Prosthodontics ODTP

Question 1

1. 4 further questions regarding missing teeth (2)

Answer 1

 When was it missing since
 Why is the teeth missing
 Does it affecting speech or mastication
 Is there food trapping in the edentulous area
 Preferred solution (bridge, crown, partial denture, implant)

Question 2

Otto lam is wearing a denture as shown in the picture. He feels pain on biting on the left area under the denture

a. 8 Questions regarding pain history you should ask

Answer 2

 Where is the pain?
 When do you feel pain? Upon biting or eating cold or hot food?

 How long has the pain been?
 Any alleviating factors?
 How long does the pain last?
 Quality of the pain e.g. dull or sharp pain
 Rate the pain from 1 to 10
 Does it bother sleep?

Question 3

Otto lam is wearing a denture as shown in the picture. He feels pain on biting on the left area under the denture

b. 4 Questions regarding the denture history you should ask

Answer 3

• Pain
• Muscle pain e.g. bilateral in temporalis and masseter muscle
• Lack of efficiency
  
  • Lack of retention
  • Jaw relationship error
  • Errors in eccentric occlusion
  • Reduced OVD
  • Errors in the orientation of the occlusal plane
  • Errors in tooth position
• Appearance
• Speech
  
  • Thickness of the denture base
  • Excessive OVD
  • Errors in the length of the incisors
  • Errors in the anteroposterior position of the incisors

Question 4

Your patient is wearing an upper removable partiable denture

a. Describe the condition of mucosa (4)

Answer 4

 Red
 Inflamed
 Swollen
 Pin-point bleeding

Question 5

Your patient is wearing an upper removable partial denture

b. What is your diagnosis for this condition; what is the common microorganism causing it (1)

Answer 5

Denture-related stomatitis, candida species e.g. Candida albicans –> if have, can give Nystatin or Amphotericin B

Question 6

Your patient is wearing an upper removable partial denture

c. What are the local and systemic factors give rise to this condition in mucosa (4)

Answer 6

Question 7

Given a panoramic radiograph, clinical photos of occlusal view of upper and lower arch.

The patient have some teeth extracted and want to replace the teeth.

a. Describe the change in oral condition by using the information from the radiograph and clinical photos

Answer 7

Probably shows then and now images for both clinical photos and radiographs Points to note

Question 8

a. Describe oral conditions shown by clinical photo

Answer 8

 Check for missing teeth
 Cheek for perio condition, any swelling or redness, has it increased or decreased

 Look for plaque and calculus
 Any there any recession
 Any tooth wear
 Any new caries
 Any over-eruption of teeth
 Drifting of teeth
 Any defective margins

Question 9

b. Describe xray finding on 21, 37 PA

Answer 9

 Probably tells us to look at the bone level and whether if there is any periapical radiolucency or radiopacity

 As well as, any radiolucency on the crown

Question 10

A chart showing multiple missing teeth (RPD)

a. What is the problem in the OPG(over-eruption on 16, missing opposing)

Answer 10

 Check for missing teeth

 Check for bone level, are there anymore decrease in both horizontal and vertical bone level

 Over-eruption

 Drifting of teeth

 Any bone pathologies

 Any radiolucency or radiopacity

 Any overhangs on crowns or bridges

Question 11

a. General features from clinical photographs (5)

Answer 11

 Recession
 Embrasure widening with black triangle

 Plaque

 Partial edentulism - multiple missing teeth

 Restorations (amalgam)
 Defective crown/ bridge on 22-23

Question 12

b. How would you assess the bridge on upper left quadrant?

Answer 12

 Defective - fracture porcelain

 Plaque-retentive

 Poor aesthetics

 No proximal contact

 How to clinically assess: run probe along crown margins to check for ledges, check pulp vitality if possible, check mobility, pain on palpation/percussion, check for worn opposing teeth…

Question 13

a. How do you do a clinical assessment of TMJ? (5 marks)

Answer 13

Question 14

9. C/O discomfort. Crown done many years ago by pt’s husband, a dental technician. A smoker. Given: PAN, // PA (Summative, 2005)
   a. 5 pathological findings from the radiograph.
   b. What are the likely causes of the patient’s discomfort? What is the mechanism of development of the discomfort?

Answer 14

 Leakage, secondary caries

 Fracture

 Perioendo lesion

Question 15

9. C/O discomfort. Crown done many years ago by pt’s husband, a dental technician. A smoker. Given: PAN, // PA (Summative, 2005)
   c. What investigations need to be done?

Answer 15

Assuming that leakage, secondary caries, fracture and perioendo lesion all occurs on the tooth that has a crown done

• EPT, cold test and percussion test
  
  • EPT –> to check if pulp necrotic
  • Cold test –> to check if irreversible pulpitis
  • Percussion –> to check for apical involvement
• If sinus tract present, use a size 25 or 30 gutta percha and trace the origin
• Measure pocket depth around the tooth to see if there is any localized deep pockets which may indicate that it is a primary endo and secondary perio lesion

Question 16

9. C/O discomfort. Crown done many years ago by pt’s husband, a dental technician. A smoker. Given: PAN, // PA (Summative, 2005)
   d. Differential diagnosis

Answer 16

 Irreversible pulpitis.

 Primary endo and secondary perio. OR Endo-periodontal lesion in non-periodontitis patients (2017 classification)

Question 17

9. C/O discomfort. Crown done many years ago by pt’s husband, a dental technician. A smoker. Given: PAN, // PA (Summative, 2005)
   e. Discuss the treatment options for the patient.

Answer 17

 Root canal treatment and then post and core and crown

 Extraction
 Hemisection if molars