Restorative Flashcards

Question

external bleaching problems sensitivity

Answer 1

* common 60% + * worse initially * resolves over 2-3 days post bleaching * predictors - pre-existing sensitivity, high conc, bleaching method, gingival recession

Answer 2

* oxidised chromogens gradually reduce with time * retreatment 1 - 3 years * varies

Answer 3

* residual oxygen from peroxide remains within enamel structure initially * gradually dissipates over a short time * delay restorative procedures for at least 24h post bleaching * better to delay for a week

Answer 4

* ph of 3 will soften tooth surface * makes teeth more prone to re-staining * teeth develop a rough surface and become extremely sensitive

Answer 5

Dead pulp causing bleeding into dentine Blood products diffuse and darken Causes grey discolouration

Answer 6

Indications - non vital tooth, adequate RCT, no apical path Contraindications - heavily restored tooth (better with crown or veneer), staining due to amalgam

Answer 7

Easy Conservative Patient satisfaction

Answer 8

External cervical resorption due to diffusion of H2O2 through dentine and into periodontal tissues Increased risk from high conc H2O2 and heat Trauma important consideration

Answer 9

1. record shade, prophylaxis and rubber dam 2. Remove filling from access cavity and remove GP from pulp chamber to 1mm below amelo-cemental junction 3. Place RMGIC over GP to seal canal - prevents root resorption

Answer 10

1. Remove any very dark dentine 2. Etch internal surface with 37% phosphoric acid 3. Place 10% carbamide peroxide gel in cavity and cotton wool over this 4. Seal with GIC 5. Repeat procedure at weekly intervals and until required shade achieved or no change

Answer 11

Normally takes 3-4 visits If no change after 4 visits it is not going to work and consider crown/veneer/composite build up

Answer 12

Restore the palatal cavity 1. Place white GP or similar into pulp chamber 2. Restore with light shade of composite

Answer 13

Will gradually darken again Retreatment every 4-5 years but this is variable

Answer 14

- inside-outside bleaching - remove GP and cover with RMGIC - make bleaching tray (palatal not buccal reservoir) - bleach placed in access cavity and in tray - replaced frequently over about a week -tricky for patient must wear tray whole time

Answer 15

Removes discolouration limited to the outer layers of enamel Combination of erosion (acid) and abrasion (pumice)

Answer 16

- fluorosis - post orthodontic demineralisation - demineralisation with staining - prior to veneering if staining is present

Answer 17

1. Clean teeth thoroughly 2 rubber dam as seal very important 3. Mix 18% HCl and pumice and apply to teeth 4. Gently rub with a prophy cup 5 seconds per tooth 5. Wash and repeat up to 10X 6. Remove rubber dam 7. Polish teeth with fluoride prophy paste 8. Apply fluoride gel or varnish

Answer 18

Review after one month Can be repeated Too much repetition can lead to yellowing of the tooth as dentine begins to show through Too much can also lead to permanent sensitivity

Answer 19

Advantages - quick, easy - no long term problems such as pulp all damage or caries Disadvantages - acid - sensitivity - only works for superficial staining - works much better for brown staining than white marks

Answer 20

Can use 37% phosphoric acid rather than HCl - will remove only 10microns compared to 100 microns with HCl - etch first for longer than 30s prior to using pumice - not as effective but this acid is readily available to GDP

Answer 21

-surface layer not removed - infiltrate the white area with resin - changes the refractive index of the white area - masks it and makes it look like the surrounding enamel - used for tx of white spot lesions - hydrophilic resin impregnation of the porous enamel surface in white area

Answer 22

Appears to demonstrate an immediate masking effect - aesthetic result durability uncertain requires further studies - could be due to potential staining and ageing of the low viscosity resins used

Answer 23

- the cosmetic products regulations 2012 - in UK tooth bleaching products considered cosmetic - in USA they are a medical device

Answer 24

- free of dental pathology - medical contraindications

Answer 25

- glucose-6-phosphate dehydrogenase deficiency - acatalasemia - neither group can metabolise hydrogen peroxide

Answer 26

- products which contain more than 6% hydrogen peroxide - or any associated products which release greater than 6% hydrogen peroxide - cannot be supplied or administered for cosmetic purposes

Answer 27

- products containing between 0.1% and 6% hydrogen peroxide cannot be used on under 18s (except if intended wholly to prevent disease) - ^ these products should not be made directly available to consumer other than tx from dentist or dental hygienist etc under a dentists prescription - breaches of regulations a criminal offence - enforced through trading standards - 0.1% products such as mouth rinse, toothpaste and tooth whitening or bleaching products are safe and continue to be available on the market

Answer 28

- whitening products only sold by dental practitioners - first cycle of tx must be supervised - conc higher than 6% hydrogen peroxide prohibited unless wholly for the purpose of prevention of disease - criminal offence to breach these guidelines

Answer 29

- dentists supplying bleaching products in excess of 6% will be prosecuted by trading standards - if dental professional found to do this they will face fitness to practice proceedings - non registrants providing tooth whitening will be prosecuted by GDC under dentists act 1984 for illegal practice of dentistry

Answer 30

* ceromer - inlays/onlays * ceramic * gold - type IV post cores and III crowns * metal ceramic

Answer 31

* poly-vinyl siloxane PVS * made before any tooth preparation

Answer 32

* ensure no cavosurface margins pass through areas of occlusal contact and are clear of contact with adjacent tooth and accessible for cleaning * ensure a butt joint is present on all cavosurface margins * smooth occlusal cavosurface margins and line angles * ensure outline form is smooth and rounded * all internal line angles should also be rounded * ensure no undercuts and all axial walls are minimally divergent

Answer 33

* after provisional restoration has been constructed * on day of tooth preparation * for valid clinical reasons you may not always intend to record the definitive impression on day of tooth prep

Answer 34

* area of prosthodontics focused on permanently attached (fixed) dental prosthesis * also referred to as indirect restorations

Answer 35

* veneers * inlays and onlays * crowns * post and cores * bridgework

Answer 36

* sensibility testing * radiographs * study models * facebow * diagnostic wax up * diet diary * plaque and gingivitis indices * clinical photographs

Answer 37

reconstructive

Answer 38

* active caries and periodontal disease * time - tooth preparation and labatory fabrication required * cost

Answer 39

1. preservation of tooth structure 2. retention and resistance 3. structural durability 4. marginal integrity 5. preservation of the periodontium 6. aesthetic considerations

Answer 40

* whenever possible preserve sound tooth structure * this is to avoid unnecessary weakening of tooth structure and damage to pulp * must balance against criteria for retention/resistance and structural durability

Answer 41

* under prep - poor aesthetics, over built crown with periodontal and occlusal consequences, restorations with insufficient thickness * over prep - pulp and tooth strength compromised

Answer 42

* retention - prevents removal of restoration along path of insertion or long axis of tooth prep * resistence - prevents dislodgement of restoration under occlusal forces * retention is improved by limiting the number of paths of insertion * taper - 6-10degrees is ideal inclination of opposing walls * extra means of retention - grooves, slots

Answer 43

* restoration must contain a bulk of material that is adequate to withstand the forces of occlusion * achieved through: * occlusal reduction * functional cusp bevel * axial reduction

Answer 44

* correct finish line configurations for type of material * knide edge * bevel * chamfer * shoulder * bevelled shoulder

Answer 45

* margins of the restoration should be 1. smooth and fully exposed to a cleansing action 2. placed where a dentist can finish them and the patent can clean them 3. placed supra-gingival or at gingival margin whenever possible - placement of the margins subgingival may be required

Answer 46

* which material provides best aesthetics - will the restoration be visible * has the least destructive prep * is least destructive to opposing teeth * best suited to bruxists

Answer 47

* aesthetics * occlusal stability - prevent tilting and overeruption of adjacent and opposing teeth * for function - mastication, speech * periodontal splinting * patient preference

Answer 48

* damage to tooth and pulp * secondary caries * effect on the periodontium * cost * failures

Answer 49

* cantilever - one adjacent tooth crowned to support bridge * fixed-fixed - conventional with rigid connectors * adhesive/resin-bonded/maryland - wings on either side of the pontic that are attached to your abutment teeth by an adhesive * conventional - crown teeth either side of bridge * hybrid * spring cantilever - posterior tooth used as retainer for anterior tooth pontic * implant supported

Answer 50

* invasiveness/reversibility * longevity and success rates (evidence based) * possible complications * time involved * costs * alternative options

Answer 51

* conservation of healthy tooth tissue - avoid weakening structures or compromising pulp * axial and occlusal reduction should provide sufficient space for material * reductions should also provide resistence form - axial symmetry, optimal taper * margin appropriate for material used and for relationship with periodontal tissues to allow optimal hygiene * prep surface smooth whit no sharp line or point angles

Answer 52

* 1.5-2.5mm incisal reduction to accomodate porcelain and metal * 1.5mm buccal shoulder required and in aesthetic areas may be placed approx 1mm into gingival sulcus * non aesthetic margins for metal should be chamfered 0.5mm and placed supra-gingivally

Answer 53

1. incisal reduction - can use depth cuts as guide 2. proximal separation - separation bur along long axis of tooth 3. buccal reduction (2. and 3. interchangable) 4. palatal or lingual reduction 5. shoulder and chamfer finish - with dam off 6. occlusion check/adjustment 7. polishing the preparation

Answer 54

* shoulder buccally * chamfer lingually - as margin made only from metal

Answer 55

* used to imporve anterior aesthetics * typically thin laboratory made * have a finite life span - consider when tx planning * usually necessary to remove healthy tooth tissue - consider alternative of direct composite veneers * hand made usually better aesthetics - ceramicist build layers of diff porcelian to give colour depth and translucency * CAD-CAM normally milled from block of porcelain - colour variations added post milling

Answer 56

* gingival retraction cord * once dam removed * to assist with placing the margin subgingivally

Answer 57

* take putty indices BEFORE tooth preparation * a sectional index tray used * if take 2 - one index can be used to make provisional veneer and other as a reduction template

Answer 58

* incisal edge enamel reduced by 0.75-1.5mm to produce incisal bevel finish * labial enamel reduced by approx 0.5mm - depth cuts can help guage amount of reduction - ensure labial face has 3D curve and not a flat cut (preserve curvature) * chamfer finish line prepared cervically at or just above gingival margin * proximal chamfer extended towards contact area * preparation finished and smoothed with red and yellow band high speed diamond burs or silicone disc

Answer 59

* conservation of healthy tooth tissue - avoid weakening structures or compromising pulp * axial and occlusal reduction should provide sufficient space for material * reductions should also provide resistence form - axial symmetry, optimal taper * margin appropriate for material used and for relationship with periodontal tissues to allow optimal hygiene * prep surface smooth whit no sharp line or point angles

Answer 60

* approx 2.5mm occlusal reduction to accomodate porcelain and metal (1-1.5mm if metal only) * 1.5mm buccal shoulder required in aesthetic areas - may be placed 1mm into gingival sulcus * non aesthetic margins should be chamfered and placed supra-gingivally * 5-7 degree taper recommended * ensure some occlusal anatomy morphology retained to increase resistance to rotational forces

Answer 61

* approx 2.5mm occlusal reduction necessary to accomodate zirconia framework and porcelain veneer - less may be required for lithium disilicate * 1.5-2mm buccal shoulder or long chamfer circumferentially - approx 1mm into gingival sulcus * non aesthetic margins should be chamfered and placed supra-gingivally unless additional prep height required * 5-7 degree taper recommended

Answer 62

1. occlusal reduction - using short tapered fissure bur can make depth cuts + functional cusp bevel 2. proximal separation - fine pointed diamond bur 3. buccal reduction 4. palatal or lingual reduction - blend buccal and lingual reductions 5. shoulder/chamfer finish 6. occlusion check/adjustment 7. polishing the prep

Answer 63

* secondary caries * cuspal fracture - is tooth restorable? * need to make clinical decision on whether tooth can be restored directly, by inlay/onlay, or requires full coverage crown

Answer 64

* long tapered diamond bur * with flat end * on high speed

Answer 65

* chairside in surgery with a CAD/CAM system - constructed inlay bonded at same visit * in a lab from an impression taken in surgery - inlay made from model directly or via lab CAD/CAM system - bonded at subsequent visit

Answer 66

* NO UNDERCUTS if restoration is to be fitted * undercus can be blocked out using GI, flowable composite, or removed * only dentine may be blocked out * enamel undercuts must be removed as blocking out materials will not support unsupported enamel and must not reach cavo-surface margin as will compromised bonding of inlay to enamel

Answer 67

1. identify and remove carious enamel 2. remove enamel to identify maximal extent at ADJ and smooth enamel margins 3. remove peripheral caries in dentine - from ADJ first then circumferentially deeper 4. only then remove deep caries over pulp 5. outline form modification - cavo surface margin, enamel finishing, requirements of rest. material 6. internal design modification - internal line and point angles smoothes and rounded, requirements of res. material

Answer 68

* inject sufficient material to cover entire prep * material used in PCS was poly-vinyl siloxane (addition silicone) * seat a tray filled with same material over the arch * allow setting without moving the tray * ensure impression of opposing arch also sent to lab

Answer 69

* preparation isolated and coated with a layer of titanium dioxide - as optical impression in 3D can only be recorded in monochrome * silicone interdental record of the morphology of opposing teeth is then placed on prep and also coated * optical 3D images processed by unit * inlay then milled from a block of leucite reinforced porcelain or lithium disilicate * takes approx 14 mins to mill * restoration bonded with self adhesive resin cement

Answer 70

1. impressions to send to lab 2. lab wax up incisors to recreate morphology prior to wear on study cast 3. make a template from the wax up to assist with clinical direct composite build up 4. rebuild lower incisors using template * build up lingual surfaces and incisal edges first * proximal and labial surfaces may be reconstructed next * continued use of wedges and matrices

Answer 71

* compromised aesthetics in smile line * degrades tooth function: occlusal reduction which destabilises occlusion * occlusal and interproximal reduction can render a tooth sensitive - exposed dentine * compromise coronal seal of RCTd teeth in some cases * provisional extra-coronal restorations should restore these characteristics

Answer 72

* have good marginal fit * be well contoured - no overhangs * cleansable and maintainable by pt - prevent plaque build up and caries - maintain gingival health and contour * establish and/or maintain dental aesthetics - mimic original tooth or definitive restoration * prevent sensitivity * prevent microleakage - preserve tooth vitality

Answer 73

* patient unable to clean * can result in caries * gingival inflammation - poor moisture control, gingival overgrowth

Answer 74

* non irritant to pulp/periodontal tissues * low temp rise during setting * dimensionally stable * adequate working and setting tume * adequate strength and wear resistance * good aesthetics

Answer 75

* custom formed - bespoke to individual situations, preferable, can be technically demanding * preformed - standard shapes and sizes - adjust to fit chairside

Answer 76

* chemically cured bis-acrylic composite resin * examples: protemp plus, integrity temp-grip * customisabe - fits tooth prep internally and reproduces contact points and occlusion externally * protemp most commonly used

Answer 77

* impressions for definitive restoration are taken * helps check that tooth prep is satisfactory * check for undercuts * sufficient reduction

Answer 78

1. sectional impression 2. prepare tooth for chosen restoration 3. syringe bis-acrylic composite resin material onto bracket table/mixing pad to ensure its mixed and monitor setting 4. syringe material into sectional impression of tooth that has been prepared 5. relocate impression in the mouth - ensure fully seated 6. remove before complete polymerisation 7. remove flash and ledges - hig speed and/or polishing discs 8. confirm tooth preparation - svensen gauge 9. check marginal fit and occlusion in situ - adjust if required 10. check aesthetics 11. cement provisional restoration

Answer 79

* used to check degree of preparation * ruler at bottom * put provisional between pincers and will show what thickness the provisional is

Answer 80

* sectional impression - full arch impression unnecessary * materials: * addition cured silicone putty - can be reused * alginate - cannot be reused * softened modelling wax - cannot be reused * alternative: custom vacuum formed plastic mould - made on study model and/or diagnostic max-up in advance

Answer 81

* loss of original tooth form (eg wear cases) - temp re-establishes tooth shape and can pilot occlusion and aesthetics using provisional restorations * guidance (anterior/incisal) produce using diagnostic wax up on articulated study models (facebow refistration required) * once guidance and aesthetics satisfactory duplicate waxed-up cast and construct vacuum-formed mould/stent/template and next visit prepare teeth and use stent to produce provisional restoration to new occlusion/aesthetics

Answer 82

* wear until happy with - form/function * adjust/alter - trim with bur, addition of composite, reassess

Answer 83

* obtain mounted casts * lab: produces diagnostic max up and duplicates cast then constructs vacuum stent over duplicate cast * carry out tooth prep if required * use stent and provisional material to produce provisional restorations * patient wears provisionals for trial period * reassess: aesthetics, occlusion * if satisfactory procees to definitive restorations

Answer 84

* use provisional restorations to achieve satisfactory emergence profile for definitive restorations * emergence profile - contour of tooth/restoration as it emerges from the gingivae

Answer 85

* tooth coloured: polycarbonate (directa) or clear-plastic crown froms filled with composite * metal: aluminium or stainless steel * different shapes/morphology and sizes

Answer 86

* + : useful for situations where no impression taken prior to tooth prep or damage eg trauma cases * - : unlikely to fit accurately and large bank of crowns needed to accomodate variation between pts - costly

Answer 87

1. select shell slightly larger than prep 2. trim back until correct prep dimension, seats fully over pre and not bedding into gingivae 3. fill shell with trim/protemp 4. seat over tooth - wipe away excess - microbrush good 5. allow polymerisation 6. remove and check fit 7. trim/tidy if necessary 8. cement using temp luting cement eg tempbond 9. cut off tag

Answer 88

1. select and trim until fit 2. pierce hole at cusp tip/canine tip/incisal angle - air escapes so no bubbles 3. fill with bis-acrylic composite resin 4. seat over tooth 5. allow setting 6. remove from tooth and remove plastic crown form 7. check margins and occlusion - adjust if necessary 8. cement with temp cement

Answer 89

* used for posterior teeth * materials: aluminium, stainless steel * remove any ledges and sharp margins - reduce soft tissue trauma * difficult to adjust - use crimping device to help mould margins

Answer 90

* can use/modify original crown for temporary - may need partially sectioned/relined * removal using WAMkey, saferelax, sliding hammer

Answer 91

* eg protemp crown temporisation material * soft and easily mouldable to tooth preparation * moulded over tooth to desired shape * partially light cured - 2/3 seconds (otherwise difficult to remove) * remove then completely cure outside mouth * check fit/adjust if necessary * cement

Answer 92

* conventional bridgework temporisation - similar to custom-formed provisional crowns - diagnostic wax up of replacement tooth * acrylic RPD * essix retainer with pontic * edentulous space and only provisional crowns on prepared teeth

Answer 93

* maintain good OH: brush 2-3 x daily, interdental cleaning 1-2 x daily * caution with floss - may pull out provisional restoration * gingival inflammation increases GCF/bleeding so poor moisture control for definitive restorations

Answer 94

* crowns * posts and cores * bridgework * inlays and onlays * veneers

Answer 95

* radiographs: caries, perio, periapical, previous RCT * sensibility testing * mounted study models: semi or fully adjustable articulator * diagnostic wax up: aesthetics, occlusion, achievability

Answer 96

* CAD-CAM * restorations milled from block of ceramic * quick * no temporary needed * accuracy??

Answer 97

* intra-coronal restorations made in lab * like a filling made outside the mouth

Answer 98

* gold * composite * porcelain * A: superior materials and margins (vs direct restoration) and wont deteriorate over time * D: time and cost

Answer 99

* occlusal cavities * occlusal/interproximal cavities * replace failed direct restorations * minor bridge retainers - no longer recommended

Answer 100

* premolars or molars * occlusal restorations * mesio-occlusal or disto-occlusal restoration * MOD if kepy narrow - if not consider onlay * low caries rate

Answer 101

* make temporary restoration * take impressions and occlusal records - send to lab for restoration fabrication (2 weeks typically) * fit temporary restoration * alternative: direct temporary materials - ZOE, GI, clip

Answer 102

* ceramic inlays: weak when not cemented so dont check occlusion as may fracture; uses adhesive systems - nexus, ABC, relyx unicem * nexus is dual cure composite luting agent * gold inlays: aquacem; panavia; RMGI

Answer 103

* pour impressions * mount casts on articulator: waxbite; occlusal record; facebow * construct restoration: tooth (FDI); material; thickness; shade; characteristics

Answer 104

* extra-coronal restorations made in lab * like inlays but with cuspal coverage * height of cusps need to be reduced during preparation * types: gold; composite; procelain

Answer 105

* 1.5mm occlusal reduction (non working cusp) * 2mm reduction (working cusp) * proximal box if required 1mm * 1mm shoulder or chamfer margin * tapered walls - no undercuts * butt joint cavosurface margins - no bevels * flat pulpal floor * rounded internal line angles * margins clear of occlusal contact points

Answer 106

* 0.5mm occlusal reduction (non working cusp) * 1mm occlusal reduction (working cusp) * 0.5mm chamfer margin * proximal box if required 1mm * 4-6degree tapered walls - no undercuts * 12-20 degree bevel upper 1/3 of isthmus wall * margins clear of occlusal contact points * flat pulpal floor

Answer 107

* sufficeint occlusal tooth substance loss - buccal and/or lingual cusps remaining * remaining tooth substance weakened - caries, pre-existing large restoration (MODs with wide isthmuses) * cast metal onlays preferable to amalgam when higher strength needed and significant tooth recontouring required

Answer 108

* toothwear cases - increase OVD * fractured cusps * restoration of root treated teeth * replace failed direct restorations * minor bridge retainers - not recommended * less destructive alternative to crowns

Answer 109

* LA if no RCT * make reduction template and impression for temporary * tooth preparation * make temporary * impression, bite registration and record shade * cement temporary

Answer 110

* remove temp * isolate, clean and dry prepared tooth * try in, assess fit, adaptation, occlusion etc * if happy to cement - cement and minor occlusal adjustments if needed * if not happy to cement - address problems

Answer 111

* large direct restorations: amalgam, composite, GI * crown: 3/4 crown in gold, full crown - GSC, MCC, PJC * extraction

Answer 112

* also called porcelain laminate venner PLV or laminate veneer * lamiinate veneer is a thin layer of cast ceramic that is bonded to labial or palatal surface of a tooth with resin * types: ceramic; composite; gold

Answer 113

* improve aesthetics * change teeth shape and/or contour * correct peg-shaped laterals * reduce or close proximal spaces and diastemas * align labial surfaces of instanding teeth * correct discolouration/enamel defects

Answer 114

* non-vital teeth * ageing * trauma * fluorosis * hypoplasia or hypomineralisation * amelogenesis imprefecta * erosion and abrasion * extrinsic: staining not amendable to bleaching

Answer 115

* poor OH * high caries rate - interproximal caries and/or unsound restorations * gingival recession * root exposure * high lip lines * if extensive prep needed * labially positions, severely rotated and overlapping teeth * extensive TSL/insufficient bonding area * heavy occlusal contacts * severe discolouration

Answer 116

* feathered incisal edge * incisal bevel * intra-enamel (window) * overlapped incisal edge

Answer 117

* 0.3mm cervical reduction - slight chamfer margin within enamel which is supragingival or slightly subgingival * 0.5mm midfacial reduction within enamel * 1-1.5mm incisal reduction

Answer 118

* may not need temp * alternative - spot bonded composite * no etch * small spot of primer and adhesice * directly apply composite

Answer 119

* no tx * micro-abrasion * penetrative resin restorations eg ICON * direct composite restorations * crowns

Answer 120

* severity of injury sustained * stage of root development * timing of treatment

Answer 121

* can use risk calculator: IADT dental trauma guide * prognosis for teeth with traumatic dental injuries * www.dentaltraumaguide.org

Answer 122

* ED#: 5% risk of pulp necrosis and 1/3% risk of pulp canal obliteration at 10 years * EDP#: 20% risk of pulp canal obliteration at 10 years

Answer 123

* hard tissue is deposited along the internal walls of the root canal and fills most of the pulp system * leaving it narrowed and restricted

Answer 124

* pulp necrosis: 3.5% at 10 years * pulp canal obliteration: 10.3% at 10 years * external root resorption: 8% at 10 years

Answer 125

* pulp necrosis: 12.5% at 10 years external root resorption: 2.7% at 10 years * bone loss: 0.9% at 10 years

Answer 126

* pulp necrosis: 56.5% * pulp canal obliteration: 21.7% * external root resorption: 27% * bone loss: 17.4%

Answer 127

* pulp necrosis: 75% * pulp canal obliteration: 18.3% * ankylosis: 1% * internal root resortion: 3/3% * external root resorption: 33% * bone loss: 5.8%

Answer 128

* tooth loss: 10% at 10 years * pulp necrosis: 45% * pulp canal obliteration: 13% * ankyolosis: 2% * internal root resorption: 4% * external root resorption: 5% * bone loss: 8%

Answer 129

* tooth loss: 29% * pulp necrosis: 100% * ankylosis: 38% * internal root resorption: 5% * external root resortion: 5% * bone loss: 63%

Answer 130

* dry storage no more than 4 minutes * followed by correct transport medium: milk, saliva or saline * increased dry storage time increasess risk for lost tooth * 5-60minutes: 44% loss at 10 years * 61+ minutes: 70% loss at 10 years

Answer 131

* open apex: maintain pulp vitality; preservation or blood supply; aim for regerneration * closed apex: maintain pulp vitality; preservation of blood supply; prevent ingress of or eliminate bacteria and toxins

Answer 132

* acute <3 hours * subacture 3-24 hours * delayed >24 hours * decision made based on pt discomfort, risk of infection, rate of complications

Answer 133

* avulsion: immediate re-implantation and acute tx * alveolar fracture: acute * extrusion/lateral luxation: acute or subacture * root #: acute or subacture * concussion or subluxation: subacute * crown or crown-root#: subacture or delayed

Answer 134

* discolouration * loss of vitality * inflammatory root resorption: internal, external, replacement * unfavourable tooth positions * defects in hard and soft tissues

Answer 135

* external: accumulation of staining media * internal: optical and light transmitting properties of enamel and dentine; following trauma may be yellow/pinl/red/grey/black * diagnosed by visual examination

Answer 136

* indicative of canal obliteration * tertiary dentine reduces light transmission * monitor for signs/symptoms of loss of vitality * consider local external bleaching

Answer 137

* rupture of BV durig severe trauma - may cause haemorrhage in pulp chamber * blood components flow into dentinal tubules * causes discolouration of the surrounding dentin * initially pink * cervical root resorption may also present as pink discolouration at cervical margin of crown

Answer 138

* in non-infected truamatised teeth accumulation of haemogrlobin molecule or other haematin molecules causes discolouration * in non vital teeth hydrogen sulphates produced by bacteria convert iron to dark coloured iron sulphates

Answer 139

* if no necrosis discolouration may reverse over time as the pulp revascularises (2-3 months) * if pulpal necrosis discolouration will worsen over time

Answer 140

* occurs following trauma if revascularisation fails * pulp tissue will undergo sterile necrosis - subsequent bacterial infection may then occur * after 3-4 weeks there will be radiographic indications of pulp necrosis * can develop to apical periodontitis * apical radiolucency on radiograph

Answer 141

* periapical radiolucency * discolouration of the tooth crown: usually grey/brown * infection-related external root resorption * no response to pulp sensitivity test * tenderness to percussion and palpation in vestibule - develops after an asymptomatic period * presence of a fistula (sinus tract)

Answer 142

* primary endodontics * internal bleaching * extraction and prosthetic replacement

Answer 143

* altered tooth position may result following displacement injuries: lucation; intrusion; extrusion; avulsion * repositioning and splinting withing 24 hours to minimise risk of complications

Answer 144

* addition of composite resin * removal of tooth tissue * if significant alterations needed: extra-coronal restorations

Answer 145

* for late presentation injuries or injuries which have incorrectly repositioned * increased risks associated with orthodontics: root resorption; loss of vitality

Answer 146

* occurs if ankylosis/replacement root resorption results from injury * most likely in severe injuries to PDL: intrusion; avulsion with prolongued EADT * trauma prior to pre-pubsescent frowth spurt highest risk: continued alveolar growth

Answer 147

* submerge below occlusal plane of adjecent teeth * mild, moderate or severe *

Answer 148

* not amendable to orthodontic repositioning * best undertaken before >4mm infra-occlusion present * depends on number of factors: prognosis of teeth; degree of infra-occlusion; wishes of the pt; cooperation of pt; lip line

Answer 149

* loss of tissue during acute injury: gingival lacerations/abrasions; alveolar # * developing deficiencies: * early extraction with significant bone remodelling * ankylosis: lack of development of alveolar process and gingival margin discrepancy; bone loss during extraction * endodontic failures

Answer 150

* bone grafting procedures * orthodontic extrusion therapy: as long as no ankylosis/replacement resorption

Answer 151

* mucogingival surgery * connective tissue grafting to increase volume of keratinised mucosa

Answer 152

* extraction of teeth = bone loss * coronectomy: aims for continued bone deposition * ostegenic distraction: cutting and slowly separating bone, allowing bone healing process to fill gap * camouflage

Answer 153

* may be difficult extractions * potential for further bone loss * socket preservation * vertical bone loss more difficult to deal with * implants challenging

Answer 154

* correct and timely tx - follow guidelines * follow up schedule * onwards referral to specialists at early stages

Answer 155

* intrusion: 4 weeks * lateral luxation: 4 weeks * root fracture: 4 weeks * alveolar fracture: 4 weeks * extrusion: 2 weeks * concussion/subluxation: 2 weeks

Answer 156

* concussion * subluxation * enamel fracture * enamel dentine fracture * root fracture: apical 2/3 and no displacement * avulsion

Answer 157

* extrusion * displaced or cervical 1/3 root fracture * lateral luxation * dento-alveolar fracture * intrusion * immature apex (paeds) * onwards referral adult dental trauma service * injury <5 days old appt same day * injury >5 days old but no long term complications next available appt

Answer 158

* inflammatory root resorption: external cervical root resorption, internal inflammatory root resorption, external inflammatory resorption * altered tooth positions: may require multi-disciplinary care * root fractures exhibiting developing pathology * loss of >1 tooth as a result of trauma

Answer 159

* IADT * International Association for Dental Traumatology * 2020 guidelines

Restorative Flashcards

(188 cards)