Periodontal Considerations 1 Flashcards
Aims of periodontal therapy (3)
- To arrest the disease
- To regenerate lost tissue
- To maintain dental health long term
How does periodontal therapy work as an aid to restorative dentistry? (5)
- Improves soft tissue management
- Establish stable gingival margin
- Contributes to aesthetics
- Reduces tooth mobility
- Informs prognosis
How long should we monitor the gingival margin before prepping for restorations?
Monitor gingival margin for at least 3-6 months after completion of periodontal therapy to check for stability
Pro’s options for partially dentate (4)
- FPD with natural abutments
- RPD with natural abutments
- Implant supported prosthesis
Combos of all
What can damage from crowns/bridges cause?
- Plaque retention
- location and fit of restoration margins - Unfavourable transmission of occlusal forces
- Pulp damage
What damage from RPD’s cause?
- Plaque retention
- Gingival margin coverage - Direct trauma from components
- To other teeth - Unfavourable transmission of forces
- Occlusal
- Insertion
- Removal
Advantages of RPD’s (3)
- Effective tooth support
- Clearance of gingival margins
- Rigid connectors
What are the supracrestal attached tissues composed of?
JE + supracrestal connective tissue attachment
How far into the gingival sulcus should you place your restoration margin?
0.5mm
If placed further you will cause problems
Possible outcomes if restorative margins enroach on the supracrestal attachment (2)
- Persistent inflammation
- Loss of attachment
- Pocketing
- Recession
Name an example of how a dentists tooth prep can cause a loss of supracrestal attachment
If you don’t follow the contour of the tooth for your crown margin
How can a provisional resto act as an indicator for the permanent one?
If its really thin or the margins don’t look good take it as a hint
What causes overcontoured crowns?
Inadequate tooth prep
List some keys to periodontally successful indirect restorations (5)
- Starts with healthy tissue
- Adequate tooth prep
- Precise margin location
- Excellent provisional restorations
- Careful tissue handling + impression technique
How do we end up with overloaded abutments?
When they’re periodontally compromoised
- Ante’s law
- Combined PDL area of abutment teeth should be = to or >PDL area of the tooth
What are some periodontal procedures that need fixed in order to aid restorative dentistry? (4)
- Excessive gingival display (gummy smile)
- Gingival overgrowth making restorative dentistry impossible
- Drug induced gingival overgrowth - Lack of clinical crown height making retention of restoration impossible
- Camouflage of gingival recession
How does a medium smile line present?
Can see the papilla
How does a low smile line present?
Can barely see the gingivae
What tx do we give to camouflage gingival recession?
Acrylic gingival veneer
DISADVANTAGE:
- Root surface caries
