other Flashcards
what are the 9 GDC principles
put patients interests first
communicate effectively
Maintain and protect patient information
have a clear and effective complaints procedure
work with colleagues in way that benefits patients
maintain, develop and work within knowledge and skills
raise concerns if patient at risk
behaviour maintains confidence in pt confidence in you and profession
why is calcium hydroxide used for pulp caps
high pH - decreases microbial load
forms calcific barrier
what wire for flexible splint
0.4mm SS wire, bonded with composite
discuss the viability of PDL cells after avulsion
replanted within 15 mins - viable
tooth stored then replanted within 60 mins - viable but compromised
EADT>60mins - non viable
discuss what should be done at avulsion injury site
keep patient calm
replant tooth - if dirty rinse with saline or milk then replant, only hold tooth by crown
get patient to bite on gauze or tissue to hold in place
if replantation not possible store in milk or saliva asap
treatment of a closed apex avulsion
clean socket or replantation area with saline
administer LA without vasoconstrictor
replant tooth or reposition if required
stabilise tooth for 2 weeks with flexible splint
initiate RCT within 2 weeks
treatment of open apex avulsion
clean socket or replantation area with saline
administer LA without vasoconstrictor
replant tooth or reposition if required
stabilise tooth for 2 weeks with flexible splint
pulp revascularisation and continued root development is the goal - monitor tooth for signs of external inflammatory RR
pt instructions after avulsion (4)
avoid contact sports
soft diet for 2 weeks
brush teeth with soft brush after every meal
use CHX 0.2% 2x daily for 2 weeks
what degree of taper should cores have
6 degrees
methods of post removal (4)
masseran kit
eggler device
sliding hammer
mosquito forceps (screw)
ultrasonic
4 risks of post removal
root fracture
cant remove post
tooth rendered unrestorable
post breaks
name 1 ester and 3 amide LAs
ester - benzocaine
amide - articaine, lidocaine, prilocaine
what is included within a LA preparation (4)
base hydrochloride e.g lidocaine HCl
reducing agent
preservative
(vasoconstrictor)
2 components in alginate
calcium phosphate
sodium alginate
why does alginate have poor dimensional stability
syneresis and imbibition of water
amalgam cavity preparations for proximal restorations
self retentive box
proximo-occlusal prep
discuss the phases of amalgam
gamma - silver and tin - good strength and corrosion resistance
gamma 1 - mercury and silver - good corrosion resistance, holds material together
gamma 2 - mercury and tin - poor strength and corrosion resistance
why was zinc added to amalgams and why is it no longer used
was added to act as scavenger and preferentially react with oxygen
removed as reacted with water to form hydrogen bubbles
why are modern amalgams copper enriched
higher early strength, less creep, greater corrosion resistance, better durability of margins
single composition contains at least 12 % copper
name an example of a low weight dimethacrylate
TEGDMA
clock positions in chariside assistance
7-11 - operating
11-2 - static
2-4 - nurse
4-7 - transfer
name 5 benefits of aspiration and retraction
patient safety
patient comfort
maximum illumination
good visualisation
name 5 things that can be used for retraction
cheek retractor
aspirator
3 in 1 syringe
mirror
tongue depressor
cotton wool rolls
what is the ideal operating seating position
balanced position
name 4 components of the balanced seating position
- 90 degree angle at hip and knee
- thighs parallel to floor
-relaxed shoulders - feet flat on floor for stability
what height should the nurse be at
2-4 inches higher than dentist
modifying factors in attrition (4)
stress
in combo with abrasion or erosion
malocclusion
lack of posterior support
contraindications to DAhl technique (4)
implants
active perio
bisphosphonates
TMJD
discuss the dahl concept (3)
conservative concept allowing localised increase in space without reorganising entire occlusion
can use bite plane or more commonly composite restorations on palatal of anteriors to create an occlusion on a raised cingulum
results in disocclusion of the posteriors and an increase in OVD of around 2-3mm.
Over 3-6 months posteriors will overupt and space will be gained
treatment of chronic hyperplastic candidiasis
risk factor modification - smoking, nutritional deficiencies
biopsy
antifungals - fluconazole
review appts
excision indicated if dysplasia found
4 aetiological factors of RAU
genetics - 40%
hormonal - luteal phase of menstruation
GI disease - associated haematinic deficiency
allergy - raised IgE
HIV - associated
RAU investigations
FBC + haematinics
TTG
allergy
lichen planus investigations
biopsy
FBC + haematinics
autoantibody screen if indicated
what wire for retention on permanent and deciduous URA
permanent 0.7mm HSSW
primary - 0.6mm HSSW
treatment of angular chelitis
miconazole 2% cream, 2x daily
treatment of denture stomatitis
fluconazole - 50mg 7 days
miconazole 20mg/g gel - 4 times to fitting surface a day
5 intra oral manifestations of HIV
kaposis sarcoma
hairy leukoplakia
RAU
erythmatous and pseudomembranous candida
ANUG
NH lymphoma
aciclovir mechanism of action (3)
activated by thymidine kinase which is only present in infected cells
competitively inhibits DNA polymerase by acting as a defective guanine
aciclovir triphsophate has greater affinity for viral DNA polymerase than host DNA polymerase
3 pharmacological managements of TMD
NSAIDs
TCAs
muscle relaxants e.g cyclobenzaprine
name 4 secondary care treatments of lichen planus
clobetasol
tacrolimus
hydroxychloroquine
azathioprine
cluster headache vs paroxysmal hemicrania
cluster - bouts then remission periods - 15 mins to 3 hours
hemicrania - multiple attacks a day up to 30 mins
3 side effects of carbamazepine
ataxia
dizzyness
drowsiness
4 signs of midface fracture
nose bleed without blow to nose
midface mobility
infraorbital numbness without blow to nerve
subconjunctival bleed
4 signs of zygomatico-orbital fractures
periorbital ecchymosis
assymetry
step deformity
unilateral nose bleed
what makes consent valid
specific to proposed treatment
obtained recently enough
remains current
what makes consent legal
pt has capacity
pt is informed
voluntary decision
6 elements of consent
not coerced
not manipulated
voluntary
valid
with capacity
informed
what size wire for lab made fixed appliances e.g quadhelix
0.9mm HSSW
what does a facebow do
records relationship of maxilla to terminal hinge axis of mandible and allows the maxillary cast to be mounted on articulator in an equivalent relationship
briefly describe the process of using a facebow (3 steps)
1 - mark anterior reference point (infra orbital foreamen)
2 - position bite fork with paste or wax, notch in midline
3 - assemble ear bows and face jig, pointer aligned with anterior reference point, parallel with interpupillary line
3 circumstances for using a facebow
toothwear
bridges
michigan splint
name 3 methods of hand file motions and describe each
watch winding - 30 -60 back and forth light apical pressure, used for small K files <=15
balanced force - 60 CW then 60-120 CCW
reaming - used with protaper series - 90 CW then another 90 CW whilst simultaneously withdrawing
discuss the protaper series
either hand files or protaper gold (rotary)
both compromise 8 files arranged in 2 series
- shaper files - 3 files for apical and middle third prep
- finishing files, 5 files used in simultaneous manner, recommended at least to F3
degrees of motion for reciproc
150 degrees counterclockwise then 30 degrees clockwise
how to decide what size reciproc
narrow canals - R25
ISO 20 passively to length - R40
ISO 30 passively to length - R50
name 3 complications that may occur when using hand files for endo prep
blockage - accumulation of debris
ledge - internal transportation
zipping - overenlargement of outerside, underenlargement of inner side
what may cause instrument separation (2)
torsional stress - tip locks and torque exceeds critical level
flexural stress due to repeat cyclic metal fatigue
