3rd year Flashcards
(200 cards)
1
Q
4 methods of obturation
A
Single point
Cold lateral condensation
Warm lateral compaction
Warm vertical condensation
2
Q
What is C-factor
A
The ratio of the bonded to the unbonded surfaces
3
Q
3 features of composite layering technique
A
Reduces shrinkage stress
Time consuming process
Requires frequent instrument changing
4
Q
3 tips to avoid distal drift of SDR
A
Cure immediately after the SDR has set
Use a sharp probe to drag the SDR mesially
Place in smaller increments than 4 mm
5
Q
2 indications of calcimol LC
A
Indirect pulp capping
Lining under deep amalgam restorations
6
Q
2 indications of dycal
A
Direct pulp capping
Cavity liner
7
Q
3 indications of vitrebond
A
Indirect pulp capping
Liner under amalgam, deep composite, ceramic restorations
Liner over Dycal during direct pulp caps
8
Q
Contraindication to vitrebond
A
Patients with known acrylate allergy
9
Q
8 indications of biodentine
A
Temporary enamel restoration
Permanent dentine restoration
Deep or large cavities
Direct pulp capping
Root perforations
Internal/external resorptions
Apexification
Retrograde surgical filling
10
Q
6 indications of GC Fuji IX
A
Peadiatric restorations
Non-load bearing Class I and II restorations
Class V and root surface restorations
Core Build up
Sandwich technique
Temporary restorations
11
Q
7 indications of RIVA self cure HV
A
Non stress bearing Class I and Class II cavities
Pediatric/geriatric restorations
Sandwich technique
Cervical restorations
Core build ups
ART technique
Temporary restorations
12
Q
6 indications of GC Fuji Triage
A
Fissure protection
Root surface protection
Hypersensitivity prevention and control
Paediatric restoration
Temporary restoration
Intermediate restorations
13
Q
2 contraindications to Fuji triage
A
Pulp capping
Sensitivity
14
Q
7 indications of Equia forte HT
A
Class I restorations
Non-bearing and load-bearing Class II restorations
Class V and root surface restorations
Core build-up
Restorations of hypomineralised teeth
Geriatric/pediatric restorations
ART technique
Intermediate restorations
15
Q
4 advantages of sectional matrix bands
A
Tighter, lower contacts
Restore natural anatomy
Tight marginal seal
Ring separates teeth
16
Q
4 disadvantages of sectional matrix bands
A
Restoration of a 3 surface cavity will require multiple rings
Technique sensitive
Requires a proximal tooth
Must protect the airways when placing small components
17
Q
4 favourable endodontic outcomes
A
Absence of pain, swelling and other symptoms
No sinus tract
No loss of function
Radiological evidence of a normal periodontal ligament space around root
18
Q
What is occlusion
A
The stationary contact between opposing teeth
19
Q
What is involved in posterior guidance
A
TMJ, glenoid fossa, disc
20
Q
What is involved in anterior guidance
A
Teeth contacting during lateral/protrusive mandibular movements
21
Q
What is intercuspal position
A
The relationship of mandible at which teeth interdigitate maximally
22
Q
What is retruded contact position
A
The relationship of mandible to maxilla on the retruded arc of closure, at which initial tooth contact occurs
23
Q
What is canine guidance
A
During lateral excursion of the mandible the canines are the teeth which guide the mandibles movement and the last to disclude
24
Q
What is group function
A
During lateral excursion of the mandible, the tooth contact which guides the movement is shared between multiple teeth on the working side
25
What are occlusal interferences
A contact between teeth in one of the excursions of the mandible interrupting free sliding movement
26
5 causes of amalagm failure
Recurrent caries
Marginal ditching
Excessive creep
Bulk fracture
Loss of retention
27
6 vehicles of fluoride delivery
Water fluoridation
Milk fluoridation
Fluoride toothpaste
Fluoride varnish
Fluoride tablets
Fluoride rinses
28
Concentrations of high fluoride toothpaste
2800ppm
5000ppm
29
7 portals of bacterial entry
Dental caries
Trauma
Fractures
Iatrogenic
Accelerated tooth wear
Microleakage from restorations
Periodontal ligament
30
5 methods of working length determination
Previous radiographs
Average values
Diagnostic working length radiograph
Electronic apex locators
Tactile sensation
31
3 disadvantages of SS hand-files
Larger diameter files are quite rigid and harder to pre-bend if needed
Takes longer to achieve a correctly tapered preparation
It is harder to achieve a fully uniform preparation
32
4 advantages of rotary filing with NiTi files
Can undergo greater stresses than SS without breakage
Resists permanent deformation
Larger files are still flexible
Tapered preparation produced more quickly and with fewer files
33
3 disadvantages of rotary filing with NiTi files
NiTi files are liable to fracture
Excessive torsional stresses are created
Larger NiTi files undergo greater stresses when rotated in a curved root canal
34
8 ways to prevent hypochlorite incidents
Pre-op IOPA
Sealed rubber dam
Straight line access to canals
Correct working length
Only use side vented, screw-on needles (Luer-Lock)
Needle should be passive and never engage the canal walls
Needle must not reach WL (2mm short)
Deliver irrigant with minimal pressure
35
What area is most vulnerable area to an overhang of a restorative material
Gingival floor of a Class II cavity
36
Describe pulpitis
Inflammation of the pulp as a result of pulp tissue exposure to an insult
37
Describe the presentation of a normal pulp
Asymptomatic
Transient response to thermal/electric stimuli
38
Describe the presentation of reversible pulpitis
No spontaneous pain
Heightened response to thermal/electric stimuli
Transient response to thermal/electric stimuli
39
Describe the presentation of symptomatic irreversible pulpitis
Localised, moderate/severe spontaneous pain
Heightened response to thermal/electric stimuli
Lingering response
40
Describe the presentation of asymptomatic irreversible pulpitis
No clinical symptoms
Mild and transient response to thermal/electric stimuli (1/2 seconds)
41
Describe the presentation of pulp necrosis
Pulp non-responsive to pulp testing
42
5 management strategies for pulpal disease
Indirect pulp cap
Direct pulp cap
Partial pulpotomy
Complete pulpotomy
Pulpectomy (RCT)
43
7 contraindications to RCT
Inadequate access
Poor oral hygiene
Patient’s general medical state
Patient attitude
Tooth not restorable
Advanced periodontal disease
Root fracture
44
8 tooth restorability considerations when assessing endodontic difficulty
Position of tooth in arch
Tooth inclination and rotation
Crown morphology after caries removal
Canal morphology
Root curvature
Apical morphology
Canal calcification
Root resorption
45
3 levels of difficulty relating to each endodontic consideration and their values
Minimal: 1 point value
Moderate: 2 point value
High: 5 point value
46
How does level of difficulty affect who is capable of doing endodontic treatment
< 20 points: dental student could treat
20 – 40 points: graduate dentist could treat
> 40 points: should be referred to specialist trainee or specialist
47
5 reasons to stop endodontic treatment
Unable to find all expected canals
Blocked canal which you are unable to negotiate to >3mm of apex
Separated instrument
Perforation
Severe ledge or apical transportation
48
Objectives of endodontic treatment
Clean: remove diseased tissue, eliminate irritants
Shape: facilitate optimal irrigation, debridement and placement of local medicaments, and permanent root filling
Fill: prevent recontamination, create a complete coronal seal
49
Number of canals and average root length in Maxillary central incisor
Number of canals: 1
Average root length: 23 mm
50
Number of canals and average root length in Maxillary lateral incisor
Number of canals: 1
Average root length: 22 mm
51
Number of canals and average root length in Maxillary canine
Number of canals: 1
Average root length: 26 mm
52
Number of canals and average root length in
Maxillary 1st premolar
Number of canals: 2, 1 or 3
Average root length: 21 mm
53
Number of canals and average root length in
Maxillary 2nd premolar
Number of canals: 1 or 2
Average root length: 21 mm
54
Number of canals and average root length in
Maxillary 1st molar
Number of canals: 4 or 3
Average root length: 22 mm
55
Number of canals and average root length in
Maxillary 2nd molar
Number of canals: 3 or 4
Average root length: 20 mm
56
Number of canals and average root length in
Mandibular incisors
Number of canals: 1 or 2
Average root length: 21 mm
57
Number of canals and average root length in
Mandibular canines
Number of canals: 1 or 2
Average root length: 24 mm
58
Number of canals and average root length in
Mandibular 1st premolars
Number of canals: 1 or 2
Average root length: 22 mm
59
Number of canals and average root length in
Mandibular 2nd premolars
Number of canals: 1 or 2
Average root length: 22 mm
60
Number of canals and average root length in
Mandibular 1st molars
Number of canals: 3 or 4
Average root length: 21 mm
61
Number of canals and average root length in
Mandibular 2nd molars
Number of canals: 3 or 2
Average root length: 20 mm
62
5 common problems caused by incorrect hand-filing techniques in curved canals
Dentine debris and pulp remnants packed into the apical part of the canal
Ledging
Apical zip
Perforation
Strip perforation
63
5 benefits of PTU files
High cutting power
Increased apical taper for better canal cleaning
Better debris removal
Optimisation of the hydraulics of the irrigation fluid
Very flexible and does not require pre-curving to negotiate curved canals
64
Settings on X-smart machines
Auto-reverse
Motor speed of 400rpm
Torque of 4Ncm
65
Reason for recapilitation
Removes any debris formed by the rotary instruments which may have fallen to the bottom of the canal causing a blockage and maintains patency of apex
66
3 chemical irrigants
Sodium Hypochlorite (NaOCl) 2%
Chlorhexidine 2%
Ethylene-diamine tetracetic acid (EDTA) 17%
67
3 root canal sealers
Zinc Oxide Eugenol (Tubliseal)
Calcium Hydroxide (Apexit)
AH Plus
68
3 endodontic outcomes
Favourable
Uncertain
Unfavourable
69
4 conditions that improve the outcome of primary root canal treatment significantly
Pre-op absence of PA RL
Root filling eith no voids
Root filling extending to 2mm within the radiographic apex
Satisfactory coronal restoration
70
Describe A δ-fibres in dental pulp
Associated with acute dental pain
Convey impulses perceived as sharp, penetrating, short lasting pain
71
Describe C-fibres in dental pulp
Associated with pain with inflammation
Convey impulses perceived as dull, lingering, long lasting pain
72
5 components of the dental pulp
Pulp extracellular matrix (ECM)
Connective tissue fibres
Odontoblasts
Fibroblasts
Defence cells
73
What does Ionising Radiation Regulations (IRR) 2017 encompass
Protection and health of staff working with ionising radiation
74
What does Ionising Radiation (Medical Exposure) Regulations (IRMER) 2017 emcompass
Safe and effective use of ionising radiation when exposing patients
75
Describe shared decision making
A collaborative process whereby the patient is supported by the health professional to reach a decision about their care that is right for them
76
Fluoride toothpaste concentration for a high caries risk patients aged 10+yrs
2800ppm
77
Fluoride toothpaste concentration for a high caries risk patients aged 16+yrs
5000ppm
78
Fluoride varnish concentration
22,600ppm
79
3 methods of providing retention for larger amalgam restorations
Dentine pins
Dentine slots, grooves and pits
Bonded amalgams
80
3 consequences of polymerisation shrinkage stress
Gap formation
Post-op sensitivity
Recurrent caries
81
4 benefits of hand-filing with SS hand-files
Tactile sensitivity
Control
Can be pre-curved
Rigidity is very useful in the negotiation of calcified root canals
82
Describe the colour and use of the SX File
No colour
Works in coronal 1/3 where the canal opening is too small to receive the Slider File
83
Equation for operating length of SX file
1/3 of root length + crown height
84
Describe the colour, taper and use of the Slider File
Purple
2% apical taper
Used at EWL to remove restrictive dentin and other calcifications and to create a reproducible pathway to the canal terminus paving the way for the canal shaper
85
Describe the colour, taper and use of the Shaper File
White
4% apical taper
Works in coronal 2/3, to haul debris and provide an easy and safe access to the apical 1/3 for the finishing files
86
Describe the colour, taper and use of the Finishing F1 File
Yellow
7% apical taper
Work in the apical 1/3 and create the ‘Deep Shape’
87
Describe the colour, taper and use of the Finishing F2 File
Red
8% apical taper
Work in the apical 1/3 and create the ‘Deep Shape’
88
Describe the colour, taper and use of the Finishing F3 File
Blue
9% apical taper
Work in the apical 1/3 and create the ‘Deep Shape’
89
Describe the colour, taper and use of the FX File
Green
12% apical taper
Used at WL in in large (wide diameter) straight canals
90
Describe the colour, taper and use of the FXL File
Double yellow
10% apical taper
Used at WL in in large (wide diameter) straight canals
91
5 ways endodontic treatment leads to weakening of tooth structure
Carious lesion
Access cavity
Changes to the properties of dentine: collagen depletion, dehydration
Changes to the mechanoreception of the PDL
Force of cold lateral condensation during obturation
92
When are endodontic outcomes assessed
Assessed at least 1 year after treatment and subsequently as required; assess further if uncertain – until resolved or for minimum period of 4 years
93
3 types of sterilisers
N: non vacuum passive air removal
B: vacuum active air removal
S: only used according to manufacturer’s instructions
94
5 stages of decontamination process
Cleaning
Disinfection
Inspection
Packaging
Sterilisation
95
6 requirements of HTM 01-05
Separate decontamination room
Evidence of correct workflow
Automated cleaning
Correctly applied processes
Training of staff and defined roles
Testing of equipment
96
3 inter-appointment dressings
Hypocal (non setting)
Odontopaste
Leddermix
97
How to ensure patient has capacity to consent
Understand, retain and weigh up the information provided
Make a decision
Communicate that decision
98
Matrix bands which are not appropriate for placing composite
Siqveland matrix bands
99
When to stop biomechanical preparation
Passively follow the canal with finishing file to the WL in one or more passes
Remove and inspect its apical flutes, when the apical flutes are loaded with debris, the preparation is finished
100
Signs a canal is still infected
Pus or blood in the canal
101
Define an unfavourable endodontic outcome
Lesion on radiograph increased in size, signs of infection, root resorption
102
Define an uncertain endodontic outcome
Lesion on radiograph remains same size
103
Describe a BPE 0 scoring code
Pockets <3.5mm (black band entirely visible)
No calculus/overhangs, no bleeding on probing
104
Describe a BPE 1 scoring code
Pockets <3.5mm (black band entirely visible)
No calculus/overhangs, bleeding on probing
105
Describe a BPE 2 scoring code
Pockets <3.5mm (black band entirely visible)
Supra or subgingival calculus/overhangs
106
Describe a BPE 3 scoring code
Probing depth 3.5-5.5mm (black band partially visible)
107
Describe a BPE 4 scoring code
Probing depth >5.5mm (black band disappears)
108
Management of a patient with a BPE 1 scoring code
Oral hygiene instruction
109
Management of a patient with a BPE 2 scoring code
Oral hygiene instruction
Removal of plaque retentive factors, including all supra and subgingival calculus
110
Management of a patient with a BPE 3 scoring code
Oral hygiene instruction
Removal of plaque retentive factors, including all supra and subgingival calculus
Root surface debridement if required
111
Management of a patient with a BPE 4 scoring code
Oral hygiene instruction
Remove supra and sub-gingival calculus
Root surface debridement
Assess the need for more complex treatment
112
Define sterilisation
Removal of all organisms/spores
112
3 interim filling materials
Kalzinol
Cavit
Glass ionomer Cement
112
Irrigant of choice and its properties
Sodium Hypochlorite 2%
Dissolves organic tissue and possesses anti-microbial properties
Lubricates the root canal for biomechanical preparation
Flushes out debris
112
Active ingredient of Hypocal and how does it work
Calcium Hydroxide
Alkaline (pH 11): anti-bacterial
113
Immediate clinical signs of a hypochlorite incident
Severe immediate pain, swelling, profuse bleeding, ulceration
114
Materials used in obturation
Gutta-Percha (GP) core material and AH plus sealant
115
Purpose of the coronal seal
Prevent any residual contamination within the root canal system entering the periapical tissues
Prevent recontamination of the root canal system via the oral cavity
116
Describe recapulation and when it is carried out
After confirming WL, go back into the canal with 10 SS handfiles set at WL+1mm
Removes any debris formed by the rotary instruments which may have fallen to the bottom of the canal causing a blockage and maintains patency of apex
117
Describe apical gauging and when it is carried out
After using finishing files, place equivalent handfile then GP point set to working length into the canal
Turn file clockwise for a quarter turn and using light pressure on file handle
Evaluate its tug-back
118
How to determine number of canals
Pre-operative radiograph: parallax
Clinical examination to check angulation of canals
119
Possible special investigations to assess pulpal disease
Endofrost testing
Electric pulp tester
120
3 amalgam cavity features that will improve its success
Box to provide retention
Occlusal key to provide resistance
90 degree cavity-surface angle to remove unsupported enamel
121
3 reasons for loss of amalgam marginal integrity
Insufficient packing
Unrestored contact point
Unsupported enamel
122
3 techniques to reduce the risk of composite debonding
Composite layering technique
Wet dentine bonding
Correct light curing
123
How to manage a hypochlorite incident
Stop irrigation immediately and reassure patient, irrigate canal with copious amounts of saline or sterile water, dry, dress and temporarily restore
Follow-up is essential at 1 day, 1 week and there-after as necessary
124
Optimal conditions for caries detection
Dry, clean field
Good illumination
125
Bitewing intervals for adult patients according to FGDP Selection criteria for dental radiography 2018
High risk: 6 months
Medium risk: 1 years
Low risk: 2 years
126
Recall intervals for adults according to NICE guidelines
High risk: 3 months
Low risk: no longer than 2 years
127
5 medical factors placing patient at high caries risk
3 + prescribed medications
Xerostomia
History of chemo/radiotherapy
Eating disorder/acid reflux
Physical disabilities
128
5 phases of steam sterilisation process
Heating phase
Air removal
Sterilisation phase
Evacuation and cooling phase
Drying phase
129
Method of sterilisation commonly used in dentistry
Autoclave
Saturated steam under pressure
98% steam 2% water vapour
130
4 clinical signs that indicate a parafunctional habit
Tongue scalloping
Linea alba
Tooth faceting
Hairline cracks in teeth
131
How to examine occlusal contacts in ICP
Black GHM articulation paper 12um
132
How to examine lateral guidance
Red GHM articulation paper 12um
133
How to examine degree of occlusal stability
Shimstock foil 8um
134
4 reasons rubber dam is mandatory in endodontics
Prevention of hypochlorite incident
Prevention of infection of the root canal
Protection of the patients airway
Protect patients soft tissues
135
Reasons for composite marginal leakage
Polymerisation shrinkage
Debonding
Incomplete light curing
136
2 important factors when positioning light cure
Angle 90 ⁰ to surface
Distance 0.5cm from surface
137
2 clinic consequences of incomplete light curing
Post operative sensitivity
Debonding
138
How does composite shade impact cure time
Darker shades require longer cure times as pigments in darker shade limit polymerisation
139
3 functions of dental pulp
Supplies nutrients to dentine
Initiates and controls the repair of dentine when it is damaged
Provides a pathway for sensory impulses
140
4 defence cells of dental pulp
Macrophages
Dendritic cells
T-lymphocytes
Mast cells
141
Active ingredient of odontopaste
Corticosteroid: antimicrobial /anti-inflammatory
142
Active ingredient of leddermix
Corticosteroid: antimicrobial /anti-inflammatory
143
4 ideal properties of root canal sealer
Biocompatible
Anti-bacterial
Radio-paque
Minimal shrinkage
144
When to take radiographs following BPE
Code 3 or 4
145
3 things instruments are inspected for prior to sterilisation
Clean with no visible debris
Functional
Condition, ensure no rust or cracks
146
What piece of equipment is used to clean dental instruments
Washer disinfector
147
Methods for administering LA
Block
Infiltration
Intra-osseous
Intra-ligamentary
Intra-pulpal
148
Define smart dentine replacement SDR
Bulk fill composite
149
Define sonic fill
Bulk fill sonic-activated nano-hybrid composite
150
Define calcimol LC
Resin modified calcium ion releasing base liner
151
Define dycal
Calcium hydroxide liner
152
Define vitrebond
Resin modified glass ionomer liner
153
Define biodentine
Calcium-silicate based material
154
Define GC Fuji IX
High viscosity glass ionomer
155
Define RIVA self-cure HV
High viscosity glass ionomer
156
Define GC Fuji triage
Low viscosity glass ionomer
157
Define Equia Forte
Bulk fill glass hybrid
158
Define Ceram-X
Nano hybrid composite
159
Define Tubiseal
Zinc oxide based sealer
160
Define AH Plus resin sealer
Epoxy-amine resin based sealer
161
Define AH Plus bioceramic sealer
Calcium silicate based sealer
162
5 circumferental matrix systems
Omni-Matrix
Pro-matrix bands
Siqveland matrix
Tofflemire matrix
Supermat matrix
163
1 sectional matrix system
Palodent V3
164
Function of cavity liners
Provide electrical, thermal and chemical insulation to the pulp
165
5 stages of the washer disinfector cycle
Flush at 45°
Wash
Rinse
Thermal disinfection at 65-90°
Dry
166
Additional ingredient in tubliseal
Eugenol
167
2 zones that make up infected dentine
Necrotic zone
Contaminated zone
168
2 zones that make up affected dentine
Demineralised zone
Translucent zone
169
4 pieces of information that should be provided to patient in order to obtain consent
Options for treatment
Your proposed treatment
Risks and benefits of your proposed treatment
Risks of no treatment
170
2 main components of the pulp
Extracellular matrix
Cells
171
4 muscles of mastication involved in elevation
Medial pterygoid
Superior lateral pterygoid
Temporalis
Masseter
172
1 muscle of mastication involved in protrusion
Inferior lateral pterygoid
173
1 muscle of mastication involved in depression
Digastric
174
Define ALARP
As low as reasonably practicable
175
Describe the radiograph quality assurance categories
1: No errors of exposure, positioning, or processing, diagnostically acceptable
2: Some errors of exposure, positioning, or processing, diagnostically acceptable
3: Errors of exposure, positioning or processing which render the radiograph diagnostically unacceptable
176
3 parameters of sterilisation phase
Temperature: 134°C - 137°C
Pressure: 2.0 - 2.3
Holding time: 3 minutes
177
Describe vitality testing
Using ethyl chloride or an electric pulp tester to assess if pulp is still vital
178
Describe justifications for radiographic assessment
To check for interproximal caries, secondary caries, assess restorations, check for PAP, check bone levels
179
Describe tenderness to percussion testing
Using instrument to tap tooth to assess if the PDL is inflamed
180
4 contraindications to direct pulp cap
TTP
Spontaneous pain
Purulent discharge
Haemorrhage last >5 mins
181
4 aspects to consider when assessing if RCT is the best treatment option
Patient preference
Remaining caries free tooth structure
Suitability for rubber dam
Periodontal status
182
Fluoride concentration of fluoride rinses
225 ppm
183
4 features determining occlusal stability
Number of posterior contacts
Occlusal stops
Contact points
Cuspal locking
184
4 C’S of clinical record keeping
Contemporaneous
Clear
Concise
Complete
185
C factor of a sealant or class V cavity
0.2 (1:5)
186
C factor of a class IV cavity
0.5 (2:4)
187
C factor of a class Ill cavity
1 (3:3)
188
C factor of class II cavity
2 (4:2)
189
C factor of class I cavity
5 (5:1)
190
Microbiological pathogens associated with apical periodontitis
Facultative anaerobic bacteria
Enterococcus group (32%)
Candida albicans (7%)
191
Define apical constriction and where it is located
Narrowest part of the root canal system
0.5-1.0 mm short of the apical foramen
192
First place to clear during caries removal
Clear around the margins of the caries so that as you approach the pulpal area you are not at risk of infecting the sensitive pulp tissue with bacteria, from an active carious site
193
2 contraindications to Duraphat varnish
Stomatitis
Ulcerative colitis
194
4 D’s of caries detection and management
Determine
Detect
Decide
Do
195
What allows localisation of pain to a specific tooth
Stimulation of the periodontal ligament propireceptors due to necrotic pulp
196
Describe articulation
Dynamic gliding contacts between opposing teeth during protrusion/retrusion and lateral mandibular movements
197
Describe ideal protrusion
Guided by the palatal surfaces of upper anterior teeth
