A1 Flashcards
MUDL
Primary interference that deviate the condyle forward produce anterior slide.
Use this principle - Mesial upper, distal lower - to adjust. Note that this rule does not specify cusps, it instead specifies inclines. This also applies to crossbite.
BULL
If you have lateral deviation towards cheek - use this.
Buccal upper lingual lower or both.
LUBL
If you have deviation torward tongue, use this. Lingual upper buccal lower.
Non-working interference - adjust with
BULL. Idea is to remove contacts as soon as lower teeth move out of MI and toward the tongue. Usually adjusting this throws off working side, and you need to alternate to get them both right.
Working side interference - adjust with
LUBL - especially best for anterior guidance cases.
When to use group function over anterior guidance?
When a patient has a large horizontal overlap (the amount by which the incisal edges of the max anterior teeth are labial to the incisals of the mandibular teeth at MI).
Protrusive interference - adjust with
DUML.
If you want to hide a color in a tooth, use
the opposite color. Opposite colors complement – if you have a blue tooth, consider orange stain/modifier*
Why etch the whole tooth?
You inevitably will have thin composite that gets on the tooth – this will stain if it is not fully bonded. Modifiers are basically flowable composite.
With Cleft Patient, ask if they eat with or without retainer
Will give you best and fastest idea of whether or not they have a fistula.
Adam’s clasp good for
flat molars that really don’t have an undercut to engage (engages embrasures)
Place anterior implants —– into crest of bone for emergence profile*
2mm
Amelogenesis imperfecta – 4 types.
Hypoplastic (type 1), hypomature (type 2), hypocalcification (type 3) (look these up and know how they look), hypomature with taurodontism (type 4). This is just the enamel.
How to know if SDF has worked
If lesion is rock hard
EKG is used to evaluate electrical, what are used to evaluate mechanical status of heart
pulse, BP
SA heart rate
60-100
AV heart rate
40-60
VEntricular heart rate
20-40
Sympathetic nervous system causes the following effect on heart
increased rate, irritability, conduction through AV node
Parasympathetic nervous system causes the following effect on the heart
Vagus nerve - decrease heart rate
Sympathetic acts on what part of heart
Atria and ventricles
Parasymp acts on what part of heart
only atria
Heart rate is too slow: what drug effect do you want
Something that either stimulates sympathetic nervous system or suppresses parasymp.
Electrocardiography
Study of arrythmias
Avoid —– – they corrode titanium. Some GI cements contain —-, which can be damaging to fibrous tissue and thus can induce peri-implantitis.
polycarboxylates (cements)
hema
Bruxr aesthetic works well with —–. Zirconia abutment (prefer attached to titanium base) for zirconia or ceramic crowns – ultimately gingival biotype is also a significant factor.
anodized abutment
Questions for new patients (FP1-2-3 pts):
Q: Am I the first person you’ve seen for this?
If yes, this appointment will be pretty deep. It will likely be info overload.
Q: Do you want something fixed or removable?
If yes to question 1, they probably won’t know this. Show them models of FP3, RP4, RP5. The younger they are the more you push to FP3.
Q: Do you have any idea as to what your investment may be?
“I am your real-estate agent. Do you want a single family home, ranch, mansion? My job is to help you get the most that you can for the money you have.
Recommends a 2 part presentation - do a few things now and a few things later. Get good impressions, photos, radiographs/CBCT at appointment 1 after going over finances. Present 3 options to pt – good, better, best. At appointment 2 (strongly recommend to do within 10 days), give 3 options, and have them bring SO or person they like complaining to with them.
As soon as you start, you must eat a liquid diet. Anything that can’t be eaten without teeth can’t be eaten.
If you need to replace —-, consider going to FP3 rather than FP2 or FP1.
papilla
Anterior implants experience
tensile force – push in back leads to pull in anterior.
Posterior handle
compressive force – recommend 35-40 ncm on each implant.
Middle implants – in the premolar area – have been shown to handle —– movements.
lateral
Thus, we have 3 zones (anterior to posterior). You need 2 in zone 1 and 2 in zone 3 – this is the typical all-on-4. If you get two more, it helps with lateral forces. You can still load if you have 2 in zone 1 and 2 in zone 2. Recommend to restore to 1st molar – maybe if they have more space give them 2 premolars.
What is your requirement to immediately load: you want at least —- on each implant for full arch.
30ncm
Autogenous bone has a high
resorption rate – hence why allograft may be preferable in certain situations.
—- implants can help with ridge split due to geometry and how you drill your osteotomy.
Tapered
Layer technique:
Autogenous bone against implant followed by allograft.
For mand molars, consider
retaining distal root and performing osteotomy with the distal root as a guide.
Torque temp prosthetics (FP2, 3) to —-. Also, 3 months post op, retorque SRA abutments before taking final impression for final prosthesis.
15nm
Recommends —- upper, —- lower on FP3s, however most occlusal schemes will work. As long as you have equal contact around the arch and posterior disclusion, you should be fine.
20deg
10deg
If you use just cortical, it is not —- (if you have autograft). Doc recommends sandwich with cortical on outside, cancellous on inside. This doc uses Vicryl 5.0 for suturing.
osteogenic
Consider stretching a flap – if you make a periosteal releasing incision, be weary of the fact that this is a
wound and will contract during healing. Look into El Chaar, as he published a few papers on titanium mesh and flap design.
When grafting immediate implant gap, put —- bone in gap to ensure blood flow, —– on outside of socket if needed.
cancellous
cortical
MSEO:
Max sinusitis of endodontic origin
Periapical osteoperiostitis:
Expansion of periostium and pushing the periostium up in the sinus. Expansion and inflammatory reaction of sinus floor periostium. This will deposit a thin layer of the inner periphery of the periosteum as it expands. It presents with a halo appearance on the root.
Periapical mucositis:
Edema of the sinus mucosa that results from periapical inflammation. This does not include expansion of the periosteum. This is extremely difficult to see, because we can’t see bone destruction.
Prob of needing RCT on one of the abutments on an FPD: ~—
14%.
For lasers: The more moisture in the area, the
less likely it is for you to have pain (water absorbs energy better depending on the type of laser).
For lasers: The more moisture in the area, the
less likely it is for you to have pain (water absorbs energy better depending on the type of laser).
when to use 3 implants to support 3 unit FPD, when to use 2?
Most studies have high success with longer implants, but literature is skewed because short implants are used for dire circumstances. Ultimately, crown-root ratio is more important. Focusing on shortening crowns is more important. Length of crown - if better than 1:1 ratio, 2 implants for 3 unit bridge is fine. As it gets longer, favor one implant per tooth.
For screw access opening, consider
fermit over cotton or teflon with composite over top.
Dr. McGlumphy temp cement for implants
TFE - 80-90 kg of force, but will almost always stay in. This is his go-to for cemented restorations, as they are still somewhat retrievable but there is no risk with it coming off during function.
Consider hydraulic pressure -
the more ideal the prep, the more pressure and displacement of cement.
GC plier
helps in removing cemented crowns. Still heart-attack inducing.
Stripped screws - happen only when
driver is inserted half-way into screw hole. If there is debris in hex, always clear this out first. Make sure that driver is fully seated before proceeding.
If a screw is stripped, you’re
SOL. Only thing you can do is try a different driver to engage it (it may be able to wedge in and get lucky to remove it). Otherwise, you pull out the handpiece so that you can remove the head of the screw to remove the crown. Then you need to get an explorer point and back out the screw. This fucking sucks, but it works.
