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Module 7 > ISCE > Flashcards

ISCE Flashcards

1
Q

What diet advice can you give to a patient?

A
  • limit consumption of food and drinks containing sugar
  • drink only water in between meals
  • snack on foods which are low in sugar e.g., fresh fruit, carrot sticks, breadsticks, cheese
  • do not eat or drink after brushing at night
  • be aware of hidden sugars in foods and the acid content of drinks
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2
Q

explain to a patient how sugar contributes to caries and further pulp infection

A

sugar fuels the growth of harmful bacteria in the mouth which produce acid that damages tooth enamel

demineralisation of enamel occurs and if the acid attacks are frequent it doesnt have the time to repair itself so it weakens. this eventually forms cavities in the teeth

if left untreated the decay can progress to the softer layer under enamel and further reach the pulp where the nerve of the tooth is. this will cause pain and infection

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3
Q

what is the fluoride concentrations for toothpaste for children at low risk of caries?

A

under 3 years old - 1000ppm smear
3-9 years old - 1000-1500ppm pea size
10+ years old - 1450ppm pea sized

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4
Q

what is the recommended fluoride concentration in toothpaste for children at a high risk of caries?

A

under 3 years old - smear of 1450ppm
3-9 years old: pea sized 1450ppm
10+ years old: pea sized 2800ppm

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5
Q

when do we place fissure sealants?

A

as soon as the permanent molars erupt

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6
Q

what types of fissure sealants are available and why may you use each type?

A

resin based (1st choice) - child is cooperative, seal all buccal bits and fissured
GI - precooperative child

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7
Q

what are the recommendations for fluoride varnish application?

A

for children aged 2+: apply 2 times a year
for children aged 2+ at high risk of caries: apply 4 times a year

2-5 years: 0.25ml
5-7 years: 0.4ml

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8
Q

what fluoride strength if fluoride varnish?

A

22600ppm

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9
Q

fluoride varnish contraindications?

A

elastoplast/ colophony allergy
hospitalisation due to asthma

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10
Q

what is the general guidance for treatment of children at high risk of caries?

A
  1. hands on toothbrushing advice at every recall
  2. provide diet advice at every recall
  3. recommend the use of higher fluoride toothpaste (can prescribe 2800ppm for aged 10+)
  4. fissure seal palatal pits on upper laterals, occlusal surfaces of Ds, Es, 6s and 7s
  5. optimal fluoride varnish application -4xyear
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11
Q

what are the indications for hall crowns?

A
  1. interproximal caries
  2. multisurface caries
  3. pulp treated teeth
  4. retaining MIH molars
    must be a clear band of dentine between caries and pulp
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12
Q

what are the contraindications for hall crowns?

A
  1. pulpal symptoms or caries close/ in pulp
  2. patients at risk of infective endocarditis
  3. insufficient tooth remaining to retain crown
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13
Q

how do you choose the correct size of hall crown?

A

you will feel a spring back when seating on tooth

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14
Q

what are hall crowns cemented with? and what may you want to warn the child of when cementing the crown?

A

GI cement - salty taste

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15
Q

what is your post op advice for hall crowns?

A

a high bite is normal and will settle
post op pain relief may be needed
recall in 3 months

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16
Q

how long are separators placed for prior to hall crown?

A

3-5 days

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17
Q

when may you refer a child patient with a full deciduous dentition to ortho?

A

severe skeletal discrepancies
delayed dental development
missing/ supplemental teeth
advice for balancing/ compensating extractions

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18
Q

when may you refer a child patient with mixed dentition to ortho?

A
  • severe skeletal patterns where early treatment may be appropriate e.g., developing class II/III
  • dental anomalies
  • teeth in unfavourable conditions e.g., canines
  • impacted 6s
  • infraoccluded teeth
  • crossbites
  • FPMs have poor prognosis
  • advice following trauma of permanent teeth
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19
Q

what is the general signs of normal development in the mixed dentition?

A

normal eruption pattern
contralateral teeth erupt within 6/12
midline diastema normal
maxillary canines palpable at 10 years old

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20
Q

why is a history of trauma important to an orthodontist?

A

ankylosed teeth will not comply with ortho treatment

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21
Q

aetiology of hypodontia?

A

single gene defect - MSX1
sequelae of severe disease and cancer tx in early childhood
syndromes: ectodermal dysplasia, downs syndrome, cleft lip/palate

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22
Q

what teeth are most commonly affected by hypodontia?

A

lower 5s
upper 2s
upper 5s
lower 1s

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23
Q

what teeth should a child have at 6months old - 1 year?

A

upper and lower As

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24
Q

what teeth should a child have at age 9 months - 1.5years?

A

upper and lower As
upper and lower Bs

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25
Q

what teeth should a child have from the age 1 year - 18 months?

A

upper and lower As
upper and lower Bs
upper and lower Ds

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26
Q

what teeth should a child have from the age 1.5year - 2 years old?

A

upper and lower As
upper and lower Bs
upper and lower Ds
upper and lower Cs

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27
Q

what teeth should a child have by the age 2- 2.5 years?

A

full dentition

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28
Q

what permanent teeth should a child aged 6 have?

A

upper and lower 6s
lower 1s

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29
Q

what permanent teeth should a child age 9 have?

A

upper and lower 6s
upper and lower 1s
upper and lower 2s
lower 3s coming in

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30
Q

what permanent teeth should a child aged 7 have?

A

upper and lower 6s
upper and lower 1s
lower 2s coming in

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31
Q

what permanent teeth should a child aged 8 have?

A

upper and lower 6s
upper and lower 1s
lower 2s
upper 2s coming in

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32
Q

what permanent teeth should a child aged 10 have?

A

upper and lower 6s
upper and lower 1s
upper and lower 2s
lower 3s
4s and upper 5s coming in

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33
Q

what permanent teeth should a child aged 11 have?

A

upper and lower 6s
upper and lower 1s
upper and lower 2s
lower 3s, upper 3s coming in
upper and lower 4s
upper and lower 5s coming in
upper and lower 7s coming in

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34
Q

what permanent teeth should a child aged 12 have?

A

everything bar 8s and maybe 7s

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35
Q

at what age do we palpate the buccal sulcus for upper canines?

A

8-9

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36
Q

how do we classify supernumerary teeth?

A

by position and/or shape

position: mesiodens, paramolar
shape: conical, tuberculate, supplemental, odontoma

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37
Q

what supernumerary teeth are found in the midline maxilla? are they of concern?

A

conical mesiodens
often impede eruption

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38
Q

describe tuberculate supernumerary teeth? are they of concern?

A

barrel shaped teeth which dont usually erupt
often impede eruption of others

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39
Q

what are supplemental teeth?

A

supernumerary teeth of normal anatomy
tend to erupt
often extra lateral, premolar

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40
Q

what are odontomes?

A

benign odontogenic tumours which dont erupt
complex or compound types

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41
Q

what is the most common microdont? is it of concern?

A

a peg lateral
normally associated with palatally ectopic canines

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42
Q

what are the 2 types of macrodonts?

A

gemination
fusion

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43
Q

what is of concern with a tooth which has dens evaginatus?

A

the dentine on the additional cusp may become exposed as it is worn down
the extra cusp contains pulp horn so there is an increased risk of the tooth losing vitality

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44
Q

aetiology of dilaceration?

A

acquired defect
trauma to the primary tooth - avulsion/ intrusion

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45
Q

aetiology of MIH?

A

early childhood illness - high fevers, infections, hypoxia

during birth - prematurity, assisted delivery, SCBU

genetic predisposition

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46
Q

what questions may you ask to differentiate MIH from AI from fluorosis?

A

AI - family history, primary dentition affected too

fluorosis - excessive toothpaste consumption, water source what country

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47
Q

clinical appearance of MIH?

A

affects cusps and smooth surfaces
white - yellow - beige - brown
fractures cusps (PEB)
variation in severity

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48
Q

symptoms of MIH?

A

sensitivity

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49
Q

what are treatment options for MIH molars?

A

fissure seal
hall crown
onlays cuspal coverage
restoration
xla

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50
Q

what are treatment options for MIH incisors?

A

microabrasion
whitening
composite camouflage/ veneer
do nothing
resin infiltration

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51
Q

what are the considerations for xla of MIH FPMs?

A

restorability
age of pt and dental development: bifurcation of 7s
symptoms - infection
xray - presence of 8s and 5s
crowding/ class I (ideal)

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52
Q

what is a balancing extraction?

A

taking teeth from same arch

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53
Q

what is compensating extractions?

A

take teeth from upper and lower arch on same side

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54
Q

when may you want to use SDF?

A

pt high risk of caries and precooperative
treatment is challenged by medical conditions
pt has several carious lesions that cant be treated in 1 visit
pts without access to dental care

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55
Q

how often are bitewings taken?

A

high caries risk - 6/12
low caries risk (primary dentition) - annual
low caries risk (permanent dentition) - 2 yearly

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56
Q

why can immature teeth withstand trauma better?

A

open apex - larger vascular supply

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57
Q

what are the trauma investigations?

A

sinus
colour
TTP
mobility
EPT
ethyl chloride
percussion note
radiograph

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58
Q

what signs may imply a safeguarding issue?

A

swellings
back of neck bruising
multiple bruises at different healing stages
frenum injury
black eye
lacerations

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59
Q

a tooth has been traumatised.
it is displaced with mobility and there are signs of root fracture.
diagnosis and treatment?

A

diagnosis: root fracture
treatment:
if coronal segment is displaced, reposition and splint for 4 weeks
if cervical fracture, splint for 4 months
monitor pulp status for 1 year

in mature teeth, if fracture is above alveolar crest, consider post core and crown

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60
Q

a tooth has been traumatised.
it is displaced with mobility but no signs of root fracture.
diagnosis and treatment?

A

diagnosis: extrusion
treatment:
reposition under LA and splint for 2 weeks
monitor pulp status

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61
Q

a tooth has been traumatised.
it is displaced but has no mobility. multiple teeth are moving as a unit.
diagnosis and treatment?

A

diagnosis: alveolar fracture
treatment:
reposition segment and splint for 4 weeks
suture any gingival lacerations
monitor pulp status

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62
Q

a tooth has been traumatised.
it is displaced but has no mobility. multiple teeth do not move as a unit. it looks infraoccluded.
diagnosis and treatment?

A

diagnosis: intrusion

treatment (incomplete root formation):
allow for re-eruption without intervention for 4 weeks. no re-eruption = ortho
monitor pulp status

treatment (complete root formation):
<3mm - allow re-eruption
3-7mm - surgical/ ortho
>7mm - surgical

pulp death is likely: initiate RCT at 2 weeks with calcium hydroxide

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63
Q

a tooth has been traumatised.
it shows no displacement and has mobility. It is TTP.
diagnosis and treatment?

A

diagnosis: subluxation

treatment: splint for 2 weeks for comfort and monitor pulp status for 1 year

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64
Q

a tooth has been traumatised.
it is not displaced and has no mobility.
diagnosis and treatment?

A

diagnosis: concussion
treatment: monitor pulp status for 1 year

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65
Q

treatment for enamel fracture?

A

bond fragment back on or restore with composite

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66
Q

treatment for enamel dentine fracture?

A

bond fragment back on after rehydrating in saline for 20 mins
restore with GIC/ composite
place CaOH liner if close to pulp

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67
Q

treatment for enamel-dentine-pulp fracture?

A

partial pulpotomy/ pulp cap followed by restoration

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68
Q

treatment for crown-root fracture with no pulp exposure?

A

stabilise mobile fragment
if not possible, extract and cover with GIC
ortho extrusion of non mobile fragment, RCT, and crown lengthen etc

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69
Q

treatment for a crown-root fracture with pulp exposure?

A

stabilise of extract mobile fragment
immature root: pulpotomy
mature root: pulpectomy + GIC/ composite

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70
Q

what advice should you give to parent/ teacher/ gaurdian on the phone if a childs tooth has been avulsed?

A
  1. reassure the patient
  2. hold the tooth by the crown (white part) and avoid touching the root
  3. if the tooth is dirty, rinse with milk, saline or the pts saliva, avoid scrubbing
  4. if possible, replant tooth immediately into socket and get pt to gently bite down on a handkerchief/ napkin
  5. if replantation not possible, store the tooth in milk, saliva or saline. if these are unavailable store in water
  6. visit dentist asap
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71
Q

what are the steps in replanting an avulsed tooth?

A
  1. clean and soak tooth in saline to remove dead cells from root surface
  2. LA
  3. irrigate socket with saline
  4. reposition any socket fracture
  5. replant tooth with gentle pressure
  6. suture any gingival lacerations
  7. take xray
  8. apply 2 week splint
  9. prescribe abx
  10. if tooth came in contact with soil - refer to GP for tetanus booster
  11. start RCT after 7-10 days
  12. 2 week follow up, remove splint

review 1,3,6,12 months then annually for 5 years

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72
Q

what are some considerations if an avulsed tooth has been out the mouth for more than 60 minutes?

A

removal of non-viable tissue
consider RCT prior to replanting
warn pt of ankylosis

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73
Q

how does treatment of an avulsed tooth differ if it has an open apex?

A

same steps to reimplantation but avoid RCT unless evidence of necrosis

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74
Q

post op advice for a reimplanted avulsed tooth?

A

avoid contact sports
soft diet for 2 weeks
brush teeth after every meal with a soft toothbrush
chlorhexidine mouthwash 2xday for 7 days

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75
Q

what type of trauma would you use a rigid/ flexible splint?

A

alveolar fracture

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76
Q

when would you perform a direct pulp cap?

A

immediate pinpoint exposures

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77
Q

how would you treat a tooth with signs of pulpal necrosis?

A

primary tooth: xla
permanent tooth with closed apex: RCT
permanent tooth with open apex: RCT with MTA apical stop

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78
Q

how would you treat a tooth with pulpal obliteration?

A

primary tooth: no rx unless sympotmatic, xla
permanent tooth: no rx unless symptomatic, RCT but very difficult

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79
Q

how would you treat a tooth with external inflammatory resorption?

A

RCT

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80
Q

how would you treat a tooth with cervical resorption?

A

RCT if necrotic

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81
Q

how would you treat a tooth with internal inflammatory resorption?

A

RCT

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82
Q

how would you treat a tooth with replacement resorption?

A

monitor

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83
Q

what are treatment options for infraoccluded teeth?

A

decoronation: allow root to bury beneath mucosa and resorb into bone then implant

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84
Q

when would you decide to use an active clamp for rubber dam?

A

if the tooth is badly broken down or partially erupted

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85
Q

when would you decide to use an anterior clamp?

A

teeth with minimal coronal structure or retraction of gingival tissues for placement of composite/ GI cervically

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86
Q

what shape is the access cavity for incisors? how many canals would you find?

A

triangle (base at the incisal edge)
1 canal

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87
Q

what shape is the access cavity for canines? how many canals would you find?

A

oval
1 canal

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88
Q

what shape is the access cavity for premolars? how many canals would you find?

A

oval
1 canal except for upper 4 has 2 (P and B)

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89
Q

what shape is access cavity for maxillary first molars? how many canals would you find?

A

triangle in mesial section of tooth - base is buccal and point extends down to palatal

4 canals (MB1 MB2 DB P)

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90
Q

what shape is the access cavity for maxillary second molars? how many canals would you find?

A

triangle in mesial portion of tooth

3 canals (MB DB P)

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91
Q

what shape is access cavity in mandibular first molars? how many canals would you find?

A

triangle mesial to distal

3 canals (MB ML D)

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92
Q

what shape is access cavity in mandibular second molars? how many canals would you find?

A

triangle mesial to distal

3 canals (MB ML D)

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93
Q

what are the properties of GP?

A

biocompatible
thermoplastic
radioopaque
insoluble
does not support bacterial growth
easy to manipulate and adapts well with compaction in canals

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94
Q

what do you use for interappointment medicament for RCT? what are its properties?

A

non setting calcium hydroxide
- kills bacterial
- reduces inflammation
- helps eliminate apical exudate
- controls inflammatory root resorption

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95
Q

what are the 4 irrigants that can be used for RCT? what are their properties?

A

sodium hypochlorite - bactericidal and dissolves organic debris
10% citric acid - removes organic material
17% EDTA - softens dentine and removes inorganic material
2% chlorhexidine - antimicrobial and removes smear layer

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96
Q

what are the available hand instruments for endo and what are they made from?

A

stainless steel

  • K file
  • Flexofile
  • Hedstrom file
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97
Q

what are the properties of rotary NiTi files with added M wire?

A

super elasticity
shape memory

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98
Q

what is the aim of a pulpotomy?

A

to remove infected pulp and treat remaining healthy pulp to maintain a tooths vitality and to allow root development if an immature tooth

99
Q

what are the stages of a pulpotomy?

A
  • local
  • rubber dam
  • amputate pulp with high speed until you see bleeding
  • arrest bleeding with cotton wool soaked in saline/ LA
  • dress exposed pulp with non setting CaOH/ MTA
  • cover with RMGI cement only covering dentine and light cure
  • composite restoration
100
Q

what is the aim of an immediate composite banadage?

A

seal over exposed dentine tubules - typically for pts with poor cooperation, limited time, purposely restoring a tooth short of occlusion

101
Q

what are the stages in an immediate composite bandage?

A
  • moisture control
  • etch, prime and bond
  • pre rolled composite to cover pulp cap and exposed dentine
102
Q

what are the stages placing a post?

A
  • remove GP from pulp chamber
  • remove GP with gates gliden leaving 4-6mm apically
  • shape post hole with twist drill series, ensuring diameter no greater than 1/3 root
  • relyX light and chemically cured
  • place post
103
Q

when preping a tooth for a crown what is the desired taper?

A

6 degree

104
Q

what are the functioning cusps?

A

FLUP (facial lower upper palatal)

105
Q

what are the reductions and margins for a metal crown?

A

occlusal 1mm
axial 0.5mm
any finishing margin

106
Q

what are the reduction and margins for metal ceramic crown?

A

occlusal 1mm, axial 0.5mm, chamfer
occlusal 2mm, axial 1.5mm, shoulder

107
Q

what are the reductions and margins for ceramic crown?

A

occlusal 1.5mm
axial 1mm
chamfer

108
Q

what is the ideal pontic design?

A

modified ridge lap

109
Q

what type of bridge may you want to use when there are unrestored/ minimally restored teeth with good quality enamel? why?

A

resin retained cantilever
minimal prep required: cingulum rests, mesial slots, occlusal rests

110
Q

where is nasion?

A

the most anterior point of the frontonasal suture in the median plane

111
Q

where is sella?

A

mid point of the pituitary fossa (sella turcica)

112
Q

where is point A?

A

deepest concavity on the maxilla

113
Q

where is point B?

A

deepest concavity of the mandibular symphysis

114
Q

where is ANS?

A

tip of the bony anterior nasal spine in the median plane

115
Q

where is PNS?

A

tip of the posterior nasal spine

116
Q

where is Pognion?

A

most anterior point on the mandibular symphysis

117
Q

where is menton?

A

most inferior point on the mandibular symphysis

118
Q

where is gonion?

A

most posterior and inferior point on the angle of the mandible (intersection of ramus plane and mandibular plane)

119
Q

what plane lines are drawn on a lat ceph?

A

S-N (cranial base)
ANS-PNS (maxilla)
Go-Me (mandible)
N-A
N-B
Upper and Lower incisor

120
Q

what does the SNA angle measure?

A

maxilla in relation to cranial base

121
Q

what does the SNB angle measure?

A

mandible in relation to cranial base

122
Q

what does the ANB angle measure?

A

maxilla and mandible in relation to each other

123
Q

what does MMPA measure?

A

intersection of mandibular and maxillary plane

124
Q

what is the rickets esthetic plane?

A

soft tissue chin and nose tip

125
Q

what does MOCDO stand for?

A

missing
overjet
crossbite
displacement
overbite

126
Q

what comes under missing and scores 5?

A

Cleft lip/palate
Impacted teeth
Hypodontia >4 teeth

127
Q

what overjet scores 5?

A

overjet >9mm
reverse overjet >3.5mm with masticatory issues

128
Q

what overjet scores 4?

A

> 6mm overjet
3.5mm reverse overjet w/o masticatory issues

129
Q

what overjet scores 3?

A

> 3.5mm overjet with incompetent lips
1mm reverse overjet

130
Q

what overjet scores 2?

A

> 3.5mm overjet with competent lips

131
Q

what crossbite scores 4?

A

crossbite with >2mm displacement

132
Q

what crossbite scores 3?

A

crossbite with >1mm displacement

133
Q

what crossbite scores 2?

A

crossbite with <1mm displacement

134
Q

what displacement scores 4?

A

> 4mm contact point displacement

135
Q

what displacement scores 3?

A

> 2mm contact point displacement

136
Q

what displacement scores 2?

A

> 1mm contact point displacement

137
Q

what overbite scores 4?

A

increased and complete overbite with trauma
>4mm openbite

138
Q

what overbite scores 3?

A

increased and complete overbite no trauma
>2mm openbite

139
Q

what overbite scores 2?

A

> 3.5mm overbite
1mm openbite

140
Q

describe Kennedy class I?

A

bilateral free end saddles

141
Q

describe kennedy class II?

A

unilateral free end saddle

142
Q

describe Kennedy class III?

A

bounded saddle not crossing the midline

143
Q

describe Kennedy class IV?

A

unilateral saddle crossing the midline

144
Q

what tool is used to assess anxiety?

A

MDAS
MCDAS (for children)

145
Q

what is used for inhalation sedation and how is it administered?

A

nitrous oxide/ oxygen - through a small nasal mask

146
Q

what state is the patient put in with inhalation sedation?

A

a state of relaxation and mild euphoria
quick onset and recovery
patient remains conscious and responsive throughout

147
Q

what drug is used for intravenous sedation and how is it adminstered?

A

midazolam - administered through a vein in arm/ hand

148
Q

what state is the patient in with IV sedation?

A

deeper level of sedation
patient is conscious but may have little to no memory of the procedure (amnesia)
may last several hours

149
Q

what drug is used for oral sedation and how is it administered?

A

diazepam - taken as tablet/ liquid form before dental appt

150
Q

what state is the patient in with oral sedation?

A

calm drowsy state
takes 30-60 mins to take effect

151
Q

what drug is used for GA and how is it administered?

A

propofol - administered by an anaesthetist in hospital

152
Q

what state is the patient in under GA?

A

completely unconscious
will be completely unaware of procedure

153
Q

what is the sequence of burs used to create an access cavity?

A

round diamond high speed - 1mm into enamel for the outline
long fissure diamond high speed - deepen access toward roof
gates glidden (slow speed long shank) - remove roof of pulp chamber
non end cutting high speed - flare and finish axial walls

154
Q

what is present in anterior teeth that must be removed with the gates glidden during access cavity?

A

palatal shelf

155
Q

what does the shape of an access cavity depend on?

A

position of canal orifices and pulp horns

156
Q

how is the long shanked round bur used for enlargement of the access cavity?

A

it works on the dentinal walls with a brushing motion to remove all dentine overhangs

157
Q

explain access cavity prep for a canine?

A

initial outline cut at 45 degrees to palatal/lingual surface (1mm deep)

change to fissure bur and proceed down the long axis of the tooth

use long shank to remove roof of pulp chamber and palatal shelf with an upward stroke movement

158
Q

what rpm and torque are protaper gold files used at?

A

300rpm
torque 4

159
Q

what is the sequence of instrumentation?

A
  1. locate canals
  2. coronal flare with SX
  3. initial negotiation and measure WL, confirm apical patency
  4. create glide path
  5. shape canal to working length with protaper gold s1 and s2
  6. complete apical prep using sizes F1-F5 as determined by apical gauging
160
Q

what instrument do you use to negotiate the canal?

A

size 10 ss flexofile
(can drop down sizes if toot tight)

161
Q

if using radiograph to determine WL, what do you measure?

A

1mm within radiographic apex

162
Q

at what point can you start creating the macro glide path?

A

once a size 10 file has reached WL and feels ‘loose’

163
Q

what is used to enhance the glide path?

A

proglider

164
Q

what rpm and torque is proglider used at?

A

300rpm
torque 2

165
Q

list important guidelines for safe use of rotary instruments?

A

constant speed of rotation with torque control
irrigation before engaging file
light pressure and progress slowly, withdraw when resistance is felt
do not stop/start in the canal
clean files regularly during use
irrigate, recapitulate, and irrigate between each rotary file

166
Q

what rpm and torque are the shaping files used at?

A

300rpm
torque 4

167
Q

what does apical preparation determine? and what process is used?

A

the diameter of the canal at the apical constriction
apical gauging

168
Q

what do finishing files do?

A

shape the apical 1/3

169
Q

what is a reproducible reference point when determining the WL?

A

cusp tip

170
Q

what is the apical constriction?

A

the narrowest part of the junction between pulpal and periodontal tissue

171
Q

how do you use the EAL?

A

size 10 file
irrigant in canal but not pulp chamber
ask pt to wet lip clip with tongue
ensure no contact with metal restorations
use a little glyde to improve conductivity

172
Q

what is apical patency?

A

the ability to pass a small flexofile passively through the apical constriction without widening it

173
Q

what is used for final irrigation?

A

3ml sodium hypochlorite
3ml citric acid
3ml sodium hypochlorite

174
Q

what are the stages after final irrigation?

A

dry canals with corresponding size of paper points
dress with non setting calcium hydroxide
cotton wool/ spongue/ septotape
coltisol
GI

175
Q

what is used instead of non setting calcium hydroxide for an emergency pulpotomy?

A

ledermix/ odontopaste

176
Q

contraindications for ledermix/ odontopaste?

A

pregnancy and breast feeding

known hypersensitivity to corticoids and clindamycins

177
Q

what is retention form?

A

retain restoration in an occlusal direction

178
Q

what is resistance form?

A

prevent dislodgement to lateral and oblique forces

179
Q

what are the reductions and finishing margins for an all metal crown?

A

0.5mm axial
1mm occlusal

any margin

180
Q

what are the reductions and finishing margins for ceramic bonded to metal crown?

A

0.5mm for metal + 1mm for ceramic = 1.5mm axial
1mm occlusal for metal
2mm occlusal for ceramic

chamfer for metal
shoulder for ceramic

181
Q

what are the reductions for a full ceramic/ composite crown?

A

0.6-1mm axial
1-1.5mm occlusal

chamfer margin

182
Q

what is the crown prep sequence?

A
  1. occlusal reduction
  2. axial reductions
  3. finishing line
  4. smoothing
183
Q

how is the labial surface of an anterior tooth prepped for a crown?

A

2 plane reduction

184
Q

what is the wing retainer on a resin retained bridge made from?

A

metal allow or fibre impregnated resin

185
Q

what preparations can be performed for a resin retained bridge?

A

cingulum rest
gingival finish line
removal of undercuts
occlusal rests

186
Q

where does a cingulum rest lie?

A

between the mesial and distal marginal grooves

187
Q

how deep are resin retained bridge preps?

A

0.5mm into enamel

188
Q

list some paediatric behaviour management techniques?

A

tell, show, do
behaviour shaping
reinforcement
modelling
desensitisation

189
Q

what age must you be for IV sedation?

A

> 12 years

190
Q

is midazolam still used for sedation?

A

no longer indicated in the UK

191
Q

list some local causes of delayed eruption?

A

congential absence
crowding
retained primary tooth
supernumeraries
crown/ root dilaceration
dentigerous cyst
trauma to primary tooth

192
Q

difference between type I and II DI?

A

I - associated with osteogenesis imperfecta
II - teeth only

193
Q

what are the sequelae of trauma to primary teeth?

A

discolouration
- grey/reddish (this can be reversible)
- grey (necrosis)
- yellow (pulp obliteration)

ankylosis

pulp necrosis

193
Q

max dose of LA for a child pt?

A

4.4mg/kg

193
Q

what file is used to locate the canals?

A

DG16

194
Q

what files are used to negotiate canals and determine WL?

A

08 and 10 flexofiles

195
Q

what file is used to verify apical patency and confirm glide path?

A

flexofile

196
Q

what file is used to enhance the glide path?

A

proglider

197
Q

what speed and torque is proglider used at?

A

300rpm
2Ncm

198
Q

what are the properties of non setting calcium hydroxide?

A
  • kills bacteria and inactivates endotoxin
  • reduces inflammation
  • helps eliminate apical exudate
  • controls inflammatory root resorpiton
199
Q

what type of sealer is used for cold lateral compaction?

A

resin based (AH plus)

200
Q

what is MTA?

A

calcium silicate cement

201
Q

what are the properties of MTA?

A
  • used as a root end filling material (apexification)
  • creates a physical barrier
  • releases calcium hydroxide when it sets
  • biocompatible and can set in the presence of moisture
202
Q

what is odontopaste?

A

antibiotic/ steroid paste

203
Q

what are the properties of odontopaste?

A
  • used for hyperaemic pulp
  • decreases inflammation
  • contains calcium hydroxide, clindamycin and a steroid
204
Q

what is hypocal/ ultracal used for?

A

an interappointment medicament where there is persistent inflammatory exudate from periapical tissues

205
Q

what does diagnostic mounting for conventional bridgework involve?

A
  • imps of both arches
  • facebow record
  • casts mounted on a semi-adjustable articulator in ICP/RCP
206
Q

what does diagnostic waxing for conventional bridgework involve?

A
  • assess aesthetics and occlusion
  • an impression of the wax up can be taken in silicone putty
  • finalise the design
207
Q

what must you ensure when doing conventional bridgework preparations?

A

parallel preps

208
Q

how is the temporary bridge for conventional bridgework constructed?

A
  • using the putty impression of the wax up
  • fill with protemp
  • cement with tempbond
209
Q

when would you take occlusal registration for conventional bridgework?

A

if the casts couldn’t be mounted in ICP

210
Q

for PFM bridgework what must you do before the porcelain is added?

A

try in the metal framework

211
Q

what cement is used for trial cementation of conventional bridgework?

A

tempbond

212
Q

what cement is used for permanent cementation of conventional bridgework?

A

traditional
RMGIC

213
Q

what are causes of bridge failure?

A

loss of retention
mechanical failure
abutment issues (perio disease/ loss of vitality)

214
Q

what design is usually used for a resin bonded bridge?

A

cantilever

215
Q

how are resin bonded bridges classified?

A

by retention:
Rochette - perforated (macromechanical)
Maryland - electrolytically etched (micromechanical)
sandblasted (chemical)

216
Q

what are sandblasted resin bonded bridges cemented with?

A

dual affinity cement (panavia) - chemical bond to enamel and the non precious alloy

217
Q

advantages of resin bonded bridges?

A
  • less expensive
  • minimal/ no tooth prep
  • no LA required
  • potential for rebond if debond occurs
218
Q

when would you consider a resin bonded bridge?

A

short-span single tooth edentulous spaces
sound abutment teeth
favourable occlusion

219
Q

what are natal teeth?

A

teeth erupted at birth

220
Q

what risks are associated with natal teeth? what must you warn the patient?

A

if they are excessively mobile they will need to be extracted due to aspiration risk.
likewise if they are impending a baby’s ability to feed.
removing this means that the child wont have incisors until they are 6 (permanents)

221
Q

at what age should a child be aided with toothbrushing?

A

7

222
Q

what is MIH?

A

molar incisor hypomineralisation
an qualitative enamel defect - enamel is of normal thickness but it is not mineralised.

223
Q

you suspect a child has MIH, what questions should you ask?

A

are the teeth sensitive to hot/ cold?
is there pain on brushing?
any childhood illness: high fevers, hypoxia, infections?
did mum have illness in the last trimester of pregnancy?
any issues during birth: prematurity, assisted delivery, SCBU?
family history?

224
Q

what are differential diagnoses if you suspect MIH?

A

Fluorosis
amelogenesis imperfecta
chronological hypoplasia
trauma

225
Q

what is the clinical appearance of MIH?

A

affects smooth surfaces and cusps
PEB
white-yellow-beige-brown

226
Q

symptoms of MIH?

A

sensitivity to cold drinks and brushing

227
Q

what are treatment options for MIH molars?

A
  • do nothing
  • xla (if infected/ pain)
  • fissure seal (tricky due to poor bond)
  • cuspal coverage
  • hall crown (only temporary)
  • restoration
228
Q

what are treatment options for MIH incisors?

A
  • microabrasion
  • bleaching
  • restoration
  • composite camouflage
  • traditional veneer
229
Q

what scores IOTN5 for missing?

A

cleft lip/ palate
impacted teeth
hypodontia >4 teeth in a quadrant

230
Q

what overjet scores IOTN5?

A

> 9mm overjet
3.5 reverse overjet w masticatory issues

231
Q

what overjet scores IOTN4?

A

> 6mm overjet
3.5 reverse overjet no masticatory issues

232
Q

what overjet scores IOTN3?

A

> 3.5mm overjet with incompetent lips
1mm reverse overjet

233
Q

what overjet scores IOTN2?

A

> 3.5 overjet with competent lips

234
Q

what crossbite scores IOTN4?

A

cross bite with >2mm displacement

235
Q

what crossbite scores IOTN3?

A

cross bite with >1mm displacement

236
Q

what crossbite scores IOTN2?

A

crossbite with <1mm displacement

237
Q

what displacement scores IOTN4?

A

> 4mm contact point displacement

238
Q

what displacement scores IOTN3?

A

> 2mm contact point displacement

239
Q

what displacement scores IOTN2?

A

> 1mm contact point displacement

240
Q

what overbite scores IOTN4?

A

increased and complete with trauma
>4mm openbite

241
Q

what overbite scores IOTN3?

A

increased and complete without trauma
>2mm openbite

242
Q

what overbite scores IOTN2?

A

> 3.5mm overbite
1mm openbite

Module 7 (72 decks)

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