Professional Documents
Culture Documents
PC 1
Contraindications
➢ Acetaminophen is contraindicated with Liver disease (cause hepatotoxicity) and alcohol
➢ Nitrous Oxide: 1st trimester only, nasal congestion
➢ Asthma, can participate with attack: Aspirin
➢ Epinephrine (Adrenalin) should NOT be used with tricyclic anti-depressant
➢ Epi is not used in: Hyperthyroidism
➢ Erythromycin and Tetracycline are prescribed carefully in patients with peptic ulcer because:
interact with Antacids
➢ Macrolides avoided in Asthma: interact with Theophylline
➢ Penicillin is cross allergenic with Cephalosporin because of Beta Lactamase
➢ Pilocarpine is not used in pt with G6PD deficiency
➢ Never give penicillin with tetracycline: due to Antagonists property
➢ Strongest glucocorticoids: Dexamethasone
➢ Benzodiazepine antagonist: Flumazenil
➢ Opioid antagonist: Naloxone
➢ Antihistamine is contraindicated with Erythromycin: Terfenadine
➢ Heparin is contraindicated to pt with taking gingko biloba
➢ In multiple sclerosis: LA with epi is contraindicated
➢ Lidocaine may show cross-allergy with: Mepivacaine
➢ Bisphosphonates are NOT used for: Multiple myeloma, Osteomyelitis
➢ Drugs caused gingival hyperplasia: Phenytoin, nifedipine, cyclosporine
Abnormality:
➢ Turner incisor: trauma during pregnancy
➢ Ectodermal dysplasia: oligodontia & hypodontia
➢ Systemic condition associated with endocarditis & glomerular nephritis: SLE
➢ Gardener’s syndrome features: unerupted teeth, retained deciduous teeth, impacted
permanent teeth, see osteoma (child)
➢ Mechanism of Fetal Alcohol Syndrome: Neural crest apoptosis
➢
Research studies
➢ Evaluation of 2 groups A & B with 2 drugs for same period, what type of study: Clinical trials
➢ One month ago, a dentist studied the prevalence of dental caries among school students, what
type of study: Cross-sectional
➢ Dentist studied 4 unrelated patients with myofascial pain & myalgia, What type of study: Case
series.
➢ Sample size is irrelevant in: Case report or Case series study
➢ Study to know the effect of gastric bypass surgery on nutritional status: Cohort
➢ Prevalence is measured by: Cross-sectional study
➢ Incidence can be directly calculated from: A cohort study
➢ 3 categories of epidemiological studies:
• Descriptive: incidence & prevalence
• Analytical: cohort, cross-sectional, & case control
• Experimental: clinical trials & community trials
Oral Surgery
➢ Most to Least Frequent Impacted teeth: Mandibular 3rd Molars, Maxillary 3rd Molars, Maxillary
Canines
➢ Non-rigid splint is recommended for Subluxation, Luxation, Avulsion to avoid Ankylosis
➢ Most Common to Least common Congenitally missing teeth: 3rd molars, 2nd PMs, and Maxillary
Lateral Incisors.
➢ Causes of Alveolar Osteitis (Dry Socket): Active dislodgement of blood clot (Fibrinolysis of the
clot)
➢ During extraction, which direction tooth should luxate: Child: Palatally, Adult: Buccally
➢ Serial extraction required: For space deficiency in mandibular anterior region
➢ Biggest risk with extracting a lone single (ankylosed) remaining maxillary molar: Fracturing
tuberosity
➢ Minimum platelet count for oral surgery: 50,000
➢ Most difficult to extract 3rd molar: Disto-angular, 2nd most horizontal, 3rd most vertical (Mesio-
angular is the easiest one)
➢ Caudwell Luc Technique: removal of root tip from Max sinus, incision over canine fossa
➢ Osteoradionecrosis pt: Use Hyperbaric O2 for angiogenesis
➢ Most common complication or negative outcome after extraction: Alveolar Osteitis (Dry Socket),
Caused by fibrinolysis (Blood clot is not forming), main symptoms is PAIN, smokers are most
common, Tx: Irrigation with Sterile solution & Medicinal/Sedative dressing, To control pain:
Analgesics. NO ANTIBIOTICS NEEDED.
➢ Primary consequences of trauma to child Jaw: Retard growth, can cause mid facial asymmetry
➢ Most common fracture in child: Condyle
➢ Standard length of maxilla-mandibular fracture fixation is 4-6 weeks.
➢ Mandibular symphysis fuse/closed: 6-9 months
➢ Paresthesia in lower lip: Angle of mandibular fracture
➢ Guerin Sign: Ecchymosis in the greater palatine vessels region, a feature of Le Fort 1 fracture
(Lower midface, floating palate)
➢ Bilateral Sagittal Split Osteotomy (BSSO): correct malocclusion of mandible, mandibular
advancement or retraction, mandibular augmentation. Worse complication: Inferior alveolar
nerve damage, causing Paresthesia. OP complication: Neurosensory disturbance.
➢ Correct Class III: Le Fort I + BSSO (If Palatal expansion plate can’t possible due to age)
➢ Distraction Osteogenesis (DO): to reconstruct Skeletal Deformities where bigger stable
movement needed. Require Long Term Follow Up.
➢ Worst place to do graft: Canine eminence, interdental
➢ Submandibular drain into what space: Deep cervical lymph nodes
➢
Extraction forceps:
➢ Maxillary PMs: 150
➢ Mandibular PMs: 151
➢ Max root: 286
➢ Mand root: Cryer Elevator
➢ #65 forceps, usually used for removing root tip
➢ Elevator in OS acts as: Lever
➢ One side tissue suture: Interrupted (immobilize the flap)
➢
Radio:
➢ Collimation:
• Control size & shape of X-ray beam
• Reduce area of exposure
• Reduce amount of scatter radiation by 60%
• Reduce x-ray beam size/diameter
• Reduce volume of irradiated tissues
➢ Filtration:
• Reduced intensity of electron beam
• Selectively absorbs low energy, high wavelength x-ray/energy photons
➢ Penumbra: the fuzzy, unclear area that surrounds a radiographic image
• Larger Penumbra: Decreased CONTRAST, Decreased SHARPNESS
• Less Penumbra: Increased CONTRAST, Increased SHARPNESS
• Influenced by: Focal spot size, Film composition, Movement
• Reduce Penumbra: decrease object – film distance
➢ Reduce/Prevent Penumbra:
• Decrease size of Focal spot
• Reduce Object-Film distance (X-ray should be parallel)
• Increased Focal Spot-Object distance
• No MOVEMENT
➢ Best revealing issue for prediction about Ossification: Hand wrist radiograph
➢ View sinus/orbital rim areas: Waters (If waters is not option, then CT scan)
➢ Mid facial fracture: Waters
➢ Mandibular fracture: Panoramic
➢ Condylar fracture: Reverse Towne
➢ Zygomatic arch/Zygomatic fracture: SMV (Submentovertex)
➢ Horizontal fracture: Multiple vertical angulated radiographs
➢ Mandibular symphysis fracture, sialolithiasis in Wharton’s ducts: Occlusal
➢ Mandibular Symphysis Fracture: Antero-posterior or CT
➢ Fracture of Angle, body, and ramus: Lateral oblique
➢ On average, nuclear workers, radiation permitted yearly: 5 rem/ 5000 mrem
➢ Angulation: Central x-ray needs to be perpendicular to film & object
Diseases in X-ray
➢ Soap bubble appearance: Odontogenic myxoma
➢ Honey combed appearance:
➢ Cotton wool appearance: Paget’s disease
➢ Ground glass appearance: Fibrous dysplasia
➢ Sunburst appearance: Osteosarcoma
➢ Swish cheese appearance: Adenoid cystic carcinoma
➢ Ghost teeth: regional odonto-dysplasia/odontogenic imperfecta
➢ Ghost cells: Keratinized odontogenic cyst
➢ Radiolucency with SPECKs: Adenoid odontogenic tumor
➢ Radiolucency around crown: Dentigerous cyst
➢
➢ Asymptomatic radiolucencies and transform radiopacities: Cemento-osseous
dysplasia/Cementoma
➢ Multiple osteomas, odontomas: Gardner’s syndrome
➢ Sequestered bone seen in Xray: Osteomyelitis
➢ Ghost cells: Keratinized Calcifying Odontogenic cysts)
➢ Ghost teeth: Regional Odontoplasia
Patient management
➢ Patient given oral habit reducing appliance to prevent an oral habit: Positive punishment
➢ Capitation is with: HMO (Health Maintenance Organization)
➢ Domestic abuse is an act of: Power of control
➢ Patient Position:
• Syncope: Trendelburge
• Asthma, COPD: Upright
• Crown in mouth: Supine
➢ How to treat manipulative Kids: Operant Extinction
➢ Dentist keeps up with recent developments and new skills, knows one’s limitations and when to
refer patient to a specialist: Non-maleficence
➢ Purpose of plaque index: patient motivation
➢ `insurance pay for your crown and core together even though were billed separately: Bundling
➢ What type of model is for IPA: Network model
➢ You let the child walk around and touch the instruments, how is that called: Systematic
Desensitizing
➢ What not to do with an uncooperative patient: Reschedule
➢
Medical Emergencies
➢ Most common respiratory emergency in dental chair: Hyperventilation (rapid breathing:
Tachycardia & Tachypnea)
➢ Most common dental complication/emergency: Syncope
➢ Most effective during acute asthmatic attack: Salbutamol (Albuterol) (beta-2 agonist)
➢ Medication for severe asthmatic attack: Aminophylline (bronchodilator), Albuterol
(bronchodilator), corticosteroids (for Long term asthma)
➢ No NSAIDs (Aspirin) for asthmatic patient
➢ Patient Position:
• Syncope: Trendelburge
• Asthma, COPD: Upright
• Crown in mouth: Supine
➢
Perio
➢ Base incision of Gingivectomy: Coronal to mucogingival junction
➢ Most common donor site of free gingival graft: Palate
➢ Main reason for failure of free gingival graft: lack of blood supply, Infection (2nd most)
➢ 2 most critical parameter for prognosis perio: Attachment loss and mobility
➢ Bacteria responsible for collagenase activity: P. gingivalis
➢
Oral Path
➢ Nikolsky Sign: Pemphigus vulgaris (Acantholysis present) & Erythema multiforme
➢ Subepithelial vesicular disease: Pemphigoid & Lichen planus
➢ Chronic Desquamative gingivitis AKA Cicatrical pemphigoid
➢ Cauliflower like pebbly appearance: Verrucous carcinoma, Condyloma accuminatum, Papilloma
➢ Granular Cell Tumor (skin or mucosal tumor) histologically resembles to: Congenital epulis, SCC
➢ Lesion that resembles to SCC, but disappears in 16 weeks: Kerato-acanthoma (Skin tumor)
➢ Most common malignancy found in:
• Metastatic Ca (Bone)
• Basal cell ca (skin)
• SCC/Epidermoid ca (oral cavity)
• Muco-epidermoid Ca (Salivary gland)
• Adenoid cystic ca (2nd most salivary gland)
➢ Texture/Consistency of Dermoid cyst VS Ranula:
• Dermoid cyst: Doughy or rubbery
• Ranula: more fluctuant, bluish mass/nodule/swelling
Prostho
➢ Gold Type I & II: Used for Inlays, Gold type III: Used for all metal ceramic crowns & Bridges
➢ Acron Articulator: The condyle element is in the lower member, resemble most accurately the
TMJ anatomy, good for fixed prosthodontics
➢
Pharm
➢ Gingival Hyperplasia:
• Dilantin (Anti-convulsant), #1
• Phenytoin (Anti-convulsant)
• Cyclosporin
• Nifedipine
• Verapamil (Calcium Channel Blocker)
• Diltiazem (Calcium Channel Blocker)
➢ Osteonecrosis most common with IV drugs: Zolmeda (zoledronic acid) & Aredia (Palmidronate),
not with Oral (Fosamax or Boniva)
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