CDCA Pearls, Dental Decks (Pediatrics), *Golden- NBDE II- Perio, CDCA, CDCA Nitrous 2018 " Nitrous Oxide Administration for Dental Hygienists - Part 1", CDCA my prep, Computer Simulated Clinical Examination-Dental Hygiene CDCA
Kvp controlls?
"K" ontrast
Hep A
"infectious" from contaminated food/water -resolves on its own within a couple weeks **if patient has it OVER A YEAR AGO, then they are OK to treat
maxillary sinus pseudocyst
"retention cyst" of the sinus. Could be due to blockage of fluid psuedocyst = NO epithelial lining
Hep B
"serum" acute/chronic prolonged incubation (4-26 weeks) **if have active hep B, then be careful prescribing drugs that are metabolized in the liver! (tylenol)
a pregnancy tumor is malignant, true or false?
false.
hereditary bilateral posterior enlarged gingiva is due to?
familial fibrous dysplasia
4 cells that are found in the pulp
fibroblasts, leukocytes, undifferentiated mesenchymal cells, odontoblasts
what is the most common cell type of connective tissue?
fibroblasts.
cluster of balls on BM on line of max dentition
fibroma or papilloma (fibroma?)
"ground glass" appearance
fibrous dysplasia on radiograph
herringbone on film - what is error?
film backwards
ectodermal dysplasia
-missing teeth (hypodontia) -hair loss?
info on BCC
-most common skin cancer -SLOW growing -deep lateral extension -rounded and rolled border
extravasation cyst treatment?
fluid-like blister on the inside of the cheek -tx: surgical removal *not a true developmental odontocyst
large central incisor
gemination
healthy pt. shows bleeding, what could this be due to?
gingivitis
which is least likely to occur w/ occlusal trauma?
gingivitis
how to tx HIV pt. w/ ANUG and fever or systemic involvement?
give AB *Metronidazole
What is the best restorative tx for a large class II restoration?
gold onlay
why give prophy prior to EXT for immediate denture?
healthy gingiva heals faster
purplish lesion of lip
hemangioma
how to treat endo treated mand molar w/ furca?
hemisection and place 2 crowns to act as 2 PM
amelogenesis imperfecta
hereditary defect of enamel-teeth are discolored, pits/grooves hypoplasia
biggest cause of cleft palate
hereditary, drugs, environment.
EPA apprves what level disinfectant
high level only. hospital grade-kills most but not all bacterial cidal spores, if it can kill spores its called sporocidal.
what are the 3 levels of disinfectants
high-hospitals medium-DDS office- must be able to KILL TB low- at home, simple phenols, not suitable for DDS office
RAS - recurrent apthous stomatitis (canker sore)
-no known cause (stress) -yellow center/red border -not contagious
3 types of recurrent aphthous stomatitis (RAS)
1. Major aphthous stomatitis 2. Minor aphthous stomatitis 3. Herpetiform
Clinical picture of primary molar with enlargement of the pulp extruding out of crown:
hyperplastic pulp
cranial nerves
1. Olfactory 2. Optic 3. Oculomotor 4. Trochlear 5. Trigeminal 6. Abducens 7. Facial 8. Vestibulocochlear 9. Glossopharyngeal 10. Vagus 11. Accessory 12. Hypoglossal
immediate dentures vs conventional dentuers
immediate: -requires MORE bone removal -more difficult to adapt -done for esthetic concerns
thymus function
immune response -- secretes thymosins that stimulate T lymphocytes to become T cells.
how do we control viruses
immunization and infection control.
What is the order of selective grinding?
1. centric 2. working 3. lateral (balancing) 4. protrusive
name the 3 types of gingival fibers that hold the gingiva against the tooth
1. circular ligament 2. dentogingival ligament 3. alveologingival ligament
Patient with history of angina has hands on chest. What should you do?
1. give nitroglycerine capsule 2. if that isnt working, they are having an MI
name 3 professionally applied topical fluorides
1. sodium 2.stannous 3. acidulated phosphate
bass- good for perio pt
45 degree angle toward the apex at gingival 1/3, placing bristles into sulcus.
best ange to place currette?
45-90 degrees
perio instrument held at what angle on the tooth?
45-90 degrees *the blade is open 45-90 degrees for working strokes
If you have 1mm recession and can probe 3mm, how much attachment loss if there?
4mm
fusion of the lip begins
4th week-completed by 6th week.
Which is not an acceptable surface disinfectant? A. Alcohol based B. Phenol based C. Chlorine based D. Iodine based
A. Alcohol based
Primary Herpetic Gingivostomatitis
Painful oral condition that results from the initial infection with the herpes simplex virus. bulbous papilla, bleeding, ulcers develop 4 days later.
***Tx of Primary Herpetic Stomatitis?
Palliative
***Swollen lesion on tongue, what do you do next - ?
Palpate lesion and see if it's firm
syncope v anaphalactic shock - difference?
anaph shk has wheezing on expiration, syncope may not breathe at all (fainting)
Cleft palate can be
anterior split- 1 or 2 sided or posterior split will be a single split.
Norpace (disopyramide phosphate)
anti-anginal and anti-arrhythmic agent
Promethazine
antihistamine to prevent MOTION SICKNESS and used as a SEDATIVE when BZDs are contraindicated -can cause tardive dyskinesia and dry mouth
Examples of regulated biohazzard waste
anything saturated
regulated waste means
anything saturated- sharps, saliva, hard and soft tissues removed from pts mouth
curette, which third adapts to the tooth?
apical 1/3
***Penicillin causes allergic reaction and gives?
arm rash (theres a pic)
non critical items
cleaned and treated with intermediate level disinfectant or barriers- trays, xray tube head. etc.
Cleft lip or palate, which is more common
cleft lip
pre-medication for patient with PENICILLIN ALLERGY
clindamycin
what is predominately in plaque 2 days after a cleaning? (2 day old plaque)
cocci and rods
Procardia (-dipine)
common CCB
systemic conditions to consider with ultrasonic use
communicable dx, respiratory conditions like emphysema, copd, cystic fibrosis, asthma, difficulty swallowing, susceptibility to infection from chemo, transplant, or disease.
sonic scalers use
compressed air; less power**
picture ID - focal sclerosing osteomyelitis
condensing osteitis is the SAME THING
most abundant type of tissue in the body?
connective tissue
acid etching does all EXCEPT -
create chemical bond (?)
impression for most predictable results
custom tray with tissue stops
root amputation of MB root?
cut @ furcation and smooth for pt. to keep clean
internal resorbtion, pink tooth of mummery
enlargement of chamber or canal, may occur after trauma, tooth is less vascular, if occurs in Pulp chamber the tooth may look pink. To treat, must include endo
treatment for lateral periodontal cyst
enucleation and monitor for recurrence
CI for sialogogue -
epilepsy?
"target" lesions
erythema multiforme -autoimmune
CI for apically positioned flap in anteriors
esthetics
Pt is taking aspirin penicllin naproxen and estrogen. What contributes to increased PD?
estrogen?
ketoacidosis
excessive production of ketones, making the blood acid- most commonly occurs in type 1 diabetes when your blood sugar is very high and your body cannot make enough insulin.
how to treat mucocele?
excise with salivary gland remnants
nasopalatine cyst tx?
excision
How do you treat epulis fissuratum under a denture?
excision and reline
maxillary sinus pneumatization
expansion of max sinus
through and through furca... tx?
ext
what is the purpose of labs placing die spacers
makes room for cement
common in school kids
marginal gingivitis
dens in dente commonly found on
maxillary lateral
regulated waste
may be MORE regulated locally but not less regulated than state. Federal laws are trumped by MIOSHA which is more regulated for MI.
missing successional dental lamina
means no permenant successor tooth. Congenitally missing tooth
Xray ID:
mental ridge
pdl is derived from
mesenchyme of dental sac
cleidocranial dysplasia is associated with?
missing clavicles, many supernumerary teeth visible on a PAN
Anterior pontic design
mod ridge lap
lip with bluish lump
mucocele
radiolucency in max sinus
mucocele
RO lesion in sinus on PAN
mucocele (?) - might actually be mucuous retention cyst...
inside of a ranula - mucous or purulent?
mucuous
COMPOUND odontoma
multiple
Antibody is made by?
my body.
what is the only mask that can filter air borne pathogens?
n-95 respirator
best way to detect furcation?
nabers (curved perio probe)
microaerophiles need
need oxygen at lower levels
after perio surgery, the dentist leaves interproximal bone apical to radicular bone, this is called?
negative architecture
new growth of cells that exhibit uncontrolled proliferation is known as?
neoplasia
our utility gloves are _____?
nitrile- best when dealing with chemicals, and most common in DDS
How you would correct recession around canine?
lateral repositioned flap
29yo retained primary molar w no problems
leave it (no tx)
medical records of employees kept for how long
length of employment plus 30 years- due to incubation period of viruses such as HEP C
unsure about shade?
less gray and less color saturation
XRAY: What is the QUALITY of photons in the beam (the energy)? What is the QUANTITY (number) of photons in the beam? kVp or mA
quaLity = kVp quanTity = mA
2 questions for SLOB rule
radiography hello
amelogenesis imperfecta XRAY
ragged occlusal surfaces
custom trays for fluoride are reccomended for
rampant caries/xerostomia patients
essential oils
listerine anticeptic- commonly has a burning effect from alcohol content, good for plaque and gingivitis, No for alcoholics or apthous ulcers
Trabecular bone aka spongey bone or cancellous
located between tooth sockets and corticol plate
corticol bone or plate
located on facial or lingual surfaces of alveolar process. Is compact.
Not associated w/ LAP
locator factors --> plaque/ calculus/ inflammation
warmer climates require ______ fluoride levels
lower- 0.7ppm
pic of tongue with purple dots - multiple papules
lymphagioma maybe
if patient complains of CHEEK BITING with denture, what should you do?
reduce the buccal contours of the MANDIBULAR posterior teeth only
Treatment for a class I malocclusion with spacing
refer for an ortho consult
BP 160/110 - next stpe?
refer to MD
poorly controlled diabetic with inflamed gums - what next?
refer to MD for consult
treatment for facial swelling over 24 hours due to wisdom tooth
refer to OMS
what do you do w pt with Bell's palsy?
refer to neurologist
14 y.o. with impacted man 2nd PM, next step is to:
refer to ortho
Cytoplasm membrane
regulates cell pressure, waste products and has enzymes to synthesize the cell wall. some disinfectants like chlorohexadine do their job by acting on this membrane.
XRay ID - what is it
remnants of primary teeth
treatment of liver clot after extraction
remove liver clot with curette?? - apply pressure, and reassess
Kaposi Sarcoma
-malignant cancer of the lining of blood vessels on the HARD PALATE (purple) -similar lesions on body too -HHV-8 -associated with HIV/AIDS -provide NORMAL tx, but NO INVASIVE tx
Kidney transplant patient
-may require ANTIBIOTICS (stress dose) due to anti-rejection meds
Needs class I RPD, distal abutments are 20 and 24. Indirect retention should be located at:
#22 and #27
Class I Occlusion
(Mesognathic)-normal; mesiobuccal cusp of the maxillary first molar is positioned in the buccal groove of the mandibular first molar. Maxillary canine occluded with the distal half of the mandibular canine and the mesial half of the mandibular first premolar.
Diet soda
(No sugar) can cause more decay than regular soda because of the acid content.
Class III Occlusion
(Prognathic) Buccal groove of the mandibular first permanent molar is mesial to the mesiobuccal cusp of the maxillary first permanent molar by at lease the width of a premolar. Mesial portion of the maxillary canine is distal to the distal surface of the mandibular canine by the width of a premolar.
Premedication of a child patient by using _______ may cause *Paradoxical Excitement* in a young child.
*Barbituate*
*Direct Pulp Caps* (DPC) involve direct placement of the capping material on the pulp. _____ is the agent most frequently used.
*CALCIUM HYDROXIDE* - only on permanent. If primary give: ZOE.
_______, alone or in combination with other drugs, is the most common sedative agent used in Pediatric Dentistry?
*CHRLORAL HYDRATE*
Most common of the *CRANIOFACIAL MALFORMATIONS* is?
*Cleft Palate and Cleft Lip*
Which of the following are the most common cause of *Endocarditis* Following a dental procedure? A. E. Coli B. Viridans group Streptococci C. Staphylococci D. Bacteroides
*VIRIDANS GROUP STREPTOCOCCI*
steam sterilization
-corrodes non stainless steel -is acceptable for some plastics, cotton rolls, -dulls instruments
Lateral periodontal cyst Treatment?
-developmental (not due to infection) -arises from the PDL REMNANTS Tx: EXCISIONAL biopsy and enucleation
primordial cyst
-develops in place of tooth (usually mand 3rd molar) -OKC
patient with recent MI
-do NOT give retraction cord with EPI in it!
important factors when pulp testing
-dont test one tooth more than 2X -avoid gingiva and metallic restorations
Cleidocranial dysplasia presentation
-enlarged skull -impacted supernumerary teeth
Toothpick holder-perio aid
-exposed class 4 furcation -interdental cleaning-concave proximal surfaces -gingival hyperplasia
periapical bone scar treatment
-failure of bone to fill area after extraction. Asymptomatic. NO TREATMENT, just observe
what are the most significant factors that influence the course of perio disease
-furcation involvement -pocket depths
Valium
-has metabolites for long duration and binds to GABA receptors to cause inhibitory effects treats anxiety, seizures, and insomnia
kidney dialysis
-if a stent was placed, NO NEED for antibiotics
Purpose for acid etch
-increased SA -retention -remove smear layer -produce tags **does NOT increase CHEMICAL bond
hypocalcified teeth
-insufficient amount of calcium in teeth (different from DEcalcification, which is the beginning of the decay process) white and brown spots on teeth
wedge simulator
-interdental areas with exposed root surfaces -recession
treatment of DRY SOCKET
-irrigate site -treat with iodoform gauze and eugenol
What is Ludwigs angina?
-large swelling on floor of mouth (submandibular space) -difficulty breathing MEDICAL EMERGENCY
what are blue/brown bumps or linear structures on the VENTRAL tongue. What are they caused by?
-lingual varicosities -caused by AGEING
MAJOR aphthous ulcers
-long standing WITH a scar (pemphigoid can also heal with a scar) -can be seen on lip or palate (minor isnt seen on the palate)
Hairy tongue -what causes it -tx?
-multifactorial (meds, dry mouth) -tx: take patient off meds and improve oral hygiene **different than oral hairy leukoplakia! (which is caused by EBV and associated with HIV)
median palatal cyst -can be seen on what xray -tx?
-occlusal film -tx: enucleation
Porcelain fractures causes between: -porcelain-metal -porcelain-oxide -porcelain-porcelain
-metal = oxide wasnt formed -oxide = contamination of oxide surface -porcelain = inclusions or voids
peripheral cemento-osseous dysplasia
-middle aged black women -mand anterior -no pain or expansion
RANULA What is it? Where is it? How do you treat it?
-swelling of CT consisting of collected mucin from ruptured salivary gland duct (usually caused by trauma) -FLOOR of mouth -EXCISION or marsupilization
A patient has SYNCOPE, what do you do?
-trendelburg position (feet higher than head) to increase cerbral perfusion pressure --> NOT recommended for hypovolemic shock -oxygen -maybe aromatic ammonia under nose
gemination
-twinning of tooth bud -incomplete formation of 2 teeth (1 root) -common on incisors (max lateral)
all sides of this handpiece are active
-ultrasonic magnetostrictive -Sonic scaler
geographic tongue (erythema migrans) -treatment?
-unknown etiology NO TREATMENT (reassure pt)
HYPOthyroidism symptoms
-weight GAIN dry hair -lower voice -feels cold
Lichen planus treatment
-white wickmans striae -treat with topical corticoSTEROIDS when SYMPTOMATIC -if asymptomatic or reticular, LEAVE ALONE
How far should the major connector be from the free gingiva in RPDs?
3mm for both maxillary and mandibular
cap stage
3rd stage of tooth development, week 9-10 with dental lamina growing into cap shape. Remember, anterior teeth develop first. This is when the the shape of the tooth changes and the enamel organ is formed from ectodermal tissue.
application frequency of NaF tray method?
4 times a year or age 3, 7, 10, 13
how long does it take for osseointegration after placement of a mandibular implant?
4-6 months
Self applied toothpaste with fluoride
400-1500 ppm
Pregnant woman, need to premed, what do you use?
Clindamycin
A tooth that has a reaction to cold that lasts about 5-10 seconds. What is the status of the pulp?
REVERSIBLE pulpitis
***Essential property for major connector?
RIGIDITY
U shaped major connector - biggest function is to provide
RIGIDITY (not reciprocation, retention etc)
dentigerous cyst
RL around crown of tooth
lingual salivary gland defect
RL at the ANGLE of the mandible
solitary bone cyst tx
RL between 2 roots -NO TREATMENT
pain on swallowing when rpd is removed
RPD lingual impingement
Dentinogenesis imperfecta
Radiographically-bulbous crowns with short and slender roots and absent pulp chambers and root canal. In a clinical photo-the teeth may be gray to yellowish brown. They exhibit translucent or opalescent hue. Enamel is usually lost early due to loss of scalloping at the DEJ. However, the teeth are not more susceptible to dental caries than normal ones.
Median Rhomboid Glossitis
Raised, red, glossy, slanted rectangular shape on dorsum due to Candida albicans infection.
Less
Raising pain threshold means patient is more or less reactive to painful stimuli?
Pic of tongue with inflamed lingual tonsils - next step?
Reassure pt and re-eval
Ulcers with other episodes slide - what condition?
Recurrent Aphthous Ulcers
succedaneous teeth
adult teeth. By the end of the 10th week initiation is already beginning for permanent teeth.
Tdap is a vaccine for tetanus, diptheria and pertusis given to whom?
adults-only 1 injection. Td is an injection given every 10 years to adults.
rapid tooth mobility is due to (advanced perio/ apical pathology)
advanced perio
common finding in a pt. w/ CP
anterior teeth fracture
pt. inter-papilla gingiva is swollen, why?
anti-convulsant meds (Dilantin)
What is naproxen taken for?
anti-inflammatory analgesic for arthritis
the immune produces ______ cells such as IgA found in saliva. what are they called?
antibodies
listerine is an
antiseptic/disinfectant
what screening method would we use to determine malignancy versus begign?
biopsy
highest incidence of perio disease found in...
black males
How do you diagnose hereditary telangectasia?
blanching on palpatation
hereditary telangiectasia sign
blanching on pressure
HEP B transmission occurs via
blood or OPIM including all except sweat: saliva, percutaneous injury, mucosal injury, sex, iv drug users, contact may be direct or indirect. highly virulant disease
pulp contains
blood vessels, nerves, and lymphatic vessels
how is hep b spread
blood, semen, other bodily fluids
fluoride is stored in
bone marrow
Interdental brush
-open embrasures -exposed class 4 furcations -ortho appliances, fixed prosthetics, dental implants. -inner wire needs to be plastic to avoid scratching cementum
tufted brush
-open proximal spaces -hard to access areas like 3rds/crowded teeth -over lapped teeth -prosthetics, under partial dentures, pontics, ortho appliances
Floss holder is reccomended for?
-physically challenged -caregivers providing OHI
stages of extractions for immediate dentures?
-posterior teeth first (leave PMs and anteriors) = this will MAINTAIN the vertical dimension -after 8 weeks, take the impressions to make the denture
antihypersensitivity in dentrifices
-potassium nitrate -strontium chloride -sodium citrate
endogenous staining includes?
-pulpal necrosis -tetracycline stain -internal resorption
treatment of an AVULSED PERMANANT tooth
-put in hanks balanced solution -DO NOT SCRUB clean (will destroy cells)
hypercementosis
-radiopacity that will follow the PDL on pan -seen in Pagets disease
BCC
-raised lesion under the eye (2 years) tx = biopsy and surgical removal
What do you recommend to a patient that is taking CCB that causes gingival hyperplasia?
-reduce or switch their meds -last option is gingivectomy
Treatment of #9 with existing crown and a fracture 1mm below the CEJ (above crest of bone)
-remove crown -RCT -post/core/crown -supraerupt the tooth with ortho to bring the marginal coronal
disadvantages to precision attachment dentures?
-requires manual dexterity (not for patients with arthritis) -more tooth reduction -requires good oral hygiene -expensive
contraindications to precision attachment dentures?
-severe periodontal disease -poor crown to root ratio -high caries
horiztonal root fracture treatment
-splint to adjacent teeth to immobilize or RCT
Name 6 Contraindications for air powder polish
-spongy ginigva bc of embolism -respiratory issues -restorations -exposed roots -immunocompromised -pts taking potassium, anti dieuretics, or steroid therapy
irreversible pulpitis
-spontaneous pain -lingering thermal -percussion pain -DIFFUSE pain (not localized) -lying down or bending over intensifies pain **best test = THERMAL COLD TEST
4 indications for use of air powder polish
-stain or biofilm -root detox done by dds or endo -sealant prep -soft debris around ortho appliance
Side effects of CHX rinse
-stains teeth, tongue, restorations, bitter taste, irritate/burn oral mucosa, increase supra G calc, wait 30mins after brushing so isnt inactivated by sodium lauryl sulfate
Hemangioma treatment
-surgical excision? or observe?
karposi sarcoma can appear
on the hard palate and gingiva, as purple, red macules in the early stage, as nodules in later stages.
1.23% ApF tray method is recomended how many times a year?
once or twice. Available in foam or thixotropic gel form
paranasal sinuses-what are they and how many do we have?
paired air-filled cavities in the bones of the face that are connected to the nasal cavity. 4 locations-maxillary, frontal, ethmoid and sphenoid
In immediate dentures, if occlusal grinding is needed, where should they grind?
palatal of upper anteriors buccal of upper posteriors
What is the first pillar in front of the tonsils?
palatoglossus arch --> tonsils --> palatopharyngeal arch
cementum color and texture
pale yellow, feels grainy. Is a thin coating on root surface
Slide: tongue, swollen lesion, what to do next?
palpate to see if it's firm or indurated
Pic of exophytic pedunculated lesion interfering with eating - ?
papilloma
factors associated with TMD inlcude
parafunctional habits clenching malocclusion
RINN xray holders
parallel film and cone is perpindicular
What would you expect after perio cleaning with chronic generalized perio pt
pocket reduction 1-2mm*
to match the shade -
polish first
What impression material do you use for dentures?
polysulfide (rubber base materials)
3 P's of diabetes
polyuria, polydipsia, polyphagia
what causes teeth to be green/ orange?
poor oral hygiene
Disinfect means
process of reducing the number of pathogenic organisms so they dont potentiate disease. Wont kill spores
Phlebitis means what risk?
pulmonary emboli risk
what is the most severe form of phlebitis?
pulmonary emboli? deep vein thrombosis?
BW - what is problem here?
pulp stones?
Acute Hepititis B virus
short term illness, occurs within first 6 months of exposure to virus. jaundice, dark urine, fever, fatigue, nausea
No
should N2O be used to substitute local anesthesia?
No
should patients with these conditions receive N2O? 1. severe mental illness 2. mental retardation 3. autism 4. Alzheimer's and other forms of dementia 4. drug abusers 5. severe alcoholics.
Yes
should you get a consult on whether or not to use N2O if there is an infection present or surgical procedure done within the last 3 months for the middle ear or eyes?
Yes
should you get a consult on whether or not to use N2O since the gas crosses placental barrier?
SSC identification and most common location
side of tongue
upper max molar area - RL with corticated border. edentulous spaces are present
sinus pneumatization (sinus moving down - normal)
dome shaped lesion in the maxillary sinus
sinusitis (Waters view)
sulcular epithelium aka crevicular epithelium seeps from where
the Junctional epithelium- both of these areas are non kertainized made up of stratified squamous epithelium
first diagnostic proceudre at recall
update med hx
consequence of over-extension of DB flange?
uprighting by masseter m
Fear
what term describes the feeling of fright or dread related to an identifiable source?
Pain Threshold
what term describes the point at which a sensation starts to be painful and a response results? (Varies from person to person and time to time)
Sophrology
what term describes the science of the spoken word; enhances N2O's relaxing effects?
Anxiolysis sedation
what type of sedation would this be? 1. Minimal sedation. 2. Drug-induced state in which patient responds normally to commands. 3. Intact protective reflexes and airway; responsive to physical stimuli and verbal commands.
Conscious-Moderate sedation
what type of sedation would this be? 1. Moderate sedation. 2. Drug-induced depression of consciousness. 3. Intact protective reflexes and airway; responsive to physical stimuli and verbal commands.
Deep sedation
what type of sedation would this be? 1. Patient not easily roused. 2. Partial loss of protective reflexes and altered responsiveness. 3. May require assistance in maintaining patient airway.
Bruxism
the involuntary grinding or clenching of the teeth that usually occurs during sleep and is associated with tension or stress- commonly with mixed dentition as teeth try to find their occlusion.
Fones
toothbrush is perpendicular to the tooth and brushing in circular motions. Good for pedo pts
Someone has an allergic reaction to penicillin and gets a fat lip. What should you give them?
topical steroids or switch antibiotics
Why should we not use gluteraldehydes as a surface disinfectant?
toxic effects of fumes if inhaled, corrosive, and must immerse in liquid for 10 hours or more.
T or F sterilization kills ALL pathogenic microbes, including spores?
true- sterilization uses heat or chemicals to kill all pathogenic microbes including spores
bi lateral
two hands are being used to examine corrosponding structures on opposite sides of the body.
asymptomatic finding on the lateral border of tongue with a 5 YEAR history (during which it has CHANGED appearance a lot) treatment?
tx = REASSURE patient (NO TREATMENT
Treatment of someone who has a HARD PALATE SWELLING for about 2 years that was previously removed.
tx = surgical removal
What pain med do you prescribe for a patient with ACID REFLUX?
tylenol
which power driven scaler works at 18,000 to 45,000 cycles per second cps
ultrasonic magnetostrictive
which handpiece works at 25,000-50,000 cycles per second?
ultrasonic piezoelectric. Works thru sounds waves and cavitation. **The lateral sides of tip are most active***
xray tooth under mand ant
supernumerary tooth
who reccomends the autoclave method
CDC- cant use closed containers in autoclave
Attachment Loss
CEJ --> Sulcus *Think LOSS and SULCUS
Attachment Level
CEJ --> pocket depth
how do you determine attachment level?
CEJ to depth of pocket
how do you determine attachment loss?
CEJ to sulcus
What disease do you have if you have INCREASED calcium levels?
HYPERparathyroidism
instrument for calc detect on posteriors
pig tail, 11/12
class 1 caries
pits and fissures on lingual surfaces of anterior teeth and occlusal/buccal/lingual surfaces of posterior teeth
disinfectants are used on
surfaces
what do you do if after SPR there are probing sites still w/ deep pocketing?
surgery/ open debidement
Classical (initial) signs of aggressive perio
*mobility *deep pockets w/ lack of inflammation
Propoxephine
-analgesic for mild-moderate pain -DO NOT USE WITH KIDNEY FAILURE
Bur for post should not be greater than _____ of diameter
1/3
Bacteria that causes ANUG
A. spirochetes
***ortho case - what was most important thing they did in max arch?
Align teeth for future restorative procedures (NOT close U&L diastemas)
Which hepatitis shot is given to the dental hygienist employee?
All dental staff should be protected from hepatitis B virus.
Herpes Zoster
Also called Shingles. It is a painful, blistering, skin rash due to the Varicella Zoster Virus-the virus that causes chickenpox. Shingles may develop in any age group but you are more likely to develop the condition if: you are older than 60, you had chickenpox before age 1, your immune system is weakened by medications or disease.
ADA
American Dental Association- reccomendations for infection control and products
***difference in anaphalaxis vs syncope
Ana has WHEEZING & BRONCHOCONTRICTION
Myofunctional considerations-lingual frenum
Another issue is the length of the lingual frenulum. If the lingual frenulum is restricted, as with ankyloglossia, it limits the possibility of creating appropriate pressure against the maxillary arch for normal expansion.
Oraqix duration
Approximately 20 minutes.
Edentulous patient with big ulcer on palate
Apthous ulcer or due to irritation.
antrolith
CALCIFIED (unlike antral polyp)
condensing osteitis tx
EXT or RCT
pt has candida - give WHAT
FLUCONAZOLE
type of bacteria in perio disease?
G-
which of the following cause bone loss? (C3a, C5a/ Endotoxin/ Interleukin/ B glucorinidase)
Interleukin
Petechiae
Pinpoint, red spots.
***surgical stent fits the gums but immediate denture doesn't fit - what do you do?
Relieve until it seats
What is Nasmyth's membrane?
Residue left over on newly erupted teeth that may leave an extrinsic green-gray stain- produced by ameloblasts
***Before you reline a CD, you must first establish what?
Restore Posterior Occl
which handpiece uses compressed air to create vibrations?
Sonic scaler
Which *Primary tooth* is most often *Retained*?
The *primary Mandibular First Molar* is most often retained.
whose responsibility is is to follow the blood borne pathogen standard and provide PPE? As well as annual training?
The employer
CI in hyperthyroidism?
Vasocont in anesth (e.g. Epi)
Crepitus
When the TMJ pops, clicks, or grinds.
Pre-medication doses
amoxicillin - 500mg; Disp 4 tabs. Take 4 tabs (2g) 1 hour before appt
angioedema of upper lip
allergic reaction tx= benedryl
Exfoliative cheilitis
With desquamation.
Primate spaces
Within a primary dentition, primate spaces may occur between the primary teeth; a space is noted between the maxillary lateral incisor and the canine, and between the mandibular first molar and canine.
Case: if pt was given kideny xplant, how would this change tx?
Would need to premed the pt bc they would be immunosuppressed
are pharyngeal spaces on panos normal?
YES
DPC is better in (young/old) teeth?
YOUNG
Does chlorhexidine have high substantivity?
Yes.
***what type of cement is the worst for a Deep Restoration
Zinc Phosphate
what is a raised area on the sinus floor?
a retention CYST (antral pseudocyst) -can be seen on a pano -usually asymptomatic and dont need tx
Ranula
a specific type of mucocele in the floor of the mouth in the sublingual duct that contains mucin from a ruptured salivary gland from trauma. Will usually be uni lateral not bilateral.
Hairy Leukoplakia
a white rough patch that arises on the LATERAL tongue. Usually seen in immunocompromised and is due to EBV induced squamous cell hyperplasia. NOT pre-malignant.
loss of tooth structure from forces of mastication is
abfraction
dilaceration means
abnormal curvature of the root believed to be caused by trauma to the tooth bud after crown formation is complete.
which is NOT a sign of periodontal inflammation (color/ consistency/ BOP/ attachment)
attachment
palatal development
begins week 5-12
eagle syndrome
calcification of the temporal STYLOID PROCESS -elongation -caused by trauma - may lead to carotid artery syndrome (unilateral neck pain, dysphagia)
pulp stones
calcified masses of dentin-not a concern unless root canal is needed
ameloblasts produce what material for enamel
calcium hydroxyapatite
most plaque retentive thing is
calculus
Yes
can N2O be used with local anestheisa if needed?
HCTZ in denture pt - ?
decr retention due to less salivation
hyperemia
dark, reddish tooth
***Problem with resin bonded bridges most commonly?
debonding
Disadv of resin bonded bridge (maryland)?
debonding
how do you treat gingivitis in puberty?
debridement and OHI
how do you tx HIV pt. w/ ANUG?
debridement and antimicrobial rinses
water irrigation removes...
debris *NOT plaque
chelitis happens in increased interocclusal space. tx?
decrease IO space and increasing VDO
PAN with RL around impacted 3M
dentigerous cyst
What comes first, dentin or enamel?
dentin
***Want to undercontour the temp to do what?
improve gingival health
left max central isnt erupted - huge RO ball - dx?
odontoma
No
should you use N2O on patients with 1. Moderate to severe COPD? 2. Infectious diseases (air-borne)? 3. Pneumothorax (abnormal collection of air/gas in the pleural space)? 4. Cystic fibrosis? 5. Sinus infections or nasal obstruction?
inner cells of the dental lamina will form
tissues of the pulp
Nitrous oxide
what may cause some analgesia?
Tidal volume
what term describes the amount of gas inspired into the lungs in one respiration cycle?
HIV pt - what do you do?
whatever tx it was that didn't induce bleeding
class 4 caries
anterior interproximal with incisal edge
what is the ideal type of implant
endosseous implant
When placing an implant in areas of #7 and 10, which type of implant is best? What structure should you be careful of?
endosseous implant nasal cavity
How do you treat an anaphylaxis reaction/shock?
epi (0.3-0.5mL epiPEN) steroids supine position oxygen
dilantin gingival hyperplasia tx
gingivectomy
Overhangs and bad crown margins can cause what?
gingivitis
Big cavity - what is best for pulpal and gingival health?
gold onlay or PFM - probably is gold onlay
Ambient air
what term describes the air we breathe?
When do the *Permanent teeth* begin to *calcify*?
*At birth*
Most common form of Diabetes in children is?
*Type 1*
What type of ETCH do you use for composite restoration?
35-37% phosphoric acid
How many mgs of anesthetic is in 2% concentration?
36 mg
6mos pregnant and had bleeding gums w mobile teeth - tx?
Conservative debridement
Broken coronal portion of a canine - what to do?
Conservative endo and prep post & core
OSHA coveres PPE in the BBPS and who clears the medical devices?
FDA
Digital film
Faster than F speed film.
A condition that is characterized by a bunch of OSTEOMAS
Gardners syndrome
***Pts weight is most critical thing for calculating?
Med dosage for child
class 3 caries
anterior interproximal-not including incisal edge
Patient is taking Naproxene. What for?
arthritis
lump that moves - benign or malig?
benign likely
2 other ways to monitor sterilization process?
chemical and mechanical.
what occurs after raising a flap?
healing of LONG JUNCTIONAL EPITHELIUM
Patient has bulging eyes. What disease is this?
hyperthyroidism
immediate dentures - EXT all teeth except which ones?
#12 & 21 ONLY
Class II Occlusion
(Retrognathic) buccal groove of the mandibular first permanent molar is distal go the mesiobuccal cusp of the maxillary first permanent molar by at least the width of a premolar. Distal portion of the maxillary canine is mesial to the mesial portion of the mandibular canine by at lease the width of a premolar. Division I-retruded mandible with one or more maxillary anterior teeth protruded facially. Division II- retruded mandible with one or more maxillary anterior teeth inclined lingually.
What do you NOT consider for esthetics when setting max denture teeth? Choose from: midline, tooth position, arch form
(not sure, maybe arch form?)
*Hand over Mouth Exercise* is known as what type of conditioning?
*AVERSIVE CONDITIONING*
**Condylar inclination on articulator =
**protrusive record
Calcification of roots normally completed by age?
*3 or 4 years old*
The crowns of all 20 Primary teeth begin to calcify between? _____ months in Utero?
*3.5 - 6 Months in Utero*
clinical studies demonstrate that acidulated Phosphate fluoride is most effective at what *PH*?
*3.5*
the minimum number of *lobes* from which any tooth may develop is?
*4 lobes*
the *Primary Mandibular Canines* are usually Exfoliated at which age?
*9-12* years old
Localized Aggressive Perio bugs
*AA Capnocytophaga
What type of leukemia is referred to as *LEUKEMIA of CHILDHOOD*?
*ACUTE Lymphocytic Leukemia*
*Dilaceration* is an abnormal bending of the root during its development, could be result from a traumatic episode, usually found in *Primary Dentition* - Dilaceration is a constant finding in children with?
*Congenital Ichthyosis*
Herpangina is caused by which virus?
*Coxsackie virus* note: 1. *Herpangina*: a Summer Illness that produces vesicular lesions of the *Uvula*, *Anterior Pillars*, and *Posterior Pharynx*. (THROAT, PALATE, and TONGUE) 2. oral lesions of *hand, foot, and mouth* disease appear on the *Buccal Mucosa* and *Gingiva*.
A defect that results in *LESS QUANTITY* of Enamel. - may cause sensitivity.
*Enamel Hypoplasia*
All acidulated Phosphate Fluoride products should be applied for ____ Min. in order to achieve the best results?
*FOUR MINUTES*
*DentinoGenesis Imperfecta* affects both *Primary* and Permanent dentitions* -what is the Treatment for Dentinogenesis Imperfecta?
*Full Coverage Crown*
All of the following syndromes demonstrate both *Supernumerary teeth* and *Hypodontia* *EXCEPT*? A. Crouzon's disease B. Gardner's Syndrome C. Down's Syndrome D. Hallerman-Streiff Syndrome
*GARDNERS SYNDROME* - does not Demonstrate *Hypodontia*
if you have a class III furcation, you can do all of the following EXCEPT?? (section it and crown both as PFMs/ tunneling procedure/ GTR)
*GTR
what cement is the best choice for *Cementing a Lower Fixed Bilateral holding arch in place*?
*Glass Ionomer Cement*
*Dentinogenisis Imperfecta* is an autosomosal dominant trait. - Originates during the ________ Stage of tooth development?
*Histodifferentiation Stage* of tooth development both *Amelogensis imperfecta* and *Dentinogenesis Imperfecta* are found in this stage.
the *Smallest* primary tooth?
*Mandibular Lateral Incisor*
the *LARGEST* Primary tooth is the?
*Mandibular Primary Second Molar*
*Dens-In-Dente* (Dens INVAGINATUS) - means Tooth within a tooth. Results from *INVAGINATION* of the inner enamel epithelium. - Most frequently found in which tooth?
*Maxillary Lateral Incisors* - usually have dens- IN- Dente.
*Koplik Spots* are associated with?
*Measles* - Koplik spots.
the Most frequently take views in Pediatric dentistry are the?
*Molar Bitewing Radiographs*
the bulbous, conically shaped primary teeth also affect the amount of the extension of the occlusal outline of the preparation. the general rule is that the occlusal outline is about_________ of the intercuspal distance?
*ONE THIRD*
an outstanding oral manifestation of *Achondroplasia* is?
*OVERCROWDING OF TEETH*
Characteristic RADIOGRAPHIC Finding of a preschool child with *Dentinogenesis imperfecta*
*Obliteration of the pulp chambers*
one alternative to the traditional full strength Formocresol pulpotomy is the Formocresol pulpotmoy using diluted solution of the formocresol. A____ Dilution has been recommended ?
*One-Fifth* dilution or *20%*
Shields type I: occurs with ____ condition?
*Osteogenesis Imperfecta*
When a child who is obviously *Afraid* the dentist should? a. Use Restraint. b. Use HOME c. Permit child to express his fear d. Avoid all reference to the child's fear.
*Permit child to express his fear*
The process of shaping a patients behavior through *Appropriately timed feedback* is called:
*Positive reinforcement*
After extracting a tooth on a child patient, the *Biggest Post-Operative concern* is the?
*Prevention of Lip Biting*
the first *PRIMARY Tooth* to Erupt?
*Primary Mandibular Central Incisor*
Which is the only Anterior tooth in either dentition to have a *Shorter Inciso-cervial height* than the MESIO-distal with?
*Primary Maxillary Central Incisor*
the occlusal form of this Primary tooth, Caries of any tooth in the Permanent dentition? Resembles no tooth.
*Primary Maxillary first molar*
a neophyte dental student gets scared when her 10 year old cousin gets hit in the face and loses a tooth. she calls you up and says that her cousin lost his Permanent mandibular first molar. once she tells you more about the root morphology. you realize its a *primary tooth*, which primary tooth is it?
*Primary mandibular Second Molar* - resembles the Permanent mandibular first molar.
the Phenomenon of *STRAWBERRY TONGUE* is associated with what disease?
*SCARLET FEVER*
Type of Dentinogenesis Imperfecta: there is: - Brittle Bones -bowing of limbs -Blue Sclera. -Bulbous crowns. -obliterated pulp chambers
*Shields Type 1*
*Shields Type III* is quite rare, the teeth demonstrate what type of appearance?
*Shields type III* - Shell like appearance -Multiple Pulp Exposures
_____ teeth are characterized by a - Significantly *Elongated Pulp chamber* - *short stunted roots* From failure of the proper level of horizontal invagination of Hertwig's epithelial root sheath.
*TAURODONTISM*
known as the *White knuckle* patient because they grip the dental chair arm rests so tightly?
*TENSE- COOPERATIVE*
Excessive Flouride leels in drinking water are associated with *Fluorosis*. Fluoride levels in Excess of _____ begin to pose a risk for flourosis? A. One part per million B. Two parts per million C. Three parts per million D. Four parts per million
*THREE PARTS PER MILLION*
*CRETINISM* is a deficiency disease, caused by the congenital absence of:
*THYROXINE*
Child that hides behind parents or puts hands over their mouth and face?
*Timid*
All of the following instances may make the use of a RUBBER DAM impractical *EXCEPT* one? a. The presence of Fixed Orthodontic Appliances b. Patient with congested nasal passages or other nasal obstruction c. Very nervous or anxious patient D. A recently erupted tooth that will not retain a clamp
*Very Nervous or Anxious Patient*
Listerine MOA
*broad spectrum antimicrobial *kill bacteria associated w/ plaque and gingivitis by disrupting bacterial cell wall *Chlorohexidine (cell mb)
an 11 year old child traumatized a Permanent maxillary central incisor some time ago. tooth has never been restored. it is now *painful* and there is evidence of *swelling*. A Periapical x ray discloses a *pathosis associated with the apex*? what treatment would you give?
*pulpectomy*
why is inorganic pyrophosphate in toothpaste?
*tarter control *removes Ca and Mg from saliva --> preventing them from being deposited on the teeth *prevents calcium phosphate crystals
oral hairy leukoplakia -what causes it? -what dz is it associated with? -tx?
-EBV (HH4) -CANNOT be scraped off -benign -associated with HIV/AIDS -tx = generally does NOT require treatment. Antivirals can be given, but will reappear when stopped. -ANTIBIOTICS may be given if they are immunocompromised
Mucocele
- Blister like lesion - Caused by the blockage of a MINOR salivary gland- goes away on its own usually and contains clear fluid.
complex odontoma
- Large radiopaque hard tissue calcified masses - Usually in the posterior jaw - Does NOT resemble an accumulation of teeth
Perio related diseases (4)
- Pap- Lefev. - Down Syndrome - Hypophosphatasia - Acrodynia
Ultrasonics (2)
- Peizoelectric - Magnetostrictive
Plaque formation (3 steps)
- Pellicle - Adhesion/ attach - Colonization/ plaque maturation
compound odontoma
- Small radiopaque masses - Usually in the anterior jaw - Resemble an accumulation of small teeth
how do you tx ANUG?
- debridement - chlorohexidine - OHI
***RO on PAN in sinus - dx?
- it's a mucous retention cyst in max sinus
ANUG characterietics
- punched out papilla (interpapilla damage)/ interproximal necrosis - Fetid odor - No pockets - Pseudomembranous coating (gray) on gingiva - Cratered gingiva
liver spot tx
- remove, irrigate, pressure, re-eval
sickle cell anemia
-"ladder-like" striations on the PAs inbetween teeth (decrease in trabecular bone density and enlarged marrow spaces)
ameloblastoma
-"soap bubble" appearance (multilocular) -posterior mandible Polycistic tx= wide surgical EXCISION/resection Unicystic tx= ENUCLEATION (YOUNG patients)
MINOR apthous ulcer
-7-10 days -regular painful -found on lips/cheeks but rarely found on palate or dorsum of tongue
median rhomboid glossitis -what causes it? -tx?
-CANDIDA infection (fungal) -treat with Nystatin
fluorosis
-CANNOT REVERSE -microabrasion and bleaching can improve esthetics
Acute herpetic gingivostomatitis
-CHILDREN (6mo-5yr) **adults can get this but will have less severe rxn) -TZANCK test is done to diagnose -small PAINFUL ulcers that recur every 5-6 months with FEVER -tx: palliative with lidocaine rinses and analgesics
Herpetic stomatitis
-COLD SORE (different from aphthous stomatitis) RECURRENT lesions on ATTACHED gingiva
If a patient has a tongue piercing, all of the following can happen due to the piercing?
-Chipped tooth -Trigeminal neuralgia -Infective Endocarditis
anemia
-DECREASED RBC count (<2million) -PALE gums normal = 4.7-5 million
Pierre Robin Syndrome
-congenital disorder -cleft palate -SMALL mandible -glossoptosis (downward displacement or retraction = airway obstruction)
acute herpetic gingivostomatitis - ID and tx
-FEVER -small herpetic lesions -tx = palliative
Leukemia symptoms (blood cell counts)
-INCREASED WBCs -gingival bleeding
myxoma
-LARGE -multilocular in post mand -soap bubble -HIGH recurrence
cleft lip vs cleft palate
-LIP: medial nasal process and maxillary process -PALATE: palatal shelves (BIFID UVULA)
SCC
-LOWER LIP and LATERAL TONGUE -may have crusted cauliflower appearance
amelogenesis imperfecta
-NO ENAMEL on teeth of BWs or PAs -hypoplastic = decrease production -hypocalcified = decrease mineralization -hypomaturation = decrease maturation (snow-capped)
condensing osteitis
-NON-VITAL TEETH!!!! (doesnt respond to tests) -no RL border (like cementoma?) -RO is NOT separated from the apex -usually due to irritation/trauma -young people and 1st molars Tx= eliminate infection source
dentinogenesis imperfecta
-OBLITERATED PULP CHAMBER -opalescent hue (gray/blue/brown) -BOTH dentitions affected (baby and adult teeth) -Type I = osteogenesis imperfecta (blue sclera/bone disease) -Type II = most common (hereditary) Type III = "shell teeth" LARGE pulp
nicotinic stomatitis
-PIPE smoker -palate -raised areas with central RED dots
cementoma/cementoblastoma (neoplastic version)
-RP lesion fused to root of teeth with RL rim around it -affects VITAL teeth -mostly mand anteriors -NO TREATMENT (just observe) --> but if cementoblastoma, removal of tooth
What carries saliva from the PAROTID gland to the mouth? Where is it located?
-Stensons duct -behind second molar **if retrograde infection occurs, take SIALOGRAM (xray) to see if stone exists. Can also PALPATE to see if saliva comes out
Cause of burning mouth syndrome
-UNKNOWN, nerves, or nutrition deficiency, meds -tx: switch meds, treat dry mouth, control pain
herpetic gingivostomatitis (or herpetic stomatitis)
-VIRAL infection (HSV-1) -vesicles that rupture into ULCERS -acute = usually a CHILDs first exposure to herpes virus -recurrent = adults Tx = ACYCLOVIR, liquid diet, analgesics
What carries saliva from the SUBMANDIBULAR gland?
-Whartons duct **to check if there is calcification, take an OCCLUSAL xray
primordial cyst (development odontogenic cyst)
-a cyst seen where a tooth didnt develop (mostly) can be seen on a pano even with all the 3rd molars present -tx: surgical removal/enucleation
HERPETIFORM aphthous stomatitis
-a form of recurrent aphthous stomatitis (ulcers/canker sores) that form anywhere in the mouth and multiple numbers -painful -heal within 10 days -NOT associated with herpes
what sides are active with ultrasonic magnetostrictive hand piece?
-all sides of the tip are active. * Mostly at the point*** secondly the concave face, then convex back, lastly lateral sides are least active.
Causes of burning tongue
-anemia -Vit B deficiency -Diabetes -HYPOthyroidism -estrogen def
periapical cemental dysplasia
-anterior mandible -VITAL teeth -AA females (age 40-50) -tx: do NOT do RCT (just reassure pt)
What is proMETHazine? What is proPOXephine?
-antihistamine -analgesic (NOT to be used with kidney failure)
HYPERthyroidism symptoms
-bulging eyes (exopthalmos) -weight loss -tremor of extremities -Graves disease (NOT FATIGUE!)
taurondontism
-bull-shaped crowns -shortened roots -long pulp chambers
MUCOCELE What is it? How do you treat it?
-bump on the lower lip -injured salivary gland (filled with saliva, MUCOUS) -treat with EXCISION
Pagets disease
-causes HYPERCEMENTOSIS of roots -generalized skull and jaw enlargement -adults -COTTON-wool bone
How can occlusal trauma contribute to perio disease?
-causes WIDENED PDL and bone resorption -causes mobility
symptoms of MI
-chest pain -pounding heart -left arm pain -may cause GI symptoms (syncope does NOT do this)
How do you treat hemangioma?
-common on the head/neck but uncommon in the mouth -watchful neglect -usually go away on their own. Can be treated with corticosteroids or surgical removal if they are bothersome
avoid polishing in the presence of
-xerostomia -demineralized areas, decay -tooth sensitivity -newly erupted teeth -severe gingivitis, irritates free gingival margin -lack of extrinsic stain or plaque -exposed root surfaces -respiratory conditions: cystic fibrosis, emphysema, asthma
forcyde granules presentation
-yellow/white spots on inside cheek -enlarged oil glands -harmless
acidic pH level
0-7
What is the minimum undercut for a clasp?
0.01 inch
Self applied fluoride fluoride rinses
0.05% Na F daily, 225 ppm
ideal amt of undercut for retentive clasp?
0.1 in
Nitroglycerine
0.4mg tablet given to person with angina -if not effective by 5min, give a 2nd and 3rd tablet. If nothing happens, the patient is most likely having a MI
What concentration is used for sodium hypochlorite?
0.5-5.25%
normal fluoride level in drinking water
0.7-1.2ppm
how long does it take plaque to accumulate (after brushing)
1 hr
***Hep A - after how long is it fine to treat dental again?
1 week
***Leave perio pack on for how long?
1 week
Hep A? how long until you can work on him
1 week
perio pack should be removed after X weeks?
1 week
after SRP, you should find a reduction in inflammation and ____mm probing depth (pocket reduction
1-2mm
forced air dry heat sterilization
375 degrees for 12 mins like a convection oven. can use a closed container in this method.
name 2 chemicals our body produces to fight off infection?
1. HCL in stomach 2. Interferon, released by cells infected with a virus- tells neighbor cells to watch out
If you have an elderly patient with BP 153/120mmHG what do you do?
1. Re-check BP in 5 minutes. 2. Consult MD immediately. 3. Do NOT perform dental treatment until the elevated pressure decreases.
Group 1 of PDL ligaments, Alveolodental ligament has 5 types. What are they?
1. alveolar crest 2. horozonetal 3. oblique 4. apical 5. interradicular
Systemic symptoms of fluoride toxicity
1. hypocalcemia 2. hyperrflexia, convulsions, paresthesia 3. cardiac failure/respiratory paralysis
Name 2 diseases/issues with CHRONIC fluoride toxicity
1. skeletal fluorosis- 2. dental fluorosis-
4 types of Connective tissue
1. soft-fat adipose 2. firm-cartillage 3. rigid-bone 4. fluid-blood, lymph
name 3 anti hypersensitivity agents in dentrifices?
1. strontium chloride 2. potassium nitrate 3. sodium citrate
One square mm of dentin can contain as many as _____________ tubules
30,000
name 4 downfalls of using stannous fluoride
1. unstable solution-must be mixed before use 2. unpleasant metallic taste from the tin ion in fluoride. 3. stains demin areas and margins of tooth colored restorations 4. causes possible gingival sloughing
how much reduction BUCCALLY for a porcelain fused to metal JACKET crown? what about OCCLUSALLY?
1.5 mm buccal 2 mm occlusal
***minimum axial reduction for crown:
1.5mm
what is the minimum FACIAL/BUCCAL reduction for PFM crown?
1.5mm
4 types of disinfectants: QPIC
1.Chlorine-based compounds= may be corrosive, strong odor 2.iodophors=may stain yellow, 3.phenols=water or alcohol based may leave residue/filmy texture 4.quaternary compounds=not corrosive, but lower kill spectrum, limited efficacy
how wide should a dowel (post) in a canal be?
1/3 the CANAL width **when using a round bur to make a dowel, post width should be 1/3 the ROOT diameter
Acute fluoride toxicity
1/4 of CLD. Symptoms begin in 30mins and can last 24 hours. Present with flu like symptoms
safely tolerated dose is?
1/4 of the certainly lethal dose
How many hours for cold sterilization?
10 hours. But usually given 8 as a choice.
sublingual gland produces ____ % of saliva
10%-mixed secretions but mostly mucous. Opening is thru whartons duct and ducts along sublingual fold
root is 16mm, post should be at least:
11mm
1.23% ApF ppm?
12,300 ppm, Ph is 3.5
what is normal respiration rate for adults?
12-20 breaths per minute
Pre-hypertension BP
120-139/80-89
what temp is autoclaving?
121 degrees 15-20 psi 20 min
15 grains= ______grams?
15 grains= 1 gram cracker- or think- there are 15 grains of sugar on 1 gram cracker
Ultrasonic cleaner
15 minute processing time. Machine that uses the energy of high-frequency sound waves that agitate to sanitize instruments before sterilization. DONT USE HANDPIECES BECAUSE THEY ARE MOTORIZED. These clean not sterilize
static dry heat sterilization
320 degrees 1-2 hours, may melt or burn items
if preparing a crown with a 2mm pocket, place the finish line ___mm under the gingiva to maintain perio health
1mm
How long should you wait after extractions to make an impression for final denture?
2 months! (8 weeks)
NaF 4 minute tray method concentration
2% ppm is 9,050 ph 7
Normal INR range
2-3
exploring strokes
2-3mm
MAX dose for a 5 year old (anesthetic)
2.2 carpules
Patient taking coumadin, normal INR level?
2.5-3.5
how long does it take for plaque to mature
24- 36/48 hrs
Autoclave temp and time standard cycle
250 degrees, 15 psi, 30 minutes standard cycle
cycle for chemical vapor sterilization
270 degrees for 20mins
Biologic width ~
2mm
Maximum amount of unsupported porcelain allowed?
2mm
pocket depth of 5mm and 2mm from CEJ and gingival margin, what is CAL?
2mm
probing depth is 7mm, your probe passes 2mm past CEJ, what is CAL?
2mm
what is the minimum amount of UNSUPPORTED PORCELAIN on a crown?
2mm
replacing an ANT crown - what do you need?
2mm INCISAL reduction
cerebral palsy is...
2nd most common developmental disorder
before trimming teeth on stone cast for immediate - mark a line X mm above FGM
3 mm
normal recall for perio pts.
3 months
final lab reline of immediate
3 mos
Recurrent aphthous stomatitis
3 types.
training records for employees is kept for how long?
3 years
hep b vaccine
3-4 shots over 6 months
normal width of keratinized gingiva in the mandibular anterior region?
3-4mm
% to be considered generalized perio?
30%
charters
45 degree angle towards the occlusal/incisal, small circular motions keeping contact with gingival margin. Good for ortho
fluorosis can be caused at what level? (ppm)
4ppm
Sodium fluoride varnishes
5%NaF, 22,600ppm. 0.3-0.5mL applicators. Fluoride is retained for 24-48 hours, which fluoride is released for reaction with underlying enamel substantivity. 2-4 Times a year is reccomended. More effective than topical gels, and effective for caries prevention and exposed root surfaces. Effective for use on kids, infants with ease of application.
fusion of palate is complete
5- 12th week.
For immediate dentures, what is the MINIMAL period of time from the initial appointment to making the impressions for the FINAL denture?
5-6 months
bone is ____ % mineralized?
50%
Lethal dose of Flouride for a typical *THREE- YEAR OLD* is?
500 mg
Case: how much attached gingiva on lingual of #25?
5mm
how far should a post be from the apex?
5mm from apex
***How long for lab reline? (i dont get what this is asking but ok)
6 months
FDA says instruments must be sterile for ____ months
6 months
hard reline - X mos after insertion
6 months
After delivering an immediate denture, how long should you wait before taking an impression for the FINAL denture?
6 months (same as hard reline)
When can a HARD reline (lab reline) be done on an immediate denture?
6 months after immediate denture is delivered
reline of immediate denture by lab
6 mos
when do primary teeth begin to develop
6 weeks in utero
because commonly they are mouth breathers, and have an open lip posture, downs syndrome patients may have signs of gingivitis from #_______ to #________?
6-11
What % of alcohol in hand disinfection solution to use in a dental office?
60%
what is a normal pulse rate for an adult
60-100 beats per minute
Cementum composition
65% mineralized calcium hydroxyapetite- fluoride can replace some calcium if lost 23%inorganic 12% water
ph of sodium varnish
7
dentin componets
70%mineralized, 20% organic material, 10%water.
the *primary Maxillary Lateral Incisor* Erupts when the child is how old?
8 months or 9 months
After extractions, how long should you wait to take an IMPRESSION for final dentures?
8 weeks (2 months)
when is the best time to take an impression for an immediate denture after initial extractions?
8 weeks (2 months)
stannous Fluoride
8% ppm is 19,360 Ph is 2.1-2.3 making it the most acidic causes brown staining and gingival reaction with demin areas and metallic taste. Suggested 1-2 times per year
Plaque
80% water. Of the 20% remaining- 70-80% of that is bacteria and the other 20% of that is inorganic and organic components.
what is a normal glucose reading?
80-120 mg/dL (100 or less)
bud stage
8th week
face of blade for curette and sickle
90 degrees to terminal shank
Columbia blade to terminal shank
90 degrees.
% sealant success
90%
at the age of *Six Years Old* a child's head is What percentage of its adult size?
90%
CDC reccmendations for CFU's colony forming units
<500 CFU/ml in water. we can use HVE, flush lines between and before patients, rubber dams, routinely disinfect lines by Iodine in tubes.
What xray is used to detect a sialolith of a submandibular gland?
occlusal film
Neurofibroma
A benign nerve sheath tumor derived from the myelin sheath of peripheral nerves in the peripheral nervous system. It's an autosomal dominant genetically-inherited disease, which can result in a range of symptoms from physical disfiguration and pain to cognitive disability.
Neurofibroma
A benign tumor most commonly on the tongue; can be on the lateral border of tongue. This tumor is derived from nerve tissue.
Prenumbra
A blurred edge to an image, a halo effect, in an x-ray film caused usually by an overlarge focal spot exacerbated by a long object to film distance.
Retrocuspid papilla
A circumscribed nodule that lies lingual to the mandibular cuspid on the gingival tissue. It is observed more frequently in young children and seems to regress or disappear with age.
Taurodontism
A condition found in the molar teeth of humans whereby the body of the tooth and pulp chamber is enlarged vertically at the expense of the roots. The underlying mechanism of taurodontism is the failure or late invagination of Hertwig's epithelial root sheath, which is responsible for root formation and shaping causing an apical shift of the root furcation.
Neuroma
A growth or tumor of nerve tissue. Neuromas are tumors of any part of a nerve (including the surrounding myelin); sometimes the term is used more broadly to refer to any tumor of neural tissue.
Cytoplasm
A jellylike fluid inside the cell in which the organelles are suspended
Mucocele
A mucous cyst and is painless, thin sac on the inner surface of the lips. It contains clear fluid. Symptoms: a thin fluid-filled sac appears on the inside of the lip. The sac is bluish and clear.
If you see a photograph with inflammation around a porcelain crown, then the inflammation is most likely due?
A poorly fitted restoration.
Amelogenesis imperfecta
A radiograph will show a lack of enamel opacity and a pathological loss of enamel. The crowns of the teeth look just like the root as far as density. On a normal radiograph the crowns are obviously more white and radiopaque but on an xray with Amelogenesis imperfecta the crowns look just like extensions of the root and there is an obvious pulp chamber. In a clinical photo- "snow capped" enamel meaning the incisal edges are a lot whiter than the rest of the tooth. The teeth are typically more yellow or brownish in color. Pitting of the enamel is also seen.
Ranula
A type of mucocele found on the floor of mouth. Ranulas present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland duct, which is usually caused by local trauma. Only appears UNILATERALLY! Not bilateral.
Herpangina
A viral illness ordinarily in children that involves ulcers or sores (lesions) inside the mouth, a sore throat, and fever.
Herpes Simplex
A virus that produces most cold sores and genital herpes. It usually affects the lips, and in some primary attacks, the mucous membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very common.
Cleft Palate A. *Class 1* B. *Class 2* C. *Class 3* D. *Class 4*
A. Class 1: involves the *Soft Palate Only* B. Class 2: involves the *Soft* and *Hard palate* but with *NO* Alveolar Process involvement. C. Class 3: Same as class 2, but with *Alveolar process involvement.* D. involves soft palate and *Continues through the alveolus on both side of the Premaxilla*
Pt is in the chair- if he is suffering an MI. His symptoms would be all of the following EXCEPT: A. Pounding heart B. Burning chest C. Numbness of left arm D. Pain in jaw
A. Pounding heart
*CLEFT LIP* A. *Class 1* B. *Class 2* C. *Class 3* D. *Class 4*
A. class 1: Unilateral notching of the Vermillion border *NOT* Extending into the lip. B. class 2: same as class 1, *BUT* the cleft extends into the LIP C. Class 3. Same as class 2, but extends into the *FLOOR OF THE NOSE* D. Class 4: *Bilateral Cleating of the Lip*
***Reason for perio flap?
ACCESS for instrumentation
what is the main GOAL of flap surgery
ACCESS roots for debridement to allow pocket elimination
***Pain reliever for pt who has kidney disease?
ACETAMINOPHEN
fat soluable vitamins
ADEK
BW of teeth with no enamel - what condition?
AI
Angioedema
Accumulation of fluid, lips.
Stafnes bone cyst (defect) Where is it Tx?
AKA: lingual salivary bone cavity -submandibular gland depression (indentation) -asymptomatic -found as a RL BELOW mandibular canal at ANGLE of mandible -Tx = NO TREATMENT (developmental)
***gingival edema is caused by?
ANAEROBES
When can a SOFT reline be done on an immediate denture?
ANYTIME (or maybe 1 month)
Emphysema
Abnormal presence of air in tissue postoperative bleeding.
loss of tooth structure from physical wear
Abrasion, this includes trauma, mal occlusion?
Cyst of Blandin-Nuhn
Accessory salivary glands on ventral surface, cyst develops from trauma.
Most important component of decay
Acid.
which fluoride application comes in a thixotropic like gel form?
Acidulated phosphate fluoride-can use to paint on with a cotton tip applicator
what bacterial species is NOT associated w/ perio dx? (Actinomyces species/ P. gingivalis/ Capnocytophaga)
Actinomyces species
bacteria that is NOT in chronic perio?
Actinomyces viscous
What is actinomycosis?
Actinomycosis is a skin infection that forms a hard, erythematous skin lesion that is very difficult to treat. When these skin lesions drain, or if they are excised, they contain sulfur-yellow, hard granules that are typical for this infection
After being called to the reception area and seeing an unresponsive patient what do you do next?
Activate EMS procedures.
<5mg fluoride ingested is ?
Acute fluoride toxicity. Treatment is to administer fluoride binding agent like milk magnesia
Purpose of a wedge during restoration?
Adaptation of matrix band
pt with hyperpigmentation of oral cavity
Addison's
Behçet's syndrome
Affects triad of oral, eye, and genital surfaces primarily.
Measles
Also known as morbilli, an infection of the respiratory system caused by a virus specifically a paramyxovirus of the genus Morbillivirus. This is the condition where you get Kopliks spots inside the mouth. It appears primarily in children. You can get a rash that starts on the head and spreads to other areas, moving down the body that appears as flat, discolored areas (macules) and solid, red, raised areas (papules) that later join together.
If a patient is not allergic to penicillin and has infectious endocarditis, what pre-medication should be used?
Amoxicillin 2 grams.
Drug classes that commonly cause xerostomia
Antiemetics, antianxiety agents, decongestants, analgesics, antidiarrheals, bronchodilators and skeletal muscle relaxants.
Peripheral giant-cell granuloma
An oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. It presents as a lobular, purplish-blue exophytic nodule exclusively on the gingiva, both edentulous and dentate, and usually anterior to the molars. It originates from the periodontal ligament or the periosteum. It occurs across a wide age range, commonly in children, young adults, and in females. It presents as sessile or pedunculated and smooth surfaced or lobular, and though usually painless it can occasionally be ulcerated, painful and accompanied by bleeding. Like pyogenic granuloma, it is usually present either on the buccal or lingual gingiva or between teeth, but it can occasionally surround the teeth and act aggressively by displacing teeth much like a sarcoma. It appears only on the gingiva or on an edentulous (without teeth) alveolar ridge. It is more often found in the mandible rather than the maxilla but can be found in either anterior or posterior areas. The underlying alveolar bone can be destroyed, leaving a unique appearance referred to as "cupping resorption" or "saucerization."
gracey 5-6
Anterior and premolars. B/L of posterior teeth
Pt just had stroke: What do you need to worry about?
Are they on anticoagulants
The canine relationship between the arches in primary teeth is the same as:
As that of the permanent dentition.
Fissured tongue
Associated with xerostomia, clean tongue.
Washing hands between patients should be done for how long?
At least 15 seconds. (sometimes 15-20 seconds, so if you don't see 15 as a choice, choose 20)
PDL sensations provide
pain, touch, pressure, temperature
Best proof of destruction of tissues
Attachment loss.
Minute volume
what term describes the amount of gas brought into the lungs per minute?
dry heat sterilization 2 types- static and forced air
BI is bacillis atrophaeus, or bacillis subtilis. kills by oxidation- pre clean same as autoclave.
Treatment of a keratotic linear formation on the lateral tongue that has been present for 2 years?
BIOPSY
leukoplakia next step?
BIOPSY lesion
BWX what can't you determine?
BL width of alv bone
the difference between NUP and NUG is?
BONE loss with NUP.
pt. is on perio recall, what best denotes good long term prognosis
BOP
What cusps do you grind to adjust complete dentures
BULL Buccal cusps of upper Lingula cusps of lower
Bby with severe caries - suspect?
Baby bottle caries
syphillis
Bacterial infection (T. pallidum) -mulberry molars -screwdriver-shaped incisors (hutchinsons) -maxillary anteriors with central depressions
which of the following is considered malignant condition a. leukoplakia b. basil cell carcinoma c. erythroplakia d. cell dysplasia
Basil cell carcinoma is malignant. anything carcinoma is malignant.
Patient has malaise, lethargy, and itching (allergic reaction). What do you give them?
Benedryl
Fibrous Dysplasia of Bone
Developmental defect-begign, rare. Where Normal bone and marrow are replaced by fibrous tissue and immature "woven" bone looks scar like and fibrous.
Solar cheilitis
Benign or pre-malignant changes on the lip due to chronic sun exposure. It is also often called actinic cheilitis, and sometimes, actinic cheilitis with histological atypia. It affects the vermillion portion of lip.
Granular Cell Tumor
Benign tumor, granular tissue, circumscribed.
Geographic tongue
Benign, inflammatory condition, irregular patches look like map.
What is not caused by a tongue piercing?
Best answer bacteremia. Fractured tooth, trigeminal neuralgia, and recession caused by piercing.
Masseteric space
Between masseter muscle and side of ramus, MN molars
***Gives pic of red/white lesion and asks how to go further.
Biopsy the red AND white portions of mixed lesion
What precipitates a thrombosis?
Blood stasis.
Which medications cause bleeding?
Blood thinners and chemotherapy agents. The main ones are antihistamine, anticholinergic, anorexiants, antidepressants, antihypertensives, anti-parkinsons agents, diuretics and sedatives. Medications: Anticoagulants such as warfarin (coumadin) Antiplatelet drugs such as aspirin and clopidogrel (plavix) Certain epilepsy, convulsion and seizure medications Chemotherapy drugs Antihistamine drugs Immunosuppressant drugs
max depth of toothbrush and floss going SubG?
Brush- 1mm Floss- 2-3mm
4 places they spread
Buccal space Masseteric space Infraorbital space Ludwig's angina
Which of the following is true concerning a *young Epileptic* who has a *Grand Mal Seizure* in the dental office? A. generally Fatal B. Best treated by injecting Insulin C. Generally recover if restrained from self injury and oxygen is maintained. D. Can be prevented with Antibiotics.
C. Generally recover if restrained from self injury and oxygen is maintained.
Pt with tooth sensitivity to cold to receive PFM crown, cement of choice is: A. Zinc phosphate B. Zinc silicone ph C. Polycarboxylate D. Glass Ionomer
C. Polycarb
how do you calculate attachment loss if tooth root is 12mm and there is 2mm recession
CAL = distance from CEJ to the base of the pocket **add 2mm to the probing depth
fracture distal MR on tooth with huge MO amalgam - how to restore?
CAST restoration
who reccomends flushing lines for 20-30 seconds between pts? And 1.5 minutes at the begining of each day?
CDC
wash hands prior to gloves - who requires?
CDC - but maybe osha?
What does the DB cusp of the mandibular first molar occlude with?
CENTRAL FOSSA of maxillary first molar
Pic of pt with Down syn & Q asks what need to be worried about as dentist
CHD
What is elevated in the blood of someone with hyper-PTH
CHECK answer! alkaline phosphatase and Calcium **HYPER-PTH = browns tumor
What type of retention occurs when bonding to enamel?
CHEMICAL retention **acid etch does NOT form chemical bond...MECHANICAL
***GTR best for what class of furcations
CLASS 2 (I had 2 class 2 furcations to choose from, i picked the one that had lesser pocket depths - it asked 'most ideal')
pt. has involuntary uncoordinated movements w/ larynx problem?
CP
when pt. is on imunosupessents for transplanted liver, what happens in the mouth?
CT overgrowth and hyperplasia
CAMBRA
Caries Management by Risk Assessment encompasses a methodology of identifying the cause of disease through the assessment of risk factors for each individual patient and then managing those risk factor through behavioral, chemical and minimally invasive procedures. The tool was developed in formats for use by dental providers for patients age 0 to 5 and patients age 6 through adult.
***What type of drug is Nifedepine?
Ca-Channel Blocker
Superimposition on a radiograph
Can be done with any film, but mostly seen in the lower anteriors. Same thing as double exposure.
Ultrasonic scalers
Can be used on dental implants provided they have a plastic tip added to the inserts. These single use tips must be used on LOW power and is effective in removing plaque and calculus around titanium implants and abutments. It is not indicated for heavy calculus.
Ultrasonic insert with plastic tips
Can be used with implants for removal of calculus. Also, titanium and plastic hand instruments can be used on implants.
Candidal cheilitis
Candida albicans, inflammatory response.
Minor aphthae
Canker sores, movable mucosa, red border.
The CAMBRA assessment tool is a part of an overall approach to prevent and treat the caries infection and is composed of the following sections:
Caries disease indicators. Caries risk factors. Caries protective factors. Clinical examination.
After you dismiss your patient and are transferring and processing instruments all would apply:
Carry instruments in a safe container to transport, wear gloves, use ultrasonic machine. A mask and safety goggles are not needed for transporting your instruments to the lab, nor processing them in the lab.
Angular Cheilitis
Caused by Candida albicans. Also, by nutritional deficiencies-riboflavin (B2) and iron deficiency anemia, which can be evidence of poor diets or malnutrition. Zinc deficiency has also been associated with it. Also, it could be a sign of anorexia or bulimia due to malnutrition and as a side effect of constant vomiting. It affects corners of lips.
cementum is acellular or cellular?
Cellular if a cementoblast is trapped inside. This occurs at the apical 1/3 of root.
***Unconscious pt in waiting room - what is first thing you do?
Check breathing
Traumatic ulcer
Chemicals (aspirin burn), heat (food), mechanical force, ill-fitting denture, broken tooth, dental injection, kids chewing numb lip after anesthesia, thumb sucking.
Pic of pt's maxilla with FPD & RPD attached to it. Asked how they were attached -
Choices were Semi-precision attachment/bur preps/extracoronal attachment - (no idea)
Cheilitis glandularis
Chronic inflammatory disorder of labial salivary glands.
pregnant lady with diastema #8 & 9. Deep probing depth and class 1 mobility on 8 & 9. Reason for diast?
Chronic perio
chlorohexadine rinse
Cidal-inhibits colonization, pellicle formation, has high substantivity, decreases supraG plaque, Inhibits gingivitis formation, supresses Strep mutans,
Angles classification of pt in pic - flared ant incs
Class 2 Div 1
class II is almost a class III furca.. best tx option..
Class II converted to class I by doing GTR
Pt with chronic asthma- had infection, took tetracycline. He keeps complaining of burning tongue, you do a smear that reveals yeast & fungal what is the tx?
Clotrimazole (anti-fungal)
CPITN
Community Periodontal Index of Treatment Needs
Hutchinson's Incisors
Congenital syphillus- notched incisal edges on incisors, also mulberry molars- tiny globules of enamel instead of cusps on first molars.
Vitamin C deals with
Connective tissue, helps cuts and wounds heal, aids in iron absorption, and collagen formation.
if a patient presents with a pacemaker, and wants to use the ultrasonic scaler, what is the best idea?
Contact the patients Physician for clearance
sealants fail why?
Contamination
Lichen planus tx if symptomatic
Corticosteroids
***Lichen Planus present on tongue that was asymptomatic - asked what treatment?
Corticosteroids (doing nothing was not an option)
end tufted brush is useful for?
Crowding, hard to reach areas, fixed partials, under pontics, ortho appliances.
Median rhomboid glossitis
Currently thought to represent a chronic fungal (candidiasis) infection in this area of the tongue. In general, no treatment is necessary for median rhomboid glossitis. For those with symptoms (pain or burning sensation), an antifungal medication may be prescribed to kill the yeast and thereby reduce the symptoms.
what is not an etchant? A. Citric acid B. Malic acid C. Phosphoric acid D. Bis GMA
D. Bis-GMA
Pt returns after inserting CD & partial lower dentures (pt had dentures before)- pt complains of soreness of both ridges, due to: A. Allergy B. OH C. Over extended flange D. Decreased freeway space
D. Decreased Freeway Spc
How often should you change sodium hypochlorite
DAILY
***ANUG tx that is most important:
DEBRIDEMENT
***Zn Phosopate is the worst cement for what type of resto?
DEEP resto
***picture of blue sclera eyes, asked what dental finding?
DI
Xray of obliterated pulps - what condition?
DI
pic of opalescent teeth - what condition?
DI
lingual tonsil pic - bumps on lateral tongue
DO NOTHING (salt water rinses were a choice)
Pt with ANUG, what is the best tx?
Debride necrotic areas & tooth surfaces, water or warm saline rinses and antibiotic therapy if systemic involvement (fever, malaise, lymphadenopathy)
Pt with lateral perio abscess - what is intiail tx?
Debridement?
***BWX of tooth with amalgam: pt complains of pain when provoked by hot or cold - why?
Deep amalgam filling
Periostat's Mechanism drug..
Doxycycline *2x daily, 20mg
child that say *"I dont want to"* type of attitude?
Defiant
Prednisone
Delayed wound healing, poor healing, with increased risk of infection. This medication affects the immune response.
Median Rhomboid Glossitis
Devoid of filiform papilla; may be assoc. with candida albicans; red area on midline dorsal of tongue. Requires no treatment unless pain or burning sensation affect the patient, and an antifungal medication can be prescribed.
which is associated w/ perio disease? (atheroschlerosis/ Diabetes/ low birth weight of babies)
Diabetes
small intestine
Digestive organ where most chemical digestion and absorption of food takes place
Drugs that DO NOT cause gingival hyperplasia
Digoxin NEfedipine *NE does not, NI does!
gracey 7-8
Direct facials and linguals of posterior teeth
Recurrent herpes simplex infection
Dormant in nerves, recurs, clusters, contagious, postpone treatment.
***Pt on steroids - you want to know the ____ & ____ before dental tx
Duration & Dosage (do not choose "does not apply to dentistry" or something like that)
best way to communicate to pt?
Dx wax-up?
film speed that requires the least amt of rad?
E speed
What type of film gives the LEAST radiation?
E-speed film (gives half the exposure time compared to D-speed)
oral hairy leukoplakia virus
EBV -bilateral -HIV related
***Pic of #10 & 11 linguals - what is wrong with gingiva?
EDEMA
Magnetostrictive (vibrations)
ELLIPTICAL --> ALL 4 sides of tip are active
who reccomends defluoridation
EPA between 2-4mg Fl2
***CI for apically positioned flap?
ESTHETICS is the concern with it (mentions canine I think)
picture of epulis fissuratum and how do you treat before making a new denture?
EXCISION
Pt missing #2 and #3. #1 has class 3 mobility and furcation involvement. What optimal tx?
EXT #1 and either implant for #3 or 2 +3
Child- 3 y.o. with severe caries in 4 primary incisors what do you do?
EXTs
Arch development
Each dental arch goes through phases of development as the permanent teeth erupt and the primary teeth are shed. During this time, the ramus and body of the jaw develops and undergoes lengthening and horizontal growth to achieve its mature form and accommodate the larger permanent teeth.
Pt has difficulty turning neck: what syndrome
Eagles' Syndrome
No hair & missing teeth?
Ectodermal Dyspl
Magnetostrictive
Eliptical pattern meaning all sides are active.
Hairy tongue
Elongation of filiform papillae (dorsum) clean tongue.
Enamel and Cementum critical Ph levels
Enamel- 4.5-5.5 Cementum- 6.0-6.7
Mesinchyme gives rise to all but:
Enamel.
Tx for internal resorption
Endo
Xray with huge RL assoc with #8 & 9. 9 had endo - what to do if pt still feels pain?
Endo #8
Lipids are derived from:
Endotoxins from gram - bacteria.
EPA
Environmental Protection Agency- Regulates medical wastes, safety and effectiveness of disinfectants and water quality.
Tx of anaphylaxis
Epi and steroids
hsv 4
Epstein-Barr virus- related to mono
T/F: immediate dentures require less bone removal than conventional dentures
FALSE more bone removal
***Hyperthyroid symptoms do NOT include:
FATIGUE (other choices = exophthalmous, tachycardia, tremor of extremities)
what is the most significant factor influencing the course of periodontal disease?
FURCATION lesions (not deep pockets)
T/F: you are required to wash your hands before and after putting on gloves (according to CDC)
False
Hypoglycemia
Fast pulse, dizziness, and fast heart rate.
What's in pulp?
Fibro, blood vessels, lymphatic channels, nerves and connective tissue.
Mesenchymal nodules and tumors
Fibromas, lipofibromas, neuromas, and neurofibromas.
only taste bud to not have taste sensation
Filliform-these are actually nerve fibers
If a patient comes into an office due to gum inflammation issues, what is the right course of action?
First step is always have dentist to a complete evaluation before performating any treatment.
Where is the retentive arm?
Flexible portion where the TIP engages the undercut placed APICAL to the height of contour CERVICAL to the contact on a BUCCAL clasp
how to kill Candida albicans?
Fluconazole
What is the most effective method of reducing the dental caries problem in the general population?
Fluoridation of the communal water supply
FDA
Food and Drug Administration- regulates the manufacturing and labeling of medical devices and PPE, soaps etc
PAN of supernumerary teeth, clavicles PRESENT
Gardner's syndrome***
Implantation cyst
Foreign-body reaction, after trauma.
Lucinae
Found in compact bone.
nikolsky's sign
Fragile mucosa may be induced to blister or slough when pressure is applied sign is particularly useful in differentiating pemphigus vulgaris, which causes a positive sign, from bullous pemphigoid, in which the sign is usually absent.
Orange complex bugs
Fusobacterium (bridge) Prevotella Intermedia (*hormone bug preg woman) Campylobacter *plaque formation and maturation *Precedes red complex
bacteria in gingivitis
G+ cocci and rods
with the development of gingivitis the sulcus becomes populated w/..
G+ organisms
chronic perio has...
G- anaerobes
bacteria in Perio disease
G- rods and filaments --> spirochetes and motile
never do what procedure w/ Class III Furca?
GTR
gemmination vs fusion
Gemmination is the attempt by a single tooth bud to form two teeth, appears as a single root with two crowns- will look like an EXTRA tooth. Fusion is when two seperate teeth try to fuse together, two seperate roots but one large crown. Will be missing teeth if counted.
What is an odontoma?
Generally benign odontogenic tumor with production of calcified teeth parts; divided into three subtypes: complex, compound and ameloblastic. The last can occasionally show aggressive behaviour and recur locally.
Keratinized tissue in mouth
Gingiva and hard palate.
gingival hyperplasia tx?
Gingivectomy
***Pt returns in 72h with pain post-EXT. Therapy?
Give irrigation & use eugenol soaked gauze (dry socket)
***CI for patient with hyperthyroidism is?
Giving them an analgesic with vasoconstrictors
What syndrome has multiple OKCs
Gorlins syndrome
What would you not use for heavy deposits?
Graceys-they are considered for fine scaling.
How do you treat Grade 1-4 furcations?
Grade 1= SRP (<3mm) Grade 2= SRP+GTR with bone graft and membrane barrier (3mm) Grade 3/4= tunelization?
GTR best for what grade furcation?
Grade II (e.g. #30)
In general, stain does not cause pathology- what is the exception here?
Green stain which is caused by poor OHI and chromogenic bacteria- usually has deminerlization underneath.
What is GTR?
Guided Tissue Regeneration: the process of preventing epith migration along cemental wall by placing barriers to cover bone and PDL. Favors repopulation of cells from the PDL and bone
Virus likely cause of Kaposi's Sarcoma
HHV8 red/purple lesion on roof of mouth (assoc with HIV)
***Large space b/w 11 & 12: what to do?
LEAVE IT ALONE
***Normal ranges & patient's numbers for RBCs, WBCs and platelets were given. What is wrong?
LEUKEMIA - high WBC, sore lymph nodes, painful gums (very swollen gingiva is the pic)
Peizoelectric (sonic)
LINEAR --> only 2 active SIDES
***Pt with purple lesions on palate said they had similar lesion on their body too. What is most probable cause?
HIV - (Kaposi's Sarcoma). Other INCORRECT options were SturgeWeber and Erythema Multiforme
What are these meds used for? ritonavir, indinavir, didanosine, zidovudine, delavirdine
HIV meds
which herpes virus is related to herpetic whitlow?
HSV 1- mouth, skin, eyes, and genitals
Primary Herpetic Gingivostomatitis
HSV type 1 usually affects children younger than 6 Inflamed, enlarged marginal gingiva; gingival bleeding pin point vesicles -> ulcers throughout the mouth and lips w/ significant pain Malise low grade fever sore throat, lymphadenopathy doesnt want to drink water
How does sensitivity of teeth reduce over time?
Hardening/sclerosis.
Film placed backwards in the mouth
Has a Herringbone or tire track appearance.
4 classic features of infection
Heat Pain Redness Swelling
Most common side effect of Heparin
Hemorrhage.
If you see a photograph of a geriatric patient with one side of the face appearing to have some bumps and redness by the eye, what would this most likely be?
Herpes Zoster
When is the pH level at its highest in regards to eating meals?
Highest right after a meal.
M.A. controlls?
How MANY electrons
Varicella Zoster
Human herpes virus 3. Primary infection (chickenpox): rash, face and trunk, vaccine prevents.
Slow growing mandible
Hyperpituitary
Exophthalmos
Hyperthyroidism
If you see a question about fluoridated water; a child drinking fluoride water and taking supplements is at greater risk for?
Hypocalcification. Dental fluorosis is a form of enamel hypocalcification which results from the ingestion of excessive fluoride during the period of enamel formation. To cause mottling, fluoride must be present in concentrations several times that found in controlled fluoridated water supplies.
Weight gain, deep voice, dry skin
Hypothyroidism
stages of tooth development
IBCBAM-Initiation, bud stage, cap stage, bell stage, apposition, maturation
Which cytokine is activated my macrophages and neutrophils and produces periodontal inflammation?
IL-1
what cytokine is responsible for osteoclasts (bone loss)?
IL-1
What causes a denture patient to have DIFFICULTY SWALLOWING?
INADEQUATE inter-occlusal space (meaning there is excessive VDO) **fix by DECREASING VDO
How can you INCREASE density in xray?
INCREASE mA, kVp, and exposure time DECREASE distance between focal spot and film
why would there be a void in the palate area of max impression tray?
INsufficient VENTING
Papilloma
Identify this lesion
Right
If an object is inhaled, it is most likely to lodge on what side?
Anemia
Impaired O2 delivery, 1st pale tongue, flattening of filiform papillae, finally painful and red.
Pic of pt with all crowns on upper & lower and asked - what is wrong?
Impingement on gums/gum health. (incorrect choices = incorect oj/ob, improper contour of cwns)
***Pt present with space bw 3M with class 2 mobility and premolar What to do to fix?
Implant
Nasolabial cyst
In canine-lateral region of maxillary lip.
Distal step
In which the primary mandibular second molar is distal to the maxillary second molar, is not an ideal molar relationship in the primary dentition and thus is not a type of terminal plane relationship.
Mesial step
In which the primary mandibular second molar is mesial to the maxillary second molar.
Flush terminal plane
In which the primary maxillary and mandibular second molars are in an end‑to‑end relationship.
Final impression for denture - want to cover tissue with (little/great) amount of force
LITTLE force
***1-2mm reduction of probing depth after performing SRP - why?
LJE
Healing after SC/RP?
LJE
Healing after sx flap?
LJE
Scalloped tongue
Indentations in the lateral border; harmless.
Cellulitis
Inflammation of the cellular tissue, bacterial infection.
dry socket
Inflammation of the tooth socket following extraction or loss of blood clot; osteitis
Stages of gingivitis
Initial Early Established
cell types in each stage of gingivitis
Initial- PMNs Early- Lymphocytes Established- Plasma Cells
inner enamel epithelium
Innermost tall, columnar cells of enamel organ; will differentiate into ameloblasts that form enamel matrix
Which fiber group acts like a fence post, holds one tooth to the other tooth?
Interdental aka transseptal fibers- connected via cementum mesially and distally to the next tooth. If you take one tooth out, it can affect the opposing tooth.
Large pulp and pink appearance
Internal resorption.
Contraindication to sealant?
Interproximal caries.
what kind of dentin makes up most of the dentin in a tooth?
Intertubular dentin-is found between tubules
Recurrent herpes stomatitis:
Intraoral.
***Hereditary Telegnastia is associated with?
Iron deficiency problems (not b12 or folate)
***Pt presents with liver clot - tx?
Irrigate, apply pressure, reasses
Congenital syphilis
Is associated with hutchinsons incisors- they appear notched central incisors along the incisal edge. ALSO associated with mulberry molars on the first permenent molars of an affected individual.
What is Parkinson's disease?
It is a progressive CNS neurological disease with a slow onset that usually occurs after age 50, rarely occurring in the black population, and leading to a respiratory death. The motor symptoms of Parkinson's disease result from the death of dopamine-generating cells
Where can you find the oblique ridge on the maxillary first molar?
It runs from the DB cusp to ML cusp.
***Pic of lip with something on corner of it - dx?
It was either SCC or syphilis (other choices - angular chelitis or herpes labialis)
Biologic width =
JE and CT attachment from the base of the sulcus to the alevolar crest
What side of the instrument is placed on the stone for sharpening?
Junction of the face and lateral surface. The entire lateral side should be sharpened. Angle between the instrument face and the stone should be 110 degrees.
Infraorbital space
Just below eye to nose area, MX premolars, anteriors.
How often do you need to have your patient sign HIPPA form?
Just once. But hippa website says sign once every 3 years.
Multiple questions about ERUPTION & looking at BW to see if it's normal
KNOW ERUPTION SEQUENCES
dark spots on palate
Kaposi (maybe sturge weber tho - SW is more diffuse purplish on half-ish of palate where Kaposi is more discrete pigmentations)
What is the most common cancer associated with HIV/AIDS
Kaposi Sarcoma
sjorgen syndrome involves symptoms which include rheumatoid arthritus, xerostomia, and what other condition?
Keratoconjunctivitis sicca (dry eyes)
How you treat a lesion seen on PA of mandibular 1st molar with IRREGULAR-shaped periapical radiopacity?
LEAVE ALONE
thrombocytopenia
LOW platelet counts (poor clotting) <50,000/ml (normal is 150-450,000)
if unsure which color to use to match the color for porcelain denture teeth, choose a color with HIGH/LOW saturation and LESS/MORE gray
LOW saturation (less intensity) LESS gray
Macroglossia
Large tongue.
Hematoma
Larger localized bruise, black eyes, mistakenly injecting posterior superior alveolar vein.
Hairy leukoplakia
Lateral border, white, corrugated lesions, associated with HIV, Epstein Barr virus.
Herpetiform
Least common, resemble primary herpes, smaller (pinpoint) at 1st, any mucosa.
***Pic of pt with very lg diastema - what to do?
Leave it alone
What is the best place for an ENDOSTEAL implant?
MANDIBULA ANTERIOR
>15mg fluoride ingested is?
Lethal Dose 1. Seek medical treatment 2. induce vomiting 3. cardiac monitoring
Conditions that CANNOT be wiped away
Leukoplakia, Snuff Keratosis, and aspirin burn.
***Pic of white things on BM and asked what it was.
Lichen Planus (but looked like leukoedema, cheek biting etc and all were choices) (wickham's striae means Lichen Planus)
Piezo
Linear and only lateral sides are active.
pic of big DO amal in 3 or 14. crack in M area. Tx?
PFM
Recurrent herpes labialis
Lip, vesicle to scab.
Organic components
Lipids, Proteins, and Carbohydrates.
what daily oral rinse would you give to a medically compromised child for plaque control?
Listerine
turners hypoplasia
Localized enamel defect of a permanent tooth secondary to infection or trauma to deciduous tooth.
Angioedema
Localized swelling of the fluid beneath the skin, most are allergic reaction.
skeletal fluorosis-(chronic fluoride toxicity)
Long term exposure 10+ years of water containing 8-10ppm
***Precision attachments are not good for patient with?
Low Dexterity (case is: pt has severe arthritis in hands)
Caries disease indicators
Low SES, developmental problems, presence of cavities, white spots and restorations placed in the previous 3 years.
bridge from #6-11. might fracture because?
METAL BENDING
Man in dental chair with chest pain, Nitroglycerin doesn't work what is happening?
MI
hep B vaccine offered to a health care worker is a ______ regulation?
MI OSHA- federal and state law- you may decline but an employer in health field must offer this to you
***Post-cementation of crown sensitivity is due to?
MICROLEAKAGE
frontal view of teeth: left side oclusion, right side has a step - where is the fracture?
MIDLINE
caruncle
MIDLINE swelling
treatment for ANGINA
MONA: morphine oxygen nitroglycerine (0.4mg) aspirin
2 months after RCT tooth still had RL?
MONITOR
Leukoplakia on the tongue or buccal mucosa treatment
MUST be BIOPSIED!
***Lesion in mouth (case is on lip, young boy) that heals with scar?
Major Apth Ulcer
Perio risk factors do not include...
Malnutrition (nutritional)
***Best place for implant?
Mand Ant
what is the name of the dentin that is first formed?
Mantle dentin
What is the name of the current TB test?
Mantoux or purified protiene derivative
MRSA antibiotics
Many antibiotics can be used to treat this condition. Look for any of these: vancomycin, linezolid, bactrim, septra, tetracycline, minocycline, doxycycline, and clindamycin.
***Worst place for implant?
Max Post
which teeth commonly relapse after perio tx?
Max molars *bc of furcation anatomy
what is the disadvantage of selecting PFM abutments? What is the disadvantage of selecting resin bonded abutments
PFM = wearing away of more tooth structure resin bonded = debonding
Dental sac arises from
Mesenchyme. The dental sac forms the alveolar bone, pdl, cementum. These 3 make up the periodontium
gracey 11/12
Mesial, facial, and lingual surfaces of posterior teeth. Cervicle 1/3
MRSA
Methicillin-resistant Staphylococcus aureus-is a strain of the staph bacteria that lives on 20-30% of the population but does not cause infection in all who are colonized with it. MRSA resides on the skin and in the nasal passage, and once you contract a MRSA staph infection it can be very difficult to eradicate the bacteria.
*Ectodermal Dysplasia* is characterized by:
Missing *Permanent and Primary Teeth*
#14 with RCT and pt is symptomatic with RL at on of the canals. How do you treat?
RETREAT ALL CANALS
Ugly Apes Sit In A Hut
Mneumonic for the stages of learning are: Unaware aware self interest interest action habit
Symptoms of solar cheilitis
Most common symptoms: Dry lips, thinned skin of the lips, scaly patches. Less common symptoms: Swelling of the lip, redness and soreness, ulceration and crusting, loss of demarcation between the vermillion border of the lip and its adjacent skin, prominent folds and lip lines, white thickened patches (leukokeratosis), discoloured skin with pale or yellow areas.
Recurrent infection-herpes zoster or shingles
Mostly in elderly, unilateral, immunosuppressed vulnerable.
can we treat ACTIVE cases of TB?
NO
Would you make a denture with precision attachments if they have arthritis?
NO - lack of manual dexterity!
Do you scrub an avulsed tooth?
NO - you want to preserve the PDL cells
5mo pregnant lady with rheumatic fever and heart murmur - premed?
NO premed
what do you do if there is no pulpal response 8 hours after trauma
NOTHING - this is normal. Wait a while and test later
necrotizing interdental papilla and fetid odor are associated with
NUG- affects people aged 15-25, increased risk with smokers, poor diet, stress, lack of sleep, poor oral health, partial loss of interdental papilla and hypersalivation
the presence of linear gingival erythema ALONE is enough to diagnose AIDS/HIV?
No- but it is a commonly seen symtom of AIDS. Candida albicans is the number one sign of HIV/AIDS, karposi sarcoma, hairy leukoplakia on lateral border of tongue, HSV, Recurrent apthous ulcers, NUP, NUG, necrotizing stomatitis, oral warts, xerostomia, non hodgkins lymphoma are all oral signs of HIV/AIDS
can you take home a varnish?
No- professional use only!
GI symptoms of acute fluoride toxicity
Nausea, vomiting, diarriah, abdominal pain, increased salivation/thirst
Buccal space
Near buccinator muscle, maxillary and mandibular molars.
***Space in b/w #29 & 30 in very old pt with no 31 or 32 and barely occluding with #3 is due to what?
No occlusion or mesial drifting premolars (one of these is correct - I think it's occlusion)
If you see a picture of fordyce granules and it asks which treatment was neccessary
No treatment is necessary. It is just a sebaceous gland.
Odontogenic infection
Orofacial infection where microbes invade tissue, replicate, and overwhelm the immune system
Accessory salivary gland tumor
Nodular, benign, rare.
Orofacial granulomatosis
Nonpainful swelling forming granulomas.
Pseudoaphthae
Nutritional deficiency, Crohn's disease often.
old and young person w/ same perio, who has better prognosis?
OLD
COMPLEX odontoma
ONE big blob
what can cause root blunting and root resorption?
ORTHO treatment (root resorption can also be caused by trauma)
who requires that pt and dentist wear eyewear?
OSHA
Blood borne pathogen standard regulated by who?
OSHA. Effective in 1992 and is a federal law requiring that healthcare facilities protect employees from blood borne health hazards
***Reason for try-in for an immediate denture is to check the?
OVD
slide with scalloping RL bw posterior roots - tx? dx?
Observe, traumatic bone cyst
All of the following involve CAMBRA.
One to two incipient and or recurrent caries in the past year, topical fluoride choices, low socioeconomic status.
***Pic with arrow pointing to soft tissue mass on FOM?
Opening of Wharton's Duct
Gingival Plaque Index is...
Ordinal *#'s like for furcation involvement
OSAP
Organization for Safety and Asepsis Procedures-recomend infection control and education in infection control specific to dentistry
What should you do after relining an immediate denture?
REDUCE vertical dimension
***t has pain on swallowing when wearing denture - why?
Overextension of LINGUAL flange/lingual impingement
Obligate aerobes require
Oxygen @ 20% not any less
mode of action of ultrasonics
P --> sonics --> linear M --> vibrations --> elliptical
Red complex bugs
P. gingivalis Tannerella forsythia Treponema denticola *BOP and deep pockets
a fistula or stoma may appear as exudate seeks a path of least resistance, in which condition?
PA absess
alkaline phosphatase is elevated - what condition?
PAGET'S
Pic ID - swollen maxilla
PAGETS
Should occlusal adjusting be required after the dentures have been inserted, one should grind....
PALATAL of UPPER anteriors BUCCAL of UPPER posteriors
ARROWS pointing to FIRST PILLARS near tonsils
PALATOGLOSSUS M (but this wasnt a choice, so he put first pillar)
red spots on arm pic
PCN allergy
which one is predominant in sulcular fluid?
PMNs
Test for warfarin
PT
coumadin blood test?
PT
Test for heparin:
PTT
What impression material has the best 24 hour stability?
PVS (it has the highest dimensional stability)
2 diseases associated with HYPERCEMENTOSIS
Pagets Gardner syndrome
Herpetic gingivostomatitis
Painful vesicles, become ulcers, contagious, can become herpetic whitlow (finger) or conjunctivitis (eye), postpone treatment.
***RL next to PM - what to do next?
REFER to OS
Max Tori in denture pt - what do you do before making new dentrue?
REMOVE
An inflammed area on the buccal mucosa directly across from the maxillary molars. What is inflammed?
Papilla of stensons duct.
Plaque Index is used for...
Patient Motivation
If a patient with infective endocarditis has no contraindications of premedication, when would they need to be premidicated?
Periodontal probing is an invasive procedure requiring medication if indicated. The remaining options are not considered invasive and therefore do not require it.
The Primary Maxillary Second Molar resembles the?
Permanent Maxillary First Molar
whats the #1 cause of med induced gingival hyperplasia?
Phenytoin (Dilantin)
Drugs that cause gingival hyperplasia
Phenytoin (Dilantin) Cyclosporin NIfedipine Verapamil (Ca channel blocker) Diltiazem (Ca channel blocker)
Inorganic components
Phosphorous, Calcium, Magnesium, and Fluoride. Elements IN periodic table and are INorganic.
Recession =
Plaque & Age
most common BENIGN SALIVARY NEOPLASM
Pleomorphic adenoma -posterior PALATE -PAINLESS swelling
Lingual thyroid
Posterior 1/3 of tongue, thyroid gland fails to migrate toward trachea as developing, difficulty swallowing.
What is the best cement to use for a SHORT crown?
RESIN cement (other choices were ZOE, zinc phosphate, or GI)
***After cleaning and there is still BOP
RETAINED SUB-G PLAQUE
Mitochondria
Powerhouse of the cell, organelle that is the site of ATP (energy) production
Actinic cheilosis
Premalignant lesion on vermilion border of the lip from the sun.
Clinical examination
Presence of white spots, decalcification, restorations, and plaque, an bacterial culture and salivar flow tests.
Sodium sulfite
Preservative in local anesthetic.
***Pic of bottom of tongue with multiple white lesions - stated that pt had complaint of sore gums and tongue, has fever of 101. 20yo pt. Most likely DX?
Primary Herpetic Stomatitis
the Most common *Congenitally missing PRIMARY tooth* is the?
Primary Maxillary Lateral Incisor
which tooth will appear more opaque, primary or permenant
Primary, because the color comes from dentin. Primary teeth have less dentin that permenant teeth
Gingival enlargement drugs
Procardia (Nifedipine) Cyclosporine Cardizem (Diltiazem) Dilantin (Phenytoin) Calcium Channel Blockers Immunosuppressants Anti-convulsants
Conditions that CAN be wiped away
Pseudomembranous candidiasis
***HIV ELISA test was NEG for person who had needle stick. What does it mean?
Pt has NO antibodies present for HIV (also choice is "pt does not have HIV - this is WRONG - antibodies just may have not shown up yet - so read carefully!)
Permanent dentition with tetracycline stating - when did this happen?
Pt ingested ttclcn when they ere bw 0-5 uears p;d
***Phlebitis major complication?
Pulmonary Emboli
First to form?
Pulp, cementum, enamel, dentin. The first part of the tooth that forms in the bone is the outer shell of the enamel.
Purpura
Purplish discoloration.
Asymptomatic crowned lateral with PARL - tx?
RCT
2y and still had RL post-RCT?
RE-TREAT
Aphthae
Red border.
Angular cheilitis
Red fissures at commissures, C. albicans and Staphylococcus aureus, nutritional deficiency, denture irritation.
***Pt complains of space b/w teeth after SRP> why?
Reduction of edematous gingiva
Double exposure
Results when the receptor is exposed twice and two images appear superimposed onto each other.
Lingual of tooth #19. Why does it have a 6mm pocket?
Rough restoration is the best answer.
What do you do if there are occlusal discrpencies when an immediate denture is fitted?
SELECTIVE grinding (centric, working, balancing, protrusive)
picture that asked what was wrong with the teeth?
SEVERE CARIES
Pic of surveyor: What are we looking at?
SPACE FOR GUIDE PLANE
what is the best (initial and most effective) treatment for ANUG
SRP (debridement) ANUG can cause foul breath
How do you treat Stillmans cleft (v-shape)
SRP and place gingival graft
Tx for LAP
SRP and systemic antibiotics *Tetracycline
what do you not do at the perio maintenance apt?
SRP pockets of 1-3mm
How does desensitizing agent work?
Sensitive toothpastes work by either occluding the exposed dentinal tubules or by desensitizing the nerve endings in the dentinal tubules with potassium ions.
PAN with black dots and lines - what is the error?
STATIC ELECTRICITY
Proteins are derived from:
Saliva into supragingival plaque.
Von Ebner's glands
Salivary glands found at the origin of foliate and circumvalllate papillae-produce serous saliva.
SLOB rule
Same Lingual Opposite Buccal **lingual roots will move in the SAME direction that you moved the tube head
Neurofibromatosis
Same as above, however it has several fibromas and has a tendency for malignant transformation. Common with Von Recklinghausen disease.
Major aphthous
Severe form, > 1 cm, multiple lesions.
Where would you use a gracey instrument with a short shank?
Shallow pockets.
*Shields type II* is also known as a ?
Shields type II is also known as *Hereditary Opalescent dentin*
PA of mandible with weird trabeculae - condition?
Sickle Cell Anemia
what disease will affect wearing CD themost?
Sjogrens (xerostomia)
name the muscle type that is voluntary?
Skeletal/striated muscle. Includes the tongue attached to the mandible
Ecchymosis
Small bruise.
Pyogenic granuloma
Small, reddish bumps on the skin that bleed easily due to an abnormally high number of blood vessels. It is a primarily oral disease which appears as an overgrowth of tissue due to irritation, physical trauma or hormonal factors. It is not an infectious but a reactive lesion due to local irritating factors.
Perio risk factors include...
Smoking OH Diabetes
Eruption cyst
Soft tissue cyst surrounding the crown of an unerupted tooth. Small, dome-shaped, translucent swelling filled with blood or serum and thus is red, brown, or blue-gray.
***If cannot pick a color for a crown, what do you choose?
Something with LOWER shade saturation and LESS GRAY
w/ ANUG which bug predominates?
Spirochetes
Chemical vapor sterilization
Sterilization by means of hot formaldehyde/acetone vapors under pressure. pre clean same as autoclave, instruments should be dried before putting in sterilizer. will damage rubber/plastics- not used for gauze or cotton.
which of the following species is a usual constituent of floras that are associated w/ perio health?
Streptococcus gordonii
Ludwig's angina
Submandibular, submental, and sublingual, bilateral, MN molars or fractured mandible.
***EXT of tooth & pt comes back with big infxn - dx?
Subperiosteal abscess
best brushing technique
Sulcular (bass)
***PAN with RO under mand incs - what was it?
Supernumerary tooth. (Other incorrect choices: odontoma, impacted incisior)
Mucocele
Swelling due to mucus from accessory salivary glands, common, most mandibular labial mucosa.
Pt with median palatal cyst, tx:
Sx removal (enucleation)
Caries protective factors
Systemic and Topical fluoride sources, adequate saliva flow, regular use of chlorhexidine, xylitol, and calcium and phosphate paste.
appliance for ortho - what is it doing?
TIPPING
What is an orthodontic tipping device used for?
TIPPING (root is tipped labially or lingually to correct the angle of the tooth crown)
Mand Inc with lg pulp chamber and PARL - what is large pulp chamber from?
TRAUMA immediately post-eruption
what is the PD of this tooth from this xray?
TRICK: can't tell PD from xrays
***Acid etching does NOT create a chemical bond. t or f?
TRUE
T/F: thyroid collars are used for intraoral films but NOT for panos
TRUE
What antibiotic can DECREASE pocket depth when used with SRP
Tetracycline (arestin)
OSHA
The Occupational Safety and Health Administration, US govn't agency that ensures safety of employees. Published 1992 ***Blood borne pathogen standard***-nationwide standard. protects employees and even dentists hired in. Owners are not included in OSHA
Free gingiva
The area from the free gingival groove to the top of the top of the gingiva (free gingival margin).
Terminal plane
The ideal molar relationship in the primary dentition, when in centric occlusion.
Alveoli Area
The is very dense; this is where does gas exchange occur over the capillary membrane?.
The World Congress of Minimally Invasive Dentistry states CAMBRA:
The latest research shows that caries is a pathogenic bacterial infection of the tooth's natural biofilm and is a multifactorial disease. Measuring the bacterial load, learning the various contributory factors for each patient and assigning a risk level for each patient allows the practitioner to effectively help patients fight caries and the subsequent cavitations.
Myofunctional considerations-mandible
The mandible may be more retruded during development in these situations or when a parafunctional habit, such as digit sucking, is present due to the excessive pressures of the thumb or hand resting against the mandible or the increased muscle activation of the mentalis muscle to help support an incompetent or everted lower lip pattern.
If a patient has gingivitis, the reason for the edema is due to:
Toxins from biofilm. Gingivitis is plaque induced and while it does have some inorganic and organic solids that only composes a small percentage of plaque. Acids from plaque are what causes caries, not gingivitis.
Peripheral giant-cell granuloma target population
There is a gender difference with 60% of the disease occurring in females. The prevalence of peripheral giant cell granulomas is highest around 50-60 years of age.
If the patient is in a panoramic machine, can they have a thyroid collar?
They should NOT be wearing a thyroid collar.
stillman
This brushing technique angles the bristles at 45* to the gingival margin and 1/2 the bristles on the tooth and the other 1/2 on gingiva
How do you determine is it Pyogenic granuloma or a Peripheral giant cell granuloma?
This can be hard to distinguish. The appearance of peripheral giant cell granuloma is similar to pyogenic granuloma. Peripheral giant cell granulomas color ranges from red to bluish -purple, but is usually more blue in comparison to pyogenic granulomas. It can be sessile or pedunculated with the size usually being less than 2cm.
Leeway space
This difference in size, mesiodistally between the two types of teeth. The contour of the bone covering the narrower roots of the premolars, in addition to the state of flux of the bone formation in this area, furnishes adjustment for dental arch measurements, making the middle segment of the arches important architecturally. Leeway space allows the future forward movement of the permanent molars.
'modified' toothbrushing method means?
To complete remaining facial/lingual surfaces. Modified means rolling.
Piercing
Tongue common site, watch for infection and tooth fractures, remove for radiographs, keep clean.
The most common occlusion related OMD is:
Tongue thrusting, which is the functional deviations occurring with habitual incorrect placement and use of the tongue, lips, and mandible during physiological rest, chewing, swallowing, and/or functional speech patterning.
APF fluoride is contraindicated with?
Tooth colored restorations or porcelain. Acid etches and creates a roughened surface or pitting over time.
>5mg fluoride ingested is?
Toxic dose. Treatment: 1. Induce vomiting, 2. administer fluoride binding agent, 3. seek medical care.
Acidulated Phosphate Fluoride
Tray method or gel-like form called thixotropic. Contraindicated in the presence of tooth colored restorations and porcelain-acid etches the glass componets causing pitting over time. 2.5ml tray for an adult and apply for 4 minutes.
***You can use tissue conditioner and soft reline on a CD at anytime - T or F
True
T or F, do not rinse mouth after fluoride application?
True. Just use saliva ejector to remove any excess. Have the patients head tilted down-this will help ensure doesnt go in their throat.
T or F, maxillary sinus tends to expand when a maxillary tooth is extracted?
True. This can lead to poor bone support for dentures or implants.
Treatment of a dense firm ULCER with INDURATED BORDERS of 4 month duration, gradually increasing in size, and restricts tongue movement
Tx = INCISIONAL biopsy **done when lesion is LARGE (>1cm) and is possibly malignant
Given a list of NSAIDs and Tylenol, Must have known that _________ can be safely given to pt with kidney disease.
Tylenol
Caries risk factors
Type and quantity of Mutans streptococci and lactobacilli, visible plaque, exposed roots, saliva reducing factors and inadequate saliva flow, frequent snacks, deep pits and fissures, and orthodontic appliances.
improving gingival health - over or under contouring of temps?
UNDER
Do you want to under- or over-contour the temporary in order to maintain gingival health?
UNDER-CONTOUR the temporary crown!
which ultrasonic handpiece describes only the lateral sides of the tip to be most active?
Ultrasonic piezoelectric
learning ladder
Unawareness Awareness Self-interest Interest Action Habit
What is NOT a recreational nitrous use symptom?
Unsteady gout. Symptoms include: loss of feeling in extremities, hearing loss, and loss of motor functions.
What is a dermoid cyst?
Usually occurs on the floor of the mouth? Is an abnormal growth (teratoma) containing epidermis, hair follicles, and sebaceous glands, derived from residual embryonic cells
Which method of fluoride application immediately gets absorbed into the enamel?
Varnish has the highest PPM and whichever product has the highest PPM gets absorbed into the enamel quicker.
Pernicious Anemia
Vitamin B12.
what is best view for sinus?
WATERS
How often do you test the autoclave sterilization?
WEEKLY SPORE test
when whitening teeth - what do you do?
Wait for at least 5 days before you do restorative
The best way to sharpen an instrument to preserve the blade?
Water with stone.
Bell's Palsy
Weakness and paralysis of 7th cranial nerve, one side of face.
Dysplasia
abnormal development or growth of cells, tissues, or organs
Hard tissue abnormalities associated with Ehler's-Danlos syndrome that are observed radiographically include:
abnormal root morphology, pulpal calcifications and abnormal pulpal shape, dentin that has irregularities,
6months to 3 yrs old how much fluoride?
about .50ppm
3-6 years old, how much fluoride?
about .75ppm
6-16 years how much fluoride?
about 1.0ppm - 1.25ppm
glands are named
according to their location in the mouth
Kidney pt - what analgesic?
acetaminophen
***facial erosion on teeth
acidic bevs
which type of fl is not in toothpaste?
acidic fl
you can increase working time of alginate by:
adding water that is colder than room temp
if patient is having MI (chest pain), what do you do?
administer anti-angina drugs (nitroglycerine vasoDILATOR) **if pt is taking viagra or CIALIS, do NOT give this (causes severe drop in BP)
Addisons disease
adrenal insufficiency -if taking steroids, may have an attack if not supplemented by DOUBLING steroid dose BEFORE dental tx to produce extra cortisol in response to stress
maryland bridge - advantages and disadvantages
advantage: less tooth structure loss disadv: debonding can happen
when does cementum form
after the root sheath via cementoblasts
gingival recession other than plaque is related to? (age/ tobacco)
age
least important when trimming teeth
age
flu is spread via
air borne particles, droplets or inhaled or direct contact with a contaminated objected
Osteonecrosis of the jaw is associated with:
alendronate (Fosamax) bisphosphates
in constructing immediate dentures, you should extract the following teeth first:
all posterior teeth except 12 and 21 (first PMs) = this will MAINTAIN VERTICAL DIMENSION
which tumor has a soap bubble like multioccular apperance on a radiograph?
ameloblastoma
"soap bubble" appearance in mandible Treatment?
ameloblastoma surgical removal
xray of multilocular RL lesion in post mand
ameloblastoma!!
enamel producing cells are called
ameloblasts-origionate from the IEE
2 purposes of cementum
an attachment point for the PDL, and to cover exposed dentinal tubules to prevent hypersensitivity.
Treatment for a patient with a missing LATERAL INCISOR (how can you close the space)?
an orthodontic FIXED appliance
Patient with KIDNEY DISEASE
analgesic = tylenol (NO NSAIDS) -no K-sparing diuretics (triamterene and spironlactone)
KNOW THINGS ABOUT ANEMIAS: pernicious, hymolytic, b12 & folate deficiency - there are 2 questions
anemia, bitches
corners of a patients mouth are dry, cracked and red. what is your diagnosis?
angular chelitis- caused by candida albicans and vitamin B deficicency
Lichen planus tx if asymptomatic
answer choices did not give no tx, so he put corticosteroids
Which pontic is the best for ANTERIOR teeth? Which is best for POSTERIOR teeth?
anterior = modified ridge lap posterior = hygienic
proper biohazzard labels must be placed on what?
anything containing regulated waste, blood or OPIM- and sharps containers. Can use a red bag or Biohazzard symbol- just one doesnt have to be both. OPIM is double bagged and has to be red container/bin or with biohazzard symbol on it.
temp relines can be done when?
anytime
biofilms form where
anywhere non sterile liquid flows over a non liquid in a non sterile environment. Begin immediately like pellicle. Is already attached to a surface- can break off and re colonize
which part of the tooth has the most cementum?
apical third
begin flossing when?
approx 2 yrs old- when interproximal contacts are evident
semi critical items
are instruments, devices and other items that are not used to penetrate skin but contact oral mucous membranes, non-intact skin or other potentially infectious materials (OPIM). sterilize if possible or at minimum be cleaned and treated with high level disinfectant.
crystals
are placed in the matrix
No
are there any restrictions for patients over 14 years of age when using N2O?
graceys are
area specific curets with one cutting edge. Blade is 60-70 degrees to the terminal shank. Use short over lapping strokes, used to smooth root surfaces. Begin coronal to the edge of the Junctional Epithelium
A patient is taking NAPROXENE for what?
arthritis
What is the treatment for geographic tongue?
assure patient and leave alone
with an extraction site, the tissue conditioner (impression material) is trimmed where?
at the GINGIVAL TISSUE level
barrierd surfaces are disinfected how often?
at the end of day, at the first start of the week and must be impervious of moisture.
when should you trim the immediate denture relining material?
at the moment of extraction
collagen fibers are formed, known as the pdl and embeded where
attached to the developing cementum and alveolar bone
Most critical factor in determining perio prognosis
attachment loss
loss of tooth structure from tooth to tooth wear
attrition
enamel is
avascular with no living tissue
BEST place for osseointegration? WORST place for osseointegration?
best = max ANTERIOR worst= max POSTERIOR
when do we change our mask
between patients or when wicked- wet on inside-whichever comes first
yellow efects on facial surfaces of anteriors
beverage erosion
what can make teeth green/ orange?
bacteria
planktonic means
bacteria that are free floating/ pass thru
neutrophils function to protect the body from _____ by triggering our immune system
bacteria, viruses, antigens
cell wall is present in?
bacteria- mammels do not have a cell wall fyi- cell wall gives shape and resistance to being crushed. Made of peptidoglycan chains- tears and saliva and penicillian work by destroying these bonds.
cancer pt with oral mucositis suggest what rinse?
baking soda or saline rinse, followed by plain water
PPE includes
barriers, eye glasses, mask, gloves, eye wear and shields, overgown/'impervious' protective clothing to protect operator
why check occlusion in perio abscess?
bc edema can cause teeth to supraerupt
why do you do perio before ortho?
bc w/ perio you have gingival and osseous change
pic of fissured tongue
be able to identify
Neruofibroma
begign nerve sheath tumor from peripheral nerves. Genetically inherited, autosomally dominant disease that can result in physical disfigurment and pain to cognitive disability. Sessile, firm, pink nodules. May be one or several. Buccal mucosa, tongue or lips and less commonly with bone.
***What to give allergic rxn to barbiturate on lip?
benadryl
delayed and abnormal tooth eruption patterns are common in patients with downsyndrome. the lips are wider, with a stronger lower lip and larger tongue.
both statements true
cancerous tumors of the jaws can develop due to metastisis from tumor sites elsewhere in the body. which of the following is/are a possible site for the primary tumors to arise?
breast, thyroid, lungs
Fusobacteria nuceatum =
bridging microorganism between early and late colonizers *orange complex
what is the difference between syncope and anaphylactic shock?
bronchospasm in anaphylactic shock
gracey 9-10
buccal lingual surfaces of molars
Before relining the denture, you must:
build up posterior occlusion
dentin makes up
bulk of tooth-provides a base for enamel to sit on. It surrounds the pulp.
Diabetes type 1 patients are usually diagnosed why
by the age of 20. AKA insulin dependent diabetes mellitis
How do you set a HORIZONTAL condylar inclination (guidance) on an articulator
by using a PROTRUSIVE inter-occlusal record
what is the purpose of doing a tooth try-in for immediate dentures?
check centric occlusion and centric relation (confirm jaw relations)
dentinogenesis imperfecta**
called herediary opalecent dentin-dentin is translucent, hereditary condition, **Obliterated pulp chambers and canals seen on xrays, maybe assoc with osteogenesis imperfecta
Cavernous sinus thrombosis
can arise from an infection subcutaneous abscess of the upper lip intrabony abscess of an anterior maxillary tooth
autoclave flash cycle aka our statim
can be wrapped or unwrapped. 273 degrees, 30psi, 10 minutes flash. for immediate use only. never use for implants.
baby bottle syndrome
can cause RAMPANT CARIES in toddlers/infants
Yes
can diazepam be used safely with N2O?
facultative anaerobes can do what?
can live with or without oxygen
Tufted floss
can use under pontics of bridges or orthodontic appliances
Yes
can use you N2O on hepatitis patients and alcoholic patients? (not metabolized in the liver)
No
can you use N2O on someone with a bowel obstruction due to N2O's gas expansive nature?
Yes
can you use N2O on someone with ulcers?
all of the following are affected by saliva
carb breakdown swallowing dental caries oral microflora
whitening in dentrifices
carbamide peroxide or hydrogen peroxide
unconscious pt - what do first?
check BREATHING
efferent nerves
carry impulses away from the brain-think exit
afferent nerves
carry impulses to the brain/cns
If a tooth has a DO amalgam with a M fracture, which is the best long term solution? MOD amalgam, MOD resin, or cast gold?
cast gold
Hep C
caused by innoculations (serum/vaccines), IV drug use, blood transfusions
ultrasonic scalers use
cavitation**
Chlorohexidine MOA
cell mb distruption *Listerine (cell wall)
fimbrae/pilli hair like projections allow?
cells to attach and pass along DNA-makes cells more virulent.
untreated dental infections can lead to?>
cellulitis bacteremia cavernous sinus thrombosis
SRP removes diseased..
cementum
DB Cusp of #30 occludes...?
central fossa of #3
What is the sequence of selective grinding?
centric occlusion working balancing protrusive
Quaternary ammonium compounds-mouthrinses
cetylpyridium chloride-example includes Scope, cepacol, crest pro health
Time frames for relining dentures: chairside reline: final lab reline:
chairside temporary reline = 1 month final lab reline = 3 months after last teeth have been extracted
Margin for PFM
chamfer
reason for gingivitis during preg?
change of GCF composotion
no matter what we believe is first priority, in what order do we always treat the patient?
chief complaint first!
DTap is a vaccine for whom
children 7 and under in a series of 5 injections.
40 yr old female w/ generalized bone loss and localized vertical bone loss... dx?
chronic perio
Do not give AB for..
chronic perio
which therapy in adding an antibiotic + debridement will have minimal effect?
chronic perio disease
which disease would you NOT have success using AB for?
chronic periodontitis
which ligament holds the free gingiva tight against the tooth- where we would slip our probe in?
circular ligament
Distal extention RPD case- what clasp is needed on posterior abutment teeth:
circumferential clasp with mesial retention
what is the dentin that surrounds the pulp?
circumpulpal dentin-the majority of dentin is located here.
which is the largest and LEAST numerous taste buds
circumvallate papillae (shaped in a "V") -they have taste buds
Root surface tx w/ what agents?
citric acid/ fibronectin/ tetracycline
mechanical washers aka hydrum dishwasher thing
clean but doesnt disinfect because doesnt get hot enough.
open insturments with?
clean, bare hands after doing hand hygiene in front of patient.
X-ray of RO areas surrounding RL area of RCT tooth. RO area is:
condensing osteitis, focal sclerosing type
Leukoplakia
condition characterized by white spots or patches on mucous membrane, which may be precancerous and cannot be wiped off. Must be biopsied to determine diagnosis. About 20% may be associated with dysplasia-a premalignancy lesion or cancer. Usually asymtomatic.
Pt with all upper and lower anteriors with cervical abrasion. Tx:
conservative filling
treatment for tooth brush abrasion?
conservative restoration
Regulated waste includes
contaminated sharps, clothing with dried blood on it, Lab specimens containing OPIM dressings and bandages that could release blood if squeezed- anything saturated
***Most likely reason that sealants fail?
contamination
main reason why sealants fail?
contamination
cidal means
controlls bacteria by killing it.
tx of Class 2 that is nearly class 3..
convert II --> I w/ GTR
***Xray with remnants of primary teeth roots reamining
cool man
What structure can play a role in maxillary denture stability by DISLODGING the denture?
coronoid process
Patient has a swollen upper lip (unilateral). Their friend gave them a barbituate that night before. How do you treat it?
corticosteroid periorally
Tx for major aphtous ulcer?
corticosteroids
what is not the initial tx for gingivitis? (SRP/ OHI/ corticosteroids)
corticosteroids
Treatment of a MIDLINE swelling on HARD PALATE for SEVERAL years. Family history of carcinoma.
could be median palatal cyst or tori? tx = leave alone and reassure patient if it is a tori. If its a median palatal cyst (will see RL on occlusal xray) then probably best to remove
What is the function of a reciprocol arm? Where is it placed?
counteract the forces of the retentive arm (its more stiff and is usually on the lingual side) placed at or CORONAL to the height of contour
Arrow to reciprocal clasp (above/at HOC) - what is purpose?
counterbalance retentive arm
***Bone loss on #4 was a
crater defect - memorize this, it was in the part II case selection questions focusing on the perio chart
convalescent stage
decrease in number of bugs, body's immune system is fighting back
addisons disease is caused by?
deficient adrenocortical secretion-causes diffuse bronzing of skin.
Ultrasonic contraindications
demin areas, exposed dentinal surfaces, implants, restorations, primary teeth, newly erupted permenant teeth, dentures.
Dentin and pulp arise from?
dental papilla- both start with D and P
dentin and pulp come from
dental papilla- part of the mesenchyme (middle layer)
MOST COMMON odontogenic cyst
dentigerous (follicular) cyst = unerupted tooth (cyst around the crown) Radicular cyst (PARL)= NON VITAL -associated with un-erupted or partially erupted tooth -unilocular, sclerotic borders, ROOT RESORPTION
after enamel, what is the next hardest structure?
dentin-it is avascular but has living tissue inside of the tubules that provide sensations of pain with recession.
Slide of blue sclera - condition?
dentinogenesis imperfecta (or osteogenesis imp)
After doctor recieves a needle-stick from an HIV patient, an ELISA test will be done on the PATIENT to detect what?
detects HIV antibodies (Ab)
Pano shows no 3rd molar and a large lucency. What is it and how do you treat it?
developing tooth bud Leave alone
how do you determine perio recall system
different for every pt.
dysphagia means?
difficulty swallowing
Denture paitent complains that one side contacts before the other side does. What is the CAUSE?
dimensional changes during CURING
Perio Index is used for...
disease activity
oral irrigator
disrupts loosely adherent plaque and flushes debris and food particles around orthodontic appliances
***Worst vert bone loss -
distal of #13
Gracey 17-18 is used where?
distal surfaces of posterior teeth
gracey 13/14
distal surfaces of posterior teeth
two common things among generalized aggressive perio and chronic perio?
distribution among the teeth
No
do dental hygienist practice deep sedation?
Yes
do dental hygienist practice minimal to moderate sedation?
very large diastema tx?
do nothing. too large to close
Pic of leukoplakia, what do you ask pt?
do you use SMOKELESS TOBACCO?
white wavy patches in labial/bucal pouch mucosa - what do you ask pt?
do you use smokeless tobacco?
Lower
does anxiety lower or increase pain tolerance?
staining of teeth
does not affect perio prog
*Downside of Perio Index....
does not take gingival recession into account
spore test is Bacillus Atrophaeus, which method of sterilization?
dry heat sterilization uses bacillus atrophaeus
painful big swelling adj to EXT site
dry socket?** (or maybe residual cyst??)
best way to communicate to lab?
dx wax up
undiagnosed diabetes has symptoms that include
dysphagia-difficulty swallowing polyuria-increased urination polyphagia-increased hunger polydipsia-increased thirst
max ant teeth missing - best type of implant?
endosseous
best time to schedule a patient that has diabetes?
early morning
prodomal phase
early symptom that might indicate the start of a disease- malaise feeling
enamel develops from
ectoderm
teeth develop from the
ectoderm and mesenchyme
Pt with no hair, no teeth
ectodermal dysp
what kind of gingiva is favorable for SRP? (erythmatous/ edematous)
edematous
best SRP results will be from a pt. who has..
edematous gingiva
***Reduction of PDs after SRP but still had mobility in ant mand teeth - what to do?
either GTR or periodic eval (Trevor put periodic eval...)
impacted 3M impinging on 2M (mandibular) - tx?
either ext 3M or ext 2M bc 3M will erupt into position
ultrasonic magnetosctrictive uses what motions
eliptical or orbital strokes**. Works through sound waves and cavitation
sonic scaler produces ______ strokes
elliptical/orbital strokes and all sides of tip are active. 2,500-7,000 cycles per second.
apposition and maturation stage
enamel, dentin, and cementum secreted in layers. The final stages of tooth development
what is the hardest material in our body
enamel. it is 2X more dense than bone
cheek biting happens when teethare in what position
end-to-end
fistula tx
endo responsible tooth will resolve?
site for cellular protein synthesis
endoplasmic reticulum
NUG clinically appears how?
erythematous gingiva, punched out interdental papilla, cratered, foul odor, metallic taste reported, painful, sloughing and gingiva appears as a pseudomembrane.
a wedge stimulator is best choice for which patient?
exposed root surfaces and recession
Molar w/ III furca and 5mm root left in bone... tx?
ext
treatment for mesioangular mandibular 3rd molar impinging on 2nd moalr
extract 3rd molar
treatment for VERTICAL root fracture and PARL
extraction
if you can see radiographic furcation involvement, it is automatically which grade?
grade 3 furcation (through and through)
probing furcation from ____ is the best? (facial/ lingual)
facial
What is a modifiable risk factor?
factor that can be changed. IE smoking, weight.
picture of a big abscess that was next to an extraction site? what is it?
fibroma? dry socket?, subgingival abscess? i dont know
Hip/joint replacement prophylaxis
first 2 years after surgery only?
non succedaneous teeth
first permenent molars- #3, #14, #19, #30
treatment for oroantral communication
flap surgery
what procedures do you recommend pre-medication?
for procedures likely to cause bleeding
12-15
for tidal flow, what is the normal respirations per minute?
atrophic candidiasis
form of candidiasis: under dentures; red on palate or tongue; burn with spicy foods & alcohol
pulp supports?
formation of dentin by providing nutrients to odontoblasts.
Interradicular fibers resist
found between roots-resist tilting, rotational, extrusive and intrusive forces-all 4
Matrix
framework that creates shape
After you take final impressions, you give the lab hard and soft tissue records. Where do you obtain the records from?
from poured MODELS
how to measure BW? *what 2 points
from the base of the sulcus to the alevolar crest
***Pt on penicillin for 2 wks, tongue is now sore. What test?
fungal test
what is the most significant factor influencing the course of perio disease?
furcation lesions
which delivery method would we suggest for rampant caries and bullimics to recieve fluoride?
gel tray method of sodium fluoride. 4 minute application-greatest uptake is within the first minute- wait 30 minutes to eat, drink or smoke. Also use this for tooth colored restorations, porcelain crowns etc.
What is Peutz-Jeghers syndrome?
genetic, autosomal dominant intestinal hamartomatous polyps in GI + mucocutaneous melanocytic macules
what is the BI for autoclaves? This is one way to monitor our sterilization process
geobacillis stearothermophilis. This is a biologic monitoring system we use to ensure sterility. done once a week, after any repairs, when using a new packaging material, first use of new machine, or new employee uses the machine
***Nifedepine causes:
gingival hyperplasia
Cyclosporine causes?
gingival hyperplasia
calcium channel blocker complication?
gingival hyperplasia
How do you correct CHEEK BITING in dentures?
grind on the BUCCAL surfaces (cusps) of posterior MANDIBULAR teeth
fibrous dysplasia radiograph
ground glass
White patch on SIDE of tongue that CANNOT be rubbed off. What is the first question you ask the patient? how will you treat this patient?
hairy leukoplakia (NOTE: candidiasis CAN be rubbed off) Do you have AIDS? Treat with universal precautions
pleomorphic adenoma
hard palate
keratinized masticatory mucosa is found in what 3 areas and consists of what cell type
hard palate, dorsal surface of tongue and attached gingiva. Stratified squamous epithelium
Alkaline- basic
having a pH greater than 7
colder climates require ______ fluoride
higher fluoride levels than warmer climates. 1.2ppm
pregnancy gingivitis is caused by..
hormomes (progesterone) and P. intermedia *think Pregnancy = P. intermedia --> P/P
gingival hyperplasia in a 14 yr old girl, cause?
hormonal induced
pregnant women have more gingivitis, why?
horomes
what does plaque NOT depend on *what is NOT part of plaque formation?
host antigen
reason pt. gets aggressive perio?
host can't fight off
resin type of incisal angle fracture
hybrid
Sub G calculus is made of
hydroxyapetite, organic componets and water. How tenacious it is depends on patients home care and minerals in saliva.
supra gingival calculus....
hydroxyl appetite (58%)
What is Papillon-Lefevre Syndrome?
hyperkeratosis of the palms of hands and soles of the feet and severe periodontal destruction
A pic of a huge pulp. What is the cause?
hyperplastic pulp? (pulp polyp) *remove pulp or extraction
With hyperparathyroidism- you can expect with this pt
hypersalivation
if a man or woman is overweight, _______ can be a contributing factor
hypertension
dental fluorosis-chronic fluoride toxicity
hypomineralization from excess fluoride of 2ppm+ in water during amelogenesis, typically between age 1-4.
tongue sticking out with laceration on it; blanches under pressure
i put result of previous laceration (other choices: included granular cell tumor...)
pic of erosive lichen planus on cheek
identify it
what does chemically monitoring do? GRCC uses a class 5 monitoring strip fyi
ie: autoclave tape and colored dots inside our packages. It tell us the autoclave got hot- doesnt tell us the proper time or pressure or even the correct temp was used.
when does tetracycline stain PERMANENT teeth?
if it was give to a child at birth to 5 years old (when calcification of permanent teeth occurs)
Recession + probing = attachment loss
if recession is 2mm and probing is 1mm, how much attachment loss? *3
instruments not wrapped before steriliztion ie statim- are for ___ use?
immediate use- as soon as you open the door they become disinfected. its okay just use them asap.
amelogenesis imperfecta
imperfect formation of enamel; hereditary condition in which the ameloblasts fail to lay down the enamel matrix properly or at all. Has a snow capped apperance with the crowns being more white than the rest of the tooth. On an x-ray the crowns will look like the same density as the roots- aka not as opaque as crowns on an x-ray should be. Pitting of enamel and teeth will be yellowish brown except for the incisal edges.
in dentistry the primary source of pathogens is found
in the patients mouth
internal pulp resorbtion occurs
in the pulp at first, then progresses outwardly.
Class 6 caries
incisal edge of anterior teeth and/or cusp tips of posterior teeth
treatment for a child with NECK SWELLING possibly related to mandibular 3rd molar
incision and drainage
LAP teeth
incisors and 1st molars
dentinogenesis imperfecta
incomplete or improper development of dentin tissue, between enamel and cementum. On an xray- the crowns will look bulbous with short, slender roots and missing pulp chamber. Teeth will appear grey, yellowish brown and lack of opacity- however the teeth are not more prone to caries.
perio probe picture -
incorrect use
Cerebral palsy pt, which is NOT true?? (95% have cognitive impairment/ all brux/ increase in periodontitis)
increase in periodontitis
what will extending a mandibular complete denture provide?
increased capacity of underlying tissue to withstand physical stress
How does periodontal disease affect levels of a diabetic pt?
increased glucose
most common method of infection is spread in the dental setting
indirect contact with contaminated object or fomite
BOP is most indicative of...
inflammation
Periostat's Mechanism =
inhibits collagenase activity in GCF of pts. w/ adult periodontitis
what do external indicators like tape or printed on packaging color change tell us?
instruments have been heat processed- sterility is NOT guarenteed.
difficulty swallowing
insufficient interoccl. space
pancreas produces
insulin
In order for glucose to pass along the cell membrane of target cells, we need?
insulin. Made from the Islets of Langerhans in the pancreas.
chroma
intensity of color ("reddish brown") **basically the same as saturation hue = color value = light/dark
Reverse architecture
interproximal bone is lower than on F and L interproximal bone is apical to the crestal bone
best for interproximal plaque removal in teeth w/o contacts (floss/ waterpick/ interproximal brush)
interproximal brush
pt. has big embrasure/ wide interproximal spaces.. use what to clean
interproximal brush
If white columns and teeth are different sizes on a pano, then what happened?
interruption during the pano
tetracycline stain
intrinsic tooth stain from ingestion of antibiotic tetracycline during tooth development
what is the diagnosis of a tooth that is VITAL and has a periapical infection/abscess
irreversible pulpitis
TX of dry socket
irrigate, pack with iodoform with eugenol
Yes
is N2O contraindicated with bleomycin sulfate (IV anti-cancer drug) ?
No
is N2O metabolized?
No
is Nitrous oxide nonirritating to respiratory mucosa, meaning does it cause any bronchospasms?
Yes
is it ok to use N2O for patients with heart murmurs, heart disease, or hypertension?
the control for BI
is not autoclaved- we use this to grow spores of geobacillis stearothermophilis
when you have a through and through furcation...
its wide enough and the currette is too big to clean
acute stage
obviously ill- stay home
stress long term causes what problem in periodontium?
it increases cortisone and cortisone brings down immune system
where is the JE located
just apical to the sulcular epithelium. Is attached to the tooth by a glue like substance.
Pt. just had SRP, best way to prevent sensitivity of newly exposed root surface?
keep it free of plaque
disinfectants do what
kill or inactivate MOST pathogenic microbes- BUT NOT SPORES!
sterilized means
killing of all microbes, means CIDAL.
Pic of BCC
know it
mandibular teeth with lingual appliance, what is it doing?
labiallly tipping
iron deficiency anemia may be caused by
lack of iron in the diet, chronic blood loss. common in african americans affecting about 8%
Xerostomia has an increased risk of caries and periodontal disease why?>
lack of saliva means a lack of salivary enzymes Amylase and antibodies like IgAA
hand scrubbing instruments
last resort to precleaning. automatic washers are better choice.
picture of denture showing working side
lateral movements were GOOD
Xray of RL lateral to VITAL tooth - dx?
lateral periodontal cyst
big diastema?
leave it alone
lateral inc negative to vitality test but asymptomatic- tx?
leave it alone
RL between primary central incisors. How should you treat it?
leave it alone??
pic of 14yo with inflamed gingiva -
leukemia, WBC less than 70k with immature ones
which permenent tooth commonly lacks a transverse ridge?
maxillary second premolar
alveolar bone proper aka alveolus aka cribriform plate
lines the socket of the teeth. Is the attachment point of the PDL fibers. This bone is compact, and dense around the roots
Lesion on the SIDE of the tongue that enlarges whenever the patient gets a SORE THROAT
lingual tonsil
which anatomical structure converts glucose to glycogen?
liver
1-2 mm pocket reduction is normally due to
long junctional epithelium
after you do SRP, how does new attachment form?
long junctional epithelium
Cause of dental fluorosis
long term ingestion of fluoride 2 ppm plus during amelogenesis
chronic hep B
long term, less symptomatic but can lead to cirrhosis of liver, liver cancer, death.
***Identify the mental ridge on radiograph
look it up
identify nicotinic stomatitis
look it up duh
effect of xerostomia on denture
loss of retention
erosion, by definition is
loss of tooth structure from chemical agents such as lemons, tomato juice, fruits, coffee, tea/soda etc. Enamel will be shiny
what edge of curette do you want to be in contact at line angle?
lower (apical) 1/3 *including tip
lump that is immovable/fixed - benign or malig?
malig likely
***Pic of red painful tongue in uncontrolled diabetic - what is it due to?
malnutrition
diabetic pt with burning tongue - cause?
malnutrition
Can see a step between teeth 24 and 25 on pano
mandibular midline fracture
most common periodontitis in school aged children
marginal gingivitis
perio tx most difficult in what tooth?
max molar
where are the most teeth lost in local aggressive periodontitis?
max molars
which tooth in the long run after perio tx will you end up extracting?
max molars
which tooth commonly has an oblique ridge
maxillary first molar- from distobuccal to mesiolingual
Denture patient complains of difficulty making "S" and "V" sounds. What is the problem?
maxillary incisor teeth placed too far SUPERIORLY
which tooth is commonly congenitally missing
maxillary laterals, mandibular second premolar
Traumatic neruoma
may result from Mental foramen injection Painful when palpated
dentin develops from
mesenchyme
gracey 15/16
mesial surfaces of posterior teeth
most benefits from SRP...
more edematous gingiva = more beneficial
sterilization by autoclave is?
most common method in DDS settings. Can be done using standard or flash cycle.
permenant molars are known as
non succedaneous teeth
xray of mandible with sialolith, what view is this?
occlusal
what is the most common malignant salivary gland tumor?
muccoepidermoid carcinoma
What are little dilated blood vessels on the tongue
multiple telangiectasias -tx: laser therapy to widen vessels (maybe antibiotics?)
Critical items
must be cleaned and heat sterilized. These include: all instruments, devices, and other items used to penetrate soft tissue or bone.
possible complication for max ant implant?
nasal cavity penetration
Birth - 6mos how much Fluoride?
none
noraml reaction to cold, no perc sens, but no xray - dx?
normal
FDA
nitrous oxide is controlled by what administration?
are dietary supplements reccomended for pregnant women?
no
What is the best way to determine if a patients periodontal condition is STABLE
no INCREASE in pocket depth
obligate anaerobes require
no oxygen
Gingival cyst of newborn = on alveolar crest Epstein pearl = midline of hard palate Bohns nodule = scattered on the hard palate
no treatment needed go away on their own
extravasation cyst tx
nodule on LOWER lip -filled with MUCOUS -tx = surgical removal **mucous RETENTION cyst = UPPER lip, floor of mouth (ranula), palate Ranula tx = incision and drainage (remove)
packs in autoclave must be dry- what if wicking occurs?
not acceptable.
liquid chemical sterilization/ high level disinfectant method
not reliable method of sterility. Bard parker tray is filled with water and tight lid. can sterilize or high level disinfect. Usually 2-4% gluteraldehyde used. 10 hours soaking time needed, expires in 28 days for sterility. items must be completely submerged-remove with foreceps and rinse with sterile water. NO BI FOR THIS
impressions
not sterilized but disinfected- dont use bare hands
aerosoles can be visable or no?
not visable. created by A/W Syringe, handpieces, ultrasonics- it stays airborne and then can be inhaled
#27 had RCT and bridge from #27 to 25. What is the RL?
nothing to do with #25, not a failed RCT on 27, re-evaluate in 3mos or chronic cyst in between 24-27
dentinogenesis Imperfecta Xray looks like?
obliterated pulp chambers, constricted crowns, short roots
Tx of a longstanding asymptomatic short fill endo
observe
peripheral bone scar tx
observe
class 5 caries
occurs in the cervical 3rd of the tooth-close to the gumline
what is SECONDARY occlusal trauma?
occurs when there is PRE-EXISTING perio condition and trauma is placed on the teeth
the outer cells of the dental lamina differentiate into
odontoblasts to produce dentin.
Ameloblastoma (benign tumor)
odontogenic tumors that can appear as uniloclear or multiloclear radiolucencies and affects men more than women. Affects ages 40-50yr olds. commonly seen in the jaw near molars. Formed during tooth development in the dental lamina and has a soap bubble appearance. Slow growing, but can be aggressive and causes pain and inflammation in the jaw. It is the most common type of Odontogenic lesion.
cranial nerves mneomic
oh, oh, oh, to touch and feel virgin girls vagina so heavenly
how do we guarentee sterility? what 3 things do these indicators measure?
only way is thru Biologic indicators aka spore tests done 1 time a week. Tells us sterilization is reaching proper temp, time, pressure to kill ALL MICROBES.
pseudocyst of max sinus tx
opaque dome in max sinus NO TREATMENT
what palatal framework should be done for a patient with torus palatinus?
open horseshoe
treatment of angioedema
oral corticosteroid
instrument for calc detect on anteriors and cervicle 1/3 posterior teeth?
orban type
blunted roots in xrays could be from?
ortho
what causes blue sclera
osteogenesis imperfecta or Marfans syndrome
"FLOATING" teeth with severe and long lasting pain or "sequestrium"
osteomyelitis
dental papilla is a mass of cells that differentiates into 2 cell types, what are they
outter cells and inner cells.
only gram negative bacteria have an outter membrane- what is significant about this?
outtermost layer and houses endotoxins which cause damage to other body cells and result in fever, inflamation, bone destruction, hemmorrhage, vomiting.
overjet vs overbite
overbite is verticle- you bite down overjet is horozontal- like a jet coming out of the mouth
What causes a denture patient to complain of difficulty SWALLOWING and PAINFUL THROAT?
overextended DL flanges on lower denture (too long)
HTN is related to the pt being ______?
overweight
puberty bacteria
p. intermedia
longest dimensional stability impre material?
pVS
inflamation of which major salivary gland is charactoristic of mumps infection?
parotid gland. Stensons duct. this is also where amylase is secreted to break down starches into maltose and glucose.
antiGENs are produced by?
pathoGENs. Our body will recognize them if they re appear for second time through lymphocytes. Antigens provide immunity to some pathogens- vaccines.
200-500 WBC means
patient is likely to have HIV/AIDS
LEAST important factor in selecting posterior teeth
patients AGE MOST important = shape of teeth ridge, size, and incisal guidance
What patient will take these drugs? Isoniazid Rifampin Pyrazinamide
patients that have TB (1st line therapy)
mass in mandibular angle
pleomorphic adenoma (hmm it must have been a clinical photo not radio...)
1st step in bacterial plaque formation on a tooth
pellicle formation
which PDL diseases causes rapid destruction of alveolar bone? (Perio abscess/ ANUG/ chronic perio)
perio abscess
what is the CTI?
perio incidence index
splinted teeth
perio tx for more comfort to pt
GP in sinus tract, does not go to apex
periodontal abscess
difference between primary and secondary occlusal trauma?
periodontal support/ healthy periodontium Primary- healthy periodontium Secondary- already reduced periodontium
Capillaries function
permit diffusion between blood and interstitial fluids like tissue.
under 200 for WBC count means
person is in AIDS stage
brown macules on the face, fingers, feet and toes are a charactoristic of what condition?
peutz-jeghers syndrome
Listerine is a...
phenolic compound
pregnant person afraid of needles?
place her in Trendelburg position (LOL)
sharpening a scaler or curette
place stone between 100-110 degrees against the blade and internal angle should be 70-80 degrees
initiator of decay
plaque
established gingivitis (macrophages or plasma cells)
plasma cells
implant safe curets/scalers include
plastic nylon graphite gold tipped
mass in post palate - benign:
pleomorphic adenoma
class 2 caries
posterior interproximal- require a wedge and matrix band-commonly includes occlusal surface
always do what before sterilization?
pre clean
How is seroconversion determined with Hep B vaccine?
presence of Hep B surface antibody HbsAG- employers must offer you this vaccination free of charge if you have not had it.
tongue sticking out with normal mucosa?
previous laceration
hsv 2
primary cause of genital herpes
Xray with RL behind 2M (no 3M) - dx?
primordial cyst (arising from absent 3M tooth bud)
Identify the pic which has PLEOMORPHIC ADENOMA
probably in parotid
parotid gland produces ______% of saliva
produces 25% of saliva, mainly serous. Located just anterior to the ear, opening is thru stensons duct next to maxillary 1st and 2nd molars
pregnancy gingivitis (estrogen/ estradiol/ progesterone)
progesterone
pregnancy induced hyperplasia...
progesterone induced *altered metabolism of progesterone
function of paranasal sinuses
provide mucous, make the head lighter, their specific shape provides sound to or voice.
purpose of PPE
provides barriers to minimize exposure to aerosols, spatter, direct contact, and indirect contact
what is most difficult to maintain OH w/ home preventive care?
proximal smooth surface (interprox)
Advantage of imm denture
pt doesnt want to be w/o teeth
when does tetracycline staining occur
pt is 0-5 years (NOT when mom was preg)
alveolar crest ligaments provide what support
resist tilting, intrusive, extrusive and rotational forces-all 4
Quality of disinfectant
rapid acting, broad spectrum antimicrobial-bacterialcidal, fungicidal, tuberculocidal, virucidal. odorless, easy to use, economical, compatible with surfaces in environment, residual-keeps on working after dried, noT toxic to touch or inhale, EPA registered, cleans and disinfects
At re-eval, what should you do if 4mm pockets remain?
re-do SRP
Traumatic ulcer next to EXT, what tx?
re-eval
repairative dentin aka
reactive or tertiary dentin- formed in response to trauma like attrition, recession, caries.
Multiple Odontoma questions
read about it dude
CDC
reccomendations for infection control and disease updates- standard of care. an office can be shut down even though these are just reccomendations
horozontal ligaments provide
resistance from tilting and rotational forces
hep B vaccine name and series
recombivax HB or Energix B- a series of 3 vaccines given at initial appt, 1 month and 6 months apart. Blood screening for seroconversion is done 1-2 months after vaccination.
What to do if patient complains of CHEEK BITING with dentures?
reduce the BUCCAL contours of the MANDIBULAR posterior teeth
Where does the kidney filter the blood?
renal corpuscle (The renal corpuscle is an interface between the blood supply and the kidney. It consists of the glomerulus, which is a capillary bed, and the glomerular (bowman's) capsule, which is part of the nephron. Filtration is the exit of small substances from the blood in the glomerulus into the glomerular capsule of the nephron.)
shingles (herpes zoster)
reoccurant viral infection producing the eruption of highly painful vesicles that may follow a nerve path
sclerotic dentin is what type of dentin
repairative dentin, the tubules become filled in. Sometimes found in an area with caries.
functions of Connective tissue
repairs stores transports supports defends packaging
what do you do if a patient is taking COUMADIN and needs a tooth extracted
request a PT test
post exposure follow up- the employer must do what?
request the source person be tested however they may decline, the employer does not get to know results of any testing- completely confidential.
best cement to improve retention for a short crown?
resin cement
Apical fibers
resist extrusive forces
2 RO next to roots
retained primary roots
retained primary root vs hypercementosis
retained root isnt attached
PAN of RL at ramus - what to do next?
retake for diagnostic reasons or refer to OS? idk
Arrow to RPD clasp cervical to HOC - which is it?
retentive arm
What does it mean when there is PAIN on RELEASE of biting
root fracture syndrome
pre-vs.-post ortho pics show what changes
root resorption in this case
embeded ends of the pdl are called
sharpeys fibers
why dont you use acidulated fluoridated toothpaste?
ruins polish of crown
SDS - infection control
safety data sheets- information for the employee regarding chemicals and how to protect yourself against hazzards
radiolucency near angle of the mandible contains what type of tissue?
salivary tissue
SLOB rule
same lingual, opposite buccal. If you move Xray towards mesial, then the LINGUAL root will ALSO move mesial (and the MB & DB roots will move opposite)
traumatic bone cyst
scalloped RL between teeth teeth are VITAL
which dentin continues to form throughout life, and is made after the apical foramen is formed?
secondary dentin
after SRP how does reattachment occur?
secondary intention
when polishing, always be?
selective
a person with HIV may not be diagnosed for many weeks after exposure to the HIV virus unitl there is evidence of?
seroconversion
what are the 2 types of cells that secrete mucous
serous cells- produce thin watery saliva mucous cells- produce thick, ropey saliva
hertwigs root sheath will do 2 things,
shape the root, induce dentin formation in the root area
each of the following is a mode of action of ultrasonic instrument except? (lavage/ vibration/ cavitation/ sharp cutting edge tip)
sharp cutting edge tip
antiseptics are used on
skin/living tissue
cell capsule functions
slime/glycocalyx layer, is a mechanical barrier and defense mechanism, helps cell survive in dry environments.
syncope will do what to the heart rate?
slow it down- bradycardia
Mechanical monitoring of sterilization process
smell, listen, look. what operator does.
Name 5 air polishing power options
sodium bicarbonate aluminum trihydroxide glycine calcium carbonate calcium sodium phosphosilicate
city water fluoridation types-3 ideas
sodium fluoride sodium silicofluoride hydrofluorosilicic acid
contraindication for a hypertensive pt using air powder polish
sodium restricted diets- but they can use a sodium free formula Aluminum Trihydroxide
mneomic for cranial nerves: sensory, motor or both
some say marry money but my brother says big boobs marry money
most important consideration for implants?
space bw roots
during treatment cerebral palsy pt. will have..
spastic oral mucosa
Nabor's probe
special periodontal probe used to measure the Furcation involvement- Think furry nabor!
bugs w/ ANUG
spiochetes/ prevotella intermedia/ fusiform
Routine masks are used to prevent what contact?
splash and splatter, not air borne diseases such as TB
disinfection
spray, wipe, spray, wait.. 3 mins for cavicide
Lateral incisor with fx in mid-root, tx:
stabilize for 3 wks, apexification may be indicated but if both coronal & apical portions are necrotic RCT can be difficult so EXT.
Golgi apparatus
stack of membranes in the cell that modifies, sorts, and packages proteins from the endoplasmic reticulum
pic of lingual bone cavity
stafnes defect pic
Quats, CPC mouthrinse side effects
staining, burning, increased supraG calc formation
2 methods of sterilization
steam pressure autoclaves and dry heat sterilizer-older version
Picture with lesion that was anterior to earlobe and it was swollen. Stated the stensons duct was also inflamed. What do you check first?
stimulate parotid to see if you get exudate
Ant to earlobe swollen inflammation of stensons duct
stimulate parotid, check for exudate
fluoride is rapidly digested in?
stomach and small intesting, excreted via kidneys
oral mucosa that is non keratinized is made up of ______ cells?
stratified squamous epithelium
name 3 ingrediants found in dentrifices that can help with sensitivity
stronium chloride, potassium nitrate, sodium citrate
which gland produces the most saliva
submandibular aka submaxillary gland, located inside the mandible. Accounts for 60-65%% of saliva. Has a mixture of serous and mucous cells, Opening into mouth is thru Whartons Duct-located in the sublingual caruncle at base of lingual freenum
Where is Wharton's duct located?
submandibular duct/gland location
which gland produces the MOST saliva?
submandibular gland - 60%, then the parotid 25%, then sublingual gland 10%. Bartholins duct is a duct of the sublingual gland
2-4% gluteraldehyde liquid disinfecting time
submerged for 45 mins NO BI FOR THIS
role of chlorohexidine
substantivity (anti-plaque)
any tooth replacing a primary tooth is known as
succedaneous tooth
gardeners syndrom
supernumerary teeth, osteomas, pre malignant colon polyps, epidermoid cysts
Tx of lateral perio cyst
surgical removal/enucleation
tx for lat perio cyst?
sx removal
tx for pleomorphic adenoma
sx removal
f/u tx for the odontoma blocking the central incisor?
sx removal of odontoma, orthodontics to erupt central into position
dizzyness, paleness, cold sweat, and decreased blood pressure are charactoristics of?
syncope
which disease caused by treponema pallidum has 3 stages and is treated with penicillin?
syphillis
a malar, butterfly rash is a charactoristic of?
systemic lupus erythematous
***Shunt on left arm?
take BP on right arm duh
swelling at mand angle - now what?
take xray
pyrophosphates
tartar control in dentrifices
teeth with bull-like extensions in pulp
taurodontism
teeth affected by fluorosis are affected in the following ways
teeth may appear chalky white, stained colorado brown stain apperance, affected teeth have a greater chance of developing carious lesions.
after delivering immediate denture, how long should patient keep it in?
tell them not to remove it until the 24 hour appointment Post-op appt after immediate denture = 1 day, 3 days, then 1 week
pt. is on calcium channel blocker, what do you do?
tell them to see their doctor to switch meds
What drugs will WEAKEN the antibiotic effectiveness?
tetracyclines and oral contraceptives
a NEGATIVE HIV Elisa test tells us what?
that NO antibodies against HIV have been produced
odontoblasts begin forming dentin before
the formation of enamel
who mandates defluoridation
the EPA if greater than 4mg Fl2 in the water
what happens after perio re-eval?
the recall interval is set but may be changed if the pt.'s situation changes
identify the worst C:R
the answer guide says #9 and that it was obvious tho
polishing removes?
the area of enamel that is richest in Fluoride- why we need to apply fluoride after polishing.
alveologingival ligaments hold
the attached gingiva to the tooth
pocket depth + CEJ value = CAL (which is equivalent to the value given for CEJ)
the depth of the sulcus is 5mm, the distance between CEJ and the base of the sulcus is 2mm... what is the attachment loss? *2mm
tooth buds develop from
the ectoderm epithelial layer. this is why defects in skin can affect teeth
what makes spores difficult to kill
thick, dense cell walls. cell can lay dormant until host is under stress, there is one spore per cell and we use them to monitor sterilizers once a week
oblique fibers are
the most numerous fibers and cover 2/3 of the root. Resist intrusive and rotational forces
Once the odontoblasts begin producing dentin, via the OEE, the basement membrane dissingrates allowing the preameloblasts to contact the newly formed dentin. What happens during this development
the pre ameloblasts turn into ameloblasts to produce enamel matrix and laying down crystals in the matrix
incubation stage
the time between entry of the virus and the time when you BEGIN to feel ill. HIV-1 month, Pox 7-10 days, HEP C virus-years, common cold 1-2 days, flu- hours.
pre-meds are sometimes needed with a patient that has downs syndrome because
they commonly have heart associated diseases such as congenital heart valve defects that have required artificial placements
if a pt is diagnosed with GERD, all of the following are charactoristics associated
they will have a weak lower esophageal sphincter, there is a back flow of gastric acids into the esophagus, their risk of caries can be increased by the increased acidity of stomach acids
t or f most bacteria are non-pathogenic
true!
What is the reasoning for doing a "try-in" for immediate dentures?
to determine CENTRIC relation (not vertical dimention)
Why are gold copings used in dentures? Where should they end?
to maintain the alveolar ridge they should end supragingivally and use a "feather edge" cavity prep
palatal and mucobuccal fold lesions are often associated with what?
tobacco (snuff)
3 risk factors for squamous cell carcinoma
tobacco use genetic predisposition prolonged exposure to sun
When setting denture teeth, you DO NOT consider:
tongue space
Xray errors: What causes elongation?
too LITTLE vertical angulation
dark PA - what is error?
too much developer
How can anti-hypertensive drugs affect retention of dentures?
too much fluid loss (diuretics) can lead to a loss of retention
what is reversible?
tooth mobility
which of these is REVERSIBLE w/ tooth movement? (tooth mobility/ bone resorption/ crestal bone/ gingival recession)
tooth mobility
most importatnt reason for doing ortho on this patient?
tooth movement and spacing
how do you diagnose cracked tooth syndrome?
transillumination
Possible cause of lower incisal root resorption
trauma
On xray, you see a MIDLINE radiopacity see in the maxillary anterior region. What could cause this?
trauma (look for step)
clinical picture of premolar with enamel hypoplasia, caused by
trauma or infection of primary tooth
Flap of skin on tongue is caused by?
trauma that has healed
lower central inc xray: NEGATIVE pulp vitality test, asympt, no caries, RL around apices - cause & tx?
trauma, endo
standard precautions/ universal precautions
treat all patients as if they were infectious- universal care. All body fluids with exception of sweat is infectious. In dentistry we are most exposed to blood and saliva.
antibacterial in dentrifices
triclosan
Elavil
tricyclic antidepressant that causes DRY MOUTH and enlarged gingiva
relines, small projections of impression material are projecting
trim projections flush with ridge (duh)
DPC works better in young teeth T/F
true
Goal of GTR
use barrier membranes to prevent epithelial migration and to direct growth of new bone and gingival tissue in deficient areas to promote regeneration of the PDL, cemental atachment and alveolar bone **used after extractions of bony defects
bi digital exam
use of 2 fingers or thumb and one finger. IE: Lips, deep cervicle
bi manual
use of fingers or thumbs of both hands at same time, posterior auricular, occipital, submental, etc
digital exam
use of one finger
what should you do if the surgical stent guide fits, but the immediate denture does not?
use tissue conditioner and adjust the immediate denture until it fits
piezoelectric insert
uses a ceramic rod to produce mechanical vibrations. Linear strokes. **
Furcation =
usually wide but cannot insert hand instrument
Benzo with LONGEST metabolism
valium/diazepam
hsv 3
varicella zoster virus- chicken pox and shingles is the later recurrent virus
Blood-gas partition coefficient
what defines how quickly a drug crosses the pulmonary membrane to enter the bloodstream?
Ambient air
what do these make up? 1. 79% Nitrogen (N2) 2. 21% Oxygen (O2) 3. 0.04% Carbon Dioxide (CO2)
how to reinforce OHI
verbal and in the dental office/ written and oral
what kind of bone loss is in aggressive perio?
vertical
deep probing w/ suppuration =
vertical Fx
which is smaller, bacteria or viruses?
viruses
glycemic control can benefit the diabeteic in the following ways
vision may improve periodontal status may improve vascularity may improve
which is true?
water and air from sonic kill bacteria
least effective for crevicular plaque?
water irrigating device
what is not good for removing plaque?
water pick
legionnaires and pseudomas primarily _________ disease?
waterborne
acromegaly tongue
way too large of a tongue, beyond macroglossia
static means
we are regulating growth of bacteria without killing it, example: refrigerator
how do we kill a virus?
we must kill the host cell to kill the virus. Anti biotics work on bacterial cell walls only- why we cant use antibiotics for a virus- we can help treat the symptoms but not the actual virus.
***OSHA makes you check autoclave how often?
weekly
OSHA requires autoclaves to be tested how often?
weekly
Nitrous oxide
what are these names associated with? 1. Conscious sedation 2. Relative analgesia 3. Inhalation sedation 4. "Laughing Gas"
Nitrous oxide
what are these physical and chemical properties of? 1. Colorless 2. Sweet smelling 3. Non-irritating to body tissue (good for asthma patients) 4. Comes as compressed liquid and gas in a cylinder 5. Gas a room temperature 6. Specific gravity = 1.53 (air = 1, thus heavier than air) 7. Nonflammable but supports combustion, do not use with grease/oil
Positive effects on cardiovascular system
what are these when using N2O? 1. Decreased anxiety 2. Increases pain threshold 3. Provides more O2 than air
Pre-procedure instructions for patients under 14 years old
what are these? 1. No clear liquid for 2 hours 2. No non-human milk for 6 hours 3. No meals for 6 hours
Precautions when using nitrous oxide
what are these? 1. Pregnancy (especially during the 1st trimester) 2. Communication barrier 3. Nasal obstruction 4. COPD 5. Cystic fibrosis 6. Emotional/mental instability 7. Epilepsy (can trigger a seizure) 8. Negative past experience with N2O 9. Extremely claustrophobic patients 10. Multiple sclerosis
Nitrous oxide
what can be used with other more potent inhaled agents to decrease the percent of other agents required?
Nitrous oxide
what can be used? 1. used when other analgesics are contraindicated (allergy). 2. Used to manage both fear and pain. 3. Used to facilitate positive behavior and lower anxiety levels with pediatric patients.
Rapid pressure increase (result in fire)
what can opening the tank valves too quickly could cause?
Nitrous oxide
what causes sedation?
Medullary center
what controls breathing?
Nitrous oxide
what does not cause a patient to lose feeling?
Nitrous oxide
what does these actions? 1. Depresses the central nervous system. 2. Patient is relaxed and comfortable. 3. Provides relative analgesia. 4. Raises pain threshold. 5. Does not totally block pain sensations.
Psychologic Effects
what effects are these associated with? 1. Decreased salivation 2. Increased respiration 3. Increased blood pressure 4. Increase heart rate 5. Increased blood glucose 6. Irritated gastrointestinal tract ("Fight or Flight" response: body releases adrenaline/epinephrine)
Behavioral and Psychological Effects
what effects are these associated with? 1. Nervous laughter 2. Emotional outbursts 3. Crying/screaming (children) 4. Uncooperative behavior 5. Irritability 6. Anger 7. Decreased tolerance to painful/noxious stimuli**
Nitrous oxide
what has a negative effect on B12 and plays a role in DNA synthesis via the enzyme methionine synthetase?
Nitrous oxide
what has a synergistic effect on bone marrow?
Anxiety
what increases these adverse events? 1. Syncope (fainting) 2. Cardiac conditions (angina) 3. Hypoglycemia
Nitrous oxide
what is a colorless, tasteless, sweet-smelling gas?
Nitrous oxide
what is a form of conscious sedation achieved through the inhalation of the gases nitrous oxide and oxygen?
Nitrous oxide
what is absorbed from the lungs into the cardiovascular system and carried to the central nervous system?
Pneumothorax
what is an abnormal collection of air/gas in the pleural space?
Nitrous oxide
what is considered the least potent of all inhalation anesthetics?
Nitrous oxide
what is considered the weakest of all inhaled sedation products?
Inspiration
what is initiated by contraction of the diaphragm and the intercostal muscles?
6-7 liters per minute
what is the minute volume for adults?
3-4 liters per minute
what is the minute volume for pediatrics?
Oxygen deficit
what is the most common cause of effects for the cardiovascular system?
Syncope
what is the number one medical emergency in a dental office?
Density of the alveoli
what is the reason nitrous oxide onset is so rapid?
High pain threshold
what pain threshold is this? 1. greater than average tolerance.
Low pain threshold
what pain threshold is this? 1. strong or rapid reaction to painful stimulus.
Bronchioles
what part of the respiratory system contains continuous division of the bronchi, but without cartilage?
Trachea
what part of the respiratory system contains muscular tube, bifurcates into the right and left bronchi; contains the carina which is a back up cough mechanism?
Bronchi
what part of the respiratory system contains the right bronchi that is shorter than the left?
Nasopharynx
what part of the respiratory system contains tonsils, adenoids, Eustachian tubes?
Larynx
what part of the respiratory system contains vocal cords, cough reflex?
Oropharynx
what part of the respiratory system is the entrance to larynx and esophagus?
Laryngopharynx
what part of the respiratory system starts at the epiglottis which directs material into esophagus to avoid trachea; contains the larynx; made of cartilage to protect larynx?
Nose
what part of the respiratory system warms, humidifies, and filters air?
Nitrous oxide
what provides pain control and anxiety relief that is quickly and easily reversed, with a minimum of side effects?
Nitrous oxide
what provides these benefits? 1. Rapid onset and recovery. 2. Not metabolized. 3. Does not affect cardiovascular system, respiratory system, liver, kidneys, or blood. 4. Reduces anxiety and raises pain threshold. 5. Alters sense of time. 6. Provides some analgesia - especially to soft tissues.
Inhalation Sedation
what sedation has these benefits? 1. Rapid onset of action and peak clinical effect. 2. Can titrate to desired effect (only with an amount needed to get clinical effect). 3. Greater control over level of sedation. 4. Flexible duration of action. 5. Rapid recovery time. 6. No injection required.
Contact lenses
what should be removed when using N2O?
Tidal flow
what term describes automatic, regular ebb and flow movement of breathing?
Analgesia
what term describes diminution/elimination of pain in a conscious patient?
Potency
what term describes how effectively an agent produces anesthesia?
Pain Reaction
what term describes interpretation and response to pain message and is highly variable among people?
Phobia
what term describes irrational fear that results in avoidance?
Local Anesthesia
what term describes loss of feeling or sensation in one part of the body?
Anxiety
what term describes nonspecific feeling of apprehension?
Sedation
what term describes partial or complete awareness of environment but with a significant decrease in anxiety and restlessness?
Pain Perception (Neurological)
what term describes physical process of receiving painful stimulus and transmitting information to the brain?
Nitrous oxide
what would you use in these situations? 1. Management of fear and anxiety (mild to moderate). 2. Gaggers. 3. For local anesthesia injection. 4. Pain management for some procedures: Periodontal probing Initial debridement 5. Medically compromised patient (stress reduction).
Median Rhomboid glossitis What is it? Tx:
what: End result of chronic candida albicans infection- devoid of filiform papillae tx: nystatin
When does demineralization occur?
when pH drops below 4.5-5.5 This is known as the critical pH level.
when does the time start for autoclave machine
when the correct temp and time have been reached not when you shut the door.
No
when using N2O, are there any absolute medical contraindications?
No
when using N2O, are there any negative effects for patients with cancer?
No
when using N2O, are there any negative effects for patients with eating disorders?
No
when using N2O, are there any negative effects on the cardiovascular system?
No
when using N2O, are there any negative effects on the neuromuscular system?
Lungs
where is N2O excreted?
leukoedema
white filmy patch or covering over buccal mucosa. Seen in 90% of african americans and common among smokers.
Joseph Priestly
who discovered the existence of nitrous oxide and oxygen circa 1775?
Horace Wells
who is the father of anesthesia?
Humphrey Davy
who was the first to relate N2O to dentistry, describing the effect as "overwhelming joy" and the "ideal existence"?
Can cause pulmonary problems if N2O is titrated higher than 30%
why is N2O contraindicated with bleomycin sulfate (IV anti-cancer drug)?
most likely shape of furcation?
wide but not very accessible to dental tools
How can you upright a mesially inclined molar
with an orthodontic FIXED appliance
Which technique would be best for recording jaw relationship used to determine the horizontal condylar inclination on a semi-adjustable articulator?
with protrusive inter occlusal record
when must the HEP B vaccine be offered?
within 10 days of employment-free of charge. If you decline you must sign a waiver.
pt presents with complaints after insertion - reason?
working or non-working interferences
how do we package casettets
wrap in plastic/paper pouches, nylon clear tubing and paper. Dont overload and need proper ventilation
hazzard communication standard
written in 2012. issued by OSHA, special regards to DDS. aka Hazcom standard, hazmat program or employee right to know standard. It is used to prevent exposure to hazzardous chemicals, proper response when an exposure happens with chemicals. Applies to all workers except self employed, family farm or federal workers. Must also include a written plan in office, photocopies are okay.
housekeeping and BBP standard must be in'?
writting
oral effects of chemotherapy include?
xerostomia mucositis leukopenia
dentin color
yellow/white
can an asthmatic receive nitrous?
yes
can a dental health care working control the number of pathogens we and our patients are exposed to?
yes- by good infection control and PPE
can cementum be formed thru life
yes- it can be repaired. Commonly seen it diminished in ortho patients when their teeth move too rapidly
can droplets be seen?
yes- spray, spatter, large moisture particles
what is the major constituent of gutta percha?
zinc oxide **gutta percha is an inert polyterpene derived from trees
What is the best cement for bonding a PFM to the prep?
zinc phosphate **also the most irritating to the dental pulp
What is the most irritating base to the dental pulp?
zinc phosphate (low pH) -2 layers of varnish needed
what cement most harmful to pulp tissue?
zn phosphate
