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3rd Year BDS > Clinical > Flashcards

Flashcards in Clinical Deck (55)
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1
Q

What are the 4 types of non-carious tooth substance loss?

A

Attrition - tooth to tooth
Abrasion - foreign object
Erosion - chemical
Abfraction - function

2
Q

When should we restore a cavity?

A
Alleviare pain
Remove disease
Restore tooth integrity, function and aesthetics
Aid plaque control
High caries risk
3
Q

When should we avoid restoring a cavity

A

Patient can access the cavitated lesion with cleaning aids
Prior to cavitation
Small, cleanable cavities with no active caries
Can it be remineralised

4
Q

Describe a Black’s CI cavity?

A

Occlusal surface of molars and premolars, buccal pits of molars and palatal pits of anterior teeth

5
Q

Describe a Black’s CII cavity?

A

Interproximal surfaces of molars and premolars

6
Q

Describe a Black’s CIII cavity?

A

Interproximal surfaces of incisors and canines

7
Q

Describe a Black’s CIV cavity?

A

Incisal edges of incisors and canines

8
Q

Describe a Black’s CV cavity?

A

Cervical margins

9
Q

Describe a Black’s CVI cavity?

A

Cusp tips of molars, premolars and cuspids

10
Q

What are the 4 anatomical sites of a carious lesion?

A

Pit or fissure
Smooth surface
Enamel
Root

11
Q

What are the 3 classifications of caries?

A

Primary
Secondary
Residual

12
Q

What are the 3 types of activity of caries?

A

Active
Rampant
Arrested

13
Q

Indications for a CI cavity?

A

Fissure sealant
PRR
Conventional therapy

14
Q

Indications for a CII cavity?

A

If confined to enamel - encourage lesion to arrest via Fl

If dentine visible - amalgam or composite possible

15
Q

Indications for a CIII cavity?

A

Restore with composite

16
Q

Indications for a CIV cavity

A

Composite

17
Q

Indications for a CV cavity?

A

Composite

18
Q

How to prepare a CII cavity?

A

Caries accessed through MR, due to loss of contact area, with a matrix band
Avoid damage to adjacent tooth
If using amalgam create undercuts
If using composite rubber dam is essential

19
Q

How to prepare a CIII cavity?

A

Access caries palatally

20
Q

How to prepare shallow and deep root caries?

A

Shallow: - recontoured and Fl applied, if they’re cleansable then restoration may not be necessary
Deep:
- remove caries and restore with GIC or composite

21
Q

How to prepare a patient for a rubber dam?

A

General outline to patient
Teeth cleaned and contacts checked with floss
Rough contacts smoothed
If occlusal restoration work planed, occlusion should be marked prior
Lips lubricated
LA given for clamp

22
Q

How many holes to punch for an anterior tooth?

A

First premolar to first premolar

23
Q

How many holes to punch for a posterior tooth?

A

Tooth needed for restoration as well as one further distal tooth

24
Q

How to apply the rubber dam clamp?

A

Clamp bow towards distal aspect
Apply from lingual to buccal
Ensure 4 point contact

25
Q

How to prepare the enamel of a cavity?

A

Gain visual access of the carious lesion
Remove demineralised, weakened carious enamel
Create a peripheral enamel margin to be able to form a seal
High speed

26
Q

How to correct enamel margins?

A

Unsupported enamel is weak and prone to fracture
Thin section of material is weak and prone to fracture
Bevel to increase surface area for bonding (not amalgam)

27
Q

How to correctly remove dentine from a cavity?

A

Lateral extent from the EDJ periphery to the caries overlying the pulp
Slow speed
Circular brush-strokes

28
Q

What is the definition of a line angle?

A

Where 2 surfaces meet

29
Q

What is the definition of the cavosurface angle?

A

Where the cavity wall meets tooth surface (between 90-110)

30
Q

What is the cavo-surface angle for amalgam and composite?

A

Amalgam:
- 90
Composite:
- >90, with bevel

31
Q

What is the definition of a point angle?

A

Where 3 or more surfaces meet

32
Q

What is the purpose of rounded angles?

A

Reduces stress in restored unit

Reduces loss of tooth tissue

33
Q

What occlusal anatomy should you try and preserve?

A

Oblique ridge in max molars

Marginal ridge in anterior/premolar teeth

34
Q

Explain the clinical protocol for a fissure sealant?

A
Isolate - rubber dam
Clean tooth
Etch for 20-30s
Wash for 10-20s and then dry for same amount of time
Apply FS
Apply light for 20-30s
Check sealant for seal and retention
35
Q

Explain the clinical protocol for a PRR?

A
Etched for 20s
Washed for 10s
Primer for 10s
Gently air dry to leave fine layer
Apply 2-3 coats of adhesive
Gently air dry and light cure for 10s
Apply composite to cavity incrementally as required. Shape with burnisher or flat plastic between increments
20-30s light application
Apply fissure sealant
36
Q

How to recreate a proximal wall for a CII restoration?

A

Proximal box:

  • buccolingual extension of 0.2-0.3mm clearance from the adjacent tooth buccally and lingually
  • gingivally there should be a 0.5 mm from adjacent tooth
  • axial wall should follow the external tooth contour
37
Q

What is the size of the proximal box?

A

1.5mm

38
Q

What is the depth of the proximal box?

A

1.5-2mm

39
Q

Explain the clinical protocol for a CV cavity?

A

Rubber dam helps to retract gingiva and gives isolation
Remove caries
Etch, prime and bond
Restore with GIC or composite

40
Q

Explain the cavity needs for an amalgam restoration?

A
Depth occlusally at least 2mm
Cavity floor flat
Walls should be parallel with slight convergence
No unsupported enamel margins
No sharp angles
Undercuts
41
Q

Explain the condensation rules of amalgam?

A
Condenser tooth must fit
Place amalgam in small increments
Condensing for up to 4 mins
Overfilled with amalgam
Condense with heavy pressure - hear a squeak - promoting adaptation to cavity walls and eliminates voids
42
Q

Explain the carving rules of amalgam?

A

Remove gross excess
Use probe to relive a ring around the matrix band and contour the marginal ridge after carving
CArver should rest on enamel/cusps adjacent and be parallel to the margin of the prep
Do not let tip of carver leave the middle of resto
Centre should be smoothed with a burnisher
Follow the cusps with tool

43
Q

What to include when reporting on a radiograph?

A
Date taken
Type of radiograph
Grade
Teeth present
Caries
Restorations
Plaque retentive factors
Bone level
Other
44
Q

BPE Code 0?

A

Pocket <3.5mm

No plaque or calculus/overhangs, no BoP (black band entirely visible)

45
Q

BPE Code 1?

A

Pocket <3.5mm
No plaque or calculus/overhangs
BoP
(black band entirely visible)

46
Q

BPE Code 2?

A

Pocket <3.5mm
Supra or subgingival plaque/calculus/overhangs
(black band entirely visible)

47
Q

BPE Code 3?

A

Probing depth between 3.5-5.5mm

Black band partially visible, indicating a pocket 4-5mm

48
Q

BPE Code 4?

A

Probing depth >5.5mm

Black band disappear, indicating a pocket of 6mm or more

49
Q

BPE Code *

A

Furcation involvement

50
Q

Treatment for BPE Code 0?

A

None

51
Q

Treatment for BPE Code 1?

A

OHI

52
Q

Treatment for BPE Code 2?

A

OHI

Removal of plaque retentive factors, including all supra and subgingival calculus

53
Q

Treatment for BPE Code 3?

A

OHI
Removal of plaque retentive factors, including all supra and subgingival calculus
6 point pocket chart recording pockets over 4mm (in that sextant)
Possible root surface debridement

54
Q

Treatment for BPE Code 4?

A

OHI
RSD
6 point pocket chart in all sextants
Assess for more complex treatment (UNC15)

55
Q

What to include for a periodontal assessment?

A
Type
Distribution
Stage
Grade
Status
Risk factors