British Society of Restorative Dentistry Guidelines

Question 1

what is the decision to place fixed pros based on

Answer 1

motivation of patient
oral and general health
condition of remaining teeth and tissues
analysis of benefits/disadvantages
complications which limit the likelihood of success
skill of clinician

Question 2

what are the alternatives to crowns and fixed pros

Answer 2

vital bleaching
composite
ceramic inlays and onlays
RBB

Question 3

what restoration would be most appropriate if the patient had minimally or moderately restored teeth at time of presentation

Answer 3

adhesive options

Question 4

definition of a fixed bridge

Answer 4

dental prosthesis which is luted/screwed/mechanically attached or otherwise securely retained to natural teeth/roots/implants

Question 5

what is the rationale for using crowns

Answer 5

restore form, function and appearance of badly broken down teeth to the extent that other restorations are contraindicated/failed

to improve form and appearance of unsightly teeth unable to be managed by cosmetics

reduce risk of fractures occurring in extensively restored teeth (and RCT teeth)

alter shape, size and inclination of teeth for cosmetic purposes (rare)

restore dental implant

Question 6

what is the rational for the use of fixed bridges

Answer 6

replace one or more teeth of functional or cosmetic important to the patient

prevent tooth movement and improve occlusal stability (rare)

Question 7

what systemic conditions/medications would contraindicate implants

Answer 7

osteoporosis
bisphosphonates
uncontrolled diabetes
smoking
radiotherapy

Question 8

what special tests may a clinician do

Answer 8

sensibility
radiographs
study casts
MP/MB
diet diary
diagnostic wax up
observe occlusal function
long-term monitoring against study casts

Question 9

what should the design for tooth-supported fixed bridges be

Answer 9

simple and conservative
avoid using multiple linked abutments
consider implants
enhance occlusal relationships and function
encourage optimal tissue response and facilitate OH
be realistic

Question 10

what should the choice of material for a bridge be based on

Answer 10

allow cosmetic expectations but do not involve excessive removal of sound tissue
facilitate tissue response
consider opposing materials

Question 11

what makes treatment planning easier

Answer 11

demonstration models and illustrated case histories to discuss with patients
use of study casts to rehearse preparations and for diagnostic wax ups
liaising with the technician
audit and peer review processes

Question 12

what do patients need to be made aware of before consenting

Answer 12

implications
sequelae
life expectancy of work
other options
they must understand that success relies on their maintenance
cost

Question 13

what treatment comes before placement of fixed pros

Answer 13

pain relief
perio
re-evaluation after initial
placement of cores
endo
assessing for implants
necessary orthodontics
surgical perio treatment
definitive occlusal adjustment
placement of implants if part of treatment

Question 14

if using implants to retain a bridge on an edentulous patient, how many implants are needed per arch

Answer 14

maxilla = 6
mandible = 4

Question 15

if using implants to retain an overdenture on an edentulous patient, how many implants are needed per arch

Answer 15

maxilla = 4
mandible =2

Question 16

after implant placement in upper and lower arches how long is the healing time for each arch
and what is this related to

Answer 16

maxilla = 3-4 months
mandible = 2-3 months

the time that the implant needs to osseointegrate into the jawbone

Question 17

how do you decide the shade

Answer 17

in a neutral colour environment
using shade guide familiar to technician
assessment under different lighting conditions

Question 18

when you are deciding the form and dimension of preparation what should you take account of

Answer 18

tooth morphology and anatomy
quantity and location of remaining tooth tissue responsible for retention
occlusal relationships
need for realignment
relationships with adjacent teeth and soft tissues
materials to be used
considerations of long-term sequelae
aesthetic requirements

Question 19

purpose of master impressions

Answer 19

obtain an accurate, dimensionally stable, fully supported impression of the prepared teeth, any dental implants and associated soft tissue

Question 20

what should the occlusal registration material be

Answer 20

readily and accurately record detail of occlusal and axio-occlusal tooth surfaces
exhibit limited flow following application
have a working time sufficient to allow correct positioning of the mandible
be dimensionally stable and capable of being adjusted without distortion when set or in the solid state

Question 21

purpose of temporary restorations

Answer 21

restore, protect and maintain the position of prepared teeth between appointments and until the placement of the final restoration

Question 22

qualities of a provisional restorations

Answer 22

improvements in tooth form/function
marginal adaptation and seal
minimal tissue response
favourable hygiene features
good marginal fit
fracture and wear resistance
functional comfort and control of sensitivity
aesthetics

Question 23

purpose of a lab prescription

Answer 23

record and communicate precise details of all aspects of crown and bridgework required

Question 24

what are the principles of a try in visit

Answer 24

inspect restorations with the master cast to confirm satisfactory completion
assessment of acceptability of restorations at time of try in
minor adjustments completed while patient present
identify issue if unsatisfactory
get the patient to confirm acceptance of appearance and comfort

Question 25

what do you check during a review appointment

Answer 25

satisfaction and comfort
proximal contacts and relationships with adjacent and opposing teeth
note the hygiene
make suitable adjustments
further instructions and advice should be given regarding oral hygiene maintenance