BDS2 Flashcards
what is kennedy class 1
bilateral free end saddles
what is kennedy class 2
unilateral free end saddle
what is kennedy class 3
unilateral bounded saddle
what is kennedy class 4
anterior saddle crossing midline only
what is craddock class 1
tooth supported
what is craddock class 2
mucosa supported
what is craddock class 3
mixed support
what does impression compound capture
saddle areas not teeth
what is the process for primary impressions
modify stock tray
take impression and inspect
disinfect
what is the aim of jaw registration
to tell technician where you want teeth to be
what is the purpose of a spacer
prevents distortion
if the framework fits the cast but not patient what is the issue
impressions or damage to cast
what do you check with delivery of dentures
fit, retention, stability, aesthetics, speech, occlusal contacts
what should denture instructions include
insertion/removal
coping with new dentures
pain
denture cleaning
speech and eating
what do you check for denture base pain
the extension
what do you check if the denture patient comes in with TMJ and MoM pain
OVD
what could the problem be if there is a retention issue for denture
overextension causing displacement
clasp engagement
what is RPI
stress relieving clasp system protecting abutment so no torque applied
what are the components of RPI
mesial rest
proximal plate
I bar clasp
what is plasma half life
time taken to eliminate half of drug
what is first order kinetics
drug metabolism increases with drug concentration
what is zero order kinetics
metabolise drug at fixed rate leading to accumulation if overdosed
what is first pass metabolism
liver metabolises all drugs taken orally to inactivate/activate drugs
what is bioavailability
portion of ingested drug available for clinical effect
what protein do drugs bind to transport around body system
plasma albumin
what do agonists do
cause an effect
what do antagonists do
stop an effect from happening
what affects drug efficacy
occupancy and affinity
what is anaemia
reduced haemoglobin
what can cause iron deficiency
coeliac
gastric ulcers
IBD
cancer
haemorrhoids
how is iron absorbed
through intestinal walls where it is converted from Fe3 to Fe2 and stored as ferritin
how is vitB12 absorbed
binds intrinsic factor and absorbed in terminal ileum
what does vitb12 come from
dairy and meat
what causes vitb12 deficiency
veganism
lack of intrinsic factor
terminal ileum disease
what does folic acid come from
vegetables
what is thalassaemia
issue with globin chains causing anaemia, cirrhosis and gallstones
what is sickle cell anaemia
globin chain issue preventing RBC passing through capillaries leading to ischaemia and necrosis
what do you need to diagnose which type of anaemia you have
Hb, RCC, HCT, MCV
what are the signs of anaemia
pallor, tachycardia, hepatomegaly, splenomegaly
what are the symptoms of anaemia
tired, weak, dizzy, palpitations
what are the dental signs of anaemia
glossitis
fissured tongue
RAS
candidiasis
what does leukaemia result in
anaemic
infection
bleeding
what is Hodgkins lymphoma
painless lymphadenopathy
high cure rate
what is non-Hodgkins lymphoma
extending further than lymph nodes and is aggressive with poor prognosis
associated with autoimmune disease/microbial/immunosuppression
what do inherited bleeding disorders affect
coagulation cascade or platelets
what affects the severity of haemophilia
amount of factor produced
how do you manage severe and moderate haemophilia A
recombinant factor VIII
how do you manage mild haemophilia A
DDAVP/tranexamic acid
how do you manage haemophilia B
factor IX
what dental anaesthetic procedures do you need to be careful with for haemophilia
IDB
posterior superior and lingual infiltration
what is warfarin
vitamin K antagonist
what drugs do you be careful with when someone is on warfarin
aspirin, azoles, NSAIDs, metronidazole
what do DOACs do
inhibit factor X
what drugs do you avoid if someone is on DOACs
NSAIDs
carbamazepine
what do antiplatelets do
inhibit platelet aggregation
what does warfarin do
inhibit synthesis of vitamin K dependent clotting factors (2,7,9,10)
what INR levels do you need for someone on warfarin to continue with treatment
2-4
what do statins do
give example of one
inhibit cholesterol synthesis in liver
atorvastatin
what do beta blocker do
give example of one
reduce heart muscle excitability
propranolol
what do diuretics do
give example
increase salt and water loss (antihypertensive)
bendroflumethazide
what dental implication can diuretics have
dry mouth
what do nitrates do
give example
dilate veins and arteries
GTN/isosorbide mononitrate
what do Ca channel blockers do
give example
block calcium channels in smooth muscle
nifedipine
what dental implication do Ca channel blockers have
gingival hyperplasia
what do ACE inhibitors do
give example
inhibit conversion of angiotensin 1 to angiotensin 2 preventing reabsorption of salt and water and reduce BP
ramipril
what dental implication do ACE inhibitors have
lichenoid reaction
angio-oedema
what is stable angina
exercise only
plaque only
what is unstable angina
anytime
plaque and thrombus
what is NSTEMI
partial occlusion of vessel
what is STEMI
complete occlusal of vessel
what are the symptoms of MI
pain, nausea, pale, sweaty
over what BP is hypertension
140/90
what guidelines are used for IE
NICE
name a common congenital heart disease
septal defect
what procedures are risky for IE
procedures manipulating the dento-gingival junction
what is the responsibility of the dentist for IE
identify at risk patients
prevention and OHI
remove dental sepsis
consult cardiologist, NICE, SDCEP
what is type 1 respiratory failure
gas exchange failure
what is type 2 respiratory failure
ventilation failure
what do beta agonists do
give example
bronchodilate
salbutamol (SA)
salmeterol (LA)
what do anticholinergics do
give example
inhibit muscarinic nerve transmission in autonomic nerves aiding dilation
ipsatropium
what do respiratory corticosteroids do
give example
reduce inflammation of bronchial walls
beclomethasone
what is asthma
narrowing due to bronchial smooth muscle constriction, bronchial mucosal oedema, excessive mucous secretion into airway lumen
what makes up COPD
bronchiectasis
emphysema
asthma
what do antacids do
eliminate formed acid
what do H2 receptor blockers and PPI do
reduce acid secretion
how do H2 receptor blockers work
prevent histamine activation
how do PPIs work
inhibits all 3 pumps
what are the features of crohns
cobbled and fissured mucosa
non-vascular
OFG potentially
what are the features of UC
granulated and ulcers on mucosa
vascular so bleeding
what is jaundice
accumulation of bilirubin in skin
what is cirrhosis
damage, fibrosis and reorganisation of liver structure
what fails in liver failure
synthetic function and metabolic function
what dental considerations do we need to have for liver failure
clotting issues and altered metabolism
ensure INR is 1
make sure platelets are normal
care with drugs and doses
LA is okay to use
what causes acromegaly
excess growth hormone
what are the dental features of acromegaly
enlarged tongue
spacing
reverse overbite
what are the symptoms of hyperthyroidism
excess sweating, weight loss, anxiety, muscle weakness
what are the symptoms of hypothyroidism
tiredness, weight gain, cold, goitre, puffy face, angina, hair loss
what do you need to avoid with hypothyroidism
sedatives
what are the side effects of steroids
hypertension
diabetes
skin thinning
peptic ulcers
cancer
what is cushings disease
adrenal hyperfunction
what are the oral side effects of cushings
pigment in mucosa
candida
what is addisons disease
adrenal hypofunction
what drugs do we avoid with renal failure
NSAIDs
what are the dental implications of renal failure
delayed eruption
oral ulceration
dysaesthesias
white patches
oral infections
dry mouth and taste issues
bleeding
what is dental treatment like for people on renal replacement
do after dialysis
liaise for drugs
no long treatment plans
check drug interactions
increased cancer risk
what are the components of composite
filler particles
resin (bisGMA)
camphorquinone
low weight dimethacrylates
silane coupling agent
what is the purpose of bisGMA in composite
the part that polymerises
what is camphorquinone
photoinitiator
what is the purpose of low weight dimethacrylates
viscosity
what is the purpose of silane coupling agent
bonds filler to resin
what is the definition of depth of cure
depth at which material hardness is about 80% that of cured surface
what is compressive strength of composite
300MPa
what is the elastic modulus of composite
15GPa
what are the thermal properties of composite
conductivity low
diffusivity low
expansion high
what is amalgam made of
silver tin, copper, zinc as powder
mercury liquid
what is the issue with zinc in amalgam
reacts with saliva and blood causing hydrogen bubbles to form in amalgam causing expansion, pulpal pain, high restoration
what is compressive strength of amalgam
500MPa
what is the consequence of creep on amalgam
ditched margins
what are the thermal properties of amalgam
everything high
what is the difference with copper enriched amalgam
> 6% copper, does not use SnHg (phase y2)
higher early strength, less creep, higher corrosion resistance, increased durability of margins
what is the purpose of cavity liners
pulpal protection
therapeutic
palliative
what is the setting reaction of CaOH
chelation reaction between ZnO and butylene glycol
what are the advantages of CaOH
bacteriocidal as pH is 12
irritates odontoblasts causing necrosis and tertiary dentine
what is the reaction of ZOE
ZnO reacting with eugenol to form a matrix
what are the properties of ZOE and how do we make it better
bad strength, soluble, good thermal properties, sets fast
add resin or EBA
what are the components of GIC
polyacrylic and tartaric acid
silica, alumina, CaF, AlF, AlPO, NaF
what are the stages of setting reaction of GIC
dissolution
gelation
hardening
what is dissolution
H+ ions from acid attack glass releasing Ca, Al, Na and F leaving silica gel around unreacted glass
what is gelation
Ca+ crosslinking (bivalent) with polyacrylic acid causing initial set
what is hardening
Al+ crosslinking (trivalent)
what is added to GIC to make it RMGIC
HEMA resin and photoinitiators
what is the dual cure of RMGIC
acid base and light cure
what is the tri cure of RMGIC
acid base, light cure, REDOX
what are the advantages of RMGIC compared to GIC
better strength, aesthetics, lower solubility
what are the disadvantages of RMGIC
polymerisation, shrinkage, swelling due to HEMA, monomer leaching
what are the beneficial properties of GIC and RMGIC
bacteriocidal
fluoride release
what type of material is alginate
hydrocolloid
what are the accuracy issues with alginate
poor tear strength
need to pour casts fast as dimensional change
can distort
what causes gaseous porosity
curing PMMA too fast
what causes contraction porosity
too much monomer in PMMA
what happens if PMMA is undercured
free monomer causing irritation
low molecular weight
what will porosity in PMMA affect
strength, appearance, texture, absorbs saliva
what are the thermal properties of PMMA
high softening temperature
low conductivity
expansion alright if acrylic tooth used
what does viscosity mean
flows readily and records surface detail
what does surface wetting mean
contact made with teeth
what does viscoelastic behaviour mean
material has some permanent deformation at the end (not truly elastic)
what is tear strength
stress material withstands before fracturing
what are the 7 elements of caries risk assessment
clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history
what are the 8 preventative elements of caries
radiographs
toothbrushing instruction
F strength
F supplements
F varnish
diet advice
fissure sealants
sugar free medications
what clinical evidence is associated with high caries risk
dmft > 5
caries in 6s and 6yrs
3 year caries increment > 3
when are bitewings taken for high risk children
every 6 months
when are bitewings taken for low risk children
12-18months
