mandibular
_ on maxillary
Ball-shaped abutments on implant
Cup-shaped attachments on
denture
Denture snaps on and off
Patient or clinician can remove for
cleaning of both appliance and
implants
Research suggests the following for best long-term success:
2 implants on mandibular
4 implants on maxillary
implant supported dentures/overdentures (SCREW RETAINED)
can only be removed by ______
what can cause a challenge for patients
can only be removed by the dentist
it must stay in place while performing oral hygiene at home, difficult for pts to clean properly
what are the benefits of implant supported over dentures (4)
- no caries risk (fake teeth)
- less bone loss compared to complete dentures (implant can retain some bone)
- improved stability and retention
- better chewing ability and quality of life
implants/implant-supported prostheses (professional care)
CONTRAINDICATIONS (3)
METAL/ABRASIVES LEAD TO (2)
PROBING?
WHAT TYPE OF SCALERS ARE AVAILABLE? (5)
ULTRASONIC USE?
AIRPOLISHING?
contraindications: stainless steel instruments, metal US tips, pumice or abrasive polish (use the ultrafine polish from sterile)
metal/abrasives cause scratching leading to: biofilm retention and peri implantitis
use a plastic (yellow) probe
plastic, gold coated, teflon coated, titanium coated, graphite
plastic or resin tipped US tips
GLCYINE for subgingival, glycine or sodium bicarbonate for supragingival
home care for implants/ implants supported prosthesis/ fixed partial dentures (bridge)
individualized based on prosthesis ____ and patient ______
______ Brushes (Plastic ____-coated wires)
Oral Irrigators
End Tuft or _____ Brushes (____ makes a variety of brush designs for different prosthetics)
Possibly ________ Method of Toothbrushing in areas of fixed prosthesis
Dentifrice: _________
Individualized based on prosthesis design and patient ability
Interproximal Brushes (Plastic nylon-coated wires)
Oral Irrigators
End Tuft or Sulcus Brushes (TePe makes a variety of brush designs for different prosthetics)
Possibly Charters Method Toothbrushing in areas of fixed prosthesis
Dentifrice: non abrasive
Regarding ortho, list 6 different types of brackets/bands
- archwire (the wire attached to the brackets)
- twin brackets (has two slots for the wire)
- elastomers/ligatures (rubber bands, you can pick the color)
- self-ligating brackets (holds the wire without the rubber band)
- band (metal ring cemented onto a tooth, anchor point for brackets/appliacnes)
- buccal tube (integrates other appliances, facilitates tooth movement)
list 4 types of orthodontics
- metal braces (most common)
- ceramic braces (more aesthetic, more expensive)
- lingual braces (difficult to clean)
- clear aligners (invisiline)
REMOVABLE ALIGNER SYSTEM
Overview
- Custom, clear ______ aligners are made
- With each ___ of aligners, misaligned teeth are _______ moved
Clinical Procedure
- ______ or _______ scan
- Patient’s _______ (if impressions taken) or ____ (if intraoral scan)
are scanned to make 3D model of teeth on the computer
- ________ are bonded to the teeth so the aligners can snap into place
- A number of aligners are given to patient to wear
- Each tray is worn for ~__ weeks
- Patient visits dentist regularly to track _______ and receive next set
of trays
- _______ are fabricated after treatment is complete
Overview
Custom, clear thermoplastic aligners are made
With each set of aligners, misaligned teeth are progressively moved
Clinical Procedure
Impressions or intraoral scan
Patient’s study models (if impressions taken) or teeth (if intraoral scan) are scanned to make 3D model of teeth on computer
Attachments are bonded to the teeth so the aligners can snap into place
A number of aligners are given to patient to wear
Each tray is worn for ~2 weeks
Patient visits dentist regularly to track progression and receive next set of trays
Retainers fabricated after treatment is complete
The American Association of Orthodontists recommends a check-up with an orthodontic specialist no later than age __
7
reasons for Pediatric ortho referral (17)
- altered eruption sequence
- overretained primary teeth
- congenitally missing teeth
- early loss of primary teeth
- anterior or posterior cross bite
- anterior crowding (should see primate spaces)
- diastema greater than 2mm
- lip incompetence (doesnt close when shut)
- deviations of max/mand midline
- malposed teeth
- impacted teeth
- lack of leeway space
- excessive overjet (4mm or more)
- excessive overbite (cervical third)
- open bite
- retroganthic/prognathic
- oral habits (thumb sucking)
PALATAL EXPANDER
- used prior to ______
- widens the _____ arch
- creates space to accomodate ______ and correct ____
- difficult to clean causing: (2)
- use _______ to clean at home with the help of the caregiver
- prior to puberty
- widens palatal arch
- accomodates tooth eruption and correct posterior cross bite
- causes food retention and biofilm retention
- oral irrigation
PHASE 1 ORTHO TREATMENT
____ orthodontic intervention to
address issues early to prevent
________ as the patient ages.
Can be early-late _____ dentition
Often in conjunction with ________
Child may be in ______ until Phase __ starts
Children are not usually able to perform adequate home care w/ _______
Early orthodontic intervention to
address issues early to prevent
worsening as patient ages.
Can be early-late mixed dentition
Often in conjunction with palatal
expansion
Child may be in retainers until
Phase 2 starts
Children are not usually able to
perform adequate home care w/
orthodontics
HABIT BREAKING DEVICES
variety of designs to stop ________
and/or ______
Brush with a _______
Special attention around ______
May or may not need ______ to c-shape floss
variety of designs to stop thumbsucking and/or tongue thrust
Brush w/ wet TB
Special attention around bands
May or may not need floss threader to c-shape floss
MAXILLARY HOLDING DEVICES
hold _______ in place
sometimes after ________
brush with a _______, pay special attention around ______
may or may not need a _______
maxillary molars
palatal expansion
wet toothbrush; bands
floss threader to maintain Cshape floss
LIP BUMPER
used for:
pressure from the ____ moves the ______
allows room for _______
can be ___ or _____; take out to brush teeth if removable
brush normally, above and below depending on placement
may need a ______
used for crowded mandibular anterior teeth
Pressure on the bumper from the lips moves the first molars posterior
Allows room for mand ant teeth to drift forward
Fixed or removable
Brush normally or above/below depending on placement if fixed
May or may not need floss threader if fixed
Remove to brush and floss if removable
ortho referral reasons for adolescent/adults (13)
- Patient dissatisfaction
- Malocclusion (Including Class I malocclusion)
- Crowding
- Anterior or posterior x-bite
- Spacing
- Impacted teeth
- Deviation of maxillary or mandibular midline
- Oral habits
- Missing teeth
- Orthodontic relapse
- Skeletal or facial discrepancies
- Lip incompetence
- As part of complex prosthodontic or cosmetic cases
BITE CORRECTION
what does the herbst device do
what is a temporary anchorage device
- correct class 2 occlusion (retrognathic)
- a small implant (in the gums) for elastic chain attachment; retrudes maxillary anterior teeth; corrects anterior open bite
what kind of OHI would we give our ortho patients (7)
- electric TB
- brush above and below the brackets/arch wire
- end tuft brush (special ortho tips)
- interproximal brushes
- floss threaders/superfloss
- oral irrigator
- FLUORIDE!!!
T/F: according to the ADA CRA, fixed or removable orthodontics always places someone at a high caries risk
FALSE: it places someone at a moderate risk at a minimum (can be a high risk)
What is the CAMBRA fluoride recommendation for ages 6+ (mod caries risk)
- 5% fluoride varnish every 6 months
PLUS
option 1: OTC fluoride toothpaste twice a day AND OTC fluoride mouth rinse once a day
option 2: prescription toothpaste (5000 ppm)
due to inadequate oral care, orthodontics often cause: (3)
- gingivitis
- gingival overgrowth
-ortho related white spot lesions
