lecture 2

Question 1

treatment planning for single tooth restorations begins with an analysis of each ______ and _____

Answer 1

each individual tooth and patient as a whole

Question 2

with treatment planning, first start with a

Answer 2

complete medical and dental history

Question 3

with treatment planning, second gather

Answer 3

further data about the tooth in question

-radiographs [bone level, extent of decay or tooth destruction, endo condition]
-periodontal charting [bone level, tissue condition like bleeding, recession, inflammation]

Question 4

with treatment planning, third look

Answer 4

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

Question 5

if the isthmus destruction is greater than 1/2 intercuspal width:

Answer 5

crown or onlay

SO less destructive central lesion

Question 6

more that 50% of tooth structure is gone and loss of cuspal support:

Answer 6

crown (and likely a core build up too)

SO large central lesion

Question 7

combined central and peripheral destruction then:

Answer 7

1. core build up and crown
2. possible RCT/post/core/crown

Question 8

with treatment planning, fourth what are the

Answer 8

options for treatment for particular pt and tooth

Question 9

with treatment planning, fifth:

Answer 9

put options into categories
best, better, acceptable, not recommended

Question 10

list the 7 types of materials used for fixed restorations

Answer 10

1. gold
2. ceramic
3. zirconia
4. zirconia fused to porcelain (PFZ)
5. composite formulations (CEREC)
6. metal
7. metal-ceramic (porcelain fused to metal PFM)

Question 11

gold crowns pros and cons

Answer 11

pros:
1. gental on gingiva
2. low wear on opposing teeth
3. can be burnished to seal smallest of margins
4. low risk of fracture
5. contacts can be added to easily polish

cons:
1. not esthetic
2. labor intensive for lab tech

Question 12

ceramic crown pros and cons:

Answer 12

pros:
1. tooth color
2. still stronger than enamel by 2x
3. most realistic and beautiful of all crown material

cons:
1. must use resin cements 90% of time
2. requires thicker margins
3. fracture risk
4. can get recurrent decay [poor protection]

Question 13

zirconia crown pros and cons:

Answer 13

pros:
1. tooth colored
2. some 4x stronger than enamel
3. becoming more esthetic
4. easy for lab to make

cons:
1. NOT ALL ZIRCONIAS ARE SAME
2. cannot easily add material to establish contacts
3. crown prep design still key for longevity
4. fracture risk with some formulations

Question 14

porcelain fused to zirconia crown pros and cons: PFZ

Answer 14

pros:
1. tooth colored
2. some 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

cons:
1. NOT ALL zirconia are the same!!
2. cannot easily add material to establish contacts
3. crown prep design still key for longevity

Question 15

cerec composite formulation crown pros and cons:

Answer 15

pros:
1. tooth colored
2. easy for lab to make
3. milled restorations
4. mic of composite and ceramic

cons:
1. longevity still in research
2. cannot easily add material
3. crown prep still key
4. esthetics still challenging

Question 16

PFM crown pros and cons:

Answer 16

pros:
1. tooth colored
2. .metal substructive adds strength
3. allows use in longer bridges
4. design where porcelain covers metal to provide excellent flexibility in design
5. metal substructure protects tooth even if porcelain fractures

cons:
1. porcelain can fracture
2. metal collars unesthetic
3. porcelain call yellow over time
4. prep is technique sensitive due to metal and porcelain components

Question 17

how long do single crowns last:
conservative amalgam:
conservative composite:
average comp:

Answer 17

10-15 years
conservative amalgam: 10-15 years
conservative comp: up to 10
average comp: 6