Restorative Dentistry Flashcards
(42 cards)
what is the definition of attrition
act of wearing or grinding down by friction - mechanical wear resulting from mastication or parafunction
name three features of attrition
lesions on occlusal and incisal contacting surfaces
polished facet on a cups
slight flattening of an incisal edge
what is the definition of abrasion
physical wear of tooth substance through an abnormal mechanical process independent from occlusion
- involved foreign object or substance repeatedly contacting tooth (eg toothbrushing)
name three features of abrasion
labial/ buccal areas
V-shaped or rounded lesions
sharp margin at enamel edge
what is the definition of erosion
progressive loss of tooth substance by chemical processes that do not involve bacterial action
name three features of erosion
bilateral concave lesions
translucent incisal edges
cupping of occlusal surfaces
is inner enamel or outer enamel more susceptible to acid attack
inner enamel
what is the definition of abfraction
loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at cervical fulcrum
name three features of abfraction
cracks in tooth substance
sharp rim at amelo-cemental junction
V-shaped tooth loss
name seven risk factors for erosive tooth wear
GORD
alcoholism
vomiting
heartburn
eating disorders
iron
hiatus hernia
what is intrinsic erosion
occurs with vomiting
patients are sick and then freshen up with water
which three mechanisms prevent reflux during swallowing
elevation of soft palate
tongue contacting pillars of fauces
upper and lower oesophageal sphincters
what is extrinsic erosion
can be due to medications and oral hygiene products
name examples of medications that can cause extrinsic erosion
Vit C tablets - chewable ones
Iron preparations that are acidic and commonly taken during pregnancy
Mouthwash and artificial saliva products that are acidic
why is the enamel around gingival margin less affected in erosion
due to the buffering affects of gingival crevicular fluid
GCF has pH of 7.5-8.7
name five aspects of a patient’s social history that may cause erosive tooth wear
occupation - wine tasters
hobbies and sport
alcohol intake
recreational drugs - ecstasy (reduces saliva)
psychological stress
what questions should you ask a patient about their drinking habits on their diet sheet
sipping drinks
swishing drinks
frothing drinks
if they hold drinks in their mouth before swallowing
what type of acid is the worst for acid erosion
citric
what aspects of extra-oral examination are important to a toothwear patient
TMJ and MOM
tenderness and hypertrophy
shortening of teeth and poor dental aesthetics
overclosure
what aspects of intra-oral examination are particularly for a tooth wear patient
soft tissues and charting
incisor relationship and dynamic occlusion
canine guidance vs group function
extent of tooth wear
what are the indices for describing tooth wear
The Tooth Wear Index - Smith and Knight
BEWE - basic erosive wear examination
what are the scores for the Tooth Wear Index by Smith and Knight
0 - no loss of enamel surface characteristics or change of contour
1 - loss of enamel surface characteristic and minimal change in contour
2 - enamel loss exposing just exposing dentine and defect less than 1mm deep
3 - enamel loss and dentine loss but no pulp exposure and defect is 1-2mm deep
4 - complete enamel loss/ pulp exposure and defect is more than 2mm deep
how is the Tooth Wear Index by Smith and Knight carried out
each surface of the tooth is given a score between 0 and 4 according to the appearance (B, L, O, I, C)
what are the scores for the BEWE examination
0 - no erosive tooth wear
1 - initial loss of surface texture
2 - distinct defect with hard tissue loss that is less than 50% of the surface area
3 - hard tissue loss more than 50% of the surface area
