Lesson 4 Flashcards
refers to procedures that must be accomplished before fixed prosthodontic treatment can be properly undertaken
mouth preparation
True or false
planning a logical treatment sequence should precede any fixed prosthodontic intervention
True
chief complaint
Relief of symptoms
GENERAL PLAN SEQUENCE
- Relief of symptoms
- Removal of causes
- Repair of damage
- Maintenance of dental health
SOFT TISSUE PROCEDURES
HARD TISSUE PROCEDURES
ORTHOGNATHIC SURGERY
IMPLANT-SUPPORTED FIXED PROSTHESES
ORAL SURGERY
→ alteration of muscle attachment
SOFT TISSUE PROCEDURES
removal of a wedge of soft tissue distal to the molars to enable
access during tooth preparation
SOFT TISSUE PROCEDURES
modification of the shape of edentulous spaces
SOFT TISSUE PROCEDURES
→ tooth extraction
→ removal of buccal torus
→ impacted or unerupted supernumerary teeth
→ tuberosity reduction
HARD TISSUE PROCEDURES
True or false
HARD TISSUE PROCEDURES is performed as early in treatment as possible, so that other needs can be attended to during healing and osseous recontouring after extraction.
True
severe skeletal discrepancies may necessitate surgical correction
ORTHOGNATHIC SURGERY
→ the success of this procedure requires meticulous patient selection and skillful execution of the selected technique
→ a team approach to treatment is strongly recommended, with close cooperation between the specialists
IMPLANT-SUPPORTED FIXED PROSTHESES
→ crowns and fixed dental prostheses are definitive restoration
→ in teeth that require crowns and are severely damaged or have large existing restorations, the restorations should be examined
if it needs to be replaced
CARIES AND EXISTING RESTORATION
also called as “core”
FOUNDATION RESTORATION
used to build a damaged tooth to ideal anatomic form before
the tooth is prepared for a crown
FOUNDATION RESTORATION
should be contoured and finished to facilitate oral hygiene and
tooth preparation is greatly simplified if the tooth is build up to it’s ideal contour
FOUNDATION RESTORATION
True or false
foundations may have to serve for an extended time before
fabrication of the definitive prosthesis and should provide the
patient with adequate function
True
True or false
selection of the correct foundation material depends on the extent of tooth destruction, the overall treatment plan, and the operator’s preference
True
has good resistance to microleakage and is therefore recommended when the crown preparation will not extend more than 1 mm beyond the foundation tooth junction
Dental Amalgam
can be shaped to ideal restoration form and serves well as a long-term interim restoration
Dental Amalgam
a suitable choice to block out a small lesion
Resin-Modified Glass Ionomer Cement
the material sets rapidly, enabling crown preparation with minimal delay
Resin-Modified Glass Ionomer Cement
→ exhibits many of the advantages of glass ionomers
→ does not require condensation and sets rapidly
Composite Resin
formulations that release fluoride are available
Composite Resin
a cemented cast foundation is retained by tapered pins
Pin-Retained Cast Metal Core
the preparation requires careful location and placement of the pinholes but is otherwise straightforward
Pin-Retained Cast Metal Core
- Isolate the tooth.
- Design the tooth preparation for the foundation restoration
with the geometry of the intended crown in mind. - Limit the extent of the outline form.
- Retain unsupported enamel if convenient.
- Finish the cavosurface margins.
- Remove any carious dentin carefully and thoroughly with a
hand excavator or a large round bur in a low-speed
handpiece. - Create optimum resistance form.
- Ensure that the foundation restoration has adequate
retention.
STEP-BY-STEP PROCEDURES in AMALGAM CORE
→ base is necessary to prevent thermal irritation if the preparation extends close to the pulp
→ calcium hydroxide liners should be reserved for use in deep cavities
Bases & Varnishes
a rigid, well-contoured matrix allows the amalgam to be properly condensed and facilitates carving
Matrix Placement
follows conventional practice, with particular attention to condensing into wells and around pins
Condensation
after allowing time for setting, the dentist trims the amalgam away from the occlusal edge of the matrix and removes the wedges and matrix retainer
Contouring & Finishing
- Isolate the tooth.
- Prepare the tooth for a casting.
- Using a syringe, apply the glass ionomer onto the tooth.
- Finish the preparation as for other types of cores.
STEP-BY-STEP PROCEDURES in
GLASS IONOMER CORE
True or false
composite resin is much stronger than glass ionomer foundations, a difference that is correlated with the higher diametral tensile strength of the composite
True
→ examination
→ probing depth
→ attachment levels
→ extents of mobility
→ crown-to-root ratios
→ furcal involvements
→ tissue health
→ presence of calculus
→ patients plaque control measures
DEFINITIVE PERIODONTAL TREATMENT
→ vitality testing of all teeth in the dental arch
→ tenderness to percussion
→ abnormal sensitivity
→ soft tissue swelling and discoloration
→ fistulous tracts
→ discolored teeth
→ radiograph
→ orthograde (conventional root canal treatment)
→ retrograde (endodontic surgery, apicoectomy)
ENDODONTIC TREATMENT
CLINICAL ASSESSMENT
True or false
for a tooth or implant to be treated with a restoration extending into the gingival sulcus (subgingival margin), approximately 5 mm of keratinized gingiva, at least 3 mm of which is attached gingiva, is recommended
True
True or false
if less keratinized gingiva is present, or in localized gingival recession, a grafting or other gingival augmentation procedure should be considered
True
is indicated to increase the width of the band of keratinized gingiva through surgical grafting
MUCOSAL REPARATIVE SURGERY
used for an area of recession or lack of attached gingiva on a single tooth when amounts of keratinized gingiva in adjacent teeth or edentulous spaces are adequate
Laterally Positioned Pedicle Graft
→ used when a single tooth or multiple teeth exhibit gingival recession
→ if the width of the attached keratinized gingiva is inadequate, a free gingival graft may be placed to increase it before the coronal positioning
Coronally Positioned Pedicle Graft
→ most common gingival augmentation
Connective Tissue Graft
involves the use of subepithelial connective tissue
graft harvested from the palate in a spit thickness manner, which allows the wound to be closed after removal of the graft tissue
Connective Tissue Graft
connective tissue grafts can be utilized to:
o cover exposed roots
o augment deficient ridges
o attempt to rebuild papilla
indications:
o clinical crown is too short to provide adequate retention
without the restoration impinging on the normal soft tissue
attachment (biologic width)
o improve appearance of multiple short teeth
o increase crown-to-root ratio
CROWN LENGTHENING PROCEDURES
True or false
CROWN LENGTHENING PROCEDURES
can be accomplished either:
o surgically
o combination of orthodontic and periodontal techniques
True
gingivectomy or removal of gingiva by electrosurgery or incision using blade alone, although osseous recontouring is most often needed to prevent encroachment of the prosthesis on the biologic width
SURGICAL CROWN LENGTHENING
a full thickness mucoperiosteal flap is reflected and the osseous resection creates a 3.5 to 4.0 mm space between the gingival crest and the margin of the existing restoration or carious lesion
SURGICAL CROWN LENGTHENING
