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DSE Flashcards

1
Q

A patient has recently had a stroke. What is your first concern?
- When was their last cleaning
- Are they on anticoagulants
- current blood pressure

A

Are they on anticoagulants

  • Stroke patients could be on blood thinners, such as aspirin, dipyradamole (Persan- tine), clopidogrol (Plavix), or Coumadin, postrecovery. Prior to major surgery, always consult with the patient’s physician to determine whether and when the blood thinners can be stopped and subsequently restarted.
  • Following a CVA that required significant hospitalization, routine dental treatment must be delayed by 6 months.
  • Routine dental treatment should be delayed by 3 months if the post-CVA recovery was uneventful and the patient was admitted overnight just for observation.
  • Avoid epinephrine containing LAs during the first 6 months of dental treatment. Subsequent use of epinephrine depends on the patient’s prognosis. Epinephrine containing LAs can be used starting 1 year after the stroke, when the patient demonstrates progressive improvement of the CVA and absence of TIAs.
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2
Q

What is the main symptom that differentiates anaphylaxis from syncope?
- bronchoconstriction
- clammy skin and pallor
- nausea, vomiting

A

Anaphylaxis is accompanied by wheezing, bronchoconstriction
- anaphyalxis: intense itching, hives, flushing over the face and chest. Rhinitis, conjunctivitis, nausea, vomiting, abdominal cramps, and perspiration. Palpitation, tachycardia, sub- sternal tightness, coughing, wheezing, and dyspnea. BP drops rapidly and loss of consciousness or cardiac arrest can occur in severe cases.
- - syncope: fright and flight response. Anxiety, tachycardia, perspiration, light-headedness, and blurred vision are commonly experienced.

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3
Q

The Enzyme Linked Immune Absorbent Assay (ELISA) Test - a negative response for a person who had needle stick means what?
- the patient definitely has an HIV infection
- the patient has antibodies to HIV-1 present
- the patient definitely does not have an HIV infection
- the patient has no antibodies to HIV-1 present.

A

the patient does not have HIV antibodies
- consider that false negatives are a thing, life happens. We cannot definitively say they do not have HIV,but we can say that no Ab were detected.

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4
Q

14 year old presents with inflamed gingiva. Bloodwork indicates abnormal RBC, WBC, and platelets. Diagnosis?
- normal 14 year old
- hypothyroidism
- leukemia
- anemia

A

leukemia –> high WBC, lymphadenopathy, painful gingiva. Don’t forget that WBC can be elevated OR decreased in leukemia! Gingival hypertrophy is a common sign/symptom

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5
Q

Stem indicates patient has recently taken medications, which one likely caused the rash present on their arm?
- Acetamiophen
- Barbituates
- Penicillin
- diphenhydramine

A

Penicillin allergy
- hives is a common response to penicillin allergies

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6
Q

Name the drugs that induce hyperplasia

A

calcium channel blockers, cyclosporines, anticonvulsants, immunosuppressants
- nifedipine, amlodipine, phenytoin, sodium valproate, phenobarbitone, ethosuximide

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7
Q

Drugs that may have increased chance of periodontal destruction
- “-statin”
- “-olol”
- “-ipril”
- Amlodipine

A
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8
Q

Purpose of a wedge during a restoration is?
- Good marginal seal
- Interproximal contact contour
- Adaptation of the matrix band
- Help with filling of the material

A

Adaptation of the matrix band

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9
Q

Patient has tongue sticking out with unusual anatomy, appears to have nonanatomic fold. What might be the cause? No redness or swelling, normal papillae.
- squamous cell carcinoma
- lichen planus
- benign migratory glossitis
- previous laceration

A

Previous Laceration

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10
Q

Tooth #14 had a RCT and patient is symptomatic with radiolucency in one of the canals. How do you treat it?
- retreat that one canal
- retreat all the canals
- retrograde fill the canal with radiolucency

A

Retreat all the canals

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11
Q

How do you increase the working time of alginate?
- add water that is colder than room temperature
- add water that is room temperature
- add water that is warmer than room temperature
- decrease the amount of water added

A

add watrer that is colder than room temperature

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12
Q

Best initial treatment for maxillary oroantral fistula?
- antibiotics
- irrigation
- gauze pack
- two of the above

A

two of the above: antibiotics and irrigation

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13
Q

What is a major complication of phlebitis?
- atrial fibrillation
- pulmonary embolism
- peripheral neuropathy
- myocardial infarction

A

Pulmonary Embolism

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14
Q

Radiograph of amalgam restoration, patient complained of pain when provoked by hot or cold. What is the issue?
- apical periodontitis
- deep amalgam restoration
- galvanic shock

A

Deep amalgam restoration

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15
Q

Best type of cement for short clinical crowns?
- resin bonded
- polycarboyxlate
- zinc phosphate

A

Resin Bonded

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16
Q

What is the reason for the try-in of an immediate denture?
- verify aesthetics with the patient
- check the vertical dimension
- check phonetics
- verify excursive movements

A

check vertical dimension
- cannot verify aesthetics as some teeth remain until full mouth extraction

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17
Q

Patient presents with jaundice. Name three possible causes?

A

cirrhosis
Hep A
Hep C

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18
Q

Hypoadrenalism is known as?
- Cushing’s
- Addison’s
- Grave’s

A

Addison’s
- bronzing of the skin, pigmentation in the oral cavity

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19
Q

Panoramic of radiolucency at the ramus, what should you do?
- retake the image for diagnostic purposes
- incision and drainage
- refer to oral surgery
- leave it alone

A

refer to oral surgeon

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20
Q

Lateral with a previous crown and PARL. What do you do?
- leave it alone
- monitor frequently
- perform RCT

A

Perform RCT

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21
Q

Drug that increase the concentration of lidocaine in the blood?
- Prozac
- Asprin
- Propanalol

A

Propanalol

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22
Q

In the event of a kidney transplant, how would this change treatment?
- no change needed
- refer for ext’s due to risk of osteonecrosis
- premedication due to immunosuppression

A

Premedicate –> immunosuppression

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23
Q

Patient presents with space between mandibular 3rd molar to premolar, class II mobility on 3rd molar. Best treatment option?
- FPD
- RPD
- implant prosthesis
- full denture

A

Implant prosthesis

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24
Q

Direct pulp cap is better in young teeth - T/F

A

True

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25
Q

If there is a red and white lesion, which do you biopsy?
- only the red portion
- only the white portion
- red and white portions of the mixed lesion
- none of the above

A

both red and white portions

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26
Q

Minimum height for posterior crown preps
- 1-2mm
- 2-3mm
- 3-4mm
- 4-5mm

A

3-4mm
- a short clinical crown is defined as a tooth with <2mm of sound opposing parallel walls remaining after occlusal and axial reduction

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27
Q

Prep guidelines for PFM crowns: anterior vs posterior
- axial
- occlusal/incisal

A

Anterior:
- labial: 1.5mm
- lingual: 1mm
- incisal: 2mm
Posterior:
- axial: 1.5mm
- nonfunctional cusp: 2mm
- functional cusp: 2.5mm

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28
Q

What is the treatment for primary herpetic stomatitis?
- antibiotics
- palliative
- do nothing
- antifungals

A

palliative care

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29
Q

Which medication is contraindicated in a patient with hyperthyroidism?
- acetaminophen
- epinephrine
- meperidine
- carbocaine

A

epinephrine
- avoid the use of vasoconstrictors in anesthetic

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30
Q

Pt has a history of multiple odontomas. What syndrome is suspected?
- Addison’s disease
- ectodermal dysplasia
- Gardner’s syndrome
- Cushing’s syndrome

A

Gardner’s Syndrome
- colorectal polyposis

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31
Q

Furcal involvement through and through w/class III mobility. Plaque control is an issue. Prognosis?
- questionable
- good
- poor
- hopeless

A

If you didn’t say hopeless, please tell me how you would save that tooth #herodentistry

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32
Q

Precision attachments should not be used in patient’s with:
- poor ridge adaptation
- flabby tissue
- low dexterity
- high esthetic demand

A

Low dexterity
- case discusses older patient with arthritis

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33
Q

Sensitivity post crown cementation is due to…
- inadequate cement
- microleakage
- too much cement
- reaction to crown material

A

microleakage
- marginal defects and gaps caused by polymerization shrinkage during placement

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34
Q

How long should you wait to complete restorations after whitening teeth?
- immediately
- 1 day
- 5 days
- 1 month

A

Wait at least 5 days post-whitening to complete restorative

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35
Q

What is the treatment for a mucocele?
- corticosteroids
- excision with local glands
- biopsy
- antifungal medication

A

cut. it. out. seriously, exorcise the demon (mucocele)!

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36
Q

Farmer comes in with a sore on his lower lip that has been there for a few months but it has not been painful or bothering him. It has rolled, raised borders and is ulcerated in the center. Likely diagnosis?
- SCC
- syphilis
- angular cheilitis
- herpes labialis

A

squamous cell carcinoma
- pay attention to the story, knowing he is a farmer means that he spends his time in sunlight; common locations for SCC in sun-exposed individuals is the lower lip.
- while angular cheilitis refers to an inflammatory condition at the corners of the mouth, actinic cheilitis refers to lip inflammation caused by long term sun exposure (can lead to SCC if untreated)

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37
Q

There is an unconscious patient in your living room, what do you do first?
- check to confirm if they are unconscious
- check pulse
- check breathing
- call for help

A

monitor vital signs and maintain ABCs; oxygen not indicated if patient is breathing adequately (increased levels of oxygen can cause further vasoconstriction, worsening of symptoms)
– only give oxygen if true breathing difficulty
– rule out obstruction due to improper position before administering oxygen
– if necessary, stabilize and get to hospital

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38
Q

Deciduous eruption sequence

A
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39
Q

Picture of a diagnostic cast on a surveyor with the survey marker at the distal of #28, #31 is present but #30 and #29 are not. What is the survey marker pointing to?
- mesial guide plane
- rest seat
- site of termination for major connector

A

mesial guide plane
- the picture makes it obvious that you are surveying the distal of tooth #28; knowing that it is adjacent to an edentulous space you can see that this would be the location for a guide plane (marker extends to the gingiva)

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40
Q

Patient was on penicillin for two weeks and now complains of a sore tongue. What do you do?
- cytology smear
- fungal test
- prescribe antibiotics
- send to emergency room

A

fungal test
- possible Candida infection

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41
Q

Intraoral picture with several lesions indicative of carious involvement. How would you describe?
- severe caries
- hypoplasia
- erosion
- abfractions

A

Severe Caries

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42
Q

Most likely reason for sealants to fail?
- inadequate retention
- poor light curing device
- contamination
- patient bruxing habit

A

Contamination

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43
Q

Ceramic restorations should have similar ___ to adjacent natural teeth to have a good esthetic outcome.
- hue
- chroma
- value

A

value –> brightness

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44
Q

When can you use tissue conditioner and soft reline on a complete denture patient?
- you can do them anytime
- 1 week after delivery
- 6 months after delivery
-1 year after delivery

A

anytime

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45
Q

Question stem describes an epulis in a denture patient., photo included How would you treat?
- apply tissue conditioner
- leave alone
- prescribe antibiotics
- excision

A

Excision

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46
Q

Tooth was extracted, patient returns with an infection. What is it?
- pericoronitis
- subperiosteal abscess
- normal healing process

A

subperiosteal abscess

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47
Q

MATCHING QUSESTION:
remember which pulpal diagnosis typically accompanies which apical diagnosis
- normal pulp, reversible pulpitis, irreversible pulpitis, necrotic pulp
- normal apical tissues, asymptomatic apical periodontitis, chronic apical abscess, symptomatic apical periodontitis

A

normal pulp –> normal apical tissues
reversible pulpitis –> asymptomatic apical periodontitis
irreversible pulpitis –> symptomatic apical periodontitis
necrotic pulp –> chronic apical abscess
these were the only answers and to me the most logical sequence, even though these are not the case every time. could only match one item on right with one item on left

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48
Q

Best location for an implant; best long term prognosis?
- mandibular anterior
- mandibular posterior
- maxillary anterior
- maxillary posterior

A

mandibular anterior (best bone)

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49
Q

Acid etching creates a chemical bond. True or false?

A

False-micromechanical

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50
Q

A periodontal pack stays in how long?
- 24 hrs
- 3 days
- 1 week
- 3 months

A

1 weeks
- periodontal dressing used to promote wound healing following flap surgery

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51
Q

In an effort to improve gingival health, temporary crowns should be:
- undercontoured
- overcontoured
- left short of the margin
- extended past the margin

A

UNDERcontoured; bulbous crowns are not good for the gingiva.

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52
Q

Name 5 disorders that have loss of lamina dura

A

hyperpituitarism
hyperparathyroidism
Paget’s
Fibrous dysplasia
osteomalacia

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53
Q

Adult patient with purple lesions on palate and said they had similar lesions on their body too. What is the most probable cause?
- Surge Weber
- Erthyema Multiforme
- HIV
- Malignant Melanoma

A

HIV - lesions are Kaposi sarcoma

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54
Q

Be able to identify vertical bone loss radiographically

A

Vertical Bone Loss

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55
Q

What would you prescribe fluconazole for?
- bacterial infection
- viral infection
- fungal infection

A

a fungal infection like Candida
- other antifungals: Nystatin, Clomtrimazole

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56
Q

How do you treat Addison’s disease?
- antibiotics
- acetaminophen
- corticisteroids
- atypical antipsychotics

A

Corticosteroids

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57
Q

Ortho case: what was the most important thing they did in the maxillary arch?
- close U and L diastemas
- align the teeth for future restorations
- adjust the occlusion for patient comfort
- promote movement of mandibular teeth

A

Alignment for future restorations (and hygiene)

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58
Q

Patient has a shunt on the left arm, where do you obtain blood pressure?
- wrist
- right arm
- neck
- finger

A

right arm
- patient is on dialysis, take BP on side shunt is NOT present

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59
Q

What is hemolytic anemia?
- autoimmune destruction of parietal cells in stomach
- genetic defect, includes variant of hemoglobin A (called hemoglobin S)
- RBCs destroyed, removed from bloodstream before normal lifespan is over
- Folic acid is deficient, patient presents w/neurologic symptoms

A

destruction of RBCs (think about it. hemo (RBC) lytic (destroy))

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60
Q

Worst cement for a deep restoration?
- Glass ionomer
- zinc phosphate
- composite resin
- RMGI

A

zinc phosphate

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61
Q

What is the main reason for periodontal flaps?
- visualize bone quality
- access for instrumentation
- greater surface field
increase primary wound healing

A

access for instrumentation

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62
Q

Large space (diastema) between #11 and #12. What do you do?
- place implant
- removable partial denture
- fixed partial denture (bridge)
- do nothing

A

let it be, let it be! let be, let it be… seriously, if it ain’t broke, don’t fix it.

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63
Q

Image of mx and md full arch crowns with erythematous gingiva. What might be the issue?
- impingement on gums
- hyperocclusion
- increased VDO

A

impingement on gums, gingival health

64
Q

In order to preserve biological width the crown margin must be ___mm above the alveolar crest
(fill in the blank)

A

2mm

65
Q

Hereditary Hemorrhagic Telangiectasia is associated with:
- B12 deficiency
- Pernicious anemia
- Iron deficiency
- hypertension

A

Iron Deficiency Anemia

66
Q

Guided tissue regeneration has the best prognosis in what kind of furcation?
- Class 1
- Class 2
- Class 3
- Class 4

A

Class 2 Furcal Defects

67
Q

When shade matching, you struggle with finding the right color. You should choose ____ shade saturation, and ____ gray
- higher, more
- lower, less
- higher, less
- lower, more

A

choose lower shade saturation and less gray

68
Q

Panorex shows a dome shaped radiopacity in the sinus. What is the likely diagnosis?
- mucous retention cyst
- squamous cell carcinoma
- osteoma
- ameloblastoma

A

Mucous Retention Cyst

69
Q

What does intrinsic factor do?
- allows iron to bind to hemoglobin
- prevents destruction on RBCs
- required for absorption of vit B12 from food

A

Required for the absorption of vitamin B12 from food

70
Q

What is the maximum amount of unsupported porcelain allowed/minimum thickness?
- 1.0mm
- 1.5mm
- 2.0mm
- 2.5mm

A

2.0 mm

71
Q

2 years after RCT, RL still present at apex
- monitor
- retreat

A

retreat
- indicates failed RCT

72
Q

What is a contraindication for anti-sialogue?
- glaucoma
- Addison’s
- HIV
- hypothyroidism

A

Glaucoma

73
Q

Periodontal disease and diabetes - what do we ACTUALLY know?
- clear relationship between severity of periodontitis and aspects of immune functioning in diabetes
- clear two-way relationship between degree of hyperglycemia and severity of periodontitis
- clear two-way relationship between periodontal inflammation and insulin levels
- Nothing

A

“glucose level increased “
- clear two-way relationship between degree of hyperglycemia and severity of periodontitis(There is a clear relationship between degree of hyperglycemia and severity of periodontitis. The mechanisms that underpin the links between these two conditions are not completely understood, but involve aspects of immune functioning, neutrophil activity, and cytokine biology. There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycemic control.)

74
Q

Be able to identify a pleomorphic adenoma

A

common benign salivary gland tumor; most common tumor of the parotid gland
- key word: firm and benign; parotid or palate; if located “in front of” or anterior to” ear –> parotid pleomorphic adenoma

75
Q

A patient was diagnosed with Hepatitis A, presentation of jaundice. How soon can you treat?
- 1 day
- 1 week
- 1 month
- 1 year

A

1 week

76
Q

Radiolucency next to a premolar on a radiograph. What should you do?
- incision and drainage
- refer to oral surgery
- refer to endodontist
- leave it alone

A

refer to OMFS
- will be obvious that it is not the mental foramen or endodontic lesion

77
Q

Image of leukoplakia in the vestibule, appears to be consistent with tobacco use

A

confirm by asking patient

78
Q

The minimum axial reduction for a crown is:
- 0.5mm
- 1.0mm
- 1.5mm
- 2.0mm

A

1.5 mm

79
Q

Name the drugs that induce hyperplasia

A

calcium channel blockers, cyclosporines, anticonvulsants, immunosuppressants
- nifedipine, amlodipine, phenytoin, sodium valproate, phenobarbitone, ethosuximide

80
Q

Identify the mental ridge on radiograph

A

typically shows a periapical radiograph with a radiopaque line underneath the anterior teeth

81
Q

Patient presents with pain on swallowing when wearing their mandibular partial denture. All signs point to….
- TMJ disorder
- overextension of the lingual flange
- increased ridge resorption

A

overextension of the lingual flange.
- difficulty swallowing can also be attributed to excessive VDO

82
Q

Image of a perio probe inserted at the facial surface, angle about 75 degrees (less than 90, but more than 40) to the long axis of the tooth. this is…
- correct angulation for measuring the height of contour
- correct angulation to measure the pocket depth
- incorrect placement/angulation

A

incorrect placement/angulation

83
Q

Zinc phosphate is the worst cement for what type of restoration?
- Class V
- Deep caries
- Shallow caries

A

deep caries (zinc phosphate is know for pulpal irritation)

84
Q

Coronal portion of canine broken, what do you do?
- conservative endo, post and core
- immediate extraction
- composite build up

A

conservative endo, post and core

85
Q

Worst location for an implant?
- mandibular anterior
- mandibular posterior
- maxillary anterior
- maxillary posterior

A

maxillary posterior (due to bone type)

86
Q

Patient arrives with lesion anterior to the earlobe, swelling present. The Stenson’s duct also appears inflamed. What do you check first?
- stimulate the parotid and check for exudate
- immediately refer to oral surgery
- excisional biopsy
- inform pt that this is normal and the swelling will subside

A

Stimulate the parotid gland and check for exudate

87
Q

When preparing a tooth your goal is:
- minimal taper
- maximal taper

A

minimal taper
- conserve tooth structure, adequate retention, proper draw

88
Q

Minimum recommended occlusal reduction for a PFM crown
- 0.5mm
- 1mm
- 1.5mm
- 2mm

A

2.0 mm

89
Q

Pt presents with shallow ulcerated lesion on the lower lip that has been present for several months. Has been a farmer for several years. Likely diagnosis?
- squamous cell carcinoma
- traumatic burn
- apthous ulcer
- mucocele

A

Squamous cell carcinoma
- ALWAYS pay attention to medical history. Knowing that he is a farmer, you know that he spends the majority of his time in the sun; also knowing that the lesion has been present for an extended time (my question stem mentioned several months). SCC is more common on the lower lip vs upper lip.

90
Q

What is the minimum occlusal reduction for a crown prep on an anterior incisor (specifically #9)?
- 1.0mm
- 1.5mm
- 2.0mm
- 2.5mm

A

2mm minimum incisal reduction

91
Q

All of the following are symptoms of hyperthyroidism except:
- fatigue
- exopthalamus
- tachycardia
- tremor of extremities

A

fatigue is NOT a symptom
symptoms include:
nervousness, anxiety and irritability.
hyperactivity - you may find it hard to stay still and have a lot of nervous energy.
mood swings.
difficulty sleeping.
feeling tired all the time.
sensitivity to heat.
muscle weakness.
diarrhoea.

92
Q

Picture of a dentures showing the working side. In an excursive movement, even contact appears across the teeth, no canine guidance
- lateral movements are good
- incorrect, no canine guidance
- incorrect, no group function

A

lateral movements are good

93
Q

Fractured distal marginal ridge, large amalgam restoration. How should you treat?
- replace with composite
- replace with new amalgam
- cast restoration
- leave alone

A

cast restoration

94
Q

Identify:
- mucocele
- ranula
- fibroma
- papilloma
- thermal injury
- SCC
- cold sore (herpes)

A
  • mucocele - bluish, swollen salivary gland
  • ranula - mucocele but on the floor of the mouth
  • fibroma - benign scar-like reaction to constant irritation/trauma
  • papilloma - wartlike lesion; likely positive hx of HPV
  • thermal injury - hx of hot food/drink; sudden occurence
  • SCC - shallow, ulcerated lesion
  • cold sore (herpes)
95
Q

Pernicious anemia is associated with:
- autoimmune destruction of parietal cells in stomach
- acute, chronic blood loss
- both

A

remember that pernicious anemia is associated with intrinsic factor from parietal cells, which is required to absorb B12 from food

96
Q

Patient complaining of space between teeth after an SRP?
- removal of tooth structure during SRP
- tooth movement is normal following SRP
- reduction in edematous tissue
- cause is unknown

A

Reduction of edematous tissue causing appearance of black triangle

97
Q

How could you reduce radiation dosage for conventional film radiographs? (select 2)
- use speed D film
- increase KvP
- Use E or F speed film
- Use a round collimator

A

E-speed film
increase KvP
- rectangular collimation reduces radiation dosage

98
Q

Image of a red, painful tongue in an uncontrolled diabetic. What is the likely diagnosis?
- malnutrition
- median rhomboid glossitis
- benign migratory glossitis

A

Malnutrition

99
Q

Once thought to be associated with BLUE SCLERA and multiple bone fractures
- hemolytic anemia
- grave’s disease
- pernicious anemia
- dentinogenesis imperfecta

A

dentinogenesis imperfecta
- question stem refers to a picture of blue sclera

100
Q

What changes for medications as we age?

A

Medications do not last ass long because less lipid solubility in elderly

101
Q

Permanent eruption sequence

A
102
Q

Picture of a patient with a very large diastema, what do you do??
- implant
- removable partial denture
- fixed partial denture
- leave it alone

A

leave it alone

103
Q

How would you INITIALLY treat a lateral periodontal abscess?
- irrigate
- incision and drainage
- obturate
- debridement

A

Debridement

104
Q

The most important treatment for ANUG is?
- antibiotics: chlorohexidine rinse
- debridement
- patient understanding the importance of oral hygiene
- explaining to the patient the link between oral health and systemic health

A

debridement - take away the disease causing factor. educating the patient is important too

105
Q

As required by OSHA, the autoclave is checked…
- daily
- weekly
- bi-weekly
- annually

A

weekly spore testing

106
Q

Which disease will affect denture wearer’s the most?
- Sjogren’s
- hypothyroidism
- Gardner’s
- Cushing’s

A

Sjogren’s - due to xerostomia
- Remember that Paget’s can also cause ill-fitting dentures

107
Q

(Very grainy) picture of #10 and #11, lingual surfaces. What is wrong with the gingiva?
- edema
- artifact
- squamous cell carcinoma

A

edema - enlargement of marginal and interproximal gingiva; smooth shiny surface, loss of stippling, diffuse redness

108
Q

Picture of the bottom of the tongue with multiple white lesions. Stated that the patient had complaint of sore gums and tongue, he had a fever of 101 degrees.Most likely diagnosis?
- Primary Herpetic Stomatitis
- Secondary Herpetic Stomatitis
- Herpangia
- Recurrent Apthous Stomatitis

A

primary herpetic stomatitis, treat with palliative care

109
Q

Surgical stent fits the gums but the immediate denture doesn’t fit, what do you do?
- re-construct the surgical stent
- re-construct the immediate denture
- relieve it until it seats

A

Relieve until it seats

110
Q

1-2mm reduction of probe depth after SRP. What caused this?
- deposition of alveolar bone
- reattachment
- formation of long junctional epithelium

A

formation of long junctional epithelium

111
Q

Which presentation is gingivectomy indicated for?
- gingival hypertrophy
- gingival hyperplasia
- gingival recession
- hemostasis

A

gingial hyperplasia

112
Q

Radiographs with many well-demarcated PARLs. What’s next?
- initiate RCT
- endodontic testing
- incision and drainage
- extract

A

endo testing
- don’t perform RCT or ext without confirming diagnosis. Radiographic hard tissue lesions may be benign

113
Q

Before trimming teeth on stone cast for immediate denture you must…
- mark a line 3mm above the free gingival margin
- nothing
- survey the remaining teeth

A

mark a line 3mm above the free gingival margin

114
Q

2 months after an RCT a RL is still present. How do you proceed?
- monitor
- retreat

A

monitor
- can take up to a year for bone to heal

115
Q

Another version Pernicious anemia is caused by:
- Decrease in intrinsic factor (required for absorption of B12)
- Chronic use of aspirin, NSAIDs, corticosteroids
- A variant of hemoglobin A (called hemoglobin S)
- Destruction of RBCs

A

decrease in intrinsic factor
- Schilling’s test to evaluate B12 absorption; most commonly used to eval pts w/pernicious anemia

116
Q

What pain reliever do you give to a patient with kidney disease?
- aspirin
- acetaminophen
- morphine
- naproxen

A

acetaminophen

117
Q

Panoramic radiograph with radiopacity below mandibular incisors. What is the likely condition?
- odontoma
- impacted incisor/canine
- supernumerary tooth
- osteoma

A

impacted tooth
- verify all teeth are present, if primary tooth is present without succedaneous, impacted tooth is likely.
- I had a lot of odontoma questions; look for ‘mini teeth’ in the radiopaque mass to diagnose compound odontomas

118
Q

Recognize Angles Class 2 division 2

A

Mx incisors inclined palatally

119
Q

How wide should the bur for a post be?
- no greater than 1/3 the diameter of the root
- at least 1/3 or greater the diameter of the root
- no greater than 1/2 the diameter of the root
- at least 1/2 or greater than the diameter of the root

A

no greater than 1/3rd the diameter of the root
- the ideal post is at least as long as the crown

120
Q

A baby or toddler presents with severe caries. What is the likely cause?
- baby bottle caries
- hypoplasia
- genetics

A

bottle rot/baby bottle caries

121
Q

Radiographic identification of a crater defect

A

crater = two wall defect

122
Q

Treatment plan for patient with a liver clot?
- antibiotic prescription
- irrigate
- apply pressure, re-assess
- two of the above

A

irrigate, apply pressure, reassess
- liver clot: unstable, large, friable clot commonly forming in mucous membranes; lead to excessive bleeding and abnormal wound healing
- it looks like a mini liver… but in your mouth. #thatswhatshesaid ?

123
Q

Panoramic with black dots and lines that are not related to anatomy. what could have caused this?
- movement
- static electricity
- improper developer solution

A

static electricity

124
Q

Using patient photos, how much attached gingiva is present on lingual of #27?
- 0mm
- 5mm
- 9mm
- 12mm

A

5mm

125
Q

Gingival edema is caused by?
- aerobic bacteria
- anaerobic bacteria
- forces

A

anaerobic bacteria

126
Q

1 present w/class III mobility, furcal involvement; #2 and #3 are missing. best way to restore?

  • fixed bridge #1-4
  • place two implant-supported crowns for #2 and #3; frequent recall to re-eval #1
  • ext#1; implants for #2, #3, or both
A

ext#1, implants for 2, 3, or both
- #1 has hopeless prognosis

127
Q

Pt presents with white lesion, lateral anterior tongue. History of trauma (continuously biting it, ect). Resembled a papillary lesion.
- papilloma
- fibroma
- squamous cell carcinoma

A

Use your best judgement. History of trauma leads to fibroma diagnosis; but medical history may lead to papilloma. If described as “cauliflower” assume papilloma!

128
Q

What is an advantage of a Maryland bridge?
- staining
- debonding
- fracture
- less tooth reduction

A

less tooth reduxtion

129
Q

Contraindication for apically positioned flap?
- difficulty
- esthetics
- no/minimal history of root caries

A

esthetics

130
Q

Space between mandibular premolar and molar in an older patient, #31 and #32 are not present, barely in occlusion w/#3. Why is this happening?
- supraeruption
- mesially drifting premolars
- malignant growth

A

likely caused by mesially drifiting premolars
- this one is hard to visualize… but knowing this is an older patient makes you think mesial drift. Also, the occlusion w/#3 is preventing #30 from moving mesially (it is tipped)

131
Q

Medication taken for arthritis?
- propranolol
- benadryl
- naproxen
- aleve

A

Naproxen

132
Q

Orthodontic appliance on maxillary arch, over palate. Wires contacting lingual of teeth and palate. What is the appliance doing?
- lingualizing the teeth
- alignment
- tipping the teeth
- palatal expansion

A

tipping the teeth
- the image makes it obvious that the appliance is applying pressure to the lingual surfaces of the teeth, which will not create palatal (boney) expansion, but will allow for tipping of the teeth

133
Q

Hereditary telegnastia is associated with…
- Vitamin B12 deficiency
- iron deficiency
- low RBC

A

iron deficiency

134
Q

What is the purpose of dialysis?
- prevent myocardial infarction
- prevent cerebrovascular incident
- remove potential toxicities from the blood

A

remove potential toxicities from the blood

135
Q

After SRP, a reduction in probing depth has occurred but there is still mobility in anterior teeth on the mandible. How do you treat?
- splint teeth together for stability
- immediate endo
- immediate extraction
- re-evaluate at next visit

A

periodic evaluations
- do not need to splint

136
Q

Mandibular incisor with a large pulp chamber and PARL. What caused the enlarged chamber?
- external resorption
- dentinogenesis imperfecta
- trauma soon after eruption
- osteogenesis imperfecta

A

trauma soon after eruption

137
Q

Patient complains of swellings that occur on the lateral side of the tongue, but only during illness. Swellings are located at the posterior most, lateral portion of the tongue. How do you treat?

A

reassure patient and re-evaluate
- lingual tonsils

138
Q

Several spots with yellowish concave areas in cervical 1/3rd of anterior teeth. Likely cause?
- erosion
- abfraction
- hypoplasia
- hyperplasia

A

Facial erosion due to acidic beverages

139
Q

Patient returns with pain 72 hours after extraction, what should you do?
- tell them its normal to still feel pain
- irrigate and place eugenol soaked gauze
- open the wound and curette any remaining bone pieces
- refer them to emergency room

A

irrigate and place eugenol soaked gauze
- alveolar osteitis

140
Q

Name three symptoms of sickle cell anemia

A

excessive fatigue
increased marrow space
reduced trabeculations

141
Q

Before relining a complete denture, you must first establish:
- anterior guidance
- maximum intercuspation position
- posterior occlusion
- centric relation

A

posterior occlusion

142
Q

White lesion present on buccal mucosa. Likely diagnosis?
- leukoedema
- cheek biting
- lichen planus
- squamous cell carcinoma

A

lichen planus
- white lesion can be describe as Wickham striae

143
Q

Drugs that may have increased chance of periodontal destruction
- “-statin”
- “-olol”
- “-ipril”
- Amlodipine

A

put Amlodipine (gingival hyperplasia,
- statins have actually been shown to improve periodontal treatment outcomes due to the osteoblastic activity induced

144
Q

Pt presents, upset with look of with canine and premolar area; spotted (pick up stains), pits and grooves on outer surface of teeth. Likely diagnosis
- hypoplasia
- hyperplasia
- abfraction
- erosion

A

hypoplasia; consider that fact it is localized, likely not related to systemic disease

145
Q

Diagnose amelogenesis imperfecta radiographically

A
  • smaller than normal teeth
  • yellow or brown discoloration
  • teeth prone to damage, breakage
  • sensitive teeth
  • open bite malocclusion
  • minimal to no enamel visible radiographically
146
Q

Large maxillary torus in denture patient causing ill-fitting dentures. How would you treat?
- remove
- leave alone
- remove that section from denture base

A

Remove Torus

147
Q

After placement of an immediate denture, how long should you wait to do a lab reline?
- anytime
- 1 week
- 6 months
- 1 year

A

6 months
- allow tissue healing; conditioning/in office soft relines can be done any time

148
Q

After a cleaning, BOP is still present. Why?
- probing too hard
- retained subgingival plaque
- this is normal

A

retained subgingival plaque
- failed to remove disease causing agent

149
Q

Arrows pointing to soft tissue mass on FOM, base of tongue. This is the opening of what?
- Stenson’s duct
- sublingual salivary gland
- Wharton’s duct

A

Wharton’s duct; submandibular duct

150
Q

Recognize Angles Class 2 division 1

A

flared mx incisors w/class II occlusion

151
Q

27 had root canal and there is a bridge from #27 to #25; What is the radiolucency? (RL not at #25, no apparent apex involved)

  • endodontic lesion
  • cyst
  • possible non-odontogenic lesion, re-evaluate at later date
A

Nothing to do with #25, not a failed RCT on #27, re-evaluate in 3 months, or chronic cyst in between #25-#27
- remembered question, I did not have this one personally…

152
Q

Pt presents with missing teeth and no hair. What is the likely medical condition?
- Gardner’s disease
- ectodermal dysplasia
- trisomy 21
- Paget’s syndrome

A

Ectodermal Dysplasia

153
Q

Diagnose dentinogenesis imperfecta radiographically

A
  • bulbous crowns
  • cervical constriction
  • thin roots
  • early obliteration of root canals and pulp chambers
154
Q

Tongue lesion is diagnosed as lichen planus. Lesion is asymptomatic, how do you treat?
- antifungal
- corticosteroids
- antibacterial
- chlorhexidine rinse

A

corticosteroids (there was no option for do nothing)

155
Q

Swollen lesion on the tongue, what do you do next?
- Refer to oral surgery
- Palpate the lesion and see if its firm
- Biopsy
- Refer to oral pathology

A

Palpate the lesion to see if it is firm

156
Q

Lesion in the mouth that heals with a scar?
- Primary Herpes Labialis
- Minor Apthous Ulcer
- Major Apthous Ulcer
- Recurrent Herpes Stomatitis

A

major apthous ulcer
- minor ulcers heal without scarring

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