Restorative/Endo/Periodontics Flashcards
Two periapical radiographs show lower anteriors 42, 41, 31, 32 that have all been treated endodontically with posts and cores. There is radiolucencies in all of the teeth affected. The patient is referred to you for periradicular surgery.
Name 3 tx options other than periradicular surgery
Attempt orthograde re-treatment
XLA
Monitor
What is 2 criteria for Valid consent?
Must be voluntary
Must be informed
(Added extras)
- Must not be coerced
- Must have capacity
Name 6 other things that you should tell the patient for valid consent.
- options for tx, risks and potential benefits
- Why you think a particular tx is necessary and appropriate for them
- Consequences, risks and benefits of the tx you propose
- Likely Prognosis
- Your recommended option
- Cost
- Risks of no tx
- Guarantee of tx; how long for?
ENDO - Name 4 and explain, stainless steel file mishaps/faults
- Ledges: Ledge is internal transportation of the canal which occurs when working
short of the length and are difficult to bypass - Canal Blockage:
Describe the endodontic process including calculating working length until the obturation stage
- Coronal access to the root canal system after taking Pre-op PA radiographs, using rubber dam and LA
- Remove all caries and defective restorations from the crownAllows assessment of restorability and creates an environment suitable for obtaining adequate isolationRoot canal system instrumentation and preparation and irrigation with Sodium hypochlorite using the ProTaper technique
Obturation of the root canal system with GP size matched cones
Coronal sealFinal restoration
Patient attends with intention of an amalgam restoration
What are the benefits of copper enriched amalgam?
Copper increases the strength and hardness of the amalgam material
Copper enriched products and the non-y2 amalgam are high in copper, which gives higher early strength before 24-hour mark, less creep, higher corrosion resistance and increased durability of the margins.
What is the function of zinc in amalgam?
Zinc is the scavenger molecule during production of amalgam, which
preferentially oxidises and forms slag.
Zinc is no longer incorporated as it reacts with water and causes a poor marginal seal
How is copper enriched amalgam made?
High copper admixed alloy procedure is made by adding silver-copper eutectic particles to silver-tin lathe cut particles to produce high copper y-2 free amalgam.
What is creep?
Creep is the slow internal stressing and deformation of amalgam under stress as the material can be repeatedly stressed for long periods at low stress levels.
What are the main symptoms of creep?
Ditching of the restoration margins, which can result in fracturing of the margins causing microleakage and thus secondary caries.
Microleakage can cause pulpal irritation, infection, discolouration and secondary caries under the restoration.
You are shown a cast with an upper Co/Cr framework in place.
What areas on the upper and lower that give tooth borne support
Upper = hard palate and residual ridge
Lower = buccal shelf, residual ridge and retro-molar pad
Define Kennedy classifications
It is an anatomical classification that describes the number and distribution of edentulous areas present.
Class I = bilateral free end saddle
Class II = unilateral free end saddle
Class III = unilateral bounded saddle
Class IV = anterior bounded (crossing the midline)
What function does the palatal extension provide?
It provides increased mucosal support as a larger surface area is covered which can create a greater seal.
Why do we place rest seats (present on 12)?
It provides bracing on anterior teeth and indirect retention
Why would a rest seat be placed on the 16?
To provide direct retentive elements to work in a planned manner and
reciprocation further more offering further support by preventing the movement of the RPD towards the mucosa.
Rest seats can be used for bracing and reciprocation
What are the different types of clasps for premolars?
Gingivally approaching I-bar clasp
What are the different types of clasps for molars?
Occlusally approaching single arm clasp
Occlusally approaching circumferential clasp Occlusally approaching ring clasp
Why would framework not extend to the anteriors and gingival margin clearance and what is the benefit of not doing this?
Less mucosal coverage, making it easier to clean the gingival tissues, less irritation and better compliance.
Two Impression trays are given one with green stick on posterior saddles and one with Impression taken in alginate.
What impression materials are used for primary impressions in complete denture cases?
Impression compound which is a non-elastic impression material
Alginate which is an elastic irreversible hydrocolloid impression material
What are the constituents of alginate and green stick?
Alginate – calcium sulphate, zinc oxide, sodium phosphate
Green stick – carnauba wax, talc, stearic acid
Why would a tooth have Impression compound placed on it?
You can record a single tooth crown preparation using green stick and the copper ring technique
A patient attends with a fractured 26 MOD amalgam which has also been root treated.
What are the restorative options for this tooth?
Onlay with cuspal coverage
MCC/GSC
indirect restoration
The GP has been exposed for 6 months; what is your new treatment plan and why?
Requires to be re-root treated when the root has been exposed to the oral environment for more than 3 months as it puts the tooth at risk of bacterial invasion.
What are the features of Nayyar core?
Retention obtained from the undercuts in the divergent canals and pulp chamber
2-4mm of Gp removed from the canal and replaced with amalgam
Immediate placement and coronal preparation can be done at the same appointment
