past paper set 2 Flashcards
1
Q
p gingivalis virulence factors
A
biofilm formation
LPS endotoxin
fimbriae - host tissue adhesion and invasion
proteases
capsule polysaccharide and outer membrane vesicles
2
Q
c albicans virulence factors
A
hyphae (morphological change and host invasion)
proteases
3
Q
s mutans virulence factors
A
binding proteins - glucosyl and frucosyltransferases glucans (communication and adhesion) sugar modifying enzymes polysaccharides acid tolerance and adaption (ATPase)
4
Q
LA mechanism
A
prevents action potentials through the voltage gated Na+ channels
5
Q
sugar substitutes
A
mannitol xylitol sorbitol aspartame saccharin sucralose cyclamates
6
Q
salivary proteins
A
amylase cystatin gustin histatin Igs lactoferrin lactoperoxidase lipase lysozyme mucoproteins 'plasma proteins' PRPs statherins
7
Q
enzymes in saliva
A
amylase
lactoperoxidase
lysozyme
8
Q
fcts of tongue
A
speech mastication mechanical cleansing taste protective reflex kissing
9
Q
Bell’s palsy
A
acute unilateral facial palsy with unknown cause
- most resolve spontaneously within a few wks
- neurological opinion if severe
- CS (+/- antiviral)
10
Q
macrocytic anaemia
A
reduced B12, folate
reticulocytes
11
Q
normocytic anaemia
A
bleed
chronic disease
12
Q
short-term adrenal suppression effects
A
mood disturbance
insomnia
13
Q
faint
A
LOC due to hypotension causing hypoperfusion of the brain due to reduced O2
14
Q
heart attack
A
MI due to atheroma causing arterial lumen occlusion
reduced O2 causing tissue necrosis of area
15
Q
detecting a conventional bridge debond
A
place probe under pontic and apply pressure coronally
- abutment may move
- saliva bubbles may be seen at margin
can you pass floss underneath?
if debonded for some time, abutment may be visibly grossly carious
may see caries radiographically underneath
can section into smaller pieces and check for adhesiveness
16
Q
features that may lead to conventional bridge failure
A
poor crown prep, insufficient reduction or crown margins finished subgingivally
retainers not prepped to common PofI
lack of sufficient ferrule for crown
inadequate root surface area for support, Ante’s law
poor moisture control during cementation
17
Q
implant considerations
A
quantity of bone quality of bone position of existing teeth - rotations, angulations OH proximity to anatomical features smoking MH
18
Q
extrinsic staining
A
diet
smoking
CHX
Fe supplement
19
Q
intrinsic staining
A
F
non-vital
tetracycline
physiological age changes
20
Q
Glickmans theory
A
inflammation spreads from gingivae into supporting PDL to produce a vertical bony defect, which local trauma exacerbates
21
Q
Waerhang’s theory
A
plaque causing bone destruction of a 2mm radius, not big enough to destroy entire width so angular defect
22
Q
common causes of vertical defect
A
trauma calculus subgingival plaque occlusion overhanging Rxs
23
Q
features in a parotid swelling that would make you suspect malignancy
A
fixed to underlying structures
firm
growing
unilateral
24
Q
fluorosis appearance
A
diffuse, mottled
pitting
yellow/brown discolouration
25
clinical governance
a framework through which NHS organisations are accountable to continuously improve quality of services and safeguard standards of care
achieved by creating an env where excellence in clinical care can flourish
26
divisions of NHS dentistry scotland
HDS
PDS
GDS
27
components of CG
```
clinical audit
clinical effectiveness
research and development
openness
risk management
education and training
```
28
ABs may not be successful for perio
```
may be inactivated
may be resisted by biofilms
superinfection could occur
may not reach site of disease activity
may have inadequate drug concentration and retention
```
29
axis of rotation when denture under load
line drawn between clasps on opposite sides of the arch, that form axis about which the denture will rotate
30
improving retention and stability in a loose Cu
relining
implant retained prosthesis
replacement
31
fluconazole and midazolam
increases sedation
32
postural hypotension
fall in cardiac output
poor venous return
venous pooling in legs
fall in stroke volume
33
what factors can make implant placement difficult?
lack of space
aesthetic zone
prosthesis may be involved in guidance
34
what does miconazole have antimicrobial action against?
candida
| staphylococci
35
minimising RBB debond
pick tooth with large bonding area for abutment
| cantilever design for anterior sextant
36
faults causing debond
poor moisture control during cementation
unfavourable occlusion
poor E quality on abutment
inadequate coverage of abutment
37
what is used for metal wing of RRB?
CoCr
38
why is PDD a contraindication for SDA?
drifting of PD compromised teeth under occlusal load
loss of alveolar bone leading to a compromised denture-bearing area in the long term
loss of space (neutral zone) for denture teeth in the long-term
39
host evasion mechanisms of p gingivalis
gingipains
adhesions
fimbriae
capsular polysaccharide
40
beclometasone inhaler
increased caries risk
increased candida risk
dry mouth
41
salbutamol and acid erosion of teeth
dry mouth
reduced salivary protections against acids
pH change of mouth
GORD
42
advice for inhaler usage
20mins before/after brushing
rinse mouth with water after use
spacer
43
class 3 miller's classification of recession
marginal tissue recession that extends to or beyond the mucogingival jct, with PD AL in the interdental area or malpositioning of teeth
44
class 4 miller's classification of recession
marginal tissue recession that extends to or beyond the mucogingival jct, with severe bone or ST loss in the ID area and/or severe malpositioning of teeth
45
IO signs of bruxism
tongue scalloping
wear facets
linea alba
46
local causes of tooth mobility
periodontitis
root resorption
PA pathology
47
factors influencing tooth mobility
width of PDL
height of PDL
inflammation
number, shape and length of roots
48
most freq causes of TN
areas of focal demyelination on the peripheral nerve
| aberrant intra-cranial artery in the cerebellopontine region
49
MS S+S
intention tremor
| balance impairment - loss of proprioception
50
brain tumour S+S
seizures
| memory problems
51
viruses linked to Bells palsy
HSV1
| VZV
52
faint physiology
reduction in blood returning to heart
reduction in bp, heart beats harder and faster (ANS)
brain responds inappropriately and causes further drop in bp - vasovagal faint
53
differential diagnosis for burning tongue
oral dysaesthesia (BMS)
subclinical infection
glossopharyngeal neuralgia
54
primary BMS
no underlying
| damage to nerves that control pain/taste?
55
possible causes of BMS
```
anxiety/depression
haematinic deficiencies
parafct
hormonal changes - DM, thyroid
allergy
xerostomia
acid reflux
```
56
swelling PD pocket
trauma
blockage
increased tissue tone of pocket following NST
57
oral manifestations of herpes
PHG
herpes labialis
KS
hairy leukoplakia
58
oral diseases caused by EBV
hairy leukoplakia
infectious mononucleosis (glandular fever)
Burkitt's lymphoma, nasopharyngeal cancer, OSCC
59
SG tumours incidence in parotid gland
```
pleomorphic adenoma
Warthin's tumour
adenoid cystic carcinoma (most common minor SG tumour)
mucoepidermoid carcinoma
acinic cell carcinoma
```
60
how does F have a bacteriocidal effect?
inhibits ATPase in the s mutans meaning it interrupts acid tolerance
61
SR of a salivary duct calculus
```
LA
incise FOM over duct to expose duct
place a holding suture behind calculi to prevent movement further along the duct
incise at duct orifice or along duct
squeeze out stone
suction
haemostasis, suture wound, POI
```
62
RFs for creating OAC
proximity of tooth to MS, large sinus
abscess/cyst associated with tooth extracted
hypercementosis
difficult ext
divergent roots
poor ext technique with excessive apical pressure
63
MCV
80-97
64
metronidazole mechanism
inhibits nucleic acid synthesis by disrupting DNA of microbial cells
65
criteria for MRONJ diagnosis
hx/tx with antiangiogenics/antiresorptives such as bisphosphonates and denosumab
exposed/non-healing bone >8wks
no hx of radio to H+N region
no obvious metastatic disease of the jaws
66
pain caused by dentine hypersensitivity - hydrodynamic theory
D has no direct innervation, v few fibres may be present in the inner 1/3, pulp is highly innervated
stimulus applied to outside of D causes movement of dentinal fluid
movement of fluid at pulpal end of tubules stimulates nerve endings in inner 1/3 and at the pulp, causing pain
blocking dentinal tubules (and therefore prevention of stimuli affecting dentinal fluid) prevents pain
67
adhesive bridge failure
```
cementation fail
lack of moisture control
divergent pathways
parafct
lack of regard for occlusion
poorly retentive prep
trauma
caries
```
68
why does cantilever have better prognosis than F-F for upper anteriors?
not subject to forces from divergent pathways
only involves one natural tooth
less worry about parallelism
less occlusal interference
69
risks of decalcification
```
poor aesthetics
sensitivity (pain)
debonding
poor tx outcome
could progress to gross caries - loss of vitality
```
70
diagnostic features of fluorosis
severity is F dose dependent - white areas/enamel opacity to areas of discolouration, pitting and hypoplastic effects
distribution on tooth surface is time dependent, areas affected will correlate with E formation at time of excess consumption - can help distinguish severe fluorosis from AI
71
causes of amalgam fracrure
CSM finished under centric stop
CSMA <70 degrees
amalgam thickness <2mm deep occlusally or <1mm deep elsewhere
secondary caries
pt occluded on it before it was fully set
too much liquid mercury in the amalgam mix
creep
trauma
high Rx
72
preventing amalgam fracture
appropriate cavity prep and Rx design (margins not under centric stops, margins >70 degrees, ideally 90 degrees)
correct thickness of amalgam
appropriate pt advice after seating - avoid eating on it for 24hrs to allow it to set properly
good OHI, diet advice and F to reduce caries risk
use amalgam capsules containing pre-set amounts of mercury and alloy powder to minimise risks of incorrect proportions being used during mixing
73
amalgam setting reaction
Ag3Sn + Hg ---> Ag3Sn + Ag2Hg3 + Sn7Hg9
| y +Hg ---> y + y1 + y2
74
copper enriched amalgam equations
y2 + AgCu ---> Cu6Sn5 +y1
| OR AgSnCu + Hg ---> AgSnCu + y1 + Cu6Sn5
75
y2 phase properties
poor strength and abrasion resistance
76
modern amalgam and copper
has high Cu (>12%) content to reduce y2
| copper reacts with tin to reduce availability of tin for y2 phase
77
pathological response to traumatic occlusion
PDL widens, tooth symptomatic/widening of PDL space fails to stabilise
tooth not adequately compensating for the changes
78
assessing where a high Rx is
articulating paper - shimstock 8um in Millers forceps
diagnostic mounting of casts
visual examination
floss
79
tx options for mobile teeth presenting with widened PDL space
control any plaque-induced inflammation - increases tissue tone and prevents any bone or AL that may contribute to mobility
occlusal correction - selective grinding, replacement Rxs, ortho
splinting - temp/long term stabilisation of v mobile teeth. May make harder to clean so not ideal if PD involvement. May also mask underlying disease progression. Not a tx for PDD
80
CHX mechsnism
dicationic
1 cation adheres to pellicle and 1 cation disrupts bacterial membrane
+ charged CHX attracted to - charged phospholipids in bacterial cell wall
CHX binding causes the cell wall to rupture and allows fluid to leak from the bacteria, leading to cell lysis and death
81
CHX substantivity
12hrs
82
surgicel
oxidised cellulose mesh that absorbs blood and swells into a gelatinous mass that aids clotting
resorbable
has a degree of bactericidal effect
careful for L8s - acidic and can damage nerve
83
kaltostat
calcium sodium alginate dressing, forms a hydrophillic gel with wound exudate to maintain a moist wound interface and prevent tissue maceration
84
bone wax
sterile mix of beeswax, paraffin and a softening agent (isopropyl palmitate) used to mechanically plug bleeding vascular channels in bone
affects osteogenesis so not used in regions that may regenerate
85
immediate bleeding
within 48hrs
likely rebound or reactionary effect of tx as the vasoconstrictors wear off, sutures are lost or wound is traumatised by the pt
86
later post op bleeding
3-7days
| more likely due to an infection, usually a mild ooze but can be more serious
87
indications for Warfarin
heart surgery - prosthetic replacement heart valve
coronary heart disease (post-MI, angina)
stroke prevention for pts w AF
thromboembolic disease e.g. DVT, PE
88
how to restore excessive FWS with worn dentures
occlusal pivots or restore occlusal surface with autopolymerising acrylic resin
89
oral signs of anaemia
```
pale mucosa
mucosal atrophy
atrophic glossitis
stomatitis
angular cheilitis
burning
ulcers
```
90
6 basic pt values
```
working together for pts
respect and dignity
commitment to quality of care
compassion
improving lives
everyone counts
```
91
plasma cell gingivitis
rare, benign
diffuse and massive infiltration of plasma cells into the sub-epithelial gingival tissue (CT)
diffuse enlargement with oedematous swelling of gingivae in anterior region
unknown aetiology - is it due to a hypersensitivity reaction to an allergen?
possibly due to neoplasia
92
meds linked to LTRs
diuretics - bendroflumethiazide
anti-hypertensives - B blockers, ACE inhibitors
NSAIDs
antimalarials - hydroxychloroquine
93
when may fordyce spots be more noticeable?
thinning of mucosa
| more aware of OH due to recent dental tx
94
what was used before MTA to seal end of root?
amalgam
95
what can amalgam be spread by?
Langerhans cells (APCs)
96
management of ROU in HDS
investigstions - FBC, exclusion diet/patch test - doesn't give definitive info
exclude coeliac and refer to gastroenterology if IBD suspected
systemic therapy if not controlled with topical - prednisolone
97
yellow base of ulcer not present
area still being traumatised
98
OSF
associated with betel chewing
| epithelial inflammatory reaction and progressive fibrosis of submucosal tissue
99
actinic cheilitis compared to IO carcinoma prognosis
much better
later metastasis (to submental nodes) and slow prognosis
cure rate high and easy to monitor
100
differential diagnoses of neck swelling
```
lymphoma
carotid body tumour
brachial cyst
sebaceous cyst
metastatic cancer in neck node
```
101
how does cancer differ from an infective cause of neck swelling?
slow enlargement
painless (gradual stretching of fascia)
not fluctuant
- but fixation can occur in chronic infection to be fibrosed
102
complications of mumps
encephalitis
pancreatitiis
meningitis
deafness
103
nebuliser
liquid medicine into a fine mist which you then breathe in
104
saliva substitutes
glandosane
saliva orthana
salivese
biotene
105
perivascular infiltrate
the mononuclear inflammatory cell infiltrate around the venules indicates a delayed type of hypersensitivity reaction
106
hyperplasia
increase in all layers of epithelium
107
why are there no Tzank cells in pemphigoid?
no weakening of attachment (acantholysis)
108
pigmentary incontinence
melanin pigment leaking out into the LP
| leaks out of epithelium into tissue and stains
109
grading
resemblance of the cells to the tissue of origin
| ability to carry out same fct as tissue of origin
110
what is mucous retention cyst lined by?
epithelium
111
where is mucous retention cyst more common?
upper lip in older adults
112
what is the most common site of pleomorphic adenoma of minor SGs?
palate
113
adenoid cystic carcinoma issues
local recurrence - difficult to determine clinically how far the tumour has spread and if surgical excision is incomplete
most likely metastasis - haematogenous spread to the lungs which is unusual for a carcinoma. LN metastasis to neck nodes is unusual
114
what to ask for in a pus aspirate?
culture and susceptibility testinf
115
safety elements when transporting materials to lab
needles must be removed from syringes and disposed of in a sharps safe waste container
transport in leak-proof containers and protected against damage
need absorbant material in case specimen leaks
at least 2 leakproof solid containers
distinct labelling on outside and practice address
116
common bacteria isolated from acute dentoalveolar abscess
streptococci - s anginosus
| strict anaerobes e.g. prevotella intermedia
117
role of pus sampling in AM stewardshipq
can take several days to obtain a C+S report from a pus aspirate and the immediate benefit of taking a specimen may not be readily apparent for most patients
but accumulation of data on susceptibility patterns helps inform the production of empiric AB prescribing by providing up to date surveillance data as patterns of AM resistance can change over time
also not all pts will respond as expected to tx and microbial identification and susceptibility testing can help inform clinical decisions
118
principles of in pt management for acute dental infection
1 - assessment of airway
2 - S+S of sepsis and resuscitation as appropriate
3 - IV ABs - benzyl penicillin and metronidazole
4 - I+D under GA (+ ext of infected teeth)
5 - pus aspirate for C+S testing
119
denture-induced stomatitis - Newton's Classification
type 1 - pinpoint hyperaemia (localised erythema)
type 2 - diffuse erythema
type 3 - granular erythema (papillary hyperplasia)
120
what should you consider if there are unusual species in the microbiology report?
concern that pt is IC and possibly HIV+
| - refer urgently
121
EM
hypersensitivity type 3
skin reaction to infection/drug exposure mediated
immune complexes deposited in superficial layer of skin and oral mucous membrane
- >50% cases due to HSV (1>2)
122
drugs predisposing to EM
```
NSAIDs
penicillin
sulphonamides
nitrofurantoin
phenothiazines
anticonvulsants
```
123
long-term potential sequelae of shingles
post-herpetic neuralgia
124
replacement options for central incisor crown fractured completely off to root at short notice?
provisional overdenture
provisional post-crown
vacuum formed splint w tooth
rebond fractured crown
125
clinical signs of erosion
loss of surface detail
smooth or polished surfaces
exposed D
cupping
126
implant bone dimensions
1.5mm horizontal bone round implant
3mm between implants
>5mm between bone crest and CP
127
check if a bridge has debonded
```
probe
visually
mobility
push and check for air bubbles
floss
```
128
tx reversible pulpitis
removal of caries or other causative factor and Rxs
129
nerve fibres most susceptible to LA
Ad, C, Ab, Aa
| smaller nerves affected quicker
130
LA constituents
```
base hydrochloride (anaesthetic agent)
vasoconstrictor
fungicide
reducing agent
preservative
```
131
what are molars better with than a post?
pulp chamber retention
132
primer
HEMA supports collagen fibrils and makes space for bond
133
inorganic content % of dentine
calcium hydroxyapatite 70%
134
advantages of amalgam
```
strong
abrasion resistance
corrosion improves marginal seal
radiopaque
long-lasting
cheap
easy
quick
```
135
disadvantages of amalgam
```
excessive tooth prep as not bonded
aesthetics
mercury toxicity
creep
weak in thin sections
high thermal conductivity
allergy
tattoo
galvanic reaction
```
136
criteria before you obturate
asymptomatic
canals dried
chemomechanical disinfection completed satisfactorily
137
sealer fct
fill lateral canals and the space between tooth and GP
| hermetic seal
138
why obturate?
seal remaining bacteria
provide apical and coronal seal
prevent reinfection
139
what % of U6s have an MB2 canal?
93%
140
advantages of crown down technique?
```
removes bulk of infected tissue
reservoir for irrigant
keeps reference point for WL
make SL access easier
limit spread of infected material at apical foramen
```
141
cementing a porcelain
silane coupling agent
covalent bonds to oxide groups on porcelain surface (hydrophilic)
hydrophobic C=C reacts with silane in composite
- etch in lab w HF acid
142
what should you do before modifying your cavity prep/finishing?
choose material
143
signs of occlusal trauma
```
pain not explained by infection
fracture of Rxs or teeth
mobility
NCTSL
TMD
scalloping, pronounced linea alba
```
144
monitoring TW
BEWE index
Smith and Knight
photos
study models
145
what % of adults have TW?
60%
146
features of a cavity for composite
no US E
no sharp internal LAs
bevel CMSA to increase area for bonding
147
techniques for placing composite
flowable at base to reduce contraction stress
incremental placement to have a low configuration factor
no more than 2mm increments to avoid soggy bottom
148
cavity features for amalgam
```
UCs for retention
other retention factors e.g. lock and key, grooves
>2mm depth for sufficient strength
flat occlusal floor
CSMA 90-120 degrees
no US E
```
149
advantages of Protaper over Kfiles
shape memory
reduced lateral pressure so reduced risk of ledge, zip etc
reduced number of instruments needed
increased cutting efficiency
150
reasons a file may separate
cyclic fatigue
torsional fatigue
flexural stress
torsional stress
151
consequences of amalgam overhang
secondary caries
gingivitis and PDD
may also lead to amalgam fracture in thin section
152
fcts of a facebow
mount upper casts
position upper cast
give relationship of upper occlusal plane to condyle
transfer angle of maxillary occlusal plane to a horizontal reference plane
153
anterior guidance preferred why
easy to reproduce
protect teeth and Rxs
easy on muscles
154
all metal crown reductions
axial 0.5mm
NFC 0.5mm
FC 1.5mm
chamfer 0.5mm
155
MCC reductions
```
axial 1.5mm
FC 2mm
NFC 1.5mm
chamfer 0.5mm
shoulder 1.5mm
```
156
ceramic crown reductions
axial 1mm
NFC 1mm
FC 1.5mm
shoulder 1mm
157
acrylic faults during production
contraction porosity - too much monomer and poor pressure
gaseous porosity - monomer boiled off
granular porosity - not enough monomer
crazing - too much stress
158
GIC composition
powder - fluoroaluminasilicate glass
| liquid - polyacrylic acid
159
why is RMGI not good as a luting agent?
contains HEMA which absorbs water and swells
| cytotoxic
160
tempbond constituents
base - zinc oxide, starch and mineral oil
| accelerator - EBA, eugenol, carunba wax
161
zirconia bonding
cannot be etched, will not chemically bond
| retention is micromechanical
162
why are lithium disilicate crowns strong?
crystals stop crack propagation
163
preventing postural hypotension
allow chair to sit up gradually and encourage pt to take their time and take deep breaths
164
GABA
gamma amino butyric acid
| inhibitory neurotransmitter in CNS
165
1/2 life of midazolam
90-150mins
166
ASA classifications
```
1 - fit and well
2 - mild systemic disease
3 - severe systemic disease
4 - severe systemic disease with threat to life
5 - moribund
6 - brain dead
```
167
managing a knife edge ridge impressions
take primary imp as normal
for master, manage similar to a flabby ridge
- take a mucocompressive imp then relieve areas around the knife-edge with a scalpel
then take a 2nd mucostatic imp with a light body material
168
soft lining
may be used on healthy mucosa as a cushion/shock absorber in a reline or for atrophic/knife edge ridges
169
tissue conditioner
used in unhealthy/ulcerated mucosa to aid healing
| also dissipates forces but is a more short-term option
170
fct impression
used w a tissue conditioner
material is applied and pt wears the denture and imp in fct for <24hrs
they return and imp is sent to lab for a reline
171
improving denture retention
```
remaking
rebase
reline
implant retained
precision attachments
```
172
why is the buccal shelf used for support?
it is non-resorbable
173
shade factors
value
hue
chroma
translucency
174
disadvantages of immediate dentures
resorption makes fit poor
requires reline/rebase
no trial stage
difficult with surgical XLA
175
clot
vasoconstriction
platelet plug
fibrin clot
176
aspirin action
inhibits platelet aggregation
177
heparin action
accelerates the rate of neutralisation of certain activated CFs by AT
178
stages of development of a biofilm - ACACD
```
adhesion
colonisation
accumulation
complex
dispersal
```
179
virulence factors for p gingivalis - PAGET
```
proteases
adhesins
gingipains
endotoxins
toxic byproducts
```
180
virulence factors for c albicans GAMES
```
germ tube formation
adhesins
metabolic acids
EC enzymes
switching mechanism
```
181
virulence factors of s mutans ASAP
adhesins
sugar modifier enzymes
acid tolerance
polysaccharide
182
swallowing liquids
from mouth
| posterior oral seal
183
swallowing solids
```
oral cavity continuous with pharynx
ingestion
stage 1 transport
mechanical processing
stage 2 transport
swallowing
```
184
stages of tooth development
```
initiation
morphogenesis
cytodifferentiation
matrix secretion
root formation
```
185
4 parts of the late bell stage
inner enamel epithelium
external enamel epithelium
stellate reticulum
stratum intermedium
186
PD abscess
acute exacerbation of an existing PD pocket e.g. trauma or obstruction
187
managing traumatic occlusion in a pt w PDD
HPT
| bite raising appliance to be worn at night
188
factors influencing localised mobility
```
existing PDD
traumatic occlusion causing widening of the PDL
morphology and length of rooths
PA bone loss
resorption
trauma
```
189
NG microbiology
fusospirochaetal complex - treponema denticola, prevotella intermedia
190
bone loss radius of destruction of plaque
about 2mm
191
SEs of CHX
stain
taste disturbance
anaphylaxis
interacts with SLS
192
local factors for gingival recession
```
PDD
habits
traumatic toothbrushing
abrasive TP
high fraenal attachment
crowding
traumatic occlusion
orthodontics
```
193
managing localised recession
```
atraumatic TB technique
minimise other RFs
monitor
tx sensitivity
free gingival graft (from palate)
root coverage surgery
```
194
indications for regenerative PD surgery
2 and 3 walled defects
G2 furcation in L teeth
G2 buccal furcation in U molars
195
diabetes as a RF for PDD - WIPA
poor wound healing
both pro-inflammatory diseases
impaired PMN fct
advanced glycation end (AGE) products causing increased tissue destruction
196
tests for diabetes
RPG >11.1mmol/L
FPG >7mmol/L
= on 2 occs
GTT
197
HbA1c ideal
48mmol/L or below
198
smoking affects PD tissues CCEB
impaired chemotaxis and phagocytosis
affects cytokine production
affects enzyme catalases
blood flow restricted
199
IL-1
a pro-inflammatory cytokine
| stimulates the release of enzymes and OCs causing increased tissue destruction
200
NST may not be successful
```
inadequate RSI
furcation/angular defects that are difficult to adequately clean
motile anaerobes moving into tissues
pt not adhering to OHI
pt IC
```
201
topical effects of F
reduce acid production by plaque
promote remineralisation
bactericidal
remineralised E as fluorapatite
202
pulp tx failure
clinically - mobility, pain, fistula
| radiographically - radiolucency, resorption, furcation
203
cause of AI
gene mutation of amelogenin and enamelin proteins
204
what can HSV1 reactivation cause?
herpes labialis (15-30% pts) or bells palsy
205
indications for SSC
```
MR broken down
restore primary molars
MIH
after pulp tx
space maintenance
```
206
health issues associated w Down syndrome
```
VSD
epilepsy
leukaemia
hearing problems
cataracts
```
207
external inflammatory resorption pathogenesis
progressive resorption of external root surface due to damaged PDL resulting in necrotic pulp tissue via dentinal tubules
pH low therefore acidic so OCs stimulated - cementum and bone resorption
208
clinical external inflammatory resorption
- to sensibility test
may be TTP
may be mobile
209
radiograph external inflammatory resorption
tramlines intact but loss of LD
| defect moves with a 2nd radiographic view
210
autism triad of impairment
communication
social imagination
social interaction
211
other features of autism
```
sensory sensitivity
obsessive
learning difficulties
epilepsy
tubular sclerosis
```
212
indications for FS
high caries risk
medically compromised pts
caries in primary dentition
caries in permanent dentition
213
types of CP
spastic
ataxic
athetoid
mixed
hemiplegia
diplegia
paraplegia
quadriplegia
214
CF dental
thick saliva so reduced caries but increased calculus
E defects
delayed eruption
avoid GA and sedation
215
biopsy LP
symptomatic
smokers
erosive
216
2 ways trigeminal neuralgia can occur
demyelination causing CN5 ischaemia
| aberrant arteriole in cerebello-pontine region lying on the nerve - blood pulsing causes nerve activation
217
anaemia
reduction in oxygen carrying capacity of the blood due to a deficiency of Hb or rbcs
218
oral signs of anaemia
ROU
candida
glossitis
(smooth iron, beefy vit B12/folate, burning mouth, mucosal pallor)
219
tx of plasma cell gingivitis
prevent exposure to allergen e.g. SLS, benzoates, cinnamon, through dietary advice
220
managing xerostomia
underlying condition
prevention (OHI, F, diet)
symptomatic relief - substitutes
221
ways ABs work
```
cell wall destruction
protein synthesis inhibition
cell membrane inhibition
DNA synthesis inhibition
DNA replication inhibition
```
222
disadvantages of ABs
resistance
GI upset
drug interactions
223
mechanisms of AB resistance
drug reaction
altered target site
reduced accumulation
altered metabolism
224
U vs L MND
"upper spares upper"
everything above eyebrows still fcts in U (CVA)
U part of facial motor nucleus receives both crossed and uncrossed fibres so the frontalis and orbicularis oculi muscles are spared - can furrow brow
225
causes of LMN disease
```
reactivated HSV causing bells palsy
mastoiditis
trauma
parotid tumour
LA
HIV
```
226
management of LMN disease
80% resolve in weeks
prednisolone to reduce swelling of facial nerve at stylomastoid foramen
eye protection
227
common causes of TMD
stress
parafct
occlusal discrepancies
trauma
228
TMJ nerve supply
auriculotemporal and masseteric branches of V3
229
BRA
minimise parafct habits
minimise load on TMJ
provide stable occlusion
eliminate occlusal interferences
230
diseases caused by coxsackie virus
HFM, herpangina, haemorrhagic conjunctivitis, aseptic meningitis
231
EBV fdiseases
hairy leukoplakia
burkitt's lympgoma
IM
232
asthma
reversible airflow obstruction
- smooth muscle contraction
- inflamed mucosa causing swelling
- increased mucus secretion
233
dental aspects of asthma
```
increased candida - steroid effects
increased erosion (intrinsic GORD, extrinsic meds), reduction in saliva exacerbating both
--->rinse w water, use spacer
possible allergy to colophony in FV
MEs for asthma attacks
```
234
S+S oral cancer
sites - lat tongue, FOM, SP
signs - unexplained >3wks white/red patch, ulcer, swelling, hoarseness, unexplained mobility
ulcer - rolled border, indurated, bleeding, numbness, pain
235
necrotising sialometaplasia histology
```
slough
inflammation
hyperplastic
metaplasia
necrosisq
```
236
OFG histology
non-caseating GCs
oedema
dilated lymph
237
radio risks
```
mucositis
xerostomia
ORN
increased infection
poor wound healing
```
