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BDS4 Exam Revision > BDS3 > Flashcards

BDS3 Flashcards

1
Q

what does edentulism do to soft tissues

A

ridge resorption
reduce face height
soft tissue changes to lip and chin

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2
Q

what are the main reasons for complete dentures

A

caries
periodontal disease
tooth wear
failing dentitions
occlusal collapse
appearance

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3
Q

what is support

A

resistance of vertical movement of a denture towards the ridge

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4
Q

what gives support on the upper arch

A

palate and ridge crest

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5
Q

what gives support on the lower arch

A

buccal shelf, pear shaped pad, ridge crest, genial tubercles

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6
Q

what is retention

A

resistance to displacement of a denture away from the ridge

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7
Q

what is stability

A

ability of a denture to resist displacement by functional stress

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8
Q

what is adaptation in relation to dentures

A

degree of fit between prosthesis and supporting structures

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9
Q

what impression material do you use for people who gag and why

A

red compound as it sets faster

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10
Q

what do you look for when assessing if an impression is adequate

A

are all edentulous areas included
are sulci recorded fully
are deficiencies present

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11
Q

what do special trays allow

A

accurate peripheral extension
uniform thickness of material
reduced amount of material
records denture area more accurately

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12
Q

what do you aim for with impression taking

A

well rounded borders
minimal air blows
impression centrally placed
all clinically relevant areas

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13
Q

what is the process of replica dentures

A

lab putting impression on working side
impression of fit surface
record blocks to record occlusion
impression of fit surface with light body silicone with denture in mouth
shade and mould
try in wax

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14
Q

what is mucocompression

A

pressure applied so tissues recorded under load

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15
Q

what is mucostasis

A

minimum pressure so records at rest

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16
Q

what is the steps of jaw registration

A

upper block for retention
upper block for tooth position
upper block for occlusal planes
lower tooth position and horizontal jaw relationship
OVD and RVD
record registration
shade and mould

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17
Q

what does LIMBO stand for

A

lip support
incisal level
midline
buccal corridor
occlusal plane

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18
Q

what is the angle for lip support

A

90 degrees

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19
Q

how much tooth should show with complete dentures

A

1-2mm

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20
Q

what are the reference lines for the occlusal plane

A

interpupillary
ala-tragus

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21
Q

what is the neutral zone

A

space between the lips and cheeks and tongue where forces are equal

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22
Q

what is the freeway space meant to be

A

2-4mm

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23
Q

what do you measure FWS with

A

willis bite gauge

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24
Q

what gives retention

A

adhesion
base shape and adaptation to mucosa
post dam seal
retromylohyoid fossa
labial undercut

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25
Q

when is retention for dentures made difficult

A

atrophic ridges
cleft palate
flabby ridge
damaged alveolar ridge
gagging
insufficient saliva

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26
Q

what do you check at try in stage

A

retention and stability
base extensions
LIMBO
tooth position
vertical dimension
even contact
speech
aesthetics

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27
Q

what are the contraindications for immediate dentures

A

ORN
MRONJ
pre-cancer treatment
large cysts
fractures
dementia

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28
Q

what are the potential contraindications to orthodontics

A

allergy
epilepsy
drugs
imaging

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29
Q

what is AP 1

A

maxilla 2-3mm in front of mandible

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30
Q

what is AP 2

A

maxilla more than 2-3mm in front

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31
Q

what is AP 3

A

mandible in front of maxilla

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32
Q

what is increased FMPA

A

lines meet before occiput

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33
Q

what is reduced FMPA

A

lines meet after occiput

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34
Q

what does a sucking habit give

A

procline upper
retrocline lowers
localised AOB or incomplete OB
narrow upper arch and unilateral crossbite

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35
Q

what do you look at when the teeth are in occlusion

A

incisor relationship
overjet
overbite/open bite
molar relationship
canine relationship
cross bites
centre lines

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36
Q

what is class 1 incisors

A

lower incisor edges occlude with cingulum plateau of upper incisors

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37
Q

what is class 2 div 1 incisors

A

lower incisors edges lie posterior to cingulum plateau of upper incisors
upper proclined or of average inclination and increased overjet

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38
Q

what is class 2 div 2 incisors

A

lower incisors edges lie posterior to cingulum plateau of upper incisors
upper centrals retroclined and minimal or increased overjet

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39
Q

what is class 3 incisors

A

lower incisors edges lie anterior to cingulum plateau of uppers
overjet reduced or reversed

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40
Q

how is cephalometry standardised and reproducible

A

due to cephalostat

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41
Q

what is SNA

A

maxilla to anterior cranial base

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42
Q

what is SNB

A

mandible to anterior cranial base

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43
Q

what is ANB

A

mandible to maxilla

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44
Q

what would dentoalveolar compensation look like in class 3

A

proclined uppers
retroclined lowers

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45
Q

what is the frankfort plane

A

lower orbital rim to superior border of EAM

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46
Q

what is the mandibular plane

A

lower border of mandible

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47
Q

what can arch width discrepancies cause

A

crossbites

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48
Q

what is asymmetry caused by

A

displacement of mandible
or skeletal issues like hemi-mandibular hyperplasia

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49
Q

what are the 4 types of supernumerary

A

conical
tuberculate
supplemental
odontome

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50
Q

what do tuberculates cause

A

eruption failure of incisors

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51
Q

what are the 2 types of odontome

A

compound
complex

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52
Q

what teeth does hypodontia commonly affect

A

upper 2s and lower 5s

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53
Q

what percentage of the population has hypodontia

A

4-6%

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54
Q

what are the causes of retained primary teeth

A

absent permanent
ectopic/dilacerated
ankylosed
delayed development
pathology/supernumerary

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55
Q

what are the options for an absent permanent but retained primary

A

keep or XLA and space closure

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56
Q

what is early loss of teeth due to

A

trauma
pathology
caries
resorption

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57
Q

what is the incidence of ectopic canines

A

1-3%

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58
Q

what are ectopic canines associated with

A

peg laterals
class 2 div 2

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59
Q

how do you check for ectopic canines

A

visualise
palpate
inclination of 2
mobility of c/2
colour of c/2

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60
Q

what are the treatment options for ectopic canines

A

extract c
accept
exposure
extract 3
autotransplant

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61
Q

why would upper centrals be missing

A

supernumerary
trauma

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62
Q

what happens to bone in areas of compression

A

resorption

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63
Q

what happens to bone in areas of tension

A

deposition

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64
Q

what does a functional appliance do

A

posture mandible away from normal position stretching face muscles generating forces transmitted to teeth
grows mandible
strains maxilla
retroclines uppers
proclines lowers
mesial movement of lowers
distal movement of uppers

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65
Q

what do light forces do

A

frontal resorption

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66
Q

what do moderate forces do

A

undermining resorption

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67
Q

what do excessive forces do

A

pain, necrosis, anchorage loss

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68
Q

when do 6s erupt

A

6

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69
Q

when do 1s erupt

A

7

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70
Q

when do 2s erupt

A

8

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71
Q

when do 4s erupt

A

10

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72
Q

when do 3s and 5s erupt

A

11-12

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73
Q

when do 7s erupt

A

12-13

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74
Q

what are the treatment options for impacted eruption of 6 by the E

A

if <7yrs wait 6 months
orthodontic separators
distalise first molar
extract E
distal disking of E

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75
Q

what are the treatment options for unerupted central incisor due to supernumerary

A

remove primaries and supernumeraries
create/maintain space
monitor for 12 months
expose and chain

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76
Q

what does early loss of primaries do

A

cause localised crowding

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77
Q

what primaries do you balance

A

c

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78
Q

what primaries do you use a space maintainer for

A

E

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79
Q

when do you compensate for molars

A

if taking lowers

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80
Q

what is the management of habits

A

positive reinforcement
nail varnish
glove/plaster
habit breaker appliance/goal posts

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81
Q

if there is infraocclusion what do you need to check for

A

percussion
mobility
PA/OPT
presence of successor
ankylosis of primary
root resorption

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82
Q

what do you do for infraocclusion if there is a permanent present

A

monitor for 6-12 months
extract if below contact/root formed
maintain space

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83
Q

what happens if you do nothing for an infraoccluded tooth

A

ankylosis
more ectopic
caries

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84
Q

what happens if you do nothing for ectopic canines

A

become more ectopic
impacted
root resorption
cyst formation
ankylosis

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85
Q

what does low calcium mean for bones

A

increased bone loss

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86
Q

what does PTH do for calcium

A

maintains serum calcium levels

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87
Q

what does hypoparathyroidism do for calcium

A

low

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88
Q

what does hyperparathyroidism do for calcium

A

high

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89
Q

what is osteomalacia

A

poorly mineralised bone

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90
Q

what is osteoporosis

A

reduced bone mass

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91
Q

what are the symptoms of osteomalacia and how do you fix it

A

bowed legs and vertebral compression
sunlight and vitamin D

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92
Q

who is more at risk for osteoporosis

A

women
steroids
inactivity
smoking

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93
Q

what does osteoporosis cause

A

bone fracture
kyphosis
scoliosis
back pain

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94
Q

how do you prevent osteoporosis

A

building peak bone mass
HRT

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95
Q

what are the symptoms of SLE

A

butterfly rash
arthritis
raynauds
ulcers, bleeding, impaired drug metabolism, lichenoid reactions

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96
Q

what are the sjogrens antibodies

A

anti-ro
anti-la

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97
Q

what are the oral complications of sjogrens

A

dry mouth
oral infection
caries risk
loss of function
denture retention
sialosis
salivary lymphoma

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98
Q

what is systemic sclerosis

A

loss of elastic tissue and connective tissue fibrosis

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99
Q

what are the dental implications of systemic sclerosis

A

plan treatment in advance
dental erosion
bad metabolism
widened PDL but no mobility

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100
Q

what can vasculitis present as

A

ulcers

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101
Q

what is kawasaki disease symptoms

A

fever and lymphadenopathy, crusted and strawberry tongue

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102
Q

what is wegners granulomatosis oral presentation

A

spongy and gingival erythema

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102
Q

what is gout

A

uric acid crystal deposition

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103
Q

what is osteoarthritis

A

degenerative joint disease on weight bearing joints

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104
Q

what can the oral implications of osteoarthritis be

A

TMJ involved sometimes
ulcers due to NSAIDs

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105
Q

what are the dental implications of rheumatoid arthritis

A

reduced dexterity
access to care
sjogrens
bleeding
infection
oral lichenoid
ulcers
pigment

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106
Q

what is rheumatoid arthritis

A

synovium disease with gradual inflammatory joint destruction

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107
Q

what is epilepsy

A

reduced GABA levels in brain leading to abnormal cell-cell propagation

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108
Q

what can the oral implications of epilepsy be

A

gingival hyperplasia
bleeding
tissue injury

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109
Q

what are the complications of stroke

A

impaired mobility
communication problems
risk of cardiac emergencies
loss of protective reflexes
loss of sensory information
stroke pain

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110
Q

what are the side effects of SSRIs

A

acute anxiety
sedation
dry mouth
GI issues

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111
Q

what do you need to avoid if your patient is on lithium

A

metronidazole
NSAIDs

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112
Q

what are the oral implications of anorexia nervosa

A

ulcers
dry mouth
bleeding

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113
Q

what are the oral implications of bulimia

A

erosion

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114
Q

what does alloys do to help porcelain

A

smaller strain on porcelain as the alloy is ductile

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115
Q

what does an alloy which is meant to bond to porcelain need to have

A

good at bonding
expansion coefficient the same as porcelain
avoid discolouration
high elastic modulus

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116
Q

what is the alloy bond to porcelain due to

A

mechanical - surface irregularities
stressed skin - difference in thermal contraction
chemical - electron sharing in oxides

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117
Q

what is transverse strength

A

how well upper denture copes with stresses that cause deflection (dropping on floor)

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118
Q

what is the difference between self cure and heat cure PMMA

A

self cure has better dimensional accuracy, lower weight and poorer mechanical properties but more unreacted monomer which absorbs water and means expansion

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119
Q

what are the important factors for elastomers

A

interaction between material and tooth
accuracy
removal and undercuts
dimensional stability

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120
Q

how is interaction between material and tooth measured

A

viscosity
surface wetting
contact angle

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121
Q

how is accuracy of elastomers measured

A

surface reproduction
viscoelasticity - shark fin

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122
Q

how is removal and undercuts of elastomers measured

A

flow under pressure
tear strength
rigidity

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123
Q

how is dimensional stability of elastomers measured

A

setting shrinkage
thermal expansion
storage

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124
Q

what are the different types of luting agents

A

zinc phosphate
zinc polycarboxylate
GI
RMGIC
composite
self adhesive composite
self etching composite

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125
Q

what is added to RMGIC to make it resin modified

A

HEMA

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126
Q

what is the effect of HEMA on RMGIC

A

short setting
long working
higher strength
better bond strength
decreased solubility
but it swells !

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127
Q

what does bonding to porcelain require

A

silane coupling agent

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128
Q

what does bonding to metal require

A

metal agent

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129
Q

what can GIC be used to bond for indirects

A

MCC
metal post
zirconia
gold

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130
Q

what can light cure composite be used to bond for indirects

A

veneer

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131
Q

what can dual cure composite be used to bond for indirects

A

fibre post
composite inlay
porcelain inlay

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132
Q

how is zirconia made hard

A

ytrria stabilised

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133
Q

what is a LiDiSi crown material

A

it is a cast and milled ceramic

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134
Q

where would LiDiSi be used

A

anteriorly

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135
Q

where would zirconia be used

A

posteriorly

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136
Q

what irrigants are used for endodontics

A

NaOCl
EDTA
chlorhexidine

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137
Q

what material is used for obturation

A

GP

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138
Q

what are the types of sealers which can be used

A

ZOE
GI
resin
calcium silicate

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139
Q

what special investigations are used for fixed pros

A

sensibility tests
radiographs
study models
facebow
diagnostic wax up
diet diary
MPMB
6PPC
photographs

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140
Q

what are the principles of crown preparation

A

preserve tooth structure
retention and resistance
structural durability
marginal integrity
preservation of periodontium
aesthetic considerations

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141
Q

what should your crown prep taper be

A

6-10 degrees

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142
Q

what needs to be spoken about to insure informed consent for fixed pros

A

invasiveness
longevity and success rates
complications
time involved
cost
alternative options

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143
Q

what are the stages for indirect restorations

A

preparation
temporisation
impressions and occlusal records
cementation

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144
Q

what are inlays used for

A

occlusal cavities
interproximal cavities
replace failed directs

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145
Q

what are porcelain inlays cemented with

A

nexus/relyx

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146
Q

what are gold inlays cemented with

A

aquacem

147
Q

what are onlays recommended for

A

sufficient occlusal tooth substance loss
remaining tooth is weak
RCT teeth
wear cases
fractured cusps
replacing failed directs

148
Q

what are veneers used for

A

aesthetics
change teeth shape
correct peg laterals
reduce or close proximal spaces
align labial surface of instanding teeth

149
Q

what are the contraindications to veneers

A

high lip lines
poor OH
caries
recession and root exposure
heavy contacts

150
Q

what are the types of temporary restorations you can use

A

custom with impressions
preformed

151
Q

what is the active ingredient in vital external bleaching

A

carbamide peroxide 10% which gives 3.6% H2O2

152
Q

what ingredients in tooth whiteners reduces sensitivity

A

potassium nitrate
calcium phosphate

153
Q

what affect bleaching

A

time
cleanliness
concentration
temperature

154
Q

what do you need to warn patient about with whitening

A

sensitivity
relapse
colour
allergy
might not work
compliance

155
Q

what is the in office procedure for vital bleaching

A

clean
dam
gingival mask
bleaching gel
heat and light
wash and repeat
30mins - 1hr

156
Q

when would bleaching be indicated

A

age related discolouration
mild fluorosis
post smoking cessation
tetracycline staining

157
Q

what are the problems with bleaching

A

sensitivity
wears off
cytotoxicity
gingival irritation
tooth damage
damage to restorations
problems bonding to tooth

158
Q

when does sensitivity with bleaching resolve

A

2-3 days after

159
Q

what is the procedure with internal non-vital bleaching

A

dam
remove restoration
remove GP from pulp chamber and 1mm below ACJ
place 1mm RMGIC over GP to seal canal
remove dark dentine
etch with 37% phosphoric acid
10% carbamide gel
then cotton wool and GIC

160
Q

what does microabrasion do

A

remove discolouration by acid and abrasion

161
Q

what is microabrasion good for

A

fluorosis
orthodeminersalisation
staining
before veneering

162
Q

what is the procedure for microabrasion

A

clean
dam
18% HCl and pumice mixed
apply to teeth
rub with prophy cup 5 secs/tooth
wash and repeat up to 10x
remove dam and polish with fluoride prophy paste
fluoride varnish
review after 1 month

163
Q

what are the 3 mandibular movements

A

rotation
translation
lateral translation

164
Q

what is rotation of mandible

A

small mouth opening occurring around the terminal hinge axis

165
Q

what is translation of the mandible

A

when lateral pterygoid contracts and articular disc and condyle move downwards and forward along articular eminence

166
Q

what does posselts envelope display

A

border movements of mandible in one sagittal plane

167
Q

what are the positions in posselts envelope

A

ICP
edge-edge
protrusion
maximum opening
retruded axis
RCP

168
Q

what is lateral translation known as

A

bennet movement

169
Q

what are functional cusps and name them

A

cusps which occlude with opposing teeth in ICP
lingual uppers
buccal lowers

170
Q

what are non-functional cusps and name them

A

do not occlude with opposing teeth in ICP
buccal uppers
lingual lowers

171
Q

what are the components of the mutually protected occlusion

A

canine guidance
posterior disclusion in lateral exclusion
no side contacts
no protrusive interferences

172
Q

why do you want to avoid posterior contacts during lateral movements

A

muscles get a rest
teeth are not designed to absorb lateral forces and occlusal trauma can occur

173
Q

what are the 2 forms of bruxism

A

eccentric - parafunctional grinding
centric - clenching

174
Q

what do the signs of bruxism include

A

wear
fractured restorations
migration
mobility
muscle pain
fatigue
headache
earache
TMJ pain and stiffness

175
Q

how do you put someone into RCP

A

bimanual manipulation
chin point guidance
anterior jig

176
Q

what is the bisecting angle technique

A

x-ray beam not perpendicular to long axes of tooth or receptor
tooth and receptor tilted at equal and opposite angles

177
Q

what are the types of upper occlusals

A

anterior oblique maxillary
lateral oblique

178
Q

what are the types of lower occlusals

A

anterior oblique mandibular
true mandibular

179
Q

what is the focus to skin distance

A

200mm

180
Q

what is the ICRP

A

international commission for radiological protection

181
Q

what does the ICRP provide

A

recommendations and guidance on radiation protection

182
Q

what is should all radiological exposures be

A

justified
optimised
limited

183
Q

what does justified, optimised, limited mean for radiology

A

justified = more good than harm
optimised = ALARP
limited = dose limits

184
Q

what is IRR17 in relation to

A

staff and public

185
Q

what are the implications of IRR17

A

employer needs registration from HSE
RPA issues certificate and answer questions
controlled are 1.5m
dose limits for staff and public

186
Q

what is IRMER17 in relation to

A

exposure of patients

187
Q

what does IRMER17 involve

A

carer and comforter
your x-ray and you sheets
referrer, practitioner, operator, employer
training records required
medical physics expert to provide advice

188
Q

if teeth are lingual to focal trough what size are they

A

bigger

189
Q

if teeth are buccal to the focal trough what size are they

A

smaller

190
Q

what does orthogonal programme on OPT allow

A

better interproximal view and bone loss view

191
Q

what are the patient instructions during OPT

A

stay still
tongue to palate
no talking or swallowing

192
Q

what is the photoelectric effect

A

lower energy photons that are potentially damaging to adjacent tissues
lighter areas on radiographs

193
Q

what is the compton effect

A

higher photons which can also damage outer shell electrons/adjacent tissues

194
Q

what is the dose range for radiology

A

60-70kV

195
Q

what do the biological effects of radiation depend on

A

type of radiation
dose
dose rate
cell irradiated

196
Q

what is absorbed dose

A

energy deposited

197
Q

what is equivalent dose

A

absorbed dose x weighting factor of tissue

198
Q

what are the factors for dose optimisation

A

E speed film
60-70kV
focus to skin 200mm
rectangular collimation

199
Q

what are the advantages of digital radiography

A

no chemicals
easy storage
put into digital notes
easy sharing
manipulated

200
Q

what are the disadvantages of digital radiography

A

worse resolution
computer needed
data loss
print outs have bad quality

201
Q

what are the horizontal tube shifts for parallax

A

2 PAs
2 bitewings
2 occlusals

202
Q

what are the vertical tube shifts for parallax

A

panoramic and oblique occlusal
panoramic and lower PA

203
Q

what are the 3 elements for abuse to be present

A

significant harm to child
carer has some responsibility for that harm
connections between carers responsibility and harm

204
Q

what does GIRFEC specifiy

A

named person for each child
lead professional where complex needs
single child plan
SHANARRI - national practice model
shared approach to sharing information

205
Q

what are the contributing factors to child abuse

A

drugs, alcohol, poverty, mental illness
crying, soiling, disability, unwanted pregnancy
violence towards pets, social isolation

206
Q

what are the big 3 concerns for parenting capacity

A

domestic violence
drug and alcohol misuse
mental health problems

207
Q

what children are vulnerable

A

under 5s
irregular attender
medical problems and disabilities

208
Q

what are the markers of neglect

A

nutrition
warmth/shelter
hygiene
stimulation
affection

209
Q

what is dental neglect

A

persistent failure to meet childs basic oral health needs likely to result in serious impairment of a childs oral or general health or development

210
Q

what are the indicators of dental neglect

A

obvious disease
impact on child
care offered but child not returned

211
Q

how do you manage dental neglect

A

preventive dental team
preventive multiagency
child protection referral

212
Q

what are the intraoral signs of abuse

A

frenal injuries
intraoral bruises
tooth trauma
abrasions

213
Q

what should increase your index of suspicion with child abuse

A

delay seeking help
vague story
story not compatible
parent abnormal mood
previous injury/violence

214
Q

what is the scale for child axiety

A

mcdasf

215
Q

what are the non-pharmacological behavioural management techniques

A

tell-show-do
enhanced control
positive reinforcement
CBT
motivational interviewing

216
Q

what pharmacological behaviour management is used for children

A

topical
wand
LA - chasing
sedation
GA

217
Q

what is the most common injury in primary dentition

A

luxation

218
Q

when someone has trauma what medical things should you watch out for

A

congenital heart disease
rheumatic fever
immunosuppression
bleeding disorders
allergies
tetanus

219
Q

what is the homecare after trauma

A

analgesia
soft diet for 10-14 days
soft toothbrush
topical chlorhexidine 0.12%
warn re signs of infection

220
Q

what is the treatment of uncomplicated crown fracture of primaries

A

smooth sharp edges/cover
exposed dentine with GI and restore

221
Q

what is the treatment of complicated crown fracture of primaries

A

partial pulpotomy, extract

222
Q

what is the treatment of crown-root fracture of primaries

A

remove fragment and determine restorability

223
Q

what is the treatment of root fracture for primaries

A

remove loose fragment

224
Q

what is the treatment of concussion for primaries

A

observe

225
Q

what is the treatment of subluxation for primaries

A

observe

226
Q

what is the treatment of lateral luxation for primaries

A

spontaneous reposition/extract/reposition and splint

227
Q

what is the treatment of intrusion for primaries

A

allow spontaneous reposition, take PA

228
Q

what is the treatment of extrusion for primaries

A

spontaneous reposition, extract if mobile

229
Q

what is the treatment of avulsion for primaries

A

no replanting

230
Q

what is the treatment of alveolar fractur for primaries

A

reposition and stabilise with splint

231
Q

what are the complications to primary tooth with trauma

A

discolouration
infection
delayed exfoliation

232
Q

what are the complications to permanent tooth from trauma to primary

A

enamel defects
abnormal morphology
delayed eruption
ectopic position
arrested development
failure to form
odontome formation

233
Q

what is the most common permanent dentition trauma injury

A

enamel dentine fracture

234
Q

what does prognosis of traumatised teeth depend on

A

root development
injury type
if PDL is damaged
time between injury and treatment
presence of infection

235
Q

what is treatment for enamel fracture

A

bond fragments/smooth edges
2PAs

236
Q

what is treatment for enamel dentine fracture

A

account for fragment
composite bandage
2PAs
sensibility test
restore

237
Q

what is treatment for enamel dentine pulp fracture

A

pulp cap
partial pulpotomy
coronal pulpotomy

238
Q

why would you do a pulp cap for trauma

A

tiny exposure
less than 24hrs

239
Q

why would you do a partial pulpotomy for trauma

A

> 1mm exposure
greater than 24hrs

240
Q

what is the process for direct pulp cap

A

LA and rubber dam
clean with saline and disinfect with NaOCl
calcium hydroxide
composite
non-TTP and positive to sensibility tests

241
Q

what is the process for partial pulpotomy

A

LA and dental dam
saline and NaOCl
remove 2mm of pulp with high speed round bur
saline soaked CW for haemostasis
CaOH then GI then comp

242
Q

why would you proceed to a full coronal pulpotomy instead of partial

A

if no bleeding OR if bleeding too much

243
Q

what is the aim of a pulpotomy

A

keep vital pulp tissue within canal to allow apexogenesis

244
Q

what is the steps of pulpectomy

A

rubber dam
access
haemorrhage control
WL radiograph
non-setting CaOH
cotton wool
GI temp
MTA plug and heated GP
definitive restoration

245
Q

what is treatment for concussion

A

none

246
Q

what is treatment of subluxation

A

none, splint if mobile

247
Q

what is treatment of extrusion

A

reposition and splint

248
Q

what is treatment of lateral luxation

A

reposition and splint

249
Q

what is treatment of intrusion

A

reposition spontaneously and splint
surgically reposition if 3-7+mm

250
Q

what is treatment of avulsion

A

reimplant
clean area
splint
tetanus
consider antibiotics

251
Q

what occurs with delayed reimplantation for avulsion

A

ankylosis replacement resorption

252
Q

what is treatment for dentoalveolar fracture

A

reposition splint suture
soft diet 7 days
no contact sport

253
Q

what should splints be

A

flexible and passive
stainless steel wire

254
Q

what is external surface resorption due to

A

localised injury

255
Q

what is external infection related resorption due to
what is treatment

A

PDL damage with indistinct root surfaces, remove infection and endo

256
Q

what is ankylosis related replacement resorption due to and what is treatment

A

when bone cells form faster than PDL fibroblasts and no obvious PDL space
plan for loss

257
Q

what is infection related internal resorption and what is treatment

A

progressive pulp necrosis
canal walls balloon
endo treatment CaOH in canal for 4-6 weeks and obturate

258
Q

what is treatment for paeds primary herpetic gingivostomatitis

A

bed
hydrate
analgesia
acyclovir
antimicrobials

259
Q

what is the appearance of OFG

A

lip swelling
gingival swelling
peri-oral erythema
cobblestoned buccal mucosa
linear ulceration
mucosal tags
fissuring
angular cheilitis

260
Q

what are bohns nodules

A

gingival cysts which are made of dental lamina
occur on alveolar ridge

261
Q

what are epstein pearls

A

small cystic lesions in palatal midline

262
Q

what should you do for communication with ASD patients

A

communication
concrete language
be calm
explain what is happening
check understanding
stick with routine
be compassionate
note special interests and triggers
have as first appointment

263
Q

what are the features of down syndrome

A

large tongue
midface hypoplasia
spaced dentition
class 3
perio disease

264
Q

what are the oral complications of cerebral palsy

A

malocclusion
trauma
bruxism
drooling
poor OH and calculus
periodontal disease

265
Q

what can acute lymphocytic leukaemia present like orally

A

gingival swelling and bleeding
ulceration
unusual mobility
petechiae
mucosal pallor
herpetic infections
candidosis

266
Q

what is the impact of dental disease in children with disabilities

A

increased caries
delayed diagnosis
delayed management
multidisciplinary planning
pain/infection hard to manage

267
Q

who is simplified BPE used for

A

7-18yr olds

268
Q

what codes of BPE is used for 7-11yr olds

A

0-2

269
Q

what codes of BPE are used from 12yrs upwards

A

all codes

270
Q

when do you refer children to periodontology

A

unexplained premature exfoliation
gross mobility
red oedematous gingivae
suppuration

271
Q

what is the life cycle of instrument processing

A

transport
cleaning
disinfection
inspection
packaging
sterilisation
transport
storage
use

272
Q

what do you need for manual washing

A

dedicated sink
standard water 30-35 degrees
enzymatic/pH neutral detergent
long handled soft bristle brush below water

273
Q

what is the cycle of the washer disinfector

A

flush
wash
rinse
disinfect
dry

274
Q

what temperature is the washer disinfector at each stage

A

flush - <35 degrees
rinse - <65 degrees
disinfect - 90-95 degrees
dry - 100 degrees

275
Q

what are the daily checks for the WD

A

spray arms
spray jets
filter clear
door seal condition
chemical in reservoir
record disinfection temperature

276
Q

what are the 4 types of purified water

A

reverse osmosis
de-ionised
distilled
sterile

277
Q

what is the temperature and pressure range for steriliser and hold time

A

134-137 degrees
2.05 - 2.35 bar
3 mins

278
Q

what is the daily testing for steriliser

A

door seals
chamber not damaged
condition of load carrier
fill and drain feedwater reservoir daily
drain water reservoir daily
bowie dick

279
Q

what are the weekly tests for steriliser

A

air leakage
air detector function

280
Q

what are the factors which affect decontamination (sinner circle)

A

time
temperature
chemicals
energy

281
Q

what does the SHTM guidance tell you

A

role designations
process definitions and descriptions
links to other guidance

282
Q

properties of aspirin

A

analgesic
antipyretic
antiinflammatory

283
Q

adverse effects of aspirin

A

GIT problems
allergy
overdose
burns

284
Q

groups to avoid with aspirin

A

peptic ulcer
bleeders
pregnancy
asthma
children under 16

285
Q

max dose of ibuprofen

A

2.4g

286
Q

properties of paracetamol

A

analgesic
antipyretic

287
Q

max dose of paracetamol

A

4g

288
Q

what is the basic surgical technique for surgical access

A

wide based incision
one continuous stroke
no sharp angles
minimise trauma to papillae
no crushing
flap margins and sutures should lie on sound bone
heal by primary intention
dont close wounds under tension

289
Q

what retracts soft tissue

A

howarths periosteal elevator

290
Q

what do you remove bone with

A

electric straight handpiece

291
Q

what do you debride bone with

A

bone file or mitchells trimmer

292
Q

what is peri-operative haemostasis

A

LA vasoconstrictor
artery forceps
diathermy
bone wax

293
Q

what is post op haemostasis

A

pressure
LA infiltration
diathermy
surgicel
sutures
tranexamic acid

294
Q

when is the lingual nerve at risk

A

incising flap
raising buccal and lingual flaps
retraction of flap
bone removal
extraction with forceps

295
Q

what nerves are at risk during 3rd molar removal

A

lingual
mylohyoid
IAN
buccal

296
Q

what peri-operative complications can occur during extractions

A

access issues
abnormal resistance
tooth fracture
alveolar bone fracture
jaw fracture
OAC/OAF/root into antrum/tuberosity

297
Q

why might you get abnormal resistance when trying to extract a tooth

A

thick bone
root shape
ankylosis

298
Q

what teeth will more commonly cause alveolar fracture during extraction

A

canines and molars

299
Q

what do you do if a patient gets jaw fracture during extraction

A

inform patient
radiograph
refer via phone
analgesia
stabilise

300
Q

how do you diagnose an OAC

A

bubbling
nose hold test
direct vision
suction and echo
blunt probe

301
Q

what are the risk factors for an OAC

A

premolars and molars uppers
close to sinus
last standing molars
large root
older patient
previous OAC
recurrent sinusitis

302
Q

how do you manage an OAC at time of extraction

A

inform patient
if small = encourage clot, suture, antibiotics
if large = buccal advancement, ABX, nose blowing

303
Q

why would a tuberosity fracture occur during extraction

A

single standing molar
inadequate alveolar support
gemination

304
Q

how do you diagnose a tuberosity fracture

A

noise
movement
palatal mucosal tear

305
Q

how do you manage a tuberosity fracture

A

reduction
splint
dissect loose bone
remove or treat pulp
antibiotics
post-op instructions
extract tooth 8 weeks later surgically

306
Q

what damage during extraction would start a haemorrhage

A

mucoperisoteal tears
fractures of the alveolar plate

307
Q

what can trismus post-op be due to

A

surgery
LA
haematoma
TMJ damage

308
Q

how do you treat post op trismus

A

exercises
trismus screw/lollipop sticks

309
Q

what is apixaban/dabigatran advice for extractions

A

miss morning dose

310
Q

what is rivaroxaban advice for extractions

A

delay morning dose

311
Q

what is edoxaban advice for extractions

A

evening only anyway so take as normal

312
Q

if you get bleeding 3-7 days after an extraction what is this most likely due to

A

infection

313
Q

how common is dry socket

A

2-3% of all extractions

314
Q

when does dry socket appear and how long does it last

A

3-4 days after extraction
7-14 days to resolve

315
Q

what are the symptoms of dry socket

A

dull aching pain
throbs to ear
up at night
sensitive bone
bad smell and taste

316
Q

what are the predisposing factors for dry socket

A

molars
mandible , posterior
smoker
female
OCP

317
Q

how do you manage dry socket

A

analgesia
LA
irrigate with warm saline
curettage
alvogyl
review, advise HSMW

318
Q

what is infected socket management

A

irrigate and remove sequestra
antibiotics

319
Q

how do you manage an OAF

A

excise sinus tract
buccal advancement flap
palatal advancement flap
graft

320
Q

how do you retrieve a foreign body from the maxillary antrum

A

flap and suction/small curettes/irrigate
buccal advancement to close
or use caldwell luc by making a buccal window

321
Q

what is osteomyelitis

A

inflammation of bone marrow

322
Q

what is the progression of osteomyelitis

A

bacteria - cancellous bone - soft tissue inflammation - oedema in closed marrow spaces - increased hydrostatic pressure - soft tissue necrosis

323
Q

where is osteomyelitis more likely to be seen

A

mandible as poorer blood supply

324
Q

who normally gets osteomyelitis

A

immunocompromised/infection/mandible fracture

325
Q

what is osteomyelitis like radiographically

A

moth eaten bone

326
Q

what is treatment for osteomyelitis

A

penicillin for 6wks - 6 months depending on acute or chronic
surgery to remove bone and necrotic bone and teeth affected
referral to OS or OMFS

327
Q

what causes ORN

A

endarteritis

328
Q

how do you prevent ORN

A

scaling/chlorhexidine mouthwash
careful extraction
antibiotics
hyperbaric oxygen
refer for extraction

329
Q

how do you treat ORN

A

irrigation
ABX for infection
loose bone removed
small wounds sutured
resect bone
hyperbaric oxygen

330
Q

what is the treatment options for MRONJ

A

manage symptoms - analgesia
smooth sharp edges
Chlorhexidine
antibiotics
debride
surgical removal of sequestra
resection
suture over
irrigate

331
Q

what is actinomycosis

A

bacterial infection which erodes tissues

332
Q

what is the treatment of actinomycosis

A

incise and rain
excise sinus tracts
excise necrotic bone
high dose antibiotics
long term antibiotics

333
Q

who gets ABX prophylaxis for IE

A

congenital heart defects
prosthetic valves
previous IE

334
Q

what are the 3 antibiotics doses that can be given for IE prophylaxis

A

amoxicillin 3g oral sachet
clindamycin 600mg
azithromycin 200mg/5ml (12.5ml)

all 60 minutes before

335
Q

what is an impairment

A

loss or abnormality of psychological, physiological or anatomical structure or function at organ level

336
Q

what is disability

A

restriction or lack of ability to perform an activity in the manner or within the range normal for a human

337
Q

what is handicap

A

disadvantage for individual resulting from disability or impairment

338
Q

what are the 5 key areas of barriers to overcome

A

accessibility
accommodation
affordability
acceptability
availability

339
Q

how do we assess capacity

A

AMCUR

340
Q

how do we communicate with blind people

A

identify yourself and others
let them know when people entering and leaving rooms
tell them what you are doing before you do it
alternative information formats

341
Q

how do we maximise communication with deaf people

A

loop system
establish communication method and BSL interpreter
clear speech with normal lip pattern
write things down
reduce background noise
allow extra time

342
Q

what are dental implications of bariatric patients

A

caries
delayed wound healing
erosion
emergenciesd

343
Q

what sedation is most appropriate for bariatric patients and why

A

inhalation sedation as you cannot find vein for IV and respiratory depression can be an issue

344
Q

what advice do we give for people who have had bariatric surgery

A

healthy diet
adequate oral hygiene
stimulate salivary flow
fibre foods
lower acidic foods and drinks
fluoride varnish and OHI

345
Q

what aids are used to help people from wheelchair into dental chair/to get treatment in wheelchair

A

hoist
banana board
reclining wheelchair
turn table
wheelchair recliner
stand aid

346
Q

what toothbrush modifications can be made for rheumatology patients

A

electric
foam handles
putty handles
ball handles
suction to wall

347
Q

when should the INR be obtained before treatment

A

ideally 24hrs before but up to 72hrs

348
Q

what is a UKELD score

A

prognosis for living with chronic liver disease

349
Q

if someone has liver disease with LA is more suitable and why

A

articaine because it is metabolised mostly in the plasma

350
Q

what are the 5 principles of the AWI act

A

benefit
minimum necessary intervention
take account of adults wishes
consult relevant others
encourage adult to exercise residual capacity

351
Q

what proxies are allowed to consent for treatment

A

welfare guardian
welfare power of attorney
combined power of attorney

352
Q

what are the signs of pain from someone who cannot verbally communicate

A

holding face
eating habits
sleeping pattern
behaviour changes

353
Q

what are the barriers to care in homes

A

untrained staff
poorly paid
volume of work
own perceptions of health

354
Q

what adjuncts to communication can we use for intellectually impaired people

A

makaton
picture boards
letter boards
drawing

355
Q

what exam aids can we use for intellectually impaired people

A

bedi shield
toothbrush
mirror and light

356
Q

what is the link between learning disability and oral disease

A

higher perio
more missing teeth
higher plaque levels
more unmet needs

357
Q

what are the risks of general anaesthesia

A

death
brain damage , nausea, vomiting, lethargy
increased risk with age and co-morbidities
anaphylaxis
waking up during operation

358
Q

what is our responsibility for cancer patients before they start therapy

A

toothbrushing instruction and ID brushes
fluoride
tooth mousse
diet
PMPR
chlorhexidine mouthwash and gel
definitively restore
remove trauma
imps for fluoride trays
extract obvious prognosis teeth 10 days prior maximum
remove ortho

359
Q

what is our responsibility for cancer patients during treatment

A

oral hygiene
chlorhexidine
diet
fluoride
symptomatic relief

360
Q

when does mucositis begin and end

A

1-2 weeks after treatment starts
6 weeks post treatment

361
Q

how can we relieve mucositis

A

caphosol
difflam
gelclair
cryotherapy
ice
oral hygiene
lidocaine mouthwash

362
Q

what are the issues that cancer patients are faced with after treatment

A

xerostomia
trismus
erosion
caries
perio
ORN

363
Q

what are the factors of radiotherapy which increase risk of ORN

A

60Gy
immunodeficient
malnourished
longer treatment

364
Q

what do eating disorders present like orally

A

exposed dentine and hypersensitivity
lingual cervical lesions
dry mouth
nutritional deficiency
increased keratin in soft tissues

365
Q

what advice do we give to people who have had eating disorders

A

reduce acidic drinks/have with meal
use straw
reduce acidic snacks
chew gum and rinse with water or antacid after sick
desensitising toothpaste and soft brush may help

BDS4 Exam Revision (6 decks)

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