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Prosthoman

Prosthoman

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Please post any questions you have I will try to help you as much as I can in my best ability.
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Here are the stuff that you will be seeing in your exam:
1)--You will see one question about Prophylaxis:
make sure you know if a pt. is alleregic to Pen what you prescribe instead
2) In Perio endo lession ..which one you treat first ( endo always first)
3) the most important factor in patient treatment, is alway pt. himeslf
4) classification of Patient: Class I, II or II or Iv and V ( as far as systemic disease goes)
4) be able to classify perio ( periodontitis, mild, moderate, sever)
5) rememeber you never do everything, if something that you can't do you have to refer.
6) Implants, clean it with plastic materials Never use metal
7) know complete denture in side out. ...
Chick bitting
teeth arrangment
kind of teeth you use with natural tooth
problem if a denture patient is Wistle
know VDR, VDO, how to measure those on real pt.
pt. with tori, least invasive method
pt. with tori best tx for a pt with tori for denture
8) know the kennedy classifcation with Modification
9) know Angle classiffication
10) distinguish b/w Horizontal bone loss and vertical
11) distinguish b/w inflamed, healty, knift edge, bulbos gingiva
12) distinguish between mental foramen, and redioluency
13) know the major connector for both arches
14) make sure you know how to calculate attachment loss
Negative number means pt. has no ressesion
positive means, pt has ressesion
15) know how to calculate the attached gingiva from a reference point such as mucogingival junction and pocket depth
16) distinguish b/w Edametous
Firm
Fibros..
Perio preceed any ortho
17) know that females are allergic to Nickle...if a partial give allergic reaction that is usually from
18) distinguish Under extention of denture border..you will see 2 questions
usually give patient an ulceration
19) make sure when to Reline, if in the day of delivery of the framework you push the posterior part, anteriro lifts, then it is ok, however in the day of actual delivery of teh partial denture if that happens, denture needs a reline
20) Deep overbit in making denture
21) best teeth for complete denture
22) sequence in denture delivery
23) make sure you underestand what a group function is
24) order of treatment..
get rid of pain first,,then do cosmetic
25) know the prep for FGC
26) know the prep for Anterior Ceramic Crown
27) they will show you a rest prep for partial denture and ask you what is wrong with it ( choose the most rounded, nice and deep prep)
28) know parts of the partial denture, and which one is for direct retention and which is fir indirect reten.
29) if not enough space exist between the upper and lower denture what would you do ( usually in posteri..do a tuberasity reducton both )
30) if an elderly has osteoprosis and has a long edentulous space..best tx is removable partial denture.
here general stuff you need to konw:
Partial denture, classifcation, major connector, when relining,,what tooth to chose
denture know it in and out
perio:
Diagnos the patient perio disease
smooking is a risk factor
Calculas on the xray
Classification of Perio disease
know the relationship b/w VDO, VDR, etc..
if VDO decreases what do you have to do
If remember VDO is alway 2-4 mm less than VDR
VDR = Vdo - 2-4 mm
I will add more if I remember
take care and good luck
 
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hi, prosthoman
thank you so much for ur help. did you read any book or some extra notes.
 
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Reading really don't help much and it is all what you have learned in your dental school. Most of the question are straight forward,
however, these are the most important topics

Complete Denture
Partial Denture
Perio classification
angle's classification
Major connectors
Kennedy classification
Sequeces of TX, in perio
Sequesces of deliv. Partial denture
problems with framework
what do you do if a partial denture tooth is broken
know that cement don't adhere to tooth, crown retention is mostly mechanical
if a denture pt. counts untill 60 and the upper falls
Means there is no retention
can cause by too thick posterior border
Overextended
and many more
remember never ever use,Porcelaine teeth with natural tooth

sequece of partial denture adjustment in day day of deliv.
I will write one example of attachment loss calculation:
Make sure you know how to Calculate Attachment loss:
Know the difference b/w Pocket Depth, CEJ, Gingival Margin
Know the abbreviation first:
CEJ : cemantoenamel junction
GM: gingival margin
PD: pocket depth

Negative Number, means Gingival Margin is Coronal to CEJ ( no Recession)
Positive Number means Gingiva is Apical to CEJ.

Example of Attachment loss of GM when Negative:
GM - 1 = means gingiva is 1 mm above CEJ. No attachment loss normal
So Pocket depth = attachment loss

Example of Attachment loss with GM when Positive:
GM + 1
Pocket depth 3
So total attachment loss is 4, because gingival margine is already 1 mm below CEJ.

Another example:
if the distance from Gingival margine to Mucogingvial junction is 10 mm and the pocket depth is 5 how much of attached gingive you would have?
10 mm - 5mm...= 5 mm is your attached gingiva
they can change this question adn ask different question however, underestand this will help you alot
Remember the numbers are in chart, make sure don't mix up Lingual, facial ...just look for what a question is asking.( common mistake)
-
I will add again if something cross my mind
good luck
 
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that class is the worst class you can take
his name is doctor gilber, terrible person
who just care about the money not the students
I have had a friend who has taken his course and
he just wasted his 1500 dollars for the course
DOn't do that, he did it and he was not satisfied.
 
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U-shaped metal major connector on a MX RPD. Lingual to MX anterior teeth the metal is about 6mm posterior to teeth. Is this to help speech or protect the marginal gingiva? I keep getting conflicting answers. pls help. thank u!!
 
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In all maxillary RPD, not only U-shaped Max RPD, there should be 6 mm space between the metal and the marginal gingiva to protect the marginal gingiva.
so your answer is: to protect Gingival margin
however, this space in all mandibular RPD should be at least four mm

I hope this help
 
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So if a pt. is allergic to pen what do u subscribe? And whatis pen?
and what is the classification of patient as far as systemic disease?
what teeth do u use with natural teeth? 0 angle acrylic ?

thanks!
 
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Hi Prosthoman,
I have a question regarding two adjacent lesions:

I have a friend who has lesion on #30 M and 29D. I would like to do 29 D for the operative part of my exam. I am not sure about 30 M b/c the lesion does not show very well on the x-ray and the mesial pulpal horn is very high.

My question will be: should i restore #30 M prior to going into the exam?
If I do end up restoring it, I would have to use composite but I would have to restore the mesial proximal contour to a perfect contour so it doesn't screw up my exit angles for 29 DO.
If i do NOT end up restoring it, will I run into the risk of having #29DO rejected? Will they ask me to do #30 M instead?

Thus far the teeth are in good proximal contact.

Thank you so much for your advice!
 
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Prosthoman said:
Here are the stuff that you will be seeing in your exam:
1)--You will see one question about Prophylaxis:
make sure you know if a pt. is alleregic to Pen what you prescribe instead
2) classification of Patient: Class I, II or II or Iv and V ( as far as systemic disease goes)
3) know Angle classiffication
4) best teeth for complete denture
take care and good luck
Click to expand...

hi prosthoman,
can u please help me with the previous question?

Thanks!
 
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futurdentist said:
So if a pt. is allergic to pen what do u subscribe? And whatis pen?
and what is the classification of patient as far as systemic disease?
what teeth do u use with natural teeth? 0 angle acrylic ?

thanks!
Click to expand...

Pen stands for Penicillin
if patient is allergic to Pen then Clindamycin is prescribed
 
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maryh320 said:
Hi Prosthoman,
I have a question regarding two adjacent lesions:

I have a friend who has lesion on #30 M and 29D. I would like to do 29 D for the operative part of my exam. I am not sure about 30 M b/c the lesion does not show very well on the x-ray and the mesial pulpal horn is very high.

My question will be: should i restore #30 M prior to going into the exam?
If I do end up restoring it, I would have to use composite but I would have to restore the mesial proximal contour to a perfect contour so it doesn't screw up my exit angles for 29 DO.
If i do NOT end up restoring it, will I run into the risk of having #29DO rejected? Will they ask me to do #30 M instead?

Thus far the teeth are in good proximal contact.

Thank you so much for your advice!
Click to expand...

I would restore M on number 30, because if you are doing D on number 29 and you open the contact, and there is a decay on m on # 30, there is a possibility that the M of number 30 can mess you up.
 
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futurdentist said:
hi prosthoman,
can u please help me with the previous question?

Thanks!
Click to expand...

Here are the stuff that you will be seeing in your exam:
1)--You will see one question about Prophylaxis:
make sure you know if a pt. is alleregic to Pen what you prescribe instead
answer Clindamycine
2) classification of Patient: Class I, II or III or IV and V ( as far as systemic disease goes)
Class I: Healthy Person
Class II: pt. with mild systemic disease and significant risk factor ( controled)
diabetic how take medications
Class III: pt. with sever systemic disease that is no incapaciating

Class IV: pt. with sever systemic disease that is in a constant threat to life
Class V: A morbound pt who is not expaxted to live without operation
Class VI: A declared-Brain dead pt. whose organ are being removed for donor porpuses.




3) know Angle classiffication
Class I: normal tooth occlusion, MB cusp of the max first molar fall into mesial groove of mand first molar
Class II: MB cusp of first molar is Mesial ( anterior) to the mesial groove of the mandibular fist molar
Class III: MB cuspof the max first molar is Distal to the mandbibular first molar. ( reverse cross bit in anterior region)

Also for Class II, we have to subdiv:
Class II div I: lateral incisors are lingual to Centrals
Calss II Div II: lateral incisors are buclle to Centrals
 
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Prosthoman said:
I would restore M on number 30, because if you are doing D on number 29 and you open the contact, and there is a decay on m on # 30, there is a possibility that the M of number 30 can mess you up.
Click to expand...

I disagree with this advice. I would definitely leave #30 alone. You want your restorations to look as ideal as possible, and placing a class II on the adjacent tooth can introduce alot of problems with respect to the exit angles and restoring the contact on #29 DO. If the proximal contact is already ideal I wouldn't mess with it until after the WREB. The examiners will only reject #29 DO if it's a non-qualifying lesion, and they could care less what's on #30. And you said youself that the caries on #30M looks so conservative on the radiograph that it way not even qualify, so it shouldn't interfere with your restoration of #29D in any way. Both of the teeth I treated for the WREB had adjacent teeth needing fairly extensive class IIs, and I am extremely thankful that I left them alone because it was much easier to prep ideal exit angles and restore the contacts. Don't touch #30 until after the WREB! Good luck.
 
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You welcome.
one note, I had two kissing lession, number 13 and 14 in my CRDTS exam, howoever, the lession on number 15 was not obvious on the x-ray. Guess what happend, I tried to work on distal of number 13, I open the contact, here is a big hole on tooth number 14 mesial side? almost got a heart attack.
so if I say something, I don't say because it is my opinion, I say it because it happend to me in the exam. it would be better to restore a tooth that you don't want, then easily prep the tooth that you want w/o worrying about unexpected surprises
 
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acrylic denture teeth
never ever use porcelain with natural teeth
 
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Prosthoman said:
acrylic denture teeth
never ever use porcelain with natural teeth
Click to expand...
I am asking about the complete denture , not the partial? and also what kind of teeth in terms of occlusal surface, monoplane or anatomic?

Another question regarding the RPD:
what is the rule to occlusal rests? i know their number should be the number of edentulous areas plus 1.
where do we put the occlusal rests? what is the rule to that?
also the clasps, when do we use the I-bar and when do we use thje cicumferential?

iam sorry if i'm asking too many questions. i'm just confused and my exam is on Tuesday.

Thanks!
 
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Prosthoman said:
You welcome.
one note, I had two kissing lession, number 13 and 14 in my CRDTS exam, howoever, the lession on number 15 was not obvious on the x-ray. Guess what happend, I tried to work on distal of number 13, I open the contact, here is a big hole on tooth number 14 mesial side? almost got a heart attack.
so if I say something, I don't say because it is my opinion, I say it because it happend to me in the exam. it would be better to restore a tooth that you don't want, then easily prep the tooth that you want w/o worrying about unexpected surprises
Click to expand...

I understand what you're saying, but I disagree for the reasons I stated above. A diagnostic bitewing should prevent being surprised by a cavitation on the adjacent tooth. If the adjacent lesion looks incipient I wouldn't (and didn't for my WREB) touch it. To each his own, I guess.
 
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If such a surprise happens and you do see cavitation or decay that will alter your contact and contour you actually can request a modification to restore the adjacent tooth first. Obviously, you will lose time, however the WREB does give you lots of time for situations like these.

DD
 
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Airforceone said:
Hi, I have a class II 12do and 20 do and on the clinically occlusal surface there is a lesion of caries along the groove and the mesial pit. I am wondering if you would consider still doing this case. Under the x-ray the class II seems to be an ideal case. Please give me your advice as I've read most of your past post and they've been extremely helpful.

thanks
Click to expand...

First make sure there is interproximal caries. If you see occlusal caries on the radiograph you might have to be careful since occlusal caries can be very unpredictable.

If the caries are extending along the mesial you might have to ask for a Modification and extend to a MOD which is going to add time and make the case more difficult (now you have two boxes and two contacts to build).

Try to look for caries solely on the interproximal entering the DEJ. Any diffuse appearance after penetration of DEJ maybe "deep caries."

Also, make sure you look for hypo/hypercalcification around the enamel, sometimes the examiners will consider that "demineralization" and ask you to remove it, or worse they will consider it caries.

If you are lucky you can use a curing light and in a dark room (turn all lights off) shine the curing light on the tooth at various angles and try to transilluminate the caries. Sometimes you can actually visualize the extent of the caries under the enamel. I also dry the tooth, cover it judiciously with caries detector (Snoop) rub it in, wait 15 seconds and rinse 20 seconds w/ water. Any fissure, groove will stain and I feel for a stick.

Good luck,

DD
 
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Take a good bitewing, make sure the film is parallel w/ the tooth. After you develop it use a perio probe and measure how much room you have around the pulp/pulp horn. If it is a premolar, I personally try to keep 3-4mm from each direction. Obviously, younger patients you might have higher pulp horns. Regardless, if you have room it is a good measure to keep in your head so if you are over your estimate for an ideal prep you know how much more room you got.

DD
 
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The WREB is a clinical exam. Once you are in the process or receive a degree from an US dental school you have to take this exam in order to be recognized as a licensed dentist. Most states require you to have the following for practice:

Dental Degree from US school
WREB/NERB/etc licensing exam
National board scores
Complete Law exam for each state
Transcript from your school.

All the information about the WREB can be found here: www.wreb.org

DD
 
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What brand of perio curettes and scalers do we need for the wreb? Also what numbers should we get
what brand of files should we use for the endo part? is there any specific brand that would be less likely to fracture?

thanks!
 
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it is all depends what your preferences are. You can you any scalers, any kind of instrument that you req. Some school they rent out ask the school to see if they have any kit for rent
 
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unfortunately they don't rent equipment. i am trying to buy my own and i heard that hu friedy are supposed to be the best, but they are very expensive. that's y i wanted to know if there is any reasonable brand that i can buy.

thanks!
 
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85% of the SC/RP will be done w/ your cavitron. Get a good one w/ various tips (the thinner the better).

Use the universal scaler and curettes. You really don't need the whole list, but it would be nice to have. However, having 3-5 different scalers are good. Have the sharp, but not so sharp that you cut tissue.

Rent or borrow a solid cavitron. Hand scaling is tenacious and difficult w/ hard calculus.

DD
 
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futurdentist said:
I am asking about the complete denture , not the partial? and also what kind of teeth in terms of occlusal surface, monoplane or anatomic?

Another question regarding the RPD:
what is the rule to occlusal rests? i know their number should be the number of edentulous areas plus 1.
where do we put the occlusal rests? what is the rule to that?
also the clasps, when do we use the I-bar and when do we use thje cicumferential?

iam sorry if i'm asking too many questions. i'm just confused and my exam is on Tuesday.

Thanks!
Click to expand...
I am asking about the complete denture , not the partial? and also what kind of teeth in terms of occlusal surface, monoplane or anatomic?
Best teeth for a denture pt. 0 Degree cusp, Monoplane
Best in Monoplane with 0 Degree
Another question regarding the RPD:
what is the rule to occlusal rests? i know their number should be the number of edentulous areas plus 1.
Occlusal rest, prevent the partal denture from moving toard Tissue.

where do we put the occlusal rests? what is the rule to that?
also the clasps, when do we use the I-bar and when do we use thje cicumferential?
Occlusal rest Prevents moving of the prosthesis toward the tissue.
Ok, I- bar is used in Class I and II cases where you have distal extension distal exentsion usally comes in RPI sys, ( uni or bi)
Rest
Proximal
I bar



iam sorry if i'm asking too many questions. i'm just confused and my exam is on Tuesday.
 
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Hi Prosthoman,
Ive been following the threads and you've been a really big help. My husband is taking his CalBoard this June. I wonder if you have any Endo reviewers that you can share?

Many thanks !

Prosthoman said:
you welcome man
we should help each other
Click to expand...
 
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Hi all,

Just finished my WREB. My endo sucks. My central incisor has voids in the middle third and apical third ,quite big and my Premolar is ok but didnot have time to properly clean the access as a result of which the radiograph shows guttapercha on the pulp chamber and a little towards the buccal canal.
My final picture for my central incisor is not very good. I just couldn't manage my time.
Rest of my exam was ok, had a modification denied so that is another 3 points
I am so dissipionted . What are my chances people? Do I have any hope at all.
 
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pampero said:
Hi Prosthoman,
Ive been following the threads and you've been a really big help. My husband is taking his CalBoard this June. I wonder if you have any Endo reviewers that you can share?

Many thanks !
Click to expand...

I really don't however, if there is any questions or concenrs please post it here i will be able to help
for endo:
best tooth for anterior:
CI
for posterior ( Mandibular first molar) direct access
measure your tooth before mounting
they are not that picky as far as monting the tooth goes, I have never seen a rejections

if you have any question post it here so other may benefit from it as well
good luck to your housband
 
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neha said:
Hi all,

Just finished my WREB. My endo sucks. My central incisor has voids in the middle third and apical third ,quite big and my Premolar is ok but didnot have time to properly clean the access as a result of which the radiograph shows guttapercha on the pulp chamber and a little towards the buccal canal.
My final picture for my central incisor is not very good. I just couldn't manage my time.
Rest of my exam was ok, had a modification denied so that is another 3 points
I am so dissipionted . What are my chances people? Do I have any hope at all.
Click to expand...
I will tell the the honest answer; if the void is in the middle of your tooth, not clear x-ray, and etc..you might end up loosing points, however, i have had friends who had 11 mm gutta purcha extended from root apex and they still passed. I hope this makes you feel better. If you have done well in other sections, then your chance of passing is great.
good luck
don't think about it cuz it will make you crazy,
try to forget it for a while ( i know this is tough), been there done that
I even was going to my mailing box almost everyday the day after my exam, I when I think about it, this exam psychologically effects lots of people.
don't worry
you did you best
take care
 
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thank you. right now I was crazy worried and preparing myself for the worst.

Your reply helps

Thanks once again
 
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DesiDentist said:
The WREB is a clinical exam. Once you are in the process or receive a degree from an US dental school you have to take this exam in order to be recognized as a licensed dentist. Most states require you to have the following for practice:

Dental Degree from US school
WREB/NERB/etc licensing exam
National board scores
Complete Law exam for each state
Transcript from your school.

All the information about the WREB can be found here: www.wreb.org

DD
Click to expand...
thankyou so much for your detailed answer.:)
 
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neha
please don't give yourself a hard time
the exam is a game
it has nothing to do with your dentistry
you have done your best
and trust yourself
whatever is gonna happen, it will and just let it go for now
always the things that we think is impossbile, can be possible if we think it other ways
 
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Do you know how hard they score on the endo part. If I didnot clean the access and left some guttapercha on the pulpal floor is that going to effect my score in a big way.

What you are saying is right. It is just that I can't even think of taking the exam again.
 
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Neha,

I remember when I took the exam, Endo was tough. I was short 2 mm on my molar due to a curve on the distal root. The anterior I just put 1 piece of gutta percha in. I was suspicious of caries so I requested 4 mods they approved 2 an denied 2 so I lost 3 points. However, everything went okay. the few days after the exam are okay, then after a week you start hallucinating about stuff which makes no sense. Just relax. Unless something critical happened you should be fine.

Best of luck,

DesiDentist
 
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Hi Prosthoman,

Could you please tell me how in detail I need to study for CSW exam? I read your posts but still got some questions.

For prostho: in terms of biomaterial, do we need to know composition of gold, porcelain, firing temperature......?

For perio: do we need to know what bacteria cause what periodontal disease? How instruments are designed in terms of angulations, etc? Histology? Anatomy? Different types of surgeries? Brushing techniques?

Have been out of school for too long and lost a lot of brain cells from having a baby, can't really concentrate now on my studies.

Thanks in advance!:luck:
 
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Sorry, one more question.

What about pathology? Other than gingival hyperplasia caused by medications, or anything gingiva related, do we need to make diagnosis for anything else? Tumors, syndromes, lab values.....?

Thank you!
 
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Hi Prosthoman,


For prostho: in terms of biomaterial, do we need to know composition of gold, porcelain, firing temperature......?
No, just know the thickness of materials
Alginate the thicker is better
PVS thin ( 1-3 mm)don't need to know any dental materials at all
( don't worrary about it)
For perio: do we need to know what bacteria cause what periodontal disease?
no, however, you have to be able to calulate attachment loss and stuff,
remember, this is done in part II board, now you taking a clinical exam.
No names of bacterial, just know and read my previous post for clinical attachment loss. Make sure you know it inside and out ( please read my posts) in this forum How instruments are designed in terms of angulations, etc? Histology? Anatomy? Different types of surgeries? Brushing techniques?
No histology
know nicotinic stomatitis for smookers ( from the slide)
know smooking is a risk factor
overall I saw one simple path question ( nicotinic stomatitis)


Have been out of school for too long and lost a lot of brain cells from having a baby, can't really concentrate now on my studies.
let me know if you have any other questions
listen, you don't need to memorize any numbers, anything. No names of bacteria no name of instruments and stuff nothing
I very much wrote everything that you will be seeing in your exam
don't worry
Thanks in advance!:luck:[/QUOTE]
 
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Thanks Prosthoman! You are the best! :bow: I am sure a lot of people will pass their CSW because of your help.
 
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Airforceone said:
I want to know why am I having voids in the lower apical third of my gutta percha even after obturating properly... after I put in the master cone am I supposed to obtur. because I am and wondering if that could be the reason...sometimes I've got a good apical seal and sometimes I don't;;;;

thanks for the answers
Click to expand...
If you're regularly getting voids in the apical 1/3 of your fill, by definition you're not doing something right. Can you describe your obturation technique? Maybe we can spot the mistakes from your description.
 
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