Tutankhamen -2 Flashcards
A laser diode works by?
Ablation of tissue
How much bone loss occurs 6 years post extraction? and in the first 6 months? and with guide eruption?
30% (6 years post)
23% (first 6 months)
<1% (with guide eruption)
When is the best time to extract an ankylosed tooth?
as soon as it is identified
When a tooth is ankylosed, the amount of ridge defect depends mainly upon?
the amount of facial growth after ankylosis
What side effect occurs when you move 2nd molars into extracted 1st molars space?
3mm gingival cleft
If the central incisor is located 5mm apical to the CEJ of the other tooth. Do you do closed eruption of apically positioned flap?
Closed eruption
In a patient with palatally impacted canines what surgical exposure technique should be used?
Open eruption
Of impacted canines … are palatal and the primary etiology is…
2/3rds palatal, genetic etiology
Of impacted canines … are labial and the primary etiology is …
1/3rd labially, arch lenth transverse skeletal discrepancy
Orthodontic traction of an unerupted tooth towards the line of the arch should begin … following surgical exposure
no later then 2-3 weeks
A molar has a buccal pocket down to the furcation area, what is the periodontal treatment of choice?
Guided tissue regeneration
If you begin orthodontic treatment in a patient with a 3 wall defect what will happen?
the defect will get worse
A patient presents with a significant crater btwn maxillary premolars what is the recommended periodontal treatment?
Ossesous recontouring
Gingival recession in adult occurs about …% of the time, is more prevalent on which arch?
68% of the time, more prevalent in the mandibular teeth, and occurs more symmetrically
Orthodontic patients with mucogingival problems that require perio tx prior to ortho?
Children …%
Adults …%
5-10% children
20-25% adults
If you find a internal resorption what is the treatment?
Immediate RCT
What are the periodontal indications for controlled orthodontic extrusion?
- one wall vertical defect
- two wall vertical defect
- defect in cervical 3rd of root (not in apical 3rd of root)
How do you treat vertical root fracture?
Extract dat shit
Endodontically treated teeth have what affect on root resorption?
decreased tendency for root resorption
Peak incidence of dental trauma occurs at what age?
8-10 years
With a root fracture 1mm below the CEJ what is the primary thing to evaluate?
Root Length
Tetracycline studies show that implants…
do not move at all
What is the minimum osteointegration required for successful TAD placement?
5% (regular restorative implant 75%)
When 300g of force is applied for 3 months to TAD for anchorage in animals, they are successful …%.
94%
The estimated healing time for implants in the mandible is… and the maxilla is…
Md. 4-6 months
Mx. 6-8 months
When should an implant be placed after extraction of over retained primary?
2 months after extraction
How do you wait for an implant after a bone graft?
9 months
When is the best time to get implants?
when growth ceases
Esthetically how much room do you need for an implant?
7mm
When placing implant the head of the fixture should be how many mm apical to the desired gingival margin?
4mm
When restoring peg laterals, create … space
more space than needed
How much OB is needed for bonded bridge
0.5mm
How much OB is needed for Maryland bridge?
1mm or less
If a patient congenitally missing lateral with retained b and c, how is it managed?
Extract b to guide canine to erupt; then move it distally for a lateral implant. Preserving bone on the lateral Alveolus.
CPR for an adult what is the the compression to breath ratio.
30:2
For adult CPR where do you place your hands for chest compression?
lower half of sternum
How many minutes can the brain survive without oxygen?
4-6 minutes
For an adult CPR, a rescue breath is given every?
5 seconds
What’s the percentage of self-correction of an impacted canine if the tip is distal to the lateral midline?
91%
if mesial to the 2’s > 64%
What is the most common transpositioned tooth?
Maxillary canine
A patient with nasopharyngeal obstruction who undergoes adenoidectomy will go from open mouth breathing to closed mouth brething by what percentage?
80%
What percentage of contemporary US and northern European population exhibit Class II malocclusion?
15-20%
What is the average oral temperature in degree Celsius?
35-37 degrees C (95-99 degrees F)
What statistical test should be used for 3 or more variables?
ANOVA (analysis of variance)
What is the population within one standard deviation? two? three?
68%
96%
99.7%
What is sensitivity?
True positive/pt w/ disease
What statistical test should be used to compare two means?
T-test
What does a Chi-square test measure?
observed vs expected frequency
A statistical correlation is generally expressed as a…
Fraction
What statistically analysis would you use to find relation btwn brushing and gum disease?
Correlation analysis
If there is no correlation btwn two data sets, what is the coefficient?
0 (1 means they are linearly correlated)
What statistically analysis should be used to predict the ceph measurement with mandibular rotation?
Correlation
What is most affected by extreme values? (mean, median, mode)
Mean
What is most affected by a large sample size? (mean, median, mode)
Median
What is the minimum sample size in a ceph study aiming to produce data for a clinical study?
15
A gold standard in clinical research for evaluating a clinical procedure?
Randomized clinical trial
Where is the thyroglossal duct attached to the foramen cecum?
at the posterior of the sulcus terminalis
Is the Nasal floor higher in an adult or a child?
Children
The Lacrimal bone articulate with what bones (4)?
Frontal, inferior concha, maxilla, ethmoid
A Brown tumor is associated with what disease?
Hyperparathyroidism (Stones, bones and abdominal groans)
-loss of lamina dura around multiple teeth
Apertognathia associated with what condition?
Acromegaly
Undermining resorption is characterized by…
- hyalinization
- infiltration of osteoclasts
- infiltration of macrophages
- infiltration of neutrophils
- occurs in medullary space
Most synchondroses fuse at what age?
2-4 years
Wolf-Hirschorn syndrome is associated with what gene?
MSX1
What chromosomes play important role in tooth development?
Chromosome X and Chromosome 4
What disease may develop benign or malignant osteosarcoma?
pagets
Under development of mandible and maxilla (micrognathia) is seen in what syndromes (3)?
- Treacher Collins
- Hemifacial Microsomia
- Marfan Syndrome
What syndrome is due to failure of neural crest migration?
Treacher Colins, Hemifacial
What four syndromes can cause multiple supernumerary teeth?
- Gardners Syndrome
- Cleidocranial dysplasia
- Sturge-Weber syndrome
- Cleft lip and palate
- (Crouzon although rarely)
What condition can cause early exfoliation?
Hyperparathyroidism (also cause loss of lamina dura)
What syndrome can cause early permanent teeth eruption?
Turners (only occurs in females, small permanent teeth, likely root resorption, SHOX gene)
The oral symptoms of Down’s Syndrome are…
- posterior crossbite (97%)
- prognathic mandible (69%)
- Class III molar (65%)
- Open bite (54%)
- freeway space 3 times more than normal 2-3mm)
Down syndrome patient commonly have (caries or periodontal disease)?
Peridontal Disease (90%) Caries are rare
Crouzon Syndrome is associated with the following genes…. and has a … inheritance pattern.
FGFR2 & FGFR3 Mutation
Autosomal Dominat
T/F Crouzon Syndrome is associated with Cleft Palate and supernumerary teeth.
True
also hearing loss, Craniofacial synostosis, midface hypoplasia
Apert Syndrome is associated with the following genes … and has a … inheritance pattern.
FGFR2 and KGFR2
Autosomal dominant
The key clinical presentation differentiating Apert to Crouzon’s is…
Syndactyly
Gardner’s syndrome is associated with multiple … and …, …. cysts, …. of the skin but does not cause….
Gardner’s syndrome is associated with multiple polyposis and osteomas, Epidermoid cysts (slow growing, caused by blockage of sebaceous gland), Fibromas of the skin but does not cause clefting.
Treacher Colins is associated with the … gene.
TCOF1
The presentation of Treacher Colins includes…
Supraorbital hypoplasia, lower eye lip coloboma, retrognathic mandible, normal mental status, ear deformity/absence of ears, Cleft Palate, large mouth, hair extends to cheeks
The classic Triad of Pierre Robin’s Sequence is..
- Retrognathic mandible
- Glossoptosis
- U shaped cleft palate
Marfan Syndrome is associated with the … genes and have a oral presentation of …
FBN1 and TGFB2
Retrognathic Mandible
(prophylaxic antibiotics to prevent endocarditis)
A patient with Cleidocranial dystosis will present with early fontanelle closure resulting in …
Brachycephaly
T/F Cleidocranial dystosis results in absence/incomplete formation of the collar bone. These patients have no oral manifestations.
T, F (primary failure of eruption, delayed eruption, supernumerary teeth, absence of sutural fusion of the mandible, and under-developed maxilla)
Osteogenesis imperfecta is associated with … genes and affects…
COL1A1 and COL1A2
Type 1 collagen defect
The classic symptoms of Osteogensis imperfecta are (3)…
- Blue sclera
- Fragile bones (brittle bone disease)
- early hearing loss
Ectodermal dyplasia has a …inheritance pattern and patients have the following symptoms…
X chromosome (usually affect men)
- lack of sweat glands, skin, sparse hair, sparse hair
- Missing teeth, peg shaped laterals, pointed teeth
Peutz-Jegher syndrome presents with the oral manifestation of …
Pigmentation of the lips, gums, mucous membrane and skin
also intestinal polyps
Cushing’s syndrome is caused by …and presents with …
- Increased corticosteroid and ACTH
- symptoms: Moon face, buffalo hump, central obesity with thin legs
Turners syndrome is associated with the … gene and follows the … inheritance pattern.
SHOX gene Sex chromosome (XO)
The dental presentation of Turner’s syndrome are…
Early eruption of permanent teeth, small teeth, root resorption
The primary palate is formed in week … in utero.
6th week
The secondary palate is formed in week … in utero.
6-8th week
Palatogenesis is completed by week… in utero.
12th week
What structures does the medial nasal process give rise to?
- nasal septum
- bridge of nose
- philitrum
- premaxilla
What structures does the lateral nasal process give rise to?
-Ala of the nose
Cleft lip (chieloschisis) is caused by the failure of the fusion of … and …
Medial nasal process and Maxillary Processes
What dental finding is NOT associated with Cleft Palate?
-Impacted centrals
common findings: rotated incisors, missing laterals, posterior x bite, ectopic eruption, supernumeraries
What is the most common congenital defect of the face and jaw?
Cleft Palate
What is the incidence of Cleft Palate across the following races: Black, asian, white and american indian?
American Indian > Asian > White > black
Cleft lip is more common in (males/females) while cleft palate alone is more common in (males/females).
males = lip females = cleft palate alone
If a sibling/kin is affect by a cleft there is a …% chance an unborn child will be afffected.
4% (also if 1 parent is affected but no sibling)
9% if two siblings are affected
What is the probability of cleft lip/palate when 1 sibling and 1 parent are affected?
17%
What is the cleft “rule of ten”?
First cleft lip surgery (lip repair)
- 10 weeks (~2-4 months)
- 10 lbs
- 10 grams of hemoglobin
The cleft soft/hard palate is normally closed…
within the 1st year of life
When is the alveolar bone graft performed in a cleft patient?
7-10 years, when the canine root is 1/2 or 2/3rd formed (so the U2 and U3 will erupt through the graft)
Following surgery the relapse often seen in cleft patients is caused by…
Scarring tissue “rebound” due to a lack of elasticity
A failure of fusion of the 2nd and 3rd brachial arches results in …
Cervical cyst (brachial cleft cyst) Diverticulum
Hypotelorism is associated with a …. cleft
Oro-ocular cleft
The …. is used to classify case difficulty of cleft patients.
Golson Yardstick (1 best prognosis, no treatment needed, 5 very poor prognosis, surgery and treatment needed)
The nasal bone completes growth as age …
10 (cartilage continues growth for life)
On Scammons curve, the Skeletal curve is inversely proportional to the … curve.
Lymphoid
The limit for transverse expansion of a SARPE is the…
coronoid process
Soft tissue thickness increases more with age in (female/male)
Female
On Scammon’s curve what curve parallels the facial growth curve?
Somatic curve
What are the two growth peaks on on Scammon’s curve?
Early infancy and adolescent
Describe the male growth sequence
Fat spurt > 12 months > Puberty > 8-12 months > PVH > 15-24 months > end of spurt
Describe the female growth sequence
Puberty > 12 months > PVH > 18 months > menarche (end of spurt)
According to Behrent study there is an increase in the following facial dimensions in adults…
All facial dimensions
Palatogensis is completed at what age in utero?
12 weeks
What is the rate of ramal height growth prior to puberty? and following puberty?
Before puberty 1-2 mm/year
After puberty 2-3 mm/year
What are the 3 mandibular growth sites?
- Condylar process
- Posterior border of the Ramus
- Dentoalveoalr process
In a female what direction of mandibular growth is more than what direction?
Vertical more than AP
Mandibular hypplasia/condylar hypoplasia is most common in what age population?
Early childhood
What happens to arch length and perimeter from primary to permanent dentition?
Decreases
Rotation of the Mandible is show by what 2 signs from Bjork?
- Bending of the mandibular canal
- condlyar neck angle
What is the ideal CVMS for functional appliances?
CVMS II (peak growth will occur within one year)
What is a patient’s growth status relative to CVMS III?
Peak growth occurred within one or two years prior
At puberty what SMI is occuring?
SMI 4 = Sesamoid bone ossification
- Occurs 1 year prior to pubertal maximum growth spurt
- 60-70% of growth remaining
At SMI 4 …% of growth is completed in females and …% is completed in males.
33% females (age 11)
29% males (age 12)
At SMI 6..% of growth is completed.
50%
At SMI 7 …% of growth is completed.
75%
What are the most common teeth with ectopic eruption?
Max 1st molars, Md laterals, Max canines
What are the most common signs of aberrant eruption in the Maxilla and Mandible?
U3’s before U4’s and U5’s
L7’s before U5’s
What is the most common tooth agenesis in primary dentition?
Maxillary Laterals
What is the most common ankylosed primary tooth?
Primary Mandibular Second molar
Transposition is more common on the … arch.
Maxillary
What are the most common teeth to transpose?
Maxilary canine with the Maxilary 1st premolar
How long does primary root completion take following eruption?
18 months
What is the ideal time to remove impacted 3rd molars?
Root 2/3rd formed
What are the most common teeth for root resorption in each arch?
- Mx. laterals > centrals > Canines
- Md. centrals > laterals
Root resorption is related to what conditions/syndromes (3)?
hypothyroidism, hypoparathyroidism, Paget’s
In children, incisors that are traumatically intruded have a 5 year survival rate of..
50% for intrusion > 6mm
In children, incisors that are traumatically intruded (< 3 mm) have a survival rate of..
100%
What protein is the major organic component of mature enamel?
Enamelin
The matrix of developing enamel induces what 3 proteins?
Enamelin, amelogenin, tuft
What teeth show the greatest variation in the onset of mineralization besides the 3rd molars?
Maxillary laterals
What ligament is related to the eruption of teeth?
Hammock
In a 11 yo male, over a 2 year period the mandibular molars are expect to erupt how much?
1.5 mm
In a 11 yo male, the lower facial height is expect to increase …mm/year
1 mm/year
What tooth is most likely to be crowded out of the maxillary arch?
Canines
What has a stronger genetic inheritance pattern: Anterior open bite or midline diastema?
Midline diastema (AOB is not an inherited trait)
What is the most common cyst?
Radicular cyst (teeth are non-vital)
What cyst can remain following an extraction?
Residular cyst (maybe of apical or dentigerous origin
What is the most common developmental cyst?
Dentigerous cyst
What is the most common location of an OKC and what is the clinical presentation?
posterior md., symptomatic, 50% jaw swelling
An AOT arises from … and is commonly found…
Adenomatoid odontigenic tumor
- arises from enamel organ or dental lamina
- 2/3 in female, anterior maxilla, impacted canine
Ameloblastoma presents with a … radiographic appearance.
- Multilocular radiolucency
- benign jaw lesion, may result in expansion
- more common in the posterior mandible
- Pathologic origin - odontogenic epithelium
- common recurrence
Cementoblastomas are common in the … and are associated with … teeth.
- usually 2nd or 3rd decades in life before 25
- More often in Caucasian males
- mandible in 1st premolar to molar region
- pain, swelling and expansion of cortical plates
- Teeth are normally vital
A excessive deposit of cementum on the root surface is known as …
Hypercementosis (vital)
A cotton wool radiographic appearance is associated with..
Paget’s disease
- high alkaline phosphatase
- high chance of osteosarcoma
- bone pain, Hat and Denture don’t fit anymore; mx. enlargement
Fibrous dysplasia has a … radiographic appearance.
- Ground glass
- aysmptomatic regional alteration of bone by replacing fibrous tissue, monostotic or polystotic
- most often in young adults and juveniles
- singular, slow growing and painless swelling of the jaws
- Increase in akaline phosphatase
Periapical Cemento-osseous dysplasia is associated with …teeth and common in…
Vital md. anterior
MABF
3 stages (osteolytic, cementoblastic, mature inactive)
Osteopetrosis results in…
- fragile bones
- abnormal calcified cartilage
- highly radiopaque
- high alkaline phosphatase
What is the recommend treatment for Condensing Osteitis?
- RCT or EXT
- usually associated with non-vital tooth
Eagles syndrome results in …. ligament calcification.
Syloid ligament (also elongation of the styloid process)
HBsAg indicates…
infectious person, high during acute or chronic hepatitis
Anti-HBs indicates
recovery and immunity
Anti-HBc indicates
a previous or ongoing infection;appears at the onset in acute infection and persists for life
IgM anti-HBc indicates
an acute or recent HBV; present for about 6 months
The symptoms of Hep b are… following a …. incubation period
jaundice, dark brown urine
4wks - 6mos
What is the radiographic appearance of osteomylitis?
Moth-eaten
The radiographic appearance of a Osteocarcoma is…
- sunburst, codman’s triangle
- can manifest as myositis
- Most common malignancy in children
The radiographic appearance of Ewing Sarcoma is… and it is most common in… (sex).
Onion skin
Boys (<15 years old)
What is the most common malignant salivary tumor?
Mucoepidermoid carcinoma
What are the systemic symptoms of rheumatoid arthritis?
Fever, fatigue, pericarditis
Active pain is associated with Osteoarthritis or osteoarthrosis?
Osteoarthritis
Multiple myelomas has what clinical feature?
- punched-out bone
- most common maliganancy
What is the blood glucose level of a Diabetes meliltus patient?
> 160 mg/dl
A 5 yo patient presents with symmetric bilateral enlargement of the posterior mandible. The radiograph reveals large, multiocular radiolucencies. What is the diagnosis?
Cherubism
What are the symptoms of Velopharyngeal insufficiency?
- hypernasality
- sleep apnea
Osteomyelitis is caused by what bacteria?
Staph aureus
What systemic antibiotic is least effective for periodontal disease?
Metronidazole
Place the following tumors from most to least common: Monomorphic adenoma, Pleomorphic adenoma, Warthin’s tumor, and Oncocytoma.
Pleomorphic adenoma > monomorphic adenoma > Oncocytoma > Warthin’s tumor
The clinical sign of traumatic occlusion is..
Mobility
What are the most common to least common malignant tumors (4)?
Mucoepidermoid carcinoma > adenoid cystic carcinoma > Carcinoma EX Pleomorphic adenoma > polymorphous low grade adenoma
A protrusive wax bite provides information on…
condylar inclination
What is the force of swallowing?
70-150 N (7-14 lbs)
Bennett angle is formed by a …. plane and the path of advancing the condyle during … movement
angle formed by horizontal plane and the path of advancing condyle during lateral moment (during lateral movement)
The articular tubercle is a part of the …. bone and found…
Part of the temporal bone, located at the base of the zygomatic arch
-anterior to the condyle, posterior to coronoid notch
Condylar hyperplasia usually presents during the … decade of life.
2nd (early adult/ late adolescent)
What is a latent radiographic image?
Image produced after exposure but prior to development
Why is radiographic filtration needed?
To remove low energy radiation, increase penetration
What thickness of aluminum is needed for filtration of radiographs above 70 kVp and below 70 kVp?
> 70 kVp = 2.5 mm
< 70 kVp = 1.5 mm
What is mandatory for patient protection in radiography?
Collimation
What does a using a Intensifying screen accomplish?
To reduce radiation needed to exposure film, thicker film -> less sharp
Using a double intensifying screen to reduce what?
Exposure time
What is the earliest sign of radition?
Erythema
What oral tissue is most sensitive to radiation?
Developing tooth buds, salivary glands
Increasing kVP has what affect on density?
increases density
In order to radiograph a root fracture what should be done to kVP?
increase
Double mA has what effect on exposure time?
halves it
Density =
= kVp x mA x T/L
What are the possible causes of a light radiograph?
- under exposed
- excessive fixation
- long distance
- film pack reversed
What are the possible causes of a dark radiograph?
- over exposure
- over development
- inadequate fixation
- short distance
A panorex is not useful in determining…
Arch perimeter/length deficiency and caries
What imaging technique would be useful to diagnose internal derangement and anterior displaced disc?
MRI
Arthrogram for perforated disc
What imaging technique is used to diagnose a perforated disk?
Atrhogram
A submentovertex radiograph is good to view what structure?
Zygomatic arch
A Towne’s view radiograph is good to view what structures?
occipital bone, petrous bone, and condylar fracture
A Water’s view radiograph is useful to view what structures?
Maxillary sinus
A Cauldwell’s view radiograph is useful to view what structures?
frontal sinus, ethmoid sinus and orbital margins
A Transcranial view radiograph is useful to view what structures?
- lateral poles of condyles
- least reliable for condylar shape
- taken in open and closed postion