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5th yr- Finals- CSB revision > Inlays and onlays > Flashcards

Inlays and onlays Flashcards

1
Q

What are some of the negative consequences of removing tooth tissue when treating caries

A

Weakening of the walls and cusps of the tooth which can lead to fractures and cracks

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2
Q

Give examples of factors that can increase the risk of posterior teeth fracturing

A
  1. If the height to base ratio of the tooth is more than 1 (height>base)
  2. Root treated teeth
  3. A group function occlusion
  4. Clenching or grinding
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3
Q

Which root filled tooth is more likely to fracture : crowned or uncrowned

A

Uncrowned is at a 6 times greater risk of fracturing

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4
Q

How can we manage weakened cusps?

A
  1. Bonding
  2. Cusps coverage
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5
Q

What are the challenges of bonding and direct composites

A
  1. Polymerisation shrinkage
  2. Achieving good contact point
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6
Q

What do we need to think about when looking at polymerisation shrinkage

A

The stress that it applies to the tooth composite interface

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7
Q

How can we try and reduce the stress on a tooth

A

Look t eat configuration factor of a cavity

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8
Q

What do we mean by configuration factor

A

(Number of bonded surfaces) / (number of unbounded surfaces)

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9
Q

What is the relationship between configuration factor and stress on the tooth

A

As the configuration fact increase so does the stress on the tooth increasing risk of polymerisation shrinkage

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10
Q

What problem can occur if we create an insufficient contact point

A

Food packing can occur and it can be hard for the patient to clean the site

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11
Q

What can we do instead of placing a direct restoration to avoid polymerisation shrinkage and poor contact points

A

We can place an inlay

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12
Q

Define what an inlay is

A

An extra coronal restoration made in the lab and cemented into the tooth

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13
Q

What problems can arise when using inlays

A
  1. They require taper which can create a weeding effect wearing the cusps
  2. They down cover the cusps so can’t provide cuspal coverage
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14
Q

Why do inlays need to be tapered

A

As they are placed into the tooth so they need to be able to sit there properly

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15
Q

What is the tissue with an inlay needing to have a taper

A

Risk of having a wedging effect which will direct forces downward putting stress on the cusps leading to fracture

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16
Q

What shoddy the height to base ratio be for an inlay to be successful

A

heigh tot base ratio of lead than or equal to 1q

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17
Q

Talk through the indications of an inlay

A
  1. Small to medium cavity eg MO or DO
  2. Conservative MOD in molars
  3. Low caries risk
  4. Good support for cusps from the remaining tooth tissue
  5. About 1/3rd buccal lingual width
  6. Height base ratio < 1:1
  7. Canine guidance
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18
Q

When are inlays most useful

A

When you have a large gap between adjacent teeth to achieve good contact points

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19
Q

Give examples of restoration we can use that offer good cuspal protection

A
  1. Full coverage crowns
  2. Onlays
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20
Q

List the principles of preparation

A
  1. Preservation of tooth tissue
  2. Retention and resistance form
  3. Structural durability of restoration
  4. Marginal integrity and position
  5. Biological
  6. Aesthetic
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21
Q

How much tooth tissue is removed when we place a full coverage crown?

A

67.5-75.6%

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22
Q

How much tooth tissue is removed when we place an onlay

A

39%

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23
Q

What is an onlay

A

A restoration constructed in the lap and cemented into a tooth that may contain an intra coronal aspect but also covers one or more cusps

24
Q

Give some indications for onlays

A
  1. Teeth with larger restorations but sound buccal and lingual walls needing cuspal protection
    2, Low caries risk
  2. Weakened cusps
  3. Over 1/2 buccal lingual width
  4. Parafunciton
  5. Excessive cusp wear
  6. Group function
25
Give examples of teeth that may need large restoration but have sound buccal and lingual walls that need cuspal protection
1. Endodontically treated teeth 2. Wider MODs 3. MODs in premolars
26
What materials can inlays and onlays be made up of
1. Gold 2. Ceramic 3. Composite
27
What is the survival rate for a ceramic inlay?
80% for 8 years
28
List some factors that govern the choice of material we use to make our inlay or onlay
1. Preservation of tooth tissue 2. Retention and resistance form 3. Structural durability of restoration 4. Marginal integrity and position 5. Biological consideration 6. Aesthetics
29
Which Material is best to use if we want to preserve tooth tissue
Gold or full coverage crown is best
30
Which Materia requires the most tooth preparation
porcelain
31
Which Materia offers the best aesthetic finish
Ceramic or composite
32
List some general preparation guidelines
1. No undercuts 2. Limited paths of insertion 3. Resistance to occlusal forces
33
How is retention achieved for inlays and onlays to sit in the cavity
As a result of friction between opposing intra coronal walls (this means the walls need to diverge)
34
How can we remove undercuts from our cavity prep
1. Make the cavity bigger (not preferred) 2. We can restore the intra coronal aspect with composite and block out the undercuts created naturally when prepping
35
How much taper do we want to create when creating a cavity for a gold onlay
6 degree taper
36
State the idea marginal width we want to achieve when creating a cavity for gold onlays
chamfer of 0.5mm
37
How much occlusal reduction do we need to do for a gold onlay?
1mm occlusal 1.5mm functional cusp bevel
38
Talk through the preparation requirements needed for a gold onlay
Taper: 6degree Marginal chamfer of 0.5mm 1mm occlusal reduction 1.5mm functional cusp bevel
39
State the minimum width space requirement for a porcelain inlay/ onlay
1. 1.5-2mm width isthmus (1/3rd intercuspal width) 2. 1.5-2mm depth 3. 2mm occlusal coverage
40
State the margin angles and chamfer needed for a composite or ceramic inlay/onlay
90-120 degree Cavo surface margin heavy chamfer/ rounded 1mm shoulder
41
State the taper we need for a composite or ceramic inlay/onlay
15-20 degree taper
42
Talk through the preparation requirements needed for a composite or ceramic inlay/onlay
1. 1.5-2mm width isthmus 2. 1.5-2mm depth 3. 90-120 degree Cavo surface margins 4. Heavy chamfer/ rounded 1mm shoulder 5. 15-20 degree taper 6. Rounded internal angles
43
When creating out cavity what should we make sure in regards to preparation margins
Need to make Sur they are not located in a areas of static or dynamic antagonise contact
44
How much taper an a lithium disilicate restoration have?
upto 12 degrees
45
What is the minimal width and occlusal reduction needed for a lithium dislocate restoration
1mm minimal width and 1mm occlusal reduction
46
What should the Cavo surface angle be for a lithium disilicate restoration
100-120 degrees
47
What is another name for adhesive onlays
Table top s or occlusal veneers
48
What materials are adhesive onlays usually made from
Gold or lithium disilicate
49
Describe the preparation needed for an adhesive onlay
0.5mm chamfer 1mm occlusal reduction
50
How do adhesive onlays adhere to the tooth
By a cement
51
What is the benefit of adhesive onlays retaining onto the tooth via a cement?
Can achieve a more conservative preparation as the restoration doesn't require any sort of intra coronal retention tool
52
Give some indications for adhesive onlays
1. Cuspal coverage for cracked tooth syndrome or protection 2. Erosion or attrition 3. Short or one tapered clinical crown 4. Patients with amelogenesis
53
Give some contra indication of adhesive onlays
1. Poor oral hygiene 2. Subgingival margins 3. Inability to gain good moisture isolation 4. Lack of enamel margins 5. Parafunction
54
Before placing a metal adhesive onlay onto a tooth what must be done to it
Must be sandblasted on its fit surface
55
What can be added to composite onlays to help improve bonding
A primer can be added onto the fit surface
56
How are cast metal onlays and inlays retained in the tooth and name the cements you'd expect to use with these metals
Mechanical retention Would use cements like: 1. Zinc phosphate 2. Glass ionomer luting cement

5th yr- Finals- CSB revision (17 decks)

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