MA1 to midterm Flashcards

1
Q

1- endo dx form

2-clinical tests

3-PDL inflammation

4-percussion

5-percussion technique

6-palpation

7-palpation technique

A

1-chief complain, history of tooth, symptoms, clinical exam, etiology, radiographic interpretation

2-periapical testing: percussion & palpatation

3-perio disease, occlusal trauma, pulpal origin, & non odontogenic

4-periradicular inflammation indicatory—info about local apical & perio health
pulpal origin?—sharp pain, periradicular pathosis

5-use finger pressure first, if no response to that…then tap the incisal/occlusal surface w/ the end of a mirror
start w/ control tooth on the contralateral side

6-soft & hard tissues in the area WNL? painful response= inflammation

7-pressure w/ gloved forefinger over apex of suspected tooth
-bilaterally palpate—baseline to assess consistency of swelling

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2
Q

1- bite test

2-cracked tooth syndrome

3-mobility

A

1-apply pressure to each individual cusp…cusp tip is seated in depression & patient is asked to bite, check for pain on release

2-severe pain/sharp uncomfortable sensation on biting/chewing

  • in specific direction
  • unable to identify offending tooth or quad involved
  • sensitve to cold
  • pain is severe during initiation & release of biting pressure

3-movememnt of tooth from original position to a diff direction depending on force

  • apply pressure w/ index finger on lingual surface, & apply pressure on opposite surface w/ mirror handle & asses movement
  • can be periodontitis, occlusal trauma, bone lesions or pregnancy
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3
Q

Miller classification

1-class 0

2-class 1

3-class 2

3-class 3

5-mobility testing

A

1-normal movement when force is applied

2-mobility greater than physiologic <1mm

3-tooth can be moved up to 1 mm or more in a lateral direction (buccolingual or mesiodistal)
-inability to depress the tooth in a vertical direction (apicocoronal)

4-tooth can be moved 1mm or more in a lateral direction (buccolingual or mesiodistal)
-ability to depress the tooth in a vertical direction (apicocoronal)

5-on contralateral tooth & adjacent teeth

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4
Q

1-perio probing

2-soft tissue exam

3-sinus tract

4-parulis

A

1-demonstrated level of CT attachment

  • teeth w/ severe perio disease are poor candidates for endo therapy
  • walk probe around tooth
  • on contralateral & adjacent teeth

2-sinus tract, swelling & lymphadenopathy

3-inside of the mouth (intraoral sinus tract) or skin surface of face or neck (extraoral sinus tract)
-abnormal channel that originates from a longstanding dental infection associated w/ necrotic tooth

4-soft erythematous papule that develops on alveolar process in association w/ a non-vital tooth

  • made up of inflamed granulation tissue
  • place a GP cone using a cotton pliers into opening until it stops & then take a radiograph bc it can actually have extended further than thought
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5
Q

1-lymphadenopathy

2-etiology

A

1-submental, submandibular, & cervical nodes

2-caries & mechanical exposure
coronal fx, trauma, prior access
-attrition & abrasion
-restorative & previously treated
-intentional
-previously initiated therapy

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6
Q

1-mandatory radiographs: straight PA

2-angled PA

3-BWX

4-radiographic exam

A

1-documents preop state of tooth existing pathosis, root lenght, curvature, axial inclination, calcification of canals & areas of resorption

2-adds another dimension to 2D
-valuable to visual additional roots

3-undistorted view of pulp chamber, extent of pulp horns, MD width of pulp chamber & vertical dimension of pulp chamber can be visualized

4-loss of lamina dura

  • radiolucency remains at apex despite radiograph angulation
  • PARL resembles a tear drop hanging off apex
  • cause= evident
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7
Q

1- selective anesthesia

2-test cavity

3-transillumination

A

1-when other tests= inconclusive
-nonspecific pain
-most useful in maxilla—inject anterior to posterior
…if pain is relieved= odontogenic if not relieved= non odontogenic
-PDL & Mandibular= limited value

2-no anesthesia, high speed w/ small round bur, penetrate dentin…quick sharp pain? vital if no pain then non vital
—useful when thermal/electric test= inconclusive

3-limitations, can be inconclusive, dont rely on a single test
-require care in performance & patients response

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8
Q

1-major theories

2-stages

3-transition

4-plateau

5-normative crisis

6-liminal stage or limbo state

7-rites of passage

-developmental tasks

9-what we experience how we describe

A

1-Erikson-Psychosocial

  • Freud- Personality
  • Paget – Cognitive
  • Bandura- Social learning
  • Bronfenbrenner- Ecological systems

2-theories break into stages even if its continuum

3-move from 1 stage to next

4-stability, no transition

5-turmoil by grappling w/ changes from 1 stage to next

6-dont feel here nor there…adolescents arent kids or adults

7-rituals to help move from 1 stage to next, drivers license drinking etc

8-must do or accomplish to move on to next stage of development

9-we experience as a continuum but describe it as discontinuous

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9
Q

1-erikson—psychosocial development

A

1- birth—>1 yr= trust vs mistrust—Q= predictable vs supportive

  • 2-3 yr= autonomy vs doubt—Q=can i do it myself or need others
  • 4-5 yr= initiative vs guilt—Q=am i good or bad
  • 6-puberty= industry vs inferiority—Q=am i competent or worthless
  • adolescence= identity vs identity diffusion—Q=who am i/where am i going
  • early adulthood= intimacy vs isolation—Q=shall i share my life or live alone
  • middle adulthood= generative vs self absorption—q=will i produce something of value
  • late adulthood= integrity vs despair—q=have i lived a full life

—each stage has a normative crisis (question) that needs to be resolved before going on to next stage

—theory is culturally biased

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10
Q

1-Freud—personality development

A

-behavior dictated by unconscioud mind—ID, EGO, Super EGO
Birth-2= oral stage= infants pleasures centers on mouth
2-3=anal stage= childs pleasures focuses on toilet training
3-6= phallic stage= childs pleasures on genitals
6-puberty=latency stage= child represses sxual interest & gets social/intellectual skills
Puberty onwards= genital stage= sexual reawakening, source of pleasure outside fam

-behavious is controlled & influenced by subconscious—driven by libidinal desires, use “talking” as cure

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11
Q

Piaget—cognitive development

A
  • kids thinking is diff from adults
  • active via exploring, environments & pay provides maturation that moves kids through stages
  • –birth-2 yrs= sensorimotor- understanding of world, coordinating sensory experience w/ physical actions
  • –2-7= preop stage- child represents the world w/ words & images= inc symbolic thinking & beyond sensory info & physical
  • –7-11= concrete operational= child can reason logically about events & classify objects into diff sets
  • –11-15= formal operational= adolescent reasons= idealistic & logical…solve problems in head

naturally curious

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12
Q

Bandura—social learning theory

A
  • learn from each other through observation, imitation & remodeling
  • reciprocal determinism= environment & behavior interact in way that each influences creation of other
  • environment what we experience, influences cognitive what we think, influencing behavior what we do
attention= focus of interest
retention= recall later/memorable
reproduction= can be imitated & practiced
motivation= want to continue behavior
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13
Q

1-bronfrenbrenner—ecological

2-4 developmental rules

A

1-balance between heredity & environement
-micro/macrosystem, mesosystem, exosystem, & chronosystem
microsystem= relations between kid & immediate environment
mesosystem= kid & immediate settings
exosystem= social settings that affect but dont contain kid
macrosystem= overarching ideology of culture

2-similar for each individual
goes at an individual rate
builds upon earlier learning
area is interrelated to development in other areas
lifelong process

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14
Q

Parentine Styles—Baumrind

1-authoritarian

2-authoritative

3-permissive

4-uninvolved

5-results

A

1-high demands placed on kid= low responsiveness of parent to kid & low level of comm from parent to kid

2-highish demands on kid

  • high responsiveness of parent to kid
  • high level of comm from parent to kid

3-low demands on kid
high responsiveness of parent ot kid
high level of comm from parent to kid

4-low demands placed on kid

  • low responsiveness of parent to kid
  • low comm from parent to kid

5-authoritarian will lead to a child that is cooperative but takes little role in his/her care
authoritative- child is cooperative & readily takes active role in care
permissive- child lacks self control
uninvolved- child in uncooperative & unwillingt o take any role in care

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15
Q

1-Infancy 0-1 yr

2-early childhood 1-5 yr

A

1-development tasks of infant…desires for & feeling affection

  • manage new motor skills
  • rhythm between periods of rest and activity
  • understanding through exploration
  • emotions to express needs/wishes
  • varying temperaments—7-9 mo= stranger anxiety 9-12 mo= separation anxiety

2-language, mobility inc, understands numbers & counting, can follow instructions & plays

  • fear of separation, limited understanding, symptoms are vague, fear of pain
  • be predictable, use easy language, be fun, keep parent there
  • watch for distress, assess past experience,
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16
Q

1-middle childhood (6-puberty)

2-adolescence—puberty to adult

A

1-lessening dependence on family, inc influenced by peers

  • concept of self & control over impulses & feelings
  • cooperative & multiple symptoms
  • fears= bodily injury
  • ask kid yes/no questions first, listen, assure safety,

2-personal identity, establish a peer relationship, consistent self image, condiers goals
-inc abstract thinking, more into appearance and etc

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17
Q

1-expected of us as dentists (time)

2-complaints

3-what we expect of patients

4-what we can do

5-+imp/-Urg

6- -imp/-urg

7- -imp/+urg

8- +imp/+urg

A

1-Show up to our practice on time
See our patients at the appointed time
Prepared well-enough not to waste time during the appointment
Devote attention to patient in chair
Conclude appointment within a reasonable amount of time
Allow reasonable amount of time to the planned care
Reschedule patients at an appropriate interval

2-Communication
Quality
Money
Appointment: poor schedule times, multiple missed appointments, assignment to new students, etc

3-That they arrive at their apt on time
That they have allotted the amount of time we have indicated to complete the scheduled care
They don’t interrupt the appointment with calls or texts
That they have made arrangements for anyone under their care to be taken care of by a responsible person while they are at the appointment
That they schedule re-appointments and at reasonable intervals to proceed with planned care

4-Schedule realistically
Document systems & protocols
Train team
Delegate your time where you can
Plan for the unplanned
Stay calm
Prioritize

5-schedule it

6-do it later

7-delegate it

8-do it now

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18
Q

1-hereditary disease

2-white sponge nevus

3-reactive change

A

1-white sponge nevus

2-

  • ​Deals with Keratin 13 and Keratin 4 gene
  • Appears at birth/early childhood
  • White, velvety corrugated plaques &&& Bilateral lesions
  • Vacuolation of spinous layer

3-frictional keratosis
nicotine stomatitis
hairy tongue
dentrifrice-associated slough
chemical injury

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19
Q

1-frictional keratosis

2-nicotine stomatitis

A

1-found in white lesions in mouth

  • White lesion related to chronic trauma or friction
  • Callus on skin (protective effect)
  • Looks like tongue bite
  • Alveolar ridge keratosis: frictional keratosis seen in the retromolar pad
  • Treat: lesion should resolve once you remove causative agent

2-

  • White change associated with heat generated from smoking,
  • grayish mucosa with red elevated papules (which are salivary gland openings that undergo inflammation)
  • Duct Metaplasia*
  • Treat: resolves upon cessation of habit, not precancerous but it’s a Warning!! STOP SMOKING
20
Q

1-hairy tongue

2-dentrifrice associated slough

3-chemical injury

4-immuno changes

A

1-

  • Accumulation of keratin on filliform papillae, increased production or decreased desquamation
  • Usually in heavy smokers**
  • Affect midline of tongue
  • Exogenous/endogenous pigmentation may cause lesions to become brown, yellow or black, maybe even green!
  • Treat: tongue scraper and remove predisposing factors

2-caused by diff brands w/ mouth wash
-whitish slough detected by patient as peeling that can be swiped away…switch brands

3-aspirin burns & debacterol canker sore relief that burns nerve ending

  • white, wrinkled mucosa…removals of necrotic tissue= bleeding tissue
  • use rubber damn, and get rid of causing agent so lesions will heal

4-lichen planus
lupus erythematosus

21
Q

1- lichen planus

2-systematic lupus erythematosus

3-chronic cutaenous lupus erythematosus

4-subacute cutaneous lupus erythematosus

5-infectious diseases

A

1-chronic derm disease
purple, pruritic, polygonal papules
women 3:2
reticular pattern= bilateral, interlacing white lines—wickhams striae
erosive pattern= erythema w/ central erosion, less common but painful
-histologically= band like infiltrate of lymphocytes (degeneration of basal layers)—lichenoid= reacts to amalgam, drugs & cinnamon
-treat= reticular pattern= not required &
erosive pattern= corticosteroids

2-multisystem, fever, weight loss, etc

  • inc activity of B lymp & abnormal of T cells
  • 8x more commin in girls over 30…
  • butterfly rash in nose area
  • complications= kidney failure & cardiac involvement (pericarditis)—libman sac= warty on heart

3-to skin & oral cavity…no signs/symptoms
-scaly, erythematous patches, in sun areas, scarring & pigmentation

4-cutaenous lesions are prom, no scarring/pigmentation

  • band-like infiltrate of lymphocytes w/ perivascular inflammation, diff from lichen planus
  • treat = avoid lots of sun, corticoids & antimalarial

5-oral hair leukoplakia
candidiasis

22
Q

1-oral hairy leukoplakia

2-candidiasis

A

1-caused by EBV/HHV4

  • white plaque on lateral of tongue
  • looks like tongue bite
  • acanthosis, corrugations, thick parakeratin & superficial balloon cells
  • dont need to treat

2-opportunistic fungal by c. albicans (dimorph)

  • immunodeficient, diabetes, pregoo, corticosteroids, xerostomia, AB therapy, poor oral hygiene
  • pseudomembrane candidiasis, thrush, white plaques, resemble cottage chees, AB use or immune system impairment
  • –acute erythematous candidiasis= common, AB sore moth
  • –chronic erythematous candidiasis= in most denture wearers= angular cheilitis & median rhomboid glossitis
  • chronic hyperplastic candidiasis=white patch thta cant be removed in anterior buccal mucosa

treat via topical and systemic drugs

23
Q

1-biologic goals for crown provisionalization

2-pulp protection

3-perio health

4-tooth protection

5-mechanical goals for provisionalization

6-esthetic goals

A

1-pulp protection, maintain perio health, tooth protection

2-act to insulate pulp—limit further odontoblastic cell damange

3-optimize plaque control by limiting traps w/ good marginal fit, closed interproximal contacts & smooth provisional surfaces

4-prevents tooth fracture, maintains opposing/adjacent tooth contacts, & keep tooth from shifting

5-resists dislodgement, providing chewing function but also limit chewing on provisional

6-acceptable crown shade & form

24
Q

1-materials used for fabricating provisional crowns

2-polymerization reaction steps

A

1-poly (methyl methacrylate)

  • poly (r methacrylate)—ethyl & isobutyl alkyl groups
  • bis GMA composite resins
  • light cured resins
  • –all consist of monomers (building blocks), initators (initiates reaction), fillers (strength), & pigments (esthetics)

2-initiator decomposes to form free radicals (activation)

  • radicals combine w/ monomer causing them to form long chain polymers
  • amount of free radicals & monomer available to combine drops so the poly reaction end
25
Q

1- common monomers

2-common initiators

3-fabrication of provisional

4-custom molds

5-performed molds

A

1-methyl methacrylate, ethyl methacrylate, isobutyl methacrylate, & bis GMA

2-benzoyl peroxide (chemically) & camphoroquinone (light)

3-external surface forms—custom molds & performed molds
-molds designed create proper functional & esthetic shape of provisional restoration

4-neg. reproduction of tooth surface made prior to tooth prep—be made on a cast or in mouth
-in preprep cast …the vacuform unit molds thermoplastic sheet around case which is then trimmed to serve as mold
and then filled w/ resin and placed over prep to fabricate provisional

but we use silicone putty mold

5-commercially available performed tooth shaped crown shells

  • polycarb, cellulose acetate, & aluminum
  • lined w/ resin to custom fit to prepped tooth
26
Q

1-provisional cementation goals

2-composition of luting agents

A

1-retain provisional restoration

  • allow removal of restoration by clinician w/o damaging tooth or restoration
  • protect pulpal tissue
  • seals against oral fluid leakage
  • nonirritating to pulp
  • easy to use
  • –thin layer so it doesnt inhibit provisional crown

2-zinc oxide
eugenol —zinc reacts w/ eugenic= luting agent a chelate complex
—eugenol can effect setting of resins, carboxylic acid can be substituted for eugenol

27
Q

1-indications for panormic radios

2-3rd molars

3-ectopic migration

4-adv of panoramic

5-comparing to intraoral radio

6-collimation

A

1-evaluate 3rd molars

  • path, trauma & developmental anomalies
  • mixed dentitions anaylsis
  • evaluate growth and development

2-id of location & orientation

3-3rd molars migrated up into coronoid process region

4-covers large anatomical area

  • exposes patient to less radiation
  • less technical expertise
  • easily tolerated by patient

5-less sharp image

  • may not reveal objects that are outside focal
  • more expensive equipment

6-order to limit exposure to patient, xray is collimated

  • collimator controls size & shape of xray beam
  • intraorally the xray beam is either round or rectangular & large enough to cover entire intraoral sensor…produces narrow, rectangular xray beam that exposes small portion of film as tubehead & film rotate around patient
  • size of hole determines size of xray beam…shape determines shape of beam
28
Q

1-rotation center

2-sliding rotation center

3-tubehead rotation

A

1-patient is still while xray source & film move in opposite directions in fixed relationship via rotation pts.

2-at starting pt, tubehead on patients left the rotationc enter is located posteriorly on same side as tubehead as shown below

  • as tubehead moves behind patient, rotation center slides towards the front
  • as tubehead continues to move to patients right, rotationc enter slides back posteriorly

3-tubehead rotates around patient, detector is also rotating so that its lined up w/ xray beam
-xray beam passes thorugh narrow vertical opening, allowing a small portion of detector to be exposed at a time…detector rotates w/in shield, exposing diff parts of film as whole unit rotates

29
Q

1-focal trough

2-dimensions in focal trough

3-sharpness

A

1-3d curved zone or image layer where structures are well defined

  • through design of machine the zone corresponds to shape of upper/lower jaws…shape & width of focal trough is determined by path of sliding rotation center
  • closer rotation is to teeth, narrower the focal trough in that area
  • bc rotation center is closer to anterior teeth, focal trough is narrower in area

2-front to back—anterior posterior
side to side—buccolingual
up and down—vertical

3-sharpness of objects vary depending on location relative to focal trough—images of objects w/ minimal tissue density are blurred dense objects are seen

30
Q

1-magnification

2-double real image

3-ghost image

A

1-objects in focal trough will be magnified in both horizontal & vertical dimensions, magnification= 20-30%

2-2 images of single object seen on film
by structures in the midline…xray passes through objects twice as tubehead rotates
-hard & soft palates, hyoid bone & cervical spine

3-opaque shadow of dense object located on opposite side of patient

  • earring in patients ear , where tubehead starts & where it stops
  • image will be oppos from image of actual object
  • same shape as actual object
  • larger than image of actual object
  • projected higher on film
  • less distinct, less sharpness
31
Q

1-patient exposure

2-teeth too anterior

3-teeth too posterior

4-head turned

5-head tipped down

A

1-exposure= 4 intraoral films
-low dose & area covered= popular choice

2-in front of notches in bitstick then it will be narrower & blurred

3-behind notches in bitestick the anterior teeth will be wider & blurred

4-if not centered then structures on one side will be closer while structures on other side will be farther
-teeth smaller on side to which head is turned…teeth farther from film are wider bc there is inc magnification

5-head positioned so frankfort plane is inclined downward, mandibular incisors will appear shortened & mandible will be vshaped (exaggerated smile)

6-frankfort plane angled up,
mandible= squared off, hard palate will be superimposed over roots= reverse smile

32
Q

1-lead apron

2-spine

3-palatoglossal air space

4-failure to remove appliances

A

1-improper positioning, may block part of beam & = clear area on film…if lcoated high on back of patients neck

2-not standing straight the cervical vertebrae block xray beam head = radioopaque area through middle of film

3-failure to keep tongue against palate

4-metal frameworks may obscure large areas of teeth & film should be retaken

33
Q

impression making goals

A

1-capture image of prepped tooth (no distortions)

2-capture image of adjacent soft tissue (proper crown contours)

3-capture image of adjacent teeth in arch (accurate mount casts on articulatory, reference for proper crown contour & determine occlusal anatomy)

4-capture image of opposing teeth (opposing dentition against which fabricated & determine occlusal anatomy)

5-capture image of portion of tooth thats apical to crown

34
Q

impression making media: physical media

1-examples

2-elastomeric material

3-polyethers

4-polyvinyl siloxanes

5-digital media

A

1-hydrocolloid & elastomeric

2-cross linked polymers—stretch & accurately return to its original shape = making it accurate (key property)

  • –easy to use —accurate—sets fast—elastic memory—stable—reasonable costs
  • polysulfides, polyethers, polymerizing silicones (condense), polyvinyle siloxanes

3-rxn take place between aziridine rings, initiator opens the ring & binds w/ each during propagation, polymerized dental impression= result
ADV= good accuracy—dimension stability—hydrophilic—easy to use
DISADV= stiff when sets (break teeth)—absorbs moisture (distorting impression)

4-PVS addition—-CDMI***rxn between silicone/platinum salt, catalyst paste, addition rxn= large cross linked polymer
ADV= good accuracy—dimension stability—easy—more flexible than polyeth—easy to remove
DISADV= hydrophobic (resist wetting)…overcome by adding surfactant to make it more hydrophilic & to make it flow better, more accuracy pouring & making impression

5-digitally imaged impression to create virtual casts
—iTERO, Lava, CEREC

35
Q

1-challenges in obtaining accurate impression

A

1-maintain patient comfort
2-control of regional anatomy
3-moisture control
4-control of soft tissue that surrounds tooth
5-gingival displacement

36
Q

1-maintain patient comfort

2-control regional anatomy

3-moisture control

4-soft tissue that surroungs tooth

A

1-keep patient seated upright, use least amt of material needed, someone stay w/ patient (reassurance & count down)

2-retract buccal mucosa & tongue

3—control saliva—excess moisture will prevent material from flowing onto tooth= voids in impression

  • use cotton rolls, isolite, svedopter & have assistant suction
  • —control tissue hemorrhaging—use Alum Chloride & ferric sulfate

4-excess gingival tissue lays over preps & blocks flow of impression material

  • –occurs when margins are subgingival
  • fully expose prep to impression material & create space for impression APICAL or beyond prepped tooth margin…correct contour provides info for dental lab & fabricates accurate crown
  • good margin helps dental tech lab visualize demarcation line & know where to place crown margin—either= marginal gap or marginal overhang
37
Q

gingival displacement

1-mechanical

2-chemical

3-surgical displacement
a-electrosurgery
b-laster surgery

4-comm w/ dental lab

A

1-retraction cords: 1-2 cord technique, leave in palce for 8-10 min= retraction
or retraction paste

2-added to pastes to help retraction & control sulcular bleeding—epi, alum chloride, & ferric sulfate

3a-electric current along electrode to cut soft tissue, removes epithelial lining, exposes subgingival tooth
ADV= excellent prep margin exposure & controls sulcular bleeding
DISADV= not in areas of thin attached gingiva…can cause recession, may not be safe for pacemakers & burning flesh smell

3b-light amplification emits light @ wavelength that cuts soft tissue, removes epi lining & exposes subgingival tooths tructure
ADV= excellent prep margin, controls sulcular bleeding, no concerns w/ metallic resotrations that harm pulp, no risk to pacemakers
DISADV= need to be careful in thin attached gingival areas, gingival recession risk, burning flesh, expensive$$$

4-crown shade selection
-select shade to create esthetic crown to blend w/ remaining dentition

38
Q

1-congenital disease

2-immunologic disease

3-reactive changes

4-neoplasms

5-metabolic conditions

6-other vascular conditions

A

1-hemangioma & vascular malformation

2-plasma cell gingivitis

3-pyogenic granuloma
peripheral giant cell lesion
peripheral ossifying fibroma

4-kaposis sarcoma

5-vit B deficiency
pernicious anemia
iron deficiency anemia

6-petechiae, ecchymoses & purpura

39
Q

1-Hemangioma

2-vascular malformation

3-plasma cell gingivitis

A

1-most common tumor of infancy
—first 8 wk of life (not born w/ it)
—most in head & neck
—more in women 5:1
Phases: birth…3 mo= rapid prolif…5 yrs=involution (50% resolve)…10 yrs= 90% resolve
treatment= most dont but oral symptoms= surgery or sclerotherapy

2-structural anomalies of BV
-no endothelial cell prolif
-present at birth (unlike hemangioma) & throughout life
—diascopy = test for blanchability…apply pressure w/ slide & observe change in color
—port wine stain= vacular malformation seen in newborns
—stufe weber syndrome= port wine stain, meningeal angioma, seizures & mental retardation
treatment= surgical/non surgical or scleropathy

3-enlargement & erythema of entire free/attached gingiva
collection of plasma cells
tx= dietary history & allergy testing

40
Q

1-pyogenic granuloma

2-peripheral giant cell lesion

3-peripheral ossifying fibroma

4-kaposis sarcoma

A

1-tumor like growth of oral cavity…red nodule often w/ ulcerated surface
-75% cases in gingiva may occur in other parts of mouth like tongue, lower lip & buccal mucosa
=pregnancy tumor
Tx=surgical excision= curative…excision to periosteum & adjacent teeth are scaled

2-seen on gingica or edentulous alveolar ridge
60% in females from 30-40
from PDL or periosteum
tx= surgery

3-pink/red nodule =ulcerated
66% pts are female pts 10-19 yrs old
exclusively on gingiva on anterior region
tx= surgery

4-herpes virus
-lesions= flat changes & w/ time become nodular & exophytic
-red blue lesions in palate, gingiva & tongue
tx= localized lesion—surgery & generalized lesions—chemotherapy

41
Q

1-vitamin B deficiency

2-pernicious anemia

3-iron deficiency anemia

4-plummer vinson

5-ecchymosis, purpura & petecchiae

A

1-from dec intake, alcholism, starvation, diets
inc demand but dec absorption
symtpms= glossitis, cheilitis
dermatitis, diarrhea, dementia, & death
tx= vit b replacement, id of underlying cause

2-extrinsic= poor absorption of vit. B12
intrinsic= destruction of intrinsic factor
hunters tongue= pernicious anemia, smooth & red
tx= vit B12 replacement

3-most common
bc of inc intake, alc, starvation & fad diets
-dec absorption, chronic blood loss & inc demand (preg)
-common in females
-red, smooth, angular cheilitis

4-iron deficiency anemia
glossitis & dysphagia

tx= iron supplements & iding underlying cause

5-from trauma or blood dyscrasis

tx= id of underlying disease

42
Q

1-reusable metal syringe

2-safety syringe

3-gauges

4-needle length

A

1-adv= visible cartridge—aspirate w/ 1 hand—autoclave—rust resistant—long lasting
disadv=weight (heavy)—syringe may be too big—possibility of infection

2-adv=pot to dec injuries compared to conventional—engineering control—safe & easy—easy to see aspirated—visibility not obstructured—adaptable to all hands—can change carpules efficiently—standard needles—disposable & lightweight
DISADV= inc vol of sharps waste—difficult to keep track of how many times sterilized
—accomodation by user & more expensive

3-25= red
27=yello
30=blue
smaller the number= bigger the lumen (diameter)

4-32 mm long (adults have 32 teeth & longer)
20 mm short (kids have 20 teeth & shorter)

43
Q

1-needle issues

A

1-never use on more than on 1 patient

  • change after 3-4 injections
  • always cover needle in protective sheath
  • pay attention to position of uncovered needle
  • long needles deflect more than short
  • higher guage deflect more than lower
  • higher gauge more likely to break at tip & hub
  • –never hub a needle & never bend a needle

-higher gauge needles are hard to aspirate—#30 cant aspirate bc of inc risk of disengaging harpoon from plunger

44
Q

1-pain

2-larger the gauge

3-safety needles

A

1-bc of speed of injection & acidity of injection

2-more tissue resistance on insertion—pressure on needle to insert, deflects needles
-more pressure to inject fluid (bc of smaller lumen= less fluid)

3-ADV= potential to dec injuries compared to conventional dental need

  • engineering control making incorrect needle recapping less likely
  • atached to conventional metal—safety w/ 1 hand—individually wrapped

DISADV=bulkiness of plastic sleeve reduce visibility—plastic sleeve fog & reduce visibility—difficult to see aspirated blood through sleeve—wont fit conventional metal—more flexible than others—produce inc volume of sharps—requires period of accomodation

45
Q

1-proper handling of cartridges & disposable needles

parts of cartridge

2-silicone rubber plunger

3-alum cap

4-diaphragm

5-mylar strip

6-single tooth anesthesia

A

1-dispose in approved container & use scoop method

2-seals glass tube, provides way for harpoon to engage aiding in aspiration

3-oppos end of plunger, holds thin diaphragm in position

4-semipermeable membrane

5-provides protection if glass breaks, info of drug listend

6-flow rates of solution deliver= computer controlled & consistent

  • operator can focus attention on position of needle tip while motor of machine delivers anesthetic & preprogrammed rate of flow
  • 3 fold dec in interpretation in pain
  • less threatening to patients visually
  • release foot rheostat will tell machine to aspirate automatically
  • less painful PDL, palatal & attached gingiva—2 rates slow=.5 &&& fast= 1.8