Practice exam questions Therapy questions: Oral 2020 2009 2008 2007 (Overlap of questions) 1)

a)

conserves tooth structure - strengthens restoration margins because the margin is away from high stress bearing areas - AMA or amalgalm margin angle greater meaning more material at the margin = more strength - reduces stress on cusps due to rounded internal angle - strengthens tooth because dentine is conserved by not flattening the floor - no extension for prevention. - adhesive used to seal adjacent pits and fissures

b) - Class I restoration using minimal intervention principles - materials: Dycal as a sub base to provide protection of pulp. Promotes secondary dentine and is anti bacterial (adhesive abilities limited therefore cannot be used alone under amalgalm and composite) Base: GIC to DEJ Condition Restore with GIC

2)

(2008) - Box - Isthmus (narrow connection between two parts of the cavity prep) - Step: consist of axial wall and pulpal floor - Occlusal lock with a dove tail design to maintain retention Broaden the base of the cavity bucco lingually 3)

a) close proximal - resoration of marginal walls and marginal ridge - adequate packing of materials

4)

- The size of the occlusal lock is dependent on the size of the proximal box therefore to ensure maximum retention of tooth surface, a minimal box is cut first and then the sixe of the lock mimics this. 5)

-Adequate moisture control - working quickly with the materials to avoid the material setting - incremental placements to reduce polymyerasiation shrinkage

- Proper preparation of the cavity, for example correct etching of the tooth surfaceto createpores in the enamel/ GIC to allow adhesion

- Condensing restoration to remove/ reduce excess mercury and ensure all parts of the cavity are covered - correct titration of material - carving to restore occlusal outline and stimulate tooth anatomy - polishing 24 hours later ( not always encouraged)

6)

These materials can be used as: Build up of salivary glycoproteins which can block ionic interchange with GIC therefore, conditioner removes this smear layer and allows the exchange Composite: Restoring medium to large restorations of any class GIC smaller restorations in non stress bearing areas Used as a base and deciduous restorations Long term temporary restorations, reduces bacterial thus pulpal pathology decreased(used preferential to ZOE as this does not under hydrolysis reaction and releases fluoride)

- Chemical adhesion to dentine - Releases fluoride - low level pulpal responses

7)

Infected: completely broken down, soft and easily removable Superficial surface of carious lesion heavily infect by bacteria Consists largely of denatured and unstructures enamel and dentine debris and is unable to be remineaslised Affected: soft and colourless, contains some bacteria but still has hydroxyapatite matrix remaining therefore can be remineralised. Removal of affected dentine in deep lesions can result in pulpal exposure and therefore should be avoided Beneath infected layer Relatively free of bacteria except possibly a few pioneer bacteria Dentine demineralised but remains basic dentine structure

GIC fluoride release and compatible with dentine Good microleakage seal

Atraumatic Restorative Technique Removal of infected dentine without the use of high speed handpiece. Creates a friendly environment for the children and fosters a positive attitude. Does not require LA

See above

8)

- Maintain good moisture control during placement - Place bond over the top of the material to prevent excess drying out of moisture uptake from the oral cavity

- In the situation of shrinkage of the materials, CaOH2 undergoes hydrolosis when in contact with moisture therefore does not provide a good seal to the pulp and can lead to pulpal pathologies 9)

conserves tooth structure - strengthens restoration margins because the margin is away from high stress bearing areas - AMA or amalgalm margin angle greater meaning more material at the margin = more strength - reduces stress on cusps due to rounded internal angle - strengthens tooth because dentine is conserved by not flattening the floor - no extension for prevention. - adhesive used to seal adjacent pits and fissures

10)

- Deminration is when the ph falls below critical pH and calcium and phosphate ions diffuse into the saliva out of the tooth. This is enhanced by bacterial plaques and refined carbohydrates. Remineralisation occurs when the pH returns to normal, above 5.5 and calcium and phosphate ions reattach to the partially dissolved enamel hydroxyapatite crystals. This is enhanced by saliva, hygiene, fluoride and natural protective factors. 11)

Fluoride ion enhances the remineralization phase by the regrowth of fluoro apatite crystals which are more resistance to subsequent acid attacks and causes a lower critical pH of 4.5. Mildy bateriostatic St Mutans fail to thrive in its presence Modifies surface energy of enamel therefore plaque cannot firmly attach to it Buffers the pH of plaque on tooth surface

12)

Evaluate control disease assess the need for invasive repair damage 13)

ECAR! 14)

Remineralisation with fluoride applications eg. Duraphat and tooth mouse for home use. Increase in patent OHI 15)

Ensure that you are not injecting directly into a blood vessel

Withdraw 0.5 mm, deposit

Buccal pad of fat Pterygomandibular raphe Mid point between Mx and Md teeth Coronoid process

Infilration: Tooth and surrounding teeth either side. Targets the branch of the nerve Block: Targets the actual nerve, giving pulpal and lingual ST

- Blood free operating field, maintaining LA in target area for longer duration. Reduces the absorption of LA from the site of deposition, decreases blood flow from the site of injection therefore reducing the required theraupatic dose, enhances properties of LA 16)

1 Individual response to drug (bell curve) 2 Accuracy of deposition of LA 3- Status of tissue at the site of drug deposition (Vascularity, pH) 4 Anatomical variation 5 Type of injection administered

Inferior dental block and buccal nerve block

Lidophilic part, Intermediate chain and Hydrophilic part

17)

Lignocaine Prilocaine Scandonest Citanest

ORAL 2040 2008

Remove caries without exposing pulp Change instruments Gently remove pulp roof chamber using sterile slow speed handpiece Remove coronal pulp with excavator

Dry pulp chamber Achieve haemostasis Apply formocresol Remove excess and leave for 6 minutes Remove formocresol Place sub base (ZOE) Place GIC Condition, rinse and dry Place GIC over subase of GIC Place Stainless steel crown

Feric sulphate MTA 2)

3)

4)

5)

Hygiene questions: ORAL 2030

1 a) encourage and education patients on how to maintain healthy dentition, and reduce the prevance iof dental decay advocating the principles of minimal internvetion dentistry and the remineralisation process.

3) a ginvivitis = bop, increased pocket depth, bacteria, loss of stipling, no loss of attachment, redness, irreversible Perio= anaerobic bacteria, alveolar bone loss, loss of attachment, inflammation, bleeding on probing,

a) Light radiograph: - The causes of a light radiograph include processing and developing errors. The temperature may have been too low in the developing room, the source to film area to great, the film is underexposed, the developing solution may have been depleted. b) Low temperature = thermostat controlling temperature in the room Source film area= ensuring the correct vertical and horizontal angulations (technique_ Underexposure = correct settings, testing regime Developer solution = checking regime and monitoring Film pack reversed = checking technique c) PA radiograph = elongated teeth, the film to the beam (vertical angulations) distance is not large enough

d) No, the crystals on the occlusograph film are large therefore requires less exposure compared to bitewing radiographs which have smaller crystals and therefore require more exposure, however the film quality on the PA is worse. e) Incisors and canines. Hard palate. Incisive foramen and canal. Alveolar bone. Unerupted teeth f) Conventional radiography: - Silver bromide crystals present in a film - With exposure, photons collide with silver crystals to become exposed and form silver ion - Silver ions then form silver atoms by binding with the sensitivity site sitting in the cystal lattice. Known as latent image! - Film is placed in developer solution which converts the silver atoms to solid silver and removing the non silver crystals Digital radiography: Photon converts to a light photon, which forms an electron, then voltage which in turn results in a digital image. Faster results More expensive to set up Dose reduction

g) Correlate clinical findings, identify disease, identify presence/ absence unerupted teeth, treatment planning, extend and process of disease, check for pathology eg. Abscess,

a) Risk factor: enhanced probability disease occurrence, which can be environmental, behavioural and social. b) Modifying factor: Anything which alters the host response to plaque. In roger = diabetes c) 1) How much water do you drink? In relation to dry mouth 2) Dietary factors to check for fluids which could lead to erosion 3) Exercise frequency? Dehydration dry mouth 4) Smoking? Dry mouth d) Saliva role in dental health! Yes saliva is very important in dental health, as it serves several functions 1) Buffering capacity buffers the intake of acids 2) Clearance of materials 3) Moisture of tissues, lubrication 4) Modifies bacterial environment 5) Maintenance of pH

6) Reservoir of ions (tooth remineralisation, fluoride and calcium ions in saliva) 7) Stephen curve critical pH

e) Diet and water consumption to aid in dry mouth. Importance of water providing a neutral pH reducing dry mouth and acidic attacks on the tooth surface

a) Evaluate (diet, saliva, tooth morphology, microflora and general health) Controlling the disease (remineralisation) Assess the need for intervention (only when tooth structure is compromised after adequate control and administered, in conjunction with patient) Repair damage ONLY when necessary using minimal intervention principles, preserving tooth structure. b) conserves tooth structure - strengthens restoration margins because the margin is away from high stress bearing areas

c) d) e) f) g)

AMA or amalgalm margin angle greater meaning more material at the margin = more strength reduces stress on cusps due to rounded internal angle strengthens tooth because dentine is conserved by not flattening the floor no extension for prevention. adhesive used to seal adjacent pits and fissures Deep Class I cavity using the minimal intervention principles Materials: Dycal sub-base, GIC base and Composite restoration Inferior dental block and long buccal if soft tissue Trismus, facial nerve paralisis, infection, needle breakage, heamatoma Change in acidic pH of infected tissues, taking longer to buffer the solution and tissues increasing time of onset. The higher the pH results in a faster onset. Vasopressor syncope placing patient in supine positon (feet above head and heart parallel to floor)

a) Amalgalm, GIC and Composite Amalgalm longevity, when aesthetics isn t a concern, technique insensitivity, GIC needing fluoride release, minimal cavity, non stress bearing areas, Composite high stress bearing, biomemetic, aesthetics, command setting b) Closed sandwich technique: when the axial wall is deep, but the gingival floor isn't below the CEJ (??). Place the GIC on the axial wall, then place the composite on gin...gival floor, axial wall and build up.

c) d) e) f)

Open sandwich technique: when gingival floor is deep. Place GIC on axial wall and gingival floor, then place composite. 'Open' as in the GIC will be visible... Pre contrououred to the tooth, don t need to cut cavity extensive to fit in , thin therefore easily placed and ensures tight contact points Incremental placement of materials and setting. Placing sealant over the top Titutration, condensing, carving, polishing, proportioning, Labial: preserves marginal ridge,small and direct access

Palatal: Broken down, exposed to occlusal forces (potential for wear and breakdown,