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BDS4 Exam Perp > Treatment of discolouration > Flashcards

Treatment of discolouration Flashcards

1
Q

Describe the HCL pumice technique for enamel microabrasion?

A
  • PPE and patient protection
  • Place petrolium jelly on gingivae and place dental dam
  • Clean teeth
  • Place sodium bicarbonate gaurd
  • HCL pumice slurry is applied to tooth for 5 seconds by rotating rubber cup for a maximum of 10 times
  • Apply fluoride varnish after cleaning the teeth
  • Polish using sandpaper discs then toothpaste
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2
Q

4 pre-op records for discoloured teeth other than radiographs and clinical photos?

A
  • Shade
  • Sensibility testing to check for sensitivity
  • Diagram of defect
  • Patient assessment
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3
Q

Why do we use sandpaper discs at the end of enamel microabrasion?

A
  • To change the optical properties of enamel so areas of intrinsic discolouration become less evident by removing the prismless layer of surface enamel
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4
Q

3 cases where you would use microbrasion for the treatment of discolouration?

A
  • Decalcification due to orthodontics
  • Fluorosis
  • Trauma to primary incisors
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5
Q

How many microns are removed from HCL pumice microabrasion?

A

100

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6
Q

What concentration of HCL is used?

A

18%

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7
Q

4 advantages of microabrasion other than easily performed and conservative?

A
  • Not expensive
  • Minimal maintenance required
  • Results are permanent
  • Fast acting
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8
Q

4 disadvantages of microabrasion?

A
  • Removes enamel
  • Must be done chair side
  • HCL components are causatic
  • Required protective apparatus for patient, dentist and dental nurse
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9
Q

What would you warn the patient about after completing microabrasion ?

A
  • To avoid highly coloured food and drinks for at least 24h
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10
Q

When would you review the patient after enamel microabrasion and what will you do at this appointment?

A

4-6 weeks
* Take post op photographs

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11
Q

When can you use 0.1% to 6% hydrogen peroxide on people who are under the age of 18 ? and when was this decision released?

A

For the purpose of treating or preventing disease
in 2014

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12
Q

What are the two types of bleaching?

A

Vital bleaching (external) and non-vital bleaching (internal)

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13
Q

What are the two options of vital bleaching?

A
  • Chairside power bleaching
  • Night gaurd vital bleaching
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14
Q

What is used in chairside vital bleaching?

A
  • Hydrogen peroxide , using 15-38%
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15
Q

Two techniques used in internal non vital bleaching?

A
  • Inside Outside
  • Walking bleach technique
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16
Q

What is used in home vital bleaching?

A

10% Carbamide peroxide

17
Q

Explain the process of Nightgaud vital bleaching?

A
  • Cut windows in customised tray over teeth which are not included in the treatment
  • Patient applies gel to tray after brushing teeth
  • Wears the tray overnight for at least 2 hours
18
Q

What is the time scale for vital home bleaching?

A

3-6 weeks

19
Q

How does carbamide peroxide relate to hydrogen peroxide?

A

10% carbamide peroxide breaks down to 3% hydrogen peroxide and 7% Urea which breaks down to water ammonia and carbon dioxide

20
Q

3 advantages of non vital bleaching?

A
  • Simple
  • Tooth conserving
  • Gingival tissues not irritated by restoration
21
Q

When selecting a tooth for non vital bleaching , what are 4 things you should take into consideration?

A
  • Adequate root filling with signs of disease
  • Anterior teeth without large restorations
  • Not fluorosis or tetracycline discolouration
  • Not amalgam discolouration
22
Q

Describe the walking bleach technique?

A
  • Root filling removed to below gingival margin
  • Bleaching agent applied on cotton wool and placed in tooth
  • Covered with dry cotton wool then sealed using GIC
23
Q

When would you renew the bleach and how many changes ?

A
  • Every two weeks , 6-10 times
24
Q

When would you stop the process if there is no change?

A

After 3-4 renewals stop if there is no change

25
Q

Describe the inside out bleaching?

A
  • Access cavity and remove root filling to ACJ
  • Custom made mouthguard is given to patient with windows cut on tooth not intended to be bleached
  • Patient applies bleaching agent on tray and tooth
  • Patient should keep access cavity clean
26
Q

When should the patient wear the tray for inside out bleaching technique?

A
  • All the time except when eating or cleaning
  • Gel changed every 2 hours except during the night
27
Q

How would you restore the pulp chamber ?

A
  • non setting calcium hydroxide for 2 weeks and seal with GIC
28
Q

After sealing with Caoh and GIC for two weeks , what would you restore the rest of the tooth with if you want to rebleach in the future?

A

White GP and composite resin

29
Q

After sealing with Caoh and GIC for two weeks , what would you restore the rest of the tooth with if you dont want to rebleach in the future?

A

Incrementally cured composite

30
Q

If regression happens after bleaching what two treatmentss can be offered?

A
  • Veneer or crown
31
Q

4 complications of non vital bleaching?

A
  • External root resorption
  • Spillage of bleaching agents
  • Failure to bleach or overbleaching
  • Brittlness of tooth crown
32
Q

Why do we place CaOH for two weeks ?

A

To reverse any acidity in the periodontal ligament that might have occured

33
Q

Why is a layer of cement placed over GP in non vital bleaching walking bleach technique?

A

To prevent the bleaching agent from reaching the external surface of the root

34
Q

What are the effects of short term exposure to bleaching agents on soft tissues ? Give 3

A
  • Minor ulceration and irritation
  • Plaque reduction
  • Aids wound healing
35
Q

Long term exposure effects of bleaching agents on soft tissues?

A
  • Delayed wound healing
  • Periodontal harm
  • Mutagenic potential
36
Q

Explain how resin infiltration is applied?

A
  • Surface layer of enamel is eroded
  • Lesions desiccated
  • Resin infiltrate(low viscosity light curing resin) is applied and penetrated lesion by capillary forces
  • Leading to a similar appearance of enamel
37
Q

Things to consider when removing enamel for veneers?

A
  • Age of patient
  • Tooth position
  • Aesthetics
  • Oral hygiene as removing enamel increases plaque retention
38
Q

Why would removing buccal enamel make the success rate of composite veneers better?

A

Increased bond strength

BDS4 Exam Perp (72 decks)

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