Maintenance Restorative Dentistry Flashcards
Why must pt be aware of maintenance?
Understand limited life of all restorations
Pt to commit time and finance
What factors determine survival?
Build quality, product handling, environment, maintenance
What curve is used for survival?
Weibull survival curve
What factors are included in build quality?
Intra-oral assembly
Biological substrate and quality of materials
Operator skill set
Facilities and time
What factors are included in loading?
Product handling
Direct and indirect loading forces
What factors are included in environment?
Variable pH, constantly wet, temperature changes, tooth-material interaction, bacterial biofilm
What should consider in bruxism cases?
Have flat occlusal plane –> lose guidance
Restore w/ palatal guidance
Metal on posterior teeth - reduce coefficient of friction - more resistant to wear
Provide splint
Draw Weibull survival curve
Y axis = increased failure rate
X axis = time
U shaped curve
Failure rate highest at neonatal and end of life
Why may have failure at time of tx?
Biological or structural failure
Immediate failure, inadequate aesthetic, occlusal interefence, de-bonding, pulpitis
Why may tx fail in middle of curve?
Low grade chronic problem
Secondaries caries, occlusal trauma, periodical periodontitis
Why may tx fail after long time?
Fatigue-related or structural failure
RCT, root caries, cusp fracture
What consider when carrying out review?
Check new or continuing disease
Check adequacy of existing restorations
Check compliance with maintenance
Determine future recall
