CDS Flashcards
Give 2 methods of topical fluoride application for an 8-year old child
- 22600ppm duraphat varnish
- SDF 44,800Pppm
- fluoride gel
- fluoride toothpaste 1450ppm
What mechanism does topical fluoride prevent cavities?
- promotes reminerilazation of enamel
- fluoride ions absorbed into enamel forming fluoroapetite, making it more resistant to decay
- inhibits bacteria growth
Outline the rationale behind using antibiotics in periodontology
- Periodontal disease primarily caused by a bacteria (P. ginigivalis)
- patient may be immunocompromised, antibiotics can prevent systemic infection
Indications for antibiotics for periodontology
- patient is immunocompromised
- infection is aggressive
- all other treatments have been exhausted
- signs of systemic infection
Reasons for carrying out obturation
- prevents bacteria remaining in root canal from escaping to periodontal space via apical Forman
- prevents bacteria reaching and infecting root tissue from coronal leakage
- prevents infection of root from peri-radicular exudate
Cold lateral compaction steps
- choose appropriate GP master cone
- mark length on cone to working length
- place cone in canal and check for tug back
- remove cone and coat in root sealer
- place in canal
- place accessory cones covered in sealer, utilising finger spreader to allow access
- cut coronal end of gp and accessory cones using hot excavator just below acj
Minimum data that should be set on a record block
- midline
- canine line
- alar-tragal line
Technical term for dry socket
alveolar osteitis
predisposing factors for dry socket
- female
- taking oral contraceptives
- mandible
Dry socket signs and symptoms
- dull aching pain
- moderate to severe
- bad taste
Dry socket management
- la
- analgesia
- irrigation with warm saline
- antiseptic pack
Factors affecting denture retention
- depth of undercuts
- thickness of alveolar ridge
2 materials that can be used for impressions on mandible
- alginate
- greenstick compound
Term for an unpleasant sensation or pain
- dysaesthesia
Term for tingling
Paraesthesia
reduced sensation
hypoaesthesia
increased sensation
hyperaesthesia
neuropraxia
contusion of nerve
- continuity of epieneural sheath and axons maintained
Axonomesis
Axon damaged
- epieneural/myelin sheath intact
Neurotmesis
- complete loss of nerve continuity
Types of tooth bleaching
- external vital bleaching
- internal non-vital bleaching
Active agent in vital external bleaching
Carbamide peroxide
Proportion of people with bleaching sensitivity
60%
Post-bleaching sensitivity risk factors
- pre-existing sensitivity
- high conc of bleaching agent
- bleaching method
- gingival recession
How can the pulp communicate with the PDL?
- via apical foramen
- via furcal canals
- via lateral/accessory canals
- via exposed dentine tubules
Best time to extract 6s
When furcations form on the 7s
Biofilm formation stages
- Attachment
- colonisation
- accumulation to form complex community
- dispersal
Reasons why a mesial overhang could occur when placing an amalgam restoration
- poor matrix band adaption
- amalgam condensed with too much force
Consequences of a digit sucking habit
- proclained upper incisors
- retroclined lower incisors
- anterior open bite
- narrow upper arch
What is meant by a localised cause of malocclusion
localised problem within either arch, usually confined to 1,2 or several teeth, causing a malocclusion
Types of supernumerary teeth
- conical
- tuberculate
- supplemental
- odontome
Stainless steel constituents and proportions
- 72% iron
- 18% chromium
- 8% nickel
- 1.7% titanium
- 0.3% carbon
constituents of steel
> 98% iron
<2% carbon
disadvantages of self cured PMMA
- poor mechanical properties
- residual monomer may remain - can cause allergy
Factors which can result in tooth mobility
- bruxism
- trauma
- Periodontal disease
- dental abscess
Structures innervated by mental nerve
chin and lower lip
position of mental foramen
between lower 4 and 5
Peri operative complications in extraction
- difficult access
- abnormal resistance
- fracture of tooth
- jaw fracture
- soft tissue damage
- haemorrhage
- dislocation of TMJ
- adjacent tooth damage
- broken instruments
-wrong tooth extracted
preventative dental team management
raising concerns with parents, offering support, setting targets, record keeping and monitoring progress
preventive multi-agency management
- leasing with other professionals to see if concerns are shared
- check if child is subject to child protection plan
- agree joint plan of action
Non accidental injury examples
- black eyes
- intra oral injuries
- inner aspects of thighs
- pinch marks on ears
- soft tissue of cheeks
oro-facial signs of physical abuse
- brushing of face - punch, slap, pinch
- bruising of ears - pinch, pull
- abrasions and lacerations
- burns
- bites
- choke marks on neck
- eye injuries
- hair pulling
- fractures - nose, mandible, zygoma
Aims of suturing
- reposition tissues
- cover bone
- prevent wound breakdown
- achieve haemostasis
- encourage healing by primary intention
Why is an electrical handpiece used in bone removal during a surgical extraction?
air driven handpiece may lead to surgical emphysema
type of bur used for bone removal and tooth division in oral surgery
round or fissure tungsten carbide bur
Oral surgery flap designs
- semi-lunar
- triangular
- rectangular
Silane coupling agent use in porcelain restorations
- applied to etched porcelain surface
- forms strong chemical bond between oxide groups on porcelain and silane
- other end of silane molecules has C=C bond which reacts with composite resin luting agent
Apixaban mechanism of action
inhibits prothrombinase activity
Amoxycillin prescription dose and frequency
500mg 3 times daily for 7 days
Metronidazole prescription dose and frequency
400mg 3 times daily for 5 days
Drugs with possible interactions with warfarin
- metronidazole
- NSAIDs
- azole antifungals
MRONJ management
- avoid invasive treatment
- extractions in primary care setting
MRONJ risk factors
- duration and dose of bisphosphonate drug therapy
- dental treatment - impact on bone
- other concurrent medication e.g. steroids
outline the differential pressure theory in relation to orthodontics
- bone is resorbed in areas of compression
- bone is deposited in areas of tension
functional cusps
- cusps that occlude with opposing teeth in the intercuspal position
- lingual cusps of upper posterior teeth
- buccal cusps of lower posterior teeth
non-functional cusps
- cusps that do not occlude with opposing teeth in the intercuspal position
- buccal cusps of upper posterior teeth
- lingual cusps of lower posterior teeth
fossa
- depression or concavity on tooth surface
overbite
- vertical overlap of incisors
overjet
relationship between upper and lower teeth in horizontal plane
cross bite
a condition where one or more teeth may be abnormally malpositioned bucally or labially with reference to opposing teeth
anterior open bite
lack of vertical overlap of anterior teeth when posterior teeth are in full occlusion
posterior open bite
failure of contact between the posterior teeth when the teeth are in full occlusion
types of tooth movement
- tipping
- bodily movement
- intrusion
- extrusion
- rotation
- torque
effects of light orthodontic forces
- hyperaemia within PDL
- remodelling of socket
- PDL fibres reorganise
- gingival fibres remain distorted
Effects of moderate orthodontic forces
- occlusion of vessels of PDL on pressure side
- hyperaemia of vessels of PDL on tension side
- cell free areas on pressure side
- relatively rapid movement of tooth with bone deposition on tension side
- tooth may become slightly loose
- healing and remodelling of PDL
Effects of excessive/heavy orthodontic forces
- pain
- necrosis and undermiming resorption resulting in permanent changes
- anchorage loss
- possible loss of tooth vitality
Factors affecting response to orthodontic force
- duration
- magnitude
- age
- anatomy
Posselts envelope: T
maximum opening
- no tooth contacts
- full translation of condyle over articular eminence
Posselts envelope: ICP
- Intercuspal position
- maximum interdigitation of the teeth
- best fit
- also known as centric occlusion
Posselts envelope: E
- Edge to edge
- incisal edges of upper and lower incisors touch
Posselts envelope:: Pr
- protrusion
- condyle moves forwards and downwards on articular eminence
- no posterior tooth contacts
- only incisors +/- canines touch
Posselts envelope: R
retruded axis position
- no tooth contacts
- terminal hinge axis
- most superior anterior position of condylar head in the fossa
Posselts envelope: RCP
retruded contact position
- first tooth contact when mandible is in retruded axis position
- ICP approx 1mm anterior
drug to treat candida in patient on warfarin and why
- nystatin
- azoles interact with warfarin enhancing effects
Collimation Effects
- lower surface area irradiated
- lower volume of irradiated tissue
- lower number of scattered photons produced in tissue
- lower number of scattered photos interacting with receptor
- loss of contrast on radiographic image
why should a triangular collimator be used for a lateral cephalogram when not using a solid-state sensor?
to reduce exposure of the cranium
Why is a rectangular collimator used over a circular?
- it further restricts the size of the X-ray beam to the appropriate size of the intra-oral receptor
ALARP stands for…
as low as reasonably possible
How to assess antero-posterior skeletal relationship
- palpating the mandible and maxilla
- Frankfort mandibular plane angle
- lateral cephalometry
Types of supernumerary teeth
- conical
- tuberculate
- supplemental
- odontome
Features of conical supernumerary
- small, peg shaped
- close to midline
- may erupt
- usually 1 or 2 in number
- tend not to prevent eruption but may displace adjacent teeth
features of a tuberculate supernumerary
- tend not to erupt
- paired
- barrel shaped
- usually extracted
- one of main causes of failure of eruption of permanent upper incisors
Supplemental supernumerary
- extra teeth of normal morphology
- most often upper laterals or lower incisors
- often extract
odontome supernumerary
- compound
- complex - disorganised mass of dentine, pulp and enamel
Chronic oro-antral fistula management options
- excise sinus tract
- buccal advancement flap
- buccal fat pad with buccal advancement flap
- palatal flap
- bone graft
MRONJ management
prevent invasive treatment
extract in primary care setting
infective endocarditis prophylaxis options
- amoxycillin 3g oral powder sachet 60 mins before procedure
- clindamycin capsules 2x 300mg 60 mins before procedure
- azithromycin 200mg/5ml - 12.5ml/500mg 60 mins before
local cause of malocclusion - define
- a localised problem or abnormality within either arch, usually confined to one, two or several teeth, producing a malocclusion
Types of local causes of malocclusion
- variation in tooth number
- variation in tooth size
- local abnormalities of soft tissues
- local pathology
- abnormalities in tooth position
Amoxycillin frequency and dose
- 500mg 3x a day for 5 days
Metronidazole frequency and dose
400mg 3x a day for 5 days
Penicillin 5 frequency and dose
2x 250mg tablets 4x a day for 5 days
