Describe and give examples for other components of anxiety
• PHYSICAL:
- Increase HR, BP, Sweating
• COGNITIVE:
- Lack of control, intellectual
• BEHAVIOURAL:
- Tension, Fear, Insomnia
• EMOTIONAL:
- Crying, feeling, tension
4 Implications of anxiety - dentistry related
- No Treatment
- Delay in treatment
- Leading to more restorative work
- Poor oral health related QoL
4 Symptoms/Signs of dental abscess
- Pain
- Pressure
- Red mucosa
- Swelling
- Pus drainage
- Malaise & Lymphadenopathy
Difference between Lateral and Periapical abscess
PERIAPICAL:
- Tooth Non-Vital
- Acute TTP
- Pus in tissues
- Radiograph shows apical change and may show cavity near pulp
LATERAL PERIODONTAL ABSCESS:
- Deep pocket
- Vital pocket
- Tooth may be extruded
- Radiograph confirms bone loss
10 stages of placing a fissure sealant
- Clean tooth with pumice
- Dry tooth
- Use saliva ejector/cotton wool rolls/dry guard
- Acid etch using phosphoric acid 37%
- Wash etch off after 15s
- Change cotton wool and dry tooth again
- Place sealant
- Use probe to get rid of air bubbles and make sure it extends to all fissures especially buccal on molars
- Light cure 30s
- Check with probe
- Check occlusion and adjust if necessary
Success rate in 4 years of FS
- 60% success against caries
* 52% retention in 4 years
Evidence to support it and what type
- Cochrane review - DBOH - Evidence type 1
- Systematic review
- RCT
Two ways to protect occlusal surface
- Applying F varnish
- Bite guard
- Pre-formed metal crown
4 types of rein sealants
- Helioseal - opaque
- Heliobond - clear
- Fluroshield
- Ultraseal
- Bis-GMA
- RMGIC
Why composite may be preferred over GIC
- Anterior teeth - class IV - aesthetics
- Cuspal build up (high occlusal load)
- Interim restorations
- Definitive restoration after endo treatment
- Temporary crown & repairing protemp
- Direct/Indirect veneer
- Adhere ortho bracket onto teeth
3 instruments to adjust and polish composite
- Diamond burs - fine diamond and tc
- Soflex discs
- Greenies/brownies
- White stones
- Diamond polish paste
Uses of GIC
- Sealing endo access cavity intervisit
- Temporary restoaration
- Fissure sealant in children
- Permanent restoration in primary teeth
- Luting agent - cement
- Class V restoration due to moisture control
- Erosion & abrasion lesions
Types of bonding systems
• Type 1:
etch + prime + bond (Allbond)
• Type 2:
etch + prime & bond (scotchbond 1)
• Type 3:
etch & prime + bond
(cleafill se)
• Type 4:
All in one (xeno iii)
phosphoric acid 37%
Composite to metal bonding
- Silica coating
- Tin-plating
- Metal primer
- Put silica coating ontop of metal
- Put silane coupling agent ontop
- Place unfilled resin
- Then composite resin
3 materials used in ceramics
- Feldspathic glasses
- Leucite reinforced glass ceramics
- Lithium disilicate glass ceramics
- Zirconia
- Alumina
Patient comes in with loose crown - after taking hx and exam how to manage pt.
- Take silicone putty
- Check prep (adequate reduction)
- Check loose crown to see any sharp edges or margin problems
- Provide temporary crown
What reasons may have the crown fallen off?
- Poor cementation technique
- Poor preparation (underpreppared)
- Heavy occlusion
- Trauma
- Wear and tear
Temporary crowns for posterior teeth
- Stainless steel
- Aluminium
- Bisacryl composite - protemp
- Cold-cure acrylic (SNAP)
Functions of a temporary crown
- maintain aesthetics
- better plaque control
- protect preparation
- identify any underprepared areas or undercuts
- maintain occlusion
- protect dentine & pulp
- prevent drifting
3 types of anterior crowns
- PFM
- High strength core substructure - all ceramic
- Resin bonded crown
Structure and dimension on aesthetic properties
PFM - Metal substructure makes it opaque but increases strength
- 0.5 - 0.7mm palatal chamfer
- 1.2 - 1.5mm buccal shoulder
High strength core substructure in all ceramic:
- good aesthetics and high strength but destructive prep and poor marginal fit:
• 1.2-1.5mm chamfer, occlusal 2.0
Resin bonded all ceramic crown:
- Good aesthetics and good marginal prep but has semi-translucent core. 0.5mm chamfer (most conservative)
Dentine bonding agent precautions
- Dessiccation
- Irrigation of pulp
- Allegies
- Moisture control
- Light curing
- Etching beforehand
Effects of dummy sucking
- Reduced overbite
- anterior open bite
- proclined upper incisors
- retroclined lower incisors
Advice to mother in longterm
- If habit not stopped by 8-9 then can have effect on permanent dentition
