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4th year > 2016/17? F > Flashcards

2016/17? F Flashcards

1
Q

Treatment options in the event of radiolucencies? (2)

A

RCT
Periradicular Surgery
XLA
No Tx & Monitor

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2
Q

Two things required for valid consent? (2)

A

Must be informed
current
continuous
specific to the procedure

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3
Q

six things you need to inform the patient for valid consent? (6)

A

Things to tell pt:
cost
likelihood of success
complications
alternative options
risks and benefits
likely consequences of no Tx

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4
Q

Patient with space between 13, 14
Investigations and justification (6)

A

Radiograph (PA or OPT) - to check if there is a supernumerary or pathology causing the spacing
Sensibility testing - as supernumerary may cause root resorption and loss of vitality
Mobility assessment - root resorption due to supernumerary may cause mobility

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5
Q

Patient with space between 13, 14. What might make treatment of this case difficult?

A

Lower canine over erupting into the space
Presence of supernumerary causing root resorption of these teeth, requiring XLA
Position of tooth may make surgical extraction difficult

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6
Q

Patient with space between 13, 14. What would make the implant placement difficult?

A

Lack of space between 13, 14 for implant to be placed
Aesthetic zone so more challenging
Prosthesis will likely be involved in guidance

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7
Q

What three features of an RPD give tooth support?

A

Occlusal rests, cingulum rests, incisal rests

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8
Q

What function does a palatal extension provide on the 12 in an RPD?

A

indirect retention

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9
Q

What function does the palatal extension place on the 16, 24?

A

Reciprocation

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10
Q

What is good about the gingival margin being clear in an RPD? (1)

A

Keeps the gingival margin of teeth clear for improved periodontal health, prevents gum stripping and food packing

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11
Q

Angular cheilitis in elderly patient
What two organisms are linked to it? (2)

A

S. Aureus, C. albicans

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12
Q

What sort of sample would you collect in a case of angular chelitis?

A

Swab

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13
Q

Why would you use miconazole if sampling taking too long when trying to sample angular cheilitis? (1)

A

As it has antimicrobial action against candida and staphylcocci

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14
Q

Give two examples of immunocompromised and gastric bleeding disease and explain aetiology in this (2)

A

HIV and Cancer Tx - immunosuppression allows opportunistic pathogen to cause the disease (C. Albicans)
Crohn’s and Coeliacs - lack of absorption causing malnutrition and suppressive Tx for Crohn’s

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15
Q

What instructions would you give the patient on denture hygiene? (2)

A

Take it out at night, soak in alkaline peroxide for 20 mins then in water overnight, brush after meals

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16
Q

Why might someone choose to use Alginate & medium body PVS for master impressions?

A

both have good flowability, wetability and capture good surface detail

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17
Q

What are two components for each Alginate & Medium body PVS?

A

alginate - sodium alginate, calcium sulphate
PVS - poly dimethysiloxane, filler

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18
Q

MOD amalgam fracture with buccal cusps involved. Intact GP. What would be your two restorative options?

A

MCC crown
Onlay

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19
Q

MOD amalgam fracture with buccal cusps involved. Intact GP. Been over 6 months, what would be your tx plan?

A

Have to reRCT the tooth as GP has been exposed >3mths, bacteria could have reinfected canal and loss of coronal seal

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20
Q

Features of a Nayyar core (3)

A

RCT as normal, 2-3mm of coronal GP removed, amalgam is packed into the canal as the core is built up and increases retention

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21
Q

2 things you can use to bond to amalgam (2)

A

MDP and 4-META

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22
Q

What has higher bond strength, composite or amalgam? (1)

A

Composite

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23
Q

What could the pathologist tell the clinician about the findings of a histological sample in a patient with pemphigus? (3)

A

Basketweave appearance of the immunofluorescence
Suprabasal split
Presence of Tzank cells in the split

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24
Q

What is the aetiology of pemphigus vulgaris? (2)

A

Caused by autoimmune antibodies IgG, caused by a genetic predisposition and an environmental trigger, more common in women

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25
What other intra oral condition would present like pemphigus vulgaris but with different pathological findings? (1)
Pemphigoid
26
Two risk factors for SC carcinoma?
alcohol & smoking
27
What type of staging is commonly used to diagnose carcinomas?
TNM
28
What three ways are there of grading carcinomas?
By level of dysplasia, mitotic figure and invasion of other tissue (eg underlying muscle)
29
What medical/surgical interventions would you do to prevent/treat a SC Carcinoma? (3)
surgical removal, chemotherapy, radiotherapy
30
Name two types of tooth wear
erosion & attrition
31
BEWE grading system (1)
0 = no surface loss 1 = initial loss of enamel surface detail 2 = distinct surface loss on <50% of sites 3 = >50%
32
Give 3 named examples of topical fluoride you can give to patient (3)
Fluoride varnish 22.600ppm Toothpaste up to 5000ppm Mouthwash 225ppm
33
What is the Dahl technique? (1)
A way of increasing the OVD over a period of time to gain space in cases of localised tooth wear
34
Describe how the Dahl technique works (3)
Composite added to anterior teeth, increasing the OVD and causing posterior disclusion, over the space of 3-6 months the posterior teeth over erupt back into contact at the new OVD, giving space for any definitive anterior restorations (usually the initial composite is definitive)
35
4 contraindicated groups for using the Dahl Technique (4)
Bisphosphonates, implants, existing bridgework, previous ortho
36
4 constituents of composite with examples (4)
Resin - bis-GMA Filler - silica photoinitiator - camphorquinone binding agent - silane coupling agent (bonds resin to silica)
37
Paeds 11 fractured. Have not examined yet What two things to ask about injury? (2)
Have all of the tooth fragments been accounted for or are pieces missing? Where and how did the injury happen?
38
Paeds 11 fractured. Mum asks about prognosis; what factors would you say are involved? (4)
Any pulpal exposure Displacement of the tooth within the socket Fracture of the root Length of time any pulp has been exposed for
39
Enamel dentine # what would you do about the missing fragment and how would you follow this up? (3)
Ask the patient if the fractured fragment was located post injury If not or unsure then PA soft tissue view radiograph to check the soft tissues If still not located then refer the patient for a chest x-ray under the concern that it has been inhaled or swallowed
40
Paeds 11 Enamel dentine #. Decide to do composite, patient has heart valve defect, what would you change about your tx? (1)
Place indirect pulp cap to minimise the risk of future RCT
41
Patient wants to get IV sedation. Why do you get consent at different times? (1)
As once the patient has been sedated the consent is no longer valid, and the amnesic effects of midazolam may mean they forget giving consent if on the same day
42
What three things do you monitor during sedation? (3)
HR, BP and O2 saturation
43
What drug do you use for sedation, what concentration? (2)
midazolam 5mg/5ml
44
What drug do you use to reverse midazolam during sedation?
Flumazenil
45
What three post op instructions would you give someone who is booked for sedation? (3)
Do not be responsible for any children Rest for the remainder of the day Do not sign any legal documents or any online shopping
46
Child with 6s and incisors yellow/brown/discoloured and unhappy. What 8 questions would you ask the patient and parent? (4)
Did the mother take any fluoride supplements during third trimester? Any illnesses in the third trimester? Any difficulties during birth? Was it a cesarean section? Any infections of the child in early months of life? Any fluoride supplements for the child? Was the child in a intensive care baby unit? Low birth weight? Premature birth? Any long term illness of the child in early life?
47
Is MIH congenital or acquired? (1)
Acquired
48
What 5 questions would you ask to rule out fluorosis?
Fluoride supplements water fluoridated fluoride supplements any toxic fluoride ingestion toothpaste strength used
49
Child with 6s and incisors yellow/brown/discoloured and unhappy. What problems might you encounter with the 6s?
sensitivity wear caries risk erosion difficult to bond to
50
Patient 13-year-old has BPE of 333/332 plaque on lots of sites. What is a score of 3?
maximum probing depth between 3.5-5.5mm in that sextant (black band partially obscured)
51
Length of ACJ to bone crest (1)
2mm
52
What teeth to examine for modified BPE (1)
16,11,26,36,31,46
53
What would be your tx plan for someone with aggressive periodontitis? (4)
six point pocket chart of the full mouth Comprehensive history to see any FH of aggressive perio radiographs to assess bone levels RSI of the deep pockets (>4mm) and supragingival scaling of the entire mouth CHX mouthwash, OHI and diet advice
54
13-year-old with decalcification, what types of fluoride delivery could you use? (4)
fluoride varnish fluoride toothpaste fluoride mouthwash tablets 1mg
55
13 year old with decalcification. what could you do other than fluoride delivery? (2)
diet advice and OHi
56
8 risks of ortho tx with fixed appliance (4)
root resorption, relapse, failure, enamel wear, recession, soft tissue trauma, loss of vitality and allergy
57
Patient has tooth extracted 4 ways of getting haemostasis (4)
damp gauze and pressure LA with vasoconstrictor surgicel and sutures diathermy artery forceps
58
What is the term for delayed onset bleeding? (1)
reactionary up to 48 hrs up to a week called secondary (generally caused by infection causing breaking down of the clot)
59
2 congenital and 2 acquired bleeding disorders (4)
Haemophilia and von willebrands drug therapy and alcoholic liver disease
60
NOAC, INR monitor at least 48 hours before procedure – true or false? (1)
false
61
Patient, 30 years old, with class III 3 ways to assess the patient (3)
frankfort parallel to the floor and visually assess, palpate skeletal bases and lat ceph
62
Patient, 30 years old, with class III 4 special investigations (2)
radiographs, study models, photographs, pgi, bpe, sensibility tests
63
4 intraoral features of a class 3 skeletal pattern (4)
Posterior crossbite displacement on closing crowded maxilla class 3 incisor relationship Decreased/reverse OJ retroclined lower incisors
64
How many occlusal units for 2 occluding premolars and one pair of occluding molars? (1)
3 units
65
What skeletal classes are contraindicated with SDA?
Severe class 2 or class 3
66
Why are severe class 2 or class 3 skeletal classes contraindicated for SDA? (1)
Less likely for there to be occluding pairs in severe malocclusion
67
Periodontal disease is a contraindication for SDA, give three reasons why? (3)
poor prognosis of teeth drifting of teeth under occlusal load loss of alveolar bone leading to compromised denture bearing area in the long term
68
What metal is used for casting adhesive bridge? (1)
CoCr
69
Why is CoCr used for casting adhesive bridges? (1)
strong, hard, high young’s modulus
70
What is the 5-year survival rate for RRB? (1)
80%
71
Sub Alveolar fracture of 12, 11 with enamel-dentine fracture. >1mm and >24hours Describe immediate management of 11 (4)
account for any missing tooth fragments radiograph to check for any root displacement or fracture LA and dam (reposition tooth if any displacement) remove coronal pulp until into healthy pulp haemostasis cotton wool pledget soaked in saline if no haemostasis continue to remove pulp tissue until haemostasis can be achieved direct pulp cap placed and sealed using an adhesive restoration
72
Subalveolar fracture is poor prognosis, why is this the case? (3)
Lack of tooth tissue to support a restoration difficulty of isolation and moisture control for any treatment difficulty of placing subgingival crown margins cant clamp the tooth to carry out endo
73
Sub Alveolar fracture of 12, 11 with enamel-dentine fracture. >1mm and >24hours Two options for replacing the tooth when it is extracted? (2)
implant retained prosthesis, RBB, RPD
74
What is your first line of treatment for denture induced stomatitis ? (2)
denture hygiene advice tissue conditioner CHX mouthwash
75
What would be your second line of treatment for denture induced stomatitis? (1)
systemic antifungals (fluconazole, itraconazole) topical antifungals (miconazole, nystatin)
76
What instructions would you give the lab regarding construction of special trays? (4)
please pour in 50/50 stone/plaster and construct special trays in light cure acrylic, non perforated, upper with 2mm wax spacer and lower with 1mm spacer with intraoral handles and finger rests in premolar region, please ensure muscle attachments are relieved
77
patient has caries on palatal 12, sensitive to sweet
reversible pulpitis
78
What design would you do to minimise the risks of a de-bond on a RRB cantilever? (2)
pick tooth with large bonding area for abutment, cantilever design for anterior sextant
79
What four faults can occur to cause a de-bond on a RRB? (4)
poor moisture control during cementation unfavourable occlusion poor enamel quality on abutment inadequate coverage of abutment
80
What material is used in metal wing of bridge? (1)
CoCr
81
What histological presentation could indicate malignancy? (1)
dysplasia
82
What clinical presentation would indicate malignancy? (2)
exophytic, raised rolled borders, firm and indurated, friable, bleeding, persistent >3 weeks with no obvious cause
83
Child with mandibular displacement on closing to RHS. Posterior unilateral crossbite of d, e and 6 on the RHS What is mandibular displacement on closing? (2)
Discrepancy between arch widths meaning teeth meet cusp to cusp so the mandible must deviate to one side to achieve ICP
84
Why should you correct a mandibular displacement? (2)
Can lead to TMJ symptoms and can cause attritive wear
85
What would you use to correct a bilateral posterior crossbite? (1)
mid palatal screw on a URA to expand maxilla
86
TMD 6 signs/symptoms (3)
hypertrophic MoMs tender MoMs pain from TMJ linea alba scalloped tongue occlusal surface wear clicking/popping noises on opening
87
What two muscles would you palpate to check for TMD? (2)
temporalis and masseter
88
What conservative advice would you give someone with TMD? (5)
stop any parafunctional habits (nail biting) no chewing gum limit mouth opening (no maximum opening) chew bilaterally soft diet don’t incise foods
89
What immediate treatment would you give someone with pericoronitis? (3)
Incise and drain any abscess irrigate under operculum with saline / CHX advise analgesics consider antibiotics if systemic involvement
90
What 6 pieces of information could you take from the radiograph when considering XLA of lower 8? (6)
relationship of IAC to root any dental caries present bone levels impaction status of the 8s pathology of supporting structures (eg tumour or cyst formation) periapical status of teeth crown and root morphology of teeth
91
What three GI conditions can cause microcytic iron deficiency anaemia ? (3)
Crohn’s, ulcerative colitis, celiacs
92
What three oral conditions can be associated with microcytic iron deficiency anaemia ? (3)
Candidosis, dysaesthesia, aphthous uclers
93
Child 13, presents with ulceration, what 8 questions do you ask the patient about the ulcers? (4)
are they recurrent how long have they been present anything that triggers them where are they in the mouth do you get any pain with them how long is the latency period between episodes anything make them better or worse any lesions elsewhere on the body
94
What 3 head, neck and oral features can occur with cocaine use? (3)
nasal septal defect, oral ulceration, bruxism and tooth wear from grinding
95
What are 4 side effects of opioid use? (4)
constipation, sedation, xerostomia, excessive sweating, addiction
96
What group does methadone belong to? (1)
opioid
97
What is a complication of methadone containing sugar? (1)
rampant dental caries
98
What is the risk of a sugar-free preparation of methadone? (1)
more likely to inject it

4th year (4 decks)

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