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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
Q

What other intra oral condition would present like pemphigus vulgaris but with different pathological findings? (1)

A

Pemphigoid

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26
Q

Two risk factors for SC carcinoma?

A

alcohol & smoking

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27
Q

What type of staging is commonly used to diagnose carcinomas?

A

TNM

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28
Q

What three ways are there of grading carcinomas?

A

By level of dysplasia, mitotic figure and invasion of other tissue (eg underlying muscle)

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29
Q

What medical/surgical interventions would you do to prevent/treat a SC Carcinoma? (3)

A

surgical removal, chemotherapy, radiotherapy

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30
Q

Name two types of tooth wear

A

erosion & attrition

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31
Q

BEWE grading system (1)

A

0 = no surface loss
1 = initial loss of enamel surface detail
2 = distinct surface loss on <50% of sites
3 = >50%

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32
Q

Give 3 named examples of topical fluoride you can give to patient (3)

A

Fluoride varnish 22.600ppm
Toothpaste up to 5000ppm
Mouthwash 225ppm

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33
Q

What is the Dahl technique? (1)

A

A way of increasing the OVD over a period of time to gain space in cases of localised tooth wear

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34
Q

Describe how the Dahl technique works (3)

A

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)

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35
Q

4 contraindicated groups for using the Dahl Technique (4)

A

Bisphosphonates, implants, existing bridgework, previous ortho

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36
Q

4 constituents of composite with examples (4)

A

Resin - bis-GMA
Filler - silica
photoinitiator - camphorquinone
binding agent - silane coupling agent (bonds resin to silica)

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37
Q

Paeds 11 fractured. Have not examined yet
What two things to ask about injury? (2)

A

Have all of the tooth fragments been accounted for or are pieces missing?
Where and how did the injury happen?

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38
Q

Paeds 11 fractured. Mum asks about prognosis; what factors would you say are involved? (4)

A

Any pulpal exposure
Displacement of the tooth within the socket
Fracture of the root
Length of time any pulp has been exposed for

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39
Q

Enamel dentine # what would you do about the missing fragment and how would you follow this up? (3)

A

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

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40
Q

Paeds 11 Enamel dentine #. Decide to do composite, patient has heart valve defect, what would you change about your tx? (1)

A

Place indirect pulp cap to minimise the risk of future RCT

41
Q

Patient wants to get IV sedation.
Why do you get consent at different times? (1)

A

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
Q

What three things do you monitor during sedation? (3)

A

HR, BP and O2 saturation

43
Q

What drug do you use for sedation, what concentration? (2)

A

midazolam 5mg/5ml

44
Q

What drug do you use to reverse midazolam during sedation?

A

Flumazenil

45
Q

What three post op instructions would you give someone who is booked for sedation? (3)

A

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
Q

Child with 6s and incisors yellow/brown/discoloured and unhappy.
What 8 questions would you ask the patient and parent? (4)

A

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
Q

Is MIH congenital or acquired? (1)

A

Acquired

48
Q

What 5 questions would you ask to rule out fluorosis?

A

Fluoride supplements
water fluoridated
fluoride supplements
any toxic fluoride ingestion
toothpaste strength used

49
Q

Child with 6s and incisors yellow/brown/discoloured and unhappy. What problems might you encounter with the 6s?

A

sensitivity
wear
caries risk
erosion
difficult to bond to

50
Q

Patient 13-year-old has BPE of 333/332 plaque on lots of sites.
What is a score of 3?

A

maximum probing depth between 3.5-5.5mm in that sextant (black band partially obscured)

51
Q

Length of ACJ to bone crest (1)

A

2mm

52
Q

What teeth to examine for modified BPE (1)

A

16,11,26,36,31,46

53
Q

What would be your tx plan for someone with aggressive periodontitis? (4)

A

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
Q

13-year-old with decalcification, what types of fluoride delivery could you use? (4)

A

fluoride varnish
fluoride toothpaste
fluoride mouthwash
tablets 1mg

55
Q

13 year old with decalcification. what could you do other than fluoride delivery? (2)

A

diet advice and OHi

56
Q

8 risks of ortho tx with fixed appliance (4)

A

root resorption, relapse, failure, enamel wear, recession, soft tissue trauma, loss of vitality and allergy

57
Q

Patient has tooth extracted
4 ways of getting haemostasis (4)

A

damp gauze and pressure
LA with vasoconstrictor
surgicel and sutures
diathermy
artery forceps

58
Q

What is the term for delayed onset bleeding? (1)

A

reactionary up to 48 hrs
up to a week called secondary (generally caused by infection causing breaking down of the clot)

59
Q

2 congenital and 2 acquired bleeding disorders (4)

A

Haemophilia and von willebrands
drug therapy and alcoholic liver disease

60
Q

NOAC, INR monitor at least 48 hours before procedure – true or false? (1)

A

false

61
Q

Patient, 30 years old, with class III
3 ways to assess the patient (3)

A

frankfort parallel to the floor and visually assess, palpate skeletal bases and lat ceph

62
Q

Patient, 30 years old, with class III 4 special investigations (2)

A

radiographs, study models, photographs, pgi, bpe, sensibility tests

63
Q

4 intraoral features of a class 3 skeletal pattern (4)

A

Posterior crossbite
displacement on closing
crowded maxilla
class 3 incisor relationship
Decreased/reverse OJ
retroclined lower incisors

64
Q

How many occlusal units for 2 occluding premolars and one pair of occluding molars? (1)

A

3 units

65
Q

What skeletal classes are contraindicated with SDA?

A

Severe class 2 or class 3

66
Q

Why are severe class 2 or class 3 skeletal classes contraindicated for SDA? (1)

A

Less likely for there to be occluding pairs in severe malocclusion

67
Q

Periodontal disease is a contraindication for SDA, give three reasons why? (3)

A

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
Q

What metal is used for casting adhesive bridge? (1)

A

CoCr

69
Q

Why is CoCr used for casting adhesive bridges? (1)

A

strong, hard, high young’s modulus

70
Q

What is the 5-year survival rate for RRB? (1)

A

80%

71
Q

Sub Alveolar fracture of 12, 11 with enamel-dentine fracture. >1mm and >24hours
Describe immediate management of 11 (4)

A

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
Q

Subalveolar fracture is poor prognosis, why is this the case? (3)

A

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
Q

Sub Alveolar fracture of 12, 11 with enamel-dentine fracture. >1mm and >24hours
Two options for replacing the tooth when it is extracted? (2)

A

implant retained prosthesis, RBB, RPD

74
Q

What is your first line of treatment for denture induced stomatitis ? (2)

A

denture hygiene advice
tissue conditioner
CHX mouthwash

75
Q

What would be your second line of treatment for denture induced stomatitis? (1)

A

systemic antifungals (fluconazole, itraconazole)
topical antifungals (miconazole, nystatin)

76
Q

What instructions would you give the lab regarding construction of special trays? (4)

A

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
Q

patient has caries on palatal 12, sensitive to sweet

A

reversible pulpitis

78
Q

What design would you do to minimise the risks of a de-bond on a RRB cantilever? (2)

A

pick tooth with large bonding area for abutment, cantilever design for anterior sextant

79
Q

What four faults can occur to cause a de-bond on a RRB? (4)

A

poor moisture control during cementation
unfavourable occlusion
poor enamel quality on abutment
inadequate coverage of abutment

80
Q

What material is used in metal wing of bridge? (1)

A

CoCr

81
Q

What histological presentation could indicate malignancy? (1)

A

dysplasia

82
Q

What clinical presentation would indicate malignancy? (2)

A

exophytic, raised rolled borders, firm and indurated, friable, bleeding, persistent >3 weeks with no obvious cause

83
Q

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)

A

Discrepancy between arch widths meaning teeth meet cusp to cusp so the mandible must deviate to one side to achieve ICP

84
Q

Why should you correct a mandibular displacement? (2)

A

Can lead to TMJ symptoms and can cause attritive wear

85
Q

What would you use to correct a bilateral posterior crossbite? (1)

A

mid palatal screw on a URA to expand maxilla

86
Q

TMD
6 signs/symptoms (3)

A

hypertrophic MoMs
tender MoMs
pain from TMJ
linea alba
scalloped tongue
occlusal surface wear
clicking/popping noises on opening

87
Q

What two muscles would you palpate to check for TMD? (2)

A

temporalis and masseter

88
Q

What conservative advice would you give someone with TMD? (5)

A

stop any parafunctional habits (nail biting)
no chewing gum
limit mouth opening (no maximum opening)
chew bilaterally
soft diet
don’t incise foods

89
Q

What immediate treatment would you give someone with pericoronitis? (3)

A

Incise and drain any abscess
irrigate under operculum with saline / CHX
advise analgesics
consider antibiotics if systemic involvement

90
Q

What 6 pieces of information could you take from the radiograph when considering XLA of lower 8? (6)

A

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
Q

What three GI conditions can cause microcytic iron deficiency anaemia ? (3)

A

Crohn’s, ulcerative colitis, celiacs

92
Q

What three oral conditions can be associated with microcytic iron deficiency anaemia ? (3)

A

Candidosis, dysaesthesia, aphthous uclers

93
Q

Child 13, presents with ulceration, what 8 questions do you ask the patient about the ulcers? (4)

A

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
Q

What 3 head, neck and oral features can occur with cocaine use? (3)

A

nasal septal defect, oral ulceration, bruxism and tooth wear from grinding

95
Q

What are 4 side effects of opioid use? (4)

A

constipation, sedation, xerostomia, excessive sweating, addiction

96
Q

What group does methadone belong to? (1)

A

opioid

97
Q

What is a complication of methadone containing sugar? (1)

A

rampant dental caries

98
Q

What is the risk of a sugar-free preparation of methadone? (1)

A

more likely to inject it

4th year (4 decks)

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