Restorations & Periodontal Health Flashcards
Define biological width
It is the combined width of connective tissue and junctional epithelial attachment formed adjacent to a §and superior to the crestal bone.
What are the mean dimensions of the biological width?
2.15mm to 2.30mm
In simple terms state what the biological width is equal to
connective tissue + junctional epithelium
What is the approx length of the junctional epithelium
0.57-1.14mm
What is the approx length of tissue attachment?
0.7-1.84mm
What is the importance of the biological width?
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
What are the 2 main causes for periodontal problems in restorative dentistry
- Plaque retentive factors
2. Food implications
Give examples of plaque retentive features we can create in restorative dentistry
- Overhangs or ledges
- Deficiencies or voids at the margins or in the restoration surface
- Rough restoration surface
Give examples of food implication features that can lead to periodontal problems in restorative dentistry
- Poor or no contact point
- Incorrect 3D contour of the supra gingival bulge in the restoration
- Overbuilt or underbid embrasures
What features do teeth have to help keep the gums heathy ?
1, Supra-gingival bulge deflects food so it doesn’t directly affect the gums
2. Contact points protect the inter papillary fissures
What are Embrasures (spillways)?
They are the large areas lingual to the contact point
What type of medicine is practiced in dentistry?
Preventative medicine
If you see that your patient is suffering from tooth packing what should you examine
Examine the occlusion for:
- abnormal cusp contact between marginal ridges, not into the normal cusp & fossae arrangement (Plunger cusps)
- Open or poor contact points between tooth & restoration or poor embrasure design, leading to the trapping of food
- Under built restorations and over erupted antagonist teeth
What can incorrect placement of a matrix band lead to?
- Gross overhangs (material extrusion) & ledges
2. Plaque retention, & caries and/or gingival/periodontal diseas3
What is the purpose of a matrix band and wedge?
- To give a Tight contact points & correct vertical positioning of contact points minimise plaque/food trapping & correct 3D contour of the restoration
- To Minimise voids or deficiencies in the restoration resulting in less plaque retention, caries and gingival inflammation
- So you have no overhangs or ledges, or gross material displacement
Before carrying out restorative treatment what should you check fro?
Check if the soft tissues are healthy IE patient isn’t suffering from gingivitis or periodontitis
What problem does gingivitis cause in restorative dentistry?
May be difficult to achieve moisture control is spontaneous haemorrhage occurs during the or when a matrix band or strip is placed
What problem does periodontitis cause in restorative dentistry?
- Pocketing and bone loss may mean your restoration will have poor contours and aesthetics
- Root caries may result in deep sib gingival floor of the restoration
- Pulpal exposure is more likely
What are the long term consequences of gingival and periodontal inflammation?
- Plaque retaining factors increase in pocket formation, pocket depth with further loss of clinical attachment attachment
- Localised alveolar bone loss
- Gingival recession
- Tooth loss and significant bone remodelling
- Aesthetic problems
How do you deal with a faulty restoration?
- Refurbish/ repair
- Modify
- Replace
- Refer to specialists
- could possibly extract
