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Exam 3 Flashcards

1
Q

A ring or cap, usually of metal, put around the end of a post, cane, or the like, to prevent fracturing

A

Ferrule

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2
Q

Ferrule effect is a __ issue

A

mechanical

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3
Q

A good ferrule prevents __

A

fracture

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4
Q

Biologic width is a __ issue

A

biologic

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5
Q

Ferrule effect and biologic width are __ but __

A

related
NOT the same thing

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6
Q

Ferrule effect is important on all teeth, but is of particular importance on __

A

endodontically treated teeth

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7
Q

In dentistry, the ferrule effect must be __

A

at least 2 mm circumferentially

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8
Q

The more ferrule the better __

A

mechanically

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9
Q

Ferrule effect is limited by

A

biologic width

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10
Q

The amount of tooth structure available to obtain adequate ferrule effect is determined by the __of the biologic width

A

location

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11
Q

Biologic width =

A

distance established by junctional epithelium (the attachment) and the connective tissue attachment to the root surface of the tooth

(Distance from where the perio probe would stop (hitting the attachment) down through tissue attachment)

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12
Q

Biologic width is also known as

A

SCAT

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13
Q

A restoration __ is considered a violation of the biologic width

A

1mm or less from the epithelial attachment

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14
Q

If your restoration is going to be 1mm or less from the epithelial attachment, what must be done

A

It must be moved = crown lengthening

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15
Q

What are the 2 types of crown lengthening

A

Periodontal hard tissue crown lengthening
Orthodontic extrusion

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16
Q

Both types of crown lengthening give __ to work with

A

more clinical crown

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17
Q

Take bone and soft tissue away from the tooth to expose more clinical crown

A

periodontal hard tissue crown lengthening

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18
Q

Pull tooth out of the tissue/ bone

A

Orthodontic extrusion

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19
Q

What are the advantages of periodontal hard tissue crown lengthening

A

Faster than orthodontic extrusion (done in one appointment)
May be more cosmetic during procedure
- May place provisional restoration
- No orthodontic appliances

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20
Q

What are the disadvantages of periodontal hard tissue crown lengthening

A

Possible post-op cosmetic concern (loss of papilla)
Removal of bone support in surgical area (effect tooth you are working on and teeth next to it - inform patient)
Possible furcation exposure (more important in max arch than mandibular)

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21
Q

Advantages of orthodontic extrusion for crown lengthening

A

Usually more cosmetic final result
Less loss of bone support (but still loosing bone support)

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22
Q

Disadvantages of orthodontic extrusion for crown lengthening

A

More treatment time (6-8 weeks / 3 m)
Less favorable Crown:Root
May require additional periodontal procedure (Depending on how quickly/slowly its done - if slow, bone may come with and may need to be recountoured)
Less cosmetic during procedure

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23
Q

Is a core done before or after crown lengthening

A

Place a core ASAP!
Especially in endo treated tooth to keep from getting contaminated
So if you can do a core before a crown lengthening it is preferred
Limiting factor = can you get a matrix band on the tooth to place the core

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24
Q

Perio re-eval vs. perio review

A

Perio re-eval = checking the area you already provided treatment to
Perio review= at the end of phase I and phase II, review perio again as a whole (basically another perio exam)

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25
When is a perio re-eval done
after all contributing factors have been eliminated/controlled
26
What are the contributing factors that need to be eliminated/controlled before a perio re-eval can be completed
Poor OH Calculus Rough cemental surfaces Iatrogenic factors Open proximal contacts Systemic issues
27
When should the perio re-eval be done
Allow adequate time for healing after periodontal therapy (4-6 weeks)
28
With a perio re-eval don't confuse TP sequence with time between appointments!
Re-eval can be listed immediately after an SRP in the TX plan because there is nothing else to do in between, but that doesn't mean we do it the next day, we do it the next appointment (4-6 weeks from SRP)
29
Perio re-eval evaluates
Efficacy of previous treatment (usually SRP, looking at PD (want no more than 4mm) and BOP (want none)) Need for further treatment Referral to grad perio? (or redo SRP on DMD level) Prognosis of teeth post treatment (can they still be used for what we want to use them for (prosthodontically) - may need a new prosthodontic consult) Plaque index (OH)
30
D7880 - occlusal orthotic device vs D9944 - Occlusal guard
D7880 - occlusal orthotic device = Indicated for occlusal guards on patients with TMD signs/ symptoms D9944 - Occlusal guard = Indicated to prevent wear or protect restorations - NO history of TMD or headache pain
31
Sequencing non-emergency TMD exams/ treatment in TP considerations
Occlusal guard is phase I treatment by definition (disease process = wear on teeth) BUT If phase II is planned, usually included at the end of phase II (we do this because we don't want to have to remake the guard from phase I after fixed prosth. work was done.If doing phase II tx, especially with anything fixed = occlusal guard goes at the end of phase II)
32
If TMD appointment is indicated use code __ If emergency = If not emergency =
D7880 Limited TP for TMD Tx Insert in TP where appropriate
33
These are examples of immediate goals / things done on a limited treatment plan prior to comprehensive treatment plan
Emergency Tx Urgent Care: Tx. to prevent emergency Temporary restorations OH issues Remove hopeless teeth
34
An exposed pulp __ for an Endodontic procedure
may not be indicated (direct pulp cap)
35
Direct Pulp Cap D3110
Small exposure that is isolated and bleeding is controlled --> can try to get this tooth to heal itself --> Dycal (remember Dycal is an irritant - tooth may be sensitive for awhile. Tooth hopefully will lay down tertiary dentin and repair itself)
36
Every tooth that has an exposure __
is not indicated for an Endodontic procedure (Don't do endo unless we have to because it makes the tooth weaker)
37
What is done prior to developing a comprehensive TP
Diagnostic data collection - NONE of these items are included in a comprehensive tx plan because we need the info from these to develop the tx plan
38
What is included in diagnostic data collection (11)
Medical history/ follow up Patient's Chief concern Dental history Social/ demographic information Clinical Examinations Radiographs Caries risk assessment Pathology follow-up Clinical consultations Indicated provocation tests Current vitals
39
Cracked teeth have specific signs and symptoms and are difficult to diagnose and treat. What are the clinical signs of a cracked tooth? (9)
None Small craze lines Definitive crack (radiographic/clinical) Periodontal defect (2/3 mm pockets and then jump to a 6mm pocket) Crack with separation Mobile segment Missing tooth structure Fistulous Tract Provocation Test results
40
Extraction codes What is the difference between the D7100 and D7200 codes
D7100 codes are extractions that only require elevator/forceps (Don't have to lay a flap/ take bone/ section roots - comes out in one piece) Tooth is erupted! (or root is exposed) D7200 codes require more than an elevator/ forceps (surgical)
41
Of the D7200 codes for surgical extraction what is the difference between D7210 from the others
D7210 is a surgical extraction requiring more than elevator/forceps but the tooth is erupted! (Not impacted) where as all the rest of the surgical extraction codes the tooth is impacted (D7250 = removal of residual tooth roots, this is a root you CAN NOT see in the patients mouth, if you can see the root = D7210)
42
CDT code for survey crown
There is NO CDT code for a survey crown! - Just use CDT code for crown (Difference in how you prepare the tooth and how you write the Rx for survey crown but CDT code = same)
43
Restorative codes (survey crowns)
D2000-D2999
44
CDT code for survey FPD
NO CDT code for survey FDP- Just use CDT code for retainer crown
45
Fixed Prosthodontics codes (Survey FPD)
D6200-D6999
46
How do you code for pontics for different purposes
A pontic is a pontic is a pontic ! CDT codes are the same for FPD bridge, Implant supported bridge.. etc
47
Failure to replace missing posterior teeth can lead to
loss of arch integrity --> posterior bite collapse
48
What needs to be considered/ discussed with the patient if a posterior tooth is being removed
What will happen to adjacent teeth (tooth falls into space - this can cause a space to open on the other side trapping food and leading to decay) What can happen to arch integrity (loss of posterior support - anterior teeth can flare) What happens to opposing arch (upper tooth drifts down) In this case ortho is the only option because now the space needed to replace the missing tooth is no longer available
49
Patient education issue: (results of posterior bite collapse) (7)
Potential tipping of teeth Potential over-eruption of teeth increased RISK for periodntal disease Increases caries RISK Change in occlusal relationships Increased mobility of anterior teeth Potential flaring of anterior teeth Let patient know about the increased RISKS - doesn't mean they are going to get it, not a hopeless situation, just requires more care
50
FPD treatment planning considerations - Inter-arch relationship (Over eruption of tooth adjacent to edentulous space)
Need to fix over erupted tooth before FPD (bridge) Or if doing a crown for this tooth it can be TX planned at the same time to all be made by the lab at the same time Just cant do the FPD by itself without addressing the over erupted tooth and the come back to that tooth after
51
What are the 4 categories of implants
Abutment supported implant single crowns Implant supported implant single crowns Abutment supported implant FPD retainers Implant supported implant FPD retainers
52
Implant services CDT codes
D6000-D6199
53
Abutment supported implant single crowns
2 codes (code for abutment and abutment supported crown) (screw retained)
54
Implant supported single crowns
1 single code (implant supported crown) (Screw retained- no abutment)
55
Abutment supported implant FDP retainers
2 implants so 2 abutment codes are needed (2 abutment codes and 1 abutment supported retainer code) (+ code for pontic)
56
Implant supported implant FPD retainers
NO abutments are treatment planed (Implant supported retainer code only) (+code for pontic)
57
Radiographic/ Surgical implant index we use what code
Student fabricated code - D2190A (Free of charge)
58
Radiographic/ Surgical implant index are treatment planned per
Per arch! Missing #3 and 19 --> Need code for UA and LA Missing #3 and 14 --> need only one code for UA
59
When planning an implant what does "stages" refer to
"Stages" refers to number of surgical procedures required to expose the restorative platform of the implant (Area we attach the abutment or area where screw goes in)
60
Tissue level implants are __ stage surgical procedures
one stage
61
Bone level implants are __ stage surgical procedures
Could be one stage or two stage surgical procedures If used a healing abutment = one If used a healing cap = two
62
For an overdenture implant gets what codes
Just implant code not a crown code
63
Implant considerations: Available bone = What is the difference between ridge preservation procedure and ridge augmentation procedure
Ridge Preservation Procedure= Resident Tx plans in conjunction with extraction. Preserve ridge when tooth is taken out in prep for implant. Done and Tx planned by a resident! (CDT code = same, fee= different). Done at the time the tooth is taken out Ridge Augmentation Procedure = Increasing bone horizontally more predictable. Augment ridge that doesn't have enough bone in order to place in implant where it need to be.
64
How many codes are there for Removables
CDs/RPDs Immediate CDs/RPDs Interim CDs/RPDs and Immediate Interim CDs/RPDs have the same codes
65
What removable is NOT done at ULSD
Immediate CDs/RPDs Intended to be definitive prosthesis after tissue healing and relining, inserted immediately after extraction or remaining teeth in arch
66
Interim Prosthesis
Designed to be replaced and only to be used for a limited period of time
67
When is the impression taken for an interim prosthesis
Most of posterior teeth have already been removed before the impression, Then when last few are taken out we have something to give
68
What else is NOT done at ULSD
Don't do an mandibular interim CD (BUT we do do an interim mandibular RPD)
69
Immediate interim dentures are planned to be inserted __
immediately after extractions
70
Interim CD and immediate interim CD have the same __
CDT code
71
An immediate interim is inserted into the treatment plan at the time __
of the impression (The sequnce with which you treatment plan an interim tells you if its immediate or not - do to codes being the same)
72
Advantages of immediate interim dentures
Esthetics Function (possibly) Maintain VDO (Possibly) Natural teeth provide guide for placement of prosthetic teeth (if natural teeth are in the spot you want them to be - incisal placement) Test for permanent CD : - VDO (possibly) - shape/shade of teeth - esthetic - phonetics
73
Preservation of ridge and immediate interim dentures
NOT an advantage of interim dentures
74
Allow __ for healing of posterior teeth extractions before immediate interim
6-8 weeks
75
Impression for immediate interim prosthesis is inserted into TP prior to
remaining extractions
76
With an immediate interim CD, RPD what other code needs to be inserted
D5850A D5851A NO ULSD fee for tissue conditioning for immediate interim (there is a fee for tissue conditioning otherwise)
77
Add how many tissue conditioning codes for each interim prosthesis
Add two tissue conditioning codes near end of phase I treatment for each interim prosthesis Per arch (Phase I because prepros surgery)
78
Diagnostic data of limited treatment patients (patient referred in for tx)
Medical history Ck-list tx mods medical consults as needed current diagnostic radiographs Provocation tests as needed Relevant peridontal data (not full perio charting unless they have perio issues) Dental consults as needed Diagnostic casts as needed

Treatment Planning (2 decks)

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