2018 paper Flashcards
2 aims for raising a flap
Better access and vision
Retraction of soft tissues
Closure of OAF
4 things that influence flap design
personal preferences Access needed Surrounding nerves Area in mouth Ability to suture Procedure
Type of handpiece for bone removal
Straight handpiece with saline cooled bur
Round or fissure tungsten carbide bur
3 methods of debridement
Physical - bone file or handpiece to remove sharp edges
Irrigation - sterile saline into socket
Suction - aspirate under flap
What is the name for dry socket
Localised osteitis - inflammtion of lamina dura
3 predisposing factos of dry socket
Female Contraceptive pill Mandible Family hisotry Excessive rinsing post XLA Excessive trauma during XLA
3 signs and symptoms of a dry socket
Bad taste
Pain keeping them awake at night
Dull pain
Radiating pain to ear
What are the management of a dry socket
Supporting and ressauring the patient LA block Irrigaite socket with saline (CHX) Curretage/debridement Antiseptic pack (Alvogyl) Advise analgesia and hot salty mw's Review patient
What is the drug family of apxiban
Noval oral anticogulant
What does apixiban inhibit
They are factor Xa inhibitors which work by blocking action of activated factor X which is needed for forming a clot
What else is apixban used for
Prevention of DVT
Prevent pulmonary embolism
Can prevent stroke
What is the blood test for apixiban
Activated partial thromboplastin
What are the dosage and requirments for anticogulants and XLA
Apixiban and dabigatra - patient should miss morning dose and take evening dose as normal as long as it has been 4hrs since heamostasis has been achieved
Rivaroxaban - the delayed morning dose should be taken 4hrs after heamastasis has been achieved
3 treatments for haemostatic control
Pressure with damp gauze LA with vasoconstrictor Diathery Surgical pack Suture
3 features of down syndrome
Short neck and flat back of head Growth failure Diminshed muscle tone Small and arched palate Broad flat face Abnormal ears
Genetic test of down syndrome
Genetic origin affecting chromosome 21 (extra copy)
2 reasons why down syndrome patients have increased perio risk
Poor OH
Reduced saliva
Immunocompromised
2 reasons for no capacity with down syndrome
Memory skills (dementia) Learning difficulites
Differnce between welfare guardian and welfare power of attorney
Power of attorney- granted by the adult when they still have capacity and certified by a lawyer.
- welfare power - power only comes into effect when the person is incapaable of decision making
- health and personal
- continuing power - only covers finicial affairs and properties
Guardianship orders - court appointed and requires 2 medical reports
- appointed for 3 years
- powers to deal with property, fianance and martial affairs
- person has no capacity
Antibiotic required for antibiotic prophylaxis
Amoxcillin 3g oral powder sachet or clindamycin 300-600mg
60 mins before starting treatment
3 features of parkinson’s
Resting tremor Bradykinesia - slow movement Impaired gait mask like face Dysphagia Rigidity - increased muscle tone
How does parkinson differ from other cerebral diseases?
It is the only one with a resting tremor, the rest have intentional active tremors
What is the reason for dry mouth with parkinsons
Due to the antichiolnegic effects of drugs
How to prevent the loss of denture in a care home
Store denture in labelled container
Mark intials on denture during processing or if already constructed then mark using sandpaper
Why is it diffucult for XLA a parkinson’s patient
Tremor can make XLA difficult
Poor mouth opening due to rigidity
2 ways to measure antero-posterior skeletal relationship
Direct palpation of skeletal bases - use fore finger and middle finger
Visual relationship of soft tissue A&B point
2 ways to measure vertical skeletal relationship
Frankfort mandibular plane angle
Lower anterior face height compared to total anterior face height
What position should paitents head be in for measuring skeletal relationship
Frankfort plane parallel to floor
What is the problem relating to growth and development
Class III - maxilla hypoplasia (too small)/mandibular prognathism
- maxilla - anteroposterior maxiallry deficiency
Class II- mandibular retrognathism (mandible too small) and overlapped upper jaw
How is porcelain surface prepped in lab for bonding hydroflouric acid
Use hydroflouric acid on porcelain to prodice retentive surface
What do you use to bond porcelain to composite luting resin
Silane coupling agent
How does a silane coupling agent act chemically
Strong bond between oxide groups on porcelain surface and C=C reacts with composite luting agent
When would you use a dual cured composite
Thick porcelain
Metal resotrations
Bonding to indirect composite
Why would you still light cure a dual cured?
As the properties are reduced by 25% if not light cured
What chemical agent do you use to bond to metal?
MDP & 4-META
4 things to ask about smoking
No. of years smoked How many do they smoke Age when they started smoking Quitting history Anyone close smoke at home How quickly do they light up
3 things to tell them about e-cigs
Less toxic but can still be harmful Aid to quitting Alternative to e-cgis Can causes mouth and throat dryness Lichenoid eruptions
2 advice services to send someone who wants to quit smoking
Local pharmacy
Community smoking support group
What to do if patient does not want to quit now
Record in patient notes that quitting advice was given
Provide leaflet on quitting and emphasise the benefits of quitting
3mm spacing material and why for complete dentures
Alginate - it is a mucostatic material and will take an accurate record of the tissues without displacement
Why do you not use silicone for denture impressions
It is a mucocompressive material and is likely to tear
Not as effective if undercuts are present
2 support areas for maxilla
Hard palate
Residual ridge
Primary support for mandible
Retromolar pad
Buccal shelf
Residual ridge
Part of mandible that interferes during maxillary working impression
Coronoid process
PICO stand for
Population
Intervention
Comparison
Outcome
How do you reduce bias in a study?
Double blinding
Radomisation
What are Herb Schilder’s endo principles
Create a continously tapering funnel shape
Maintain apical forament in place
Apical opening as small as possible
Why is irrigation useful part of disinfection in endo
Disinfect root canal
Dissolve organic debris
Flush out debris
Lubricate root canal instruments
What is the best irrigant for endo?
Sodium hypochlorite
What is the ideal strength of irrigant for endo?
3% (available 0.5-6%)
4 reasons for a child to be anxious
Past negative dental experience Expectation of pain Poor knowledge Attitude of parents towards dental experience Media representation of dentistry
2 ways to treat an anxious child
Work quickly and in a calm manner
Giving reassuring support
Distraction techniques for child
What are the types of behaviour management methods?
Postive reinforcement Tell show do Aclimitasation Desensitiisation Distraction Role modelling Voice control
