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BDS4 > 2019? > Flashcards

2019? Flashcards

1
Q

Name 4 fluoride supplements you would give patient to prevent decalcification?

A

-flouride varnish- 22,600ppm
-fluoride tooth paste age dependant(1450, 2800,5000)
-fluoride mouthwash 225ppm
Fluoride tablets 1mg

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2
Q

What other methods could be used to prevent decalcification?

A
  • OHI - 2x daily and after meals
  • Diet advice
  • FS
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3
Q

8 potential risks of orthodontic treatment other than decalcification?

A
  • root resorption
  • gingival recession
  • relapse
  • loss of vitality
  • TMJD
  • loss of teeth vitality
  • ulceration/irritaion of soft tissue
  • loss of periodontal support
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4
Q

How would you treat a peri-hemorrhage?

A
  • damp gauze and apply pressure for 10 mins
  • take a full medical history including drugs
  • use haemostatic aids- fibrin foam, WHVP
  • Place suture
  • post op instructions with contact details
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5
Q

What local factors may delay the onset of bleeding?

A
  • trauma
  • loosening of sutures
  • vasoconstrictor wears off
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6
Q

What are 2 congenital bleeding disorders?

A

heamophilia A and B

Von willebrands

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7
Q

What are 2 acquired bleeding disorders?

A

Vitamin K deficiency

drugs- warfarin

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8
Q

name a NoAD?

A

apixaban - should miss morning dose if attending for high bleeding risk appointment

No need to check INR

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9
Q

What should the INR be for warfarin?

A

<4 for oral surgery to be carried out. Refer to local guidelines

No need to alter medication

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10
Q

What is the Shortened dental arch?

A

When most posterior teeth are missing, however satifactor oral function can stilll be gained without the use of an RPD.

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11
Q

What skeletal classes are contraindicated for SDA?

A

Class III and in Severe class II

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12
Q

Why is periodontal disease contraindicated for SDA?

A
  • potential drifting of teeth under occlusal load
  • distal tooth migration of the last standing teeth
  • loss of bone and increase of mobility
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13
Q

What material is used for casting adhesive bridges?

A

CoCR

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14
Q

Why is CoCr used to cast adhesive bridges?

A

?????????

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15
Q

What are the indications for a SDA?

A
  • missing posterior teeth but still have at least 3-5 units left
  • patients tolerance to RPD
  • good prognosis of anterior teeth with no active perio and low restorations
  • good patient motivation
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16
Q

What are the contraindications for SDA?

A

-poor perio status
-poor prognosis of the current dentition
- TMJD
severe class II or Class III
-wear or bruxism habit

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17
Q

How is it possible to extend an SDA?

A
  • implant placement

- mesial cantilever bridge (max 1 unit per side of arch)

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18
Q

What is the immediate treatment for enamel dentine fracture?

A

-Locate missing partical of the tooth.
-place LA and rubber dam on 11
PARTIAL PULPOTOMY
remove 2-3 mm of pulp using a slow speed, and check bleeding by placing a CWP with saline on it and try and achieve haemostatis.
place non setting CaHO, seal with RMGI and place composite bandage.

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19
Q

Why would subalveolar fracture be of poor prognosis?

A
  • lack of coronal tissue to bond to

- poor moisture control for RCT/ restoration

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20
Q

2 types of restoration following XLA?

A
  • implant
  • bridge
  • single tooth RPD
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21
Q

What would you diagnosis redness at commissures of the mouth?

A

Angular cheilitis

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22
Q

What are 2 possible microbes involved in angular cheilitis?

A

S. Aureus
C. Albicans
C. tropicalis
S. epidermis

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23
Q

What type of sample would you take to send to the lab?

A

swab of the area

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24
Q

Name a immune deficiency disease which would increase the risk of a candida infection?

A

HIV

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25
Q

Name one gastrointestinal bleeding disease which can increase the risk of candida infections?

A

Crohns disease

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26
Q

Name one intra-oral and one extra-oral disease that could be associated with this?

A

intra-oral -oral candidiasis

extra-oral -OFG

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27
Q

Patient attends with denture induced stomatitis, what do you notice about the palatal tissue?

A

erythematous and oedema of the denture baring area

inflamed palatal mucosa

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28
Q

What are the classifications of denture induced stomatitis?

A

Newton class 1 - localised inflammation

Newton type 2- diffused inflammation and erythema confined to the mucosa contactig denture without hyperplasia

Newton class 3- granular inflammation with erythema and papillary hyperplasia

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29
Q

What causes denture induced stomatitis?

A

adhesionand colinisation of acrylic surfaces caused by co-aggrigation and biofilm formation

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30
Q

What is your first line of treatment in for denture induced stomatitis?

A

OHI

31
Q

What is your second line of treatment for denture stomatitis?

A

Fluconazole 50mg - 7 days (one a day )

Miconazole oromucosal gel 20mg -80mg tube for 7 days after lesions have healed (pea sized amount to fitting surface of denture after food 4 x daily)

Nystatin oral suspension 100,000 units/ml 30ml (1ml after food 4x daily for 7 days and 48 hours after lesions have healed

32
Q

What type of bridges can you use anterior?

A 
cantilever 
fixed- fixed 
spring cantilever 
resin bonded 
resin retained
33
Q

What pulpal diagnosis and why?

A

Reverasble pulpitis -

  • short lived sharp pain on sweet stimulus which goes away when stimulus is removed
  • No TTP
  • pain on cold
  • well localised pain
34
Q

How would design a bridge which is less likely to de-bond

A
  • prep adjacent tooth
  • larger wing
  • consider an adhesive bridge ( cantilever) wouldnt be a plaque trap if it fell out
35
Q

what are 4 faults which can cause to it to de-bond?

A
  • poor moisture control during cementation
  • bruxism habit
  • unfavourable occlusion
  • poor OH
  • trauma
36
Q

What epitheilum is affected in smokers keratosis?

A

stratisfied squamous keratinised epithelium of the hard palate

37
Q

What is the clinical presentation?

A

Thickened white are patch with some dark brown /grey areas on the palate which is painless.
may have staining elsewhere.

38
Q

What factors cause smokers keratosis?

A

tomacco smoke
pipe smoke
chronic inflammation
drugs - hydroxychloroquine

39
Q

What histological presentation could indicate malignancy?

A
  • hyperkeratinosis
  • hyperchromatism
  • atypia
  • dysplasia
  • infiltration of macrophages
40
Q

What clinical presentation would suggest malignancy?

A
  • raised rolled boarder
  • non–homogenous
  • lesions is hard and attached to underlying tissue
41
Q

What is mandibular displacement on closing?

A

happens when inter arch descrepancies cause upper and lover teeth to meet cuspto cusp which causes the mandible to deviate in one side in order to achieve intercuspation

42
Q

Why would you correct mandibular displacement?

A
  • best intercepted early
  • can cause TMD
  • tooth wear can occur
  • displacement causes facial asymmetry
  • teeth erupt into displaced ICP
43
Q

What would you use to correct unilateral posterior crossbite?

A

maxillary expansion with -

  • rapid maxillary expansion device
  • URA
  • Quadhelix
44
Q

What are 6 signs/ symptoms of TMD?

A
  • pain on opening
  • limitation on opening
  • muscle/ joint/ ear pain
  • clicking and popping on opening
  • trismus
  • sore heads
  • signs of wear
45
Q

What muscles would you palpate when querying TMD?

A
  • masseter

- temporalis

46
Q

What are the most common cause of TMD?

A

-parafunction habbits (muscle inflammation)
- chewing gum
- trauma to the joint (indirect or direct)
-stress
-disc displacement (with or without anterior reduction)
occlusal abnormalities
-degenerative disease

47
Q

What nerve supplies the TMJ?

A

auriculotemporal and massetric branches of maxillary branch of trigeminal nerve

48
Q

What would conservative advice be for TMD?

A

-reassurance
-do not chew chewing gum
- soft diet with food cut into small pieces
-chew on both sides at the same time
support mouth when opening wide/ yawning
-be aware of bruxism when its happening
- wear splint at night /when at high risk
- painkillers for relief

49
Q

What is the mechanism of an overnight splint?

A

prevents tooth to tooth wear occuring and provides stabilisation of occlusion and of the masticatory muscles and thus decreasing abnormal activity.

50
Q

What is arthrocentesis?

A

operation which involves the washing out of the jaw joint with sterile saline and anti-inflammatory steriods.

51
Q

What are 2 other options for surgery on the TMJ?

A
  • disc resposition or replacement

- arthroscopy

52
Q

What is pericoronitis?

A

inflammation of the soft tissue above a partially erupted tooth which allows for the communication into the oral cavity and thus bacteria and debris gets under the soft tissue.

53
Q

What are the signs and symptoms of pericoronitis?

A
  • pain swelling and ulceration of the operculum
  • halitosis
  • pus discharge
  • limited opening
  • occlusal trauma to the operculum
54
Q

How is pericornoitis?

A
  • incision and drainage of abccess
  • rinse the operculum with CHX and saline
  • potential removal of operculum
  • if repeated cases, consider XLA of third molar
  • advise pain relief and CHX mouthwash
  • antibiotics if systemic involvement/ SIRS assessment
55
Q

What are 6 signs of close proximity of the 3rd molars roots to the IAN canal?

A
  • division /deflection of the canal
  • deflection of the root
  • darkening of the root where it cross
  • juxta of apical area
  • narrowing of the canal
  • interruption of the canal
56
Q

What imaging should be requested when an 8 is close to the IAN?

A

CBCT

57
Q

What are the risks linked with damage to the IAN when XLAing the 3rd molar?

A
  • altered sensation of the lip, chin and tongue
  • numbness or tingling of the lower lip, chin or and half of tongue
  • Temp-10-30%
  • Perm- less than 1%
58
Q

What a treatment would you carry out to prevent complications of 3rd molar XLAs?

A

cornoectomy

59
Q

What is an ulcer?

A

the loss of the full thickness of the epithelium and underlying tissue can be seen

60
Q

What is eroision?

A

the partial loss of epithelial tissue

61
Q

How would you differ between major and minor recurrent apthous ulcers?

A

size -
minor <10mm
major >10mm

Shape-
minor- round or oval
major-oval or irregular

Number -
minor- 1-20
major- <5

Healing time -
minor - 1-2 weeks
major - 6-12 weeks (may have scaring)

62
Q

What is the potential problems with recurrant aphthous ulcers?

A
  • infections
  • inability to eat/drink- malnutrition/dehydration
  • diffuculty brushing teeth
  • difficulty problems wearing denture/appliances
  • speech and mastication problems
63
Q

What are the causes of recurrent aphthous ulcer?

A

-nutrition deficiencies
-systemic disease
-trauma
-allergies
infections
-stress
-genetic

64
Q

How would you treat recurrent aphthous ulcers?

A

Correct underlying cause=

  • remove possible traumatic cause
  • avoid allergens
  • treat systemic cause
  • replace deficient nutrients
  • CHX
  • benzydamine oromucosal spray 0.15%
  • betamethasone mouthwash/inhaler
  • prednisolone (systemic steroid)
65
Q

What would microcytic blood results show?

A

reduced MCV count of less than 80fL

66
Q

3 GI conditions which can cause microcytic anemia?

A

crohns
Ulcerative colitis
coeliac disease

67
Q

What are other casues of microcytic anaemia?

A

thalassaemia
iron deficiency
lead poisioning

68
Q

3 oral conditions which are associated with microcytic anaemia?

A
  • atrophic glossitis
  • candida infections
  • recurrent aphthae
  • tenderness or burning sensation
69
Q

Child attends with ulcers, what 8 questions would you ask?

A 
have you had these before?
Any symptoms elsewhere?
Any symptoms on the lips?
Have they been aware of the blisters?
Are the getting worse?
Have they gotten any better?
Has the patient had a fever?
Any other skin lesions?
Any difficulty eating or refusal of food?
70
Q

Ulcer on lips, what would you see intra orally?

A
  • painful red swollen gingivae
  • halitosis
  • ulcers/blisters on cheeks
71
Q

What are 2 local factors for implant placement?

A

7mm required to place implant

alveolar bone levels

72
Q

What are 2 general factors for implant placement?

A

smoking status

bisphoposphate use

73
Q

Before placement, what does an implantologist consider?

A

-medical and drug history
-alveolar bone quality and quantity
- OH and perio status
- occlusion
- aethetic expectations of patient
patient motivation

74
Q

What dimensions are required for an implant?

A
  • 1.5 mm horizontal bone required around implant
  • 3mm between implants
  • > 5mm space for papilla
  • 7mm spacing between crowns
  • 2mm from adjacent structures

BDS4 (11 decks)

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