Periodontal Considerations in Restorative Dentistry 1 Flashcards
What are the aims of periodontal therapy?
To arrest the disease process
To regenerate lost tissue
To maintain periodontal health long term
THESE ALL PREVENT TOOTH LOSS.
Why is periodontal therapy used as an aid to restorative dentistry?
Improves soft tissue management Establishes stable gingival margin position Contributes to aesthetics Reduces tooth motility Informs prognosis.
Why is an inflamed gingival margin not good?
Bleeds during operative procedures
Is unstable in its apico-coronal location
Makes effective restorative dentistry impossible.
What can cause gingival recession?
Ill fitting veneer with excess luting cement.
How long should the gingival margin be monitored for after periodontal treatment completion?
3-6 months
-Can place restorations after this time.
What are prosthetic options for the partially dentate?
FPD with natural abutments (bridges etc)
RPD with natural abutments
Implant supported prothesis
Combinations of above.
What damage can crowns and bridges cause?
Plaque retention
Unfavourable transmission of occlusal forces
Pulp damage.
What damage can be caused from RPD?
Plaque retention
Direct trauma from components
Unfavourable transmission of forces.
What are the 3 things we need to consider when making an RPD?
Effective tooth support
Clearance of gingival margins
Rigid connectors.
What are the histological components of the supracrestal attachment?
The junctional epithelium and supracrestal connective tissue.
Where should you NOT place the restoration margins?
In the gingival sulcus (don’t breach the supracrestal attachment).
What will taking the crown margin in a straight circle around the tooth cause?
Will cause loss of supracrestal attachment.
Look at the images on this lecture of poorly fitting crown margins.
.
What does healthy tissue and carefully located preparation margins equal?
Easy impression and reduced risk of disease.
What is surgical crown lengthening?
Crowns must be able to firmly affix to an existing tooth. Crown lengthening can help. Dental surgeons perform crown lengthening by recontouring gum tissue, and sometimes bone, to expose more of a tooth’s surface for a crown. It’s a common procedure and often takes less than an hour to complete. It allows gum and supracrestal attachment to reform.
What can overhanging restorations cause?
Associated with more inflammation and bone loss than non-restored sites
Larger the overhand the greater the bone loss
Development of pathogenic flora.
What happens if a crown is underprepared?
Causes a bulbous crown.
What are the key principles to periodontally successful indirect restorations?
Start with healthy tissue Adequate tooth prep Precise margin location Excellent provisional restorations Careful tissue handling and impression technique.
What is Ante’s law?
The combined periodontal area of the abutment teeth should be equal to or greater than the periodontal area of the tooth or teeth to be replaced.
What are periodontal procedures that can aid restorative dentistry?
Excessive gingival growth
Gingival overgrowth making restorative dentistry impossible
Lack of clinical crown height making retention of restoration impossible
Camouflage of gingival recession.
What 4 things contribute t soft tissue harmony?
gingival health
gingival display
genera gingival inclination
gingival outline and symmetry.
Clinical crown height for retention?
2-3mm of space between gingival margin and alveolar crest.
How can you camoflague gingival recession?
Acrylic gingival veneer.
What does a acrylic gingival veneer patient have to do?
Take it out as much as possible.
