2017 Flashcards
Benefits of electronic records over traditional records?
-less paperwork
-less storage space
-accessible anywhere
-can be backed up
-neat and clear , easy to read
-histories tracked
-less likely to be lost
-
Professional obligations that may be concerns when using web based electronic patient records?
-pt confidentiality and safety
-follow guidelines data protection act 20118
-only accessed to those who need it
-hacking system could breach confidentiality
-GDPR. Guidelines
-files should be encrypted and password protected
-Caldecott guidelines
What is water fluoridation?
Controlled addition of fluoride to a public water supply/system as a public health measure to prevent caries
Usually 1ppm
Ways of delivery of fluoride
Water fluoridation
Children’s milk
Fluoride varnish
Toothpaste
Mouthwash
Salt
Fluoride supplements
Natural food and drinks
School programmes
What would u advice for a 10 year old with high caries?
- According to Delivering better oral health (2017) recommendations as follows:
- Toothpaste 2800ppm high fluoride toothpaste
- 3-4 times a year F varnish
- Diet diary
- OHI & diet advice- brush x2 a day, at night and one other time, spit dont rinse.
- Daily F mouthwash 0.05% or weekly 0.2%
- Fissure sealants perm molars, Treat pain & Restore with GIC then replace once stabilised
- Diet advice: eatwell plate. Freq and amount f sugary foods reduce. Less than 4 sugar attacks in a day (Stephen curve) Starchy foods. Snacks water in between meals. No drinks taken to bed. Snacks
- Sugar free medications
- Reduce recalls to 3 month, rads every 6 months
- Treatment planning for long-term restorative - PMC remaining posterior primary teeth that are not symptomatic or restore restorable teeth/ extraction under LA/IS/IV/GA
Implant clinical assessment?
-access( mouth open 2 fingers wide) no trismus , TMD
-pc , HOPC,
-mh bone disorders like pagets, osteoporosis , busphoosoanates, poor diabetes, bleeding disorder
-DH like anxiety other tx
-sh smoking,
Cares, perio, bone levels, ridge, space vertical and width , smile line occlusion , endo statues, oh,
-pt expectations
Other option to fill gap?
Bridge resin bonded, cantilevered, fixed movable
RPD
Orthodontics close of space or open space
Transplantation , crown veneer
Lost upper crown with exposed GP not painful, asses for restorabiloty?
HOPC: when and how lost, when last rct appt done, if more than 24 hours then contaminated with saliva so re-rct. Where’s is crown, symptoms, how long crown for
MH: is enough crown left, consider ferrule for post crown, need at least 1.5mm sound dentine apical to core and 360 degrees around
Any pa abscess sinus pain
How restored is tooth, fracture caries
X ray: pathology, rct good enough 2mm from access, enough bone, is it subgingival , root fractures, perio , pocketing , margins supra gingival,
Occlusion interferences
Considerations for framework for design for single unit adhesive cantilever bridge?
CR BELOW
• Connector design - significant width and height, need to resist bending of alloy
• Retainer thickness - 0.8mm for posterior molars (thicker if doesn’t extend occlusally)
• Bonding area - want maximum enamel bonding- occluso-gingivally and circumferentially
• Length of span - Ideal 1 tooth, more are not contraindicated but consider in design due to debond potential/ putting lute under tensile loading.
• Occlusal extension - palatal surface of anteriors
• If you are extending framework the whole height of palatal/lingual wall then no prep is required
• If you are extending framework to 1-3mm below incisal edge (for example for aesthetic reasons for anterior teeth) then minimal prep would be required for adequate retention
• Occlusal extension for posteriors- over whole surface to: increase rigidity, increase surface area for bonding, increase retention (prevents axial or lateral displacement of retainer)
• Wrap around - 180 degrees maximum
Morphology of pockets that have healed and those that havnt
HAVE:no bop, stippled and pink gingivae, shallow pockets, CAL gain, recession as black triangles , no pus, improved tissue contour, les mobility, bone on x ray is same
HAVE NOT: BOP, inflamed, loss of gingival contour, loss of stippling, pus, mobility, bone loss, drifting
4 types of perio surgery?
Excisional: gingivae Tommy
Rescued flap so modified widmen flap
Repositioned flap -apically repositioned flap’
Mucoginngval like frencromt, free gingival graft or CT graft
Excisional/gingivectomy
a. Type: Gingivectomy
b. Indications: Hyperplasia, false pocketing (never for true pocketing) , crown lengthening, to improve gingival contour of tooth (requires adequate attached gingiva)
c. Objectives: Improve aesthetics, better OH, remove hyperplastic tissue, to ferrule a tooth
Replaced flap/ modified widmen flap
a. Type: modified widman flap- doesnt cause recession so better for aesthetics and sensitivity
b. Indications - Deep persistent bleeding/ suppurating pockets; correction of bony defects, crown lengthening
c. Objective - Better access for RSD, Improve tissue contour. Visualise bony defects,to eliminate pockets, clinical attachment gain - encourage regeneration of lost periodontal support
Repositioned flap/. Apically repositioned flapp
a. Types: apically repositioned flap - crown lengthening, reduced pocket depth,
b. Coronally repositioned flap- used for generalised gingival recession
c. Laterally repositioned flap- used for localised gingival recession
d. Indications: deep pocket, gingival recession
e. Objectives: eliminate pockets, improve aesthetics, reduced bleeding, unsuccessful gingival encroaching restorations.
Mucogingival procedures
a. Types: Frenectomy, Free gingival graft, connective tissue graft, and free gingival plant, recession, GTR.
b. Indications - Prominent frenum, gingival recession, deep bony defects
c. Objectives: restore aesthetics, restore tissue contour, elimination of deep bony defects to aid cleaning,
