Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS5 OSCE > Dentistry in a Nutshell > Flashcards

Dentistry in a Nutshell Flashcards

1
Q

what things must you talk to the patient about to ensure you are obtaining valid consent

A

why treatment necessary
what might happen if treatment is not carried out
treatment options - risks and benefits
recommended option
cost
duration
likely prognosis
whether treatment is guaranteed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what tests can you do quickly when the patient comes in with toothache

A

visual
air from 3 in 1
palpation
probing
percussion
vitality
mobility
tooth sleuth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

apart from the usual endodontic diagnoses for pain, what other reasons may a patient have pain

A

hypersensitivity
dry socket
TMJ pain
oral ulceration
necrotising gingivitis
sinusitis
orthodontic problem
salivary gland infection
ill/loose fitting dentures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the immediate management for adults with dental infections

A

establish drainage
extirpate if endodontically involved
debride pockets if periodontally involved
prescribe antibiotics if indicated
recommend analgesia
consider extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the indications for antibiotics

A

limited mouth opening
facial swelling
systemic infection
immunocompromised patient
elevated temperature >38 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when would you refer to maxfax/a&e

A

difficulty breathing/likely to obstruct airway
involvement of orbital area/closure of eye
difficulty in swallowing/unable to stick tongue out
swelling rapidly increasing in size
evidence of infection in facial spaces (ludwigs angina)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the dose of penicillin for dental infections

A

phenoxymethylpenicillin 250mg
2 tablets 4x daily for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the dose of metronidazole for periodontal abscesses

A

metronidazole 400mg
1 tablet three times a day for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the dose of metronidazole for pericoronitis and ANUG

A

metronidazole 400mg
take one tablet three times day for 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when the patient is complaining of post extraction pain what extra oral exam do you do

A

pyrexia
lymphadenopathy
bruising
trismus
step deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when the patient is complaining of post extraction pain what intra oral exam do you do

A

visual
tactile
inspect socket for healing status
debris
clot
pus
bone sequestra
necrosis
tender/damaged adjacent tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the differential diagnoses when a patient is complaining of post extraction pain

A

dry socket
retained root/bone
infection
LA related trauma
haematoma
MRONJ
OAC
ORN
fractured maxillary tuberosity
step deformity
dislocated/fractured mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what symptoms may someone have if they have a cracked tooth

A

pain on biting
localised pain/sensitivity to cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the signs of a cracked tooth

A

lymphadenopathy
visible fracture
interferences in occlusion
toothwear
heavily restored dentition
swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the special investigations for a cracked tooth

A

sensibility testing
radiographs
percussion
tooth sleuth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

before deciding that a patient has a cracked tooth, what other diagnoses must you rule out

A

periodontal and periapical issues
dentine sensitivity
facial pain
apical pathology
high restoration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if a cracked tooth does not extend to the pulp chamber floor how do you manage it

A

restore with composite/temp crown with occlusal reduction
assess after 2-3 months
if symptomatic after this time then RCT with crown or extract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

if a cracked tooth has cracked subgingivally and there is insufficient coronal tissue what is the treatment

A

extract as this is hopeless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

if a tooth is cracked and it extends to the pulp chamber floor and is restorable what is the treatment

A

RCT and crown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the symptoms of pericoronitis

A

pain on biting
localised pain
pyrexia
may struggle to open mouth wide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the signs of pericoronitis

A

inflamed operculum
signs of trauma
trauma from opposing tooth
swelling
lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the management of pericoronitis

A

debride around inflamed tooth
irrigate with saline and instruct patient how to perform OH
consider adjusting traumatic occlusion/extracting upper tooth
antibiotics if spreading infection/trismus
review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the signs and symptoms of dry socket

A

pain 24-48 hours post extraction
inflamed non-healing socket
lost blood clot
trapped food debris or bad taste/odour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the risk factors for dry socket

A

smoking
alcohol
immunocompromised
female
oral contraceptive
mandibular
posterior teeth
previous dry socket
poor compliance with post op instructions
traumatic extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the management of dry socket

A

curette socket
irrigate with saline and instruct OH
pack the socket with alvogyl (eugenol based dressing)
advise good OH and smoking cessation if available
review after 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

if a patient attends with a swelling what do you look for extra orally

A

site
hard/soft
eye affected
redness
temperature
difficulty breathing
trismus
difficulty swallowing
drainage
lymph nodes examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

if a patient attends with a swelling what do you look for intra orally

A

associated tooth
hard/soft swelling
mobility
drainage
pocket depth
percussion test
palpation test
sensibility test
fractured tooth/filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if a patient has a swelling and there is apical pathology on the radiograph what are the differential diagnoses

A

periapical periodontitis
perio-endo lesion
periodontal abscess
periapical cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

if a patient has a swelling and there is no apical pathology on the radiograph what are the differential diagnoses

A

salivary gland obstruction/infection
pericoronitis
fractured jaw
fractured tooth
malignancy
bony diseases
tumour
tori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are the signs/symptoms of acute apical abscess

A

localised pain
pain increases on chewing/touching tooth
quick onset of swelling and pain
possible mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the immediate management of acute apical abscess

A

establish drainage
analgesia
antimicrobials if indicated
consider relieving occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the long term management of acute apical abscess

A

review
definitive treatment RCT/XLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are the signs/symptoms of perio-endo abscess

A

generalised periodontitis with localised pain
swelling
deep pocketing to root apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the immediate management of perio-endo abscess

A

debride pockets
irrigate
chemical plaque control
establish drainage
antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the long term management of perio-endo abscess

A

review OH
decide if the cause is initially perio or endo and treat accordingly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are the signs/symptoms of salivary gland obstruction/infection

A

pain in major salivary gland
swelling
history of dehydration
history of xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the immediate management of salivary gland obstruction/infection

A

analgesia
advise patient to increase fluid intake
use warm compress on gland
massage gland
encourage salivary flow
consult with GMP to consider changing medication
refer to medical centre in severe cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is the long term management of salivary gland obstruction/infection

A

saliva substitutes
high caries risk prevention protocol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the signs/symptoms of periodontal abscess

A

pain/tenderness of gingiva
increased mobility
gingival swelling
suppuration from gingiva
systemic symptoms include pyrexia, lymphadenopathy and malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the immediate treatment of a periodontal abscess

A

LA and supra and subgingival debridement of pockets
antibiotics if indicated
consider extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is the long term treatment of a periodontal abscess

A

review OH
periodontal treatment
consider extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are the signs of a radicular cyst

A

apical to non-vital tooth
egg shell crackling of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

treatment of radicular cyst

A

RCT
XLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the signs of residual cyst

A

following extraction of tooth with radicular cyst, cyst remains and becomes a residual cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

treatment of residual cyst

A

no treatment and monitor
enucleation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

signs of dentigerous cyst

A

cyst that develops around CEJ of teeth and prevents eruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

treatment of dentigerous cyst

A

surgical removal
uncover tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

describe a mucocele

A

fluid filled sack due to trauma of minor salivary gland usually in lower lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

treatment of mucocele

A

monitor
enucleation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

describe a ranula

A

cyst formed from major salivary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

treatment of ranula

A

marsupialisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

treatment of salivary gland stone/obstruction

A

no treatment
surgical removal
basket retrieval
lithotripsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are the special tests in the trauma stamp

A

sinus
colour
TTP
colour
mobility
electric pulp test
ethyl chloride
percussion note
radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

if there is dental trauma with displacement and single tooth mobility what injuries could this be

A

root fracture and extrusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

if there is dental trauma with displacement but no single tooth mobility what injuries could this be

A

alveolar fracture
intrusion
lateral luxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

treatment of root fracture

A

reposition and confirm radiographically
stabilise for 4 weeks with passive and flexible splint
monitor pulp for up to 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

treatment of extrusion

A

reposition and splint for 2 weeks
monitor pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

treatment of alveolar fracture

A

reposition and splint for 4 weeks
suture lacerations
monitor pulp status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

treatment of intrusion with incomplete root formation

A

allow for re-eruption without intervention for 4 weeks
if no re-eruption then ortho reposition
monitor pulp
RCT if required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

treatment of intrusion with complete root formation

A

<3mm allow for re-eruption
3-7mm ortho/surgical reposition
>7mm surgical reposition
start RCT at 2 weeks and use corticosteroid paste as intra-canal medicament to prevent external resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

if a tooth has no displacement but is mobile and is TTP what trauma is this

A

subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

if a tooth has no displacement but is mobile and not TTP what injury could this be

A

crown fracture if fracture is present
crown-root fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

if a tooth has no displacement and is not mobile what injury is this

A

concussion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is treatment for subluxation

A

no treatment
monitor pulp for 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is treatment for enamel fracture

A

bond fragment or restore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is treatment for enamel dentine fracture

A

bond fragment or restore
consider need for pulp cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is treatment for enamel dentine pulp fracture

A

partial pulpotomy/pulp cap followed by restoration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is treatment for concussion

A

no treatment
monitor pulp for 1 year
if mobile then splint for 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is treatment for crown-root fracture

A

if no pulp exposure then stabilise mobile fragment and monitor
if pulp exposure then stabilise or extract fragment, pulpotomy or pulpectomy depending on root maturity. RCT and restore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

treatment for avulsion

A

clean tooth
administer LA
irrigate with saline
reposition socket fracture if present and reimplant tooth
suture any lacerations
radiograph to ensure correct reimplantation
flexible splint for 2 weeks
antibiotics and tetanus booster
RCT after 7-10 days with intracanal medicament
2 week follow up
clinical and radiographic follow up 1 month, 3 months, 6 months, 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

post operative advice for avulsion

A

avoid contact sports
soft diet for 2 weeks
brush teeth after every meal with soft toothbrush
chlorhexidine 0.1% twice a day for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

if an avulsed tooth is immature do you start RCT?

A

no the aim is to revascularise the pulp
no RCT unless necrotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

emergency management of avulsion

A

reassure patient
hold by crown DO NOT TOUCH ROOT
clean tooth with milk or saliva
reimplant if possible or store in saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

treatment for pulp exposure when it is an immature tooth

A

PARTIAL PULPOTOMY
remove 1-3mm of inflamed coronal pulp or until reaching healthy pulp
control bleeding using CHX or NaOCl
dress with CaOH, biodentine or MTA
RMGIC
restore with bonded restoration
follow up with vitality testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

when are direct pulp caps performed

A

on immediate pinpoint exposures <1mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

differential diagnoses for extra oral swellings

A

trauma
dental infection
sialosis
ranula
suppurative/viral sialadenitis
Crohns/OFG
salivary gland tumour
OSCC
pagets
fibrous dysplasia
acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

differential diagnoses for intra oral swellings that are pink

A

fibroepithelial polyp
drug induced hyperplasia
crohn’s disease
OFG
OSCC
salivary gland tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

differential diagnoses for intra oral swellings that are red

A

pyogenic granuloma
giant cell granuloma
denture induced hyperplasia
scurvy
OSCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

differential diagnoses for intra oral swellings that are white

A

squamous papilloma
OSCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

differential diagnoses for intra oral swellings that are blue

A

mucoele
ranula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

differential diagnoses for intra oral swellings that are yellow

A

bone exostosis
sialolith

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

differential diagnoses for localised pigmented lesions

A

amalgam tattoo
haemangioma
melanotic macula
malignant melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

differential diagnoses for widespread pigmented lesions

A

drug induced pigmentation
addisons disease
sturge weber syndrome
smoking associated pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

differential diagnoses for white patches that are painful

A

chemical burn
lichen planus
lichenoid reaction
lupus erythematous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

differential diagnoses for non painful white patches

A

white sponge naevus
leukoplakia
candida
OSCC
keratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

differential diagnoses for painful ulcerative red patches

A

erosive lichen planus
post radiotherapy mucositis
contact hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

differential diagnoses for painful non ulceration red patches

A

any anaemia
angular cheilitis
acute erythematous candidiasis
geographic tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

differential diagnoses for painless ulcerative red patches

A

OSCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

differential diagnoses for painless non ulcerative red patches

A

erythroplakia
chronic erythematous candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

differential diagnoses for single ulceration

A

trauma
RAS
behcets
OSCC
syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

differential diagnoses for multiple discrete ulcers

A

ANUG
herpetiform RAS
behcets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

differential diagnoses for multiple diffuse ulcers

A

erosive lichen planus
lichenoid reaction
GVHD
radiotherapy induced mucositis
ORN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

differential diagnoses for blistering conditions in children

A

chickenpox
herpangina
primary herpetic gingivostomatitis
hand foot and mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

differential diagnoses for blistering conditions in adults

A

shingles
pemphigoid
pemphigus
erythema multiforme
angina bullosa haemorrhagica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

causes of dry mouth

A

medications
dehydration
drinking and smoking
mouth breathing
anxiety
cancer treatment
health conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

management of dry mouth

A

assess to see if lifestyle/medication modifications can be made
drink water, suck ice cubes, sugar free sweets, chewing gum
regular check ups, caries assessment and fluoride application
high strength toothpaste
saliva substitues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

medications causing dry mouth

A

beta blockers
anti-convulsant
analgesics
anti-emetics
parkinsons drugs
diuretics
antidepressants
antihistamines
antipsychotics
anti-manic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

management of oral ulceration

A

make note of appearance
soft diet, avoid spicy foods, avoid SLS, anbesol, CHX
adjust ill fitting dentures/traumatic areas, prescribe
keep ulcer diary and refer for further testing if recurrent
review at 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

medications causing ulcers

A

NSAIDs
beta blockers
methotrexate
penicillin
nicorandil
allopurinol
sulfasalazine
gold
anti-convulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

systemic conditions causing ulceration

A

herpetic gingivostomatitis
lichen planus
vesiculobullous
hand foot and mouth
haematological malignancy
OSCC
erythema multiforme
haematinic deficiency
inflammatory bowel disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

management of acute pseudomembranous candidiasis (oral thrush)

A

identify and address underlying causes
improve OH
CHX mouthrinse
miconazole gel/nystatin mouthrinse/fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

management of chronic hyperplastic candidiasis (candidal leukoplakia)

A

biopsy
check vitamin levels
smoking cessation
2-4 weeks oral fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

management of acute erythematous candidiasis (sore mouth)

A

spacer device/rinse after inhaler
oral thrush treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

management of chronic erythematous candidiasis (denture stomatitis)

A

denture hygiene advice
miconazole gel to fitting surface of denture
refer to GMP if unresolving or make new denture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

management of angular cheilitis

A

correct the cause
topical miconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

who is ANUG commonly found in

A

smokers
immunodeficient
stress
poor OH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

what bacteria causes ANUG

A

spirochetes and fusiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

clinical appearance of ANUG

A

pseudomembranous slough covering ulcerated gingival margin
papillae are punched out
loss of crestal bone
bad breath and metallic taste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

advice for ANUG

A

stop smoking
use soft toothbrush, toothpaste and ID brushes
0.2% chlorhexidine 10ml 2x daily or diluted 6% hydrogen peroxide 3x daily
topical pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

treatment for ANUG

A

advice
LA and debride
advise paracetamol
prescribe antibiotics if required (metronidazole)
review in 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

clinical findings of a periodontal abscess

A

patient has periodontitis
loss of alveolar crest
mobile and TTP in lateral directions
abscess adjacent to periodontal pocket
pus drainage
fever/malaise
tooth is usually vital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

treatment of periodontal abscess

A

LA and debride
antibiotics if required
discuss and make aware of cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

what does NaOCl do

A

dissolves necrotic and vital organic tissue
antimicrobial
lubricant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

what does EDTA do

A

dissolves smear layer, inorganic tissue
lubricant
chelator
decalcifying agent (for sclerosed canals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

before commencing RCT what do you analyse on the radiograph

A

root canal anatomy, number, length, curvature and calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

what burs are used for access

A

flat fissure/round bur for initial access
safe ended access bur for widening pulp chamber/removing roof

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

how do you ensure that hypochlorite is safe

A

use side venting needle
fill needle up to 3/4
use forefinger to inject
label clearly
ensure the tip does not bind
irrigate using in and out motion
pass behind patient’s head
be mindful of droplets
bend needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

what are the principles of access cavity design

A

allow removal of entire contents of pulp chamber
allow visualisation of pulp floor and canal orifices
allow direct access to apical 1/3 of canal for instrumentation
allow retention and support of a temporary filling material - good seal
provide reservoir for canal irrigant
be as conservative as possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

is modified step back a hand filing or a rotary technique for canal preparation

A

hand filing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

what are the steps of the modified step back technique

A

scout canals and coronal pre-flaring with gates gliddens
prepare coronal 2/3 with gates gliddens
establish working length
establish glide path
prepare the canal to 3 sizes larger than first file which binds at the apex
step back using next file size up and 1mm from that length, keep stepping back until you have joined the apical preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

why would you use a file 3 sizes larger than that which binds at the apex to prepare the canals

A

remove dead pulp tissue, bacteria and substrates
increase capacity of canals to retain a larger amount of irrigant
prepare canal for adequate obturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

what are the steps of the crown down technique for RCT

A

scout canals and coronal pre-flaring
prepare coronal 2/3
establish working length
establish glide path
use rotary system to prepare the canal in a brushing motion to working length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

what are the advantages of using a coronal preparation technique first in endodontics

A

improves tactile sensation
prevents pushing bacteria from infected coronal aspect further into the canal reducing the incidence of flare ups
allows more accurate working length determination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

how do you manage a hypochlorite accident

A

stop and inform and reassure patient
irrigate with saline
administer long acting LA and prescribe NSAIDs for pain
cold compresses in initial days and warm compresses later
review after a few days and place temporary seal
clinical photographs for record keeping
if the swelling of the affected side is more than 30% compared to the contralateral side consider referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

what are the steps for obturation via cold lateral compaction

A

thorough irrigation
select master GP cone and mark working length
coat in sealer
seat in canal and ensure it goes to length
select finger spreader
accessory points
remove GP with super endo alpha at canal orifice
clean access cavity with ultrasonics and cotton pellet
seal root canal filling with core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

what are the types of root canal sealer available

A

resin
GIC
ZOE
calcium hydroxide
bioceramic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

how do you manage a ledge in RCT

A

identify location of ledge with hand file
enlarge canal space to 1mm short of ledge
place shark kink at the end of the hand file
file up and down to smooth the ledge
once a K8 file can glide smoothly move up to 10, 15, 20 etc
continue with preparation as normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

how do you avoid ledges

A

good cavity access with straight line access to canals
pre curved hand files with lubricant and watch winding motion
never force files

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

risks of root canal treatment

A

perforation
instrument separation
continued symptoms
hypochlorite accident
missed canals
trismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

alternative options to RCT

A

accept and monitor
extraction
surgical RCT
other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

how do you manage perforations in house

A

achieve haemostasis using heat or pressure
plug perforation
allow appropriate setting time
seal with GIC
complete RCT
review at 6 months and then annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

how do you achieve haemostasis and plug perforations in house

A

haemostasis = 5mins pressure with cotton pellet OR heated instrument to cauterise
plug = use MTA or biodentine for gold standard, can also sue GIC or ZOE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

if you are going to refer a perforation, what do you need to do before

A

cotton wool over the perforation with CaOH and dress with ZOE or GIC
write letter with information on cause and location of perforation

134
Q

what is the success of perforation repair dependent on and what is the success rate of them

A

depends on location, size and time
coronal perforations have lower prognosis as can develop perio-endo lesions
smaller perforations and those treated sooner have better success rate

135
Q

why do perforations normally occur

A

over instrumentation and poor understanding of anatomy of tooth

136
Q

why would you re-organise an occlusion

A

when ICP cannot be established reliably it is re-designed

137
Q

when would you use a split dam technique

A

insufficient coronal tooth structure
deep subgingival cavity
tight contacts
indirect cementation

138
Q

steps of recording a facebow

A

mould wax around bitefork
place in patient mouth until wax hardens
mark anterior reference point on face - 43mm above distal of 12 incisal edge
assemble transfer jig to earbow and tighten screw securely
re-insert bitefork and tighten earbow
adjust earbow until locating arm is aligned with anterior reference marked on patient face
bitefork and transfer jig sent to lab as one unit

139
Q

when taking a patient history for tooth wear what things are important to establish

A

parafunction
diet
gastric issues
morning sickness
lifestyle
recreational drug use
eating disorders
steroid inhalers
medication
habits

140
Q

what do you assess with extra oral exam for tooth wear

A

smile line
lip line
RVD, OVD, FWS
phonetics
TMJ

141
Q

what are the wear indices used

A

BEWE
Smith and Knight

142
Q

what special investigations are used for wear

A

radiographs
articulated study models
sensibility testing
photographs
diagnostic wax ups

143
Q

what are the types of wear in relation to severity

A

1 - wear with loss of OVD
2 - wear without loss of OVD with space
3 - wear without loss of OVD and limited space

144
Q

what is the immediate management of wear

A

adjust sharp edges
desensitising agent
GIC over exposed dentine

145
Q

what is prevention advice for wear

A

modify diet and lifestyle
cease bad habits
promote good oral hygiene
splint
refer to GP for medical problems
apply fluoride
treat dry mouth

146
Q

what are the absolute contraindications to implants

A

patient not compliant
ongoing chemotherapy
high dose immunosuppressive therapy
incomplete maxillary/mandibular growth
allergies to implant materials

147
Q

around the localised site where an implant would be placed, what should we be looking at

A

distance of bone interproximally between neighbouring teeth
bucco-lingual width of bone
minimal vertical mouth opening
minimal interocclusal distance and soft tissue condition

148
Q

what are the special investigations for implants

A

clinical photography
study models
radiographs (PA, OPT, CBCT)

149
Q

what should be discussed in the consent process of implants

A

risks v benefits
costs
estimated
number of visits
likely prognosis
importance of maintenance visits

150
Q

when would you use a facebow when planning for a bridge

A

when replacing upper canines and multi-unit bridges

151
Q

how do we ensure a bridge is cleansable

A

connectors should be at the contact point to allow adequate embrasure space for cleaning
smooth, polished and glazed

152
Q

how do you prep for anterior adhesive bridge

A

ensure parallel wall of tooth
no prep needed if 0.7mm of interocclusal space free for retainer
minimal palatal chamfer finish can help with seating and increases resistance form

then take impressions with lightbody on teeth, medium/heavy body or lab putty in tray

153
Q

what information is included in the lab card for adhesive bridges

A

shade
pontic design
metal wing coverage
connector level
embrasure space
locating peg
sandblasted metal wings
ask for casts to be articulated to jaw registration provided

154
Q

what is the average longevity of a conventional bridge

A

10 years

155
Q

what is the incidence of devitalisation in a conventional bridge preparation

A

1 in 5

156
Q

how do you prep for conventional bridge

A

outer axial walls have 6-15 degree taper
parallel guideplanes
non functional cusp reduction of 1.5-2mm
functional cusp reduction of 2mm
axial reduction dependant on bridge material

157
Q

what special investigations are needed for crowns/onlays

A

radiographs
photographs
impressions for study models
diagnostic wax ups
sensibility testing if needed

158
Q

what is the risk of devitalisation with crown prep

A

20-30%

159
Q

what is the disadvantage of an MCC (porcelain and metal)

A

metal cervical area can become visible due to gingival recession

160
Q

what is the advantage and disadvantage of a zirconia crown

A

adv = good aesthetics
disadv = more abrasive than metal

161
Q

what are the advantages of a LiDiSi crown

A

the flexural strength is similar to tooth tissue (much less than MCC though)
good aesthetics

162
Q

what are the advantages of metal crowns (precious and non-precious)

A

flexural strength very high
less abrasive

163
Q

what are the options for crown materials available

A

porcelain fused to metal (MCC)
zirconia
lithium disilicate
precious metal (gold)
non-precious metal (silver)

164
Q

what degree of taper should the internal walls of inlay/onlay/crown prep have

A

4-6 degree

165
Q

indications for an inlay

A

occlusal and/or proximal cavities
failed direct restoration replacement

166
Q

if you are using a ceramic onlay, what should the cusp reduction be

A

2mm for functional
1.5mm for non-functional

167
Q

indications for an onlay

A

cusp fracture
toothwear
caries weakening tooth structure
pre-existing failed restoration with large isthmus
restoration of RCT teeth

168
Q

axial reduction for MCC crown

A

buccal = 1.5mm shoulder
porcelain palatal = 1mm chamfer
metal palatal = 1.5mm chamfer

169
Q

axial reduction for a ceramic crown

A

1mm rounded chamfer

170
Q

indications for crown

A

cusp fracture
toothwear
caries weakening tooth structure
pre-existing failed restoration with large isthmus
restoration of RCT teeth
high aesthetic demand
onlay not possible

171
Q

steps of a crown preparation

A

LA
sectional impression for temp construction and separate impression for reduction matrix
occlusal reduction - bevel the functional cusp
axial reduction
interproximal reduction
impressions
temporary construction

172
Q

what do you do to finish a crown prep

A

polish proximal boxes and flare edges
prepare rounded shoulder or chamfer margin
round off internal sharp angles
remove any enamel lips
no undercuts

173
Q

what is deep margin elevation

A

building up a subgingival proximal box with composite to ensure margins are supragingival before beginning crown preparation

174
Q

how much space should you have in the interocclusal space of anterior crown prep

A

2mm

175
Q

prep dimensions for anterior MCC crown

A

0.7mm chamfer palatal
0.7mm cingulum reduction
1.5mm labial shoulder

176
Q

prep dimensions for anterior all ceramic crown

A

1-1.5mm shoulder/chamfer palatal
1mm cingulum reduction
1-1.5mm shoulder/chamfer labial

177
Q

steps of temporary crown construction

A

fill putty index with protemp
allow initial set in mouth and then remove to allow full set out of mouth
use burs and discs to remove excess material
take final impression of crown prep for lab
cement temp crown with temp bond

178
Q

steps for impression taking for crowns/onlays

A

syringe light body silicone around prep
take impression with medium/heavy body silicone or lab putty
take opposing arch alginate
take bite registration in ICP

179
Q

what information do you include on the lab card for crowns/onlays

A

shade
ask for sandblasting (zirconia/metal) or HF acid treatment (LiDiSi)
ask for casts to be articulated

180
Q

consequences of poor marginal fit of crown/bridge

A

plaque retention
secondary caries
localised periodontitis
cement dissolution
poor aesthetics

181
Q

what causes poor marginal fit of a crown/bridge and how do you fix it

A

inaccurate impression
poor gingival retraction
inadequate marginal preparation

redefine margins and retake impression and communicate issue to lab

182
Q

consequences of crown/bridge not seating properly

A

patient discomfort
plaque retention
secondary caries
localised periodontitis
unnecessary occlusal adjustments

183
Q

what causes a crown/bridge to not seat properly

A

inaccurate impression
undercuts in final prep
insufficient taper of axial walls
drifting of adjacent teeth

184
Q

how do you fix a crown/bridge not seating properly

A

retake impression
check for undercuts in final preparation
4-6 degree tapered axial walls
ensure good contact points on temporary crown
minimal interproximal reduction with high speed

185
Q

consequences of occlusal interferences of the crown/bridge

A

post op pain on biting
occlusal trauma
indirect fracture
opposing tooth cuspal fracture
decementation
bruxism

186
Q

what would cause occlusal interference with indirects

A

inaccurate impression
insufficient occlusal reduction
inaccurate bite registration
poor planning and clinical assessment

187
Q

what can glass ionomer cement

A

MCC
metal crown

188
Q

what can RMGI cement and give a brand

A

MCC
metal crown

brand = RelyX or RIVA luting cement

189
Q

what can light cured resin cement and give brands

A

porcelain veneer/inlay/onlay

brand = RelyX

190
Q

what can dual cured resin cement and give brand

A

MCC
metal crown
porcelain inlay/onlay
all ceramic crown

brand = nexus/relyX/panavia

191
Q

what are the ideal endodontic/root factors for post placement

A

good apical and coronal seal obturated within 2mm of apex, well condensed
no periapical radiolucency
wide width of root
1:1 crown:root ratio
minimal curvature
no resorption
no sinus/abscess/TTP

192
Q

how many millimetres subcrestal should a post extend

A

4mm

193
Q

what are the restorative and occlusal requirements for post

A

caries free
2mm ferrule minimum around 3/4 of tooth
2mm interocclusal space after core placement
need to have group function
no wear or bruxing habits

194
Q

what are the periodontal requirements for post

A

no bleeding pockets >4mm
no pockets >5mm
no pus
BOP <15%
not mobile and no furcations

195
Q

adv and disadv of direct post

A

adv = same day placement and lower cost
disadv = less accurate fit, not suitable for wider canals, need ferrule

196
Q

adv and disadv of indirect post

A

adv = more accurate fit, wider canals fine, can use when less ferrule remaining
disadv = more than 1 appointment, costly

197
Q

materials for a post

A

metal = gold, stainless steel, titanium
ceramic = zirconia, alumina
fibre = glass, quartz, carbon

198
Q

adv and disadv of metal posts

A

adv = radiopaque, retrievable, better fit to crown
disadv = poor aesthetics, root fracture, corrosion

199
Q

adv and disadv of ceramic posts

A

adv = high flexural strength, greater aesthetics
disadv = difficult retrievability, technique sensitive

200
Q

adv and disadv of fibre posts

A

adv = allows light cure, more closely replicates root elasticity
disadv = difficult to retrieve, less radiopaque

201
Q

adv and disadv of parallel post

A

adv = less stress on root, greater retention
disadv = less conservative

202
Q

adv and disadv of tapered post

A

adv = more conservative
disadv = greater stress on root, less retentive

203
Q

what is the ideal post

A

parallel sided
non-threaded
cement retained

204
Q

what are the risks of post placement

A

perforation
root fracture
post fracture
infection requiring re-RCT
bruxism, class 2 div 2, deep overbite, edge-edge ALL increases post fracture risk

205
Q

what are the steps of direct post preparation and cementation

A

LA and dam
refine crown prep margins
calculate working length and post width required
use gates gliddens to remove 2mm of GP from entrance of canal
prepare post space to correct size for post being used
irrigate with NaOCl
try in post and radiograph to confirm position
cement
build composite core incrementally
remove remaining post coronally once core has been built up
redefine crown margins and do impressions

206
Q

what are the steps of indirect post preparation

A

LA and dam
redefine crown prep margins
calculate working length
gates gliddens to remove 2mm of GP from canal entrance
prepare post space to correct post size
irrigate with NaOCl

207
Q

what are the steps of indirect post impression taking once preparation has already taken place

A

insert retraction cord
insert impression post and ensure 2mm interocclusal space present
remove retraction cord
light body silicone syringed around post and impression with medium/heavy body
take opposing alginate
bite reg
place temp post inside post prep
build up core

208
Q

what is on the lab card for cast post

A

outline only cast post and core are to be constructed
shade
ask for sandblasting of fit surfaces
ask for casts to be articulated
send burn out post corresponding with post preparation drill used to lab

209
Q

steps of indirect post cementation (cast post)

A

LA and dam
remove remnant temp cement with ultrasonic scaler
irrigate with NaOCl
try in post and core and take PA radiograph

210
Q

questions to ask in the denture history

A

happy with current dentures
how old are current dentures
how many have you had and which were best
what are your main concerns
did your denture fit initially
are you able to eat with dentures in
what are expectations of new dentures
how long do you wear your dentures for

211
Q

what do you look at in extra oral exam at denture assessment appointment

A

face structure
centrelines
OVD, RVD
incisal show
lips
aesthetics
occlusal plane
speech

212
Q

how do you check for retention in complete dentures

A

push on incisal edges of anterior teeth and check for posterior drop

213
Q

how do you check for stability in complete dentures

A

press unilaterally on the posterior teeth and check for a drop on opposite side

214
Q

how do you check for support in complete dentures

A

press on occlusal surfaces of teeth and check if denture sinks or if it causes patient discomfort

215
Q

what do you check for with primary impressions

A

full coverage of denture bearing areas
no encroachment of impression material on tongue space
presence of rolled borders with no drags
absence of drags, voids and tears
mechanical retention of impression material through tray perforations

216
Q

what depth of undercut does a 15mm cobalt chrome clasp engage

A

0.25mm

217
Q

define retention

A

resistance to vertical displacement of the denture

218
Q

define indirect retention

A

resistance to rotational displacement of the denture

219
Q

what provides indirect retention

A

connectors
rest seats
saddles
denture base

220
Q

how do you decide where indirect retention should be

A

draw line between most posterior clasp and clasp on opposite side
then draw perpendicular line and place indirect retention component here

221
Q

how much space does a lingual bar require from floor of mouth to gingival margin

A

8mm

222
Q

how short of the sulcus should a special tray be in order to achieve rolled borders

A

2mm

223
Q

what do you check when trying in CoCr framework

A

adaption
presence of sharp edges
are clasps engaging the undercuts
lab induced defects on denture bearing areas
path of insertion

224
Q

what do you check on partial dentures at the try in stage

A

adaption
flange extensions
no lab induced defects
balanced occlusion
position of denture teeth bucco-lingually compared to natural teeth

225
Q

what plane should the posterior occlusal plane be parallel to

A

ala-tragus line

226
Q

denture hygiene instructions/denture advice

A

take denture out at night and leave in bowl of water
clean denture after every meal with warm water and soap and soft brush
retention and general feel improves over time
begin with soft diet
if causes irritation return to previous set but wear 24 hours before so we can see traumatised areas

227
Q

what is poor retention of complete record blocks caused by

A

under/overextension
inaccurate fit
incorrect post dam

228
Q

how much freeway space is desirable

A

2-4mm

229
Q

what are the indications for replica dentures

A

patient requested spare denture set and likes current dentures function and aesthetics
staining of current denture
worn teeth/overclosure
fractured baseplate or denture teeth in an otherwise functional denture

230
Q

what is the technique for replica dentures

A

select tray larger than denture
use heavy body putty to take impression of occlusal surface
cut location notches on impression that is set
put more heavy body putty on top of this and then seat an impression tray on top
send away for wax try in
use the fit surface of the wax try in as an impression tray and use light body PVS

231
Q

risks of immediate denture

A

suboptimal immediate denture fit as secondary impressions are not routinely taken
denture fit may worsen with time as socket heals and bone remodels
unaesthetic appearance as gingival recession occurs over time

232
Q

what is the technique for immediate dentures with single tooth

A

alginates
light body bite registration
shade
send above to lab
proceed with extraction
fit denture

233
Q

what is the advice given with an immediate denture

A

wear denture for 24 hours to protect clot formed
remove denture at night and tore in glass of water after initial 24 hours
wash daily

234
Q

risks of additions to dentures

A

point of addition slightly weaker and prone to breakage
denture may not fit satisfactorily
unaesthetic appearance possible
limitation
patient will not have their denture for a short period

235
Q

how do you do impressions for additions to dentures

A

take impression with denture in situ

236
Q

indications for overdentures

A

RCT teeth with wear
bone preservation necessary
over implant abutment

237
Q

requirements of remaining teeth for overdenture success

A

satisfactory RCT on retained teeth
adequate interocclusal space
retained tooth periodontally stable

238
Q

adv and disadv of overdenture

A

adv = maintains bone around teeth, good transition
disadv = optimal hygiene required

239
Q

cause and resolution of excessive tooth visible on denture

A

C = increased OVD, upper anterior teeth set out too far
R = reset all teeth and reduce OVD, reset teeth over ridge

240
Q

cause and resolution of teeth looking false on denture

A

C = no gingival contouring, teeth may all appear to have same shape
R = rotate or stagger teeth for natural look, ask lab for anatomical finish

241
Q

cause and resolution of upper lip too bulky on dentures

A

C = labial flange too bulky, teeth set too anterior
R = reduce bulk, reset upper anteriors

242
Q

cause and resolution of upper lip having a sinking appearance with dentures

A

C = upper anterior teeth are set too far palatally
R = reset teeth anteriorly, add more wax to labial aspect and reset teeth

243
Q

cause and resolution of having over-closed appearance with dentures

A

C = reduced OVD
R = remake denture, copy denture with increased vertical dimensions

244
Q

cause and resolution of having a whistle on S sounds with dentures

A

C = palate too narrow or space between centrals
R = remove wax from palate, remove acrylic from palate

245
Q

cause and resolution of lisping sounds on S with denture

A

C = too much tongue space
R = add more wax or add more acrylic

246
Q

cause and resolution of muffled F and V sounds with denture

A

C = incorrect positioning of upper anteriors vertically and horizontally
R = back to try in and reposition teeth

247
Q

cause and resolution of instability of denture but not when chewing

A

C = extension issue of flange, post dam issue, xerostomia, flabby ridge
R = adjust extension and post dam, dry mouth treatment, 2 step impression for flabby ridge

248
Q

cause and resolution of instability of denture when chewing

A

C = lack of post dam seal, anterior teeth labially, flabby ridge, biting only on anterior teeth, incorrect occlusion
R = new masters, reset teeth, 2 step impressions, repeat jaw reg

249
Q

cause and resolution of soreness on ridge of denture

A

C = premature contact, inaccurate denture base, roughness on fit surface
R = new bite registration, reline/rebase, use PIP to identify and adjust

250
Q

cause and resolution of soreness under lingual flange of denture

A

C = RVD and OVD dont coincide, overextended lingual flange, molars too distal
R = recheck vertical dimensions, shorten overextended flange, remove last molars

251
Q

cause and resolution of loose denture

A

C = extension issues, xerostomia, occlusal errors
R = adjust flange, reline denture, articulate denture and remove interferences

252
Q

cause and resolution of tight denture

A

C = denture not relieved in undercut areas causing pain on insertion and removal, clasps too tight
R = check path of insertion and adjust denture, adjust clasps

253
Q

cause and resolution of burning feeling under denture

A

C = denture not relieved in undercut areas causing pain on insertion, clasps too tight, high pressure area
R = check path of insertion and adjust denture with acrylic bur, adjust clasps, PIP and adjust

254
Q

cause and resolution of biting cheek or tongue with denture

A

C = overclosed, posterior teeth set too lingual or buccal
R = denture needs to go back to try in stage to reset teeth

255
Q

cause and resolution of denture making patient gag

A

C = loose denture, patient has strong gag reflex and post dam too far back
R = construct new denture with better retention, CBT for gag reflex or trim post dam

256
Q

cause and resolution of redness over denture bearing areas or cheeks

A

C = overclosed, posterior teeth set too lingual or buccal, allergic reaction
R = go back to try in stage and rearticulate and reset teeth, do a patch test

257
Q

what are the intrinsic causes of discoloured anterior teeth

A

fluorosis
non-vital
RCT
tetracycline
age
enamel defects

258
Q

what are the extrinsic causes of discoloured anterior teeth

A

tea, coffee, alcohol
tobacco
coloured food spices
chlorhexidine
chemo and radiotherapy

259
Q

what are the treatment options for discoloured anterior teeth

A

vital bleaching
non-vital bleaching
deep resin infiltration
microabrasion
composite resin bonding
veneers
crown

260
Q

risks of external vital bleaching

A

existing restorations not same shade
transient sensitivity
gingival irritation
external cervical resorption
reduced bonding strength of composite

261
Q

what are the instruction given to patients on how to use whitening trays and gels

A

clean and dry whitening trays
brush and floss
hydrogen peroxide used for 1-2 hours during day or carbamide peroxide used for 6-8 hours over night
treatment lasts 12-14 days
place a bit of gel at the base of each tooth in the tray
avoid coloured foods, drinks and toothpaste

262
Q

what is the instructions to lab for bleaching trays

A

please cast the impressions and construct a gingivally fitted bleaching tray

263
Q

what is the process for internal non-vital bleaching

A

PA radiograph
open access cavity and remove 2-3mm of GP below CEJ
place 1mm of GIC over GP
remove stained dentine with round bur
etch with 37% phosphoric acid, wash and dry
place whitening agent into access cavity and cover with cotton pellet
seal access cavity with GIC
repeat at weekly intervals and review after 3 sessions

264
Q

what are the indications for ICON deep resin infiltration

A

opaque white spots
fluorosis
MIH

265
Q

why is initial whitening before icon resin infiltration essential to treatment

A

changes the refractive index of the white spot to become more similar to enamel

266
Q

what are the steps for ICON resin infiltration

A

apply ICON etch (15% hydrochloric acid) for 120seconds
apply ICON drying material (99% ethanol) for 30 seconds
dry and observe, repeat up to 3 times if necessary
apply ICON infiltrant and leave for 3 minutes
light cure for 40 seconds
polish

267
Q

what does the ICON resin infiltrant do to white spots

A

alters the refractive index of the opaque white spot such that it becomes similar to that of enamel

268
Q

advantages of microabrasion

A

conservative
cheaper
minimal maintenance required
permanent results
quicker results
easy to perform

269
Q

disadvantages of microabrasion

A

outcome unpredictable
removes 25-75 microns of enamel per treatment
must be performed chairside
requires PPE

270
Q

what is the process of microabrasion

A

pre-op photos
clean the tooth
place rubber dam
place sodium bicarbonate guard around gingival margin
6-10% HCl pumice with a slowly rotating rubber cup on white spot for 5 seconds
wash directly into aspirator
dry tooth and place guard again and repeat maximum of 10 times
fluoride varnish application (profluorid)
polish with fine soflex disc
final polish with prophy paste
avoid coloured foods and drinks that till stain a white t-shirt
review at 4-6 weeks and take photos

271
Q

what are the reductions required for veneer prep

A

cervical enamel = 0.3mm
mid-buccal third = 0.5-0.7mm
incisal third = 0.5-0.7mm

incisal edge reduction = 1-1.5mm

272
Q

what are the steps of veneer preparation

A

sectional silicone impression
LA and shade
diagnostic wax up to create silicone indices for depth guides
prepare labial surface in 3 planes
consider incisal edge reduction
interproximal reduction
assess preparation from 3 different views
smooth and polish preparation
scan or take silicone impressions
place temporary veneer

273
Q

how would you go about composite bonding as a temporary trial smile for a patient

A

take impression of diagnostic wax up and use this as stent
spot etch and wash and dry
load stent with composite and seat and wait for seat
remove stent and excess composite with probe
floss contacts and light cure
review in 2 weeks

274
Q

diet advice for children

A

promote balanced diet
milk and water only
reduce sugar to mealtimes only
promote non-cariogenic snacks
no eating or drinking after brushing teeth
be wary of hidden sugars and acid

275
Q

from what age do you start applying fluoride varnish in practice

A

3

276
Q

what is the fluoride application frequency for low and high risk

A

low = 2x per year
high = 4x per year

277
Q

what is the fluoride varnish dose for 2-5 years and 6+ years

A

0.25ml for 2-5 years
0.4ml for 6+ years

278
Q

instructions to patient after fluoride varnish

A

avoid eating, drinking or rinsing for 30 minutes

279
Q

what are the management options for paediatric caries

A

complete caries removal and restoration
partial caries removal and restoration
no caries removal and restoration
no caries removal and prevention advice
extraction or delay until pain or sepsis

280
Q

what would partial caries removal and restoration be suitable for

A

all types of restorable carious lesions as long as good marginal seal
clear superficial caries and from ADJ

281
Q

when would no caries removal and restoration placement be undertaken

A

when hall crown used or fissure sealant

282
Q

how would you perform no caries removal and making the lesion self cleansing

A

remove undermined enamel and apply fluoride
good for cavitated lesions

283
Q

steps for fissure sealant

A

clean teeth
isolate and dry
etch and rinse and dry
fissure sealant application
light cure for 30 seconds
check integrity with probe

284
Q

steps of vital pulpotomy of a primary molar

A

assess compliance
LA and dam
remove caries and access pulp chamber
remove roof of pulp chamber
large excavator or slow speed to remove coronal pulp
rinse chamber and apply gentle pressure with ferric sulphate cotton pellet
fill pulp chamber with ZOE/MTA/biodentine
remove dam and select preformed metal crown

285
Q

when is vital pulpotomy of a primary molar indicated

A

when vital restorable tooth has:
- large proximal carious lesion
- carious/mechanical exposure of vital coronal pulp tissue
- no radicular pulpitis
- no abscess or when extraction is contraindicated

286
Q

indications for hall crown

A

interproximal caries
caries on 2 or more surfaces
pulp treated tooth

287
Q

contraindications to hall crown

A

pulpal symptoms or caries close to pulp
patients at risk of infective endocarditis
insufficient tooth remaining to retain crown

288
Q

method for hall crown

A

place separators into contact points for 3-5 days
place gauze to protect airway
select appropriate crown size
place GIC into crown
seat crown with finger pressure and child biting
remove excess cement and floss interproximally
reassure that high bite will settle and advise post operative pain relief if needed

289
Q

parts of the extra oral assessment for orthodontics

A

AP
vertical LAFH
asymmetry
TMJ
MoM
lymph nodes
salivary glands
soft tissues (lip competence, lip trap, smile line, naso-labial angle)

290
Q

parts of the intra oral assessment for orthodontics

A

charting, OH, caries, wear
degree of crowding (mild, moderate, severe)
incisor, molar, canine class
proclination of incisors
overbite
overjet
centrelines
crossbite

291
Q

risks of orthodontic treatment

A

relapse
decalcification
root resorption
soft tissue trauma
toothwear
loss of periodontal support
loss of vitality
failed treatment

292
Q

what is mild crowding

A

0-4mm

293
Q

what is moderate crowding

A

4-8mm

294
Q

what is severe crowding

A

8mm+

295
Q

define class 1 incisors

A

lower incisal edges occlude with or lie immediately below the cingulum

296
Q

define class 2 div 1 incisors

A

lower incisal edges lie posterior to the cingulum plateau of upper incisors, the upper centrals are proclined or of average inclination and there is an increased overjet

297
Q

define class 2 div 2 incisors

A

lower incisal edges lie posterior to the cingulum plateau of the upper incisors, the upper central incisors are retroclined, overjet is minimal or may be increased

298
Q

define class 3 incisors

A

lower incisor edges lie anterior to the cingulum plateau of the upper central incisors, overjet is usually reduced or reversed

299
Q

define class 1 molars

A

mesiobuccal cusp of maxillary first molar aligns with the buccal groove of the mandibular first molar

300
Q

define class 2 molars

A

mesiobuccal cusp of maxillary first molar occludes anterior to buccal groove of mandibular first molar

301
Q

define class 3 molars

A

mesiobuccal cusp of maxillary first molar occludes posterior to buccal groove of mandibular first molar

302
Q

define canine class 1

A

mesial incline of maxillary canine occludes with the distal incline of mandibular canine

303
Q

define canine class 2

A

mesial incline of the maxillary canine occludes anterior to distal incline of mandibular canine

304
Q

define canine class 3

A

mesial incline of maxillary canine occludes on mandibular first premolar

305
Q

what are the referral guidelines for non-third molar teeth extractions

A

unsuccessful initial attempt
abnormal tooth morphology requiring surgical removal
peri-apical radiolucency requiring histological assessment
increased risk of damage to adjacent major anatomical structures
reduced access to treatment site
medically compromised

306
Q

referral guidelines for third molar extractions

A

one or more episodes of pericoronitis
unrestorable caries in third molar or impaction causing caries in adjacent second molar
risk of caries in third molar or adjacent tooth
anatomical position of tooth inhibiting proper oral hygiene
periapical pathology
prior to orthognathic surgery
prior to initiating radiotherapy or chemotherapy

307
Q

referral guidelines for MOS

A

impacted teeth
OAC/OAF closure
root in maxillary antrum
pre-prosthetic surgery

308
Q

what is warfarin

A

vitamin K inhibitor

309
Q

what is apixaban

A

factor Xa inhibitor

310
Q

what is dabigatran

A

direct thrombin inhibitor

311
Q

what is rivaroxaban

A

factor Xa inhibitor

312
Q

what do you do if patient is on warfarin

A

check INR 24hrs before

313
Q

what do you do if patient is on apixaban or dabigatran

A

miss morning dose

314
Q

what do you do if patient is on rivaroxaban or edoxaban

A

delay daily dose till 4 hours post extraction

315
Q

high risk patients for MRONJ

A

on oral or IV bisphosphonates for over 5 years
concurrent treatment of systemic glucocorticoids
patient is being treated for cancer
previous MRONJ

316
Q

recommendations for people on bisphosphonates

A

assess risk category
avoid extractions
atraumatic extraction technique
liaise with physician
consider referral
consider 8 week review

317
Q

risks of extraction

A

pain
swelling
bleeding
bruising
dry socket
jaw stiffness
infection
OAC
root fracture
maxillary tuberosity fracture
altered sensation
damage to adjacent teeth
root displacement into sinus
need for surgical intervention

318
Q

what are upper straights for

A

upper incisors and canines

319
Q

what are upper universals for

A

upper canines and premolars

320
Q

what are upper left and right molar forceps for

A

upper left and right molars

321
Q

what are upper root forceps for

A

upper narrow single roots
upper retained roots

322
Q

what are upper third molar forceps for

A

upper third molars

323
Q

what are lower universal forceps for

A

lower anteriors and premolars

324
Q

what are cowhorns for

A

lower 6s

325
Q

safe dose of lidocaine

A

4.4mg/kg

326
Q

safe dose of articaine

A

7mg/kg

327
Q

safe dose of prilocaine

A

6mg/kg

328
Q

safe dose of mepivicaine

A

3mg/kg

329
Q

principles of flap design

A

gain maximum access with minimum trauma
large flaps heal at the same rate as smaller flaps
broader base to maintain blood supply
cut to bone using a firm continuous incision
avoid sharp angles
either include or exclude papillae entirely
do not crush tissue
keep tissue moist with saline

330
Q

post operative instructions

A

be careful because you are still numb
blood stained saliva is normal
wear dentures as normal
call if any issues
dont touch area
avoid hot drinks for rest of day
soft diet for rest of the day
do not smoke or drink alcohol for 24 hours
avoid strenuous activity rest of day
HSMW 4x/day especially after eating starting from tomorrow
damp gauze for bleeding
same painkillers as headache before LA wears off

BDS5 OSCE (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions