BDS3 treatment planning Flashcards
(33 cards)
what are diff types of special investigation?
- sensibility testing
- radiographs
- study models
- facebow
- diagnostic wax-up
what is purpose of a facebow?
to find relationship between maxilla and angles of the mandibular condyles
what are stages of treatment planning?
- immediate
- initial
- re-evaluation
- reconstructive
- maintenance
what do you do during immediate stage for treatment?
- relief of acute symptoms
- consider endo and extractions
- consider immediate denture/bridge
what do you do during initial stage of treatment?
disease control
- extraction of hopeless teeth
- OHI and diet advice
- HPT
- Management of carious lesions and defective restorations with direct or provisional restorations
- endo
- denture design, wax up for fixed prosthodontics
what do you do during re-evaluation part of treatment?
- re-assessment of perio status, confirm denture/bridge design
what do you do during reconstructive part of treatment?
- perio surgery
- fixed and removable prosthodontics
why place veneers?
Improve aesthetics
Change teeth shape and/or contour
Correct peg-shaped laterals
Reduce or close proximal spaces and diastemas
Align labial surfaces of instanding teeth
what do you do during maintenance part of treatment?
- supportive perio care and review of restorations
what is gurel minimal prep technique?
Veneers
Wax up
Stent
Intra-oral mock up
Preparation into mock up (can use depth cut burs
when not to use veneers?
Poor OH
High caries rate
Interproximal caries and/or unsound restorations
Gingival recession
Root exposure
High lip lines
If extensive prep needed (>50% of surface area no longer in enamel)
* Consider alternatives – PJC, DBCs MCCs
Labially positioned, severely rotated and overlapping teeth
Extensive TSL/insufficient bonding area
Heavy occlusal contacts
Severe discolouration
when is extensive prep needed so veneers can’t be used?
> 50% of surface area no longer in enamel
why restore teeth with inlays/onlays?
Tooth wear cases
* Increase OVD
Fractured cusps
Restoration of root treated teeth
Onlays provide cuspal coverage
Replace failed direct restorations
why not use inlays/onlays?
Active caries and periodontal diseases
Time
* Tooth preparation and laboratory fabrication required
Cost
Why restore teeth with crown?
To protect weakened tooth structure
To improve or restore aesthetics
For use as a retainer for fixed bridgework
When indicated by the design of a RPD
* Rest seats
* Clasps
* Guide planes
To restore tooth function
* e.g. restore in OVD
Why not restore with crowns?
Active caries and periodontal disease
More conservation options available
Lack of tooth tissue for preparation
Unable to provide post and core
Unfavourable occlusion
what are the principles of crown prep?
o 1) Preservation of tooth structure
o 2) Retention and resistance
o 3) Structural durability
o 4) Marginal integrity
o 5) Preservation of the periodontium
o 6) Aesthetic considerations
what does under preparation of crown prep result in?
- Poor aesthetics
- Over built crown with periodontal and occlusal consequences
- Restorations with insufficient thickness
in terms of principle of crown prep what is meant by retention?
Prevents removal of the restoration along the path of insertion or the long axis of the tooth preparation
in terms of principle of crown prep what is meant by resistance?
Prevents dislodgement of the restoration by forces directed in an apical or oblique direction and prevents any movement of the restoration under occlusal forces
what is the ideal inclination of opposing walls with taper?
6-10 degrees
what do longer walls of a crown prep interfere with?
tipping displacement
in terms of principle of crown prep what is meant by path of insertion?
- Imaginary line along which the restoration will be place onto or removed from the preparation.
- Is set before the preparation is begun and all the features of the preparation must coincide with that line
what are extra means of retention for crown preps?
- Grooves
- Slots
