5 Perio II (Exam 1): Crown Lengthening I & II (Esthetic CL)

Surgical Exposure to facilitate Restorative Therapy

What is a Major Indication for Crown lengthening:

false

t/f: Altered Passive Eruption also known as delayed passive eruption is pathologic

true

t/f: Altered Passive Eruption also known as delayed passive eruption is a variation of normal/ healthy anatomy

true

t/f: Altered Passive Eruption also known as delayed passive eruption has a clinical presentation excess gingival

tissue i.e. the clinical crown is shorter than the

anatomic crown

CEJ

In Altered Passive Eruption also known as delayed passive eruption , it may be associated with the osseous crest being

located close to the _____

3

from the osseous crest, you can expect the gingiva to grow back about __ mm

2

dentogingival junction is ____mm

- supracrestal fibrous attachment: 1mm

- epithelial attachment: 1mm

what is the dentogingival junction made of?

occluso-apical

the longer a preparation in a _______ dimension, the greater the crowns resistance to dislodgement

false

t/f: a gingivectomy is the necessary treatment to treat altered passive eruption in the case that the bone is located at the level of the CEJ

true

t/f: Crown Lengthening can Improve Esthetics when delayed or altered passive eruption is present

false

t/f: Crown Lengthening cannot expose caries and expose the anatomic crown

2

the Dentogingival Junction is about __mm

1

a Healthy Sulcus depth is about __mm

3

The recommended distance between the osseous

crest and a restorative margin is still __mm

violation of biological width

ID the problem:

bone loss

A crown w/ a margin closer than 3 mm to the osseous crest

may result in _____

3

When providing a CLP, we need to obtain a __ mm occlusal-apical distance between the restorative margin and the osseous crest!!

embrasure space

Crown Lengthening can result in improvement in ______, making it more cleansable

1.5 to 2

A ferrule length should be ____ mm

- chronic inflammation

- bone loss

a crown margin closer than 3mm to the osseous crest will result in what consequences?

help establish Ferrule

how does a CL procedure help in a post/core with crown procedure?

Ferrule

height of natural tooth structure engaged by a full coverage restoration apical to a foundation restoration

-prevents clinical failure of luting cement

-prevents fracture of root

-resists occlusal forces when placed on lingual and buccal surfaces

What are the benefits of having Ferrule?

exposure of tooth to supragingival caries

all the following are indications for a crown lengthening procedure except:

- exposure of subgingival caries

- exposure of subgingival fracture

- exposure of tooth structure for increased retention of crown

- exposure of tooth structure for esthetics

- exposure of a prosthetic ferrule

- exposure of tooth structure to prevent impingement of supraosseous attachment

- exposure of tooth to supragingival caries

extensive occlusal caries

all the following are contraindications to crown lengthening except:

- an esthetic compromise

- poor crown to root ratio

- extensive occlusal caries

- furcation invasion

- caries located ≤3mm from CEJ to fornix of furcation

extract the tooth

If osseous resection of 3 mm results in furcation invasion, you should _____

extract the tooth

If you have to remove bone 3 mm in an apical direction to expose Caries on the root trunk and you would remove bone in the furcation, you should ______

•Reshaping the bone

•Decontaminating root surfaces

Elevation of periodontal flaps can help to achieve our goals of:

false

t/f: a gingivectomy can provide access to recontour the bone

true

t/f: a surgical flap elevation can provide access to recontour the bone

3

If the caries or fracture is not just located on the

facial or lingual but extends to the mesial or distal,

the surgery should involve __ teeth to establish

positive osseous architecture

ostectomy

the removal of supporting bone:

osteoplasty

the removal of nonsupporting bone:

3 months

after crown lengthening, the posterior teeth take about ______ to heal

3-6 months

after crown lengthening, the anterior teeth take about ______ to heal

All of the above

A restorable maxillary 1st molar, number 3, has

subgingival caries on the mesial and distal. Endodontic

therapy with post and core is treatment planned. A CLP

outcome involving osseous resection should:

- Result in Positive osseous architecture

- Not result in Furcation invasion

- Expose an adequate ferrule

- All of the above

false

t/f: bone recontouring should be done with a diode laser

waterlase ND: YAG

how should bone recontouring be done?

bone in the M-D area is more coronal to the bone in the B-L area

what does it mean to have positive architecture when performing CL procedure?

3mm biologic width + 2mm ferrule

how much vertical tooth structure must a tooth fitted for a post/core with crown have?

3

The ideal distance between a restorative margin and the osseous crest (Biologic Width) is __mm:

- 1

- 2

- 3

- 4

2

The optimal length for a ferrule on a tooth treated with a post and core and full coverage crown is __mm:

- 1

- 2

- 3

- 4

3

if there are mesial and distal caries on the tooth in question, how many teeth will be involved in the osseous surgery?

- 1

- 2

- 3

- 4

PDL

When you include a 2mm ferrule in your post and core prep, you allow the occlusal forces to be distributed to the:

- post

- PDL

- dentin

- alveolar one

periodontal disease

reverse/negative architecture is associated with:

- perio health

- periodontal disease

- optimal bony contour

apical

in reverse/negative architecture, the interdental bone is ____ to the buccal/lingual bone height:

- equal to

- coronal

- apical

apico-occlusal

reduction of thick bone ( bucco-lingually) decreases soft tissue height in an _______ dimension on aproximal and interproximal surfaces

- osseous crest follows the CEJ

- aproximal bone is apical to the interdental bone height

- the CEJ is apically positioned on the buccal and lingual and rises coronally on the proximal surface

describe positive architecture:

1

a long root trunk tooth has ____ parabola on the approximal surface:

- 0

- 1

- 2

- 3

2

a short root trunk tooth has ____ parabola on the approximal surface:

- 0

- 1

- 2

- 3

Delayed/incomplete passive eruption (gummy smile)

You patient present like this clinically, but radiographically the crowns look much longer. What is the diagnosis?

ressective surgery

You patient present like this clinically, but radiographically the crowns look much longer. What is the treatment?

expose the anatomical crown

What is the goal for treating patients with Delayed/incomplete passive eruption (gummy smile)?

clinical crown is equal in length to the anatomic crown

The goal of an aesthetic crown lengthening procedure when treating delayed passive eruptio is to resect periodontal tissue so the:

- clinical crown is equal in length to the anatomic crown

- clinical crown is shorter in length than the anatomic crown

- clinical crown is greater in length than the anatomic crown

- None of the above