Periodontal & Prosthodontic Interface Flashcards
What may occur if restorations are provided in the presence of active periodontal disease?
It may eventually cause the failure of the restoration and the tooth.
What may happen when restorations are provided in the presence of inflammation?
The tooth restoration interface may become exposed when the inflammation subsides.
When may you provide restorations before resolving inflammation, peri disease?
The exception to this is the provision of emergency care or treatment required to stabilise progression of disease e.g. temporisation of a caries lesion.
When may inflammation set in (physiologically as well as mechanical)?
Inflammation may set in when the epithelial integrity (primary defence barrier) is breached by pathogenic microflora and their metabolic products, as well as a result of trauma during restorative procedures or by restorations.
What factors influence disease severity and activity?
Influenced by host susceptibility and response, tissue characteristics, virulence factors of the organisms, and iatrogenicity of restorations or prostheses.
The iatrogenicity of restorations or prostheses can influence disease activity and severity. Expand on this.
Iatrogenecity may result from design characteristics and/or the biomechanical interactions of restorations with the periodontal tissues e.g. a subgingival/overhanging margin.
What must be considered and addressed to be able to deliver a successful restorative dental treatment?
A sound understanding of the biology- anatomy and physiology- of the hard and soft tissues involved, immuno-pathogenesis mechanisms, biomimetics, biomechanical and biochemical aspects of dental biomaterials and their interactions with the intraoral tissues are essential.
What is the biological width?
The vertical dimension of the dentogingival complex, which comprises the sulcular depth, the junctional epithelium and connective tissue attachment
Why is the biological width important?
It provides the natural seal around the tooth, protecting it from the unchecked ingress of pathogenic organisms in to the connective tissue i.e. primary defence barrier
What are the guides to measuring the biological width?
Biological width has been defined as the measurement between the depth of the gingival sulcus and the crest of alveolar bone.
What happens when a restoration is extended into the biological width?
There is an attempt to re-establish the biologic width. This results in persistent gingival inflammation within the attachment apparatus. Gram negative and anaerobic organisms thrive in the environment leading to progression of persistent inflammation.
What can be done in clinic to assess and avoid impingement of the biological width?
The location of the margins of a restoration must be carefully planned prior to tooth preparation.
To avoid consequences of violation of the biologic width, must measure the probing depth to account for the sulcus depth. A radiograph must be taken to assess the crestal bone level and its relationship to the location of the planned margin.
What should the distance between the planned margin location and the alveolar bone crest be?
The distance between the planned margin location and alveolar bone crest must be at least 3mm.
What kind of gingival phenotypes are there?
Gingivae may be either thick & flat or thin & scalloped.
Is thin & scalloped or thick and flat more susceptible to recession?
Thin and scalloped gingivae are more susceptible to recession compared to thick and flat gingivae.
