MSA 2012 Flashcards
3 materials used for crowns
metal (gold, nickel, chromium, titanium)
metal ceramic (porcelain fused to metal)
all ceramic (milled)
4 types of post
smooth/threaded/serrated
parallel or tapered
metal/fibre
prefabricated/casted
name given to residual collar of dentine required before placing a post
ferrule
how much GP should be left in the canal space when placing a post
4-5mm apically
key purpose of post placement
to provide resistance, retention and geometric form to the otherwise compromised crown of the tooth
width of taper required for MCC crown
5-9 degrees
2 types of bone loss
horizontal
vertical
3 ways dose to pt reduced in normal radiographic technique
collimation
lead lined film packet
film speed
describe Compton scatter and how it differs from photoelectric effect
interaction of x-ray photon with loosely bound outer electron of atom. Electron is ejected due to greater energy of photon.
- Photon has lower energy after collision and undergoes change in direction
in photoelectric effect, there is interaction of the photon with the inner shell electron
- complete absorption of the photon and no scatter
metal used to absorb heat energy generated during X-ray production
copper
2 other metals (not copper) used in x-ray production
tungsten
alumnium
mental nerve is a branch of
inferior alveolar nerve
remove a retained root in 44
what type of surgical flap should be used
2 sided envelope flap - crevicular incision with distal relieving incision
EADT
EAT
(paeds)
extra alveolar dry time
extra alveolar time
3 potential storage mediums for an avulsed tooth
saliva
milk
saline
2 key points of information you would give to someone phoning up about avulsion
handle by the crown of the tooth
wash off any debris and if possible re-implant and get child to bite gently onto tissue
splint used in subluxation
min time in place
flexible splint
2 weeks
fluoride regime for high risk 4 year old
pea-sized 1450ppm fluoride toothpaste
apply fluroide varnish an additional 2 times a year (total = 4)
0.5mg fluoride supplements
what age is it suitable to deliver mouthwash to paediatric pt
7
if able to demonstrate able to swirl and spit
fluoride toxic dose
5mg/kg
tx of 5mg/kg F toxic dose
give calcium orally (milk)
tx 5-15mg/kg F toxic dose
give calcium orally (milk, calcium gluconate)
admit to hospital
tx >15mg/kg F toxic dose
admit to hospital immediately
cardiac monitoring, life support (IV calcium gluconate)
retention of denture design feature
extension of flanges to function depth of sulcus and incorporation of post dam
stability of denture design feature
no interference with frenal attachments
materials that can be used in primary impression stage
impression compound
polyvinyl siloxane
impression compoud
- mucocompressive - displaces the tissues meaning a more accurate record can be taken with the master impression
- resulting in a denture which is tight fitting to tissues
- relatively cheap
- re-usable
polyvinyl siloxane
- low permanent deformation
- more accurate (less viscoelastic) than hydrocolloids
- more tear resistant than hydrocolloids
thickness of shimstock
8 microns
name this shape
Posselt’s envelope
RCP
Retruded contact position
ICP
intercuspal position
Pr
maximum protrusion
R
maximal mandibular opening with the condylar heads in the reproducible retruded position but no antero-inferior condylar translation
- arc (retruded arc of closure) has its centre of rotation passing through condylar heads (terminal hinge axis)- termed centric relation (CR)
T
maximal mandibular opening with full antero-inferior translation of the condylar heads
E
edge-to-edge position of incisors
RCP-ICP
path is termed a slide
- potential for horizontal, vertical and lateral components (lateral element cannot be seen in sagittal plane)
supracrestal attachment in mm
2mm
chlorohexidine commonly used to tx perio disease
3 other instances where it can be used
post periodontal or oral surgery
physically or mentally impaired pts
immunocompromised pts
(adjunct to OH)
give a way in which chlorohexidine is dimished in efficacy by the pt
may use it only once a day when should use it twice daily
may not rinse it around the mouth for the required amount of time (1min)
substantivity
persistence of action of a drug
TID on prescription means
three times a day
(ter in die (latin))
phenytoin side effect
ginival hyperplasia
3 drugs which can cause gingival hyperplasia
phenytoin
cyclosporin A
nifedipine
2 ways to tx gingival hyperplasia
gingivectomy
high standard oral hygiene and hygiene phase therapy
3 clincal signs of ANUG (acute nectorising ulcerative gingivitis)
pain
bleeding
halitosis
Antibiotic for ANUG
metronidazole 400mg 3x day 3days (SDCEP)
when would you given antibiotics for ANUG
only after systemic involvement (e.g. lymphadenopathy)
5As in smoking cessation
ask
assess
advise
assist
arrange
3As in smoking cessation
ask
advice
act
5Rs of motivation
relevant benefits
rewards
risks
roadblock
repeat
what periodontal phenomenon is experience by smokers when trying to quit
rebound gingivitis - due to increased vascular supply to gingival tissues
5 indications to extract a tooth
tooth is non-restorable
symptomatically partially erupted
trauamatic position
orthodontic indications
interference with construction of denture
2 drugs to be careful of when extracting
aspirin
warfarin
aspirin reason for caution on extraction
antiplatelet
risk of clot failing to form after extraction
warfarin reason for caution on extraction
anticoagulant
inhibits clotting factors 2, 7, 9 and 10
risk uncontrolled bleeding after extraction
4 tx for pt if complain of persistent bleeding after extraction (1 day ago)
get pt to bite down on damp gauze
LA with vasoconstrictor
oxidised cellulose which provides framework for clots
suture socket (interrupted or horizontal mattress)
anterior crossbite lab prescrition
A
- Z sping 0.5mm HSSW (one coil a week)
R
- 14, 16, 24, 26 Adam’s clasp 0.7mm HSSW
A
- OK
B
- self cure PMMA
- posterior bite plane
posterior crossbite lab priscription
A
- mid palatal screee
R
- 14, 16, 24, 26 adam’s clasp 0.7 HSSW
A
- ok
B
- self cure PMMA
- posterior bite plane
retracting canines
A
- palatal finger spring and guard, 13 and 23, 0.7mm HSSW
R
- adam’s clasps, 16, 26; 0.7mm HSSW
- southend clasp; 11, 21; 0.7mm HSSW
A
- ok
B
- self cure PMMA
- self
moving canines palatally lab prescription
A
- buccal canine retractor; 13, 23; 0.5mm HSSW and 0.5mm I.D. tubing
R
- adam’s clasps; 16, 26; 0.7mm HSSW
A
- ok
B
- self cure PMMA
overbite lab presciption
A
- Robert’s retractor; 21, 22; 0.5HSSW and 0.5 ID tubing
R
- adam’s clasp; 16, 26; 0.7mm HSSW
A
- ok
B
- self cure PMMA
- flat anterior bite plane OJ + 3mm
fitting of URA
- ensure it is the right appliance for the right pt
- ensure appliances matches prescription
- ensure fitting surfaces free of sharp edges
- check wire integrity
- fit in the pts mouth and assess for any areas of blanching or trauma
- check posterior retention (flyovers, arrowheads)
- check anterior retention
- activate components to induce 1mm tooth movement per month
- get pt to demo insertion and removal
- see pt every 4-6 weeks
6 pt instruction for URA
- wear 24/7 including mealtimes
- take it out and clean with soft brush after every meal
- avoid hard and sticky foods and sugary drinks
- be cautious of hot foods and drinks as base plate acts as insulator
- non-compliance will significantly lengthen tx
- supply pt with emergency contact number
4 types of porositiy which can be generated in URA or full denture production (self cure PMMA)
contraction porosity
gaseous porosity
crazing
granularity
sugery used to repair cleft lip and palate
orthognathic surgery
what drug conteracts benzodiazepine sedation
flumazenil
to have capacity:
4 aspects
to understand, to act and communicate a reasoned decision, to retain memory of decision
5 principles of consent
not manipulated
not coerced
informed
given with capacity
voluntary
glycated haemoglobian
HbA1c
average plasma glucose concentration (long term)
higher HbA1c - higher risk of developing diabetes related complications
xerostomia reasons
- removed salivary gland or absent salivary gland (congential)
- drugs
- antihypertensive (ACE inhibitors) phentolamine, benzopril
- antidepressants - citalopram, fluoxetine
- beta blockers - propranolol
- anti-diuretics - bendrafluazide
- polypharmacy
- non-drug related
- diabetes, sjorgen’s syndrome
method of LA for haemophillia
infiltration
method of LA for warfarin
if INR below 4 and under control - safe to give IDB
optimum dose F in drinking water
1ppm
foods and drinks which have added fluoride (not water) by manufacturers
salt
milk
4 methods of topical fluoride application in 8 year old
fluoride varnish - 22600ppm
fluoride toothpaste - 1450ppm
fluoride mouthwash - 225ppm
fluoride supplements - 1mg
3 mechanisms by which topical fluoride helps prevent caries
promotes remineralisation
converts hydroxyapatite to fluorapatite (F replaced OH) resulting in strengthening of tooth surface
daily dose of F table of 4yo high risk caries and lives in area of less than 0.3ppm water fluoride
0.5mg
rational for use of antibiotics in perio tx (3)
- perio is caused by bacteria
- some bacteria are inaccessible to debridement
- e.g. they have invaded dentine tubules and tissues
- non dental areas - tonsils, tongue affected
- systemic signs of infection
problems limiting use of AB in perio tx (5)
- antibiotics may inactivate or degrade by non-target oragnisms
- biofilms - resist AB
- allergic reactions
- resistance
- superinfection
in which perio situations would it be appropriate to prescribe AB
- periodontal abscesses or ANUG with systemic involvement
- ongoing disease despite meticulous mechanical therapy and good OH
- medically compromised pts
3 reasons for carrying obturation of prepared root canals
- prevent bacteria left in the canal after obturation escaping to surrounding periodontal space - via apical foramen and lateral canals
- prevent bacteria from infecting root tissue via coronal leakage
- prevent infectin of root from periradicular exudate via apical forament, lateral canals
describe stages in obturating root canal in upper central incisor
cold lateral compaction technique
- choose appropriate GP master file cone corresponding to final extirpating file
- mark the length of the canal preparation on the cone
- check tug back
- cover in root canal sealer (epoxy resin) and place in canal
- place in accessory cones covered in sealer utilising a finger spreader (2mm from apical stop)
- using a hot excavator, cut the coronal end of the GP just below the ACJ
which part of the canal filling is most important in ensuring long term success of tx
coronal seal (determines the success of the final restoration)
vertical interproximal bone loss with perio
2 theories
- plaque causes destruction within 2mm radius, if a bone is >2mm thick an angular bone defect may occur
- occlusion with bacterial plaque is a causative factor in perio attachment loss and bone destruction. Inflammation of gingivae occurs and this spreads to the PDL resulting in an area of co-destruction - produces vertical bone defect due to local trauma which exacerbates it
horizontal bone loss in molars significant when
it involves furcation
4 tx options for quadrant after HPT and excellent OH but persistent pockets >5mm
- non surgical re-treat with HPT
- surgical open flap curettage/debridement
- do nothing
- extract
tooth brushing regimes for children as per SIGN 83 guideline
modified bass technique
- hold the toothbrush at 45 degrees to the tooth to get under the gum line
- horizontal strokes
- 1 tooth at a time
- be methodical - start in upper right proceed to upper left then lower left and lower right
diet diary kept for
3 days (1 day is a weekend day)
2 most common models of disability
social model
medical model
social model of disability
is caused by the way society is organised rather than person’s impairment
looks at removing barriers that restrict people’s lives
medical model of disability
people are disabled by their impairments
these impairment should be fixed by medical or other tx
2 pieces of UK legistlation for disability
equality act 2010
disability discrimination act 2004
