2019? Flashcards
(74 cards)
1
Q
Name 4 fluoride supplements you would give patient to prevent decalcification?
A
-flouride varnish- 22,600ppm
-fluoride tooth paste age dependant(1450, 2800,5000)
-fluoride mouthwash 225ppm
Fluoride tablets 1mg
2
Q
What other methods could be used to prevent decalcification?
A
- OHI - 2x daily and after meals
- Diet advice
- FS
3
Q
8 potential risks of orthodontic treatment other than decalcification?
A
- root resorption
- gingival recession
- relapse
- loss of vitality
- TMJD
- loss of teeth vitality
- ulceration/irritaion of soft tissue
- loss of periodontal support
4
Q
How would you treat a peri-hemorrhage?
A
- damp gauze and apply pressure for 10 mins
- take a full medical history including drugs
- use haemostatic aids- fibrin foam, WHVP
- Place suture
- post op instructions with contact details
5
Q
What local factors may delay the onset of bleeding?
A
- trauma
- loosening of sutures
- vasoconstrictor wears off
6
Q
What are 2 congenital bleeding disorders?
A
heamophilia A and B
Von willebrands
7
Q
What are 2 acquired bleeding disorders?
A
Vitamin K deficiency
drugs- warfarin
8
Q
name a NoAD?
A
apixaban - should miss morning dose if attending for high bleeding risk appointment
No need to check INR
9
Q
What should the INR be for warfarin?
A
<4 for oral surgery to be carried out. Refer to local guidelines
No need to alter medication
10
Q
What is the Shortened dental arch?
A
When most posterior teeth are missing, however satifactor oral function can stilll be gained without the use of an RPD.
11
Q
What skeletal classes are contraindicated for SDA?
A
Class III and in Severe class II
12
Q
Why is periodontal disease contraindicated for SDA?
A
- potential drifting of teeth under occlusal load
- distal tooth migration of the last standing teeth
- loss of bone and increase of mobility
13
Q
What material is used for casting adhesive bridges?
A
CoCR
14
Q
Why is CoCr used to cast adhesive bridges?
A
?????????
15
Q
What are the indications for a SDA?
A
- missing posterior teeth but still have at least 3-5 units left
- patients tolerance to RPD
- good prognosis of anterior teeth with no active perio and low restorations
- good patient motivation
16
Q
What are the contraindications for SDA?
A
-poor perio status
-poor prognosis of the current dentition
- TMJD
severe class II or Class III
-wear or bruxism habit
17
Q
How is it possible to extend an SDA?
A
- implant placement
- mesial cantilever bridge (max 1 unit per side of arch)
18
Q
What is the immediate treatment for enamel dentine fracture?
A
-Locate missing partical of the tooth.
-place LA and rubber dam on 11
PARTIAL PULPOTOMY
remove 2-3 mm of pulp using a slow speed, and check bleeding by placing a CWP with saline on it and try and achieve haemostatis.
place non setting CaHO, seal with RMGI and place composite bandage.
19
Q
Why would subalveolar fracture be of poor prognosis?
A
- lack of coronal tissue to bond to
- poor moisture control for RCT/ restoration
20
Q
2 types of restoration following XLA?
A
- implant
- bridge
- single tooth RPD
21
Q
What would you diagnosis redness at commissures of the mouth?
A
Angular cheilitis
22
Q
What are 2 possible microbes involved in angular cheilitis?
A
S. Aureus
C. Albicans
C. tropicalis
S. epidermis
23
Q
What type of sample would you take to send to the lab?
A
swab of the area
24
Q
Name a immune deficiency disease which would increase the risk of a candida infection?
A
HIV
25
Name one gastrointestinal bleeding disease which can increase the risk of candida infections?
Crohns disease
26
Name one intra-oral and one extra-oral disease that could be associated with this?
intra-oral -oral candidiasis
| extra-oral -OFG
27
Patient attends with denture induced stomatitis, what do you notice about the palatal tissue?
erythematous and oedema of the denture baring area
inflamed palatal mucosa
28
What are the classifications of denture induced stomatitis?
Newton class 1 - localised inflammation
Newton type 2- diffused inflammation and erythema confined to the mucosa contactig denture without hyperplasia
Newton class 3- granular inflammation with erythema and papillary hyperplasia
29
What causes denture induced stomatitis?
adhesionand colinisation of acrylic surfaces caused by co-aggrigation and biofilm formation
30
What is your first line of treatment in for denture induced stomatitis?
OHI
31
What is your second line of treatment for denture stomatitis?
Fluconazole 50mg - 7 days (one a day )
Miconazole oromucosal gel 20mg -80mg tube for 7 days after lesions have healed (pea sized amount to fitting surface of denture after food 4 x daily)
Nystatin oral suspension 100,000 units/ml 30ml (1ml after food 4x daily for 7 days and 48 hours after lesions have healed
32
What type of bridges can you use anterior?
```
cantilever
fixed- fixed
spring cantilever
resin bonded
resin retained
```
33
What pulpal diagnosis and why?
Reverasble pulpitis -
- short lived sharp pain on sweet stimulus which goes away when stimulus is removed
- No TTP
- pain on cold
- well localised pain
34
How would design a bridge which is less likely to de-bond
- prep adjacent tooth
- larger wing
- consider an adhesive bridge ( cantilever) wouldnt be a plaque trap if it fell out
35
what are 4 faults which can cause to it to de-bond?
- poor moisture control during cementation
- bruxism habit
- unfavourable occlusion
- poor OH
- trauma
36
What epitheilum is affected in smokers keratosis?
stratisfied squamous keratinised epithelium of the hard palate
37
What is the clinical presentation?
Thickened white are patch with some dark brown /grey areas on the palate which is painless.
may have staining elsewhere.
38
What factors cause smokers keratosis?
tomacco smoke
pipe smoke
chronic inflammation
drugs - hydroxychloroquine
39
What histological presentation could indicate malignancy?
- hyperkeratinosis
- hyperchromatism
- atypia
- dysplasia
- infiltration of macrophages
40
What clinical presentation would suggest malignancy?
- raised rolled boarder
- non--homogenous
- lesions is hard and attached to underlying tissue
41
What is mandibular displacement on closing?
happens when inter arch descrepancies cause upper and lover teeth to meet cuspto cusp which causes the mandible to deviate in one side in order to achieve intercuspation
42
Why would you correct mandibular displacement?
- best intercepted early
- can cause TMD
- tooth wear can occur
- displacement causes facial asymmetry
- teeth erupt into displaced ICP
43
What would you use to correct unilateral posterior crossbite?
maxillary expansion with -
- rapid maxillary expansion device
- URA
- Quadhelix
44
What are 6 signs/ symptoms of TMD?
- pain on opening
- limitation on opening
- muscle/ joint/ ear pain
- clicking and popping on opening
- trismus
- sore heads
- signs of wear
45
What muscles would you palpate when querying TMD?
- masseter
| - temporalis
46
What are the most common cause of TMD?
-parafunction habbits (muscle inflammation)
- chewing gum
- trauma to the joint (indirect or direct)
-stress
-disc displacement (with or without anterior reduction)
occlusal abnormalities
-degenerative disease
47
What nerve supplies the TMJ?
auriculotemporal and massetric branches of maxillary branch of trigeminal nerve
48
What would conservative advice be for TMD?
-reassurance
-do not chew chewing gum
- soft diet with food cut into small pieces
-chew on both sides at the same time
support mouth when opening wide/ yawning
-be aware of bruxism when its happening
- wear splint at night /when at high risk
- painkillers for relief
49
What is the mechanism of an overnight splint?
prevents tooth to tooth wear occuring and provides stabilisation of occlusion and of the masticatory muscles and thus decreasing abnormal activity.
50
What is arthrocentesis?
operation which involves the washing out of the jaw joint with sterile saline and anti-inflammatory steriods.
51
What are 2 other options for surgery on the TMJ?
- disc resposition or replacement
| - arthroscopy
52
What is pericoronitis?
inflammation of the soft tissue above a partially erupted tooth which allows for the communication into the oral cavity and thus bacteria and debris gets under the soft tissue.
53
What are the signs and symptoms of pericoronitis?
- pain swelling and ulceration of the operculum
- halitosis
- pus discharge
- limited opening
- occlusal trauma to the operculum
54
How is pericornoitis?
- incision and drainage of abccess
- rinse the operculum with CHX and saline
- potential removal of operculum
- if repeated cases, consider XLA of third molar
- advise pain relief and CHX mouthwash
- antibiotics if systemic involvement/ SIRS assessment
55
What are 6 signs of close proximity of the 3rd molars roots to the IAN canal?
- division /deflection of the canal
- deflection of the root
- darkening of the root where it cross
- juxta of apical area
- narrowing of the canal
- interruption of the canal
56
What imaging should be requested when an 8 is close to the IAN?
CBCT
57
What are the risks linked with damage to the IAN when XLAing the 3rd molar?
- altered sensation of the lip, chin and tongue
- numbness or tingling of the lower lip, chin or and half of tongue
- Temp-10-30%
- Perm- less than 1%
58
What a treatment would you carry out to prevent complications of 3rd molar XLAs?
cornoectomy
59
What is an ulcer?
the loss of the full thickness of the epithelium and underlying tissue can be seen
60
What is eroision?
the partial loss of epithelial tissue
61
How would you differ between major and minor recurrent apthous ulcers?
size -
minor <10mm
major >10mm
Shape-
minor- round or oval
major-oval or irregular
Number -
minor- 1-20
major- <5
Healing time -
minor - 1-2 weeks
major - 6-12 weeks (may have scaring)
62
What is the potential problems with recurrant aphthous ulcers?
- infections
- inability to eat/drink- malnutrition/dehydration
- diffuculty brushing teeth
- difficulty problems wearing denture/appliances
- speech and mastication problems
63
What are the causes of recurrent aphthous ulcer?
-nutrition deficiencies
-systemic disease
-trauma
-allergies
infections
-stress
-genetic
64
How would you treat recurrent aphthous ulcers?
Correct underlying cause=
- remove possible traumatic cause
- avoid allergens
- treat systemic cause
- replace deficient nutrients
- CHX
- benzydamine oromucosal spray 0.15%
- betamethasone mouthwash/inhaler
- prednisolone (systemic steroid)
65
What would microcytic blood results show?
reduced MCV count of less than 80fL
66
3 GI conditions which can cause microcytic anemia?
crohns
Ulcerative colitis
coeliac disease
67
What are other casues of microcytic anaemia?
thalassaemia
iron deficiency
lead poisioning
68
3 oral conditions which are associated with microcytic anaemia?
- atrophic glossitis
- candida infections
- recurrent aphthae
- tenderness or burning sensation
69
Child attends with ulcers, what 8 questions would you ask?
```
have you had these before?
Any symptoms elsewhere?
Any symptoms on the lips?
Have they been aware of the blisters?
Are the getting worse?
Have they gotten any better?
Has the patient had a fever?
Any other skin lesions?
Any difficulty eating or refusal of food?
```
70
Ulcer on lips, what would you see intra orally?
- painful red swollen gingivae
- halitosis
- ulcers/blisters on cheeks
71
What are 2 local factors for implant placement?
7mm required to place implant
alveolar bone levels
72
What are 2 general factors for implant placement?
smoking status
bisphoposphate use
73
Before placement, what does an implantologist consider?
-medical and drug history
-alveolar bone quality and quantity
- OH and perio status
- occlusion
- aethetic expectations of patient
patient motivation
74
What dimensions are required for an implant?
- 1.5 mm horizontal bone required around implant
- 3mm between implants
- >5mm space for papilla
- 7mm spacing between crowns
- 2mm from adjacent structures
