FCD(SA) OMP Part II THE COLLEGES OF MEDICINE OF SOUTH AFRICA Incorporated Association not for gain Reg No 1955/000003/08

Part II Examination for the Fellowship of the College of Dentistry of South Africa 17 March 2009 Paper I Oral Pathology (3 hours)

All questions to be answered. Each question to be answered in a separate book (or books if more than one is required for the one answer)

Section A : Compulsory 1 Classify and describe the peripheral/exophytic gingival lesions. Comment on the different nomenclatures (that exist in the literature) for those lesions that (can) present with calcifications. [25]

Describe and explain the application of immunofluorescence in the correct diagnosis of desquamative gingivitis. [25] Section B : (Choose 2) 3 Describe briefly the pathogenesis, histological and clinical features of i) ii) iii) iv) 4 Oral discoid lupus Wegeners granulomatosis Traumatic eosinophilic ulcer Oral Kaposis sarcoma. (6) (7) (6) (6) [25]

Describe the application of oral epithelial dysplasia grading and the microscopic criteria that are used in the grading process. Make comments on the reliability of histological findings in biopsies of clinically suspect mucosal lesions. [25] Classify the pigmented lesions/changes of the oral mucosa and mention, where applicable, the systemic factors involved in the aetiology. [25] Discuss the aetiology and diagnosis with criteria of i) ii) Sjgrens syndrome. Squamous papilloma. (15) (10) [25]

GKT(SA) OMP Deel II DIE KOLLEGES VIR GENEESKUNDE VAN SUID-AFRIKA Ingelyfde vereniging sonder winsoogmerk Reg Nr 1955/000003/08 Deel I Eksamen vir die Genootskap van die Kollege van Tandeelkunde van Suid-Afrika 17 Maart 2009 Vraestel I Mondpatologie (3 uur)

Al die vrae moet beantwoord word. Elke vraag moet in aparte boek (of boeke indien meer as een nodig is vir vraag) geskryf word

Afdeling A : Verpligtend 1 Klassifiseer en beskryf die perifere/eksofitiese letsels van die gingiva. Gee kommentaar oor die verskillende benamings (wat in die literatuur voorkom) vir daardie letsels wat met kalsifikasies (kan) presenteer. [25]

Beskryf en verduidlik die toepassing van immuunfluoressensie vir die korrekte diagnose van deskwamatiewe gingivitis [25] Afdeling B : (Kies 2) 3 Beskryf kortliks die patogenese, histologiese and kliniese kenmerke van i) ii) iii) iv) Orale diskoide lupus Wegener se granulomatose Traumaties eosinofiel ulser Orale Kaposi se sarkoom. (6) (7) (6) (6) [25]

Beskryf die toepassing van die gradering van mondepiteel displasie en die mikroskopiese kriteria wat in die graderings proses gebruik word. Gee kommentaar oor die betroubaarheid van histologiese bevindings in biopsies van klinies verdagte slymvliesletsels [25] Klassifiseer die gepigmenteerde letsels/veranderings van die mond mukosa en noem, waar dit van toepassing is, die sistemiese faktore wat betrokke is by die etiologie. [25] Bespreek die etilogie en diagnose met kriteria van i) Sjgren se sindroom. ii) Plaveisel papilloom. (15) (10) [25]

FCD(SA) OMP Part II THE COLLEGES OF MEDICINE OF SOUTH AFRICA Incorporated Association not for gain Reg No 1955/000003/08 Part II Examination for the Fellowship of the College of Dentistry of South Africa 18 March 2009 Paper II Oral Medicine (3 hours)

All questions to be answered. Each question to be answered in a separate book (or books if more than one is required for the one answer)

Bis-phosphonate therapy has become fairly common in treatment of not only osteoporosis, but also as supportive therapy for oncology patients a) Describe what possible intra-oral complications this treatment can cause and describe how you would manage this. (10) b) Discuss the possible theories of the pathogenesis of bis-phosphonate related oral complications. (10) [20]

Discuss Potential Malignant Disorders under the following headings a) b) The latest classifications of Potential Malignant Disorders. (5)

Management of Potential Malignant Disorders with specific reference to severe cases against the background of field cancerization. (15) [20]

The world population is aging as people live longer, bringing with it a shift in oral medicine related complaints. We are seeing more patients with xerostomia than ever before a) Give an overview of the aetiology of xerostomia in the elderly. b) Discuss how you would manage patients in the above categories. (10) (15) [25]

Discuss how the clinical characteristics of oral ulceration will help in the establishment of a differential diagnosis. [15] Give an overview of the pharmacological choices of a specialist in oral medicine in the treatment of oral conditions with an immunological background. [20]

GKT(SA) OMP Deel II DIE KOLLEGES VIR GENEESKUNDE VAN SUID-AFRIKA Ingelyfde vereniging sonder winsoogmerk Reg Nr 1955/000003/08 Deel I Eksamen vir die Genootskap van die Kollege van Tandeelkunde van Suid-Afrika 18 Maart 2009 Mondgeneeskunde Vraestel II (3 uur) Al die vrae moet beantwoord word. Elke vraag moet in aparte boek (of boeke indien meer as een nodig is vir vraag) geskryf word

Bisfosfonaat terapie het redelik algemeen geraak in die behandeling van nie net osteoporose nie, maar ook as ondersteuningsterapie vir onkologie pasinte. a) b) Beskryf watter moontlike binnensmondse komplikasies hierdie terapie kan veroorsaak en beskryf hoe u dit sal hanteer. (10) Bespreek die moontlike teorie vir die patogenese van bisfosfonaat verwante orale komplikasies. (10) [20]

Bespreek potensieel maligne toestande onder die volgende hoofde a) b) Die mees onlangse klassifikasies van potensieel maligne toestande. (5)

Hantering van potensieel maligne toestande met spesifieke verwysing na erge gevalle teen die agtergrond van field cancerization. (15) [20]

Die wreld populasie is besig om te verouder soos mense langer lewe, wat verskuiwing in mondgeneeskunde verwante klagtes meebring. Ons sien meer pasinte met xerostomie as ooit te vore a) b) Gee oorsig van die etiologie van xerostomie in bejaardes. Bespreek hoe u pasinte in bogenoemde kategorie sal hanteer. (10) (15)

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Bespreek hoe die kliniese eienskappe van orale ulserasie kan help in die bepaling van n differensile diagnose. [15] Gee oorsig van die farmakologiese keuses van spesialis in mondgeneeskunde in die behandeling van orale toestande met immunologiese agtergrond. [20]

FCD(SA) OMP Part II THE COLLEGES OF MEDICINE OF SOUTH AFRICA Incorporated Association not for gain Reg No 1955/000003/08 Part II Examination for the Fellowship of the College of Dentistry of South Africa 19 March 2009 Periodontics Paper III (3 hours) All questions to be answered. Each question to be answered in a separate book (or books if more than one is required for the one answer)

There is a growing trend amongst patients to demand immediate placement of dental implants in the event of losing teeth. Discuss this treatment modality critically, with special reference to the treatment planning, surgical approaches and success rates. Compare where applicable with a delayed approach. [20] The treatment of periodontitis will be strongly influenced by genetics; discuss this statement in detail, with special reference to diagnostic tests that can be utilised in the decision making. [20] The biggest challenge in implant dentistry is to create and maintain interdental papillae over the long-term, especially in the aesthetic zone. Against this background, discuss treatment plans for a 24-year-old female patient, with missing 12,11,21 and 22 teeth. Discuss all the relevant factors that will impact on the final solution and motivate your choices for the final treatment. [20] Discuss risk factors for periodontitis. [15]

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Discuss the use of Bone Morphogenetic Proteins in guided bone regeneration intraorally, with reference to the current shortcomings of this type of treatment. [15] Criticise the 1999 AAP classification for periodontitis, with specific reference to the entity of Aggressive Periodontitis. [10]

GKT(SA) OMP Deel II DIE KOLLEGES VIR GENEESKUNDE VAN SUID-AFRIKA Ingelyfde vereniging sonder winsoogmerk Reg Nr 1955/000003/08 Deel I Eksamen vir die Genootskap van die Kollege van Tandeelkunde van Suid-Afrika 19 Maart 2009 Periodonsie Vraestel III (3 uur) Al die vrae moet beantwoord word. Elke vraag moet in aparte boek (of boeke indien meer as een nodig is vir vraag) geskryf word

Daar is toenemende neiging onder pasinte om onmiddelike plasing van tandheelkunde inplantate te eis wanneer tande verloor word. Bespreek hierdie behandelingsmodaliteit krities, met spesiale verwysing na die behandelingsbeplanning, chirurgiese benadering en sukseskoers. Vergelyk waar van toepassing met vertraagde benadering. [20] Die behandeling van periodontitis sal tot groot mate benvloed word deur genetika. Bespreek hierdie stelling in detail, met spesiale verwysing na diagnostiese toetse wat gebruik kan word in die belsuitnemingsproses. [20] Die grootste uitdaging in inplantaat tandheelkunde, is om interdentale papille te vestig en te behou oor die langtermyn, veral in die estetiese sone. Teen die agtergrond, bespreek behandelingsplanne vir n 24-jarige vroulike pasint met vermiste 12,11,21 en 22 tande. Bespreek alle relevante faktore wat n impak sal h op die finale uitkomste en motiveer jou keuse vir finale behandeling. [20] Bespreek risiko faktore vir periodontitis. [15]

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Bespreek die gebruik van been morfogenetiese proteiene in gerigte beenregenerasie binnemonds, met verwysing na die huidige tekortkominge van hierdie tipe behandeling. [15] Kritiseer die 1999 AAP klassifikasie vir periodontitis, met spesifieke verwysing na die entiteit aggressiewe periodontitis. [10]