Wear 2 Flashcards
how do you diagnose tooth wear
determine primary causative factor and decide on best fit
what are the 3 patterns on wear
with loss of OVD
without loss of OVD but available space
without loss of OVD but limited space
what are the solutions to dealing with pain from wear
deal with sensitivity
pulp extirpation
smooth sharp edges
extraction
TMJ pain - fix this
how can you deal with sensitivity
fluoride
bonding agents
GIC coverage
what is the initial treatment of a wear patient
stabilise existing dentition
deal with caries
deal with perio
oro-mucosal
treat whole mouth
preventive
what can wear recording and monitoring indicate
whether wear is progressing or historic
what is prevention for abrasion
remove foreign object
change toothpaste
alter brushing habits
how do you treat abrasion lesions
RMGIC restoration
what is the prevention for attrition
CBT/hypnosis
splints
what is a soft splint
diagnostic device as it wears fast
what is hard splint
longer term splint than soft splint
what is a michigan splint
hard splint which gives idea of occlusion with even centric stops. canine ridge present with provides disclusion in eccentric mandibular movements
what is prevention for erosion
fluoride
desensitising agents
take away source
habit changes (straw)
control gastric acid
what is prevention for abfraction
fill with low modulus restorative materials
what is passive management
prevention and monitoring
when should passive management be done
first part of any treatment of wear and lasts for 6 months
what is active management
intervention threshold
what is simple restorative intervention
cover exposed dentine
fill cupped defects
when do you use extensive restorative intervention
wear leading to further complications, aesthetics, bad prognosis
what 5 things does maxillary anterior management depend on
pattern of tooth wear
inter-occlusal space
space required for restorations being planned
quality and quantity of remaining tooth tissue particularly enamel
aesthetic demands of the patient
how do you manage maxillary wear
composite resin
what gives adequate inter-incisal space
rapid tooth wear
AOB
increased overjet
what is dento-alveolar compensation
where the bone grows to maintain mastication but you cannot get a restoration in
what are the problems with creating space for traditional restorations
little tooth tissue to begin with
poor retention due to short axial walls
good chance of pulpal damage due to short clinical crowns
new materials offer better more conservative approach in these cases
how can you make space for restorations
increase OVD with posterior extra-coronal restorations
occlusal reorganisation from ICP to RCP
surgical crown lengthening
effective RCT
conventional orthodontics
what are the effects of surgical crown lengthening
expose more crown
reposition gingiva apically
removal of bone
sensitivity increased
what is the Dahl technique
method of gaining space in localised wear
use composite as anterior bite plane covering palatal surfaces resulting in posterior open bite where posterior teeth will then erupt and give OVD increase by 2-3mm
how long does the patient need to use the dahl technique for
3-6 months
who is the Dahl technique not suitable for
active perio disease
TMJ patients
post orthodontics
bisphosphonates
dental implants
existing conventional bridges
what is the technique of choice for localised anterior tooth wear
dahl technique
