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39 Cards in this Set
- Front
- Back
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What factors affect tooth visibility at rest, and how?
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1. Racial Factors (Max CI: Increased exposure Blacks<Asians<Caucasians; Mand CI: Increased exposure Caucasians<Blacks<Asians)
2. Gender (avg exposure: Male=1.91mm, Female=4.0mm) 3. Age (Max CI= Exposure decreases w/age; Mand CI = Exposure Increased w/age) 4. Lip Length (Short upper lip = Increased Max CI exposure; Long upper lip = increased Mand CI exposure) |
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What are the Racial factors that affect tooth visibility at rest?
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Racial Factors
Max CI: Increased exposure Blacks<Asians<Caucasians Mand CI: Increased exposure Caucasians<Blacks<Asians |
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What are the Gender factors that affect tooth visibility at rest?
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Gender avg exposure: Male=1.91mm
Female=4.0mm |
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What are the Age factors that affect tooth visibility at rest?
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Age
Max CI= Exposure decreases w/age Mand CI = Exposure Increased w/age |
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What are the Lip Length factors that affect tooth visibility at rest?
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Lip Length
Short upper lip = Increased Max CI exposure Long upper lip = increased Mand CI exposure |
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During smiling, the amount of tooth exposure depends on?
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1. Degree of contraction of muscles of facial expression
2. Soft tissue levels 3. Skeletal factors 4. Design of restorations |
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What are the different smile classifications?
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1. Hi lip line: Displays teeth and gingival
2. Middle lip line: Displays teeth and interdental papilla 3. Low lip line: Displays limited part of teeth |
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Define Smile Line
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a. A hypothetical curved line drawn along the edges of the anterior max. teeth that ideally would coincide or run parallel with the curvature of the Inner border of the lower lip.
b. More pronounced in women |
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What is lateral negative space and how does it affect the anterior esthetics?
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a. Dark space that appears between the jaws during laughter and mouth opening
b. Lateral negative space i. Dark space between the outer surface of the maxillary teeth and the corner of the mouth ii. Results from the difference between the widths of the max. arch and the breadth of the smile iii. In golden proportion to the anterior segment |
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Explain how the golden rule applies to esthetic dentistry
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a. Ratio of 1:1.618
b. S/L = L/(S+L)= 0.618 c. The width of the max. central incisor is in golden proportion to the width of the max. lateral incisor, which is in turn proportional to the width of the max. canine. d. The lateral negative space is in golden proportion to half the width of the anterior smiling segment. |
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How does lateral negative space affect the graduation effect?
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a. Graduation effect- similar structures placed at different differences appear to undergo a progressive reduction in size.
b. The lateral negative spaces help to achieve the graduation effect by affecting the illumination of the teeth. |
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Define the ideal location of the gingival zenith from Central Incisors to Canines
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a. Gingival zenith is the most apical point of the gingival tissue.
b. Max. central and canine it is located distal to the long axis of the tooth. c. Max. lateral it is located at the long axis of the tooth. |
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How can you achieve Narrowing Illusion?
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i. Adjust the lateral prominences toward the center
ii. Increase the curvature and length of the central prominence mesiodistally iii. Increase the staining of the interproximal spaces |
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How can you achieve Widening Illusion?
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i. Adjust the lateral prominences (line angles) proximally
ii. Reduce the curvature and height of the central prominence iii. Reduce interproximal staining |
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How can you achieve Shortening Illusion?
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i. Adjust the incisal incline lingually
ii. Reduce the length of the central prominice iii. Emphasize the horizontal characterization iv. Flatten the middle 1/3 of the labial surface (increase light reflection) v. Darken the gingival third vi. Reduce interproximal staining |
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How can you achieve Lengthening Illusion?
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i. Flatten labial surface
ii. Increase the length of the central prominence iii. Emphasize the vertical characterization iv. Lighten the gingival 1/3 v. Increase the interproximal staining |
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What is 1. Miller’s classification of Ging Recess and predictability of root coverage:
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a. Class I
a. Marginal tissue recession DOES NOT extend to MGJ b. No perio loss in interdental bone c. 100% root coverage b. Class II a. Recession extends to MGJ b. No perio loss in interdental c. 100% root coverage c. Class III a. Recession is at OR BEYOND MGJ b. Bone/soft tissue loss in interdental area or malpositioned teeth c. Partial root coverage d. Class IV a. Recession at or beyond MGJ b. Severe bone/soft tissue loss in interdental area or malpositioned teeth c. NO root coverage |
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What is Miller's classification of Gingival Recession and predictibility of root coverage Class I?
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a. Class I
a. Marginal tissue recession DOES NOT extend to MGJ b. No perio loss in interdental bone c. 100% root coverage |
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What is Miller's classification of Gingival Recession and predictibility of root coverage Class II?
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b. Class II
a. Recession extends to MGJ b. No perio loss in interdental c. 100% root coverage |
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What is Miller's classification of Gingival Recession and predictibility of root coverage Class III?
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c. Class III
a. Recession is at OR BEYOND MGJ b. Bone/soft tissue loss in interdental area or malpositioned teeth c. Partial root coverage |
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What are the indications/contraindications of Root coverage?
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a. Indications:
a. Sensitivity b. Progressive receding c. Want to increase width or thickness of attached gingival d. Esthetics e. Preparing for prostho or ortho tx f. Oral Hygiene b. Contra a. Sites w/ pronounced dehiscences in alveolar bone b. Broadly denuded root surfaces c. Non-progressive recession |
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What are 4 types of different grafting techniques?
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1. Free Autogenous Gingival Graft (All instances where root coverage is indicated except whe a graft of sufficient thickness cannot be harvested)
2. Subepithelial Connective Tissue Graft 3. Pedicle Gingival Grafts (Laterally positioned & Double papilla) |
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What are the advantages/disadvantages of Free autogenous gingival graft?
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1. Poor ability to provide blood supply to graft
2. Exposed and large palatal wound 3. Inferior esthetic 4. 2 Surgical sites |
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What are the advantages/disadvantages of Connective Tissue Graft?
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Advantages
1. Highly predictable 2. Good blood supply 3. Wound closed at donor site 4. Good esthetics 5. Multiple teeth Tx Disadvantages 1. Technically demanding 2. Postoperative gingivoplasty may be needed (2nd surgery) |
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What are the advantages/disadvantages of Pedicle Gingival Grafts?
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Advantages
1. One surgical area 2. Blood supply preserved 3. Highly esthetic Disadvantages 1. Only for minor recession and one tooth 2. Lower success rate |
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What are the indications and contraindications for Laterally positioned Pedicle Gingival Grafts?
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Indications
1. Donor site with sufficient width, length and thickness of keratinized tissue 2. 1-2 teeth coverage 3.Narrow gingival recession Contraindications 1. Low keratinized tissue 2. Thin bone, osseous defect 3. Retrusive gingival recession |
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What are the indications for crown lengthening?
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1. Surgical site free of plaque, calculus and inflammation
2. Adequate blood supply to donor tissue 3. Excessive gingival tissue 4. Altered passive eruption 5. Esthetics |
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What are the advantages & disadvantages of crown lengthening?
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Advantages
1. Excellent blood supply 2. Initial wound closure 3. Easy stabilization of graft 4. Fast healing 5. Homeostasis control 6. Color match Disadvantages 1. Demanding 2. Less increase of alveolar ridge height compared to only graft procedure |
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How do you determine whether osseous reduction is indicated vs soft tissue recontouring?
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2.5-3mm between free gingival margin and osseous crest must remain to eliminate biological width to avoid osseous reduction
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What are the advantages/disadvantages of site prep for ovate pontic?
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Advantages
1. Esthetics 2. Oral hygiene Disadvantages 1. Requires oval shape 2. Receptor site must be 1-1.5 mm deep 3. Must have at least 2 mm between pontic and bone |
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Define 3 parameters of color
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1. Hue - Particular variety or tone of color determined by reflected wavelength
2. Value - relative darkness or lightness of the color randing from 0 (black) to 10 3. Chroma - saturation or intensity of the hue and is decreased by bleaching |
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What is the most important parameter of color?
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Value - relative darkness or lightness of the color ranging from 0 (black) to 10
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What are the different color mixtures?
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1. Primary: red blue yellow
2. Secondary: Orage green purple 3. Tertiatry: mix a primary and secondary (brown) |
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Discuss the shade taking guidelines and the reason for each step
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1. Clean teeth to get most accurate view
2. Select shade at eye level 3. Lipstick is removed 4. Select shade at beginning of appt 5. Make quick decisions in less than 5 seconds under color corrected fluorescent lighting 6. Confirm selection under a second type of lighting |
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What are colors with different spectral reflectance that appear to match under a certain lightling condition but unmatched under a different lightling source? How do you avoid this?
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Metamerism
Confirm selection under two lights |
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List the various shade guides available and the proper color communication to the lab
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a) Vita lumin
b) Ivoclar chromoscop c) Vitapan 3D Master (Select the value, then chroma, then hue; hold shade guide to pts mouth at arms length; Select value and from the group remove the middle tab to determine chroma d) Divide tooth into 3 regions (match each region independently to corresponding sample; draw and desired characterization like hypocalcification or strain; take photographs) |
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What are the indications/contraindications to vital bleaching?
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Indications
1. Unacceptable color/irregularities 2. Prior to restorative Tx 3. Conservative alternative Contraindications 1. Defective/leaking restoration 2. Active caries 3. Sensitive teeth/roots 4. Periapical pathosis 5. Exposed dentin 6. Pts attitude/expectations 7. Preganacy/nursing |
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What is the active ingredient in home bleaching?
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10% carbamide peroxide - hydrogen peroxide + urea
Good for yellow brown discoloration, not so much for blue-gray Have pts sleep in it overnight (only really need 1-2 hrs/day) |
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What are bleaching agents use in dental office?
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15-25% hydrogen peroxide + plasma arc, LED, argon lasers, metal halide, xenon(Never used for home bleaching TOO AGGRESSIVE
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