Theory II Exam 3
Know what three things we are looking at for intraoral examinations on a patient with dentures
Monitoring of palatal tissues for signs of lesions
Monitoring of edentulous ridge for mucosal lesions
Denture induced oral lesions
How far the denture goes back inside of the patients mouth
Know what three type of fungi and bacteria can accumulate on dentures with biofilm
Actinobacteria
Bacilli
79% showing candida
Herpes Simplex
In stomatitis, denture biofilm contains candida albicans with what two higher level viruses?
Prevotella
Veillonella
Herpes Simplex
Lactobacilli
What are three things a new denture wearer experience?
Hypersalivation
Trouble with cheweing
Adaption and adjustment to the new denture
The desire to have their original teeth back
True or false? Each patient is different and progress in adjusting to new dentures and it takes time for adjustment
True
False
What are four things that you can educate your patient on regarding a new pair of dentures
The use of the denture
The limitations of the denture
The function of the denture
Try eating softer food at first
The price and how expensive they are going to be
Fixed partial dentures are known as?
Bridges
Abutment
Connectors
Pontics
Bridges can be created using what?
Metals
Ceramics
Both!
What are implant supported dentures?
Most often the endosseous (Endosteal) implant is used to support fixed partial dentures and overdentures
Dentures that can easily support another pair over top
Which of the following are three natural tooth supported dentures?
Traditional
Cantileveler
Resin retained
Temporary
What best describes traditional/bilateral fixed partial denture?
Supported by one or more natural teeth at each end.
Wing-like extensions are bonded with resin cement to etched enamel. Requires minimal or no preparation for tooth structure. Also called a Maryland Bridge.
Pontic supported by one or more teeth at one end only.
What best describes a Cantilever partial denture?
Pontic supported by one or more teeth at one end only.
Wing-like extensions are bonded with resin cement to etched enamel. Requires minimal or no preparation for tooth structure. Also called a Maryland Bridge.
Supported by one or more natural teeth at each end.
What best describes a Resin retained partial denture?
Wing-like extensions are bonded with resin cement to etched enamel. Requires minimal or no preparation for tooth structure. Also called a Maryland Bridge.
Supported by one or more natural teeth at each end.
Pontic supported by one or more teeth at one end only.
What are five characteristics of Fixed Partial dentures?
Biologically and esthetically harmonious with the teeth and surrounding periodontium.
All parts accessible for cleaning by the patient and the dental professional.
Does not interfere with the cleaning regimen for the remaining natural dentition.
Does not traumatize oral tissues.
Restores function of the missing tooth or teeth
It fits snuggly and remains on the patient for the entirety of their lifespan
What is an obturator?
A prosthesis designed to close a congenital or acquired opening, such as a cleft of the hard palate
A small box like compartment that can be used to place a dneture inside
Which fluoride is contrainidcated for porcelain and composite restorations?
Acidulated fluoride
Stannous fluoride
What does a hypochlorite solution (household bleach?) useful with denture immersions?
Denture cleansers with a hypochlorite solution are effective at destroying pathogens but can damage the removable partial if soaked longer for 10 minutes. Its's best to immerse the RPD with water and a cleaning solution.
It stains and permanently damages the denture if applied
What is a complete overdenture?
An overdenture is a complete denture supported by both retained natural teeth and/or implants and the soft tissue of the residual alveolar ridge.
A denture that covers up the original as a form of protection
When would complete overdentures be viable choices?
When the clinical crowns of a patient are not restorable.
When the patient is completely edentulous
True or false? The pain of hypersensitivity does not subsides when the stimulus is removed.
False
True
What are six diagnostic techniques/tests that can be used for hypersensitivity?
Visual assessment of tooth and surrounding tissue
Palpation of extra and intraoral soft tissue
Radiographic assessment, looking for any vertical tooth fractures or irregularities surrounding the teeth
Mobility testing
Transillumination with a high intesnity light
Evaluation of nasal congestion or sinus drainage
The amount of bleeding that occurs on the gigniva
True or false? Chewing pain can indicate pulpal paing and Pulpal pain is more sever and throbbing
True
False
True or false? It is difficult to distinguish between pain of hypersensitivity and other causes of dental pain when both are in the mild to moderate range
True
False
Why would management of hypersensitivity be difficult?
Historically, a vast array of treatment approaches have been utilized with varying degrees of success; no one best method has been identified due to lack of quality randomized controlled trial data, difficulties inherent in dentin hypersensitivity research design, and a significant placebo effect.
It's not, because all stmuli and pain are correlated
What five stimuli can elicit a pain reaction in individuals with hypersensitivity?
Tactile: Contact with toothbrush and other oral hygiene devices
Thermal: Temperature change such as cold beverage or cold air
Evaporative: Dehydration of oral fluid from drying the teeth
Osmotic: Alteraion of pressure in the dentinal tubules through a selective membrane
Chemical: Acid in food and fruits
Hemorages: Bleeding from the gingiva
What best describes Attrition?
Teeth to teeth wear
Wedge shaped cervical lesion caused by latera/ occlusal stresses of tooth flexure from bruxing
Tooth brush wear
What best describes Abfraction?
Wedge shaped cervical lesion caused by latera/ occlusal stresses of tooth flexure from bruxing
Teeth to teeth wear
Tooth brush wear
What best describes Abrasion?
Tooth brush wear
Wedge shaped cervical lesion caused by latera/ occlusal stresses of tooth flexure from bruxing
Teeth to teeth wear
What is the hydrodynamic theory?
Is a currently accepted explanation for transmission of stimuli from the outer surface of the dentin to the pulp. Fluid movement creates pressure on the nerve endings within the dentinal tubule, which transmits the pain impulse by stimulating the nerves in the pulp.
It is a theory that spongebob can go faster in water thanks to the use of the holes surrounding his body
What happens to dentinal tubules in the presence of biofilm
Dentinal tubule orifices increase to three times the original size. With reestablishment of biofilm control measures, there is a 20 percent decrease in size.
The begin to shrink down on account of the invading pathogens
What is the identifying characteristics of dentin hypersensitivity?
A definitive characteristic associated with dentinal hypersensitivity is pain elicited by a stimuls and alleviated upon its removal
A definitive characteristic is overall mobility of the tooth along the bone surface
What does VRS stand for?
The verbal rating scale, It quantifies and records the baseline pain intensity using objective measures such as the visual analog scale (VAS) and or the verbal raing scale (VRS)
The Venus Rectal scaling
What are 10 contributing factors for gingival recession?
Effects of improper oral self care
An anatomically narrow zone of attached gingiva is more susceptible to abrasion
Facial orientation of one or more teeth
Tight and short labial or buccal frenum attachement that pulls the gingiva
Scaling and root debridement
Subgingival instrumentation
Periodontal surgery
Apical tissue alteration on account of periodontal disease
Restorative procedures
Metal jewelry used in an oral piercing of the lip or tongue
Parahabits such as stretching out the mouth
What can exacerbate a pain response?
Stress
Smoking
Alcohol
Temperature
Which two factors contribute to a loss of tooth enamel and cementum, causing sensitivity?
Cementum at the cervical area is thin and easily abrades when exposed
Enamel and cementum do not meet at the cementoenamel junction in about 5-10% of teeth, leaving an area of exposed dentin.
Healthy upkeep with the use of fluoride products
What four mechanisms promote desensitization naturally over time?
Sclerosis of dentin
Secondary dentin
Smear layer
Calculus
Fluoride toothpaste
Potassium nitrate dentrifice
Which best describes a Subperiosteal implant?
Custom-fabricated framework of metal that rests over the bone of the mandible or maxilla, under the periosteum
An implant placed within the bone to replace a single tooth or provide support for the replacement of complete or partial loss of teeth.
A dental implant that penetrates both cortical plates and passes through the full thickness of the alveolar bone. Also known as a mandibular staple implant or staple bone implant
Which best describes a Transosseous implant?
A dental implant that penetrates both cortical plates and passes through the full thickness of the alveolar bone. Also known as a mandibular staple implant or staple bone implant
An implant placed within the bone to replace a single tooth or provide support for the replacement of complete or partial loss of teeth.
Custom-fabricated framework of metal that rests over the bone of the mandible or maxilla, under the periosteum
Which best describes a Endosseous implant?
An implant placed within the bone to replace a single tooth or provide support for the replacement of complete or partial loss of teeth.
Custom-fabricated framework of metal that rests over the bone of the mandible or maxilla, under the periosteum
A dental implant that penetrates both cortical plates and passes through the full thickness of the alveolar bone. Also known as a mandibular staple implant or staple bone implant
Which dental implant is commonly used?
Endosseous (root form)
Transosseous
Subperiosteal
What materials make up a Subperiosteal implant?
Titanium or Vitallium (cobalt–chromium–molybdenum).
Primarily sandblasted and acid-etched titanium or titanium alloy (Ti-6Al-4V)
Stainless steel, ceramic-coated materials, and titanium alloy.
What materials make up a Transosseous implant?
Stainless steel, ceramic-coated materials, and titanium alloy.
Primarily sandblasted and acid-etched titanium or titanium alloy (Ti-6Al-4V)
Titanium or Vitallium (cobalt–chromium–molybdenum).
What materials make up a Endosseous implant?
Primarily sandblasted and acid-etched titanium or titanium alloy (Ti-6Al-4V)
Titanium or Vitallium (cobalt–chromium–molybdenum).
Stainless steel, ceramic-coated materials, and titanium alloy.
What does osseointegration mean?
Successful tooth replacement is accomplished by osseointegration, which means direct bone anchorage to an implant body.
It means that something has fused into the bone of a body part
What four interdental implements are recommended for patients with implants?
Interdental brushes with nylon-coated wires
A floss threader
A water flosser or air flosser
The end tufted brush with soft filaments
Normal floss would work just fine
What are three ideal ways to remove calculus from implants?
Specialized implant-specific instruments typically made of plastic are indicated for hard deposits remaining after soft deposit removal
Implant-specific plastic-covered ultrasonic tips and inserts
Current implant-specific instruments mimic traditional universal curettes and sickle scalers in design.
Simply use a standard polishing set with abrasive prophy paste
What are six risk factors for implant failure?
Periodontal disease
Alcohol abuse
Poorly controlled diabetes mellitus
Tobacco usage
Osteoporosis
Anticoagulant medication use
GERD
How does bone density play a role in planning for dental placement? (2)
It determines the time frame for integration of the implant
It determines the window of time for prosthetic loading
It shows how much of a risk the patient is of obtaining osteoporosis
True or false? Implants do not preserve surrounding bone through function
False
True
How does smoking affect implants?
The development of peri-implant disease is closely related to the host response to the microbiome composition.
It makes it so that the implant won't fit because of the gingiva shrinking incredibly small
What best describes mild intellectual disorder?
IQ approximate range 50-69 (in adults, mental age from 9 to under 12 years). Slower in acquisition and comprehension of complex language, academic, social, and daily living skills.
IQ under 20 (adult mental age below 3 years). Severe limitation in self-care, continence, communication, and mobility. Close supervision is necessary
IQ approximate range 35-49 (adult mental age from 6 to under 9 years). A marked developmental delay occurs in the early years; child can be trained in personal care and hygiene with moderate support. Capacity for language and academic skills is limited to basic skills and they may not learn to read and write.
IQ approximate range 20-34 (adult mental age from 3 to under 6 years). Very limited language and communication skills. Limited capacity for academic skills. Motor impairments require daily support in a supervised setting
What best describes moderate intellectual disorder?
IQ approximate range 35-49 (adult mental age from 6 to under 9 years). A marked developmental delay occurs in the early years; child can be trained in personal care and hygiene with moderate support. Capacity for language and academic skills is limited to basic skills and they may not learn to read and write.
IQ under 20 (adult mental age below 3 years). Severe limitation in self-care, continence, communication, and mobility. Close supervision is necessary
IQ approximate range 50-69 (in adults, mental age from 9 to under 12 years). Slower in acquisition and comprehension of complex language, academic, social, and daily living skills.
IQ approximate range 20-34 (adult mental age from 3 to under 6 years). Very limited language and communication skills. Limited capacity for academic skills. Motor impairments require daily support in a supervised setting
What best describes severe intellectual disorder?
IQ approximate range 20-34 (adult mental age from 3 to under 6 years). Very limited language and communication skills. Limited capacity for academic skills. Motor impairments require daily support in a supervised setting
IQ under 20 (adult mental age below 3 years). Severe limitation in self-care, continence, communication, and mobility. Close supervision is necessary
IQ approximate range 50-69 (in adults, mental age from 9 to under 12 years). Slower in acquisition and comprehension of complex language, academic, social, and daily living skills.
IQ approximate range 35-49 (adult mental age from 6 to under 9 years). A marked developmental delay occurs in the early years; child can be trained in personal care and hygiene with moderate support. Capacity for language and academic skills is limited to basic skills and they may not learn to read and write.
What best describes Profound intellectual disorder?
IQ under 20 (adult mental age below 3 years). Severe limitation in self-care, continence, communication, and mobility. Close supervision is necessary
IQ approximate range 50-69 (in adults, mental age from 9 to under 12 years). Slower in acquisition and comprehension of complex language, academic, social, and daily living skills.
IQ approximate range 20-34 (adult mental age from 3 to under 6 years). Very limited language and communication skills. Limited capacity for academic skills. Motor impairments require daily support in a supervised setting
IQ approximate range 35-49 (adult mental age from 6 to under 9 years). A marked developmental delay occurs in the early years; child can be trained in personal care and hygiene with moderate support. Capacity for language and academic skills is limited to basic skills and they may not learn to read and write.
What best describes a provisional intellectual disorder?
Evidence of intelectual disorder but individual is an infant under 4 and not possible to conduct assessment.
A collection of conceptual, social, practical skiull that all people learn in order to function in their daily life. It's a learnt behavior that reflects an individuals social and practical competence to meet demands of daily living.
What best describes an unspecified intellectual disorder?
Cannot be tested due to lack of cooperation or severe impairment
Evidence of intelectual disorder but individual is an infant under 4 and not possible to conduct assessment.
What are five risk factors for intellectual disorders?
Level of functioning
Medication induced xerostomia
Ability to perform dental care
Use of sugary treats as rewards
GERD
Intensive exertion of motion
What are seven prenatal risk factors for autism?
Advanced maternal or paternal age greater than 35
Mother or father is white or asian
Maternal and paternal education level beyond college graduate
Gestational diabetes
Gestational hypertension
Antepartum hemorrhage
Threatened miscarriage
Overmedication of the mother with birth control
What are six perinatal risk factors for autism?
Cesarean delivery
Gestational age less than or equal to 36 weeks
Breech birth
Preeclampsia
Fetal distress
Induced labor
Abortion tactics
Overdose of pregnancy drugs
What are four postnatal risk factor for autism?
Low birth weight
Postpartum hemmorrhage
Male gender
Brain anomaly
Hermaphroditism
Body malformation
What is one main thing to notice about dental caries incidence in intellectual disorder population vs general population?
Research on the caries rates of those with intellectual disorders do not agree and at this time evidence suggests the risk for caries is similar to the general population. However, the rate of untreated caries is higher with more missing permanent teeth due to caries.
Currently, research on the caries rates of those with intellectual disorders do agree and at this time evidence suggests the risk for caries is not similar to the general population. However, the rate of untreated caries is higher with more missing permanent teeth due to caries.
What is adaptive behavior?
A collection of conceptual, social, practical skiull that all people learn in order to function in their daily life. It's a learnt behavior that reflects an individuals social and practical competence to meet demands of daily living.
Evidence of intelectual disorder but individual is an infant under 4 and not possible to conduct assessment.
What are some common oral features in down syndrome patients?
Mouth breathing
Severe eriodontal infections
Poor oral hygiene
Bruxism
Xerostomia
Sinus shrinkage
What is the autism specturm disorder?
A complex spectrum of developmental disorders marked by limitations in the ability to understand and communicate.
A spectrum of intensity showing just how inflicted an individual is with autism
What group does autism affect more frequently?
Males
Females
What is the purpose of cognitive behavioral therapy for people with autism?
It helps people with autism lead a more normal life by decreasing anxiety and increasing their ability to respond to everyday stimuli with appropriate coping mechanisms
It allows peers and parents of autism to get a better understanding of them as well as give directives in order to assimilate them better towards self care
What is the most common inherited cause of intellectual disorder and occurs in 1 to 5000 males
Fragile X syndrome
Down Syndrome
Autism
ADHD
True or false? X syndrome is NOT the most common single gene cause of autism spectrum disorder
False
True
What are four physical characteristics of Fragile X syndrome?
Prominent forehead
Narrow, long face
Protruding ears
Connective tissue dysplasia resulting in hyperflexibilty of joints
Abnormally large face
Thick neck
True or false? Regarding Fragile X syndrome, Girls are often carriers, carry the gene on one X chromosome, but will not exhibit the characteristics unless both X chromosomes are affected.
True
False
What are seven cognitive characteristics for Fragile X syndrome?
Hyperactivity disorder.
Intellectual disorders.
Autism spectrum disorder.
Limitations in executive function which controls aspects of behavior such as
Weaknesses in short-term and working memory limit the ability to retain and
Difficulty with visual-motor coordination which means they may have trouble with motor skills like toothbrushing.
Relative strengths include verbal reasoning (ability to understand and logically work through problems) and simultaneous processing (ability to see the big picture and understand relationships)
Intense long term memory and recalling of past events or directions
What is the other term for Down Syndrome?
Trisomy 21
Trisomy 13
Klinefelter syndrome
Chrubism
What are five basic characteristics of autism?
The onset of autism is typically before age 3 and some parents may notice signs in the first year of life.
Impairment in nonverbal communication for social interaction (e.g., eye-to-eye gaze, facial expression, gestures
Lack of social or emotional reciprocity or inability to initiate and respond to social interaction.
Deficit in developing, maintaining, and understanding peer relationships appropriate for the developmental level
Severity designation is based on the level of communication impairments and behavior patterns
Being openly social and open to fellow compatrions
One characteristic of autism is restricted interests and repetitive behaviors manifested by two of the following four. Which four are the TRUE ones?
Highly restricted patterns of interest that are abnormal in intensity or focus.
Insistence on sameness or inflexible adherence to routines or rituals
Repetitive body movements, use of objects, or speech.
Hyper- or hyporeactivity to sensory input
The willingness to try new things without worry
Being flexible with new changes that occur over time.
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