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Treatment Planning > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Subjective
Can Only be reported by the patients

A

Symptom

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2
Q

“It hurts”
“ I feel tired”
“keeps me awake at night”
“I have a metallic taste”

A

Symptom

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3
Q

Objective
Can be observed/ measured

A

Sign

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4
Q

Increased pulse rate, BP, temp
Radiographic findings
observed swelling
Provocation test results

A

Sign

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5
Q

Listen to your patients for __ of disease and evaluate your patient for __ of disease

A

symptoms
signs

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6
Q

If the dentist can observe or measure a reported symptom, the symptom is

A

also a sign

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7
Q

When would you do a provocation test

A

unexplained periapical radiolucency
Isolation of diffuse dental pain
Determine vitality of discolored teeth
Determination of perio vs endo origin

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8
Q

What are the 4 types of provocation tests

A

Percussion
Cold
Heat
Electric pulp test

(ONLY USE if needed)

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9
Q

What are the 4 possible results of provocation tests

A

Normal pulp
Necrotic pulp (No results)
Reversible pulpitis
Irreversible pulpitis

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10
Q

Reversible pulpitis

A

Responds quicker to stimulus than control tooth
Pain subsides quickly with removal of stimulus (pain goes away fast)

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11
Q

Irreversible pulpitis

A

Responds quicker to stimulus than control tooth
Pain lingers
Pain more intense
Pain spontaneous
Heat sensitivity

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12
Q

What are the treatment options for irreversible pulpitis

A

Endodontic therapy (If tooth is restorable)
Extraction (Non-restorable or finances)

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13
Q

Patient needs endo therapy because there is irreversible pulpitis and tooth is restorable, need to get patient out of pain for today, what do we do

A

Emergency pulpal debridement (cant charge for endo and pulpal debridement on same day)

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14
Q

Radiographically how do you know if there is necrotic pulp

A

Possible periapical RL
- Not all periapical RL are associated with necotic pulp (cyst, tumors, cementomas)
Some necrotic pulps do not present with periapical radiolucencies (Bone loss has to be present to show)

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15
Q

Possible signs and symptoms of necrotic pulp

A

Possible intraoral swelling, extraoral swelling, percussion sensitivity, possible pain, possibly febrile

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16
Q

If pulp is necrotic what are provocation test results

A

For EPT, cold test and heat test it would all test negative
For percussion test it could test positive or negative (Tap it could hurt)

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17
Q

T/F: If tooth is not restorable we do endo

A

FALSE if not restorable = no endo

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18
Q

Internal vs external resorption is diagnosed by

A

evaluating radiographs taken at different angles
(internal resorption will always be in the middle of the pulp, external and look like its in the middle of the pulp or external based on the angles)

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19
Q

Endodontic success rates

A

Initial Tx: 90%+

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20
Q

Factors that decrease endodontic prognosis

A

calcified canals
pulp stones
dilacerated roots
Root fracture
Root resorption
Retreatment

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21
Q

T/F: Necrosis does not decrease the endodontic prognosis for that tooth

A

TRUE

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22
Q

What falls under periodontal disease

A

Gingivitis and periodontitis (both are forms of periodontal disease)

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23
Q

Localized vs generalized perio is determined by

A

teeth involved
Localized: <30% of teeth evaluated

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24
Q

Must have __ for a diagnosis of periodontitis

A

CAL
(Can only do an SRP if they have perio = means they have to have CAL)

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25
What is the difference between the two perio codes
one is 4+ teeth per quad other is 1-3 teeth per quad
26
How is perio disease addressed in treatment planning
OHI Tobacco counseling SRP Replace defective restorations protective restorations (use GI) Perio re-eval (phase I) Perio surgery Preventive review Perio review Maintenance schedule
27
perio is only treatment planned after
all contributing factors are eliminated
28
Perio re-eval vs perio review
Perio re-eval = following up on perio you have treated Perio review = looks at whole pt again to see if there are new perio findings since 1st exam (end of phase 1 and phase 2)
29
What determines restorative surfaces
Line angles
30
ULSD amalgam uses
Anterior direct restorations (class III distal of canines, lingual class V) Posterior direct restorations Cores
31
ULSD Composite uses
Anterior direct restorations (class III, V, VI and composite veneers) Posterior direct restorations Cores
32
ULSD Class II composite indications
Small/ moderate restorations with enamel margins (doesnt bond well to cementum) Most premolars and molars A restoration that does not provide all of the occlusal contact A restoration that does not have heavy occlusal contacts Ability to obtain good isolations
33
Advantages of composite veneers vs porcelain (7)
reversible test restoration less expensive single appointment shade can be modified easy to repair life span 5-8 years
34
Disadvantages of composite veneers vs procelain
difficult to mask severe staining thin edges chip and stain pits/voids tend to stain become flat looking with wear relatively short life span
35
Advantages of glass ionomer
Cosmetics (vs amalgam, but not as esthetic as composite) Fluoride release Bonds to dentin and enamel Minimal prep Good provisional material
36
glass Ionomer disadvantage
Esthetics inferior to composites more prone to fracture than composites more prone to wear than composites
37
At ULSD we dont use glass ionomer in any area that is
providing occlusion (Class v on #20 = yes) (DO on #20 = no)
38
Uses for glass ionomer at ULSD Fuju II LC Fuji IX GP
Class V restorations Emergency repair of fractured tooth Protective restoration after E&E Provisional during active TX Margin repairs on indirect restorations
39
What to know about Dycal
Direct/indirect pulp caps Pulpal irritant promotes tertiary dentin formation does NOT bond to tooth (why we cover GI) Sets quickly Easy to place Highly soluble (why we cover GI) Poor compressive strength (disadvantage) (why we cover GI)
40
Patients has irreversible/ reversible pulpitis and is in pain, do we place dycal
NO, because it irritates pulp and will only hurt more (still would promote tertiary dentin but would be more painful)
41
What to know about Vitrebond LC plus
RM glass ionomer Used as a liner (not for a direct pulp cap) Bonds to tooth (but is not a bonding agent) Thermal insulator Non-irritating to pulp (doesn't produce tertiary dentin)
42
Clinical caries are __ than radiographic decay
larger
43
Suspected radiographic carious lesions __
must be verified clinically
44
Clinically detected caries must __
be restored even without radiographic verification
45
Caries is driven by
frequency of eating
46
Each time S. Mutan is exposed to __, what is produced
sucrose lactic acid (this is what dissolves tooth)
47
After a carious lesion is initiated, __ can utilize __
lactobacillus any fermentable sugar
48
If you see a picture of caries, what bacteria is present
lactobacillus
49
Frequency of sugar is worse than
super high amount of sugar
50
Step mutans initiates caries because if produces __ plaque from sucrose than other bacteria It also can survive in an __
more adherent acidic environment (when others cant)
51
S. Mutans initiates caries process utilizing __
sucrose
52
__ becomes the predominant bacteria in a lesion after caries process is initiated
Lactobacillus
53
Lactobacillus is the most efficient __ bacteria
acid producing (why cavities go bad fast) Acidophilic
54
Lactobacillus can utilize
ANY fermentable sugar (avoid carbs)
55
During mineralization of a tooth, fluoride is circulated via blood plasma to tissues surrounding the __. Fluoride is incorporated into the __ as __
tooth bud enamel matrix fluorapatite
56
After tooth mineralization but pre-eruption: Fluoride is deposited in __ which is beneficial if it occurs within __
surface enamel 2 years of eruption (Fluoride before tooth eruption is important)
57
Post eruption: Fluoride is deposited in __ and inhibits __ and enhances __
surface enamel demineralization remineralization
58
Post-eruption: Demineralized areas have the greatest __ Benefits occur throughout the life of tooth
uptake of topical fluoride
59
Fluoride protects against caries by
Making enamel more resistant to demineralization promoting remineralization in areas of demineralization Inhibiting plaque bacteria from growing and producing acid
60
Preventive review and restorative review addresses
caries
61
Always treatment plan a crown foundation as a __
core if an indirect restoration is planned
62
Core build up includes
Pins
63
Kentucky medicaid does not pay for
cores (Instead tx plan these cores for the anticipated restorative material and surfaces)
64
When may a properly placed core function as a long term restoration
Questionable periodontal prognosis Patient compliance issues Financial constraints Patient health status
65
The only purpose for a post is for
retention of the core
66
The General consent form is for __ and does not meet the requirements for __
diagnostic data collection informed consent
67
Causes of hard tissue loss:
Decalcification erosion (non-bacterial) Abrasion Attrition Abfraction Periodontitis Endodontic issues Trauma Oral cancer
68
Causes of soft tissue loss:
Toothbrush abrasion harmful oral habits periodontitis endodontic issues trauma oral cancer
69
A posterior tooth that has been endo treated needs
Full cuspal coverage
70
Crowns make a tooth
weaker
71
Extraction of hopeless teeth: address on __ or __
limited TP or sequenced early in comprehensive TP (Want out ASAP)
72
Extract hopeless teeth before
SRP adjacent restorations
73
Categories of service D0100-D099 D1000-D1999 D2000-D2999 D3000-D3999 D4000-D4999 D5000-D5899 D5900-D5999 D6000-D6199 D6200-D6999 D7000-D7999 D8000-D8999 D9000-D9999
Diagnostic Preventative Restorative Endodontics Periodontics Prosthodontics, removable Maxillofacial Prosthetics Implant Services Prosthodontics, fixed Oral & Maxillofacial surgery Orthodontics Adjunctive General Services

Treatment Planning (2 decks)

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