tomorrow Flashcards
wedge or v shaped cervical lesion created by the stresses of lateral or eccentric tooth movement during occlusal function bruxing or parafunctional activity resulting in enamel microfractures
abfraction
repeated rubbing of a tooth surface with a toothpick or wooden stick
burnishing
transient pain arising from exposed dentin typically in responce to a stimululs which cannot be explained as arising from any other form of dental defect and subsides quickly when stimulus is removed
dental hypersensitivity
currently accepted mechanism for pain impulse transmission to the pulp as a result of fluid movement
hydrodynamic theory
dentin locate dbetween dentinal tubules
interubular dentin
increased deposition of minerals into tubules that become more minerilizezd with increasing age resulting in thicker schlerotic dentin
intratubular or pertiublar dentin
reduction of the resting potential of the nerve membrane so that a nerve impulse is fired
neural deopolarlization mechanism
creates the nerve impulse
depolarilization
restored
repolarized
the passage of fluids and soloutions of lesser concentration through a selective membrane to one of greater solute concentration
osmosis
open obstructed a patent dentin tubule allows fluid flow to signal pain many desentiizing agents work by decreasing the patentcy of the tubule
patent
specific type of scientific expierment that is the gold standard for a clinical trial
Randomized clinical trials
dentin that is secretely slowly over time after root formation to wall of the pulp from fluid flow with dentin tubules following a stimulus
secondary dentin
has been referred to as grinding debris from instrumentation or other devices applied to tooth
smear layer
a type of dentin formed along the pulpal wall or root canal as a protective mechanism in responce to trauma
tertiary reparitive dentin
contact with tooth brush and other oral hygiene devises eating utensils dental instruments and frictionf from prosthetithc devices such as denture clasps
tactile
temp change caused by hot and cold food and beverages
thermal
deyhydration of oral fluids from high volume evacation or application of air to dry teeth during intraoral proceudres
evaporative
alteration of pressure in dentin tubules through a selective membrane
osmotic
in foods and bevarages such as citrus fruits, condiments spices wines
chemical
portions of tooth covered by enamel on the crown and cementum on the root
dentin
highly innervated with nerve cell fiber endings that extend just beyond the dentiopupal interface of the dentinal tubules
pulp
nerve fiber endings extend just beyond the dentin pulpal junction and wind around the odontoblatsic processess
nerves react the same through neural depolarilization mechanism
the sequence of gingival recession, loss of cementum or enamel, and subsequent dentin exposure can result in
hypersenstivity
hypersensitivity may be a clinical outcome of
erosion
erosion can occurs from
dietary acids
dietary acid results in an immediate drop in oral ph after normal salivary neutralization a physiologic ph of
7 re establishes within minutes
wedge shaped cervical lsion has a questionalble etiology
lateral occlusal stresses or bruxing
enamel rods chip away from cervical area of tooth
abfraction
currently accpted explanation for transmission of stimuli from the outer surface of the dentin to pulp
hydrodynamic theory 1960s by brannstorm
There are several mechanisms by which desensitization can occur naturally over time:
schlerosis of denitn
secondary dentin
smear layer
calculus
`
a large malpractice cross survey found a prevalence of dentin hypersensitivity of
12.3 percent with an average of 3.5 hypersensitive teeth
the highest prevalence occured in those
18-44 years of age
gingival recession is more prevalent with
aging
dentin hypersensitivity is not more prevalent with
aging
hypersenst. occurs more in
women
hyperse. has been reported to occur primarily at the cervical
1/3 of the facial surfaces of premolars and mqndiibular anterior teeth or on premolars and molars
hyperse can manifest as
acute or chronic
acute results from
anxiety
chronic pain may result from
depression
non noxious stimulant
cold water
many types of dental pain can be intensifited by
thermal
sweet
sour
chewing pain can be indiciative of
pulpal pathology
pulpal pain is
severe
intermittent
throbbing
diagnostic techniques and tests
visual assesment of tooth integrity
palpation of etral and intraoral soft tissues
evaluation of nasal congestion drainage and sinus
ocsslusal examination
two basic treatment goals
pain relief
modification or elimanition of contributing factors
allow sufficient time to elapse to evalutate effectiveness and reinfornce behavior changes
2-4 weeks
2 ways agents measures disrupt the oain transmission
prevent nerve depolarilization that interrupts the neural trannsmission to the pulp
prevent a stimulus from moving the tubul fluid by occlusion of dentin tubule orfices
encourage habits that allow tubules to remain occluded or that occlude patent tubules
motivational interviewing approach
educate the pateint that some products may take 2- 4 weeks to decrease senstivity
are the only agents that are theorized to work by depolarization
potassium salts
potatssium nitrate dentrifices containging flurloride
are widely used
precipaate calcium flurlide crystals wit the
dentin tubule to decrease the lumen diameter
create a barrier by precip caf2
blocks open dental tubules
oxalates
coagulates proteins and amino acids within the dentin tubule to decerease the dential utbule lumen diameter
can be combined with hema as a resin
creates calcium crystal
gluterahyde
advocated for use sa caries control agent to reduce deminerilzation and increase reminerilization by releasing calcium and phosphate ions into saliva for deposition of tooth minteral
calcium phosphate technology
theorizd to plug dentinal tubules with calcium and phosphate precipate
enhances fluride
acp
contains sodium and silica in addition to calcium and phosphurus
deliveredin solid bio active glass particles that react in the presence of salva and water to release calcium and phosphate ions
CSP
is a milk derived protien that stabalized acp and allows it to be released during acidic challenges
cpp acp
devellope in an affort to create a calcium material that can co exist with fluride
TCP
dentirfices are
5 percent in toothpastes
they are avaiable in
5000 ppm fluride
mouthrinses containing
.63 stannous fluride mouth rinses can be prescribed for daily use
a tray delivery can be used to apply
2 percent netural sodium fluoride soloution
dentin bonding agents may protec against further eriosin for
3 to 6 months
tooth whitening thought to result from by products of
10 percenet carbamid
3 hydrogen peroxiide
and 7 urea
thermal mechanical evaproative osmotic chemical sens. sharp sudden transient pain
clinical examination gingival recession and loss of tooth structure
dentinal hypersensitivity
thermal sensit
pain on pressure
pain with sweets
clinical ex
rad ex
caries extending into dentin
thermal sens
severe throbbing pain
pain on chewing
clincal ex
radi ex
pulpal caries
therm sen
pain on pressure
clincical ex
fractured tooth
therm sen
pain on pressure
dental history
clincial ex
occlus ex
recently placed restoration
chem sens
therm sen
pain on pressure
mobility
occlusal ex
occlusal trauma
severe throbbing pain
thermal and electric pulp tests percussion
pulpitis
non desc tooth pain nasal congesetion sinus pressure headache clinical ex rad ex
sinus infection
sudden sharp stabbing pain on tooth to tooth contact
exam for contact between restoration of dissimilar non precious metals
galvanic pain
pain on chewing
clinic ex inlcuding palaption for apical tenderness
percussion
peridontal ligment inflammation
cratered ares of enamel or dentin at cej in the shade of a wedge or v shaped tooth
clinical ex
occ ex
abrfraction
