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Treatment Planning > L7 - definitive > Flashcards

L7 - definitive Flashcards

1
Q

indirect restorations / fixed options

A

single units

multi units

implant supported crowns / bridges / splints

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2
Q

indirect restorations

A

partial dentures

full dentures

over dentures

implant supported or retained prosthetics

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3
Q

major options for material for crowns

A

gold / metal (semi-precious and non-precious)

porcelain / resin and hybrid ceramics

combinations of porcelain and metal

resin and metal

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4
Q

onlays vs amalgam and composites

A

amalgam and composite wear and stain and breakdown and must be replaced – finite life span and inlays use material with a LONGER life span

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5
Q

ceramic vs metal inlays

A

ceramic and resin inlays are BONDED = REINFORCE the tooth structure

metal inlays are cementd but mat be looked at as a WEDGE placed in the tooth – because of the divergent preps so create force

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6
Q

use of onlays

A

used to restore larger lesions with a material that has a long life span and to shoe or SUPPORT / PROTECT CUSPS

  • amalgam onlays
  • composite onlays (wear and stain and breakdown and have to be replaced - FINITE life span)
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7
Q

describe metal onlays - pros and cons

A

are cemented and are an excellent long term restorative option

pros

  • RETAIN much of the natural tooth anatomy – can be used anywhere
  • good for patient with parafunctional habits

cons

  • not good against porcelain
  • looked at as a aesthetic concers
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8
Q

good onnlay choice for parafunctional habit problems

A

metal

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9
Q

composite is what type

A

direct

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10
Q

what influences success of composite

A

size
location
isolation
occlusla forces

caries risk / hygeine (like amalgam could be less leakage?)

parafunctional habits

operator skills

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11
Q

pros of composite

A

tooth colored - bonded - seals and useful in small occlusal and interproximal lesions

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12
Q

cons of composite

A

micro -leakage, sensitivity, technique sensative

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13
Q

amalgam is good for and pros

A

restore defective in posterior teeth on the five surfaces of the tooth

missing cusps especially non functinal , core material

durable material long service life and works well in area where it is hard to visualize

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14
Q

inlay used for what size usually

A

like smaller lesiosn 1/3 width of tooth

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15
Q

ceramic and resin onlays are ___ to tooth? vs metal

A

BONDED

metal = cemented

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16
Q

pros and cons of cerami and resin onlays

A

pros

  • reinforce the tooth structure
  • aethstic

cons
- ceramics are subject to fracture if adequate THICKNESS is not maintained

  • high skill level, technique sensative
  • not for all situations and teeth - selective usage = success
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17
Q

esthetic of PFM depend on

A

reduction

  • potential visiable metal margins
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18
Q

pros for use of PFM corwns

A

aesthetics compared to all metal

less aggressive prep than ceramic

multiple FINISH LINE OPTIONS

more places and conditions favor the use of PFM

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19
Q

bevels usually added when

A

situations where a shoulder is already present – and destruction by caries previous restoratins

facial of metal ceramic

metal restorations

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20
Q

shoulder use

A

all ceramic and margin of PFM crowns

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21
Q

radial shoulder

A

rounded shoulder – round ended tapered diamond ceramics need this

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22
Q

indications for chamfer

A

cast metal crowns and metal only portion of PFM crowns

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23
Q

heavy chamfer

A

ALL CERAMIC

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24
Q

cavo surface of chamfer

A

90 degrees but with havy – need a round end taperes

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25
Q

indication for knife edge margin

A

mandibular posterior teeth with very CONVEX axial surfaces

lingually tilted lower molars

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26
Q

knife edge permit

A

acute margin of metal

thin margin

suscetible to distortion

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27
Q

decision of PFM vs ceramic usually comes down to

A

finish line, location, and occlusion

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28
Q

prepare tooth and less than ___ there is a problem

A

less than 3 mm

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29
Q

which biotype for which type of crown

A

thick - pfm will work

thin – porcelain

30
Q

canine guidance and crown material vs group fucntion

A

canine guidance – may want to think about PFM

grouo function – forces more distributed can do porcelain

31
Q

clearance vs reduction

A

reduction – to only the tooth – to satisify the material using on that tooth

clearance – in relationship to the other arch

32
Q

two unit bridge aka

A

cantilever

33
Q

cantilever details

A

forces are put onto the pontic which is a potential problem

axis of rotation – is a lever

34
Q

PFM connectors in bridge vs ceramic

A

PFM 4.5 square mm

ceramic 16 square mm

35
Q

if you are going to bond a bridge in what do you need to consider?

A

do you have enough etchable tooth structure?

36
Q

connector sizze is determined by

A

measuring the height from the gingival to incisal or occlusal as well as the width measured from buccal to lingual

37
Q

guidelines for one pontic if zirconia in posterior and anterior

A

ceramics

9 square mm in posterior

7 square mm in anterior

38
Q

guidelines for one pontic if lithium disilicate in posterior and anterior

A

16 square mm in posterior

12 square mm in anterior

39
Q

case for marilyn bridge?

A

younger patients

one wing?

40
Q

pre-requisite for veneers?

A

need enamel present – because needed to be bonded to this

41
Q

veneers shade change dictates?

A

PORCELAIN THICKNESS

42
Q

A3 to A0 requires?

A

0.6mm to 0.8mm reduction to achieve that change

43
Q

main thing to think about when going to bond something

A

% of enamel left and locatino of that enamel

44
Q

signs of overload

A

enamel crazing, abfraction lesions

45
Q

signs of occlusal trauma

A

gingival recession and wear patterns

46
Q

flexural risk assessment looks at

A

highest stress before rupture

47
Q

rank materials from lowest MPa to highest

A

feldspathic

leucite-reinforced

lithium disilicate

glass-filled

alumina

zirconia

48
Q

pascal =

A

pressure measurement

1 newton per square meter

49
Q

MPa=

A

1 million Pa

50
Q

bond strength to dentin =

A

19 MPa - 2756 psi

51
Q

Emax bond strength

A

360-400 Mpa = 52k-58k psi

52
Q

zirconia bond strenght

A

1170 MPa

53
Q

lithium dislicate aka

A

emax

54
Q

achilles heel of porcelain

A

shear and tensile stress assessment

55
Q

stress - resist failure?

A

according to the load applies – so it is variable – force exerted on a material

like remove a bonded bracket from a tooth requires stress failure of the composite

56
Q

implication of flaw in ceramic?

A

that is where stress will concentrate – propagation of cracks – yield to relieve stress and get DEFORMATIN

57
Q

Deformation occuring?

A

in high stress area with no or little enamel

58
Q

reduce the rotation radius?

A

put grooves in the axial walls

59
Q

strength is derived from? implication of this?

A

derived from the ENAMEL
- so no enamel then high strength ceramic or a core material must be used

necessary to overcome deformity of the ceramic material

60
Q

flexural strength

A

deformation / bend

61
Q

tensile strength

A

resist pull apart

62
Q

shear strength

A

how hard it is to cut – like paper and scissors

63
Q

if using zironia what must you do at end?

A

POLISH

64
Q

most ceramics are made how now?

A

milled or pressed

65
Q

requirements for milled ceramics

A

need HIGH SHEAR STRENGTH OR THICKNESS of material AT THE EDGE / MARGIN of the restoration

66
Q

sharp areas in ceramics?

A

concentrate stress – enemy

67
Q

polish or glaze?

A

polish trumps glazing

68
Q

implant supported removable in terms of soft ttissue?

A

soft tissue becomes LESS of a problem

69
Q

what do you need in a patient?*

A

stable periodontal condition overall

free of carious lesions

STABLE OCCLUSION

70
Q

what would i like in a patient?*

A

class I occlusion anteriorly and posteriorly

existing canine guidance

no occlusal interferences

71
Q

major reasons for planing for a removable option

A

stabalize a denture

replace missing occlusal support

function

Treatment Planning (9 decks)

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