resortations and periodontal health

Question 1

define biological width

Answer 1

the combined width of ocnencitve tissue and junctional epithelial attachment formed adjacent to a tooth and superior to the crestal bone

Question 2

what is the importance of the biological width

Answer 2

• the mean dimensions are 2.15mm to 2.30mm. this concept establishes a healthy state of the periodontium and any violations to it, while providing treatment, will hinder the healthy state of the periodtiuntium resulting in periodontal problems such as gingivitis or periodontitis. Therefore it is important to try and preserve it while providing treatment

Question 3

why doe we get periodontal problems in restorative dentistry

Answer 3

plaque retentive feature s
- created by shape of the restoration with overhangs or ledges
- deficiencies or voids at the margins or in the restoration surface
- roughness of the restorative surface causing plaque mention

Food impaction
- poor or no contact point
- incorrect 3D contour of he supragignival bulge in the restoration
overbuilt or under built embrasures

Question 4

what should we do prior health status of the periodiutm and teeth

Answer 4

• always undertake prevention first
• dietary analysis/advice and don’t forget smoking cessation
• oral hygiene advice
• exposure to and the use of flruodie toothpaste
• if food package is a problem , then examine the occlusion for
• plunger cusps abrnoal cusp contact between amrhginal ridges not into he normal cusp and fossae arrangement
• open or poor contact points between tooth and restorations or poor embrasure design leading to the trap of food
• under built restoration and overruptied antagonist teeth

Question 4

what do we need to remember before alternating or defacing enamel and dentine whether healthy or disease

Answer 4

• teeth are hard tissues help in a vital and dynamic tissue matrix
• lost hard tissue can be replaced with other materials but seldom with results as acceptable as the natural tooth tissues
• tooth tissue loss may affect the vital supporting hard and soft tissues , in both the shorter and longer terms

Question 5

how is iatorgneic damage causes to gingival/periodontal health

Answer 5

• incorrect placement of matrix band and no wedges leads to
• gross overhangs and ledges
• plaque retention and caries and/ rod gignvalperidotnla disease

Question 6

how is gingival periodntla health maitnitnaed

Answer 6

• correct placement of matrix band and wedges lead to
• tight contact points and correct vertical positioning of contact points minimise plaque.food trapping and correct 3D contour of the restoration
• Minimises voids or defiicneies in the restoration trusting in less plaque mention,caries and gingival inflammation
• no overhangs/ledges or gross material dispalcemtn

Question 7

how can you check if gingivitis or periodontitis is present

Answer 7

spontaneous heamoorhaneg on prep
- matrix band or strip is placed
-bleeding prevents adequate moisture control

Periodontitis present?
- will pocketing and bone loss mean poor restoration contours and aesthetics
- deep subgingibal floor of the restoration because of root caries

Question 8

what is the long term consequence of gingival and periodontal inflammation

Answer 8

• plaque retaining factor/ plaque will increase In pocket formation, pocket depth with further loss of clinical attachment
• localised alveolar bone loss
• gingival recession
• tooth loss and significant alveolar bone remodelling
• aesthetic problems as a result of the restoration margins becoming exposed

Question 9

describe the clinical relevance of restorations and periodontal health

Answer 9

• PREVENTION comes first
• check and review baseline gingival/peridontal disease status before starting
• Correctly address any gingival/periodontal disease
• Correct any faulty restorations; refurbish/repair, modify or replace
• Always plan, design and carry out any restoratiove treatment by respecting the biological with, natural tooth morphology and anatomical contact relationships