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Fixed Midterm Spring > 1. Tissue Management I > Flashcards

1. Tissue Management I Flashcards

1
Q

Before starting the impression what should you do first (3 things)

A

Ask the patient

  • Secure provisional?
  • Tooth aysmptomatic?

Administer LA

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2
Q

Benefits of administering LA before impression

A
  • Patient comfort
  • Reduced salivary flow
  • Reduced bleeding
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3
Q

Why does LA contribute to less saliva flow

A

Pain increases saliva flow (less pain less saliva)

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4
Q

When removing an RDP provisional the hemostat should be placed where

A

at the connector- should alternate from one connector to the other

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5
Q

After removing the pateint’s temp and before the impression you should consider what

A
  • Is the tooth prep adequate

- (Correct reductions and distinct finishline)

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6
Q

Pre-reqs for a good impression are (3 things)

A
  • Gingival health
  • Saliva control
  • Displacement of gingiva
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7
Q

Reasons to make a well fitting temp

A
  • Maintain tooth comfort

- Maintain gingival health and position

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8
Q

If you are going to take an impression and the patients tissues are inflammed you should

A
  • Reinforce OHI

- Perscribe chlorhexidine (1 week)

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9
Q

Chlorhexidine shouldn’t be used for more than how long

A

10 days

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10
Q

What are the reasons these issues occur with temps

  • Cement washout
  • Debris collection
A
  • -Cement washout=Poor fit

- Debris collection=Rough surface

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11
Q

Cement can be removed from the tooth with

A

Explorer

Prophy cup and pumice

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12
Q

Impression materials for crown and bridge are (hydrophilic/hydrophobic)

A

hydrophobic

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13
Q

Blood and saliva lead to what issues with impression

A
  • Bubbles
  • Voids
  • Distortions
  • Dilution of cord chemicals
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14
Q

What is the most common saliva control method (mechanical/pharmacologic)

A

mechanical (saliva ejector, cotton rolls, dri-angles, etc.)

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15
Q

What are the two pharacologic categories of anti-sialogogue meds

A
  • Anticholinergic meds

- Antihypertensive meds

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16
Q

Give examples of anticholinergic and antihypertensive meds

A

Anticholinergic
-Atropine sulfate
-Pro-banthine
(Also dicyclomine and propantheline)

Antihypertension
-Clonodine

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17
Q

Contraindications for anticholinergic and antihypertensive meds

A

Anticholinergic

  • Heart disease
  • Glaucoma

Antihypertensive

  • No specific contraindications
  • Caution in patients using hypertensive meds
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18
Q

What are anti-cholinergic drugs contraindicated in people with glaucoma

A

can lead to permanent blindness (prevalence of undiagnosed gluacoma in the population is high and come physicians suggest that all patients be evaluated opthalmologically before anticholinergics are used)

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19
Q

What are the three categories of gingival managment

A
  • Mechanical
  • Chemomechanical
  • Surgical (electrosurgery or laser)
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20
Q

What are the two forms of mechanical gingival retraction

A
  • Rectraction cords (most common)

- Displacement paste

21
Q

Describe displacement paste

A
  • Contains AlCl3

- Less effective retraction compared to cords

22
Q

What are the advantages of electrosurgery over surgical gingivectomy with a scalpel

A
  • Less discomfort

- Less bleeding

23
Q

Disadvantages of electrosurgery

A
  • Can cause recession
  • Contraindicated in patients with electronic medical devices (i.e pacemaker)
  • Not suitable on thin attached gingiva
24
Q

What types of instruments (i.e mirrors) should be used with electrosurgery

A

plastic (metal –> electric shock)

25
Q

_Electrode is best for sulcular enlargement and _ is best for gingival contouring

A

Thin wire…loop

26
Q

T/F anesthesia is not required for electrosurgery

A

f

27
Q

What mode should the electrosurgery machine be set to

A

unmodulated alternating current

28
Q

How do you know is the instrument setting is too high and too low

A

too high= sparking

too low= tip will drag

29
Q

Cutting strokes shouldn’t be repeated within _sec of each other

A

5

30
Q

Contact with metal restorations greater than 0.4 sec has ben shown to cause what in dogs

A

irreversible pulpitis

31
Q

After electrosurgery and before the cords are place the sulcus should be irrigated with

A

hydrogen peroxide

32
Q

Advantages of soft tissue laser for gingival displacement

A
  • No anesthesia needed
  • Achieves tissue ablation and hemostasis
  • Favorable tissue healing
33
Q

Astringent causes what to the gingival tissues

A
  • Transient ischemia

- Shrinkage of gingival tissues

34
Q

Tissues start to relapse as quick as _ sec after cord removal

A

30

35
Q

What are the three types of retraction cords

A
  • Twisted
  • Knitted
  • Braided
36
Q

Compared knitted and braided cords

A

Knitted

  • May collapse in sulcus
  • Shear when hit with handpeice (better

Braided

  • Doesn’t collapse in sulcus (no memory) –> better displacement
  • Better fluid absorption
  • Easier to apck
  • Cord grabs on to but and comes out
37
Q

The smallest and largest sizes of knitted and braided cords are

A

Knitted

  • Smallest= 000
  • Largest= 0

Braided

  • Smallest= 0
  • Largest= 2
38
Q

Braided cords are impregnated with

A

aluminum potassium sulfate

39
Q

Braided cords shouldnt be combined with what astringent and why

A

ferric sulfate —> staining

40
Q

T/F Epinephrine is the more potent astringent

A

F- epi is not and astringent it is a vasoconstrictor

41
Q

Hemodent –>
Viscostat –>
Astringident –>
Viscostat clear –>

A

Hemodent –> Aluminum chloride
Viscostat –> Ferric Sulfate
Astringident –> Ferric sulfate
Viscostat clear –> aluminum chloride

42
Q

Contraindications for epi use in the cord

A
  • History of cardiovascular disease
  • Hyperthyroidism
  • Allergy to epinephrine
43
Q

Signs of epinephrine syndrome

A
  • Tachycardia
  • Increased respiration rate
  • Nervousness
  • Increased BP
  • Post op depression
44
Q

Conc of epi to use in cords is

A

0.1%

45
Q

Astringents constrict blood flow through what mechanism

A

coagulation

46
Q

pH of viscostat is? hemodent?

A

both are acidic

47
Q

Implications of acidity of viscostat and hemodent

A
  • Decalcification of tooth structure –> sensitivity

- Removal of smear layer –> affects adhesion to tooth if done right before cementation

48
Q

Recommendations to reduce the implications of the acidity of astringents

A
  • Minimize contact with tooth
  • Minimize application time
  • Before cementation clean the tooth with pumice and consider use of desensitizer

Fixed Midterm Spring (9 decks)

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