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clinical practise 2 > Restorative 2 > Flashcards

Restorative 2 Flashcards

1
Q

what is the ‘Gate Control Theory’?

A
  • melzack and wall 1965
  • possible explanation of how pain can be modulated in the spinal cord and physiological, pyschological and sociolocultural factors contribute to the experience
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2
Q

What pain index is often used for adults?

A
  • McGill pain index

- numbers

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3
Q

what pain index is often used for children?

A
  • Wong-Baker pain index

- smiley faces

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4
Q

What is a placebo?

A

-An inert medicine given for its suggested effects, but has no pharmacological benefits but can have psychological benefits

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5
Q

what word should be avoided when doing treatment?

A

-oain

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6
Q

how can anxiety be reduced?

A
  • initial explanation of things
  • calm and instruct the patient to be calm
  • warn the patient if there is any discomfort to be expected
  • give the pt control and help them to cop (eg. breathing exercises)
  • distract them
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7
Q

what is the aim of analgesia?

A
  • elimination of pain

- reduction of haemorrahe

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8
Q

what is the physiology of a nerve?

eg. ….-……-……

A

-dentride-cell body-axon

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9
Q

What are two parts of a nerve that contribute to conduction?

A
  • nodes of ranvier

- end feet synapse

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10
Q

what are 4 pain producing substances that are produced by injured tissue?

A
  • potassium
  • sodium
  • chloride
  • calcium
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11
Q

what are the 4 phases of physiological conduction?

A

1-polarisation
2-depolarisation
3-action potential
4-repolarisation

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12
Q

what happens in the polarisation stage (1st stage) of physiological conduction?

A
  • NO pain

- pottasium inside the cytoplasm and sodium outside

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13
Q

what happens in the depolarisation stage?

A
  • ionic exchange

- pottasium now higher concentration outside the cell and sodium now higher inside the cell

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14
Q

what stage of physiological conduction is the same as ‘resting’?

A

-polarisation is the same as resting as there is now pain

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15
Q

what are the 6 contents of LA?

A

-LA agent
-vasoconstrictor
-reducing agent
-preservative
-fungicide
-climbing
(Long Vales Reduce People From Climbing)

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16
Q

what is the gold standard LA?

A

-lidocaine

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17
Q

what is prilocaine less effective at?

A

-less effective in controlling haemorrhage

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18
Q

what is articaine useful for?

A

-repeat injections

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19
Q

what are 3 advantages of using epinephrine?

A
  • more profound anaesthesia
  • longer lasting
  • haemostasis
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20
Q

is felypressin better or worse at haemorrhage than epinephrine?

A

-felypressin is not as good at haemorrhage as epinephrine

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21
Q

what are some precatutions required for safe analgesic?

A
  • good pt cooperation
  • enrolled with GDC
  • written/signed prescription
  • needle guards
  • sharps boxes
  • self aspirating syringe
  • MH checked and updated at each dental visit
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22
Q

how may toxicity due to LA occur?

A

-IV injection

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23
Q

if a pt shows signs/symptoms of allergy to LA who should they be referred to?

A

-dermatologist

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24
Q

what LA is latex free?

A

-citanest

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25
Q

how many LA cartridges is max. for cardiac pt’s?

A

-3

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26
Q

what is the dose needed of LA to induce labour?

A

100 cartriges

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27
Q

what nerve are you aiming for when you anaesthatise the apex of 12?

A

-anterior superior alveolar nerve

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28
Q

can therapists carry out indirect restorations?

A

-no. therapists can only carry out direct restorations

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29
Q

what does the word ‘onlay’ mean?

A

-overlying the cusps of the teeth

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30
Q

what is attrition?

A

-tooth to tooth surface lost

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31
Q

what is abrasion?

A
  • abrasion from a foreign object in the mouth
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32
Q

what is erosion?

A

-acid causes tooth loss

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33
Q

what is abfraction?

A
  • loss of tooth due to flexural forces

- stress from occlusal overload

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34
Q

what is micro-preperation?

A

-hand pieces and burs of reduced size keep cavity to a minimum

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35
Q

what is sonic preperation?

A

-handpiece’s work by vibration rather than rotation

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36
Q

what is ‘air abrasion’?

A

-spray aluminium oxide particles through a fine angled nozzle

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37
Q

what are some advantages of air abrasion?

A
  • no LA required
  • preservative
  • quite
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38
Q

what are some disadvantages of air abrasion?

A
  • lots of contamination
  • irritates asthma
  • expensive
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39
Q

what can lasers remove?

A

-soft and hard tissue

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40
Q

what is meant by ‘ozone’?

A
  • new concept
  • where bacteria in caries is identified with a laser and it delivers ‘active’ oxygen molecules through suction cup to desired area
  • this kills certain types of cariogenic bacteria
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41
Q

what are some disadvantages to ‘ozone’?

A

-not much scientific research been done about it

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42
Q

what is Atraumatic Restorative Treatment (ART) ?

A

-hand excavaion, restore with GI

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43
Q

what are some advantages of ART?

A

-ideal for under developed countries and for very nervous patients

44
Q

what are some disadvantages of ART?

A

-often not all the caries is removed

45
Q

do you take maxillary or mandibular impressions first?

A

-mandibular

46
Q

what are the 6 steps to taking impressions?

A

1-prepare the patient
2-assemble the materials and equipment
3-select and prepare the impression trays
4-take mandibular impression
5-take maxillary impression
6-take the interoclussal record for occluding the casts

47
Q

to prevent cross contamination of the impressions. what is done to stop this?

A

-disinfection

48
Q

what disinfection material is used in DDH?

A

-‘Artichlor’

49
Q

what is another name used fr the ‘interocclusal record’?

A

-the wax bite

50
Q

who classified cavity preperations?

A

-Greene Vardiman Black (GV Black)

51
Q

what is GV Black class 1?

A

-occlusal surfaces of molars and premolars, buccal pits of molars

52
Q

what is GV black class 2?

A

-approximal surfaces of molars and pre molars

53
Q

what is GV Black class 3?

A

-approximal surfaces of incisors/canines

54
Q

what is GV Black class 4?

A

-icisal edges of incisors and canines

55
Q

what is GV Black class 5?

A

-cervical margins of teeth

56
Q

what are some disadvantages of blacks classification?

A
  • was used before adhesive materials were available, therefor retentive cavities needed to be cut
  • removes more tooth substance than necessary
  • does not include root or secondary caries
57
Q

what are 6 principles relating to cavity preperation?

what steps do you do…

A
  1. Outline form
  2. resistance form
  3. retention form
  4. tx of residual caries
  5. correction of enamel margins
  6. cavity debridement
58
Q

what is outline form?

A

-gaining access to the caries

59
Q

what is resistance form?

A
  • to resist occlusal forces

- make sure cavity floor is at right angle to the direction of occlusal forces

60
Q

what is retention form?

A

-designs to retain the material in the cavity

61
Q

what are some forms of retention?

A
  • ‘grooves’ in wall of cavity
  • use of undercuts and occlusal key
  • use of acid etch and bonding agents
  • dentine pins (therapists cannot use these)
62
Q

what happens in the stage ‘treatment of residual caries’?

A

-removing caries from the enamel-dentine juntion first (peripheries) then moving onto the base of the cavity

63
Q

when is firm but stained dentine removed?

A

-only on anterior teeth if it shows through the enamel

64
Q

what happens in the stage ‘correction of enamel margins’?

A

unsupported enamel is weak and prone to fracture

-sometimes a bevel to increase surface area for bonding

65
Q

what happens in the stage ‘cavity debridement’?

A

-cavity should be thoroughly washed and dried to remove debris and bacteria

66
Q

what is line angle?

A

-where two surfaces meet

67
Q

what is cavosurface angle?

A

where the cavity wall meets the surface (90-110 degrees)

68
Q

what is another name used for hidden occlusal caries?

A

-occult caries

69
Q

what is the technique for doing sealant restoration?

exam Q last year

A
  • take occlusal registration(outline form)
  • remove caries
  • add lining if necessary
  • acid etch, prime and bond to cavity walls and margins
  • build up cavity with comp. resin
  • apply acid etch to remaining fissures
  • thoroughly wash acid etch of fissures
  • apply fissure sealant to remaining fissures
  • check occlusion
70
Q

what is technique for conventional restoration?

A
  • occlusal registration (outline form)
  • remove caries
  • apply lining if necessary
  • acid etch, prime and bond
  • restore with 2 mm increments of composite
  • finish with polishing burs or one gloss
  • check occlusion
71
Q

what must always be checked after doing a restoration?

A

-occlusion must always be checked after doing a restoration

72
Q

if a cavity is within 2 mm of pulp do you need a lining?

A

-yes

73
Q

if cavity is 0.5mm or less close to the pulp what do you do?

A

-dycal and GI

74
Q

what is dycal?

A

-calcium hydroxide

75
Q

what are some disadvantages of tunnel preperation?

A
  • technically difficult
  • marginal ridge is prone to fracture
  • not always good access to caries at ADJ
76
Q

what is root caries usually filled with?

A

-GI

77
Q

cervical caries is a sign of what?

A

-high caries risk

78
Q

what are some risk factors for root caries?

A
  • xerostomia
  • repeated carbohydrate rate intake
  • partial denture wearing
  • poor OH
  • high caries experience
  • high salivary counts of S.mutans and lactobacilli
79
Q

what are 3 functions of fissure sealant?

A
  • prevent caries
  • eradicate fissures
  • aid cleaning
80
Q

what are the 3 different etching patterns?

A

type 1: -prism core removed, peripheral material left
type 2: -prism core remains intact, peripheral regions removed
type 3: -haphazard effect. does not work very well

81
Q

what is bruxism?

A

-involves grinding and clenching of the teeth

82
Q

what are some signs and symptoms or bruxism?

A
  • abnormal rate of attrition
  • TMJ pain
  • hypertrophy of masticatory muscles
  • pulpal sensitivity to cold
83
Q

what are the 4 different types of abrasion?

A

1-cervical abrasion
2-habitual abrasion
3-iatrogenic abrasion
4-industrial abrasion

84
Q

what are some signs of erosion?

A
  • palatal chipping of incisal edges
  • smoothed and polished surfaces
  • ‘proud’ restorations
  • cupping of lower molar cusps
85
Q

what are some examples of extrinsic erosion?

A
  • acidic foodstuffs
  • sucking citrus fruits
  • swimming in heavy chlorinated water
86
Q

what are some examples of intrinsic erosion due to reflux?

A
  • hiatus hernia
  • gastric ulceration
  • alcohol abuse
  • gastro oesophageal reflux
  • stress reflux syndrome
87
Q

what are some examples of intrinsic erosion due to vomitting?

A
  • pregnancy

- bulimia

88
Q

what are some clinical signs of bulimia?

A
  • normal body weight
  • erosion of palatal surfaces of upper teeth
  • lesions on palate, fingers, oral mucosa, lips
  • signs of malnutrition
89
Q

what does NCTTL stand for?

A

Non-carious tooth tissue loss

90
Q

what 3 things do you protect the pulp from?

A
  1. thermal attack
  2. chemical attack
  3. galvanic effects
91
Q

what is galvanic shock?

A

metal on metal with no insulation. Electrolytes occurs due to saliva

92
Q

cavity preperation ‘insults’ the pulp. This results in what?

A

increased inflammatory cell infiltrate

93
Q

what does the ‘smear layer’ do?

A

occludes the dentinal tubules

94
Q

what are some features of the ideal pulp protector?

A
  • non toxic
  • non irritant
  • bacteriostatic
  • gives good coronal seal
  • thermal/electrical insulator
  • strength to withstand restoration placement
  • radiopaque
  • obtundant
95
Q

what are some features of calcium hydroxide (dycal)?

A
  • high pH initially irritates the pulp causing reactionary dentine to be laid down
  • bacteriocidal
  • electrical/thermal insulator
  • radiopaque
  • not adhesive so there is no coronal seal
96
Q

give an example of zinc polycarboxylate cement?

A

poly F

97
Q

what are some features of zinc polycarboxylate cement?

A
  • high molecular weight reduces penetration to tubules, only mildly irritant to the pulp
  • sufficient strength for restoration placement
98
Q

give an example of zinc oxide eugenol

A

kalzinol, sedanol

99
Q

what are some features of zinc oxide eugenol?

A
  • slight irritancy to the pulp
  • thermal/electrical insulator
  • very obtundant to the pulp
  • zinc oxide eugenol is not compatible with resin composite
100
Q

what are some features of zinc phosphate?

A

-not obtundant to the pulp

101
Q

what is an indirect pulp cap?

A

when cavity is extended to 0.5mm of pulp and calcium hydroxide placed at the deepest part of the restoration.

102
Q

what is a direct pulp cap?

A

-when an exposed pulp is covered by capping materials

103
Q

what is the criteria for direct pulp capping?

A
  • tooth is vital
  • no history of pain in the tooth
  • no evidence of periradicular pathology
  • pulp is pink and health
  • no bop
104
Q

when does GI fully set?

A

not till 24hrs after

105
Q

what is the treatment plan order?

A
  1. emergency care
  2. prevention
  3. stabilisation
  4. restorative
  5. maintenance
  6. referrals
106
Q

what are some symptoms of amalgam poisoning?

A
  • headaches
  • GI upset
  • Dyspepsia
  • Salivation/xerostomia
  • fatigue
  • oedema of face/ankles
  • character changes

clinical practise 2 (12 decks)

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