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Operative Dentistry Viva ques

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Operative Dentistry Viva ques

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Operative Dentistry Viva questions. To help you revise your syllabus for examination.
If you found it helpful, please leave a feedback.
Thank You,
Dr. Almas Muhammad Arshad
Dr. Muaaz Amjad

Operative Dentistry Viva questions. To help you revise your syllabus for examination.
If you found it helpful, please leave a feedback.
Thank You,
Dr. Almas Muhammad Arshad
Dr. Muaaz Amjad

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Operative Dentistry Viva ques

  1. 1. Dr. Muaaz Amjad Awan Dr. Almas M Arshad UCD, UOL (PAKISTAN)
  2. 2. • Pulp capping agent • Intracanal medicament • Canal sealer • Antimicrobial properties • Ph 12.5 strongly alkaline • Types: • Setting • Non - Setting (Intra-canal)
  3. 3. Composition: 1- Tricalcium Silicate 2- Tricalcium Aluminate BOSA 3- Tricalcium Oxide 4- Bismuth oxide 5- Tetracalcium Silicate (Grey MTA) USES: 1-Pulp capping Agent 2- Root end filling after apicectomy 3- In Internal and external root resorption 4- Lateral perforation sealing 5- Root canal sealer
  4. 4. • In the crown: o Temporary enamel restoration o Permanent dentin restoration o Deep or large carious lesions o Deep cervical or radicular lesions o Pulp capping o Pulpotomy….. • In the root: o root and furcation perforations o internal/external resorptions o Apexification o Retrograde surgical filling.
  5. 5. ZnO 75% Gutta percha 25% Types: • Standardized type: follows same ISO classification as endodontic files • Non-standardized: have a greater taper than the standard ISO type
  6. 6. Use: Root canal Irrigant Root canal Medicament Advantages: broad spectrum antimicrobial properties 2% equals to 5% NAOCL in sense of antibacterial action synergic affect when used with NAOCL Disadvantage: can’t dissolve orgainc and inorganic components of pulp
  7. 7. • Chlorohexidine • Sodium hypochloride • EDTA (also decalcifying agent)
  8. 8. • Sodium Hypocholorite (5 – 35%) • Sodium Perborate – Walking bleach • Carbamide peroxide
  9. 9. • Components : • Bacteria: • Streptococcus mutans • Peptostreptococcus • P gingivalus • Fusobacterium • P denticola • P Forshytia
  10. 10. • Prevents Hypocholorite accident
  11. 11. • K FILE: • triangular or square cross section •Advantages: • More flexible and don’t fracture •Disadvantages: 1- Less cutting efficiency 2- Extrusion of debris periapically • H FILE: • has flutes that resemble successive triangles.. • Advantage: They have superior cutting efficiency • Disadvantage is they are not flexible and fracture easily
  12. 12. • Used to extirpate PULP • Removal of cotton and paper points
  13. 13. • Small flame shaped • Used in conventional hand piece • Used for : 1- enlarging canal orifice (/coronal 3rd) 2- to remove lingual shoulder in Anteriors
  14. 14. • To remove GP during post preparation • Small flame-shaped cutting instrument • used in the conventional handpiece
  15. 15. • Small flexible instrument • Placement of material into the canal • Fits into the conventional slow handpiece
  16. 16. • Loss of working length • Ledging and stripping • Perforations
  17. 17. • ZIP: Apical portion transportation of a canal • ELBOW: Rotating the instrument in curved canal can produce a biomechanical defect. How to avoid these 1- never rotate instrument in curved canal 2- Always pre curve the small size instruments
  18. 18. Requirements: Good adhessivness Biocompaitability Slow setting time Easy manipulation Less solubility Types: 1- zinc oxide eugenol bases 2- Plastics: epoxy based 3- Calcium hydroxide 4- glass Inomers
  19. 19. Returning to smaller num file time to time before advancing to a larger file.
  20. 20. • Tofflemire Universal • Ivory Bands • Pilodent – for composites • Automatrix – difficuilt to contour
  21. 21. • When the tooth structure is prepared with a bur or instruments, residual organic and inorganic components form a smear layer that is composed of hydroxyapatite and denatured collagen. • When primer and bonding agent are applied on the etched dentin they form resin-dentin interdiffusion zone called hybrid layer.
  22. 22. • Etching with 35% Phosphoric acid • EDTA
  23. 23. 1. Cold Lateral 2. Warm vertical 3. Thermoplastisized GP inj 4. Chemically Plasticized GP 5. McSpadden thermomechanical GP 6. Continuous wave compaction 7. Carrier based GP 8. Custom cone
  24. 24. • Maxillary 1st Molar • MB (MB1 MB2), DB, Palatal • Mandibular 1st Molar • MB (MB1 MB2), DB
  25. 25. • Should have a continuous tapering, conical shape, with the narrowest cross-sectional diameter apically and the widest diameter coronally. • The walls should taper evenly towards the apex and should be confluent with the access cavity. • To give the prepared root canal the "quality of flow;' i.e, a shape that permits plasticized gutta-percha to flow against the walls without impedance. • Should keep the apical foramen as small as practical. • Should clean and shape the canal without transporting the apical foramen.
  26. 26. • Iodoform paste – (zinc oxide and iodoform mixture) – bactericidal and nonirritant • ZnO Eugenol paste (without catalyst) why catalyst not used… > to increase working time…….. • Material should be resorbable, nonirritant and radioopaque. • Why GP not used? – Not degraded
  27. 27. • Abutment for space maintainer • Bruxism • Caries involving 3 or more surfaces • Developmental defects like Dentinogenesis imperfecta and enamel hypoplasia • Extensive caries in class 2 involving cusps • Following pulp therapy to avoid fracture of weekend tooth • Handicapped children
  28. 28. • Stain less steel crowns • Nickel based crowns (ni-chromium 3M)
  29. 29. • The process of inducing the development of root and apex closure in an immature permanent tooth with open apex. • Calcific Root-End closure. • Types: 1. Multiple Step(CaOH) 2. Single Step (MTA)
  30. 30. • Physiological process • Formation of apex in vital young permanent tooth with appropriate vital pulp therapy • MAINTAIN PULP VITALITY • Includes : 1- Direct pulp capping 2- Indirect pulp capping 3- Pulpotomy/Partial Pulpotomy
  31. 31. • Since gallium amalgam expands after trituration, it provides better marginal seal than silver amalgam…. • Setting time is less than silver mercury amalgam, therefore can be finished and polished after one hour.. • Most of the physical and mechanical properties of gallium alloy are similar to high copper mercury amalgam. So better marginal seal, less setting time and same mechanical properties………
  32. 32. • A ferrule, is defined as a circumferential area of axial dentin superior to preparation bevel should have a height of 1.5mm to 2.5mm
  33. 33. •Vertical → Extraction •Horizontal: • Coronal 3rd  Immobilization + Splinting (4weeks) • Middle 3rd  RCT of coronal segment +/- removal of apical segment • Apical 3rd  Reposition  Radiograph Splint (4-6weeks)
  34. 34. • Leave the tooth in place • Clean with saline and chlorohexidiene • Suture the lacerated gingiva • Determine position of the tooth both clinically and radiographically. • Apply a flexible splint for 2 weeks • Antibiotics adminstration for 7 days • Initiate root canal in transplanted tooth after 10 days with closed apex • Open apex in growing children can be waited for pulp revasculrization and in adult cases open apex closed with MTA
  35. 35. • Apply local anesthesia • Rinse the area with saline or chlorohexidine • Reposition the tooth using digital pressure or forcep. • Reposition the displaced bone both facially and lingually • Suture the gingiva if lacerated • Splint with wire or acrylic for 4 months.
  36. 36. • BV Rupture → Blood into Dentin → Breakdown of blood (Hemin, Hematin, Hemosiderin) → Pinkish brown discoloration
  37. 37. • Concentration: 5% NaF • When to apply?
  38. 38. • Radiographic Apex : Apex of tooth determined radiographically • Anatomic Apex: apex of tooth determined morphologically. At the CDJ. • Difference can be 1.5 – 3 mm because of cementum deposition with age.
  39. 39. • From a Coronal refrence point to the point where cleaning and shaping or obturation ends • Refrence point: – Anteriors → Incisal Edge – Anteriors with broken edges → Smoothen the edge – Posteriors → Cusp Tip
  40. 40. Pulp sensibility Test MOA: Ionic shift in the dentinal tubules  Local depolariztion in Delta A fibers Tells if the tooth is Vital or Non-Vital
  41. 41. • False Positive ➢ Gangrenous necrotic pulp ➢ Partially necortic pulp in multi-rooted • False Negative ➢ Recent Trauma ➢ Extensive pulpal calcification ➢ Fibrotic pulp ➢ Extensive restorations with base ➢ Pt on sedatives
  42. 42. 1. Zinc phosphate 2. GIC 3. RMGIC 4. Dual cured resin cement 5. Light cured composite cement 6. Polycarboxylate 7. Conventional cement
  43. 43. Based on Shape (Parallel, Tapered, Parallel and Tapered) Based on surface characteristic ( Active, Passive) Based on Method of fabrication: • Custom • PreFabricated (Metal, Zirconia, Fiber-post) Which one causes most internal stresses..+ Fracture : Metal, Active, Tapered
  44. 44. Tooth has incompletely cracked but no part of the tooth has yet broken off. Diagnosed with: Bite Test Biting on Tooth Sloth (Pain on releasing of biting force) Pain on biting  Symptomatic apical periodontitis
  45. 45. Conventional tooth prep: • Specific walls, floor, angulation. • Amalgum Modified: • Does not require specific wall forms, angulation, Walls and floor • Composite
  46. 46. Shape and form of cavity is such that it prevents the displacement or removal of restoration by tipping and lifting forces Occlusal covergence Adhesive systems Beveling/flaring cavity margin for composite
  47. 47. “Shape and placement of preparation walls and cavity is such that it enables to tooth structure AND THE RESTORATION to withstand the forces of mastication without getting fractured”  Box like cavity  Flat floor  Rounded line angles  Adequate thickness of material  Preservation of cusps and marginal ridges  Reduction of cusp for capping
  48. 48. • Macrofill (filler size upto 8um) • Microfill (0.01-0.04 micrometer) • Nanofill 0.007um • Hybrid type (0.4-1um) • Flowable (having lower filler content and hight matrix)………….
  49. 49. Resin : BISGMA/UDMA Filler: Silica Coupling agent: Silane Initiator : Camphorquinone
  50. 50. Powder: Flouroaluminosilicate Liquid : Polyacrylic acid
  51. 51. • Silver • Tin • Mercury • +/- Copper • Zinc - Setting Expansion • Pallidium etc
  52. 52. Primary Occlusal Convergence Secondary Pins Slots Retention Grooves (0.5mm into the dentin, axiolingual and axiobuccal walls) Coves Amalgum Bond
  53. 53. Hydrodyanamic Theory Stimulus (Hot/Cold/Sweet) → Movement of fluid in dentinal tubules → stimulation of Delta A fibers → PAIN PRECIEVED!!
  54. 54. Sharp pain → Delta A fibers (Fast Conducting/Myelinated) Dull, Continuous Pain → C - fibers
  55. 55. Treatment: RCT + Follow up Sinus Tract will heal on its own
  56. 56. 1.Bisecting Angle - Used in Endo a.Xray beam is at right angle to long axis of tooth 2.Parallex a.For curved roots in upper anteriors b.Not recomended for Endo though c.Superimposition of zygomatic process
  57. 57. • Right angle to the dentin surface • Vertical in the cuspal region • Deciduous  Horizontal cervically • Permenant  Oblique cervically

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