2016 ppq Flashcards
two organisms involved in angular cheilitis?
Condition that would be seen orally?
s.aureus
C.albican
denture induced stomatitis
hyperplastic candidiasis
sample to collect for angular cheilitis?
swab
What would you use if could not/ no sample for angular cheilitis?
Miconazole
antibacterial and antifungal activity
against candida and staphylocci
Two example of immunocompromised and gastric bleeding disease. Aetiology?
immunocompromised:
- HIV
- Diabetes
- Leukaemia
immunosuppression=
= allows opportunistic pathogen to cause the disease
= reduced immune function .:. reduced ability to fight off infection
bleeding: -Crohn's -Ulcerative Colitis -peptic ulcer = loss of immune cells in blood =lack of absorption .:>malnutrition
Instructions to give pt on denture hygiene?
remove at night
soak in alkaline peroxide for 20 minutes then in water
Types of fluoride delivery for a 13 year old
fluoride varnish 22600
fluoride toothpaste 1450
fluoride mouthwash 225
fluoride tablets 1mg
For pt with orthodontic decal what else could you give?
diet advice and OHI
8 risks of ortho tx with fixed appliance?
root resorption relapse failure enamel wear recession soft tissue trauma loss of vitality allergy
4 ways to gain haemostasis
damp gauze and pressure LA with vasoconstrictor surgicel and sutures diathermy artery forceps
term for delayed onset of bleeding
reactionary up to 48 hours
up to a week is called secondary
- secondary generally caused by infection causing breakdown of clot
2 congenital and 2 acquired bleeding disorders
Haemophilia and von Willebrands disease
drug therapy and alcohol liver disease
When do you have to monitor INR for before procedure?
ideally no more than 24 hours before the procedure.
if a stable INR, checking the INR no more than 72 hours before is acceptable.
How many occlusal units is 2 occluding premolars and one pair of occluding molars?
3
WHat skeletal classes are contraindicated with SDA?
why?
severe class 2 class 3
less likely for there to be occluding pairs in a severe malocclusion
Why is periodontal disease a contraindication for SDA? 3 reasons
poor prognosis of teeth
drifting of teeth under occlusal load
loss of alveolar bone leading to compromised denture bearing area in long term
What metal is used for casting an adhesive bridge?
why?
CoCr
strong, hard, high young’s modulus
What is the 5 year survival rate for resin retained bridge?
~80%
11 ed fracture, >1 mm >24 hours. immediate mgmt?
- –account for missing tooth fragments
- –radiograph to check for any root displacement or fracture
- –LA, dam
- –reposition tooth if any displacement
- –removal coronal pulp until into healthy pulp
- –haemostasis cotton wool pledget soaked in saline
- –if no haemostasis remove pulp tissue until haemostasis can be achieved
- –direct pulp cap placed and sealed using adhesive restoration
why is subalveolar fracture poor prognosis?
- lack of tooth tissue to support a restoration
- difficulty of isolation and moisture control for any treatment
- difficulty placing subgingival crown margins
- cannot clamp tooth to carry out endo
denture induced stomatitis. features of palatal tissues?
erythematous
papillary hyperplasia
first line of tx denture induced stomatitis?
second line?
denture hygiene advice
tissue conditioner
CHX MW
2) systemic antifungals- fluconazole, itraconazole
topical- miconazole, nystatin
lab instructions for special tray manufacture?
please pour primary impressions in 50/50 stone/plaster and construct special trays in light cure acrylic, non perforated, upper with 2mm wax spacer and lower with 1mm space with intraoral handles and finger rests in premolar region, please ensure muscle attachments are relieved
sensitivity to sweet. pulpal diagnosis?
reversible pulpitis
Metal used in wing of resin retained bridge?
CoCr
Four faults that can occur to cause RRB to debond?
poor moisture control during cementation
unfavourable occlusion
poor enamel quality on abutment
inadequate coverage of abutment
what design could you do for RRB to minimise risk of debond?
pick tooth with large bonding area for abutment
cantilever design for anterior sextant
3 questions to ask mum of child who has swallowed toothpaset
How old is the child?
What concentration of fluoride is in the toothpaste? (strength of toothpaste)
How much toothpaste they swallowed?
potentially toxic dose
mgmt
5mg
Go to a hospital
Give calcium orally
fluoride supplementation for 1 yo 4 yo 7yo
1 year old (0.25mg)- Fluoride drops (0.25mg/0.5ml)
4 years old (0.5mg)- Fluoride chewable tablet (0.5mg)
7 years old (1.00mg)- Fluoride mouthwash 225 ppm
histology q-smoker’s keratosis- what histological presentation could indicate malignancy?
evidence of dysplasia
hyperchromatism
atypia
histology q - smoker’s keratosis - what clinical presentation would indicate malignancy?
raised, rolled, indurated margins
ulcerated with yellow/necrotic base
bleeding non homogenous surface friable areas exophytic growth >3 weeks w/o obvious cause
what is mandibular displacement on closing?
discrepancy between arch widths meaning teeth meet cusp to cusp so mandible must deviate to one side ro achieve ICP
why should you correct a mandibular displacement?
Can lead to TMJ symptoms and cause attritive wear
What would you use to correct a bilateral posterior crossbite?
mid palatal screw on a URA to expand maxilla
design ura to correct bilateral posterior crossbite
A- mid palatal screw
R- Adams on Ds (0.6HSSW) and 6s (0.7HSSW)
A- reciprocal
B- self cure PMMA with FPBP and mid palatal split
6 signs or symptoms tmd
hypertrophic MoMs tender MoMs pain from TMJ linear alba scalloped tongue occlusal surface wear clicking popping on opening
two muscles you would palpate for TMD
temporalis and masseter
conservative advice to give for TMD
- stop parafunctional habits- nail biting
- limit mouth opening - no maximum opening
- soft diet
- do not incise food
- hot compresses
- supported yawning
- no chewing gum
pericoronitis- immediate treatment you would give the patient?
incise and drain any abscess
irrigate under operculum with saline/ CHX
advise analgesics
consider antibiotics if systemic involvement
6 pieces of information to take from radiograph of 3rd molars
- relationship of IAC to root any dental caries present bone levels impaction status of the 8s pathology of supporting structures crown and root morphology of teeth
- darkening of canal
- diversion root
- disruption id canal
- interuption tram lines
three GI conditions that could cause microcytic anaemia?
Crohn's peptic ulcer ulcerative colitis colon polyposis h. pylori gastritis
three oral conditions microcytic anaemia could be associated with?
- -atrophic glossitis
- -oral lichen planus
- -RAU recurrent apthous ulcers
- burning sensation of mucosa
- -xerostomia
child presents with ulcer on lip
what else would you see intraorally?
what would be your diagnosis?
erythematous gingiva
ulcerated mucosa
intact vesicles
white tongue due to buildup of dead squamous cells
primary herpetic stomatitis
what 8 questions could you ask parent of 13 year old child presenting with ulcer on lip
- are they recurrent
- how long have they been present
- anything that triggers them
- where are they in mouth
- any pain from them
- how long is latency period between episode
- anything make them better or worse
- any lesions elsewhere on body
two local and two general factors for implant placement?
local -
- bone height
- smoking
- OH
- -perio
general-
- diabetes
- psychiatric conditions
- pt motivation
- osteporosis
what are 4 side effects of opioid use?
constipation sedation xerostomia excessive sweating addiction
what group does methadone belong to?
opioid
what is a complication of methadone containing sugar?
rampant dental caries
what is the risk of a sugar free preparation of methadone?
more likely to inject it
three types of sterilisers?
N
B
S
clinical and lab investigations for pt with generalised bone loss
thorough history - including family history
periodontal pocket chart - 6ppc
microbiological analysis of sample- rinse - to check for Aa
oral examination
fluoride supplementation for 1 yo 4 yo 7yo
1 year old (0.25mg)- Fluoride drops (0.25mg/0.5ml)
4 years old (0.5mg)- Fluoride chewable tablet (0.5mg)
7 years old (1.00mg)- Fluoride mouthwash 225 ppm
5 causes of transient sensitivity post deep restoration in composite + their solutions
Deep cavity,
Insufficient coolant on prep,
Uncured resins entering the pulp and causing irritation,
Pulp exposure,
Fluid
from tubules occupying space under restoration
Lining material (RMGI/vitrebond), Pulp cap, Indirect restoration/ cure in increments, Liner, Stepwise excavation
fluoride supplementation for 1 yo 4 yo 7yo
1 year old (0.25mg)- Fluoride drops (0.25mg/0.5ml)
4 years old (0.5mg)- Fluoride chewable tablet (0.5mg)
7 years old (1.00mg)- Fluoride mouthwash 225 ppm
Periapical abscess q - pt has haemophilia. tx for abscess
root canal therapy if tolerable as pt has bleeding disorder- pulpectomy
list 8 stages to pulpectomy
- topical and la
- rubber dam and clamp
- access- caries removal and removal roof of pulp chamber
- coronal pulp extiration, root canal preparation
- obturate with vitapex
- GIC core
- Stainless steel crown
- review
Name 2 local haemostatic agents in paeds
ferric sulphate
surgicel
Name 2 local haemostatic agents in paeds
ferric sulphate
surgicel
5 possible treatment options for impacted molars
leave and monitor xla upper e discing of upper e ortho separator ortho appliance attached to 6
features of permanent dentition allow for replacement of primary without crowding
growth of maxilla
proclination of permanent teeth
extension of dental arch
what is leeway space
mediodistal width of canines and primary molars is larger than mesiodistal with of canines and premolars of permanent
extrusion splint
37% etch
2 weeks
trauma review 4 tests
ept ethyl chloride sinus colour mobility ttp
trauma radiograph - features expetced on extrusion 11
tx
widened pdl
loss of LD
EIRR
RCT with CaOH canal dressing,
periradicular surgery
clinical governence 6 factors
Clinical audit Clinical effectiveness Openness Risk management Research and Development Education and training
dental complications of a dental retainer
fixed-
- can debond from teeth
- wire can fracture
- gingivitis
- diffciulty to keep good OH
pressure vacuum formed-
- can be lost
- can alter occlusion
- can be chipped/ fractured
- low compliance as removable
suspected trigeminal nerualgia what tests would you carry out
- radiographs
- IDB perfomed- -to rule out TMD or muscle pain
- -MRI
- FBC
drug therapy for TN
carbamazepine
tests to carry out every 3 months for TN
FBC
LFT
check for imporvement with pain scale
radiographs
tests to carry out every 3 months for TN
FBC
LFT
check for imporvement with pain scale
radiographs
when would you decide to go for surgical management of TN
what surgical mgmt
no improvement of condition with carbamazepine and has been tried for substantial period
medication causing side effects
balloon compression
cryotherapy
long acting LA bupivicaine
3 local and 3 general causes pigmentation
local:
amalgam tattoo
melanoma
peutz jeghers
general: smoking racial addison's karposi medication
2 types of hemangioma and histological difference
capillary
cavernou
capillary- non capsulated aggregates of closely packed, thin walled capillaries, endothelial lining, separated by connective tissue
cavernous- encapsulated nodular mass composed of dilatedm cavernous vascular spaces. endothelial lining, separated by connective tissue. smooth muscle cells surround vascular spaces
things to note of facial swelling
size
colour
texture
heat
