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BDS Finals > Restorative Dentistry > Flashcards

Restorative Dentistry Flashcards

1
Q

Treatment options for missing teeth - general (3)

A
  1. No treatment - Leave space
  2. Replace missing teeth
  3. Close space
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2
Q

Reasons for treating tooth loss (4)

A

Aesthetics
Function
Speech
Maintenance of dental health (over eruption etc.)

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3
Q

Treatment options for replacing teeth - specific (3)

A

Denture
Bridgework
Implants

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4
Q

What is a bridge

A

Prosthesis which replaces a missing tooth or teeth and is attached to one or more natural teeth (or implants)

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5
Q

Main Types of Bridgework (2)

A

Adhesive
Conventional

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6
Q

Abutment Definition

A

A tooth which serves as an attachment for a bridge

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7
Q

Pontic Definition

A

The artificial tooth which is suspended from the abutment tooth/teeth

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8
Q

Bridge Retainer Definition

A

The extracoronal or intracoronal restorations that are connected to the Pontic and cemented to the prepared abutment teeth

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9
Q

Edentulous Span

A

Space between natural teeth that is to be filled by a bridge or partial denture

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10
Q

Pier Definition

A

An abutment tooth which stands between and is supporting two pontics, each Pontic being attached to a further abutment tooth

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11
Q

Unit Definition

A

Either a retainer or a pontic
A bridge with 2 retainers is a 3 unit bridge

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12
Q

Bridge Designs (5)

A
  1. Fixed-fixed
  2. Cantilever
  3. Fixed-moveable
  4. Hybrid
  5. Spring cantilever
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13
Q

How can a pontic be manufactured (4)

A
  1. Patients own tooth
  2. Acrylic denture tooth
  3. Polycarbonate crown
  4. Cellulose matrix filled with composite
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14
Q

General Indications for Bridgework (6)

A
  1. Function and stability
  2. Appearance
  3. Speech
  4. Psychological Reasons (denture difficulty)
  5. Systemic Disease (epilepsy)
  6. Co-operative patient
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15
Q

Local Indications for Adhesive Bridgework (4)

A

Big teeth
Favourable abutment angulations
Favourable occlusion
Heavily restored teeth (conventional)

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16
Q

General Contraindications for Bridgework (6)

A
  1. Uncooperative patient
  2. Medical history contraindications
  3. Poor OH
  4. High caries rate
  5. Periodontal disease
  6. Large pulps (conventional bridge)
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17
Q

Local Contraindications for Bridgework (6)

A

High possibility of further tooth loss within arch
Prognosis of abutment poor
Length of span too great
Ridge form and tissue loss
Tilting and rotation of teeth
Periapical/Periodontal status

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18
Q

Other names for adhesive bridgework (5)

A

Resin retained bridgework
Resin bonded bridgework
Minimal preparation bridgework
Maryland bridge
Resin bonded fixed partial denture

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19
Q

RBB

A

Resin Bonded Bridgework

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20
Q

RRB

A

Resin Retained Bridgework

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21
Q

RBFPD

A

Resin Bonded Fixed Partial Denture

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22
Q

Metal used in adhesive bridgework (2)

A

Cobalt chrome or Nickel Chrome

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23
Q

Longevity of adhesive bridgework

A

Around 80%

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24
Q

How do you ensure a common path of insertion for fixed-fixed conventional

A

Ensure preparation of abutment teeth are parallel

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25
Q

Issues with hybrid bridges

A

The adhesive side tends to debond first and accelerates decay underneath the wing

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26
Q

What should you of when you see a fixed-fixed adhesive bridge clinically

A

Lightly press on both wings to ensure they are still bonded.
If one side is not bonded you will see bubbles and the wing will depress slightly

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27
Q

Optimum crown to root ratio for abutment teeth

A

2:3

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28
Q

Minimum crown to root ratio for abutment teeth

A

1:1

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29
Q

Spring Cantilever Bridge

A

One Pontic attached to the end of a metal arm that runs across the palate to a rigid connector on the palatal side of a retainer

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30
Q

Indications for adhesive bridgework (6)

A
  1. Young teeth
  2. Good enamel quality
  3. Large abutment tooth surface area
  4. Minimal occlusal load
  5. Good for single tooth replacement
  6. Simplify partial denture design
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31
Q

Contraindications for adhesive bridgework (6)

A
  1. Insufficient or poor quality enamel
  2. Long spans
  3. Excess soft tissue or hard tissue loss
  4. Heavy occlusal forces
  5. Poorly aligned or tilted teeth
  6. Contact sports - Debate, ensure mouth guard
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32
Q

Amalgam in potential abutment teeth

A

Replace with composite
Amalgam does not bond well

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33
Q

Why should you aim to stay in enamel for preparation of adhesive bridges

A

Enamel creates a stronger bond than dentine

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34
Q

Where should preparation be for an adhesive bridge in relation to the gingival margin

A

0.5mm supra-gingival

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35
Q

What should happen to the metal wing of a bridge before it arrives at your chair?

A

The surface should be sandblasted
Aluminium oxide
50 microns

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36
Q

Temporary solutions to tooth loss (5)

A
  1. Consider RPD
  2. Essix retainer with tooth inside
  3. If prep remains in enamel is there any need for temp?
  4. If prep into dentine - cover with layer of dentine bonding agent
  5. Fit bridge asap to minimise over eruption and tooth movement
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37
Q

Abutment evaluation (6)

A
  1. Remaining tooth structure
  2. Root configuration
  3. Periodontal health
  4. Surface area for bonding
  5. Risk of plural damage
  6. Quality of current restorations/endo
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38
Q

Types of Pontic (4)

A
  1. Wash through/Sanitary
  2. Dome/Bullet/Torpedo
  3. Modified ridge lap
  4. Ovate pontic
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39
Q

Pontic Function (3)

A
  1. Restore appearance of missing tooth
  2. Stabilise the occlusion
  3. Improve masticatory function
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40
Q

Wash through Pontic (3)

A

Makes no contact with soft tissue
Functional rather than for appearance
Consider in lower molar area

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41
Q

Dome shaped/Torpedo/Bullet Pontic (3)

A

Useful in lower incisor, premolar or upper molar areas
Acceptable if occlusal 2/3 of buccal surface visible
Poor aesthetics if gingival 1/3 of tooth visible

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42
Q

Modified Ridge Lap Pontic (4)

A

Buccal surface very tooth like
Lingual surface cut away
Line contact with buccal of ridge
Problems with food packing on lingual surface of ridge

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43
Q

Ridge Lap Saddle Pontic (4)

A

Greatest contact with soft tissue
If designed carefully: can be cleansed
Less food packing than ridge lap
Care taken not to displace soft tissue or cause blanching

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44
Q

Types of all ceramic crown (2)

A

Zirconia
Lithium disilicate

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45
Q

Metals used in conventional bridges (3)

A
  1. Gold
  2. Nickel/Cobalt chromium
  3. Stainless steel
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46
Q

Longevity of conventional RBB

A

Around 80%

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47
Q

Longevity of conventional fixed-fixed metal ceramic

A

5 year - 93%
10 year - 89%

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48
Q

Longevity of conventional fixed- fixed ceramic

A

88%

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49
Q

Longevity of conventional cantilever bridge

A

5 year - 91%
10 year - 80%

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50
Q

Longevity of implant retained bridge

A

5 year - 95%
10 year - 87%

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51
Q

Direct vs Indirect Restorations

A

Direct - Can be placed in a single visit
Indirect - Fabricated outside the mouth

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52
Q

Indirect restoration stages (4)

A

Preparation
Temporisation
Impression and occlusal records
Cementation

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53
Q

Types of Inlays/Onlays (4)

A

Composite
Gold
Porcelain
Ceromeric

54
Q

Advantages of indirect restorations over direct (3)

A

Superior materials
Superior margins
Won’t deteriorate over time

55
Q

Disadvantages of indirect restorations over direct (2)

A

Time
Cost

56
Q

Most important factor for long term success of a crown

A

Coronal seal

57
Q

Which crown material is better if a retentive cavity can be cut

A

Ceromeric

58
Q

Which crown material gives a better bond

A

Porcelain

59
Q

How can you make a veneer more adhesive

A

Lab with 10% acid

60
Q

What etch is used in dentistry

A

37% phosphoric etch

61
Q

Tooth Surface Loss (4)

A

Caries
Trauma
Developmental Problems
Toothwear

62
Q

Non-Carious Tooth Surface Loss (3)

A

Trauma
Developmental Problems
Toothwear

63
Q

Physiological Toothwear

A

Normal wear associated with function

64
Q

Pathological Toothwear

A

Remaining tooth structure or plural health is compromised
OR
Rate of toothwear is excessive for age
OR
Patient experiences masticatory or aesthetic defecit

65
Q

Causes of Toothwear (4)

A

Attrition
Abrasion
Erosion
Abfraction

66
Q

Attrition Definition

A

Physiological wearing away of tooth structure as a result of tooth to tooth contact

67
Q

Where are attritive lesions found

A

Occlusal and incisal contacting surfaces

68
Q

Early attritive lesions

A

Polished facet or flattening of cusp/incisal edge

69
Q

Abrasion Definition

A

The physical wear of tooth substance through and abnormal mechanical process independent of occlusion. It involves a foreign object or substance repeatedly contacting the tooth

70
Q

Common Features of Abrasive Lesions (3)

A

Labial/Buccal
V shaped or rounded lesions
Sharp margin at enamel edge

71
Q

Erosion Definition

A

The loss of tooth surface by a chemical process that does not involve bacteria action

72
Q

Features of Erosive Lesions (5)

A

Loss of surface detail of enamel
‘Cupping’ of occlusal surfaces as dentine becomes exposed
Fillings stay high as the tooth erodes around them
Increased translucency of incisal edges
No tooth staining

73
Q

Abfraction Definition

A

The loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the crevical fulcrum areas of the tooth

74
Q

Abfraction Theories

A
  1. Abfraction is the basic cause of all non-carious cervical lesions
  2. Multifactorial aetiology. A combination of occlusal stress, abrasion and erosion
75
Q

Where does abfraction occur

A

Cervical margin

76
Q

Wear Indices

A

Smith and Knight
BEWE

77
Q

BEWE 0

A

No erosive wear

78
Q

BEWE 1

A

Initial loss of surface texture

79
Q

BEWE 2 (3)

A

Distinct defect
Hard tissue loss
<50% of surface

80
Q

BEWE 3

A

Hard tissue loss >50% surface area

81
Q

BEWE No risk

A

</=2

82
Q

BEWE Low risk

A

3-8

83
Q

BEWE Medium risk

A

9-13

84
Q

BEWE High risk

A

14+

85
Q

Dento-alveolar compensation

A

Bone growing to compensate for tooth surface loss

86
Q

SOI

A

Severe Odontogenic Infection

87
Q

Pericoronitis Treatment if no systemic signs present (2)

A

Operculectomy
Irrigation

88
Q

Pericoronitis treatment if systemic signs present

A

Systemic treatment

89
Q

Salivary gland infection treatment (3)

A
  1. Drainage
  2. Flucoxacillin
  3. Metronidazole
90
Q

What condition might result in grey teeth?

A

Cystic fibrosis

91
Q

What might result in green teeth (3)

A

Hyperbilirubinaemia
Thalassemia
Sickle cell anaemia

92
Q

Types of tooth bleaching

A

External
Internal non-vital

93
Q

Factors affecting bleaching (4)

A
  1. Time
  2. Cleanliness of tooth
  3. Concentration of solution
  4. Temperature
94
Q

What should be done before bleaching? (3)

A
  1. Pt dentally fit
  2. Shade recording
  3. Ideally clinical images
95
Q

Warnings for the patient before bleaching (5)

A
  1. Sensitivity
  2. Relapse
  3. Restoration colour
  4. Compliance
  5. May not work
96
Q

Should chlorine dioxide be used in bleaching

A

No. Never use it

97
Q

Contraindications to non-vital internal bleaching (2)

A
  1. Heavily restored tooth
  2. Staining due to amalgam
98
Q

Combination bleaching

A

Inside-outside bleaching

99
Q

Medical contraindications to tooth bleaching (2)

A

Glucose-6-Phosphate dehydrogenase deficiency
Actalasemia

100
Q

Why should you never use GI or a material that bonds to tooth surface as a temp for indirect restorations?

A

The shape of the preparation will change when the temp is cut away

101
Q

What type of caries is seen in between teeth

A

Aproximal

102
Q

Cavity base liners (4)

A
  1. Zinc phosphate
  2. Zinc oxide eugenol
  3. CaOH
  4. RMGI
103
Q

Effects of CaOH (4)

A
  1. High pH - stimulates fibroblasts
  2. Simulates recalcification of demineralised dentine
  3. Cytotoxic - can kill pulp cells
  4. Very soluble if not protected
104
Q

How much enamel does acid etching remove

A

10 microns

105
Q

How much enamel does prophy with pumice remove

A

5-50 microns

106
Q

Types of vital bleaching (2)

A
  1. Chairside
  2. At home
107
Q

Types of non vital bleaching (2)

A
  1. Inside outside technique
  2. Walking bleach technique
108
Q

Are the effects of bleaching permanent

A

No

109
Q

What is used for home bleaching

A

10% carbamide peroxide

110
Q

Why should chair side bleaching be avoided

A

Unpredictable and greater risk to soft tissues and eyes

111
Q

What is used for chair side bleaching

A

Rapidly reaction hydrogen peroxide equivalent to 75% carbamide peroxide

112
Q

What does carbamide peroxide break down into

A

Water, ammonia and carbon dioxide

113
Q

Non vital bleaching methods (2)

A
  1. Walking bleach
  2. Inside-outside
114
Q

After how long does bleach stop working

A

2 weeks

115
Q

After how many renewals of bleach should you stop if there’s been no change

A

3-4

116
Q

Walking bleach

A

Bleach placed inside tooth and covered with GI

117
Q

Inside-Outside bleach (4)

A
  1. Mouth guard worn all the time
  2. Windows cut in teeth that don’t need whitened
  3. Gel replaced every 2 hours
  4. Don’t need GI lining
118
Q

Non-vital bleaching complications (5)

A
  1. External cervical resorption
  2. Spillage of bleach
  3. Failure to bleach
  4. Over bleach
  5. Brittleness
119
Q

What makes external cervical resorption more likely in non vital bleaching

A

Trauma

120
Q

Prevention of external cervical resorption after non vital bleaching (2)

A
  1. Layer of cement over GP
  2. Non setting calcium hydroxide in tooth for 2 weeks pre final restoration
121
Q

Tooth mousse

A

CPP-ACP

122
Q

How long to use tooth mousse for post microabrasion

A

4 weeks

123
Q

How long to use tooth mousse for post bleaching

A

2 weeks

124
Q

Resin infiltration - what is used

A

Low viscosity light cured resin
ICON

125
Q

Passive Management of toothwear (4)

A
  1. Prevention/Monitoring
  2. First part of tx of toothwear
  3. 6 months +
  4. For many, this is the only tx
126
Q

Width of composite for incisal edges

A

2mm
1mm unstable

127
Q

Active Management Toothwear (3)

A
  1. Preservation of remaining tooth
  2. Simple restorations
  3. Pragmatic aesthetic approach
128
Q

Pattern of maxillary incisal wear (3)

A
  1. Palatal only
  2. Palatal and incisal
  3. Labial only
129
Q

Factors that influence maxillary incisal toothwear restoration decision (5)

A
  1. Pattern
  2. Inter-occlusal space
  3. Space required
  4. Quality and quantity of remaining tooth
  5. Aesthetic demands
130
Q

Increasing inter occlusal space options (5)

A
  1. Increase OVD
  2. Crown lengthening
  3. Elective RCT and post crown
  4. Ortho
  5. Reorganise occlusion

BDS Finals (23 decks)

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