DES410 Fixed & Removable Prosthodontics Quiz

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Questions and Answers

What is the primary purpose of using splints in dental treatment?

To speed up the healing process

To increase occlusal vertical dimension (correct)

To strengthen enamel

To improve tooth color

Which of the following is NOT a role of splints?

Check for muscle origin pain

Prevent toothwear

Support root canal treatment (correct)

Enable assessment of denture fit

What is a post in dental terminology?

A type of dental cleaning technique

A tooth filling material

A patient follow-up procedure

A metal or rigid restorative device in the root (correct)

What defines a core in dental restoration?

The substructure replacing missing coronal structure Signup and view all the answers

What is commonly used to restore the upper anterior teeth?

Composite resin Signup and view all the answers

Which procedure is used to create a mold for wax-ups?

Silicone index making Signup and view all the answers

What type of material is traditionally used for dowels in dental posts?

Metal Signup and view all the answers

What is the function of a putty index in dental procedures?

To take impressions for wax-ups Signup and view all the answers

What type of materials is Zinc Phosphate primarily used for?

Cast restorations Signup and view all the answers

Which property of Zinc Phosphate can affect its usage?

Low tensile strength Signup and view all the answers

What is a significant characteristic of Glass Ionomer cement?

Fluoride release Signup and view all the answers

For what type of restorations is Resin based cement particularly indicated?

All-ceramic restorations Signup and view all the answers

What is a disadvantage of using Glass Ionomer cement?

Moisture contamination susceptibility Signup and view all the answers

Which cement type is less susceptible to early moisture exposure?

Resin Modified GIC Signup and view all the answers

What aspect can affect the performance of Resin based cement?

Technique sensitivity Signup and view all the answers

What is the primary use of articulating papers in dentistry?

Checking occlusal contacts Signup and view all the answers

What is a common clinical feature of attrition?

Flat cusps with matching wear facets Signup and view all the answers

Which of the following is the least conservative management for TSL?

Extractions Signup and view all the answers

What is an indication that splints should not be offered?

Active erosion of teeth Signup and view all the answers

What is a key feature seen with tooth erosion?

Dentine appears smooth and shiny Signup and view all the answers

Which method is recommended for maintaining tooth structure in a patient with erosion?

Diet analysis and fluoride toothpaste usage Signup and view all the answers

What clinical sign is NOT typically associated with attrition?

Cupping of tooth surfaces Signup and view all the answers

Which of the following is a feature of erosion?

Cupping observed Signup and view all the answers

What is the recommended first step in managing a patient experiencing erosion?

Conduct a diet analysis and suggest changes Signup and view all the answers

What is the minimum height of ferrule required for dental posts?

1.5 mm Signup and view all the answers

For a ferrule height of 2-3 mm, which post type is preferred?

Indirect cast post Signup and view all the answers

What is the primary factor in determining whether to use a direct or indirect post?

Amount of ferrule present Signup and view all the answers

What is the recommended core type for molar teeth instead of a post and core?

Nayyar core Signup and view all the answers

What does the Tooth Restorability Index (TRI) assess?

Remaining coronal tissue Signup and view all the answers

How many sextants are used in the TRI assessment?

6 Signup and view all the answers

What score indicates 'inadequate' remaining coronal dentine in the TRI?

1 Signup and view all the answers

What is the ideal method to create a representation of a post and core system for laboratory fabrication?

Using duralay or wax for an exact representation Signup and view all the answers

What is the primary issue with adhesion in zirconia-based components?

Traditional adhesive techniques are ineffective. Signup and view all the answers

Which acidic monomer is recommended for chemically bonding with zirconia?

10-MDP Signup and view all the answers

What method is often required to increase the surface roughness of zirconia?

Aggressive mechanical abrasion. Signup and view all the answers

Which type of materials differ in composition and properties from zirconia?

Silica-based materials Signup and view all the answers

What is a consequence of using aggressive mechanical abrasion on zirconia?

Development of surface flaws that reduce strength. Signup and view all the answers

Which of the following is NOT a recommended resin cement for zirconia ceramics?

Zirconia Luting Cement Signup and view all the answers

What is the significance of chemically functionalizing the surface of zirconia?

It aids in achieving adhesive bonding. Signup and view all the answers

Which of the following best describes the interaction between bonded cements and forces on restorations?

They dissipate forces away from the tooth-restoration interface. Signup and view all the answers

What is the typical thickness range of normal articulating paper used for dentures?

70-200 microns Signup and view all the answers

During which phase would you stabilize periodontal disease in the treatment planning process?

Stabilization Phase Signup and view all the answers

Which of the following materials has the thinnest thickness among those listed?

Shimstock Signup and view all the answers

What should be the primary focus during the Rehabilitation Phase?

Restore all teeth needing restorations Signup and view all the answers

Which error is not correctable and will require a new impression?

Impression distortion Signup and view all the answers

What is the first step in managing a patient with irreversible pulpitis and multiple carious cavities?

Initiate root canal treatment or extract the affected tooth Signup and view all the answers

Which of the following is a method for checking the fit of a crown?

Visual inspection with magnification Signup and view all the answers

What is the main purpose of GHM articulating paper in dentistry?

To adjust the occlusal contacts Signup and view all the answers

Study Notes

Course Information

Course code: DES410
Course title: Fixed & Removable Prosthodontics
Lecturers: Dr. Christos Theocharides, Dr. Alexandros Panayiotou
Institution: European University Cyprus, School of Dentistry, Department of Dentistry

Exam Format

20 multiple-choice questions (MCQs): 10 fixed, 10 removable; 1 mark each; 5 options per question; one correct answer
10 short-answer questions (SAQs): 5 fixed, 5 removable; 4 marks each
Questions primarily based on clinical practice
Review year 3 notes and clinical guidelines
Read questions carefully before answering

Crowns

Indications for a dental crown:
- Protect remaining tooth structure
- Improve aesthetics
- Alter crown form for removable partial dentures (abutments)
- Alter occlusal plane
Most conservative to most destructive crowns:
- Zirconia (monolithic)
- All-metal crown
- All-ceramic crown
- Ceramo-metal crown
- Porcelain fused to zirconia

Tooth Reductions

Table of biomaterials and their respective reduction levels for occlusal (posterior) and incisal (anterior) surfaces and axial. Different biomaterials are shown starting from least destructive to most destructive.

Crown Preparation (steps)

Take shade of crown (for porcelain or zirconia)
Take two or three putty indices
Use local anesthetic if required
Prepare the tooth properly (use indices as guides)
Construct a temporary crown
Place retraction cord with a haemostatic agent
Take an impression
Place a temporary crown
Check occlusion and adjust if needed
Complete records and laboratory card

One-Stage Impression Technique

Choose appropriate tray
Apply adhesive to tray (following manufacturer's recommendations)
Block any undercut areas in the mouth (e.g., using wax)
Load heavy-bodied material into the tray (using green/blue mixing tip)
Simultaneously, syringe light-bodied material around the prepared tooth/teeth (using yellow mixing tip with intra-oral tip)
Place loaded tray in the mouth
Hold the tray firmly until impression sets
Remove impression from mouth, rinse, and disinfect
Follow manufacturer's instructions

Inspection of Impression Quality

Rinse the impression with water to remove saliva and blood
Dry the impression with 3-in-1 and examine under light magnification
Disinfect the impression per manufacturer's recommendations
Complete and sign the lab form, and send it to the lab
Check preparation margins for visibility
Ensure morphological features of teeth match the impression
Verify no air bubbles or debris
Check for detachment of impression material

Crown Cementation(steps)

Check lab work (crown fit and shade)
Remove temporary restorations
Clean the prepared tooth
Try in the restoration
Check marginal fit, contacts, and occlusion
Verify patient satisfaction with fit and appearance
Remove the crown and clean both the crown and tooth surfaces (sandblast if indicated with Al2O3 50μm)
Cement the crown using appropriate cement
Check and remove excess cement
Recheck occlusion

Cements or Luting Agents

Temporary cements: Zinc Oxide (with/without eugenol)
Permanent cements: Definitive cementation (conventional cements); acid-base reaction (resin cements); polymerization reaction (hybrid cements); combination of above reactions

Choosing the Right Cement

Use stronger cement for weaker restoration materials
Bonded cements spread forces away from the interface.
Consider the amount of retention needed (preparation form, tapers, length of crown/walls)

Non-silicate Ceramics (especially Zirconia)

Clinical challenge with zirconia-based components is difficulty in achieving suitable adhesion
Traditional adhesive techniques do not work effectively with zirconia
Current research focuses on surface modification of ceramics to achieve chemical functionalization of the surface to improve bonding

Other Important Concepts

Tooth Reductions: Table provided details on reduction amounts for different biomaterials (e.g., Zirconia, All metal, All Ceramic crowns) for occlusal and incisal surfaces.
Articulating Papers: Normal (70-200 microns), GHM (12-20 microns), and Shimstock (8 microns) are used to check occlusal contacts.
Treatment Planning Process: Stages include: Emergency, Investigation/Stabilization, Rehabilitation, and Maintenance.
Clinical Case Scenario: A patient case of tooth pain (tooth 46) is given; students need to design a management plan (including emergency, stabilization, rehabilitation, and maintenance phases).
Common Errors in Crown Marginal Fit: Tight proximal contacts, casting blebs, over/under-extended margins, lack of die spacer, and impression distortion can lead to poor marginal fit
Checking Crown Fit: Visual examination (margins, direct/mirror observation, magnification) and use of explorers (straight probe) are crucial for determining a crown's fit, especially for subgingival margins.
Types of Defective Margins: Overextended (surplus wax or ceramic), Underextended, Over-Contoured (e.g., thicker crowns with over-waxing), and Open margins (castings not completely seated).
Evaluating Crowns Before Cementation
- Assess proximal contacts (use floss)
- Evaluate marginal fit (use explorer)
- Check aesthetics (shape and shade)
- Evaluate occlusion (use articulating paper)
Semi-precision Attachments
Objectives of Modifying Abutment Tooth Contours (Advantages of Milled Crowns): Develop acceptable path of insertion, enhance biomechanics (retention, support, stability), improve aesthetics, and improve tooth's structural durability (especially if heavily restored).
Options for Replacing Teeth: Removable (partial/complete acrylic, cobalt chrome, valplast) and fixed (resin-bonded bridge, implant, conventional bridge).
Factors Affecting Prognosis of Teeth: Patient factors (restorative status, medical/dental history, expectations, finances/behaviour), and dentist factors (skills/expertise, available equipment/materials).
Prognosis Factors (Structural, Endodontic, Periodontal Integrity): Tooth structure remaining (at least 1.5mm ferrule), endodontic outcome for successful root canal treatment, and periodontal health (amount of bone loss and mobility).
Strategic Value of a tooth: Aesthetic considerations, medical concerns (related to lip line and soft tissues), prosthodontic factors (role as abutment), functional aspects, and financial constraints (e.g., NHS funding).
RCP (Retruded Condylar Position), ICP (Intercuspal Position): Definitions and clinical relevance.
Management of Teeth with Extensive Tooth Loss: Discussion of tooth restorability index (TRI) scoring system for evaluating tooth structure, including types of tooth surface loss and management strategies.
Toothwear: Various causes (attrition, abrasion, erosion, abfraction) and management strategies (monitor, treatment planning, wax-ups, materials).
Clinical Features of Erosion/Attrition: Presentation of symptoms or signs related to each condition are provided
Management of TSL (Tooth Surface Loss): A workflow for addressing TSL cases with different restorative options (Most conservative—least conservative).
Management of Erosion: Dietary modifications, fluoride toothpaste, composite resin restorations, and indirect lab restorations are recommended.
How a Wear Case is Managed: Sequence of procedures, including creating articulated casts, constructing wax-ups, creating putty index or plastic retainer, and choosing composite resin to restore the anterior teeth.
Role of Splints: Evaluation and treatment of TMD cases where pain arises as muscle origin that splint application can be used to resolve the problem, alongside prevention of tooth wear before/after treatment. The role of splints in managing toothwear (e.g., increasing occlusal vertical dimension, checking RCP, treatment of TMD), as well as managing partial/complete dentures or overdentures is addressed.
Posts & Cores: Post (metal/rigid restorative in root canal of a non-vital tooth); and Core (replaces coronal structure to retain final restoration). Suitable post length and other specifics for indirect/direct method that is ideal.
Tooth Restorability Index (TRI): Provides a structured assessment (scores and procedures) for evaluating remaining coronal/crown tissue (i.e., dentin) for stability and resistance.
Clinical Guidelines needed for further review.

Additional Information

Understand the clinical guidelines and pay specific attention to the topics mentioned in this revision lecture, as well as other lectures, to gain a strong understanding.

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Description

Test your knowledge in fixed and removable prosthodontics with this quiz designed for the DES410 course. The quiz covers clinical practice, indications for dental crowns, and various crown types. Prepare using your third-year notes and clinical guidelines to succeed.