Toothwear and Indirect Restorations Flashcards
What indirect restoration should be your first preference?
Adhesive minimially-invasive prosthesis first (adhesive bridge)
What is the rule of thumb when assessing a tooth for restoration?
Fixed restorations usually possible if 50% of the tooth structure is remaining above the gingival margin.
In what ways do toothwear patients pose a challenge to fixed prosthodontics?
Lack of occluso-gingival height
Lack of occlusal space
Typically severely compromised teeth
What modfications can you make to create retention and resistance form for indirect restorations?
Materials
Grooves
Inlays
Ferrule
Parallel preps
Margins & occluding surfaces
Cores
Electrosurgery
Surgical Crown lengthening
What is the benefit of using metal on biting surfaces in toothwear cases?
More ductile, so more forgiving
Less prone to fracture
Can be less abrasive than some porcelains
Thinner material for same or higher strength
What is the benefit of utilising inlay preps or placing grooves for indirect restorations?
Maximise retention/resistance form
Enhance resistance form by reduction in radius of rotation, place inlays & grooves in long axis of tooth
How does a ferrule provide resistance?
Enhances the restance form by sharing the lateral forces across both core and dentine.
If there is no coronal dentine above the prep, all the force will be transfered to the core and post, risking fracture.
What are the ideal dimensions of a ferrule?
Minimum 2mm tall
1mm or greater thickness
Should be at least 3/4 dentine
What steps can you take to ensure accuacy of impressions regarding the gingiva for indirect restorations?
Astringant
LA for vasoconstriction
Electrosurgery/gingivoplasty
What options are there when there is such little tooth material, but there is still a need to crown the tooth?
Surgical crown lengthening
How long does it take for the gingival margin to stabilise after surgical crown lengthening?
3 months
