Chapter 9 Part III Flashcards
Taurodontism is a failure of invagination of what?
Hertwig’s Epithelial root sheath
elongation of crowns at expense of roots
What is the method of action of MTA?
mineralization, formation of tertiary dentin
Anomalies in which morphological developmental stage are associated with AI hypo-plastic type?
Histodifferentiation
For AI hyp-calcified type, it is Mineralization
For the “obstruction” group of acyanotic congenital heart disease, describe this group
defects that cause obstruction (aortic stenosis, coarctation of the aorta) Clinical manifestations include labored breathing and congestive heart failure
PT measures intrinsic or extrinsic clotting function?
Extrinsic
prolonged in liver disease, impaired vitamin K production, and surgical trauma
What is the treatment for Behcet’s Syndrome?
Steroids, ulcerations on genitals and oral apthae
blood vessel inflammation throughout the body
What molecule reflects the acid-base balance?
bicarbonate
List some conditions associated with periodontal disease:
Papillon-Lefevre cyclic neutropenia agranulocytosis Downs LAD Hypophosphatasia Chediak Higashi Cathepsin-C gene
What is deposited into dentin that makes it sclerotic?
calcium salts
Leukemia, inflammation, trauma, toxicity are a result of:
a) high WBC
b) low WBC
a) high WBC
T/F: For resin infiltration, polymerized filled resin is used to infiltrate (via capillary action) areas of demineralization that are non cavitated. Hydrochloric acid, dessication with air then ethanol, infiltrate the area with filled resin, polymerize with light
FALSE
use UNFILLED resin
T/F: Most of the resin-based composite systems available have a volumeric polymerization shrinkage percentages that range between 1.4 and 5.67%
True
The specific gravity of urine is increased or decreased in diabetes mellitus and increased or decreased in nephritis, diabetes insipidus, and aldosteronism
Increased
Decreased
What are two groups of Acyanotic congenital heart disease?
1) Left to right shunting
2) Obstruction
What is the treatment for LAP (localized aggressive periodontitis)?
Metronidazole WITH amoxicillin (or tetracycline if child is over 8 yo) for 7-10 days with debridement.
NOTE: tetracycline is ineffective against AA
NOTE: LAP responds well to therapy, but GAP does NOT respond well to therapy
What is the normal range (%) of shrinkage of resins?
1.4-5.67%
Mineralization of primary teeth in order
A, D, B, D, E
At birth, all primary teeth and first molars are calcifying
What condition is characterized by over-riding aorta, right ventricular hypertrophy, pulmonary stenosis, and VSD?
Tetralogy of Fallot
child will appear blue, hypoxic, clubbing of fingers, cyanotic defect
What is the normal range for hematocrit?
35-50%
Anomalies in which morphological developmental stage result in fusion, hypodontia, congenital absence/gemination, natal teeth, epithelial rests, odontoma?
Proliferation
Which is increased in Hodgkin’s disease, lipid storage disease, recovery from severe infections, monocytic leukemia?
a) Basophils
b) Neutrophils
c) Lymphocytes
d) Eosinophils
e) Monocytes
e) monocytes
Anomalies in which stage result in congenital absence + hypodontia?
a) Initiation
b) Proliferation
b) Proliferation
for initiation, result is anodontia
T/F: A slight fever (temp to 100.5F) is not uncommon the first 48 hours after surgery. If a higher fever develops or the fever persists, have the patient call the office
True
Which type of blood disorder involves mostly muscles and joints?
a) Hem A and B
b) VWD
a) Hem A and B
VWD is in the skin, subcutaneous
Patients presents with teeth that are exfoliating early, what could be elevated in the urine?
phosphoethanolamine
hypophosphatasia
T/F: PTT is prolonged in Hemophilia A, B, and C but not VWD
False, prolonged in BOTH
Chewing tobacco users are ___ times more likely to have decayed dental root surfaces than non-users
four
What is the method of action of formocresol?
tissue fixation
Current bonding systems are marketed as total and self-etch systems. What is total etch?
involves three or two step placement technique, with a separate step for acid etching (traditional way of etching)
What is the method of action for ferric sulfate?
agglutination of blood proteins and control hemorrhage without clot formation (hemostatic)
What is rubeola also known as?
measles
What is self etch?
all-in-one systems that combine acid etchants, primers, and adhesives
Use of available self-etching bonding agents may provide less retention than the total acid etching
What is deposited into dentin that makes it sclerotic?
calcium salts
Dental lamina: location and what are they a remnant of?
Occur on alveolar crest, remnants of dental lamina (gingival cyst of the newborn)
What does bleeding time measure?
quality of platelets
Two ways to measure the oxygen carrying capacity of blood
1) Hemoglobin
2) RBC (4-6 million)
Low: Hemorrhage, anemia
High: Polycythemia
INR measures intrinsic or extrinsic clotting function
extrinsic
INR is increased when on anticoagulant therapy. Normal value=1. Anticoag therapy target range is 2-3
INR/PT: extrinsic
PTT: intrinsic
What is the normal WBC count for a 4-7 yo?
6000-15,000 mm3
Gemination and fusion are most common in which dentition?
primary
Which of the following vitamins are in Enamel and Dentin?
a) A
b) C
c) D
d) Ca
e) Phosphate
c) D
The others are all in enamel but not dentin
A child who receives sealants is ___% less likely to receive restorative services over the next three years than a child who does not
72%
When tissue breakdown occurs, is potassium increased or decreased?
Increased
Which type of blood disorder involves mostly skin, subcutaneous?
a) Hem A and B
b) VWD
b) VWD remember, deep bleeds are hemA and B
involves muscles and joints
Unregulated piercing parlors and techniques have been identified by the National Institutes of Health as a possible vector for disease transmission of what three entities per the guidelines?
1) Hepatitis
2) Tetanus
3) Tuberculosis
T/F: Thrombin mediates platelet-platelet aggregation. The cross-linking action of thrombin stabilizes the clot
FALSE, FIBRIN
Patients presents with teeth that are exfoliating early, what could be elevated in the urine?
phosphoethanolamine
hypophosphatasia
Two ways to measure the oxygen carrying capacity of blood
1) Hemoglobin
2) RBC (4-6 million)
Low: Hemorrhage, anemia
High: Polycythemia
What is a normal range for prothrombin time?
11-13 seconds/ prolonged in liver disease, impaired vitK production, surgical trauma with blood loss
What is the normal range for platelet count?
120,000 - 340,000/mL measures clotting potential
T/F: More than 60% of children ages 4-11 are exposed to environmental cigarette smoke. 60% of teenagers have gingival bleeding on probing. 10% of children have calculus
True
What teeth are calcifying at birth?
All primary teeth and first molars are calcifying
T/F: More than 60% of children ages 4-11 are exposed to environmental cigarette smoke. 60% of teenagers have gingival bleeding on probing. 10% of children have calculus
True
What is in the urine in patients with hypophosphatasia?
urinary phosphoethanolamine
Which microbes are associated with NUG? (2 of them)
1) Spirochetes
2) P. intermedia (fusiform bacteria)
Note: The microbe involved with LAP is Actinobacillus actinomycetecomitans + bacteroides)
Epstein pearls: location and what are they a remnant of?
palatal midline, epithelial inclusion cysts
What material bonds to enamel and dentin via chelation?
Glass ionomer
What factor is deficient in hemophilia B?
Factor 9
Christmas disease; plasma thromboplastin component
What enamel defect is associated with celiac disease?
enamel hypoplasia
gingival cyst of the newborn = ?
dental lamina cyst
What is the term for a supernumerary “mirror image” tooth?
Twinning
Which is increased in Hodgkin’s disease, lipid storage disease, recovery from severe infections, monocytic leukemia?
a) Basophils
b) Neutrophils
c) Lymphocytes
d) Eosinophils
e) Monocytes
e) monocytes
What type of shunting exists in cyanotic heart disease?
Right to Left
Examples:
1) Tetralogy of Fallot
2) Tricuspid atresia
3) Transposition of the great arteries
4) Total anomalous venous return
5) Truncus arteriosus
Clinical manifestations include: cyanosis, hypoxic spells, poor physical development, heart murmurs, and clubbing of the terminal phalanges of the fingers
Mild to moderate factor 8 deficiency can be treated with what?
DDAVP - vasopressin acetate, releases endogenous factor from epithelium
What type of heart disease/shunting pattern is characterized by ASD, VSD, PDA?
Acyanotic, left to right shunting
Smokeless tobacco users are ___% more likely to develop ORAL cancer and __% more likely to develop pancreatic/esophageal cancer
80%, 60%
The inner enamel epithelium invaginated incorrectly during morphodifferentiation results in what?
Dens in dente
What is increased in bacterial infections, hemorrhage, and diabetic acidosis?
a) Basophils
b) Neutrophils
c) Lymphocytes
d) Eosinophils
e) Monocytes
b) Neutrophils, 54-62% normal value
Tetralogy of Fallot, transposition of the great vessels, pulmoary stenosis, and tricuspid atresia are examples of what type of heart disease/ shunting pattern?
Cyanotic congenital heart disease
characterized by right to left shunting of blood
Length of time for root completion of primary teeth?
18 months post eruption
Tobacco is a risk factor for ___ of the 8 leading causes of deaths in the world, and it kills nearly six million people a year
6
NOTE: Cotinine is a biomarker for exposure to tobacco smoke
For the “left to right shunting” group of acyanotic congenital heart disease, describe this group
defects that cause left to right shunting of blood within the heart: VSD and ASD. Clinical manifestations of these defects can include congestive heart failure, pulmonary congestion, heart murmur, labored breathing, and cardio-megaly
Aplastic anemia, drug toxicity, and infections are a result of:
a) high WBC
b) low WBC
b) low WBC
What is the normal WBC count for an infant?
8000-15,000 mm3
T/F: TMJ begins to develop around week 8. Morphologic development begins at 11 weeks. D, E, F, and G begin calcifying at 14 weeks
True
T/F: In the first three years of use of spit tobacco, 50% of users develop leukoplakia
True
Anomalies during which stage of morphological development result in enamel pearls, hypercementosis, enamel hypoplasia, and dentin dysplasia?
Apposition
List the 5 most common cyanotic lesions: (5 T’s)
1) Tetralogy of Fallot
2) Tricuspid atresia
3) Transposition of great arteries
4) Total anomalous venous return
5) Truncus arteriosus
What are the developmental stages?
Initiation, proliferation, histodifferentiation, morphodifferentiation, apposition, mineralization, eruption
What is the key factor in success of sealants?
Isolation
NOTE: A child who receives sealants is 72% less likely to receive restorative services over the next three years than a child who does not
T/F: The ADA panel noted that use of currently available self-etching bonding agents that do not include a separate etching step might result in lower retention than that achieved with the standard acid etching technique and is not recommended
True
T/F: Condyloma acuminatum is caused by HPV 6, 11, 16, 18 and is sexually transmitted
True
Surgical excision is recommended. Multiple papillary areas of epithelial hyperplasia occuring on the genital and oral mucosa
What has helped to decrease shrinage of resins?
Using smaller filler particles
Mineralization of cusps:
MB, ML, DB, DL
LEngth of time for root completion of permanent teeth?
3 years post eruption
Dental lamina: location and what are they a remnant of?
Occur on alveolar crest, remnants of dental lamina (gingival cyst of the newborn)
T/F: Aplastic anemia, the WBC will be low. Leukemia, the WBC will be high
True
Is sodium increased or decreased in Cushing syndrome?
Increased
BQ: What are koplik spots?
prodromic viral enanthem of measles (rubeola) manifesting two to three days before the measles rash itself. they are characterized as clustered, white lesions on the buccal mucosa (opposite the lower 1st and 2nd molars) and are pathognomonic for measles
What is the goal of IPT?
1) preserve tooth vitality
2) arrest caries
3) tertiary dentin
T/F: Kawasaki disease is a condition that causes inflammation in the walls of medium-sized arteries throughout the body, including the coronary arteries, which supply blood to the heart muscle. Kawasaki disease is also called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose, and throat
True
TMJ begins to develop around week ___
8
T/F: 60-78% of spit tobacco users have oral lesions
True
BQ: Tuberculosis testing: there are two ways (1) Mantoux tuberculin skin test (2) IGRAS - Interferon gamma release assays (T-spot or QFT-GIT)
Definitive diagnosis is based on isolation from secretions or biopsy of specimen
Globodontia primarily affects which primary teeth?
A,J,K,T: second primary molars
Most common childhood malignancy?
ALL: most common malignancy
1/3 of all childhood malignancies are from ALL
How do curing lights work?
Photopolymerization - photoinitiators efficiently convert monomers into polymers
What measurement demonstrates oxygen carrying capacity?
Hemoglobin (12-18 g/100mL)
Low: Hemorrhage, anemia
High: polycythemia
Most common tumor in infancy?
Neuroblastoma
In which condition is the specific gravity of urine decreased?
Acute nephritis, diabetes insipidus, and aldosteronism
In dens in dente, this is invagination of which part of the enamel epithelium?
The inner enamel epithelium (IEE)
What is increased in types of blood dyscrasias?
a) Basophils
b) Neutrophils
c) Lymphocytes
d) Eosinophils
e) Monocytes
a) Basophils
What is the normal range for platelet count?
120,000 - 340,000/mL measures clotting potential
Which size arteries are affected by kawasaki disease?
medium sized arteries
BQ: What immunoglobulins are elevated in NUG?
IgG, IgM
Compared to gingivitis and healthy groups, ANUG groups exhibit higher IgG and IgM titers to intermediate-sized spirochetes and higher IgG titers to Bacteroides melaninogenicus subsp intermedius
NOTE: IgG2 is elevated in LAP and lowered in tobacco users
NOTE: IgM, basophils, mast cells are involved in anaphylaxis
T/F: Natal teeth, epithelial rests, gemination are effects of excessive proliferation
True
_____________ is a biomarker for exposure to tobacco smoke
Cotinine
BQ: Tuberculosis testing: there are two ways (1) Mantoux tuberculin skin test (2) IGRAS - Interferon gamma release assays (T-spot or QFT-GIT)
Definitive diagnosis is based on isolation from secretions or biopsy of specimen
Treatment choice for NUG? (interproximal necrosis/ulceration. gingival pain. fever. punched out papilla, halitosis)
Metronidazole+Penicillin. Debridement. (Note: the treatment for LAP is Metronidazole + Amoxicillin 7-10 days/ or tetracycline if child is over age 8)
Which of the following is not a property of glass ionomer?
a) Less prone to hydration problems
b) Bonds to dentin and enamel via chelation
c) Biologically compatible with connective tissue
d) High shrinkage
d) LOW shrinkage
BQ: What are koplik spots?
prodromic viral enanthem of measles (rubeola) manifesting two to three days before the measles rash itself. they are characterized as clustered, white lesions on the buccal mucosa (opposite the lower 1st and 2nd molars) and are pathognomonic for measles
Drug influenced gingival enlargement - name the three categories of meds and provide examples
Anti-epileptics: Phenytoin, dilantin
Immunosuppressants: Cyclosporine
Calcium channel blockers: nifidepine, verapamil
What is the method of action of sodium hypochlorite?
Sterilization
A platelet count measures what?
clotting potential
Aggressive periodontitis: describe the cellular changes observed
Macrophages hyperresponsive. phagocyte abnormalities, neutrophil defects (reduced chemotaxis) IgG2 elevated. Reduced Gp-110
How do you minimize BPA exposure when placing composites/sealants?
Wiping and rinsing the restoration reduces exposure to BPA
What is third hand smoke?
The particulate residual toxins that are deposited in layers all over the home after a cigarette has been extinguished
Coxsackie A virus causes what condition?
Herpangina
What are the 6 most common acyanotic lesions?
1) ASD
2) VSD
3) PDA
4) Pulmonary stenosis
5) Aortic stenosis
6) Coarctation of aorta
First 3: left to right shunting group
Last 3: obstruction group
What type of poisoning looks similar to NUG?
Mercury poisoning
What factor is deficient in hemophilia A?
Factor 8
x-linked recessive; males are affected, females are carriers
What is a common vitamin deficiency in vegetarians?
VitB12 (B9-folate)
B12 is needed to make red blood cells, deficiency can indirectly cause iron deficiency. B9 (folate) binds to red blood cells when there is an iron deficiency
Morphologic development begins at week ___
11
What are the top two reasons posterior composite fail?
1) Fractures
2) Recurrent caries
BQ: What is the term used for infiltrating the demineralized area during resin infiltration?
CApillary action
T/F: Fusion, hypodontia, congenital absence are effects of deficient proliferation
True
READ: Acyanotic disease can reflect the risk for dangerous desaturation during general anesthesia and/or other planned procedures (local anesthesia, nitrous oxide) or in post-operative period
acyanotic heart disease: oxygenated blood moves from left side of heart to right side and then to lungs, This can occur as a result of a hole between the left and right atria. In acyanotic heart disease, the body receives oxygenated and non-de-oxygenated blood from the heart. bluish skin coloration does not occur with acyanotic heart disease except when the body needs more oxygen than the heart can supply
Anomalies during which stage of morphological development result in enamel pearls, hypercementosis, enamel hypoplasia, and dentin dysplasia?
Apposition
What is the measure of intrinsic clotting of the blood?
PTT (partial thromboplastin time) - congenital clotting disorders/ prolonged in hemophilia A, B, C and VWD
BQ: What disease is characterized by fissured lips, infected pharynx, strawberry tongue, erythema of palms and soles, rash, cervical adenopathy
Kawasaki disease, also called mucocutaneous lymph node syndrome
BQ: Condyloma acuminatum is caused by HPV____
6, 11 ,16, 18. it is sexually transmitted
T/F:As the resin is polymerized, there is an effective strategy
True, as the polymer chains crosslink, they get closer together. Inevitably, filling will be smaller than prep
T/F: Collagen stimulates platelets that in the presence of thrombin+fibrin form a blood clot
True
What is the normal WBC count for a 8-18 yo?
4,500-13,500 mm3
Which type of dentinogenesis imperfecta occurs with osteogenesis imperfecta?
DI Shields Type I
Is fusion a result of deficient or excessive proliferation?
Deficient
What is increased in viral and bacterial infections, acute and chronic lymphocytic leukemia, or antigen reaction?
a) Basophils
b) Neutrophils
c) Lymphocytes
d) Eosinophils
e) Monocytes
c) lymphocytes, 25-30% normally
T/F: Hypophosphatasia - limited cementum is produced, teeth exfoliate early, elevated serum alkaline phosphatase, urinary phosphoethanolamine
False
Decreased serum alkaline phosphatase
What is the success rate of sealants after 10 years with recalls and maintenance?
80-90% success rate after 10 years with regular recalls and maintenance
What is in the urine in patients with hypophosphatasia?
urinary phosphoethanolamine
What does hematocrit measure?
the relative volume of cells and plasma in the blood
