2020/2019

Question 1

Fibrous hyperplasia/fibroepitheial polyp

Answer 1

Mucosa coloured, firm, painless unless traumatised caused by trauma, orthoapploances
Histo: fibrous tissue by hyperkeratinsed SSE
Manage: excise, remove cause, reassure pt, biopsy and send to histology

Question 2

Pyogenic granuloma

Answer 2

Red vascular growth, rapid growth , soft bleed easily, less than 40 yrs old,in pregnancy and puberty and release to trauma and calculus and plaque,
Endothelial cells and fibroblasts and lots of blood vessels granulation tissue
Manage: remove cause, improve oh , refer to 2 care, decision biopsy, send to histology

Question 3

Peripheral giant cell granuloma

Answer 3

Clinical: soft red bleeds easily swelling, cyst like, anterior teeth,mandibualr, on gingivae
Histo: vascular Strom a fibrous tissue ,multinucleated ginat cells
Manage: central giant cell granuloma is within bone and broken thru cortical plane to gingivae , will reoccur so excision

Question 4

How to manage pt with pericoronitis?

Answer 4

• thorough history so first time or recurrence
• is pt immunocompromised
  -is food present in area, check occlusion forces from opposing teeth
• check gums/ulceration/swelling/frictional keratosis
  -reassure pt
  -irrigate beneath gum flap with saline or chlohexidine
  -advise hot salt water rinses and single tufted brushes
• paracetamolpainkillers 1000mg every 6 hours no more than 4g in 2 hours
  Antibiotics like metronidazole
  Drain and review
• if worse refer to OMFS, can cause pyrexia,breathing , swallowing , temp, fever trismus , drooling,raised floor of mouth

Question 5

Risk factors when assessing roots with ID canal?

Answer 5

-radiolucency- within canal/tip of root
- loss of cortication-
- deviation ID canal around roots
-narrowing of roots
-canal constriction

Question 6

Warnings to give pt about risk of roots to ID canal

Answer 6

Pain , bleeding, pain,bruising,swelling,infection, temp or permanent numbness, altered sensation ,damage to adjacent teeth and fillings,fractured mandible,if divergent roots are higher risk,

Question 7

Nerve damage

Answer 7

IAN- perm 0.1-1%, temp- 5-7%
Lingual perm 0.3-0.5% temp 0.5-1%

Question 8

What soft tissue around extracted impacted wisdom tooth

Answer 8

Paradental cyst , on lateral aspect of tooth from inflammation from perio pocket.on vital teeth on buccal aspect .
Histo: NKSSE, hyperplastic and inflammatory cells, cyst lumen and brown stain of hemosiderin from breakdown of iron and cholesterol clefts

Normal granulation tissue like healing tissue ,fibroblasts and myofibroblats which are long and spindly , capillaries and endothelial cells,inflammatory cells, keratin SSE

Question 9

If pain in temporal region?

Answer 9

Bruxism or grinding
-take history
-headaches
-lack of sleep
-stressed
-QOL
-MOM are tender
Trauma in head and neck
-sensitivity in teeth
-toothache
- jaw lock
- parafunctional habits
-teeth worn down /facets /loss of OVD, sensitivity , fractured restorations , frictional keratosis,scalloped tongue,mobile teeth, limited opening, skeletal class 2, palpate mom , clicking, deviation of jaws, TMJ hyper mobility