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NBDE II > Mental Dental Videos > Flashcards

Mental Dental Videos Flashcards

1
Q

What are the major types about actinomycosis?

A

Periapical: jaw infection

Cervicofacial : head and neck

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2
Q

What is tx for actinomycosis?

A

Long term-high dose Penicillin

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3
Q

What is major thing about actinomycosis?

A

Sulfur granules in pus

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4
Q

What is major thing about scarlett fever?

A

Strawberry tongue (only on fungiform papillae of tongue)

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5
Q

What is a red candidiasis called?

A

Atrophic candidiasis

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6
Q

What is candidiasis on midline of posterior tongue?

A

Median rhomboid glossitis (bald flat red spot on the tongue)

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7
Q

What is candidiasis on corners of mouth?

A

Angular cheilitis

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8
Q

Most common locations for Blastomycosis

A

US Northeast (spores)

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9
Q

Most common locations for Coccidiodomycosis

A

US Southwest (valley fever)

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10
Q

Most common locations for Cryptococcosis

A

US west

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11
Q

Most common locations for Histoplasmosis

A

US Midwest

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12
Q

Aphthous Ulcer, 5 major things:

A
  1. Canker sore
  2. Nonkeratinized tissue (like on soft palate, buccal mucosa etc…)
  3. Minor heals without scarring
  4. Major will scar
  5. Sutton Disease: Another name for a major aphthous ulcer
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13
Q

What is Erythema Multiforme?

A

Often occurs on lips, but can occur anywhere.It has a minor and major form. Minor form is herpes simplex hypersensitivity. Major form is drug sensitivity.

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14
Q

What is Stevens-Johnson Syndrome?

A

Another name for a major form of Erythema Multiforme.

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15
Q

What is angioedema?

A

Allergic reaction to drug or food contact. Has diffuse swelling of lips,neck or face caused by mast cell release of IgE and histamines. Tx is antihistamines.

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16
Q

Wegener’s Granulomatosis?

A

Allergic reaction to inhaled antigen. Characterize by strawberry gingivitis.tx is corticosteroids

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17
Q

Lichen Planus

A

T lymphocytes target and destroy basal keratinocytes

Sawtooth rete pegs

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18
Q

Two major types if Lichen Planus

A

Reticular - whickham striae

Erosive - wickham striae with red ulcerations

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19
Q

Tx for Lichen Planus

A

corticosteroids

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20
Q

Lupus Erythematosus

A

Has two types

  1. Discoid Chronic Type - disk like lesions on face, oral lesions look like erosive lichen planus
  2. Systemic acute type - butterfly rash on nose (RUN AN ANA test)
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21
Q

Scleroderma

A

Hardening of skin and CT, which will restrict opening mouth harder. PDL space will be generally wider

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22
Q

Pemphigus Vulgaris

A

Suprabasilar
Autoantibodies against desmosomes
Has multiple painful ulcers preceded by bullae
Positive Nikolsky’s sign (blowing air will shed the outer layer of mucosa)

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23
Q

Mucous Membrane Pemphigoid

A

Subasilar
Autoantibodies against basement membrane
Otherwise same as pemphigus vulgaris

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24
Q

Proliferative Verrucous Leukoplakia

A

White and warty, recurrent patch on mucosa
Associated with HPV 16 and 18
High risk of malignancy

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25
Q

Actinic Cheilitis

A

Sun damaged lips (UVB rays especially) UVA rays are not that bad.

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26
Q

What are the highest risk sites in mouth for malignancy?

A

Floor of mouth

Posterior lateral tongue

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27
Q

What are the 4 major types of cancer?

A

Carcinoma - epithelium
Sarcoma - mesenchymal or Connective Tissue
Leukemia - blood
Lymphoma - lymphatic

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28
Q

What are the 3 stages of cancer?

A

Dysplasia - pre cancer
Carcinoma in situ - all of the epithelium is affected
Malignant neoplasm - cancer as soon as it invades past the basement membrane

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29
Q

Squamous Cell Carcinoma

A

Caused by oncogenes
In mouth associated with HPV 16 and 18
5 year survival is 50%

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30
Q

Basal Cell Carcinoma

A

Due to sun damage

Very rarely metastasizes

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31
Q

Oral Melanoma

A

Malignancy of melanocytes
High risk sites are palate and gingiva
5 year survival rate for skin is 65% but in mouth is 20%

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32
Q

What are other names for fibroma?

A

Traumatic fibroma, irritation fibroma, hyperplastic scar

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33
Q

What is a traumatic neuroma?

A

A mass of nerve tissue as a result from nerve damage. Most common at mental foramen

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34
Q

Pyogenic granuloma

A

Hyperplasia of capillaries on gingiva. Bright red. Caused by chronic trauma or irritation

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35
Q

Nodular Fasciitis

A

Neoplasm of fibroblasts, easy to eradicate, rarely recurs

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36
Q

Fibromatosis

A

Neoplasm of fibroblasts, hard to eradicate, often recurs

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37
Q

Schwannoma

A

Neurilemmoma. Neoplasm of schwann cells. Has acellular bodies of Antoni A tissue.

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38
Q

Neurofibroma

A

Neoplasm of schwann cells and fibroblasts

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39
Q

Von Recklinghausen disease

A

multiple neurofibromas + cafe au lait + Crowe’s sign +Lisch spots
Can become malignant!

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40
Q

Leiomyoma

A

Smooth muscle cell neoplasm.

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41
Q

Neurofibrosarcoma

A

Also known as malignant peripheral nerve sheath tumor

Malignant proliferation of schwann cells

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42
Q

Kaposi’s Sarcoma

A

Malignant proliferation of endothelial cells (it is purple)
Caused by HHV8
Associated with AIDS

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43
Q

Leiomyosarcoma

A

Malignant - smooth muscle cells

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44
Q

Rhabdomyosarcoma

A

Malignant - skeletal muscle cells

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45
Q

Liposarcoma

A

Malignant - fat cells

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46
Q

What is Mucous Extravasation Phenomenon?

A

Caused by trauma to salivary duct. Examples are mucocele or Ranula

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47
Q

Mucous retention cyst

A

Same as mucocele, but histologically lined with epithelium. Caused by blockage of salivary duct by sialolith.

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48
Q

Necrotizing Sialometaplasia

A

Rapidly expanding ulcerative lesion. Heals on its own. Caused by trauma to minor salivary gland.

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49
Q

Sinus retention cyst

A

Also called antral pseudocyst. Caused by blockage of glands in sinus mucosa. No tx needed

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50
Q

Sarcoidosis

A

Hyperimmune (involves granulomas). Triggered by mycobacteria. Can cause Xerostomia.

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51
Q

Pleomorphic adenoma

A

Most common salivary gland benign tumor
Composed of epithelial and CT (hence the “pleo” (mixed) in the name.)
Firm rubbery swelling
Most common on palate or parotid gland

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52
Q

Monomorphic Adenoma

A

Salivary gland benign tumor

Composed of single cell type

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53
Q

Warthins Tumor

A

Salivary gland benign tumor

Composed of oncocytes and lymphoid cells. Found in parotid of older men.

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54
Q

What are the 2 most common salivary gland malignancies?

A

Mucoepidermoid Carcinoma

Polymorphous Low-Grade Adenocarcinoma

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55
Q

Mucoepidermoid Carcinoma

A

Most common salivary gland malignancy

Composed of mucous and epithelial cells

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56
Q

Polymorphous Low-Grade Adenocarcinoma (PLGA)

A

Second most common salivary gland malignancy

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57
Q

Adenoid Cystic Carcinoma

A

Cribriform or swiss cheese microscopic appearance

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58
Q

How serious are lymphoid neoplasms?

A

They are all malignant because they are all below the basement membrane.

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59
Q

How are lymphoid neoplasms manifested in the mouth?

A

Through MALT tissue

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60
Q

Hodgkin’s Lymphoma

A

Very rare in oral cavity

Involves Reed-Sternberg cells (malignant B cells)

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61
Q

Non-Hodgkins Lymphoma

A

B or T cells

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62
Q

Burkitt’s Lymphoma

A 
Type of non-hodgkins lymphoma
B cell
Tooth mobility
Lip numbness
Incomplete root development
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63
Q

Multiple Myoloma

A

Also called plasma cell myeloma (B cells)
Punched out RL in skull
Accumulation of amyloid proteins

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64
Q

Leukemia

A

Effects youngest pts to oldest pts in this order:
ALL>CML>AML>CLL (ALL Children Are ChiLL pneumonic)..
Either myeloid or lymphoid, acute or chronic
Symptoms are bleeding, fatigue, infection

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65
Q

Radicular Cyst

A

Also known as periapical cyst (this is an endo associated lesion)
Most common
RL at apex of non vital tooth
Encapsulated by Epithelial Rests of Malassez (ERM) from Hertwig’s Epithelial Root Sheath (HERS)

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66
Q

Dentigerous cyst (important stuff to know)

A

Most common with canines and third molars

Fluid between crown and “reduced enamel epithelium”

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67
Q

Mandibular periodontal cyst

A

Most common in mandibular premolar region

Always with a vital tooth

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68
Q

Gingival cyst of adult

A

Cyst under gingiva of mandibular premolar region

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69
Q

Gingival cyst of newborn

A

Bohn’s nodules - when on lateral palate
Epsteins’s pearls - midline palate
Origin of epithelium is rests of dental lamina

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70
Q

Primordial Cyst

A

Develops where tooth would have formed

Most common in mandibular third molar region

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71
Q

KCOT or OKC

A

Keratocystic Odontogenic Tumor
Aggressive and recurrent
Most common in posterior ascending ramus
Gorlin Syndrome = many OKCs +many BCCs (basal cell carcinomas) +calcified falx cerebri (fatal) also called nevoid basal cell carcinoma

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72
Q

Calcifying odontogenic cyst (COC)

A

Also called Gorlin Cyst
Rare
Ghost cells (RL with little calcifications in it)

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73
Q

Ameloblastoma

A

Benign but aggressive (very expansile)
Posterior mandible
Tx is bx with wide margins

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74
Q

What are the differential diagnoses of multilocular RL in posterior mandible?

A

Ameloblastoma
KCOT
CGCG
COF

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75
Q

CEOT

A

Calcifying epithelial odontogenic tumor
Also known as Pindborg Tumor
Driven Snow
Liesegang rings

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76
Q

AOT

A

Adenomatoid Odontogenic Tumor

Anterior maxilla over impacted canine

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77
Q

Odontogenic Myxoma

A

Also called myxofibroma
Slimy stroma
Honeycomb pattern in radiograph (unclear borders)

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78
Q

COF

A

Central Odontogenic Fibroma
Has two forms
Central = in bone
Peripheral = in gum tissue

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79
Q

Ameloblastic Fibroma

A

In children or teens

Posterior mandible

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80
Q

Odontoma

A 
Compound = bunch of mini teeth (anterior mostly)
Complex = mostly posterior (conglomerate mass)
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81
Q

Central Ossifying Fibroma

A

Composed of fibroblastic stroma with pieces that become calcified,
Two types
Central = in bone
Peripheral = in gingiva

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82
Q

Fibrous dysplasia

A

Ground glass

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83
Q

Periapical Cemento-osseous dysplasia

A

Most common in mandibular anterior teeth, and middle aged black females
Teeth are vital

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84
Q

Osteoblastoma

A

Circumscribed opaque mass of bone and osteoblasts.

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85
Q

What are the giant cell bone lesions or things associated with them?

A 
CGCG
Aneurysmal bone cyst
Hyperparathyroidism (brown tumor)
Cherubism
Langerhan’s cell disease
Paget’s disease
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86
Q

Central Giant cell granuloma

A

Has both fibroblasts and multinucleated giant cells
Anterior mandible
Has central and peripheral form (bone and gingiva respectively)

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87
Q

Aneurysmal bone cyst (ABC)

A

Blood soaked sponge

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88
Q

What lesions are found in Hyperparathyroidism?

A 
Brown tumor (due to excess osteoclastic activity) RL lesion
Von Recklinghausen’s disease of bone
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89
Q

Langerhans cell disease

A

Also called histiocytosis
Rare type of cancer
“Floating teeth”

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90
Q

Paget’s disease

A

“Cotton wool”

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91
Q

Acute Osteomyelitis

A

Most common cause is tooth infection or trauma, but it spreads to cortical bone
Very painful, high fever
Teeth are NOT loose

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92
Q

Chronic osteomyelitis

A

Diffuse

Sequestra

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93
Q

Garre’s osteomyelitis

A

Chronic osteomyelitis with “onion skin” from infected periosteum.

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94
Q

Condensing Osteitis

A

Also known as focal sclerosing osteomyelitis

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95
Q

Diffuse sclerosing osteomyelitis

A

Can lead to jaw fracture

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96
Q

BRONJ

A

From any medication that ends in “-dronate”

Tx is CHX rinse, antibiotics

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97
Q

Most common symptom of malignancy is…

A

numb lip.

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98
Q

Osteosarcoma

A

Sunburst pattern

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99
Q

Ewing’s sarcoma

A

“Round cells”

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100
Q

Telangiectasia definition

A

Red macule or papule, dilated or broken capillary.

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101
Q

Cleidocranial Dysplasia

A

Missing clavicles

Supernumerary teeth

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102
Q

Ectodermal dysplasia

A

Hypoplastic hair and nails

Missing teeth

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103
Q

Albergs-Schonberg disease

A

Also known as osteopetrosis

“Stone bone”

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104
Q

Amelogenesis Imperfecta

A

Alters enamel only

Both primary teeth and permanent teeth

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105
Q

Dentinogenesis imperfecta

A

Alters dentin only
Short roots, bell shaped crowns, obliterated pulp
Blue Sclera of eyes

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106
Q

Dentin Dysplasia

A

Chevron Pulps and short roots

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107
Q

Regional Odontodysplasia

A

“Ghost teeth”

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108
Q

What is an important condraindication for extraction?

A

head and neck radiation - but hyperbaric oxygen is beneficial for pts that are on radiation

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109
Q

What are the most common impacted teeth in the dentition?

A

Mandibular third molars>maxillary third molars>maxillary canines

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110
Q

What are the most commonly missing teeth?

A

What are the most commonly missing teeth?

Third molars>maxillary lateral incisors>mandibular 2nd premolars

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111
Q

What is soft tissue impaction?

A

The height of contour is above bone, but tooth is completely or mostly in gingiva

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112
Q

What is partial hard tissue impaction and full bony impaction?

A

Partial - height of contour is below bone level

Full - entire tooth is encased in bone

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113
Q

What is the winters classification system?

A

For impacted third molars, based on angulation
Mesioangular - easiest
Distoangular - most difficult

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114
Q

What is the Pell and Gregory classification?

A

Its for impacted mandibular third molars only
ABC (describes the height of the impacted tooth compared to occlusal plane)
123 (describes how far tooth is within the ramus)

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115
Q

What condition arises if a spicule of bone is left behind underneath a flap from a surgical extraction? How do you avoid this from happening?

A

A subperiosteal abcess, this is avoided by irrigating thoroughly after extraction.

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116
Q

What is the most common site for oro-antral communications? (OAC)

A

Maxillary first molars

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117
Q

What is tx if you get a sinus exposure?

A 
If less than 2mm - nothing
From 2-6mm - The 4 A’s
	Antibiotics
	Antihistamines
	Analgesics
	Afrin Nasal Spray
Greater than 6mm - flap surgery for primary closure
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118
Q

What is another name for dry socket?

A

Alveolar osteitis

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119
Q

What is tx for alveolar osteitis?

A

Irrigation and local pain control (dry socket paste that has eugenol)

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120
Q

What is tx for nerve injury?

A

Medrol dosepak

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121
Q

In case of nerve injury, how long do we wait to see if feeling comes back before referral for evaluation?

A

4 weeks

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122
Q

Where is the most common site for a tooth to be displaced during extraction?

A

Maxillary first molar - sinus
Maxillary second molar - sinus
Maxillary third molar - infratemporal fossa
Mandibular third molar - submandibular space

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123
Q

What type of motion is the straight elevator used for in oral surgery?

A

Lever action

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124
Q

What is the instrument number for the straight elevator?

A

301

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125
Q

What type of motion is the cryer elevator used for in oral surgery?

A

Wheel and axle action

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126
Q

What is the instrument # for the malt periosteal elevator?

A

9

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127
Q

What are the universal forceps called for upper and lowers? What if you need one for premolars or primary teeth?

A 
#150 - uppers
#151 - lowers
150-A is for premolars, 150-S is for primary teeth etc…
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128
Q

What is the instrument # for lower cowhorns?

A

23

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129
Q

What are the ash forceps used for? What is the instrument # for them?

A

74 - used for lower premolars

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130
Q

What are the major blades used in oral surgery?

A 
#10 - large skin incisions
#11 - for stab incisions (like I&D)
#12 - mucogingival surgery, curve enhances ease of access to the sulcus
#15 - intra oral surgery - most common
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131
Q

What syringe is used in irrigation in OS? What is it used for?

A

Monojet syringe - to keep bone cool during surgical removal of bone

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132
Q

How is a bone file used?

A

With a pull stroke

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133
Q

What is an osteotome?

A

A bone chisel

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134
Q

Why do you not use air driven handpieces for oral surgery?

A

Air can pass through the tissue spaces and cause air emphysema, which is serious.

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135
Q

What are hemostats used for?

A

Hemostatis (clamping a vessel closed)

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136
Q

How is needle holder different than a hemostat?

A

Needle holder beak is cross-hatched

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137
Q

What is the primary purpose of a suture?

A

To immobilize a flap

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138
Q

What direction should a suture be placed?

A

From moveable tissue to non-moveable tissue

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139
Q

What is unique about silk material in sutures?

A

It has a wicking feature, which allows bacteria to invade, so its not a good thing. It should be removed after a few days.

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140
Q

What is an adson forcep?

A

Its a tissue forcep

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141
Q

What is a utlility forcep?

A

For grabbing things from your tray etc, not for tissue

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142
Q

What are the two different types of OS scissors and what are they used for?

A

Dean scissors - cutting sutures

Mayo scissors - cutting tissue

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143
Q

What is the initial forcep movement when performing a simple extraction?

A

If permanent tooth - buccal
If primary - lingual
If conical root - rotation

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144
Q

What is a semilunar incision and what is it used for?

A

A rounded incision apical to mucogingival junction used for apicoectomies

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145
Q

What is a double Y incision and what is it used for?

A

A palatal incision with a cut at the midline and two wings anterior and posterior (used for removal of palatal torus)

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146
Q

How much space do you need for implant placement around the following items?

Away from adjacent natural tooth
adjacent implant
IAN
mental nerve
buccal plate
lingual plate
inferior border of jaw
sinus
nasal cavity
A 
Away from adjacent natural tooth - 1.5mm
Away from adjacent implant - 3 mm
Away from IAN - 2mm
Away from mental nerve - 5 mm
Away from buccal, lingual plate, inferior border etc… 1mm
Away from sinus and nasal cavity - 1 mm
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147
Q

What is the difference between one stage and two stage surgery for implant placement?

A

One stage - place healing abutment and implant in one visit

Two stage - place implant with just a cover screw at one appt and healing abutment at second appt

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148
Q

How are gingival fibers oriented next to an implant cuff?

A

Parallel

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149
Q

How much peri implant bone loss is normal after the first year?

A

0.2mm per year

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150
Q

What temperatures are enough to compromise osseointegration during placement?

A

47 degrees celsius for one minute or 40 degrees celsius for 7 minutes.

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151
Q

What is the best imaging technique to visualize a jaw fracture on the mandible?

A

Panoramic x ray

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152
Q

What are the most common structures to fx in the mandible?

A

condyle>angle>symphysis

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153
Q

What is the best imaging technique to visualize a jaw fracture in the midface?

A

CBCT x ray

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154
Q

What are the 4 types of fxs in the midface?

A

Le Fort I - horizontal across maxilla
Le Fort II - pyrimidal fx
Le Fort III - complete craniofacial disjunction
Zygomaticomaxillary complex fx -also known as a tripod fx, involves bleeding under conjunctiva

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155
Q

What is ideal tx for mandibular fractures?

A

Open reduction and internal fixation or (ORIF) (open reduction means exposing bone surgically, internal fixation means placing titanium plates)

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156
Q

What is apertognathic?

A

Refers to anterior open bite

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157
Q

What is vertical maxillary excess?

A

Maxilla is too long, which makes a gummy smile

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158
Q

What is horizontal transverse discrepancy?

A

Posterior crossbite

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159
Q

What is macrogenia?

A

Chin too big

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160
Q

What are the main imaging used to tx orthognathic surgeries?

A

Lateral Cephs

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161
Q

What is le Fort osteotomy?

A

Move maxilla, used for retrusive maxilla or vertical maxillary excess

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162
Q

What is BSSO?

A

Move mandible, Bisagittal split osteotomy, used for retrusive or protrusive mandible. Causes nerve damage!

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163
Q

What is genioplasty?

A

Alters chin anatomy

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164
Q

What is distraction osteogenesis?

A

A way to lengthen a bone. They make a cut through the bone and then put an appliance that they will activate in one week that will pull them apart gradually to allow more bone to heal in between them

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165
Q

What is axis 1 pain vs axis 2 pain?

A

Axis one is normal pain, axis 2 is more chronic pain

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166
Q

What are the 4 steps of the pain pathway?

A

Transduction - PNS to CNS
Transmission - CNS to brain
Modulation - limitation of flow of pain info
Perception - the sum of all the other steps

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167
Q

What is somatic pain?

A

An increased stimulus will yield an increased pain. (TMJ, Muscular pain, visceral pain like pulpal pain and salivary glands)

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168
Q

What is Neuropathic pain?

A

Pain independent of stimulus intensity. Involved damage to pain pathways

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169
Q

What is trigeminal neuralgia?

A

Also called tic douloureux. Happens in post menopausal women older than 50. There is a trigger point that causes it and a refractory period in between episodes. It is unilateral. Tx is anticonvulsants

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170
Q

What is atypical odontalgia?

A

Phantom toothache after extraction or pulpectomy.

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171
Q

The TMJ has two spaces, the lower space and the upper space. What are these two spaces functions?

A

Lower joint space - rotation

Upper joint space - translation

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172
Q

What muscle opens the mandible?

A

Lateral pterygoid

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173
Q

What muscles close the mandible?

A

Medial pterygoid
Temporalis
Masseter

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174
Q

What is the function of the capsular ligament?

A

It covers the joint space

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175
Q

Discal or collateral ligament

A

Keeps disc attached to condyle

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176
Q

Posterior ligament

A

Prevents anterior disc displacement

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177
Q

Lateral ligament

A

Prevents posterior disc displacement

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178
Q

TMJ blood supply

A

MADS: Maxillary, Ascending pharyngeal, Deep auricular, Superficial Temporal

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179
Q

Internal Disc Displacement with reduction

A
  • click
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180
Q

Internal Disc displacement without reduction -

A

Limited range of motion of either one side or both sides

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181
Q

What is deflection?

A

Mandible deflects to the side that is stuck

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182
Q

What is deviation?

A

Mandible deviates while opening then returns back to midline at maximum opening

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183
Q

What is recurrent dislocation?

A

Jaw is locked open due to extreme opening and requires manual manipulation to close it.

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184
Q

What is the most common nerve injured in TMJ surgery?

A

Facial nerve

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185
Q

What is the most common cause of masticatory pain?

A

Myofascial pain syndrome (has trigger points of pain in muscles)

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186
Q

When are biopsies indicated?

A

If no response to tx or it doesnt go away after 2 weeks

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187
Q

What is fine needle aspiration used for?

A

To know if fluid exists and what type of fluid it is. Often for RL lesions of bone like odontogenic cysts or ameloblastomas etc…

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188
Q

How big should a lesion be to do an incisional bx instead of excisional?

A

> 1cm, and suspect malignancy with a narrow deep wedge incision

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189
Q

What type of incision is used for excisional bx?

A

Ellipitical

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190
Q

How do you store a bx?

A

In 10% formalin with a biohazard label

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191
Q

What is enucleation?

A

Surgical removal of mass without cutting into or rupturing it

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192
Q

What is marsupialization?

A

Cut a slit into an abcess and suture it open so it can drain.

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193
Q

What acronymn is used to tell you what to do for a medical emergency?

A

SPORT: Stop tx, Position Pt, Oxygen (most of the time), Reassure, Take Vitals

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194
Q

What is most common medical emergency to happen in a dental office?

A

Syncope

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195
Q

What is vasovagal syncope?

A

Needle anxiety fainting

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196
Q

What is Trendelenburg?

A

It is a supine position with head is lower than their feet. A good tx for syncope.

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197
Q

If pt is pregnant and has syncope, what is tx?

A

Use left lateral decubitus pt, which is laying on left side, so fetus doesn’t compress inferior vena cava.

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198
Q

What is orthostatic hypotension?

A

Second most common cause of syncope, dizziness when quickly standing up.

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199
Q

When is angina unstable?

A

When pain is at rest

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200
Q

What is tx for angina?

A

ONA: Oxygen, Nitroglycerine, Aspirin

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201
Q

How much nitroglycerine do you give when a pt has angina?

A

0.4 mg tab sublingual wait 5 minutes. If symptoms dont go away, do it again (up to three doses) then give aspirin and call 911.

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202
Q

What is tx for MI?

A

MONA: Morphine, Oxygen, Nitroglycerine, Aspirin

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203
Q

How to manage hypoglycemia if pt is unconscious?

A

IV dextrose or IM glucagon

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204
Q

When do you not give oxygen to a pt during an emergency?

A

If pt is hyperventilating, use a brown paper bag instead.

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205
Q

What can a stroke be caused by?

A

Hyponatremia

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206
Q

What is difference between CVA and TIA?

A

TIA is mini stroke

CVA is full stroke

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207
Q

What is tx for anyphylactic shock?

A

AEIOU: Albuterol, Epinephrine (.3 mg dose), IM antihistamine, Oxygen, U call 911

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208
Q

When would you need a CBC from a patient?

A

Anemia, leukopenia, thrombocytopenia

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209
Q

When would you need a PT from a patient?

A

If they are on anticoagulants, have liver damage, or vitamin K deficiency

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210
Q

When would you need a bleeding time test on a patient?

A

If pt is on an anti platelet drug like aspirin

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211
Q

When would you need an INR from a patient?

A

If they are on Warfarin or Coumadin (should be between 2-3)

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212
Q

When would you need a PTT on a patient?

A

If pt is on Heparin, on renal dialysis, or has hemophilia

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213
Q

What are the herbal anticoagulants?

A

Garlic, Ginger, Ginko, Ginseng

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214
Q

What is the ideal crown to root ratio? What is a poor crown to root ratio? What is minimum crown to root ratio?

A

Ideal: 2:3
Minimum 1:1
Poor: 1:2

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215
Q

When is splinting a good idea in fixed prosthodontics?

A
  1. When replacing a canine, central and lateral should be splinted together to prevent lateral drifting of bridge.
  2. When crown to root ratio of abutment tooth is insufficient.
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216
Q

What is the ideal root shape for a bridge?

A

Anything NOT straight conical and round.

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217
Q

When is a complete maxillary denture contraindicated?

A

When only mandibular anterior teeth are present

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218
Q

How many implants in maxilla or mandible for overdenture is common?

A

Mandible - 2

Maxilla - 4

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219
Q

What is the biggest negative to cement-retained implants?

A

Excess cement can cause peri-implantitis

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220
Q

What is the biggest negative to screw-retained implants?

A

Screw can loosen during function over time

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221
Q

What is the real name for alginate?

A

Irreversible Hydrocolloid

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222
Q

What is the compound in alginate that controls setting time?

A

Trisodium Phosphate

223
Q

How long do you leave alginate in someones mouth?

A

2-3 minutes

224
Q

How long can you wait before pouring up an alginate impression?

A

Up to 10 minutes

225
Q

What is MMR?

A

Maxillo-Mandibular Relations. This is about occlusion. The two components of this is CR and MI.

226
Q

What is the definition of CR?

A

The position in which the condyles articulate with the thinnest avascular portion of their respective discs in the most anterior-superior position against the articular eminences.

227
Q

What is the percentage of population where CR=MI?

A

10%

228
Q

What is the most accurate method of getting a pt to a CR position?

A

Bimanual Manipulation

229
Q

What is the purpose of a facebow?

A
  1. To duplicate the relationship of the maxillary arch to the skull
  2. To duplicate the relationship of the mandible to the rotational center of the TMJ
230
Q

What is a nonadjustable articulator and why is it not ideal?

A

A simple hinge articulator. It may result in premature contacts and incorrect ridge and groove direction of restorations.

231
Q

What do you set the bennet angle at on a semiadjustable articulator?

A

15 degrees

232
Q

What do you set the HCI (Horizontal condylar inclination) on a semiadjustable articulator

A

30 degrees

233
Q

What is an arcon articulator?

A

When condyles are part of the lower member and fossa is part of the upper member

234
Q

What is a non-arcon articulator?

A

Upper and lower members are rigidly attached

235
Q

Alginate casts are best mounted and articulated with what type of bite records? What about PVS records

A

Alginate - Wax

PVS - ZOE paste

236
Q

What is the difference between anterior guidance and canine guidance?

A

Anterior refers to both canine and incisal guidance.

Canine refers only to canine guidance

237
Q

During protrusive movements, what guidance is used? What about lateral movements?

A

Protrusive - condylar guidance and incisal guidance

Lateral - canine guidance on working side and condyle on balancing side provide clearance

238
Q

What is the butterfly line?

A

A line separating the hard palate and soft palate. You can find it by doing the valsalva test.

239
Q

What are the fovea palatini?

A

Little dimples in the palate 2 mm from the vibrating line.

240
Q

How do you capture the coronoid notch in a pt during an impression for a denture?

A

Have patient move laterally from side to side.

241
Q

What are the two most important movements for maxillary denture impressions?

A

Laterally and open wide

242
Q

What 2 maxillary anatomical landmarks are important for posterior border molding?

A

Hamular notch and pterygomandibular raphe

243
Q

What muscle makes the labial frenum on the mandibular arch? What about the buccal frenum? Lingual frenum?

A

Labial frenum - Orbicularis Oris

Buccal frenum - orbicularis oris, buccinator

Lingual frenum - genioglossus

244
Q

What muscle forms the inferior border of the labial vestibule on the mandible?

A

Mentalis

245
Q

What muscle forms the inferior border of the buccal vestible on the mandible?

A

Buccinator

246
Q

What 4 muscles attach to the retromolar pad?

A

Temporalis
Buccinator
Superior pharyngeal constrictor
Pterygomandibular raphe

247
Q

What is the DB most area of the maxillary and mandibular impressions in the edentulous arch?

A

Maxilla - coronoid notch

Mandible - masseteric notch

248
Q

What is the alveolingual sulcus?

A

The lingual vestibule on the mandible. It is located between the tongue and the ridge.

249
Q

What important anatomical feature is in the anterior region of the alveolingual sulcus? Why is it important for dentures?

A

The sublingual gland sits above the mylohyoid muscle. The denture flange in this area will be shorter and touch the anterior floor of the mouth.

250
Q

What important anatomical feature is in the middle region of the alveolingual sulcus? Why is it important for dentures?

A

The mylohyoid ridge sits here and will deflect the denture out to avoid this ridge in this area.

251
Q

What important anatomical feature is in the posterior region of the alveolingual sulcus? Why is it important for dentures?

A

This is the area of the retromylohyoid fossa. In this area, the posterior fibers of the mylohyoid muscle run more vertically, which allows the flange of the denture to be deeper and deflect laterally. This is what forms the “S” shape on the lingual flange of the mandibular denture.

252
Q

What muscles on the mandible prevent a large distal extension of a denture?

A

Palatoglossus and superior constrictor

253
Q

What is the buccal shelf? What is its function for a denture?

A

It is an anatomical landmark on the posterior mandible, just lateral to the posterior ridge. This is where the buccinator muscle attaches and it provides support for the denture.

254
Q

What are the most common frenectomies?

A

Labial>Buccal>Lingual

255
Q

What is the purpose of a free gingival graft pre-dentures?

A

It widens the band of keratinized tissue around implants or teeth. This aids in keeping them clean.

256
Q

What is a hyper mobile ridge?

A

A flabby ridge, most commonly seen in anterior maxilla, that can cause issues with retention.

257
Q

What is the major cause of epulis fissuratum?

A

An overextended flange

258
Q

What is a fibrous tuberosity?

A

It is common when large anatomic tuberosity touch the retromolar pads, which can interfere and limit interarch space. These are commonly removed prior to denture fabrication.

259
Q

What is the main cause of papillary hyperplasia?

A

Candida Albicans

260
Q

What is combination syndrome?

A

When a pt only has mandibular anterior teeth and nothing else.

261
Q

What are the symptoms of combination syndrome?

A

Overgrowth of tuberosities
Papillary hyperplasia on hard palate
Extrusion of lower anterior teeth
Loss of bone under the partial denture bases

262
Q

When can residual root tips be left alone?

A

When lamina dura is intact and no RL

263
Q

How does Paget’s disease effect dentures?

A

Ridge expands and dentures will no longer fit. Dentures will need to be remade periodically.

264
Q

What is alveoloplasty used for?

A

Sharp, spiny ridges that can cause pain in dentures

265
Q

When are tori removed?

A

When creates undercut or interferes with posterior palatal seal when making a denture.

266
Q

What is vestibuloplasty?

A

Apically repositioning the vestibule to create more height of ridge. It requires repositioning the alveolar mucosa and muscles in the area.

267
Q

Where are the major sources of bone graft?

A

Illiac crest and rib

268
Q

Is it more difficult to restore vertical ridge height or horizontal ridge width with a bone graft?

A

Horizontal is easier to restore.

269
Q

What is the difference between VDO and VDR?

A

VDO - vertical dimension of occlusion (distance between nose and chin in occlusion)
VDR - Vertical dimension of rest (distance between nose and chin at rest) usually 3 mm of space between upper and lower premolars

270
Q

What are signs and symptoms of excessive VDO?

A

Muscles of mastication will be fatigued
Lips will appear strained
Excessive display of mandibular teeth
Gagging

271
Q

What are symptoms of insufficient VDO?

A

Aging appearance of lower third of face due to wrinkles etc…
Angular cheilitis
Diminished occlusal force

272
Q

What is Christensen’s Phenomenon?

A

Refers to the distal space created between the maxillary and mandibular occlusal space surfaces when mandible is protruded, due to downward and forward movement of condyles down articular eminence. (posterior open bite in protrusion)

273
Q

How do you deal with christensen’s phenomenon when making a mandibular denture?

A

Have posterior teeth be a little higher than occlusion (slope upward)

274
Q

What is Camper’s line?

A

Imaginary line from ala of nose to tragus of ear

275
Q

What is interpupillary line?

A

Imaginary line between pupils of the eyes

276
Q

How are those lines related to maxillary dentures?

A

The maxillary wax rim should be parallel to both of these lines (measured with a fox plane)

277
Q

How does anterior guidance play into a denture?

A

Anterior guidance should be avoided to prevent dislodgement. You want tripodization even in eccentric movements.

278
Q

What is lingualized occlusion?

A

Only palatal cusps of maxillary posterior teeth contact mandibular posterior teeth.

279
Q

What is the difference between Bennett angle, Bennett shift, and Bennett movement?

A

Bennett Angle - angle obtained after nonworking side condyle has moved anteriorly and medially relative to sagittal plane
Bennett Shift - lateral movement of mandible toward the working side during lateral excursions.
Bennett Movement - lateral movement of both condyles toward the working side

280
Q

Determinants of disclusion (eccentric occlusion is opposite to these):

  1. Anterior guidance
  2. Posterior guidance
  3. Cuspal anatomy
  4. Tooth Arrangement
  5. Orientation of occlusal plane
A

Anterior guidance
Horizontal dimension (protrusive movement) Steep incisal guidance
Lateral (excursive): Steep canine guidance

Posterior guidance
Horizontal: steep horizontal condylar inclination
Lateral: Less bennett movement

Cuspal anatomy:
Short cusps with shallow inclines (so they can disclude faster)

Tooth arrangement:
Less curve of spee, less curve of wilson

Orientation of occlusal plane:
less parallel to orientation of condylar path ( _ vs / )

281
Q

What is the curve of spee?

A

Anteroposterior curve

282
Q

What is the Curve of wilson?

A

Mediolateral curve

283
Q

What is another word for fricative sounds?

A

Labiodental sounds

284
Q

What is a sibilant sound?

A

Linguoalveolar sounds. These are the ‘S’ and “Sh” and “ch” and “J” sounds

285
Q

What does it mean if a denture patient whistles when trying to say “s”

A

The arch form is too narrow

286
Q

What does it mean if a denture patient says “sh” when trying to say “s”

A

Arch form is too wide

287
Q

How much space between incisors when a pt says ‘S’?

A

1 to 1.5 mm

288
Q

What does it mean if tongue sticks out when a pt pronounces the ‘th’ sound?

A

Teeth are too far back, if tongue is not visible at all, too far forward

289
Q

What is a bilabial sound?

A

B,p,m

290
Q

What is the gutteral sound?

A

G,k

291
Q

What is support in a denture?

A

Resistance to vertical seating forces

292
Q

What are the things in the upper arch that provide the most support for a denture?

A

Palate and alveolar ridge

293
Q

What are the things in the lower arch that provide the most support for a denture?

A

Buccal shelf and retromolar pad

294
Q

What part of the denture provides support to the mouth?

A

Denture base

295
Q

What is stability in a denture?

A

Resisitance to horizontal dislodging forces

296
Q

What provides stability in a denture?

A

Height of ridge and depth of vestibule

297
Q

What part of the denture provides stability?

A

Denture flange

298
Q

What is retention in a denture?

A

Resistance to vertical dislodging forces (pulling away vertically)

299
Q

What is the thing that provides the most retention on an upper denture?

A

Peripheral seal

300
Q

What is the difference between adhesion and cohesion?

A

Adhesion is attraction of unlike molecules

Cohesion is attraction of like molecules

301
Q

What is the acrylic used in complete dentures?

A

Heat-cured acrylic

302
Q

What are the 2 parts of heat cured acrylic?

A

PMMA - powder polymer

MMA - liquid monomer

303
Q

What is MMA? What is in it?

A

Methyl methacrylate - monomer
Hydroquinone - inhibitor
Glycol dimethacrylate - corss-linking agent
Dimethyl-p-toluidine - activator

304
Q

What is PMMA? What is in it?

A

Polymethyl methacrylate - polymer
Benzoyl peroxide - initiator
Salts of iron and cadmium - pigment

305
Q

Shrinkage of dentures happens more when you have more of what?

A

Monomer

306
Q

What is the ideal ratio of monomer to polymer?

A

1:3

307
Q

What would lead a denture to have a higher porosity?

A

Due to unpacking of resin at time of processing, or being heated too rapidly

308
Q

What are the two materials denture teeth can be made out of?

A

Acrylic or porcelain

309
Q

What is the advantage of having acrylic teeth in a denture?

A

Better retention due to better bonding

310
Q

What is the advantage of porcelain in a denture?

A

Esthetics, more stain and wear resistant. But they can wear the opposing teeth

311
Q

How is retention increased with porcelain teeth in a denture?

A

Posterior teeth - diatorics ( like a box into the tooth that forms retention.
Anterior teeth - pins

312
Q

What is kennedy class I?

A

Bilateral distal extension

313
Q

What is kennedy class II?

A

Unilateral distal extension

314
Q

What is kennedy class III?

A

Unilateral bounded edentulous space (a section of missing teeth that has teeth on both sides.)

315
Q

What is kennedy class IV?

A

Bilateral bounded edentulous space (it crosses the midline)

316
Q

What are the 6 applegate’s rules?

A

Rule #1 - classification should be assigned only AFTER extractions
Rule #2 - missing 3rd molars are not considered
Rule #3 - Abutment third molars ARE considered
Rule #4 - Missing second molars are not considered (if they are not planned on being replaced)
Rule #5 - most posterior edentulous are determines classification!
Rule #6 Class IV cannot have any modifications

317
Q

What is the main function of the major connector?

A

It provides rigidity

318
Q

Where is one place where a major connector cannot be?

A

On moveable tissue

319
Q

What is the most rigid maxillary major connector type?

A

Complete palatal plate

320
Q

When would you use a complete palatal plate as a major connector?

A

In kennedy class I (missing all posterior teeth)

321
Q

What is the least rigid maxillary major connector?

A

Horshoe

322
Q

When would you use a horshoe as a major connector on the maxilla?

A

Only if large palatal torus is there

323
Q

What is an important design rule for major connectors?

A

They should cross the midline at a right angle

324
Q

What is the purpose of beading in RPD design? What is beading?

A

Using a ½ round bur to shape the connector on the stone model. The borders of the connector would be thicker and more rigid, and it would prevent a food trap.

325
Q

When can a lingual bar be used as a major connector on the mandible?

A

When the depth of the vestibule is at least 7mm.

326
Q

When would a lingual plate be used as a mandibular RPD major connector?

A

When depth of vestibule is less than 7mm
Additional tooth loss is expected
Lingual tori
All posterior teeth missing

327
Q

What RPD element provides more support?

A

Rests

328
Q

What are the dimensions of an occlusal rest?

A

⅓ the MD width
½ intercuspal width
1.5 mm deep for the base metal

329
Q

What are the dimensions of a cingulum rest?

A

2.5 - 3 mm MD length
2mm labiolingual
1.5mm deep

330
Q

On which teeth are cingulum rests contraindicated?

A

Mandibular incisors

331
Q

What is an indirect retainer?

A

It is a rest located perpendicular and anterior to the fulcrum line ( a line drawn across the RPD from most distal rest to most distal rest.) It resists rotational movement of the distal extension area.

332
Q

What is a direct retainer?

A

A clasp assembly that has a rest, minor connector and clasp arms

333
Q

What part of the clasp assembly provides stability?

A

The reciprocal clasp, and the minor connector

334
Q

What is the most commonly used clasp in an RPD?

A

Akers clasp (circumferential clasp)

335
Q

What are the two types of clasps?

A

Infrabulge (from below the height of contour) and suprabulge (from above the height of contour)

336
Q

When is a ring clasp used?

A

It wraps around the entire tooth if an undercut is only present by the rest seat.

337
Q

What are the 3 clasp assemblies?

A

RPI - Rest, proximal plate, I-bar (the ideal class II lever system)
RPA - Rest, proximal plate, akers claps
RPC - Rest, proximal plate, circumferential clasp (same as RPA)

338
Q

What is wrought wire? When is it used?

A

Its more flexible that typical clasp design, used more in perio compromised teeth and endo teeth.

339
Q

What material is the framework of an RPD made of?

A

Cobalt-Chromium

340
Q

How much shrinkage does cobalt-chromium have?

A

2.3%

341
Q

What is the main reason a clasp breaks?

A

Cold-working (bending back and forth with use)

342
Q

What is another name for a build up?

A

A foundation restoration or a core.

343
Q

What are the 3 principles of tooth preparation?

A

Biologic (health of oral tissues)
Esthetic
Mechanical (integrity and durability of restoration

344
Q

Where is the thinnest gingival tissue in the mouth?

A

Lingual molars and facial premolars

345
Q

Why is it bad to use a dull bur?

A

It cuts a lot hotter

346
Q

What is retention form in a crown?

A

Feature that prevent removal of crown along long access of prep (sticky foods pulling crown up.)

347
Q

What is resistance form in a crown?

A

Feature that prevents removal of crown along horizontal or oblique access (occlusal forces or grinding)

348
Q

What is R&R form?

A

Retention and resisitance form

349
Q

What is the property that we have the most operative control of in a crown prep?

A

Taper

350
Q

What is the minimal height we would like for crowns?

A

3 mm for anterior and PM

4 mm for molars

351
Q

What does a short clinical crown prep require?

A

Buccal grooves for retention

Proximal grooves for resistance

352
Q

What margin type has the best marginal seal?

A

Featheredge

353
Q

What type of margin is often used for gold crowns?

A

Light chamfer (0.3-0.5mm thick)

354
Q

What is the #1 lab complaint?

A

Tooth is under reduced so lab is forced to overcontour crown.

355
Q

What type of crown is shoulder most often used for?

A

All-ceramic crowns

356
Q

What are the 3 benefits of ¾ and ⅞ crowns

A

Conserve tooth structure
Less crown near the gingiva
More easily seated during cementation

357
Q

What type of pontic design is the worst?

A

saddle/ridge lap

358
Q

What is a modified ridge lap pontic used for?

A

Anterior teeth

359
Q

What is the most esthetic pontic design?

A

Ovate

360
Q

What are the two types of connectors?

A

Rigid - cast in one piece or soldered together

Non-rigid - male and female connectors (called tenon and mortise)

361
Q

What is the minimum height of a connector on a PFM fixed bridge?

A

3mm

362
Q

What is a good antisialagogue?

A

Atropine

363
Q

What is the chemical name for hemodent?

A

Aluminum chloride

364
Q

What is the chemical name for ViscoStat?

A

Ferric sulfate

365
Q

What are the two types of impression materials?

A

Aqueous hydrocolloids (powder and water) and nan-aqueous hydrocolloids

366
Q

What are the two types of aqueous hydrocolloids?

A
  1. Agar (reversible hydrocolloid)
    a. Can change between two phases, sol and gel phase, based on temperature.
    b. High accuracy
  2. Irreversible hydrocolloid (alginate)
    a. Setting time 3-4 minutes
    b. Should be poured within 10 minutes
367
Q

What is the most inaccurate impression material?

A

Irreversible hydrocolloid

368
Q

What is the primary ingredient in alginate?

A

Diatomaceous earth

369
Q

What is the active ingredient in alginate?

A

Potassium alginate

370
Q

What increases setting time of alginate?

A

Hot water, less water

371
Q

What is imbibition?

A

Absorption of water

372
Q

What is syneresis?

A

Loss of water

373
Q

What are the 3 types of non-aqueous elastomeric materials for impressions and there main points to remember?

A
  1. Polysulfide rubber - leaves a water byproduct, hydrophobic, syneresis, 30-45 minutes to pour.
  2. Silicone (two types)
    a. Condensation silicone - leaves an alcohol byproduct, causes shrinkage of impression. 30 minutes to pour
    b. Addition silicone (PVS) - no byproducts, best fine detail, inhibited by sulfur in latex gloves and rubber dam.
  3. Polyether - very stable, easily influenced by water and humidity, imbibition, hydrophilic, very stiff and easy to break teeth on cast, 60 minutes to pour
374
Q

What is the raw form of gypsum?

A

Calcium-sulfate dihydrate

375
Q

What is the processed form of gypsum?

A

Calcium-sulfate hemihydrate (processed with heat to get rid of some water)

376
Q

What is Type I gypsum?

A

Impression plaster

377
Q

What is Type II gypsum?

A

Model plaster

378
Q

What is Type III gypsum?

A

Dental stone

379
Q

What is Type IV gypsum?

A

Dental stone, high strength, low expansion

380
Q

What is Type V gypsum?

A

Dental stone, high strength, high expansion

381
Q

What is gauging water?

A

Extra water needed to mix gypsum just to be able to mix it.

382
Q

What does more water do in gypsum?

A

Less strength, more porosity, less expansion, increased setting time

383
Q

Why does type I gypsum have low expansion?

A

It sets quickly so there is no time for expansion

384
Q

What is type II gypsum used for?

A

To fabricate mouth guards and essex retainers

385
Q

What is type III stone used for?

A

Removable prostheses and diagnostic casts

386
Q

What are the benefits of type IV stone?

A

Best abrasion resistance
Least gauging water
Least expansion
Used to fabricate dies

387
Q

How long to mix gypsum for for vaccuum mixing or by hand?

A

Vaccuum - 20 seconds

By hand - 30 seconds

388
Q

What is setting time of gypsum?

A

45 to 60 minutes

389
Q

How to decrease setting time of stone?

A

Hot water
Less water
Slurry water
Increased mixing time

390
Q

What is the least strong to most strong type of stone?

A

Type 1 to type 5

391
Q

What is the least porous to most porous type of stone?

A

Type 5 to type 1

392
Q

What are the 3 noble metals?

A

Gold, platinum, palladium

393
Q

What is good about gold?

A

Tarnish resistance, resistance to corrosion

394
Q

What is good about platinum?

A

Strength, increases melting temperature

395
Q

What is good about palladium?

A

Strength

396
Q

What is a disadvantage to silver?

A

Causes greening of porcelain

397
Q

What % is high noble vs noble?

A

60% and 25%

398
Q

What are the main features of the 4 types of gold alloys?

A 
Type I
Soft - used for class v only, 98-99% gold

Type II
Medium, used for inlays, 77% gold

Type III
Hard, used for crowns, 72% gold

Type IV
Extra hard, used for bridges, post and cores, clasps, 69% gold

399
Q

What is compressive strength?

A

Ability of a material to resist fx during compression

400
Q

What is fx toughness?

A

Ability of a material to resist propogation of a crack

401
Q

What material has the best fx toughness?

A

Zirconia

402
Q

What is transformation toughening in zirconia?

A

Tetragonal phase to monoclinic phase (the stronger phase)

403
Q

What is modulus of elasicity?

A

Stiffness or rigidity. Stress divided by strain

This is the ability of a material to resist stretching without permanently deforming

404
Q

What is brittle?

A

Fx without dimensional changes (porcelain)

405
Q

What is percentage elongation?

A

Ability of a material to be burnished

406
Q

What materials have the most to least coefficient of thermal expansion?

A

composite>metal>tooth>porcelain (gold is the best because it is the closest to tooth)

407
Q

What are the 3 materials used in provisional crowns

A

PMMA -used for indirect provisionals, exothermic reaction
PEMA - not used a lot
Bis-acryl Composite - used for direct provisionals

408
Q

Why is it important to remove all provisional cements?

A

It contains eugenol, which inhibits polymerization of resin

409
Q

How is porcelain fused to metal?

A

Using a monomolecular oxidative layer.

410
Q

What are the three layers of porcelain in a PFM crown?

A

Opaque layer - thinnest and next to the metal
Body or dentin porcelain - contains most of the shade
Incisal or enamel porcelain - most translucent layer

411
Q

How far from the metal porcelain junction of a PFM should occlusion be?

A

1.5 mm at least

412
Q

How is an all ceramic crown bonded to a tooth?

A

Its etched with hydrofluoric acid and treated with silane. Then you can use cement. (if all ceramic contains NO glass, it can be cemented like normal with silane)

413
Q

How much reduction do you need for porcelain veneers?

A

Gingival ⅓ reduction needs 0.3mm
Facial reduction is 0.5 mm
Incisal reduction is 1-2 mm

414
Q

What is a con of maryland bridge?

A

It can experience debonding

415
Q

What is hue

A

Color family (red vs blue etc…)

416
Q

What is chroma

A

Saturation or intensity of color

417
Q

What is value

A

Lightness or darkness

418
Q

What is metamerism?

A

Colors appear different under different light

419
Q

What is the ideal light?

A

5500k

420
Q

What is fluorescence?

A

Object emits visible light when exposed to UV light

421
Q

What order do you go through to select a shade?

A 
Select value
Select chroma (cervical third)
Select Hue (incisal third)
422
Q

What is the first thing you do when you get a crown back from the lab?

A

Check shade and esthetics

423
Q

What are the two types of LA?

A

Amides in liver

Esters in pseudocholinesterase (Plasma)

424
Q

What are the LA that are in the amide group?

A 
Lidocaine
Bupivicaine
Mepivicaine
Articaine
Prilocaine
425
Q

What anesthetic is the safest to use in children? Which one is NOT safe?

A

Lidocaine-safe

Bupivicaine

426
Q

Which anesthetic causes the least vasodilation?

A

Mepivicaine

427
Q

Which anesthetic has one ester chain?

A

Articaine (even though it is an amide) metabolized in both liver and plasma

428
Q

Which anesthetic can induce methemglobinemia?

A

Prilocaine

429
Q

Which anesthetic has the longest duration? Shortest?

A

Bupivicaine(0.5%), articaine(4%)

430
Q

Which anesthetic is packaged in multiple percentages?

A

Mepivicaine (2% and 3%) can also come without epi

431
Q

Which anesthetic is a vasoconstrictor?

A

Cocaine

432
Q

What mechanism do local anesthetics have?

A

They are sodium channel blockers

433
Q

What two processes are not fused in cleft lip?

A

Medial nasal process and maxillary process

434
Q

What percentage of cleft lip is unilateral vs bilateral?

A

80% unilateral 20% bilateral

435
Q

How rare is cleft palate vs cleft lip?

A

Cleft lip 1:1000

Cleft palate 1:2000

436
Q

What fails to fuse in cleft palate?

A

Palatal shelves

437
Q

What is van der Woude Syndrome?

A

Clefts + Lip Pits

438
Q

What are Fordyce Granules?

A

Ectopic sebaceous glands

439
Q

What condition is in buccal mucosa that disappears when stretched?

A

Leukoedema

440
Q

What is a lingual thyroid?

A

Thyroid tissue mass that is located at midline on base of tongue. IT IS located along the embryonic path of thyroid descent.

441
Q

Where does the thyroid gland start in embryo?

A

The foramen cecum of the tongue

442
Q

What is a thyroglossal duct cyst?

A

A midline neck swelling located along the embryonic path of thyroid descent.

443
Q

What are the two other names for geographic tongue?

A

Benign migratory glossitis and erythema migrans

444
Q

What is Melkerson-Rosenthal syndrome?

A

Fissured tongue + granulomatous cheilitis (lip inflammation) + facial paralysis

445
Q

What is an Angioma?

A

A tumor composed of blood vessels or lymph vessels

446
Q

What is a cherry angioma?

A

A benign red mole

447
Q

What is a hemangioma?

A

A congenital focal proliferation of capillaries. Most of these undergo involution (will shrink), but if they persist, they are cut off.

448
Q

What is a lymphangioma?

A

More rare, purple spots on the tongue

449
Q

What is a lymphangioma called when it is on the neck?

A

Cystic hygroma (more common than in the mouth)

450
Q

What is Sturge-Weber Syndrome?

A

Angiomas of leptomeninges + skin along trigeminal nerve

451
Q

What is a Dermoid Cyst?

A

Mass in midline either in floor of mouth or in upper neck (depending on if it is above the mylohyoid muscle or below it)

452
Q

What is the defining characteristic of a dermoid cyst?

A

It has a doughy consistency

453
Q

What is a branchial cyst?

A

Lateral neck swelling. It is an epithelial cyst within a lymph node of the neck.

454
Q

What is the defining characteristic of a cyst?

A

It has an epithelial lining and fluid filled center

455
Q

What is an Oral Lymphoepithelial cyst?

A

Cyst within lymphoid tissue of oral mucosa

456
Q

Where are oral lymphoepithelial cysts commonly found in the mouth?

A

In palatine and lingual tonsils

457
Q

What is the defining characteristic of a nasopalatine duct cyst?

A

Heart shaped RL in nasopalatine canal

458
Q

What is tx for nasopalatine duct cyst?

A

Excision

459
Q

What is a Globulomaxillary Lesion

A

Its a clinical description for any RL between maxillary canine and maxillary lateral incisor

460
Q

What are 2 other names for traumatic bone cyst?

A

Simple Bone Cyst, Idiopathic Bone cyst

461
Q

What is the difference between mucosal erosion and ulcer?

A

Erosion is incomplete break through epithelium

Ulcer is a complete break through epithelium

462
Q

What are the common chemicals that cause chemical burns?

A

Aspirin
Hydrogen Peroxide
Silver Nitrate
Phenol

463
Q

What is the defining characteristic of nicotine stomatitis?

A

Red dots which are inflamed salivary duct openings on the hard palate

464
Q

When is nicotine stomatitis considered pre-malignant?

A

When it is related to “reverse smoking”

465
Q

What is smoking-associated melanosis?

A

Brown, diffuse macules on anterior gingiva caused by chemicals in tobacco that stimulate melanocytes.

466
Q

What is tx for smoking-associated melanosis?

A

If pt stops smoking, it can go away on its own.

467
Q

What is Peutz-Jegners Syndrome?

A

Melanotic macules (on face, lips or in mouth) + intestinal polyps

468
Q

What is hairy tongue?

A

Elongated filiform papillae

469
Q

Dentrifice Associated sloughing

A

Ingredient called sodium lauryl sulfate that causes tissue sloughing in mouth of some people

470
Q

What is tx for dentrifice associated sloughing?

A

Suggest Toms of Maine, or Rembrandt toothpaste (does not have sodium lauryl sulfate)

471
Q

How do you diagnosis hemangiomas?

A

Diascopy test (tissues will blanch)

472
Q

What is a submucosal hemorrhage?

A

Extravascular lesions that DO NOT blanch

473
Q

What are petechiae?

A

1mm hemorrhages

474
Q

What are purpurae?

A

Larger than petechiae

What is an ecchymosis? 1cm or bigger bruise

475
Q

What is hematoma?

A

Mass of blood within tissue, caused by trauma to oral mucosa like an anesthetic needle

476
Q

What are the 4 types of submucosal hemorrhages?

A

Petechiae
Purpura
Ecchymosis
Hematoma

477
Q

What are defining characteristics in primary HSV?

A

Can occur anywhere in an around mouth. Occurs mostly in childhood.

478
Q

What are defining characteristics of recurrent HSV?

A

Keratinized

On hard palate, attached gingiva (intraoral) or on vermillion border of lips (herpes labialis)

479
Q

What is HSV on the finger called?

A

Herpetic Whitlow

480
Q

What is HSV on the head?

A

Herpes gladiatorum

481
Q

What is tx for recurrent HSV?

A

Acyclovir in prodromal period

482
Q

What is VZV?

A

Vericella Zoster Virus, or chickenpox

483
Q

Where does VZV reside when it is latent?

A

In trigeminal ganglion

484
Q

How to tx VZV?

A

Acyclovir

485
Q

What is Ramsay Hunt Syndrome?

A

VZV reactivation in geniculate ganglion. Facial Paralysis + deafness + vertigo

486
Q

What is Herpes Zoster?

A

Shingles

487
Q

What is the Coxsackie Virus?

A

VZV reactivation in geniculate ganglion. Facial Paralysis + deafness + vertigo

488
Q

What is Herpes Zoster?

A

Shingles

489
Q

What is the Coxsackie Virus?

A

Virus that results in Hand-Foot-Mouth disease

Can cause Herpangina (posterior oral cavity)

490
Q

What is Rubeola?

A

Measles

491
Q

What is defining characteristic of Rubeola?

A

Koplik’s spots

492
Q

What is verruca vulgaris?

A

Common skin wart

493
Q

What is condyloma acuminatum?

A

Genital wart, or from oral sex with someone that has genital warts.

494
Q

What is condyloma acuminatum caused by?

A

Caused by HPV 6 and 11

495
Q

What is Focal Epithelial Hyperplasia?

A

Heck’s Disease
Caused by HPV 13 and 32
Small dome shaped warts on oral mucosa

496
Q

What is Oral hairy Leukoplakia?

A

White patch on lateral tongue
Ebstein barr Virus
Associated with HIV
Associated with Burkitt’s lymphoma

497
Q

Major things to know about Syphilis

A

Caused by treponema Pallidum
Primary lesion is a chancre
Secondary lesion is an oral mucous patch, or condyloma latum
Tertiary lesion is gumma

498
Q

What is major thing to know about congenital syphilis?

A

Hutchison’s triad
Notched incisors or mulberry molars
Deafness
Ocular keratitis

499
Q

What is primary infection of Tuberculosis characterized by?

A

Ghon complex

500
Q

What are tx drugs for TB?

A

Rifampin
Isoniazid
Ethambutal

501
Q

What is gonorrhea caused by?

A

Neisseria gonorrhoeae

502
Q

What is actinomycosis caused by?

A

Actinomyces Israeli, NOT FUNGAL

503
Q

DIGE

A
  1. Calcium channel blockers: Nifedipime, verapamil, amlodipine
  2. Dilantin
  3. Cyclosporine
504
Q

Infrabony defects:

A

1 wall- hemiseptal
2 wall- crater (most common)
3 wall- trough
4 wall- circumferential

505
Q

Orange complex

A

Fusobacterium nucleatum
Campylobacter rectus
Prevotella intermedia

506
Q

Red complex

A

P. Gingivalis
T. Denticola
T. Forsythia

507
Q

Order of plaque formation

A

Pellicle -seconds
Attraction and attachment- minutes
Colonization and maturation-24 to 48 hours

508
Q

Name the 4 risk elements and examples of each

A
  1. Risk Factors
    Diabetes
    Smoking
    Bacteria/plaque
2. Risk Determinants
Genetics
Age
Gender
Socioeconomic status
3. Risk Indicators
HIV
Osteoporosis
Infrequent dental visits
Stress
  1. Risk Markers
    Hx of perio
    BOP
    CAL
509
Q

What are the major components of pulpal tissue?

A

Fibroblasts
Odontoblasts
Undifferentiated mesenchymal cells

510
Q

What is another name for secondary dentin? What does it do?

A

Reactionary dentin, repairs minor damage.

511
Q

What are the histologic zones of pulp form outside to inside?

A 
Predentin
Odontoblastic layer
Cell-free zone of Weil
Cell-Rich Zone
Pulp Core
512
Q

What are the two pain fibers in a tooth?

A

A delta fiber - major pain fiber, sharp pain,COLD

C fibers - throbbing pain, HOT

513
Q

What is hyperalgesia?

A

A heightened response to pain

514
Q

What is Allodynia?

A

A reduced pain threshold. Pain due to a stimulus that doesn’t normally provoke pain. Ex: sunburn (it normally doesnt hurt to touch your skin.)

515
Q

Mandibular molars often refer pain to where?

A

Pre-auricular area (maxillary molars do NOT)

516
Q

What is the chemical in endo ice called?

A

Dichlorodifluoromethane (-30 degrees celsius)

517
Q

Symptomatic reversible pulpitis

A
  • cold test, with heightened response, non lingering
518
Q

Symptomatic irreversible pulpitis

A
  • cold test, heightened response, lingering
519
Q

Asymptomatic irreversible pulpitis

A
  • cold test, normal response
520
Q

Symptomatic periapical periodontitis

A
  • positive to percussion
521
Q

Asymptomatic periapical periodontitis

A
  • RL at apex
522
Q

Acute apical abscess

A
  • swelling and pain on gums
523
Q

Chronic apical abscess

A
  • draining fistula tract
524
Q 
What are shapes for RCT access on the following?
Incisors 
Canines
Premolars
Maxillary Molars
Mandibular Molars
A 
Incisors 
- triangular
Canines -
 oval
Premolars - 
narrow oval
Maxillary molars - 
blunted triangle, or rhomboid
Mandibular molars - 
trapezoidal
525
Q

What are the main files to instrument a canal? What size of taper? What shape are the files? How are they used?

A
  1. SS hand files - .02 taper
    a. K file (Kerr) - twisted square, watch winding
    b. H-file (Hedstrom) - spiral cone, up and down motion
  2. NiTi rotary - .04 or .06 taper
526
Q

What is the color pattern for endo files starting with a 6 and ending at 40?

A

Pink, gray, purple, white, yellow, red, blue, green, black, white…

527
Q

What is the D2 or D16 of the 15 file?

A

0.47mm (.15 + (.02*16mm)

528
Q

What is a barbed broach used for?

A

Its an endo file used to remove stuff from the canal

529
Q

How far away from apex do you want to instrument to?

A

0-2mm

530
Q

What irrigant dissolves organic material? Inorganic material? Gutta percha?

A

Organic - sodium hypochlorite
Inorganic - EDTA
Gutta percha - chloroform

531
Q

What bugs are primary bacteria in first endo tx tooth? In retreated tooth?

A

Primary - bacteroides (gram positive anerobic)

Failed tx - enterococcus faecalis (gram positive facultative)

532
Q

What is the sealer used in endo?

A

ZOE (zinc oxide eugenol)

533
Q

What is trephination?

A

An incision and drainage procedure where you cut a hole in bone to drain an infection and the root of a tooth. Incision and drainage normally refers to soft tissue only.

534
Q

How much root tip is excised in an apicoectomy?

A

3 mm

535
Q

What angle or bevel do you cut off a root tip in an apicoectomy?

A

0-10 degrees.

536
Q

What do you do after cutting the root tip off in apicoectomy?

A

Clean with ultra sonic and instrument 3 mm into canal. Then retrofill with mineral trioxide aggregate (MTA)

537
Q

Where is the most common place to have a strip perforation in an endo case?

A

The distal side of the mesial root on a mandibular molar (the dentin is thinner there.)

538
Q

How can you fix an endo perforation?

A

With MTA

539
Q

What is the acronym for trauma protocol?

A 
TRAVMA
Tetanus booster (for avulsions only)
Radiographs
Antibiotics (for avulsions only)
Vitality testing (often not reliable right after trauma. More accurate after 2 weeks)
More
Appointments
540
Q

What is the Ellis classification system?

A 
A classification of types of tooth trauma
Class I
 - enamel only (smooth the edges)
Class II
 - enamel and dentin (restore)
Class III
 - enamel, dentin and pulp 
	Less than 24 hours (DPC)
	More than or equal to 24 hours (Cvek pulpotomy)
	More than or equal to 72 hours (Pulpotomy)
Class IV
 - traumatized tooth that has become non vital
Class V
 - luxation
Class VI
 - avulsion
541
Q

What imaging should you take in a horizontal root fx

A

3 PAs and one occlusal (take at different angles)

542
Q

What is subluxation?

A

Tooth becomes loose in the socket (blood around sulcus of tooth) - should have flexible splint for 1-2 weeks. 6% chance necrosis

543
Q

What is extrusion?

A

Where tooth is pulled a little bit out of the socket - should have flexible splint for 1-2 weeks and RCT if needed (if apex is closed) 65% chance necrosis

544
Q

What is a lateral luxation?

A

Displacement of tooth in any direction except axially (same tx as extrusion) 80% chance of necrosis

545
Q

What is intrusion?

A

Apical displacement of tooth (pushed into the socket) 96% chance of necrosis because vessels generally are cut (in kids, allow to re-erupt. In adults, reposition, flexible splint, RCT)

546
Q

What is avulsion?

A

Tooth is knocked out. (reimplant ASAP, splint for 1-2 weeks (dont let tooth dry keep in milk, saline, saliva, Hanks Balanced Salt Solution (HBSS) (NOT WATER)

547
Q

What is the pH of calcium hydroxide? What is the function of it?

A

12.5 (this stimulates secondary odontoblasts to form tertiary dentin

548
Q

How does MTA work?

A

It stimulates cementoblasts to produce hard tissue.

549
Q

Indirect pulp cap

A
  • use CaOH or RMGI placed
550
Q

Direct Pulp cap

A
  • CaOH placed directly on exposure
551
Q

What is a cvek pulpotomy

A
  • a partial pulpotomy only to remove infection portion of pulp. Often done if pulp has been exposed to air for over 24 hours, or a larger exposure more than 2mm.
552
Q

What is apexogenesis?

A

Trying to stimulate continued root development when exposure exists (almost all caps and pulpotomies on immature permanent teeth with open apices. (So tx would include a pulp cap AND apexogenesis, for example)

553
Q

What is apexification?

A

Closing root apex that has not finished developing (with MTA or CaOH after pulpectomy on immature permanent tooth)

NBDE II (3 decks)

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