Monthly Archives: October 2007

Introduction to Orthodontics

Posted on October 21, 2007 by CheerioKing| Leave a comment

This class has been a breath of fresh air this semester. Nothing is more relaxing than taking a small wire into your pliers and creating a messy, gnarled, disfiguring mass of metal for someones mouth. Despite the learning curve of working with wires, this class is fairly laid back and is fun at the same time. This class has the following requirements:

  • Take an impression of someones mouth. We paired up and took an impression of a classmate. The amount of alginate all over someones face was directly related to the amount of experiance the person who took the impression had. The more alginate on the face of one partner, the less experiance the other partner had. I had never done one before and I managed to keep my partner fairly clean, but I saw some people with alginate on their earlobes and the back of their necks. It was pretty fun.
  • Pour up a stone model with the impression, get a thick base and then after it is set, grind it down to the proper specifications. There is a specific shape for each arch model and the shapes have specific angles have specific angles they must be trimmed to. See my pictures for a general idea.
  • Bend wires! The idea is to end up with a retainer. A retainer gets it’s name for, well, being retentive I guess. Wires are what retains the retainer in the mouth. The first one is a c-clasp. The c-clasp goes around molars and is shaped like the letter ‘c’. It is retentive because it wraps around the tooth below the height of contour.
  • The second is what is called an Adams clasp (also called an arrowhead clasp). This was difficult because of the small bends and I heard many shouts of frustration echo out in the pre-clinic while people attempted to bend these. It is difficult because the bends have to be very precise and have to follow contours, embrasures, and should have proper curves and angles.
  • The next wire for the retainer is the labial bow. This is the wire that follows the curve of the arch on the front teeth. This was slightly easier to do than the Adams clasp because the bends are slightly larger.
  • The last wire we had to bend was a spring. This spring is placed behind the tooth and pushes it forward. I found a picture on the internet. Look at the two lateral incisors and the springs that are designed to move the tooth forward. This is the basic idea. lingual spring orthodontics
  • The above picture also shows some Adams clasps on the back molars and a labial bow in the front.
  • We then placed all these on the model and filled the palate with acrylic to set them into place. The end result after modeling and polishing of the acrylic is a retainer.

I found a website with some nice pictures of what I have been discussing. Google searches on the same topics and vocabulary words will also result in more information.

Orthodontic website with pictures.

Here are some pictures of my wire bending:

ortho wires

ortho wires

ortho retainer

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Posted in Orthodontics

Restorative III projects

Posted on October 20, 2007 by CheerioKing| Leave a comment

I haven’t been as diligent in picture taking this year. Partly due to a broken camera for the first month and partly due to time crunches in lab. When you are trying to pass off crown preps, wax-ups, provisionals, and get castings done for a porcelain fused to metal casting the last thing to think about is taking pictures. HOWEVER, I have been able to take a few pictures of some random things we are doing.
Last year in Restorative II we had a gold crown due as our final project. The final project in Restorative III is a porcelain fused to metal (PFM) crown. In short the steps of the PFM crown are similar to the gold crown. You do the crown preparation, make a custom tray, take an impression, pour up jade stone, drill pindex holes, form the base, mount on articulator, cut the jade stone, and then wax up the full crown. This is where it gets different from a gold crown.

Porcelain requires a certain thickness for strength, so instead of casting the whole wax crown you must cut back some of the crown so you can add porcelain to it AFTER it has been cast. The tooth is also prepared differently so after you remove some wax from the crown there is still enough wax left to make a strong enough metal base. The metals minimal thickness is .5mm while the minimum porcelain thickness is 1mm. This means that anywhere on the tooth where there is going to be porcelain you want to reduce it by 1.5-2mm.

Here is a shot of tooth #8, upper left central incisor with a temporary on it. If you look to the right you will see a chunk of acrylic on tooth #5 an upper 1st premolar. We are doing the porcelain on the opposite premolar, #12.

#8 temporary

The next picture is of tooth #12 after the preparation, provisional, impression, jade stone, pindex, and articulator mount. It is ready to be waxed up. We wax up the tooth to look like the full tooth and then we remove wax in certain areas of the tooth (facial, occlusal, coronal 1/3 of the lingual, and the mesial and distal contact areas. Porcelain also has to meet metal at a 90 degree butt joint angle. The cut back also has specific dimensions. Here is the mounted articulator with #12:

articulator first premolar pindex

I have made the wax cut back and sent it off for investing. It turned out nicely. I will be taking picture as we progress with this project. The next steps will be to add various layers of porcelain to the casting. There is an opaque layer which covers the color of the dark metal casting, a dentin layer to add natural tooth color and then a translucent layer to look like enamel. The steps include time in the oven at very hot temperatures after layers are added to bake the porcelain on. More to come on these details.

We have also been practicing doing PFM preps on various other teeth in the mouth. It is hard to believe that we will be doing this on patients in about 22 weeks. Here are some more pictures:

PFM cown preps and temporaries

Temple Dental Lockers

Pathology Lecture:

PICT0102

More information on PFM’s (I did a google search so you can browse these at your leisure, most are randome websites)

http://www.pjsdental.com/porcelain_to_metal.htm

http://www.smartooth.com/PFM%20Preparation.htm (Has some good preparation shapes and critiques)

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Posted in Crown and Bridge, Restorative Dentistry, Wax Ups

Half Way There, Living on a Prayer

Posted on October 19, 2007 by CheerioKing| Leave a comment

I should title all my posts with cool songs from the 80′s…thanks Jon Bon Jovi.  OK, I know I haven’t been able to keep up as much this year with the blog as last year, but if anyone has been following along with this blog they will have remembered all me previous posts about how 1st year at Temple Dental is pretty laid back and 2nd year is where they fill your plate. My plate is full. Don’t worry though, I am happy. We have had 7 tests and a couple of quizzes over a two week period. This sounds like a lot. Let me add some more to it though. The preparation that goes into a couple of weeks of midterms is tremendous! Time management skills are very beneficial in dental school. Organizational skills are also important. I will break down the classes so far:

General Pathology: We have two teachers in this course. They are both very knowledgeable on the subject and run a very large pathology lab at Temple Hospital. I am convinced they are trying to set a record for ‘most information in one lecture’. Imagine that and then add 7 more lectures to it and this is the course. Every disease that can manifest itself in the body and oral.facial region is combed over. Granted it isn’t like reading Andreoli’s Medicine book, but it is a difficult class. I took the first test with a fever of 102 degrees F. I did OK considering I was pretty out of it. NY-QUIL is my hero. We took our second test today and I did much better with a normal brain. Lets hope to see similar results with test 3 & 4.

Microbiology: First test was easier than eating ice cream with peanuts. Unless you have a Type I hypersensitivity reaction to peanuts…yep, the stuff we learn in micro is good for every day use, as just demonstrated. Did you know that Graves Disease is a Type II hypersensitivity? I missed that on the path test even though we were tested on this question in micro a week before! I sat staring at the test for 15 minutes wondering why I couldn’t remember the answer to one of the most basic questions. The first micro test was easy. The second one was considerably harder. I am going to try a different approach for the 3rd & 4th and hopefully do better. There are so many bugs around us that a classmate of mine kept saying one day, “It is amazing we are still alive.”

Intro to Orthodontics: Breath of fresh air! It is good to just be able to sit back relax, bend some wires, make a retainer and turn it in tomorrow and take a final in a couple of weeks. I like the instructors and the lab.

Restorative III: Last year we learned all the basic cavities, and all metal crown information. The dimensions, burs, measurements, etc. This year we are learning about porcelain metal crowns (PFMs). The learning curve is much shorter and I feel more comfortable with my drill then ever. Way to go cerebellum! Neuroanatomy IS true! We have had two quizzes and our first test next Thursday. I am going to start preparing yesterday…much of this course is repeat from last year. LEARN YOUR MATERIALS. We have the same materials lecture this year as last year (more emphasis on PFM crowns) and I wish I could remember more. We’ll see how the test goes. We also have a practical tomorrow. When you get into second year you basically have a practical every Friday all semester long. Get used to prepping a tooth and provisionalizing it in 2-3 hours. This may sound excessive to D3, D4′s, graduates, but c’mon we are still learning. Remember your roots. Lots of information in this class, but it is dentistry and the reason you wanted to come to school, so it is FUN!

Dental Public Health: A lot harder than I had imagined a one credit class to be. I studied quite a bit for this and even let my micro grade stink a little for it…guess it is time to rethink my strategy. I can still get a low B…

Periodontology I: Straight forward notes, good lectures, the tests ARE hard, but the key is that every answer is in the notes. You just have to make sure you know the notes and you can get the answer. No tricks, just useful information.

Oral Surgery: Interesting class. The test was basically common sense. Some of which I did not have that day and paid the piper. Nothing I can’t rebound from though. Bring it on!

We basically have a test a week until finals where we get worked over the coals again.

Quick Story: A man’s donkey falls into a well and it stuck at the bottom. The man cannot get the donkey out by himself and decides to let it die in the well. He gets a friend and for whatever reason they decide to bury the donkey at the bottom of the well. (It works out for the moral – don’t call PETA). As they throw dirt on the donkey the donkey shakes the dirt off and he is able step on the dirt and rise with it as more is dumped on him. The donkey slowly rises out of the well and is free. He is bruised on his back, dirty and tired, but he i alive and the man is happy.

Parable: Well = dental school, dirt = school work, the man = THE MAN (teachers, deans, parents, bosses, etc.) Whatever is thrown at us or dumped on us we must shake it off and rise because of it.

Yes, I am going to end with this cheesy message.

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Posted in General Info, Sophomore Year

In the Midst of Dental Midterms

Posted on October 7, 2007 by CheerioKing| Leave a comment

I’ve got teeth on my mind…

dental stache

Updates coming soon…but not soon enough.

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Posted in General Info

Month Two Begins

Posted on October 2, 2007 by CheerioKing| Leave a comment

I was sitting in pre-clinic today working away on a PFM crown wax cutback when I heard someone scream my name. I turned around to see an pre-dental interviewee rushing up to my seat. “It’s really you!” At first I was surprised as I didn’t know anyone interviewing today. Then it hit me, my website has made me famous. The interviewer reiterated this thought when she told me she was an avid reader of this blog. She then made the comment that I haven’t written anything for a while. I apologize, it is a busy year! I must say that it was very nice to meet you. (I will not mention her name for privacy matters – but let me know how your application turns out!) I hope your interview went well and also the guy who was with her. I apologize if I wasn’t proficient in answering your questions. I must admit I was taken back a little when I was singled out like that.
Also if anyone else is coming to Temple for an interview they can come talk to me, just ask someone where I sit if you are touring the pre-clinic when the sophomores are in it.

To explain why I have been absent I will go through the next month of my calender:

  • Oct 05: Practical 5 & 6: Prep and Provisionalize for PFM
  • Oct 09: Periodontology I Midterm
  • Oct 10: Micro test 2, Dental Public Health midterm
  • Oct 11: Pathology Lab Test 1
  • Oct 12: Restorative Quiz 2 (On about 8 chapters and countless lectures)
  • Oct 16: Intro to Oral Surgery Midterm
  • Oct 18: Pathology test 2
  • Oct 19: Practical 7 & 8: three unit prep and provisionalize for PFM
  • Oct 25: Restorative Test 1
  • Oct 26: Practical 9 & 10: I don’t remember
  • Oct 31: Micro Test 3

November isn’t quite as rough, but it is still very busy and then December is when we have all of our finals and projects due. I have basically been studying from morning until evening with some breaks in between. Here is a typical schedule:

  • Monday: Study in the morning. Class from 8:30-3:00, study with breaks for lunch, dinner, and the TV show Heroes. Go to bed by 11:30
  • Tuesday: Class from 8:00-4:30. Study with breaks for lunch, dinner, and in bed by midnight.
  • Wednesday: Class from 8:00-4:30. Study with breaks for lunch, dinner, in bed by midnight.
  • Thursday: Class from 8:00-4:30. Study with lunch/dinner breaks. In bed by midnight.
  • Friday: Class from 8:00-5:00. Go home and get a baby sitter and go out with my lovely wife. Hang out and unwind.
  • Saturday: Hang out in morning, played flag football last week, chores, etc. Study for at least 5 hours and then watch football and play with my kids.
  • Sunday: Go to church, hang out, play with the kids, nap, NFL.

I wake up Mon-Fri at 6:30am and in bed by midnight. Sometimes I take a nap for 15 minutes. Saturday/Sunday I am awake by 8am. The last two weeks I have been basically getting ready for midterms. There are many chapters to read and some of the material is very arduous and technical. Pathology can be exceptionally difficult to crunch through because of all the technicalities and mechanisms. The lab quizzes are not very hard though, so there are some buffer points. (You still have to know the material)! I have also never had pathology before so most of the words are new terms and it is more difficult to commit them to memory compared to biochemistry and histology (both of which I have taken before). Micro is a little easier because I have taken several microbiology classes. It definitely helps to have taken a class before hand to get the exposure. Even if it was two years ago. It is surprising what your brain can store in the dark places of yester-year. :)

Now you know where I have been and what I have been up to. My studies take precedence over the blog and I unfortunately haven’t had very much time to make this a priority. I also don’t have very much to write about right now – all I do is study! As it gets closer to board taking time I will try to start more board review articles and keep a schedule of my study time. I can hear my micro notes calling my name…and must say farewell until next time…if I am still alive! j/k, I will survive – don’t worry about me and remember to come say ‘hi’ if you are at Temple for an interview.

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Posted in Classes, General Info, Sophomore Year