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    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)

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    (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

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    - Proper preparation of the cavity, for example correct etching of the tooth surface to 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:

    - Composite: Restoring medium to large restorations of any class- GIC- smaller restorations in non stress bearing areas- U

    sed 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)

    --- Build up of salivary glycoproteins which can block ionic interchange with GIC therefore,

    conditioner removes this smear layer and allows the exchange

    -Chemical adhesion to dentine

    - Releases fluoride

    - low level pulpal responses

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    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 friendlyenvironment for the children and fosters a positive attitude. Does not require LA

    See above

    8)

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    - 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 contactwith

    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 whichare 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

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    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

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    - Blood free operating field, maintaining LA in target area for longer duration. Reduces the

    absorption ofLA from the site of deposition, decreases blood flow from the site of injection

    therefore reducing the required theraupatic dose, enhances properties ofLA

    16)

    1 Individual response to drug (bell curve)

    2 Accuracy of deposition ofLA

    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

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    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

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    - 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)

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    5)

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    Hygiene questions:

    ORAL 2030

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    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.

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    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,

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    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 roomSource 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 notlarge enough

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    d) No, the crystals on the occlusograph film are large therefore requires less exposurecompared 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. Uneruptedteeth

    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 andremoving the non silver crystals

    -Digital radiography:

    - Photon converts to a light photon, which forms an electron, then voltage which in turnresults in a digital image.

    - Faster results- More expensive to set up- Dose reductiong) Correlate clinical findings, identify disease, identify presence/ absence unerupted teeth,

    treatment planning, extend and process of disease, check for pathology eg. Abscess,

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    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 = diabetesc) 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 severalfunctions

    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

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    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 neutralpH reducing dry mouth and acidic attacks on the tooth surface

    a) Evaluate (diet, saliva, tooth morphology, microflora and general health) Controlling thedisease (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

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    - AMA or amalgalm margin angle greater meaning more material at the margin = morestrength

    - 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 fissuresc) Deep Class I cavity using the minimal intervention principles

    Materials: Dycal sub-base, GIC base and Composite restoration

    d) Inferior dental block and long buccal if soft tissuee) Trismus, facial nerve paralisis, infection, needle breakage, heamatomaf) 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.

    g) Vasopressor syncope placing patient in supine positon (feet above head and heart parallelto floor)

    a) Amalgalm, GIC and CompositeAmalgalm longevity, when aesthetics isnt 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 theCEJ (??). Place the GIC on the axial wall, then place the composite on gin...gival floor, axial

    wall and build up.

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    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...

    c) Pre contrououred to the tooth, dont need to cut cavity extensive to fit in , thin thereforeeasily placed and ensures tight contact points

    d)

    Incremental placement of materials and setting.Placing sealant over the top

    e) Titutration, condensing, carving, polishing, proportioning,f) Labial: preserves marginal ridge,small and direct accessPalatal: Broken down, exposed to occlusal forces (potential for wear and breakdown,