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BDS4 Past Papers Flashcards

1
Q

Name 4 radiographic features that indicate close proximity of lower 8s to IAN

A

Deflection of canal
Interruption of IAC lamina dura
Juxtapical area
Darkening of root where IAC has crossed it

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2
Q

Name 2 potential complications of extracting a tooth that is in close proximity to IAC

A

IAN dysaesthesia
IAN paraesthesia

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3
Q

If there was a risk of injuring the IAN during an extraction what procedure could be carried out instead

A

Corenectomy

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4
Q

List 6 signs/symptoms of TMD

A

PAIN
Mom hypetrophy
Mom tenderness
Clicking popping and crepitus
Linea alba
Tongue scalopping
Tooth wear

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5
Q

List 5 points of conservative advice you could give to a TMD patient

A

Stop any parafunctional habits
No chewing gum
Cut foods into small pieces
Do not incise foods
Avoid hard and sticky foods
Chew bilaterally

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6
Q

Define retention

A

Resistance to vertical dislodging force

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7
Q

Define indirect retention and how it can be incorporated into a design

A

Use of the supportive components to resist rotational forces, components are placed at 90 degrees to the clasp axis and opposite from dislodging forces

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8
Q

Name three conditions you would see desquamative gingivitis in order of relevance

A

Lichen planus
MMP
PV

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9
Q

Name 2 types of haemangioma and give 2 histological differences between them

A

Capillary - not encapsulated and thin walled capillaries
Cavernous - encapsulated and large vascular spaces

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10
Q

What percentage of fluoride is the optimum in drinking water

A

1ppm

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11
Q

Name three methods of delivering fluoride to an 8 year old child and provide concentrations for each

A

Fluoride toothpaste 1450ppm
Mouthwash 225ppm
Varnish 22600ppm

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12
Q

What is the local action of fluoride in the oral cavity

A

Promotes remineralisation of any demimeralsied enamel and forms fluroapitite which has higher erosion resistance.

Inhibits bacterial metabolism and acid production

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13
Q

Give the best tx option for fluorosis and 2 advantages of this treatment

A

Micro abrasion

Conservative and results are permanent

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14
Q

Name 2 local and 2 systemic risk factors for pseudomembranous candidias

A

Local
- use of corticosteroids inhaler
- removable prosthesis

Systemic
- diabetic
- immunosuppressive side affect of treatment e,g, chemo

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15
Q

If you are taking a swab and oral rinse give an advantage and disadvantage of each

A

Oral rinse
- quantitative and not site specific

Swab
-site specific and not quantavie

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16
Q

If a child has possibility injested a toxic dose of fluoride what is your advice ?

A

Inject a large amount of calcium - milk
Take to A and E

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17
Q

What is the most common cause of fluorosis in the UK

A

Water

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18
Q

Please provide the fluoride supplement values for the following patients all living in an area of <0.3ppmF of water

A

6mths - 1 year - 0.25mg per day
1-3 years - 0.5mg per day
3-6 - 1mg per day

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19
Q

Give three diagnostic features of subluxation

A

Tooth has not been displaced from the socket
Increased mobility from the tooth
Bleeding from gingival sulcus

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20
Q

How would internal inflammatory respotion present both clicnally and Radiographically and what medicament could you place

A

Clinically there would be a pink colour of the tooth
Ballooned irregular shaped canal

Non setting CaOH

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21
Q

What are the 6 components of clinal goverence

A

Research and delelopment
Education and training
Clinical effectiveness
Risk management
Openness
Clinical audit

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22
Q

What are the 6 dimensions of healthcare quality

A

Paitent centered
Safe
Effective
Efficient
Equitable
Timely

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23
Q

Give three uses of a URA rather than tipping teeth

A

Habit breaker
Retainer
Growth modification
Overbite reduction

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24
Q

List 6 signs of good wear on URA on visits

A

Active component has become passive
Patient can insert and remove appliance well
Post dam park present on palate
Patient can speak normally with appliance in
No hypersalvaition when in situ
Patient is wearing appliance when they come in

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25
Q

Give 4 intra-oral signs of ANUG

A

Recessions of the papillae
Greyish slough over ulcers which can be removed
Red and puffy gingivae
Punched out crater like ulcer

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26
Q

What are 4 risk factors for ANUG

A

Smoker
Stress
Poor OH
Malnutrition

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27
Q

Give three potential reasons for a post and core to have debonded

A

Secondary caries
Poor moisture control during cementation
Root fracture

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28
Q

If there is a fracture at the junction of the post and core, why may this have happened

A

Biocorrosion ]

Lack of sufficient ferrule
Trauma

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29
Q

Name a wetting agent used to bond metal to resin within resin bond luting cement

A

MDP
4-META

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30
Q

Name three ways of retrieving a fractured post

A

Ultrasonic tip
Eggler forceps
Moskito forceps

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31
Q

Name the 3 stages in the formation of a clot

A

Vasoconstriction
Platelet plug formation
Fibrin clot

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32
Q

How do the following drugs affect the clot formation processes and at what stage
Aspirin
Warfarin
Heparin

A

Aspirin ; reduces platelets aggregation at plug formation site
Warfarin ; Vit K antagonist so prevents formation of clotting factors 2,7,9 10
Heparin ; reduces action of platelets so affects clot formation

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33
Q

Why are aspirin and clopidotgrel used in conjunction

A

A synergistic effect on platelet aggregation

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34
Q

What is a biofilm

A

Thin but robust layer of mucilage adhering to solid surface, containing a community of bacteria and other microorganisms embedded in a glycocalyx matrix

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35
Q

What are the stages in the development of a biofilm

A

Adhesion
Colonisation
Accumulation
Complex community
Dispersal

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36
Q

What is the nerve supply of the submandibular gland

A

Chrorda tympani and submandibular ganglion

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37
Q

What is the innervation of the parotid gland

A

Glossopharnygeal nerve

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38
Q

What water is used for a final rinse of a washer disinfector and why

A

Reverse osmosis because it is deminerlasied so will not leave residue on instruments

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39
Q

4 examples of coping mechanisms for stress

A

Work/lfe balance
Excersie
Eduction on stress
Set goals
Know limits

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40
Q

What are the principles of the adults with incapacity act 2000

A
  1. Treatment must benefit the patient
  2. Must be the minimal necessary intervention
  3. Account for the patients past wishes
  4. Consult with relevant others
  5. Encourage residual capacity
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41
Q

What are the signs and symptoms of Parkinson’s

A

Intention tremor
Mask life face
Slow movement/ bradykinesoa
Riding its

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42
Q

Name 4 factors which could cause a bridge to debond

A

Poor moisture control during cementation
Unfavourable occuslion
Parafunction
Truama to front of face
Poor oh

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43
Q

List three forms of tooth borne support

A

Occlusal rest
Cingulum rest
Full coverage rest

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44
Q

Where should a denture base extend to CocR

A

2mm anterior to palatine foam a

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45
Q

What are 5 criteria’s for valid consent

A

Informed
Voluntary
Not manipulated
Not coerced
With capacity

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46
Q

What are 3 ways a tooth could be desensitised

A

Tooth mouse
Seal and protect
Sensitive toothpaste

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47
Q

Why do you chose RMGIC over composite for a cervical cavity

A

Moisture control and less polymerisation shrinkage

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48
Q

Name 3 post matierals

A

Gold
Ceramics
Fibre

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49
Q

Please name 4 indications for the size of a post

A

3-5mm of GP left apical
1/3 width of root
Post to crown should be in a 1;1 ratio
1cm of circumferential dentine

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50
Q

Name 5 factors you would consider before giving a patient a bridge

A

Oral hygiene
Quality of enamel
Parafunction
Occulusion
Abutment health

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51
Q

What are the signs and symptoms of reversible pulpitis

A

Short sharp pain
Stops when the stimulus is removed
No TTP
Pain on cold
Well localised

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52
Q

What are the signs and symtoms of irreversible pulpitis

A

Lingering pain after the removal of a stimulus
Sponentouis
Wakened at night
Pain with heat
Poorly localised
TTP

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53
Q

How does local anaesthetic work

A

Blocks voltage gated sodium channels and prevents up regulation of action potentials

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54
Q

What is the maximum dose of lidocaine

A

4.4mg /kg

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55
Q

What are three ideal characterucs of a post

A

Parallel
Non threaded
Cement retained

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56
Q

Name 3 post materials

A

Fibre - glass
Gold
Ceramics

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57
Q

Paitent has a gold post and core that has debonded serveral times
Why has this happend

A

A fracture in the post or a fracture in the core
A fracture in the root at the level of the post
Inadequate moisture control
Traumatic fracture
Untreatable caries

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58
Q

A fracture has occurred at the junction of the post and core - why does this happen give three reasons

A

Biocorroson of metallic post core
Tooth structure loss
Inadequate ferrule
Truama - bruxist patient
Bacterial interfaction

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59
Q

What is the hydrid layer

A

Collagen network providing intimate adhesion between the tooth and material though primer and bonding agent with Collagen

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60
Q

What changes have been made to modern amalgam to improve it

A

Copper has been added to reduce the gamma 2 phase because that has poor strength and abrasion resistance, copper reacts with tin to reduce availability for that phase

Zinc is also no longer added as it reacted with the water leading to a poor marginal seal

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61
Q

What two symtoms can come from zinc being in amalgam , and why does this happen

A

Zinc interacts with salvia and blood and forms bubbles oh H2 within amalgam and this causes a build up of pressure which causes expansion

  • this can either cause pulpal pain for the paitent
  • or can cause the restoration to sit high
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62
Q

What 3 criteria must be filled out before u obtiurate a canal

A

Asymptomatic
Full biomechanical cleaning
Tooth must be fully dyr

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63
Q

Name 3 common sealers

A

Epoxy resin
Calcium hydroxide
Zoe
GIC

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64
Q

What percentage of maxillary molars have an MB2 canal

A

93%

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65
Q

What are the three design objectives of endo

A

Continously tapering
Maintain apical foramen in same position
Keep apical foramen as small as possible

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66
Q

What are the advantages of the crown down technique

A

Removes bulk of infected tissue
Resovior for irrigant
Keeps reference point for WL
Makes straight line access easier
Limits spread of infected material at apical foramen §

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67
Q

What is the difference between crown down and step back in endo

A

In step back a proper apical stop prepared first before preparing the middle and coronal third

It is the opposite in crown down

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68
Q

Why is sodium hypochlorite a good irriagmnt

A

Disinfects the canal and dissolves organic material

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69
Q

What is the function of 17% EDTA

A

Removes the smear layer

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70
Q

Feature of a tooth that will make it unsuccessful in treatment

A

Quality of tooth tissue present
Amount of remaining tooth tissue present
Mobility
Periodontal status
Pulp status
Crown root ratio

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71
Q

What are 3 short term options to replace a debonded crown

A

Recement the failed MCC as a temporary crown to protect the remaining tooth structure

Make a provisional crown in pro temp and use a temporary cement ( non eugenol temporary )

Adhesive cantilever as a temporary bridge

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72
Q

4 pieces of information needed from patient to technician to make bridge

A

Bridge design
Master impressions
Bite registration
Shade of teeth

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73
Q

How does the clincal presentation of caries compare to a radiograph

A

Caries deeper clinically

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74
Q

Give three advantages of compostie over amalgam

A

Minimal preparation
Aesthetics
Bonds to tooth surface
Marginal seal
Low thermal conductivity

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75
Q

What are 4 indications for a resin retained bridge

A

Replace missing tooth
Good enamel quaility - unrestored tooth
Large abutment surface area for bonding
Minimal occlusal load

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76
Q

What are the contraindications for a resin retained bridge

A

Long span
Poor / sufficient enamel
Parafunction
Abutment which is periodontally involved

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77
Q

How do u cement a metal bridge

A

10MDP or 4META in composite luting cement

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78
Q

What are 5 requirements in occlusal stability

A
  1. Stable and even contacts in ICP
  2. Anterior guidance in Harmony with the envelope of function
  3. Disocclusion of all posteior teeth in mandibular protrusion
  4. Disocclusion of posteior teeth on working side
    5, Disocclusion of posteior teeth on non working side
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79
Q

Why is a shortend dental arch considered acceptable

A

Provides suitable aesthetics function and occlusal stability and masticatory ability as well as they are able to clean their teeth

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80
Q

How does vital bleaching with hydrogen perioxide work

A

H02 forms and acts as an oxidising agent. Oxidation leads to be breaking down long chain chromogenic molecules to shorter ones which arent as pigmented

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81
Q

What is the common active ingredient in tooth whitening bleach - how is it realted to hydrogen peroxide

A

10% carbamide peroxide

Breaks down to form hydrogen perioxide and urea

Approx a 1/3 is hydrogen perioxide

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82
Q

What are 4 risk of vital bleaching

A

Sensitivity - 60% of patients
Relaspe
Might not work
Soft tissue irritation

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83
Q

What techniques are used for successfully placing composite

A

Flowable at base to decrease contraction stress
Incremental placement to have a low configuration factor
No more than 2mm increments to avoid a soggy bottom

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84
Q

What angle should be cavo surface margin be for amalgam

A

90 degrees

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85
Q

What design/prep features may have lead to a bridges failure

A

Poor abutment health
Unfavourable occlsuion
Parafunction
Poor crown root ratio
Over tapered prep

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86
Q

A patient attends with a debonded cast gold post and core give 4 reasons for deboned

A

Incorrect cementation matieral
Contamination during cementation
Unfavourable occlusion
Inadequate prep or over tapered prep

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87
Q

The core has fractured from the post what are three reasons for this

A

Casting error
Inadequate ferrule
Trauma
Parafunction

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88
Q

Giver three methods of removing a fractured post

A

Ultrasonic vibration
Cut out for fibre posts
Sliding hammer

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89
Q

Using a stainless steel file in 20 degree curved canal of molar - give 4 complications that can occur and explain

A

Zipping
Perforations
Blockage
Ledges
Fractured instrument

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90
Q

How do managed a patient when you have accidental injected LA into their parotid gland

A

Explain to patient what has happed and reassure that it is only temporary
Provided eye protection - e.g. cotton wool over the eye
Advise length of paralysis
Review next day

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91
Q

Can you name 3 reasons for instrumentation of root canals

A
  1. Remove infected tissue
  2. Allow irrigant access to apex
  3. Make space for medicaments and obturation.
  4. Create an environment for periradicular healing
92
Q

Name 3 reasons why a file may serpearte

A

Flexural stress - repeated cyclic fatigue
Torsional stress - binding to canal wall
Complicated curved canal

93
Q

What is the thickness of shimstocl

A

8 microns

94
Q

What is the average biological wdith

A

Approx 2mm from alveolar crest to sulcus of gingivae

95
Q

Give 5 reasons why a patient with a newly placed composite may be experiencing sensitivity and pain on biting
A radiograph shows no pathology or caries

A

High in occlusion
Polymerisation contraction stress
Soggy bottom due to increments placed inn more than 2mm so inadequate curing depth
Cracked tooth syndrome
Deep restoration close to the pulp without a lining
Tooth prep irritated the pulp

96
Q

An amalgam has an overhang on its mesial surface - how could this have been avoided

A

Correct adaptation of a matrix band
Wedge
Adequate condensing of amaglam

97
Q

An amalgam has an overhang on its mesial surface - what issues can occur from an overhand

A

Plaque trap and food packing leading to secondary caries, gingivitis and periodontal disease
May also cause a fracture if in a thin section

98
Q

What are the two ways to manage an overhang

A

Replace - remove all and replace with a new restoration
Repair - if possible adjust the overhand

99
Q

Give 4 functions of a facebow

A

Used for mounting upper cast only
Transfers the relationship between the maxillary teeth and the axis of rotation from patient to articulator
Positions the upper cast vertically
Transfers the angulation of the maxillary occlusal plane in relation to horizontal reference plane

100
Q

Name 4 types of articulator

A

Simple hinge
Semi-adjustable
Fully adjustable
Average value

101
Q

Give three reasons as to why antieor guidance is proffered

A

Easier on patients musculature
Easier to reproduce
Posterior disocclsiuion - protecting posteior teeth and restorations

102
Q

Why is RMGI not good as a luting agnet

A

Contais HEMA which absorbs water and swells - it is also cytotoxic to the pulp

103
Q

What is the anterior reference point in a face bow representative of

A

Approximation of infra-orbital foramen

104
Q

How many mm is the anteior reference point in a face bow usually from the incisal edge of the 12

A

43mm

105
Q

What does a facebow record

A

The relationship of the maxilla to the hinge axis of the rotation of the mandible

Allows us to mount the mxilary casr

106
Q

What two cements can be used for all metal conventional bridgework

A

Aquacem - GI luting
RelyX - RMGIC luting

107
Q

What do we bond adhesive/resin retained/bridgework with

A

Panavia - dual cure resin cement

108
Q

Once a bridge has been cemented with panavia what else must we do

A

Apply oxyguard around the margins for 3 minutes
Panavia is an anaerobic cement so this allows it to set

109
Q

For an all ceramic restaotion what do we cement this w

A

Nexus - dual cure resin

110
Q

What is the proffered choice of Pontic and why

A

Modified ridge lap
This allows cleansibilty with maximum aesthics by overlying part of the ridge to minimic emergence of the Pontic from gingival tissues in a similar way to tooth

111
Q

Paitent is missing 22 and 23 - what problems might you face with function - 4 things

A

These teeth would be subject to heavy occlusal load
As the 3 is missing any protrusive movements would take a heavy load
RPD would pose a difficulty for masticating - cannot take the same forces as a natural denition
Speech would be impeded by a prosthesis

112
Q

Of all the people with missing teeth how many are missing primary teeth and how many are missing permanent

A

1% primary
6% permanent

113
Q

What would you see clinically in fluorosis

A

Diffuse molted appearnce
Pitting
Brown yellow discolouration

114
Q

4 affects of primary truama on permanent dentition

A

Enamel defects
Ankylosis
Delayed eruption
Failure to eruption
Dilarecaed root
Ectopic postion

115
Q

What is the ideal age range for interceptive ortho

A

10-13 years old

116
Q

Define clinical governance

A

A framework through which the nHS organisations are accountable to continuously improve quality of services and safeguard standards of care.

117
Q

3 divisions of NHS Scotland

A

Hospital dental service - consult advice and refferal of difficult cases

Public dental service - promote oral health of the public

General dental service - first point of contact for dental treatment

118
Q

What would make you say erson is the most likely cause of toothwear

A

Location of the tooth wear - Palatal of the upper anterior
Presentation of the teeth ; cupping defects
Loss of surface detail ;smooth glazed surfcae

119
Q

Other than replacement dentures state two other treatment methods which can be used by a dentist ro improve retention and stability in a loose complete denture

A

Relining the denture
Retained prosthesis - implants

120
Q

Name the 6 stages of principles of caries removal

A

Identify and remove carious enamel
Remove enamel to identify extent of caries at the ADJ and smooth enamel margins
Remove peripheral caries in dentine first ADJ and the deeper
Then remove deep caries over the pulp
Outline form modification
Internal design modification

121
Q

What does SIRS stand for

A

Systemtic inflammatory response syndrome

122
Q

Give 4 parameters of SIRS

A

Temp below 36 or above 38
Pulse over 90
Reps over 20
White cell count under 4000 or more 12

123
Q

Apart from site of a facial swelling give 4 other things thay could be concerning

A

Size
Colour
Teceture
Heat

Induration
Size
Pus
Palpation
Airway compromise

124
Q

6 signs and symptoms of a zygomatic fracture involving orbital floor

A

Peri-orbital ecchymosis
Numb lip
Aysmetry
Diplopia
Reduced visual activity
Subconjuctival haemorrhage

125
Q

What radiographs do u take to confirm a diagnosis of a zygomatic orbit fracture

A

Occipitomeatal radiograph at 10 and 30 degreees

126
Q

Fluconazole reacts with many drugs name 2 drugs that it could and the interaction it would have

A

Warfarin ; increases anticoagulation effect
Simvastatin ; risk of myopathy

127
Q

What tests would you carry out ever 3 months before giving carbamazepine

A

FBC; RBCS WBC platelets MCV and Hb
LFT ; urea and electrolytes

128
Q

When are three reasons you would opt for surgery in a paitent with trigeminal neuralgia

A

No improvement from medication and has been tried for a substantial period of time
Medication causing too many side affects
If the patient has stated they want surgery

129
Q

What are the two non pharmacological managements in trigemenal neuralgia

A

Micro vascular decompression
Gamma knife sterostatic

130
Q

4 medical conditions a child with Down syndrome more likely o have

A

Cardiac heart defect
Epilepsy
Thyroid problems
Autism

131
Q

What is dento-alveolar compensation

A

System that attempts to maintain normal interarch relationships
Often seen in class 3

132
Q

Define supernumary and name 4 types

A

Teeth that appear in Addition to the regular number of teeth

Conical
Odontome
Supplemental
Tuberculate q

133
Q

4 effects of supernumerary

A

Failure of eruption
Displacement of permanent tooth
Dentigerous cyst fromation
Crowding

134
Q

Name. 2 chloride releasing agents and what is there conc

A

Sodium hypochlorite
Sodium dichloroisocyanurate

10,000ppm

135
Q

How long would you leave the chlorine realising agents on a spillage

A

3-5mins

136
Q

What are the 6 stages in the chain of infection

A

Infectious agent
Resoviour
Portal of exit
Route of transmission
Portal of entry
Susceptible host

137
Q

What 4 things happen in postural hypotension

A

Fall in cardiac output
Poor venous return
Venous pooling in legs
Fall in stroke volume

138
Q

What are 4 advantages of IS over IV

A

Adults dont need an escort
Drug not metabolised
No cannulation
Rapid onset and rapid recovery

139
Q

List 5 safety features of the quantifiex IS machine

A

Colour coding between the O2 and NO
Oxygen flush button
Pin index
Scavenging mouthpiece
Resoviour bag

140
Q

Following HPT how long should you wait until reviewing the condition again and why

A

8 weeks
Most of the healing occurs at 4-6 weeks
Any sooner than 8 weeks you could disrupt the reattahment of the long junctional epithelium

141
Q

List 3 host evasion mechanisms of P.gingivlas

A

Biofilm formation
Gingipans - evasion of host cytokines
Induction of tissue destruction by MMP

142
Q

Describe the nature of the mutation in dentinogeneis imperfecta that leads to the condition

A

Autosomal type 1 collagen mutation

143
Q

Name 2 clinical and 2 Radiographical findings in dentinogenesis imperfecta

A

Radiograph ; abscess formation and pulpal obliteration

Clinical ; enamel lost very quickly both dentition affected

144
Q

Give 3 dental implacications of the use of a beclomethasone inhaler

A

Increased risk of infection due to local steroid deposits
Dry mouth
Increased caries risk
Angina boullosa haemorrhagica
Burning mouth syndrome

145
Q

What are3 risk factors for angina bullosa haemorrrhagica

A

Assoaction with the use of steroid inhalers without a nebuliser
Eating of rough foodstuff
Use of vey hot drinks

146
Q

What is the link between salbutamol and acid erosion of teeth

A

Salbutamol is acidic
Aerosols drys the mouth out so salvia can’t restore neutral Ph

147
Q

Describe two ways you could clinically diagnose a reduced OVD

A

Increased labial commissure folds
Decreased anterior face height

148
Q

Name three scenarios when splinting for mobile teeth is appropriate

A

When mobility is due to LoA
Causing difficulties eating
When they need to be stabilised for PMPR

149
Q

Why is there a decrease in mobility after supra and subgingival RDS

A

Increase in junctional epithelium
Collagen deposition increasing tissue tone
Decrease in inflammation

150
Q

What is a sevre complication of a zygomatic orbital fracture

A

Retrobulbar haemorrhage
If present treated with lateral canthotomy to decrease the pressure behind the eye

151
Q

What are 4 things we want to do before doing fixed pros for a patient

A

Eliminate any aetiology in a tooth wear case
Diagnostic was ups
Transitional denture
Impressions and study models
Crown lengneitng surgery

152
Q

Give 3 reasons an the cusp of an amalgam restoration may fracture

A

High in occlusion
Inadequate condensing of amalgam
Overhang

153
Q

No putty or study casts how do we temporally restore a indirect

A

Spot etch and n bond composite

154
Q

A patient with a burning mouth what else may they complain of

A

Psychological Isues
Altered taste
Dry mouth

155
Q

3 reasons from an MRI you might have trigeminal neuralia

A

Compression of the artery
Brain tumour
Skull deformity

156
Q

Why does a paitent need a blood test for carbamazepin

A

Liver function toxicity
Risk of apalastic anaemia

157
Q

Patient with TN gets it when washing his face in the morning why and 2 ways to change

A

This is because TN can be brought on from lightly touching the face in the a region of the trigmental nerve - it is triggered by innocuous touch.
2 changes - use warm, water not hot or cold
Avoid trigger zones

158
Q

5 ways to manage and identify a patients anxeity

A

Early appointment so not having to wait in waiting room
No visible instruments in surgey when they enter
MDAS questionnare
Longer appointment time
Realistic tx plan

159
Q

What is the name of a TAD and why is it better

A

Mini screw
Fixed position so there is fixed anchorage

160
Q

2 malocclusion features leading to marginal gingivitis

A

Anterior cross bite
Traumatic oB

161
Q

What is facebow used for

A

Used to record the relationship of the maxilla to the terminal hinge axis of rotation of mandible

162
Q

4 methods/mateirelas to help mount casts into ICP

A

Hand articulation
Bite registration
Was wafer
Record block

163
Q

Discoloured permanent incisor what are three treamtent options for this and what is a disadvantage for each

A

Microabrasion ; removes 100microns of enamel
Vital bleaching ; increased sensitivity and not permanent
Composite restoration; risk of staining and secondary caries

164
Q

4 perio treamtent outcomes to determine sucess

A

Less than 10% plaque
Less than 15% bleeding
No pockets more than 4mm
Pockets that are equal to 4mm no bleeding
Stable and comfortable dentition

165
Q

Swelling in LR6 with furcation involvement - what is your initial treatment?

A

Debridement of pocket to allow drainage - debridement to just shy of base of pocket
Oral hygiene instruction
CHX
Review
Completion of PMPR

166
Q

4 things that can affect where an infection spreads too

A

Thickness of bone
Location of tooth
Length of root
Muscle and fascia attachment

167
Q

What is the name of the seating postion in dentistry

A

Balanced postion

168
Q

Describe the operator and nurse postions

A

12-7 right hand operator
12- 2 static zone
2-4 - nurses zone
4-7 transfer zone

169
Q

What are 4 agents of bias

A

Blinding
Selection bias
Publication bias
Sequence generation

170
Q

What is a confidence internal

A

A range of plausible values rather than a single point estimate

171
Q

What is a risk ratio

A

Comparing the risk of the same outcome in differnt groups

172
Q

Name 4 factors to determine periodontal sucess

A

Furcation involvement
Mobility
PA pathology
Bone defects
Patient motivation and coooperation

173
Q

Paitent is requesting implants - what should you warn them of

A

Cost
Maintenance
Nature of surgery
Risk vs benefit

174
Q

5 questions to ask a patient about thier smokig

A

How long
How much
What do they smoke
Have they tried to quit
Are they interested in tryin

175
Q

2 medications that cause hyperplasia besides amlodipine

A

Cyclosporine - immunosuppressant
Nifedipine - Ca channel blocker
Phenytoin - anti-convulsant

176
Q

4 things to have a successful posteiror restoration

A

No occlusal interfence
No overhang
Cleansbale
Strong enough to withstand occlusal forces

177
Q

How do the landmarks listed help you prepare and obturate the canal
- apex
- apical constriction
- apical foramen

A

Apex - obturation should be completed within 2mm of apex
Apical constriction - master file goes to apical constriction
Apical foramen - file passed through apical foramen to create a glide path

178
Q

2 ways that the working length in endo can be measured without an apex locator

A

Estimation from PA radiograph
Tug back with master apical file

179
Q

2 ways an apex locator reading cna be affected

A

Curvature of the canal
Blockages in the canal

180
Q

Minimum thickness of a metal in RBB

A

0.7MM

181
Q

What monomer is used in panavia

A

10MDP

182
Q

What is oxyuguard gel and why is it important

A

It is an 02 inhibitor this is important as panavia is an anaerobic cement so by placing this around the margins for 3 mins following cememetation allows the material to set

183
Q

3 dental issues assoacted with class 3

A

Attrition
Mandibuar displacmet
Incising
TMD

184
Q

3 difficulties in using appliances in adults

A

Slow movement due to lack of growth
More likely to have periodontal disease
More likely to have a heavily restored dentition

185
Q

2 lines used as a guide for occlusal plane

A

Ala tragus
Interpupillary

186
Q

What’s the most important line when mounting a kaw reg

A

Midline

187
Q

4 things that can cause stress in dentistry

A

Paitent expectation
Time managment
Workload
Professional inadequacy

188
Q

3 ways to reduce exposure to risk that are diminishable

A

Know your skill set
Manage expectations
Time Managment

189
Q

3 ways to reduce risk that are unavoidable

A

Work life balance
Recognise stress
Communicate with colleagues

190
Q

7 marks to consent for an extraction

A

Options
Risk of having treatment
Risk of having no treatment
Cost
Complications
What to expect after
What treatment involves
Replacement options for tooth

191
Q

How can we reassure patients when they are being referred for a surgical

A

They will lift your gym and you may need stitches after
Same drill as for a filling and lots of water
You will feel pressure but not pain

192
Q

How do bisphosphonates wokr and what can they cause in a patient

A

MRONJ

Bisphosphonates are anti-restorptive medication - they inhibit the differentiation of osteoclasts which reduces bony turnover and therefore reduces healing capacty

193
Q

Target INR for warfarin

A

2-4

194
Q

How do you manage a paitent taking apixaban

A

Inform patient to miss their morning dose
Expect prolonged bleeding
Use local haemostatis measured
Advise patiet to take normal evening dose - no earlier than 4 hours following haemostatis. - the end of the appointment

195
Q

Major sociodemographic determinants for oral cancer

A

Low income
Poor eduction
Access to healthcare

196
Q

Behavioural risk factors for oral cacner

A

Smoking
High alcohol intake
Diet
Betel quid hewing

197
Q

What is an emerging factor for the need to differentiate between OPC and OC

A

HPV16

198
Q

What other mucous membranes foes MMP affect

A

Eyes and genital

199
Q

Two differential diagnosis for MMP

A

Bullous pemphigoid
PV

200
Q

8 questions to ask mum about primary herpetic gingivostomatisis

A

Have they been eating/ drinking - can they swallow

Do they have any siblings have they attend ed school

When did you first notice the lesions

Have the parents had any cold sores

Have this happened before - are there any known triggers

Are there lesions on the rest of the body

Does the child have any relevant MH

Do they have a fever

201
Q

Explain to mum the aetiology of primary herpetic gingivostomatitis

A

Common illness caused by the same virus that causes cold sore
It is self limiting and should go away on its own
It is transmitted by direct contACT

202
Q

4 points for advice and treatment to give for a child with primary herpetic gingivostomatitus

A

Keep them hydrated
Keep them off school as very contagious
Suck on ice cubes for relief
Analgesia advice

203
Q

Paitent presents again in 14 days - following primary herpetic gingivostomatitis what do u think it is and what treatment

A

Recurrent herpetic gingivostomatis

Treatment with aciclovir 200mg 1 tablet 5xdaily 5 days

204
Q

3 histological features of lichen planus

A

Basal cell liquidification
Hugging band of lymphocytes
Saw tooth rete pegs

205
Q

2prescription only meds for lichen planus

A

Beclomethasone 0.5mg per puff 2-4 daily
Betamethasone 0.5mg tablets dissolved in 1mg in 10ml water

206
Q

Dental complications and advice regarding inhaler use

A

Candida - local steriod deposits
Xerostomia ; mouth breathers
Caries ; due to dry mouth
Inhaler can cause reflux which can cause erosion

Inhaler
- use a spacer
- rinse after use

207
Q

What is the most reliable point to locate Canal orifices

A

ACJ

208
Q

How does the DAHL technique work

A

Composite on palatal surfaces of upper incisors and canines to prop open occlusion
This allows posterior teeth further erupt , creating an increase in OVD so no reduction of teeth needed to place build ups

209
Q

Why are PVS and alignaite good materials

A

Good flowability wetability and capture good surface detail

210
Q

What are two components of alginate

A

Sodium alginate and calcium sulphate

211
Q

What are the three ways to grade the oral cancer

A

Level of dysplasia
Mitotic figure
Invasion of other tissues

212
Q

Why do we consent someone for IV sedation at a different appointment

A

As once the patient has been sedated the consent is no longer valid and the amnesiac effects of Midazolam may mean they forget giving their consent on the same day

213
Q

What are three factors which influence displacement of a fracture

A

Magnitude of force
Mechanism of injury
Opposing occlsuion

214
Q

Why are severe class 2 and severe class 3 contraindicated in SDA

A

Less likely for their to be occlsuion pairs in a severe mallocclusion

215
Q

Why is periodontal disease a contraindication in SDA

A

Poor porngisis of teeth
Drifting of teeth under occlusal load
Loss of alveolar bone leading to compromised denture bearing area in long term

216
Q

What 4 faults can cause a RBB to debond

A

Poor moisture control during cementation
Unfavourable occlusion
Poor enamel quality
Inadequate coverage of abutment

217
Q

What histological presentation could indicate malignancy

A

Presence of dysplasia

218
Q

What clinical presentation would indicate malignancy - 6 marks

A

Exophytic
Raised rolled borders
Firm and indurated
Bleeding
Persisting for more than 3 weeks wiht no obvious cause

219
Q

What would you look at for individual teeth to determine poor prognosis - 5 marks ( perio related)

A

Pocket depth
Furcation involvement
Loss of attachment
Mobility
Caries

220
Q

What is a mandibualr displacement on closing

A

Discrepancy between arch widths meaning that teeth meet cusp to cusp so the mandible must deviate to one side to achieve ICP

221
Q

Why do we want to correct a mandibular displacement - 2 reason as

A

Can lead to TMJ Symtoms and can cause attritive wear

222
Q

How would you correct a bilateral posterior cross bite

A

Mid palatal screw on a URA to expand maxilla

223
Q

What three GI conditions can cause microcytic anaemia

A

Crohns
Ulcerative colitis
Coeliac

224
Q

What three oral conditions might anaemia be assoacted with

A

Candidosis
Dyaesthesia
Apthous ulcers

225
Q
A

PastPapers (5 decks)

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