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Prosthodontics > Treatment Planning for Fixed Prosthodontics > Flashcards

Treatment Planning for Fixed Prosthodontics Flashcards

1
Q

What is fixed prosthodontics?

A

Area of prosthodontics focused on permanently attached (fixed) dental prostheses

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2
Q

List some examples of fixed prosthodontics (4)

A
  1. Veneers
  2. Inlays/onlays
  3. Crowns
  4. Bridgework
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3
Q

What to look for extra-orally (5)

A
  1. TMJ
  2. MOM
  3. Lymph nodes
  4. Symmetry
  5. Lips
    - Vermillion borders
    - Commissures
    - Smile lines
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4
Q

What to look for intra-orally (5)

A
  1. Whole mouth
  2. Soft tissues
    - Buccal mucosa
    - Tongue (lateral borders + dorsum)
  3. Sublingual tissues/floor of mouth
  4. Palate (Hard/ soft)
  5. Lips
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5
Q

What to look for in the occlusion section of the hx + examination

A
  1. Incisal relationship
  2. Excursions of the mandible
    - Protrusion
    - Retrusion
    - Lateral
  3. Canine guidance or grouped function
  4. Inter-arch space
  5. Inter-tooth space (mesio-distal)
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6
Q

What do sensibility tests check for?

A

Vitality of teeth

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7
Q

Examples of special investigations (9)

A
  1. Sensibility testing
  2. Radiographs
  3. Study models
  4. Facebow
  5. Diagnostic wax up
  6. Diet diaries
  7. Plaque + gingivitis indices
  8. Clinical photographs
  9. Microbiology, biosy, haematology
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8
Q

When do we need a facebow?

A

If placing any restorations on teeth involving guidance (canines)

If you’re changing anything about a patients occlusion
- Contact points or occlusal vertical dimension

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9
Q

Tx planning headings (5)

A
  1. Immediate
  2. Initial (disease control)
  3. Re-evaluation
  4. Reconstructive
  5. Maintenance
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10
Q

What happens in the immediate phase of tx planning? (3)

A
  1. Relief of acute symptoms
  2. Consider endo + extractions
  3. Consider immediate denture/bridge
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11
Q

What happens in the initial phase of tx planning? (6)

A
  1. Extractions of hopeless teeth
  2. OHI + dietary advice
  3. HPT
  4. Management of carious lesions + defective resto’s with direct restorations or provisional restorations
  5. Endodontics
  6. Denture design
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12
Q

What happens in the re-evaluation phase of tx planning?

A

Re-assessment of periodontal status, confirm denture/bridge design

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13
Q

What happens in the reconstructive phase of tx planning?

A
  1. Perio surgery

2. Fixed + removable prosthodontics

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14
Q

What happens in the maintenance phase of tx planning?

A

Supportive periodontal care + review of restorations

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15
Q

Why is fixed pro’s more expensive and more time consuming?

A

Requires tooth prep + need a lab stage + fixed stage

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16
Q

Disadvantages of fixed pro’s (2)

A
  1. Time

2. Cost

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17
Q

Why are crowns not a 1st option? (5)

A
  1. For patients with active caries + periodontal disease
  2. More conservative options available
  3. Lack of tooth tissue for prep
  4. Unable to provide post + core
  5. Unfavourable occlusion
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18
Q

List the principles of crown preparation (6)

A
  1. Preservation of tooth structure
  2. Retention + resistance
  3. Structural durability
  4. Marginal integrity
  5. Preservation of periodontium
  6. Aesthetic considerations
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19
Q

Why do we want to preserve sound tooth structure?

A

Pulp + tooth strength weakened / compromised

20
Q

Disadv of overprepping for a crown?

A

Tooth likely to fracture and reach pulp

21
Q

What type of material requires a thinner prep?

A

Metal materials

22
Q

What type of material requires a thicker prep?

A

Porcelain - as it has adequate strength

23
Q

Disadc of underprepping for a crown?

A
  1. Poor aesthetics

2. Over built crown with PDL + occlusal consequences

24
Q

What does retention prevent?

A

Prevents removal of the restoration along the path of I or the long axis of the tooth prep

25
Q

What does resistance prevent? (2)

A
  • Prevents dislodgement of the restoration by forces directed in an apical or oblique direction
  • Prevents any movement of the restoration under occlusal forces
26
Q

How is retention achieved in crowns?

A
  1. Taper between 5-7 degrees
  2. Grooves
  3. Slots
27
Q

Why are longer walls better for a crown?

A

If the crown is going to be dislodged it has a longer wall to slide up the tooth before it lifts off the tooth

28
Q

Why are shorter walls worse for a crown?

A

The crown doesn’t have v far to slide before its over the top of the tooth

29
Q

How is retention improved?

A

By limiting the paths of I

30
Q

What is structural durability?

A

Restoration must contain a bulk of material that is adequate to withstand the forces of occlusion

31
Q

How is structural durability achieved? (3)

A
  1. Occlusal reduction
  2. Functional cusp bevel
  3. Axial reduction
32
Q

What is a functional cusp?

A

The cusp that deals with occlusal vertical load

33
Q

How is marginal integrity achieved?

A

FINISHES

  1. Knife edge finish
  2. Bevel
  3. Chamfer
  4. Shoulder
  5. Bevelled shoulder
34
Q

When is a chamfer used?

A
  • Veneers

- Any restoration where the outside surface is made of metal

35
Q

When is a shoulder used?

A

Crowns

- Ceramics

36
Q

How is preservation of the periodontium maintained?

A

Margins of the restorations should be:

  1. Smooth + fully exposed to a cleansing action
  2. Placed where the dentist can finish them + patient can clean them
  3. Placed at gingival margin whenever possible
    - Placement of margins subgingival if required
37
Q

Whatis the biological width?

A

The height from the most superior aspect of the alveolus to the base of the gingival sulcus

38
Q

Why might you consider composite ceramic crowns?

A

Best tooth colour

39
Q

Why might you avoid composite ceramic crowns?

A

Nor as strong as metal ones
Can cause toothwear - avoid in bruxism patients / strong bites

OPT for Metal ceramic crowns instead

40
Q

List the different types of crowns (4)

A
  1. Metal crowns
  2. Ceramic crowns
  3. Metal ceramic crowns
  4. All ceramic crowns
41
Q

Bridgework:

List some reasons why we replace teeth

A
  1. Aesthetics
  2. Occlusal stability
    - Preventing tilting + over-eruption of adjacent + opposing teeth
  3. Function
    - Mastication + speech + wind instrument players
  4. Periodontal splinting
  5. Restoring OVD
  6. Patient preference
42
Q

Bridgework:

List some reasons we wouldn’t replace teeth (5)

A
  1. Damage to tooth + pulp
  2. Secondary caries
  3. Effect on periodontium
  4. Cost
  5. Failures
43
Q

What are some examples of bridge designs (4)

A
  1. Cantilever
    - Bridge held onto an adjacent tooth on 1 side
  2. Fixed-fixed
    - Prosthetic tooth held on by 2 restorations on either side
  3. Adhesive/resin bonded
  4. Conventional
44
Q

What must we communicate to the patient before any fixed pro’s work? (6)

A
  1. Verbal + written consent
  2. Invasiveness / reversibility
  3. Likely longevity + success rate
  4. Possible complications
  5. Time involved
  6. Costs
  7. Alternative options
45
Q

What makes up informed consent? (6)

A
  1. Tx to be performed
  2. Why
  3. Consequences of no tx
  4. Risks (material risks)
  5. Alternatives
  6. Relative costs

Prosthodontics (1 decks)

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