OPERATIVE ODTP Flashcards
A female aged 60, suffering from DM …( I remember there was a table on C/O, HPC, PDH, etc)
Fig.1 (assume coming from the same patient)
a. Comment on aesthetics/give necessary diagnosis of the anterior teeth (3?)
- Gap between upper central incisors
- Yellowish teeth
- Restoration not the same colour as the tooth on 21
- Stained margins of the restoration
- Diagnosis
- Fractured tooth
a. Comment on the aesthetics of the restoration
Colour: not match, margins are discoloured, not resemble the tooth fat shape,
b. Treatment options for peg-shaped lateral incisors (6)
CMC, ceramic crown, shiny gold crown, direct restoration, no treatment, replace with huge implant
c. What factors would affect your decision?
Amount of tooth substance left
The cost of treatment
Aesthetic consideration
Patient has toothache. A picture is shown (CMC exposed metal). X-ray is also given
a. What is the restoration?
Ceramo-Metallic Crown restoration
Patient has toothache. A picture is shown (CMC exposed metal). X-ray is also given
b. How to assess the restoration
Use a probe to probe at the margins of the crown to see if the margins are still acceptable Check the aesthetics of the crown, see if there is any staining
Check for allergy
Check if there is any fracture of the crown
Check if there are any secondary caries
Check if there is any wear of crown and opposing dentition
Check if there is any cracks in the crown
Patient has toothache. A picture is shown (CMC exposed metal). X-ray is also given
c. Describe the radiograph. (defective root canal filling?)
Defective root canal filling
Patient has toothache. A picture is shown (CMC exposed metal). X-ray is also given
d. Differential diagnosis
Irreversible pulpitis
Necrotic pulp with apical periodontitis
Patient has toothache. A picture is shown (CMC exposed metal). X-ray is also given
e. Is the tooth in picture is the same one as the one in x-ray? Explain (Need you to identify the root morphology and crown morphology)
Lets look at the root morphology and crown morphology and also the location
a. What would you ask the px about the fractured upper left premolar? (4 or 5)
How did the tooth fracture?
When did the tooth fracture?
Any pain or sensitivity or discomfort?
Has there been any previous restoration done on that tooth?
Do you still have the fractured tooth fragment?
b. Describe clinical photo in related to fractured upper left premolar.(4 or 5)
Can’t answer
c. Why tooth will fracture? (3)
see page 143, long answer
d. What will be the condition (or consequence??) if this left untreated?
Pain and discomfort during mastication
Possibility of pulpitis
Reduced masticatory function
Tooth sensitivity
e. List the treatment plan (in phase) in detail. Assume that the premolar can be retained. (5)
- Initial Phase
- Emergency Root Canal Treatment on premolar and provisional crown
- Systemic Phase
- Does the patient smoke, have diabetes?
- Preventive Phase
- Oral Hygiene Instructions
- Root surface debridement
- Supragingival scaling
- Dietary analysis
- Corrective Phase
- Post and core and CMC crown
- Maintenance Phase
- I have no idea
- Operative - Patient complains for pain/sensitivity initiated by hot and cold food and biting, pain goes off quickly. Found to have deep DO composite placed last week. (Formative, 2013)
a. What is the pulp condition(1)
Vital, reversible pulpitis
- Operative - Patient complains for pain/sensitivity initiated by hot and cold food and biting, pain goes off quickly. Found to have deep DO composite placed last week.
b. What would you do to confirm your diagnosis (6)
Pulp test (thermal, EPT), percussion, radiograph, air blow, check occlusion, detect crack line by several test (bite test, transillumination, etc), check other tooth to exclude referred pain
50 year old man. Clinical photo (anterior teeth apart front view), PAN, Study Cast.
C/O: reduced height of anterior tooth.
HPC: Sharp pain on cold drink. Not spontaneous.
I/O Photographs: showing generalized attrition and erosion of upper and lower arch. (mainly anterior) PAN
Describe the radiographic findings. (5) b. Describe the clinical findings. (5)
What is the diagnosis of the patient?
Tooth hypersensitivity
50 year old man. Clinical photo (anterior teeth apart front view), PAN, Study Cast.
C/O: reduced height of anterior tooth.
HPC: Sharp pain on cold drink. Not spontaneous.
I/O Photographs: showing generalized attrition and erosion of upper and lower arch. (mainly anterior) PAN
c. List 5 questions you will ask the patient to support your diagnosis. (5)
Diet (acidic beverage)
Brushing method, forces and tools
Parafunctional habit like bruxism or clenching / stress / muscle or joint pain
Eating disorder like anorexia nervosa
Pain is generalized or specifically to certain tooth or teeth
50 year old man. Clinical photo (anterior teeth apart front view), PAN, Study Cast.
C/O: reduced height of anterior tooth.
HPC: Sharp pain on cold drink. Not spontaneous.
I/O Photographs: showing generalized attrition and erosion of upper and lower arch. (mainly anterior) PAN
d. Why the patient feel pain on cold drink? (2)
Hydrodynamic theory
Plasma-like biological fluid inside the dentinal tubules. Cold stimulus cause outward fluid movement and deform the odontoblastic process, which stimulate the A-delta fibers to initiaite short durated sharp pain
