Tooth Supported Fixed Dental Prosthesis

Question 1

What is horizontal tooth mobility depended on?

Answer 1

1. Height of the alveolar bone
2. Width of the periodontal ligament
3. Shape and number of roots
4. Age
5. Sex
6. Time of day
7. Force (Initial vs. secondary tooth mobility)

Question 2

What is the purpose of measuring mobility during a periodontal charting?

Answer 2

• Check disease progression
• Find the cause.
• Tooth prognosis and treatment planning

Question 3

What are the grades of tooth mobility? Do they distinguish between physiologic and pathologic mobility?

Miller’s classification

Answer 3

Miller’s classification

• 0: Physiologic tooth mobility of up to 0.25mm.
• 1: Increased tooth mobility <1mm in the horizontal direction.
• 2: Increased tooth mobility >1 mm in the horizontal direction
• 3: Mobility both in the horizontal and vertical directions.

It may distinguish between pathologic and physiologic condition, but not always

Question 4

Why is there a distinction between increased and increasing mobility?

Answer 4

• Increased tooth mobility: The cause of the mobility does not exist anymore
• Increasing tooth mobility: A pathologic condition is going on

Question 5

What might happen to a tooth if a restoration is creating occlusal interferences, in a non-periodontitis patient? Is this reversible? What might be different if the same occurs in a treated periodontitis patient who is under maintenance?

Answer 5

Trauma from occlusion

1. No pocket formation
2. Occasionally, bone loss, resorption (horizontally directed forces)
3. Widening of PDL
4. Increased mobility
5. No difference in the case of periodontitis history

Question 6

When is teeth splinting recommended?

Answer 6

1. Disturbed function
2. Disturbed comfort
3. Hypermobile teeth - mechanical disruption of remaining PDL
4. Tooth replacement
5. Stabilization after orthodontic movement/correction

Question 7

You treat a fractured tooth in a non-periodontitis patient with a metal-ceramic crown. In a month the patient presents with increased horizontal mobility. You also observe generalized gingivitis and lack of proper oral hygiene, but the patient is not diagnosed with periodontitis.

Do you expect to have a periodontal problem surrounding this specific tooth? Increased PPD?

Answer 7

• Trauma from occlusion.
• Complication due to bad hygiene.
• Too short (1 month) to PPD formation

Question 8

You treat a fractured tooth in a non-periodontitis patient with a metal-ceramic crown. In a month the patient presents with increased horizontal mobility. You also observe generalized gingivitis and lack of proper oral hygiene, but the patient is not diagnosed with periodontitis.

Do you expect to observe a difference in a periapical radiograph of the area comparing to the initial situation, and if yes what might that be?

Answer 8

Widening of the PDL

Question 9

You treat a fractured tooth in a non-periodontitis patient with a metal-ceramic crown. In a month the patient presents with increased horizontal mobility. You also observe generalized gingivitis and lack of proper oral hygiene, but the patient is not diagnosed with periodontitis.

What would be the possible diagnosis and proposed treatment? What would be the expected result of treatment?

Answer 9

• Trauma from occlusion->Occlusal adjustment
• Gingivitis-> Oral hygiene instructions ev. scaling