Written exam Flashcards
(189 cards)
1
Q
Clinical features of a periodontal abscess
A
- Localized infection within the pocket
- swelling,
- pus discharge,
- increased tooth mobility,
- deep periodontal pockets,
- bleeding on probing (BOP),
- suppuration,
- pain on percussion.
2
Q
Epidemiology of periodontal abscess
A
Periodontal abscesses account for 6-14% of dental emergencies
3
Q
Diagnosis of periodontal abscess
A
Clinical examination including probing depths and mobility, radiographic imaging to rule out other pathologies
4
Q
Management/Treatment of periodontal abscess
A
- Drainage of abscess,
- scaling and root planing,
- systemic antibiotics if systemic involvement is suspected,
- regular follow-up to monitor healing and prevent recurrence.
5
Q
Clinical features of endodontic abscess
A
Infection originating from the pulp, often due to necrosis
- radiolucency at the apex of the tooth,
- non-vital response to pulp tests.
6
Q
Diagnosis of endodontic abscess
A
Radiographic examination, pulp vitality tests.
7
Q
Management of endodontic abscess
A
- Root canal therapy to remove the infected pulp,
- drainage of abscess if necessary,
- antibiotics if systemic symptoms are present,
- follow-up to ensure resolution.
8
Q
Clinical features of endo-perio lesion
A
Lesion involving both periodontal and endodontic components,
- deep pockets,
- radiographic evidence of bone loss extending from the APEX to the periodontal pocket.
9
Q
Epidemiology of endo-perio lesion
A
Prevalence ranges from 4.2% to 16.5%.
10
Q
DIagnosis of endo-perio lesion
A
Clinical examination, radiographic imaging.
11
Q
Management of endo-perio lesion
A
Treatment involves both root canal therapy and periodontal therapy, including scaling and root planing, possible surgical intervention for persistent pockets, antibiotics if indicated.
12
Q
Clinical features of chronic periodontitis
A
Long-standing inflammatory condition resulting in progressive attachment loss and bone destruction.
- Generalized or localized bone loss,
- Deep periodontal pockets,
- Clinical attachment loss
13
Q
Epidemiology of chronic perio
A
Affects up to 47.2% of adults over 30 in the United States.
14
Q
Diagnosis of chronic perio
A
Comprehensive periodontal examination, radiographic imaging.
15
Q
Management/treatment of chronic perio
A
Scaling and root planing, periodontal surgery if necessary, maintenance therapy to prevent recurrence, patient education on oral hygiene.
16
Q
Clinical features of VRF
A
- Crack extending from the root to the crown,
- often associated with a history of trauma or extensive restorations/endo. - isolated deep probing depths,
- localized swelling,
- pain on biting,
- J-shaped radiolucency
- possible sinus tract formation.
17
Q
Diagnosis of VRF
A
Radiographic imaging showing “halo” or “J-shaped” radiolucency, clinical examination.
18
Q
Treatment of VRF
A
Extraction of the affected tooth, possible replacement with a dental implant or bridge.
19
Q
Clinical features of lateral periodontal cyst
A
Developmental cyst located adjacent to the root of a vital tooth, usually asymptomatic but can cause localized swelling if infected.
20
Q
Diagnosis of lateral perio cyst
A
Clinical examination, radiographic imaging showing well-defined radiolucency lateral to the tooth root.
21
Q
Treatment of laterial perio cyst
A
Surgical enucleation of the cyst, follow-up to monitor for recurrence.
22
Q
Clinical features of neoplastic lesion
A
Malignant processes such as squamous cell carcinoma, characterized by rapid progression, non-healing ulcer, induration, irregular radiographic appearance.
23
Q
Diagnosis of neoplastic lesion
A
Clinical examination, biopsy for histopathological analysis, imaging for extent and staging.
24
Q
Management of neoplastic lesion
A
Referral to an oncologist, surgical excision, radiation therapy, chemotherapy as indicated.
25
Clinical features of periapical abscess
Swelling associated with a non-vital tooth, often intermittent with episodes of exacerbation and remission. Radiographic evidence of a radiolucency at the apex of the tooth.
26
Diagnosis of periapical abscess
Clinical examination, radiographic imaging.
27
Management of periapical abscess
Root canal therapy, drainage of abscess, antibiotics if systemic symptoms are present.
28
Clinical features of Chronic Apical Periodontitis
Long-standing low-grade infection at the apex of a tooth, may present as a painless swelling with an intermittent course.
29
Diagnosis of Chronic Apical Periodontitis
Radiographic imaging showing radiolucency at the apex, clinical examination.
30
Management of Chronic Apical Periodontitis
Root canal therapy, monitoring and follow-up.
31
Clinical features of Radicular Cyst
Cyst arising from the apex of a non-vital tooth, usually presents as a slow-growing painless swelling that can wax and wane in size
32
Diagnosis of radicular cyst
Radiographic imaging, clinical examination.
33
Treatment of radicular cyst
Surgical enucleation, root canal therapy or extraction of the affected tooth, follow-up.
34
Clinical features of of fibroma
Benign fibrous overgrowth of tissue often arising from chronic irritation, usually painless and may fluctuate slightly in size.
35
DIagnosis of fibroma
Clinical examination, biopsy if necessary.
36
Management of fibroma
Surgical excision, removal of irritant.
37
Clinical features of mucocele
Mucous retention cyst that can cause swelling, typically fluctuant and may decrease in size intermittently.
38
Diagnosis of mucocele
Clinical examination, biopsy if necessary.
39
Treatment of mucocele
Surgical excision, marsupialization.
40
Clinical features of Salivary Gland Neoplasm
Benign or malignant tumor of the salivary glands, usually presents as a firm non-painful swelling that persists or grows over time.
41
Diagnosis of Salivary Gland Neoplasm
Clinical examination, imaging, biopsy.
42
Management of Salivary Gland Neoplasm
Surgical excision, radiation therapy if malignant, follow-up.
43
Clinical features of osteomyelitis
Infection of the bone, often presenting with swelling, tenderness, possibly fever. Radiographic changes include areas of radiolucency and sclerosis.
44
Diagnosis of osteomyelitis
Clinical examination, radiographic imaging, microbiological culture.
45
Management of osteomyelitis
Antibiotic therapy, surgical debridement if necessary, monitoring and follow-up.
46
Clinical features of multiple myeloma
Malignant neoplasm of plasma cells leading to bone destruction and marrow failure. Symptoms include bone pain, fractures, anemia, hypercalcemia, renal impairment, increased susceptibility to infections.
47
Diagnosis of multiple myeloma
Blood tests for monoclonal proteins, bone marrow biopsy, imaging for osteolytic lesions.
48
Management of multiple myeloma
Chemotherapy, bisphosphonates to manage bone pain and hypercalcemia, careful management of dental procedures due to risk of osteonecrosis of the jaw (ONJ).
49
What is Guided Tissue Regeneration (GTR)?
GTR is a periodontal surgical procedure aimed at regenerating lost periodontal structures, including alveolar bone, periodontal ligament, and cementum.
50
What are the primary indications for GTR?
GTR is indicated for deep intrabony defects, furcation involvements (especially Class II furcations in molars), and significant recession defects with substantial alveolar bone loss.
51
What types of barrier membranes are used in GTR?
Barrier membranes used in GTR can be resorbable (e.g., collagen) or non-resorbable (e.g., expanded polytetrafluoroethylene - ePTFE).
52
What is the primary principle behind GTR?
The principle of GTR involves using a barrier membrane to exclude gingival epithelium and connective tissue from the defect area, allowing periodontal ligament and bone cells to repopulate the area.
53
What is the purpose of primary closure in GTR?
Primary closure of the flap over the membrane minimizes the risk of membrane exposure and contamination, aiding in the healing process.
54
What are the clinical improvements expected with successful GTR?
Clinical improvements include probing depth reduction, clinical attachment level gain, and defect fill.
55
What is the most commonly missing tooth in most ethnic groups, excluding the third molar?
Mandibular second premolar.
56
List three dental anomalies that can co-exist with hypodontia.
1. Microdontia
2. Delayed eruption
3. Peg-shaped laterals
57
What complication is observed in the extraction socket following the removal of an upper left first molar?
Oroantral communication (OAC).
58
What are the immediate management steps for oroantral communication following extraction?
1. Confirm diagnosis with a Valsalva maneuver.
2. Place a figure-of-eight suture.
3. Prescribe antibiotics, decongestants, and analgesics.
4. Schedule a follow-up appointment.
59
What post-operative instructions should be given to a patient with oroantral communication?
1. Avoid vigorous rinsing and spitting for 24 hours.
2. Do not blow your nose for at least two weeks.
3. Stick to a soft diet initially.
4. Take prescribed medications as directed.
5. Attend follow-up appointments.
60
What additional procedures may be required for implant placement in the posterior right maxilla?
1. Sinus lift (lateral window or transalveolar approach).
2. Bone grafting (onlay grafting or ridge expansion).
3. Guided bone regeneration (GBR).
61
Name three types of bone grafting that could be used.
1. Autografts
2. Allografts
3. Xenografts
62
What is the success rate of implants placed in augmented sinuses using the lateral window technique?
98.3% (Pjetursson et al. 2008).
63
What is the survival rate for implants placed in sites augmented with onlay grafts?
95.1% (Chiapasco et al. 2009).
64
What are the findings and potential cause of pain in the right mandible and lower lip after implant placement?
Possible neurological condition, such as trigeminal neuralgia or post-implant neuropathy, not an odontogenic problem.
65
What is immediate implant placement?
Immediate implant placement involves placing an implant immediately after tooth extraction.
66
What are the indications for immediate implant placement?
Sufficient residual bone volume and quality
Absence of active infection at the extraction site
Intact extraction socket walls
Patient preference for fewer surgical interventions
67
What is type 2 implant placement?
Early implant placement occurs 4-8 weeks after tooth extraction, allowing soft tissue healing and partial bone healing.
68
What are the indications for type 2 implant placement?
Presence of minor soft tissue defects
Partially healed extraction site with soft tissue coverage
Moderate risk of infection or inflammation
Adequate primary stability achievable
69
What is type 3 implant placement?
Delayed implant placement occurs more than 8 weeks after tooth extraction, allowing complete soft tissue healing and significant bone remodeling.
70
What are the indications for delayed/type 3 implant placement?
Insufficient bone volume requiring augmentation
Presence of infection or chronic inflammation
Extensive soft tissue defects needing regeneration
Patient systemic health conditions affecting healing
71
What is immediate loading in implant dentistry?
Immediate loading refers to the placement of a prosthetic restoration on the implant within 48 hours of implant placement.
72
What are the indications for immediate loading?
High primary stability of the implant (torque >35 Ncm)
Favorable bone quality and quantity
Occlusal conditions allowing minimal load on the implant
Patient compliance with post-operative instructions
73
What is early loading in implant dentistry?
Early loading refers to the placement of a prosthetic restoration on the implant between 1 week and 2 months after implant placement.
74
What are the indications for early loading?
Adequate primary stability of the implant
Favorable healing response and bone quality
Controlled occlusal load during the healing phase
Patient preference for faster restoration of function
75
What is conventional loading in implant dentistry?
Conventional loading involves placing the prosthetic restoration on the implant after a typical healing period of 3-6 months.
76
What are the indications for conventional loading?
Standard bone quality and volume
Sites requiring significant osseointegration time
Patients with systemic conditions affecting bone healing
Clinical situations requiring cautious loading approach
77
What is the survival rate for implants placed in sites treated with guided bone regeneration (GBR)?
92-97% (Aghaloo and Moy, 2007).
78
What would be included in a referral letter to a specialist for a patient with severe periodontal disease?
* Clinical and radiographic findings
* Concerns about rapid disease progression
* Request for comprehensive periodontal evaluation
* Attached dental records
79
How would you explain findings of a patient with a neurological issue causing pain in the right mandible and lower lip?
* Explain there are no dental problems causing the pain.
* Suggest the pain might be due to nerve-related issues.
* Recommend referral to a neurologist or oral and maxillofacial specialist.
80
What steps would you take for initial treatment and management of an oroantral communication?
* Confirm diagnosis with Valsalva maneuver.
* Place figure-of-eight suture.
* Prescribe antibiotics and decongestants.
* Schedule follow-up appointment.
81
What is the potential impact of a ‘J’ margin on a restoration?
* Poor marginal fit
* Increased plaque accumulation
* Difficult detection
* Cementation issues
* Weakens tooth structure
* Aesthetic compromises
82
What are the primary benefits and disadvantages of autografts in bone grafting?
* Benefits: High osteogenic potential, contains living cells and growth factors.
* Disadvantages: Limited availability, additional surgical site morbidity.
83
What are the common complications of sinus lifts and bone grafting procedures?
* Sinus membrane perforation
* Infection
* Graft failure
* Prolonged healing time
84
What are the indications for using guided bone regeneration (GBR)?
* Insufficient bone volume for implant placement
* Need to regenerate bone around implants
* Horizontal and vertical bone augmentation
85
What are the immediate steps to manage a patient with suspected trigeminal neuralgia post-implant placement?
* Confirm absence of odontogenic causes.
* Prescribe appropriate neuropathic pain medications.
* Refer to a neurologist for further evaluation.
86
What is the importance of using a Valsalva maneuver in diagnosing oroantral communication?
To detect air movement or bubbles indicating communication between the oral cavity and maxillary sinus.
87
Describe the lateral window technique for sinus lift.
Creating an access window on the lateral wall of the sinus to elevate the sinus membrane and place bone graft material.
88
Describe the transalveolar (crestal) approach for sinus lift.
Accessing the sinus membrane through the osteotomy site and gently elevating it to place bone graft material.
89
What is the success rate of the transalveolar approach for sinus lift?
Mean implant survival rate of 92.8% (Tan et al. 2008).
90
What is the definition of a ‘J’ margin?
An improper, over-contoured preparation margin on a tooth, creating an overhanging ledge.
91
What is the importance of primary closure in managing oroantral communication?
To reduce the risk of infection and promote healing.
92
What is the role of antibiotics in managing oroantral communication?
To prevent sinus infection following the communication.
93
What is the recommended follow-up period for a patient with oroantral communication?
1-2 weeks for initial reassessment.
94
What is the primary purpose of a figure-of-eight suture in oroantral communication management?
To stabilize the blood clot and reduce the size of the communication.
95
What are the advantages of using allografts in bone grafting?
Good osteoconductive properties and no need for a second surgical site.
96
What are the disadvantages of using xenografts in bone grafting?
Longer resorption time and potential for immunogenic reactions.
97
What are the advantages of using alloplasts in bone grafting?
Unlimited supply and no risk of disease transmission.
98
What are the disadvantages of using alloplasts in bone grafting?
Primarily osteoconductive, lacking osteoinductive properties.
99
What is the importance of maintaining a blood clot in an extraction socket?
To promote healing and prevent complications like dry socket.
100
What is the role of nasal decongestants in managing oroantral communication?
To reduce sinus pressure and minimize the risk of further communication.
101
What is the potential impact of sinus membrane perforation during sinus lift?
Increased risk of infection and graft failure.
102
What is the importance of guided bone regeneration (GBR) in implant dentistry?
To direct new bone growth where bone volume is deficient.
103
What is the osteogenic potential of autografts?
High, due to the presence of living cells and growth factors.
104
What is hypomineralization of molars?
Hypomineralization of molars is a condition where teeth exhibit compromised structural integrity due to poor mineral content, often leading to increased sensitivity and higher susceptibility to caries and fractures .
105
What further clinical information is needed to diagnose swelling and mobility in tooth 13?
Further clinical information needed includes a comprehensive medical history, detailed history of present illness, oral hygiene practices, systemic health status, and radiographic examination .
106
What is the treatment plan for hypomineralized molars?
The treatment plan includes applying topical fluoride and desensitizing agents, using glass ionomer cement or composite resin for reinforcement, and scheduling regular dental check-ups .
107
What is the management approach for peri-implantitis?
Management of peri-implantitis involves non-surgical debridement, antimicrobial therapy, plaque control, smoking cessation, surgical debridement if necessary, and regular follow-up visits
108
What record is obtained during the functional jaw movements with wax rims in place for complete denture fabrication?
The record obtained is a combination of the centric relation record and functional jaw movements, capturing the patient's protrusive and lateral movements to establish the correct vertical dimension and occlusal plane .
109
What additional procedures may be required for implant placement in the posterior right maxilla?
Additional procedures may include sinus lift (sinus augmentation), bone grafting, and guided bone regeneration (GBR) to ensure sufficient bone volume for stable implant placement .
110
What is the purpose of a customized impression coping in implant dentistry?
The purpose of a customized impression coping is to transfer the exact position and orientation of the dental implant to the dental laboratory, ensuring accurate prosthetic restoration fit and function .
111
What are the treatment objectives for correcting a deep overbite?
Treatment objectives include aligning teeth, reducing the deep overbite through orthodontic treatment, improving occlusal function, enhancing esthetics, and maintaining oral health through effective hygiene practices .
112
What are the key elements of a periodontal maintenance program?
Key elements include regular follow-up appointments for professional cleaning, patient education on oral hygiene, monitoring periodontal health, and adjusting treatment plans as necessary based on the patient's progress .
113
What is multiple myeloma and its relevance in dentistry?
a malignant neoplasm of plasma cells that leads to bone destruction and marrow failure.
Relevant due to osteolytic lesions, increased bleeding tendencies, infection risks, and complications from bisphosphonate therapy
114
What is an oroantral communication (OAC) and its immediate management?
An OAC is a communication between the oral cavity and the maxillary sinus, often following the extraction of an upper molar. Immediate management includes confirming the diagnosis, ensuring blood clot protection, placing a figure-of-eight suture, prescribing antibiotics, decongestants, and providing post-operative instructions .
115
What are the contributing factors to deep periodontal pockets and their improvement methods?
Contributing factors include plaque and calculus accumulation, periodontal disease, trauma from occlusion, tooth anatomy, previous periodontal treatment, smoking, and systemic conditions. Improvement methods involve scaling and root planing, antimicrobial therapy, periodontal flap surgery, regenerative procedures, occlusal adjustment, and patient education .
116
What are the key considerations for improving the appearance of anterior teeth?
Key considerations include a comprehensive dental examination, aesthetic evaluation, radiographic examination, diagnostic impressions, understanding patient's expectations, assessing medical history, and ensuring periodontal health before aesthetic procedures
117
What is a lateral periodontal cyst?
A lateral periodontal cyst is a developmental cyst located adjacent to the root of a vital tooth, usually asymptomatic but can cause localized swelling if infected.
118
What are the clinical features of vertical root fracture?
Clinical features of vertical root fracture include isolated deep probing depths, localized swelling, pain on biting, and possible sinus tract formation.
119
What is osteomyelitis and its clinical features?
Osteomyelitis is an infection of the bone, often presenting with swelling, tenderness, and possibly fever. Radiographic changes include areas of radiolucency and sclerosis.
120
What are the steps for managing a periodontal abscess?
Management steps include drainage, scaling and root planing, systemic antibiotics if systemic involvement is suspected, and regular follow-up to monitor healing and prevent recurrence.
121
What is the recommended treatment for a true combined perio-endo lesion?
Management involves root canal therapy to address the non-vital pulp, scaling and root planing for periodontal pockets, possible surgical intervention, and regular follow-up to monitor healing and ensure stability.
122
What is the significance of tooth agenesis in dental development?
Tooth agenesis is the most common dental developmental defect with around 5% of people failing to develop at least one tooth (excluding third molars). It can lead to various dental anomalies and requires careful management for proper dental function and aesthetics.
123
What is the most commonly missing tooth in tooth agenesis (excluding third molars)?
The most commonly missing tooth in tooth agenesis (excluding third molars) is the mandibular second premolar.
124
What are three dental anomalies that can co-exist with hypodontia?
Three dental anomalies that can co-exist with hypodontia are microdontia, delayed eruption of teeth, and enamel hypoplasia.
125
What is the likely diagnosis for a purplish soft raised lesion on the gingiva overlying teeth 11 and 12 in a 13-year-old?
The likely diagnosis could be a pyogenic granuloma, hemangioma, or other benign soft tissue lesion. Further investigation such as biopsy is needed for definitive diagnosis.
126
What are the contributing factors to generalized gingival recession?
Contributing factors include poor oral hygiene, traumatic tooth brushing, chronic periodontitis, occlusal trauma, anatomical factors, and smoking.
127
What is the management for deep periodontal pockets with persistent inflammation?
Management includes scaling and root planing, possible antimicrobial therapy, periodontal flap surgery if necessary, and regular follow-up to monitor and maintain periodontal health.
128
What are the differential diagnoses for a 60-year-old female presenting with a 2-month duration swelling that sometimes gets worse and subsides?
Differential diagnoses include periapical abscess, periodontal abscess, chronic apical periodontitis, radicular cyst, fibroma, mucocele, salivary gland neoplasm, and osteomyelitis.
129
What factors may contribute to the formation of a deep periodontal pocket on the midpalatal of tooth 12?
Factors include plaque and calculus accumulation, periodontal disease, trauma from occlusion, anatomical factors, previous periodontal treatment, smoking, and systemic conditions such as diabetes.
130
What is the prognosis for a tooth with deep pockets, furcation involvement, and grade I mobility?
The prognosis is fair to poor, depending on the severity of periodontal involvement, patient compliance with maintenance, and the effectiveness of initial and ongoing periodontal treatment.
131
What are the primary considerations for treating gingival recession?
Considerations include improving oral hygiene, scaling and root planing, possible surgical intervention such as gingival grafting, addressing contributing factors like orthodontic appliances or frenal attachments, and patient education .
132
What is the role of occlusal adjustment in periodontal therapy?
Occlusal adjustment helps to distribute occlusal forces evenly, reducing trauma to the periodontium and aiding in the management and prevention of periodontal disease .
133
What are the typical clinical features of trigeminal neuralgia?
Clinical features include severe shooting pain or a burning sensation in the lower face and jaw, often triggered by touch, chewing, or speaking, and described as burning, aching, or shock-like pain .
134
What is the management approach for post-implant neuropathy?
Management includes pain management strategies, possible removal of the implant if it is causing nerve compression, and referral to a specialist for further evaluation and treatment .
135
What are the indications for a frenectomy?
Indications for a frenectomy include a high frenum attachment contributing to gingival recession or diastema, reducing tension on the gingival tissue, and improving oral hygiene and periodontal health .
136
What are the treatment objectives for correcting a deep overbite?
Treatment objectives include aligning teeth, reducing the deep overbite through orthodontic treatment, improving occlusal function, enhancing esthetics, and maintaining oral health through effective hygiene practices .
137
What is the clinical presentation of peri-implantitis?
Clinical presentation includes suppuration, bleeding on probing, increased probing depths (7-9mm), and presence of bone loss around the implant.
138
What are the contributing factors to peri-implantitis?
Factors include microbial colonization, residual cement, biomechanical factors (improper force distribution), host susceptibility (diabetes, osteoporosis), smoking, and a history of periodontitis .
139
What is the treatment plan for peri-implantitis?
Treatment includes mechanical debridement, antimicrobial therapy, open flap debridement, resective surgery, regenerative procedures, occlusal adjustment, and maintenance therapy.
140
What are the potential causes of trismus?
infectious conditions (pericoronitis, abscesses), trauma (fractures, soft tissue injury), muscle spasm or dysfunction (TMJ disorders, myofascial pain syndrome), systemic conditions (tetanus, scleroderma), oncologic causes (tumors), radiation therapy, and dental causes (post-extraction trismus) .
141
What is the likely diagnosis for a patient with aching and burning in the right mandible and lower lip post-implant placement?
The likely diagnosis includes trigeminal neuralgia, post-implant neuropathy, or atypical odontalgia, given the absence of odontogenic causes .
142
What is the management plan for a purplish soft raised lesion on the gums of a 13-year-old patient?
Management includes initial assessment and patient management, comprehensive history, clinical examination, radiographic evaluation, biopsy, oral hygiene instruction, professional cleaning, and definitive treatment based on biopsy results (e.g., lesion removal if benign) .
143
What are the differential diagnoses for a 60-year-old female with a swelling of 2 months' duration?
Differential diagnoses include periapical abscess, periodontal abscess, chronic apical periodontitis, radicular cyst, fibroma, mucocele, salivary gland neoplasm, and osteomyelitis .
144
What is the treatment for a healthy 55-year-old male with periodontal health who wants to improve his anterior teeth aesthetics?
Treatment includes professional cleaning, teeth whitening (in-office and at-home), restorative procedures (direct composite veneers, porcelain veneers), and regular dental check-ups .
145
What is the management approach for a 64-year-old patient with limited mouth opening and pain near the right ear?
Management includes identifying the cause (e.g., peritonsillar abscess), immediate management with antibiotics and pain relief, possible drainage of abscess, and referral to an ENT specialist.
146
What is a lateral periodontal cyst?
A lateral periodontal cyst is a developmental cyst located adjacent to the root of a vital tooth, usually asymptomatic but can cause localized swelling if infected .
147
What is osteomyelitis and its clinical features?
Osteomyelitis is an infection of the bone, presenting with swelling, tenderness, and possibly fever. Radiographic changes include areas of radiolucency and sclerosis .
148
What is the management approach for peri-implantitis?
A 'J' margin is an over-contoured preparation margin on a tooth, leading to poor marginal fit, plaque accumulation, difficulty in detection, cementation issues, weakened tooth structure, and aesthetic compromises .
149
What is the management approach for a combined perio-endo lesion in tooth 46?
Management includes root canal therapy, scaling and root planing, antibiotic therapy if needed, reevaluation, periodontal surgical procedures if needed, restorative measures, and maintenance phase with regular follow-up visits .
150
What are the potential causes of persistent symptoms in a tooth with incomplete root canal treatment?
Potential causes include incomplete debridement of the root canal system, missed canals, inadequate obturation, and persistent periapical infection .
151
What are the indications for a frenectomy?
Indications for a frenectomy include a high frenum attachment contributing to gingival recession or diastema, reducing tension on the gingival tissue, and improving oral hygiene and periodontal health .
152
What is the biological mechanism of guided tissue regeneration (GTR)?
GTR involves placing a barrier membrane over a periodontal defect to prevent epithelial and connective tissue migration into the wound, allowing bone and periodontal ligament cells to repopulate the area and regenerate lost tissues.
153
What histological changes occur in gingivitis?
In gingivitis, there is an inflammatory response characterized by increased blood flow, dilation of blood vessels, infiltration of inflammatory cells (such as neutrophils and lymphocytes), and collagen degradation in the gingival connective tissue.
154
How do fibroblasts contribute to tissue repair in the periodontium?
Fibroblasts produce collagen and other extracellular matrix components essential for wound healing and tissue repair. They play a critical role in the regeneration of the periodontal ligament and gingival connective tissue.
155
What are the histological features of a healthy gingival epithelium?
Healthy gingival epithelium is characterized by a stratified squamous keratinized epithelium, with a dense, organized connective tissue layer underneath. It provides a protective barrier against mechanical and microbial insults.
156
What role do matrix metalloproteinases (MMPs) play in periodontal disease?
MMPs are enzymes that degrade extracellular matrix components. In periodontal disease, overproduction of MMPs leads to excessive breakdown of collagen and other matrix proteins, contributing to tissue destruction and disease progression
157
Explain the process of bone remodelin
Bone remodeling is a continuous process involving bone resorption by osteoclasts and bone formation by osteoblasts. It is essential for maintaining bone strength, repairing microdamage, and regulating calcium and phosphate homeostasis.
158
What are the characteristics of inflamed periodontal tissue?
Inflamed periodontal tissue exhibits increased blood flow, redness, swelling, and the presence of inflammatory cells such as neutrophils, macrophages, and lymphocytes. Collagen fibers are degraded, and there is potential bone resorption.
159
What histological changes occur in periodontitis?
Periodontitis is characterized by the breakdown of periodontal ligament fibers, resorption of alveolar bone, infiltration of inflammatory cells (such as neutrophils, macrophages, and lymphocytes), and formation of periodontal pockets.
160
How does inflammation affect the gingival epithelium?
Inflammation causes changes in the gingival epithelium, including increased permeability, infiltration of inflammatory cells, collagen degradation, and epithelial proliferation or ulceration.
161
What is the structure and function of Sharpey's fibers?
Sharpey's fibers are collagen fibers embedded in the cementum and alveolar bone, anchoring the periodontal ligament and helping to secure the tooth in the socket.
162
How do cytokines influence periodontal disease?
Cytokines are signaling proteins that modulate the inflammatory response. In periodontal disease, pro-inflammatory cytokines (e.g., IL-1, TNF-α) contribute to tissue destruction, while anti-inflammatory cytokines (e.g., IL-10) help regulate inflammation.
163
What is the role of gingival fibroblasts in periodontal health?
Gingival fibroblasts produce collagen and other extracellular matrix components essential for maintaining the structural integrity and function of gingival connective tissue.
164
How does the periodontal ligament (PDL) adapt to mechanical stress?
The PDL adapts to mechanical stress by remodeling its collagen fibers, changing their orientation, and adjusting the turnover rate of its extracellular matrix components to maintain tooth stability and function.
165
What is the significance of epithelial cell rests of Malassez in the periodontal ligament?
Epithelial cell rests of Malassez are remnants of the Hertwig's epithelial root sheath. They may play a role in the maintenance and repair of the periodontal ligament and can contribute to the formation of periapical cysts under pathological conditions.
166
What are the indications for root canal therapy?
Indications include irreversible pulpitis, pulp necrosis, symptomatic apical periodontitis, acute apical abscess, and chronic apical abscess.
167
What are common irrigants used in endodontics?
Common irrigants include sodium hypochlorite (NaOCl), chlorhexidine (CHX), and EDTA (ethylenediaminetetraacetic acid).
168
What is the significance of the apical constriction in endodontics?
The apical constriction is the narrowest part of the root canal near the apex. It serves as a natural barrier, aiding in the accurate termination of cleaning, shaping, and obturation.
169
What is the role of calcium hydroxide in endodontics?
Calcium hydroxide is used as an intracanal medicament for its antimicrobial properties and ability to promote hard tissue formation and healing.
170
What are the non-surgical treatment options for peri-implantitis?
Non-surgical options include mechanical debridement, use of antiseptic agents like chlorhexidine, systemic or local antibiotics, and laser therapy.
171
What are the surgical treatment options for peri-implantitis?
Surgical options include flap surgery for debridement, resective surgery to remove infected tissue, regenerative procedures like bone grafting, and implant surface decontamination.
172
What role does implant surface modification play in peri-implantitis treatment?
Surface modification involves using techniques such as air abrasion, laser treatment, or chemical agents to clean and detoxify the implant surface during surgical interventions.
173
What are the differences between peri-implant mucositis and peri-implantitis?
Peri-implant mucositis is limited to inflammation of the soft tissues around the implant without bone loss, while peri-implantitis involves both soft tissue inflammation and progressive bone loss.
174
What are the indications for using stainless steel crowns in pediatric dentistry?
Indications include extensive decay in primary teeth, after pulp therapy, fractured teeth, and teeth at high risk for further decay, providing durability and full coverage protection.
175
Primary Endo with Secondary Perio
Initially, an endodontic infection progresses to involve the periodontal tissues due to chronicity or lack of treatment. Endodontic treatment often resolves the lesion, with minimal periodontal treatment needed afterward.
176
Primary Perio with Secondary Endo
Advanced periodontal disease progresses to affect the pulp, often through accessory canals or the apical foramen. The periodontal condition is typically more extensive and requires both endodontic and periodontal therapy, but endo is still addressed first.
177
True Combined Lesion
Independent endodontic and periodontal lesions coexist and eventually join, affecting both tissues simultaneously. Both endodontic and periodontal treatments are necessary, starting with the endodontic therapy.
178
What are the indications for the use of MTA (Mineral Trioxide Aggregate) in pediatric pulp therapy?
Indications for MTA use include direct pulp capping, pulpotomy procedures in primary and young permanent teeth, apexification in non-vital immature permanent teeth, and as a root-end filling material.
179
How is the Hall Technique utilized in pediatric dentistry?
The Hall Technique involves placing preformed stainless steel crowns on carious primary molars without any caries removal or tooth preparation, relying on the crown to seal the caries and arrest its progression.
180
Describe the process and purpose of indirect pulp capping in primary teeth.
Indirect pulp capping involves removing the carious dentin near the pulp, leaving a thin layer of affected dentin, which is then covered with a biocompatible material like calcium hydroxide or MTA to promote healing and dentin formation, preserving the vitality of the pulp.
181
What are the clinical criteria for performing a pulpectomy in primary teeth?
Criteria for pulpectomy include irreversible pulpitis or necrosis in a primary tooth, presence of infection or abscess, and sufficient root structure to allow for proper cleaning, shaping, and obturation of the canals.
182
Describe the application and benefits of silver diamine fluoride (SDF) in pediatric dentistry.
SDF is applied to arrest active dental caries, especially in young children, special needs patients, or those with high caries risk. It is minimally invasive, painless, and effective in preventing the progression of caries and reducing sensitivity.
183
How do you manage a child with non-nutritive sucking habits?
Management includes educating parents, providing positive reinforcement for cessation, using reminder appliances if necessary, and monitoring for potential dental effects such as open bite or posterior crossbite.
184
Describe the C-factor and its significance in restorative dentistry.
The C-factor, or configuration factor, is the ratio of bonded to unbonded surfaces in a dental restoration. A higher C-factor indicates more stress on the bonded interfaces during polymerization shrinkage, increasing the risk of marginal gaps and postoperative sensitivity.
185
What are the benefits and limitations of using CAD/CAM technology in restorative dentistry?
Benefits include precise and accurate restorations, reduced treatment time, and improved patient comfort. Limitations include the high cost of equipment, the need for technical expertise, and the initial learning curve for practitioners.
186
How does the use of adhesives differ between total-etch and self-etch systems?
Total-etch systems involve etching the tooth surface with phosphoric acid before applying the adhesive, enhancing mechanical retention. Self-etch systems combine etching and priming in one step, simplifying the procedure and reducing the risk of postoperative sensitivity.
187
Describe the role of bioactive materials in restorative dentistry.
Bioactive materials, such as bioactive glass and calcium silicate cements, interact with biological tissues to promote remineralization, enhance the sealing of restorations, and support the healing of pulp and periodontal tissues.
188
What is the role of silane coupling agents in composite bonding?
Silane coupling agents enhance the bond between the inorganic fillers and the organic resin matrix in composite materials, improving the mechanical properties and durability of the restoration
189
What is the clinical significance of thermal expansion in dental materials?
The coefficient of thermal expansion of dental materials should be similar to that of natural tooth structure to minimize stress and potential failure due to temperature changes in the oral environment.
