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REVISION > IMPORTANT > Flashcards

IMPORTANT Flashcards

1
Q

How does cusp fracture

A
  • Trauma
  • Caries
  • High occlusal load
  • Bruxism
  • Parafunctional habits
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1
Q

Crown materials

A

Metal
Ceramic
Metal ceramic

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2
Q

Inlays/onlays materials

A

Gold
Composite
porcelain

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3
Q

What is erosion

A

The loss of tooth surface by a chemical process that does not involve bacterial action.

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4
Q

What is attrittion

A

physiological loss of tooth surface by tooth to tooth contact

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5
Q

Describe the DAHL technique

A
  • it is a method of gaining space in localised anterior toothwear cases
  • An Anterior bite plane appliance is seated with the aim of increasing the OVD 2-4mm by allowing eruption of posterior to gain space anteriorly for restoring the anterior teeth
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6
Q

How to temporarily restore an indirect restoration when there is no putty or study casts?

A
  • using a direct temporary restoration such as glass ionomer or zinc oxide eugenol
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7
Q

How to replace space?

A
  • implant
  • RPD
  • Ortho treatment to close space
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8
Q

What are the non periodontal challenges in placing an implant?

A

bone levels
restorative status of adjacent teeth
soft tissue anatomy
bone levels at adjacent teeth
Lip line
Smoking habit

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9
Q

What are the disadvantages of implants?

A
  • Requires more than one visit
  • expensive
  • outcome depends on operator skills
    needs excellent oral hygiene
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10
Q

What are the advantages of implants?

A

patient gains confidence
replaces missing teeth with good function and aesthetics
good prognosis and long lasting

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11
Q

missing central incisors wearing RPD and wants implants , other options?

A
  • Spring cantilever bridge
  • Resin bonded bridge
  • Do nothing
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12
Q

What is burning mouth syndrome?

A

a chronic painful condition often described as a burning, scalding, or tingling feeling in the mouth which can be caused by stsemic diseases such as gord or blood deficiencies

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13
Q

What complaints might a patient with burning mouth syndrome present with?

A
  • Dry mouth
  • altered taste
  • Pain, tingling
  • numbness
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14
Q

What psychological disorders are associated with burning mouth syndrome?

A
  • Depression
  • Anxiety
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15
Q

Blood tests for burning mouth syndrome

A
  • Thyroid funtion test
  • Liver function test
  • Full blood count
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16
Q

What organisms is associated with Hyperplastic candiasis

A
  • C. albicans
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17
Q

What special investigations to carry out for C.albicans

A
  • Oral rinse or oral swab for biological culture
  • Biopsy for histopathology
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18
Q

What other oral conditions are associated with candida albicans

A
  • Denture induced stomatitis
  • Angular Cheilitis
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19
Q

What medical conditions are associated with candida albicans infection?

A
  • Crohn’s disease
  • HIV
  • coeliac disease
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20
Q

What staining is involved in histology?

A

Hematoxylin and Eosin Stain (or H&E Stain)

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21
Q

What common drug is used in oral medicine and what class of drug?

A
  • Prednisolone - corticosteroid
  • Fluconazole - antifungal
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22
Q

What is trigeminal neuralgia?

A

demyelination or compression of the trigeminal nerve usually unilateral causing severe stabbing pain

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23
Q

Typical symptom ?

A

Stabbing pain

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24
Q

Why may cause trigeminal neuralgia?

A
  • compression of trigeminal nerve by blood vessels
  • demyelination of trigeminal nerve
  • space-occupying lesion
  • multiple sclerosis
  • Skull base bone deformity
  • connective tissue disease
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25
Q

Patient feels pain in the morning when washes face with cold water , how to change regime? (TN)

A
  • avoid touching the face when washing the face
  • use warm water instead of cold water as this might trigger the pain
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26
Q

Other drugs for treating TN?

A
  • Oxcarbazepine
  • Gabapentin
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27
Q

Why do you need blood tests for cabazepine?

A

Because it can cause liver failure

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28
Q

5 ways to identify anxiety in a patient?

A
  • ask patient about previous dental experience and their reaction to it
  • Use MDAS (modified dental anxiety scale)
  • Look at patient non verbal cues : ex. shaking. disconnected, nervous?
  • Look at phyisologial cues such as dry mouth , altered tone voice
  • Low pain tolerance
    -stomatisation
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29
Q

Pharmacological ways to help anxiety?

A
  • intravenous sedation - midazolam (5mg/5ml) - max dose 10mg
  • topical anaesthesia - lidocaine 5% gel
  • inhalation sedation - nitrous oxide 5-6L with oxygen through nose
  • transmucosal sedation with midazolam
  • local anaesthesia using lidocaine (1cartridge per 10kg)
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30
Q

non pharmacological ways to manage anxiety?

A
  • CBT
  • densitisation
  • Relaxation techniques
  • make patient take control for example tell them to raise their finger when they want to stop the treatment
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31
Q

How to order extractions?

A

Start with simple extractions first and then complicated ones , Avoid leaving single standing posteriors as may cause alveolar fracture

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32
Q

When to review patient after denture?

A

ideally 24-48h

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33
Q

What to tell patient about the denture?

A
  • This is a temporary denture as sockets heal , it might feel bulky and might become ill fitting as the bone underneath is likely to reduce , permanent denture will be given afterwards
  • The area underneath the denture will be incomfortable , it will get less painfull as the sockets heal
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34
Q

What is a fixed orthodontic appliance called

A

fixed braces

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35
Q

What can a fixed appliance do that a URA can’t

A
  • Precise tooth movements ex. torque rotations
  • Correct complex malocclusions
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36
Q

What is TAD and why is it better?

A
  • temporary anchorage device such as non osseointegrating mini screws in cortical bone to achieve absolute anchorage as the forces are directed to cortical bone
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37
Q

Risks of orthodontic treatment

A
  • gingival recession
    -decalcification
    -root resorption
  • relapse
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38
Q

What is molar relationships?

A

Mesial-buccal cusp of maxillary 6 occluded with media-buccal groove of mandibular 6 (class 2 anterior class 3 posterior)

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39
Q

What is canine relationship?

A

Upper canine lies between embrasure of lower canine and first premolar (class II anterior and Class III posterior)

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40
Q

What condition can give rise to group function in orthodontics?

A

Bruxism

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41
Q

What features determine the IOTN?

A
  • missing teeth
  • extent of overbite
  • crossbites
    -displacement
  • overjet
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42
Q

Malocclusion features leading to marginal gingivitis?

A
  • anterior crossbite
    -anterior open bite
    -severe crowding
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43
Q

What is facebow used for?

A
  • to mouth causts on articulators
  • to determine relationship between the maxilla to the terminal hinge axis of the mandible
  • Can be used in the process of constructing veneers, incisal composite buildups for toothwear cases
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44
Q

4 methods/materials to help mount casts on ICP ?

A
  • No material - many tooth contact so ICP is obvious
  • Wax wafer - place wax over biting surfaces and let patient bite
  • Registration paste - place over biting surface and get patient to bite down
  • Record blocks - when free-end saddles present and casts cannot be hand articulated (use with bite reg paste)
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45
Q

Eruptions dates

A

▪ 6yr = lower and upper 6; lower 1
▪ 7yr = upper 1; lower 2
▪ 8yr = upper 2
▪ 9yr = lower 3
▪ 10yr = lower and upper 4; upper and lower 5
▪ 11yr = upper 3
-12 : 7s

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46
Q

Caries risk assessment for paeds

A
  • diet
  • MH
  • SH
  • FLUORIDE
  • clinical evidence
  • plaque control
  • saliva
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47
Q

most likely discolouration in paediatric children

A
  • Trauma causing non vital tooth
  • Fluorosis?
  • medications - tetracycline?
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48
Q

What special tests to take?

A
  • Clinical photos
  • sensibility testing
  • 2 PA radiographs
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49
Q

Treatment options

A
  • micro abrasion - takes some of the enamel
  • Internal non vital bleaching - may cause brittleness to crown
  • resin infiltration - loss of some enamel
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50
Q

How does resin infiltration work?

A

resin infiltrates between hydroxyapatite in enamel by capillary forces, same refraction indice as enamel which make it closer to sound enamel optical properties

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51
Q

A trans kid is now a female , What do you do?

A

Ask her about her name ans what she like to be called , use that name and record in the notes about this

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52
Q

Initial treatment for tooth swelling

A
  • Supra and subgingival PMPR
  • OHI
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53
Q

Things to tell hygienist about LA ?

A
  • Dose
  • Frequency
  • Route of administration
  • type of anaesthesia
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54
Q

What are the disadvantages of implants?

A
  • Requires more than one visit
  • expensive
  • outcome depends on operator skills
    needs excellent oral hygiene
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55
Q

What are the advantages of implants?

A

patient gains confidence
replaces missing teeth with good function and aesthetics
good prognosis and long lasting

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56
Q

Spread of infection in upper anteriors?

A

lip
nasolabial region
lower eyelid

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57
Q

upper lateral incisors spread of infection?

A

Palate

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58
Q

upper premolars and molars spread of infection?

A

Cheek
infraorbital region
maxillary antrum
Palate

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59
Q

Lower anteriors spread of infection?

A

Mental and submental space

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60
Q

Lower molars and premolars spread of infection?

A

Buccal space
submasseteric space
Sublingual space
Submandibular space
Lateral pharyngeal space

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61
Q

Types of articulators used in facebow?

A
  • Semi adjustable
  • Average value
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62
Q

perio outcomes to determine success?

A
  • plaque scores of below 15%
  • bleeding scores of below 10%
  • probing depths of less than 4 mm
  • Patients with significantly improved oral hygiene, reduced bleeding on probing and a considerable reduction in probing depths from baseline
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63
Q

Things that effect where can an abscess infection travel to?

A
  • thickness of cortical bone
  • anatomic site of initial infection
  • type of microorganism involved
  • nearby anatomical spaces
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64
Q

What is immediate management of an Abscess?

A
  • Incise and drain
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65
Q

What are the risk factors of OAC?

A

XLA upper molars and premolars
Last standing molars (sinus grew down due to missing adjacent teeth)
Older patient
if the patient previosly had OAC
Recurrent sinusitis
Big bublous rootsH

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66
Q

Signs of OAC?

A

Per-operative
- Size of tooth
- radiographic position of roots in relation to antrum
Peri-operative
Bubbling at socket
Change in suction sound
Direct vision
Bone removed at trifurcation
Post-operative
Unilateral discharge
non-healing socket
difficulty singing

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67
Q

Things to tell the patient after they had an OAC?

A

do not blow nose
sneeze with mouth open
use inhalation aids or nasal decongestion spray
Avoid flying or diving

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68
Q

What is the position of the nurse in relation to operator position? and why?

A
  • 2’‘-4’’ higher than operator
    To enable operator to see over obsructions
    -The dental nurse and operator should be seated in the balance position
    -no twisting and bending and lower back should be fully seated on the back of the chair
    -bottom should be at the back of the chair
    -nurse should position their thigh adjacent to the shoulder of the patient and be angled inwards
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69
Q

What is the neutral seating position?

A
  • Operator back at 90 degrees
  • thigh is parallel to floor
    no slouching
    feet is on the floor to support posture
    12’’ to 18’’ between patient and operator
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70
Q

What is the position of the nurse in relation to operator position? and why?

A
  • 2’‘-4’’ higher than operator
    To enable operator to see over obsructions
    -The dental nurse and operator should be seated in the balance position
    -no twisting and bending and lower back should be fully seated on the back of the chair
    -bottom should be at the back of the chair
    -nurse should position their thigh adjacent to the shoulder of the patient and be angled inwards
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71
Q

Name the seating zones

A

Operating zone (7-11o’Clock)
Static zone (11-2 o’Clock)
Nurse’s zone (2-4 o’Clock)
Transfer zone (4-7 O’clock)

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72
Q

What are the types of aspiration?

A

Direct and indirect

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73
Q

How to hold an aspirator? and how to check it?

A

like a pencil grip
make sure tip is secured in aspirator tubing
bevel of aspirator should be held adjacent or distal to tooth being treated

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74
Q

How to perform direct aspiration?

A

Adjacent to tooth treated
Slightly distal
remove any excess fluid from the back of the mouth

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75
Q

How to perform indirect aspiration?

A
  • if aspirator obstructs operator view
  • lower left quadrant
  • anteriors - side closest to you
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76
Q

How to retract soft tissues?

A

Cheek retractor
mirror
3:1 syringe
Aspirator
Tongue depressor

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77
Q

What is PICO

A

Population
intervention
Control
Outcomes

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78
Q

What are the agents of bias?

A

Selection bias : differenced between selected participants
Attrition bias : when participants withdraw
Performance bias : how participants perform
Reporting bias : when there selective reporting from participants about outcomes

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79
Q

What is the p value?

A

determine the significance of the results p value < 0.05 means that you reject the null hypothesis and results are significant

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80
Q

Confidence interval

A
  • the range of values the absolute risk difference will fall onto
  • 95% - true population ARD
  • should not overlap 0 ( if overlaps null hypothesis)
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81
Q

Risk ratio

A

ratio of incidence rate in exposed group to risk of incidence in non exposed group
1- no difference
overlaps 1 - insufficient evidence

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82
Q

Periodontal diagnosis

A
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83
Q

What information to tell patient about implants?

A

Implants need good bone levels
implant need excellent oral hygiene and compliance
Natural teeth is better than implants and altough implants are an alternative they are not as good as natural teeth
Implants are expensive

84
Q

What medications cause gingival hyperplasia

A

Phenytoin and cycloporine

85
Q

What system is used for periodontal risk?

A

Periodontal risk assessment tool

86
Q

Why is the periodontal risk assessment used?

A
  • to evaluate outcomes of periodontal treatment
  • to predict future tooth loss
  • for treatment planning
87
Q

Things to note about a bad radiograph

A
  • cervical burnout
  • white spots
  • dark spots
    -multiple images
  • magnification
  • blurry
  • higher
  • tilted/moved
  • bending, creasing, or scratching
88
Q

Four things for successful posterior restoration?

A
  • Good tooth preparation
  • Good material selection
  • Good finishing and polishing
  • No overhangs
  • Good marginal seal
  • Good cusp coverage
89
Q

Apical parts of root

A
  • Apical constriction
    -Apex
  • Apical foramen
90
Q

Describe obturation and preparation using anatomic landmarks

A
  • maintain apical foramen at original place
  • Keep apical constriction as small as possible
  • Obturation and preparation should end at apical constriction
91
Q

Ways to measure working length without apex locator?

A
  • using pre-op radiograph : the working length is 2mm short to the radiographic apex
  • Using tactile sensation working length by exploring the canal using a K file and bending the tip of it
92
Q

How can apex locator reading be affected?

A
  • If there is fluid in the canal
  • If there is perforation in the canal while preparing
93
Q

What alloy is used for metals in bridges?

A

Gold IV

94
Q

minimum thickness of metal in bridges?

A

0.7mm

95
Q

advantages of modified lap technique?

A
  • Good aesthetics
  • allows patient to keep the area clean as it is not extended to the gingivae lingually
96
Q

Alternative bridge designs?

A
  • fixed-cantilever conventional
  • spring cantilever
97
Q

What monomer is used in Panavia?

A

MDP

98
Q

What is oxyguard and why is it used?

A

It is an oxygen inhibiting, it aids in setting dual resin composite cement

99
Q

What causes retroclination of lower incisors?

A
  • Hyperactive lower lip
  • Thum sucking habit
100
Q

How to measure freeway space?

A

Using willis gauge and sprung divider
measure the RVD then the OVD
the freeway space is the difference between RVD and OVD
the patient ala-tragus line should be parallel to the floor

101
Q

Most important line to mount in jaw registration?

A

Midline

102
Q

What instrument to use to adjust record blocks?

A

Wax knife and bunsen burner
Hot plate

103
Q

What two planes are used in fox bite plane?

A
  • alatragus line
  • interpupillary line
104
Q

things that cause stress in dentistry

A

time concerns
preparing for exams
financial worries
isolation

105
Q

How to prevent stress?

A
  • exercising, eating healthy, sleeping well
  • maintaining good work/life balance
  • better regulation and governance
106
Q

How to cope with stress?

A

By reseliance
- thinking rationally
-awareness of the surroundings and what is happening
-reaching out for help
-fitness (physical and mental)

107
Q

How to consent for extraction?

A
  • Treatment carried out, which tooth and what is done
  • risks and benefits (long term and short term)
    -post op instructions
  • check patient understanding
  • check patient understands and answer any questions
  • Give written consent for the patient to sign
108
Q

how reassure patient when crown fracture after extraction?

A
  • Tell her that the top part of her tooth came out and the roots are still intact
  • they will remove it by sectioning the root in half and taking it out and they will put stitches and that she will be numbed up for this and will not feel pain (only pressure) , she might hear some noises and that this is a normal complication that happens when extracting a grossly carious tooth
109
Q

Management of pericoronitis?

A
  • coronectomy
  • Irrigation and under operculum with saline an CHX
110
Q

Warning signs before surgical extractions

A
  • Pain
  • swelling
  • infection
  • damage to bone/adjacent teeth
  • nerve damage (temporary or longterm)
  • Dry socket
  • tuberosity fracture
  • Damage to soft tissues
111
Q

nerves likely to be at risk for corenectomy?

A
  • lingual nerve
  • inferior alveolar nerve
112
Q

How does bisphosphonates work?

A

It works by inhibiting bone resorption resulting in increasing bone density and preventing bone fracture , after dental treatment bone resorption is important in the healing process. In patients taking bisphosphonates osteonecrosis can happen

113
Q

INR in warfarin?

A

Below 4

114
Q

What guidance for people taking anticoagulants?

A

SDCEP guidance for management of patients taking anticoagulants and antiplatelets drugs

115
Q

How to manage a patient taking apixaban?

A
  • assess bleeding risk of procedure
  • if high bleeding risk miss or delay morning dose in the day of treatment and
  • if low bleeding risk do procedure as normal without missing the dose
    -considerr suturing and staging complex treatment and limiting initial treatment area and treat early in the morning
116
Q

Sociodemographic determinants of OC

A
  • Age
  • Sex
  • socioeconomic status x2 risk
117
Q

behavioral risk factors for OC

A
  • smoking tobbaco
  • exposure to UV light
  • Betel nut chewing
  • Poor diet
    -alcohol use
118
Q

factor to differentiate between Oral cancer and oropharyngeal cancer?

A
  • HPV virus infection
119
Q

What did the uk do to prevent the transmission of oral pharyngeal cancer?

A
  • vaccination against HPV virus in boys and girls schools to reduce the transmission of it
120
Q

Signs of pemphigoid?

A
  • straight line pattern on IF
  • fluid filled blisters in the patient mouth that are erythmatous and painful
  • Sub basal split on histopathology analysis
  • Ulceratoin in the mouth
121
Q

Further investigations

A

Direct immunofluoresence and indirect immunofluoresence

122
Q

differential diagnosis for pemphigoid?

A
  • lichen planus
  • pemphigus vulgaris
123
Q

immunosuppressants used examples

A

Azathioprine
Methotrexate

124
Q

What other mucous membranes does MMP affect?

A

Eyes
Genitals

125
Q

8 questions about ulcers to ask mom in a child?

A

o Have you had this type of symptoms before?
o Have they seen or felt any blisters present (not erosions or ulcers)?
o Have they got any similar symptoms else where in the body?
o Any symptoms on the lips?
o Is it getting worse/progressively worse?
o Any other associated symptoms?
o Any other associated skin lesions?

126
Q

Diagnosis for ulcers in child’s mouth?

A

Primary herpatic gingivostomatitis

127
Q

To explain aetiology of primary herpatic gingivostomatitis?

A

This is a viral infection caused by a virus called Herpes simplex virus , it usually presents as small ulcers with redness in t e mouth , it usually affects children under 5, this is the same virus that causes cold sores in adults when its reactivated

128
Q

Advice to mom with child having primary herpatic gingivostomatitis

A
  • Usually it resolves on its own in two weeks
  • keep hydrated
  • apply topical analgesia such as lidocaine gel
  • it can be contagious to the eyes of the patient and prevent touching it
  • Contact if did not resolve
129
Q

What do you think if herpes simplex recurs in 14 days?

A
  • Herpes labialis
  • Prescribe aciclovir cream
130
Q

Histological features of lichen planus

A

-lymphocytes at dermoepidermal junction
- Acantholysis
-Orthokeratosis
- Elongated rete pegs
- Hugging band of lymphocytes under epidermis

131
Q

Factors of patient history that may indicate malignancy of lichen planus?

A
  • Smoking
  • Drinking
132
Q

Medications to manage lichen planus

A

Tacrolimus gel
azathioprine
Clobetasol cream

133
Q

What to ask to diagnose MIH

A
  • Type of birth : natural or C section
  • any severe illness during pregnancy such as anaemia ; any problems in 3rd trimester such as pre-eclampsia?
  • Any birth trauma?or preterm birth?
  • how long did the child breastfeed for ?Any fever or medication during this time?Socioeconomic status
  • did the child get any infections such as measles , rubella or chicken pox?
134
Q

Main symptoms of MIH

A

Discoloration of enamel (brown/yellow)

135
Q

Would you extract 6’s

A

Depends on the development
If yes - to allow mesial drift of 7 , extract when calcification of the bifurcation of the 7s
If no , this will close space
If no - the bifurcatoin of the 7 is not calcified , the MIH is mild and can be managed?

136
Q

What dental complications are associated with children with asthma?and give advice

A

Xerostomia
halitosis
increased periodontal disease
increased caries rate
increased risk of erosion
Rinse mouth after inhaler use
Use spacer and correct use of inhaler
excellent oral hygiene , twice daily for two minutes and use of fluoride supplements

137
Q

Methods of prevention

A

Fluoride varnish
Fissure sealants
high fluoride toothpaste 1440 ppm
fluoride supplements

138
Q

What material is the wing in RRB made of?

A

NiCr

139
Q

What cement is used in different bridge types?

A
  • metal - Aquacem
  • metal-ceramic - Aquacem
    -ceramic - nexus
  • adhesive - panavia
140
Q

What to check on assessment appointment in sedation?

A

History - social , dental and medical
Examination - intraoral and extraoral and vital organs
Heart rate
Blood pressure
Oxygen saturation
BMI (more than 35 is contraindicated)

141
Q

What to tell the patient of sedation on the day of treatment?

A

Treatment being done
risks and benefits
that they might feel excited , talk much , have sexual fanatsies and it will make them feel more relaxed , they might forget about the experience and ask them if they brought an escort, gain consent verbal and written

142
Q

Medications used in IV sedation

A
  • midazolam (5mg/ml) - 1mg/ml every 5 minutes , max dose 10 mg/ml
  • propofol
  • multi agent
143
Q

Fibrous epulus histological signs

A
144
Q

How to manage fibrous epulis?

A

Coe pak dressing
Exisional biopsy
removal of source of irritation

145
Q

What causes fibrous epulus?

A
  • overhanging restoration
  • subgingival claculus
146
Q

What is sepsis

A

it is the spread of infection in the body via blood

147
Q
A
148
Q

What is sepsis?

A

when bacteria spread throughout the body via blood leading to organ dysfunction and it is life threatening

149
Q

Symptoms of sepsis

A

very high or low temparature
uncontrolled shivering
confusion
cold and blotchy hands and feet
not passing as much urine as normal

150
Q

What is SIRS

A

systemic inflammatory response syndrome

151
Q

What are the requirements for SIRS?

A

temp less than 36 or above 38
pulse less than 90 per min
Resp rate >20/min
WCC below 4 or more than 12
Varying degrees of facial swelling
Trismus
Dehydration

152
Q

What is biological caries management?

A

It is a non-invasive way in managing caries or a non operative way of managing caries by remineralising the tooth tissues

153
Q

Caries risk assessment

A

diet
medical history
social history
fluoride use
clinical evidence
plaque control
saliva

154
Q

What is the aetiology of Sjogren’s syndrome?

A

related to gentic predisposition associated with ant-ro and anti-la autoantibodies leading to dysregulated inflammatory process with dentritic AP cells recruiting band T cell responses,leading to exocrine gland destruction, can be triggered by environmental factors and tissue injuries

155
Q

What is sjogrens syndrome

A

An autoimmune disease affecting salivary and lacrimal glands leading to destruction

156
Q

How does sjogren’s syndrome present in salivary glands?

A

As a snowstorm radiopacity in the salivary gland area

157
Q

What happens to lymph nodes in Sjogren’s syndrome

A

Become enlarged due to inflammation or secondary infection due to sjogren’s patients being more suceptible to disease as they are immunocompromised , and lymphoma as sjogren’s patients have a higher risk of developing lymphoma

158
Q

How to check lymphnodes

A

By palpating the lymphnodes and if suspected lymphandenopathy, then do MRI of major salivary glands
- ulltrasound of glands

159
Q

What are the complications associated with sjogrens syndrome?

A
  • lymphoma risk (can present with unilateral gland swelling)
  • salivary enlargement
  • Dry mouth
  • increased caries risk
  • increased periodontal disease risk
160
Q

What to do if the patient present with a salivary gland disease and no dry mouth?

A

This means it is caused by a systemic disease and need to lialise with rheumatologist

161
Q

What are the causes of TMD?

A

Myfacial pain
Disc displacement
degenerative diseases
Chronic recurrent dislocation
Ankylosis
Hyperplasia
Neoplasia
Infection
Parafunctional habits
Stress

162
Q

What are the common clinical features of TMD?

A
  • affects more females
  • age between 18-30
    -intermittent pain of several months or years duration
  • Muscle/joint and ear pain
  • Trismus/locking
  • Clicking/popping joint noises
  • headaches
    -crepitus indicated late degenerative changes
    -muscle hypertrophy
163
Q

Treatment of TMD (reversible)

A

- Patient education :
reassurance
soft diet
masticate bilaterally
no wide opening
no chewing gum,
do not incise foods
cut food into small pieces
stop parafunctional habits
Support mouth when opening
- Splints
Bite raising appliance stabilise occlusion and improve function of mastucatory muscles)
Anterior repositioning splint
**- physical therapy **
physiotherapy
massage/heat
acupuncture
relaxation
ultrasound therapy
**- Medications **
NSAIDS
muscle relaxants
Tricyclic antidepressants
Botox
Steroids
- Jaw exercises

164
Q

Treatment of TMD (irreversible)

A
  • Occlusal adjustment (rarely done and there is no evidence of benefit)
  • TMJ surgery
    arthrocentesis
    arthroscopy
    disc repositioning surgery
    disc repair and removal
    high condylar shave
    total joint replacement
165
Q

Best way to clean hand scalers?

A

ultrasonic bath

166
Q

What is fibrous epulis?

A

It is a hyperplastic fibrous inflammation on the gingivae due to irritation (overhanging restoration) can be describes as smooth, pink and pedunculated

167
Q

What are the SCIPS?

A

Hand hygiene
Personal protective equipment
Safe management of care equipment
Safe management of care environment
Safe management of blood and body fluid spillages
Safe disposal of waste (including sharps)
Occatoinal safety: prevention and exposure management (including sharps)
Respiratory and cough hygiene

168
Q

How to clean a blood spillage?

A
  • local policy must be followed
  • Appropriate PPE to be worn, apron, mask, gloves and eye protection
  • Organic matter to be removed using a disposable absorbent towel
  • dispose in healthcare waste
  • apply the appropriate granules or solution to disinfect area and leave for 3 minutes
  • remove granules using a scope and dispose
169
Q

Examples of bone pathologies

A

Developmental
- Tori
-Fibrous dysplasia
-osteogenesis imperfecta (type 1 collagen defect )
Inflammatory
-Dry socket
- Osteomyelitis
Neoplasm (abnormal new growth)
steoma
osteosarcoma
osteoblastoma
Metabolic
osteoporosis

170
Q

OPT errors and reasons

A
  • Distorted anteriors - patient not in focal plane leading to horizontal distortion(too forward in the machine)
  • blurry image - patient moving during exposure
    -image too wide - patient canine is behind x-ray machine canine line - patient far back in the machine
171
Q

Ways to reduce patient dose to radiation?

A

Use E speed film
Use Kv range from 60-70Kv with focus skin distance more than 200mm
- rectangular collimation and use film holders

172
Q

Campton scatter and absorption

A

Xray photon interacts with outer shell electrons which is greater than the electron energy which results in change of direction of the photon due to the electron taking some of the photon energy

173
Q

What is the photoelectric effect?

A

X-ray photon react with inner shell electron resulting in absorption and ejection of the electron leading to a white image

174
Q

what metal absorbs X-rays

A

lead
prevents back scatter of photon
absorbs scattered photon
absorb some primary beam

175
Q

what medications may cause BPE scores of 3 in young children?

A

epilpsy - phenytoin
immunsuppression - cycloprine

176
Q

What medical conditions may cause BPE’s of 3s in children?

A

aggressive periodontitis
leukaemia
down’s syndrome
agranulocytosis
puberty

177
Q

What are the things that determine prognosis of a fractured tooth?

A

stage of root development
type of injury
damage to pdl
time between injury and treatment
presence of infection

178
Q

What type of antibiotics is given to patients of sepsis?

A

intravenous antibiotics in maximim dose

179
Q

What to inform patient regarding tooth discolouration treatment?

A

It needs long term maintenance for life

180
Q

What is attrittion

A

the physiological wearing away of tooth structure as a result of tooth to tooth contact

181
Q

What is abrasion

A

the physical wear of tooth substance through abnormal mechanical process independent of occlusion - such as hard toothbrushing

182
Q

What is erosion

A

The loss of tooth surface by a chemical process that does not involve bacterial action

183
Q

What is abfraction?

A

the loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth

184
Q

clinical signs of abfraction and why?

A

V shaped tooth loss where the tooth is under tension
Sharp rim at the amelo-cemental junction
caused by biomechanical loading forces result in flexuure and failure of the enamel and dentine at a location away from the loading

185
Q

Most common type of toothwear in old patients?

A

physiological

186
Q

how to diagnose toothwear

A

Recognise the problem
grade its severity
diagnose the likely cause or causes
monitor the progression of the disease

187
Q

What are the BEWE scores?

A

0 - no erosive wear
1- initial loss of surface texture
2- distict defect - hard tissue <50% of surface
3- Hard tissue loss more than 50% of the surface area

188
Q

Risk levels of tooth wear from BEWE score

A

None
Low risk - between 3 and 8
Medium risk - between 9 and 13
High risk - between 14 and over

189
Q

Intrinsic causes of erosion?

A

eating disorders
GORD
other medical conditions

190
Q

What is childsmile universal approach

A

That actions needs to universal to reduce the gradient of inequality. The intensity should be proportionate to the level of advantage and need.

191
Q

What did childsmile do

A
  • A core programme – including universal daily tooth-brushing in all nurseries and targeted tooth- brushing in primary schools.
  • targeted nursery and school fluoride varnish programme (2x a year)
  • A universal practice programme
192
Q

What is the 2018 new classification of periodontal disease?

A
  1. Periodontal health, gingival disease and conditions
    * periodontal health and gingival health
  • gingivitis - induced by dental biofilm
  • gingival diseases : non dental biofilm induced
    2. Periodontitis
  • necrotising periodontal disease
  • periodontitis
  • periodontitis as a result of systemic disease
  1. other conditions affecting the periodontium
    * systemic diseases or conditions affecting the periodontal supporting tissues
    * periodontal abscess and periodontic endodontic lesions
    * mucogingival deformities and conditions
    * Traumatic occlusal forces
    * tooth and prosthesis related factors
193
Q

What is the nice guidelines for infective endocarditis?

A
  • problems affecting the structure of the heart (replacement heart valve and hypertrophic cardiomyopathy)
  • people who are having any dental surgery
  • people who are had previous endocarditis
194
Q

What does SDCEP tells us about these guidelines?

A

classified people at risk of infectiive endocarditis as two groups , is it advised to consult with cardiologist and ask patient if they want to have the prophylaxis

195
Q

Who are people at high risk of getting antibiotic prophylaxis? (SDCEP)

A
  • prosthetic valve
  • who had a previous episode of infective endocarditis
  • people with congenital heart disease
196
Q

Post materials

A

Cast metal (Type IV gold m , SS)
cermics
fibre

197
Q

What is a periodontal abscess

A

An acute Excacerbation of periodontal poocket caused by trauma to the pocket epithelium or obstruction of the pocket entrance , without RSD this causes pus accumulation and lead to abscess

198
Q

Tooth 15 root treated with 9mm pocket, differential diagnosis?

A

perio endo lesion
true combined lesion

199
Q

interventions for inadequate bone levels

A

guided tissue regeneration
bone grafting
biological mediators
sinus lift

200
Q

Describe the pattern of one loss that will be seen on radiograph of a vertical bony defect

A

Generally V shaped and sharply outlined

201
Q

If surgery fail to treat bony defect give other options

A

Root resection
Tunnel preparation
Hemisection
XLA
Palliatibe care

202
Q

Define RPI

A

it is a stress relieving system which is used in free end saddle designs to prevent stress on the last abutement tooth and can also provide reciprocation

203
Q

What is the functions of the components of the RPI

A

Rest mesially acts as an axis of rotation. As the proximal plate and I bar rotates downwards and mesially around the axis of rotation during occlusal load , avoiding potentially traumatic torque

204
Q

What is combination syndrome

A

When we have a partial and complete denture in the same patient , this results in a flappy ridge , this causes rapid bone loss which is replace with fibrous tissue of the anterior region where the partial denture displaces.

205
Q

How to manage combination syndrome?

A
  • Use window technique - cut relief holes in special trays on anterior region
  • take mucostatic impression at rest
  • use 2 stage impression technique : medium body silicone first then cut out impression material in flabby ridge area and take seconod impression with light body
206
Q

What is Ante’s Law?

A

root surface area of abutment tooth should be equal to or greater than that of the tooth being replaced with a pontic

207
Q

How to temporarily restore inlay/onlay after prep if. there is no putty and no study cast

A
  • Direct temporary restoration using GI or zinc oxide eugenol

REVISION (4 decks)

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