Restorations & Periodontal Health

Question 1

Define biological width

Answer 1

Is is the combined width of the connective tissues and junctional epithelial attachment formed adacemg to and superior to the crystal bone

Question 2

What are the mean dimension fo the biological width

Answer 2

2.15-2.3mm

Question 3

In simple terms state what the biological width is equal to

Answer 3

Connective tissue + junctional epithelium

Question 4

What is the approximate length of the junctional epithelium

Answer 4

0.57-1.14mm

Question 5

What is the approximate length of the tissue attachment

Answer 5

0.7-1.84mm

Question 6

What is the importance of the biological width

Answer 6

If this area is invaded when placing a restoration then you will disturb healthy periodontium which can lead to periodontal disease

Question 7

What are the 2 main causes for periodontal problems in restorative dentistry

Answer 7

Plaque restive factors
food packing

Question 8

Give examples of plaque retentive factors we can create in restorative dentistry

Answer 8

1. Overhand and ledges
2. Deficiencies and voids at etc margins or in the restoration surfaces
3. Rough restoration surfaces

Question 9

Give examples of food implication features that can lead to periodontal problems in restorative dentistry

Answer 9

1. Poor or no contact point
2. Incorrect 3D contour of the supra finical bulge in the restoration
3. Overbuilt or underbailr embrasures

Question 10

What features do teeth have to help keep the gums heathy ?

Answer 10

1, Supra-gingival bulge deflects food so it doesn’t directly affect the gums
2. Contact points protect the inter papillary fissures

Question 11

If you see that your patient is suffering from tooth packing what should you examine

Answer 11

Examine the occlusion for:
1. Abnormal cusp contact between marginal ridges
3. Open and poor contact points between tooth and restoration or poor embrasure design leading to food trapping
3. Under built restorations and over erupted antagonist teeth

Question 12

What can incorrect placement of a matrix band lead to?

Answer 12

1. Gross overhangs and ledges
2. PRF
3. Caries
   4 Periodontal disease

Question 13

What is the purpose of a matrix band and wedge?

Answer 13

1. To give a Tight contact points & correct vertical positioning of contact points minimise plaque/food trapping & correct 3D contour of the restoration
2. To Minimise voids or deficiencies in the restoration resulting in less plaque retention, caries and gingival inflammation
3. So you have no overhangs or ledges, or gross material displacement

Question 14

Before carrying out restorative treatment what should you check fro?

Answer 14

Check if the soft tissues are healthy IE patient isn’t suffering from gingivitis or periodontitis

Question 15

What problem does gingivitis cause in restorative dentistry?

Answer 15

May be difficult to achieve moisture control is spontaneous haemorrhage occurs during the or when a matrix band or strip is placed

Question 16

What problem does periodontitis cause in restorative dentistry?

Answer 16

1. Pocketing and bone loss may mean your restoration will have poor contours and aesthetics
2. Root caries may result in deep sub gingival floor of the restoration
3. Pulpal exposure is more likely

Question 17

What are the long term consequences of gingival and periodontal inflammation?

Answer 17

1. Plaque retaining factors increase in pocket formation, pocket depth with further loss of clinical attachment attachment
2. Localised alveolar bone loss
3. Gingival recession
4. Tooth loss and significant bone remodelling
5. Aesthetic problems

Question 18

How do you deal with a faulty restoration?

Answer 18

1. Refurbish/ repair
2. Modify
3. Replace
4. Refer to specialists
5. could possibly extract