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Fixed II Midterm > 1. Tissue Management I > Flashcards

1. Tissue Management I Flashcards

(51 cards)

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1
Q

What are some common issues seen in crown impressions

A
  • voids on finishlines
  • tears
  • partial set streaks of impression material
  • debris
  • impression separation from the try
  • incomplete recording of all necessary teeth
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2
Q

What should you as a patient coming in for a crown impression before administering local anesthesia

A
  • Is the provisional secure?

- Tooth asymptomatic?

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3
Q

What are the benefits of administering LA for crown impression

A
  • Patient comfort

- Reduces salivary flow

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4
Q

Why does LA reduce salivary flow

A

-Increased discomfort leads to increased saliva

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5
Q

When removing a provisional FDP where should the hemostat be placed

A

alternating at each connector.

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6
Q

What should you look at after removing the provisional

A
  • Adequate tooth prep (correct reductions- centric and eccentric)
  • Distinct regular continuous finishline
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7
Q

What are the three pre-requisites for a successful impression

A
  • Gingival health
  • Saliva control
  • Displacement of the gingival tissues
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8
Q

Cement can be removed from the prepped tooth with

A

explorer

prophy cup with pumice

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9
Q

Why is saliva control important for impressions

A
  • Impression materials are hydrophobic (blood and saliva produce voids, bubbles, and distortions)
  • Increases visibility for cord placement
  • Increased efficacy of cord chemicals
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10
Q

What is the most common method of saliva control? How else can saliva control be achieved?

A

mechanical (cotton rolls, dry angles, saliva ejector, Svedopter)…. pharmacologic

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11
Q

Use of LS (increases/decreases) salivation

A

decreases

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12
Q

What two pharmacologic classes of drugs can be used for saliva control

A
  • Anticholinergic drugs

- Antihypertensives

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13
Q

Anticholinergic drugs used to reduce salivation are? Antihypertensives?

A

Anticholinergic

  • Atropine sulfate
  • Pro-Banthine
  • Dicyclomine
  • Propantheline

Antihypertensives
-Clonidine

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14
Q

Contraindications for anticholinergic and antihypertensive drugs

A

Anticholinergic

  • Heart disease
  • Glaucoma

Antihypertensive
-None (But caution with patients using antihypertensive meds)

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15
Q

Why are anticholinergics contraindicated in people with gluacoma

A

causes permanent blindness

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16
Q

What are the goals of gingival management

A
  • Displace gingival tissues (make room for impression material to access margin)
  • Control hemorrhage (hydrophobic materials)
  • Control sulcular fluid (hydrophobic materials)
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17
Q

What are the three different methods of gingival management

A
  • Mechanical
  • Chemomechanical
  • Surgical (electrosurgery or laser)
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18
Q

What is the most common form of mechanical retraction? Less popular alternative

A

retraction cords Less popular alternative are the displacement pastes

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19
Q

Displacement pates contain what chemical

A

aluminum chloride

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20
Q

Which has a longer healing time (scalpel/electrosurgery/laser)

A

scalpel

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21
Q

What is the disadvantage of electrosurgery

Study These Flashcards
A

potential for gingival recession

22
Q

What is the advantage of electrosurgery

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A

control hemorrhage

23
Q

Electrosurgery is contraindicated in what patients

Study These Flashcards
A

ones with electronic medical devices

-i.e pacemaker

24
Q

What area of the mouth is typically not good for electrosurgery due to thin keratinized gingiva

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A

labial surface of the maxillary canine

25
Describe the instruments you should use with electrosurgery
plastic (mirrors and evacuation tubes)- could cause an electric shock
26
Soft tissue anesthesia with electrosurgery (is/is not) required
is
27
What electrode for electrosurgery is best suited for sulcular enlargement
thin wire
28
Loop electrode for electrosurgery is used for
gingival recontouring
29
The electrosurgery machine should be on what setting when in use
unmodulated alternating current mode
30
How do you know if the current on an electrosurgery is too low/high
``` low= if the tip is dragging high= sparking is visible in the tissue ```
31
A cutting stroke with electrosurgery shouldn't be repeated within _sec
5
32
If the electrode contacts a metalic restoration what can happen
contact as long as 0.4 sec can lead to irreversible pulpal damage
33
The sulcus should be irrigated with _ before the displacement cord is placed
hydrogen peroxide
34
Anesthesia (is/is not) needed for soft tissue laser
is not
35
Astringents can lead to _
transient ischemia and gingiva shrinkage
36
Tissues collapse as quickly as _ sec after cord removal
30 sec
37
What are the three types of retraction cords
- Knitted* - Braided * - Twisted
38
What are the two classes of chemical agents used for chemomechanical gingival retraction
- vasoconstrictors | - astringents
39
Compare and contrast knitted v.s braided cords
Knitted - May collapse in sulcus - Cord will shear when in contact with handpeice (better) -- important if the cord is being used when refining the finishline Braided - Doesn't collapse in the sulcus (no memory-- better tissue displacement) - Claimed better fluid absorotion - Claimed easier to pack - Cord will grab on bur and come out
40
Braided cords are impregnated with
aluminum chloride (10%)
41
Sizes of knitted and braided cords
Knitted - 000 - 00 - 0 Braided - 0a - 1a - 2a
42
t/s aluminum chloride is a vasoconstrictor
f it is an astringent
43
What are the three astringents and one vasoconstrictor
Vasoconstrictor -Epi Astringent - Potassium aluminum sulfate (ALUM) - Aluminum chloride (hemodent) - Ferric Sulfate (Viscostat, Astringident)
44
Contraindications for epi use in tissue management
- History of CVD - Hyperthyroidism - Allergy to epi
45
1 inch of cord with 1.0mg of epi contains 2.5x the max dose for healthy patients and 12x the dose recommended for cardiac patients
ok
46
Sign of epinephrine syndrome
- Tachycardia - Increase respiration rate - Nervousness - Increase BP - Post op depression
47
What % epi should be used when packing cord
0.1% (NOT 8%)
48
Astringents stop blood flow how
coagulation
49
Viscostat and hemodent are (acidic/basic)
acidic
50
What are the implications of acidity of hemodent and viscostat
- Decalcification of tooth (sensitivity) | - Removal of smear layer (affects adhesion to tooth if done right before cementation)
51
How to minimize the deleterious effects of the acidity of hemodent/viscostat
- Minimize contact with tooth - Min. application time - Before cementation clean tooth well with pumic and consider desensitizer

Fixed II Midterm (1 decks)

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