2023 Flashcards
How to replace space?
- Implant
- RPD
- Resin bonded bridge
What are the non periodontal challenges in replacing a space?
- width of edentulous area
- Restorative status of adjacent teeth
- Smile line
2 advantages of an implant?
- Restore function
- Restore aesthetics and improve patient confidence
2 disadavantages of implants?
- cost - expensive
- Require a surgical procedure
- Long healing time (3-6 months)
What is the name of this seating position?
Neutral or balance seat position
Describe operator seat position (4)
- 90 degree angles at the hip and knee
- Thighs parallel to the floor
- Feet on the floor with back and neck upright
- Relaxed shoulder
Describe nurses position? (4)
- Straight back with relaxed shoulder
- Thighs parallel to the floor
- Hip parallel with patient shoulder
- Feet supported by chair ring to provide stability
What is the nurse position relative to the dentist position?
nurse 2-4 inches higher than dentist
What are the two types of aspiration?
Direct and indirect
What is direct aspiration?
- adjacent to the tooth being treated
- Slightly distal to the tooth
What is indirect aspiration?
- lower left quadrant for right handed
- Side closest to you in the anterior region
How to avoid soft tissue damage during a procedure?
By retracting soft tissues
3 ways a dental nurse can retract soft tissues?
- 3 in 1 syringe to retract lips with Aspirator retract the cheek
- Cheek retractor
- Tongue depressor
- 3 in 1 syringe (lips) with dental mirror (cheek)
What can be the agents of bias in RCTs?
- Reporting bias
- Selection bias
- Attrition bias
- Performance bias
- Publication bias
What will a patient with burning mouth syndrome complain of ? (4)
- dysgeusia - foul, salty or metallic taste
- dry mouth
- burning sensation in the mouth
- Paraesthesia - tingling
What psychological disorder is associated with burning mouth syndrome?
Anxiety or Stress
What other tests to carry out for burning mouth syndrome other than haematinics?
- Thyroid function test
- Full blood count
What organism is involved in chronic hyperplastic candiasis ?
- Candida albicans
- Hyphae form
What other 2 conditions are associated with candida albicans?
- Denture stomatitis
- Oral candidiasis
- Angular cheilitis
What 2 special investigations can be carried out for oral candidiasis?
- Oral swab or oral rinse for microbiological culture testing
- Biopsy for histopathological analysis
What staining is involved in histology?
- H&E (Haematoxylin and Eosin)
- Periodic acid-schiff staining
What is the most common drug prescribed in oral medicine and what class of drug is it?
Chlorhexidine - bisbiguanide antiseptic
What is the typical symptom of trigeminal neuralgia?
Unilateral Stabbing pain in the face
4 reasons why trigeminal neuralgia may have occured ?
- Vascular compression of the trigeminal nerve
- Intracranial lesions
- Multiple sclerosis
- arteriovenous malformation
Patient feels pain in the morning after washing face, why does this occur and give 2 changes to regime?
- Washing the face with cold water in the morning can trigger an a pain attack in trigeminal neuralgia patient
- Use warm water instead of cold
- Increase the night dose of carmazepine
What two other medications than carbamazepine can treat trigeminal neuralgia?
- Oxcarbazepine
- Lamotrigine (slow onset of action)
Antiepileptics
Why does patient need blood tests for cabamezapine?
- Due to the side effects of carbamazepine such as thrombocytopenia and liver toxicity
- It is best to make sure patient fit and healthy during treatment
What would you do if a patient gets an attack of trigeminal neuralgia in the dental chair?
Administer local anaesthesia
Define erosion?
The loss of the tooth substance due to a chemical process
Define attrition?
Physiological wearing away of tooth structure as a result of tooth to tooth contact
Describe the DAHL technique?
- It is a method of gaining space for anterior localised toothwear by placing an anterior bite plane (CoCr) that leads anteriors to intrude and posteriors to erupt into occlusion allowing space for anterior restoration
- This increases the OVD 2-3 mm
- within 3-6 months
5 ways a cusp may fracture in a tooth with an amalgam restoration?
- Bruxism
- Previous RCT
- Occlusal trauma
- Weakened tooth structure
- Trauma
What indirect restoration would you place for a failed amalgam restoration ? and what material?
Onlay , composite
You want to place an Onlay and you do not have putty or study casts , how do you temporarily restore the tooth?
- a direct temporary restoration using glass ionomer
What are 5 risk factors of OAC?
- Previous OAC
- Older patient
- Extraction of Maxillary molars/pre-molars
- Large bulbous roots
- Roots of tooth close to maxillary sinus
Give 6 clinical signs of OAC during an extarction?
- Dark hole when visualising socket
- Bubbling of socket
- Change in suction sound
- Fluid comes out from nose
- non healing socket
- Bone removed at trifurcation when XLA
4 things to tell patient not to do after confirming an OAC?
- Do not Sneeze with mouth closed
- Do not blow nose
- Avoid drinking from a straw
- Avoid flying or diving
5 ways to identify a patient anxiety?
- Ask patient about previous dental experiences
- Use MDAS (Modified dental anxiety scale)
- Look at non verbal cues such as shaking, disconnected or nervous
- Look at physiological signs such as dry mouth, altered tone voice
- Low pain tolerance (stomatisation)
Give 4 non pharmacological management options for anxiety?
- CBT
- Desensitisation
- Relaxation techniques - breathing
- Make patient take control - raise finger if you want treatment to stop
3 pharmacological ways to treat a patient anxiety?
- Midazolam
- Nitrous oxide gas
- Beta blockers
Give the doses and routes of administration of Midazolam, Nitrous oxide , Beta blockers ?
- Midazolam - 5mg/ml - intravenous
- Nitrous oxide 5-6 L with oxygen through nose (nasal)
- Beta blockers - oral , 10mg
How can you order extractions for full mouth clearance?
- Start with simple extractions then complicated extractions
- Start from maxillary arch
When to review a patient after an immediate denture?
24-48 hours
2 things to tell a patient after delivering an immediate denture?
- they may come loose over time due to bone resorption after extractions and another denture is going to be made
- It may be uncomfortable and painful but this will go away once healing has occurred
What can a functional appliance do that a URA can’t?
- Complex tooth movements
- Control the root of the tooth
What is TAD?
Temporary anchorage device using non osseointegrating mini screws in cortical bone to achieve absolute anchorage
Why is TAD better?
- It have good anchorage control as the force is transmitted into cortical bone instead of using other teeth for anchorage
Give 4 risks of receiving orthodontic treatment?
- Relapse
- Gingival recession
- Decalcification
- Root resorption
What features of a malocclusion can lead to marginal gingivitis?
- Increased overjet
- Deep overbite
What is facebow used for?
- Transfer the relationship between the maxilla and terminal hinge axis of rotation of the mandible into an articulator
- This reproduces the patient mandibular movements on an articulator
- Can be used in severe toothwear cases or when constructing several posterior indirect restorations that may change the occlusion
4 methods/materials used to take registration in ICP?
- No material - ICP obvious to technician
- Wax - ICP not obvious
- Registration paste - ICP not obvious
- Records blocks - Free end saddles
Give 2 types of articulators used ?
- Arcon
- Average value
- Semi-adjustable
Grossly carious canine , what space can infection travel to ?
- if upper - infraorbital space
- If lower - submental
What 4 things that can affect a dental infection route of travel?
- Anatomic site of initial infection
- Nearby anatomical spaces
- Thickness of nearby muscles and facia attachments
- Thickness of cortical bone
What is your immediate management if you suspect infection spread?
Refer the patient urgently to secondary care
What system is used for periodontal risk?
Through the periodontal risk assessment tool
Why is the periodontal risk assessment used?
- Determine further progression of periodontal disease
- Determines subsequent tooth loss
Give 4 things for successful posterior restorations? (4)
- Good marginal seal
- Can withstand occlusal forces
- Correct material choice
- Good retention and resistance
Label the apical parts of the root
Describe using the landmarks provided how you would prepare and obturate
- Create a continuously tapering funnel shape of the root canal
- Maintain apical foramen in original position
- Keep apical constriction as small as possible
What are two ways to measure working length without apex locator? (2)
- Tactile sensation using a handfile
- Using a radiograph of the tooth taken with a handfile in the canal according to estimated working length from pre-operative radiograph