Advanced dentistry techniques: Prosthodontics (Some MCQs at end)

Question 1

What is Prosthodontics?

Answer 1

This is the branch of dentistry involved in dental prostheses. Missing teeth may
be replaced by a variety of prostheses such as; crowns, bridges and dentures,
and these may be fixed or removable, and may be supported by implants.

Question 2

What is a crown?

Answer 2

A crown (sometimes known as a ‘cap’) is a type of restoration which completely or
partially covers the crown of an existing tooth. This may be performed after root
canal therapy, in an attempt to strengthen a tooth, for instance in working dogs.

Question 3

Why would implants not work in cats and dogs?

Answer 3

The original research for the possibility of implants in humans was performed in
dogs. So, while this is theoretical possible, it is not carried out in dogs and cats
due to the extreme forces they are subjected to and likelihood of failure.

Question 4

How should the crown be prepared for crown therapy?

Answer 4

The preparation of the tooth for a crown involves the irreversible removal of a
significant amount of tooth structure. The amount will depend on the material
used for the crown, and the preparation ideally should be kept within enamel,
but this is hard in dog teeth, as the enamel is so thin. The preparation should be tapered, with no undercuts, in order to allow the crown to be placed. However,
excessive taper will allow the crown to be dislodged more readily. The margin is
the most apical part of the preparation, and is usually supra-gingival in animals.
It is either a chamfer-shape, or feather-shape. This must be detectable on the
impression sent to the laboratory.
After preparation, an impression is made, which is used by a dental laboratory
to fabricate the crown, usually from a titanium alloy. Once fabricated, the patient
is anaesthetised once more in order to bond the crown onto the tooth.

Question 5

Stages of crown therapy?

Answer 5

1. Preparation
2. Impressions
   3.The crown will then be cemented onto the prepared tooth under a
   separate anaesthetic episode.

Question 6

Full mouth impressions are usually obtained using VPS putty impression
material (provided as a base and catalyst) held within a veterinary tray. This
allows the laboratory to?

Answer 6

Produce a model of the mouth to ensure the crown size
and shape does not interfere with mouth closure.

Question 7

What is a bite registration?

Answer 7

A bite registration is taken, which records the occlusal relationship between
upper and lower jaws, and is used when stone models/crowns are produced by
the laboratory. This can be performed using a piece of baseplate wax, or VPS
material. The patient must be extubated (or the connector of the ET tube
removed so the mouth can be fully closed), and the incisor and canine teeth
closed onto the impression material as it sets.

Question 8

What are Restorative techniques?

Answer 8

Restorative techniques are used to replace missing (involves prosthodontics) or
damaged teeth, which can be due to caries, trauma or genetics. Restorations
(fillings) can be placed to replace missing tooth substance and prevent future
problems. Restorations may be placed on enamel-dentine fractures if the pulp is
vital, at the end of a root canal treatment to restore the crown, if early stage
caries lesions are detected or to replace missing enamel in cases of enamel
hypoplasia. The conservation of natural tooth substance is the first rule of
restorative dentistry. Glass ionomers and composites are regularly used in
operative dentistry.

Question 9

What is the Classification of Cavities (and caries)?

Answer 9

Class I (Incisor, Premolar, molar) beginning in structural defects,
such as pits and fissures (commonly found on occlusal surfaces)
* Class II (Premolar, molar) proximal surfaces of molars and
premolars.
* Class III (incisor, canine) proximal surfaces of central and lateral
incisors and canines without involving the incisal angles.
* Class IV (Incisor, canine) proximal surfaces including incisal angles
* Class V (incisor, canine, premolar, molar) gingival 1/3 of facial or
lingual surfaces.
* Class VI (never described by Black, added later by W J Simon in
1956) (incisor, canine, premolar, molar) defect of incisal edge or
cusp.

Question 10

Caries in dogs are usually a class what lesion?

Answer 10

Caries in dogs are usually a class I lesion.

Question 11

List Restorative materials?

Answer 11

Glass ionomers (GI)
Composites
Curing light
Acid-etching
Bonding agents

Question 12

What are glass ionomers?

Answer 12

• Come in powder/liquid
  forms which should be mixed, or light-cured versions (e.g. Ionoseal).
  *Emit fluoride ions after setting.
  *Bond weakly to the tooth structure.
  *Often used as a liner for composite restorations in a process known
  as the sandwich technique.
  *highly sensitive to moisture
  contamination, so should be used in a dry field.

Question 13

What are composites?

Answer 13

Dental composites are known as ‘white fillings’ .attach to the tooth substance via a
bonding agent via a polymerisation process.
*composed of a resin matrix plus fillers, initiators
and accelerators and pigments.
* Composites are generally
classed according to the size of the fillers. E.g. Midifill, microfill, nanofill. The
smaller the size, the higher the strength and increased polishability.
*classified according to whether they flow or not.
*Composites need to be light-cured, using a curing light.
*cannot be
cured to depths >2mm, so place layers <2mm at a time
*polished with a series
of polishing discs, ensuring no rough edges or steps which could accumulate
plaque.
*A resin matrix without fillers is termed an
unfilled resin (e.g. Permaseal).
*an unfilled resin is placed as a composite sealant, which will fill
any minor defects between tooth and composite and account for any marginal
shrinkage by the product.

Question 14

What is a dental curing light?

Answer 14

*used to start the polymerisation process of light cure
resin-based composites and bonding agents.
*The blue light can
however cause ocular damage.
*look at the area being treated through the provided orange filter, and instruct assistants not to look directly at the light.

Question 15

What is Acid-etching?

Answer 15

*Before placement of the bonding agent, the tooth should be acid-etched.
*Phosphoric acid 10-40%.
*acid-etching selectively dissolves some of the
dental/restorative surface, allowing the bonding agent to enter these microporosites.
*enhances overall bonding to the tooth substance.
*Before etching, the tooth should be scaled and then polished using a non fluoride paste without any oil. (Flour of pumice is ideal).
*The acid gel is placed onto the required area for 20 seconds (dentine)- 30 seconds(enamel), and then rinsed off
for 10-20 seconds.
*Gel should not contact oral soft tissues (or
your skin!) for risk of acid burns.
* Area will then take on a frosted or chalky appearance.
*now ready to receive either an unfilled resin (e.g. a bonded sealant), or bonding agent if a composite restoration is being placed.
*Over-etching or over-drying can cause the
collagen within the tubules to collapse and thus reduce subsequent bonding
strength.

Question 16

What are bonding agents?

Answer 16

*usually based on
methacrylates.
*Bonding agents need to be cured with a curing light, to start the polymerisation
process.

Question 17

How should a cavity be prepared?

Answer 17

1. Area to be filled should be cleaned prior to application of the composite with
   a fluoride -free polishing paste, such as flour of pumice.
2. Enamel edges
   should be bevelled with a gingival margin trimmer or curette, and any loose or
   undercut areas of enamel removed.
3. cavity is then acid etched, rinsed, a
   bonding agent applied and cured and then the composite applied, cured and
   then polished and a sealant applied.

Question 18

5 principles of crown placement?

Answer 18

1. Preservation of tooth structure
2. Retention and Resistance
3. Structural durability
4. Marginal integrity
5. Preservation of periodontium

Question 19

1) In the image, the instruments depicted are:

• 2 different designs of explorers.
• 2 different periodontal probes designs.
• An explorer (top) and a periodontal probe (below)
• An periodontal probe (top) and a explorer (below)

Answer 19

• An explorer (top) and a periodontal probe (below)

Question 20

How many permanent teeth does a dog have?
* 28
* 32
* 42
* 44

Answer 20

• 42

Question 21

3) In which of the following teeth can two orthogonal (two planes at right angles to each other) views
be obtained by using standard intraoral dental radiography techniques?
* For the maxillary and mandibular incisor teeth
* For the maxillary fourth premolar teeth (upper carnassial teeth) in cats
* For the mandibular molar in cats
* For the canine teeth.

Answer 21

• For the canine teeth.

Question 22

4) When radiographs of the mandibular incisors and canines of the dog is displayed in the
conventional way, the crowns of the teeth face upwards. On this view, with the canine tooth on the
right side of the radiograph, this would be the:
* The patient’s right mandibular canine tooth
* The patient’s right maxillary canine tooth
* The patient’s left maxillary canine tooth
* The patient’s left mandibular canine tooth

Answer 22

• The patient’s right mandibular canine tooth

Question 23

5) Which of the following methods are not effective to examine tooth roots?
* Computed tomography (CT)
* Ultrasound scan
* Intraoral Radiography using digital sensors
* Intraoral radiography using film

Answer 23

• Ultrasound scan

Question 24

1) In the photograph above the instruments are arranged as follows (top to bottom)
* These are all explorers
* Two shepherd’s hook explorers and then two periodontal probe probes
* Three explorers and a periodontal probe
* These different designs for periodontal probe

Answer 24

• These are all explorers

Question 25

2) In intraoral radiographs of the maxillary premolar teeth of cats, which structure of the skull is
often superimposed the images of these teeth?
* The ramus of the mandible of the same side as the teeth radiographed.
* The ramus of the mandible from the opposing side to the ones radiographed
* The symphysis

Answer 25

• The zygomatic arch.

Question 26

3) During embryonal development, the deciduous teeth develop from:
* Endoderm
* Mesoderm
* Endoderm and mesoderm
* Ectoderm and mesoderm

Answer 26

• Ectoderm and mesoderm

Question 27

4) The correct description of the position of the wear facet on the discoloured left lower canine tooth
(not the one of the tip of the crown) would be:
* Rostral
* Labial
* Mesial
* Palatal

Answer 27

• Mesial

Question 28

5) This is a photograph of the left rostral aspect of the the mouth of a dog. Which of the following
is the best description of this malocclusion
* Neutrocclusion.
* Mesioversion of the left maxillary canine
* Mandibular distocclusion
* Labioversion of the left mandibular canine tooth

Answer 28

• Mandibular distocclusion

Question 29

1) Acepromazine is a sedative agent belonging to which class of drugs?
* Benzodiazepines
* Phenothiazines
* Alpha 2 adrenergic agonists
* Opioids

Answer 29

• Phenothiazines

Question 30

2) Which of the following nerve block is anatomically the most rostral for needle placement?
* Mandibular
* Maxillary
* Mental
* Infraorbital

Answer 30

• Mental

Question 31

3) Which of the following statements about alphaxalone is true?
* It is solublised in a cyclodextrin base
* It is antagonised by flumazenil
* It causes histamine release in dogs
* It is only suitable for intravenous injection.

Answer 31

• It is solublised in a cyclodextrin base

Question 32

4) Which of the following analgesic drugs is a Schedule 3 controlled drug?
* Ketamine
* Methadone
* Pethidine
* Gabapentin

Answer 32

• Gabapentin

Question 33

5) Which of the following crystalloid fluids has the lowest concentration of sodium?
* 0.18% NaCl with 4% glucose
* Hypertonic saline
* Hartmann’s solution
* Normal saline

Answer 33

• 0.18% NaCl with 4% glucose

Question 34

1) According to Confidential enquiry into peri-operative small animal fatalities (CEPSAF), what
percentage of canine deaths that occur in the peri-anaesthetic period happen in the first 3 hours of
recovery from anaesthesia?
* 20%
* 30%
* 40%
* 50%

Answer 34

• 50%

Question 35

2) The blood volume of a 20kg dog will be approximately
* 1000ml
* 1400ml
* 1800ml
* 2400ml

Answer 35

• 1800ml

calculation approx:
Total blood volume (mL) = 90 ml/kg

Question 36

3) The Glasgow Composite pain scales for dogs and cats are example of what type of pain scoring
systems?
* Visual analogue score
* Simple descriptive scale
* Numerical rating scale
* Quantitative sensory scale

Answer 36

• Simple descriptive scale

Question 37

4) Post procedural blindness in cats attributed to use of mouth gags is attributed to a decrease in
blood supply of what vessel?
* Mandibular artery
* Maxillary artery
* Infraorbital artery
* Mental artery

Answer 37

• Maxillary artery

Question 38

5) Which of the following is not included in the triad of anaesthesia?
* Muscle relaxation
* Analgesia
* Unconsciousness
* Disinhibition

Answer 38

• Disinhibition

Question 39

1) In what percentage of apparently healthy teeth does dental radiography identify clinically
significant pathology in cats?
* 5
* 25
* 40
* 60

Answer 39

• 40

Question 40

2) Which of the following is commonly true about dental X-ray generators?
* Exposure is controlled through alteration of time
* Exposure is controlled through alteration of mA
* Exposure is controlled through alteration of kV
* All of the above

Answer 40

• Exposure is controlled through alteration of time

Question 41

3) When performing dental radiography Local Rules require operators to withdraw from the x ray
generator by at least
* 1 meter
* 2 meters
* 3 meters
* 4 meters

Answer 41

• 2 meters

Question 42

4) What is the largest conventional dental film size?
* o
* 2
* 4
* 10

Answer 42

• 4

Question 43

5) Which statement is false regarding indirect digital dental radiography?
* Screen sizes are limited to size 1 & 2
* Image acquisition is slower than direct digital dental radiography
* Individual screens are significantly cheaper to replace than direct sensors
* Specialised screens can be used for intra-oral lagomorph dental radiographs

Answer 43

• Screen sizes are limited to size 1 & 2

Question 44

1) In what instance would extra-oral dental radiography be useful?
* Imaging the maxillary 3rd and 4th premolar in dogs
* Imaging the mandibular 3rd and 4th premolar in the cat
* Imaging the maxillary incisive region in the dog
* Imaging the maxillary 3rd and 4th premolar in cats

Answer 44

• Imaging the maxillary 3rd and 4th premolar in cats

Question 45

2) If after acquisition of a radiograph the image appears elongated, what action should you take?
* Move the position of the screen
* Perform a tube shift
* Alter the incident beam angle closer to the axis of the tooth
* Alter the incident beam angle closer to the axis of the screen

Answer 45

• Alter the incident beam angle closer to the axis of the tooth

Question 46

3) A rostral tube shift of the maxillary 4th premolar would result in?
* The mesio-palatal root appearing to move caudally
* The mesio-buccal root appearing to move caudally
* Elongation of the roots
* The mesio-buccal root appearing to move rostrally

Answer 46

• The mesio-buccal root appearing to move caudally

Question 47

4) Prolonged maximal mouth opening in the cat may result in which of the following?
* Bradycardia
* Hypertension
* Decreased cerebral vascular perfusion
* Retinal detachment

Answer 47

• Decreased cerebral vascular perfusion

Question 48

5) What radiographic appearance may be consistent with chronic pulpitis?
* Abnormally wide pulp space
* Narrowing of the pulp space
* Resorption replacement of the apex of the tooth
* Periodontal wedging

Answer 48

• Narrowing of the pulp space

Question 49

1) During a conscious examination of an 8 month old Labrador, you notice the third mandibular
premolars are absent bilaterally. Which of the following is the best advice to the owner?
* It is still possible that these teeth will erupt so no reason for any further consideration at this stage.
* These teeth might be unerupted and radiography is important to investigate further.
* As long is this patient continues to eat there is no reason to intervene
* This is a real concern as it might be a sign of a papillary squamous cell carcinoma and the area should be biopsied
immediately.

Answer 49

• These teeth might be unerupted and radiography is important to investigate further.

Question 50

2) Which of the follow statements is the most accurate when tooth resorption in dogs?
* Tooth resorption has never been diagnosed in dogs
* It does occur in dogs but it is extremely rare and of no consequence
* Inflammatory tooth resorption does not occur in dogs
* Radiography is the best way to diagnose this common problem in dogs

Answer 50

• Radiography is the best way to diagnose this common problem in dogs

Question 51

3) A 10 month old Main Coon kitten presents with severe halitosis and gingivitis. Which of the
following is the most accurate advice to the owner?
* The teeth are still erupting, it is part of a normal process, so no need to be concerned about this at all
* This is Feline Chronic Gingivostomatitis and full mouth extraction should be performed without delay
* Investigation, including intraoral radiography is indicated as gingivitis could be an indication of
periodontitis
* This is Calici virus infection so treat this as indicated

Answer 51

• Investigation, including intraoral radiography is indicated as gingivitis could be an indication of
  periodontitis

Question 52

4) A 1 year old mixed breed dog with a malocclusion have the left mandibular canine impinging on
the palate. This had caused a 7 mm deep defect on the palate The dog still eats and shows no signs
of discomfort. Which of the following options is best treatment/management plan?
* The dog is fine so no need to be concerned
* This is potentially painful and extraction of the left mandibular canine is the only treatment option
* It is very likely that this is at least occasionally painful and with the possibility of oronasal fistula
formation this should be treated. Various treatment options are available
* Use antibiotics to address the localised infection whenever it becomes an obvious problem

Answer 52

• It is very likely that this is at least occasionally painful and with the possibility of oronasal fistula
  formation this should be treated. Various treatment options are available

Question 53

5) During a conscious examination of a two year old domestic shore haired cat, you notice a fracture
of the right maxillary canine. Only about 4 mm of the crown is absent and there is no obvious pulp
exposure. Which of the following options are the best?
* It is very possible that the pulp of this tooth is exposed and it probably requires treatment. Provide
analgesia and arrange further investigation and treatment (if indicated)at the first possible
opportunity
* This is a mall fracture and unlikely to be significant. No red to be concerned
* As long as the patient does not indicate any oral pain, signs of swelling or infection, there is no indication for
intervention
* This is probably associated with tooth resorption so as long as the first mandibular premolar teeth is not affected,
there is no further indication for intervention.

Answer 53

• It is very possible that the pulp of this tooth is exposed and it probably requires treatment. Provide
  analgesia and arrange further investigation and treatment (if indicated)at the first possible
  opportunity

Question 54

1) A 5 year old border collie presents after a dog fight with bleeding from the mouth and the left
maxillary canine displaced labially by at least 10 mm. Which of the follow options are the best
advice.
* The tooth root is probably fractured. The crown remnants should be removed under sedation and the would left
open to drain.
* Start antibiotic treatment immediately and arrange surgical debridement once the infection is under control
* If radiography does not indicate a root fracture, the tooth and alveolar bone associated with the
luxation can be reduced and the gingiva sutured. This should only be considered if endodontic
treatment of the left maxillary canine is considered otherwise the tooth should be extracted when
the soft tissue wound is closed
* If radiography does not indicate a root fracture, the tooth and alveolar bone associated with the luxation can be
reduced and the gingiva sutured. This is generally very effective, is likely to recover well and no further treatment will
be required.

Answer 54

• If radiography does not indicate a root fracture, the tooth and alveolar bone associated with the
  luxation can be reduced and the gingiva sutured. This should only be considered if endodontic
  treatment of the left maxillary canine is considered otherwise the tooth should be extracted when
  the soft tissue wound is closed

Question 55

2) Which of the options below describes dilaceration most accurately
* A bifid crown of incisor teeth in both cats and dogs.
* A sharp bend of the apical aspects of tooth root.
* The partial fusion of the adjacent teeth
* A supernumerary root in an otherwise single rooted tooth

Answer 55

• A sharp bend of the apical aspects of tooth root.

Question 56

3) Which of the following statements are true for dental caries?
* It is a rare condition that affects cats dogs and rabbits.
* It is associate with sugary food causing demineralisation of enamel and dentin and amongst
domestic pets, it mainly affects the distal premolar and molars of dogs.
* It affects the third mandibular premolars (307 and 407) in cats first.
* This a human dental-problem and does not affect pet animals

Answer 56

• It is associate with sugary food causing demineralisation of enamel and dentin and amongst
  domestic pets, it mainly affects the distal premolar and molars of dogs.

Question 57

4) An enamel-dentin fracture is identified on the main cusp to then right mandibular carnassial
tooth of a dog during an oral examination under general anaesthesia .The pink sheen in the area of
the pulp chamber is visible but no pulp exposure is evident. Which of the following statements are
true:
* There is probably less than 1mm of dentin that remains covering the pulp. Analgesia, radiography
and further treatment is indicated ideally during this procedure
* This is an insignificant finding, dog is lucky and needs no further intervention.
* With no pulp exposure there is no need for any concern and advice on hard chews the only intervention indicated.
* This injury are probably caused by varying large sticks and apart from advice on behaviour change, should be
considered as an insignificant coincidental finding

Answer 57

• There is probably less than 1mm of dentin that remains covering the pulp. Analgesia, radiography
  and further treatment is indicated ideally during this procedure

Question 58

5) A 10 mm diameter mass is discovered on the buccal aspect of the left mandibular first molar of a
3 year old German shepherd. It is slightly exophytic and slightly inflamed but this corresponds to
the occlusion of the opposing left maxillary fourth premolar. The best approach from the options
below to discuss with the owner, is:
* In such a young dog it is unlikely to be anything serious and a follow up visit during the next vaccination, should be
considered
* This is an impingement defect from the left maxillary fourth premolar and this tooth should be extracted as soon as
possible
* This is probably and traumatic injury so antibiotics and anti-inflammatory treatment should resolve the issue
* Any mass in the oral cavity should be further investigated and radiography and biopsy is
important

Answer 58

• Any mass in the oral cavity should be further investigated and radiography and biopsy is
  important

Question 59

1) Calculus is a contributor to periodontal disease because:
* Heavy calculus displaces the gingiva and causes gingival recession
* The rough surface causes irritation to in contact vestibular mucosa
* The rough surface allows the more rapid accumulation of plaque and it is the latter that triggers
gingivitis
* Without heavy calculus periodontal disease would never become significant

Answer 59

• The rough surface allows the more rapid accumulation of plaque and it is the latter that triggers
  gingivitis

Question 60

2) Which of the follow statements are true of the gingiva?
* The gingiva extends from the gingival margin to the mucogingival junction
* The gingival extends from the alveolar margin to the mucogingival junction
* The gingiva extends from the gingival margin to the deepest aspect of the gingival sulcus
* The gingiva extends from the deepest aspect of the gingival sulcus to the mucogingival margin

Answer 60

• The gingiva extends from the gingival margin to the mucogingival junction

Question 61

3) The periodontium includes the following tissue:
* All the soft tissue in the oral cavity, expose tooth surfaces and alveolar bone
* The attached and free gingiva and the junctional epithelium
* The tooth and tooth surface structures like the cementum, is not considered part of the periodontium
* The periodontium consists of the gingival, periodontal ligament cementum and alveolar bone.

Answer 61

• The periodontium consists of the gingival, periodontal ligament cementum and alveolar bone.

Question 62

4) The periodontal ligament anchors the tooth in the alveolus by means of
* A loose network if connective tissue with lots of blood vessels and nerves
* There are no blood vessels and the periodontal ligament are mainly made of elastic fibres to provide shock
absorption
* Bundles of collagen imbedded on cementum on the tooth side and into the alveolar bone on the
opposite side
* Bundles of collagen that are arrange parallel to the tooth root surface extends from the root apex to the gingival
margin

Answer 62

• Bundles of collagen imbedded on cementum on the tooth side and into the alveolar bone on the
  opposite side

Question 63

5) The best description of dental plaque from the options below is:
* It is s sticky substance that form from food remnants and bacteria on the and is confined to the crowns of teeth
* It is a complex biofilm that has a defined lifetime and self destructs when the layers become overly thick
* It is poorly organised mass of bacteria supported by food debris that sticks to the tooth crown surface
* It is a very well organised stratified colony of various bacteria the supports and contributes to the
establishment and maintenance of the biofilm

Answer 63

• It is a very well organised stratified colony of various bacteria the supports and contributes to the
  establishment and maintenance of the biofilm

Question 64

1) Which of the following statement is accurate for periodontal disease in cats
* Gingivitis is less common in cats an always associate with type II tooth resorption
* Gingivitis always progresses to periodontitis
* Periodontitis is the most common infectious disease in cats
* Periodontitis is present with as little as 2mm probing depth

Answer 64

• Periodontitis is present with as little as 2mm probing depth

Question 65

2) The best description of cementum from the options below, is:
* A composition very similar to enamel but restricted to the tooth root apical to the cemento-enamel junction
* A bone like substance but does not contain living cells, blood supply or innervation.
* A bone like, mineralised tissue that contains living cells (cementocytes), and is continually formed
throughout life of the patient.
* Cementum is similar to dentin and is deposited at the dentino-cemental junction.

Answer 65

• A bone like, mineralised tissue that contains living cells (cementocytes), and is continually formed
  throughout life of the patient.

Question 66

3) The bony dental alveolus can best be described
* Cortical bone
* Perforated compact bone
* Trabecular bone
* Medullary bone

Answer 66

• Perforated compact bone

Question 67

4) The * in the diagram represents:
* Rete pegs
* Cement-enamel junction
* Junctional epithelium
* Alveolar Mucosa

Answer 67

• Junctional epithelium

Question 68

5) The bacteria most prevalent in mature plaque biofilms in dogs with periodontal disease are:
* Gram negative aerobes
* Gram Positive aerobes
* Gram negative Anaerobes
* Gram positive anaerobes

Answer 68

• Gram positive anaerobes

Question 69

1) Wound healing in the oral cavity follows distinct but overlapping phases. Which two phases follow
the inflammatory phase?
* Maturation and Epithelialisation phases
* Proliferation and Remodelling phases
* Resorptive and granulation phases
* Non-inflammatory and scarring phases

Answer 69

• Proliferation and Remodelling phases

Question 70

2) A Luxator is often used during dental extractions. How is it identified?
* The handle is usually plastic. The blade is thin, and the tip is very sharp.
* The handle is usually metal. The blade is thick and the tip is kept blunt to reduce iatrogenic trauma.
* The handle can be either plastic or metal. The blade has wings around the tip to engage more of the root surface.
* This is a triangular shaped elevator with left and right versions.

Answer 70

• The handle is usually plastic. The blade is thin, and the tip is very sharp.

Question 71

3) In order to perform extractions competently, safely and atraumatically, dental instruments and
equipment should be held appropriately. Which is the correct grip for the high-speed handpiece?
* Palm grip
* Palm and thumb grip
* Modified pen grip
* Wide-based tripod grip.

Answer 71

• Modified pen grip

Question 72

4) What is the most common cause of oronasal fistula formation in the dog?
* Iatrogenic trauma
* Periodontitis.
* Aspergillosis.
* Neoplasia.

Answer 72

• Periodontitis.

Question 73

5) What are the three types of flap which may be designed during an open extraction?
* Gingival, mucogingival, mucogingivoperiosteal
* Envelope, triangular, pedicle
* Axial pattern, local, free
* Buccal, palatal, lingual

Answer 73

• Envelope, triangular, pedicle

Question 74

1) A 2 year-old Labrador retriever is presented for a post-operative check. Five days previously, a
colleague performed a closed extraction of the left maxillary 2nd pre-molar tooth. You notice the
blood clots have disappeared from the alveoli. Which of the following complication is most likely to
occur?
* Osteomyelitis with absence of healing
* Alveolar osteitis with delayed healing
* Focal gingivitis with otherwise normal healing
* Alveolus abscess formation with delayed healing.

Answer 74

• Alveolar osteitis with delayed healing

Question 75

2) Which of the following instruments is used to raise a mucogingival flap?
* Luxator
* Number 15 Scalpel blade on a handle.
* Periosteal elevator
* Periodontal curette

Answer 75

• Periosteal elevator

Question 76

3) Which is the most suitable bur for sectioning a multi-rooted tooth prior to extraction?
* Round diamond bur
* Rugby ball diamond bur
* Round tungsten carbide bur
* Taper fissure tungsten carbide bur

Answer 76

• Taper fissure tungsten carbide bur

Question 77

4) A 15mm periodontal pocket is noted on the palatal aspect of the right maxillary canine tooth (104)
of a 10 year-old Miniature Schnauzer during oral examination under anaesthesia. Blood is noted at
the ipsilateral nostril. What is the correct treatment for this finding?
* Closed extraction of tooth 104, plus antibiotic therapy.
* Open root planing of tooth 104, plus ultrasonic scaling and polishing.
* Open extraction of tooth 104, plus surgical correction of the defect.
* Guided tissue regeneration of tooth 104.

Answer 77

• Open extraction of tooth 104, plus surgical correction of the defect.

Question 78

5) Complications can occur during or after extraction attempts in dogs and cats. When is
displacement of a root tip into the mandibular canal most likely to occur?
* When excessive apical force is used.
* When excessive buccal bone is removed during an open extraction.
* Any time a closed extraction is used for mandibular teeth.
* When an elevator rather than a luxator is used to extract mandibular teeth.

Answer 78

• When excessive apical force is used.

Question 79

1) What is the most appropriate transport medium for avulsed teeth?
* Tap water
* Egg white
* Skimmed Milk
* A moist paper towel

Answer 79

• Egg white

Question 80

2) Which description best describes an “unfavourable” fracture?
* Grossly infected soft tissue wounds
* A comminuted fracture
* Presence of severe periodontal disease at the fracture site
* An oblique fracture running in a ventrocaudal to rostrodorsal direction

Answer 80

• An oblique fracture running in a ventrocaudal to rostrodorsal direction.

Question 81

3) What methods are appropriate for the stabilisation of mandibular symphyseal separations?
* External Skeletal fixation
* Rigid internal fixation
* BEARD
* Intraoral wire and acrylic splint

Answer 81

• Intraoral wire and acrylic splint

Question 82

4) Which statement is true?
* Interfragmentary wires neutralise torsional forces
* Non-locking plates are stiffer than locking plates
* A minimum of 4 cortices on either side of a fracture are needed to stabilise a mandibular fracture
with a locking plate.
* Iatrogenic injury to teeth is unavoidable and can be ignored

Answer 82

• A minimum of 4 cortices on either side of a fracture are needed to stabilise a mandibular fracture
  with a locking plate.

Question 83

5) The most common direction of temporomandibular luxation is?
* Rostrodorsal
* Caudoventral
* Lateral
* Medial

Answer 83

• Rostrodorsal

Question 84

1) Which form of traumatic dento-alveolar injury is reported to be most common?
* Concussion
* Enamel dentin fracture
* Enamel dentin pulp fracture
* Intrusive luxation

Answer 84

• Enamel dentin pulp fracture

Question 85

2) What is the approximate reported frequency of jaw fractures in relation to all reported fractures,
in cats?
* 15-23%
* 1.5 -3%
* 7-12%
* 0.5-1.5%

Answer 85

• 15-23%

Question 86

3) Which statement below best describes direct gap bone healing?
* Formation of a fibrous union without bone bridging or complete stabilisation
* Production of a fibrocartillagenous and bone callous as an intermediate stage of healing.
* Direct contact of bone fragments held rigidly
* Bone fragments held rigidly and less than 800µm gap between them.

Answer 86

• Bone fragments held rigidly and less than 800µm gap between them.

Question 87

4) What complications can be associated with maxillo-mandibular fixation?
* Inability to thermoregulate
* Aspiration
* TMJ ankylosis
* All of the above

Answer 87

• All of the above

Question 88

• All of the above
  5) In which circumstance presented below would it be inappropriate to utilise a wire and acrylic
  splint in the management of a traumatic injury?
• Mandibular symphyseal separation
• Unfavourable fracture of the mid body of the mandible
• Favourable fracture of the mid body of the mandible
• Fracture with a critical size defect of the mid mandibular body

Answer 88

• Fracture with a critical size defect of the mid mandibular body

Question 89

1) What is a cancer?
* A tumour
* A neoplasm
* A growth of tissue which is out of the host’s control
* A growth of tissue which forms due to a disease

Answer 89

• A growth of tissue which is out of the host’s control

Question 90

2) What method of administration of cytotoxic chemotherapy poses the biggest risk to the people
administering the treatment?
* Intravenous
* Intramuscular
* Subcutaneous
* Oral

Answer 90

• Oral

Question 91

3) What is palliative radiation therapy?
* A means of control of pain and inflammation
* A means of controlling incomplete tumour excision
* A means of controlling the tumour if surgery is not possible
* A means of shrinking the tumour before surgery can take place

Answer 91

• A means of control of pain and inflammation

Question 92

4) You have diagnosed a 20kg Labrador dog with a large oral melanoma (8cm diameter) in the fauces
of his mouth where adequate surgery is not possible. What is likely to be the most beneficial
treatment to consider?
* Radiation therapy
* Immunotherapy with the Merial Oncept Vaccine
* Chemotherapy with carboplatin
* Palliative care

Answer 92

• Radiation therapy

Question 93

5) A 4kg DSH cat has an oral squamous cell carcinoma, measuring 2cm diameter in his lower left
mandible, extending across the midline underneath his tongue. What is likely to be the most
beneficial treatment to consider:
* Radiation therapy
* Immunotherapy with APAVAC product
* Chemotherapy with carboplatin
* Palliative care

Answer 93

• Palliative care