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3 Past Papers > 2020 MSA > Flashcards

2020 MSA Flashcards

1
Q

What number of canals are found most often in an upper first premolar?

A

2

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2
Q

Where is the ideal end point of obturation?

A

The apical constriction
The CEJ

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3
Q

What is the term for maintaining communication between the pulpal space and peri-radicular tissues?

A

Patency

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4
Q

What is a working length in endodontics?

A

Distance from the occlusal reference point to the point at which the root canal preparation should stop

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5
Q

What two common intra-operative radiographs can be utilised during endodontic treatment to aid working length determination?

A

Working length radiograph
Master-cone radiograph

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6
Q

Give 2 potential causes of a corrected working length changing during the course of endodontic shaping

A

Perforation
Straightening of the canal

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7
Q

Which systemic antimicrobial is prescribed for necrotising gingivitis as well as dose, daily frequency and duration of administration?

A

Metronidazole 400mg 3x daily for 3 days

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8
Q

What 3 warnings should be given to a patient taking metronidazole?

A

Don’t consume alcohol
Don’t take if pregnant
Seek medical attention immediately if they experience signs of allergic reaction and stop taking the medication

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9
Q

What follow up care is arranged after necrotising gingivitis?

A

Review in 2 weeks
HPT therapy after acute symptoms subside

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10
Q

What is the difference between the mandible at rest and ICP?

A

Freeway space

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11
Q

What is the average freeway space?

A

2-4mm

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12
Q

What positions is the mandible in retruded axis between?

A

RCP
Retruded axis position

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13
Q

What is a border position?

A

A position determined by the anatomy of the TMJ and its musculature

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14
Q

Why is the retruded axis important in clinical dentistry?

A

It is a reproducible jaw position

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15
Q

What two records are required for mounting casts on a semi adjustable or average value articulator?

A

Facebow
An interocclusal record

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16
Q

What is the average value of the sagittal condylar guidance angle which may be used on an articulator?

A

30º

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17
Q

What are the 2 main differences in composition between decorative and dental ceramic?

A

Decorative ceramic contains more Kaolin
Dental ceramics contain more feldspar

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18
Q

What does translucency mean with regard to optical properties of materials?

A

The degree of a material to allow light to pass through but be scattered at one of the surfaces or internally leading to a blurring of the transmitted light

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19
Q

What does opalescence mean with regard to optical properties of materials?

A

A translucent materials ability to appear orange in transmitted light and blue in refracted light

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20
Q

How can you modify the ceramic surface to make it more retentive prior to using silane?

A

Etch with hydrofluoric acid

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21
Q

Chemically how does a silane coupling agent work when bonding composite to ceramic?

A

C=C on one side of silane reacts to the composite
Oxide groups on other side of silane form strong bonds with the porcelain

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22
Q

What is the function of silane in a composite restorative material?

A

Improves bond strength between composite resin filler particles

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23
Q

List 4 features of an RCT

A

Randomisation
Blinding
Inclusion/exclusion criteria
Control group

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24
Q

How can randomisation be implemented in an RCT?

A

Use a computed generator to decide which participants are put into which group

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25
Q

Name the standards developed to improve the reporting of RCTs

A

CONSORT

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26
Q

What 4 things can you ask a patient around their tobacco use and to ascertain whether they would be interested in quitting?

A
  • No. of years a smoker
  • What do they smoke
  • Have you tried to quit before
  • How many attempts to quit have you had
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27
Q

What is dependence?

A

A compulsive psychological and physiological need for something that forms a habit

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28
Q

Name a model/approach that can be used to help a patient quit smoking

A

5As
- Ask
- Advise
- Assess
- Assist
- Arrange

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29
Q

Give 2 examples of evidence based treatments used to support patients who want to quit smoking

A

Nicotine replacement therapy
E-cigarettes

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30
Q

What can you do if a patient tells you now is not the right time for them to quit smoking?

A

Record it in the patient notes with a reminder to bring it up again at a future appointment

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30
Q

What can you do if a patient tells you now is not the right time for them to quit smoking?

A

Reassure that support is available if they do ever want to quit
Record this in the patient notes

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31
Q

What radiographic view is most suitable for an unerupted central incisor?

A

Periapical

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32
Q

What are the 4 principles of the orthodontic management of non-eruption of upper central incisors?

A
  • extract deciduous tooth and any supernumeraries to encourage eruption of permanent
  • maintain space
  • wait 12 months if patient is under 9
  • surgically expose, bond gold chain and apply orthodontic traction
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33
Q

Give 2 ways to clinically assess the antero-posterior skeletal relationship

A

Visual assessment
Palpation of the skeletal bases

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34
Q

Give 2 ways to clinically assess the vertical skeletal relationship

A

FMPA - if average, lines should meet at external occipital tuberance
LAFH to TAFH ratio - if average should be approximately 55%

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35
Q

How should the patients head be positioned during clinical assessment of skeletal relationship

A

Frankfort plane parallel to the floor

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36
Q

List 3 causes that may be contributing to continual bleeding of a socket following extraction?

A

Patient traumatises area with tongue or finger
Undiagnosed bleeding abnormality
Vasoconstrictive effects of LA worn off

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37
Q

How would you manage continual post-operative bleeding from a socket following extraction (5 marks)

A

Pressure - ask patient to bite on damp gauze
LA with vasoconstrictor
Haemostatic agents
Diathermy
Suture

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38
Q

State 1 pre-extraction blood test that would allow you to test the patients bleeding/clotting status?

A

FBC

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39
Q

If you cannot stop bleeding post-extraction what should you do?

A

Refer to local OMFU

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40
Q

List 4 occlusal features due to a prolonged digit sucking habit

A

Proclined upper incisors
Retroclined lower incisors
Anterior open bite
Unilateral posterior crossbite

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41
Q

Describe 4 methods that could be used to dissuade a digit sucking habit

A

Positive reinforcement
Elastoplast on finger
Habit breaker device
Bitter tasting nail varnish

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42
Q

Explain the effect that a prolonged digit sucking habit can have on the posterior dentition

A

The digit sits where the tongue should causing the surrounding musculature to incline the upper arch palatally causing a narrow upper arch
The mandible must displace on closing causing a unilateral posterior crossbite

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43
Q

Give 5 functions of a provisional restoration

A

Maintain occlusal relationship
Maintain function of the tooth
Maintain aesthetics of the tooth
Test the fit and function of the permanent restoration
Prevent sensitivity by covering exposed dentine/pulp

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44
Q

What variations of preformed anterior provisional crowns are available? (3 marks)

A

Polycarbonate
Clear-plastic crowns
Preformed composite crowns

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45
Q

Give 2 disadvantages of preformed provisional crowns in comparison to custom provisional crowns

A

Unlikely to fit accurately
Large bank of crowns needed

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46
Q

Give 4 factors that may contribute to increased tooth mobility

A

Occlusal trauma
Attachment loss
Root resorption
Periodontal inflammation

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47
Q

Give 2 circumstances in which you would decide to intervene in order to try to reduce the mobility of a tooth or teeth

A

If mobility is progressively increasing
To facilitate restorative treatment

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48
Q

In a patient with periodontal disease, following successful HPT would tooth mobility be more likely to increase or decrease? Give reasons for your answer. (2 marks)

A

Decrease
Bacteria causing loss of attachment have been removed which will promote the attachment of long junctional epithelium to the root, increasing stability of the tooth

49
Q

What are the disadvantages of splinting?

A

Can cause oral hygiene difficulties

50
Q

Which type of study would provide the highest level of evidence for the effectiveness of treatment?

A

Systematic review and meta analyses

51
Q

List the 4 main features of an RCT?

A

Blinding
Randomisation
Control group
Inclusion/exclusion criteria

52
Q

Name the standards developed to improve the reporting of RCTs

A

CONSORT

53
Q

Name the standards developed to improve the reporting of RCTs

A

CONSORT

54
Q

Which external reference plane of the patient should you position horizontally when setting up for a panoramic radiograph?

A

Frankfort plane

55
Q

In an OPT what causes the incisors being horizontally magnified?

A

Patient too far back in machine

56
Q

In an OPT what causes posterior teeth on one side being wider than on the other?

A

Patient rotated in machine

57
Q

Give 3 important features that apply to all ghost images

A

Image appears higher
Always horizontally magnified
On the opposite side

58
Q

What panoramic radiograph would you take for pre-extraction of a partially erupted 48 under local anaesthetic, when there is no evidence of 38 in the mouth?

A

Right half panoramic radiograph

59
Q

What panoramic radiograph would you ask to be taken for a child patient with caries, who cannot tolerate bitewings?

A

Orthogonal projection

60
Q

Which margins of the maxillary sinus is seen horizontally above the roots of the premolars and molars?

A

Inferior

61
Q

Which margins of the maxillary sinus are seen vertically above the third molar region?

A

Posterior

62
Q

Who should you first discuss concerns of child abuse with?

A

Social services

63
Q

What courses of action may take place after discussing physical abuse with parents?

A

Child referred directly to lead paediatrician
Child protection ask you to refer directly to social services
Further investigations occur with child protection

64
Q

What should you do where there is suspected physical abuse and a mother fails to bring their child back to appointments?

A

Write a letter to the health visitor

65
Q

What special investigation is appropriate for a poorly cooperative 9 year old child with gross caries?

A

OPT radiograph

66
Q

What information are you ideally looking for to establish the suitability of the timing of extraction of 6s?

A

Calcification of bifurcation of 7s
5s and 8s present

67
Q

How would you manage a caries free 26 when 16, 36 and 46 are being extracted due to gross caries?

A

Compensating extraction

68
Q

List 2 advantages of extraction of first permanent molars of poor prognosis at the correct stage?

A

Spontaneous closure of space
Caries free dentition

69
Q

List 2 disadvantages of extraction of first permanent molars of poor prognosis at the correct stage

A

Risks associated with GA
Traumatic experience now could negatively impact the child’s view of future dental care

70
Q

What might a child require to enable extractions?

A

General anaesthetic
Inhalation sedation

71
Q

What type of drug is warfarin and what is its mechanism of action

A

Anticoagulant
Vitamin K antagonist

72
Q

What test must be carried out prior to extractions in a patient on warfarin?

A

INR

73
Q

Which guidance document would you refer to for advice on dealing with patients on warfarin and within what timeframe should this test be carried out prior to extractions?

A

SDCEP
Within 24 hours

74
Q

Below what level INR is it safe to continue with extractions?

A

4

75
Q

Outline options that you could carry out clinically to deal with post-op bleeding?

A

Bite on damp gauze
LA with adrenaline - vasoconstrictor
Haemostatic agents
Suture
Diathermy

76
Q

If following intervention, you still cannot stop post-op bleeding, what would you do?

A

Urgent referral to local oromaxillofacial unit

77
Q

Anatomically, which nerves must be anaesthetised to remove a 48 safely?

A

Right long buccal nerve
Right lingual nerve
Right inferior alveolar nerve

78
Q

List 2 ways you could assess that anaesthesia has been achieved?

A

Ask patient if right side of chin or lip feels numb
Probe area adjacent to associated tooth - patient should feel pressure but no pain

79
Q

What word described pins and needles feeling or partial loss of sensation?

A

Paraesthesia

80
Q

What word describes painful, unpleasant or neuralgic sensation that lasts for a fraction of a second?

A

Dyaesthesia

81
Q

What word describes a total loss of sensation?

A

Anaesthesia

82
Q

Give 3 clinical reasons that could account for a neuro-sensory deficit during extraction of the 48

A

Cutting
Crushing injury
Transection of nerve

83
Q

Name two adjustments that can be made to a building to improve access for someone using a wheelchair

A

Elevator
Ramp

84
Q

Name two relevant acts of law for people with an impairment or disability

A

Equality Act 2010
Disability Discrimination Act 1995

85
Q

Describe the difference between the two models of disability

A

Medical - disability is caused by a persons impairment and should be fixed by medicine
Social - disability is caused by society around a person rather than any difference that person medically has

86
Q

List two augmentative and alternative communication methods

A

Makaton
Picture boards

87
Q

Name two options that are available to allow for the improved positioning of a gentleman in a wheelchair to allow for safe dental examination?

A

Hoist
Wheelchair recliner

88
Q

Which particular aspect of cerebral palsy may affect the dentists access to the patients mouth?

A

Uncontrolled muscle spasm

89
Q

Name two non-pharmacological adjuncts available to overcome access to the patients mouth

A

Bedi shield
Open wide mouth rest

90
Q

List four physical characteristics which are associated with Down’s syndrome

A

Broad, flat face
Decreased muscle tone
Short neck
Upwards slanting of eyes

91
Q

What genetic change is responsible for Down’s syndrome?

A

Full trisomy of chromosome 21

92
Q

List 2 medical aspects of Down’s syndrome which may result in lack of capacity

A

Intellectual disability
Dementia

93
Q

List 2 differences between a Welfare Guardian and a Welfare Power of Attorney

A

Welfare guardian is court appointed, PoA is drafted through a solicitor
Welfare guardian is for someone who lacks capacity, PoA is chosen by the person before they lose capacity

94
Q

List 2 features associated with Down’s syndrome that are likely to contributed to periodontal disease

A

Systemic immunodeficiency
Inability to carry out good oral hygiene practices

95
Q

What antibiotic and dose should be prescribed for infective endocarditis prophylaxis and when should you provide and observe the antibiotics being taken?

A

Amoxicillin 3g
1 hour before the procedure

96
Q

List four risk factors for mouth cancer

A

Alcohol consumption
Smoking
Diet low in fruit and vegetables
Immunosuppression

97
Q

What 2 pieces of information do you need to know about radiotherapy treatment a patient has received?

A

Dosage of radiotherapy
Area of exposure to radiotherapy

98
Q

What dose of radiotherapy delivered to the primary tumour increases the risk of osteoradionecrosis?

A

60Gy

99
Q

Describe the pattern of decay which is unique to radiation caries

A

Affects cervical margins of teeth

100
Q

How would you manage teeth needing extraction if a patient is at increased risk of ORN?

A

Primary orthograde endodontics and decoronate

101
Q

List two oral complications associated with radiation therapy other than ORN and radiation caries to the head and neck

A

Trismus
Oral mucositis

102
Q

List two preventative measures that should be implemented to reduce the risk of future dental disease for patients who have received radiotherapy to the head and neck?

A

2,800ppm flouride toothpaste
Tooth mousse

103
Q

List a management strategy for established ORN of the jaw?

A

Hyperbaric oxygen therapy

104
Q

Provide 3 examples of PPE to be used during manual washing and describe what each item is protecting you from

A

Heavy duty gloves - sharps injuries
Apron - splashing
Visor - aerosols to the face

105
Q

What two methods are used for manual cleaning of instruments? For each of these give an example of an instrument cleaned in this way

A

Immersion - dental mirror
Non-immersion - handpiece

106
Q

How often should an ultrasonic cleaner be de-gassed?

A

Before every production cycle

107
Q

What is removed by de-gassing an ultrasonic cleaner?

A

Air bubbles

108
Q

Why is it important to de-gas an ultrasonic cleaner?

A

Any bubbles created in the ultrasonic process would collapse into the air bubbles, preventing them from reaching the surfaces of the instruments

109
Q

Provide one good reason why dental handpieces should not be placed in the ultrasonic cleaner

A

The ferocious ultrasonic process can damage them

110
Q

Why is it important to use demineralised water in the steriliser?

A

Minerals and impurities could leave residue on the instruments, reducing the efficacy of the sterilisation process

111
Q

What term can be used to describe the collective group of microorganisms within the oral cavity and what are they referred to when attached to a surface?

A

Oral microbiota
Biofilm

112
Q

List the 4 key microbial stages of caries plaque formation

A

Adhesion
Colonisation
Maturation
Production

113
Q

Name 2 key virulence factors used by S. mutans to influence enamel dissolution

A

Glucans attach to the enamel
ATPase controls the pH

114
Q

Name the bacterium associated with secondary endodontic infections

A

E. faecalis

115
Q

Name on of the virulence factors used by E. faecalis

A

Adhesins

116
Q

Why is it difficult to determine causality from a specific bacteria in endodontic infection?

A

Integrity of sampling - difficult to ensure no contamination

117
Q

Which antimicrobial is primarily used to disinfect the root canal?

A

Sodium hypochlorite

118
Q

What culture independent technique could be used to assess changes in the oral microbial populations following antibiotic exposure?

A

Next generation sequencing

119
Q

What is the limitation of next generation sequencing?

A

It is limited to describing what is present rather than what the community is doing

3 Past Papers (10 decks)

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