NBDE Part II
best clinical aid to determine if subgingival calculus is removed is using the
explorer and bite wing x rays
dentiogingival fibers
extend from cementum apical to the epithlelial attachment (JE) and travel laterally and coronally into the lamina propria of the ginigva
alveolar crest fibers
extend from cervical cementum of the tooth to the alveolar crest and function to counterbalance the occlusal forces on the more apical fivers and resist lateral movements
dentoperiosteal fibers
extend from cervical cementum over the alveolar crest to the periostum of the cortical plates of bone
posterior palatal seal
extends through the hamular notches in the maxilla, and passes 2 mm infront of the fovea palatinae the flatter the palate, the wider the posterior palatal seal excessive depth of the posterior palatal seal usually results in unseating of the denture always done by the dentist
what provides branches for the most direct blood supply for the TMJ
external carotid artery
what is the best way to palpate the posterior aspect of the mandibular condyle is ________ over the posterior surface of the condyle with the mouth open
externally
which treatment is indicated for a 5 year old patient with a sinus tract and a dark discoloration associated with their max central incisor that appeared following trauma?
extraction if you retained this tooth it can lead to abnormal formation of the permanent tooth
Submucosal Hemmorhage
extravascular lesions that do not blanch in contrast, vascular lesions like hemangiomas and telangiectasias do blanch on a diascopy test petechiae= 1 mm hemorrhages purpura= slightly larger than petechiae ecchymosis= 1 cm or bigger bruise hematoma- mass of blood within tissue, caused by trauma to oral mucosa like an anesthetic needle Tx: none, eliminate cause if possible
balancing side (non working side) interferences generally occur on the inner aspects of the
facial cusps of mandibular molars
syndroms with macrodontia
facial hemilhypertrophy otodental syndrome
Bells Palsy
facial paralysis from damage to Facial nerve sudden onset but paralysis begins to subside in 2-3 weeks
maxillary anterior teeth in a complete denture are usually arranged
facial to the ridge--best for esthetics
hemophilia C
factor 11
hemophilia A
factor 8
T/F you should shoe the functional cusp
false! never shoe the functioanl cusp
a 48 year old male patient with osteogenic sarcoma has been managed with a morphine pump. which of the following drugs is used to ameliorate his pain incase of morphine tolerane
fentanyl
Acrodynia
fever, anorexia, sweating, gi disturbance, desquamation of soles and palms ulceration of mucus membrane, excess saliva, premature exfolitaiton of teeth
what distinguishes a base from a cement from a cavity liner
final application thickness
cavity liners
final film thickness of 5 microns
cements for luting
final film thicness of 15-25 microns
differentiation- bell stage
final shaping of the tooth DI and AI occur in this stage
zinc polycarboxylate cement
first cement system developed with a potential for adhesion to tooth structure compressive strength is slightly lower than zinc phosphate cements, but they have greater tensile thermal conductivity is low can bond to tooth structure due to ability of carboxylate groups in the polymer molecule to chelate to calcium in the tooth disadvantage: extremly short working time
Rx for infective endocarditis prophylaxis
first choice: Ammoxicilian 2 g 1 hour before tx children: ammoxicilian 50 mg/kg 1 hr before PCN allergy: clinamycin 600 mg 1 hr before children PCN allergy: clinda 20 mg/kg 1 hr before non oral, IV or IM- Ampicillin 2g 30 min before children non oral, Ampicillin 50 mg/kg 30 min before
3rd generation dentin bonding agents
first generation to bond to tooth structure and dental metals/ceramics
strattera
first non stimulant approved for treating ADHD in children and adults
G.V. Blacks four number formula for insruments
first number: width of blade in tenth of a millimeter second number: cutting edge angle in gradians third number: length of the blade in millimeters fourth number: blade angle in gradians
hypermobile ridge
flabby edentulous ridges are common in anterior maxilla may use a tissue conditioner may use electro surgery or laser use large relief in tray or perforate a custom tray when taking impression
internal bevel incision
flap is reflected to expose underlying root and bone restores pocket lining, conserved univolved gingiva surface, produce a sharp, htin margin to adapt to the bone tooth junction
guide planes
flat parallel surfaces of abutment teeth that provide path of insertion and removal one third buccolingual width extends 2-3 mm vertically down from marginal ridge
which corticosteriod is administered by inhalation to treat asthma
fluticasons(Flonase)
what Rx for OCD
fluvoxamine
fissured tongue
folds and furrows of tongue dorsum Melkersson Rosenthal Syndrome= fissured tongue+granulomatous cheilitis+facial paralysis
a carpule of 2% lidocaine solution with 1:100,000 epi would contain how much epi in mg
for .001% epi, = .018 mg
incorrect vertical angulation
foreshortening- teeth appear too short elongation- most common error. teeth appear too long
secondary dentin
formed after completion of the apical foramen
P and B labial sounds
formed from the lips
reparative dentin
formed very rapidly in response to irritants more irregular
saddle pontic
forms a large concave contact with the ridge unclean and uncleanable and causes tissue inflammtion dont use
primary dentin
forms the inital shape of the tooth
traumatic bone cyst (pseduocyst)
found in mandible between canine and ramus of many teenagers due to trauma painless, well defined scalloped radiolucency
thyroglossal duct cyst
found in midline position and is usually dark colors and may be vascular resembling a hemangioma hemorrhage into the mouth is a common and important symptom tx: complete excision of the tract to the base of the tongue
post junctional alpha 1 adrenergic receptors
found in radial smooth muscle of the iris, arteries, arterioles and veins and in the GI tract causes contraction and vasoconstriction NE and EPI combine with alpha 1 receptors. found in arterioles in skin, mucosa, viscera and kidney
post junctional B1 adrenergic receptors
found in the HEART NE and EPI bind to B1 to increase HR, CO, BP and force of contraction
foliate papillae
found on the lateral margins as 3-4 vertical folds. have taste buds
interradicular fibers
found only on multi rooted teeth
compound fracture
fracture that communicates with the outside envionrment (open fracture) most common ocmplication is infection
pier abbutment
freestanding abutment with edentulous spaces on each side that requires a non rigid connector
the incisal edges of the maxillary anterior teeth should touch the wet/dry line of the lower lip when enunciating which sound
fricatives or labiodental sounds (f,v,ph)
overall pattern observed in dental plaque development is a shift
from an early predominance of gram positive faculative aeroboes to gram negative major factor in determining the different bacteria is oxygen
vibrating line
from hamular notch to hamular notch 2 mm away from fovea palatini
height or length of prep
from occlual/incisal surface to crown margin 3 mm min for incisors and premolars 4 mm min for molars
mutual protection
front teeth protect back teeth- front teeth disclude posterior teeth during protrusive and lateral movements back teeth protect front teeth- back teeth have flat occlusal surfaces and strong roots to help protect anterior teeth from bite forces
full mucoperiostal flap
full thickness allows maximum access and visibility raised from the gingival sulcus
Nabers 2N (hamp probe)
furcation
the protorype loop diuretic is
furosemide (Lasix)
ankylosis
fusion of surrounding alveolar bone to a tooth root the ankylosed tooth has lost it PDL space
which phase of amalgam reaction is prone to corrosion in clinical restorations
gamma 2 it is the weakest and softest phase
what is the strongest phase of amalgam set
gamma phase
order of phases of amlgam by srong to weak
gamme>gamma>gamma1> gamma 2
side effects of steroids
gastric ulcers immunosuppressio acute adrenal insufficiency ( 20 mg for 2 weeks within 2 years of dental treatment) osteoporosis hyperglycemia redistribution of body fat
lingual frenum
genioglossus
cleidocranial dysplasia (dysostosis)
gentic disorder of bone development characterized by absent or incomplete formed COLLAR BONES, heavy protruding jaw, wide nasal bridge, and dental , abnormalities, (malalinged teeth, multiple supernumerary teeth and unerupted teeth)
retention form for class V amalgam prep
gingival retention groove at the gingivoaxial line angle and the incisla retentiongroove placed along the incisoaxial line angle
where is an incipient carious lesion on an interproximal surface
gingival to the contact area
the TMJ is what kind of joint
ginglymoarthrodial joint because it has characteristics of a hinge joint and glinding joint
direct retainerr
gives the rpd mechanical retention resist displacement away from basal seat tissues
which of the following are involved in the path for parasympathetic innervation of the parotid gland
glossopharyneal nerve otic ganglion the parotid gland is th elargest of the major salivary glands and is entirly serous in secretion the parotid gland is drained by Stenson duct
sucrose is degraded by S. mutans into
glucans and lactic acid, thereby causing caries initiation and progression
apexification
goal is to induce further root development in a pulpless tooth (dead tooth)
what is the most ductile and malleable metal
gold
occlusal clearance
gold- 1.5 mm function; 1 non func PFM- 1.5-2 function, 1-1.5 non func all ceramic crowns- 2 mm
glockman furcation
grade 1- incipient bone loss.can feel depression of furcation opening grade2- partial bone loss, tip enters under the roof of furcation grade III-totall bone loss with through and through opening of furcation grade 4- furcation entrance is visible
the most acute and severe type of hyperthyroidsim is
graves disease
radiolucent
gray/black allows radiation to pass through
odontogenic keratocyst OKC
great tendency to reoccur usually between 10-30 year often associated with an impacted tooth 50% are found in mandib 3rd molar area well circumscribed radiolucency with smooth margins and thin radiopaque borders
the smaller the condenser point , the ____ pressure exerted on amalgam
greater
what are the most common causitative organisms of cellulities
group a streptococci and staph aurous
vitamin K
group of fat souble vitamins essential for the synthesis of coagulation factors II, VII, IX, X and prothrombin in the liver enhances improves blood clotting
D-PPO and D-IPA
groups of doctors who practice in the community and are distinct from the insurance provider an insurance agency contracts with the providers for discounted rates and may refer patients to these providers exclusively
the strength of dental investments for gold alloys is dependent on the amount of
gypsum
coxsackie virus
hand foot and mouth disease herpangina-- posterior oral cavity (soft palate, throat and tonsils)
acquired nevi
hard palate 5 subtypes 1. intramucosal nevus- most common in oral cavity 2. blue nevus- second most common 3. compound nevus- very rare. raised and solid 4. junctional nevus- rare in the oral cavity. interface between the epihtlium and lamina propria 5. intradermal nevus- the most common lesin of skin
nasopalatine block
hard palate from canine to canine most painful
strain hardening or work hardening
hardening (or deformation ) of a metal at room temperature
reverse pull headgrear
has an extra oral component class III malocclusions
non arcon articulator
has condylar elements on the upper memeber and condylar parth elements on the lower member angle between condylar inclination and occlusal plane is not constant when open vs closed
articaine 4%
has one ester chain can be metabolized in both sites shortest duration
according to the ADA classification for alloy systems used for metal ceramic restorations, noble alloys
have a noble metal content of >25%
short wavelength (high energy) x rays
have great penetrating power produced at higher kilovoltages and penetrate objects more readily form the image on the film
glass ionomer
have lower compressive strength, tensile strength and hardness than resin composites ideal liners and bases- can bind to composite
hydrocolloids
have the advantage of wetting inraoral surfaces bc 85% water
what is the most common removable retainer in ortho
hawley retainer
nasopalatine duct cyst
heart shaped radiolucency in nasopalatine canal caused by cystification of canal remnants Tx: excision
ethylane oxide gas sterilization
heat sensitive materials like surgical instruments and plastics alkylating proteins and nucleic acids toxic to humans and is flammabel
dental plaster is produced by
heating gypsum in an open vessel at 150-160 C
the sequence of craino facial growth from last to first is
height,length, width
guide planes
helps establish a definite path of insertino/dislodgement of the RPD must be below the abutments height of contour with class I and II designs to prevent abutment torquing during functional movements when plates are used with I bars and mesial rests on the premolars to avoid lingual tori, the plate must end exactly at the height of contour ensure predictable clasp retention
what tissue is the most sensitive to radiation
hemopoietic tissue
purpura
hemorrhages in the skin and mucous membranes that cause the appearance of purplish spots or patches
ectodermal dysplasia
hereditary condition characterized by abnormal development of the skin and associated structures involves all structures derived from extoderm Males:> females manifests orally as reduced/missing teeth clinical signs: hypothrichosis (decrease in hair) anhidrosis (no sweat or sebaceous glands, causing heat intolerance), anodontis (complete absence of teeth) oligodontia (partial absence of teeth), no tooth buds of the primary or permanent dentition, depressed nose bridge, lack of salivary glands. child apprears much older affects tooth bud development causing congenitally missing teeth, and peg shaped teeth, enamel may be defective tx: dentures for childrem, or implants upon complete growth
which cause failure of tooth eruption or delayerd tooth eruption
hereditary gingival fibromatosis down syndrome rickets
what strucutre functions to shape the root and induce dentin formation in the root area so that it is continuous with the coronal dentin
hertwig sheath
the maxillary sinus opens into the middle meatus of the nose through the
hiatus semilunaris
brittleness
high compressive strength but low tensile strengh
what is th emost significant complication of molar uprighting
high mandibular plane angle
Adenoid cystic carcinoma
high-grade salivary malignancy palate most common site Cribriform/ swiss cheese microscopic pattern spreads through perineural spaces MINOR SALIVARY GLANDS OF PALATE!
IAN Block
highest failure rate Halsted= classif gow gates- open mouth akinosi- closed mouth numbs all mandib teeth and if lingual nevre bloacked then tongue. and soft tissue facial to anterior and pre molard
ADA type 1 gold alloys
highest gold content 83% noble metals. small inlays and easily burnished due to high ductility
lesions covered by a nonspecific gray membrane with induration is seen in
histoplasmosis
hamalar process
hook like projection of bone located posterior to the max tuberosity appears radiopaque on max molar PA image
nitrous oxide
horace wells was first to use for own extraction by his assistant sensation before onset--> tingling side effect--> nausea long term exposure-->peripheral neuropathy MAC- 105% diffusion hypoxia
anterior guidance is the result of
horizontal and vertical overlap
Lefort 1
horizontal fracture- causes an open bite used to correct max retrognathia (class II)
3/4 and 7/8 crowns
hybrid between onlay and full crown conserves tooth structure less restoration margin in close proximity to gingival tissues more easily seated during cementation
epilus fissuratum
hyperplastic tissue reaction caused by an ill fitting or overextended flange treat with tissue conditioner and by adjusting flange may use surgery if inadequate response
when can residual root tips be left alone
if they have an intact lamina dura and no radiolucency
where does bone marrow for defects i the mandib and maxilla come from in an autogenous graft
iliac crest
interpupillary line
imaginary line between pupils of the eyes
campers line
imaginary line from ala (side) of nose to tragus of ear
a cavosurface bevel is used when preparing a tooth for a cast gold inlay or only mainly to
improve marginal adaptation also used to remove unsupported enamel and compensate for casting inaccuracies
modfinil (Provigil)
improves wakefulness during daytime sleepiness
Mucoepidermoid carcinoma
in the parotid gland pt usually asymptomatic swelling with a peak incidence in the 3rd decade of life facial weakness or paralysis
incisal guidance
incisal edges of lower incisors against lingual slopes of upper incisors represented by pin and guide table on articulator anterior determinant of occlusion
F and V labiodental sounds
incisal edges of max incisors and lower lip
when a biopsy is being performed, it is important to
incise perpendicular to the long axis of any muscle fibers beneath the lesion
maxillary denture complains of a burning sensation in the palatal area of his mouth. this is indicative of too much pressure being exerted on the
incisive foramen
what is the most common cause of root canal failure
incompletlely and inadequately disinfecting the root canal system second most is leakage from a poorly filled canal
to increase film density-
increase mA, kVp, and time
to increase film density
increase mA, kVp, and time and decrease source object distance
Acid etching for resin composites will accomplish what
increase retention of the restoration create a clean surface with which to bond prevent microleakage
vestibuloplasty
increase the relative height of the alveolar process to increase denture base area by apically repositioning the avleolar mucosa and the buccinator, mentalis and mylohyoid muscles as they inset into the mandible
shock is characterized by
increase vascular resistance: cool mottled skin, oliguria tachycardia adrenergic response: diaphoresis, anxiety, vomiting, diarrhea myocardial ischemia mental status changes
increasing amalgams trituration time...
increases compressive strength and decreases setting expansion
nickel
increases ductility greatest potential for allergic reactions in the mouth
sintering of a ceramic
increases its density
cobalt
increases the frameworks rigidity, strength and hardness
during canal preparation, excessive instrumentation leads to the loss of the apical seat. The dentist should proceed by
increasing the file size and decreasing the file length
The best way to produce a radiographic image with low contrast is by doing what?
increasing the kilovoltage peak (kVp)
trituration
increasing trituration time reduces the setting expansion of amalgame a properly triturated amalgam is shiny, wet smooth and homogenous
Caldwell-Luc operation
indicated for retrieval of a broken tooth root from maxillary sinus removal of abnormal tissue growths treatment of maxillary infections
half and half clasp
indicated for lingually inclined premolars
ring claspp
indicated to engage an undercut of a mesially lingual tilted molar when a sevre tissue undercut exists that prevents using an i bar almost exclusively on mandib molar that drifted mesially and lingually to engage a lingual undercut allows the undercut to be approached from the tooths distal used almost exclusively on ML tilted molar abutments
Acute apical periodontitis (AAP)
indicates irriateed apical tissues possibly associated with a vital pulp with a potential reversible pulpitis
what is the name of the technique in which deep caries are excavated from a tooth, a small amount of affected dentin ins left (provided that a caries free DEJ is present) and a base is placed along with a permanent restoration
indirect pulp cap
zone V
infected dentin the outermost zone consisting of decomposed dentin filled with bacteria must be completly removed prior to restoration
Congenital syphilis
infection by spirochete bacteria treponema pallidum during the fatal period 50% of infants infected dueing gestation die shortly before or after birth newborn symptoms: saddle nose, frontal bossing, short and high maxilla older infant: hutchinsons incisors, peg shaped incisors no chancre!!
vascularitly
inflammation
osteomyelitis
inflammation or infection of the bone marrow and adjacent bone, usually caused by bacteria (staphylococci) due to trauma or surgery by a direct extension from nearby infection or via the bloodstream signs and symptoms: pain, redness, swelling in the infected area, fever, and general malaise. Radiographicaly: poorly circumscribed radiolucency with a central sclerotic nidus may be present
lateral periodontal cyst
inflammatory in origin. forms along vital tooth lateral surface 95% along the mandibular canine premolar area radiographic: well defined, round or tear drop shaped radiolucency with an opaque margin
fascial space that is rarely infected is
infratemporal
trauma to muscles or blood vessels in the_____ is the most common etiological factor in trismus associated with dental injections of local anesthetics
infratemporal fossa
impacted maxillary thirds are occasionally displaced into
infratemporal space and max sinus
hydroquinone
inhibitor
Acetaminophen Tylenol
inhibits pain in CNS, liver drug of choice in feverish child, whereas asprin can cause Reye's Syndrome
pre junctional alpha 2 adrenergic receptors
inhibits the release the NE. Less common alpha receptor. NE and EPI combind with alpha 2 receptors found on pre synaptic nerve endings to inhibit NE release. found on post synaptic ending in the CNS to decease sympathetic tone
alveologingival fibers
insert in the crest of the alveolar process and spread out through the lamina propria into the free gingiva.. helps form the ginigval ligament
the most frequent cause of porosities in the denture is
insufficient pressure on the flask during processing
delayed expansion of amalgam restorations is associate with
insufficient trituration and condensation, and amalgam contamination by moisture during trituration and condensation
delayed expansion of amalgam restorations is associated with what
insufficient trituration and condension and the contamination of the amalgam by moisture during trituration and condensation
blood glucise concentration is regulated by
insulin ( decrease blood glucose) glucagon (increase blood gloucse)
during typical empty mouth swallowing the mandible is braced in what position for proper stabilization
intercuspal position
what drugs act to induce gene transcription, inhibit cellular growth and alter the state of cell differentation
interferons
intra coronal retainer
internal attachment most esthetic direct ratinser best vertical support attached totally within the abutments restored natural contours prefabricated key and keyway not used with extensive tissue supported distal extensions unless a stress breaker is used
all ceramic corwn margin design is
internally rounded shoulder
ANUG
interproximal necrosis and pesudomembrane formation on marginal tissues no attachment loss history of soreness/pain and bleeding gums neutrophil is dominant WBC
SNA angle
intersection from sella turcica to nasion maxillas position relative to cranial base good skeletal pattern SNA- 82 >82= max prognathism <82= max retrognathism
oral melanotic macule
intra oral lesion found on the gingiva, buccal mucosa and palate
the crainal vault is made up of a number of flat bones that are formed by__________________________________. without cartilaginour precursors
intramembranous bone formation
lip pits
invaginations at commissures or near midline Van der Woude Syndrome=clefts and pits
CIngulum Rest
inverted V or U shape 2.5- 3 mm MD length 2 mm labiolingual width 1.5 mm deep contraindicated for mandibular incisors benefits include good distribution of occlusal load, esthetic, strength from closeness or major connector
root amputation
involve max 1 and 2 molars seperation of an individual root from the crown
vascular phase of inflammation
involves basophils, tissue mast cells and platelets which release histamine eosinophils are not in the vascular phase
myelogenous leukemiai
involves granulocytes and megakaryocytes. Philadelphia chromsome and low levels of leukocyte alkaline phaoshpathase. CML is characterized by uncontrolled proliferation of immature granulocytes
monocytic leukemia
involves monocytes oral lesions are common CML is very rare
reparative dentin
irritation dentin pulps 2nd line of defence
heparin
is a high molecular weight heteropolysaccharide that inactivates thrombin and other coagulation factors and thus prevents blood clotting
dovetail keyway
is placed on the distal side of the pier abutment
key
is placed on the mesial of the distal pontic the parth of insertion of the key into th ekeyway is parallel to the pathway of the retainer that is not involevd with the keyway
Subgingival calculus
is usually darker in color, because pigments from blood breakdown are usually incorporated. Calculus or tartar deposits are most commonly seen on the lingual surfaces of mandibular anterior teeth because of their close proximity to the sublingual and submandibular salivary ducts. The buccal surfaces of maxillary molars are also known to be at risk for calculus deposits because of their proximity to the Stensen duct of the parotid glands
uncomplicated respiratory tuberculosis is best treated with a combination of
isoniazid and rifampin, because they function by different mechanisms
mylohyoid muscle and dentures
it affects the slope of the lingual flange of the impression in the molar region (at its most posterior distal aspect) causing the flange to slope toward the tongue forms the muscular floor of the mouth
as caries progresses through enamel
it appears triangular in shape with the apex at the DEJ
traumatic bone cyst
it is most commonly found in younger people with no sex predilection . in the mandible between the canine and ramus. regional teeth are vital
after processing a film, it appears brown....
its because the fixing time was not long enough
premolars have contacts at
junction of o and middle third
class VI
just incisal edge of anterior or cusp tip of posterior
herpes simplex type 8
kaposis sarcome HIV>AIDS superficial cancer of the skin, multiple made of blood vessels and is negative to pressure test red lesions to the hard palate
Rx for prosthetic joint prophylaxis
keflex 2 g 1 hr before tx
what is the primary medication used in dissociative anesthesia
ketamine
dissociative anesthesia is used with what primary medicine
ketamine it increases airway secretions increases BP, Hr and cardiac output but not respirations produces bronchial smooth muscle relaxation potent cerebral vasodilarot side effects: hypertension, increased pulse, and delirunm
taurodontism syndroms
kleinfelter syndrom trichodentossues syndrome ectodermal dysplasia amelogenesis imperfectia type IV oral facial digital syndrome 1 down syndrome
frenectomy
labial>buccal>lingual (most to least common)
gold inlays
lack of undercuts is the chracteristic common to all class II gold inlay preparations the restoration will not seat if undercuts exists
trigeminal nerve
largest crainal nerves and prinicpal general sensory nerve to head and face no parasympathetic component at its origin
horseshoe U shaped palatal connector
last desirable max major connector bc has the least strength and rigidity used to go around inoperable palatal tori or with major gaggers lacks rigidity used in class III mod I designs
bennett movement
lateral movement of both condyles toward the working side, basically TMJ looseness
bennet shift
lateral movemnet of the mandible toward the working side during lateral excursions
branchial cyst
lateral neck swelling epithelial cyst within lymph node of neck
which muscile is responsible for forward displacemnt of the condylar head when the condyle neck is fractured
lateral pterygoid
Pedical flap
laterally positioned flap full thickness flap perform to correct defects in morphology, position or amount of attached gingivia areas where narrow gingival recession
Horseshoe
least rigid only used if large palatal torus
needle dimensions
length: short= 20 mm long- 32 mm diamater 30 gauge- .3 mm blue 27 gauge- .4 mm yellow 25 gauge - .5 mm red
codiene
less efficacious opoid analgesic with mod abuse potential codeine+aspirin(Empirin)- analgesic/antiinfmalltory--avoid in asthmatics and patients who cant take aspirin codiene+tylenol (Tylenol 3)- poor anti inflammatory but better than Empirin if pt has GI problems, pregnant
Degeneration of the basal cell layer, a mononuclear inflammatory cell infiltrate in the subepithelial connective tissue, and "saw tooth" rete pegs are indicative of which mucocutaneous disorder?
lichen planus
cross allergy is most likely to happen with the anesthetic agents
lidocaine and mepivacaine IgE mediated reacitions with amide group local anesthtetics
CR is a what guided position
ligament guided
as the developing solution gets weaker, the films get
lighter
what determines whether muscles will displace fractured segments from their origional position
line of fracture
the ____ arises from the anterior surface of the external carotid artery and then passes near the greater cornu of the hyoid bone
lingual artery it supplies the structures of the floor of the mouth and the posterior and inferior surface of the tongue
prilocaine
linked to condition known as methemglobinemia
Hep B
liver disease caused by DNA virus contaminated blood or serum drug addicts help b vaccine is available
mental nerve block
locate rubbery bundle with fingers apical to 2nd pm mental foramen by apices of premolars
carcinoma in situ
located only inside epithelium, atypical mitosis, hyperchromatism does not invade CT! better prognosis than carcinoma invasive malignant but CANT METASTASIZE due to lack of blood of lymphatic vessels in epithlium FLAT
________ is the least lipid soluble of the three main benzos, resulting in a slow onset of action but long duration of action
lorazepam
dehiscence
loss of buccal or lingual bone overlaying the tooth root, leaving the root area only covered by soft tissue
garlic
lower cholesterol and inhibit platelet aggregation resulting in decreased blood clotting
lymphocytic leukemia
lymph node enlargemtne acute lymphocytic (lymphoblastic)= most common in children
the histological presence of which of the following indicates an infected dental pulp
lymphocytes and plasma cells
sjogrens syndrome has been linked to what malignacy
lymphoma
bell stage erroes
macrodontia, microdontia, dentingogensis imperfecta dn amelogeneis imperfects
linguoalveolar sounds or sibilants (s,x,sh,ch,j)
made with the tip of the tongue and the most anterior part of the palate or lingual durface of the teeth these sounds help to determine the vertical length and overlap of the anterior teeth
onlays
main advantage is it can prematurely restore and reinforce a tooth by conservative technique needs parallelism of vetical surface (axial walls) is the primary retentive feature in an only prep sharp point and line angles increase onlay retention
osseous recountouring surgery
main goal is to eliminate preiodontal pockets
direct filling gold
main indication for using a direct filing gold is a small initial class III lesion finest and most desirable restorable material
incisal rests
mainly as auxillary rest or indirect retainer rounded notch is placed 3-4 mm either MI or DI edge least esthetic rest and most likely to cause ortho movement 2.5 mm wide and 1.5 mm deep
palatal plate (complete coverage) aka metal plate
mainly in class I design when the last abutment tooth on either side of a bilateral distal extsion is a canine or PM complete palatal coverage is advised covers at least 50% of the hard palate and replicates the anatomy of the palate acts more in indirect retention
beta receptors
mainly responsible for INHIBITORY effects
benign cementoblastoma
males under 25 years mandibular pm or molars tooth is vital well demarcated, mottled or densely radiopaque mass with radiolucent periphery attached to the root causing the root resorption tx: extract the involved tooth
15 yr old pt has a numb lower lip and pain in right posterior mandible. radiograph shows uniform thickening of periodontal membrane in space of tooth 30. abnormamly increaded mobility. what dx
malignancy when you read numb lip--cancer!
acute myeloid/myelogenous leukemia
malignant bone marrow disease where hematopoietic precursors are arrested in an early stage of development the most malignant leukemia
osteosarcoma
malignant bone tumor of anaplatic cells derived from mesechyme most common primary malignant tumor of bone, arising in long bones SUNBURST peak incidence is before epiphyseal fusion symmetrically widened PDL space. mixed RL RO
Letterer-Siwe disease
malignant histiocytosis <2 yrs old; diffuse eczematous rash; organ involvement damage to lungs usually fatal without treatment
Erwings sarcoma
malignant tumor developing from bone marrow, usually in long bones or pelvis of adolescent boys (10-20 years). highly lethal malignan neoplasm of bone pelvis, thigh and body trunk are most common sites MOTH EATEN, ONION SKIN intermittent pain and swelling of bone are earliest clinical signs and symptoms cells contain GLYCOGEN
the most common pathognomonic sign of a mandibular fracture is
malocclusion
the most common pathognomonic sign of a mandibular fratcure is
malocclusion
which alignate impression should you take first max or mandib
mandib
the lowest incidence of radicular cysts is seen with respect to
mandib canine
for fixed partial prosth, hemisection is best recommended for
mandib first molars
higher incidence of vertical root fractures are reportedly seen in
mandib second molars
leeway space
mandib: 3-4 mm max: 2-2.5
most common primary tooth to be retained
mandibular first molars
greenstick fracture
mandibular fracture that extends only through the cortical portion of bone without complete fracture of the bone most common in children
what are the easiest teeth to perforate
mandibular incisors and max 1st premolars
a reverse 3/4 crown is most frequently fabricated for a
mandibular molar
retromolar pad
marks distal extension of enentulous ridge ideally covered for support and retention since the integrity of the bone in this area is maintained contains attachments from temporalis, buccinator, superior pharyngeal constrictor and pterygomandibular raphe
dermoid cyst
mass in midline floor of mouth if above mylohyoid mass in upper neck if below mylohyoid contains adnexal structures like hair and sebaceous glands doughy consistency
embolus
mass, an air bubble or foreign body that moves within a blood vessel to lodge at a site distant from its place of origin the most common source of a pulmonary embolism is thrombophelbitis femoral vein is the most common course of origin of the thrombus which then occludes a blood vessel in the lung
which muscles elevate the mandible
masseter, medial pterygoid and temporalis
what tooth is the most likely to benefit form occlusal sealant
max 1 molar
infraorbital block
max anteriors and pm also called true ASA Block infraorbital foramen
primate space
max arch: between lat inciors and canines mandib arch: canines and 1 molars
when posterior teeth are in a normal ideal relationship, which of the following cusps are considered to be guiding cusps
max buccal mandib ling
toxicity
max epi for ASA 1: .2 mg max epi for cardio pt: .04 mg max lido w/o vasoconstrictor: 4.4 mg/kg max lido with vaso: 7 mg/kg
anterior posterior palatal strap
max major connector to almost always use for all kennedy classes greatest strength and rigidity used for large endentulous span kennedy class III mod I RPDs must be at least 15 mm between anterior and posterior straps straps are 6-8 mm wide
PSA block
max molars 16 mm depth (half of length of needle high hematoma risk doesnt always do MB of max 1st molar
neurofibroma
may be derived from schwann cell or perineural fibroblast and can be of 2 forms 1. solitary neurofibroma- an asymptomatic nodule on the tongue, buccal mucosa or vestibule treated by surgical excision 2. multiple lesions as part of the neurofibromatosis syndroms
kolpiks spots are assoctaed with
measles- rubeola_
modulus of elasticity
measure of a materials stiffness or rigidity the higher the modulus of elasticity the stiffer the material
erythrocyte sedimentation rate (ESR)
measures time it takes for erythrocytes to settle to the bottom of a test tube the speed that RBC fall to the bottom reflects the drgee of inflammation
biologic
mechanical injury-- thinnest gingival tissue is lingual molars and facial premolars thermal injury-- proximity to pulp water spray, sharp cutting instruments, intermittent light pressure chemical injury-- soaked retraction cord, certain cements bacterial injury- leakage under crown
where is the optimum site for IV sedation for an outpatient is the
median cephalic vein
curve of wilson
mediolateral curve along posterior cusp tips to ensure loading into long axis of each tooth more lingual inclination as you move distally
the optimun site of the IV sedation for an outpatient is the
medium cephalic vein
what is the last area of the brain depressed during general anesthesia
medulla
a burning sensation in the mandibular anterior area is caused by pressure on the
mental foramen
labial vestibule of mandible
mentalis
_________ should be used cautionasly in the elderly. it should never be given to matients on MAO inhibitors for psychiatric disease is is contraindicated in pts receiving phyenotin(dilantin ) for seizure disorders
meperidine
excessive salivia is a promient toxic effect of
mercury xerostomia isnt!
what is the most important consideration in the strength of the amalgam
mercury content removing the mercury rich matrix by proper condensation and carving produces a stronger and more corrosion resistant amalgam
in which direction would a mandib second molar move if the first molar were extracted
mesially
correct sequence of the 4 basic angulation types of mandibular impactions in terms of difficulty level from esier to most dififcult is
mesioangular, horizontal, vertical, distoangular
width
mesiodistal or faciolingual dimension of base
what will develop in a patient with recurrent vomiting of gastirc contents
metabolic alkalosis
esters
metabolized in pseudocholinesterase in plasma
Amides
metabolized in the liver
proximal plate
metal plate that contacts proximal surface of abutment tooth (type of minor connector)
ductility
metals ability to easily be worked into desired shapes expressed in terms of percent elongation decreases as temperature increases
Skeletal muscle relaxants
methocarbamol(robaxin) cyclobenzaprine (flexeril) baclofen (lioresal) carisoprodol (soma)
the main ingredient in traditional acrylic resin temproary materials for intraoral fabrication is
methyl metharcylate
what is the primary advantage of placing a microfilled resin composite
microfilled resin composites are highly polishable
thyroglossal duct cyst
midline neck swelling located along embryonic path of thyroid descent
geographic tongue
migratory glossitis and erythemia migrans white annular (ringed) lesions surrounding central red islands that migrate over time occasionally hurt and burn Tx: none
in the dental xray tube, the number of electrons flowing per second is measured by
milliamperage (mA)
height to base ratio
min ratio is .4
echinacea
minimze the severisty of the common cold and seasonal flu
how does porcelain chemically bond to metal
mixing of oxidized metal layers with porcelain oxides
what are the two most critical factors to determine the prognosis of a perio involved tooth
mobility and attachment loss
which of the folloiwng focuses the electrons into a narrow beam and idrects the beam across the tube toward the tungsten target of the anode
molybdenum cup
MMA Methyl methacrylate
monomer (liquid)
extracoronal retainer
more common, conventional clasp design clasp should encircle a tooth at least 180 degrees
porcelain
more esthetic because more stain and wear resistant brittle may wear opposing teeth mechanical retention is achieved with pins (anterior) or diatorics (posterior)
longer and thinner (smaller diameter ) the clasp arm =
more flexible
it is important that a wrought wire clasp have an elongation percentage of
more than 6% , allowing the clasp to bend without microstructure changes that could compromise its physical properitites
hydrodynamic theory-
most accepted theory as the cause of root sensitivity caused by dentinal fluid movement in the tubules that stimulates mechanoreceptors in the pulp
eosinophilic granulmos
most benign form of histicytosis x males 20-40 yo may be totally asymptomatic but there may be locla pain or swelling especially if bone fracture occurs teeth on the affected side being loose and gingivitis pneumothorax is a common complication
Bilateral Sagittal split osteotomy
most commoly performed mandibular orthognathic procedure to correct mandib retrognathia
Beta blockers
most common adverse effect are weakness and drowsiness treat hypertension, angina, cardiac arryhtmas, MI, glaucoma and prophylaxis of migrane
papilloma
most common benign neoplasm of epithelial tissue origin. it appears as a pedunculated or sessile whitish cauliflower like mass on the tongue (posterior border), lips, gingiva, or soft palate a vital cauilflower like white lesion with a verrucuous and pedunculated (foot shaped) surface. viral. must excise surgically and recurrence is rare finger like projections of stratified squamous epithelium supported by thin cores of vascular fibrous CT epithium
pleomorphic adenoma
most common benign salivary gland tumor
post junctional B2 adrenergic receptors
most common betw receptor found in BRONCHIOLAR and VASCUAR smooth muscle EPI binds with B2 receptors to vasodilate bronchiles NE usually combines weakly or not at all to b2
ameloblastoma
most common epithelial odontogenic tumor! enlargement may spread to the buccal, lingual cortical plates of bone or palatal bone plates unerupted mandibular 3rd molar is associated with the radiolucent defect often assoicated with unerupted teeth mainly in the posterior body and angle of the mandible SOAP BUBBLE irregular scalloped margins
monostotic fibrous dysplasia
most common form mainly maxilla affected a diff diagnosis is ossfying fibroma (but ossfying fibroma has a well circumscribed appearance unlike this) causes expansion and deformity of the jawbone and tooth displacement
metastic carcinoma
most common malignancy affecting skeletal bones. a jaw tumor may be the first evidence of dissemination of a known tumor from its primary site metastases to the jaws most commonly oirginate from primary carcinoms of breat, kidney, lung, colon, prostate and thyroid. least likely to originate from the brain paresthesia or anesthesia of the lip or chin
squamous cell carcinoma
most common malignancy in the oral cavity!!!! a malignant epithelial tumor that is twice as prevalane in males more common on the lower lip than intra orally. the most common intra oral site is the lateral border and ventral surface of the tongue. floor of the mouth is the second most common intra oral site with the worst prognosis metastasis occurs via the cervical lymphatics
zygomatic complex fractures
most common midfacial fracture fractures of the facial bone mat on rare occasions be complicated by damage to the contents of the syperior orivital fissure paresthetsia hematoma occular muscle balance may be impaired
periodontal flap
most common of all perio surgical techniques flaps should be uniformly thin and pliable, the flap base must be uniformly thin ( about 2 mm thick) and all flap corners should be rounded flap base is wider than the free margin incision lines not be placed over bony defect incisions made in tissues that harbor uncontrolled infection may cause rapid infection spread all flap corners must be rounded
grand mal epilepsy
most common seizure disorder tonic clonic type seizure usually 2-5 mins
mesiodens
most common supernumerary tooth small tooth with a cone shaped crown and short root visible between vital PERM MAX CENTRALS appears dituated in the maxilla near the midline and almost always posterior ot normal central incisors
combination clasp
most commonly used when an abutment next to a distal extension where only a MB undercut exists or if large tissue undercuts prevent a bar clasp from being used bracing arm, wrought wire retentive circumferental arm and distal rest use when the undercit is on the side of the abutment away from the edentulous space bc it is more flexible
hoes
most effective for buccal and lingual surfaces function at right angles for supragingival calculus cutting edge is angled at 90 degrees to the tooth surface and is turned at a 90-100 ange to the shank
alkylating agents
most effective in treating chronic leukemias, lymphomas, myelomas and carcinomas form alkyl bonds to nucleic acids N-7 position of guanine is a common bonding site
ekta speed film
most effective way to reduce exposure time, amount of radiation reaching the patient and the amount of scatter radiation
Methyldopa
most effective when combined with a duiretic to produce a false transmitter that replaces NE in the vesicular storage sites and is released by the nerve impule most beneficial for treating hypertension in patients with renal damage
oblique fibers
most numerous resist forces along the tooths long axis
filiform papillae
most numerous. small cones in the v shaped rows paralleing the sulcus. no taste buds
youngs frame
most popular U shaped frame
complete palatal plate
most rigid indicated when all posterior teeth are missing bilaterally, perio compromised teeth, shallow vault, small mouth, flat or flabby ridges
Mineral troxide aggregate
most superior retro filling material seals the apical portion of the root canal MTS must always be placed when an apical seal may be faulty
Prothrombin Time (PT)
most valuable test used to evaluate if a patient taking anticoagulants is a surgical risk detects certain plasma coagulation defects owing to a deficiency of factors V, VII, X a prolonged PT indicates a deficiency in one of the factors INR is the ratio of prothrombin time measured in the patient divided by a standard prothrombin time value, and multiplied by a constant
fixed edgewise applicance
most widly used appliance today bands on all teeth , tubes on the last molar and brackers
appropriate actions to prevent sensitivty when scaling
move instrument faster, decrease device power, proceed to another tooth and come back , adjust water spray and use less pressure
intrusion
movement into the sockelt along long axis very difficult to accomplish
Narcotics/opioids
mu opoid receptor agonists (in CNS) oxycontin- controlled release codeine- suppresses cough reflex, cough syrup tramadol- similar to codeiene meperidine (demerol) lethal if combined with a MAO)
lining mucosa(reflective mucosa)
mucosa that lines most of the oral cavity except the gingiva, anterior palate and dorsum of the tongue lining muscosa is a thin, movable tissue with a thin, non keratinized epithlium , and thin lamina propria
commuinuted fracture
multiple fractures of a single bone thta can be simple or compound
Peutz-Jeghers syndrome
multiple melanotic macular pigmentations of skin and mucosa around eyes, nose and mouth associated with gastrointestinal polyposis
excessive VDO
muscles of mastication fatigue excessive display of mandibular teeth clicking of the posterior teeth when speaking strained appearance of the lips patient unable to wear dentures discomfort excessive trauma to supporting tissues gagging
which of the following are needed in combination to produce neuroleptanesthesia
narcotic analgesic neuroleptic agent nitrous oxide neuroptanestheia is a state of neuroleptanlgesia and unconsciousness produced by the combined administration of a narcotic analgesi and neuroeptic agent together with the inhalation of nitrous oxide and oxygen
non odontogenic fissural cysts (developmental cysts)
nasopalatine, nasoalveolar,median palatal and globulomaxillary cysts
most common side effects of narcotis
nausea constipation respiratory depression
nevus
nearly all moles are normal
free gingical graft
necessary for some overdenture teeth FGG widens band of keratinzed tissue
which pulpal condition is suggested when a patient experiences prolonged, unstimulated pain while trying to sleep
necrosis
acidifier - acetic acid or sulferic acid
neutralizes the alkaline dveloper and stops development process and provides necessary acidic enviornment for fixer
extended arm clasp
never used with class I and II bc functional forces cause rotation around the rest and upward movement of the clasp tip
INCIDENCE
new cases
how will a larger than normal functional residual capacity affect nitrous oxide sedation
nitrous oxide will take longer the functional residual capacity is the amount of air remaining in the lungs at the end of normal expiration
proper treatment for an intruded primary anterior tooth is
no treatment
conservative surgival excision woul dbe appropriate treatment and probably curative for which of the following?
nodular facilitis
minimum PFM thickness
non contact areas 1.5 (1.2 mm porcelain, .3 mm metal)
NSAIDS
nonsteroidal anti-inflammatory drugs limit or prevent inflammation Apirin (ASA) Cox 1 and 2 blocker (irreversible), GI
ANB angle
norm= 2 (difference between SNA and SNB0 >4 class II <0 class III
platelets counts
normal 150,000-450,000 min count for oral surg 50,000
dentin dysplasia
normal enamel, atypical dentin, pulpal obliteration, defective root formation, multiple periapical radiolucencis type I- radicular- more common type involving both dentitions.mobile teeth. root dentin is disorented. pulpal obliteration by excess dentin. chevron shaped root chambers type II- coronal involves both dentitions. bluish gray opalescent appearance. obliterated pulp chambers
a properly sharpened instrument with no rounded surface area will
not reflect light
bupivicaine .5%
not safe in children longest duration
prevalence
number of old cases
Facebow record
objective to duplicate the relationship of the maxillary arch to the skull and the mandible to the rotational center of the TMJ
altered cast impression
obtain the max support possible from the edentulous ridges in class I and II designs captures edentulous ridge tissues in relation to the way the framework fits in the mouth
added filtration
obtained by placing thin sheets of aluminum in the cone to filter the useful beam further, increase in quality decrease in quantity
occlusal schemes
occlusal point contacts preferred to be broad and flat to prevent wear cusp marginal ridge- seen in class I occlusion cusp fossa- seen in class II malocclusion
while eruptng the permanent teeth move
occlusally and buccaly
toxic effects of aspirin
occult bleeding from GI tract tinnitis nausea and vomiting metabolic acidosis decreased tubular resorption of uric acid
Hydrophobic interactions
occur between the drug, its receptor and the aqueous enviornment that can play a major role in stabilizing drug receptor binding
cleft palate
occurs in 6-8 week of embryonic life isolated cleft palates are more common in females, characterized by a fissure in the midline of the palate due to failure of the two sides to fuse during embryonic development. the most severe handicap caused by cleft palate is an impaired mechanism preventing normal speech and swallowing this speech problem is due to the inability of the soft palate to close airflow into the nasal area
residual cyst
occurs when a tooth with a radicular cust is extracted but the radicular cyst is left undisturbed and persisits within the jaw now as a residual cyst to prevent a residual cyst, you must curette the radicular cyst out of the tooth socket after extraction
imbibition
occurs when the impression absorbs water which expands the dimensions of the impression
reciprocation
occurs when the retentive arm and bracing arm contact the tooth at the same time duing seating and removing the RPD timing is critical in reciprocation
the odontogenic neoplasm which is composed of loose, primitive appearing connective tissue that resembles dental pullp is known as
odontogenic myxoma
total infiltration
of the xray beam before it reaches the patient consists of the inherent filtration + added filtration. the recommended total is the equilvant of .5 mm (below 50 kvp_ and 2.5 mm over 70 kVp of aluminum
silver
offsets the color contributions of copper in a gold casting alloy 2nd most ductile and malleable metal
zinc phosphate cements
oldest luting cement with longest track record powder is zinc oxide while liquid is orthophosphoric acid used as a cement for cast restorations varnish applied prior to placing the base clean from crown margins after the cement is completely set
where do the occlusal contact possibilities occur during a protrusive movement?
on the maxillary distal inclines and mandibular mesial inclines
where is the greatest contour of the cervical lines and ginigval attachments occur
on the mesial surface of anterior teeth
wiskott-aldrich syndrome
only boys and causes eczema, low platelet count and a combined deficiency of B and T lympocytes that lead to repeated infections
partial thickness flap
only the mucosa epithelium and a layer of the underlying CT the mucosa is separated from the periodteum by sharp dissection alveolar bone is not exposed used when attached gingiva is thick (>2 mm wide)
tissue borne appliance
only tissue borne funcional appliactions whose function is to expand the arch
secobarbital and pentobarbital
oral administration short acting barbs
Benign Mucous Membrane Pemphigoid
oral and ocular mucous membranes women 50+ better prognosis than pemphigus desquamative gingivitis act against basement membrane and destruction is below the epithelium
oral surgery
oral surgery
periodontal knives that are used specifically in giving the third incisin are
orban and merrifield knives
mandib labial frenum
orbicularis oris
buccal frenum
orbicularis oris, buccinator
inverse square law-
original intensity= new distance^2 new intensity original distance^2 the intensity is inversely proportional to the square of the distance from the radiation source
suprabulge
originate above survey line circumferential ring combination embrasure
infrabulge
originate below survey line I bar Tbar bar type y type
reciprocal clasp (stabilizing clasp)
originates from minor connector and rest contacts tooth above HOC/survey line braces abutment tooth so it is not torqued by retentive clasp
retentive clasp
originates from minor connector and rest contacts tooth below height of contour/survey line shoulder and middle should be above HOC, only the tip should be under HOC tip is designed to engage in undercut and resist dislodging forces--only active when dislodging forces are applied to them, otherwise seat passively
ortho
ortho
methyldopa adverse effects
ortho hypotension, bradycardia sedation and fever cloitis and possible hepatitis and cirrhosies
which presents radiographically as a sub burst lesion, and can cause paresthsia, loosening and displacement of teeth along with a localized swelling in the posterior mandible
osteosarcoma
most common osseous malignancies
osteosarcomas--> chondrosarcomas --> fibrosarcomas and ewings sarcome
nasopalatine duct cyst (incisive canal cyst)
oval or heart shaped radiolucency in the midline of the hard palate most common non odontogenic /developmental /fissural cyst teeth are vital tx: surgical excision/enucleation radiographically: a circular (round) well demarcated oval or heart shaped between and above the maxillary central incisors. the lesion crosses the midline
horizontal angulation error
overlapping-interproximal areas are overlapped due to incorrect horizontal tube angulation
what is more preferable for amalgam titration
overtiturated mix
amyl nitrate is used in the emergency treatment of cyanide poisoning becayse it
oxidizes hemoglobin
laryngospasm is treated by administering
oxygen
what is the pH does enamel demineralization occurs
pH 5.5
free unmyelinated endings in PDL
pain
what muscles are influential in border molding the lingual border of the mandib impression
palatoglossus, superior pharyngeal constrictor, mylohyoid and genioglossus muscle
insulin
pancreatic hormone secreted by pancreatic beta cells of islets of langerhand decrease gluconeogenesis and increase triglyceride storage, glycogen synthesis and protein synthesis
lesions of the hypoglossal nerve
paralize the tongue on one side on protrusion, the tongue deviates to the ipsilateral or contralateral side dependin on the lesion side lower motor neuron lesion- deviates to the paralyzed side upper motor nerson lesion- pparalysis on the contralateral side
oral irrigation devices are contraindicated in
patients with periodontal inflammaiton as it can cause bacteremia
what tends to occur following an intra arterial injection of anesthetic
penetration of the vessel is met with resistance and elicits pain the needle moves with the rhythm of the heartbeat injection of the test done elicits acute pain aspirated blood is bright red in color NOT: vessels tend to collapse and obstruct
Adrenal gland suppression
people of small doses (5 mg prednisone/day) will have suppression when they have been on it for a month people whotake 100 mg will have abnormal funciton in a week short term therapy (1-3 days) will not alter adrenal cortical function a preon who has been on suppressive doses of steriod will take as long as a year to regain full adrenal cortical funciton patients with adrenal insufficency are hyperpigmented adrenally insufficient patients have adqauete steriod replacement since the stress of oral surgery can precipitae adrenal crisis
ACTH stimulation test
performed to examine the response of the adrenal gladnd to an exogenously administerd dose of ACTH normal patients have a doubling of the serium cortisol level after a dose of ACTH. the serum should rise to >20 if there is adequate adrenal function
perio
perio
ginko biloba
peripheral artery vasodilator
sclerotic dentin
peritubular dentin pulps inital defence mechanism
headgrea
permits posterior movement of teeth in one arch without adversely disturbing the opposing arch
postherpetic neuralgia
persistent nerve pain from herpes infection that lasts for months after lesions disappear after an attack of herpes zoster involves CN 7 and geniculate ganglion that produces Ramsey Hunt Syndrome
bleeding that consists of pinpoint dots of blood
petechiae
weight loss
phenermine is used
the propylene glycol in IV valium can cause
phlebitis which is an irritation or inflammation of a vein
attrition
physiologic wearing away of enamel and dentin due to normal function or mainly excessive grinding polished facets
drugs that treat glacuoma
pilocarpine- causes papillary constriction latanoprost- a prostaglandin analog. reduce introcular pressure by increasing aqueous humor outflow betaxolol- beta blocker. redudce intraocular pressure by reducing aqueous humor production
class I
pit and fissure
thyrotoxicosis caused by secondary thyroid hyperfunction is seen in individuals with
pituitary adenoma
direct pulp capping
place calcium hydroxide base directly on a pulp exposure very successful in immatrue teeth should not be attempted on teeth with a history of pain, sensitivity to percussion or periapical radiolucencies
double lingual bar (with continuous bar)
placed above the cingula and below inter proximal contacts need 7-8 mm above the mouth floor or cannot use best inducated for perio surgery cases for wide embrasures must have rest seats on the superior bar on at least the canines
extra coronal retainer
placed on external surfaces of abutment teeth retentive clasp arm that is flexible and placed in areas below cervical to the tooth's height of controu (tooths gingival 1/3)
straight pull headgear
places a force in straigh distal direction from max molar, indicated for class II div I
the most severe tissue reaction occurs with what kind of suture material
plain catgut suture
D-HMO
plan most commonly associated with dental managed care aka capitation dental plan
gingivectomy
pocket depth elimination by resecting the tissue coronal to the pocket base final aspect is to bevel the coronal margin to provide the most physiological shape and marginal thickness so adequate oral hygeien techniques can be performed
conical pontic
pointic of choice for a thin mandibular ridge in a non appearance zone
ovate pontic
pointic of choice with a broad, flat ridge to give appearance it is growing from the ridge good for max incisors, canines and pm requires surgival preparation
PMMA
polymer (powder)
cellular phase of inflammation
polymorphonoculear neutrophils (leukocytes) predominate and are first to migrate to the injured tissue via chemotaxis
which impression material is uniquely radiopaque
polysulfide
hygiene pontic - fish belly
ponitic of choice in non appearance zone occlusogingival thickness must be at least 3 mm with adequate space under it for cleaning
modified ridge lap pontic
pontic of choice in appearance zone has all convex surfaces for easy cleaning and preventing food impaction
lymphepithelioma
poorly differentiated squamous cell carcinoma involving lymphoid tissue in the tonsils and nasopharynx regions high frequency in young adults of east asian decent primary lesion is very small. swelling of lymph nodes, followed by sore throat, nasal obstruction metastasis at an early stage to the cervical lymph nodes tx: radiatoin. poor prognosis
zinc phosphate cement
porcelin crowns high pH is a problem bc two layers of varnish must be appiled to protect the pulp
the distobuccal extension is determined by the
position and action of the massater muscle
Centric Relation
position in which condyles articulate with the thinnest avascular position of their respective discs in the most anterior superior position against the articular eminences independent of teeth
what converts electrons into x-rays
positive anode
during the calcification of plaque the calcifcation foci exhibits
positive periodic acid schiff reaction
zygomatic arch fracture
possible slight shrinkage of the cheekbone area
what is the best inidcator of success of a periodontal flap procedure
post operative maintenance and plauqe contorl by the patient
greater palatine nerve block
posterior hard palate greater palatine foramen
which surgical approach is the best to expose the TMJ
preauricular
what is the best incision to expose the TMJ
preauricular incision
the abesence of which layer of dentin predisposes it to internal resorption by cells present in the pulp
predentin
corticosteroids
prednisone, hydrocotrisone trimcinolone dexamthasone1
chamfer margin
preferred finishing line for cast full gold restorations preferred for veneer metal
rigid connector
preferred for teeth with decreased periodontal attachemnt
what is the most common cause of generalized irritation of the basal seat
premature occlusal contacts
hypercementosis involves mostly
premolars
rest seat
prepared into the O, L, or I surface of an abutment tooth in order to receive and support a rest
encapsulated, myelinated nerve ednings in PDL
pressure
preservative = sodium sulfite-
prevents the deterionation of the fixing agent
which is contradicated in hepatic disease
prilocaine
distal shoe
primarly second molar space maintenace
rests
primary function is to provide rpd vertical support. prevents vertical dislodgement need a min of 3 for any partial denture
what is the only anterior tooth in either dentition to have a shorter incisocervical height than the mesiodistal width
primary max central incisor
what is the most comon congentially missing primary tooth
primary max lat
lateral pterygoids
primary protactors of the mandible
mandibular complete dentures
primary support stress bearing area is the buccal shelf a secondary peripheral seal area for a mandibular complete denture is the anterior lingual border
calcification (minerlaization)
primary teeth clcify during the 2nd trimester of prgnanacy
Varicella Zoster Virus( VZV)
primary--> varicella aka chickenpox, self limiting and childhood latent in trigeminal ganglion recuurent--> herpes zoster aka shingles Ramsay Hunt Syndrome= herpes zoster reactivation in geniculate ganglion affecting cranial nerves VII and VIII resulting in facial paralysis, vertigo, deafness Tx: acyclovir
Herpes Simplex Virus (HSV)
primary-->pan oral, self limiting and childhood Tx: pallative latent in trigeminal ganglion recurrent--> keratinized herpes labialis (cold sore) vermillion border recurrent intraoral herpes-- attached gingivia, hard palate reactivation is triggered by stress, sunlight or immunosuppression herpetic whitlow-->finger herpes gladiatorum--head Tx: acyclovir in prodromal period
which is co administered with antibiotics to delay the renal clearance of the antibiotic
probenecid
positioned flaps
procedures in which the flaps coronal margins are advanced (lifted but the flap is not freed up) apically, coronally or laterally
a depressor response
prodeces a decrease in Bp and is mediated by B2 receptors
long wavelength (low energy)
produced at lower kilovoltages thus have low penetrating power (are easily absorbed) aluminum discs are used to filter out these useless long wave rays to increase the overall quality of the x ray beam
silabants (ch,j,s)
produced by max and mandib incisors approximating each other . palate and tongue controlling valve
"Pressor response"
produces an increase in BP and is mediated by alpha receptors,
gingival changes during pregnancy result from the effect of
progesterone and an increase in the number of mast cells increase levels of prevotella intermedia
erythromycin
prolong the QT interval of cardiac electricla conduciton and can increase the risk of cardiac arrhythmias
calcium hydroxide
promotes formation of a hard substance at the root apex by creating an alkaline environment that promotes hard tissue deposition
What is the most useful when polishing an amlagam restoration
prophylaxis cup with tin oxide abrasive impregnated rubber points sof lex disks
what is not found in the pulp
proprioceptors nerve fibers
cavity linerss
protect the pulp seals the dentinal tubules
which test is most valuable for evaluating the surgical risk of a patient on warfarin who needs a tooth extracted?
prothrombin time normal is 12-13 seconds INF is used in conjunction and its normal is .8-1.2
woodbury rubber dam frame
provdes more retraction of soft tissues
investing
provess of surrounding a wax pattern with a material that can be accurately duplicate its shape and anatomical features
replacement of defective amalgam with a cast gold restoration can achieve which of the following
provide better marginal seal provide more ideal contours
sprue former
provides an ingate or sprue in the investment rhough which the molten alloy can reach the mold after the wax has been eliminated the diameter of the sprue pin should be equal to or greater than the thickest portion of the pattern attach the sprue at the point of greatest bulk
major connector
provides rigidity unities all other components not placed on movable tissue
the functional cusp bevel
provides space for restorative material of adequate thickness in an area of heavy occlusal contact
CR record for edentulous patient
provides the ability to increase or decrease the VDO more accurately in the articulator by establishing a radius of the mandibles arc of closure facebow transfers the relationship between the hinge axis and maxilla from the patient to the articulator `
class III
proximal of anterior (no incisal edge)
class IV
proximal of anterior with incisal edge
class II
proximal of posterior
nausea, pallor, cold perspiraiton, widly dilated puplis, eyes rolled up and brief convulsions are indicative of a patient having a ____ rxn
psychogenic this is caused by psychological factors rather than physical factors
the venous return of both dental arches is the
pterygoid plexus of veins
venous return of both dental arches is the
pterygoid plexus of veins
the buccinator and superior pharyngeal constrictor muscles of the pharynx are attached to each other at the
pterygomandibualr raphe it extends from the hamulus and passes inferiorly to attach to the posterior end of the mandibles mylohyoid line
periapical cemental dysplasia in its early stages is best differentiated clinically from an apical abscess by
pulp testing
waters projection
purpose is to evaluate the maxilllary sinus area
reverse towne projection
purpose is to identify fractures of the condylar neck and ramus
altered cast techinique
purpose is to record the form of the edentulous segment without tissue displacement and to accurately relat the edentulous segment of the teeth via the metal framework helps to obtain soft tissue support
larger flat areas where blood has collected under the tissue up to a centermeter in diameter
purpura
circumferential filling
push pull filing action that scrapes canal walls to create a smooth, tapered prepatation enhances prepatatio when a flaring mehtod is used
LeFort II
pyramidal fracture signs: preiorbital edema, ecchymosis, subconjunctival hemorrhage, and nose bleeding a common finding is parestheisia over the distribution of the infraorbital
information about differences in the sensitivity of individuals to incresing doeses of a drug is determined by
quantal dose response curve
apical fibers
radiate apically from cementum to bone offer inital resistance to tooth movement in an occlusal direction
stafne bone defect
radiolucency in posterior mandibular canal due to lingual concavity of jaw
complex odontoma
radiopaque mass with a thin radilucent rim at the junction most common in the posterior mandible 20-30 years in mandib pm/molar area asymptomatic but may delay eruption of permanent teeth well defined radiopaque mass surrounded by a narrow radiolucent zone
the edge angle is formed between the ______face and the _face
rake; clearance
squamous odontogenic tumor
rare benign odontogenic tumor from ectoderm painless or mild painful gingival swelling assoicated with tooth mobility radiolucency lateral to the roots of an unerupted or erupted tooth
median palatal cyst
rare but may occur along the median palatal raphe, usually in the hard palate midline, posterior to the pre maxilla may produce swelling on the palate. clinically this lesion presents as a firm, painless swelling
dentinogenesis imperfecta
rare disorder found in only 1: 7000 children mesodermal defect of dentin opalescent hue pulp chambers completley obliterated type 1- blue sclara type 2- most common. no bone involvement type 3- only a dentin abnormally exists. there are clinical and radiographic variations that include multiple pulp exposures in the primary dentition
verrucous carcinoma
rare form of SSC. does not metastasize men 60+ whitish cauliflower or coal like papillay appearance slow growth pattern non aggressive, very well differentialed tumor that does not metastasize can be seen on the upper alveolar ridge
Mikulicz's disease
rare salivary gland lesion related to sjogrens syndrome asymptomatic enlargement of the parotid and submandibular gland overtimes becomes bilateral middle aged women histo: epimyoepithelial islands within
odontogenic myxoma
rare slow growing, usually asymptomatic mantibular tumor patients are usually <35 years of age causes localized jaw expansion tx: curettage
median alveolar cyst
rare, but occurs in the bony alveolus between the central incisors distinguished from a peripical cyst by the fact that the adjacent teeth are vital
rubella virus
rash swollen and congested tonsils and red macules1
c factor
ratio of sound to unsound surfaces
chloroform
reagent of choice to dissolve gutta percha
peripheral giant cell granulom
realtively uncommon, pedunculated broad based growths with a smooth surface always on gingiva between 1st permanent molar and incisors or alveolar process reddish blue in color most patients older than 20 yrs females 2x males tx: complete surgical excision
body temperature is taken the most accurate way
rectally
Blepharochalasis
recurrent swelling of the eyelid cauing stretching and atrophy
carcinoa invasive
red area in mouth of floor. not flat
nicotine stomatitis
red dots are inflamed salivary duct openings only premalignant if related to reverse smoking (lighted end in mouth)
primary support denture bearing areas on max denture
redisudal ridges and palate secondary support is the palatal rugae
anemia associated with infections and inflammatory disease present with
reduced MCV, reduced MCH, normal MCH concentration
what is the most significnat advantage of acid etch
reduction of microleakage
anterior guidance
refers to both incisal and canine guidance
quality of xray
refers to the average energy or penetrating power of the xray beam and is controlled by KVp
Christensen's phenomenon
refers to the distal space created between the maxillary and mandibular occlusal surfaces when the mandible is protruded, due to downward and forward movement of condyles down their articular eminences
masseteric notch
refers to the distobuccal area on the impression/denture masseter contracts when the mouth closes against resistance
xray quantitiy
refers to the number of xrays produced and is controlled by the miliamerage mA
Protrusive record
registers the anterior inferior condyle path in the translation movement of the condyles
Enviornmental protection agency
regulates waste treansportaion from the dental office
Dentifrice associate sloughing
related to surfactant ingrediant sodium lauryl sulfate suggest toms of Maine or Rembrandt toothpaste
dermoid cyst
relatively uncommon cyst in the oral cavity. this cyst contains hair, sebaceous and sweat glands and tooth structures most common site is the floor mouth
dental wax patterns should be invested as soon as possible after fabrication to minimize changes in the shape caused by
relaxtion of internal stress
debridement
removal of foreign material and contaminated or devitalized tissue chemomechanical debridement of the root canal system is the most crucial aspect of root canal treatment glassy, smooth canal walls is the best and most reliable indictor of root canal debridement
ostectomy
removal of osseous defects or infrabony pockets by elinination of bony pocket walls the bone removed is supportive in nature dont do if the removal will weaken an adjacent tooths bony support
filtration
removal of parts of the x ray sepctrum using absorbing materials in the x ray beam filtration reduces patient dose, contrast and film density
EDTA
remove smear layer on walls of the canal after preparation with instruments
NaOCL
remove vital and necrotic tissue
free gingival graft
removes attached gingiva from another area of the mouth used to increased the zone of attached gingia and possibly gaining root covergae recieves its nutrients from the viable CT bed main reason it fails is disruption of the vascular supply before engraftment. infection is the second most common reason
reaming
repeated clockwise instrument rotation canal is round in shape
submarginal triangular and rectangular flap
requires at least 4 mm of attached gingivia and a healthy periodontium flap is raised by a scalloped incision not better than a full mucoperiostal flap
digital radiography
requires nearly 90% less radiation than traditional radiography becuase the sensor is more sensitive to x rays radiation exposure is reduced 50-80%
hypophosphatasia
resembles osetogenesis imperfectia. its an inherited metabolic chemical bone disease that resulrs from LOW LEVELS OF ALKALINE PHOSPHATASE (enzyme essential to the calcification of bone tissue) loosening, hypocalcification and premature loss of deciduous teeth are characteristic radiographically, large pulp chambers and alveolar bone loss are present
gingivoplasty
reshape the gingiva and papilla of a tooth to correct deformities and provide the gingiva with normal functional form provides more physiological tissue contour
osteoplasty
reshaping or recontouring the laveolar bone that does not provide attachment for periodontal fibers without removing supporting alveolar bone
which luting agent (cement) has the lowest solubility
resin modified glass ionomer
retention form
resist dislodgement of displacement of the restoration
circular fibers
resist rotational forces and help form the gingival ligament encircle the tooth around the most cervical part of the root and inset into the cementum and lamina propria of the free gingiva and alveolar crest
stability
resistance to horizontal dislodiging forces for upper and lower: ridge height and depth of vestibule denture: denture flange
what do guiding grooves in the crown prep provide
resistance to rotation, retention and path for seating the crown improve crown retention
retention
resistance to vertical dislodging forces denture: peripheral seal
support
resistance to vertical seating forces for upper: palate and alveolar ridge for lower: buccal shelf and retromolar pad for denture: denture base
chromium
responsible for corrosion resistance in colbalt crhomium alloys a RPD made of a base metal alloy is resistant to tarnish and corrosion bc of its surface oxide layer
indirect retention
rest seat located as far anterior as possible the function is to prevent vertical dislodgement of the distal extension base of a removable partial denture
RPA
rest, proximal plate, Akers clasp
RPI system
rest, proximal plate, I bar used only with kennedy class I or II (distal extensions) mesial rests are placed on the terminal abutment tooth for all distal extensions
RPI
rest, proximal plate, I bar (ideal class II level system)
RPC
rest, proximal plate, circumferential clasp
direct retainer (clasp assembly)
rest= support minor connector= stability clasp arms retentive clasp arm=retention reciprocal clasp arm= stability
ionic bonds
result from the electrostatic attraction between ions of opposite charge
lateral cefting of the lip
results from failure of the maxillary and frontal nasal process to merge cleft lip occurs during the 5th-6th week of embryonic life
foreshortening
results when the vertical angulation is too steep - teeth look short
gingival third of retentive clasp
retention
mechanical
retention form resistance form
which component of the TMJ has the most vasculature and innervation?
retrodiscal tissue
Glycoprotein IIb, IIIa inhibitor antiplatelet agents
reversibly block platelet aggregation to prevent thrombosis
rest
rigid extension of a RPD framework that contacts the O, L or I surface of an abutment tooth direct forces through long axis= support
clinical characteristics of malignant hyperthermia
rigidity, fever, hypermetabolism, myoglobinuria treated with dantrolene
periapical abscess
rises from pulpal infection of a tooth due to carious involvement of the tooth or traumatic injury clinical features: acute periapical abscess- tooth is extremely painful to percussion and is mobile. radiograph presents only a slight thickening of the peridontal membrane (PDL) chronic periapical abscess-presents as a granulma or cyst but there are no clinical features or symptoms Tx: establish drainage by openingthe pulp chamber or extracting the tooth
Modified Stillman Method
roll technique bristles on the cervical area of the teeth and partially o the ginigiva pointing toward the ginigval margin brush moved with short back and forth strokes
incisal rest
rounded notch at incisal angle 2.5 mm MD length 1.5 mm deep used as indirect retainer less favorable leverage than lingual rest not used often because of esthetic compromise
max tuberosity
rounded prominence of bone that extends distal to the third molar region on max molar PA appears as a rounded radiopaque bulge distal to third molar region
occlusal rest
rounded, semi-circular outline form (spoon shaped) one third MD width one half intercuspal width 1.5 mm deep for base metal floor inclines apically toward center angle formed with vertical minor connector is <90
horizontal fibers
run perpendicular from alveolar bone to cementum and resists lateral forces
lidocaine 2%
safest in children
incisive nerve block
same as mental nevrve block except hold pressure for 2 mins after injection to force anesthetic into mental foramen
fungiform papillae
scattered among filiform papallie. flattened mushroom shaped and found mainly at the tongue tip and lateral margins. have taste buds
zinc
scavenger of oxygen during processing
highly infectious stages of the syphillis is/are
secondary stage
Terazosin
selective to block alpha 1 receptors to manage mild to moderate hypertension and treat benign prostate hyperplasia
Tolazoline
selectively blocks alpha 2 receptros a parenteral anti hypertensive agent whose actions are caused by a direct peripheral vasodilation treats persistant pulmonary hypertension of the newborn
prazosin
selectivly blocks alpha 1 receptors and rarely used to treat hypertension due to unwanted adverse effects
root surface
senile caries found in older patients and attacks cementum and radiular root dentin actinomycyes viscosus
bases
serve as a replacemtn or rubstitiute fro the protective dentin destoryed by caries or cavity preparation
cretinism
servere hypothyroidsm in child, due to lack of thyroid hormone causieng retardation of growth and abnormal bone development. sevre mental retardation is caused by improper CNS development dental findings: large tongue, under developed mandible, over developed maxilla, delayed teeth eruotopm and longer retained decidusous teeth
masseter muscle in border molding
shapes DB area overextension of a mandib denture base in DF area causes a dislodgement of the denture as a result of the Masseter
superior constrictor muscle in border molding
shapes DL border modeling overextended lingual flange can cause a sore throat most critical area in border molding a max denture is the mucogingival fold above the max tuberosity area
reamers
shave dentin using only a reaming action to enlarge canals remove debris in a clockwise action
hardening agent- potassium alum
shirnks and hardens the gelatin in the emulsion
anterior guidance ____ be avoided in complete dentures
should it can cause dislodgement of bases
when extracting maxillary teeth, the patients maxilla is at the same height as the dentists
shoulders
denture processing
shrinkage always occurs, but even more shrinkage if excessive monomer ideal ratio of monomer to polymer is 1:3 porosity is due to underpacking with resin at time of processing or being heated too rapidly
dose equivalent is expressed in terms of
sievert (Sv)
pink tooth
sign of internal resorption and cervical root resportion
verruca (warts)
similar to a papilloma but is NOT pedunculated caused by a viral infection. do excision and biopsy
balanced occlusion for complete dentures
simultaneous anterior and bilateral posterior contacts (tripodization) in centric and eccentric movements to maintain seating of dentures
where should max anterior denture teeth be placed
slightly anterior to the ridge
posterior teeth have contacts
slightly buccal to middle third
condylar guidance
slope of articular eminence represented by HCI on articular posterior determinant of occlusion
central ossifying fibroma
slow growing painless benign lesion that may ooccur in the maxilla or mandib most commonly only involves one kind of bone more common in young adults well circumscribed and demarcated from surrounding bone teeth displacement
when a force is applied to a tooth in occlusion and discontinued, the recovery stage of the tooth is described as
slow, asymptomatic and pulsating
local anesthetic depress which of the following nerve fibers first
small unmyelinated fibers (which conduct pain and temperature)
for mandib extractions, the pattient is positioned
so the occlusla plane of the mandib arch is parallel to the floor
irrigants
sodium hypochlorite- most commonly used irrigant toxic to vital tissue so always use a rubber dam hydrogen peroxide- much less oslvent action than NaOCl-bubbling action , liberation of oxygen urea peroxide-useful irrigant available in an anahygroud glycerol base to prevent decomposition excllent irrigant for treating canals with normal periapcal tissue and wide apices
the primary action of local anesthetics in producing a conduction block is to decrease the permeability of the ion channels to
sodium ions
PDL
soft fiberous CT containing numerous cells, blood vessels, nerves and etxracellular substances and ground substances a highly vascular and cellular CT that surrounds the roots of teeth and briges root cementum with alveolar bone hour glass shaped most abundant cells in PDL are fibroblasts
rake angles
soft materials want positive rake angle burs hard and birttle materials- negative rake angle burs
epulis granulomatosum
soft, non painful beed easily. most often caused by retained foreign materal (bone or tooth fragment) due to an latrogenic error tx: curettage microscopic features: granulation tissue in bone, dentin,cementum or foreign material
osteomalacia (adults rickets
softening of bones in adults because osteoid tissue in bones failed to calcify due to lack of vitamin D. more common in women and may be asymptomatic until a bone fracture occurs Steatorrhea- one of the most common causes of osteomalacia due to fat malabsorption where the body cannto absorb fats so ats are passed directly out of the body in stool causing poor absorption of vitamin D (fat soluble) and calcium osteomalacia affects all bones, specifically at their epiphyselal growth plats
copper
solution hardening, orange color, ranks 3rd in malleability
combination syndrome
specific pattern of bone resorption in the anterior endentulous maxilla when it is opposing mandibular anterior teeth only overgrowth of tuberosities papillary hyperplasia in hard palate extrustion of lower anterior teeth loss of bone under the partial denture base
what ligament is most often damaged in an IAN block
sphenomandibular ligament
what is a pharmacologic antagonist of aldosterone in the collecting tubule
spironolactone (Aldactone)
primary indicator of the accuracy of border molding is the
stability and lack of displacement of the tray in the mouth
middle third of retentive clasp
stabilization
Geudels Stages of Anesthesia
stage 1- amnesia and analgesia--administration of anesthetisa dn continues to the loss of consciousness stage II- deliruium and excitement- loss of consciousness to the onset of total anesthesia stage III- surgical anesthesia- establishment of a regular pattern of breathing stage IV- signals danger
stages of fracture healing
stage 1- inflammation (immediately following fracture) stage 2- soft callus (2-3 weeks after) stage 3- hard calllus (4-8 weeks after stage 4-bone remodeling (8-12 weeks after)
in 1996, Universal Precautions were revised and renamed
standard precautions
submandibular approach (Risdom approach)
standard surgical approach to the andibular ramus and neck of the condyle
friable
state of mineralization
under States Childrens Health Insurance Program (SCHIP)
states can cover up to 300% of the federal poerty line
black branching lines appear on a processed film. what is the likely cause
static electricity
what is the most severe form of asthma
status asthmaticus
indirect pulp cap differs from stepwise caries excavations how?
stepwise involves the placement of temporary filling whereas an indirect pulp cap involves the placement of the permanent restoration
glass beed sterilizer
sterilizes endo files in 15 sec at 220 C
Xanthines
stimulants like caffeine, throphylline and theobromine used to improve mental alertnesss, reduce urge to sleep and leevate mood Theophylline is the only xanthine important in asthma treatment
Guanfacine and Guanabenz
stimulate a2 adrenergic receptors to inhibit sympathetic nervous system outflow, reducing peripheral vascular resistance and are used either alone or with a thiazide diuretic
x-ray fixing solution
stops development and remove remaining unexposed crystals 1. clearing agent( sodium or ammonium thiosulfate) 2. antioxidant preservative (sodium sulfite)- prevents decompostion of the fixer chemical 3. acidifier (acetic acid)- correct action of other chemicals and neutralizes any alkaline developer 4. hardner (potassium alum) shrinks and hardens the gelatin in the emulsion
all oral mucosa is
stratified squamous epitholim regardless if it is keratinized or onkeratinized
dential caires is initiated at the tooth surface by the growth of
streptococci these produce dextran sucrase which catalyzes foramtion of extracellular glucans from dietary sources. glucan production contributes to dental plaque formation which then holds the lactic acid produced by streptococci against the tooth
the most abundant bacteria in a healthy sulcus are
streptococcus and actinomyces species
what is the universal sign of laryngeal obstruction
stridor (crowing sounds)
for zinc phosphate cements, they should be mixed on a cool mixing slab bc
stronger final set and lower solubility
composite resin cement
strongest bond use with ceramic crowns
curettes
subgingival
which oral landmark marks the opening of the submandibular duct
sublingual caruncle
ludwigs angina
submadib, subling and submental spaces
which lymph nodes directly receive lyph from the anterior 2/3 of the tongue (except the tip)
submandibular lymph nodes
congeners
substances that are closely related in composition, function or origin
behavior shaping is also called
successive approximation
what is the most common type of malignant melanoma
superficial spreading melanoma
36 year old pt suddenly has seizure. dentist should put him in what position
supine
occlusal third of retentive clasp
support
the lingual cusps of the maxillary posterior teeth are
supporting and working
The experimental gingivitis model
supports the non specific plaque hypothesis demonstrates the relationship between plaque formation and gingivitis demonstrates that the bacterial ecology changes as plaque accumulates demonstrates that gingivitis is a reversible disease
the strength of a solder joint is proportional to its
surface area
durig condensation of cold
surface hardness of gold foil is always increased
when a broken instrument file protrudes past the apex
surgey should be performed
Caldwell-Luc approach
surgical procedure in which an opening is made into the max sinus by way of an incision into the canine fossa above the level of the premolar roots
Alveoloplasty
surgical reshaping of alveolar bone useful for sharp, sping or extremly irredular edges
Amphetamines
sympathetic amines that stimulate CNS and PNS increase systolic and diasoltic blood pressures and act as weak bronchodilators and respiratoyr stimulants have high abuse potential pass rapidly into CNS and cause a rapid release of NE in the brain
eccrine sweat glands are primarily innervated by
sympathetic-cholinergic
resistance form
take to resist forces of mastication to prevent fracture of the restoration and tooh
working side
teeth on the side the mandible is moving towards a denture must have the canaine and at least 4 other cusps contacting opposing teeth
what correlates with a steep mandibular plane
tendency toward a class III malocclusion
what is associated with liver damage
tetracycline
what is the most sensiitve area of the tooth during vavity prep
the DEJ
Antimetabolites act on
the S phase of the cell cycle by interfering with the biosynthesis of the purine and pyrimidine bases
what is the most critical factor to determin if a tooth should be extracted or have surgery
the amount of attachment loss (the amount of apical migration of the epithelium attachment)
deductible
the amount of eligable expenses a covered person or family must pay each year from his own pocket before the plan will make payment for eligable expenses
half valve layer
the amount of material required to reduce the intensity of an x ray beam to half HVL is an indicator of QUALITY of an xray beam not constant
how to sharpen your instrument
the angle between the blade face and stone is kept at 100-110 . when sharpening with a flat stone the angle between the insturment and stone is 100-110
rake angle
the angle made between the line connecting the edge of the blade to the axis of the bur and rake face most important design characteric of a bur blade
as caries spreads laterally into dentin
the base of the triangle at the DEJ and apex pointed toward the pulp chamber
sprue
the best angle to attach the sprue pin to the proximal wall of a eax pattern is 45 degrees the purpose is to provide an ingate or sprue in the investment through which the molten alloy can reach the model after the wax has been eliminated smaller than 1.5 mm are contraindicated the sprue pin diameter should be equal to or greater than the thickest portion of the pattern most related to the turbulence of molten gold
ridge
the best indicator for success of a denture is the ridge wide broad ridge is the best situation
Townes view
the best view to visualize the condyles and neck of mandible from an AP projection assess the condyles, condylar neck and rami
hamular process
the bony projection that arises from the sphenoid bone and extends downward and slightly posterirly
boundaries of the buccal shelf
the buccal foramen to the retromolar pad crest of the residual ridges to the external oblique line
internal finish line
the butt joint between the metal and acrylic on the tissue side of the edentulous area
the carotid sheath contains
the carotid artery jugular vein vagus nerve it does not contain the sympathetic trunk
atelectasis
the collapse of part or all of a lung most common anesthetic complication occuring within the first 24 hours can lead to pneumonia
oligodontia
the congenital absence of many but not all teeth
collimnation
the control of the size and shape of the x ray beam radiation beam be as small as practical the diamater of a circular beam of radiation at the patients skin can not be longer than 2.75 inches
tipping
the crown moves in one direction while the root tip/apex id displaced in the opposite direction
max canine from perm to primary teeth
the cusp on the primary max canine is much longer and sharper than the cusp on the perm max canine
PDL is derived from
the dental SAC
during non working, excusrive movements, the permanent max first molars ML cusp escapes through
the distobuccal groove of the mandibular first molar
lethal dose
the dose that kills 50% of the people who receive the drug, as determined by mice experimentation
margin #1
the edge or shelf at the base of a crown prep
effective dose ED
the effective dose at which 50% of people will respond
resillence
the energy that a material can absorb
external finish line
the external junction (butt joint) of the metal framework and denture base
in an ideal intercuspal position, the facial cusp tips of permanent max premolars oppose
the facial embrassure between their class ocunterpart and the tooth distal to it
inherent filtration
the filtration of an x ray beam by any parts of the x ray tube or tube shield thorugh which the beam must pass the parts include the glass envelope of the x ray tube and OIL surrounds the x ray tube to cool the tube to dissipate heat
mantle dentin
the first formed dentin that is ladi before the odontoblast layer is organized
convenience form
the form the cavity prep takes to aid the operator in preparing, placing or finishing the restoration
pins
the function is to retain the resorativematerial do not increase the strength of the restorative material pin retention increases as the pin diamater increases Dentin only!
gingival apparatues
the ginigval fibers and epithelial attachment
therapeutic index
the greater a drugs therapeutic index, the less likely fatalities will follow an accident overdose
INR
the higher the INR, the greater the anticoagulant effect (greater clotting) INR of 1: means normal prothrombin times of about 12 sec, normal clotting would be present INR>1 indicates an anticoagulant effects exists many patients taking anticoagulants have INR values of 2,3,4,5 and even 6 for surgical procedures and INR of 1-1.5 indicates a normal prothrombin time (12-16 sec) this is within a safe range
acute inflammation
the initial protective response of tissue to irritation or injury involving vasuclar and cellular response
zone 1 Normal dentin
the innermost zone of normal dentin with no bacteria in the tubules
inverse square law
the intensity of the radiation is inversly proportional to the square of the distance from the source of radiation when the target receptor distance is increase, the intensity is decreased doubling the distance the distance results in a beam that is 1/4 as intense
stippling
the irregular surface texture of the attached gingiva that resembles an oragne peels surface
flourides are mainly elimnated from they body via
the kidneys
parotid gland
the largest salivary gland and pure serous gland supplied by general visceral effernt nerve fibers of the glosspharyngeal nerve drained by stensons duct
circumvallate papillae
the largest, least numerous papillae. circular shaped arranged in the inverted v shaped row toward th eback of the tongue. associated with ducts of von ebners glands. have taste buds
exposure time
the length of time x rays are produced and the time the patient is exposed to them
when establishing a balanced occlusion, the lingual cusps of maxillary posterior teeth on the balancing side should contact
the lingual inclines of facial cusps of mandibular posterior teeth`
the most important enzyme systems for the biotransformation of drug molecules are found in
the liver by the P540 system
kertanized tissue in a denture
the more keratinzied tissue the better denture support and comfort
superoxol
the most common bleaching agent for endo treated teeth 30% aqueous solution by weight of H2O2 in distilled water
charged coupled device (CCD)
the most common digital image receptor a solid state detected with a silicon chip embedded within it
Von Recklinghausens disease (neurofibromatosis)
the most common feature is NEUROFIBROMATOSIS (multiple tumors of nerve tissue origin autosominal dominant characterized by multiple neurofibromas, cutaneous cafe au lait macules, bone abnormalities and CNS changes clinical signs: 6 or more cafe au lait macules tx: none
localized actute gingivitis
the most common form of gingival periodontal disease in school aged children
autogenous tooth transplantation
the most common idication for a tooth transpolantation is severe decay of a 1st molar most likely cause of failure is a chronic, progressive external root resorption universal sequelae of an allogenic tooth transplant in akylosis and progresisve root resorption
dental granuloma
the most common sequelae of pulpitis at the root apex. only distinguished from a radicular cyst histologically asymptomatic necrotic tooth but may be percussion sensitive
bisphenol A -glycidyl methacrylate
the most common to most compostie resins, sealants , bonding and glazing agents and resin cements for otho bands
hypoglycemia
the most serious and common complication of insulin therapy
malignant melanoma
the most severe and potentially serious type of skin cancer often developed from or near a mole skin cancer is the most common malignancy in the US uncommon in the oral cavity but has a prediclection for the hard palate and maxillary alveolar ridges(hard palate is the most common intra oral site)
boundaries that define the attached gingiva extend from
the mucogingival junction to the free ginigval groove (base of the sulcus)
which nerve can also serve as an afferent nerve for the mandib first molar
the mylohyoid nerve
flush terminal plane
the normal relationship of the primary molars in primary dentition
as plaque ages
the number of gram positive aerobic bacteria decreases while the number of gram neg anaervbic bacteria increases
what is an unfavorable consequence of placing mandib molars on the ascending border of the ramus during the fabrication of a complete denture
the occlusal forces over the inclined ramus would dislodge the mandib denture
campers line significance
the occlusal plane, established by the wax occlusion rims surfaces is parallel to campers line and inter pupillary line
alveolar process
the part of the maxilla and mandible that houses teeth and consists of two main parts alveolar bone proper and supporting alaveolar bone
margin 2
the part of the restoration which forms its outer limit that adjoins to the cavosurface margin of the prepared tooth
coinsurance
the portion of covered dental care costs for which the coverd person has a financial responsibility, usualy a fixed percentage
pneumothorax
the presence of air in the pleural cavity
kilovoltage (kVp)
the quality or penetrating power of the x ray beam that controls the speed of electrons affects the contrast and predominately determines the penetrating ability of the xray beam
primary radiation
the raditaion generated at the ANODE of the x ray tube that is attenuated by the filter and the object
open reduction
the reduction of a fractured bone by manipulation after incision into skin and muscle over the fracture site the most common site for open reduction is at the angle of the mandible
closed reduction
the reduction of a fractured bone by manipulation without incision into the skin maintained in place by intermaxillary fixation (pre-fabricated arch bars)
reliability
the repeatability and reproductibility of the test
most designs of streebreakers will rather effectively dissipate vertical forces to terminal abutments, However, this occurs at the expens of what supporting entitiy?
the residual ridge
balancing side
the side opposite to the side the mandible is moving toward at least 3 cusps touch but not the canine
distal wedge flap
the simplest distal flap procedure used for retromolar reduction wedge base is the periosteum overlying the bone and the apex is the coronal gingival surface
Wrought wire retentive clasp
the simplest form of stress relief advantages: higher yeid strength, greater flexibility, more ductile and resillent often used with M rest in class I and II deisgns on the most posterior abutment tooth if occlusion prevents using a mesial rest on the most posterior abutment in a distal extension only a WW can be used with a distal rest bc it is okay for its retentive tp to be in front of the axis of rotation tip of its retentive arm should engage the undercut anterior to the fulcrum line (axis of rotation). terminal end of its retentive arm is optimally placed in the middle of gingival 1/3 of clinical crown the retentive arm should be passive and applying no pressure on the teeth not used in class III and IV do not use wrought wires thorugh embrassures or with embrasure claps has a tensile strength at least 25% greater than the cast alloy from which it was made
Barton bandage
the simpliest form of immobilization. primarily a first aid measure until definitive therapy can be instituted
Moyers mixed dentiion
the size of unerupted canines and premolars id predicted by knowing the size MD width of the mandibular inciors that have already erupted into the mouth early in the mixed dentition
focal spot
the small area of tungsten on the anode from which x rays emanates and that recieves the impact of speeding electrons focal spot is 1 of 3 factors that influences image sharpness the size of the x ray tube focal spot influences radiographic definition
palatine papilla cyst
the soft tissue variant of the nasopalatine duct cyst
Waters view
the standard radiograph of choice for showing an anterior view of the paranasal sinus and of th emid face and orbits water is one of the best films for radiographic diagnosis of mid facial fractures , sinus infections and lesions of the max sinus
in fabricating complete dentures, if the teeth are too far lingually placed then
the t will sound more like a th
linguodental sounds (this, that and those)
the tip of the tongue should protrude slightly between the maxillary and mandibular anterior teeth
prognosis of a tooth with a broken insturment is best if
the tooth had a vital pulp and no periapical lesion
gold foil
the traditional and oldest type of gold
Roentgen (R)
the traditional unit of radiation exposure measure in air only applies to x rays and gamma rays
zone iV turbid dentin
the zone of bacterial invasion as the dentinal tubules are filled with bacteria this dentin cannot reminerlaize and must be removed prior to restoration
the earliest and most common symptom assoicated with an inflamed pulp is
thermal sensitivity- sensitivity to hot and or cold stimuli
why are vasoconstrictors included in local anesthetic
they prolong the duration of action of the local anesthetic they reduce the toxicity because less local is necessary they reduce the rate of vascular absorption by causing vasoconstriction they make the anesthesia more profoudn by increasing the concentrations of the local anesthetic at the nerve membrane
which barb is ulta short acting compound
thiopental
which is a system where a provider of coverage contracts to pay for some of the patient's dental treatment
third party dentistry
coronoid process
this image of the mandible often appears in the periapical radiographs of the molar region of the maxilla tapered or traingular radiopacity
why should the powder be sprinkled onto the water in the bowl
this process results in better powder mixing and reduced chance for air bubbles
retention form
those features that prevent removal of crown along long axis of the tooth prep (sticky food)
resistance form
those features that prevent removal of crown by apical, horizontal, or oblique forces (occlusal forces)
functional appliances
those that change the posture of the mandible, holding it ope or open and forward frankel bionator clarks twin block herbst activator
the absolute max number of posterior teeth which can be safely replaced with a fixed bridge is
three
flouride levels in excess of _________ begin ot pose a risk for fluorosis
three parts per million
what is the highest risk associated with use of oral contraceptives
thromboembolic disorders
lingual thyroid
thyroid tissue mass at midline base of tongue located along embryonic path of thyroid descent
creep
time dependent deformation or strain relaxatoin deformation with time in resposne to a constant stress main causes for margin fractures on amalgam restorations time dependent high copper and low mecury contant decrease creep undertitrutation and overtrituration increase the creep rate
S sound
tip of tongue approaches the anterior plate and lingual surfaces bring the mandible and maxilla close together
T and D anterior lingual palatal sounds
tip of tongue touching the anterior palate
z springs
tipping anterior teeth but deliver excessibely heavy forces and lack range of motion
a pt who places aspirin directly in the oral vestibule often see a well circumscribed white patch on the mucosa where the aspirin was placed. The best description would be
tissue necrosis
periodontium
tissues that surround and support the teeth consisting of gingivia, PDL, cementum, alveolar and supporting bone functions are to support, protect and nurish the teeth
what is the function of silanes in resin composites
to bind inorganic and organic materials with hydrogen and covalent bonds
what is the main reason to take bitewings?
to detect interproximal caries
function of a post
to provide a platform for the crown (retain the core)
facebow
to record the patients maxilla/hinge axis relationship
which way does the mandible deivate in an injury
to the side of the injury upon opening
cancer of which oral cavity structure is most commonly associated with mortality
tongue
Th linguodental sound
tongue should protrude slightly 2-4 mm
the tongue receives its blood supply from
tonsillar branch of the facial artery longual artery ascending pharygneal artery
what is the primary reason for choosing a veneer over crown
tooth structure is spared
what is the most common etiologic factor/cause of gingival recession
toothbrush abrasion left canines of right handed people
anodontia
total abscence of teeth
toughness
total energy absorbed to the point of fracture
condylar guidance is dictated by who?
totally dictated by the patient and cannot be varied or adjusted by the dentist
Graves disease
toxic diffuse goiter most common that occurs mostly in women 20-40 typical signs of hyperthyroidsm plus Goiter (buldging neck) and exophthalmos (buldging eyes)
Plummers disease
toxic multinodular goiter caused by the presence of many toxic thyroid nodules (adenomas) within the thyroid gland uncommon in adelosecents and young adults increases with age no exophthalmos (bulding eye) super rare
direct intraosseous wiring combined with a period of IMF
traditional method of bone stabilization after open reduction
zone III
transparent dentin softer than normal dentin and show futher demineralization no bacteria present capable of remineralization
free mucosal autograft
transplant is CT without an epithelial covering often used on canines where little keratinized gingivva exists to create a band of gingiva like tissue
Lefort II
transverse fracture or crainofacial dysfunction a fracture in which the entire maxilla and one or more facial bones are completly separated from the crainofacial skeletion resturcted mandibular movement
amalgam tattoo
traumatic implantation of amalgam particles into mucosa tiny radiopaque particles in xray
Propranolol
treats hypertension decrease BP by decreasing CO nonselective B blockers are contraindicated in patients with asthma or other chronic obstructive airway disease as they cause fatal bronchospasm and in pt with insulin dependent diabates as they block hypoglycemia recovery BLOCKS BETA ADRENERGIC heart receptors
T/F Fluoride mouth rinses are the most popular school based fluoride regimin in the US
true
for an onlay preparation, the most effective means for verifying adequate occlusal clearance is a wax bite chew in
true
Angioma
tumors composed of blood vessels or lymph vessels
multiple endocrine neoplasia syndromes (MEN syndrome)
tumors of various endocrine glands that occur in association with a variety of other pathologic features. medullary carcinoma of the Thyroid due to its ability to metastasize and cause death MEN I syndrome- tumors or hyperplasias of the pituitary , parathyroids, adrenal cortex and pancreatic islets (pancreas) MEN II (Sipple's Syndrome) parathyroid hyperplasia or adenoma, but NO tumors of the pancreas MEN III- mucocutaneous neuromas, pheochromocytomas of the adrenal medulla and medullary carcinoma of the thyroid glans the most constant feature is neuromas (especially in the oral cavity) most commonly of the lips, tongue, and buccal mucosa
multiple clasp
two opposing c clasps joined at the terminal end of the two reciprocal arms
ADA alloy classification
type 1- used for small inlays type II- larger inlays and onlays type III-onlays, crowns and short span FPD type IV: thin veneer crowns, long span FPD and RPS
gingival fibers
type I collagen fibers ginigval fibers are only found within the free gingivia are continuous with the PDL designated by their orientation
what is the most important factor when selecting a clasp for distal extensions
undercut location
retention in a cavity prepared for composite resin usually is gained by what?
undercuts in dentin and acid etching
kennedy class III
unilateral bounded edentulous space
kennedy class 2
unilateral distal extension
condylar hyperplasia
unilateral enlargemtn of the condyle unilateral slowly progressive elongation of the face with deviation of chin away from the affected side
Pagets Disease
unknown etiology, bone resportion and repair leading to deformities dentures not fitting--need to be remade periodically
Nonarcon-
upper and lower members are rigidly attached not anatomical
Zinc Oxide Eugenol cements
used as a sedative filling material as an insulative base and in interim caries treatment pallative effect on pulp powder is zinc oxide liquid is eugenol do not have thermal insulation qualities that compare to dentin cant be used as a liner with composites
Mat gold (crystalline gold)
used for bulk filling of cavities not as good as gold foil or powdered gold
alloy
used for cast restorations
external skeletal fixation
used in cases in which the management of a fractured bone segment is not satisifactory accomplished by intermaxillary fixation
reverse action Hairpin clasp
used on abutments of tooth borne dentures where a proximal undercut is below the point of origin only iwhen a bar clasp is ocntraindicated due to a tissue undercut, tilted tooth, shallow vestible or high tissue attachment
embrasure clasp
used on sound teeth with retentive areas or when multiple restorations are justified requires at least 1.5 mm marginal ridge reduction to prevent fracture of clasp assembly used with double occlusal rests wrought wires are never used with embrasure clasps
whip spring appliances
used to de rotate one or two teeth
Pantograph
used to follow patients border movements
reverse townes view
used to idenify fractures of the condylar neck and ramus area
PMA index
used to record the prevalence and servity of gingivitis in school children
coronally positioned flap
used to restore gingival height and the zone of attached igingiva over isolated areas of gingial recession
band and loop
used when primary first molar has to be extracted
ring clasp
used when undercut is adjacent to BES
gypsum bonded investments
used with types I,II,III gold alloys refractory filler- quartz or cristobalite. it regulates and provides thermal expansion 2. binder- adds strenhth. it will decrease the setting expansion, increase setting time, increase porosity and weaken the set material 3. modifiers- added to modify various physical properities of the investment
begg appliance
uses round wires that fit loosely into the brackets vertical slot
third party reinbursement
usual, customary and reasonable fee a third party determins what fees it will pay for each procedure
polyostoti cfibrous dysplasia
usually displays a segmental distribution of the involved bones occurs during childhood affects long bones, face, clavicles, and pelvic bones
congenital epulis of newborn (congenital gingival granular cell tumor)
usually on the anterior gingiva of newborns as a pink, non inflammed , pedunculated or broad based mass females>males does not exhibit pseudo-epithliomatous hyperplasia of the overlaying epithelium
which technique is best for a wide based frenectomy
v-y advancement
the consent dentist should obtain before beginning any dental treatment procedure is
valid
shade is determined by
value, chroma and then hue
cocaine
vasocinstrictor
what is the most common premedication prior to general anesthetia for a child
versed
hemisection
vertical sectioning of the tooth through both the crown and root 50% of the tooth is extracted if one specific root has excessive loss in osseous support and the remaining half of the molar tooth is treated as a premolar
featheredge margin
very actue and thin less invasive best marginal seal insufficient clearance for most materials difficult to visualize
traumatic ulcer
very common erosion=incomplete break ulcer= complete break through epihtelium
Myxedema-
very severe in adults, more common in women than men puffiness of face and eyelids, swelling of tongue and larynx
combined narcotics
vicoden- hydrocodone+ APAP Percocet= oxycodone+APAP Tylenol 1= 200 mg APAP + 8 mg Codeine tylenol 2- 300 mg APAP + 15 mg codeine tylenol 3- 300 mg APAP+ 30 mg codeine tylenol 4- 300 mg APAP + 60 mg codeine
when using a disinfectant what kind of gloves should be used
vinyl exam gloves
hand foot and mouth disease
viral infection (coxsackie A) that affects infants and children produces red erythematous lesions in mouth, foot and hands fever , malaise, vomitting and fatigue
what is the ideal abutment
vital teeth with no mobility optimum crown root ratio for a tooth to be used as a fpd is 2:3 crown to root ratio 1:2 is idea root configuration with the widest FL dimension 1st molar is best abutment and canine is 2nd
which drugs inhibit blood clotting by affecting the coagulation pathway to prevent fibrin formation
warfarin and heparin
what is th emost effective way to verify adequate occluslal clearance
wax bite chew in
Casts poured from alginate are more accurately mounted with
wax records
centifying fibroma
well defined radiolucency with scattered radiopaque foci occurs in the mandible of adults as a painless welling
peripheral fibroma
well demarcated focal mass of hyperplastic tissue with either a sessile or pedunculated base 3 forms 1. peripheral ossifying fibroma- gingival mass with visible characteritic calcified islands of bone and an ulcerated surface. the gingivia naterior to th epermanent molars is most often affected. Young adult females 2. peripheral odontogenic fibroma- ginigval mass composed of well vascularized non encapsulated fibrous CT 3. giant cell fibroma- a fibrous hyperplasia composed of multi nucleated CT cells
lingual plate
when depth of lingual vestibule is < 7 mm additional loss anticipated lingual tori all posterior teeth are missing bilaterally
lingual bar
when depth of lingual vestibule is greater than or equal to 7 mm simpliest and most common
Canine guidance
when in lateral movements all posterior teeth are immediately discluded as contact occurs solely between the upper and lower canines on the working sided
when is the ideal time to reove impacted 3rd molars
when the root is about 2/3 formed
labial bar (swinglock)
when there is a missing canine unfavorable soft tissue contour questionable periodontal prognosis
K and G velar sounds (posterior palatal sounds)
when toungue touches posterior palate tooth set up does not affect these sounds
elongation
when vertical angulation is too flat- teeth look long and stretched
lingualized occlusion
where only the palatal cusps of maxillary posterior teeth contact the mandibular posterior teeth theoreticaly eliminating the destablizingb buccal force vectors
validity
whether questions asked by the study are answered by the method a valid test is sensitive, specific, and unbiased
radiopaque
white inhibit x rays to pass through
linea alba
white line in buccal mucosa type of focal hyperkeratosis due to chronic friction on mucosa
leukoedema
white or whitish gray edematous lesion of buccal mucosa dissipates when cheek is stretched
in the intercuspal position, the ML cusp of a permanent max first molar occludes
with the centra fossa of the mandib first molar
inlay
within cusps
the bennet movement refers to the
working side condyle only it roates with a slight lateral shift in the direction of the movement
clasp selection
wrought wire used for perio compromised and endo treated teeth BES use Akers clasps with rest seats located adjacent to endentulous space distal extension use in order of preference: RPI, RPA, and wrought wire
after administration of an IAN block and lingual nerve block
you can extract canaine and 1 PM on the injection side you would need to do a long buccal injection to extract the molars
zone II carious dentin sub transparent
zone of demineralization created by acid from caries capable of remineralization
_________are second only to nasal fractures in frequency of involvement
zygomatic fractures
for most cities, every $1 invested in water flurodation saves ___ in dental treatment
$38
what angulation should vertical bitewings be
+8 and +10 degrees
hereditary gingivofibromatosis
- a rare GENETIC DISEASE that is a progressive proliferation of the gingiva (especially collagenous elements). Clinically, there is generalized diffuse gingival enlargement, often extensive enough to cover the teeth. The tissue is dense and firm , with considerable distortion of normal contour. Gingival color is normal, but erythematous changes are a result ,of secondary bacterial involvement. • There is a striking lack of inflammatory cells, proliferating capillaries, and vascular engorgement commonly seen with most types of gingivitis.
doxazosin
-Selective α1-blocker -Uses: urinary symptoms of BPH; -Hypertension -Toxicity: 1st-dose orthostatic hypotension, dizziness, headache longer duration of actino
what is the thickness of a good class II amalgam restoration
.002 inches
the optimal thickness of the opaque layer of porcelin should be
.3 mm
light chamfer
.3-.5 mm thick gold crowns wide gold collars of PFM crowns
min metal thickness of crown
.5 mm at margin 1 mm non contact areas 1.5 mm contact areas
what is the min porcelin thickness
.7 mm ( 1 is ideal)
slow injection
1 carp per min
Cleft palate
1 in 2000 births lack of fusion between palatal shelves
calculating local anesthetic
1 mL of liquid at sea level weighs 1 g carpule/cartrige of anesthetic contains 1.8 mL so one carpule is 1.8 g for 1% LA, then 18 mg then multiple by whatever percent of the anesthetic you are using ex: 2% lido= 36 mg 4%articaine= 72 mg
slow injection technique is defined as the deposition of
1 ml of local anesthetic solution in no less than 60 sec
heavy chamfer
1-1.5 mm thick PFM crowns and some all ceramic crowns if not given enough room, lab will be forced to overcontour crown
shoulder
1-1.5 thick porcelain of PFM restorations all ceramic crowns maximizes esthetics-eliminate display of metal aggressive preparation-potential for pulpal embarrassment
bases have a final application thickness of
1-2 mm
opioid receptors
1. Mu- morphine 2. delta- enkephalins 3. kappa- dynorphins
principles of prep
1. all faults or caries removed 2. all friable or weakened enable should be removed 3. all margins should be placed in a position to allow good finishing of the margins of the restoration
the body contains 3 naturally occuring endogenous opioids ppeptides
1. beta endophins 2. Enkephalina- bind to delta receptors 3. dynorphins- most powerful opioids found throughout the CNS and PNS that bind to kappa receptors
stages of shock
1. compensatory (increased heart rate and peripheral resistance) 2. progressive stage: metabolic acidosis occurs 3. irreversible- organ damage-- survival is not possibel
x ray developming solution contains 4 chemicals
1. developing agent (hydroquinone) - a chemical compound capable of changing the exposed silver halide crystals to black metallic silver. gives detalis to the x ray image 2. antioxidant preservative (sodium sulfite)- prevents developer solution from oxidizing in the presence of air 3. accelerator (sodium carbonate)- an alkali that activates the developing agents and maintains the alkalinity of the developer at the correct value 4. restrainer (potassium bromide)- is added to developers to control the action of the developing agent so it does not develop the unexposed silver halide crystals to produce fog
Rheumatoid Arthritis drugs
1. etanercept (enbrel) binds to tumor necrosis factor 2. Infliximab (remicade)- binds to TNF alpha to reduce inflammatory action 3.prednisone- corticosteriod that decreases inflammatory response 4. piroxicam-NSAID drug that inhibits prostaglandin synthesis. adverse effects: gastric irritation, heart burn and nausea 5. gold injections- decreases prostaglandin production 6. methotrexate- may affect immune functiont
diagnostic aids to idenify vertical root fracture
1. fiberoptic light 2. wedging the tooth in question and take an xray 3. persistant periodontal defects 4. tooth slooth
ideal wire material for otho
1. high strength 2.low stiffness 3. high working range 4. high formability
3 major phenomena of inflammation
1. increased vascular permeability 2. leukocytic cellular infiltration- involves mainly neutrophils 3. repait
sequence of radiation injury
1. latent period period of time between radiation exposure and onset of symptoms 2. period of cell injury- comes after the latent period. cellular injury may cause cell death , changes i cell function or abnormal mitosis of cells 3. recovery period- some cells recover from the radiation injust, expically if radiation is low level
3 reasons to use cantilever brudge
1. missing max lateral 2. missing mandib 1 pm 3. can replace missing 1 molar to avoid unilateral rpd or prevent supraeruption
parts of a flame obtained from a gas air blow torch to melt alloys
1. mixing zone- 1st zone that is cool and colorless 2. combustion zone- 2nd zone thta is grenish blue and surrounds the inner cone 3. reducing zone- 3rd zone which has a dim blue tip and is the hottest area in the flame and is the only part of the flame that should be used to heat the alloy 4. oxidizing zone- outer zone where final combustion between the gas and surrounding air ocurs
vasoconstrictor
1. prolong numbness 2 reduce toxicity 3. promote hemostasis
4 types of melanoma
1. superficial spreading- most common form. lesion is tan, brown, black or admixed 2. nodular- there is no radial growth-- only vertical. more often on back head and neck of men 3. lentigo maliga melanoma- most common in the elderly population 4. acrolentiginous melaoma- occurs on hands and feet
3 ligaments that support and reinforce the TMJ and involve in complex jaw movements
1. temporomandibular ligament (lateral ligaments)- major ligament that runs from the articular eminence to the mandibular condyle to provide direct support to the capsule. (the only ligament that gives direct support to the TMJ capsule). prevents posterior and inferior displacement of the condyle 2. stylomandibular ligament- an accessory ligament that separates the infratemporal region anteriorly from the parotid region behind (posterior border of the mandible) 3. sphenomandibular ligament -an accessory ligament attached to the spine of the sphenoid bone and lingula of the mandible (located on the medial surface of the mandible)
Signs of incipient malocclusion
1. the lack of interdental spacing in the primary dentition 2. the crowding of the permanent incisiors in the mixed dentition 3. the premature loss of the primary canines, particulary inthe mandib arch
4 zones of an incipient carious lesion in enamel
1. translucent zone- the deepest zone that represnets the advancing front of the enamel lesion 2. dark zone- does not transmit polarized light. areas of demineralization and remineralization 3. body of the lesion- the largest portion of the incipient lesion that has areas of demineralization 4. surface zone- relatively unaffected by the caries attack
stages of hemostasis
1. vascular phase 2. platelet phase 3.coagulation phase
three types of SSC
1. verrucous carcinoma 2. carcinoma in situ 3. carcinoma invasive
min porcelain thickness
1.5 mm
the min labial reduction on a PFM crown is
1.5 mm
ferrule
1.5-2mm of sound root structure apical ot the core that the margins of the crown should engage to protect against root fracture
golden proportion
1.618:1:.618
how many hours are required to kill bacterial spores when a dental instrument is placed in a 2% solutin of glutaraldehyde
10 hours aka cold sterilization
for local anesthetics, for every 1% of solution there is
10 mg/mL of anesthetic
MI and CR coincide in only --% of the population
10%
the gingival margin trimmers used for inlay-onlay preparations with steep gingival bevels are
100 and 75 pairs
what is the acceptable max exposure level allowed by OSHA for nitrous oxide
1000 ppm
in good health, what is the ratio of calcium to phosphrous in the blood
10:4
when gutta percha is heated, the transition form its beta phase to alpha phase occurs at
115 F
autoclave
121 C or 250 F at a pressure of 15 psi for 20 mins or 132 C or 270 F at a presusre of 30 psi for 8 mins
patients with a fasting plasma glucose level higher than _____ or a random plasma glucose of greater than _____ have diabetes mellitus
126 mg/dL, 200 mg/dL
normal platelet count is
150,000-450,000
functional integration of the gingival graft occurs by the
17th day
when is the closure of apicies
18 months after eruption
Applegates Rule
1: classification should be assigned after any extractions 2: missing third molars are not considered 3: abutment third molars are considered 4: missing second molars are not considered 5: most posterior edentulous area determines the classification 6: other edentulous areas are referred to as modifications 7: extent of modification does not matter, only number 8: class IV cannot have any modifications by definition
the optimal incisal reduction for a PFM crown is
2 mm
to ensure adequate strenth for the marginal ridge, the distopulpal line angle should NOT apprach the distal surface of the tooth closer than
2 mm
occlusal rest
2 mm deep in center outline form: rounded triangle, with apex toward the center of the occlusal surface concave (spoon shaped) occlusal surface triangle base is at least 2.5 mm wide rest floor is inclined apically (deeper) angle formed by occlusal rest and vertical minor connector must be less than 90 degrees always prepared after the proximal guide planes
the placement of a retraction cord should be under the free gingiva at
2 mm facial to the facial margin
rule of thumb for pins
2 mm in dentin 2 mm in amalgam and 1 mm from DEJ
how much is a custom tray on a preliminary cast trimmed
2 mm short of the mucosal reflection and frenae the primary indicator of border molding accuracy is stability and lack of displacement of the custom tray in the mouth
the prep for a full veneer crown is begun with occlusal reduction there should be ___ clearance on the functional cusps and about ___ on the non function cusps
2 mm, 1.5 mm
cobalt chrominum
2.3% shrinkage which causes irregularities and porosity cold working involves manipulating the metal while at abient temperature clasp assembly is cold worked every time it is seated and dislodges main reason why clasps break
a short arm clasp should be made in what gauge of wire for optimum function below its proportional limit
20 gauge
what is the range of the lethal dose of flouride
20-50 mg/kg
what kind of needle is used for IV sedation
21 gaugae needle with valium
have to lose about __% of enamel mineral before you can see a radiolucency
25
the strength, hardness and tensile strength of wrought wire is approx
25% greater than the cast alloy from which it was fabricated
condylar neck fractures
25% of fractures
the long axis of FPD abutments must converge no more than 1
25-30 degrees
autoclave
250 F for 15-20 mins
chemical vapor sterilizer
270 F at 20 psi for 20-40 mins requires use of orgainc solvents instead of water no corrosion or dulling instruments must be completly dired before processing
unsaturated chemical vapor sterilacation
270 F for 20-40 mins does not rust or corrode metal instruments and carbon steal
when are the best trimester for preggo work
2nd and 3rd for elective treatment
calcification of primary teeth begins during which of the following time periods
2nd trimester
amalgam has a coefficent of thermal expansion that is
2x tooth structure
how many teeth can be safely replaced with a fixed bridge
3
the minimal amount of tissue between the suture and the edge of the flap should be
3 mm
impant
3 mm both mesially and distally to the implant if next to another implant total space of >7 mm MD buccal and lingual have 1 mm of bone 2 mm from vital structrues
bone grafting procedure is most likely to be successful with
3 walled defect
per OSHA guidelines, what is the min amount of time required for employeers to keep employee trainig records
3 years
acidulated phosphate fluoride is most effective at what pH
3.2
max dose of ibuprofen
3.2 g/day
maximum allowable dose of 2% lidocaine with 1:000,000 Epi is
3.2 mg lidocaine per lb
the crowns of all 20 primary teeth begin to calcify between
3.5-6 months in utero
most self cured composite restorations require approx
30 sec for mix 1 min for insertion 3 min for final set
How much bone loss must occur before a standard X-ray can detect it?
30%a reduction of .5-1 mm thicknes of cortical plate is sufficient to permit radiographic visualization of destruction of inner cancellous trabeculae
dry heat oven
320 F for 120 mins sterliizes much less efficiently than moist hear a higher temp and a longer cycle time is required for sterilization to occur no dulling or corrosion of metals
dry heat sterilzation
320 F for 2 hours, 340 for 1 hr causes coagulation of proteins
the ave settings or values of the condylar inclination on the articulator for sagittal and lateraly condyle path inclinations respectivelya re
33 ad 15 degrees
microfill composite
35-50% filled
Prior to direct bonding, ______is used as an etching agent. Prior to placing bands, _________is used as an etching agent
35-50% unbuffered phosphoric acid nothing
rapid heat transferr sterilization
375 F for 12 mins for wrapped 6 for unwarpped
rule of 4
4 teeth every 4 months begining with 4 teeth at 7 months
the optimal absorption of energy for the activation of camphorquinone is which of the following ranges
400-499
visible light curved
410-500 nm with a peak intensity at 470 nm can cause retinal damage most serious limitation is polymerization shrinkage
flowable composite
44-54 % filled
the bevel angulation and width in a class IV composite prep is
45 degree .25-2 mm
packable composite
48-65%filled
max dose of acetaminophen
4g/day
max exposure of radiation per year
5 REM (.1 REM per week)
immediate dentures should be scheduled for relines at
5 and 10 months post extraction
a teaspoon can hold what volume of liquid
5 ml
per OSHA guidelines what is the min amount of time required for amployers to keep a sharps injury log
5 years
what is the ideal taper for a crown
5-6 degrees
sutures placed intraorally are normally removed
5-7 days postoperatively
microhybrid
50-66% filled
the minimal depth of a detectable carious lesion on a radiograph is about
500 micrometers
when taking radiographs the operator should stand at least
6 feet away from the patient
the definite threshold duration of force for tooth movement per day below hwich no bone remodeling takes place is
6 hrs
the min amount of protrustion for condylar guidance adjustment is
6 mm
how long does it take for a periapical radiolucency to reduce in size upon RCT treatment
6-12 months
time required to upright a molar
6-12 monthss
collagen
60% of gingival protein vitamin C is required for hydroxylation of praline and lysine which are essential for collagen formation most common it type 1 collagen
A full E cylinder of oxygen contains approx
600 L at a pressure of 2000 psi
the normal value for blood urea nitrogen is
7-18 g/DL
hybrid composite
70-77% filled
what generation bonding eliminates the need for separate etching rinsing and mixing for light cured
7th
at age of 6, a child's head is what percentage of its adult size
90%
what percentgae of 6 year old children have a median (maxiollary) diastema
98%
normal prothrombin time PT
<11 sec + 2 sec best test to determine if oral surgery can be safely performed on a patient taking Coumadin should be within 5-7 seconds
low gold alloys
<25% gold
base metal alloys
<25% noble metal content (no gold required)
bleeding time
<9 min
noble alloys
>25% noble metal content (no gold required)
high noble alloys
>60% noble metal content (gold >40%)
ADA type III alloys
>75% noble metals onlays and crowns
ADA type IV >75% noble metals. bridges and RPDs hardest high gold alloy
>75% noble metals. bridges and RPDs hardest high gold alloy
ADA type II alloy
>78% noble metals used for larger inlays on onlays
? Arc-Fixed Partial Denture ( Perel Pontic )
?concave M-D & convex underside F-L ( HYPERBOLIC PARABOLOID )
clarks twin block
?two piece appliance that postures the mandible forward ?the vertical seperation of the jaws also configured by the height of the bite blocks.
Maryland bridge
A conservative, prepared resin-retained prosthesis using a bonding procedure to hold to adjacent teeth; may be used in either anterior or posterior area. grooves for a resin bonded FPD provide mainly resistance form by preventing BL rotation cant use in patients with deep vertical overbite, extensive caries and nickle sensitivity, mobility
Herbst appliance
A fixed appliance that improves the overbite by encouraging lower jaw growth
glossopharyngeal neuralgia
A painful disorder of the ninth cranial nerve (glossopharyngeal nerve). Irritation of this nerve causes intense pain on one side of the throat near the tonsil area that can radiate to the ear. unilateral pain
Plummer vinson syndrome
A rare disorder associated with severe and chronic iron deficiency anemia, characterized glossitis, koilonychia (thin, spoon-shaped nails and dysphagia. Has been associated with esophageal squamous cell carcinoma.
ABC model
A= antecedents (trigger) B=behaviors C= consequences
Adderal
ADHA mixture of dextroamphetamine and amphetamine
Which odontogenic tumor is defined based on the presence of both odontogenic epithelium and odontogenic ectomesenchyme without a hard tissue formation?
Ameloblastic fibroma Ameloblastic fibroma is a benign odontogenic tumor arising from epithelial and ectomesenchymal tissues and produces no mineralized product. It is more common in patients 10-20 years old with unerupted teeth in 50% of cases. It appears radiographically as a sharply demarcated radiolucent lesion. Ameloblastomas are benign tumors derived from strictly odontogenic epithelium and not ectomesynchymal tissue.
antibiotics that treat sinus infections
Ampicillin- due to upper respiratory infections Penicillin and ammoxicilian- due to odontogenic foci
campers line
An imaginary line traced from the inferior border of the ala of the nose to the tragus of the ear
Therapeutic Effects of Aspirin
Analgesic-->inhibit COX 1 and 2 (PG synthesis) Anti inflammatory--> same Antipyretic (fevers)-->inhibits PG synthesis in temperature regulation center of hypothalamus bleeding time-->inhibit TXA 2 synthesis thereby inhibiting platelet aggregation
the mandible will deviate TOWARD the side of injury with
Ankylosis of the condyle (the most common cause of TMJ anklyosis is trauma) a unilateral condylar frecture damage to the lateral pterygoid muscle
8 year old patient fractured max central incisor after traume. There is a 3 mm opening into the pulp. What do you do?
Apexogenesis a pulpotomoy is performed and the chamber is filled with a layer of MTA, leaving the root intact and allows it to finish forming
isoproterenol
B1,2 agonist and the most potent bronchodilator
which syndrome classically contains lesions on oral, ocular and genital regions
Behcets syndrome
Semiadjustable Articulator
Bennet angle- 15 HCI- 30
Polymorphonuclear neutrophils (PMN) cause tissue damage while protecting host tissues because of the release of proteases during the degranulation process.
Both the statement and the reason are correct and related. Polymorphonuclear leukocytes or PMNs are the white blood cells of the immune system that actively engulf foreign bodies that enter the body. PMNs are the first defense cells to migrate to the site of injury and fight against pathogens during an acute inflammatory reaction. Although PMNs engulf and eliminate most of the pathogen, some pathogen are able to evade phagocytosis, causing an accumulation of PMNs in the affected area. The excess PMNs that are unable to engulf the pathogens die and degranulate which results in the release of host proteases which also may damage the hosts' cell matrix. The uncontrolled and destructive potential of host proteases released by the PMNs can kill pathogens and at the same time damage the host's tissue. Severe uncontrolled PMN functions may lead to endotoxic shock and disorders mediated by the immune complex.
vertical root fractures are best detected by
CAT scan
CREST syndrome
Calcinosis, Raynaud's, esophageal dysmotility, Sclerodactyly, Telangiectasia
Long-term exposure to low, chronic doses of X-radiation poses which of the following serious risks?
Carcinogenesis Repeated low doses of ionizing radiation may induce irreparable DNA damage which leads to errors in replication and transcription that result in carcinogenesis. Persistent low dose radiation can induce a type of genomic instability in cells that may trigger viral interactions leading to premature aging and carcinogenesis. Ionizing radiation results in the enhancing of the frequency of mutation and other genetic changes in the descendants of the irradiated cell after many generations of replication. Gap junction mediated cell-cell communication and activation of the p53 damage response pathway may result in carcinogenesis.
which two NSAIDs are only COX 2 blockers
Celecoxib and Meloxicam
nitrous oxide works on the
Central nervous system excteted solely via the lungs, unchanged nontoxic to body tissues main effects on the reticular activating system and limbic system MAC is 104
what classes have a fulcrum line
Class 1 and II
inflammatory gingival enlargement
Clinical findings include an Increase in gingival size, distortion of normal form, and change in tissue tone. There is significant increase in sulcular depth and pocket formation occurs (pseudopocket or relative pocket).
what should not be filled with composite
DL of canines is a class III lesion that should not be filled with composite resin
Dental Pharm
Dental Pharm
Which of the following conditions exhibit globular dentin, early pulpal obliteration, defective root formation, periapical granulomas/cysts, premature exfoliation, and appear to be normal clinically?
Dentin dysplasia is a hereditary disease characterized by a disturbance in normal dentin formation causing pulpal chamber obliteration, alteration or absence of root formation, and premature tooth exfoliation. Amelogenesis imperfecta affects ONLY the formation of enamel and NOT dentin. Dentinogenesis imperfecta is also a form of dentin dysplasia which causes dicoloration or some sort of translucency to affected teeth.
Christensen's phenomenon
Disarticulation of posterior teeth upon protrusion
burkitts lymphoma (HSV 4)
EBV non hodgkins lymphoma with a viral etiology endemic in africa! moth eaten appearance with poorly marginated bone destruction older abdominal mass and intestinal obstruction first human cancer with strong evidence of viral etiology
ENDO
ENDO
what is the doc to treat/reverse anaphylactic reactions
EPI
Bronchodilators
EPI, Albuterol, Salmeterol, Metaproterenol they stimulate beta receptors in the airway to cause bronchodilation
Each of the following aids in the diagnosis or evaluation of Sjögren's syndrome EXCEPT ONE. Which is the EXCEPTION?
Exfoliative cytology uses the scraped off or exfoliated tissues to evaluate and examine lesions through cytopathologic analysis and CANNOT be used to diagnose Sjögren's syndrome. Labial salivary gland biopsy is an important diagnostic tool in identifying affected salivary glands and is performed by taking a small sample of the salivary gland for analysis. Determining any abnormality in saliva flow rate may hint for the presence of Sjögren's syndrome. Sialograms are used to determine any blockage or clogged structure at the salivary ducts and glands. It is a helpful tool to diagnose or rule out Sjögren's syndrome.
Bass method: Sulcular Brushing
Filaments directed apically, positions the sides of the filaments parallel with the long axis of the tooth, brush head toward gingival margin to make a 45 degree angle to the long axis of the tooth. most effective and preferred
What reverses benzodiazepines?
Flumazenil
thalassemia major and minor
Hemolytic anemias low level of erythrocytes and abnormal Hg -Anemic pallor & flaring of maxillary anterior teeth
hemophilia
Hemophilia A- factor VIII Hemophilia B- factor IX hemophilia C- not sex linked and factor XI
Verruciform Xanthoma
Hyper plastic epithelium of mouth, skin, and genitalia, lipid-laden macrophages beneath epithelium, papillary but not associated with HPV
what is the most abundant immunoglobolin in gingivitis
IgG
Pt is experiencing inflammation at max molar interproximal areas. What immunoglobulin would be found during the primary immune response in this area
IgM
Pharmacokinetics
Increased blood flow--> shorter duration of action increased lipid solubility/hydrophobicity--> more potent, longer duration of action increase protein binding--> longer duration of action decrease pKa--> faster onset of action Mepivicane: 7,6m lido, prilo and articane 7.8 and bupivicaine: 8.1
to determine the number of clasps to use in a rpd
Kennedy class +1 does not apply to class IV
Measles (Rubeola)
Koplik's spots (buccal mucosa dot ulcers) precede skin rash primary--> self limiting and childhood
Parkinson's disease drugs
Levodopa bromocriptine selegiline amatadine Anticholinergic drugs (benztropine and trijexyphenidyl)
thyroid supplements to treat hypothyoridism
Levothyroxine sodium liothyronine Liotix
Amides (local anesthetics)
Lidocaine, mepIvacaIne, bupIvacaIne , articaine, prilocaine (amIdes have 2 I's in name)
Acinic cell carcinoma
Low-grade malignancy that consists of mature-appearing serous acinar cells; low clinical aggressiveness PAROTID GLAND
class I amalgam
M and D walls must diverge alightly towaards to the occlusal surface to provide support for mesial and distal marginal ridges
wall convergence on a class I prep
M and D walls should diverge B and L should converge
fibroma
MOST COMMON INTRA ORAL BENIGN neoplasm oF CONNECTIVE TISSUE most common tumor in the oral cavity most common on buccal mucosa, lateral border of tongue, and lower lip
radicular cyst
MOST COMMON ODONTOGENIC CYST mostly found at the root apex asymptomatic. tooth is necrotic, can be sensitive to percussionnnn
max 1 molar innervated by
MSA and PSA nerves
which type of cephalometric analysis provides a straightfoward way to etsablish skeletal relationship without having the movement affected by tooth position
McNamara analysis
A 42-year-old asthmatic patient who smokes and is human immunodeficiency positive (HIV+) presents to your office for a routine evaluation. Upon examination, you notice an asymptomatic red patch on the midline dorsum of their tongue and a marked loss of lingual papillae. Which of the following is the most likely diagnosis?
Median rhomboid glossitis is a condition characterized by a midline erythematous patch on the dorsum of the tongue immediately in front of the circumvallate papillae combined with a loss of lingual papillae. Median rhomboid glossitis is thought to be created by a chronic fungal infection, and usually is a type of oral candidiasis. Risk factors include: Smoking Denture wearing Corticosteroid sprays or inhalers Human immunodeficiency virus (HIV) infection
Oral Pathology
Mental Dental
Thyroid suppresants to treat hyperthyroidism
Methimazole Propylthiouracil
arteries that vascularize the TMJ
Middle meningeal artery Ascending pharyngeal artery Deep auricular artery Superficial temporal artery
therapeutic and side effects of morphine
Miosis Out of it Respiratory depression Pneumonia Hypotension Infrequency Nausea and vomiting Euphoria and dysphoria
pleomorphic adenoma
Most common benign salivary gland tumor Mix of more than one cell type ( epithelial and ct) Palate is most common site for minor gland lesions
if NE or EPI stimulate or combine with eye alpa receptors they cause
Mydrasis (pulpil dilation)
is there necrotic slough of positioned flaps
NO bc positioned flaps carry their vascular suppy with them
with onlays preps is showing a functional cusp indicated
NO DUH capping is always preferred
should solution liners be placed under composite restorations?
NO bc they inhibit the polymerization of the resin
can areas of support be determined by surverying
NO. DUH
pharmacodynamics of local anesthetic
Na channel blockers! only non ionized (free base) form can penetrate neuron membrane critical length ( better when 3 consecutive nodes of raniver are blocked
overdose and addiction
Nalxone- inverse agonist, emergency naltrexone- antagonist, treat addition methadone- treat addiction pentazocine- mixed agonist antagonist nalbuphine-mixed agonist-antagonist buprenophine-mixed agonist-antagonist
What is not always visible on radiographs?
Nasolabial cyst Nasolabial cysts are NOT always visible on radiographs because of their soft tissue origin and extraosseous occurrence. Nasolabial cysts are rare, non-odontogenic, soft-tissue, developmental cysts that occur inferiorly to the nasal alar region. They are also known as nasoalveolar cysts or Klestadt`s cysts.
two cystic radiolecencies in the mandible of a 16 yr old boy were lined by thin parakeratinized epithelium showing palisading of basal cells. all teeth were vital, and pt had no symptoms. what is likely the cause
OKC
Operative Dentistry
Operative Dentistry
PEDO
PEDO
multiple myeloma
PUNCHED OUT fatal malignant neoplasm/lesion of bone marrow and plasma cells. elevated Bence JOnes Protein and multiple radiolucent areas in the mandible and skull 40 + years old. Males 2x- females mandibular molar ramus area is the most cmomone intra oral site lateral skull radiograph best confirms
A patient exhibiting a "cotton wool" appearance of the bone on X-ray and an elevated level of alkaline phosphatase with normal calcium, phosphate, and aminotransferase concentrations in their blood is most probably suffering from which of the following diseases?
Paget's disease of bone is a chronic disorder that can result in enlarged and misshapen bones, pain, fractures, and arthritis. Paget's disease of bone is diagnosed by the presence of an elevated level of alkaline phosphatase and normal calcium, phosphate, and aminotransferase levels in the blood. The pathognomonic sign for Paget's disease is a radiopaque "cotton wool" appearance of the bone on X-ray. Other signs of Paget's disease include: •Enlarged skull and facial bones •Enlarged maxilla and alveolar ridges •Displaced teeth •Hypercementosis
Patient Mang
Patient Mang
full thickness flap
Periosteum is reflected to expose the underlying bone. Indicated in resective osseous surgery. -Flap is elevated by blunt dissection with periosteal elevator used where attached gingiva is thin (<2 mm wide) apically and coronally positioned flaps are full thickness
instruments used for implant debridement are
Plastic resin instruments Graphite instruments Gold-tipped (titanium nitride) instruments Ultrasonic scaler with plastic tip
A patient presents to your office with an indurated submucosal tumor that when biopsied, suggests a neoplasm of glandular and myoepithelial origin. Which of the following is the most likely diagnosis?
Pleomorphic adenoma Pleomorphic adenoma is a common benign salivary gland neoplasm of glandular cells along with myoepithelial components, that can potentially become malignant. It is the most common variety of salivary gland tumor and also the most common tumor of the parotid gland. Pleomorphic adenoma derives its name from the architectural pleomorphism (variable appearance) observed with light microscopy. The tumor usually presents as a slowly proliferating, painless, indurated, single nodular mass. Schwannomas and mucoceles are not indurated or firm. Fibromas, mucocoeles, and schwannomas do not present microscopically with glandular or myoepithelial cells.
Albright syndrome (McCune-Albright syndrome)
Polyostotic fibrous dyslasia Patchy skin pigmentation i.e. cafe-au-lait spots Endocrine abnormality e.g. precocious puberty in girls 25% facial symmetry
W arch
Porter appliance used for expansion of upper and lower teeth widens only the teeth in the arch form and reduce crowding efficient for correction of posterior crossbite
Esters (local anesthetics)
Procaine, cocaine, tetracaine, benzocaine more toxic and more allergic due to presence of methylparaben
Prosth
Prosth
POMP regimen
Purinethol, Oncovin, Methotrexate, Prednisone treats ALL
polycythemia vera
RBC too big= blood clots and stroke
Hep A
RNA enterovirus fecal-oral route young adults shellfish damage to liver causes increased serum levels of enazymes like transaminases recovery in 4 months
Which diagnostic test would best allow a clinician to differentiate between amelogenesis imperfecta from dentinogenesis imperfecta?
Radiographic appearance Amelogenesis imperfecta is a hereditary tooth development disorder in which the teeth are covered with thin, abnormally formed enamel. Amelogenesis imperfecta involves weak and abnormally formed enamel. The enamel is avascular and highly calcified and does not contain the proteins ameloblastin, enamelin, tuftelin, and amelogenin. •The affected teeth are often yellow or brown. •The teeth of patients with osteogenesis are more likely to have a blue hue. •Severity of amelogenesis imperfecta ranges from complete absence of enamel to minor defects. •The enamel is deposited, but fails to fully mature. •The crowns of these teeth are often subject to rampant caries and excessive attrition. Radiographically amelogenesis enamel may appear totally absent. When present may appear as a thin layer, chiefly over the tips of the cusps and on interproximal surfaces. Squarish type of crown but devoid of the normal mesial and distal contours. Radiographically dentinogenesis appear with bulbous crowns with constricted short roots. Initially pulp chambers may be abmormally wide and resemble shell teeth but will progresseively obliterate.
Radiology
Radiology
eaton lambert syndrome
Similar to myasthenia gravis, but is caused by inadequate release of Ach
Metastatic squamous cell carcinoma of the tongue will likely migrate to which of the following sites first?
Squamous cell carcinoma of the tongue most commonly migrates to the cervical lymph nodes because the lingual lymph drainage occurs through the cervical lymph nodes. The spread of carcinoma in the cervical lymph nodes typically results in its poor prognosis. Surgical neck dissection is typically used to treat this type of cancer.
the mucoginigval surgical technique of choice for root ocverage in isolated upper teeth is
Tarnow technique
curve of spee
The anterior- posterior anatomic curvature of the occlusal surfaces of the teeth
density-
The overall darkness or blackness of an image increases as Ma, kVp or exposure time increases and decreases as mA, kVp or exposure time decreases
most common cause of TMJ ankylosis is
Trauma
Syphilis
Treponema pallidum 1 primary : non painful ulcer/canker that appears 26 weeks after exposure 2: a highly infectious stage that occurs 6 weeks after non treatment of primary syphilis. skin rash with brown penny sized sores 3. tertiary : a gymma!
Alginate Irreversible Hydrocolloid
Trisodium phosphate controls the setting rate Diatomaceous earth adds strength more bulk means less susceptibility to unwanted dimensional changesd 2-3 min remove tray within 15 mins--> pour impression 30-60 min cast setsd
Four types of High Gold Alloys
Type 1: highest gold content- 83% noble metals. easily burnished and intended for small inlays type 2: greater than 78%. larger inlays and onlays type 3- greather than 75%. for onlays and crowns type 4- greater than 75%. for bridges and partials. hardest of all!
Hypothyroidism
WEIGHT GAIN, cold intolerance, lowered pitch of voice, slowness, puffiness of face, eyelids, and hands Myxedema, cretinism
sensitivity
WITH the disease
specificity
WITHOUT disease
highest incidence of fractures occurs in
Young males ages 15-24
in order to produce a 1:100,000 concentration of vasoconstrictor
a 1 ml of 1:10,000 concentration is added to 9 ml of solvent
Acebutolol
a B1 cardioselective antagonist that treats hypertension and controls ventricular arrhythmias. it has low lipid solubility which reduces its liklihood of producing adverse CNS effects
Analeptic
a CNS stimulant with the ability to overcome drug induced respiratory depression and hypnosis
Aminophylline
a Theophylline compound administered orally as bronchodilators in reversible airway obstruction due to asthma or COPD relax bronchial smooth muscle to improve airway function a CNS stimulant that treats asthma
first order bend
a bend of ortho wire in horizontal plane
aneurysmal bone cyst
a benign bone lesion generally regarded as a reactive process a rare expansile bone lesion consitening of a proliferation of vascular tissue that forms a lining around blood filled cystic lesions equal males- females lesions are tender and painful blood soaked sponge radiographically: cystic with a honeycomb or soap bubble
papillary fibroma
a benign neoplasm of CT origin
neurilemoma (schwannoma)
a benign soft tissue tumor of Schwann cells around the nerve that presents as an asymptomatic lump most common on the TONGUE!. covered by normal mucosa, sessile and does not metastiase but still do biopsy Tx: conservative excision
Adenomatoid odontogenic tumor
a benign tumor of ectodermal origin children and teenagers females 2x anterior maxilla snowflake calcifications
central giant cell granuloma
a benign tumor. occurs almost exclusively in the jawbones after trauma 0-20 years (females) most common in anterior segment of females slight to moderate bulging of the jaw tx: curettage or surgical excision
lymphangioma
a benign yellowish tan tumor composed of a mass of dilated lymph vessels most common site is the tongue painless, nodular, vesicle like swelling that equally affects both sexes
thrombocytopenic purpura (Werlhof's disease)
a bleeding disorder characterized by a deficiency in the number of platelets resulting in multiple bruises, petechiae and hemmorrhage into the tissues may be caused by heparin (warfarin ) therapy
idiopathic throbocytopenic purpra
a bleeding disorder due to a deficiency in the number of platelets causing multiple bruises, petechiae, and hemorrhage bleeding time is abnormally prolonged
fibrous dysplasia
a bone disorder of unknown cause that destroys normal bone structure and replaces it with fibrous tissue GROUND GLASS monostotic- involves one bone polyostotic- involves more than one bone albrights syndroms- involves more than one bone with endocrine disturbances a symtomatic alteration of bone need to do skull radiograph and blood chemistries to confirm the diagnosis tx: surgery you never see the lesions borders it blends with the bone
giant cell tumor
a bone tumor of multi nucleated giant cells that resemble osteoclasts scattered in a matrix of spindle cells
indirect pulp capping
a calcium hydroxide base is placed on a thin layer of questionable dentin remaining over the pulp
Zinc Oxide EUgenol
a cement that has been used as a base root canal sealer acts as a lubricant to facillitate gutta percha cone placement forms a bond betwen the gutta percha and dentin walls exerts antibacterial activity
developer solution
a chemical solution that converts the invisible image on a film into a viisble image composed of minute masses of black metallic silver. its function is to reduce silver halide crystals to black metallic silver
myasthenia gravis
a chronic condition of extreme muscle weakness due to an autoimmune disorder where the body creates antibodies against its own nicotinic ACh receptors in the neuromuscular junctions muscles are quicly fatigues with repetitive use flattened smile and droopy eyes xerostomia and rampant caries may be present because ACh needed for proper transmission of nerve impulses is destoryed, so salivary glands no not recieve adequate stimulation
sickle cell anemia
a chronic disease marked by crescent shaped red blood cells characterized by fever, leg ulcersm jaundice and episodic pain due to production of abnormal hemoglobin (hemoglobin S) due to a genetic defect primary affects african americans radiographs show enlarged bone marrow medullary spaces because of loss of many bony trabeculae lamina dura and teeth are unaffected
Pagets disease
a commone, chronic, non metabolic bone disorder characterized by an increase in serum alkaline phosphatase levels bones become enlarged and deformed, dense, but fragile due to excessive breakdown and formation of bone has potential to undergo spontaneous malinant transformation COTTON WOOL on pan effects males and females equally, but rarely under 40 yo signs and symptoms: pain in affected area, bone deformity and susceptibility to fractures in the affected area, headache and heaing loss. occur slowly increase in hat size or need for new dentures bones warm to touch due to increased vascularity lab tests show highly increased serum alkaline phosphatase, urinary calcium, and hydroxyproline with normal levels of serum phosphate and calcium tx: anti metabolites or CALCITONIN ti decease bone resportion or teat with a high protein and high calcium diet
concrescence
a condition where only the cementum of two or more teeth are joined
Methacholine is related to acetylcholine as
a congener
down syndrome
a congenital defect caused by chromosmal abnormality Trisomy 21, marked by various degrees of mental retardation and characteristic features: short, flattened skill, slanting eyes, thickened tongue/fissured , broad hands/feet) oral manifestations: mandibular prognathism, increased periodontal disease, thickened or fissured tongue, delayed teeth eruption, high incidence of congeitally missing teeth, malocclision and enamel dysplasia
Cystic fibrosis
a congenital/genetic metabolic disorder that causes exocrine glands (glands that secrete fluids into a duct) to produce abnormal secretions mainly affecting GI and respiratory systems mucous producing glands produce secretions that clog airways allowing bacteria to multiply. CF is the MOST COMMON genertic disease causing death among white people in the US and is equally common in boys and girls Oral manifestations- staining of teeth as patients with CF are usually subjected to large amounts of tetracyclines during childhood. a high % have dark colored teeth. there is a greatly reduced caries rate in CF patients, probably due to saliva laterations and long term use of antibiotics
a periodontal probing defect that may not be managed by endo treatment alone is
a conical shaped probinb-- this is typically primarily of periodontal problem
copayment
a cost sharing arrangmenet in which an insured pays a specified charge for a specified service
translation
a coupled force applied to control root movement in same direction as crown movement
bisphosphonate osteonecrosis (BON)
a dental phenomenon that may lead to surgical complications (bone necrosis) due to impaired wound healing after extractions, perio surgery, or RCT caution with patients taking IV bisphosphonates (Zometa and aredia) caution for patients taking oral bisphosphonates (fosamax, actonel and bonica)
capitation
a dentist is paid a fixed amount, usually on a monthly basis
stress breaker
a device that relieves the abutment teeth to which an FPD or RPD is attached of all or part of the forces generated by occlusal the functional stress in directed onto the residual ridge and only minimal transfer of functional stress to abutment teeth occurs
storage phosphor imagine
a digital imaging system that uses a reversible imaging plate rather than a sensor to record the image
Albright's syndroms (McCune Albright Syndrome)
a disease of unknown cause female premature puberty most severe form of polyostotic fibrous dysplasia, cafe au lait skin spots and endocrine abnormalities
gemination (twinnind)
a dividion of a single tooth germ b invagination causing incomplete formation of two teeth (usually the incisors)
pharmacologist agonist
a drug that binds to physiologic receptors to result in specific cellular effects
pharmacologist antagonist
a drug that binds to the physiologic receptor, but does not trigger an effect
chloral hydrate
a drug widly used for pediatric sedation by acting on the CNS to induce sleep children often enter a period of excitement and irritability before becoming sedated
capitation fee
a fixed monthly payment paid by a carrier to a dentist based on the number of patients assigend to the dentist for treatment
aplastic anemia
a form of anemia where bone marrows cpacity to produce RBC is defective the most serious and life threatening blood dyscrasia associated with drug toxicity 1. primary anemia- unknown cause 2. secondary enamia-caused by exposure to toxic agents
apically positioned flap
a full thickness mucoperiostal flap that is the work horse or perio surgically eliminates pockts by positioning the flap apically while retaining the attached gingivia crown lengthening!
cerebral palsy
a group of disorders affecting body movementand muscle coordination due to an insult of anomaly of the barins motor contorl centers spastic paralysis over voluntary muscles no oral pathologic manifestations are present but several conditions are more common or severe including: high incidence of peio, caries, bruxism and malocclusion prone to ginigival hyperplasia if Dilantin is used to control seizures more suspectible to trauma, especially max anterior teeth
porphyria
a group of disordes involving abnormalits in the production of heme pigments, myoglobin and cytochromas can result in discoloration of teeth 1. photodermatitis 2. neuropsychaitric complaints visceral complais
muscular dystrophy
a group of genetic diseased marked by progressive weakness and degeneration of skeletal or voluntary muscles that control movement oral manifestations: increase in dental disease of OH is neglected, weakness in muscles of mastication causeing decreased maxillary biting force, higher incidence of mouth breathing and open bite
enamel hypocalcification
a hereditary dental defect where the enamel is soft and undercalcified yet normal in quantity due to defective maturation of ameloblasts teeth are chalky, surfaces wear down rapidly and a yellow brown stain appears due to underlying exposed dentin
a drug with a high LD50 and low ED50 has
a high therapeutic index, thus is relatively sade
Acromegaly
a hormonal disorder that occurs when the pituitary gland produces excess growth hormone due to a benign tumor after adeloscence (fusion of long bone epiphyses) most commonly affects middle aged adults and can cause serious illness and premature death in >90% of patients GH overproduction is caused by a benign tumor of it pituitaty gland (adenoma) oral manifestations_ enlarged tongue, mandibular prognathism (Class III), teeth are tipped to buccally or lingually due to enlarged tongue and roots may be longer than normal gigantism- caused by a benign tumore before adolsecence (non fusion of epiphyses)
for a custom post and core place
a keyway or groove to prevent roation
labial melanotic macule
a lesion on the lips (mainly lower lip) and almost always near the midline
suspension liner (ZOE)
a liquid where calcium hydroxie and sometimes zinc oxide are suspended in a solution of natural or synthetic resins are thicker 15 microns than solution liners (1-5 microns) pallive effect on pulp Dycal-- most commonly used usupension liner that prevents thermal shock
Concerta
a long acting form of Ritalin
basal cell carcinoa
a malignant epithelial cell tumor that begins as a papule that enlarges peripherally forming a central crater that erodes, crusts and bleeds only found on the skin, and never in the mouth due to excessive sun exposure most common skin cancer. rarely produces metastasis
quenching
a metal is rapidly cooled from an elevated temperature to room temp or below
malleability
a metals ability to be hammered into a thin sheet without rupture depends on plasticity increases as temperature increases
Methylphenidate (Ritalin)
a mild CNS stimulant that increases attention span, reduces hyperactivity and improves behavior in children with ADHD
dental porcelin
a mixture of Feldspar, quartz and metallic oxides
vacuum investing
a mthod of investing that is more dependable in preventing surface nodules/ defects on a casting
keratoacanthoma
a non painful crater formed lesion (viral) growing for 2-3 months in the SKIN that looks like squamous cell or basal cell carcinoma and can heal by itself but must still do biopsy
phentoalmine hydrochloride
a non selective blocker of both alpa 1 and alpha 2 receptors pre surgical management of Pheochromocytoma
prolonged bleeding time conditions
a patient taking Dicumarol- inhibits formation of prothrombin in the liver a patient taking heparin- acts as an antirhombin by preventing platelet aggregation idiopathic thrombocytopenic purpura often assoicated with leukemia von willebrands disease- deficiency of vWF results in impaired platelet adhesion long term treatment with asprin
tongue position and dentures
a patient with a retracted/retruded tongue is a poor denture candidate the tongue affects stablility and retention
actinic cheilits
a pre malignant condition cause by chronic and excesisve exposure to the UV sunlight there is a thick whitish discoloration of the lip at the border of the lip and skin may lead to SCC so must be treated
intraconronal retainer
a precision attachment with key and keyway pattern more esthetic because no clasps
body osteotomy
a procedure that involves extractingmandibular teeth bilateraly, a piece of bone is removed form the mandible and everything lides back corrects mandibular prognathism (class III)
filing
a push pull action with emphasis on the withdrawal stroke prodeces a canal that is irrgular in shape
rhabdomyoma
a rare benign tumor of skeletal muscle tongue is most common sessile nonpainful and covered by normal mucosa
gingival cyst
a rare circumscribed swelling of the gingiva usually found in the canine and premolar areas on the mandible. can be easily excised
calcifying epithelial odontogenic tumor (Pindborg tumor)
a rare lesion purely from ectoderm 30-50 years old mandible (molar-pm area), painless, slow growing swelling is the most common clinical sign scalloped margin impacted tooth (3rd molar mandib)
osteoporosis
a reduction of total skeletal mass due to increased bone resorption causing a predisposition to pathologic fractures by calcium or estrogen deficiencies bone becomes less dense and brittle most common in thin, eldery white eomen Tx: estrogen therapy, calcium and vitamin D
scleroderma
a relatively rare autoimmune disease affecting the blood vessels, and CT characterized by hardness and rigidity of the skin and subcutaneous tissue clinical features: middle age in females!. the skin is affected first and becomes indurated
frankels appliance
a removable functional appliance used for abnormal hyperactive soft tissue patterns
back action clasp
a ring clasp modification use is difficult to justify bc you can use a c clasp
thrombotic thrombocytopenic purpura
a severe and fatal form characterized by thrombocytopenia, hemolytic anemia, renal insufficiency, fever and neurologic ambornamlities.. low platelet count in the blood and thrombosis in the terminal arterioles and capillaries of many organs
stevens johnson syndrome
a severe bullous form of erythema multiforme where systemic symptos are severe acute onset of fever, and eruptive ulcerative lesions on skin, oral mucosa and eyes BULLS EYE SHAPED LESIONS tx: IV fluids, systemic steroids, pallative rinses and antibiotics
erythoblastosis fetalis
a severe hemolytic disease of the fetus or newborn caused by the production of maternal antibiodies for fetal RBC usually involves the Rh factor incompatability in between mother and fetus hemolytic reaction only occurs when the mother is Rh - and infant is Rh + oral manifestations- teeth have a green, blue or brown hue. enamel hypoplasia
sialoscintigraphy
a simple, non invasive procedure that seperates benign tumors of the salivary glands from malignant tumors and greatly affects the course of treatment
oncocytomas
a small, benign, rare glandular tumor composed of large cells with a granular and eosinophilic cytoplasm due to the presence of many mitochrondria development may be due to aging process cells have bright pink cytoplasm
nasolabial cyst (nasoalveolar cyst)
a soft tissue cyst of the upper lip superficially located in soft tissue of the upper lip that histologically develops from epithelial remnants from the inferior and anterior portion of the nasolacrimal duct cannt see this cyst on a radiograph
oral traumatic neuroma
a soft tissue tumor due to trauma to a peripheral nerve, usually appearing as a very small nodule of the mucosa near/over the mental foramen on the alveolar ridge in edentulous areas.!! but they can occur whereever a tooth has been extracted may be due to trauma from a surgical procedure painful when palpated as applied digital pressure elicits a response described as electic shock multiple neuromas on the lips, tongue or palata may indicate MEN III Tx: surgical excision of nodule
eruption cyst
a soft tissue variant of the dentigerous cyst, invariably associated with an erupting tooth reddish pink or bluish pink black, fluctuant, localized swelling of the alveolar ridge over the crown of an erupting primary or permanent molar
hydrogen bonds
a special type of interaction between polar (water) molecules
actinomycosis
a subacture to chronic bacteria infection with Actinomycoses which are gram positive filamentous bacteria that are normal inhabants of the oral cavity SULFER GRANULES chronic suppurative lesions about the jaws lumpy jaw!
where there is a point to surface contact of the cusps, it should be changed to
a surface to surface contact
frequency distributions
a tabulation of values that one or more variables take in a sample
cholinergic
a term for a nerve ending that releases Ach stimulation of sweat, salivary, tear and bronchial glands stimulation of smooth muscles of the bronchi, GI tratc slowing of heart constriction of pupils
compound odontoma
a tumor of enamel and dnetin common in the anterior maxilla derived from ectodermal and mesenchymal components of tooth germ 20-30 years miniture teeth mandible premolar/canine area groups of small radiopacities
gomphosis
a type of fibrous joint where a conical process is inserted into a socket like portion
tylenol
a weak inhibitor of prstaglandin synthesis lacks anti inflammatory effects of aspriin, but is a good analgesic when aspriin or ibuprofen are contraindicated better to used in GO, bleeding disorders, asthma, young children and pregnancy no peripheral anti inflammatory effects does not affect platelet aggregation or the coagulation pathway 2 major pharm actions: analgesic and antipyretic large doses= liver toxicity does not affect bleeding time
specificity
ability of the test to classify health
sensitivity
ability of the test to diagnose correctly with a condition or disease that actually exists
abrasion
abnormal, pathologic wearing away of tooth structure 1. toothbrush abrasion- V shaped wedges at cervical margins 2. occlusal abrasion- flattened cusps on posterior teeth and worn incisal edges
PDL ave thickness in an adult
about .25 mm
when does periodontium remain healther when crown margins are
above the gingival crest
hypodontia-
absence of only a few teeth
strep mutans are _______ and therefore ___________--
acidogenic; cariogenic
antimetabolites
act in the S phase of the cell cycle by interfeing with the biosynthesis of purine and pyrimidine bases
constructive aggression
act of self assertiveness
chelating agents
act on calcified tissues with little effect on periapical tissue act by substituting Na_ ions that combine with dentin to form soluble salts for Ca_ ions that are bound in a less solutble concentration EDTA0 removes the mineralized portion of the smear layer EDTAC- is EDTA + cetavolon RC-PREP- a foamy solution that combines funciton of EDTA +urea perxide to provide chelation and irrgeation. has a natural effervescence
which is more likely to develop into a malignant lesion
actinic cheliitis
the distobuccal extension is limited by the
action of the superior constictor muscle
dimethyl-p-toluidine
activator
Antivirals and antifungals
acyclovir and valcyclovir->herpes fluconazole, ketoconazole--> candidasis clotrimazole (mycelex) is in the troche form
effects of radiation are
addative
the principal feature of a sealant required for success is
adequate retention
first step in fitting a gold inlay casting in the mouth is to
adjust proximal contact areas
what is the first step in fitting the casting
adjust proximal contacts
addisons disease
adrenal cortex hypofunciton of cortisol-- not enough cortisol is produced the hypofunciton is either due to an andrenal gland disorder or inadequate secretion of ACTH by the pituitary gland causes bronzing of entire skin main dental concern is that patients adrenal cotetx has no capacity to produce extra cortisol in response to stress, which may result in addisons crisis
giantiform cementoma
affects middle aged black women. multiple, often symmetrical , may cause jaw expansion large dense lobulated readiopaque masses
osetogenesis imperfectia (brittle bones)
affects the collagen production person either has less collagen than normal, or poorer quality of collagen than normal causeing weak bones that fracture/ break easily main clinical characteristic is extremly fragility and porous bones with a proneness to fracture due to the effects of inadequate osteoid production additional clinical features: blue sclera, deafness , loose joints, low muscle tone, triangular face teeth have bulbous crowns with a cervical constriction, partially or completely obliterated pulps and narrower or shorter roots, may be linked to dentinogenesis imperfectia Tx: no known cure
insufficient VDO
aging appearance of lower third of face because of thin lips, wrinkles, chin too near nose angular chelitis
what does the optimal concentration for flouride for community water depend on
air temperature
primoral cyst
aka follicular cyst well defined, oval radiolucent lesion that differs from other cysts since it contains no calcified structures found in the mandibular 3rd molar space found in place of a tooth rather than direclty associated with a tooth
glutaralhyde
alkalizing agent highly lethal to all microogansima can be used on heat sensitive materials
for a rubber dam to be stable what must contact the tooth ginigval to the height of contour
all 4 points of the clasp
Palatal strap
all major connectors should cross the midline at a right angle
shoulder margin (butt joint)
all porcelin/emax crowns poorest finish line used with cast metal restorations
erythema multiforme
allergic hypersensitivity in response to medications, infections and illness damaged skin blood vessels with subsequent damage to skin tissues bulls eye shaped lesion
wegeners granulmoatosis
allergic reaction to inhaled antigen strawberry gingivitis tx: corticosteroids and cyclophosphadmie
which of the following osseous grafting materials is harvested from a human donor and placed in another human
allograft
inferential statistics
allows someone to generalize from the sample of data to a larger group
nasal decongestant
alpha 1 agonist causes vasoconstrictor with Phenylephrine
Phenylephrine
alpha 1 selective agonist. a nasal decongestant and mydriatic in ophthalmic preparations to treat chronic orthostatic hypotension 100 x less potent then EPI
clonidine
alpha 2 selective agonist. used as a anti-hypertentive agent
clonidine
alpha 2 selective agonists works by controlling nerve impulses along certain nerve pathways to relax blood vessels so bood flows through them easier to help lower Bp reduces Hr, co and total peripheral resistance
centrally acting anti hypertensive agents
alpha 2 selective agonists that inhibit adrenergic nerve transmission through actions within the CNS they reduce BP by reducing cardiac output, vascular resistance or both
Traumatic Bone cyst
also called simplle bone cyst and idiopathic bone cavity large radiolucency scalloped around roots no epithelial lining (dead space) in mandible of teens usually associated with jaw trauma Tx: aspirate to diagnosis, just monitor
Candidiasis
also known as thrush pseudomembranous-white plaque that rubs off atrophic- red median rhomboid glossitis-loss of lingual papillae angular cheilitis- corner of mouth Tx: antifungal (azole or statin)
I bar
always place the tip of I bar retentive arm Mesial to the greatest MD curvative on the abutments facial surface to ensure retention in the undercut the undercut must be mesial the greatest MD curvature on the abutments facial surface the foot of the i bar is completely below the height of contour in distal extension designs when a patient bites down the I bar should release from the undercut
reduction
amount of occlusal tooth structure removed during the prep (1.5-2)
clearance
amount of space left between tooth prep and opposing tooth (1.5-2)
agranulocytosis
an abnormal condition due to severe reduction in the number of granulocytes caused by ingesting a drug prounced leukopenia WBC <2000 with almost complete absence of PMN neutrophils begins with high fever, chills and sore throat necrotizing ulcerations of the oral cavity eliminate the causative drugsic
odontogenic myxoma
an aggressive tumor derived from the papilla, dental sac or PDL adults 30-40 yrs as a painless welling in the mandible tx: curettage with cautery. high rate of recurrence if inadequatly treated
dental managed care
an arrangement whereby a third party payer mediates between doctors and patients, negoitating fees for service
pyogenic granuloma (pregnancy tumor)
an elevated ulcerated mass that bleeds easily pregnant woman caused by minor trauma tx: excision. has exuberant granulation tissue microscopically benign most common site is the inter dental gingiva- but may also occur on the lower lip, tongue and buccal mucosa
trigeminal neuralgia
an excruciating, painfull illness where the person feels sudden stab like pains in the face that usually last only moments. but are among the most sevre pain humans can feel paroxysmal episodes may last hours Tx: Carbamazepine which is an analgesic and anticonvulsant
Pierre-robin syndrome
an inherited disorder with the following findings in the neonate: -micrognathia-smallness of the jaws -glossoptosis- downward displacement or retracted tongue - breathing problems and cleft palate
amelogenesis imperfecta
an inherited heredity ectodermal defect transmitted as a dominant trait that affects the deciduous and permanent dentition causing enamel to be soft, thin and yellow due to exposed dentin though the thin enamel layer radiographic findings are often distinctive and pathognoonic dentin pulp, and cementum are not affected by AI AI will only show pulp obliteration if there is advanced abrasion with secondary dentin formation 1 Hypoplastic AI- enamel has not formed to full normal thickness. defective formation of the enamel matrix 2. hypomaturation AI-immature crystallites 3. hypocalcifed AI- quantity of enamel is normal but so soft it can be removed during prophylaxis due to the defective minerralization of the enamel matrix
globulomaxillary cyst
an inverted pear shaped radiolucency in bone between the roots of the maxillary lateral and canine (often causes roots of the involved teeth to diverge) usually asymptomatic . regional teeth are vital occurs within bone inverted pear shaped radiolucency
DMFT index
an irreversible index applied only to permanent teeth groups caries susceptibility cant be used for root caries or sealed teeth
dentigerous cyst
an odontogenic cysts always associated with the crown of an unerupted or developing tooth or dental anomaly most commonly found with a developing 3rd molar the bulging the cyst produces on the ridge is an eruption cyst found in children and teenagers 2nd most common odontogenic cyst
Osteopetrosis -Albers-Schonberg disease -Marble bone disease
an uncommon genetic disorder that manifests in infancy characterized by an overgrowth and denseness of bones due to a defect in osteoclasts which are needed for bone marrow formation. the long bones become dense and hard to the extent that bone marrow is obliterated bones are hard but brittle and dense clinical signs: abnormal bone and dental development, fragile bones, stunded growth anemia, spleen, and liver enlargement. blindness and progresisve deafness
granular cell myoblastoma (tumor)
an uncommon neoplasm of unknown etiology, presenting as an uninflamed, asymptomatic mass tongue is the most common location in the head and neck region females>males
freys syndrome (auriculotemporal syndrome)
an uncommon phenomenon due to damage to the auriculotemporal nerve can occur after surgery gustatory sweating is the chief complaint
condensing osteitis (chronic focal sclerosing osteomyleitis)
an unusual bone reaction to an infection (most often associated with a long standing periapical infection) occuring in instances of extremely high tissue resistance or in cases of low grade infection. there may be no signs and symptoms of the disease. Mandibular 1st molar is the tooth most commonly involved periapical radiographs show pathognomonic, well circumscribed radiopaque mass of sclerotic bone surrounding and extending below the apex of one or both rooths. the entire root outline is always visible (important feature that distinguishes it from a benign cementoblastomia) can be treated with RCT or extracted. the sclerosis bone remains after the tooth is treated or removed
therapeutic effects of steroids
analgesic-->inhibit phospholipase A2 (AA synthesis) anti-inflammatory--Same
where is the most common anatomic site of fracture in the mandible
angle
bennet angle
angle obtained after nonworking side condyle has moved anteriorly and medically relative to the sagittal plane 15 on articulator
taper or parallelism
angle of convergence formed between two opposite prepared axial surfaces, most operator control
what is the most common complication of rheumatoid arthritis
anklyosis
Determinants of Occlusion
ant. guidance post guidance cuspal anatomy tooth arrangement
all cast claps both suprabuldge and infrabula are never placed where
anterior to the fulcrum line bc they would release during functin and toque the abutment
curve of spee
anteroposterior curve to ensure loading into long axis of each tooth more mesial inclination as you move distally
midazolam
anti anxity and makes child sleepy and relaxed
Warfarin (coumadin)
anticoagulants that antagonize vitamin K to prolong blood clotting time, causing decreased liver synthesis of vitamin K dependent factors (II, VII, IX, X) warfarin inhibits blood clotting by affecting the coagulation pathway to prevent fibrin formation used after myocardial infarction to prevent coronary occlusion, treat pulmonary embolisn and venous thrombosis
drugs that cause orthostatic hypotension
antihypertensives phenothiazines tricyclic antidepressants narcotics antiparkinsons drugs gamma blockers
the type of patients who are poor candidates for home care instructions are
anxious
odontoma
any odontogenic tumor often assoicated with an unerupted tooth. 14 years old
Catecholamines
any one of a group of sympathomimetic coumpounds composed of a catechol molecule and the aliphatic portion of an amine EX: Epi Norepinephrine Isoproterenol Dopamine DObutamine
true pocket
apical migration of the epithelial attachment beyone its physiological level which is noramlly at or near the CEJ
which portion of the pulp contains more collagen
apical portion
which locations would a perforation demonstrate the best prognosis?
apical third of the root the more apical the perforation, the more favorable the prognosis for the tooth, except for perforations of the crown
infrabuldge retainers
approach abutment undercut from a gingival direction below the height of contour contra indicated: if a tissue undercut exists or with high frenum attachments or excessive buccal or lingual tilt of the abutment tooth
Cleft lip
approx 1 in 1000 births unilateral (80%) bilateral (20) lack of fusion between medial nasal process and maxillary process
the b,p and m sounds
are made by the contact of the lips
alpha receptors
are mainly excitatory in nature
indirect retainers
are placed as far away from the distal extensin as possible to prevent vertical dislodgement of the base from the tissue increases the effectiveness of direct retainers and prevents the RPD from rotating around the fulcrum line the greater the distance between the fulcrum line, and IR the more effective the IR prevents vertical dislodgement!
K files
are the strongest and cut the least aggressibely
epilus fissuratum
area of the denture borders more common in the maxilla
secondary radiation
arises from interactions of the primary radiation beam with atoms in the object being imaged most scattered x rays in diagnostic x ray imagine arise from Compton scattering. a leaded, rectangular cone best reduces the amoutn of scatter radiation
branchiogenic cyst
arises from the persistence of the second branchial arch cleft cyst is located along the anterior border of the sternocleidomastoid muscle at any level in the neck tx: surgical excision
Dwarfism
arrested growth caused by under secretion of growth hormone oral manifestatios: delayed eruption rate and shedding of teeth, clinical crowns and roots appear smaller, dental arch is smaller causing malocclusion and under developed mandible most common type is Acondroplasia = child is very short, fingers are stubby, bowed legs, bulging forehead, bossing of frontal bones, saddle like nose and mandibular prognathism
sensitivity and specificity are inversely proportional
as the specificity of a test increases, the sensitivity decreases
chemical burn
aspirin, hydrogen perocxide, silver nitrate
when a diagnosis of OKC is made, the pt should be advised regarding the ____
associated recurrence rate
hypoparathyrodism
associated with congenital thymic hypoplasia (DiGeorge's syndrome). most commonly caused by accidential surgery excision during thyroidiectomy
when should immediate dentures be scheduled for relines
at 5 months, 10 months post extraction to compensate for contour changes
when do permanent 1st molars begin to calcify
at birth
the trigeminal ganglion is located
at the apex of the petroud part of the temporal bone in the middle cranial fossa
diminished volume afecting all of part of a lung is called
atelctasis occurs when mucus or a foreign object airflow in a main stem bronchus causing collapse of the affected lung tissue into an airless state
adhesion
attraction of unlike molecules salivia to tissues, saliva to denture bases intimate contact of denture base to tissues creates best seal occlusal prematurities may break retention
hydrocodone
avoid in asthmatics poor anti inflammatory
oxycodone
avoid in asthmatics treat mod to severe pain HIGHEST DEPENDNECY liability
Fluoroquinolones
bactericidal DNA synthesis inhibitor Ciprofloxacin, Levofloxacin
Monobactams
bactericidal cell wall synthesis inhibitor , B lactam Aztreonam
Carvapenems
bactericidal cell wall synthesis inhibitor, b lactam imipenem
Penicillians
bactericidal cell wall synthesis inhibitor, B lactam cross allergenic with cephalosporins- because they are chemically related Penicillin G- IV more sensitive to acid degradation Penicillin V- oral amoxicillian-broad spectrum augmentin- amoxicillin_ clavolanic acid (beta lactamse resistant) methicillin/ dicloxacilin-B lactamase resistant ampicillin- best/broadest gram neg spectrum carbanicilli- used specifically against peseudomonas
cephalosporins
bactericidal cell wall synthesis inhibitor, b lactam 1st gen= cephalexin (keflex) 2nd gen- cefuroxime 3rd gen= ceftriaxone 4th gen= cefepime 5th gen= ceftaroline
tetracyclines
bacteriostatic protein synthesis inhibitor (30 S ribosomal subunit) Tetracycline, doxycycline, minocycline broadest antimicrobal spectrum
Lincosamides
bacteriostatic protein synthesis inhibitor (50s rubosomal subunit) Clindamycin, Lincomycin Link also hides mice
Sulfonamides
bacteriostatic (slows growth of bacteria) folate synthesis inhibitor (completes with PABA) Sulfadiazine, Sulfamethoxazole
macrolides
bacteristatic protein synthesis inhibitor (50 s ribosomal subunit_ Erythomycin, clarithrymycin, azithromycin Mac likes to throw mice
modified T bar
bar of choice for DB undercuts below the height of contour immediatel next to edentulous space indicated when undercuts are immediately next to an edentulous area and no tissue undercuts vertical arm must approach and engage mesial to the greatest MD curvature on the abutments facial surface
glass ionomer cements
based on the reaction of silicate glass powder and polyalkenoic acid useful in restorations of carious lesions in low stress areas such as smooth surface and small anterior proximal cavities in primary teeth
hue
basic colors. orange stain is most often used to change the hue
why are ZOE cements good temporary sedative restorations
bc their pH is about 7
why is there no free mercury in titurated amalgam
bc tritutation coats the alloy particles with mercury
a master cast for a rpd should be blocked out and duplicated
before the framework is waxed up
behavior science, public health , osha and infection control
behavior science, public health , osha and infection control
in amelogenesis imperfecta there is in error in what stage
bell stage
cherubisn
benign genetic autosominal dominant diease. typically by age 5 (males 2:1) most occur in the mandible. the jaws are firm and hard to palpation and regional lymphadenopathy may be present. Bilateral expansion of the jaws gives the child a very round face. the tumors stop growing shortly after puberty histologically:: lesions closely resemble central giant cell granulomas. Perivascular collagen cuffing is pathognomonic for cherubism radiographically: lesions appeak as multiple, well defined, multi locular radiolucencis of the jaw. deciduous dentition may shed spontaneously and there is delayed eruption of permanent dentition. Tx: cautious waiting as it regresses. DO NOY TREAT w/ RADIATION
Melanotic Macule
benign hyperpigmentation in mucous membrane basically a feckle of mucosa Peutz-Jeghers Syndrome= freckles_intestinal polyps
Warthin's tumor
benign parotid tumor arising from heterotopic ductal epitheliium within lymph nodes or near the parotid gland cigarette smoking 60-70 yr nodule over angle or ramus of the mandible
osteochondroma
benign tumor of bone and cartilage
leiomyoma
benign tumor or smooth muscle. non painful, sessile
cementoma
benign tumor that occurs most frequently in anterior mandible and affects multiple vital teeth an unusual response of the periapical bone to some loca factor no tx required occurs at apex or vital anterior teeth. women over 30 (especially black women) stage 1- lesion is periapical radiolucency stage 2- lesion begins to calcify and become more radiopaque (mixed) stage 3- well defined radiopacity borded by a thin radiolucent line
finger springs
best method for tipping max and mandib anterior teeth
the heart is generally considered to have predominatnly which type of adrenergic receptors
beta 1
dobutamine
beta 1 selective agonist
albuterol
beta 2 selective agonist primarly used in long term treatment of obstructive airway dieases, emergency treatment of bronchospasm or to delay premature delivery
terbutaline
beta 2 selective agonist administered orally, subcutaneously or by inhalation primarily used in long term treatment of obstructive airway diseases or emergency treatment of bronchospasm emergency treatment of status asthmaticus and to delay premature delivery
acrylic denture teeth
better retention because can bone to acrylic resin of denture base
Alvelolingual sulcus
between mandibular alveloar ridge and tongue Anterior region: from lingual frenum to the premylohyoid foss sublingual gland sits above mylohyoid muscle in thie region so the flange is shorter anteriorly and should touch the mucosa of the floor of the mouth middle region: from premylohyoid fossa to distal end of mylohyoid ridge flange is deflected medially away from mandible due to prominence of mylohyoid ridge in this area and contraction of mylohyoid medially posterior region: extends into retromylohyoid fossa although mylohyoid attaches higher posteriorly, the posterior fibers are directed more vertically so the denture seats deeper and the lingual flange is longer -flange is deflected laterally toward the ramus of the mandible to form typical S form of lingual sulcus denture extension in this area is limited by palatoglossous and superiror constrictor muscles
what is the occlusion for complete dentures
bilateral balanced occlusion
kennedy class IV
bilateral bounded edentulous space which means it crosses the midline
Kennedy Class 1
bilateral distal extension
signs and symptoms of a zygomatic fracture
binocular diplopia difficulty with masrication due to masseter spasm or bony impingement of the coronoid process ipsilateral epistaxis
characteristics of sealant materials
bio-compatible with oral tissues resistant to dissolution by oral fluids last for a long time in the oral cavity not technique sensitive when applied
articular disc
bioconcave fibrous saddle shapped structure composed of dense fibrous ct
three principles of tooth prep
biologic-health of oral tissues esthetic- appearance of restoration mechanical- integrity and durability of restoration
ZOE
biologically compatable cements
Deep fungal infections
blastomycosis- US northeast, spores Coccidiodomycosis- US SW, valley fever Cryptococcosis- US West Histoplasmosis- US Midwest
what is the most reliable indicator of gingival or periodontal inflammation
bleeding
oral contraceptives
block ovulation by inhibiting the anterior pituitary hormones FSH and LH highest risk with use of oral contraceptives: thromboembolic disorders
non selective alpha antagnoists
blocks alpha 1 and alpha 2 do not treat cardiac conditions as blocking both alpha receptors can cause tachycardia and palpatations used in pre surgical management of pheochrmocytoma and Raynauds phenomenon
warfarin
blocks vitamin K binding sites and injihits the synthesis of vitamin K dependednt coagnulation factors VII< IX , X and II (prothrombin)
hep c
blood to blood contact with IV drug use, poorly steralized equipment and transfucion no vacinne
ginigval cyst of the newborn
bohns nodules= lateral palate epstein pearls- midline palats rests of dental lamina- epithelialize the small lesions
osteonecrosis
bone death or necrosis. a rare complication of cancer patients, patients with tumors or infectious embolic events or osteoporosis taking IV or oral bisphosphonates
which is found between the bone and implant of an endosseous dental implant
bone implant interface
mandib arch after extraction
bone loss occurs in vertical direction (downward and forward/outward) bone loss is oriented along the cross sectional shape of the mandible mandibular bone resorption is 4x faster than in the maxilla severe bone resorption can cuase a pseudo class III malocculsion appearance
max arch after extraction
bone loss/resorption occurs in a vertical and palatal direction (upward and inward) (.1 mm/year is sustained)
cantric relation
bone to bone relation aka retruded contact terminal hing position and is when the condyles articulate with the thinnest avascular portion against the shapes of the articular eminences independent of tooth contact
In the treatment of Adult periodontitis, the use of tetracycline as an adjunct to scaling and root planing initally reduces the inflammation.but after several weeks does not result in substantial clinical benefit
both are true
Periapical granuloma lesion can be considered as an expression of delayed hypersentivity because much of the bone and tooth resportion associated with this lesion is due to the production of osteoclast activating factor
both statement and reason are correct and related
humulin
brand name for insuiln
charters method
bristles pointed away from the gingival margin at a 45 angle
what is most likely to cause superinfection
broad spectrum antibiotics
non rigid connector-
broken stress mechanical untion of a retainer and pontic used for a short span bridge replacing one tooth
if you have a short clinical crown prep
buccal grooves for retention proximal grooves for resistance
a patient walks in saying "when I smile, my upper denture does not hold" what needs to be adjusted
buccal notch and buccal flange
buccal vestibule
buccinator
initiation of tooth development
bud stage formation of dental mainia
taurodontism
bull like found usually in molars apical shift of the pulpal floor and tooth furcation down the tooth rooth caused by fialure or late invagination of Hertwigs epitherlial rooth sheath that is responsible for root formation
value
c olors brightness them ost critical characteristic that is checked first
the max occlusion rim should be parallel to
campers line
intrinsic staining-
can be caused from all of the following except diabetes mellitus dentinogenesis imperfecta erythroblastosis fetalis porphyria fluorosis pulpal injury internal resorption tetracyclines
powdered gold
can be placed in a very short time period and a gold foil veneer is not required example of atomic attraction
St Johns Wort
can inhibit the re-uptake of serotonin mild antidepressant can decrease the efficetness of medications
condylar hypoplasia and aplasia
can occur unilaterally or bilaterally shifts toward the affected side during opening
leukemias
cancers of white blood cells with most of unknown cause. uncontrolled proliferation of leukocytes causing a diffuse and almost total replacement of the red bone marrow with leukemic cells classified by the dominant cell type and by duration from on set to death. ionizing radiation, viruses (epstein barr) and genertic mutations (philidepphia chromosome 22 and 9) oral manifestations: oral lesions. the most common is seen in acute monocytic leukemia. where 80% have gingivitis, gingival hyperplasia, petechiae and hemmorhage
which teeth should ideally provide the predominant guidance through the full range of movement in lateral mandibular excursion
canines
cingulum rest
canines>incisors rounded inverted V at junction of gingival and middle 1/3 of lingual surface 2 mm wide FL 2.5-3 mm MD length min 1.5 mm deep
Apthhous ulcer
canker sore nonheratinized minor- heal without scarring major- heal with scarring Sutton Disease- another name for major form Behcet's syndrome= multisystem vasculitis that causes aphthous type ulcers of oral and genital and inflammation of eye Tx: corticosteroids for Behcets
Phenytoin is indicated for treatment of epilepsy and
cardiac arrhythmia Phenytoin is commonly prescribed as an anticonvulsant and has an antiarrythmic effect. It decreases the activity of the motor cortex, thereby controlling seizures. Phenytoin can treat cardiac arrhythmias secondary to digitalis intoxication but cannot treat arrhythmias related to cardiac diseases.
when is antibiotic prohlaxis not required
cardiac pacemaker rheumatic fever WITHOUT valvular dysfunction mitral valve prolapse without valvular regurgitation
when is antibiotic prophylaxis required
cardio conditions: prosthetic heart valve history of endocardidits heart transplant with valvulopathy/valve dysfunction congenital heart problems compromised immunity organ transplant neutropenia cancer therapy
residual caries
caries that remains in completed preparation either by the dentists intention or accident
bevel (feather edge) margin
cast full gold least marginal strength
Alpha blockers
cause tachycardia, lower Bp, vasodilation and orthostatic hypotension any a antagonist can cause EPI reversal decreases BP , elicting reflex tachycardia act by competitively inhibiting catechloamine actions at the alpha receptor site to cause blood vessels to relax (dilate_ hypotension is the major adverse effect
Actinomycosis
caused by Actinomyces israelii (filamentous) NOT FUNGAL opportunistic infection, chronic and granulomatous periapical--jaw infections cervicofacial- head and neck infections sulfer granules in purulent exudate tx: long term high dose penicillin
Oral Hairy Leukoplakia
caused by EBV white patch on lateral tongue that does not wipe off opportunistic infection associated with HIV associated with Burkitts lymphomia
Focal epithelial hyperplasia (Heck's disease)
caused by HPV 13 and 32 multiple small dome shaped warts on oral mucosa Tx: excision with excellent prognosis
Condyloma Acuminatum
caused by HPV 6 and 11 genital wart or from oral sex with someone with genital warts Tx: excision with high recurrance
measeles (rubeola)
caused by RNA paramyxoviruscharacterized by formation of Kopliks spots in the oral cavity clustered white lesions on the buccal mucosa near each stenson duct
combination syndrome with dentures
caused by an edentulous maxilla is opoosed by a partially dentate mandible (anterior teeth only) causing severe bone resorption of anterior maxilla during chewing, the denture tips anterioly compress the mucoperiostium of the premaxilla
Syphillis
caused by contact with Treponema pallidum primary lesion--chancre secondary lesion- oral mucous patch, condyloma latum, maculopapular rash tertiary lesion--gumma, CNS involvement, CV involvement congenital syphilis- hutchinson's triad (notched incisors and mulberry molars, deafness, ocular keratitis
dens in dente
caused by deep invagination of the enamel organ Hertwigs epithelial rooth sheath max lat incisor!!
herpes simplex type 4
caused by epstein barr causes mono and hairy leukoplakia
Scarlet fever
caused by group A step (streptococcus pyogenes) this is when strep throat becomes a systemic infection strawberry tongue= white coated tongue with red inflamed fungiform papillae Tx: penicillin
pernicious anemia
caused by inability to absorb adequate amounts of vit B12. lack of secretion of intrinsic factor in normal gastric juice characterized by a triad of symptomes- weakness, sore painful tongue
Tuberculosis
caused by inhalation of Mycobacterium tuberculosis oral nonhealing chronic ulcers follow lung infection primary--> Gohn complex (inhaled bacteria surrounded in granuloma that undergoes caseating necrosis and infected hilar lymph node draining the first lesion) Hilum= root of the lung secondary= more widespread lung infection with cavitation miliary= systemic spread HIV patients are at high risk of getting progressive disease Tx: multidrug therapy (isonizid, rifampin, ethambutol)
Gonorrhea
caused by neisseria gonorrhoeae oral pharyngitis rarely seen
Cushing syndrome
caused by prolonged exposure of the bodys tissues to high levels of the hormone cortisol moon facies, truncal obesity, muscular wasting and hirsutism hypoer cortisolism female>> and adults 20-50 hypertensive because of lfuid retention most common cause is a tumor in the pituitary gland
cervical burnout
caused by relatively low x ray absorption on the mesial or distal surfaces, between the edges of the enamel and adjacent crest of the alveolar ridge
Papilloma (Wart)
caused by several strains of HPV Benign epithelial pedunculated or sessile proliferation on skin or mucosa
Verruca Vulgaris
caused by several strains of HPV Common skin wart
mepivicaine 2% and 3%
causes least vasodilation
metamerism
causes teeth/porcelin to appear color matched under one light and different under another source
Rickets
causing skeletal deformities and usually accompanied by irritability and generalized muscle weakness bowlegs, pigeon breast, and protruding stomach are signs. teeth are affected by delayed eruption, maloccllusion, and developmentla abnormaliites of dentin and enamel with a higher caries rate
apposition
cells begin to dposit the specific dental tissues majority of cells are fibroblasts
which teeth can not be used as an abutment
central max incisors due to the anatomical structure of the root
which will cause extrucion of the max first molar which can cause an open bite
cervical pull headgear
class V
cervical third
which occurs only at 70kVp or higher and accounts for a very small part of the xrays produced in dental xray machines
characteristic radiation
cracked tooth syndrome
characterized by a sharp but brief pain occuing unexpetedly only when the patient is chewing
acute caries
characterized by rapidly progressing, little or no staining, often multiple, soft to touch lesions and most common in children
EPT
checks tooth sensibility and vitality low current and high potential difference acute pulpitis- indicated by a ower than normal current chronic pulpitis- responsic at a higher current than normal hyperemia- lower than normal current pukp necrosis- no response
erosion
chemical loss of tooth structure from non mechanical means
Smoking Associated Melanosis
chemicals in tobacco stimulate melanocytes brown, diffuse, irregular macules typically seen in anterior gingiva Tx: reversible if smoking discontinued
petit mal epilepsy
children under 16 years 5-10 seconds little to no danger to victim
hemophilia B
chirstmas disease factor 9
_________ is the most common sedative agent used in pediatric dentistry
chloral hydrate
patients with G-6-PD deficency have increased sensitivity to
chloramphenicol
what is associated with aplastic anemia
chloramphenicol
postganglionic sympathetic nerouns are the only ones that are not
cholinergic
pemphigus vulgaris
chronic rare skin disease vesicles and bullae produced by acantholysis jewish people oral lesions are first Nikolskys sign intraepithelia tzank cells must do biopsy
drug interactions
cidal and static drugs cancel each other out penicilin and probenecid tetracycline and antacids/dairy broad spectrum and anticoagulants antibiotics and oral contraceptives macrolides and seldane/digoxin
the antibiotic of choice in the treatment of rapidly progressing periodontitis is assoiated with non oral gram negative facultative rods is
ciprofloxacin
circumferental clasp
clasp of choice in class III and IV when the most posterior abutment undercut is away from the endentulous space (MB surface) undercut must always be on opposite side of the tooth/rest from where the clasp originates do not use when an undercut is adjacent to the edentuous space (DB or DL)
Vaughan Williams classification system
class 1- Sodium channel blockers class II- beta blockers classIII- Potassium channel blockers Class IV- Ca channel blockers
mesial step
class I
which caviaites can involve both anterior and posterior teeth
class I, V, VI
classification of heart failure
class I- no cardiac symptoms with activity class II- symptoms with marked activity class III- symptoms with mild activity class IV- symptoms at rest
four classes of cleft palate
class I- only soft palate class II- soft and hard palate but no alveolar process class III- same as class II but with alveolar process class IV- soft palate and continues through the alveolus on both sides of the premaxillia
classes of cleft lip
class I- unilateral notching of the vermillion not extening into the lip class II_ same as class I but the cleft extends into the li but not the floor of the nose classIII_ same as class II But extending into the floor of the nose class IV- any bilateral clefting of the lip
distal step c
class II
what class does not have a fulcrum line
class III
fixing agent-
clears all unexposed and underdeveloped silver halide crystals from emulsion
syndroms with supernumary teeth
cleidocrainal dysplasia gardner syndrome down syndrome crouozon disease sturge weber oral facial digital syndrome i hellermann streiff syndrome
disc displacement without reduction
clicking and popping has disappeared with limited and pain (<35 mm) consistent limited opening (hard end feel) not a reproducable reciprocal click most disc displacements are anterior and medial
disc displacement with reduction
clicking joint disc is out of place patient has normal opening or an S shaped opening TMJ is only rotating reciprocial clicking on opening is a sign
what causes GI upset and pseudomonas colitis
clindamycin
drug concentration
clindamycin--> bone tetracycline-->gingival crevicular fluid
cohesion
clinging of like molecules saliva to saliva thick and ropey saliva is unfavorable, thin and watery saliva causes better retention
the distance from the CEJ to the depth of the gingival sulcus
clinical attachment level
Globulomaxillary lesion
clinical term denoting any radiolucency between max canine and lateral incisor
26 year old female has failed to become pregnant, what drugs would be effective in treating infertility due to anovulatory cycle
clomphene
Van der Waals forces
collectively describe the weak interactions that develop when two atoms are placed in close proximilty
hybrid and microfill resins use
colloidal silica fillers to increase hardness and wear resistance of the base resin material while maintaining high polishability and esthetcis
surface tension
combination of adhesion and cohesion froces that maintain film integrity
ante's law
combined abutment teeth root surface area must be equal or greator than the edenutlous space
hyperparathyroidism
common complication is Kidney stones kidney stones form due to an increase in urinary excreteion of calcium and phosphate. osteoperosis, Giant cell granulomas and metastic calcifications are manifestations of hyperparathyroidism blood values: increase Ca, decrease serum phosphours, increase serum alkaline phos, increase serum PTH the main cause is an adenoma (tumor of the gallbladder epithelium) clinical findings-cystic bones lesions, nephrocalcinosis, kidney stones and peptic deudental ulcers excess loss of calcium in urine stimulates parathyroid glands to undergo hyperplasia because the feedback mechanism that detects low serum calcium elicits growth of the gland
chronic caries (slow or arrested caries)
common in adults dark pigmentation with leathery dentin, shallow lesion (small lesion) and pain is uncommon
verruca vulgaris (squamous papillmoa)
common wart of viral etiology that is a common skin tumor analogous to the oral papilloma may occur in the oral cavity sessile, soft, cauliflower like lesion
fibrous (pendulous) tuberosity
common when large tuberosities touch retromolar pads can limit interarch space corrected by surgicial excision of fiberous tissue and or bone
Metoprolol
competitive B1 cardioselective to treat hypertension
Maximum Intercucspation
complete interdigitation of teeth independent of condylar position aka centric occlusion
lipoma
completely benign tumor derived from adipose fat tissue yellow white nodular mass. floor of mouth, buccal mucosa, and tongue floats in formalin
masticatory mucosa
composed of free and attached gingiva, and mucosa of the hard palate the epithlium of these tissues is keratinized the surface epithlium of the gingiva is highly impermeable, which makes it resistant to bacterial invasion
articular fossa
concave fossa non functioning portion of TMJ
which impression materials is it advisable to wait 20-30 mins before pouring models for stress relaxation to occur
condensation silicones
Acorn articulator
condylar elements on the lower member of the articulator and condylar path elements on the upper member angle between condylar inclination and occlusal plane remains constant (more accurate) commonly used for study casts
the mandible will deviate away from the affected side with
condylar hyperplasia
Acron-
condyles are a part of the lower member, fossa are a member of the upper member
HPV has been found in all the follong lesions except one. what is the exception a. oral papillmoas b. verucca vulgaris c. condyloma latum d. condyloma acuminatum e. focal epithelial hyperplasia
condylmoa latum its secondary syphillis
initiatation errors
congenital absence of teeth and supernumary teeth
hemangioma
congenital focal proliferation of capillaries most undergo involution but persistant lesions are excised
Lymphangioma
congenital focal proliferation of lymph vessels -oral lymphangiomas are very rare, purple spots on tongue called a cystic hygroma when occurs in the neck sturge weber syndrome= angiomas of leptomeninges(arachnoid and pia mater) + skin along the distribution of the trigeminal nerve
oligodontia
congential absence of many but not all teeth
transseptal fibers
connect two adjacent teeth (tooth to tooth) and are sometimes classified withi n the PDL principal fibers not found on the facial maintain integrity of dental arches
minor connector
connects major connector to rests, indirect retainers, and clasps
steptococcus viridans
consist of a variety of al[ha hemolytic steptococci that are common oral flora
gingival ligament
consists of dentogingival, alveologingival and circular fibers
specialized mucosa
consists of non keratinixed epithleium thatcovers the tongue dorsum and taste buds
attachment apparatues
consists of the alveolar bone proper, PDL fibersand cementum that attaches the root to alveolar bone
optimal PFM thickness
contact areas 2.0 (1.5 mm porcelain, .5 mm metal)
guttural sounds= g,k
contact between back of tongue and throat
bilabial sounds= b,p,m
contact between both lips insufficiant lip support by the teeth or labial flange can affect production of these sounds
Fricative or labiodental sounds f,v,ph
contact between max incisors and wet/dry line of lower lip help determine position of incisal edges of max anterior teeth have pt count up from 50-60
sibilant or lingualveolar sounds= s,z,sh,ch,j
contact between tip of tongue and the anterior palate or lingual surface of the teeth help determine vertical length and overlap of anterior teeth whistling--> too narrow arch form lisp where s becomes sh--> too wide arch form closest speaking space= also want to evaluate vertical dimension during pronunciation of s sound, the interincisal separation should be 1 to 1.5 mm count in the 60
linguodental sounds= th
contact between tip of tongue and upper and lower teeth help determine labiolingual position of the anterior teeth tongue is not visible=teeth are set too far forward tongue sticks out= teeth arfe set too far back
medium gold alloys
contain 25-75% gold or other noble metals
attached gingiva
contains keratinized epithlium and lamina propria of dense well organized fiber bundles with few elastic fibers firmly joined to underlying tooth structure , periosteum and bone and structures to withstand frictional stresses of mastication and brushing narrowest band of attached gingiva is found on F surfaces of the mandib canine and 1 PM
kVp
contorlls the speed and energy of the electrons and determins the penetrating power of the beam
torque
controlled root movement Fl or MD
milliamperage (mA)
controls the number of x rays produced suitable ranges are 7-15 mA
articular eminence
convex ridge linked with a thick layer of fibrous ct functional and articular portion of the TMJ
cavity varnish
copalite is the most commonly used and reduces inital microleakage of a restoration not used under composite because it inhibits the polymerization of the resin reduces marginal leakage to improve the marginal seal for the short tetm
attached gingiva is normally
coral pink color varies depending on the degree of keratinization, thickness of epithelium, presence of melanin and number of blood vessels
which type of cells can be categorized as radio responsive
corneal cells
Sialolithiasis frequenctly seen involveing the submandib duct bc of its long and irregular course in the oral cavity
correct and related
vertical ramus osteotomy
correct mandibular prognathism
what type of bone provides greater success with implants?
cortical bone provides greater implant bone contact and fixation
manibular condyle
covered with a vascular layer of fibrous CT
onlay-
covers cusps
ibuprofen (motrin/advil)
cox 1 and 2 blocker (reversible) kidney
Apert syndrome
crainal limb anomalies blindness is not a clinical feature supernumary teeh, fused fingers
creep
creep is a process that happens over time undertituration tends to increase the creep rate increasing the condensation pressure decreases the creep
glycol dimethacrylate
cross linking agent
syndromes with both hyperdontia and hypodontia
crozons down syndrome oral facial digitial syndrome 1 hallermann streiff syndrome
files
crush or fracture heavy calculus buccal and lingual surfaces, next to edednutlous areas and reduce amalgam overhags
which disease is associated with a decrease in caries
cystic fibrosis
punching holes too close together in rubber dam may cause
damage to gingival papilla
what are the first areas adjusted if the framework does not fit
damaged areas on the cast
secondary (recurrent) caries
decay appearing at and under restoration margins
DMFT or DMFS
decayed missing filled surfaces teeth
DMFS
decayed missing filled surfaces involves tooth surfaces
DEFT index
decayed, extracted, filled teeth- used for primary dentition
to decrease densitry and make it lighter
decrease mA, kVp and time
marginal leakage of an amalgam restoration___ as the restoration ages
decreases
when pins are included in amalgam cavity prep the strength of amalgam
decreases
local anesthetsia affects the nerve membrane by
decreasing the membranes permeability to Na and decreasing the membranes excitability
composite filler particle functions
decresae coefficient of thermal expansion and polymerization shrinkage, increase tensile and compressive stengths hardness and improve wear resistance
SNB
defines the sagittal location of mandib denture base 80 is ideal >80 mandib prognathism <80 mandib retrognathism
outline form of a class V amalgam prep
deformed trapazoid- kidney shape m,d g and I walls diverge outward retention form is provided by the gingival retention groove along the gingiovoaxial line angle and an incisal retention groove along the incisoaxial line angle
chroma
degree of saturation
which pharmaceutical is most closely associated with dermal photosensitivity
demeclocycline a tetracycline used in the treatment of Lyme disease, acne and bronchitis may induce photosensitivity, interfere with bone development and discolor teeth causes nephrogenic diabetes insipidous binds to 30 s and 50 s ribosomal subunits, impairing protein synthesis by bacteria
etchant
demineralized enamel and dentin and removed smear layer creates a spongy low energy surface that is perfect for primer and adhesive
cap stage errors
dens in dente, geminnation, fusion, tubercle formation
open panel
dental services provided by any dentist willing to accept third party payment
closed panel
dental services provided by salaried dentists at specified locations only
which of the following odontogenic cysts occurs as a result of stimulation and proliferation of the reduced enamel epithelium
dentigerous cyst
pulp function
dentin formation
sclerotic dentin
dentinal tubules that become calcified
legally dental radiographs are property of the
dentist
overextension of denture
denture flange is too long get sore spot or ulcer after wearing tx: relieve denture and re-evaluate in a few weeks denture extends too far back- denture teeth are set so far back that they go to ramus. occlusal forces would dislodge denture
underextension
denture flange is too short lack of retention
the health belief model emphasizes that behavior such as visiting the dentist or tooth brushing and flossing are
dependent on the individuals cognition
odontogenic fibroma
derived from dental papilla, dental sacor PDL occurs as a painless welling in the mandible of children and young adults multilocular or unilocular that may be associated with unerupted or displaced teeth
the presentation, organization and summarization of data
descriptive statistics
inhalation anesthetic with a very low blood:gas partition coefficiency is
desflurane
which drug requires a heating component to allow delivery at room temperature
desflurane
Submental vertical x ray
designed to diagnose basilar skull fractures and provides info about the zygoma, zygomatic arches and mandible
anthracyclines
destroy DNA so cell cant replicate Daunorubicin and doxorubicin. commonly associated with the development of oral mucosititis
partial thromboplastin time PTT
detects coagulation defects of the intrinsic system. the basic test for hemophilia normal value is 25-36 sec
fusion
developmental joining of >2 teeth where dentin and another dental tissue are united
where is the most susceptible area on the tooth for plaque retention
developmental pits and fissues pit and fissure caries has the highest prevalance of all caries
narcolepsy
dextroamphetamine is used to prevent daytime sleepiness
conditions assoictaed with Parotid gland enlargement
diabetes mellitus, sjogrens syndrome, warthins tumor, ninfections, benign lymphoepithelial lesion, acute epidemic parotitis, malnutrition
strip perforations occu frequently due to excessive instrumentation on the
diatal aspect of the MB root of max 1 molar
interocclusal space
difference between VDO and VDR (ideally 2-4 mm) VDR= VDO+3 mm
ginigval hyperplasia
diffuse soft tissue overgrowth affecting both jaws with a pink to red color and firm consistency from the mucogingival junction to the free ginigval margin drugs: dilantin, valproic acid, cyclosporine and Ca Channel blocers
composite adhesive systems rely on which of the follow for proper bonding between dentin and resin composite
difunctional coupling agents
which muscles depress th emandible and displace the distal fractured segment inferiouly and posteriorly
digastric, mylohyoid, geniohyoid and laterla pterygoid
inward aggression
directed agianst oneself
destructive aggression
directed toward an external object or person
the force generated in a spring is ____ porpotional to the distance that a spring is deflected and the radius of the wire. the force is inversely proportional to the springs length
directly
the positive inotropic effect of Digoxin
directly increases the force of myocardial contractions
th e most common cause of class I malocclusion is
discrepancy between the tooth size and supporting bone
histoplasmosis
disease caused by fungi histoplasma capsulatum primarily affect the lungs may produce a benign, mild pulmonary illness
MS
disease that attacks the CNS due to an autoimmune response women 2x men facial and jaw weakness, Bells palsy and trigeminal neuralgia
Chlorhexidine
disinfect canal space
histocytosis X
disorders where abnoramal scavenger immune system cells hitiocytes and eosinophils proliferate in the bone and lungs causing scars to form
extrusion
displacement of tooth from its socket in direction of eruption
cercial pull headgear
distal and downward forces against maxillary teth and maxilla (possible extrusion of max molars) class II div I
high pull headgear
distal and upward force on maxillary teeth and maxilla class II, div I malocclusions with open bite
indirect retainer
distal extension area of a partial is "loose" and is not anchored posteriorly there is rotational movement centered around an imaginary line drawn through the most distal rests indirect retainer is directly perpendicular and anterior to the fulcrum line which provides bracing to resist rotational movement of distal extension area
Vertical dimension of occlusion
distance between nose and chin when biting together indicates superior inferior relationship of the maxilla and mandible when the teeth are occluded in MI
Vertical dimension of rest
distance between the nose and chin at rest where elevator and depressor muscles are in a state of equilibrium in this position there is usually 3 mm of space between upper and lower premolars
target film distance
distance from the source of radiation to the film 20 cm-is the short cone that exposes more tissue by producing a more divergent beam 41 cm- the long cone that reduces the amount of exposed tissue by producing a less divergent beam and a sharper image
a seven eights crown is a three quarter crown whose vertical
distobuccal margin is positioned slightly mesial to the middle of the buccal surface
simple fracture
divides the bone into two distinct parts with no external communication
gardners syndrome
dominant syndrome thousands of polps in the large intestinge, duodenum, colon and stomach polyps appear around 15 years and eventually become malignant eventually causing colon cancer multiple odontomas, cotton wool
thrombocytopenia
dominated clinically by petechiae cutaneous bleeding, intra cranial bleeding and oozing from the mucosal surfaces characterized by decreased platelt count causing prolonged bleeding time. the most common cause of bleeding disorders
buccal nerve block
done in tandem with IAN block to get soft tissue of molars
autogenous free gingival graft
donor site from where the graft is taken is an edentulous region or palatal area maturation is not complete until 10-16 weeks
Aschers syndrome
double lip, blepharochalasis and thyroid enlargement
gypsum bonded investment material can be used for
dowel crowns to be cast in silver palladium alloys
indirect acting agonists (sympathomimetics
drugs that cause release of stored NE at post ganglionic nerve endings to produce their effects Tyramine, Amphetamine, Methamphetamine, hydrooxyamphetamine, methoxamine and ephadrine pharmaceutical agents that bring about tissue responses resembling those produce by stimulation of the sympathetic nervous system
opioids
drugs without anti inflammatory properities most appropriate time to adminster inital dose of an analgesic to control post op pain is before the effect of local anesthttic wears off NAUSEA narcotic analgesics do not cause peptic ulcers or insomnia respiratory depression contraindicated in pts with severe head injury
the rate of at which carious destruction of dentin progress is slower in adults than young people . why?
due to generalized dentinal sclerosis which occurs with aging
a properly acid etched enamel surface appears
dull white and chalky
flexible RPD
duraflex, valplast and TCS fexible partial dentures offer unitque physical and esthetci properties clinically unbreakable, less likely for stains and odors
sympatholytic agents
durgs that acts in a way opposite to sympathetic nervous systems. 4 types all treat hypertension
hand schuller cristian disease
early childhood -- boys triad of symptoms: exophthalmos, diabetes insipidus and bone destruction oral signs: bad breath, sore mouth, loose teeth
a very large area of blood is called
ecchymosis
syndroms with hypodontis
ectodermal dysplasia chondroectodermal dysplasia achondroplasia reiger syndrome incontinential pigent sekel syndrome
syndromes with microdontia
ectodermal dysplasia chondroextodermal dysplasia hemifacial microsomia down syndromw
fordyce granules
ectopic sebaceous glands
the facial nerve carries what
efferent components afferent components parasympathetic components
Casts poured from elastomeric materials are more accurately mounted with
elastomeric materials PVS or ZOE paste
submentovertex projection
elevate fractures of the zygomatatic arch
platinum
elevates the melting range platinum ranks 3rd in ductility
hairy tongue
elongated filiform papilae
A mature pulp doesnt form
enamel
enamel hypoplasia
enamel developmental defect due to incomplete formation of the enamel matrix enamel is ahrd but thin and deficient in amount usually caused by illness or injury during tooth formation white and brown defects on tooth structure due to exposed dentin
apposition errors
enamel dysplaia , concresence and formation of enamel perals occur
cap-proliferation
enamel organ is formed fused or geminiation teeth occur during this stage
local infiltration
enter in vestibule aim for root apex works well in anterior because facial cortical plate is thin
how do you histologically differetniate free ginigiva from epithelial attachment?
epithelial attachment does not contain rete pegs while the free gingiva does
oral lymphoepithelial cyst
epithelial cyst within lymphoid tissue of oral mucosa palatine and lingual tonsils are common regions
A dose of 4 grays of X-radiation administered locally to a patients hand would likely result in
erythema
desquamative gingivitis
erythematous, eroise, vesiculobullous and desquamative involvement of the free and attached gingiva most pt are postmenopausal females aged 40-70 years tx: topical corticosteroids
what is associated with allergic cholestatic hepatitis
erythromycin estolate
intermaxillary fixation IMF
establishing proper occlusla relationship by wiring the teeth together. the method successfully treats most mandibular fractures-- wiring, arch bars and aplints
what is the primary role of anterior teeth on dentures
esthetics
S. sanguis
etiologically related to caries but is not a primary stiological agent in caries
child less than 8 has a pulse but breathless, rate of rescure breathing?
every 3 secons adults 8+ is every 5-6 seconds
hypercementosis
excessive cementum formation around or on root surface after tooth eruption thickening of cementum (root tissue) can be seen in acromegaly and pagets disease many affects vital teeth (mainly Premolars)
hyperthyrodism
excessive production of Thryoxin (T4) that stimulates cellular metabolism, growth, differentation of tissues it leads to high basal metabolism, fatigue, weight loss, elevated temp, tachycardia Graves disease and Plummers diesease
what is the cause of clicking of denture teeth
excessive vdo
beading
exclusive for maxillary major connector involves scribing a .5mm rounded groove in the cast at the boarders of the major connector add strength and maintain tissue contact to prevent food impaction
melanoma
exhibits a radial (horizontal) or vertical growht phases in skin 1. radial growth phase- the inital growth phase of melanoma just above and below the dermoepidermal junction in a horizontal plate 2. vertical growth phase- begins when neoplastic cells populate the underlying dermis. characterized clincally by an increase in size, change in color, nodularity and ulceration. Metastasis is possible when the melanoa reaches this phase
what is the only way to determine the number of walls left surrounding tooth
exploratory surgery
