p.8
Types of Electrosurgical Currents
What are the effects of a partially rectified, damped current on tissue?
It produces good coagulation and hemostasis but causes considerable tissue destruction and slow healing.
p.8
Types of Electrosurgical Currents
What are the characteristics of a fully rectified, filtered current?
It produces a continuous wave that offers excellent cutting and better initial healing compared to modulated waves.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What are two methods mentioned for stopping persistent bleeding?
Electrocoagulation and ferric sulfate.
p.8
Types of Electrosurgical Currents
Which type of current is better for enlarging the gingival sulcus?
A fully rectified (full-wave modulated) current.
p.9
Contraindications and Safety in Electrosurgery
Why is electrosurgery contraindicated for patients with pacemakers?
Electrosurgery can alter the normal function of a pacemaker and presents a hazard to the patient.
p.9
Electrosurgery in Gingival Management
What type of vacuum tip should be used during electrosurgery?
A high-volume plastic vacuum tip.
p.6
Mechanical and Chemicomechanical Gingival Retraction
How is ferric sulfate used to stop bleeding in the gingival sulcus?
A plain knitted cord is soaked in ferric sulfate and placed in the gingival sulcus for 3 minutes.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What are the three factors determining the suitability of gingiva for rotary curettage?
Absence of bleeding upon probing, sulcus depth less than 3.0 mm, and presence of adequate keratinized gingiva.
p.8
Types of Electrosurgical Currents
Why might filtered current produce better healing in situations requiring an incision?
Because there is less coagulation of the tissues in the walls of the wound.
p.1
Svedopter for Isolation and Evacuation
What is the most effective position for using a Svedopter?
With the patient in a nearly upright position.
p.9
Electrosurgery in Gingival Management
What should be verified before performing an electrosurgical procedure?
That anesthesia is profound and reinforced if necessary.
p.8
Types of Electrosurgical Currents
What type of current produces a waveform with damping in the second half of each cycle?
A partially rectified, damped (half-wave modulated) current.
p.1
Rubber Dam in Restorative Dentistry
What is a limitation of using a rubber dam in cast restorations?
It has limited direct application and can produce more aggravation than assistance for most full or partial coverage crowns.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What is the purpose of using a torpedo-nosed diamond in rotary curettage?
To extend the finish line apically, converting it into a chamfer.
p.8
Contraindications and Safety in Electrosurgery
What is the most important safety factor when using electrosurgery?
Proper grounding of the patient.
p.2
Antisialagogues and Their Applications
What are the side effects of glycopyrrolate?
Drowsiness, blurred vision, and risk of heat prostration.
p.5
Mechanical and Chemicomechanical Gingival Retraction
How is the retraction cord prepared before insertion?
The retraction cord is drawn from the dispenser bottle with sterile cotton pliers, and a piece approximately 5 cm (2 inches) long is cut off.
p.2
Antisialagogues and Their Applications
What is the recommended dosage of clonidine hydrochloride for reducing salivary flow?
A 0.2-mg dose administered an hour before the dental appointment.
p.2
Gingival Health and Cast Restorations
Why is it important for gingival tissue to be healthy before starting cast restorations?
Healthy gingival tissue is essential to prevent complications and ensure the success of the restoration.
p.7
Electrosurgery in Gingival Management
How does electrosurgery achieve controlled tissue destruction?
By using a small cutting electrode that produces a high current density and rapid temperature rise at its point of contact with the tissue.
p.10
Electrosurgery in Gingival Management
What should be done if a second pass is necessary during electrosurgery?
Allow 8 to 10 seconds before repeating the stroke to minimize lateral heat production.
p.1
Rubber Dam in Restorative Dentistry
When is the use of a rubber dam particularly valuable?
During the removal of old restorations or excavation of caries when exposure of the pulp is a possibility.
p.3
Gingival Health and Cast Restorations
What types of die materials can be used with elastomeric impressions?
Stone or electroplated metal.
How can a simple saliva ejector be effectively used by a dentist working without an assistant?
It can be placed in the corner of the mouth opposite the quadrant being treated, with the patient's head turned toward it.
p.9
Contraindications and Safety in Electrosurgery
How have recent pacemaker models reduced risks from electromagnetic interference?
Shielding in recent pacemaker models diminishes the risks.
p.4
Mechanical and Chemicomechanical Gingival Retraction
What was found in a study comparing hemorrhage control between aluminum sulfate and epinephrine-impregnated cords?
No significant difference in hemorrhage control.
p.5
Mechanical and Chemicomechanical Gingival Retraction
Why should care be taken not to touch any part of the cord other than the ends?
Handling the cord with latex gloves may indirectly inhibit polymerization of a polyvinyl siloxane impression.
p.5
Mechanical and Chemicomechanical Gingival Retraction
What can be used to control slight hemorrhage in the gingival crevice?
A hemostatic agent, such as Hemodent liquid (aluminum chloride).
p.9
Electrosurgery in Gingival Management
How should the electrode be cleaned during electrosurgery?
By wiping it with an alcohol-soaked 4 × 4-inch sponge.
p.10
Electrosurgery in Gingival Management
What is the recommended speed for moving the electrode during electrosurgery?
No less than 7 mm per second.
p.3
Gingival Health and Cast Restorations
What is the purpose of festooning one end of the tube in restorative dentistry?
To follow the profile of the gingival finish line, which often follows the contours of the free gingival margin.
p.9
Contraindications and Safety in Electrosurgery
What happens when a pacemaker incorrectly senses electromagnetic interference?
The generator shuts down until the interference ceases.
p.3
Rubber Dam in Restorative Dentistry
Why should rubber dam not be used with polyvinyl siloxane impression material?
Because the rubber inhibits its polymerization.
p.8
Contraindications and Safety in Electrosurgery
Where should the ground electrode be placed to avoid burns?
Under the thigh rather than behind the back.
p.9
Contraindications and Safety in Electrosurgery
Why should electrosurgery not be used in the presence of flammable agents?
Because it can produce sparks that may ignite flammable agents.
p.2
Antisialagogues and Their Applications
What is clonidine hydrochloride used for in dentistry?
Clonidine hydrochloride is used as an antisialagogue to diminish salivary flow.
p.7
Electrosurgery in Gingival Management
Can electrosurgery stop bleeding once it starts?
No, bleeding must first be controlled with pressure and/or chemicals before using a coagulating ball electrode to seal the vessels.
p.7
Types of Electrosurgical Currents
What did Kalkwarf et al. report about wounds created by a fully rectified, filtered current in healthy gingiva?
They reported epithelial bridging at 48 hours and complete clinical healing at 72 hours.
p.7
Types of Electrosurgical Currents
What is the difference between electrosurgery and electrocautery?
In electrosurgery, the cutting electrode remains cold, whereas in electrocautery, a hot electrode is applied to the tissue.
p.10
Mechanical and Chemicomechanical Gingival Retraction
What should be done before making an impression after enlarging the gingival sulcus?
Loosely pack retraction cord in the enlarged sulcus.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What should be done if active bleeding persists during impression taking?
The impression attempt should be aborted.
p.4
Contraindications and Safety in Electrosurgery
What are the symptoms of epinephrine syndrome?
Tachycardia, rapid respiration, elevated blood pressure, anxiety, and postoperative depression.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What is the effect of rotary curettage on gingival height compared to lateral gingival displacement using retraction cord?
Rotary curettage results in less change in gingival height.
p.4
Mechanical and Chemicomechanical Gingival Retraction
What are some alternative agents to epinephrine for gingival retraction?
Aluminum chloride, alum (aluminum potassium sulfate), aluminum sulfate, and ferric sulfate.
p.7
Electrosurgery in Gingival Management
What is the primary purpose of using electrosurgery in gingival management?
To enlarge the gingival sulcus and control hemorrhage to facilitate impression making.
p.7
Contraindications and Safety in Electrosurgery
What are the concerns associated with using electrosurgery on inflamed tissue?
Concerns include an exaggerated response due to proximity to bone and lateral heat production, which can cause tissue damage.
p.5
Mechanical and Chemicomechanical Gingival Retraction
How should the retraction cord be placed around the prepared tooth?
The cord is formed into a U and looped around the prepared tooth, held between the thumb and forefinger, and slight tension is applied in an apical direction.
p.10
Mechanical and Chemicomechanical Gingival Retraction
What type of electrode is used to enlarge the gingival sulcus for impression making?
A small, straight or J-shaped electrode.
p.10
Gingival Health and Cast Restorations
What should be done if the band of attached gingiva is too narrow for crown lengthening?
It must be widened with a graft or an alternative restoration must be made.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What is rotary curettage?
A technique to produce limited removal of epithelial tissue in the sulcus while creating a chamfer finish line in tooth structure.
p.3
Gingival Health and Cast Restorations
What are the potential gingival effects of using copper bands?
Incisional injuries and minimal recession ranging from 0.1 mm to 0.3 mm.
p.2
Antisialagogues and Their Applications
What is glycopyrrolate used for in dentistry?
Glycopyrrolate is used to reduce salivary secretions before dental procedures.
p.5
Mechanical and Chemicomechanical Gingival Retraction
What must be done to the operating area before placing a retraction cord?
The operating area must be dry.
p.4
Mechanical and Chemicomechanical Gingival Retraction
What effect do aluminum chloride and alum have on surface detail reproduction?
They have an adverse effect and should be removed before polyvinyl siloxane impressions.
p.7
Electrosurgery in Gingival Management
Why might it be necessary to use electrosurgery instead of retraction cord alone for gingival management?
Electrosurgery may be necessary when the gingiva cannot be sufficiently retracted with cord alone, especially in areas of inflammation and granulation tissue.
p.4
Mechanical and Chemicomechanical Gingival Retraction
What was the result of using concentrated solutions (60%) of aluminum chloride in gingival crevices in dogs?
Severe inflammation and necrosis.
p.4
Gingival Health and Cast Restorations
What effect did 0.12% chlorhexidine gluconate have on plaque, bleeding, and gingivitis indices?
It lowered plaque, bleeding, and gingivitis indices.
p.2
Electrosurgery in Gingival Management
What are the surgical techniques for exposing the preparation finish line?
Rotary curettage and electrosurgery.
p.10
Electrosurgery in Gingival Management
How should the electrode be positioned to minimize loss of gingival height?
The wire should be parallel to the long axis of the tooth.
p.1
Rubber Dam in Restorative Dentistry
Why should teeth with old or questionable endodontic treatments be isolated with a rubber dam?
For post and core preparation, pattern fabrication, and cementation.
p.9
Contraindications and Safety in Electrosurgery
What can hinder a pacemaker's sensing function?
External electromagnetic interference.
p.1
High-Volume Suction Techniques
What is the role of a high-volume suction tip during the preparation phase?
It is extremely useful and can act as an excellent lip retractor when used by a knowledgeable assistant.
p.8
Types of Electrosurgical Currents
What is a potential advantage of bipolar electrosurgical units?
They eliminate the need for a grounding plate and help avoid current passing through adjacent bone, implants, or restorations.
p.9
Contraindications and Safety in Electrosurgery
What precaution should be taken when using electrosurgery with nitrous oxide-oxygen analgesia?
Any cotton packing in the mouth should be kept slightly moist.
p.4
Mechanical and Chemicomechanical Gingival Retraction
Which over-the-counter drugs show promise as gingival retraction agents?
Phenylephrine hydrochloride, oxymetazoline hydrochloride, and tetrahydrozoline hydrochloride.
p.5
Mechanical and Chemicomechanical Gingival Retraction
What can happen if a dry cord is removed from the gingival crevice?
It can cause injury to the delicate epithelial lining.
p.5
Mechanical and Chemicomechanical Gingival Retraction
Why is it important to avoid overpacking the retraction cord?
Overpacking can traumatize the tissue, create gingival problems, and jeopardize the longevity of the restorations.
p.10
Electrosurgery in Gingival Management
What is the purpose of removing an edentulous cuff before fabricating a pontic?
To ensure cleanable embrasures and strong connectors.
p.3
Gingival Health and Cast Restorations
What materials can be used to fill the tube in restorative dentistry?
Modeling compound, impression compound, and elastomeric materials.
p.1
Rubber Dam in Restorative Dentistry
Why should a rubber dam not be used with polyvinyl siloxane impression material?
Because rubber dam will inhibit its polymerization.
p.6
Mechanical and Chemicomechanical Gingival Retraction
What is a potential risk of using diamonds on sulcular walls during rotary curettage?
It can produce deepening of the sulcus and potential destruction of the periodontium if used incorrectly.
p.3
Mechanical and Chemicomechanical Gingival Retraction
What are the three criteria for a gingival retraction material?
Effectiveness in gingival displacement and hemostasis, absence of irreversible damage to the gingiva, and minimal untoward systemic effects.
p.3
Mechanical and Chemicomechanical Gingival Retraction
What are the systemic effects of epinephrine that have led to its controversial use in gingival retraction?
Elevation of blood pressure and increased heart rate.
p.3
Mechanical and Chemicomechanical Gingival Retraction
Which patients should avoid the use of epinephrine-impregnated cord?
Patients with cardiovascular disease, hypertension, diabetes, hyperthyroidism, known hypersensitivity to epinephrine, or those taking certain medications like monoamine oxidase inhibitors.
p.9
Electrosurgery in Gingival Management
What speed should the electrode move at to prevent lateral heat penetration?
No less than 7 mm per second.
p.7
Electrosurgery in Gingival Management
What is the principle behind the development of electrosurgery?
Electricity at high frequency can pass through a body without producing a shock, instead increasing the internal temperature of the tissue.
p.10
Gingival Health and Cast Restorations
Why is it important to assess the width of the band of attached gingiva before removing tissue?
Because the electrosurgery tip cannot restore lost gingiva, and if there is unattached alveolar mucosa too near the gingival crest, periodontal surgery may be needed.
p.10
Electrosurgery in Gingival Management
What is the purpose of crown lengthening in electrosurgery?
To create a longer clinical crown for better retention and margin placement.
p.3
Rubber Dam in Restorative Dentistry
When is a rubber dam typically used in restorative dentistry?
When a limited number of teeth in one quadrant are being restored and preparations do not have to be extended very far subgingivally.
p.2
Antisialagogues and Their Applications
What is the recommended dosage of glycopyrrolate for reducing salivary flow before dental impressions?
A 1-mg tablet taken 30 minutes before the impression, with a possible increase to a 2-mg tablet if needed.
p.3
Mechanical and Chemicomechanical Gingival Retraction
What was the limitation of using plain cotton cord for sulcus enlargement?
It often did not control sulcular hemorrhage effectively.
p.1
Svedopter for Isolation and Evacuation
What are some drawbacks of using a Svedopter?
Limited access to the lingual surfaces of mandibular teeth, potential for bruising tender tissue, and issues with mandibular tori.
p.8
Contraindications and Safety in Electrosurgery
Why should electrosurgery not be used on patients with cardiac pacemakers?
Because the demand (synchronous) type of pacemaker is designed to sense cardiac impulses, and electrosurgery could interfere with its function.
p.5
Mechanical and Chemicomechanical Gingival Retraction
How should the retraction cord be moistened before insertion?
By dipping it in buffered 25% aluminum chloride solution.
p.2
Mechanical and Chemicomechanical Gingival Retraction
What are the three techniques for exposing the preparation finish line?
Mechanical, chemicomechanical, and surgical techniques.
p.7
Types of Electrosurgical Currents
What is the unrectified, damped current and why is it not used routinely in dental electrosurgery today?
It is characterized by recurring peaks of power that rapidly diminish, causing intense dehydration, necrosis, and slow, painful healing. It is not used routinely due to these adverse effects.
p.2
Antisialagogues and Their Applications
What are the contraindications for using glycopyrrolate?
Hypersensitivity to glycopyrrolate, glaucoma, obstructive uropathy, obstructive gastrointestinal disease, paralytic ileus, intestinal atony, unstable cardiovascular status, severe ulcerative colitis, toxic megacolon, and myasthenia gravis.
p.5
Mechanical and Chemicomechanical Gingival Retraction
What should be done if a twisted or wound cord is used?
The ends should be grasped between the thumb and forefinger of each hand, held taut, and twisted to produce a tightly wound cord of small diameter.
p.9
Electrosurgery in Gingival Management
How should the cutting electrode be applied during electrosurgery?
With very light pressure and quick, deft strokes.
p.9
Electrosurgery in Gingival Management
What should be done if the electrode drags or collects tissue shreds?
Adjust the power setting as it may be too low.
p.5
Mechanical and Chemicomechanical Gingival Retraction
What should be done if the cord persists in rebounding from a particularly tight area of the sulcus?
Gentle force should be maintained for a longer time, or a smaller or more pliable cord should be used.
p.10
Electrosurgery in Gingival Management
How should tissue debris be cleaned off the electrode tip?
Using a cotton pellet dipped in hydrogen peroxide.
p.10
Electrosurgery in Gingival Management
What are the three key steps for proper electrosurgery technique?
Proper power setting, quick passes with the electrode, and adequate time intervals between strokes.
