All year revision Flashcards

Question

What factors should you consider before endodontic treatment?

Answer 1

1. Strategic value of the tooth 2. Periodontic factors 3. Patient factors - MHx, age, compliance 4. Restorability options - consider oral hygine - and consider teeth that are not restorable

Answer 2

American Association of Endodontists Endodontic Case Difficulty Assessment Guidlines The following considerations are used: 1. Patient considerations 2. Diagnostic & treatment considerations 3. Other considerations Tally the numbers: 1. Easy - less than 20 2. Moderate - 20-40 3. Hard (refer) - above 40

Answer 3

Endoprobe is used to assist in identification of root canals

Answer 4

1. EDTAC - 15% commonly used as a removal of smear later and to increase permeability of dentinal tubules 2. Sodium hypochlorite - 1% commonly used, dissolves organic matter - DANGEROUS

Answer 5

Bend the needle but not at the hub and measure it - so it is far from the apex!!!!

Answer 6

Gates-Glidden burs - they are used coronaly in order to make the canal access easier You distinguish them by number of slots - 2 slots is size 2, 3 slots is size 3

Answer 7

1. Know average lengths 2. Measure from pre-operative radiographs - Estimate working length 3. Use electronic apex locator 4. Confirm with radiograph - Correct working length established

Answer 8

1. Moisture in canals but not too much 2. Attach the lip clip 3. Attach the file clip 4. Advanced the file until the read is "Past apex" withc careful watch-winding movement 5. Come back to "Apex" reading 6. Measure the file

Answer 9

To condense the master GP and create space for accessory GPs - it has one end unlike endo probe

Answer 10

SLOB - (Same lingual opposite buccal) - usually the tube shift goes lingual

Answer 11

1. Consent, LA, rubber dam isolation 2. Removal of caries and access to the pulp 3. Idenitifcation of the appropriate access using radiographs 4. Identification of canals using endo probe 5. Using a small size file a few milimeters into a precieved canal in order to confirm that it is actually a canal 6. Irrigation with a bent needle for safety 7. Flaring of the coronal protion of each canal using Gate-Glidden burs 8. Irrigation 9. Estimationg of working length of each canal. 10. Determination pf correct working length with appropriate file, raiographs and apex locators 11. Apical preperation of each canal. Pre-curved files, watch-winding technique performing circumferential filing 12. Recapitulate with a size 10 file between each file and irrigate well between each file 13. Work up until file 25 -take radiograph to check the master apical file is at an appropriate length 14. - irrigate and try master gutta percha of the the biggest size possible 15. Place medicaments with lentulo spiral 16. Resore with cavit and GIC

Answer 12

1. Consent, LA, Rubber dam isolation 2. Re-access tooth and remove caivt safeyl 3. Irrigate 4. Check master apical file goes to correct working length 5. Select master GP largest size that goes to correct working length 6. Take radiograph to confirm 7. Dry canals with paper points 8. Place the sealer with lentulo spiral 9. Coat master GP with sealer and place into the canal 10. Use lateral spreader to condense the master GP 11. Place accessory GP into space create 12. Continue with lateral spreader until the space is filled 13. heat the end of the endodontic pluger and burn off GP points 14. FInal level of root-fillin should bet at or below CEJ 15. Clean pulp chamber and reestore.

Answer 13

1. Bone resorption - can lead to high frenum/muscle attachment 2. Overreruption of opposing tooth 3. Medially/distally drifting/tilting of adjacent tooth/teeth 4. Occlusal disharmony affecting function 5. Change in speech and aesthetic 6. General affects on general health as well as quality of lfie

Answer 14

1. Based on location of missing teeth - partial vs comlete 2. Based on materials - acrylic, valplast, crhome 3. Based on support - tissue or tooth or combined 4. Construction methods - immediate vs conventional

Answer 15

Restore: 1. Aesthetics 2. Function 3. Speech 4. Preserving remaining soft and hard tissues

Answer 16

1. Replacing single or multiple missing teeth 2. Temporary space maintenance in congenital missing teeth 3. Obturation of hard palate after removal or oral cancer

Answer 17

1. Lack of suitable abutmnet teeth 2. Rampant caries 3. Severe periodontal diseases 4. Poor oral hygiene 5. Patients who cannot tolerate dentures 6. Patient who recently received head and neck radiation treatment

Answer 18

1. Patient oral hygiene 2. Existing oral health conditions: caries, perio, pathologies, salivary flow and quality 3. GIngivae and abutment tooth/teeth 4. Gagging issues patient might have 5. Patient's perception

Answer 19

1. Codes starting with 7 2. Denture reline 3. Denture repair

Answer 20

1. Denture consult + primary impressions 2. Secondary impressions 3. Bite registration + shade mould selection 4. Denture try on 5. Denture insert 6. Review denture

Answer 21

1. Excessive saliva 2. Change in speech 3. Feeling of bulkiness 4. Food might get stuck under denture 5. Denture moves to some extend 6. Remove denture to clean 7. Might have a sore spot or ulcer 8. Might have a high spot

Answer 22

1. Remove dentures and clean after meals 2. Brush dentures as brushing your teeth 3. Brush and remove dentures at night and keep in denture container

Answer 23

Overlay - the denture sits around the tooth Overdenture - the chrome part of the denture sits on top of teeth

Answer 24

1. Denture consult + primary impressions 2. Secondary impressions 3. Frame try in + bite registration + shade mould selection 4. Trial denture - aka wax 5. Denture insert 6. Review denture

Answer 25

1. Take all histories 2. Do a specialised limited exam - extra oral exam, intraoral exam, occlucal exam 3. Take alginate impressions

Answer 26

To make a study cast and fabrication of a special trays - preforated (for secondary alginate) vs non perforated (for rubber based material)

Answer 27

1. Please pour up alginate impressions for study models 2. Please construct a CCA special tray for upper or lower arch

Answer 28

It stops the tray from touching the teeth. Similarly - the gingival stopper will stop at the gingival thus making your impression better

Answer 29

1. PVS 2. PE 3. Alginate

Answer 30

Record centric relation

Answer 31

As an interim denture or immediate partial denture Usually 3 appointments: 1. Denture consult, alginate impression + shade selection 2. denture try in 3. Denture insert (after extractions) + Review (Can't be chrome or varplast)

Answer 32

It is the state of being edentulous, without natural teeth

Answer 33

It means "without teeth". It could be partial or complete

Answer 34

1. Decay and periodontal disease 2. Trauma 3. Orthodontic extractions 4. Congenital missing teeth 5. Impacted teeth 6. Pathologies 7. Radiation therapy to treat head and neck cancers

Answer 35

Class I - bilaterla edentulous areas located posterior to the remaining natural teeth Class II - A unilateral edentulous area located posterior to the remaning natural teeth Class III - A unilateral edentulous area with natural teeth remaining both anterior and posteror Class IV - A single, bilaterla edentulous crossing mid line

Answer 36

1. Morphological changes - extra and intra oral changes 2. Neuromuscular changes 3. Functional changes

Answer 37

1. FLat philtrum and deep nasolabial grooves 2. Hollow cheeks 3. Decreased columella-philtrum angle 4. Narrowing of the lips 5. Decrease face height 6. Commissures drop 7. Lost support for facial muscle 8. Reduced facial height

Answer 38

1. High frenal attachment due to bone loss 2. Bone resorption 3. Traumatised neuromascular structure under denture 4. Atrophic mucosa - can cause pain due to proximity of the denture to the nerves 5. Class III skeleton relationship will develop eventually 6. Decrease in occlusal vertical dimension

Answer 39

1. Occlusal disturbances 2. Lost of occlusal vertical dimension 3. Increase in parafunctional habits

Answer 40

1. Emotional effects of tooth loss 2. May increase stress levels 3. Social-disability

Answer 41

1. Prevention of edentulism - MAIN STRATEGY - think about biopsychosocial approach 2. Monitor alveolar ridge resorption 3. Monitor oral mucosa health and screening oral mucosa lesions 4. Rem. Pros. 5. Consider implant retained overdenture or implat supported overdenture where appropriate

Answer 42

1. Consult, alginate impressions, bite reg, shade selection adn mould 2. Dentur try in 3. Denture insert 4. Review

Answer 43

Complete denture retention is the resistance to displacement of the denture base away from the ridge. It provides psychologic comfort to the patient.

Answer 44

Stability is the resistance to horizontal and rotational forces. Stability has been cited as the most significant property in providing for physiologic comfort.

Answer 45

Support is the resistance to vertical movement of the denture base towards the ridge.

Answer 46

1. Overextension of denture base 2. Overcontour of polished surface

Answer 47

It is a virtual potential denture space with a dynamic equilibrium forces of the tongue, cheeks and lips. If denture seats in a neutral zone - denture is more retentive.

Answer 48

Good primary and secondary impressions - good accuracy, tissue contact and adequate periphery seal - remember special tray needs to have near perfect coverage and cover all hard tissues such as the tuberosities

Answer 49

1. Height of bone ridge 2. Shape and width of bone 3. Muscle attachment 4. Neuromuscular control - muscle movement diseases such as Huntington's disease may cause some problems

Answer 50

1. Adequare extension and shape of the falanges of the denture 2. Adequare saliva to provide adhesion, cohesion and surface tension - water can be used before insert 3. Mechanical - overdentures using implants or root stumps

Answer 51

1. Firm keratinised tissue 2. Ridge height 3. Ridge contour 4. Ridge stability 5. Intimate base adaptation 6. Adequate extension 7. Occlusal harmony 8. Neuromuscular control

Answer 52

Upper - primary support area is the hard palate Lower - retromolar area and buccal shell

Answer 53

1. Clasp units 2. Major connectors 3. Intra/extra coronal attachments 4. Implant locator attachment 5. Locator attachment on root 6. Survey crown

Answer 54

1. Clasps 2. Acrylic dental papilla - soft tissue support

Answer 55

1. Maximise denture base extension 2. Bilateral balance of occlusion 3. Consider mono-occlusion

Answer 56

Only use in edentulous patient because it is very very very rigid. Please apply vasaline to patient face because it may burn the patient

Answer 57

After taking the impressions make sure you wrap it in a damp towel!

Answer 58

1. Halas Alginate - very dimensional stable 2. Kromopan Alginate - EXTREMLY DIMENSIONALLY STABLE WOW

Answer 59

1. Primary impression 2. Secondary impression - for mobile teeth 3. Valplast denture impressions 4. Obturator of cleft palate

Answer 60

Light body - gingival sulcus Heavy body - everywhere else and to push the light body DONT USE WITH LATEX

Answer 61

1. Seondary impressions for all impression 2. Wash impressions for reline 3. Impressions for obturators for cleft palate

Answer 62

1. Impressions for reline 2. Impression for obturators of cleft palate 3. Functional/neautral zone impressions 4. Temporary reline 5. Tissue condition impression

Answer 63

1. Denture base 2. Denture teeth Denture connectors: 3. Major connect 4. Minor connector 5. Clasp unit

Answer 64

1. Polymethyle methacrylate (PMMA) and it's modifications- also know as acrylic 2. Rubber reinforced Lucitone 199 - a type of acrylic that is specifically used at ADH 3. Polyamides like Valplast - good for aesthetics for short saddles 4. Formlabs denture resin

Answer 65

1. They can not be adjusted or need glaze after occlusal adjustment 2. They cause significant wear to opposing teeth 3. They are quite brittle and easy crack or chip

Answer 66

1. Cobalt chrome - Remanium+ is used at ADH 2. Titanium - for patient alergic to cobal chrome or other materials 3. HPPE frame

Answer 67

It is the retruted contact position. It is the maxillo-mandibular relationship independent of tooth contact. This CAN BE RECORDED IN EDENTULOUS PATIENT. You can ensure that the patient is in centric relation by asking them to go through repeated movement of protrusion and retrusion in order to arrive at the centric relation.

Answer 68

It is the intercuspation position. It is the occlusion of opposing teeth when the mandible is in centric relation. This may or may not coincide with maximum intercuspal position

Answer 69

The posselt's envelope of motion looks at the following aspects of incisor potion through the movement of the mandible? 1. Intercuspal position (ICP) aka cnetric occlusion 2. Retruted contact position (RCP) aka centric relation 3. Edge-to-edge articulation (E) 4. Maximal opening without condylar translation of the condyle (rotation only)(R) 5. Maximal mandibular opening with translation of condyle (T) 6. Protrusion (Pr)

Answer 70

When you have a full denture: During bite registration you need to take an impression of the centric relation While in try in and insert you need to assess the centric occlusion When you have a partial denture: During bite registration you need to take an impression of the centric occlusion While in try in and insert you need to look at centric occlusion or maximal intercuspal position

Answer 71

It is the occlusal vertical dimension + 2-4 mm

Answer 72

OVD is determined by the contact between natural teeth. If there is no natural teeth - please estimate OVD by subtracting from natural resting position

Answer 73

1. Balanced occlusion - the best type of occlusion - when is a balanced intercuspal position on anterior and posterior teeth - best of denture stability and create pressure to retain the bridge. 2. Monoplane occlusion 3. Lingualised occlusion - the elimination of buccal cusp contact - may be used if the patient has a modified occlusion due to skeletal and other reasons

Answer 74

1. Natural teeth retained by periodontal tissue - denture teeth are not 2. Natural teeth move independently - denture teeth move as a unit 3. Malocclusion in natural dentition may not cause any symptoms for yeras - in denture teeth there will be an immediate response 4. In natural teeth, second molar is one of the power points of mastication - in denture teeth this may cause a shifting of the denture base 5. Bilateral balance during excusrion is rare in natural teeth - in dentured teeth it is required for stabilisation of denture base 6. Proprioceptors guide neuromuscular control during function, meaning mandible return to centric occlusion - if any interference occurs in dentured teeth, denture base shift and may be dislodged

Answer 75

It is position of the mandible when the jaws are in centric relation

Answer 76

1. Curve of Spee os designed to permite protrusive disocclusion of the posterior teeth by combination of anterior and condylar guidance 2. Curve of Wilson permits lateral mandibular excursion free from posterior interference

Answer 77

For partial: If anatonical teeth have been severley worn For full: If the alveolar ridges are poor and there is uncoordinated jaw movements

Answer 78

1. Excessive occlusal vertical dimension 2. Excessive overjet or proclination of upper anterior teeth 3. Excessive upper incisal length

Answer 79

In a sense - no. Because caries is primarily driven by free sugars - remove the sugars and there will be no caries. But only because there other modifying factors - we claim that caries is a multi-factorial disease. This is an argument made by Aubrey Sheiham, a dential rsearch of University College London

Answer 80

1. Logistic challenge with the geographical distribution of dental practitioners 2. Dentist-to-population ratios are only a crude measure of oral health-care service availability, and are not correlated to disease prevalence 3. Individual actions in clinical settings are unlikely to prevent future disease

Answer 81

1. If this worked (alone) and actually changed behaviours, we would have different figures by now 2. Dental education campaigns, when not articulated with other actions may not be effective overall and may also increase inequalitie

Answer 82

1. Since patterning of health behaviours reflects underlying inequalities in material and social resources, it is unlikely that the growing inequality in health behaviours can be addressed without tackling these social factors 2. The likelihood of adhering to health-related behaviours following universal education campaigns is also shaped by the social determinants of health

Answer 83

1. Counseling & Education 2. Clinical interventions 3. Long-lasting protection interventions 4. Changing the context, so the defaul choice is healthy 5. Socioeconomic factors

Answer 84

Counselling & education of an individual in regards to caries. It result in the ost benefit to the individual but the efforts by the individuals must be high, it is more suseptible to socio-economic difference and has minimal impact on overall population.

Answer 85

Universal water fluoridation to prevent caries. This is an example where an individual needs to put low effort, yet statistically we have evidence of high impact on populations. These universal adjustments also help to deal with socio-economic inequalities as we can regulate the aount of fluoridation depending on the gneral community need.

Answer 86

1. Peace 2. Shelter 3. Education 4. Food 5. Income 6. A stable exosystem 7. Sustainable resources 8. Social justice and equity

Answer 87

1. Build healthy public policy - think sugar tax 2. Create supportive environments - think ban of sugary foods in schools 3. Strengthen community action - support your local dental programs such as the indigenous oral health unit 4. Develop personal skills - raising awareness with patients 5. Reorient health services - focus on both high risk and popuation approach

Answer 88

1. Normative need - expert opinion on needs of an individual 2. Perceived need - based on the individual's perception 3. Expressed need - defined based on people's use of service 4. Comparative need - when different types of need are interpreted considering other populations' standards

Answer 89

1. Systematic approach 2. Normative/ preceived/ expressed needs addressed 3. Likelihood of engaging in interventions 4. Workforce and skills requirement 5. Effectiveness of interventions

Answer 90

1. Disease prevention - action to reduce or eliminate or reduce the onset, causes, complications or recurrence of disease 2. Health protection - crafting a safe environment 3. Health promotion - process of enabling people to increase control over and to improve their health

Answer 91

The main difference are: - Exposures with high individual risk can have a small impact on population risk if the exposure is rare (aka people with sever conditions are very rare - thus intervention is not as widespread) - Exposures with low individual risk can have a big impact on population health if exposure is widespread (aka people with not so severe conditions are common - thus intervention is more widespread)

Answer 92

1. Beneficial for the individuals 2. Important in addressing inequalities

Answer 93

1. Does not change population levels of disease 2. Issues in identifying who is at risk 3. Does not change the drivers in the population

Answer 94

1. Tries to remove the reason why the disease is common 2. Almost everyone benefits 3. May have a large impact at a population level

Answer 95

1. May not address health inequalities 2. Does not represent a large benefit to the individual

Answer 96

1. Primary prevention 2. Secondary prevention 3. Tertiary prevention

Answer 97

Secondary prevention occurs to treat asymptomatic disease - example: small restorations

Answer 98

Primary prevention occurs to stop the disease - example: water fluoridation

Answer 99

Tertiary prevention occurs in established diseases or established disease with complications - example: full mouth rehabilitation

Answer 100

1. Using evidence to guide our decisions about interventions 2. Consistently evaluating the effectiveness of interventions in terms of their impact

Answer 101

Australian Medicines handbook

Answer 102

1. We prescribe them 2. For the one we dont prescribe - patient may want to have info about them or drugs they are taking may affect your approach to their dental treatment

Answer 103

1. Right drug 2. Right dose 3. Right frequency 4. Right duration and deprescribing

Answer 104

1. Prevent diseases 2. Cure a disease 3. Decrease mortality 4. Decrease sickness 5. Decrease symptoms of illness

Answer 105

It is a substance that is not synthesized in the body but must be introduced into the body from outside.

Answer 106

Lock & key relationship

Answer 107

It is the effect of drug on bod. Like paracetamol relieves pain and is antipyretic (lower body temp)

Answer 108

Effects of body on the drug. Like absorption and distribution and elimination. It looks at the how it is done and the rate at which it is done

Answer 109

Always use the GENERIC NAME. Because that way when prescription is getting fulfilled - it is not dependent on the supply of a certain brand name.

Answer 110

Due to affect on platelets by aspirin, by irreversible inhibition of platelets, there needs to be extra caution in planing and use of extra tools such as mucoperiosteal flap use due to increase risk of inability to achieve adequate haemostasis. Please ensure use of local haemostatic measures and remember that temporary interruption is not required.

Answer 111

1. Agonists - drugs that elicit response 2. Antagonist - drugs that bind but do not elicit response - essentially just occupy the space on the receptor by being competetive

Answer 112

1. Adverse harmful effect to a medicine in people oftent due to altered pharmacokinetics - e.g. kidney disease 2. Patient does not get better or gets worse on a medicine often due to altered pharamacokinetics 0 e.g due to genetic factor or taking other medicines

Answer 113

Same does does not suit all patient. There is a difference in doses due to age, weight, pregnancy, environment, diet and use of other medications.

Answer 114

1. Not dosing properly 2. The drug is broken down too fast and it can not reach appropriate blood levels 3. The drug is not being absorbed properly due to nausea and vomiting

Answer 115

1. Metronidozale can not affect the bacteria that is responsible for the odontogenic infection 2. Bacterial resistance

Answer 116

1. Enteral - through the intestine - oral, sublingual and rectal 2. Parentral - everything else due to them being sensative to gastric juices or we need a quick effect - injections basically - intravenous, intramuscular or subcutaneous 3. Other routes - inhalation, tranasal, topical, transdermal patches and other other like eyes, nose, ears drops

Answer 117

1. Blood flow 2. Surface area of the intestines - remember stomach does not matter intestine is due to increased surface area of the intestine - microvilli and villi. 3. Gastric emptying - e.g. codeine slows down the emptying of the stomach thus may increase the time that the drug may take to the site of absorption - water pormmotes stomach emptying 200ML OF WATER IS GOOD

Answer 118

1. To reduce side effects 2. To reduce side-effects of stomach upset 3. To treat heartburn/indigestion 4. To ensure the medicine is absorbed into the blood stream: like very water soluble drugs 5. To help process the meal - like for diabetes medication

Answer 119

1. Insufficient time for absorption 2. Decomposition in gut lumen 3. Liver and first pass effect - portal vein passes through the liver thus the drug might be over processed there and it does not really reach systemic circulation

Answer 120

1. Initially drug enters the blood stream and makes it to the capillaries around the organ tissue in the body 2. Capillary endothelium is very "leaky" which means certain molecules can pass through. Exception: blood-brain barrier which is actually less permeable 3. Drugs need to be lipid soluble to defuse into the target cell if not they can interact with receptors on the cell membrane

Answer 121

Ciclosporin is an immunosupresant that is able to aid in organ transplants. St John's Wort is a over the counter herb that cna aid in depression. St John's Wort is able to trigger an increase production of an enzyme that metabolises ciclosporin. Thus decreasing long term plasma concentration leading to transplant organ rejetion by the body.

Answer 122

Pharmacokinetics control the dosage regiment.

Answer 123

It is when the optimal concentration is reached, meaning the concentration of a medication is not too low to be ineffective and not too high to cause toxicity.

Answer 124

The ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response. Essentially drugs with a large therapeutic index are more safe and harder to get an overdose on. Example of low therapeutic index - morphine 70:1 index Example of high therapeutic index - remifantanil 33000:1

Answer 125

1. Non-specific targets 2. Proteins - the most common 3. RNA/DNA 4. Lipid cell membranes

Answer 126

1. Ligand-gated ion channels (ionotropic receptors 2. G-protein-coupled receptors (metabotropic) 3. Kinase-linked receptors 4. Nuclear receptors

Answer 127

Miliseconds

Answer 128

Nicotinic receptors and ACh receptors. Benzodiasapine like xanax

Answer 129

Muscarinic receptors, ACh receptors Opiod agonists like morphine

Answer 130

Cytokine receptors Methotrexate

Answer 131

Oestrogen receptors

Answer 132

1. Relievers - bind to G protein-coupled receptors for relaxation 2. Preventers - bind to nucleus to alter ntranscription of inflammatory mediators

Answer 133

1. Afferent arteriole caries the blood to the glomerulus - drugs are than filtered as plasma water 2. The plasma enters into the proximal tubules in which the drug is secreted via active pumps that pup the drug into the kidney lumen 3. Lumen moves through the proximal tubule into the dital tubules and collecting duct where some rebasorption could occur but most emportantly water is removed and lipid soluble drugs will be diffused back into the blood stream - thus they need to metabolised by the liver

Answer 134

Usually, the metabolites have no pharmacological activity but: 1. Some may act as parent drgus 2. Some may be antagonistic - causing convulsions or nauses/vomiting Concept - active metabolites is clinically important for elderly and patients with renal disease - because some patient may not be able to excrete the metabolite at the same rate thus the metabolite may have a toxic effect.

Answer 135

1. Paracetamol enters the liver where 55% of it is turned into water soluble Paracetamol Glucuronide, 40% of it is turned into water soluble Paracetamol Sulphate and 5% is turned into Reactive Electrophilic metabolite 2. This reactive electophilic metabolite than can turne into paracetamol glutathione and be excreted in the kidneys or it may bind with metabolite-proteins and cause hepatic cell death Now in overdose: 1. There is not enough sulphate to turn paracetamol into paracetamol sulphate so more paracetamol is trned into a reactive electrophilic metabolite thus increasing binding to metabolit-protein and cause more heaptic cell death 2. The way to help a patient in this situation - measure blood and introduce a N-acetylcysteine (NAC) which will hel with conversion thus stop metabiolite-protein bindings

Answer 136

1. Presentation of chief concers 2. Information collection - medical history, patietn history, clinical examiantion and special tests 3. Information collation 4. Development of a differential diagnosis - list most likely diagnoses and do specific test to eliminate potential diagnoses 5. Arrive to definitive diagnosis and commence treatment

Answer 137

1. Clinical differential diagnosis 2. Radiographic differential diagnosis 3. Provisional/working/tentative diagnosis 4. Histological differential diagnosis 5. Definitive diagnosis

Answer 138

Use this scheme 1. Developmental origin 2. Inflammatory origin 3. Hyperplastic origin 4. Degenerative origin 5. Hormonal origin 6. Neoplastic origin 7. Idiopathic origin DIHDHNI

Answer 139

1. Duration when the patient first started seeing the lesion 2. Variations in site and character of the lesion 3. Symptoms - related to the lesion and any systemic symptoms 4. Onset - any associated hsitorical events related to the lesion

Answer 140

1. Site - using anatomical terminology 2. Size - measure with a probe 3. Morphology - elevated, flat or depressed 4. Colour - compare to adjacent normal tissue 5. Consistency - how it feels (ONLY CLINICAL DO NOT SAY THIS IN EXAM), texture - how the surface looks like (PHOTOS ARE APPROPRIATE :))

Answer 141

1. Scalpel biopsy - incisional or exitional - most common procedure 2. Fine needle aspiration 3. Core biopsy 4. Exfoliative cytology - taking the gunk and spreading it over a film

Answer 142

1. stratum basale (D) 2. stratum spinosum (C) 3. stratum granulosum (B) 4. stratum corneum (A) E and F and the papillary and reticular layer accordingly

Answer 143

Periodontists is a multi factorial, inflammatory diseases associated with dysbiotic microbial dental biofilms and characterised by non-reversible progressive periodontal tissue destruction. It manifests through: CAL, radiographically assessed alveolar bone loss, presence of periodontal pocketing, gingival bleeding and leads eventually to tooth loss.

Answer 144

1. All plaque bacteria are equally pathogenic 2. Quantity of plaque determines the pathogenicity 3. Host has threshold capacity to detoxify bacterial products 4. Disease develops if threshold is surpassed Treatment: non-specific mechanical removal of total amount of plaque

Answer 145

1. Due to advancement of microbiological technologies, specific bacteria that are believed to be pathological to the periodontium were isolated 2. Not all plaque is equally pathogenic 3. Presence and increase of specific microorganism causes more destruction Treatment: targeting and elimination of specific microoganisms using antimicrobials

Answer 146

1. Disease is the result of an imbalance in the total micro-flora due to ecological stress 2. Quantitative plaque increase changes local micro-environment promoting the growth of specific pathogens, qualitative shift 3. Ecological factors such as the presence of nutrients and essential cofactors, pH and redox potential Treatment: prevention of dental caries, modification of micro-environment to prevent nourishment of pathogens

Answer 147

1. The yellow, orange and red groups are suggested groups of bacteria that are associated with periodontal health and pathology 2. Yellow group - include: S. Mitis, S. Oralis and S, Snagius - are early coloniser groups that are related to healthy periodontium 3. Orange group - include: P.Intermedia, P.Nigrescens and F. Nucleatum - are late coloniser that are believed to be an intermediate step and are able to facilitate red group (the most pathogenic group) in binding in the periodontal pocket 4. Red group - include: P. Gingivalis, T.Forsythia, T. Denticola - believed to be the most pathogenic group

Answer 148

Virulence is defined as the degree of pathogenicity of the ability of the organism to cause disease measured in experimental procedures. Organism need to: 1. Attach and colonise 2. Multiply and gain access to appropriate nutrition 3. Evade host defences 4. Propagate

Answer 149

Stage 0 - gingival and periodontal health Stage 1 - gingival inflammation Stage 2 - Polymicobial emergence Stage 3 - Inflammation - mediated dysbiosis - initial perio Stage 4 - Late stage periodontitis

Answer 150

1. Predominance of PMNs in pocket epithelium/activation in connective tissue 2. Elevated activity of macrophages 3. Plasma cells dominate the infiltrate 4. Increase of pro-inflammatory cytokine production (like IL-6 and IL-8 and more) 5. This results in disturbed tissue homeostasis leading to destruction of collagen, connective tissue matrix and bone 6. This results in true pocket development from the junction epithelium

Answer 151

1. RANKL - produced by osteocytes in large quantities, due to stimulation of pro-inflammatory cytokines like IL-6 and IL-8, able to activate osteo clasts - bone resorbing cells 2. RANK - receptor on osteocalst - binding site of RANKL 3. OPG - scavenger receptor that prevents RANKL binding thus preventing bone resorption RANKL:OPG ratio: relative amount regulate the bone turn over

Answer 152

The mechanisms: 1. Chronic reduction in blood flow and vascularity 2. Increase the prevelance of potential periodontal pathogens in the sulcus 3. Shift in neutrophil function towards destructive activities 4. Shift to a dysbiotic, pathogen enriched microbiome 5. Affects PMNs making them more aggrevated 6. Increase the number of aggravated T cells that produce inflammatory cytokines It increases the risk of periodontitis by 85%! Smoking cessation has beneficial effect on therapy outcomes and disease progression - this should be attempted for patient with nicotine dependence/

Answer 153

1. No solid evidence of causal relationship between poorly controlled diabetes and periodontal microbial dysbiosis in humans, but there some evidence in vitro thus it is biologically plausible 2. Osteogenesis reduction due to apoptosis of osteoblasts and PDL fibroblasts 3. Increase in RANKL expression and OPG expression is decreases 4. Increase in collagenase activity It increases the risk of periodontitis by 3x to 4x! Multidisciplinary control and treatment of diabetes is ESSENTIAL to treatment of periodontitis.

Answer 154

1. Type of periodontal disease 2. Disease extent 3. Stage 4. Grade 5. Current disease status 6. Risk factor profile E.g. Periodontitis: generalized (65%), Stage III (CAL <10 mm), Grade C (HbA1c 8.9%), currently unstable (PPD <8mm, BOP 45%). Risk factors: uncontrolled diabetes (HbA1c 8.9%), smoking 20 cig/day, high strss levels (change in work)

Answer 155

It was discovered, that on avergaere, people with sever cases of periodontists have attachment loss of around 0.45mm per annum. Thus in the new classification, Grade C (fast progressing) is considered to be when an individual has a rate of progression of more than 2mm per 5 years (5 x 0.45)

Answer 156

1.Interdental CAL detectable at 2 non adjacent teeth or 2. Buccal or oral CAL above or equal to 3mm with pocketing equal or more than 3mm at 2 or more teeth AND OBSERVED CAL CANNOT BE ASCRIBED TO NON-PERIODONTITIS CAUSES: SUCH AS VERTICAL ROOT FRACTURE/S

Answer 157

BOP score of less or equal to 20% because that is associated with significantly lower risk of CAL progression and want the score to decrease continuously and keep stable.

Answer 158

Code 0 - healthy - treatment: home care Code 1 - bleeding on probing but no attachment loss - treatment: oral hygiene instructions Code 2 - calculus present + BOP - treatment: calculus removal and scaling + OHI Code 3 - pockets of below 5 mm - treatment: calculus removal and scaling + OHI Code 4 - pockets of above 6 mm - treatment: complex therapy + calculus removal and scaling + OHI

Answer 159

It believed that due to increased number of bacteria and smaller barrier to penetrate (ulcerated epithelial pocket lining). 1. The ulcerated periodontal pocket liing acts as a gate for viable bacteria, bacterial toxins/componetns 2. It results in frequent transient bacteremia 3. And could result in substantial systemic inflammatory response This pathway also goes via other organs and systems like during swallowing or inhalation. Important to understand that systemic bacteraemia as a result of periodontal infection is rare. There is actually a way you can calculate periodontal inflamed surface area thus it is important to reduce that area with treatment.

Answer 160

It also relates to the periodontal inflamed surface area. It is a theory that states that affects on the systemic health from periodontal disease result due to pro-inflammatory mediators that are involved in periodontitis. Less plausible than the direct pathway.

Answer 161

AVD is the most common form of death worldwide. It is a result of vascular inflammation and subintimal lipid accumulation which could result in build up of atheroma, stenosis of the valves, rupture of blood vessels and thrombosis. There is some evidence to suggest there is association between the A.a. bacteria and P. Gingivalis being recovered from human atheromas. Thus an increase in those bacteria may result in increases risk of atheromas. These bacteria may effect the endothelia walls, immune function, impact macrophage function through different mechanisms.

Answer 162

1. Periodontal health needs to be assesed 2. A treatment plan with focus on prevention should be constructed 3. Combination of at home and in chair procedures must be performed to maintain good periodontal health thus reduce the risk of AVD worsening

Answer 163

A prognosis s a prediction of the probable course duration, and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of is factors for the disease. Prognosis is establish after diagnosis.

Answer 164

It is a very objective system that involves 1. Bone loss 2. Furcation and modbility 3. PAI score

Answer 165

1. Due to pain 2. Due to acute abscesses 3. If patient request due to other treatment like ortho

Answer 166

1. Absence of pain 2. Reduction and elimination of infections and inflammation 3. Cessation of attachment loss and gain of attachment 4. Restoration of physiologic bone and gingival contour to aid plaque control 5. Satisfactory function and aesthetic for the individual

Answer 167

1. Immediate goals 2. Intermediate goals 3. Long term goals Remember - patient must know that periodontal treatment is not a one off - it is continuous

Answer 168

1. Reason for referral 2. CC 3. MHx 4. DHx 5. Family Hx 6. Diagnosis 7. Oral hygiene 8. Establishing goals and motivation 9. Prognosis 10. Treatment plan 11 Treatment

Answer 169

1. Emergency phase - e.g. exo 2. Systemic phase - e.g. control systemic diseases 3. Initial phase - e.g. testing and debridement 4. Surgical phase - regenerative surgery 5. Restorative phase - temporary crowns 6. Maintenance phase - depending on risk close recall or normal recall

Answer 170

They are conditions that are: 1. Rapid in development 2. Cause pain/discomfort 3. Rapid tissue destruction 4. Usually a result of infection e.g. hepatic gingival stomtitis, necrotising gingivitis/periodontitis

Answer 171

Yes you would if they have an underlying health condition.

Answer 172

1. Patient self care and removal of biofilm by patient with - behavioral modification, mechanical (like brushing and using of inderdental brushes or other methods) and chemical (mouthrinse and oral irrigation) 2. Supragingival scaling and reduce predisposing factors such as bad restorations - the evidence suggest that are not preffered way i.e 1 quadrant per session or half the mouth per session

Answer 173

1. Macromorphology of the roots - e.g. the mesial forcation of the upper sixes is quite deep and hard to get 2. Micromorphology of the cellular cementum 3. Irregular of the base of the pocket Even with these problems, subgingival debridement seen to be incredibly useful in causing a reduction in bacteria levels and pathogenic bacteria like P.Gingivalis reduces

Answer 174

1. Smoking 2. Number of roots on the tooth 3. Plaque levels

Answer 175

Repair through long junctional epithelium: It is a restoration of the continuity in the wound or defect area, without regeneration of the originally intact tissues from and function for example long junctional epithelial attachment with new collagen fibers parallel to it. Thus the periodontal pocket closes up. Some of the tissue may actually reattach but it important for those tissues to not be infected.

Answer 176

1. Reduction in gingival tissue due to reduced oedema - increase in th black triangle between teeth 2. Increase in dentine hypersensativity due to damaged cementum that covers dentinal tubules 3. OH may causes reduction in dentine like making those wedge like

Answer 177

1. Pocket depth and type (supraboney or infraboney) 2. Vertical bone loss 3. Furcation ivolvment 4. Ridge defects 5. Masticatory dysfunction

Answer 178

1. 3 Wall defect - balcony-like defect 2. 2 wall defect - 2 roots of adjacent teeth are connected ( a little bit) or where is 2 walls of the defect 3. 1 wall defect - might manifest itself as a v shape with a single wall All defects must undergo non-surgical therapy. The defects can be accessed using horizontal strokes, mini-currettes or special ultrasonic scalers.

Answer 179

1. There is excessive occlusal force 2. This results in acute inflammation and compression 3. This lead to bone resoprtion and widening of the PDL with no clinical attachment loss 4. When occlusal forces removed - PDL goes to normal

Answer 180

1. Excessive occlusal force applies to healthy teeth, healthy gingiva on a reduced periodontium 2. SImilar addaption and widening of the PDL with no clinical attachment loss 3. When forces removed some bone apposition might occur BUT when untreated periodontitis is involved: 1. The occlusal forces may cause damage to the connective tissue supporting the teeth 2. When occlusal trauma remove attachment is lost

Answer 181

They may be considered, in some cases, as adjuncts to mechanical debridement - cases like patient who cant perform proper mechnanical plaque control post surgery or necrotising periodontal disease or people with saviour arthritis

Answer 182

1. There are thousands different types of periodontal bacteria present - hard to choose one antibiotic 2. The bacteria reside within a biofilm thus they are harder to reach - THUS BIOFILM NEEDS TO BE REMOVED AND ANTIBIOTICS ADMINISTERED 24 HOURS POST DEBRIDEMENT

Answer 183

Amoxicillin 500 mg orally, 8-hourly for 7 days PLUS Metronidazole 400 mg orally, 12-hourly for 7 days

Answer 184

1. Young patient 2. Generalised severe periodontitis patient 3. Patients with systemic diseases 4. Rapidly progressing form 5. Refractory/therapy-resistant forms of periodontitis

Answer 185

After around 12 weeks in order to give the periodontium the chance to heal

Answer 186

1. Review MHx and risk factors 2. Assess the OH performance 3. Periodontal examination 4. Re-evaluation - caries check, restorative and implant status 5. Supportive periodontal therapy session - the aim of therapy is to have pocket of no more than 4 mm 6. The third step can be taken aswell after another reassessment - this involves teeth that did not respond to therapy well and may need to address those remaining point of biofilm accumulation 7. If the pocket are more than 6mm, surgeyr may be needed

Answer 187

It is treatment that plans to maintain already achieved goals with improvement of periodontal health. Patient should come back for assessment every 3-12 months depending on their risk profile )high risk - come every 3 months, low risk - every 12 months)

Answer 188

There dirrent matrix you can use to determine the recall frequency - a common one is the PRA (periodontal risk assessment) and it can be accessed online. Preio-tools.com seems like the website to go to to find different matrix that may assist you.

Answer 189

YES of course you should to understand the health of pockets - but you can choose not to do a brand new perio chart unless you find some findings

Answer 190

1. Periodontitis - a disease that destroys the bone underneath the tooth 2. Usually occurs from bacteria aggrevating the gums 3. Aggrevating the gums leads to inflammatory condition - gingivitis 4. When gingivitis is present with some underlying risk factors such as smoking, diabetes or immunuesupressed organism - periodontitis is caused 5. Periodontitis is caused by the immune system trying to fight off the bacteria in the plaque - but not bring very mindful of the surrounding tissue 6. Unfortunatley periodontitis is irreverisble - but if proper treatment - it can be slowed down or even arrested - thus we need to collaborate on this issure

Answer 191

1. Apical foremen 2. Dentinal tubules 3. Accessory canals 4. Lateral canals

Answer 192

1. Endo or perio infection 2. Trauma an/or iatriogenic trauma - like perforation during root canal treatment or root fracture or crack post RCT or root resorption

Answer 193

An EPL (endo-perio lesion) is a pathological communication between the pulpal and periodontal tissues at a given tooth accompanied by a deep periodontal pocket and altered pulp sensitivity test that may occur in (symptomatic) acute or chronic (asymptomatic) form.

Answer 194

1. Primary endo infection - carious lesions affect the pulp and secondarily affect the periodontium - Inflamed pulp exerts little or no effect on the periodontium - Necrotic pulp cause bone resorption - Sinus tract drain through PDL into gingival sulcus - Isolated periodontal defect 2. Primary perio - periodontal disease introduces bacteria through different channels of communication in

Answer 195

1. Pulp test negative 2. Compromised coronal integrity 3. Isolated deep narrow peridontal pocket - might need to use a guttapercha and take a PA

Answer 196

1. RCT 2. No immediate scaling and root instrumentation - please await healing first - 3-6 months should be enough for healing and reassessment

Answer 197

1. Sever periodontitis 2. Pathological changes occur in pulp 3. Retrograde pulpitis - acute pain for long duration 4. Pulp test incoclusive 5. Coronal integrity intact 6. Deep periodontal pockets around the tooth

Answer 198

1. Scaling and root instrumentation needs to be done together with the root canal treatment or 1. Extraction depending on prognosis

Answer 199

1. Pup test is negative 2. Deep peridotnal pockets on multiple sites

Answer 200

1. Scaling and root instrumentation needs to be done together with the root canal treatment 2. Possible resective surgery

Answer 201

1. Write that it is a endo perio lesiom 2. Root damage extent 3. Perio status of the patient 4. Grade of the problem

Answer 202

Grade 1 - narrow and deep periodontal pocket in 1 tooth surface Grade 2 - wide deep periodontal pocket in 1 tooth surface Grade 3 - wide deep periodontal pocket in more than 1 tooth surface

Answer 203

Grade 1 - narrow deep periodontal pocket in 1 tooth surface Grade 2 - wide deep periodontal pocket in 1 tooth surface Grade 3 - deep periodontal pockets in more than 1 tooth surface

Answer 204

BPE stands for basic periodontal examination and we use it as a code system similar to PSI! Children with codes 0,1,2 should just have routine exams While children with codes 3 & 4 should be undergoing consistent periodontal care to improve their condition Note that some times Code 3 in a mixed dentition could be just erupting teeth so please be considerate.

Answer 205

1. Periodontal therapy - treating of Stage 4 perio is successful 2. During ortho therapy - after periodontal stabilityis achieved - patient periodontal status needs to be closely managed by a periodontist - maintenance and interruption of ortho treatment is possible 3. Life long orthodontic and periodontic care needs to be provided for the patient

Answer 206

1. Airflow instrument 2. Different ultrasonic scalers 3. Hand instruments - use appropriate size because it is generally difficult to debride

Answer 207

It is the combination of junctional epithelium width and connective tissue attachment width

Answer 208

It results in violation of supracrestal attached tissues resulting in chronic inflammation and bone loss because the body ants to maint that SAT at around 2mm

Answer 209

1. Radiographic findings 2. Clinical assessment - beeding on probing int he area, clinical attachment loss and pocket formation - debridement does not help the lesion 3. Bone sounding - pass through the attached tissues witha sterile probe should be around 3mm from gingival margin - if the margin of the restoration and the alveolar crest have a distance of less than 2mm it is considered as a SAT violation - note that this is a guide, healthy alveolar crest could be upto 3mm below CEJ

Answer 210

1. Consider restoring appropriately - please do not damage the tissues, remove the cement properly 2. Re-establish SAT width by surgical crown lengthening or orthodontic extrusion

Answer 211

This is necrotising gingivitis. It is usualy caused by a presence of an opportunistic bacteria and an underlying stress factor. Clinical features: necrosis of the papilla, sudden onset, ulcer covered by greyish pseudomembrane from surrounding mucosa Treatment: 1. OHI 2. Debridement 3. CHx 4. Metronidozole 400mg 6 hourly for 5-7 days

Answer 212

1. Clearance 2. Half life 3. Volume of distribution 4. Bioavailability

Answer 213

1. Dose 2. Route of administration 3. Single dose versus chronic dose 4. Patients' elimination and distribution rates

Answer 214

It is how much of the drug enters the blood stream and how much can actually be used. Usually calculated by finding the difference of plasma concentration betwene oral ingestion and with use of IV Good drugs - bioavailabiltiy 100% Symbol on graphs - F

Answer 215

When we can achieve the balance between the rate of elimination and plasma concentration

Answer 216

It determines the dose rate. It is important to know that clearance is an independent pharamakokinetic parameter. If clearance is higher than concentration in the plasma should be higher. If clearance is lower than concentration in plasma is higher.

Answer 217

Half-life - time for blood concentration/amount of drug in body in half. Half-life is very useful because it tells us when we are in the steady state. E.g. if half-life 97% is achieved in 5 doses - means it takes 5 half-lifes to get to the steady state. It will also take 5 half-lifes to clear the drug.

Answer 218

Pharamacokinetic: Interacting drug alters the plasma concentrations of index drug. Usually also alters the hepatic clearance, could up or down shift it. Commonly, renal clearance is down regulated. Pharamacodynamically - some drugs may make the reaction to other drugs more potent

Answer 219

When a drug stimulates gene transcritption that makes of a certain enzyme in general resulting in need in higher dose. E.g. St Johns Wort

Answer 220

1. Fluconazole is an aenzyme inhibitor which prevents warfarin to be metabolised 2. Thus decreasing the clearance of warfarin and increasing plasma concentration 3. Increased plasma concentration results in toxicity which leads to increase in bleeding and bruising

Answer 221

It is a pharmacodynamic problem which occurs with use of ACE inhibitor, diuretic and NSAID and can result in Acute Kidney Injury (AKI) Process: 1. ACE inhibitors preserve renal function and also cause constriction of efferent renal arteriole 2. NSAID are able to increase the vasoconstriction of the afferent arteriole by inhibiting the production of prostoglandins - a potent afferent arteriole dilator 3. Dirutetic drive the increase exertion of water through the renal system thus increasing the amount of blood that is carried to the glomerulus through the afferent arteriole 4. All three factors compound and increase the pressure within the nephron in their own way and increase the risk of acute kidney injury due to increase pressure tearing the nephron 5. Solution - avoid NSAIDs

Answer 222

1. Thorough history 2. Check the list with the datatbases 3. Remember of the over-the-counter and herbals

Answer 223

Any response to a drug which is unintended, harmful and which occurs at a dose usually given to humans for management of disease. This does not include: Overdoes or Error in dosing

Answer 224

An injury resulting from medical intervention related to a drug - includes wrong dose or device malfunction

Answer 225

Type A - Exaggerated response to medication even tho the dose is normal - it is usually predictable with dose decrease should fix it Type B - BIZARRE effect - not predictable - high risk of death - need to stop the drug - ALWAYS ASK THE PATIENT IF THEY ARE ALLERGIC BEFORE ANY PRESCRIPTION ESPECIALLY WITH ANTI-BIOTICS Type C - long term affects - tolerance like for caffeine Type D - delayed effect - thalidomide with babies Type other - unavoidable toxicity - cancer chemotherapy

Answer 226

1. Elderly 2. Infats and children 3. Women 4. People with history of multiple allergies 5. People with other diseases 6. Certain ethnicity and pharmacogenetics

Answer 227

1. Local reaction such as chemical irritation or suppression of oral flora 2. Systemic reaction like from bone marrow depressor or immune suppressors 3. Stevens-Johnson syndrome - lots of ulcers - could be caused by ibuprofen 4. Lichen planus - can be caused by allopurinol 5. Gingival bleeding - SSRIs 6. Xerostomia - polypharmacy

Answer 228

1. Purification from natural sources through tradition medicine and chance observation - aspirin 2. Screening of biological sources such as soil, microbes or marine organisms 3. Chemical modification of active and known drugs 4. Rational Drug Design depending on the disease - custom designs by manipulation or proteins etc - SSRIs 5. Pure chance (Srendipity) - Aspartame 6. New Indications from clinical observation 7. Recombinant proteins - using bacteria to make endogenous proteins

Answer 229

1. Laboratory tests in vitro - through use of high throughput screening 2. Whole animal testing 3. Phase I trials - is it immediatley safe? 4. Phase II trials - trials in the target illness - can it work? 5. Phase III trials - large scale clinical trials - is it effective?

Answer 230

1. Aims - to protect public from drugs that are: unsafe, ineffective and poor quality 2. Process - TGA is presented data 3. Evaluation of quality, safety and efficacy 4. Registration 5. Movement to the market

Answer 231

AUST L - listed produucts with little side effects - like sports supplements AUST R - registered products with side effects - think all other proper medicines

Answer 232

1. Schedule 1 - unscheduled drugs - paracetamol 2. Schedule 2 - Pharmacies only - Telfast 3. Schedule 3 - Pharmacist Only medicines - Morning-after pill 4. Schedule 4 - Prescription only - Antibiotics 5. Skip all other schedules 6. Schedule 8 - Drugs of addiction dependence - Morphine

Answer 233

Infection - invasion & multiplication of pathogenic microorganism in body tissue Colonisation - localised presence of microorganisms Bacteraemia - presence of viable bacteria in circulation Septicaemia - systemic infection caused by microorganisms multiplying in circulation Sepsis - multiple organ involvement from organisms

Answer 234

They are drugs that stop the spread and multiplication of bacteria in the body that are causing harm. They come under general term of anti-infectives and antimicrobials.

Answer 235

1. Antibacterials - bacteria 2. Antivirals - viruses 3. Antifungals - fungal infections 4. Antimycobacterials - for TB 5. Antiprotozals - malaria medication 6. Anthelminitics - againts worms

Answer 236

Antibiotics do not cure infections - our immune system does. Antibiotics just needed for their bactericidal or bacteriostatic functions. Antibiotics give immune system more time to mobilise more effectivley

Answer 237

1. Inhibit metabolism of a bacteria (folic acid blockage) - trimethoprim - bacteriostatic effect 2. Inhibit cell wall synthesis - penicillins - bacteriocidal effect 3. Disrupt cell membrane - both bacteriostatic abd bacteriocidal 4. Inhibit protein synthesis - metronidazole inhibits DNA synthesis

Answer 238

1. Narrow spectrum - a few species - benzylpenicillin 2. Moderate spectrum - several species - amoxicillin 3. Broad spctrum - many species - tetracyclines

Answer 239

1. Time-dependent killing - time in the blood where drug is above MIC - MIC can change with resistence - penicillins 2. Concentration-dependent killing - the higher the peak concentration the more it will kill - prologned duration of killing - aminoglycosides

Answer 240

1. Bacteria produce enzymes that inactivate the drug 2. Bacteria changes drug binding site 3. Drug is pumped out of microbe 4. Microbe makes alternative enzyme bypass pathway Example: MRSA - multiresistant Staphylococcus aureus

Answer 241

M - microbiology guides therapy I - indications should be evidence-based N - narrowest spectrum required D - dosage appropriate to the site & typ of infection M - minimise duration of therapy E - ensure monotherapy in most situations

Answer 242

1. Use narrowest antibiotic to treat disease 2. Use the safest 3. Avoid topical administration of a drug used systemically 4. Don't use combinations 5. Don't give prophylactically 6. After considering all theses factors - choose lowest coast

Answer 243

Number of days and numbers of pills

Answer 244

Preventer is taken before to lower the chance or severity of asthma through different vasodialating effect. Usually a low dose of corticosteroids Reliever - is usually just use for quick relaxation of smooth muscles.

Answer 245

Myasthenia Gravis is a auto-immune disease that affect acetylecholine receptors on skeletal muscles - thus affecting the contraction of said muscles. It is an inhibitor. Neostigmine inhibits the enzyme acetylcholine esterase which breakswdown acetylcholine thus increasin it's number in synaptic cleft. this results in improvemenet in the condition due to greater numbers of acetylecholine.

Answer 246

1. GABBA receptor - inhibitory receptor in the nerve - very quick because it is an ion channel 2. Opiod receptor - G protein-coupled receptors - moderatley quick 3. Glucocoricoid receptor - nuclear receptor superfamily of transcription factors - very slow

Answer 247

Category C drug like ibuprofen. Aloso Category D drugs but they are pretty rare!

Answer 248

SRTART LOW & GO SLOW BUT DON'T STAY LOW if chronic dosing.

Answer 249

Warfarin and iboprofen/aspirin - increase bleeding significantly

Answer 250

AUST R listing Shedule 1 or unscheduled

Answer 251

Sulfanilamide antibiotics have a bacteriostatic effect by targeting synthesis of folica acid - an important component of bacterial RNA and DNA Sulfanilamide can completitivley inhibit enzymes that are used in production of folic acids, thus slotwing the synthesis thus slowing growth of bacteria due to reduced production of plasmids (circular DNA in bacteria).

Answer 252

By inhibiting cell wall synthesis through rapid depolarization. Beta-lactam - like amoxycillin - able to bind to bacterial cell walls causing repid depolirasation resulting in loss of membrane potential leading to inhibition of protein synthesis and destruction of DNA.

Answer 253

1. Aesthetics 2. Functional reasons: increased overjet, crossbites 3. Societal and cultural pressures

Answer 254

Interceptive orthodontics or primary orthodontics is an approach that uses phased treatments to manipulate growth, and particularly common growth patterns and correct developmental occlusion problems.

Answer 255

1. Distinguish abnormal development and growth from that which is normal 2. Perform an orthodontic examination and explain the diagnosis, then devise treatment options, detailing the benefits and risks of each 3. Commence, monitor and complete interceptive orthodontic treatment in a patient

Answer 256

Growth - is an increase in size Development - is an increase in complexity

Answer 257

1. Establish possible aetiological factors 2. Seek assessments 3. Understand suitable options for intervention

Answer 258

It is a chart of proportional growth. Structures towards to head grow first

Answer 259

Scammon's curves They are graphs that represent that different tissues grow at different rates

Answer 260

Developmental. It is more useful to know stage of growth, rather than age, that specific growth occurs for orhtodontics.

Answer 261

1. Childhood peak at about 5 years 2. Juvenile peaks at about 7 and years old 3. Adolescent peak at about 11-13 years for females and 13-15 years in males

Answer 262

Class II treatment are most effective when you detect that the patient cephalogram is at CS 1 or 2 and you able to utilise maximum mandibular growth. Class III treatment is most eefective when it is broken down itno two distinct stage: Maxillary expansion before maximum mandibular growth AND mandibular manipulation during pre-pubertal/pubertal stages.

Answer 263

Lateral cephalometry standardised, reproducible radiograph used primarily for orthodontic diagnosis and treatment planning. It is used to compare jaw growth over time thus is a good guide in orthodontic treatment. It is able to assist with cervical vertebrae maturation which is a type of biological indicator of skeletal maturity. The vertebrae C2-C4 is assessed.

Answer 264

Intramembranouse ossification - which is a direct transition of the mesenchymal tissue into bone due to osteoblasts deposition. This usually occurs in non-load bearing areas csuch as the cranial vault, maxilla and mandible (body)

Answer 265

Endochondral ossification - where bone develops from carilagious precursor. It is usually occuring in load bearing areas like cranial base, long bone and mandibular condyle.

Answer 266

It grows downwards & forwards in relation of the cranial base.

Answer 267

The mandible grows up and back. It occurs via the bone remodelling via subperiosteal resorption & deposition. Cartilaginous growth occurs in the condyle

Answer 268

Bone resorption creates space for the eruption of teeth that don't have of decidious pre-cursor - thus lower the probability of impacted molars (think surgical extraction or third molars)

Answer 269

1. Much of the vertical face height increase due to tooth eruption + alveolar bone production 2. Mx & Md + dentitions desplaced down and forward relative to the cranial base 3. Individuals experience differing amounts and direction of facial growth 4. Around adolescence, slight differential growth of Md relative to Mx - meaning mandible tries to catch up 5. Facial growth dependent on idividual growth patterns 6. Factors infleuncing growth & development: genetics, SES, neural control, exercise, neural control, hormones and more.

Answer 270

1. Cranial vault akak calvarium 2. Cranial base

Answer 271

1. Naso-maxillary complex 2. Mandible

Answer 272

2 distinct methods of growth: 1. Intramembrenous ossification - provides gross growth 2. Ectocranial resorption and remodeling - localised growth - the inner cortical plate resops and the outder cortical plate experiences deposition due to local growth of brain - think about all the cruves and bumb the brain has

Answer 273

1st Branchial arch.

Answer 274

It is the junction of alveolar & basal bones of the maxillary & mandible in the region of the apices of the teeth. It is important for dento-alveolar compesation - which means that tooth eruption and alveolus dvelopment compensate for apical base dimension - making the teeth look "out of place slightly"

Answer 275

It is a failure of the dento alveolar compensatory mechanism.

Answer 276

Crowding - the discrepancy between tooth size & jaw size that results in the misalignment teeth. Primary crowding - genetic origin Secondary crowding - environmental factors such as extraction as a child Tertiary crowding - occurs in the post adolescent period

Answer 277

Palpate around the areas that are distal and lingual of the primary canines in order to feel the permanent canines - because they are the most impacted teeth besides third molars.

Answer 278

It is the approximate distance from central incisors to most distal point of 2nd primary molars

Answer 279

Distance measured round the arch from the mesial contact of first primary molar to the mesial contact of the other first primary molar

Answer 280

The horizontal distance between cusp tips of the upper and lower canines

Answer 281

The horizontal distance between the righ and left central fossae of the upper and lower first primary molars

Answer 282

It is the difference between the combined mesio-distal width of the permanent canine & premolars and the width of the corresponding precursors. This space is eventually lost as mesial drift of first primary molars occurs following eruption of permanent canine & pre-molars

Answer 283

It is the difference between the total mesio-distal dimensions of the decidous and permanents incisors

Answer 284

Space is gained from: 1. Residual spacing between deciduous incisors 2. Permanent incisors erupt into more labial position and occupy a great arch perimetes 3. Deciduous canines move distally as incisors erupt 4. Transvers increase in intercanine arch width

Answer 285

It is a variation of normal dental development It arises as the effcts of: - incisor apicies initially close together as incisors erupt - lateral pressure from erupting laters and canines Diastema may close after laterla incisors erupt Diastema may persist if: - deciduous canines have been lost - upper incisors are flared labially

Answer 286

1. Use of interdental, primate and leeway spaces 2. Increased inter-canine width; mainly due to transverse growth 3. Proclined eruption of permanent incisors, forming a wider arch & increases dental arch length 4. Appositional growth of alveolar processes in 3 planes 5. Appropriate size of apical base and teeth

Answer 287

1. Lack of interdental, primate and leeway spaces 2. Reduction in dental arch length after permanent incisors erupt 3. Dento-alveolar disproportion (mismatch between tooth & jaw size) 4. Early loss of primary teeth 5. Soft tissue issues - low frenal attachment resulting in midline diastema 6. Oral habits such is sucking on a pacifier or suck on a thumb

Answer 288

1. Because they are known to leave moisture bubles at the surface as well as water tress that impare bonding 2. Because there is an issue with the acid that is used with self etching. Essentially a special compound is used to neutraulise the acid over time so that self etching does not continue to destroy tooth structure - but unfortunaley that compound affect may be delayed thus the created resin tags are not formed properly - this reduced their effectiveness thus making the restoration last less time :(

Answer 289

An average composite may last around 3-8 years but only if it is maintained. Give car analogy.

Answer 290

1. Block dentinal tubules - using restorations or protective coverings 2. Block nerve activity - stanous fluoride and potassium nitrate 3. Remove the cause - erosion and toothbrushing technique change

Answer 291

1. Occlude dentinal tubules to reduce impact of stimuli on fluid movement - can be done through chemical occlusion (fluorides) or physical occlusion (sealed resorations) 2. Reduce sensitivity of nerves - using potassium nitrate

Answer 292

1. PULPAL diagnosis - pulpitis, necrosis or absent pulp 2. PERIAPICAL DIAGNOSIS - Symptomatic/Asymptomatic Periodontitis/Abscess 3. CAUSATIVE AGENT -caries, trauma, idiopathic Please refer to the radiograph if you looking at one

Answer 293

1.Completion of all histories and exams 2. Taking consent for additional testing - TRI-PLAQUE GEL 3. Diagnosis, presentation of treatment plan and consent 4. Chief Concern 5. Preventative care 6. In chair treatment 7. Close date recall 8. Transition to regular recall

Answer 294

1.Teeth present/missing 2.Morphology of teeth 3.Wear - mild, moderate, sever 4.Crowding,spacingrotations 5.Axail inclanations 6.Shape of dental arch 7.Cruve of spee and wilsons curve 8.Angle molar classification/canine classification 9.Overbite (%) / overjet (mm) 10.Mediolateral

Answer 295

Infants with cleft lip and palate may have trouble with the sealing of the nasal cavity as well as creating vaccum for sucking

Answer 296

1. Informed consent 2. Sit the patient up right or on a slight angle - situated the tube next to the patients side where the taking of the x-ray will take place - check the settings on the x-ray machine 3. Grab a standart size film 4. Situated the film dot to slot - black to beam 5. Situated the film parallel to the palatal/lingual surface of tooth being imaged 6. Ask your patient to gently hold the film with their thumb - make sure the patient does not bend the film 7. Horizontal beam angulation - align the beam at the right angle to the tooth of interest - similarly to a bitewing - unless 14 8. Vertical beam angulation - assess the angulation of long axis of the tooth and angulation of detector - mentally bisect the angle created between the tooth & detector 9. Vertical beam adjusted so central ray is at 90 degrees to bisecting line 10. Technique is the same for all teeth in mouth

Answer 297

1. Measure the teeth and cut the Ribbond - could be done by making a pattern closely adapting a piece of tinfoil or dental floss around teeth 2. Prepare lingual surfaces and labial interproximals for bonding - etch bond cure 3. Wet the ribbond with resin 4. Apply a thin layer of flowable resin the to the lingual and interproximal surfaces 5. Adapt the ribbond around the ressin filled surfaces including interproximal contacts 6. Remove excess composite 7. Cure the first layer 8. Cover the ribbond splint with a flowable 9. Light cure the covering layer of composite 10. BE VERY CAREFUL WHEN POLISHING

Answer 298

History taking: - History of pain or discomfort and general health - Causative factors -- trauma or everyday activity - Social history Extra-oral examination - Symmetry of the facial features - Signs of vertical dimension loss - Palpation of masticatory muscles Palpation and TMJ opening - Palpation of the TMJ on opening checking for crepitus or clicking - Assess the range of motion on opening - Assess the amount of opening - use fingers Intra-oral examination - Occlusal analysis

Answer 299

1. Myofacila pain 2. TMJ hypertranslation 3. Inflammed TMJ 4. TMJ Internal derangement

Answer 300

Use cold therapy during initial injury - in order to reduce the symptoms of inflammation. Use hot therapy if you experience muscle stifness.

Answer 301

1. Oral preparatory stage 2. Oral propulsive phase 3. Pharyngeal phase 4. Oesophageal phase

Answer 302

1. Food enters oral cavity 2. Voluntary mastication and bolus formations

Answer 303

Tongue elevated and propels bolus to pharynx

Answer 304

1. Machanoreceptos in the pharynx detect the bolus 2. Soft palate elevates to seal nasopharynx 3. Larynx and hyoid bone move anteriorly and superiorly 4. True and folse vocal cord adduct 5. Epiglotis moves posteriorly and inferiorly 6. Respiration stops 7. Pharyngeal wave occurs 8. Upper oesophageal sphincter relaxes and opens

Answer 305

1. Bolus passes to oesophagus 2. Oesophagus contracts sequentially and involuntaraly 3. Lower oesophageal sphincter relaxes 4. Bolus reaches stomach

Answer 306

1. Muscle spindles within the muscle of mastication detect stretch 2. Through the first order neuron, which passes through the foramen ovale, trigeminal ganglion into the trigeminal tract nucleus 3. Synapses occurs and through the interneuron, the action potential is propagated to wht trigeminal motor nucleus 4. Synapses occurs in the trigeminal motor nucleus to the muscle of mastication (for example the masseter) in order to generate an appropriate response and maintaining the mandible in anappropriate position during running fo rexample

Answer 307

1. To test patients status of the trigeminal nerve 2. To keep the madnible in an appropriate position

Answer 308

Fluoride usually reacts with calcium in the saliva to form CaF2 which sits on the surface of the tooth and releases fluoride ions as it dissolves over time “slow release device”. Can occlude dentinal tubules.

Answer 309

Fluoride is able to create lobules and aid in occlusion of dentinal tubules.

Answer 310

1. Precipitation of metal ions on physically occlude dentinal tubule, relieving sensitivity 2. Precipitate is also acid resistant and can act as a barrier against future erosive lesions to an extent

Answer 311

1. MI Varnish contains NaF and CPP-ACP dispersed in rosin and ethanol solution 2. When applied, it adheres to the tooth surface and seals exposed dentine tubules 3. Contact with saliva sets the varnish and starts the slow dissolution process, driving the release of fluoride and CPP-ACP 4. Fluoride ions that are released bind with calcium ions in pellicle and plaque to form globules of calcium fluoride. 5. These globules deposit on the tooth surface, providing additional blockage of exposed dentine tubules, enhanced acid resistance and promote calcium and phosphate enriched saliva

Answer 312

1. Assess patient preferences for shared decision-making. 2. Educate patients about all possible treatment options and how they fit into a patient's current health status. 3. Discuss patient values and health-related goals. 4. Come to a treatment decision with the patient.

Answer 313

It induces: 1. Advanced glycation end products 2. Monocyte and marcophage activation 3. Alteration responsiveness to acute pathogens 4. Inflammatory mediator release 5. Th2, and Th17 - type inflammation

Answer 314

Decreases: 1. Immunity to infections 2. Innate defenses againts pathogens 3. Adaptive immune cell activation 4. Function of natural killer cells 5. Phagocytic uptake of bacteria and apoptotic cells

Answer 315

1. Consultation with nephrologist 2. Platelet dysfunction and anaemia resulting in bleeding tendency should be discussed 3. Heparin anticoagulation can be given to patient who is on haemodialysis - thus maybe try to do a procedure on another day 4. Avoid compression on the arm with the vascular access 5. Do not presribe some drugs - check with MIMS or consult with the renal specialist 6. Look out for renal osteodystrophy - there is weaker bone with those patients so extra care need to be taken care when performing surgery

Answer 316

1. Xerostomia 2. Increase is dysbiosis of biofilm 3. Heat damage to the cells 4. Increase in extrinsice staining

Answer 317

They are ruffini-type endings

Answer 318

Due to osseoperception - a type of mechanoreception in the absence of a functional periodontal mechanoreceptive input

Answer 319

1. TMJ receptros 2. Receptors in the muscles 3. Mucosal receptors 4. Periosteal mechanoreceptors

Answer 320

Masseter and lateral pterygoid

Answer 321

Anterior temporalis: 1. Anterior maxillary teeth 2. Eye brows Posterior temporalis: 1. Posterior molar teeth 2. Just posterior of the temporal muscle

Answer 322

1. Respect for the patient's values, preferences, and expressed needs; 2. Information and education; 3. Access to care; 4. Emotional support to relieve fear and anxiety; 5. Involvement of family and friends; 6. continuity and secure transition between health care settings; 7. physical comfort; 8. coordination of care.

Answer 323

They cure by the use of a photo-initiator (light cure) but they can be cured deeper due to 1. A more translucent material 2. Filling that is more efficient in a present of a photo-initiator

Answer 324

LHS inferior border of the orbit

Answer 325

LHS Condyle

Answer 326

Superimposed over the sinus, malar process

Answer 327

Pterygo-maxillary fissure

Answer 328

Condesnsing osteotitis around the 35

Answer 329

Zygomatic arch

Answer 330

LHS Inferior Alveolar Nerve Canal

Answer 331

Central Hyoid bone

Answer 332

RHS Styloid Process

Answer 333

RHS Maxillary Sinus

Answer 334

RHS Zygomatic Arch

Answer 335

Primary image of RHS hard palate

Answer 336

Secondary image of RHS palate

Answer 337

LHS External Acoustic Meatus

Answer 338

Genial tubuciles

Answer 339

Mandibular notch/oro-pheryngeal space

Answer 340

Nasal septum

Answer 341

Infra-orbital fissure

Answer 342

Nasal cavity/sinus

Answer 343

RHS Maxillary tuberosity

Answer 344

1. Elongation - vertical beam angulation is too shallow 2. Foreshortening - vertical beam angulation too steep 3. Vertical detertor postion - not the entire tooth structure present 4. Contact point of two adjacent teeth 5. Cone cutting

Answer 345

1. IANB 2. Gal-gates technique 3. Mentla nerve block 4. Supraperiosteal infiltration

Answer 346

1. Take full patient history 2. Thourguh exam including palpations, stretchung and whipping - checking for symmetry 3. Risk factor modification 4. Accurate clinical diagnosis 5. SYmptom relief 6. Reviews/follow up

Answer 347

1. Unnecessary artefacts i.e. the glasses - Results in unnecessary object being presented on the DPR, the glasses 2. Patient positioned forward - Anterior teeth blury and too small - spine sen on the film 3. Failure to position the tongue against the palate - large, dark, shadow over the maxillary teeth between palate and dorsum of tongue 4. Head is tilted to the side in the horizontal direction - condyles are not equal in height, nasal structure is distorted 5. Head is turned to one side - seems like the RHS was closer to the detector than LHS - resulting in LHS ramus appearing larger 6. Exposure factors have not been selected properly - the image appears to be blur overall 7. Chin down - the V shape - joker brain 8. Chin up - fraun

Answer 348

1. Hand hygine, as consistent with the 5 moments for hand hygiene 2. The use of appropriate personal protective equipment 3. The safe use and disposal of sharps 4. Routine environment cleaning 5. Reprocessing of reusable medical equipment and instruments 6. Respiratory hygiene and cough etiquette 7. Aseptic technique (the dirty and clena areas) 8. Waste management

Answer 349

1. Before touching a patient 2. Before a procedure 3. After a procedure or body fluid exposure risk 4. After touching a patient 5. After touching a patient's surrounding

Answer 350

It inhibitis enolase - an enzyme which is use if break down of carbohydrates

Answer 351

Decrease in kVp

Answer 352

Folate and pyrim

Answer 353

Merkel's disk for fine discrimination for light touch

Answer 354

1. Aknowledge frustrations 2. Say sorry 3. Provide opportunity to ask question and relate their experiences 3. Discuss the potential consequences of the injury 4. Discuss the steps that are taken to prevent that injury from reoccuring

Answer 355

1. Patient name 2. Our name and adress of practice 3. Generic drug name 4. Form of the drug aka tablet or capsule 5. Strength 6. Quantity 7. Dose & frequency of administration 8. Our signature 9. Date

Answer 356

1. Red buccal gingiva 2. Pain on brushing 3. Eating certain foods 4. Condition does not resolve post debridement

Answer 357

1. Topical steroid - 0.05% betamethasone diproponate 2x daily for about 7-14 days - continue for 7 days after smptom subside 2. Rinses with 0.2% CHx muhtrinse for 2 weeks seperate to the betamethasone and tooth brushing 3. Avoid spicy foods 4. Brush with soft brissle tooth brush

Answer 358

1. Exposure settings- contrast and density 2. Orientation of detector- dot to distal 3. Horizontal detector placement 4. Vertical detector placement 5. Horizontal beam angulation 6. Vertical beam angulation 7. Central beam position 8. Collimator alignment 9. Sharpness of image Overall diagnostic quality

Answer 359

Direct bond approach: etch-37 % orthophosphoric acid+ primer+ adhesive + CR 20% polyacrylic acid for 10secs,RMGIC base/liner+ CR Sectional matrix+ clamp + wedge + ball burnisher/flat plastic Tofflemire matrix +retainer+ wedge + ball burnisher/flat plastic LC Floss (+/- polishing strip if required)

All year revision Flashcards

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