2013 ppq Flashcards
How can you test clinically if a conventional bridge has debonded
place probe under pontic and apply pressure coronally visually look for flex floss look for bubbles of saliva good light
- may be grossly carious visibly or radiographically
4 design/prep features that could lead to conventional bridge debonding
poor crown preparation, insufficient reduction or crown margins finished subgingivally
retainers not prepped to common path of insertion
lack of sufficient ferrule for crown
inadequate root surface area for support- ante’s law
poor moisture control during cementation
2 alternatives to replace conventional bridge pontic
implant
denture
space closure- ortho
2 alternative bridge designs to a conventional bridge for 11-21-22 - not RRB as both teeth prepped
conventional mesial cantilever bridge- fixed crown on 22
conventional fixed-movable bridge
tooth 15 rct, 9mm pocket, vertical bony defect
diagnoses?
si?
initial tx?
periodontal abscess- perio lesion with endo involvement
periapical abscess- endo lesion with perio involvement
true combined lesion-perio-endo lesion
si: PA 15, OPT
sensibility testing EPT EC TTP
6PPC, PGI
if no history perio, tooth non-vital and isolated deep pocket then carry out re-rct
if history perio: tooth vital: pocketing throughout- RSD
if diagnosis uncertain, tooth non vital, perform endodontic therapy and observe
How to classify vertical bone defects?
number of walls - 1 wall defect 2 wall 3 wall combined osseous defect
Mechanism of vertical bony defect?
factors causing vertical defect
the plaque has a zone of destruction surrounding the biofilm - 2mm
if bone is thicker than this and on one tooth only the destruction if angular rather than horizontal
- thicker cortical bone
- presence of plaque
- occlusal trauma leading to widened pdl
How to determine success of HPT clinically
<15% plaque
<10% bleeding
<4mm pocket depth
reduced mobility
reduced furcation involvement
bony infill
4 features that indicate proximity to IDC in rad?
imaging you would take
tramlines interrupted darkening of tooth root diversion roots deviation id canal narrowing of tramlines
HALF OPT
CBCT
What feature in IDC are you worried about and list 2 potential complications
inferior alveolar nerve
axonotmesis neurataxia neurotmesis paraesthesia dysaesthesia
3 potential complications in extraction of a lone standing upper molar
of the 3 how would you diagnose 2
how would you manage 1
oro-antral communication
fractured maxillary tuberosity
root/tooth in antrum
OAC: bubbling blood from extraction site, direct visual assessment, blunt probe, bone in furcation
rads
mgmt: inform pt, reassure, if small encourage clot, suture, ABs,
if large: close with BAF, ABs 7 days and nose blowing instructions
fractured tuberosity:
sound of fracture, movement, multiple tooth mobility, visual tear
mgmt: dissect out and close wound, reduce and stabilise with forceps
-
fixation with ortho buccal arch wire spot, arch bar of splints. check occlusion, ABs, RCT affected tooth. post op insturctions. XLA tooth 8 weeks later
root in antrum: post op rads/ visual assessment
mgmt:
raise flap, suction, curette, irrigation, endoscopic retrieval, caldwell-luc approach
What tissues could be responsible for prolonged bleeding after xla, how would you manage each?
soft tissues- LA use or suturing
bone - WHVP, bone wax
vessels - diathermy
4 risk factors for bleeding
- medical conditions - haemophilia A/B, von willebrand disease, liver disease
- medications - warfarin, anticoagulants
- lifestyle - alcoholic
traumatic occlusion, mobile tooth tx
HPT
Upper anterior BRA at night
OPT rad in onenote
onenote
- condyle
- hard palate
- zygomatic buttress
- styloid process
- soft palat
- hyoid bone
- nasal septum
- ear lobe
- bite peg
- ghost image opp lower mandible
side effects carbamazepine
GI discomfort dizziness drowsiness tardive dyskensia fatigue oedema vomiting headache
Two objective tests for sjogrens?
schirmer test
unstimulated salivary flow- <1.5ml in 15 minutes
autoantibodies- anti-Ro, Anti-La
What gland would you biopsy for sjogrens?
labial gland
2 things you would ask histopathologist for when you send the sample for biopsy?
how many focal collections of lymphocytes are there with 4mm
does each collection have 50+ lymphocytes?
Features in parotid swelling that would make you suspect malignancy?
firm,
attached to underlying structures
rapid growth
unilateral
2 syndromes associated with hypodontia
down’s syndrome
cleft lip and palate
ectodermal dysplasia
% missing primary
% missing permanent
1% primary
6% permanent
optimum water concentration?
1ppm
2 foods that are natural sources of fluoride
bony fish
tea