Tooth wear part 2.3 Flashcards
Before carrying any dental demolition what is it important to consider
Be clear on benefits: Health, appearance or both
Be clear on risks: Health, appearance or both
Clarity & honesty about longevity and cycles of replacement
Adequate dental health risk assessment
Can you achieve health & aesthetic objectives
Balance risks v benefits
Appropriate information provision
Valid consent
Learn to say “no”; learn to refer; or treat
What do you assess for ease of demolition
Assess the crown and under it with radiographs
Is there any caries? Is it a sound core?
What is the basic technique for removing indirect restorations
Porcelain cutting – Coarse diamond
Metal cutting – Gold cutting bur
Whole way up buccal surface use chisel
Remember operator & patient safety
High volume suction – porcelain fragments
If buccal surface doesnt work may have to cut onto occlusal or palatal surface
May need to section horizontally
Sectioning abutment teeth and making 2 seperate crowns may make it easier
If re-RCT what is good at getting rid of GP
Eucalyptus/turpentine oil
If removing posts what must you consider before hand
Case assessment critical
Risk of fracture
Ease of removal
(Length/taper/surface)
Contingency plan for fracture
Other pathology with tooth
How would you remove a fractures post
Either refer or
-use ultrasonic around side of the posts
-use maseran kit
What is meant by a failing dentition
A dentiton where deteriorating teeth, restorations or oral health or a combo of issues means a loss of adequate basic oral functions such as mastication and acceptable aesthetics is inevitable if untreated
What are the keys to success when managing dental failure
Comprehensive history and examination (Information gathering)
Thorough planning
Seek advice if needed
Prevention
Avoid overambitious treatment
Effective communication
Decision-making and treatment planning around basic principles
Keep plans simple
Have an effective maintenance strategy and regularly reassess the situation
What is meant by herodontics
The use of minimally invasive adhesive dentistry to restore or maintain the functions or aesthetics, sometimes provisionally, of a questionable and compromised tooth/dentition
What is meant by superherodontics
The concept of attempting overambitious high failure risk, often invasive and complex, restorative treatment to restore a questionable and compromised tooth/dentition
What is a good way to breaking bad news to a Pt
SPIKES
Set up the interview, mental and physical preparation
Perception, assess what the pt knows about the situation
Invitation, ask hiw much they want to know
Knowledge, give the emdical facts
Emotion, respond to patients emotions
Strategy and summary, negotiate a concrete follow up step
