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Flashcards in Restorative 2 Deck (106):
1

what is the 'Gate Control Theory'?

-melzack and wall 1965
-possible explanation of how pain can be modulated in the spinal cord and physiological, pyschological and sociolocultural factors contribute to the experience

2

What pain index is often used for adults?

-McGill pain index
-numbers

3

what pain index is often used for children?

-Wong-Baker pain index
-smiley faces

4

What is a placebo?

-An inert medicine given for its suggested effects, but has no pharmacological benefits but can have psychological benefits

5

what word should be avoided when doing treatment?

-oain

6

how can anxiety be reduced?

-initial explanation of things
-calm and instruct the patient to be calm
-warn the patient if there is any discomfort to be expected
-give the pt control and help them to cop (eg. breathing exercises)
-distract them

7

what is the aim of analgesia?

-elimination of pain
-reduction of haemorrahe

8

what is the physiology of a nerve?
eg. ....-......-......

-dentride-cell body-axon

9

What are two parts of a nerve that contribute to conduction?

-nodes of ranvier
-end feet synapse

10

what are 4 pain producing substances that are produced by injured tissue?

-potassium
-sodium
-chloride
-calcium

11

what are the 4 phases of physiological conduction?

1-polarisation
2-depolarisation
3-action potential
4-repolarisation

12

what happens in the polarisation stage (1st stage) of physiological conduction?

-NO pain
-pottasium inside the cytoplasm and sodium outside

13

what happens in the depolarisation stage?

-ionic exchange
-pottasium now higher concentration outside the cell and sodium now higher inside the cell

14

what stage of physiological conduction is the same as 'resting'?

-polarisation is the same as resting as there is now pain

15

what are the 6 contents of LA?

-LA agent
-vasoconstrictor
-reducing agent
-preservative
-fungicide
-climbing
(Long Vales Reduce People From Climbing)

16

what is the gold standard LA?

-lidocaine

17

what is prilocaine less effective at?

-less effective in controlling haemorrhage

18

what is articaine useful for?

-repeat injections

19

what are 3 advantages of using epinephrine?

-more profound anaesthesia
-longer lasting
-haemostasis

20

is felypressin better or worse at haemorrhage than epinephrine?

-felypressin is not as good at haemorrhage as epinephrine

21

what are some precatutions required for safe analgesic?

-good pt cooperation
-enrolled with GDC
-written/signed prescription
-needle guards
-sharps boxes
-self aspirating syringe
-MH checked and updated at each dental visit

22

how may toxicity due to LA occur?

-IV injection

23

if a pt shows signs/symptoms of allergy to LA who should they be referred to?

-dermatologist

24

what LA is latex free?

-citanest

25

how many LA cartridges is max. for cardiac pt's?

-3

26

what is the dose needed of LA to induce labour?

100 cartriges

27

what nerve are you aiming for when you anaesthatise the apex of 12?

-anterior superior alveolar nerve

28

can therapists carry out indirect restorations?

-no. therapists can only carry out direct restorations

29

what does the word 'onlay' mean?

-overlying the cusps of the teeth

30

what is attrition?

-tooth to tooth surface lost

31

what is abrasion?

- abrasion from a foreign object in the mouth

32

what is erosion?

-acid causes tooth loss

33

what is abfraction?

-loss of tooth due to flexural forces
-stress from occlusal overload

34

what is micro-preperation?

-hand pieces and burs of reduced size keep cavity to a minimum

35

what is sonic preperation?

-handpiece's work by vibration rather than rotation

36

what is 'air abrasion'?

-spray aluminium oxide particles through a fine angled nozzle

37

what are some advantages of air abrasion?

-no LA required
-preservative
-quite

38

what are some disadvantages of air abrasion?

-lots of contamination
-irritates asthma
-expensive

39

what can lasers remove?

-soft and hard tissue

40

what is meant by 'ozone'?

-new concept
-where bacteria in caries is identified with a laser and it delivers 'active' oxygen molecules through suction cup to desired area
-this kills certain types of cariogenic bacteria

41

what are some disadvantages to 'ozone'?

-not much scientific research been done about it

42

what is Atraumatic Restorative Treatment (ART) ?

-hand excavaion, restore with GI

43

what are some advantages of ART?

-ideal for under developed countries and for very nervous patients

44

what are some disadvantages of ART?

-often not all the caries is removed

45

do you take maxillary or mandibular impressions first?

-mandibular

46

what are the 6 steps to taking impressions?

1-prepare the patient
2-assemble the materials and equipment
3-select and prepare the impression trays
4-take mandibular impression
5-take maxillary impression
6-take the interoclussal record for occluding the casts

47

to prevent cross contamination of the impressions. what is done to stop this?

-disinfection

48

what disinfection material is used in DDH?

-'Artichlor'

49

what is another name used fr the 'interocclusal record'?

-the wax bite

50

who classified cavity preperations?

-Greene Vardiman Black (GV Black)

51

what is GV Black class 1?

-occlusal surfaces of molars and premolars, buccal pits of molars

52

what is GV black class 2?

-approximal surfaces of molars and pre molars

53

what is GV Black class 3?

-approximal surfaces of incisors/canines

54

what is GV Black class 4?

-icisal edges of incisors and canines

55

what is GV Black class 5?

-cervical margins of teeth

56

what are some disadvantages of blacks classification?

-was used before adhesive materials were available, therefor retentive cavities needed to be cut
-removes more tooth substance than necessary
-does not include root or secondary caries

57

what are 6 principles relating to cavity preperation?
(what steps do you do...)

1. Outline form
2.resistance form
3.retention form
4.tx of residual caries
5.correction of enamel margins
6.cavity debridement

58

what is outline form?

-gaining access to the caries

59

what is resistance form?

-to resist occlusal forces
-make sure cavity floor is at right angle to the direction of occlusal forces

60

what is retention form?

-designs to retain the material in the cavity

61

what are some forms of retention?

-'grooves' in wall of cavity
-use of undercuts and occlusal key
-use of acid etch and bonding agents
-dentine pins (therapists cannot use these)

62

what happens in the stage 'treatment of residual caries'?

-removing caries from the enamel-dentine juntion first (peripheries) then moving onto the base of the cavity

63

when is firm but stained dentine removed?

-only on anterior teeth if it shows through the enamel

64

what happens in the stage 'correction of enamel margins'?

unsupported enamel is weak and prone to fracture
-sometimes a bevel to increase surface area for bonding

65

what happens in the stage 'cavity debridement'?

-cavity should be thoroughly washed and dried to remove debris and bacteria

66

what is line angle?

-where two surfaces meet

67

what is cavosurface angle?

where the cavity wall meets the surface (90-110 degrees)

68

what is another name used for hidden occlusal caries?

-occult caries

69

what is the technique for doing sealant restoration?
(exam Q last year)

-take occlusal registration(outline form)
-remove caries
-add lining if necessary
-acid etch, prime and bond to cavity walls and margins
-build up cavity with comp. resin
-apply acid etch to remaining fissures
-thoroughly wash acid etch of fissures
-apply fissure sealant to remaining fissures
-check occlusion

70

what is technique for conventional restoration?

-occlusal registration (outline form)
-remove caries
-apply lining if necessary
-acid etch, prime and bond
-restore with 2 mm increments of composite
-finish with polishing burs or one gloss
-check occlusion

71

what must always be checked after doing a restoration?

-occlusion must always be checked after doing a restoration

72

if a cavity is within 2 mm of pulp do you need a lining?

-yes

73

if cavity is 0.5mm or less close to the pulp what do you do?

-dycal and GI

74

what is dycal?

-calcium hydroxide

75

what are some disadvantages of tunnel preperation?

-technically difficult
-marginal ridge is prone to fracture
-not always good access to caries at ADJ

76

what is root caries usually filled with?

-GI

77

cervical caries is a sign of what?

-high caries risk

78

what are some risk factors for root caries?

-xerostomia
-repeated carbohydrate rate intake
-partial denture wearing
-poor OH
-high caries experience
-high salivary counts of S.mutans and lactobacilli

79

what are 3 functions of fissure sealant?

-prevent caries
-eradicate fissures
-aid cleaning

80

what are the 3 different etching patterns?

type 1: -prism core removed, peripheral material left
type 2: -prism core remains intact, peripheral regions removed
type 3: -haphazard effect. does not work very well

81

what is bruxism?

-involves grinding and clenching of the teeth

82

what are some signs and symptoms or bruxism?

-abnormal rate of attrition
-TMJ pain
-hypertrophy of masticatory muscles
-pulpal sensitivity to cold

83

what are the 4 different types of abrasion?

1-cervical abrasion
2-habitual abrasion
3-iatrogenic abrasion
4-industrial abrasion

84

what are some signs of erosion?

-palatal chipping of incisal edges
-smoothed and polished surfaces
-'proud' restorations
-cupping of lower molar cusps

85

what are some examples of extrinsic erosion?

-acidic foodstuffs
-sucking citrus fruits
-swimming in heavy chlorinated water

86

what are some examples of intrinsic erosion due to reflux?

-hiatus hernia
-gastric ulceration
-alcohol abuse
-gastro oesophageal reflux
-stress reflux syndrome

87

what are some examples of intrinsic erosion due to vomitting?

-pregnancy
-bulimia

88

what are some clinical signs of bulimia?

-normal body weight
-erosion of palatal surfaces of upper teeth
-lesions on palate, fingers, oral mucosa, lips
-signs of malnutrition

89

what does NCTTL stand for?

Non-carious tooth tissue loss

90

what 3 things do you protect the pulp from?

1.thermal attack
2.chemical attack
3.galvanic effects

91

what is galvanic shock?

metal on metal with no insulation. Electrolytes occurs due to saliva

92

cavity preperation 'insults' the pulp. This results in what?

increased inflammatory cell infiltrate

93

what does the 'smear layer' do?

occludes the dentinal tubules

94

what are some features of the ideal pulp protector?

-non toxic
-non irritant
-bacteriostatic
-gives good coronal seal
-thermal/electrical insulator
-strength to withstand restoration placement
-radiopaque
-obtundant

95

what are some features of calcium hydroxide (dycal)?

-high pH initially irritates the pulp causing reactionary dentine to be laid down
-bacteriocidal
-electrical/thermal insulator
-radiopaque
-not adhesive so there is no coronal seal

96

give an example of zinc polycarboxylate cement?

poly F

97

what are some features of zinc polycarboxylate cement?

-high molecular weight reduces penetration to tubules, only mildly irritant to the pulp
-sufficient strength for restoration placement

98

give an example of zinc oxide eugenol

kalzinol, sedanol

99

what are some features of zinc oxide eugenol?

-slight irritancy to the pulp
-thermal/electrical insulator
-very obtundant to the pulp
-zinc oxide eugenol is not compatible with resin composite

100

what are some features of zinc phosphate?

-not obtundant to the pulp

101

what is an indirect pulp cap?

when cavity is extended to 0.5mm of pulp and calcium hydroxide placed at the deepest part of the restoration.

102

what is a direct pulp cap?

-when an exposed pulp is covered by capping materials

103

what is the criteria for direct pulp capping?

-tooth is vital
-no history of pain in the tooth
-no evidence of periradicular pathology
-pulp is pink and health
-no bop

104

when does GI fully set?

not till 24hrs after

105

what is the treatment plan order?

1.emergency care
2. prevention
3.stabilisation
4.restorative
5.maintenance
6.referrals

106

what are some symptoms of amalgam poisoning?

-headaches
-GI upset
-Dyspepsia
-Salivation/xerostomia
-fatigue
-oedema of face/ankles
-character changes