Periodontal Considerations 1

Question 1

Aims of periodontal therapy (3)

Answer 1

1. To arrest the disease
2. To regenerate lost tissue
3. To maintain dental health long term

Question 2

How does periodontal therapy work as an aid to restorative dentistry? (5)

Answer 2

1. Improves soft tissue management
2. Establish stable gingival margin
3. Contributes to aesthetics
4. Reduces tooth mobility
5. Informs prognosis

Question 3

How long should we monitor the gingival margin before prepping for restorations?

Answer 3

Monitor gingival margin for at least 3-6 months after completion of periodontal therapy to check for stability

Question 4

Pro’s options for partially dentate (4)

Answer 4

1. FPD with natural abutments
2. RPD with natural abutments
3. Implant supported prosthesis

Combos of all

Question 5

What can damage from crowns/bridges cause?

Answer 5

1. Plaque retention
   - location and fit of restoration margins
2. Unfavourable transmission of occlusal forces
3. Pulp damage

Question 6

What damage from RPD’s cause?

Answer 6

1. Plaque retention
   - Gingival margin coverage
2. Direct trauma from components
   - To other teeth
3. Unfavourable transmission of forces
   - Occlusal
   - Insertion
   - Removal

Question 7

Advantages of RPD’s (3)

Answer 7

1. Effective tooth support
2. Clearance of gingival margins
3. Rigid connectors

Question 8

What are the supracrestal attached tissues composed of?

Answer 8

JE + supracrestal connective tissue attachment

Question 9

How far into the gingival sulcus should you place your restoration margin?

Answer 9

0.5mm

If placed further you will cause problems

Question 10

Possible outcomes if restorative margins enroach on the supracrestal attachment (2)

Answer 10

1. Persistent inflammation
2. Loss of attachment
   - Pocketing
   - Recession

Question 11

Name an example of how a dentists tooth prep can cause a loss of supracrestal attachment

Answer 11

If you don’t follow the contour of the tooth for your crown margin

Question 12

How can a provisional resto act as an indicator for the permanent one?

Answer 12

If its really thin or the margins don’t look good take it as a hint

Question 13

What causes overcontoured crowns?

Answer 13

Inadequate tooth prep

Question 14

List some keys to periodontally successful indirect restorations (5)

Answer 14

1. Starts with healthy tissue
2. Adequate tooth prep
3. Precise margin location
4. Excellent provisional restorations
5. Careful tissue handling + impression technique

Question 15

How do we end up with overloaded abutments?

Answer 15

When they’re periodontally compromoised

• Ante’s law
• Combined PDL area of abutment teeth should be = to or >PDL area of the tooth

Question 16

What are some periodontal procedures that need fixed in order to aid restorative dentistry? (4)

Answer 16

1. Excessive gingival display (gummy smile)
2. Gingival overgrowth making restorative dentistry impossible
   - Drug induced gingival overgrowth
3. Lack of clinical crown height making retention of restoration impossible
4. Camouflage of gingival recession

Question 17

How does a medium smile line present?

Answer 17

Can see the papilla

Question 18

How does a low smile line present?

Answer 18

Can barely see the gingivae

Question 19

What tx do we give to camouflage gingival recession?

Answer 19

Acrylic gingival veneer

DISADVANTAGE:

• Root surface caries