MA1 to midterm Flashcards
1- endo dx form
2-clinical tests
3-PDL inflammation
4-percussion
5-percussion technique
6-palpation
7-palpation technique
1-chief complain, history of tooth, symptoms, clinical exam, etiology, radiographic interpretation
2-periapical testing: percussion & palpatation
3-perio disease, occlusal trauma, pulpal origin, & non odontogenic
4-periradicular inflammation indicatory—info about local apical & perio health
pulpal origin?—sharp pain, periradicular pathosis
5-use finger pressure first, if no response to that…then tap the incisal/occlusal surface w/ the end of a mirror
start w/ control tooth on the contralateral side
6-soft & hard tissues in the area WNL? painful response= inflammation
7-pressure w/ gloved forefinger over apex of suspected tooth
-bilaterally palpate—baseline to assess consistency of swelling
1- bite test
2-cracked tooth syndrome
3-mobility
1-apply pressure to each individual cusp…cusp tip is seated in depression & patient is asked to bite, check for pain on release
2-severe pain/sharp uncomfortable sensation on biting/chewing
- in specific direction
- unable to identify offending tooth or quad involved
- sensitve to cold
- pain is severe during initiation & release of biting pressure
3-movememnt of tooth from original position to a diff direction depending on force
- apply pressure w/ index finger on lingual surface, & apply pressure on opposite surface w/ mirror handle & asses movement
- can be periodontitis, occlusal trauma, bone lesions or pregnancy
Miller classification
1-class 0
2-class 1
3-class 2
3-class 3
5-mobility testing
1-normal movement when force is applied
2-mobility greater than physiologic <1mm
3-tooth can be moved up to 1 mm or more in a lateral direction (buccolingual or mesiodistal)
-inability to depress the tooth in a vertical direction (apicocoronal)
4-tooth can be moved 1mm or more in a lateral direction (buccolingual or mesiodistal)
-ability to depress the tooth in a vertical direction (apicocoronal)
5-on contralateral tooth & adjacent teeth
1-perio probing
2-soft tissue exam
3-sinus tract
4-parulis
1-demonstrated level of CT attachment
- teeth w/ severe perio disease are poor candidates for endo therapy
- walk probe around tooth
- on contralateral & adjacent teeth
2-sinus tract, swelling & lymphadenopathy
3-inside of the mouth (intraoral sinus tract) or skin surface of face or neck (extraoral sinus tract)
-abnormal channel that originates from a longstanding dental infection associated w/ necrotic tooth
4-soft erythematous papule that develops on alveolar process in association w/ a non-vital tooth
- made up of inflamed granulation tissue
- place a GP cone using a cotton pliers into opening until it stops & then take a radiograph bc it can actually have extended further than thought
1-lymphadenopathy
2-etiology
1-submental, submandibular, & cervical nodes
2-caries & mechanical exposure
coronal fx, trauma, prior access
-attrition & abrasion
-restorative & previously treated
-intentional
-previously initiated therapy
1-mandatory radiographs: straight PA
2-angled PA
3-BWX
4-radiographic exam
1-documents preop state of tooth existing pathosis, root lenght, curvature, axial inclination, calcification of canals & areas of resorption
2-adds another dimension to 2D
-valuable to visual additional roots
3-undistorted view of pulp chamber, extent of pulp horns, MD width of pulp chamber & vertical dimension of pulp chamber can be visualized
4-loss of lamina dura
- radiolucency remains at apex despite radiograph angulation
- PARL resembles a tear drop hanging off apex
- cause= evident
1- selective anesthesia
2-test cavity
3-transillumination
1-when other tests= inconclusive
-nonspecific pain
-most useful in maxilla—inject anterior to posterior
…if pain is relieved= odontogenic if not relieved= non odontogenic
-PDL & Mandibular= limited value
2-no anesthesia, high speed w/ small round bur, penetrate dentin…quick sharp pain? vital if no pain then non vital
—useful when thermal/electric test= inconclusive
3-limitations, can be inconclusive, dont rely on a single test
-require care in performance & patients response
1-major theories
2-stages
3-transition
4-plateau
5-normative crisis
6-liminal stage or limbo state
7-rites of passage
-developmental tasks
9-what we experience how we describe
1-Erikson-Psychosocial
- Freud- Personality
- Paget – Cognitive
- Bandura- Social learning
- Bronfenbrenner- Ecological systems
2-theories break into stages even if its continuum
3-move from 1 stage to next
4-stability, no transition
5-turmoil by grappling w/ changes from 1 stage to next
6-dont feel here nor there…adolescents arent kids or adults
7-rituals to help move from 1 stage to next, drivers license drinking etc
8-must do or accomplish to move on to next stage of development
9-we experience as a continuum but describe it as discontinuous
1-erikson—psychosocial development
1- birth—>1 yr= trust vs mistrust—Q= predictable vs supportive
- 2-3 yr= autonomy vs doubt—Q=can i do it myself or need others
- 4-5 yr= initiative vs guilt—Q=am i good or bad
- 6-puberty= industry vs inferiority—Q=am i competent or worthless
- adolescence= identity vs identity diffusion—Q=who am i/where am i going
- early adulthood= intimacy vs isolation—Q=shall i share my life or live alone
- middle adulthood= generative vs self absorption—q=will i produce something of value
- late adulthood= integrity vs despair—q=have i lived a full life
—each stage has a normative crisis (question) that needs to be resolved before going on to next stage
—theory is culturally biased
1-Freud—personality development
-behavior dictated by unconscioud mind—ID, EGO, Super EGO
Birth-2= oral stage= infants pleasures centers on mouth
2-3=anal stage= childs pleasures focuses on toilet training
3-6= phallic stage= childs pleasures on genitals
6-puberty=latency stage= child represses sxual interest & gets social/intellectual skills
Puberty onwards= genital stage= sexual reawakening, source of pleasure outside fam
-behavious is controlled & influenced by subconscious—driven by libidinal desires, use “talking” as cure
Piaget—cognitive development
- kids thinking is diff from adults
- active via exploring, environments & pay provides maturation that moves kids through stages
- –birth-2 yrs= sensorimotor- understanding of world, coordinating sensory experience w/ physical actions
- –2-7= preop stage- child represents the world w/ words & images= inc symbolic thinking & beyond sensory info & physical
- –7-11= concrete operational= child can reason logically about events & classify objects into diff sets
- –11-15= formal operational= adolescent reasons= idealistic & logical…solve problems in head
naturally curious
Bandura—social learning theory
- learn from each other through observation, imitation & remodeling
- reciprocal determinism= environment & behavior interact in way that each influences creation of other
- environment what we experience, influences cognitive what we think, influencing behavior what we do
attention= focus of interest retention= recall later/memorable reproduction= can be imitated & practiced motivation= want to continue behavior
1-bronfrenbrenner—ecological
2-4 developmental rules
1-balance between heredity & environement
-micro/macrosystem, mesosystem, exosystem, & chronosystem
microsystem= relations between kid & immediate environment
mesosystem= kid & immediate settings
exosystem= social settings that affect but dont contain kid
macrosystem= overarching ideology of culture
2-similar for each individual
goes at an individual rate
builds upon earlier learning
area is interrelated to development in other areas
lifelong process
Parentine Styles—Baumrind
1-authoritarian
2-authoritative
3-permissive
4-uninvolved
5-results
1-high demands placed on kid= low responsiveness of parent to kid & low level of comm from parent to kid
2-highish demands on kid
- high responsiveness of parent to kid
- high level of comm from parent to kid
3-low demands on kid
high responsiveness of parent ot kid
high level of comm from parent to kid
4-low demands placed on kid
- low responsiveness of parent to kid
- low comm from parent to kid
5-authoritarian will lead to a child that is cooperative but takes little role in his/her care
authoritative- child is cooperative & readily takes active role in care
permissive- child lacks self control
uninvolved- child in uncooperative & unwillingt o take any role in care
1-Infancy 0-1 yr
2-early childhood 1-5 yr
1-development tasks of infant…desires for & feeling affection
- manage new motor skills
- rhythm between periods of rest and activity
- understanding through exploration
- emotions to express needs/wishes
- varying temperaments—7-9 mo= stranger anxiety 9-12 mo= separation anxiety
2-language, mobility inc, understands numbers & counting, can follow instructions & plays
- fear of separation, limited understanding, symptoms are vague, fear of pain
- be predictable, use easy language, be fun, keep parent there
- watch for distress, assess past experience,
1-middle childhood (6-puberty)
2-adolescence—puberty to adult
1-lessening dependence on family, inc influenced by peers
- concept of self & control over impulses & feelings
- cooperative & multiple symptoms
- fears= bodily injury
- ask kid yes/no questions first, listen, assure safety,
2-personal identity, establish a peer relationship, consistent self image, condiers goals
-inc abstract thinking, more into appearance and etc
1-expected of us as dentists (time)
2-complaints
3-what we expect of patients
4-what we can do
5-+imp/-Urg
6- -imp/-urg
7- -imp/+urg
8- +imp/+urg
1-Show up to our practice on time
See our patients at the appointed time
Prepared well-enough not to waste time during the appointment
Devote attention to patient in chair
Conclude appointment within a reasonable amount of time
Allow reasonable amount of time to the planned care
Reschedule patients at an appropriate interval
2-Communication
Quality
Money
Appointment: poor schedule times, multiple missed appointments, assignment to new students, etc
3-That they arrive at their apt on time
That they have allotted the amount of time we have indicated to complete the scheduled care
They don’t interrupt the appointment with calls or texts
That they have made arrangements for anyone under their care to be taken care of by a responsible person while they are at the appointment
That they schedule re-appointments and at reasonable intervals to proceed with planned care
4-Schedule realistically
Document systems & protocols
Train team
Delegate your time where you can
Plan for the unplanned
Stay calm
Prioritize
5-schedule it
6-do it later
7-delegate it
8-do it now
1-hereditary disease
2-white sponge nevus
3-reactive change
1-white sponge nevus
2-
- Deals with Keratin 13 and Keratin 4 gene
- Appears at birth/early childhood
- White, velvety corrugated plaques &&& Bilateral lesions
- Vacuolation of spinous layer
3-frictional keratosis
nicotine stomatitis
hairy tongue
dentrifrice-associated slough
chemical injury
1-frictional keratosis
2-nicotine stomatitis
1-found in white lesions in mouth
- White lesion related to chronic trauma or friction
- Callus on skin (protective effect)
- Looks like tongue bite
- Alveolar ridge keratosis: frictional keratosis seen in the retromolar pad
- Treat: lesion should resolve once you remove causative agent
2-
- White change associated with heat generated from smoking,
- grayish mucosa with red elevated papules (which are salivary gland openings that undergo inflammation)
- Duct Metaplasia*
- Treat: resolves upon cessation of habit, not precancerous but it’s a Warning!! STOP SMOKING
1-hairy tongue
2-dentrifrice associated slough
3-chemical injury
4-immuno changes
1-
- Accumulation of keratin on filliform papillae, increased production or decreased desquamation
- Usually in heavy smokers**
- Affect midline of tongue
- Exogenous/endogenous pigmentation may cause lesions to become brown, yellow or black, maybe even green!
- Treat: tongue scraper and remove predisposing factors
2-caused by diff brands w/ mouth wash
-whitish slough detected by patient as peeling that can be swiped away…switch brands
3-aspirin burns & debacterol canker sore relief that burns nerve ending
- white, wrinkled mucosa…removals of necrotic tissue= bleeding tissue
- use rubber damn, and get rid of causing agent so lesions will heal
4-lichen planus
lupus erythematosus
1- lichen planus
2-systematic lupus erythematosus
3-chronic cutaenous lupus erythematosus
4-subacute cutaneous lupus erythematosus
5-infectious diseases
1-chronic derm disease
purple, pruritic, polygonal papules
women 3:2
reticular pattern= bilateral, interlacing white lines—wickhams striae
erosive pattern= erythema w/ central erosion, less common but painful
-histologically= band like infiltrate of lymphocytes (degeneration of basal layers)—lichenoid= reacts to amalgam, drugs & cinnamon
-treat= reticular pattern= not required &
erosive pattern= corticosteroids
2-multisystem, fever, weight loss, etc
- inc activity of B lymp & abnormal of T cells
- 8x more commin in girls over 30…
- butterfly rash in nose area
- complications= kidney failure & cardiac involvement (pericarditis)—libman sac= warty on heart
3-to skin & oral cavity…no signs/symptoms
-scaly, erythematous patches, in sun areas, scarring & pigmentation
4-cutaenous lesions are prom, no scarring/pigmentation
- band-like infiltrate of lymphocytes w/ perivascular inflammation, diff from lichen planus
- treat = avoid lots of sun, corticoids & antimalarial
5-oral hair leukoplakia
candidiasis
1-oral hairy leukoplakia
2-candidiasis
1-caused by EBV/HHV4
- white plaque on lateral of tongue
- looks like tongue bite
- acanthosis, corrugations, thick parakeratin & superficial balloon cells
- dont need to treat
2-opportunistic fungal by c. albicans (dimorph)
- immunodeficient, diabetes, pregoo, corticosteroids, xerostomia, AB therapy, poor oral hygiene
- pseudomembrane candidiasis, thrush, white plaques, resemble cottage chees, AB use or immune system impairment
- –acute erythematous candidiasis= common, AB sore moth
- –chronic erythematous candidiasis= in most denture wearers= angular cheilitis & median rhomboid glossitis
- chronic hyperplastic candidiasis=white patch thta cant be removed in anterior buccal mucosa
treat via topical and systemic drugs
1-biologic goals for crown provisionalization
2-pulp protection
3-perio health
4-tooth protection
5-mechanical goals for provisionalization
6-esthetic goals
1-pulp protection, maintain perio health, tooth protection
2-act to insulate pulp—limit further odontoblastic cell damange
3-optimize plaque control by limiting traps w/ good marginal fit, closed interproximal contacts & smooth provisional surfaces
4-prevents tooth fracture, maintains opposing/adjacent tooth contacts, & keep tooth from shifting
5-resists dislodgement, providing chewing function but also limit chewing on provisional
6-acceptable crown shade & form
1-materials used for fabricating provisional crowns
2-polymerization reaction steps
1-poly (methyl methacrylate)
- poly (r methacrylate)—ethyl & isobutyl alkyl groups
- bis GMA composite resins
- light cured resins
- –all consist of monomers (building blocks), initators (initiates reaction), fillers (strength), & pigments (esthetics)
2-initiator decomposes to form free radicals (activation)
- radicals combine w/ monomer causing them to form long chain polymers
- amount of free radicals & monomer available to combine drops so the poly reaction end
