Restorative Flashcards
Toothache - pt on warfarin - why we may not be able to do anything today?
Avoid jargon
- take history
- identify needs XLA
- ask about INR, when was it last done? Ideally within 24hrs
- ask to see INR book
If INR greater than 4 in 24hrs then no
if stable values consistently for 3 months, and within 72hrs then ok
Options
- extirpate and analgesia
What do we cement in using NX3 nexus
Fibre post
Veneer
Composite inlay / onlay
Porcelain inlay
What cement in using aquacem GIC?
MCC
Cast metal post
Zirconia crown
Gold restoration
What are stages of treatment planning and some tx in them?
Immediate
- pain, pericoronitis, abscess etc
- XLA hopeless teeth if replaced by crown and bridge later
Initial
- stabilise OH
- pmpr, OHI, diet advice, smoking and alcohol cessation
- fillings
Re-evaluation
- perio evaluation
Reconstructive
- crown and bridge, denture construction, XLA of hopeless teeth for immediate dentures
Methods of bleaching / whitening?
Non vital internal bleaching
Vital in house bleaching
Vital at home bleaching
Risks of bleaching
Tooth bleaches but fillings dont
Post operative sensitivity
- usually resolved over 2-3 days
- worse with pre-existing sensitivity
Possible gingival irritation due to the H202
External cervical resorption
Failure to bleach
Relapse from smoking / tea / coffee
Process of at home bleaching?
Alginate impressions and vacuum formed retainer made with buccal spacer
Stopped 1mm short of gingival margin to prevent irritation
1mm dot placed buccal and retainer inserted overnight
Technique for internal bleaching?
Shade, dam, remove filling in access cavity
Seal gp with vitrebond
Remove dark dentine
Etch internal surface with phosphoric acid
Place carbamide peroxide gel topped with cotton wool and seal with gic
Repeat weekly until shade desired has been reached
Contraindications to tooth whitening?
- acatalesemia
- glucose 6 phosphate dehydrogenase deficiency
