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Cat Remembered Questions Part 2:

Day 1: 400 questions split in half with an hour break in the middleMost of the endo questions were straightforward diagnoses that we learned in classThere were a lot of perio questionsY! there are pics and radiographs on day 1"ead the #$ page document going around bc % reali&ed when trying to remember questions there were easy repeatsfrom there

%mplants' something about what could you do to make sure a buccally angled ma(illary implant did not show metalmargin

)actobacillus plays an important role in caries but not initially

*nce enamel ca+itation has occurred, the underlying dentin has already been a-ected by the progression ofthe destruction and the lactobacillusorganism then becomes a primary agent for further destruction of thedentin

!trep mutans has been shown to be he most predominant bacteria in+ol+ed in the initiation of enamel lesion.)actobacilli has been shown to be in+ol+ed in the caries process, but is a secondary organism and /ourishes ina carious en+ironment. oth of these organisms are probably the consequence of a high sugar diet and arethe reason for the dip in p le+els in dental plaque

2le(ibility of clasp does not depend on depth of undercut

3olyether impression is the most dicult to take out of the mouthMaterial Advantages Disadvantages Uses PrReversibleHydrocolloids (Agar)

'5o custom tray oradhesi+es required'igh wettability')ong working time'6lean7pleasant withacceptable odor

!"ui#ment needed'Dimensionally unstable

Multi#le im#ressions'3roblems with moisture

'3P

&rreversibleHydrocolloids(Alginate)

'est wettability8')owest cost8'"apid set

9nstable'3our immediately&mbibition'orst stability8')owest tear strength8

Most impressions ''da2

Polyvinyl ilo*ane 'est dimensional stability8

'3leasant to use'!hort setting time

3oor wettability

Release %ydrogen gas

Most impressions 'D

reC,

Polysul.de ')ong working time ;ood reproduction

'Messy/ad odor'!tains clothes'6ustom tray required0ong setting time (1,2minutes)

'Most impressions P'?

Polyet%er '(cellent dimensionalstability'?ccurate'!hort setting time'>ood wettability

'Most !ti-8'Most e(pensi+e8Dicult to remove+rom mout%Un#leasant taste

Most impressions 'teca

Condensation ilicone '3leasant to use'!hort setting time

'ydrophobic'Tray requires specialadhesi+e'orst wettability8

'Most impressions $bestoc

hat material to use on root caries: gerristore and glass ionomer

6haracteristics of >utta percha ?d+antages of gutta percha:

o 3lasticity: adapts with compaction to irregularitieso asy to manageo )ittle to(icity

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o asy to remo+eo !elf sterili&ing ;doesn@t support bacterial growth=

>utta percha has A0'#0B &inc o(ide

>utta percha is freely soluble in ether, chloroform, and (ylol, and these sol+ents can be used to remo+e thegutta percha during retreatment

There were a handful of pharm deCnitions' didn@t know them. %t wasn@t the usual ecacyE or bioa+ailabilityE5eneral #rinci#les o+ drug action

?gonist Drugs that elicit a response from a tissue are known as agonists. ?gonists that produce ceiling e-ects;e-ects that are not e(ceeded by other drugs are called full agonists). Drugs whose ma(imal e-ectsare less than those of full agonists arepartial agonists.

%ntrinsicacti+ity

The ma(imal e-ect of a drug ;ema(=

6ompetiti+eantagonist

? competiti+e antagonist is a receptor antagonist that binds to a receptor but doesn@t acti+ate thereceptor. The antagonist will compete with a+ailable agonist for receptor binding sites on the samereceptor. !ucient antagonist will displace the agonist from the binding sites, resulting in a lowerfrequency of receptor acti+ation. Drugs that bind to a receptor at the same site as the agonist but ha+ean intrinsic acti+ity of &ero ;no receptor acti+ationF aG0 are competiti+e antagonists. y makingreceptors less a+ailable for agonist binding, a competiti+e antagonist will depress the response to agi+en dose or concentration of agonist.

?nity "efers to the attracti+eness of a drug to its receptor. ?nity is usually measured by the dissociationconstant ;Hd=. The lower the ;kd= the higher the anity

3otency ow much drug does it take to produce an e-ect

cacy cacy is how much of an e-ect is a drug capable of producing

Therapeutic inde(

? comparison of the amount of a therapeutic agent that causes the therapeutic e-ect to the amountthat causes death or to(icity.. the therapeutic inde( is the lethal dose of a drug for

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3an asking what line this was L e(ternal oblique ridge

1. maxillary sinus2. pterygomaxillary fissure3. pterygoid plates4. hamulus5. zygomatic arch6. articular eminence7. zygomaticotemporal suture8. zygomatic process9. external auditory meatus1. mastoid process

25. sigmoid notch26. medial sigmoid depression27. styloid process28. cervical vertebrae29. external oblique ridge30. mandibular canal3. mandibular !oramen32. lingula33. mental !oramen3". submandibular gland !ossa

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11. middle cranial fossa12. lateral !order of the or!it13. infraor!ital ridge14. infraor!ital foramen15. infraor!ital canal16. nasal fossa17. nasal septum18. anterior nasal spine19. inferior concha2. incisi"e foramen

21. hard palate22. maxillary tu!erosity23. condyle24. coronoid process

35. internal oblique ridge36. mental !ossa37. mental ridges38. genial tubercles39. hyoid bone"0. tongue". so!t palate"2. uvula"3. posterior pharyngeal #all"". ear lobe

"5. glossopharyngeal air space"6. nasopharyngeal air space"7. palatoglossal air space

eart rate of 4 year old' % said 110Age 4 Age 6 Age ,2 Adult

Pulse 110 100 #< #0ystolic /P 100 100 110 1$0Diastolic /P A0 A< #0 #62 is the Crst detectable sign of in/ammation the source of subgingi+al calculus is gingi+al cre+icular /uid

6an@t remember my /ap questions but % feel like there were a lotPedicle so+t tissue gra+ts: is a Mucogingival ;a#designed to ser+e as a soft tissue graft that maintains an intactblood supply from the donor site. 3edicle grafts are indicated to widen an inadequate &one of attached gingi+a, and torepair an isolated area of gingi+al recession. 3edicle grafts o-er the best blood supply to the donor tissue

2our types of mucogingi+al /apso "otated /apRaka laterally positioned /aps: uses the donor gingi+a from a healthy adKacent tooth to

co+er the e(posed root of a problem tooth. 2or deep wide recessiono ?d+anced /aps ;coronally positioned /aps, semilunar /aps= L /aps that mo+e +ertically in a coronal

direction and don@t de+iate laterally. 6oronally positioned /ap: can be used for class % recession

!emilunar /ap: create a pouch for 6T> or recession co+erageo ?pically positioned /aps

Mo+es apically and e(poses more of the tooth and sometimes the al+eolar bone

2or increasing the &one of attached gingi+a, crown lengthening, and e(posing impacted teeth

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o "eplaced /aps: a /ap that is re/ected and replaced to its original position. *ften used for surgical

access or subgingi+al restoration placement. 6an be used for >T", bone grafting, subgingi+al surface Techniques to increase the width of attached gingi+a: 2>>, 6T>, ?pically positioned /ap

Treating recession: fgg, 6T>

Deep7wide recession: laterally positioned /ap, subepithelial 6T>

%ncrease &one of attached gingi+a: 2>>, 6T>, apically positioned /ap

Periodontal

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2D? is osseoconducti+e allograft material

%@m pretty sure % got a question on what type of bone graft to use for a sinus lift ;not sure what % put L two ofthe answer choices had two grafts each. % picked the only one that had an autogenous graft listed, but % don@tknow if it@s right= .

% had a bunch of questions on diagnosing ?59>, chronic gingi+itis, locali&ed etc7U5 vs9 7UP7ecroti=ing Ulcerative 5ingivitis %nterdental >ingi+al 5ecrosis: 3unched'out papillae

3ain

leeding

2etid oris, )ymphadenopathy, fe+er, malaise

?ssociate with treponema denticola ;trench mouth=

7ecroti=ing UlcerativePeriodontitis

)oss of 6linical attachment

)oss of bone

May result in rapid and e(tensi+e necrosis to tissues and underlyingal+eolar bone

Darker stain on root seen by recession most likely caused byN 5ot sure if this is the answer, but subgingi+al calculus is often dark because of e(posure to gingi+al cre+icular

/uidDiabetics ha+e 1

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o 3laque and calculuso >ingi+al conditiono *cclusion, tooth mobilityo *ther pathologic changes

There was a question about !6"3 and gross debridement how would you go about the Crst appointment 5onsurgical phase ;phase % therapy=

o %n+ol+es remo+al of calculus and root planning

ad a question about sequencing perio treatments: 3laque control, !"3, restore carious lesions, 3erio surgeryo The obKecti+e of this phase is to alter or eliminate the microbial etiology and contributing factors to

periodontal diseases, leading to reduction in in/ammation. This is achie+ed by caries control inpatients with rampant caries, remo+al of calculus, correction of defecti+e restorations, treatment of

carious lesions, and institution of oral hygiene practices. %t may include local or systemic antimicrobial

therapy, minor orthodontic tooth mo+ement, occlusal therapy, and pro+isional splinting and

prostheses. The e+aluation phase is designed to determine the e-ecti+eness of the treatment

pro+ided during phase % therapy. %t should occur about 4 weeks after the completion of phase %

therapy. is allows time for epithelial and connecti+e tissue healing by the formation of long Kunctiona

epithelium

Hnow the di-erent names for each brushing technique. They asked me which one was best for interpro(imal brushing lectromechanical brushes are more e-ecti+e than manual brushing. This is particularly true in interpro(imal

areas Manual toothbruhsing doesn@t generally ha+e much of an e-ect on interdental plaque and gingi+itis

o The most common interdental cleaning aid is dental /osso ?lso use /oss threader, especially for a patient with a remo+able prosthesiso !uper/osss: has three portions, a rigid end, a spongy tufted region, and a regular /oss part. The rigid

end passes through the embrasure between the retainer and the pontic rushing is a supragingi+al method because the bristles of a brush will only reach a ma( of 1'$ mm

subgingi+ally/ass Met%od ?ngle bristles at 4

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6a+ernous sinus general question: no +al+es hich ner+es are embedded in the lateral wall of the 6a+ernous !inusN C7 &&&? C7

&>? >,? and >2

hat structures pass through the 6a+ernous !inusN &CA and C7 >&

6a+ernous !inus !yndrome is caused by edema that paralysisN C7 &&&?

C7 &>? C7 >&? >, and >2

hen remo+ing mandibular tuberosity in danger of hitting lingual ner+e most common cause of paresthesia of the lower lip is remo+al of a

mandibular third molar

hat is an ad+antage of body osteotomy o+er !!*N

yo

u shouldn@t section the entire tooth wile performing a surgical remo+al of a mandibular molar because there is apossibility of accidental perforation of the lingual plate and inKury to the lingual ner+e

)efort 1 in+ol+es ma(illa

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0e+ort && 10B of 2acial 2ractures

Pyramidal

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The hematocrit of adult men a+erages about 4$, while that of women a+erages about % had a couple questions on when to premedicate a patient

)one ma(illary rdmolar: beware of .. % put tuberosity fracture 8%e most common com#lication in removing a +reestanding isolated ma*illary molar is +racture o+ t%e

tuberosity or alveolar #rocess

Ma(illary third molars are occasionally displaced into infratemporal space and ma( sinus

ad a question about preferred order of e(tractions for molars L answer choices mi(ed order between 1st, $nd, rdmolars=: % picked rd, than $nd, than 1st ;beware the lone'standing molar=.

The palatal root of the ma( Crst molar is the root most often dislodged into the ma( Crst molaro %f you ha+e a small oroantral communication, lea+e it alone and let a blood clot formo %f you ha+e a moderate one ;$'A mm= treat with Cgure suture o+er the tooth socketo

%f you ha+e a large communication ;#mm or more= close with a /apo 3ost oroantral communication prescribe the decongestant afrin, the antibiotic amo(icillin, and ?ctifed, a

systemic decongestanto Teeth that are impacted into the ma( sinus are remo+ed +ia the 6aldwell')uc approach.

The surgical approach to the ma(illary sinus is made intraorally with an incision designed to re/ecta /ap e(posing the anterior wall of the sinus in the canine fossa

%f in the e(traction of a ma( third molar you reali&e the tuberosity was e(tracted, treat by smoothing sharp edgesof the remaining bone and suture soft tissue. The treatment of a fractured but intact tuberosity during toothe(traction is to reposition the tuberosity and stabili&e with sutures.

Dry socket is most likely cause by : ans choices were physiological, functional, loss of Cbrin and something else The most common complication seen after e(tracting mandibular molars is dry socket.

? mandibular third molar root tip that disappears is most likely in the submandibular space, but it can also bedislodged into the mandibular canal or lingual cortical plate.

Treat dry socket by gently /ushing out the debris with warm saline solution, then placing a sedati+e ;eugenol=

in the socket ;remo+e the dressing within 4 hours=. 3rescribe 5!?%D!, antibiotics aren@t needed Dry socket is a disturbance in wound healing

8%e

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*steomyelitis

2or 3harm: ? lot of the questions were easy things that were on the tuft doc ;not same question but same concept=

They asked me the mechanism of ?cetylcholine uptake % thinkNDynamics of neurotransmission iosynthetic pathway for ?6h

6holine is taken up into ner+e +ia action of permease

6holine acetyltransferase cataly&es the synthesis of ?ch from acetyl 6o? and choline

iosynthesis of 5 and

Tyrosine to D*3? ;en&yme is tyrosine hydro(ylase= D*3? to Dopamine ;en&yme is domain beta hydro(ylase=

Mostly in the adrenal medulla: 5 to ;en(yme is phenylethanolamine 5'methyltransferase=

Tyrosine hydro(ylase cataly&es the rate limiting step in the synthesis ;this en&yme is inhibited by metyrosine=

The neurotransmitters ?6h, 5, and dopamine are stored in +esicles and granules

Termination of transmission by ?ch takes place primarily by metabolism by acetylcholinesterase located onpostsynaptic or postKunctional membranes

!chedule $ drugs cannot be reClled

? lot of the pharm questions were asking the purpose of drugs % ha+e ne+er heard of ;like '4=' can@t e+en rememberthe names bc they were long as shit . the only one % remember is griseoful+in ;see chart below=

hat do you treat M"!? withN % said Pancomycin Pancomycin is a narrow spectrum antibiotic ;treats gram positi+e aerobes and anaerobes=

!ome sensiti+e organisms and indications:1. !taphylococcus aureus ;including methicillin resistant staph=$. !treptococci, enterococci, clostridium dicile

?dministration: gi+en intra+enously% had a lot of anti'+iral stu- especially for ?%D! and herpes

Anti+ungals and Antivirals?nti+irals ?cyclo+ir Treats !P, P[P %nhibits +iral D5?

polymerase afterundergoingphosphorylation

?mantadine 9sed for in/uen&a a locks uncoating of+irus and blocksreplication

2amciclo+ir,

penciclo+ir

%ysed for !P and

+aricella &oster +irus

%nhibits +iral D5?

polymerase afterundergoingphosphorylation

2oscarnet 9sed for !P and+aricella &oster +irus

%nhibits +iral D5?polymerase

"e+ersetranscriptaseinhibitors

9sed for %nhibit +iral "5?dependent D5?polymerase

?nti+iral drugs attack the mechanism used by the +iruses to replicate and infect. The M*? of most of thesedrugs is to inhibit D5? or "5? synthesis and function.

?ntifungals

?mphotericin

%ndicated for mostsystemic fungalinfections9sed for serious

fungal infectionscaused by a +arietyof fungi

?mphotericin produces nephroto(icityand hypokalemia as aside e-ect

5ystatin 9seful primarily fortreating candidaalbicans%n the polyene classTopical antifungal

6ombine withergesterol to formmembrane pores

3olyenes cause renalto(icity, hemolyticanemia, hypokalemia

6lotrima&ole,miconaole

9seful topically forcandidiasis

The a&olesE inhibitergesterol synthesis

The a&olesE causehormonal imbalance

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;especially Hetona&ole=,inhibit drug metabolism;especiallyketocona&ole=, causeli+er to(icity

Hetocona&ole2lucona&ole%tracona&ole

used systemically fortreating a +ariety offungal infections

>riseoful+in %nhibits mitosis9sed primarilyagainstdermatophytes ;skinfungi=

3hotosensiti+ity, inducesli+er metabolism, li+erto(icity

hat organism mostly causes sinusitis in diabeticsN 3articularly se+ere forms of chronic sinusitis are caused by fungi ;e( mucormycosis= especially in diabetics

!ulfonylurea stimulatesN % said release from pancreas !ulfonylureas are oral hypoglycemic indicated for type %% diabetics;tobutamide, acedohe(amide, tola&amide,

chlorpropamide, glyburide, glipi&ide, glimepiride= M*?: close H channels in cell membranes, stimulate release of insulin from pancreas, increase sensiti+ity of

target organs to insulin. *ther oral hypoglycemic: repaglinide ;act like sulfonylureas= and metformin ;reduces glucose production by

the li+er and increases sensiti+ity to in insulin in muscle, li+er and fat cells. These are also used by type %%diabetics

*ral 3ath: these were mostly things that were in tufts and stu- Dr. 6hilders embedded in us. They were Kust pics or alist of symptoms

% know % got pyogenic granuoloma, osteosarcoma, ameloblastoma, Cbroma, multiple myeloma, ?*T, stafne, glandradiolucency in mandible

ump on the gum di-erential, pyogenic granuloma, Cbroma, peripheral ossifying Cbroma, peripheral giant cellgranuloma

o 3yogenic granuloma occurs at any age, most commonly on interdental papilla, in/ammatory process,bleeds readily, e(ophytic, not painful, grows +ery fast, proliferati+e.

o 3eripheral giant cell granuloma: looks like pyogenic granuloma, often brownish color, limited toal+eolar ridge gingi+a, usually anterior to Crst molar region

o 2ibroma' most common connecti+e tissue tumor, reacti+e ;not a true tumor=, common site is tonguedue to trauma

o 3eripheral ossifying Cbroma: soft tissue lesion, not in bone, but makes osteoid bone. *ccurs ongingi+a, especially interdental papilla area

Pyogenic 5ranuloma ;any age=;greater in 2=

Trauma provides pathway for non-specicorganisms, calculus

le+ated mass'5ro$s +ast

Ulcerated and bleedseasily

Most common location:Interdental papilla

)ocated on gingi+a , lipsand buccal mucosa

>ranulatio

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Secondary cause of altered endocrinesystem

+ast

Ulcerated and bleedseasily

)ocated on gingi+a , lipsand buccal mucosa

*steosarcoma is in the poorly demarcated bordersE di-erential

!unburst appearance

Diseases Clinical Radiogra#%ic Histo#atsteosarcoma

Mesenchymal Malignancy that is boneproducing

Mandible:

!welling7locali&ed pain

)oosening of teeth

3aresthesia due to %?5

Ma*illary

!welling7locali&ed pain

)oosening of teeth

3aresthesia to infraorbitalner+e, epistasis, nasalobstruction and eyeproblems

iden 3D) spaceMot%eaten R0

%rregular, poorlymarginated

unRaysunbursta##earance

M) radiolucency di-erential: ameloblastoma, *H6, 6>6>Disease Clinical Radiogra#%ic Histo#aAmeloblastoma

Most aggressive odontogenic tumor*Most common epithelial odontogenictumor**

etween < and 4orlin has multiple odontomas and okcs, >ardner has multiple osteomas>ardners' supernumerary teeth >% polyps, osteomas>orlins ;ne+oid basal cell carcinoma=' associated with odontoma, multiple *H6,

% had a lot of symptoms of herpes

Disease Clinical Radiogra#%ic Histo#aHer#es im#le* >irus , (Herpes Labialis)

!ies dormant in the trigeminal ganglion*

%n/amed gingi+a

?ny part of the oral mucosaand lips may be in+ol+ed

Cold sores3ainful ulcers

H>,

0i#sc%u

These bfound insmear

Recurrent %er#etic tomatitis 8riggered by

Trauma

2atigue

H>,

0i#sc%u

1

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!ies dormant in the trigeminal ganglion*

%mmunosuppression

!tress

?llergy

!unlight

These bfound insmear

Primary Her#etic 5ingivostomatitis

Most serious potential problem isdehydration

6ommon in young children?lso a-ect 1ulgaris

Most common +orm o+Pem#%igus

Mucosal erosions9lcerations

7i-ols-yJs signepithelium slides o- byrubbing

AntibodiesdesmosomamoleculesD

Acant%oloyu#rabasil

Pem#%igoid Clear;uid blistersthatbreaks rapidly in themouth, lea+ing behindtender /at ulcer

5ingiva mainlyinvolved!lough during brushingand eating

7i-ols-yJs sign'

Antibodiesattachment >&& collage

ube#idervesicles

1O

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epithelium slides o- byrubbing

3eds:

3ulpotomy and pulpectomy questions ;like class stu- but there weren@t any board questions that thwaites ga+e us=Pul# 8*8oot% 8rauma

hen should an ape(iCcation procedure indicatedN 7ecrotic #ul#s $it% o#en a#e*es

hat material is typically used to encourage root formation in ape(ogenesis proceduresN M8A

hat is the best sign of a successful ape(ogenesis procedureN Continuous com#letion o+ t%e a#e*

3ulp Therapy is contraindicated on children withN erious illnesses (0eu-emia? cancer) hich primary tooth is commonly known for not ha+ing accessible canalsN Primary molars

&ndications +or Primary 8oot% !ndodontics

? tooth that is restorable with a stainless steel crown

5o pathological root resorption

)ayer of o+erlying bone between permanent tooth bud and area of pathological boneresorption

!uppuration

3athological periapical radiolucencyContraindications +or Primary 8oot% !ndodontics

2loor of pulp opens into bifurcation

(tensi+e internal resorption tooth is ea!ened" can#t support stainless steel cron

More than $7 the roots ha+e been resorbed Teeth without accessible canals

PULPOTOMY

3ulpal e(posures in primary teeth are indications for what procedureN Pul#otomies

hat is the most commonly used medicament for pulpotomies on primary teethN /uc-leyJs +ormocresol

hen is formocresol indicatedN Primary teet% $it% vital root ti#s

hat procedure is formocresol used inN Pul#otomy

2ormocresol consist ofN ,IG

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Delayed se(ual de+elopment and hypothyroidism8reac%er Collinsyndrome

6left palate

%ortened so+t #alate

Anterior o#en bite

namel hypoplasia

Down syndrome less caries but more periodontitis Down syndrome has underde+elopment or hypoplasia of the mandible, it@s associated with class %%%

malocclusion. 3atients often ha+e open bites, tooth eruption is delayed. The tongue is often Cssured, andmacroglossia is usually relati+e to the small oral ca+ity. Dry cracked lips often result from a protruding tongueand frequent mouth breathing

3atients with Down syndrome and heart defects often require subacute bacterial endocarditis prophyla&is

?cute herpetic gingi+ostomatitis age rangeN 9nder y7oPuberty 5ingivitis

hat are the characteristics of puberty gingi+itisN !nlarged interdental gingiva ands#ontaneous bleeding

hat is the treatment for puberty gingi+itisN Pro+essional cleaning and im#rovedoral %ygiene

Primary Her#etic5ingivostomatitis

hat causes 3rimary erpetic >ingi+ostomatitisN H>, hat age group is primarily a-ected by 3rimary erpetic >ingi+ostomatitisN C%ildren

under 4 years old

hat is the treatmentN Rinsing $it%63:63 sus#ension /enadryl 'ao#ectateandor >iscous 0idocaine

Acute Her#etic5ingovstomatitis

ow is ?cute erpetic >ingi+ostomatitis treated if diagnosed within days of onset NAcyclovir sus#ension K ,6mg-g 6* a day +or F daysL

ow is ?cute erpetic >ingi+ostomatitis treated if diagnosed after days of onsetNPalliative care K #la"ue removal? 7A&DJs? to#ical)

RecurrentHer#etic im#le*herpes labialis+

hat type of herpetic lesions are associated with emotional stressN RecurrentHer#etic im#le*

here are "ecurrent erpetic !imple( lesions locatedN *n o+ li#s? corners o+ mout%?and beneat% t%e nose

Xuestions on caliciCcation times: showed a pic with hypocalciCed teeth and asked when it happened!rrors During 8oot% Develo#menttage 8ime Conse"uences%nitiation A'# weeks ?nodontia and !upernumerary Teethud !tage weeks6ap !tage(proliferation)

O'10 weeks Dens'in'dente ;Dens %n+aginatus=>ermination2usionTubercle 2ormation

ell !tage(Histodi%erentiation and&orphodi%erentiation)

11'1$ weeks Macrodontia and Microdontia3eg lateral incisorsDentinogenesis %mperfecta?melogenesis %mperfecta

?pposition Paries per tooth namel Dysplasianamel ypoplasia6oncrescencenamel 3earls

6alciCcation Paries per tooth ypocalciCcation L Due to infection, trauma or systemic/uoride ingestion

$1

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ruption Paries per tooth?ttrition Paries per toothas asked a question about when ;what week= dental lamina for succedaneous teeth begins forming. ;1$ weeks ' udstage=2 questions from chart L hat would you gi+e a # year old li+ing in a community with no /uoridationN 1.00 mg7dayDietary

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as acrylic button that rest on palate

hich one is most like epiphyseal plateN 6hoices were !ynostosis, cranial base, something like that During adolescence, two competing phenomena occur: the growth rate of long bones accelerates and at the

same time, hormonal changes cause gradual ossiCcation of the epiphyseal plates ;syntosis=!erial e(t order: primary canines, then primary molars, then permanent 1st3M

3rostho:

? picture of epulis Cssuratum ;see picture on right= ?n epulis Cssuratum is a hyperplastic tissue reaction caused by ill'Ctting or

o+ere(tended /ange in a denture

3atient comes in wants a new denture, has a complete denture already. You noticewhite lesion on mandibular posterior on buccal. hat do you do CrstN ?dKustdenture and tell them to come back, do biopsy, e(cise, or make new dentureN

Hnow combination syndromehen a patient wears a complete ma( denture against natural anterior teeth they will e(perience a loss of bonestructure in the anterior ma(illary arch

3alatal e(tension of ma(illary denture0imiting tructures o+ t%e Ma*illary DentureAnterior Region )abial +estibulePosterior Region Qunction of mo+able and immo+able tissue

)ine is drawn through the hamular notches, $mm posterior to the fo+ea palatine;+ibrating line=

% had a ton of questions on adKusting bites, which cusp surfaces to grind, and what to do on articulator with mountedcasts in order to increase +do'cclusion

SELECTIVE GRINDING

hat is the purpose of selecti+e grindingN 8o remove all inter+erences $it%out destroying cus# %eig%t

hich cusps are not to be grinded when during selecti+e grinding of artiCcial teethN U##er lingual or lo$er

buccal cus#s

hich surfaces should be grinded when attempting to achie+e a forward slide from centric relationN Mesial

inclines o+ ma*illary teet% and distal inclines o+ mandibular teet%

hat are the primary holding cuspsN Ma*illary 0ingual Cus#s %ever grind+

hat are secondary holding cuspsN Mandibular /uccal Cus#s

hen is it ok to grind mandibular buccal cuspsN nly i+ t%ere is a balancing side inter+erence inner

inclines+

hen should cusp tips be grindedN Premature centric? lateral? #rotrusive contacts

elective 5rinding in Oor-ing ide Relations KRule o+ /U00L

/uccal cusp inner inclines of Upper teeth 0ingual cusps inner inclines of 0ower teeth

hen there is a surface'to'surface contact on /at cusps it should be changed toN Pointtosur+ace contact

/asic Princi#les +or cclusal Adustment

Ma(imum distribution of occlusal stresses in centric relation

2orces of occlusion ;should be borne as much as possible by the long a(is of the tooth= (A)

!urface'to'surface contacts on /at cusp , should be changed to point'to'surface contacts (/)

5e+er take teeth out of 6entric *cclusion once its established

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! sound is when teeth are almost touching#eec% ounds

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Pit and .ssure caries: mostly ! sanguis and other strep, narrow at the enamel surface and $idens at t%eD!;in+erted P. "apid destruction as many dentinal tubules are in+ol+ed. ?ctual lesion is often larger thanclinically presentable. )esion progression parallels the enamel rods. 3re+ent with Cssurotomy and sealant

moot% sur+ace caries:interpro(imal or cer+ical. The second most pre+alent caries. 9sually found Kustgingi+al to the pro(imal contact. !tart wide at the surface, and con+erge towards the DQ ;P shaped=

Dentin caries: dentin has less minerali&ed tissue and more tubular structures which allows for spread of theacidogenic destruction ;di-erent from enamel= faster progression than enamel caries because there is less

mineral content. P shaped caries with broad base at t%e D!and the ape( towards the pulp @ones o+ carious enamel:aka &one of incipient lesion. 4 &ones ha+e been characteri&ed in a sectional

incipient lesion:1. Translucent &onedeepest &one, named according to its absent or composition less appearance seen

under polari&ed light$. Dark &one represents reminerali&ation and is called this because it can@t transmit polari&ed light. ody &one largest &one, represents a deminerali&ing phase4. !urface &oneoutermost &one, seems una-ected by the caries

Most common cause of fracture of marginal ridge of amalgam restoration: 6auses of marginal ridge fracture:

o 5ot rounding a(iopulpal line angleo Marginal ridge too higho %mproper occlusal embrasure form

o %mproper remo+al of matri( bando *+er&ealous car+ing of restoration

? .< mm ditch in amalgam restoration, how do you treatN ? ditch or gap is the deterioration of the amalgam'tooth interface because of wear, fracture, or improper tooth

preparation !hallow ditching less than .< mm deep usually isn@t a reason for restoration replacement. The e+entual self'

sealing property of amalgam allows the restoration to continue ser+ing adequately if it can be satisfactorilycleaned and maintained. %f the ditch is too deep to be cleaned or Keopardi&es the integrity of the restoration ortooth structure, the restoration should be replaced.

To pre+ent ditching the margins, trim the margins of an amalgam restoration with a sharp instrumentDi-erence btw $4< and 0 bur

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3atient management:

% had a bunch of questions about cohort studies and that section in Mosby@s. types of studies: epidemiological studies can be organi&ed into three categories

o descri#tive: used to quantify disease status in the community. The maKor parameters of interest arepre+alence and incidence

#revalenceindicates what proportion of a population is aEectedby a condition at a gi+enpoint in time. %t is e(pressed as percentages. (. The pre+alence of periodontal diseaseamong 100,000 adolescents was

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Day $: random cases , 100 questions total ;similar to case presentation class with Dr. >alloucis=

% can@t really remember the cases. They gi+e you a med ], a pan, sometimes 2M], and sometimes pics. Theradiographs are awful.

There will be a list of meds the patient is on and they will e(pect you to know side e-ects of these meds, or sidee-ects of the disorder that the meds are treating.

% had one patient on 6hanti( ;to stop smoking=

% had another on ?dderall ;for ?DD=

% had a patient with %P and a ob+iously on a bunch of meds

% had a child with a little bump on the gums o+er a central primary incisor with the permanent coming in.They asked if her 3?5 coincided with her real age or if one was laggingThey asked where the bump could be coming from ;she did fall and fracture the adKacent tooth=They asked about a space on her pic and if she needed a space maintainerThere was a radiolucencyE on the medial aspect of a primary 1stmolar and they wanted to know what to do. % couldn@te+en see it on the (ray

?nother case with the child on ?dderall, all % remember is them asking if he should be taken o- the adderall for theappointment if he was getting multiple restorations done

There was a patient with a 3?5 showing a tiny radiolucency o+er the central incisior. The pic showed a slightly darkmark on the gingi+a that could ha+e been at the same spot. % said it was an amalgam tattoo, howe+er it was rightabo+e an endo'treated tooth and in one radiograph looked like it was gutta percha past the ape(. %n another ]ray itlooked slightly lighter than the gutta percha' % looked at that thing fore+er trying to Cgure out if it was the gutta perchabc my entire e(am cast a double shadow ;including the wording on the questions so imagine how the radiographslooked=. Then they asked how you would treat the toothN )ea+e it alone, retreat it or do surgical retreat.

% had a patient on %P bisphosphonates and chemotherapy on a bunch of wacky drugs L asked which one was the %Pbisphosphonate ;% put ibandronate aka oni+a.E % belie+e one of the other choices was tiludronate aka !kelid,E whichis oral only=.

A+urayJs Mi*9

Don@t ask me how % got this but this were most of my questions.3t o+erdosed on D[, what do you administer../umane&il3t o+erdosed on narcoticRnalo(onehat component is present in %"M that is not present in [* L %"M is [* with 3MM? beads

o %rm is a polymer reinforcement &inc o(ide eugenol compositionhich is the best area to obtain a free gingi+al graft

o The palate is the most common donor site for the fgg and 6T>. The ideal thickness of the free gingi+al graft is1'1.< mm ;page $itality Pital 5ecrotic

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?cute periradicular periodontitis: painful in/ammation around the ape( ;locali&ed in/ammation of the 3D)= canbe the result of pulpal disease e(tending nto the periradicular tissue, canal instrumentation or o+erCll, occlusaltrauma like bru(ism.

o Tooth can be +ital or non +ital %f tooth is +ital, a simple occlusal adKustment will often relie+e the pain %f the pulp is necrotic and remains untreated, additional symptoms may appear as the disease

progresses to the ne(t stage' acute apical absecess ?cute periradicular abscess ;acute apical abscess=: a painful, purulent e(udate around the ape(

o %t is a result of the e(acerbation of acute apical periodontitis from a nerotic pulp

o "adiographically may see a normal or slightly thickened lamina durao !ymptoms:

"apid onset of swelling, moderate to se+ere pain, pain with percussion and palpation, slightincrease in tooth mobility,

The acute apical abscess can be di-erentially diagnosed from the lateral periodontal absecesswith pulp +itality and testing, and sometimes with periodontal probing

6hronic periradicular periodontitits: a long standing, asymptomatic, or mildly symptomatic lesiono 9sually accompanied by raiographically +isible apical bone resorptiono Diagnosis is conCrmed by:

The general absence of symptoms The radiographic presence of a periradicular radiolucency The conCrmation of pulpal necrosis

!uppurati+e periradicular periodontitis ;chronic periradicular abscess=o ?ssociated with a draining sinus tract without discomforto The e(udate can drain through the gingi+al sulcus, mimicking a perio lesion with a pocketo "adiographic e(amination shows the presence of bone loss at the periradicular areao !inus tract resol+e spontaneously with nonsurgical endo treatment

6hronic focal sclerosing osteomyelitis ;condensing osteitis=o (cessi+e bone minerali&ation around the ape( of an asymptomatic +ital tootho This radiopacity may be caused by low grade pulpal irritation

?lso, know protocol if tooth is a+ulsed 1 hr and Z1 hr. ?lso know about splinting ;ow long you splint for intrusion,e(trusion and )u(ation

Treatment: the Crst priority is to protect the +iability of the 3D)o %mmediate implantation impro+ed 3D) damage healing pre+ents root resorptiono %f implanting a closed ape( that has been a+ulsed for ZA0 minutes in storage media

Don@t handle the root surface and don@t curette the socket "emo+e coagulum from socket with saline and e(amine the socket "eplant slowly with digital pressure !tabili&e with a semirigid splint ;for #'10 days= ?dminister systemic antibiotics ;penicillin 4( daily for # days, or do(y $( per day for # days=

6losed ape( that has been a+ulsed for o+er A0 minuteso "emo+e debris and necrotic 3D)o "emo+e coagulum from socket with saline, and e(amine al+eolar socketo %mmerse the tooth in a $.4B sodium /uoride with a p of

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?t the Crst sign of infected pulp, the ape(iCcation procedure is beguno (traoral time A0 minutes

6losed ape(: the same protocol as ZA0 minute time *pen ape( ;if replanted=

%f endo treatment wasn@t performed out of the mouth, the ape(iCcation procedure isinitiated

%f there is a combined perio'endo lesion, which would you treat Crst endo Crst . 3erio therapy should be addressed Crstin cases with primary perio lesionsHnow which cells predominate in a healthy pulp +s. hyperemic pulp

in a diseased pulp, 3M5s plasma cells, basophils, eosinophils, lymphocytes, and mast cells are present

strict anaerobes play a signiCcant role in periapical pathosisC%ronic CellularRes#onse('o direct eposure)

3lasma cells

Macrophages

)ymphocytesAcute Cellular res#onse;pulpal e(posure=

3olymorphonuclear ;3M5= )eukocytes

Hnow the cells dominate in early stages of gingi+itisR3M5!, lymphocytes, and plasma cells. The answer for thatparticular question was plasma cells b7c it asked for that speciCc time frame ;see chart in perio section of Mosbys= seecat breakdoown!hape of access opening for mandibular canine

Ma( central: o+al triangular,

*ther anterior teeth and premolars: o+al

Ma( molars: triangular with base at buccal cusps

Man molars: trape&oidal

Hnow sequence of teeth e(traction for serial e(traction 3rimary canines, then primary molars, then permanent 1stpremolar

Hnow /uoride chart cold see cat breakdownHnow reduction for functional cusps +s. nonfunctional cusps

5e+er grind ma(illary lingual cusps ;primary holding cusps=

!econdary holding cusps are mandibular buccal cusps, it@s ok to grind these if there is balancing sideinterferences ;inner inclines=

6usp tips should be grinded in premature centric, lateral, protrusi+e contactshere is porcelain strongerRcompressi+e strength ;options were tensile, etcR=

3orcelain is stronger under compressi+e forces%f a natural tooth is opposed to porcelain, what is the restoration for the tooth in questionhich of the following materials would gi+e the best result in wear resistanceN >oldctodermal dysplasia +s. cleidocranial dysplasia . know about both please^

ctodermal dysplasia' ( linked recessi+e ;a-ects more males than females=, hypertrichosis, anhidrosis,?nodontia or oligodonitia, cleidocranial dysplasia: supernuperary teeth, hypoplasia of cla+icles, r

!ource agent for herpanginaR6o(sackie +irus erpangina ;stomatitis= is in ulcerati+e conditions di-erential, location of ulcerations is in posterior soft palate

and nasopharyn(. 3atient will ha+e sore throat and diculty swallowing, mild fe+er, and last 1 week"ecurrent aphthous ulcer

"ecurrent painful ulcers ;not preceded by +esicles=

?ppear on wet ;not +ermillion= nonkeratini&ed oral mucosa ;not hard palate or gingi+a

Three types: minor, maKor, herpetiform,

May be seen in association with some systemic diseases!P1

Pirus )ocation !igns !ymptoms Treatments

3rimary herpessimple( !P1 3erioral, oral,especiallygingi+a,

Pesicles ulcers 2e+er mailaise,painful ulcers ?cyclo+ir,symptomatic

!econdary;recurrent=herpes simple(

!P1 )ips, hard palate,and gingi+a,

Pesicles, ulcers 3ainful ulcers ?cyclo+ir

Paricella Paricella &oster+irus

Trunk, head, andneck

Pesicles, ulcers, 2e+er, malaise,painful ulcers,

!ymptomatic

erpes &oster Paricella &oster 9nilateral trunk,unilateral oral

Pesicles, ulcers 3ainful ulcers acyclo+ir

!ystemic condition *ral lesions

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6hrohn@s disease >ranulomatous in/ammation of >%tract

Minor apthae

ehcet@s syndrome %mmunodysfunction featuring+asculitis

Minor apthae

6eliac sprue >luten sensiti+e enteropathy Minor apthae?ids %mmunodeCciency MaKor apthae

ad picture of !tafne cyst

!tafne defect: a de+elopmental conca+ity of the lingual corte( of the mandible,

usually in the third molar area, that forms around an accessory lateral lobe of thesubman gland and has the radiographic appearance of a well circumscribed cysticlesion within the bone, usually below the inferior al+eolar canal

3icture of radiolucent lesion between ma(illary central incisorsRnasopalatine canal

%f attempting an e(traction of a ma(illary third molar and tooth is displaced posteriorly and superiorly, where will it belocatedRinfratemporal space

hat is the depth to which brushing goes into the sulcus, what is depth that /ossing goes into the sulcus. rushing only reaches a depth of 1'$ mm subgingi+ally

hich medication is the best med to t( systemic fungal infection.'nystatin ;topical=, ketocona&ole;used systemicallyfor treating a +ariety of fungal infections= , amphotericin ;indicated for most systemic fungal infections=, clotrima&ole;topical=

?mphotericin is indicated for most systemic fungal infections, ketocona&ole, and /ucona&ole is usedsystemically for treating a +ariety of fungal infections

hat receptor do opioids act on to cause their e-ect ..mu *pioid receptors

o Mu: largely responsible for mediating euphoria, reduced >% motility, physical dependence, andrespiratory depression

Mu1' analgesia Mu$ respiratory depression, bradycardia, physical dependence, euphoria

o Delta: analgesia, modulates acti+ity on mu receptoro Happa: analgesics, sedation, dysphoria, psychomimetic

6ompound Mu Delta HappaMorphine II I2entanyl III II3enta&ocine 3artial agonist IIuprenorphine 3artial agonist ?ntagonistMet'enkephalin II IIIeta endorphin III III5alo(one ?ntagonist ?ntagonist ?ntagonist5altre(one ?ntagonist ?ntagonist ?ntagonist

ach receptor mediates analgesia

I means agonist, the additional pluses indicate relati+e potency

hat % biggest ad+antage of using nitrous o(ide as sedati+e You must know this 3g.441%@m guessing anti'an(iety properties6alculation of amounts of ml of anest., and +asoconstrictor can be gi+en to pts.-ects of !Korgen syndrome

dry eyes, dry mouth ;sicca=hat med increase sali+ation N pilocarpine and cim+emilinehat is disad+antage of using 5i2i Cles compared to stainless steel Cles G you will not see when the Cle gets oldhich of the following do not cause gingi+al enlargementRphenytoin ;anticon+ulsant=, cyclosporine;immunosuppressant=, nifedipine;high blood pressure=, digo*in;cardiac glycoside= does not cause gingi+alenlargementDeCne if case is primary perio7endo lesions or primary endo7perio lesion

primary endo lesion: tooth tests non+ital, in/ammatory processes may appear along the lateral aspects of theroot or in the furcation, or may ha+e a sinus tract along the 3D) appearing like a narrow deep pocket

0

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primary perio lesions: perio disease starts in the sulcs and migrates to the ape( as deposits of plaque andcalculus produce in/ammation that cause loss of surrounding al+eolar bone and soft tissue. road basedpocket formation, and teeth are +ital

primary perio lesion with secondary endo in+ol+ement: deep pocket with history of e(tensi+e periodontaldisease, possibly past treatment history

hich bacteria is found in normal /ora gram positi+eHnow abfraction lesionHnow what medicare is and what it co+erage for dental procedureshat term deCnes color saturationRchroma, hue , +alue chromahich test would you use to analy&e proportions of men and women with oral cancer Rchi square

acterial /ora of aggressi+e perio a.a is the primary etiological agent of aggressi+e perio

aggressi+e perio also has p. gingi+alis, capnotophaega, spirochetes,Di-erence b7w fear and an(iety

fear decreases pain and an(iety increases painDi-erence b7w acute periapical abscess and acute periodontal abscess already co+ered3ic of &ygomatic process see cat@s breakdown3ic of papilloma see cat@s breakdown3ic of interma(illary suture

hat herbal supplement strengthen the e-ect of antio(idantsR.chamomille, st. wort@sR. st Kohn@s wort inhibits the reuptake of serotonin at neuronal synapses resulting in the ele+ation of seraotnin

within the 65!. This is similar to antidepressants chamomile: helps digesti+e ailments

!t. Kohn@s wort acts as whatRantidepressanthat does an area of implant need to ha+e, mm of space buccal lingually G 1 mm on each side making the bonedimention bucal7lingually at least Amm wide3t. on ginsing what do u want to a+oidN arfarin7nsaids

hen would u t( an a+ulsed tooth with calcium hydro(ide therapy related to splintingR$ wks after splinting,immediately beforesplinting, after splinting and e+aluation

10 days to $ weeks after replantation, the root canal is prepared;cleaned and shaped= and calcium hydro(idepast is plaed into the canals. This paste is replaced e+ery months for one year. ?fter one year, t appearsthat resotption has re+ersed ot stopped, a permanent gutta percha can be placed. %

f a tooth is out of the mouth for more than $ hours, ankylosis and e(ternal root resortption ;most commoncause of reimplant failure= can occur in $ years rct is perfomed in its entirety prior to replantation. "inse toothwith saline, replant into socket and splint for a ma( of $ weeks. "esorption is the most frequent sequel to

replantationow would use remo+e ma(illary torusRdouble y incisionow remo+e mandibular tori t(@d area if tissue o+er area becomes denuded and sloughs o-6on+entional osteotomies +s. distraction osteotomy procedures?l+eoloplasty indications

surgical prep of the al+eolar ridges ;remo+ing undercuts and sharp edges from areas like the mylohyoid ridgefor the reception of dentures or shaping and smoothing the socket margins agter e(tractins of teeth withsubsequent suturing to insure optimal healing

hat (ray best for determining midface fractures 6That do you do with endo t( tooth with lateral canal w no material in the lateral canalR.retreatement, wait ande+aluate laterhat caused pain in pt with pre+ious "6TR o+erinstrumentation of canal, separated Cle w7in canal, o+ere(tensionapically, breakage of apical seal

1

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3ic of +ertical root fracture 'K shaped lesion

3ic of M"% asked what image wasow does gingi+al tissue connect to implant implants ha+e a biological width of '4 mm.

ct Cbers are present as circular Cbers oriented parallel to the implant or abutment surface, but no connecti+eCbers insert into the titanium

osseointegration means direct bone to implant contact with no inter+ening periodontal ligament or any othertissue. There is no insertion of the ct Cnbers into titanium.

ithin a few weeks of placement of the implant, wo+en bone is laid down at the bone implant interface.o+en bone is characteri&ed by a random orientation of Cbrils. ithin a few more weeks, the wo+en bonebecomes lamellar bone. The con+ersion to lamellar bone is thought to be encouraged by the presentce offunctional forces placed on the implant to stimulate bone

ow do you check probing depth of implant when determining the attachment le+el on teeth, the ceK is used as the landbark to determine the attachment

le+el.

ecause an implant and its restoration ha+e no ceK, the shoulder of the implant, or the restoration is used totell the relati+e attachment le+elE instead of the clinical attachment le+elE on a tooth. 3robing depthsaround implants are determined with a standard shaped perio probe with plastic probes generallyrecommended instead of metal probes

hat instruments do you use to scale an implant plastic tipped6ancer from body metastasi&es to where in the oral ca+ity most frequently

?ttached gingi+a is themost common site

!econd most common Kaw bone

rdoral mucosahat cancer of the oral en+ironment is most malignant mucoepidermoid carcinomahat is disulCram used forRt( of alcohol abuseen&odia&epine M*?

Modulate the acti+ity of the inhibitory neurotransmitter, >?? ;increase >??=

3henothia&ines should not be used with what med ;used to treat mental and emotional disorders= ?lcohol: additi+e 65! depressant e-ects

?mphetamines: may cause e(acerbation of psychotic symptoms

?ntidepressants T6?sG may result in increased chlorproma&ine concentration, monitor for ad+erse e-ects

6ns depressants: chlorproma&ine and other 65! depressants ;alcohol antihistamines, general anesthetics,opiates, or other narcotic analgesics, barbiturates, ben&odia&epines and other sedati+e7hypnotic agents= mayresult in additi+e 65! depressant e-ects. Monitor to a+oid e(cessi+e sedation or respiratory depression

)e+odopa: phenothia&ines may inhibit the antiparkinsonian e-ects of le+odopa due to their dopamine blockinge-ects in the 65!.

pinephrine: patients on chlorproma&ine who are hypotensi+e shouldn@t be gi+en epi. 6hlorproma&ine blocksperipheral alpha adrenergic receptors, thereby inhibiting alpha agonist e-ects of epi like +asoconstriction andincreased bp7

3henothia&ines M*?

lock dopaminergic sites in the brain.

Maoi can@t be used with with indirect acting sympathomimetics likeRamphetamine?sthmaT( for asthma7medication: for acute attack' ?minophylline You must know this 3g.44$

if patient has asthma, don@t gi+e them nsaids.

6hronic asthma can be treated with steroids

?cute asthma: treat with epi, le+albuteral, albuterol, salmeterol, metaproterenol ;or any beta $ adrenergicagonist=

' eta $ adrenergic agonist: ?lbuterol, metaproteerol, salmeterol;slow acting=R ;M?*: beta$ agonist..rela( smoothmuscle in lungsR rapidR side-ect tachycardia and tremor=

$

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' inhaled glucorticoids: beclomethasone, budesonide, /uisolide, /uticasone ;M?*: increases lipomdulin whichin%ibiting #%os#%oli#ase A2 and 6o($=,' antimuscarinic: ipratropium M?*: blocks muscarinic receptors in lung leading to bronchodilationR side e-ect(erostomia' leukotriene synthesis inhibitor: &ileuronR taken orallyR reduces in/ammation' luekotriene receptor antagonist: montelukast, &aCrlukast ;block leukotriene receptorR cys')T1=..long acting'' bo* ,44 Management o+ acute ast%ma

Drugs: _'adrenergic agonists ;epinephrine or albuterol= +ia aerosol, *$, and isoproterenol and glucocorticosteroids;+ia an %P route= are used to manage se+ere acute attacks. You must know this 3g.44 ;Malamed, !tanley 2.. &edicalEmergencies in the ental *+ce, th Edition . 6.P. Mosby, 01$000. 1.

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6ap stage L period of proliferation, di-erentiation,a nd morphogenesisdens in dente

ell stage L problems of istodi-erentiation and morphodi-erentiation' amelogenesis imperfecta, Macrodontia,Microdontia

?pposition' cells begin to deposit dental tissues ;enamel, dentin, cementum=' enamel dysplasia, enamelhypoplasia, concrescence

"eferred pain to the ear ;mandibular molars= You must know this 3g.44raft from another member of the space species D2D?, 2D?Materials Used to Correct sseous De+ects

A

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Autogenous 5ra+ts *sseous 6oagulum

one lend

6ancelous one Marrow Transplant

%liac 6ancellous one Marrow ;(traorally=Allogra+t 9ndecalciCed 2ree&e'Dried one ?llograft

DecalciCed 2ree&e'Dried one ?llograftVenogra+t io'*ss ;o+ine'deri+ed bone=CO7onbone 5ra+t ioacti+e glass: 3erio>las J and io>ranJ

6oal'deri+ed Materials

Malocclusion is least commonN 6lass %%% ;1'$B= 6lass %% ;1'$ardners syndrome but not as much as 66D

ctodermal dysplasia L abnormalities of two or more ectodermal structures such as hair, teeth, nails, sweat glands,etc. these people ha+e thin hair, thick nails, lightly pigmented skin, sweat glands that function abnormally ;thesepeople cannot perspire or regulate body temperature=F teeth are congenitally absent

o ]'linked hypohidrotic ectodermal dysplasia ;most well known form=o !parse hair, little yey brow hair, light pigmentationRo *ligodontia most commonR usually not anodontiaR mutation with 6hromosome 14 pa( O gene

#

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o !ometimes teeth e(hibit taurodontism

Taurodontism:

' This conditions may e(ist as an isolated trait ;autosomal dominant= oras part of se+eral syndromes including the trichodentoosseoussyndrome ;TD*=, otodental dysplasia, ectodermal dysplasia, tooth andnail syndrome, amelogenesis imperfecta and others

' bull like teeth, a molar with an elongated crown and apically placedfurcations of the roots resulting in enlarged rectangular coronal pulpalchamber elongated pulp chamber, short root canals

' e able to identify radiographically

%f 3aget@s disease of bone ;osteitis deformans= occurs in the QawR will see Y3"6M5T*!%! also see hyper cementosis in gardners and acromegaly

Hnow about dentigonesis imperfectaHnow about ?melogenesis imperfecta:

' autosomal dominant condition a-ecting both deciduous and permanent teeth. ?-ected teeth are gray toyellow brown and ha+e broad crowns with constriction of the cer+ical area resulting in a tulip shape.

' ?melogenesis imperfecta: teeth lack enamelF dentin and cementum una-ected, shapes of roots and crownsare normal, enamel is missing,

' Dentinogenesis imperfect: opalescent dentin' blue gray, often associated with osteogenesis imperfect ;bluesclera, multiple bone fractures=, lack of pulp chambers and root canals, bell shaped crowns with constrictedcer+ical region

' Dentin dysplasia: dentin abnormal with e(posure, draining Cstulas, misshapen teeth

2luoride and the ages irth'Amonths, Z 0.ppm, no /uoride supplementation

A months L years, if Z 0. ppm then gi+e 0.$< mgF if between 0. ppm L 0.A ppm none, 0.A none

'A years, if Z 0. ppm then gi+e 0.

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!igns for 3P in oral ca+ity, oral 3P type 1A: 3P 1A has been identiCed in some oral leukoplakias

These are the same 3P subtypes associated with uterine cer+ical carcinoma and a subset of oral squamouscell carcinomas

3P'1A has been shown to induce dysplasia like changes in normally di-erentiating squamous epithelium in anotherwise sterile in +itro en+ironment

*H67basal cell ne+us aka R >orlin syndromeR>ardners' supernumerary teeth >% polyps, osteomas, odontoma>orlins ;ne+oid basal cell carcinoma=' associated multiple *H6, fal( cerebri, biCd rib, frontal bossing, hypertelorism,palmar and plantar dyskeratosis

3atient were to get a crown, but they want bleaching. hats the sequenceNo /leac%ing is al$ays ,st ste# and t%en t%e restoration is matc%ed to t%e lig%test s%ade9

T( sequenceo *ral signs of ?ddison@s disease (%y#oadrenocorticismS lo$ adrenal corticosteroids bc destruction o+

adrenal corte*) diEuse melanin #igmentation in ;oor o+ mout%ventral sur+ace o+ tongue (usually,st sign o+ AddisonJsS later t%e Wbron=ingX o+ s-in can occurS usually in sune*#osed areas)

?fter /ap surgery, how does the tissue healN )ong Kunctional epithelium

ealing after 2lap !urgery

%mmediately after suturing ;up to $4 hours=, a connection between the /ap and the tooth or bone surface isestablished by a blood clot, which consists of a Cbrin reticulum with many polymorphonuclear leukocytes,erythrocytes, debris of inKured cells, and capillaries at the edge of the wound.acteria and an e(udate ortransudate also result from tissue inKury.

*ne to days after /ap surgery, the space between the /ap and the tooth or bone is thinner and epithelial cellsmigrate o+er the border of the /ap, usually contacting the tooth at this time. hen the /ap is closely adapted tothe al+eolar process, there is minimal in/ammatory response.

*ne week after surgery, an epithelial attachment to the root has been established by means of hemidesmosomesand a basal lamina. The blood clot is replaced by granulation tissue deri+ed from the gingi+al connecti+e tissue,the bone marrow, and the periodontal ligament.

Two weeks after surgery, collagen Cbers begin to appear parallel to the tooth surface.9nion of the /ap to thetooth is still weak because of the presence of immature collagen Cbers, although the clinical aspect may be almost

normal.

*ne month after surgery, a fully epitheliali&ed gingi+al cre+ice with a well'deCned epithelial attachment is present.There is a beginning functional arrangement of the supracrestal Cbers.

%deally after reconstructi+e periodontal surgery you want new attachment with periodontal regenerationbecause it results in obliteration of the pocket and reconstruction of the periodontium. owe+er, othertherapeutic results can be seen like :

o ealing with )Q which can result e+en if Clling of bone has occurredo ?nkylosis of bone and tooth with resultant root resorptiono "ecessiono "ecurrence of the pocket,o ?ny combo of these results

' *nly in >T" does long Kunctional epithelium not occur and is by the actual mo+ement of osteocytes mo+ement from3D) to area

%n what order do you e(tract the molarsNerial !*tractions:

o 1st: primary )ateral incisor ;as perm. ruptR only if nec=o $nd:primary canine ;as perm. )at. rupt=.. 'O yrso rd: primary 1st molar ;A'1$mos. efore normal e(foliation=.. done to erupt 1st 3M to erupt before normal

timeR so they can be e(tracted.. and permit 6anine to mo+e distally into spaceR O'10 yrso 4th:perm. 1st 3M ;Kust as canine emerges through mucosa

Ma(. canine. Hnow if they ha+e two canals

O

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o Ma*9 canine only %as , canalS mandibular canine can %ave 2 canals 43G

6anine L frenum attachment igh renum attachment can cause locali&ed recession in kids

)ocal ?nest. 3atient has an ad+erse reaction to it.o 3robably due to preser+ati+e methylparaben ;1mg7ml=o 3rilocaine metabolie o'toludine can cause methohemoglobiniea

?mides ;lidocaine, Mepi+icaine, bupi+acaine, 3rilocaine= are metaboli&ed by the li+er, ha+e few allergiesthan esters ;procaine, Tetracaine, cocaine= esters are metaboli&ed by esterases in plasma

3rilocaine causes methemoglobunimeia

)ocal anesthethics cause 65! system e-ects like: lightheadedness, di&&iness, muscle twitching,con+ulsions, and cardiac e-ects like cardiac depression, speciCc antiarrhythmic e-ects, and cardio+ascularcollapse due to myocardial depression, and hypotensi+e shock

Hennedy class %, no retentionN here is the problemN' 6lass 1 is strict tissue retainedR problem could be in baseN' ?n unseating occurs in the edentulous segments, a line through the rests located furthest from the retenti+e

clasp tips acts as the fulcrum in a class %%% le+er system. Mo+ing the fulcrum line still further from the clasp tipsimpro+es the mechanical ad+antages of the le+er arm system. y maintaining this position, the most distantrests augment the retenti+e action of the clasp and indirectly contribute to retention. "ests G indirectretainers, which augment mechanical retention

o ?s the denture base mo+es upwards, the more anterior rest ;the indirect retainer= resists downwardsmo+ement and this increases the e-ecti+eness of the direct retainer

o 6lass % and

'ennedy Classi.cation ilateral edentulous areas located posterior to the remaining natural teeth

9nilateral edentulous area located posterior to remaining natural teeth

9nilateral edentulous area with natural teeth remaining both anterior andposterior to it

? single, but bilateral ;crossing the midline= edentulous area located anterior tothe remaining teeth

3ic of white plaque that can@t be rubbed o-Rleukoplakia hite lesion that can@t be scraped o-. May show benign hyperkeratosis, epithelial dysplasia, or in+asi+e

carcinoma 3remalignant lesion. Tobacco, alcohol

1 histamine and $ ;gastric=' 1: 1st generationR sedati+e7hypnotic Anti%istamines

1?ntihistamines

6hlorpheniramine

9seful for treatingdermatologicmanifestations of anallergic response

3rometha&ine 3reoperati+emedication forsedation, antiemeticproperties,anticholinergic

W

40

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e-ects

Diphenhydramine

2or controlling thesymptoms ofparkinsonism

$antihistamines

6imetidine 9sed to reducegastric acidsecretion.5ow a+ailable *T6for heartburn

You must know this 3g.4erd, ulcer, stop parietal secretion of I'

6heek biting ;dentures=' hori&ontal o+erlap' post teeth too edge to edge

%f patient can@t make 2 and P sounds, what@s the problemN Too far superior and too anterior#eec% ounds

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o ?cute apical abscess: purulent e(udates around ape(, symptomatic, 3D) maybe normal looking or slightlythickened in (ray, normal or slight thickened lamina dura, !))%5>R rapid onset of swelling, mod. To se+erepain, pain w7percussion and palpation, slight inc. in tooth mobility

o 6hronic periradicular periodontitis: asymptomatic, radiographic +isible, endoto(ins cascading into pulp causee(tensi+e deminerali&ation of cancellous and cortical bone, slight tenderness to percussion7palpation

o 6hronic periradicular periodontitis7phoeni( abscess: similar presentation as acute apical abscess 9Tradiographic e+idence7 periapical "adiolucencyR histo: liquefaction necrosis w73M5, +iable macrophages andoccasional lymphocytes and plasma cells,

o !uppurati+e periradicular periodontitis7chronic periradicular abscess: draining sinus tract w7o discomfort,mimic perio pocket, non'+ital pulp, bone loss (ray

*perati+e gypsum ;setting time7working time= The setting e(pansion of any gypsum product is a function of calcium sulfate dehydrate crystal growth. !ome

is the result of thermal e(pansion >ypsum classiCcations:

o Type %: plaster, impression plastero Type %%: model plastero Type %%%: dental stoneo Type %P: dental stone, high strength die stoneo Type P high strength.

? thinner mi( of gypsum base product decreases the degree of e(othermia, decreasing setting e(pansion.

%ncreasing the water: powder ratio increases setting time and decreases strength.

3otassium sulfate and sodium chloride accelerates setting of gypsum, whereas sodium citrate and bora( retardsetting

The poured cast should be allowed to set for 4< to A0 minutes before separating it from the impression %n+estments e(pand during setting when heated.

o >ypsum bonded in+estments used for casting alloys containing A

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6'factoro The ratio of bonded to unbonded surface areas of a composite restoration.

o 3olymeri&ation shrinkage in a composite creates stress that can damage surrounding enamel walls of theca+ity preparation. The amount of stress depends on the 6'factor of the composite restoration. ? high 6'factorindicates the ca+ity is more likely to be damaged. %ncremental curing reduces the 6'factor, and thereforereduces the residual stress of the resulting composite restoration.

hich tissue is least radiosensiti+eN 5eurons, skeletal muscle. 6ells that are mitotically acti+e are the mostradiosensiti+e ;basal cells of the oral mucosa=R -eletal muscles are least radiosensitive

6a+ulinic acid7augmentinR incr. action of penicillin b7c cal+unic acid is a beta'lacatamase inhibitorR t(: . in/uen&a,

5. gonnorreha, . coli, 3. numococci y combining cla+ulanic acid with a penicillin, the beta'lactamase en&yme is permanently inhibited by the

acid, and the antibacterial acti+ity of thepenicillin is maintained *ne popular preparation is augmentin which contains amo(icillin and cla+ulanate potassium. ?ugmentin is

used orally as pill or liquid form. !ulbactam is another beta lactamase inhibitor

$nd 1@ molar L distal shoe Missing primary Crst molarN and and loop

Missing primary second molarN Distal shoe

3remature loss of primary mandibular caninesN ? )ingual holding arch will pre+ent the posterior teeth fromtipping mesially

ilateral loss of ma(

primary teethN 5ance appliance

M*733*o M* L health maintenance organi&ation is a type of managed care organi&ation that pro+ides a form of health

care co+erage in the 9nited !tates in which doctors and other pro+iders ha+e a contract with.o 33* L preferred pro+ider organi&ation is a managed care organi&ationF doctors accept reduced fees in

e(change for referrals.o hats the most common reason patient needs to repair anterior compositeN The maKority of 5orth ?merican

dental schools reported marginal defects ;4 percent= and You must know this 3g.4

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makes it acontraindication forglaucoma=

M?*%s Tranylcypromine

lockade of aminereuptake or alterationof receptor numbers

?nticholinergic oratropine side e-ects

3henylene

!!"%s 2luo(etine lock serotoninreuptake

?nticholinergic oratropine side e-ects

Tra&odone

?ntimanics

)ithium 3rimary use is in thetreatment of themanic phase ofdepressi+e psychosis

(erostomia

edatives

ben&odia&epines

Dia&epam;+alium=

)ess addicti+epotential thanbarbiturates)ess profound 65!depression thanbarbs)arger therapeuticinde(

)ess respiratorydepressionater insoluble,needs propyleneglycol to dissol+e it

Modulate the acti+ityof the inhibitoryneurotransmitter,>?? ;increase>??=

2orm acti+e metabolites%nKection of dia&epamcan cause irritation suchas thrombophlebitis dueto the sol+ent the D[ isdissol+ed in

2luma&enil re+erse the

e-ects ofben&odia&epines

6arbama&epine is usedto treat trigeminalneuralgia.6arbama&epine is anantiepileptic med usedto treat grand mal andpsychomotor sei&ures.

Mida&olam !hort actingcompared to +aliumbecause it doesn@tha+e acti+emetabolites likedia&epam.The most lipidsolubleben&odia&epine, sorapid onset, shortduration

atersoluble ;sodoesn@tneed to bedissol+ed inpropyleneglycol like+alium=

6hlordia&epo(ide6lona&epam

arbiturates

Thiopental arbs are notanalgesics

arbs often inducee(cess sali+ation andbronchial secretions.

a+e anticon+ulsantproperties

Depress all le+els ofthe 65!

5o signiCcantanalgesic e-ects

9sed for anesthesia,anticon+ulsant, andan(iety

6an produceunconsciousness in

Thiopental@s action isterminated byredistribution of thedrug out of the brainL it enters the brainrapidly and e(itsrapidly, thus quickonset and shortduration of action

%nhibit depolari&ationof neurons by binding>?? receptors

nhancestransmission ofchloride ions

Metaboli&edby the li+er

(creted inthe urine

arbiturate o+erdosekills you because ofrespiratory depression

arbiturates arecontraindicated in apatient with intermittentporphyria' barbsenhance porphyrinsynthesis and thus will

aggra+ate the disease!udden withdrawal froma high dose can be fatal

6ontraindicated inpregnant patients andpatients with respiratorydiseases

Drug interactions with65! depressants,alcohol, and opioid

44

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under 0 seconds;+ery lipid soluble, sorapid onset of action=

analgesics enhances65! depression

?fter ortho t(, rotated tooth, what causes thisR supracrestal periodontal Cbers' DeCnition of ecacy

o The number of receptors that must be acti+ated to yield a ma(imal response.o ? drug with high ecacy needs to stimulate only a small percentage of receptors, while a drug with

lesser ecacy has to acti+ate a larger proportion of receptors' The ability of a drug'receptot comple( to produce a functional response.

ater on amalgamo %s moisture is incorporated into an alloy that contains &inc, the water reacts with the &inc to produce hydrogen

gas, which causes severe e*#ansion o+ t%e amalgam9

*+ertrituration L decreased e(pansion

"oot caries7(erostomia N

Ma( tuberosity and retromolar area touching. hat do you doN... reduce tuberosity

DT? chelating7green stainsNNN

Hnow the signs of traumao 6linical signs include: increased tooth mobility, thermal sensiti+ity, attrition of enamel, recession of the facial

gingi+al tissue.Di-erence between bur $4< and 0

o These two burs are +ery similar to one another. The $4< is .0mm long.o 0 is shorter than $4ingi+ectomy is indicated for elimination of suprabony pockets, elimination of gingi+al enlargments, and

elimination of suprabony periodontal abscess Do not do gingi+ectomy if base of pocket is located at the M>Q or apical to the al+eolar crest ;must consider

pocket depths=hat is the min age for speech congintion;something like that= ,

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Ma( 1 pm: canals AB

Mand 1 pm: canals: 0B

Ma( $ pm: canals 1B

Mand $ pm: canals 0B%nfection from mand m, erodes lingual corete(, where does it goN !ubling, pterygoma(, submental or submand space

!ublingual space L from mandibular molars and premolars

3terygoma(illary space' mandibular molars and premplars

!ubmental space L mandibular incisors

ubmandibular s#ace mandibular molars and #remolars

Masseteric space mandibular third molars

%f a third molar disappears during e(traction, it@s most likely in the submandibular spaceDirection of Cbers for implant 6TN parallel, perpendicular

%mplants ha+e a biologic width of '4 mm

6onnecti+e tissue Cbers are present as circular Cbers oriented parallel to the implant or abutment surface, butno connecti+e Cbers insert into titanium

?fter brushing how long until forming mature plaque reappearsN 1'$hrs, A', $4'$ hrs Day 1'$ young plaque consists primarily of cocci ;strep mutans and sanguis=

Day ;$'4= cocci still dominate, but there are increasing numbers of Clamentous forms and slender rods

Days 4'# Claments increase in umebers, and a more mi(ed /ora begins to appear with rods, Clamentous formsand and fusobacteria.

Days #'14: +ibrios and spriochetes appear and the number of white blood cells increase. More gram negati+eand anaerobic organisms appear. The signs of in/ammation are beginning to be obser+able in the gingi+al

Days 14'$1: +ibrios and spirochetes are pre+alent in older plaque, along with Clamentous forms. >in+itis is

e+ident clinically ?s plaque ages, the number of cocci decreases, and the number of rods, fusiforms, Claments and spirochetes

increases. ?naerobes and gram negati+e organisms increase as wellarly cononiser of early plaqueN !trep sanguinis, strep sali+ariousa&ard communication standard: *!?Most common site site for recurrent hepies: hard palate, soft palate,

!econdary or recurrent herpes simple( appears on the lips, hard palate and gingi+aThermionic emission: The heating of a metal wire to a temperature at which electrons in the wire gain enough energyto escape to the space surrounding the wirealready e(plainedhere is lichen planusN uccal mucosa

)acelike white striae ;wickham@s striae is bilateral and symmetrical=. ?ppears more in women then men.Mainly a-ects buccal mucosa. May also be seen on the tongue, lips, hard palate and gingi+a. The striae isusually asymptomatic. %ntraoral lesions respond to topical steroid therapy.

>orlin syndrome: cysts of the Kaw, osteomas, ;% think okc=

>ardners has multiple osteomas and intestinal polyps, odontomas ;from decks=, and supernumerary teeth >orlins has okcs, palmer pitting, bigid rib, multiple basal cell carcinoma

ingi+al hyperplasia: +ermapril ;66=

6alcium channel blockers ha+e been associated with gingi+al hyperplasiao 6alcium channel blockers end in dipineE

( of calcium channel blockers: +erapamil, nifedipine, diltia&emhat med for anti con+ulsant also appro+ed for neuogenic pain:Carbama=e#ine treats trigeminal neuralgiaMa( 6i sloped and notched from whatN 6ong syphilis

picture shown is hutchinsons incisors of congenital syphilis.

utchinson@s triad includeso utchinson@s teetho *cular interstitial keratitiso ighth ner+e deafness

hat stages are syphilis infectiousN 1, 2,, any combo of 3rimary: Crst symptom is a nonpainful chancre that appears $'A weeks after e(posure, it@s generally found on

the part of the body e(posed to the partner@s ulcer ;like the penis, +agina, lip, tongue= the chancre disappearswithin a few weeks whether or not person is treated

econdary : highly infectious stageF occurs A weeks after non'treatment of primary syphilis. idelydisseminated spirochetes cause mucous membranes to e(hibit a reddish brown maculopapular cutaneous rashand ulcers are co+ered with a mucoid e(udate. 6ondyloma lata ;ele+ated broad based plaques= are also seen

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on skin and mucosal surfaces. %f left untreated, these symptoms will resol+e on their own, but the infectiousmicrobe remains behind. %t is at this point syphilis passes into the latent phase.

Tertiary: occurs in infected persons many years after non'treatment of secondary syphilis. The guma ;a focal,nodular mass= typiCes this stage. %t most commonly occurs on the palate and tongue. The bacteria damagethe heart, eyes, brain, ner+ous system, bones, Koints or almost any other part of the body. eadache, sti-neck, and fe+er are symtpoms of neurosyphilis

hat do u see in a opioid abuserN ]erostomia, mydriasis, loose bowels,!ymptom of subacute g poisonN Diarrhea, tinnitis, hair loss, weight loss

(cess sali+a

Mercury that is absorbed into the circulatory system may be deposited in any tissue. igher than a+erage

accumulationsoccur in the brain, li+er and kidney."estorati+e concern for primary molarsN Di+ergent roots, wide *cclusal table, shallow pits' The occlusal table is narrower on primary molars 3rimary teeth ha+e thinner enamel

The pulp chamber is larger in primary teeth

The pulp horns are closer to the surface of the tooth

The crown is shorter and has a greater constriction in the cer+ical regionhat metal is most allergicN 5ickel5ickel and eryllium in the base metal alloys are allergenichich way does the ma( ridge resporbN 9p and back, back, forward, forward and downhat do you not do about internal resporptionN watch it ;ans=one composition of woman with osteoporosisN Dec calciCcation of osteoid, mosaic bone,hat cells responsible for local destruction in period (Nb cells, t cells, fungal, +irushat is the best indicator of perio stability for maintance pt with chronic perioN ?ttachment le+el, probing, bop, hygine

hat kind of sterili&ation for carbon steel carbide burs doesn@t corrodeN Dry heat only, ethylene, dry and gas,autocla+e7w pts how do u clean surfaceN 3reclean then disincetant and lea+e for 10 mins, spray and wipe down, preset up 10mins before pt and clean,hats most moisture tolerant imp materialN ydrocolloid, polyether, p+s, polysulCde!equence of steps to repair porcelain with composite: some +ersion of silane, sandblast, etch and bondYou ha+e a cast crown that seats on 0 that mand de+iates to left when biting, what surface was prematureN uccalinclines, lingual incline, mesial,hat systemic condition cant pt handle epiN ?ddison, hyperthyroid, adreanal insu-, you want to be carful withadministering epinephrine to patints that ha+e hyperthyroid because it will ele+ate their blood pressure and cardiacstrains.True about /uride ca+it pre+ention7minerali&ationN 6an reminerali&e without apatite crystals, pre+ent demin duringacid challenge,

yper+entilation syndrome has dissiness and whatN Dissiness and confusion, tacky cardia and tackypenia, tackypenia

and bradycardia,eakness, confusion, fainting, agitation, chest pain and shortness of breath

est place to place implantsN ant mand6hronic caries, what you see clinicallyN 3igment, e(tensi+e undermined enamel, easy elicit pain,Ma( ci with radiograph no pulp chamber, what fromN Trauma, physiologic age,"estore with amalgam class $, where is the band pro(N 1mm higher than M"hats most powerful and longest lastingN 3regnisone, cortisol, hydrocodisone, De(amethasone

Don@t get consentN atteryTruthG+eracityDentist with M?Gcontact dermatitisThe lack of secrtions from enadryl fromN ?nticholinergic, antihistamine, anti adrenergic>raft from di-erent speciesG(enograft

?nug with hi+ pt, what do u doN Debridement and antibacterial medshich osseos defect would >"T and bone be leaste-ecti+eN*ne wall, two wall, three narrow, wide

Most neoplasms in what glandsN 3arotid, minor, subman, subling

3t disoriented and hypoglycemic gi+e whatN >lucose, epi, steroids, insulin6onscious L fruit Kuice9nconscious' ?, nitrous only$.A hich med should not be used in an(iety control for a child: choices were 5$*, Palium, ydro(i&ine,

Mida&olam ;?nswer choice G NNN ?ll of them can be used, as far as % know. The child in the question

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wasn@t taking any medicationsF had no health problems. ad history of tonsillectomy and one other Lectomy surgery that %@d ne+er hear of.

%mplant with internal component for whatN ?nti rotationhat is true about a threaded post for amalgamN 1 mm in a(ial direction of tooth, 1.< mm a(ial, parallel to outercontour, perpendicular to pulp chamber ;stupid q="eason for functional cusp be+elN !tructural durability, resitance, R3fm crown with opaque area in incisal 17, whyN %nadequate $ndplane reduction, o+er reduction of incisal, too muchbody porcelain,R3t syncope how to stop themN ead below heart, stand, supine, prone,3t swallows crown do whatN !it up or stand up, supine, prone, semi supineTaking 6" what positionN !upine, semi supine, sitting up7standing,est biopsy for $(($ white lesionN %ncisonal, e(cisional, brush, aspiopsy to identify candidaN rush3t with general muscle weakness see whatN )ow mand plane angle ,RMost common cause bells palsy: hs+, idioscratic, parotid malig,>enerali&ed ma( denture sorenessN 6andida, +itamin def, allergy, gross *cclusal discrepancy(cess monomerGshrinkageow long does pain ha+e to persisit to be chronic: 1' mo, 'A mo, #'1$ mo, 1$I2ull thickness /ap, what bone resporbs afterN Thin interdental, thick interdental, thin radicular, thick radicularhats not characteristic of Mod idman /apN MarginsMosby@s p$

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o The teeth adKacent to the suspected tooth and the equi+alent teetth in the same archo !ame tooth in di-erent arch and adKacent tooth

' Hnow slob rule^ % had se+eral questions on hiso e able to apply it,o %f the ( ray cone is shifted mesially, the lingual palatal root7 lesion will shift to the mesial side

' You performed an mod restoration on a patient a month ago. !he comes back and reports that she has beenha+ing incredible pain when she bites.

o 6racked tootho Hnow that cracked teeth ha+e pain only on upon release of biting pressure. patient with cracked tooth

syndrome patients may e(perience sensiti+ity to mild stimuli like sweet or acidic food, and also cold.

You can use transillumination or tooth sloth in order t diagnose' %n what situation is "6T contraindicatedo P"2o this is a hopeless prognosis. Diagnose by +isuali&ing the fracture with an e(ploratory surgical /ap. %n

a lot of cases there is an isolated probing defect at the site of the fracture. ill presentradiographically as a Q shaped lesion.

' Mandibular access opening is trape&oid shape' dta is a chelator which remo+es inorganic material' hich isnota beneCt of a steel Cle +s. a nickel'titanium Cle.

o More /e(ibleo )ess chance for breakingo ?llows the Cle to be centerd in canal before separation.o 5iti Cles are more /e(ible, stainless steel shows more chance o breaking. !tainless steel Cle % more

prone to show signs of fatigue ;from pals=' hy will you recapitulate with a smaller Cle in between Cles

o To clean the apical 17 of the tooth that won@t be cleaned with Kust irrigation' ow can you diagnose hori&ontal fractureN

o ?ngle the cone hori&ontally at multiple di-erent angleso ?ngle the cone at +arious +ertical heights to capture the tooth at di-erent +ertical angleso !ince root fractures are generally oblique ;facial to palatal= one pa radiograph may miss it, so the

radiographic e(amination should include an occlusal Clm, and pas ;one at 0 degrees, then one at Iand L 1< degrees from the +ertical a(is of the tooth.

' ad a patient with a hori&ontal apical root facture ;it was in the apical third= the ape( was closed, tooth had nomobility. ow do you treat

o Monitor for a yearo "cto 6oronal fractures ha+e a poor prognosis, midroot fractures ha+e a guarded prognosis, and apical

fractures ha+e the best prognosiso ori&ontal fracture is better than +ertical, nondisplaced is better than a displaced fracture, and oblique

is better than trans+erseo % think you Kust monitor this for a yearR a coronal root fracture, you@d splint for A'1$ weeks, a mid root

facture you@d stabili&e for weeks. ?n apical root fracture has the best prognosisR they didn@t@ tspecify a treatment

' Hnow procedures for pulp cappingo 3ulp capping procedure is most successful in accidental e(posure of the pulp, and in the pulp of a

young child. 3ulp capping is most successful if the e(posure was accidental ;trauma with a dental buras opposed to carious. The pulpal e(posure should be only pinpoint to e(pect success. "epair isaccomplished by the formation of a dentin bridge at the site of e(posure. +en a small cariouse(posure should ha+e root canal therapy for the best long'term prognosis. Young pulps are more+asculari&ed and therefore more amenable to repair.

o %ndirect pulp capping in+ol+es remo+ing infected dentin almost to the point of pulpal e(posure. 6a*$is placed and then a resin modiCed glass ionomer cement is placed o+er that. 2ormation of asecondary dentin should occur and then a Cnal restoration is placed after remo+al of the intermediate

restoration and residual caries. The goal of indirect pulp capping is to ha+e the tooth participate in itsown reco+ery. %ndications for indirect pulp capping include deep carious lesions that encroach but arenot actually in the pulp, no history of chronic pain, no radiographic pathology, +ital pulp, and normaltooth mobility and color

o Direct pulp capping is indicated if there has been a small mechanical e(posure, if it is an astmptomatic+ital pulp, and there is no coronal or periapical pathology. ? hard tissue barrier ;reparati+e dentinbridge may be +isuali&ed as early as A weeks postoperati+e

' 6auses of endodontic failureo *bturating material is o+ere(tendedo )ateral canalso The main causes of endo fails is inadequate seal of the root canal system, poor access ca+ity,

inadequate debridement, missed canals, and procedural errors ;perforation, ledging, loss of length=

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' 3atient reports pain on chewing in ma(illary posterior regiono Ma(illary sinusitiso The ma(illary sinus is the most common location for sinusitis, and it@s associated with all of the ommon

signs and symptoms, but also results in tooth pain, usually in the molar region' hy is [* a good temporary restoration

o %t pro+ides a good sealo ithstands compressi+e forceso %T! 5*T easy to reamo+eo Most root canal sealers are some type of &inc o(ide eugenol cement, and are capable of producing a

seal while being well tolerated by periapical tissues

' Hnow thisR lots of questions on this:' ?cute periradicular periodontitis: painful in/ammation around the ape( ;locali&ed in/ammation of the 3D)= canbe the result of pulpal disease e(tending into the periradicular tissue, canal instrumentation or o+erCll,occlusal trauma like bru(ism.

o Tooth can be +ital or non +ital %f tooth is +ital, a simple occlusal adKustment will often relie+e the pain %f the pulp is necrotic and remains untreated, additional symptoms may appear as the disease

progresses to the ne(t stage' acute apical abscesses' ;acute apical abscess=: a painful, purulent e(udate around the ape(

o %t is a result of the e(acerbation of acute apical periodontitis from a necrotic pulpo "adiographically may see a normal or slightly thickened lamina durao !ymptoms:

"apid onset of swelling, moderate to se+ere pain, pain with percussion and palpation, slightincrease in tooth mobility,

The acute apical abscess can be di-erentially diagnosed from the lateral periodontal abscesseswith pulp +itality and testing, and sometimes with periodontal probing' 6hronic periradicular periodontitis: a long standing, asymptomatic, or mildly symptomatic lesion

o 9sually accompanied by radiographically +isible apical bone resorptiono Diagnosis is conCrmed by:

The general absence of symptoms The radiographic presence of a periradicular radiolucency The conCrmation of pulpal necrosis

' !upurati+e periradicular periodontitis ;chronic periradicular abscess=o ?ssociated with a draining sinus tract without discomforto The e(udate can drain through the gingi+al sulcus, mimicking a perio lesion with a pocketo "adiographic e(amination shows the presence of bone loss at the periradicular areao !inus tract resol+e spontaneously with nonsurgical endo treatment

' 6hronic focal sclerosing osteomyelitis ;condensing osteitis=o

(cessi+e bone minerali&ation around the ape( of an asymptomatic +ital tootho This radiopacity may be caused by low grade pulpal irritation

' Mandibular molar access opening is' trape&oid shaped' %n endo perio lesion, treat endo Crst.' hy would you put a dowelE on an endodontically treated tooth

*perati+e' %n a class %% lesion, the caries are located apical to the contact point' hen would you place a wedge

o ?fter you@+e placed the rubber damo ?fter you@+e p