VIVA QUESTIONS FOR MFD PART 2

• According to 2017-18 format,

• Viva session is for 30 minutes. 15 minutes on two tables.
• Each table has 2 examiners
• Each examiner will ask you about a particular specialty. Which
means that atleast 4 subjects of dentistry you shall have to
answer to pass in viva.
• Each examiner has their own laptop on which they display
pictures and ask you questions about it.
• You are assessed based on number of questions you are able to
answer correctly in a specific manner.
• Which means that you have to be very accurate in instantly
identifying the diagnosis and differential diagnosis with
treatment planning, causes, etiology, etc.
• Below mentioned questions are collected after lot of hardwork
from various examinations and students who appeared for Royal
college part 2 examination.
• Your answer needs to be precise and not a story. The more
questions you answer, more are chances of you clearing.
• If you don’t know answer to any question, just say PASS , do
not think about it and waste the precious time.
• Also, you shall have to answer question in a specific manner
as points are based on how you answer.
• If you thoroughly practice the below mentioned questions with
answers and the WAY to answer them, atleast 6-7 times, you
shall be very comfortable in the exam, with addition of tips and
other topics mentioned in the answer booklet.
• Visit this link for complete VIVA MFD book (over 150
pages and updated till 2019) which has more than 12
well explained papers made creatively for you to
understand and remember question and answers.

http://dentalprometric.com/prepare-for-mfd-part-
2-royal-college-dental-exams/
 A) Viva exam April 2018, Bahrain

First examiner:
1) Picture for lower 6 with fissure sealant:
• Types
• GIC resin
• Advantages
• Disadvantages
• Which one is better - Tinted or coloured Sealant is better as
if it wears off it can be easily identified.

Following notes are on Pit and fissure sealants and anything can be
asked from them.
 2) Molar Incisor Hypomineralization
• Everything in details
• Causes - It is thought to be caused by a disturbance in tooth
development around the time of birth or in the first few years
of life.
• How did you know the diagnosis,
• Treatment

Brief Important points about MIH

 3) Crown and loop space maintainer
• When to use band and loop – Premature loss of deciduous
molars. To prevent loss of space. Between age of 5 years and
12 years.

• Follow up – 6 months to 1 year to evaluate developing

dentition.
• When to remove it
When premolar starts erupting.

Second examiner:

1) Picture of Periapical x ray

• What do you see - It was elongated.
• Why? – Improper vertical angulation
• Risk of radiograph?-
The amount of radiation received from dental radiography is
so low that it is highly unlikely that it results in a measurable
risk. Dose reconstructions using techniques commonly used
during the last decades of the last century show that the
exposure to the brain from 4 bitewings is approximately 0.07
mGy, and from a panoramic examination about 0.02 mGy. A
full-mouth examination (typically consisting of 12 periapical
and 4 bitewing exposures) results in a brain dose of
approximately 0.24 mGy.
• Prevention of risk? – Proper usage of lead aprons and
Thyroid collars
 2)Picture with exposed bone after 2 days of extraction

• Diagnosis – Dry socket

• What is the scientific name of dry socket - Fibrinolytic
alveolitis
• How to know definitive diagnosis? –
Signs and symptoms of dry socket may include:

• Severe pain within a few days after a tooth extraction

• Partial or total loss of the blood clot at the tooth extraction site,
which you may notice as an empty-looking (dry) socket
• Visible bone in the socket
• Pain that radiates from the socket to your ear, eye, temple or neck
on the same side of your face as the extraction
• Bad breath or a foul odor coming from your mouth
• Unpleasant taste in your mouth

• Everything about osteonecrosis in details

Osteoradionecrosis (ORN) is an unusual complication from radiation
therapy to the head and neck that unfortunately results in bone death.
Once a section of the jaw dies it begins to deteriorate and weaken.
Minor trauma such as dental surgery or other procedures to the head
and neck may exacerbate the weakness and lead to further pain. The
jaw bones can become exposed in the mouth or through the facial skin
and the weakness may even lead to jaw fracture.

Symptoms include:
• Limited range of motion of jaw
• Pain that occurs at rest
• Jaw or facial swelling
• Exposure of the mandible or maxilla, which are the upper and lower
jaw
Diagnosis
• CT scan
• MRI
• X-ray
• Bone scan
Treatment
Depending on the stage of osteoradionecrosis, your doctor may
recommend that the dead bone be removed and that you undergo
reconstructive surgery to return normal facial contour and function.
The primary reconstructive procedure is microvascular head and neck
reconstruction.

• Everything about dry socket in details

Dry socket (alveolar osteitis) is a painful dental condition that
sometimes happens after you have a permanent adult tooth extracted.
Dry socket is when the blood clot at the site of the tooth extraction
fails to develop, or it dislodges or dissolves before the wound has
healed.

Normally, a blood clot forms at the site of a tooth extraction. This

blood clot serves as a protective layer over the underlying bone and
nerve endings in the empty tooth socket. The clot also provides the
foundation for the growth of new bone and for the development of
soft tissue over the clot.
Exposure of the underlying bone and nerves results in intense pain,
not only in the socket but also along the nerves radiating to the side of
your face. The socket becomes inflamed and may fill with food
debris, adding to the pain. If you develop dry socket, the pain usually
begins one to three days after your tooth is removed.

Dry socket is the most common complication following tooth

extractions, such as the removal of third molars (wisdom teeth). Over-
the-counter medications alone won't be enough to treat dry socket
pain.
 3) Patient with ulcer on lower lip
What can you see? - Traumatic ulcer

The treatment of ulcerated lesions varies depending upon size,

duration, and location.
• With ulcerations induced by mechanical trauma or thermal burns

from food, remove the obvious cause. These lesions typically

resolve within 10-14 days.
• Ulcerations associated with chemical injuries will resolve. The

best treatment for chemical injuries is preventing exposure to the

caustic materials.
• With electrical burns, verify status and administer the vaccine if

necessary. Patients with oral electrical burns are usually treated at

burn centers.
• Antibiotics, usually penicillin, may be administered to prevent

secondary infection, especially if the lesions are severe and

deeply seated. Most traumatic ulcers resolve without the need for
antibiotic treatment.

• Treatment modalities for minor ulcerations include the following:

o Removal of the irritants or cause

o Use of a soft mouth guard

o Use of sedative mouth rinses

o Consumption of a soft, bland diet

o Use of warm sodium chloride rinses

o Application of topical corticosteroids

o Application of topical anesthetics

 Third examiner:

1) Panorama with impacted canine

• Diagnosis –
You start by saying that you see a Panoramic Radiograph of
an adult / Mixed dentition which shows unerupted canine
which seem like they are impacted due to lack of space.

• Prognosis –
Depends upon patient cooperation and amount of space
available and Patients choice of treatment.

• How to know where impacted (clinically) –

feeling for the bulge of the tooth by palpation.

• Then how to know by other technique:

Parallax technique which can be two Periapical radiograph,
two Occlusal readiographs at different angulations of a
combination of both.

2) Another panorama with mixed dentition What you see :

(Hypodontia)
You start by saying you see a panoramic Radiograph of an
adult/ mixed dentition with abnormality in number of teeth
present for the age of the patient. If they were not extracted
then the patient sufferes from Hypodontia.
 If more than 5 teeth are missing it is oligodontia. If all teeth
are missing it is Anodontia. If less than 5 teeth are missing
then it is Hypodontia.

• Another pic with anterior cross bite

You start by saying – It’s a clinical intraoral Picture showing

anterior teeth in occlusion and looks like anterior crossbite of
tooth 11.
• Everything about crossbite
Causes – Overretained deciduous tooth
Finger sucking habit
Traumatic displacement of tooth
Lack of space during eruption

Treatment – Removable appliance therapy with z spring

Fixed orthodontic appliance therapy
Fourth examiner:

1) Tumor in palate

• Diagnosis, risk factor

Smoking, Long standing ulceration, Systemic disorders
like HIV, Leukemia, Long standing irritation from
intraoral appliance, Metastasis.
• Treatment what can you do with him as GP
Refer to the oral surgeon or Oral Pathologist or an
Oncologist.
• Types of biopsy
 2) Third molar impaction
• Classification

• Treatment (easy or not to extract, type of xray you will

take and why)
Depending upon what impaction is shown you will have to decide
whether its easy or not to extract.
IOPA, Mandibular occlusal film and OPG are standard radiographs
needed. If you feel root is involving the nerve then you may suggest
for a CBCT image.

3) Patient with infected space (It was bilateral in floor of the

mouth)
• Risk – High Risk as swallowing and breathing may
become difficult and risk of spreading in mediastinum area
is there.
• What can you do with him as GP – refer to an oral surgeon
and prescribe antibiotics and give instructions.
• What are the medical condition if Patient has it will
increase the risk?
-Diabetes
-Any Immunodeficeincy syndrome
- Leukemia

• Then ask me about types of diabetes

4) Patient with complete denture

 • Come to me with pain, soreness exposed bone
starting from history to examination in details (medical
history social ......)
• What your diagnosis
Ulcer leading to necrosis of overlying mucosa leading to
exposure of bone underneath
• I asked the examiner if patient with cancer he said yes with
breast cancer and taking drug for cancer
• Asked about definitive diagnosis
Osteoradionecrosis
• Bisphosphonate - The bisphosphonates inhibit the
resorption of bone by osteoclasts and may have an effect
on osteoblasts.

• ARONJ - The term ARONJ (Antiresorptive drug related

osteonecrosis of the jaw) presently replaces the term BRONJ
• Biphosphonates (BP) may predispose to ‘bisphosphonate-related

osteonecrosis of the jaw’ (BRONJ)

• What your role as GP – explaining the condition to the

patient and referring him to specialist.

• Visit this link for complete VIVA MFD book (over 150
pages and updated till 2019) which has more than 12
well explained papers made creatively for you to
understand and remember question and answers.

http://dentalprometric.com/prepare-for-mfd-part-
2-royal-college-dental-exams/