Periodontal Considerations in Restorative Dentistry 1

Question 1

What are the aims of period tonal therapy

Answer 1

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

Question 2

What is a good result from periodontal therapy

Answer 2

prevention of tooth loss

Question 3

How can periodontal therapy act as an aid to restorative dentistry

Answer 3

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

Question 4

Why is the inflamed gingival margin an issue in restorative dentistry

Answer 4

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

Question 5

What is crucial when planning restorations in the aesthetic zone

Answer 5

the position of the GM

Question 6

When will the position of the gingival margin be stable

Answer 6

when its healthy

Question 7

If aesthetic demands are high, what should be done

Answer 7

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

Question 8

What are the prosthodontics options for the partially dentate px

Answer 8

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

Question 9

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

Answer 9

plaque retention
unfavorable transmission of occlusal forces
pulp damage

Question 10

What does plaque retention from crowns and bridges depend on

Answer 10

location and fit of restoration margins

contours of retainers and poetics

Question 11

How can damage be caused by an RPT

Answer 11

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

Question 12

What does plaque retention from RPD depend on

Answer 12

gingival margin coverage

Question 13

What type of prosthesis is preferable from a periodontal perspective

Answer 13

fixed prostheses

Question 14

What are important features of an RPD

Answer 14

effective tooth support
clearance of GM
rigid connector

Question 15

What is the supracrestal attachment

Answer 15

it is histologically composed of junctional epithelium and supracrestal connective tissue

Question 16

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

Answer 16

0.5mm but even then can’t recession

Question 17

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

Answer 17

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

Question 18

What is important inter proximally

Answer 18

that JE changes position
more coronal now
should bare in mind

Question 19

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

Answer 19

persistent inflammation

loss of attachment causing pocketing and recession

Question 20

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

Answer 20

3mm

Question 21

What are issues with overhanging restoration

Answer 21

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

Question 22

What are the keys to periodontally successful indirect restorations

Answer 22

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

Question 23

What should we consider when restoring px w periodontitis

Answer 23

what is the prognosis

will more teeth be lost in the future

Question 24

What is Ante’s law

Answer 24

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 25

What are we afraid of when it comes to abutments in period px

Answer 25

abutments which are periodontally compromis

ed will be overloaded

Question 26

What is the success of crowns and bridges attributed too

Answer 26

meticulous cause related therapy
compliance with rigorous maintenance programme
careful occlusal design

Question 27

What are periodontal procedures that can aid restorative dentistry

Answer 27

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

Question 28

What are the aspects that lead to soft tissue harmony

Answer 28

gingival health
gingival display
general gingival inclination
gingival outline and symmetry

Question 29

How can gingival recession be camouflaged

Answer 29

acrylic gingival veneer