Treatment Planning

Question 1

How treatment plan for simple restoration?

Answer 1

Know occlusion prior restoration - ICP contact/ RCP contact, is tooth involved in guidance
Most situation want replicated

Question 2

When may want to change occlusion for simple restoration?

Answer 2

Avoid excursion restored cusp
Change ICP/RCP contact away from restoration-tooth interface
Reintroduce canine guidance
Remove non-working side interference

Question 3

When canine guidance lost?

Answer 3

Usually result of tooth wear - guidance transfer posterior

Question 4

How restore canine guidance?

Answer 4

If just restore TSL likely lead restoration failure

Need maintain ICP contact on canine - then restore so only tooth involve working side excursion

Question 5

When is re-organised approach taken when providing indirect restorations?

Answer 5

If multiple units
Want to incase OVD
Full mouth rehab

Question 6

When may find issue with providing indirect restoration - what scenario?

Answer 6

Restoring last tooth in the arch

Question 7

Why is restoring last tooth in arch an issue?

Answer 7

When prepare tooth - space lost

Want maintain ICP contact following prep w/ occlusal stop

Question 8

What is done with occlusal stop at the lab?

Answer 8

Removed by technician when fabricating the crown - this is then removed prior fit
Prevent loss of space

Question 9

What does facebow allow the correct positioning of?

Answer 9

The UPPER model - records condyle movement related maxillary teeth
Lower model mounted to upper using interocclusal record

Question 10

What to assess if doing simple confirmative case?

Answer 10

Assess contact ICP
Assess RCP contact
Assess guidance in excursions

Question 11

What assess during prep for simple com formative indirect prep?

Answer 11

Sufficient space restorative material

Question 12

What assess during fit for simple com formative indirect prep?

Answer 12

Check ICP, RCP and excursions - adjust if needed

Question 13

When is a confirmative indirect restoration case complex?

Answer 13

If have 3+ units

If unit is guiding tooth

Question 14

What to do if doing complex confirmative indirect case?

Answer 14

Full occlusal analysis

Facebow - cast articulated and analyse

Question 15

What ideal features of tooth involved in guidance?

Answer 15

Suitable root structure

Enough remaining tooth structure

Question 16

Ideal features of occlusion on bridge work?

Answer 16

Light contact in ICP on Pontic
Contact in ICP on abutment
AVOID GUIDANCE ON PONTIC

Question 17

What materials are good to use if tooth in guidance?

Answer 17

Gold

Question 18

If using PFM what consider?

Answer 18

Metal on guiding surface

Question 19

What can do if want to replicate guidance form current teeth?

Answer 19

Customised incisal guidance table

Question 20

What is a customised incisal guidance table?

Answer 20

Allows replicate guidance w/ minimal adjustment

Question 21

How to use customised incisal guidance table?

Answer 21

Take imp upper arch when happy with guidance 
Mount model articulator usingg facebow
Ask technician construct customised incisal guidance table 
Prepare teeth
Working imp
Construct provisional 
Lab construct using guidance table 
Fit definitive

Question 22

What occlusion aiming for if re-organising?

Answer 22

Ideal

ICP=RCP
Forces via long axis of teeth
Lateral excursion - canine guidance w/ no NWS contact
Protrusion - anterior teeth w/ posterior disocclusion
Mutual protection