Periodontics › Treatment
Restorative & Prosthetic Considerations
High-yield revision notes with linked practice questions, written for dental students and candidates preparing for the ADC and other licensing examinations.
High-yield notes
Failure to control active periodontitis can result in acute exacerbations and bone loss during tooth movement.
At least 2 months of healing is recommended after soft tissue grafting procedures before initiating restorative dentistry.
The healthy gingival sulcus has shown an average depth of 0.69 mm
Greater than 3 mm of soft tissue between the bone and gingival margin, with adequate attached gingiva, allows crown lengthening by gingivectomy.
With less than 3 mm of soft tissue between the bone and gingival margin, or less-than-adequate attached gingiva, a flap procedure and osseous recontouring are required for crown lengthening.
The biologic, or attachment, width can be identified for the individual patient by probing to the bone level (referred to as "sounding to bone") and subtracting the sulcus depth from the resulting measurement.
Practice questions
Select an option to check your answer. Answers are shown below each question.
Definitive periodontal pocket therapy for deep pockets
- Amay be postponed until after the completion of orthodontic tooth movement, If nonsurgical treatment is sufficient
- Bshould be carried out during the orthodontic treatment, even if nonsurgical treatment is sufficient
- Cshould never be carried out in the tooth previously moved by orthodontic forces
- Dis not required.
Minimal distance between alveolar bone crest and the gingival margin should be
- A2.04 mm
- B2.07 mm
- C1.97 mm
- D3.0 mm
Surgical crown lengthening include the removal
- ASoft tissue to increase the crown length
- BAlveolar bone
- CApex of the root
- DBoth a and b
which of the following restorative margin is least desirable?
- ASupragingival due to unesthetic appearance
- BEquigingival as it is unesthetic as well as retain more plaque than supragingival or subgingival margins and therefore result in greater gingival inflammation.
- CSubgingival as these margins are not as accessible as supragingival or equigingival margins for finishing procedures.
- DBoth b and c
False regarding Biological width
- Athe dimension of space that the healthy gingival tissues occupy between the base of the sulcus and the underlying alveolar bone
- Bis comprised of the junctional epithelial attachment and the connective tissue attachment
- Cthe connective tissue attachment occupies 0.97 mm and that the junctional epithelial occupies another 1.07 mm of space resulting in total of 2.04 mm width.
- DAll of the options are correct.
During the placement of the zirconia crown on maxillary central incisor, the biological width was violated interproximally by 1 mm. This can be corrected by
- ARemoving interproximal bone 1 mm
- BRemoving interproximal bone 1.5 mm as a safety factor
- COrthodontic extrusion of the teeth
- DBoth b and c
Which of the following is not carried out while Orthodontic extrusion during correction of violation of biological width is done
- ABy applying low orthodontic extrusion force
- BRapid extrusion by cutting the supracrestal fibres
- CBoth of the above may be done
- DNone of them is desired
The first step in using sulcus depth as a guide in margin placement is to
- AMaintain the depth of sulcus to 3.0 mm
- BMeasure the biological width
- CMaintain the gingival health
- DOrthodontic extrusion of the teeth
If the sulcus probes more than 1.5 mm, the guideline to place restoration margin is
- Aplace the restoration margin 0.5 mm below the gingival tissue crest
- Bplace the margin half the depth of the sulcus below the tissue crest
- Cevaluate to see if a gingivectomy could be performed to lengthen the teeth and create a 1.5-mm sulcus. Then the patient can be treated using Rule 1.
- Devaluate to see if a gingivectomy could be performed to lengthen the teeth and create a 3.0 mm sulcus. Then the patient can be treated using Rule 1.
These notes are compiled from standard periodontology texts for study purposes. They are a revision aid, not a substitute for your own reading or current clinical guidelines. If you spot an error, please leave a comment.