1. Tissue Management I Flashcards
What are some common issues seen in crown impressions
- voids on finishlines
- tears
- partial set streaks of impression material
- debris
- impression separation from the try
- incomplete recording of all necessary teeth
What should you as a patient coming in for a crown impression before administering local anesthesia
- Is the provisional secure?
- Tooth asymptomatic?
What are the benefits of administering LA for crown impression
- Patient comfort
- Reduces salivary flow
Why does LA reduce salivary flow
-Increased discomfort leads to increased saliva
When removing a provisional FDP where should the hemostat be placed
alternating at each connector.
What should you look at after removing the provisional
- Adequate tooth prep (correct reductions- centric and eccentric)
- Distinct regular continuous finishline
What are the three pre-requisites for a successful impression
- Gingival health
- Saliva control
- Displacement of the gingival tissues
Cement can be removed from the prepped tooth with
explorer
prophy cup with pumice
Why is saliva control important for impressions
- Impression materials are hydrophobic (blood and saliva produce voids, bubbles, and distortions)
- Increases visibility for cord placement
- Increased efficacy of cord chemicals
What is the most common method of saliva control? How else can saliva control be achieved?
mechanical (cotton rolls, dry angles, saliva ejector, Svedopter)…. pharmacologic
Use of LS (increases/decreases) salivation
decreases
What two pharmacologic classes of drugs can be used for saliva control
- Anticholinergic drugs
- Antihypertensives
Anticholinergic drugs used to reduce salivation are? Antihypertensives?
Anticholinergic
- Atropine sulfate
- Pro-Banthine
- Dicyclomine
- Propantheline
Antihypertensives
-Clonidine
Contraindications for anticholinergic and antihypertensive drugs
Anticholinergic
- Heart disease
- Glaucoma
Antihypertensive
-None (But caution with patients using antihypertensive meds)
Why are anticholinergics contraindicated in people with gluacoma
causes permanent blindness
What are the goals of gingival management
- Displace gingival tissues (make room for impression material to access margin)
- Control hemorrhage (hydrophobic materials)
- Control sulcular fluid (hydrophobic materials)
What are the three different methods of gingival management
- Mechanical
- Chemomechanical
- Surgical (electrosurgery or laser)
What is the most common form of mechanical retraction? Less popular alternative
retraction cords Less popular alternative are the displacement pastes
Displacement pates contain what chemical
aluminum chloride
Which has a longer healing time (scalpel/electrosurgery/laser)
scalpel