Periodontal Considerations in Restorative Dentistry 1 Flashcards

1
Q

What are the aims of period tonal therapy

A

to arrest the disease process
ideally to regenerate lost tissue
to maintain periodontal health long term

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2
Q

What is a good result from periodontal therapy

A

prevention of tooth loss

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3
Q

How can periodontal therapy act as an aid to restorative dentistry

A
improves soft tissue management
establishes stable gingival margin position
contributes to aesthetics
reduces tooth mobility
informs prognosis
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4
Q

Why is the inflamed gingival margin an issue in restorative dentistry

A

it bleeds during operative procedures
it is unstable in its apico-coronal location
makes effective restorative dentistry impossible

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5
Q

What is crucial when planning restorations in the aesthetic zone

A

the position of the GM

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6
Q

When will the position of the gingival margin be stable

A

when its healthy

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7
Q

If aesthetic demands are high, what should be done

A

the GM should be monitored for at least 3-6 months after completion of periodontal tx to check that it is stable

once stability is confirmed then place restorations

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8
Q

What are the prosthodontics options for the partially dentate px

A

FPD with natural abutments
RPD wit natural abutments
implant supported prosthesis
combo of above

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9
Q

What is the damage that can be caused by crowns and bridges

A

plaque retention
unfavorable transmission of occlusal forces
pulp damage

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10
Q

What does plaque retention from crowns and bridges depend on

A

location and fit of restoration margins

contours of retainers and poetics

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11
Q

How can damage be caused by an RPT

A

plaque retention
direct trauma from components
unfavorable transmission of forces (occlusal, insertion and removal)

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12
Q

What does plaque retention from RPD depend on

A

gingival margin coverage

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13
Q

What type of prosthesis is preferable from a periodontal perspective

A

fixed prostheses

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14
Q

What are important features of an RPD

A

effective tooth support
clearance of GM
rigid connector

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15
Q

What is the supracrestal attachment

A

it is histologically composed of junctional epithelium and supracrestal connective tissue

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16
Q

How much of the restoration margin in the gingival sulcus can you get away with

A

0.5mm but even then can’t recession

17
Q

What happens if you put a restoration further than 0.5mm into the sulcus

A

most likely you are infringing on the supracrestal attachment and this will cause issues

18
Q

What is important inter proximally

A

that JE changes position
more coronal now
should bare in mind

19
Q

What are the possible outcomes if the restoration margins encroach on the supracrestal attachment

A

persistent inflammation

loss of attachment causing pocketing and recession

20
Q

How many mm do you need between the restoration margin and bone

21
Q

What are issues with overhanging restoration

A

associated with more inflammation and bone loss than non restored sites
the larger the overhang the greater the bone loss
development of pathogenic flora

22
Q

What are the keys to periodontally successful indirect restorations

A

start with healthy tissues
adequate tooth prep according to material
precise margin location
excellent provisional restoration
careful tissue handling and impressions technique

23
Q

What should we consider when restoring px w periodontitis

A

what is the prognosis

will more teeth be lost in the future

24
Q

What is Ante’s law

A

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

25
What are we afraid of when it comes to abutments in period px
abutments which are periodontally compromis | ed will be overloaded
26
What is the success of crowns and bridges attributed too
meticulous cause related therapy compliance with rigorous maintenance programme careful occlusal design
27
What are periodontal procedures that can aid restorative dentistry
excessive gingival display (gummy smile) gingival overgrowth making restorative dentistry impossible lack of clinical crown height making retention of restoration impossible camouflage of gingival recession
28
What are the aspects that lead to soft tissue harmony
gingival health gingival display general gingival inclination gingival outline and symmetry
29
How can gingival recession be camouflaged
acrylic gingival veneer