Coronal Foundations Flashcards
(26 cards)
What 6 things are involved with assessing tooth restorability?
Preservation of tooth structure, Function and longevity, Aesthetic consideration, Cost effectiveness, Patient health, Treatment planning
How do we try to preserve the tooth tissue?
Assess existing restoration for signs of creep, micro leakage, secondary caries, fracture. Assess Periodontium. Assess for signs of tooth wear.
How do we assess the function and longevity of the tooth?
Radiographic assessment, Assess tooth vitality, Assess occlusion.
How can we consider the aesthetics?
Consider tooth position, is orthodontic treatment required prior? Assess gingival position and smile line.
How can patient health affect tooth restorability?
Any allergies to materials, Infection may occur and could spread, Gastric disorders, vomiting, eating disorders, Psychological conditions eg bruxism.
What to consider for treatment planning?
Condition of the tooth/teeth, Consider if teeth require elective root treatment, Construct study models and diagnostic wax ups, Examine occlusion, Record shade, Consider what materials may perform better in the treatment area.
How can previous dental history affect tooth prognosis?
Need to understand previous dental treatments, frequency of caries, oral hygiene habits, history of bruxism, perio.
How does age affect tooth prognosis?
Younger patients may have better outcomes with certain restorations, older people might have better outcomes with implants.
What should be assessed in a clinical examination?
EOE, IO - soft tissues, hard tissues, periodontal examination, occlusal assessment, evaluation of aesthetic zone, appraisal of any edentulous spaces.
What is a low smile line?
No more than 75% of anterior teeth on show, No gingival tissue on show.
What is a medium smile line?
75-100% of anterior teeth on show as well as interdental papilla.
What is a high smile line?
Exposes the teeth in full display as well as gingival tissues beyond the gingival margin. Often referred to as a ‘gummy smile’.
What can we do if there isn’t enough tooth structure for the restoration?
Consider a core build up with adhesive resin, Consider RCT and post/core or extraction (this depends on the available ferrule).
What is the ferrule effect?
The protective effect achieved by the supra-marginal extension of the dentine coronal to the shoulder of a post and core crown prep.
What material is often used for core build ups?
Composite.
What does the ferrule provide?
Additional strength and retention, Prevents fracture or failure.
When is the role of the ferrule particularly crucial?
When the tooth has lost a substantial amount of its crown structure.
What are the three characteristics of a successful ferrule?
Sufficient height - 2mm, Sufficient thickness, Encircling the tooth.
How high should a ferrule be?
2mm.
What are ideal situations for ferrule use?
Root canal treated teeth bc teeth are more brittle, Teeth with extensive structural loss, Post and core - ferrule helps to secure the post and improve strength.
What are the indications for core build ups?
Root canal treated teeth bc teeth, Teeth with significant structural loss, Teeth requiring crowns, Teeth that are abutments for bridges.
List three materials that can be used for core build ups.
Composite, Amalgam, GIC, RMGIC, Pre formed post and core systems, Fiber posts.
What factors can affect success of the core build up?
Amount of remaining tooth structure, Material selection, Adhesion, Proper post placement (if required).
What are some possible complications of core build ups?
Core material fracture - if material is too weak or placed incorrectly, Post failure - if it does not bond properly or is too large, Insufficient bonding - weak bonding.
