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2nd Year > Restorative 2 > Flashcards

Restorative 2 Flashcards

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1
Q

what is an impression?

A

negative imprint of an oral structure used to make a positive replica

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2
Q

what are the components of alginate?

A 
irriversible hydrocolloid 
carbonated polysaccharide based on alginic acid - gels by cross linking of calcium ions
sodium alginate
calcium phopshate 
sodium phosphate - retarder
fillers - zinc carbonate
pH indicators
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3
Q

what is the working time of alginate?

A

gelation ideal time of 3-4 mins
spatulation of 1 min
working time - 30 secs

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4
Q

what should an impression tray cover?

A

retromolar area of mandible
maxillary tuberosity
anterior - clears most protruded incisor

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5
Q

how do you seat a lower impression?

A

pt should lift tongue

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6
Q

how do you seat an upper impression?

A

seat post before ant

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7
Q

how do you disinfect an impression?

A

sodium hypochlorite 5-10 mins

10- tabs/litre for 2 mins

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8
Q

what is a wax bite?

A

interocclusal record

registration of normal positional relationship of arches

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9
Q

what is gate control theory?>

A

melzack and wall 1965

pain is modulated at the spinal cord and influenced by physiological and psychological and socoiocultural factors

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10
Q

what is the adults pain index?

childrens?

A

mcgill

wong and baker

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11
Q

what are other forms of pain and anxiety control?

A

hypnosis
acupuncture
electric analegsia

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12
Q

what is the aim of analgesia?

A

elimination of pain

haemostasis

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13
Q

how is haemostasis achieved by anaesthetic?

A

vasoconstrictor

tissue blanching - local ischaemia, prolonged activity, reduced toxicity

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14
Q

how do the nodes of the ranvier take part in anaesthesia?

A

ionic exchange of pain impulses

analgesic solution gains access here and blocks nerve conduction

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15
Q

what causes pain?

A 
inflammation
trauma
necrosis
ischaemia
K, Na, Cl, Ca
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16
Q

what are the stages of polarisation?

A

1 - polarisation - no pain, potassium in cytoplasm, na outside
2 - depolarisation - ionic exchange, destruction of polarity, sodium outside
3 - action potential - change in membrane potential permeability, transference of ions
4 - repolarisation - sodium potassium pump, reverts ion to polarised state

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17
Q

what are the contents of LA?

A

vasoconstrictor - prolongs anaesthetic time
reducing agent - prevents oxidation of vasoconstrictor, competes with adrenaline for oxygen
preservative - poss allergic reaction
fungicide - thymol
carrier solution - modified ringers lactate solution adjusted for biocompatible pH

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18
Q

what is lidocaine?

A

dissolved in solution as HCL salt

2% solution

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19
Q

what is prilocaine?

A

3% octapressin
4% plain
less effective at haemorrhage control but only slightly vasoconstrictive

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20
Q

what is mepivicaine?

A

2% 1:100000 ep

3% plain

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21
Q

what is articaine?

A

more quickly metabolised good for repeat injections with ep

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22
Q

what does epinephrine give?

A

more profound anaesthesia, longer lasting

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23
Q

what to be careful with giving LA to someone with liver disease?

A

risk of toxicity

bc impaired metabolism

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24
Q

what to be careful with giving someone with cardiac disease?

A

impact on epinephrine use

arrhythmias/unstable angina

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25
what is the max dose of plain lidocaine? | 2%
11 cartidges/70kg adult | 6-8/70kg
26
what is the max dose of plain prilocaine? | with octapressin?
9/70kg | 4
27
what may the analgesic component of LA interact with?
beta blockers | calcium channel blockers
28
what may the vasoconstrictor component of LA interact with?
``` beta blockers diuretics calcium channel blockers antiparkinson drugs canabis ```
29
what are contraindications to LA?
leukaemia, antcoag therapy, steroid therapy, liver dysfunction, renal disease, local sepsis/vascular abnormality pregnancy, rheumatic fever, uncontrolled diabetes, toxaemia, haemophilia
30
what are local complications to LA?
``` infection IV infection haematoma nerve damage needle fracture cartidge failure facial palsy needle stick ```
31
what are the divs of the trigeminal nerve?
opthalmic nerve maxillary mandibular
32
what are the main divisions of the maxillary nerve?
superior alveolar nerve nasopalatine greater palatine
33
what are the main divisions of the of the mandibular nerve?
``` inferior alveolar nerve incisive nerve mental nerve long buccal nerve lingual nerve ```
34
what is the superior alveolar nerve?
sensory branch of the mandibular nerve foramen ovale - infratemporal fossa passes through lateral and medial pterygoids through mandibular foramen into mandibular canal
35
where is an IDB placed?
analgesia introduced to nerve through lateral side of mouth into fat of pterygomandibuar space
36
what are contra indications to an IDB?
haemophiliacs anticoagulant tx co operation
37
what is the aim of an IDB?
to deposit the solution as close to the mandibuar foramen as poss
38
what is the anatomy associate with an IDB?
external oblique ridge at anterior aspect of ascending ramus pterygomandibular raphe thumb palpates ramus needle from premolars of opp side barrel of syringe parallel to lower occluasal plane above occlusal level of last standing molar
39
what is the nerve supply to the maxillary incisors and canines?
superior alveolar nerve | palatal - nasopalatine
40
what is the nerve supply to the maxillary premolars?
mid sup/plexus | palatal - gretater paltine/nasopalatine
41
what is the nerve supply to the max molars?
superior post alv nerve | palatal greater palatine nerve
42
how can the zygomatic arch cause problems with LA>
mesial and distal LA
43
how do you aneasthetise the lingual nerve?
interpapillary | LIA under lingual attached gingivae
44
why do teeth need restored?
restore tooth integrity restore function remove disease restore appearance
45
what is the tx of a proximal enamel lesion?
monitor | duraphat
46
what is the tx of a proximal enamel lesion at ADJ?
high risk - restore | low risk - monitor
47
what is the tx of a proximal dentinal lesion in outer third of dentine? mid third of dentine?
outer third - high risk - restore low - monitor mid - restore
48
what is microprep?
burs and handpieces of reduced size used with magnification
49
what is chemo mech caries removal?
sodium hypochlorite 0.5% carisolv
50
what is sonic prep?
vibration rather than rotary movements
51
what is air abrasion?
aluminium oxide through a nozzle
52
what are lasers used for?
soft and hard tissue removal
53
what is ozone?
caries identified with a laser | acitve oxygen to anaerobic bacteria
54
what is ART?
hand excavation and GI
55
what is blacks classification?
1 - occlusal surfaces of molars and premolars and buccal pits of molars 2 - approximal surfaces of molars and premolars 3 - approximal surfaces of incisors and canines 4 - inicisal edges of incisors and canines 5 - cervical margins
56
what is wrong with blacks classification?
pre adhesive materials removes too much tooth tissue does not include secondary or root surface caries
57
what are the stages of a filling?
``` outline form resistance form retention form tx of residual caries correction of enamel margins cavity debridement ```
58
what is outline form?
gaining access to caries | - direct access/cutting through enamel
59
what is resistance form?
resisiting occlusal forces cavity floor at right angle to direction of occlusal forces ensure sufficient depth
60
what is retention form?
retaining material in cavity | grooves/undercuts/occlusal keys/bond
61
how do you treat residual caries?
1st ADJ.2nd base of cavity | firm stained dentine can be left in cavity base
62
why do you correct the enamel margins?
leave no unsupported margins | bevel surface to increase bonding area
63
what are names of the walls/floors of the cavity?
occlusal floor pulpoaxial wall gingival floor
64
what is a line angle?
where 2 lines meet
65
what is a cavosurface angle?
where the cavity wall meets the tooth surface at an angle of 90 to 110 degrees
66
what is a point angle?
3 or more lines
67
what is a fissure sealant?
hard insoluble material in liquid form used to fill pits and fissures without cutting enamel
68
what is the aim of using FS?
eradicate fissures aid cleaning prevent caries
69
what is acid etch and what does it do?
30-50% phosphoric acid dissolves enamel - up to 8 micrometers of enamel porosities up to 50micrometres deep
70
what are they etching patterns?
1 - core removed, periphery left = most common 2 - core intact, peripheries removed 3 - haphazard effect - not related to prism morphology
71
what are the diff types of set fissure sealants?
self polymerised UV light cure white light polymerised
72
what can fissure sealants be filled with? what does this do?
lithium alumina silicate increased abrasion resistance increased wear of opposing teeth
73
when to use FS?
``` high caries risk medically compromised limited dexterity tooth cant be isolated deep fissure pattern ```
74
what are occult caries?
occlusal surface intact but carious underneath - bacteria enter deepest part of fissure and rapidly spread along ACJ
75
when do you restore caries?
obv cavitation caries at EDJ infected dentine
76
what is a PRR?
restore carious part of fissure system and seal over rest
77
what is the c factor?
number of bonded surfaces over the number of unbonded surfaces
78
what class cavities are approximal cavities?
``` anterior - class 3 posterior - class 2 ```
79
``` how do class 2 cavities develop? how are they diagnosed? ```
below contact point visual bitewings transillumination
80
what is the use of a matrix band?
retain material in cavity restore contact points protection of adj tooth during cavity prep
81
what is a tunnel prep?
gaining access to caries from occlusal and leaving marginal ridge intact
82
what are cervical caries a sign of?
high risk pt
83
what is the tx of cervical caries?
ensure cavity is self cleansing | intervene when pulp is threatened
84
what are problems with restoring cervical cavities?
access moisture control - blood/gcf contouring
85
what are risk factors for RSC?
``` xerostomia diet partial denture wearing poor oh high caries experience salivary s mutans count ```
86
what is physiological tooth wear? | pathological tooth wear?
occurs with age | excessive toothwear
87
what is attrition?
loss of tooth substance as a result of mastication or of occlusal/proximal contact between the teeth
88
what is physiological attrition?
occlusal surfaces/incisal edges prox surfaces because of mastication deciduous more susceptible -
89
what are signs of physiological attrition?
disappearance of mammelons occlusal cusps flatten exposed dentine - brown cup shaped lesions
90
what is pathological attrition?
confined to local areas, parafunction or misalignment | e.g - bruxism/clenching/grinding
91
what are signs of pathological attrition?
``` visible wear facets abnormal attrition rate hypertrophy of masticatory muscles TMJ pain tooth mobility sensitive to cold ```
92
what is abrasion?
pathological wearing away of tooth structure because of repetitive mechanical habit - notches in root surface
93
why are pulpal exposures commonly avoided in NCTSl?
slow process - secondary dentine laid down
94
what are the types of abrasion and what are they caused by?
1 cervical abrasion - v shape - horizontal brushing 2 habitual abrasion 3 iatrogenic - grinding to accomodate filling 4 industrial abrasion
95
what is abfraction?
tooth flexure from occlusal loading microfractures in enamel cavitiation
96
what is erosion?
progressive loss of tooth structure by an acidic chemical process without bacterial involvement
97
what are signs of erosion?
``` smooth polished surface shallow depressions proud restorations palatal/incisal chipping of edges cupping of molar cusps ```
98
where does extrinsic erosion affect the teeth?
labial surfaces of ant teeth | occlusal surfaces of lower molars
99
where does intrinsic erosion affect the teeth?
palatal surfaces of uppers | occlusal surfaces of lower perm molars
100
what are sources of intrinsic erosion?
``` hiatus hernia alcohol abuse bullimia pregnancy gastric ulceration reflux ```
101
what does the pulp need protection from?
- chem attack - acrylic resin/acids in dentine, bonding agents and residual acid from acidogenic bacteria - thermal attack - polymerisation exothermic setting reactions, hot/cold food and drink, cavity prep - galvanic shock - restorations of disimilar material in close proximity set up an electrolyte cell = pain
102
how does cavity prep insult the pulp?
increased inflammatory cell infiltrate | smear layer produced = occludes tubules with bacteria from cavity, collagen and HA
103
describe calcium hydroxide?
high pH - bacteriocidal high pH - initially irritant - reactionary dentine produced insulator, radiopaque, compatible, strong no coronal seal
104
describe zinc polycarboxylate?
high MW = reduced tubule penetration, mild irritation F = bacteriostatic strong,, insulates, compatible, radiopaque
105
describe zinc eugenol?
``` slight irritancy bacteriocidal and radiopaque bc zinc content insulates not compatible, no coronal seal v obtundant ```
106
describe zinc phosphate?
low pH. low MW = highly irritant insulator, bacteriocidal, radiopaque, compatible, strong not obtundant, no seal
107
desrcibe glass polyalkenoates?
low pH high MW = mild irritancy F = bacteriostatic insulates, strong, direct adhesive, good seal compatible
108
when to line a cavity?
<2mm no lining >2mm line line pulpal wall and occlusal floor
109
when would you feel discomfort from a tooth?
when caries is within 0.5mm of pulp
110
what is an indirect pulp cap?
cavity in 0.5mm of pulp | caoh and GI
111
what is a direct pulp cap?
exposed pulp vital tooth, no history of pathology, no periradicular pathology, pulp pink and healthy, no excessive bleeding, caoh and GI
112
what is a stepwise excavation?
``` stained soft dentine is left in the base of a cavity but a cleared ADJ seal over base with dycal dress with GI cement remove 6-12 months = stained but firm base of cavity ```
113
what is the restorative staircase?
with each restoration = larger prep and prep eases gradually towards pulp
114
when can a restoration be repaired or refurbished?
aesthetics no pain no caries

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