2013 Resit MSA

Question 1

What 4 factors can cause tooth mobility?

Answer 1

PDL width
PDL height
Inflammation
Number, shape and length of roots

Question 2

In what 2 circumstances of tooth mobility would you intervene?

Answer 2

If mobility is progressively increasing
If mobility is symptomatic

Question 3

If a patient with moderate/advanced perio had successful HPT, would their mobility increase or decrease and why?

Answer 3

Decrease
HPT removes any bacteria that caused loss of attachment and promotes attachment of long junctional epithelium to the root, increasing stability

Question 4

Patient has mobile lower incisors causing discomfort but refuses XLA. Advise treatment and disadvantages of this.

Answer 4

Splinting
It can create hygiene difficulties

Question 5

What are 2 aims when retracting a flap?

Answer 5

Access to operative field
Protect soft tissues
Direct vision

Question 6

Give 4 factors that influence the design of a flap

Answer 6

Location of surgical site
Post-operative aesthetics
Retraction
Surgical procedure being carried out

Question 7

What instrument is used to remove bone?

Answer 7

Straight electric handpiece with saline cooled bur

Question 8

What are the 3 methods of debridement?

Answer 8

Irrigation - saline into socket and under flap
Physical - bone file to remove soft tissue debris
Suction - aspirate under flap

Question 9

What 3 blood tests can be used to investigate a bleeding disorder?

Answer 9

FBC - full blood count
INR
aPPT - activated partial thromboplastin time

Question 10

Name an inherited coagulation disorder

Answer 10

Haemophilia A
Haemophilia B
Von Williebrand’s disease

Question 11

Name a disorder of platelet numbers?

Answer 11

Thrombocytopenia

Question 12

What LA technique is used for XLA of 47 when the patient has a bleeding disorder?

Answer 12

Articaine infiltration as risk of bleed into pterygomandibular space with IDB

Question 13

Name 2 clotting factors affected by warfarin

Answer 13

Vitamin K dependent clotting factors - II, VII, IX and X

Question 14

What LA technique should be used for XLA of 47 in a patient with warfarin?

Answer 14

IDB

Question 15

Name 3 forms of candidosis

Answer 15

Erythematous
Pseudomembranous
Hyperplastic

Question 16

Name a polyene antifungal and its mechanism of action

Answer 16

Nystatin
Binds to ergosterol, leading to increased membrane permeability and eventually cell death

Question 17

Give 2 resistance mechanisms of candida

Answer 17

Biofilm formation - production of ECM makes it difficult for drugs to penetrate the biofilm
Fungal cells increase the expression of efflux pumps that actively pump antifungal drugs out of the cell

Question 18

Name 1 species of candida other than albicans and how to differentiate the 2?

Answer 18

Candida. glabrata - it is resistant to azole antifungals, which candida. albicans is not

Question 19

Before prescribing F- mouth rinse, what should you check before prescribing?

Answer 19

Fluorosis
Allergy

Question 20

What is the daily strength of F- mouth rinse?

Answer 20

230ppm

Question 21

How do you decide between conventional vs post and core?

Answer 21

Post and core when remaining tooth tissue doesn’t provide enough retention for conventional crown to be prepared
Depends on root canal shape, length, diameter and presence of ferrule

Question 22

What is the function of a post?

Answer 22

Core retention

Question 23

What 2 materials are used in post and cores?

Answer 23

Core - composite
Post - cast metal, steel zirconia or carbon/glass fibre

Question 24

Give 3 ways to determine post length?

Answer 24

Radiographic length of root - should be 1/2-1/3 of root length
Post should at least be height of crown
3-5mm of GP in apex of root

Question 25

What problem does a wide post give?

Answer 25

Root fracture

Question 26

What problem does a narrow post give?

Answer 26

Retention problem

Question 27

Give 3 general health effects of smoking

Answer 27

Increased cardiovascular disease risk High blood pressure Increased risk of respiratory diseasew

Question 28

Give 3 oral health effects of smoking

Answer 28

Halitosis Oral cancer Xerostomia

Question 29

Describe the margin design and reduction of a labial incisor crown prep and give the benefits of this design

Answer 29

Shoulder margin reduced by 1mm and 1.5mm where in occlusion Allows smooth transition from porcelain to tooth, continuous colour, thick margin so colour is maintained

Question 30

Describe the margin design and reduction for a palatal incisor crown prep and give its benefits

Answer 30

All ceramic, shoulder 1-1.5mm, if MCC then chamfer palatally Preserves tooth tissue, easy to place, thinner reduction at these areas

Question 31

Give 4 properties of impression materials suitable for crown prep

Answer 31

Dimensionally stable Hydrophilic High tear strength Low rigidity

Question 32

What is xerostomia?

Answer 32

Dry mouth caused by reduced salivary flow

Question 33

Give 3 oral health problems exacerbated by xerostomia

Answer 33

Caries Candidosis Dysphagia

Question 34

Name 4 drugs that cause xerostomia?

Answer 34

Tricyclics Opioids Diuretics Nicotine

Question 35

Give 2 non drug related causes of xerostomia

Answer 35

Sjögren’s syndrome Radiotherapy to the head and neck

Question 36

What does ARAB stand for?

Answer 36

Active component Resistance Anchorage Baseplate

Question 37

What component corrects a posterior crossbite?

Answer 37

Midline palatal screw

Question 38

Name 2 areas of primary support on a maxillary impression

Answer 38

Hard palate Residual ridge

Question 39

Name an area of primary support in mandibular impressions

Answer 39

Buccal shelf

Question 40

What group does chlorhexidine belong to?

Answer 40

Bisguanide

Question 41

Describe the mode of action of chlorhexidine

Answer 41

Adheres to pellicle coated tooth surface and to bacterial membrane increasing cell permeability and causing cell death

Question 42

What is the substantivity of chlorhexidine?

Answer 42

12 hours

Question 43

What volume, concentration and frequency of chlorhexidine should be given?

Answer 43

0.2%, 10mg twice daily for 1 week 20mg per day

Question 44

Give 4 indications for chlorhexidine

Answer 44

Difficult OH due to trauma Treatment of candida infection Immunocompromised patient Endo irrigation when NaOCl is contraindicated

Question 45

What is SIMD?

Answer 45

Scottish Index of Multiple Deprivation Ranks data zones based on deprivation, factors include housing, crime, unemployment, and education

Question 46

What are the key links in the chain of infection?

Answer 46

Infectious agent Reservoir Portal of entry Mode of transmission Portal of exit Susceptible host

Question 47

What can reduce chance of injury when playing contact sports?

Answer 47

Custom made bite splint absorbs initial shock form trauma

Question 48

Give 3 ways to determine if an impression is usable

Answer 48

Accuracy of capturing tooth position Fine detail production Material uniformity

Question 49

List 4 potential faults of an inlay impression

Answer 49

Distortions or tears Air bubbles or voids Poor detail reproduction Insufficient thickness