General Exam question form last years - MCQ, EMQ, SAQ Flashcards

Question

What are water trees?

Answer 1

They are water channels in adhesive layer

Answer 2

It decreases tensile strength of CR and GIC

Answer 3

Polymerisation shrinkage

Answer 4

If history of epilepsy or seisures is present - please use a bite block on the patient 1. Stop dental treatment 2. Ensure patient is not in danger 3. Turn the patient to the side 4. Avoid restrainning 5. Wait until seizure stops 6. Maintain airways 7. Assess the patient 8. If still unconscious, call 000 and maintain airways

Answer 5

1. Greater bleeding tendency due to reduction in platalets 2. Hypertension due to extra blood volume 3.Anaemia 4.Drug intolerance - antibiotic and analgesics 5. Increased susceptibility to infections 6. Halitosis, burning sensation int eh mouth, uremic stomatitis, periodontal disease 7. Xerostomia 8. Impared healing Please consider collaborating with a nephrologis

Answer 6

Consider 1. Time of day for appointment 2. Duration of the appointment 3. Positioning of the patient 4. Pre-procedure preparation/action plan - e.g. ask the patient to bring their medication 5. Use of local anaesthetics 6. Medications - contraindications, toxicities, interaction 7. Caries risk 8. Perio risk 9. Xerostomia

Answer 7

1. If they are managed situational by an inhaler - they are probably okay 2. If they take medication - this may be a little more sus 3. If they have been hospitalised - maybe consult with tutor

Answer 8

Higher Blood glucose leads to advanced glycosylated end products (AGE) and free radicals which damage tissues - mostly on two levels Microvascular damage - think perio Macrovascular - think coronary artery disease and renal disease

Answer 9

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 10

1) The microorganism must be found in diseased but not healthy individuals; 2) The microorganism must be cultured from the diseased individual; 3) Inoculation of a healthy individual with the cultured microorganism must recapitulated the disease; 4) The microorganism must be re-isolated from the inoculated, diseased individual and matched to the original microorganism.

Answer 11

1. 3D structure of the extra-cellular matrix provide a site for adhesion 2. Provides water and nutrient channels 3. Provides protection from desication 4. Provides protection from host defences - think B-Lactam aggregation

Answer 12

S. Mutants

Answer 13

1. Leukodema 2. Leukoplakia 3. Lichen Planus 4. Frictional keratosis 5. Oral squamous cell carcinoma

Answer 14

1. Pyogenic granuloma 2. Haemangioma 3. Peripheral Giant Cell Granuloma 4. Erythroplakia 5. Oral squamous cell carcinoma

Answer 15

1. Oral melanotic macule 2. Mucosal melanocytic naevus 3. Amalgam tattoo 4. Malignant melanoma 5. Smokers melanosis

Answer 16

1. Haemangioma 2.Fibroepithelial polyp 3. Pyogenic granuloma 4. Peripheral giant cell granuloma 5. Calcifying fibroblastic granuloma

Answer 17

1. Herpetiform ampthous ulcer 2. Mild amthous ulcer 3. Major ampthous ulcer 4. Traumatic acute ulcer 5. Traumatic chronic ulcer

Answer 18

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 19

1. Photo-initiator - in a form of specific frequency of light (light cure or UV light) initiates the creation of free radicals within the composite material 2. The free radicals with an extra electron will bind with monomers in order to create a polymer - at the end of this process an electron is loss thus another free radical can be initiated 3. This continues when around 80% of resin is polymerised and 20% is not - this is important to allow addition of other composite resin 4. Over time, free radicals will combine - creating a stable compound

Answer 20

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

Answer 21

Amalgams last longer due to the hardness of the material - but if they fail they fail spectacularly

Answer 22

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 23

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 24

1. Deep cavity 2. No pulpal exposure 3. Removal of all infected dentine may result in pulpal exposure 4. No signs or symptoms of irreversible pulpits

Answer 25

CORONAL SEAL IS VITAL.

Answer 26

The varnish that is used is able to neutralise necrotic tissue and cause the deposition of tertiary dentine

Answer 27

Re-stiffen collagen tubules/structure

Answer 28

Coupling agent, act as intermediary which binds organic and inorganic components phases

Answer 29

A-delta fibre and sometime C fibres

Answer 30

Anterio-medially displaced disc

Answer 31

LHS IANB + long buccal nerve block

Answer 32

Medial pterygoid

Answer 33

Irreversible pulpitis

Answer 34

Fractured cusp

Answer 35

Maxillary sinusitis

Answer 36

Myofacial pain

Answer 37

Sjogren's syndrome - lack of saliva thus no transport

Answer 38

Exoprotease

Answer 39

Masseter and temporalis

Answer 40

Malleus and Incus - bonny ossifications of the ear canal

Answer 41

Means they are taller than 97% of the population

Answer 42

Prostoglanding

Answer 43

Strep bacteria

Answer 44

Actinomyces

Answer 45

Righat lateral pterygoid

Answer 46

Pyramidal process

Answer 47

Cranial Nerve XI

Answer 48

Active grinding

Answer 49

Active erosion

Answer 50

The full pyramid

Answer 51

Orange complex bacterium

Answer 52

Usually the green and small amount of orange complex bacterium

Answer 53

The red complex bacteria only

Answer 54

Erythrocytes

Answer 55

Glycosidase

Answer 56

Matrix metalloproteinases

Answer 57

IgA protease

Answer 58

Edge to edge

Answer 59

Retruded contact

Answer 60

Maximum protruded contact

Answer 61

Microleakage

Answer 62

Please dry the surface of the teeth before seating the tray

Answer 63

Tertiary dentine

Answer 64

Decrease the water temperature

Answer 65

Rubber dam isolates the tooth from the oral cavity and saliva and dehydrates the tooth, thereby changing its refractive index.

Answer 66

Styloid process of temporal bone (origin) & angle of mandible (insertion)

Answer 67

Inner aspect of the mandible

Answer 68

Medial/lingual surface of mandible

Answer 69

Muscle problems and TMJ internal derangement

Answer 70

Mesio-buccal cusp of upper 6 occludes mesial to the mesio-buccal groove of lower 6; significantly proclined central and lateral incisors

Answer 71

To relate the condyles to the maxillary arch

Answer 72

The teeth on the right hand side appear wider than the left

Answer 73

A-beta fibres

Answer 74

CGRP - calcitonin gene related peptide

Answer 75

Antidromic activation of nociceptors/sensory endings

Answer 76

Periodontal mechanoreceptors

Answer 77

Central sensitisation

Answer 78

Maxillary anterior teeth

Answer 79

1. Jaw opening 2. Jaw closing 3. Periodontal

Answer 80

Circumvallate

Answer 81

Periodontal mechanoreceptors

Answer 82

Through de nove and salvage and pathways

Answer 83

Inhibition of PEP/PTS

Answer 84

Release ammonia

Answer 85

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 86

Coxsackie viruses (type A)

Answer 87

Inappropriately packed restoration

Answer 88

Muscle Spindle receptors

Answer 89

Mesencephalic nucleus

Answer 90

1. Ask question about oral hygine - relevant history taking 2. Diet diary 3. Saliva tets 4. OPG and other readiographic test 5. Risk matrix or Traffic Light Matrix

Answer 91

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 92

DPR or OPG

Answer 93

OPG: when the object is outside of the focal trough (closer to the film). The calibration of the horizontal film plate produces an approximate 1:1 ratio to offset the inherent magnification. However this only works for objects in the focal trough. If you are too anterior, then you will have minimization of the actual object. This only occurs in the horizontal plane as there is only horizontal movement of the plate, and not vertical.

Answer 94

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 95

1. Mild (grade I) - dysplasia is in the first third of the pithelium 2. Moderate (grade II) - dysplasia entering the middle third of the epithelium 3. Severe (grade III) - dysplasia near the basal layer

Answer 96

An abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum.

Answer 97

It is an increased capacity of a cell to stain with dye; usually refers to staining of cell nuclei with hematoxylin.

Answer 98

Mitoses of cells that are just above the basal layer

Answer 99

Developmental - Oral White Spngey Naevus Inflammatory - Smokers keratosis Hyperplastic - Fibroepithelial Hyperplasia Degenerative - Chronic hyperplastic Candiasis Hormonal - / Neoplastic - Oral squamous cell carcinoma Idiopathic - Idiopathic lesion

Answer 100

Always think Oral Squamous Cell Carcinoma - send for biopsy

Answer 101

1. If there is any invasion of malignant epithelial cells - what is the nature of invasion 2. Any local tissue destruction 3. Potential spread to lymph nodes 4. Any distant metastasis 5. Any deeper structures involved

Answer 102

1. Poor resistance 2. Overcarving 3. Underpacking 4. Condensation error 5. Inappropriate use of burs on the material post restoration during polishing 6. Using the burs for gross reduction before the amlgam set

Answer 103

1. Electric pulp teest 2. COld test 3. Pariapical radiograph 4. DPR 5. Thermal test with hot water 6. Periodontal probing 7. Mobility 8. Tenderness on pulpation 9. Percussion 10. Local anaesthetic

Answer 104

I think a packable resin composite is appropriate because 1. Appropriate strength and resistance to fractures 2. There us enough tooth structure to bond to 3. Easier ability to provide future repair if any fracture occur

Answer 105

First obtain consent For this tooth specifically - apply Ziagel (5% lignocaine) in the labial area adjacent of 27 and 25, use Lignospan Special (2% lignocaine with 1:80000 adrenaline) in the labial area adjacent of 27 and 25 - 3/4 carpule at 25 and 1/4 carpule at 27 1. Prepare rubber dam for isolation from 27 to 23 - use the W3 damn with prior flossing through - please try the clamp on first 2. Take a shade before putting on the rubber dam - consult with the patient! 2. Put the rubber dam and do appropriate inversion 3. Access the cavity with an 838 or 822 diamond high speed bur 4. Clean the caries with slow speed bur of appropriate size 5. Use a caries disclosing solution 6. After caries is clean apply a sectional matrix appropriately 7. Use 37% orthophosphoric acid as an etch solution for 20-30 seconds or as recommended by the manufacturer and recent dental material research 8. Wash and dry very well 9. Apply the unfilled resin to the dentine and enamel - cure for 20 seconds every 2mm increments 10. Apply packable resin - cure for 20 seconds 11. Polish apropriatley

Answer 106

LHS inferior border of the orbit

Answer 107

LHS Condyle

Answer 108

Superimposed over the sinus, malar process

Answer 109

Pterygo-maxillary fissure

Answer 110

Condesnsing osteotitis around the 35

Answer 111

Zygomatic arch

Answer 112

LHS Inferior Alveolar Nerve Canal

Answer 113

Central Hyoid bone

Answer 114

RHS Styloid Process

Answer 115

RHS Maxillary Sinus

Answer 116

RHS Zygomatic Arch

Answer 117

Primary image of RHS hard palate

Answer 118

Secondary image of RHS palate

Answer 119

LHS External Acoustic Meatus

Answer 120

Genial tubuciles

Answer 121

Mandibular notch/oro-pheryngeal space

Answer 122

Nasal septum

Answer 123

Infra-orbital fissure

Answer 124

Nasal cavity/sinus

Answer 125

RHS Maxillary tuberosity

Answer 126

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

Answer 127

We always want to follow the ALARA principles. But if the concern is to understand the overall periodontal health or have an understanding of a specific lesion - you might consider to retake the image.

Answer 128

A ghost image occurs when the object or anatomic structure located between the X-ray source and the center of rotation and has a density that is sufficient to ettenuate the X-ray beams. This image subsequently presents the same morphology as the object, but with distortion, it appears on the opposite side and at a higher point than the corresponding real object and larger. An example is that maxillary sinus on the LHS a little above the the trueLHS sinus - which is actually the ghost image of the RHS sinus

Answer 129

In order to generate a ghost image - the object needs to be between the source of radiation and centre of rotation. The teeth re usually rotated between the centre of rotation and the rcepting plate at all times (that's how most of OPGs are designed and programmed)

Answer 130

Because of the negative nature of the angle at which the beam is pointed.

Answer 131

Developmental - Oral melanotic macule Inflammatory - Smoker melanosis Infective - Amalgam tattoo Hyperplastic - Mucsal melanocytic naevus Hormonal Neoplastic - Oral Squamous Cell Carcinoma, Malignant Melanoma

Answer 132

No response = non-vital pulp or false- negaitve

Answer 133

Mild response = normal pulpal health

Answer 134

Strong but brief response = reversible pulpitis

Answer 135

Strong but lingering = irreversible pulpitis

Answer 136

1. Calcified canals 2. Immature apex 3. trauma 4. Premedication of the patient

Answer 137

1. Prior to restorative dental treatment 2. Prior to root canal therapy 3. Following trauma to teeth 4. Prior to other dental treatment

Answer 138

1. Distance 2. Position 3. SHielding

Answer 139

1. Structures within the trough are relativley well defined int he final image 2. The closer a structure is to the centre of the trough the more sharply defined is the final image. The further, the blurrier.

Answer 140

Zone 1 - Nose and sinuses Zone 2 - Md Body Zone 3 - Articular Eminence, Condyle, Mx Tuberosities, Pterygo Mx Fissures, EAM, Cervical Spine Zone 4 - Epiglottis Zone 5 - Md Ramus and Spine Zone 6 - Dentition

Answer 141

Site Size Morphology Colour Cosnistency Texture

Answer 142

Sodium alginate forms a hydrogel former

Answer 143

It provide calcium ions

Answer 144

It controls working time - acts as a retarder of the rapid use of calcium within the reaction

Answer 145

1. When mixed with water, a cross-link polymer chain is formed, resulting in a three-dimensional network structure 2. Calcium sulphate dihydrate provides the Ca ions for the cross-linking reaction that the sol to a gel 3. In order to decrease the setting time, sodium phosphate is added, which acts as a retarder, decreasing the number of Ca ions available for cross linking 4. When a certain threshold of Ca ions have been achieved, the cross linking reaction fully sets

Answer 146

It is the loss of fluid within the alginate gel - this causes shrinkage

Answer 147

It is the loss of water from the surface of the alginate gel - this causes shrinkage

Answer 148

It is swelling of the alginate if immersed in water - this causes distortion

Answer 149

1. Alginate mix is homogenous and smooth - is it mixed well, is it too runny 2. Tray appropriate size - are all teeth included and past the tuberocity area 3. Alginate has had adequate time to be inserted into the mouth, seated onto the teeth and set prior to removal - is it seated on teeth correctly, has it set, has the material flown past the CEJ 4. Adequate amount of alginate in tray and the treay has been seated and muscled trimmed correctly - has muscle been trimmed, have the tongue been placed properly 5. Tray has been removed correctly

Answer 150

1. 2% Lignocaine with 1:80000 adrenaline (Lignospan special) 2. 3% Mepivicaine (Scandonest Plain) 3. 4% Articaine with 1:100000 adrenaline (Articadent)

Answer 151

They act as an antibacterial preservative?

Answer 152

They act as an anti-oxidant for the vasoconstrictor

Answer 153

1. Level - coronoid notch, 1 cm above lower occlusal plane, midway between arches with mouth wide open 2. Angle - opposite premoalrs 3. Entry point - pterygotempora depression - but this may be missing so rely on the palpation of the coronoid notch

Answer 154

1. Stop dental treatment 2. Elevate patient's legs to achieve a position where their head is lower than the heart. If patient is in dental chair, tilt the chair back to a horizontal angulation 3. Allow patient to recover slowly 4. Measure patient's blood pressure & heart rate

Answer 155

C - colour C - contour C - consistency T - texture E - exudate

Answer 156

1. Patient 2. CC 3. MHx 4. SHx 5. DHx 6. Exam

Answer 157

TRIM is an acronomy for: Timing Relevance Involvment Method

Answer 158

1. State what radigraph and side you are looking at 2. FDI: notatation with restorations and radioopacities 3. Pathology: radiolucencies, extent and causes

Answer 159

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 160

The posterior superior alveolar nerve

Answer 161

The middle superior alveolar nerve

Answer 162

The anterior superior alveolar nerve

Answer 163

1. If above the mylohyoid line, the infection would progress lingually, eroding the lingual cortical plate and entering the sublingual space. This will elevate the tongue and create diffuculties with breathing 2. If below the mylohyoid line, the infection would progress down into the submandibular space. This may causes swelling near the angle of the ,and able to potentially causing trismus and therefore diffuculties chewing..

Answer 164

1. Alternatives and all options for treatment 2. Information surrouding the nature and what the treatment involves 3. Risks of treatment 4. Pros and Cons of treatment and No intervention 5. Cost of treatment

Answer 165

1. Extend - localised or generalised depending on the BOP 2. Disease - gingivitis 3. Specification - biofilm induced, mediated by pregnancy or leukemia

Answer 166

1. Debridment under LA (removal of biofilm, calculus and necrotic tissues) 2. Local irrigation with chlorhexidine 0.2% 3. Antibiotic therapy - Metronidazole 400 mg orally, 12-hourly, 3-5days 4. Review and reffer when needed

Answer 167

1. Type of periodontal disease - periodontitis 2. Disease extent - generalised or localised 3. Stage - I, II, III, IV 4. Grade - A, B, C 5. Current disease status - stable, remission, unstable 6. Risk profile smoking, diabetes, etc E.g. Periodontitis; generalised, Stage III, Grade C, currently unstable. Risk factors: smoking 20cig/day

Answer 168

1. Deep cavity 2. No pulpal exposure 3. Removal of all infected dentine may result in pulpal exposure 4. No signs or symptoms of irreversible pulpits

Answer 169

CORONAL SEAL IS VITAL.

Answer 170

Cause: needle was positioned too far posteriorly & LA administered instead in the body of the parotid gland where facial and tympanic nerve run through Signs + sympotms: Facial paralysis, unilateral, drooping of eyelid and upper lip / corner of mouth Managment: 1. Tell patient this is temporary 2. Tell patient to not rub their eye 3. Cover the affected eye with eye patch 4. Keep under observation until better 5. No driving back home 6. IF not recovered in 12 hours - will need a medical review

Answer 171

Causes: Trauma to the muscles or blood vessels, often caused by withdrawing the needle through tissue distension Signs + symptoms: may present as a prologned spasm of the jaw muscles with limited or complete inability to open the mouth, or pain associated with mouth opening Managment: Usual improvement within 48-72 hurs with up to 6 weeks for complete recovery. Patient may seek heat therapy, wamr saline rinse, soft diet & jaw exercises.

Answer 172

Cause: It is usually self-inflicted injury by the aptient themselves; induced trauma or burn Sings + symptoms: May present as a soft tissue lesion, accompanied by localised pain and swelling. More noticeable once LA has worn off. Managment: Provide appropriate post-operative insructions. If sever, antibiotics may be prescribed to void infection. Warm saline rinses.

Answer 173

Cause: Intravascular administaton. Pathway: Inferior alveolar nerve into middle meningeal artery into opthalmic artery causing loss of vision Signs + Symptoms: Loss of vision a few minutes post IANB administration. Managment: Stop dental treaatment. Call 000 because patient needs to go to the emergency department. CPR if patient is unconcious.

Answer 174

Cause: Direct sensory nerve damage caused by the needle. Injecting too much LA at high concentrations. Haemorrhage from around/near the neural sheath put pressure on the nerve Signs + symptoms: paraesthesia will vary depending on structures involved - usually drooling, numbness, pins & needles. If damage to lingual nerve there can be altered taste sensation. Management: Paraesthesia resolves within approx 8 weeks, if above 8 weeks refer to oral surgeons. Reassure patient and reassess

Answer 175

Cause: Intravascular injection may cause an excitation of the cardiovascular system Signs + symptoms: Tachycardia, palpitations and headache Management: Typically only short in duration. Ensure to stop procedure and monitor the patient.

Answer 176

Cause: May be caused by physical trauma, an allergic response, haemorrhage or irritation Signs + symptoms: Present as a swelling tissues on the medial side of the ramus after deposition of LA Managment: Pressure and cold compress applied to the area for 3-5 minutes, acoompanied by warm saline rinse

Answer 177

Causes: 1) LA travelling down the brachial plexus (unlikely) 2) LA deposited too far back into the fascia surrounding pharyngeal muscles -> anaesthetised supraclavicular branch of cervical plexus that innervates ur traps -> arm numbness (more likely) Sing + symptoms: Tingling in the throat and trap Managment: Reassure patient it is temporary. Monitor. If the paraesthesia is persistent, need to get medical care.

Answer 178

1. Miller technique - two radiographs are taken at right angles to each other - good at determining the position of an impacted tooth 2. Tube shift - a slight shift of the tube is needed after the first radiograph (SLOB) to discern which root is which

Answer 179

It relates a patients maxillary arch to the intercondylar axis and the point orbital and enable these relationships to be transferred to an artiulator where this can be reproduced

Answer 180

1. Identify a tooth in question 2. Dry the tooth thoroughly and also try a tooth that you would use a base reading (maybe two) 3. Explain to the patient to indicate if they feel pain using their hand 4. Ask the DA to apply endofrost on a cotton bud while you retract the tissue over the tooth you going to use as base reading 5. Carefully, without touching soft tissue, place the cotton bud with endo frost on the tooth that is used as baseline 6. When the patient reacts, remove the cotton bud and ask how they feel - it should be "It felt cold but it went aaway fast" 7. Now move on to the tooth in question and repeat the procedure

Answer 181

1. Ensure the patient understands what the procedures entitles 2. identify the tooth of interest 3. Dry the tooth thoroughly and also try a tooth that you would use a base reading (maybe two) 4. Ask the patient to hold on to the lip clip for you 5. Ask the patient to indicate when they feel something by raising their hand up 6. Make sure that the light on the Electric pulp test is visible by operator, apply tooth paste to the tip of the EPT pen for conduction and begin conduction on the baseline tooth - carefully without touching the soft tissue and maintaining appropriate moisture control 7. When patient reacts, record the reading and move onto the tooth in question

Answer 182

1. Do normal steps of caries removal BUT do not remove all of the infected dentine 2. When try to remove as much infected as possible, slowly, preferably not using a power headpiece with leaving a small layer at the bottom of the cavity prep 3. Using RMGIC or GIC base cover the cavity, incrementally, ensuring THERE IS APPROPRIATLEY CORONAL SEAL 4. Reduce the RMGIC and replace with Resin 5. Tell the patient they might experience sesativity in the tooth, thus might needs to take some NSAIDS -recall in 3 months for re-examination if the tooth remains asymptomatic

Answer 183

Patient causes: panic attack due to hyperventilation and dental anxiety Operator: Intravascular injection Or Both at the same time

Answer 184

1. Let them know in advance 2. Use fast set alginate 3. Use warmer water 4. Use salt on the roof of the mouth 5. Add wax to the posterior of the tray 6. Ask the patient to lean forward to reduce flow to the back of the mouth 7. Get a vomit bag for the patient 8. TRY NOT TO REMOVE THE TRAY

Answer 185

1. Draining sinus 2. Non-responsive to sensibility test 3. Tenderness to percussion 4. Tooth mobility 5. Tenderness to apical palpation

Answer 186

1. Heart failure 2. Acute Myocardial Infraction 3. Hypertension - high blood pressure 4. Congenital Heart Disease - bacterial endocarditis 5. Arrhythmias - related to heart failure and blood thinners

Answer 187

1. Open communication about fears and concerns 2. Short appoitment 3. Mornign appoitment 4. Ensure profound local anaesthesia 5. Need to provide adequate post-operative pain control 6. Post-procedure telephone call

Answer 188

1. Inherited bleeding disorders - haemophilia 2. Anaemia 3. Leukemia or blood dyscrasias 4. Blood thinners

Answer 189

1. Asthma 2. Chronic obstructive airways disease 3. Tuberculosis 4. Sleep apnea or sleep disordered breathing

Answer 190

1. Stroke 2. Epilepsy, seizures and convulsions 3. Behavioral/psychiatric disorders

Answer 191

1. Diabetes - type I and type II 2. Thyroid disease - uncontrolled hyperthyroidism and stress sensativity

Answer 192

1. Kidney disease - abnormal drug metabolism 2. Sexually transmitted disease - HIV, Hep b and C

Answer 193

1. Arthritis - relating to TMJ and use of NSAIDS 2. Prosthetic joints

Answer 194

1. Tobacco and alcohol use 2. Drug addiction and substance abuse 3. Cancer treatment 4. Use of steroids 5. Pregnancy 6. Previous operations or hospitalisations

Answer 195

Any blood pressure where the systolic (first reading) is below 120 and diastolic (second reading) is below 80 e.g. 119/79

Answer 196

1. Stop treatment 2. Measure: blood pressure, heart rate and pulse oximetry 3. Assess consciousness 4. To relieve symptoms use glyceryl as instructed, call the registered nurse If patient reports pain to be THE WORST EVER DO: 1. Call 000 2. Give glyceryl to a patient with previous history of angina 3. Give aspiring 300 mg orally 4. Measure: blood pressure, heart rate and pulse oximetry 5. Start supplemental oxygen - call registered nurse 6. Provide reassurance 7. If patient loses consciousness - start DRSABCD protocol

Answer 197

Cardiac arrest is the stop of heart function. Signs: no pulse, loss of consciousnes and respiration Causes: ventricular tachycardia, ventricular fibrillation, asystole Managment: 1. Stop dental treatment 2. Call 000 3. DRSABCD

Answer 198

1. Moderate/mild: Saturation level of oxygen in blood abover 94% 2. Severe: Oxygen saturation of 90-94% Life-threatning: oxygen saturation of less than 90%

Answer 199

1. 4 puffs of slabutamol inhaler, 1 puff at a time, shaken before each puff 2. Ask the patient to take 4 breaths in and out of the spacer after each puff 3. Wait 4 minutes 4. If no imporvement - repeate 5. If no improvement again - define this as a sever or life-threatening attack

Answer 200

1. Call 000 2. Start oxygen and airway support 3. Salbutamol - 12 puffs for 6+ years, 6 puffs for less than 6 year olds 4. 1 puff at a time, 4 breaths in between 5. When waiting for help - perform the protocol every 20 minutes 6. If patient is worsening - continuously administer salbutamol

Answer 201

1. Call 000 2. Reassure the patient and ask them to relax, breete deeply and try to dislodge the object by coughing 3. If coughing is ineffective - give upto 5 back blows between the shoulder blades - check between each hit 4. If the back blows dont work, do 5 chest thrust similar to CPR 5. Continue until assistance arrives

Answer 202

1. Call 000 2. Inspect the back of the throat for foreign object 3. Start DRSABCD 4. Consider performing cricothyroidotomy 5. DO NOT DO THE HEIMLICH MANOEURVE

Answer 203

1. Stop dental treatment 2. Call 000 3. Measure: blood pressure, heart rate and pulse oximetry 4. Start oxygen and airway support 5. Monitor vital signs

Answer 204

If history of epilepsy or seisures is present - please use a bite block on the patient 1. Stop dental treatment 2. Ensure patient is not in danger 3. Turn the patient to the side 4. Avoid restrainning 5. Wait until seizure stops 6. Maintain airways 7. Assess the patient 8. If still unconscious, call 000 and maintain airways

Answer 205

1. Stop administratioe patchn of local anaesthetic 2. Explain what happened 3. Tell the patient to not rub their eye 4. Close the eye with an eye patch 5. Keep the patient under observation until the ability to blink starts to return 6. Advise patient not to drive 7. Phone the patient in 12 hours and make sure the issue resolved - if not refer for extra medical care

Answer 206

1. Stop dental treatment 2. Give 15 g of glucose or a similar drink or food 3. Measure blood glucose - if does not return to normal - repeat the dose 4. If after 3 doses normal blood sugar not returned - call for help 5. If unconscious call 000 than DRSABCD

Answer 207

Usually occurs in patient with hyperthyroidism or use of corticosteroids 6-12 hours after surgica; stress Managment: 1. Call 000 2. Give hydrocortisone 200 mg 3. Think about GIVING MORE STEROID BEFORE PROCEDURES

Answer 208

1. Stop dental treatment 2. Remove or stop administarion of the allergen 3. Refer for urgent medical attention; systemic corticosteroids may be indicated

Answer 209

1. Stop dental treatment 2. Remove or stop administration of the allergen 3. Call 000 4. Give intramuscular injection of adrenaline

Answer 210

1. Stop dental treatment 2. Remove or stop administration of the allergen 3. Lie patient flat 4. Give an intramuscular injection of adrenaline 5. Call 000 6. Start supplemental oxygen and airway support if needed 7. DRABCD 8. Repeat adrenaline every 5 minutes

Answer 211

1. Avoid treating if upper respiratory infection is present 2. Treat in upright chair position 3. Avoid rubber dam in sever disease 4. Use pulse oximetry in severe disease 5. Avoid nitrous oxide/oxygen inhalation sedation with sever COPD - in order to not reduce the respiratory drive 6. Avoid using narcoticts - in order to not reduce the respiratory drive 7. Consider using steroids before the appoitment

Answer 212

Thorough history is important - contact their respiratory physician about the stage of their disease and procautions that they need. If patient is confirmed free of disease than patient is safe to be treated as normal.

Answer 213

1. Obstructive sleep apnea 2. Central Sleep Apnea - lack of breathing as a result of lack of CNS respiratory drive

Answer 214

1. General measures - weight loss, exercise, nsala decongestants 2. Positive airway pressure machine 3. Oral appliances 4. Upper airway surgery - Powell-Riley protocol - ENT and maxilofacial surgery

Answer 215

The main purpose is to protrude the mandible forward (and the tongue) in order to reduce the airway restriction. Some association with TMD.

Answer 216

1. Incisional - small section of a lesion taken 2. Ecsitional - all of the lesion is taken

Answer 217

Cancerous 1. Fixed 2. Enlarged 3. Rubbery and hard 4. None-tender During an infection: 1. Can be rolled 2. Enlarged 3. Kinda soft

Answer 218

1. Greater bleeding tendency due to reduction in platalets 2. Hypertension due to extra blood volume 3.Anaemia 4.Drug intolerance - antibiotic and analgesics 5. Increased susceptibility to infections 6. Halitosis, burning sensation int eh mouth, uremic stomatitis, periodontal disease 7. Xerostomia 8. Impared healing Please consider collaborating with a nephrologis

Answer 219

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 220

1. Consultation with nephrologist 2. Platelet dysfunction and anaemia resulting in bleeding tendency should be discussed 3. Risk of adrenal crisis if they are teated with long standing corticosteroid therapy: morning appoitment and consider the need of supplemental steroids 4. Immunosuppression may require antibiotic prophylaxis prior to invasive dental procedures 5. Disturbances in removal of drugs: care is needed prior to prescribing analgesia or antibiotics 6. Gingival overgrowth as result of immunosuppressive drugs such as cyclosporin - also consider medication interactions If anything beyond a clean is needed - please consider sending them to a specialist such a special needs dentist or a OMFS.

Answer 221

Direct - the tooth surfae is preparred and the material is directly applied to it Indirect - restoration is prepared in a lab and only after inserted onto the desired tooth/teeth

Answer 222

1. Macromechanical (Amalgam) 2. Micromechanical (Resin) 3. Interfacial / chemical (Resin composite to ceramic) 4. Chemical (GIC)

Answer 223

1. Porcelain 2. Etched porcelain 3. Silane 4. Resin cement 5. Adhesive resin 6. Etched enamel This results in a continuous bonded layer with chemical and micromechanical bonding

Answer 224

1. Factors associated with the type and quality of the tooth structure (e.g. prismatic vs aprismatic enamel or secondary vs tertiary dentine) 2. Factors associated with cavity preparation (moisture, cavity size, smear layer, foundation of the bonding substrate) 3. Factors associated with restorative materials (etch concentration, patient factors, polymerisation shrinkage)

Answer 225

Aprismatic enamel usually occur on the outer enamel surface or permanent and deciduous teeth. It is irregular in organisation and does not have the same hexagonal structure of enamel rods. In a sense, aprismatic enamel is not harder to etch, it is harder to achieve an even etch in aprismatic enamel thus it is less likely to retain material using micro-mechanical retention.

Answer 226

It is a thin layer of tooth fragments and other materials that is formed during cavity preparation. It reduces the bonding ability.

Answer 227

1. Incomplete infiltration of primer into demineralized collagen 2. Long-term water sorption into the hybrid layer with HEMA based adhesives

Answer 228

1. Formation of water blisters at the resin/dentine interface 2. Semi-permeable membranes 3. Greater failure rates and poorer bonding strengths than etch-and-rinse adhesives

Answer 229

It is a condition characterised by short, sharp pain arising from exposed dentine in response to stimuli. Rapid onset of pain - can persist as dull, throbbing pain. Usually associated with deeper dentine because deeper dentine wider and more dense dentinal tubules.

Answer 230

Alpha fibres - short and sharp pain C fibres - dull, lingering pain

Answer 231

1. Carious dentine 2. Tooth fracture exposing dentine 3. Cracked tooth syndrome 4. Postoperative sensitibity 5. Traumatic occlusion 6. Marginal leakage with exposed dentine around the margins 7. Irreversible pulpitis 8. Vital bleaching

Answer 232

Desensitisation of the tooth with blocking of the dentinal tubules or reducing sensitivity of the pulp to stimulus.

Answer 233

1. Prevention - removing cuasative factors, address relevant histories 2. Management - tubule occlusion by adhesion of exogenous materials, modification of nerve excitability

Answer 234

1. Potassium Nitrate 2. Fuji bond LC 3. CPP-ACP, F or Stanous fluoride

Answer 235

Potassium nitrate is able to over-saturate the space outside the nerve cell membrane with positive potassium ions (K+) thus blocking the re-polarisation phase of the action potential, thereby blocking pain impulses.

Answer 236

1. Direct - resin, amaglam, liners and basis 2. Indirect - crowns, bridges, inlay, onlay

Answer 237

1. Inorganic phase - filler particles like glasses containing quartz or zirconia + barium or strontium for radiopacity 2. Organic pahse - BisGMA, UDMA and TEGDMA 3. Interfacial phase - silane coupling agent - essentially bind the organic and inorganic phases 4. Miscellaneous parts - like accelerators

Answer 238

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 239

1. Photo-initiator - in a form of specific frequency of light (light cure or UV light) initiates the creation of free radicals within the composite material 2. The free radicals with an extra electron will bind with monomers in order to create a polymer - at the end of this process an electron is loss thus another free radical can be initiated 3. This continues when around 80% of resin is polymerised and 20% is not - this is important to allow addition of other composite resin 4. Over time, free radicals will combine - creating a stable compound

Answer 240

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

Answer 241

Amalgams last longer due to the hardness of the material - but if they fail they fail spectacularly

Answer 242

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 243

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 244

1. Deep cavity 2. No pulpal exposure 3. Removal of all infected dentine may result in pulpal exposure 4. No signs or symptoms of irreversible pulpits

Answer 245

CORONAL SEAL IS VITAL.

Answer 246

The varnish that is used is able to neutralise necrotic tissue and cause the deposition of tertiary dentine

Answer 247

1. Receptors in the PDL 2. Receptors in alveolar mucosa 3. Receptors in gingiva 4. Receptors in periosteum of the jaw bone They inform about the external loading when for example we chew

Answer 248

1. Muscle spindles in mastictory muscles 2. TMJ spindles

Answer 249

They enable patients to detect new restoration which are high in occlusion

Answer 250

They function as pain receptors and proprioceptors. They may act as velocity detectors and static-position of the TMJ detectors.

Answer 251

Because during two-point discrimination test, the tongue can detect 2 distinct points at around 1.4mm distance between them. This sensitivity is related to tongue function and can be damped with local anaesthetics. Tongue is also very very sensitive to temperature changes especially o n the dorsum area.

Answer 252

It is a type of perception that occurs int eh absence of a functional periodontal mechanoreceptive input. The mechanoreceptors are derived from TMJ, muscles or periosteal mechanoreceptors. They provide mechanosensory infromation for oral kinaesthetic sensibility in relation to the jaw function and the contacts of artificial teeth.

Answer 253

It is the ability to recognise and discriminate forms. Oral stereognosis is the ability to feel depth and understanding of 3 dimentions of objects. Oral stereognosis can be used to measure oral functions. Oral stereognosis is influences by forms, size and surface characteristics of the test piece. Oral steregnosis is associated with health. Oral stergnosis is HIGHLY DEPENDENT ON PERIODONTAL MECHANO RECEPTORS. PULP IS NOT INVOLVED

Answer 254

1. Fast pain - sharp pain that is well localised and has a short duration - facilitate by A-delta fibres 2. Slow pain - aching, burning pain that is poorly localised and is long in duration - involves unmyelinated C fibres

Answer 255

it is belied that in some cases, injury that is detected by the receptor through orhodromic means, meaning due to the injury itself, may cause propogation of the action potential to other receptors thus causing the pain to intensify through Substance P release. Hot pulps: 1. In 'hot pulps' the pain from the lesion is able to causes antidromic activation though the stimulus thus releasing substance P and Calcitonin gene related peptide (CGRP) 2. Substance P is able to induce oedema formation through plasma extravasation and also cause mast cells degranulation, releasing histamines which activate more nociceptors 3. CGRP are able to cause aditional oedema through dilation of peripheral blood vessels 4. The increase in oedema causes an additional release of bradykinin which activates more nociceptors 5. Through this multi step process, patient has a large number of nociceptors released thus causing hyperlgesia meaning the action potential threshold is considerably lower

Answer 256

It relates to central sensitisation and neuroplasticity. Central sensitisation is process of shifting of the sensation by the central nervous system due to new stimuli. Neuroplasticity is a process in which the central nervous system may change it's ability to detect different stimuli. The adaptation to the new stimuli occurs first to central sensitisation and lead to the changes to the face sensorimotor cortex due to neuroplastic changes.

Answer 257

A-beta A-delta C unmyelinated fibres - close to the pulp

Answer 258

1. Anterior 2/3 of the tongue - nerve supply: Chorda tympani - VII 2. Posterior 1/3 of the tongue nd pharynx - nerve supply: Glossopharyngeal - IX 3. Anterior epiglotis and larynx - nerve supply: Vagus - X

Answer 259

1. Must be volatile 2. Must have sufficient water solubility 3. Must be lipid soluble ]4. Must have a minimal concentration and minimal time of exposure to be detected

Answer 260

Periodontal mechanoreceptors are ruffini type receptors that are within periodontal ligament. They regulate the forces applied by the teeth in occlusion and mastication. Response of the receptors vary ith the force applied to the tooth, but there is greater sensativity at low force levels. This allows the mechanoreceptors to aid patient with finding high spots on restorations

Answer 261

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 262

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 263

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 264

Blisters - Fuild filled masses: 1. Vesicle - upto 0.5cm 2. Bulla - more than 0.5cm 3. Pustule - pus of any size Non-blisters - not fluid filled elevations 1. Papule - upto 0.5cm 2. Nodule - from 0.5cm to 2 cm 3. Tumour - more than 2 cm 4. Plaque - more than 0.5cm but it is only clightly raised

Answer 265

Depressed: 1. Ulcer (epithelium lost) - if it is yellow tissue more likely to be an ulcer 2. Erosion (epithelium lost)/atrophy - if it is redness tissue more likely to be an erosion/atrophy Flat: 1. Macule - discoloration (freckel) 2. Patch - big discolouration

Answer 266

Use a small, transparent plate and apply pressure - if the lesion stars to blanch, it is most likely to be vascular

Answer 267

1. Haematoxylin and eosin 2. Periodic Acid-Shiff - used for fungal infection

Answer 268

It is mostly used for intraosseous pathology and fluctuant soft tissue pathology and neck masses

Answer 269

It is used to remove the core of some tissues - it is similar to scalpel biopsy but it has more complication than fine needle biopsy. Mostly used in biopsy in the abdomen but also can be used on a lymph node

Answer 270

1. If it is a fungul infection 2. If it is a bacterial infection - antibiotic infection may be needed 3. If it is a viral infection

Answer 271

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 272

1. Leukoedema 2. White Sponge Nevus 3. Epidermolysis Bullosa

Answer 273

It is a common developmental lesion of the oral mucosa. It is a variation of normal mucosa and it is more common in individuals with dark skin. Mainly in buccal mucosa It can be implicated by the use of tobacco or alcohol. They are asymptomatic, bilateral, poorly defined and it disappears when the mucosa is stretched or whipped with a gauze. Please consider not to stretched the attached gingiva!

Answer 274

It appears in the supperficial half of the epithelium. There are large vacuolated cells present with some Pyknotic nuclei. Epithelial hyperplasia present as well as long elongated rete pegs

Answer 275

It is a rare inherited condition. It is autosomal dominants trait and it is early onset. Majority of cases present with oral lesion, other mucosal surface may be affected. It is asymptomatic, diffuse, with white thickening and if irregular thickening

Answer 276

It appears in the superficial layer of the epithelium. Large vacuolated cells. Pyknotic nuclei and thickened parakeratin layer No dysplasia present

Answer 277

It is also known as geographic tongue - it is quite common and the aetiology is well known It is a result of loss (atrophy) of filiform papillae. Sometimes it can be sore but again not much can be done - if concerning please refer for biopsy

Answer 278

Numerous microabscesses in the surface of epithelium filled with neutrophils and lymphocytes

Answer 279

It is a condition with poorly understood aetiology and a result of increased length of filliform papilla. May be initiated by heavy smoking, atiobiotics and other. Usually asymptomatic. Increased number of chromogenic microorganisms thus a change in colour to usually darker one

Answer 280

1. Ensure the patient that this is not something pathological 2. Take a smear if needed

Answer 281

It is a localised vascular proliferation that may be congenital or arise later in life. Could be single or multiple and results in soft tissue lesions usually

Answer 282

1. Layer of epileium 2. Perforations of endothelial blood vessels and cells - forming capillaries

Answer 283

This is capillary haemangioma due to the small capillary vessels presence

Answer 284

This is cavernous haemangioma due to larger blood vessels present

Answer 285

This is a caliber persistent labial artery. It occurs when the inferior alveolar artery maintains it's size after leaving the mental forament and becomes superficial in the lower lip. It can present as a nodule. PLEASE PULPATE IT BECAUSE IT WILL PULSE

Answer 286

It is usually: 1. Symmetrical 2. Follows normal anatomy/tissue architecture 3. Commonly seen in the gingivae 4. Associated with increase melanin production

Answer 287

Oral melanotic macule or focal melanosis or an intraoral freckle It is a well demarcated, uniform in colour, asymptomatic and has the same consitency as the surrounding mucosa macule. Histologically it is related to increase melanin deposition. Sometimes can arise due to medication use specifically oral medications. Remeber macules DO NOT CHANGE OVER TIME

Answer 288

This iss a mucosal menocytic naevus. It is a rare oral cavity lesion or patch. It is bening proliferation of neaevus cells. The lesion is not neoplastic but is a hamartomatous lesion

Answer 289

This is a junctional naevus because is confined to the basal layer of the epithelium

Answer 290

This is intraomucosal naevus - because is is not in the epeithelium

Answer 291

This is an amalgam tattoo - it is associated with some of the amalgam being incorporate into the adjcent soft tissue over time. PLEASE LOOK AT AMALGAM NEAR BY. This lesion can grow but usually at a none alarming rate.

Answer 292

They are ectopic sebaceous glands that usually occur on the buccal mucosa - their instance increases with age. They are slightly elevated yellowish nodules. It arises due to the arisal of the tissue from the ectoderm during the embrio development

Answer 293

They are very similar to sebaceous glands

Answer 294

These are lingual tonsils. This is part of the lymphoid tissue (Welder's ring) that is used to fight infection. The lymphoid tissue underneath the folliate papilla goes through lymphoid hyperplasia (growth) and result in an elevation on the postra-lateral tongue surface.

Answer 295

This is lingual thyroid tissue

Answer 296

They are bony protuberances. Non-neoplastic. Possibly inherited Exotoses - multiple or single nodules at the buccal aspect of the alveolar bone

Answer 297

It is an increase in the size of a particular tissue by increase in cell number - it is reversible and stimulus dependent

Answer 298

It is an increase in the size of particular tissue by increase in cell size.

Answer 299

1. Senssile lesion - broad based lesion 2. Pedunculatedlesion - on a stalk - use a perioprobe to see if a lesion has a neck

Answer 300

1. Papillary - any small growth projectin into a cavity 2. Verrucous - warty surface appearance (small hyperkeratinised projections) 3. Epulis - lump on the gum non-neoplastic

Answer 301

It is a growth of fibrous connective tissue underneath an epithelium

Answer 302

It is a exophytic lesion. Site is a site of trauma Size is around 1-2mm upto 1cm Moprphology could be sessile or pedunculated Colour is similar to normal mucosa but could look inflamed Consistency could be soft to hard depending on the age of the fibrous tissue

Answer 303

Aetiology: Chronic physical trauma, cheek biting, irritation from broken teeth etc. Pathogenesis - cellular proliferation and production of cell product - predominantly connective tissue Treatment: Excision of the tissue and removal of the cause

Answer 304

It is a nodular overgowth that is associated with dentures and S.Candida infection. Associated with nodular hyperplasia in histological samples

Answer 305

It is a presented as a nodule appearance with chronic inflammatory cell infiltrate

Answer 306

This is fibroepithelial polyp. It is a localised fibroepithelial hyperplasia. Can occur anywhere but commonly sites prone to trauma. It is similar to the colour of the surroinding tissue but may appear a bit more inflammaed.

Answer 307

This is fibroepithelial polyp. It is a localised fibroepithelial hyperplasia. Can occur anywhere but commonly sites prone to trauma.

Answer 308

It is an overlying epithelium - hyperplastic or atopic or normal. Bulk lesion is made up of densely collagenous fibrous connective tissue. MAY OCCUR WITH OSSIFICATION

Answer 309

Aetiology: chronic physical trauma and inflammation Treatment: Excision

Answer 310

Aetiology: chronic physical trauma and inflammation Treatment: Excision

Answer 311

This is pyogenic granuloma. It is a localised soft tissue lesion that is common in people who are pregnant due to the hormone imbalance. Site: Anywhere but classically arises from the interdental papilla

Answer 312

Usually sensile Sudden onset and rapid growth Bright red and haemorrhagic, ulcerated surface. Tissue may mature thus becomes fibrosed

Answer 313

Usually sensile Sudden onset and rapid growth Bright red and haemorrhagic, ulcerated surface. Tissue may mature thus becomes fibrosed

Answer 314

Many lesions are made up of exuberant granulation tissue. It is a very vascular lesion with large numbers of thin walled dilated blood vessels lined by endothelial cells

Answer 315

Excision and removal of causative factors

Answer 316

It is a similar lesion to the pyogenic granuloma but it also involves bone tissue

Answer 317

It is a well vascularised cellular tissue with mononuclear cells. If you see multinucleadted diant cells - probs a peripheral giant cell granuloma

Answer 318

It is important to determine that the lesion is not an intra-bony or central lesion which has perforated cortical bone

Answer 319

It is a relatively common oral lesion. Presents as localised lesion of gingiva like fibrous epulis and pyogenic granuloma. Clinical features: 1. Painless 2. Relatively rapid growth 3. Size usually less than 1 cm 4. Sometimes - surface ulceration

Answer 320

It is a very cellular lesion - well vascularised and collagenous. IT CONTAINS CALCIFICATIONS.

Answer 321

They are lesion that occur due to underlying factors such as plaque or use of certain medications such as hypertension medication (calcium channel blockers) or anti-covulsants or immunosupresants. Drug Induced Gingival Overgrowth is one of them

Answer 322

It is a lesion occurring on the buccal mucosa as a result of a local mechanical trauma

Answer 323

It is cheek biting which causes chronic mechanical trauma. Clinical presentation is a unilateral or bilateral white patch on the buccal mucosa, which is rough and whitenned. Usually symptomless

Answer 324

1. Control of habit 2. Might need to treat the underlying stress

Answer 325

It is similar to the cheek biting and linea alba but usually occurs on commonly traumatised sites such as the lips, lateral border of the tongue, buccal mucosa, edentulous alveolar ridge. Appears as a poorly demarcated white lesion.

Answer 326

Histological features: 1. Hyperkeratosis 2. No dysplastic changes Management: 1. Identify and try and remove a cause - might be difficult with edentulous patients 2. Always biopsy if in doubt :)

Answer 327

It is a diffused, white, moderately thickened palate that can be sometimes roughened. It usually involves the entire palate with characteristic, red, minor salivary gland dots. Associated with tobacco smoking, especially reverse smoking.

Answer 328

Hyperkeratosis is common. Thickening of stratum spinosum (prickle cell layer)

Answer 329

This chronic hyperplastic candidiasis. It is usually a single, fixed, white or mix of white and red patch that syays when whipped. May occur anywhere but common sites are the tongue and buccal mucosa.

Answer 330

Thickening large bulbus epithelial with keratinisation

Answer 331

1. Squamous papillomas/Oral warts - EXCISE MIGHT BE MALIGNANT 2. Condyloma accuminatum - EXCISE MIGHT BE INFECTIOUS 3. Focal epithelial hyperpklasia

Answer 332

The main difference between giant cell fibroma is the Giant Stellate Cells rather than the osteoclast like cells. The clinical features are similar: small, raised, pedunculated lesion that is asymptomatic

Answer 333

usually surgical excision. The reoccurance of giant cell fibroma is relativley rare

Answer 334

It is a lesion thatoccurs due to the damage of a nerve trunk following some sort of injury (like surgery or pressure on dentures). Essenially - the repair of the axon does not go as planned and the lesion if fully comprised of the neural tissue. Clinical features: small swelling or nodule on mucosa near mental foramen, alveolar ridge, lips or tongue. Pressure on the nodule cuases pain

Answer 335

Histopathology: Presents as a mass of irregular bundle situated in variable amount of connective tissue stroma. Treatment: surgical excision

Answer 336

This is verruciform xanthoma, it is a rare lesion that mimic squamous cell carcinoma. It is flat, velvety, pebbly.

Answer 337

It is usually associated with foamy, lipid filled marophages. The lesion is bening

Answer 338

An ulcer is the loss of contnues of epithelial linings and some fo the connective tissue. It is associated with colour yellow.

Answer 339

1. Border 2. Depression

Answer 340

1. Long-standing ulcers with no obvious cause 2. Indurated (hard) borders - PLEASE PALPATE 3. Deep ulcers with rolled borders 4. Ulcer that is fixed to underlying tissues - usually ulcers are mobile 5. Painless ulcer 6. Ulcers associated with lymphadenopathy - if there is a large swelling - EMERGENCY

Answer 341

1. Reactive lesions 2. Developmental 3. Inflammatory/immunologic 4. Infective 5. neoplastic 6. Idiopathic

Answer 342

It is a type of ulceration from mechanical, chemical, thermal and radiation injury. Please recall the patient in 2 weeks and during the session try to remove the cause.

Answer 343

1. Acute traumatic lesions - a lot of pain, surface covered by yellow fibrinous exudate and halo border 2. Chronic traumatic lesions - minimal pain, elevated margins, fibroepithelial hyperplasia, epithelial hyperkeratosis, induration

Answer 344

It is a bening chronic ulcer usually presenting on the tongue. It is crateriform in shape.

Answer 345

Eosinophilic ulcers are usually associated with an abnormal presentation of eosinophils thus it is important to send a biopsy sample of the ulcer for histopathological investigation to ensure it is not malignant

Answer 346

This is a minor aphthous ulcer - which one of the most common ulcer of infectious origin. It usually occurs in non-keratinised mucosa, it is shallow and rounded. It has erythematous margins and yellowish floor

Answer 347

This is a major Aphthous Ulcer - an uncommon ulcer of infectious origin. It is usually very large and can involve keratinised mucosa. This need to be reffer for biopsy because this could be a melignancy.

Answer 348

This is Herpetiform aphthous ulvers - it is an uncommon and are very very small. Named herpetiform due to the resemblance of the ulcers to those of herpetic stomatitis ONLY OCCURS ON NONE-KERATINISED TISSUES

Answer 349

1. Accurate diagnosis 2. Symptomatic treatment 3. Steroid

Answer 350

1. Diffuse lip swelling 2. Coble stone thickening of the mucosa 3. Ulcers

Answer 351

It is the atrophy of the lingual papilla

Answer 352

1. Viral disease 2. Fungal disease 3. Bacterial disease

Answer 353

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 354

This is cancrum oris (noma) - it is a destructive condition involving oral soft tissues and jawbone. Usually associated with children who are malnourished and have lower immunity due to systemic infections. Thought to arise from NG

Answer 355

This is actinomyces - an infection characterised by multiple foci of chronic suppuration. Patient present with firm swelling commonly in the submandibular region with variable pain symptoms. Treatment: prologned antimicrobial treatment after cultures

Answer 356

1. Chronic granulomatous inflammation surrounded by abundant granulation tissue and fibrosis 2. Granules consisting of tangled meshes of organisms may be seen

Answer 357

It is a sexually transmitted disease that is cause by T. Pallidum Two common types 1. Congenital 2. Aquired

Answer 358

1. Notched permanent incisors 2. Hypoplastic first molars 3. Saddle bone deformity

Answer 359

It is a chancre - which occurs at the site of primary inoculation 3-4 weeks after infection. Lesions are high infectious - be careful! Heals naturally

Answer 360

They are usually described as some mucous patch, rash or condyloma lactum. Usually occur 6-8 weeks after primary stage. Still infectious - please be careful

Answer 361

They are called Gumma - they usually involve the hard palate perfiration or syphilitic glossitis

Answer 362

Mulitlobular ulcerated growth due to immundeficency - histologically it is associated with granuloma inflammation.

Answer 363

Nodular mucosa lesions are present in 20-60% of the patient

Answer 364

Local factors: - Poor denture hygiene -Reduced vertical dimension -Reduced salivary flow Systemic factors: -Extreme of age -Endocrine disturbances -Malnutrition -Antibiotic therapy

Answer 365

1. Acute: - Atrophic (denture or antiotic-associated) - Pseudomembranous condidosis - thrush 2. Chronic -Atrophic -Hyperpastic 3. Mucocutaneous - Usually T cell deficiency

Answer 366

It is a generalised, red focal area of red/inflamed oralmucosa. This condition has no other specific symptoms other than pain. Management: -Correct diagnosis -Oral denture hygiene -Antifungal agents

Answer 367

it is most common type of acute candidiasis. This is a lesion/lesions that is associated with soft, white/yellow plaque that can be lifted off the mucosa. These plaques represent inflammatory exudate, dead cells and fungal colonies

Answer 368

1. Base your diagnosis on oral features and cytology smear 2. Managment depedns on sverity of symptoms and predisposing factors: - for simple case - antibiotic therapy, topical antifungal agents and oral hygiene instructions - for a complex case e.g. patient with immunosuppression - medical consultation and topical/systemic antifungal agents

Answer 369

Chronic Atrophic Candidosis - is a non-specific red area in the mouth. Some of the example of it is angular cheilitis Take a smear.

Answer 370

It is lesion/lesions that may occur anywere but are common to the tongue and buccal mucosa. Present as white or mixed white/red patches or plaques on the mucosa. THIS LESION CAN RESEMBLE OTHER PATHOLOGY - like lichen planus or early squamous cell cercinoma biopsy and re-biopsy after antifungal treatment

Answer 371

1. Fungal infections 2. Bacterial infections 3. Viral infections

Answer 372

Miconazole 2% gel 2.5 mL topically (then swallowed), 4 times daily, after food, for 7 to 14 days; continue treatment for at least 7 days after symptoms resolve - NO WOFERIN Or Amphotericin B 10 mg lozenge sucked (then swallowed),4 times daily, 7 to 14 days; continue treatment 2 to 3 days after resolved

Answer 373

Miconazole 2% gel 2.5 mL topically (then swallowed), 4 times daily, after food, for 14 days; continue treatment for at least 14 days after symptoms resolve - NO WOFERIN or Chlorimazole 1% cream topically to the angles of the mouth, twice daily for at least 14 days; continue treatment for 14 days after symptoms resolve

Answer 374

1. Herpes labialis 2. HPV 3. HIV 4. Hep C

Answer 375

It is a widespread vesicular eruption involving skin, vermillion and mucosa. It results in painful widespread infection that can be observed in the photo. It is associated with young children or older adult who are immunocomprimised

Answer 376

It is a vesicular eruption affecting perioral skin, lips, gignivae and palate - knowns as harpes labialis

Answer 377

1. Intraepitheial vesicle formation - aka acantholysis 2. The vesicles contain inflammatory cells and exudate 3. Destruction of epithelial cells

Answer 378

It is also known as chicken pox! It is a vesicular infection that migh have some oral mucosal involvement

Answer 379

It leads to shingles. Shingles may result in oral manifestations like vesicular lesiosn aorund the oral cavity.

Answer 380

A dermatome is an area of sking that is associated with a root of a single neural connection to the spine or orofacial (cranial) nerves

Answer 381

It is a oral manifestation that relates to the Epstein Barr Virus and is associated with HIV invection

Answer 382

1. Hand-foot-and-mouth disease 2. Herpangina Both are self limiting infections that effect children more than the adults

Answer 383

Systemic symptoms such as fever and enlarged tender lymph nodes.

Answer 384

True herpes infections come with systemic symptoms herpetiform does not

Answer 385

Tumour - means swelling above the size of 2cm.

Answer 386

Neoplasm - is a tumour that does not stop growing

Answer 387

1. Bening tumours have the suffix "...oma" 2. Melignant tumours: - Epithelial tumours are "carcinoma" - Mesenchymal tumour have a suffic "...sarcoma" The exeptions are: melanoma and lymphoma which are both malignant

Answer 388

Most of them arise from fibropepithelials polyps and fibroepithelial hyperplasia

Answer 389

It is a clinical presentation that carry a risk of cancer development in the oral cavity whether in a clinically definable precursor lesion or in clincally normal oral mucosa.

Answer 390

1. Tobacco 2. Alcohol 3. Betel-quid (tobaco in a different form) - bucal sulcus

Answer 391

1. Normal mucosa 2. Thin, smooth leukplakia 3. Thick, fissured, leukoplakia 4. Granular, verruciform leukoplakia 5. Red tissue - erytholeukoplakia

Answer 392

It is a predominantly white plaque of questionable risk having excluded other known diseases or disorders that carry no increased risk of cancer

Answer 393

Proliferative verrucous leukoplakia is a progressive, persistent and irreversible disorder characterized by the presence of multiple leukoplakia that frequently become warty.

Answer 394

Erythroplakia is a predominantly fiery red patch that cannot be characterized clinically or pathologically as any other definable disease

Answer 395

A lichen Planus is a chronic inflammatory disorder of uknown etiology with characteristis relapses and remissions, displaying white reticular lesions, accompanied or not by atrophic, erosive and ulcerative and/or plaque type areas. Lesion are frequently bilaterally symmetrical. Desquamative gingivitis may be a feature.

Answer 396

This is an oral lichenoid lesion - which is similar to oral lichen planus but is usually around a single site. Usually associated with medications and go away when medication is stopped

Answer 397

It is the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer.

Answer 398

1. Drop shaped rete pegs 2. Irregular eppithelial stratification 3. Loss of polarity in basal cells 4. Increased number of mitotic figures 5. SUPERFICIAL MITOSES

Answer 399

1. Nuclear pleomorphism 2.Cellular pleomorphism 3. Increased nuclear size

Answer 400

1. Mild (grade I) - dysplasia is in the first third of the pithelium 2. Moderate (grade II) - dysplasia entering the middle third of the epithelium 3. Severe (grade III) - dysplasia near the basal layer

Answer 401

It is when dysplasia that has been only registered in one layer of the tissue but is through out the whole layer - the epithelium have not yet created island in the connective tissue below thus the basal layer has not yet been breached

Answer 402

1. Observation: - Mangaing lifestyle risk factors - Regular follow-ups -Clinical risk assessment Excision - Cold-knife excision - Cryosurgery - CO2 laser ablation - Photodynamic therapy

Answer 403

90% of the oral malignancies are from the oral mucosa and are squamous cell carcinomas

Answer 404

It is a carcinoma with a squamous differentiation arising from the mucosal epithelium

Answer 405

1. Tobacco 2. Alcohol 3. Betel-quid (tobaco in a different form) - bucal sulcus 4. Human Papillomavirus (HPV) types 16 and 18 5. Ultraviolet radiation

Answer 406

1. Loss of cell cycle control through loss of apoptosis proteins (p53) and up regulation of proliferation proteins - cell communication occurs 2. Invasion and metastasis - through breach of basement membrane and over expression of oncogenic enzymes - metastasis could be distant

Answer 407

RULE acronym: 1. Red/white 2.Ulcer 3.Lump Exceeding 3 weeks in duration

Answer 408

1. Non-healing extraction socket 2. Pigemented lesion (melanoma) with irregular borders

Answer 409

1. Invasion of malignant epithelial 2. Localised tissue destruction like bone erosion - floating tooth on the radiograph (primary intraosennous carcinoma 3. Spread to the lymphatic system 4. Distant metastasis

Answer 410

It is a process of examining the degree of differentiation of cells Grade 1 - well differentiated squamous cell carcinoma Grade 2 - moderately differentiated squamous cell carcinoma Grade 3 - Poorly differentiated squamous cell carcinoma Grade 4 - anaplastic - fucked The greater the grade the worst a prognosis

Answer 411

1. Direct extension into adjacent tissue 2. Perineural infiltration 3. Vascular invasion 4. Lymphatics

Answer 412

Based on TNM system T is size N is invasion of surrounding tissue M is distant malignancies Minimum is Stage 1: T1N0M0 Max Stage 4 : Any M

Answer 413

Stage 1 and 2 - around 50% over 5 years Stage 3 - 15-20% over 5 years Stage 4 - less than 5% over 5 years

Answer 414

1. Initial diagnosis 2. Definitive treatment 3. Management of complications and monitoring

Answer 415

1. Surgery 2. Radiotherapy 3. Chemotherapy 4. Combination of treatments above

Answer 416

1. Detection of potentially problematic lesions and referral 2. Management role - for any other oral concern, including complications from treatment of oral cancer 3. Ongoing screening

Answer 417

1. Loss or atrophy of acini 2. Inflammation 3. FIbrosis 4. Dilation of ducts

Answer 418

1. Endarteritis obliterans - destruction of blood vessels thus making the tissue depleted of oxygen and nutrients 2. Osteonecrosis 3. Infection and pain 4. Can be potentially life threatnening

Answer 419

1. Apthous ulcers 2. Herpex simplex lesions 3. Trauma associated lesions 4. Migratory glossitis 5. Candidiasis infection lesions

Answer 420

It is a process where multiple granulomas can be seen in the oral cavity. Associated with: Crohn's disease Leprosie TB

Answer 421

Squamous papilloma. An asymptomatic, solitary lesion that is associated with cauliflower like apperance

Answer 422

Exaggerated growth of usually parakeratinsed benign squamous epithelium. Finger-like projections of epithelium with central cres of fibrovascular tissue

Answer 423

Sometimes HPV can playe a role in oropharyngeal carcinoma - which is a basaloid subtype of squamous cell carcinoma.

Answer 424

Genital warts in the mouth or Oral Condyloma Accuminatum. It is an infections lesion that can cause transmission through direct contact. It presents as a broad based pink nodule that grows and coalesce (come as one)

Answer 425

1. Non-Hodgkin lymphoma 2. Hodgkin lymphoma

Answer 426

Large ulceration, swelling, pain, paraesthesia and losse teeth Aetiology is unknowns

Answer 427

They have a defused appearance

Answer 428

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 429

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 430

A. Actinomycetemcomitans or AA is a gram negative anaerobe that is associated with localised aggressive periodontitis. Able to produce high level os leukotoxins thus causes the lysis of PMNs. It is equiped with adhesis and invasisn which means it can penetrate the tissue and attach to the space it has penetrated

Answer 431

P. Gingivalis is a gram negative anaerob that is associated with periodontits (around 79-90% of perio cases will have this bacteria) Main cause of the inflammation to the tissue - release of endotoxin (name: P.Gingivalis LPS) Contains invasins, adhesins and also collagenases which degrade connective tissue.

Answer 432

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 433

It is widely believed that periodontal destruction occurs due to effects of the immune response and not directly due to bacteria. 80 immune response, 20 bacteria.

Answer 434

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 435

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 436

Any factor that result in retention of biofilm or prevents ts removal thus predisposing for disease progression. E.g.: Anatomical factors: root proximity, tooth malposition, concavities and furcation Aquired/Iatrogenic factors: overhangs, open contacts and appliances All this needs to happen in a susceptible host.

Answer 437

They are factors that modify disease expression and may influence disease progression by altering host's immune response e.g. in periodontitis: smoking and diabetes

Answer 438

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 439

1. Regular smokers have around 50% less improvement in clinical parameter after nonsurgical therapy 2. Regular smoker have 2x implant failure rate compared to nonsmokers

Answer 440

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 441

There is a bi-directional relationship between diabetes and periodontitis, meaning improvement in diabetes improve periodontitis but also improvement in periodontitis improve diabetes!

Answer 442

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 443

1. 10-15% resist periodontitis 2. 10-15% have rapid progression 3. 70-80% have moderate progression

Answer 444

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 445

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 446

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 447

They are some relatively common systemic conditions that have a moderate impact on prevalence / severity of priodontitis. These diseases usually have an influence on the parthenogenesis of periodontal disease. Some of these disease and disorders are: 1. Diabetes 2. Obesity 3. Osteoporosis 4. Arthritis - could through are process of inflammatory aggravation called citrulination 5. Stress and depression 6. Hypertension - maybe but probably not - but people with perio are more likely to have hypertension

Answer 448

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 449

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 450

Periodontitis and diabetes have a bilateral relationship thus an improvement in one of them may result in improvement of the other The process of periodontitis affecting diabetes: 1. Periodontal infection causes elevation of serum pro-inflammatory cytokines 2. Systemic inflammation leads to insulin resistance by blocking insulin receptors 3. Bacterial dissemination may alter b cell secretion through b-cell dedifferentiation - also enzymes produced by P.Gingivalis may reduce glucose-induced insulin production 4. There are also some evidence that P.Gingivalis may cause gut dysbiosis but take it with a grain of salt

Answer 451

You should do non-surgical treatment ad collaborate with GP and inform patient that perio help with diabtes

Answer 452

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

Answer 453

Only teeth with hopeless prognosis and that are not favourable

Answer 454

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

Answer 455

It is when the periodontal status of the tooth can be stabilised with comprehensive periodontal treatment and periodontal maintenance. Future loss of periodontal supporting tissue in unlikely.

Answer 456

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 457

1. Initial therapy 2. Revaluation or reassessment of prognosis 3. Surgical or maintenance phase

Answer 458

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 459

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 460

Yes you would if they have an underlying health condition.

Answer 461

The objective is to achieve clean and infection free conditions for the oral environment by removal of soft and hard deposits and any retentive points and factors that might propagate them

Answer 462

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 463

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 464

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

Answer 465

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 466

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

Answer 467

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 468

1. Periodontitis 2. Endodontic infection 3. Iatrogenic - rct perforation 4. Anatomy - like enamel pearls

Answer 469

1. Improved access for professional instrumentation 2. More efficient calculus removal 3. Significant clinical improvements

Answer 470

Tunneling technique - surgical exposure of inter-radicular space. Most common complication - root caries. Root resection - for a patient with RCT and class 3 furcation

Answer 471

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 472

1. Treat the cause 2.Periodontal surgery 3.Splinting - remember to adjust the occlusion

Answer 473

1. Local - to the site 2. Systemic - through the blood stream

Answer 474

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 475

Metronidazol & amoxicillin which is known as Winkelhoff cocktail - it is the most researched combination and also does produce clinically significant improvements

Answer 476

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

Answer 477

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 478

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 479

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 480

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 481

1. Patient greeting and interview 2. Review of medicla history 3. Existing factors evaluation and counselling 4, Clinical examination and re-evaluation: Oral Path, OH status, Perio exam, Caries check, fix-pros check 5. Hygiene 6. Motivation 7. ALWAYS BOOK ANOTHER APPOINTMENT

Answer 482

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 483

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 484

The bacterial shift that associated with periodontitis is a shift from facultative gram positive bacteria to anaerobic gram negative bacteria. It is important to state that this shift is seen in cultivable gingival micro-flora meaning this statistic is only understood in lab grown bacteria. The level of cultivated bacteria also explain why gingivitis is considered a transitional stages, because in gingivits it can be seen that the bacterial makeup is relatively equal.

Answer 485

1. P. Gingivalis 2. T. denticola 3. T. Farsythia 4. A. Actinomycetemcomitans And more but 75% of them are gram negative and nearly all are strict anaerobes

Answer 486

1. Attachemnt - cell surface through adhesins 2. Multiplication - enzymes to obtain nutrients through tissue damage of the host tissue 3. Evasion of defense - capsule production, leukotoxin production and other 4. Tissue damage - direct - through collagenese, hyaluronidase, bone resorbing factors, cytotoxins and more 5. Tissue damage - indirect - through hightening of the inflammatory response

Answer 487

1. Plaque control 2. Professional debridement 3. Potentially antibiotic therapy

Answer 488

It a process of elimination of the causative agents, thereby providing an environment (sterile) conducive to healing. Basically - remove as much bacteria from he root canal system as possible.

Answer 489

Mainly anaerobic bacteria - becauses of low oxygen availability within the pulpal tissue (autogenic succession - driven by bacterial consumption of oxygen) - anaerobic bacteria are very destructive due to their fastidious nutritional requirements

Answer 490

1. Caries 2. Mechanical exposure 3. Trauma 4. Anachoresis - bacteremia 5. Periodontal pockets - when pockets reach root apex

Answer 491

1. Root canals 2. Lateral/ accessory canals 3. Dentine tubules 4. Extra-radicular tissues

Answer 492

1. Instrumentation - physical bacterial reduction of the infected root canal system with irrigation and medication - major challenge: anatomical complexities of the root canal system 2. Irrigation - using a root canal irrigant that has an anti-microbial properties - sodium hypochlorite (hypochlore) could be used - make sure not toxic to the host - major challenge: infiltration into dentinal tubules problematic 3. Medicaments - high pH medicine with strong antimicrobial action - like calcium hydroxide (pH12.5)

Answer 493

Nucleotide synthesis - which occurs during nucleic acid synthesis - when it is effected, no DNA can be produce thus a cell can not replicate, thus cancer is stopped in its rapid division

Answer 494

Thymidylate synthase

Answer 495

Due to targeting of dTTP - it is possible that chemotherapy causes damage to some normal but fast replicating cells in the body like immune cells

Answer 496

1. Pyrimidine analogs - destroy thymidylate synthase - adrucil is an example - reduction in conversion of dUMP into dTMP 2. Folate analogs - interfere with formation of the methyl group - methotrexate is an example - conversion of serine to glycine

Answer 497

1. Alpha - patial lysis of red blood cells 2. Beta - complete lysis or red blood cells 3. Gamma - no haemolysis

Answer 498

1. Skin infections 2. Food poisoning 3. Toxic shock syndrome - associated with biofilm formation Mostly infections are associated with hospitlaisation

Answer 499

Staphylococci have a unique ability to invade bone tissue thus are able to destroy said tissue - diabetics are more susceptible due to lover immune function and tissue regeneration - oral implications: perimplantitis

Answer 500

Coagulase test - extra-cellular protein that binds to prothrombin - coagulation only occurs with S.aureus

Answer 501

Acid-fast stain can be used - the TB will be seen in red

Answer 502

S. Mutants

Answer 503

4 concepts are the: 1. Partnership or collaboration between individual and councillor 2. Acceptance - respecting the client's autonomy 3. Compassion - keep clients best interest in mind 4. Evocation - the best ideas come from the client

Answer 504

1. Open questioning 2. Affirmations 3. Reflections 4. Summaries

Answer 505

A SMART plan: Specific Measurable Achievable Relevant Timed

Answer 506

1. Ask - ask if they smoke 2. Assess - assess their stages of change 3. Advise - information is the key 4. Assist - discuss the benefits of quitting 5. Arrange - arrange for follow-up

Answer 507

1. To increase motivation 2. To reduce withdrawal intensity 3. To decrease exposure to tobacco smoke 4. To improve coping responses to stress and anxiety 5. To facilitate abstinence from tobacco smoking

Answer 508

There are some research that suggests that e-cigarette smokers are at higher risk of periodontal disease than non-e-cigarette smokers due to increase in inflammation, cell injury and impaired cell repair. It is also worth mentioning that e-cigarette smokers are at a lower risk of periodontal disease than conventional cigarettes users - more research is needed!

Answer 509

Roll with resistance - getting information about behaviours that does not support patient goals - e.g. "Patrice, would it be okay if we discussed what smoking and vaping may to your gum health?" Express empathy - try to listen and understand patient struggle - e.g. "I can see that you really want to make a change but this time around it is a little harder" Avoid solutions and suggestions - sit the patient don't control them - e.g. "There are a few method we could try, would you like to know more about them?" Develop choice - help the patient to weigh pros and cons - e.g. "Are there any downsides to smoking for you?" Support success - accentuate the positives - e.g. "I can see you made great progress in moving away from cigarettes to vapes, that will definetly help to reduce the impact of nicotine on your oral health!" (Quit Australia 2023).

Answer 510

1. Exposure 2. Detector orientation 3. Horizontal detector positioning 4. Vertical detector positioning 5. Horizontal beam angulation 6. Vertical beam angulation 7. Central beam position 8. Colimator rotation 9. Sharpness 10. Overall diagnostic value

Answer 511

Reduce the potnetial tooth loss that may occur from apical periodontitis.

Answer 512

Patient does not seem to be in need for any emergency medical treatment thus the following needs to be done: 1. Dental treatment shoudl be haulted - due to high risk of asthma attack in the patient due to dental triggers such as aerosols 2. Patient GP should be contacted and informed about the aptient condition 3. A consultation with the GP regarding the patient should be ongoinging to ensure minimisation of potential asthma attack 4. Patient should bring appropriate medication to their next visit

Answer 513

1. When were they diagnosed 2. When was their last attack 3. Were they ever hospitalised due to asthma 4. What medication do they take 5. What medication do they have with them

Answer 514

No because of: - Flawed study designs - Inbility to appropriate test an individual Flawed study design: The common theory is that night bruxsim is triggered due to a obstructive sleep apnoe episode. During the arousal following an OSA episode, the mandible protrudes foward in order to increase the openess of the airways which could be interpreted as bruxism, but that does not take into the account a population of people who have bruxism but do not have OSA. This flawed study design leads to inappropriate conclusions and bias understanding of the relationship between OSA and NB Inability to appropriate test an individual: In sleep studies, subject are usually situated in specialised clinics. This may increase their stress level. Stress level are associated with night time bruxism. Thus it creates a bias environment.

Answer 515

1. Ill-defined borders 2. Asymmetric appearace 3. Destruction of adjacent bone 4. Radiolucency with pieces of bone trapped 5. Destruction of the palatle or mucosa

Answer 516

1. Urgent refferal for biopsy 2. Management of lifestyle factors - smoking cessation 3. Managing the dental needs of a patient with cancer 4. Providing appropriate supporting care and monitoring when the patient is in remisssion

Answer 517

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

Answer 518

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 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 519

Fluoride releasing material such as RMGIC or GIC

Answer 520

Calcium hydroxide or MTA

Answer 521

1. Using unfilled resin - not great because it comes off over time 2. Using RMGIC liner - not great because it erodes over time 3. Using other restorative material - not great for erosion 4. Using Duraphat - high Fluoride - occlusion of dentinal tubules but does not last for a long time 5. Using MI Varnish - occlusion of dentinal tubules but does not last for a long time 6. Silver fluoride - effective but aesthetic concerns and availability

Answer 522

1. Sodium fluoride 2. Stanous fluoride 3. Potassium nitrate 4. CPP - ACP

Answer 523

1. Sodium fluoride 2. Stanous fluoride 3. Potassium nitrate 4. CPP - ACP

Answer 524

1. Managing risk factors : referral for GERD and stopping acidic drinks 2. Do additional testing - saliva testing 3. Do testing for comparison - scratch test 4. Do mouthiness in the middle of the day - 1 cup of water, 1 teaspoon of bicarb soda, 1 time per day, for 2 weeks 5. At home use of Potassium Nitrate 2 times a day, no rinsing

Answer 525

TRIM Timing - asess the patients starting point Relevance - make sure that the infromation relates to the patient Involvement - involve the patient, make sure the patient contributes Method - say it in chunks - rpovide panflates

Answer 526

Ask them their opinion Give options Remeber to re-assess and ask for feedback

Answer 527

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 528

1. Frictional keratosis 2. Leukoplakia 3. Fibroepithelial hyperplasia 4. OSSC

Answer 529

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

Answer 530

1. Tongue 2. Earlobes 3. Epiglotis 4. Anteior and posterior walls of the pharynx

Answer 531

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

Answer 532

1. crown's disease 2. Actinomises

Answer 533

It usually follows the pathway of the nerve

Answer 534

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 535

Radiographically you can only see upto 2 walls - the one in the interporximal and one in the labial or lingual - because of superimposition Refer to the periochart to identify walls - compare the labia, interproximal and lingul

Answer 536

When there is BOP aove 10% and perio pockets are above 4mm OR Pocket above 5 mm

Answer 537

It is perio screening test where teeth ahve been devided into sextant and probed Grade - 0 - nothing is occuring and nothing has to be done Grade 1 -bleeding on probing with no calculus - need for OHI and plque removal Grade 2 - bleeding and calculus present - OHI and subgingival and supragingival calculus removal Grade 3 - probing depth 3.5-5.5 - ohi, debridement and full periodontal exam and radiographs Grade 4 - probing depth abover 6mm - ohi, debridement, full periodontal exam, radiographs and surgical therapy

General Exam question form last years - MCQ, EMQ, SAQ Flashcards

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