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BDS3 past papers > 2018 > Flashcards

2018 Flashcards

1
Q

state aims for raising a flap

A
  • allows better access to the tooth if finding any difficulty to extract e.g. due to abnormal resistance, ankylosis etc.
  • helps with closure of an OAF
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2
Q

state aims of retracting a flap

A
  • protection of the soft tissue
  • better access and vision
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3
Q

state factors which influence flap design

A
  • design may be influenced if the tooth is in an area of aesthetics
  • narrow ridge- bone augmentation may be required so wide flap desisgns should be utilised
  • the anatomy surrounding the tooth being treated e.g. nerves and muscles (lingual nerve can be damaged during surgical removal of lower 3rd molars)
  • the treatment which is being carried out
  • ability to access/visualise and ability to suture it back
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4
Q

name 3 types of flap design

A
  • semi-lunar
  • triangular
  • rectangular
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5
Q

what type of handpiece is used for bone removal?

A
  • electric straight handpiece with saline cooled bur
  • round or fissure yungsten carbide burs
  • air driven handpieces may lead to surgical emphysema
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6
Q

what are the 3 methods of debridement?

A
  • physical
  • aspiration
  • irrigation
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7
Q

describe physical debridement

A

using bone file or handpiece to remove sharp bony edges
mitchell’s trimmer/Victoria curette to remove soft tissue debris

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8
Q

describe debridement by irrigation

A

sterile saline/water placed into the socket and under flap

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9
Q

describe debridement by aspiration

A

aspirate under the flap to remove debris
check the socket for retained apices

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10
Q

what is the clinical term for a dry socket?

A

alveolar osteitis
(inflammation of the lamina dura)

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11
Q

what are the predisposing factors of a dry socket?

A
  • female
  • young
  • previous dry socket
  • smoker
  • trauma during extraction
  • excessive swishing in the mouth post extraction (damage to blood clot)
  • more common on the mandible
  • oral contraceptive pill
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12
Q

what are the signs and symptoms of a dry socket?

A
  • dull aching pain
  • exposed, sensitive bone
  • patient will be kept up at night
  • pain can radiate to the ears
  • bad breathe
  • bad taste in the pts mouth
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13
Q

what are the treatment options for dry socket?

A
  • remove the blood clot to encourage new clotting
  • irrigate the socket with warm saline
  • support and reassure the patient
  • antiseptic pack e.g. BIP
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14
Q

what family of drugs does apixiban belong to?

A

NOAC
novel oral anticoagulant

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15
Q

what does apixiban inhibit?

A

factor Xa
stops conversion of prothrombin to thrombin, stopping the production of a fibrin clot

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16
Q

what are the uses of apixiban?

A
  • inhibits conversion of prothrombin to thrombin
  • prevention of DVT
  • prevention of pulmonary embolism
  • can prevent stroke and reduce risk in pts with AF
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17
Q

what blood tests do you carry out on a patient who is on apixiban before treatment?

A

APTT
activated partial thromboplatin time assay

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18
Q

what do you do for a patient who is taking a NOAC before a low risk procedure?

A
  • do not disrupt the medication
  • treat the patient according to general advice for managing bleeding risk
  • plan treatment early in the day
  • limit the intial treatment area
  • actively consider suturing and packing
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19
Q

give examples of low risk procedures

A
  • simple extraction (1-3 teeth)
  • incision and drainage
  • 6PPC
  • RSD and subgingival scaling
  • direct or indirect restorations with subgingival margins
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20
Q

how should a pt alter their NOAC before a high risk procedure?

A

miss morning dose for apixiban or dabigatran
delay morning dose until after procedure- rivaroxaban

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21
Q

give examples of high risk procedures

A
  • extraction >3 teeth
  • biopsies
  • surgical procedure (perio surgery, periradicular, crown lengthening etc.)
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22
Q

how do you manage a patient who is taking a NOAC and receiving a high risk procedure?

A
  • Treat the patient according to the general advice for managing bleeding risk
  • Plan treatment for early in the day.
  • Consider carrying out the treatments in a staged manner.
  • Actively consider suturing and packing
  • Advise the patient when to restart their medication.
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23
Q

give methods of haemostatic control

A

apply pressure by biting on damp gauze
LA with vasoconstrictor
Suture
Surgicel
Bone wax
Diathermy

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24
Q

give physical features of downs syndrome

A
  • broad flat face, flat nasal bridge
  • short neck
  • short nose
  • small arched palate
  • macroglossia- big tongue and protruding tongue. Fissured tongue
  • upslanting palpebral fissure
  • open bite
  • class 3 malocclusion
  • hypodontia
  • abnormal ears
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25
Q

what is the result of a genetic tesgt for down’s syndrome?

A

extra copy of chromosome 21

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26
Q

why are people with Down’s syndrome at increased risk of perio disease?

A
  • immunocompromised
  • poor oral hygiene
  • less saliva
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27
Q

what are 2 reasons for a patient with down’s syndrome not having capacity?

A

learning difficulty
dementia

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28
Q

what are the two types of power of attorney and the difference between them?

A
  • welfare- matters relating to health and personal welfare
  • continuing - financial affairs and property
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29
Q

describe a power of attorney

A
  • granted by the adult while they still have capacity
  • certified bu a lawyer or medical practitioner
  • powers only come into effect when the adult is incapable fo decision making
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30
Q

describe a welfare guardian

A
  • appointed by the court after the adult has lost capacoty
  • requires 2 medical reports
  • continuous management of welface and financial matters
  • usually appointed for 3 years
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31
Q

when should antibiotic prophylaxis be taken?

A

1 hour before the procedure

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32
Q

gives features of parkinson’s

A
  • bradykinesia – slow movement
  • rigidity – increase motor tone
  • mask like face
  • resting tremors
  • posture instability – impaired use of upper limbs; impaired gait and falls
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33
Q

how does Parkinson’s disease differ from other cerebellar diseases?

A

Parkinson’s- resting tremors
other cerebellar diseases- intentional active tremors

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34
Q

why might a patient with Parkinson’s suffer from dry mouth?

A

medication due to antichollinergic effects of drug treatment (Benztropine)

35
Q

how do you prevent a denture getting lost in a care home?

A

initial it during processing
if already constructed, can mark using sandpaprer or a sealant
store them in a labelled container

36
Q

why would you avoid extracting teeth in.a denture wearing patient with Parkinson’s?

A
  • tremor can make extraction difficult
  • poor motuh opening due to rigidity
  • will require new prostheses to replace missing teeth- won’t be able to tolerate it
37
Q

define local malocclusion

A

a localised problem or abnormality within either arch, usually confused to one, two or several teeth producing a malocclusion
tends to get worse with time

38
Q

gives reasons for abnormalities of tooth number

A
  • supernumerary teeth
  • hypodontia
  • retained primary teeth
  • early loss of primary teeth
  • unscheduled loss of permanent teeth
  • variation of timing
39
Q

state 4 types of supernumerary

A

conical
tuberculate
supplemental
odontome

40
Q

how do you measure anterio-posterio skeletal relationship?

A

visual assessment
palpate skeletal bases
measure the ANB angle on a lateral cephalogram

41
Q

how do you measure vertica skeletal relationship?

A
  • Frankfort Mandibular Plane Angles (FMPA)
  • LAFH to TAFH ratio
42
Q

who sets the classifications for incisor relationships?

A

British Standards Institute

43
Q

describe a class I incisor relationship

A

The lower incisor edges occlude with or lie immediately below the cingulum plateau of the upper central incisors

44
Q

describe a class II incisor relationship

A

The lower incisor edges lie posterior to the cingulum plateau of the upper incisors

45
Q

what is the difference between a clas II division 1 and class II division 2 incisor relationship?

A

divison 1- upper incisors are proclined or of average inclination and there is an increase in overjet
division 2- upper central inciors are retroclined- overjet is usually minimal or may be increased

46
Q

describe a class III incisor relationship

A

The lower incisor edges lie anterior to the cingulum plateau of the upper incisors. The overjet is reduced or reversed.

47
Q

how is porcelain surface prepped in the lab for bonding?

A

hydrofluoric acid is applied to produce a retentive surface

48
Q

what do you use to bond porcelain to composite luting resin?

A

silane coupling agent

49
Q

how does silane coupling agent act chemically?

A

double carbon C=C bonds attach to composite luting agent
oxide groups in the silane coupling agent attach to the porcelain

50
Q

what metal can be used for an acid-etch retained bridge?

A

CoCr or NiCr

51
Q

what chemical agent do you use to bond to metal?

A

MDP, 4-META

52
Q

give 4 examples of questions you would ask a patient about their smoking habits

A
  • what do you smoke?
  • how many cigarettes a day?
  • how long have you been smoking?
  • are you thinking of quitting?
53
Q

what would you tell patients about e-cigarettes?

A
  • suggest use of research backed product e.g. patches
  • they are not harmless but considerably safer than conventional cigs if used in moderation
  • dont use them in public spaces
  • can cause dry mouth, soft tissue damage due to battery overheating
54
Q

what is the methodology for smoking cessation?

A
  • Ask
  • Advise
  • Assess
  • Assist
  • Arrange a referral
55
Q

give advice services you could refer a smoker to

A
  • community clinics
  • hospital advisor
  • mental health in-patient service
  • specialist pregnancy service
  • prison serive
  • community pharmacy setting
56
Q

what do you do if a patient tells you they do not currently wish to quit smoking?

A
  • provide a leaflet and emphasise that when they do want to stop, support is available
  • record advice given in notes
57
Q

why is alginate a more suitable impression material than silicone for 3mm spacing?

A
  • alginate is a mucostatic and will take an accurate record of the tissue without displacement
  • silicone is a mucocompressive and is likely to tear- also not effective if undercuts are present
58
Q

name 2 support areas for the maxilla (dentures)

A

residual ridge
hard palate

59
Q

name the primary support for the mandible (dentures)

A
  • residual ridge
  • retromolar pad
  • buccal shelf
60
Q

which part of the mandible can interfere during maxillary working impression?

A

coronoid process

61
Q

how is PICO used in study design?

A
  • Population- can only be one group of people
  • intervention- represents the intervention of interest
  • comparison- a standard deviation
  • outcome- expected result
62
Q

how do you reduce bias during a study design?

A

randomising
double blinding

63
Q

what is the absoulte risk difference?

A

the difference in risk between groups

64
Q

what is a confidence interval?

A
  • the range of values the ARD witll take in the population
  • 95 times out of 100 the CI will contain the TRUE population ARD
65
Q

what is the most important thing for preventing healthcare associated infection?

A

PPE- gloves, apron, visors, face masks

66
Q

name SICPs

A

standard Infection Control Precautions
* hand hygiene
* respiratory and cough etiquette
* ppe
* safe management of care equipment
* safe management of blood and bodily fluid spillages
* safe disposal of waste including sharps
* occupational safety

67
Q

name 2 agesnt which can be used to clean a blood spillage

A
  • sodium dichloroisocyanurate
  • sodium hypochlorite
68
Q

how do you break the chain of infection at transmission for dirty forceps?

A

the chain is broken at the reservoir wherethere are dirty contaminated forceps- break by cleaning, disinfecting, sterilising prior to use

69
Q

what features of extracellular matrixs make them resistant?

A
  • the biofilm impairs diffusion
  • it causes binding of antibiotics
  • extracellular DNA persists
70
Q

name microorganisms that cause caries

A
  • lactobacillus acidophilus
  • streptococcus mutans
  • candida albican
  • actinomyces viscosus
71
Q

name systemic diseases related to periodontal disease

A
  • diabetes
  • rheumatoid arthritis
72
Q

describe Herb Schilder’s endodontic principle

A
  • create a continuously tapering funnel shape
  • maintain apical foramen in original position
  • keep apical opening as small as possible
73
Q

why is irrigant a useful (apart from disinfection)?

A
  • dissolves organic materials
  • flushes out debris
  • lubricate root canal instruments
  • removes the endodontic smear layer
74
Q

what is the best irrigant and ideal strength?

A

sodium hypochlorite
3%

75
Q

what features should you take into account whilst using irrigant?

A

NAoCl can damage the soft tissues
can discolour fabric
opthalmic injuries if contact with eyes is made
allergic reactions

76
Q

indications that trauma is NOT accidental

A
  • injuries to both sides of the body
  • injuries to soft tissue
  • injuroes with particular patterns
  • any injury that doesn’t fit the explaination
  • delay in presentation
  • untreated injury
77
Q

what are the effects of trauma on the primary dentition?

A

discolouration
delayed exfoliation
infection

78
Q

what are the effects of trauma on permanent teeth?

A
  • fails to form
  • ectopic eruption
  • dilaceration
  • hypomineralisation
  • odontoma formation
  • delayed eruption
  • enamel defects
  • abnormal tooth/root morphology
  • delayed eruption
  • ectopic tooth position
  • arrest in tooth formation
  • complete failure of tooth to form
  • odontome formation
79
Q

when is the ideal time to extract permenant first molars in children?

A
  • when bifurcation of 7s is visible
  • when permanent premolars and wisdom teeth present
  • class 1 incisor relationship
80
Q

why might a child be nervous at the dentist?

A
  • media coverage prior to dental experience
  • family experience
  • poor knowledge of treatment
  • expectation of pain
  • past negative medical/dental experience
  • dental experince of friends and siblings
  • the attitude of the parents
81
Q

how woul dyou treat an anxious child?

A
  • positive reinforcement
  • tell-show-do
  • acclimatisation
  • desensitisation
  • voice control
  • distraction
  • role modelling
  • relaxtion technique/hypnosis
82
Q

how do overhangs occur?

A
  • poor adaptation of the matrix band
  • excessive force applied when condensing amalgam
83
Q

how do you fix an overhang?

A

you can remove and replace the restoration
use of finishing strips/soft flex files

84
Q

give features of a ghost image

A
  • image is always higher
  • the image is horizontally magnified
  • on theopposite side
  • can interfere with diagnosis

BDS3 past papers (8 decks)

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