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past papers Flashcards

1
Q

clinical records from pt for bridgework

A

master impressions with bite reg
tooth selection - size, shape, shade
chosen bridge designs

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2
Q

+s of RMGI

A

higher mechanical strength
lower solubility than GIC
command set via light

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3
Q

why is it wrong to use GI filling material as a luting agent?

A

glass powder particle size too large - interfere with seating of Rx
may absorb moisture
weak mechanically - prone to caries ingression

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4
Q

disadvantages of pocket chart

A

standardised - don’t account for individual pt morphology

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5
Q

why does furcation involvement mean poor prognosis?

A

hard to keep clean

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6
Q

discolouration/staining could be?

A

potential caries ingress

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7
Q

NST may fail to eliminate bacteria from PD pockets

A

pockets may be blocked e.g. calculus
instruments may not reach depths of pocket as too big so do not disrupt biofilm
pt compliance and skill set
clinician skills

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8
Q

oral ABs limited use for periodontitis tx

A

unable to penetrate biofilm
may not reach sites
chance of developing AB resistance

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9
Q

PD abscess SDCEP

A

careful subgingival instrumentation short of base of PD pocket to avoid iatrogenic damage, may need LA
if pus - drain by incision or through PD pocket
recommend optimal analgesia
no ABs unless signs of spreading infection/systemic involvement
recommend 0.2% CHX MW until acute symptoms subside
following acute management review within 10 days and carry out definitive RD instrumentation and arrange appropriate recall interval

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10
Q

why relief/window in midline of U denture?

A

palatine torus

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11
Q

how to rectify attrition of occluding denture teeth in short term?

A

add autopolymerising resin to build teeth back up

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12
Q

essential info for a NHS prescription

A

pt details: name, address, age (legally required if under 12), DOB, CHI
drug - generic name, prep, dose, daily freq and dose, length of duration, total amount of prep needed for length of duration
GDP - name, practice address and contact number, signature
date of prescription and cross out any free space

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13
Q

non-controlled drugs prescription expiry

A

6m

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14
Q

CD prescription expiry

A

28days

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15
Q

OAF pt symptoms

A 
fluid from nose when drinking
nasal/whistle sound when breathing
bad taste
halitosis and bad smell
difficulty smoking
difficulty using straw
difficulty playing wind instruments
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16
Q

OAC POIs

A 
no forceful nose blowing
don't use straw
no smoking/alcohol
open mouth when sneezing
use steam inhalation
amoxicillin 7 days
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17
Q

medical conditions associated with pseudomembranous candidiasis

A

diabetes - poor control/undiagnosed

HIV - IC

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18
Q

mouth swab pros and cons

A

site specific

can be painful and easily contaminated

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19
Q

oral rinse pros and cons

A

sufficient quantity of MOs as whole cavity

not site specific so incs MOs which may not be relevant to diagnosis

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20
Q

fluconazole interactions

A

warfarin - increases free warfarin so increases bleeding risk
statins - increases risk of rhabdomyolysis and hepatotoxicity

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21
Q

where does HSV lie dormant?

A

trigeminal ganglion

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22
Q

triggers for recurrent HSV

A

trauma (physical to lip, UV)
immunocompromised, cold/illness
stress

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23
Q

microcytic anaemia

A

Fe deficiency

thalassaemia

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24
Q

topical therapies for minor RAU

A

benzydamine MW/spray
CHX MW 0.2% 10ml x2 daily
steroids - betamethasone MW, beclomethasone inhaler

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25
Q

effects of supernumeraries on permanent dentition

A

delayed/failed eruption
crowding/impaction/ectopic position of permanent teeth
diastemas
pathology - cyst formation

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26
Q

Down syndrome medical conditions

A 
CHDs - VSD
leukaemia
hypothyroidism
hearing loss
cataracts
epilepsy
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27
Q

Down syndrome EO

A 
frontal bossing
widely spaced eyes
Brushfield spots- white spot on iris
small midface (hyoplasia) - small nose
class 3
upslanting palpebral fissures
low set small folding ears
short neck
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28
Q

Down syndrome IO

A 
class 3 incisors
microdontia
hypodontia
macroglossia with fissures
AOB
increased caries and PDD risk
wear facets
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29
Q

SEs of chronic cocaine use

A

numbness of gingiva (area where rubbed)
erosion of floor of nasal cavity
ulceration of gingivae
wear due to bruxism

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30
Q

complications if LA with adrenaline administered to pt who has recently abused cocaine

A 
increased hr (hypertension) - palpations, LOC
mood swings - aggressive
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31
Q

SEs of opiate abuse

A 
addiction
vomiting, nausea
drowsiness
resp depression
death
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32
Q

methadone

A

opioid

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33
Q

methadone caries

A

acidic and sugar

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34
Q

disadvantage of SF methadone

A

doesn’t have chloroform so less irritant to inject - need to monitor pt closely

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35
Q

cleaning essential to ensure effective disinfection/sterilisation

A

removes gross debris
removes any Rx materials
helps next stage to reach all surfaces of instrument
ensure equipment functioning optimally and correctly

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36
Q

non y2 amalgam pros

A

corrosion resistance
less creep
higher mechanical strength
better marginal seal

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37
Q

reducing y2 amalgam

A

add Cu - preferentially reacts with tin making less available to produce y2

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38
Q

zinc free amalgam

A

originally was necessary to add Zn - scavenger, so it preferentially oxidises rather than other constituents
but can get creep - formation of ZnO (slag) - increase pressure which could cause Rx to rise
ZnO +H2O - ZnO + H2 (react with saliva/blood)
H2 increases pressure - downward pulpal pain, upward sits proud - risk of Rx fracture

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39
Q

vertical bone loss

A

plaque - destruction of bone with a 2mm radius which may be more than the thickness of bone in that area leading to a vertical bone defect

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40
Q

short term Rx of crown and core fracture

A

rebond
vacuum formed splint holding it in place
overdenture - keep space by covering teeth

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41
Q

retention in upper denture

A

peripheral seal
post dam
full extension into buccal sulcus

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42
Q

factors that cause displacement of a mandibular fracture

A

direction of fracture line
opposing muscles/occlusion
force applied to fracture

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43
Q

discolouration pt info

A

SHADE assessment - sensibility scores, draw out the teeth and areas of discolouration on them and shade of different areas of the teeth and lesions
take photos
record and get pt to sign saying they agree with current shade

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44
Q

why do you use a soft flex disc after microabrasion?

A

to remove the prismless layer that has formed

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45
Q

6 links in chain of infection

A 
infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
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46
Q

protaper sequence

A 
10,15 - 2/3 EWL
s1 - no deeper than 15
10 - find CWL
15 - glide path to CWL
s1
s2
f1
f2
etc
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47
Q

prognosis of individual teeth perio

A

pocket probing depths
LOA
mobility
furcation involvement

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48
Q

ABs might not be effective in eliminating pocket bacteria

A 
may be inactivated
may be resisted by biofilms
super-infection could occur
may not reach site of disease activity
may have inadequate drug conc and retention
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49
Q

transient sensitivity to thermal stimuli and pain on biting after composite and preventing

A

uncured resins
insufficient coolant on prep
fluid from tubules occupying space under Rx
pulp exposure

prevent

  • pulp cap
  • cure in increments
  • coolant
  • liner
  • stepwise excavation
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50
Q

local factors contributing to DG

A

plaque and SLS

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51
Q

local haemostatic agents

A

surgicel
LA with vasoconstrictor
bone wax
ferric sulphate

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52
Q

general implant checks

A 
PDD
smoking
diabetes
osteoporosis
bisphosphonates
bleeding disorder
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53
Q

local implant checks

A

quality and quantity of remaining bone
position of teeth - rotations, angulations
OH

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54
Q

tx options for impacted FPMs

A 
monitor
XLA E
disc distal E
ortho separator
ortho appliance attached to 6 to bring into position
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55
Q

complications of a fixed retainer

A

debond
fracture
OH issues
gingivitis risk

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56
Q

complications of PFR

A

can be lost
can alter occlusion
chip or fracture
low compliance

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57
Q

local causes of pigmentation

A

amalgam tattoo
malignant melanoma
naevus

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58
Q

general causes of pigmentation

A

smoking
racial pigmentation
drug
Addison’s

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59
Q

capillary haemangioma histology

A

non-capsulated aggregates of closely packed, thin-walled capillaries, with single layer endothelial lining and separated by CT

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60
Q

cavernous haemangioma histology

A

encapsulated nodular mass composed of dilated, cavernous vascular spaces with endothelial lining separated by CT. Smooth muscle cells surround the vascular spaces

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61
Q

UE tooth investigations

A

radiograph
sensibility test
mobility

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62
Q

angular cheilitis organisms

A

s aureus, c albicans (streptococcus)

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63
Q

bonding to amalgam

A

MDP

4-META

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64
Q

BEWE

A 
0 - no tooth wear
1 - initial loss of E surface texture
2 - distinct defect, hard tissue loss <50% surface area*
3 - hard tissue loss ≥ 50% SA*
*D often involved
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65
Q

contraindications to the Dahl technique

A 
active PDD
bisphosphonates
implants
existing bridgework
post-ortho
TMD
short roots
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66
Q

why is IV sedation consent separate visit?

A

once pt sedated consent no longer valid

amnesic effect of midazolam - may forget giving consent if on same day

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67
Q

midazolam dosage

A

5mg/ml (1mg/ml)

2mg bolus then 1mg increments every 60s

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68
Q

flumazenil dosage

A

500mcg/5ml

200mcg then 100mcg increments every 60s

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69
Q

MIH problems

A 
sensitivity
wear
caries risk
erosion
difficult to bond to
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70
Q

when is reactionary bleeding

A

<48hrs

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71
Q

what is secondary bleeding caused by?

A

infection causing breaking down of the clot

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72
Q

factors which can cause displacement of a mandibular fracture?

A

muscle attachments
mechanism of injury
unfavourable fracture lines
mechanism of force

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73
Q

possible IO features of class 3

A 
posterior CB
displacement on closing
crowded maxilla
class 3 incisors
decreased/reverse OJ
retroclined L incisors
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74
Q

learning outcomes of an intervention

A 
reinforce good practice
identify gaps in knowledge
allow people to work in small groups
encourage continued learning
help staff understand importance of...
modify attitudes

after this carry out a clinical audit to see what changes are required and implement them
carry out another clinical audit to see if improvement has been made

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75
Q

why is severe class 2/3 contraindicated for SDA?

A

less likely for there to be occluding pairs in severe malocclusion

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76
Q

why is PDD contraindication for SDA?

A

poor prognosis of teeth
drifting of teeth under occlusal load
loss of alveolar bone leading to compromised denture bearing area in the long term

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77
Q

subalveolar fracture poor prognosis

A

lack of tooth tissue to support a Rx
difficulty of isolation and moisture control for any tx
difficulty of placing subgingival crown margins
clamp/isolation for endo

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78
Q

features of denture induced stomatitis

A

erythematous

papillary hyperplasia

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79
Q

instructions to lab re special tray

A

pour in 50/50 stone/plaster
construct special trays in light cure acrylic, non-perforated
U with 2mm wax spacer
L 1mm wax spacer
IO handles and finger rests in premolar region
ensure muscle attachments are relieved

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80
Q

minimise risk of debond RBB

A

tooth with large bonding area for abutment

cantilever design for anterior sextant

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81
Q

factors causing debond RBB

A

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

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82
Q

material RBB wing

A

CoCr

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83
Q

clinical indicators of malignancy

A 
exophytic
raised rolled borders
firm and indurated 
friable
bleeding
persistent >3wks without obvious cause
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84
Q

mandibular displacement on closing

A

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

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85
Q

why should mandibular displacement on closing be corrected?

A

can lead to TMJ symptoms and can cause attritive wear

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86
Q

correcting a bilateral posterior CB

A

midpalatal screw on URA to expand maxilla
4 Adams clasps
reciprocal anchorage
self cure PMMA with FPBP and mid-palatal split

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87
Q

S+S of TMD

A 
hypertrophic/tender MofM
pain
linea alba
scalloped tongue
occlusal surface wear
clicking/popping noises on opening
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88
Q

what GI conditions can cause microcytic iron deficiency anaemia?

A

Crohns
UC
Coeliac

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89
Q

other oral conditions associated with microcytic iron deficiency anaemia

A

candidosis
dysaesthesia
aphthous ulcers

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90
Q

cocaine use features

A

nasal septal defect
oral ulceration
bruxism and TW from grinding

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91
Q

side effects of opioid use

A 
constipation
sedation
xerostomia
excessive sweating
addiction
92
Q

complication of methadone containing sugar

A

rampant caries

93
Q

risk of SF methadone

A

more likely to inject it

94
Q

lower RPD not supplied and complete upper

A

will get resorption of bone, deposition of fibrous tissue, causing flabby ridge

95
Q

Cu denture retained

A

muscular
adhesion/cohesion
post-dam
extension into buccal sulcus - peripheral seal

96
Q

biometric guidance setting U and L teeth

A

Hanau’s quint

Watt and McGregor

97
Q

features of a tooth that will make it successful/unsuccessful to tx

A 
ferrule
perio status
mobility
remaining tooth tissue
pulp status
98
Q

short term options to replace tooth

A

temp bridge
temp RPD
if tooth not XLA temp post crown

99
Q

10% carbamide peroxide breaks down into

A
  1. 4% H2O2

6. 6% urea

100
Q

Albrights syndrome

A

polyostotic fibrous dysplasia
abnormal pigmentation
precocious puberty

101
Q

what can alkaline phosphatase indicate?

A

liver damage or a bone disorder

102
Q

what is hypercalcaemia often due to?

A

hyperparathyroidism

103
Q

what associated condition can you get with temporal arteritis?

A

polymyalgia rheumatica - pain and stiffness in shoulder and neck muscles

104
Q

SS ABs

A

anti-SSA (anti-Ro) or anti-SSB (anti-La)

105
Q

2 things to do after audit cycle

A

implement changes

repeat audit cycle

106
Q

clinical governance 6 components

A 
education and training
clinical audit
clinical effectiveness
research and development
openness
risk management
107
Q

Audit cycle

A 
identify problem/issue
set criteria/standards
observe practice/data collection
compare performance with criteria and standards
implement change
108
Q

prevalence of hypodontia primary dentition

A

<1%

109
Q

prevalence of hypodontia permanent dentition

A

6%

110
Q

tx options for ectopic canines

A

XLAc and review 6m
accept and monitor
expose and ortho align
XLA3 and replacement or autotransplant

111
Q

differential diagnoses for L8 dull throbbing pain

A

otitis media
irreversible pulpitis
pericoronitis

112
Q

how a splint works

A

habit breaker
stabilises occlusion
keeps MofM in relaxed position
minimises loading on TMJ

113
Q

arthrocentesis

A

inject fluid into TMJ to flush out inflammatory exudate and remove adhesions

114
Q

features of zygomatico-orbital fractures

A 
periorbital ecchymosis
numbness of cheek
subconjunctival haemorrhage
diplopia
lacerations
enophthalmos
swelling then flattening
asymmetry
trismus
reduced acuity
pain on eye movements
115
Q

xrays for zygomatico-orbital fractures

A

OM 15/30

116
Q

management of zygomatico-orbital fractures

A

undisplaced - monitor and conservative advice

displaced/symptomatic (eye/nerve)/defect on xray/suspicion of late enophthalmos - ORIF

117
Q

disadvantage of rinse

A

not site specific

only indicates presence of microbe, doesn’t guarantee its implication in infection

118
Q

pseudomembranous candidiasis - what to ask pathologist for

A

culture and sensitivity

119
Q

herpes groups that cause oral ulcers

A

HSV1
HSV2
CMV

120
Q

coxsackie diseases

A

HFMD

herpangina

121
Q

EBV diseases

A

glandular fever

hairy leukoplakia

122
Q

effect of supernumeraries on permanent dentition

A

root resorption
delayed eruption
ectopic eruption
diastemas

123
Q

class 2 div 1 incisors

A

lower incisor edges lie posterior to the cingulum plateau of the upper incisors
increased OJ
U central incisors proclined or of average inclination
15-20%

124
Q

why are elderly more at risk of postural hypotension?

A

age-related impairment in baroreflex mediated vasoconstriction
deterioration of diastolic filling of heart
low bp

125
Q

reasons pt LOC

A

hypoglycaemia
epilepsy
stroke

126
Q

NES 3 other types of formal QI activity within NHS “terms of service”

A

peer review
research project
SEA - critical incident review
scottish pt safety initiative

127
Q

peer review

A

groups of dentists get together to review aspects of practice
share experience and identify areas in which changes can be made with objective of improving quality of care, share learning and implement change

128
Q

practice based research project

A

participation in formal/approved research project within Scottish Dental Practice Based Research Network (SDPBRN)

129
Q

steps of SEA

A 
identify event
collect and collate info
set up a meeting to discuss events
meet and undertake a structured analysis - what? why? learned?
implement changes and monitor progress
write up the SEA
seek external feedback/comment
130
Q

balancing ext

A

ext of a tooth from the opposite side of the same arch

designed to minimise midline shift

131
Q

LP histology

A

hugging band of T lymphocytes
change in surface epithelium: hyperkeratosis/atrophy
civatte bodies: apoptosing intra-epithelial cells
basal cell liquefaction
saw-tooth rete pegs

132
Q

pemphigoid lab

A

hemidesmosomes/BM
linear appearance
subepithelial bullae
CT inflammatory response (immunofluorescence along BM)

133
Q

pemphigus lab

A 
intra-epithelial desmosome split, bullae
basket weave appearance, IF suprabasal
acantholysis
suprabasal split, tzank cells in cleft
intact basal cell layer still attached to basal lamina
mild inflammatory infiltrate
134
Q

causes of LP

A

idiopathic
immunomediated
hep c

135
Q

LTR causes

A

drugs
SLS
amalgam
plaque (desquamative gingivitis)

136
Q

which drugs can cause LTR?

A 
NSAIDs
B-blockers
anti-hypertensives
hypoglycaemics
diuretics
137
Q

LP/LTR tx

A 
SLS free tp
good OH
monitor
CHX
stop smoking
138
Q

oral effects of cannabis

A

dry mouth, can lead to PDD

vomiting - wear

139
Q

oral effects of cocaine/crack cocaine

A

acidic when mixes with saliva - erosion
grinding/muscle spasms “buccolingual dyskinesia”
rub powder on gums - gum sores
snorting - damage to HP - hole between nose and mouth

140
Q

oral effects of ecstasy/amphetamines

A

grinding

dry mouth

141
Q

oral effects of heroin

A

crave sugar

grind

142
Q

oral effects of meth

A

caries, crave sugar
bv effects - gums
dry mouth
grinding

143
Q

CHX mechanism

A

dicationic

one to pellicle, other to bacterial membrane to increase permeability and then to cell death at higher concs

144
Q

nystatin mechanism

A

polyene

bind to sterols in fungal membranes, allows leaking of metabolites

145
Q

polyenes mechanism

A

bind to sterols in fungal membranes, allows leaking of metabolites

146
Q

azoles mechanism

A

interfere with the primary sterol component of fungal cell walls

147
Q

restoring excessive FWS with worn dentures

A

occlusal pivots
restore occlusal surface with autopolymerising acrylic resin
replica technique if only occlusal surface needs adjusted

148
Q

aetiology of TN

A

trigeminal nerve ischaemia
distortion of myelin sheath
therefore interrupted/altered electrical conductivity
abnormal electrical current in sensory nucleus of trigeminal

149
Q

TN investigations

A 
rule out odontogenic
MRI
FBC
LFT/ U+E
assessment of suicidal intent
150
Q

localised causes of pigmentation

A 
Am tattoo
malignant melanoma
melanotic macule/naevi
peutz-jehger's syndrome
KS
pigmentary incontinence
151
Q

generalised causes of pigmentation

A 
Addisons
drugs
OCP
racial 
smoking
152
Q

black hairy tongue

A

chromogenic bacteria and stained with cigarette smoke and trauma

153
Q

amalgam LTR actions

A

replace
may need new RPD
review to ensure resolution of lesion
refer to specialist if no improvement following tx for provision of topical steroid tx to reduce symptoms from lesion

154
Q

TMD red flags and red flags for orofacial pain

A

prev hx of malignancy
persistent or unexplained neck lump/cervical lymphadenopathy (may indicate neoplastic, infective, AI cause)
persistent and worsening pain
jaw pain in pts taking bisphosphonates
concurrent infection
hx of recent H/N trauma
neurological symptoms: headache, CN abnormalities
facial asymmetry/swelling/profound trismus
recurrent epistaxis, purulent nasal discharge, persistent anosmia, reduced hearing on ipsilateral side - may indicate nasopharyngeal carcinoma
unexplained fever/weight loss
new-onset unilateral headache/scalp tenderness, jaw claudication, general malaise, esp if >50yrs - giant cell arteritis
occlusal changes

155
Q

TMD differential diagnoses

A

dental - caries, PDD, tooth abscess, 8 eruption
parotitis/sialadenitis/sialolithiasis
maxillary sinusitis
headaches - migraine, tension-type, cluster and other TACs, meds overuse
neuralgias - TN, peripheral neuritis, post-herpetic neuralgia, post-traumatic and post-surgical neuralgia
ear conditions e.g. otitis media
other viral conditions - mumps, shingles
AI - RA, SLE, SS
ORN
giant cell arteritis

156
Q

instructions to lab for stabilisation splint

A 
pour imp in 100% stone
hard splint
covering entirety of occlusal surfaces
halfway down crown
min 2mm thick
made with hard acrylic
157
Q

desquamative gingivitis

A

clinical descriptive term to describe an oral manifestation of MC disorder (usually) where the superficial layer of the epithelium is atrophied/separated from the remainder of the epithelium. Relates to an immune response
tissues involved - attached gingiva to MG jct, sparing margins, full thickness, striae possible. Labial

158
Q

burning mouth causes

A

poor vascularisation as bv’s decrease in size
poor nutrition means atrophy of the tissue/mucosa
sensory receptors change into nociceptors

159
Q

differential diagnoses of burning mouth

A 
oral dysaesthesia
diabetes
stroke
xerostomia
hormonal imbalance (menopause)
stress
anxiety
cancerphobia
fungal infection
allergy
160
Q

tx of burning mouth

A

investigate - haematinics, FBC, AB, blood glucose, saliva, parafct, denture, cancerphobia, psychiatric
reassure pt
correct deficiencies and underlying disease
difflam
correct parafct/denture problems
gabapentin/antidepressant
CBT

161
Q

what is dermatitis herpetiformis?

A

AI skin condition linked to celiac disease - IgA deposits due to gluten

162
Q

6 types of candidiasis

A 
acute pseudomembranous
acute erythematous (AB sore mouth)
chronic erythematous (denture induced)
CHC
MRG
angular cheilitis
163
Q

investigating pt with candida

A 
FBC
haematinics
blood glucose
dry mouth
HIV
swab/rinse
164
Q

mechanism of action of bisphosphonates

A

reduce bone turnover by inhibiting formation, recruitment, activity of OCs

165
Q

diseases bisphosphonates are used for

A

osteoporosis
bone disease/metastases
malignancy

166
Q

MRONJ criteria

A

> 8wks exposed necrotic bone
take bisphosphonates etc
no hx of H+N radio

167
Q

where are bisphosphonates esp active?

A

areas of high bone turnover i.e. jaw - reduce blood supply and turnover

168
Q

Pagets pathogenesis

A

enlargement of maxilla due to overactivity of OCs and OBs
normal bone remodelling is replaced by chaotic bone alteration of bone deposition and resorption, with resorption dominating early stages
- hypercementosis
- evidence of Paget’s in >5% >55yrs, mainly men

169
Q

RPI action

A 
saddle sinks into denture bearing area
rotation about mesial rest
distal guide plate and I bar clasp rotate downwards and mesially
disengage from tooth
torque forces avoided
170
Q

symptoms of increased OVD

A

difficulty eating and speaking
teeth together at rest
pain

171
Q

symptoms of reduced OVD

A

poor facial profile
lack of chewing pressure
angular cheilitis
generalised facial discomfort

172
Q

why can’t impression be mucocompressive in a flabby ridge?

A

leads to denture being well-adapted when compressed during occlusal pressure but will cause displacement during tissue recoil at rest
window technique

173
Q

indications for replica technique

A

correct position of teeth (in neutral zone)
polished surfaces satisfactory
wear of occlusal surfaces (indicates long-term wear)
replacement of immediate dentures
spare set
loss of retention in otherwise favourable dentures
deterioration of denture base materials

174
Q

contraindications for replica technique

A

polished surfaces incorrect
not in neutral zone
major modifications needed
prev dentures not available

175
Q

neutral zone

A

zone of minimal conflict of muscular displacing force

176
Q

management of knife-edge ridge

A

take imp as normal
roll finger along ridge to identify areas of discomfort, cut relief in impression and take imp again with mucostatic material e.g. light-bodied PVS
soft lining
surgery to smooth ridge down

177
Q

when would you use a lingual plate?

A

if no space for a lingual bar

178
Q

pt concerns re amalgam

A 
colour
leaching/toxicity/poisoning
allergy
oral cancer
toothwear
longevity
cost
179
Q

amalgam pt reassurance

A 
mercury within compound so non-toxic
minute amounts
clinical evidence
good longevity
no link to cancer
cheap
180
Q

where shouldn’t you finish a restoration?

A

on contact point

181
Q

how composite bonds to dentine

A

etch - demineralises D surface, widening tubules and exposing collagen fibrils
dry
prime - invades spaces created from etching with primer monomer - displacing water by solvent. Has a bi-fct coupling molecule which is both hydrophobic and hydrophillic
bond - unfilled resin monomer infiltrates spaces occupied by primer, creates hybrid layer which when cured forms strong cross-linked bond to D, resin tag creating micromechanical retention. Air inhibition of surface layer leaves unreacted monomer to subsequently bond with incrementally built up composite

182
Q

bonding agents based on chain length

A

bis-GMA medium
UDMA short - more polymerisation shrinkage
tegDMA long

183
Q

potential problems when designing bridge

A 
long axis angulations coincident
occlusal interferences
adequate root area for support (ante's law)
aesthetics
resorbed alveolus - floating tooth syndrome
large saddle
technique sensitive
pontic choice
184
Q

D hypersensitivity mechanism

A

pain arising from exposed D in response to a thermal, tactile or osmotic stimulus.
thought to be due to dentinal fluid movement stimulating pulpal pain receptors
diagnosis by exclusion of other causes

185
Q

tx of D hypersensitivity

A

eliminate or reduce aetiological factors

reduce permeability of dentinal tubules

186
Q

what do you use to assess occlusion when designing bridgework?

A

semi-adjustable articulator with FB mount and customised incisal guidance table

187
Q

what to look for when assessing occlusion in bridgework?

A

overeruption of occluding teeth
space m-d for teeth
angulation of adjacent and occluding teeth

188
Q

pros and cons of PMMA as temp Rx

A

+ high wear resistance and strength

- polymerisation shrinkage, exothermic, free monomer

189
Q

pros and cons of PEMA as temp Rx

A

+ less shrinkage, less exothermic

- mod strength and wear resistance, discolours and stains easily

190
Q

pros and cons of bis-acryl composite as a temp Rx

A

+ high wear resistance, less shrinkage, aesthetics

- brittle in thin sections, difficult to add/repair to, £

191
Q

cracked tooth syndrome S+S

A

short sharp pain on opening from bite
often large Rx
+ response to vitality testing
may be associated w bruxing habit
pain can usually be elicited by pt biting on a tooth sleuth
transillumination and possible removal of Rx may aid visualisation

192
Q

tx of cracked tooth syndrome

A

temp - band around tooth
comp on minimal Rxs
may need onlay/crown (full occ coverage)
occ RCT

193
Q

reasons for post failure

A 
perforations
reintroduced bacteria on post prep
accessory canals not cleaned
poor post design/placement
not considered occlusion
not cemented correctly
194
Q

addressing concerns re a child

A 
raise concerns with parents
explain what changes are required
offer support
keep accurate records
continue to liase with parents/carers
monitor progress
if concerned pt suffering/at risk of harm - involve other agencies
195
Q

long term effects of trauma in primary teeth

A

discolouration
discolouration and infection
delayed exfoliation

196
Q

AI - hypoplastic

A

yellow brown

E crystals don’t grow to correct length

197
Q

AI - hypomineralised

A

yellow/brown soft and rough

crystallites fail to grow in thickness and width

198
Q

AI - hypomaturation

A

yellow brown and calculus

E crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation

199
Q

AI mixed type

A

with taurodontism

brown mottled

200
Q

clinical aspects of AI

A

E soft and thin, teeth appear yellow and easily damaged
affects both primary and permanent dentition
pt c/o sensitivity

201
Q

radiographic aspects of AI

A

UE crowns have normal morphology
E has reduced contrast to D
taurodontism has large pulps

202
Q

types of DI

A

type 1 - OI - blue sclera
type 2 - AD
brandywine - maryland USA

203
Q

clinical DI

A 
affects both dentitions
no complaint of sensitivity
aesthetics
caries susceptibility
spontaneous abscess
blue sclera
204
Q

radiographic DI

A

bulbous crowns
obliterated pulps
E loss

205
Q

local factors causing discolouration

A 
caries
demineralisation
hypomineralisation
extrinsic tooth staining
fluorosis
pulpal necrosis
internal resorption
206
Q

diagnostic features of fluorosis

A

E defects - opacities
affecting >1 tooth
history of F ingestion/high F water concentration

207
Q

indications for treating an anterior CB

A

mandibular displacement - predisposition to TMD
a traumatic displacing anterior occlusion may deflect a lower incisor labially and compromise D support
pt aesthetics

208
Q

epidemiology of ectopic canines

A

2% pop

85% are palatally ectopic

209
Q

aetiology of ectopic canine

A 
crypt displacement
long eruption path
small/absent laterals
crowding for buccals, spaced/uncrowded for palatals
retention of deciduous canine
genetic factors
210
Q

clinical signs of impacted 3s

A 
delayed eruption
retained c
unable to clinically palpate
distal tipping of 2s
loss of vitality and mobility of 1s and 2s
diminuitive 2s
211
Q

features of class 2 div 1 amenable for URA

A

labial tipping
needs good anchorage
space available
can correct OB

212
Q

what causes tooth mobility

A 
loss of attachment
occlusal trauma
PA lesion
trauma
following perio tx
213
Q

-s of ABs perio tx

A 
may be inactivated or degraded by non-target organisms
biofilms resist ABs
resistant organisms
superinfection
allergic reactions
214
Q

-s of a pocket chart

A

assumes all pts’ teeth have same root lengths therefore making some teeth seem like they have a poorer prognosis than they actually do
potential for errors: probing force, probe angulation, presence of Rxs/calculus, degree of inflammation, clinical experience, visibility, pt cooperation

215
Q

theories of vertical bone loss defect

A

usually localised and related to occlusal trauma (glickmans theory)
wide interdental bone between teeth and plaque present (waerhaugs theory)
overhanging Rxs - plaque trap leading to a bony defect progressing faster than rest of jaw

216
Q

theory for horizontal bone loss

A

more generalised chronic periodontitis

ID bone <2mm

217
Q

what does CHX substantivity depend on?

A

absorption to oral surfaces
active when absorbed
slow neutralisation of antimicrobial activity

218
Q

2 doses of CHX

A
  1. 2% 10ml = 20mg x2 daily

0. 12% 15ml = 18mg x2 daily

219
Q

aims of root coverage surgery

A

improve aesthetics
facilitate plaque control
address sensitivity

220
Q

is the prognosis of the tooth negatively affected by an NaOCl accident?

A

no

221
Q

S+S of NaOCl extrusion

A 
intense pain
facial swelling
profuse bleeding into RC from PR tissues
burning
haematoma
ecchymosis of skin
222
Q

pathogenesis of NaOCl extrusion

A

severe acute inflammatory reaction, can be oedomatous and/or haemorrhagic
can lead to significant tissue necrosis as NaOCl has tissue dissolving properties

223
Q

tx of NaOCl extrusion

A 
stop
inform and reassure
LA for pain relief
aspirate any NaOCl out
irrigate with copious saline
temporise nsCaOH
analgesia
cold then warm compresses
 - reduction of ST swelling and elimination of haematoma
review 24hrs
if severe - refer
224
Q

why do NiTi rotary instruments reduce creation of blocks, ledges, transportations and perforations?

A

remain centred within the natural path of canal

225
Q

management of pt panic attack

A 
stop any tx
sit upright
reassure pt - safe env, tell them they are in control
offer support
encourage breathing
arrange follow up appt
226
Q

acts re illegal drugs

A

Classification of drugs

Misuse of Drugs Act

227
Q

general health problems with illegal drugs

A

BBVs
psychotic illness
STDs
liver disease

past papers (3 decks)

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