Wear 3 Flashcards
Why is composite build ups considered the first choice for restoring anterior tooth wear?
It is conservative and reversible
What is the advantage of having an enamel ring when fixing tooth wear?
Enamel provides better bonding
-> more retention
Why is fixing Lower anterior tooth wear more difficult?
As there is less enamel and a smaller bonding area
-> lingual surface may need to be utilised
How is lower anterior wear treated?
Aim to improve aesthetics but not increase OVD
If uppers and lowers required- do lower first as they are more likely to debond (same technique as uppers)
What can be used as reference point for incisal height?
Height of tallest remaining incisor
When is localised posterior wear found?
Ruminating patients
Bullimia
Alcoholics
How is localised posterior wear treated?
If asymptomatic- prevention and monitoring
Erosive wear can be filled directly with composite with no change in occlusion
What can be causing posterior wear to occur? How can it be treated?
Loss of canine guidance (group function)
-> Add composite to palatal surfaces of upper canines to increase the canine rise and disclude the posteriors during lateral and protrusive excursions (restore guidance)
What techniques can be used to restore guidance to treat posterior wear?
Freehand
Diagnostic wax up/template
What are the methods for doing composite build ups?
Alginate impressions- produce cast
-> Wax up
-> Putty Matrix OR Vacuum formed splint
What are the advantages of composite build ups?
Generally good patient satisfaction
Posterior occlusion is normally re-achieved
Seldom TMJ problems
No detrimental effect on Pulpal health
No worsening of Periodontal condition
Good medium term option (like most of dentistry)- 70% success over 10 yrs
Easy repair and maintenance
Why do maxillary restorations last longer than mandibular
Due to increased bonding area
Why are maxillary teeth more prone to wear than mandibular?
Tongue and saliva protects lowers
Why are composite build ups considered biological management?
Not removing sound tissue (preserves it- adding not removing)
Why must aesthetic goals be pragmatic?
To prevent unrealistic expectations in patients