OSCE Revision Flashcards

(153 cards)

1
Q

transfer lines for pros and why we note them

A

high smile line - can get idea of how much tooth will show when smiling
centre line - midline of teeth matches midline of ptx face
canine line - dictates size of tooth to be used
residual alveolar line - so teeth are set in such a way above the lower residual ridges that the contacts are on this line
alveolar contour line - if teeth are set at slope then the denture may be displaced during function
rim profile - to ensure adequate lip support

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2
Q

mouthwash F- content and when to give

A

225ppmF
can give over 6/7 years; only when they have the capacity to spit

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3
Q

what is a toxic dose of fluoride

A

32-54mg/kg i.e. 5-10g of toothpaste in a 75kg individual

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4
Q

what is a potentially toxic dose of fluoride

A

5mg/kg - give milk & observe
5-15mg/kg - milk & hospital
15mg/kg+ - hospital & IV calcium gluconate

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5
Q

max dose of F- safely tolerated

A

1mg/kg

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6
Q

toothpaste for different ages

A

1000ppmF = 6m-6y unless high risk (smear for <2 & pea sized >2)
1450ppmF = >6y low risk & >3y high risk
2800ppmF = >10y high risk
225ppmF or 0.05% daily mouthwash = >6y high risk
***toothpaste now 1500ppm for everyone of all ages in scotland

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7
Q

what the different radiographic film holders are for

A

red = bitewing for coronal of posterior teeth
yellow = posterior periapical image of complete tooth including the root
blue = anterior periapical image for complete anterior tooth including root
green = endo for identifying working lengths

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8
Q

what size of film the radiographic holders take

A

BW = 2 for permanent teeth & 0 for deciduous
anterior PA & endo = 0
posterior PA & endo = 2

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9
Q

how to complete diet diary

A

3 days including 1 weekend day
write down everything eaten and time it is eaten

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10
Q

difference in ortho wire for springs & for retentive components

A

0.5mm for springs
0.7mm for retentive components

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11
Q

what are the dimensions of the bite plane

A

OJ + 3mm

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12
Q

INR

A

international normalised ratio

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13
Q

what should the INR be for an XLA

A

<4

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14
Q

ARAB

A

A - active component
R - retention
A - anchorage
B - baseplate

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15
Q

drug interactions of warfarin

A

inhibiting - alcohol, epilepsy drugs
potentiating - NSAIDs, ACE inhibitors, antibiotics

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16
Q

tx of ANUG

A

ultrasonic debridement
CHX
OHI
400mg metronidazole TID 3 days if necessary

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17
Q

standard drug tx of ANUG

A

metronidazole 400mg 3 TID for 3 days
alternative is amoxicillin 250mg 3 TID for 3-5 days

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18
Q

3 predisposing factors to ANUG

A

smoking
stress
poor OHI

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19
Q

endo materials - irrigants

A
  1. EDTA solution 15% - removes smear layer
  2. sodium hypochlorite 3% - disinfects & dissolves pulpal remnants, disrupts organic portion of smear layer
  3. chlorhexidine 0.2% - disinfects canal
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20
Q

endo materials - paper points

A

to ensure canal is dry before medicating or obturating

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21
Q

endo materials - medicaments

A
  1. ultracal/hypocal - NS calcium hydroxide; inter-visit medication to prevent infection
  2. ledermix - corticosteroid & antibiotic mixture; inter-visit medication for hot, infected pulps to reduce inflammation
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22
Q

endo materials - obturation

A
  1. GP points - cold lateral compaction or thermafill, requires AH+ sealant
  2. resilon - resin based, requires epiphany sealant
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23
Q

lignocaine interaction

A

2.2ml lignocaine 2% with 1:80,000 adrenaline not advised in ptx with sensitivity to adrenaline or latex, uncontrolled cardiovascular disease, taking MAOIs, tricyclics or beta blockers
citanest 3% with octapressin given as an alternative

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24
Q

post op painkiller - what groups to be wary of

A

warfarin or pregnant give no NSAIDs (ibuprofen/aspirin)
liver / kidney disease reduce dose

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25
cocodamol
contains paracetamol with 8g or 30g of codeine
26
ibuprofen dose
200mg or 400mg tablets take 1.2-1.8g daily in 3-4 doses spread out preferably after food do not take more than 2.4g in 24hrs
27
precaution prescribing ibuprofen to
- elderly ; reduced drug metabolism - peptic ulceration / GORD; may exacerbate - pregnant or lactating ; cannot give NSAIDs - renal / hepatic / cardiac impairment - asthmatics - don't give unless they have had before - history of NSAID hypersensitivity - taking other NSAIDs - on long term steroids ; susceptible to gastric ulcers
28
dose of paracetamol
500mg tablets 1-2 every 4 hrs no more than 8 tablets a day i.e. 4g in 24hrs
29
precaution prescribing paracetamol to
hepatic / renal impairment alcohol dependent
30
post op instructions
- take it easy, avoid strenuous activity i.e. exercise for 24hrs - expect pain; take painkillers before anaesthetic wears off & keep taking for as long as required; ibuprofen gold standard - may experience swelling, bruising, tenderness in other teeth, stiffness of jaw - take care when eating & drinking until LA wears off & avoid hard or very hot foods for a few days - don't was mouth out for 6hrs but can still brush teeth at night just be gentle - eat on opposite side of mouth & leave site alone; don't explore with finger, tongue, toothbrush - if bleeding occurs at home bite down on damp gauze for 20-30mins - avoid smoking for as long as possible and don't drink alcohol for 24hrs - starting next day gently swirl warm salty mouthwash around mouth 3-4 times a day until healed - give written instructions - come back if any problems / if needing sutures removed
31
smoking cessation advice
ASK - if they are a smoker, how may per day, how long have they been smoking, what do they smoke, do they want to stop, interested in quitting in near future & do they want help doing so ADVISE - aware of health benefits of quitting, single most effective way of improving health status, past failures will improve chance this time, acknowledge difficulty in quitting, oral & lung cancer, heart disease, gun disease, stained teeth ASSESS - desire to stop smoking, help must be offered ASSIST - negotiate a stop date, review previous failed attempts, anticipate what problems they may encounter, suggest enlisting family & friends, inform of NRT availability, and NHS stop smoking service 1-2-1 or group ARRANGE - follow up NHS SSS referral, give helpline, monitor, support, encourage at future dental appointments remember to record in notes you had the conversation & the outcome and revisit
32
special tests to diagnose sjogrens
blood tests - checking for anti-la antibody principally, also anti-ro and ANA histopathology assessment of labial secondary salivary gland biopsy radionucleotide assessment into salivary duct imaging
33
complications of ptx with sjogrens
dry mouth difficulty with speech & swallowing burning mouth increased risk of oral infection & caries difficulty with denture retention long term risk of salivary lymphoma
34
maxillary anatomy
primary support = hard palate, maxillary tuberosities 2ndary support = alveolar ridge, rugae area, buccal shelves - post dam along vibrating line, in front of palatine fovea and through hamular notches - incisive papilla & palatine torus must be relieved - labial & buccal fraena are muscle attachments which must not be encroached upon
35
mandibular anatomy
primary support = buccal shelf, pear shaped pad 2ndary support = buccal & lingual slopes of alveolar ridge - lingual pouch utilised for retention - floor of mouth is mylohyoid muscle - lingual, buccal, labial fraena must be accounted for
36
splinting times primary teeth
only for dento-alveolar fracture resposition and splint for 3-4wks
37
splinting times in permanent teeth
- concussion = none - subluxation = 2wks flexible - intrusive & extrusive luxation = reposition & 2wks flexible - avulsion = replantation & 2wks flexible - lateral luxation = reposition & 4wks flexible - apical & 2/3 root # = replantation & 4wks flexible - coronal 1/3 root # = replantation & 4mths flexible - dento alveolar # = reposition & 4wks rigid
38
principles of AWI 2000
1. must benefit ptx 2. minimum intervention 3. take into account wishes of ptx 4. consultation with relevant others 5. encourage residual capacity
39
name the emergency drugs
oxygen salbutamol midazolam adrenaline GTN spray aspirin glucagon
40
emergency oxygen
15L/min
41
emergency salbutamol
2 x 100mg actuations in severe asthma up to 10 not given if foreign body in airway
42
emergency midazolam
10mg into buccal sulcus
43
adrenaline
1/2 ampule of 1:1000 parts adrenaline (0.5mg) given as an IM injection using Z plasty admin route disruption technique if worsening the same can be given in the other leg
44
emergency aspirin
300mg crushed and under tongue or chewed for anyone having an MI
45
emergency glucagon
1mg IM will reduce all glucose stores from the liver as soon as consciousness restored should be given sugar in a quickly absorbable form
46
7 elements of caries risk assessment
1. medical history 2. social history 3. diet 4. plaque control 5. fluoride 6. saliva 7. clinical evidence
47
impression trays & materials
boxed tray = partially dentate non boxed = edentulous materials: polyether -> impregum irreversible hydrocolloid -> alginate reversible hydrocolloid -> agar polyvinylsiloxane (addition silicone) -> extrude non elastic -> impression compound
48
paeds moisture control (6)
1. dental dam 2. cotton wool rolls 3. parotid shield (dryguard) 4. tongue retractor 5. aspirator 6. saliva ejector
49
stages for a complete denture
stage 1 - primary impressions in alginate or impression compound LC - please pour in 50:50 plaster stone, construct upper and lower custom trays in light cured PMMA non perforated with upper 2mm spacing and lower 1mm spacing (close fitting), intraoral handles and finger stops stage 2 - master impressions in silicone or polyether LC - please pour in 100% dental stone and construct wax rims for jaw reg & return rims on casts stage 3 - jaw reg LC - please mount casts in registration provided and set teeth for wax trial, return wax trial dentures on mounted casts stage 4 - tooth trial LC - ask for retrial if required or please finish in heat cured PMMA and return on casts stage 5 - delivery
50
pain history
SOCRATES site onset character radiation associated features time exacerbating / relieving factors and severity
51
angina
chest pain due to ischaemia of heart muscle characterised by retrosternal chest pain or discomfort that may radiate to arms, shoulders, neck
52
stable v unstable angina
stable = occurs with activity or stress and is relieved by rest unstable = lack of blood flow and oxygen that may lead to heart attack (MI); is spontaneous and can happen at any time
53
MI
heart attack occurs when blood flow to part of your heart is blocked for long enough that part of the heart muscle is damaged / dies differs from angina as pain is more severe and persistent not relived by rest
54
tx for MI
stop treatment, sit up, oxygen 15L/min via non re breathing mask GTN sublingually if pulse 70 or above 300mg aspirin crushed or chewed call ambulance
55
reversible pulpitis
mild inflammation tooth may respond more than normal to certain stimuli such as heat & sweet sharp pain (A delta) that resolves within 5-10secs after removal once cause of inflammation i.e. caries has been removed the pulp-dentine complex will return to normal
56
irreversible pulpitis
dull aching pain (C fibres) that can last for mins - hrs worse at night or when lying down due to increase in intra pulpal pressure symptoms may be initiated by temp changes removal of causal factor does not lead to pulpal regeneration and if untreated becomes necrotic tx = RCT/XLA
57
LA when high BP/heart problems
want adrenaline free prilocaine with felypressin don't use lidocaine without adrenaline as it doesn't have enough vasoconstrictor so effects would not last long enough max 3 doses of lidocaine with adrenaline for any heart problems but want to use other
58
LA if ptx on beta blockers
adrenaline free or limit quantity
59
LA if ptx on tricyclic anti depressants
limit dose to max 2 cartridges of adrenaline
60
LA if ptx has latex allergy
citanest (prilocaine with felypressin)
61
max dose of lidocaine
2.2ml 2% HCl lidocaine 1:80,000 adrenaline max dose = 4.4mg/kg so 7 cartridges metabolised in liver & excreted in kidney amide LA 44mg in a cartridge
62
max dose prilocaine
2.2ml prilocaine HCl 3% with (1.2mg) fely/octapressin amide LA max dose = 8mg/kg so 8 cartridges 66mg in a cartridge
63
max dose articaine
2.2ml articiane HCl 4% with either 1:100,000 1:200,000 1:400,000 adrenaline metabolised in liver excreted in kidney more potent and more rapid onset than lidocaine max dose = 7mg/kg so 5 cartridges 88mgs in a cartridge
64
local complications of LA
failure to achieve anaesthesia prolonged anaesthesia pain during or after injection trismus haematoma broken needle soft tissue damage facial paresis intravascular injection
65
3 types of handwashing
social - plain/antimicrobial soap and running water / ABHG if hands not visible soiled; used for removing transient organisms hygienic hand wash - used for removing transient microorganisms & reducing resident microorganisms, liquid soap & water then ABHG, antimicrobial soap or antiseptic hand cleanser surgical scrub - antiseptic hand cleansers, longer & more thorough, inc lower arms, hibi scrub often used
66
eruption dates
FPMs 6yrs (6s at 6) lower incisors 31 41 6yrs upper incisors 11 21 7 yrs lower laterals 32 42 7yrs upper laterals 12 22 8yrs lower canines 33 43 9yrs upper & lower 1st premolars 10yrs upper canines 13 23 11yrs upper & lower 2nd premolars 11yrs upper & lower SPM 12yrs wisdom teeth 18+yrs
67
elevators & luxators
elevators - loosen tooth luxators - cut PDL couplands - spoon shaped, straight end, not sharp cryers - break bone inbetween roots warwick james - hold infront and curve points to side of ptx mouth you use it for
68
lab prescription for primary imps
LOWER - pleasure pour primary imp in 50:50 plaster stone & construct close fitting (1mm spaced) non perforated light cured PMMA tray with intra oral handles if bony undercuts present then 2mm spacing may be prescribed for use with an appropriate elastomer UPPER - please pour up primary imp in 50:50 plaster stone and construct a 2mm spaced non perforated light cured PMMA tray with intra oral handles (so they don't interfere with soft tissues i.e. lips)
69
lab prescription for 2ndary imps
please pour up master imps in 100% dental stone and construct upper & lower wax occlusal rims on light cured bases
70
lab prescription for jaw reg
please mount casts on articulator (average value) and set the upper teeth to the wax rim please set lower teeth to uppers specify any special features e.g. diastema or imbrications
71
lab prescription for trial
finish - please wax up for finish and process in heat cured acrylic resin re trial - remount casts and make specified changes for 2nd trial
72
ortho prescription for anterior crossbite
A - Z spring 0.5mm HSSW R - 4/4 6/6 adams clasps 0.7mm HSSW A - yes B - self cure PMMA FPBP
73
ortho prescription for posterior crossbite
A - mid palatal screw 0.5mm HSSW R - 4/4 6/6 adams clasps 0.7mm HSSW A - yes B - self cure PMMA FPBP
74
ortho prescription for retracting canines
A - 3/3 palatal finger spring + guard 0.5mm HSSW R - 6/6 adams clasps 0.7mm HSSW & southend clasp on 11/21 in 0.7mm HSSW A - yes B - self cure PMMA *if clasps on primary teeth then 0.6mm HSSW
75
ortho prescription for moving canines palatally
A - 3/3 buccal canine retractor 0.5mm HSSW + tubing R - 6/6 adams clasps 0.7mm HSSW, 1/1 southend clasps 0.7mm HSSW A - yes B - self cure PMMA
76
ortho prescription for OB (check this)
A - 13-23 robert's retractor 0.5mm HSSW R - 6/6 adams clasps 0.7mm HSSW A - yes B - self cure PMMA FABP OJ +3mm
77
prescription for mounting casts with facebow
please mount upper casts and transfer cast onto average value articulator using facebow registration articulate lower cast to upper in ICP and fabricate custom incisal table
78
colombia curette
red double ended point scaler 2 cutting edges on each blade for sub gingival & root planing anywhere in mouth but with limited access to deep pockets 4R-4L
79
mini sickle
red double ended 2 cutting edges on each blade buccal & lingual embrasure surfaces supra gingivally and within pocket orifice
80
gracey curette 1-2
grey double ended each blade has single cutting edge subgingival scaling of upper and lower anteriors
81
gracey 7-8
green double ended each blade has single cutting edge subgingival of buccal / lingual surfaces of posterior teeth
82
gracey 11-12
orange double ended with single cutting edge sub gingival scaling of mesial surfaces of posterior teeth
83
gracey 13-14
blue double ended each blade has single cutting edge sub gingival scaling of distal surfaces of posterior teeth
84
hoe scaler 134-135
yellow double ended gross supra and sub gingival scaling of buccal & lingual surfaces
85
hoe scaler 156-157
red double ended gross supra and sub gingival scaling of mesial & distal surfaces
86
seating positions when scaling
7 o clock = 43-33 labial & lingual 9 o clock = - 14-18 buccal - 44-48 buccal - 34-38 lingual 11 o clock = - 14-18 palatal - 44-48 lingual - 34-38 buccal - 24-28 buccal & palatal - 13-23 labial & palatal
87
post op XLA
- do not rinse out for several hrs ideally wait until next day; don't rinse vigorously when you do & rinse with warm salty water - avoid exploring socket with tongue finger toothbrush etc - avoid hot food on day of XLA & chew on other side of mouth when eating - avoid excessive exercise for 1-2 days - avoid smoking / drinking on day of XLA - brush as normal but take care of where socket is - if bleeding starts bite down on damp gauze for 20mins - if it doesn't stop contact GDHS or A&E - may have slight discomfort so take analgesia before LA wears off
88
alkaline hypochlorites for denture cleaning
dont leave CoCr dentures for longer than 10mins as they corrode superior cleaning properties effective dissolution of plaque stain removal properties bacterial & fungicidal properties possible bleaching of acrylic resin residual taste after use e.g. dentural, milton
89
effervescent peroxidises for denture cleaning
powder of tablets rapid in action and simple to use problems can arise if hot water used with denture, can cause bleaching additional mechanical cleansing action bubbles created by release of oxygen which may dislodge debris
90
materials
ledermix - antibiotic & steroid used on vital pulp riva - GI used as cavity base relyx - RMGI to cement MCCs in calzinol / sedanol - ZOE (used in primary RCT as it is resorbable) dycal / ultracal - CaOH used for pulp capping if small exposure during cavity prep & used as cavity lining material vitrebond / vitermer - RMGI used as restorative material in cervical cavities if adequate moisture control cannot be achieved
91
jaw reg data
OVD centre line canine line high lip line occlusal plane arch form width (width-lip support)
92
setting teeth
profile of upper rim trimmed by dentist is transferred onto occlusal plane guide - provides arch form for setting teeth centre of lower ridge is transferred onto occlusal guide plane centre line is transferred onto casts and the occlusal plane guide canine lines marked at level distal to incisive papilla on cast contour of occlusal rim is marked to show flat area of ridges where teeth should be placed
93
what LA can you not use for an IDB
articaine
94
purpose of beak on molar forceps
to engage root furcation
95
movement types for XLA
coronal shape: round = rotation movement oval = buccal and back oblong = figure of 8 therefore lower anterior = buccal & back lower premolars = rotation lower molars = fo8 upper anterior = rotation upper premolars = buccal & back upper molars = buccal & back (fo8 would snap root)
96
to identify caries / unrestorable teeth from photographs
look for large overhanging restorations broken down teeth discolouration marginal ridge breakdown fracture lines NCTSL active lesions arrested lesions
97
crown prescription lab card
primary imp - please pour impressions in 100% dental stone & construct study models. mount casts with facebow - please mount upper casts on arcon articulator using facebow reg and construct customised incisal table special trays - please construct non perforated custom trays made of light cure acrylic with 3mm wax spacer, please include extra handles master imp - please pour master imp in 100% improved stone to construct definitive casts, please mount on articulator with jaw reg, please section tooth for MCC with metal palatal surface with canine guidance & labial aspect in porcelain with interproximal contact delivery - fit & cementation
98
polycythaemia
raised Hb
99
leukocytosis
raised WCC
100
thrombocythemia
raised PLT
101
normal values Hb
normal male = 13.5-17.5g/dl so anaemic = <13g/dl normal female = 12-15.5g/dl so anaemic = <15.5g/dl
102
normal RCC
male = 4.7-6.1 million cells/mcL female = 4.2-5.4 million cells/mcL
103
normal WCC
4.5-10 thousand cells/mcL
104
normal MCV
87 +/- 5 femtolitres fL will be normal in bleeding but reduced volume overall
105
normal HCT
newborn = 60% 0.6 males = 40-52% 0.4-0.52 females = 46% 0.46
106
normal PLT
150-400x10 to the 9 / mcL
107
iron deficient anaemia
causes - chronic blood loss, malabsorption of iron (coeliac), dietary deficiency, increased demand i.e. pregnancy, puberty, low ferritin levels clinical features - concave nails, itching, angular stomatitis, beefy tongue (painless glossitis) low Hb, low MCV & MCH
108
pernicious anaemia
both B12 & folic acid needed for DNA synthesis in maturing erythroblasts so def in either causes erythroblasts to have large nuclei = megoblasts in marrow B12 absorbed by intrinsic factor in terminal ileum folate absorbed in duodenum clinical features - painful glossitis, demyelination of spinal cord, peripheral neuropathy, ataxia low Hb, high MCV
109
thalassaemia
normal Hb production genetic mutation of globin chains (alpha in asian & beta in Mediterranean) clinical features - chronic anaemia, marrow hyperplasia, splenomegaly, cirrhosis, gallstones treated with blood transfusions & prevent iron overload
110
sickle cell anaemia
beta chain substitution change shape in hypoxic environment (prevents passage of cells through capillaries) heterozygous = sickle cell trait homozygous = sickle cell disease clinical features - vascular occlusion, retinal ischaemia, acute chest syndrome
111
aplastic anaemia
diminished or absent haemopoietic precursors in bone marrow present as pancytopenia, macrocytosis (inc MCV) and reticulocytopenia (immature RBCs)
112
acute leukaemia
neoplastic proliferation of leukocytes, usually disseminated accumulation of malignant white cells in bone marrow & blood malignant cells tend to be precursors (blast cells) 2 types - acute myeloid and acute lymphoblastic
113
lymphoma
neoplastic proliferation of leukocytes, usually a solid tumour malignant lymphocytes accumulating in lymph nodes lymphadenopathy, peripheral vasculature even organs hodgkins & non hodgkins
114
interactions of penicillin
1. bacteriostatic antibiotics i.e. clindamycin, erythromycin, tetracycline = impaired action of penicillin 2. methotrexate = reduced efficacy of penicillin
115
interactions of cephalosporins e.g. ceftaroline fosamil
1. warfarin = increased bleeding risk 2. bacteriostatic antibiotics i.e. clindamycin, erythromycin, tetracycline = impaired action of cephalosporin
116
interactions of macrolides i.e. clarithromycin & erythromycin
1. benzos = CNS depression 2. clindamycin = antagonist 3. statins = myotoxic (avoid!)
117
interactions of metronidazole
1. anticoagulants = increased bleeding risk 2. barbituates = decreases clinical effect
118
interactions of tetracyclines i.e. doxycycline, minocycline, tetracycline
1. antacids = reduced serum conc of tetracyclics 2. oral contraceptive = slight increase in ovulation 3. doxycycline with methotrexate = AVOID
119
interactions of antifungals i.e. metronidazole, fluconazole
1. miconazole w warfarin - AVOID potentially life threatening bleeding 2. fluconazole w cimetidine = reduced efficacy of fluconazole
120
interactions of NSAIDs i.e. aspirin
1. warfarin = increased bleeding risk 2. cyclosporin = nephrotoxicity 3. salicylates = increased GI damage with reduced analgesic effect 4. ibuprofen with digoxin = increased digoxin levels 5. tramadol w SSRI anti depressants = causes serotonin syndrome
121
interactions of narcotic analgesics i.e. opioids, codeine, meperidine
1. opioids w alcohol = CNS depressant 2. codeine w cytochrome inhibitors = inhibits activation of codeine 3. meperidine w MAOIs = hypertension / hyperpyrexia or coma & hypotension
122
interactions of LA
1. amides w beta blockers / cimetidine = metabolism of lidocaine reduced (liver metabolism) 2. esters w anticholinesterases = metabolism of esters reduced
123
endo files colour
white yellow red blue green black universal K files 2% taper
124
protaper colours
yellow red blue black NiTi
125
access cavity shape
max incisors = triangle max canines = ovoid max premolars = elongated oval max molars = quadrilateral mandib incisors = triangles mandib canines = ovoid mandib premolars = ovoid mandib molars = trapezium
126
what to include in radiograph report
type of radiograph grade of radiograph teeth present caries PDL /lamina dura periapical bone loss
127
for UR / LL PA radiograph
hold bite block in left hand insert rod from right side place square side into rod
128
for UL / LR PA radiograph
hold bite block in left hand insert rod from left side place non square side into rod
129
key radiograph dimensions
rectangular collimator = 40x50mm max beam diameter cannot >60mm FSD 100mm <60kVp & 200mm for >60kVp aluminium filter 1.5mm <70kVp & 2.5mm for <120kVp
130
recall for uncomplicated / complicated crown / root #
6-8wks & 1 yr
131
recall for root #
4wks, 6-8wks, 6mths, 1yr, yearly for 5yrs
132
recall for pdl injuries
6-8wks, 6mths, 1yr, yearly for 5yrs
133
recall for avulsion
open apex = 2wks, 1mth, 2mth, 3mth, 6mth, 1yr, yearly for 5yrs closed apex = ST, 1mth, 3mth, 6mth, 1yr, yearly for 5yrs
134
recall for dento alveolar #
1mth, 2mth, 4mth, 6mth, 1yr, yearly for 5yrs
135
recall for primary tooth trauma
all injuries except intrusion = clinical review 1, 3, 6mth, radiograph every 6mths intrusion = clinical review every mth & radiograph every 6mths
136
% pulp necrosis of root # & dento alveolar #
root # = 20% dento alveolar # = 50%
137
fluoride varnish mechanism
slows caries progression by stopping demineralisation increases resistance of enamel to acid attack (fluoroapatite) antibacterial effect by affecting bacteria H+ ATPase
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amount of fluoride varnish to use
sodium fluoride 5% (22600ppmF) 2-5yrs = 0.25ml >5yrs = 0.4ml
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frequency of fluoride varnish
standard risk = 2x yearly enhanced risk = 4x yearly
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post fluoride varnish instructions
avoid eating & drinking for the next 1hr eat soft food for rest of day brush teeth as usual that night do not take fluoride supplements that day teeth may appear yellow but will disappear with eating & drinking
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placement of FS
fissure pattern of FPM & SPM buccal groove of lower 6 palatal groove of upper 6 cingulum pits
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materials for FS
bisGMA GIC - if moisture control hard to achieve
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ortho equipment
no 64 universal pliers no 65 coil formers wire cutters
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retentive appliance components
adams clasp south end clasp labial bows c clasps 0.7mm HSSW
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active components
palatal finger spring z spring 0.5mm HSSW midline palatal screw buccal canine retractor roberts retractor 0.5mm HSSW with 0.5mm ID tubing
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when fitting a URA
1. Check appliance for right patient 2. Check match prescription 3. Check and sharp edges on all surfaces of appliance 4. Check integrity of wire (eg areas of work hardening, areas of damage) 5. Check active component in passive state (uncoil to activate, EXCEPT for Robert’s retractor = coil to activate) 6. Fit into patient mouth. Check for (a) no ST blanching (b) anterior and posterior retention (c) flyover not interfering with occlusion 7. if happy, remove & activate components 8. show ptx how to insert and remove and ask ptx to demonstrate this back to you 9. book review in 4-6wks
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ptx instructions for URA
1. Appliance feel bulky in mouth à reassure patient that he will get used to it 2. Appliance causing patient to speak with a lisp à advice patient to practice reading at home and tongue will adjust 3. Appliance causing hypersalivation à reassure patient that this will pass within 24h 4. Patient feels mild discomfort à tell patient that this is because appliance is working 5. Tell patient to wear 24h, including meal times, except a. Take out after meal to wash b. Take out in contact sports c. Avoid hot food d. Avoid sticky food 6. Non-compliance will significantly increase treatment time
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FABP V FPBP
FABP used only to correct overbite
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to stop digit sucking
patient & parent education positive reinforcement habit reversal; child taught to carry out alternative activity reframing (turning habit into duty) bitter flavoured gel / plaster to make digit sucking less appealing fixed appliance i.e. palatal crib / inverted goal post / beads
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hanau's quint
orientation of occlusal plane incisor guidance angle cuspal inclination sagittal condylar guidance angle compensating curve
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what to check during denture delivery on cast (6)
1. smooth borders 2. stable on cast 3. teeth set on alveolar ridge 4. centre line & canine line 5. occlusal relationship 6. teeth shade & mould
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what to check during denture delivery in ptx mouth (4)
1. extension, retention, stability 2. OVD / FWS 3. occlusion 4. comfort, speech, aesthetics
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clamps used
A / AW K - universal clamp for molars E / EW - anterior & premolars