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past paper set 2 Flashcards

1
Q

p gingivalis virulence factors

A

biofilm formation
LPS endotoxin
fimbriae - host tissue adhesion and invasion
proteases
capsule polysaccharide and outer membrane vesicles

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2
Q

c albicans virulence factors

A

hyphae (morphological change and host invasion)

proteases

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3
Q

s mutans virulence factors

A 
binding proteins - glucosyl and frucosyltransferases
glucans (communication and adhesion)
sugar modifying enzymes
polysaccharides
acid tolerance and adaption (ATPase)
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4
Q

LA mechanism

A

prevents action potentials through the voltage gated Na+ channels

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5
Q

sugar substitutes

A 
mannitol
xylitol
sorbitol
aspartame
saccharin
sucralose
cyclamates
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6
Q

salivary proteins

A 
amylase
cystatin
gustin
histatin
Igs
lactoferrin
lactoperoxidase
lipase
lysozyme
mucoproteins
'plasma proteins'
PRPs
statherins
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7
Q

enzymes in saliva

A

amylase
lactoperoxidase
lysozyme

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8
Q

fcts of tongue

A 
speech
mastication
mechanical cleansing
taste
protective reflex
kissing
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9
Q

Bell’s palsy

A

acute unilateral facial palsy with unknown cause

  • most resolve spontaneously within a few wks
  • neurological opinion if severe
  • CS (+/- antiviral)
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10
Q

macrocytic anaemia

A

reduced B12, folate

reticulocytes

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11
Q

normocytic anaemia

A

bleed

chronic disease

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12
Q

short-term adrenal suppression effects

A

mood disturbance

insomnia

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13
Q

faint

A

LOC due to hypotension causing hypoperfusion of the brain due to reduced O2

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14
Q

heart attack

A

MI due to atheroma causing arterial lumen occlusion

reduced O2 causing tissue necrosis of area

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15
Q

detecting a conventional bridge debond

A

place probe under pontic and apply pressure coronally
- abutment may move
- saliva bubbles may be seen at margin
can you pass floss underneath?
if debonded for some time, abutment may be visibly grossly carious
may see caries radiographically underneath
can section into smaller pieces and check for adhesiveness

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16
Q

features that may lead to conventional bridge failure

A

poor crown prep, insufficient reduction or crown margins finished subgingivally
retainers not prepped to common PofI
lack of sufficient ferrule for crown
inadequate root surface area for support, Ante’s law
poor moisture control during cementation

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17
Q

implant considerations

A 
quantity of bone
quality of bone
position of existing teeth - rotations, angulations
OH
proximity to anatomical features
smoking 
MH
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18
Q

extrinsic staining

A

diet
smoking
CHX
Fe supplement

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19
Q

intrinsic staining

A

F
non-vital
tetracycline
physiological age changes

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20
Q

Glickmans theory

A

inflammation spreads from gingivae into supporting PDL to produce a vertical bony defect, which local trauma exacerbates

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21
Q

Waerhang’s theory

A

plaque causing bone destruction of a 2mm radius, not big enough to destroy entire width so angular defect

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22
Q

common causes of vertical defect

A 
trauma
calculus
subgingival plaque
occlusion
overhanging Rxs
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23
Q

features in a parotid swelling that would make you suspect malignancy

A

fixed to underlying structures
firm
growing
unilateral

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24
Q

fluorosis appearance

A

diffuse, mottled
pitting
yellow/brown discolouration

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25
Q

clinical governance

A

a framework through which NHS organisations are accountable to continuously improve quality of services and safeguard standards of care
achieved by creating an env where excellence in clinical care can flourish

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26
Q

divisions of NHS dentistry scotland

A

HDS
PDS
GDS

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27
Q

components of CG

A 
clinical audit
clinical effectiveness
research and development
openness
risk management
education and training
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28
Q

ABs may not be successful for perio

A 
may be inactivated
may be resisted by biofilms
superinfection could occur
may not reach site of disease activity
may have inadequate drug concentration and retention
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29
Q

axis of rotation when denture under load

A

line drawn between clasps on opposite sides of the arch, that form axis about which the denture will rotate

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30
Q

improving retention and stability in a loose Cu

A

relining
implant retained prosthesis
replacement

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31
Q

fluconazole and midazolam

A

increases sedation

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32
Q

postural hypotension

A

fall in cardiac output
poor venous return
venous pooling in legs
fall in stroke volume

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33
Q

what factors can make implant placement difficult?

A

lack of space
aesthetic zone
prosthesis may be involved in guidance

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34
Q

what does miconazole have antimicrobial action against?

A

candida

staphylococci

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35
Q

minimising RBB debond

A

pick tooth with large bonding area for abutment

cantilever design for anterior sextant

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36
Q

faults causing debond

A

poor moisture control during cementation
unfavourable occlusion
poor E quality on abutment
inadequate coverage of abutment

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37
Q

what is used for metal wing of RRB?

A

CoCr

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38
Q

why is PDD a contraindication for SDA?

A

drifting of PD compromised teeth under occlusal load
loss of alveolar bone leading to a compromised denture-bearing area in the long term
loss of space (neutral zone) for denture teeth in the long-term

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39
Q

host evasion mechanisms of p gingivalis

A

gingipains
adhesions
fimbriae
capsular polysaccharide

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40
Q

beclometasone inhaler

A

increased caries risk
increased candida risk
dry mouth

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41
Q

salbutamol and acid erosion of teeth

A

dry mouth
reduced salivary protections against acids
pH change of mouth
GORD

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42
Q

advice for inhaler usage

A

20mins before/after brushing
rinse mouth with water after use
spacer

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43
Q

class 3 miller’s classification of recession

A

marginal tissue recession that extends to or beyond the mucogingival jct, with PD AL in the interdental area or malpositioning of teeth

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44
Q

class 4 miller’s classification of recession

A

marginal tissue recession that extends to or beyond the mucogingival jct, with severe bone or ST loss in the ID area and/or severe malpositioning of teeth

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45
Q

IO signs of bruxism

A

tongue scalloping
wear facets
linea alba

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46
Q

local causes of tooth mobility

A

periodontitis
root resorption
PA pathology

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47
Q

factors influencing tooth mobility

A

width of PDL
height of PDL
inflammation
number, shape and length of roots

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48
Q

most freq causes of TN

A

areas of focal demyelination on the peripheral nerve

aberrant intra-cranial artery in the cerebellopontine region

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49
Q

MS S+S

A

intention tremor

balance impairment - loss of proprioception

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50
Q

brain tumour S+S

A

seizures

memory problems

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51
Q

viruses linked to Bells palsy

A

HSV1

VZV

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52
Q

faint physiology

A

reduction in blood returning to heart
reduction in bp, heart beats harder and faster (ANS)
brain responds inappropriately and causes further drop in bp - vasovagal faint

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53
Q

differential diagnosis for burning tongue

A

oral dysaesthesia (BMS)
subclinical infection
glossopharyngeal neuralgia

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54
Q

primary BMS

A

no underlying

damage to nerves that control pain/taste?

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55
Q

possible causes of BMS

A 
anxiety/depression
haematinic deficiencies
parafct
hormonal changes - DM, thyroid
allergy
xerostomia
acid reflux
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56
Q

swelling PD pocket

A

trauma
blockage
increased tissue tone of pocket following NST

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57
Q

oral manifestations of herpes

A

PHG
herpes labialis
KS
hairy leukoplakia

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58
Q

oral diseases caused by EBV

A

hairy leukoplakia
infectious mononucleosis (glandular fever)
Burkitt’s lymphoma, nasopharyngeal cancer, OSCC

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59
Q

SG tumours incidence in parotid gland

A 
pleomorphic adenoma
Warthin's tumour
adenoid cystic carcinoma (most common minor SG tumour)
mucoepidermoid carcinoma
acinic cell carcinoma
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60
Q

how does F have a bacteriocidal effect?

A

inhibits ATPase in the s mutans meaning it interrupts acid tolerance

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61
Q

SR of a salivary duct calculus

A 
LA
incise FOM over duct to expose duct
place a holding suture behind calculi to prevent movement further along the duct
incise at duct orifice or along duct
squeeze out stone
suction
haemostasis, suture wound, POI
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62
Q

RFs for creating OAC

A

proximity of tooth to MS, large sinus
abscess/cyst associated with tooth extracted
hypercementosis
difficult ext
divergent roots
poor ext technique with excessive apical pressure

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63
Q

MCV

A

80-97

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64
Q

metronidazole mechanism

A

inhibits nucleic acid synthesis by disrupting DNA of microbial cells

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65
Q

criteria for MRONJ diagnosis

A

hx/tx with antiangiogenics/antiresorptives such as bisphosphonates and denosumab
exposed/non-healing bone >8wks
no hx of radio to H+N region
no obvious metastatic disease of the jaws

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66
Q

pain caused by dentine hypersensitivity - hydrodynamic theory

A

D has no direct innervation, v few fibres may be present in the inner 1/3, pulp is highly innervated
stimulus applied to outside of D causes movement of dentinal fluid
movement of fluid at pulpal end of tubules stimulates nerve endings in inner 1/3 and at the pulp, causing pain
blocking dentinal tubules (and therefore prevention of stimuli affecting dentinal fluid) prevents pain

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67
Q

adhesive bridge failure

A 
cementation fail
lack of moisture control
divergent pathways
parafct
lack of regard for occlusion
poorly retentive prep
trauma
caries
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68
Q

why does cantilever have better prognosis than F-F for upper anteriors?

A

not subject to forces from divergent pathways
only involves one natural tooth
less worry about parallelism
less occlusal interference

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69
Q

risks of decalcification

A 
poor aesthetics
sensitivity (pain)
debonding
poor tx outcome
could progress to gross caries - loss of vitality
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70
Q

diagnostic features of fluorosis

A

severity is F dose dependent - white areas/enamel opacity to areas of discolouration, pitting and hypoplastic effects
distribution on tooth surface is time dependent, areas affected will correlate with E formation at time of excess consumption - can help distinguish severe fluorosis from AI

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71
Q

causes of amalgam fracrure

A

CSM finished under centric stop
CSMA <70 degrees
amalgam thickness <2mm deep occlusally or <1mm deep elsewhere
secondary caries
pt occluded on it before it was fully set
too much liquid mercury in the amalgam mix
creep
trauma
high Rx

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72
Q

preventing amalgam fracture

A

appropriate cavity prep and Rx design (margins not under centric stops, margins >70 degrees, ideally 90 degrees)
correct thickness of amalgam
appropriate pt advice after seating - avoid eating on it for 24hrs to allow it to set properly
good OHI, diet advice and F to reduce caries risk
use amalgam capsules containing pre-set amounts of mercury and alloy powder to minimise risks of incorrect proportions being used during mixing

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73
Q

amalgam setting reaction

A

Ag3Sn + Hg —> Ag3Sn + Ag2Hg3 + Sn7Hg9

y +Hg —> y + y1 + y2

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74
Q

copper enriched amalgam equations

A

y2 + AgCu —> Cu6Sn5 +y1

OR AgSnCu + Hg —> AgSnCu + y1 + Cu6Sn5

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75
Q

y2 phase properties

A

poor strength and abrasion resistance

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76
Q

modern amalgam and copper

A

has high Cu (>12%) content to reduce y2

copper reacts with tin to reduce availability of tin for y2 phase

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77
Q

pathological response to traumatic occlusion

A

PDL widens, tooth symptomatic/widening of PDL space fails to stabilise
tooth not adequately compensating for the changes

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78
Q

assessing where a high Rx is

A

articulating paper - shimstock 8um in Millers forceps
diagnostic mounting of casts
visual examination
floss

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79
Q

tx options for mobile teeth presenting with widened PDL space

A

control any plaque-induced inflammation - increases tissue tone and prevents any bone or AL that may contribute to mobility
occlusal correction - selective grinding, replacement Rxs, ortho
splinting - temp/long term stabilisation of v mobile teeth. May make harder to clean so not ideal if PD involvement. May also mask underlying disease progression. Not a tx for PDD

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80
Q

CHX mechsnism

A

dicationic
1 cation adheres to pellicle and 1 cation disrupts bacterial membrane
+ charged CHX attracted to - charged phospholipids in bacterial cell wall
CHX binding causes the cell wall to rupture and allows fluid to leak from the bacteria, leading to cell lysis and death

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81
Q

CHX substantivity

A

12hrs

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82
Q

surgicel

A

oxidised cellulose mesh that absorbs blood and swells into a gelatinous mass that aids clotting
resorbable
has a degree of bactericidal effect
careful for L8s - acidic and can damage nerve

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83
Q

kaltostat

A

calcium sodium alginate dressing, forms a hydrophillic gel with wound exudate to maintain a moist wound interface and prevent tissue maceration

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84
Q

bone wax

A

sterile mix of beeswax, paraffin and a softening agent (isopropyl palmitate) used to mechanically plug bleeding vascular channels in bone
affects osteogenesis so not used in regions that may regenerate

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85
Q

immediate bleeding

A

within 48hrs
likely rebound or reactionary effect of tx as the vasoconstrictors wear off, sutures are lost or wound is traumatised by the pt

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86
Q

later post op bleeding

A

3-7days

more likely due to an infection, usually a mild ooze but can be more serious

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87
Q

indications for Warfarin

A

heart surgery - prosthetic replacement heart valve
coronary heart disease (post-MI, angina)
stroke prevention for pts w AF
thromboembolic disease e.g. DVT, PE

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88
Q

how to restore excessive FWS with worn dentures

A

occlusal pivots or restore occlusal surface with autopolymerising acrylic resin

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89
Q

oral signs of anaemia

A 
pale mucosa
mucosal atrophy
atrophic glossitis
stomatitis
angular cheilitis
burning
ulcers
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90
Q

6 basic pt values

A 
working together for pts
respect and dignity
commitment to quality of care
compassion
improving lives
everyone counts
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91
Q

plasma cell gingivitis

A

rare, benign
diffuse and massive infiltration of plasma cells into the sub-epithelial gingival tissue (CT)
diffuse enlargement with oedematous swelling of gingivae in anterior region
unknown aetiology - is it due to a hypersensitivity reaction to an allergen?
possibly due to neoplasia

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92
Q

meds linked to LTRs

A

diuretics - bendroflumethiazide
anti-hypertensives - B blockers, ACE inhibitors
NSAIDs
antimalarials - hydroxychloroquine

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93
Q

when may fordyce spots be more noticeable?

A

thinning of mucosa

more aware of OH due to recent dental tx

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94
Q

what was used before MTA to seal end of root?

A

amalgam

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95
Q

what can amalgam be spread by?

A

Langerhans cells (APCs)

96
Q

management of ROU in HDS

A

investigstions - FBC, exclusion diet/patch test - doesn’t give definitive info
exclude coeliac and refer to gastroenterology if IBD suspected
systemic therapy if not controlled with topical - prednisolone

97
Q

yellow base of ulcer not present

A

area still being traumatised

98
Q

OSF

A

associated with betel chewing

epithelial inflammatory reaction and progressive fibrosis of submucosal tissue

99
Q

actinic cheilitis compared to IO carcinoma prognosis

A

much better
later metastasis (to submental nodes) and slow prognosis
cure rate high and easy to monitor

100
Q

differential diagnoses of neck swelling

A 
lymphoma
carotid body tumour
brachial cyst
sebaceous cyst
metastatic cancer in neck node
101
Q

how does cancer differ from an infective cause of neck swelling?

A

slow enlargement
painless (gradual stretching of fascia)
not fluctuant
- but fixation can occur in chronic infection to be fibrosed

102
Q

complications of mumps

A

encephalitis
pancreatitiis
meningitis
deafness

103
Q

nebuliser

A

liquid medicine into a fine mist which you then breathe in

104
Q

saliva substitutes

A

glandosane
saliva orthana
salivese
biotene

105
Q

perivascular infiltrate

A

the mononuclear inflammatory cell infiltrate around the venules indicates a delayed type of hypersensitivity reaction

106
Q

hyperplasia

A

increase in all layers of epithelium

107
Q

why are there no Tzank cells in pemphigoid?

A

no weakening of attachment (acantholysis)

108
Q

pigmentary incontinence

A

melanin pigment leaking out into the LP

leaks out of epithelium into tissue and stains

109
Q

grading

A

resemblance of the cells to the tissue of origin

ability to carry out same fct as tissue of origin

110
Q

what is mucous retention cyst lined by?

A

epithelium

111
Q

where is mucous retention cyst more common?

A

upper lip in older adults

112
Q

what is the most common site of pleomorphic adenoma of minor SGs?

A

palate

113
Q

adenoid cystic carcinoma issues

A

local recurrence - difficult to determine clinically how far the tumour has spread and if surgical excision is incomplete
most likely metastasis - haematogenous spread to the lungs which is unusual for a carcinoma. LN metastasis to neck nodes is unusual

114
Q

what to ask for in a pus aspirate?

A

culture and susceptibility testinf

115
Q

safety elements when transporting materials to lab

A

needles must be removed from syringes and disposed of in a sharps safe waste container
transport in leak-proof containers and protected against damage
need absorbant material in case specimen leaks
at least 2 leakproof solid containers
distinct labelling on outside and practice address

116
Q

common bacteria isolated from acute dentoalveolar abscess

A

streptococci - s anginosus

strict anaerobes e.g. prevotella intermedia

117
Q

role of pus sampling in AM stewardshipq

A

can take several days to obtain a C+S report from a pus aspirate and the immediate benefit of taking a specimen may not be readily apparent for most patients
but accumulation of data on susceptibility patterns helps inform the production of empiric AB prescribing by providing up to date surveillance data as patterns of AM resistance can change over time
also not all pts will respond as expected to tx and microbial identification and susceptibility testing can help inform clinical decisions

118
Q

principles of in pt management for acute dental infection

A

1 - assessment of airway
2 - S+S of sepsis and resuscitation as appropriate
3 - IV ABs - benzyl penicillin and metronidazole
4 - I+D under GA (+ ext of infected teeth)
5 - pus aspirate for C+S testing

119
Q

denture-induced stomatitis - Newton’s Classification

A

type 1 - pinpoint hyperaemia (localised erythema)
type 2 - diffuse erythema
type 3 - granular erythema (papillary hyperplasia)

120
Q

what should you consider if there are unusual species in the microbiology report?

A

concern that pt is IC and possibly HIV+

- refer urgently

121
Q

EM

A

hypersensitivity type 3
skin reaction to infection/drug exposure mediated
immune complexes deposited in superficial layer of skin and oral mucous membrane
- >50% cases due to HSV (1>2)

122
Q

drugs predisposing to EM

A 
NSAIDs
penicillin
sulphonamides
nitrofurantoin
phenothiazines
anticonvulsants
123
Q

long-term potential sequelae of shingles

A

post-herpetic neuralgia

124
Q

replacement options for central incisor crown fractured completely off to root at short notice?

A

provisional overdenture
provisional post-crown
vacuum formed splint w tooth
rebond fractured crown

125
Q

clinical signs of erosion

A

loss of surface detail
smooth or polished surfaces
exposed D
cupping

126
Q

implant bone dimensions

A

1.5mm horizontal bone round implant
3mm between implants
>5mm between bone crest and CP

127
Q

check if a bridge has debonded

A 
probe
visually
mobility
push and check for air bubbles
floss
128
Q

tx reversible pulpitis

A

removal of caries or other causative factor and Rxs

129
Q

nerve fibres most susceptible to LA

A

Ad, C, Ab, Aa

smaller nerves affected quicker

130
Q

LA constituents

A 
base hydrochloride (anaesthetic agent)
vasoconstrictor
fungicide
reducing agent
preservative
131
Q

what are molars better with than a post?

A

pulp chamber retention

132
Q

primer

A

HEMA supports collagen fibrils and makes space for bond

133
Q

inorganic content % of dentine

A

calcium hydroxyapatite 70%

134
Q

advantages of amalgam

A 
strong
abrasion resistance
corrosion improves marginal seal
radiopaque
long-lasting
cheap
easy
quick
135
Q

disadvantages of amalgam

A 
excessive tooth prep as not bonded
aesthetics
mercury toxicity
creep
weak in thin sections
high thermal conductivity
allergy
tattoo
galvanic reaction
136
Q

criteria before you obturate

A

asymptomatic
canals dried
chemomechanical disinfection completed satisfactorily

137
Q

sealer fct

A

fill lateral canals and the space between tooth and GP

hermetic seal

138
Q

why obturate?

A

seal remaining bacteria
provide apical and coronal seal
prevent reinfection

139
Q

what % of U6s have an MB2 canal?

A

93%

140
Q

advantages of crown down technique?

A 
removes bulk of infected tissue
reservoir for irrigant
keeps reference point for WL
make SL access easier
limit spread of infected material at apical foramen
141
Q

cementing a porcelain

A

silane coupling agent
covalent bonds to oxide groups on porcelain surface (hydrophilic)
hydrophobic C=C reacts with silane in composite
- etch in lab w HF acid

142
Q

what should you do before modifying your cavity prep/finishing?

A

choose material

143
Q

signs of occlusal trauma

A 
pain not explained by infection
fracture of Rxs or teeth
mobility
NCTSL
TMD
scalloping, pronounced linea alba
144
Q

monitoring TW

A

BEWE index
Smith and Knight
photos
study models

145
Q

what % of adults have TW?

A

60%

146
Q

features of a cavity for composite

A

no US E
no sharp internal LAs
bevel CMSA to increase area for bonding

147
Q

techniques for placing composite

A

flowable at base to reduce contraction stress
incremental placement to have a low configuration factor
no more than 2mm increments to avoid soggy bottom

148
Q

cavity features for amalgam

A 
UCs for retention
other retention factors e.g. lock and key, grooves
>2mm depth for sufficient strength
flat occlusal floor
CSMA 90-120 degrees
no US E
149
Q

advantages of Protaper over Kfiles

A

shape memory
reduced lateral pressure so reduced risk of ledge, zip etc
reduced number of instruments needed
increased cutting efficiency

150
Q

reasons a file may separate

A

cyclic fatigue
torsional fatigue
flexural stress
torsional stress

151
Q

consequences of amalgam overhang

A

secondary caries
gingivitis and PDD
may also lead to amalgam fracture in thin section

152
Q

fcts of a facebow

A

mount upper casts
position upper cast
give relationship of upper occlusal plane to condyle
transfer angle of maxillary occlusal plane to a horizontal reference plane

153
Q

anterior guidance preferred why

A

easy to reproduce
protect teeth and Rxs
easy on muscles

154
Q

all metal crown reductions

A

axial 0.5mm
NFC 0.5mm
FC 1.5mm
chamfer 0.5mm

155
Q

MCC reductions

A 
axial 1.5mm
FC 2mm
NFC 1.5mm
chamfer 0.5mm
shoulder 1.5mm
156
Q

ceramic crown reductions

A

axial 1mm
NFC 1mm
FC 1.5mm
shoulder 1mm

157
Q

acrylic faults during production

A

contraction porosity - too much monomer and poor pressure
gaseous porosity - monomer boiled off
granular porosity - not enough monomer
crazing - too much stress

158
Q

GIC composition

A

powder - fluoroaluminasilicate glass

liquid - polyacrylic acid

159
Q

why is RMGI not good as a luting agent?

A

contains HEMA which absorbs water and swells

cytotoxic

160
Q

tempbond constituents

A

base - zinc oxide, starch and mineral oil

accelerator - EBA, eugenol, carunba wax

161
Q

zirconia bonding

A

cannot be etched, will not chemically bond

retention is micromechanical

162
Q

why are lithium disilicate crowns strong?

A

crystals stop crack propagation

163
Q

preventing postural hypotension

A

allow chair to sit up gradually and encourage pt to take their time and take deep breaths

164
Q

GABA

A

gamma amino butyric acid

inhibitory neurotransmitter in CNS

165
Q

1/2 life of midazolam

A

90-150mins

166
Q

ASA classifications

A 
1 - fit and well
2 - mild systemic disease
3 - severe systemic disease
4 - severe systemic disease with threat to life
5 - moribund
6 - brain dead
167
Q

managing a knife edge ridge impressions

A

take primary imp as normal
for master, manage similar to a flabby ridge
- take a mucocompressive imp then relieve areas around the knife-edge with a scalpel
then take a 2nd mucostatic imp with a light body material

168
Q

soft lining

A

may be used on healthy mucosa as a cushion/shock absorber in a reline or for atrophic/knife edge ridges

169
Q

tissue conditioner

A

used in unhealthy/ulcerated mucosa to aid healing

also dissipates forces but is a more short-term option

170
Q

fct impression

A

used w a tissue conditioner
material is applied and pt wears the denture and imp in fct for <24hrs
they return and imp is sent to lab for a reline

171
Q

improving denture retention

A 
remaking
rebase
reline
implant retained
precision attachments
172
Q

why is the buccal shelf used for support?

A

it is non-resorbable

173
Q

shade factors

A

value
hue
chroma
translucency

174
Q

disadvantages of immediate dentures

A

resorption makes fit poor
requires reline/rebase
no trial stage
difficult with surgical XLA

175
Q

clot

A

vasoconstriction
platelet plug
fibrin clot

176
Q

aspirin action

A

inhibits platelet aggregation

177
Q

heparin action

A

accelerates the rate of neutralisation of certain activated CFs by AT

178
Q

stages of development of a biofilm - ACACD

A 
adhesion
colonisation
accumulation
complex
dispersal
179
Q

virulence factors for p gingivalis - PAGET

A 
proteases
adhesins
gingipains
endotoxins
toxic byproducts
180
Q

virulence factors for c albicans GAMES

A 
germ tube formation
adhesins
metabolic acids
EC enzymes
switching mechanism
181
Q

virulence factors of s mutans ASAP

A

adhesins
sugar modifier enzymes
acid tolerance
polysaccharide

182
Q

swallowing liquids

A

from mouth

posterior oral seal

183
Q

swallowing solids

A 
oral cavity continuous with pharynx
ingestion
stage 1 transport
mechanical processing
stage 2 transport
swallowing
184
Q

stages of tooth development

A 
initiation
morphogenesis
cytodifferentiation
matrix secretion
root formation
185
Q

4 parts of the late bell stage

A

inner enamel epithelium
external enamel epithelium
stellate reticulum
stratum intermedium

186
Q

PD abscess

A

acute exacerbation of an existing PD pocket e.g. trauma or obstruction

187
Q

managing traumatic occlusion in a pt w PDD

A

HPT

bite raising appliance to be worn at night

188
Q

factors influencing localised mobility

A 
existing PDD
traumatic occlusion causing widening of the PDL
morphology and length of rooths
PA bone loss
resorption
trauma
189
Q

NG microbiology

A

fusospirochaetal complex - treponema denticola, prevotella intermedia

190
Q

bone loss radius of destruction of plaque

A

about 2mm

191
Q

SEs of CHX

A

stain
taste disturbance
anaphylaxis
interacts with SLS

192
Q

local factors for gingival recession

A 
PDD
habits
traumatic toothbrushing
abrasive TP
high fraenal attachment
crowding
traumatic occlusion
orthodontics
193
Q

managing localised recession

A 
atraumatic TB technique
minimise other RFs
monitor
tx sensitivity
free gingival graft (from palate)
root coverage surgery
194
Q

indications for regenerative PD surgery

A

2 and 3 walled defects
G2 furcation in L teeth
G2 buccal furcation in U molars

195
Q

diabetes as a RF for PDD - WIPA

A

poor wound healing
both pro-inflammatory diseases
impaired PMN fct
advanced glycation end (AGE) products causing increased tissue destruction

196
Q

tests for diabetes

A

RPG >11.1mmol/L
FPG >7mmol/L
= on 2 occs
GTT

197
Q

HbA1c ideal

A

48mmol/L or below

198
Q

smoking affects PD tissues CCEB

A

impaired chemotaxis and phagocytosis
affects cytokine production
affects enzyme catalases
blood flow restricted

199
Q

IL-1

A

a pro-inflammatory cytokine

stimulates the release of enzymes and OCs causing increased tissue destruction

200
Q

NST may not be successful

A 
inadequate RSI
furcation/angular defects that are difficult to adequately clean
motile anaerobes moving into tissues
pt not adhering to OHI
pt IC
201
Q

topical effects of F

A

reduce acid production by plaque
promote remineralisation
bactericidal
remineralised E as fluorapatite

202
Q

pulp tx failure

A

clinically - mobility, pain, fistula

radiographically - radiolucency, resorption, furcation

203
Q

cause of AI

A

gene mutation of amelogenin and enamelin proteins

204
Q

what can HSV1 reactivation cause?

A

herpes labialis (15-30% pts) or bells palsy

205
Q

indications for SSC

A 
MR broken down
restore primary molars
MIH
after pulp tx
space maintenance
206
Q

health issues associated w Down syndrome

A 
VSD
epilepsy
leukaemia
hearing problems
cataracts
207
Q

external inflammatory resorption pathogenesis

A

progressive resorption of external root surface due to damaged PDL resulting in necrotic pulp tissue via dentinal tubules
pH low therefore acidic so OCs stimulated - cementum and bone resorption

208
Q

clinical external inflammatory resorption

A
  • to sensibility test
    may be TTP
    may be mobile
209
Q

radiograph external inflammatory resorption

A

tramlines intact but loss of LD

defect moves with a 2nd radiographic view

210
Q

autism triad of impairment

A

communication
social imagination
social interaction

211
Q

other features of autism

A 
sensory sensitivity
obsessive
learning difficulties
epilepsy
tubular sclerosis
212
Q

indications for FS

A

high caries risk
medically compromised pts
caries in primary dentition
caries in permanent dentition

213
Q

types of CP

A

spastic
ataxic
athetoid
mixed

hemiplegia
diplegia
paraplegia
quadriplegia

214
Q

CF dental

A

thick saliva so reduced caries but increased calculus
E defects
delayed eruption
avoid GA and sedation

215
Q

biopsy LP

A

symptomatic
smokers
erosive

216
Q

2 ways trigeminal neuralgia can occur

A

demyelination causing CN5 ischaemia

aberrant arteriole in cerebello-pontine region lying on the nerve - blood pulsing causes nerve activation

217
Q

anaemia

A

reduction in oxygen carrying capacity of the blood due to a deficiency of Hb or rbcs

218
Q

oral signs of anaemia

A

ROU
candida
glossitis
(smooth iron, beefy vit B12/folate, burning mouth, mucosal pallor)

219
Q

tx of plasma cell gingivitis

A

prevent exposure to allergen e.g. SLS, benzoates, cinnamon, through dietary advice

220
Q

managing xerostomia

A

underlying condition
prevention (OHI, F, diet)
symptomatic relief - substitutes

221
Q

ways ABs work

A 
cell wall destruction
protein synthesis inhibition
cell membrane inhibition
DNA synthesis inhibition
DNA replication inhibition
222
Q

disadvantages of ABs

A

resistance
GI upset
drug interactions

223
Q

mechanisms of AB resistance

A

drug reaction
altered target site
reduced accumulation
altered metabolism

224
Q

U vs L MND

A

“upper spares upper”
everything above eyebrows still fcts in U (CVA)
U part of facial motor nucleus receives both crossed and uncrossed fibres so the frontalis and orbicularis oculi muscles are spared - can furrow brow

225
Q

causes of LMN disease

A 
reactivated HSV causing bells palsy
mastoiditis
trauma
parotid tumour
LA
HIV
226
Q

management of LMN disease

A

80% resolve in weeks
prednisolone to reduce swelling of facial nerve at stylomastoid foramen
eye protection

227
Q

common causes of TMD

A

stress
parafct
occlusal discrepancies
trauma

228
Q

TMJ nerve supply

A

auriculotemporal and masseteric branches of V3

229
Q

BRA

A

minimise parafct habits
minimise load on TMJ
provide stable occlusion
eliminate occlusal interferences

230
Q

diseases caused by coxsackie virus

A

HFM, herpangina, haemorrhagic conjunctivitis, aseptic meningitis

231
Q

EBV fdiseases

A

hairy leukoplakia
burkitt’s lympgoma
IM

232
Q

asthma

A

reversible airflow obstruction

  • smooth muscle contraction
  • inflamed mucosa causing swelling
  • increased mucus secretion
233
Q

dental aspects of asthma

A 
increased candida - steroid effects
increased erosion (intrinsic GORD, extrinsic meds), reduction in saliva exacerbating both
--->rinse w water, use spacer
possible allergy to colophony in FV
MEs for asthma attacks
234
Q

S+S oral cancer

A

sites - lat tongue, FOM, SP
signs - unexplained >3wks white/red patch, ulcer, swelling, hoarseness, unexplained mobility
ulcer - rolled border, indurated, bleeding, numbness, pain

235
Q

necrotising sialometaplasia histology

A 
slough
inflammation
hyperplastic
metaplasia
necrosisq
236
Q

OFG histology

A

non-caseating GCs
oedema
dilated lymph

237
Q

radio risks

A 
mucositis
xerostomia
ORN
increased infection
poor wound healing

past papers (3 decks)

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