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BDS4 exam revision > Mock case presentation > Flashcards

Mock case presentation Flashcards

1
Q

What to do when a patient presents with pain?

A
  • SOCRATES
  • Get pt out of pain as soon aspossible
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2
Q

Why might tooth 17 be causing the pt pain? (amalgam restoration recently replaced)

A
  • post op sensitivity
    -potential high occlusion
  • amalgam close to pulp (pulpal irritation)
    -heat irritation during drilling
    -microleakage and secondary caries
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3
Q

What is depression?

A

A mental health disorder characterised by extreme sadness and hopelessness and loss of interest in activities.

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4
Q

How can depression affect oral health?

A
  • neglect of OH
  • may trigger periodontal disease due to chronic stress
  • bruxism
  • xerostomia due to medication
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5
Q

What kind of drug is propranolol?

A

beta blocker

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6
Q

what is the mechanism of action of propranolol?

A
  • blockage of beta-adrenergic receptors (b1 and b2) that are normally activated by adrenaline
  • b1 bockage reduced effect of sympathetic stimulation of heart
  • reduced heart rate
  • reduced force of contraction
  • b2 blockage causes bronchoconstriction and vasodilation
  • Reduces physical symptoms of anxiety
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7
Q

What side effects might occur when taking propranolol?

A
  • fatigue or weakness
  • dizziness or light headedness
  • xerostomia
  • hypotension and bradycardia
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8
Q

How might propranolol interfere with dental treatment? and how can you manage this?

A
  • xerostomia which might cause an increased caries risk > ecourage hydgration by sipping water during appointment , use artificial saliva
  • interaction with LA (adrenaline) as it leads to a more pronounced decrease in blood pressure > monitor vital signs throughout treatment, consider reducing the concentration of vasoconstrictor in LA if possible
  • hypotension when moving ot from lying flat > encourage patient to move slowly while standing up
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9
Q

What kind of drug is sertraline?

A
  • SSRI (selective serotonin reuptake inhibitor)
  • antidepressant
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10
Q

What is the mechanism of action of sertraline?

A
  • blockage of serotonin transporter
  • prevents reuptake of serotonin
  • increases levels of serotonin
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11
Q

How can sertraline interfere with dental treatment? and how can you manage this?

A
  • xerostomia < encourage OHI, let pt sip water throughout appointment
    -affect platelet function (bleeding risk) - look at history of bleeding , consider alternative haemostatic measures
    -increases CV effects of vasoconstrictors
    -can cause orthostatic hypotension
  • drug induced hypersensitivity reaction
  • May interact with sedatives used during dental treatment
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12
Q

Patient has lost confidence in dentists due to previous bad experience, how can you support patient?

A
  • listen to patient
  • gather history and how it happened
  • reassure patient
    -clinical exam
  • use open communication with patient
  • address pain
  • rebuild trust
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13
Q

What is bimaxillary osteotomy?

A

surgical procedure performed to correct significant skeletal abnormalities or malocclusions of the maxilla and mandible (repositioning of both maxilla and mandible)

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14
Q

What is the relevance of the pt being a full time carer for her autistic son?

A

can affect
- patient availability
- patient stress levels
-patient priorities and concerns

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15
Q

What is linea alba?

A

white linear ridge or band on buccal mucosa that extends horizontally adjacent to the occlusal plane

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16
Q

What can linea alba suggest?

A
  • pt is bruxist or grinds
  • may indicate high stress levels
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17
Q

What does sensibility testing involve?

A

electric pulp tests
ethyl chloride

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18
Q

What is symptomatic irreversible pulpitis

A

infalmmation of the dental pulp, accompanied by severe and spontaneous pain that persists even after the removal of causative stimulus
- indicates irreversible damage to pulp tissue
-requires definitive treatment, such as root canal therapy or tooth extraction

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19
Q

What is symptomatic periapical periodontitis?

A

inflammation and infection in the periapical tissues surrounding root apex of the tooth

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20
Q

what are the signs and symptoms of symptomatic perapical periodontitis?

A
  • TTP (percussion and palpation)
  • soft tissue swelling
  • sinus tract sometimes visible
  • PDL widening or PA radiolucency on radiograph
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21
Q

What are some causes of hypodontia?

A
  • family history of hypodontia
  • trauma to area
  • idiopathic
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22
Q

if the patient was to lose the C- what optoins are available for them?

A
  • accept space
  • orthodontics to close space (unlikely due to plates and screws)
  • Bridge
  • Implant
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23
Q

What type of bridge would you use to replace Cs space once it exfoliates

A

mesial fixed cantilevel (abutment tooth being the 14) - only fixed on one side with a wing so if debonds will come away and not act as plaque trap for caries management

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24
Q

What you must assess about abutment teeth of fixed cantilever bridges?

A
  • quality of enamel
  • periodontal status
  • root length
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25
Q

how many canals does a 17 typically have?

A

3 or 4 (sometimes 2 mesially)

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26
Q

Tooth 36 is grossly carious and requires XLA, what factors determine if a tooth is restorable or not?

A
  • extent of decay
  • location of decay
  • strength and integrity of remaining tooth structure
  • patient OH and compliance
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27
Q

How much space is required for implant placement?

A
  1. 7-8mm of interdental space
  2. 6-8mm bone width
  3. 10-12mm of bone height
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28
Q

What types of root resorption exists?

A
  • external root resorption
  • internal root resorption
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29
Q

what is meant by a cariogenic diet?

A

dietary habits or food consumption that promote development of dental caries
- high sugar intake
- high fermentable carbohydrate intake
-ideal environment for the growth of cavity-causing bacteria in the mouth
- bacteria metabolise sugars and produce acids that can erode tooth enamel and lead to the formation of cavities

30
Q

What materials can be used as temporary fillings after extirpation of a tooth?

A
  • Kalzinol (ZOE material)
  • Glass ionomer (RIVA- self/light cure)
31
Q

Why might a bridge to replace tooth 36 not be suitable?

A
  • pt has linea alba suggesting parafunctional habit
  • high occlusal load on 6s anyway, increased in parafunctional habit pts
32
Q

How can posts be removed from teeth?

A
  • drilling
  • ultrasonic scalers
  • heat ti soften any resin based cement
  • manual instruments (pliers/post extractors)
33
Q

Why do root treated teeth require cuspal coverage restorations?

A
  • fracture resistance(root treated teeth are structurally weakened)
  • sealing and protection
34
Q

What a type of restorations are considered as cuspal coverage?

A
  • onlays and crowns
35
Q

What is the ideal taper when crowning teeth? and why?

A

ranges between 6 to 10 degrees
- sufficient retention
-resistance to displacement

36
Q

When placing posts, how much of the root filling should be left?

A

4-5mm root filling apically

37
Q

What is the ideal width of a post?

A

max 1/3 of root width at narrowest point
- 1mm remaining circumferential coronal dentine

38
Q

what is the ideal ferrule for post placement?

A

1.5mm height and width of remaining coronal dentine

39
Q

What is salbutamol? and how does it work?

A
  • Short acting beta-2-adrenoreceptor agonist
  • Targets beta-2 receptors
  • Causes muscle relaxation and bronchodilation
40
Q

What are the side effects of salbutamol

A

Arrhythmias (tachicardia)
headache
palpitations
tremor

41
Q

What are the dental implications of salbutamol

A

Can cause xerostomia
Can trigger caries as it has acidic content

42
Q

What is Flixotide inhaler?

A
  • Known as Fluticasone (orange)
  • It is a corticosteroid which inhibits inflammatory cells (Neutrophils , lymphocytes, macrophages etc..) which are released during asthmatic response
43
Q

What are the side effects of Fluticasone?

A
  • Headache
  • oral candidiasis
  • pneumonia in pts with COPD
  • Taste alteration
  • Voice alteration
44
Q

What are the dental complications of fluticasone? and how can this be managed?

A
  • Candidiasis risk
  • Caries risk as has acidic content
  • Managed : rinse water after use, good OHI
45
Q

What is a dentine pin

A

A small pin made out of metal or composite to add support to dental restorations such as crowns and filings

46
Q

Why extirpate and not extract (17)?

A
  • Check for extent of decay, check integrity of remaining structure and then assess restorability
  • most likely will restore using an onlay
47
Q

why extract and not extirpate (36)?

A

Periapical periodontitis, failed restoration for a while, I think after removing the GI and the caries around it there will not be much tooth tissue to restore - which made me think that an extraction is the best effective option for eliminating the pathology

48
Q

Why did you choose to leave post? (25)

A
  • there may be a risk of the tooth to fracture
  • it is not giving the patient any symptoms right now
  • i think the best option currently is to leave it and monitor it for any changes , if the decay progress in the future , removing the post and re-RCT might be an option or XLA
49
Q

What are the dis advantages of amalgam?

A
  • Aesthetics
  • More tooth structed to be removed when preparing cavity
    -Corrosion and discoloration
    -biocompatibility
50
Q

-What are the advantages of amalgam?

A
  • Durability
  • Cheap
  • Ease of placement
  • resistance to wear
    -less sensitive to moisture
51
Q

What are the advantages of composite over amalgam?

A
  • better aesthetics
  • chemical bond to tooth
  • conserve tooth tissue as minimal preparation is needed
  • reduced sensitivity to temperature (similar thermal expansion coefficieint as tooth)
52
Q

What are the advantages of Amalgam over composite?

A
  • durability
  • cheap
    -lasts longer
  • good structural support due to high compressive strength which might be useful for big cavities
  • Self sealing properties which can prevent recurrent caries
53
Q

What materials can be used for an onlay?

A
  • Gold
  • Composite
  • Ceramic (porcelain)|
  • ceromeric (cross between composite and porcelain)
54
Q

What is secondary caries and how does this happen?

A

the development of cares adjacent to current restorations which can be caused by several factors :
- Poor OH
- Marginal leakage
- Dietary factors
- Patient MH - for example medications that may cause caries

55
Q

Why does C needs monitored?

A
  • Short roots which may be a poor prognostic factor, so tooth might come out soon
56
Q

What are the advantages of an onlay?

A
  • preserve tooth tissue
  • preserve tooth strength
  • aesthetics
    -durable
57
Q

What are the disadvantages of an onlay?

A
  • cost
  • multiple appointments
  • tooth sensitivity after placement
58
Q

What are the steps in placing an onlay?

A
  • preparation (1.5mm buccal/lingual margins)
    -temporisation (protemp)
  • impression and occlusal record (polyvinyl siloxane)
  • cementation
59
Q

what are the indications for an onlay?

A
  • sufficient occlusal tooth substance loss
  • one cusp remaining?
  • weakened remaining tooth structure by caries
  • MOD with large isthmus
60
Q

What to communicate to lab when doing an onlay?

A
  • pour-up impressions in 100% dental stone
  • Mount on articulator using - occlusal record , facebow , average value
  • construction details : tooth, material, thickness, shade
61
Q

What defines generalized gingivitis based on BSP periodonal guidelines?

A

Code 0/1/2
>30% BoP

62
Q

How can camdida risk from use of inhalers be minimised?

A
  • use a spacer with MDIs
  • rinse mouth after use
  • maintain good OH
63
Q

What type of onlay are you going to place on the 37?

A

Composite onlay (good aesthetic and bonds directly to tooth)

64
Q

What do you use to cement a composite onlay ?

A

Nexus (dual cure composite luting cement)

65
Q

What is used to cement an MCC ?

A

Aquacem (glass ionomer luting cement)

66
Q

What is used to cement a zirconia crown?

A

Aquacem ( GILC)

67
Q

What is used to bond an adhesive bridge?

A

Panavia (self adhesive resin cement)

68
Q

What is used to cement porcelain veneers?

A

Nexus (dual cure composite and DBA )

69
Q

what is the concentration of NAOCL and EDTA

A
  • NaOCL : 1-5.25%
  • EDTA - 17%
70
Q

What is considered cariogenic in the pt diary?

A
  • Sugar in tea
  • porridge
  • biscuit
  • ice-cream
71
Q

What OHI would you give the pt?

A
  • The use of interdental cleaning
  • brush 2 minutes morning and night
  • use fluoride toothpaste
  • Floss twice daily morning and night

BDS4 exam revision (6 decks)

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