Restorative Flashcards

Question

OHI for an implant

Answer 1

Patients should be made aware an implant is a high maintainance dental restoration Superfloss Implant floss (implant floss technique) 360⁰ flossing technique Interdental brushes Implant care brush Single tufted brush CHX mouthwash after surgery Clean area with soft toothbrush until area has healed Smoking cessation advice if relevant

Answer 2

Probe gently at 4 points around the implant Assess; BOP Supporation (suggests tissue necrosis and collagen breakdown) Pocket depth (3mm is normal) Mobility Radiographic evidence Gingival condition: texture, color Should be checked and recorded in the notes at every appointment. *an implant is expensive. So you don't want to assume its okay. If its not and you miss it, your patient will be pissed BOP is normal because its not a normal tissue interface but if there's a lot of bleeding, judge it in respect to the rest of the dentition.

Answer 3

Provide advice and OHI regarding its keeping clean If avaliable, use carbon fibre, titanium (hand instruments) or plastic ultrasonic inserts to protect the implant superstructure and clean iatrogenic damage free

Answer 4

CO HPC Mx Dx Sx Fx E/O I/O

Answer 5

Radiographs MPBS 6PPC Sensibility testing; ECL, EPT Mobility Trans-illumination Diet diary Clinical photographs Biopsy Diagnostic wax up

Answer 6

Immediate: relief of acute symptoms *considering xla, rct, immediate denture/bridge Initial: (Disease control) xla of hopeless teeth Diet diary OHI NSHPT (perio) Management of carious lesions with direct or temporary restorations Re-evaluation: (evaluate OH compliance) Re-assess perio status Reconstructive: Indirect restorations Dentures Maintenance: Supportive periodontal care

Answer 7

Onlay or crown for cuspal coverage. Reduce fracture risk

Answer 8

Conventional Resin-retained Cantilever Fixed-fixed Spring cantilever

Answer 9

Talk about the irreversiblity of the restoration Talk about the likely prognosis in terms of how long it will last Talk about the risks and benefits Talk about the time involved Talk about what the procedure involves (impressions, drilling, anaesthetic ect) Talk about the cost Talk about alternative options

Answer 10

The patient wasn't aware of the; cost implication time involved (time off work) procedure itself (gooey impression material or needles) Alternative options The risks of this treatment failing The likely success rate/chance this restoration has to keep the tooth

Answer 11

Posterior Lower Buccal cusps occlude fossae and marginal ridges of uppers Posterior Upper palatal cusps occlude the fossae and marginal ridges of the lowers

Answer 12

The teeth are only in ICP for a matter of minutes every day (to chew). At relatively low biting forces. With parafunction, the teeth are in contact outside of these times exclusively for chewing. So, that includes greater and more frequent purposeless forces being exerted, in different directions on the teeth and the periodontium. Which can lead to tooth damage, damage to the periodontium, damage to the soft tissues and damage to the joints

Answer 13

The factors that lead to the movement of teeth in: protrusion and lateral excursions Ie. The anterior teeth and the tmj Basically, your anterior teeth and your tmj guide how your lower teeth move in those 3 movements Different size/shape/missing anteriors/tmj dysfunction would equal a different pattern of movement Tooth guidance is usually most important factor in determining mandibular movement

Answer 14

Conforming to existing ICP Or Reorganising to somewhere on the retruded axis (because the restorative objectives cannot be met in existing ICP) So the new ICP=RCP Reorganised always requires a bite registration: there must be no muscle interference, the operator manipulates the mandible and the patient curls their tongue to the back of their mouth

Answer 15

They put that on the lower cast and then put the upper cast on top. So basically, you don't want any increase in OVD using the bite registration. Otherwise the models will have a propped bite. All the technician wants is to mount the casts successfully. Help a brother out. Is the ICP stable and reproducible? Then the technician will be able to find it too when hand articulating the casts

Answer 16

Tooth wear Mobility Fractured teeth Fractured or de-bonded restorations Difficulty chewing TMD

Answer 17

A posterior tooth should not be involved in excursive movements, so make sure it doesn't disrupt the original anterior guidance scheme

Answer 18

Epilepsy. It may dislodge during a seizure/fall. Inform patient of the risk

Answer 19

Soft tissue check Clinical photograph Refer

Answer 20

For all, refer if present for >3 weeks Is there pain on swallowing Unexplained head or neck lumps Red or white patches in mouth Throat pain Ulceration or unexplained swelling Factor in when it started Ie. If they've had pain for months. Refer immediately instead of waiting 2 weeks

Answer 21

New assessment Maybe a biopsy Maybe a CT scan

Answer 22

14 days to appointment 28 days to diagnosis ~8 weeks to treatment

Answer 23

Start to think about getting them dentally fit (no infection or sources of potential infection before beginning cancer therapy) You don't want the patient to interrupt or delay their cancer tx because of outstanding dental tx

Answer 24

Stop any ortho immedietly Remove any teeth of dubious prognosis no less than 10 days before cancer treatment Do not do any dental treatment during cancer therapy If emergency, liase with cancer team Can use CHX mouthwash as short term alternative to toothbrushing if gums are sensitive At high risk for fungal/viral infections: can be prescribed CHX, miconazole (topical) or fluconazole (systemic) to prevent candidal infections *nystatin ineffective

Answer 25

Swallowing, speech, mastication, salivary function, outward appearance, taste, mouth opening, mucosa (traumatic/herpes simplex reactivation), mouth opening, radiation-induced caries, erosion Xerostomia: 50%-60% reduced salivary flow in first week with further 20% loss in subsequent 5-6 weeks Salivary function may return over years or not at all After cancer treatment, the saliva becomes thicker and more acidic. Patients are more prone to caries and perio disease Saliva adjuncts; frequent sips of water, biotene oral balance gel, bioxtra gel Therabite and active/passive physiotherapy movements for trismus treatment

Answer 26

Oral mucositis begins 1-2 weeks after treatment starts and typically ends ~6 weeks after treatment is complete During this time, typical OHI may not be able to be performed (ie. CHX mouthwash) Prevention and management: Caphosol Gelclair Mugard Difflam Zinc supplements *may prevent Aloe Vera Cryotherapy Manuka honey 2% lignocaine mouthwash prior to eating Ice chips Remove sharp edges of teeth/ poorly fitting dentures Tea tree oil mouthwash

Restorative Flashcards

(53 cards)