2013 Resit MSA Flashcards
What 4 factors can cause tooth mobility?
PDL width
PDL height
Inflammation
Number, shape and length of roots
In what 2 circumstances of tooth mobility would you intervene?
If mobility is progressively increasing
If mobility is symptomatic
If a patient with moderate/advanced perio had successful HPT, would their mobility increase or decrease and why?
Decrease
HPT removes any bacteria that caused loss of attachment and promotes attachment of long junctional epithelium to the root, increasing stability
Patient has mobile lower incisors causing discomfort but refuses XLA. Advise treatment and disadvantages of this.
Splinting
It can create hygiene difficulties
What are 2 aims when retracting a flap?
Access to operative field
Protect soft tissues
Direct vision
Give 4 factors that influence the design of a flap
Location of surgical site
Post-operative aesthetics
Retraction
Surgical procedure being carried out
What instrument is used to remove bone?
Straight electric handpiece with saline cooled bur
What are the 3 methods of debridement?
Irrigation - saline into socket and under flap
Physical - bone file to remove soft tissue debris
Suction - aspirate under flap
What 3 blood tests can be used to investigate a bleeding disorder?
FBC - full blood count
INR
aPPT - activated partial thromboplastin time
Name an inherited coagulation disorder
Haemophilia A
Haemophilia B
Von Williebrand’s disease
Name a disorder of platelet numbers?
Thrombocytopenia
What LA technique is used for XLA of 47 when the patient has a bleeding disorder?
Articaine infiltration as risk of bleed into pterygomandibular space with IDB
Name 2 clotting factors affected by warfarin
Vitamin K dependent clotting factors - II, VII, IX and X
What LA technique should be used for XLA of 47 in a patient with warfarin?
IDB
Name 3 forms of candidosis
Erythematous
Pseudomembranous
Hyperplastic
Name a polyene antifungal and its mechanism of action
Nystatin
Binds to ergosterol, leading to increased membrane permeability and eventually cell death
Give 2 resistance mechanisms of candida
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
Name 1 species of candida other than albicans and how to differentiate the 2?
Candida. glabrata - it is resistant to azole antifungals, which candida. albicans is not
Before prescribing F- mouth rinse, what should you check before prescribing?
Fluorosis
Allergy
What is the daily strength of F- mouth rinse?
230ppm
How do you decide between conventional vs post and core?
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
What is the function of a post?
Core retention
What 2 materials are used in post and cores?
Core - composite
Post - cast metal, steel zirconia or carbon/glass fibre
Give 3 ways to determine post length?
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
What problem does a wide post give?
Root fracture
What problem does a narrow post give?
Retention problem
Give 3 general health effects of smoking
Increased cardiovascular disease risk
High blood pressure
Increased risk of respiratory diseasew
Give 3 oral health effects of smoking
Halitosis
Oral cancer
Xerostomia
Describe the margin design and reduction of a labial incisor crown prep and give the benefits of this design
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
Describe the margin design and reduction for a palatal incisor crown prep and give its benefits
All ceramic, shoulder 1-1.5mm, if MCC then chamfer palatally
Preserves tooth tissue, easy to place, thinner reduction at these areas
Give 4 properties of impression materials suitable for crown prep
Dimensionally stable
Hydrophilic
High tear strength
Low rigidity
What is xerostomia?
Dry mouth caused by reduced salivary flow
Give 3 oral health problems exacerbated by xerostomia
Caries
Candidosis
Dysphagia
Name 4 drugs that cause xerostomia?
Tricyclics
Opioids
Diuretics
Nicotine
Give 2 non drug related causes of xerostomia
Sjögren’s syndrome
Radiotherapy to the head and neck
What does ARAB stand for?
Active component
Resistance
Anchorage
Baseplate
What component corrects a posterior crossbite?
Midline palatal screw
Name 2 areas of primary support on a maxillary impression
Hard palate
Residual ridge
Name an area of primary support in mandibular impressions
Buccal shelf
What group does chlorhexidine belong to?
Bisguanide
Describe the mode of action of chlorhexidine
Adheres to pellicle coated tooth surface and to bacterial membrane increasing cell permeability and causing cell death
What is the substantivity of chlorhexidine?
12 hours
What volume, concentration and frequency of chlorhexidine should be given?
0.2%, 10mg twice daily for 1 week
20mg per day
Give 4 indications for chlorhexidine
Difficult OH due to trauma
Treatment of candida infection
Immunocompromised patient
Endo irrigation when NaOCl is contraindicated
What is SIMD?
Scottish Index of Multiple Deprivation
Ranks data zones based on deprivation, factors include housing, crime, unemployment, and education
What are the key links in the chain of infection?
Infectious agent
Reservoir
Portal of entry
Mode of transmission
Portal of exit
Susceptible host
What can reduce chance of injury when playing contact sports?
Custom made bite splint absorbs initial shock form trauma
Give 3 ways to determine if an impression is usable
Accuracy of capturing tooth position
Fine detail production
Material uniformity
List 4 potential faults of an inlay impression
Distortions or tears
Air bubbles or voids
Poor detail reproduction
Insufficient thickness
