Advanced Restorative Final Review- Lecture 1

Question 1

____ occurs when the process of physiologic wear is accelerated by exogenous and endogenous factors and is frequently mulitfactorial and a variable phenomenon:

Answer 1

Pathologic wear

Question 2

Pathologic wear is frequently ____ and can be described as a ____

Answer 2

multifactorial; variable phenomenon

Question 3

Etiologies of wear include:

Answer 3

1. congenital anomalies
2. attrition
3. loss of posterior vertical support
4. abrasion
5. erosion
6. abfraction

Question 4

The excessive wear of just one tooth of extensive restorations or of the full dentition has been associated to:

Answer 4

1. supreruption of the opposing teeth
2. inclination of the teeth to a contact that has been eroded
3. reduction of the vertical dimension
4. a contributing factor in TMDs

Question 5

Etiologies of MECHANICAL wear include:

Answer 5

1. Loss of posterior support
2. Premature occlusal contacts
3. Bruxism
4. Inadequate brushing technique
5. Parafunctional habits

Question 6

Characteristics of MECHANICAL wear:

Answer 6

1. Presence of wear facets with a well defined loss, that coincides on the articulated models
2. The pattern of the wear facets should be analyzed because they tend to occur in predictable places

Question 7

Etiology of CHEMICAL wear:

Answer 7

1. chronic vomit
2. sucking of citric fruits
3. consumption of acidic drinks and foods
4. medicines with an acidic pH
5. abuse of certain drugs
6. environmental factors

Question 8

Characteristics of CHEMICAL wear:

Answer 8

1. Presence of amalgam “islands”
2. Presence of grooves and fossae
3. Hypersensitivity
4. No stains/Changes of color
5. Wear facets without defined perimeter

Question 9

It is assumed that extensive wear of the dentition results in:

Answer 9

A reduced VDO

Question 10

T/F: There is no evidence that proves the concept “excessive wear leads to reduced VDO”

Answer 10

True

Question 11

Some authors coincided that cases in which there is extensive wear of the dentition, the wear is compensated by:

Answer 11

overeruption

Question 12

Evaluation of the vertical dimension:

Answer 12

1. Posterior support
2. History of the wear present
3. Phoenetic evaluation
4. Interocclusal distance
5. Facial appearance
6. Perception of the patient

Question 13

1. Etiology of the occlusal wear
2. Motivation of the patient to preserve his teeth
3. Capability of the patient to make a financial and time comitment to the proposed treatment
4. Periodontal health
5. Severity of the wear present
6. Number and position of the remaining teeth
7. Patient expectations
8. The patients willingness to wear an occlusal guard and also to work on control of parafunctional activities during the day
9. Analysis of the diagnostic tools

Answer 13

Important determinants in the treatment of patients with excessive occlusal wear

Question 14

Treatment options for patients with excessive occlusal wear:

Answer 14

1. No active intervention
2. Prevention of loss of additional dental structure
3. Restoration to revert the effects of the loss of dental structure

Question 15

Restoration methods for patients with excessive occlusal wear:

Answer 15

1. Extraction followed by replacement with CD, RPDs, or overdentures
2. Restorations using amalgam, composite, resins, onlays etc.
3. Restorations using fixed or removable prosthesis, implants or a combination

Question 16

____ should be used when a new vertical dimension is established

Answer 16

Good clinical criteria

Question 17

The changes in vertical dimension should be evaluated with ___ prior to starting any irreversible treatment

Answer 17

occlusal splint

Question 18

Symtoms of intolerance to an increased VDO include:

Answer 18

1. clenching
2. muscular fatigue
3. pain in the teeth/muscles/articulations
4. headaches
5. intrusion of teeth
6. fractures of restorations
7. occlusal instability

Question 19

When can the provisional restorations be made?

Answer 19

after the patient accepts and is using the occlusal guard

Question 20

When can the patients function & esthetics & oral hygiene be evaluated?

Answer 20

After the patient accepts and wears the occlusal guard and the provisional is made

Question 21

The final restorations in a patient with history of excessive occlusal wear should present elements like:

Answer 21

shallow cusps & a reduced occlusal surface in the BL aspect

Question 22

By the final restorations having shallow cusps & a reduce occlusal surface in the BL aspect for patients with a history of excessive occlusal wear this:

Answer 22

Helps reduce the destructive forces directed to the restored teeth

Question 23

What type of occlusal guard is preferable to prevent nocturnal parafunctional habits, wear, or fracture of the restorations?

Answer 23

Rigid

Question 24

In patients with extensive fixed restorations with inadequate oral hygiene and high indices of plaque, _____ should be used once a day and applied with a tray:

Answer 24

Neutral sodium fluoride

Question 25

A routine of ____ should be established in patients receiving treatment following history of excessive occlusal wear:

Answer 25

Periodic evlautions

Question 26

Describe the recall schedule for patient receiving treatment following history of excessive occlusal wear:

Answer 26

Every 3 months the first year and every 6 months after that in combination with periodic, periodontal treatment