Treatment planning for fixed pros Flashcards

1
Q

What features are relevant when checking occlusion for fixed pros?

A

incisor relationship
excursions of mandible
canine guidance
group function

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2
Q

What are the indications for veneers

A

Improve aesthetics
Change teeth shape and/or contour
Correct peg shaped laterals reduce or close proximal spaces and Diastemas
Align labial surfaces of instanding teeth

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3
Q

What are the contraindications for veneers?

A

poor OH
high caries rate
interproximal caries
gingival recession
root exposure
high tip lines
if extensive prep needed
labially positioned, severely rotated and overlapping teeth
extensive TSL/insufficient bonding area
heavy occlusal contacts
severe discolouration

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4
Q

When are inlays/onlays indicated?

A

Inlays - Isthmust greater than 1.5-2mm, cusps in tact, previous failed direct, occlusal/proximal caries

Onlays - As above but cusps broken down, and a large isthmus.

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5
Q

What are the disadvantages of inlays/onlays?

A

active caries and periodontal diseases
time
cost

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6
Q

Why would you use a crown to restore teeth?

A

Protect weakened tooth structure
Improve/restore aesthetics
Use as a retainer for fixed bridge
When indicated by design of RPD
Restore tooth function

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7
Q

When would you not restore with crowns?

A

Active caries and periodontal disease
More conservation options available
Lack of tooth tissue for preparation
Unable to provide post and core
Unfavourable occlusion

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7
Q

What are the principles of crown preparation?

A

Preservation of tooth structure
Retention and resistance form
Structural durability
Marginal integrity
Preservation of periodontium
Aesthetic considerations

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8
Q

Why would you preserve sound tooth?

A

To avoid weakening tooth structure and damaging pulp
Prostethesis will never be as good as natural tooth

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9
Q

What does under preparation result in?

A

Poor aesthetics
Over built crown with periodontal and occlusal consequences
Restorations with insufficient thickness

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10
Q

What does over preparation result in?

A

Pulp exposure risk and tooth strength compromised

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11
Q

What does retention form prevent?

A

Removal of restoration along path of insertion or long axis of tooth preparation

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12
Q

What does resistance form prevent?

A

Dislodgement of restoration by forces directed in an apical or oblique direction and prevents any movement of restoration under occlusal forces

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13
Q

How do you create retention and resistance form?

A

Taper
Length of walls
Path of insertion
Grooves and slots

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14
Q

How do you achieve structural durability?

A

occlusal reduction
functional cusp bevel
axial reduction

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15
Q

What are the types of finish line configurations?

A

knife edge
bevel
chamfer
shoulder
bevelled shoulder

16
Q

To help preserve the periodontium, how should the margins of the crown be prepared?

A

smooth and fully exposed to cleansing action
Placed where the dentist can finish them and patient can clean them
Placed supragingivally or at gingival margin

17
Q

Why replace teeth with a bridge?

A

Aesthetics
Maintain occlusal stability
Function
Periodontal splinting
Restoring occlusal vertical dimension
Patient preference

18
Q

Why would you not replace teeth?

A

Damage to tooth and pulp
Secondary caries
Effect on periodontium
Cost
Failures

19
Q

What are the types of bridge design?

A

Cantilever
Fixed-fixed
Adhesive/resin bonded
Conventional
Hybrid
Fixed moveable
Spring cantilever

20
Q

What do you need to communicate to patients to ensure you get informed consent for fixed pros?

A

Invasiveness/reversibility
longevity and success rates
Possible complications
Time involved
Costs
Alternative options
What treatment performed
Why it is necessary
Consequences of not having treatment
What risks there are

21
Q

What is the risk of devitalisation when performing a direct for a crown or bridge?

A

Tooth has a 20-30% chance of devitalisaion, and would require endo.

22
Q

What is meant by the term biological width?

A

The biological width is defined as the dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone.

23
Q

What is the effect if an indirect margin encroches on biological width?

A

Invasion of biologic periodontal space for additional retention will cause iatrogenic periodontal disease with a premature loss of restoration.

24
Q

What aspects determine if a tooth is restorable?

A

Amount of remaining strucutre
Bone levels (including no caries at bone level)
Active disease management
Sufficient biological width