wear and such Flashcards

1
Q

Why may wear be repaired?

A
  • aesthetic concerns
  • symptoms of pain/discomfort
  • unstable occlusion
  • function difficulties
  • excessive rate of tooth loss
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2
Q

How would you study the rate of tooth wear ?

A

photos
study models
measurements - taken at 6-12 month intervals

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3
Q

What are the 5 factors which should be taken into consideration for restoring wear are ?

A
  1. pattern of tooth loss
  2. inter-occlusal space
  3. space requirements for the restorations to be used
  4. the quality and quantity of the remaining hard tissue (especially the enamel)
  5. the aesthetic demands of the patient
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4
Q

What is the dahl technique ?

A

it is a means of gaining interocclusal space in localised looth wear and tooth reduction cases.
an anterior appliance is placed in order to allow for tooth eruption posteriorly to allow for an increase of 2-3mm in the OVD which allows for the restoration of the anteriors.

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5
Q

What are the various types of NCTSL?

A
  1. Attrition
  2. Abrasion
  3. Abfraction
  4. erosion
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6
Q

What are the characteristics of erosion?

A

loss of hard tissue due to chemical processes which does not involve bacteria. usually co-exsits with attrition and/or abrasion so differential diagnosis can become difficult,

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7
Q

What is the presentation of erosion?

A

transparent, thinned edges of the incisal edge
irregular occlusal plane
reduction in crown height
loss may not be uniform

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8
Q

What problems occur with erosion?

A

sensitivity
dental pain
loss of vitality
aesthetics

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9
Q

What is combination syndrome?

A

lower anterior teeth opposing upper edentulous ridge
instability Cu/- in function with the concentration of occulasal forces at the anterior

** consider extension of SDA

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10
Q

What is the concept of the shortened dental arch ?

A

anterior teeth which also have occluding premolars or molars with at least 3-5 occluding units should be present
1 unit - one pair of premolars
2 units one pair of molars

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11
Q

What are some examples of adhesive bridges?

A
resin retained bridge (RRB)
resin bonded bridge (RBB)
Maryland 
resin bonded fixed partial denture (RBFPD)
minimal prep required
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12
Q

What are some examples of conventional bridges?

A

fixed-fixed bridge = abutment (pontic) abutment bridge with 2 crown preps
Cantilever - has crown or wing at one side only
Fixed movable bridge - ridged pointic (usually at the distal end ) and a more flexable connector at the othe r(mesial ) in order to allow for vertical movement.

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13
Q

What are the contraindications for bridgework ?

A

Uncooperative patient

Medical history contra-indications

Poor oral hygiene

High caries rate

Periodontal disease

Large pulps- for conventional bridges

High possibility of further tooth loss within arch

Prognosis of abutment poor

Length of span too great

Ridge form and tissue loss

Surface area of root insufficient

Tilting and rotation of teeth

Degree of restoration (how much of tooth is left after preparation)

Periapical status

Periodontal status (bone loss)

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14
Q

What are good indications for bridgework ?

A

Function and stability

Appearance

Speech

Psychological reasons

Systemic disease e.g. epileptics also if a implant is not able to be placed

Co-operative patient

Heavily restored teeth

Favourable abutment angulations

Favourable occlusion

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15
Q

What must be considered when evaluating abutments?

A
  • must be able to withstand forces
  • supporting tssue must be healthy and free of inflammation or pathology
  • crown ratio must be minimum 1:1 ratio but with an noptimun of 2:3
  • root surface area (antes law)
  • perio status
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16
Q

What is antes law?

A

states that the root surface area of the abutment teeth shoul dbe equal or greater than that of the teeth being replaced

17
Q

Why are cantilever bridges more successful anteriorly ?

A

due to their divergent path of insertion

18
Q

What are the indicators for anterior cantilever bridges?

A

Young teeth

Good enamel quality

Large abutment surface area

Minimal occlusal load

Good for single tooth replacement

19
Q

Contraindications for adhesive bridges?

A

Long spans

Soft or hard tissue loss

Heavy occlusal load such as bruxism or overeruption of opposing teeth

Poor quality enamel or lack of

20
Q

What drugs are available for prescription in the DPF?

A

Dental & orofacial pain

Oral infections

Anaesthetics, anxiolytics & hypnotics

Oral ulceration & inflammation

Mouthwashes, gargles & dentifrices

Dry mouth

Minerals

Aromatic inhalations

Nasal decongestants

21
Q

What is the importance of the misuse of drugs act 1971?

A

The penalties applicable to offences involving the different drugs are graded broadly according to the harmfulness of a drug when it is misused.

22
Q

What is the misuse of drugs regulations 2001?

A

Define classes of person who are authorised to supply and possess controlled drugs while acting in their professional capacities and lay down the conditions under which these activities may be carried out

23
Q

Principles of prescribing?

A

The legal responsibility for prescribing lies with the doctor (or dentist) who signs the prescription.

Treat the whole person – NOT just the condition or disease

Drugs have side effects and interactions

Drugs can kill

Medicines should be prescribed only when their use is essential

The benefits weighed against the risks involved

Children – age related dosage

Hepatic impairment

Renal impairment

Breast-feeding

Pregnancy

Elderly

24
Q

What are the principles of tooth preparation?

A
  1. preserve the tooth structure
  2. Retention and resistance
  3. Structural durability
  4. marginal integrity
  5. Preservation of the periodontium
  6. aesthetic considerations
25
Q

What are the causes of extrinsic discolouration?

A
  • smoking
  • tannins- coffee, tea, red wine
  • chromogenic bacteria
  • CHX
  • iron suppliments
26
Q

What are the instrinsic causes of discolouration?

A
  • fluorosis
  • tetracycline
  • age
  • amalgam
  • non-vitality
  • CF- grey
  • hyperbilirubinaemia - green
  • porphyia - red primary
27
Q

How does vital bleaching work ?

A

long chains in extrinsic discolouration is oxidised by the bleach. Oxidation leads to reduction in the smaller molecule which are not usually pigmented. This leads to a lighter shade due to the ionic echange in molecules (metallic)

28
Q

What are the indications for micro-abrasion?

A
  • fluorosis
  • demineralisation from ortho
  • demineralisatio with staining
  • may consider prior to veneer placement
29
Q

What are the consitutes of whitening gel?

A
  • Carbamine peroxide( ACTIVE INGREDIENT) -breaks down hydrogen peroxide and urea
  • Carbopol -(THICKENING AGENT) allows for slow release
  • Urea- increases pH and stabilises HP
  • pigment dispensers
  • preservative
  • flavour
  • Potassium nitrate (DESENSITISING AGENT)
  • Fluoride