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BDS 3 CDS > Restorative > Flashcards

Restorative Flashcards

1
Q

what are the indications for crowns

A

improve aesthetics, improve OVD, improve occlusion and function, support reduced tooth tissue, support or retention for RPD or bridgework

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2
Q

what are the contra-indications for crowns

A

extensive caries and periodontal disease, fracture, when more conservative options are available

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3
Q

what are the principles of crown prep

A

preserve tooth tissue, structural durability, marginal integrity, preserve periodontal tissue, improve aesthetics

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4
Q

what are the crown prep measurements for a metal only crown

A

axial - 0.5mm, functional cusp - 1.5mm, non-functional cusp - 0.5mm, margin - chamfer, 0.5mm

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5
Q

what are the crown prep measurements for a metal ceramic crown

A

if metal only - 0.4mm, if ceramic as well - 0.9mm - 1.3mm

margin - 1.3mm or 0.5mm, chamfer non aesthetic, shoulder for aesthetic. functional cusp - 1.8mm

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6
Q

what types of crowns are there

A

metal only - gold, metal ceramic crown - metal and porcelain, porcelain jacket - zirconia underneath supporting porcelain, porcelain only

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7
Q

why do functional cusps need more prep

A

under more force, need more material so its stronger, thicker material - more prep

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8
Q

name 3 types of preformed crowns

A

polycarbonate, clear plastic, stainless steel

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9
Q

what are the disadvantages of preformed crowns

A

not an accurate fit, requires a large bank - costly

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10
Q

why is a good provisional crown so crucial

A

if poor margins - not cleansible, cause inflammation and recession - definitive then wont fit, will also make it more difficult to take impressions

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11
Q

what are indications of a successful provisional crown

A

good aesthetics, restore function - OVD, reduces sensitivity, easily cleansed - should be exposed to cleansible, margins at access for finish for dentist and clean for patient, above gingiva margin

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12
Q

what are the indications for a veneer

A

improve aesthetics - shape, colour of teeth
correct peg shaped laterals
reduce or close proximal spaces
improve discolouration

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13
Q

what are the contra-indications for veneers

A

if too extensive a prep is required - should be in enamel for mechanical retention
gingival recession
caries and perio disease

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14
Q

what is the main failure for RCT

A

coronal microleakage - ingress of oral bacteria through coronal seal

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15
Q

how do you decide what to restore RCT with

A

if marginal ridges intact - composite
if intact but discolouration - either composite and bleaching or crown/veneer
if broken down - crown

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16
Q

when is a post-core used

A

for intra-radicular support when insufficient tooth tissue, gives retention and support for restoration

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17
Q

what is the function of a post

A

retain and support core build up, extends from root canal

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18
Q

what is the function of a core

A

retain and support restoration, what prosthesis is fixed to

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19
Q

what is a post and core made of

A

post - metal, gold - ceramic, zirconia - fibre, glass

core - composite, amalgam, GI

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20
Q

what is a ferrule

A

a dentinal collar, 1-2mm in vertical axis, circumferentially around cervical aspect of tooth. crown needs to bond on to tooth surface. if no ferrule, increased rate of fracture

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21
Q

what are guidelines for post and core

A

should have ferrule, post should be tapered at 6 degrees, non-threaded and cemented, should be 3-5mm of GP left apically

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22
Q

give 3 examples of post

A

smooth tapered, smooth parallel, threaded tapered, threaded parallel

23
Q

what structures are in the TMJ

A 
cranial base - temporal
condyle head of mandible
articular disc - with superior and inferior articular space
mandibular fossa
articular eminence
24
Q

what are the movements at the TMJ

A

rotation, translation and lateral translation

25
Q

describe the rotation movement of TMJ

A

rotation of condylar head around an imaginary horizontal line - terminal hinge axis. movement fully within fossa, slight opening of 20mm, passive movement, clenching of teeth

26
Q

what is the facebow used for

A

to record the relationship of the maxilla with the terminal hinge axis

27
Q

what is posselts envelope

A

the border movements of the mandible in the sagittal plane

28
Q

what are the positions of posselts envelope

A 
ICP - intercuspal position
E - edge to edge
P - protrusion
T - maximum opening
R - retruded axis position
RCP - retruded contact position
29
Q

what is the mutually protected occlusion and why is it desired

A

canine guidance. desired as prevents excess lateral force on teeth caused by occlusion, unwanted tooth contacts can distort the teeth coming into ICP. no posterior teeth contacts - not subjected to lateral force

30
Q

what is used to record tooth contacts

A

miller forceps and articulating paper - 40 microns thick

31
Q

when do you record tooth contacts

A

before placing a restoration and before removing an old one - want to conform to occlusion
after placing restoration or crown - ensure occlusion is not altered and no heavy contact on restorations

32
Q

what is static occlusion and how is it recorded

A

intercuspal position. lingual cusps of upper molars in contact with lower fossa, buccal cusps of lower molars in contact with upper fossa. recorded by tapping teeth together

33
Q

what are some deviations from ICP

A 
incisor relationship class 2 div 1 - increased overjet
div 2 - increased overbite
anterior open bite
posterior open bite
cross bite
34
Q

what is dynamic occlusion

A

contacts during movement. lateral movement - working side and non-working side contacts. protrusive movement - posterior contacts

35
Q

what is the problem with posterior teeth contacts during lateral or protrusive movements

A

excessive lateral force which teeth are not able to withstand, musculature unable to rest as it should

36
Q

what would you be looking for when record dynamic occlusion

A

any marks on posterior teeth - slide marks, during lateral or protrusive movement

37
Q

what are some pathologies caused by unwanted tooth contacts

A

bruxism - eccentric or centric

38
Q

what is the anterior reference point

A

43mm apically to lateral incisor

39
Q

what different approaches can be used

A

conformative or reorganised

40
Q

what contact is used for designing a reorganised approach

A

first occlusal contact in Retruded arch of closure - RCP

41
Q

why might a reorganised approach be used

A

to increase OVD, when change in aesthetics is desired

42
Q

what is used to ensure casts are mounted accurately

A

facebow and intercuspal registration using either wax or paste

43
Q

what are the different types of discolouration

A

internal - fluorosis, tetracycline, nonvital tooth

external - tannins (coffee, tea, red wine), smoking, chromogenic bacteria

44
Q

explain how external bleaching works

A

hydrogen peroxide oxides high weight molecules to lower weight - less pigmentation

45
Q

what factors affect external bleaching

A

time, tooth surface, temperature, concentration

46
Q

compare at home bleaching with chairside

A

chairside - dentist in control, can ensure no damage to gingiva etc, however takes time and more expensive. faster results but dont last as long
at home - patient needs good written instructions, trusting them, cheaper, takes longer for results but lasts longer, patient can keep guard in over night

47
Q

what are some disadvantages of external bleaching

A

sensitivity, relapse, tooth damage, gingival inflammation, problems with bonding

48
Q

describe internal bleaching

A

can only be done on non-vital teeth, gain access to pulp chamber, remove GP 1mm below ACJ, place RMGI, put hydrogen peroxide in, cotton wool and seal with RMGI. Remove in a day and do it weekly

49
Q

what are the requirements for internal bleaching

A

non-vital tooth, good RCT, no apical pathology

50
Q

what is external cervical resorption and how is it caused

A

odontoclasts breaking down dental hard tissue around cervical junction, caused by H2O2 diffusing through dentinal tubules to periodontal tissues

51
Q

how can internal and external bleaching be combined

A

can prepare tooth for internal, put bleach inside but also provide mouth guard and fill with bleach too, leave access cavity open with bleach in, patient has to keep this in 24 hours or will fill with food

52
Q

when is micro abrasion useful

A

for removal of discolouration caused by demineralisation, brown/yellow stain

53
Q

what are the legal requirements regarding bleachin

A

any hydrogen peroxide over 0.1% can only be sold or prescribed by dental professionals, anything over 6% cannot be sold unless requirement to prevent disease.

BDS 3 CDS (7 decks)

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