Restoration of the Worn Dentition Flashcards
when does pathologic wear occurs
when the process of physiologic wear is accelerated by exogenous or endogenous factors and frequently it is multifactorial and a variable problem
the excessive wear of just one tooth of extensive restorations or of the full dentition has been associated to:
- supraeruption of the opposing teeth
- inclination of the teeth to a contact that has been eroded
- reduction of the vertical dimension
- some authors also believe that it can be a contributing factor in temporomandibular disorders
what are the etiologies of wear
- congenital anomalies
- attrition
- loss of posterior vertical support
- abrasion
- erosion
- abfraction
what should be evaluated in the intitial interview to determine type of wear presetn
a detailed review of the medical history, diet, and an evaluation of the presence of environmental factors and patient habits should be done
what are the etiologies of mechanical wear
- loss of posterior support
- premature occlusal contacts
- bruxism
- inadequate brushing technique
- parafunctional habits
what are the characteristics of mechanical wear
- presence of wear facets with a well defined loss that coincides on the articulated models
- the pattern of the wear facets should be analized because they tend to occur in predictable places
what are the causes of greater wear on anterior teeth compared to posterior teeth
- posterior suport inadequate or unstable
- loss of posterior teeth
- premature occlusal contacts
what is the cause of progressive wear greater on anterior teeth
can be result of bruxism
what is the cause of wear on the buccal surfaces of premolars and canines
can be the result of excessive brushing or an inadequate brushing technique
what is the cause of wear on the incisal or occlusal surfaces
usually due to parafunctional habits
what are the etiologies of chemical wear
- chronic vomit
- sucking of citrus fruits
- consumption of acidic drinks and foods
- medicines with an acid pH
- abuse of certain drugs
- environmental factors
what are the characteristics of chemical wear
- presence of amalgam islands
- presence of grooves and fossae
- there can be hypersensitivity
- in most cases there are no stains or changes in color
- the wear facets dont have a defined periphery
what are the causes of greater loss of dental structure on anterior surfaces than on posterior surfaces
- the more common cause is chronic vomit
- sucking on citrus fruits
what are the causes of greater loss on posterior surfaces than on anterior surfaces
- consumption of acidic foods or drinks
- rinse with or retain acidic drinks in the mouth
- chew the pulp of certain fruits
what are the variable location and miscellanesou causes of chemical wear
- medicines with an acid pH that have frequent contact with dental surfaces
- abuse of amphetamine extasis
- application of cocaine to the oral mucosa
- patients that are exposed to acidic vapors and aerosols
it is assumed that extensive wear of the dentition results in a:
reduced vertical dimension of occlusion
what are the 3 situations in which it is possible that wear is present
- fast wear in which compensation is not achieved and there is a reduction of the vertical dimension
- slow wear in which the vertical dimension is maintained
- wear is not present or very slow
what is evaluated in the vertical dimension
- posterior support
- history of the wear present
- phonetic evaluation
- interocclusal distance
- facial appearance
- perception of the patient
what is category 1 of patients with occlusal wear
- excessive wear and reduction of the vertical dimension
- the pt will present:
- few posterior teeth missing
- excessive occlusal wear present on anterior teeth
- unstable occlusion on posterior teeth
- closest speaking space close to 3mm
- interocclusal space of 6mm
what should be fabricated to evaluate if the pt tolerates the increase in vertical dimension
an interocclusal splint or a temporary RPD
the provisional restorations will provide the opportunity to:
objectively evaluate the comfort, esthetics and hygiene
what is category II of occlusal wear
excessive wear without reduction of the vertical dimension with space for restorative materials
- the pt will present:
- extensive history of occlusal wear
- interocclusal space of 3mm
- patients closest speaking space of 1mm
- sufficient space for materials
in category II patients, the constant eruption has:
maintained the vertical dimension
the preparation of the teeth to establish adequate ___________ forms is complex in these patients
retentive and resistant
