Treatment planning 2 Flashcards
What do we do when we are stabilising a patient?
- Remove unrestorable teeth and teeth with poor prognosis
- Caries stabilization
- Endodontics
- We can place semi permanent restorations
- Immediate Dentures
If a patient comes in with several issues which we one do we tackle first?
Look at the problem that is more extensive
Where do we get our preventative advice from?
The evidence base tool kit
How does the evidence based tool kit rank varying topics?
On a scale of 1-6 in relation to how much evidence there is backing up each topic eg theres a lot of info on fluoride
Give an example of advice that we give that has an evidence based ranking of 1?
- Brush twice daily
- Us fluoridated toothpaste
- Frequency of sugary drinlks should be reduced
What does the evidence based tool kit say about smoking?
Smokers respond less well to treatment for periodontal disease
90% of refractory cases in smokers
Following stabilisation what do you do?
You review the patient checking if they are caries free, are they motivated and if they have a high plaque free score
If the patient passes the review following stabilisation what can you do?
You can move on to corrective and/or reconstructive treatment
If the patient fails the review following stabilisation what can you do?
You will need to continue stabilising them until you see improvement
What is the shortest review/recall interval?
3 months
What is the longestreview/recall interval?
24 months
What does the recall/review period depend on?
Depends on patient risk factor and on the treatment provided
According to NICE guidelines what is the recommended recall period for a healthy patient?
6 month regular dental check ups
Which treatments fall into corrective therapy?
- Placement of permanent/ definitive restorations
- Completion of RCT or re-RCT
2. Completion of RCT or re-RCT
What is the long term aim for patients following reconstruction?
- A long term plan for restoring patients mouth ( at least 10 years)
- Addresses any functional or aesthetic concerns following stabilisations
- Diagnostic waxup for rehabilitation cases
What do we need to consider when doing and planning reconstructive treatment?
- Do we need to refer?
- What are the long term maintenance concerns
- How long will it take to complete the treatment
- Availability of the patient
- Cost
What treatments fall into reconstruction?
- Surgical periodontics
- Crown lengthening surgery
- Definitive crowns, onlays
- Fixed bridges
- Definitive partial dentures
- Dental implants
- Management of tooth wear
- Stabilisation splits
Give examples of fixed bridges?
Resin retained bridges
Conventional
Before suggesting a bridge to a patient what should you take into consideration?
The patients oral hygiene as they need to be able to clean the bridge properly
Also need to make sure the neighbouing teeth are not mobile
What materials can be used to make a definitive partial denture?
Cobalt or chrome
What habit can stop a patient having dental implants?
Smoking as it reduces the success rate by half so it is not worth putting an implant in a smoker
(you need to be smoking free for 12 months)
What can we use to plan reconstructive treatment?
We can make articulated models and wax-ups
What do you have to do after the reconstruction phase
Maintenance
What maintenance do you need to do following root canal treamtent
Need to take an x ray within a year
