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

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

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


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