Wear 3 Flashcards
what should be the first choice of treatment for majority of anterior wear
composite
what are the contraindications to using composite for anterior wear
short roots
reduced periodontal support due to periodontal disease
lack of remaining enamel
if uppers and lowers are both worn what teeth do you build up first
lowers
how do you treat localised posterior wear
fill occlusal wear with composite
build up canines for canine guidance and to make disclusion in the posteriors
what can canine wear lead to
lack of guidance and lead to posterior wear
what are the methods of composite build up
alginate impressions - wax up - putty matrix
vacuum formed splint
what are the steps for constructing a vacuum formed splint
alginate impression
diagnostic wax
impression poured in stone
vacuum formed clear plastic matrix formed on this
cut to size and used as mould for build up
what are the effects of vacuum formed splints
posterior occlusion achieved
uncommon TMJ problems
not detrimental to pulpal health
doesnt worsen periodontal condition
what information do you give a patient about getting composite build ups for wear
front teeth get tooth coloured fillings to prevent wear
no LA used as minimal drilling
improved aesthetics
bite feels strange for a few days
after a week you get used to bite
lisping
tender to bite on front teeth
may bite lips and tongue
crowns and bridges need replaced
need maintained
what are the 3 categories of generalised wear
excessive wear with loss of OVD
excessive wear without loss of OVD but with available space
excessive wear without loss of OVD and with no space available
how do you manage generalised wear
give adhesive restoration and assess patient tolerance to change
can give conventional restorations later
how do you treat excessive wear with loss of OVD
splint used to assess patient tolerance of new face height
increase OVD on maxillary and mandibular aspects
adhesive and conventional restorations required
how do you treat excessive wear without loss of OVD but with limited space
consider splint for increased face height
restore teeth at new occlusal face height
use adhesive restorations
how do you treat excessive tooth wear without loss of OVD but with no space available
need specialist opinion prior to commencing treatment
attempt to increase OVD by splints
crown lengthening surgery
endodontics and orthodontics?
what can crown lengthening lead to
increased amount of coronal tooth substance
black triangles between teeth
unfavourable crown to root ratio
