Lec 5 DH 308 midterm

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Questions and Answers

What is a key requirement for temporary crowns?

They should be constructed from acrylic.

They should have well-fitting margins. (correct)

They should be mildly polished.

They should have rough margins.

How should restorations be designed regarding the embrasure space?

They should preserve the embrasure space. (correct)

They should permanently close the embrasure space.

They can decrease the embrasure space for aesthetic reasons.

They should ignore the embrasure space.

What condition can result from amalgam overhangs?

Reduced plaque buildup.

Gingival inflammation. (correct)

Increased enamel remineralization.

Improved gum health.

What instruction should be given to wearers of partial dentures regarding maintenance?

They should clean the appliance daily with proper tools. Signup and view all the answers

Which condition does NOT negatively affect periodontal health?

Excessive water intake. Signup and view all the answers

What can excessive and rapid orthodontic force lead to?

Bone loss in adult patients. Signup and view all the answers

Which of the following is NOT a type of trauma referred to in the content?

Coloring damage. Signup and view all the answers

How can malocclusion affect oral hygiene maintenance?

It makes dental hygiene more challenging. Signup and view all the answers

What is the average total thickness of Supracrestal Attached Tissue?

2.04 mm Signup and view all the answers

What is a consequence of placing a restoration margin too far below the gingival tissue crest?

Bone loss and gingival recession Signup and view all the answers

Which factor is NOT a retentive factor for biofilm affecting periodontal health?

Poor oral hygiene Signup and view all the answers

Which property of subgingival fixed restorations contributes to increased plaque biofilm formation?

Suboptimal fit to tooth structure Signup and view all the answers

What should be the distance of restoration margins from the gingiva?

Kept away from the gingiva Signup and view all the answers

What is the role of a healthy gingival sulcus before restorative treatment?

To determine gingival margin height Signup and view all the answers

What is a potential effect of over-contoured crowns on periodontal health?

Gingival inflammation Signup and view all the answers

What is a consequence of having a thin line of cement at crown margins?

Easy biofilm adherence Signup and view all the answers

What is the primary effect of unreplaced missing teeth on remaining teeth?

Increased occlusal pressure Signup and view all the answers

Which teeth are likely to migrate mesially after the loss of a first molar?

Second and third molars Signup and view all the answers

What oral condition is typically associated with mouth breathing?

Localized gingival inflammation Signup and view all the answers

What common palliative care method is recommended for managing mouth breathing inflammation?

Placement of petroleum jelly Signup and view all the answers

What impact does tobacco use have on periodontal disease?

Increases the amount of calculus and stains Signup and view all the answers

What is a toxic effect of tobacco that affects the gingival tissues?

Increased keratinization Signup and view all the answers

Why are smokers at higher risk for aggressive forms of periodontal disease?

Tobacco-related toxic effects Signup and view all the answers

Combining tobacco and alcohol use increases the risk of which type of cancers?

Esophageal and throat cancer Signup and view all the answers

Study Notes

Biofilm Retentive Factors in Periodontal Health

Over-contoured or worn restorations, food impaction areas, and orthodontic appliances can negatively impact periodontal health.

Supracrestal Attached Tissue (SAT)

SAT, formerly known as biologic width, averages 2.04 mm (range: 0.75 mm - 4.3 mm).
It comprises connective tissue attachment (1.07 mm) and junctional epithelium attachment (0.97 mm) above the alveolar bone crest.

Violation of Supracrestal Attached Tissue

Restorations placed too far subgingivally can cause unpredictable bone loss and gingival recession, or gingival inflammation without bone level changes.

Crown Contours and Margins

Over-contoured restorations are linked to gingival inflammation and periodontal disease.
Subgingival margins increase plaque biofilm formation due to surface roughness, fit issues, and restoration contour.

Dental Hygiene Considerations for Crown Margins

Healthy gingival sulcus is crucial before restorative treatment for proper margin height assessment.
Margins should be kept away from the gingiva.
Thin cement lines on margins promote biofilm adhesion.
Temporary crowns must fit well and be polished.
Restorations should maintain embrasure space and be contoured for easy hygiene.
Customized oral hygiene instructions are essential.

Amalgam Overhangs

Contribute to gingival inflammation.
Removal is often a dental hygienist's responsibility.

Removable Partial Dentures

Collect supragingival calculus.
Daily cleaning with appropriate tools is necessary.
Associated with deep periodontal pockets, increased caries risk in natural teeth, necessitating proper home care.

Conditions Affecting Periodontal Health

Orthodontic appliances, malocclusion, mouth breathing, first molar loss, tobacco, and alcohol use all negatively impact periodontal health.

Orthodontics and Periodontal Health

Increases plaque, gingivitis, and caries risk.
Can cause bone loss if periodontal disease isn't controlled.
Excessive orthodontic force increases apical root resorption risk.

Trauma and Periodontal Health

Toothbrush and flossing trauma, self-inflicted injuries, oral jewelry (e.g., tongue piercing), chemical irritation, food impaction, smokeless tobacco, radiation therapy (mucositis), and occlusal trauma can all negatively affect periodontal health. Note that occlusal trauma itself does not initiate pocket formation.

Malocclusion

Poorly aligned teeth affect embrasure spaces, hindering hygiene.

Unreplaced Missing Teeth

Leads to increased occlusal pressure on remaining teeth causing migration, usually mesially (mesial drift), premolars may drift distally.

First Molar Loss

Associated with gingival inflammation and pocket formation.
Causes mesial drift of second and third molars and distal drift of mandibular premolars, affecting vertical dimension.

Mouth Breathing

Leads to labial gingival inflammation of maxillary anterior teeth, characterized by redness, swelling, shininess, and easy bleeding.
Associated with increased plaque, gingivitis, and treatment resistance.
Palliative care might include petroleum jelly or saliva substitutes.

Anatomic Anomalies

Variations in tooth anatomy require careful instrumentation.

Tongue and Lip Piercing

Can cause localized trauma and inflammation

Tobacco and Alcohol Use

Increases the severity and prevalence of periodontal disease. The combined effect significantly increases the risk of oral and other cancers.

Tobacco Use

All forms increase periodontal disease risk.
Associated with increased calculus, stains, and risk of aggressive periodontal disease.
Causes keratinization, vasoconstriction, and presence of nicotine metabolites in saliva and gingival crevicular fluid.

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Description

This quiz covers key factors affecting periodontal health, including the impact of crown contours and the importance of supracrestal attached tissue (SAT). It explores common issues such as over-contoured restorations and their link to gingival inflammation and periodontal disease. Test your knowledge on how these elements interplay in maintaining oral health.