Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NBDE II > Mental Dental Videos > Flashcards

Mental Dental Videos Flashcards

(553 cards)

Start Studying
1
Q

What are the major types about actinomycosis?

A

Periapical: jaw infection

Cervicofacial : head and neck

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

What is tx for actinomycosis?

A

Long term-high dose Penicillin

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

What is major thing about actinomycosis?

A

Sulfur granules in pus

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

What is major thing about scarlett fever?

A

Strawberry tongue (only on fungiform papillae of tongue)

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

What is a red candidiasis called?

A

Atrophic candidiasis

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

What is candidiasis on midline of posterior tongue?

A

Median rhomboid glossitis (bald flat red spot on the tongue)

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

What is candidiasis on corners of mouth?

A

Angular cheilitis

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

Most common locations for Blastomycosis

A

US Northeast (spores)

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

Most common locations for Coccidiodomycosis

A

US Southwest (valley fever)

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

Most common locations for Cryptococcosis

A

US west

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

Most common locations for Histoplasmosis

A

US Midwest

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

Aphthous Ulcer, 5 major things:

A
  1. Canker sore
  2. Nonkeratinized tissue (like on soft palate, buccal mucosa etc…)
  3. Minor heals without scarring
  4. Major will scar
  5. Sutton Disease: Another name for a major aphthous ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Erythema Multiforme?

A

Often occurs on lips, but can occur anywhere.It has a minor and major form. Minor form is herpes simplex hypersensitivity. Major form is drug sensitivity.

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

What is Stevens-Johnson Syndrome?

A

Another name for a major form of Erythema Multiforme.

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

What is angioedema?

A

Allergic reaction to drug or food contact. Has diffuse swelling of lips,neck or face caused by mast cell release of IgE and histamines. Tx is antihistamines.

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

Wegener’s Granulomatosis?

A

Allergic reaction to inhaled antigen. Characterize by strawberry gingivitis.tx is corticosteroids

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

Lichen Planus

A

T lymphocytes target and destroy basal keratinocytes

Sawtooth rete pegs

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

Two major types if Lichen Planus

A

Reticular - whickham striae

Erosive - wickham striae with red ulcerations

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

Tx for Lichen Planus

A

corticosteroids

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

Lupus Erythematosus

A

Has two types

  1. Discoid Chronic Type - disk like lesions on face, oral lesions look like erosive lichen planus
  2. Systemic acute type - butterfly rash on nose (RUN AN ANA test)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Scleroderma

A

Hardening of skin and CT, which will restrict opening mouth harder. PDL space will be generally wider

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

Pemphigus Vulgaris

A

Suprabasilar
Autoantibodies against desmosomes
Has multiple painful ulcers preceded by bullae
Positive Nikolsky’s sign (blowing air will shed the outer layer of mucosa)

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

Mucous Membrane Pemphigoid

A

Subasilar
Autoantibodies against basement membrane
Otherwise same as pemphigus vulgaris

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

Proliferative Verrucous Leukoplakia

A

White and warty, recurrent patch on mucosa
Associated with HPV 16 and 18
High risk of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Actinic Cheilitis
Sun damaged lips (UVB rays especially) UVA rays are not that bad.
26
What are the highest risk sites in mouth for malignancy?
Floor of mouth | Posterior lateral tongue
27
What are the 4 major types of cancer?
Carcinoma - epithelium Sarcoma - mesenchymal or Connective Tissue Leukemia - blood Lymphoma - lymphatic
28
What are the 3 stages of cancer?
Dysplasia - pre cancer Carcinoma in situ - all of the epithelium is affected Malignant neoplasm - cancer as soon as it invades past the basement membrane
29
Squamous Cell Carcinoma
Caused by oncogenes In mouth associated with HPV 16 and 18 5 year survival is 50%
30
Basal Cell Carcinoma
Due to sun damage | Very rarely metastasizes
31
Oral Melanoma
Malignancy of melanocytes High risk sites are palate and gingiva 5 year survival rate for skin is 65% but in mouth is 20%
32
What are other names for fibroma?
Traumatic fibroma, irritation fibroma, hyperplastic scar
33
What is a traumatic neuroma?
A mass of nerve tissue as a result from nerve damage. Most common at mental foramen
34
Pyogenic granuloma
Hyperplasia of capillaries on gingiva. Bright red. Caused by chronic trauma or irritation
35
Nodular Fasciitis
Neoplasm of fibroblasts, easy to eradicate, rarely recurs
36
Fibromatosis
Neoplasm of fibroblasts, hard to eradicate, often recurs
37
Schwannoma
Neurilemmoma. Neoplasm of schwann cells. Has acellular bodies of Antoni A tissue.
38
Neurofibroma
Neoplasm of schwann cells and fibroblasts
39
Von Recklinghausen disease
multiple neurofibromas + cafe au lait + Crowe’s sign +Lisch spots Can become malignant!
40
Leiomyoma
Smooth muscle cell neoplasm.
41
Neurofibrosarcoma
Also known as malignant peripheral nerve sheath tumor | Malignant proliferation of schwann cells
42
Kaposi’s Sarcoma
Malignant proliferation of endothelial cells (it is purple) Caused by HHV8 Associated with AIDS
43
Leiomyosarcoma
Malignant - smooth muscle cells
44
Rhabdomyosarcoma
Malignant - skeletal muscle cells
45
Liposarcoma
Malignant - fat cells
46
What is Mucous Extravasation Phenomenon?
Caused by trauma to salivary duct. Examples are mucocele or Ranula
47
Mucous retention cyst
Same as mucocele, but histologically lined with epithelium. Caused by blockage of salivary duct by sialolith.
48
Necrotizing Sialometaplasia
Rapidly expanding ulcerative lesion. Heals on its own. Caused by trauma to minor salivary gland.
49
Sinus retention cyst
Also called antral pseudocyst. Caused by blockage of glands in sinus mucosa. No tx needed
50
Sarcoidosis
Hyperimmune (involves granulomas). Triggered by mycobacteria. Can cause Xerostomia.
51
Pleomorphic adenoma
Most common salivary gland benign tumor Composed of epithelial and CT (hence the “pleo” (mixed) in the name.) Firm rubbery swelling Most common on palate or parotid gland
52
Monomorphic Adenoma
Salivary gland benign tumor | Composed of single cell type
53
Warthins Tumor
Salivary gland benign tumor | Composed of oncocytes and lymphoid cells. Found in parotid of older men.
54
What are the 2 most common salivary gland malignancies?
Mucoepidermoid Carcinoma | Polymorphous Low-Grade Adenocarcinoma
55
Mucoepidermoid Carcinoma
Most common salivary gland malignancy | Composed of mucous and epithelial cells
56
Polymorphous Low-Grade Adenocarcinoma (PLGA)
Second most common salivary gland malignancy
57
Adenoid Cystic Carcinoma
Cribriform or swiss cheese microscopic appearance
58
How serious are lymphoid neoplasms?
They are all malignant because they are all below the basement membrane.
59
How are lymphoid neoplasms manifested in the mouth?
Through MALT tissue
60
Hodgkin’s Lymphoma
Very rare in oral cavity | Involves Reed-Sternberg cells (malignant B cells)
61
Non-Hodgkins Lymphoma
B or T cells
62
Burkitt’s Lymphoma
``` Type of non-hodgkins lymphoma B cell Tooth mobility Lip numbness Incomplete root development ```
63
Multiple Myoloma
Also called plasma cell myeloma (B cells) Punched out RL in skull Accumulation of amyloid proteins
64
Leukemia
Effects youngest pts to oldest pts in this order: ALL>CML>AML>CLL (ALL Children Are ChiLL pneumonic).. Either myeloid or lymphoid, acute or chronic Symptoms are bleeding, fatigue, infection
65
Radicular Cyst
Also known as periapical cyst (this is an endo associated lesion) Most common RL at apex of non vital tooth Encapsulated by Epithelial Rests of Malassez (ERM) from Hertwig’s Epithelial Root Sheath (HERS)
66
Dentigerous cyst (important stuff to know)
Most common with canines and third molars | Fluid between crown and “reduced enamel epithelium”
67
Mandibular periodontal cyst
Most common in mandibular premolar region | Always with a vital tooth
68
Gingival cyst of adult
Cyst under gingiva of mandibular premolar region
69
Gingival cyst of newborn
Bohn’s nodules - when on lateral palate Epsteins’s pearls - midline palate Origin of epithelium is rests of dental lamina
70
Primordial Cyst
Develops where tooth would have formed | Most common in mandibular third molar region
71
KCOT or OKC
Keratocystic Odontogenic Tumor Aggressive and recurrent Most common in posterior ascending ramus Gorlin Syndrome = many OKCs +many BCCs (basal cell carcinomas) +calcified falx cerebri (fatal) also called nevoid basal cell carcinoma
72
Calcifying odontogenic cyst (COC)
Also called Gorlin Cyst Rare Ghost cells (RL with little calcifications in it)
73
Ameloblastoma
Benign but aggressive (very expansile) Posterior mandible Tx is bx with wide margins
74
What are the differential diagnoses of multilocular RL in posterior mandible?
Ameloblastoma KCOT CGCG COF
75
CEOT
Calcifying epithelial odontogenic tumor Also known as Pindborg Tumor Driven Snow Liesegang rings
76
AOT
Adenomatoid Odontogenic Tumor | Anterior maxilla over impacted canine
77
Odontogenic Myxoma
Also called myxofibroma Slimy stroma Honeycomb pattern in radiograph (unclear borders)
78
COF
Central Odontogenic Fibroma Has two forms Central = in bone Peripheral = in gum tissue
79
Ameloblastic Fibroma
In children or teens | Posterior mandible
80
Odontoma
``` Compound = bunch of mini teeth (anterior mostly) Complex = mostly posterior (conglomerate mass) ```
81
Central Ossifying Fibroma
Composed of fibroblastic stroma with pieces that become calcified, Two types Central = in bone Peripheral = in gingiva
82
Fibrous dysplasia
Ground glass
83
Periapical Cemento-osseous dysplasia
Most common in mandibular anterior teeth, and middle aged black females Teeth are vital
84
Osteoblastoma
Circumscribed opaque mass of bone and osteoblasts.
85
What are the giant cell bone lesions or things associated with them?
``` CGCG Aneurysmal bone cyst Hyperparathyroidism (brown tumor) Cherubism Langerhan’s cell disease Paget’s disease ```
86
Central Giant cell granuloma
Has both fibroblasts and multinucleated giant cells Anterior mandible Has central and peripheral form (bone and gingiva respectively)
87
Aneurysmal bone cyst (ABC)
Blood soaked sponge
88
What lesions are found in Hyperparathyroidism?
``` Brown tumor (due to excess osteoclastic activity) RL lesion Von Recklinghausen’s disease of bone ```
89
Langerhans cell disease
Also called histiocytosis Rare type of cancer “Floating teeth”
90
Paget’s disease
“Cotton wool”
91
Acute Osteomyelitis
Most common cause is tooth infection or trauma, but it spreads to cortical bone Very painful, high fever Teeth are NOT loose
92
Chronic osteomyelitis
Diffuse | Sequestra
93
Garre’s osteomyelitis
Chronic osteomyelitis with “onion skin” from infected periosteum.
94
Condensing Osteitis
Also known as focal sclerosing osteomyelitis
95
Diffuse sclerosing osteomyelitis
Can lead to jaw fracture
96
BRONJ
From any medication that ends in “-dronate” | Tx is CHX rinse, antibiotics
97
Most common symptom of malignancy is…
numb lip.
98
Osteosarcoma
Sunburst pattern
99
Ewing’s sarcoma
“Round cells”
100
Telangiectasia definition
Red macule or papule, dilated or broken capillary.
101
Cleidocranial Dysplasia
Missing clavicles | Supernumerary teeth
102
Ectodermal dysplasia
Hypoplastic hair and nails | Missing teeth
103
Albergs-Schonberg disease
Also known as osteopetrosis | “Stone bone”
104
Amelogenesis Imperfecta
Alters enamel only | Both primary teeth and permanent teeth
105
Dentinogenesis imperfecta
Alters dentin only Short roots, bell shaped crowns, obliterated pulp Blue Sclera of eyes
106
Dentin Dysplasia
Chevron Pulps and short roots
107
Regional Odontodysplasia
“Ghost teeth”
108
What is an important condraindication for extraction?
head and neck radiation - but hyperbaric oxygen is beneficial for pts that are on radiation
109
What are the most common impacted teeth in the dentition?
Mandibular third molars>maxillary third molars>maxillary canines
110
What are the most commonly missing teeth?
What are the most commonly missing teeth? | Third molars>maxillary lateral incisors>mandibular 2nd premolars
111
What is soft tissue impaction?
The height of contour is above bone, but tooth is completely or mostly in gingiva
112
What is partial hard tissue impaction and full bony impaction?
Partial - height of contour is below bone level | Full - entire tooth is encased in bone
113
What is the winters classification system?
For impacted third molars, based on angulation Mesioangular - easiest Distoangular - most difficult
114
What is the Pell and Gregory classification?
Its for impacted mandibular third molars only ABC (describes the height of the impacted tooth compared to occlusal plane) 123 (describes how far tooth is within the ramus)
115
What condition arises if a spicule of bone is left behind underneath a flap from a surgical extraction? How do you avoid this from happening?
A subperiosteal abcess, this is avoided by irrigating thoroughly after extraction.
116
What is the most common site for oro-antral communications? (OAC)
Maxillary first molars
117
What is tx if you get a sinus exposure?
``` If less than 2mm - nothing From 2-6mm - The 4 A’s Antibiotics Antihistamines Analgesics Afrin Nasal Spray Greater than 6mm - flap surgery for primary closure ```
118
What is another name for dry socket?
Alveolar osteitis
119
What is tx for alveolar osteitis?
Irrigation and local pain control (dry socket paste that has eugenol)
120
What is tx for nerve injury?
Medrol dosepak
121
In case of nerve injury, how long do we wait to see if feeling comes back before referral for evaluation?
4 weeks
122
Where is the most common site for a tooth to be displaced during extraction?
Maxillary first molar - sinus Maxillary second molar - sinus Maxillary third molar - infratemporal fossa Mandibular third molar - submandibular space
123
What type of motion is the straight elevator used for in oral surgery?
Lever action
124
What is the instrument number for the straight elevator?
#301
125
What type of motion is the cryer elevator used for in oral surgery?
Wheel and axle action
126
What is the instrument # for the malt periosteal elevator?
#9
127
What are the universal forceps called for upper and lowers? What if you need one for premolars or primary teeth?
``` #150 - uppers #151 - lowers 150-A is for premolars, 150-S is for primary teeth etc… ```
128
What is the instrument # for lower cowhorns?
#23
129
What are the ash forceps used for? What is the instrument # for them?
#74 - used for lower premolars
130
What are the major blades used in oral surgery?
``` #10 - large skin incisions #11 - for stab incisions (like I&D) #12 - mucogingival surgery, curve enhances ease of access to the sulcus #15 - intra oral surgery - most common ```
131
What syringe is used in irrigation in OS? What is it used for?
Monojet syringe - to keep bone cool during surgical removal of bone
132
How is a bone file used?
With a pull stroke
133
What is an osteotome?
A bone chisel
134
Why do you not use air driven handpieces for oral surgery?
Air can pass through the tissue spaces and cause air emphysema, which is serious.
135
What are hemostats used for?
Hemostatis (clamping a vessel closed)
136
How is needle holder different than a hemostat?
Needle holder beak is cross-hatched
137
What is the primary purpose of a suture?
To immobilize a flap
138
What direction should a suture be placed?
From moveable tissue to non-moveable tissue
139
What is unique about silk material in sutures?
It has a wicking feature, which allows bacteria to invade, so its not a good thing. It should be removed after a few days.
140
What is an adson forcep?
Its a tissue forcep
141
What is a utlility forcep?
For grabbing things from your tray etc, not for tissue
142
What are the two different types of OS scissors and what are they used for?
Dean scissors - cutting sutures | Mayo scissors - cutting tissue
143
What is the initial forcep movement when performing a simple extraction?
If permanent tooth - buccal If primary - lingual If conical root - rotation
144
What is a semilunar incision and what is it used for?
A rounded incision apical to mucogingival junction used for apicoectomies
145
What is a double Y incision and what is it used for?
A palatal incision with a cut at the midline and two wings anterior and posterior (used for removal of palatal torus)
146
How much space do you need for implant placement around the following items? ``` Away from adjacent natural tooth adjacent implant IAN mental nerve buccal plate lingual plate inferior border of jaw sinus nasal cavity ```
``` Away from adjacent natural tooth - 1.5mm Away from adjacent implant - 3 mm Away from IAN - 2mm Away from mental nerve - 5 mm Away from buccal, lingual plate, inferior border etc… 1mm Away from sinus and nasal cavity - 1 mm ```
147
What is the difference between one stage and two stage surgery for implant placement?
One stage - place healing abutment and implant in one visit | Two stage - place implant with just a cover screw at one appt and healing abutment at second appt
148
How are gingival fibers oriented next to an implant cuff?
Parallel
149
How much peri implant bone loss is normal after the first year?
0.2mm per year
150
What temperatures are enough to compromise osseointegration during placement?
47 degrees celsius for one minute or 40 degrees celsius for 7 minutes.
151
What is the best imaging technique to visualize a jaw fracture on the mandible?
Panoramic x ray
152
What are the most common structures to fx in the mandible?
condyle>angle>symphysis
153
What is the best imaging technique to visualize a jaw fracture in the midface?
CBCT x ray
154
What are the 4 types of fxs in the midface?
Le Fort I - horizontal across maxilla Le Fort II - pyrimidal fx Le Fort III - complete craniofacial disjunction Zygomaticomaxillary complex fx -also known as a tripod fx, involves bleeding under conjunctiva
155
What is ideal tx for mandibular fractures?
Open reduction and internal fixation or (ORIF) (open reduction means exposing bone surgically, internal fixation means placing titanium plates)
156
What is apertognathic?
Refers to anterior open bite
157
What is vertical maxillary excess?
Maxilla is too long, which makes a gummy smile
158
What is horizontal transverse discrepancy?
Posterior crossbite
159
What is macrogenia?
Chin too big
160
What are the main imaging used to tx orthognathic surgeries?
Lateral Cephs
161
What is le Fort osteotomy?
Move maxilla, used for retrusive maxilla or vertical maxillary excess
162
What is BSSO?
Move mandible, Bisagittal split osteotomy, used for retrusive or protrusive mandible. Causes nerve damage!
163
What is genioplasty?
Alters chin anatomy
164
What is distraction osteogenesis?
A way to lengthen a bone. They make a cut through the bone and then put an appliance that they will activate in one week that will pull them apart gradually to allow more bone to heal in between them
165
What is axis 1 pain vs axis 2 pain?
Axis one is normal pain, axis 2 is more chronic pain
166
What are the 4 steps of the pain pathway?
Transduction - PNS to CNS Transmission - CNS to brain Modulation - limitation of flow of pain info Perception - the sum of all the other steps
167
What is somatic pain?
An increased stimulus will yield an increased pain. (TMJ, Muscular pain, visceral pain like pulpal pain and salivary glands)
168
What is Neuropathic pain?
Pain independent of stimulus intensity. Involved damage to pain pathways
169
What is trigeminal neuralgia?
Also called tic douloureux. Happens in post menopausal women older than 50. There is a trigger point that causes it and a refractory period in between episodes. It is unilateral. Tx is anticonvulsants
170
What is atypical odontalgia?
Phantom toothache after extraction or pulpectomy.
171
The TMJ has two spaces, the lower space and the upper space. What are these two spaces functions?
Lower joint space - rotation | Upper joint space - translation
172
What muscle opens the mandible?
Lateral pterygoid
173
What muscles close the mandible?
Medial pterygoid Temporalis Masseter
174
What is the function of the capsular ligament?
It covers the joint space
175
Discal or collateral ligament
Keeps disc attached to condyle
176
Posterior ligament
Prevents anterior disc displacement
177
Lateral ligament
Prevents posterior disc displacement
178
TMJ blood supply
MADS: Maxillary, Ascending pharyngeal, Deep auricular, Superficial Temporal
179
Internal Disc Displacement with reduction
- click
180
Internal Disc displacement without reduction -
Limited range of motion of either one side or both sides
181
What is deflection?
Mandible deflects to the side that is stuck
182
What is deviation?
Mandible deviates while opening then returns back to midline at maximum opening
183
What is recurrent dislocation?
Jaw is locked open due to extreme opening and requires manual manipulation to close it.
184
What is the most common nerve injured in TMJ surgery?
Facial nerve
185
What is the most common cause of masticatory pain?
Myofascial pain syndrome (has trigger points of pain in muscles)
186
When are biopsies indicated?
If no response to tx or it doesnt go away after 2 weeks
187
What is fine needle aspiration used for?
To know if fluid exists and what type of fluid it is. Often for RL lesions of bone like odontogenic cysts or ameloblastomas etc…
188
How big should a lesion be to do an incisional bx instead of excisional?
>1cm, and suspect malignancy with a narrow deep wedge incision
189
What type of incision is used for excisional bx?
Ellipitical
190
How do you store a bx?
In 10% formalin with a biohazard label
191
What is enucleation?
Surgical removal of mass without cutting into or rupturing it
192
What is marsupialization?
Cut a slit into an abcess and suture it open so it can drain.
193
What acronymn is used to tell you what to do for a medical emergency?
SPORT: Stop tx, Position Pt, Oxygen (most of the time), Reassure, Take Vitals
194
What is most common medical emergency to happen in a dental office?
Syncope
195
What is vasovagal syncope?
Needle anxiety fainting
196
What is Trendelenburg?
It is a supine position with head is lower than their feet. A good tx for syncope.
197
If pt is pregnant and has syncope, what is tx?
Use left lateral decubitus pt, which is laying on left side, so fetus doesn’t compress inferior vena cava.
198
What is orthostatic hypotension?
Second most common cause of syncope, dizziness when quickly standing up.
199
When is angina unstable?
When pain is at rest
200
What is tx for angina?
ONA: Oxygen, Nitroglycerine, Aspirin
201
How much nitroglycerine do you give when a pt has angina?
0.4 mg tab sublingual wait 5 minutes. If symptoms dont go away, do it again (up to three doses) then give aspirin and call 911.
202
What is tx for MI?
MONA: Morphine, Oxygen, Nitroglycerine, Aspirin
203
How to manage hypoglycemia if pt is unconscious?
IV dextrose or IM glucagon
204
When do you not give oxygen to a pt during an emergency?
If pt is hyperventilating, use a brown paper bag instead.
205
What can a stroke be caused by?
Hyponatremia
206
What is difference between CVA and TIA?
TIA is mini stroke | CVA is full stroke
207
What is tx for anyphylactic shock?
AEIOU: Albuterol, Epinephrine (.3 mg dose), IM antihistamine, Oxygen, U call 911
208
When would you need a CBC from a patient?
Anemia, leukopenia, thrombocytopenia
209
When would you need a PT from a patient?
If they are on anticoagulants, have liver damage, or vitamin K deficiency
210
When would you need a bleeding time test on a patient?
If pt is on an anti platelet drug like aspirin
211
When would you need an INR from a patient?
If they are on Warfarin or Coumadin (should be between 2-3)
212
When would you need a PTT on a patient?
If pt is on Heparin, on renal dialysis, or has hemophilia
213
What are the herbal anticoagulants?
Garlic, Ginger, Ginko, Ginseng
214
What is the ideal crown to root ratio? What is a poor crown to root ratio? What is minimum crown to root ratio?
Ideal: 2:3 Minimum 1:1 Poor: 1:2
215
When is splinting a good idea in fixed prosthodontics?
1. When replacing a canine, central and lateral should be splinted together to prevent lateral drifting of bridge. 2. When crown to root ratio of abutment tooth is insufficient.
216
What is the ideal root shape for a bridge?
Anything NOT straight conical and round.
217
When is a complete maxillary denture contraindicated?
When only mandibular anterior teeth are present
218
How many implants in maxilla or mandible for overdenture is common?
Mandible - 2 | Maxilla - 4
219
What is the biggest negative to cement-retained implants?
Excess cement can cause peri-implantitis
220
What is the biggest negative to screw-retained implants?
Screw can loosen during function over time
221
What is the real name for alginate?
Irreversible Hydrocolloid
222
What is the compound in alginate that controls setting time?
Trisodium Phosphate
223
How long do you leave alginate in someones mouth?
2-3 minutes
224
How long can you wait before pouring up an alginate impression?
Up to 10 minutes
225
What is MMR?
Maxillo-Mandibular Relations. This is about occlusion. The two components of this is CR and MI.
226
What is the definition of CR?
The position in which the condyles articulate with the thinnest avascular portion of their respective discs in the most anterior-superior position against the articular eminences.
227
What is the percentage of population where CR=MI?
10%
228
What is the most accurate method of getting a pt to a CR position?
Bimanual Manipulation
229
What is the purpose of a facebow?
1. To duplicate the relationship of the maxillary arch to the skull 2. To duplicate the relationship of the mandible to the rotational center of the TMJ
230
What is a nonadjustable articulator and why is it not ideal?
A simple hinge articulator. It may result in premature contacts and incorrect ridge and groove direction of restorations.
231
What do you set the bennet angle at on a semiadjustable articulator?
15 degrees
232
What do you set the HCI (Horizontal condylar inclination) on a semiadjustable articulator
30 degrees
233
What is an arcon articulator?
When condyles are part of the lower member and fossa is part of the upper member
234
What is a non-arcon articulator?
Upper and lower members are rigidly attached
235
Alginate casts are best mounted and articulated with what type of bite records? What about PVS records
Alginate - Wax | PVS - ZOE paste
236
What is the difference between anterior guidance and canine guidance?
Anterior refers to both canine and incisal guidance. | Canine refers only to canine guidance
237
During protrusive movements, what guidance is used? What about lateral movements?
Protrusive - condylar guidance and incisal guidance | Lateral - canine guidance on working side and condyle on balancing side provide clearance
238
What is the butterfly line?
A line separating the hard palate and soft palate. You can find it by doing the valsalva test.
239
What are the fovea palatini?
Little dimples in the palate 2 mm from the vibrating line.
240
How do you capture the coronoid notch in a pt during an impression for a denture?
Have patient move laterally from side to side.
241
What are the two most important movements for maxillary denture impressions?
Laterally and open wide
242
What 2 maxillary anatomical landmarks are important for posterior border molding?
Hamular notch and pterygomandibular raphe
243
What muscle makes the labial frenum on the mandibular arch? What about the buccal frenum? Lingual frenum?
Labial frenum - Orbicularis Oris Buccal frenum - orbicularis oris, buccinator Lingual frenum - genioglossus
244
What muscle forms the inferior border of the labial vestibule on the mandible?
Mentalis
245
What muscle forms the inferior border of the buccal vestible on the mandible?
Buccinator
246
What 4 muscles attach to the retromolar pad?
Temporalis Buccinator Superior pharyngeal constrictor Pterygomandibular raphe
247
What is the DB most area of the maxillary and mandibular impressions in the edentulous arch?
Maxilla - coronoid notch | Mandible - masseteric notch
248
What is the alveolingual sulcus?
The lingual vestibule on the mandible. It is located between the tongue and the ridge.
249
What important anatomical feature is in the anterior region of the alveolingual sulcus? Why is it important for dentures?
The sublingual gland sits above the mylohyoid muscle. The denture flange in this area will be shorter and touch the anterior floor of the mouth.
250
What important anatomical feature is in the middle region of the alveolingual sulcus? Why is it important for dentures?
The mylohyoid ridge sits here and will deflect the denture out to avoid this ridge in this area.
251
What important anatomical feature is in the posterior region of the alveolingual sulcus? Why is it important for dentures?
This is the area of the retromylohyoid fossa. In this area, the posterior fibers of the mylohyoid muscle run more vertically, which allows the flange of the denture to be deeper and deflect laterally. This is what forms the “S” shape on the lingual flange of the mandibular denture.
252
What muscles on the mandible prevent a large distal extension of a denture?
Palatoglossus and superior constrictor
253
What is the buccal shelf? What is its function for a denture?
It is an anatomical landmark on the posterior mandible, just lateral to the posterior ridge. This is where the buccinator muscle attaches and it provides support for the denture.
254
What are the most common frenectomies?
Labial>Buccal>Lingual
255
What is the purpose of a free gingival graft pre-dentures?
It widens the band of keratinized tissue around implants or teeth. This aids in keeping them clean.
256
What is a hyper mobile ridge?
A flabby ridge, most commonly seen in anterior maxilla, that can cause issues with retention.
257
What is the major cause of epulis fissuratum?
An overextended flange
258
What is a fibrous tuberosity?
It is common when large anatomic tuberosity touch the retromolar pads, which can interfere and limit interarch space. These are commonly removed prior to denture fabrication.
259
What is the main cause of papillary hyperplasia?
Candida Albicans
260
What is combination syndrome?
When a pt only has mandibular anterior teeth and nothing else.
261
What are the symptoms of combination syndrome?
Overgrowth of tuberosities Papillary hyperplasia on hard palate Extrusion of lower anterior teeth Loss of bone under the partial denture bases
262
When can residual root tips be left alone?
When lamina dura is intact and no RL
263
How does Paget’s disease effect dentures?
Ridge expands and dentures will no longer fit. Dentures will need to be remade periodically.
264
What is alveoloplasty used for?
Sharp, spiny ridges that can cause pain in dentures
265
When are tori removed?
When creates undercut or interferes with posterior palatal seal when making a denture.
266
What is vestibuloplasty?
Apically repositioning the vestibule to create more height of ridge. It requires repositioning the alveolar mucosa and muscles in the area.
267
Where are the major sources of bone graft?
Illiac crest and rib
268
Is it more difficult to restore vertical ridge height or horizontal ridge width with a bone graft?
Horizontal is easier to restore.
269
What is the difference between VDO and VDR?
VDO - vertical dimension of occlusion (distance between nose and chin in occlusion) VDR - Vertical dimension of rest (distance between nose and chin at rest) usually 3 mm of space between upper and lower premolars
270
What are signs and symptoms of excessive VDO?
Muscles of mastication will be fatigued Lips will appear strained Excessive display of mandibular teeth Gagging
271
What are symptoms of insufficient VDO?
Aging appearance of lower third of face due to wrinkles etc… Angular cheilitis Diminished occlusal force
272
What is Christensen’s Phenomenon?
Refers to the distal space created between the maxillary and mandibular occlusal space surfaces when mandible is protruded, due to downward and forward movement of condyles down articular eminence. (posterior open bite in protrusion)
273
How do you deal with christensen’s phenomenon when making a mandibular denture?
Have posterior teeth be a little higher than occlusion (slope upward)
274
What is Camper’s line?
Imaginary line from ala of nose to tragus of ear
275
What is interpupillary line?
Imaginary line between pupils of the eyes
276
How are those lines related to maxillary dentures?
The maxillary wax rim should be parallel to both of these lines (measured with a fox plane)
277
How does anterior guidance play into a denture?
Anterior guidance should be avoided to prevent dislodgement. You want tripodization even in eccentric movements.
278
What is lingualized occlusion?
Only palatal cusps of maxillary posterior teeth contact mandibular posterior teeth.
279
What is the difference between Bennett angle, Bennett shift, and Bennett movement?
Bennett Angle - angle obtained after nonworking side condyle has moved anteriorly and medially relative to sagittal plane Bennett Shift - lateral movement of mandible toward the working side during lateral excursions. Bennett Movement - lateral movement of both condyles toward the working side
280
Determinants of disclusion (eccentric occlusion is opposite to these): 1. Anterior guidance 2. Posterior guidance 3. Cuspal anatomy 4. Tooth Arrangement 5. Orientation of occlusal plane
Anterior guidance Horizontal dimension (protrusive movement) Steep incisal guidance Lateral (excursive): Steep canine guidance Posterior guidance Horizontal: steep horizontal condylar inclination Lateral: Less bennett movement Cuspal anatomy: Short cusps with shallow inclines (so they can disclude faster) Tooth arrangement: Less curve of spee, less curve of wilson Orientation of occlusal plane: less parallel to orientation of condylar path ( _ vs / )
281
What is the curve of spee?
Anteroposterior curve
282
What is the Curve of wilson?
Mediolateral curve
283
What is another word for fricative sounds?
Labiodental sounds
284
What is a sibilant sound?
Linguoalveolar sounds. These are the ‘S’ and “Sh” and “ch” and “J” sounds
285
What does it mean if a denture patient whistles when trying to say “s”
The arch form is too narrow
286
What does it mean if a denture patient says “sh” when trying to say “s”
Arch form is too wide
287
How much space between incisors when a pt says ‘S’?
1 to 1.5 mm
288
What does it mean if tongue sticks out when a pt pronounces the ‘th’ sound?
Teeth are too far back, if tongue is not visible at all, too far forward
289
What is a bilabial sound?
B,p,m
290
What is the gutteral sound?
G,k
291
What is support in a denture?
Resistance to vertical seating forces
292
What are the things in the upper arch that provide the most support for a denture?
Palate and alveolar ridge
293
What are the things in the lower arch that provide the most support for a denture?
Buccal shelf and retromolar pad
294
What part of the denture provides support to the mouth?
Denture base
295
What is stability in a denture?
Resisitance to horizontal dislodging forces
296
What provides stability in a denture?
Height of ridge and depth of vestibule
297
What part of the denture provides stability?
Denture flange
298
What is retention in a denture?
Resistance to vertical dislodging forces (pulling away vertically)
299
What is the thing that provides the most retention on an upper denture?
Peripheral seal
300
What is the difference between adhesion and cohesion?
Adhesion is attraction of unlike molecules | Cohesion is attraction of like molecules
301
What is the acrylic used in complete dentures?
Heat-cured acrylic
302
What are the 2 parts of heat cured acrylic?
PMMA - powder polymer | MMA - liquid monomer
303
What is MMA? What is in it?
Methyl methacrylate - monomer Hydroquinone - inhibitor Glycol dimethacrylate - corss-linking agent Dimethyl-p-toluidine - activator
304
What is PMMA? What is in it?
Polymethyl methacrylate - polymer Benzoyl peroxide - initiator Salts of iron and cadmium - pigment
305
Shrinkage of dentures happens more when you have more of what?
Monomer
306
What is the ideal ratio of monomer to polymer?
1:3
307
What would lead a denture to have a higher porosity?
Due to unpacking of resin at time of processing, or being heated too rapidly
308
What are the two materials denture teeth can be made out of?
Acrylic or porcelain
309
What is the advantage of having acrylic teeth in a denture?
Better retention due to better bonding
310
What is the advantage of porcelain in a denture?
Esthetics, more stain and wear resistant. But they can wear the opposing teeth
311
How is retention increased with porcelain teeth in a denture?
Posterior teeth - diatorics ( like a box into the tooth that forms retention. Anterior teeth - pins
312
What is kennedy class I?
Bilateral distal extension
313
What is kennedy class II?
Unilateral distal extension
314
What is kennedy class III?
Unilateral bounded edentulous space (a section of missing teeth that has teeth on both sides.)
315
What is kennedy class IV?
Bilateral bounded edentulous space (it crosses the midline)
316
What are the 6 applegate’s rules?
Rule #1 - classification should be assigned only AFTER extractions Rule #2 - missing 3rd molars are not considered Rule #3 - Abutment third molars ARE considered Rule #4 - Missing second molars are not considered (if they are not planned on being replaced) Rule #5 - most posterior edentulous are determines classification! Rule #6 Class IV cannot have any modifications
317
What is the main function of the major connector?
It provides rigidity
318
Where is one place where a major connector cannot be?
On moveable tissue
319
What is the most rigid maxillary major connector type?
Complete palatal plate
320
When would you use a complete palatal plate as a major connector?
In kennedy class I (missing all posterior teeth)
321
What is the least rigid maxillary major connector?
Horshoe
322
When would you use a horshoe as a major connector on the maxilla?
Only if large palatal torus is there
323
What is an important design rule for major connectors?
They should cross the midline at a right angle
324
What is the purpose of beading in RPD design? What is beading?
Using a ½ round bur to shape the connector on the stone model. The borders of the connector would be thicker and more rigid, and it would prevent a food trap.
325
When can a lingual bar be used as a major connector on the mandible?
When the depth of the vestibule is at least 7mm.
326
When would a lingual plate be used as a mandibular RPD major connector?
When depth of vestibule is less than 7mm Additional tooth loss is expected Lingual tori All posterior teeth missing
327
What RPD element provides more support?
Rests
328
What are the dimensions of an occlusal rest?
⅓ the MD width ½ intercuspal width 1.5 mm deep for the base metal
329
What are the dimensions of a cingulum rest?
2.5 - 3 mm MD length 2mm labiolingual 1.5mm deep
330
On which teeth are cingulum rests contraindicated?
Mandibular incisors
331
What is an indirect retainer?
It is a rest located perpendicular and anterior to the fulcrum line ( a line drawn across the RPD from most distal rest to most distal rest.) It resists rotational movement of the distal extension area.
332
What is a direct retainer?
A clasp assembly that has a rest, minor connector and clasp arms
333
What part of the clasp assembly provides stability?
The reciprocal clasp, and the minor connector
334
What is the most commonly used clasp in an RPD?
Akers clasp (circumferential clasp)
335
What are the two types of clasps?
Infrabulge (from below the height of contour) and suprabulge (from above the height of contour)
336
When is a ring clasp used?
It wraps around the entire tooth if an undercut is only present by the rest seat.
337
What are the 3 clasp assemblies?
RPI - Rest, proximal plate, I-bar (the ideal class II lever system) RPA - Rest, proximal plate, akers claps RPC - Rest, proximal plate, circumferential clasp (same as RPA)
338
What is wrought wire? When is it used?
Its more flexible that typical clasp design, used more in perio compromised teeth and endo teeth.
339
What material is the framework of an RPD made of?
Cobalt-Chromium
340
How much shrinkage does cobalt-chromium have?
2.3%
341
What is the main reason a clasp breaks?
Cold-working (bending back and forth with use)
342
What is another name for a build up?
A foundation restoration or a core.
343
What are the 3 principles of tooth preparation?
Biologic (health of oral tissues) Esthetic Mechanical (integrity and durability of restoration
344
Where is the thinnest gingival tissue in the mouth?
Lingual molars and facial premolars
345
Why is it bad to use a dull bur?
It cuts a lot hotter
346
What is retention form in a crown?
Feature that prevent removal of crown along long access of prep (sticky foods pulling crown up.)
347
What is resistance form in a crown?
Feature that prevents removal of crown along horizontal or oblique access (occlusal forces or grinding)
348
What is R&R form?
Retention and resisitance form
349
What is the property that we have the most operative control of in a crown prep?
Taper
350
What is the minimal height we would like for crowns?
3 mm for anterior and PM | 4 mm for molars
351
What does a short clinical crown prep require?
Buccal grooves for retention | Proximal grooves for resistance
352
What margin type has the best marginal seal?
Featheredge
353
What type of margin is often used for gold crowns?
Light chamfer (0.3-0.5mm thick)
354
What is the #1 lab complaint?
Tooth is under reduced so lab is forced to overcontour crown.
355
What type of crown is shoulder most often used for?
All-ceramic crowns
356
What are the 3 benefits of ¾ and ⅞ crowns
Conserve tooth structure Less crown near the gingiva More easily seated during cementation
357
What type of pontic design is the worst?
saddle/ridge lap
358
What is a modified ridge lap pontic used for?
Anterior teeth
359
What is the most esthetic pontic design?
Ovate
360
What are the two types of connectors?
Rigid - cast in one piece or soldered together | Non-rigid - male and female connectors (called tenon and mortise)
361
What is the minimum height of a connector on a PFM fixed bridge?
3mm
362
What is a good antisialagogue?
Atropine
363
What is the chemical name for hemodent?
Aluminum chloride
364
What is the chemical name for ViscoStat?
Ferric sulfate
365
What are the two types of impression materials?
Aqueous hydrocolloids (powder and water) and nan-aqueous hydrocolloids
366
What are the two types of aqueous hydrocolloids?
1. Agar (reversible hydrocolloid) a. Can change between two phases, sol and gel phase, based on temperature. b. High accuracy 2. Irreversible hydrocolloid (alginate) a. Setting time 3-4 minutes b. Should be poured within 10 minutes
367
What is the most inaccurate impression material?
Irreversible hydrocolloid
368
What is the primary ingredient in alginate?
Diatomaceous earth
369
What is the active ingredient in alginate?
Potassium alginate
370
What increases setting time of alginate?
Hot water, less water
371
What is imbibition?
Absorption of water
372
What is syneresis?
Loss of water
373
What are the 3 types of non-aqueous elastomeric materials for impressions and there main points to remember?
1. Polysulfide rubber - leaves a water byproduct, hydrophobic, syneresis, 30-45 minutes to pour. 2. Silicone (two types) a. Condensation silicone - leaves an alcohol byproduct, causes shrinkage of impression. 30 minutes to pour b. Addition silicone (PVS) - no byproducts, best fine detail, inhibited by sulfur in latex gloves and rubber dam. 3. Polyether - very stable, easily influenced by water and humidity, imbibition, hydrophilic, very stiff and easy to break teeth on cast, 60 minutes to pour
374
What is the raw form of gypsum?
Calcium-sulfate dihydrate
375
What is the processed form of gypsum?
Calcium-sulfate hemihydrate (processed with heat to get rid of some water)
376
What is Type I gypsum?
Impression plaster
377
What is Type II gypsum?
Model plaster
378
What is Type III gypsum?
Dental stone
379
What is Type IV gypsum?
Dental stone, high strength, low expansion
380
What is Type V gypsum?
Dental stone, high strength, high expansion
381
What is gauging water?
Extra water needed to mix gypsum just to be able to mix it.
382
What does more water do in gypsum?
Less strength, more porosity, less expansion, increased setting time
383
Why does type I gypsum have low expansion?
It sets quickly so there is no time for expansion
384
What is type II gypsum used for?
To fabricate mouth guards and essex retainers
385
What is type III stone used for?
Removable prostheses and diagnostic casts
386
What are the benefits of type IV stone?
Best abrasion resistance Least gauging water Least expansion Used to fabricate dies
387
How long to mix gypsum for for vaccuum mixing or by hand?
Vaccuum - 20 seconds | By hand - 30 seconds
388
What is setting time of gypsum?
45 to 60 minutes
389
How to decrease setting time of stone?
Hot water Less water Slurry water Increased mixing time
390
What is the least strong to most strong type of stone?
Type 1 to type 5
391
What is the least porous to most porous type of stone?
Type 5 to type 1
392
What are the 3 noble metals?
Gold, platinum, palladium
393
What is good about gold?
Tarnish resistance, resistance to corrosion
394
What is good about platinum?
Strength, increases melting temperature
395
What is good about palladium?
Strength
396
What is a disadvantage to silver?
Causes greening of porcelain
397
What % is high noble vs noble?
60% and 25%
398
What are the main features of the 4 types of gold alloys?
``` Type I Soft - used for class v only, 98-99% gold ``` Type II Medium, used for inlays, 77% gold Type III Hard, used for crowns, 72% gold Type IV Extra hard, used for bridges, post and cores, clasps, 69% gold
399
What is compressive strength?
Ability of a material to resist fx during compression
400
What is fx toughness?
Ability of a material to resist propogation of a crack
401
What material has the best fx toughness?
Zirconia
402
What is transformation toughening in zirconia?
Tetragonal phase to monoclinic phase (the stronger phase)
403
What is modulus of elasicity?
Stiffness or rigidity. Stress divided by strain | This is the ability of a material to resist stretching without permanently deforming
404
What is brittle?
Fx without dimensional changes (porcelain)
405
What is percentage elongation?
Ability of a material to be burnished
406
What materials have the most to least coefficient of thermal expansion?
composite>metal>tooth>porcelain (gold is the best because it is the closest to tooth)
407
What are the 3 materials used in provisional crowns
PMMA -used for indirect provisionals, exothermic reaction PEMA - not used a lot Bis-acryl Composite - used for direct provisionals
408
Why is it important to remove all provisional cements?
It contains eugenol, which inhibits polymerization of resin
409
How is porcelain fused to metal?
Using a monomolecular oxidative layer.
410
What are the three layers of porcelain in a PFM crown?
Opaque layer - thinnest and next to the metal Body or dentin porcelain - contains most of the shade Incisal or enamel porcelain - most translucent layer
411
How far from the metal porcelain junction of a PFM should occlusion be?
1.5 mm at least
412
How is an all ceramic crown bonded to a tooth?
Its etched with hydrofluoric acid and treated with silane. Then you can use cement. (if all ceramic contains NO glass, it can be cemented like normal with silane)
413
How much reduction do you need for porcelain veneers?
Gingival ⅓ reduction needs 0.3mm Facial reduction is 0.5 mm Incisal reduction is 1-2 mm
414
What is a con of maryland bridge?
It can experience debonding
415
What is hue
Color family (red vs blue etc…)
416
What is chroma
Saturation or intensity of color
417
What is value
Lightness or darkness
418
What is metamerism?
Colors appear different under different light
419
What is the ideal light?
5500k
420
What is fluorescence?
Object emits visible light when exposed to UV light
421
What order do you go through to select a shade?
``` Select value Select chroma (cervical third) Select Hue (incisal third) ```
422
What is the first thing you do when you get a crown back from the lab?
Check shade and esthetics
423
What are the two types of LA?
Amides in liver | Esters in pseudocholinesterase (Plasma)
424
What are the LA that are in the amide group?
``` Lidocaine Bupivicaine Mepivicaine Articaine Prilocaine ```
425
What anesthetic is the safest to use in children? Which one is NOT safe?
Lidocaine-safe | Bupivicaine
426
Which anesthetic causes the least vasodilation?
Mepivicaine
427
Which anesthetic has one ester chain?
Articaine (even though it is an amide) metabolized in both liver and plasma
428
Which anesthetic can induce methemglobinemia?
Prilocaine
429
Which anesthetic has the longest duration? Shortest?
Bupivicaine(0.5%), articaine(4%)
430
Which anesthetic is packaged in multiple percentages?
Mepivicaine (2% and 3%) can also come without epi
431
Which anesthetic is a vasoconstrictor?
Cocaine
432
What mechanism do local anesthetics have?
They are sodium channel blockers
433
What two processes are not fused in cleft lip?
Medial nasal process and maxillary process
434
What percentage of cleft lip is unilateral vs bilateral?
80% unilateral 20% bilateral
435
How rare is cleft palate vs cleft lip?
Cleft lip 1:1000 | Cleft palate 1:2000
436
What fails to fuse in cleft palate?
Palatal shelves
437
What is van der Woude Syndrome?
Clefts + Lip Pits
438
What are Fordyce Granules?
Ectopic sebaceous glands
439
What condition is in buccal mucosa that disappears when stretched?
Leukoedema
440
What is a lingual thyroid?
Thyroid tissue mass that is located at midline on base of tongue. IT IS located along the embryonic path of thyroid descent.
441
Where does the thyroid gland start in embryo?
The foramen cecum of the tongue
442
What is a thyroglossal duct cyst?
A midline neck swelling located along the embryonic path of thyroid descent.
443
What are the two other names for geographic tongue?
Benign migratory glossitis and erythema migrans
444
What is Melkerson-Rosenthal syndrome?
Fissured tongue + granulomatous cheilitis (lip inflammation) + facial paralysis
445
What is an Angioma?
A tumor composed of blood vessels or lymph vessels
446
What is a cherry angioma?
A benign red mole
447
What is a hemangioma?
A congenital focal proliferation of capillaries. Most of these undergo involution (will shrink), but if they persist, they are cut off.
448
What is a lymphangioma?
More rare, purple spots on the tongue
449
What is a lymphangioma called when it is on the neck?
Cystic hygroma (more common than in the mouth)
450
What is Sturge-Weber Syndrome?
Angiomas of leptomeninges + skin along trigeminal nerve
451
What is a Dermoid Cyst?
Mass in midline either in floor of mouth or in upper neck (depending on if it is above the mylohyoid muscle or below it)
452
What is the defining characteristic of a dermoid cyst?
It has a doughy consistency
453
What is a branchial cyst?
Lateral neck swelling. It is an epithelial cyst within a lymph node of the neck.
454
What is the defining characteristic of a cyst?
It has an epithelial lining and fluid filled center
455
What is an Oral Lymphoepithelial cyst?
Cyst within lymphoid tissue of oral mucosa
456
Where are oral lymphoepithelial cysts commonly found in the mouth?
In palatine and lingual tonsils
457
What is the defining characteristic of a nasopalatine duct cyst?
Heart shaped RL in nasopalatine canal
458
What is tx for nasopalatine duct cyst?
Excision
459
What is a Globulomaxillary Lesion
Its a clinical description for any RL between maxillary canine and maxillary lateral incisor
460
What are 2 other names for traumatic bone cyst?
Simple Bone Cyst, Idiopathic Bone cyst
461
What is the difference between mucosal erosion and ulcer?
Erosion is incomplete break through epithelium | Ulcer is a complete break through epithelium
462
What are the common chemicals that cause chemical burns?
Aspirin Hydrogen Peroxide Silver Nitrate Phenol
463
What is the defining characteristic of nicotine stomatitis?
Red dots which are inflamed salivary duct openings on the hard palate
464
When is nicotine stomatitis considered pre-malignant?
When it is related to “reverse smoking”
465
What is smoking-associated melanosis?
Brown, diffuse macules on anterior gingiva caused by chemicals in tobacco that stimulate melanocytes.
466
What is tx for smoking-associated melanosis?
If pt stops smoking, it can go away on its own.
467
What is Peutz-Jegners Syndrome?
Melanotic macules (on face, lips or in mouth) + intestinal polyps
468
What is hairy tongue?
Elongated filiform papillae
469
Dentrifice Associated sloughing
Ingredient called sodium lauryl sulfate that causes tissue sloughing in mouth of some people
470
What is tx for dentrifice associated sloughing?
Suggest Toms of Maine, or Rembrandt toothpaste (does not have sodium lauryl sulfate)
471
How do you diagnosis hemangiomas?
Diascopy test (tissues will blanch)
472
What is a submucosal hemorrhage?
Extravascular lesions that DO NOT blanch
473
What are petechiae?
1mm hemorrhages
474
What are purpurae?
Larger than petechiae | What is an ecchymosis? 1cm or bigger bruise
475
What is hematoma?
Mass of blood within tissue, caused by trauma to oral mucosa like an anesthetic needle
476
What are the 4 types of submucosal hemorrhages?
Petechiae Purpura Ecchymosis Hematoma
477
What are defining characteristics in primary HSV?
Can occur anywhere in an around mouth. Occurs mostly in childhood.
478
What are defining characteristics of recurrent HSV?
Keratinized | On hard palate, attached gingiva (intraoral) or on vermillion border of lips (herpes labialis)
479
What is HSV on the finger called?
Herpetic Whitlow
480
What is HSV on the head?
Herpes gladiatorum
481
What is tx for recurrent HSV?
Acyclovir in prodromal period
482
What is VZV?
Vericella Zoster Virus, or chickenpox
483
Where does VZV reside when it is latent?
In trigeminal ganglion
484
How to tx VZV?
Acyclovir
485
What is Ramsay Hunt Syndrome?
VZV reactivation in geniculate ganglion. Facial Paralysis + deafness + vertigo
486
What is Herpes Zoster?
Shingles
487
What is the Coxsackie Virus?
VZV reactivation in geniculate ganglion. Facial Paralysis + deafness + vertigo
488
What is Herpes Zoster?
Shingles
489
What is the Coxsackie Virus?
Virus that results in Hand-Foot-Mouth disease | Can cause Herpangina (posterior oral cavity)
490
What is Rubeola?
Measles
491
What is defining characteristic of Rubeola?
Koplik’s spots
492
What is verruca vulgaris?
Common skin wart
493
What is condyloma acuminatum?
Genital wart, or from oral sex with someone that has genital warts.
494
What is condyloma acuminatum caused by?
Caused by HPV 6 and 11
495
What is Focal Epithelial Hyperplasia?
Heck’s Disease Caused by HPV 13 and 32 Small dome shaped warts on oral mucosa
496
What is Oral hairy Leukoplakia?
White patch on lateral tongue Ebstein barr Virus Associated with HIV Associated with Burkitt’s lymphoma
497
Major things to know about Syphilis
Caused by treponema Pallidum Primary lesion is a chancre Secondary lesion is an oral mucous patch, or condyloma latum Tertiary lesion is gumma
498
What is major thing to know about congenital syphilis?
Hutchison’s triad Notched incisors or mulberry molars Deafness Ocular keratitis
499
What is primary infection of Tuberculosis characterized by?
Ghon complex
500
What are tx drugs for TB?
Rifampin Isoniazid Ethambutal
501
What is gonorrhea caused by?
Neisseria gonorrhoeae
502
What is actinomycosis caused by?
Actinomyces Israeli, NOT FUNGAL
503
DIGE
1. Calcium channel blockers: Nifedipime, verapamil, amlodipine 2. Dilantin 3. Cyclosporine
504
Infrabony defects:
1 wall- hemiseptal 2 wall- crater (most common) 3 wall- trough 4 wall- circumferential
505
Orange complex
Fusobacterium nucleatum Campylobacter rectus Prevotella intermedia
506
Red complex
P. Gingivalis T. Denticola T. Forsythia
507
Order of plaque formation
Pellicle -seconds Attraction and attachment- minutes Colonization and maturation-24 to 48 hours
508
Name the 4 risk elements and examples of each
1. Risk Factors Diabetes Smoking Bacteria/plaque ``` 2. Risk Determinants Genetics Age Gender Socioeconomic status ``` ``` 3. Risk Indicators HIV Osteoporosis Infrequent dental visits Stress ``` 4. Risk Markers Hx of perio BOP CAL
509
What are the major components of pulpal tissue?
Fibroblasts Odontoblasts Undifferentiated mesenchymal cells
510
What is another name for secondary dentin? What does it do?
Reactionary dentin, repairs minor damage.
511
What are the histologic zones of pulp form outside to inside?
``` Predentin Odontoblastic layer Cell-free zone of Weil Cell-Rich Zone Pulp Core ```
512
What are the two pain fibers in a tooth?
A delta fiber - major pain fiber, sharp pain,COLD | C fibers - throbbing pain, HOT
513
What is hyperalgesia?
A heightened response to pain
514
What is Allodynia?
A reduced pain threshold. Pain due to a stimulus that doesn’t normally provoke pain. Ex: sunburn (it normally doesnt hurt to touch your skin.)
515
Mandibular molars often refer pain to where?
Pre-auricular area (maxillary molars do NOT)
516
What is the chemical in endo ice called?
Dichlorodifluoromethane (-30 degrees celsius)
517
Symptomatic reversible pulpitis
- cold test, with heightened response, non lingering
518
Symptomatic irreversible pulpitis
- cold test, heightened response, lingering
519
Asymptomatic irreversible pulpitis
- cold test, normal response
520
Symptomatic periapical periodontitis
- positive to percussion
521
Asymptomatic periapical periodontitis
- RL at apex
522
Acute apical abscess
- swelling and pain on gums
523
Chronic apical abscess
- draining fistula tract
524
``` What are shapes for RCT access on the following? Incisors Canines Premolars Maxillary Molars Mandibular Molars ```
``` Incisors - triangular Canines - oval Premolars - narrow oval Maxillary molars - blunted triangle, or rhomboid Mandibular molars - trapezoidal ```
525
What are the main files to instrument a canal? What size of taper? What shape are the files? How are they used?
1. SS hand files - .02 taper a. K file (Kerr) - twisted square, watch winding b. H-file (Hedstrom) - spiral cone, up and down motion 2. NiTi rotary - .04 or .06 taper
526
What is the color pattern for endo files starting with a 6 and ending at 40?
Pink, gray, purple, white, yellow, red, blue, green, black, white…
527
What is the D2 or D16 of the 15 file?
0.47mm (.15 + (.02*16mm)
528
What is a barbed broach used for?
Its an endo file used to remove stuff from the canal
529
How far away from apex do you want to instrument to?
0-2mm
530
What irrigant dissolves organic material? Inorganic material? Gutta percha?
Organic - sodium hypochlorite Inorganic - EDTA Gutta percha - chloroform
531
What bugs are primary bacteria in first endo tx tooth? In retreated tooth?
Primary - bacteroides (gram positive anerobic) | Failed tx - enterococcus faecalis (gram positive facultative)
532
What is the sealer used in endo?
ZOE (zinc oxide eugenol)
533
What is trephination?
An incision and drainage procedure where you cut a hole in bone to drain an infection and the root of a tooth. Incision and drainage normally refers to soft tissue only.
534
How much root tip is excised in an apicoectomy?
3 mm
535
What angle or bevel do you cut off a root tip in an apicoectomy?
0-10 degrees.
536
What do you do after cutting the root tip off in apicoectomy?
Clean with ultra sonic and instrument 3 mm into canal. Then retrofill with mineral trioxide aggregate (MTA)
537
Where is the most common place to have a strip perforation in an endo case?
The distal side of the mesial root on a mandibular molar (the dentin is thinner there.)
538
How can you fix an endo perforation?
With MTA
539
What is the acronym for trauma protocol?
``` TRAVMA Tetanus booster (for avulsions only) Radiographs Antibiotics (for avulsions only) Vitality testing (often not reliable right after trauma. More accurate after 2 weeks) More Appointments ```
540
What is the Ellis classification system?
``` A classification of types of tooth trauma Class I - enamel only (smooth the edges) Class II - enamel and dentin (restore) Class III - enamel, dentin and pulp Less than 24 hours (DPC) More than or equal to 24 hours (Cvek pulpotomy) More than or equal to 72 hours (Pulpotomy) Class IV - traumatized tooth that has become non vital Class V - luxation Class VI - avulsion ```
541
What imaging should you take in a horizontal root fx
3 PAs and one occlusal (take at different angles)
542
What is subluxation?
Tooth becomes loose in the socket (blood around sulcus of tooth) - should have flexible splint for 1-2 weeks. 6% chance necrosis
543
What is extrusion?
Where tooth is pulled a little bit out of the socket - should have flexible splint for 1-2 weeks and RCT if needed (if apex is closed) 65% chance necrosis
544
What is a lateral luxation?
Displacement of tooth in any direction except axially (same tx as extrusion) 80% chance of necrosis
545
What is intrusion?
Apical displacement of tooth (pushed into the socket) 96% chance of necrosis because vessels generally are cut (in kids, allow to re-erupt. In adults, reposition, flexible splint, RCT)
546
What is avulsion?
Tooth is knocked out. (reimplant ASAP, splint for 1-2 weeks (dont let tooth dry keep in milk, saline, saliva, Hanks Balanced Salt Solution (HBSS) (NOT WATER)
547
What is the pH of calcium hydroxide? What is the function of it?
12.5 (this stimulates secondary odontoblasts to form tertiary dentin
548
How does MTA work?
It stimulates cementoblasts to produce hard tissue.
549
Indirect pulp cap
- use CaOH or RMGI placed
550
Direct Pulp cap
- CaOH placed directly on exposure
551
What is a cvek pulpotomy
- a partial pulpotomy only to remove infection portion of pulp. Often done if pulp has been exposed to air for over 24 hours, or a larger exposure more than 2mm.
552
What is apexogenesis?
Trying to stimulate continued root development when exposure exists (almost all caps and pulpotomies on immature permanent teeth with open apices. (So tx would include a pulp cap AND apexogenesis, for example)
553
What is apexification?
Closing root apex that has not finished developing (with MTA or CaOH after pulpectomy on immature permanent tooth)

NBDE II (3 decks)

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