Dental Treatment Procedures Overview

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Questions and Answers

What is the first step in the mouth preparation procedure before fixed prosthodontic treatment?

Removal of causes

Maintenance of dental health

Repair of damage

Relief of symptoms (correct)

Which of the following procedures should typically occur last in the treatment sequence of a patient with extensive dental disease?

Emergency treatment of symptoms

Fixed prosthodontics

Orthodontic treatment

Follow up care (correct)

Which of the following materials would be most appropriate for a tooth that has extensive damage and requires a strong foundation for restoration?

Dental Amalgam

Composite Resin

Pin-Retained Cast Metal Core (correct)

Resin-Modified Glass Ionomer Cement

What is a key indication for performing a Free Autogenous Gingival Graft?

To increase the width of the attached gingiva Signup and view all the answers

When should orthodontic treatment be initiated in relation to surgical correction of skeletal discrepancies?

After surgical correction Signup and view all the answers

Which professional hygiene treatment focuses on smoothing rough surfaces of teeth?

Polishing Signup and view all the answers

In cases where adequate retention cannot be gained, which treatment is indicated?

Elective endodontics Signup and view all the answers

What is the minimum amount of keratinized gingiva needed for restoration extending into the gingival sulcus?

5 mm Signup and view all the answers

What is a key advantage of using a coronally positioned pedicle graft?

It provides maintained blood supply to the pedicle. Signup and view all the answers

What is an indication for surgical crown lengthening?

When the clinical crown is too short for adequate retention. Signup and view all the answers

What factor does NOT influence the success of surgical reproduction of the interdental papilla?

The type of dental materials used. Signup and view all the answers

What is a common application of the pouch and tunnel technique?

Root coverage and ridge augmentation. Signup and view all the answers

What is NOT a consideration when performing surgical crown lengthening?

Patient's dental insurance coverage. Signup and view all the answers

What advantage does uprighting a mal-positioned abutment tooth provide?

It conserves tooth structure substantially. Signup and view all the answers

When is orthodontic-periodontic extrusion indicated?

When fractures or carious lesions extend apical to the free margin of the gingiva. Signup and view all the answers

What is a critical factor when assessing the need for maintenance of the interdental papilla?

Blood supply for the area. Signup and view all the answers

Study Notes

Mouth Preparation

Refers to procedures before fixed prosthodontic treatment.
Crowns or fixed dental prostheses are rarely provided without initial therapy.
Caries and periodontal disease must be corrected early in treatment to stabilize existing teeth and prevent further damage.

Treatment Sequence

Procedures should follow a specific order:
- Relief of symptoms (chief complaint).
- Removal of causes (e.g., caries, calculus).
- Repair of damage.
- Maintenance of dental health.

Treatment Sequence (Extensive Dental Disease)

Typical steps in extensive dental disease treatment:
- Preliminary assessment
- Emergency treatment of presenting symptoms
- Oral Surgery
- Caries control & replacement of existing restorations
- Endodontic treatment
- Definitive periodontal treatment
- Orthodontic treatment
- Definitive occlusal treatment
- Fixed prosthodontics
- Removable prosthodontics
- Follow-up care

Professional Hygiene

Procedures for professional hygiene include:
- Scaling
- Root planning
- Polishing

Oral Surgery

Includes soft tissue procedures (details not provided).
Also includes hard tissue procedures (details not provided).

Orthodontic Treatment

Severe skeletal discrepancies require surgical correction before treatment.

Implant-Supported Fixed Prostheses

Procedures for implant-supported fixed prostheses are discussed.

Caries and Existing Restorations

Procedures for dealing with and/or replacing existing restorations, which have been affected by caries.

Materials Selection

Factors considered for material selection in dental restorations:
- Extent of tooth destruction.
- Overall treatment plan.
- Operator's preference

Endodontics

Elective (intentional) endodontics may be needed in certain situations:
- Problems with obtaining a common path of insertion between abutments
- Inadequate retention in badly worn/damaged teeth
- Questionable cases

Definitive Periodontal Treatment

Keratinized gingival tissue is crucial, needing at least 5mm of keratinized tissue, with 3mm being attached tissue.

Mucosal Reparative Therapy

Technique for increasing the width of attached gingiva.
- Free autogenous gingival graft is one type.

Laterally Positioned Pedicle Graft

Used for recession or lack of attached gingiva on a single tooth.
Successful if adequate keratinized gingiva exists in adjacent teeth/edentulous spaces.
Advantage: predictable due to maintained blood supply.

Limitations of Laterally Positioned Pedicle Graft (LPPG)

Typically results in 1mm recession in the donor area.
Severe recession is possible if bony defects (fenestrations/dehiscences) are uncovered.

Coronally Positioned Pedicle Graft

Used for gingival recession/sensitivity on a single tooth.

Pouch and Tunnel Technique (Connective Tissue Graft)

Root coverage is a primary goal.
May address deficient ridge augmentation.
Aids in rebuilding papillae.

Crown Lengthening Procedure

Performed when the clinical crown is too short, needing adequate retention without affecting the biologic width.
Process repositions osseous crest, creating space between existing restorations/carious lesions.

Esthetics (Crown Lengthening)

Esthetic concerns (problems) can occur after surgery, especially when anterior teeth are lengthened.

Crown Lengthening - Assessment Factors

Analyzing factors including root length in bone, effect on adjacent teeth, furcation exposures (posterior), post-surgical mobility (small conical roots), extent of the defect, perforation, and soft tissue thickness.
Provisional restoration may be done before or soon after surgery.
Definitive restoration often happens after 3 months.

Maintenance and Reconstruction of the Interdental Papilla

Surgical techniques are used to reproduce/recreate papillae.
Success depends on attachment loss, blood supply, and distance to interproximal bone crest.
computer imaging often utilized

Orthodontic-Periodontic Extrusion

Performed when fracture or carious lesion extends below gingival margin
Flap is reflected/used to treat perforation.
Technique addresses perforation and related lesions.

Orthodontic Treatment - Uprighting

Advantages of uprighting mal-positioned abutments for fixed prostheses
- Improves alignment.
- Creates ideal pontic spaces.
- Improves embrasure form.
- Directs occlusal forces along the correct axis.
- Conserves tooth structure.

Assessment - Diagnostic Procedures

Assessment steps, including diagnostic preparations, cast sectioning, and computer imaging techniques.

Treatment - Orthodontic Procedures

Correcting diastema.
Uprighting a mesially tilted molar.
Repositioning teeth.
Orthodontic extrusion.
Orthodontic intrusion when tooth position needs adjustment.

Definitive Occlusal Treatment

Current research shows that occlusion has limited impact on development of TMJ disorders and associated muscle issues.

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Description

This quiz covers essential procedures involved in mouth preparation and treatment sequencing for fixed prosthodontics. Key steps include symptom relief, removal of causes, and maintenance of dental health, especially in cases of extensive dental disease. It emphasizes the importance of prior therapy before providing crowns or fixed dental prostheses.