Treatment Planning (Pt. I) Flashcards Preview

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Flashcards in Treatment Planning (Pt. I) Deck (38)
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1
Q

Treatment Planning Overview

• Appropriate treatment plan INFORMS the patient about:
– Current ____
– Extent of dental treatment proposed
– ____ of treatment
– Level of home care needed
– Amount of ____ for success
– The possibility some details may need to be altered once treatment is started

A

conditions
time and cost
professional follow-up

2
Q
Treatment Goals
• (1)Correct an existing \_\_\_\_
• (2)Prevent \_\_\_\_ disease
• (3)Restore \_\_\_\_
• (4)Improve \_\_\_\_

May include combination

A

disease
future
function
appearance

3
Q

(1)Correction of Existing Disease

• Existing disease revealed during ____ examination
• Usually arrest by identifying and improving resisting factors
– Example: ____ instruction
– Example: increasing ____ intake
• Need to control cause

A

clinical
oral hygiene
fluoride

4
Q

(2)Prevention of Future Disease

• Predict ____ disease
– by evaluating disease experience
• Recommend ____ if future disease seems likely without treatment

A

future

treatment

5
Q

(3)Restoration of Function

• \_\_\_\_ loss often difficult to assess
• May plan treatment to correct \_\_\_\_
– Example:
• \_\_\_\_
• \_\_\_\_
A

degree of function
impaired function
mastication
speech

6
Q

(4)Improvement of Appearance

• Often dissatisfied with ____
• Evaluate appearance
•____ to
patient’s views
• ____ dental health should NOT be compromised by esthetics
• Patient needs to know possible ____ of treatment

A

appearance
listen
long-term
adverse consequences

7
Q

(1)Plastic Materials
– Capable of being shaped or formed
• Most ____ used restorative materials
– Ex. ____ resin
• Allows simple and conservative restoration of damaged teeth
• Mechanical properties ____ to cast metal, metal-ceramic or ceramic restorations
• Success depends on strength and integrity of remaining ____
• May use as ____

A
commonly
amalgam and composite
inferior
tooth structure
foundation or core
8
Q

Plastic Materials vs. Indirect Restorations

____ restorations are difficult to condense and contour accurately intraorally

____ facilitate the fabrication of more accurately shaped restorations

A
large amalgam
indirect procedures (crowns)
9
Q

(2)Cast Metal Restorations

• Cemented with ____ agent
• Indirect technique
– enables more ____ than direct
• Preparation design crucial

A

luting

precise contours

10
Q

(2) Cast Metal
(a) Intracoronal Restoration

• Inlay
– Relies on strength of remaining ____ for support and retention

A

tooth structure

11
Q

(2)Cast Metal (a)Intracoronal Restoration

• Greater tooth bulk needed to resist ____ effect
– Contraindicated in ____ tooth
• Extremely ____ due to strength and corrosion resistance of casting alloy
• Requires ____ tooth removal than amalgam
• Does ____ have sufficient resistance or retention to use as ____ for FDPs

A
wedging
weakened
durable
greater
NOT
abutment retainers
12
Q

(2) Cast Metal
(b) Extracoronal Restoration

• Crown or Onlay
– Encircles all or part of remaining ____
• Can strengthen and protect tooth weakened by ____

A

tooth structure

caries or trauma

13
Q

(2) Cast Metal
(b) Extracoronal Restoration

• More ____ than for intracoronal restoration
• Margins generally near ____ – makes maintenance of tissue health
____
• Intracoronal features may be incorporated into the preparation design
– ex. ____
• add resistance and retention

A

tooth removal
gingival margin
difficult
grooves

14
Q

(3)Metal Ceramic Material

• Tooth colored layer of porcelain bonded to a cast metal substructure
• Used to restore ____
• Need sufficient bulk for porcelain to be ____
– Among least ____ preparation design
• ____ margin, if metal, is unesthetic
– Porcelain labial margin improves ____
• Technique sensitive

A
appearance
esthetic
conservative
labial
esthetics
15
Q
(4)Fiber-Reinforced Resin
• Indirect composite resin restorations for \_\_\_\_, crowns, and FDPs
• Excellent \_\_\_\_ adaptation
• Excellent \_\_\_\_
• Do not withstand \_\_\_\_ well over time
• Useful as \_\_\_\_ interim restorations
A
inlays
marginal
esthetics
functional loads
long-term
16
Q
(5)Complete Ceramic
• Most \_\_\_\_ restorations
• Comparative lack of \_\_\_\_ in comparison to other materials
• Difficulty with \_\_\_\_
– Technique sensitive (technician and
dentist)-depends on fabrication method
• \_\_\_\_ technique
• Can mill and do directly in the \_\_\_\_
• Luted with \_\_\_\_
A
esthetic
strength
marginal fit
indirect
office
composite resin
17
Q

(5)Complete Ceramic

• Focus in improving strength of esthetic
restorations
– Veneering high strength core (ex. Zirconia or lithium disilicate) with a more translucent ____ or ____ reinforced translucent material
• ____ restorations are among the strongest ceramic restorations
– ____ acceptable esthetics for posterior teeth
• ____ retained with composite resin

A
porcelain
leucite
monolithic esthetic restorations
colored monolithic zirconia
etchable ceramic crowns
18
Q

(1)Fixed Dental Prosthesis (FDP)

  • Indicated for one or more ____ teeth
  • ____ attached with connectors to retainers
  • ____ technique
  • Requires precise alignment of tooth preparations
  • Long-term success with proper placement and meticulous oral hygiene
A

missing
pontics
indirect

19
Q

(2)Implant-Supported Prostheses

• Indicated for one or more ____ teeth
• Titanium cylinders are drilled into bone and 􏰀____􏰁 for several months
• Following osseointegration, the implant is restored with a ____
– Either left in place without ____ for several months or restored immediately with ____
• Does not involve ____ teeth

A
missing
osseointegrate
prosthesis
loading
interim restoration
adjacent
20
Q

(3)Partial Removable Dental
Prosthesis (PRDP)

  • Replaces missing teeth and supporting structures
  • Forces distributed to ____ and residual alveolar ridges
  • Forces best distributed with carefully contoured ____ and rest seats
  • ____ restorations may be needed to provide the best contours
  • Specific design requirements can affect tooth preparation design for “____”
A

remaining teeth
guide planes
fixed cast restorations
survey crowns

21
Q

(4)Complete Removable Dental
Prosthesis (Complete Dentures)
• A ____ prosthesis replacing entire dentition and associated structures
• Complicated by lack of ____ and gradual loss of supporting bone
• Damage to premaxilla when ____ opposing maxillary denture
– Combination syndrome
• Complete denture opposing fixed restorations
require careful planning of occlusion
• ____ can enhance stability and preserve ridge
– Rests on ____ or implants

A
removable
stability
mandibular incisors
overdentures
endodontically treated roots
22
Q

Combination Syndrome

• Occurs when ____ maxilla is opposed by natural ____ teeth
– Bone loss from ____
– Overgrowth of ____
– Papillary hyperplasia of ____
– ____ of lower anterior teeth
– Loss of ____ and ridge height beneath mandibular PRDP bases
• Also called ____ syndrome

A
edentulous
mandibular anterior
anterior portion maxillary ridge
tuberosities
hard palate mucosa
extrusion
alveolar bone
anterior hyperfunction
23
Q

Combination Syndrome
• Severe resorption of ____ with hyperplastic tissue
– Occlusal forces have been concentrated in ____

A

anterior maxilla

anterior region

24
Q
Treatment of Tooth Loss
• Reasons for tooth loss
– \_\_\_\_
– Periodontal
disease
– \_\_\_\_
– Trauma
– \_\_\_\_
A

dental caries
congenitally absent
neoplastic disease

25
Q

Decision to Remove Tooth
• Part of ____ process
• Assess advantages and disadvantages of ____
• If needs extraction, tooth replacement should be recommended and discussed ____ to tooth removal

A

treatment planning
tooth retention
prior

26
Q

Consequences of Removal without Replacement

• Replace or not replace?
– Analyze \_\_\_\_
• Loss of posterior occlusion
– May lead to \_\_\_\_ on remaining
dentition
• May result in \_\_\_\_ and poor function
– Studies have demonstrated adequate function possible with reduced posterior occlusion
A

costs and benefits
excessive forces
damage

27
Q

Consequences of Removal without Replacement

• Lack of replacement may result in upset of balance of forces on tooth by:
– ____ teeth
– ____ teeth
– ____ tissues
– Soft tissues of cheeks, lips, and tongue
• Future replacement may be more difficult due to tooth movement
– May require more extensive treatment
• Example: ____ treatment to reestablish space

A

adjacent
opposing
supporting
orthodontic

28
Q

Why Replace Teeth?

Why Replace Teeth?

(1) ____ of opposing teeth;
(2) ____ of adjacent teeth;
(3) Loss of ____

A

supraoocclusion
tilting
proximal contacts

29
Q

Selection of Abutment Teeth
• Design FDP as ____ as possible
• Ideal: single ____ fixed rigidly at each end of ____
• More complex treatment often compromises ____ prognosis
– Multiple ____ teeth
– ____ connectors
– Intermediate ____

A
simply
well-anchored
pontic
long-term
splinted
non-rigid
abutments
30
Q

With good ____, FDP is good option

A

bone support

31
Q

Replacement of Single Missing Tooth

• Cantilever fixed dental prosthesis – ____ is retained and supported on
only one end by one or more ____
• Long-term prognosis ____
• Induces ____ forces on supporting tissues
• may be harmful and lead to tipping, rotation, or drifting of the abutment
• Can be successful with with ____ abutment teeth

A

pontic
poor
lateral
multiple

32
Q

Replacement of Single Missing Tooth

____ can cause tipping, and horizontal forces, rotation of abutment teeth

Forces applied to cantilever are resisted only on one side leading to i____.

____ teeth resist forces much better

A

vertical forces
imbalance
two

33
Q

Assessment of Abutment Teeth

• Thoroughly evaluate ____
• ____ assessment
• Pulpal health assessed
– If questionable, endodontic therapy needed
• Always remove existing ____, caries, cavity liners

A

abutment teeth
radiographic
restorations

34
Q

(1)Endodontically Treated Abutments
• Proper ____ can be successful abutment
• If ____ or minimal ____ tooth structure, often recommend removal rather than endodontic therapy

A

endodontic treated tooth
short roots
coronal

35
Q

(2)Unrestored Abutments

• ____, caries- free tooth is ideal abutment
• Can be safely prepared without jeopardizing ____
• Sometimes reluctance to cut down sound tooth structure
– Implant?

A

unrestored

pulp

36
Q

(3)Mesially Tilted Second Molar

• Loss of ____ common
• If no replacement, mandibular second molar may tilt ____
– space maintainer
• Difficult to achieve ____ paths of insertion

A

mandibular first molar
mesially
parallel

37
Q

(3)Mesially Tilted Second Molar

____ to prevent tooth drifting following extraction

A

space maintainer

38
Q

(3)Mesially Tilted Second Molar

• Treatment options
– Orthodontic ____
– ____ connector

A

uprighting

non-rigid