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Dent Y3 > Fixed Prosthodontics > Flashcards

Fixed Prosthodontics Flashcards

1
Q

What is a fixed prosthesis?

A

a prosthesis not removable by the patient

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2
Q

Give three examples of fixed prosthesis

A

crowns, veneers, bridges

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3
Q

What are some indications for fixed prosthesis?

A

teeth with large multi-surface restorations, fractured teeth, endodontically treated posterior teeth, to replace a missing tooth, as part of a RPD

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4
Q

What are some contraindications for fixed prosthesis?

A

tooth unrestorable, uncontrolled perio, untreated caries, poor oral hygiene, no interocclusal space, short clinical crown

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5
Q

What must you ensure before commending a crown preparation?

A

ensure the tooth is restorable

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6
Q

What should you check to determine how restorable a tooth is?

A

remaining tooth, are there any subgingival restorations, how much remaining enamel, is the perio attachment good, is there any apical pathology, is there RCT, is the tooth important for masitcation, are patients motivated, the tooth restorability index

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7
Q

What is the tooth restorability index?

A

an index to determine if there is enough remaining sound tooth structure to retain a core or crown

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8
Q

What does a sextant score of 0 mean in the tooth restorability index?

A

no axial wall of dentine to aid retention or resistance

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9
Q

What does a sextant score of 1 mean in the tooth restorability index?

A

inadequate coronal dentine distribution to make a predictable contribution to retention or resistance

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10
Q

How thick would the coronal dentine need to be to get a score of 1?

A

less than 1.5mm

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11
Q

What does a sextant score of 2 mean in the tooth restorability index?

A

a questionable amount of dentine is present, more than 1 but no predictable contribution to retention and resistance

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12
Q

What does a sextant score of 3 mean in the tooth restorability index?

A

adequate coronal dentine for retention and resistance

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13
Q

What does a whole tooth score of 12 and greater mean in the tooth restorability index?

A

restorable

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14
Q

What does a whole tooth score of 9-12 mean in the tooth restorability index?

A

Acceptable if 2-3 sextants have a comfortable 3 score

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15
Q

What does a whole tooth score of less than 9 mean in the tooth restorability index?

A

unacceptable to retain a plastic core

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16
Q

What are potential other treatments to consider if the whole tooth score is less than 9 in the tooth restorability index?

A

crown lengthening, cast post and core

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17
Q

What must you ensure is complete before the patient arrives for their crown prep?

A

stabilisation of any active disease process, periapical radiograph, assessment of the interocclusal space and occlusion, restorability assessment, know which type of prep you are completing

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18
Q

What must you ensure is done while you complete the crown prep?

A

ensure you use sharp highspeed burs with copious water irrigation to ensure the tooth doesn’t overheat, ensure the prep is smooth and not undercut, ensure there are adequate retention features

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19
Q

What must you ensure is complete once the crown prep is done?

A

retraction cord placed and an impression taken of the prep, impression of the opposing arch, take a shade match

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20
Q

What are the five principles of crown prep?

A

preservation of the tooth structure, retention and resistance form, structural durability, preservation of the periodontium, marginal integrity

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21
Q

What can excessive reduction of the tooth structure lead to?

A

thermal hypersensitivity, pulpal inflammation, pulpal necrosis, tooth may be over tapered or shortened which may affect its retention and resistance form

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22
Q

What is retention in crown prep?

A

the ability of the preparation to resist the dislodgement of the crown restoration by forces directed along its path of insertion

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23
Q

What is resistance in crown prep?

A

the ability of the preparation to resist the dislodgement of the restoration by forces directed horizontally to the restoration

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24
Q

What are the six factors affecting retention and resistance?

A

taper of the preparation, surface area of the preparation, length and height of the preparation, diameter of the tooth, texture of the preparation, accessory means

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25
Q

What is the convergence angle in regards to the taper of a crown prep?

A

the angle that is formed between each two opposing axial walls of a tooth prep to receive a crown restoration. It determines the taper of the tooth

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26
Q

What is the ideal overall taper for a crown prep and what does that mean for the ideal taper either side of the tooth?

A

ideal is 6 degrees, meaning the taper either side of the tooth needs to be 3 degrees in line with the long axis of the tooth

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27
Q

What can the surface area of the crown prep depend upon with regards to retention?

A

the size of the tooth, the extent of the tooth covered by the restoration, the accessory features

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28
Q

How can the size of the tooth affect the surface area for retention of the crown?

A

the larger the size of the tooth, the larger the surface area available for bonding, therefore the higher the retention

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29
Q

How can the extent of tooth coverage by the restoration affect the surface area for retention of the crown?

A

the higher the area covered by the restoration, the higher the retention

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30
Q

How can accessory features such as boxes, grooves, slots within a crown prep affect the surface area for retention of the crown?

A

increases the surface area for bonding as well as providing mechanical interlocking which increases the retention

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31
Q

How can the length and height of the preparation affect the retention of the crown?

A

increasing the length of the prep will increase the retention and resistance

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32
Q

How can the diameter of the tooth affect the retention of the crown?

A

a narrower tooth can have greater resistance to tipping than a wider tooth

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33
Q

How can the texture of the crown prep affect the retention of the crown?

A

rough surfaces can provide more mechanical interlocking which would increase retention however, we should aim for a smooth prep to give the best fit for the crown

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34
Q

What is structural durability in crown prep?

A

crown must be rigid enough to not flex, perforate or fracture

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35
Q

What are the two features related to structural durability in regards to crown prep?

A

occlusal reduction and axial reduction

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36
Q

Why is it important to remove enough tooth structure during occlusal reduction?

A

so the restoration can be built back to the ideal occlusion and thick enough to prevent wearing or distortion

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37
Q

Why is it importance to remove enough tooth structure during axial reduction?

A

important to provide enough space so that the restoration can be built with adequate thickness

38
Q

What are five reasons why we should aim to place the margin of the prep supra-gingivally?

A

easily prepared and finished by the operator, provides good vision for the operator, patient can keep the area clean easier, mostly on enamel, less destructive to the periodontium

39
Q

What does equi-gingivally mean?

A

with the level of the gingiva

40
Q

What are four situations which require sub-gingival placement of the finishing line?

A

aesthetics, when we need extra retention in teeth with short crowns, when there is caries or restoration at the area of the finish line, margin should be placed on sound tooth structure

41
Q

What should a crown preparation never involve?

A

the biological width

42
Q

What is the biological width?

A

the band of tissue attached to your tooth until it meets the alveolar bone - approx 2mm

43
Q

What will impinging on the biological width lead to?

A

attachment loss, gingival inflammation, difficulty cleaning, crestal bone loss

44
Q

What are the three requirements of a restoration margin?

A

it must fit as closely as possible against the finishing line of the prep, it must have sufficient strength, it should be placed in an area the dentist can finish

45
Q

What are the 6 factors to consider when choosing an indirect restoration?

A

location of the tooth, amount of tooth structure available, remaining dentition and occlusion, parafunctional habits, underlying tooth colour, what cement can be used to bond the crown based on the material

46
Q

Which types of cements can be used to cement metal crowns?

A

a wide range

47
Q

Which types of cements can be used to cement ceramic crowns?

A

resin-based

48
Q

What should you not cement a temporary crown with if you aim to use a resin-based cement for the permanent crown? why?

A

a eugenol based temporary cement as it inhibits polymerization

49
Q

What is needed for glass based ceramic crowns to have a strong bond?

A

sufficient enamel to bond to

50
Q

Where can you not use a resin-based cement?

A

sub-gingival finish lines

51
Q

What are the four types of crown available?

A

metal based, PFM, ceramic, zirconia monolithic

52
Q

What should the occlusal reduction be for metal based crowns?

A

1mm

53
Q

What should the axial reduction be for metal based crowns?

A

0.5mm

54
Q

What should the function cusp bevel reduction be for all crowns?

A

0.5mm

55
Q

What should the occlusal reduction be for PFM crowns?

A

1.5mm

56
Q

What should the axial reduction be for the porcelain sections of the PFM prep?

A

1.2-1.5mm

57
Q

What should the axial reduction be for the metal sections of the PFM prep?

A

0.5mm

58
Q

What should the occlusal reduction be for ceramic crowns?

A

1.5mm

59
Q

What should the axial reduction be for ceramic crowns?

A

1mm

60
Q

What should the occlusal reduction be for zirconia monolithic crowns?

A

1mm

61
Q

What should the axial reduction be for zirconia monolithic crowns?

A

0.5mm

62
Q

Should the finishing lines for metal based crowns be champfer or shoulder?

A

champfer

63
Q

Should the finishing lines for the porcelain sections of PFM crowns be champfer or shoulder?

A

shoulder

64
Q

Should the finishing lines for the metal sections of PFM crowns be champfer or shoulder?

A

champfer

65
Q

Should the finishing lines for ceramic crowns be champfer or shoulder?

A

champfer

66
Q

Should the finishing lines for zircoina monolithic crowns be champfer or shoulder?

A

champfer

67
Q

What are some indications for the use of metal crowns?

A

minimal prep required, patient request, bruxism, subgingival margin

68
Q

What are some indications for the use of PFM crowns?

A

aesthetics, bruxism, metal sub structure required to block out discolouration, insufficient enamel for ceramic crown, subgingival margin

69
Q

What are some indications for the use of ceramic crowns?

A

aesthetics and sufficient enamel for bonding

70
Q

What are some indications for the use of zirconia monolithic crowns?

A

compromise between minimal prep and aesthetics, non-metal crown in a posterior region

71
Q

How can high speed handpieces affect the pulp complex?

A

can cause localised inflammation and changes in odontoblast nuclei

72
Q

How can drying the dentine affect the pulp complex?

A

can cause aspiration of the odontoblastic nuclei and pulpal inflammation

73
Q

How can opening the dentinal tubules affect the pulp complex?

A

increases the chance of bacterial contamination of the pulp

74
Q

How can cementing uncured resin components affect the pulp complex?

A

been shown to inflict localized pulpal inflammation when in close proximity to pulp tissues

75
Q

How can inadequate cementation of the crown and inadequate marginal fit affect the pulp complex?

A

can lead to microleakage and subsequent inflammation of the pulp

76
Q

What issues can under-preparing the crown prep result in?

A

compromised structural durability of the crown, knife edge crown margins which can splay or fracture, lack of inter-occlusal clearance, damage to opposing teeth, bulky restorations, poor aesthetics

77
Q

What issues can occur if a sub-gingival margin is used?

A

localised gingival inflammation, plaque accumulation, increased pathogenicity of subgingival plaque, violation of the biological width, attachment loss

78
Q

What issues can occur if there are poorly defined or poorly captured crown margins?

A

the technician may struggle to determine the margins which will result in overhanging or open crown margins leading to perio issues

79
Q

What is retraction cord used for?

A

to temporarily displace the gingivae so an accurate impression can be taken of the finish line to allow the use of hydrophobic impression materials

80
Q

If the retraction cord is used too aggresively, what can occur?

A

gingival bleeding, patient discomfort, damage to epithelium attachment, gingival recession

81
Q

Can crowns be used alongside RPD?

A

yes, the crowns can be incorporated into the design

82
Q

What does hue mean regarding shade selection?

A

colour tone such as red or blue or yellow

83
Q

What does value mean regarding shade selection?

A

intensity or saturation of the hue such as light blue or dark blue

84
Q

What does chroma mean regarding shade selection?

A

the relative brightness or darkness of the hue

85
Q

What does an A grade mean on the vita shade guide?

A

red-yellow hue

86
Q

What does a B mean on the vita shade guide?

A

yellow hue

87
Q

What does a C grade mean on the vita shade guide?

A

grey hue

88
Q

What does a D grade mean on the vita shade guide?

A

brown hue

89
Q

What does the number for each grade on the vita shade guide mean?

A

the chroma of each tooth

90
Q

Does every area of the tooth need to have the same shade selection?

A

no

Dent Y3 (23 decks)

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