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The First day (written)

The bisphosphonates (previously referred to as biphosphonates or diphosphonates) are a group of agents which are analogues of pyrophosphate. When administered either orally or parenterally they are adsorbed onto hydroxyapatite crystals in bone mineral and, because their structure renders them resistant to enzyme degradation, they act principally by inhibiting bone resorption, although some effect on bone formation probably also occurs. Oral Medicine (time management is very important you have only Half hour) 1. Patient 28 years old presented to the clinic complaining of pain on chewing and tenderness especially in the morning...She had Trauma or accident one year ago but the x-ray shows no fracture 1. What is your differential diagnosis? Temperomandibular pain dysfunction syndrome the pain is more sever on waking if its associated eith noctural parafunctional activity. pain, check for clkick , noise , palpate tmj joint. Palapate the muscles. Pafunctional habits like bruxism clenching Find if its due its got dental cause or any other cause 2. What are the investigations you going to do? Ask proper history ..wat typr of pain? Examination. Intensity, duration, relieving factors , ppt factors, long term investigation would be ct scan, mri scan etc, but unlikely to be that serious, pain of sinusitis aggravated by lyin down 3. What is the most probable diagnosis? Cos early in the morning signifies overactivity of masset musle invoved in brusim in the night 4. What is your management and advice to the patient according to your diagnosis? Take rest.. find out whether shes aware of it? Reassure , soft diet, explain tht the condition is benign, self limiting problem of the nature. Rest- soft diet. Limitation of the movement, anti inflammatory analgesics eg ibuprofen 400mg three times a day. Occlusal splint therapy

Local physiothearapy. 2. What are the recognizable types of uphthus ulcers, describe them 3. Slide showing edentulous patient with white plaque like lesions at the buccal mucosathe patient has these lesions for two weeks and they can be wiped off with gauze... 1. What are your differential diagnosis and the most probable one? One tht can be wiped away- either necrotic epitheliu or inflammatory exudates. 2. What are the investigations you going to do?

3. What are the probable causes of the condition? 4. If these lesions are there for months or years what will be your differential diagnosis? 4. Slide showing tooth 36 with gold crown and the surrounded gum has been ulcerated 1. What is your differential diagnosis? 2. Describe the lesion as you will write a report to the specialist? 3. Dont remember. 5. What are the causes of xerostomia? and what is the most common cause ? And what is the consequence of Xerostomia?

Oral Radiology (time management is important)

1. PA x-ray of the upper molar area and maxillary tuberocitygive the Anatomical land marks in it. 2. PA of upper premolar with a well defined radiolucent lesion associated with the apex. Describe the lesion and give 5 differential diagnoses. 3. PA showing radiolucent lesion Describe it. 4. Bitewing Radiograph with caries and overhang restorations describe what you can see. 5. In processing x-ray films how do you know that the developer should be replaced? 6. You want to take a radiograph to a patient and there is no barrier in the room what is the best position to stand (put X on the diagram provided) and what should be the distance between you and the patient (in meter and foot)? And why you chose this position and distance?

Oral Surgery
1. Types of antibiotic used if the patient has infection? And write a prescription to one type. 2. What are the causes of Failure of local Anesthesia? 3. What are the indications and contraindications of surgical removal of the third molar? 4. What are the possible emergencies that might happed in the dental clinic? Enumerate.

Infection control
1. Define the standard precautions. 2. What are the Standard precautions? 3. a. Define Tracking. b. something about the critical and semi critical instrument 4. How can you sterilize the Endodontics instruments? 5. Hepatitis C a. What is the causative organism? hepatitis C virus an rna virus structurally unrelated to other hepatitis virus. b. what are the sign and Symptoms of the acute infection? Test for HCV antibody which indicates exposure to HCV but doesnt indicate active infection however presence of positive antibody test and presence of elevated ALT levels indicate some degree of liver damage. if infection is established a liver biopsy is indicated to determine the severity of infection. Virus can cause long term liver problems such as liver cirrhosis and hepatocellulat carcinoma. c. what are the mode of transmittion of the disease? Blood borne virus its transmitted when the infected blood enters the blood stream of other person, unsterile infected drug use. 2. receipt of blood transfusion or blood product prior to 1990 after feb 90 in Australia its generally safe., needl stick injury.

Mother to child risk of transmission is 5%, no cases of transmission via milk. d. how can you deal with a Hepatitis C patient? e. Why Hepatitis C is of Major concern to the population? 6. Enumerate four instruments that should be discarded in the sharp container and four materials that should be discarded by incineration (I dont know what that means!!!)

The second day (written) Pedodontics

1.MCQs central incisor fracture with pin point exposure , block injection to a child compared to an adult, PA with carious D close to the pulp with a resorb root , amelogensis imperfecta , consequence of Amelogensis imperfecta , cause of lesion on the lower lip 2. Photo with badly carious lower 6s what is the cause and what is your management? Pg 47 odell 3. Child aged 7 had avulsed his central I one hour ago and the tooth kept in milk until replanted write you management for the next 24 months. 4. Photos and radiographs for a child 5 years old with caries every where do the charting and write a treatment plan for the child...The child is co-operative. 5. If the child has a congenital cardiac problem what will be the changes to the treatment plan. 6. What are the pharmacological types of behavior management? 7. Types of suture used for children.

Case assessment
Patient 50 years old complaining of pain and tenderness in the upper right quadrant bleeding on brushingand bad taste in the mouth(x-rays and periodontal charting is given)on examination tooth 15 has been endo treated 7 years ago and received a crown 5 years ago( overhanged) and has a pocket of 5 mm 1. What are the probable causes of the pain and explain why? 2. What is your management (treatment options) for this tooth according to your differential diagnosis? 3. What other treatment the patient needs (to other teeth) and give the long term treatment plan.

Periodontics
1. Patient has a lone standing molar and this tooth will be used as an abutment to a partial denture how can you assess the tooth as periodontally safe to be used as an abutment? 2. What are the signs and symptoms of chronic periodontal disease? 3. 4. Patient smoker for 20 years and diabetic and has a neglected mouth what will be you initial management? 5. What is the relationship between Gum recession and attachment loss and what is the clinical significance of gum recession?

Prosthodontics
1. Why it is preferred to use hard bases during the try in procedure? 2. What is surveying? What are the indications of surveying? And why do we use the double cast technique? 3. What are the steps for infection control you should do when you take the denture from the patient mouth for adjustment?

4. Upper Partial denture design (upper and lower cast provided) and it should be hygienic, and the patient is concerned about esthetics and has a high lip line (there was 22, 23 missing in addition to other teeth but I cant remember them 5. Write a lab prescription.

Monday (clinical work) Crown and Bridge

The task is to prepare 21-23 for PFM Bridge with equigingival margin. (3 hours 15 minutes) for Viva 1. After you finish your preparation what are you going to do? 2. What is the impression material you are going to use? And why? 3. When you take the impression what should you check? 4. Where will you put your margin? 5. Why supragingival? And why subgingival? 6. How do you do gingival retraction? 7. Explain the impression technique you are going to use. and what type of tray you use with this impression material? 8. Why do you use haemostatic agent with the retraction cord and what is it? 9. If the patient has a periodontal problem or gingival inflammation what will be your management to this patient to receive a crown or bridge? 10. When you receive the crown from the lab what are you going to check? 11. How do you check the crown in the patient mouth? 12. If you cant insert the crown between the teeth what do you think the cause and what will be your management? 13. How much do you reduce buccally and how much lingually and why? 14. What is the luting cement you are going to use and why? 15 .What do you know about Ketac Cem? 16. Why do you temporize? 17. If your temporization has a ill fitted margin what will happen?

Amalgam
The task is to prepare 4 cavities and 1 amalgum build up ( tooth 16 complex cavity, teeth 24 , 25, 26 with distal caries and 35 MODLi for build up) you will have 3 hour and 15 minutes for the viva. 1. What are the forces that applied on the tooth? 2. How can you prevent you filling from fracture? 3. What is the resistance form and what is the retention form? 4. Why do you use Matrix band? 5. Why do you use wedge? 6. What is the composition of amalgum? 7. What types of Amalgum do you know? 8. Which one is better? And why? 9. What is the liner and what is the base? And why do you use them? 10. When will you use a liner and when a base? 11. What are the types of liner and base you are going to use? And why? 12. Can you use CA (OH)2 alone under the amalgum?

Composite
The task is to prepare two cavities and one build up(tooth 11 has an old composite which was done by someone else and the tooth has fractured so modify the cavity, tooth 14 has a flat pulpal floor and buccal cusp has been capped ..Put retentive features to receive Composite. Tooth 46 for build up) you have 3 hours and 15 minutes for the Viva 1. Are you going to do bevel to the palatal cusp of 14? And why? 2. When and why do you do bevel? 3. How can you protect this palatal cusp from fracture? 4. What is the matrix band you use with composite? Why clear and why metal? 5. If you are using metal how can you do the light cure? 6. Which one is stronger Amalgum or composite? 7. What liner or base you use with composite and why? 8. if the margin of you cavity extend to the root surface what modification you are going to do to the cavity and why? 9. I f the moisture control is difficult and do you use below the composite? 10. What is the name of this technique and what its types? 11. What is the smear layer? 12. Are you going to remove it or not? And why?

Pedodontics
1.I have been showed a slide of a child with swelling of the right side of the face in which the patient cant open his eyesthey want the management of this case and what are the types of Antibiotic you may prescribe for a child. 2. Slide showed a baby with Lower Neonatal teeth that cause a trauma to the tongue and lip what will be you management? 3. After you did an exo to a child bleeding started from the socket you applied pressure but the bleeding continued what are you going to doand there was nothing in the medical history. 4. You gave LA to a child and you about to start exo then the father collapsed what will be your management in this situation? 5. Bitewing (right and left) of a child and explain what do you see.

Oral Radiology
You have to take two x-rays within 10 minutes...for me it was right bitewing and PA of 14, 15 so I used the paralling technique. Dr Keur and Dr Highfield were there watching everything then the Viva 1. I have been showed a bitewing right and left and I have to describe it there was lots of enamel caries, root caries or cervical burnout, overhang restorations, Metallic restoration 2. I have been showed and OPT with a very large radiolucent cyst in the lower anterior region I had to describe the lesion then give the differential diagnosis and most probable diagnosis and what is the age of the patient.

Oral Medicine
1. Slide showed an exophytic lesion on the buccal mucosa ..Pale in colour, round describe what you see and give the differential diagnosis and what is your management in this case(my differential diagnosis was Lipoma, Fibroma, Haemangioma). 2. Slide showed the palate of a child normal in shape but with bluish discoloration describe what you see and give the differential diagnosisand in case you cant reach to a diagnosis what are you going to do..

3. Slide of an ulcer on the lateral side of the tongue...Describe the lesion, what questions you should ask the patient...give the differential diagnosis what will be your managementand how can you differentiate clinically between traumatic ulcer and Sq.Cell Carcinoma ? 4. What are the causes of ulcers in the mouth?

Oral Surgery
1. First there were some instruments on the table and I have been asked which instrument I will use to extract 16 and what is the name of it and why you choose this one 2. if you extract the 16 and when you removed the tooth you noticed that the distal root has been left in the socket and you tried to remove it the you feel that it was not there where do you think it has gone and what is your management? What are you going to tell the patient? Are you going to prescribe antibiotics? What kind of Antibiotic and what is the dose and for how long? 2. What are the other reasons for prescribing Antibiotics? 3. Who are the patients that may require prophylaxis antibiotics? Do you think that the prophylaxis antibiotic is really important? (Check the recent British dental journal about that cus Im not sure about the answer)and what do you give? 4. Patient collapse on the dental chair what will be your management? (Everyone has been asked about CPR) 5. What are the important things that should be available in every clinic? (Glucose, Oxygenetc) 6. Explain how do you give block injection? 7. OPG asking about (Calcified styloid process and the Syndrome associated with, external auditory meatus, Zygomatic Arch, articular eminence) 8. What is the absolute contraindication of lignocaine with adrenaline? Do you think that any one could have sensitivity to the adrenaline? Why not? Then Ive got an patient required the exo of 32, 33, 34 for perio reasons and there was nothing in the medical history except she is a smoker and taking sleeping pills 2 at night I used Xylocaine with adrenalineby the way check about the Citanest cus I think it is not available any more

Endodontics
You will be given a block with 3 teeth and asked to prepare an access cavity to all of them then determine the working length to one canal only then they will br assessed before you proceed 1. Are you happy about your working length? 2. How many roots do you expect to find in such a tooth? Then you will do the instrumentation and assessed before obturation (dont wait until you will be asked about the method you used for instrumentation once they start the assessment talk about the step back tech. and what your initial file is and how did you do the instrumentation ) 1. Are you happy about your instr.? 2. Why did you choose this initial file? 3. If your initial file was loose are you still going to precede 3 files above this? What are you going to do? Then you do the obturation and they will require the final x-ray...also dont wait to be asked explain your obturation technique... 1. Are you happy about you obturation? 2. What sealer did you use? Why? What good about it and what not good? 3. How long is the setting time for AH 26? 4. What filling material are you going to use to fill the tooth coronally? 5. If composite are you going to use it alone? 6. Why do you use GIC? Rubber dam task was to isolate tooth 37 which was prepared to receive crown 1. Why do you use rubber dam? Advantages

2. What is the strong intra canal material you might use? 3. Why did you put floss around the bow of the clamp? 4. Why did you use the plastic frame?

Periodontics
I had a patient who has nothing in the history not smoker, not diabetic, brush twice a day, and use Listerine once at night with no family historybut she has an advanced chronic periodontal diseaseany way you have to take a full history and do the charting with an assistant to one quadrant and do scaling and root planning to another one. Once they come to assess you work start talking about your patient as you presenting the case dont forget to ask your patient about everything. Then after the patient being dismissed you will be given half an hour or so (for me it was one hour and a half cus my no. was the last one) to arrange your papers and determine your diagnosis and write your treatment plan then the viva most of the questions will be case related 1. What is your diagnosis? Why? 2. What do you think about the prognosis of these teeth? 3. Are you going to tell your patient that he will lose these teeth? 4. In such an advanced case what will be your management? 5. Which instrument did you use for scaling and root planning? 6. Why do you use curette and why do you use scalar? 7. What do you think about the quadrant you scale and the pocket depths? 8. Determine the factors that make you know that this tooth will be lost? 9. What is the sign and what is the symptom? Is mobility a sign or symptom? 10 .What is your patient age? (45 years) do you think it is common in Australia to find such an advanced disease in this age????What is the ratio to find an advanced disease in such age comparing to the ratio of the disease in age 75 !!!!!!!!!! 11. What is you patient job? (Prison officer) do you when she finished her last shift????What she think about her job? (Stressful) 12. So what is the relationship between stress and periodontal disease?!! 13. Do you know if your patient brushed her teeth this morning???????? 14. Are you sure? (If yes or no)