Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Restorative > Toothwear > Flashcards

Toothwear Flashcards

1
Q

What is the aetiology of non-carious tooth surface loss?

A

Trauma
Developmental Problems
Tooth wear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does tooth wear count as pathological?

A

If the remaining tooth structure or pulpal health is compromised or the rate of tooth wear is in excess of what would be expected for that age
It can also be considered pathological if the patient experiences a masticatory or aesthetic deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 types of tooth wear?

A

Attrition
Abrasion
Erosion
Abfraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Attrition?

A

The physiological wearing away of tooth structure as a result of tooth to tooth contact
Attritive lesions are found on the occlusal and incisal contacting surfaces
Almost always related to a parafunctional habit (bruxism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Abrasion?

A

The physical wear of tooth substance through an abnormal mechanical process independent of occlusion. It involves a foreign object or substance repeatedly contacting the area
Commonest area is labial/buccal, cervical on canine and premolar teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the commonest cause of abrasion?

A

Tooth brushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Erosion?

A

The loss of tooth surface by a chemical process that does not involve bacterial action
Caused by chronic exposure of dental hard tissue to acidic substances which can be extrinsic or intrinsic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the characteristic feature of erosion?

A

Cupping of the occlusal surfaces of the molars and incisal edges of the anteriors
Typically bilateral
More common on the upper anteriors- lower incisors influx of saliva from the sublingual gland
Increased translucency of incisal edges (appear dark)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Abfraction?

A

The loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth
Caused by biomechanical loading forces
Forces result in flexure and failure of the enamel and dentine at a location away from the loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 theories of abfraction tooth wear?

A

Abfraction is the basic cause of all non-carious cervical lesions
Multifactorial aetiology. A combination of occlusal stress, abrasion and erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the aetiology of cervical wear?

A

Multifactorial
Lesions mainly in premolar and molars on the buccal surface almost never lingually
Good OH and this wear pattern go together
Likely to be combination of erosion, abrasion and abfraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What features of medical history can contribute to tooth wear?

A

Medications with low pH
Medications which dry the mouth
Eating disorders
Alcoholism
Heartburn
GORD
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What features of social history would you investigate in tooth wear?

A

Lifestyle stresses e.g. Bruxism
Occupational details
Alcohol consumption
Dietary analysis
Habits
Sports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What features of past dental history would you investigate in tooth wear?

A

Previous patient attendance, regular or not
A non-regular poorly motivated patient is not a good candidate for complex treatment
Previous experience of treatment
Oral hygiene habit
-poor oral hygiene
-toothbrushing in abrasive wear- frequency, intensity, duration, type of toothpaste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What about the occlusion should you investigate when examining a tooth wear patient?

A

FWS should be assessed
Record the OVD and resting face height
Record overbite and overjet
Are there stable contacts in centric occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What about the wear should you examine?

A

Location
-anterior/posterior
-generalised/localised
Severity
-enamel only
-into dentine
-severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a BEWE?

A

Basic Erosive Wear Examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the scores and criteria of a BEWE?

A

0- No erosive wear
1- Initial loss of surface texture
2- Distinct defect; hard tissue loss <50% of surface
3-Hard tissue loss >50% of the surface area

Works like a BPE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the immediate treatment of a patient with tooth wear?

A

Deal with pain
Sensitivity
-desensitising agents, fluorides, GIC coverage of exposed dentine
Pulp extirpation
-if wear has compromised pulpal health
Smooth sharp edges
-prevent trauma to cheeks and tongue
Extraction
TMJ pain
-important in attrition, acute symptoms need to be controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the initial treatment of a patient with tooth wear?

A

Stabilise the existing dentition
Deal with caries and perio
Institute preventative regime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the risk levels in a BEWE?

A

None - less than or equal to 2
Low - between 3 and 8
Medium - between 9-13
High - 14 and over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name 2 index’s used for tooth wear.

A

Smith and Knight
BEWE

23
Q

How can you prevent Abrasion?

A

Remove the ‘foreign object or substance’ involved in causing the abrasive wear
Change toothpaste
Alter tooth brushing habits
Change habits

24
Q

How can you prevent Attrition?

A

Splints
-wear away instead of the tooth
-work as they are softer than teeth
-cause no damage to opposing teeth
-habit breaker
-can be soft splints or hard splints

25
Q

How can you prevent Erosion?

A

Fluoride (toothpaste, mouthwash, fluoride varnish)
Desensitising agents
-not prevention, more symptomatic relief

26
Q

How can you prevent erosion through dietary habits?

A

Habit changing
-swilling drinks around the mouth
-drinking from cans- use a straw
-rumination
-sports drinks/gels

27
Q

How can you prevent erosion through medical changes?

A

Control gastric acid
-GORD
-Reflux
-Hiatus hernia
Xerostomia
Anorexia and bulimia

28
Q

How can you prevent abfraction?

A

If it exists
Assess occlusion on teeth with abfraction lesions
Fill cavities with low modulus restorative materials

29
Q

For maxillary anterior tooth wear, what is the decision on treatment and restoration dependent on?

A

The pattern of anterior maxillary tooth wear
Inter-occlusal space
Space require for the restorations being planned
Quality and quantity of remaining tooth tissue, particularly enamel
The aesthetic demands of the patient

30
Q

What is the pattern of maxillary incisor wear categories?

A

Tooth wear limited to the palatal surfaces only
Tooth wear involving the palatal and incisal edges with reduced clinical crown height
Tooth wear limited to labial surfaces

31
Q

How does the bone adjust to tooth wear?

A

Dento-alveolar compensation
Increased bone growth
This maintains masticatory efficiency and this is a good thing but leaves no space for restorations to be placed

32
Q

What is the DAHL technique?

A

Method of gaining space in cases of localised toothwear
Most commonly used for localised anterior tooth wear

33
Q

What is involved in the DAHL technique?

A

Increasing the OVD by 2-3mm to have room for restorations on teeth affected by tooth wear so that there is no need
Usually an RPD that is used for posterior disclusion and creating space between upper and lower anteriors

34
Q

When is the DAHL technique not suitable?

A

Active periodontal disease
TMJ problems
Post orthodontics
Bisphosphonate therapy
If dental implants are present
If existing conventional bridges

35
Q

What methods are there of composite build ups?

A

Alginate impressions
Wax up
Putty matrix

36
Q

What are the 3 categories of localised tooth wear?

A

Excessive wear with loss of OVD
Excessive wear without loss of OVD but with available space
Excessive wear without loss of OVD but with no space available

37
Q

List 3 modifying factors of tooth wear.

A

Lack of posterior teeth- wear on remaining teeth is higher so increases progression
Occlusion (e.g. deep overbite, certain teeth take more load and modified progression)
Stress & anxiety
Restorations
Parafunctional habits- e.g. bruxism

38
Q

List 5 extrinsic contributors to erosion.

A

Carbonated drinks
Sports drinks
Alcoholic acidic drinks
Citrus drinks
Acidic fruits
Pickles
Drug abuse

39
Q

List 3 intrinsic contributors to erosion.

A

Eating disorders (bulimia)
GORD
Uncontrolled diabetes

40
Q

What are some common features of erosion due to carbonated drink intake?

A

Incisal erosion on upper centrals (can or bottle directly goes onto these teeth)
Cupping on lower molars
Palatal erosion on upper incisors
Sensitivity
Interproximal caries and buccal white spot/brown spot caries

41
Q

What are some common features of erosion due to an eating disorder?

A

Palatal erosion on upper teeth
Polished restorations
Erosion around restorations
Sensitivity
Caries
Altered taste
halitosis
Soft tissue changes

42
Q

What common preventative advice can you give to someone with erosion tooth wear?

A

Fluoride use- high dose toothpaste
Alcohol free fluoride mouthwash
Dietary modification
-frequency & quantity
-method of delivery (glass, straw, bottle, can)
-elimination & addition

43
Q

What is a ferrule?
Why is this important?

A

Amount of sound tooth structure that is left supragingivally (retained coronal dentine)
Decreases the risk of tooth fracture and the overall prognosis of the tooth

44
Q

What should you try to avoid in bruxist patients?

A

Complete dentures
Bruxism does not stop- fracture dentures easily, ridge resorption, pain & ulceration under complete denture

45
Q

What is an overdenture?

A

Any removable prosthesis that rests on one or more remaining natural teeth, the roots of natural teeth and/or dental implants

46
Q

What are the advantages of overdentures?

A

Correction of occlusion and aesthetics
Support
Tooth wear management
Preservation of ridge form
Proprioception
Denture retention
Can be used with precision attachments
MRONJ & radiotherapy patients- avoid extraction
Eases transition to edentulism

47
Q

What are the disadvantages of overdentures?

A

Need good oral hygiene
Increased caries/periodontal problems
Denture fracture
Discomfort/infection around the roots
Medical History

48
Q

What is conforming to a patients occlusion?

A

Prosthesis/ restoration does not alter the occlusion
Works best in a stable occlusion with sufficient index teeth
Patient’s OVD remains the same

49
Q

What is changing (rehabilitation) of a patients occlusion?

A

When occlusion is unstable and there is a lack of index teeth you would change a patients OVD to adjust this accordingly

50
Q

What is dental demolition in tooth wear?

A

Demolition of restorations
Very common
Heavily restored teeth
Previous failure= less tooth substance
High occlusal loads

51
Q

How do you remove a fractured post?

A

Masseran kit or ultrasonic to go around the side of the post

52
Q

What is a failing dentition?

A

A dentition where deterioriating teeth, restorations or oral health or a combination of issues means that a loss of basic oral functions such as mastication and acceptable aesthetics is inevitable if untreated

53
Q

What is the Protocol for giving bad news? (SPIKES)

A

Set up the interview: Mental and Physical preparation
Perception: assess what the patient knows about the medical situation
Invitation: ask how much they want to know
Knowledge: give the medical facts
Emotion: respond to patients emotions
Strategy and summary: negotiate a concrete follow-up step

Restorative (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions