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Little black book notes Flashcards

1
Q

What inheritance pattern does haemophilia follow?

A

Sex linked recessive

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2
Q

What are two weaknesses of DOACS

A

They have no standardised testing for monitoring
They have no antidote

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3
Q

If a patient presents to you and in their medical history they are taking, metaforamin, dapagliflozin and sulfonylureas. What might this suggest to you

A

This is triple therapy medication for a patient with diabetes, this suggests that it is a challenge to keep this patients diabetes under control

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4
Q

Patient presents to you complaining of ‘’ white patch on their palate, it can be scraped off but leaves a bleeding base when removed’’
What could this be and how would you manage it

A

Pseudomembranous candidiosis

Denture hygiene should be observed - denture should be removed at night
Toothbrush and gauze to clean the palate

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5
Q

What two medications are contraindicated for miconazole and what should be prescribed instead

A

Warfarin and statins

These patients should instead be prescribed nyastatin

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6
Q

You are examining a patient and while carrying out their intra-oral exam you note that the mucosa is continuously getting stuck to the mirror, that there are food residues left in the oral cavity and that their is a frothiness of the patients saliva

What condition could this raise suspicion of

A

Sjrogens syndrome

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7
Q

What is the minimum temperature and time for the sterilisers in the LDU

A

134-137 degrees for minimum of 3 minutes

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8
Q

Why may it be a good idea to make someone with pseudomebranous candidosis a new denture

A

Candidal species have the ability to penetrate acrylic dentures

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9
Q

Why are the ultrasonic baths degassed at the start of each day and at each water change

A

This is to get rid of airbubbles to prevent interference as this will reduce the efficacy of cleaning

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10
Q

Why might someone with COPD have polycythaemia ( high Hg)

A

This is because these patients are hypoxic for long, this then induces erythropoietin realease from the kidney and therefor an increase in red blood cell production

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11
Q

What are causes of micro cytic anaemia

A

Iron deficiecey
Thalassemia

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12
Q

B12/folate defiency results in what kind of anaemia

A

Macro cytic

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13
Q

Name 3 reasons that a radiographic film image may be pale

A

Film was removed from the solution to early
Solution was too cold
Solution was too dilute

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14
Q

What is the difference between IRR17 and IRMER17 and who enforces each

A

IRR17 - deals with the occupational exposure of the general public
Enforced by health and safety officer

IRMER17 - deals with the medical exposure of the patient
Enforced by heath improvement Scotland

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15
Q

If you were wanting to send away to the lab for bacteria present in a patient with gingivitis how would you do that

A

Paper point to swab the subgingival plaque- from the base of the periodontal pocket

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16
Q

Which kind of Candida is resistant to fluconazole and what should b prescribed instead

A

Candida Glabrata

Nyastatin should be given

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17
Q

What is the bacteria present in endodotnic infections and how does this differ between primary and secondary infections

A

Enterococcus faecalis
In primary it is gram negative bacteria and in secondary it is grampostiove

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18
Q

What are the microbial stages of caries

A

Adhesion
Survival and growth
Biofilm formation
Complex plaque
Acid
Caries

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19
Q

If a dentist is to consent for a patient without capacity under act 47 of adults with incapacity they must adhere to 5 principles
What are these

A

Intervention must benefit the adult
Must be the least invasive option
Have regard to the adults past wishes
Take into account the wishes of the adults closest relatives, primary caregivers
Encourage participation of the adult as much as possible - residual capacity

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20
Q

In accordance with Andrew’s 6 keys of occlusion what should the molar relationship be

A

Distal surface of the distobuccal cusp of the upper 6s occludes with the mesial. Surface of the mesiobuccal cusp of the lower second molar

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21
Q

What are the occlusal effects of a digit sucking habit

A

Proclination of the upper incisors
Retroclination of lower incisors
Localised AOB
Narrow upper arch and/or unilateral postieor cross bite

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22
Q

How would you manage a patient that has a digit sucking habit

A

Positive reinforcement
Bitter nail polish o the nails
Glove on hand
Habit breaker appliance - such as a URA with goal post

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23
Q

What things would you be looking for when assessing a RCT on a radiograph

A

Coronal seal
Well condensed
Continuously tapering
Within 1-2mm of apex
No apical pathology

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24
Q

What is the ideal core design for MCC

A

6 degree taper
2mm clearance for MCC

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25
Q

What are the three ideal features for post design

A

Parallel - prevents wedging and fracture
Non threaded - avoids stresses
Cement retained - buffer between masticatory forces and tooth

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26
Q

What is a ferrule

A

1.5mm of circumferential Dentine above the gingivae

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27
Q

How much GP should be left apically in post core crow prep

A

3-5mm

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28
Q

In lateral cephalometric radiographs the SNA angle relates the maxilla to the anterior cranial base
What is the average value for this

A

81 degrees (+/-3)

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29
Q

In lateral cephalometric radiographs the SNB angle relates the mandible to anterior cranial base what is the average value for this

A

78 degrees (+/-3)

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30
Q

In lateral cephalometric radiographs the ANB angle relates the mandible to the maxilla what is the average value for this

A

3(+/-2)0

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31
Q

Patients ceph radiograph states that there SNA angle is average, there SNB angle is decreased and that they have a ANB angle of >5
What skeletal class would you expect this patient to be

A

Class 2

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32
Q

Patients ceph radiograph states that there SNA angle is decreased, there SNB angle is average and that they have a ANB angle of <1
What skeletal class would you expect this patient to be

A

Class 3

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33
Q

What the two ways that vertical sketel relationship can be measured

A

Frankfort Mandibular plane angle
Assessment of lower face height

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34
Q

What is the average value for the Frankfort mandibular plane angle

A

27(+/-4)

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35
Q

What on average is the LAFH-TAFH in lateral cephalometric radiographs

A

55%

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36
Q

What is the gold standard for restoration of posteior teeth

A

Cuspal protection restoration

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37
Q

What are the three methods of debridement

A

Physical
Irrigation
Suction

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38
Q

Name 4 types of sutures

A

Resorable monofilament - monocryl
Resorable polyfilament - vicryl rapide
Non Resorable monofilament - prolene
Non Resorable polyfilament - mersilk

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39
Q

What kind of bur must be used for bone removal and why

A

An electric straight hand piece with an saline cooled bur
This is because air turbines cannot be used as they will blow air into the tissues and create surgical emphysema which can be life threatening

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40
Q

What is the origin and insertion of the temporalis muscle

A

O - temporal fossa
I - coronal process of the mandible and anterior border of the ramus

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41
Q

What is the origin and insertion of the masseter muscle

A

O - maxillary process of zygomatic bone and inferior border of zygomatic arch
I - angle and lateral surface of ramus of mandible

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42
Q

The medial ptergygoid muscle has to heads a deep and superficial.
Name both the origins and insertions of each - the insetion is the same

A

Deep
- O = medial surface of lateral pterygoid plate
- I = medial surface of ramus and angle of the mandible

Superficial
- O = maxillary tuberosity and pyramidal process of the palate bone
- I = medial surface of rammed and angle of mandible

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43
Q

The lateral ptergyoid muscle has two head, an upper and lower what are the origins of each and the insetion of both

A

upper - infratemporal fossa of greater wing of spehnoid
lower - lateral surface of lateral pterygoid plate

They both insert into the front of neck of mandible

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44
Q

What is the function difference of the intrinsic and extrinsic muscles of the tongue

A

Intrinsic - alter shape of the tongue
Extrinsic - alter postion of the tongue

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45
Q

Which extrinsic muscle of the tongue is the only one that protrudes the tongue

A

genioglossus

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46
Q

Where are the intrinsic and extrinsic muscles of the tongue separated

A

the saggital septum

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47
Q

All muscles of the tongue recieve motor innervation from the hypoglossal nerve, which is the only muscle that does not?
where does that muscle recieve its motor nerve supply

A

Palatoglossus and it comes from the vagus nerve

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48
Q

The general sensation of the tongue is split into anterior 2/3 and posterior 1/3, which two nerves supply each

A

Anterior 2/3 is supplied by the lingual branch of the trigeminal nerve
Posterior 1/3 by the lingual branch of glossophanrygeal nerve

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49
Q

Like general sensation supply the special sensation is also split into anterior 2/3 and posterior 2/3 - what nerve supplies each section

A

Anterior 2/3 - Facial nerve via the chorda tympani
posterior 1/3 - lingual branch of glossopharyngeal

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50
Q

You are working in general practice and a child presents to your surgery with a root fracture.
On examination the coronal fragment is displaced excessively mobile and causing occlusal interference.
What are the two treatment options

A

1- Extract coronal fragment, apical fragment should be left in place to be resorbed
2 - Gently reposition the loose fragment, if unstable in its new position then can SPLINT with flexible splint for 4 weeks

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51
Q

What is the difference in the formulas of the filling materials of GI and RMGIC and there cement forms

A

In both GI and RMGIC there cemet forms contain a smaller particle size

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52
Q

RMGIC contains HEMA, what is a potential problem with HEMA

A

HEMA is cytotoxic and irritatant to the pulp - therefore it is essential that no monomer remains

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53
Q

What is porcelain etched with and why

A

Hydrofluroic acid - to roughen and make the surface more retentive

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54
Q

Patient presents to your surgery. During initial consultation you learn that the patient is in their early twenties, is a smoker and is currently going through an exam period at university.
On examination you find that marginal gingival ulceration with loss of interdental papillae and grey sloughing on top of the ulcers

what is the provisional diagnosis and managment

A

Acute necrotising ulcerative gingivitis

  • debridement
  • 0.2% chlorohexdine 2xdaily
  • OHI, smoking cessation
  • review in 10 days - continue PMPR

If there is systemic involvement
- metronidazole 200mg 3xdaily for 3 days

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55
Q

What is the difference in crown prep for procelain and metal ceramic crowns

A

In a porcelain crown there is a shoulder margin
In a metal ceramic crown there is a chamfer margin

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56
Q

What are the components of GP

A

Zinc
Rubber
Resin
Barium Sulphate - makes It radiopaque

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57
Q

Name three reasons for obturating

A

To create an apical seal
To provide a physical barrier that prevents microorganisms and other bacteria entering root Canal system
Seals in any microorganisms that are left behind in root canal system

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58
Q

What is the purpose of sealer in RCT

A

Acts as a lubricant
Seals space between GP points
Seals space between wall and dentine core
Seals lateral cancels

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59
Q

What are 4 advantages of an upper removable appliance

A

Excellent anchorage
Shorter chairside time
Oral hygiene is easier to maintain
Non destructive to the tooth surface

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60
Q

What is the maximum percentage of hydrogen peroxide in home bleaching

A

6%

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61
Q

What are the functions of posterior palatal seal

A

Aids in retention
prevents food accumulation
compensation for polymerisation shrinkage
reduces tenancy for gag reflex as it prevents the formation of gap between the denture case and the soft palate during functional movement

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62
Q

What are the stress bearing areas in the maxilla

A

Hard palate
residual alveolar ridge

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63
Q

What are the stress bearing areas in the mandible

A

Buccal Shelf and residual alveolar ridge

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64
Q

What is the best material to use to restore root caries and why

A

Glass ionomer

This is because glass ionomer does not cause pulpal irritantion, it contains 20% fluoride release
It is anticarciogenic and antibacterial

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65
Q

State 4 surgical principles

A

Maximal access with minimal trauma
Use scalpel in one continuous stroke
Minimal trauma to the dental papillae
Keep tissue moist - irrigate while working

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66
Q

What is the main blood supply of the tongue

A

The lingual artery

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67
Q

Which nerve does the chorda tympani join onto and where does this happen

A

The chorda tympani joins the lingual nerve and this happens in the infratemporal fossa

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68
Q

You are working in general practice and a child presents to you with a complicated crown fracture following trauma.
What is your management?

A

Make sure that in trauma history location of tooth and fragments is accounted for

Preserve the pulp via a pulpotomy
Non setting CaOH should be applied over the exposed pulp and then GI covered and then sealed with a restoration

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69
Q

What are 4 effects on the permanent tooth from trauma

A

Failure to erupt
White or brown discolouration
Crown dilatercation
Disturbance in eruption

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70
Q

Why is CaOH effective to place over an exposed pulp

A

CaOH has a ph of 12-14 so it has chemical properties which cause the formation of tertiary dentine so this then rebuilds the dentine between the pulp and the resotivtaive material so that the pulp is able to stay heathy and reduces need for RCT

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71
Q

What is used to record the distance between the condoles

A

Face bow

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72
Q

What is a rotation movement of the mandible

A

This is when there is a small amount of mouth opening up to 20mm
The condyle and the articulate disc remain in the fossa
There is no downwards to forwards movement

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73
Q

During the bennet movement ( lateral translation) what stops the movment going to far to one side

A

Bony wall of the glenoid fossa

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74
Q

What is posselts envelope

A

The extreme mandibular movements.

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75
Q

Which plane is posselts envelope in

A

The saggital plane

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76
Q

During protrusion of the mandible there should be no posterior contact, if there is what is this called

A

Protrusive interference

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77
Q

What is the bennet angle

A

This is the path of the non working condyle in the horizontal plane during lateral excursion

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78
Q

What are 4 things that are present in a mutually protected occlusion

A

Canine guidance
Poster dissoclusion
No non working or working side contacts
No protrusive interference

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79
Q

Why do we want to avoid posterior contact during dynamic movment

A

We want free way space during dynamic movment

If the posterior teeth are always in contact the muscles will become tired and painful

80
Q

What is fremitus

A

This is a type of occlusal trauma

Increased movement of teeth when subjected to occlusal forces

81
Q

What is the difference between and overjet and overbite

A

Overjet - is the horizontal overlap of the teeth
Overbite - is the vertical overlap of the teeth

82
Q

What kind of dynamic movment is often seen in toothwear

A

Bilateral group function

83
Q

Define cross bite

A

One of more teeth abnormally positioned buccally/lingually or labially

84
Q

What are the two types of bruxism

A

Centric - clenching
Eccentric - para functional grinding

85
Q

A child has an early loss of there ‘e’s what must we do

A

This requires a space maintainer because if not the 6 will drift mesially and block the eruption of the 5s

86
Q

If there is early loss of deciduous ‘c’s do we use balance or compensating extractions

A

We balance when extracting ‘c’s to prevent a midline short

87
Q

Define interceptive ortho

A

Interceptive ortho is any procedure that will reduce or eliminate the severity of a malocclusion

88
Q

What is Lee-way space

A

Lee- way space is the extra mesio-distal space occupied by the primary molars to accommodate for the permanent premolars.

Maxilla = 1.5mm
Mandible =2.5mm

89
Q

10% of all desicious molars become infraoccluded - why does this happen

A

This happens because there is ankylosis of the primary tooth
The bone continues to grow around it and the primary tooth gets left behind

90
Q

What kind of percussion note would come from an infraocluded tooth

A

Dull

91
Q

What are 4 reasons that we want to treat increased overjet early

A

Trauma risk
Incompetent lips
Appearance - self esteem/bullying
Difficult to achieve correction once stopped growing

92
Q

For growth of both the maxilla and the mandible, out of height length and width what stops growing first

A

Width is completed before the pubertal growth spurt

93
Q

What are the three endo design objectives

A

Create a continuously tapering funnel shape
Maintain apical foramen in original position
Keep apical opening as small as possible

94
Q

What prob be can be used in endo to explore pulp chamber and identify orifices

A

DG16 - double ended probe

95
Q

How do you determine CWL

A

Pass 10 file into canal and advance to EWL
Take apex locator and using a watch winding motion until a ‘0’ reading
This is the PDL
Measure the file and subtract 1mm
This is the corrected working length

96
Q

What is estimated working length

A

This is the length at which instrumentation should be
Obtained by measure prep radiograph distance between coronal reference point and radiographic apex then subtract 1

97
Q

What is the master apical file

A

This is the largest diameter file taken to working length and therefore represents the final prepared size of the canal of apical proton of canal at WL

98
Q

Name 4 functions of irrigation

A

Dissolves organic debris
Disinfects canal
Lubricates canal
Removes debris from prep

99
Q

What is the function of EDTA in endo prep

A

Removes smear layer

100
Q

What are the three components of SDF

A

Fluoride 44,800ppm
Ammonia
Silver

101
Q

Why is SDF useful as a caries detection agent

A

This is because is stains Carious lesions permanently black but does not have an effect on sound enamel

102
Q

What is sialadenitis

A

This is inflammation of the salivary glands, this can happen in xerostomia

It can look like mumps and it happen as the salivary glands are over working due to the lack of saliva

103
Q

What is unusual about the presentation of radiation induced caries

A

They tend to present on the cerival margins and incisal edges

104
Q

What condition might pentoxyfyllne and vitamin E be considered for the prevention of

A

Osteo-radionecrosis

Encourages blood vessels healing, protects healing and reduces inflammation

105
Q

What are two characteristics of biofilm ECM that makes it resistance to anti-microbial

A

Traps and binds antimicrobial agents preventing them getting to the cell
Creates a low nutrient/. Low 02envirment that allows bacteria to evade the effect of anti-microbial

Glycocalyx

106
Q

What is key info that must be on a waste transfer note and how long must the hazourdous waste register be kept

A

Description of waste
Orgin of waste
Quantity of waste
Transport destination

3 years

107
Q

What are 3 aims of suturing

A

Approximate tissues, compress blood vessels and cover bone
Prevent wound breakdown and achieve haemostatis
Prevent enters of forgein bodes

108
Q

Three aims of flap deign

A

Good access
Adequate vision
Maintance of good vascular supply
Good aesthetic outcome

109
Q

Patient comes to your surgery following an extraction. From the history the patient tells you ;
They have a pain worse than toothache that is keeping them up at night,
It is a dull achy pain that is radiating to thier ear
They have a bad taste in their mouth and they fell as low it smells

What is your provisional diagnosis

A

Alveolar osteitis (dry socket)

110
Q

Following a diagnosis of dry socket what is your management of this patient

A

Supportive management first - you must reassure the patient that the wrong tooth has not been extracted and advise analgesia
Provide the patient with LA and irrigate with saline in the area.
Begin debridement on the area to encourage clot formation
Can provide an antiseptic pack

111
Q

What histological feature of oral antral fistula prevents it from closing

A

It is epithelial lined e

112
Q

What are post operative instructions for someone with an oral antral communication

A

No nose blowing
Don’t Drink through a straw
Sneeze with mouth open so not to create pressure

113
Q

After how long does an oral antral communication then become a fistula

A

6 weeks

114
Q

What is osteomyltitis

A

This is invasion of the bacteria into the cancellous bone which causes soft tissue inflammation and oedema in the closed bone marrow space

115
Q

Why is osteomyltis more common in the mandible than in the maxilla

A

This is because the the mandibles primary blood supply id from the inferior alveolar artery whereas the maxilla has a rich blood supply

116
Q

Radiographic appearance of osteomyelitis may take 10/12 days to appear, what may it look like

A

Increased radioluney with a ‘’moth like’’ appearance

117
Q

How many weeks of not healing until you suspect a patient has MRONJ

A

8 weeks

118
Q

Why do bisphosphoantes lead to MRONJ

A

They inhibit osteoclasts activity so inhibit bone resorption and therefore bone renewal

119
Q

What are the three special considerations for infective endocarditis prophylaxis

A

Patients with previous endocarditis
Patients with a prosthetic valve
Patients with a congenital heart disease

120
Q

What do you use to achieve haemostatis in pulptomy and why

A

Ferric sulphate
It controls pulpal bleeding and prompts formation of clot over radicular pulp

121
Q

State three reasons why you may make replica dentures

A

A spare set of satisfactory dentures
An elderly patient who has worn satisfacotry dentures for many years
Replacing immediate dentures

122
Q

What is the neutral zone in the maxilla

A

The neutral zone is a specific area where the functions the musculature will not unseat the denture and the forces of the tongue are neutralised by forces generated by the lips and cheeks

123
Q

What are 4 purposes of orthodontic study models

A

Record keeping
Allows monitoring of progress
Allows inspection of perspectives that cannot be seen in the mouth
Demonstration and motivation for the patient
Treatment planning

124
Q

During instrumentation in endo where is teh ideal end oint for shaping/obturation

A

2mm from apical Foramen

125
Q

What are three specific warnings you would give the patient when prescribing metronidazole

A

No alcohol
Take with food
Finish course

126
Q

What is a border position of the mandible

A

Maximum opening of the mandible in any plabe

127
Q

What is a border position of the mandible

A

Maximum opening of the mandible in any plabe

128
Q

What are 4 patient related factors which should be considered when interpreting results in a study

A

Patients oral hygiene
Patients diet
Patients pDH
Patients MH

129
Q

Name the principles of orthodontic managment for the non-eruption of central incisors

A

Remove supernumaries or retained primary teeth
Maintain space
If they are less than 9. - monitor for12 month
If it fails to erupt or the patient is over 9 - expose and bond gold chain for orthodontic traction

130
Q

If when looking at a radiograph theincisor teeth seem horizontally magnified what has happened

A

The patient is too far back

131
Q

If when looking at a radiograph the posterior teeth on one side are wider than the other, what has happened?

A

The mid saggital plane is not centered

132
Q

What are three features that apply to ghost images

A

They are appear more superior
They appear on the contra-lateral side
They appear horizontally magnified

133
Q

Lisr two ways you could check that anaesthesia has been achieved

A

Ask patient if there chin and lip feel numb and compare to the other side
Probe around gingival margin

134
Q

What are two features in someone with Down syndrome that could lead to thier periodontal disease?

A

Upregualtion of inflammatory mediators
Impaired neutrophil chemotaxis

135
Q

Name 4 risk factors for mouth cancer

A

Smoking alcohol use
Poor nutrition
HPV
Obesity

136
Q

What information about a patients radiothepry would we want to ask

A

Dosage and target of treatment

137
Q

What dose of radiotherapy increases the risk of ORN

A

60 grays

138
Q

Tthere are two types of manual cleaning what are they and name one instrument that would be cleaned in each way

A

Immersion - mirror
Non Emersion - hand piece

139
Q

What are to key virulence factors of strep mutants

A

ATPase and glucans

140
Q

When viewing the OPT you notice that it looks like a ‘’smiling occlusal plane’’ what has happened in the machine

A

The patient has had their chin down in the machine

141
Q

When viewing an OPT there is distortion on one side and the posterior teeth on that side look larger, what has happened in the machine

A

The mid saggital plane was not centered

142
Q

If the patient is too far forward in the OPT machine, how will the incisors appear

A

They will appear narrower
This is because they are now BUCCAL to the focal trough

143
Q

If a patient is too far backwards in an OPT machine, how will the incisors appear?

A

They will appear wider
This is because they are now lingual to the focal trough

144
Q

Name two advantages of using orthogonal program when taking OPTs

A

They reduce the overlap of the teeth
They are a more accurate representation of interdental bone levels

145
Q

Why is the bite peg important when taking radiographs

A

This is because it forces the patient into edge to edge occlusion
This ensures that both arches are within the focal trough

146
Q

What are three instructions that you must give to your patient while they are in the OPT machine?

A

Stay still
Tongue to top of the mouth
Do not talk or swallow w

147
Q

What is the typical angulation of the beam in panoramic radiography

A

8 degrees above horizontal

148
Q

If when the patient is in the OPT machine they slump, how might the image look

A

There will be an excessive cervical spine shadow

149
Q

Patient attends your surgery and on examination it is noted that they have 1-2mm of crowding on the lower arch. What would be ur management for this?

A

Enamel stripping
Metal sand paper interproximally

150
Q

Why is it when there is more severe crowding we tend to take the 4s rather than the 5s

A

This is because even though the 5s tend to be bigger, to get more space it is better to take the 4s due to the mesial drift of the 6s

151
Q

What are three limitations of stock trays

A

They rarely fit accurately
They often require modification
It may be difficult to obtain necessary border seal

152
Q

What is the difference between mucocompression and mucostatis

A

Mucocoompression is when pressure is applied to the mucosa so that the shape of the tissues is recorded
Mucostatis is when there is minimum pressure applied to the tissues at rest

153
Q

Name three reasons that you would not provide your patient with a veneer

A

Poor oral hygiene
High caries rate
Gingival recession or root exposure

154
Q

State the 6 principles of crown preparation

A
  1. Preservation of tooth structure
  2. Retention and resistance
  3. Structural durability
    4.Marginal integrity
  4. Preservation of the periodontium
  5. Aesthetics
155
Q

What are the three ways structural durability is achieved in crown prep

A

Occlusal reduction - minimum 2mm
Functional cusp bevel - these cusps take the occlusal load
Axial reduction

156
Q

Define retention in crown prep

A

Prevents removal of restoration along path of insertion or long axis of tooth prep

157
Q

Define resistance in crown prep

A

Prevents dislodgement of restoration by forces directed in an apical or oblique direction and prevents movement of restoration under occlusal forces

158
Q

Preserving the periodontium is one of the principles of crown preparation, what are three things that the margin of the restoration should be to achieve this?

A
  1. Smooth and fully exposed to cleansing action
  2. Placed where dentist should be able to finish it and patient able to clean it
  3. Placed supra-gingival or at gingival margin where possible
159
Q

Why would you be wearing placing a ceramic crown in a patient with a bruxism habit?

A

Ceramic can wear natural tooth tissue

160
Q

What are two situations that intermittent non axial force may occur

A

When a clasp over a tooth is too tight
When a patient has a para functional habit

161
Q

Why is there more coronal movement when force is applied to a tooth, in a tooth which has had previous perio compared to a healthy periodontium

A

This is due to the position of the fulcrum ( point of rotation)
In normal bone levels the fulcrum is at the level of the alveolar bone however in a reduced periodontium the fulcrum is much more apical causing there to be a greater amount of coronal movement
A larger lever

162
Q

Tooth mobility does not always indicate a pathological state of affairs! What may it instead represent?

A

This may indicate successful adaptation of the periodontium to functional demands and/or reflect the nature of the remaining attachment

163
Q

Tooth mobility can be accepted unless what…

A

It is progressively increasing
It gives rise to symptoms - such as interference with occlusion
This creates difficulty in restorative work such as in bridges

164
Q

What would be considered a successful adaptive response to occlusal trauma

A

PDL width would increase until the forces can be adequately dissipated then PDL would stabilise
Tooth mobility would be increased as a result

165
Q

What is a pathological response of the periodontium to occlusal trauma

A

If the forces are too great the PDL width will continue to increase, the PDL width and tooth mobility fail to reach a stable phase

166
Q

What are 4 key properties that you must look for in an investment material

A
  1. Porosity - to trap gases that are released in casting of the alloy
  2. Expansion - to counter the alloys shrinkage on cooling
  3. Strength - withstand pressure during cooling
  4. Stability - doesn’t degrade
167
Q

What are he two components of investment materials and what do they do

A

Refractory - some form of silica. This withstands high temperatures and undergoes expansion

Binder - gyspum or phosphate. This provides substance

168
Q

What kind of alloy is gyspum bonded used for

A

GOLD alloys

Anything that has a melting point of over 1200 cannot use gypsum

169
Q

What is the mechanism of pain

A

Trauma and infection lead to breakdown of membrane phospholipid producing ARACHIONDONIC acid, this is then broken down to produce prostaglandins.
Prostaglandins sensitise other tissues to inflammatory mediators

170
Q

What is the mechanism of action of aspirin

A

Inhibits cox1 and 2 leading to a reduction of production of prostaglandins

171
Q

What are the 4 groups that aspirin is contraindicated in

A

Children under 16 and breastfeeding
Previous or active peptic ulceration
Haemophilia
Hypersensitive to aspirin/ NSAIDS

172
Q

What is Reye’s syndrome

A

Happens in children it is fatty deposits in the liver and encephalopathy

173
Q

What is the max dose of aspirin

A

4g

174
Q

What is the BNFs stance on dihydrocodie for dental pain

A

Due to the side affects of nausea and vomiting the BNF states that there is little value for dental pain

175
Q

What is the mode of action for paracetamol

A

Hydroperoxides are generated from the metabolism of arachidonic acid by COX and exert a postive feedback to stimulate cox activity
This feedback is. Blocked by paracetamol thus directly inhibiting COX especially in the brain

176
Q

What is the antidote for dyhydrocodeine

A

Naloxone

177
Q

What are three cautions for paracetamol

A

1.hepatic impairment
2. Renal impairment
3. Alcohol dependence

178
Q

What dosage of fluoride tablet would you give a child between 3 and 6 years

A

0.5mg

179
Q

Mutually protected occlusion is the gold standard, what are the 4 things involved in this

A

Canine guidance
Posterior disocclusion
No non working/working side contacts
No protrusive interference

180
Q

What are 4 affects of trauma to the primary tooth on the developing permanent tooth

A

Failure to erupt
Crown dilaceration
White or brown discolouration
Disturbance in eruption

181
Q

Child presents to your surgery fit and well, no complaints. However on examination you notice white brown discolouration of the upper anteriors and cavitation of the first primary molars . What do you think has happened here

A

This is presentation of nursing bottle caries aka early childhood caries

This is usually from inappropriate use of a bottle or a feeding cup

182
Q

What are the three stages in the the management of dental neglect

A
  1. Preventative dental team management
  2. Preventative multiagency Management
  3. Child protection referral
183
Q

What features may raise concern for you that a child is being abused

A

Delay in presentation of pain
Clinical findings and story do not match up
Bruises on child’s face that are at different stages of healing
Previous concerns about the child or the child’s siblings

184
Q

When assessing a patient who you think has xerostomia what scale would you use?

A

The Challacombe score can be used to assess dry mouth in Sjögren syndrome and to assess salivary flow and therefore calculate a risk of dental caries, which are more likely in drier mouths.

185
Q

A frontward growth rotation would result in what kind of face and what would you see clinically

A

Short face and a deep bite

186
Q

A patient has a backward growth rotation and a long face, clinically what kind of of bite would you expect to see

A

Anterior open bite

187
Q

What kind of ossification do the mandible and maxilla form by

A

Intramembranous ossification
Bone is layer down directly onto primitive mesenchyme tissse

The vault of the skull Also forms in this way

188
Q

Name 4 dental aspects of a patient with Cleft lip and/or palate

A

Hypodntia
Crowding
Impaction
Caries

189
Q

What are 4 physical features of foetal alcohol syndrome

A

Small head
Short nose
Small mandible
Large upper lip with deficient philtrum

190
Q

What are three indications for taking a lateral cephalogram

A

To aid in diagnosis
To treatment plan
To progress monitoring

191
Q

What is the prevelacne of schizophrenia

A

1-2%

192
Q

Lithium can be used as a mood stabilising drug - what must we be wary of in dentistry with this

A

Cannot prescribe NSAIDS or metronidazole

193
Q

What are some dental concerns in relation to anorexia nervosa

A

Dry mouth
Infections
Bleeding gums from lack of vitamins

194
Q

Dopamine antagonist drugs can cause extra-pyramidal side affects, name some of these

A

Akathesia - restlessness
Dystonia - muscles involuntary contract
Parkinsonism - tremor, slow movement, stiffness
Tardive dyskinesia
- uncontrollable facial movements - these do not go away when medication is stopped

195
Q

What are 3 causes of cone cutting in radiograph

A

Incorrect assembly of the holder
Incorrect alignment between the X-ray tube and the receptor holder
Incorrect orientation of rectangular collimation

196
Q

If we are assessing a vertical shift using the parallax technique, what are 2 sets of radiographs we could use

A

Panoramic and oblique occlusal
Panoramic and lower PA

Random Revsion (2 decks)

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