Toothwear part 2 Flashcards
What are 5 modifying factors of progression of attrition?
- Lack of posterior teeth
- Occlusion - deep overbite
- Restorations - natural teeth opposed by restorations
- Erosion and abrasion
- Stress and anxiety
What are 5 common features of bruxism
- wear throughout the dentition
- rapid progression of toothwear
- patient in early adulthood
- repeated failure of restorations
- root fractures
How does lack of posterior support affect toothwear?
more extensive and rapid progression of toothwear
What common features of the occlusion increase the risk of toothwear?
- Deep overbite - lower incisors affected
- Edge to Edge occlusion - localised wear
What common features relating to restorations can make wear worse?
- Natural teeth opposed by restorations
- mainly porcelain
What are 4 modifying factors of erosion?
- Life style
- Amount and frequency of acid attacks
- Level of control
- Psychosocial
What are 5 extrinsic causes of erosion?
- Carbonated drinks
- Sport drinks
- Citrus drinks
- Acidic fruits and sweets
- Drugs - methamphetamine
- Pickles
What are 3 intrinsic causes of erosion?
- Eating disorders
- GORD
- Diabetes
What are 4 common features of carbonated drinks erosion?
- incisal erosion on upper centrals
- Cupping of lower molars
- Palatal erosion on upper incisors
- Tooth sensitivity
- Interproximal and buccal caries (white/brown)
What are 4 common features of eating disorders erosion?
- Palatal erosion on upper teeth
- Polished restorations
- Erosion around restorations
- Halitosis
- Sensitivity
- Caries
What is the main factor to control in abrasion?
Abrasive behaviours change
3 examples of abrasive behaviours?
- tooth brushing
- oral self-harm
- tongue studs
5 common preventive advice for patients with erosion?
- Fluoride
- Diet modifications
- Remineralisation using tooth mousse
- Sugar free gum
3 reasons why to avoid complete dentures in brixusm?
- Lead to fractured dentures
- Ridge resorption
- Pain and ulceration
3 removable prosthodontics can be used in toothwear?
- Overdentures
- Transitional dentures
- Metal based dentures
What is rehabilitation?
Using of direct and indirect restorations and prosthesis to improve patient oral health, can be used to manage severe tooth wear and involve increase in the occlusal vertical dimension
What is an overdeture?
Any removable prosthesis that rests on one or more remaining natural teeth, the roots of natural teeth or dental implants
4 advantages of overdentures?
- Correction of occlusion and aesthetics
- Support
- Preservation of ridge form
- Proprioception
- Denture retention
In what 3 categories of patients is overdenture useful?
- MRONJ and radiotherapy patients
- Elderly patients
- Patients transitioning to edentulism
4 disadvantages of overdentures?
- Need for good oral health
- Increased caries and periodontal problems
- Discomfort and infection
- may lead to traumatic extractions
How can you minimise the disadvantages of overdentures?
- OHI
- Denture hygiene instructions
- Regular examinations and radiographs
- Fluoride toothpaste application to roots
In what cases can a transitional (temporary) denture be indicated?
To increase OVD in cases where poor posterior support to create space for restorations
What dentures would be suitable for bruxists?
- Metal based dentures with CoCr backing
- Overlay denture (splint) - protect remaining teeth
- need wax trial first
2 ways to make a denture more retentive and better resistant to fracture in bruxist patients for an upper denture?
- Metal palate with acrylic post dam
In what case might simplifying small saddles be indicated?
Bruxists
Give an example of simplifying small saddles?
Using of bridgework with partial dentures
What does conforming mean in dentistry?
- Making prosthesis that do not alter the current occlusion
- mostly in stable occlusion with sufficient index teeth
Why is tooth preparation in toothwear very difficult? (3)
- Lack of occlusogingival height
- Lack of occlusal space
- Severely compromised tooth
What material to use on biting surfaces for bruxists?
Metal
Ways to enhance resistance and retention of indirect restorations?
- Grooves
- Slots
- Parallel preparations
- Ferrule
- chamfer and shoulder finish
- Nayyar core
What bur will you use to cut porcelain?
Coarse diamond
What bur will you use to cut metal?
Gold cutting bur
2 ways to remove a post?
Masseran kit
Ultrasonics
Failure rate of gold restorations? at 10 years
25% at 10 years
What porotocol would you use for telling a patient bad news?
Set up the interview
Perception - assess pt awareness
Invitation - ask how much they want to know
Knowledge - give medical facts
Emotion - respond to patient emotions
Strategy and summary - discuss follow up step
