Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Fixed Prostodontics 2 > Fluid control > Flashcards

Fluid control Flashcards

1
Q

Fluid Control -
-Too much water –
-Too little water –

A

Controlling water and saliva during tooth preparation

you can’t see and patient is drowning
you can heat tooth and cause pulpal necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gingival Control
Saliva and crevicular fluid management is crucial for making a
Soft tissue management, such as gingival displacement, is important for
the (3)

A

quality impression and for proper cementation

preparation, impression, and cementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Soft tissue management
Managed with (3) to re-contour the
gingiva as well as move or remove it from the operative environment

A

lasers, Electrosurge, or a scalpel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Uses for Rubber Dam:
(6)

A

-Still the gold standard for isolation and
moisture control
-Caries, O&R, removing old restorations
-Placing a Core
-During Post and Core procedures
-Root Canal Treatment
-When tissue retraction is difficult
(hypertrophied tissue or a pseudopocket)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rubber Dam can be used during
preparation and cementation of
(2)
-Rubber Dam provides necessary
isolation for —
-Rubber Dam used during
preparation for Inlay/Onlay.
Then, Dam is removed to check
(2)

A

Inlays and Onlays.
resin cement procedures.
occlusion and clearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primary way to manage fluid during
preparations is with —
There are tons of products out there to help
manage this in other ways.

A

high-speed suction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fluid Control
(5)

A

Cotton roll isolation
Dry Angle cheek guards
Dentopop
Nu-Bird. Suction and
mirror in one device
Releaf hands free
suction device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fluid Control - Isovac
Isovac and Isolite
(5)

A

-Isolates both Max and Mand at the same time.
-Retracts tongue and cheek
-Continually aspirates fluids and oral debris
-Obturates throat – prevents aspiration of material
**Used in clinics at UMKC as alternative to Rubber Dam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fluid control with Medication
Medications can be used to reduce saliva (anti-sialagogues)
(3)

A

-Not very commonly used for this purpose
-GI Anticholinergics (Robinul / Pro-Banthine)
-Clonidine (anti-hypertensive drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

-GI Anticholinergics (Robinul / Pro-Banthine)
(2)

A

-Decreases stomach acid and other secretions
including saliva
-Contraindicated in patients with heart disease /
glaucoma/ asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

-Clonidine (anti-hypertensive drug)
(2)

A

-Safer that anticholinergics but have side effects like
sedation, blurred vision, allergic reactions
-Caution for hypertensive patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Periodontal health is critical in the preparation and
design process of a crown or bridge.
-The health and biotype of the gingiva needs to be
evaluated

A

prior to, during, and after restorative
treatmen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Poorly contoured restorations are responsible for
inflammatory reactions:
(5)

A

-Roughness and porosity of materials
-Inaccessibility for patient OH
-Lack of patient OH
-Defective crown margins
-Invasion of biological width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Periodontal health management:
-Use the provisional to —
-SRP may be needed to —
-Pre-placement of —
- — for two weeks prior to crown
preparation can be useful in more significant
inflammation situations.

A

re-create or maintain
proper gingival contours.
remove foreign
substances and kickstart the healing process.
retraction cord and careful
final marginal preparation
Chlorhexidine 0.12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Biologic Width:
(5)

A

-Gingival Sulcus
-Junctional Epithelium
-Connective Tissue Attachment
-Radiographic Evaluation
-Crown Finish line ideally no deeper than half
the depth of the sulcus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

-Radiographic Evaluation

A

-PA/BW – Determine if crown lengthening
is advisable or needed to avoid impinging
on Biological width.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

-Crown Finish line ideally no deeper than half
the depth of the sulcus.
-Usually —

A

0.5 – 1.0mm sub gingival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Thin, scalloped gingiva–

A

More
susceptible to damage and
recession.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thick, flat gingiva–

A

More stable.
Responds better to treatments and
more resistant to recession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is gingival control so critical to
restorative treatment?
Rapid marginal recession may occur as
soon as

A

2 weeks. (results in
unpredictable tissue levels).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is gingival control so critical to
restorative treatment?
Rapid marginal recession may occur as
soon as 2 weeks. (results in
unpredictable tissue levels).
How?
(5)

A

-Damage during tooth preparation
-Over contoured provisional
-Over contoured final crowns
-Injury caused by cord packing
-Poor OH resulting in inflammation
Tissue displacement must be gentle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Purpose of Tissue Retraction –
(4)

A

-To Displace the Gingiva for margin exposure
-As a cutting guide during tooth preparation
-Displacement of gingival tissue for impression
-Control of crevicular fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

-As a cutting guide during tooth preparation
(2)

A

-Tissue protection during margin placement
-Visualization of finish line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

-Displacement of gingival tissue for impression
(2)

A

-When margin is at or below the gingival contour
-For impression and die trimming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
-Control of crevicular fluids (3)
-water, saliva, blood
26
Placement of retraction cord prior to preparation. (3)
-Improves visibility -Reduces tissue trauma -Acts as a guide for margin placement
27
-Most often, begin with a
rough preparation supragingival to start. Then pack cord. Proceed to finalization of preparation and margin
28
Gingival Control – Tissue Retraction Cord causes --- displacement of tissues to ... Allows subgingival margins without significant ... Can be left in place for final impression using --- Aiming for no deeper than ...
vertical, visualize the margin placement damage to tissues 2 Cord technique half the depth of the sulcus.
29
Tissue covering subgingival margins must be retracted or displaced horizontally. Packing Cord: -Provides space for enough ... -Removes (2) to accurately record the crown margins. -Helps arrests --- -Aid in (2) prior to impression.
impression material to record this anatomy. fluids and anatomy heme cleanliness and dryness
30
Techniques for gingival control: (3)
Mechanical Chemo-mechanical Surgical
31
Mechanical (3)
-Rubber dam -Retraction cord -Cordless materials (pastes, gels, compounds)
32
Chemo-mechanical (1)
Retraction cord AND chemicals for hemostasis
33
Surgical (3)
Electrosugery Laser Scalpel
34
Retraction Cord – Produces ... Stretches circumferential fibers to ... Types – (3) Sizes - --- cord used at UMKC
enlargement of the gingival sulcus displace tissue laterally and vertically Braided, twisted, knitted #000 - #3 Ultradent knitted
35
Gingival Control There is a --- in the cap of the cord container. Stretch out how much you need and...
blade snap the cap down to cut the cord.
36
Using Retraction Cord AND a Hemostatic agent: (3)
-Hemostatic medicaments control crevicular fluids and seepage -Retraction cord can be purchased impregnated with a chemical for this purpose -Non-impregnated cord can be soaked in heme controlling agents prior to placement.
37
Retraction Cord soaked in Epinephrine Advantages: (3)
-Can be kind to tissues -Sulcus not overly harmed and left clean -No additional tissue loss
38
Retraction Cord soaked in Epinephrine Disadvantages: (1)
-Extra epinephrine systemically for patient
39
Retraction Cord soaked in Epinephrine *Not used in UMKC clinic due to the
unpredictability of the epinephrine exposure to patients.
40
Astringents are substances that cause
constriction of soft tissues. They have a massive use in bleeding control in various dental procedures such as impression making in fixed prosthodontics, class V restorations and root surface restorations, etc.
41
Astringents: Buffered Aluminum Chloride (20% Hemodent) Advantages: (3)
-Moderate hemostasis and tissue shrinkage -Sulcus not overly harmed -Does not inhibit PVS polymerization
42
-Moderate hemostasis and tissue shrinkage -Precipitates --- -Contracts --- -Extracts --- from tissues -Leaves sulcus ---
protein blood vessels fluid clean
43
Astringents: Buffered Aluminum Chloride (20% Hemodent) Disadvantages: (1)
-Nasty taste
44
Astringents: Ferric Sulfate (15%) Astringedent Advantages: (2)
-Stypic (clotting agent) -Applied to cut tissue for best hemostasis
45
Astringents: Ferric Sulfate (15%) Astringedent Disadvantages: (3)
-Leaves a dark residue (esthetic issue) -Causes dentin discoloration (delayed) -Inhibits setting of PVS impression materials
46
-Causes dentin discoloration (delayed) -don’t use with
veneers or esthetic anterior cases.
47
-Inhibits setting of PVS impression materials -leads to
inaccurate impressions
48
Dentin Darkening:
Possible high acidity of gingival retraction fluids (GRFs) and the high affinity of iron for hard tooth tissues, resulting in an interaction with bacterial byproducts and precipitation of insoluble ferric sulfide in the porous demineralized dentin
49
For proper exposure of your finish line (margin) cord aims to: (3)
Provide adequate thickness of impression material and access to the preparation margin. Reduces tears and distortions of impression material Sulcus is opened in a cone shape
50
Single Cord Technique (4)
-Use of single cord for entire circumference -In deeper sulcus, a second cord could be used in select area -Remove all cords for impression -Best used in shallow sulcus
51
Double Cord Technique (4)
-#000 or #00 pre-packed into sulcus. -Second cord placed over the top of existing cord -For impression, top cord is removed. Second cord (lower, smaller cord is left in place for the impression). -If smaller cord is picked up in impression, it is cut off prior to pouring up in stone
52
Double Cord Technique -Remember – must
remove first cord after impression and before patient goes home! Severe inflammation and pain can occur.
53
--- is considered the gold standard for impression taking. All other techniques are compared to this.
Double Cord technique
54
Tissue retraction procedure: Mandatory (2)
Use of Local is mandatory Moisture control is mandatory
55
Use of Local is mandatory (2)
-Patient comfort -Also aids in reduced salivary flow and some heme control.
56
Moisture control is mandatory (3)
-Prevents dilution of hemostatic agents -Cotton rolls to displace tongue and cheek -Other isolation techniques can be used
57
Gingival Control – Cord Placement --Place cord near --- --Place looped cord around tooth with --Start in --- part of sulcus (usually ---) --Use --- instrument --Use gentle pressure to avoid --- --Placement is --- to the root
crevice cotton forceps deepest, interproximal blunt stripping attachment parallel
58
Gingival Control – Cord Placement Note angle toward tooth at approximately -- degrees. Straight downward pressure caused cord to Packing toward starting point will Packing away from starting point will
45 not seat and creates tissue trauma and further bleeding. keep cord in place pull cord out
59
Gingival Control – Cord Placement Common problems: (4)
Insufficient tissue retraction leading to impression material being too thin. Cord could be too small vertically or horizontally Retraction cord too small – Bottleneck of tissue Top of cord needs to be fully visible with no tissue overlap at the top of the sulcus.
60
Gingival Control – Cord Placement Step 1 – (3)
Determine # of cords to use (2 cord technique is the default) Select largest cord you believe will fit appropriate for your technique Cut cord into anticipated length plus a little extra
61
Step 2 – (4)
Place cord segments into hemostatic solution. In clinic, we use small clear cups for this. Recommend Hemodent as primary astringent. After soaking cord, dab off excess leaving cord still wet just prior to placement in the mouth. If you know your patient's gingiva will be bleeding, some Astringedent can be drawn into a syringe and placed on your cart.
62
Step 3 – (3)
Pack smaller (#000 or #00) cord (now moistened with Hemodent) into the sulcus with smooth blade instrument. Cut off excess length. The margin should be visible ABOVE the cord.
63
Step 4 – (3)
Pack larger (#0 or larger) cord (now moistened with Hemodent) into the sulcus with smooth blade instrument. Do not cut off excess length. Leave some cord hanging out to grab later. The margin should be visible ABOVE the cord.
64
Step 5 – (8)
Allow cord to sit and be isolated (dry and heme free) for 3-5 minutes. Remove top cord Air dry the tooth and crevicular area Place light body material into sulcus circumferentially Blow the impression material down into sulcus with LOTS of air. (Circular motion around the tooth multiple times with lots of air) Start again to place light body impression material Place impression tray with medium, hard, or rigid impression material Remove any remaining smaller cord prior to temporizing
65
Do not remove a --- cord. This -- the gingiva creating bleeding and an inflammatory reaction.
dry tears
66
Double Cord Technique. Always check for
the smaller cord’s removal prior to the patient being dismissed! This will create pain and inflammation!
67
Has cord been placed gently and does not overflow the sulcus BUT you still have bleeding from your preparation or patients gingival unhealth?
Rub Astringedent on tissue until bleeding stops. Remove dark debris from Astringedent by using Hemodent and cotton pellet. Dry thoroughly Check for bleeding and repeat if necessary
68
REMEMBER – Astringedent will inhibit the setting of your PVS impression material. --- may allow you to get an adequate impression
A thorough wash and dry
69
*There are some situations where the bleeding cannot be controlled well enough for a final impression that day. In this case, you
temporize, send the patient home, and have them back in a week to remove the temp, pack cord and take a new impression after healing has occurred. Can also prescribe Chlorhexidine to help reduce inflammation etc.
70
Retraction Pastes – (2)
Traxodent (Expasyl, Dryz) Magic Foam Cord (PVS)
71
Traxodent (Expasyl, Dryz)
-15% aluminum Chloride
72
Magic Foam Cord (PVS) (2)
-Material Expands in sulcus -**Does not have a hemostatic agent
73
**If using a paste, best to combine with a
single small cord and add pressure with a cotton cap
74
Electrosurge (7)
-Burns tissue away -Burnt tissue odor -Cauterizes (no bleeding after) -Tissues heal quickly -Predictability of final tissue contour or location is unpredictable -Inexpensive! (maybe $500 versus $5,000 for laser) -Easy to use
75
Laser (6)
Vaporizes tissue ”Cut” around the tooth is usually ragged Laser can be slow to cut. Best for fine detail work. If there is a lot of tissue to contour or remove, use Electrosurge. Hemorrhage is not a problem Tissue heals well Laser available in UMKC Clinic
76
Rotary (5)
Intentional use of a handpiece to remove excess gingiva Hemorage can be a problem here Tissues will heal, but may have some discomfort to patient Healing contour and levels is unpredictable Final impression not likely to happen same day. Patient will have to come back for assessment of healing results and of tooth preparation and impression.

Fixed Prostodontics 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions