Indications for Crowns and Core Success Flashcards

1
Q

what tooth fractures are considered restorable/unrestorable?

A

restorable - craze lines, fractured cusp, cracked tooth above ACJ
unrestorable if crack extends past crown onto root surface

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2
Q

what are telescopic/double crown dentures?

A

removeable dentures that fit precisely over teeth prepared with an inner crown - the inner crowns aid denture retention

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3
Q

what condition must abutment tooth be in for it to be prepped to retain a bridge?

A

abutment tooth must be heavily restored to justify crown prep

it would not be acceptable to prepare an unrestored/minimall restored tooth for a crown as a bridge retainer

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4
Q

what is the biological width? on average how far above is it to the crest of the bone?

A

the distance between the junctional epithelium and connective tissue attachment to the root surface

3-4mm above the crest of the bone

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5
Q

what will happen if crown margin encroaches the biological width? how will this look on a person?

A

gingiva will reject crown - gingiva will become inflammed and bone loss around tooth

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6
Q

why is crown prep not indicated for everything?

A

crown prep produced heat and may cause pulp damage
may cause pulpal irritation and necrosis
may risk ingress of bacteria to pulp
crown placement places tooth one step closer to XLA

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7
Q

what are contraindications for a crown?

A

poor diet, poor OH, smoking, parafunction
active caries, periodontal disease, periradicular disease or tooth wear
inadequate crown height
inadequate access for tooth prep and impression taking
when a more minimally invasive option is available

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8
Q

give 3 tx options if crown fails

A

new crown
post retained crown
XLA

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9
Q

what must pulpal state be prior to crown prep?

A

tooth must be asymptomatic - if pulp vital and infected then RCT prior to crown placement

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10
Q

what is the ideal excursive movement for crown placement?

A

canine guidance

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11
Q

when is a core build up required?

A

if tooth to be crowned is heavily restored/broken down

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12
Q

list 4 ways to aid core retention

A

undercut preparation
dentine pins
adhesives
elective endo to place posts

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13
Q

list some disadvantages of self threading pins

A

induces stress
can cause dentinal crazing
often doesn’t penetrate full pin hole depth
can reduce fracture resistance of core
may perforate periodontium

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14
Q

what can be used to aid retention of amalgam core in posterior teeth?

A

Nayaar core - amalgam extends down coronal part of canals

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15
Q

why do we not place cores in posterior teeth?

A

the posts weaken roots
roots in posterior teeth often narrow and curved - risks perforation, weakned tooth amd root fracture

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16
Q

when only are cores required in anterior teeth?

A

posts only required when insuffieicent tooth structure and heavily broken down tooth - marginal ridges not intact

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17
Q

what 3 ways can GP be removed from canals prior to post placement?

A

heat, chemicals or mechanically using gates gliddens (non cutting tip bur)

18
Q

how much GP should be left apically? what must length and diameter of post be? what ferrule is required?

A

4mm
post should be longer than crown
post should not be >1/3rd the diameter of the root
1.5-2mm ferrule required

19
Q

what is the ferrule?

A

band of natural tooth tissue between crown and core

20
Q

explain the difference between active and passive posts

A

active posts = engage the walls of the canal - inc retention but more stress on root

passive posts = retained strictly by luting cement

21
Q

what type of post is more retentive? texture and parallel/tapered

A

texture = threaded>serated>smooth

angle = parallel>tapered

22
Q

how does diameter and length of post affect retention?

A

diameter has little effect on retention
post length has effect on retention - longer posts more retentive

23
Q

explain difference between direct and custom made posts

A

direct posts = cylindrical and may ot match shape of canal

custom made posts = indirect, impression taken of post space, post allows natural shape of canal to be replicated

24
Q

fibre reinforced posts - what are they cemented with? what crowns are they used for?

A

adhesive resin cements
used for all ceramic bonded crowns

25
Q

what posts should be avoided?

A

threaded, metal and tapered posts

26
Q

list 3 types of extracoronal indirect restorations

A

full/partial crowns, veneers, onlays

27
Q

list 2 types of intracoronal restorations

A

inlays and onlays

28
Q

explain difference between extra and intra coronal restorations

A

extracoronal opposes soft tissues buccally/lingually
intracoronal opposes the prepped tooth buccally/lingually

29
Q

what is retention form?

A

retains in occlusal direction

30
Q

what is resistance form?

A

prevents dislodgement in lateral and oblique direction

31
Q

what degree of taper is aimed for/most often achieved?

A

aimed for = 6 degrees
most often achieved = 10-20 degrees

32
Q

metal crown prep - mm walls, occlusal, margin

A

0.5mm walls
1mm occlusally
any margin type

33
Q

metal ceramic crown prep - mm walls, occlusal, margin

A

1.5mm buccally
0.5mm lingual/palatally
1-2mm occlusally
shoulder for metal ceramic, chamfer for just metal

34
Q

all ceramic/composite crown prep - mm for walls, occlusal, margin

A

0.6-1mm axial reduction
1-1.5mm occlusal reduction
chamfer margin

35
Q

why is a shoulder avoided for ceramic/comp alone?

A

sharp corner could cause crack propagation of ceramic

36
Q

where should finishing margin be?

A

on sound tooth - avoid restorations, caries
below contact
supragingival
to allow for adequate prep height

37
Q

where should functioning cusp bevel be on maxillary and mandibular molars?

A

maxillary = palatal bevel
mandibular = buccal bevel

38
Q

how many planes of reduction for buccal/palatal side?

A

2 plane reduction for buccal
1 plane reduction for lingual/palatal

39
Q

how should the interproximal slice be cut?

A

following gingival contour i.e. coming up interproximally

40
Q

how should cingulum be reduced in anterior teeth?

A

using rugby ball bur - very minimal reduction as cingulum important aspect for crown retention

41
Q

what cements can be used for amalgam bonding?

A

panavia, amalgam bond, relyX ARC, GI

42
Q

what can be done when the roots become compromised i.e. caries around the post?

A

open and clean canal and dress w/ CaOH for 2 weeks
place MTA apical plug
etch, rinse and dry post space then bond and comp a luminex smooth sided post w/ vaseline
remove luminex post, modify post space w/ drill then cement quartz fibre post w/ adhesive resin cement
build up comp core