EXAM II (First impressions, Occlusion, Types of Clinical Examination, Dental materials & their uses) Flashcards
The communications skills needed for patient-centered care include:
- Eliciting the patients agenda with ______ (especially early on)
- Not _______ the patient
- Engaging in ________
- open-ended questions
- interuppting
- focused active listening
Learning how to improve communications skills will make you a better dentist enabling:
You to better understand the patients needs
As a provider, you need to try and minimizes _____ to mutual understanding
Barriers
As a dentist you treat _____ not ____
Patients; teeth
The most important tool in dentistry:
Communication
What are the five benefits of a good patient-doctor relationship:
- More likely to follow recommendations
- More likely to pay bills on time
- More likely to refer others to your practice
- Reduces anxiety- both patients and yours
- Less likely to sue
Often in dental school its taught that simply providing info is enough to change a patients behavior. Why is this not true?
- Need to motivate patient
- Need to teach/show a patient the VALUE of dentistry
68-70% of medical litigation cases cited ______ as the primary cause
communication
What are the outcomes of good communication between patient & dentist? (4)
- Build trust
- Reduces anxiety
- Pt & Dr are on same page
- Increase patient satisfaction (and therefore your satisfaction)
Having good communication with your patient means that, you have to ______ before you _____ and you pave your way with _____
inform; perform; words
Identify the seven tools to effectively communicate with your patient:
- Body language
- Interactions
- Proper respect
- Patience
- Mechanics
- Simple written instructions
- Ample time
How might you use body language as a tool to effectively communicate with your patient?
- Have body at same level as patients
- Eye contact
- Face them while speaking
How can you make your interactions easier as a tool for effectively communicating with a patient?
- Keep sentences/questions short
- Stay on one topic at a time
- Use clear terms
What are some ways to offer proper respect to your patient as a tool for effective communication with a patient?
- Accommodate their requests
- Offer them choices (rather than speaking in commands)
- Strive to help them maintain their dignity
What are some reasons that may require you to have extra patience with a patient?
Due to their age, physical or cognitive difficulties, they may move and speak more slowly
How might you use having patience with a patient as a tool of effective communication?
Give them time to speak and move at their own pace
Positive patient communication is NOT ______
Rushed
What are some ways to monitor your mechanics as a tool for effective communication?
- Speak clearly & slowly
- Speak louder than usual (w/o yelling)
- Enunciate complex words
- Use simple language as much as possible
Providing _______ when necessary (post-op instructions / treament plans) is a tool for effective communication
simple written instructions
What is a tool of effective communication that can help your patient to feel like a valued partner in the management of their care?
Giving your patient ample time to respond or ask questions
What is perceived, not necessarily what transpired:
Perception
What is one key to the patients perception of the situation.
Organization- remembering how it looks to the patient
_____, ______ & _____ all factor in to how a patients perception on the situation
Delivery, Emotion, Body language
What do we mean by “delivery” when talking about patients perception?
Provide some examples:
How words are spoken
- vocal quality
- tone
- pitch
- emphasis
- volume
- pause inflection
What are some examples of aspects that contribute to body language?
Stance, posture, gesture, use of space
list the three aspects of perception:
- delivery
- emotion
- body language
Nonverbal perception is:
Facial/emotional
A fake smile is considered a ___ smile
A genuine smile is considered a _____ smile
Social; Duchenne
A genuine smile involves:
Eye muscles
Name of genuine smile person:
Duchenne Du Bolonge
- Uh
- You know
- Right
- Okay
- Clearing throat
- Monotone
Unconscious personal habits: vocal/hearing include
Raising eyebrows, fiddling with glasses, hair, beard or earrings:
Unconscious personal habits: Facial/emotional
Spinning pen, foot-tapping, fingernail-tapping, rocking & hand gestures:
Unconscious personal habits
What should you do with your hands while speaking?
- folded
- behind back
- Akimbo (hands on hips & elbows out)
- Fig leaf (placing hands infront of midsection)
Identify non-verbals that promote good conversation:
- Appropriate space (arms length)
- Eye contact
- Eye level
- smile
Office distractions including multi-tasking, chart-reviewing & staff interuptions are all examples of:
Roadblocks to good listneing
Identify the verbals that promote good conversation:
- open-ended questions
- use Mr. Mrs. or Ms. unless they ask you to do so otherwise
- Don’t rush
- Give patient a chance to talk
Identify the verbals that inhibit good conversation:
- Rushing to diagnose- let patient be a part in the decision making
- Asking close-ended questions
Arrogance, sarcasm, high-pressure marketing can all be considered:
Negative dentist, attitudes
- Making sure the patient is comfortable
- Being flexible to ensure patient acceptance
- Leaving time for emergency visits
These are all ways for a dentist to be:
Accomodating
Identify some reasons patients avoid dental care:
- Previous dental experiences
- Dental anxiety
When should you typically communicate with other faculty:
Usually away from the patient
Reasons for dental anxiety: (3)
- Choking (gagging & suction)
- Embarrassment (being judged, scared of lecture & feeling that teeth can’t be saved)
- Parents (bad experiences when young)
What are the three initial contact questions you should be asking:
- How long since your last dental visit
- What kind of past treatment? How was it?
- Do you have any concerns about receiving dental treatment?
Physiological signs of dental anxiety: (3)
- Perspiration (forehead, hands, palms, upper-lip, under-arms)
- Cardiovascular (BP & HR)
- Respiration (Rate & depth)
- Explain procedures before starting
- Give specific info during procedures
- Give reassurance
- Give the patient some control (such as raising hand if they feel pain)
- Provide distraction
- Build trust
- Show personal warmth
- Stress-reduction protocol
These are all:
Ways to reduce anxiety
A condition in which there is a deflection from the normal relation of the teeth to other teeth in the same arch and/or to teeth in the opposing arch:
Malocclusion
Angles classification was developed in _____ by _____-
1899; Edward H. Angle
Angle’s classification is based on the relationship of the _____
The MB CUSP of the maxillary 1st molar & the BUCCAL GROOVE of the mandibular first molar
Describe Angle’s Class I:
MB cusp of maxillary 1st molar BISECTS buccal groove of mandibular 1st molar
MB cusp of maxillary 1st molar bissects buccal groove of mandibular 1st molar:
Angle’s class I
Same as normal occlusion, but characterized by crowding, rotations, and other positional irregularities:
Class I- Malocclusion
A Class I- malocclusion is the same as normal occlusion but is characterized by _____, _____ & other ______
Crowding, rotations & other positional irregularities
This image shows:
Class I- with severe crowding & labially errupted canines
Describe Angle’s Class II:
MB CUSP of maxillary 1st molar is MESIAL to mandibular 1st molar’s BUCCAL GROOVE
Angle’s class II in simple terms can be described as:
Overbite
MB cusp of maxillary 1st molar is MESIAL to mandibular 1st molars BUCCAL GROOVE
Angle’s Class II
Diagnose this occlusion:
Angle’s Class II
Diagnose this occlusion:
Top: Normal occlusion
Bottom: Class I- malocclusion
Diagnose this occlusion:
Angle’s Class II
Describe Angle’s class III:
MB cusp of maxillary 1st molar is DISTAL to the BUCCAL GROOVE of mandibular 1st molar
Angle’s class III in simple terms can be described as:
Underbite
Diagnose this occlusion:
Class III- malocclusion
The HORIZONTAL overlap of the maxillary central incisors over the mandibular central incisors:
Overjet
When discussing overjet & overbite, we are describing the relationships between what teeth?
Maxillary & mandibular central incisors
Overjet is measured using:
Periodontal probe
A typical measurement for overjet:
Usually 2-3 mm
The VERTICAL overlap of the maxillary central incisors over the mandibular central incisors:
Overbite
Overjet is describing a _____ overlap while overbite is describing a _______ overlap
Overjet= horizontal
Overbite= vertical
How much of the maxillary teeth cover up the mandibular teeth would describe:
Overbite
The amount of overbite is measured using:
Periodontal probe vertically
A typical overbite measurement:
Usually 2-3 mm or approximately 20-30% of the heigh of the mandibular incisors
A is showing:
B is showing:
A= Overbite
B= Overjet
Diagnose this image:
Anterior crossbite
Diagnose this image:
Posterior crossbite
Diagnose this image:
Posterior crossbite
ETW:
Erosive tooth wear
Generally, ETW is classified according to the specific:
Mechanism that is responsible for the wear
Mechanisms of wear that are responsible for ETW:
- Erosion
- Abfraction
- Abrasion
- Attrition
The etiology of dental wear is multifactorial with complex relationships between three types of wear, including:
- Attrition
- Erosion
- Abrasion
Evidence of occlusal wear/trauma include:
- Wear facets
- Broken restorations
- Chipped teeth
List the evidence of Bruxism: (5)
- Bony ridges-exostosis, tori
- Recession
- Abfraction
- Broken teeth & restorations
- Excessive attrition
Describe the abfraction seen in bruxism:
Loss in cervical area
This image shows evidence of:
Bruxism
Mechanical wear of the incisal or occlusal surface as a result of functional or para-functional movements of the mandible (tooth-to-tooth contact):
Attrition
Bruxism accelerates _______
Attrition
Attrition can be _______ related
Age
In attrition occlusal surface match _______ and usually have a similar degree of wear
Jaw movements
Diagnose this image:
Attrition
Cervical wedge-shaped defects in teeth:
Abfraction
Bruxism resulting in cervical loss of the cervical area of the tooth under the flexure load:
Abfraction
Abfraction can be described as:
Physical wear
Diagnose this image
Abfraction
A form of physical wear along the gingival margin that is not caused by bacterial acid activity
Abfraction
What is the shape of the defects in abfraction and where are they located?
Wedge-shaped; cervical portion of the tooth right by the gingiva
Diagnose this image:
Abfraction
Abnormal surface loss resulting from direct frictional forces between the teeth & external object or from frictional forces between contacting teeth in the presence of an abrasive medium:
Abrasion
Abrasion is abnormal surface loss, resulting from ______ between the teeth and external objects, or from _____ between contacting teeth in the presence of an ________
Direct frictional forces; frictional forces; abrasive medium
What may cause abrasion: (3)
- improper brushing techniques
- Habits
- Vigorous use of toothpicks
What is the most common cause for abrasion?
Improper brushing techniques
Abrasion due to improper brushing techniques typically results in:
V-shaped notch in the gingival 1/3 of the tooth
What is an example of a habit that may lead to abrasion?
Holding a pipe stem between the teeth
Interproximal abrasion may be due to:
Toothpicks
Incisal notching abrasion may be due to:
Nails, pipe
Cervical abrasion may be due to:
Toothbrushing
What are three locations for abrasion?
- Interproximal
- Incisal notching
- Cervical
Diagnose this image (be specific):
Interproximal abrasion
Wear or loss of tooth structure by chemicomechanical action:
Erosion
Erosion is wear or loss of tooth structure by:
Chemicomechanical action
Where is erosion seen on the tooth?
Facial & lingual
What are some causes of facial erosion of teeth?
Lemons, chlorine
What is the main cause of lingual erosion?
Bulimia
Diagnose this image (be specific):
Facial erosion
Diagnose tis image (be specific):
What might this be caused by?
Lingual erosion; bulimia
What are oral signs of bulimia?
- “Raised” amalgams
- Thermal sensitivity
This image is showing a patient with potential:
Bulimia
Describe what might occur to the dentition of a bulimic patient: (3)
- Thinning or chipping of incisal edges
- Anterior open bite
- Loss of vertical dimension
The foundation of any form of successful treatment is:
Accurate diagnosis
The bridge between the study of disease and the treatment of illness:
Diagnosis
You should always _____ before you perform
Inform
If it isnt written:
It didn’t happen
Types of clinical examinations include: (5)
- Comprehensive dental diagnosis
- Periodic/recall diagnosis
- Diagnosis of a specific problem
- Emergency diagnosis
- Screening diagnosis
The diagnostic method can modified to most effectively:
Address the needs of the patient
- Pain, acute infection, bleeding, or traumatic injury require immediate attention
These are all:
Chief complaints that require immediate care
A chief complain can be something that requires immediate care or can also be:
a request for less urgent care
In the C.C., patients may report several complaints, which are listed in order of priority:
As stated by the patient
C.C.:
Chief complaint
What is the most extensive diagnostic treatment?
Comprehensive dental diagnosis
A comprehensive dental diagnosis may also be called:
Initial diagnosis or IOE
What would be the reasons to classify the appointment as a “Comprehensive Dental Diagnosis”
- Patient who wants total dental care who has not previously been seen
- Patient of record who has not been seen for 3-5 years
- Patient of record who has had major change in medical/dental history
The part of the comprehensive dental diagnosis that starts the minute you see the patient:
Physical exam & assessment
In a comprehensive dental diagnosis, when you are asking the patient about systemic disease, surgeries, current medications, & allergies:
Detailed medical history
When taking a detailed medical history, it is important to ask about what types of medications:
Both RX & OTC
When you are taking a detailed medical history in a comprehensive dental diagnosis, this is when you establish:
ASA class
After getting the detailed medical history in a comprehensive dental diagnosis, it is now time for:
Intra/extra oral evaluation & Perioral conditions
Following the intra/extra oral evaluation & noting perioral condition, what is the next step of a comprehensive dental diagnosis?
Dental radiographs
What dental radiographs are obtained during a comprehensive dental diagnosis?
FMXR vs. Pano & BWX
Following taking radiographs in a comprehensive dental diagnosis, the next step is to:
Making diagnostic casts
The data obtained in a comprehensive dental diagnosis is of value because:
It serves as the patients initial status which serve for comparison later in assessing treatment effectiveness
Comprehensive dental diagnosis require _______ but it reliably provides a _______ for comprehensive dental care
Considerable time; sound diagnostic foundation
A comprehensive dental diagnosis can _______ by documentation of the patients initial status if treatment complications occur & lead to accusations of sub-standard care
Protect the clinician
Periodic diagnosis may also be referred to as a:
Recall diagnosis
This type of appointment is appropriate for a patient who requests total dental care when the results of a prior comprehensive dental diagnosis are available:
Periodic diagnosis
What is the assumption regarding the prior comprehensive exam when seeing a patient for a periodic diagnosis:
The assumption is that a portion of past information in still accurate, but other aspects of the patients medical/dental history may have changed
A periodic recall diagnosis ususally is a ______ interval
6-month
What is the goal of a periodic diagnosis:
Goal is to identify conditions that have changed & supplement the prior database so that it reflects the patients current status
A periodic diagnosis can be as simple as _______ or as complex as ______
Simple as asking patient if there has been any changes since the last appointment or as complex as repeating most of the comprehensive dental diagnosis
What is ALWAYS a good practice regardless of the time interval between appointments with a patient:
Asking if there has been any changes since the last appointment
In a periodic diagnosis examination, if a different clinician conducted the original diagnosis, the current dentist must:
Must confirm the accuracy of prior data & record current findings prior to diagnostic decisions
If someone comes in with a specific problem, this appointment type would be considered:
Diagnosis of a specific problem (or limited exam)
The diagnosis of a specific problem (limited exam) is _____ focused:
problem
For a recently evaluated patient, a diagnosis of a specific problem/limited exam serves as a:
Second opinion
The ______ is an effective approach to such situations if the available diagnostic database is current & accurate (during diagnosis of a specific problem/limited exam)
SOAP evaluation
_____ form is in Axium
SOAP
What category of a SOAP note is this information classified as:
The reason for the evaluation:
CC (Chief complaint)
What category of a SOAP note is this information classified as:
Information or symptoms of the condition as supply by the patient. Patient’s chief concern or complaint. It is recorded in the PATIENTS OWN WORDS
S: Subjective
What category of a SOAP note is this information classified as:
Physical findings of the clinician. Includes visual finding, periodontal assessment, clinical tests (percussion, palpations, vitality tests.)
O: Objective
What category of a SOAP note is this information classified as:
Clinical impression of the condition by the clinician. THIS IS THE DIAGNOSIS
A: Analysis
What category of a SOAP note is this information classified as:
Recommended management of the problem. May be specific treatment, referral, or dismissal of the condition as clinically insignificant
P: Plan
What category of a SOAP note is this information classified as:
“Tootheach on the upper right for the last 2 weeks- getting worse.” Patient reports pain to cold & hot, duration 5-10 minutes, loss of sleep & requires Motrin 3-4x day.
S: Subjective
What category of a SOAP note is this information classified as:
Grossly decayed #3 (+) response to percussion & palpation, (-) swelling, mobility.
O: Objective
What category of a SOAP note is this information classified as:
Caries, necrotic pulp, - tooth is restorable
A: Analysis
What category of a SOAP note is this information classified as:
Discussed treatment options including RCT and crown vs. extraction. Risk/benefits of each procedure explained. Patient refers RCT & understands that the tooth may need crown lengthening procedure
P: Plan
A SOAP note would be used in what type of examination:
Diagnosis of specific problem/limited exam
Type of appointment that is designed to manage a chief complaint such as pain, bleeding, or acute infection that required immediate attention:
Emergency diagnosis
In an emergency diagnosis, the ________ is sacrificed in the interest of providing attention to the ______
Comprehensive diagnostic evaluation; urgent problem
In an emergency diagnosis appointment, the physical examination is limited to:
The chief complaint
In an emergency diagnosis, the patients CC can be demanding & interfere with:
Obtaining an adequate patient history
Type of appointment in which specific questions about the patient are answered:
Screening diagnosis
In this type of appointment, the evaluation is limited to obtaining the information needed to answer the question without accepting comprehensive diagnosis or treatment responsibility for the patient:
Screening diagnosis
Institutions often rely on a screening diagnosis to determine:
The patient’s general dental treatment needs
_____ is the most common symptom arising in the mouth, face & neck area
Pain
Most common reasons for emergency appointements:
Pain
Pain is ______ & unlike an ulcer, there may be nothing to assess ______
Subjecive; Visually
In order to diagnose pain, you need to be _____ and have _____
A good listener; have good follow-up questions
What questions would you as a provider would you as a provider ask a patient regarding their pain? (7)
- How would you describe the pain?
- When did you first notice the pain?
- Is the pain continuous or does it go away?
- Does it wake you up at night?
- Has it gotten better, worse or stayed the same?
- Have you taken anything for the pain?
- Anything make it worse? Anything make it better?
Descriptive words for pain:
- Dull/throbbing
- Sharp/stabbing
- Burning
Pain arising from pathology is usually:
Unilateral
Other symptoms related to pain that may indicate an infective origin: (7)
- Swelling
- Discharge
- Bad taste
- Bad breath
- Elevated temperature
- Malaise
- Cervical lymphadenopathy
Dental biocompatibility works both ways meaning:
The material may affect the environment and/or the environment may affect the material
The material must be of benefit to the patient and above all, the patient must be:
Safe from any adverse reactions
The biological reaction can take place at either:
- At the local level
- Far removed from the contact site
What is an example of a biological reaction taking place at a local level:
Injection site rxn
What is an example of a biological reaction that occurs far removed from the site of contact:
Systemically-adverse Rx
Adverse reaction from acrylic monomer in denture:
Denture stomatitis (a systemic reaction)
Systemic reactions to a biocompatibility reaction may not always be:
readily apparent
What are some examples of systemically-adverse reactions that may not always be readily apparent:
- Dermatological
- Immune-mediated
- Neural reactions
What is the most common reaction to dental staff:
Hand/facial dermatitis or respiratory symptoms
List the possible interactions between dental restorative material and the biological environment: (4)
- Postoperative sensitivity
- Toxicity
- Corrosion
- Hypersensitivity/allergy
What interaction between dental material & the biological environment is being described below:
Nanomaterial (size of 1-100nm) growing concern about their biosecurity & crossing the blood-brain barrier & going to the central nervous system
Toxicity
What interaction between dental material & the biological environment is being described below:
Amalgam or its components may cause type IV (usually 24-48 hours after exposure) on the oral mucosa
Hypersensitivity/Allergy
If amalgam causes a hypersensitivity reaction:
- What type of hypersensitivity reaction is this
- When will it likely occur
- Where does it likely occur
- Type IV
- 24-48 hours after exposure
- Oral mucosa
In the study regarding contact allergies to dental materials:
- What were the most common allergies to?
- What were the most common allergens
- What did denture resins show?
- metals
- nickel & cobalt
- Mucosal changes, contact stomatitis & burning sensations in the mouth
Some patients can develop allergic/hypersensitivity reactions to even very small quantities of:
Metals
Even in very small quanities, some patients will develop an allergic/hypersensitivity reactions to the following metals: (3)
- Mercury
- Nickel
- Cobalt
Direct contact of oral mucosa to this material can cause oral lichenoid lesions (OLL):
Mercury
Chronic inflammatory lesion on the oral mucosa, can be caused by exposure to mercury:
OLL (Oral Lichenoid Lesion)
In order to determine if a patient can tolerate ______ we should ask if they can wear costume jewelry:
Nickel
What is the diagnosis of the following image?
Oral lichen planus
What can be seen in the following image?
Amalgam tattoo
What is the diagnosis of the following image?
Mucosal Melanoma
A rare but highly aggressive neoplasma of the oral cavity
Mucosal melanoma
One of the most common causes of allergic contact dermatitis & produces ore allergic reactions than all other metals combined:
Nickel hypersensitivity
Several brands of orthodontic wires are made of:
Nickel titanium alloy
Non-precious metal crowns contain high levels of ______. Some as high as 55%
Nickel
The following image is a reaction to:
Nickel
Some people with _____ allergies have allergic symptoms around & in the mouth & throat after eating raw fresh fruits, vegetables, nuts or seeds which contain cross-reactive proteins to this.
Pollen allergies
Diagnose what is seen in the following image:
Oral hypersensitivity reaction
What metal is commonly found in dental implants?
Titanium
Dental practicioners are _______ for the materials to which a patient will be exposed
ultimately responsible
Sargenti paste for root canals:
Paraformaldehyde
Dentists must have a knowledge & understanding of the ______ of materials to be used and how these might affect the patient
composition
Materials that cause destruction of connective tissue, bone, nerves, chronic infection & pain would be materials that cause ______ damage
What is one material that might cause this:
Irreversible; Paraformaldehyde-containing endodontic filling materials
A concern of paraformaldehyde-containing endodontic materials is that they can through the:
- Body-blood
- Lymph nodes
- Adrenal glands
- Kidney
5.Brain
Leaders in science-based biological dentistry:
IAOMT (International academy of oral medicine & toxicology)
If you wish to remove mercury amalgams, fillings or metal-based crowns it is recommended to use an IAOMT dentist certified in the:
SMART (Safe Mercury Amalgam Technique)
HAD- improving overall health through dentistry
Holistic Dental Association
Some materials have a distinctly _____ effect on the pulp
Positive
A material that has a positive effect on the dental pulp by stimulating tertiary dentin formation:
Calcium hydroxide
Since a restoration may have an adverse effect on the pulp, a range of materials termed _______ have been developed to be applied to the dentin, prior to the placement of the final restoration:
Intermediate restorative materials (IRMs)
When are IRMs placed, where are they placed?
Prior to the placement to the final restoration & applied to the dentin
Cavity varnishes, bases & liners are all examples of:
Intermediate restorative materials
Intermediate restorative materials are intended to remain ______ & should not be confused with _____
permanently; temporary restorative materials
The role of IRMs may be: (3)
- protective
- palliative
- therapeutic
The goal of this material is to protect the pulp from chemical, electrical & thermal reactions:
IRMs
What is an example of an electrical reaction that IRMs protect against:
Galvanic-shock-dissimilar metals
IRMs protect the pulp from: (3)
- Chemical
- Electrical
- Thermal
Give an example of a specific IRM and the qualities it posseses:
Zinc oxide-eugenol (ZOE)
Sedative like qualities on hypersensitive pulp & is a good thermal insulator as well
Intermediate restorative material:
- acts as a _____
- Excellent ______ resistance
- Good _____ properties
- Low ______
- May be used under cements & restorative materials that DO NOT contain resin components such as: ____,____ & _____
- Thermal insulator
- Abrasion
- Sealing
- Solubility
- Amalgams, inlays & onlays
What can intermediate restorative materials NOT be placed under:
amalgams, inlays & onlays
This material should NOT discolor a tooth or the restoration:
Intermediate restorative materials
A ______ should harden quick enough to allow subsequent insertion of the restoration:
Intermediate restorative materials
An IRM should be able to withstand the _______ of the over laying restoration
condensation
An IRM should be easily ________
manipulated
IRMs are liners and bases are materials placed between dentin (and sometimes pulp) and the restoration to provide: (2)
- Pulpal protection
- Pulpal response
As far as use of an IRM, protective needs for a restoration vary depending on: (3)
- Location of the restoration
- Extent of the restoration
- Restorative material being used
How is the characteristic of the liner to or base to be used as the IRM selected?
largely by the purpose its expected to serve
Because they share similar objectives/properties liners and bases are not:
Fully distinguishable
The IRM that is a thick mix of material which is placed in bulk; used as dentin replacement to minimize final restorative material:
Bases
What IRM serves to block out undercuts?
Bases
The type of IRM that is only applied as a thin coating over exposed dentin:
Liners
What type of IRM is placed less than 0.5mm thick and is able to promote health of the pulp by adhesion or antibacterial action?
Liners
A liner should be less than 0.5mm thick and is able to promote health of the pulp by: (2)
- adhesion
- antibacterial action
Primary role is to protect the pulp:
Liner
Liners form a strong bond to _____ and prevent _____
Dentin; fluid movement down the dentin tubules
Functions to provide a bacterial barrier
Liner
Liners cause sustained _____ release:
Fluoride
Give an example of an intermediate restorative material that may be used as a liner or base:
Vitrebond
Light Cure Resin- modified glass ionomer that can be used under composite, amalgam, metal and ceramic restorations
Vitrebond
What can Vitrebond be used under?
What is Vitrebond NOT indicated for?
Composite, amalgam, metal, ceramic restorations
Direct pulp capping
Calcium Hydroxide - Ca(OH)2 that is highly alkaline with a pH of 11-12.5
Liner
Liners are highly _____ with a pH of _____
alkaline
11-12.5
Liners contain ______ activity which retains its anti-bacterial properties for about ______
Bactericidal activity
2 months
Liners cause the formation of ______
Tertiary dentin
Liners can be used for _____ & ______ pulp capping
direct & indirect
Calcium hydroxide liner that can be self curing OR light cured
Dycal
A natural gum (copal), resin, or synthetic resin dissolved in organic solvent
Varnish
Varnishes:
- Has some _____ & ____ properties
- Easily seeps into open ______
- Prevents transfer of ________ to ______
- We use _____ instead of varnishes at SOD
- Antiviral & antimicrobial
- Dentin tubules
- Heat & cold to dentin & pulp
- Vitrebond
Varnishes are not to be used under ________
Why?
composite restorations; because they interfere with the setting reaction
Glass ionomers; prevents fluoride release
A varnish used as an insulating layer under gold & amalgam restorations
Copalite
In a shallow tooth prep what should be placed:
Nothing, vitrebond or varnish
In a moderate depth tooth prep what should be placed:
Liners ma be placed (for thermal protection & pulpal medication) along with varnish
In a very deep tooth prep what should be placed:
Liner (may be calcium hydroxide) then the base Vitrebond or IRM