Mock past papers Flashcards
2 ways to drain a abscess
Incise and drain
Drain through periodontal pocket
What are 4 potential reasons for the debonding of a bridge clinically
Unfavourable occlusion
Insufficient coverage with adhesive wing for bonding
Poor enamel quality of abutments
Inadequate moisture control during cementation
Caries
Cite 4 methods of checking of bridge debonding clinically
Pressing on the pontic and looking for movement of adhesive wings
Pressing on the adhesive wings and looking for bubbling of saliva at the wing/tooth interface
Explore the margins with a probe looking for defects, and place probe under pontic and apply coronal pressure, looking for movement in adhesive wings
Try and pass floss underneath the adhesive wings
Radiograph
2 General and local factors that should be considered before implants
General
-Any head and neck cancer treatment (radiotherapy), –Any bisphosphonates, diabetes
Local
-Bone height
-space available between existing teeth
-any rotations or drifting of teeth
-smoking status
-OH
State 2 potential complications of extracting a tooth that is in close proximity to the Inferior alveolar canal
IAN paraesthesia
IAN dyaesthesia
Name 2 scenarios where there would be an increased risk of bleeding for a patient and 2 post- operative methods of achieving haemostasis
-Anticoagulant/antiplatelet therapy
-Alcoholic liver disease
-Damp gauze and pressure
-Surgicel and suturing margins
-LA with vasoconstrictor
-Diathermy
List 6 signs/symptoms of TMD
Pain
MoM hypertrophy
MoM tenderness
Clicking, popping, crepitus at TMJ
Linea alba
Tongue scalloping
Tooth wear (attrition)
5 points of conservative advice you would give to a pt with TMD
Stop any parafunctional habits
No chewing gum
Cut foods into small pieces
Do not incise foods
Avoid hard and sticky foods
Chew bilaterally
Define indirect retention
Use of supportive components to resist rotational forces, components are placed at 90º to the clasp axis and on opposite side from dislodging force
Describe Desquamative gingivitis
A clinically descriptive term to describe severely erythematous and ulcerated gingiva caused a number of conditions or allergies, inflammation can extend beyond the mucogingival junction
Name three conditions that you would see Desquamative gingivitis
Lichen planus
Pemphigus
Pemphigoid
Describe how you would manage Desquamative gingivits
Biopsy an area of mucosa and use immunofluorescence and histological analysis to determine the cause
6PPC where indicated, OHI
Diet advice and SLS free toothpaste
Betamethasone mouth rinse
Tacrolimus ointment
Systemic corticosteroids to prevent any new lesions from forming (prednisalone)
A patient presents at your practice with a large discoloured swelling
Name 3 local and 3 generalised causes of pigmentation
Local
-Malignant melanoma
-Melanocytic neavus
-Amalgam tattoo
-Haemangioma
Generalised
-Racial pigmentation
-Addison’s/cushings disease
-Smoking
Name 2 types of haemangioma and give 2 histological differences between the two
Types
-Capillary
-Cavernous
Cavernous is encapsulated and capillary is not
Cavernous is dilated vascular space and capillary is thin walled capillaries
Name 4 key personnel involved in the Decontamination process and give a description of each of their roles
Operator
-Responsible for day to day operations, recording machine readings
User
-Responsible for daily testing and maintenance of records
Manager
-Ultimately responsible for running of LDU and release of instruments fit for use
Engineer
-Annual and quarterly testing of the machines and any maintenance
What type of water is used for the final rinse cycle and why use this as opposed to mains water
Deionised
Mains water has minerals present in it which can
Damage instruments
Cause limescale build up
Give a roughened surface for bacteria to adhere to
Describe the appearance of dental fluorosis
Diffuse chalky discolouration, symmetrical
What is the local action of fluoride in the oral cavity
Promotes remineralisation of any demineralised enamel and forms fluoroapetite which has a higher erosion resistance
Inhibits bacterial metabolism and acid production
Give the best treatment option for fluorosis and 2 advantages of this treatment
Microabrasion
-Conservative, only removing 100 microns of enamel
-Results are permanent
Name 4 pre-disposing factors for Pseudomembranous candidosis, 2 local and 2 medical
Local
-Use of a corticosteroid inhaler
-Removable prosthesis (ie URA for this patient)
Systemic
-Diabetes
-Systemic immunosuppressive treatment
-Immunosuppression side effect of treatment (ie chemotherapy)
You take an oral swab and an oral rinse; give an advantage and disadvantage of each
Swab
-Site specific
-Not quantitative
Rinse
-Quantitative
-Not site specific
Name you first-line medication for Pseudomembranous candidosis, state 2 drugs that it interacts with and the nature of
their interaction
Fluconazole
-Warfarin will interact to cause an increased risk of bleeding
-Statins can cause muscle death and rhabdomyolysis
Describe how Porcelain is treated to improve its retention
Sandblasting of fitting surface and hydrofluoric acid to etch the surface and then silane coupling agent applied
Name 2 luting cements, other than resin based, that could be used to bond this crown should you proceed with her request
RMGIC/GIC
Zinc polycarboxylate
Describe how a resin based luting cement bonds to porcelain
Silane coupling agent bonds with the oxides present in the porcelain, it also has a C=C end of the molecule, rendering the surface hydrophobic and allowing the resin based agent to bond to the surface
Name one advantage to placing a crown as a posterior restoration
Cuspal coverage to provide support and protection for the remaining tooth tissue
A patient is referred to your practice to have a large MOD amalgam in their 46 replaced you successfully replace it with composite patient attends 5 days later complaining on pain when biting up and down and to transient thermal stimuli
Give 5 potential causes of these symptoms
Cracked tooth/cusp syndrome
Residual resin monomer causing pulpal inflammation
Pulpal damage due to excessive heat production during cavity preparation
High restoration causing premature occlusal contact
Uncured HEMA expanding due to moisture
A patient is referred to your practice to have a large MOD amalgam in their 46 replaced you successfully replace it with composite patient attends 5 days later complaining on pain when biting up and down and to transient thermal stimuli
Give 5 restorative features that could prevent this from occurring
Low configuration factor to prevent polymerisation shrinkage stresses
Incremental placement to prevent soggy bottom
Ensure bur cooled by water on high speed
Check occlusion after placement using articulating paper
Ensure an appropriate curing regime is used
The mother of one of you young patients phones your practice, stating that her son has ingested fluoride toothpaste and she is worried.
What three questions should you ask mum
What is the fluoride strength of the toothpaste
How much of the toothpaste did the child ingest
What is the weight of the child
What is the most common cause of fluorosis in the UK
Water
If the patient is 10 with fluorosis what would you first line of treatment be
microabrasion
Please provide the fluoride supplement values for the following patients, all living in an area of <0.3ppm fluoridated water
age 1, 4 and 7
Age 1- 0.25mg per day
Age 4- 0.5mg per day
Age7- 1mg per day
Give 3 diagnostic features of a subluxation
Tooth has not been displaced in the socket
Increased mobility of the tooth
Bleeding from the gingival sulcus
What type of splint would you place for a subluxation and for how long
Flexible splint
2 weeks
When would you review a subluxation patient
2 weeks for splint removal
1 month
3 months
6 months
6 monthly for 2 years
Name 2 features you would be assessing radiographically of a subluxation
Forming of any periapical lesion (widening of the PDL)
Initiation of inflammatory resorption
How would internal inflammatory root resorption present both clinically, radiographically, what would it indicate about the tooth, what medicament would you place to attempt to halt resorption
Asymptomatic
Ballooned, irregular shaped canal
Non setting calcium hydroxide
As a member of the dental profession, CPD is one of the standards of practice.
Under clinical Governance, how many hours of CPD are to be done in a 5 year cycle and How many are to be verifiable
100 verifiable hours
What are the components of Clinical Governance
Research and development
Education and training
Clinical effectiveness
Risk management
Openness
Clinical audit
What are the dimensions of healthcare quality
Patient centred
Safe
Effective
Efficient
Equitable
Timely
Name 3 possible complications associated with the extraction of a lone-standing upper molar
OAC/OAF
Tuberosity fracture
Root displaced into the maxillary antrum
Diagnose OAC/OAF, Tuberosity fracture and Root displaced into the maxillary antrum
OAC
-Bubbling of blood in the socket
-Good light and suction, direct vision (echoing of the suction)
-Nose holding and explore with blunt probe (may cause OAC)
-Bone present at the trifurcation of the roots post XLA
Fractured tuberosity
-Crack felt/heard during mobilisation of the tooth
-Tear in the palate
-Mobility of the ridge and tuberosity palpable
Root in antrum
-Good suction and irrigation and visually assess
-Radiograph may show root placed in the antrum
-CBCT
Give 3 uses of URA other than tipping and tilting teeth
Habit breaker
Retainer
Growth modification
Overbite reduction
What 4 risk factors pre-dispose someone to ANUG
Smoking
Poor OH
Stress
Malnutrition
A patient arrives at your practice with a debonded gold post and core crown
Give three potential reasons why this post and core may have debonded
Secondary caries
Poor moisture control during cementation
Root fracture
There is a fracture at junction of the post and core, give three reasons why this may have happened
Biocorrosion
Lack of sufficient ferrule
Trauma
Name 3 ways of retrieving a fractured post
Ultrasonic tip
Eggler forceps
Moskito forceps
2 alternative Tx to missing teeth besides implants
Resin bonded bridge
RPD
Essex retainer
3 general factors considered before implants
The pt undrstands what is likely to be involved and is willing to comply with tx
Good OH
Smoking
Cost
Lack of viable bone or alternatively availabilty of suitable bone
Perio history
History of contact sports
3 factors local to a proposed implant area that should be assessed
Bone height
Bone width
Root position
Soft tissue adequacy
Smile line
Gingival biotype
Local perio health
3 potentional complications to warn patients about implants
Implant failure
Peri-implantitis
Peri-implant mucositis
Screw failure
Recession
Why are lower incisors more ar risk of gingival recession
Think gingival biotype
Thin buccal plate
Other S&S from Gingival recession
Poor aesthetics
Root caries
dentine hypersensitivity
What do you want to know about a enamel dentine pulp fracture before you decide on Tx
Size of exposure
When injury occured
Stages of pulpotomy
Apply dam and LA
Remove pulp tissue 2-3mm around exposed area
Assess bleeding and if no bleeding remove more tissue and if gushing dark red bleeding
Gain haemorrhage control using saline soaked cotton rool
Asess nleeding and if hyperanemic remove more
Once normal bleeding stopped apply non-setting CaOH and seal with GI and restore
What are favorable signs on a radiograph that pulp has stayed vital
Continued root development
Continued thickening of dentine
Apical devlopment
No pathology
A puloptemy didnt what to do now
Dental dam and LA
endo access and pulp extirpation
Dress with CaOH
Immmediate referral to paeds
MTA placed for apexification
4 ways MRONJ can be prevented
Pt education
OHI
Make pt dentally fit before Drug Tx
smoking cessation
Non-invasive alternatives eg endo
Remove risk factors
10 management options of MRONJ
Careful monitoring
Specific OHI in relation to exposed bone areas e.g. irrigation syringes
Antiseptic MW
Ocassionally antibiotics
Primary closure where possible
remove any traumatic causes
Consult with GMP if drug replacement or modification wararnted
Symptomatic relief
Topical preperations eg. analgesics
Surgical debridement of dead bone
4 histopathological features of minor salivary gland biopsy in sjrogens
lymphocytic focus particulary located in the periductal area, each focus 50+ cells with at least 1 every squared4mm
Atrophy of acini
Ductal epithelial hyperplasia
Ductal dilation
Fibrosis
Most common maliganancy assoc. wit sjogrens
Non-hodgkins lympoma
4 URA active components that move teeth
palatal finger spring
buccal canine retractor
Z spring
expansion screw
Name space maintainers
Fixed palatal arch
band and loop
In a sterilizer if the sterilization temp. of a cycle achieves 135.2 what is the corresponding pressure range in pressure absolute and the minimumu hold time
3.05-3.35 for a minimum of 3 mins
Instruments need to be sterile till point of use how is this achieved
Instruments wrapped prior to processing in a Type B
On a daily basis what 4 bits of info must be recorded from first production cycle
Cycle number
Sterilisation hold time
Temp.
Pressure
What is the name of the PCD used in first cycle of the day on a vaccum sterilizer and what does it test for
Bowie dick pack
Steam penetration
4 types of purified water
disilled
De-ionised
sterile
reverse osmosis
What part of the SHTM 01-01 providers guidance for operating and teseting sterilizers
Part C
What SICP do we need to know
Hand Hygiene
➢Personal Protective Equipment
➢Safe Management of Care Equipment
➢Safe Management of Care Environment
➢Safe Management of Blood and Body Fluid Spillages
➢Safe Disposal of Waste (including sharps)
➢Occupational Safety: Prevention and Exposure Management (including sharps)
➢Respiratory and Cough Hygiene
