toothwear - dental demolition Flashcards
Give 4 reasons for dental demolition in toothwear?
Heavily restored teeth
Previous failure
Small teeth
High occlusal loads
What should be considered before picking up a handpiece for demolition?
Be clear on benefits and risks to health and appearance
Be honest about longevity of restorations and cycles of replacement
Dental health risk assessment
Can you achieve both health and aesthetic objectives
Give pt all the info
Get valid consent
Learn to say no
Know when to treat and when to refer
What is needed for operator safety in demolition?
Eye protection
Surgical gloves
Airway protection
Good suction
What should be used to cut porcelain?
As coarse diamond bur
What should you warn patients when using a gold cutting bur?
There will be vibration
What type of metal is harder to cut through - precious or non-precious?
Non-precious metal is harder to cut through
What should be taken before demolition of a restoration?
Pre-op impression for a temporary
Why should bridges be kept intact during demolition?
They can make good temporary restorations
What other instruments can be used for demolition?
Sliding hammers and matrices to cut occlusal and palatal surfaces
Enamel chisel
What does the ease of post removal depend on?
Length
Taper
Surface
Amount of remaining dentine
What is a failing dentition?
A dentition where deteriorating teeth, restorations or oral health or a combination of issues means a loss of adequate basic oral functions such as mastication and acceptable aesthetics
Give 6 examples of keys to success when managing failure
Any from:
- comprehensive history and exam
- thorough planning
- seeking advice
- individualised prevention
- avoiding overambitious tx
- effective communication
- tx planning around basic principles
What should be included in prevention?
Individualised OHI, dietary advice and fluoride regime
Individualised habit advice
Referral for any safeguarding issues
Document in records
What is herodontics?
The use of initially invasive adhesive dentistry to restore or maintain the function or aesthetics, sometimes provisionally, of a questionable and compromised tooth/dentition
What is superherodontics?
The concept of attempting overambitious high failure risk, often invasive and complex, restorative tx to restore a questionable and compromised tooth/dentition
