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Need To Recall > EndoPerio > Flashcards

EndoPerio Flashcards

1
Q

% NaOCl for irrigation

A

0.5- 5.25%

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2
Q

Management for hypochlorite accident

A

Irrigate with NSS everyday to the point na it is not harmful to the tissues

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3
Q

PDL average width

A

0.2 - 0.25mm

Widest at cervical and apical
Thinnest at middle portion

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4
Q

Gingival epithelium histologic divisions

A

Oral epith - keratinized stratified squamous (parakeratinized > orthokeratinized)
Sulcular epith - non keraritinized but can be keratinized
Junctional - non keratinized, thicker near the sulcus and thinner at the apex

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5
Q

Contents of gingival crevicular fluid

A

Type of transudate
Contains cells (neutrophils), enzymes, IgA

Becomes exudate
Dead neutrophils, enzymes, proteins, microorganisms

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6
Q

Parallel to the surface of the root

A

Oxytalan fibers

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7
Q

How to prevent relapse

A

Retainers
Overcorrection
Circumferential supracrestal fiberotomy

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8
Q

Type of collagen: gingival fibers

A

Type 1 collagen

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9
Q

Gingival fiber group that resists rotational forces

A

Circular fibers

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10
Q

Gingival fiber associated with relapse of ortho tx

A

Transseptal fibers

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11
Q

Most numerous principal pdl fiber

A

Oblique - higher attachment at alveolar to cementum

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12
Q

Pdl fiber group; Most resistant to forces along long axis of the tooth

A

Oblique fiber group

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13
Q

Primary fibers that resists tooth towards occlusal direction/extrusion, compressed during intrusion/mastication

A

Apical fiber group

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14
Q

periodontal fibers embedded in cementum and bone are called

A

sharpey’s fibers - mineralized

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15
Q

most numerous cells found in periodontal ligament

A

fibroblast

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16
Q

elastic-like fibers that run parallel to the tooth surface and bend to attach to cementum

A

oxytalan fibers

oxyphilic cells are seen in the parathyroid gland. function is unknown

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17
Q

free gingival groove is a line between? does it coincide with any landmark?

A

marginal gingival and attached gingiva

coincides with apical border of JE

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18
Q

part of the gingiva where you can find stipplings

A

attached gingiva
-measured from the free gingival groove to the mucogingival junction

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19
Q

attached gingiva is thickest at? thinnest at?

A

thickest at maxillary anterior region (labial of lateral incisors
thinnest at mandibular posterior region (lingual of premolars)

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20
Q

what is the source of blood supply of autografts (FGG)?

A

revascularized –> bed of recipient tissue

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21
Q

most common cause of failure of FGG

A

loss of blood supply infection

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22
Q

other name for interdental col

A

interdental saddle

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23
Q

probing force

A

10-25g or 0.022 lbs - 0.055 lbs

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24
Q

calcular deposits are composed of what minerals?

A

calcium and phosphate

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25
Q

immediately after cleansing a tooth, a thin film of saliva covers the tooth. it is called?

A

salivary pellicle - made up of glycoproteins

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26
Q

source for free gingival graft (autograft)

A

PALATAL area or edentulous region -deepithelialized. connective tissue ang nilalagay.

autografts doesn’t retain its blood supply

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27
Q

joint between a tooth and alveolar bone

A

gomphosis

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28
Q

most critical factor in determining if a tooth is candidate for extraction or gan be saved with surgical periodontal therapy

A

clinical attachment loss*
mobility

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29
Q

most common location of furcation involvement

A

maxilla > mandi
distal aspect of 1st and 2nd molars

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30
Q

best indicator to evaluate success of scaling and root planing?

A

significant reduction of plaque index and bleeding index

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31
Q

most common post op complication for SRP?

A

tooth sensitivity

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32
Q

gracey curettes for anterior teeth

A

gracey #1-2 and 3-4

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33
Q

gracey curettes for anterior and premolar

A

gracey #5-6

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34
Q

gracey curette for posterior teeth: facial and lingual surfaces

A

gracey #7-8 and 9-10

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35
Q

gracey curette for posterior teeth: mesial surface

A

gracey #11/12, 15/16

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36
Q

gracey curette for posterior teeth: distal surface

A

gracey #13/14, 17/18

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37
Q

rationale for using periodontal dressing after gingivectomy

A

reduce bleeding and pain
promote healing
mechanical barrier/protection
create a debris-free environment

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38
Q

contents of periodontal dressing

A

The liquid contains eugenol, rose oil or peanut and resin. The powder contains zinc oxide, powdered resin and tannic acid.

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39
Q

different toothbrushing techniques

A

bass method - 45 degrees towards sulcus
modified bass - bass + rolling stroke
stillman
charters - 45 degrees towards occlusal

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40
Q

what is fones technique, leonard technique, scrub tech?

A

fones - circular - least effective
leonard - vertical
horizontal -scrub - most commonly used by px

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41
Q

gingival enlargement involving the marginal and attached gingiva and papillae

A

diffuse

discrete- an isolated sessile or pedunculated, tumor-like enlargement

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42
Q

diseases associated with desquamative gingivitis

A

pemphigus vulgaris
pemphigoid
lichen planus
chronic ulcerative stomatitis

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43
Q

causative agent of NUG and NUP

A

fusobacterium
prevotella intermedia
spirochetes (treponema denticola)

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44
Q

how to classify localized or generalized aggressive periodontitis

A

localized - involves molars and incisors + at most 2 other teeth

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45
Q

causative agent of localized aggressive periodontitis

A

Aggregatibacter/actinobacillus actinomycetemcomitans
capnocytophaga ochracea

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46
Q

causative agent of generalized aggressive periodontitis

A

prevotella intermedia
eikenella corrodens

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47
Q

syndromes associated with severe periodontitis

A

chediak-higashi syndrome - cafe au lait
papillon-lefevre syndrome / palmoplantar keratoderma periodontitis - hyperkeratosis of palms and soles
down syndrome - due to increase P. intermedia
Lazy leukocyte syndrome
Leukocyte adhesion deficiency

48
Q

primary proteinase that destroys periodontal tissue

A

matrix metalloproteinase (MMP) - degradation of ECM

contributing factor: Reactive oxygen species (ROS) - disrupt cellular proteins, depolymerize matrix components; can be protective as ROS kills pathogen but leaks out to CT

49
Q

first colonizer of plaque

A

s. sanguis
(streps / yellow complex)

50
Q

way of communication of microorganisms

A

quorum sensing

51
Q

early/primary colonizers

A

yellow complex (strep)
blue complex (actinomyces)

52
Q

late/secondary colonizers

A

*green complex
eikenella corrodens
actinobacillus actinotherapeutics
capnocytophaga

*orange complex
fusobacterium
prevotella
campylobacter

*red complex - causes bleeding
porphyromonas gingivalis
treponema denticola
tannerella forsythia

53
Q

other name for the osseous defects

A

one wall - hemiseptum
two wall - osseous craters
three wall - INTRAbony defect

54
Q

complete healing of tissue after flap surgery takes ____

A

1 month

55
Q

full thickness flap (mucoperiosteal flap) vs partial thickness flap (split thickness)

A

full - inclues epith, ct and periosteum
-uses periosteal elevator
- less than 2mm width of attached gingiva
-alveolar bone exposed

partial - epith and CT only
-Bard parker knife
- >2mm width of attached gingiva
- alveolar bone not exposed

56
Q
  1. diameter of periodontal probe
  2. UNC vs WHO probe
A

0.4 - 0.5mm
with graduation in millimiters
blunt, rod-shaped working end

UNC probe vs WHO probe
UNC - 12mm to 15mm, 1.0mm graduation
WHO - has a 0.5mm ball at the tip; measurements: 3.5, 5.5, 8.5, 11.5mm

57
Q

Jacquette scaler vs sickle scaler

A

jacquette - straight blade
sickle - curved blade
face meets terminal shank at a right angle

58
Q

area specific curette vs universal curette

A

universal - 90 degree, 2 cutting edge
asc - 70 degrees, 1 cutting edge

59
Q

only hand instrument that is used with a push stroke to remove deposits on the lingual surface of anterior teeth

A

chisel

hoe- pull motion, 100 degree angle with terminal shank

60
Q

the free gingival groove is most pronounced with what tooth/teeth in oral cavity

A

mandibular premolar and incisor regions
least frequent in mandi molars and maxi premolars

61
Q

shape of interdental papilla

A

dependent on the space provided by two adjacent teeth

anteriors: pyramidal
molars: flattened mesiodistally
diastema: none

62
Q

fibers located mostly at the apical 3rd for the viability of the blood vessels and support the functions of the root

A

reticulin fibers

63
Q

fibers mostly found near blood vessels for dilation and constriction of blood vessels, for tooth mobility within the socket

A

elastic fibers

produces elastin which gives the gingiva its ability to recoil when food toches it

64
Q

Sharpey’s fibres are derived from_____________?
A. Hertwig’s root sheath
B. Epithelial rests of malassez
C. Alveolar bone
D. Dental follicle

A

D

65
Q

composed of epithelial cells, bacteria, bacterial byproducts but it is not adherent (airwater syringe or gargling can remove this.

A

material alba

*biofilm is adherent os it needs mechanical disruption

66
Q

when is the biofilm considered as mature?

A

marked increase in the gram (-) anaerobic bacteria

67
Q

calculus crystalline forms

A

brushite - supragingival
whitlockite - subgingival
octa calcium phosphate - exterior
hydroxyapatite - inner

68
Q

chemical mediators in healthy periodontium

A

IL-10, TGF-b, Tissue inhibitors of MMPs (TIMP) ==> decrease in MMPs

69
Q

chemical mediators with periodontal disease

A

IL-1b, IL-6, TNFa, INF-y, PGE2 ==> increase MMPs

*PGE2 at low levels regulates bone formation; osteoclastic at high levels

70
Q

signals pre-osteoclast to mature into a fully functional osteoclast which will resorb bone?

A

RANK-L (receptor activator nuclear factor kappa-B ligand) - induced by TNF, IL1, PGE2, IL6)

*decoy receptor: Osteoprotegerin (OPG) - blocks the binding of RANKL to RANK

inc RANKL, dec OPG = osteoclastogenic activity

71
Q

rate of progression by Loe et al 1986

A

rapid rate = 0.1-1mm
moderate = 0.05-0.5mm
minimal/no progression = 0.05-0.09mm

clinical attachment loss per year

72
Q

classification of periodontitis according to extent? severity?

A

generalized > 30% of sites are affected (sites affected divided by number of sites examined)

severity:
slight/mild 1-2mm CAL
mod 3-4mm
sev >= 5mm

73
Q

1999 classification
refers to the destructive periodontal disease in patient who demonstrate additional attachment loss at one or more sites despite well executed therapeutic and patient efforts to stop progression (NON RESPONSIVE TO TX)

A

refractory periodontitis

74
Q

component of endo ice

A

difluorodichloromethane

75
Q

where to drill for test cavity?

A

up to DEJ (most sensitive part)

76
Q

most accurate test for pulp vitality?

A

laser doppler test (checks flow of RBC)

77
Q

where to deposit anes during anesthetic test for diffuse or vague pain?

A

deposit first at the distal side of most distal tooth

78
Q

used to determine necrotic pulp or fractured teeth

A

transillumination - fiberoptic light source

79
Q

what is pink tooth mummery

A

internal root resorption
Tx for deciduous: observe/exo
for permanent: rct/exo

Rx: moth-eaten, asymptomatic

80
Q

increase radiopacity of adjacent bone tissues and can be positive or negative to percussion and palpation

A

condensing osteitis or chronic focal sclerosing osteomyelitis
- usually seen with low grade infection and px with good immunity

81
Q

other term for condensing osteitis

A

chronic focal sclerosing osteomyelitis

82
Q

inflammation of the periosteum adjacent to the area of an infected tooth with a periapical lesion is called

A

garre’s osteitis aka proliferative periostitis

83
Q

an exophytic overgrowth of pulpal tissue with a present epithelial surface

A

pulp polyp/ chronic hyperplastic pulpitis

84
Q

root fractures are common to what tooth?

A

mandibular molars

85
Q

vertical vs horizontal root fracture

A

vertical - j-shape, teardrop or halo-like radiolucency; isolated probing defect but without perio disease; poor prognosis

86
Q

tx for monorooted teeth with vertical fracture? for multi-rooted?

A

mono - exo

multirooted - hemisection

87
Q

hemisection vs root amputation

A

hemisection- splitting of mandi molar and removal of affected root involving the crown
root amputation - removal of portion of a root without involving the crown

88
Q

types of horizontal root fracture

A

coronal - tx: stabilize and observe (poorest prognosis due to oral fluids)
middle - usually stabilization and observe
apical - usually observe (best prognosis)

RCT if necessary and apicoectomy if there is continuation of fracture for middle and apical. for coronal, remove the coronal portion.

89
Q

when can you do direct pulp capping

A

pinpoint (0.25 - 0.5mm) mechanical exposure of asymptomatic pulp in a clean, dry field

90
Q

type of medicament for pulpotomy contraindicated for deciduous? and young permanent tooth?

A

deciduous - CaOH - causes internal resorption
open apex - Formocresol - causes cessation of apical closure

91
Q

obturation material for pulpectomy of deciduous

A

vitapex (Calcium hydroxide)
ZOE

Akala ko CaOH causes resorption sa deciduous?

92
Q

tooth that usually have C-shaped orifice

A

mandi 2nd molars
mandi 1st molars
maxi pm (check rudman)

93
Q

outline forms of access prep

A

incisors - ovoid or triangular
canines - ovoid
premolars - ovoid
mx molars - triangular or rhomboidal
md molars - trapezoidal

94
Q

exacerbation of an otherwise asymptomatic apical periodontitis

A

phoenix abscess -same features with acute apical abscess but this happens after initiation of treatment

95
Q

degree of taper of files

A

0.02mm per 1mm

For #15 file at D0 = 0.15mm
D4 = 4 x 0.02 = 0.08 + 0.15mm = 0.23mm

96
Q

length of cutting edge of files

A

16mm

remember ADA spec No. 28 ang endo files

97
Q

number of orifice

A

Maxi incisors = 1
Maxi canines and 2nd PM and mandi incisors to 2nd premolars = 1 but may be 2
Maxi 1st PM = 2 but may be 1
Maxi 6 = 4 but may be 3
maxi 7s and mandi 6s = 3 but may be be 4
mandi 7 = 3 but may be 2

98
Q

laws of access cavity prep

A

law of centrality - always at the center of tooth at the level of CEJ
law of concentricity - wall of pulp chamber are always concentric to the external surface
law of color change - darker floor
first law of symmetry (except mx molars)- orifice are equidistant from a line drawn in MD direction across the floor of the chamber
second law of symmetry - canal orifices lie on a line perpendicular to a line drawn in a MD across the center of the pulp chamber floor
law of orifice location - orifice at junction of walls and floors; always located at the terminus of the root’s developmental fusion lines

99
Q

extra root of mandibular molar

A

radix entomolaris if lingual
radix paramolaris if buccal

100
Q

most common anterior tooth associated with 2 orifices

A

Md lateral incisor (lingual) pero all md anteriors and premolarts can have 2 canals

101
Q

the canal orifice that is most dificult to locate

A

MB2 of mx 1st molars located palatal to MB1

102
Q

posterior tooth with highest endo failure rate

A

mx 1st molar, md 1st molar, mx PM

103
Q

file that cuts only during pulling

A

hedstrom file ( O )
k-files - watch wind and push and pull

104
Q

file number and color

A

6 - pink
8 - gray
10 - purple
12 - orange

white yellow red blue green black

Wala yata red, bruha go black

105
Q

Irrigants and concentration

A

sodium hypochlorite (0.5% to 5.25%)
hydrogen peroxide (3%)
NSS (0.9% NaCl)
chlorhexidine (2% …chx perio is 0.12%; chx medicament is in GEL form)
EDTA 17% (chelator)

106
Q

chelating agent, removes smear layer

A

EDTA 17%
ethylene diamine tetraacetic acid

also used as etchant

107
Q

NaOCl + CHX =

A

parachloroaniline (PCA) orange-red substance

108
Q

Ethylene diamine tetraacetic acid + CHX =

A

white foggy precipitate

109
Q

Medicaments used in RCT

A

calcium hydroxide
camphor monochlorophenol (CMCP)

110
Q

principal component of GP

A

zinc oxide

111
Q

solution to soften GP during retreatmetn

A

chloroform, eucalyptol, xylene/xylol

112
Q

most predominant bacteria in an infected root canal cavity

A

strep and enterococcus (dmf)
primary infection: bacteroides
secondary - enterococcus faecalis
extraradicular - actinomyces

113
Q

recall the patient after root canal after ___

A

6 months

114
Q

apicoectomy cut the root up to?

A

3mm of root with 0-10 degree bevel
then prep another 3mm for retrograde filling

115
Q

autoclave
dry heat
glass bead

A

autoclave (250F) 121C for 20-30mins 15psi
dry heat (320F) 160C for 1hr (dmf) 170C for 1 hr or 160C for 2hrs (decks)
glass bead 450F or 232C for 10 seconds (dmf) 216C (up lec)

Need To Recall (19 decks)

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