post insertion adjustment and follow up care

27
POST INSERTION ADJUSTMENT

Upload: emjei-mendoza

Post on 14-Jun-2015

3.077 views

Category:

Health & Medicine


6 download

TRANSCRIPT

Page 1: Post insertion adjustment and follow up care

POST INSERTION ADJUSTMENT

Page 2: Post insertion adjustment and follow up care

The following may be required after cementation of the final restoration:

-Check the occlusion of the teeth making sure that they are in their correct intercuspation

-Remove again all existing premature contacts after the restoration has been seated completely

-Make sure the gingiva is not impinged

Page 3: Post insertion adjustment and follow up care

-Remove excess cements on the surrounding soft tissues to avoid inflammation

-Instruct the patient of the proper home care procedures

-Regular recall appointments are required to check the health of the tooth/teeth and surrounding structures

-Seek the attention of the dentist in cases of pain and discomfort after the final installation of the denture

Page 4: Post insertion adjustment and follow up care

FOLLOW-UP CARE

Page 5: Post insertion adjustment and follow up care

Well-organized and efficient follow-up care is the chief mechanism for ensuring successful fixed prosthodontics.

Page 6: Post insertion adjustment and follow up care

A restoration that is cemented, forgotten and ignored is likely to fail no matter how expertly it was designed and executed.

Page 7: Post insertion adjustment and follow up care

Restored teeth should require careful plaque removal and maintenance than healthy unrestored teeth. An FPD requires an additional care and attention.

Page 8: Post insertion adjustment and follow up care
Page 9: Post insertion adjustment and follow up care
Page 10: Post insertion adjustment and follow up care
Page 11: Post insertion adjustment and follow up care

Common Complications associated after Completion of the Treatment: (Post Insertion Problems)

dental caries periodontal failure/disease endodontic failure occlusal dysfunction loose retainers porcelain fracture fractured connector pain

Page 12: Post insertion adjustment and follow up care

DENTAL CARIES

Most common cause of failure of a cast restoration

Detection is difficult particularly where complete coverage is used

Page 13: Post insertion adjustment and follow up care

Undetected caries beneath this FPD

Page 14: Post insertion adjustment and follow up care

PERIODONTAL DISEASE

Often occurs after placement of fixed prostheses especially where the cavosurface margin is placed subgingivally or the prosthesis is over contoured

Inflammation is more severe with poorly fitting restorations but even perfect margins have also been associated with periodontitis

Page 15: Post insertion adjustment and follow up care
Page 16: Post insertion adjustment and follow up care

At recall appointments, attention is given to sulcular hemorrhage, furcation involvement and calculus formation as early signs of periodontal disease

Improper contoured restoration should be recontoured or replaced

Page 17: Post insertion adjustment and follow up care

OCCLUSAL DYSFUNCTIONAn examination of the occlusal surfaces

may reveal abnormal wear facets

Questions should be asked concerning any parafunctional habits such as BRUXISM

Abnormal tooth mobility is investigated and also muscle and joint pain

Page 18: Post insertion adjustment and follow up care

If a cast restoration is not designed according to neuromuscular and temporomandibular controls, extensive wear can result after a relatively short time.

Page 19: Post insertion adjustment and follow up care

PULP AND PERIAPICAL HEALTH Px may reveal having experienced one or

more episodes of pain which indicate the loss of vitality of an abutment tooth/teeth

Radiographs provide useful information as to the presence of periapical pathosis

Endodontically treated teeth should be examined radiographically every few years

Page 20: Post insertion adjustment and follow up care

PAIN

Should be examined as to its location, character, severity, timing and onset

Most oral pain is of pulpal origin

Page 21: Post insertion adjustment and follow up care

LOOSE RETAINERSUsually a sign of inadequate tooth

preparation, poor cementation technique or caries

In this case, the tooth/teeth require repreparation and a new prosthesis

The best policy is to section the prosthesis rather than attempt to remove it intact

Page 22: Post insertion adjustment and follow up care

(A) severe tooth destruction may result when a loose retainer goes undetected(B) looseness of one retainer can occasionally be observed directly (arrow) when force is exerted in an occlusal direction(C) water is then applied to the cervical area, and the diagnosis is confirmed if bubbles appear when pressure is exerted (D)

A B

C D

Page 23: Post insertion adjustment and follow up care

FRACTURED CONNECTOR

Px may complain varying degrees of pain due to extra force transmitted to the abutment teeth

Wedges can be used to separate individual components enough to permit the correct diagnosis

Page 24: Post insertion adjustment and follow up care

Fractured connector

Page 25: Post insertion adjustment and follow up care

FRACTURED PORCELAIN VENEERUsually related to faulty framework

design, improper laboratory procedures, occlusal functions or trauma

If porcelain has fractured but not missing on a satisfactory prostheses, repair than remake may be justified with a porcelain repair system utilizing silane coupling agents to promote bonding with acrylic/composite resin

Page 26: Post insertion adjustment and follow up care

Fractured porcelain

Repaired porcelain using acrylic/composite resin

Page 27: Post insertion adjustment and follow up care

SEE YOU ALL SOONIN THE CLINIC!GOODLUCK!!!

o

DR. VIVIAN C. CARLOSProsthodontics Section