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BDS Exam style questions > Restorative > Flashcards

Restorative Flashcards

1
Q

What are the steps in immediate treatment of traumatised 12 and 11. 12 is completely missing crown and has sub alveolar fracture, 11 has pulpal exposure greater than 2mm. Both are sensitive.

A

Trauma sticker

Apply LA and dam

Clean with water

Remove 2mm of pulp with high speed (whole width)

Place saline cotton wool over exposure until
haemostasis achieved (if not proceed with full coronal pulpotomy)

Apply CaOH the vitrebond
-> restore with composite

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2
Q

What makes a tooth with sub-alveolar fracture unrestorable?

A

Not enough coronal dentine to retain a crown/indirect restoration

Moisture control is impossible

Cannot take impression for indirect restoration

Difficult to clean

Cannot establish marginal integrity

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3
Q

What can be done to replace an anterior tooth following extraction?

A

Bridge

Implant

Partial denture

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4
Q

If a patients anterior bridge has de-bonded, what is the likely design of the bridge?

A

Adhesive fixed-fixed

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5
Q

Bridge de-bonded on abutment tooth 12 but not on abutment tooth 21. The de-bonded wing on the 12 became a plaque trap leading to caries and ultimately causing pain. Name a better alternative bridge design for this patient and explain why your design would be better?

A

Adhesive cantilever
-> not affected by divergent guide paths
-> would come out and not trap plaque

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6
Q

What can cause a bridge to de-bond?

A

Heavy/unfavourable occlusal forces

Lack of moisture control during bonding

Parafunction

Trauma

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7
Q

What components in CoCr provide tooth support?

A

Occlusal rests

Cingulum rests

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8
Q

What are the different Kennedy classifications?

A

Class 1- bilateral free end
Class 2- Unilateral free end
Class 3- unilateral bounded
Class 4- anterior bounded crossing midline

Most posterior saddle used, extra saddles are classified as modification

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9
Q

What else can rest seats be used for instead of support ?

A

Indirect retention

Bracing and reciprocation

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10
Q

What are the different types of clasps?

A

Gingival approaching
-> T, roach T, I bar
Occlusally approaching
-> Ring

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11
Q

Why may there be areas of mucosa relieved by framework in an RPD?

A

Less mucosal covergae

Easier cleaning

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12
Q

A patient attends with radiolucencies present from 32-42 which are all endodontically treated and have post and core. What are the treatment options?

A

Extraction

Periradicular surgery

Re-RCT

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13
Q

What are the criteria for valid consent?

A

Informed

Voluntary

Not coerced

Not manipulated

With Capacity

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14
Q

What things should you tell the patient before proceeding with treatment?

A

What the treatment is and what it involves

The risks of the treatment

The benefits of the treatment

Alternative options

Risks of no treatment

Cost of treatment

Your recommended option

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15
Q

What are the restorative options for a 26 which has a fractured MOD amalgam and has been root treated?

A

MCC

Onlay with cuspal coverage

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16
Q

What are the restorative options for a 26 which has a fractured MOD amalgam and has been root treated?

A

MCC

Onlay with cuspal coverage

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17
Q

What do you do if GP has been exposed in the mouth for more than 6 months?

A

Re-RCT as GP has been exposed to oral environment for more than 3 months

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18
Q

What is a Nayyar core?

A

Retention is obtained from undercuts in canals and pulp chamber

2-4mm of GP is removed and replaced with amalgam

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19
Q

What materials can bond amalgam to tooth?

A

GIC

RMGIC

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20
Q

What are the types of tooth wear?

A

Attrition

Abrasion

Abfraction

Erosion

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21
Q

What are the different scores in the BEWE classification?

A

0= No erosive wear
1= Initial loss of surface texture
2= Distinct defect-hard tissue loss <50% of surface
3= Hard tissue loss >50% of the surface area

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22
Q

What can be used to desensitise a tooth?

A

DBA

FV

Densitising toothpaste

Tooth mouse

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23
Q

What is the Dahl technique?

A

Using restorations or appliance to create space for restorations in areas of localised tooth wear

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24
Q

How does the Dahl technique work?

A

Propping occlusions open anteriorly with a bite plane/composite build up creating posterior disocclusion to allow over-eruption

*Anteriors should intrude slightly

-> can increase OVD by 2-3mm

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25
Q

What are 4 contraindications for use of Dahl technique?

A

Active Perio

TMD

If existing conventional bridges present

If implants present

If patient on bisphosphonates

Post orthodontics

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26
Q

What are the constituents of composite?

A

Glass filler particles- quartz, mircofine silica

Monomer- BIS-GMA

Photointiator- Camphorquinone

Low weight dimethacrylates- TEGDMA

Silane coupling agent

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27
Q

Why is RMGIC preferred instead of composite in cervical abrasion cavities?

A

Lower modulus, more flexible than composite in this situation
-> better retention

Easier moisture control

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28
Q

What factors would influence your choice of treatment for traumatic exposure of pulp?

A

Time since exposure- if less than 24 hours

Size of exposure- <1mm

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29
Q

How would you treat an exposed pulp in practice?

A

Partial or complete pulpotomy

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30
Q

When irrigating with sodium hypochlorite what are the causes of extrusion?

A

Using excessive pressure- >1ml/15 secs

Needle locking in canal

Loss of control of working length

Larger apical diameter

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31
Q

What are the steps of immediate management of sodium hypochlorite extrusion?

A

Stop treatment

Inform patient- reassure them

If pain present- LA block to affected area

Observe Haemostasis

Place odontopaste in canal (contains a steroid)

Seal coronal access cavity

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32
Q

What would your action be after that?

A

Cold compresses during the first few days- reduce swelling

Warm compresses for resolution of the soft tissue swelling and elimination of the hematoma

Analgesics (Ibuprofen 400-600mg QDS/Paracetamol 1000mg QDS)

Review within 24 hr

Prescription of antibiotics (case specific)- prevent secondary infection

Refer if severe

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33
Q

How would you prevent a sodium hypochlorite extrusion from occurring?

A

Depress plunger on syringe with index finger

Use side vented needle

Securely attach luer lok needle to 3ml syringe

Set silicone stop on needle ar 2mm less than working length

Ensure all syringes are labelled

Use dental dam with oral-seal if required
-> test with CHX

Ensure needle does not bind in canal

Pre-op radiographic assessment- ensure no open apices

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34
Q

What stage would you expect to use greenstick on posterior saddles?

A

Master imps

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35
Q

What are the components of compound (green stick)?

A

Wax

Resin

Stearic acid

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36
Q

What are the components of alginate?

A

Sodium alginate
Calcium sulphate
Trisodium phosphate
Filler
Modifiers, flavouring, chemical initiators

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37
Q

What are the options to replace central incisor fractured off to root completely at short notice ?

A

Adhesive bridge

Vacuum formed splint with tooth

Provisional over denture

Provisional post crown

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38
Q

What are the different post materials?

A

Stainless Steel

Fibre- glass, quartz, carbon

Gold

Titanium

Ceramic- alumina, zirconia

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39
Q

What are the indications for post size?

A

Minimum 1:1 post length/crown length ratio

At least half of post length into root

Post should be no more than 1/3 of root width at narrowest point with 1mm of remaining circumferential dentine

Ferrule- 1.5mm in height and width of coronal dentine

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40
Q

How are posts cemented?

A
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41
Q

How can posts be removed?

A
  • Ultrasonics
  • Masseran Kit
  • Eggler post remover
  • Moskito forceps
  • Stieglitz forceps
  • Sliding hammer
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42
Q

What are the signs of erosion?

A

Cupping on occlusal and incisal surfaces

Translucency of incisal edges

Lack of staining

Composite/amalgam restorations sit proud of tooth

Base of lesions is out of contact with opposing tooth

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43
Q

What are the causes of erosion?

A
  • Intrinsic- GORD, bulimia, vomiting, xerostomia, hiatus hernia
  • Extrinsic- carbonated drinks, alcoholic drinks, asthma inhalers, sport gels, habits- swilling drinks, vegan diet
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44
Q

How is erosion managed?

A
  • Fluoride supplementation
  • Dietary management- less acidic foods, less snacking
  • Desensitising toothpastes
  • Habit changes- avoid swilling drinks in mouth, drink through straw
  • Control gastric acid- Gaviscon, PPIs, H2 blockers
  • Referral for help with eating disorders
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45
Q

What factors does an implantologist consider before placing an implant?

A

Smoking status

Amount of bone- 10mm of healthy bone

Periodontal condition

Occlusion

Will graft will be required

Aesthetics

Age

Distance between

Soft and hard tissue defects

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46
Q

What are the alternatives to implants for a space?

A

Bridge

RPD

Do nothing

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47
Q

How can you check a bridge has debonded?

A

Visual inspection

Mobility

Probe

Floss

Push and check for air bubbles

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48
Q

What factors should be taken into account before placing a bridge?

A

Aesthetics

Occlusion

Length of span

If tooth had been prepared

Material to use

Abutment teeth condition

OH

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49
Q

What are the alternatives to bridges?

A

No treatment

RPDs

Implants

Overdentures

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50
Q

What are the treatment options with a patient who has congenitally missing 22 and 23?

A

Implants

Bridge

RPD

Orthodontics (combined with restorative)

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51
Q

What are the aesthetic and functional issues with congenitally missing teeth?

A

Aesthetic
- Teasing
- Self consciousness/psychological issues
- Awkward spacing- difficult to fill with prostheses

Function
- Difficulty eating
- Difficulty speaking
- Over eruption of opposite teeth

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52
Q

What would a dentist check before referring a patient for implants?

A

For Periodontal disease

Smoking

Diabetes

OP

Bisphosphonates

Blood clotting disorder

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53
Q

What local features would an implantologist check?

A

Quality of bone

Proximity to nearby anatomical structures

OH

Position of existing teeth

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54
Q

What are the signs and symptoms of reversible pulpitis?

A

Pain is not spontaneous- lasts for a few seconds when stimulated

Pain to cold and sweet

Responds to sensibility testing

No radiographic changes

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55
Q

How is reversible pulpitis managed?

A

Remove caries or deep restoration

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56
Q

What are the signs and symptoms of irreversible pulpitis?

A

Sharp pain on thermal stimuli
-> can linger for 30secs

Spontaneous pain

Referred pain/poor localisation

Accentuated by postural changes

OTC drugs are ineffective

Kept up at night

Non-TTP- hasn’t reached periodontal tissues yet

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57
Q

How is irreversible pulpitis managed?

A

RCT

Extraction

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58
Q

What are 5 causes of transient sensitivity to thermal stimuli and pain on biting following replacement of amalgam filling with composite?

A

Deep restoration with no lining

High in occlusion

Uncured resin irritating the pulp

Polymerisation contraction stress

Tooth preparation has irritated the pulp

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59
Q

How can transient sensitivity and pain on biting after composite placement be prevented?

A

Reduce polymerisation contraction stress
-> Place composite in increments less than 2mm to allow for complete curing
-> Place increments touching as little amount of surfaces as possible (low configuration factor)

Place lining material- RMGIC, flowable

Check occlusion after completing restoration with articulating paper

Use FV- 22600ppm

Use desensitising toothpaste

Use water with high speed when preparing
-> consider excavator for deep caries

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60
Q

How does local anaesthetic work?

A

Prevents propagation of neural signals (action potentials) through blockage of voltage gated sodium channels

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61
Q

What nerve fibres are most susceptible to LA?

A

Ad-> C-> Ab-> Aa

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62
Q

What are the amide anaesthetics?

A

Lidocaine

Articaine

Prilocaine

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63
Q

What are the ester anaesthetics?

A

Procaine

Cocaine

Benzocaine

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64
Q

What are the components of a cartridge of anaesthetic?

A

Anaesthetic agent- base hydrochloride

Vasoconstrictor

Fungicide

Propyl parabéns

Sodium metasulphite/bisulphite

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65
Q

What is the max dose of lidocaine?

A

5mg/kg

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66
Q

What are the characteristics of an ideal post?

A

Non threaded (passive)

Non-tapered (parallell)- avoids wedging

Cement retained

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67
Q

What are the factors which we assess to see if a tooth would be suitable for a post?

A

Ratio of crown to post should be 1:1

Ratio of crown to root should be 1:1.5

4-5mm of root filling present apically

Ferrule present- 1.5mm of coronal dentine present in height and width

Post width- no more than 1/3 of root width at narrowest point and 1 mm of remaining circumferential coronal dentine

Avoid curved canals

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68
Q

What are 3 core materials?

A

Amalgam

Composte

GIC

69
Q

What are the treatment options for large MOD amalgam fractures along both buccal cusps with exposed GP?

A

Extraction under LA

Onlay

Crown

70
Q

If GP has been exposed for 6 months on tooth with fractured MOD amalgam what would you do?

A

Remove restoration and perform ReRCT

71
Q

What has greater bond to tooth out of composite and amalgam?

A

Composite- amalgam does not bond to tooth

72
Q

What are the reasons for debonding of gold post and core?

A
73
Q

Why does fracture of a post occur at junction of post and core?

A

If post and core are made of 2 different materials

74
Q

What are the principles of cavity preparation?

A
  1. Identify carious enamel
    -> remove to identify maximal extent of lesion at ADJ and smooth margins
  2. Remove peripheral caries in dentine from ADJ first then move circumferentially deeper
  3. Remove deep caries over pulp
  4. Modify outline form
    -> Enamel finishing- rounded and smooth (no acute angles)
    -> Occlusion
    -> Any requirements for restorative material
  5. Modify Internal design
    -> Smooth/remove internal line and point angles
    -> Any requirements for restorative material

CSMA
-> remove unsupported enamel
-> aim for smooth finish

75
Q

What is they hybrid layer?

A

The layer of dentine which has been conditioned to remove smear layer and into which adhesive resin flows into to produce collagen/resin phase

76
Q

What are the types of dentine and how do they affect bonding?

A

Primary dentine- laid down during development
-> open tubules which are good for bonding

Secondary dentine- laid down with age
-> ok for bonding

Tertiary Dentine- laid down by odontoblasts (reactionary to mild stimuli/reparative to intense)
-> Poor for bonding due to irregular structure with fewer/sclerosed tubules

77
Q

What is the inorganic content percentage of dentine?

A

Calcium hydroxyapatite- 70%

78
Q

What is the setting reaction for Amalgam?

A

Ag3Sn + Hg -> Ag3sn + Ag2Hg3 + Sn7Hg9

Y + Hg= Y + Y1 + Y2

79
Q

What changes have been made to modern amalgam to improve it?

A

Y2 phase has poor strength and corrosion resistance
-> modern amalgam has high copper (>12%) which has no Y2 phase meaning more corrosion resistance, better strength, less creep, better marginal durability

Use of single composition amalgam

Zinc free- prevents h2 bubbles forming

80
Q

What are the advantages of Amalgam?

A

Durability

Shorter placement time than composir e

Radiopaque

Colour contrast

Self hardens at mouth temp

Resistance to surface corrosion

Good wear resistance

Good bulk strength

81
Q

What are the disadvantages of amalgam?

A

Potential mercury toxicity

Poor aesthetic

Does not usually bond to tooth

High thermal diffusivity

Requires removal of sound tissue during cavity prep

Lichenoid reactions- T4 hypersentivity

Tooth discolouration

Amalgam tattoos

Creep/Marginal breakdown

82
Q

What’re the advantages of using non-Y2 amalgam?

A

Less corrosion

Less marginal breakdown

Higher early strength

Less creep

83
Q

How is Y2 removed?

A

Using copper

84
Q

Why was zinc added to amalgam?

A

Acts as scavenger which preferentially oxidises and removes slag

85
Q

What is the drawback of adding zinc to amalgam?

A

It interacts with saliva/blood forming h2 bubbles which can cause pressure build up and expansion

86
Q

What are the symptoms a patient may feel from zinc in amalgam?

A

Expansion causes
-> downward pressure leading to pulpal pain and upward causing restoration to sit proud

87
Q

What criteria must be fulfilled before obdurating?

A

Tooth must be asymptomatic

Canal must be dried

Chemomechanical instrumentation must have been carried out

88
Q

What are the constituents of GP?

A

Gutta Percha

Zinc oxide

Plasticisers

Radio-opacifiers

89
Q

What are the functions of a sealer?

A

Seal space between dentine and cone

Lubricate the canal

Fill voids- in canal, lateral canals, between GP

90
Q

What are examples of common sealers?

A

Epoxy resin- AH plus

Glass ionomer

ZOE based

Calcium Silicate

91
Q

How would you assess an obturation on a radiograph?

A

Look at length- should be within 2mm of radiographic apex

Check for voids

Check coronal seal

Check taper

Check GP has been removed to oriface level

Check that you haven’t missed canals

92
Q

What are the reasons for obturating?

A

Creates apical seal/coronal seal

Creates environment suitable for healing

Prevents reinfection- entombs exiting bacteria

93
Q

What are the different methods of obturation?

A

Cold lateral compaction

Warm vertical compaction

Continuous wave

Carrier based

Thermoplastic injection

94
Q

What percentage of maxillary FPMs have MB2 canal?

A

93%

95
Q

What are the 3 design objectives of Endodontics?

A

Create a continously tapering funnel shape

Maintain apical foramen in its original position

Keep apical foramen as small as possible

96
Q

What are the advantages of the crown down technique?

A

Coronal part has most bacteria
-> remove this first to prevent inoculating bacteria into the apical region

Less impeded file path

97
Q

What are the laws of pulp floor anatomy?

A

Law of symmetry (excludes maxillary molars)
1. Orifaces of canals are equidistant from line drawn in mesial-distal direction across pulp floor
2. Orifices of the canals lie on a line perpendicular to a line drawn in a mesial-distal direction across the centre of pulp floor

Law of Colour change- colour of the pulp chamber floor is always darker in comparison to the vertical surrounding dentin walls

Law of oriface location:
1. Orifices of the root canals are always located at the junction of the dentin walls and the floor of the pulp chamber.
2. Orifices of the root canals are located at the angles of the junction of dentin wall to the pulpal floor
3. Orifices of the root canals are located at the terminus of the root developmental fusion lines

98
Q

What are the reasons for irrigating?

A

Remove smear layer

Detachment of biofilm

Dissolution of organic matter

Mechanical process alone does not remove all bacteria

Flushes out debris

Disinfects canal

99
Q

Why is sodium hypochlorite a good irrigant?

A

Potent antimicrobial activity

Dissolves pulp remnants and collagen

Dissolves necrotic pulp and vital tissue

Helps disrupt smear layer by acting on organic component

100
Q

What strength of NaOCl is used in Endo?

A

3%

101
Q

What are the other common irrigants?

A

CHX- 2%

102
Q

What is used to remove the smear layer?

A

EDTA- 17%
-> chelating agent that exposes collagen

103
Q

What are examples of Intra-canal medicaments?

A

CaOH- antibacterial (pH 11)

Ledermix- contains steroid/tetracycline used in management of inflamed hot pulps

104
Q

What are the features that make re-fitting of debonded MCC successful?

A

Quality of tooth tissue

Amount of tooth tissue remaining

Mobility

Periodontal status

Pulp Status

Crown root ratio being favourable

105
Q

What are the differential diagnoses for throbbing pain keeping patient up all night- 37 has caries and 38 is impacted?

A

Symptomatic Irreversible pulpitis

Periocoronitis

106
Q

What types of bridge could be used to replace missing upper laterals and what abutment teeth would be used?

A

Resin bonded mesial cantilever

Fixed-Fixed

107
Q

What information is required by technician in order for them to produce a bridge?

A

Material

Tooth- FDI

Shade

Type of pontic

What teeth are being used as abutments

Bite registration

108
Q

How does clinical presentation of caries compare to radiograph?

A

Caries is usually deeper clincially

109
Q

What are the advantages of composite over amalgam?

A

Better aesthetics

Bonds to tooth

Minimal prep required

On demand set

Lower thermal conductivity

Supports remaining tooth structure

110
Q

What are the different types of composite?

A

Bulk-fill

Hybrid

Syringable

Macro-filled

Micro-filled

Condensible

Flowable

111
Q

What are the disadvantages of composite, how can these be minimised?

A

Under-polymerised base
-> Place increments smaller than 2mm

Polymerisation shrinkage
-> Place composite in small increments (keep configuration factor low)

Composite insufficiently cured
-> cure for longer than 30 secs

Moisture sensitive
-> use dental dam

Post-op sensitivity
-> use correct technique and bonding

112
Q

What are the indications for resin retained bridge?

A

Young teeth- Less destructive

Good enamel quality

Large abutment tooth surface area- more space for bonding

Minimal occlusal load

Single tooth replacement

To simplify partial denture design

113
Q

What are the contraindications?

A

Insufficient or poor quality enamel

Long spans

Excess soft or hard tissue loss- perio

Heavy occlusal force e.g. Bruxist

Poorly aligned, tilted or spaced teeth

Contact sports?

114
Q

How do you cement a porcelain bridge?

A

Using nexus- dual cure composite resin with Silane coupling agent
-> bonds to oxide groups and makes hydrophilic porcelain surface hydrophobic so it can bond to C=C double bonds in composite cement

115
Q

How do you cement a metal bridge?

A

Using GIC or RMGIC

116
Q

What is done to surface of porcelain veneer to improve adhesion?

A

Etched with Hydrofluoric acid

117
Q

When else is a silane coupling agent used for in dentistry?

A
118
Q

When is use of dual cure cement indicated?

A

When indirect restoration is thick or opaque and light cure cannot penetrate

119
Q

What is the Shortened dental Arch?

A

20 healthy units with 3-5 occluding pairs

120
Q

Why is it considered acceptable?

A

Acceptable matiscatory function

Acceptable aesthetics

Easier OH- less teeth to maintain

Provides sufficient occlusal stability

121
Q

What are the indications for SDA?

A

Patient does not want denture

Good prognosis of remaining teeth

Missing posteriors with 3-5 occlusal units remaining

Patient unable to afford further treatment

122
Q

What are the contraindications for shortened dental arch?

A

TMD

Poor prognosis of remaining teeth

Periodontal disease

Pathological tooth wear

Malocclusion

123
Q

How can SDA be extended?

A

Resin retained bridge

Implant

RPD

124
Q

What are the requirements for occlusal stability?

A
125
Q

What are the signs of occlusal trauma?

A

Widening PDL on radiograph

Progressive tooth mobility

Fremitus

Wear facets

Fracture

Migration

Cement tears

Root resorption

126
Q

Describe the appearance of the 4 types of tooth wear?

A

Attrition- tooth to tooth contact (parafunction)
-> polished facets/flattening of incisal edges and occlusal plane

Erosion- exposure of teeth to acid
-> loss of surface detail, becomes flat and smooth

Abrasion- physical wear due to foreign object repeatedly contacting tooth
-> wear at site exposed to foreign object

Abfraction:
The loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth
-> Typically appears as loss of tooth substance at cervical margin

127
Q

How can tooth wear be monitored?

A

Indices- BEWE

Photographs

Study models

128
Q

What % of adults have tooth wear?

A

60%

129
Q

What are the intrinsic causes of tooth discolouration?

A

Porphyria

Cystic fibrosis

Loss of vitality- blood products

Fluorosis

Amalgam

Root filling materials

Sickle cell

Hyperbilirubinameia

130
Q

What are the extrinsic causes of tooth discolouration?

A

Tannins

Smoking

Iron supplements

CHX

Chromogenic bacteria

131
Q

How does vital bleaching with Hydrogen peroxide work?

A

Hydrogen peroxide is an oxidising agent that breaks down long chain chromogenic compounds into smaller non pigmented compounds
-> also causes ionic exchange in metallic molecules giving lighter colour

132
Q

What is the active ingredient in whitening bleach?

A

Carbamide peroxide
-> breaks down to form hydrogen peroxide and urea

133
Q

What are 4 risks of vital bleaching?

A

Sensitivity

Relapse

Allergy

May not work

Restoration don’t change in colour

Soft tissue irritation

134
Q

What are the features of a cavity for composite?

A

Does not require undercuts

Smooth margins

No unsupported enamel

No sharp line angles

Beveled Cavo-surface margin angle- increase bonding area

135
Q

What techniques are used to successfully placed composite?

A

Etch enamel- 10 secs
Etch Enamel and dentine- 10 secs

Apply DBA- primes surface for bonding

Put flowable at base- reduce contraction stress and achieve optimal adaption to non-load bearing margins

Place composite in increments that are touching as few surfaces as possible
-> Lowers configuration factor

Place increments <2mm so that adequate curing can occur

Warm composite- mediates contraction stresses

136
Q

What are the features of a cavity prep for amalgam?

A

Undercuts required- retention and resistance form

CSMA- 90 degrees for butt joint finish

Add grooves, isthmus, dove tails for retention

Must be at least 2mm deep

No unsupported enamel

137
Q

How would you find out the aetiology of a discoloured tooth that has been previously traumatised but is non-sensitive or symptomatic? What special investigations would you do?

A

Aetiology:
History- ask about trauma
Examination

Investigations:
Sensibility testing
PA radiograph

138
Q

Treatment options for discolouration?

A

Accept/monitor

Veneer- composite/porcelain

Microabrasion

Bleaching- V/NV

Crown

139
Q

What are some features of design and preparation that may lead to a bridge debonding?

A

Unfavourable Occlusion

Parafunction

Poor abutment teeth health

Poor crown-root ratio

Over-tapered prep (no parallelism)

140
Q

What are the alternative options to a conventional fixed fixed bridge with 2 prepped abutments?

A
141
Q

What are the reasons for debonded post and core?

A

Moisture contamination on cementation

Using incorrect cement

142
Q

What are the reasons for cores fracturing from posts?

A
143
Q

What are the complications that can occur when using a stainless steel file in a canal with 20 degree curve?

A

Perforation

Instrument seperation/fracture

Ledge creation

Zipping

144
Q

What is the protaper sequence for shaping and cleaning a canal to 0.25mm?

A

Before working length calculated: 10k, 15k, S1, Sx

After working length is calculated: 10k, 15k, S1, S2, F1, F2

145
Q

What are the landmarks for an inferior alveolar nerve block?

A

Coronoid notch

Posterior border of ramus

Pterygomandibular raphe

Contralateral premolars

146
Q

What are the alternative techniques to IAN?

A

Akinosi

Gow-gates

147
Q

How do you manage patient if you accidentally inject into parotid gland?

A

Inform patient

Reassure patient that palsy is temporary and will last a few hours

Put eye patch on affected eye to prevent any dust causing damage

Review in 24 hrs

148
Q

What are the reasons for instrumentation of root canal?

A

Removal of infected tissue

Allows delivery of irrigants to apex

Shape canal

Creates shape for obturation

149
Q

What advantages does protaper have over K files

A

Increased flexibility in larger sizes and tapers

Increased cutting efficiency

If used appropriately good safety in use

Can be more user friendly with less instruments and simple sequences

Shape memory

Super-elasticity

150
Q

What are the rotary Endodontics systems?

A

Reciproc

Protaper Gold

151
Q

What are the types of motion files can do?

A

Filing

Reaming

WW- back and forward oscillation of 30-60* with light apical pressure

Balanced force- quarter turn clockwise, half turn counter clockwise

152
Q

What are the reasons for file separation?

A

Curved canal with non-flexible instrument

Lack of straight line access

Cyclic fatigue- flexural stress

Torsional fatigue

153
Q

What are the parts of Posselt’s envelope?

A

ICP- maximum interdigitation

E- edge to edge position of incisor

Pr- maximum protrusion

T- Maximum opening

R- retruded axis position

RCP- retruded contact position

154
Q

What is RCP?

A

First tooth contact when mandible is in retruded axis position

-> reproducible

155
Q

What is Hanau’s Quint?

A

5 variables that affect occlusal contacts:
1. Occlusal plane
2. Condylar distance
3. Incisal Guidance
4. Cuspal angle
5. Compensating curve

156
Q

What is the thickness of shim stock?

A

8 Microns

157
Q

What is the average Biologic Width?

A

2mm

158
Q

If patient says they have had GP exposed in the mouth for 6 months what does that mean for your treatment?

A

You must re-RCT if it has been longer than 3 months

159
Q

How can overhangs on Amalgam be avoided?

A

Correct adaption of matrix band

Use of wedge

Adequate condensing of amalgam

160
Q

What issues can occur due to overhangs?

A

Difficulty cleaning

Food packing

Periodontal disease

Secondary caries

161
Q

How can you manage overhang?

A

Use finshing strip

Replace restoration

162
Q

What are the functions of Facebow?

A

Records intercondylar distance

Records terminal hinge axis

163
Q

What are the different types of articulator?

A

Simple hinge

Average value

Semi-adjustable

Fully adjustable

164
Q

Why is anterior guidance preferred?

A

Less stress on musculature

Posterior teeth are not designed to take lateral forces

Less occlusal trauma and undesirable tooth movements

165
Q

What are the principles of Crown Preparation?

A
  1. Preserve tooth structure
  2. Retention and resistance form
  3. Structural durability
  4. Marginal integrity
  5. Preservation of periodontium
  6. Aesthetics
166
Q

What are the stages of crown preparation?

A

Occlusal reduction

Seperation

Buccal reduction

Palatal and lingual reduction

Finishing

167
Q

What are the reductions for an all metal crown?

A

Functional cusp- 1.5mm
NF- 0.5mm
Finish line- 0.5mm chamfer

168
Q

What are the reductions for MCC?

A

F- 1.8
NF- 1.3
Finish line- Buccal shoulder 1.3mm, 0.5mm palatal chamfer

169
Q

What are the reductions for an all ceramic?

A

F- 2mm
NF- 1.5mm
Finish Line- 1-1.5mm chamfer

BDS Exam style questions (15 decks)

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