Treatment Planning (Pt. II) Flashcards

1
Q

Replacement of Several Missing Teeth
• FDP is more difficult when ____ teeth must be replaced
• Problems encountered with ____ abutment teeth
– Especially when replacing ____ teeth simultaneously
• ____ of the problems involved in extensive prosthodontics can lead to failure
• ____ helpful for success

A
several
intermediate
anterior and posterior
underestimation
diagnostic
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2
Q

Replacement of Several Missing Teeth

____ can act as fulcrum during function

A

middle abutment

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3
Q

Replacement of Several Missing Teeth
• (1)Overloading of abutment teeth
– (a)____ of forces
– (b)____ area

• (2)Root shape and angulation
– (a)____ disease
– (b)____ length

• (3)Replacing ____ teeth

A
direction
root surface
periodontal
span
multiple anterior
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4
Q

(1)Overloading of Abutment Teeth
• Important to consider ability of abutment teeth to accept applied forces
– Avoid ____ or mobility
– ____ increases forces on teeth

A

tooth drifting

parafunction

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5
Q

(1)Overloading of Abutment Teeth
(a)Direction of Forces
• Difficult to regulate ____
• Want FDP to distribute forces by directing them down the ____ of the abutment teeth

A

magnitude of force

long axis

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6
Q

(1) Overloading of Abutment Teeth
(b) Root Surface Area

• Ante’s Law
– The root surface area of abutment teeth should be ____ than the root surface area of the teeth being replaced
• Useful for determining the ____ of fixed dental prostheses
• Controversial
– Some studies have shown success with reduced ____

A

equal or greater
prognosis
bone support

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7
Q

(1)Overloading of Abutment Teeth
Ante􏰀s Law
• Example
– If missing a first molar and second premolar, a four unit FDP is an ____ risk if no significant periodontal diseas

Surface area of 1st premolar and 2nd molar is greater than ____

A

acceptable

2nd premolar and first molar

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8
Q

(2)Root Shape and Angulation

• When tooth support is borderline, ____ and ____ should be considered
– Example: molar with ____ roots provides better support than conical with little or no interradicular bone
– Example: a single rooted tooth with ____ cross section offers better support than ____ cross section
• ____ tooth provides better support than tilted one
– May need to orthodontically upright

A
shape of roots
angulation
divergent
ellipitical
circular
well-aligned
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9
Q

(2) Root Shape and Angulation
(a) Periodontal Disease

• Healthy periodontal tissues are a prerequisite for all fixed restorations
– without healthy ____, the results can be disastrous
– Successful FDPs can be fabricated on teeth with severely reduced ____ if periodontal tissues have been returned to excellent health and long term maintenance is ensured

A

periodontal tissues

periodontal support

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10
Q

(2)Root Shape and Angulation (a)Periodontal Disease

• Due to conical root shape, when ____ of root length is exposed, ____ supporting area is lost
– Forces applied are ____ because of greater ____ from lengthened clinical crown

A

1/3
1/2
magnified
leverage

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11
Q

(2)Root Shape and Angulation (b)Span Length

• All FDPs ____ when occlusal load applied
• The longer the ____, the greater the flexing
– With long span FDP, pontics and connectors should be made as ____ as possible to ensure optimum rigidity
• Without compromising ____
• Prosthesis should have high strength and rigidity

A

flex
span
bulky
gingival health

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12
Q

(2)Root Shape and Angulation (b)Span Length

• Excessive flexing under occlusal loads may cause \_\_\_\_ of FDP
– Fracture of \_\_\_\_
– Breakage of \_\_\_\_
– Loosening of \_\_\_\_
– Unfavorable \_\_\_\_ response
A
failure
porcelain veneer
connector
retainer
soft tissue
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13
Q

(3)Replacing Multiple Anterior Teeth

• Loss of several maxillary anterior teeth is difficult
– ____ subject to tipping forces
– Need to use ____ as abutments

A

maxillary incisors

canines and first premolars

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14
Q

(3)Replacing Multiple Anterior
Teeth

• Maxillary anterior
– Tooth contours, esthetics, phonetics difficult
– ____ essential
– ____ (provisional) to 􏰀test􏰁 contours, phonetics, esthetics

A

diagnostic wax up

interim restoration

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15
Q

(3)Replacing Multiple Anterior
Teeth

• Severe anterior bone loss
– May need \_\_\_\_ to replace teeth and supporting tissues
• FDP only replaces missing teeth
– Evaluate \_\_\_\_
– Possible \_\_\_\_ to augment ridge
A

partial RDP
smile line
surgical intervention

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16
Q

Fixed Dental Prosthesis
• FDP if possible
– Better ____ than partial RDP
– Preferred by most patients

A

health and function

17
Q

Partial Removable Dental Prostheses

• Indications
– No \_\_\_\_ abutment
– Long \_\_\_\_ span
– Considerable \_\_\_\_ in anterior region
• Where FDP would have unacceptable appearance
A

distal
edentulous
bone loss

18
Q

Multiple edentulous spaces often best restored with combination of ____

A

fixed and removable

19
Q

Proper ____ is very important to avoid mistakes

A

sequencing

20
Q

(1)Treatment of Symptoms

• Priority to relieve ____
• May not be able to complete full examination until symptoms addressed
• Nonacute problems may also need attention
– Examples:
• Lost ____
• Cracked or broken veneer
• Fractured ____

A

discomfort
anterior crown
RDP

21
Q

(2)Stabilization of Deteriorating Conditions

• Second phase of treatment is to stabilize conditions
– (a)____
– (b)____

A

dental caries

periodontal disease

22
Q

(a)Dental Caries

• Teeth restored with plastic materials
– May serve as foundation for future castings
• Cast restorations not recommended in patient’s with ____
– Due to ____ caries
– Recommend ____ and advice, oral hygiene instructions and fluoride treatment

A

active caries
recurrent
diet analysis

23
Q

(b)Periodontal Disease

• Chronic periodontitis with continuing irreversible bone loss should be treated with ____ and ____ (scaling and root planing)
– Teeth need to be ____ for effective plaque control
• Replace defective ____
• Remove ____ lesions
• Recontour ____ crowns (especially furcation region)
• Proper oral hygiene instructions

A
daily plaque control
dental cleaning
smooth
restorations
carious
overcontoured
24
Q
(3)Definitive Therapy
• (a)\_\_\_\_
• (b)\_\_\_\_
• (c)\_\_\_\_
• (d)\_\_\_\_
• (e)\_\_\_\_
• (f)\_\_\_\_
A
oral surgery
periodontics
endodontics
orthodontics
fixed prosthodontics
removable prosthodontics
25
``` (a)Oral Surgery • Allow time for healing and remodeling • Extract ____ in treatment – Hopeless teeth – Unerupted teeth – Residual roots and root tips • Pre-prosthetic surgical procedures (ex. ____) early in treatment ```
early | ridge contouring
26
``` (b)Periodontics • Most periodontal procedures should be part of ____ phase • Periodontal surgery – ____ elimination – ____ procedures – ____ regeneration – ____ resection ```
``` stabilization pocket mucogingival guided tissue root ```
27
(c)Endodontics • Some may be accomplished as part of relief of discomfort and stabilization • Elective endodontics, if needed – Example: • ____ needed for badly damaged tooth • Treat abutments with doubtful pulpal health
cast post and core
28
``` (d)Orthodontics • Minor orthodontic tooth movement common as adjunct to ____ – Upright – Rotate – Move laterally – Intrude – Extrude • Always consider in treatment planning – Especially when tooth drifting has occurred ```
fixed prosthodontics
29
(e)Fixed Prosthodontics • May need to ____ plan if unexpected occurrences in previous treatment – ex. non-restorable endodontically treated tooth • ____ possible prior to treatment to stabilize occlusion – Correct supraeruption or drifting
adjust | occlusal adjustment
30
(e)Fixed Prosthodontics * ____ restorations – Usually restored first * Influence ____ of mandible – Shape ____ surfaces of posterior teeth • Posterior restorations – Advantageous to restore opposing posterior segments ____ – One side at a time ____ than all four posterior quadrants • Difficult to confirm accuracy of ____
``` anterior border movements occlusal simultaneously easier jaw relationships ```
31
(f)Removable Prosthodontics • Will proceed ____ fixed prosthodontics, but is treatment planned ____ to definitive treatment
fixed | prior
32
(4)Follow-Up • Essential to develop program for follow- up care and recall visits – Monitor ____ – Identify signs of ____ early – Initiate prompt ____, if needed • Adequate follow up will help maintain long-term health
dental health disease corrective
33
Summary • Basis of logical treatment planning – Identifying patient’s ____ – Eliciting patient’s expectations and wishes – Comparing expectations and wishes with available corrective materials and techniques – Determining treatment options • Advantages/disadvantages, cost, time involved • Work with patient to determine best option – Not just 􏰀ideal􏰁 plan – Determining overall prognosis
needs
34
Summary • Rational sequence of treatment includes: – ____ – ____ – ____ – ____ • Treatment plan may need to be modified during treatment depending on circumstances – Patient needs to be advised ____
``` symptomatic relief stabilization definitive therapy follow up care prior ```