Sem 2 exams Flashcards
What do you need a secondary impression for?
Acrylic partial denture for multiple edentulous areas
Chrome denture
Complete denture
Some immediate dentures
What is the Australian fluoride guide?
6-17 months – no fluoride
18 months – 6 years – childrens toothpaste (400-550ppm) 2x per day spit no rinse
6+ years – normal tooth paste 1000ppms x2 a day spit no rinse
6+ years + high risk of caries – 5000ppm tooth paste 2x times a day spit no rinse
What are contraindications for immediate denture?
Patient on bisphosphonate/blood thinner medications
Any contraindication for extraction
What code do we use for a denture rest?
731
What are the clinical features of pyognic granuloma?
Usually sensile
Sudden onset and rapid growth
Bright red and haemorrhagic, ulcerated surface.
Tissue may mature thus becomes fibrosed
What is a normal platalet count?
150-450 billion cells/L or 150,000 to 450,000/mcL
How many microsieverts does bitewing produce?
5
What are the categories of communication disorders?
- Language disorders: Speech Disorders (Autism or aphasia after stroke) or Auditory Processing (hearing impairment, vision impariment or ADD) - these disorders make speaking difficult
- Physical disorders: Oral Muscular - physical oro-motor disorders like mutism or dysphonia
- Intellectual delay and disability
What are the oral side effects after radiotherapy?
- Impaired quality and quantity of saliva
- Radiation caries
- Trismus
- Xerostomia
- Dysphagia
What should you do with mobility 2 teeth before primary impressions?
Splint them
What is a dry socket?
Absence of blood clot in the socket post extraction (socket is either empty or full of debris)
What are some social determinants of health?
- economic stability
- Physical environment
- Education
- Food
What are the steps of drawing a denture design?
Cross teeth not to replce
Outline denture saddles
Decide & draw clasp units and clasp types
Decided major connector
Decide denture base and denture teeth
Join all components together
Draw saddles
Draw support and draw major connectors
Indicate abutmnet tooth/teeth
Draw rests and clasp
Draw flanges (gum fitted vs buccal flange)
Specify/draw the extension of the denture
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What is pericoronitis?
It is a localised infection in gingival tissue and mucosa surrounding a partially erupted tooth. Patient complain of a sore tooth. Explain to patient that pain actually arises from infection and inflammation in the soft tissues surrounding the tooth and not the tooth itself.
When should you consider antibiotic for periodotal treatment in non-acute patient?
A young patient in stage 3 or 4 Grade B or C in adjunct to periodontal treatment.
What is a primary impression?
It is an initial impression taken using a stock tray and alginate impression material. Used to produce study models
What is the treatment for periodontal abcess?
1.Debridement under LA and draining of the pus if patient can tolerate. If they can not tolerate, give LA, drain the pus and give antibiotics and recall in 3 days.
2.Irrigate area with Betadine (povidone-iodine antiseptic)
3.Chlorhexidine mouth rinse twice daily for a week
4.Investigation of causative factors
- If systemic symptoms exist – amoxicillin 500mgs tds+ metronidozole (very important for your anaerobic bacteria) 400 mgs bs x 5-days. You need to debride prior to this as the antibiotic will not be able to penetrate the biofilm througb the crevicular fluid!
How do you examine at radiographic boney lesions?
1.Location
2.Margin – well-defined or illdefined
3.Zone of transition – short or long
4.Periosteal reaction
5.Internal matrix
6.Single vs multiple
7.Relationships to the joints
8.Effect on soft tissue
What is the purpose of overall impression?
For denture repair
What are the consideration for regeneration?
- Defect size and topography. 3 wall defects are the most stable for regeneration.
- Defect cause
- Technical difficulties. Access or patient factors.
- Predictability. Always tell the patient the success rate. Grade 3 mobility, probably not the best idea.
What are the features of non-aggressive lesions?
1.Well-defined margin
2.Often schlerotic border
3.Short zone of transition
4.Little or no periosteal reaction
5.Bone often thinned and/or expanded
6.Minimal effect on soft tissues
What is pressure resorption and orthodontic resorption?
Type of traumatic resorption that occurs due to impacted teeth or orthodontic treatment
Do you need a radiologist?
Yes because:
1.It provides a provider number to allow Medicare rebates
2.Review of all areas of the scan
3.Removes much of the legal responsibility
In addition to examination what should you assess in a patient?
- perception of oral health - health literacy/beliefs/trust
- Oral health Seeking behaviour -Social/personal/cultural/medical influences
- Access to oral health care
- Their engagement in past oral health care processes - e.g. oral hygiene practices
What is subluxation? What is the treatment?
An injury to the tooth-supporting structures with abnormal loosening, but without displacement.
Treatment:
- Usually no treatment
- A passive and flexible splint to stabilize the tooth for up to 2 wk if there is excessive mobility
What is individual ageing?
Refers to the structural, sensory, motor, behavioural and cognitive changes in a person over time, in particular relating to how these factors influence opportunities and lifestyle at various stages of the life of the person.
What is external surface resorption? What is the treatment?
External surface resorption is a self-limiting process which is usually caused by a localized to the involved part of the cementum and/or PDL.
Treatment: self-limiting so no treatment.
What kind of clasps do you use for anteriors?
Gingival approaching
What is HSPM?
Hypomiralisaed second primary molars is a condition where the second primary molar is hypomineralised. There is association between that and Molar hypomineralisation (MH)
What are the Miller Classification of gingival recession?
Class I – recession that does not extend to the mucogingival junction with no periodontal bone loss
Class II – recession that extends to or beyond mucogingival junction with no bone loss
Class III - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area
Class IV - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area with exposure of interproximal root surface
How can we measure incisors?
Bioclear template that utilizes the Fibonacci gold sequence.
Within the context of special needs dentist, what are some of the other factors/barriers shoudl you consider when treating a patient?
- Medical conditions and treatments
- Medications
- patient ability to co-operate
- Patient’s expectations and wishes
What are the two different saddle design for a cobalt chrome denture?
Free-end Saddle design
Bounded saddle
How do we take history about a lesion?
- Duration when the patient first started seeing the lesion
- Variations in site and character of the lesion
- Symptoms - related to the lesion and any systemic symptoms
- Onset - any associated hsitorical events related to the lesion
What should we look out for when examining a patient with special needs when it comes to barriers?
Their capactiy to:
- Perceive the need for oral health care
- Seek oral health care when appropriate
- Reach or access oral health care
4.Engage in the oral health care process
What is the neutral zone?
Neutral zone is the area where the outward forces from the tongue are neutralised by the forces of the lip and chicls.
What is a bite registration?
It is the impression of patient’s occlusion when upper and lower teeth biting together. The purpose of the bite registration is to register maxillo-mandibular relationship so that lab can articulate casts and set up teeth. For partial dentures used maximal intercuspal position, for complete dentures use centric relation.
What questions should you ask particularly an elderly before prescribing an NSAID?
- Have you experience recent changes in your bowel habits, such as black or tarry stools?
- Any episodes or recent nausea, vomiting or abdominal pain?
- Have you noticed any changes in your urine output or color?
- have you experienced any shortness of breath, chest pain or swelling?
- Do you have a care giver or support group that may aid you or remind you about taking the medication?
- Do you take any over the counter medications recently that are beyond the once in your medical history?
- Do you take a deuretic or an ACE inhibitor?
What is trauma informed care?
Trauma-informed care is an approach to engaging people with histories of trauma that recognises the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. It involves the awareness and avoidance of practices that lead to re-traumatisation.
What is this condition?
This is actinomyces - an infection characterised by multiple foci of chronic suppuration.
Patient present with firm swelling commonly in the submandibular region with variable pain symptoms.
Treatment: prologned antimicrobial treatment after cultures
What are the most commonly used material in periodontal regenerations?
1.Bone grafts
2.Membranes
3.Growth factors
In which Kennedy’s class would you use both soft tissue and tooth support?
Kennedy 1 and 2
What is common appearance of allergic reaction to SLS?
Ulcers, biofilm and tissue slouching
What is a secondary impression?
Secondary impression is a detailed impression to produce a master cast from which a denture is fabricated. AKA a master impression.
What should you write on a lab form prescription for partial chrome denture?
Describe saddles
Describe support
Specify abutment teeth
Draw rest seats – scoop them outh on the model
Speciy clasps and flanges
Specify the extensions of the denture
Fill lab form and draw design
What is hyperplasia?
It is an increase in the size of a particular tissue by increase in cell number - it is reversible and stimulus dependent
Give 5 differential diagnosis for a pigmented lesion?
- Oral melanotic macule
- Mucosal melanocytic naevus
- Amalgam tattoo
- Malignant melanoma
- Smokers melanosis
What do you want to record for bit registration in an edentulous patient?
Centric relation.
Centric relation is a maxillomandibular relationship, independent of tooth contact, in which the condyles articulate in the anterior-superior position against the posterior slopes of the articular eminences; in this position, the mandible is restricted to a purely rotary movement; from this unstrained, physiologic, maxillomandibular relationship, the patient can make vertical, lateral or protrusive movements; it is a clinically useful, repeatable reference position
What are the stages of tooth socket healing?
- haemostasis and coagulation - this is where suturing in warfarin is important
- Inflammation
- Proliferation
- Modeling and remodeling
What are the levels of patient-centered decision making?
From most basic to complex:
Level 1-Patient provided information only
Level 2-Patient provided information & choices
Level 3-Patient is provided infomation, choices and tools
Level 4-Patient is in full control of their treatment
What are follow up procedures for a patient who has an open apex regardless of extra oral dry time?
First 7-10 days - no root canal treamtnet unless clinical or radiographic signs of pulp necrosis are evidents
2-4 weeks - splint removal
4 weeks - radiographic examination
What are functionally dependent older adults?
They are those persons who are no longer able to survive in the community independently and are either homebound or living in institutions.
What do Australians define as age?
- Health status
- Appearance
- outlook and attitude to life
- level of fitness
What do you do if you have a mobility 3 tooth?
You need to extract it and recall the patient in 3 months
What are the steps of management of MRONJ when doing bone invasive procedures?
- Inform patient about the risk
- Drug holidays are essential
- No antibiotic prophylaxis
- Ensure optimal oral hygiene with use of mechanical debridment
- Reduce trauma to periosteum
- Monitor oral wound for 8 weeks, if does not heal than refer
- DO NOT DEBRIDE NONHEALING WOUNDS
What are the standard precautions?
- Hand hygine, as consistent with the 5 moments for hand hygiene
- The use of appropriate personal protective equipment
- The safe use and disposal of sharps
- Routine environment cleaning
- Reprocessing of reusable medical equipment and instruments
- Respiratory hygiene and cough etiquette
- Aseptic technique (the dirty and clena areas)
- Waste management
Up until which point can you perform a pulpotomy?
Up until reversible pulpitis as after, according to the continuum of Pulp Status, an extraction or a pulpectomy is recommended. Followign symptoms are bad:
1.Spontaneous pain kept awake at nigh
2.TTP
3.Abscess
4.Mobility
5.Facial swelling celulitis
What embodies professionalism?
- Patient centered practice
- Effective communciation
- Ethical and trustworthy professionals
- Professionals that protect and promote health
- Regular reflections on practice
- Constant learning and improvement of skills
- Practicing within the scope of skills
- Commitment to safeety and quality in healthcare
What are factors to consider for pharmacological intervention for behaviour management?
1.Patient age
2.Patienet behaviour
3.Treatment required
4.Medical condiitons
5.Distance travelled
6.Language barrier
7.Risk and benefits
8.Practitioner experience
9.Informed consent
What is a treatment for a patient with angular cheilitis?
Miconazole 2% gel 2.5 mL topically (then swallowed), 4 times daily, after food, for 14 days; continue treatment for at least 14 days after symptoms resolve
or
Chlorimazole 1% cream topically to the angles of the mouth, twice daily for at least 14 days; continue treatment for 14 days after symptoms resolve
How does tobacco affect periodontal disease?
- Negative affect on tissue vasculature
- interfering with normal humoral immune reaction and host inflammatory response
- changes of subgingival microflora thsu facilitating early acquisition and colonisation
- changes in bone turnover
What are the Tori and exostoses?
They are bony protuberances.
Non-neoplastic.
Possibly inherited
Exotoses - multiple or single nodules at the buccal aspect of the alveolar bone
What is a traumatic eosinophilic ulcer?
It is a bening chronic ulcer usually presenting on the tongue.
It is crateriform in shape.
Give 5 differential diagnosis for red lesions
- Pyogenic granuloma
- Haemangioma
- Peripheral Giant Cell Granuloma
- Erythroplakia
- Oral squamous cell carcinoma
What type of nodules are theses?
This is lymphoid hyperplasia
What are some of the effective major connectors for a maxilla?
Posterior palatal strap
Anterior palatal strap
What is the DOT DAM principle of radiology?
Don’t Order Tests that Don’t Affect Management
What is extrusive luxation? What is the treatment?
It is the displacement of the tooth out of its socket in an incisal/axial direction.
Treatment:
1. Reposition the tooth by gently pushing it back into the socket
- Stabilise with 2 week using a passive and flexible splint
- Monitor pulp. If necrotic, start treatment appropriate for the stage of tooth maturation
What are the different ways of high transmission?
- Contact
- Droplet
- Airborne
What should you try during the denture try in stage?
- Denture articulation
- In patient mouth
- Aesthetics
- Occlusion
- Fitting surface
- Check function and pronunciation
- Obtain patient consent
What is important to understand about ankylosis?
After the delayed reimplantation, ankylosis is essentially unavoidable and needs to be considered
What to do in a hypoglycemic event?
- Stop treatment
- Give 15 g of glucose and measure glucose level in 15 minutes
- If still low, administer 3 or more portions
- f symptoms persist, seek medical advise and call 000 if patient is unconcious
- IF all is good after a few protions, no dental treatment today, get some longer acting carbohydrates like a sandrwich or yogurt and observe the patient until they feel okay
What do you do if a cobalt chrome denture is loose?
Adjust the clasps
How to maintain staff safety during the OPG?
- Distance
- Position
- SHielding
What do you do if during tell-show-do exercise a child retracks their hand fromt eh prophy brush?
1.Retrace your steps. The show componenet needs to be modified
2.Ask the child how they are feeling, if they are withdrawn they are probably just anxious
3.Maybe to give them a more sense of control, do it on your fingernail first
4.Then let a child hold a hand mirror next to your finger to give them a sense of control
5.After do it on their finger
6.And finally on their tooth
7.Praise the child for being brave
8.Promise a sticker if you can do it on al teeth – children love stickers
How would go about the extraction stage?
First you need to extract the posterio teeth and give a few months for healing and boney remodeling. Anterior teeth will be extracted before denture insert
What is an overall impression?
Pick up + wash impression together
What is eryhtroplakia?
Erythroplakia is a predominantly fiery red patch that cannot be characterized clinically or pathologically as any other definable disease
What are the three common oral HPV infections?
- Squamous papillomas/Oral warts
- Condyloma accuminatum
- Focal epithelial hyperpklasia
What is the prescription of amoxicillin + clavulanate for spreading odontogenic infection?
Amoxicillin 875 + clavulanate 125mg) orally, 12 hourly for 5 days
What is the common appearance of fibrous dysplasia?
Genetic disorder resultin in replacing of bone with fibrous tissue. Ill-defined margin and grounnd-glass appearance. Only condition that can displace the mandibular canal superiorly.
What are some allergic reactin that may occur in chair?
- Urticaria – red itchy patches – stop administration of any allergens and administer a less sedating oral antihistamine like cetirizine or fexofenadine (not on PBS but good to have around and they are cheap)
- Anaphylaxis – cardiovascular collapse and bronchoconstriction – stop administration of any allergens, call 000 and lie patient flat and give intramuscular injection of adrenaline, start supplemental oxygen, support airway, start CPR if needed. Do proper documentation.
How do we take a reline impression for a partial denture
Light body on denture sadled to record soft tissue
Pop the denture into the patients mouth
Take and alrginate impression
What is a Type 5 indicator and what does it do? What is it’s disadvantage?
Integrating indicators whouse time, temperature and pressure. Provide the same amount as a biological indicator, mimicking the conditons require to destroy biological organisms.
Disadvantage: If one of the processes fail, the indicator will not be able to show it. Thus, either of the two components have failed or both of them have failed. This can create confusion and hinder the resolution of the sterilisation machine problem.
What is the key of periodontal regeneration?
Formation of new cementum and bone
What is lichen planus?
A lichen Planus is a chronic inflammatory disorder of uknown etiology with characteristis relapses and remissions, displaying white reticular lesions, accompanied or not by atrophic, erosive and ulcerative and/or plaque type areas. Lesion are frequently bilaterally symmetrical.
Desquamative gingivitis may be a feature.
What denture can’t we repair?
Valplast
What is osteoconduction?
It permits bone growth on surface or pores. This occurs in bone implants.
How can we as dental specialist prepare patient for the impacts of agein?
- Start having conversations early about the longevity of treatment plans
- For aged care patients, long term dental fitness is essential
Your patient comes in with an avulsed tooth that has been placed in a storage medium or has been drying out for less than 60 minutes. The tooth is believed to have an open apex. What are the steps for management?
- Clean the root and apical foramen with saline and do not touch the root
- Soak the tooth in doxycycline (1mg per 20 ml of saline) for 5 minutes if possible
- Administer local anesthesia
- Irrigate the socket with saline
- Examine for possible fractures and repositoon if necessary
- Replant the tooth slowly with digital pressure
- Verify with radiograph
- Suture gingival lacerations
- Apply flexible splint for 2 weeks
What are the international frameworks that support the provision of care in the context of special needs dentistry?
- Universal declaration of human rights
- UN Convention on the Rights of Persons with Disabilities
What are neurological disabilities?
These are conditions that are attributable to a neurological cause which may impact on the ability to perform physical activities e.g. cerebral palsy
What is the similarity between rheumatoid arthritis and periodontal disease?
Both are:
1. Chronic inflammations
2. Involve imbalance of immune regulation
3. Release inflammatory cytokines
4. Have environmental and genetic factors
What is the 5 As framework?
- Ask - ask if they smoke
- Assess - assess their stages of change
- Advise - information is the key
- Assist - discuss the benefits of quitting
- Arrange - arrange for follow-up
What is the most appropriate type of empathy that can be used in a healthcare setting?
Compassionate empathy is the type of empathy that is usually most. Nobody wants to understand them or feel what they feel, they just want support.
What is lateral luxation? What is the treatment?
It is the displacement of the tooth in any lateral direction, usually associated with a fracture or compression of the alveolar socket wall.
Treatment:
1. Reposition the tooth digitally by disengaging it from its locked position and gently reposition it into its original location under LA
- Stabilised the tooth for 4 weeks with passive and flexible splint
- Monitor and at 2 weeks make an endodontic evaluation
- For immature teeth - might need endodontic procedure IF THE PULP IS NOT NORMAL. Similar for mature teeth
What is a Type 6 indicator and what does it do? What is it’s disadvantage?
Indicators that emulates the critical conditions for sterilization. E.g. 134 degrees for 3.5 minutes. GOLD STANDARD.
Disadvantage: If one of the processes fail, the indicator will not be able to show it. Thus, either of the two components have failed or both of them have failed. This can create confusion and hinder the resolution of the sterilisation machine problem.
What are the indications for a veneer?
- Diastema closure
- Alter shape, contour, position
- Alter tooth color
- Mask tooth surface anomalies
What are the standard precautions?
- Hand hygiene, as consistent with 5 moments for hand hygiene
- The use of appropriate personal protective equipment
- Safe use and disposal of sharps
- Routine environmental cleaning
- Reprocessing of reusable medical equipment and instruments
- Respiratory hygiene and cough etiquette
- Aseptic technique – standard or surgical technique
- Waste management
- Appropriate handling of linen
What is a gingival zenith?
It is the line drawn at the terminus of the gingival margin at each incisors. Low gingival zenith in central and high in laterals will result in poor aesthetics. It central incisor and canine should coincide.
What is a leukoplakia?
It is a predominantly white plaque of questionable risk having excluded other known diseases or disorders that carry no increased risk of cancer
What should we examine/assess our patient fo access?
- Perceive the need for oral health care
- Seek oral health care when appropriate
- Reach or access oral health care
- Engage in oral health care process
What is the most aesthetic way for a incisal line to run?
You want it to run parallel to the lower lip.
What should you do if the crown is 1mm out of margin howere it sits perfectly on the cast?
- Check contact point with adjacent teeth
- Check fitting surface (intaglio surface)
- Check for excess temporary cement
- Check the tooth has not moved
- Check soft tissue and hard tissue defect
What to do if a patient has acute symptoms and you want to do debridement?
Give them anti-biotics and give them a few days and make them come back
What are the ideal cement properties?
Biocompatibility
Sufficient working time
Low film thickness
Low solubility
Compressive and tensile strength
Adhere to tooth structure and restorative material
Anticariogenic properties
Shade options
What are the aspects of shared decision making?
- Clinicians and patients are equally involved
- both share information equally
- Both express treatment preferences
- An agreement is reached
How do cements act?
- Mechanical – through interlocking with surface irregularities
2.Micromechanical – air abrasion or acid etching
3.Chemical bonding
What is MIP?
Maximal intercuspal position.
The complete intercuspation of the opposing teeth independent of condylar position, sometimes referred to as the best fit of the teeth regardless of the condylar position; comp, CENTRIC OCCLUSION
What is new attachment?
Formation of new collagen fibres which are embedded in newly formed cementum. This is the ideal process.
What is important to understand as a dentist when treating people with developmental disabilities?
You need to be aware of the different needs - behavioural, physical,e motional and cognitive.
You need to expand and update your skill set and techniques to meet the unique oral needs of people with developmental disabilities by creating a person-centered environment and identifying a person’s intellectual capability and level of cooperation.
What is the pathogenesis of periodontitis?
- Initial colonisation of the periodontal pocket by Strep and Actinomyces species
- Increase in the amount of biofilm causing a shift from aerobic to anerobic species
- Initial sub-gingival build up biofilm occurs, initiation of immune response in form of PMN mobilisation for containment of infection
- Cytokine releases in response of bacteria in form of IL-1, TNF-a and IL-6, resulting in amplification of inflammatory response
- Production of MMPs (especially MMP 8 and 9) resultin in destruction of periodontal tissues.
- Osteoclastic activation through RANKL from IL1 and TFN-a, resulting in alveolar bone loss
- Reduction in alveolous anf soft tissue results in periodontal pocket
- Diabtes and Smokign makes it worst through AGEs and immunomodulation
How do you deal with an upset patient?
- Show empathy to neutralise the situation
- Present the factual information again
- Tell the patient that it is within their right not to do anything about the situation or seek another opinion - empower the patient
What are the two different PCC techniques you can use to present bad news?
PREPARED:
1. Prepare for discussion
2. Relate to the person
3. Explore priorities
4. Provide information
5. Acknowldege emotions and concerns
6. Foster realistic hope
7. Encourage questions
8. Document
TRIM:
1. Timing - correct amount and type of info - chunk the information
- Relevance - what will help the patient connect to this info? - relate to patients perspective
- Involvement - How can patient contribute? - offer suggestions and choices rather than directives
- Method - Help patient understand and recall? - use visual methods of conveying - PANFLETS
SPIKES
Setting - Find a quite and private setting
Perception - Estabslih how much the patient knows and his or her perceptions abut the medical situation
Invitation or information - Ask the patient and significant other how much and what kind of information will be helpful
Knowledge - Share bade news with the patient using gentle, nonclinical language is small segments
Empathy - Acknowledge the patient’s emotions and reaction with appropriate responses
Summarise and strategise - summarise in language that the patient can understand. Ask the patient to repeat or summarise the information received and the next steps
What are some of the growth factors that can be used for regenerative surgery?
1.Autogenous – platelet rich plasma
2.Xenograft – enamel matrix protein like Emdogain (very common) (requires prior etching)
3.Synthetic
How to write a diagnosis for rem pros?
Type of edentulousness
Edentulousness
Location
Tissue or tooth support
Associate issues
Example: Bilateral edentulous maxillary arch with localised periodontitis and unilateral edentulous mandibular arch with large mandibular tori
What are the barriers faced by people with special needs in Australia?
- Govemental, organisation or syste, barriers
- Physical barriers
- Professional or workforce barriers
- Patient or carer barriers
- Financial barriers
What are the three factors of tooth colour?
Hue – base pigment – red, pink, green, blue and other
Value – most important – quantity of light reflected – how bright is the object can be shown with black and white images
Saturation – chroma – intensity or vividness – how much of base pigment is there within tooth structure
What are risk factors for cancer?
- Tobacco
- Alcohol
- Betel-quid (tobaco in a different form) - bucal sulcus
What are local haemostatic measures?
1, Pressure
- Minimal trauma
- Cellulose or collagen
- Sutures
- 4.8% tranexamic acid for blood clot stability (warfarin only). Before surgery + 10ml for 2 minutes 4 times a day for 2 days
What code do we use for a retainer?
732
What are the six features are wrong with this OPG and what are the error on effect on final image?
- Unnecessary artefacts i.e. the glasses - Results in unnecessary object being presented on the DPR, the glasses
- Patient positioned forward - Anterior teeth blury and too small - spine sen on the film
- Failure to position the tongue against the palate - large, dark, shadow over the maxillary teeth between palate and dorsum of tongue
- Head is tilted to the side in the horizontal direction - condyles are not equal in height, nasal structure is distorted
- Head is turned to one side - seems like the RHS was closer to the detector than LHS - resulting in LHS ramus appearing larger
- Exposure factors have not been selected properly - the image appears to be blur overall
- Chin down - the V shape - joker brain
- Chin up - fraun
How much of the radiation does CBCT produce?
75 uSv (microSieverts)
What is osteoconduction?
It permits bone growth on surface or pores. This occurs in bone implants.
What condition is this?
This is pyogenic granuloma.
It is a localised soft tissue lesion that is common in people who are pregnant due to the hormone imbalance.
Site: Anywhere but classically arises from the interdental papilla
What are some examples of Zin Oxide Eugenol temporary cements?
- TempBond – set time 7 minutes – dry tooth and restoration – DO NOT USE IF RESIN BASED PERMANENT NEED TO BE USED
- RelyX Temp – set time 1.5 minutes – DO NOT USE IF RESIN BASED PERMANENT NEED TO BE USED
When don’t you need secondary impressions?
- Valplast denture
- Small acrylic
- Temporary denture or short immediate
What code do we use for a denture tooth?
733
How do you calculate the new OVD during the examination?
Resting dimension minus freeway space. Think about it if OVD is between 2 point at occlusion, rResting vertical dimension minus freeway space will give you that!
What are the different types of alveolar bone defects?
Class 1 – Bucco-lingual deficiency
Class 2 – vertical deficiency
Class 3 – combination
What are some of the geriatric syndromes that can be experienced by older adults?
Different dementia related illnesses
How does it take to regenerate periodontal tissues like alveolar bone, periodontal ligament and cementum?
3-6 months
What is external pressure resorption? What is the treatment?
It is a resorptive process that occurs when there is pressure applied to the external surface of a tooth root.
Can be caused by impacted teeth or pathologies such as cysts.
Treatment: Removal of impacted tooth or removal of pathology or removal of resorbing tooth and extrusion of the impacted tooth with ortho
What are the Miller Classification of gingival recession?
Class I – recession that does not extend to the mucogingival junction with no periodontal bone loss
Class II – recession that extends to or beyond mucogingival junction with no bone loss
Class III - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area. Not good prognosis
Class IV - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area with exposure of interproximal root surface. Very unpredictable prognosis.
What is proliferative verrucous leukoplakia?
Proliferative verrucous leukoplakia is a progressive, persistent and irreversible disorder characterized by the presence of multiple leukoplakia that frequently become warty.
What are the 4 different types of cementum?
- Acellular Afibrillar Cementum (AAC): Protection of enamel surface (function not well understood).
2.Acellular Extrinsic Fiber Cementum (AEFC): Primary attachment for periodontal ligament fibers, crucial for tooth stability.
3.Cellular Mixed Stratified Cementum (CMSC): Adaptive and reparative functions, contributing to the periodontium’s response to occlusal forces. Most important cementum in regeneration of the periodontal pocket.
4.Cellular Intrinsic Fiber Cementum (CIFC): Repair and regeneration of damaged cementum and periodontal ligament, maintaining root integrity.
What rem pros appliances do not need a secondary impression?
Valplast denture
Acrylic denture for a small saddle replace one or two teeth
Temporary denture
What is this condition?
This is verruciform xanthoma, it is a rare lesion that mimic squamous cell carcinoma.
It is flat, velvety, pebbly.
What is the role of a general denstist for a patient with oral cancer?
- Detection of potentially problematic lesions and referral
- Management role - for any other oral concern, including complications from treatment of oral cancer
- Ongoing screening
What are the two different groups of unwanted effect after CBCT?
1.Deterministic – result of cell killing
2.Stochastic – result from cell modification
What materials are available at ADH for secondary impressions?
Alginate
Polyether – impregum – use if no undercuts (hard or soft tissue) are seen
Polyvinyl Siloxane – honigum – use if undercuts are present
How can we construct a rough prototype for restoration?
You can you putty or isolating material like PTFE tape and old, out of date composite just to get a nice 3D, functional structure. Do not bond as you need to remove it. Check with patient. Create a clear PVS bite reg material to register the prototype restoration so you can replace with permanent one – key guide.
What is the advantage of Bio-Oss and Emdogain comparing to Perioglas?
Both Bio-Oss and Emdogain results in formation of cementum
What are the steps of pathology for a transverse root fracture?
1.Facial trauma, frontal force
2.Transverse fracture – occurs if dentine, cementum and pulp involved, if enamel is also involved – it is a crown root fracture
3.Take radiograph and do all of the test
4.Reparative tissue in a form of tertiary dentine is laied down in the fracture area
5.Over time – root canal stenosis may occur – pulpal tissue will be replaced with deposited hard tissue through “buldging hard tissue” with prior joining of fracture line with fibrous connective tissue - this is done primarily by the pulp - the reparative capacity of dental hard tissue should not be underestimated
What are the principals of a post?
- Diameter
Wider diameter -> more retention but more risk of root fracture
=> recommend 1/3 of root diameter
Need to assess all direction - Only MD direction on radiograph -> check the master GP for the diameter of the root canal
- Length
At least 1/2 or 2/3 of the root
Sufficient GP (minimum 4-5mm) from the Apex -> measure from end of GP to end of the post - For adequate apical seal
- Can leave more if u have longer root (eg upper canine)
Bone lvl - Make sure the post is below the alveolar crest
- Material
Aim - Withstand functional stresses
- Resist corrosion
- Radiopacity
To check on radiograph - Biocompatibility
Non-corrosive
Non-toxic - Retrievable
- Bond to the resin cements
- Elastic modulus similar to dentine
Potential fracture location due to the uneven distribution of occlusal load by the post to the tth - Not interfere with aesthetics
Who are vulnerable people?
They are people aged under 18 or other individuals who may be unable to take care of themselves or are unable to protect themselves againt harm or exploitation.
What are the main barriers for people with special needs that prevent them from accessing primary care?
- Training of professionals
- Knowledge and awareness of the rpoviders
- Communication
- Fear and embarrassment
- Lack of involvement in healthcare decision-making
- Time constratins
What are the steps to the extra oral exam for rem pros?
- TMJ
- Facial thirds
- Facial shape
- Lip and cheek support
- SMile line
What is the purpose of AHPRA’s code of condutct?
To set expectation about professional behaviour and conduct for registered health practitioners based on the concept that maintaining a high level of professional competence and conduct is essential for good care.
What are the signs of salivary gland dysfunction?
- Frothy mucinous saliva
- Pooling of saliva in sublingual area
- Dry mucinous strands coating the tongue
- Epithelial atrophy
- Lack of calculus
- Candida infection
- Coronial root caries
- Accelerated tooth wear
What are 5 components of discussion when it comes to informed consent?
- Diagnosis of condition
- Recommended treatment plan
- Alternate treartment plan
4.Potential risks of all treatemnt alternatives
- Potential risks of no treatment
What are the causes of acute tooth pain?
- Reversible pulpitis
- Irreversible pulpitis
- Endodontic abscess
- Cracked tooth
- Root fracture
- Occlusal related pain
- Dentinal hypersensativity
When do you refer a patient to a special needs unit?
- Pt who are unable to cope/ cooperate with dental tmt provided in the primary care settings
- Beyond (clinical or knowledge) skill set of the general dentist in the primary care settings
- Require adjunctive support (eg haematological, behavioural, medico-legal aka consent, bariatric, portable dental equipment
What type of plan works the best for client who would like to change?
A SMART plan:
Specific
Measurable
Achievable
Relevant
Timed
What makes an experience traumatic?
- It involves a threat to one’s physical or emotional well-being
- it is overwhelming
- It result in intense feelings of fear
- it leaves people feeling helpless
- It changes the way a person understands themselves
What to do if the patient comes in with an immidiate denture, that is loose and they are unhappy with it’s aesthetics?
Construction of a new denture is the best option!
What are the cytological changes in dysplasia?
- Nuclear pleomorphism
2.Cellular pleomorphism
- Increased nuclear size
What is trauma?
Trauma is simply exposure to any traumatic situation or event that overwhelms your ability to cope
What is the significance of curve of spee in dentures?
- it maintains occlusal harmony
- Supports efficient mastication
- Allows posterior disocclusion during portrusive movement
What is the hierarchy of consent in South Australia?
- Patient themselves
- Advance care directive - ‘Substitute Decision maker’ - a person who can reflect the decision that the person would have made in the circumstances if they had the capacity to consent
- A guardian
- A spouse or domestic partner
- Adult related by blood
- Aboriginal or Torres Strait Islander kinship/marriage
- An Adult Friend
- An Adult Charged with overseeing the day-to-day care of the person
- The SA Civil Administrative Tribunal upon application as last resort to appoint a Public Advocate
What are secondary impressions used for?
For constructions of master models
For construction of wax bite or to make C/C frame
What is an intelectual disability?
It starts at the time before child turns 18 and is characterised by difficulties in communication, memory, udnerstanding and can also include physical skills
What is this condition?
This is Herpetiform aphthous ulvers - it is an uncommon and are very very small.
Named herpetiform due to the resemblance of the ulcers to those of herpetic stomatitis
What do you do if the patient takes injectable anti-thrombotic therapy?
Wait until they stop the therapy, it is usually given after hospital visit
How to write a diagnosis for rem pros?
Type of edentulousness
Edentulousness
Location
Tissue or tooth support
Associate issues
Example: Bilateral edentulous maxillary arch with localised periodontitis and unilateral edentulous mandibular arch with large mandibular tori
What are the Indications of PBM crown?
o Heavy occlusal load
o Aesthetics
o Longevity
o Mask discolouration
What are the basic of acrylic denture designs?
Flange
Base
Teeth
Clasps
What are the steps for chrome denture design?
- Saddle
- Support
- Retention
- Connectors
- Simplification
What are the problems with Cone beam CT?
1.Movement artifact – shown as multiple lines– patient need to be very still
2.No soft tissue resolution – use convetional CT
What is the purpose of periodontal surgical therapy?
The goal and purpose can only be considered in conjuction with complete periodontal treatment. SO first initial closed surgical root debridement and then open surgical root debridement.
In Stage 1 and 2 perio, initial closed surgical root debridement is sufficient. In Stage 3 and 4, open surgical root debridement may be required.
What is treatment for peridontal abscess?
1.Fully debried the area with or without use of surgery, under LA with saline irrigation
2.Analgesia in form of panadol
I3.f systemic symptoms exist – amoxicillin 500mgs tds+ metronidozole 400 mgs bs x 5-days
What matterials are used for bite registration?
Exabite
Modeling/beuty wax
Copper wax
Wax rims – use only in large edentulous areas with unstable contacts
What are the 4 ethical principle of healthcare?
- Beneficence
- Non-maleficence
- Patient autonomy
- Justice (this is an essential principle of SND (social justice))
What are the contraindications for a partial denture?
- Lack of suitable abutment teeth
- Rampant caries
- Perio disease
- Poor oral hygiene
- Patient can not tolerate them
- Post readiotion tratment - osteoradionecrosis
When can periodontal disease cause endodontic problems?
If the periodontal pocket reaches the apex
OR
If there is a large laterla canal in the tooth
OR
When it reaches the furcation canal
How to use Vita 3D master guide?
1.Select value by leaving only M hue in guide body natural light and TURN OFF YOUR LIGHTS AND GO TO THE WINDOW. Get close to the tooth.
2.Chroma is evaluated. How saturated are the teeth
3.Hue selection. Is the tooth more yellowish then middle? Is it more red??? Move from middle (M) to either R or L
4.Remember computer generator system allow you to match shade in between value ranges or chroma
What is a gingivoplasty?
Reshaping of gingival tissues to improve gingival contours. Can be done with periodontal knife, scalpel, diamond stone or electrosurgery. Can be done after necrotising gingivitis.
What kind of structure is this?
This is herpes labialis - please do not touch them
Site - LHS vermillion border and just below the lower LHS conissure
Size - scattered but overall spands around 10-20mm, irregularly shapped, diffused
Morphology - slightly elevated but mostly flat, distinct, spread, a crop of vesicles
Colour - yellow but also some of the lesion is similar to the vermilion border
Consistency - NOPE IT IS A PHOTO Texture - rough because some have been bursed but some are smooth
What are the features of necrotising gingivtis?
1.Necrosis of interdental papillae and loss of gingival margin contour
2.Bleeding, halitosis and pain in the site
3.Punched-out and cratered depression/lesions in interdental sites covered with greay or grey-yellowish pseoudomembrane
4.Patient complains of metallic taste
How do we identify secondary images?
- They are blurred and put of focus
- They have the same orientation as the primary image
- They are larger than primary image
- They are higher up and on the opposite side
What are some of the patient-related factors that we need to consider when treating patient?
Generally, patient centered care (shared decision-making model) and evidence-based dentistry should be utilised.
Culturally safe practices should also be utilised.
Also:
- Social determinants of health
- Cultural issues
- Health literacy
- Previous life/dental experiences
- Health issues
What is syncope, what’s it’s causes and how do we manage it?
Syncope - transient self-limiting loss of consciousness. The onset is rapid and spontaneous and complete. Has presyncope phase of light-headed, nauseated, anxious and pale.
The underlying mechanism - cerebral hypoperfusion - i.e. low oxygen levels
Causes:
Vasovagal
Orthostatic
Cardiac dysrhythmias
Cardiac disease
Managmenet:
- Stop treatment
- Lie the patient down
- Support airway by removing all object for the mouth
- Measure the patient’s blood pressure and heart rate
- If the patient does not regain consciousness - call 000 begin DRSABCD
What are highlights of resin cements?
Use resin primarily
Mechinsms of matrix formation – self/auto cure, light cure or both
Bonding procedure – total etch and rinse (the best), one step etch and bond (self-etching) or self adhesive
Micromechanical bonding to tooth and etched crown
Good strength
Polymerization shrinkage can be significant
Difficult removal
Post-op sensitivity
Technique sensitive
Eugenol may inhibit polymerization – NON-EUGENOL TEMP CEMENT PLEASE USE
Use MDP and 4-META to bond to metals
What are the significant problems that could occur if the curve of wilson is not maintained appropriately?
There could be interference during lateral mandibular excursion and needs to be adjusted
What is the objective of periodontal regeneration?
To crease a physical barrier that permits the growth of bone and PDL cells rather than epithelial or gingival connective tissue into the periodontal defect.
This process takes weeks to months thus probing in GBR should not be performed.
What is the standard steps to diagnose dental pain?
- History taking
- Visual examination
- Pulp sensibility testing in form of electrical pulp testing and other teeth
- Percussion testing
- Periodontal probing
- Palpation
- Crack detection
- Radiograph
What is a developmental disability?
It applies to children aged 0-5 where conditions have appeared in the early developmental period, but no specific diagnosis has been made and the specific disability group has not yet been diagnosed. E.g. Autism or cerebral palsy
What is external inflammatory resorption? What is the treatment?
External inflammatory resorption occurs when the tooth has an infected root canal system and there has been damage to the external surface or communication between the pulp and external surface.
Can occur at the apex or lateral surface of the root.
Treatment: preventative approach: after external injury, utilise systemic antibiotics + corticosteroid based root canal treatment. Interceptive approach: when the resorption is already evident use corticosteroid based root canal treatment
What is important to let the patient know about peirodontal disease?
It is not a one off, it is a continuous process that takes multiple visits and ongoign care. If else, the systemic disease will get worst
What is external inflammatory root resorption?
Resorption due to periapicla infection
What are the indication for surgical correct of recession?
- Increase in recession
- Dentinal hypersensitivity
- Aesthetic concerns of the patient
- Persistent inflammation
- Age
What to do if a denture is retentive but falls out during chewing?
You might need to adjust occlusion. If it happens during speech you might need to change the extension or smooth the surface
What is SNU?
It is a branch of dentistry that manage pt who are adversely affected by their general health condition:
o Complex Medical hx
o Intellectual disability
o Physical disability
o Psychiatric disability
o Geriatric pt
Need a special methods or techniques to prevent or treat oral health + modify conventional tmt plan. Primary dental practitioners may not be able to manage these pt in the primary care setting
o Liase w ppl giving consent
o Liase w support worker
Specifically tailored preventive and corrective tmt (tailored OHI and rational dental care).
The need for special needs dentistry arose to address barriers faced by many individuals due to their special needs.
What is an endo-perio lesion?
It is a draining sinus that goes through the PDL
What is a normal fasted plasma glucose level?
4-6 mmol/L
For each of the Seatle Care groups, devise a quick treatment plan?
- Pre-dependency - consider the long-term viability of restorations and prostheses. Plan treatment outcomes for easy maintenance
- Low dependecy - focus on repair and replacement of strategically important teeth and plan for ongoing maintenance
- Medium dependency - repair or replace strategically important teeth with conservative treatments like the atraumatic restorative technique (GIC+use of hand instruments for removal of caries) and oral prosthesis to simplify oral hygiene
- High dependency - offer palliative treatment
What are the objective of treatment for a patient with DDE?
1.Reduce pain & sensitivity
2.Provide adequate restoration
3.Eliminate need for multiple repeat restorative procedures
4.Minimise dental anxiety and fear
5.Maintain occlusion and minimise cplexity of any furutre ortho treatment
6.Aesthetic rehabilitation
What is the varicells virus?
It is also known as chicken pox!
It is a vesicular infection that migh have some oral mucosal involvement
What are the initial post denture instructions?
- Excessive saliva
- CHange in speech
- May feel bulky
- FOod might get stuck
- Denture move to some extend
- Migh have high spots
- Remove dentures and clean after meals
- Brush denture as brushing teeth
What should you mark on the wax rims?
- Mark mid line
- Mark canine lines
- Mark smile line
What is enamel infraction? What is the treatment?
It is an incomplete fracture of the enamel, without loss of tooth structure.
Treatment: usually, no treatment but if needed etching and sealing with bonding resin should be considered.
When do you need a secondary impression?
- Acrylic partial for multiple edentulous areas
- Chrome denture
- Complete denture
- Some immediate dentures
How to manage a patient with corticosteroids?
- Find out how long they have been on steroids
- Reduce stresses
- If extraction or other steroids, to prevent an Addisonia crisis start teatment in the morning and get more steroids the day before (double the dose) and the day of treatment (double the dose) - contact GP prior.
What is at of extreme importance when you have an aesthetic case?
For signs of erosion, attrition and abrasion. Parafunctional wear = poor longevity of a restoration. Patient will need a night guard.
What is important to understand about periodontal surgery?
Only small amount of attachment gain (through pocket healing) occurs after any form of conventional periodontal surgery at the base of the defect.
Goal of treatment: a non bleeding pocket of 5 mm or less. This is a healthy pocket depth.
Remember that presence of a pocket does not equate to active periodontitis but BOP and bone loss does.
What is apexogenesis?
A vital pulp therapy procedure performed to encourage physiological development and formation of the root.
What is the prescription of intravenous antibiotics for spreading odontogenic infection?
Benzylpencilli aintravenously in intensive care 2.4g 4 hourly
How do we deal with barries faced by people with special needs?
- We identify all the barries
- We adress barries we can adress throuh legislative changes, chaning our environemnt, trainign progress, population approaches and public funding
What is the common appearance of MRONJ?
Pains, swelling and draining sinuses. Bone destruction. Periosteal reaction is common.
What is orthodontic resorption? What is the treatment?
Orthodontic resorption is the process by which the apical part of one or more teeth undergo resorption, resulting in a shortened root.
Treatment: when ortho stops, resorption stops. Monitor and treat when other conditions occur.
What are some of the implication of our ageing population on access to oral health care and service delivery?
- Patient issues - residence, transport barriers, financial barriers, health issues, consent
- Workforce issures - suitability trained individuals, appropriate skills, equipment and willingness to provide care
When do you consider periodontal sugery?
After the initial phase of sub- and supra debridement for after about 8-10 weeks (to no breakdown the long junctional epithelium) if the pocket is above 6 mm with bleeding on probing.
If it does not have BOP or is only 5mm, simple deplaque and debridement is sufficient.
What are the material available for the primary impressions?
Alginate with periphery wax
What is a lipoma?
It is an uncommon lesion in the oral cavity - most commonly filled with adipose tissue (fat cells)
What are the options for replacement of loss teeth?
- Removable denture
- Implant
- Fixed pros
- No treatment
When do you cut rest sits?
Rest sits must be cut prior to secondary impression to be taken. DO NOT CHANGE IT
What are some of the oral that require urgent attention and referral?
- Long-standing ulcers with no obvious cause
- Indurated (hard) borders - PLEASE PALPATE
- Deep ulcers with rolled borders
- Ulcer that is fixed to underlying tissues - usually ulcers are mobile
- Painless ulcer
- Ulcers associated with lymphadenopathy - if there is a large swelling - EMERGENCY
How to communicate appropriately?
- Communicate courteousley, respectfully, compassionatley and honestly
- COnsider the ahre, amturity and intellectual capacity
- Be aware of health literacy issues
- Meet the specific language, cultural and communicaiton needs
- Endeavour to confirm a patient understading of the information
- Encourage the patient to engage in conversation
- Only relevant infromation
- Be non-judmental
What is incisal configuration?
It is the V shaped area between the incisors. It needs to be at 90 degrees to both of the teeth making up the incisal configuration
When should you not use SDF?
- Heavy metal allergy
- Pregnancy or breastfeeding
- Lesions close to the pulp/possible pulpal involvement
- Signs or symptoms of periapical pathology
- Ulceration, mucositis or stomatitis
- Restoratio of permanenet anterior teeth
What is a complicated crown-root fracture? What are the treatments?
It is a fracture involving enamel, dentin, cementum and the pulp.
Treatment: temporary stabilisation to the non-mobile fragment or adjacent teeth
In immature teeth: Partial pulpotomy
In mature teeth: Pulp extirpation
Then one of the following:
1. Completion of root canal treatment
2. Orthodontic extrusion
3. Surgical extrusion
4. Root submergenbce
5. Intentional replantation
6. Extraction
7. Autotransplantation
What is importatn to consider when treating patients with immunodeficiency/immunopcompromise/immunosupression?
- Review of serology
- Antibiotic prophylaxis
- Supportive blood products during surgery
- Assessment for opportunistic infection of the oral cavity
- Management of herpes simplex and zostra virus with acyclovir
- CHx rinse pre and psot operativley
- AIDS defining illnesses like Necrotising periodontits
What are the steps to occlusal analysis?
1.Teeth present/missing
2.Morphology of teeth
3.Wear - mild, moderate, sever
4.Crowding,spacingrotations
5.Axail inclanations
6.Shape of dental arch
7.Cruve of spee and wilsons curve
8.Angle molar classification/canine classification
9.Overbite (%) / overjet (mm)
10.Mediolateral
What are the properties of saliva?
Physical properties:
- lubrication
- coats food bolus
- solvent for flavour
- cohesive effects
Chemcial properties:
- maintains pH
- neutralises acid
- controls bacterial growth
- remin
What should you cover in penicillin allergy history?
- What did patient react to?
- What was the type of rection? Is it really sever, did it limit their function or made them die? Did it have it for mono, that one can create a fake reaction to antibiotic
- How long after start of treatment did it occur eg after a few hours or many days?
- How long ago was the reaction?
- How was it treated?
- Have they had similar antibiotics since?
What are the clinical steps for denture repair appoitment or reline?
Book with lab
9am – send denture to lab with alginate
4pm insert the denture or if cobal chrome allow 3 days if you need mollopalst reline, allow 24 hours
Review in 1 week
What is osteoinduction?
Recruitment of immature cells and stimulation of these cells to develop into pre-osteoblast e.g. bone healing situations
What are favourable fractures?
Favourable because the elevator muscles will not be able to displace the fracture. The anterior segment will obstruct the upward displacmenet.
Masseteric - posterior angled fracture
Medial pterygoid and mylohyoid - lingual angle fracture
What is a code for adding a tooth ona denture?
768+071
What code do we used for a denture fabrication stage?
799
What is the difference between serous and mucous saliva?
Serous - produced by the parotid gland and a bit by submandibular of protein rich watery fluid.
Mucous - produced by the sublingual and minor salivary glands. It is important for lubrication
What are the three factors of tooth colour?
Hue – base pigment – red, pink, green, blue and other
Value – most important – quantity of light reflected – how bright is the object can be shown with black and white images
Saturation – chroma – intensity or vividness – how much of base pigment is there within tooth structure
What are the conditions for consent to be valid?
- Capacity - to understamt and appreciate the consequences of the decision
What is the neutral zone impression technique used for?
The neutral zone impression technique is applied for taking imp of atrophy and mandibular ridge.
What is the best bonding technique?
4th generation ethc-prime-bond-composite.
What are the oral side effects during radiotherapy?
- Mucositits
- Taste changes
- Dry mouth
- Increased mucous
- Tooth hypersensitivity
- Dysphagia
- Weight loss
What are the eruption times for permanent teeth?
1.Lower central incisors – 6-7 years
2.Upper First molar – 6-7 years
3.Lower First molar – 6-7 years
4.Upper Central Incisors – 7-8 years
5.Lower Lateral Incisors – 7-8 years
6.Upper Lateral Incisors – 8-9 years
7.Lower canine – 9-10 years old
8.Upper first premolar – 10-11 years
9.Lower first premolar – 10-12 years
10.Upper second premolar – 10-12 years
11.Upper cannines – 11-12 years old
12.Lower second molar – 11-13 years old
13.Upper second molar – 12-13 years old
14.All third molars 17-21 years old
What intra-operative factors are associated to negative outcome in endo?
1.Iatrogenic perforation
2.Patency at apical terminus
3.Extrusion of root fillings
What is replacement resorption?
Can follow trauma. Tooth structure is replaced.
What is free way space?
freeway space obs, slang: syn, INTEROCCLUSAL REST DISTANCE, INTEROCCLUSAL REST SPACE
What is traumatic neuroma? What are it’s clinical signs?
It is a lesion thatoccurs due to the damage of a nerve trunk following some sort of injury (like surgery or pressure on dentures).
Essenially - the repair of the axon does not go as planned and the lesion if fully comprised of the neural tissue.
Clinical features: small swelling or nodule on mucosa near mental foramen, alveolar ridge, lips or tongue. Pressure on the nodule cuases pain
Give 5 differential diagnosis for an ulcer?
- Herpetiform ampthous ulcer
- Mild amthous ulcer
- Major ampthous ulcer
- Traumatic acute ulcer
- Traumatic chronic ulcer
What is the cultural iceberg?
- Behaviors & practices - clothing, greeting, speech
- Atttitudes - levels of fomality - manners or politness
- Core values - good or bad behaviours
What is classified as moderate periodontitis by CDC/AAP?
- At least two proximal sites not on the same tooth with attachment loss of 4mm or more
- At least two such sites have pockets of 5mm or more
What are contraindication for RA
Pulmonary heart disease
Sever asthma
Blocked nose
Refusal to breathe through nose
CNS disease
Otitis media or middle year disturbance/surgery - only active
Claustrophobia
GI issues
Cystic fibrosis
What type of tissue is this?
This is lingual thyroid tissue
What is main treatment for patient with oral cancer?
- Initial diagnosis
- Definitive treatment
- Management of complications and monitoring
What is a common radiographical appearance of squamous cell carcinoma?
Smoking adults. Ill-defined, permeative lesion. Spread localy and lymph nodes. Destroys bone.
What if a patiet has problem with gaggin?
The extension of the denture may need to be modified.
Following options:
- Remove the palatal extension of the denture
- Reduce the buccal extension of the denutres
- Desensitisation therapy
- Re-do the denture with a reduced secondary impression
What are the steps for reprocessing of Reusable medical devises (RMDs)?
- Pre-cleaning at the chairside
- Mechanical cleaning using ultrasonic
- Manual cleaning using of professional cleaning machines
- Thermal disinfection
- Thermal disinfection using washer-disinfection
- Inspection
- Choice of packaging material and sealing of packages
- Labelling packages of reuseable medical devices
- Run a Bowie-Dick type tests for air removal and steam
What are some of the pre-requisites for health according to the Ottawa Charter?
- Peace
- Shelter
- Education
- Food
- Income
- A stable exosystem
- Sustainable resources
- Social justice and equity
What is a normal GFR?
Above 60 if it is below 15 they are in kidney failure
What can you do to reline the denture to new OVD?
You can use CCA stopper or a wax compound + border molding + taking impression of upper and lower dentures with Upper first.
So the wax compound needs to increase the OVD and ned reline will ensure that soft tissue retention and supprot can be achieved.
Always use adhesive
What is the definition of dental impression?
Dental impression creates a negative imprint of hard and soft tissues in order to create a positive cast or model.
What are predisposing factor to periodontal abscess?
1.Furcation areas because they are hard to clean.
2.Patients with diabetes – impaired cellular immunity, decreased leukocyte chemotaxis and bactericidal activity.
What are some of the treatment for salivary dysfunction?
- Stimulation of salivary flow through masticatory sialagogues or medication
- Use of saliva substitutes in form of carboxycellulose or mucin based
- Use of mucosal wetting agents like water or GC dry mouth gel
What are the advantages of low individual effort for the population?
- Widespread effect on nearly all populations across the social spectrum
- Large impact at population levels
- In certain instances - may be able to target health inequalities, though can only apply on legislative level
What is the Mach effect?
It is an optical illusion. Form of edge enhancement which facilitates the detection of the edges of an object. Basically, the edges between light and dark appear darker. SO NO PATHOLOGY.
Give 5 differential diagnosis for a white lesion
- Leukodema
- Leukoplakia
- Lichen Planus
- Frictional keratosis
- Oral squamous cell carcinoma
What are the main types of temporary cements?
Zinc oxide eugenol
Zinc oxide non eugenol
Resin
What can you do to improve bone levels after periodontal surgery?
You can add a boney material for regeneration. But remember, no probing for at least this much for each material:
Perioglas – 6-12 months
Bio-Oss – 12-18 months
Emdogain – 2-3 years
When treating a patient with solid organ transplant what should you consider?
- Corticosteroid supplementation
- Any increased risk of bleeding
- Any infection risk
You are at a footy game and your mate avulses his tooth, what do you do?
Management of avulsion with alveolar fracture
First aid
* Keep pt calm
* Pick up the crown (not the root)
* If the tth is dirty,
o Rinse with milk/saline/pt saliva
o If the dirt is tenacious, use a damp gauze to gently wipe the tooth
* Replant immediately
* Ask pt to bite on the gauze/ handkerchief/napkin to hold the tth in place
* See dentist ASAP
* If replantation is not possible, plant the tth in a storage medium ASAP to avoid dehydration of the PDL cells on the root surface,
o Milk/ HBSS/pt saliva
o Let pt hold it in their buccal sulcus (make sure to warn them not to swallow the tth
o Water is a poor medium -> osmosis -> kill the cells. Better to leave in the air
What should you do if a patient takes anti-platelet therapy?
Use local haemostatis measures like pressures, coagulation assiting material like surgicel and suturing of the wound
What are the types of resective surgery?
- Gingivectomy – removal of pocket epithelium, connective tissue and mucosal epithelium
- Modified Widman flap – removal of pocket epithelium and connective tissue +/- osseous, leacing behind mucosal epithelium
How do you check for high pressure spots?
PIP creame on fitting surface
What are the 3 things that are suggested by Dr. Alison Nelson in regards to effective cross culture communication
- Building relationship/building rapports/building trust - be humble in your approach, be friendly. Remember, you are there to learn about the person and their culture.
- Genuinley reciprical communication. Tell them about yourself as well and use points of connection between yourself and individual under your care.
- Breakdown the power imbalance with person under your care
- Overcome cultural faux pas. Roll with mistakes and listen to patient in those situates. Be a learner not a teller.
What are the indications for MTA?
- Vital Pulp Therapy
- Immature apices
- Perforations - lateral and furcation
- Retrograde root canal filling
What can we repair on a denture?
Broken/cracked denture base
Broken/lost clasp
Chipped/broken/debonded denture tooth/teeth
Broken rest
What are the types of trauma-induced tooth resorption?
- Surface resorption
- Transient apical internal resopriton
- Pressure resorption
- Orthodontic resorption
- Replacement resorption
What is the significance of curve of wilson in dentures?
- Allows lateral mandibular excursion
What are two different types of ankylosis?
1.With replacement resorption – bone is replacing dentine
2.Without replacement resorption - no bone replacing den
What are the common accidental findings on CBCT?
1.Dense bone Islands
2.Torus
3.Osteomas
4.Degenerative Joint Disease
5.Chondrocalcinosis
6.Synovial osteochondromatosis
7.TMJ Dysfunction
8.Sinus pathology
9.Nasal septum pathology – including different sinusitis, and mucucoel
10.Nasal cycles
What is considered to be Grade C periodontitis?
- More than 2mm bone loss over 5 years
- Bone loss to age ratio between 1.0 inclusive radiographically (ie for a 50 year old patient the range is around 50.0 percent and above)
- Low biofilm deposit and large amount of periodontal destruction. Unequal pattern, resulting in small amount of biofilm but large amount of destruction.
- Smoking more than 10 cigarettes per day
- HBA1c level of more than 7.0 in diabetic patient
What should you put on a lab form?
Describe saddles, cross teeth which are not restored
Describe support and draw rests, major connector/plat
Specify abutment tooth/teeth
Specify clasps: rest, retentive, reciprocal
Specify flanges gum fitted vs buccal flange
Specify the extensions
Fill lab form and draw design
Obtain tutor signature
What to do if a patient has chest pain or angian?
1.Stop treatment
2.Pulse oximeter on, see if patient is concious, check heart rate and blood pressure – if no pulse, CPR - ask patient if they used viagra, as it can make GTN way more potent
3.Use glyceryl trinitrate spray 400 micrograms sublinguallt, repeat 5 minutes if pain persists, for total of 3 dosease if tolerated
4.If pain continues, call 000
5.Give 300mg of aspirin orally chewede before swallowing
6.Strat supplemetan oxygen and maintain oxygen between 90-96% saturation
How can we overcome barries related to government, organisation or the way our system is set up?
- Through legislative changes that protect people with special needs and support them through policy change. E.g. Disability Discrimination Act or Australia’s Disability Strategy
- Highlightin groups that are less represented in healthcare and improving their access to health services e.g. Putting people with special needs in a priority population in National Oral Health Plan as there is large overlap between their complex medical/social situationa nd complex oral health conditions
What is an uncomplicated crown-root fracture? What are the treatments?
It is a fracture involving enamel, dentin and cementum.
Treatment: Temporary stabilisation of the loose fragment to adjacent teeth or non-movng fragment
And after one or multipel of the following:
1. Orthodontic extrusion
2. Surgical extrusion
3. Root canal treatment and restoration if pulp becomes necrotic
4.Root submergence
5. Intentional replantation
6. Extraction
7. Autotransplantation
What is rettachment?
It is the reunion of existing collagen fibres after tooth avulsion
How does PIP cream work?
Put the PIP in the denture and insert intot he patient mout. Make them chew nicely. Remove the denture. Where you see spots of missing PIP are usually high spots that cause patient to be in pain! Adjust with straight hand piece.
What is the definition of open disclosure?
Open disclosure is the process of providing an open, consistent approach to communicating with patients/consumers, their family, carer and/or support person following a patient incident. The process includes expressing regret or saying sorry.
What type of bones are present in the cranial vault?
Flat membranous bones with suture in between. Osteogenesis occurs in the ossification centres + sutures. The cause of increase area of bones occurs due to brain growth. The out cortical plate usually deposits and inner cortical plate resorts.
What are the materials available for bite registration?
- Wax rims
- Exabite
What are 4 parts of patient centered care?
- Explore illness and disease and their context
- Seeing the patient as a whole person - aka holistic care
- Showing compassion and empathy
- Reaching a shared sense of patient-doctor responsibility
What is an example of indirect retainer?
Rest, minor unit or major connector
What can implant do?
Always check for nerve injury and boney plate perforations.
What is a good measure for double teeth?
1.Fissure sealing
2.Surgical separation
3.Ortho, implants, autotransplants or prosthesis
What are some the benign lesion of epithelial layer with idiopathic or developmental origin?
- Leukoedema
- White Sponge Nevus
- Epidermolysis Bullosa
What do you do if the patient takes triple antitrhombotic therapy?
Refer to specialist
What is guided bone regeneration?
GBR involves the placement of a physical/biological barrier to ensure that the hard tissue deficiency becomes repopulated with bone. This exclusivley relates to the augmentation of resorped ridge.
What are the three different types of empathy?
o Cognitive empathy – desire to understand
o Emotional empathy – desire to feel
o Compassionate empathy – desire to help & support
What are the steps for internal bleaching?
- Remove extrinsic staining
o Prophy, U/S
o Pt education re extrinsic staining - Pre-op shade
- RD
- Remove restoration but not stained dentine
- Remove GP 1-2mm below CEJ
- Place Cavit or GIC to seal GP from the orifice
o At least 2mm of GIC or cavit - Etch pulp chamber, rinse and dry
o Request DA to dispense bleaching material - Mix sodium perborate with water until u get a stiff paste consistency
- Place bleach mix onto the labial surface of access cavity
- Seal bleaching material w cotton pellet and seal w GIC or cavit
- Repeat the above steps every 1wk until the desired colour is achieved
- Once the shade is reached
o Remove all bleaching material
o Rinse thoroughly
o Record post-op - Defer definitive restoration for 7d,
o Enamel margin might be weakened -> bond strength may be compromised
Your patient comes in with an avulsed tooth that has already been re-implanted. The tooth is believed to have an open apex. What are the steps for management?
- leave the tooth in place
- Clean area with saline
- Suture gingival lacerations
- Varify normal position of the replanted tooth radiographically
- Apply flexible splint for 2 weeks
What are some of the predisposing factor for necrotising gingivitis?
- Local factors – poor oral hygiene, plaque retentive factors (overhangs, crowded teeth and calculus), cigarette smoking
- Systemic factors – stress, poor nutrition (vitamin C deficiency), hormonal imbalance, systemic disease affecting immune response
What is the main feature of oral malignant melanomas?
They have a defused appearance
What is the imortant aspect of the peripheral giant cell granuloma?
It is important to determine that the lesion is not an intra-bony or central lesion which has perforated cortical bone
What is internal inflammatory resorption? What is the treatment?
It is a type of resorption defined as an inflammatory process within a section of the pulp/root canal that results in loss of dentin commencing at the root canal wall and progressing towards cementum. A radiographic oval shape appearance is very common
This can be caused by traum or caries.
Treatment: Root canal treatment with corticosteroid and antibiotic + calcium hydroxide after
What is a common appearance of a odontogenic keratocyst?
Odontogenic keratocyst is a well-defined sclerotic which causes less jaw expansion and grows along the jaw bone.
What is physiological resorption? What is the treatment?
It is the physiological resorption is the resorptive process that primary teeth undergo as they exfoliate. It is normal.
Treatment: monitoring exfoliation or extraction of primary teeth
What is internal inflammatory root resorption?
Resorption that occurs internally
What are the different types of boney defects? How do you determien them? Which one have the best treatment?
Types of boney defects
3 wall defect - bone only missing in specific site and surround on 3 different sides. This defect can be considered intrabony - best treated with regeneration.
2 wall defect - bone missing on multiple sites with only 2 sites surrounding the defect. This defect can be considered infrabony - can be treated with regeneration but not as successful
1 wall defect - bone missing on 3 different sites of the tooth and is only supported by 1 wall. This defect can be considered infrabony - regeneration is mostly unsuccessful.
Can be determined with step motion perio probing and radiographs.
What is external replacement resorption? What is the treatment?
External replacement resorption is the process where cementum and dentin are resorbed and replaced by bone.
Aetiology: can occur after external injuries
Treatments: lower the amount of time out of the socket after avulsion
What are giant cell lesions?
Anterior to first molar. Slow growing with well-defined margin. Some cortical expansion can occur.
What condition is this?
This is an oral lichenoid lesion - which is similar to oral lichen planus but is usually around a single site.
Usually associated with medications and go away when medication is stopped
What is the treatment for a mandbiular and condyle fracture?
- Direct epihpyseal fracture of the mandible, single, closed
- Indirect fracture of the RHD condular head
Treatment for 1 - exposure of the fracture at site at the mandible and placement of direct plating of the fracture (ORIF)
Treatment for 2 - intermaxillary fixation with use of arch bars to allow the condyle to heal if it is not displaced, comminuted or severely damage in other way. This will manage the occlusion. TMJ ficxation with direct bars may be possible.
Remember:
Soft food, and wire shut jaw for the next 3 months at least.
After the surgery, patient needs to be observed until reasching 12 hour stability.
Review 24 hours, a week, a month and 3 months after. If any complications occur, review.
Remove arch bars when the condyle is healed. A period of physiotherapy might be needed.
What is recurrent herpes simlex vitus?
It is a vesicular eruption affecting perioral skin, lips, gignivae and palate - knowns as harpes labialis
What does the reactivation vericells virus lead to?
It leads to shingles.
Shingles may result in oral manifestations like vesicular lesiosn aorund the oral cavity.
What are some of the options of regeneration that can occur during periodontal treatment?
- Gingival connective tissue growth resulting in root resoprtion. This is not ideal.
- Epithelium growth and formation of long junctional epithelium. This occurs in closed and open debridment
- Alveolar bone prolifiration resulting in ankylosis. This is not ideal.
- PDL and bone regeneration resulting in strong tisseu attachement - this is the goal of GBR
What is morsicatio buccarum?
It is cheek biting which causes chronic mechanical trauma.
Clinical presentation is a unilateral or bilateral white patch on the buccal mucosa, which is rough and whitenned. Usually symptomless
What is idiopathic resorption? What is the treatment?
It is resorption with no apparent causes. Typically it involves multiple teeht with shorter roots.
Treatment: determining systemic causes through general health checks and after monitoring.
What condition is this?
These are lingual tonsils.
This is part of the lymphoid tissue (Welder’s ring) that is used to fight infection.
The lymphoid tissue underneath the folliate papilla goes through lymphoid hyperplasia (growth) and result in an elevation on the postra-lateral tongue surface.
What is internal replacement resorption? What is the treatment?
Internal replacement resorption is a process where the pulp and dentin are replaced with bone. It usually begins within the pulp/root canal and on the root canal walls and it progresses towards the cementum. Clinical appearance may be normal or discolored.
Usually as a result of insult to the pulp.
Treatment: observation and eventual extraction. If diagnosed early, root canal treatment may be feasible.
What are the 7 signs of IAN involvement?
1.Darkening of the roots
2.Interruption of the white line
3.Diversion of the mandibular canal
4.Deflection of the roots
5.Narrowing of the roots
6.Dark and bifid roots
7.Narrowing of mandibular canal
What is nasopalatine cyst?
A defined radiolucency that occurs in the palate
What are some of the other adjectives that can be used to describe a lesion?
- Papillary - any small growth projectin into a cavity
- Verrucous - warty surface appearance (small hyperkeratinised projections)
- Epulis - lump on the gum non-neoplastic
What is a common appearance of a odontogenic keratocyst?
Odontogenic keratocyst is a well-defined sclerotic which causes less jaw expansion and grows along the jaw bone.
What is external invasive resorption? What is the treatment?
It is a process that is not fully understood. It commences at the sub-gingival location and spreads through out the tooth in all directions.
According to Prof Heithersay, it can be classified as Class I-IV using a PA.
Class I-II are better treated with trichloroacetic acid (TCA) to the resorbing tissues followed by curettage of the defect and restored with glass ionomer cement. Result are usually quite good.
Class III might need adjunt treatment such as root canal treatment.
Class IV have undpredictable outcomes and patient need to be made aware of future issues and probable extraction
What is this condition?
This is a minor aphthous ulcer - which one of the most common ulcer of infectious origin.
It usually occurs in non-keratinised mucosa, it is shallow and rounded.
It has erythematous margins and yellowish floor
What is communication internal-external inflammatory resorption?
Both internala nd external resorptions
What is a myxoma?
It is an uncapsulate lesion with infiltrative growth and stellate and spindle.
Occurs as bubbly in appearance.
What is the common appearance of eosinophilic granuloma?
Solitary lesion, well-defined bu non-corticated with irregular margins. DESTROYS BONE AND LEAVES THE FLOATING TOOTH APPEARANCE. Periosteal new bone formation is common.
What is the common appearance of the radicular cyst?
Lesion consists of a lucent centre and a thin, well-defined sclerotic rim. Cortical bone destruction may occur if cyst becomes too big.
What is a common appearance of cemento-ossifying fibroma?
Mandible, fibrous capsule gives a thin raiolucent halo. Rapid expansion and tooth displacement. May contain abnormal bone and cementum like tissue.
What is a common appearance of mucoepidermoid carcinoma?
Well-defined border in posterior body or angle of mandible.
What are the 7 signs of IAN involvement?
1.Darkening of the roots
2.Interruption of the white line
3.Diversion of the mandibular canal
4.Deflection of the roots
5.Narrowing of the roots
6.Dark and bifid roots
7.Narrowing of mandibular canal
What condition is this?
This chronic hyperplastic candidiasis.
It is usually a single, fixed, white or mix of white and red patch that syays when whipped.
May occur anywhere but common sites are the tongue and buccal mucosa.
What is internal surface resorption?
It is a type of resorption that is defined as minor areas of resorption of the dentin walls of the root canal. It is believed to be transient and self-limiting.
What is a common appearance of an adenomatoid odontogenic tumour?
Anterior mandible, well defined with corticaed border. Tooth displacement is common, root resorption is uncommon.
What is common appearance of periapical cemental dysplasia?
At apex bone is replaced with fibrous material. Lesion persistent after extraction.
What type of conditon is this and why?
These are fordyce spots
They are sebatious glands in the oral mucosa.
Do not biopsy and reassure the patient that this is normal.
Pathogenesis: ectoderm refrences
What is the common appearance of osteomyelitis?
PAIn _ subtle changes in bone density. Bone destruction with sequestration formation.
What are the potential response following horizontal root fracture?
- Interposition of dental HT
- Interposition of bone and PDl
- Intrposition of dense fibrous CT
- Non-healing
What is the common appearance of metastases to the jaw?
Usually from renal, breast, lung, colon and prostate. Affect posterior mandible. Ill-defined, lytic lesions with clear bone destruction.
What is a common appearance of an ameloblastoma?
Has aggressive growth characteristics. Typically well-defined and radiolucent. Cause root resorption, tooth displacement and bone expansion. Floating tooth appearance.
What are some of the types of biopsy?
- Scalpel biopsy - incisional or exitional - most common procedure
- Fine needle aspiration
- Core biopsy
- Exfoliative cytology - taking the gunk and spreading it over a film
What is another type of lesion that can be caused by HPV?
Genital warts in the mouth or Oral Condyloma Accuminatum.
It is an infections lesion that can cause transmission through direct contact.
It presents as a broad based pink nodule that grows and coalesce (come as one)
What is peripheral giant cell granuloma?
It is a similar lesion to the pyogenic granuloma but it also involves bone tissue
What is a common appearance of cementoblastoma?
Slow growing lesion full of cementum like tissue. Attached to root apex. Well-defined with cortical border.
What lesion is associated with human papilloma virus?
Squamous papilloma.
An asymptomatic, solitary lesion that is associated with cauliflower like apperance
What is a Stafni’s bone defect?
It is a salivary inclusion cyst. A well-defined oval lucencies anterior to angle of mandible.
What is Transient apical internal resorption?
This process can follow luxation injuries and may be associated with TAB
What is surface resorption?
Type of trauma-induced tooth resorption. Involves cementum and small amount of dentine.
What is a common appearance of osteogenic sarcoma?
Posterior mandible. Painless swelling. Ill-defined borderd\s. “Sun-ray” spiculation appearance. Breaks bone.
What is the clinical presentations of malignant lesions?
RULE acronym:
- Red/white
2.Ulcer
3.Lump
Exceeding 3 weeks in duration
What are generalised gingival hyperplastic lesions?
They are lesion that occur due to underlying factors such as plaque or use of certain medications such as hypertension medication (calcium channel blockers) or anti-covulsants or immunosupresants.
Drug Induced Gingival Overgrowth is one of them
What is this condition?
This is necrotising gingivitis. It is usualy caused by a presence of an opportunistic bacteria and an underlying stress factor.
Clinical features: necrosis of the papilla, sudden onset, ulcer covered by greyish pseudomembrane from surrounding mucosa
Treatment:
- OHI
- Debridement
- CHx
- Metronidozole 400mg 6 hourly for 5-7 days
What is the basic investigative process in oral pathology?
- Presentation of chief concers
- Information collection - medical history, patietn history, clinical examiantion and special tests
- Information collation
- Development of a differential diagnosis - list most likely diagnoses and do specific test to eliminate potential diagnoses
- Arrive to definitive diagnosis and commence treatment
What instrument can be used for a gingevectomy?
A kirkland knife
What is a common appearance of cementoblastoma?
Slow growing lesion full of cementum like tissue. Attached to root apex. Well-defined with cortical border.
What is TAB?
Transient apical breakdown (TAB) is a phenomenon that indicates temporary apical periodontal destruction and root resorption after tooth luxation injuries, followed by the healing process of the dental pulp.
This is why in luxation injuries, root canal treatment is usually needed in mature teeth but not always. WATCH FOR SYMPTOMS.
What is the common appearance of the dentigerous cyst?
Lesion uniformly lucent with a thin, well-defined sclerotic rim attached to the cemento-enamel junction.
