Year 3, Sem 2 Flashcards

Question

What is this?

Answer 1

Late periapical cemental dysplasia

Answer 2

Hypercementosis

Answer 3

Hypercementosis

Answer 4

Slow growing, mesenchymal neoplasm composed of cementum that attaches to apex of permanent tooth.

Answer 5

Benign cementoblastoma Tx: exo

Answer 6

* Vital and painful * Slow growing and may displace teeth * Md molar/premolar area most common * Mixed radiopaque/lucent lesion with wheel spoke pattern, surrounded by radiolucent halo and corticated border * Can cause ERR or expansion of jaws

Answer 7

Balance of bone metabolism is tipped toward inc bone formation, producing subsequent sclerotic radiographic appearance. Caused by dental infection or cellulitis involving perioteum.

Answer 8

Garres Osteomyelitis

Answer 9

* Non-vital tooth * Intermittent recurrent swelling, pain, fever, lymphadenopathy * Common in young adults * Mor common in md * Poorly defined borders when disease is active * Radiopaque lines parallel to cortical bone surface (onion skin appearance) * Roots may undergo ERR and lamina dura may be lost

Answer 10

Exo of affected tooth

Answer 11

Condensing osteitis Garre's osteomyelitis

Answer 12

Localised growths of compact bones within the cancellous bone

Answer 13

* Asymptomatic * Normal overlying mucosa * Vital tooth

Answer 14

* Asymptomatic * Normal overlying mucosa * Vital tooth * Common around md premolars and molars * Borders well defined or ragged

Answer 15

Idiopathic osteosclerosis

Answer 16

* Mature components of dental hard and soft tissue * Can interfere with normal tooth eruption and can cause expansion of jaw

Answer 17

Collection of small radiopaque masses (denticles), most commonly in ant mx

Answer 18

* Irregular mass of calcified tissue with no resemblance to normal tooth. * May be missing tooth if it arises from normal tooth follicle. * Often found in post md

Answer 19

* Most severe expression of dens invaginatus * Found in anterior mx * Radiopaque with radiolucent central portion (donut form)

Answer 20

Surgical removal (no recurrence)

Answer 21

True generalised (assoc with pituitary gigantism or dwarfism) Relative generalised Focal/localised

Answer 22

Gemination, fusion

Answer 23

Continued proliferation of dental lamina to form 3^rd tooth germ

Answer 24

Cleidocranial dysplasia Aperts syndrome

Answer 25

* Paramolar: located B or L to mx molar * Distomolar: located D to 3rd molar

Answer 26

* 3rd molar * 2nd premolar * Mx lat incisors * Md central incisors

Answer 27

Lack of development of 6 or more teeth

Answer 28

* Fusion: 2 tooth germs fuse to form one * Gemination: Single tooth bud attempts to divide

Answer 29

* Downs syndrome * Klinefelter’s disease * Ectodermal dysplasia

Answer 30

Extra cusp found commonly on mx lat incisor. Cusp can have pulp horn so exposure possible in bruxism pts

Answer 31

Tubercle of enamel on occlusal surface of premolars. Pulp can be present in tubercle so pulp exposure is high possibility.

Answer 32

* Deep surface invagination of crown root lined by enamel. * Commonly found in mx lat incisors. * Debris can get caught and lead to caries * On radiograph can have inverted tear drop shape * Tx: place prophylactic restoration & monitor

Answer 33

Hutchinson's incisors- associated with congenital syphillis

Answer 34

If conventional film is used, air bubble artifact. Calculus Pulp stone

Answer 35

Developmental alteration in enamel structure in absence of systemic disease. * Hypoplastic * Hypomaturation * Hypocalcification

Answer 36

* Hypoplastic: hard, translucent, thin enamel, random pits/grooves, Square crowns, open contacts, lack of proper anatomy * Hypomaturation: adequate enamel thickness, pitted, snow capped, enamel wears rapidly, enamel exhibits radiodensity similar to dentin * Hypocalcified: adequate thickness of enamel, chalky appearance, yellow/orange, brittle, enamel, fractures off

Answer 37

Altered structural development of dentine in absence of systemic disease

Answer 38

Type I: assoc with osteogenesis imperfecta Type II: **not** assoc with osteogenesis imperfecta Type III: Bradwine type (racial isolate in maryland)- egg shell teeth

Answer 39

Hypocalcified AI

Answer 40

Hypomaturation AI

Answer 41

Hypoplastic AI

Answer 42

* Normal enamel but wears rapidly * Abnormal dentine and pulp * Translucent, opalescent appearance * Yellow-brown to grey in colour

Answer 43

* Thin roots * Bulbous crown * Cervical constriction * Obliteration of pulp chamber

Answer 44

* Egg shell appearance * Large pulp * Thin dentine

Answer 45

Jacket crowns anteriorly SSC posteriorly

Answer 46

Type I Radicular Type II Coronal

Answer 47

* Rootless teeth (W shaped molar roots) * Pulp obliterated * Teeth misaligned * Normal colour

Answer 48

* Normal roots (except for radicular pulp obliteration) * Large coronal pulp * Multiple pulp stones

Answer 49

* Thin rough enamel * More common in mx anterior region * Uncommon * Small * Thin enamel + dentine * Large pulp * Marked reduction in radiodensity

Answer 50

* Local hypoplastic defect (brown spot) on permanent tooth as a result of periapical infection/trauma of primary predecessor. * Crown may appear as ill-defined radiolucent region * Mx incisors and premolars are most affected

Answer 51

Dentinogenesis Imperfecta type I and II

Answer 52

Type III dentinogenesis imperfecta

Answer 53

Type I dentine dysplasia

Answer 54

Type II dentine dysplasia

Answer 55

Regional odonto‐dysplasia (Ghost teeth)

Answer 56

Turners hypoplasia?

Answer 57

* HSV-1 * Common in children * Fever, malaise, lymphadenopathy * Vesicles on lips, tongue and cheek that rupture and form shallow ulcers * Difficulty in eating/swallowing * Tx: hydration, analgesics, CHX mouthwash 3/day

Answer 58

* When HSV-1 is reactivated due to sunlight, fevers, trauma, immunosuppression * Tingling, burning * Vesicles on lip (cold sore) that rupture to form ulcers * Heals in 7-10 days * Tx: self limiting, acyclovir cream may reduce duration

Answer 59

* Occurs of keratinised epithelium * Shallow, irregularly shaped clusters of surface erosion

Answer 60

* Highly contagious * Malaise and fevere * Rash on trunk, then face, limbs * Macule/papule develop intro vesicle and can rupture * Tx: self limiting, antivirals

Answer 61

* Virus becomes dormant in dorsal root of trigeminal ganglia * Reactivation occurs in 5-7th decade * Dermatomal distribution * Pain and burning along nerve followed by vesicles in 24-48hours * Tx: systemic antiviral therapy (if within 72 hours), analgesics, specialist referral if immunocompromised * Tx: supportive, acyclovir

Answer 62

* Kissing disease * EBV * Malaise, fever, sore throat, lymphadenopathy * Mucosal petechiae (near vibrating line) * Enlarged tonsils with exudate

Answer 63

* Seen in immuno-compromised pts * Assoc with EBV * No malignant potential

Answer 64

* Can infect major salivary glands and cause xerostomia * Ulcerations

Answer 65

Seen in HIV pts Vascular tumour (purplish, bleeds readily) Found on palate

Answer 66

* Verruca vulgaris * Squamous papilloma * Condyloma acuminata * Focal epithelial hyperplasia * SCC

Answer 67

* Appears on vermillion border or keratinised surfaces of gingiva and palate * Oval, white * Contagious * Common in children/adolescents * Tx: excision, recurrence uncommon

Answer 68

* Sexually transmitted (suspect sexual abuse if found in young children) * Multiple/single lesions * Lips, commissures and gingiva * Common in homosexual males * Tx: excision, laser, cryotherapy

Answer 69

* Rare * Predominantly children * Asymptomatic and contagious * Tx: spontaneous recover, laser, cryotherapy

Answer 70

* Single, \<1cm * Painless * Pedunculated with numerous projections * Tx: excision, do not recur

Answer 71

* Highly contagious * Runny nose, cough, conjunctivitis, fever * Macullo-papular rash on skin * **Koplik spots** on B mucosa * Tx: OH, antipyretic

Answer 72

* Highly contagious * Salivary gland enlargement * Fever, pain * Symptomatic management

Answer 73

* Highly contagious * Salivary gland enlargement * Fever, pain * Symptomatic management

Answer 74

* Coxsackie virus * Young children * Lesions of hand foot and mouth * Oral vesicles lead to ulcers with peripheral erythema * Symptomatic management

Answer 75

* Coxsackie virus * systemic infection * Children * Fever * Vesicles rupture leaving ulcers * Tonsils, soft palate, uvula * Symptomatic management

Answer 76

* Even colour and texture * Uniformly flat * Thin * Shallow cracks of surface keratin * Lower malignant transformation

Answer 77

* Non uniform colour and texture * Higher malignant transformation * Speckled, nodular, verrucous

Answer 78

* Affects older females * Covers wider area (usually gingiva and mucosa) * No strong association with tobacco or alcohol * Resistant to all tx * Recurrence common following excision * High malignant transformation (70-100%)

Answer 79

* Female * Long duration of leukoplakia * Leukoplakia in non-smokers * Tongue/FOM * Larger size * Non-homogenous * Present of dysplasia

Answer 80

Betel nut chewing- induces inflammation, inc collagen synthesis and dec collagen degradation leading to excessive fibrous tissue formation → fibrosis

Answer 81

* Early: Burning sensation, depigmentation, de-papillation of tongue, leathery mucosa, vesicles * Late: fibrous bands in B mucosa and rima oris, trismus, narrowing of oropharyngeal orifice, distortion of uvula

Answer 82

* Trismus * OH * Difficulty eating, OH * Poor nutrition * Malignant transformation

Answer 83

Male, older age, low SES, presence of other OPMD.

Answer 84

* Chronic inflammatory condition of lip arising from excessive solar UV radiation exposure * Malignant potential * Hyperplastic/atrophic changes with pigmentation and keratinisation * Risk factors include: * UV intensity * Age * Lack of lip protection * Genetic predisposition * Immunosuppression

Answer 85

* Light end of cigar inside mouth * Exclusively on palate * Diffuse whitening of palatal mucosa * Elevated red nodules

Answer 86

* Quick inc size * Crack or fissure * Bleeding spots * Ulceration * Appearance of growth * Induration * Rolled edges

Answer 87

* White plaques/papules on surface of oral mucosa- may appear as milky curds * Can be wiped of, revealing erythematous mucosa * Found in immunosuppressed individuals * Risk factors: elderly, poorly controlled diabetes, HIV, corticosteroids, broad spectrum AB therapy

Answer 88

* Localised erythema of oral mucosa * May/may not have symptoms * Commonly on dorsum of tongue and palate * Risk factors: broad spectrum AB, corticosteroids, HIVS

Answer 89

* Affects mucosa in contact with fitting surface of denture * Erythema and oedema * Asymptomatic, mild discomfort or burning sensation * Risk factors: poor denture hygiene, ill fitting denture, denture wearing at night

Answer 90

* Chronic inflammatory lesion at labial commissure * Fissured erythematous lesion * Risk factors: reduced vertical height (dentures), wrinkling at angle of mouth, maceration with saliva, iron/B12 deficiency

Answer 91

* Chronic erythematous lesion on tongue, affecting dorsum anterior to circumvallate papilla * Symmetrical * Rhomboid shape * Depapillation * Cause unknown * Candida hyphae growing to epithelium

Answer 92

* Can be isolated oral lesion or mucocutaneous candidosis * Appear as white patch affecting anywhere on oral mucosa * Common in post commissural area * Common among smokers * Higher risk of malignant transformation

Answer 93

Can lead to secretion of nitrous amides (carcinogenic), making epithelium more vulnerable to malignant transformation

Answer 94

* Heterogenous disorder affecting mucosa, skin and nails * Often associated with endocrinopathies or immunodeficiency

Answer 95

* Identify predisposing factor and eliminate/control * Inspect denture for denture induced lesions * Denture hygiene advice * Reline or new denture if required * Correction of iron, B12 deficiency * If non-responsive or systemic antifungals are required (fluconazole), refer to specialist * Antifungal meds: topical or systemic

Answer 96

* Invasive fungal infection caused by histoplasma capsulatum * Causes chronic pulmonary infection- similar to TB * Need biopsy

Answer 97

* Streptococcal infection * Begins as tonsillitis and pharyngitis * Most common children * Tonsils, pharynx and soft palate erythematous and oedematous * Palatal petechiae, strawberry tongue * High fever

Answer 98

* Superficial skin infection * Streptococcal and staph aureus * Affect young or elderly * Cheeks, nose affected * Bright red, painful, swollen, indurated, warm areas

Answer 99

* Involvement of oral cavity due to oral sex * Painful ulceration of lips, erythematous gingivae * Gonococcal pharyngitis * Vesicles or ulcers with gray/white pseudomembrane

Answer 100

* Oral lesions relatively rare * Secondary to pulmonary lesions (hx of TB useful) * Chronic ulcers on dorsum on tongue

Answer 101

Sexually transmitted & caused by treponema pallidum * Primary: forms 3-90 days after exposure, primary chancre, heals in 3-8 weeks * Secondary: systemic symptoms, snail track ulcers, forms 4-10 weeks after initial infection * Tertiary: 1-30 yrs latency, syphilitic gumma

Answer 102

* Screwdriver or peg shaped incisors * Mulberry molars * Hypoplastic teeth * Saddle nose * Atrophic glossitis * Post-rhagadic scars * High arched palate

Answer 103

* Chronic, suppurative infection * Rare * Organism enters through area of trauma (exo socket) * Minimal/no pain

Answer 104

Invasive epithelial neoplasm with varying degrees of squamous differentiation and a propensity to early and extensive lymph node metastases, occurring predominantly in alcohol and tobacco-using adults in the 5th to 6th decades of life.

Answer 105

* Require massive surgery * Disfugirement * Disability and rehab * COst/hospital stay * Social * Significantly affects quality of life * If uncontrolled- death

Answer 106

Method for detection of disease when it is not symptomatic

Answer 107

* Pros: MI, high validity, short time, can be repeated, no special facilities required, can be undertaken during exams * Cons: depends on quality of examiner, training of screeners required, can't distinguish between benign lesions, cancer and OPMD's, may not turn up for next appt, cost effectiveness uncertain

Answer 108

Vital staining Autofluorescence Brush biopsy

Answer 109

* Good in detecting SCC * High sensitivity and specificity * Detection of dysplasia doubtful * Cheap, simple * Clean surface with acetic acid, apply toluidine blue on lesion, remove excess stains with acetic acid. If blue still present, indicates carcinoma in situ or carcinoma

Answer 110

* Light of 400-500nm wave length * Loss of fluorescence/dark patch indicates presence of abnormal tissue * Does not diagnose any lesions and interpretation is required by specialist.

Answer 111

1 year old

Answer 112

* Genetics, environment, habits (thumb sucking) * Crowding, impaired nasal breathing, over retention of primary teeth

Answer 113

* Study models and I/O * Need to assess face and dentition in frontal, sagittal and transverse views

Answer 114

Functional shift can cause adaptive remodelling of TMJ and asymmetric md growth. This can become a permanent skeletal asymmetry if not intercepted early.

Answer 115

Relative: when teeth are in class I occlusion, there is no transverse discrepancy Absolute: when teeth are placed in class I occlusion this is transverse discrepancy

Answer 116

* Andrews WALA ridge * Transpalatal width * Maxillomandibular transverse differential * CBCT's

Answer 117

* Dental: Mx molars are tipped lingually with maxilla of normal width * Skeletal: Mx teeth are often tipped buccally to compensate for mx constriction

Answer 118

* Skeletal: RME * Dental : tip mx posterior teeth buccally

Answer 119

* Eliminates functional shifts and wear on erupted permanent teeth and possible dento-alveolar asymmetry * Increases arch circumference to provide more space * Simplifies future tx

Answer 120

Tipping teeth bucally

Answer 121

Mx: * Before age 14 ideal: can use any expansion device * If early adolescence: RME with heavy force * If suture has fused: camouflage tx or surgical mx expansion (if severe) Md * Camouflage tx or surgical md constriction (if severe)

Answer 122

* Quad helix * W arch * URA- Hawley

Answer 123

* Hyrax * Haas * Tooth-bone or bone anchored RME

Answer 124

* More flexible and greater range of action than W arch * Helices of anteriror palate are bulky so can help eliminate thumb sucking habit

Answer 125

* Palatal suture fills with bone * Crowns tilt mesially to close gap * Roots shift mesially

Answer 126

Posterior extrusion Anterior intrusion Anterior teeth flaring

Answer 127

* Straight continuous arch wire * Step bend archwire * Bite plates in ant region * Md reverse curve of spee * Altering bracket placement heights

Answer 128

Short lower facial height Excessive curve of spee Moderate-minimal incisor display

Answer 129

Pts with Class II div II deep bite or Class III

Answer 130

Long lower facial heights Excessive incisor display Overeruption of upper incisors

Answer 131

Moves md downward and backwards, increasing lower facial height and interfacial gap

Answer 132

* Genetics * Environment (habits, mouth breathing)

Answer 133

* Narrow transverse width of mx * Anterior open bite * Proclination of upper incisors * Retroclination of lower incisors * Posterior cross bite

Answer 134

* **Phase 1:** normal process, birth-3yrs * **Phase 2:** 3-6/7 years, chil needs to break habit to prevent use of appliances, can indicate anxiety * **Phase 3:** intractable sucking, often require psychological assistance, usually goes beyond age 4-5

Answer 135

* Nail paint * Positive reinforcement * Finger splint * Gloves

Answer 136

In primary dentition

Answer 137

If other methods have ineffective by age 7, more definitive tx is required.

Answer 138

Speech therapy and appliance to correct tongue posture

Answer 139

* Prevents tongue pressing against teeth and seating on palate * Prevents thumb/pacifier entering mouth * Effective until permanent incisor root apices have fully developed

Answer 140

No, it is secondary to thumb sucking. It just prevents it going back to normal

Answer 141

If greater than 2mm

Answer 142

If central incisor apices are already formed

Answer 143

At least 6 hours

Answer 144

* Removable: once habit is already stopped and you need to correct tongue posture * Fixed: to stop habit

Answer 145

* Hawley plate with tongue crib and posterior bite block * Hawley plate with incisive orifice * 6 months

Answer 146

Preventing tooth movement in one group of teeth while moving the other group of teeth.

Answer 147

75-100% movement from anterior segment and the rest from posterior segment to close extraction space

Answer 148

50% movement from anterior and posterior segments

Answer 149

75-100% movement from posterior segment and the rest from anterior segment to close extraction space

Answer 150

* Occipital (headgear) * Intermaxillary (elastics) * Stationary (reinforcement of anchorage units through banding of multiple teeth) * Simple (relied on competing support of dentition to affect tooth displacement) * Reciprocal (as above)

Answer 151

Use of larger tooth or teeth to move smaller tooth using tipping movement

Answer 152

Anchorage teeth move bodily while the movement teeth are allowed to tip.

Answer 153

Teeth of equal size are moved together by same amount

Answer 154

Utilises extra forces to limit/eliminate movement in one segment and promote movement in other segment

Answer 155

Utilising 7’s Incorporating more teeth for anchorage Reducing number of teeth to be moved Elastics Headgear Implants/miniscrews

Answer 156

Implants and ankylosed teeth

Answer 157

Type A (75% canine, 25% molar)

Answer 158

Type A (90-100% anchorage required)

Answer 159

Type B (50% of each to make molar full unit class II and canine class I)

Answer 160

When adolescent growth spurt is completed

Answer 161

Intramembranous ossification * Apposition of bone at sutures * Surface remodelling Until 7 years, growth is predominantly forwards from the cranial base pushing it forwards. When the cranium ceases its growth, maxilla growth is from sutural growth on the posterior and superior aspects. This growth pushes mx downwards and forwards. Resorption of anterior surface occurs

Answer 162

Posterior md ramus Condyle Coronoid process

Answer 163

There is resorption of the nasal floor and apposition of bone on the palate

Answer 164

Boys: 17 Girls: 15

Answer 165

Downwards and forwards

Answer 166

There is forward translation of chin resorption above chin (no bone apposition occurs on chin)

Answer 167

* 10 years is too late and will need to be treated with surgery * Ideal age is around 7 as you want pt after eruption of incisors

Answer 168

Difficult to treat. Often require surgery.

Answer 169

Tongue Lips/cheeks PDL

Answer 170

6hours each day

Answer 171

Tongue exerts more force against the teeth than the lip and cheek. However, this is only a very short amount of time and isn’t enough to cause tooth movement

Answer 172

At rest, there is around 5g more force coming from the tongue than the lips/cheek. The PDL is able to withstand 5g of force to prevent tooth movement. Therefore the PDL is able to resist movement and teeth remain in equilibrium

Answer 173

In mobius syndrome, there is underdevelopment of cranial nerves 6 and 7. This can result in facial paralysis and inability to move eyes side to side. As there is paralysis of orbicularis oris muscle there is no force coming from the lip side, while there is still forward pressure from the tongue. This disrupts equilibrium and causes teeth to procline.

Answer 174

Tongue isn't sitting high against palate so mx posterior teeth are not supported with tongue pressure anymore. Increased pressure against teeth from cheek side due to sucking, results in palatal tipping of mx posteriors. Can have narrow mx arch and posterior cross bite.

Answer 175

By definition means no anchorage loss. The only true maximum anchorage can be achieved with skeletal anchorage systems.

Answer 176

Pushing tongue against lower lip

Answer 177

Tongue spurs and TPA

Answer 178

20 weeks in utero

Answer 179

Ectodermal dysplasia Ellis Van Crevald Downs Syndrome Crouzon

Answer 180

Can build up tooth or crown it Can extract and orthodontically close the space. Can extract and place implant or bridge

Answer 181

They will become submerged as the bone continues to grow around it.

Answer 182

* Cleidocranial dysplasia * Ehlor danlos syndrome * Ellis-van Creveld * Apert syndrome * Gardener syndrome

Answer 183

Can be extracted They can be left if not causing any harm If spacious arch, they may fit in If crowded arch, may erupt and then extract. If it doesn’t erupt, surgically extract at later stage

Answer 184

Inverted/non inverted Erupted/non erupted Type (mesiodens, distomolar etc) Tooth number closest to S E.g. inverted non-erupted mesiodens 11S

Answer 185

Ectodermal dysplasia Pituitary dwarfism Ellis-van crevald Downs syndrome

Answer 186

Pituitary gigantism Klinefelters disease

Answer 187

Dens invaginatus

Answer 188

Protection of the tubercle by placing composite resin around it. Best done before the tooth comes into occlusion. Avoid grinding of tubercle and sealing as it can expose pulp.

Answer 189

PEIR Hypoplasia

Answer 190

* Pre-eruptive intracoronal resorption. * Lesion located within dentine that presents as radiolucency adjacent to the DEJ in a radiograph.

Answer 191

If there is a disturbance during birth, teeth can exhibit a linear defect on the tooth crown. Often found on primary incisors and molars as they are developing at this time.

Answer 192

C's (calcification takes place from birth-1st year)

Answer 193

Lack of mineralisation in growing body * Vit D dependent rickets * Hypophosphatemia rickets: inability to absorb vit D

Answer 194

* Med hx: allergies, transmissible disease, bleeding disorders * Have they had tetanus immunisation (if wound has been contaminated with soil) * Prev trauma hx * When, what, how, where?

Answer 195

* Intrusion * Lateral luxation * Avulsion

Answer 196

* Sensibility testing measures neural supply. If a tooth is sensible we often assume it is vital and has adequate blood supply. * Vitality testing measures blood flow.

Answer 197

* Dull: PDL is present and intact * Ankylotic/higher: loss of PDL

Answer 198

* Incomplete fracture of enamel (crack) * No tx required unless present with other injury

Answer 199

* Loss of enamel without visible signs of exposed dentine. * Recontour any sharp areas or restore. Follow up.

Answer 200

Enamel + dentine fracture with pulp involvement Tx: * Pulp capping if exposure occurs straight away and is pinpoint * Pulpotomy or pulpectomy * Exo may be indicated

Answer 201

* Fracture extends subgingival but does not involve pulp * TTP * Tx: depends on location and extent of fracture- fragment removal and resto OR exo. POI and review also important

Answer 202

* Fracture extends subgingival and involves the pulp. Crown can be split into 2 or more fragments with possibility of loose fragment. * TTP * Can sometimes do pulpotomy or pulpectomy and then resto with strip crown. Often indicated for exo. POI and review

Answer 203

* Coronal fragment may be displaced and mobile. Can be discoloured * TTP * If no significant mobility, no tx. If coronal segment is displaced or mobile, do exo. POI and review

Answer 204

Observation only, soft diet, OH, poss complications, review

Answer 205

* Bleeding from sulcus if seen promptlty after * Mobile + TTP * Tx: observation only, soft diet, OH, poss complications, review

Answer 206

* Mobile and TTP * PDL is wider apically * Tx: do NOT reposition. If only slightly mobile, monitor. If fairly mobile, exo. Soft diet, OH and poss complications, review.

Answer 207

* Tooth may be proclined or retroclined * Usually jammed into bone so non-mobile * Ankylotic sound present. TTP * Shortened if proclined, elongated if retroclined * PDL space wider apically * Can leave to spontaneously erupt if no excessive mobility and not in traumatic occlusion. If in slight traumatic occlusion and minimal mobility can grind tooth slightly to remove occlusal interference. If excessive mobility, exo indicated. Soft diet, OH, poss complications, review

Answer 208

* Short crown/may appear missing * Jammed into bone and non mobile * TTP and ankylotic sound * If toward bone, can leave to erupt spontaneously. If alveolar fracture or toward successor, exo. * \< ½ crown: leave to spontaneously erupt over next 3 months * ½ crown: monitor closely. May erupt or may need exo. * 75%: exo indicated

Answer 209

* Do not reimplant. Soft diet, OH, poss complications. * Review 1 week, 6months, 1 year

Answer 210

* Clean, reposition coronal fragment and splint * If coronal ⅓ fracture and not too mobile, can do flexible splint for around 4 months (poor prognosis- exo likely) * Fractures more apically, can be managed by flexible splint for 3-4 weeks.

Answer 211

Mobile, TTP, usually -ve sensibility 1. Clean area 2. Reposition 3. flexible splint for 10-14 days 4. POI 5. Review (check RR and vitality)

Answer 212

Usually jammed into bone, -ve TTP, usually -ve sensibility, wider apical PDL space 1. Clean, LA 2. Reposition tooth with finger pressure or forceps 3. Reposition displaced bone with finger presser if fractured 4. Splint for 4 weeks if bone fracture otherwise splint for 2 weeks 5. POI, review

Answer 213

Non-mobile, TTP, -ve sensibility, loss of PDL space * If immature tooth or 12–17-year-old with \<6mm intrusion, leave to spontaneously erupt. If no change in position after 1 months, do ortho traction. * In pts 12-17 years with \>6mm of intrusion or pt \>17 years, perform ortho or surgical repositioning, splint for 4 weeks and perform RCT within 3-4 weeks.

Answer 214

1. Clean, reimplant tooth 2. Flexible splint for 10-14 days 3. RCT within 7-10 days if mature tooth. If immature tooth, see how tooth responds- if no response in 3-4 weeks do RCT 4. AB/tetanus, POI 5. Review (every week for 4 weeks, 2 months, 3 months, 6 months, 1 year)

Answer 215

Open apex Short root Thin dentinal walls

Answer 216

* Calcified tissue * Connective tissue * Bone and connective tissue * Granulation tissue

Answer 217

Indicates, coronal part of fractured root is non vital as the pulp has been severed. Can root fill the coronal section and the radiolucency should resolve with bony healing. Fracture line acts as apical stop. Place MTA plug, obturate and then assess for healing.

Answer 218

Revascularisation Pulp canal obliteration Necrosis

Answer 219

* Surface root resorption (repair related) * Replacement root resorption (ankylosis) * Infection related inflammatory root resorption (most concerning- rapidly progresses)

Answer 220

* 1 week: soft tissues * 3-4 weeks: PDL (if you see resorption, do pulp therapy to halt resorptive process) * 6-8 weeks: Pulp * 6 months: Review * 1 year: review

Answer 221

* Soft diet * OH- CHX swab if child under 6, otherwise CHX mouthrinse. * Analgesics as indicated * AB as indicated * Tetanus prophylaxis as indicated * Follow up

Answer 222

T shaped * Forehead, nose, upper lip, chin

Answer 223

* In children \< 4years, injury to **t**runk, **e**ars or **n**eck. * Any bruising in infant \<4months old as they can’t move. * **F**renulum * **A**uricular area * **C**heek * **E**yes * **S**clera * Patterned bruising

Answer 224

* Injury that doesn’t match history * Bilateral injury * Untreated injury * Injuries with particular patterns

Answer 225

RULE OF 4's Central Incisors: 7 months Lateral Incisor: 11 months First Molar: 15 months Canine: 19 months Second molar: 23 months

Answer 226

Sequence Age Symmetry

Answer 227

After 12 months (med syndrome, missing permanent successor?)

Answer 228

* No excessive symptoms –only drooling * Might get irritability, rise in temperature, loss of apetite, runny nose * Only get symptoms day or 2 before tooth erupts.

Answer 229

* Rubbing or cooling the gums (teething rings, fruits & veggies) * Topical anaesthetic * Analgesic –for babies (paracetamol) * Alternative therapies (amber beads, clove oil/ointment)

Answer 230

* Normal crown shape * Undeveloped, loosely attached root * Gingival inflammation * May cause trauma to tongue (Riga-Fede) and/or to mother’s breast with feeding,

Answer 231

* Endocrinopathies * Downs syndrome * Rickets * Cleidocranial dysplasia * Gingival hyperplasia * Mx & md hypoplasia * AI, ED * Disturbance of bone metabolism

Answer 232

* Fibromatosis of the gingiva * Supernumerary * Tooth/ root formation anomaly * Crowding * Cyst * Ankylosed primary tooth may delay eruption of successor

Answer 233

- At 9yrs, palpate canine bulge - Obtain OPG if absence of canine bulge or anomalous upper lat incisor - If cusp tip of canine lies over distal half of lat incisor root.

Answer 234

- Early intervention - Extraction of primary mx canines to provide room (9-10yrs age) - Surgical exposure of canine (can have ortho bracket) if diagnosed at later stage

Answer 235

- Self correction possible between 6-7yrs - Placement of separating elastics between the teeth - If mild, distal grinding of second primary molar to free permanent molar. - Distalisation of permanent molar

Answer 236

* Hypophosphatasia * Prepubertal periodontitis * Cherubism * Acrodynia * Rickets * Cyclic neutropenia * Downs sydrome * Ehlor Danlos syndrome * Juvenile diabetes * Papillon Lefevre syndrome * Leukaemias

Answer 237

* Spontaneous exfoliation * Deficient cementum * Root not completely resorbed (roots can be intact as attachment of PDL to bone and tooth is impaired) * Lack of severe gingival inflammation * May have decreased alveolar height

Answer 238

- Tilting of adjacent teeth - Infraocclusion of tooth in growing child - Over-eruption of opposing teeth - Deficient vertical height of alveolar bone in area of ankylosed tooth.

Answer 239

* Monitor (ankylosed primary molars with successor usually exfoliate) * May be built up/place crown if to be kept and if infraoccluded * May need exo if severe infraocclusion, tipping, if ortho plan involves exo, vertical bone loss

Answer 240

* Alveolar bone preservation * Proprioception * Masticatory performance * Inc occlusal forces * Retention, support, stability * Psychological advantages * Tooth mobility greatly reduced

Answer 241

* Grade 1: well-rounded slightly atrophic alveolar ridge with slight reduction in height * Grade 2: knife edge with only slight vertical bone loss. Reduce height to create flatter bone surface * Grade 3: height of md if reduced significantly but well rounded * Grade 4: height and width reduced significantly

Answer 242

Mucosal receptors under denture are unable to stimulate bone with occlusal overloading

Answer 243

* More expensive * Frequently need perio therapy * Bulkier * If overdenture and teeth are not kept clean, caries and perio can progress * Secondary caries under margins of copings

Answer 244

* Pt has some stable remaining teeth * Pt with badly attritted down teeth * Pt with congenital or acquired I/O defect of cleft palate, oligodontia, microdontia or cleidocranial dysplasia

Answer 245

* Immediate: fabricated immediately after removal of natural teeth- it has minimal discomfort and interference with function * Transitional: made by converting existing RPD to a full denture as a temporary appliance * Definitive * Overlay

Answer 246

Ideally 4 (one canine & one molar/premolar each side)

Answer 247

* Endo tx * Tooth reduced to 1-2mm above gingival margin * Amalgam placed in access to root canal and dentine * Coping placed if indicated (prev caries/resto below gingival margin or if natural teeth present in opposing arch)

Answer 248

* Cast post and tall core * Cast post and short core * Amalgam in prepared tooth

Answer 249

* Drifting/rotation of teeth * Change of facial structure * Jaw line can recede

Answer 250

* Can't afford it * Can take several months to compete * May be emotionally challenging * Implant may loosen and require replacement * Risk for infection greater with implant than fixed bridge * Severely immunocompromised * Pts with diseases of CV, respiratory and GI systems

Answer 251

* Implant mucositis just involves soft tissues surrounding the implant * Peri-implantitis is more severe and involves loss of surrounding bone

Answer 252

* Endosteal: placed directly into bone * Subperiosteal: placed below periosteum but on top of bone * Transosteal: inserted through inferior border of md

Answer 253

* Get accurate, well extended and articulated diagnostic casts * Wax up * Consider protocol for rehabilitation

Answer 254

Direct structural and functional connection between ordered, living bone and the surface of a load bearing implant

Answer 255

* Early immune inflammatory response * Angiogenesis * Osteogenesis

Answer 256

* **Within 24hrs:** neutrophils infiltrate, blood clot forms, neovascularization happens * **2-4 days:** macrophages and monocytes infiltrate which removes blood clot and debris. Large secretion of cytokines and growth factors help mesenchymal cells differentiate into osteoblasts. There will be osteogenesis and vascularization happening * **5-7 days:** new bone formation on implant surface with calcification from host bone onto implant * **By 4 weeks**: implant surface will have osteogenesis and osteoblastic activity on it * **After 8-12 weeks**: initial phase of osseointegration completed. Quite soft and not fully mineralized. Peri-implant interface is replaced by mature lamella bone

Answer 257

* Closed tray: easier to use, lack of draw so can lock impression in mouth if implants are misaligned * Open tray: multiple implants, more accurate

Answer 258

* Sustained: provide drug delivery for \<24hours * Controlled: duration of drug release exceeds 1 day

Answer 259

* Actisite * Periochip * Elyzol * Arestin * Atridox * Periocline

Answer 260

CHX gluconate 2.5mg, chip Placed directly into pockets _\>_5mm following SRP

Answer 261

Minocycline HCL 10%, microspheres

Answer 262

Non restorable fibres can lead to infection if left in pocket

Answer 263

Metronidazole benzoate 25% gel Gel placed in pocket where it is liquidized by body heat and then hardens, forming crystals in contact with water

Answer 264

Doxycycline 10% gel Solidified upon contact with GCF allowing for controlled release for 7 days. It is considered equally as effective as monotherapy compared to SRP alone

Answer 265

During active phase as adjunct to active therapy During evaluation in non-responding site During maintenance phase

Answer 266

When localised recurrent and/or residual PD at least 5mm with inflammation is still present following conventional therapies

Answer 267

Multiple sites _\>_ 5mm Use of LDD's has failed to control periodontitis Anatomical defects are present (intrabony defects)

Answer 268

* Periodontitis bacteria can cause disease without entering tissue * Bacteria in subgingival plaque and their products interact with host tissues without direct tissue penetration

Answer 269

* They do not remove calculus and bacterial residues * High dose required to be effective against biofilm microbes

Answer 270

* Local: * Narrow range * High dose at treated sites, low levels elsewhere * May act better locally on biofilm associated bacteria * Reinfection from non-treated sites * Limited to treated sites * Systemic: * Wide range * Variable levels in diff areas * May reach widely distributed organisms better * Systemic side effects * Requires good pt compliance

Answer 271

* Simple and easy administration * Economical * Target multiple perio sites of higher disease severity * inhibit microbes on oral mucosa and other tissues

Answer 272

* NUG (if systemic signs exist) * Stage III-IV periodontitis (if non responsive to perio therapy) * NUP * Periodontitis as a manifestation of systemic disease

Answer 273

Clavulanic acid + amoxicillin

Answer 274

* More effective with mechanical therapy * Specifically useful in NUG * Refractory cases (with amoxicillin or augmentum)

Answer 275

* Effective against anaerobes and G -ve bacilli * Higher levels in diseased vs healthy perio tissues * Penetrates fibroblasts and phagocytes * 250mg/day for 5 days after initial loading of 500mg * **Can alter heart electrical activity (prolonged QT interval- avoid in pts with heart conditions)**

Answer 276

* Wider spectrum of activity than single agent * May reduce development of bacterial resistance * May have synergistic action against target organisms, allowing lower dose of each AMA

Answer 277

Tetracycline 250mg qid

Answer 278

* Modifying host reaction to bacteria * Useful in patients with non-modifiable risk factors e.g. genetic defect in neutrophils

Answer 279

Tetracycline (sub antimicrobial dose doxycycline 20mg 2x daily for 3 months)

Answer 280

Blocks destruction of tissue * Reduces osteoclast activity and bone resorption * Stimulates osteoblast activity and bone formation

Answer 281

* Spaces between teeth after calculus removal * Inc sensitivity * Teeth may become mobile * Black triangle

Answer 282

* Reduction of etiological factors * Elimination of predisposing factors * Suppression/elimination of pathogens * Return of inflamed to healthy gingiva * Shrinkage of swollen inflamed tissue

Answer 283

1: Plaque control instructions 2: Removal of supragingival & subgingival plaque biofilm and calculus. 3: Recontour defective restos and crowns 4: Management of carious lesions 5: Tissue re-evaluation

Answer 284

Full mouth disinfection prevents reinfection of treated sites from untreated sites.

Answer 285

* Reduction in pocket depth and inflammation. * Deepest pockets show highest improvements. * Shift in flora from G-ve to G+ve microbes in the subgingival area. * No osseous repair

Answer 286

* Junctional epithelium * Gingival connective tissue * PDL cells * Bone cells

Answer 287

* Good: control of etiologic factors and adequate periodontal support * Fair: approx 25% AL and/or class I furcation * Poor: 50% AL, class II furcation involvement (location & depth make maintenance possible but difficult) * Questionable: \>50% AL, poor crown-root ratio, poor root form, class II or III furcation, \>2+ mobility * Hopeless: exo indicated

Answer 288

* Smoking * Systemic disease * Genetic factors * Stress

Answer 289

* Plaque/calculus * Subgingival restos * Overhangs * Abnormally placed denture clasps

Answer 290

* Short tapered roots * Cervical enamel projection * Enamel pearls * Bifurcation ridges * Root concavity * Developmental grooves * Root proximity * Furcation involvement * Tooth mobility

Answer 291

* Age * Disease severity * Plaque control * Pt compliance

Answer 292

* Abutment selection * Caries * Non vital teeth * Root resorption

Answer 293

Deep pockets and little AL and BL

Answer 294

* Mx first premolars * MB root of mx first molar * Both roots of md first molars * Md incisors

Answer 295

* Mx lateral and central incisors * Can lead to necrosis of pulp without symptoms of caries.

Answer 296

* Enlargement/overgrowth: clinical term * Hyperplasia: histological assessment

Answer 297

* Grade 0: no signs of gingival enlargement * Grade 1: enlargement confined to interdental papilla * Grade 2: enlargement involves papilla and marginal gingiva * Grade 3: enlargement covers ¾ or more of crown

Answer 298

* Inflammatory * DIGO * Systemic conditions * Systemic disease * Other forms

Answer 299

* Puberty * Pregnancy * Vit D deficiency * Plasma cell gingivitis

Answer 300

Leukaemia Wegener's granulomatous

Answer 301

* Painless but can become painful if it develops into gingival abscess * Occurs due to trauma from foreign object getting stuck in gingiva e.g. bristle of toothbrush * Localised enlargement

Answer 302

* Plaque induced * Progresses slowly * Occurs due to ortho appliances, irritation from resto's, poor OH * Can be localised of generalised * Painless unless complicated by acute infection or trauma

Answer 303

* Dryness causes irritation to mucosa * Presents as red, oedematous, shiny gingiva * Occurs in mx anterior region

Answer 304

* Anticonvulsants (phenytoin, Lamotrigine) * Calcium Channel Blockers (nifedipine, amlopidine) * Immunosuppressants (cyclosporine)

Answer 305

* Generalised but more prominent anteriorly. * Starts out in interdental gingiva and then spreads to marginal gingiva. They unite and cover the portion of the crown. * It recurs after surgery. * Pale pink, mulberry shaped gingiva. * No tendency to bleed unless there’s plaque or secondary inflammation

Answer 306

When gingiva is non inflamed, fibroblasts are quiescent and do not respond to circulating levels of phenytoin. Rare to get DIGO if there’s no plaque presence

Answer 307

* Elongated rete pegs * Abundance of amorphous ground substance * Abundant collagen bundles * Hyperplasia of connective tissue and epithelium

Answer 308

* Decrease in collagen degradation. * Decrease in salivary IgA. * Lack of OH increases severity of growth.

Answer 309

More vascularised than phenytoin enlargement. More frequent in children.

Answer 310

Defect in collagen degradation due to reduced folic acid uptake. Upregulation of KGF

Answer 311

* Cause is unknown, but hereditary basis * Pale, firm, leathery gingiva * Can cover large portion of crown * Can impact eruption of teeth due to dense, fibrous gingiva. * Affects interdental, marginal and attached gingiva.

Answer 312

* Dense collagen bundles * Elongated rete pegs * Relatively avascular

Answer 313

Systemic condition of pt exaggerates normal gingival response to plaque. * Nutritional * Hormonal * Allergy

Answer 314

* Affects marginal and interdental gingiva in areas of plaque accumulation. * Occurs in both sexes

Answer 315

* Marginal enlargement (usually generalised) * Increase in progesterone and estrogen * Vascular changes (dilated capillaries) * More anaerobic bacteria and p.intermedia.

Answer 316

* Highly vascular solitary tumour * Sessile or pedunculated * Mushroom shaped mass from IP space * Painless, superficial * Smooth glistening surface with red pin-points. * Painless

Answer 317

* Increase in plasma cells. * Gingiva becomes red and friable * Intense oedema, inflammation and hyperaemia * More prevalent in young females. * Involves marginal, interdental and attached gingiva. * May be allergic

Answer 318

* Nasopharynx * Solitary plasma cell tumour * Pink and smooth * Slow growing * Pedunculated * Oral manifestation of multiple myeloma in rare cases.

Answer 319

* Haemorrhagic tendency * Friable * Buish red and shiny * Acute necrotising painful ulcers * Chronic inflammation with leukocytes

Answer 320

Solitary benign tumour of gingiva

Answer 321

* Slow growing, solitary, spherical mass * Normal colour * Firm & nodular * Arises from gingival connective tissue * Bundles of well-formed collagen fibres with variable vascularity

Answer 322

* Scaling involves plaque, stain and calculus removal from crown and root surface. * Root planing involves removing contaminated and rough cementum from root

Answer 323

20 000 cycles per sec

Answer 324

* More efficient * Thinner tip \> more comfortable * Water flushing effect * Less pressure applied * Multiple surfaces of tip are capable of removing calculus * Less tissue destruction * No need to sharpen * Less chance for repetitive stress injuries

Answer 325

* Aerosol production * Can’t be transported easily * Louder * Less tactile sensation * More precautions and limitations * Reduced visibility

Answer 326

* Piezoelectric range is uniform, it uses scraping or tapping motion and has linear pattern * Magnetostrictive range is uniform, uses scraping motion and has elliptical pattern

Answer 327

* Pt with communicable disease * Pt with pacemaker * Young pt * Pt with deglutination problems * Porcelain or bonded restos

Answer 328

* Proto-oncogenes: controls normal cell growth * Tumour suppressor genes: regulate mitosis- p53, Rb

Answer 329

* Stage: progression or spread in body * Grade: cell differentiation (how many mutations)

Answer 330

* Iron deficiency * Megaloblastic anaemia * Immune haemolytic anaemia

Answer 331

· Pale · Dizzy · Extreme fatigue · Chest pain · Shortness of breath, · Tachycardia

Answer 332

* Macrocytic * Very few and very large

Answer 333

* Microcytic hypochromic * Small and pale. Fewer RBC present too.

Answer 334

* Lower - Iron def * Higher - megaloblastic & haemolytic anemias

Answer 335

Cancer of bone marrow blasts. - Inc blast (cancer) cells - Dec RBC, WBC and platelets - Anaemia, fever and bleeding

Answer 336

Chronic lymphatic leukaemia

Answer 337

- Malignancy of mature B cells. - Tumour produces plenty of monoclonal antibodies - Blood becomes thick - Symptoms: multiple punched out bone lesions, infections, renal failure

Answer 338

1. Thrombocytopenia 2. Vit K deficiency 3. Haemophilia (A&B) 4. Von Willebrand Disease

Answer 339

PT - tests extrinsic pathway (7) PTT - tests intrinsic pathway (8, 9, 12)

Answer 340

Von Willebrand Factor carries and protects factor 8. Deficiency results in lack of platelet function. - Normal platelet count but not functional so increased bleeding time. - Normal PT but PTT is increased

Answer 341

Extensive activation of coagulation all over the body. Consumption of coagulation factors and platelets lead to severe bleeding.

Answer 342

Combined heights of connective tissue and junctional epithelium attachment to a tooth. If you invade biological width you can get permanent gingival inflammation around crown.

Answer 343

* Crown lengthening * Gingival recontouring * Excision of hyperplastic gingival tissue * Haemostasis * Exposing of tooth margins

Answer 344

* Electrosection * Electrocoagulation (white coagulation, dessication, black coagulation)

Answer 345

Fully rectified wave forms

Answer 346

White coagulation Dessication Fulguration (tissue left charred)

Answer 347

* CI in cardiac pacemaker pts. * CI in radiation therapy and acutely immuno-compromised pts. * Don't use near alveolar bone or flammable vapours/liquids * Do not contact tooth or alloy restos * Do not use with N2O2 or O2. * Do not retract tissues with metal instruments * Avoid prolonged tissue contact. * Have good ventilation * Adjust current for optimal use

Answer 348

A 2.5cm length of cord contains just less than the amount of epinephrine in 4 LA carpules. This is about 2x the allowable dose for a cardiac pt.

Answer 349

Clay material that you place in gingival tissue margin, leave for 5 minutes and wash off. Will retract gingival tissue

Answer 350

* When most or all axial surfaces of a posterior tooth are weakened or are restored. * When there is insufficient interocclusal distance * Heavy bruxism * Bridge abutment

Answer 351

* Functional cusp: 1.5mm * Non-functional cusp: 1mm * B and L walls: 0.5mm chamfer * B seating groove

Answer 352

Also known as RCP. Relationship of md to mx when condylar head is situated in the most anterior superior position within the glenoid fossa. It is a reproducible position.

Answer 353

Premolar and molar takes over the lateral excursion (rather than canine discluding posterior teeth)

Answer 354

Excessive wear on O surface of molars

Answer 355

* Semi-adjustable: simulates anatomy slightly better * Plane line: smaller radius of closure so posterior teeth tend to get premature contacts on restos. Also, lateral jaw movements cannot be simulated so posterior restorations should be fabricated on semi-adjustable articulators.

Answer 356

* RED: known as boxing wax. Place wax around tray to make box and this is where you can pour your stone into. * PINK: bite registration wax. Not as soft as red wax. Requires to be heated up with hot water or gas flame.

Answer 357

* Tooth sensitivity * Bacterial ingress/pulpitis * Proximal tooth drift * Over-erupted prepared tooth * Eruption of opposing teeth * Compromised appearance * Prep prone to damage

Answer 358

* Instrument (carver, scaler, excavator tip) * Cotton pledget soaked in CHX * Ultrasonic tip

Answer 359

* Tight proximal contacts * Undercuts and very parallel prep walls * Flaws in resto fitting surface

Answer 360

* GC Fit Checker * Artispot fit checker. - Paint red on fitting surface of crown. - Put crown on tooth - Pull crown off tooth - Adjust when the red is gone. (if there is risk of perforation it may be necessary to minimally alter the tooth.

Answer 361

Adjust proximal contacts Alter taper of prep Alter fitting surface of resto

Answer 362

* Retake impression * Remake crown

Answer 363

* Remake without impression * Alter shade in lab with low fusing ceramic addition. * Alter shade with indirect resin

Answer 364

Resin cements (Panavia)

Answer 365

* Adhesion to enamel/dentine * Well tolerated by pulp * Mix is sticky * Contains fluoride (caries resistance)

Answer 366

* Good film thickness * Poor strength * High solubility * Nil chemical adhesion * Easy to use * Minimal sensitivity

Answer 367

Fixed prosthesis with alloy frame, bonded to abutment teeth with resin cement via an acid etch technique

Answer 368

* Fracture through proximal contact area. * Metal mesh incorporated into prosthesis and placed on lingual aspect (rochette bridge) to strengthen connector areas

Answer 369

Electrolytic etching of alloy fitting surface and cementation with panavia resin cement * Basically same as rochette bridge. However, maryland bridge doesn't use holes in framework for retention. Instead, bridge fitting surface is electrolytically etched and CR bonds nicely to it.

Answer 370

* Electrolytic: less safe, better retention, voids trap air, technique sensitive, air inhibits resin polymerisation * Sandblasting: safer, less retention, less air entrapment, good oxide layer for adhesion

Answer 371

* Short edentulous span * Stable abutments * Sound coronal tooth structure * Good ridge form * Open bite * Cuspid guidance * Ortho space maintainance * Splinting * Protection against tooth surface loss * Interim fixed option before implants

Answer 372

* Long edentulous span * Poor ridge form * Severe tooth rotations or angulations * Deep bite * Bruxer * Mobile abutments * Heavily restored tooth * Alloy hypersensitivity

Answer 373

Base metal alloys can be cast to 0.3mm whereas gold requires 0.5mm. Thicker material can prevent posterior teeth occluding (don't want to place metal on occlusal contact areas) Get pt to bite on articualting paper. Don't want to place metal on occlusal contact areas bc when pt bites down they won't be able to get posterior teeth together. Tend to use . That's why base alloy is good for maryland bridge.

Answer 374

* Wax up * Investing * Casting * Trimming- surface treatment * Ceramic or resin addition

Answer 375

Panavia system Place rubber dam Clean abutments with pumice and water Apply etchant and self etching primer to tooth Place alloy primer on metal fitting surface Mix resin pastes and apply to retainers only Seat bridge, wipe away excess cement Apply Oxyguard II Finish metal margins

Answer 376

* Lingual rest seat * Lingual reduction * Proximal groove * Proximal reduction * Chamfer

Answer 377

* Partial or total debond * Secondary caries * Pontic movement * Pontic fracture * Hyperocclusion * Gingival inflammation

Answer 378

* Protect pt nasogastic passage * Tie floss around bridge * Have HVE to suction bridge fragments

Answer 379

* Less tooth preparation (only one side) * Avoids caries under a debonded retainer * Less expensive * Lasts longer than fixed fixed as the pontic moves with tooth

Answer 380

* Zirconia: 750MPa * Emax: 360MPa

Answer 381

* Rely x unicem * Ivoclar SpeedCem Plus

Answer 382

1. Wash and dry restoration 2. Apply Ivoclean for 20 seconds-then wash and dry again 3. Apply Ivoclar SpeedCem Plus dual cure cement (transparent) to the crown or bridge fitting surface. Apply with a micro-brush to ensure all margins are covered. 4. Seat the restoration and use dental floss inter-proximally. 5. Tack light cure margins for 5-10 seconds and remove excess. The material will self- cure in 3- 4 minutes

Answer 383

SpeedCEM Plus cement contains MDP which bonds to the tooth and zirconia surface by means of PO4 groups

Answer 384

High speed fine diamond bur to adjust zirconia. Will then need to polish with ZirconBrite otherwise will wear adjacent tooth rapidly as it is harder than enamel

Answer 385

1. HF acid etch in lab 2. Apply 3M Scotchbond Universal onto the fitting surface of the restoration and tooth prep for 35 secs (silanates fitting surface and etches tooth surface) 3. Apply Nexus 3 (shade clear) to the restoration and seat. 4. Clear contacts with floss and tack cure for 5-10 seconds. 5. Remove excess resin. 6. Check occlusion

Answer 386

* Splinting of perio teeth * Single anterior and posterior crowns * Full coverage for fractured teeth * Abutment for RPD * Retainer and pontics for fixed bridgework * High stress situation (deep overbite or bruxer)

Answer 387

* Base metal: 0.2mm- issues bonding to porcelain, casting diffiulties * Nobel metal: 0.3-0.5)- superior bond with porcelain * Porcelain: 0.7mm

Answer 388

980 degrees which melts the ceramic particles, forming a composite structure of crystals within a glass matrix. Vacuum removes air bubbles

Answer 389

* Micromechanical * Molecular * Chemical * Compressive

Answer 390

* Tooth prep * Impression * Die * Wax up * Cast metal * Oxidise surface of metal * Placement of opaque layer * Place body and enamel porcelain * Heat 980 degrees and place in vacuum

Answer 391

* More expensive * More destructive preparation * Less aesthetic due to reflectance from opaque layer

Answer 392

* Incisal : 2mm * Occlusal: metal + ceramic: 2mm, metal alone on non-functional cusp: 1mm, metal alone on functional cusp: 1.5mm * Labial/incisal ⅔: 1.5mm * Labial/gingival ⅓: 1.3mm * Proximal: 0.5-1mm * Gingival/cingulum wall: 0.5mm * Lingual concave surface * Metal + ceramic: 1mm * Metal only: 0.5-0.8mm

Answer 393

* Ceramic radial shoulder * Ceramic heavy chamfer * Heavy chamfer with gold collar * 45 degree beveled shoulder with gold collar

Answer 394

Covers the metal so the tooth won't appear as grey in colour. Also helps the ceramic and metal bond.

Answer 395

* Metal collar * Overbuilt crown

Answer 396

* Metal collar * Overbuilt crown

Answer 397

If margins terminate on root and not much tooth structure can be drilled away

Answer 398

* Body porcelain * Incisal porcelain * Opaque layer * Unveneered metal * Veneered metal

Answer 399

Lithium disilicate glass

Answer 400

As convex as possible

Answer 401

* Class I: Reduced B-L dimension but normal ridge height * Class II: Reduced ridge height but normal width. * Class III: Reduced ridge height and width.

Answer 402

* Sanitary * Conical * Ovate * Modified ridgelap * Saddle ridgelap

Answer 403

Easy to clean Poor aesthetics Generally posterior mandible Not used anteriorly

Answer 404

Good aesthetics Difficult to clean Generally not recommended

Answer 405

* Poor aesthetics * Food entrapment in undercut areas * Good access for cleaning * Generally for molars with non aesthetic requirement * CI in pts with poor OH and highly aesthetic situation.

Answer 406

* Easy to clean * Some food packing in undercut area * Good aesthetics

Answer 407

* Excellent aesthetics * May require minor surgical preparation * Fairly easy to clean * Minimal food entrapment * Primarily for upper anteriors

Answer 408

Retain & stabilise the core Obturation of post canal

Answer 409

* Post at least crown length * Retain apical seal * Correct angle in root canal * Do not over prepare canal

Answer 410

* Non-restorable tooth * Short roots, thin roots, carious roots * Existing root pathology * Poor periodontal support * If core can be retained and supported without post * Endo filled canals without coronal seal (3 months or longer)

Answer 411

Tapered Tiered Parallel

Answer 412

Ribs on post cut into dentine. Divets are where the cement flows and holds post against dentine of root canal

Answer 413

* Passive: post placed without actively cutting into dentine surface. * Active: Placed and cemented with post actively engaging dentine.

Answer 414

GG: can fracture PP: can perforate

Answer 415

* Fibre posts: Diamond bur and water spray. Don't cut with scissors as glass fibers will fracture. * Parapost: Cut from apical end. Sharp edges smoothened with diamond bur.

Answer 416

1. Remove GP with universal drill, leaving a minimum 4 mm of filling apically 2. Select post size and matching drill. Use appropriate drill to widen and shape the root canal. 3. Insert post to check the fit in the prepared canal. Should be able to easily remove the post. 4. Shorten post to the required length using a diamond disk and Suction system 5. Disinfect the post with alcohol and dry it with air free of water and oil. 6. Disinfect the root canal with 2.5-5.25% NaOCl. Rinse immediately with water and dry with paper points 7. Begin apically in the root canal and dispense RelyX Unicem cement. Keep elongation tip immersed in the cement initially and during the entire cement application process to avoid trapped air in the cement 8. Seat the post immediately. Twist slightly and apply moderate pressure to hold in position. Remove excess cement 9. Light cure cement for 40 seconds or allow to self-cure for 5 minutes from start of mix

Answer 417

GIC Auto-mix self etching resin cement

Answer 418

Direct restorative material placed into root canal (e.g. amalgam, CR). Difficult and rarely used.

Answer 419

If you just have post stick in the hole without a key/notch, there is propensity for composite resin crown to rotate around tooth. Core will be retained better with anti-rotation design. Use in ovoid or asymmetrical root canals.

Answer 420

1. Go in with gates glidden burs with stopper (WL-5mm) 2. Cut post 3. Place light body material and plastic post down root canal to take impression (plastic post is mechanically retained in impression to prevent distortion of silicon upon removal)

Answer 421

Up to but no more than ⅓ of root width

Answer 422

* Conserve as much dentine as possible. * Don't over prepare root canal. * Adequate post lengths to achieve core retention. * Keep cement within root canal. * Preserve apical seal.

Answer 423

* Loss of retention * Secondary caries * Root fracture * Post fracture * Post bending * Root resorption * Apical infection

Answer 424

* Create space around post (fine diamond, Masseran Kit) * Ultrasonic agitation * Post-puller

Answer 425

May need LA if tooth is vital. Can use spoon excavator under margin to lift off Otherwise can drill small hole in buccal surface and use spoon excavator to twist off.

Answer 426

* Removal of enamel defects * Diastema closure * Tooth colour correction * Alter shape of teeth

Answer 427

Highly aesthetic Minimally invasive Good clinical record Good colour stability Well tolerated by gingiva

Answer 428

* Hard to block out dark stains * Difficult for severe tooth angulation and position * Fragility * Sensitivity

Answer 429

0. 3mm: md incisors 0. 5mm: everywhere else

Answer 430

1. Isolate fracture site with RD 2. Bevel fracture margin with HS diamond 3. Etch porcelain with 9.5% HF acid gel and wash + dry 4. Etch enamel/dentine and wash +dry 5. Apply silane primer to porcelain edges 6. Wait 60 seconds 7. Apply Optibond Solo Plus and LC 8. Repair with resin composite LC 9. Recontour and polish

Answer 431

1. Isolate fracture site with RD 2. Bevel fracture margin with HS diamond 3. Etch porcelain and fragment with 9.5% HF acid and wash + dry 4. Etch enamel/dentine and wash + dry 5. Apply silane primer to porcelain and fragment, wait 60 seconds 6. Apply Optibond Solo Plus to tooth and porcelain margin and LC 7. Apply Nexus 2 cement to fractured piece and seat correctly. LC 8. Recontour and polish

Answer 432

* Margin contamination during etching, bonding * No enamel adhesion * Poor cementation technique * Tooth flexure

Answer 433

* Diastema closure * Conservative full coverage restoration * Alter tooth shape (peg lateral, microdontia) * Correct angulation or tooth form * Sufficient area for adhesion

Answer 434

Less invasive than full crown Aesthetic

Answer 435

1. Roughen surface of the metal with high speed diamond bur 2. Bevel edges of porcelain 3. Place Panavia alloy primer over exposed metal and porcelain (use an applicator to apply primer) and let dry 4. Place scotch bond over the metal and porcelain, air dry and light cure 5. Place opaquer or shade modifier on the metal and light cure 6. Place appropriate shade resin composite over the opaquer and light cure 7. Finish and polish

Answer 436

Motivation Financial status Caries experience Salivary flow Perio status

Answer 437

Length of span Height and width of ridge Over erupted opposing tooth Inter arch distance

Answer 438

Can cause secondary caries under margin bc gap is formed

Answer 439

Attachment placed on pier abutment that allows the posterior segment to move independently from the anterior segment. Reduces load on whole bridge

Answer 440

* Need to take off substantial amount of tooth structure to be able to seat the bridge * Can cause pulp exposure * Mesioangular 3^rd molar * Over tapered, non-retentive prep

Answer 441

* Overprepared root canals. * Heavy forces * Perio involved roots * Absence of ferrule * Sharp post tip * Active post

Answer 442

Mechanoreceptors regulate the amount of pressure placed on teeth so when they are removed, there is greater force placed on them

Answer 443

Beta 2 receptor agonist for asthmatics. Causes bronchodilation to relax airway muscles irrespective of the spasminogen causing the attack. It is a physiological antagonist.

Answer 444

* B2- Bronchodilation and vasodilation (perfusion of vital organs) * B1- Increase heart rate * A1- vasoconstriction to prevent CV collapse and venoconstriction to force blood back to the heart

Answer 445

It is a selective antiplatelet drug. It produces its effect by preventing coagulant effects of TXA2 and retaining anti-coagulant effects of PGI2

Answer 446

Give pt supplemental dose of corticosteroid prior to treatment as they could otherwise become hypotensive under stress.

Answer 447

* Impairment: any loss, abnormality or defect in structure or function * Disability: any restriction or lack of ability to perform activity due to impairment * Handicap: disadvantage resulting from impairment or disability that limits fulfilment of role considered normal for that individual

Answer 448

* Epilepsy * Sleep apnoea * Brachycephalic skull with delayed closure of fontanelles * \> risk infections, eczema. * \> risk of childhood leukemia * Cardiac problems (teratology of fallot) * Intellectual disability * Altered speech * Sight and hearing issues * Dementia * Atlanto-axial instability

Answer 449

* Pulmonary stenosis * Aorta emerges from both ventricles * Ventricular septal defect * Ventricular hypertrophy

Answer 450

There is instability between C1 and C2 so need to be aware of this when adjusting chair and head rest.

Answer 451

* Mouth breathing * Drooling * Angular cheilitis * Chapped, everted lower lip * Tongue: scalloped, fissured, macroglossia, geographic tongue, tongue thrusting * V shaped high vault palate * Teeth: microdontia, peg laterals, hypodontia, supernumeraries, hypoplasia and hypocalcification, taurodontism, spacing, reduced risk of dental caries, delayed eruption * More susceptible to perio

Answer 452

High salivary pH High bicarbonate levels Lower strep mutans levels

Answer 453

* Hypotonia * Periodontal disease * Diet and OH * Positioning neck (atlanto-occipital instability) * Cardiac defects * Consent

Answer 454

A non-progressive motor disorder caused by brain injury prior to completion of maturation of CNS (in utero or before age 4)

Answer 455

* Intellectual disability * Seizure disorders * Speech difficulties * Visual problems * Hearing problems

Answer 456

* Drooling * Dental trauma (falls) * Attrition * Malocclusion * Caries * Enamel hypomineralisation & hypoplasia * Mouth breathing * DIGO * Tongue thrust * Poor swallow reflex * Hyperactive gag reflex * Erosion (GI reflux)

Answer 457

* Ataxia * Athetoid (benefit from N2O or benzos) * Spastic

Answer 458

If there's hypoxic event during birth or brain damage from infection in first 4 yrs (that has resulted in CP), ameloblasts are susceptible to alterations from oxygen levels.

Answer 459

* Early contact from young age. * Malocclusions can be reduced by oral stimulation and training from early age, sometimes with palatal plates and meds. * Regular follow ups.

Answer 460

Defective closure of the vertebral column due to defect of skin, vertebral arches and neural tube.

Answer 461

* Complete paralysis of lower limbs and sphincters of bladder and bowel. * Club foot. * Dislocated hip. * Links with folic acid deficiency during pregnancy.

Answer 462

* May require AB prophylaxis id shunt is in place * May be in wheelchair

Answer 463

* Obtain med hx (contact GP or carer) * Discuss management strategies with carer/pt * Ask carer for level of tolerance * Find out who legally gives consent * Who pays? * Transport

Answer 464

* Obtain hx and level of independence * Understand emotional context of pt * Explain what are are doing at appropriate level for pt * Explain equipment * Evaluate reflexes * Evaluate meds

Answer 465

* Ability to carry out OH * Level of interest in oral care * Urgency of medical condition * Medical treatment planned * Urgency of dental tx * Any necessary planned surgical procedures * GA?

Answer 466

* Involve carer where appropriate (diet, OH advice) * Modified toothbrush * Fluoride in surgery and home (esp neutrofluor 5000) * Reward with non carious food * Shorter dental recalls (3-6 months) * Pit and fissure sealants * CPP-ACP * CHX

Answer 467

* Repetitive or ritualistic movement, posture or utterance. * Rigidly following routines

Answer 468

* Range in intelligence * Physically normal (may have difficulties) * Inability to relate to ppl (reduced social skills), variable ability to form emotional relationships * Unable to interpret language * May dislike physical contact * Lack of eye contact * Lack of response * Usually immersed in activity that interests them * Attuned to routine & lists * Abnormal facial perception * Selective attention * Altered sensory perception

Answer 469

* No big smiles * No back and forth sharing of sounds or facial expressions by 9 months * No babbling by 12 months * No back and forth gestures (waving, pointing) by 12 months * No words by 16 months * Any loss of speech, babbling or social skills at any age.

Answer 470

Disorder of DOING- they know what to do but can't manage to do it. * Impulsive * Hyperactive * Poor mood regulation * Easily distracted * Can't sort out what to attend to.

Answer 471

* ADHD: Ritalin (dec hyperactivity and impulsivity, improve alertness & concentration) * ASD: only for certain aspects- difficulty sleeping. Last resort after behaviour intervention failed.

Answer 472

* Obtain med hx * Discuss management strategies with carer * Ask carer level of tolerance * Who gives consent? * Need for chemical restraints?

Answer 473

* Should not be kept waiting * Short, regular appts * Desensitising appts * Keep instructions brief and simple * Be consistent * Minimise distractions * Tell-show-do

Answer 474

* Epilepsy meds can cause gingival hyperplasia, delayed eruption. * Trauma- head banging, falls, accidents, seizures assoc w/ epilepsy * Oral habits- self mutilation, lip/cheek biting, pica. * Bruxism * GORD- erosion * Dental caries- cariogenic foods as reward for behavioural management * Periodontal disease- poor OH, poor compliance.

Answer 475

Serous acini

Answer 476

* 2.2Gy reduces salivary flow within 24 hours * 40Gy causes permanent hyposalivation

Answer 477

* 2.2Gy reduces salivary flow within 24 hours * 40Gy causes permanent hyposalivation

Answer 478

Thick, ropey or aerated

Answer 479

Lubrication Cleansing Antimicrobial Remin Buffering Mucosal integrity Digestion & taste

Answer 480

Partial restoration of taste 20-60 days post RT. Full restoration after 2-4 months. Some report long term changes.

Answer 481

Donor T cells react against pt tissues directly or through exaggerated inflammatory responses following HCT.

Answer 482

* Pseudomembranous ulceration * Erythema and atrophy (acute) * Lichenoid hyperkeratotic changes (chronic) * Dysgeusia * Salivary gland dysfunction

Answer 483

* Shift to cariogenic flora * Reduced salivary antimicrobials * Loss of bioavailable calcium phosphate * Weakens dentine-enamel bonds * Alters prismatic enamel structure * Denatures collagen in dentine * MMPs hydrolyse dentine bonding agents * Can alter pulp vascularity & capacity to repair

Answer 484

* Different locations than common dental decay. - Labial surfaces - Incisal/cuspal tips - Proximal surfaces of lower anteriors

Answer 485

Usually lower anteriors are bathed in saliva so they aren't susceptible to caries. However, with salivary gland dysfunction, caries can occur frequently here. Distance between proximal surface and pulp is small for md anteriors.

Answer 486

Neutrofluor sensitive (low in SLS) as it is less irritant to mouth.

Answer 487

High rates of loss and recurrent caries.

Answer 488

Potential to release fluoride so it's unlikely to get recurrent caries. Also, better to loose resto than get recurrent caries. Not always bad to lose the filling as the pt keeps coming back.

Answer 489

Can compromise plaque control and increase risk of ORN. Avoid in partial dentate unless essential aesthetics and function.

Answer 490

Trismus complicates endo- rubber dam, access cavity, instrumentation. Access cavities through incisal or labial aspect or decoronating tooth may improve access.

Answer 491

Fibrosis and damage

Answer 492

* Early tx can prevent/minimise effects * Stacking wooden tongue depressors together 3-4x/day (add more over time) * Therabite device or Dynasplint Trismus system * Trigger point injections * Analgesics * Muscle relaxants * Botulinum toxin * Heat pack

Answer 493

1st: Inflammatory/vascular (initiation) 2nd: epithelial (messaging, signalling and amplification) 3rd: ulcerative/bacteriological (pseudomembranous) 4th: healing

Answer 494

Grade 0: none Grade 1: mild (sore mouth) Grade 2: moderate (ulcers) Grade 3: severe (can only swallow liquids) Grade 4: life threatening (can't eat or drink)

Answer 495

* Pain * Poss oral bleeding * Impact on communication, speech and expression * Difficultly with denture use, OH, dysgeusia, bad breath, dysphagia. * Poor nutrition and hydration * Oral medication difficult to take * Portal for systemic infection * Hospitalisation * Increased cost of care

Answer 496

* MUCOSITIS MANAGMENT: Start difflam oral rinse at commencement of chemoradiotherapy (delays mucositis onset). If they get mucositis, switch to 0.12% Curasept (helps keep mouth clean). * CARIES RISK MANAGMENT: Get them to use CCP and high fluoride toothpaste

Answer 497

* Topical fluoride followed by CPP-ACP, starting 1 week before radiotherapy & continued * Foam brushes and rinses to reduce risk of microtrauma. * Avoid removable prosthesis (except while eating) * Refrain from smoking and food/drink that can cause irritation. * Saliva substitutes * Bicarb rinse after eating * Difflam, curasept * Natural yoghurt * Xylocaine gel

Answer 498

Miconazole

Answer 499

* Topical anaesthetics * Difflam (anti-inflamm) * Bicarb/salt rinse * Systemic analgesics * Cryotherapy (causes vasoconstriction so may reduce amount of chemotaxic agent being delivered to oral mucosa)

Answer 500

Exposed and necrotic bone associated with ulcerated or necrotic soft tissue which persists for \>3months in an area that has been previously irradiated

Answer 501

1. Notani I: confined to dentoalveolar bone 2. Notani II: ORN limited to dentoalveolar bone &/or mandible above the inferior dental canal 3. Notani III: ORN involving the md below the inferior dental canal or pathological fracture or skin fistula.

Answer 502

* Pain * Infection * Loss of function * Malodour * Pathological md fracture * Disfigurement * Social isolation

Answer 503

Only present on surface of bone and not in the necrotic area.

Answer 504

* Radiation induced fibroatrophic theory (Pentoclo used to treat ORN) * activation and deregulation of fibroblastic activity creating imbalance btwn tissue synthesis and tissue degradation (fragile healed tissue) * Hypoxic-hypocellular-hypovascular theory ((hyperbaric oxygen is used to treat ORN)

Answer 505

Dense bone and higher mineral content absorb a higher radiation dose.

Answer 506

* Location (tongue, FOM, alveolar ridge, retromolar pad, tonsil) * Stage of cancer * Dose of radiation (\>60Gy) * Prior surgery for tumour in jaw * Having teeth * Poor OH * Smoking & alcohol * Poor nutrition

Answer 507

* Dental exam prior to radiotherapy * Perform exos 2-3 weeks prior to tx * Management of OH and preventative strategies * Dietary advice * Regular dental recalls

Answer 508

* Tx planning: informed consent, place on operating list with senior staff. * Pre-op: rinse with mouthwash containing CHX, prophylactic AB. * Peri-op: Conservative surgical technique, primary closure of soft tissues where poss. * Post-op: CHX rinse for 2 weeks, post op antibiotics for 5 days.

Answer 509

* Systemic AB saved for episodes of acute infection. * Gentle removal of sequestra. * Reduction of local irritants (smoking, alcohol)

Answer 510

Resistant against Calcium hydroxide High Penetration into Tubuli Biofilms

Answer 511

If more than 40% of bone structure is demineralised

Answer 512

Sealer being pushed out of foramen

Answer 513

At least ISO size #15 (K files more visible than H)

Answer 514

Can take 1-3 years

Answer 515

Protect airway from files Prevent saliva contamination

Answer 516

16% EDTA Citric acid

Answer 517

4 minutes (use during terminal rinse)

Answer 518

High: tissue dissolving, comes first Low: disinfection, comes second

Answer 519

It can form a high pressure system, and extrude out of the apical foramen, burning the mucosa.

Answer 520

Sodium hypochlorite (5ml per canal) in between instrument changes 16% EDTA Sodium hypochlorite final rinse Dry with paper points CHX for problem cases

Answer 521

Tetracycline and corticosteroid

Answer 522

* Corticosteroid * Clindamycin * CaOH * ZnO

Answer 523

2 colours appear same colour under same lighting but not under different lighting

Answer 524

Chroma is the amount of colour (it can appear faded) Hue is the shade of colour (dominant wavelength)

Answer 525

Lch | (lightness, chroma, hue)

Answer 526

* A: reddish-brown * B: reddish-yellow * C: grey * D: reddish-grey

Answer 527

Colours aren’t evenly distributed Lightness plays no role

Answer 528

Opalescence Translucency, Lightness (comes from prismatic structure)

Answer 529

Reduces show through effect

Answer 530

Marginal: dark, high chroma, opaque Incisal: light, low chroma, translucent

Answer 531

Incisal: 55% Opaque: 30% Universal: 51%

Answer 532

To keep incremental layering under control

Answer 533

Opalescent layer first Place opaque layer along fracture line Place first dentine layer as core Place second dentine layer, creating mamelons at this stage Place first enamel layer Place second enamel layer just short of incisal edge Place clear layer on incisal edge.

Answer 534

Device measures spectrum of lights reflected by and coming from tooth and coverts it into shade * Measures LCh * Calculates distance to all tooth colours * Table and sort colours * Find smallest distance and report connected tooth colour Teeth colour positions can be very close so measurements can vary greatly

Answer 535

* Opaque and characterising colours * Dentine * Enamel * Enamel opalescent * Translucency

Answer 536

Combined width of junctional epithelium and connective tissue attachment. Also known as SCAT. 2.04mm

Answer 537

Crown lengthening Ortho extrusion

Answer 538

If pt has stomach ulcers, diabetic, taking warfarin

Answer 539

Once access cavity is drilled, you place needle into canal and deposit LA. Thin needle and high pressure

Answer 540

Expose pulp at small point and place ledermix or odontopaste. Seal with cotton pellet and GIC Reopen after 24hours and try to extirpate

Answer 541

Pulp tissue remaining in canals * Redetermine working length and shape the canals * Disinfect (consider other disinfection routine) * Dress with CaOH

Answer 542

No, they just reduce bacterial count

Answer 543

Spread is across a jaw Radiation is from mx to md or vice versa

Answer 544

Lymphomas are rubbery hard SCC are rock hard and non-movable

Answer 545

Temperature Heart rate Respiratory rate Blood pressure

Answer 546

WBC Neutrophil Platelets Hb

Answer 547

* Males: 135-180 * Females: 115-160

Answer 548

Systolic is BP when your heart is contraction Diastolic is BP when you heart is resting

Answer 549

140-160mmHg

Answer 550

Bisphosphonates RANKL inhibitors Anti-angiogenic (most risky)

Answer 551

Quit smoking Healthy diet Maintain OH Limit alcohol intake Get pt dentally fit

Answer 552

Assess risk and inform them of the risk Advise them to quit smoking, have healthy diet and maintain OH Aim to get them as dentally fit as possible

Answer 553

1. Inform patient of the risks and that they are low risk. Gain consent. 2. Carry out the procedure normally. No AB prophylaxis is necessary. 3. Recall in 8 weeks to see if socket has healed. If no signs of healing and you suspect MRONJ, refer to oral specialist

Answer 554

1. Try to consider other alternatives to extraction. If it is the best option, continue with extraction. Inform pt of risks and gain consent 2. Carry out procedure as normal 3. Recall in 8 weeks to see if the socket has healing. If no signs of healing and you suspect MRONJ, refer to oral specialist.

Answer 555

Platelet plug Coagulation cascade Fibrin clot Vasoconstriction Thrombin activation

Answer 556

They will have normal bleeding while in the chair as vasoconstriction and platelet function are part of primary haemostasis. One their way home they will start bleeding excessively

Answer 557

* Sedative Pre-Medication (benzo) * Brief Treatment Visits * Careful Use of LA with Vasoconstrictor (last thing you want to do for cardiac disease pt who is anxious to is have inadequate LA so using vasoconstrictor is appropriate) * Consider Patient Positioning (don’t want to lie pt who has heart failure flat- accumulation of fluid within thoracic cavity and lungs, preventing them from breathing properly) * Monitor BP and Pulse Oximeter * Endocarditis Prophylaxis

Answer 558

10 minutes

Answer 559

Liver clot * Gently remove clot * Apply haemostatic agent * Suture

Answer 560

Reassure pt that it will start to improve within 1-2weeks

Answer 561

Apply haemostatic agents Suture If inadequate to control bleeding, send to hospital

Answer 562

Haemolysis- anaemia

Answer 563

Blue bloater: chronic bronchitis Pink puffer: emphysema

Answer 564

Pts undergoing surgery and are on long term steroid therapy that is \>7.5mg. Recommended to double dose before procedure.

Answer 565

Because they will be unable to make enough natural steroid to deal with stress when they are taking long term steroid therapy. Can lead to Addisonian crisis if pt does not get steroid cover when needed

Answer 566

Excessive exercise Not eating enough Excessive insulin Stress Alcohol Hypoglycaemics

Answer 567

* Dizziness * Irritability * Sweating * Drowsiness * Tingling

Answer 568

* Renal failure * Cataracts, retinopathy * Peripheral neuropathy * Arteriosclerosis- amputations more common * Depression more common

Answer 569

Metabolism Cholesterol and bile formation Blood clot factor production Detoxification Glycogen storage Immune function

Answer 570

Jaundice Excessive bleeding Dark urine Oedema Finger clubbing Sialosis

Answer 571

Pt may have excessive bleeding (important for exos) Pt may not be able to metabolise drugs effectively Transmission of viral hepatitis