C. Degenerative arthrosis.
D. Psoriatic arthritis.
E. Lupus arthritis.
o May develop years after the onset of an associated rheumatic disorder, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, primary biliary cirrhosis etc. (secondary Sjögren's syndrome)
Contraindication for max molar with class 2 furcation? hemisection w/ crown
o hemisection mand molar Mandibular molars to treat Class II or III furcation invasions o Root amputation max molar
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
What does sodium hypochlorite do? Disinfectant germicidal solvent action o 5.25% solution provides excellent germicidal solvent action
What is a sign of ectodermal dysplasia? retained teeth
o Hereditary; M>F; from ectoderm; abnormal development of the skin and associated structures (hair, nails, and teeth, and sweat glands
o Common clinical findings include hypothrichosis (decrease in hair), anhidrosis (no sweat glands, leading to heat intolerance), anodontia or oligodontia (complete or partial absence of teeth), depressed bridge of nose, lack of salivary glands
o child appears much older than what he or she is.
All these meds decrease saliva except? Pilocarpine
o Pilocarpine (Salogen) is used to stimulate salivary flow in patients suffering from xerostomia due to radiation therapy in the treatment of head and neck cancer.
o Pt has round bump on midline of floor of mouth, what is it? ranula
o The ranula, a true retention cyst, characteristically occurs in the floor of the mouth and is unilaterally located.
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.
Which is least likely to occur with occlusal trauma? gingivitis
On the trauma of occlusion ---gingival reccetion o Radiographic signs of trauma from occlusion:
Widening of the periodontal ligament space
Sometimes thickening of the lamina dura
Angular bone loss and infrabony pocket formation
Root resorption
Hypercementosis
o Trauma from occlusion is reversible,
o Periodontal pocket formation is an inflammatory lesions and are not caused by occlusal trauma or bruxism
Most common characteristic of cherubism? bilateral jaw swelling
Normal occlusal wear shows what? Attrition
What substance has corrosion resistance in PFM metal? chromium
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
Best way to suture an incision? interrupted suture
Best way to determine outcome of disease?
o Med history of the patient (If the lab test was choose may be that) o ESR LAB result
Best reason to do an onlay? cuspal coverage
What is a sign of ectodermal dysplasia? anodontia, aligodonsia
Mechanism of opiods? attach to MU receptors
Main advantage of using GI cement? Fluoride Release
Why don’t you use acidic F with GI?
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
Where are the primate spaces?
Osteoporosis is associated with which of the following diseases? Hyperparathyroidism
Do not give which medication to lactating female? codiene and tetracycline
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
How to do treat porcelain veneer before you cement it?
Which is the best systemic anti-fungal? ketoconazole, and others are amphotericin B and fluconozole b. nystatin
c. miconazole d. Clotrimazole
conical shaped caries w/ broad base with apex towards pulp is commonly seen in? smooth caries
best clinical determinant of root caries a. sensitivity to cold
b. sensitivity to sweets
c. soft spot on tooth - visual and tactile methods are used for detect 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
What is most numerous at site of chronic inflammation? macrophages
Main difference and advantage of using GMT instead of Enamel hatchet?
a. bi-angled cutting surface b. angle of the blade
c. push/pull action instead of
Tooth #30 has huge MOD amalgam and is deep. Hurts pt when he eats french bread. what is the cause? a. root fracture
When do you do calcium hydroxide therapy in an avulsed tooth? wait 2 weeks
Chronic periodontitis most likely found in?black males
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.
surgical dressing is indicated for what? protect the wound
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
Praising, smiling and congradulating is what type? social reinforcement o Positive reinforcement:
Social reinforcement: Praising, smiling, ....
No-Social (Token) reinforcement: Toy, Token
What do you do when pt on hospital bed has allergic reaction to iv antibiotics?
a. take off iv antibiotics b. give epi
What are you most likely to see in a kid who has a mandibular canine tipped facially? gingival recession
Why do you do triangular access on incisors (max central inccisor?) a. to help with straight line access
b. help expose pulp horn
c. to follow the shape of the crown
Metastasis to the oral cavity is most likely to end up where?
a.lip b. tongue c. palate d. mucosa e. floor of mouth
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
Unconscious diabetic is treated with what?
a. subcutaneous sugar b. give him Orange Juice c. give him insulin injection d. 50 % dextrose solution
e. IV sugar solution or IM glucagon pt should wake up within 15mins
Most common place of recurrent caries in a class 2 composite? Gingival
What type of bond is composite on tooth structure?
a. chemical bond b. mechanical bond c. organic coupling d. Adhesion
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
Mand complete dentures must be extended how far distally?
a. just anterior to retromolar pad b. must sit on the retromolar pad
c. must be 5mm beyond the retromolar pad
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
Which does not show empathy to the patient?
a. open-mindedness
b. sharing personal experiences
c. reflection and showing understanding
Patients with autism will usually show?
b. heightened sense of lights and sounds
o Children with autism are easily overwhelmed by sensory overload. This can cause “stimming” (flapping of arms, rocking, screaming, etc). T are hypersensitive to loud noises, sudden movement, and things that are felt.
A gingival bevel can be placed with all, except?
a. sharp fluted instrument b. enamel hachet
c. Gingival margin trimmer d. thin diamiond bur
In what situation would a pt need to premedicate?
a. mitral valve prolaspe b. prosthetic heart valve c. bicuspid valve disease d. rheumatic heart disease
Proximal resistance form of amalgam restoration comes from what?
a. convergence of buccal/lingual wall
b. retention grooves in axiobuccal/axiolingual walls - for proximal resistance c. Dovetail - provides retention form
Stages of anesthesia o Analgesia /Amnesia o Excitement/Delerium
Begins with unconsciousness and ends with loss of eyelid reflex, purposeless movements and hyper-reaction, dilated pupils, reflex vomiting, tachycardia and hypertension
o Surgical anesthesia – working in this stage o Medullary paralysis: Cessation of respiration
Denture sore throat : palatoglossal and superior constrictor of pharynx is inflammed (pt. cannot swallow)
Port-wine stains associated with sturge-weber
Cephalosporins – beta-lactam family, anaerobic.
A prodrug is a drug made active by metabolism.
How much reduction veneer in the middle 1/3 of facial? 0.5mm
What does vertical pull headgear with chin cup do?
o correct vertical and a wide range of facial myofuntional problems, such as open bite.
o Headgear holds the mouth closed continuously, reducing interdental habits and tongue protrusion.
o Intrusive force on the molars is increased.
o This appliance can quickly change a mouth breathing habit to nose breathing o Know which kind of head gear is for maxillary vs mandible
What is an open-ended question?
o Allows freedom of response
New patient comes into office; 1st visit?
o Full exam, probing, med hx, impressions.
Why amalgam fails. Bad prep design.
What drug causes dilation of eye or midriasis?
o Atropine, antimuscarinic
How soon do you correct a noticeable crossbite o ASAP
Most difficult part of seting denture teeth?
What causes greatest occlusal wear? Porcelain o Amalgam is the strongest to wear
What increases in pulp with age? Fibroblasts
Width of Keratinized gingiva is : Free gingiva + attached gingiva
Bone density changes : Subtraction Radiography
Occlusal sealants succeed by change Pt susceptibility
Which of material cause less allergy? 1-Lido 2-Procaine 3- epi
The most common between five? 1-Papilloma 2-Rhabdomyoma 3-Leiomyoma 4-Lymphangioma 5-Neurofibroma
The Most connective tissue tumor : Fibroma (Not true tumor)
TMJ pain are mostly related to: 1- VII 2- V3 3- V2 4-VIII
What is the most common site of new cases of oral cancer? 1-Palate 2-Tongue 3-Floor of mouth 4-lip
Major mechanisms for the destruction of osseointegration are o Related to surgical technique
o Similar to those of natural teeth o related to implant material o related to nutrition
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)
Where do we find most caries? 1- occlusal2- Proximal
Dermoid cyst Occurs in the midline in the floor of the mouth
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
Which of the following resembles an epiphysial growth plates? Synchodrosis
Most beneficial aspect to brush tongue is reduce? Halotosis
What is diff of 330 and 255 bur? 255 is longer
The main reason of breaking of RPD clasp? High Mudule of Elastisity Work Hardening
HIV with recurrent herpes labialis? Acyclovir
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 to give to pt with allergy to codeine? Propoxyphene WITHDRAWN FROM MARKET
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
Factors that affect the prognosis of perforation repair include o location of perforation
o time delay before perforation repair o ability to seal the defect
o previous contamination with microorganisms
Immediate repair is better than delayed repair, because delay can cause breakdown of the periodontium, resulting in endoperiodontal lesions that are difficult to manage, and elimination of microbial contamination of the defect and proper sealing are critical to success
---
Tx of ANUG: ultrasonic debridment, oral rinse chlorhexidine or hydrogen peroxide, o abt tetra and metro only if lymphadenopathy involved
o tx of juvenile periodontitis: abt alone or with sc/rp
Which of the following drugs best reverses the effects of benzodiazepines?
o Naloxone opiod reversal agent o Flumazenil
o Midazolam bdz
o Aminophylline relaxes respiratory smooth muscle
o Physostigmine anticholinergic toxicity antidote; parasympathomimetic inhibits Ach-ase
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
Ostectomy is a procedure that involves the
use of an autograft.
use of an allograft.
use of a contiguous graft.
removal of tooth-supporting bone.
Which of the following drugs is administered orally to treat vaginal candidiasis?
Fluconazole (Diflucan®)
Griseofulvin (Grifulvin®)
Clotrimazole (Mycelex® Troche)
Miconazole (Monistat®)
Nystatin (Mycostatin®
Test Cavity
o The test cavity method for assessing pulp vitality is very seldom used today.
o Used only when all other test methods are deemed impossible or the results of the other tests are inconclusive
ex. when the tooth suspected of having pulpal disease has a full coverage crown.
o If no sound tooth structure is available to use a bridging technique with the electric pulp tester and cold test results are inconclusive, a small class I cavity preparation is made through the occlusal surface of the crown.
o The patient is not anesthetized while this procedure is performed
o If the patient feels pain once the bur contacts sound dentin, the procedure is terminated and prep is restored.
This signifies that there is some viable nerve tissue remaining, not that the pulp is totally healthy.
o If the patient fails to feel any sensation when the bur reaches the dentin, it is a good indication that the pulp is necrotic and root canal therapy is indicated.
Treacher Collins syndrome
o genetic disorder downward slanting eyes, micrognathia, conductive hearing loss, underdeveloped zygoma, drooping part of the lateral lower eyelids, and malformed or absent ears.
Turner tooth----Infection and trauma
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
Amelobelastoma and myxoma---- Hony comb-soap bubble
Paget's: Billateral maxilla---Cotton wool
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
PDL widening: Hyperparathyoid, osteosarcoma and scleroderma (Trismus, widened PDL spaces, mask-like face, Excess type I