Restorative Management of the Compromised Dentition Flashcards
Grinding on its own causes little or no wear. You also need:
Acid.
Loss of posterior suport can increase attrition
True or false
False
What do you need to be cautious of when prescribing a splint for wearing at night?
Does patient have an acid problem? Will pool.
3 endogenous causes of erosion?
- Regurgitation
- Psych issues eg bulimia
- Saliva quality/quantity eg older patients - low buffering
4 exogenous causes of erosion
- Diet and dietary habits
- Medicines causing dry mouth (or more than 5)
- Occupation/recreation
- Dehydration
What is the most important preventive advice for pts with exogenous erosion?
Reduce frequecy of acidic foods and drinks, particularly outside meal times
How long does it take teeth to remineralise?
2 hours
What is the fastest way to manage dentine hypersensitivity?
Apply bond. Will last 6 months. might need to give LA to do it.
What are the three main causes of loss of tooth surface
- Attrition
- Abrasion
- Erosion
List 6 consequences of excess tooth surface loss
- Loss of OVD
- Loss of facial and dental aesthetics
- Pseudo-prognathism
- Loss of masticatory efficiency
- Speech problems
- Tooth sensitivity
- Loss of self esteem
What is the rationale of txing tooth surface loss with composite/amalgam before fixed pros?
- Cost
- Time
- Avoid dentures
- Protection of tooth structure
- Easy to modify
- Interim step before C&B
What sound indicates you are close to having anterior guidance?
S
When you increase the OVD, the increase in facial height will be:
Half of that
Dentate patients have considerable ability to adapt to increased OVD.
True or false
True
What are the five principles of the occlusal scheme to follow:
- Bilateral posterior contact
- Anterior guidance
- Flat occlusal plane
- Inter-arch stability (reduce differential and total wear)
- Intra-arch stability (reduce tooth movement eg gaps)
Most people can function with 5-5 in each arch. What is the main limitation though?
Smiling shows 6-6
What is the leading cause of teeth and cement breaking?
Non-axial forces
How can you adjust teeth to improve axial loading?
- Increase fossa height
- Reduce cusp height
What are the three main points to achieve when establishing occlusal contacts:
- Centric contacts on point or flats - not inclines
- Never have a contact on a margin
- Adjust teeth to reduce cusp angles
What is the second leading cause of teeth breaking after non-axial loading?
Cavity depth
Two tools for increasing retention when increasing OVD:
- Boxes and grooves (amalgam)
- Bonding
What are the two main reasons for loss of restorations within a short time frame
- Not enough tooth structure to bond to
- Haven’t checked occlusion and left it high
What are the two main reasons composite fractures
- Load on tooth too heavy
- Not enough thickness of material