Restorative Dentistry Flashcards
What are the indications for the replacement of missing teeth?
To Masticatory efficiency Improve speech Preserve or improve health of oral cavity Prevent unwanted tooth movement vertical rotational tipping drifting Improve distribution of occlusal loads Space maintenance Restore aesthetics Prepare pt for complete denture
How are resin bonded bridges classified?
Position; anterior or posterior
Retention.: macromechanical; micromechanical or chemical
What are the different types of retention?
Macro mechanical
Micro mechanical
Chemical
What are the advantages of resin bonded bridges?
Less expensive than conventional bridge or cobalt chromium partial denture or implant in the shorter arm
Minimal or no tooth prep required
No LA required as prep is in enamel
Potential for rebond if debond occurs
What are the disadvantages of resin bonded bridges?
Tendency to debond
Especially if planning/preparation/placement technique poor
Creation of a natural emergence profile can be challenging especially in very resorbed ridges. Use of an ovate pontic can be helpful
What are the indications for using resin bonded bridges?
Short span
Single tooth edentulous space
Sound abutment teeth or only minimal restoration
Sufficient heat to ensure sufficient surface area for acid etch bonding
Favourable occlusion
What design is used for reían bonded bridges?
Cantilever
Why is a cantilever design used for resin bonded bridges?
If a fixed fixed design is used and there is a debond of one retainer, caries can develop quickly and undetected under this retainer
When may a fixed fixed resin bonded bridge be indicated?
If periodontal splinting is required or retention required following orthodontics
What are the guidelines for preparing a RBB?
Single path of insertion
Provide near parallel guiding planes
Eliminating undercuts which allows coverage of maximal surface area for bonding
Provide space in occlusion to accommodate bridge
What is the prevalence of CLP?
1:700
What is the prevalence of CP?
1:2000
What is the percentage presence of family history in CLP cases?
40
What is the percentage presence of family history in CP cases?
20
How is CLP classified?
Primary or secondary palate
Complete or incomplete
Bilateral or unilateral
How does submucous cleft of the palate present?
Overlying mucosa is intact
Poor speech
Diagnosis often missed as only noticed when speech begins
What is the management of unilateral complete CLP?
At birth
Prenatally/birth: reassurance, explanation, feeding obturator
What is the management of unilateral complete CLP?
At 3- 6 months of age
Lip closure
Delaire or millard & or modifications Eg vomer flap are the most popular
Bilateral lip can be closed in 1 or 2 ops
What is the management of unilateral complete CLP?
9 - 12 months
Palatal closure
When is lip closure completed?
3 - 6 months
When is palatal closure completed?
9 - 12 months
How is lip closure completed?
Delaire or millard
Vomer flap
How is palatal closure completed?
Delaire or Von Lamgenbeck
Why may repair (of cleft palate) be deferred until pt is older?
Decreased growth disturbance
Speech development is adversely affected
What are the clinical signs of chronic periodontitis?
Gingival inflammation Bleeding Pocketing Gingival recession Tooth mobility Tooth migration Discomfort Halitosis
What are the clinical signs of gingivitis?
Classic triad of redness, swelling, bleeding on gentle probing are diagnostic
Usually associated with c/o bleeding on brushing
How is the clinical appearance of gingiva in health described
Knife edge margin
Stippled appearance
How is the clinical appearance of gingivitis described
Rounded shiny appearance
Is gingivitis associated with bone loss?
No
Can probing depth > 3mm occur in gingivitis? Explain how these probing depths occur
Yes probing depth > 3mm occur in gingivitis if its chronic
Increase in gingival size
What are two reasons for increase in gingival size in gingivitis? (false pockets)
Oedema
Hyperplasia
How is the severity of clinical attachement loss classified ?
Mild 1-2 mm CAL
Moderate 3-4mm CAL
severe > 5mm CAL
What % of sites which bleed will go on to lose attachement?
30%
What is the aim of obturation ?
Provide a 3D hermetic seal to the root canal
What is meant by hermetic seal in endodontics?
A restoration that
Prevents reinfection of root canal
Prevent the ingress of bacteria or tissue fluid which might act as a culture medium for any bacteria that remain in the RCT
Incarcerate any microbes left in RCT
What is meant by ‘favourable’ outcome?
Symptom free
Functional tooth
Clinically healthy tissues
Radiographic evidence of healthy Periapicsl tissues or healing by scar tissue formation
What is Reiter’s syndrome?
Reactive arthritis
What is the causative agent of Reiter’s syndrome?
Unknown
What are the symptoms of reactive arthritis?
Urethritis
Arthritis
Conjunctivitis
Oral ulcers or erosiona
Who is mainly affected by reactive arthritis?
Young males
What is the serology of Reiter’s syndrome?
Leucocytosis
Increased ESR
HLA B27 in 80% of patients
