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BDS2 CDS > Operative techniques > Flashcards

Operative techniques Flashcards

1
Q

Hand piece safety

A

Check back cap
Check bur
Check coupling (ie attachment to machine)
Check resistance/ grainy
Check lateral movements of bur
Check for weird sound and water

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2
Q

Principles of cavity design and preparation

A
  1. Identify and remove carious enamel
  2. Identify maximal extent of lesion at the ADJ, smooth enamel margins
  3. Remove peripheral caries in dentine, circumferential deeper to avoid exposing pulp
  4. Outline form modification (ie shape)
  5. Internal design modification (smooth and rounded)
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3
Q

Line angle

A

Line angle = two linear surfaces meet

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4
Q

Point angle

A

Point angle = three linear surfaces meet

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5
Q

what angles can act as stress concentration points

A

sharp angles

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6
Q

what happens if we leave stress concentration points

A

stress and fracture or microleakage

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7
Q

when to restore a tooth

A
  • lesion is cavitated
  • patient can’t access lesion for prevention
  • lesion into the dentine radiographically
  • Lesion causing pulpitis or pain
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8
Q

whats LA and PA

A

LA = labial approach
PA = proximal approach

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9
Q

WHEN TO Pulp exposure

A

If necrotic material in pulp

Irreversible pulpitis

RCT

Sensitivity tests required

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10
Q

why keep Configuration factor low

A

reduce polymerisation contraction stress, ie less bonded surfaces, restoration involves minimal tooth structure

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11
Q

Configuration factor

A

ratio of bonded to unbounded surfaces, especially important for composite restoration

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12
Q

Polymerisation contraction stress

A

Polymerisation contraction shrinkage -> plastic deformation; composite pulls away from the bonded surface towards the direction of curing light

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13
Q

plastic deformation

A

Plasticity = non reversible change of shape in response to an applied force
Deformation = change in shape due to an applied force

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14
Q

Differential etch

A

Differential etch = 10 sec on enamel before moving the etch to dentine for another 10 seconds (total 20sec on enamel)

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15
Q

Injuries of pulp

A
  • Caries
  • Cavity prep
  • Trauma
  • Heat, vibrations, sharpness, strong force from high speed
  • Chemicals from materials eg. Etch
  • Tooth wear
  • Periodontal health
  • Ortho
  • Dehydration of dentine
  • Cutting odontoblastic processes, essentially damaging pulp
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16
Q

what risky substances can permeate into the pulp

A
  • Bacteria
  • Immune complexes
  • Antibodies
  • Microorganisms that cause pulpal disease
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17
Q

which fibres respond to an EPT

A

A fibres

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18
Q

what pain does C fibres detet

A

C fibres unmyelinated for dull pain, increased pulpal blood flow -> pressure -> pain

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19
Q

when looking at pulpal health what are the two broad categories of diagnosis

A

pulpal diagnosis and periapical diag

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20
Q

Reversible pulpitis vs Irreversible pulpitis

A

Can reverse to health
pain to cold
no change to pulpal blood flow
A fibres

vs

Still vital but inflammation cannot be healed
negative pain to cold
C fibres due to increase in pulpal blood flow

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21
Q

how to treat Reversible pulpitis and Irreversible pulpitis

A

o Vital pulp therapy
vs

o Pulpotomy -> vital pulp therapy
o Pulpectomy -> RCT

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22
Q

what is a necrotic pulp

A

o Non vital
o Can be partial or total necrosis

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23
Q

where do you find open apices?

A

 Immature teeth

24
Q

difference in treatment of open and closed apices

A

Closed apices
 RCT or extraction

Open apices
 Pulpotomy -> vital therapy
 Pulpectomy -> RCT
 Extraction
 Open apices immature teeth have more recovery potential since more blood supply

25
Q

dangers of rct on open apices

A

, rct can be dangerous because the materials used can be shoved through the open apex

26
Q

c fibres stimulated is reversible or irreversible pulpitis

A

irreversible

27
Q

5 types of periapical diagnosis

A

healthy
periapical periodontitis
acute apical abscess
chronic apical abscess
condensing osteitis

28
Q

4 types of pulpal diagnosis

A

healthy
reversible pulpitis
irreversible pulpitis
necrotic pulp

29
Q

how to diagnose healthy periapical

A

o Not sensitive to tapping or palpation
lamina dura intact
PDL space uniform

30
Q

Periapical periodontitis

A

 Pain when biting or palpation
 Inflammation

31
Q

wha is Acute apical abscess

A

o Inflammatory rxn to infection

32
Q

symptoms of acute apical abscess

A

o Rapid onset
o Spontaneous pain
o Extreme tenderness
o Pus
o Swelling
o Fever or malaise
o Lymphadenopathy

33
Q

difference between acute and Chronic apical abscess

A

both are Inflammatory rxn to infection

acute is rapid while chronic is Gradual onset

acute is very pain while chronic has little to no pain

34
Q

another name for Chronic apical abscess

A

sinus

35
Q

what is a gp cone used for

A

o Can use GP cone to tell you which tooth pulp is the source of infection

36
Q

Condensing osteitis

A

Represents localised bony reaction to inflammation usually found at apex

No treatment usually because RCT doesn’t clear up this bone condition

37
Q

How to tell if a tooth is vital or not?

A
  • Discoloration
  • Sinus
  • Gross caries
  • Large restoration
  • PA Radiolucency
  • Sensibility tests
38
Q

RMB THAT SENSIBILITY TESTS DOES NOT MEAN THE SAME AS VITALITY TEST

A
39
Q

Electric pulp tester which fibres stimulated

A

A delta fibres stimulated
- If current is high and patient still doesn’t feel anything prob necrotic
- EPT doesn’t tell you the condition of pulp

40
Q

why EPT on young pulps and recently traumatised pulps are unreliable

A

the nerves may not be fully developed

the pulp may not have recovered from the trauma

41
Q

Cold -> outward or inward flow of dentinal fluid?

A

Cold -> outward flow, nerves stretched, cold more sensitive than hot

42
Q

Thermal tests work on the basis of?

A

Thermal tests work on the basis on dentinal fluid movement

43
Q

what is used in hot test and what fibre does it stimuate

A

Hot test
- Hot gutta percha
- A and c fibres
- Too much heat can cause irreversible pulpitis be careful

44
Q

what happens to pulp as we age

A

o less regenerative potential
o pulp becomes smaller, less blood vessels and nerves
o more fibrous content
o Less resistant to inflammation

45
Q

what does insult to the pulp do to it

A

o Dentinal tubules occlude, tertiary dentine forms, pulp becomes smaller

46
Q

reparative vs reactionary dentine

A

Reactionary is mild stimulus

Reparative is intense stimulus

47
Q

treatment for an unexposed pulp

A

indirect pulp cap
stepwise excavation
seal caries in

48
Q

stepwise excavation

A
  • remove caries but leave someone over the pulpal floor if too close to the pulp
  • temporary restoration
  • Wait for tertiary dentine to form over the pulp
  • Remove remaining caries and fully restore
49
Q

seal caries in

A
  • Leave caries there over the pulpal floor
  • Seal well so that you cut off the sugar supply of bacteria
  • Caries doesn’t progress
50
Q

exposed pulp treatment options

A

direct pulp cap
partial pulpotomy + vital pulp therapy
complete pulpotomy
pulpectomy
RCT

51
Q

pulpotomy vs pulpectomy

A

Partial pulpotomy – remove necrotic parts only
Complete pulpotomy – remove all but the root pulp
Pulpectomy – remove all and RCT

52
Q

materilas used for vital pulp therapy

A

o Calcium hydroxide
o RMGIC
o Bioceramics ->Mineral trioxide aggregate MTA or Biodentine

53
Q

what happens to dentine permeability as we get closer to the pulp?

A

it increases

54
Q

how does CaOH work

A

kills bacteria-high pH

irritates pulp and stimulates tertiary dentine as a protective layer

stimulates recalcification of demineralized dentine

neutralizes pH from acidic restorative materials

55
Q

how does MTA work

A

high pH to kills bacteria

bacteria tight seal

hard enough to act as a base

biocompatible

56
Q

how does biodentine work

A

same as MTA but no discoloration

57
Q

whats a complete pulpotomy

A

remove entire pulp from pulp chamber but leave the pulp in root canals

BDS2 CDS (15 decks)

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