Mock? Flashcards
what 2 things do you need to know about a traumatic injury before you can decide between direct pulp cap or pulpotomy
- size of exposure
- length of time since injury occurred
explain the stages of pulptomy
- LA
- apply rubber dam
- remove pulp tissue 2-3mm radius around exposed area
- assess bleeding = if no bleeding then remove more tissue
- gain haemorrhage control using saline soaked cotton wool ball
- once normal bleeding stopped, apply non-setting CaOH
- seal with GI
- definitive restoration with composite
6 months after pulpotomy in pt with no symptoms
which radiographic signs would you expect to see if the tooth has remained vital
- continued root development
- continued thickening of entire in root walls
- apical development
- no pathology
list uses of URA other than tipping and tilting of teeth
- reduce overbite
- habit breaker
- space maintenance
- retainer
pt is having XLA of 4’s to allow eruption of upper canines
design a suitable removable space maintainer
+ another type of space maintainer
a = Southend clasp 11+21 0.7mm
r = adam’s cribs 16+26
b = PMMA
fixed palatal arch
URA for anterior cross bite, how could you know if the pt has been wearing as instructed
give 8 signs of good wear
- ask them
- can they speak with appliance in
- is it in when they enter room
- can they handle the appliance
- does it look worn
- has the tooth moved
- is the active component passive
- does it fit
- signs of wear on palate
- no excess salivation
68 y/o with fractured neck femur
-> what 2 drugs is she likely taking
-> what oral condition is at risk from these drugs
- bisphosphonates, calcium, vitamin D
- medication induced osteonecrosis of the jaw
-> how can MRONJ be managed
-> how can you avoid MRONJ in the first place
- conservative approach
- antiseptic MW
- ABX
- surgical debridement
- primary closure
- avoid XLA
- retain teeth/roots if possible
- avoid trauma
- good OH
how does RPI system work
- allows vertical rotation of a distal extension saddle into denture bearing mucosa without damaging periodontium of abutment tooth
- as saddle sinks into denture bearing area, there is rotation of the denture about the mesial rest
- both the distal guide plate and I-bar rotates downwards and medially (retrospectively) and disengages from the tooth
- potentially damaging torque is avoided
-> state 2 reasons for lingual bar as a major connector
-> state the choice of material
- depth of sulcus, oral hygiene, requirement for rigidity
- CoCr or gold allow
RCT on 16 - has been prepped over 2 visits, the 3rd you plan to obturate
what 3 criteria must be fulfilled before the RC can be obturated
- no symptoms
- not TTP
- canal must be able to be dried
- full biomechanical cleaning
give 3 constituents of gutta percha cones, in addition to GP
- *zinc oxide 59-75%
- *radio pacifiers - barium salts
- waxes
- colouring agents
-anti-oxidants
what is the function of a root canal sealer when used with GP cones
fills the space between GP and the RC wall and provide a fluid-tight seal
give 3 types of sealer that are commonly used in RC obturation
- zinc oxide eugenol (ZOE)
- resin based
- CaOH
- calcium silicate
congenitally missing 22 + 23
pt wants implants
give 2 alternatives
resin-bonded bridge
RPD
for RBB
-> what issues in aesthetics
-> what issues in functionality
space too narrow mesio-distally for 2 unit bridge but too wide for single unit
prosthesis is to replace the canine and is likely to be involved in guidance
LL3 appears over erupted
3 factors which need to be considered before implant referral
- pt understands what is involved and is willing
- good OH
- smoking status
- cost
- lack of viable bone or availability of suitable bone
- perio history
- history of contact sports
3 factors local to implant site which need to be assessed
- bone height
- bone width [bucco-palatally]
- root position of adjacent teeth
- soft tissue inadequacy
- smile line
- local perio health/plaque control
- general biotype
45 y/o complaining of mobility to lower incisors
-> what is the likely cause of gingival recession seen in LI
-> where else in mouth would you expect to see signs of this problem
traumatic overbite
palatal gingiva behind UI
5 investigations for pt complaining of mobility to LI (other than charting + occlusion)
- BPE
- 6PPC if indicated
- mobility scores
- PA radiographs
- impressions for study casts
- sensibility testing
- photographs
->2 general approaches for pt initial tx with mobility to LI
-> at reevaluation, perio stable but LI still mobile, what further tx?
- hygiene phase therapy
- upper anterior bite raising appliance for night time use
- splinting
name a set of published guidance for wisdom teeth removal
NICE
SIGN
3 reasons for wisdom teeth removal
- pericoronitis
- caries
- periodontal disease
- pathology
wisdom teeth removal, what is the incidence of
-> temporary loss of sensation
-> permanent loss of sensation
- approx. 5-20%
- < 1%
list 4 post-op complications of wisdom teeth removal
- pain
- swelling
- bruising
- infection
- bleeding
- jaw stiffness
- trismus
- delayed healing
explain the main features in context of food ingestion and mastication
-> stage 1 oral transport
-> stage 2 oral transport
- food gathered on tongue tip, tongue retracts taking food back to level of posterior teeth
- sufficiently masticated food transferred to oropharynx by queue-back mechanism in which the bolus is squeezed between the tongue and palate
name 2 biological factors that can affect masticatory performance
- number of occluding teeth/occlusal contact area
- biting force
what is mean by the term “shortened dental arch”
dentition in which posterior teeth have been lost
usually consists of 6 anteriors and 4 premolars in each teeth
20 teeth in all
3 aspects of oral function that are regarded by proponents of the shortened dental arch as acceptable in older pts
- acceptable masticatory performance
- acceptable aesthetics
- can be maintained in healthy state by pt
to which group of chemicals does chlorhexidine digluconate belong
bisbiguanides
describe MOA of CHX
- CHX binds to microbial cell wells [negatively charged phospholipids]
- causes cell wall damage [membrane disruption]
- interferes with cell wall permeability [osmotic damage]
- leakage of cell contents leading to cell death
the activity of an oral antiseptic depends on its substantivity
-> how is substantivity defined
-> provide 2 examples of factors which may influence the substantivity of CHX in oral cavity
- the ability of a substance to adhere to oral tissues and be released slowly over time, providing prolonged antimicrobial action.
- how long the active ingredient stays in contact with the tissues to exert its effect
- saliva flow
- presence of food or drink
- oral pH
4 indications for use of CHX mouth wash
- recurrent oral ulceration
- denture stomatitis
- pre op rinsing
- dry socket
- endodontic irrigant
- acute necrotising ulcerative gingivitis
- post intra-oral surgery
- maintain OH in jaw fixation pt
edentulous pt with inflamed mucosa and papillary hyperplasia
-> what is the diagnosis
-> what is the tx first line
-> if continued, what would the next line of tx be
-> denture stomatitis
-> denture hygiene, predisposing factors, miconazole gel applied to fitting surface
-> systemic fluconazole if worsening/immunosuppressed
what instructions would you give the technician for special tray construction of complete dentures
non-perforated
2mm wax spacing
handles
????
emergency appt, pain in upper central
O/E - red swelling associated with 11, tooth is TTP, associated lymphadenopathy. pt has had previous periodontal therapy
-> 2 differential diagnosis for this condition
-> 2 special investigations to confirm diagnosis
-> chronic periapical abscess
periodontal abscess
-> sensibility testing = PD abscess will be vital, PA will not
periodontal probing = PD with deep pocket, PA normal
PA radiograph = PD vertical bone loss, PA pathology around root
state 2 ways to drain a swelling of PD/PA abscesses
- incision and drainage
- drain through pocket
- pulp extirpation
management of periodontal abscess at emergency appt
- drainage through pocket or external excision
- debridement of pocket, deep scaling of root surface, take care not to traumatise pocket base
- [occlusal adjustment may provide immediate relief]
- systemic abx as lymphadenopathy = metronidazole 400mg ads 3 days
- reevaluate perio therapy after acute resolution
adhesive bridge fixed fixed with 11 being the Pontic
it has been debonded
-> give 4 reasons for debunking
-> give 4 methods for checking of debonding clinically
-> insufficient bonding technique, lack of moisture control, wrong cementation, poor adhesions, lack of good quality enamel, caries, bruxism, trauma, perio
-> visual assessment, probe to gently feel around the wings looking for movement, look for bubbling of saliva/air/water at the wing and tooth interface, press of Pontic to test mobility, floss underneath wings
