Professional Documents
Culture Documents
Board Review OziDent PDF
Board Review OziDent PDF
Biological width Pedo: 0-2mm normally; 0-4mm if next to an erupting permanent tooth or exfoliating primary tooth
How much for max NO: flow rate 4-6 L/min; in children, increase by 10% increments, maintenance is usually at 30%
Orofacial Clefts
Cleft Lip: 25%, 4-5 weeks in utero
o defect between medial nasal process and maxillary process
o unilateral 80%, bilateral 20%; 1:1000 births
Cleft palate: 25%, 6-8 weeks in utero
o lack of fusion between palatal shelves
o 1:2000 births
Both 50%
Ectodermal dysplasia: "heritable conditions in which there are abnormalities of two or more ectodermal structures such as the hair,
teeth, nails, sweat glands, cranial-facial structure, digits and other parts of the body."
Congenitally missing teeth, peg shaped, or pointed, defective enamel
Also have frontal bossing, thin brittle hair/nails, light skin, cannot perspire cannot regulate body temperature
Bleeding values:
Bleeding: 1-3 minutes
PT: 10-13 seconds; extrinsic pathway
INR: 0.8-1.2; (INR=PTtest/PTnormal)
o in patients on anticoagulation therapy- 2.0-3.0
PTT: 25-29 seconds; intrinsic pathway
Platelet count: 150k-450k / µL
o Oral agents that alter/suppress platelet function include: aspirin, clopidogrel, cilostazol, ticlopidine, and prasugrel
Bone graft
Autograft – same person; from intraoral sites (maxillary tuberosity marrow, osseous coagulum, bone blend); also iliac bone
Allograft
o uDFDBA – osteoconductive (outside cells penetrate scaffold and form new bone)
o DFDBA – osteogenic (contanes MMPs that induce formation of new bone)
Xenograft – BioOss – anorganic bovine-derived bone – osteoconductive
Cosmetic dentistry
Hue – the color
Chroma – the purity/saturation of the color; high rich, low dull
Value – lightness or darkness of the color; light “tint”, dark “shade”
Class III cavity in two proximal teeth: Drill: BIG to small; Fill: small to BIG
Herpetic gingivostomatitis – within 3 days of onset: treat with Acyclovir 15mg/kg 5 times per day for 7 days
All patients: palliative care: plaque removal, systemic NSAIDS, and topical anesthetics
Contagious when vesicles are present
Ameloblastoma – adult, odontogenic, molar region, benign, aggressive, recurrent, external swelling
Mucus retnsion cysts – blockage of salivary duct by sialolith (salivary stone); blueish; on palate, Buccal
mucosa, upper lip
Called a ranula if on floor of mouth
Do not confuse with mucocele (mucous extravasion phenomenon) – nodule of saliva due to escape
from duct of salivary gland
Which gland (parotid, submandibular, or sublngual) is a sialoth most common
Which space is not involved in ludwig’s angina? (submental submandibular, retropharyngeal, or submental)
Impression materials
Irreversible hydrocolloid (alginate) – rapid set, pour immediately, not accurate (dx casts only)
Reversible hydrocolloid (agar) – hydrophilic, long working time, accurate, pour immediately; no custom tray but requires
special equipment, tears easily
Polysulfide polymer (for complete dentures) – high tear strength, smells, messy, good reproducibility, pour within 45
minutes; H2O is a byproduct contraction
Condensation silicone (?) – short setting time, pour immediately; EtOH is a byproduct dimensional contraction; base+acc
Addition silicone (VPS) – no byproducts dimensional stability, low tear strength, fewer voids when poured immediately
Polyether (Impregum) – base and accelerator; no byproducts excellent dimensional stability; pour soon
Malleability – deform (without fracture) under compressive strength; ability to form a thin sheet; gold is malleable
Greatest malleability to least: gold, silver, lead, copper, aluminium, tin, platinum, zinc, iron, and nickel
Ductilty – deform (without fracture) under tensile strength; ability to stretch into wire
greatest ductility to least: gold, silver, platinum, iron,nickel, copper, aluminium, zinc, tin, and lead.
Gold inlay/onlay – divergent walls (2-5 degrees per wall), 30 degree bevel margins for better fit, skirt – extend beyond line angle
RPD classifications
class I – bilateral edentulous area posterior to remaining teeth
class II – unilateral edentulous area posterior to remaining teeth
class III – unilateral edentulous area with natural teeth anterior and posterior
class IV – single bilateral edentulous area with natural teeth remaining on both sides
RPD components
Major connector – connect all rpd components on one side to those on other side
Minor connector – stabilization
Rest – support
Clasp arms – stabilization (middle 1/3) and retention (gingival 1/3)
Epidemiology definitions
Incidence - measure of the risk of developing some new condition within a specified period of time
Prevelance - measure of the total number of cases of disease in a population
Sensitivy - measures the proportion of actual positives which are correctly identified as such
Specificity - proportion of negatives which are correctly identified (e.g. the percentage of healthy people who are correctly
identified as not having the condition).
Pictures
Dentinogenesis Imperfecta
Lymphoid epithelial cyst – odontogenic origin
Cemetoblastoma – RO mass that replaces root; tooth is removed with lesion
Periapical Cemento-Osseous dysplasia – vital, lower anteriors, middle age women, RL then RO; no symptoms
Florid Osseous dysplasia involves entire jaw
Migratory glossitis
Nicotinic Stomatitis
Questions
Pt with inlay has pain during biting..no radiographic evidence m-d cusp fracture poor prognosis
o M-D fracture can’t be seen radiographically because the fracture line is not in the plane of occlusion
Cracked tooth with more symptom to---cold,heat,pressure (hard to reproduce), sweets, acidic foods also
o Commonly lower first molar
o Dx: stain, transillumination, tooth slooth, air to detect where pain from crack occurs
o Tx
healthy/reversible splint/observe or crown (temporary then permanent);
irreversible/necrosis endo, core (no post if possible, crown
Which procedure least likely to produce bacteremia--extraction, non surgical endo, oral prophylaxis
Which gracey curet is used for the mesial surface of distal root in max tooth---11-12, 13-14
Units
o Exposure – Roentgen
o Absorbed dose – Gy
o Effective dose – Sv
o Radioactivity Bq
Which structure is most radiosensitve----hemopoitic bone marrow , also oral mucous membrane
o Cells that are mitotically active and undifferentiated and have long mitotic futures
Collimation – reduce SIZE of x-ray beam reduce volume of irradiated patient tissue
o Circle 7cm in diameter
Tranillumination method is most useful in carious diagnosis ---anterior proximal, posterior proxmal
Porcelein laminate veneer fixed by resin show black margin in 2 days cause---porcelein break,resin wears off??? Amine?as
Troches available fungal agent---clotimazole for treating oral Candidiasis; also Nystatin
Which is not an antifungal? Options were ketoconazole, Nystatin, Clotrimazole, and something else
Adult child can decide a treatment plan of his old patient his parent in what suitation---when he is payig money,when he is
impaired either ear or eye,patient want his decision has power of attorny
Dentist does the treatment for 2 crowns but the insurance company pays the money for one crown downcoding.
o The alteration by an insurer or other third-party payer of service codes for physicians or other health care
providers, to those of lesser complexity, resulting in decreased reimbursement
o Q was either about downcoding or upcoding, know both
which area is most difficult to achieve matrix adaptation max mesial 1 prem also common place for perforation
Which impression material has good wettability---Hydrocolloid > Polyether > Hydrophilic Addition Sillicone > Polysulfide >
o Hydrophobic addition silicone and condensation silicone has same wettability
Epidemiological studies
o Cross sectional: Sample of people assessed at one time
o Case control: people with (cases) are compared to people without (control), but are otherwise similar
May establish exposure-disease relationship
o Prospective cohort: follow group over time; describe prevalence of outcomes in the group
o Retrospective cohort: choose a group that HAD the outcome of interest
evaluate effect that an exposure had on a population (ex occupational hazards)
o Double blind clinical trial: neither subject nor investigator knows which group is control or case
Used to compare incidence and side effects
o Community trial: community as a whole is studied; the more similar the communities, the more valid the results
Ex. Fluoridation trial of 1945 (fluoridated community vs non-fluoridated)
Pt has composite restoration with severe pain with localized swelling---- Incision & Drainage
Action of sodium hypochlorite disinfection of root canals, dissolves organic matter; DOES NOT REMOVE SMEAR LAYER
Ectopic eruption of man 1st molar in relation to pri man 2nd molar cause some resorption -management---extraction of 2nd
molar,separation, disking of 2nd molar
Acid etching show decalcification at the area but did give the appearance of frosty why more fluoride in tooth, therefore
you have to etch longer or again. MUST HAVE FROSTY APPEARANCE
Beveling in acid etching composite use more surface area. Exposes the enamel rods obliquely
o Something about which is not a reason to bevel; the answer will be obvious
Removing the mylohoid ridge have the common error in--lingual nerve damage
Cheek bit due to---horizontal overlap (edge-to-edge), or too far buccal or lingual
Post op managment after denture delivery pt has pain in crest of the ridge---defect in post occlusion (or whatever area)
o Excessive VD, bubble in acrylic, inaccurate denture base,
Placement of rubber dam affect the colour selection by dehydration of tooth gives inaccurate tooth shade
Tooth set in 20 degree for balanced occlusion...but adjusted to 45 degree what is need to corrected for balanced occlusion--
compensatory curve
Tooth with endo treated and post with crown have pain after several days esp during biting and cold..vertical root fracture
Use of indium with alloy is mainly to provide chemical bond with porcelain
Classification of pontic mainly depend on their relationship ---to the ridge (mucosal or nonmucosal)
o Mucosal: concave and passively contact the ridge
Saddle Ridge lap NOT USED because it forms a concave area B-L that is uncleasable
Modified ridge lap very esthetic, moderately easy to clean, for PFM, all-metal, or all-ceramic
Ovate very high esthetics, good for high smile line, easy to clean, requires surgical preparation
Conical Molars without esthetic requirement, easy to clean
Bullet shaped
o Nonmucosal – used in nonesthetic areas
Sanitary (hygienic) about 2mm from mucosa, all metal pontic
Modified sanitary (hygienic)
Severe alcoholic now recovering need 24 tooth extraction which test needed----INR CBC
What is the disadvantage of using elastomer for jaw relations or CR (something like that). Like what will happen when you
try to mount?
Occlusal trauma symptoms - fremitus is the best test to test TFO, vascular - blood clots in PDL, gingival recession, widening
of PDL
After having denture (partial) the pt have pressure for few days, later it subsides---occlusal
trauma, pressure of clasp, pulp damage
Which doesnt need replacement or repair--recurrent carious at margin,pulpoaxial line fracture, ditched restoration
Pt has restoration shows demarcation b/w restoration, which is fracture in middle of restoration. Whats the next step---
look for further fracture line, replacement of restoration...?
Sensitivity following composite restoration in post most comman cause---due to resin,polymerization shrinkage in
margin,shrinkage floor...???
If implant with width of 4mm is used what should be the bucolingual width of the ridge? 6mm
o minimum Vertical height of bone to place implant - 8mm
o minimum Width of bone is 6mm choices were 5mm, 7mm, 8mm, 12
o minimum distance of apex of implant From nerve - 2mm
o platform of implant from adjacent CEJ - 2-3 mm
o between implants 3mm
o between implant and tooth (height of coutour) is 1mm
o Mini implant is 2.4mm
o When there is FPD from natural tooth to implant, the max stress is concentrated on the SUPERIOR PORTION OF
THE IMPLANT
RPD:
o Retention: Direct retainer , and indirect retainer
o Stability: Minor connectors, proximal, ligualul plate, denture base
o Support: Rest, major connectors, denture base
Attrition---normal wear
Pt with diabetes having sedation IV and LA---ask the pt to take high calorie food with insulin, low calorie food which
inusulin…no restrictions
While giving inf inferior alveolar injection the pathway from?contra lateral premol,contra canine,contra molar,ipisi lat
premol
How to split the tooth using bur tech of tooth removal---spilt buccal and lingual up to furcation
Pt with bisphosphanate 3ml IV for 3 yrs, have carious and unrestorable tooth; management: stop regmen 1 mnth extract,
do non invasive endo treatmnt.
o bisphosphonate has half life of 6 months, it is advisable to wait for atleast 6 months before invasive procedures
Advantage of gold on occlusal surface, porcelain in facial surface----conserve tooth struc,minimal rsduction...????
Why do you bevel the functional cusp for a full coverage crown?
Drug most likely cause xerostomia---lithium (antipsychotic), ca channel blockers (like nefidipine), and anticonvulsants.
Pt have swelling after extraction, he is under penicillin therapy. What would be the next drug of choice? Clindamycin
Both drug have same intrinsic effect and different receptor affinity---same potency, same efficacy
Antipsychotic with irreversible side effect----Tardive dyskinesia ---Sudden purposesless movement(parkinson like disease)
Lantaprost indication----Glaucoma(Latanoprost)
Treacher-Collins Syndrome
o downward slanting eyes
o micrognathia (a small lower jaw)
o conductive hearing loss
o underdeveloped zygoma
o drooping part of the lateral lower eyelids
o malformed or absent ears.
Hypercemtosis
o Etiology of Hypercementosis can be caused by many things. "PIG ON TAP":
Pagets, Ideopathic, Gigantism
Occusal Trauma, Non functional tooth
Trauma, Acromeglia, Periapical granuloma
Localization of mesiodens is done with occlusal radiograph
Neuropraxia: It is a transient episode of motor paralysis with little or no sensory or autonomic dysfunction
o Neurapraxia describes nerve damage in which there is no disruption of the nerve or its sheath
St John's wort is most widely known as an herbal treatment for depression (300mg of extract)
o may work against gram negative bacteria, ADHD
Pt is a child and is diabetic undergoes hypoglycemia in the chair if conscious give him orange juice
o If unconscious give him 50% dextrose IV
o Type I Diabetes leads to a) Aphasia b) Ataxia c) Blindness d) Deafness
Prophylactic treatment
o for pacemaker – no premedication required
o for Prosthetics heart valves – premedication required
LA calculations 4.4mg/kg
o One carpule of 2% xylocaine has 36mg
Primate spaces are seen between maxillary Lateral incisors and canines; mandibular canines and molar
Radiology
o Focal spot influences resolution
o Collimation influences penetration
o Milliampere influences intensity
o KVP influences energy and pentration
Most common
o Odontogenic cyst is periapical cyst (non-vital tooth)
o odotogenic ectodermal is ameloblastoma
o odontogenic mesenchymal is fibroma
o non-odontogenic cyst of the oral cavity is the nasopalatine duct cyst
o salivary gland tumor is pleomorphic adenoma
Recommended daily intake of fat Intake as per USDA is 30% of total daily caloric intake or 10% saturated fat intake of
caloric intake
American Society of Anesthesiology patient classification status
o ASA I: Normal healthy Pt
o ASA II: No functional limitations; has a well-controlled disease of one body system; controlled hypertension or
diabetes without systemic effects, cigarette smoking without chronic obstructive pulmonary disease (COPD); mild
obesity, pregnancy
o ASA III : Some functional limitation; has a controlled disease of more than one body system or one major system;
no immediate danger of death; controlled congestive heart failure (CHF), stable angina, old heart attack, poorly
controlled hypertension, morbid obesity, chronic renal failure; bronchospastic disease with intermittent
symptoms
o ASA IV : Has at least one severe disease that is poorly controlled or at end stage; possible risk of death; unstable
angina, symptomatic COPD, symptomatic CHF, hepatorenal failure
o ASA V : Unstable moribund Pt who is not expected to survive 24 hours with or without the operation
o ASA VI : Brain-dead Pt whose organs are removed for donation to another
Periapical cyst
Odontoma
Recurrent apthous ulcer
Thyroglossal cyst
Location of Inferior Alveolar Nerve - They then pierce the buccinator muscle between the palatoglossal & palatopharangeal
folds, lying lateral to the medial pterygoid at the mandibular foramen.
Odontogenic Myxoma:
o Most common odontogenic tumor of mesenchymal origin
o Post Mand
o Honeycomb & multilocular appearance
o Rx: similar to ameloblastoma & Giant cell Granuloma
o Tx: Curettage, possible recurrence
Ameloblastoma:
o Most common EPITHELIAL ODONTOGENIC TUMOR…mand molar area
o Age 40’s 50’s
o Histo: reverse polarity
Ameloblastic fibro-odontoma
o similar to the above except it occurs in the MAXILLA AND MANDIBLE in equal freq
Ameloblastic odontoma:
o same as above except it occurs in max & mand pre-molar & molar area
Radiology
o mean energy of Xray photons is increased by increasing KVP
o collimation makes the X ray photon decrease the radiation to
the pt
Fogging of film is in overdevelopment, contaminated sols, deteriorated
Which endocrine system does thick hair become thin hair thyroid - hypothyroidism
o (cretinism in kids and myxoedema in adults)
Extrusion of canine what flap technique is used except 1)Envelope flap 2) Semilunar flap 3) Apical repositioning flap
Know about flaps (incisions etc)
Pt has Asthma and is allergic to Aspirin what pain medicaction will be given?
o Acetamenophen 2) Ibuprofen 3) Diclofenac Sodium
o NSAIDS - are contraindicated in asthma pts.
When you place a implant, widening of crestal bone is seen because of which force?
o Horizontal 2) Oblique 3) Vertical 4) Aapical
o Fibers on implant
What is the reason for unhappiness of denture Instability of the lower denture
Antibiotic contraindicated with ALCOHOL are Metronidazole, Tinidazole, Antimalarial, flurazolione, Griseofulvin
o headache, nausea, vomiting, irregular heart beat, tachycardia, flushing, breathlessness, low BP
In a # of rt side of body of mandible, which other # is to be suspected - condyle on the contralateral side of the subcondylar
region
o Trauma to one side often produces an ipsilateral body fracture and a contralateral subcondylar fracture.
o A heavy blow to the symphysis produces a symphyseal fracture and bilateral subcondylar fractures.
o It is also important to exclude damage to the cervical spine and to ascertain that the airway is not compromised.
In condylar hyperplasia, mandible deviates to which side? to the contralateral side (the unaffected side),
in condylar hypoplasia the mandible deviates to the affected side
Treatment of ranula (floor of mouth): a) marsupialisation b) enucleation c) inj steroid; Treatment of a mucocele
enucleation
Pt complains of high fees of dentist, how should the dentist answer? Fee is fine according to the geographic area, it is fair
and reasonable, I have to make a living too
Handling of an ADHD pt and how to get them to maintain oral hygiene - no modifications
Working side interferences? Max: palatal inclines of buccal cusps, Mand: buccal incline of lingual cusps
o In MIP or CO, Max: buccal incline of palatal cusp, Mand: lingual incline of buccal cusp
o Balanced side interferences are Max: buccal incline of palatal cusps and Mand: lingual incline of buccal cusps
Protection for inf alv nerve while placing an implant : surgically move the nerve, meticulous placement of the implant, place
a barrier
Denaturation of the proteins - alcohol and autoclave; Coagulation of proteins - dry heat
Source of epithelium for graft: host, graft, adjacent tissue. Source of the blood supply is the host connective tissue
Disadvantage of hydroxyapatite graft - control of granules is hard and in the region of lower bicuspds, graft might be solidify
over the mental foramen and cause parasthesia.
After flap surgery, how does repair occur? Pdl moves occlusally, apically, laterally
Upon using the fluorescent light, in which of the conditions is the complete tooth illuminated: vertical fracture, periapical
abscess, split tooth?
Which does not describe a biohazard waste box: made of metal, closed, puncture proof, leak proof
Some law on hazard communication law. What is it and what organization created?
Pt swallows a crown, what position should you place them in
For a pt with head and neck cancer who is to be irradiated, when should be questionable teeth removed: before irradiation,
after, during?
What happens if penicillin and erythromycin are given together: summation, potentiation, idiosyncrasy
Tetracycline cancels out Penicillin
Numbers of surgical forceps for tooth extraction 150 = upper, 151 = lower;
What forceps would you use to extract mandibular premolar? Choices were like 150, 151, 23, 71…
Angulation of cutting edge to the tooth surface while root planning more than 45 less than 90
After using a gingival retraction cord, tissue reacts by recession. Where do you see this the most; lingual, buccal,
interproximal.
Which aspect most commonly needs convincing for the pt with new CD: speech, chewing, max denture retention, mand
denture retention
Which of the following is absent in facial palsy: drooling, inability to wink, loss of muscle tone, excessive salivation
o May be caused by Herpes Zoster, Sarcoidosis, middle ear infection, Lyme disease, HIV infection
o May also experience: dry mouth and dry eye, headache, loss of taste, hearing louder in one ear
Consequences of tooth ext in a pt with adrenaline crisis – probably delayed healing, infection, inflammation, LoC, dizziness,
tachycardia, tachybradia
o If Pt uses more than 10 mg prednisone daily then: double the dose of daily steroids at the day of surgery as well as
double the dose the day after surgery. (always after consultation with MD
Contraindications for the use of opiates – cannot be used with MOA inhibitors, incase of head injury
Bacteria that is responsible for progression of caries but not causing the initial phase - Lactobacillus
Patient presents with eroded occlusal surface, lingual surface of max teeth, fillings raised from the surface. What should be
suspected – possible GI regurgitation
Cleft lip and palate is usually associated with which kind of malocclusion? class III
Cause of dry socket (alveolar osteitis) : fibrinolysis of clot, physical dislodgement of clot?
o How do you treat it? (make sure you recognize dry socket as “alveolar osteitis”
o Multiple types of alveolar osteitis can result from disturbances in the healing process. The type that is commonly
referred to as dry socket is one in which the disturbance is from the time a blood clot forms immediately after
tooth extraction to the initiation of healing in the 4-5 day period after extraction occurs.
o The healing tissue that is supposed to replace the blood clot, known as granulation tissue, may fail to grow or be
disrupted after beginning to grow, leading to the well known symptoms of dry socket.
Which of the following is a dentist not supposed to do: talk about options provided by other specialist, risks of not having tx
done, benefits of having treatment done, discuss about copay
Note:If you see a fact e.g broken file,or tooth perforation you have to inform the Pt but not blame the previous dentist
Child with blue lips, thickened nail beds, pale skin. What disease is to be suspected?
Congenital Cyanotic heart disease
Muscle that decides posterior extension of lingual side of dental flange? Mylohyoid,
superior pharyngeal constrictor?
Oral hygiene instructions for ADHD pt: hygienist to pt, hygienist to pt and parents, dentist to pt, printed material
All of the following can be used for plaque removal
except: water irrigation, tooth picks, toothbrushing,
floss What is water irrigation used for?
Pregnant woman goes into syncope in second trimester. What should be the immediate action?
o turn her to the left in order to remove the pressure from inf. vena cava
Use of pulp testing: check disease or health or extension of damage of pulp, check the responsiveness of pulp nerves.
How does a tooth covered with crown react to pulp testing--- cold is better test
Pt is addicted to oxycodone which contra indi- Patients receiving CNS depressants such
as other opioid analgesics, general anesthetics, phenothiazines, other tranquilizers,
centrally-acting anti-emetics, sedative-hypnotics or other CNS depressants (including
alcohol) concomitantly with PERCOCET tablets may exhibit an additive CNS depression.
o When such combined therapy is contemplated, the dose of one or both agents
should be reduced.
o The concurrent use of anticholinergics with opioids may produce paralytic ileus.
Common reason for angular chelitis---decreased vertical dimension (in elderly), skin fold, poor diet (Vit B2 and B12)
o Seen in pts with Anorexia/bulemia
o In edentulous pts, when there is decrease vertical dimension, most common sign is ANGULAR CHELITIS
o Can be fungal (Candida) or bacterial
Clift lip prevalence in USA is 1:700- 1:800 (other source says 1:1000); occurs week 4-5 in utero
o Cleft lip is done in 2-3 months after the child is born
o The lip is corrected as early as is medically possible. The soft palate is closed btw 18-24 months of age
Clept palate occurs weeks 6-8 in utero. The hard palate cleft is then closed around age 4 or 5.
o Alveolar correction surgery is at age 8 before the eruption of canine
o Correcting the alveolar cleft is usually left till a later time, around the age of 8 or 9. If the surgery is conducted
when the child is younger than this, the scar tissue that forms during healing will interfere with the normal
development of the face.
o An alveolar cleft is corrected with a graft of bone and soft tissue
Endo
o Sodium hypochlorite in root canal treatment has the following advantages EXCEPT:
1.lubricating, 2.Anti-microbial, 3.Chelating agent, 4.Disinfection
o Gutta percha has the following advantages EXCEPT:
1.easy manipulation, 2. Adapts to tooth surface, 3.Anti-microbial 4. Biocompatible
o During root canal treatment, the operator creates a ledge. What is the next step?
1. Fill up to the ledge and leave the ledge intact,
2. Extract and replace with an immediate implant,
3. Take a smaller file to working length, remove as much debris as possible and gently try to remove the
ledge.
o What is the NOT an advantage of stainless steel files?
1. More flexible, 2. Less chance for breaking, 3. Allows the file to be centered in canal
Before separation, SS files exhibit fluting distortions, highlighting unwound or twisted regions of
the file signs of fatigue
Nickel-titanium files do not show these same visual signs of fatigue. Discard before visual signs
are seen
o Primary endo infection STRICT ANAEROBES: G- Porphyromonas, G- Bacteriodes, G+ Actinomyces (root caries)
o Unsuccessful rct need re-tx from persistent infection of facultative anaerobes
o Abts:
DOC: Pen VK good for strict and G+ facultative anaerobes
Metronidazole is effective against strict anaerobes but not facultative anaerobes or aerobes
o Which has worst prognosis? Ledge in midroot, fracture while obturating, transport through apex in curved root…
Which tooth is least successful for a patient to remove plaque with floss?
o 1. Maxillary premolar, 2. Mandibular premolar, 3. Mandibular molar, 4. Maxillary molar
Upon extraction of a maxillary molar, a 2mm sinus defect is noticed. What is the next step in treatment?
o No treatment necessary, follow up in 3 days.
A teenager (11 yo) presents with an intruded maxillary lateral incisor (#7). What is the next step of treatment?
o Extract and Implant, 2. Splint for 2 weeks with RCT treatment after, 3. Splint for 2 weeks and follow up
o 4 year old intrudes primary maxillary central, what do you do leave it, wait for it to re-erupt
For a young patient (6 yo), the treatment of choice for a necrotic pulp on permanent first molar would be:
o 1. Apexification (open apex, necrotic) 2. Apexogenesis (open apex, vital) 3. Root Canal Treatment (closed apex)
o It takes 10 yrs from calcification for root completion, 13 years for canine
Which treatment has the least successful long term prognosis on a deep carious lesion on #3?
o Direct pulp capping, 2. Indirect pulp capping, 3. Pulpotomy, 4. Pulpectomy and RCT
What would be the most reasonable cause for a tooth’s symptoms to change from reversible to irreversible pulpitis?
o Accumulation of traumatic injuries, 2. Bacterial involvement inside pulp chamber, 3. Increased intra-pulpal
pressure
What is the most accurate pulpal test to determine vitality of a tooth with a full-gold crown?
o Electric testing, 2. Percussion test, 3. Palpation test, 4. Thermal test
What is the outline shape of the access cavity for a permanent mandibular first molar?
o Triangular, 2. Trapezoid, 3. Oval, 4. Circular
nd
On a radiograph, you notice a distal carious lesion on the mandibular first premolar. Upon restoring the adjacent 2
premolar, with direct vision, you notice that there is no decay.
o What is the most probable cause? 1. Cervical burnout, 2. Root caries
For a lesion in enamel that has remineralized, what most likely is true?
o The enamel has smaller hydroxyapatite crystals than the surrounding enamel
o The remineralized enamel is softer than the surrounding enamel
o The remineralized enamel is darker than the surrounding enamel
o The remineralized enamel is rough and cavitated
o Know about chalky white lesions
On the cementation day for a full gold crown, what is the first step?
o Evaluate margins, 2. Evaluate occlusal contacts, 3. Evaluate proximal contacts, 4. Evaluate proximal contours
For a surgical extraction of mandibular first molar, what is the best course of action?
o Cut a Y into the coronal portion and extract each root separately,
o Cut the coronal portion from the roots and extract the roots separately,
o Cut the tooth bucco-lingually and extract the roots separately
For a surgical extraction, what does not contribute to developing post-operative pain?
o High-speed drill, 2. Low speed low torque drill, 3. Sharp burs, 4. High-speed drill with water spray
apirin - single dose - how much time- 4 hours, 1 day, for baby aspirin dosage is 81mg/day
KNOW THIS!
Injury Closed apex Primary teeth or Open apex
Fractures
Enamel fracture – class I Smoothen, restore lost tooth structure. Good px Smoothen enamel, check vitality 1,2,6 months
Enamel/Dentin – class II Restore with bonded resin. Good px. Smooth/restore
Vital pulp therapy if possible Primary:
Crown w/ pulp – class III If not, RCT (also if complex restoration needed) Vital: pulpotomy, Necrotic: pulpectomy
Resorption: EXT
Dx with occlusal + 3 PA (at different angles) Relatively rare
Vital: vital pulp therapy + splint Coronal ½: splint or EXT
Horizontal root fracture Coronal: splint 6-12 wks, if no reattachment, EXT Apical ½: no tx
Midroot: splint 3 wks, endo if possible, EXT
Apical – good px, pulp should be vital
Luxation Class V
Concussion percussion + Occlusal adjustment, no tx, follow up No tx, CHX if desired, Better px than closed apex
Subluxation mobility + Splint 3 wks if mobile No tx, CHX if desired, Better px than closed apex
Resposition, splint, endo if necessary If before periapical blood clot reposition and
Extrusion/ lateral luxation Extrusion: 65% pulp necrosis splint 7-10 days
Lateral: 80% pulp necrosis Then endo
Closed apex: ortho/surgery, endo No tx unless determined that tooth is impinging
Intrusion
96% pulp necrosis on permanent successor; should re-erupt
Re-implant immediately (within 0-60min) Within 0-30 minutes
Clean socket with saline (no curet), replant Clean root with saline if contaminated
Splint 7-10 days Tooth in doxy, clean socket
Pen or Doxy for 7 days Replant, splint 7-10 days, soft diet
refer for tetanus booster Pen or doxy (if not succeptible to tetracycline
Avulsion – class VI
staining); tetanus booster
Re-implant (after 60 min) After 60 minutes – replantation not indicated
2.4% NaF for 5 minutes
Saline, Replant, splint 7-10 days, Pen or doxy 7d
Endo 7-10 days after replantation in both cases 7-10 days later try apexification
Ginseng - antiplatelet (interferes with coagulation – not given with aspirin).
perodontal stability attachment loss is the most imp criteria in diagnosing periodontal conditions, followed by mobitiliy.
Flaps
o Partial thickness (mucosal) flap only epi and CT
o Full thickness includes periosteum
Horizontal incisions all three together allow for visualization of alveolar bone
Internal bevel incision:
o 0.5-1mm from fgm apically displaced flap
o 1-2mm from fgm modified widman flap (not reflect beyond mgj)
o Coronal to base of pocket undisplaced flap or reverse bevel incision
crevicular incision:
o Base of pocket to crest of alveolar bone, conserves papilla;
o (1) + (2) creates a collar of tissue around teeth
interdental incision: separates collar of gingiva from tooth
Cover site with periodontal pack don’t enhance healing rate though.
Contain zinc oxide and some with Abts
Give CHX 2x/day for 1-2 weeks
protection act- Good Samaritan Act – is accepted in all states, but dentists are not included in all the states.
The Dentist completes exam and advises x-rays but the pt refuses. What should the dentist immediately do.
o Explain the need for X-rays.
X-ray identification: Median Palatal Suture, Zygomatic process of maxilla, Dorsal Surface of tongue, odontoma
Radiology
The severity of response increases with the amount of X-ray exposure. This effect is called:
ans is Deterministic, Stochastic, Genetic??
o Radiosensitive cells ANS. Hemopoeitic bone marrow.
o When there is no barrier, protection of dentist. 6 feet; 90-135 degrees
o If the buccal root of maxillary ist premolar appears distal to palatal root .The X ray was mesially angulated
o Reverse occlual plane on a panoramic view. Chin tilted upwards;
smiley(happy face) is chin down.
o Best view to observe pathology of maxillary sinus
CT , Panoramic, Lateral skull view ( all these are good to view max sinus) waters
o What is the reason for increased radio-opacity on the mesio-occlusal surface of maxillary I molar.
Cusp of Carabelli, restoration on disto-lingual surrface, dens in dente
Commonest tooth with vertical root fracture .Maxillary incisor, mandibular incisors, maxillary molars, mand.molars.
Which are the two most imp. steps for diagnosis. History and clinical examination
Which procedure does not require antibiotic prophylaxis
o Non surgical endodontic treatment, Scaling and root planing, Extraction, surgical treatment.
Material used for mouth guard vital bleaching ANS. 10% carbamide peroxide.
Most critical for pulpal protection ANS. Remaining dentin thickness 2mm
Tooth with the best prognosis ANS. Internal resorption Q about characteristics of internal resorption
What is the effect of extraction of primary 2 molar on the eruption of 2nd premolar with one third root formation .
o Eruption is faster. Eruption is slow, no effect on eruption rate, condition varies depending on the patients age.
What is the effect on growth of a child with unilateral sub-condylar fracture retarded growth
The provoking factor for pain after placing bridge. Heat, cold, sweet, biting(occlusion)
Kerrs syndrome Kerrs syndrome shows all except Maxillary ridge resorption, flabby tissues, enlarged tuberosities, increased
vertical dimension of occlusion. combination syndrome with maxillary CD opposing Mandi Natural Ant
Lack of function of indirect retainer is manifested by ANS. Lifting of distal extension away from tissues.
Common feature between porcelain veneer and all-ceramic crown preparation – rounded internal line angle
The dentist cements the porcelain veneer with light cured resin and the patient returns with brownish discoloration at the
margins.why?
o not enough cement or microleakage(depends on duration of pt return)
patient receives a blow to the chin who has a MOD inlay placed on the maxillary molar 3 months earlier.Now the patient
has a vague pain on biting ,there are no other symptoms.why? maxillary sinusitis, m-d fracture, b-l fracture
when you wax the removable partial denture on a cast; what is it called- Master cast, refractory cast
Purpose of addition of tin and indium to metal ceramic alloys ANS.chemical bond-covalent bond
Something about how soon do you see the marginal leakage or discoloration…?
curve of Spee
o an anatomic curvature of the occlusal alignment of teeth, beginning at the tip of the mandibular canine, following
the buccal cusps of the natural premolars and molars, and continuing to the anterior border of the ramus, as
described by von Spee.
the curve of the occlusal surfaces of the arches in vertical dimension, brought about by a dipping downward of the
mandibular premolars, with a corresponding adjustment of the maxillary premolars.
curve of Wilson
o the curvature of the cusps, as seen from the front view. The curve in the mandibular arch is concave, whereas the
one in the maxillary arch is convex.
Reverse curve
o a curve of occlusion that is convex upward when viewed in the frontal plane.
You are giving cusid-cuspid bridge and want to change the canine guided anterior disclusion.What is required. –
o change to group function
All are symptoms of TFO on an implant except. Gingivitis, pain, loosening of implant, breakage of abutment screw.
Oral granulomas, apthous ulcer, rectal bleeding is seen in. Wegeners granulomatosis, ulcerative colitis, crohn’s disease.
Least wettability is seen with which impression material.polysulfide, condensation silicones, hydrocolloids, polyether.
Most stable in moisture environment. Polysulfide, condensation silicones, addition silicones, polyether.
Setting of polyvinylsiloxanes is retarded by. ZOE, latex gloves, ferric chlorides, aluminium chloride
Which produces least change on implant surface while removing calculus. Ultrasonics, sonics, curettes, plastic curettes
What has ultimate effect on the thickness of epithelium of free gingival graft. Recipient epithelial tissue, donor epithelial
tissue, donor CT, recipient CT
The internal bevel gingivectomy extends approximately from 2mm from margin to base of pocket or crest
Indications for gingivectomy – gingival hyperplasia, suprabony pockets, suprabony periodontal abscess
The purpose of barrier. Apical movement of PDl cells, Coronal movement of cells.
Gingivectomy is contraindicated in .The sulcus is apical to gingival groove, sulcus is apical to convexity of tooth, sulcus is
apical to the crest of alveolar bone.
Desquamative gingivitis is associated with which 2 conditions. Pemphigus and bullous pemphigoid, Lichen planus and
erythema multiforme
o Pemphigus – supra, acantholysis
o Pemphigoid - basal
o Questions about lichen planus
The depth of sulcus is 5mm the distance between CEJ and the base of sulcus is 2mm.what is the attachment loss. – 2mm
The role of chlorhexidene is cos of.ANS- Substantivity – high concentrations for long time
Condition seen in normal individuals and also in pregnant patients.ANS Pyogenic granuloma or pregnancy tumor.
First thing u need to check while placing crown.ANS Esthetics then Proximal contact
Periostat = subantimicrobial-dose doxycycline (SDD) selectively inhibits MMP-8 and MMP-13 destruction of collagen.
o Approved as adjunct to SRP tx of chronic periodontitis
o 20mg dose 2x/day for 3-9 months; CI: preggers, kids under 12, tetracycline allergy
Perio procedures
o Gingivectomy elim SUPRAbony pockets, gingival enlargements, suprabony perio abscess
CI: osseous recontouring, pocket is apical to mgj, inadequate attached ging, esthetic concern
Bevel incision apical to pocket depth
Healing by SECONDARY INTENTION (clot, epithelial migration, ct repair
o Gingivoplasty reshape tissue: clefts, ging enlargement, shelf-like papilla
CI: reduce or eliminate periodontal pockets
o Mucogingival surgery widen attached gingiva, deepen vestibule, resection aberrant frena
via graft and AP flap
o Osseous Surgery
Correct osseous M and D crater by recontouring F and L walls
Correct vertical or angular defects by resective osseous surgery or perio regeneration
Ressective osseous surgery for interprox bony craters, early furcations, cases w/ thick alv bone
CI: esthetics
Ostectomy removing tooth-supporting bone; must be sure to remove “widows peaks”
Osteoplasty removal of nonsupporting bone
o Regeneration
GTR prevent epi migration on cementum while pocket is healing from flap reflection
Membrane used to exclude epi and CT from root and protect clot formed
Citric acid and/or Emdogain enhance new attachment of ging tissues following excision
o Implants
Titanium implants offer the best biological attachment to bone and gingival tissue osteointegration
The normal recall appointment between periodontal treatment. 3 months, 1 month, 4 month, 6 month
45 year patient comes for appointment schedule.His B.P is 160/100.What should the dentist do.
o Call up the physician, reschedule appointment when the B.P comes down , check B.P again after 15 mts
rd
Frequent urination seen during 3 trimester ANS. Pressure on the bladder.
Pt comes with carious involvement and localized swelling of cheek.What is the immediate treatment. establish drainage
After periodontal surgery, the dentist leaves interproximal bone apical to radicular bone.What is this called
o negative architecture.
Evaluation after scaling and root planning is done after how many days. 7-10 days, 14-21 days 4-6 weeks
Order of tx: emergency, disease control, re-eval, definitive, maintenance mosby pg 252
Mode of action of ultrasonics. ANS. Vibration in elliptical (magnetostrictive) , sonics is linear(work with air) piezo
Which of the following is not an advantage of Ni-Ti over stainless steel file. Maintains the shape of canal, flexibility,
resistance to fracture.
Medications associated with hyperplasia. Calcium channel blockers, Dilantin sodium, Cyclosporine
o Nifedipine
In most of the cases, localized fibromas are often: Dysplasias, metaplasia, anaplasia, hyperplasia.
The major environmental risk factor for periodontal disease. Diabetes, smoking
In a scientific article, where should the description of study sample be? materials and methods, results, discussion
Viral load for HIV pts – test sensitivity – detect more than 48 viral copies.,
o Neutrophils – less than 500 no tx
o Platelets – below 50000 no tx
o CD4 – should be 200, but 50 is critical.
Increased no.of teeth + supernumerary and impacted teeth is seen in ANS. Cleidocranial dysplasia.
o Gradner’s syndrome has supernumerary teeth.
The patient who is diagnosed with Basal cell carcinoma, says to the dentist “give me the report, do I have cancer”, what
should the dentist’s initial reaction be. Pic of basal cell carcinoma, white old man, outside of mouth…
o DO you have any one accompanying you, this cancer has better prognosis than other cancers.
Which of the following is not recommended for a patient who is on Nicotine de-addiction
o mucous patches, nicotine gum, Bupropione, nicotine nasal sprays.
o Buproprione is also used to treat depression
Which of the following does not have cauliflower like , pebbly appearance.
o Verrucous carcinoma, fibroma, condyloma accuminata, papilloma.
o Description of papilloma
Common finding in a patient with cerebral athetoid palsy. ANS. Anterior teeth fracture
Anti-fungal used as troches for treatment of oral candidiasis.ANs Clotrimazole
o swish and swallow is nystatin.
o AmphotericinB is only antifungal given in IV
o Fluconazole(tab) is given for systemic candidiasis.
Infections from mandibular premolars spread to which space Submandibular, because the roots are below the mylohyoid.
Anterior roots above the mylohyoid has submental spread.
Cellulitis most of the time involves unilateral, ludwigs angina is bilateral and complication is edema of GLOTTIS.
The patient who is a tobacco addict says to the dentist,”I want to quit the habit”,what should the initial reaction of the
dentist be.
All are seen in a patient with sjogrens syndrome except: sicca, xerostomia, lymphoma, arthritis, other choice is option.
Clinical photographs- Lymphoepithelial cyst, cheek biting, smokers palate, Dentinogenesis imperfecta, facial palsy,
migratory glossits, mucocele, fordyces granules
Dentist realizes that the distal margin of crown preparation is within 1mm of interdental bone.what should the dentist do.
ANS crown lengthening
Necrotizing sialometaplasia minor salivary gland disease presents on the palate which is most commonly confused with
carcinomas due to the ulcerated presentation. Heals without scarring.
Questions on herpes ulcers and apthous ulcers , vesicles are not seen in apthous ulcers
The patient develops oral ulcers and target or bulls eye skin lesions within 24 hrs.ANs Erythema multiforme
A chronic alcoholic requires extraction what test should the dentist advise for INR due to cirrhosis of liver
which of the following is not true for a patient requiring surgery and on oral anti coagulants.
o PT should be 1.5-2 times that of control, INR should be above 2.5
o Norma INR is 1, can be treated till 3(acc to manual)
Question on parulis
o bumps on the gum parulis ,also known as gum boils looks like sinus tract
o Pyogenic granuloma, peripheral gaint cell granuloma, peripheral ossigying fibroma, peripheral odontogenic
fibroma,
A patient received radiation therapy and requires extraction,what should the treatment be.Extraction, extraction with
alveoloplasty and sutures, extraction with alveoloplasty of basal bone and suture, pre-extraction and post extraction
hyperbaric oxygen
Virus associated with Chicken pox also causes ANS herpes zoster
Unilateral lesions after herpes zoster infection. Reactivation of the virus from sacral ganglion causes shingles
o induced by stress and sunlight exposure.
Management of moderately apprehensive child Replacing words like LA with sleepy juice is called as Euphenism.
Complication associated with removal of internal oblique ridge (mylohyoid) ridge. ANS Lingual n
The drug which causes withdrawal symptoms in pts taking oxycodene mainly pentazocine and nalbuphine
The drug contraindicated in pt taking ginkgo biloba.Heparin (CI with antiplatelet/anticoagulants) also CI garlic & ginseg
o Ginseng used for male impotency, diabetes
o Ginkgo biloba – used for memory loss.
* Chamomile is CI with Warfarin or other Anti coagulants.
The drug of choice in patient with bradycardia - Atrophine, Epinephrine.
Which of the following does not have anti-inflammatory action. ANS Acetaminophen
Some question on difference between aceta and aspirin but it was about about anti-inflam action. Something about
duration I think
The immediate choice of tx for large radiolucency in the mandible. Biopsy, aspiration biopsy and wait for the bone to fill in
o Safest of all biopsies – aspirational
The patient returns to the dentist the next day after extraction with pain and swelling.
o The drug of choice in this penicillin allergic pt. Clindamycin 300mg qid
The information about hazards of chemicals used in the office should be present in ANS. Material safety data sheets
o Red – flammable
o White – Personal protection
o Blue – health hazard
o Yellow- identitifies the reactivity or stability of a chemical.
The failure of a test to detect the presence of 5 cases of disease. ANS. False negative
The dentist separately for core-build up and the crown but the insurance company says that the core build up is part of
crown.what is this called. bundling know unbundling also
the investigator studies the occurrence of oral cancer in pts in a private nursing home. what is this?
o Cross-sectional study, longitudinal study, Descriptive epidemiology(prevalence and incidence)
common missing permanent tooth ANS. Maxillary third molar also mand second pm>maxi lateral inc>max 2nd PM
The main role of chlorhexidene before surgery ANS. Reduce the no.of microbes
Blood transfusion before surgery should be done when the platelet concentration falls
o below. 20,000, 50,000 , 100,000
The most effective method of caries reduction. ANS. Systemic water fluoridation
The Child has 12 deciduous and 12 permanent teeth.what is the age of the patient 8-9 yrs 12CDE6 in Palmer notation
When does the calcification of permanent incisors occur 3-4 months(decks) Excepting maxillary lateral incisors 10-12
months
The bacteria that causes rheumatic fever.streptococcal infection like sore throat or scarlet fever
What is the correct method of excavation of deep caries. Long bur from periphery to the center
Threaded post, what is the best way to prevent root fracture when inserting?minimum force and passive insertion
Apical closure of permanent tooth occurs. ANS.21/2 to 31/2 yrs after eruption
The dentist realizes that there is formation of ledge.what should he do next.ANS Gently by pass the ledge.
Pt asks questions regarding the face mask, gloves and other sterilization methods.what should the dentist say. probably
something to do with standard(universal) precautions
The patient retires and loses health benefits. treatment is done on the next day. the pt requests the dentist to enter the
previous day date and the dentist does Fraud
The frequent intake of juices by the child does all except. ANS. Increase ph., juices decrease PH
Child goes to bed with bottle filled with ________________, which one doesn’t cause caries?
o Choices were formula with F- water, plain non F- water, 100% juice, and something else
Which is true of intra pulpal anesthesia? produces anesthesia after 30 sec, it does not cause the discomfort to patient,
produces anesthesia by pressure.
The position of permanent incisors in relation to deciduous incisors. ANS.inferior and lingual
Advantage of distraction osteogenesis over ostectomy . better patient compliance, wider range movements, less relapse
and can be done in yonger patients
What is not true of alveolar osteitis (dry socket). ANS pain starts on the first day,
Acid-etching does not cause. Reduced leakage, better esthetics, increased strength of composites.
Purpose of placing posterior palatal seal ANS.compensates for shrinkage.It adds retention and avoids food lodgement
o Factors to consider when designing posterior palatal seal…
Patient comes back to the clinic 5 hrs after extraction with bleeding. what should the dentist do. ANS.search for the source
of bleeding
flexibility of the clasp depends on all except. Depth of the undercut, cross-section of the clasp arm, taper of the clasp,
length of the clasp.
Pt after scaling and root planing and with excellent oral hygiene does not show reduction of pocket depth, what is the next
step for the dentist to do.ANS. Periodontal surgery.
Patient has 2mm communication with the maxillary sinus. what is the treatment of choice.
o 2mm: don’t do anything and follow up
o 2-6 mm: place gel foam (surgicel), suture ,decongestant and antibiotic , inform patient
o more than 6 mm: buccal flap
How to split the impacted mandibular tooth when viewed from occlusal.+, Y slope, split buccal to lingual till the furcation.
What is the effect seen when propranolol and epinephrine are injected simultaneously
o in cases of mild reactions it causes hypotension; in severe reaction it is malignant hypertension
Patient c/o burning sensation at the corner of the mouth - angular chelitis
What incision is given to remove palatl tori - double Y incision was not the choice ;
o other possible answer might be a linear incision from A-P with oblique releasing incisions
How do u clean implants - scaler with a plastic sleeve; rubber cup and paste, stailess steel scaler, titanium scaler
It is required/mandatory to report all except - child abuse, reaction to drug, one more choice,
o Abuses that have to be reported to authorities
colleague practicing with chemical impairment
colleague advertising on electronic media
child abuse
domestic violence
elderly abuse
Patient had old PFM on # 9, he complains that PFM is lighter than other teeth, what will u do? - change PFM, bleach teeth
o When will you bleach teeth in anterior veneer prep- before veneer prep, wait for 2-3 weeks
o bleaching affects both enamel and dentin
where will you place the margins in a anterior PFM prep - Subgingival, at the crest
PVS impression material has which of the following - is unstable, doesnt come out completely from tissue undercut,
releases alcohol as byproduct, may release H ion
Hyperthyroidism restless/irritable, heat intolerance, weight loss, muscle wasting, tremor, diarrhea, sweaty, fine hair
o Causes: Graves, Thyroid adenoma, Pituitary adenoma (2˚ hyper), Hashimoto’s thyroiditis (early)
Hypothyroidism mental slowing, cold intolerance, weight gain, deep voice, constipation, edema, dry skin, hair loss
o Causes: Cretinism (child), Myxedema (adult), Hashimoto’s thyroiditis (late; autoimmune)
Drugs used to control salivary secretion – Pilocarpine, cevemille - increases, Atropine - decreases
To expose a mandibular lingual torus of a patient who has a full complement of teeth, the incision should to
o a. Semilunar b. Paragingival
o c. in the gingival sulcus and embrasure area
o d. directly over the most prominent part of the torus
o e. inferior to the lesion, reflecting the tissue superior
ARCON ARTICULATOR - An instrument following anatomic guidelines such that the ball of the condyle analogs are carried
on the mandibular element, and the fossa assemblies on the maxillary element.
CONDYLAR ARTICULATOR - A non-arcon articulator.
Pt has a stable bite, ant. guidance is fine and you need to fabricate FPD. What kind of articulators? - Semi adjustable.
Non-Adjustable
o (Class 1) A simple holding instrument capable of accepting a single static registration. Vertical motion is possible.
o (Class 2) An instrument that permits horizontal as well as vertical motion but does not orient the motion to the
tmj
o Uses: Single restorations, multiple restorations if good bilateral cuspid disclusion exists; Certain FPD’s.
Semi-Adjustable
o (Class 3) An instrument that simulates condylar pathways by using average or mechanical equivalents for all or
part of the motion.
o These instruments allow joint orientation of the casts and may be arcon or nonarcon instruments.
Non arcon: Hanau H2, Arcon: Whip Mix
o Uses: Multiple restorations; Fixed partial dentures with: minimal occlusal pathology, no loss of VDO, no immediate
side shift, Full mouth restoration if good anterior guidance exists.
Fully-Adjustable
o (Class 4) An instrument that will accept three dimensional dynamic registrations. Those instruments allow for
orientation of the casts to the temporomandibular joints.
o Uses: Full mouth restoration, Extensive occlusal pathology, Group function/posterior guidance, Restoring at a
different VDO
Purpose of making plaster index of complete denture - to preserve face bow record
Tooth responds with lingering pain to cold - irreversible pulpitis with normal periradicular tissue; irreversible pulpitis with
chronic periradicular tissues
Differentiate perio and pulpal abscess- Endo to perio lesion is outward, Perio to Endo lesion is inward.
Which has best px? Perio lesion caused be endo, endo lesion caused by perio, combo lesion, perio caused by perio…
Reliable test for teeth with open apex - heat, cold,
ept--- same when tooth has gold , or porclain crown
Coefficient of thermal expansion is most for which material – tooth < gold < amalgam < filled resin < unfilled resin
Rule of 6s
o F- > 0.6 ppm NO SUPP
o Pt < 6 mos NO SUPP
o Pt > 16 yrs NO SUPP
2.2 mg of NaF will provide 1 mg of Flouride *memorize*1.1 mg of NaF will have 0.5mg
Tooth release of pain on biting and sensitive to cold - cracked tooth syndrome
o Tooth with a recent crown - sensitive to cold and biting ( hyperocclusion)
Diagnosis of ANUG - punched interdental crater on the interdental papilla, fetid odor, metallic taste and pseudomembrane.
Reason of cheeck biting in a denture patient - when mandibular molars placed more buccally
What will happen if pt consumes too much of opiod analgesic - respiratory depression
If dentist seals a small carious lesion what happens - caries stops, caries increases
Normal Dose
o Amoxillin - 500mg TID
o Clindamycin - 300mg qid, longterm usage is pseudomembranous colitis
o Cefalexin - 500mg qid
When will the BULL rule be utilized with the selective grinding working side ONLY
Pan showing lucency going inferior over the body of mandible close to the angle. Informed the patient was involved in an
accident. Identify the lucency fracture
There are more detached plaques within supragingival plaques that subgingival plaques. The detached plaques within
subgingival area are the ones that are more toxic to tissue than attached plaques
o both statements are correct
o the first statement is correct but not the second
o the first statement is wrong, but the second statement is correct - supragingival plaque is always attached and
subgingival is unattached.
o both statement are wrong
Organism that cause severe spreading abscesses include: Fusobacterium, Campylobacter, Enterococci, Bacteroides
Definitions
o Unbundling: "the separating of a dental procedure into component parts with each part having a charge so that the
cumulative charge of the components is greater than the total charge to patients who are not beneficiaries of a
dental benefit plan for the same procedure."
o Bundling: "the systematic combining of distinct dental procedures by third-party payers that results in a reduced
benefit for the patient/beneficiary."
o Upcoding or overcoding: "reporting a more complex and/or higher cost procedure than was actually performed."
o Downcoding: "a practice of third-party payers in which the benefit code has been changed to a less complex
and/or lower cost procedure than was reported except where delineated in contract agreements."
Border molding
o Recording of retro mylohyoid area during border molding - muscles in this area are Superior constrictor(directly),
and palatoglossus(indirectly)
o On the buccal of mandibular border molding - u record Buccinator when the pt opens his mouth.
When the posterior border(distal of tuberosity) of the max denture is thick, the denture dislodges as the pt opens because
the coronoid process hits the denture.
If hamular notch hits retromolar pad, what do you need to do before fabricating denture? Reduce tuberosity
Cemento-osseous dysplasia Black women, middle aged , anterior radioluceny (can be radio opaque); vital; no symptoms
A study is designed to determine the relationship bet. emotional stress and ulcers . To do this, the researchers used
hospital records of pt's diagnosed with peptic ulcer disease and pt. diagnosed with other disorders over the period of time
from july 1988 to july 1998 . The amount of emotional stress each pt. is exposed to was determined from these records.
This study is
o Cohort, Cross-sectional, Case-study*, Historical Cohort, Clinical Trial
Why is the surgical stent required for an immediate denture? to give an idea of the anatomy of the region
Which tooth will the matrix band be a problem with when placing a two surface amalgam?
o mesial on maxillary first molar b/c of the cusp of carabelli
also Mesial Of max premolar> Distal of max molar
Maximum dose of
o Prilocaine 400mg METHEMOGLOBINEMIA
o Mepivicaine 400mg = 80ml of 0.5% or 40ml of 1% LEAST VASODILATOR EFFECT
o lidocaine without epi 300mg (about 9 carpules)
o lidocaine with epi 300mg
o bupivacaine 90 mg MORE SELECTIVE FOR SENSORY NERVES
o *all are amides metabolized in the liver
Ethical Principles
o Autonomy “self-governance” duty to respect the patient’s rights to self-determination and confidentiality
o Nonmaleficence “do no harm” duty to refrain from harming patient
o Beneficence “do good” duty to promote the patient’s welfare
o Justice “fairness” duty to treat people fairly
o Veracity “thruthfulness” duty to communicate truthfully
Which of the following mandibular fracture will heal in 4-6 weeks? Symphysis
Question said when does bony healing begin? 1-3 weeks, 4-6 weeks, …
nd
Mandibular Fractures – can always be visualized on pano radiograph; take 2 with another view to confirm
o Condylar 29%
o Angle 24.5%
o Symphysis 22%
o Body 16%
Pt on kidney dialysis, when can you perform TE? One day after dialysis
o Pt with end stage renal disease (ESRD) >>> 1)are on steroid therapy 2)prone to bleeding 3) do NOT use NSAID
because they cause nephrotoxicity
Action of Listerine it disrupts adhesion of bacteria to plaque; is a phenolic compound
o LISTERINE :Antiseptic mouthrinse is a broad-spectrum antimicrobial, and it kills bacteria associated with plaque and
gingivitis by disrupting the bacterial cell wall.
Chlorhexidine The mechanism of action is membrane disruption . It has Substantivity
Dental anxiety can be caused by Pt’s helplessness. What would reduce it? Telling Pt to raise her/his hand when feels pain
What does St. John's Wort do? Decrease the body immunity, it is involved in most drug-herb interaction.
o Note: there is no option “anti depressant” in choices.
o in Pt with HIV it interacts with anti HIV drugs such as Indinavir (increase immunity) and reduces their function so
the immunity decreases
A kid is on recall appointment and is not cooperative. You should do voice control followed by? Alternating appraisal
What is the side effect of pilocarpine (Tx of dry mouth) in toxic dose? Bradicardia and hypotension
o Nontoxic side effects: excess sweating and salivation, bronchospasm
Which of the following decreases the salivary flow? Scopolamine (like atropine) (also use for nausea and motion sickness)
Study group A and B give some agents for plaque control then compare which agent is more effective. Which study is that?
o Clinical trial
Which of the following images best shows the mid-facial fracture? Commuted Tomography (take axial and coronal
orientations)
o Reverse towne’s for condyle fracture
o Submentovertex for zygomatic fracture
o Waters (occipito-mental projection) THE BEST VIEW TO EVALUATE THE FACIAL FRACTURE and maxillary sinus
Disable Pt comes in and not cooperative, how should you act? Permissiveness (give Pt freedom and treat in the way Pt feel
comfortable)
Ankylosed tooth diagnoses best by Percussion test (metallic sound); See on xray a thick lamina dura and no PDL space
Base metal alloy
o Cobalt – gives rigidity, strength, hardness
o Chromium – prevents Tarnish & corrosion ,Chromium Oxide film
o Zinc - increases hardness Nickel - ductility
o Tin & Indium helps in porcelain bonding
Cheek biting caused by? Decreasing posterior horizontal overlap Also Posterior teeth placed edge to edge.
o Tx: reduce facial of mand molar
Biting on the corners of the mouth? Reset canine position
lip biting may be due to the following: Large anterior horizontal overlap also in reduced Muscle Tone
Tongue biting caused by: Having posterior mandibular teeth too lingually (increasing posterior over jet)
Two different drugs with same dosages bind to the same receptor and cause same intrinsic affect however they have
different affinities for the receptor: In which aspect these 2 drugs are similar? Efficacy, ED50, Potency
After caries removal sound tissue is on cementum. How do you restore? Build up with GI and place composite
Periapical lesion caused by all except? Occlusal trauma, Abrasion, Maxillary sinusitis
What will prohibit mesial drift of tooth toward edentulous area? Proper axio-occlusal contact (opposing and adjacent tooth)
In which syndrome Pt has multiple odontomas? Gardner's syndrome and esophageal stenosis syndrome
Which syndrome Pt has calcified falx cerebri, multiple okcs, bifid ribs? - Gorlin Goltz syndrome aka Basal cell bifid rib
syndrome.
A lesion that has re-mineralized will be more difficult to penetrate in the future
What is the bacteria that is not initially involved in caries but plays an important
role? LACTOBACILLUS
o gram positive facultative anaerobe, the # of this species has been used as a
caries test
Affected dentin has bacteria present but smaller amounts and can be reversed.
Infected dentin has large amounts of bacteria and needs to be removed because non-reversible
The dentist accidently did not see Occlusal caries and he placed a sealant over it; Will the caries
o Stop
o Rapid Progression
o Slow Progression
Recently placed gold inlay; what is the most common reason for pain afterwards? Fracture of the tooth has to be suspected
o Galvanic shock Sensitivity - choose this if only question says opposing dissimilar metal
There are two drugs that with the same dosages bind to the same receptor and have same intrinsic affect however different
affinities for the receptor: How are these two drugs the same?
o ED50
o LD50
o Potency
o Efficacy
Question asking the definition of antagonist vs. agonist; the answer choices also included partial agonist and partial
antagonist
o Agonists have intrinsic activity (maximal effect of a drug); efficacy of 1
o Pure antagonists have no intrinsic activity; efficacy of 0
o Partial agonist has an intrinsic value between 0-1
Therapeutic Index = LD50/ED50 or TD/ED and higher therapeutic index is better because wont do as much harm
o A drug with high LD50 and low ED50 has high therapeutic index, therefore relatively safe.
Do benzodiazepines have a anxiolytic effect? in moderate doses ANTIANXIOLYTIC and high doses is SEDATIVE
Rebound effect when you discontinue med, it brings back the same symptoms that it relieved, stronger than before;
Must withdraw gradually to prevent this
o Benzos rebound anxiety and insomnia
o Eszopiclone and Zolpidem rebound insomnia
o Triazolam (short-acting) daytime rebound anxiety, metallic taste, perceptual disturbances
o Methylphenidate or Dextroamphetamine Rebound stimulatory effects psychosis, depression and a return of
ADHD symptoms
o SSRIs rebound depression, anxiety, panic attacks
o Clonidine and Guanfacine (alpha-2 adrenergic agents) rebound hypertension
Tricyclic Antidepressants ( Amitriptyline, Imipramine, Trimipramine) inhibit the reabsorption (reuptake) of serotonin and
norepinephrine by brain cells. To a lesser extent, TCAs also inhibit reabsorption of dopamine. Therefore more can reach
brain.
Lithium- bipolar disorders manic phase mainly
What do you often need to supplement with diuretics? Potassium
Potassium-sparing Diuretics : Spirinolactone, Amiloride, Triamterene
Which of the following ACE inhibitor? ends in -PRIL
Which of the following drugs causes gingival hyperplasia? Calcium channel blocker : Nephidipine , Cyclosporines
Patient comes in and is on Coumadin, what do you do? Do not need to stop medication
Child comes in with an oral infection and is NOT allergic to Pen. What do you prescribe? Penicillin VK
What drug has cross allerginicity with Penicillin? Cephalosporin- both have Beta lactamase ring.
o If pt has allergic to penicllin then pt has allergy to cephalosporin
In a gold MOD onlay, how are the axial pulpal walls? Converging
When pouring up a cast which of the following has the least wet ability with a slurry water?
o Polyether hydrophilic, no byproduct
o Polysulfide byproduct H2o
o Condensation Silicone poor wet ability, byproduct ethyl alcohol
o Irreversible Hydrocolloid
A patient with stable posterior occlusion and only missing maxillary incisors you are making a bridge from #6-#11. What do
you need to send to the lab?
o Semi adjustable articulator in CR with facebow, lateral records, and incisal guide
o Semi adjustable articulator in MIP with facebow, lateral records, and incisal guide
o A simple nonadjustable articulator in MIP
What is the cause of cheek biting in a complete denture? Not enough horizontal overlap
A post palatal seal (post dam) is used for Polymerization shrinkage of acrylic
Indirect retainer is used to prevent distal extension dislodgement away from the tissue TRUE
The flexibility of a clasp is determined by everything except? Depth of undercut
What is the strongest type of metal a FPD can be made from? Type 4
What do a veneer and all ceramic crown have in common? Rounded internal
A resin bonded FPD in not seated all the way or is not stable. What could be the reason? microleakage
Veneer which is bonded with resin. Patient comes back after a month or so with a dark stain near margin Microleakage
When you want to seat a crown, the following contribute to it fitting passively EXCEPT:
o Die spacer
o Increasing gypsum investment material
o Fit checker
Know about metamerism and how it can affect color based on the light source? How do you prevent it?
o The quality of some colors that causes them to appear differently under different light sources.
o For example, two color samples might appear the same in natural light, but not in artificial light.
If a kid comes in and has trauma to the face and the IA is damaged, where did the kid get hit? Angle of mandible
o IN KIDS: most mandibular fractures occurred at the condyle (55%), followed by the parasymphysial region (27%),
then the body (9%), and angle (8%)
o IN ADULTS: Condyle : 29% > Angle 24.5%>Symphysis 22%> Body 16%> Ramus 1.7% > Coronoid 1.3%
Know the Maximum dose of lido with epi is 7mg/kg for an adult
o Note: text says 5mg/kg for (According to Malamed 4.4mg/kg) and 7mg/kg for articaine
What does band and loop NOT do? Does NOT create a vertical stop
lateral periodontal abscess is best differentiated from the acute apical abscess by? pulp testing
Epidermology question :
o A study is done to determine the affectiveness of a new antihistamine. To do this, 25 allergic pts are assigned to
one of the two groups, the new drug (13 pts), placebo (12 pts) . The pts are followed for 6 months . This study is
called clinical trail; (assigned or give is the clue )
o Study among smokers and nonsmokers in a persons of 6 years (e.g 2000-2006) to develop disease? cohort
What substance has corrosion resistance in pfm metal? Cobalt-chromium and are more rigid in comparison to Ag and Pd
o Base metal alloys (non-precious metals) are based on active metallic elements that corrode, but develop corrosion
resistance via surface oxidation that produces a thin, tightly adherent film, which inhibits further corrosion.
o Base metal alloy advantages are principally found only in their strength and low density.
How does fluoride play role in decreasing caries? makes enamel stronger
o The topical effect of constant infusion of a low concentration of fluoride into the oral cavity is thought to increase
remineralization of enamel.
o Fluoride ion inhibits the enzymatic production of glucosyltransferase inhibits glycolysis
o The incorporation of fluoride into the enamel hydroxyapatite crystal producing fluorapatite which is less soluble in
catabolic acids produced by oral bacteria.
o Prevent caries by directly interfering with the growth and metabolism of organisms such as streptococcus mutans
that produce acids responsible for decay.
What sleep med do you give to a pt the night before a dental appt? Diazepam?
Value is the single most important factor in shade selection. Intensity is included in the term value.
o Stains are metallic oxides that fuse to the porcelain during a predetermined firing cycle.
o Drastic changes of the hue (color or shade) are often impossible.
o Orange stain is the most often used to change the HUE. Staining a porcelain restoration will reduce the VALUE (as
will using a complementary color). It is almost impossible to increase the value.
o CHROMA can be successfully increased by the use of stains, particularly in the gingival area.
Tooth #30 is endo tx with restoration, pt is in pain when he bites, why? cracked tooth
Suturing
o Resorbable sutures evoke an intense inflammatory reaction. Plain gut or chromic gut are NEVER used for suturing
the surface of a skin wound.
o When suturing an extraction site in the anticoagulated patient, a non-resorbable suture is recommended.
o Suture size is based on strength and diameter. This system uses "0" as the baseline, average size suture.
o As suture diameter decreases, "0" are added or numbers followed by a "0" (for example, 000 and 3-0 are the same
size).
o Because suture material is foreign to the human body, the smallest-diameter suture sufficient to keep the wound
closed properly should be used.
What meds do you take for asthma? Bronchial relaxation, airway dilation
o Beta agonists – albuterol, salmeterol metaproterenol
Patient is getting front tooth fixed ... whats the purpose of using an incisal guide table?
o Acrylic resin reproduces the surface of teeth (lingual concavity/incisal edges) that have a direct influence in guiding
the mand.
o Through ALL EXCURSIVE movements incisal guidance plays as important a role as the temporo-mandibular
articulation in establishing a functional and harmonious occlusion, as much on the anterior teeth as the posterior
teeth.
What sleep med do you give to a pt the night before a dental appt? ambien CR (zolpidem tartrate)
19 yo girl has halatosis, interproximal recession and bleeding ... because? ANUG
The drug enforcement agency is concerned with what? potential for abuse
Where are you most likely to perforate on a maxillary central incisor? Buccal
Dentist restored tooth and accidentally left caries ... what happens to caries? caries is arrested
Two things that account for a successful posterior composite restoration? type of resin and type of prep
What is the initial step when you have an acute perio abscess? incision and drainage not Abts immediately
How do you repair a porcelain veneer with composite? microetch, etch and silane
conical shaped caries w/ broad base with apex towards pulp is commonly seen in? smooth caries
40 yo pt w/ all 32 teeth. No cavities. Has stain & catch in pit of molar. what do you do? a. watch and observe
b. sealant
c. Composite
12 yo kid w/ carious lesion on tooth #9 that shows pulp exposure w open apex... what do you do?
a. rct
b. apexiflcation
Tooth #30 has huge MOD amalgam and is deep. Hurts pt when he eats french bread. what is the cause? a. root fracture
What branch off facial nerve gets damaged the most during TMJ surgey? temporal
When pt has mouth open, what oral structure would inhibit from capturing buccal flange when taking impression?
c. coronoid process
Note: Masseter an buccinator are not functioning during opening of mouth. coronoid process has direct involvement in max
molar buccal area during mouth opening and can interfere with impression taking.
You see 3 mand incisors w/1 wide tooth. x-ray shows tooth has 2 canals. what condition is it? fusion
b. Gemination c. Concrescence d. Dilacerations
What are you most likely to see in a kid who has a mandibular canine tipped facially? gingival recession
How do you make a crown narrower? move line angles more facially
Not enough room when edentulous pt closes. what do you do? adjust mandibular denture
a. tuberosity reduction
c. adjust maxillary denture
What do x-rays depict when viewing osseous craters ... or something? underestimates bone reduction
What occlusion class will it be if you have an ANB of -8 degrees? class III
Trauma to max incisor, x-ray shows no pulp, asymptomatic and no endo lesion. what do you do? Observe
Main advantage of doing direct composite over composite onlay? better marginal adaptation
Patient trouble keeping her lower complete denture in because of a low ridge, how to fix this problem?
a. ridge augmentation
b. place anterior implants
c. alveolar bone sectioning
Pt says "your fees seem high" ... how do you respond? "my fees are comparable to geographic area"
You are extracting a 2nd mand premolar... what injections do you give? lingual, buccal and IA
Most common condition that occurs in the dental office? Syncope What do you do?
Pt has some condition that had blue sclera ... what disease does the pt have?
a. osteogenesis imperfect
b. marfan's syndrome
o A chest that sinks in or sticks out -- funnel chest (pectus excavatum) or pigeon breast (pectus carinatum)
Flat feet
Highly arched palate and crowded teeth
Hypotonia
Joints that are too flexible
Learning disability
Movement of the lens of the eye from its normal position (dislocation)
Nearsightedness
Small lower jaw (micrognathia)
Spine that curves to one side (scoliosis)
Thin, narrow face
Pt's max denture made her tissue inflamed and weird, you decide to make her a new denture after?
a. you reline her old denture
a. you place tissue conditioning material in her old denture
c. you surgically remove her tissue
You inadvertantly extract the wrong tooth ... what do you do?
a. replant it asap
b. do rct and then replant it
c. wait until next appointment to replant
d. place implant asap
You extract a molar and bone fragments come out with it... what do you do?
a. take out bone fragments and make sure its all gone
Flap back the tissue and see the entire area
Denture sore throat : palatoglossal and superior constrictor of pharynx is inflammed (pt. cannot swallow)
What is the most common site of new cases of oral cancer? 1-Palate 2-Tongue 3-Floor of mouth 4-lip
A painless, well-circumscribed radiolucency and radioopacity in the posterior mandible of 11yrs old boy . what is the
differential diagnosis Ameloblastic fibro -odontoma
(If age above 50 ,its Paget's disease also remember Ameloblastoma occurs in oldies)
"Ghost teeth " Regional odontodysplasia (only one side of mouth affected)
The Stafne defect is a depression of the mandible on the side nearest the tongue. It was previously known as a latent bone
cyst and static bone cyst but is now known as a pseudocyst. The depression allows for the presence of a salivary gland
The main reason of breaking of RPD clasp? High Mudule of Elastisity Work Hardening
Which medication is controbuting to Insomnia, lack of apetite, and abdominal pain? Dextroamphethamine
o Stimulant that promotes NE release in CNS; used for narcolepsy, ADHD,
How far the brush and floss goes in sulcus? Brush 1mm , floss 2mm
Is Propoxyphene (opiod) contraindicated in pregnant women? In 3rd trimester; WAS WITHDRAWN FROM MARKET
What is the best to clean implant? a-water pick b-tooth pick c-floss d-proxibrush
What is hypertelorism? eyes too far. Seen in Gorlin and Down syndrome
What is 4 -7 years old afraid of ? a- pain b-unknown c-dental chai r d- sepration from parent
ADHD is most common in? boy Boys have higher rates of ADHD than do girls.
Former smoker has less chance of periodontitis compare with current smoker.
Examination reveals a soft, fluctuant, tender swelling in the middle of the hard palate. The teeth test vital. Radiographs
reveal a radiolucent area projected between the roots of the maxillary central incisors. The cyst that represents the most
likely diagnosis is a
o Nasopalatinal cyst
o Nasiolabial cyst
o Pleomorphic adenoma
o globulomaxillary cyst
The pulpal floor is perforated during access preparation. The best course of action is to
o CONTINUE RCT, REPAIR THE PERFORATION AT A SUBSEQUENT APPT IF ASSOCIATED PATHOSIS DEVELOPS.
o REPAIR THE PERFORATION, SCHEDULE PT FOR ANOTHER APPOINTMENT TO FINISH RCT
o REPAIR PERFORATION, INITIAL CLEANING/SHAPING SCHEDULE PT FOR FINISHING RCT
Following flap surgery, new junctional epithelium can form on either cementum or dentin. Junctional epithelium is
reestablished as early as one week.
o Both statements are TRUE.
o Both statements are FALSE.
o The first statement is TRUE, the second is FALSE.
o The first statement is FALSE, the second is TRUE
Hand-Schuller-Christian triad
o Diabetes insipidus
o Exophthalmos
o Bone lesions (Langerhans dis)
Oral signs of hand-schuler-christ. = bad breath, sore mouth, loose teeth
o lesion are sharply punched out radiolucency and teeth appear as FLOATING IN AIR
Gorlin syndrome or Basal Nevus Cell Syndrome: Bifid rib, OKC, BCC
Gardner Syndrome: multiple facial osteoma, Odontomas, hyperdontia, GI polyps w/ potential for colon carcinoma
Erythema Multiforme: young men, viral or drug, sudden onset, vermilion, intraoral not on gingiva, (target) bulls eye on
hands and feet
o Steven’s Johnson = severe form of Erythema Multiforme (affects eyes, mouth, and genitalia)
PDL widening: Hyperparathyoid, osteosarcoma and scleroderma (Trismus, widened PDL spaces, mask-like face, Excess type I
& III collagen)
Multiple neuromas on lips, tongue or palate may indicate that pt has MEN III adrenal pheochromocitoma
Tumors of Endocrine glands esp. Medullary carcinoma of thyroid (can cause death)
Oral hairy leukoplakia & Mono, Burkit lymphoma all caused by EBV; nasopharyngeal carcinoma
Garre's (prolifrative periostitis) and Ewing sarcoma are both onion skin
Cementoblastoma:
o also known as true cementoma, is a rare benign neoplasm of cementoblast origin.
o It occurs typically before 25 years of age; no gender predilection.
o It is more often seen in the posterior mandible
o It is intimately associated with the root of a tooth, and the tooth remains vital.
o Cementoblastoma may cause cortical expansion and, occasionally, low-grade intermittent pain.
o opaque lesion, usually surrounded by a radiolucent ring representing the periodontal ligament space
o TX: cannot be removed without sacrificing the tooth.
Bone relief is typically required to remove this well-circumscribed mass.
Recurrence is not seen.
Candidiasis Pt has both burning sensation of tongue and altered taste sensation.
Sjogren’s syndrome does NOT have burning sensation of tongue but has altered taste sensation.
o Pt complains of difficulty wearing the denture and shows cervical caries.
o Tx of sicca (dry mouth, eye) in Sjogren syn is pilocarpine
infection from mandibular premolars most like to drain into? Sublingual area
o mandibular Molars submandibular area
The lingual wall of mandibular teeth is most easily perforated when preparing an access opening due to the lingual
inclination of these teeth.
Where are the primate spaces? max= between lateral & canine & mand= between canine & 1st molar
you separate an endo file 3mm from the apex and obturate above it... which case will show the best prognosis?
o vital pulp w/ no periapical lesion
o vital pulp wI periapical lesion
o necrotic pulp wI no periapical lesion
o necrotic pulp wI periapical lesion
12 ylo kid w/ carious lesion on tooth #9 that shows pulp exposure wI open apex... what do you do? apexiflcation
How enough space provided for eruption of permanent anterior mandible? primate space
Dentist charge for crown is $500. Insurance only covers $400. Dentist waves copayment($100) but still tells insurance he
charges $500 for crown. what this action called?
o a.Down codding
o Over billing
o c.Price fixing
o d.Unbundling
Pt with cafe au lait spots and some problem with iris (lisch nodules)...does not mention about GI polyps
o a.neurofibromatosis
neurofibromatosis characteristics: lisch nodules: traslucent brown-pigmented spot of iris
axillary freckling (crowe's sign), enlargement of fungiform papilla, enlargement of mandibular foramen
o b.peutz jegher
o c.jaffe syndrome
Dentist reviewed of his existing 1000 Pt charts. Noticed among these 1000, last year 200 had periodontitis but in a year
after 300 have periodontitis, how much is the incidence?
o a.0.3
o b.0.1
o c. 0.2
what kind of study is above? descriptive
what percentage of US population have access to fluoridate water? a.45% b.65% (42 states) c.85%
You are the 8th dentist, pt did not like none of the previous. Likes you and will bring all his family. Pt suffers from?
o paranoid--no trust
characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of
others
o schizoid
personality disorder characterized by a lack of interest in social relationships, a tendency towards a
solitary lifestyle, secretiveness, and emotional coldness
A primordial cyst is a devleopmental odontogenic cyst. It is found in an area where a tooth should have formed but is
missing. Primordial cysts most commonly arise in the area ofmandibular third molars.
o Under microscopes, the cyst looks like an odontogenic keratocyst.
Kid 5 years with systemic ds came to control plaque- sodium fluoride or chlohexidine
Adrenergic receptors
o Eye Only alpha1
o Blood vessel Alpha1,2, B2
o Lung Only B2
o Heart B2, B1
Papillion-Lefevre:
o Autosomal recessive, impaired T and B lymphocyte
o reduced killing of bacterial and fungal infection
o advanced periodontitis in primary and permanent dentition related to AA
o hemoraghic gingivitis-teeth float in the soft tissue, excessive bone loss, spontaneously tooth exfoliation, palmar-
planar keratosis, keratosis of elbow and knee, may be confused with psoriasis
o ectopic calcification of falx cerebri.
o Tx: rigorous OH, chlorhexidine rinse and periodic antibiotic therapy
A practitioner has been using bisect technique for taking xray for his patients. His distance was 8 inches using that system
now if he wants to take x-ray utilizing parallel technique form a distance of 16 inches the time of exposure would be: (
double,half….) Same
Best caries preventive measure for retained root under Compete Denture cast coping
Rectal bleeding, granolumatous gingivitis and recurrent aphtous ulcer. Crohn disease
liner in the casting ring! Its purpose? compensate for casting material expansion
All causes gingival hypertrophy except Diltiazem (phenytoin), dilantin, nifedipine, dixosin, cephalox
Medicare is a federal thing that provide health care for elderly . It does not cover dental (both statements are true)
nd
Which pulp horn in primary teeth is most susceptible for exposure during operative procedure MB of 2 molar
st
Most common cause of arch space lost in primary dentition decay, ectopic eruption 1 molar
Cancer of the other part of the body metastases most commonly to?
o Bone:Molar region of mandible
o Soft tissue: attached gingiva then tongue
o Breast cancer is the most metastatic to the oral cavity appearing in the mandible
o then lung cancer is the second appearing in the soft tissue.
After trying the anteriori teeth in the mouth for complete denture patient. In order to determine condylar inclination we
make a record of patient’s anterior guidance. What we have to take into consideration in the lab:
o Raise the pin on the articulator while setting the condylar inclination
A tooth is not responsive to cold, not percussion and pulpation tender necrotic pulp and chronic apical periodontitis
A child is allergic to ampicillin, what is the regimen for prophylaxis? ( know the dosage for cephalexin , azithromicin)
open tray technique impression for implant to transfer the exact angle of implant to the lab
In office bleaching changes the shade through all except surface demineralization
For internal bleaching: use sodium perborate & 10% carbamide peroxide****
Have lot of incisal overlap, what do you want to change to maintain balanced occlusion
a) ↑ condylar inclination
b) ↓ condylar inclination
During the child's first visit, the dentist requested that the parents wait in the reception room. The child cried moderately,
but tearfully, throughout the dental examination and prophylaxis. The dentist "gave her permission" to cry while he/she
worked and then took no notice of her crying. Her crying diminished in intensity over time and then stopped. With respect
ONLY to the crying behavior, the dentist has
o used positive reinforcement.
o used negative reinforcement.
o extinguished the behavior.
o ignored the problem.
You have HIV+ pt you can do all of the following except a) treat with metronidozole b) free gingival graft c)prophylaxis to
treat candidiasis
You give the nitroglycerin to the pt with angina and heart rate goes up what's the reason?
o natural reflex to the decrease in blood pressure
Which kind of caries has been reduced over time? Occlusal, root, proximal
Max ridge in denture pt becomes ………….. over time? Narrow, wide , small , large
Pic of dorsum of tongue with 1 side totally red with white nasty patches and painful? Phemigus
Primary tooth most like to have high chance of pulp exposure? Mand first molar
If have large caries near pulp, what do you do? Placed GI liner, restore with composite
What is function of reciprocal clasp? Retention Oppose force on buccal clasp or stability
Signs of hyperocclusion Recession Pain when biting down hard Root resorption Alteration of lamina dura and pdl space
Patient with past heart attack, high bp, high chlosterol, asa type? Type 3
Our office is fee schedule and pt needs new crown but pt used up all of her allowance (or something like that), what do you
do?
o Charge same fee
Want to compare 2 groups of people, male and female for something, what test do you look at? Chi square test
Pic of all max anterior lingual totally eroded but incisal edges are fine Pt sucking on lemon
Temp that necrosis happens during implant placement is 47 for 1-5 min
What do you do when you see a decalcification spot? Fluoride and leave
Kid is 15 yrs old and living in a community with 0.75ppm of fluoride, what do u do? – no supplementation
Free gingival graft receives it’s eptithelium from – adjacent tissue (blood supply from CT)
Most common reason for cardiac arrest in children – respiratory depression, CHD, atrial septal defects, congenital heart
disease
Most common impacted tooth – Max canine, max lateral, mand premolar or max premolar(if wisdom was chioce that one)
What is the most common tooth to erupt in crossbite?
Radiograph showing radiolucency in furcation area in a primary second mand molar – reason is periodontal, pulp necrosis, trauma
If you have to extract 1st, 2nd and 3rd molar, in which order do u extract? 3, 2,1 for better visibility
What is compomer
combined benefits of composites (the “comp” in their name) and glass ionomers (“omer”).
Why don’t you use GI resin cement in cementation of all ceramic restoration - its expansion could cause cracking of porclain
Epidermolysis bullosa
Rare genetic disorder caused by a mutation in the keratin gene.
Characterized by the presence of extremely fragile skin and
recurrent blister formation, resulting from minor mechanical friction or
trauma.
Pt has a chronic periapical abscess with sinus tract – tx is RCT, what is that tx for sinus tract : antibiotics, curettage, cautery, no tx
Perineural invasion is seen in – adenoid cystic carcinoma, Pleomorphic adenoma or low grade muco epidermoid carcinoma
This tumor has a marked tendency to invade nerves. Perineural invasion is seen in about 80% of all specimens.
Post herpetic neuralgia cause by varicela zoster virus- shigles extreme unilateral pain
Why do you give methadone to pt who is trying to stop heroine? to decrease withdrawl symptoms
Patient tried using nicotine patches, gum but still couldn’t stop what do you do? Buproprion or behavior counseling
When RPD is rocking on the fulcrum line, whats the problem? No option about the base
problem with denture base
problem with indirect retainer
Periostat – doxycycline 20mg placed in periodontal pocket – what does it do? I think it inhibits collagenase
Dentist tells a patient that mercury is toxic and she should replace her amalgams with composite – which principle of ethics dentist
does not follow? veracity
What do you prescribe for pts with ANUG? Tetracycline in immunocompromised; Debridement and mouthwash Hydrogen peroxide
Pt with manic depression (bipolar) disorder not willing to get treated for that is now getting dental treatment from you. What do you
see in this patient mood swings
One of your patient is having a dental problem and treatment that is not under your capability and you are reffering that patient to a
specialist, this type of behaviour comes under which of the following codes of ethic nonmaleficience
Which of the following causes Cavernous sinus thrombosis
A)Subcutaneous Abscess of upper lip
b)Subcutaneous abscess of lower anterior region
Infections in upper front teeth are within the area of the face known as the "dangerous triangle". The
dangerous triangle is visualized by imagining a triangle with the top point about at the bridge of the nose and
the two lower points on either corner of the mouth
Pt brushes twice a day n also floss but still he has calculus what do u suggest C) demonstration of brushing
First upper molar is supra erupted and the lower opposite molar is missing which of the following u will not do?
A) up righting the molar B) rotation of molar C) Intrusion
Pt has hepatic dysfunction which pain medication can prescribe? a-Oxycodone b-naproxen c-acetaminophen
which of the following dental treatment can be done with pts taking bisphosponate A)Alveoloplasty B) endo C) Extraction D) Scaling
Confounding
In Epidemiology a confounder is: not part of the real association between exposure and disease
o predicts disease unequally distributed between exposure groups
o A researcher can only control a study or analysis for confounders that are: known, measurable
Example: Grey hair predicts heart disease if it is put into a multiple regression model because it is unequally distributed
between people who do have heart disease (the elderly) and those who don't (the young). Grey hair confounds thinking
about heart disease because it is not a cause of heart disease.
Strategies to reduce confounding are:
o randomization (aim is random distribution of confounders between study groups)
o restriction (restrict entry to study of individuals with confounding factors - risks bias in itself)
o matching (of individuals or groups, aim for equal distribution of confounders)
o stratification (confounders are distributed evenly within each stratum)
o adjustment (usually distorted by choice of standard)
o multivariate analysis (only works if you can identify and measure the confounders)
Primary stress bearing area in mandible: a-Retomolar pad b-alveolar ridge c-buccal shelf
and in case the residual ridge is in good shape it also contributes to primary support.
In which of the following muscles you can place the mandibular denture
a-lateral pterygoid b-middle pterygoid c- buccinator (Buccal) d-maseter (Distobuccal)
picture of diffused pigmentation in anterior max and mad incisors in attached gingiva? Racial pigmentation
Perio: If little attached gingiva is present, what do you not do? GINGIVECTOMY
Rubber band if around central incisors to close diastemas, what condition will allow this?
o T- no additional adverse effect
Which clinical trial where sample size doesn’t make a difference? surveillance
Lesion in the middle of tongue also pt had it on palate before and pt is healthy?
o Karposi
o T- candidasis—sounds right
o Syphilis
Which is antidepressant?
o Something pentol
Fluexitine (SSRI), Mazindol, Buspirone, Isocabaxazid
If your jaw is broken, allow to heal, how will the growth be?
o Bilateral
o Symmetrical effective
o Condylar side
If you are doing a graft mandibular molar and premolar, what interferes?
If you pack bone, how does allograft heal Bone morphongenic protein
Did RCT, pt went home, still sensitive, what is most likely? overinstrumentation
If a child is told from parent you will feel no pain from filling, what does this cause
o Bad relationship between pt and dentist
Unrooly child
o Unruly child is someone who does not respect authority and go abide rules---
Aspirin?
o Platelet aggregation
Aspirin is it extrinsic or intrinsic pathway?
Arachidonic is a precursor for Prostaglandin
What surface build for oseointigration for implant Surface titanium oxide
Mand ant teeth picture with opaque line to the apex Nutrient canal
Another vasoconstrictor: know alpha blocker, what causes it, or agonist of alpha and beta
Xray – put lateral border orbit, out of focus, or lateral wall of max sinus
Know what happens with incorrect vertical or horizontal angulation when taking bitewings on a child
If jaw broken, allow it to heal (without taking care of it), what will be affected: subcondylar fracture, symmetrical non symmetrical
3?’s definitive Dx, if shit is growing on side of tongue; incisional biopsy, toulidine blue, cytology, which test he say incisional biopsy
Implants- most likely to disturb what? Apical, transeptal, oblique ligaments, or overall musculature
Patient goes to periodontist to get flap surgery, who does re-eval? You, perio, both? (both I believe)
Physical composition of food, which aspect related is carcinogenic? The amount of times you chew? (a choice, no idea)
If you have class V lesion and bottom part on cementum? Occlusal you bevel, part on cementum, 90 degree butt joing
When can you have unsupported enamel? Class III, IV, facial of I or II
Patient comes in with bad perio, why Listerine rinse? because it causes plaque destruction
Question about doctor touching PMMA, what kind of reaction may he experience…
Which material in 100% humidity would distort? Reversible hydrocolloid, addition silicone, etc
Cement: When doing composite, what inhibits polymerization? Zinc oxide, Eugenol, Water
Highest chance of leakage under rubber dam? Holes too wide, Holes too far apart, Too close
Which is worst/most uncomfortable for patient to do: Increase VOD, have CR, slightly off, Decrease VOD (in full dentures) – causes
angular chelitis
T test average between clinical trial A & B what to do? Standard deviation, chi test,
Day 2:
If ext of max molar what type of tissue on root which is embedded in maxillary sinus
o Pseudostratified ciliated columnar epithelium
What molar has a c shaped canal (xray shows pa of #31 and the roots where convergent)
nd
o Mand 2 molar with convergent roots
Where is it most important area to have thickness on the metal on FPD on connector area
o M-D
o F-L
Pt has had a cleft palate as a child, it was taken care of and at 30 years wants to get implants.
o No! never implants with cleft palate-
Sickle cell
o HgS
Picture shows bilateral distal extention and max teeth had been chewing down on the edentulous ridge, man edentulous
ridge looked white and beat up, question said Which layer on top later of cells has increased.???
o T- Strt corneum
o Strt lucidum
Max canine and mand canine ectopic from facial, what angle classification
o T- I
o II
o III
SNA angle 6
o Class II
Molar Mesial caries in xray, xray shows caries to pulp and occlusal picture shows super white mesial structure
o Early decal
o T- Usupported enamel
nd st
2 molar stain happened b4 extraction of 1 molar
o T- stain happened b4
o After
o During
SCC on tongue
o What you do---- Incisional
If you upright molar a mesially tilted…. Distal and inferior, crown moves distraly root stays at same place
Belladonna alkaloids and anticholinergics increase intraocular pressure and are CONTRAINDICATED in
patients with GLAUCOMA
Semilunar flap allows you to see the root with the least soft tissue reflection
Amyl nitrite
o inhalation causes
Tachycardia
Coronary arterial dilation
Peripheral arterial dilation
Decreases arterial blood pressure
o Prolonged use causes methemoglominemia
Irreversible anticholinesterase poisoning die because of respiratory failure via paralysis of diaphragm