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Crown And Bridge Anterior Teeth Flashcards

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0
Q

What is a provisional crown?

A

Made to last for a longer period eg whilst periodontal treatment carried out

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1
Q

What is a temp crown?

A

Made to only last a short time

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2
Q

What are the biological requiements for temp crown?

A

BAM
Biological: protect prepared dentine, prevent gingival overgrowth, prevent over eruption and tilting of adjacent teeth
Aesthetics: good surface topography and shade
Mechanical: strong enough to withstand forces of occlusion and mastication

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3
Q

How can temp crowns be made?

A

Chair side or preformed crown

Preformed: polycarbonate for canine, incisor and premolar
Aluminium for molar teeth: aluplast
Tin alloy : ion

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4
Q

What are the advantages of tooth coloured crowns?

A

Aesthetics

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5
Q

What are the all tooth coloured crowns?

A

All porcelain
Lab constructed composite
Resin/detine bonded

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6
Q

What are the non all tooth coloured options for anterior crowns?

A

PFM

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7
Q

How can all porcelain crowns be made?

A

Conventional build up on platinum folk or refractory model

CAD/CAM coping with conventional build up
CAD/CA! Without coping eg Cerec

Pressed porcelain
Glass infused ceramics
Cast glass ceramic

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8
Q

Which technqie is commonly used for all ceramic crowns?

A

Conventional build up on platinum foil

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9
Q

Which technqie is commonly used for veneers?

A

Conventional buildup on refractory model

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10
Q

What is the purpose of the foil I the porcelain?

A

Platinum foil laid down and then alumina or porcelain core used for strength
Platinum foil removed after glazing and prior to cementation

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11
Q

What type of joint is used for the platinum foil?

A

Tinners

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12
Q

How can you build up the core for the porcelain crowns?

A

Using a paint birth or a le cron handle

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13
Q

What is the technique called when you leave the platinum foil on ?

A

Mac clean sced techqnie

The pt foil is tin plated and allows porcelain to bond to foil

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14
Q

What are the options for discoulored anterior teeth?

A 
Hydrochloric acid pumice microabrasion 
Non Vital bleaching
Vital bleaching
Localised composite 
veneers
Crown
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15
Q

What can be the cause of discoloured tooth?

A

Intrinsic or extrinsic
Intrinsic: caries, erosion ingestion, trauma, non vital, neonatal jaundice, genetic

Extrinsic: plaque, calculus, mouth wash, smoking,diet, restorations

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16
Q

What are the manamagemt aims for discoloured anterior teeth?

A 
Restore aesthetics
Restore function
Resolve sensitive t
Preserve tooth
Respect periodontal health
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17
Q

How does hydrochloric acid - pumice work?

A

This improves discolouration limited to outer enamel only

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18
Q

How much enamel is removed in microabrasion and pumice?

A

Less than 100 micrometers

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19
Q

What is the technique to microasbriaon?

A

Vitality test, x ray and photos
Clean dry and isolate
Protect soft tissues with sodium bicarbonate

18% HCL and pumice 5 sec application using slow rotary or wooden stick
Max of 10 times 5 secs

Fluoride drops for 3mins
Oldish for 1 min with soflex

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20
Q

When is micoabrsairon indicated?

A

Fluorisis
Idiopathic speckling
Post ortho demin
Well demarcated brown patch before veneer
White or brown surface staining eg turner teet

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21
Q

When shoud you see an improvement in colour with the microabrasion?

A

1/12

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22
Q

Which colour staining is more easily removed with microabrasion?

A

Brown

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23
Q

How do white stains improve?

A

Due to optical changes of aprismatic enamel

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24
T/F there is an association between caries and prolonged thermal sensitive and microabrasion?
F
25
What kit do you need for microabrasion?
``` Pumice Rubber am and copalite varnish Bicarbonate tsoda 18% HCL or 37% phosphoric acid Non acid fluoride Fine soflex disk Fluoridated tooth paste ```
26
When is non vital bleaching indicated?
Non vital discoloured teeth
27
What causes the discolouration in non vital teeth?
Diffusion of Hb products from necrotic pulp tissue
28
What are the requirements for non vital bleaching?
Well condensed GP | No clinical evidence radiographic signs of Periapical disease
29
How do you perform non vital bleaching?
Pre op X-ray Clean tooth and note shade Access pulp chamber and remove filling to level of dento gingival 1mm zinc phosphate placed on top Etch tooth with 37% phosphoric acid for 30-60secs Mix bleaching agents and cover with GIC. For 1 week
30
WHen is non vital bleaching not effective?
Heavily restored teeth Staining due to amalgam 21% failure rate
31
How often should you do the non vital bleaching?
Every week once a week until over bleached
32
How kong should you leave non setting CaOH in cavity for?
2 weeks
33
How should you restore the cavity?
With white GP and composite
34
When should you abandon non vital bleaching?
If no improvement after 3 times
35
What kit do you need for non vital bleaching?
``` Rubber dam Zinc phosphate 37% phosphoric acid 30 volume hydrogen peroxide Sodium perborate Cotton wool and GIC Composte resin ```
36
What type of resorption can non vital bleaching lead to?
Cervical
37
How do we prevent cervical resorption in non vital bleaching?
1mm zinc phosphate at neck of tooth | CaOH dressing to eradicate pulpal inflammation
38
What are the options for vital bleaching?
Chair side or night time
39
What percentage HP can be used for vital bleaching?
Up to 6%
40
When is chair side bleaching implicated?
Mild fluorosis Ageing Sclerosed pulp chamber
41
What happens to the hydrogen peroxide applied to the tooth in vital bleaching?
Activated with a light source of heat
42
What is the legislation behind vital bleaching?
Before 2012 could only use 0.1% HP one can use up to 6%
43
What is the process of home bleaching?
For each cycle,first cycle must be done by practitioner and for over 18 only Can use 10% carbamine peroxide gel which breaks down to 3% HP and 7% urea which both diffuse through enamel and dentine
44
What are the concerns with vital bleaching?
- Trace amounts of phosphoric and citric acid might lead to low pH and demin - initial decrease in bond strength of composite which resolve over 7 days - possible cytotoxic
45
Why is thre an initial decreases in composite bond strength?
Due to residual O2
46
What is vital bleaching cytotoxic to?
Vascular endothelium
47
What are the advantages and dis of localised resin based composite for discoloured anterior teeth?
AD Useful for demarcated lesion Dis: marginal staing, accurate colour match and reduce composite translucent and need good quality enamel
48
When are veneers indicated?
Discolouration, Diaestema Mal positioned tooth Large restoration a
49
When are veneers contra indicated?
Poor quality tooth for bonding Teeth to buccal in the arch Heavy occlusal loading
50
What is a good intermediate before placing porcelain veneers?
Composte resin Good for children since have large pulp and immature gingival contour For adults can be used as permanent but reversible and can be used a Dahl
51
When are porcelain veneers indicated?
Adults
52
T/F composite resins can be used directly ?
T | Lab made or direct
53
What is the problem with composte veneers?
Increased labio Palatal bulk can be detrimental to gum health
54
What are the disadvantages with porcelain veneers?
Hard to repair | Abrasive
55
T/F porcelain veneers mask out gross discolouration?
T
56
How much do you prepare porcelain veneers into teeth?
0.5mm
57
How do you prepare the surface of the veneer?
Sand blast and the HF acid and then apply silane coupling agent
58
What is a RRB?
A resin bonded bridge fixed to one or more unprepared or minimalist prepared natrual teeth
59
What are the alternative names for RRb?
Adhesive Minimum prep bridge Maryland bridge
60
What is the history begin RRB?
1973: Rochette used metsl wings to splint periodontal compromised teeth Tags of resins were used to retain metal wing that had perforations on
61
What are the advantages to RRb?
``` Fixed Conservative No La Short clinical time Relatively inexpensive Reversible/diagnostic ```
62
What are the disadvantages of RRB?
Aesthetic: greying of the abutment and metal showing over Try in of bridge can be hard Temporising can be difficult Extensive restore teeth cannot be used Risk of debond and failure rate higher than conventional bridge work Risk of caries greater if partial de bond of fixed fixed design Technqie sensitive
63
What are the failure rates for RRB? Reference
Djemal 1999 92% debond 4% metal fracture 2% caries
64
What are the indications for RRB?
Single tooth replacement ideally Unrestored abutments Teeth with sufficient good quality enamel Intermediate prosthesis in young patient
65
What are the contras indications to RRB?
``` Heavily restored abutments Teeth with lack of good quality enamel Excessive occlusal loading Poor OH Diffuculty in isolation Translucent incisal edge Disastomer ```
66
What are the designs for a RRB?
Cantilever Fixed fixed Hybrid
67
What are the features of a cantilever?
Eliminate problem of partial de bond Less expensive Limited to replacing only single tooth Less stress on resin lute since no differential tooth movement
68
What are the features of a fixed fixed?
Provide periodontal splinting Orthodontic retention Can restore multiple missing teeth Needed for anything other than single premolar or anterior r Differential movement of abutment
69
What is a hybrid design?
Resin retained and conventional design Needed when one or more of abutments to be restored with conventional crown Two testiness maybe joined by a moveable joint
70
What is the median survival rate for RRB? Reference
Fixed fixed 7.8 yrs Cantilever 9.8 yrs Djemal 1999
71
What are the clinical stages to RRB prep?
``` Sharp angles of tooth removed Bulbosities removed Guide planes No finish lines Crete bevel for incisal anterior teeth Aim for max coverage 180 degrees Consider crown lengthening Retauner extends into incisal edge and cusps Posterior teeth need extensive occlusal coverage Rigid framework ```
72
How thin can the metal be finished to in RRB?
0.1-0.5mm
73
How thick should the metal retainers in RRB. Be?
0.7mm minimum
74
How can you create space for the retainer in the RRB?
Prepare abutment Reduce oppsing teeth Ortho Dahl
75
Which method of space creation is ideal for the Pontic? Except for which patients?
Dahl | Except: occlusally aware and periodontal compromised
76
Which metal allot is used for the bridge?
Ni-Cr
77
What tyke of cement must be used for RRB?
4-Meta or Phosohate groups
78
What are the future options for RRB?
Metal free made from zirconia or ceramic | Good for premolar region
79
What are the problems with the metal free RRB?
Need increase bulk for retainer and increased risk of fracture of Pontic

Restorative (45 decks)

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