Mucosa Management

Question 1

What is the goal of Mucosa and gingival retratction?

Answer 1

Gain access to area being treated, isolate tooth or teeth, adequately expose the prep margins to make an excellent impression

Question 2

What is the moving of tissue to expose a part or structure of the body?

Answer 2

Retraction

Question 3

What is the term for the stopping of bleeding through natural (clot formation, blood vessel constriction) artificial (compression, ligation), or surgical means (electrosurgery)

Answer 3

Hemostasis

Question 4

What is the physical displacement of the gingival tissue by placement of materials in the gingival sulcus, e.g. copper band, rubber dam, cotton cord?

Answer 4

Mechanical retraction

Question 5

What is the chemical used in conjunction with retraction cord to retract sulcus, stop bleeding?

Answer 5

Mechanical-chemical retraction (Chemicomechanical)

Question 6

What is the method of gingival retraction and exposure of finish line using a small needle shaped electrode with a high frequency electrical current (>1.0MHz)?

Answer 6

Electrosurgery

Question 7

Is Electrosurgery the same as electrocautery?

Answer 7

No, electro surgery electrode stays cold

Question 8

What is a troughing technique producing limited removal of epithelial tissue in sulcus while chamfer finish line is created in tooth structure done with rotary diamond?

Answer 8

Gingettage

Question 9

What are 4 types of current that can be used in electrosurgery?

Answer 9

1. Unrectified damped
2. Partially rectified damped
3. Fully rectified
4. Fully rectified filtered

Question 10

What is the single most important safety factor when electrosurgery is used?

Answer 10

The proper grounding of patient

Question 11

Where is ground plate recommended to be placed?

Answer 11

Under the patient’s thigh

Question 12

What are some contraindications for electrosurgery?

Answer 12

Patient with pacemaker, or near flammable materials/gases

Question 13

What are the symptoms of epinephrine syndrome?

Answer 13

1. Tachycardia
2. Increased respiration
3. Increased BP
4. Anxiety
5. Postop depression

Question 14

How much Epi is in each inch of 8% epi cord?

Answer 14

0.5-1.15 mg Epi/inch 8% epi cord

Question 15

The amount of epi lost/absorbed from 8% epi cord of 2.5 cm during a 5-15 min procedure is 71μg, which is equivalent to how many carpules of local anesthetic with 1:100k epi?

Answer 15

4 carpules

Question 16

What is the max dose of Epi for healthy adult?

Answer 16

0.2 mg (200 μg) (10 carpules)

Question 17

What is the max dose of Epi for a cardiac patient?

Answer 17

0.04 mg (40 μg) (2 carpules)

Question 18

What are the components of alum cord?

Answer 18

AlK(SO4)2 aluminum potassium sulfate

Question 19

What are the hemodent cord components?

Answer 19

AlCl3 Aluminum Chloride 5-25%

Question 20

What are the astringedent cord components?

Answer 20

Fe2(SO4)3 Ferric Sulfate 15.5 %

Question 21

When packing cord, where must the overlap always occur?

Answer 21

In proximal area where extra tissue will tolerate extra material

Question 22

How long leave retraction cord in?

Answer 22

10 min

Question 23

What is the appearance of adequate gingival retraction when the cord is removed from the sulcus?

Answer 23

No blood or crevicular fluid and visible margins around entire prep

Question 24

What are 8 retraction agents to avoid?

Answer 24

1. Epinepherine In pts with CV disease, HTN, DB, Hyperthyroid, Epi hypersensitive, MAOi meds, or sulcus severly lacerated
2. Sulfuric acid
3. Trichloracetic acid
4. Negatol solution (45%)
5. ZnCl
6. Ferric Subsulfate (monsels solution)
7. Tannic Acid (20-100%)
8. Combo of drugs

Question 25

What are 2 things that can be done if bleeding persists after the cord is removed?

Answer 25

1. Apply astringodent

2. Electrosurgery

Question 26

What is the time required to cement provisional?

Answer 26

10 min to cement and clean up

Question 27

How much time is required to make an impression of 2 prepared teeth with subgingival margins?

Answer 27

1. Paint tray 15 min prior to impression
2. Retract Gingiva 10 min
3. Apply light body around prep and retracted gingiva ~10sec
4. Place in heavy body filled tray for 7 minutes Overall ~15 min tray paint + 7 minutes impress= 22 minutes (retraction can be done in the 15 min waiting for tray to dry) (however, the book doesn’t say how long the overall impression procedure should take)