notes Flashcards
tx
periapical abscess
- RCT
- drainage (if possible)
- antibiotics if severe infection/systemic/swelling spread
periodontal abscess Tx
- drainage
- debridement
- saline mouthwash
lost crown/bridge
Tx
should have used a putty index to make the crown, therefore use this again to make a temporary
6 points of Possel’s envelope
- centric relation contact/ RCP
- maximum intercuspaction ICP
- edge to edge
- max protrusion
- terminal hinge axis
- maximum opening
chewing arch
posselts envelope is view from
sagittal
mandibular frontal plane movements
- max intercuspation
- max opening
- max lateral (s)
shield shaped
CD4+ helper cells
Th1
CD8+ killer/macrophage
secretes cytokines usually associated with inflammation, such as interferon-gamma and TNF and induces cell-mediated immune responses
CD4+ Helper cells
Th2
produces cytokines such as IL-4 and IL-5 (interleukins)
that help B cells to proliferate and differentiate and is associated with humoral-type immune responses.
class III malocclusion
treatment options dependent on if
non-growing
or
growing
non-growing Class III malocclusion tx options (3)
acceptance
orthodontic camoflage (procline U, retrocline L)
surgery
growing class III malocclusion tx options (3)
- acceptance
- orthodontic camouflage
- growth modification (reverse pull headgrear, maxilla forward /down, mandible backward/down, forehead/chin anchorage)
pemphigrus vulgaris
blisters to orofacial/genital region
autoimmune
corticosteroids
OAC
passage of fluids and food
leakage of air
some symptomatic
quatiflex MDM
inhalation sedatin
5% Nitrous oxide increase every 3-5mins
10-20% used
3-5min 100% oxygen recovery time
swollen lips 5 causes
trauma
allergy
bug bite
eczema
orofacial granulomatosis
stroke impact
impaired cognitive reasoning
arms/legs may be affected
drooping but not paralysed facial muslces (move eyebrows - forehead spared)
may not be able to understand them
non stroke nerve damage to face (e.g. bell’s palsy)
unilateral paralysation of one side of face
only facial muscles
cannot close eye or wrinkle brow
FAST for stroke
- face - can they smile/drooping mouth?
- arm - can they lift both arms?
- speech - can you understand what they are saying?
- Time to call 999
neurological site of damage for stroke
CNS
contralateral side
non-stroke (bell’s palsy) site of neurological damage
peripheral
same side (ipsilateral)
checks for ortho appliance delivery
- right pt for appliance
- matches prescription
- integrity of wire work
- sharp areas
- blanching when placed in
- posterior retention (arrowheads, flyovers)
- anterior retention
- activate
- tell-show-do
- review 4-6 weeks
advice for pt after delivery URA
- practice speaking - read a book aloud
- increased salivation for 24hours
- discomfort - normal means working
- wear 24/7
- clean after every meal with soft toothbrush
- remove when playing contact sports or high apiration activities
- avoid hot or sticky foods - scald
- non compliance increases time for tx
- emergency contact number
neurological action of stroke
- interuption of the supranuclear fibres from the motor areas in the cerebral cortex (before they reach the facial nucleus)
- upper facial muscles receive crossed and uncrossed fibres
- frontalis/orbicularis oculi spared
SIMD
scottish index of multiple deprivation
- area based (postcode) index of deprivation
based on 7 indicators
- education
- crime
- access
- housing
- income
- employment
- health
nerves anaesthetised in inferior alveolar nerve block
inferior alveolar (and so mental)
lingual
long buccal
areas affected by inferior alveolar nerve block
mandibular teeth to midline
body of mandible
buccal mucosa
anterior 2/3 tongue and floor of mouth on same side
anatomical guides for IAN bloock
coronoid notch
pterygomandibular raphe
retromolar pad
anterior ramus of mandible
opposite 5
too lateral IAN placement
hit bone early before 2-2.5cm advancement
reposition handle distally
too far IAN placement
no bone hit
reposition handle distally
IAN block achieve test
numb
lower 1/2 lip
1/2 tongue
probe gingival adjacent to tooth for op
azoles action
prevent ergosterol biosynthesis via inhibition of 1,4 demihylase enzyme
azole resistance
- upregulation of efflux pumps (CDR/MDR)
- biofilm formation
- changes to ergosterol target enzyme
dentally fit for cancer tx
free from dental disease and any possible source of infection before start cancer tx
caries - clincal Vs radiograph appearance
deeper clincally than on radiograph
composite Vs amalgam
aesthetics
minimal prep
bond (marginal seal adv)
similar modulus of elasticity
biofilm and antimicrobials
impair diffusion (need mechanical removal)
antibiotics can bind to it - resistance
growth rate
glucans affect inbiofilm
adhesion enamel surfcaes
autoaggregate
maxillary nerve CNV2 route
trigeminal ganglion
foramen rotundum
- pterygopalatine ganglion - greater and lesser palatine nerves
inferior orbital fissue
- Ant, mid and post alveolar nerves
- infraorbital nerve
- zygomatic temporal and facial
highest quality study
systematic review of RCT
RCT 4 characteristics
blinding
ramdomisation
comparative (control)
inclusion criteria
reasons for lower 6s extractions
grossly carious
avoid caries in adj teeth
reduction of future ortho need (crowding) - spontaenous space closure
reasons to avoid paediatric extractions
possible GA risk
bad dental experience - can hinder future
how to check practice protocol (e.g. decon)
- check current legislation and compare to cuurent SOP
- observe (audit)
- compare findings to current legislation
determine if action required
warafarin pt
antibiotic of choice
amoxillcillin
least interference (BNF)
