Treatment planning 2 Flashcards
In the stabilisation stage of treatment planning what occurs
- remove unrestorable teeth and teeth with poor prognosis
- help patient clean around teeth better and remove infection and pain
- stabilise active caries lesions
- patient has anterior teeth caries
- gignval diseases seen form gingival margin
- restprae caries cavities with temporary or intermediate restorations
-Provide patient with multiple treatments to address clinical issues they are presenting - establish healthy oral environment
How are patients stabilised in endodontics
- Endodontic treatment carried - abscess /sinus pain
- pain - pulp was exacerbated
- endodontic needs to be completed to prevent curter infection to root canal
- stabilise with intermediate restoration such as crown
- place semi permanenet restoration
how are patients stabilised when extracting teeth
- provisional and immediate dentures
- if patient goes through multiple extractions
- then dentures are considered
- need to provide aesthetic during the healing process
- If 1 or 2 teeth are extracted then can wait for denture for teeth to heal
- if full clearance, need to provide immediate dentures
how is caries stabilised?
- include caries removal even if it was partial
- if we leave this caries untouched while trying to stabilise periodontal disease, this could worsen the disease which could lead to the tooth to extraction or root Cana treatment
what other strategies are used in stabilisation
- preventative advice
OHI, smoking, Fluroide
comes from leaflet that is available online - evidence supported leaflet
-caries prevention evidence - number 1 category - strong imminence
- ## show the difference between manual and strong powered toothbrushes
what is given in smoking cessation advice
- periodontal disease is most common smoking disease
- smoking does not cause but likely to develop
-90% that don’t respond to treatment is due to smoking - provide with various leaflets
- Refer to NHS smoke free online service
- GP
When to proceed tot he next stage after stabilisation
- review patient and evaluate how motivated they are
- ask about diet
- evaluate oral hygiene
- evaluate peirodontium
-PFS - Aim- motivated patient, caries free and high PFS
when is a patient recalled for a review?
- shortest review interval is 3 month
- longest is 24 months s
-depends of the patients risk factors - depends on the treatment provided
- 6 months regular rental check up is normally recommended for everyone
when can you move onto corrective therapy?
IF patients are reviewed and they are very motivated, the PFS is high
- no new caries
what does corrective therapy consist of
placement of permanent or definitive restorations
- stabilising the caries
- placement of percent definitive restorations
- last for few weeks/motnhs
- Direct GIC restorations replaced with composite restoration that recreated fall of molar tooth in addition to having accurate anatomy
what does Re- RCT consist of
- recinducting treatment
- re root canal treatment
- GP point extruded- infection associated with that tooth
- Pain emergency phase
- root canal was re done to get rid of apical infection
- right hand side - root canal treatment redone - infection has subsided
what does reconstruction aim for
- a long term plan for restoring a patients mouth (10 years+)
- addresses any functional or aesthetic concerns of the patient after stabilising mouth
- Diagnostic wax for rehabilitation cases
what are considerations of reconstructions?
- referrals
- long term meiantence concerns
- time to complete treatment
- availabiilty of patient
-cost - no active disease a patient have
- patient is implant
- long term maintenance
- consider complexity of plan and time required to complete it
- cost
what reconstruction processes could be used for advanced perio
crown lenghtneign surgery
- severe tooth wear over erupted teeth
- expose more tooth by crown lengthening surgery
- definitive crowns,onlyas
- provided with amalgam reparations
- cam back for review
crowns or onlays tp provide long term functional stable teeth
- fixed bridge, resin retained, conventional
- definitive partial dentures co/cr
- Direct/ indirect veneers - good moisture control sop no bleeding gums
- dental implants
how is tooth wear managed?
complex planning
reconstruction
- before embarking management of tooth wear, you need to make sure they have stable periodontal disease
- cause of wear is addressed before restoration of those teeth
