Pre-Clinic - Exam 3

Front 1

What causes perio?

Back 1

biofilm

Front 2

____________ is the instrumentation of the crown or root surface.

Back 2

scaling

Front 3

____________ is a definite instrumentation procedure designed to remove necrotic/altered cementum that is rough, impregnated w/ calculus or contaminated w/ toxins or microorganisms.

Back 3

Root planing

Front 4

What do you NOT want to do w/ root planing?

Back 4

remove cementum! ....just remove rough surfaces.

Front 5

________________ is applied to a group of procedures that includes scaling, root planing, and procedures carried out by patient on a daily basis.

Back 5

debridement

Front 6

___________ is applied to everything that we do.

Back 6

debridement

Front 7

__________ is the disruption/removal of subgingival plaque/byproducts from cemental surfaces & pocket space following completion of instrumentation.

Back 7

deplaquing

Front 8

Deplaquing is known as "___________"

Back 8

polishing

Front 9

Which therapy is used for full mouth infection done in 24 hours?

Back 9

anti-microbial therapy

Front 10

What all may non-surgical therapy include? (6)

Back 10

1. removal of bacterial plaque, endotoxins, and calclulus

2. root planing

3. irrigation

4. sustained release antibiotic/antimicrobial agents

5. removal of iatrogenic plaque retainers

6. concurrent dental procedures

Front 11

Which non-surgical therapy is the MAIN one we use?

Back 11

plaque removal (could use ultrasonic)

Front 12

Examples of irrigation?

Back 12

chlorahexidine/listerine (removes microbial count in mouth)

Front 13

Examples of sustained release antibiotic?

Back 13

atridox, arestin and perio chip

Front 14

Iatrogenic = ?

Back 14

clinician induced (problem)

Front 15

Example of iatrogenic?

Back 15

retainer collecting plaque caused by roughness

Front 16

Concurrent dental procedures means -

Back 16

"same time" --> DH does job (cleaning) then dentist comes in (filling)

Front 17

6 expected outcomes of non-surgical perio therapy -

Back 17

1. interrupt/stop progess of disease

2. enhance gingival health

3. change subgingival microflora

4. prevent/postpone disease recurrence

5. condition tissue prior to more complicated therapy

6. patient motivation

Front 18

DH MAIN expected outcomes of non-surgical perio therapy -->

Back 18

1. interrupt/stop progress of disease

2. enhance gingival health

Front 19

Change of gingival microflora means =

Back 19

change gram - anerobic to gram + aerobic

Front 20

Condition tissue prior to more complicated therapy means =

Back 20

preparing tissue by reducing inflammation & getting feeling back so there's not a lot of bleeding

Front 21

_____________________ is a bacterial infection of the periodontium.

Back 21

periodontal disease (reduces periodontium)

Front 22

Name the 2 categories of perio disease :

Back 22

1. gingivitis

2. periodontitis

Front 23

Of the 2 perio categories, which is REVERSIBLE?

Back 23

gingivitis

Front 24

_______________ is a bacterial infection that is confined to the gingiva.

Back 24

gingivitis

Front 25

What makes gingivitis REVERSIBLE?

Back 25

- because the gingival margin hasn't moved apically & junctional epithelium is still at CEJ resulting in no damage.

- once there is BONE LOSS & JUNCTIONAL EPITHELIUM MOVES --> periodontitis.

Front 26

___________________ is a bacterial infection of all parts of the periodontium including the gingiva, PDL, bone, & cementum.

Back 26

periodontitis

Front 27

What makes periodontitis IRREVERSIBLE?

Back 27

once attachment moves apically and losing support for tooth (bone loss)

Front 28

What will occur w/ periodontitis after instrumentation?

- what changes?

Back 28

- some healing

- as in decrease in pocket by long junctional epithelium forms

Front 29

T/F: "Instrumentation restores periodontitis w/ alveolar bone, cementum, PDL fibers that were destroyed by the disease."

Back 29

FALSE, it does NOT restore

Front 30

T/F: "In periodontitis, once alveolar bone is gone - there is no going back although you can keep it from getting worse."

Back 30

TRUE

Front 31

What is the CRITICAL STEP in prevention/treatment of periodontal disease?

Back 31

removal of calculus deposits

Front 32

How do you prepare for instrumenation? (3)

Back 32

1. review patient history (medications needed/temperature & vitals)

2. review x-rays

3. explore for calculus both supra/sub gingivally

Front 33

We review x-rays of pts to look for -

Back 33

bone loss, thickening of PDL, calculus, caries, restorations, & overhang.

Front 34

What conclusion do we come to once we ID calculus on an x-ray of a pt?

Back 34

that pt has HEAVY (a lot) of calculus

Front 35

How do we explore the supra/sub gingival? (3)

Back 35

1. visual

2. tactile

3. root morphology

Front 36

Where is calculus located at?

- Which is more difficult to remove?

Back 36

- enamel and root (cementum)

- root is harder to remove

Front 37

Process of calculus removal : (7)

Back 37

1. probe to determine type of pocket, position of gingivia & level of attachment

2. select correct cutting edge

3. maintain good grasp

4. establish finger rest

5. insertion, angulation, activation

6. use adequate lateral pressure

7. stay w/in instrumentation zone

Front 38

What results with a diseased sulcus?

Back 38

pocket

Front 39

Whats results with a healthy sulcus?

Back 39

crevice

Front 40

When exploring, what kind of grasp/pressure do you use?

Back 40

light grasp/light lateral pressure (so we can feel the calculus more)

Front 41

What kind of lateral pressure do we use for calculus removal?

Back 41

a heavier lateral pressure against tooth in order to remove the calculus

Front 42

Instrument sequence: (7)

Back 42

1. get ready and insert

2. prepare for stroke

3. tilt lower shank

4. lock on toe-third

5. calculus removal stroke

6. stop the stroke

7. relax b/t strokes

Front 43

Which instrument do we use for calculus removal?

Back 43

gracey

Front 44

How do you insert the gracey for calculus removal?

Back 44

closed face (angle) against tooth at ZERO degrees for instertion

Front 45

In step 2 of instrumentation (preparing for stroke), we position the _________________ beneath calculus deposit.

- what angle (degrees) do we use for step 2?

Back 45

working-end

- 70 degrees

Front 46

For gracey, the cutting edge is a right angle called =

Back 46

offset to blade or self angulated

Front 47

For step 3 instrumentation, (tilt lower shank), we use what angulation (degrees)?

Back 47

80 (range from 70-80) degrees

Front 48

For step 4 (lock on toe-third), we lock the toe-third of the working-end ___________ tooth surface.

Back 48

against

Front 49

For step 5, (calculus removal), do we keep the toe-third locked against the tooth?

Back 49

YES

Front 50

In step 5, (calculus removal), what kind of stroke do we use to snap the deposit off the tooth?

Back 50

tiny, biting stroke upward (short overlaping tiny/biting stoke)

Front 51

For step 6 (stop the stroke), at the end of each stroke we end with ________________, by pressing down w/ your _____________ finger.

Back 51

- precision

- fulcrum

Front 52

In step 6, (stop the stroke), each stroke is _________.

- how so?

Back 52

- distinct

- by making only ONE upward stoke then PAUSING

Front 53

Each calculus removal stroke should be a ______, precise stroke against sulcus,

Back 53

short

Front 54

T/F: "Make a series of back and forth (up and down) strokes for calculus removal."

Back 54

FALSE.

- do NOT make a series of up/down.

Front 55

Calculus removal strokes are always made in a ___________ direction, away from the soft tissue base of the sulcus pocket

Back 55

coronal (apical)

Front 56

Describe process of step 7 (relax b/t strokes) :

Back 56

- make single calculus removal stroke, stop the stroke, and immediately relax your fingers.

Front 57

T/F: "When removing large calculus deposits - it needs to be removed in sections. Small pieces at a time, not all at once."

Back 57

TRUE

Front 58

T/F: "When removing large calculus deposits, it should be removed in layers."

Back 58

FALSE, remove in sections.

Front 59

T/F: "Removing the outermost layer of calculus will leave the deposit with a smooth surface."

Back 59

TRUE

Front 60

Removing the outermost layer of calculus will leave the deposit with a smooth surface. What is this called?

Back 60

burnishing

Front 61

T/F: "Once burnished, it is EASY to remove smooth calculus." -

Back 61

FALSE: it is VERY DIFFICULT to remove smooth calculus.

Front 62

Why is burnished calculus difficult to remove?

Back 62

since the cutting edge tends to slip over the smooth outer surface of the deposit.

Front 63

What are the effects of burnished calculus? (2)

Back 63

1. more difficult to detect and remove

2. retains plaque biofilms that are associated w/ continuing inflammtion of perio tissues.

Front 64

Incorrect angulation of the working-end can result in -

Back 64

tissue injury or burnished calculus

Front 65

Angulation greater than 90 degrees results in -

Back 65

tissue injury

Front 66

Angulation less than 45 degrees results in -

Back 66

burnished calculus

Front 67

Think of root surface as having "_______", that are as wide as the toe-third of the instruments cutting edge.

Back 67

zones

Front 68

Zones are also knows as what?

Back 68

channels

Front 69

Use __________ strokes in a series of these "zones" or narrow tracts.

Back 69

removal (overlapping zones)

Front 70

We don't want to remove gross calculus because it can cause what?

Back 70

abcess

Front 71

We want to work in ______ for heavy calculus cases.

Back 71

sextants

Front 72

For light case calculus, we use which instruments (in order) -

Back 72

1. probe / EXD first

2. Super calculus = sickle then the curet (barnhart)

Front 73

For heavy cases of calculus, we use what instrument -

Back 73

Sub calculus = curets / graceys / barnhart

Front 74

Type of stroke that is used to remove residual calculus deposits, bacterial plaque/by products from root surfaces that are exposed in the mouth due to gingival recession and root surfaces w/ in deep perio pockets -

Back 74

root debridement stroke (or known as root planing stroke)

Front 75

Describe the process of using root debridement - (4)

Back 75

1. use sharp curet

2. lighter grasp, lateral pressure and shaving stroke (on cementum)

3. blade can be closed more

4. use short, even, overlapping strokes going to longer strokes

Front 76

4 noncarious dental lesions -

Back 76

1. enamel hypoplasia

2. attrition

3. erosion

4. abrasion

Front 77

___________ is the wearing away if tooth caused by bruxism (clenching/grinding)

- Is this mechanical or chemical?

Back 77

1. attrition

2. mechanical

Front 78

_________ is caused by acid (gastric reflux/belimic), wearing away of enamel (limes/lemons).

- Is this mechanical or chemical?

Back 78

1. erosion

2. chemical

Front 79

For abrasion, you have to have _______ BEFORE abrasion occurs from toothbrush.

- Is this mechanical or chemical?

Back 79

1. recession

2. mechanical

Front 80

_________________ is when pt has some primary teeth and some permanent teeth.

Back 80

mixed dentition

Front 81

___________ is defective/incomplete development of any tissue/structure.

- What is a possible factor?

Back 81

1. hypoplasia

2. fever/trauma

Front 82

_____________ is produced by any disturbance severe enough to interfere w/ ameloblastic function during formation of enamel matrix.

Back 82

enamel hypoplasia

Front 83

_________ is caused by any factor that inhibits enamel maturation..whiter appearance.

Back 83

enamel hypocalcification

Front 84

_________ is an aquired form of enamel hypocalcification. The TOXIC effect of fluorine is not sufficient enough to injure the ameloblasts, but the matrix formed by these ameloblasts doesn't mature completely.

Back 84

fluorosis

Front 85

__________ is a hereditary form of enamel hypoplasia. Ranges from minor effects to complete absence of enamel.

Back 85

amelogenesis imperfecta

Front 86

____________ is when dentin doesn't form completely, pearl color.

Back 86

dentinogenesis imperfecta

Front 87

______________ is cervical stress resulting from plunger cusp or occlusal load of trauma.

Back 87

abfraction

Front 88

What starts are white spot lesions and can be reveresed?

Back 88

cervical carries

Front 89

What is the ideal molar relationship? (normal occlusion)

Back 89

MB cusp of max 1st molar occludes w/ B groove of man 1st molar

Front 90

What causes funny taste in mouth due to draining the in the mouth?

Back 90

sinus tract

Front 91

Name the 3 types of facial profiles / malocclusions :

Back 91

1. retrognathic (over bite)

2. mesognathic (normal)

3. prognathic (either over jet or under bite?) -check

Front 92

Class 1 malocclusion is knows as -

Back 92

neutroclusion

Front 93

Class 2 is known as what?

What are the 2 divisions?

Back 93

1. Distocclusion (BG is distal to MB cusp)

2. division 1 = max incisors protrude (could see spaces b/t teeth)

division 2 = 1 or more max incisors retruded

Front 94

Class 3 is known as what?

Describe class 3 -

Back 94

1. mesiocclusion

2. B groove of man 1st molar is mesial to MB cusp of max 1st molar

Front 95

What else is class 3 mesiocclusion is also known as?

Back 95

angles classification

Front 96

Classifications of overbite:

1. normal =

2. moderate =

3. severe =

Back 96

1. max incisal edges are w/ in incisal 3rd of man

2. incisal edges of max are w/ in middle 3rd of man

3. insical edges of max are w/in cervical 3rd of man

Front 97

What is posterior crossbite?

Back 97

max/man posterior teeth are either facial or lingual to their normal position.

Front 98

overbite =

Back 98

vertical dimension (1-3 mm normal)

Front 99

overjet =

Back 99

horizontal dimension, when max incisors are labial to the man incisors.

Front 100

Terminal step =

Back 100

good relationship (what you want)

Front 101

Terminal plane =

Back 101

not so good relationship

Front 102

2 types of occlusal contacts -

Back 102

1. functional

2. parafunctional

Front 103

parafunctional =

Back 103

outside normal range of occlusion

Front 104

2 types of proximal contacts :

Back 104

1. drifting

2. pathologic migration

Front 105

drifting =

Back 105

teeth have tendency to move in mesial direction

Front 106

pathologic migration =

Back 106

drifting from bone loss or caries, contacts aren't where they used to be.

Front 107

2 types of trauma occlusion =

Back 107

1. primary trauma (excessive forces)

2. secondary trauma (relation to inflammatory factors - bone loss)

Front 108

4 methods of application of excess pressure -

Back 108

1. individual teeth touch before closure

2. 2/few teeth in contact during movement of jaw

3. heavy forces not in vertical/axial direction (could be horizontal or oblique force)

4. increased frequency, intensity, duration of contacts

Front 109

Anterior crossbite?

Back 109

max anterior teeth are lingual to man anterior teeth (occurs in angle's class 3 malocclusion)

Front 110

Edge to edge bite?

Back 110

incisal surfaces occlude

Front 111

end to end bite?

Back 111

molars in cusp-to-cusp occlusion

Front 112

Underjet?

Back 112

max incisors are lingual to man incisors (horizontal dimension)

Front 113

Open bite?

Back 113

lack of incisal contact, posterior teeth in normal occlusion.

Front 114

Deep (severe) anterior overbite?

Back 114

incisal edge of max is at cervical 3rd level of facial surface of man anterior tooth.