Cards Flashcards
What is a gingivectomy
Removing gingivae to help improve aesthetics or oral health
What is a operculectomy?
It is a minor surgical procedure where the affected flap/soft tissue of gum over the wisdom tooth is cut away. Preventing build up of debris and plaque and inflammation.
What is a frenectomy
Removal of the frenulum ( lingual frenectomy and maxillary(labial) frenectomy)
What are the 3 bacteria found in dental caries
Streptococcus mutants- initial stages of cavity formation
Streptococcus sanguis
Lactobacilli- later stages of cavity formation
What does cariogenic mean
Capable of causing caries
What is a non-milk extrinsic sugar
Not found in milk and have been added to the food artificially
What is an intrinsic sugar
Found naturally in foods- such as fructose in fruits
Milk extrinsic sugar
Lactose
What are refined sugars
Sucrose, glucose and dextrose
Refined sugars are the worst for your teeth
How long does acid produced by the mouth last
20 mins - 2 hours until it is neutralised by the buffering action of saliva
What is demineralisation
The initial acid attack (a microscopic layer or enamel is dissolved away)
What acidity is saliva /ph level
Neutral. PH level of 7
Which PH level is critical, producing cavities
5.5
What is the healing process of enamel called after an acid attack
Remineralisation
What is a stagnation area
The parts of the tooth that ate more prone to caries as food tends to collects easily
What does an early acid attack show as
White spot lesion on the enamel surface
What is pulpitis
Where the pulp becomes irritated or inflamed
What does a chronic alveolar abscess involve
Pus drains from the sinus into the mouth through an outlet (small hole in the gum) leading from the alveolar bone through.
This does not hurt as much as the acute abscess as the puss is draining
What does saliva contain
Water, inorganic ions and materials, ptyalin, antibodies and leukocytes (white blood cells)
What is a dry mouth called
Xerostomia
What probes are used to check occlusal surfaces
Sickle probe or right angle probe
What probe is used for interproximal areas
Briault probe
What is transillumination used for
Using a curing light to shine through the contact points of anterior teeth by putting the mouth mirror behind to detect any shadowing
What is a Willis bite gauge used for
It measures the mandible in the rest and bite positions (verticle dimensions between the maxilla and mandible)
What is a carborundum polishing stone used for
To grind and smooth instruments
What is pressure relief paste used for
Used to fit a prosthesis, checking if it fits well. Checking where there are high points.
What is a skeleton denture chrome
Used for partial dentures, increasing strength of denture and making it less bulky
What is a denture reline
Adds material to the area that touches the gingivae, replacing lost or broken parts of the denture or adding in case of alveolar bone shrinkage
What is tissue conditioning
A soft liner material that Helps your gums heal so that your dentures can fit comfortably
It can be used to record a functional impression
What is an obturator
An obturator is used to close palatal defects after a maxillectomy, to restore mastticatory function and to improve speech
What is an overdenture
It goes over the natural tooth roots, teeth/implants they are either tooth supported or implant supported
What does endentulous mean
Missing teeth
What is an acrylic denture made out of
Polymer powder and a monomer liquid
What is a post-dam
Is it a ridge cut into the posterior palatal margin of the denture to provide more retention
What is an alveoplasty
It is a surgical procedure where the jawbone is smoothed where a tooth has been extracted/lost
What is a crown form
A plastic material that comes in the shape of each tooth and can be filled with composite material to create a crown in surgery
What is a Pontic, retainer and abutment
Pontic- the unit replacing the missing teeth on a bridge
Retainer- the units holding the bridge in place
Abutment- the teeth that are cemented onto
What are temporary crowns made of
Preformed acrylic, cold cure acrylic or polycarbonate
What is a fixed fixed retainer
Cantilever bridge
Adhesive bridge
Fixed fixed retainer- a bridge that has a Pontic and 1 retainer either side (two teeth are prepared for one missing tooth)
Cantilever bridge- one Pontic and one retainer (only one tooth prepared but only one tooth to rely on and take all the pressure)
Adhesive bridge- such as Maryland, the back of two teeth is smoothed down and the metal wings are centred onto them instead of preparing them
What is a vasalva test
Where the patient blows through their nose whilst their nostrils are closed to check if there is bubbling out of the gingivae. If there is then the sinus and the apex of the root are touching
What are bayonets
Used to extract upper roots or third molars (wisdom teeth) they have angled pointed blades.
Why would you carry out a labial frenectomy
For orthodontic and hygiene reasons, it may cause a gap between the front teeth. Food can get stuck easily so the patient may suffer from gingivitis
What are haemostats used for
They are inserted into the blood socket to aid blood clotting, can be used with or without a suture
Made of gelatine or oxidised cellulose packs
What would you use for an extraction for moisture control
Fine Bore aspirator
Why would you use cowhorn forceps
To grip the furcation of lower molar teeth
Types of elevators
Cryers, winters and Warwick James’
Triangular shaped and pointed
Winters- triangular shaped and pointed but corkscrew style handle for more leverage
Warwick james’ Round blade
What is a coupland chisel
Is used to split multi rooted teeth
What does ankylosed mean
When a root of a tooth is permanently connected to the jaw
What is the mucoperiosteal flap
A flap of mucosal tissue that is raised doing minor oral surgery
What is an osteotrimmer
Raises the corners of the flap off the underlying alveolar bone
What is a periosteal elevator
Completes the elevation of the flap off the bone, effectively “peeling it off the bone”
What is a rake retractor used for
To retract the mucoperiosteal flap itself
What are the cheek retractors called
Austin and Kilmer retractors
What are bone rongeurs used for
To produce a smooth bone surface for healing, nibbling away bone spicules
What are dissecting forceps
To hold the loose flap edges taut (stretched or pulled tight) during suturing
What is a resorbable suture material
Vicryl
What does trismus mean
Limited mouth opening
What is localised osteitis
Dry socket
The bony socket walls become infected and there is a loss of the blood clot
Primary, reactionary and secondary haemorrhage
Primary- usually stops within 5 mins, is the first bleeding after an extraction which is normal
Reactionary- occurring several hours after the XLA, usually caused by patient not following post op advice
Secondary- this happens after 24 hours of an XLA, the blood clot is lost early and the socket becomes infected. The socket should be cleaned out and a haemostatic sponge should be placed
What can be used to reduce risk of infection before xla
Applying chlorhexidine to the gingival crevice
What is alvogyl used for
To help a dry socket
What does avulsed mean
This is when a tooth has been knocked out accidentally, can sometimes be put back in if done quickly and following the correct steps
What is the gap called caused by labial frenum
Median diastema
What are orthodontic springs used for
To move the teeth along the arch as required
What are orthodontic retractors used for
To push one or several teeth backwards
What are orthodontic expansion screws used for
To move several teeth or each half of the upper arch outwards
What are adams cribs used for
To retain the appliance in the mouth, is usually put onto the molar/premolar teeth
What are adams cribs pliers used for
To adjust all metal springs and retractors when needed
What is an expansion screw key
It counts the number of turns applied to the screw between visits to ensure compliance by the patient
What is a functional appliance used for
To correct skeletal class || discrepancies (when the mandible jaw is too far back) it allows the jaw to grow into the correct position.
Have to have premolars to clasp onto but need to be young enough to still be developing (up to 14 years old)
What is osseointegration
The process of the alveolar bone growing around the implant so that it locks into the bone itself
What is perimplantitis
When plaque allows periodontal disease to develop around the implant, making the implant loose and fail
What is an archwire used for
To fasten into the brackets or bands
Nickel titanium or stainless steel wires
End cutters
Right-angled cutters to trim the ends of the archwire after replacement
Alastiks
Rubber bands to hold the archwire into the slots of each bracket
Alastik holders
Ratcheted holders to apply the alastiks to the brackets
Bands
Metal rings to attach to molars
Bracket holders
To hold and position each bracket to the centre of the tooth, if any replacements are required
Bracket and band removers
To remove brackets, bands and any residual bond material
Beebee crown shear
Short beaked shears for cutting and shaping the margarine of temporary crowns
What would you disinfect impressions in
10% sodium hypochlorite
What to do with elastomer imps after soaking in disinfectant
Dry with 3in1 tip
Irreversible hydrocolloids
Addition silicones
Polyethers?
Alginate
Heavily bodied putty / light bodied paste
?
What is a plain broach and barbed broach used for
Plain broach- to help locate the entrance to each root canal
Barbed broach- to remove (extirpate) the pulpal content forms the canal
What is a reamer used for
Hand or rotary- to enlarge the root canals in a circular shape laterally, down to the apex
What is a file used for
Hand or rotary, to meagre the can in it’s actually shape laterally, smooth the root canal walls and remove any residual debris from them
What is an apex locator used for
To determine the working length electronically
Spiral paste filler used for?
Used with the slow handpiece to spin sealant material into the root canal
What is a lateral condenser/finger spreader used for
To condense the root filling points laterally into each root canal, so that no space remains for microorganisms to return.
What root canal irrigation can some patients be allergic to
Chlorhexidine
What is an antiseptic paste for rct
It is non-setting and contains antiseptic anti-inflammatories, used to dress infected root canals for a Time before root filling e.g ledermix paste
What is cresophene
Used to dress infected root canals, soaked into paper points before insertion
What does obturate mean in Rct
To fill
What is the success rate of rct
70-80%
What’s a gingivalplasty
Similar to gingivectomy but is used to reshape the gingiva
How to deal with a small Mercury spillage
Globules of Mercury can be collected in a intravenous syringe or bulb aspirator and placed in a Mercury container
Small globules can be collected by adhering them to the lead foil from X-ray film packets
Waste amalgam can be gathered with a damp towel
How to deal with a larger Mercury spillage
What does the spillage kit contain
Stop work and report the incident to the dentist immediately
Put on full PPE
The globules of Mercury must be smeared with a Mercury-absorbent paste from the spillage kit
Pick dry globules up with a wet disposable towel and
Placed in storage container
Equal parts of calcium hydroxide and flours of sulphur mixed into a paste with water
What are the ingredients of amalgam, composite and glass ionomer
Amalgam- alloy powder (silver, copper, zinc and tin), liquid Mercury
Composite- inorganic filler (powdered glass, quarts, silica) liquid resin binder
Glass ionomer- powder (aluminosilicate and poly acrylic acid particles) sterile water
What is calcium hydroxide used for and what are its advantages and disadvantages
Used as a cavity liner, used in pulp capping, pulpotomy and other roo treatment procedures
Advantages- non-irritant to the pulp
Alkalinity helps to kill caries bacteria
Compatible with all filling materials
Promotes secondary dentine formation at cavity base
Promotes enamel remineralisation due to its calcium content
Disadvantages-
Too weak to use without a base in deep cavities
Soluble in water unless a light-cured product is used
What are the temporary restorations made out of
Zinc oxide and eugenol cement
Zinc phosphate cement
Zinc polycarboxylate cement
Gutta percha
Zinc oxide powder and eugenol liquid
Zinc oxide powder, phosphoric acid liquid
Zinc oxide powder, polyacrylic acid liquid or both as powder with sterile water as liquid
Greenstick compound, which is practically obsolete as a temporary filling
What is zinc oxide and eugenol cement used for and the advantages and disadvantages
Used as temporary filling
Non irritant base for deep cavities
Sedative dressing for painful carious teeth and for dry sockets
Main constituent of some impression pastes, periodontal packs and root filling materials
Advantages- sedative properties of eugenol, helps to settle hypersensitive pulp
Multi-use cement
Best base cement for use with amalgam fillings
Disadvantages-
Only modern cements set fast enough for use at filling visit
Incompatible with composite fillings
Should be avoided in patients who are sensitive to eugenol products
Not adhesive to tooth
What is zinc phosphate cement used for and what are the advantages and disadvantages
The thick mix- a temporary filling
Cavity base
Blocking out undercuts in inlay and crown preparations
Thin mix-
A luting cement to place inlays, crowns and bridges
A luting cement to place orthodontic bands
Advantages- setting can be controlled by varying the mix of the cement
Multi-use cement
Adhesive to dentine-can be used as a luting cement
Sets hard and quickly- stronger base beneath fillings
Disadvantages-acidic liquid with a PH of 2, so can be irritant to the pulp in deep cavities
May need a lining beneath the zinc phosphate base to prevent this
Moisture-sensitive and non-adhesive if the tooth is wet
What is zinc polycarboxylate used for and advantages and disadvantages
Used as a cavity base as a thick mix
Luting cement as a thin mix
Advantages- alternative to zinc phosphate in most applications
Less acidic than zinc phosphate
More adhesive than zinc phosphate
Disadvantages- adhesive to stainless steel instrument so can be difficult to manipulate
Must be removed from instruments before setting
What is the gutta-percha temporary restoration used for
Advantages and disadvantages
Practically obsolete as a temporary filling
No advantages over other materials
Poor marginal adaptation
What does a high/low inorganic ion/mineral content saliva cause
High- thick stringy saliva which protects teeth against caries but allows dental calculus to form easily in large amounts
Low- watery saliva, which doesn’t give much protection against caries but prevents large amounts of calculus from forming
What does Sjögren’s syndrome cause
It is a autoimmune disease it causes xerostomia (dry mouth) affecting the salivary glands
What is ptyalism
Causes excess saliva, people with periodontal disease can have this and those with Parkinson’s
What is an iatrogenic factor
A factor caused by imperfect dentistry
Causes problems such as plaque formation
How deep should a gingival crevice be when healthy
Up to 3 mm
What is a false pocket
An appearance of a pocket but this is caused by inflammation of the gingiva. Not the loss of attachment between the epithelium junction
Name 2 anaerobic bacteria
Actinomyces and porphyomonas (both bacteria specifically associated with periodontal disease
What colour is supragingival calculus and subgingival calculus
Supra-yellow
Sub-brown
Due to the blood pigments incorporated into it from the bleeding gingival tissues
Why do the gums bleed on probing due to calculus
The rough calculus and irritation of the bacterial toxins cause painless micro ulcers to develop within the gingiva
What are true pockets
Pockets caused by the destruction of the base of the gingival crevice and its attachment to the tooth. Chronic periodontitis
What are the 3 main ways to prevent caries
Control the build-up of bacterial plaque using good oral hygiene techniques
Increase the tooth resistance to acid attack, by incorporating fluoride into the enamel structure
Modification of the diet- to include fewer cariogenic foods and drinks and to reduce their frequency of intake
What are the 3 main ways to prevent periodontal disease
Control the build-up of bacterial plaque by using good oral hygiene techniques
Modify the contributory factors- for example smoking
Control the host response-for example, having hygiene visits more frequently, monitoring the condition, intervening if needed
3 main techniques to remove plaque
Tooth brushing- using a good toothpaste
Interdental cleaning
Using suitable mouthwashes
How much sodium fluoride is in toothpastes normal and high fluoride
1000parts per million for normal
Between 2800-5000 ppm for high fluoride
What does triclosan combined with zinc do
Acts as an antiseptic plaque suppressant
Which ingredient helps with sensitivity in toothpaste
Stannous fluoride
What ingredient helps with whitening teeth
Biological enzymes
What are the different types of interdental cleaning
Dental floss and tape
Flossette-style (the floss with the handle that you can use with one hand)
Interdental brushes
Woodsticks- can also be plastic, these can easily get stuck in the gum so should be used correctly (least effective)
Mouthwashes- what different ingredients are there and what for
Sodium fluoride-provides topical fluoride application to the teeth
Triclosan- a chemical that suppresses the formation of plaque in the oral cavity
Hydrogen peroxide- helps eliminate anaerobic bacteria
Chlorhexidine- an antiseptic plaque suppressant
What is a detergent food
A raw, firm, fibrous fruit /vegetable
Such as apples, pears, carrots and celery
Hard cheese is not a detergent food but can be eaten to increase salivary flow
What should the fluoridation of water be
1ppm
What does DMF stand for
Decayed missing and filled teeth
Scalers used for supragingival calculus removal
Sickle scaler
Cushing’s push scaler
Jaquette scaler
Instruments used for sun gingival scaling
Gracey curette
Other subgingival curettes
Periodontal hoe
Ultrasonic scaler
What would you use as an additional stage of subgingival debridment
Gracey Curette- has only one cutting surface
What is bruxing
Clenching and grinding teeth
Causes attrition
What is abfraction
The specific loss of tooth in the cervical region due to the shearing forces that occur by overloading single standing teeth
What is periocorontis
An infection of the gingival flap that lies over a partially erupted tooth called the operculum
What bacteria causes ANUG
And how to treat it
Bacillus fusiformis and treponema
Vincenti
Treat it with antibiotics usually metronidazole but penicillin can be used.
What is a buffering agent, preservative and vasoconstrictor used for in LA cartridges
Buffering agents- keep the contents of the cartridge at a neutral PH of 7, so they are neither acidic nor alkaline, not irritating the soft tissues
Preservative-to give adequate shelf life to the contents
Vasoconstrictor - acts to prolong the action of the anaesthetic by constricting local blood vessels so that the solution is not carried so quickly into the bloodstream (adrenaline is a vasoconstrictor)
What’s another term for adrenaline
Epinephrine
What health conditions would prevent you from using adrenaline
Hypertension- high blood pressure
Cardiac disease- poor functioning of the heart
Hyperthyroidism- an overactive thyroid gland
What is a nerve block
Different types of nerve blocks (3)
What technique should be used when doing nerve blocks
An injection that anaesthetises the nerve trunk as it runs in soft tissue before it enters the jaw bone or after it leave it
Numbs several teeth at once
The inferior dental block is the most common nerve block
There is a mental nerve block- to anaesthetise the end portion of the inferior dental nerve only (only the anterior teeth are affected)
Posterior superior dental nerve block- the upper second and third molar are affected
An aspirating technique should be used for nerve blocks to ensure that you do not inject the blood vessel
Local infiltration?
Given over the apex of the tooth to be anaesthetised, inserted beneath the mucous membrane overlying the jaw bone.
It applies it to the nerve endings instead of the nerve trunk. Usually used for all upper teeth and lower incisor teeth
Local infiltration can numb the gingivae area of lower teeth as well as the nerve block
Intra-ligamentary injection
Used to produce deeper anaesthesia around hypersensitive teeth, used alongside infiltration/nerve block
It is injected into the periodontal ligament of the tooth, a lot of force is needed to do this type of injection, special syringe must be used
Intra-osseous injection
Used when infiltration or nerve block has failed, this type rarely fails
A small home is drilled through the compact bone to allow a needle to be inserted directly into the spongey bone.
Cannot be used where there is a gum injection and cannot be used around the mental foramen of the mandible as the nerve could be damaged
Good for extractions, very old technique, doesn’t last as long as other techniques
Doesn’t numb the cheek, lip or tongue , numbs deeply into the tooth, and buccal/lingual gum
What technique would you use to numb upper teeth for XLA/restoration
Xla- infiltration for buccal/labial and palatal sides.
For second and third molars a posterior superior dental block may be used instead
Restoration- the same
What anaesthesia technique would be used to numb the lower teeth for XLA/restoration
XLA-An inferior dental block would be used for all teeth. However the lower molars would need local buccal infiltration as well as this.
When numbing the incisors, the dentist may do local infiltration instead of nerve block as the bone of the mandible is thinner here
Restoration-
An inferior dental block will numb all lower teeth
A mental block may be used if the lower molars are not involved
Infiltration may be used instead of the mental block is only lower incisors involved
Gauge of short and long needle
Long- 27
Short -30
What does paraesthesia mean
Pins and needles when anaesthetic is wearing off
What are the different classes of cavities
Class |- cavities involving a single surface in a pit or fissure ( a filling could be an occlusal, buccal or a lingual filling)
Class ||- involving at least 2 surfaces of a posterior tooth, the mesial or distal and the occlusal surface of a molar/premolar (could be a mesial-occlusal filling in a premolar or a MOD filling in a molar)
Class |||- involving the mesial or distal surface of an incisor or canine
Class |V - same as class ||| but extend to involve the Incisal edge on the affected side
Class V- involving the cervical margin of any tooth (could be a labial cervical filling in an upper incisor or a lingual cervical filling in a lower molar)
What is a right angled probe used for in a cavity preparation
To feel the cavity margins, to feel softened dentine within the cavity, to detect overhanging restorations
What is an amalgam plugger used for In a cavity preparation
To push filling materials into the cavity and adapt them to the cavity shape, leaving no air spaces and forcing excess mercury to the surface of the filling for removal during carving
What is a Burnisher used for in a cavity preparation
to press and adapt the restoration margins fully against the cavity edges so that no leakage occurs under the restoration
What is a gingival margin trimmer used for
To trim the margin of the cavity to ensure no unsupported enamel nor soft dentine remains, not used as much anymore due to more burs being available
What is an enamel chisel used for
To remove any unsupported enamel from the cavity edges, not used as much anymore due to more burs being available
What are airturbine handpiece sand slow handpiece
Airturbine handpiece run at up to 500,000 revolutions per minute, they used friction grip diamond or tungsten carbide burs to cut easily through both enamel and dentine.
Slow handpieces run at around 40,000 revolutions per minute and are driven by air or electric motors at the base of the handpiece. They used latch grip stainless steel or tungsten carbide burs
What are different shaped burs used for
Round- used for gaining access to cavities, and at low speed for removing caries
Pear- used for shaping and smoothing cavities
Fissure- used for shaping and outlining the cavity
What type of matrix system would you use for amalgam, composite and GI
Amalgam/ metal strips held in a retainer device which can be tightened around the tooth. (Siqveland and tofflemire) Wooden wedges/plastic wedges can be used with them
Composite- a transparent plastic strip to allow light curing to occur, which is held in place by hand during curing
GI- specially shaped cervical foil matrix which adapts to the shape of the tooth in this area. Held in place by hand and the inner foil layer produces a smooth surface. Cannot be used with light cure materials as it is Opaque, light will not go through
