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BDS Exam style questions > Challenging Questions > Flashcards

Challenging Questions Flashcards

1
Q

What dies the effect of traumatic forces depend on?

A

Magnitude

Duration

Direction

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2
Q

What is the pathological response to traumatic occlusion?

A

Occlusal force is too great meaning that width of PDL and therefore mobility does not stabilise

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3
Q

When is intervention for mobile teeth considered?

A

If becoming progressively worse

If causing discomfort

If interfering with restorative tx

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4
Q

What are treatment options for traumatic occlusion?

A

Occlusal management
Break parafunctional habits
Spint
Address tooth symptoms

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5
Q

What is trigeminal neuralgia?

A

A chronic disorder of trigeminal nerve characterised by sudden/severe onset of sharp, shooting unilateral facial pain

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6
Q

What investigations are done for TN?

A

Blood tests:
-> FBC
-> Blood glucose

Imaging:
-> MRI
-> CT
-> PET

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7
Q

What are the causes of TN?

A

MS
Brain tumour
Aneurysm
AV malformation
Epidermoid, dermoid and arachnoid cysts

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8
Q

How do you detect a debonding bridge?

A
  • Visually- with good illumination/magnification
  • Using floss and probe
  • Movement with pushing
  • Saliva bubbles gathering at margin on pressure
  • Evidence of secondary caries at margin
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9
Q

What are the reasons for a bridge or post/core debonding?

A

Issue with cementation- moisture contamination

Unfavourable occlusion

Bruxism

Trauma

Root fracture

Wing fracture- caries under wing

Angulation and parallelism issue
-> divergent guide paths
-> prep being too minimal

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10
Q

What is a perio abscess?

A

Localised infection of periodontal pocket
-> swelling due to pus accumulation
-> caused by food packing, plaque accumulation, lack of cleansing

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11
Q

How is perio abscess differentiated from PA abscess?

A

Position of swelling

Tooth is vital in perio abscess

Poor periodontal condition in rest of mouth

No radiolucency of perio

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12
Q

How does vertical bone loss occur?

A

Plaque induces inflammation which travels from PDL to bone
-> radius of destruction is <2mm meaning only localised area of bone adjacent to affected tooth is lost (some of the septum is still present)

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13
Q

What patients are at high risk of bleeding?

A

Haemophilia patients

Anticoagulant/Antiplatelet medication

Alcoholics and ALD

Liver disease

Patient with previous history of bleeding

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14
Q

What are the treatment options for unerupted ectopic canine?

A

Leave and monitor

Remove C or create space and wait for eruption

Open exposure

Close exposure- with gold chain

Autotransplantation

XLA and replace with prostheses

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15
Q

What are the causes of ABs being ineffective in perio?

A

Bacterial resistance

Failure to penetrate biofilm without mechanical disruption

AB may not be specific to bacteria

Inadequate concentration and retention of AB at required site

Allergy

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16
Q

What are the RFs for Candida infection?

A

Erythrmatous- ill fitting denture, poor denture hygiene, wearing denture overnight

General:
Anaemia
Diabetes mellitus
HIV
Chemotherapy
Broad spectrum AB use
Inhaler with no spacer or rinsing

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17
Q

What are the indications as per FDS2020 for extraction of M3M?

A

Infection- 1 or more episodes of pericoronitis

Caries- making tooth unrestorable

Periodontal disease

Radicular or dentigerous cyst formation- if XLA will help prevent expansion or recurrence

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18
Q

What extra post-op complications can happen following extraction in the upper?

A

Tuberosity fracture

OAC

Root in antrum

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19
Q

What extra post-op complications can happen following extraction in the lower?

A

Altered/loss of sensation (P/T) to lower lip, cheek and tongue (may affect taste)

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20
Q

What are the primary and secondary HSV 1 and 2 infections?

A

Primary- PHG

Secondary- Herpes Labialis

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21
Q

What are the primary and secondary infections of Varicella Zoster (HHV3)?

A

Primary- chicken pox

Secondary- shingles

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22
Q

What are the oral effects of HHV4 (EBV)?

A

Ulceration

Glandular fever

Hairy leukoplakia

Burkitt’s lymphoma

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23
Q

What conditions can be caused by coxsackie virus?

A

Herpangina

Hand, foot and mouth disease

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24
Q

What are the symptoms of a coxsackie virus infection?

A

Pinhead vesicles of back of throat and soft palate

Sore throat

Sore head

Fever

Lymphadenopathy

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25
Q

How is a coxsackie virus condition treated?

A

Rest

Hydration

Soft diet

Analgesia

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26
Q

What is Fluorosis?

A

Generalised disorder characterised by hypomineralisation of enamel matrix as a result of excessive fluoride ingestion
-> usually in first 8 years of life
-> Diffuse opacities
-> Brown and yellow pitting

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27
Q

What are the biological factors influencing masticatory performance?

A

Number occluding units

Number of functional teeth

Maximum bite force

Age

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28
Q

What is the SDA?

A

3-5 occlusal units remaining
-> Ideally 6 anteriors and 4 premolars

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29
Q

What are 5 conclusions form SDA?

A

Achieves mandibular stability

Sufficient functions and aesthetics

Achieve occlusal stability

Same rate of attritive wear

Same rate of bone loss

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30
Q

What are the different roles in Decontamination?

A

Owner- owns practice and LDU (responsible for running LDU)

User- designated person that is responsible for day to day running of LDU

Operator- person with authority to operate equipment and performs simple maintenance

Maintenance engineer- employed to carry out maintenance and repairs when required

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31
Q

What is vitapex?

A

CaOH and iodoform paste

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32
Q

What are the factors which help relief crowding from primary to permanent dentition?

A

Further maxillary and mandibular growth

Proclined path of eruption in upper incisors

Leeway space

Primate space

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33
Q

How is composite bonded to dentine?

A

Dentine conditioner (35% phosphoric acid)
-> removes smear layer, opens tubules and decalcifies surface dentine

DBA is applied- contains primer and adhesive

Primer (bifunctional)- Hydrophilic ends bon to dentine, hydro phobic ends are exposed

Adhesive penetrates dentinal surface by molecular entangled bonding to primer tails by hydrophobic interactions
-> forms hybrid layer (collagen and resin)

Composite can bin d to adhesive surface as both are hydrophobic

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34
Q

What are the causes of pain to biting and thermal stimuli following cavity prep? How is this rectified?

A

Deep prep (place lining)

Pulp exposure (pulp cap/RCT)

Lack of coolant- reversible pulpitis (use coolant)

Undercure of composite- ingress into pulp causing irritation (cure for longer and place increments <2mm)

Unfavourable contacts (check with articulating paper and adjust)

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35
Q

What are the causes of different discolouration primary teeth?

A

Pink- bleeding into dentine tubules

Yellow- tertiary dentine being laid down

Grey/dark- necrosis of pulp

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36
Q

What are we looking at when reviewing trauma radiographically?

A

Apical radiolucency

External or internal inflammatory resorption

Pulp necrosis

Continued root development- height and width

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37
Q

What faults can occur when preparing a canal with SS file?

A

Canal blockage

Apical zipping

Ledging

Debris extrusion

Perforation

File fracture

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38
Q

What are the different sizes of reciproc and their use?

A

R25- small canals

R40- medium canals

R50- large canals

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39
Q

What are the steps in using reciproc?

A

To 2/3rds:
3 pecks with R25, irrigate, recapitulate, patency file
-> repeat

Gain CWL
-> Take 10 to WL- if no pre-curve use R25
-> If pre-curve- create glide path with 15 and then use R25
-> If 15 not possible- finish with hand files

To length- irrigate, recapitulate, latency

Check for apical gauging

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40
Q

Why is copper enriched amalgam preferred?

A

Corrosion resistance
Strength
Creep resistance
Marginal integrity

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41
Q

What are the signs and symptoms of Albright’s syndrome?

A

Fibrous dysplasia

Precocious puberty

Hyperthyroidisim

Cushing’s

Cafe au Late spots

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42
Q

What are the features of Paget’s?

A

Increased alkaline phosphatase

Disturbed balance of bone formation and resorption

Bony swellings

Nerve compression

Ill-fitting dentures

Blindness

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43
Q

What are the phases of Paget’s?

A

Osteolytic

Mixed

Osteosclerotic

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44
Q

What are the features of Cherubism?

A

Autosomal dominant inheritance

Fibro-osseus condition

Progressive, painless bilateral joint swelling in childhood

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45
Q

What are the physical forms of Orofacial pain?

A

TMD

Neuropathic pain- TN

Myofascial pain syndrome

Neurvascular pain disorders- Migraines

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46
Q

What are the psychological forms of Orofacial pain?

A

Mood and anxiety disorders manifesting as atypical facial pain

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47
Q

What is an RPI systems function?

A

Relieves stress and prevents traumatic torque
-> on loading, mesial occlusal rest acts and pivot point and I bar/proximal plate move around this going downwards and mesially disengaging from last standing tooth

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48
Q

What are the histological features of Sjogrens?

A

Lymphocyte infiltrate

Loss of acini

Atrophy

Ductal epithelial hyperplasia

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49
Q

What are the signs of salivary malignancy?

A

Hard

Fixed

Rapidly growing

Cervical lymphadenopathy

Loss of weight

Facial nerve palsy

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50
Q

What are the causes of post core fracture?

A

Trauma
Unfavourable occlusion/bruxism
Biocorrosion of metal post
Lack of 1.5mm ferrule

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51
Q

What are the different types of provisionals?

A

Custom made temporary- pro temp and putty matrix

Prefomed temporary- malleable composite, polycarbonate, transparent crown and composite

Bonding fractured tooth or old indirect restoration

Immediate denture or over denture

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52
Q

What are the medical issues associated with Down’s?

A

Congenital heart defect

Hypothyroidism

Coeliac

Epilepsy

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53
Q

What are the EO features of down’s?

A

Oblique palpebral fissures
Almond shaped eyes (epicanthic fold)
Flat nasal bridge
Eyes set wide apart
Brushfields spots
Small head
Short thick neck
Atlanto-axial instability
Palmar crease
Small dysplastic ears

54
Q

What are the IO features of Down’s?

A

Hypodontia
Microdontia
Enamel defects
Delayed eruption
Macroglossia
CLO
High vaulted palate
High caries risk and perio risk

55
Q

What is done in terms of prevention for patient with down’s?

A

FS

FV

F supplements

Hygienist

Bitewings

56
Q

What are the features of primary teeth to consider when restoring?

A

Larger pulp

Thinner enamel and dentine

Shorter distance from occlusal surface to pulpal floor

Ribbon shaped canals

More curved canals

Position of apical foramen changes

57
Q

What is the function of the twin block? (C2D1)

A

Retroclination of upper incisors
Proclination of lower incisors
Distal migration of uppers
Mesial migration of lowers
Restrains maxillary growth
Encourgages mandibular growth (postures and muscular forces)

-> most of change is dentoalveolar with minor skeletal change

58
Q

What are the effects of supernumeraries on permanent dentition?

A

Root resorption

Mobility

Impaction

Failed eruption

Delayed eruption

Ectopic positon

Crowding

59
Q

What are the general risk factors for periodontal disease?

A

Genetics/FH

Smoking

Pregnancy

Diabetes

Immunocomprimised

Drugs

Malnutrition

Stress

60
Q

What are the treatment options for furcation involvement?

A

Palliative

Repair

Resective tx

Extraction

Regeneration

61
Q

What are the functions of splints for TMD?

A

Diagnostic tool

Cognitive awareness of parafunction

Dentition protection

Reduced TMJ loading
-> postures condylar head forwards in articular fossa

62
Q

What is bracing in RPDs?

A

Any rigid components of a denture which provide resistance to lateral movement by contacting afainst vertical anatomical structures (tooth/residual ridge)

63
Q

What is reciprocation?

A

Any component which acts to prevent displacement of denture by active retention forces
-> contacts tooth while clasp flexes over bulbosity

64
Q

What are the different types of impression materials?

A

Polyether- Impregum (philic)

Silicones- PVS (phobic)

Compound (phobic)

Irreversible hydrocolloid- alginate (philic)

65
Q

What is the dahl effect?

A

Loclaised placement of appliance and resotration in anterior region
-> increases inter-occlusal space posteriorly allowing further eruption
-> takes 6 months
-> Increases OVD

66
Q

What are the contraindications for the Dahl Effect?

A

Root resorption

Perio

RCT teeth

Implants

Post-ortho

Bisphosphonates

Fixed conventional bridgework

TMD

67
Q

What are the issues with SDA in perio patients?

A

Remaining teeth could drift distally

Increased anterior load

Teeth already poor prognosis (not suitable for SDA concept)

68
Q

Reasons for using Nickel Chrominium alloy in RBB?

A

Similar thermal expansion to procelain

Corrosion resistant

Can be manufactured in thin cross section and cope with occlusal load

Can be sandblasted and etched with current for extra retention

69
Q

What are the issues with subgingival or alveolar preparations?

A

Limited tooth structure to bond to

Limited access and visualisation

Challenging mositure cintrol

Issues with impression

Issues assessing marginal integrity

Issues removing excess cement

70
Q

What are the different types of preps for resin bonded bridges?

A

Light- no prep

Moderate- cingulum undercut removal, 0.5mm supragingival chamfer margin

Heavy- cingulum rest seat prepared, 0.5mm palatal reduction, 0.5mm supragingival chamfer margin, proximal grooves
-> 180 wraparound prep

71
Q

What are the issues with mandibular displacement?

A

Alters growth and developmetn of jaw musculature

Potential TMJ instabilty

Attritive tooth wear

72
Q

What may you wabt to find out about if a child patient presents with ulcers?

A

Medical conditions

Nutirent defieciency

Diet

OH regime

Are there lesions elsewgwre

Systemic symptoms

When they started

Exacerbating and releiving factors

Trauma/biting

73
Q

Whar are the causes of ROU?

A

Anaemia

Trauma

Stress

Behcets

74
Q

How does PHG present?

A

Painful ulcerative lesiosn on mucosa and gingivae
-> swelling
-> bleeding
-> yellow vascular lesions

75
Q

What are the sequalae of dental trauma?

A

Mobility

Root fracture

Root resorption

Pulp necrosis

76
Q

What may hep you determine the aetiology of discolouration?

A

Trauma Hx

Dental Hx

Diet diary

MH- porphyria, tetracycine staining etc

Special investigations- radiographs, sensibilty testing, percussion notes

77
Q

What are the ADV of CoCr as a denture base?

A

Corrosion Resistance

Rigid

High thermal conductivity

Mechanical retention provided by clasps

One piece casting

Strong in thin section

78
Q

What are the histological features of malignancy?

A

Dysplasia

Atrophy

Candida infection

79
Q

How is HPV infection sampled?

A

Oral rinse

80
Q

What are the red flags for parotid malignancy?

A

Deep fixation

Rapid enlargement

Facial nevre palsy

Cervical Lymphadenopathy

81
Q

What is a benign and malignant tumour of the parotid gland?

A

B- Pleomorphic adenoma

M- Mucoepidermoid Carcinoma

82
Q

What is a benign and malignant tumour of upper lip?

A

B- Monomorphoc adenoma

M- Adenoid cystic carcinoma

83
Q

What is a benign and malignant tumour of soft palate?

A

B- Pleomorphic adenoma

M- Mucoepidermoid carcinoma

84
Q

What are the indications for a URA?

A

Malocculusion can be corrected by simple tipping

Only 1/2 teeth to be moved- baseplate provides adequate anchorage

Sufficient space available

85
Q

What is done prior to carrying out microabrasion?

A

Radiograph

SHADE recording

Clinical photograph

Diagram of defect

Percussion note

Sensibility testing

86
Q

What is a risk ratio?

A

Probability of an increased or reduced risk of an outcome occurring in one group compared to another

87
Q

What is an odds ratio?

A

A measure of association between exposure and outcome

88
Q

How long is a consignment note kept for?

A

3 years

89
Q

What is contained in a consignment note?

A

Quantity and contents of wast e

Waste origin

Transport

Waste destination

90
Q

What info is required to send to the lab for a bridge?

A

Putty wash impression

Oclusal registration

Material

Design

Shade

91
Q

How is a metal post/core cemented?

A

GIC

92
Q

How is a porcelain veneer cemented?

A

Light cure/dual cure composite luting agent with silane coupling agent

93
Q

How is a fibre post cemented?

A

Dual cure composite luting cement

94
Q

How is a prescription written?

A

Date
Pt name, DOB, age
Pt address
Practice address

Name of drug
Preparation
Strength
Dose and frequency

Total quantity to be supplied
Total length of time for prescription

Signed- draw lines in space underneath

95
Q

How long does a controlled/uncontrolled drug prescription last?

A

Controlled- 28 days

Uncontrolled- 6 months

96
Q

What other conditions is denture stomatitis associated with?

A

Angular cheilitis

Candida leukoplakia

Media rhomboid glossitis

97
Q

What medical conditions are associated with Candida infection?

A

Asthma- inhaler use

Microcytic anaemia

Immunocompromising conditions
-> Diabetes, HIV, chemo/radio

98
Q

What are the ADV/DIS of oral swab?

A

ADV:
Site specific
Avoids perioral contamination

DIS:
Invasive
Uncomfortable
Not full mouth representation

99
Q

What are the ADV/DIS of an oral rinse?

A

ADV- full mouth representation

DIS- contamination of sample

100
Q

What instructions are given to the lab on suspected Candida infection?

A

Please culture sample and assess anti-fungal sensitivity and typing

101
Q

How does secondary infection of HSV occur?

A

Following primary infection- HSV enters peripheral trigeminal ganglia neurons

HSV releases viral DNA into nucleus to establish latency
-> HSV1 genomes persist in nucleus

Stimuli results in reactivation of latent virus in infected ganglia

Virus travels to axonal shaft and tip at periphery where they are released to cause blisters and sores

102
Q

What are the triggers for HSV reactivation?

A

Stress

Fever

UV

Trauma

103
Q

What conditions may we test for when investigating recurrent aphthous ulcers?

A

Neutropenia

Anaemia

Nutrient deficiency

Inflammatory markers

Thyroid autoimmunity

104
Q

What are the effects of cocaine mixed with adrenaline in LA prep?

A

Cocaine enhances effect

Increased heart rate

Increased myocardium oxygen demand

Coronal artery vasoconstriction

Increased risk of stable angina, MI, arrhythmia

105
Q

How is MRONJ treated?

A

Analgesia

Resect necrotic bone

Irrigate and debride (saline)

Primary closure

CHX

Prophylactic AB

106
Q

How is MRONJ prevented?

A

Preventive regime

Avoid extractions

Atraumatic extraction technique

Avoid trauma

107
Q

What are the uses of URA?

A

Simple tipping of teeth

Habit breaker

Correction of oB

Retainer

Space maintainer

108
Q

What other space maintainers are used in ortho?

A

Fixed palatal arch

Nance button

109
Q

What is substantivity?

A

Capacity of a chemical agent to continue its therapeutic effect iver prolonged time
-> dependant on conc and absorption to oral tissues

110
Q

What are the uses of CHX?

A

Post extraction

ANUG

Candidiasis

Aphthous ulcers

Vesiculobullous conditions

Endo irrigant

Testing Dam

Pericoronitis irrigation

111
Q

What is SDA concept reliant on?

A

Occlusal stability- stable occlusal contacts of equal intensity in centric occlusion

-> not provided by sever class 2 or 3

112
Q

What is mandibular displacement on closure?

A

Mandible deviates from initial path of closure to progress from first occlusal contact to RCP when closing on retruded arc of closure

113
Q

What is herpes labialis?

A

Manifestation of reactivation of latent HSV1
-> labial sores, blisters, ulcers

114
Q

When should we biopsy LP?

A

If symptomatic

If patient is smoker

Red patches

115
Q

What are the topical/systemic treatments for LP?

A

Topical- hydrocortisone, betamethasone, beclamethasone

Systemic- Prednisolone, hydroxychloroquine

116
Q

Which variants of LP have more malignant potential?

A

Erosive and gingival variants

117
Q

What is Grinspan’s syndrome?

A

Oral lichen planus

Hypertension

T2 Diabetes

118
Q

How is LP distinguished from Oral lichenoid reaction?

A

Both clinical and histopathological confirmation required

119
Q

What are the symptoms of Sjogren’s?

A

Tiredness and fatigue

Dry mouth- issues eating/speaking/swallowing/tatse, caries, fungal infections

Joint pain and aches

Tiredness

Swollen salivary glands

Dryness of skin and digestive tract

Dry and sore eyes

120
Q

What are the signs/symptoms of Behcet’s?

A

Oral ulceration- similar to RAS

Genital ulceration

Occular inflammation

Fatigue

Thombosis risk

Joint pain

Headache

121
Q

What gene is behcets associated with?

A

HLA-B51

122
Q

What immune cells are involved in hypersensitivity reactions?

A

T1- IgE

T2- IgG, IgM, complement

T3- IgG and complement

T4- T cell

123
Q

What is erythema multiforme?

A

Acute immuno-mediated inflammatory mucocutaneous disease
-> likely T3/T4 rxn to trigger- infection/drugs

124
Q

What are the symptoms of EM?

A

Oral ulceration/skin lesions- target

Lip crusting

Flu-like symptoms prior to oral and skin lesions

125
Q

How is EM treated?

A

Antiseptic mouthwash- CHX

Analgesic mouthwash- benzydamine

Topical corticosteroids

Systemic corticosteroids- if persistent or recurrent

Changing medication

AB/AV if infection is cause

Azathioprine- very severe

126
Q

Types of EM?

A

Isolated

Recurrent- >6 episodes per year

Persistent- continuous with no interruption

127
Q

What is SLE?

A

Autoimmune multi system condition
-> systemic inflammation and tissue damage
-> Broad spectrum of manifestations

128
Q

What are the signs and symptoms of SLE?

A

Fatigue

Fever

Splenomegaly

Butterfly rash

Weight loss

Arthritis

OP

Myalgia

Lupus nephritis

Uveitis/scelritis

Pericarditis

Pulmonary disease- lupus pleuritis

GI issues- IBD, coeliac

129
Q

How is SLE treated?

A

Prednisolone

Hydroxychloroquine

Methotrexate

Rituximumab (monoclonal antibody)

130
Q

What is the clinical appearance of OSCC?

A

Ulceration

Speckled

Exophytic

Easily bleeds

Doesnt heal

Indurated

Fixed

Uneven/rolled margins

131
Q

What are the symptoms of late stage OSCC?

A

Ulceration

Pain

Trismus

Decreased tongue mobility

Increased tooth mobility

BDS Exam style questions (15 decks)

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