Periodontal Considerations in Restorative Dentistry 1

Question 1

What are the aims of periodontal therapy?

Answer 1

To arrest the disease process
To regenerate lost tissue
To maintain periodontal health long term
THESE ALL PREVENT TOOTH LOSS.

Question 2

Why is periodontal therapy used as an aid to restorative dentistry?

Answer 2

Improves soft tissue management
Establishes stable gingival margin position
Contributes to aesthetics
Reduces tooth motility
Informs prognosis.

Question 3

Why is an inflamed gingival margin not good?

Answer 3

Bleeds during operative procedures
Is unstable in its apico-coronal location
Makes effective restorative dentistry impossible.

Question 4

What can cause gingival recession?

Answer 4

Ill fitting veneer with excess luting cement.

Question 5

How long should the gingival margin be monitored for after periodontal treatment completion?

Answer 5

3-6 months

-Can place restorations after this time.

Question 6

What are prosthetic options for the partially dentate?

Answer 6

FPD with natural abutments (bridges etc)
RPD with natural abutments
Implant supported prothesis
Combinations of above.

Question 7

What damage can crowns and bridges cause?

Answer 7

Plaque retention
Unfavourable transmission of occlusal forces
Pulp damage.

Question 8

What damage can be caused from RPD?

Answer 8

Plaque retention
Direct trauma from components
Unfavourable transmission of forces.

Question 9

What are the 3 things we need to consider when making an RPD?

Answer 9

Effective tooth support
Clearance of gingival margins
Rigid connectors.

Question 10

What are the histological components of the supracrestal attachment?

Answer 10

The junctional epithelium and supracrestal connective tissue.

Question 11

Where should you NOT place the restoration margins?

Answer 11

In the gingival sulcus (don’t breach the supracrestal attachment).

Question 12

What will taking the crown margin in a straight circle around the tooth cause?

Answer 12

Will cause loss of supracrestal attachment.

Question 13

Look at the images on this lecture of poorly fitting crown margins.

Answer 13

.

Question 14

What does healthy tissue and carefully located preparation margins equal?

Answer 14

Easy impression and reduced risk of disease.

Question 15

What is surgical crown lengthening?

Answer 15

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.

Question 16

What can overhanging restorations cause?

Answer 16

Associated with more inflammation and bone loss than non-restored sites
Larger the overhand the greater the bone loss
Development of pathogenic flora.

Question 17

What happens if a crown is underprepared?

Answer 17

Causes a bulbous crown.

Question 18

What are the key principles to periodontally successful indirect restorations?

Answer 18

Start with healthy tissue
Adequate tooth prep
Precise margin location
Excellent provisional restorations
Careful tissue handling and impression technique.

Question 19

What is Ante’s law?

Answer 19

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.

Question 20

What are periodontal procedures that can aid restorative dentistry?

Answer 20

Excessive gingival growth
Gingival overgrowth making restorative dentistry impossible
Lack of clinical crown height making retention of restoration impossible
Camouflage of gingival recession.

Question 21

What 4 things contribute t soft tissue harmony?

Answer 21

gingival health
gingival display
genera gingival inclination
gingival outline and symmetry.

Question 22

Clinical crown height for retention?

Answer 22

2-3mm of space between gingival margin and alveolar crest.

Question 23

How can you camoflague gingival recession?

Answer 23

Acrylic gingival veneer.

Question 24

What does a acrylic gingival veneer patient have to do?

Answer 24

Take it out as much as possible.

Question 25

What is orthognathic surgery?

Answer 25

Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work.