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BDS4 EXAM PREP > restorative > Flashcards

restorative Flashcards

1
Q

indications for replacing/restoring teeth

A
  • pain
  • sensitivity
  • poor aesthetics
  • fracture
  • functional problems (mastication, speech)
  • structure problems
  • occlusal instability
  • perio splinting
  • restoring OVD
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2
Q

reasons to not restore/replace teeth

A
  • Damage to tooth and pulp
  • effect on periodontium
  • cost
  • unrestorable teeth
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3
Q

principles of cavity prep

A

Access - identify and remove carious enamel.
Remove enamel to identify maximal extent of lesion at ADJ and smooth enamel margins.
Ensure ADJ margins are caries-free
Caries management - progressively remove peripheral dentinal caries.
Remove deep caries over pulp.
Cavity modification - outline form modification and internal design modification (for chosen material)

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4
Q

D1

A

clinically detectable enamel lesions with intact surfaces

preventative care

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5
Q

D2

A

clinical detectable cavities limited to enamel

preventative

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6
Q

D3

A

clinically detecetable lesions into dentine

preventative care and restorative care

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7
Q

affected dentine

A

softened demineralised

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8
Q

D4

A

into pulp

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9
Q

infected dentine

A

softened demineralised dentine that has been invaded/contaminated by bacteria

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10
Q

partial caries removal

A

access
caries removal
removal of infected dentine where possible
definitive restoration

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11
Q

stepwise caries removal

A

access
caries removal
leave caries over pulp
temporary restoration
allow tertiary denine formation
remove temporary and remove remaining soft dentine
defintive restoration

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12
Q

methods of managing caries

A

partial caries removal
stepwise caries removal
self cleansing
direct pulp cap
pulpotomy

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13
Q

functional/stable occlusion

A

free of interferences to smooth gliding movements of the mandible with the absence of pathology

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14
Q

mutually protected occlusion

A

gold standard - canine guidance, posterior disculsion in lateral excursions, no protosive interference, no non-working side/working side contacts

working side is the side you move to

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15
Q

supporting cusps

A

cusps that occlude with opposing centric stops

palatal uppers, buccal lowers

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16
Q

non-supporting cusps

A

cusps that don’t occlude with opposing centric stops

buccal upper, lingual lower

BULL

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17
Q

non-supporting cusps

A

cusps that don’t occlude with opposing centric stops

buccal upper, lingual lower

BULL

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18
Q

centric stops

A

points on occlusal surface which meet with opposing teeth

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19
Q

occlusal interefernce

A

undesirable tooth contacts that may produce mandibular deviation during closure to ICP or may hinder smooth passage to and from ICP

Contacts that hinder smooth excursive movements of the mandible.
* Lateral obtrusive - undesirable working side contact
* Protrusive - posterior contact during protrusion

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20
Q

benetts angle

A

angle described by the orbiting condyle during lateral protrusive movements
average is 10-15 degrees

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21
Q

sagittal condylar angle

A

angle at which teh condyle descends down the glenoid fossa of the TMJ in the saggittal plane

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22
Q

rest position

A

normal position when not eating/talking

teeth slightly appart (interocclusal clearance)
TMJs in fossa
neutral, relaxed position

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23
Q

free way space

A

difference between rest position and ICP
difference between OVD and RVD
av 2-4mm

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24
Q

conformist

A

maintain existing/original occlusion

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25
Q

reorganised

A

altering existing/original occlusion (new occlusal scheme)

need pt in RCP

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26
Q

guidance

A

factors which control protrusive and excursive movements of mandible

  • anterior teeth contact (incisors and canines) on working side during excurisve movement
  • group function - multiple posterior teeth contacts on working side during excursive movements
  • canine - disclusion of teeth on working side - except canines; and absence of non working side contacts during excursive movements

reproducible and protects posterior teeth - preferred

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27
Q

ideal features of occlusal contacts

3

A
  • lower incisal edges occlude afainst upper cingulum (BSI class I)
  • lower buccal cusps and upper palatal cusps occlude against fossa and marginal ridges of opposing teeth
  • tripid/cusp tip to base of fossa contacts - forces directed down long axis of tooth
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28
Q

features of unfavourable occlusal contacts

A
  • on cuspal inclines
  • no contacts
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29
Q

features of normal occlusal forces

A
  • contact only in ICP
  • short duration
  • light forces compared to maximum biting forces
  • forces directed down long axis of tooth
  • protective neuromuscular reflexes prevent injury
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30
Q

features of abnormal occlusal forces
and what may occur

A
  • greater forces exerted
  • longer duration
  • contacts in many mandibular positions
  • horizontally directed
  • protective neuromuscular reflexes do not operate

may cause damage to teeth, PDL, muscles and joints

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31
Q

what is posselts envelope of motion

A

3D concept of mandible movement - a combination of border movements in a ll 3 planes (sagittal, transverse, frontal)

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32
Q

ICP

A

intercuspation
position of maximum interdigitation/intercupation
postiion of best fit between maxillary and mandibular teeth

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33
Q

RCP

A

guided position in which condyle in most anterior superior position within the condylar fossa

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34
Q

edge to edge

A

incisal edge to incisal edge.
Upper and lower incisors at same coronal/frontal leve

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35
Q

protrusive position

A

occlusion when mandible maximally protruded

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36
Q

retruded axis position

A

position adopted by condyle during terminal hinge movement opening and closing
(condyles in most anterior superior position - rotation not translation)

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37
Q

maximum opening

A

when mandible maximally despressed

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38
Q

centric relation

A

mandible position when condyles are in most anterior superior position in their fossa, resting against the posterior slopes of the articular eminences with articular discs interposed
repeatable, reproducible position that can occur anywhere between retruded axis position and RCP

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39
Q

protrusion

A

jaw position when mandible maxillary protruded

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40
Q

SDA

A

dentition where most posterior teeth are missing but satisfactor function without RPD
long term occlusal stability
3-5 occlusal units left
(usually 5-5)

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41
Q

pair of occluding molars in occlusal unit

A

2

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42
Q

pair of occluding premolars in occlusal units

A

1

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43
Q

indications for SDA

A
  • missing posterior teeth with 3-5occlusl units remaining
  • sufficient occlusal contacts to provide large enough occlusal table
  • favourable prognosis of remaining teeth
  • pt not motivated to pursure more complex tx plan
  • limited finances
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44
Q

contraindications for SDA

A
  • poor prognosis of remaining teeth
  • untreated/advanced perio disease
  • pre-existing TMD
  • signs of pathological wear
  • significant malocclusion (class II or III)
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45
Q

occlusal stabilitiy definition

A
  • stablity of tooth position relative to its spacial realtionship in occluding arches
  • absence of tendency for tooth migration other than normal physiologic compensatory over time
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46
Q

features that can determine occlusal stablity

A
  • absence of pathology (tooth wear, caries)
  • perio support
  • number of teeth in each arch
  • interdental spacing
  • occlusal contacts
  • mandibular stability
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47
Q

requirements for occlusal stability

A
  • stable contacts on all teeth of equal intensity in centric relation (balanced occlusion)
  • anterior guidance in harmony with Posselt’s envelope of motion
  • disclusion of all posterior teeth during mandibular protrusive movement
  • disclusion of all posterior teeth on non-working side due to madnibular lateral movement
  • disculsion of all posterior teeth on working side during mandibular lateral movement
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48
Q

purpose of facebow

A

used to orientate maxillary base in same relationship on articulator as maxilla is related to condyles in the pt

is a horizontal record of the hinge axis of mandible

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49
Q

function of articulators

A
  • obsever occlusal relations
  • provide dx wx ups and locate undercuts

mechanical devices which represent TMJ and jaw members to which casts can be attached to simtulate jaw movement
* non adjustable (hinge, av valu)
* semi-adjustable (arcon/non arcon)
* fully adjustable

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50
Q

adv of indirect gold restorations

A
  • excellent strength
  • good support
  • good cuspal protection
  • durable
  • corrision resistant
  • wear resistant
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51
Q

disadv of indirect gold restorations

A
  • expensive
  • poor aesthetics
  • difficult to make
  • demanding and non conservative prep
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52
Q

adv of indirect Vs direct composites

A

no polymerisation contraction stress
no cuspal flexure

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53
Q

adv of milled porcelain restoration

A

best aesthetics
good wear resistance
good retention

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54
Q

5 advantages veneers

A

improve aesthetics
change tooth shape/colour
correct peg shaped laterals incisors
reduce/close spaces
align labial surfaces of instanding teeth
minimal tooth prep

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55
Q

disadvantages of veneers

A

often fail and require replacement with crowns
destructive prep
irrevsible
expensive

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56
Q

indications for veneers

A

sound tooth - perio
mild discolouration
hypoplasia
fracture tooth
tooth wear
shape modification/space closure wanted

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57
Q

contraindication veneers

A

poor OH
heavily restored/extensive tooth surface loss - insufficient bonding area
high caries rate - interpoximal caries
gingival recession/ root exposure
heavy occlusal anterior tooth contacts
severe discolouration

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58
Q

2 types of veneer materials

A

composite and porcelain

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59
Q

adv composite veneer

A

less destructive
can be direct or indirect

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60
Q

adv of porcelain veneers

A

better aesthetics and stronger

but indirect only, cost more

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61
Q

standard tooth prep for veneers

A

0.5mm incisal depth cuts - for labial reduction
chamfer finish line extending to gingival margin and into embrasures (short of contact point)
incisal edge reduction (0.5mm)

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62
Q

indications for crowns

A

protect weakened tooth structure - cuspal coverage
restore function
fixed bridge retainer
after veneer failure

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63
Q

contraindications for crowns

A

active caries/perio disease
lack of tooth tissue available - ferrule
unfavourable occlusion
healthy tooth
poor OH

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64
Q

advantages of crowns

A

restore function
strong
good aesthetics
abutment possible - restore tooth shape

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65
Q

disadv of crown

A

destructive to tooth
£££
irreversible
indirect - multiple visits
likely to fail and need post/core

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66
Q

principles of crown prep

A

preserve tooth structure
retention and resistance form
structural durability
marginal integrity
preserve periodontium
aesthetic considerations

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67
Q

materials for crowns

A

precious metal - gold shell crown
Porcelain jacket crown
metal ceramic crowns
all ceramic crowns - zironia, lithium disilicate
non precious metal - stainless steel

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68
Q

metal crown margins

A

0.5mm axial, non-working cusp;
1.5mm functional cusp;
0.5mm chamfer

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69
Q

PJC prep

A

1.0mm axial, non-functional cusp;
1.5mm functional cusp;
1.0mm shoulder

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70
Q

MCC prep

A
  • 1.5mm axial, non-working cusp;
  • 1mm functional cusp;
  • 0.5mm lingual chamfer, 1.5mm buccal shoulder (0.4mm metal and 0.9mm porcelain)
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71
Q

ceramic crown prep

A

1.5mm axial, non-functional cusp;
2.0mm functional cusp;
1.5mm chamfer circumferentially

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72
Q

functions of temporaries

A

restore function
restore aesthetics
restore occlusion
prevent sensitivity
prevent microleakage
prevent bacterial ingress

73
Q

characteristic ideal temp restoration material

A

non irritatnt
good aesthetics
good strength
good wear resistant
dimensionally stable
able to be removed

74
Q

labial margin

A

shoulder

75
Q

palatal margin

A

chamfer

76
Q

3 example preformed provisionals materials

A

metal
plastic
polycarbonate

easier to use, unlikely to fit accurate

77
Q

stages in making custom made temporary

A

pre-prep impression
prep
fill impression with temporary cement
re-seat impression
cure
remove impression
trim temp
check occlusion

78
Q

3 options for RCTx anterior tooth with margin ridges

A

composite
veneer
crown

+/-bleaching

79
Q

options for RCTx anterior tooth without marginal ridges

A

core and crown
post-core crown

80
Q

posterior RCTx tooth options

A

onlay
crown
core build up + crown

81
Q

defintion of core

A

provides retention for crown in a tooth with insufficient tooth tissue remaining

82
Q

core material options

A

composite - good aesthetics; strength; bond; technique sensitive
amalgam - strong; not retentive; poor; aesthetics
GIC - temp only - moisture ingress

83
Q

ferrule definition

A

collar of dentine circumferentially for crown placement
min 1.5-2mm
min 1-2 vertical axial tooth structure within crown structure

prevents fracture

84
Q

post definition

A

provides retention for core in teeth with insufficient tooth structure remaining

in canal with 4-5mm apical GP remaining, at least 50% of length into root, ideally 1:1 post:crown length ratio, 1/3 root width
longest straightest canal

85
Q

post materials

A

Cast metal/SS - poor aesthetics, radiopaque, root # common, corrosion.

Most common - Ceramics - high flex strength and # toughness, good aesthetics, difficult retrievability, root # common

Fibre - flexible, good aesthetics, retrievable, bonds to dentine (DBA), radiolucent, similar properties to dentine. Requires 2mm ferrule

86
Q

ideal post features

3

A

parallel sided
non threaded (passive)
cement retained

87
Q

define bridge

A

prosthesis used to replace missing teeth and attched to one/more natural teeth

88
Q

indications for bridge

7

A

restore function
prevent unwated tooth movements (space maintainer)
restore aesthetics
cooperative pt - OH
systemic disease - implants contraindicated
improve distibution of occlusal load
heavily resotred dentition

89
Q

contraindications for bridges

7

A

Poor cooperation,
poor OH - high caries rate and active unstable perio disease,
further tooth loss within arch likely,
poor abutment prognosis,
span length too great,
bone loss (mobility),
tilted/rotated teeth

90
Q

advantages to bridges

4

A

Restore function,
restore stability - improve distribution of occlusal load
restore aesthetics,
fixed appliance
fill gaps

91
Q

disadvantages of bridges

4

A

Destructive prep,
generally expensive,
risk of debond (caries, etc.),
if teeth not stable or high occlusal load - may rotate
metal shine through

92
Q

3 types of bridges

A

adhesive or conventional - cantilever or fixed-fixed
fixed - moveable bridge
spring cantilever

93
Q

4 key considerations of pontic design

A

Cleansability,
appearance,
strength,
surfaces

94
Q

Pontic types

5

A

Wash-through (hygienic/sanitary) - no contact, not aesthetic

Dome-shaped - point contact with tip of ridge

Ridge lap/saddle - difficult to clean

Ovate - greatest mucosal coverage, difficult to clean

Modified ridge lap - minimal buccal ridge contact, lingual cut away. Good aesthetics, most popular, risk of food packing

95
Q

reasons for bridge failure

3 categories

A

loss of retention (debond)
mechanical failure (fracture of casting),
abutment teeth problems (secondary caries, loss of vitality, perio disease)

96
Q

5year and 10year success rate for RBB

A

Adhesive - 80% 5/10yrs

highest rate of failure in initial 2 years

97
Q

5year nad 10year success rate for conventional

A

93%, 89%Cantilever
91%, 80% fixed
Implant-retained - 95%, 87%

98
Q

abutment

A

tooth used as a bridge attachment

99
Q

pontic

A

arrtifical tooth suspended from abutment teeth, repalces missing tooth

100
Q

retainer

A

extra coronal restorations connected to pontic and cemebted to abutment teeth

101
Q

connector

A

connect pontic to retainer

102
Q

edentulous span

A

space between natural teeth to be filled

103
Q

saddle

A

area of edentulous span over which Pontic will lie

104
Q

pier

A

abutment tooth which stands between and supports 2 pontics (each pontic attached to further abutment tooth)

105
Q

unit

A

abutment or pontic

106
Q

support

A

resistance to occlusal load/occlusally direct displacement

107
Q

resistance

A

prevents dislodgement of restoration by forces directed in apical/oblique direction and prevents movement under occlusal forces

108
Q

retention

A

prevents removal of restoration along PoI or long axis of abutment

109
Q

describe fixed-fixed bridge

A

Rigid connector at either end of edentulous span.

110
Q

descrive fixed-moveable bridge

A

Pontic anchored rigidly to major retainer at one end and via moveable joint to minor connector at other end.

111
Q

disadv fixed-moveable bridge

2

A

complicated lab construction, limited by span length

112
Q

adv fixed-moveable bridge

3

A

No PoI required,
conservative prep,
allows for minor tooth movement,

113
Q

adv fixed fixed bridge

3

A

Robust, good retention, good strength,

114
Q

disadv fixed fixed bridge

2

A

difficult prep, destructive prep

115
Q

describe cantilever RBB(adhesive)

A

Resin retained by wing (usually metal CoCr 0.7mm; can be ceramic)
by 1 pontic

116
Q

toothwear definition

A

Irreversible loss of tooth substance by factors other than caries or trauma

117
Q

attrition

A

wear caused by tooth-tooth contact

118
Q

abrasion

A

wear casued by abnormal mechanical processess independent of occlusion

e.g. toothbrushing, wire stripping, pipe smoking etc

119
Q

erosion

A

pathological loss of tooth substance by chemical process not involving bacteria

120
Q

abfraction

A

pathological loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at cervical fulcrum of the tooth

121
Q

clinical features of attrition

A

polished wear facets,
reduced crown height,
matching wear facets on opposing teeth

122
Q

clincial features of abrasion

A

V-shaped/rounded lesions (usually cervical),
sharp enamel margin

123
Q

clinical features of erosion

A

occlusal cupping,
exposed dentine,
smooth surface, loss of surface detail,
restorations stand proud,
reduced crown height
irregular occlusal plane, non-uniform loss,
no chalky appearance or staining

labial/buccal if extrinsic acid, palatal/lingual if intrinsic,

124
Q

toothwear indices

3

A

BeWe, Smith and Knight, Eccles and Jenkins

125
Q

BEWE index

A

british erosive wear examination

0 no surface loss
1 initial loss of surface texture
2 distinct defect, hard tissue loss <50% of surface area
3 distinct defect, hard tissue loss >50% of surface area

126
Q

consequences of untreated erosion

5

A

Pain,
sensitivity,
loss of OVD,
poor aesthetics,
loss of vitality

127
Q

extrinsic sources of acid

A

fruit (juice), iron, vitamin C, vinegar, carbonated drinks, some alcohol e.g. white wine

128
Q

intrinsic sources of acid

A

GORD, vomiting, eating disorders, pregnancy, stress, rumination

129
Q

tx options for erosion

A

Identify and remove cause,
prevention (OHI, FV), diet advice,
desensitising agents,
composite build-ups,
indirect restorations - veneers, crowns, onlays
crown lengthening

130
Q

tx for attrition

A

Identify and remove cause,
behaviour management - stress management, habits
hard/soft splint,
composite build-ups,
indirect restorations,
crown lengthening

131
Q

tx for abrasion

A

Identify and treat cause,
behaviour Mx,
OHI,
lifestyle/habit change,
composite build-ups,
indirect restorations,
crown lengthening

132
Q

2 types of desensising agents

A

Strontium chloride/NaF/stannous fluoride -
Potassium nitrate

133
Q

strontium chloride/NaF/stannus fluoride mech of action

A

occludes dentinal tubules, narrowing opening, less affected by air and hydrodynamic theory

134
Q

potassium nitrate mechanism of action

A

interacts with AP propagation, preventing APs firing as efficiently, reducing sensitivity

135
Q

3 techniques for composites build ups

A

Putty matrix,
vacuum-formed stent

free hand

136
Q

adv of composite build ups

7

A

Good patient satisfaction,
seldom TMJ problems,
no detrimental effect on pulp,
no perio disease worsening,
easy to repair,
no LA,
no drilling

137
Q

disadv of composite build ups

4

A

Short/medium-term solution,
requires repair and maintenance,
good aesthetics but not excellent,
unrealistic patient expectations

138
Q

how to tx localised ant toothwear with space

A

Composite build-ups, lowers before upper

139
Q

how to tx localised posterior toothwear

A

Asymptomatic - prevention, monitoring
Occlusal wear - fill in defects with composite (ensure canine guidance)

140
Q

how to tx generalised toothwear with loss of OVD

A

Dentures then composite build-ups

141
Q

how to localised anterior tooth wear with no space

A

DAHL technique

142
Q

DAHL technqiue

A

Method of creating interocclusal space where no existing space for restoration placement in cases of localised wear

143
Q

describe DAHL technqiue

A

Composite build-ups to anteriors (incisor and canine contacts only),
posterior disclusion, 2-3mm OVD increase,
3-6mths to create inter-incisal space - anteriors intrude and posteriors erupt causing posterior occlusion and inter-incisal space when composite removed

144
Q

indications for DAHL technqieu

A

yonger pts
localised wear with loss in OVD

145
Q

contraindications ot DAHL technqieu

A

Bisphosphonates use,
active perio disease,
TMJ problems,
post-ortho,
implants,
existing conventional bridges,
ankylosed teeth

146
Q

adv to DAHL technqieu

A

No prep/LA, relatively simple and atraumatic

147
Q

disadv of DAHL technique

A

Long treatment course, likely to require to be replaced over time

148
Q

extrinsic sources of staining

A

smoking, tannins, chromogenic bacteria, CHX, iron supplements

149
Q

intrinsic sources of staining

A

fluorosis, amalgam, tetracycline, ageing, porphyria, cystic fibrosis

150
Q

tx options for discoloured teeth

4

A

HPT,
micro-abrasion,
external vital bleaching,
internal non-vital bleaching

veneers - direcr or indirect

151
Q

contituents of bleaching gel

A

Carbamine peroxide,
carbapol,
urea,
surfactant,
potassium nitrate,
fluoride,
pigment dispersers,
preservatives,
flavourings

152
Q

active ingredient in bleaching gel

A

carbmamide peroxide

153
Q

how does carbamide peroxide work

A

breaks down to form hydrogen peroxide and urea.

Hydrogen peroxide breaks down to form water and oxygen and forms free radical - hydroxyl

154
Q

max concentration of carbamide peroxide

A

16.7% (6% H2O2)

155
Q

risks of whitening

9

A

sensitivity,
wears off/relapse,
allergy,
does not affect restoration colour,
gingival irritation,
cytotoxicity/mutagenicity,
tooth damage,
might not work,
reduced compliance leads to a reduced effect

156
Q

predictors of sensitivity after whitening

5

A

Pre-exisiting sensitivity,
high concentration of bleaching agent,
frequency of technique change,
bleaching method,
gingival recession

157
Q

describe how discolouration occurs
and how external vital bleachin works

A

Discolouration occurs due to the formation of chemically stable, chromogenic products within the tooth substance.

Whitening causes oxidation through H2O2.
Oxudation leads to the formation of smaller molecules which are often not pigmented and can cause ionic exchange in metallic molecules, leading to a lighter colour

158
Q

indications for external vital bleaching

A

Age-related darkening,
mild fluorosis,
post-smoking cessation,
tetracycline staining

159
Q

methods of external vital bleaching

2

A

Chairside - HPT, dam, bleaching gel applied, heat/light applied, tooth washed, dried, repeated

Home - dentist for HPT, impressions, tray fitting. Trays have 1mm buccal spacer. Patient brushes teeth, loads spacer with bleaching gel, seats tray for 2hrs (usually overnight). Trays should stop 1mm short of gingival margin

160
Q

adv of chairside external vital bleaching

A

ontrolled by dentist,
quick results for patients, can use heat/light

161
Q

adv of home external vital bleaching

A

asy and quick to do, good results, relatively cheap

162
Q

indications for inernal non vital bleaching

3

A

Non-vital tooth, adequate RCT, no Periapical pathology

163
Q

2 contraindications for internal non vital bleaching

A

Heavily restored teeth,
amalgam staining

164
Q

adv of internal non vital bleaching

A

Easy,
conservative,
good patient satisfaction

165
Q

disadv of internal non vital bleaching

A

Doesn’t always work,
external cervical resorption

166
Q

procedures for internal non vital bleaching

A

HPT, dam, remove filling,
remove GP to 2mm below ACJ, RMGIC over GP to seal canal,
dark dentine removed, etch internal surface, place gel,
cotton wool roll, GIC temp.

Repeat weekly for 3-4 weeks then place white GP in pulp chamber and lighter composite shade

167
Q

external cervical resorption in internal nonvital bleacing
what it is and why
prevention

A

Occurs due to diffusion of H2O2 through dentine into perio tissues.

More likely if higher concentration and heat.

Prevent by placing RMGIC over GP to seal canal

168
Q

combination bleaching

A

internal bleaching as normal but no temp restoration.
Bleaching tray with palatal reservoir. Gel in cavity and tray and replaced regularly

169
Q

microabrasion

A

Removal of discolouration limited to outer layer(s) of enamel.
Controlled acid erosion and pumice abrasion

170
Q

indications for microabrasion

A

Mild fluorosis,
post-ortho demin,
demin with staining,
before veneering if dark staining present

171
Q

contraidindications for microabrasion

A

Eroded teeth,
tetracycline/amalgam staining,
primary teeth

172
Q

adv of microabrasion

A

Quick,
easy,
no LT problems

173
Q

disadv of microabrasion

A

Sensitivity,
yellowing dentine shine through,
can only have one course,
only works for superficial staining

174
Q

techniques for microabrasion

A

HPT, dam, sealant. 18% HCl mixed with pumice, applied to teeth. For 5s x10 or 10s x5. Teeth rinsed/washed, dam removed, fluoride prophy polish, FV. Avoid coloured foods for 7 days post-R

175
Q

factors to consider before implants

A

systemic medical history - bisphophonates, immunosuppression, poorly controlled diabetes, scleroderma
Smoking status,
bone quality, bone quantity,
OH - caries rate, poor perio status
patient motivation,
occlusion,
aesthetics

176
Q

bone dimesntions needed for implants
best way to mesaure this

A

1.5mm horizontal bone around impact,
3mm between implants,
>5mm space for papilla between bone crest and contact point,
7mm height of bone,
at least 2mm from important structures (IAN, sinus, etc.)

CBCT

177
Q

alt to implants

A

do nothing and accpet gap
RPD
bridge

178
Q

possible grafts

A

Autograft - own tissue
allograft - diff human tissue
xenograft - diff species tissue
allopastic - artficial tissue

179
Q

implnat av intergation time

A

Mandible - 3mths
Maxilla - 4-6mths

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