BDS4 Past Papers Flashcards
Name 4 radiographic features that indicate close proximity of lower 8s to IAN
Deflection of canal
Interruption of IAC lamina dura
Juxtapical area
Darkening of root where IAC has crossed it
Name 2 potential complications of extracting a tooth that is in close proximity to IAC
IAN dysaesthesia
IAN paraesthesia
If there was a risk of injuring the IAN during an extraction what procedure could be carried out instead
Corenectomy
List 6 signs/symptoms of TMD
PAIN
Mom hypetrophy
Mom tenderness
Clicking popping and crepitus
Linea alba
Tongue scalopping
Tooth wear
List 5 points of conservative advice you could give to a TMD patient
Stop any parafunctional habits
No chewing gum
Cut foods into small pieces
Do not incise foods
Avoid hard and sticky foods
Chew bilaterally
Define retention
Resistance to vertical dislodging force
Define indirect retention and how it can be incorporated into a design
Use of the supportive components to resist rotational forces, components are placed at 90 degrees to the clasp axis and opposite from dislodging forces
Name three conditions you would see desquamative gingivitis in order of relevance
Lichen planus
MMP
PV
Name 2 types of haemangioma and give 2 histological differences between them
Capillary - not encapsulated and thin walled capillaries
Cavernous - encapsulated and large vascular spaces
What percentage of fluoride is the optimum in drinking water
1ppm
Name three methods of delivering fluoride to an 8 year old child and provide concentrations for each
Fluoride toothpaste 1450ppm
Mouthwash 225ppm
Varnish 22600ppm
What is the local action of fluoride in the oral cavity
Promotes remineralisation of any demimeralsied enamel and forms fluroapitite which has higher erosion resistance.
Inhibits bacterial metabolism and acid production
Give the best tx option for fluorosis and 2 advantages of this treatment
Micro abrasion
Conservative and results are permanent
Name 2 local and 2 systemic risk factors for pseudomembranous candidias
Local
- use of corticosteroids inhaler
- removable prosthesis
Systemic
- diabetic
- immunosuppressive side affect of treatment e,g, chemo
If you are taking a swab and oral rinse give an advantage and disadvantage of each
Oral rinse
- quantitative and not site specific
Swab
-site specific and not quantavie
If a child has possibility injested a toxic dose of fluoride what is your advice ?
Inject a large amount of calcium - milk
Take to A and E
What is the most common cause of fluorosis in the UK
Water
Please provide the fluoride supplement values for the following patients all living in an area of <0.3ppmF of water
6mths - 1 year - 0.25mg per day
1-3 years - 0.5mg per day
3-6 - 1mg per day
Give three diagnostic features of subluxation
Tooth has not been displaced from the socket
Increased mobility from the tooth
Bleeding from gingival sulcus
How would internal inflammatory respotion present both clicnally and Radiographically and what medicament could you place
Clinically there would be a pink colour of the tooth
Ballooned irregular shaped canal
Non setting CaOH
What are the 6 components of clinal goverence
Research and delelopment
Education and training
Clinical effectiveness
Risk management
Openness
Clinical audit
What are the 6 dimensions of healthcare quality
Paitent centered
Safe
Effective
Efficient
Equitable
Timely
Give three uses of a URA rather than tipping teeth
Habit breaker
Retainer
Growth modification
Overbite reduction
List 6 signs of good wear on URA on visits
Active component has become passive
Patient can insert and remove appliance well
Post dam park present on palate
Patient can speak normally with appliance in
No hypersalvaition when in situ
Patient is wearing appliance when they come in
Give 4 intra-oral signs of ANUG
Recessions of the papillae
Greyish slough over ulcers which can be removed
Red and puffy gingivae
Punched out crater like ulcer
What are 4 risk factors for ANUG
Smoker
Stress
Poor OH
Malnutrition
Give three potential reasons for a post and core to have debonded
Secondary caries
Poor moisture control during cementation
Root fracture
If there is a fracture at the junction of the post and core, why may this have happened
Biocorrosion ]
Lack of sufficient ferrule
Trauma
Name a wetting agent used to bond metal to resin within resin bond luting cement
MDP
4-META
Name three ways of retrieving a fractured post
Ultrasonic tip
Eggler forceps
Moskito forceps
Name the 3 stages in the formation of a clot
Vasoconstriction
Platelet plug formation
Fibrin clot
How do the following drugs affect the clot formation processes and at what stage
Aspirin
Warfarin
Heparin
Aspirin ; reduces platelets aggregation at plug formation site
Warfarin ; Vit K antagonist so prevents formation of clotting factors 2,7,9 10
Heparin ; reduces action of platelets so affects clot formation
Why are aspirin and clopidotgrel used in conjunction
A synergistic effect on platelet aggregation
What is a biofilm
Thin but robust layer of mucilage adhering to solid surface, containing a community of bacteria and other microorganisms embedded in a glycocalyx matrix
What are the stages in the development of a biofilm
Adhesion
Colonisation
Accumulation
Complex community
Dispersal
What is the nerve supply of the submandibular gland
Chrorda tympani and submandibular ganglion
What is the innervation of the parotid gland
Glossopharnygeal nerve
What water is used for a final rinse of a washer disinfector and why
Reverse osmosis because it is deminerlasied so will not leave residue on instruments
4 examples of coping mechanisms for stress
Work/lfe balance
Excersie
Eduction on stress
Set goals
Know limits
What are the principles of the adults with incapacity act 2000
- Treatment must benefit the patient
- Must be the minimal necessary intervention
- Account for the patients past wishes
- Consult with relevant others
- Encourage residual capacity
What are the signs and symptoms of Parkinson’s
Intention tremor
Mask life face
Slow movement/ bradykinesoa
Riding its
Name 4 factors which could cause a bridge to debond
Poor moisture control during cementation
Unfavourable occuslion
Parafunction
Truama to front of face
Poor oh
List three forms of tooth borne support
Occlusal rest
Cingulum rest
Full coverage rest
Where should a denture base extend to CocR
2mm anterior to palatine foam a
What are 5 criteria’s for valid consent
Informed
Voluntary
Not manipulated
Not coerced
With capacity
What are 3 ways a tooth could be desensitised
Tooth mouse
Seal and protect
Sensitive toothpaste
Why do you chose RMGIC over composite for a cervical cavity
Moisture control and less polymerisation shrinkage
Name 3 post matierals
Gold
Ceramics
Fibre
Please name 4 indications for the size of a post
3-5mm of GP left apical
1/3 width of root
Post to crown should be in a 1;1 ratio
1cm of circumferential dentine
Name 5 factors you would consider before giving a patient a bridge
Oral hygiene
Quality of enamel
Parafunction
Occulusion
Abutment health
What are the signs and symptoms of reversible pulpitis
Short sharp pain
Stops when the stimulus is removed
No TTP
Pain on cold
Well localised
What are the signs and symtoms of irreversible pulpitis
Lingering pain after the removal of a stimulus
Sponentouis
Wakened at night
Pain with heat
Poorly localised
TTP
How does local anaesthetic work
Blocks voltage gated sodium channels and prevents up regulation of action potentials
What is the maximum dose of lidocaine
4.4mg /kg
What are three ideal characterucs of a post
Parallel
Non threaded
Cement retained
Name 3 post materials
Fibre - glass
Gold
Ceramics
Paitent has a gold post and core that has debonded serveral times
Why has this happend
A fracture in the post or a fracture in the core
A fracture in the root at the level of the post
Inadequate moisture control
Traumatic fracture
Untreatable caries
A fracture has occurred at the junction of the post and core - why does this happen give three reasons
Biocorroson of metallic post core
Tooth structure loss
Inadequate ferrule
Truama - bruxist patient
Bacterial interfaction
What is the hydrid layer
Collagen network providing intimate adhesion between the tooth and material though primer and bonding agent with Collagen
What changes have been made to modern amalgam to improve it
Copper has been added to reduce the gamma 2 phase because that has poor strength and abrasion resistance, copper reacts with tin to reduce availability for that phase
Zinc is also no longer added as it reacted with the water leading to a poor marginal seal
What two symtoms can come from zinc being in amalgam , and why does this happen
Zinc interacts with salvia and blood and forms bubbles oh H2 within amalgam and this causes a build up of pressure which causes expansion
- this can either cause pulpal pain for the paitent
- or can cause the restoration to sit high
What 3 criteria must be filled out before u obtiurate a canal
Asymptomatic
Full biomechanical cleaning
Tooth must be fully dyr
Name 3 common sealers
Epoxy resin
Calcium hydroxide
Zoe
GIC
What percentage of maxillary molars have an MB2 canal
93%
What are the three design objectives of endo
Continously tapering
Maintain apical foramen in same position
Keep apical foramen as small as possible
What are the advantages of the crown down technique
Removes bulk of infected tissue
Resovior for irrigant
Keeps reference point for WL
Makes straight line access easier
Limits spread of infected material at apical foramen §
What is the difference between crown down and step back in endo
In step back a proper apical stop prepared first before preparing the middle and coronal third
It is the opposite in crown down
Why is sodium hypochlorite a good irriagmnt
Disinfects the canal and dissolves organic material
What is the function of 17% EDTA
Removes the smear layer
Feature of a tooth that will make it unsuccessful in treatment
Quality of tooth tissue present
Amount of remaining tooth tissue present
Mobility
Periodontal status
Pulp status
Crown root ratio
What are 3 short term options to replace a debonded crown
Recement the failed MCC as a temporary crown to protect the remaining tooth structure
Make a provisional crown in pro temp and use a temporary cement ( non eugenol temporary )
Adhesive cantilever as a temporary bridge
4 pieces of information needed from patient to technician to make bridge
Bridge design
Master impressions
Bite registration
Shade of teeth
How does the clincal presentation of caries compare to a radiograph
Caries deeper clinically
Give three advantages of compostie over amalgam
Minimal preparation
Aesthetics
Bonds to tooth surface
Marginal seal
Low thermal conductivity
What are 4 indications for a resin retained bridge
Replace missing tooth
Good enamel quaility - unrestored tooth
Large abutment surface area for bonding
Minimal occlusal load
What are the contraindications for a resin retained bridge
Long span
Poor / sufficient enamel
Parafunction
Abutment which is periodontally involved
How do u cement a metal bridge
10MDP or 4META in composite luting cement
What are 5 requirements in occlusal stability
- Stable and even contacts in ICP
- Anterior guidance in Harmony with the envelope of function
- Disocclusion of all posteior teeth in mandibular protrusion
- Disocclusion of posteior teeth on working side
5, Disocclusion of posteior teeth on non working side
Why is a shortend dental arch considered acceptable
Provides suitable aesthetics function and occlusal stability and masticatory ability as well as they are able to clean their teeth
How does vital bleaching with hydrogen perioxide work
H02 forms and acts as an oxidising agent. Oxidation leads to be breaking down long chain chromogenic molecules to shorter ones which arent as pigmented
What is the common active ingredient in tooth whitening bleach - how is it realted to hydrogen peroxide
10% carbamide peroxide
Breaks down to form hydrogen perioxide and urea
Approx a 1/3 is hydrogen perioxide
What are 4 risk of vital bleaching
Sensitivity - 60% of patients
Relaspe
Might not work
Soft tissue irritation
What techniques are used for successfully placing composite
Flowable at base to decrease contraction stress
Incremental placement to have a low configuration factor
No more than 2mm increments to avoid a soggy bottom
What angle should be cavo surface margin be for amalgam
90 degrees
What design/prep features may have lead to a bridges failure
Poor abutment health
Unfavourable occlsuion
Parafunction
Poor crown root ratio
Over tapered prep
A patient attends with a debonded cast gold post and core give 4 reasons for deboned
Incorrect cementation matieral
Contamination during cementation
Unfavourable occlusion
Inadequate prep or over tapered prep
The core has fractured from the post what are three reasons for this
Casting error
Inadequate ferrule
Trauma
Parafunction
Giver three methods of removing a fractured post
Ultrasonic vibration
Cut out for fibre posts
Sliding hammer
Using a stainless steel file in 20 degree curved canal of molar - give 4 complications that can occur and explain
Zipping
Perforations
Blockage
Ledges
Fractured instrument
How do managed a patient when you have accidental injected LA into their parotid gland
Explain to patient what has happed and reassure that it is only temporary
Provided eye protection - e.g. cotton wool over the eye
Advise length of paralysis
Review next day
Can you name 3 reasons for instrumentation of root canals
- Remove infected tissue
- Allow irrigant access to apex
- Make space for medicaments and obturation.
- Create an environment for periradicular healing
Name 3 reasons why a file may serpearte
Flexural stress - repeated cyclic fatigue
Torsional stress - binding to canal wall
Complicated curved canal
What is the thickness of shimstocl
8 microns
What is the average biological wdith
Approx 2mm from alveolar crest to sulcus of gingivae
Give 5 reasons why a patient with a newly placed composite may be experiencing sensitivity and pain on biting
A radiograph shows no pathology or caries
High in occlusion
Polymerisation contraction stress
Soggy bottom due to increments placed inn more than 2mm so inadequate curing depth
Cracked tooth syndrome
Deep restoration close to the pulp without a lining
Tooth prep irritated the pulp
An amalgam has an overhang on its mesial surface - how could this have been avoided
Correct adaptation of a matrix band
Wedge
Adequate condensing of amaglam
An amalgam has an overhang on its mesial surface - what issues can occur from an overhand
Plaque trap and food packing leading to secondary caries, gingivitis and periodontal disease
May also cause a fracture if in a thin section
What are the two ways to manage an overhang
Replace - remove all and replace with a new restoration
Repair - if possible adjust the overhand
Give 4 functions of a facebow
Used for mounting upper cast only
Transfers the relationship between the maxillary teeth and the axis of rotation from patient to articulator
Positions the upper cast vertically
Transfers the angulation of the maxillary occlusal plane in relation to horizontal reference plane
Name 4 types of articulator
Simple hinge
Semi-adjustable
Fully adjustable
Average value
Give three reasons as to why antieor guidance is proffered
Easier on patients musculature
Easier to reproduce
Posterior disocclsiuion - protecting posteior teeth and restorations
Why is RMGI not good as a luting agnet
Contais HEMA which absorbs water and swells - it is also cytotoxic to the pulp
What is the anterior reference point in a face bow representative of
Approximation of infra-orbital foramen
How many mm is the anteior reference point in a face bow usually from the incisal edge of the 12
43mm
What does a facebow record
The relationship of the maxilla to the hinge axis of the rotation of the mandible
Allows us to mount the mxilary casr
What two cements can be used for all metal conventional bridgework
Aquacem - GI luting
RelyX - RMGIC luting
What do we bond adhesive/resin retained/bridgework with
Panavia - dual cure resin cement
Once a bridge has been cemented with panavia what else must we do
Apply oxyguard around the margins for 3 minutes
Panavia is an anaerobic cement so this allows it to set
For an all ceramic restaotion what do we cement this w
Nexus - dual cure resin
What is the proffered choice of Pontic and why
Modified ridge lap
This allows cleansibilty with maximum aesthics by overlying part of the ridge to minimic emergence of the Pontic from gingival tissues in a similar way to tooth
Paitent is missing 22 and 23 - what problems might you face with function - 4 things
These teeth would be subject to heavy occlusal load
As the 3 is missing any protrusive movements would take a heavy load
RPD would pose a difficulty for masticating - cannot take the same forces as a natural denition
Speech would be impeded by a prosthesis
Of all the people with missing teeth how many are missing primary teeth and how many are missing permanent
1% primary
6% permanent
What would you see clinically in fluorosis
Diffuse molted appearnce
Pitting
Brown yellow discolouration
4 affects of primary truama on permanent dentition
Enamel defects
Ankylosis
Delayed eruption
Failure to eruption
Dilarecaed root
Ectopic postion
What is the ideal age range for interceptive ortho
10-13 years old
Define clinical governance
A framework through which the nHS organisations are accountable to continuously improve quality of services and safeguard standards of care.
3 divisions of NHS Scotland
Hospital dental service - consult advice and refferal of difficult cases
Public dental service - promote oral health of the public
General dental service - first point of contact for dental treatment
What would make you say erson is the most likely cause of toothwear
Location of the tooth wear - Palatal of the upper anterior
Presentation of the teeth ; cupping defects
Loss of surface detail ;smooth glazed surfcae
Other than replacement dentures state two other treatment methods which can be used by a dentist ro improve retention and stability in a loose complete denture
Relining the denture
Retained prosthesis - implants
Name the 6 stages of principles of caries removal
Identify and remove carious enamel
Remove enamel to identify extent of caries at the ADJ and smooth enamel margins
Remove peripheral caries in dentine first ADJ and the deeper
Then remove deep caries over the pulp
Outline form modification
Internal design modification
What does SIRS stand for
Systemtic inflammatory response syndrome
Give 4 parameters of SIRS
Temp below 36 or above 38
Pulse over 90
Reps over 20
White cell count under 4000 or more 12
Apart from site of a facial swelling give 4 other things thay could be concerning
Size
Colour
Teceture
Heat
Induration
Size
Pus
Palpation
Airway compromise
6 signs and symptoms of a zygomatic fracture involving orbital floor
Peri-orbital ecchymosis
Numb lip
Aysmetry
Diplopia
Reduced visual activity
Subconjuctival haemorrhage
What radiographs do u take to confirm a diagnosis of a zygomatic orbit fracture
Occipitomeatal radiograph at 10 and 30 degreees
Fluconazole reacts with many drugs name 2 drugs that it could and the interaction it would have
Warfarin ; increases anticoagulation effect
Simvastatin ; risk of myopathy
What tests would you carry out ever 3 months before giving carbamazepine
FBC; RBCS WBC platelets MCV and Hb
LFT ; urea and electrolytes
When are three reasons you would opt for surgery in a paitent with trigeminal neuralgia
No improvement from medication and has been tried for a substantial period of time
Medication causing too many side affects
If the patient has stated they want surgery
What are the two non pharmacological managements in trigemenal neuralgia
Micro vascular decompression
Gamma knife sterostatic
4 medical conditions a child with Down syndrome more likely o have
Cardiac heart defect
Epilepsy
Thyroid problems
Autism
What is dento-alveolar compensation
System that attempts to maintain normal interarch relationships
Often seen in class 3
Define supernumary and name 4 types
Teeth that appear in Addition to the regular number of teeth
Conical
Odontome
Supplemental
Tuberculate q
4 effects of supernumerary
Failure of eruption
Displacement of permanent tooth
Dentigerous cyst fromation
Crowding
Name. 2 chloride releasing agents and what is there conc
Sodium hypochlorite
Sodium dichloroisocyanurate
10,000ppm
How long would you leave the chlorine realising agents on a spillage
3-5mins
What are the 6 stages in the chain of infection
Infectious agent
Resoviour
Portal of exit
Route of transmission
Portal of entry
Susceptible host
What 4 things happen in postural hypotension
Fall in cardiac output
Poor venous return
Venous pooling in legs
Fall in stroke volume
What are 4 advantages of IS over IV
Adults dont need an escort
Drug not metabolised
No cannulation
Rapid onset and rapid recovery
List 5 safety features of the quantifiex IS machine
Colour coding between the O2 and NO
Oxygen flush button
Pin index
Scavenging mouthpiece
Resoviour bag
Following HPT how long should you wait until reviewing the condition again and why
8 weeks
Most of the healing occurs at 4-6 weeks
Any sooner than 8 weeks you could disrupt the reattahment of the long junctional epithelium
List 3 host evasion mechanisms of P.gingivlas
Biofilm formation
Gingipans - evasion of host cytokines
Induction of tissue destruction by MMP
Describe the nature of the mutation in dentinogeneis imperfecta that leads to the condition
Autosomal type 1 collagen mutation
Name 2 clinical and 2 Radiographical findings in dentinogenesis imperfecta
Radiograph ; abscess formation and pulpal obliteration
Clinical ; enamel lost very quickly both dentition affected
Give 3 dental implacications of the use of a beclomethasone inhaler
Increased risk of infection due to local steroid deposits
Dry mouth
Increased caries risk
Angina boullosa haemorrhagica
Burning mouth syndrome
What are3 risk factors for angina bullosa haemorrrhagica
Assoaction with the use of steroid inhalers without a nebuliser
Eating of rough foodstuff
Use of vey hot drinks
What is the link between salbutamol and acid erosion of teeth
Salbutamol is acidic
Aerosols drys the mouth out so salvia can’t restore neutral Ph
Describe two ways you could clinically diagnose a reduced OVD
Increased labial commissure folds
Decreased anterior face height
Name three scenarios when splinting for mobile teeth is appropriate
When mobility is due to LoA
Causing difficulties eating
When they need to be stabilised for PMPR
Why is there a decrease in mobility after supra and subgingival RDS
Increase in junctional epithelium
Collagen deposition increasing tissue tone
Decrease in inflammation
What is a sevre complication of a zygomatic orbital fracture
Retrobulbar haemorrhage
If present treated with lateral canthotomy to decrease the pressure behind the eye
What are 4 things we want to do before doing fixed pros for a patient
Eliminate any aetiology in a tooth wear case
Diagnostic was ups
Transitional denture
Impressions and study models
Crown lengneitng surgery
Give 3 reasons an the cusp of an amalgam restoration may fracture
High in occlusion
Inadequate condensing of amalgam
Overhang
No putty or study casts how do we temporally restore a indirect
Spot etch and n bond composite
A patient with a burning mouth what else may they complain of
Psychological Isues
Altered taste
Dry mouth
3 reasons from an MRI you might have trigeminal neuralia
Compression of the artery
Brain tumour
Skull deformity
Why does a paitent need a blood test for carbamazepin
Liver function toxicity
Risk of apalastic anaemia
Patient with TN gets it when washing his face in the morning why and 2 ways to change
This is because TN can be brought on from lightly touching the face in the a region of the trigmental nerve - it is triggered by innocuous touch.
2 changes - use warm, water not hot or cold
Avoid trigger zones
5 ways to manage and identify a patients anxeity
Early appointment so not having to wait in waiting room
No visible instruments in surgey when they enter
MDAS questionnare
Longer appointment time
Realistic tx plan
What is the name of a TAD and why is it better
Mini screw
Fixed position so there is fixed anchorage
2 malocclusion features leading to marginal gingivitis
Anterior cross bite
Traumatic oB
What is facebow used for
Used to record the relationship of the maxilla to the terminal hinge axis of rotation of mandible
4 methods/mateirelas to help mount casts into ICP
Hand articulation
Bite registration
Was wafer
Record block
Discoloured permanent incisor what are three treamtent options for this and what is a disadvantage for each
Microabrasion ; removes 100microns of enamel
Vital bleaching ; increased sensitivity and not permanent
Composite restoration; risk of staining and secondary caries
4 perio treamtent outcomes to determine sucess
Less than 10% plaque
Less than 15% bleeding
No pockets more than 4mm
Pockets that are equal to 4mm no bleeding
Stable and comfortable dentition
Swelling in LR6 with furcation involvement - what is your initial treatment?
Debridement of pocket to allow drainage - debridement to just shy of base of pocket
Oral hygiene instruction
CHX
Review
Completion of PMPR
4 things that can affect where an infection spreads too
Thickness of bone
Location of tooth
Length of root
Muscle and fascia attachment
What is the name of the seating postion in dentistry
Balanced postion
Describe the operator and nurse postions
12-7 right hand operator
12- 2 static zone
2-4 - nurses zone
4-7 transfer zone
What are 4 agents of bias
Blinding
Selection bias
Publication bias
Sequence generation
What is a confidence internal
A range of plausible values rather than a single point estimate
What is a risk ratio
Comparing the risk of the same outcome in differnt groups
Name 4 factors to determine periodontal sucess
Furcation involvement
Mobility
PA pathology
Bone defects
Patient motivation and coooperation
Paitent is requesting implants - what should you warn them of
Cost
Maintenance
Nature of surgery
Risk vs benefit
5 questions to ask a patient about thier smokig
How long
How much
What do they smoke
Have they tried to quit
Are they interested in tryin
2 medications that cause hyperplasia besides amlodipine
Cyclosporine - immunosuppressant
Nifedipine - Ca channel blocker
Phenytoin - anti-convulsant
4 things to have a successful posteiror restoration
No occlusal interfence
No overhang
Cleansbale
Strong enough to withstand occlusal forces
How do the landmarks listed help you prepare and obturate the canal
- apex
- apical constriction
- apical foramen
Apex - obturation should be completed within 2mm of apex
Apical constriction - master file goes to apical constriction
Apical foramen - file passed through apical foramen to create a glide path
2 ways that the working length in endo can be measured without an apex locator
Estimation from PA radiograph
Tug back with master apical file
2 ways an apex locator reading cna be affected
Curvature of the canal
Blockages in the canal
Minimum thickness of a metal in RBB
0.7MM
What monomer is used in panavia
10MDP
What is oxyuguard gel and why is it important
It is an 02 inhibitor this is important as panavia is an anaerobic cement so by placing this around the margins for 3 mins following cememetation allows the material to set
3 dental issues assoacted with class 3
Attrition
Mandibuar displacmet
Incising
TMD
3 difficulties in using appliances in adults
Slow movement due to lack of growth
More likely to have periodontal disease
More likely to have a heavily restored dentition
2 lines used as a guide for occlusal plane
Ala tragus
Interpupillary
What’s the most important line when mounting a kaw reg
Midline
4 things that can cause stress in dentistry
Paitent expectation
Time managment
Workload
Professional inadequacy
3 ways to reduce exposure to risk that are diminishable
Know your skill set
Manage expectations
Time Managment
3 ways to reduce risk that are unavoidable
Work life balance
Recognise stress
Communicate with colleagues
7 marks to consent for an extraction
Options
Risk of having treatment
Risk of having no treatment
Cost
Complications
What to expect after
What treatment involves
Replacement options for tooth
How can we reassure patients when they are being referred for a surgical
They will lift your gym and you may need stitches after
Same drill as for a filling and lots of water
You will feel pressure but not pain
How do bisphosphonates wokr and what can they cause in a patient
MRONJ
Bisphosphonates are anti-restorptive medication - they inhibit the differentiation of osteoclasts which reduces bony turnover and therefore reduces healing capacty
Target INR for warfarin
2-4
How do you manage a paitent taking apixaban
Inform patient to miss their morning dose
Expect prolonged bleeding
Use local haemostatis measured
Advise patiet to take normal evening dose - no earlier than 4 hours following haemostatis. - the end of the appointment
Major sociodemographic determinants for oral cancer
Low income
Poor eduction
Access to healthcare
Behavioural risk factors for oral cacner
Smoking
High alcohol intake
Diet
Betel quid hewing
What is an emerging factor for the need to differentiate between OPC and OC
HPV16
What other mucous membranes foes MMP affect
Eyes and genital
Two differential diagnosis for MMP
Bullous pemphigoid
PV
8 questions to ask mum about primary herpetic gingivostomatisis
Have they been eating/ drinking - can they swallow
Do they have any siblings have they attend ed school
When did you first notice the lesions
Have the parents had any cold sores
Have this happened before - are there any known triggers
Are there lesions on the rest of the body
Does the child have any relevant MH
Do they have a fever
Explain to mum the aetiology of primary herpetic gingivostomatitis
Common illness caused by the same virus that causes cold sore
It is self limiting and should go away on its own
It is transmitted by direct contACT
4 points for advice and treatment to give for a child with primary herpetic gingivostomatitus
Keep them hydrated
Keep them off school as very contagious
Suck on ice cubes for relief
Analgesia advice
Paitent presents again in 14 days - following primary herpetic gingivostomatitis what do u think it is and what treatment
Recurrent herpetic gingivostomatis
Treatment with aciclovir 200mg 1 tablet 5xdaily 5 days
3 histological features of lichen planus
Basal cell liquidification
Hugging band of lymphocytes
Saw tooth rete pegs
2prescription only meds for lichen planus
Beclomethasone 0.5mg per puff 2-4 daily
Betamethasone 0.5mg tablets dissolved in 1mg in 10ml water
Dental complications and advice regarding inhaler use
Candida - local steriod deposits
Xerostomia ; mouth breathers
Caries ; due to dry mouth
Inhaler can cause reflux which can cause erosion
Inhaler
- use a spacer
- rinse after use
What is the most reliable point to locate Canal orifices
ACJ
How does the DAHL technique work
Composite on palatal surfaces of upper incisors and canines to prop open occlusion
This allows posterior teeth further erupt , creating an increase in OVD so no reduction of teeth needed to place build ups
Why are PVS and alignaite good materials
Good flowability wetability and capture good surface detail
What are two components of alginate
Sodium alginate and calcium sulphate
What are the three ways to grade the oral cancer
Level of dysplasia
Mitotic figure
Invasion of other tissues
Why do we consent someone for IV sedation at a different appointment
As once the patient has been sedated the consent is no longer valid and the amnesiac effects of Midazolam may mean they forget giving their consent on the same day
What are three factors which influence displacement of a fracture
Magnitude of force
Mechanism of injury
Opposing occlsuion
Why are severe class 2 and severe class 3 contraindicated in SDA
Less likely for their to be occlsuion pairs in a severe mallocclusion
Why is periodontal disease a contraindication in SDA
Poor porngisis of teeth
Drifting of teeth under occlusal load
Loss of alveolar bone leading to compromised denture bearing area in long term
What 4 faults can cause a RBB to debond
Poor moisture control during cementation
Unfavourable occlusion
Poor enamel quality
Inadequate coverage of abutment
What histological presentation could indicate malignancy
Presence of dysplasia
What clinical presentation would indicate malignancy - 6 marks
Exophytic
Raised rolled borders
Firm and indurated
Bleeding
Persisting for more than 3 weeks wiht no obvious cause
What would you look at for individual teeth to determine poor prognosis - 5 marks ( perio related)
Pocket depth
Furcation involvement
Loss of attachment
Mobility
Caries
What is a mandibualr displacement on closing
Discrepancy between arch widths meaning that teeth meet cusp to cusp so the mandible must deviate to one side to achieve ICP
Why do we want to correct a mandibular displacement - 2 reason as
Can lead to TMJ Symtoms and can cause attritive wear
How would you correct a bilateral posterior cross bite
Mid palatal screw on a URA to expand maxilla
What three GI conditions can cause microcytic anaemia
Crohns
Ulcerative colitis
Coeliac
What three oral conditions might anaemia be assoacted with
Candidosis
Dyaesthesia
Apthous ulcers
