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Prosthodontics > Tissue Management Prostho long quiz > Flashcards

Tissue Management Prostho long quiz Flashcards

1
Q

exclusion of sulcular fluid, saliva and gingival bleeding from operating field

A

moisture control

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2
Q

prevention of aspiration or swallowing of fluid sprayed from the handpiece and restorative debris
*objectives are isolation, retractions and accessibility

A

moisture control

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3
Q

objectives of isolation

A
  • obtain a dry clean operating field
  • improve properties of dental materials
  • protect the patient and operator
  • improve the dentists operating efficiency
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4
Q

methods of fluid control

A
  • mechanical (saliva ejector, high vol evacuator), absorbant(cotton rolls, cellulose wafers)
  • rubber dam-should not be used w/ polysiloxane impression materials for it to inhibit polymerization
  • chemical-use of antisialogogues drugs and local anest
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5
Q

group of drugs used to control salivary flow
-are gastrointestinal anti-cholinergic drugs that inhibit the action of myoepithelial cells in salivary glands producing dry mouth

A

anti-sialogogues

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6
Q

woven cord impregnated w/ chemicals

  • electrosurgery
  • combination of chemical in cord and electrosurgery
  • curettage with stone while doing prep of Finish line
A

Gum Retraction Technique

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7
Q

the shallow groove around tooth bounded on one side by surface of tooth and on the other by the epith lining of free margin of gingiva.

A

gingival crevice

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8
Q

-‘V’ shaped w/ its base at the most coronal level of the epithelial attachment to the tooth root

A

gingival crevice

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9
Q

what is the dentist’s goal?

A

to accomplish the required procedure w/ a minimal degree of unintended alteration of the gingival tissue

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10
Q

what is the purpose of tissue retraction?

A
  • exposure and inspection of subgingival and equigingival finish line
  • control of bleeding
  • accessibility to finishing line
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11
Q

what are some points to consider during tissue retraction?

A
  • location of cord should be within gingival crevice at or just below the finish line
  • avoidance of any trauma
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12
Q

what is the process of chemico-mechanical? (soaked retraction cord)

A
  1. combine mech (pressure packing) w/ chemical leadin to enlargement of gingival sulcus and fluid control
    * retraction cords are soaked in chemicals w/c promotes gingival contraction to provide better gingival retraction than plain cord
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13
Q

ideal requirments of chemicals used

A
  • should produce effective gingival displacement
  • should promote hemostasis
  • should not produce irreversible damage to gingiva
  • no systemic side effects
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14
Q

drugs used for cord retraction

A
  • epinephrine
  • alum astringent
  • ferric sulfate(15%)
  • ferric chloride(22%)
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15
Q

Contraindications of epinephrine

A
  • cardiovasc diseases
  • diabetes
  • hyperthyroidism
  • known hypersensitivity to epinephrine
  • causes tachycardia (if placed in lacerated tissue)
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16
Q

signs of epinephrine reaction

A
  • increase in cardiac rate
  • increase in force of cardiac contractions
  • increase in respiration
  • patient will usually appear nervous
  • px may seem frightened
  • px may be confused about what is happening
  • at a later time, px may feel depressed about the visit
17
Q

Significance and Treatment of Epinephrine Reaction

A

-No significance, only an exaggerated physiologic reaction to the drug and not life threatening.

18
Q

how to treat the epinephrine reaction?

-Patient w/ No cardiac Insufficiency

A

Calm the patient by showing to them that you are aware of the situation

  • remove the cord
  • stay with them
  • take pulse and blood pressure at intervals
  • terminate appointment after
19
Q

Patient w/ cardiac insufficiency or hypertension

significance

A

could be lifethreatening if cardiac reserve is exceeded by the effects of the epinephrine which is rare

20
Q

how to treat patient w/ cardiac insufficiency or hypertension

A

assume that the patient is experiencing a cardiac crisis and follow procedure for a medical emergency

21
Q

What to do in operating technique of retraction cord

A
  • operating area should be dry.
  • fluid control w/ evacuating device
  • isolate prepared quadrant w/ cotton rolls
  • cut about 5cm long retraction cord
  • Twist cord to make it tight and small
  • (if not pre-soaked), dip cord in chemical
  • loop retraction cord tightly around the tooth held by thumb and forefinger
  • Pack cord into the sulcus starting from mesial using instrument like Fisher packing instrument or DE plastic instrument (care not to damage gingiva)
  • Force should be applied in mesial direction so that packed cord will not be dislodge.
  • Packing instrument should be angled slightly toward the tooth/root to facilitate subging placement of cord (if instrument is placed parallel to long axis, cord will be pushed against the wall of gingival crevice will rebound)
  • -technique where a portion of the epithelium w/in the sulcus is cut/removed to expose finish line, done only on healthy gingiva
22
Q

a portion of the epithelium w/in the sulcus is cut/removed to expose finish line, done only on healthy gingiva

A

rotary curettage (gingettage)

23
Q

surgical removal of sulcular epithelium using an electrode

A

electrosurgery

24
Q

what is the criteria of rotary curettage (gingettage)

A
  • absence of bleeding on probing
  • depth of sulcus less than 3mm
  • presence of adequate keratinized gingiva
25
Q

technique of rotary currettage

A
  • done simultaneously along w/ finish line prep
  • torpedo diamond (used to create chamfer) is carefully extended into sulcus (half its depth) to remove portion of sulcular epithelium
  • handpiece at slow speed
  • abundant water spray during the procedure
  • retraction cord impregnated w/ aluminum chloride can be used to control bleeding
26
Q

a high frequency radio transmitter that uses either a vacuum tube or a transistor to deliver a high frequency electrical current of at least 1.0 MHz (one million cycles per second)

A

electrosurgical retraction

27
Q

what are the indications of electrosurgical retraction?

A
  • in areas of inflamed gingival where impossible to use retraction cord
  • in cases w/ gingival proliferation around the prep’d finish line.
28
Q

contraindication of electrosurgical retraction

A

patients w/ cardiac pacemakers

29
Q

advantages of electrosurgical retraction

A
  • quick procedure
  • produces little or no bleeding
  • can be done in cases w/ gingival inflammation
30
Q

disadvantages of electrosurgical retraction

A
  • technique sensitive
  • application of excessive pressure may produce severe tissue damage
  • difficult to control lateral dissipation of heat (will produce tiss damage)
  • cannot be done in dry field(should be moist)
31
Q

helps stabilize electrical flow w/in patients body (electrical accidents happen if single electrode is used)
-placed under px thigh or at back of px (should not be placed close to bony tubercles as it may generate enough electricity to produce burn)d

A

ground electrode

32
Q

designs of cutting edge of surgical electrode

A

-coagulating diamond loop, round loop, small straight probe, small loop

33
Q

basic principles during electrosurgical procedure

A
  • local anesthesia should be given
  • unpleasant odor in tissue necrosis, so use aromatic oils at vermillion border of lips to mask unpleasant odor
  • grounding should be dnoe to protect px from electrical accidnets
  • electrode should be applied w/ very light pressure w/ swift strokes.
  • pressure should not be applied for it may produce excessive tissue damage
  • electrode should never be placed stagnant at any one point as it may lead to lateral dissipation of heat producing injury
34
Q

technique for sulcus enlargment

A

-use small electrode positin parallel to long axis of tooth
-run probe at min speed of 7mm/sec to avoid lateral heat dissipation
-tissue debris entangled in probe should be cleaned after each stroke
run probe in facial, mesial, lingual, distal direction
-debris in sulcus should be removed using cotton pellet dipped in hydrogen peroxide

35
Q
  • done when clinical crown is short in comparison to the anatomic crown
  • if a wide band of attached gingiva surround the tooth, crown lengthening is done to increase accessibility.
  • removal of hyperplastic gingiva (gingivectomy) in order to expose the anatomical crown
  • done using diamond shaped electrode
A

-crown lengthening

36
Q

technique of crown lengthening

A

diamond electrode is run over the tissues such that one of its surfaces follows the incline of tooth

  • bevel should be done on attached to prevent re-growth
  • when there is extensive wound, periodontal dressing is given
37
Q

a remnant of a remnant of edentulous papilla, w/c forms as a roll of tissue adjacent to the proximal surface of the teeth adjacent to the edentulous space

A

edentulous cuff

38
Q

can be removed surgically or electrosurgically

-electrosurgical loop electrode are best used for these procedures

A

removal of edentulous cuff

Prosthodontics (4 decks)

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