Toothwear part 2

Question 1

What are 5 modifying factors of progression of attrition?

Answer 1

• Lack of posterior teeth
• Occlusion - deep overbite
• Restorations - natural teeth opposed by restorations
• Erosion and abrasion
• Stress and anxiety

Question 2

What are 5 common features of bruxism

Answer 2

• wear throughout the dentition
• rapid progression of toothwear
• patient in early adulthood
• repeated failure of restorations
• root fractures

Question 3

How does lack of posterior support affect toothwear?

Answer 3

more extensive and rapid progression of toothwear

Question 4

What common features of the occlusion increase the risk of toothwear?

Answer 4

• Deep overbite - lower incisors affected
• Edge to Edge occlusion - localised wear

Question 5

What common features relating to restorations can make wear worse?

Answer 5

• Natural teeth opposed by restorations
• mainly porcelain

Question 6

What are 4 modifying factors of erosion?

Answer 6

• Life style
• Amount and frequency of acid attacks
• Level of control
• Psychosocial

Question 7

What are 5 extrinsic causes of erosion?

Answer 7

• Carbonated drinks
• Sport drinks
• Citrus drinks
• Acidic fruits and sweets
• Drugs - methamphetamine
• Pickles

Question 8

What are 3 intrinsic causes of erosion?

Answer 8

• Eating disorders
• GORD
• Diabetes

Question 9

What are 4 common features of carbonated drinks erosion?

Answer 9

• incisal erosion on upper centrals
• Cupping of lower molars
• Palatal erosion on upper incisors
• Tooth sensitivity
• Interproximal and buccal caries (white/brown)

Question 10

What are 4 common features of eating disorders erosion?

Answer 10

• Palatal erosion on upper teeth
• Polished restorations
• Erosion around restorations
• Halitosis
• Sensitivity
• Caries

Question 11

What is the main factor to control in abrasion?

Answer 11

Abrasive behaviours change

Question 12

3 examples of abrasive behaviours?

Answer 12

• tooth brushing
• oral self-harm
• tongue studs

Question 13

5 common preventive advice for patients with erosion?

Answer 13

• Fluoride
• Diet modifications
• Remineralisation using tooth mousse
• Sugar free gum

Question 14

3 reasons why to avoid complete dentures in brixusm?

Answer 14

• Lead to fractured dentures
• Ridge resorption
• Pain and ulceration

Question 15

3 removable prosthodontics can be used in toothwear?

Answer 15

• Overdentures
• Transitional dentures
• Metal based dentures

Question 16

What is rehabilitation?

Answer 16

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

Question 17

What is an overdeture?

Answer 17

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

Question 18

4 advantages of overdentures?

Answer 18

• Correction of occlusion and aesthetics
• Support
• Preservation of ridge form
• Proprioception
• Denture retention

Question 19

In what 3 categories of patients is overdenture useful?

Answer 19

• MRONJ and radiotherapy patients
• Elderly patients
• Patients transitioning to edentulism

Question 20

4 disadvantages of overdentures?

Answer 20

• Need for good oral health
• Increased caries and periodontal problems
• Discomfort and infection
• may lead to traumatic extractions

Question 21

How can you minimise the disadvantages of overdentures?

Answer 21

• OHI
• Denture hygiene instructions
• Regular examinations and radiographs
• Fluoride toothpaste application to roots

Question 22

In what cases can a transitional (temporary) denture be indicated?

Answer 22

To increase OVD in cases where poor posterior support to create space for restorations

Question 23

What dentures would be suitable for bruxists?

Answer 23

• Metal based dentures with CoCr backing
• Overlay denture (splint) - protect remaining teeth
• need wax trial first

Question 24

2 ways to make a denture more retentive and better resistant to fracture in bruxist patients for an upper denture?

Answer 24

• Metal palate with acrylic post dam

Question 25

In what case might simplifying small saddles be indicated?

Answer 25

Bruxists

Question 26

Give an example of simplifying small saddles?

Answer 26

Using of bridgework with partial dentures

Question 27

What does conforming mean in dentistry?

Answer 27

• Making prosthesis that do not alter the current occlusion
• mostly in stable occlusion with sufficient index teeth

Question 28

Why is tooth preparation in toothwear very difficult? (3)

Answer 28

• Lack of occlusogingival height
• Lack of occlusal space
• Severely compromised tooth

Question 29

What material to use on biting surfaces for bruxists?

Answer 29

Metal

Question 30

Ways to enhance resistance and retention of indirect restorations?

Answer 30

• Grooves
• Slots
• Parallel preparations
• Ferrule
• chamfer and shoulder finish
• Nayyar core

Question 31

What bur will you use to cut porcelain?

Answer 31

Coarse diamond

Question 32

What bur will you use to cut metal?

Answer 32

Gold cutting bur

Question 33

2 ways to remove a post?

Answer 33

Masseran kit
Ultrasonics

Question 34

Failure rate of gold restorations? at 10 years

Answer 34

25% at 10 years

Question 35

What porotocol would you use for telling a patient bad news?

Answer 35

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