Restorations & Periodontal Health

Question 1

Define biological width

Answer 1

It is the combined width of connective tissue and junctional epithelial attachment formed adjacent to a §and superior to the crestal bone.

Question 2

What are the mean dimensions of the biological width?

Answer 2

2.15mm to 2.30mm

Question 3

In simple terms state what the biological width is equal to

Answer 3

connective tissue + junctional epithelium

Question 4

What is the approx length of the junctional epithelium

Answer 4

0.57-1.14mm

Question 5

What is the approx length of tissue attachment?

Answer 5

0.7-1.84mm

Question 6

What is the importance of the biological width?

Answer 6

Its an area where if you invade that space when doing a restoration then you are going to disturb healthy periodontium and can lead to periodontal problems such as gingivitis or periodontitis

Question 7

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

Answer 7

1. Plaque retentive factors

2. Food implications

Question 8

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

Answer 8

1. Overhangs or ledges
2. Deficiencies or voids at the margins or in the restoration surface
3. Rough restoration surface

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 gingival bulge in the restoration
3. Overbuilt or underbid 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

What are Embrasures (spillways)?

Answer 11

They are the large areas lingual to the contact point

Question 12

What type of medicine is practiced in dentistry?

Answer 12

Preventative medicine

Question 13

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

Answer 13

Examine the occlusion for:

1. abnormal cusp contact between marginal ridges, not into the normal cusp & fossae arrangement (Plunger cusps)
2. Open or poor contact points between tooth & restoration or poor embrasure design, leading to the trapping of food
3. Under built restorations and over erupted antagonist teeth

Question 14

What can incorrect placement of a matrix band lead to?

Answer 14

1. Gross overhangs (material extrusion) & ledges

2. Plaque retention, & caries and/or gingival/periodontal diseas3

Question 15

What is the purpose of a matrix band and wedge?

Answer 15

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 16

Before carrying out restorative treatment what should you check fro?

Answer 16

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

Question 17

What problem does gingivitis cause in restorative dentistry?

Answer 17

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

Question 18

What problem does periodontitis cause in restorative dentistry?

Answer 18

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

Question 19

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

Answer 19

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 20

How do you deal with a faulty restoration?

Answer 20

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