RCT WORKING LENGHT DETERMINATION

 Determining the working length is a crucial step in endodontic treatment to ensure proper cleaning, shaping, and obturation of the root canal space. The working length is the distance from a reference point to the point at which the root canal preparation and obturation should terminate. Here's a common method for determining the working length:

1. Radiographic Method:

• Preoperative Radiograph: Begin with a preoperative radiograph to assess the root canal anatomy, curvature, and length.
• Apical Foramen Identification: Using the radiograph, estimate the location of the apical foramen, which is the natural opening at the tip of the root.
• Apical Reference Point: Choose an apical reference point, often the tip of the root or the apex, and mark it on the radiograph.

2. Electronic Apex Locator:

• Introduction: Use an electronic apex locator, which is a device that measures the resistance or impedance of tissues to the passage of an electrical current.
• Probe Placement: Place the electronic probe in the access cavity and establish contact with the canal orifice.
• Measurement: The device provides an electronic measurement indicating the distance to the apical foramen. This is a valuable tool for determining working length accurately.

3. Clinical Measurement:

• Apical Stop: Utilize a hand file to establish an initial apical stop by gently inserting the file until resistance is felt at the apical foramen.
• Radiographic Confirmation: Confirm the file position radiographically to verify its proximity to the apical foramen.
• Working Length Adjustment: Adjust the working length based on the radiographic assessment, taking into account the apical constriction or desired apical terminus.

4. Combining Methods:

• Radiographic Verification: After using an electronic apex locator or clinical measurement, confirm the working length radiographically to ensure accuracy.
• Cone Fit Radiograph: Take a radiograph with a gutta-percha cone placed to the determined working length. Verify its position in relation to the apical foramen.

5. Reassessment during Instrumentation:

• Periodic Verification: Throughout the cleaning and shaping process, periodically verify the working length using radiographs and electronic apex locators.
• Adjustment as Needed: If necessary, make adjustments to the working length based on the progress of the instrumentation and the anatomical variations encountered.

Always consider the patient's clinical symptoms, radiographic findings, and electronic measurements collectively for an accurate determination of the working length. Regular reassessment during the treatment process helps ensure precision and successful endodontic therapy.

aetiology and pathogenesis of periodontal disease

Answer

Answer

Periodontal disease, commonly known as gum disease, has multifactorial causes involving both host and microbial factors.

Aetiology:

1. Dental Plaque: The primary cause is the accumulation of dental plaque, a biofilm of bacteria, on teeth. Plaque contains pathogens that trigger an inflammatory response.
2. Microorganisms: Certain bacteria, particularly pathogenic species like Porphyromonas gingivalis and Treponema denticola, play a key role in periodontal disease development.
3. Host Factors: Individual susceptibility is influenced by genetic, systemic health, and immune factors. Some people are more predisposed to developing periodontal disease.
4. Environmental Factors: Smoking, stress, and poor nutrition can contribute to the disease's onset and progression.

Pathogenesis:

1. Initiation: Plaque accumulation on teeth leads to the formation of calculus (tartar). This provides a surface for more bacteria to adhere to and initiates the inflammatory response.
2. Gingivitis: Initially, the inflammation is confined to the gingiva, causing redness, swelling, and bleeding. Gingivitis is reversible with good oral hygiene.
3. Periodontitis: If left untreated, gingivitis can progress to periodontitis. In this stage, the inflammation extends deeper, affecting the supporting structures of teeth, including the periodontal ligament and alveolar bone.
4. Tissue Destruction: Immune responses intended to eliminate bacteria can cause collateral damage, leading to breakdown of the connective tissues and bone around teeth. This results in pocket formation and tooth mobility.
5. Systemic Impact: Emerging research suggests a bidirectional relationship between periodontal disease and systemic conditions like cardiovascular diseases and diabetes.

Understanding both the causes and the process of periodontal disease is crucial for effective prevention and management. Regular dental care, proper oral hygiene, and addressing risk factors contribute to maintaining periodontal health.

Criteria that makes a disease a public health interest

 There are several criteria that can make a disease a public health concern. These include:

1. Severity: The disease must have significant consequences for the health of individuals and populations, such as high morbidity and mortality rates.
2. Communicability: The disease must be contagious and easily transmitted from person to person or from animals to humans.
3. Geographical distribution: The disease must be widespread, or have the potential to spread rapidly across different regions and countries.
4. Economic impact: The disease must have a significant economic impact on individuals, communities, and societies, including the cost of medical treatment, lost productivity, and other related expenses.
5. Social impact: The disease must have significant social consequences, such as stigmatization, discrimination, and social isolation.
6. Preventability and treatability: The disease must be preventable or treatable with available interventions such as vaccines, medications, or other health interventions.
7. Potential for outbreaks: The disease must have the potential to cause outbreaks or epidemics, which could pose a significant risk to public health.
8. Political and legal considerations: The disease may attract the attention of governments and international organizations, and may require coordinated efforts to address it through policies, laws, and regulations.

Overall, the criteria for determining whether a disease is of public health concern depend on a range of factors that may vary depending on the context and circumstances.

check the following on other related topics RESTORATIVE DENTISTRY

“PATH OF INSERTION” and “PATH OF REMOVAL” of a denture

 Define “PATH OF INSERTION” and “PATH OF REMOVAL” in a Removable cast partial denture. Discuss the factors affecting the same and the role Played by the surveyor.

Answer

Answer

Path of Insertion: The "path of insertion" in removable cast partial dentures refers to the direction in which the partial denture is placed or inserted into the patient's mouth. It is the route that the prosthesis follows as it moves from an initial point of contact with the abutment teeth to its final seated position.

Path of Removal: The "path of removal" is the opposite of the path of insertion. It is the direction in which the removable partial denture is removed from the patient's mouth. The path of removal is critical for the ease and comfort of inserting and removing the partial denture without causing damage to the oral structures.

Factors Affecting Path of Insertion and Removal:

1. Undercuts: The presence and location of undercuts on abutment teeth influence the path of insertion and removal.
2. Tooth Arrangement: The alignment and positioning of artificial teeth impact the path of insertion and removal.
3. Soft Tissue Contours: The shape of the surrounding soft tissues affects the path of the removable partial denture.
4. Gingival Architecture: The contours of the gingiva play a role in determining the ideal path of insertion and removal.
5. Alignment of Abutment Teeth: The alignment and angulation of abutment teeth influence the direction in which the partial denture can be inserted and removed.

Role of the Surveyor: A surveyor is a crucial tool in removable partial denture fabrication. It assists in analyzing the cast and identifying undercuts, guiding the design of the prosthesis. Here's how a surveyor contributes:

1. Undercut Identification: The surveyor helps locate and mark undercuts on abutment teeth. This information guides the design of rest seats and clasps.
2. Parallelism: It aids in achieving parallelism between guiding surfaces of abutment teeth. This is essential for a proper path of insertion and removal.
3. Guidance for Design: The surveyor serves as a guide for designing the framework of the removable partial denture. It assists in determining the most favorable path for insertion and removal based on the specific features of the patient's oral anatomy.
4. Precision in Design: By providing a stable platform for surveying, it ensures precision in the design of the partial denture components, enhancing the overall fit and functionality.

In summary, the path of insertion and removal in removable cast partial dentures is influenced by various factors, and the surveyor plays a crucial role in identifying undercuts, achieving parallelism, and guiding the precise design of the prosthesis for optimal function and patient comfort.

QUESTIONS IN RESTORATIVE DENTISTRY

 1. 6 factors to be considered for patient for RPD

2. Phases required for treatment of partially edentulous patient and explain it

3. Instruments for designing RPD

4. Application of a surveyor

5. Component of RPD

6. 3 Functions of each components

7. What is RPI

8. Describe it mechanisms of it action as it applied to it's indications in both Kennedy class i and ii RPI

9. List 7 principles of RPD designs

10. Briefly describe each principles

11. List 7 steps in the fabrication of metal framework for RPD

12. List 3 problems encountered during it tryin

13. What is the term altered cast technique mean

14. Describe how the procedure is carried out

15. Briefly describe 6 functional requirement of a clasp

16. Briefly describe 5 factors that affect flexibility of a clasp

17. List 6 factors govern the chance of a retentive clasp

Answer

1. Factors for RPD Patient Selection:

• Oral and periodontal health
• Patient's ability to maintain oral hygiene
• General health and cooperation
• Psychological considerations
• Financial considerations
• Anatomical factors such as ridge form and residual tooth support

2. Phases of Treatment for Partially Edentulous Patient:

• Assessment and Diagnosis: Evaluate oral health, patient history, and treatment needs.
• Treatment Planning: Develop a comprehensive plan considering patient factors and prosthesis design.
• Tooth Preparation: Modify teeth to accommodate components like rests and clasps.
• Impressions: Capture accurate impressions for cast models.
• Try-in: Evaluate fit and esthetics with a trial prosthesis.
• Delivery: Provide the final partial denture.

3. Instruments for Designing RPD:

• Surveyor
• Surveyor's dye
• Calipers
• Dividers
• Mouth mirror
• Periodontal probe

4. Application of a Surveyor:

• Guides the positioning of components during the design phase.
• Assesses and records undercuts in the cast.
• Aids in achieving parallelism of guiding surfaces.

5. Components of RPD:

• Major connector
• Minor connector
• Rest
• Direct retainer (clasp)
• Denture base

6. Functions of RPD Components:

• Major Connector: Connects and stabilizes various parts of the prosthesis.
• Minor Connector: Joins other components, providing support and rigidity.
• Rest: Distributes occlusal forces to supporting teeth.
• Direct Retainer (Clasp): Engages undercuts, offering retention.
• Denture Base: Supports artificial teeth and distributes occlusal loads.

7. RPI (Rest, Proximal Plate, I-bar):

• An RPI system is a modification in removable partial denture design.
• It combines a rest, proximal plate, and I-bar clasp.

8. Mechanisms of RPI Action:

• Class I (Kennedy I): The rest provides stability, the proximal plate resists rotational movement, and the I-bar clasp engages undercuts for retention.
• Class II (Kennedy II): Similar to Class I, but additional support is needed on the distal extension side.

9. Principles of RPD Design:

• Preservation of remaining teeth.
• Minimal tissue coverage.
• Effective distribution of occlusal forces.
• Proper use of direct retainers.
• Stability and support.
• Esthetics.
• Ease of maintenance.

10. Brief Description of Principles:

• Preservation of remaining teeth: Retain healthy teeth and distribute functional loads.
• Minimal tissue coverage: Preserve oral tissues, enhancing comfort.
• Effective distribution of occlusal forces: Prevent overloading of supporting structures.
• Proper use of direct retainers: Ensure secure retention without damaging abutment teeth.
• Stability and support: Enhance stability for functional efficiency.
• Esthetics: Consider appearance and patient satisfaction.
• Ease of maintenance: Facilitate oral hygiene and maintenance of the prosthesis.

11. Steps in Fabrication of Metal Framework for RPD:

• Framework design.
• Surveying and marking.
• Tooth preparation.
• Impression making.
• Framework try-in.
• Framework adjustment.
• Final framework fabrication.

12. Problems Encountered during Framework Try-in:

• Inadequate fit.
• Clasp interference.
• Occlusal discrepancies.

13. Altered Cast Technique:

• A method to compensate for processing changes in the cast framework.
• A duplicate cast is made after processing the wax pattern.

14. Procedure for Altered Cast Technique:

• Duplicate the cast after wax pattern processing.
• Pour duplicate cast with refractory material.
• Adjust the refractory cast to match the processed metal framework.
• Fabricate denture using the altered cast.

15. Functional Requirements of a Clasp:

• Retention.
• Stability.
• Reciprocation.
• Encirclement of tooth.
• Minimal interference with oral hygiene.
• Esthetic compatibility.

16. Factors Affecting Flexibility of a Clasp:

• Material type.
• Cross-sectional shape.
• Length of the clasp arm.
• Thickness of the clasp arm.
• Design of the clasp tip.

17. Factors Governing the Chance of a Retentive Clasp:

• Undercut depth.
• Location of the undercut.
• Retentive quality of the tooth surface.
• Flexibility of the clasp material.
• Design of the clasp.