introduction Flashcards
(38 cards)
What problems can people have with the aesthetics of their teeth
- Colour
- Surface texture
- Symmetry
- Spaces
- Shape
- Arrangement
List the different ways we can change the colour or shape of teeth
- Whitening
- Microabrasion
- Composite
- Veneers
- Crowns
List the different wats we can whiten all the teeth
- Chairside
2. At home with night guard vital bleaching
List the different wats we can whiten an individual tooth
- Internal bleaching
2. Inside/ outside bleaching
How do we carry out night guard vital bleaching
- Requires personalised bleaching tray
- Give patient 10% carbamide peroxide
- First application done in surgery under observation
- Patient applies bleaching gel to tray every night
- Regular review after 1-2 weeks to assess change to shade and any problems
what does carbamide peroxide break down into
3.6% Hydrogen peroxide
What is the maximum strength of hydrogen peroxide we can give to a patent legally
6% hydrogen peroxide
What effect does bleaching have on enamel surface morphology
- Enamel pores, depressions dn erosive alterations seen following two weeks of treatment
- Transient sensitivity common
but all this is reversible
How can we reverse the negative effects of bleaching on the enamel surface
Recommend patient to use a fluoride mouth rinse/ varnish
What effect does bleaching have on bonding
Research found significant reduction dentine bond strength with 35% hydrogen perioxide, 35% carbamide immediately after bealchign
What is the recommended waiting time for a patient who’s teeth we are bleaching to put in a restoration
at least 2 weeks
When might we carry out non vital bleaching
On a root filled tooth that has darkened over time
Why do root filled teeth darken over time
- Pulpal remenants break down causing darker colour
- Oigmeneted bacteria may be present t
3 Caries
What are the 2 ways we can carry out non vital bleaching
- Internal bleaching
2. Inside/outside bleaching
Talk through the stages if internal bleaching
- Remove coronal restoration
- Take GP down to 2mm below level of CEJ
- Clean walls with ultrasonic
- Place 1mm RMGIC over GP (not on walls)
- Acid etch for 30 seconds wash / dry
- Place pledget of cotton wool soaked in 10% carbamide peroxide
- Temporary restoration with high contrast material
What temporary restoration can we use following internal bleaching
A high contrast material such as Poly F or Chemfil Rock
Talk through the stages if inside/ outside bleaching
- Remove coronal restoration
- Take GP down to 2mm below level of CEJ
- Clean walls with ultrasonic
- Place 1mm RMGIC over GP (not on walls)
- Leave tooth open and provide patient with a vital night guard bleaching tray
- Review
What is micro abrasion
The use of acid etching and pumice to remove surface stains and superficial enamel defects or mild flourosis
How do we carry out micro abrasion
- Rubber dam
- Clean tooth with water and dry
- Apply phosphoric acid 37% to enamel surface for 30 seconds
- Wash and dry
- Clean tooth with pumice and water slurry in slow rotation rubber prophylaxis cup
- Wash
- Repeat If necessary unto 3 application
- Review in one month ask repeat as needed
What can we do with composite for cosmetic treatment
- Change shade with a composite veneer
- Change the shape of the teeth
- Close diastema
- Make teeth longer
- Make teeth wider
what are the advantages of using composite restorations to improve aesthetics
- Non destructive
- No lab fees or waiting time
- Can alter the shape to get the right result yourself
what are the disadvantages of using composite restorations to improve aesthetics
- reversible
- Stains over time leading to loss of aesthetics
- Needs maintenance
- Challenging to get aesthetics right
What might we use before placing composite on a patients tooth to help with planning
Diagnostic wax up so that the lab can simulate what we are about to do
What are veneers made up of
Porcelain
