Restorative 1 Flashcards
what can impede calculus removal?
crowding/tilting root anatomy pocket size and shape access furcations
what are the effects of RSD?
health improved
gingival resolution
reduced pocket depth
long JE forms
when is RSD contraindicated?
poor oh compliance
acute inflammation
severe dentinal hypersensitivity
what does RSD do to the crown length?
makes it longer
what is calculus?
a calcified mass that adheres to hard surfaces not subject to friction
where is supra calc found?
opposing salivary ducts
e.g stensons/whartons
what is calc made of?
70-80% inorganic - calcium/phosphate
organic - lipids, carbs, proteins
what types of calc exist?
HA
octacalcium phosphate
brushite
magnesium whitelocke
where is brushite mostly found?
supra and new calc
where is HA mostly found?
older calc
where is mg whitelocke mostly found?
sub calc
what shapes does calc exist in?
needle, rod, platelet shape
what are the 3 calc formation theories and what do they mean?
Co2 theory - new saliva, increased CO2 conc = increased pH = crystallisation
ammonia theory - increased urea = ammonia = increased pH = crystallisation
Nucleation theory = crystallisation bc seeding agent
what are the indirect effects of calculus?
rough surface
hampers good oh
porous and holds toxins
what are anticalculus agents?
pyrophosphates = reduce new supra calculus
what is the critical pH of enamel ?
5.5
features of healthy gingivae?
pink, firm, uniform colour, stippling, knife edge margin, flat traiangular ID papillae, no BOP
features of gingivitis?
bleeding halitosis pain unpleasant taste inflammation starts ID and spreads
what happens to the tissues in gingivitis?
blood vessels dilate
tissue becomes red and swollen because of inflammatory exudate
fibres broken down by inflammation and stippling lost
false pocketing
what does long standing plaque irritation cause?
fibrous tissue
types of plaque disclosing tablets?
erythrocin - red fresh plaque
malachite green
blue - older
what TB technique is recommended?
modified stillman technique
45 degrees to gingival margin
what is the primary cuticle?
remnants of tooth development near g margin
usually worn away by natural friction
can persist and stain
what is the aqcuired pellice?
forms within seconds of cleaning, salivary glycoproteins
how is the acquired pellicle protective?
- glycoproteins and calcium phosphate adsorbed onto teeth - increased resistance
- restricts diffusion of acids from sugar breakdown
- antibacterial factors - IgA, IgM, complement, lysozyme
what is chronic periodontitis?
plaque induced inflammation of the tissues resulting in : pdl destruction
loss of alv crestal bone
apical migration of JE
what is a perio pocket?
deepened crevice, migration of JE onto root surface
how does perio disease progress?
BURST theory
bursts of disease activity can cause >3mm of attachment loss in a few weeks
what is the probing force used?
20-25g, modified pen grasp used
what is a biofilm?
microbial ecosystem adherent to a solid surface
what is a biofilm made of?
70% microorganisms, 30% interbacterial matrix
what is the intermicrobial matrix?
dead organisms, metabolic by products, enzymes, toxins
what does rubber dam do?
isolates tooth from salivary bac, protects airway
watertight junction around cervical margin, excludes moistures
what are the 2 types of disease progression?
linear - RAL/GAL
burst theory - bursts of disease with quiescent periods
describe a BPE probe?
WHO probe
ball end 0.5mm
coloured band 3.5-5.5mm
2nd coloured band - 8.5-11.5mm
disadvantages of a BPE?
lack of detail
no info on LOA
not for younger pt’s - crown length maturation not occured
what % of bleeding sites go onto have LOA?
30%
how is a furcation graded?
1 - horizontal loss under a third
- horizontal loss over a third
- through and through
how is mobility graded?
horizontal <1mm
horizontal >1mm
horizontal and vertical movement
what are the 5A’s?
ask assess advise assist arrange
what are the 5 R’s?
relevance, risks, rewards, roadblocks, repetition
what is NRT?
patches, lozenges, gum, inhaler, microtab, nasal spray, E cigs
what is non nicotine replacements?
champix, dummy cigs, hypnosis, diet and exercise
what is yellow stain?
discoloured plaque
what is tobacoo stain?
yellow/black, in plaque and calc
what is green stain?
primary cuticle
what is black stain?
good oh
what is metallic stain?
occupational/drugs
what is tetracycline staining?
antibiotic during tooth development causing brown banding
what is pulp damage?
decomposing material in dentinal tubules
what is blood borne pigmentation?
jaundice/typhus
what is enamel hypoplasia?
white spots
what is amelogenesis imperfecta?
lack of enamel
yellow/brown
what is dentinogenesis imperfecta?
grey/blue/brown
what is sedanol?
accelerated zinc oxide eugenol
what is kalzinol?
resin bonded zinc oxide eugenol
what is the abrasive component of TP?
calcium carbonate
20-40%
stain removal
what is the humectant in TP?
glycerol, retains moisture
what is the binding agent in TP?
alginate
prevents seperation
what is the preservative in TP?
formaldehyde
prevents bacterial growth
what is the detergent in TP?
SLS
foaming action
what does the solvent in TP do?
water
dissolves other ingredients
what is the antiplaque agent in TP?
triclosan
what is the anticalc agent in TP?
pyrophosphate
what is the desensitising agent in TP?
potassium chloride
what is the buffer in TP?
bicarbonate, reduced plaque activity
how does chx work as an antibacterial?
damages cell wall
disadvantages of chx use?
staining
calc formation
parotid swelling
mucosal erosion
what is an example of a phenolic?
listerine
high alcohol content
mod action
what is an example of an oxygenatingMW?
peroxyl hydorgen peroxide fizz O2 kills bac ANUG
what is sanguinarine?
organic MW
mod plaque reduction
what is the conc of F varnish?
26000ppm
what is chx varnish?
cervitec
root surface
reduced sensitivity
who is discovered the relationship between staining and fluoride?
dr frederick Mckay
who discovered the relationship between mottling and caries?
Dr trendley dean
what is the dose for F tabs?
6m - 3yrs - 0.25mg
3yrs-6yrs - 0.5mg
6yrs + 1mg
what is the strathcylde case?
1978
catherine mccall, lord jauncey
- ultra vires, nuisance and harmful, breach of water act, medicinal product with no license
F in water at what conc is not mutagenic?
1ppm
what did the Knox case prove?
1980
uncancerous
when does fatal F poisoning occur?
5-10g
children >5mgs
what is the use of the dental mirror?
retraction reflection indirect vision protection transillumination
how is a sickle scaler used?
working tip is at a right angle
what are the two types of mech scalers?
USS
sonic
what is the use of the water from the working tip?
cools the working tip and flushes the debris
what are the types of USS scaler?
- magnetostrictive - metal and electrical windings = magentic flux = transferred to working tip
- piozolectric - currents alter dimensions of quartz crystal = vibration
how does a sonic scaler work?
air over metal reed causes vibrations
what are the 3 modes of action of a scaler?
- mechanical abrasion - back/forth/circulatory movements abrade and chip away at the calc deposits
- cavitational effect - air bubbles implode and energy = shock waves remove an oxygen kills bacteria
- acoustic streaming - vigorous movement of water
what can overheating cause to the tooth?
irriversible pulp damage
longevity of enamel decreased
pt discomfort and sensitivity