http://forums.studentdoctor.net/threads/official-nbde-part-2-study-q-a-thread.

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Endo Diagnosis:

QUESTION: which teeth do you perform pulp eval on?

a. tooth only
b. tooth and neighboring teeth---?
c. tooth, neighboring teeth, contralateral tooth
d. tooth, neighboring teeth, opposing tooth
QUESTION: When testing tooth for cold; test adjacent teeth and opposing teeth & contralater
teeth)

QUESTION: Is an apical radiolucency present for a long time with no symptoms and no sinus tract
associated with necrotic pulp or asymptomatic apical periodontitis? Asymp chronic periodontits
QUESTION: You have a tooth, no pulp, but periapical radiolucency, you do access and find no canal,
what do you do? - I said dont try to be a hero, refer to an endodontist
QUESTION (DAY 2): A molar is super-erupted, but has irreversible pulpitis, what do you do? RCT
and Crown (other choices were EXT, just do crown this was tricky because to answer the
question, you have to look at the patient dental chart and findings)
QUESTION: 5yrs old patient, he fell down 2 months ago, and hit his #E when he fell down, the tooth
is now discolored, what do you suspect? Necrotic pulp.

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QUESTION: Same patient as above, there is a red swollen lesion on the gingival of tooth #E, what is
most likely be? Sinus tract (other choices, periapical cyst, periapical granuloma, etc)
QUESTION: Same kid from above, What do you recommend for this tooth? EXT!
QUESTION: What does radiolucency at furcation of primary M1 in 5yo usually indicate: erupting
permanent PM1, necrotic pulp, normal anatomy

a. Necrotic pulp it is in a 5yo so man PM1 shouldnt be causing resorption yet

QUESTION (DAY 2): A case of a patient with tooth that has sensitivity that lingers with thermal test,
and positive to percussion, what does the patient have? Irreversible pulpitis with acute
periapical abcess (other choices were Irreversible puplitis with no acute peripical abcess, and 2
other choice with reversible pulpitis in them).

QUESTION: Prolonged, unstimulated night pain suggests which of the following conditions of the
pulp?
A. Pulp necrosis
B. Mild hyperemia
C. Reversible pulpitis
D. No specific condition
QUESTION: Chronic periradicular abscess indicates: necrotic pulp

QUESTION: X-ray of PA R/L of a primary teeth: Normal R/L because perm tooth is erupting
underneath
QUESTION: Lucency is seen in PA, its under the furcation of primary molar, what could this be due to?
Necrotic pulp (other options were roots are resorbing, permanent tooth caused it, some other stuff)
QUESTION: Little girl had ALL, had radiolucency in furcation of primary 2nd molar. What is the
treatment?
Extraction
Pulpotomy
Pulpectomy

QUESTION: primary tooth got necrosis, and the inflammation went down through furcation and
affects permanent tooth. What is it gonna cause to permanent tooth? Can disturb ameloblastic
layer of permenant successor or spread infection

QUESTION: Radiolucency in furcation of primary tooth? Necrotic, extract

QUESTION: In a primary tooth apical infection the first radigrapoh sign is where?- in the furcation.
QUESTION: Most common medication for pulpectomy/pulpotomy? FOROMCRESOL

QUESTION: calcium hydroxide is contraindicated in pulpotomy in a child because it causes

irritation leading to resorption in primary teeth
QUESTION: 5.38 picture: know when to extract

If its a primary 1st with furcation involvement: EXT

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If it's a primary 2nd, furcation, but restorable: PE

If its any other primary tooth no furcation: PO

QUESTION: The best method to test newly erupted primary teeth percussion
QUESTION: Which is incorrect? Do EPT for traumatic tooth

QUESTION: Least reliable test on primary teeth

Electric pulp test
Percussion (MOST RELIABLE)
QUESTION: If you have pain, what would be the hardest to anesthetize?

a. Irreversible pulpitis and maxillary

b. Irreversible pulpitis and mandibular
c. Necrotic pulp and maxillary
d. Necrotic pulp and mandibular

When irreversible pulpitis is a factor, the teeth that are most difficult to anesthetize are the
mandibular molars, followed by the mandibular premolars, the maxillary molars and premolars,
and the mandibular anterior teeth. The fewest problems arise in the maxillary anterior teeth.
Hargreaves, Cohen. Cohen's Pathways of the Pulp, 10th Edition. Mosby, 052010.

QUESTION: pulpal pain that only occur at night with no stimulation: pulpal necrosis
QUESTION: when the heat apply to tooth, lingering pain for several minutes: irreversible pulpitis
QUESTION: what is diagnosis: lingering pain to cold and sensitivity to percussion?Irreversible pulpitis
and acute periapical abscess
Usually periodontal abscess is sensitive to percussionirreversible is usually percussion
positive
QUESTION: A tooth is not responsive to cold, not to percussion, and palpation is tender: necrotic pulp
and chronic apical periodontitis. irreversible pulpitis and normal apex) there was not an item saying
necrotic pulp and normal apex)
QUESTION: Which of the following least important factor in referring an endo case to specialist?
Dilacerations, calcifications, inability to obtain adequate anesthesia? Lease import is mesial inclination
of a molar*** correct answer
QUESTION: 7 yr old boy has vital exposure of tooth 1st perm max molar. What do you do for
treatment. Pulpotomy carious? Pulpotomy.

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QUESTION: Child had carries exposure on primary 1st molar.what to do pulpotomy
QUESTION: A 7-year-old patient fractured the right central incisor three hours ago. A clinical
examination reveals a 2-mm exposure of a "bleeding pulp." The treatment-of-choice is

A. pulpectomy and apexification.

B. pulpotomy with calcium hydroxide.

C. direct pulp cap with calcium hydroxide.

D. one-appointment root canal treatment.

QUESTION: Did pulpotomy in a 7 yr olds pulp exposed decayed tooth #30 why? To allow
completion of root formation (apexogenesis)

QUESTION: Why would you do a pulpotomy in a mandibular first molar of a 7 year old? To continue
physiologic root development

Apexification: Create an apical barrier in a necrotic tooth with an open apex.

Induce a calcified apical barrier by placing dense calcium hydroxide paste after the
instrumentation. Canals are obturated when barrier is formed in 36 months.
Placement of an artificial apical barrier, such as MTA, prior to obturation. This method, can
be completed in a day or two, appropriate when patient compliance or long-term follow-up
care is questionable.

Apexogenesis: Vital pulp therapy performed to allow continued physiologic development and
formation of the root.
Place calcium hydroxide over the radicular pulp stump. Recall every 3 months to check for
the pulpal status.
RCT is indicated when the root development is completed.

apexogenesis & apexification on primary vital & non vital teeth

apexogenesis: tx of VITAL tooth w/ an OPEN apex & pulp exposure using calcium hydroxide to
preserve vitality & encourages the continued development of the root
apexification: tx of NONVITAL tooth w/ incomplete apex formation & pulp exposure using
calcium hydroxide to achieve apical closure

Apicoectomy: (Root-end resection): Prep of flat surface by excision of apical portion of root.

QUESTION: Know when to do indirect pulp cap, pulpotomy, apexification (non vital teeth with MTA),
and pulpectomy (ZOE if apex is not closed in primary teeth) in pedo patients.
QUESTION: Indications for apicoectomy: RCT cant be done by conventional means, failed existing
RCT and cant re-treat

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QUESTION: why you do apico surgery except : When an apical portion of canal cannot be cleaned,
persistent apical pathology after RCT, apical fracture, overextension of material interferes with
healing.
QUESTION: When do you use an apicoectomy? failing RCT and cant do retreat also w/ post and
cant get to area
QUESTION: If a tooth with previous endodontic treatment becomes reinfected, it is best to retreat it
conventionally by removing the filling material, debride the canals, and refill. However, if the tooth has
been restored with a post, core, and crown, then apical curettage, then an apicoectomy and retrofill
should be performed.

QUESTION: PEriapical lesion biopsied after apicoectomy of RCT treated tooth, tooth still sensitive
tooth, with neutrophils, plasma cells, nonkeratanized stratified epithelieum (islands of), and
fibrous connective tissue abcess, granuloma, cyst,
QUESTION: There is a study that shows there is extraradicular plaque in an infected tooth what
does this mean the Dentist might need to do: I was deciding between mechanochemical irrigation
and debridement of the canal vs doing surgical endo (apicoectomy)

QUESTION: Extraradicular biofilm theory recommends endo with: Crown down, debridgement, Ca(OH)2
therapy? (irrigate and debride)

QUESTION: Why you perform apexification: When you have necrosis on an open apice tooth.
QUESTION: why you do apico surgery : When an apical portion of canal cannot be cleaned,
persistent apical pathology after RCT, apical fracture, overextension of material interferes with
healing.
QUESTION: Why you do apico surgery: When an apical portion of canal cannot be cleaned, persistent
apical pathology after RCT, apical fracture, overextension.
QUESTION: Patient (6 yo), the treatment of choice for a necrotic pulp on permanent first molar would be:
1. Apexification (Non vital) 2. Apexogenesis, (vital) 3. Root Canal Treatment
QUESTION: why you perform apexification(non-vital) :When you have necrosis on an open
apex tooth
QUESTION: Definition of apexification:The process of induced root development or apical closure of the
root by hard tissue deposition NONVITAL
QUESTION: Tx for Traumatic pulp exposure on max incisor that root has not completed formation?
Apexogenesis
QUESTION: pt comes to you and theres non vital tooth with open apex-apexification NONVITAL
QUESTION: irreversible pulpitis with open apex apexification

QUESTION: Six months ago you did a RCT on central with an open apex (the pt was young, but cant
remember the exact age). You place calcium hydroxide in canal and waited the 6 months. You open the
canal but can still pass #70 file through the apex. What would you do?
- *calcium hydroxide
- Zinc oxide eugenol
- gutta percha
QUESTION: Pt is 13 years old and has a non-vital maxillary central. The apex is still open what do you
do.
A. Apexogenesis
B. Apexification** I think this is right I put A.

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 C. Pulpectomy
D. Nothing
QUESTION: Pulp is vital, pts a 8 year old. Apex is open. What do you do.
A. Apexification
B. Apicoectomy
C. Pulpectomy
D. calcium hydroxide pulpotomy.**

Tooth Avulsion: complete dislodgment of a tooth out of its socket by traumatic injury. Short extra-
oral dry time and proper storage medium are key factors in offering favorable treatment outcome.
Indications for treatment: Treatment is indicated when a tooth is completely dislodged from
its alveolus.

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QUESTION: Reason for failure of replantation of avulsed tooth: external resorption, internal
resorption

QUESTION: Most important factor about avulsed tooth Time (other options were like what you store it
in, etc)
QUESTION: why an implanted avulsed tooth fails: outside of mouth too long: too much extra oral
time
QUESTION: Before 15 min what is success rate of avulsed tooth? 90 percent success rate, by 30
min success rate decreases to 50%

QUESTION: why an implanted avulsed tooth fail : a) the dentist curettage the socket b) too much
extra oral time c)the dentist clean the root surface d)failure to place the tooth in the solution ( Fl )
QUESTION: Which is incorrect: should rinse with water if tooth is taken out

QUESTION: Splinting Avulsed tooth 1-2 weeks **yes..mosbys says splint for 7-10 days
QUESTION: How long do you splint after tooth has been avulsed? 1-2 weeks
QUESTION: Splinting avulsed teeth for how many days? 7-10 days
QUESTION: Best substance to place avulsed tooth.? hanks solution(na, K,calcium plus glucose) if not
milk.
QUESTION: What is best storage media for avulsed tooth? HANK(HBSS: Hanks balanced salt
solution) Best solution

QUESTION: If tooth has closed apex, immerse tooth in 2.4% sodium fluoride solution with what pH
for how many minutes? pH of 5.5 (changed the pH) for 5 min

QUESTION: Avulsed tooth should be treated with what to reduce root resorption? 2% Sodium
fluoride for 20 minutes.
QUESTION: Avulsed tooth, extraoral time was less than 60 mins, primary tooth, what you do? Dont put
it back.
QUESTION: If tooth has open apex, and it gets avulsed, how you close it? You use MTA.
QUESTION: Which material is least cytotoxic for perforation repair? MTA
QUESTION: CaOH tx for an avulsed tooth????? Yes or no?
QUESTION: Splint tooth for pt comfort
Avulsion 7-10 days non rigid splint, antibiotics
Rigid splint for horizontal root fractures 3 months
Extrusion is a splint for 2-3 weeks

QUESTION: Intrusion tx of permanent teeth? Reposition and splint

QUESTION: Patient intrudes mature maxillary incisor. Trauma causing deep intrusion to a
permanent tooth causes PULP NECROSIS and conventional RCT is necessary.
QUESTION: Tooth with closed apex gets intruded, what is most likely to occur? Necrosis
QUESTION: Intrusive trauma pulp necrosis, what percent is rate of pulp necrosis? 96 %

RCT related:
Endo tests?

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Percussion- presence of inflammation in PDL or not.
Palpation- spread of inflammation to perodotium from PDL or not.
EPT- Pulp vitality (necrosis or not).
Thermal test (hot & cold)-pulp vitality. Hot (irrev), cold (rev)
QUESTION: Primary purpose of sodium hypochlorite? Dissolve necrotic tissue
***Sodium hypochlorite NaOCl is NOT a chelator, (it dissolves organic tissue)
QUESTION: Bleach is not a chelating agent

QUESTION: Sodium hypochlorite is used for everything except? Chelation

QUESTION: Sodium hypochlorite is not a chelating agent. **It is an 5.25% irrigation solution
germicidal. It is also vital to tissue. Other irrigation solutions include urea peroxide (glycerol based) and
3% hydrogen peroxide. Chelating agents are good for sclerotic canals. Substitute sodium ions and soften
canal walls.

QUESTION: What is the job of Ca(OH)2 during a root canal procedure: Intracanal medicament

QUESTION: which is a chelator for endo? EDTA, sodium hypochlorite, etc.

EDTA is chelator, removes SMEAR LAYER and inorganic material.
(NaOCl = sodium hypochlorite only dissolves organic material, only disinfects and is most
common irrigant.)

QUESTION: EDTA: **Percentage of EDTA: 17%

QUESTION: What is the function of EDTA: remove inorganic material and smear layer

QUESTION: Which one is false about NaOH? Its a chelating agent.

QUESTION: Which one is correct about EDTA? Its a chelating agent.

QUESTION: Chelating agent: EDTA
QUESTION: contraidication for CaOH: Pulp symptomatic for last month..
QUESTION: PAR seen on asymptomatic tooth, when opened the canal is calcified what do you do: do
nothing, refer to endodontist, place EDTA

QUESTION: Internal resorption left untreated can lead to? I think Pink tooth
QUESTION: Similar question: What causes Pink Tooth Mummery? Trauma and infection internal
resorption
QUESTION: treatment for internal resorption (endo): RCT
QUESTION: How to treat internal root resorption : Endo
QUESTION: Internal resorption shows all BUT radiography is symmetrical with the pulp space, can
resorb all the way to the PDL, a treatment option is observe until resorption stops, resorb to create
pink tooth
QUESTION: when a tooth is ankylosed what type of resorption : replacement resorption
QUESTION When you replant teeth, what will happen
a. Ankylosis (will not say that) replacement bone formation ANS

QUESTION: Inflammatory external root resorption? What do you do? Extraction ENDO!
QUESTION: The treatment-of-choice for an external inflammatory root resorption on a non-vital tooth is

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which of the following?

A. Extraction

B. Surgical curettage of the affected tissue

C. Pulpectomy and obturation with gutta-percha and sealer

D. Removal of the necrotic pulp and placement of calcium hydroxide

E.Observation since it is a self-limiting process

QUESTION: when a reimplanted tooth presents external resorption what is the Tx : a) RCT with
gutta percha JUST OBTURATE AND PLACE CaOH
QUESTION: How you manage tooth with external root resorption
b. Instrument and put CaOH
QUESTION: when a reinplanted tooth presents external resorption what is the Tx : a) RCT with
gutta percha b) obturation with CaOH c) extraction
(do CaOH every 3 months until PDL is healthy then complete RCT)
QUESTION: which has the best prognosis
perforation in extneral resorption
perforation in internal resorption??
extruded gutta percha
QUESTION: least likely to result in endo failure? overfilling with gutta percha, inadequate either
obturation or cleaning and shaping (can't remember), lateral root resorption, perforating
internal resorption
QUESTION: cause of grey tooth
blood products in the dentinal tubules (what I put, I think this is correct)
internal resorption
external resorption
calcified canal
(hyperbilirubinemia: grayish-blue: Xtina)
QUESTION: Why are traumatized primary incisors discolored? Pulpal Necrosis and Pulpal
Bleeding
QUESTION: elective endo
pulp exposure
unrestorable tooth
endo contraindicated in: non restorable tooth
QUESTION: Most common cell in necrotic pulp? PMN cells

QUESTION: Biggest reason for failure of RCT cleaning of the canals, proper obturation
QUESTION: root canal failed on upper canine - due to cleaning and shaping
QUESTION: root canal failed on upper canine - (lack of seal)
QUESTION: RCT done 1.5 yrs ago, now radiolucency and fistula - incomplete RCT

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QUESTION: Pt comes in for a RCT on a non-vital tooth with 1mm apical lucency. 5mo later comes back
with 5mm lucency, why?- Improperly done endo, retx. Others another canal, osteosarcoma, carcinoma.

Most common cause of RCT failure is inadequate disinfected RC, 2nd most common cause is poorly
filled canals.
QUESTION: Incomplete removal of bacteria, pulp debris, and dentinal shavings is commonly caused
by failure to irrigate thoroughly. Another reason is failure to
A. use broaches.
B. use a chelating agent.
C. obtain a straight line access.
D. use Gates-Glidden burs.

QUESTION: least likely cause for failed RCT

a. GP beyond apex---causes of failure 1) insufficient canal debridement 2) insufficient
obuturation/leakage.
b. clean & shaping no good
c. obturation no good
QUESTION: Gutta percha, all except adapts to tooth (needs sealer)
QUESTION: Which of the following is not a property of gutta-percha . radiopacity, Biocompatibility,
Antibacterial, Adaptation
QUESTION: Gutta percha has the following advantages EXCEPT: 1.easy manipulation, 2. Adapts to
tooth surface, 3.Anti- microbial,4. Biocompatible

QUESTION: Patient comes back few months after RCT & Crown with pain upon biting, what
happenedcracked tooth, hypersensitivity
QUESTION: Pt has pain in tooth after crown and root canal: vertical root fracture, a lot of these type of
questions, know wehter its vertical, or occlusion problems (sensitive to cold, hot and all that).
QUESTION: Similar questions: Crown cemented two weeks ago is sensitive to pressure and cold, why?
Occlusal trauma
QUESTION: Pain on tooth 2 weeks after crown placement? I put root fracture
***No why would it be root fracture after a crown placement?? it would make more sense that its a root
fracture after RCT not crown placement. I think answer should be hyperocclusion, if the option was there
****
QUESTION: Tooth with endo treated and post with crown have pain after several days esp during biting
and cold: vertical root fracture
QUESTION: Patient has pain 1 month after cemented crown and post and rct, pain on biting, why?
Vertical root fracture
QUESTION: You did endo on patient, weeks later you did CPC after that? Patient has post-op pain on
tooth? Vertical fracture
QUESTION: RCT is contraindicated for a vertical root fracture
QUESTION: RCT is contraindicated for a vertical root fracture
QUESTION: Vertical root fracture non restorable after
QUESTION: Most common cause of vertical rt fracture?
In endo txd teeth: excessive lateral condensation of GP
In vital teeth: physical trauma
QUESTION: Vertical Root Fracture is most likely found? Mand posteriors

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QUESTION: Which teeth do vertical fractures more common? Lower posterior teeth.
QUESTION: What causes most vertical root fractures? Condensation of gutta percha
QUESTION: most probability of vertical root fracture- isolated pocket depth
QUESTION: isolated pocket . What condition? Vertical root fracture
QUESTION: Patient get paid every now and then on a tooth when he eats meal? Cracked tooth
syndrome
QUESTION: Which one has a different transillumination? I said cracked tooth (other choice were crown-
and-root fracture, have no idea!)
QUESTION: which allows the enitre tooth tooth to light up under transillumination? I said
cracked tooth (other choice were crown-and-root fracture, separated tooth, have no idea!) I said
ccraze lines? ? CRAZE LINE (WHOLE TOOTH)
QUESTION: When does transillumiator show evenly through tooth: craze line, crack, fracture from
crown to root: Craze line

QUESTION: when does translumination shows the whole crown : a) fracture cusp b) cracked tooth
c) craze lines
TRANSILLUMINATION: shows cracks. Whole tooth = craze line
QUESTION: Type of fracture that lets light pass completely through
a. crazed CRAZE LINE
b. split tooth
QUESTION: Which will show up on transillumination best?
Cracked tooth
Fractured cusp
Vertical root fracture
Craze line
QUESTION: Vertical root fractures are also called cracked teeth. The prognosis of cracked teeth varies
with extent and depth of crack.
a. Both statements are true
b. Both statements are false.
c. First statement is true, second is false.
d. First statement is false, second is true.
QUESTION: If two cavities were thought to be two separate fillings but upon exam it was a crack through
the isthmus. What do we tx this symptomless crack with?- observe
QUESTION: most common tooth associated w/ cracked tooth syndrome: Mandibular second molars,
followed by mandibular first molars and maxillary premolars, are the most commonly affected teeth.
QUESTION: Crack tooth syndrome is most likely found? Mandibular Molars
QUESTION: Most common to have cracked tooth = mand 1st molar (mand 2nd first) MD
direction
QUESTION: horiz root fracture
a. reduce & immobilize
QUESTION: How do you first tx a horizontal root fracture?
Immobilize the segments

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 Rct
Splint
CaOH
QUESTION: Apical horoziontla root fracture: no pain, what do you do? Rct, scaling, rct if tested
nonvital, monitor 1 year

QUESTION: Horizontal Root Fracture more common in anteriors, the success and healing of
horizontal root fractures is the immediate reduction of the fractured segments and the
immobilization of the coronal segment 12 weeks

QUESTION: Horizontal rooth fracture: take multiple vertical angulated xrays

QUESTION: What teeth most likely to have crown/root fracture max anteriors, mand anterior, max
posteriors, mand posteriors- a strong majority are lower molars (1st)

QUESTION: Most common teeth with crown to root fracture? Mand molars
QUESTION: which tooth is least likely to fracture: mx premolar, mx molar, md premolar, md
molar
QUESTION: which tooth is most commonly fractured? mx incisors, md incisors, etc.
QUESTION: Chronic endo lesion, what type of bacteria? Anerobes ANS (multiple anerobes)

QUESTION: Reason for failed endo?

Seal 2mm away from apex
Bacterial infection
RCT sealer beyond apex
Forgot other one

QUESTION: Endo file breaks when you at 15 file. refer to endodontist.(retrieving it was not an option)
QUESTION: If file breaks tooth asx:
Leave and monitor

QUESTION: You being the best doctor in the world, you broke a 5mm dental instrument in a canal during
RCT procedure, whats the best thing to do? Tell the patient what happened, and refer her to an
endodontist. (Other choices were, take a picture and only tell patient if you see the instrument in there, re-
schedule patient to continue with RCT, Put a watch on it)
QUESTION: Endo on a molar.
Break a file on apical level, what should you do?
-write on med history and continue?
-refer patient to specialist?- if it was in middle third you would continue treatment.
QUESTION: what file was the endodontist using?
Stainless steel
Ni Ti

QUESTION: What is not an advantage of NiTi over stainless steel

Ability to stay centered in canal
Something aided depth penetration into canal
My bad don't remember this question very well

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QUESTION: all are advantages of using nickel titanium endo files over regular steel files except?
a. flexibility (yes)
b. bending memory (yes)
c. direction of the flutes (no)?

QUESTION: What is the weakness of Ni files vs regular- strength, flexibility... and some other choices ( I
wrote strength)
QUESTION: What is the NOT an advantage of stainless steel files? 1. More flexible.., 2. Less chance for
breaking, 3. Allows the file to be centered in canal,

NiTi rotary files remain better centered, produce less transportation, and instrument faster than stainless
steel files due to their superior flexibility and resistance to torsional fracture. They have 10x the stress
resistances of stainless steel (stronger).

QUESTION: Which of the following is not an advantage of Ni-Ti over stainless steel file?
a. Maintains the shape of canal,
b. flexibility,
c. resistance to fracture.

QUESTION: you separate an endo file 3mm from the apex and obturate above it... which case will
show the best prognosis?

a. vital pulp w/ no periapical lesion(yes)

b. vital pulp wI periapical lesion

c. necrotic pulp wI no periapical lesion

d. necrotic pulp wI periapical lesion

QUESTION: Best prognoses for a broken instrument at apical third?

Vital pulp with no PA abscess
Necrotic pulp with no PA abscess
Vital pulp with PA abscess
Necrotic pulp with PA abscess

QUESTION: which has worst prognosis? File fracture, transportation, I put perf through furcation

QUESTION: How many canals do you expect in primary M2: four

QUESTION: Access design mandibular is trapezoid

QUESTION: What is the shape of the access of mandibular 1st molar?
A. Square
B. Trapezoid**

QUESTION: maxillary 1st molar access opening: triangular

QUESTION: Pulpal anatomy dictates a triangular-access cavity preparation in the MAXILLARY

CENTRAL INCISOR.

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QUESTION: why do you do triangular access on incisors (max central inccisor?)

a. to help with straight line access

b. help expose pulp horn

c. to follow the shape of the crown

QUESTION: Ept tests whether its responsive or nonresponsive thats it (not tell level of
necrosis/how vital the tooth is, etc.): Nerve

QUESTION: EPT responsiveness (not health)

QUESTION: How does a tooth covered with crown react to pulp testing--- cold is better test (thermal)

QUESTION: what can you diagnose with the EPT test : pulpal necrosis
QUESTION: How do you differentiate between an endo/perio lesion? EPT
QUESTION: EPT: to differentiate if perio (some response to ept) or endo(necrotic, no response to EPT)
involvement
QUESTION: Vitality test used to distinguish periodontal from endo lesion vitality and probing
depths

QUESTION: know best way to diagnose irreversible pulpitis ? heat. Cold/ thermal test
QUESTION: EPT is more accurate than cold test for pulp necrosis? FALSE

QUESTION: What is untrue about EPT?

It is more reliable than cold testing for necrotic teeth (false!!!)
It gives relative health status of pulp (true)
Tells if there are vital nerve fibers (true)
QUESTION: EPT does NOT indicate health of the pulp

QUESTION: EPT- compared to cold test it is superior (False).

QUESTION: What is not true regarding electric pulp test: Doesnt tell you about vascular or
something like that (doesnt tell you about vascularity of pulp which is true pulpal diagnosis)

QUESTION: Did not respond thermal and ept but response to palpation and percussion? Necrotic pulp
QUESTION: Most reliable way to test vitality of a tooth? EPT (I think Thermal was more correct, damn I
was tired at this point, and I was low on RedBull) **Mosbys states that thermal tests must be done before
a final diagnosis, because EPT can have may false readings
QUESTION: Luxated tooth, negative EPT - disruption of nerves to tooth
QUESTION: Best prognosis of perio endo lesion
Endo with rct perform first
Perio scaling and root planning
QUESTION: what is initial treatment of combination perio and endo lesion: do rct first or perio first,
etc: RCT first

QUESTION: Pulp vitality testing. Difference between perio and endo periapical lesions. Best
prognosis perio started from endo, or endo started from perio?
QUESTION: test performed to differentiate endo vs. perio lesions : Percussion
QUESTION: Percussion: can identify perio involvement
QUESTION: Difference b/w acute apical abscess and lateral periodontal abscess: Vitality test

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QUESTION: lateral periodontal abscess is best differentiated from the acute apical abscess by?

a-pulp testing

b.radiographic appearance

c.probing patterns

QUESTION: how do you distinguish acute apical absess and periodontal absess : vitality

QUESTION: differential diagnosis of periodontal abscess and periradiculal abscess?

a.percussion

b. vitality test

c.palpation

QUESTION: on primary teeth you dont want to use ept thin enamel false results and after
trauma you don't want to use electronic pulp tester.
QUESTION: What is test to diagnose acute periradicular periodontitis sensitive to percussion

QUESTION: Good way to diagnose acute periradicular periodontitis sensitive to percussion

QUESTION: acute apical periodontitis is best diagnosed with: percussion

QUESTION: acute periradicular periodontitis sensitive to what? Cold, Percussion
QUESTION: radiographically the acute apical abscess
a. is generally of larger size than other lesions
b.may not be evident
c.has more diffuse margins than other lesion
QUESTION: What is test to diagnose chronic periradicular periodontitis? Percussion (palpation?)
QUESTION: How do u test a tooth to differentiate between chronic perio and supperative perio?
a. cold test
b. percussion (and lateral percution of course)
c. EPT
QUESTION: Indications of perio lesion vs endo lesion: apical radiolucency and pain upon lateral
pain pressure (not apical)
QUESTION: Which of following is not endodontic in origin: tooth with wide sulcular pocket not
extending to apex
QUESTION: What is feature that makes it a perio lesion thats not seen on an endo lesion: I said it
was there is pain on lateral percussion of tooth and wide space of pocket against tooth

QUESTION: Which of the following conditions indicates that a periodontal, rather than an
endodontic problem, exists?

A. Acute pain to percussion with no swelling

B. Pain to lateral percussion with a wide sulcular pocket

C. A deep narrow sulcular pocket to the apex with exudate

D. Pain to palpation of the buccal mucosa near the tooth ape

15
(true perio-endo lesion) Evaluate strategic value of the tooth. If tx is warranted, initiate endo
therapy first. Perio treatment may be combined with periapical surgery, if needed. Prognosis is
poorest.

If Endo lesion is draining through periodontal ligament space, Complete endodontic treatment and
wait several months to evaluate healing of periodontal lesion

If Perio Lesion has spread to the periapical region, Evaluate vitality of the pulp, institute
periodontal treatment alone if vital (treatment may devitalize pulp).

Endo-perio: pulpal necrosis leading to a perio problem as pus drains from PDL.
Perio-endo: infection from pocket spreads to pulp causing pulpal necrosis.

QUESTION: Endo abscess but no sinus tract, can pus drain through the PDL: True

QUESTION: endo lesion with sinus tract. Do RCT and leave the sinus tract alone, will heal
QUESTION: What treatment is required with tooth with draining sinus tract has been treated via RCT:
no further treatment
QUESTION: when do you puncture? An abcess.
Localized chronic fluctuant in palpation.
Localized chronic hard in palpation (if hard there is no pus)
QUESTION: A patient has a non vital tooth and a fistula is draining around gingival sulcus. What to
do
endo and perio at same time
perio and then endo
only endo
only perio
QUESTION: There usually is no lesion apparent radiographically in acute apical periodontitis. However,
histologically bone destruction has been noted.
a. Both statements are true
b. Both statements are false.
c. First statement is true, second is false.
d. First statement is false, second is true.

QUESTION: Based solely on the sharp transient response of pulp to hot stimuli, what is the periradicular
diagnosis?
a. Acute apical periodontitis
b. Cannot diagnose based on information provided.
c. Acute Apical abscess
d. Irreversible pulpitis

QUESTION: What is the clinical hallmark of a chronic periradicular abscess?

a. Large periradicular lesion
b. Sinus tract drainage
c. Granulation tissue in the periapex.
d. Cyst formation.

QUESTION: Hallmark of periradicular abscess - sinus tract

16
QUESTION: A periradicular radiolucent lesion of endodontic origin on the radiograph may be any of these
histological diagnoses except one. Mark this exception.
a. A cyst
b. A granuloma
c. An Abscess
d. Dentigerous cyst

QUESTION: What complete endodontic diagnosis could be completely asymptomatic but should require
endodontic therapy?
a. Pulpal necrosis and acute periradicular periodontitis
b. Normal pulp and acute periradicular periodontitis.
c. Pulpal necrosis and chronic periradicular periodontitis.
d. Normal pulp and normal periapex

QUESTION: A lesion of non-endodontic origin remains at the apex of the suspected tooth regardless of X-
ray cone angulations.
a. True
b. False

QUESTION: Periapical abscess, what do you do? DO NOT DO RCT FIRST, YOU ARE SUPPOSE TO
INCSION AND DRAINAGE AND PRESCRIBE ANTIOBIOTCS AND WAIT TO DO RCT AT A
LATER DATE
QUESTION: How do you treat perio abscess? I put ENDO first, then possible perio tx later
QUESTION: Acute perio abscess you must drain lesion
QUESTION: Acute perio abscesses that require drainage are usual firm, localized lesion (other
options are fluctuant, local lesion; generalized firm lesion)

QUESTION: First thing do with periapical abscess? Incise and drain,

Use gutta percha to find it
QUESTION: number one thing for acute apical abscess is drainage and cleaning the canal (multiple
questions reformatted that ask about this)

QUESTION: after an endo in maxillary molar what Tx would you for sinus track : no tx

QUESTION: Most critical for pulpal protection ANS. Remaining dentin thickness (2mm)

QUESTION: What will not regenerate after RCT: dentin formation, cementum, PDL, alveolar bone
QUESTION: Each of the following can occur as a result of successful rct tx except which one? - formation
of reparative dentin
QUESTION: What will not regenerate after RCT: dentin formation, cementum, PDL, alveolar bone
QUESTION: Boy has horizontal root fracture in apical 3rd, no symptoms or mobility, what tx? Monitor,
RCT, extract, pulpotomy, splint
QUESTION: A maxillary central incisor of an adult patient is traumatized in an accident. The tooth is
slightly tender to percussion, is in good alignment, and responds normally to pulp vitality tests.
Radiographic examination shows a horizontal fracture of the apical third of the root. The best treatment is
which of the following?
A. Root canal treatment
B. Splint and re-evaluate the tooth for pulpal vitality at a later time
C. Apexification

17
D. Apicoectomy to remove the fractured apical section of the root followed by root
canal treatment
QUESTION: Worst prognosis for RCT ledge formation, vertical fracture during obturation,
instrument gets stuck in apical 1/3
QUESTION: Fracture at apical 1/3, how long do you splint 7-10 days, 2-3 weeks, 4-6 weeks
QUESTION: Nonvital after a fracture? Reevaluate at a later time
QUESTION: a Pt with an endo in a molar tooth, after one year a cyst form, the tooth was extracted,
after another year the cyst was bigger what happened : bad endo, the dentist did not curettage
well when the extraction was done
QUESTION: during root canal you notice you left debris in the canal most likely due to lack of use of
which? Gates burs, broaches, chelating agents? Others? Irrigant??
QUESTION: Taurodontism has enlarged pulp chamber in which direction? apical, occlusal or apical
AND occlusal **** know what tauradontism looks like on x-ray****
QUESTION: Taurodontism pulp bigger: apically

Operative:
QUESTION: Critical pH of developing cavity? pH 5.5*
QUESTION: pH that enamel starts to demineralize 5.5
QUESTION What can tell best thing about caries: past caries history
QUESTION Which is least likely to predict future caries?
Amount of sugar intake
Frequency of sugar intake
Amount of caries and restorations
(I would have prob put amount of caries and restorations b/c this is known to be an indicatior of
past caries not future caries.)
QUESTION: 3 factors that affect caries initiation? substrate, bacteria, host susceptibity
QUESTION: Which of the following is the earliest clinical sign of a carious lesion?
A. Radiolucency
B. Patient sensitivity
C. Change in enamel opacity
D. Rough surface texture
E.Cavitation of enamel
QUESTION: What is true of Strep. mutans?
Can live in plaque,
Can live on gingival
Can live in a child with no teeth
Has to live on a non-shedding surface
QUESTION: Most Cariogenic? Sucrose... S.mutans adheres to the biofilm on the tooth by
converting sucrose into an extremely adhesive substance called dextran polysaccharid.
QUESTION: How do cells first attach- dextran or lextran? **I think its dextran. S. Mutans is involved in
converting sucrose dextran like long chain polysaccharides (glucans/fructans) using enzyme
Glucosyltransferase. This is the main way caries develop.
QUESTION: Caries progression lactobacillus
QUESTION: what contributes to caries formation Lactobacillus

18
QUESTION: What helps in carious process but it is not the primary inititator for caries:
Lactobacillus

QUESTION: Lactobacillus: does not initiate caries but is part of the progression of caries

QUESTION What is the most important etiologic factor in getting caries?

Saliva ph
Refined sugar
fluoride tx
saliva flow
QUESTION: Which race has most caries in kid population?
Hispanics
QUESTION: What race for children has highest caries incidence? HISPANIC
QUESTION: early childhood caries- centrals and molars

QUESTION: Which population has the most number of UNRESTORED caries: black

QUESTION: White females have the most caries in permanent teeth

QUESTION: Know how to determine if a patient is a high caries risk? Assessment

QUESTION: most recent increase in caries is seen in: roots

QUESTION: What one of the following increasing in the US? Root caries

QUESTION: New data regarding caries shows: more smooth surface caries, more pit-fissure caries,
same, more root caries

a. More root caries

QUESTION: Recent survey, what kind of stats on caries?

inc in smooth surf caries - wrong
inc in pit/fissure caries - wrong
smooth surf caries and pit/fissure caries is same - wrong
inc in root caries****
QUESTION: How do you diagnose root caries? Soft
QUESTION: Best indicator of root caries is a soft spot
QUESTION: best clinical determinant of root caries ?

sensitivity to cold

sensitivity to sweets

soft spot on tooth - visual and tactile methods are used for detect caries

QUESTION: Remineralized teeth are they stronger than regular enamel?

19
QUESTION: For a lesion in enamel that has remineralized, what most likely is true? 1. The enamel has
smaller hydroxyapatite crystals than the surrounding enamel, 2. The remineralized enamel is softer than
the surrounding enamel, 3. The remineralized enamel is darker than the surrounding enamel, 4. The
remineralized enamel is rough and cavitated

QUESTION: Sign of remineralization: I put rougher than tooth structure and darker, but not sure
QUESTION: Whats the characteristic of a remineralized tooth? Darker, harder, more resistant to acid
QUESTION: Remineralized lesion is shiny and more resistant to future decay
QUESTION: Characteristic of a lesion that is remineralized:
black, dark, bright
black, dark, opaque
black, dark, cavitated
QUESTION: remineralized lesions, yellow: -more resistant to future caries
QUESTION: Remineralization? Harder than normal. (Pit and fissure are most prevalent caries)
QUESTION: What does arrested caries look like? Black dark
QUESTION: Leathery brownwhite lesion? arrested, acute, chronic
QUESTION: Scleoritc dentin: harder, better to bond to?

QUESTION: Which of these is NOT an important reason for a clinician to be able to distinguish
remineralization? I put color. I have no idea what this was asking.
QUESTION: Most common area for caries initiation? I put cervical to contact, Pit and Fissure
QUESTION: What is the most common site of enamel caries?
pit and fissure*
at the contact point
slightly incisor to contact
slightly cervical to contact
QUESTION: Where does caries start? Apical to proximal contact.
QUESTION: location of interproximal caries lesion : below the contact
QUESTION: Most interproximal decay happens where? Just under the contact.

QUESTION: A class II caries is: Apical to contact

QUESTION: When do you restore a lesion? When there is cavitation (others were when its half
through enamel, when it passes CEJ, when you see it on xray).
QUESTION: When do you tx caries: half way to the enamel, through enamel, when you can see it
on xray (NO) Answer: cavitation

QUESTION: In which of these cases do you start restoration: can see on x-ray, cavitation present,
lesion into enamel, cross CEJ (not DEJ)

QUESTION: when you start to do a caries : a) more than half way into enamel b) in the DEJ c) in CEJ
d) when you see it in the xray
QUESTION: When do you restore a tooth?

a. Either when its CAVITATED or when its in enamel (but this can remineralize..)?
b. Nothing about dentin involvement.

20
QUESTION: Tx of root surface caries (pg 40): what kind of dentin should not be restored?
Eburnated dentin(Sclerotic dentin)

QUESTION: Fluoride is used for? Smooth interproximal surfaces.

QUESTION: Smooth surface caries most likely due to? Plaque
QUESTION: Where does fluoride work the best?
A. interproximal**
B. Pit and fissure (I saw this somewhere and it said smooth surfaces, pit and fissure is
prr/sealant)
**WORKS BEST ON SMOOTH SURFACES***
QUESTION: What caries lesion has a V shape pointing to pulp- occlusal, smooth, root caries
QUESTION: Which of the following is a factor for smooth caries and sugar in-take? Consistency (others
were volume, and other option. Consistency I thought would be like if you keep taking a lot sugar diet on
daily basis)
QUESTION: Which of the following is a factor for smooth caries and sugar in-take? Consistency
consistency b/c if its the sticky type it stays on the tooth longer allowing bacteria to keep pH lower
longer
QUESTION: Caries in children depend most on: amount, consistency, time

QUESTION: occlusal caries where is base and cone? Triangle point at enamel and base to dentin,
dentin base to tip at pulp

QUESTION: Pit and Fissure caries is described as two cones:

a. Two bases are pointing toward the pulp

b. Two apexes are pointing toward pulp>>>> in smooth surface (proximal caries)
c. One apex toward the pulp and one base toward DEJ
d. Both bases facing DEJ

QUESTION: Pit and fissures caries have the base of both triangles lie along the DEJ

QUESTION: pit and fissure caries, base is at dej

QUESTION: DEJ- diff btw smooth caries(conical), occlusal (apex at occlusal), interprox (apex at
DEJ)

QUESTION: conical shaped caries w/ broad base with apex towards pulp is commonly seen in?

a. root caries

b. smooth caries

c. pit/fissure caries

QUESTION: Dx of pit and fissure caries, explorer catch, or dark stained grooves? Others? Inverted V on
x-ray
QUESTION: Most likely dx indicator of pit and fissure carries is what?- explorer catch. Others, xray,
adjacent tooth decalcify, contralateral tooth thingy
QUESTION: enamel caries best detected by explorer catch, pit and fissure stain.

21
QUESTION: 40 y pt w/ all 32 teeth. No cavities. Has stain & catch in pit of molar. what do you do?

a. watch and observe b. sealant c. composite

QUESTION: Pt 32 year old, none of the teeth has restoration, pits and fissure stain? What do you do?
Observe, Fluoride

QUESTION: if you inadvertently seal over caries what happens? Arrested caries.
QUESTION: Fill over a caries arrested caries
QUESTION: If a dentist seals a caries lesion on tooth, what would be the most likely result? 1. Arrest
caries (answer), 2. Extension caries, 3. Discoloration of tooth, 4. Micro-leakage
QUESTION: If you feed a person through a tube, then you decrease risk of caries
QUESTION: mechanism of caries indicator: enters the dentin and binds to the denatured collagen
QUESTION: Caries die- marks denatured collagen
QUESTION: How does caries indicator dye work. Bind to surface collagen of caries
QUESTION: How does caries indicator work? (p.17)
A colored dye in an organic base adheres to the denatured collagen which distinguishes between
infected dentin and affected dentin
QUESTION: What does caries indicator do I put it only stains affected dentin, not infected dentin
QUESTION: What type of caries detection is the Dyfoti used for? Class I Class II, Class III
detection of incipient, frank and recurrent caries, demineralization
QUESTION: DaignoDent is Class I ONLY OCCLUSAL CARIES (pit and fissure)
QUESTION: Incidence of caries in your office this year is 300 out of 1000, last year it was 200, so what is
it for this year? 300/1000
QUESTION: Number of people with caries or other stat your looking for in your office this year is
300 out of 1000, last year it was 200, so what is it for this year? 300/1000 im pretty sure incidence
is NEW cases. And the answer is 100/1000. DESCRIPTIVE STUDY
QUESTION: Incidence of caries in your office this year is 300 out of 1000, last year it was 200, so what is
it for this year? 300-200/1000= 100/1000= 0.1
QUESTION: dentist has 300/1000 patients with periodontitis; last year only 200 had periodontitis
what is the incidence for this year: 10%

QUESTION: Radiographic decay most closely resemble which zone of carious enamel? Body zone*, dark
zone, translucent zone, surface zone
QUESTION: When looking at a radiograph, what zone of caries are you looking at? Body zone
Demineralization.

22
QUESTION: Know what DMFS stands for decay missing filling surface
QUESTION: Know DMFS : Decayed, missing, filled, surfaces

QUESTION: DMFS is for surfaces including 3rd molars 0-160, for primary use def index
QUESTION: what is DMFS : Decayed, missing, filled surfacesIt is a dental epidemiologic
indice
QUESTION: in DMFS s stand for ----------- surface DECAY MISSING FILLED SURFACE
QUESTION: In the DFMS system whats the S stand for?- Surfaces
QUESTION: DMFS stands for? Decayed Missing Fillings and Surfaces

QUESTION: DMF index measures how permenant dentition is affected by caries

QUESTION: Dmf-measures the amount tooth decay

QUESTION: DMFT is for permanent teeth ( no 3rd molars nor primary teeth ) 0-28
QUESTION: DMFT- who has the most F- white, blacks, Hispanic, Indians
QUESTION: Which race has a higher F in DMFT index: White
QUESTION: For adults, black males for untreated decayDMFT
QUESTION: Which population has the most number of unrestored caries: Black
QUESTION: deft= for primary (e=extraction)

QUESTION: which of the following acronyms is only used for kids? PI, def, DMF, OHI-S, another weird
acronym

QUESTION: DEFT for kids

QUESTION: Whats the D__ the one thats only three letter system of tooth carries tracking, what can it
not do?- Track how teeth were lost.

QUESTION: Differences between 245 and 330 burs- 245 bur is 3mm in length, 330 is 1.5mm. All
other dimensions the same except for length.

QUESTION: Difference between but 225 and bur 330: ive never seen 225 before, deciding between
longer bur length for 225 and sharper line angles made with 225 (old exams say 245/255 burs
have longer head so im assuming it was the same, I went with this)

QUESTION: 245 carbide and 330 carbide have what difference? Length distance
QUESTION: 245 bur vs 330 bur - 245 is longer (3mm) 330 (1.5mm) inverted cone

23
QUESTION: burs 245 vs 330 question = 245 is longer!!! (3mm) 330 is 1.5mm in length.

QUESTION: difference between 330 bur and 245 bur: how is the shape, what angle they form,
length and 245 has sharper angle

QUESTION: Example pear shape bur- 56 or 699? (Isnt pear shapedmore like a 330?)
Pear = 329, 330, 245 (330L)

QUESTION: Bur used that converges F and L walls? # 169, 245, 7901,

QUESTION: Bur used that converges F and L walls? #245, 7901, 169 if 169 is not there pick 245

245 = 330L = pear and elongated bur, 169 = tapered bur, .9 diameter

QUESTION: What bur do you use to shape convergent walls for amalgam
The bur # that aids in wall convergence!! They had 169 and 245 not 254!!!
QUESTION: Which bur do you use for peds? A.245 B.18 C.51

QUESTION: which is best for occlusal convergence in a prep, 245 (169 is better for occlusal)

QUESTION: Diameter of 245 bur ? 0.8

QUESTION: What bur use for Amalagam retenetion in class II- 245 or 330

QUESTION: Burs and smoothing out preps? More flutes and shallow, more flutes and deeper, less flutes
and shallow, less flutes and deeper
QUESTION: more Blade? less efficient more smooth,
QUESTION: More blades on bur: SMOOTHER, DECREASED CUTTING EFFICIENCY

QUESTION: More blades on carbide bur = less efficient cutting, smoother surface
QUESTION: More blades on bur = smoother! But poor cutters Less blades = cut better but less
smooth.
QUESTION: increase # blades = increase smoothness, decrease cutting. Decrease blades of bur =
better cut of decrease smoothness.
QUESTION: Which burr is used to smoothe the prep? diamond, carbides with flutes??????
QUESTION: Which high speed bur gives a smoother surface? Plain cut fissure bur = best
cross cut fissure have a higher cutting efficiency

QUESTION: Bur used for polishing Carbide more threads STEEL FOR POLISH

QUESTION: Use a large bur and start in the middle of a cavity

QUESTION: What is the correct method of excavation of deep caries. Long bur from periphery to the
center, large bur from center to periphery, small bur from periphery to center, small bur from center to
the periphery

QUESTION: How to excavate if think might be close to pulp- small or large bur, take out first in deepest
or periphery first **I would think you would use the largest bur that fits, and go around the periphery
and then towards the deepest

QUESTION: Rotary hand instruments: high speed how many round per min? 200,000 rpm

24
QUESTION: know applications of chisel and spoon

Chisels are intended primarily to cut enamels, but spoons remove caries and carve
amalgams
QUESTION: whats difference btwn an enamel hatchet and gingival marginal trimmer (both chisels)
GMT has curved blade and angled cutting edge. Enamel HA: cutting edge in plane of handle

QUESTION: main difference and advantage of using GMT instead of Enamel hatchet?

a. bi-angled cutting surface

b. angle of the blade

c. push/pull action instead of

QUESTION: what can't you use to bevel inlay prep? a. enamel hatchel b. ging marg trimmer c. flame
diamond d. carbide.
QUESTION: What do u not use when beveling gingival margins? Tapered diamond

QUESTION: Instrument to plane gingival margin on a class II?

2 with 3 number and 2 with 4 numbers
Answer has 4 numbers last number is different.
QUESTION: How do you bevel occlusal floor (gave list of instruments)
13,8
15,80
15,95
QUESTION: How do you bevel occlusal floor (gave list of instruments): 15,80
QUESTION: What instrument would not be used to bevel the gingival margin of an MOD prep?
Enamel Hatchet
QUESTION: Proper pulpal floor depth using Bur 245?

is 3mm, so half of it is 1.5 mm which is proper pulpal floor depth

QUESTION: Hydrodynamic theory?

Definition: Postulates that the pain results from indirect innervation caused by
dentinal fluid movement in the tubule that stimulates mechanoreceptors near the
predentin
QUESTION: Sensitivity theory hydrodynamic theory

QUESTION: Most commonly accepted theory of dentinal sensitivity?

A: Hydrodynamic theory

QUESTION: Best theory to explain dentin hypersensitivity. ANS Hydrodynamic theory

QUESTION: You did a prep with high speed and diamond bur, tooth is sensitive, what is it about bur
and handpiece that it caused sensitivity?

A) Desiccation b) traumatized dentin? Heat

QUESTION: Most common pulpal damage from cavity prep heat, dentin dessication

25
QUESTION: What would cause displacement of odontoblastic processes? Thermal, dessication
/mechanical/chemical/
QUESTION: Displacement of odontoblastic nuclei caused by: mechanical, thermal, chemical
QUESTION: What causes the displacement of nuclei in the dental tubules?
Thermal? Chemical?mecanical?dessication???
QUESTION: Displacement of odontoblasts in tubules: Thermal, mechanical, chemical, caries:
related to hydrodynamic theory I think so I put thermal

QUESTION: Wat doesnt cause corrosion of burs? Dry heat

QUESTION: Which method of sterilization does not corrode instruments Dry Heat, Ethylene oxide

QUESTION: Which method of sterilization does not dull carbide instruments Dry heat

QUESTION: Sterilization most destructive to burs: steam heat

QUESTION: What is best to sterlize carbide burs? Autoclave? DRY HEAT or unsaturated chemical
vapor->no corrode or dull
Ethylene oxide is for heat-sensitive instruments.

Amalgam:
QUESTION: Symptom of amalgam toxicity for dentists
QUESTION: Acute mercury toxicity for dentists, first signs nausea, muscle weakness (hypotonia)?,
QUESTION: Acute mercury toxicity for dentists, first signs nausea, muscle weakness?,
Paresthesia = first sign or tremors
QUESTION: Subacute mercury poisoning symptoms hair loss and muscle weakness
QUESTION: Subacute mercury poisoning: Hypotonia- muscle weakness
QUESTION: Mercury poisoning effects? Loss of hair was a choice (I looked it up, and I think that is the
answer)
QUESTION: Most likely for amalgam to fail? Outline cavity design, poor condensation
QUESTION: MOD amalgam with hole why? -poor condensation
QUESTION: Most common reason for Amalgam fracture occuring in a primary tooth: Inadequate
cavity prep (especially the isthmus area)

QUESTION: Most common fracture of Class II amalgam: isthmus

QUESTION: Most common reason for failed amalgam= depth

QUESTION: Most likely reason for fracture line in amalgam? Inadequate depth on prep
QUESTION: Similar question: Most common reason for failed amalgam = depth (prep design)
QUESTION: Most common reason for failure of dental amalgam:
moisture contamination
improper prep design- not enough depth
improper titrutration,
improper condensation
QUESTION: Failure of amalgam - poor condensation (water or saliva contamination during
condensation)
QUESTION: Patient had occlusal amalgam on tooth #30 few weeks ago, one day the dude went to China-
town and was having lunch with his hommies. He bit down on something and the amalgam broke off. He
came back to your office demanding how could this happen with a new filling. What should be crossing
your mind? The prep was not deep enough.

26
QUESTION: Page 48. Table 2-3.Prepped the amalgam, which is incorrect?: Cavo surfaces is
greater than 90 degree

QUESTION: Axial pulp should be ? 0.2-0.5 into DEJ

QUESTION: how far extend pulpal floor in class I amlgam cavity on primary dentition
a. 1mm into dentin **
b. Just into dentin

QUESTION: Greatest wear on teeth enamel? Enamel, hybrid composite, amalgam

QUESTION: Greatest wear on opposing tooth: amalgam, porcelain, microfill, hybrid composite?
Porcelain

QUESTION: Causes greatest wear on enamel? I chose zirconia porcelain, amalgam, enamel, hybrid
composite

QUESTION: Picture of deep amalgam with overhang but it looks really bad why does it look like
that? Corrosion

QUESTION: What is wrong with marginal ridge of DO amalgam of #29? All of the following (except
maybe)? Occlusal wear, over carving, wedge not placed right, i put OVER CARVED
Pic of deep amalgam w/overhand but it looks really bad why does it look like that ?
o corrosion
What is wrong with marginal ridge of DO amalgam of #29? All of the following?
o overcarve

QUESTION: Which tooth will the matrix band be a problem with when placing a two surface amalgam?
to give an idea of the anatomy of the region: mesial on maxillary first molar b/c of the cusp of
carabelli also Mesial Of max 1st premolar (MOST DIFFICULT) > Distal of max molar
QUESTION: worse restorative material for ID canine? gold, glass ionmer, composite,
amalgum? worst will be Composite > GIC> Amalgam> Gold( according to dental
decks composite not given for class 3 DL in canines)

QUESTION: class 3 on a canine, all are appropriate except: gold inlay, composite, amalgam,
glass ionomer
QUESTION: More corrosion in which phase? Tin-mercury phase
QUESTION: What causes corrosion? Silver and tin k[ .....according to first aid pg 76 noble metals
(gold, pd, platinum) are CORROSION RESISTANT, Tin and gold, Gold and silver

QUESTION: What is the corrosive phase of amalgam? Tin/Copper phase, Gamma2 tin/mercury
QUESTION: What causes corrosion in amalgam? Tin
- The most common corrosion products found with conventional amalgam alloys are oxides
and chlorides of tin.
- The chief function of zinc in an amalgam alloy is to act as a deoxidizer, which is an oxygen
scavenger that minimizes the formation of oxides of other elements in the amalgam alloys
during melting.
QUESTION: Zinc in Amalgam, what is used for? **Decreases oxidation of other elements, deoxidizer
QUESTION: What type of Mercury is in the dental office? Inorganic, elemental
QUESTION: Amalgam- most toxic mercury- Elementary murcery, ethyl murcey, methyl mercury
QUESTION: most toxic mercury - methyl mercury (organic mercury)

27
QUESTION: Type of mercury most hazardous to dentist health: methylmercury, ethylmercury,
inorganic mercury, elemental mercury

QUESTION: Amalgam large condenser with lateral condensation is used in: Spherical

QUESTION: What type of amalgam needs to be condensed more? Spherical.

QUESTION: MC amalgam: Irregular cut last cut.
QUESTION: Material to use for best interprox contact of a CLASS II is Admix Amalgam (others
Spherical amalg., Composite w/ and w/o filler)

QUESTION: Over triturating amalgam? sets too fast, decreases setting expansion (increase compressive
strength)
QUESTION: Similar question: Over titrate amalgam?? Decrease setting expansion, (increases strength)
QUESTION: Overtrituation of amalgam causes? Decreased setting time and decreased expansion and
makes it stronger
QUESTION: Huge MOD in posterior restore with amalgam
QUESTION: MOD amalgam with tooth pain? fractured
QUESTION: Tooth #30 has huge MOD amalgam and is deep. Hurts pt when he eats french bread. what
is the cause? a. root fracture

QUESTION: Patient has a line of separation coronoapical (the wont say vertical fracture on the test),
the tooth is asymptomatic and it only hurts when patient eats French bread. What should you do?
Ext only if moveable pieces. If asymptomatic & not moveable fair prognosis RCT

QUESTION: days after placed an MOD amalgam pt present pain in biting and cold : check occlusion.

QUESTION: Placing pin in amalgam restoration, only choices I remember are 1mm pin or 1.5mm
pin. Others didnt make sense. 2mm into amalgam

QUESTION: Threaded pin- Amt in tooth/restoration/angulation

The optimal depth of the pinhole into dentin is 2mm.
Threaded pins used in a dental amalgam restoration should be placed -2mm in depth at
a position axial to the DEJ and parallel to the external surface between the pulp and
tooth surface. Pins should be 2mm into dentin, 2mm within amalgam, and Imm from the
DEJ (to be safe) with no bends in the pins.
QUESTION: What happens to amalgam if it is contaminated with water? Loss of strength
QUESTION: Moisture contamination during amalgam restoration? Decreased strength
QUESTION: If there is water while you are condensing amalgam, what happens? I put decrease
in strength
QUESTION: If there is water while you are condensing amalgam, what happens? Delayed explansion
(severe expansion, corrosion and decreased compressive strength)

QUESTION: What is true of amalgam within a year after placement

Marginal leakage increases as restoration ages
Marginal leakage decreases as restoration ages
No marginal leakage
QUESTION: Marginal leakage in an amalgam after 1 year, then what happens? I put that it
decreases.

28
QUESTION: You have an amalgam that is ditched at the margin by .5mm and no signs of recurrent
decay what do you do: observe/monitor, remove and replace
QUESTION: Amalgam restoration is good, margin is .5 mm open, what do you do? Repair with
amalgam, repair with comp, don't touch it

QUESTION: Know the ideal preps of Amalgam Class I and V. (can leave unsupported enamel in class V)
both into dentin.
QUESTION: Where is it acceptable to leave unsupported enamel? Occlusal of class V amalgam
QUESTION: What do class I & class V Ag ideal prep have in common
a. both slightly extend into dentin
b. both have flat axial & pulpal wall

QUESTION: Indirect restoration over amalgam: in order to get ideal contours

QUESTION: What is the reason you would do MOD onlay vs Amalgam: Better facial contour &
Microleakage

QUESTION: Class 2 amalgam vs class 2 gold inlay except:

QUESTION: Advantage of inlay over amalgam? Esthetics, less tooth reduction

QUESTION: Is the isthmus the same for inlay and amalgam YES

QUESTION: Proximal retention in class II box for amalgam? Retentive grooves, convergence of facial
lingual walls, bevel on axiopulpal line angle, all of the above, none of the above

QUESTION: Resistance form for amalgam prep : bevel in the axiopulpal line angle to reduce stress
and increase RESISTANCE form- ways to resist stress. Flat walls are right angles of tooths long
axis
QUESTION: resistance form for amalgam prep : bevel in the axiopulpal line angle to reduce stress
and increase RESISTANCE form.
QUESTION: how to prevent proximal displacement of Cl II filling - retention grooves

QUESTION: Whats the best way to prevent proximal dislodgement/fracture of class II amalgam filling?
Retentive grooves* I put this, but not 100% sure
converging axial walls (B&L walls)
depth of prep

QUESTION: Proximal resistance form of amalgam restoration comes from what?

a. convergence of buccal/lingual wall
b. retention grooves in axiobuccal/axiolingual walls - for proximal resistance
c. Dovetail - provides retention form
QUESTION: Mesial and distal walls of class I amalgam must be divergent not to undermine
marginal ridges

RETENTION: 1st = BL walls converge, 2nd = Retention grooves/Occlusal dovetail

RESISTANCE: 1st = Flat floors, rounded angles (bevel in axiopulpal line angles)

29
QUESTION: How to account for mesial concavity on maxillary 1st premolar when restoring with
amalgam: custom wedge? Other options, acrylic within matrix, normal matrix create overhang and
recontour
QUESTION: BWX, Tooth #18 has mesial amalgram restoration with overhang and very light contact.
What lead to this Doctor? A wedge was not used! (or poor adaptation of matrix band)

QUESTION: premolar restored with open contact, why?

Wedge not placed right-I think ive seen this question before
Matrix band was not well adapted

QUESTION: Put wedge after matrix

QUESTION: From pt images, Which amalgam filling has the lowest Copper content? One that looks
corroded.

QUESTION: a pt presents with amalgams restorations in good shape, the dentist suggest to change
them for composites due to systemic toxicity of the amalgam what ethic principle is there or the
dentist is violating what principle:,
veracity,
QUESTION: Dentist tells patient they need to replace all amalgams because mercury is toxic to body.
Which principle of ethics does it violate? Veracity? Beneficence
QUESTION: Definition of Veracity - doctor lied to patient about amalgam should be replaced with
composite, because amalgam causes toxicity

Gold:
Malleability deform (without fracture) under compressive strength; ability to form a thin
sheet; gold is malleable
Greatest malleability to least: gold, silver, lead, copper, aluminium, tin, platinum, zinc, iron, and
nickel

Ductilty deform (without fracture) under tensile strength; ability to stretch into wire
greatest ductility to least: gold, silver, platinum, iron,nickel, copper, aluminium, zinc, tin, and lead.

Gold inlay/onlay divergent walls (2-5 degrees per wall), 30 degree bevel margins for better
fit, skirt extend beyond line angle
QUESTION: onlay resistance/retention: 2 to 5 degrees of taper per wall, as long a wall as possible, .
primary retention is from wall height and taper. Secondary retention is from retention grooves,
skirts, and groove extensions.

QUESTION: most rigid: type 4 gold

QUESTION: What is the hardest metal? Gold Type IV
QUESTION: When do use base metal apposed to gold. Long span bridges
QUESTION: Ductility Golds ability to be worked into different shapes

QUESTION: only advantage of porcelain over gold : esthetics.

QUESTION: advantage of gold on occlusal surface, porcelain in facial surface----conserve tooth

structure, minimal reduction...???? Gold is compatable in wear with natural tooth, porcelain gives
esthetics. Gold crown is more conservative.

QUESTION: Reduction dimension for functional/non-functional cusps in gold and PFM

30
Gold: functional = 1.5, non-function = 1. PFM = 1.5-2mm

QUESTION: Why bevel edge of gold- marginal stability

QUESTION: why bevel gold inlay
answer was obvioushad to do with better adaptation. Other choices were not right
QUESTION: Effects burnishability in gold- yield
QUESTION: Ductility Golds ability to be worked into different shapes
QUESTION: What is the reason the burnish gold to the margin: Acute angle of gold margin
QUESTION: Weakest part of the gold mod inlay is its??- cement layer (cement = weakest part of cast
gold restoration)
QUESTION: Gold crown being cemented, which is wrong? Zinc phosphate is not an option. DOES
NOT REMEMBER WHAT THE QUESTION IS ASKING

QUESTION: Zinc phosphate can be used for gold.

QUESTION: Which is not correct? resin ionomer used to cement crown

QUESTION: When is base metal indicated over gold alloy: fpd

QUESTION: When do use base metal apposed to gold. Long span bridges
QUESTION: What is the most accurate pulpal test to determine vitality of a tooth with a full-gold
crown? Electric testing, 2. Percussion test, 3. Palpation test, 4. Thermal test

QUESTION: Recently placed gold inlay; what is the most common reason for pain afterwards?
Fracture of the tooth has to be suspected

Galvanic shock Sensitivity - choose this if only question says opposing dissimilar metal

QUESTION: gold on upper tooth, lower amalgam, patient has severe pain? Galvanic shock.

QUESTION: Gold casting --? Due to hygroscopic expansion or setting expansion

QUESTION: Effects burnishability in gold- yield

QUESTION: Isthmus of MOD prep extend over 1/3 of cusp to cusp, how to treat? amalgam, onlay,
inlay crown
>1/3 intercuspal dimension

QUESTION: Which indicated for MOD with intercuspal dimension > 1/3? MOD amalgam, MOD
onlay, MOD inlay, full coverage
QUESTION: Preparation with isthmus more than 1/3 wide between cusps-inlay or onlay
QUESTION: Best indication for onlay? Low caries index, dentin not supporting cusps.

Want atleast 1mm of dentin supporting cusps.

QUESTION: When is onlay indicated: when cuspal coverage is needed or when cusp undermined by
not enough dentin,
QUESTION: 14 year old with MOD restoration, decay interproximally and undermined enamel in all
cusps.
-onlay(maybe)
-inlay

31
 -crown

QUESTION: Why bevel for a gold onlay? Resistance; percent elongation for burnishing and remove
unsupported enamel

QUESTION: why bevel gold inlay

c. better adaptation
QUESTION: What is the reason the burnish gold to the margin
Acute angle of gold margin
QUESTION: Why bevel edge of gold- marginal stability
QUESTION: which is the only surface not beveled for an onlay (pulpal)
QUESTION: Dentist has to reduce a weak cusp during onlay preparation is to : a) outline form b)
resistance form c) retention form
QUESTION: what form are you taking into account to involve the cusp during the prep of a tooth (I
said resistance, could be outline but I doubt it)

QUESTION: when you include cusp into preparation, what is it called? Is it convenience or retention
form?

Removing cusp affects retention form

Increasing intercuspal space affects resistance form

Marginal ridges help with resistance form

Loss of marginal ridge affects both resistance and retention

QUESTION: Cuspal coverage retention form

QUESTION: Pt w/ onlay, 3yrs later sensitivity- cement wash out?
QUESTION: Reason for using porcelain for posterior onlay (bond to dentin, to correct occlusion,
etc)
QUESTION: use of indium (tin & iron) with alloy is mainly to provide chemical bond with porcelein

QUESTION: Purpose of addition of tin and iron to metal ceramic allows: Chemical bond, covalent
bond with porcelain

QUESTION: Cut onlayfind out margin of crown w/in 1 mm of interseptal bone

a. pack cord, take imp
b. crown length surgery----impinges biologic width
c. use amalgam
QUESTION: In a gold MOD onlay, how are the axial pulpal walls? Converging
QUESTION: Pulpal axial walls converge

QUESTION: Which are incorrect? Inlay and onlay are divergent. They are convergent. ONLY
WALL TO CONVERGE IN INLAY ONLAY = AXIAL WALL

QUESTION: Axial walls converge in inlay preps.

QUESTION: Which is a characteristic of a gold inlay?

32
 A: Axial walls converge toward the pulpal floor
QUESTION: From facial to lingual, the axiopulpal line angle of an onlay preparation is longer than the
axiogingival line angle (if it were not, the preparation would be undercut and the onlay would not seat).
For an MOD onlay prep, the axial walls must converge from the gingival walls to the pulpal wall (for
the same reason, the onlay would not seat if they diverged).

QUESTION: Indication for inlay? low caries risk

QUESTION: When is the best case to use an inlay? Patient with low caries index.

QUESTION: all of the following u can use inlay except (high caries risk)

QUESTION: Where is the MOD inlay hitting when it contacts early?- interprox

QUESTION: What causes most post op sensitivity in direct inlay: Polymerization shrinkage

QUESTION: Patient receives a blow to the chin who has a MOD inlay placed on the maxillary molar 3
months earlier. Now the patient has a vague pain on biting, there are no other symptoms. why? maxillary
sinusitis, m-d fracture,
QUESTION: Reason of reduction of tooth for MOD inlay except- amt of enamal on teeth
QUESTION: Disadvantage of gold inlays. Lack of resistance to wear??
QUESTION: main disadv of gold inlay
a. deform under load- since it is high noble gold and softer, it may have higher creep
b. wear opposing
c. cement is soluble
d. possible attrition

QUESTION: How to remove a gold inlay? Section isthmus and remove in 2 pieces

QUESTION: Cement for porcelain onlay HAS TO BE RESIN

QUESTION: Cement onlay and see black lines few months later MICROLIKAGE
QUESTION: Coefficient of thermal expansion
is most for which material - tooth<gold (most) <amalgam<filled resin<unfilled resin
QUESTION: Linear thermal coefficient is most for tooth- gold- amalgam- composite (most)

QUESTION: What has the largest thermal expansion? Composite? Unfilled resin = 8x. highest

Prosthodontics:
QUESTION: only advantage of resin over porcelain : done in one appointment
QUESTION: Common feature between porcelain veneer and all-ceramic crown preparation rounded
internal
QUESTION: What is the most important thing for retention? surface area
QUESTION: Most lab complain? tooth is under reduced
QUESTION: Porcelain greatest in compression
QUESTION: Porcelain is stronger under compression forces
QUESTION: Porosity in PFM inadequate condensation
QUESTION: Reason for porcelain porosity - inadequate condensation

33
 QUESTION: What is the weakest porcelain? I put Feldspathic
QUESTION: What is the weakest porcelain? pressed leucite, unless feldspathic dental porcelain was an
answer
Feldspathic porcelain <Leucite-reinforced ceramic< Castable glass <Glass-infiltrated
alumina
QUESTION: Best material to oppose a porcelain crown? Porcelain
QUESTION: Best way to see if a crown seats: die spacer
QUESTION: Silver turns porcelain what color? Green
QUESTION: What turns a PFM green? Silver
According to Mosbys, silver (Ag) is not considered noble; it is reactive and improves
castability but can cause porcelain greening.

QUESTION: what component makes a PFM green in the cervical 1/3 copper at the margin its
copper, other places its silver

QUESTION: Dentist has most control in success of PFM: parallelism

QUESTION: What parts of tooth prep can be managed by operator: parallelism, surface area, length,
circumference

QUESTION: Wear of enamel due to porcelain on opposing

QUESTION: What is function of opaque porcelain EXCEPT

mask metal framework

to help come up with a base/stump shade
for initial bond to metal
to decrease contamination of additional porcelain with metal in ensuing firing and baking
procedures

QUESTION: When you receive a crown back and want to seat it what is the first thing you check for?
a. Shade (Aesthetics) or internal
b. Proximal contacts
c. Margins

QUESTION: for a crown try in what would check first : interproximal contacts. (remember check
shade first!)
QUESTION: First thing to check when trying in metal-porcelain FPD? Contacts true if esthetic is not
an option

QUESTION: First thing to check when trying in metal-porcelain FPD? I put contacts, esthetics

Porcelain veneer measurements:

QUESTION: Most technique sensitive part of placing veneers? Preparation, color match, impressing

QUESTION: Pt had veneers cemented with light cured resin. Now comes back few weeks later with
brown staining at gingival margins. Why?
Chromogenic bacteria **
Breakdown of light cured resin cement released some chromogenic substance
Pretty much all the choices other than a had to do with the cement. I didnt know the
answer. They all seemed right. The only think we were taught in Hewletts lecture

34
 was you get brown/black precipitate when you mix viscostat and nephrostat cus of
the action when alum chloride and ferric sulfate mix. But that wasnt an answer
choice.
QUESTION: There is a veneer which is bonded with resin and the patient comes back after a month or so
with a dark stain near margin,reason? Microleakage

QUESTION: The dentist cements the porcelain veneer with light cured resin and the patient returns with
brownish discoloration at the margins.why? not enough cement or microleakage(depends on duration
of pt return)

QUESTION: How much tooth structure needs to removed on the facial for a porcelain veneer? .5
mm

QUESTION: Mid facial reduction of a porcelain veneer? .5mm

QUESTION: when preparing for a porcelain veneer how much would you reduce in the facial 1/3 :

Gingival third:0.3 mm veneer reduction

Facial third: 0.5 mm veneer reduction

QUESTION: Veneer fractures, what do you do? Pumice, etch, microetch, etch, microabrasion,
silaneknow what to do and the order, application of etch to the prep, bonding resin to prep, etch the
inside of veneer, silane the inside of the veneer, luting agent
QUESTION: Patient has an all veneer on incisal edge, small piece of porcelain came off and wants
you to fix the chip only, what is the sequence of events: microethc, etch, silanate, and bonding
agent

QUESTION: What do you use to cement a veneer?

Resin cement
Polyacrylic

QUESTION: Opaque coming through on veneer whats the problem? Veneer under prepped

QUESTION: Advantage of a direct composite vs. a veneer? --direct composit-only 1 appointment vs.
veneer is at least 2
QUESTION: Order of bleaching and veneering process: bleach, wait 2 weeks, prep tooth, cement

QUESTION: When will you bleach teeth in anterior veneer prep- before veneer prep, wait for 2-3
weeks, after preping veneer and then bleach, after cementing veneer and bleach

QUESTION: Pt has veneers from 6-11, which fluoride do you use to not stain?
A. Stannous Flouride
B. Sodium Flouride**
C. Acid Flouride

QUESTION: where will you place the margins in a anterior PFM prep: Subgingivally

QUESTION: minimum incisal reduction in anterior PFM : 2 mm

35
QUESTION: The necessary thickness of metal substructure is 0.5mm . The minimal porcelain
thickness is 1-1.5mm. Thus, the tooth reduction required for a PFM crown is -1.5-2.0mm. The labial
shoulder width is ideally 1.5mm.
QUESTION: Facial reduction for PFM at gingival 3rd is 1.5mm
QUESTION: Reduction for functional cusp bevel on porcelain? 1.5-2mm

minimum metal thickness of 1.5 mm for functional cusp & 1 mm for nonfunctional
2 mm for porcelain
QUESTION: How much reduction would you do for a PFM crown on anterior- 1.5mm on facial
incisal plane not incisal angle

QUESTION: How do you make sure your all ceramic restoration does not fracture? I put you must
have NOT LESS than 1.5mm porcelain @ occlusal

QUESTION: What to do to increase retention of the crown . (All are possible options, EXCEPT!)-
options were- proximal boxes, buccal grooves, functional cusp bevel?
QUESTION: When you have a short crown for pfm: place proximal boxes and vertical grooves to
increase retention

QUESTION: Reason for functional cusp bevel = resistance

QUESTION: Functional cusp bevel: structural durability
QUESTION: Why do a functional cusp bevel on a crown prep? To prevent fracture of the cusp and for
proper casting/fabrication of the crown
QUESTION: Reason for functional cusp bevel: Prevent cusp fracture

QUESTION: In PFM, Porcelain fractures because the junction should be? right angle, not round

QUESTION: When you want to cement crown, what is the sequence?, look inside the
crown(internal fit), contact, then margin Interna;contact margin

QUESTION: Which of the following do you not do in cementation of a porcelain crown: etch enamel
with hydrofluoric acid

QUESTION: With resin cement on all porcelain what is NOT the reason why you use it: for added
retention cements shouldnt be used for added retention, to fill small openings at margin

QUESTION: With resin cement on all porcelain what is NOT the reason why you use it: I put down
for added retention bc I thought cements shouldnt be used for added retention (other choices,
was to fill small openings at margin and something else)

QUESTION: You have a patient who wants an all porcelain on number 8 the incisal edge keeps
breaking off and u have to come in to repair, why does it keep breaking off? Because the anterior
guidance and the protrusive movements/clearance space was not properly
calculated/maintained

QUESTION: Porcelain is strongest under compression or right after being processed and cooled???
QUESTION: #10 crown on a patient is PFM. It looks longer than #7. All of the following maybe the
reason why the crown looks like this, except? Incorrect shade. (Other choices; insufficient tooth prep
(yes), too think metal (yes), too thick porcelain (yes) all of these could have caused it).
QUESTION: what didnt cause the unesthetic opacity of crown: shade selection; other choices were
under-prepared tooth, too thick metal, too thick base porcelain or something like that

36
QUESTION: What could the reason be if you see opaque porcelain in the incisal third of the facial of
the PFM crown: inadequate reduction of the inciso facial part of the tooth

QUESTION: Incisal 1/3 of pfm is opaque white why? Too little reduction

QUESTION: Incisal 1/3 of pfm is opaque white why? Isa id because of too much base porcelain
placed

QUESTION: Anterio pFM, incisal 3rd was radioopague? Improper second plane of reduction**

QUESTION: If incisal edge of PFM is opaque it is because they didnt do a second plane of reduction

QUESTION: Lab overbulks porcelainwhy? Not enough reduction on tooth, compensate for 20%
shrinkage

QUESTION: All porcelain crown on 8 that is too light but it is a good crown what would u do and I
put to whiten the other teeth. (vital tooth bleaching)
QUESTION: crown of inferior molar has a wear facet in porcelain on the mb inclination of MB cusp.
Most likely associated with?
Interference in protrusion? & working interference
Dotn know the other choices

QUESTION: Where do you attach a non-rigid retainder from a FPD? Dont know and dont remember
choices, they were medial and distal of and to somethings.
QUESTION: For a stress breaker on a FPD to be effective it must be- dont know and dont remember but
something mesial of the distal abut and so on and so forth.
isnt that the one with the key and u place on mesial of pontic.??????
QUESTION: A fixed partial denturekeeps breaking. POOR FRAMEWORK.

QUESTION: Most common reason for PFM bridge breakage? Firing schedule, high contact,
inadequate design
QUESTION: FPD is seated during framework try in but when come back for final cementation holds up:
interproximal porcelain overcontoured
QUESTION: All ceramic FPD should cover how much of abutment? I put 270 degrees
QUESTION: crown advantageous except for? I put it has LESS retention than full crown
QUESTION: Resistance to lingual movement of crown? Lingual wall of groove, facial wall of
groove, facial aspect of prep
QUESTION: What prevents lingual displacement of a crown? Lingual wall ( of grooves)

QUESTION: What is the basis for classification of different F P D pontics: Relation of the pontic to
the supporting tissue

QUESTION: Modified ridge lap pontic: Minimal ridge contact

QUESTION: Modified ridge lap has what kind of contact? Minimal contact with residual ridge

QUESTION: The modified pontic how should it touch the gum?

Barely touch it
Impinge on it
QUESTION: pontics : should not blanch tissues

37
QUESTION: pontics : should not blanch tissues

QUESTION: Pontic of 3-unit fpd should rest gently on the soft tissue

QUESTION: Anterior teeth, which pontic is best? ovate or modified ridge, read the case and see
if ext or not, if you can do the ext prior, you can do ovate which is best aesthetic

QUESTION: Pontic length on a bridge, whats most important AP dimension, MD dimension**

QUESTION: Strength of Abutment connection to pontic which is more important? occlusogingival
width

QUESTION: Most important dimension that ensures the metal connector between abutment and
pontic is sufficient (in 3-unit fpd bridge)? occlusal-gingival,

QUESTION: Most important dimension that ensures the metal connector between abutment and
pontic is sufficient (in 3-unit fpd bridge), I said cross section (idk if that makes sense); other options
are buccal-lingual, occlusal-gingival and mesial-distal (I would think its all three but it wasnt an
option)

QUESTION: a pontic in the bridge shows the metal, why?

Underreduction
Framework was not done well( since is a pontic this is probably the answer)
QUESTION: if patient has ging 1/3 translucent of a pontic: prob because of poor shade selection

QUESTION: Edentulous space is wider than adjacent anterior tooth, how to match them? Make
pontic line angles farther apart and deeper interproximal embrasures, make pontic line angles
closer and deeper interproximal embrasures, make pontic line angles farther and shallower
interproximal embrasure, make pontic line angles closer and shallow interproximal embrasures
QUESTION: How do you decrease the width of an artificial tooth? Deepen the facial line angle
proximally and increase the interproximal embrasure, Deepen the facial line angle proximally and
decrease interproximal embrasure, take the facial line angle labially and increase the
interproximal embrasure, take the facial line angle labially and decrease the interproximal
embrasure.

QUESTION: How do you make a crown narrower? move line angles more facially

QUESTION: Antis law; 3 abutments, one being lateral, with 2 pontics, prognosis good, poor, excellent?
Poor? (root surface of abutment teeth have to be greater than root surface of pontic)

QUESTION: Which of the following is not ideal abutment-pontic connection? Lateral Incisor-Central
Incisor (other choices, Central Incisor-Lateral Incisor, Canine-Lateral Incisor, etc)

QUESTION: What is most damaging in canteliever: it was between mand molar pontic-premolar
abutment

QUESTION: Which canteliever bridge would be most destructed of abutment tooth: lateral incisor as
abutment with central incisor as pontic (larger root surface of pontic than abutment)

QUESTION: worst cantilever lateral abutment with central pontic

QUESTION: The strength of soldered connector of FPD in enhanced? 1. Using higher carat solder, 2.
Increasing height (answer), 3. Increasing width, 4. Increasing gap

QUESTION: When soldering, what is the most important factor?

38
 width
height**
etc..
QUESTION: Fixed -do preparation and design.Ex type of margin for ceramic (shoulder). What should be
placed against porcelain bridge. What is a "key"
**NONRIGID CONNECTOR: Key and keywayfor pontics and shortspan bridges where you cant get
proper draw without a lot of tooth reduction. POI is parallel to pathway of retainer.

QUESTION: Keyhole for post and core to prevent rotation

QUESTION: What is an active screw (post) vs. inactive post?
An active post is one that engages (screws into) the dentin in the canal space. Traditionally, the major
concern about active posts has been the potential for vertical fracture of the tooth during placement of the
post. active posts are indicated when the canal length is insufficient to gain adequate retention with a
passive post
QUESTION: What is the advantage of a fiber post over a cast post? Forgot the options but the one I
put was the fiber post is stronger and causes less fracture of the tooth Not sure one other option
was it was fiber post is more radiopaque and another saying that fiber post has the same modulus
of elasticity as dentin.
QUESTION: How does a dowel post and core help prevent vertical fracture? Ferrule, Ventilating groove,
bevel, vertical stop

QUESTION: Dowel core = vertical stop FURREL

QUESTION: What is the point of putting a post on an endo treated tooth? retain the build-up and
restoration (not sure about the restoration part). Retain core
QUESTION: Purpose of placing a post after RCT = retain core

QUESTION: Function of a post?

A: Retain the core
QUESTION: Dowel after endo for: Retention of core (Dowel=post Im guessing)
QUESTION: cast post and core - you put extra slit - what is that for? prevent rotation
QUESTION: how should prep for cast post? Etc. Need at least 4 mm of GP to preserve apical seal

QUESTION: Most important when selecting shade? VALUE. value, transluceny, chroma,
concentration, and hue, color . Value is the most critical of the three parameters when attempting
to match an adjacent natural tooth; hue is the least important

QUESTION: Most important is value when selecting a shade

QUESTION: What is chroma- saturation
QUESTION: What is value- black and white
QUESTION: Hue, Value, Chroma (which one is color?)

QUESTION: Most important color: value

QUESTION: Least importatnt: fluorescence, hue, etc?

QUESTION: When you have color index of 100, which of the following is effected? Value

39
QUESTION: When you have color index of 100, which of the following is effected? I said Chroma.
(others were value, hue, etc)
QUESTION: When you have color index of 100, which of the following is effected? I said Chroma.
(others were value, hue, etc)
QUESTION: Scale of 100

a. Chroma
b. Value
c. Or Hue?

QUESTION: Color value : 0 black 100 : white

QUESTION: Staining a porcelain restoration: Decrease the value

QUESTION: What does staining do for ceramics? Alters hue. Decreases value. Alters chroma.
QUESTION: Crown #9 and #10. One of the crowns looks very light(white). What did the dentist pick
wrong?
Hue
Chroma
Value
QUESTION: When you add a different color to a resin, you increase what? Hue? Value? Chroma

QUESTION: Dentist changes shade with complementary color what does he do: increase chroma?
QUESTION: Add complement color: Decrease Value

QUESTION: A dentist adjusts the shade of a restoration using a complementary color. This
procedure will result in

A. increased value.

B. decreased value.

C. intensified color.

D. increased translucency.

QUESTION: complementary color that changes ? Old TQ A. Value

QUESTION: Complimentary color decreases value

QUESTION: Which can you not do: increase value

QUESTION: brightness is equal to: Value ( you can decrease but not increase it )

QUESTION: What cant occur with the addition of stain? Increase value, decrease value, increase
chroma, increase hue, decrease chroma
QUESTION: What cant you change: hue, increase value, decrease value, change chroma
QUESTION: how to change hue: add orange to it
QUESTION: How do you lower value in a restoration? STAIN, Complement color or orange
QUESTION: Value least, due to lack of variation in mouth=Hue

QUESTION: What complement color to darken porc? gray, orange, ochre, violet. Add gray to
decrease value.
QUESTION: Use complimentary color to change/stain crown to decrease the value most common is:

40
Violet Orange, gray, yellow

QUESTION: complementary color used to change-orange

QUESTION: If you add a complementary color yellow, what happens to the hue? Dec red content of
yellow red shade Side note: adding yellow stain=Inc chroma of basic yellow shade
Pink purple makes yellow yellow red
QUESTION: Which represents position on the spectral wavelength? hue
QUESTION: Wavelength assoc with hue
QUESTION: which color characteristic is dependent on spectral wavelength: hue
QUESTION: what is best way to determine value: open eye as wide as you can, arrange the shade
guide in increasing value (chose the latter)

QUESTION: Value? Most important, Lightness. Put shade guide from light to dark. Half close eyes to
increase sensitivity to better select value.
QUESTION: How pick shade - place values in order, Squint for chroma

QUESTION: Which one can human eye see, hue vs value, vs chroma? Value. (more rods than cones, and
eyes are more sensitive to value)

QUESTION: Avoid metamarism Want consistant look in light

QUESTION: How to prevent metamerism shade under multiple light sources

FUNCTIONAL/NON FUNCTIONAL MOVEMENTS:

Balancing LUBL
Working BULL
Protrusive DUML

Centric Relation: Man to Max

Centric Occlusion: teeth

QUESTION: Non-working movement, which one is true? Lingual cusps of upper molars hit lingual
inclines of facial cusps of mandibular molars.
QUESTION: Non-working movement, which one is true? Lingual cusps of upper molars hit lingual
inclines of facial cusps of mandibular molars.
QUESTION: Non-working contacts mand buccal cusp lingual incline

QUESTION: Contact on lingual portion of buccal cusp of mandibular molar = what kind of
interference? Non-working, working, protrusive
QUESTION: questions on nonworking interference. wear facets on lingual incline of mx lingual
cusp and facial incline of md facial cusp on left side. pt has : left nonworking interference,
protrusive interference, right nonworking interference, etc

QUESTION: Working side interferences are seen on what surfaces? palatal inclines of buccal
cusp of upper and buccal incline of lingual cusp of lower; (the nonworking cusps on the fxnal
side are interfering)
In MIP or CO, the buccal incline of palatal cusp of upper and lingual incline of buccal cusp of
lower. Balanced side interferences are buccal incline of palatal cusp of upper and lingual incline
of buccal cusp of lower (its the working cusps interfering)

41
QUESTION: Wear on buccal of maxillary premolars due to, due to mandibular movement working
or nonworking?
QUESTION: When will the bull rule be utilized with selective grinding? Working side

QUESTION: The mesiobuccal incline on the mesiobuccal cusp of mand molar (with stainless steel
crown) has wear: this is because of movement in which direction(s): I said working and
protrusive movement

QUESTION: #30 gold crown has wear located on the MB cusp of the MB incline, cause protrusive and
working side movement

QUESTION: Max molar on mesial slope of mesial lngula cusp wher do you have wear on lower
teeth? Mesial or diatal incline of either mesial facial aor mid facial cusp? Distal incline of midfacial
cusp

QUESTION: The mesial angle of the ML of max 2nd molar occludes with what on the man 2nd molar

a. Mesial MB cusp
b. Distal MB cusp
c. Mesial DB cusp
d. Distal DB cusp

QUESTION: mesial angle of the L of maxillary second molar occludes with what on the mand 2nd
molar.? Distal of MB CUSP
QUESTION: Pt bites down after cementing down and deviates to the right #30
Lingual incline of the buccal cusp
QUESTION: Crown on number 30, pt tries to close, contact interference deviates to left, lingual incline of
buccal cusp needs to be altered buccal incline of the lingual cusp

QUESTION: #30 hyperoccluded, deviated incline most effected is max/mand balancing cusp?
QUESTION: In restoring a canine protected occlusion, with anterior overbite of about 2mm. The buccal
cusps of posterior teeth should be flat, BECAUSE they will guide the protrusion.
a. both are true
b. only the second statement is true
c. both are false

QUESTION: what kind of occlusion is if in right lateral movement all posterior teeth are not in
occlusion : canine guidance
QUESTION: which of the following would result in inaccurate terminal hinge record? acutely
apprehensive patient, severe skeletal cl III, tooth contact, muscle pain, etc

QUESTION: IF you are making a crown but before you begin, when you do equilibration, what are
you trying to achieve to get rid of the non-working interference?

a. Posterior dissocculusion??

QUESTION: You have a patient who wants an all porcelain on number 8 the incisal edge keeps
breaking off and u have to come in to repair, why does it keep breaking off? Because the anterior

42
guidance and the protrusive movements/clearance space was not properly
calculated/maintained

Bimaxillary protrusions, Refers to a protrusive dentoalveolar position of maxillary and

mandibular dental arches and flare teeth.

QUESTION: Where to the condyles go in CR?-Superio-anterio-Medial

QUESTION: Which anatomical components are responsible for rotation of the mandible? Disc
and condyle
QUESTION: If you both condyle break, what you get? Posterior open bite!
QUESTION: Dislocation of condyle- mandible deviates opposite

QUESTION: What is Bennett angle?

a. it is the angle that is formed by the non-working condyle and the sagittal plane during lateral
movement
b. it is the angle that is formed by the condyle and the horizontal plane during protrusive movements.
c. It is an difference in condylar inclination between protrusive and lateral movements
d. It is the difference between in the condylar and incisal inclinations.

QUESTION: bennett shift mainly on: lateral movement or working side

Composite:
QUESTION: what type of bond is composite on tooth structure?

a. chemical bond

b. mechanical bond (micromechanical)

c. organic coupling

d. adhesion

QUESTION: Two things that account for a successful posterior composite restoration? type of resin
and type of prep
QUESTION: Postoperative MOD composite pain, most likely due to? hyperOcclusion
QUESTION: Few days after placement of composite restoration complains of pain especially with biting
but relieved by cold: check occlusion

QUESTION: What determine class 1 composite prep? - The depth of decay!

QUESTION: What indicates the design of composite class I preparation
Only incorporates pits of lesion - this one
2mm pulpal floor depth
45 degree bevel cavosurface
Ortho
QUESTION: When doing a class 1 with composite what is the requirement: contain to only pit and
fissure caries

QUESTION: consideration for a class I posterior composite restoration :

Case, selection, isolation
QUESTION: What determines composite class 2 prep? Caries, Access

43
QUESTION: prep shape for composite is determined by caries extent
QUESTION: 2 things that account for successful post composite restoration type of resin and
type of prep

QUESTION: When do you replace class 2 composite? - When you have recurrent decay!
QUESTION: When do you replace class 2 composite? When you have ditching at the margin (other
choices were discoloration, and roughness)
QUESTION: You are doing a composite slot on mesial and distal of 1st molar, dds decided to connect
by crossing the oblique ridge, why? Only answer that made sense was that when oblique ridge is
less than 1.5mm you involve it

QUESTION: Restoration of class 2 for posterior with heavy occlusion amalgam, composite, microfill
QUESTION: Class II prep into cementum, how should you restore? GI, Hybrid , non-restorable
QUESTION: What is the main problem with class 2 composite- water or constructions of material
QUESTION: Small occlusal fillings need to be done on posterior, what do you use amalgam,
composite? (small lesion so dont want to take away too much with amalgam), GI
QUESTION: Large MOD composite, whats disadvantage? Occlusal wear

QUESTION: What is not a class I cavity preparation? gingival 1/3 of #19, Lingual pit of #7, Lingual pit of
#18
amount of stress for composite depends on c factor

QUESTION: C factor in class 1 composites, which one is correct? less walls is lower C factor (you
need less walls) for ex, class I composite: 5 bonded/1 unbonded: 5
QUESTION: C factor in class 1 composites, which one is correct? More walls, higher C Factor
QUESTION: which has the highest C factor- class 1 & class 5
QUESTION: What has most stress on it? ( c factor) class IV, CLASS 1
QUESTION: C factor question. Asked which is correctclass 5 is worst, bonded/unbonded,
QUESTION: Which part of composite stains the most- gingival proximal, facial proximal, lingual
proximal, or occlusal
QUESTION: 2ndary caries is most likely at gingival mrgin

QUESTION: Transillumination is useful in the diagnosis of .Class 1, class 2, class5, class 3

44
QUESTION: What do u place on a 75 yo patient with like 8 class v carious lesions? I put GI just
because there a lot of caries but the other options were composite, amalgam and something else.
QUESTION: Class V lesions? Composite or GI?

QUESTION: Pt w/ a lot of cervical caries Resin composite best material to use false. Best would
be GI

QUESTION: Patient had a lot of cervical caries in posterior-resin would be the best to use FALSE GI
QUESTION: pt. comes in and has a lot of class 5 caries- RMGI
QUESTION: 65 y/o pt shows several new caries in molars and pre molars class V what material
would you use : a) amalgam b) composites c) glass ionomer

QUESTION: #5 cervical lesion Class V what do you need to consider? Isolation

QUESTION: Class V onto root: Bevel enamel, 90 butt margin on cementum

QUESTION: What is not an indication for restoring class V abrafaction?
a. sensitivity,
b. esthetics,
c. prevention of decay,
d. prevention of further structure loss,
e. restoring physiological contour

QUESTION: Too light on class v composite, how would u treat?

QUESTION: if a class IV is too light what to do? Add more composite
QUESTION: what to do if Class IV is too light? Stain composite, or veneer ? Or replacement?
QUESTION: Class IV composite, notice it is too light 2 weeks later. Add composite tint or do direct
facial composite in new color
QUESTION: If a dentist notices that a large but acceptable composite is too light a few weeks
after placing it, what should he do? I put nothing

QUESTION: Class 4 stained. Veneered with composite

QUESTION: class 3 extends to facial. The restoration is pigmented but margins are perfectly sealed,
however they have bad color. What should you do? -remove 1mm prep and add more composite
QUESTION: If a patient has a stained but acceptable composite and wants it fixed, what do you
do? I put remove 1mm and replace
QUESTION: Class 3 stained ? Removed? Veneered with composite
QUESTION: Marginal stain on class 3 composite, how would u treat? REPAIR ?? or replace? I would
guess repair I dunno
QUESTION: Patient has class 3 on facial with marginal staining what do you do to fix it: I said
replace with composite

QUESTION: Recently placed a class 3 comp, pt isnt happy with it and has a huge staining on margins
what to do? Replace, remove on margins and place composite, extract/implant, etc

QUESTION: After caries removal sound tissue is on cementum. How do you restore? Build up with GI
and place composite

QUESTION: Prep you did went down to cementum , what d you do to fill it: pdf old exam question
answer says put rmgi then composite on top

QUESTION: Class 3 prep subgingival, restore with GI, followed by composite

45
QUESTION: Subgingival composite where cementum is exposed- what type should u place? Dual cure or
fluoride releaseing composite?
QUESTION: Class 3 composite w/ radiolucency under it this cud result from all the following
except: liner, recurrent caries, contraction from shrinkage of curing, etc. (agus answer:
contraction)

QUESTION: MOD amalgam that passes the 1/3 distance of cusp height, do what MOD amalgam, MOD
composite, MOD onlay, MOD inlay

QUESTION: All are advantages of indirect composite over direct except: better marginal
adaption/seal

QUESTION: Direct composite vs inlay- what is better about the direct composite- I wrote seal

QUESTION: main advantage of doing direct composite over composite onlay?

a. less shrinkage-Ive seen this in other tests

b. better marginal adaptation - best answer among the options

c. greater hardness and wear resistance

QUESTION: Most important factor when placing a composite in post teeth. Case selection
QUESTION: Posterior composite fails because usually water degradation or shrinkage?
QUESTION: Main reasons for failure of posterior composites? I put case selection and technique.
QUESTION: Composite for back molar: technique and case selection
QUESTION: Main reasons for failure of posterior composites? I put case selection and
technique.
QUESTION: Posterior composite failure mostly due to shrinkage
QUESTION: sensitivity following composite restoration in post most common cause---???due to
resin,polymerization shrinkage in margin,shrinkage floor...???

QUESTION: You place a conservative composite on a posterior tooth and the patient returns due
to sensitivity. What is the most likely reason? I put trauma to dentin during preparation, as in
they didnt use bonding agent? But I read in the questions that a lot of people put
microleakage.
Failure decay, microleakage
Sensitivity occlusion, debonding

QUESTION: You place a conservative composite on a posterior tooth and the patient returns due to
sensitivity. What is the most likely reason? Putting large amount of comp while filling, microleakage,
trauma to dentin during preparation, Etch causing pulpal pain, bacteria, gap, cuspal

QUESTION: Post op composite: sensitive

QUESTION: Cause for post-operative sensitivity of composites shrinkage

QUESTION: reason for replacing posterior composite, and factors that affect success
QUESTION: Most common reason for replacing posterior composites: RECURENT caries, inadequate
margins, fracture of composite (ONLINE SAYS: The two main causes of posterior composite
restoration failure are secondary caries and fracture (restoration or tooth)

46
QUESTION: What is the most common reason that posterior composites need replacement? I put
recurrent decay

QUESTION: After placing a crown with composite resin, after six month around the porceline
gingiva there is a discoloration ( brown color) what is the cause: ? Amin discoloration of resin

QUESTION: an anterior composite placed 10 years ago without caries what is the most common
reason to make a new one : color change
QUESTION: How long should you wait after bleaching to do a composite on an anterior tooth? I
put 1 week at least
QUESTION: How long after vialt tooth bleaching can you bond resin to it? 24 hours, 3 days, 1 week

QUESTION: Why do you replace anterior composites- staining

QUESTION: Why do you bevel when placing anterior composite?

Beveling does everything except strong margin in composite
QUESTION: beveling in acid etching composite for.... more surface area.

QUESTION: why do we bevel cavosurface of comp? A: more surface area

QUESTION: Which one is not reason for post-op sensitivity Class I comp? cusp deformation due to
shrinkage force,
QUESTION: You have a pt. with a composite filling that complains of pain to cold a chewing, you ditch it
out with a bur, no more pain. What was the cause of the pain? Polymerization Shrinkage.
QUESTION: Post op sensitivity on MOD so removed a portion of the occlusal and placed more
composite what was cause: fracture, microleakage, inadequate margins and water coming out of the
tubules, acid etch, compression pulling on cusps

QUESTION: Which of the following Is not the reason for postop hypersensitivity of a composite:
options are toxic effect of aci etch on the pulp (I said this one), polymerization shrinkage on the
margins so that bact can come in, poly shrinkage on the occlusal floor (idk what answer is)

QUESTION: Restore tooth with MOD comp. then pt. comes back 2 days later with sensitivity. Then
you put composite over it and relieves the pain.
QUESTION: What is the least likely cause of sensitivity after composite placement? Fluid
movement in pulp caused by open margin

QUESTION: Composite recently placed. all could be a reason for sensitivity. EXCEPT:-polymerization
shrinkage, pulpal irritation from etch, shrinkage created gap for bacteria to go in
1 etchant causes sensitivity
2 gap causing microleakage of bacteria
3 gap causing movement of fluid out of pulp
4 polymerization shrinkage that causes cuspal shrinkage

QUESTION: When do you see microleakage with composite restoration done without rubber dam?
Same amount of time as if done with rubber dam?
2 weeks later
2 months later

QUESTION: Class 2 done without rubber dam, how long until you see microleakage 2-4 weeks, 4-6
weeks, same time as with rubber dam on

47
QUESTION: When do u start to see lines if u do class 2 without rubberdam? 4-6 Weeks? when not
applied under rubber dam isolation 4-6 weeks you see leakage compared to RDI

QUESTION: You did class II composite without rubber dam. When do you start having marginal
leakage?
4-6wks, 6mo-1yr (something like that), same time as the one you did with rubber dam on, ??

QUESTION: Highest chance of leakage under rubber dam? Holes too wide, Holes too far apart, Too
close

QUESTION: What is not an advantage of rubber dam when compared to not using it: Improved properties
of materials, shortens operative time, facilitates the use of water spray

QUESTION: Placement of rubber dam affect the colour selection by dehydration of tooth gives
inaccurate tooth shade

QUESTION: Placement of rubber dam affect the colour selection by black background

QUESTION: W on the rubber dam clamp means it is? wingless

QUESTION: repairing porcelain veneer with composite microetch, etch, silane, resin
QUESTION: How to fix porcelain chip on PFM with composite? Microetch, etch, silane, bonding
QUESTION: Steps for adding to porcelain? Microetch, etch, silane, bonding agent

QUESTION: Veneer replacement: microetch, etch, silane, bond

QUESTION: Similar question Patient has an all veneer on incisal edge, small piece of porcelain came off
and wants you to fix the chip only, what is the sequence of events: microetch, etch, silanate, and
bonding agent

QUESTION: Patient has an all veneer on incisal edge, small pice of porcelain came off and wants you
to fix the chip only, what is the sequence of events: microethc, etch, silanate, and bonding agent
(there was another option that has silanate involved so not sure)

QUESTION: pt has composite restoration with severe pain with localized swelling---- Incision & Drainage

QUESTION: Pt had #8 & had a bunch of little pits in #8; how would you fix it? Composite over pits,
or over entire tooth, or veneer w/ porcelain, etc. (agu put: composite over pits only)

QUESTION: pt complains of a marginal stain on #8, what do you do? i said polish it
QUESTION: Similar question: Patients chief complaint is #8 and #9 dont look right. Picture shows
nothing is wrong with #9, #8 has extra enamel at the incisal-distal aspect. What do you do? Shave the
inciso-distal aspect of #8. (Other choices were stupid; like put composite on both teeth, put a crown on
#9, etc)
QUESTION: Advantage of a direct composite vs. a veneer? direct composite- 1 appointment vs. veneer
=atleast 2

QUESTION: You place a CaOH on the tooth for a direct pulp cap what is needed: placement of a
liner

Cement & Materials:

48
QUESTION: Beveling in acid etching composite Increase surface area

QUESTION: beveling in acid etching composite use more surface area.

QUESTION: Etch cleans the tooth and creates micropores for micromechanical retention.

QUESTION: Etchant does all except- provide chemical bond

QUESTION: Etchant does all except- provide chemical bond
QUESTION: Etchant does all except? Increase surface area, remove debris, Increase wettability of
enamel, or decrease irregularities at cavosurface margin.

QUESTION: What does acid etching NOT do: Cleans surface debris, Roughens enamel surface, Gives
more surface area, Helps in wetting the enamel

QUESTION: Etch dissolves smear (does not)- dry out collagen

Etch removes the smear layer, exposed collagen fibers can form hybrid layer with resin
QUESTION: Hybrid layer. ANS primer within intertubular dentin

QUESTION: Acid-etching does not cause. Reduced leakage, better esthetics, increased strength of
composites.

Acid etch technique: conserves tooth structure, reduces microleakage, improves esthetics and provides
micromechanical retention.

Etch does improve marginal seal, helps in wetting enamel, cleans surface debris, created micropores
(roughness of surface)

QUESTION: if contamination after etch : re etch

QUESTION: Pg 62, current dentin bonding system: know the difference of total etch and self etch

QUESTION: The most unreliable? self etch

QUESTION: Function of filler in resinstrength (reduces polymerized shrinkage and increases hardness)
QUESTION: Filler composites: Larger fillers have more strength, but do not polish as well

QUESTION: denstist who work with HEMA( composite) can have what kinda complication.? contact
dermatitis
QUESTION: HEMA can give dentist what health problems HEMA causes contact dermatitis
QUESTION: HEMA used by dentist, what phenomenom happens anaphylaxis, contact dermatitis,
immune mediated reaction, arthus phenomema?

QUESTION: What acid is in GI cement > silicate glass powder & polyacrylic acid.
Components of GI CEMENT alumina silicate and polycarboxylate
QUESTION: Asked about use of glass ionomer what is liquid made of? ***P= fluoroaluminosilicate glass
L=polyacrylic acid
QUESTION: What is the acid in glass ionomer? Phosphoric acid, Polyacrylic acid-in durelon
QUESTION: conditioner in glass ionomer : polyacrylic acid- = liquid

49
QUESTION: Cool glass slab why? More powder incorporated, less powder incorporated, decrease
working time
QUESTION: purpose of a cool glass slab when mixing cement is to incorporate the most powder into
liquid as possible.
QUESTION: Veneer after a month time has some brown stain: not enough cement at margin,
Microleakage

QUESTION: Which indicated for high caries risk or multiple class Vs? GI

QUESTION: Check proximal contacts first when cast that fits on die cannot be seated on the tooth in the
mouth
QUESTION: When you seat a crown, it isnt seating. What is the first thing you do?
Check contacts?
Look for nodules on casting?

QUESTION: What is the most practical way to seat a casting at the time of cementation? grind the inside
away since the other answer choices would be either impractical or not done at cementation
QUESTION: Make sure casting seats do the following EXCEPT:
Increase thermal expansion of investment
Mix cement thin
Remove internal nodule with occlude
QUESTION: if you have a bubble in an impression for a crown that is not visible what is going to
happen with the crown when comes from the lab and you try to seated in the mouth does not
seat
QUESTION: Void in die, crown was processed, what will happen? crown will seat in die, but not on
tooth
QUESTION: What wont affect metal casting seated on master cast? Impression inaccuracies
It wonr fit tooth, it WILL fit cast
QUESTION: You notice void on occlusal of cast. Crown will
a. Fit on die and not on tooth
b. Fit on tooth and not on die
c. Fit on both
d. Not fit on either

QUESTION: What do you not do if your crown doesn't fit? - can't change the cement ratio mixture

QUESTION: With resin cement on all porcelain what is NOT the reason why you use it: for added
retention cements shouldnt be used for added retention, to fill small openings at margin

QUESTION: Why do we lute all ceramic crowns with composite: increase strength, color stability,
sealing of margins, enhance retention
- Composite Resin-the luting material of choice to cement a ceramic crown and can provide the
STRONGEST BOND

QUESTION: Why don't you use GI resin cement in cementation of all ceramic restoration? its expansion
could cause cracking of porclain

QUESTION: Which is not correct? resin ionomer used to cement crown

50
QUESTION: Sensitivity of pulp in regards to cement, which is correct? resin ionomer and glass
ionomer cause highest pulp sensitivity

QUESTION: which cement is the easiest to remover after procedure? Zinc Phosphat
QUESTION: Zinc phosphate pH is is 3.5, what is the significance of that? this might also cause
pulp sensitivity

QUESTION: what component of cement contributes to adhesion? Polycarboxylic acid, benzoyle

peroxide, others, Polyacrylic side group chelation between carboxyl groups and calcium in tooth.
QUESTION: Photo initiator of composite? Camphoroquinone
QUESTION: resin activator: camophoroquinone
QUESTION: Diketones activate by ? visible light, blue light to produce slow reactions. Amines are
added to accelerate curing time. Cross link reaction.
QUESTION: the most radiopaque in composite is: Barium ( it is a metal)
QUESTION: most radioopaque in porcelain
a. barium and zirconium glass
b. silica
c. quartz

QUESTION: Heat cured indirect composite (increase strength )vs direct composite. Which is
incorrect?
a. Heat composite is harder
b. Heat composite is more resistant to abrasion
c. Heat = Less irritation to tooth due to less shrinkage
d. Heat indirect has better bonding to the dentin and enamel **

QUESTION: Which composites have more color stability? I put light cure due to TEGDMA

HEAT CURED (light cured) RESINS HAVE SUPERIOR COLOR STABILITY

QUESTION: Which composites have more color stability? light cure due to Triethylene glycol
dimethacrylate TEGDMA
QUESTION: with tegdma and hema: light cure to maintain proper shade

Microfill composites are more color stable than hybrid. Microfill have the
smoothest finish compared to hybrids which are rougher. Rougher will pick up stain
easier.

QUESTION: What is importance of light cured vs autocured in terms of shade balance (question
didnt make sense): I said it was the less number of nitrates when you lightcure; other option is
light cure

QUESTION: What is importance of light cured vs autocured in terms of shade balance; the less
number of nitrates when you lightcure;

QUESTION: curing light intensity: 400

QUESTION: What is false about LED vs halogen curing lights:

a. blue light is 340-370 450-750

51
 b. battery powered/cordless LED is acceptable
c. LED lasts longer than halogen
d. something about a photoinitiator
e. Blue light is not 340-370

QUESTION: Lasers and LED lights dont cure all resins b/c some resins photoinitiatiors have require
light sources is out of range: true and correct logic

QUESTION: Which of the following will be not be good against enamel? Hybrid resins (other
choices, enamel, amalgam and unfilled resins Hybrids have silica filler, which increase
hardness wear resistance) mine also had porclelain though. porcleain

QUESTION: Which of the following will be not be good against enamel? Hybrid resins (other choices,
enamel, amalgam and unfilled resins Hybrids have silica filler, which increase hardness wear resistance)
--hybrid is the most abrasive

QUESTION: Which one is true about Glass Ionomers It has good tensile strength (others choice
were compressive strength, or something thats for more stronger material like amalgam) there was
one more option that seemed to be a better attribute than tensile dont remember. ?

QUESTION: GI non benefit- good tensile (not compression)

GI is brittle = high compressive, low tensile strength
QUESTION: *** VRMGI? Advantage beside fluoride release? Ionic bond btwn enamel and dentin,

QUESTION: Something about glass ionomer: forms ionic bond.

QUESTION: GI forms ionic bonds

QUESTION: Direct Pulp cap w/ CaOH; wuts most important thing to do? Put 2mm of it, put 3mm of
it, put a hard liner/base above CaOH, etc. (agus answer: put hard liner/base above CaOH)

QUESTION: direct pulp cap- do you put 2mm of calcium hydroxide or calcium hydroxide liner and
a glass ionomer base
QUESTION: How do you improve the success of calcium hydroxide on a direct pulp cap? Place GI liner
over calcium hydroxide,
QUESTION: 1 mm away from pulp horn, large carious lesion what do you do? Pulp cap, with liner etc
Other options too
QUESTION: Pulp Capping use calcium hydroxide, in order to protect the pulp put 2mm
thickness base
QUESTION: What is the composition of Glass Ionomers? Silica glass and polyacrylic acid.

Know GI cement/GI restorative--**think GI joe! He leads a double life and can be both a cement and
restorative material! As a cement---low pH can cause sensitivity, pulp irritation, least erosive (because GI
joe is super strong you cant beat him up). As a restorative material---releases F, low solubility, thermal
ins, sim therm exp to tooth, chemical adhesion, biocompatible. However, GI has less surface hardness,
compressive strength, and tensile compared to COMmander COMposite!
QUESTION: What is a compomer? (p. 26) GI and Composite modified with polyacid groups, used in
low-stress-bearing areas (Less wear resistant than composite, Releases fluoride)Root caries and Class V.
RMGI is better.

QUESTION: What is compomercombined benefits of composites (the comp in their name) and glass

52
ionomers (omer).

QUESTION: Reinforced Zinc Phosphate Eugenol: Best luting agent? (This statement does not make
sensereinforced ZOE is biocompatible but has very low strength and is only used for very retentive
restorationsnowadays only used as a temporary cementXtina)

QUESTION: The strength of Zinc Oxide Eugenol can be increased by adding what? Methylmethacrylate
QUESTION: Methyl methacrelate (reinforced ZOE)

QUESTION: *Zinc oxide eugenol is IRM but theres an extra component that makes it IRM which is the
methylmethacrylate which is an inactive ingredient.

QUESTION: zinc oxide-eugenol with polymer reinforcement.

QUESTION: IRM is ZOE mixed with what? Titanium, MMA

QUESTION What has been added to IRM: ZOE + PMMA beads added to poweder to increase strength
QUESTION: pH of ZOE (near 7), zinc phosphate: **pH of 3.5acidic irritates pulp.

QUESTION: Zinc eugenol good temp filling: gives a good bacterial seal, high compressive strength,
high tensile strength, good biological seal

QUESTION: the main component of any root sealers is? Zinc oxide
QUESTION: when you used ZOE in a primary what kind? ZnOE without catalyst., Lack of catalyst
gives adequate working time filling the canals

QUESTION: what do you fill a root canal with on a primary tooth

ZOE without catalyst
QUESTION: what do you fill a root canal with on a primary tooth
Gutta percha
Sealer alone
ZOE with accelerator
ZOE without accelerator

QUESTION: What is the material in reinforced IRM that give it strength

A. amalgam powder
B. Zinc phosphate
C. Poly methyl methacrylate**
D. Titanium powder
QUESTION: Zinc phosphate cement is used as luting agent : the initial acidity may elicit a traumatic
response if
a. Only a thin layer of dentin is left btwn cement and pulp
b. very thin mix of cement is used
c. tooth has already a previous traumatic injury
d. No cavity varnish is used

A. a, c, & d
B. a or d

53
C. b only
D. all of the above
QUESTION: If you add BIS-GMA to PMMA increases strength or results in the doughy texture to
have more working time

QUESTION: PMMA resin? bis-GMA

QUESTION: Crosslinking factor of P-MMA? bis-gma, benzoyl peroxide

QUESTION: Crosslinker in pmma: bisgmma, benzoyl peroxide

QUESTION: Bis-GMMA- provides the CROSS LINK

QUESTION: Cross-linking in polymers leads to what? Better Strength.

QUESTION: Cross-linking in polymers leads to what? Better Strength.

QUESTION: PMMA and what crosslinking does? I put strength but not sure
QUESTION: Addition of long chains in PMM is for what reason: increase strength, allow doughy
consistency before set, allow for addition of more powder without crazing, prevent shrinkage

QUESTION: If too much monomer is added to polymer: Causes excessive shrinkage

QUESTION: Increase monomer causes shrinkage

QUESTION: By having excess amount of monomer in acrylic can create excessive amounts of what:
shrinkage, expansion, thermal conduction are 3 of the 4 options

QUESTION: Adding more monomer increases

a. Expansion
b. Shrinkage?
c. Brittleness
d. Harness
QUESTION: KNOW WHAT INCREASES AND DECREASES SETTING TIME:
increased water:powder ratio increases setting time, decreases expansion,
mix faster, increase water temp decreases setting time
QUESTION: If you decrease water temp (make it colder), you have more working time for an
irreversible hydrocolloid

QUESTION: If you decrease water temp (make it colder), you have more working time for an
irreversible hydrocolloid

QUESTION: Increase set time with Alginate (Irreversible Hydrocolloid)? Cold water and more water
QUESTION: If you increase water to powder ratio, you have decrease expansion

QUESTION: If you increase water to powder ratio, you have decrease expansion

QUESTION: IF you have decrease spatula/mixing, you decrease expansion

QUESTION: IF you have increase spatula/mixing, you increase expansion

QUESTION: Increased trituration time will increase compressive strength/decrease setting

expansion;
QUESTION: Increasing trituration timeReduced the setting expansion

54
QUESTION: Know what increases and decreases setting time for gypsum
(slurry/temperature/spatulation) longer spatulation time, greater expansion (shorter time) ----
***Gypsum bonded investments. Type I, II, III gold. Gold shrinks, so mold must expand to compensate.
Older invstdecrease expansion; Increased time between mixing in water bath immersion---dec exp;
Increase water:powder rationdec exp; Increase spatulation timeincrease expansion
QUESTION: What decreases setting time of Gypsum: Decrease water:powder ratio

QUESTION: What happens if you increase water in gypsum stone? Less expansion and strength (b/c
particles are farther apart)
QUESTION: How to decrease setting time (increase spatulation time, increase water temperature,
use of slurry water, decreases water:powder ratio)

QUESTION: How to increase setting time? Hot water, increase water/powder ratio, decrease
water/powder ratio

QUESTION: Same thing but with increase/decrease in setting expansion-more water, less
expansion, less strength

QUESTION: what happens when you increase w/p ratio of an investment: increase thermal
expansion, decrease thermal expansion, increase setting expansion...?

QUESTION: Similar question with how to increase setting time of alginate

QUESTION: take an impression and lip immediately swells? Angioedema

QUESTION: C1 inhibitors are used in angioedema to inhibit the complement system
QUESTION: C1 esterase inhibitor angioedema
QUESTION: C1 Esterase Ihibitor question-hereditary angioedema

QUESTION: Which of the following systems is thought to malfunction in the hereditary form of
angioneurotic edema?
A. C-1 esterase
B. C-1q inhibitor
C. CH50 consumption
D. Serine phosphatase
E.Complement synthetase

QUESTION: Alginate 100% humidity: Shrinks due to syneresis.

QUESTION: Alginate impresssion shrinks due to - syneresis.
QUESTION: Alginate imp 100% humidity will shrink: syneresis= extraction or expulsion of a liquid
from a gel shrinkage
QUESTION: With alginate in 100% humidity, why will shrinkange still occur? Imbibemnt,
syneresis, historgysm

QUESTION: Most inaccurate? Irreversible hydrocolloid

QUESTION: Synerisis imbibition applies to which impression mat? Reversible hydrocolloid. Irreversible
is not an option

55
QUESTION: when pouring gypsum material into an impression which material will cause the least amount
of bubbles? Polysulfide, polyether, silicone, irreversible hydrocolloid
QUESTION: Dimensionally stable impression- additional silicone (polyvinylxsiloxane?...Xtina)
QUESTION: Most stability:
hydrocolloid reversible
hydrocolloid irreversible
polysulfide
*PVS and polyether were not option

QUESTION: Most stable impression material: additional silicones ( aka PVS ) they just used
QUESTION: which provides best dimensional quality (PVS)
QUESTION: polyvinyl siloxanes gets affected by latex (handle with latex gets messed up the sulfer
in latex gloves that retards the setting of PVS addistion silicone))
QUESTION: PVSPolyether-Most!
QUESTION: Polyether wuts bad about it? Hard to take out cuz it sticks to teeth

QUESTION: Polyether disadvantage compared to other elastomerics?choices: sticks to teeth,

longer working time, less accuracy

QUESTION: Biggest disadvantage of polyether? I put hard to remove from teeth

QUESTION: Which one most likely to get stuck in mouth? Polyether??***

QUESTION: Impressions: whats wrong with polyether- its hard engages undercuts

QUESTION: When compared to other materials, which of the following is the main disadvantage of using
polyether elastomeric impression materials: Are much stiffer

QUESTION: Most rigid impression material, Polyether

QUESTION: Most rigid impression material polyether

QUESTION: which is hardest one to remove from the oral cavity (STIFFEST) (polyether)
QUESTION: what material you would not use for a single crown : a) polyether b) polysulfide c) PVS
etc
QUESTION: Which of the following is the best for tear strength polysulfide / polyether

QUESTION: Polysulfide gives out ? water

QUESTION: Catalyst of polysulphide POLYSULFIDE impression material- lead dioxide

QUESTION: Condensation silicone ethyl alcohol as by product

QUESTION: Condensation silicone releases? Alcohol

QUESTION: Dont use for casting impression? Reversible Hydrocolloid.

QUESTION: Acceptable impression material for a casting?
Irreversible hydrocolloid
Reversible hydrocolloid
QUESTION: Which of the following is not good for use in taking impression of a cast restoration I
said irreversible hydrocolloid (other option was reversible hydrocolloid, and addition silicone)

56
QUESTION: Which is not recommended for final FPD impression?
irreversible hydrocolloid*
reversible hydrocolloid
PVS
Polyether
QUESTION: Which material cannot be used to get cast impression?

o Reversible hydrocolloid
o Irreversible hydrocolloid
o Polysulfide
o PVS

QUESTION: All of the following are good impression materials for crowns except: irreversible
hydrocolloid,
QUESTION: addition silicone is the most stable elastic impression material in a moist environment
QUESTION: Addition silicon(PVS) releases? H2 (as secondary reaction)
QUESTION: The most stable elastic impression in moisture environment?
a. polyether
b. additional silicon
c. condensation silicon
d. polysulfide
QUESTION: Which impression least distorted by water? Addition silicone (Condensation silicone
better ans if available

QUESTION: imbibition and syneresis affect which one the most

a. reversible hydrocolloid----
b. impression compound
c. polysulfide
d. silicone

FLUORIDE:
QUESTION: how many mg of fluoride in 1 liter of water at 1 ppm : 1 mg
QUESTION: Patient has 1ppm fluoride in water-what is that equal to in mg/L?- 1mg/L = 1ppm
QUESTION: Patient has 1ppm fluoride in water-what is that equal to in mg/L?- 1mg/L = 1ppm
QUESTION: What does floried replace in hydroxyl appetite: hydroxyl

QUESTION: What ion is replaced to get hydroxyfluoroapatite? HYDROXYL

Hydroxyapetite + Flouride ------> Flourapetite + Hydroxy
The incorporation of fluoride into the enamel hydroxyapatite crystal: Fluoride ions replace the hydroxyl
radicals of the hydroxyapatite crystals in the enamel, producing fluorapatite. This form of enamel is less
soluble in catabolic acids produced by oral bacteria.
QUESTION: least soluble
a. fluorapatite
QUESTION: Fluoride becomes fluoroapetite which is insoluable

QUESTION: ***Fluoride works in all these ways except: Increases strength of collagen**

57
Fluoride BREAKSDOWN collagen, is bacteriocidal, fluoroapetite is more resistant to acid
attack, decreases solubility of enamel, excreted by kidneys, helps remineralize

QUESTION: Fluoride helps prevent caries in all ways except? lower pH of the oral cavity
QUESTION: Fluoride helps prevent caries in all ways except? I put lower pH of the oral cavity,
since it does not do that! Fluorapetite has a lower critical pH of 4.5
QUESTION: Flouride accumulated most- away from DEJ (surface of tooth)
QUESTION: Where does fluoride localize? Outer enamel**
QUESTION: Fluoride spot makes enamel more resistant to future caries

QUESTION: Fluoride does all the following, except? Direct action on plaque
QUESTION: What does floride do? Floroapitate thats acid resistance.

QUESTION: How do you determine the severity of fluorosis? Look at the two worst teeth?
Higher the fluoride level, greater degree of enamel change
QUESTION: Flouride in acidualted flouride. 1.23 %
QUESTION: What conc of acidulated phosp fluoride is used in the dental office? 1.23
QUESTION: ADA recommends to apply in-office floride foam for how long?- 4 MIN
QUESTION: How many minutes do you place Neutral sodium fluoride tray on teeth? 4 minutes
QUESTION: Floride supplementation is effective in: everybondy, only kids, anyone but most
beneficial to children.

QUESTION: Supplemental fluoride when can you give it? 6 mos

QUESTION: what age should fluoride supplements be started? 6 months

QUESTION: Minimum fluoride age? 6 months

QUESTION: What age does fluoride incorporate into primary dentition? 4 months in utero

QUESTION: At what age does florousis of teeth anterior permanent teeth occur?- 4-6mo (others 0-4mo,
1year, 2years and 6 years)

QUESTION: Fluoride toxic dose 5-10 mg/kg

QUESTION: Usual water flouridation- 1.0 ppm

QUESTION: 1ppm for average fluoride in water (FYI in January of 2011 this statement was
issued: The Department of Health and Human Services today announced that it will revise the
recommended levels for optimally fluoridating community water systems. Historically, the
recommended optimal level for community water fluoridation has been 0.7 to 1.2 parts per million.
The new recommended level is 0.7 ppm.)

QUESTION: What is the EPA highest conc of natural fluoride in drinking water? 4 or 1ppm????
QUESTION: Maximum allowed fluoride in the water by EPA (environmental protection agency)?
4.0mg/liter

QUESTION: Maximum fluoride according to some agency is ? 4ppm (options were 1,2 ,3, 4mm)

QUESTION: Community fluoride: 0.2% / week in udnerprivelaged areas

58
QUESTION: Flouride is given to children in schools usually by what method: .05 daily, .2 daily,
.05 weekly, .2 weekly ( I guessed this, I have no idea because this question is a total waste of my
time and I cant think of any situation where knowing this would be useful)
QUESTION: How do they administer Fluoride in schools? 0.2% Fluoride rinse 1x week
QUESTION: What happens when a kid with primary teeth ingests fluoride? - It affects their
permanent teeth.
QUESTION: Fluoride table, 5yrs old with .75ppm intake - I said don't give more (answer said 0ppm)
QUESTION: Floridation supplement for a 5 year old drinking .75ppm h2o?- 0mg
QUESTION: 4 yrs old patient, 0.25ppm fluoride intake, what do you? Give her systemic Fluoride
(other were apply fluoride, change diet to more fluoride intake).
QUESTION: 4 yr old lives in community with .28 ppm: systemic fluoride supplement, prescription
fluoride rinse
QUESTION: 4 yo with .4ppm fluoride. Supplement? 0.25PPM or 0.25mg/L
QUESTION: 4 yr old lives in community with .28 ppm: systemic fluoride supplement, prescription
fluoride rinse
QUESTION: 2 yo takes 20mg fluoride pill coma, nausea, renal failure, cardiac arrest
QUESTION: a child has injested 20 mg of fluoride. What will likely happen? Nausea
QUESTION: 7 year old patient has no fluoride in drinking water. What do you give them systemically
5 mg, 1 mg, .25 mg
6 months-3 year = 0.25mg
3 -6 years = 0.5mg
7 16 y.o. = 1mg
QUESTION: IF PATIENT GETS 0.3-0.6mg from water then half supplement from 3-16years
QUESTION: 4.5 years old child with .75ppm fluoride in their water req. how much fluoride
supplement? 0 mg. optimal range of fluoride in water lies between 0.7 and 1.2 ppm
QUESTION: The appropriate amount of fluoride in the community water: 0.75-1.2

QUESTION: Supplementation for 10 year old with no other fluoride source? 1 mg every day or 1 mg
every week?!?

QUESTION: 2.5 year old with 0.4 ppm fluoride in water normally I would say rx nothing but that
wasnt a choice I put 0.25 mg supplement

QUESTION: The drinking water supply of a community has a natural F level of .6ppm. The F level is
raised by .4ppm. Tooth decay is expected to decrease by what % after 7 years?
40%

QUESTION: 3 year old patient lives in area with 0.4ppm fluoride. How much do you
supplement? 0.25 mg
QUESTION: 7 year old child living in area with .2 ppm fluoridated water-supplement 1.0

QUESTION: what type of Fl in water: include fluorosilicic acid (hydrofluorosilicate) most

commonly used, sodium fluorosilicate, and sodium fluoride

QUESTION: Types of Fluoride used in toothpaste: sodium fluoride, Stannous fluoride(most

effective), Sodium monofluorophosphate

QUESTION: Which type of fluoride not in toothpaste: acidic fluoride

59
QUESTION: Which fluoride is not found in toothpaste? Acidulated (???)

QUESTION: what toothpaste should not be used in a patient with multiple porcelain crowns?
acidulated
QUESTION: Best thing for child to rinse with? Sodium fluoride
QUESTION: What mouthwash is good for children with caries? NaF

QUESTION: What rinse is used at home for developmental disabled child to reduce of plaque: NaF,
stannous fluoride, chlorhexidine

QUESTION: the usual metabolic path of ingested fluoride primarly involves urinary excretion
with remaining portion in? skeletal tissue

QUESTION: where is the biggest store of fluoride in tissues? Skeletal tissues

QUESTION: Where does fluoride work the best?
A. interproximal**
B. Pit and fissure (I saw this somewhere and it said smooth surfaces, pit and fissure is
prr/sealant)
**WORKS BEST ON SMOOTH SURFACES***
QUESTION: In history of dentistry, which of the following has decreased?
Interprox-due to fluoride
Pit and fissure

QUESTION: What is least likely to cause baby bottle caries?

a. Breast milk at night
b. Formula made with fluoridated water
c. water with no fluoride
d. juice
QUESTION: ECC cause by all at night except bottle feeding with formula with fluoridated water, breast
feeding, sippy cup with OJ, bottle feeding with processed water with no fluoride
QUESTION: ECC which location?
a. Max incisors and molars?
b. Max incisor and molars?
c. Max canine
d. Man canine and molars?
Primary max incisors (B&L), then primary molars, mandibular unaffected bc
tongue blocks
QUESTION: ECC early childhood caries. Question asked which teeth specfically affected. 1) Max and
mand incisors 2) max central and 1st molar 3) man central and 1st molar Max anterior and primary
molars
QUESTION: What teeth are assoc with ECC? primary incisors, incisor and canine, incisor and molar

QUESTION: Question about what determines fluoride supplementation for a city - temperature
QUESTION: percentage of fluoride water in US - 85% (should be about 65-70%)**ADA site talks about
percentage of people receiving fluoridated water.. couldnt find percentage of fluoridated water itself.
Percentage went up from about 65% to 74%.

60
QUESTION: What percentage of americans have public fluoride in water: 66%, 85%, other lower
numbers Update: CDC 2010 reports Americans have 79.6% water fluoridation

QUESTION: porcentage of cities in U.S with fluoridate water : 69or 75%???

QUESTION: water fluoridation in what percentage of towns/cities? 30%, 70%, 85%

QUESTION: What is percentage of communities that are fluoridated in America? 60, 85%...
QUESTION: What is percentage of community water fluoridation- 67, 85, 35
QUESTION: Fluoridation for water: effectiveness: early studies showed that it prevents 50%-70%
of caries in permanent teeth, Howerver currently the effectiveness is 20%-40%

QUESTION: Effectiveness of Water fluoridation in the U.S. is 20%-40% (40%)

QUESTION: Fluoridation: daily use of tablet cause 30% reduction in new carious lesions

QUESTION: Fluoridation: know the primary/secondary/tertiary prevention differences.

Primary: aims to prevent the disease before it occurs. Health education, community fluoridated water,
sealants.

Secondary: Elimates or reduces disease after they occur. Composite filling

Tertiary prevention: Rehabilitates an individual in later stages to restore tissues after the failure of
secondary prevention. Examples include dentures and crown and bridge.

QUESTION: Fluorosis does what inhibits remineralization (irreversible)

QUESTION: Fluorosis does what inhibits remineralization, however fluoride induced enamel
hypoplasia or hypocalcification which is characteristic of fluorosis is caries resistant
QUESTION: How do you determine the severity of fluorosis? Look at the two worst teeth?
Higher the fluoride level, greater degree of enamel change
QUESTION: Which fluoride do you give and why? Do certain fluorides stain? Stannous fluoride
may stain. Better to recharge GI? APF
QUESTION: Dentist places sodium fluoride on patient with GI fillings rather than acidulated fluoride
because acid of fluoride will wear away at GI. TRUE
QUESTION: Dentist places sodium fluoride on patient with GI fillings rather than acidulated fluoride
because acidulated fluoride will wear away at GI?
QUESTION: Applying Fluoride (APF) on GI cement what happens? A. dissolves it b. stains it
(decks says loos glace) roughens it
QUESTION: Pt has veneers from 6-11, which fluoride do you use to not stain?
A. Stannous Flouride
B. Sodium Flouride**
C. Acid Flouride
QUESTION: What fluoride tx used in a pt with amalgams, pfms , composite restorations, implants? NaF
more profound= acidulated
QUESTION: Pt has fillings and full porc. Crowns, but has decalcification on class V? 1.1 % NaF,
QUESTION: Caries in elderly, which one is not useful in managing: use of 1.1% fluoride as a standard
of care

61
QUESTION: what is her dental age based on xrays advanced, chronological lags behind dental, Tx for
#D TE, c. what to do with lesion on distal of #S (look incipient, resorbed) apply fluoride varnish
every week, do DO comp or amalgam, observe and reassess next visit, disc the distal surface, d. both
child and guardian should receive oral health instructions, oral health care should include daily fluoride
rinses both statements are true.

QUESTION: Sealants- mechanical microretention binding to tooth

QUESTION: Contradiction of sealant: when you have rampant or gross caries

QUESTION: a child with no decay but deep pits and fissures what is the Tx plan : sealants
QUESTION: Patient has deep grooves but no decay on permanent molars, what do you suggest?
Sealants
QUESTION: Patient has deep grooves but no decay on permanent molars, what do you suggest? - Sealants
QUESTION: Ortho pt: has never had a restoration? Wut wud you do? sealants, do nothing, etc.
(agu put: do nothing)

QUESTION: High caries risk patient, when is he indicated for sealants? Obvious clinical cavitation on the
occlusal, deep fissures without caries

QUESTION: Pt at high caries risk? Place sealants in deep fissures

QUESTION: pictures of molars in 16 y/o does it need sealants, no treatment, Class I. Book says do
sealant age 6-12, so no treatment most likely unless caries visualized.

Bleach:
QUESTION: In-home bleaching percentage - 10% carbamide

QUESTION: 25% carbamide peroxide for home bleaching: False, its 10% carbamide peroxide

QUESTION: H2O2 35% used in in-office bleaching

QUESTION Material used for mouth guard vital bleaching: 10% carbamide peroxide.

QUESTION: Home bleaching kit. Maximum dosage? Carbamide peroxide 10%

QUESTION: home bleaching what causes : sensitivity
QUESTION: Most successful teeth for bleaching? Aged yellow staining

QUESTION: What is the most effective way of bleaching teeth? In-home vital bleaching.

QUESTION: Non vital bleaching is with? hydrogen peroxide 35%, carbamide peroxide, and
sodium perborate.

QUESTION: Bleach most often used in internal bleaching: sodium perborate

QUESTION: Difference b/t dentist and home bleaching.. strength of peroxide
QUESTION: Bleaching tray at home? Make sure custom fit
QUESTION: best way to decrease gingival irritation w/ home bleaching? well fitting trays
QUESTION: Bleach used to dissolve organic tissue
QUESTION: Purpose of bleach except- getting past foramen to treat bone

62
QUESTION: most common complication of internal bleaching cervical external root
resorption

QUESTION: How do you treat it? Scale the area

QUESTION: What is worse outcome of nonvital bleaching (internal bleach for endo)external root
resorption, internal root resorpotion /CERVICAL RESORPTION. Non vital bleaching
consequence: internal resorption /cervical resorption
QUESTION: You are about to prep a tooth for PFM crown, patient also needs teeth bleached, how do
you go about it? Bleach first, wait 2 weeks, prep tooth, then restoration.

QUESTION: You are about to prep a tooth for PFM crown, patient also needs teeth bleached, how do you
go about it? Bleach first, wait 2 weeks, prep tooth, then restoration. (Other choices, Bleach and prep 1st,
then wait 2 weeks, Bleach last after prep and crown).

QUESTION: How long after vital tooth bleaching can you bond resin to it? 24 hours, 3 days, 1 week

QUESTION: Anterior crown lighter than rest of teeth bleach rest of teeth
QUESTION: Patient is complaining about a very light colored anterior PFM crown she had done
sometime ago, there is nothing clinically wrong with the crown. What do you do Doctor? Bleach
natural teeth (other choices, re-do the crown, put a darker shade composite on crown, some other
stupid answers).
QUESTION: #8 PFM is too light but good margins and been there for 10 years vital night guard
bleaching
QUESTION: Anterior crown placed 10 years ago, 45 yr old woman, color doesnt match natural teeth
now, appears clinically acceptable, what will you do?
a. vital bleaching
b. new crown
c. microetch and composite bond

QUESTION: The prognosis for bleaching is favorable when the discoloration is caused by
a. necrotic pulp tissue
b. amalgam restoration
c. precipitation of metallic salts
d. silver-containing root canal sealers

QUESTION: The office bleaching changes the shade through all except
a. dehydration
b. etching tooth
c. oxidation of colorant
d. surface deminearalization

QUESTION: No obvious clinical caries in a child. Radiographically, interproximal caries on primary tooth
T. Best tx: MO and DO composites, MOD amalgam, stainless steel crown

Oral Pathology:
http://www.aapd.org/media/Policies_Guidelines/RS_LabValues.pdf

QUESTION: Hairy tongue hypertrophy filly form papilla

QUESTION: What is usually seen with affected hypertrophic filiform pappilae: Hairy tongue

63
QUESTION: Causes ofHairy tongue ? antibiotic , corticosteroid, hydrogen peroxide

Many people with BHT are heavy smokers.[4] Other possible associated factors are poor
oral hygiene,[4] general debilitation,[4] hyposalivation (decreased salivary flow rate),[5]
radiotherapy,[4] overgrowth of fungal or bacterial organisms,[4] and a soft diet.[5]
Occasionally, BHT may be caused by the use of antimicrobial medications e.g.
tetracyclines,[5] or oxidizing mouthwashes or antacids

QUESTION: Which of the following is seen with hyperplastic(or was it associated with) foliate
papilla: hairy tongue, Lingual tonsil hyperplasia

QUESTION: Which of the following is seen with (or was it associated with) hyperplastic foliate
papilla: I put hairy tongue, other option was median rhomboid glossitis, also lyphadenopathy)
a. Lingual tonsil hyperplasia

QUESTION: Hyperplastic lingual tonsils may resemble which of the following?

a. Epulis fissuratum.
b. Lingual varicosities.
c. Squamous cell carcinoma
d. Median rhomboid glossitis.
e. Prominent fungiform papillae.

QUESTION: Loss of filliform papilla- vitamin def- vit b

QUESTION: Bilateral swelling of parotid cannot be caused by: Anorexia,

QUESTION: Patient has bilateral white lines @ occlusal plane, what is primary microscopic finding?
Epithelial hyperkeratosis
QUESTION: Pt has hyperkeratosis around occlusal? linea alba

QUESTION: What is white and bilateral on buccal mucosa (leukoedema not choice), Linea Alba
QUESTION: Ulcer on tongue repeated every 4 months- apthous ulcer

QUESTION: why brush tongue - to reduce odor

QUESTION: Pic: had a red thing on tongue where is it from (candidiasis, Kaposi, syphilis, gonnaria)
QUESTION: Behet's disease Pic of something on tongue: aphthous ulcer related to bechets disease

QUESTION: Behcets syndrome? Oral lesions similar to apthous ulcers?

QUESTION: Bechets syndrome produces what type of mouth lesion: Apthous Ulcers , apthous stomatitis,
recurrent. herpes
Behet disease sometimes called Behet's syndrome,Morbus Behet, Behet-Adamantiades syndrome, or
Silk Road disease, is a rare immune-mediated small-vessel systemic vasculitis that often presents with
mucous membrane ulceration and ocular problems. Triple-symptom complex of recurrent oral aphthous
ulcers, genital ulcers, and uveitis. As a systemic disease, it can also involve visceral organs such as the
gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems. This
syndrome can be fatal due to ruptured vascularaneurysms or severe neurological complications.

QUESTION: Pathognomonic for measles? Kopliks spots

64
QUESTION: koplick spot? buccal muscosa ulcerated, related to measle

*Koplickulcerated buccal mucosaMEASLES

QUESTION: Transillumination in children Koplik? (Kopliks spots are associated with

measles)

QUESTION: Syphilis: hutchinson triad (presentation for congenital syphilis, and consists of three
phenomena: interstitial keratitis, Hutchinson incisors, and eighth nerve deafness.)

QUESTION: indents on incisal edge with narrowing at mesial and distal? I guessed congenital
syphilis (Hutchinsons tooth?)

QUESTION: A chanker due to Syphilis mostly resembles: Aphthous ulcers.

QUESTION: stages of syphilis is most infectious: primary and secondary, primary, secondary, tertiary,
primary secondary and tertiary

QUESTION: Heck disease: 13 and 32

(also known as focal epithelial hyperplasia) is a cutaneous condition characterized by

white to pinkish papules that occur diffusely in the oral cavity.[1]:411 It is caused by the
human papilloma virus types 13 and 32.

QUESTION: baby with streaks on palate

bone nodulus
Epstein pearls
congenital epulus
QUESTION: Kid has nodule on palatal suture-what is it
Ebstein pearl
Bohn nodule hard/soft palate+ B/L of ridge

QUESTION: neonate with a bunch of nodules on alveolar ridge. What is it?

a. Bohns nodule
- keratin-filled cysts of salivary gland origin on palate of newborn
Eruption cyst
Congenital cyst of newborn

Oral Pathology:

Systemic Lupus Erythematosus:

Lupus Erythematosus collagen/CT multisystem disease. Unknown cause. Women 10x more
frequently. Avg age =31yo. Malar rash, kidney problems 50% of time &lead to organ failure.
Pericarditis also frequent complication; warty vegetations on valves =Libman-Sacks endocarditis.
Oral lesions if evident- palate, B mucosa, gingiva.

QUESTION: Xerostomia, complication of :Sjo gren's syndrome, dry moth dry eye PAROTID

65
SWELLING LUPUS RHEUMATIOD ARTHRITS poorly controlled diabetes,

QUESTION: Which syndrome has rash on cheeks, ulcers, kidney, etc? lupus
QUESTION: Which skin condition has endocaditis and glom- lupus

Cavernous Sinus Thrombosis:

QUESTION: cavernous sinus problem - due to infection of upper lip / canine space infxn / max ant
teeth

QUESTION: Most likely to cause cavernous sinus thrombosis: valve infected by endocarditis, soft tissue
abscess in upper lip (veins of face dont have valves)

QUESTION: a cavernous sinus infection would most likely come from, maxillary sinus, paranasal sinus,
frontal sinus, ant. Max. teeth
QUESTION: Site of infection most likely to enter cavernous sinus? Anterior triangle, naso-labial
cyst

QUESTION: Danger triangle of the face cavernous sinus (no valves in the veins)
QUESTION: Why are you afraid of having infection in anterior triangle (i.e. upper lip) because there
are valve-less veins that can send infection back to the brain

QUESTION: Which of the following causes Cavernous sinus thrombosis: A)Subcutaneous Abscess of
upper lip b)Subcutaneous abscess of lower anterior region

Infections in upper front teeth are within the area of the face known as the "dangerous triangle". The
dangerous triangle is visualized by imagining a triangle with the top point about at the bridge of the
nose and the two lower points on either corner of the mouth

QUESTION: Danger zone of Cavernous Sinus: Signs and symptoms. What is the first one? Blurred
vision

QUESTION: first sign of cavernous sinus:

bulging eye??
loss vision
***HEADACHE***
QUESTION: Pathognomonic sign of CST? Ptosis, bulging eye, headaches(1st one)
QUESTION: Cavernous sinus thrombosis early indication? Peri-orbital swelling, blurry vision
QUESTION: Cavernus sinus has : ptosis, decreased vision, opthalplagia
QUESTION: Danger zone of Cavernous Sinus: Signs and symptoms. What is the first one? Blurred
vision

66
Cavernous sinus thrombosis (CST) is the formation of a blood clot within the CS at the base of the
brain which drains deoxygenated blood from the brain back to the heart. usually from a infection
from nose, sinuses, ears, teeth or Forunculo. Staphylococcus aureus and Streptococcus are often
the associated. symptoms include: decrease or loss of vision, chemosis, exophthalmos (bulging
eyes), ptosis, headaches(1st one) and paralysis of the cranial nerves which course through the
cavernous sinus. This infection is life-threatening and requires immediate TX.

Ludwigs Angina:
QUESTION: Which space is not involved in ludwigs angina? (sublingual, submandibular,
retropharyngeal, or submental)

QUESTION: What space is not associated with ludwigs angina? Associated with sublingual,
submental, submandibular
QUESTION: Ludwigs angina seen in all spaces except: Retropharyngeal
QUESTION: Cellulitis most of the time involves unilateral, ludwigs angina is bilateral and complication is
edema of GLOTTIS

QUESTION: patient has bilateral submand infection, tongue is raised due infection - Ludwig's
QUESTION Bilateral submandibular infection, tongue was elevated due to infection - Ludwig's
Notes: Ludwig angina is the bilateral cellulitis of submandibular and sublingual spaces.
QUESTION: What u need to worry most abt ludwigs? swelling of glottis
QUESTION: Ludwigs: edema of glossitis
QUESTION: complication of lugwigs angina:edema of glottis
QUESTION: Ludwigs Angina symptoms? Swelling, pain and raising of the tongue, swelling of the neck
and the tissues of the submandibular and sublingual spaces, malaise, fever, dysphagia (difficulty
swallowing) and, in severe cases, stridor or difficulty breathing.
QUESTION: What is the main danger in Ludwigs angina? closing of the airway

QUESTION: Mandibular 2nd molar infection spreads to what space? Submandibular space.
QUESTION: What space is mand 2nd molar below buccinators? Submandibular, submenal, sublingual, or
Buccal ???
QUESTION: Infection on the mand buccal side of premolars is most likely to go where? Submand space.
QUESTION: Infxn of mnd 2nd pm goes into submandibular space

QUESTION: Mand premolar infection can go to submandibular space

QUESTION: Premolars and molars infection submandibular space

QUESTION: Which muscle separates 2 potential infection spaces from a maxillary 2nd molar?
Buccinator or Masseter

QUESTION: if you have an infection in the lateral pharyngeal space what muscle is involved? Medial
pterygoid
The lateral aspect is more involved, and is bordered by the ramus of the mandible, the deep lobe of
the parotid gland, the medial pterygoid muscle, and below the level of the mandible, the lateral
aspect is bordered by the fascia of the posterior belly of digastric muscle.

QUESTION: You are extracting a mandibular 3rd molar and the distal root disappears into which

67
space? submandibular space
QUESTION: Root of Mand molar displaced into what space? submandibular
QUESTION: If you extrad madibular molar where to goes, submandibular space.
QUESTION: IAN tract infection, '-[involves what space? Pterymandibular space

Treacher Collins Syndrome:

Downw=ard facing eyes

QUESTION: Which disorder least developmental delay-trecher collins syndrome

QUESTION: Treacher Collins-loss (hypoplasia) of zygomatic bone, what do patients with cleidocranial
dysplasia have? Loss of clavicle
QUESTION: Malformed ear, mandibular hypoplasia Treacher Collins
QUESTION: Describes patient saying they have mandibular hypoplasia, Malformed ear
eyelids, ear pinna-- Treacher Collins

Scarlet Fever:
QUESTION: Strawberry tongue seen in scarlet fever, Also in Kawasaki disease and toxic shock syndrome

QUESTION: Picture of strawberry tongue (scarlet fever)

QUESTION: Strawberry tongue seen in scarlet fever

Fordyce Granules:

QUESTION: Fordyce granules ectopic sebaceous gland

QUESTION: Fordyce granule is what?

salivary gland
sebaceous gland*
sweat gland
Turner Tooth:

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QUESTION: Turners teeth is assoc with?
QUESTION: Most probable reason for a Turner Tooth? Syphilis? Trauma
QUESTION: Most probable reason for a Turner Tooth? Trauma at birth, trauma when young
QUESTION: turners tooth single tooth affected
QUESTION: Turners tooth is caused by: I put trauma or local infection
QUESTION: What gives you Turners incisors
syphilis
trauma during delivery
*trauma during pregnancy (occurs when developing permanent tooth is damaged
by periapical infection in overlying deciduous tooth. This causes defect in enamel)

Recurrent Aphthous Stomatitis:

aphtous ulcers in non keratinized tissue herpes in keratinized tissue
aphthous stomatitis: recurrent discrete areas of ulceration that are almost always painful. occurs
on freely movable mucosa that does not overlie bone,Aphthous can be differentiated since it
usually does not occur over bone, does not form vesicles and is not accompanied by fever or
gingivitis.

QUESTION: Patient has ulcer at mucolabial fold, it goes away and comes back, what could it be?
Apthous!

QUESTION: Pt has occasional sores on mucolabial fold on mandibular arch that healed without scarring:
minor aphthous

QUESTION: Ulcer that appears often on buccal vestibule that goes away without scarring after a week or
so? Minor Apthous ulcer.
QUESTION: Ulcer healing with scar tissue: major

QUESTION: A chancre due to Syphilis mostly resembles: Aphthous ulcers.

QUESTION: History of lesions that go away after 1 week recurrent aphthous ulcers

QUESTION: What dont u treat aphthous ulcers with acyclovir

Benign Mucous Membrane Pemphigoid (cicatricial):

Pemphigoid = D = DEEPER (subepithelial separation) than pemphigus S = SURFACE (epithelial

separation)

69
Know Pemphigoid--**autoimmune disorder where antibodies attack epidermis. Blisters and vesicles
developBMMPbenign mucous membrane pemphigoid. This is DIFFERENT than Pemphigus
vulgaris becauseless severe and HISTO: vesicles are SUBepidermal and NO acanthylosis.

QUESTION: Pemphigoid separation of basement membrane

QUESTION: Subepithelial separation on immunofluorescence indicates? benign mucous membrane
pemphygoid
QUESTION: Another name for chronic desquamative gingivitis? Cicatricial pemphigoid
QUESTION: Most likely to cause desquamative gingivitis:
lichen planus-
Pemphidus vulgaris
Pemphigoid- I would think this one!

Disease with Desquamative gingivitis: lichen planus, mucous membrane pemphigoid (95%),
and pemphigus
A band of red atrophic or eroded mucosa affecting the attached gingiva is known as dequamative
gingivitis. Unlike plaque-induced inflammation it is a dusky red colour and extends beyond the
marginal gingiva, often to the full width of the attached gingiva and sometimes onto the alveolar
mucosa

QUESTION: Desquamative gingivitis is associated with which 2 conditions. Lichen planus and
pemphigoid
QUESTION: Desquamative gingivitis? Answers are in pairs: Pemphigoid and lichen planus

QUESTION: basic question of pemphigusasked which was a vesicular disease. BUT classmate did
get question on which layer it effects. Lichen Planus and pemphigoid =subepithelial, and
pemphigus is suprabasilar vesicle.

QUESTION: Sloughing of gingiva epithelium in max and mand arches: pemphigus or pemphigoid
QUESTION: Which pemphigoid like lesion most often in infants? Bullous Pemphigoid , Pemphigus
Vulgaris, Pemphigoid etc dont remember.
QUESTION: A child is most likely to have which of these: pemphigus, pemphioid, erythema
multiform, epidermolysis bullosa

QUESTION: Child formed blisters with minor lip irritation? Epidermolysis bullosa
QUESTION: Which pemphigoid like lesion most often in infants? Pemphagus Vulgaris, pemphigoid etc
dont remember. Epidermolysis bullosasmall blisters that develop from mild provocation over areas of
stressie elbows and knees****
QUESTION: Young child/infant exhibits ulcerations of mouth: epidermalysis bulosa

QUESTION: Said something about a kid who formed blisters with minor irritation to the lips

a. EPIDERMOLYSIS BULLOSA

Condyloma Acuminatum:

QUESTION: Condyloma accuminatum (genital wart) is caused by which virus? HPV*

QUESTION: Condyloma acumulatum- caused by HPV (venereal warts)

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QUESTION: Which of the following does not have cauliflower like , pebbly appearance? Verrucous
carcinoma, fibroma , condyloma accuminata, papilloma.
QUESTION: HPV: know the subtypes, 6 and 11 for condyloma acumintam

HPV types 6 and 11 are most frequently the cause of genital warts

Candidiasis:

Candida forms ulcer, Erythema, white hyperplastic, white/curd

QUESTION: Hiv patient with oropharyngeal candidiasis, what would u prescribe- fluconzole ????

QUESTION: Systemic antifungal in HIV patient?? Fluconazole

QUESTION: Patient with HIV has candidiasis- bec it is HIV related, increased CD 4... ( I wrote increase
CD4...?)

QUESTION: which oral medication would you give to tx vaginal candidiasis? Nystatin, griseofulvin,
monistat, Diflucan (fluconazole)

QUESTION: If pt undergoes radiotherapy for cancer, the most common oral infection that necessitates
drug tx in this stage is? 1. Candida albicans (answer)

QUESTION: Candidasis in cancer patients due to- chemotherapy, radionecrosis

71
QUESTION: Inhaled methacholine (steroid) produce oral candidiasis

QUESTION: Pt has multiple white patches that can be scraped off candidiasis

QUESTION: Oral cytology smears are MOST appropriately used for the diagnosis of which of the
following? Pseudomembraneous candidiasis

QUESTION: What oral manifestation is seen in children with HIV? Candidiasis #1

QUESTION: Patient is 4yrs old on lots of AB what is most likely? Candidiasis

QUESTION: Candida- can wipe away: Nysatatin

QUESTION: systemic med for candida: amphotericin B
QUESTION: broad spectrum antibiotics : increase superinfection (infxn by candidiasis) and
resistance.

QUESTION: Which is associated w/ burning mouth? Candida

QUESTION: Lesion in the middle of tongue also pt had it on palate before and pt is healthy?
Karposi, candidiasis, Syphilis

QUESTION: Rhomboid tongue thought to be- a type of candidiasis

QUESTION: Median rhomboid glossitis***smooth red area of tongue that lacks the papillae

QUESTION: Healthy 36 year old, red patch on palate, redness in middle of tongue:
-kaposi sarcoma,
-syphilis
-median rhomboid glossitis
-gonorrhea

Primary Herpes:

Gingivostomatitis Herpetica: initial presentation during the first ("primary") herpes simplex
infection. of greater severity than herpes labialis (cold sores) which is often the subsequent
presentations. is the most common viral infection of the mouth,affects both the free and attached
mucosa. Tx Acyclovir, valacyclovir, Penciclovir Famciclovir.

QUESTION: 85% of people have herpes

a. 65-90% worldwide; 80-85% uSA

QUESTION: Kid with herpes. What is the age of infection?

2 years
QUESTION: Age of primary infection of herpes? 2 yo, 4 yo, 6 yo, 8 yo, 10 yo (added info below)

QUESTION: Age of primary infection of herpes? 2 months, 4 yr , 6 yr, 8 yr

From oral path book under viral infections; acute herpetic gingivostomatitis arise between 6
months and 5 years, with peak prevalence btwn 2-3 years of age. Development before 6 months is
rare due to protection of maternal anti-HSV antibodies.

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QUESTION: Young person w/ fever & vesicles: FEVER = PRIMARY herpes stomatitis
QUESTION: Primary herpatic gingivostomatitis- fever, ulcer in mouth. No symptoms
QUESTION: Primary herpatic gingivostomatitis- child 2 yrs , fever, not ant to eat
QUESTION: After orthodontic tx, pt with no other systemic disease develop high fever? due to
canker sores by newly placed brackets.
QUESTION: ways to treat kid w/ herpetic gingivostomatitis EXCEPT
a. antibiotics
b. give numbing anesthetic before eating
c. have pt rest and drink lots of water

Recurrent Herpes Simplex:

aphtous ulcers in non keratinized tissue herpes in keratinized tissue

QUESTION: Herpes can be diagnosed by exfoliative cytology. A characteristic multinucleated cell

appears in the smear of herpes infections.
QUESTION: Recurrent intraoral herpes occurs almost exclusively on mucosa overlying bone.
The hard palate is the most common site, alveolar mucosa
QUESTION: 2ndary herpes ? lip, gingival, and palate pg 106, table 4-1

QUESTION: Herpes simplex is most common cause for Bells palsy

QUESTION: Herpetic withlow? Herpes on finger

DRUG OF CHOICE:
acyclovir: herpes I, II, VZV,EBV
ganciclovir (IV): CMV or (valancyclovir oral)
Primary HSV: PALLATIVE

recurrent herpes medication: docosanol (abreva), acyclovir (zovirax)

Know drugs that are used for Herpes: Acyclovir, valtrex (valacyclovir), docosanol (abreva), and
PENCICLOVIR

QUESTION: Acyclovir given for herpetic lesions. Also, phosphorylated and activated in infected
viral cells.
QUESTION: herpes, zoster Valacyclovir treats herpes labialis
QUESTION: Patient gets recurrent herpetic lesions very often with gingivostomatitis. What should
be done?
Acyclovir.
Palliative trt
QUESTION: Hiv pt with oral herpes, what would u prescribe- vir
QUESTION: Tx for herpatic gingivostomatitis?
palliative tx**
acyclovir
systemic antibiotic
steroids

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QUESTION: Patient has all clinical signs of Herpes (with lesion on corner of mouth that comes and goes)
which medication do you recommend? The one that ended with a vir. (no acyclovir in the answer
choices)
QUESTION: best med for herpes, CMVacyclovir.
QUESTION: Valcyclovir (Valtrex): Tx for herpes simplex/herpes zoster

QUESTION: Tx for herpes simplex and herpes zoster : Valtrax

QUESTION: Which most closely mimics dental pain: herpes zoster, CMV, herpangina

QUESTION: Pain lesion - Herpes Zoster

QUESTION: Patient comes with recurrent herpetic stomatitis on the lips and history shows no signs
of primary herpetic gingivostomatitis. Why? Most primary infections are subclinical

QUESTION: 2nd recurrent herpes, supposed to have a primary phase but no sign? It is subclinical
QUESTION: pt presents at 3 days with secondary herpes lesion? What the treatment of choice?
Antiviral?
Palative treatment****
Acyclovir was an answer choice (but acyclovir works best before you get the lesion)

QUESTION: Herpetic gingivostomatitis within 3 days of onset: treat with Acyclovir 15mg/kg 5 times
per day for 7 days
All patients: palliative care: plaque removal, systemic NSAIDS, and topical anesthetics
Contagious when vesicles are present
QUESTION: Primary herpretic stomatitis? Reactivation of the primary can cause recurrent herpes
infection
QUESTION: Which dz is caused by the virus that causes acute herpetic gingivostomatitis?
A: herpes simplex 1

QUESTION: Herpes lesion intra orally how do u treat? Palliative, acyclovir?? *Tx is supportivetopical
before eating, analgesics, maintain fluid/electrolyte balance, anti-viral agents. DO NOT GIVE
CORTICOSTEROIDS.
QUESTION: acyclovir inhibits mrna. How does it have selective toxicity MOA? Only
phosphorylated in infected cells and inhibits viral mRNAdoes not work on dna

QUESTION: Acyclovir-inhib mRNA?-phosphorylated-. nucleoside analogues--cant make RNA

The mechanisms of antiviral action of acyclovir are well known (Figure 40-9). The nucleoside
analogue is phosphorylated to form acyclovir monophosphate by herpesvirus-encoded
thymidine kinase and phosphorylated further by other enzymes to acyclovir diphosphate and
triphosphate. Acyclovir triphosphate acts to inhibit viral DNA polymerase and to terminate
elongation of the viral DNA chain as spurious nucleotide is incorporated into DNA. In the
noninfected host cell, phosphorylation of acyclovir occurs to a limited extent. Acyclovir
triphosphate inhibits HSV DNA polymerase 10 to 30 times more effectively than it does
mammalian cell DNA polymerase.
QUESTION: how is Acyclovir selective toxicity mechanism of action?
1. only phosphorylated in infected cells and inhibits viral mRNA
2. does NOT work on DNA

74
QUESTION: Post herpetic neuralgia cause by: (VZV)herpes zoster, HSV 1, HSV 2, CMV
QUESTION: What does histoplasmosis oral lesion look like? I put recurrent herpes
Painful, ulcer with irregular borders, similar to cancer
QUESTION: Same patient as #49, has upper denture, when he removes it, there is unilateral lesion on the
palate. What could it be? Herpes (other choices were more serious pathological lesions).
QUESTION: Pic with half the tongue (left side) that looks like herpes lesion and other nothing on it- I
wrote zoster
QUESTION: Pic of tongue one side with messed up: herpes zoster

QUESTION: Antivirals(wrong match)- azt with herpes zoster

QUESTION: Herpetic neuralgia seen after Herpes Zoster (complication of longer shingles) (hh3,
VZV)
QUESTION: Syphilis Chancre resembles 1) Cancer 2)Herpes: 3)Herpangina 4) Apthous Ulcer
QUESTION: Kaposi sarcoma by herpes 8

QUESTION: Kaposi sarcoma most likely on hard palate

Traumatic Neuroma:

QUESTION: A patient has a denture and a firm, swelling under the buccal flange midway
between incisors and molars. What is it? traumatic neuroma
QUESTION: Mandibular Denture: Lump hurts: Anterior to posterior areas cause is: traumatic neuroma

Pyogenic Granuloma:
QUESTION: Picture said: erythematous, bleeding swelling mandibular swelling right next to
premolars on R side? I put pyogenic granuloma
QUESTION: Pyogenic granuloma develops RAPIDLY
QUESTION: Pink growth on palatal between canine and 1st pre? Papilloma, pyogenic granuloma,
peripheral ossifying, irritation fibroma?
QUESTION: Which lesion shows the most rapid change in size?
fibroma
*pyogenic granuloma
QUESTION: fastest growing tumor????

75
 a. oncocytoma
b. pyogenic granuloma
c. pleomorphic adenoma
QUESTION: Which one is common in pregnancy and in normal condition--pyogenic granuloma
QUESTION: Patient is female and pregnant and is said to have this enlargement and picture has it
on the corner of her mouth (vermillion border) and she said it just developed; the picture had it
shown as a boil and very red, said it bled, and was no painful I went with pyogenic Granuloma
other option that could have made sense bc I didnt know what it was a varix (dilated vein)

QUESTION: Picture... Lesion near labial comissure? Canditits Pyogenic Granuloma???

QUESTION: Lesion on gingival if you press, it blanches and it bleeds easily dx = pyogenic
granuloma

Giant Cell Granuloma:

QUESTION: Where do u find giant cells? Hyperthyroidism, Hypothyroidism, Hyperparathyroid,
Hypoparathyroid
QUESTION: Giant cell lesion found in bone what test would you run to help with diagnosis? Bence
Jones(from multiple myeloma, this is what I put), calcium levels, Complete blood count
QUESTION: Giant cell lesion is most like histology of congenital epulis of the newborn. NO!
Granular cell Myoloma

Squamous Papilloma:
QUESTION: Lesion on the palate verrucous and pedunculated: Papilloma

QUESTION: The causes of Verrucus xanthoma? Human papilloma virus

QUESTION: Cauliflower looking lesion, no picture given - Papilloma
QUESTION: lesion in lip with cauliflower shape : PAPILLOMA - the most common benign
neoplasm of EPITHELIAL TISSUE ORIGIN. It appears as apedunculated (foot-shaped), or sessile
whitish cauliflower-like mass on the tongue (posterior border), lips, gingiva, or soft palate.

QUESTION: pedunculated lesion on palate what is it? Papilloma

QUESTION: The most common between five? 1-Papilloma 2-Rhabdomyoma 3-Leiomyoma 4-

Lymphangioma 5-Neurofibroma

Fibroma:

QUESTION: Which one resembles Epilus Fissuratum Fibroma (both share trauma as etiology)

QUESTION: Epulis fissuratum is most similar cellularly to: fibroma, granulomar cell tumor, etc

a. Fibroma (and a question about how to treat a patient with old denture and epulis
usually make new denture or modify; dont just wear same denture)

QUESTION: there was a picture of Fibroma but the term fibroma was not used instead they used
another name: Focal Fibrous Hyperplasia

QUESTION: Fibromas are a result of what dysfunction? Neoplaisa, dysplaia, hyperplasia

76
QUESTION: In most of the cases, localized fibromas are often: Dysplasias, metaplasia, anaplasia,
hyperplasia``

QUESTION: Which of the following does not have cauliflower like , pebbly appearance: Verrucous
carcinoma , fibroma, condyloma accuminata, papilloma.

Granular Cell Tumor:

pseudoepitheliomatus hyperplasia: resembles SCC. It is seen in inflamm papillary hyperplasia, chronic

hyperplastic candida, Granular Cell Tumor, blastomycosis.

QUESTION: Congential epulis histological similar to: hemangioma, lymphangioma, granular cell
myoblastoma

QUESTION: Patient has congenital epulis. What is the histology most similar to? Granular cell tumor

Leukoplakia:

QUESTION: If you have leukoplakia for biopsy, do you incise or excise for biopsy? 1. Incision (answer)

QUESTION: Leukoplakia all over- incise multiple areas w incisional.

Erythroplakia:

QUESTION: In smokers soft palate, theres red points, wut could it be? erythroplakia, initial
stages of SCC, nicotinic stomatitis (hard palate), etc.

QUESTION: what presents with severe dysplasia? Erythroplakia, white sponge nevus
QUESTION: Lesion commonly with dysplasia and carcinoma in situ-- Erythroplakia

Squamous Cell Carcinoma:

QUESTION: White ppl have least oral carcinoma: or asian, Indian, blacks
QUESTION: Worse rate of SCC is in? I put Black men
QUESTION: Etiology of Squamous Cell Carcinoma, external factors and stress.
(alcohol, tobacco, UV radiation, certain HPV types, vitamin deficiency, immunocompromised, iron
deficiency anemia plummer Vinson syndromeetiologies added from First Aid)
QUESTION: Xerostomia increases risk of SCC
QUESTION: lateral boarder of the tongue picture looked like squamous cell carcinoma

QUESTION: Lesion that resembles SCC16wks and then disappers

a. papilloma

77
 b. keratoacanthoma
c. papillary hyperplasia
QUESTION: Which of the following has the best survival rate?
a. squamous cell carcinoma
b. adenocarcinoma
c. osteosarcoma
QUESTION: SCC on tongue, What you do? Incisional

QUESTION: #1 risk factor for oral cancer Tobacco

QUESTION: Most likely site for SCC? Ventrolateral tongue (other choices were weirdpalate
(least))

QUESTION: Beetle nut case SCC, xerostomia ? gingival recession ?

QUESTION: Pt has been a smoker (60 pack yr history); ulcer in lower lip, non-indurated; wuts most
probable diagnosis? SCC

QUESTION: Most common malignancy in the oral cavity?

a. metastatic ca (most common malignancy found in bone)
b. basal cell ca (most common type of skin cancer)
c. epidermoid ca (aka SCCIm pretty sure this is the right answerXtina)
d. mucoepidermoid ca (most common salivary gland carcinoma)
e. adenoid cystic ca (second most cmoon salivary gland carcinoma)

QUESTION: Most malignant cancer in oral cavity? Epidermoid carcinoma ***SCC! (look it up)

QUESTION: Which of these is the most likely to become malignant? low grade mucoepidermoid
carcinoma;
QUESTION: Radiographic Picture: image was upside down, had pink tissue-two teeth on bottom, bump
on palate-what is the lesion? ---SCC?

Leukoedema:

QUESTION: Leukoedema blanches, no treatment

QUESTION: Leukoedema: Stretch and it disappears

QUESTION: dr stretches buccal mucosa, white, and spreads out thinner: leukoedema
QUESTION: Similar question: Which white lesion disappears upon stretching? Leukoedema
QUESTION: White on mucosa-no information-hyperkeratosis? Gauri put leukoedema; white sponge
nevus other option, lichen planus

QUESTION: Lesion that blanches -Leukoedema- it disappears on streching, it is always bilateral

QUESTION: A patient presents with a bilateral, grayish-white lesion of the buccal mucosa. This lesion
disappears when the mucosa is stretched. Which of the following is the MOST likely condition?

A. Leukoedema

B. Leukoplakia

C. Lichen planus

78
D. White sponge nevus

Leukemia:

lymphocytic leukemia-involves Iymphocytes.

Chronic lymphocytic leukemia runs a variable course (older patients may survive years
even without treatment). lymph node enlargement is the main pathologic finding. May
be complicated by autoimmune hemolytic anemia.
CML Philadelphia chromosome (chromosomal translocation)**Chronic myelogenous leukemia
QUESTION: Leukemia picture

o Says bleeding gums

o 20 yr old patient
o Been bruising easily

QUESTION: Patient shows up with kid always bleeds, discomfort leukemia

QUESTION: Leukemia Picture: young person that is fatigued and has a jacked-up mouth

QUESTION: Pic of kid with bleeding gums problem healing- leukemia

QUESTION: Most common type of leukemia in children? 1. ALL (answer) (lymphoblastic)

QUESTION: Pt had erythematous and gingival enlargement over past 5 weeks. And increased report
of bruising on body cause is acute leukemia: Specifically, AML

QUESTION: A 6 years old patient has acute lymphatic leukemia. Her deciduous molar has a large carious
lesion and furcation lucency. How will you treat this person?
a. pulpotomy
b. pulpectomy
c. extraction
d. nothing
QUESTION: An 18 year old man complains of tingling in his lower lip. an examination discloses a
painless, hard swelling of his mandibular premolar region. the patient first noticed this swelling three
weeks ago. radiograph indicate a loss of cortex and a diffuse radiating pattern of trabeculae in the mass.
which of the following is the MOST likely diagnosis?
a. leukemia
b. dentigerous cyst
c. ossifying fibroma
d. osetosarcoma
e. hyperparathyroidism

Verrucous Carcinoma:

QUESTION: Best prognosis? Verrucous carcinoma in vestibule, verrucous carcinoma floor of mouth,
SCC floor of mouth, SCC in other areas
QUESTION: smokeless tobacco : verrucous carcinoma

QUESTION: Verricus leukoplakia, HPV 16 and 18

QUESTION: Most common most pathogenic location verrucus carcinoma-floor mouth buccal vestibule

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QUESTION: Verrucous carcinoma presents with

warty lesion
white ulcerated patch (thats what it looks like on google images)
smooth pedunculated lesion
I put large warty mass- variant of SCC
(large broad based exophytic papillary leukoplakic lesion: Xtina, First aid)
Salivary Gland Tumors:

Most common salivary gland benign major or minor : Pleomorphic adenoma

Most common malignant minor: Adenoid cystic carcinoma

Most common malignant major: Mucoepidermoid carcinoma

QUESTION: Most common salivary gland tumor: Pleomorphic adenoma

QUESTION: Most common gland in Pleomorphic adenoma:

MOST COMMON SITE = MINOR GLANDS OF PALATE

*MOST COMMON TUMOR OF PAROTID GLAND*

QUESTION: Pleomorphic adenoma most common benign tumor of salivary glands

QUESTION: which s most common salivary gland tumor pleomorphic adenoma and
mucoepidermoid
**Pleomorphic adenoma-most common belign
Mucoepidermoid: Most common malignant
QUESTION: Which of the salivary tumor glands has the best prognosis: Mixed Tumor, Adenoid
cystic carcinoma (perineural spread), Mucoepidormoid Carcinoma (most common)
Acinar Cell Carcinoma (better answer if there)
QUESTION: Which of the salivary tumor glands has the best prognosis: Mixed Tumor (plemomorphic
adenoma), Adenoid cystic carcinoma (perineural spread), Mucoepidormoid Carcinoma (most common)
Acinar Cell Carcinoma (better answer if thereI put polymorphous low grade adenoma but I think the
answer is adenoid cystic

QUESTION: Best prognosis for oral cancers: Adenomatoid od. Tumor, low-grade --, malig. Mixed tumor

Benign Mixed tumor (pleomorphic adenoma) = best prognosis

Low grad mucoepidermoid is also good

Malig Mixed tumor & adenomatoid = worst

QUESTION: Perineural invasion is seen in: adenoid cystic carcinoma, Pleomorphic adenoma or low
grade mucoepidermoid carcinoma. This tumor has a marked tendency to invade nerves. Perineural
invasion is seen in about 80% of all specimens.

QUESTION: Adeno cystic carcinoma : neurotrophic factor and perineral invasion

80
QUESTION: perineural invasionACC (adenoid cystic carcinoma) other choices were OKC, etc

QUESTION: Table 4. 3: swish cheese? adenoid cystic carcinoma

Adenoid cystic carcinoma

o High grade salivary malignancy
o Palate most common
o Most common malignant
o swiss cheese microscopic pattern
o spreads through perinueral spaces*****
Ameloblastoma:

Most common EPITHELIAL ODONTOGENIC TUMOR...mand molar area

QUESTION: Ameloblastoma histology : stellate reticulum in bell stage, epithelium in net flex
pattern

QUESTION: Which one can leads to ameloblastoma? Dentigerous Cyst.

QUESTION: What cyst is ameloblastoma most likely to stem from? Dentigerous cyst

QUESTION: Which describes ameloblastoma best? I put local invasion

QUESTION: What is the most definite way to distinguish ameloblastoma from OK?
a.smear cytology
b.reactive light microscopy
c.reflective microscopy

QUESTION: Ameloblastoma case Q. You get a picture, slow progessing, other false choices included
dentigirous cyst.

QUESTION: Multiluncency in bone and ramus: ameloblastoma

ameloblastoma
o benign, aggressive odontogenic tumor w/recurrence
o most common tumor
- Ameloblastoma consists entirely of odontogenic epithelium. MOST AGGRESSIVE odontogenic tumor.
MOST COMMON epithelial odontogenic tumor.
Solid (multicystic or polycystic) most aggressive kind and requires surgical excision

Ameloblastic Fibroma: compared to ameloblastoma - younger age, slower growth, does not infiltrate

QUESTION: A painless, well-circumscribed radiolucency and radioopacity in the posterior mandible of

11yrs old boy. what is the differential diagnosis? Ameloblastic fibro odontoma

QUESTION: Xray - Ameloblastic fibro odontoma/odontoma?

Odontoma:

QUESTION: pic of compound odontoma

81
QUESTION: x-ray of odontoma ( anterior lots of little tooth in the x-ray around the canine)

QUESTION: recognize odontoma--- **compound odotomalooks like a tooth more defined; complex
odontomagiant mass that is also radiopaque, but does not look like a tooth

QUESTION: Syndrome with multiple odontomas-gardners syndrome

QUESTION: Picture of multiple small teeth within a radiolucency: compound odontoma, pindborg
tumor, calcifying odontogenic
- The other tumor of mixed, (epithelial and mesenchynal) origin is the odontoma. These
calcilied iesions take one or two general configurations. They may appear as multiple
miniature or rudimentary teeth, in which case they are known as compound odontomas,

Adenomatoid Odontogenic Tumor (AOT):

QUESTION: AOT (Adenomatoid odontogenic tumor) radiograph picture

o Exact picture used

QUESTION: Max canine surrounded by lesion: AOT

QUESTION: 2/3 tumor: adenomatoid odontogenic tumor: 2/3rd in maxilla, 2/3 in female, 2/3rd
in anterior jaw

QUESTION: Radiolucency at the end of a tooth that looks like there might be an AOT but the patient is
having symptoms (I wrote pericapical cyst)
QUESTION: Radiolucent lesion Between canine -lateral with radiopacity inside: adenomatoid
tumor
QUESTION: mixed density young child: AOT
QUESTION: AOT on xray- REMEMBER lesion goes to apex

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QUESTION: A 16 year old boy. Xray showed maxillary anterior tooth with a radiolucency with
SPECKS in it (yes thats the word that was used). Adenomatoid Odontogenic Tumor

Amelogenesis Imperfecta:

QUESTION: amelogenesis imperfecta is autosomal dominant.

QUESTION: Amelogenesis imperfect: X-ray: open contacts

QUESTION: Pictures of teeth, premolars just erupted. Thick dentin thin enamel, pulps not
obliterated, no contact AI

QUESTION: Radiographic picture with large decay and radiolucency. In addition to periapical
radiolucency what other thing do you see? amelogenesis imperfecta (tooth lacks enamel)

QUESTION: Know the Imperfectas Amelogenisis: Hypoplastic pitting enamel

QUESTION: All of the following are congenital except

a. dentinal dysplasia
b. amelogenesis imperfecta
c. regional odontodysplasia
d. ectodermal dysplasia
QUESTION: Question describing regional odontodysplasia: ghost teeth. (enamel, dentin and pulp
are all affected. Non hereditary)
QUESTION: when does enamel hypoplasia occur: Altered matrix formation. (BELL STAGE)

DI vs Dentinal Dysplasia:

DI: Crowns are short & bulbous, narrow roots, obliterated pulp

DD: Short roots (sometimes rootless), obliterated pulp, sometimes PA RL, mobile teeth

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QUESTION: Dentingenesis imperfecta related to osteogenesis imperfect
QUESTION: What is seen with Osteogenesis Imperfecta: Dentinogenesis Imperfecta

QUESTION: osteogenesis imperfecta usually assoc w/

a. DI
b. AI
c. hypercementosis
d. cleidocranial dysplasia
QUESTION: pulp is gone: DI Dentinogenesis imperfect
QUESTION: Dentinogenesis Imperfecta: Obilterated pulp chambers

QUESTION: all of the following are differential for Dentinogensis imperfecta except?
ectodermal dysplasia,
amelogenesis imperfecta,
enamel dysplasia,
dentinal dysplasia
QUESTION: Which is not associated with dentogenesis imperfecta? Ectodermal dysplasia because
the enamel is the ectoderm, dentin is mesoderm I think

QUESTION: Differential diagnosis of Dentingenesis imperfect includes all except:

-OI
-ECTODERMAL DYSPLASIA
-enamel hypoplasia (AI)
-dentin dysplasia

QUESTION: Dentinogenesis Imperfecta poorly mineralized dentin, enamel frequently fractures

from the teeth leading to rapid wear and attrition of the teeth.
QUESTION: Dentinogenesis imperfect type I when? part of osteogenesis imperfect BLUE
SCLERA..... or it can be a separate inherited dominant trait without OI (DI type II)

QUESTION: Which one is associated with dentinogenesis imperfecta?

blue sclera (this is from osteogenesis imperfecta)
hypodontia
Other characteristics of this condition: opalescent teeth, affects both primary and
permanent, teeth are bluish-brown and translucent, enamel is lost early, type 1 is with osteogenic
imperfecta, type 2 is not with OI, type 3 is the bradywine type which occurs in absence of OI and is
isolated to Maryland. Type 3 also exhibits multiple periapical radiolucencies and large pulp chambers.
QUESTION: Dentin dysplasia looks like dentinogenesis imperfect, WITH ONE DIFFERENCE?
dysplasia has radiolucency.

QUESTION: Radiograph what is it: Aentinogenesis Imperfecta pulpless tooth 1 and 2Type 3 are shell
teeth
dentinal dysplasia (coronal type II) no/short roots, large pulp chamber-looks like dental
imperferca radicular is type-1-complete pulpal obliteration, short roots, PA RL

QUESTION: Dentinal dysplasia type 1 is pulpless

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QUESTION: Dentinal Dysplasia Clinically the dental crowns appear normal while radiographically,
the teeth are characterized by pulpal obliteration and short blunted roots. The teeth are generally
mobile, frequently abscess and can be lost prematurely.

QUESTION: KID x ray cant see shit on xray however you can tell the roots are short. Sister also has
same condition. What condition is this?
DI-autosomal dominant!!
AI-autosomal recessive
Detin dysplasia autosomsal dominant
QUESTION: A picture of dentin dysplasia Short rooted teeth with periapical lucencies

QUESTION: Teeth with very large pulp chambers and open apex, 12 yo boy, sister also effected:
Dentinal dysplasia

QUESTION: Some teeth appear to be clinically normal, but exhibit (1 ) globular dentin, (2) very
early pulpal obliteration, (3) defective root formation, (4) periapical granulomas and cysts, and (5)
premature exfoliation. The condition is known as which of the following?

A. Shell teeth B. Dentin dysplasia C. Regional odontodysplasia D. Amelogenesis imperfect

E.Dentinogenesis imperfecta

QUESTION: Ectodermal dysplasia expressed as? anodontia or hypodontia, with or without a cleft
lip and palate. Anodontia also manifests itself by a lack of alveolar ridge development; as a result,
the vertical dimension of the lower face is reduced, the vermilion border disappears, existing
teeth are malformed, the oral mucosa becomes dry, and the lips become prominent. The face of an
affected child usually has the appearance of old age.

QUESTION: Ectodermal dysplasia definition

QUESTION: Ectodermal dysplasia? Abnormality of 2 or more ectodermal structures. Hair loss, thick nails,
light skin, no sweat glands, missing teeth.
QUESTION: Congenitally missing teeth often seen in? Ectodermal dysplasia
QUESTION: Ectodermal dysplasia: which of the following is correct? It is xlinked, not autosomal
dominant

- Ectodermal dysplasia hereditary, abnormal skin, hair, nails, teeth, sweat glands. Teeth develop
abnormally causing anodontia or oligodontia (partial). Retained primary teeth. CONICAL shaped anterior
teeth.

QUESTION: Characteristic of Ectodermal Dysplasia is? Oligodontia (some missing teeth, not all)
QUESTION: Ectodermal dysplasia: Oligodontia

QUESTION: ectoderman dysplasia : partial or complete anodontia

QUESTION: hypohidrotic child --> ectodermal dysplasia
QUESTION: Ectodermal dysplasia sparse hair
QUESTION: Ectodermal dysplasia- sparse hair
QUESTION: ectodermal dysplasiaoligodontia and lack of sweat glands
QUESTION: what characterizes ectodermal dysplasia? Skin, hair, nails, SWEAT GLANDS?
QUESTION: What does hypodontia affect the most? I put growth of the alveolar bone?

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QUESTION: Having hypodontia/anodontia will prevent/undermine formation of what? I said
alveolus (others were maxillary and mandibular arch but not together)
QUESTION: What do you see when you have hypodontia: maxillary deficiency, mandibular
deficiency, atrophic ridge, midface deficiency
QUESTION: Hypodontia affects maxillary constriction
QUESTION: Hypodontia- FEWER number of teeth
1. max deficiency
2. man deficiency
3. mid-face deficiency
4. cortical bone deficiency
5. alveolar bone deficiency

QUESTION: Radiographs of a patient's teeth reveal that the crowns are bulbous; the pulps,
obliterated; and the roots, shortened. These findings are associated with which of the following?

A. Osteogenesis imperfecta

QUESTION: Radiographs of a patient's teeth reveal that the crowns are bulbous; the pulps,
obliterated; and the roots, shortened. These findings are associated with which of the
following?

Porphyria
Pierre Robin syndrome
Amelogenesis imperfecta
Osteogenesis imperfecta
Erythroblastosis fetalis
QUESTION: Blue sclera seen in? osteogenesis imperfect
QUESTION: Blue sclera? Ectodermal dysplasia or OI
QUESTION: What is the most common? Dentinal dysplasia, amelogenesis imperfecta, dentinogenesis
imperfecta, cleft lip (Cleft Lip/palate)

Cherubism:

QUESTION: Cherubism: Bilateral jaw expansion

QUESTION: A kid presents for bilateral enlargement, painless, etc (they are implying Cherubism, what is
the Tx? No Tx required!

Fibrous Dysplasia:

QUESTION: Fibrous Dysplasia ground glass appearance**Mccune-Albright Syndromepolyostotic

fibrous dysplasiaareas of radiolucent/radiopaque---potential for malignant transformation

QUESTION: fibrous dysplasia on xray: lucency w/ no opacity, no tooth involved

QUESTION: Panoramic with big radiopacity?

-fibrous dysplacia: it is diffuse radiopacity-vital tooth
-osseous fibroma:radiolucent vital tooth
-cementous dysplacia

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QUESTION: Fibrous dys (diffuse expansion of the mandible)
QUESTION: Picture of couple radiolucency lateral to lateral incisors, asymptomatic, 35 yo female:
fibrous dysplasia- Monostotic fibrous dysplasia may be completely asymptomatic and is often an
incidental finding on x-ray

QUESTION: Which of the following is frequently accompanied by melanin pigmentation (cafe-au-

lait spots)?

A. Osteomalacia

B. Hyperparathyroidism

C. Osteogenesis imperfecta

D. Polyostotic fibrous dysplasia

QUESTION: McCune Albrights Syndrome Caf au lait spots (coast of Maine)bone and skin
disorderbrown spots! Coast of maine hahaha

Condensing Osteitis:

QUESTION: Cause of radio opacity of infected tooth- condensing osteitis

QUESTION: Xray condensing osteitis

Traumatic Bone Cyst:

QUESTION: Scalloped and vital : traumatic bone cyst

QUESTION: Traumatic bone cyst (simple bone cyst) nothing inside
QUESTION: Traumatic bone cyst pic-
QUESTION: Picture said: scalloped border, patient is asymptomatic I put traumatic bone
cyst- Psuedocyst, heals by itself
QUESTION: question about traumatic bone cystnot a true cyst b/c not epithelial lined
d. scallops around the roots of teeth

QUESTION: Young patient with traumatic bone cyst, what tx? None, spontaneous healing

Pagets Disease of Bone:

QUESTION: Pagets Disease cotton wool appearance of skull

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QUESTION: picture of paget disease : cotton wool in skull

QUESTION: picture of paget disease : cotton wool in skull

QUESTION: Pagets disease : increase alkaline phosphatase

QUESTION: Pagets disease : increase alkaline phosphatase

QUESTION: Which one most likely has potential for malignant transformation: osteomas, pagets,
QUESTION: what has high incidence of becoming malignant? Cant remember options but I put
Pagets disease
QUESTION: Which of the following has the potential for undergoing spontaneous malignant
transformation?
A. Osteomalacia
B. Albright's syndrome
C. Paget's disease of bone
D. Osteogenesis imperfecta
E. von Recklinghausen disease of bone

QUESTION: Which has the highest potential for malignant transformation? Pagets disease->
Osteosarcoma

QUESTION: Pagets can lead to osteosarcoma

QUESTION: Denture does not fit anymore as a result of? paget disease aka osteitis deformans!
cotton wool

- -->Pagets Disease aka Osteitis Deformans chronic bone disorder where bones become enlarged and
deformed dense but fragile. Seen in pts OLDER pts. Dentures stop fitting. Develops slowly. COTTON
WOOL appearance, hypercementosis, and loss of lamina dura. Labs INCREASE serum ALKALINE
phosphatase but normal serum phosphate and calcium. Risk of osteosarcomas.

Langerhans, Histocytosis X:

QUESTION: Langerhans x- floating teeth in air.

QUESTION: Radiographic Picture: Floating tooth-not in bone, opacities in lesion-what is it?

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 Whole jaw cyst
Ameloblastoma
Keratocyst
Dentigerous cyst
QUESTION: Hand-Schuller-Christian triad

o Diabetes insipidus

o Exophthalmos

o Bone lesions (Langerhans dis)

Oral signs of hand-schuler-christ. = bad breath, sore mouth, loose teeth

lesion are sharply punched out radiolucency and teeth appear as FLOATING IN AIR

Nasolabial Cyst:

QUESTION: Not a bone cyst? Nasolabial cyst, occurs outside of bone

QUESTION: Which one is soft tissue involvement, not bone - Nasolabial Cyst
QUESTION: Soft tissue cyst- nasopalatanine duce, nasolabial,
QUESTION: A patient has a swelling under the upper lip that is by her lateral incisor and raises
the ala of the nose from the outside. What is it? I put nasolabial cyst
QUESTION: Radiolucency radiating from root of central incisor toward midline, could be all of the below
except lateral periodontal cyst, nasopalatine cyst, some sort of fibrous dysplasia, nasolabial cyst
- Because this cyst is extraosseous, it is not likely to be seen on a radiograph.
QUESTION: Which one not seen radiographically? Naoslabial cyst
QUESTION: Nasolabial angle: angle b/w base of nose and lip; should be perpendicular, if its acute,
that means patient has big lips
QUESTION: Lining of nasolabial cyst- pseudo stratified squamous
QUESTION: What is the rarest cyst? Lateral Periodontal Cyst
Nasolabial cyst?
Lymphoepithelial Cyst:

QUESTION: Round yellow-white bump underneath tongue? Lymphoepithilial cyst? Yellowish cyst on
floor of mouth? Oral lymphoepithelial cyst
QUESTION: Round yellow-white bump underneath tongue? Lymphoepithalial cyst?
QUESTION: Patient (young child) w/ nodules on right side of tongue that are fluid filled the rest of
the mouth is WNL no other systemic signs
a. Neurofibromatosis
b. Lymphangioma *
c. Granular cell tumor
Odontogenic Keratocyst:

OKC
High recurrence
Intrabony, post mandible;
basal cell nevus syndrome (a.k.a. Gorlins syndrome, multiple OKCs seen:
Xtina)

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QUESTION: Which is most likely to recur? I put OKC
High recurrence!
Intrabony, posterior mandible but anywhere; BCNS association

QUESTION: Largest incidence of recurrence? OKC

QUESTION: Most reccuring :okc

QUESTION: What has the highest recurrence rate?
*Odontogenic keratocyst
Dentigerous cyst
QUESTION: initial treatment for OKC is enucleate or resect?? (Usually therapy is enucleation and
cryosurgerynot sureXtina)
Nevoid Basal Cell Carcinoma:

QUESTION: Gorlin syndrome = nevoid basal cell carcinoma. Commonly seen OKCs and palmar
pitting, plantar keratosis (odontogenic keratin cyst)
QUESTION: which disease has multiple OKCs? nevoid basal cell carcinoma. Is answer.

QUESTION: What else most often seen with bifid rib, nevoid basal cell? Odontogenic keratocyst

QUESTION: Basal cell nevus syndrome (a.k.a. Gorlins syndrome, multiple OKCs seen Nevoid basal cell
carcinoma: lots of cyts OKC or NEW NAME ---keratocystic odontogenic tumor (KCOT) multiple OKC
- nevoid basal cell carcinoma

QUESTION: Has Lots of odontogenic keratocysts (OKC): Nevoid Basal Cell Carcinoma Syndrome
(Gorlin Syndrome; Basal cell nevous syndrome)

QUESTION: What else most often seen w bifid rib, nevoid basal cell? Odontogenic keratocyst.
QUESTION: What does multiple OKC tell you? Gorlin syndrome! **also called basal cell nevus
syndrome
QUESTION: multiple OKC=GOrlin gotz
QUESTION: Basal cell nevus bifid rib syndrome (gorlin-goltz syndrome)
QUESTION: What else most often seen with bifid rib, nevoid basal cell? Odontogenic keratocyst
QUESTION: Nevoid basal cell carcinoma causes cyst in the jaws?
QUESTION: nevoid BCC and palmer melatonin indicative of: OKC
OKC from remnants of dental lamina
QUESTION: Gorlins- calcified falx cerebri

QUESTION: Which syndrome Pt has calcified falx cerebri, multiple okcs, bifid ribs? - Gorlin Goltz
syndrome aka Basal cell bifid rib syndrome.

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Gardner Syndrome:

QUESTION: Which syndrome includes osteoma? Gardners

QUESTION: multiple osteomas are found in--> garderners

QUESTION: Which condition presents w/ many osteomas? Gardners Syndrome (Multiple

facial osteomas & skin nodules)

QUESTION: Gardner multiple osteomas and intestinal polyps

QUESTION: In which syndrome Pt has ? Gardner's syndrome and esophageal stenosis syndrome

QUESTION: Colon polyps and some kind of oral lesion? Gardners syndrome
QUESTION: gardners syndrome with multiple osteoma and intesbtinal polyps

QUESTION: What do Gardners and Peutz-Jeghers syndrome have in common? GI polyps?

QUESTION: What has polypsGardners , Peutz-Jegher, and Crohns

QUESTION: What do Gardners and Peutz-Jeghers syndrome have in common? GI polyps?

QUESTION: In Gardners Syndrome there may be cancerous transform of what?- polyps in intestine.

Bells Palsy:

QUESTION: unilateral eye and lip, unable to close (picture of black chick) - bells palsy photo of a
person to identify the condition : bell palsy ( see mosbys photo )

QUESTION: Know bells palsy: unilateral facial paralysis

QUESTION: What causes bells palsy? I chose idiopathic.
Decks: Bell's palsy: involves unilateral facial paralysis with no known cause, except that there is a loss of
excitability of the involved facial nerve. The onset oft his paralysis is abrupt, and most symptoms reach
their peak in 2 days. One theory of its cause is that the facial nerve becomes inflamed within the temporal
bone, possibly with a viral etiology.
QUESTION: Which cranial nerve affected bells palsy? Facial nerve (7th )

Temporomandibular Dysfunction:
QUESTION: Clicking in tmj: internal derangement with reduction
QUESTION: Which artery supplies the TMJ? Deep auricular, maxillary, superficial temporalMADS
Middle meningeal from maxillary, ascending pharyngeal, Deep auricular, superficial temporal

QUESTION: Best imaging for TMD: MRI

QUESTION: Best way for soft tissue ( disc of TMJ ) : MRI

QUESTION: Mri is best way to look at condyle/tmj

QUESTION: best diagnostic eval for TMJ disc? MRI, CT, PA radiograph

QUESTION: Which radiograph will give you a direct view of the TMJ? (TMJ Tomography?)

QUESTION: Scanning disk tmj- mri best view

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QUESTION: Part of the TMJ that purely rotates : Articular eminence of condyle

QUESTION: Rotation involves what structures? condyle, glenoid fossa, disc, TMJ

Condyle and articular fossa

QUESTION: Which anatomical components are responsible for rotation of the mandible? Condyle and
articulating disk

QUESTION: When TMJ is in rotational movement, rotation is in lower compartment

QUESTION: Lower compartment of TMJ is for? Rotation, upper compartment translation

QUESTION: what causes tmj ankylosis? Trauma?? Rheumatoid arthritis

QUESTION: Patient cant speak English well, she doesnt work, she has TMJ problems, she is on meds.
Which one will not affect her oral hygiene prognosis? - TMJ problems. (Rationale here is; she may not
be able to afford hygiene procedure, she might not understand doctors recommendations, and her meds
can contribute to hygiene issues. TMJ problem was not serious enough, as in she can open her mouth to
clean her teeth)
QUESTION: Man comes in after years of tmjd with reduction and is now only able to open 25mm and
thats it with muscle pain. Whats his disorder?- Myofacial pain syndrome.

QUESTION: Pt is clicking in the jaw suddenly cannot open 25 mm: myofacial pain syndrome (can
cause clicking, limited opening, pain), internal derangement without reduction has no noises or
clicking but limited opening to <30mm

QUESTION: Patient always had internal derangement with clicking all of a sudden no noise and
open max 30 mm what happened? Myofascial pain

QUESTION: Football player with mouthguard, crepitation of left TMJ, trigger zone tenderness L
temporalis, stiffness upon wakening: Myofacial pain syndrome
QUESTION: Highschool football player wears a mouthguard, very tender to palpation of temporal
area, muscle soreness..? question never said about noises: Myofacial pain disorder (possibly
osteoarthritis)
QUESTION: Football player with a mouthguard tenderness to temporalis and hard to open mouth in
morning
myofacial pain
tmj dislodgement
QUESTION: Most immediate sign after high occlusion bridge? Myofacial pain

QUESTION: symptoms of pain and tenderness upon palpation of the TMJ are usually associated with
which of the following
a. impacted mandibular third molars
b. flaccid paralysis of the painful side of the face
c. flaccid paralysis of the non painful side of the face
d. excitability of the second division of the fifth nerve
e.deviation of the jaw to the painful side upon opening the mouth.

92
QUESTION: TMJ pain are mostly related to: 1- VII, 2-V3, 3-V2, 4-V111

QUESTION: What branch off facial nerve gets damaged the most during TMJ surgey? Temporal

QUESTION: Nerve most damaged in tmj surgery- FACIAL

QUESTION: TMJ ligaments purpose limit the movement of mandible, helps open mandible, helps
closes mandible

QUESTION: Which muscle mainly responsible for positioning and translating condyles? Lateral
pterygoids

QUESTION: Stress causes immune weakness which leads to disease and bruxism
QUESTION: How do you treat bruxism? Mouthguard
QUESTION: Occlusal guard-distribute occlusal force
QUESTION: Main function of the occusal guard:
Distribute forces more evenly
To relax the musculature
Bruxism

Erythema Multiforme:
QUESTION: Target lesions? Erythema Multiforme (also has positive nikolsky sign)
QUESTION: Steven-Johnson syndrome? conjuctiva, and genital problems

Pemphigus:
QUESTION: A patient has painful lesions on her buccal mucosa. A biopsy reveals acantholysis and a
suprabasilar vesicle. Which of the following represents the MOST likely diagnosis?

A. Pemphigus

B. Psoriasis

C. Erythema multiforme

D. Bullous lichen planus

E.Systemic lupus erythematosus

QUESTION: basic question of pemphigusasked which was a vesicular disease. BUT classmate did
get question on which layer it effects. Lichen Planus and pemphigoid =subepithelial, and
pemphigus is suprabasilar vesicle.

QUESTION: intraepithelial-pemphigus

QUESTION: immunofluorescence of antibodies , Pemphigus intraepithelial , demosomas.

Pemhigoid and pemphigus: which one comes apart from Connective Tissue
Actinolysys is present in pemphigus
If antibody is linear pemphigoid

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 If antibody is fishnet pemphigus

QUESTION: immunofluoresence used for dx of

a. pemphigus
b. LP
Know Pemphigoid--**autoimmune disorder where antibodies attack epidermis. Blisters and vesicles
developBMMPbenign mucous membrane pemphigoid. This is DIFFERENT than Pemphigus
vulgaris becauseless severe and HISTO: vesicales are SUBepidermal and NO acanthylosis.
Pemphigus--**autoimmune disorder where there is acanthylosis, tzanck cells. Antibodies are directed
against the epithelium. Target the desmosomal Dsg3 and cause sloughing. Nikolskys sign is when the
epithelium can just be rubbed off of an unaffected areaHISTO: vesicles are suprabasilar and there is
presence of acanthylosis

QUESTION: Pic that looked like herpangia in back of palate- qusion stated there are nikoski signs what
is it- I wrote herpangia... but pemphigus was also a choice (Erythema multiform and pemphigus vulgaris
both show Nikolsky sign
QUESTION: White film w/ pos nikolsky-pemphigus tx w incisional biopsy
QUESTION: Blow cold air on mucosa causing a positive Nikosky sign a) erythema multiformb) herpes
c) phemphigoid NO PEMPHIGUS AS ANS CHOICE. eipdermolysis bullosa IS THE ANSW (maybe
erythema mutiforme)

INFO: In Pemphigus this disease, patients have autoantibodies against desmogleins, which are part of
the spot desmosomes
Types: Most commonly Vulgaris
INFO: In Pemphigoid, the antibodies are directed against hemidesmosomes
Types of Pemphigoid (Bullous -Rarely affect mouth), Blisters of skin
Cicatrical-- Affects mucous lining, MOUTH
1. nikolski sign: pemphigus
2. basement separation between ET: pemphigus

Scleroderma:
QUESTION: Widening of PDL and loss of ramus of mandible: Scleroderma
QUESTION: scleroderma: symmetrical widening of PDL and deposition of collogen in organs leads
to failure

QUESTION: CREST Syndrome=SCLERODERMA . connective tissue disease of skin, blood vessels,

muscles, and internal organs. autoimmune disorder. Blue fingers, Hair loss Skin hardness Skin that
is abnormally dark or light

Geographic tongue:

QUESTION: Picture of fissured tongue

QUESTION: Description of geographic tongue
QUESTION: Guy with lesions on his tongue that seem to move locations --> erythema migrans
(geographic tongue)
QUESTION: burning sensation on tongue,, moves around: geographic tongue
QUESTION: cause of geographic tongue: unk
a. ulceration of mucosa

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QUESTION: Xray Erythema migrans

QUESTION: Migratory glossitis picture

QUESTION: red whiteborder path-migratory glossitis.
QUESTION: Lesion hurts after eating spicy food, has white lesions with red borders that move
Geographic tongue

Aspirin Burn:

QUESTION: aspirin burn is due to: coagulation necrosis.

Basal Cell Carcinoma:
QUESTION: Oral path picture of Basal Cell carcinoma. round bluish lesion on side of lip

QUESTION: Painless ulcer, upper lip, it grew bigger after 2 weeks - Basal cell carcinoma

QUESTION: Painless ulcer, upper lip, it grew bigger after 2 weeks - Basal cell carcinoma
QUESTION: Picture of basal cell carcinoma on patients face

QUESTION: a picture of basal cell or kerato ancathoma ......on the face crater like with a crust in the
middle **remember keratoacanthoma has a bump with a crusty crater in the middle, but BCC can be
pink, waxy/pearly, or skin colored or brownish. BCC is more reddish/can be flat while keratoacanthoma
has a crust and looks really gross

Mucocele:
Mucocele: Caused by ruptured salivary duct, Usually due to trauma, Seen on the lower lip

NEVER ON GINGIVA

QUESTION: Most common location for mucocele? Lower lip

QUESTION: Mucocele most likely is on the Lower lip!
QUESTION: Patient had SSC removed and now has a mucocele looking lesion on the lower lip what is it?
I wrote mucocele, other choices fibroma, SSC

95
QUESTION: You get mucocele due to? - rupture of salivary ducts (trauma related)
QUESTION: You get mucocele due to? - rupture of salivary ducts (trauma related)
QUESTION: Mucocele, what causes it clinical term that refers to two related phenomena: mucus
extravasation phenomenon, and mucus retention cyst. The former is a swelling of connective
tissue consisting of collected mucin due to a ruptured salivary gland duct usually caused by local
trauma, in the case of mucus extravasation phenomenon, and an obstructed or ruptured salivary
duct (Parotid duct) in the case of a mucus retention cyst

QUESTION: most common site for mucous retention cyst? Lip

Ranula:
QUESTION: Ranula: blue mass under tongue
Blue nodule floor of mouth, fluctuant..ranula
QUESTION: Lady presents w/ blue swelling under tongue? I put ranula
QUESTION: ranula due to mucus plug
sialolith
mucus plug
trauma
fibrous plug
QUESTION: Trauma to floor of mouth
Mucocele
Submandibular hemangioma
Ranula
QUESTION: How do you treat a ranula? excise (all of it)
QUESTION: ranula treatment: excision of sublingual gland
QUESTION: Ranula txtExcisional, incisional, or aspiration

Texture/consistency of dermoid cyst vs ranula

dermoid is doughy/rubbery consistency
ranula is more fluctuant, bluish
QUESTION: Sialolithiasis is found where? - submand duct (whartons)
QUESTION: Sialolithiasis (calcified salivary stone) is found where? REPEAT question - submand duct

QUESTION: Sialoliths most commonly associated with submandibular gland

QUESTION: Sialoliths most common in what gland: Submandibular gland and duct

QUESTION: Some histology question about the paratoid gland. Mentions SAUSAGE LINKS: Answer
is Sialodochitis

QUESTION: Gland most frequently involved in Sialolithiasis? Parotid? Small glands? SM? SL?

QUESTION: Parotid gland chronic sialodochitosis

QUESTION: Most probable cause of swelling of the upper lip? Sialolithiasis? Mucous plug?
QUESTION: Pt with sialadenitis (actini enlarge) caused by sialith in the duct
Procedure: No removal of the gland
Non sx therapy
Attempt removal non sx (supposed to give moist heat, or citrus foods to encourage
dislodgmentwikiXtina)
Intra oral sx

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QUESTION: How do u tx painful Sialolith in whartons duct.. initially?
Moist heat
Dilation of duct
Surgically remove sublingual gland
Surgically remove submand gland (cannulate the duct and remove stone)
(massage or lemon drops not an option)
(If it is a smaller stonemoist heat is the first optionwikiXtina)
QUESTION: tx for large sialolith near orifice of Whartons duct
a. transoral to unblock duct
b. extraoral to remove gland
c. cannulation & dilation---***?? Canulate the duct (sialotomy) to remove stone
QUESTION: mucous retention cyst

Antral Pseudocyst (mucous retention pseudocyst):

QUESTION: something in maxilla - muco-retention cyst?? Antral pseudocyst?

QUESTION: Pic of inverted Y xray (antral y??)
QUESTION: Antral Y (they also called it an inverted Y)

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QUESTION: Radiograph 6 arrows - inverted Y floor of nasal fossa
QUESTION: What is the inverted Y made up of? Maxillary sinus/floor of nasal cavity
QUESTION: what is the isthmus of Y (where nasal floor (straight radiopaque line) and maxillary sinus
(curved radiopaque line) start and meet). What are the two anatomical factors that border this?

Floor of nasal cavity and maxillary sinus

QUESTION: radiograph of earlobe and turbinate: inferior nasal turbinate or mucous retention cyst
or antral pseudocyst

QUESTION: Radiographs of the ear lube, mucous retention cyst aka antral pseudocyst in maxillary
sinus
QUESTION: Huge PA radioopacity in maxillary sinus mucus retention cyst

QUESTION: diffuse but distinct radiopacities in max sinus: mucous retention pseudocyst made
sense, others were sinusitis and something else

QUESTION: something radiolucent in the entire sinus with was sinusitis. was not Mucous retention
cyst
QUESTION: What is this lesion seen in patients right maxilla (pano picture)? Mucoretention cyst.
QUESTION: photo of maxillary sinus with radiopacity in one of the sinus and you have to identify
the condition: mucous retention cyst- antral cyst
QUESTION: antral pseydocyst

Ankyloglossia:
QUESTION: Ankylglossitis- tongue tied!!

Dentigerous Cyst:
QUESTION: which can become ameloblastomic ?? dentigerous cyst, lymphedema, epidermoid,

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QUESTION: Radiographic picture: upside down molar with lucency around crown-what is it? Dentigerous
cyst

STARTS AT CEJ
QUESTION: Which cyst is most likely to become neoplastic?
a. dentigerous
b. residual
c. radicular
Varicies:
QUESTION: Varicosities in ventral tongue in elderly

QUESTION: What causes varices on the tongue? I put hyperthyroidism HYPERTENSION

QUESTION: bilateral asymptomatic blue stuff under tongue
a. hemangioma
b. varices
Parulis (gum boil):
QUESTION: picture #30 endo txedparulis.
QUESTION: Photo ID: Parulis

QUESTION: Reason for parilis- incomplete root canal (redue root canal)

Tuberculosis:
QUESTION: Oral signs of tuberculosis- cervical lymph nodes, larynx, and middle ear. Oral lesions of
TB are uncommon- usually chronic painless ulcers. Secondary lesions on tongue, palate and lip.
Primary lesions usually enlarged lymph nodes. Rare is leukoplakic areas.

QUESTION: What does tuberculosis lesion in the oral cavity look like? large ulcer
The most frequently affected sites were the tongue base and gingiva. The oral lesions took the
form of an irregular ulceration or a discrete granular mass.
QUESTION: What does tuberculosis lesion in the oral cavity look like? large ulcer (Painful nonhealing
indurated often multiple ulcers)

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Extravasated Blood:
QUESTION: Hemangioma excised from tongue. Which is it? Choristoma, hamartoma, teratoma
QUESTION: 4 yr old kid has hemangioma on his tongue from when he grew. It grew at the same rate he
did. chroistoma, hamartoma, teratoma
HAMARTOMA- Normal tissue overgrowth
CHORISTOMA- TISSUE overgrowth in Wrong location
QUESTION: patient has had a hemangioma on tongue since birth, it grows at the same rate as the tongue.
Hamartoma, teratoma, etc.hamartoma grows at the same rate as the surrounding tissues
QUESTION: What goes away from mouth by itself- eccymosis

Allergic Mucositis:
QUESTION: Allergic Stomatitis of the mouth is commonly seen because of the: flavors in a
toothpaste: Cinnamon

QUESTION: Allergic gingivitis caused most by- toothpaste flavor(cinnamon)

QUESTION: cause of allergic gingivitis
a. flavoring in toothpaste---?
b. food coloring in foods
c. Fluoride in toothpaste
QUESTION: Patient has red gums and is told she has plasma cell gingivitis. Common cuase is?
I put cinnamon flavoring in the dentrifice
QUESTION: Plasma cell gingivitis- cinnamon!!

Crohns Disease:
QUESTION: Child with granulomatous gingiva and bleeding rectal-anus has what?
Crohns
QUESTION: Oral granulomas, apthous ulcer, rectal bleeding is seen in
a. Wegeners granulomatosis
b. ulcerative colitis
c. crohns disease
QUESTION: Crohns granulomatous gingival hypertrophy
QUESTION: Couple questions on crohns disease and mouth- I think one of the questions mentioned
something about ulcerations in the rectum (thats right we are going to be dentist and checking peoples
buttholes out for our differential diagnosis!)mouth ulcers and swollen gums!!

Dermoid Cyst:
QUESTION: Which would be located in the floor of the mouth and be doughy?
A Ranula, this is what I put but could be B or C not sure
B. Dermoid cyst DOUGHY
C Lymphoepithelial cyst **
Multiple Endocrine Neoplasia Syndrome
QUESTION: MEN- adrenal over production

Nasopalatine Cyst:

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QUESTION: most common nonodontogenic cyst
nasopalatine duct cyst
a. dermoid
b. thyroglossal
c. lymphoepithelial
QUESTION: Nasopalatine X-ray- heart shaped central

QUESTION: Nasopalatine cyst tx- enucleation

QUESTION: Pic of nasopalatine canal
Intraoral picture of nasopalatine cyst by incisive papilla on backside of 7 and 8. The foramen and
nasopalatine canal is where the incisive papilla is and if theres a cyst there then what does it look
like clinically? Soft tissue is swelling and discolored.
QUESTION: The clinical radiograph and picture didnt match up. The clinical pictures were taken after
the radiographs so it could have developed afterwards and there was fineprint that this was written and
not for other cases so it was a trick and it was a nasopalatine cyst probably
White sponge nevus:
QUESTION: leukoplakia that you cant wipe offI put white sponge nevus.

QUESTION: White on movable mucosa- leukoplakia or white sponge nevus

QUESTION: Patient has bilateral white lines @ occlusal plane, what is primary microscopic
finding? White Spongy Nevus

QUESTION: White stuff under tongue what is it not? White sponge nevus

Picture of something white. Said it was not wipeable/stretchable.

a. Lichen planus or

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 b. White sponge nevus.

QUESTION: White lesion, cannot be scaped away, picture: leukoplakia is not there in the options
QUESTION: Pic- white sponge nevus *white sponge nevus usually presents bilaterally/symmetrically. It
usually appears before puberty. Often mistaken for Leukoplakia. /// Leukoplakia differs in that it presents
later on in life.

QUESTION: White stuff under tongue what is it not? White sponge nevus
It presents itself in the mouth, most frequently as a thick bilateral white plaque with a spongy
texture, usually on the buccal mucosa, but sometimes on the labial mucosa, alveolar ridge or floor of
the mouth. The gingival margin and dorsum of the tongue are almost never affected.

QUESTION: Buccal cheek of 60 yrs man, not wipe-able? leukoplakia( more on floor 50%,
tounge25%), candida, white spongy nevous bilatral- autosomal dominant

Trigeminal Neuralgia:
QUESTION: Patient feels pain on biting and feeling of fullness in maxillary posterior teeth, why?
sinusitis, atypical trigeminal neuralgia,
QUESTION: ***Maxillary sinusitis bacteria: Strep pnuemoniae
Drug for max sinusitis: Amox with clavulnic acid (for b-lactamase strep)

QUESTION: Which of the following is most likely to be interpreted as toothache by Pt?

maxillary sinusitis can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, headache)

tmj dysfunction

otitis media

QUESTION: lady, pain, hurts at night, cant find pain:

-trigeminal neuralgia
-something about mandibular teeth intruded

QUESTION: A fews qs on trigeminal neuralgia. Affects what age group? What type of pain?

Age: The average age of pain onset in trigeminal neuralgia typically is sixth decade of life, but
it may occur at any age. Symptomatic or secondary trigeminal neuralgia tends to occur in
younger patients. >35 years

Nature of pain: Pain is stabbing or electric shock like sensation and is typically quite
severe. Pain is brief (few seconds to one to two minutes) and paroxysmal, but it may

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 occur in volleys of multiple attacks. Pain may occur several times a day; patients typically
experience no pain between episodes.

Distribution of pain: Pain is one-sided (unilateral, rarely bilateral). One or more

branches of the trigeminal nerve (usually lower or midface) are involved.

QUESTION: Carbamazapine - Tx trigeminal neuralgia

QUESTION: Carbamazepine:used for Trigeminal Neuralgia, Do not use to treat constant, fascial pain.
Use NSAIDS
Actinic Cheilitis:
QUESTION: Actinic chelitis---> SCC

QUESTION: Symptoms of actinic cheilitis? Loss of vermillion border

QUESTION: How do you treat actinic cheilitis? According to wiki, its 5-fluorouracil or imquimide,
but im not sure if those were even answer choices
QUESTION: Actinic Chelitis: lower lip shows epithelial atriohy and focal keratosis same as
Actinic Keratosis

QUESTION: Which of the following lesions has the greatest malignant potential?
A. Leukoedema
B. Lichen planus
C. Actinic cheilitis
D. White sponge nevus

Post-Development Loss of Tooth Structure:

Attrition is wearing away from natural dentition

QUESTION: All of the following cause xerostomia except?

a. caries,
b. candidiasis
c. dental attrition
QUESTION: Xerostoma causes the following except:

o Caries
o
o Attrition

QUESTION: Most attrition of an enamel against what? (porcelain not an option in the answer)
a) Enamel
b) Amalgam
c) Hybrid resin
d) Microfill resin
QUESTION: attrition or bruxing on mand anteriors (posterior looked fine)
QUESTION: All of the following reasons to restore erosion lesion except one, which one?
a. prevent future erosion
b. reduced sensitivity
c. esthetic
QUESTION: Erosion? Chemical & Bulimia.

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QUESTION: Bulimia and gastric reflux cause...erosion
QUESTION: Type of wear from gastric acids: erosion

QUESTION: Erosion- chemical wearing of tooth (gerd)

QUESTION: Which one is chemical cause of tooth destruction: Erosion

QUESTION: chemical wear of tooth : erosion

QUESTION: Abfraction: if not too deep dont touch it. If deeper, fill with glass ionomer cement?
Compomers
QUESTION: Abfraction: flexure of tooth

CEMENTO-OSSEOUS DYSPLASIA:
Know Cemento-osseous dysplasia aka CEMENTOMA:
Usually 30-50 years old, African-American Female
Mandibular anterior VITAL teeth
Asymptomatic periapical radiolucencies which transform to radiopacities
No treatment required
QUESTION: Cementoma (periapical cemental dysplasia)-usually occurs in the anterior region of
the mandible, starting as a radiolucent lesion that eventually calcifies. Cementoma DOES NOT
affect pulp vitality. Asymptomatic= no bone expansion. Periapical cemental dysplasia; periapical
osseous dysplasia)
QUESTION: Periapical cemento-osseous dysplasia.on a radiograph, anterior mandible, black women
***REACTIVE; vital teeth, radiolucencies around apices of mand incisorsusually!!!! Ck
QUESTION: X-Ray: Black women, middle aged , anterior radioluceny (can be radio opaque):
cemento osseous dysplasia, periapical cemental dysplasia

QUESTION: Radiographic Picture: lower mand incisors, slight radiolucency-kind of smeared together-
what is the lesioncemento-osseous dysplasia
QUESTION: Most common place for periapical cemental dysplasia : Lower anteriors
QUESTION: Black woman, middle aged, case Q: osseous cemental dysplasia.
QUESTION: Most common site for cementoosseous dysplasiamand ant vital teeth, no pain or
expansion, multifocal periapical lucencies which mature over time and become mixed then finally
opaque.
anterior mandible

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 Periapical cemento-osseous dysplasia
QUESTION: Tooth with normal PDL, totally vital, tissues normal, but radio-opaque lesion @
apex? periapical cemento-osseous dysplasia
QUESTION: cemento-osseous dysplasia pic, but dont forget lower anterior, black female.

Florid Cemento-osseous Dysplasia:

Florid Black females vital all four Quads: Florid Cemento-Osseous Dysplasia
Focal White females vital edentoulous one lesion: Focal Cemento-Osseous Dysplasia
30-50 white female
Posterior mand / asymptomatic solitary lesion
Lichen Planus:
QUESTION: Histologically, the loss of the rete peg often is a sign of?
a. pemphigus
b. lichen planus
c. pemphigoid
d. syphills
QUESTION: Desquamative gingivitis is associated with which 2 conditions. Lichen planus and
pemphigoid
QUESTION: Lichen planus discription
QUESTION: Lichen plannus: Target T lymphocyte

1. Lichen planus
a. Mucocutaneous disease
b. T lymphocytes target (destroy) basal keratinocytes, (reason unknown)
c. Hyperkeratosis, lymphocyte infiltrate at the epithelial CT interface
d. Basal zone vacuolation due to basal keratinocyte destruction
e. Epithelium may exhibit a saw tooth pattern
f. Bilateral on buccal mucosa***
g. Reticular type: interlacing lines (wickhams striae)
h. Tx: corticosteroids

QUESTION: Pic of 55 yo woman with erosion: lichen planus

QUESTION: Lichen planus most commonly found on buccal mucosa

QUESTION: Lichen planus more common in women

QUESTION: Erosive lichen planus gingival is magenta to bright red

QUESTION: Lichen planus, what do you treat with? Choices (dont remember the specific names)
were antifungal, antiviral, etc. so know the etiology of each pathology, many pharm questions are
simple, but its just that I couldnt remember etiology of certain diseases. TOPICAL
CORTICOSTEROIDS OR ANTIHISTIMINE

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Peripheral Ossifying Fibroma:

QUESTION: Which of the following reactive lesions of the gingival tissue reveals bone formation
microscopically? Peripheral ossifying fibroma

Cleidocranial Dysplasia:
QUESTION: What is the most significant finding in cleidocranial dysplasias: odontomas, supernumery
teeth, sparse hair, multiple impacted teeth

QUESTION: Cleidocrainal dysplasis - supernumerary tooth

QUESTION: Cleidocrainal dysplasis retained teeth, REPEATED AGAIN

QUESTION: Cleidocranial dysplasia- over retained primary teeth
QUESTION: Cleidocranial: can your shoulders touch? Absence of teeth, also has supernumerary
QUESTION: Cleidocranial dysplasia? Disease of the bones of the skull and clavicles. Short, big head,
shoulders move in, high palate, retention of primary teeth, and supernumerary teeth.
QUESTION: Cleidocranial dysplasia- no clavicals

QUESTION: Cleidocranial syndrome: x ray with absence of clavicle

QUESTION: Heridatary / hypoplastic clavicle? cleidocranial dysplasia

Cleidocranial dysplasia
o Autosomal dominant
o Delayed tooth eruption, supernumerary teeth, hypoplastic or aplastic clavicles,
cranial bossing, hypertelorism
QUESTION: Which will give you very narrow facial structures and delayed eruption of permanent teeth?
*cleidocranial syndrome
downs syndrome
QUESTION: questions on cleidocranial dysplasia : Multiple supernumerary teeth, prognathic jaw-
class III, delayed eruption, fontanelle failed to close

QUESTION: Many questions (5) on Cleidocranial dysplasia: Multiple unerupted supernumerary

teeth, Retention of primary teeth, delayed eruption of permanent teeth, Missing clavicle

QUESTION: Head distortion at birth? Fontanelles

QUESTION: What allows for compression of skull during birth? Fontanelles -_-

QUESTION: What is the part of the infants head that allows it to change shape?
Fontanelles (enable the bony plates of the skull to flexaccording to wikinot sure if it would be
the correct answer but I guessXtina)
QUESTION: What is the part of the infants head that allows it to change shape?
a. Fontanelles
QUESTION: Which structures in a baby allow the head to deform in the birth canal? I put
fontanelles
QUESTION: Fontanelas close anterior-12-18months, posterior 3-4 months
QUESTION: Fontanelles, child skull, close by age 2

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Neurofibromatosis (Von Recklinghausen):
QUESTION: Clinical picture with nodules & caf laut spots: neurofibromatosis
QUESTION: Neurofibromatosis ? caf au lait spots.
QUESTION: Caf-Au-Lait Neurofibromatosis **Von Recklinh..diseaseneural tumors all these
bumps all over its disgusting. (Remember that McCune Albright Syndrome Polyostoic FIBROUS
DYSPLASIA also has caf au lait spots---fibrous bone replaces normal boneLiche nodules, caf aulet
spots-Neurofibromatosis
QUESTION: An adult patient presents with multiple, soft nodules and with macular pigmentation of the
skin. Which of the following BEST represents this condition?
lipomatosis
b. neurofibromatosis
c. metastatic malignant melanoma
d. polyostotic fibrous dysplasia
e. bifid rib-basal cell carcinoma syndrome
QUESTION: which of these have supernumerary teeth, lisch nodule on iris, ____
neurofibromatosis
QUESTION: Neurofibromatosis clinical presentations: Caf au lait, lisch nodules, neurofibromas

Calcifying Odontogenic Cyst/Gorlin Cyst:

QUESTION: Ghost cells: keratinized calcifycing odontogenic cyst

Auriculotemporal Syndrome/Freys Syndrome:

QUESTION: Pt has problems on one side of their face when they eat, they recently had parotid surgery,
also had to do with something with their nerve
A. Papillon Leferve
B. Freys Syndrome* --strong salivation
QUESTION: Freys syndrome**symptom where you sweat near cheek area when eating. Usually after
parotid surgery.
QUESTION: Patient had portid surgery now sweats before he eats only on one side this is due to what? I
wrote Freys syndrome (whatever it is the guy needs serious help and should not be in my office!)
QUESTION: Injure arteritemporal nerve-sweating out of parotid (auriculotemporal syndrome)
QUESTION: freys syndrome parotid gland
QUESTION: Auriculotemporal nerve is severed, what are symptoms? gustatory sweating,

Actinomycosis:
QUESTION: Actinomycosis of jaw presents how? Lumpy Jaw
QUESTION: Actinomycosis has pus, antibiotics
Abscess, Draining fistula, contains yellow sulfur granules
I&D + antibiotics
QUESTION: Which dz is most likely to cause suppuration?
A: Actinomycosis

Condylar Hyperplasia:

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QUESTION: A patient presents with malocclusion and a unilateral, slowly progressing elongation of her
face. This elongation has caused her chin to deviate away from the affected side. The MOST probable
diagnosis is which of the following?
A. Ankylosis
B. Osteoarthritis
C. Myofascial pain
D. Condylar hyperplasia

Dens Invaginatus:
QUESTION: Dens in dente: Most common seen in max lateral incisor

QUESTION: Talon cusp is for? dent evagenatus, NOT invagenalis

Evangelicals believe in Eagles ( Talons)

Epulis Fissuratum:
QUESTION: Which one resembles Epilus Fissuratum Fibroma (both share trauma as etiology)

QUESTION: Epulis fissuratum is most similar cellularly to: fibroma, granulomar cell tumor, etc

Keratoacanthoma:
QUESTION: Lesion looks like squamous cells: Keratoacanthoma
QUESTION: Keratosis happen where in the mouth?
a. palate
b. buccal mucosa
c. floor of mouth
d. upper lip

Warthin Tumor:
QUESTION: Warthin tumor most common in what gland: Parotid (dont get mixed up with whartons
duct)

Stafne Defect (salivary gland depression defect)

QUESTION: Radiograph of mandibular gland depression. 1. Stafne defect (answer)
QUESTION: A picture of stafne's defect, but there was no stafne answer - submandibular fossa defect
(this is what I wrote)
QUESTION: very well defined round radiolucency in panoramic, posterior mandible below inferior
alveolar canal static bone cyst (stafne defect)
QUESTION: ID salivary bone cyst (another name for stafne bone cyst) on PAN

QUESTION: Pan of jawlucent lesionsalivary gland inclusion

QUESTION: Xray of Stafne defect (only option was salivary inclusion defect)

QUESTION: Stafne defect: salivary inclusion

SjOgrens Syndrome:
QUESTION: Complications of Sjogrens syndrome features of (Stevenson sth) Answer was with
keratoconjunctivitis it involes the genitalia too.
QUESTION: Sjogrens autoimmune destroy glands
QUESTION: Sjogrens syndrome: destruction of salivary and tear ducts dry mouth
QUESTION: Sjogrens Synd associated with all EXCEPT

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 Herpes
Keratoconjunctivitis
SLE
QUESTION: what is most common with sjogrens? lymphoma (or maybe lipoma or some other
growth)pleomorphic adenoma, increased sweating and osteoarthritis.

QUESTION: Which articular disease most often accompanies Sjo grens syndrome?
A. Suppurative arthritis.
B. Rheumatoid arthritis.
C. Degenerative arthrosis.
D. Psoriatic arthritis.
E. Lupus arthritis.
QUESTION: xerostomia is present in all of the following except? Options were : Sjogrens syndrome, Vit
C. Defenciency (Other parotid problems) Xerostomia is rarely due to a vitamin deficiency
QUESTION: Sjogren syndrome? Laboratory test: SS-A / SS-B (also ANA or Rheumatoid factor)

QUESTION: Secondary Sjogren Syndrome: dry eye, dry mouth, Rheumatoid Arthritis

QUESTION: Which of these are used in lab test for sjogren,? ANA

Typical Sjgren's syndrome ANA patterns are SSA/Ro and SSB/La

Sarcoidosis:
abnormal collections of inflammatory cells (granulomas) that can form as nodules
QUESTION: Treatment of sarcoidosis? Corticosteroids, antibiotics...
QUESTION: TB is similar to? Sarcoidosis
QUESTION: question on sarcoidosis? Know that it is granulomatous
QUESTION: Sarcoidsis commonly involved organ: lungs
QUESTION: Sarcoidosis is mainly related to which organ? predominately a pulmonary disease

QUESTION: ***Girl with caries into the pulp on tooth #3 radiograph shows alternating RL/path at
inferior border of mandible (a.k.a onion skin, bacterial)Garres Osteomyelitis aka chronic
osteomyelitis

QUESTION: Garre's (prolifrative periostitis) and Ewing sarcoma are both onion skin

Peutz-Jeghers Syndrome:
QUESTION: Peutz Jeghers and Pierre showed up on my exam. They gave only description and you
had to diagnose.

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QUESTION: Peutz Jeger syndrome ? Not cafe au lait, but freckles on lips.
QUESTION: Peutz-Jeghers syndrome multiple menanotic macules and gastrointestinal polyposis
QUESTION: Peut-jeghers syndrome : intra oral melanin pigmentation also intestinal polyps
Osteosarcoma:
QUESTION: Widening of pdl is early sign of what? Osteosarcoma!
QUESTION: most common primary malignant tumor of young people-osteosarcoma
QUESTION: osteosarcoma in x ray : sun burst and simetrical widening of pdl.
QUESTION: Enlarge PDL and radiolucency at mandibular angle? A. Osteosarcoma sunburst
QUESTION: Osteosarcoma: causes early lesion of PDL widening (Symmetric widening of the
periodontal ligament space is an early radiographic sign of osteosarcoma)
QUESTION: Uniform wdining of PDL and there is resorbtion in the bone : osteosarcoma, fibrous
dysplasia
QUESTION: osteosarcoma in x ray : SYMMETRICALLY WIDENED PDL SPACE, SUN-
RAYAPPEARANCE
QUESTION: Patient has paresthesia and grows in mandible: is going to be osteosarcoma (young
patient)

Osteoporosis/Osteopetrosis:
QUESTION: Which one is NOT RO? (choice: osteopetrosis marble bone, extremely rare; osteoporosis,
pagets cotton wool)

Multple Myeloma:
QUESTION: Multiple Myeloma: Punched out lesions.
QUESTION: Considerations for multiple myeloma
QUESTION: first sign of multiple myeloma : bone pain ( in limbs and thoracic region)
QUESTION: first sign of multiple myeloma: bone pain ( in limbs and thoracic region)
QUESTION: multiple myeloma -> plasma cell
QUESTION: Multiple myeloma appearance? punched out lesion

multiple myeloma/plasma cell myeloma

o monoclonal neoplastic expansion of immunoglobulin secreting B cells
o multiple punched out bone lucencies
o high M protein in serum
o bence jones protein in urine (light chains)
o tx: chemo poor prognosis

Necrotizing Sialometaplasia
QUESTION: Know necrotizing sialometaplasia.painless ulcer on hard palategoes away on its own.
Heals without scarring

Odontongenic Myxoma:
QUESTION: Pic of Myxoma pt. Usually in post. mandible, no symptoms, moves teeth, **cortical
explansion and root displacement, always radiolucent and honeycombed pattern!!!!!
QUESTION: soap bubble lesion in xray , what is it, there was no cherubisum ????? Giant cell
Odontogenic Myxoma , often seen with impacted tooth

*Soap bubble lesion= odontogenic myxoma

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QUESTION: Picture of Odontogenic Myxoma: Soups bubbles.

QUESTION: Odontogenic myxoma

Radiology:
QUESTION: When there is no barrier, protection of dentist: 6 feet, 90-135 degrees

QUESTION: most of the x-ray is converted to? heat

QUESTION: most of the x-ray is converted to: heat

QUESTION: what is the oil in the x ray tube for : dissipate the heat ( cooling)
QUESTION: why oil in x-ray tube: heat: cools off the anode
QUESTION: purpose of oil in x-ray tube housing: prevent rust, reduce radiation, dissipate heat
to the target, lubricate
QUESTION: Something about what is best x-ray: short wavelength, high energy

QUESTION: What is primary source of radiation to the operator when taking xrays: I said it was
radiation left in the air, other options were scatter from the patient, scatter from the walls,
leakage from the xray head.

QUESTION: In performing normal dental diagnostic procedures, the operator receives the greatest
hazard from which type of radiation?

111
A. Direct primary-beam
B. Secondary and scatter

C. Gamma

QUESTION: Radiology-sievert dosage allowed in a year for dentist 50msv

QUESTION: Max dose for dental personnel for radiation is? I put 50 Msv per year

QUESTION: Max radiation dose: 50 msv or 5 rem per year

Per month = 4msv, Per week = 1 msv
QUESTION: Collimation and what it does: reduces xray beam size and volume of irradiated
tissue, usually with circle diameter of 2.75 in
QUESTION: What does collimation do? Reduce area of exposure, remove scatter

QUESTION: Collimater function is all but- increase penetratability

QUESTION: collimnation in xrays - reduces low energy radiation
QUESTION: Collimation = block (lead)
QUESTION: collumnation in xrays decreases the diameter of the beam
QUESTION: Collimator: reduces size of xray beam to reduce patient radiation
QUESTION: what the collimator does : reduce the 1)volume of tissue being irradiated and
2)reduce the amount of scatter radiation by 60%

QUESTION: what the collimator does : reduce the volume of tissue being irradiated and reduce the
amount of scatter radiation.

QUESTION: Collimation does everything except: reduce pt exposure, reduce operator exposure, film fog,
reduce average energy of xrays (energy is unchanged)

Scatter radiation decreases with change to rectangular collimator, film fog(scattered radiation that reaches
the film, unwanted darkness decreased by collimation) decreases and image quality increases.

QUESTION: Collimating device on the x ray

Except: prevents fogging
QUESTION: Collimation is?
The accurate adjustment of the line of sight of a telescope.
Control of size and shape of xray beam
QUESTION: By what % do you decrease radiation when you use a square collimator vs.
rectangular? 80%

QUESTION: How do you minimize exposure radiation I remember one answer choice that I took
into account was minimizing the amount of tissue being radiated but thats not what I selected

QUESTION: the use of intensifying screens --> reduce the radiation

QUESTION: Xray filters are used for? Reduces intensity of electron beam, selectively absorbs low
energy photons. LONG WAVELENGTH Inherent filtration=glass, oil. Total filtration=aluminum and
inherent filtration (from Gohels lecture)

QUESTION: filter absorbs.

112
 a. Long wavelength
b. Filtration is a mechanism where the low quality, long wavelength xrays are
absorbed from the exiting beam. Alumnium disks absorb lower penetrating xrays.
241 First Aide
QUESTION: X-ray tube target made out of: tungsten, lead copper
QUESTION: Target metal in xray: tungsten

QUESTION: Filament produces heat in the xray

QUESTION: which material is used as a filter in xray machines? Lead, aluminum, others
QUESTION: filtration = filter (aluminum)
QUESTION: Digital image: which is digital detector? Charge coupled device (pg132)

QUESTION: The greatest decrease in radiation to the patient/gonads can be achieved by

a. change from D to F speed
b. thyroid collar
c. filtration
d. collimation
e. high doses low frequency

QUESTION: Which of the following safety techniques provides the GREATEST DECREASE in overall
radiation-risk to patients?

A. Changing from Group D to Group E film

B. Switching from round to rectangular collimation

C. Using an automatic rather than manual processing switch

D. Adding a cervical collar to a leaded apron

QUESTION: What happens when you dont have proper vertical angulation when taking xrays I
said it was elongation of the object other options were fuzzy pic (either resolution or contrast)

QUESTION: Change vertical angulation when taking a PA will cause what? Distortion?
Magnification? ELONGATION OR FORESHORTENING

QUESTION: Change in vertical angulation of the xray what happens

o Distortion
o Increase- shorten if decrease- elongates

QUESTION: Vertical angulation distortions

QUESTION: Excessive vertical angulation, distort (xrays)
QUESTION: change in vertical angulation in xray what happens? Distortion
QUESTION: xray with shortened teeth. Whats wrong? I put vertical angulation

QUESTION: If you take a PA and the tooth is foreshortened, why did it happen? I put because
the vertical angulation was too large
QUESTION: Foreshortening of roots caused by...excess vertical angulation
QUESTION: xray beam is perpendicular to the film, not to the tooth, = forshortening

113
 ***Elongation & foreshortening occurs when there is excessive vertical angulation
Central ray needs to be perpendicular to film and object
Perpendicular to object but not film: elongation
Perpendicular to film but not object: foreshortening

QUESTION: Overlap on bitewings horizontal angulation

QUESTION: BW Overlap? Horizontal angulation off.
QUESTION: horizontal movement of xray - leads to overlapping
QUESTION: if you horizontally angle in BW, you can get- overlap

QUESTION: horizontal movement of xray - leads to overlapping

QUESTION: xray with cone cut. Whats wrong? I put PID, other choices are horizontal, vertical, etc
MISALIGNED of XRAY TUBE HEAD, incorrect beam centering

QUESTION: Pano max centrals look abnormally wide has to do with position of pt head either too
back, forward

the patient is positioned too far backward, (Figure 2, position 3) the skin anterior to the tragus can
be felt immediately posterior to the head support. The further the patient is positioned backward in
the focal trough, the wider the images of the anterior teeth will become until they are so wide that
the outlines of the crowns of the teeth can hardly be discerned.
QUESTION: Something that causes teeth to look longer has to do with angulation how much tilt up and
down

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If the head/chin position is too low the images of maxillary anterior teeth will appear elongated and the
mandibular anterior teeth will appear foreshortened.

If the head/chin position is too high (a lack of negative vertical angulation On the radiograph, the occlusal
plane of the teeth will then appear horizontal or, with a positive occlusal plane, as a "frown line."

QUESTION: Reversed occlusal plane on pano chin raised too high

QUESTION: Pan has a reverse occlusal plane patient head tilted too far upward
QUESTION: Know the positioning of panoramic films (why is there an error? ex: chin tilted to high/low,
etc.)
CHIN UP = frown
Chin down = steeper smile
QUESTION: Pano, with short upper roots? 1. Patients didnt put tongue on the top of their mouth (correct
answer)

QUESTION: Fuzziness on outside of radiograph due to:

Umbra
Pneumbra
QUESTION: Pneumbra affected by all except:
Moving x-ray tube
Moving film
X-ray dimensions/field/scatter
Film-object distance (decrease)
Reduction of film target distance
QUESTION: How does penumbra affect the contrast of an x-ray? Decrease in contrast

Larger PenumbraDECREASE contrast

Larger penumbra = more unsharpness

QUESTION: Penumbra how to prevent this in x-rays: decrease size of focal spot, increase
source-object distance, and reducing object-film distance (should be parallel), central ray
must be perpendicular to tooth, object and film, no movement.
QUESTION: how to reduce penumbra? Choices were moving object, decrease object/source
distance, decrease object/film distance
QUESTION: How do you prevent prenumbra?
o Should be produced from a point source to blurring of the edges of the image
o Strong beam to penetrate
o Xray should be parallel

QUESTION: What is pneumbra. it was in a qs and i had no idea what it was talking about pneumbra
The area on the film that represents the image of a tooth is called the umbra, or complete
shadow. The area around the umbra is called the penumbra or partial shadow. The
penumbra is the zone of unsharpness along the edge of the image; the larger it is, the less
sharp the image will be. The diagram at right shows how the penumbra is formed. X-rays
from either extreme of the target, and from many points in between, pass through the edge
of the object and contribute to the penumbra.

115
QUESTION: PA distortion answer according to an article online is 14% , there was answer choices
3-5% , 11-15%
QUESTION: Margin of error of PA daiograph - 3-5% (this is what I wrote)??
QUESTION: Pano distortion is : 25% but could range 10-30%
QUESTION: What does it look like on a pano when your patient moves during the pano? A vertical blur
line vs horizontal defect.
QUESTION: Big artifact in pano which was a ghost of a necklace.
QUESTION: tear drop shaped in max sinus - pterygomaxillary fissure
QUESTION: Earlobe on the pano was asked from yesterday.

QUESTION: MRI uses what electromagnetic wave? RADIOWAVES

QUESTION: BW placed vertically why? More alveolar bone

QUESTION: Vertical BWX are better than horizontal BWX because of what Doctor? You see more
bone.
QUESTION: What cannot be seen with a PA? pterygoid hamulus, coronoid notch, mental foramen,
mand. Canal
QUESTION: What structure can you not see on a PA radiograph
-Hamular process Visible
-Mental Foramen Visible
-Coronoid process Visible
-Mandibular foramen

QUESTION: If you have lesion of maxillary sinus, what kind of radiograph do you take? 1. Waters
(answer)
QUESTION: Which is most important for diagnosis of maxillary sinus xray: occlusal, panaromic,
Waters- Water's view is best to evaluate orbital rim areas.
QUESTION: Which is most important to see the maxillary sinus xray: CT, occlusal, panaromic, MRI,
Waters
QUESTION: Best imaging for sinusitis or sinus infection: I put CT, but had occlusal radiograph, PA
radiograph, Panoramic. Know that sinuses are best viewed with Waters technique, but this was not
in answer choice neither was none of the above as a choice.

QUESTION: Source/object distance for lateral ceph: 5 feet, 6 feet, 15 cm, 60 cm

QUESTION: Xray taken from mesial of max 1st premolar, buccal root will be where? mesial, distal,
occlusal
QUESTION: Max sinus diagnostic tool: waters, towne, ap, pano
QUESTION: best way to diagnosis sinus problems: CBCT

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QUESTION: Same question but answer for that one was waters x-ray
QUESTION: best radiograph for max sinus problem waters
QUESTION: Which picture is best for max sinus lesions? CT (no waters in the choices)
QUESTION: Which picture is best for max sinus AGAIN? Waters!
QUESTION: best radiograph for max sinus problem waters (CT)
QUESTION: Which picture is best for max sinus lesions? Pano (no waters in the choices) (NO)-- CT
QUESTION: Which picture is best for max sinus AGAIN? Waters! (NO)CT

QUESTION: Best diagnostic image for pathology in max sinus: waters, CT, MRI, periapical, pan?

a. CT

QUESTION: all types of x rays to diagnose or to see maxillary sinus ? Waters, panoramic, CT scan
QUESTION: Which radiograph would you use to view a fracture of the mandibular symphisis? Posterio-
Anterior also Mand occlusal works too. Lateral oblique for fractures in angle, body and ramus

QUESTION: They liked to ask intermaxillary suture a lot which comes up clear on radiograph and it looks
like a fracture (which is an answer choice), but its not. The decks are good enough.

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 median palatal suture/intermaxillary suture
Nose vs lip line in radiograph

LIP LINE
QUESTION: best view for zygomatic arches: Pano
Zygomatic arch on radiograph

1. Coronoid process of the mandible. Begin at the right coronoid process. Examine for
coronoid hyperplasia. Tip of coronoid should not be more than 1cm above superior
border of zygomatic arch.
2. Sigmoid notch. Do not mistake a rarefied medial sigmoid depression for pathosis.

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3. Mandibular condyle. Evaluate for erosions, remodeling, eburnation, subchondral cysts,
osteophyte formation which may signal arthritis.Less commonly, erosions may be
caused by neoplastic disease.
4. Subcondylar (condylar neck) region. Evaluate.
5. Ramus of the mandible. Evaluate.
6. Angle of the mandible. Evaluate.
7. Inferior border of the mandible. Evaluate #4 - 7 for cortical integrity. Rule out fractures.
Repeat steps 1 - 6 on the patient's left side.
8. Lingula. Evaluating the precise location in any individual patient assists in determination
of where to give inferior alveolar nerve block.
9. Inferior alveolar neurovascular bundle (mandibular canal). Follow from lingula to mental
foramen. In some patients the anterior extension which exits out the lingual foramen will
be visible. Evaluate relationship of impacted teeth to the canal. Evaluate general bone
quality and check for focal osseous defects.
10. Mastoid process. Evaluate structures on the left side of the maxilla first.
11. External auditory meatus. Evaluate.12 Glenoid fossa (temporal component of the TMJ).
Check for erosions, sclerosis, and other signs of arthritis.
12. Glenoid fossa (temporal component of the TMJ). Check for erosions, sclerosis, and
other signs of arthritis.
13. Articular eminence. Look for zygomatic air cell defect (ZACD).
14. Zygomatic arch. Do not mistake a wide zygomatico-temporal suture for a fracture. May
also contain ZACD in the posterior half of the arch.
15. Pterygoid plates. Evaluate.
16. Pterygomaxillary fissure. Check for cortical integrity to rule out neoplasia.
17. Orbit. Evaluate.
18. Inferior orbital rim. Check for cortical integrity to rule out fracture.
19. Infraorbital canal. The infra-orbital foramen should not be viewed if the patient was
properly positioned.
20. Nasal septum. Evaluate for septal deviation or perforation. Evaluate the nasal fossa for
polyps.
21. Inferior turbinate/soft tissue concha covering. Evaluate.
22. Medial wall of the maxillary sinus. Evaluate.
23. Inferior border of the maxillary sinus. Evaluate.
24. Posterolateral wall of the maxillary sinus. Evaluate the integrity of the sinus walls to rule
out developmental, inflammatory, traumatic or neoplastic processes. Examine the
content of the sinus for the degree of pneumatization. Check for antral pseudocysts,
chronic mucosal hypertrophy, polyposis, mucocele or neoplasia.
25. Malar process. Repeat 10 - 25 on the right side of the patient.
26. Hyoid bone. Evaluate.
27. Cervical vertebrae 1 - 4. Observe for osteophyte formation, loose bodies or other
evidence of osteoarthrosis. Remember the circular radiolucency in C2 is the transverse
foramen.
28. Epiglottis. Evaluate.
29. Soft tissues of the neck. Evaluate for a wide range of soft tissue calcifications.
30. Auricle (earlobe). Evaluate.
31. Styloid process. If elongated/ calcified stylo-hyoid ligament, rule out Eagle's syndrome.
32. Oropharyngeal airspace. Evaluate.
33. Nasal air. Evaluate.

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QUESTION: Look at pano picture on mosbys pg 141. I messed up on it but it was an arrow pointing
b/w posterior wall of maxilla and posterior wall of zygomatic process of maxilla: ans. Is
pterygomaxillary fissure

QUESTION: Identify the following on xray :External oblique ridge, genial tubricle, Stylo hyoid
ligament on xray

External oblique: running down roots on mandibular molars

Genial Tubricle: radiopaque line under mandibular abteriors

Stylohyoid ligament:

QUESTION: Showed a pan, what is the round opacity under #24 and #25 genial tubercles

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nutrient canal, zygomatic process of maxilla, normal anatomy (I had lateral canal and I put that.
Other choices were all pathological findings)

QUESTION: Nutrient canals seen radiographically most common where? Mandibular incisors

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 Nutrient Canal

X-ray of nutrient canals in mandibular anterior

There was a x-ray pointing with arrow to the lower lingual anterior. The answer was nutritional
canal.

MAND. TORI

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know the SLOB rule. Also know Vertical rule, which is same as SLOB but in a vertical dimension.

QUESTION: Digital X-rays less exposure from d-films to digital films. digital 50% less radiation
exposure (75% less radiation exposure)
QUESTION: Digital xray vs D speed film, numbers: 10, 30, 60 , I put 60. I forget what it was asking
QUESTION: Going from a d speed film to digital film whats the speed diference (speed increases)

Film Speed Group Speed Range (reciprocal

roentgens)
C 6-12
D (Kodak Ultraspeed) 12-24
E (Kodak Ektaspeed Plus) 24-48
F (Kodak Insight) 48-96
1. (is Digital speed equal or similar to F film?)

QUESTION: going from d speed film to digital film, speed is increased

QUESTION: By reducing film speed from D to E and still keeping film density the same what would you
need to change? Decrease Exposure time

D to E will reduce radiation by 30-40%

D to F will reduce radiation by 60%

F to digital reduce radiation by 40%

QUESTION: Latent period of xrays is time btw when you exposed patient and clinical reaction to
xray

QUESTION: In radiobiology, the "latent period" represents the period of time between

A. cell rest and cell mitosis.

B. the first and last dose in radiation therapy.

C. film exposure and image development.

D. radiation exposure and onset of symptoms.

QUESTION: Which electron shell has highest power? (f/d...outermost shell)

QUESTION: which electron level has the highest binding energy? N K L OR M

K is located closest to the nucleus highest energy

QUESTION: Radiographic Picture: looked washed out, no contrast, what was adjusted?
Decrease kvp
Increase kvp
Increase time
Less developing solution
QUESTION: what was the problem of x ray that appears too white: incorrect distance from target to
film distance, low mA and low density.

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QUESTION: what was the problem of x ray that appears to white : incorrect distance from target to
film distance, low mA and low density.
QUESTION: light films (underexposed/image not dense enough): due to incorrect milliamperage
(too low) or exposure (too short), incorrect focal-film distance, or cone too far from the patient's
face, or film is placed backwards.
QUESTION: If xray is too dark : It was too long in developer solution
QUESTION: Dark films (overexposed/image too dense): due to incorrect milliamperage (too high),
exposure (too long), incorrect kVp (too high).
QUESTION: You take an xray at a certain mA, KvP and exposure time is 8 seconds when the
beam is 10 inches away. What if everything were the same except the beam was 20 inches
away? I put quadruple the exposure time
QUESTION: You increase the distance of the tube by 2 times the length, how much does the xray
exposure decrease I said by 4

QUESTION: I aka intensity inversely proportional to 1/D2: -if increase distance by 2- intensity is
decreased by 4

QUESTION: If change from 8mm cone to 16mm how much exposure time do u need to increase by?
2.4.6.8? **inverse square lawgoing from 8 16 = double distance 2r 1/22 = radiation exiting so
increase exposure by 4!!!! Another example, if you go from 8 24 = triple distance 3r 1/9 radiation
leaks so increase exposure by 9!!! Remember that going from an 8 mm to 16 mm cone means the
cone/target is LONGER. This is the PID (target to film distance). If the PID is increased there is LESS
magnification. If the PID is shorter there is MORE magnification. Also density increases when kA, mA
and exposure are increased. That means the xray looks darker

QUESTION: By what factor would you increase kVp if the doctor doubles the distance. Its a factor of 4
since its squared distance.
QUESTION: Increase BID distance from 8 to 16, exposure time change from 0.5sec to? .25, 1, 2, 3......
with parallaling technique .....

QUESTION: The x-ray of an interproximal underestimates the size of the actual crater (other is
overestimates and is same size)
QUESTION: How do you increase the average energy of the beam kvp versus ma

QUESTION: If developer is used up, what will happen?lighter picture

QUESTION: Deterministic radiology effects: increases effect with dosage-direct effect

QUESTION: The severity of response increases with the amount of X-ray exposure. This effect is called:

Deterministic, Stochastic, Genetic

QUESTION: Radiation injury from free radical formation from indirect, free radical from direct

QUESTION: How do you minimize exposure radiation? minimizing the amount of tissue being
radiated

QUESTION: which type of radiation is constantly in effect: Inhaled radon radiation, not terrestrial or
cosmic

QUESTION: Most radiation from nature inhaling radon internal, terrestial, cosmic
QUESTION: Radiation that is stochastic, with non threshold effects would a clinician notice first
leukemia, skin burn, hair loss, bone marrow effect

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 Stochastic effects are associated with long-term, low-level (chronic) exposure to radiation.
("Stochastic" refers to the likelihood that something will happen.) Increased levels of exposure make
these health effects more likely to occur, but do not influence the type or severity of the effect.

QUESTION: Thermionic emission where? Filament Cathode

QUESTION: Therm-ionic emission of x-ray comes from filament
Emission of electrons from heated cathode. Cathode has a filament circuit.
QUESTION: Irradiation cause saliva to have lower- sodium content
QUESTION: know how xrays interact with matter: photoelectric effect
In the photoelectric effect, electrons are emitted from matter (metals and non-metallic solids, liquids
or gases) as a consequence of their absorption of energy from electromagnetic radiation of very short
wavelength and high frequency, such as ultraviolet radiation. Electrons emitted in this manner may be
referred to as photoelectrons.
X ray photon interacts with an orbital electron, all of the energy of the photo is absorbed by the
displaced electron in the form of kinetic energy

QUESTION: if something is a structure in mouth thick it absorbs more radiation, appears more radio-
opaque on xray

QUESTION: Dentist is more exposed to what type of radiation besides machine?

Scatter tube
Scatter patient
Scatter wall

QUESTION: how does x-rays primarily damage cells: Hydrolysis of water molecules

QUESTION: Radiation induced mutation is the result of? 1. Hydrolysis of water molecules.

QUESTION: which kind of radiation causes most cancer? Hydrolysis of water, etc

QUESTION: Radiation affects the body by: LYSIS of H20

QUESTION: Which structure is most radio sensitve: hemopoitic bone marrow

QUESTION: Radiation injury from free radical formation from indirect, free radical from direct

QUESTION: What cells are radiosensitive? Bone marrow cells, reproductive cells lymphoid cells,
immature cells, intestine. **REMEMBER radioRESISTANT salivary glands, kidney, liver

QUESTION: What is most radio-resistant cell: Muscle (also nerve and mature bone)

QUESTION: Which one of the following tissues is least sensitive to ionizing radiation: muscle,
lymphocytes, squamous epithelium

QUESTION: radiation least likely to cause damage: muscle cells

QUESTION: Tissue least affected by radiation- muscle

QUESTION: Radiation of 4(Gy) to the skin will cause? Erythema
QUESTION: basic osteoradionecrosis questionbisphos with radiation
QUESTION: To get osteoradionecrosis radiation dose must be: Above 50 gys (above 60)

125
QUESTION: Which is greater risk for ORN? IV bis for a year, radiation 65 grays
QUESTION: 69 Gray= osteoradionecrosis
QUESTION: Bisphosphonates used for all except: multiple myeloma, osteomyelitis, metastasis to
bones from breast cancer, metastasis to bones from prostate cancer
QUESTION: Bisphosphonates used to treat everything except? multiple myeloma, osteomyelitis
QUESTION: What conditions not to use bisphosphonates: Metastatic disease to bone, Multiple myeloma,
Metastatic breast cancer, Metastatic prostate cancer?

QUESTION: Indication for bisphosphonates: osteoporosis

QUESTION: Does bisphosphonate add calcium to bone (know this so you can answer one question)
No, It inhibits osteoclast via apoptosis
QUESTION: What is the mechanism of action of bisphosphonates? Inhibit osteoclasts,
QUESTION: Osteonecrosis is more common with IV drugs like zolmeda(zoledronic acid) and
aredia(palmidronate) (NOT fosamax or boniva)

Zolendronic acid- IV bispho

Aredia (is a bisphophosate)- Its IV
Boniva is- oral bisph

QUESTION: Which one these IV bisph would be contraindicated for orthro? Aredia
QUESTION: Why is orth contraindicated: pt is taking bisphosphonates (Aredia)
QUESTION: What is Aredia: IV Bisphosphonate
QUESTION: Why one is not true about a patient who takes Fosamax and will need an invasive procedure?
Discontinue Fosamax 1 week before procedure (that stuff stays in the system longer than that)
QUESTION: pt taking bisphosphonates for 1yr IV, highest risk during dental tx? Osteonecrosis
QUESTION: Pt doesnt like her bridge didnt like her smile. Can you do bone graph in
bisphosphonate and would last? NO BONE GRAFTING

QUESTION: A scenario about a patient who is taking bisphosphonates and gets osteonecrosis of the
jaw.

a. Osteonecrosis without radiation

b. Osteonecrosis with radiation
c. Answer is the first one bc it did not say anything about osteoRADIOnecrosis. You get
necrosis due to the bisphosphonates.

QUESTION: Osteonecrosis of jaw (2 questions): more common in mandibular; nothing to do with

radiation

QUESTION: How does Osteoradionecrosis negatively effect dental healing?

(well causes presence of non vital bone and loss of circulation to the areawould have to see answer
choicesXtina)
QUESTION: Osteoradionecrosis most associated w/ what?
A: Mandible
QUESTION: Cause of ORN: Loss of vascular supply

QUESTION: osteoradionecrosis:
underdeveloped film
QUESTION: If need to extract teeth after patient had radionecrosis- I think refer to OS

126
QUESTION: Osteoradionecrosis scenarios..pre extract questionable teeth, hyperbaric oxygen pre
and post if doing invasive procedures

QUESTION: Kvp energy

QUESTION: A higher kilovoltage produces x-rays with:Greater energy levels More penetrating
ability Shorter wavelenghts , increase in density

QUESTION: KVp inc more penetrating , high energy

QUESTION: Increasing milli amperage results in an increase in: Temperature of the filament &
Number of x-rays produced MA increase

QUESTION: Increasing mA alone results in a film with: High contrast

QUESTION: If you increase distance,then u need to increase mA

QUESTION: What does ma and kvp do? Longer KVP, shorter Wavelenght, Higher energy
QUESTION: How do you increase the average energy of the beam kvp versus ma

QUESTION: how do you change from a low contrast (longer scale of contrast) to a high contrast
(shorter scale) without changing density: increase mA and kvp, decrease mA and kvp, increase
kvp decrease mA, decrease kvp increase mA

Anemia:
QUESTION: sickle cell anemia - nitrous oxide,
QUESTION: Which is not Contraindication for sickle cell anemia or something like that ? Nitrous,
infection, trauma, cold
QUESTION: All increase risk of sickle cell crisis except: cold, infection, trauma (of these 3)

QUESTION: sickle cell anemia in childrens : risk factor for nitrous and cold
QUESTION: which hemoglobin is affected- S
QUESTION: sickle cell anemia what is trigering it
QUESTION: A question about sickle cell anemia and you have a thromolytic crisiswhat could
precipitate this?

a. Nitrous oxide / oxygen use used for treatment?

b. A cold
c. Trauma
d. Something else

QUESTION: **Infection (cold) can trigger a crisis bc decrease of o2***

Sickle cell anemia is seen exclusively in black patients. Periods of unusual stress or of O2
deficiency (hypoxia) can precipitate a sickle cell crisis.

QUESTION: Chloramphenicol-aplastic anemia

QUESTION: hemolytic anemia RBC are destroyed but bone marrow cant produce fast enough
QUESTION: which happens more in males? Mandibular dysostosis, hypothyrodisim, diabetes, sickle

127
cell anemia
QUESTION: Macrocytic anemia which vitamin deficient? A, B, C, D, E
QUESTION: which one is microcytic anemia? iron deficiency anemia.

QUESTION: ***Difference between aplastic, pernicious, sickle cell anemia

Aplastic anemia: bone marrow doesn't make enough new blood cells.
Sickle cells contain abnormal hemoglobin called sickle hemoglobin or hemoglobin S.

Pernicious anemia: body can't make enough healthy red blood cells because lacks vitamin B12
because they lack intrinsic factor, a protein made in the stomach. A lack of this protein leads to
vitamin B12 deficiency.

Microcytic hypochromic anemia- iron def anemia (most common)

Oral Surgery:
QUESTION: Warfarin(Coumadin) what test? INR

QUESTION: warfarin pt. what test do you run prior to extraction or surgery: INR/PT

QUESTION: how does warfarin work on anticoagulation: decrease K+ needed to synthesize

factors II, VII, IX, X

QUESTION: The most important anticoagulant effect of heparin is to interfere with the conversion of

A. PTA to PTC. B. PTC to Factor VIII. C. fibrinogen to fibrin. D. prothrombin to thrombin. E.

proaccelerin to accelerin.

QUESTION: pt taking dicumorol (vit K antagonist) is probably treated for? coronary infarct

QUESTION: Pt is taking dicumarol what are they being treated for? This was an old board repeat
A. Myocardial infarction (dicumarol is similar to warfarin)
QUESTION: Patient is on Coumadin, what do you needINR, ptt

QUESTION: Pt using Warfarin, what lab test would help determine if pt is treatable? INR, PTT, PT
QUESTION: INR of patient on Coumadin.2-3

QUESTION: warfarin patient and when should you do treatment: INR = 2.0-3.0

QUESTION: Coumadin - INR

QUESTION: What is the best way to test clotting function on a patient taking Warfarin? INR
QUESTION: Patient is taking warfarin, what could u do? proceed with treatment because his INR is <2.5
QUESTION: Patient is taking Coumadin and you wan to know the coagulation status of patient
before surgery, what do you order?
INR
QUESTION: INR deals with PT
QUESTION: INR value of 1 is normal (12 sec)
The higher the INR, the greater the anticoagulant effect.
QUESTION: question that was testing INR numbers .....i forgot the details **normal INR =1, higher
INR more bleeding, PT value,

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QUESTION: suspend warfarin 3 days prior to extraction (stop drug 5 days before, and resume the
day after surgery)
QUESTION: suspend warfarin 5 days prior to extraction
QUESTION: Patient comes in and is on Coumadin, what do you do?
a. Stop for 1 day
b. Stop medication of 3 days
c. Do not need to stop medication
QUESTION: what INR is ok to place implant? 2.5, 3.5, etc I believe u can place implant in patient who
has INR less than 2.5
bleeading measuments : PTT 25-36 sec PT 5-7 sec platelets 150K-450K minimum platelets 50 k
bleeding time : less than 9 min INR : 1 do not treat with more than 3.5
QUESTION: Coumadin (warfarin): give vitamin KKKKKKKKK

QUESTION: alcoholic patient, order:

PT/INR
QUESTION: severe alcoholic now recovering need 24 tooth extraction which test needed----INR,CBC

QUESTION: Alcoholic patient come for extractions: INR?

QUESTION: Alcoholic patient, is about to undergo surgery. Which blood work test is most
important?
-creatinine
-PT extrinsic system (Vit. K coagulation factors-2,7,9,10); used to test warfarin/coumadin
effectiveness, for liver damage, and Vit. K status
-PTT intrinsic system; used to test Heparin
-Bleeding time
QUESTION: accurate way to detect blood alcohol in the body except
liver glucouronidation
weight
amount of food in stomach **amt of food in stomach dictates how fast your blood alcohol level
will increase
percentage of alcohol in drink
how fast you drank it

QUESTION: best way to determine platelet fxn

a. platelet count
b. bleeding time
c. PTT
d. INR
QUESTION: What aspirin affects? Extrinsic, intrinsic, bleeding time, common pathway?

QUESTION: What determines the bleeding time? Intrinsic, extrinsic, platelet adherence, common
pathway

QUESTION: Aspirin: platelet count

QUESTION: aspirin decrease platelet fxn

129
QUESTION: Bleeding time has to do with platelet count - Bleeding time = time required for blood
to stop (2-6min normal) Bleeding time is increased in disorders of platelet count, uremia, and
ingestion of aspirin and other antiinflammatory medication

QUESTION: asprin has no affect on PT or PTT or INR... it affects platelets..

QUESTION Aspirin is CONTRAINDICATED with which of the following drugs?
A. Coumarin (Coumadin)
B. Triazolam (Halcion)
C. Barbiturates (Phenobarbital)
D. Pentobarbital (Nembutal)
E.Methylprednisolone (Medrol)
QUESTION: Patient taking aspirin for hypertension: Consultation with physician

QUESTION: prostaglandin inhibitor cause all expect: increase gastric mucous

PG:decrease gastric acid and increase gastric mucous ..... Inhibiting PG will increase gastric acid and
decrease mucosa. That's why people taking too much aspirin can get stomach bleeding cause more
acidic and no protection

QUESTION: What makes prostaglandin: Arachidonic acid

QUESTION: ginseng- antiplatelet ( interferes with coagulation not given with aspirin). pt on warfarin,
aspirin

QUESTION: Before doing extraction you look at a patients CBC report. What causes to contact
patients physician? Hematocrit was given as 25. While in males it is 45% and females 40%

QUESTION: Anticoagulants act antagonize Vitamin K to work, prolong bleeding.

QUESTION: Anticoagulants antagonize vit. K, INR used for Coumadin patients

QUESTION: INR 1.75 what do you do after extraction to control bleeding? Keep stuffing shit in it, bite
on normal gauze, squeeze b/l plate to collect bone fragments,

QUESTION: Warfarin = INR. Know numbers! I got pt with INR of 12.5, then asks what to do next.
Classmate had same questions with INR of 2.

QUESTION: extractions for a pt with an INR of 2. what should you do? Nothing

QUESTION: Safe INR is 2 for coumadin pt

QUESTION: pt on coumadin, INR 2--- I think it is okay to continue tx. Mosbys states that normal INR of
people on anticoagulants is 2.5-3.0.
a. extract, use sutures, hemostatic agents
b. get pt off coumadin for 2 days before extraction
QUESTION: Patient had extraction and socket is still bleeding 5 hours later? refer for INR

QUESTION: Tooth extraction, 3 days later starts to hemorrhage what is the cause? Fibrinolysis

130
QUESTION: PT (12-14 secs, Factors 2, 7, 9, 10) and INR are extrinsic pathway

QUESTION: PTT intrinsic factor 8.9.11.12 test for detecting coagulation defects of the intrinsic
system - hemophiliac
QUESTION: Factor VIII is hemophila A

QUESTION The drug contra indicated in pt taking gingko biloba: HEPARIN

Diabetes:
QUESTION: Glucocorticoides are contraindicated in: Diabetes
QUESTION: Glucocorticoids side effects? Infection, reduce inflammation, hyperglycemia.
QUESTION: Negative effect of chronic use glucocorticoids? Pg. 303 mosby section D adverse effect
QUESTION: Overweight patient that has to piss 2wice at night? Diabetes
QUESTION: Oral hypoglycemic drug for diabetes --?sulfonylurea and metformin (MOA)
QUESTION: Why dont you give Sulfonylureas to Type I diabetic patients? They do not have beta cells
for insulin & Sulfonylureas MoA is to stim those cells
QUESTION: Sulfonyl ureas diabetes drugs: They act by increasing insulin release from the beta cells in
the pancreas.
QUESTION: MOA of sulfonylureas: release of insulin
QUESTION: How do Sulfoneureas work? Stimulate insulin release from Beta cells, stimulate
binding, decrease glucagon levels.
QUESTION: MOA of sulfonylurea- increase insulin PRODUCTION and SENSITIVITY by Beta cells
stimulation
receptor name?binds to ATP-dependet K channels
QUESTION: Metformin suppresses glucose production in liver (decreasing hepatic gluconeogenesis
decreases glucagon levels) bind to AMP protein kinase receptors

QUESTION: Proposed modes of action for the oral antidiabetic agents include each of the following
EXCEPT one. Which one is the EXCEPTION?

A. Blockade of glucagon release from pancreas

B. Blockade of catecholamine release from adrenal medulla
C. Stimulation of insulin release from pancreatic beta cells
D. Action as direct receptor agonists for the insulin receptor
E. Increase affinity of tissues for utilization of available plasma glucose

QUESTION: Diabetes more in men?

QUESTION: Hb1AC: Measuring glucose level over extended period

QUESTION: Pt who took too much insulin will have all except- Hyperglycemia

QUESTION: decrease in glycogenolysis in the liver would be expected with insulin

QUESTION: Which one of the following effects males almost exclusively?

*hemophilia (it is carried by the female but only effects the male)
downs
diabetes

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QUESTION: which happens more in males? Mandibular dysostosis , hypothyrodisim, diabetes, sickle cell
anemia
QUESTION: Sign of hypoglycemia- I put bradycardia but later checked I think answer is mydriasis
other options were diaphoresis (sweating),
Signs of hypoglycemia: headache, mental confusion, somnolence, sweating, tachychardia,
tremors, nervousness
QUESTION: Which is risk factor for hypoglycemia? Age, alcohol, hypertension
Well-known risk factors for the development of hypoglycemia include exercise, alcohol, older age,
renal dysfunction, infection, decreased intake of energy, and mental health issues, including
dementia, depression, and psychiatric illnesses. In the ADVANCE trial, cognitive dysfunction
increased the risk of hypoglycemia

QUESTION: Controlled diabetes has same perio problems as those who dont have diabetes TRUE
QUESTION: Controlled diabetic patients do not get more perio disease than non-diabetic
QUESTION: What is not true regarding patient with diabetes and perio: either increase of
crevicular fluid or increase of sugar in crevicular fluid (of these two choices, 1st is better cuz there
is sugar in the fluid)

QUESTION: Patient with diabetes which finding is not consistent increase collegenase in crevicular
fluid, increase glucose in crevicular fluid, increase gram negative in crevicular fluid, decrease in
thickness of basilar lamina of blood vessels in periodontium.

QUESTION: Diabetic patients have more of the following except: higher glucose levels in gingiva,
increased anaerobic bacteria in pockets,
QUESTION: increases in diabetics except? IL1, collagenase, glucose, bacteria
QUESTION: Diabetics are more prone to perio and are less resistant to the effects of bact.- both statements
are true.

QUESTION: By recent studies, which one has a correlation with periodontitis? Diabetes -
diabetics are 15 times at risk

QUESTION: pt presents with aggressive bone loss, bleeding gums, mobile teeth. Etc
uncontrolled diabetes
non hodgkins lymphoma
QUESTION: ASA III: uncontrolled diabetes

QUESTION: Diabetes you get infections more likely, not bleed easier
QUESTION: diabetes most common: black men
QUESTION: What diabetes patient should be monitoring daily except for what? NOT glucose in urine
QUESTION: Endo surgery contraindicated when diabetes? HTN

QUESTION: When would elective endo treatment be contraindicated? diabetes, hiv, etc

QUESTION: What disease will alter healing after root canal treatment? HIV or diabetes?think its diabetes
since they have altered wound healing..

QUESTION: Periodontal disease is associated with what systemic diseases? Diabtes and HIV

QUESTION: Diabetes can you place implant if HbA1c is 8: refer to physician, and no cant place implants

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QUESTION: Pt with hemoglobin A1C of 12%. Pt just visited the MD, what kind of TX we can do?
Consult with an MD prior to tx

In most labs, the normal range is 4-5.9 %.

In poorly controlled diabetes, its 8.0% or above

In well controlled patients it's less than 7.0

QUESTION: LA with epinephrine contraindicated in? Uncontrolled Diabetes, hypothyroidism,

hyperthyroidism

QUESTION: LA with epinephrine contraindicated in? Diabetes, hypothyroidism, hyperthyroidism

QUESTION: epinephrine is contraindicated in what disease? Cardiac patients hyperthyroidism,
diabetes mellitus...sorry can't remember the rest

QUESTION: Type I Diabetes leads: a) Aphasia b) Ataxia c) Blindness d) Deafness

QUESTION: Common complication of Type 1 diabetes: I wrote as blindness assuming retinopathy!!

QUESTION: Treat diabetic patient 2 hours after eating and taking insulin
QUESTION: Kidney dialysis: best to do tx when, I put day after dialysis, or inbtwn days of dialysis
QUESTION: Insulin shock, what do u give?- give insulin, give OJ, give oral sucrose **glucagon shot?
Do NOT give more insulin, blood sugar is already low enough. Give OJ or oral sucrose maybe.. depends
on the answer choices.
QUESTION: what would you give to a patient who goes into a diabetic shock (hypoglycemia)?
QUESTION: Pt is a child and is diabetic undergoes hypoglycemia in the chair if conscious give him
orange juice (unconscious give him 50% dextrose IV)

QUESTION: child goes into insulin shock in the chair (hypoglycemia)

a. give OJ----?
b. ask parent to give kid insulin shot
QUESTION: Unconscious diabetic is treated with: 50 % dextrose in water I V.

QUESTION: HgbA1c is 12 for a patient in your office? Get him out of there, haha! , refer him to
physician for diabetic/sugar management. (I believe normal A1c levels are 4.0-6.0Xtina) HbA1c stands
for Glycosylated hemoglobin. Measures blood glucose in past 2-3 months. NORMAL = 4-6%. Increased
is above 7%

QUESTION: Diabetic for IV sedation. If insulin dependant, have them not eat, not take short acting
insulin and take half dose of long acting insulin. If not dependant, no food and no meds

QUESTION: Patient is non-insulin dependent diabetic and needs minor oral surgery w/ IV
sedation. What should he do? I put clear-liquids and regular dose of diabetes meds. Minor
surgery: normal as long as procedure occurs within 2 hours of eating and taking
meds.

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QUESTION: Day of surgery- diabetic what do u tell him- no food no insulin, food and insulin, clear liquid
and insulin, clear liquid and normal insulin
QUESTION: You have a diabetic patient, you can manage him all the following ways except? Tell him
to eat light breakfast on the day of the appointment (the other choices were, schedule the dude a morning
appointment, tell him not to take his hypoglycemia meds for his appointments, monitor his blood sugar
level on the day of the procedure)

QUESTION: pt with diabetic having sedation IV and LA---ask the pt to take high calorie food with
insulin, low calorie food with insulin (reduce dose of insulin and no food)

QUESTION: DM pt. What to instruct before conscious sedation procedure?

A: Low calorie meal and reduce insulin dose

QUESTION: IV sedation Diabetic patient comes for surgery. What are the instructions? dependent-
dont eat, remove short duration insulin, half dose of long, type II not dependent- no eating no
medication.

QUESTION: how are the diabetic drugs classified- by duration

QUESTION: Various preparations for diabetes are differneces in what? Duration of action,
mechanism of action?

QUESTION: Patient has ketone breath and is confused. Why? I put HYPerglycemia.
QUESTION: Ketone breath: Diabetes type 1
QUESTION: Ketone breath and alter state of consciousness? Hyperglycemia

Congestive Heart Failure/Heart:

QUESTION: Patient with orthopnea(shortness of breath-dyspnea-while laying flat), dyspnea,
pedal edema
a. Emphysema
b. Pulmonary edema
c. COPD
d. Congestive heart failure

QUESTION: Dypspnea, orthopnea seen in? CHF

QUESTION: What is common symptom of CHF? Orthopnea* (other symptoms: dyspnea, fatigue,
paroxysmal nocturnal dyspnea, edema)
QUESTION: Common s and s of ChF
QUESTION: Dyspnea, orthopnea seen in? CHF What is common symptom of CHF? Orthopnea*
QUESTION: Tx of CHF pt? early morning appts?

QUESTION: Most common reason for cardiac arrest of kid respiratory distress

QUESTION: what is the most common heart problems in children: c) Ventricular septal defects

QUESTION: Most common cause of heart failure in kids: congestive heart failure, cyanotic heart
disease,didnt know answer, according to google, its respiratory failure
QUESTION: heart failure in kids - due to defect in heart respiratory distress

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QUESTION: what is the most common heart problems in childrens : a)congestive heart failure b)
septical Atrial. Etc. ventricular septal defects or communications between the bottom
chambers(structural heart defects)
QUESTION: Peripheral edema : congestive heart failure.
QUESTION: Patient has distended jugulars, pitting edema and dyspnea? I put
congestive heart failure
QUESTION: Pt edematous pitted, shortness of breath? Congenital heart failure,

QUESTION: why is pt taking ACE inhibitor (hypertension / CHF)

QUESTION: pt taking cardiac glycosides. what is it used for? (choices: hypertension,
congestive heart failure, etc...can't remember)
QUESTION: what do cardiac glycosides(Digitalis) do? Inhibit NA/K atpase and Increase Na and ca in
cell and increases the refractory period.
QUESTION: how does digitalis works : blocks Na/K/ATP ase = influx more Ca
QUESTION: how does digitalis works : blocks Na/K/ATPase = increase influx more Ca
QUESTION: Digitalis -Increase Ionotropic (contractions) effect of the heart, know the mechanism as well
QUESTION: Use of digitalis: Post myocardial infarction, Supraventricular arrhythmia, (digitalis...cardiac
glycosidecommon indications for use is for atrial fib)
QUESTION: Action of Cardiac glycosides,(Digoxin ) binds and inhibits Na+/K+ ATPase for atrial
fibrillation
QUESTION: How does Digoxin work? Inhibits Na/K ATPase of cardiac cell membranes resulting in
increase of Na concentration intracellularly. cardiac glycoside. ALSO increases intracellular Ca++
QUESTION: mechanism of Digoxin blocks Na/K+ pump increase intracellular sodium promote
calcium influx contractility
QUESTION: Ginseng question! pt takes for energy, but it will interfere withdigitalis, cant
remember the rest. ASPIRIN. Ginseng = antiplatelet
QUESTION: Ginseng: CI with aspirin or digoxin??

QUESTION: Pt. on ginsing what do u want to avoid? Warfarin/nsaids and Aspirin

QUESTION: Pt taking ginseng. Which med should be avoided?

Penicillin
Aspirin*
Digitoxin
QUESTION: Peripheral edema : increase systole : congestive heart failure.
QUESTION: Peripheral edema : congestive heart failure.

QUESTION: Patient has distended jugulars, pitting edema and dyspnea? I put congestive heart
failure
QUESTION: Pt has history of cardiovascular disease and now pt is taking aspirin. Pt needs ext. What
should dentist do?
Med consult with physician*
Normal extraction
Stop aspirin 3 days before and 2 days after surgery

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QUESTION: Mechanism of most drugs that tx arrhythmias? Decreases repolarization rate, Prolongs
refractory period.
QUESTION: Cardiac referred pain not consistent with? Pain goes away with LA
QUESTION: MI and arrhythmia difference? Thrombosis, arthrosclerosis

QUESTION: When you have artial arrythimia.whats the mech of action for the drug for it?

a. Well, I know you can give Quinidine, Verapamil, and Digitalis for atrialand the side
mechanism of Quinidine is it increases the refractory period..thats the only
answer that made sense

QUESTION: general question about arrhythmias. They increase calcium inotropic effect, decrease SA
node transmission, increase refractory period
QUESTION: If a patient has chest pain while at rest, what kind of angina is it? Unstable
QUESTION: Angina at rest?
a. Pseudo-angina
b. Unstable angina
c. Infarction
QUESTION: patient has pain in heart when sleeping-unstable angina.
QUESTION: side effect of nitroglycerin : orthostatic hypotention and headache.
QUESTION: side effect of nitroglycerin : orthostatic hypotension and headache.
QUESTION: nitrites /nitrates : Vasodilation
QUESTION: nitrites /nitrates : Vasodilation
QUESTION: nitrates and nitriles have what systematic effect? Vasodilation of arteries decreased
BP tachycardia

QUESTION: Nitrates/Nitriles, how do they respond to Angina? blood vessels.

QUESTION: Nitrates/Nitriles, how do they respond to Angina? I said they act on muscle cells, correct
answer was through blood vessels. (dilate blood vessels)
QUESTION: How do nitrates work on the heart- relaxing and widening the blood vessels in the
body, allowing more blood and oxygen to flow to the heart. Since the arteries are wider, it is easier
for the heart to pump blood, so it does not require as much blood and oxygen.

QUESTION: You give the nitroglycerin to the pt with angina and heart rate goes up what's the
reason? natural reflex to the decrease in blood pressure

QUESTION: Nitrates and how they affect the heart: something with relaxation of smooth muscle

QUESTION: Nitrates effect in blood vessel? . Nitroglycerin is a nitrovasodilator. It produces nitric

oxide, which activates guanylyl cyclase which, in turn, catalyzes the production of cGMP.

QUESTION: Amilnitrate & Nitroglycerine? Vasodialate coronary arteries **for angina pectorischest
pain caused by occlusion of coronary arteries!!!
QUESTION: *** For Angina drug, which drugs cant you take: some type of hydrothiazide med
QUESTION: Diuresis(excessive urine production) after tx of angina w/ a glycoside ? b/c of
increased blood flow caused increased blood flow to kidney

QUESTION: Epi and Nitroglycerine : ....antagonist,

QUESTION: Transient Ischemic Attack what is false

o More prone to heart attack

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 o Should take nitroglycerin

QUESTION: TIA-transient inschemic attack; what is false? Better chance to get stroke-true, patient
should take nitroglycerin FALSE-give for angina to prevent heart attacks.

Lungs:
QUESTION: Asthma causes constriction on bronchioles and inflammation true: Beta 2 receptors for
the lungs

QUESTION: asthma causes constriction of bronchioles and inflammation, constriction of smooth

muscle
QUESTION: What does asthma do? Causes constriction of smooth muscle T and inflammation of
bronchioles? T
BETA 2 RECEPTOR FOR LUNGS
BETA 1 FOR HEART

QUESTION: What do asthmatic patients have problem with? Wheezing Exhalation

QUESTION: Child makes a wheezing sound before injection? Asthma (induced by stress)
QUESTION: Wheezing exhale with high pitch
QUESTION: Wheezing sound: insp or exp
QUESTION: COPD vs Asthma? Asthma have problem breathing in,(but wheeze when exhaling), COPD
has problem exhaling

QUESTION: Most breathing problem in dental setting? Asthma (other were hyperventilation, COPD,
etc)
QUESTION: Most common respiratory problem in dental office: COPD/asthma

QUESTION: most common respiratory condition you will encounter in office? COPD
hyperventilation

QUESTION: Most common respiratory emergency in dental office: hyperventilation

QUESTION: Hyperventilation causes tachycardia and tachypnea

QUESTION: What is the most common cause for breathing difficulty in the dental chair? asthma
QUESTION: Patient has palmar pits, something and something when he presents: either CHF or
emphysema

QUESTION: Soft tissue emphysema: endo

QUESTION: face swelling after air spray in perio pocket: soft tissue emphysema (sudden painless
swelling)
QUESTION: Perio surgery, air into sulcus. What occurs?- subcutaneous emphysema
QUESTION: Emphysema: constriction of air sacks
QUESTION: Pt has emphysema. What are his symptoms? Dyspnea, wheezing, cough, chest tightness. Air
sacks are all destroyed (narrowing of distal airways)
QUESTION: Crowing sound when breathing? Stridor??
asthma attack
COPD* I put this but I didnt know what crowing sound means.. so not sure

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 Pneumothorax
QUESTION: What causes a crowing sound? COPD (maybe)* laryngeal SPASMS
QUESTION: Stridor? Laryngospasm
QUESTION: Stridor- laryngospasm- blockage of UPPER resp. tract
QUESTION: Epi for laryngiospasm what does it do? (multiple answers- multiple choice with 3 answers
each)- brochodilater, increase HR, increase BP
QUESTION: Theo-phylline
Theophylline is used to prevent and treat wheezing, shortness of breath, and difficulty breathing
caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air
passages in the lungs, making it easier to breathe.

QUESTION: Theophylline drug used for asthma sometimes. Particularly for wheezing,
shortness of breath, chronic bronchitis, emphysema.

QUESTION: Which drugs for ***asthma?

Albuterol was not in it, levabuterol(xopenex), ipratropium(atrovent), Combivent, Advair,

Smbicort, Spiriva, Budenoside

QUESTION: Most effective during acute asthma attack: albuterol- generic name is Salbutamol

QUESTION: asthma attack albuterol this is a beta 2 agonist causes bronchodialation

QUESTION: medication for severe asthma attack : aminophiline.

QUESTION: Singulair(montelukast) action? Block action of leukotrienes, is a leukotriene
receptor antagonist.used for asthma tx and seasonal allergies
QUESTION: leukasts block leukotrienes

QUESTION: M.O.A of Albuterol: Give for severe asthma. Its a bronchodilator

QUESTION: Albuterol question, does not help asthma what do you give next,. Epinephrine
QUESTION: Pt has asthmatic attach, took albuterol, and it didnt work. Whats next step?
epinephrine
atropine
something else
QUESTION: A child treated with albuterol. Why? I put asthma
QUESTION: What drug cause asthma? Aspirin

QUESTION: Which of the following drugs is can trigger asthma? a) narcotic

analgesic b) NSAID c) corticosteriod d) sympatolytic amine.

QUESTION: Asthmatic only use Tylenol (not aspirin bc of hypervent) Bronchiospasms

QUESTION: What is used for a severe bronchial asthma attack? Albuterol, corticosteroids,
aminophylline
QUESTION: Patient begins to wheeze what do you not do?

o Beta2 blocker inhaler, sit pt more comfortable, corticosteroid inhaler

o Give oxygen

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QUESTION: If patient starts wheezing? Dont give oxygen; last thing you would do; other options
give beta 2 blocker inhaler, corticosteroid inhaler, make patient more comfortable
QUESTION: asthma patient, most important thing NOT to give: O2 (rest was inhaler, albuterol, etc.) - i
got it wrong
QUESTION: What cause dry mouth?Albuterol

QUESTION: Pt goes home from elective orthognathic sx and in 24hrs, without sign of inflam or edema,
but a fever of 102oF- Atelectasia (or pneumotosis depending on answers. Atelectasia and pneumotosis =
most common cause of fever within 24 hour of GA)

Syncope:

QUESTION: Pregnant women with syncope what hip should they lay on? Right or left (pretty sure
not trendelenburg) --- and why do you do that? To avoid compression of vena cava I think
QUESTION: 5 mo pregnant patient with syncope, what position would u put her in? supine with
legs raised, reverse trendelburg, on her left,

prego CO increases 30-50%. Gradual increase in BP. 2nd and 3rd trimester- decrease in BP and CO
can occur while pt in supine position. =decrease in Venous return to heart due to compression of
inferior vena cava. =supine hypotensive syndrome. = light headed, hypotension, tachycardia,
syncope. Roll pt onto left side to lift uterus off vena cava. To avoid, prego pt positioned in semi-
reclining position. = elevate right butt and hip 15 degrees.
QUESTION: If a 3rd trimester pt all of a sudden feels a drop in BP what do you do?- Have pt lay on left
side.

QUESTION: Prego question syncope, which side you put pt? Raise right hip.

QUESTION: Pregnant woman - put her right hip up if she not comfortable in chair or experiences
loss syncope, etc..

QUESTION: pregnant women, with syncope. turn them chicks on the left bc it won't compress the
inferior vena cava.

QUESTION: 2 questions on prego

a. Baby crushing IVC

b. Lay on left hip, Right hip UP

QUESTION: Pregnant women should lay in which direction (Trendelenberg, right hip up, left hip up?)
More proned to what medical emergency?

QUESTION: What causes pregnant woman to syncope pressure on inferior vena ceva
QUESTION: Pregnant in supine position, what gets too much pressure? I said Fetus (other choices were,
placenta, inferior vena cava, superior vena cava) ( inferior vena cava)

orthostatic hypotension (colloquially as head rush or dizzy spell, is a form of hypotension in

which a person's blood pressure suddenly falls when standing up or stretching. Vs
vasovagal syncope (the most common type of fainting. is a malaise mediated by the vagus nerve.)
QUESTION: Most important thing to do when patient syncope maintain airway, loosen up buttons,
place head below heart, supine
QUESTION: Crown disappears down patients throat, what position do you put them in? Supine, Upright,
Trendelberg

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QUESTION: Place crown in mouth and it comes out and to back of throat, place patient upright, prone,
supine, trendelburg
QUESTION: Want to determine patient physiologic rest position, place in supine, upright/standing,
tredenlburg
QUESTION: Purpouse of the trendelberg position is to- maint circulation so that the most vital organs are
never hypoxic.
QUESTION: what position you place the Pt when is having syncope? (TRENDELENBURG
POSITION) (SUPINE WITH FEET ELEVATED SLIGHTLY), The most common early sign of
syncope is PALLOR (paleness).
QUESTION: U walk to office, pt is unconscious? Supine, tendenberg, upright

QUESTION: Trendelenburg position: (for anaphylaxis)

Position in which the patient is on an elevated and inclined plane, usually about 45, with the
head down and legs and feet over the edge of the table. It is used in abdominal operations to push
abdominal organs towards the chest. This position is also usually used in treating shock, but if there is an
associated head injury, the head should not be kept lower than the trunk.
QUESTION: All forms of shock have?
Hypovolemia
Decreased perfusion to tissue
Sepsis
QUESTION: Vasovagal syncope: Common cause of transient loss of consciousness

QUESTION: Vasovagal syncope is a common cause of transient loss of consciousness

QUESTION: Syncope? Inhale ammonia, irritates es trigeminal nerve sensory. 100% oxygen works,
except hyperventilation syndrome.

QUESTION: High-flow 100% 02 is indicated for treating each of the following types of syncope
EXCEPT one. Which one is this EXCEPTION?

A. Vasovagal

B. Neurogenic

C. Orthostatic

D. Hyperventilation syndrome

QUESTION: most Emergency in dental chair : syncope

QUESTION: Most common dental complication in office? Syncope

QUESTION: Most common ER after use of local: syncope

QUESTION: Most common dental complication in office? Syncope

QUESTION: What is the most likely emergency in the dental office? Syncope

QUESTION: You gave Local Anesthetic, BP went up to 200/100 and HR went up too, what could be due
to? Due to vasoconstrictor injected into venous system.

140
QUESTION: You gave Local Anesthetic, BP went down to 100/50 and HR went down too, what could it
be due to? Syncope
QUESTION: After receiving one cartridge of a local anesthetic, a healthy adult patient became
unconscious in the dental chair. The occurrence of a brief convulsion is
A. pathognomonic of grand mal epilepsy.
B. consistent with a diagnosis of syncope.
C. usually caused by the epinephrine in the local anesthetic.
D. pathognomonic of intravascular injection of a local anesthetic.
QUESTION: signs of syncope: blood pressure falls
QUESTION: signs of epi overdose: blood pressure and heart rate rises
QUESTION: Carpopedal spasm seen in? asthmatic attack, hyperventilation,
Seizures:

QUESTION: grand mal seizure give Dilantin *phenytoin*

QUESTION: Which of these is indicated for grand mal seizure? DILANTIN phenytoin

QUESTION: Most common seizure in children grand mal

Febrile seizures, which occur in young children and are provoked by fever, are the
most common type of provoked seizures in childhood. Then generalized tonic-clonic
(grand mal)

**** Diazepam is for status epilepticus******

QUESTION: Status epilepticus give what drug? Diazepam
QUESTION: Drug of choice of status epilepticus (seizure that last for long period)? `1. Valium
(diazapams) (answer) look up how much too, 5ml?---***5-10 mg IV / per minute
QUESTION: Grand mal seizure : Phenytoin Status epilecticus : Valium

DIAZEPAM CONTRAINDICATIONS: Pregnant, myasthenia gravis, acute narrow glaucoma

QUESTION: Diazepam is contraindicated in the following pt? Asthma**

QUESTION: contraindication of diazepam : Pregnacy
QUESTION: What drug for patient with petit mal seizures in dental office?
Only 2 drugs for absence seizures (petit mal): ethosuximide (Zarontin) only treats petit mal-
and valproic acid (Depakene, Depacon) treats grand mal, petit, and myoclonic seizures.

QUESTION: What is best to give for petit mal seizure? I chose phenytoin. They also had diazepam
QUESTION: What may induce seizures? Hyponatremia, hypernatremia, hyperkalemia
QUESTION: cause seizure? Hypoglycemia, hypokalemiccant remember the rest, hyponatremia

QUESTION: convulsions where : a) hypoglycemia b) hypokalemia c) hyponatremia

QUESTION: Seizures due to lack of what nutrient/vitamin/electrolyte (sodium)
QUESTION: What causes seizures?
a. Hypocalcemia
b. Hypophosphatasa
c. Hyponantremia

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d. Hypernantremia.
QUESTION: Epileptic pt least likely to take
a. ethosuximide petit mal seizures
b. diazepam
c. Lasix (furosemide)----? This is a loop diuretic..
QUESTION: Which of the following drugs, when administered intravenously, is LEAST likely to
produce respiratory depression?
A. Fentanyl
B. Diazepam
C. Thiopental
D. Meperidine
E.Pentobarbital
QUESTION: Which of the following is the current drug-of-choice for status epilepticus?
A. Diazepam (Valium)
B. Phenytoin (Dilantin)
C. Chlorpromazine (Thorazine)
D. Carbamazepine (Tegretol)
E.Chlordiazepoxide (Librium)
QUESTION: Each of the following is an advantage of midazolam over diazepam EXCEPT one. Which
one is this EXCEPTION?
A. Less incident of thrombophlebitis
B. Shorter elimination half-life
C. No significant active metabolites
D. Less potential for respiratory depression
E. More rapid and predictable onset of action when given intramuscularly
QUESTION: The clinical activity of a single intravenous dose (10 mg) of diazepam is most
dependent on which of the following?
A. Alpha half-life
B. Betahalf-life
C. Renalexcretion
D. Enzymatic degradation
E. Hepatic biotransformation
QUESTION: Each of the following are narcotics used in outpatient anesthesia EXCEPT one. Which
one is this EXCEPTION?
A. Fentanyl
B. Sufentanil
C. Meperidine
D. Diazepam
E. Morphine

142
QUESTION: Which of the following describes the titration of diazepam to Verrill's sign for IV
conscious sedation?
A. It is recommended as an end-point.
B. It is recommended only when supplemental 02 is used.
C. It is usually not attainable with diazepam alone.
D. It is not recommended since it can indicate a too-deeply sedated patient.
E. It is not recommended since few patients are adequately sedated at that level.
QUESTION: Which of the following is the treatment of choice for lidocaine-induced seizures?
Epinephrine (EpiPen ) Naloxone (Narcan ) Diazepam (Valium ) Flumazenil (Romazicon )
Succinylcholine (Anectine )
QUESTION Which of these opioid analgesics is associated with a serious life threatening drug interaction
when administered with an MAO inhibitor? Meperidine morphine fentanyl propoxyphene codeine

Can cause life-threatening hyperpyrexic reactions

QUESTION: Drug-drug interaction with MAOI(Hydralazine) and Meperidine.(opioid)

QUESTION: MAOI contraindication? Meperdine

QUESTION: No opioids for patient taking MAOIs )in case of head injury)
QUESTION: Opiate contraindicated in severe head injury cases
QUESTION: Opioids contraindicated in: severe head injury, renal insufficiency
QUESTION: An opiate type MAA with both agonist and antagonist properties is- pantazocin
QUESTION Which of the following effects are common to pentobarbital, diazepam, and meperidine?

A. Anticonvulsant and hypnotic

B. Analgesia and relief of anxiety

C. Sedation and ability to produce dependence

D. Amnesia and skeletal muscle relaxation

QUESTION: Absolute Contraindications to Opioid Prescribing: Allergy to

Codeine/Oxycodone/Hydrocodone give Methadone or Meperidine or Tramadol..

QUESTION: Which of the following narcotics/opioids is synthetic? Meperidine (Demerol) or

propoxyphene
QUESTION: Use for sedation of children- Secobarbitol or pentobarbital (good for pre-op/anxious kids)
Ketamine is used in emergency situations (good anxiolytic and analgesic at low doses) Meperidine should
not be used in kids

QUESTION: Which is not done by opiates

o Diuresis (opiates cause urinary retention)

o Constipation
o Bronchiolar constrction
o Vomiting

QUESTION: opioids do NOT do what? Peripheral pain block

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 o they do: constipation, respiratory depression, somnolence
QUESTION: opioid side effect constipation

QUESTION: Opiate overdose--> miosis

QUESTION: Opoid overdose side effect (from cocaine) constipation, respiratory depression,
euphoria, miosis, coma
QUESTION: opioid OD symptoms answer was hypotension. Other options were irritability
(restlessness), hypertension, insomnia = withdrawl symptoms.
QUESTION: Symptom seen in oral opioid overdose: hypothermia, headache, insomnia, irritability
(rest are withdrawal sympotms)

QUESTION: Symptoms if too much codeine? Cold and clammy skin

QUESTION: Opioid usage all except: xerostomia, chronic cough, diarrhea, miosis (for sure get
constipation)
QUESTION: adverse effect most severe of opioids: respiratory depression.
QUESTION: What is the most significant side effect of morphine: respiratory depression

QUESTION: Major disadvantage of opioids is respiratory depression.

QUESTION: Miosis seen in opioid abuse - except with meperidine (an exception)
QUESTION: Which of the following symptoms is the most distinct characteristic of morphine poisoning?

A. Comatose sleep

B. Pin-point pupils

C. Depressed respiration

D. Deep, rapid respiration

E. Widely dilated, non-responsive pupils

QUESTION: Opioids : opioids receptors in GI tract, CNS and adrenal medulla

QUESTION: Opioid Receptors- brain, and are found in the spinal cord and digestive tract.

QUESTION: opioid stomach upset - act in the brain, not in stomach receptors (I got this wrong!)

QUESTION: Opioid agonists act by

a. stimulating GABAergic neuron
b. increase pain threshold
c. acting as Mu receptor agonists

QUESTION: Naloxone: use for Opioid overdose. Used Meperidine (Demerol) to decrease
withdrawl symptoms

QUESTION: Opioid (Fentanyl, Morphine, Meperidine, Methadone, Sulfentanil, Codeine, Heroin,

Dextromethorphan) reversal drug? Naloxone.

144
QUESTION: antidote for Percodone overdose (Oxycodone+aspirin)? all opiate antidote is
Nalaxone

QUESTION: True opioid antagonist should have-high affinity and no intrinsic effect

QUESTION: How does an antagonist work? No intrinsic activity, High affinity

QUESTION: Antagonist: Binds to receptor but lacks intrinsic activity

QUESTION: Fentanyl is the opioid analgesic given trans dermally

QUESTION: TRANSDERMAL patch- Fentanyl (opoid)

QUESTION: Which opiate is part of intradermal system? Fentanyl

QUESTION: If you give too much of an opioid (but its not an overdose!), whats the first sign you
would see?

a. Irritation
b. Headache
c. I dont remember the other twoI put headache..? I really think it has something to
do with pin point pupils and respiratory depression constricted pupils and
absent/slow breathing

QUESTION: Methadone? Helps alleviate withdrawl from heroine (opiates). ***Buprenorphine and
Methadone is for opioid addiction. Naloxene is an opioid antagonist for OVERDOSE***

QUESTION: why use methadone: long half life- extra info give to heroine addicts? to decrease
withdrawl symptoms

QUESTION: Methadone for detoxification of opioid addicts

(Methadone is a synthetic opiod, analgesic, antitussive, antiaddictive, acts on MU receptors so produces

similar effects of opioidswithout addictive qualitiesreceptor antagonist to glutamate)
QUESTION: Why is nalbuphine contraindicated in previous heroin addict: A mixed agonist-
antagonist which may potentiate withdrawal symptoms

QUESTION: Nalbuphine (NUBAIN) (opioid agonist and antagonist)

withdrawal symptoms.

QUESTION: pt is addicted to oxycodone which contra indi--- codeine, pentozocaine

QUESTION: Sedative drug such as hydroxyzine, meperidine and diazepam are carried in the blood in
a. serum
b. white blood cells
c. red blood cells
d. hemoglobin

QUESTION: where do opioids act? Medulla (bind to opiod receptors in CNS)

Morphine, codeine, as well as oxycodone, and hydrocodone all belong to the phenanthrenes
class
QUESTION: where are mu receptors?
Medulla
Periphery
QUESTION: The codeine produces nausea because?

145
 Activates vasodialator blah blah blah
Works on the medulla (stimulates medullary chemoreceptor trigger zone)
QUESTION: How codeine causes nausea: CHEMOTACTIC RECEPTOR ZONE (CRZ)
QUESTION Mechanism of how codeine causing nausea? Chemotactic receptor zone CRZ
QUESTION: How does morphine cause emesis in the body: know the pathway via central action

QUESTION: Had a question about codeineand what effects arelike it being antitussive, antidiarrheal
and analgesics, sedatives and preanesthetic meds
CODEINE: analgesic, antitussive, antidiarrheal, antihypertensive, anxiolytic, antidepressant, sedative and
hypnotic properties. IS ADDICTIVE

QUESTION: Symptoms if too much codeine? Insomnia, Cold and Clammy skin, irritable.
QUESTION: Allergy to codeine: what do you take for pain random opioids, tylenol #3, hydrocodone,
acetominophin with aspirin I think
ALLERGY TO CODEINE: can prescribe another opioid from different class: Meperidine or
fentanyl for moderate to severe pain or acetaminophen or NSAID for mild pain.
QUESTION: What give to pt allergy to codein? Propoxyphene
QUESTION: Patient allergic to codeine what do you give?? Naproxen
QUESTION: Patient is allergic to codeine when you look at their medical history tab, (this is the trick
about the exam, look up stuff before you answer questions), what do you prescribe him for pain?
Hydrocodone with Acetominaphen (Other choices were Tylenol 3, Hydrocodone with Aspirin)
Acetaminophen + aspirin
QUESTION: Codeine allergy, pain killer option? - for pts with opioid allergy use synthetic opioids
(meperidine, tramadol)
QUESTION: Allergic to Codeine what can you give? Demerol(meperidine), Pentazocine

QUESTION: Pt has hx of codeine allergy. What drug to give?

Tylenol #3 has codeine
Vicodine
Naproxen *
Hydrocodone

Group 1 (aka opiates) - Naturally occurring agents derived from the opium plant
o Morphine, codeine, thebaine
Group 2 - Semi-synthetics
o Hydrocodone, oxycodone, hydromorphone, oxymorphone, buprenorphine (heroin is also in this
group)
Group 3 - Synthetics
o Fentanyl (alfentanil, sufentanil, etc.), methadone, tramadol, propoxyphene, meperidine

All of the group 1 and 2 agents are structurally very similar to each other and should not be given if a true
allergy exists to any other natural or semi-synthetic derivative. Group 3 agents have structures different
enough that they can be given to a patient intolerant to the natural or semi-synthetics without fear of cross
reactivity. They are also very different from others in this same group.
QUESTION: Know the effects of histamine and that it is derived from histidine
histamine is bronchospastic and vasodilator
QUESTION: what is not true about histamine?it is released by histamine
QUESTION: Benadryl (diphenhydramine) both are H1 blockers

146
QUESTION: What is used for motion sickness? Diphenadryin (Benadryl)----I think this is scopolamine
QUESTION: What does diphenhydramine (Benadryl) cause? Xerostomia (anticholinergic,
antihistamine, sedative)

QUESTION: What property of topical diphenhydramine would alleviate pruritus (itching)? I put
anti-cholinergic NO antihistamine

The antihistamine relieves itchy/watery eyes and itchy throat by blocking a substance
(histamine) released by allergies. The anticholinergic dries up a runny nose and the fluid that
runs down your throat causing itching/irritation.

QUESTION: what antihistaminic cause less drowsiness : H1 blocker 2nd generation zyrtec, allegra,
Claritin (loratidine), Clarinex (Desloratidine) Certizine (Zyrtec) because they dont cross BBB,
poor CNS penetration
QUESTION: what antihistaminic cause less drowsiness : H1 blocker 2nd generation zyrtec,allegra,
Claritin because they dont cross BBB

QUESTION: Which one of these has the least sedative effect? (2nd generation H1 blocker)
Diphenylhydramine/ Benadryl (Most)
chlorpheniramine- (LEAST)
Tripelennamine

QUESTION: Least sedating anti-histamine? (2nd generation H1 blocker)

QUESTION: Which antihistamine is least likely to cause drowsiness Loratidine
QUESTION: Claritin/loratidine second generation H1 blocker/antihistamine
QUESTION: WHAT DO YOU GIVE SOMEONE WHO IS ALLERGIC TO ESTERS AND AMIDES?
DIPHENHYDRAMINE (BENADRYL)
QUESTION: Which of the following (from a list of H1 blockers) would have slowest onset after IV
administration? Diphenyhydramine, loratadine.. didnt recognize other options. IDK
Levocetirizine is listed as having an onset of action of one hour with duration of
greater than 24 hours, whereas loratadine has an onset of action within two hours
with duration of action of 24 hours. Hydroxyzine, a first generation antihistamine,
has an onset of action of two hours with duration of action of 24 hours.

QUESTION: How does antihistamines work? Competitive inhibition of histamine receptors

QUESTION: How does antihistamin work? I put competitively block histamine receptor
QUESTION: actions of H1 antagonist. Blocks H1 receptors. Block vasodilation,
bronchconstriction, and capillary permeability. Vasoconstriction, bronchodilation, and
decrease capillary permeability

QUESTION: What property of diphenhydramine causes xerostomia?

a. Anticholinergic
b. Antihistaminic
c. Antimuscarinic

QUESTION: Diphenhydramine/benadryl use results in xerostomia due to its anticholinergic activity.

Side effects of Benadryl dry mouth and throat, increased heart rate, pupil dilation (mydriasis),
urinary retention, constipation anticholinergic

147
QUESTION: H2 antihistamine Cimetidine decrease ulcers H2 antihisamine ratidine****** thats
answer
QUESTION: Histamine 2 blocker meds - for gastric reflux Cimetidine all the drugs with dine
are histamine 2 blockers
QUESTION: H2 drug. What is it best used for? Gastric ulcer
QUESTION: Histamine 2 blocker meds - for gastric reflux (block the action of histamine on parietal cells
in the stomachie. Cimetidine, ranitidine, famotidine, nizatidineXtina)
QUESTION: when would you use H2 blocker (they only gave the name cimetidine)- H2 Blocker
(reduce the acid secretion) for GERD (gastro esophageal reflux disease)

QUESTION: H2 antihistamines for (cimetidine ie tagamet) (ZANTAC = RANTIDINE) : gastric ulcers

QUESTION: Detailed mechanism questions on H1 (histamine) compete with histamine to bind at H1
receptor sites.
QUESTION: effects of H1 blocker EXCEPT: (causes CNS depression)
a. CNS increase
b. CNS decrease
c. increase acid secretion
d. resp depression
e. local anesthesia

QUESTION: Pt is allergic to aspirin? Wat can u give, Tylenol #3 is acetomenophen and codeine. Just
tylenol
QUESTION: Wat does acetametaphine do with codeine? Increase its activity, increase how long its around
due to clearance,...
QUESTION: Why opioid analgesic containing both acetaminophen and hydrocodone so effective?
acetaminophen and hydrocodone works differently, and combining these effects
makes it stronger* I put this, but not sure.
acetaminophen blocks the binding of protein with hydrocodone, so hydrocodone
level in blood is high, so it is strong
Narcotics work in brain (CNS) while NSAIDS/acetomenophen work in peripheral tissues (PNS)
2 diff mechanisms compliment each other for effective pain reduction

QUESTION: How do you treat acetaminophen overdose? I put n-acetylcysteine

QUESTION: What to give when there is overdose of acetaminophen, opioid analgesics? N-
acetylcysteine
QUESTION: Reversal of acethaminophen: NAC , N-acethylcysteine-liposome.
QUESTION: Tylenol- liver toxicity
QUESTION: Tylenol - can cause hepatotoxicity

QUESTION: Pt has hepatic dysfunction which pain medication can prescribe?

a-Oxycodone b. naproxen c-acetaminophen

QUESTION: what is relationship bet Tylenol and aspirin anti pyretic and analagesic
QUESTION: Another Q: Difference: asprin is antimflammatory common: anti pyretic

148
QUESTION: Which of the following does not have anti-inflammatory action: Acetaminophen
QUESTION: Tylenol and acetaminophen: analgestic and antipyretic
QUESTION: Ibuprofen doesnt cause as much GI upset as aspirin
QUESTION: Tylenol vs. NSAID: Apirin- reyes fever and adults GI, If liver problems give aspirin
QUESTION: Similarity between Advil and Tylenol: Anti-pyretic and analgesic

QUESTION: NSAIDs--> stimulate asthma attack-->COX inhibitor

QUESTION: NSAIDs inhibit cyclooxygenase

QUESTION: NSAIDS are....
options included aspirin, Advil, tylenol
they are both irreversible and reversible
go with irreversible (aspirin)
(NSAIDs are a mix of the two) ->advil = reversible
QUESTION: NSAID irreversible affect platelets

QUESTION: NSAIDS? Suppress inflammatory response (antiinflam, analgesic, antipyretic not

immunosupp)

QUESTION: NSAIDs mech of action of suppressing platelets inactivate cyclooxygenase decreased

prostaglandin synthesis

QUESTION: Asprin stops pain by:

a. stopping the unpward transduction of pain signal in the spinal cord

b.intefere wiht signal intrepretation in the CNS

c. stopping the local signal produtction and transduction

d.stopping the signal transduction in the cortex

QUESTION: what does NSAID do? Irreversibly block platelets, reversibly, inhibit instric, extrinsic
pathways..

QUESTION: NSAIDS...irreversible or reversible (question which of the following true about

NSAIDS)answer 1 irreversibly binds answer 2 reversibily answer 3 somethong about bleeding
time answer 4 something about platelets
Cox 2 does not increase bleeding time and less platelet adhesion.

QUESTION: Nsaid least likely to effect stomach (Rofecoxibaka Vioxx...however taken off the market)
Cox 2 inhibitor CELEBREX
QUESTION: Dyspepsia =upset stomach what drug can cause it Less likely to be acetaminophen,
ibuprofen (less GI upset than other nsaids).
QUESTION: Aspirin inhibits platelet aggregation

QUESTION: Plavix and aspirin: alter platelet function

QUESTION: What affect does Plavix has? Inhibits platelet aggregation.(Given to patients allergic to
aspirin) no ulcer side affect, give to patients with past ulcer history
QUESTION: Clopidogrel (Plavix) inhibits platelet aggregation irreversibly

149
QUESTION: Patient is taking baby aspirin.
a)how long before should you stop before surgery?
b)is it necessary to stop?
c) for long will the platelets be inhibited? 5-7days
QUESTION: aspirin stays in body for 7 days
QUESTION: For how long a single dose of aspirin will have effect on the platelets? 2h, 12h, 1 day, 10
days, 1 month 10 days
QUESTION: After one effective dose of aspirin how long must you wait before there is not effect on
bleeding time (I said 1 week, I think it was an old exam q)

QUESTION: apirin - single dose - how much time- 4 hours, 1 day for baby aspirin (81mg, day)
aspirin is 325mg (to 650mg) q 4-6 hrs (max dose is 4000)

QUESTION: aspirin is irreversible

QUESTION: Aspirin works on which pathway for pain?- Cyclo-ox pathway
QUESTION: Aspirin works how to inhibit bleeding?- Thrombox A2
QUESTION: Bleeding time: Inhibits thromboxane A2 preventings platelet synthesis

QUESTION: Differences between Bleeding time, PPT, which one it is affected by aspirin(BT)
QUESTION: Patient is on 3-5 grams acetylsylic acid per day for 3 months what is the most likely to see in
this patient?
Choices were
Increased PT and Bleeding time
Increased PT and PTT
Acidosis and increased bleeding time (I am not sure if the second part of this choice was bleeding time
but I rememberly I instantly picked this as soon as I saw acidosis, since acetylsyllic acid is aspirin and its
an acid and 3g daily is a lot!!!!
QUESTION: Pt. on saw palmetto what do u want to avoid? Aspirin
QUESTION: Saw palmetto enhances anticoagulants
QUESTION: which effects (that heighten, I think) anticoagulants...St. Johns wart, cammomile, saw
palmette, licorice(antiviral )
QUESTION: HERBAL supplement that potentiates anti-coagulation (CHAMOMILE DIRECT EFFECT)

a. St. Johns Wort

b. Saw Palmetto (this is what I put)

QUESTION: **Which herb complicates in someone on anticoagulants: st johns wort-dec immunity

in hiv pt on heart mehs and antidepressant, chamomile, ginko, ginseng-anti-platelet (at least 2
questions)

a. Chamomile not ot be had with anti-coagulats

QUESTION: Which one has anticoagulant properties? St Johns Wort nope. its the saw palmetto
QUESTION: Which one has anticoagulant properties? Saw palmetto
QUESTION: ibuprofen allergy, dont give aspirin
QUESTION: Allergic to Aspirin? Take acetaminophen. DO NOT take ibuprofen.
QUESTION: similar question: Pt has reaction to aspirin, cannot give what else? Ibuprofen (only nsaid in
the answers)
One very important point is that most NSAID's (or Non-steroidal anti-inflammartory drugs) cross-react
with aspirin - meaning that they can cause the same types of reactions in aspirin sensitive people
QUESTION: If someone cant take ibuprofen what can u give them?

150
a. aspirin
b. demerol narcotic w/out aspirin
c. pentazocaine - narcotic w/aspirin
QUESTION: Which statement is correct for Ibuprofen?
ceiling analgesia at 400mg
safe use for pt w/ peptic ulcer
safe to use for pt w/
QUESTION: Methotrexate toxicity increases with use of nsaids or penicillin
QUESTION: No NSAIDs for asthmatic patient
QUESTION: in asthmatic patient===nsaid contraindications - NSAIDS cause bronchospasm.

QUESTION: Asthma patient: NSAID contraindication

QUESTION: What causes asthma: NSAID (aspirin)
QUESTION: longterm asthma give corticosteroid

QUESTION: Long acting Corticosteroid Dexamethasone

QUESTION: What doesnt affect platelets of list of NSAIDS: Celebrex
QUESTION: Celebrex- Cox 2!!!

QUESTION: Celebrex (cox 2) doesnt stop bleeding? It causes bleeding as a side effect

QUESTION: Does NOT have an affect on platelets (from list of NSAIDS): Celebrex/celecoxib is a
NSAID

QUESTION: Something about arachidonic acid breakdown.Prostaglandin? Bradykinin?

QUESTION: Oral Ketorolac: NSAID,usually used after IV dose of Ketorolac after surgery

Ketorolac (toradol) can be given orally or IM. Ketorolac is used to relieve moderately
severe pain, usually pain that occurs after an operation or other painful procedure.

The speed of absorption is faster for intramuscular injection compared to

subcutaneous injection. This is because the muscle tissue has a greater blood
supply than the area just under the skin. Muscle tissue may also hold a larger
volume of medication than subcutaneous tissue.

QUESTION: Ketoralac is an NSAID that inhibits prostoglandin synthesis (competitive non-selective

cox inhib)
QUESTION: What med to give for moderate post-op extraction pain? Ibuprofen, Acetaminophen, NSAID,
opioid

QUESTION: pt has mild pain from ortho. What med NOT to give?
Aspirin
Ibuprofen
Hydrocodone *
Naproxen

151
QUESTION: What would you prefer for a patient with renal vascular disease & why?
a.acetaminophen (the other drugs are nsaids and they affect the kidney in a more negative way. This
drug affects the liver and causes liver toxicity.)
b.aspirin
c.ketorolac
d.ibuprofen

QUESTION: Tylenol non-narcotic analgesic of choice for pt taking anti-coagulants no anti-inflamm.

Properties
QUESTION: For pregnant- only give Tylenol- NOTHING WITH CODEINE
QUESTION: Pregnant patient (third trimester) needs pain medication options: Tylenol 325mg,
Tylenol 3m aspirin, or ibuprofen 600mg?
QUESTION: Pateint is pregnant and needs 2 teeth extracted, needs postop analgesic what do you rx:
ibuprofen vs aspirin vs Tylenol 3 vs regular Tylenol (I said acetaminophen)

QUESTION: Patient pregnant, what NSAID-Acetametaphin

QUESTION: What is a safe pain killer to give a woman who is pregnant? Tylenol (answer)
QUESTION: Breastfeeding mother dont give her What? I was expecting tetracycline but it wasnt there
so I put Propoxyphene because it has aspirin. Maybe could cause Reyes
QUESTION: do not give which medication to lactating female? Codiene and tetracycline
QUESTION: do not give which medication to lactating female? codiene (yes)
FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause
breathing problems or addiction/withdrawal symptoms in a newborn.
QUESTION: Kid has pain acetominophen
QUESTION: What would you give to 5 year old for pain: Give Tylenol

QUESTION: What analgesic do you give a child with Asthma? Tylenol

QUESTION: Asthmatic only use Tylenol (not aspirin bc of hypervent)
QUESTION: Kids w fever- tylenol
QUESTION: 5 year old patient with fever and pain
Codeine
Tylenol
Asprin
NSAID
QUESTION: DEA schedules there drugs by their toxicity ABUSE POTENTIAL or dependency
potential
QUESTION: DEA classifies drugs on addiction
QUESTION: DEA number required for prescribing opioids/narcotics, like codeine, oxycodeine, etc
QUESTION: dentist cant write prescription for schedule class 2 for back pain.
QUESTION: What is not true of drugs? Schedule II drugs cannot get refill without script . the
following are true:
o Schedule 3, 4, 5 drugs CAN be filled over the phone.
o Scripts must have patients name and address
o DEA number must be on each script

QUESTION: Oxycodone, Hydrocodone: schedule 2

152
QUESTION: What can be combined with tylenol to make it a level 2oxycodone, codeine etc.
Tylenol 1 = 8mg codeine ; Tylenol 2 = 15mg codeine ; Tylenol 3 = 30 mg Codeine ; Tylenol 4 =
60mg Codeine
QUESTION: Tylenol - can cause hepatotoxicity
QUESTION Which one is a class 2 narcotic? Vicodin, percoset, hydrocodone

QUESTION Vicodin schedule?: 2 acetaminophen + Hydrocodone

QUESTION Percocet schedule: 2 acetaminophen + Oxycodone
QUESTION LESS than 15 mg of hydrocodone per dosage unit is schedule 2

QUESTION schedule 2: combination products containing less than 15 milligrams of hydrocodone

per dosage unit (Vicodin)

QUESTION Schedule 3: products containing less than 90 milligrams of codeine per dosage unit
(Tylenol acetaminophen- with codeine).
QUESTION schedule 4 narcotic is propoxyphene (Darvon and Darvocet-N 100). alprazolam
(Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam
(Ativan), midazolam (Versed), temazepam (Restoril), and triazolam (Halcion).

QUESTION: Drug schedules II or III they are all acetaminophen with opioid except for one that
was hydrocodene with nsaid (vicoprofen)

QUESTION: Schedule II drug- Percocet (it didnt say oxycodone so know that Percocet is oxycodone
and Tylenol)

QUESTION: Schedule II narcotic and antipsychotic neuroleptic analgesia

QUESTION: if a guy wants to relieve his pain for 8 hours- ibuprofen, naproxen, Tylenol, aspirin
QUESTION: If a patient had some teeth extracted and asked what drug he can take thatll provide at
least 8 hours of relief

a. Tylenol
b. Ibuprofen
c. NAPROXEN- this is what I put

QUESTION: Naproxen 8hr nsaid

QUESTION: Pt. has pain and wants to sleep for eight hours? Naproxen --- a nonselective cox inhibitor
nsaid
QUESTION: What are you worried about when a patient is on Naproxin? (DDI w/ aspirin antiplatelet
activity)
QUESTION: Which of the following has least effect on platlets/bleeding?
Aspirin
Ibuprofen
Naproxin
Difluzole (vaginal candidiasis medication)

Biopsy:
QUESTION: Pt has worn denture for 19 years, now he has a sore on Buccal with swelling what do
you do: refer out, biopsy, cytology, Relieve denture in area and re-evaluate in 2 weeks
QUESTION: White patch on buccal mucusa? Whats best way to get biopsy?? Smear**

153
QUESTION: You have a lesion in mouth, you tried to treat it, still looks the same after 2 weeks
Take biopsy
QUESTION: You have a lesion in mouth, you tried to treat it, still looks the same after 2 weeks Take
biopsy
QUESTION: Patient comes in with preliminary diagnosis of candidiasis on ventral tongue and floor of
mouth, white lesion rough and firmly attached. What do you do? Incisional biopsy, Do cultural testing
and confirm that it is/is not candidiasis
I chose confirm/deny with cultural test because leukoplakia is when you have no other
differential but idk cuz you have to biopsy leukoplakia and the lesion looked like it.
QUESTION: Oral candidiasis biopsy of choice is incisional biopsy, excisional biopsy, brush biopsy
(collects the cells for cytological smear), cytomologic smear
QUESTION: Biopsy - indicated when treatment doesnt work after 14-20 days
QUESTION: When do u have to do a biopsy- I wrote if cant treat in 10-14days**about 2 weeksany red
or white lesion that doesnt resolve itself in two weeks BIOPSY THAT SHIT
QUESTION: When to do biopsy? whenever there is a progressive metasis even though antibiotics are rx
QUESTION: White lesion 2x3x2 cm excisional biopsy, incisional biopsy, smear
QUESTION: What should you not do initially with a patient with desquamative gingivitis--> BIOPSY,
topical corticosteroids (other choices were, encourage OH)
QUESTION: When you do biopsy, how do you store the specimen before it gets to oral pathologist? 1.
Formalin (answer)
QUESTION: Patient has a sore, shiny red area that when you blow air on it, a white membrane
comes off and the sore starts bleeding. What should you do? Culture and Medical
management (Or biopsy + Med Man)
QUESTION: To test for malignancy what test? Cytology, brush biopsy, etc? Incisional biopsy
QUESTION: Difference between incisional and excisional biopsy
Notes:
Incisional biopsy is a technique used when a lesion is large >1 cm, polymorphic suscpicious for
malignancy, or in an anatomic area with high morbidity,
Excisional biopsy is used on smaller lesions <1cm that appear benign and on small vascular and
pigmented lesions. It entails the removal of the entire lesion and a perimeter of surrounding
uninvolved tissue margin.

Implant:
QUESTION: Diff btween 1 stage and 2 stage, immediate loading vs traditional way
QUESTION: Similarity between bone and implant? Vascular bundle below the bone
QUESTION: What kind of bacteria is under implants? At the apex of root canal?

Gram negative, Gram positive, Cocci, filament, rods. Know each.

Gram (-), rods and filaments anaerobic

Strict anaerobes are predominate in endo

QUESTION: What bacteria is responsible for implant falure?- gram anaerobics

QUESTION: Bacteria around failing implants? Gram negative,motile, strictly anaerobics

QUESTION: best area to place implant? Anterior mand or posterior mand wasnt sure
QUESTION: best bone to implant in --- apparently ant md? WORST: post mx

154
QUESTION: when an implant placement where in the least success: MAXILLARY POSTERIOR

QUESTION: Implants osteointergrate best in ? anterior mandible

QUESTION: Best area to place implants? Anterior Mandible
QUESTION: best reasoning for implant in max lateral
a. no rest on central & canine
QUESTION: what is the least important factor when evaluating for implant: ( concavity of mandible,
bone density , distance to mandibalr cancal, bone width)
QUESTION: Bone should not reach temperatures above? (temperature in Celsius) 47 for 1 min 40
for 7 mins
QUESTION: What is the limit before bone dies in implant procedure (in Celcius!): 47 for 1-5 minutes
QUESTION: Max temperature for bone in implants 47*C
QUESTION: Temperature you dont want to exceed during implant placement? They had 26, 36, 56. No
47. I chose 56

QUESTION: implant to implant 3mm

QUESTION: Distance between adjacent implants minimum? 3 mm

QUESTION: Distance between two implants: 3mm

QUESTION: Space between 2 adjacent implants 3mm. 1.5mm teeth

QUESTION: How much space between implant and tooth? Answers were 1.5, 2, 3.5 3,

QUESTION: space from implant to nerve needed2 mm

QUESTION: Implant diameter is 3.75 mm. What is the minimum labiolingual distance required? 5.75mm
QUESTION: Minimum width (bucco-lingually) bone should be for 4mm diameter implant
Choices were 5mm and 7mm I put 7mm (4 for diameter + 1mm each side = 6)

QUESTION: Minimum ridge width for 4mm implant is?

a. 6mm
b. 8mm
c. 4mm
d. 10mm

QUESTION: if implant with width of 4 is used what should be the bucolingual width of the ridge----6

Need 1mm bone on each side (facial and lingual)

minimum Vertical height of bone to place implant - 10mm (according to decks)

minimum Width of bone is 6mm

minimum distance of apex of implant From nerve - 2mm

155
platform of implant from adjacent CEJ - 2-3 mm

between implants 3mm

between implant and tooth (height of coutour) is 1mm

Mini implant is 2.4mm

QUESTION: When there is FPD from natural tooth to implant, the max stress is concentrated on the
SUPERIOR PORTION OF THE IMPLANT.

QUESTION: If implant and bridge are done with natural tooth, what is the complication?, there is a
lot of force on crown of implant and cause fracture. diff mobility

QUESTION: how does fibers grow from crest of bone to implant?

Perpendicular with implant, parallel with implant, other options that didnt make sense
QUESTION: How does gingival fibers orient next to implant parallel to implant with no insertion,
perpendicular with insertion, parallel with cuff, perpendicular with cuff.
QUESTION: Tissue around implant? PARALLELL WITH CUFF LIKE
QUESTION: How does gingival fibers orient next to implant parallel with cuff, (Parallel and/or circular
to implant surface)
Periodontium surrounding the implant: no periodontium, bone and implant.(false)
You have long JE and ct (parallel and circular only)
Periodontium = gingival, pdl, cementum, and bone

QUESTION: CASE: Case shows a picture of a bridge, when you look at it closely it resembles a
Maryland bridge because lateral is intact. What to do if Maryland is removed?
-regular bridge
-implant- she answered this because lateral was intact.

QUESTION: know implants CI:

uncontrolled diabetes
immunocompromised patients
volume and height of bone(anatomic considerations)
bisphosphonate therary
bruxism
tobacco(relative)
cleft palate
young kids

QUESTION: Contraindications to implant placement? Adolescents should not get implants.

QUESTION: never place implants in a patient that had cleft palate
QUESTION: Bruxism is implant CI
QUESTION: Old people can get implants
QUESTION: Implants not CONTRAINDICATED older patient
QUESTION: All affect implant placement EXCEPT smoking 1 pack a day, cardiovascular disease,
uncontrolled diabetes, radiation of 60 Gy
QUESTION: Does not affect implant success? Age

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QUESTION: All these are contributing factors for why implant wud fail in this pt except: smoking,
diabetes, AGE, etc. (AGE)

QUESTION: Implant treatment better option for smoker than perio surgery because perio surgery
in smoker doesnt work as well as non-smoker.
a. Both statements are true but unrelated
b. Both statements true and related
c. First statement true but reason is not
d. Neither the statement or the reason is true

QUESTION: When getting crown for implant, what occlusal scheme is preferred? metal occlusal is
preferred

QUESTION: When you use screw over cement retained? when you don't have space occlusally,
use screw

need more interocclusal space for cemented

QUESTION: What is the purpose of hex screw? Antirotational

QUESTION: External hex function: anti-rotation

QUESTION: Implant internal component helps with what? Prevents rotation of the abutment

QUESTION: Hex screw implant prevent rotation of the crown

QUESTION: A lot of implants have external hex-what is it used for?

Stabilization of abutment
For cementation
QUESTION: What is the component of the implant that replicates implant in cast? ---analogue
QUESTION: What is most important for osteointegration in implant procedures? How well the surgical
procedure is managed.
QUESTION: Osteointegration of implants should be assessed:
prior to placement of restorative abutment- Thats why you torque before restoration.

QUESTION: At what appointment do you first check osseointegration-2nd stage surgery I think

QUESTION: When do you check osteointegration? Before place of abutment

QUESTION: when can you tell the an implant is osseointegrated : a)before taking the final
impression. B)before placing the abutment c) before cementing the crown

QUESTION: All of the following are true about Surgical stents, except? It tells you the number of
implants you can place. (Other choices were, angulation of implant, location implant, thickness of
implant. I think number of implants to be placed is decided before the stent at the time of CT xray or
during a consult)
QUESTION: why do you use a stent? make sure implants are aligned properly
QUESTION: Implant question: surgical template for angulation of bur for implant placement
QUESTION: implant guides and what info it relates to the surgeon: location, angulation, size,
number of implants

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QUESTION: What will you do when implant is inclined too buccally and you dont want the screw to
be seen on the buccal surface of crown? Angled abutment

QUESTION: implant placed in facial angulation, what do you do to prevent facial access for screw
abutment? I said place an angled abutment and cement it down; other options is correct implant
placement or put composite where facial access for screw will be

QUESTION: Implant placed at angle where screw hole will be on buccal surface. What do you do so
that you cant see screw on buccal?
Cover with composite?
Angled abutment cemented?
Remove implant?

QUESTION: implant is angled to facial, use custom abutment

QUESTION: Preload of implant is comparable to what force
a. torque
b. compressive

A compressive force presses the components of the system together and normally does not
introduce any mechanical problems in the anchorage unit itself. On the other hand, tensile loading
refers to a force that tends to separate components

QUESTION: What is the problem with preloading a screw implant? Low loading can make it loose, high
loading can make it loose, low loading can lead to implant creep or something, high loading can lead to
implant creep (wtf)
High frictional forces between components decrease as a result of Creep leads to a decrease in preload

QUESTION: In an appointment for the impression of implant what do you do first? put the coping
first

QUESTION: What do you want to do first when taking an impression of the implant and abutment
splinting the 3 implants with a bar?- Make sure the abut is attached right when the pt comes in others
were check fit of custom tray, incert impression coaping, insert imp coaping with acrylic.

QUESTION: Advantages of an open tray impression

Advantage to open tray technique: Reduce effect of implant angulation
QUESTION: open technique impression for implant: to transfer the exact angle of implant to the lab
QUESTION: Advantages of an open tray impression
Open tray: pick up, reduces effect of implant angulation, dont have to put coping back into
impression, impression material not deformed. Open tray is more accurate
Closed tray: transfer, easier, better for shorter interarch distance, more accurate, not
suitable for deep implants, dont work for nonparallel implants

QUESTION: Mobility in implants is failure, remove and greft

QUESTION: Implant success is determined by what? Mobility
QUESTION: During uncovering, you realized implant is mobile and there is bone loss - failed
implant, take it out!
QUESTION: What main reason implants fail? Surgical error , Lack of early loading , Inadequate
occlusal design

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QUESTION: Most common implant failure due to Screw loosening, occulsal loading, Does not
osseointegrate
QUESTION: Most common complication for crown? screw loosening

QUESTION: 10-year success rate: -I think its 80 for 10yrs and 85 for 5yrs; what is most common
reason of failure

QUESTION: Most important thing about implant success (in the procedure the things are most important
for osseointegration)

QUESTION: Major mechanisms for the destruction of osseointegration are

Related to surgical technique

o Similar to those of natural teeth

related to implant material

related to nutrition

QUESTION: Why implant fails: no osseointegration

QUESTION: What causes the greatest incidence of implant failure? Overheating not smoking.

QUESTION: What is the worst type of force for an implant? Horizontal.

QUESTION: When you place a implant, widening of crestal bone is seen because of which force?
horizontal

QUESTION: What main reason implants fail

Surgical error
Lack of early loading
Inadequate occlusal design

QUESTION: Most likely to cause implant to fail?

Smoking
Osteoporosis with HTN
Hypotension
Allergy to antibiotics
QUESTION: What causes the least buccal-lingual resistance to lateral forces
Two 5mm diameter splinted implants
Two 4mm diameter splinted implantsI chose this but idk
One 5mm diameter implant
One 4mm diameter implant
QUESTION: What is the strongest from lateral force2, 5mm implants splinted together, 1 single 4 mm
wide implant, etc,
QUESTION: What causes the least buccal-lingual resistance to lateral forces?
Two 5mm diameter splinted implants
Two 4mm diameter splinted implantsI chose this but idk
One 5mm diameter implant
One 4mm diameter implant

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QUESTION: In anterior maxilla, for a 4mm diameter implant, how far apical to the CEJ of adjacent tooth
for optimal emergence profile`
CHOICES WERE:
1 mm above cej of adj tooth
1 mm below cej of adj tooth
2-4 mm below cej of adj tooth I chose this
another one I cant remember
QUESTION: In anterior maxilla, for a 4mm diameter implant, how far apical to the CEJ of adjacent tooth
for optimal emergence profile
CHOICES WERE:
1 mm above cej of adj tooth
1 mm below cej of adj tooth
2-4 mm below CEJ of adj toothI chose this
another one I cant remember
ANSWER IS 2-3mm below CEJ

QUESTION: ImplantBELOW the gingiva (for better esthetics)

QUESTION: implants placed 2-3mm below adjacent tooth
QUESTION: where should you put implant platform in esthetic area (at level of alv.crest/ below
opposing tooth gingiva, etc.) I didnt know answer, just went with whatever put it subg

a. 1mm subgingival to adjacent teeth CEJ

QUESTION: To obtain ideal emergence profile, where should the Implant head be in relation to
adjacent gingival margin? 1-2mm above, 3-5 mm above, same level, 1-2 mm apical
QUESTION: If you want the most natural emergence profile for an implant, how far should the
head be from the gingival? I put 2-3 mm apical
QUESTION: Cervical position while placing an implant-How much below CEJ? (3mmXtina) **Rest
platforms placed 2-3 mm below adjacent CEJ. Implant 5 mm from mental foramen, because nerve loops
out 4 mm. Implant 2 mm from vital structures. At least 1 mm of bone all around implant. 1.5 mm of bone
between implant and adjacent tooth. 3 mm of space between adjacent implants.
QUESTION: how far up or down from tissue should the implant be placed in relation to adjacent CEJ
***implant platform should be 2-3 mm below adjacent CEJ
QUESTION: Where should implant / abutment interface ideally be?
A: At height of alveolar crest

QUESTION: Trauma from occlusion in implants no gingivitis

QUESTION: All are symptoms of TFO (trauma from occlusion) on an implant except. Gingivitis, pain,
loosening of implant, breakage of abutment screw.

QUESTION: What evidence is not seen in failed implants: something about gingivitis

QUESTION: 1mm crestal bone remains around implant after 1 year, why? inflammation, heavy occlusal
load,
QUESTION: Which of these show clinically acceptable results of implant placement? ;Periimplant
pathoses, implant mobility, .ans. bone loss less than .1mm per yr or
QUESTION: Implant success criteria--- I think choices included mobility,
(ONLINE) The basic criteria for implant success are?

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 immobility, absence of peri-implant radiolucency, adequate width of the attached gingiva,
absence of infection
Average bone loss of 0.2mm for the first year is acceptable

QUESTION: Whats the worst thing you can do to a tooth you plan to re-implant right before you do so?-
Scrape the tooth with a curret.

QUESTION: How does titanium of an implant help in osseointegration? Forms titanium oxide
layer
QUESTION: If doing implant for that area where supposed radiopacity? What are your
considerations; interocclusal height or width; would you excise lesion? NO
QUESTION: Check to see when your placing implants, whether or not radiopaque lesions are of
concerns?
QUESTION: Which of the following is bad for placing implants exceptradiopaque

QUESTION: When placing implant mandibular posterior how do you ensure you dont hit IAN? Look
at panorex and measure with mm caliper, look at PA and put some screen over to measure,
move the nerve down and be very careful when placing implant
QUESTION: implant supported bridges and one doesnt fit.
Section and index
QUESTION: At the time of delivery of an implant supported prosthesis, only 2 of the 3 implants
seat. What do you do next? I put separate the prosthesis and re-index it
QUESTION: Implant retained fixed prosthesis, doctor took radiograph and it showed 2 out of 3 implants
seat positively with good margin. What should doctor do after?
section and index* This is what I put but not sure
tighten screw
take another x-ray

QUESTION: Which one is true about implant placement? High Torque (other choices were high speed,
etc) **handpieces for implants are low speed and high torque
QUESTION: what speed and torque for implant is used: High Torque, slow speed
QUESTION: use high torque for implant: Implant handpiece = High torque, low speed
QUESTION: Use slow speed handpiece and high torque drill to place implants
QUESTION: Which one is true about implant placement? High Torque low speed

QUESTION: Which of these is not a consideration for replacing patients lower molars with implants?
Bone quality in the area? (I dont think thats the answer, cuz it is but he says in mandibular it should
always be good)
QUESTION: Pano given, sinus very low, what should be done prior to implant? Bone graft should be
done

QUESTION: Max sinus lift implants

QUESTION: In implant preparation, which of the following can be used? A) hydroxyapatite irrigation b)
High Speed Hand Piece c) Low torque Drill d)Air Coolant. IT SAYS COOLING SALINE SPRAY IN
FIRST AID

QUESTION: water is used when implant placement- cooling

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QUESTION: Why you use irrigation in implant surgery? To prevent bone from over heating. (other
options were to keep it clean, etc)
QUESTION: Why you use irrigation in implant surgery? To prevent bone from over heating.
QUESTION: Why do you irrigate while preparing osteotomy for implant: keep bone cool (but clear
blood to visualize and remove debris make sense)

QUESTION: When doing an osteotomy for implant placement why do you use saline: to help cool
down the bone

QUESTION: When placing an implant, you keep the temperature of the bone below 56 degrees C how?
Alkaline irrigation,
QUESTION: Percent of implants that are successful after 10 years: think its 80%.

QUESTION: What is the success rate of implants in 10 years? I put 90% (80)
QUESTION: % of implant success after 10 years : 95 %
QUESTION: When not to immediately load an implant
Denture in contact
Bone grafting with GTR: ans

QUESTION: Implant supported RPD, where to put occlusal rests None

QUESTION: where do you put occlusal rests for implant abutment rpd? NONE!!!!
QUESTION: I believe u can place implant in patient who has INR less than 2.5 *uhhh normal INR =
1and higher INRO leads to a higher chance of bleeding.. People on anticoags INR range is around 2-3
or on higher doses 2.5-3.5
QUESTION: 13y/o present for implants : wait until 18-20 y/o

QUESTION: how to clean implants (os decks) ** Plastic scaler

QUESTION: implants, which instrument is ok to use for perio? plastic perio probe

QUESTION: Do we probe like normal for an implant?

A. No because you will disturb the epithelial attachment
B. I put yes. It didnt say anything about a plastic probe being available but it seems like we still
would have to probe.
QUESTION: How to clean implant- prophy cup, plastic, not stainless steel!

QUESTION: indications for implants vs fixed partials

QUESTION: type of epithelial and connective tissue attachment to implants

QUESTION: Implant interface- how does CT and epithelium react? Like normal or not (for each)
QUESTION: Pt has an implant. Do the connective tissue and epithelium attach the same as they do to
natural tooth, meaning biological width?
A. Both attach the same
B. Neither attach the same
C. epi attaches the same but not connective tissue**
D. CT attaches the same but not Epi.
QUESTION: Epithelial attachment for implat?

162
 Hemidesmosome* (epithelial attachment to tooth structure and implant are the
same)
fibronectin
QUESTION: You are considering the placement of an upper and lower important retained complete
denture. How many implants will you place in the anterior region?
a. maxillary one and mandibular one
b. maxillary two and mandibular two
c. maxillary four and mandibular two
d. maxillary four and mandibular six

QUESTION: After implant placement, an edentulous patient should:

a. avoid wearing anything for 2 weeks
b. immediately have healing abutments placed over the implants
c. should wear an immediate denture to protect the implant site

QUESTION: esthetics of a max central anterior implant replacement determined

adjacent tissue
perio of other maxillary central
wax up to full contour (did not understand this question)
QUESTION: When palciing implant in max central, most important thing to consider in esthetics:
emergence proifile, perio health of adjacent tissues

Extraction:
QUESTION: 13 year old had 2 bombed out molars, asked what treatment is best: extractions,
extractions followed by implants, extractions followed by RPD, Root Canal and Crown
QUESTION: extracting upper posterior molarsorder of extraction and reason? First, second then
third molar for visualization, 3rd,2nd,1st to prevent fracture of tuberosity, then the other
options didnt make sense.

QUESTION: order of tooth extraction1st molar, 2nd then 3rd for visualization or 3rd then 2nd then 1st to
spare tuberosity MAXILLARY Teeth first and MOST POSTERIOR TEETH FIRST

QUESTION: Same old question of where is the max 3rd molar most likely to be displaced?
A. infratemporal fossa**
B. maxillary sinus
QUESTION: When extracting 3rd molar, which space is it most likely to become dislodged in
QUESTION: What is the most common impacted tooth? Maxillary K-9. (after 3rdmolars? Xtina)

QUESTION: The most frequently IMPACTED teeth are MANDIBULAR 3rd MOLARS (followed by
maxillary 3rd molars and maxillary canines).

QUESTION: Most common impacted tooth? (3rd molars not an option) max canines
QUESTION: Most impacted tooth? Maxillary canines
QUESTION: Which tooth is least likely to be missing I said canine (other options are 2nd pm, lat
inc, and 3rd molar)

QUESTION: What is least missing tooth congenitally? canines, premolars, 3rd molars, lateral incisors

163
QUESTION: What is least missing tooth congenitally? (others were 3rd molars, lateral incisors,
canines) nope. canine is the best option. of all 32 teeth the 2nd mand premolar is the 3rd MOST
congenitally missing. #1: 3rd molars, #2 max lateral.
QUESTION: Least congenital missing tooth (most 3rd molars, mand 2nd premolars, lateral incisors,
max 2nd premolars)

extractions in ortho tx : max 1st premolars.

extractions in ortho tx : max 1st premolars.
extraction of molars with divergent roots :hemisection
QUESTION: Easy to extract impaction in max tooth:
-Distoangular, Maxillary: maxillary 3rd molars, mesioangular impactions are the most
difficult to remove, while vertical and distoangular impactions
are the easiest to remove.
-Mesioangular: Mandibular
QUESTION: In which direction do you luxate distoangular max third molar? distal palatal,
distobuccal ,palatal, mesial

QUESTION: #32 - Complete bony impaction, horizontalmain concern? Excessive bleeding,

damage to nerve, etc. (he put damage to nerve)

QUESTION: #16 - half in bone, half in gum most common kind of impaction & easiest to take out
(both FALSE)

QUESTION: FMX, question about right side of patient, #1 and #32 were both impacted, how would you
describe these impacted teeth? - #1 disto-angular impaction, #32 horizontal impaction (other choices had
other angulations, but with FMX, it should be straightforward to guess them right)
QUESTION: most important in eruption: sequence
QUESTION: RL under the furcation in primary teeth?
1. Diagnosis is pulpal necrosis
2. Treatment: EXTRACTION
QUESTION: ectopic eruption of mand 1st molar in relation to primary mand 2nd molar cause some
resorption management: extraction of 2nd molar, separation, disking of 2nd molar
QUESTION: When you extract 3rd molar, inform possible damage. Extraction of lower 3/2 molar dmg to
lingual nerve
QUESTION: Greatest risk to injure IA nerve on extraction of third:
Lack of visualization of end of roots
Root tips sit on top of mandibular canal
Horizontal impaction
Forgot last option

QUESTION: Most likely to cause nerve damage during extraction? Nerve canal overlaps apices?,
nerve canal narrows
QUESTION: Mylohyoid surgery can accidentally damage to what nerve? Lingual nerve

QUESTION: where is most likely to damage a nerve in vertical release of flap : lingual, whartons
duct and the sublingual gland ( avoid vertical incisions in lingual and palatal )
QUESTION: where is most likely to damage a nerve in vertical realese of flap : lingual, whartons
duct and the sublingual gland ( avoid vertical insicions in lingual and palatal )
QUESTION: Doing flap surgery on mandible, what structure do you watch for? I put
mental nerve (If 3rd molar TE= Lingual)

164
QUESTION: Doing flap surgery on mandible, what structure do you watch for? mental nerve mentalis
attachment
QUESTION: Where does man branch of trigeminal nerve come thru? Ovale

QUESTION: Old guy with impacted 3rd molar, whats indication for extraction?
QUESTION: Indication to extract thirdchoices were making space for ortho, prevent crowding, pt has
pain during eruption, theres an infection
QUESTION: 65 yo has hypertension and congestive heart disease, referred to you to TE impacted molar,
absolute indication to do the TE is when radiograph shows bone pathology prevent distal pocket of
2nd molar, prevent jaw fracture, prevent distal caries for 2nd molar
QUESTION: Old patient, medically compromised with impacted molar extraction, only reason to extract
them is? if you notice pathology

QUESTION: Patient has pain, trismus, inflammation for 3rd molar TE

QUESTION: Know pericorinitis treatment, question had nothing to do with surgery though.
Wout surgeryclean and antibiotics
With surgery. Before surgery..control infection. IND, irrigate drain, antibiotics, then remove the 3rd
molar

QUESTION: MOST common complication of extracdtion? Hemorge, infection, root fracture?

QUESTION: Radiograph of mandibular molar extraction sight. Patient came back having pain and
puss in that area: did not have dry socket as a choice??? Infection? osteomyletits

QUESTION: A picture of Occlusal radiograph with a lot of bone resorption - patient has pain and
something was draining after few weeks of EXT Osteomylitis (other were radicular cyst, lateral cyst,
etc) Osteomyelitis common following tooth extraction -- bone infx

QUESTION: Xray of Older woman tooth extract 3 years ago, still hurts and exudate, shows (cotton-wool
radiograph, "prob wrong") what is it? Residual cyst, osteomyelitis, 2 other lesions that are radiolucent
QUESTION: X ray: pt had tooth extraction 3 years ago at site, now site has draining tract and painful, x-
ray shows a radiolucent area over ridge no teeth around areaforgot the answer choices
QUESTION: You got patient with Osteomylitis, after EXT, what do you do? you clean the walls of the
socket to remove infection)

QUESTION: patient w/ Osteomyelitis, after EXT, what do you do? I said put dressing in hole (wrong,
you curretage the walls of the socket to remove infection) (Mosby saysfor acute treat with appropriate
antibiotic and drainage of lesionfor chronic treat with antibiotics and sequestrectomyXtina)

QUESTION: Premolar with huge MO amalgam and recurrent caries and if needing saving needed CL,
endo and crown-didnt have all there options so i put extraction because C:R ratio would have been
bad

QUESTION: Extraction #30 which way would you section? B-L

QUESTION: Extraction of #30 which way do you section: Buccal- lingual

QUESTION: After fx a mesial root tip on a molar extraction whats the first thing you do?- get hemostasis
and visualive the root. Others, take an xray, pick at it with root pick, surgical retrieval

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QUESTION: resorption of bone takes place in which direction after extraction----
downward/inward,downward outward,forward inward (something)

QUESTION: Aderall 5 yr old kid on prescription. needs an extraction. do u higher the dose? lower
the dose? no change?

QUESTION: Which direct do you luxate tooth #1 and #16? Distally and Bucally
QUESTION: which direction do you luxate the tooth --**Children: Palatally, bc molars are positioned
more palatally and palatal root strongest. Adults: bucally!!!
QUESTION: Patient is about to undergo radiotherapy, what do you? EXT all questionable teeth before
radiation. (another answer said, EXT all teeth before radiation)
QUESTION: Patient is taking IV bisphosphanates and need TE RCT then coronotomy and seal,
hyperbaric oxygen followed by TE, antibiotics and TE, Bisphoshanates.
QUESTION: A patient has begun radiation therapy in the mandible and needs teeth extracted. What do
you do?
DO endo, and amputate the crown without any trauma to soft tissue or bone

QUESTION: A patient received radiation therapy and requires extraction,what should the treatment
be? Extraction, extraction with alveoloplasty and sutures, extraction with alveoloplasty of basal
bone and suture, pre-extraction and post-extraction hyperbaric oxygen
QUESTION: Best tx for bisphosphonate iv patient? 1. Best tx is do rct and section crown off (as oppose to
ext) (answer), 2. Atraumatic ext, 3. Ext under hyperbaric oxygen. The answer was confirm by oral
surgeon.
QUESTION: It pt has been on IV bisphosphonates for two eyars? Do root canals and keep roots,
no exts
QUESTION: Look up side effects of bisphosphonates. Contraindicated except? RCT is ok!!!!!!!
QUESTION: All of the following are contraindicated for bisphosphonates, except? Do RCT (other
choices were invasive procedures)
QUESTION: Pt on IV bisphosphonates for 6 months needs tooth extracted what do you do? Atraumatic
extraction, hyperbaric oxygen and then extract, try to do RCT or some other form of restoration

QUESTION: Patient taking bisphosphonates for 6 months, but now needs extractions. Nontraumatic
extraction? Or hyperbaric oxygen and then extraction
QUESTION: Patient is on 6 months of bosphophanate therapy what do u do? Hypo dives and extract,
atraumatic extraction, or endo with crownectomy and place sealants
QUESTION: Pt on IV bisphosphonates for 6 months needs tooth extracted what do you do?
Atraumatic extraction, hyperbaric oxygen and then extract, try to do RCT or some other form of
restoration
QUESTION: if Pt takin biphosphonates for 3 years and tooth non restorable what is the Tx : a) endo
of remaning root b) extraction . Etc Extract + Abx
QUESTION: pt has history of osteonecrosis and need to do extraction: can do under hyperbaric o2

QUESTION: pat has history of osteonecrosis and need to do extraction: give hyperbaric o2

QUESTION: Iv bisphosphonates and extractions are needed-what do you do? (hyperbaric O2 dives)
QUESTION: Patient has bronj and bone is exposed, what is treatment? hyperbaric oxygen, sc/rp,
chlorhexidine rinse (antibacterial rinse, and oral antibiotics)
QUESTION: Osteoradionecrosis: Swelling, degeneration and necrosis of the blood vessels with
resulting thickening of the vessel wall. Use hyperbaric for angiogenesis

166
QUESTION: when do you do serial extraction?
space deficency in the max ant region
b. space deficiency in the max posterior region
c. space deficiency in man ant region
d. space deficiency in man post region
QUESTION: When do you do serial extraction?
a. for space deficiency in mandibular anterior region
b. for space deficieny in mandibular posterior region
c. for space deficiency in maxillary anterior region
d. for space deficiency in maxillary posterior region
#9 Periosteal elevator
#23 Mandibular cowhorn
#74 ash forceps (mand PM)
#151A (premolars)
#65 Bayonet-shaped forceps Max incisors or roots
Cryer elevator: best for single retained root of extracted mandibular molar
Upper cowhorn forcep is #88 right and left for upper molars
Lower cowhorn forcep is #23 for lower molars
#151A is modification of #151, and its for mandibular premolars only
#17 is for mandibular molar but not fused root
#222 is for mandibular molar but fused root
QUESTION: What forcep used for mandibular premolars? 151 or 151A
QUESTION: What number forceps to use when extracting mand premolars: 151A or 74 (ash)
QUESTION: What forceps are best for a mandibular premolar extraction? #17, #23, #151, #150
(whichever is ash forceps)
ASH IS #74!!
Max Molar 150
Mand Molar 151
QUESTION: The universal forceps #151 is commonly used for extracting _______________.
a. maxillary anteriors b. maxillary molars c. mandibular molars d. maxillary premolars
QUESTION: The #65 forceps is typically used for removing ____________.
a. canines b. premolars c. molars d. root tips
QUESTION: extraction a mandibular molar and all of a sudden mesial root break:what instrument
u use? crayer forcep
QUESTION: Which direct do you luxate tooth #1 and #16? Distally and Bucally
QUESTION: Elevator can be used to advantage when
a. Interdental bone is used as fulcrum
b. Multiple adjacent teeth are to be extracted
QUESTION: Elevator in oral surgery acts as what type of machine? Lever, wedge
QUESTION: what does Medicaid cover? Extraction, 1 denture , children until 18
QUESTION: What cover Medicaid? Extractions, one time denture, children until 18.
QUESTION: Biggest risk with extracting remaining max molar? Fracturing tuberosity
QUESTION: When ext erupt max molar what is most like cause of complication (I said It was high
chance of max sinusitis, other is that you can have broken tuberosity/sinus floor, or high chance
of dry socket because low circulation)

QUESTION: Lone molar beware cuz tubersotiy fracture

167
QUESTION: removing a single lone max molar: worry about tuberosity fracture and sinus
involvement due to pneumatization
QUESTION: Lone molar ex most likely to fracture maxillary tuberocity (beware of lone molarXtina)
QUESTION: Can tell its ankylosed if submerged (there was an answer different sound but I think thats
wrong) **Decks state that an akylosed tooth emits an atypical sharp sound on percussion soooo I think
different sound is right. Also Beware of the LONE molar they are usually ankylosed.
QUESTION: Oro-antral communication 2mm- do nothing
QUESTION: You see sinus is open by 2mm with ext what do you do: dont do anything and
observe

QUESTION: Oro-antral communication of 4mm, what do you do? Observe, buccal flap, palatal flap?
FIGURE 8 SUTURE

QUESTION: Oroantral communication best Tx? DEPENDS: <2 DO NOTHING, 2-6mm AB, nasal
deconjest+ figure 8 suture, more than 6 = flap surgery
QUESTION: If you have 3mm unifected root into sinus, what you do? You do one an attempt, and if
unsuccessful, leave it alone, no surgery.

QUESTION: What is the Caudwell lock technique? Removal of root tip from max sinus, incision over
canine fossa.

Suture:
QUESTION: What kind of suture do you use if you are only removing on one side of toothsling,
continuous, interrupted
QUESTION: What suture when only buccal tissue is displaced? I put interrupted
QUESTION: What suture do you place when you only displace facial of mandibular teeth? I put
interrupted; mattress, continuous, etc were other options.
QUESTION: best way to suture an incision? interrupted suture

QUESTION: What does an interrupted suture accomplish?

a. brings the flap closer
b. covers all exposed bone
c. immobilize the flap
QUESTION: what suture allows bacteria to invade gut, silk, nylon
QUESTION: What suture contains wicks(?) that allows bacteria to enter extraction site?
Gut
Silk
Nylon

QUESTION: suture -movable to non movable

QUESTION: Incision on the corner of lip, where do you put suture: movable to fixed (Most important is
the vermilion border)
QUESTION: If 2cm laceration on lip how do u stich- continous, in middle and work both ways, reconnect
orbicularis oris first, reconnect vermillion border first, continous

Incisions/Flaps:

QUESTION: Types of Periodontal Flaps? Just 3... Modified Widman flap, Undisplaced Flap, Apical
Flap

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Modified widman flap: Instrumentation for root therapy, not pocket depth reduction but removes
pocket lining pocket shrinkage bc healing. Internal bevel incision.

Undisplaced flap: PD reduction. Excisional procedure of gingiva = gingivectomy. internal bevel

gingivectomy. But also reverse bevel. Final placement of flap determined by first incision

Apical positioned flap: pocket elimination (by apical position) and/or increases width of attached
gingiva. Best position is 2mm apical to alveolar crest. Internal bevel incision.

Periodontal flap preferred for mandibular anteriors. Lateral repositioning is done for gingival
recession.

QUESTION: Least desirable place to place graft: mandibular 1st premolar space

QUESTION: Careful with mandibular flap: a. mental nerve, chin, vestibule

QUESTION: Location apical position flap contraindicated: max palatal

QUESTION: Extrusion of canine what flap technique is used except 1)Envelope flap 2) Semilunar
flap 3) Apical repositioning flap

QUESTION: where is most likely to damage a nerve in vertical release of flap : lingual, whartons
duct and the sublingual gland ( avoid vertical incisions in lingual and palatal )
QUESTION: Vertical or oblique flap, where do you make incision? At line angles
QUESTION: modified widman flap can be characterize by all BUT internal bevel incision, replaced flap,
QUESTION: know actual procedure of modified widmam flap, (Internal or external bevel, is it apically
repositioning? Etc) It is internal bevel and replaced/nonrepositioned flap.
QUESTION: I had many modified widman flap qs, where do you make incision to? (T/F: to the base
of pocket. I put false, not sure tho)

Another side note: Flap reflection with the MWF approach is only 2 to 3 mm beyond the alveolar crest
and not beyond the mucogingival junction. al, Rose et. Periodontics: Medicine, Surgery and Implants.
Mosby, 072004.

QUESTION: Indications for modified widman flap :

QUESTION: modified widman flap can be characterize by all BUT interal bevel incision, replaced flap
Reflected beyond mucogingival line (which would be false)

QUESTION: With a modified Widman flap you mostly reduce bone if

a. adapt the flap margin
b. osseous restructuring
c. removal of infected osseous tissue
d removal of malignancy tissue

QUESTION: What type of incision for palatal tuberosity reduction- T, Y **not sure but all I found was
that an elliptical incision is made so that from cross section the cut is obliqueand diverges towards
the bone.
QUESTION: Which of the following statements about the flap for the removal of a palatal torus is correct?
A. The most optimal flap uses a midline incision which courses from the papilla between teeth #8 and 9
posteriorly to the junction of the hard and soft palates.

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B. The most optimal flap is a reflection of the entire hard palate mucoperiosteum back to a line between
the 2 first molar teeth.
C. The most optimal flap uses a midpalatal incision that courses from the palatal aspect of tooth #3 across
to the palatal aspect of tooth #14
D. The most optimal flap is shaped like a "double-Y", with a midline incision and anterior and
posterior side arms extending bilaterally from the ends of the midline incision.

QUESTION: Y shaped palatal incision. Maxillary tori removal

QUESTION: where don't you do an apical flap? - maxillary palatal area
QUESTION: An apically displaced flap is generally impossible in which of the following areas?
a. mandibular facial
b. mandibular lingual
c. maxillary facial
d. maxillary palatal

QUESTION: Where can you not do a apical positioning flap:Max palatal area
QUESTION: Where can you not do apical flap: lingual of maxillary molars

QUESTION: Distal wedge contraindication? On 3rd molars without attach gingiva

QUESTION: CI when using distal wedge technique: Not enough keratinized tissue.
QUESTION: Distal Wedge limited to:
Formation of the ramus
Long buccal nerve
Mental nerve
QUESTION: how to fix gingival recession in anterior region: pedicle graft (laterally repositioned
flap) (never lost blood supply)
QUESTION: bleeding points used for incisional area location
QUESTION: What is purpose of bleeding incisions in gingivectomy? No idea what that is: choices
were like: location of dehiscence, location of alveolar defects, guide for incision

QUESTION: Function of bleeding points in gingivectomy: to guide incisions,

QUESTION: Bleeding spots established in gingevectomy to? I think outline incision line.
QUESTION: Gingivectomy indications/contraindications

QUESTION: Gingivectomy is for? supra bony pocket

QUESTION: gingivectomy done for hyperplastic gingiva

QUESTION: Indications for gingivectomy gingival hyperplasia,

QUESTION: Few questions on when to do and not to do gingivectomy? infrabony pkts, gingival
hyperplasia, little attached gingiva, high smile line

You do gingivectomy to: eliminate supra bony pockets, eliminate gingival enlagements or eliminate
suprabony periodontal abcess
You DONOT do gingivectomy if osseous recontouring is needed, if the bottom of the pocket is
apical to the mucogingival junction, if there is inadequate attached gingivaa, or if aesthetic is
concerned.

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QUESTION: Which is contraindicated in 2nd molar region to reduce deep pocket with limited
attached gingiva? Gingivectomy

QUESTION: If little attached gingiva is present and have deep pockets, what will you NOT do to get
rid of them

o Gingivectomy
o Cannot recontour bone
o Cannot graft

QUESTION: Gingivectomy is contraindicated in: when the sulcus is apical to gingival groove, sulcus is
apical to convexity of tooth, sulcus is apical to the crest of alveolar bone.

QUESTION: CI of gingivectomy-not enough keratinized tissue

QUESTION: Patient has very little keratinized gingiva which of the following flaps should u not do:
gingivectomy

QUESTION: mandibular molar minimum keratinized gingiva with pocket depth? Which of the
following way is not acceptable is a way to minimize pocket depth? Gingictomy

QUESTION: Patient has crown #18 w/ minimal attached gingival. Which do you NOT do to
expose the finish line? dont do gingivectomy

QUESTION: gingivectomy is contraindicated with? minimum attached gingiva

QUESTION: Contradiction to do gingevectomy is when ? when there is infra bony pocket when there
is a defect!!!

QUESTION: When do you not do gingivectomy apical to the alveolar crest

QUESTION: Gingivectomy is contraindicated when bottom of the pocket is apical to alveolar crest
(infrabony)

QUESTION: Which of these is a contraindication to a gingivectomy? I put if the pocket extends

beyond the mucogingival junction (also infrabony pockets present)

QUESTION: Intrabony bone defect?

Same as infrabony, Vertical bone loss.
QUESTION: What should be considered for gingivectomy? level of attached gingiva*, degree of
attachment loss
QUESTION: The base of the incision in the gingivectomy technique is located
A. in the alveolar mucosa.
B. at the mucogingival junction.
C. above the mucogingival junction.
D. coronal to the periodontal pocket.
E. at the level of the cementoenamel junction

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QUESTION: Gingivectomy type of Bevel used? , external bevel incision ??

QUESTION: gingivectomy - is it incisional (reverse) or excisional

QUESTION: When doing gingivectomy, which is NOT right about internal and external bevel?
QUESTION: Epithelium over connective tissue, how fast per day in mm? 0.5-1mm (RELATED TO
GINGIVECTOMY)
QUESTION: How many mm a day does epithelium grow over connective tissue? 0.5-1, 1-2. 2-3 NO
CLUE
QUESTION: How does external bevel gingivectomy heal? Primary intention, secondary, tertiary, granular
tissue formation
QUESTION: How does external bevel gingivectomy heal? Primary intention, secondary, tertiary,
granular tissue formation
QUESTION: How does a gingivectomy heal? Secondary intention
Primary healing=flap
Secondary healing is for sc/rp and regular gingivectomy
Tertiarty healing: Tissue grafts

QUESTION: After a gingivectomy how does the site heal?

a. from the epithelium of the pockets
b. epithelium of the adjacent alveolar mucosa
c. endothelium of the blood vessels
d. primary intention
QUESTION: How does site heal after gingivectomy? Long junctional epithelium
QUESTION: After lay a flap: how does wound healing work: long JE, new ct attachment?

QUESTION: Following flap surgery, new junctional epithelium can form on either cementum or
dentin, junctional epithelium is reestablished as early as one week.. First is False, Second is true.

QUESTION: Following flap surgery, new junctional epithelium can form on either cementum or dentin.
Junctional epithelium is reestablished as early as one week. BOTH ARE TRUE

QUESTION: after you perform a flap where you see regeneration : ephitelial attachement via
long junctional epithelium and connective tissue adhesion.

QUESTION: Healing of flaps surgeries: something about its Long junctional epithelium

QUESTION: What do u want from perio flap: want regeneration of PDL cementum and bone

QUESTION: The soft tissue-tooth interface that forms most frequently after flap surgery in an area
previously denuded by inflammatory disease is a

E. collagen adhesion.

F. reattachment by scar.

G. long junctional epithelium.

H. connective tissue attachment.

QUESTION: type of healing in SRP and free gingival graft : LJE and CT

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QUESTION: Gingivoplasty is? a reshaping of the gingiva to create physiologic gingival contours,
with the sole purpose of recontouring the gingiva in the absence of pockets.

QUESTION: Gingivectomy means? excision of the gingiva. By removing the pocket wall,
gingivectomy provides visibility and accessibility for complete calculus removal and thorough
smoothing of the roots, creating a favorable environment for gingival healing and restoration of a
physiologic gingival contour.

QUESTION: external bevel incision where is it made? Attached gingiva?

QUESTION: External bevel, ginviectomy: apical to epithelial tissue, vascular bundle(where to you
make incisision) Junctional epithelium (apical to base of pocket (epithelial attachment)

QUESTION: External bevel is put to tooth apical to what? Crest of bone, JE, CT. Junctional
epithelium I think
Starts at top of junctional epithelium

QUESTION: What direction reverse bevel (internal bevel): axial toward bone
QUESTION: How to make inverse bevel incision?
A: Start at crest of gingival margin or step back .5-2 mm and make incision to crestal bone
Gingivectomy base of sulcus

QUESTION: What causes wound healing after Perio flap? I put Long JE but the others were new CT
attachment, CT adhesion and something else
QUESTION: Periodontal regeneration involves - Sharpeys Fibers, Cementum and Alveolar Bone
QUESTION: What is involved in periodontal regeneration? I think pdl, cementum, alveolar bone maybe
one other thing in there. Pdl & bone cells
QUESTION: Perio Surgery. Know what is regenerating? bone, cementum, and more was listed.
Regeneration is defined as the type of healing which completely replicates the original architecture and
function of a part. It involves the formation of a new cementum, periodontal ligament, and alveolar bone.
Repair, on the other hand, is merely a replacement of loss apparatus with scar tissue which does not
completely restore the architecture or the function of the part replaced. The end product of repair is the
establisment of long junctional epithelium attachment at the tooth-tissue interface.

QUESTION: Regeneration vs repair in perio attachment

REGENERATION: new PDL/cementum made (bone and gingiva too)
REPAIR: long jxnal epi formed
QUESTION: Know about internal bevel incision and where to cut: I think apical to the base of the
periodontal pockets, but coronal to the MGJ.

QUESTION: After flap surgery, where does repair occur? PDL moves occlusally, apically, laterally

QUESTION: Doing flap surgery on mandible, what structure do you watch for? I put mental
nerve (If 3rd molar TE= Lingual)

QUESTION: A tooth had epithelium above cej what flap would you use? Undisplaced/Replaced flap

QUESTION: Long jxn epith was coronal to CEJ and margin was around cej,
apical position flap, widman flap, replace flap
QUESTION: Extrusion of canine what flap technique is used except:

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1)Envelope flap 2) Semilunar flap 3) Apically repositioning flap

QUESTION: What type of flap do you use in crown lengthening? Apical Repositioning Flap

QUESTION: Crown lengthening procedure what would u do

Choices were
Modified woodman flap
Apical repositioned flap w/ osteotomy and ostectomy (I chose this)
QUESTION: Rct, getting post and core and crwon lenghteningin, why do crown lengthing:
feral effect, adequate crown length
QUESTION: Crown that came falling off? Inadequate ferrule!!!! or inadequate post

QUESTION: Sliding flap? What do you do it for?

QUESTION: The most common incision given by oral surgeons is?
a. envelope flap
b. y incision
c. Z incision
d. Semilunar incision

QUESTION: To expose a mandibular lingual torus of a patient who has a full complement of teeth, the
incision should be
a. Semilunar
b. Paragingival
c. In the gingival sulcus and embrasure area
d. Directly over the most prominent part of the torus
e. Inferior to the lesion, reflecting the tissue superior

QUESTION: If removal of torus must be performed to a patient with full-mouth dentition, where
shouldthe incision be made?
a. Right on the top of the torus
b. At the base of the torus
c. Midline of the torus
d. From the gingival sulcus of the adjacent teeth

QUESTION: What has the biggest effect on the flap?

a. initial incision
b. extensiveness of reflection
c. post op oral hygiene
d. final position of flap

QUESTION: Correction of an inadequate zone of attached gingiva on several adjacent teeth is best
accomplished with a/an?
a. apically repositioned flap.
b. laterally positioned sliding flap.
c. double-papilla pedicle graft.
d. coronally positioned flap.
e. free gingival graft.

QUESTION: Whats contraindicated for pt post mand radio tx.?- flap apico on pt.

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QUESTION: During maintenance therapy pt has recurrent 6mm pocket on M of #4 and D of #20 what is
1st tx option: flap surgery, scaling root planning with local microbial administration
QUESTION: Pockets are still the same and oral health care is excellent? Flap and clean out

QUESTION: To prevent exposure of a dehiscence or fenestration what kind of flap? partial or split
thickness flap

QUESTION: Split thickness flap involves what tissues? Mucosa (only) or submucosa or they can say
epithelium and ct (submucosa)

surface mucosa (consisting of epithelium, basement mem brane, and connective tissue lamina
propria

QUESTION: In a partial thickness flap, what do you cut through? I put epithelium, connective
tissue, but NOT periosteum
QUESTION: Perio flap- expose bone?? - Full thickness
QUESTION: Full thickness flap will result in bone atrophy (or loss) in: thin periradicular bone (do
partial-thickness flap for this), thick periradicular bone, thick interproximal bone, thin
interproximal bone
QUESTION: Know about difference between regenerative surgery and flap surgery?

regenerative surgery - for regeneration with bone graft

flap surgery - to get acess for better srp

Grafts:
QUESTION: epithilium of free ging graft----degenerate
QUESTION: Free gingival graft gets blood from base first,

QUESTION: Free gingival graft: Which area can be affected

Greater palatine nerve bundle

Nasopalatine nerve bundle
Nasopalatine artery
Greater palatine artery

QUESTION: Most likely damage when you take tissue from gingival graft: damage to greater
palatine neurovascular bundle

QUESTION: Donor site complication when free gingiva graft (taken from palate) performed:
cutting the major palatine bundle.

QUESTION: mucosal graft what nerve would u damage ? greater palatine

QUESTION: What nerve is most likely injured when transferring donor tissue to area of free gingival
graft? Greater palatine
QUESTION: mucosal graft epithelization by---connect tissue from underlying tissue (recipient site)
QUESTION: Where does the epithelial for a graft come from?

a. Donor epithelium
b. Donor connective tissue

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 c. Recipient epithelium
d. Recipient connective tissue

QUESTION: What effects the epithelial cells from gingival graft? epi cells from donor, epi cells from
recipient, connective tissue cells or donor or recipient

QUESTION: What has ultimate effect on the thickness of epithelium of free gingival graft?
a. Recipient epithelial tissue,
b. donor epithelial tissue,
c. donor CT
d. recipient CT
QUESTION: What is the disadvantage of a connective tissue graft? Two surgical sites
QUESTION: You only have 4 mm of bone above max sinus, how do you do bone graft (weird
question)fill towards sinus, fill towards alveolar ridge (I put this, didnt really get it), fill graft towards
mesial
QUESTION: If question is saying that you currently have 4mm of bone *alveolar ridge*..You can not add
to alveolar ridge, its not gonna integrate. So you FILL TOWARDS SINUS..
QUESTION: Only 4mm of bone below ridge and sinus where do you place graft? Floor of sinus (NOT
Top of ridge)
QUESTION: What graft is best for sinus lift? Autogenous and alloplastic
QUESTION: Sinus lift best to use? Answers are in pairs: Autogenous, alloplastic?

QUESTION: Your patient was referred to an oral and maxillofacial surgeon for an implant, and you were
advised that she was going to need a sinus lift procedure with placement of an autogenous bone graft.
What is the definition of that graft?

A. The graft will use an artificial, bone-like material.

B. The graft uses bone from another human being.
C. The graft uses the patient's own bone, taken from another site.
D. The graft uses bovine bone, or bone from another animal species.

QUESTION: Which is the most predictable when restoring an edentulous mandibular ridge? I put
autograft
QUESTION: Which is the best graft: autograft
QUESTION: how you call a graft from a different species : Xenograft
QUESTION: bone graft : iliac crest
QUESTION: How to replace large chunks of mandible? Freeze dried bone; autogenous

QUESTION: What is the most osteogenic? (Choices: alloplast, autograft, etc) ONLY autograft

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QUESTION: Know what an allograft is (b/w members of the same species)

QUESTION: Freezed dried cadaver bone is a type of? Allograft
QUESTION: Decalcified freeze dried bone allograft: has bone morphogenetic proteins

QUESTION: Freeze dried graft allograft

QUESTION: best allograft material: dried freezed bone
QUESTION: Freeze dried bone has the advantage of having which protein: bmp/pdgf

QUESTION: Which hormone is used to bone graft? BMP, GH...

QUESTION: Dfdg- bone morphologic protein

QUESTION: Which type of grafts causes bone growth?: Osteoinductive Osteoconductive

QUESTION: Which type of grafts causes bone growth?:
OsteoINDuctiveAllograph, autograph
QUESTION: Maxillary canine is contraindicated in a grafting procedure

QUESTION: least likely to need bone graft one wall, two wall, three wall wide, three wall narrow
QUESTION: What is not going to need a bone graft to improve 1, 2, wide 3, or narrow 3 walled defect
narrow 3
Wide and deep 3 walled GTR
Narrow 3 walled bone graft regeneration
QUESTION: Best prognosis for bone graft: narrow 3 wall defect

QUESTION: Purpose of lateral graft (Peddicle graft)...For gingival recession

QUESTION: how to fix gingival recession in anterior region : pedicle graft ( never lost blood supply )
QUESTION: Recession of a single tooth, what do you do?
Double papilla graft
Free gingival graft
Apical repositioning
QUESTION: 8 year old with anterior crossbite recession

177
a. chlorhexadine
b. lateral sliding graft
c. pedicle graft

QUESTION: Max canine is contraindicated in a grafting procedure

QUESTION: Facial recession on mandibular canine of 14 year old graft not indicated? Reposition
with ortho?
QUESTION: You take a graft from a patient to another patient, what is this called? Allograft
(alloplast was a choice, but thats synthetic)
QUESTION: Which is least likely to be successful facial soft tissue graft? Lower 1st premolars (no
canine in the choices) ?
QUESTION: Guided grafts- better for max
QUESTION: Best prognosis for a guided tissue regeneration? three walled defect,
QUESTION: GTR in Class II furcations is most effective
QUESTION: Tx for ClassII furcation involvement (called cul-de-sac)? GTR

QUESTION: Furcations distal class II and GTR: better than furcation I and III
QUESTION: Class III furcations are least successful in GTR procedures.
QUESTION: Class 3 furcation which not an option? GTR
Guided tissue regeneration (GTR) is a surgical procedure used by dentists to promote the new
growth of tissue in areas
QUESTION: The purpose of GTR is to prevent: Long J.E, migration of PDL cells Migration of CT cells.

Decks: Guided tissue regeneration is a procedure that blocks the re-population of the root surface by long
junctional epithelium and gingival connective tissue to allow cells from the periodontal ligament and bone
to re-populate the periodontal defect.

QUESTION: In guided tissue regeneration, inserted material is preventing which of the following attached
to tooth structure?
epithelial
connective tissue (hinder the migration of fibrous connective tissue while
supporting the growth of bone: Xtina, First Aid)
gingival
QUESTION: The purpose of a barrier: .Apical movement of PDl cells, coronal movement of
cells

QUESTION: 3 things u need when doing GTR: bone, sharpeys fibers, & cementum

GTR excludes gingival epithelial cells allows progenitor cells to close the wound. Gingival
epithelium and connective tissue are excluded by the membrane. Progenitor cells form
cementocytes and fibroblasts which form new cementum and PDL fibers. This gives you
regeneration of the attachment apparatus and not long junctional epithelium. LJE is not as
strong as the original attachment apparatus (which is lost by debridement).

QUESTION: In gtr, you get new CT.??? PDL & sharpeys fibers are CT.
QUESTION: which tx is best for type III furcation
a. guided tissue regenNOT THIS

178
 b. apical flap
HEMISECTION
QUESTION: In a through and through furcation lesion, which is the least appropriate treatment? I
put GTR

QUESTION: contraindication for max molar with class 2 furcation? hemisection w/ crown

hemisection = mand molar. Mandibular molars to treat Class II or III furcation invasions

For max molar - we do root amputation

QUESTION: Tx plan for furcal involvement ? GTR, Hemisection, Root amputation,

QUESTION: How to treat endo treated mand molar that has furcation: only answer that seemed
logical was hemisection and place 2 crowns to act as 2 premolars. Root amputation is for
maxillary teeth

QUESTION: Hemisection of maxillary molar which has best prognosis

Furction that is more coronal or apical
Furcation that is more coronal
QUESTION: Hemisection, one wall remaining (interproximal wall) whats it called: hemiseptum

QUESTION: Elevator in oral surgery acts as what type of machine? Lever, wedge

QUESTION: Bony area between two premolars has no mesial, facial and lingual wall, what is it
called? Hemiseptum

QUESTION: Class 3 furcation tooth already had RCT, best tx, ext not option? split and tx as two
premolars

Healing (bone & wound):

QUESTION: Indication for periodontal/surgical dressing: Healing the tissue, Protect the wound

QUESTION: For Perio; Why do you put a surgical dressing over a wound?

QUESTION: What is surgical dresses? Just protect wound, DOES NOT accelerate
QUESTION: After periodontal surgery, what type of healing is it most of the time? Repair
QUESTION: What do you want to see healing after perio surgery? PDL, bone, etc.
Restore/regen: PDL Bone Cement. Repair: Long junctional epi and CT.
QUESTION: Where does the epithelial for a graft come from after you place it and its healing?

a. Donor epithelium
b. Donor connective tissue
c. Recipient epithelium and surviving basal cells of donor epithelium are what supply
for new epithelium
d. Recipient connective tissue

QUESTION: What environment factor alters healing? Smoking

QUESTION: 2 questions on Dry socket...pt comes in 3 days after mand extraction with pain and bad
taste, what is it..also question on how to treat
QUESTION: most common complication after extraction : dry socket.

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QUESTION: What is pt more at risk of getting after ext (pt hx said she was a smoker)? dry socket
QUESTION: Whats the most common complication after EXT? dry socket
QUESTION: Most common complication in extraction: dry socket (alveolar osteitis)

The most common soft tissue injury during oral surgery is the tearing of the mucosal flap during
surgical extraction of a tooth. Hupp. The second soft tissue injury that occurs with some frequency
is inadvertent puncturing of the soft tissue. The most common problem associated with the tooth
being extracted is fracture of its roots. Hupp. Contemporary Oral and Maxillofacial Surgery, 5th
Edition. Mosby, 032008.

QUESTION: pathophysiology of dry socket

QUESTION: how do dry sockets develop? Blood clots not forming
QUESTION: Dry socket: Loss of healing blood clot

QUESTION: Dry socket: fibrinolysis of clot

QUESTION: What causes alveolar osteitis? Active dislodgement of blood clot - I chose this one?
(fibrinolysis of the clot)
QUESTION: What causes alveolar osteitis? Lack of blood clot because lack of bleeding
Active dislodgement of blood clot - I chose this one? (I think the wording was fibrinolysis of the clot)
QUESTION: Main cause of alveolar osteitis (dry socket)? blood clot diminished and fell out

QUESTION: dry socket why

blood clot not produced
blood clot broke
QUESTION: MAIN CAUSE OF ALVEOLAR OSTEITIS (DRY SOCKET)? BLOCK CLOT
DIMINISHED AND FELL OUT
QUESTION: Main symptom of alveolar osteitis pain
QUESTION: Dont forget with dry socket = NO ANTIBIOTICS NEEDED! Just medicinal dressing.
QUESTION: Alveolar osteitis place dressing; dont need antibiotics and no curettage
QUESTION: Alveolar osteitis tx? Medicated dressing
QUESTION: acute osteitis = dry socket. How to take care of it? Gentle irrigation and Medicated
dressing
QUESTION: Treat dry socket with dressing
QUESTION: Ways to tx dry socket except
a. curette walls to make socket bleed
b. no non-narcotic analgesic as needed
c. sedative dressingg
d. flush out debris w/ sterile solution
QUESTION: Dry socket (except Q)- need for oral antibiotics
QUESTION: What is the treatment for dry socket? sedative dressing
QUESTION: Treatment of alveolar osteitis: placement of a palliative medicament/dressing
QUESTION: Most common negative outcome of routine TE: alveolar osteotitis, hemorrhage, infection
QUESTION: Multiple questions about when you would not give antibiotics: all the answers were
alveolar osteitis (all the others had a systemic infection ie cellulitis), other questions about osteitis
is how would/wouldnt you treat alveolar osteitis

Fractures:

180
QUESTION: most common trauma: avulsion, intrusion, lateral luxation, fracture

QUESTION: Mand fracture sign? Occlusal discrepency

QUESTION: Key sign of Mand fracture? change in occlusion
QUESTION: Inform about mental nerve damage and fracture of mandible
QUESTION: Patient has a condylar fracture, what happens when mandible grows asymmetric growth
with damaged side lagging

QUESTION: Fracture near condyle, what happens to growth of mandible? I chose injured side lags behind.
QUESTION: Patient fractures one condyle, what is the expected growth? The fractured side will lag. The
unaffected will continue growth.
QUESTION: What child has mandibular trauma, what do they have later? Midline asymmetry

QUESTION: most common trauma on children what happens to mandible? Asymmetry of face
QUESTION: Retarded growth due to unilateral sub-condylar fracture on child I think its
ipsilateral?
QUESTION: what is primary consequsence of trauma to jaw in kids (normal def of jaw, vs retarded
growth vs hypertrophic growth on one side, etc): retards growth

QUESTION: Fracture 1 condyle the other lags behind: Malocclusion

QUESTION: if kid had a problem with fractures in mand.. later they will have TMJ disfunction
QUESTION: most common area of fracture in children---symphysis, condyle, coronoid
QUESTION: Ankylosis of condyle most likely due to? Trauma? Fracture (looked this one up)
QUESTION: Splinting closed bone fracture 6 weeks
QUESTION: Fractured mandible. Keep it in closed reduction for how long?? 6 weeks

QUESTION: Splinting closed bone fracture I said 12 weeks (not sure) ? 6

QUESTION: Closed reduction, immobilize mandible for how long?, 6 weeks,

The standard length of maxillomandibular fixation (MMF) is 4-6 weeks.
QUESTION: Paresthesis occurs most commonly in what type of mandibular fracture? Angle

QUESTION: Lower lip numbness is seen in what kind of mandibular fracture: Body or angle fracture

QUESTION: angle of mandible fracture increases chance of IAN paresthesia and numbness

QUESTION: Fracture of what cause Paresthesia of the lower lip? evident with mandible
fractures distal to the mandibular foramen (in the distribution of the inferior alveolar nerve).

QUESTION: lefort frac 1 associated with- what fracture--nasoethmoidal air cell,frontal sinus,max
sinus,mastoid air cell

QUESTION: Lefort I fracture maxillary sinus

QUESTION: Le fort 1: maxillary

QUESTION: Guerin sign is a feature of Le Fort 1/2/3? Guerins sign: ecchymosis in the region of
greater palatine vessels.

QUESTION: The LeFort I tx of? brings the lower midface forward, from the level of the upper
teeth, to just above the nostrils.

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QUESTION: Lefort I fracture: "floating palate", Disturbed occlusion, palpable crepitation in upper
buccal sulcus

QUESTION: The LeFort III brings the entire midface forward, from the upper teeth to just above
the cheekbones.

QUESTION: LeFort II: separation and mobility of the midface, Gagging on posterior teeth, Anterior
open bite, Pathongnomonic sign is? Periorbital ecchymosis/hematoma, diplopia and /or
subconjunctival hemorrhage , Infra-orbital nerve damage

Le Fort II - separation of the maxilla, attached nasal complex from the orbital and zygomatic fractures

Le Fort III - Nasoethmoidal complex, the zygomas, and the maxilla from the cranial base which results in
craniofacial separation

QUESTION: Lefort II most common injured nerve: infraorbital

QUESTION: subconjuctival hemorrhage seen in what fracture? Lefort 1 , nasal, frontal sinus,
zygomaticomaxillary complex
QUESTION: A patient experiences numbness of the left upper lip, cheek, and the left side of the nose
following a fracture of his midface. This symptom follows a fracture through the
A. nasal bone.
B. zygomatic arch.
C. maxillary sinus.
D. infraorbital rim.
QUESTION: What was the most common fracture in the face? Zygomcomplex fracture. Nasal bone
fractures = 1st, zygomatic = 2nd (but first common midfacial fracture)
QUESTION: Which radiograph would you use to view a fracture of the mandibular symphisis? (A-P?)
QUESTION: What age does mandibular symphysis fuse? I think 6 months 6-9 months
QUESTION: What age does the mandibular symphisis close: birth, 3, 6-9 months

QUESTION: Fracture of which part of the face would compromise pt respiration?

*Fracture through the body of mand (bilateral)
Fracture to condyle
Fracture to angle of mand
QUESTION: if there is a fracture in the left body of the mandible where will the other fracture most likely
be? Right Condyle
Most COMMON = condyle (29%) 2nd most (angle of mandible 24.5%)
LEAST COMMON: coronoid (1.3%) 2nd least (ramus of mandible 1.7%)
QUESTION: if hit on the right side of the jaw, what will get broken
left condyle
right condyle
both
right mandible

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 QUESTION: you hit a guy in the right body of mandible and fracture where is other site of fracture
(opposite side condyle)

QUESTION: punched on lower right and broken jaw. What else to worry about? Contralateral
conylar fracture
QUESTION: When pulling out tooth and jaw fractures what do you do? Open flap to see all of the
fracture, remove all the fractured pieces, remove all the fractured pieces that are not attached to
periosteum
QUESTION: What xrays do you take to confirm horizontal fracture? 3 xrays moving horizontally, 3
xrays moving vertically,, ...
QUESTION: Horizontal fracture easily seen with multiple vertical angulated xrays

QUESTION: What is best view to see zygomatic process?

(other is submentovertex, SMV for zygomatic arch)
QUESTION: Max sinus: waters
QUESTION: Which of the following images shows better the mid-facial fracture? Waters

QUESTION: Pano >>>> best for mandible fracture

QUESTION: Reverse townes>>>> for condyle fracture

QUESTION: Submentovertex>>>>for zygomatic fracture

QUESTION: What causes Trauma in the US? By auto-accidents! (in 3rd world is knife fights)
QUESTION: Pan showing lucency going inferior over the body of mandible close to the angle. Informed
the patient was involved in an accident. Identify the lucency a.pharyngeal
airspace b.fracture c.artifact-retake radiograph

Frenectomy:
QUESTION: thick upper buccal frenum with diastema. Yound kidwait til upper permanent
canines erupt, frenectomy, use elastics(a repeat I saw on old exam-answer was wait til max
canines erupt).

QUESTION: Kid has a diastema b/w 8 and 9 at age 10, how do you treat?: wait till permanent
canines have erupted, then do frenectomy
QUESTION: frenun centrals. What age do frenectomy
-when canines have erupted
QUESTION: If diastema is caused by a frenum, you dont do a frenectomy until the canines have
erupted

QUESTION: sequence to close diastema in a child with low labial frenum:

1)wait for the canines to erupt,
2)close the diastema with ortho and at the end
3)perform the frenum surgery
QUESTION: What do you do for an 8 year old with a fibrous frenum and a large diastema? I put wait till
all ant teeth are in and then fix diast and frenum. (wait for canines..ortho before frenectomyXtina)
QUESTION: All of the following are risk for ortho treatment except ? Frenal displacement (other
choices, were plaque management, bone loss, resorption)
QUESTION: Which of the following explains why the Z-plasty technique used in modifying a labial
frenum is considered to be superior to the diamond technique?

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 a. it is less traumatic
b. it is technically easier
c. it requires fewer sutures
d. it decreases the effects of scar contracture (I believe this is itbecause improves the appearance of
scars and porpose is to relax the frenum pull less contracture)
e. it allows for closure by secondary intention

Orthognathic surgery:
QUESTION: Most commonly used surgery for mand augmentation?- bilateral sagital osteotomy
QUESTION: BSSO = Vertical Osteotomy (when used) push mand. Forward or back for class III.
QUESTION: How would you repair a Class II malocclusion?- BSSO (bilateral sagital split osteotomy)
QUESTION: Class II patient needs sx saggital split
QUESTION: Bilateral sagital split osteotomy : The BSSO is the most commonly used osteotomy for
mandibular advancement.
QUESTION: Worst complication of BSSO: Damage to IAN BSSO = Bilateral sagittal split osteotomy
QUESTION: whats the main thing you have to be careful with BSSO: INFA
QUESTION: Biggest disadvantage of BSSO?parasthesia
QUESTION: most complication of sagital osteotomy: IAN loss of sensitivity
QUESTION: During which surgery do you have most chance of paresthesia? BSSO, vertical ramus
osteotomy, etc. (dont know)
QUESTION: Which osteotomy most likely to cause parestesia to lip and tongue: sagital split or
inverted L, vertical

QUESTION: Bsso indications:

Mandibular advancement or retraction
QUESTION: Correction of severe class II
Maxillary Impaction and autorotation of the mandible
BSSO
QUESTION: Patient wants to fix Class 3, what you going to do lefort 1 with BSSO, lefort 1, BSSO,
max palatal expansion with BSSO
QUESTION: What surgery for class III? Le fort I, BSSO, rapid expansion?
QUESTION: Class III, what kind of surgery? Options include rapid palatal expansion, le forts, BSSO
- BSSO is for CLASS II (lengthen undeveloped mandible)
- Rapid palatal expander is for crossbite or minimal class III
QUESTION: 16 y.o. girl need to do lefort + BSSO cant do RPE because shes too old

QUESTION: Main disadvantage of BSSO damage to the IA nerve

QUESTION: how long do you splint mandibular BSSO: You dont do MMF, as there is internal plate.
Use an occlusal splint to help with occlusion but not wired shut. Keep splint on 4-6 week.

QUESTION: Most common surgery for maxilla: LeFort I

QUESTION: If a patient has vertical maxillary excess, how would you fix it? I put Le Forte 1
(other choices were mandibular and didnt make sense)

QUESTION: Which of the following is the MOST common postoperative problem associated with
mandibular sagittal-split osteotomies?
a. infection
b. TMJ pain

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c. Periodontal defects
d. Devitalization of teeth
e. Neurosensory disturbances

QUESTION: A patient has a skeletal deformity with a Class III malocclusion. This deformity is the
result of a maxillary deficiency. The treatment-of -choice is
A. orthodontics.
B. surgical repositioning of the maxilla.
C. anterior maxillary osteotomy.
D. posterior maxillary osteotomy.
E.surgical repositioning of the mandible.

QUESTION: whats the main difference between distraction osteogensis and a regular osteotomy :
DO has less relapse or DO cant move the mandible posterior . Dunno
QUESTION: Distraction Osteogenesis over traditional osteosurgery: I put more stability during wide
span of movements, (not sure tho, another option was about patient compliance)
QUESTION: Distraction osseogenisis: when to use over convetnial: bigger stable movements

QUESTION: Advantage of distraction osteogenesis is that you can do bigger movements because
muscles can react over time
QUESTION: complication following distraction osteogenesis : Long term follow up
QUESTION: What is the difference btw distraction osteogenesis Max and BSSO Man?
QUESTION: distractive osteogenesis differs from osteotomy by..???

DO = benefit of simultaneously increasing bone length and the volume of surrounding soft tissues.
easier in children, shows less relapse. 2 surgical procedures, hospitalization time is less, more discomfort.
Compliance of patient and parent is a difficulty in DO

distractive osteogenesis is a surgical process used to reconstruct skeletal deformities and lengthen the
long bones of the body.

BSSO = stable for normal/decreased facial height, high relapse in patient with high mandibular plane
angle

An osteotomy is a surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment

Orthodontics:
QUESTION: Dolycocephalic long narrow face
QUESTION: Which is correct: Growth of Mandible is both intramembranous and endocondral

QUESTION: Scammon Growth curve: Neural tissue grows until what age? 5 (this was the number
on the test, but on book it is about 6-7)

QUESTION: Which tissue show most growth in first 6 years and then plateaus? lymph, neural,
genital

QUESTION: which is most fully developed at birth

e. muscle system
f. neural system **
gonadal system

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QUESTION: Which grows faster, maxilla or mandible? Maxilla grows earlier and faster bc it is
closer to brain

closer to brain, grow faster

QUESTION: What is the best revealing issue for prediction about ossification ? wrist hand
radiograph

QUESTION: Majority of the tissues in FACE are derived from? A) ectoderm, b)mesoderm,
c)ectoderm and mesoderm

Ectoderm= Afractoderm

QUESTION: Eruption sequence of peds? ABDCE

Order: Central-Central, Lateral-Lateral, 1M-1M, Canine-Canine, 2M-2M

QUESTION: Curve of spee and curve of Wilson? Sagital is curve of spee, frontal curve of Wilson

Sagital: curve of SPEE Anterior-posterior

Frontal: corve of Wilson Left and right

QUESTION: Overjet in permanent teeth should be ? 2-3mm

QUESTION: What do you do to camouflage class 2? you extract upper premolar

QUESTION: Based on Frank behavioral rating scale, what is the rate that indicates positive rapport
with dentist? rating 4

QUESTION: Tell-show-do? most appropriate

QUESTION: Figure 5.23 (pg 175) which one more stable and which one is problematic

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Occlusion:
QUESTION: facial profile of class 2 malocclusion---convex, Class III is concave

QUESTION: MB max cusp in mandibular first molar: class 1

QUESTION: MB cusp in buccal groove: class I (in pic)
QUESTION: Normal class1 occlusion has mb cusp in buccal groove of mnd molar

QUESTION: Little girls, ortho casts were taken, what class is she? Class 1 (her 1st permanent molars
were out, mesiobuccal cusp of upper 1st molars on buccal-lingual groove on lower 1st molars.
QUESTION: What occlusion when MB cusp of max 1st molar is distal to buccal groove of mand 1st molar
CLASS III
QUESTION: What occlusion when MB cusp of max 1st molar is distal to buccal groove of mand 1st
molar Class III
QUESTION: Diatalized occlusion w/ uprght cental anterior and deep bite: class II div II

QUESTION: Pt is in Mixed dentition and they are end on, what type of occlusion will this result in
permanent dentition? Class I**, Class II, Class III
QUESTION: What's the difference btw primary class II and permanent class II? Shallow grooves,
broad contacts

QUESTION: What ethnicity with most class 3?

QUESTION: Class 3 is due to what? Max retrusin, mand protrusion
QUESTION: Most common type of occlusion in primary teeth: flush terminal plane
QUESTION: Most common malocclusion- ***CLASS 1***--
QUESTION: highest percentage of malocclusion in the US: class I, class II, class III?

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QUESTION: What Percentage of population have class I normal occlusion? 30 %

QUESTION: What Class Occlusion gets most ant tooth fx?- Class II Div. 1
QUESTION: most common patients to have anterior tooth fractures : class II div I
QUESTION: Which class is susceptible to trauma? as(class II division 1)
QUESTION: Most likely to cause fracture in children: class II division 1

QUESTION: in a cl III patient, which of the following is not helpful in establishing whether pt has
retrognathic maxilla or prognathic mandible? photographs, study models, ceph analysis,
clinical exam

QUESTION: A child who has a distal step in the primary dentition generally develops which of the

following molar relationships in the permanent dentition?

A. Class I

B. Class II

C. Class III

QUESTION: What happens to the permanent molar occlusion in the presence of a flush (straight)
terminal plane and mandibular primate spaces?

A. Erupts end-to-end; early mesial shift into Class I occlusion

B. Erupts end-to-end; late mesial shift into Class I occlusion

C. Erupts with Class II tendency

D. Erupts with Class III tendency

QUESTION: primate spaces **MAX: between LATERAL and CANINE; MAND: between CANINE and
1st MOLAR

QUESTION: What makes space for mand teeth when they erupt- primate space
QUESTION: Where are the primate spaces?
Maxb/w lateral and canine Man: b/w Canine and
Primary 1st molar
QUESTION: Primate space tested for maxillary and mandible

a. Max LI-C, Man C-M1

QUESTION: What is the purpose of primary teeth said it was space holder of permanent teeth
QUESTION: Premature loss of which tooth will cause mesial drift of permanent tooth primary 2nd
molar

Leeway space = Sum of primary tooth widths is greater than sum of permenant successors.
When primary teeth fall out, there is extra space to help relieve crowding. If nothing done,
then first molars drift forward.

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QUESTION: The space difference between primary canine, first & second molar and the
succedaneous teeth: Leeway space
QUESTION: How to create space for mand incisors: increase intercanine distance with primate
space?

QUESTION: What will account for the anterior space for the perm. Mandibular incisors?

a. Either the flaring of the max incisors

b. Primate space!! Because this is the space between the canines and the central
incisors

QUESTION: What will account for the anterior space for the perm. Mandibular incisors?

c. Either the flaring of the max incisors

d. Primate space (but decks says this extra space is most frequently due to growth of
the alveolar dental arches)??

QUESTION: allow more space for eruption of secondary lower incisors? Allow them to protrude
buccally, use primate space, use early mesial shift (which actually is primate space), or Leeway
space (aka late mesial shiftI picked this one).
QUESTION: Leeway space enough room for mandibular teeth to erupt?
Leeway space helps with spacing for the molars
QUESTION: Premature loss of which would lead to arch length deficiency? Primary canine

QUESTION: Class II is formed with distal step

QUESTION: Class I can be formed with edge to edge or mesial step

QUESTION: Primary teeth edge to edge molars...class 1 in perm. teeth w/ mesial shift of perm
molar
QUESTION: When ortho is end to end? Shifts to mesial, turns to class 1. If it remains, class 2.
QUESTION: Distal step and mesial step CLASS II/III
QUESTION: Which of the following will most likely lead to a class 2 malocclusion on a patient (I said
distal step, vs. terminal flush plane, vs mesial step, etc)

QUESTION: What head gear would you use to correct a class III? Reverse pull headgear
QUESTION: What ortho appliance to pull maxilla forward to correct class III? front facing head gear***
its reverse pull headgear****
QUESTION: What head gear would you use to correct a class III Reverse pull headgear/ protraction
headgear or facemask
QUESTION: Which headgear is used for pt who needs to bring maxilla towards protrusive? reverse
pull/facemask (protection headgear)

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QUESTION: Which of the following dimensions are compared in the transitional dentition analysis?

A. Arch width to arch length

B. Leeway space to freeway space

C. Leeway space to size of tooth

D. Space available to space required

E.The arch perimeter of the primary and transitional dentition

QUESTION: A dentist will perform a Moyers' mixed dentition analysis. Which of the following teeth
will be measured to predict the size of the unerupted canines and premolars?

A. Maxillary incisors

B. Mandibular incisors

C. Primary molars and canines

D. Maxillary incisors for the maxillary arch; mandibular incisors for the mandibular arch

QUESTION: Moyers predict MD canine & premolars using a table, with the sum of all 4 primary
lower incisors
QUESTION: Tanaka predict canine & premolars MD width using 1/2 of sum of all 4 lower incisors

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QUESTION: The late mesial shift of a permanent first molar is primarily the result of closure of

which of the following spaces?

A. Canine

B. Leeway

C. Primate

D. Extraction

QUESTION: Ugly duckling stage: maxillary central incisors

Ugly duckling stage = when 2 maxillary centrals erupt, move labially and have
diastema perm canines erupt & move mesially to close diastema

QUESTION: ugly duckling tage: diastema between 8 and 9 no canines

QUESTION: The duckling phase refers to? mixed dentition
QUESTION: ugly duckling stage maxillary centrals

The maxillary central incisors can also be quite distally inclined when they first erupt

QUESTION: Ugly duckling stage definition: Wait for canines before doing ortho on centrals
QUESTION: If patient has their nose always stuffed and they breathe through their mouth what happens? I
said anterior open bite, some of the other choices posterior open bite, constriction on archesOrtho decks:
Mouth breathing causes long face syndrome, which is SKELETAL OPEN BITE.
QUESTION: Patient with airway obstructions often have an open anterior bite
QUESTION: Chronic nasal congestion in kid..open bite (mouth breather)

most posterior cross-bites appear to be unilateral, they are usually the result of a bilaterally
underdeveloped maxilla with a shifting of the mandible to one side during closure.
QUESTION: a patient with maxillary arch constriction of 3mm and a posterior crossbite what will you
see? Normal midline, midline shift towards the unaffected side, midline shift toward the affected side
QUESTION: Maxillary constricted 3mm pt is closing down
Which way does the pt attempt to correct.
To the crossbite side

QUESTION: patient has 3mm palatal constrict what is most likely complication: bilateral crossbite

QUESTION: 3mm max constriction--> Bilateral crossbite

QUESTION: cross bite unilateral and appliance of choice=bilateral expansor

QUESTION: why is the reason for that cross bite unilateral =mandibular shift
QUESTION: Unilateral posterior crossbites in kids are usually due to a MANDIBULAR SHIFT; treat
w/ MAXILLARY EXPANSION
QUESTION: Pt w/unilateral posterior crossbite

True unilateral maxillary constriction & functional crossbite

Mandibular shift
Bilateral constriction

191
QUESTION: How would you fix?

Rapid Palatal expansion

Nance

If true unilateral maxillary contriction use unequal W arch or asymettrical maxillary expansion
QUESTION: What is indicated for the tx of unilateral cross bite? Elastics from Lingual of max mol to
Buccal of mand mol,
QUESTION: Hawley appliance for skeletal or non-skeletal deformities? Correction of skeletal crossbites

QUESTION: How do you fix a posterior cross bite? Quad helix, RAPID palatal expansion.
QUESTION: When to fix cross bite-ASAP
QUESTION: cross bite in child : correct immediately
QUESTION: most likely crossbite- maxillary lateral
QUESTION: Anterior permanent tooth most commonly erupts in cross-bite? Max laterals

QUESTION: what kind of appliance for posterior cross bite and when? Quad Helix (with digit sucking) or
Palatal Expander

QUESTION: Most common cause of anterio crossbite: thumbsucking, lack of interdental arch
space,
QUESTION: ant crossbite is done by all except: functional shift vs lower third of face is
hypertrophied

QUESTION: ant crossbite is done by all except: functional shift

QUESTION: Leveling of oclusal plane when? if open bite

QUESTION: Leveling of mandibular teeth OPEN BITE (treats the overbite)

QUESTION: Leveling of mandibular teeth open bite

QUESTION: In an 8 year old child, there is a recession in a mandibular incisor with posterior crossbite,
which of the following treatment options is the least acceptable?
a. oral hygiene instruction
b. graft
c. correction of cross bite
d. observation
QUESTION: Case: Black,Girl around 7 years old. Presents with unilateral cross bite; she had a cleft
palate that was fixed. Palate in picture looks like a triagle and laterals are towards the palate.
A)What is the pigmentation?-racial pigmentation
B)what is the most likely cause of the crossbite?
-early loss of laterals
-due to cleft palate

QUESTION: 10 year old loses primary first molar, space maintenance? None, since premolar about
to erupt
QUESTION: A 10yo loses a primary M1, what should you do: nothing, band and loop
a. Nothing the PM1 should be erupting at this age

192
QUESTION: Patient is has crown on first primary molar and second primary molar is going to be
extracted due to caries. What should be done in order to maintain space?
b. -nothing- because premolar is about to erupt
c. -band loop
d. -distal shoe
QUESTION: For child w avulsed 4 yr old mand incisor- what would you do? Leave out?
QUESTION: Can tx all with appliances except- crepetis
QUESTION: Loss of a primary right molar in a 3 year old child requires placement of a
a. band and loop
b. distal shoe
c. removable acrylic appliance
d. none of the above

QUESTION: Lower 1st molar come out too early, what do you do? Band and Loop

QUESTION: child lost primary 2nd molar : distal shoe

QUESTION: Most common space maintainer- band and loop.
QUESTION: Patient has a Stainless Steel Crown on tooth #L, its going to before EXT, but what else will
be needed? Do band-and-loop for space maintenance.
QUESTION: What does band and loop not have- occlusal stop for tooth above?
QUESTION: characteristics of a band and loop space maintainer include all of the following except?
Potential for decalcification if the cement is lost
provide space maintenance
provides food trap if not properly soldered
provides occlusal stop to prevent opposing dentition from supraerupting
QUESTION: What does band and loop NOT do? Does NOT create a vertical stop
QUESTION: Cementation of band and loop - common outcome
All of the above except
Creates space
If leakage from cement recurrent decay
Prevents tooth from super erupting with opposing
QUESTION: What primary reason for restoring primary teeth
a. To maintain arch space
QUESTION: What tooth is the most important to keep for space maintenance: Primary 2nd molar

QUESTION: What tooth is the most important to keep for space maintenance: Primary 2nd molar

QUESTION: What is the most common tooth that involves space management in primary teeth? 2nd
molar, 1st molars

QUESTION: if mandibular primary canine is premature lost what happened : incipient

malocclusion..insufficient arch size in anterior region..when laterals erupt, canines root are
resorbed and when canine is shed, midline will shift in the direction of the lost tooth.

QUESTION: if mandibular primary canine is premature lost what happened : incipient

malocclusion..insufficient arch size in anterior region..when laterals erupt, canines root are
resorbed and when canine is shed, midline will shift in the direction of the lost tooth

193
QUESTION: Child lost both his primary mandibular canines prematurely why? Lack of arch space

QUESTION: Primary tooth lost prematurely, what does that do to perm tooth? Delayed eruption of
perm

**IF the kidss primary molar is lost, the eruption is delayed. If the pt loses primary after age
7, eruption is accelerated

QUESTION: How do you determine arch perimeter?

Answer: Distal of primary second molar OR Mesial of permanent 1st molar

QUESTION: How to do measure the projected arch length space for permanent teeth? Incisors, Canine to
canine,

***Arch length: Distal p2 to distal p2 or Mesial M1 to Mesial of M1

Arch width: inter-canine space

QUESTION: What tooth erupting FIRST would cause some sort of arch discrepancy? Man 2nd perm
molar erupting before the 1/2nd man perm premolar

QUESTION: Lower 1st primary molar tooth has lower permanent premolar underneath, what will
determine when the premolar will come in? How fast roots of 1st primary molar resorbs (other choices
were age, how much of root of premolar is formed, etc) (not sureusually would think how much of a
root of the permanent tooth is formedabout 2/3 formationXtina)

QUESTION: Lower 1st primary molar tooth has lower permanent premolar underneath, what will
determine when the premolar will come in? How fast roots of 1st primary molar resorbs, how
much of root of premolar is formed, etc

QUESTION: Post emergence eruption is mostly result of: root develompent, bone growth,

QUESTION: The primary tooth is missing/extracted. The perm tooth root is 1/3 formed. What is
driving the eruption of the perm tooth?

a. Either something about vascular supply to the tooth or the fact that the root is 1/3
formed.

QUESTION: When does tooth start to emerge in the oral cavity?

b. When root starts to form

c. Only after crown has been formed WHEN DONE CALCIFYING
d. After complete root formation
e. After root has been formed (through gingival) (2/3 erupts through bone!)

QUESTION: root formed-when crown erupts

QUESTION: Root formation (teeth start to erupt) which is associated when teeth are about to erupt?
b. 2/3 root formation when teeth erupt (3/4)
c. crown formation answer choices
QUESTION: teeth erupt when root form is of root I think (not when root just started I dont think)
a. erupt through bone when 2/3, erupt through gingiva when 3/4

QUESTION: how long for the root take to complete after eruption? 2.5- to 3.5 was the choice

194
QUESTION: Apical root closes---21/2-31/2 years after eruption,
QUESTION: Takes 2.5-3.5years for root formation to happen after eruption

QUESTION: What race has most deep bites? White? Black? Hispanics? Asians?
Severe deep bite is nearly twice as prevalent in whites as blacks or Hispanics (p < .001), while open bite
>2 mm is five times more prevalent in blacks than in whites or Hispanics

QUESTION: The best age to correct a thumb sucking habit is

a. The primary dentition. Kids are easier to desensitize (5-6 years)

Mild displacement of the primary incisor teeth is often noted in a 3- or 4-year-old thumbsucker,
but if sucking stops at this stage, normal lip and cheek pressures soon restore the teeth to their
usual positions. If the habit persists after the permanent incisors begin to erupt, orthodontic
treatment may be necessary to overcome the resulting tooth displacements. Proffit, William R..
Contemporary Orthodontics, 4th Edition. C.V. Mosby.
QUESTION: The space for the eruption of permanent mandibular second and third molars is created
by the
A. apposition of the alveolar process.
B. apposition at the anterior border of the ramus.
C. resorption at the anterior border of the ramus.
D. resorption at the posterior border of the ramus.
QUESTION: Additional space for successive eruption of permanent maxillary molars is provided by
A. interstitial bone growth.
B. appositional growth at the maxillary tuberosity.
C. continuous expansion of the dental arch due to sutural growth.
D. an increase in palatal vault height due to alveolar growth.

QUESTION: Edgewise bracket- for intrusion motion

QUESTION: Ortho case where patients upper central were little flared, and needed to up-righted better,
what appliance do you use? Rectangular Arch Wire (Other choices were headgear, facemask, etc)
QUESTION: Ortho case where patients upper central were little flared, and needed to up-righted better,
what appliance do you use? Rectangular Arch Wire (Other choices were headgear, facemask, etc)
QUESTION: ORTHo- finger springs??? (on removable to move a tooth via tipping)For what-tipping
of anterior mand and maxillary teeth
QUESTION: Labial bow- tipping teeth? (Passive labial bow - treats overjet) (Active labial bow for
incisor retraction)
QUESTION: Patient needs ortho with partially erupted #17 and #32. Radiographically, both teeth had
crowns with distal area that are susceptible pericornitis. What do you do? EXT both teeth surgically.
QUESTION: Patient with 16mm overjet surgical and ortho combo
QUESTION: How to Tx 16mm of overjet: Ortho w/ surgery, premolar extraction route
QUESTION: ortho for kid with very poor oral hygene what treatment to do? Removable
QUESTION: Best time to fix lingaual inclined incisors- when canines erupt.
QUESTION: When to do ortho movement if max central is erupting lingually? During eruption, after
fully erupted?
QUESTION: Primary anterior tooth intruded 5mm-How would you treat it?

195
 Extract
Splint
Ortho-bring it down
QUESTION: Ortho uprighting of molar-what is the problem-what should you do?
Occlusal interferences-need to adjust occlusion
QUESTION: How do you prevent rotation in ortho?
Anti-rotational clasp
QUESTION: Ortho Treatment sequence question. (prophy, restorative, etc). be able to rank
QUESTION: Ortho sequencing questions
level and align (light round wire)
corrects vertical discrepancies (working arch wires) square/rectangular wires
Finishing arch wires (finishing touches) light round wirest
QUESTION: Perio after the ortho b/c bone will change
QUESTION: Y would u move a tooth before doing perio? I wrote bec more likely to get bone loss after
perio surgery, other choices bec it easier to move now, stable teeth are harder to access...
QUESTION: Why do you restore primary teeth?
1. SPACE MAINTENANCE
QUESTION: Light ortho pressure-direct resorption
QUESTION: Ortho - Light movement causes what type of bone resorption (indirect (I picked) vs
direct): direct

QUESTION: A light force applied to the periodontal ligament during orthodontic treatment is considered?
a. intermittent
b. direct
c. continuous
d. indirect

QUESTION: Which one of the following doesnt happen in PDL during ortho movement? Chemical
change (Dont think it chemical change because there is a release of chemical messengers in the
pression-tension theorybut not sure what the right answer would beXtina)
QUESTION: When moving with ortho what does not happen? Chemical change in pdl, pressure on one
side and release on the other...
QUESTION: Orthodontic movement- widened pdl due to decalcification? Due to tension
Compression (where tooth is moving toward) and tension side (where tooth is moving away from). First,
widened PDL occurs on tension side in presence of light prolonged orthodontic forces, indicating tooth
movement is soon to begin.
Compression side: osteoclasts are removing lamina dura
Tension side: Osteoblasts are laying down new bone

QUESTION: Which of the following soft tissue elements (fibers) are commonly associated with relapse
following orthodontic rotation of teeth: Supracrestal

QUESTION: What causes rotation of a tooth after ortho therapy: transeptal fibers
QUESTION: What fibers cause reversement of a rotated tooth after ortho treatment? Transseptal

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QUESTION: During orthodontic relapse, which fibers are primarily responsible for the relapse? Oblique
(I cant remember if circular was on there, but I think I got this wrong!) (should be something to do with
supracrestal fibersXtina) **The supracrestal fibers, in particular Transseptal fibers, have been
implicated as a major cause of postretention relapse of ortho treatment.

QUESTION: 2 ortho cases:

a. 14 yr old kid w/ pano; all PMs congenitally missing except #28 (missing 7 of them);
retained primary molar crowns over congenital missing PMs
i. 4 primary teeth are ankylosed & 4 perm teeth are missing (BOTH FALSE)
ii. Using a ceph, you gotta tell if facial profile is convex, straight, or concave
all 3 were CONVEX
iii. This case was dental class III but w/ convex profile
iv. Given ANB = 6 & ask wut class it is its Class II
v. Other ortho pt: explorer catches in 1 pit of #19? Wut wud you do? PRR
b. Upper & lower canines are ectopically erupted out of the arch; besides that
everything else was normal in this case (15 yr old?)
i. How do u treat?
1. Extract 1st PMs & bring canines into arch OR
2. Take out 4 canines & keep PMs
a. (agu put take out canines)
3. if youre gonna extract 1st PMs wut would you NOT use: 150, 151, 3_,
2_ _ (answer must be 1 of the last 2; look em up)
ii. This case was Class I
iii. Ortho pt: has never had a restoration? Wut wud you do? sealants, do
nothing, etc. (agu put: do nothing)

QUESTION: Ectopic eruption of maxillary first molar? Most likely needs ortho? 50% self resolves?
(66% self correct)
QUESTION: Permanent 1st molar ectopically erupting with slight resorption of primary
separating device (Can use elastic seperators)

QUESTION: # of vertical planes in the face? 5

Esthetic analysis, face divided:

QUESTION: Vertically by 5 (4 planes)

QUESTION: Horizontally - 3 (2 planes)

ANB = SNA - SNB.

A positive ANB angle indicates that the maxilla is positioned anteriorly relatively to the
mandible (Class I or Class II malocclusion cases).
A negative ANB angle indicates that the maxilla is positioned posteriorly relative to the
mandible (Class III malocclusion cases).

The normal range is 1-5.

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>5 indicates a Class II skeletal jaw relationship, protrusive maxilla or retrognathic mandible.
<1 indicates a Class III skeletal jaw relationship, deficient maxilla or prognathic mandible.

Normal ANB is 2 degrees

QUESTION: SNA measures maxilla

QUESTION: Bigger SNA means? Maxilla is more protrusive

SNA-SNB=ANB maxilla to mandible relationship

QUESTION: ANB 6, what skeletal classification? Class 2

QUESTION: angle ANB: 6. type of occlusion: class 2

QUESTION: Girl class II, ANB WAS 6(class 2)

QUESTION: ANB -4: class III

QUESTION: ANB is -6 degrees? Whats the facial profile? Class III

QUESTION: With ANB value being -6 what is the patient class/malocclusion: Class III

QUESTION: Ceph- ANB of -6: Class III

QUESTION: SNA 76 AND SNB 78=-2 = class 3

QUESTION: Know snb vs SNA (SNA = 82, SNB = 80)

QUESTION: ANB -2 --> negative ANB so class 3

QUESTION: Frankforts horizontal plane = porion (upper external auditory meatus) to orbitale
(inferior border of orbit)
QUESTION: Know the landmarks for the Fox plane.

Fox plane is parallel to campers line (alar of nose mid tragus line) for anterior-posterior
plane

Fox plane is parallel to interpuppillary line for anterior plane

QUESTION: Know the landmarks for the Fox plane.
Lower alla upper tragus and interpuplar distance.

QUESTION: cleft lip and palate? 6-9 weeks in utero

QUESTION: with cleft lip and palate what occlusion is mostly seen? class III malocclusion

QUESTION: Patients with cleft palate, what class will they present? Class 3.

QUESTION: cleft lip more common in boys cleft palate more common in girls
QUESTION: Pt had cleft lip and palate. Later in life during ortho analysis what do you see?
*Deficient maxilla
Normal mand

QUESTION: Most developmental deformity in Maxilla? Cleft Palate

QUESTION: Most developmental deformity in Maxilla? Cleft Palate

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QUESTION: Most prevalence: cleft lip and palate
QUESTION: What is more commonly seen?

o Amelogenesis imperfect
o Ectodermal dysplasia
o Dentinogenesis imperfect
o Cleft lip and palate (I chose this option)

QUESTION: What is cleft palate class 3: soft and hard palate plus alveolar process

QUESTION: What mostly gives cleft palate? Genetic or environmental

QUESTION: Cleft palate and lip is: autosomoal dominant ,
QUESTION: Cleft lip/palate is caused by: autosomal dominat, multifactorial, autosomal recessive?

QUESTION: Cleft palate

o Environmental
o Genetic
o MULTI-FACTORIAL!!

QUESTION: What are the reasons for closing a cleft lip except?- Support the premax on a unilat cleft, felp
speech, and the not is to support the ala of the nose.

QUESTION: Speech impediments from cleft palate are due to? tongue being unable to close
nasopharynx

QUESTION: Speech problems associated with cleft lip and palate are usually the result of: the inability of
soft palate to close air flow into the nasal area.

QUESTION: Why do people with cleft palate have a hard time talking?
because they cannot close the air space between the nose and the soft palate

QUESTION: A cleft lip occurs following the failure of permanent union between which of the
following?
A. The palatine processes
B. The maxillary processes
C. The palatine process with the frontonasal process
D. The maxillary process with the palatine process
E. The maxillary process with the frontonasal process

QUESTION: Age when repair cleft palate for normal canine eruption: When canine tooth is
formed (8-9years old)

QUESTION: When correcting cleft problem how do you end/finish?

Closing plate
Suturing lip
Alveolar augmentation (phase 2)
QUESTION: When correcting cleft problem how do you end/finish?
Suturing lip

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QUESTION: percentage of cleft lip and cleft palate in Caucasians? 1/750, 1/1100, 1/1500from
OS lecture caucasin=1/1000, blacks=1/2000, Asians=1/500

QUESTION: Cleft palate and lip is seen in how many americans? 1/300. 1/700. 1/1100, 1/1500
QUESTION: Cleft palate prevalence in caucasion? 1/1000 (cleft lip in caucasion 1/800 (Asians
have it the most common)
QUESTION: Caucasions cleft lip and palate: 1:700

QUESTION: incident of cleft palate / Cleft lip in US - 1 in 700

QUESTION: Cleft lip/palate: 1:700

But be careful. It can ask for just cleft lip in White: 1:1000 or cleft palate 1:2000

Cleft PALATE with out cleft lip 1in2,000. (CDC2012)

Cleft LIP with and without cleft palate 1 in 1000. (CDC 2012)

QUESTION: Patient was class I according to molar relationship but skeletal she was class III because
of ANB and cleft palate
QUESTION: Angle class I but skeletal is CL 3 bc it tells you ANB and cleft palate

QUESTION: What surgery will a pt with cleft palate most likely needmove maxilla up or move
mandible back(mandibular set back)
QUESTION: At 3 months they get the cleft palate and cleft lip surgery. Usually this causes future Class III
issues. So at later age they will need to move back the mandible to correct the class III. This is
called MANDIBULAR SETBACK

QUESTION: Chronic nasal stuffiness assoc with what occlusion? Class III????

QUESTION: What happens to cause class one from edge to edge- both mesial shift, only mand shift, only
max shift**?? I think only mandiblethat is the only way it makes sense.
QUESTION: If lose primary max second molar early what happens? Class 2 or class 3 occlusion?

QUESTION: Crowding - will displace centralssomething about how are u gonna fix the anterior mand
crowding, answer was youll have to do stripping
QUESTION: WHAT IS A MODERATE Crowding ? less than 4mm is moderate

>4mm severe crowding

QUESTION: Ortho take out pre-molar for crowding, not sure which it was.
QUESTION: If a child has 3mm crowding on the lower and permanent canines havent erupted,
what do you do? I put nothing
QUESTION: 9 year old boy, 5 mandibular incisors, primary canines still present, already
crowding, permanent canines still have a long way to come. What would you do
to treat this anamoly: remove one of middle three, remove end, remove primary
canines.

QUESTION: anterior crowding : mixed dentition analysis.

QUESTION: What happens with intercanine distance after mixed dentition?
a. increased

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b. decreased
c. stable, no change

QUESTION: What does the moyers probability chart predict when a transitional dentition analysis is
performed?
a. The widths of mandibular anterior teeth
b. The space available for permanent canine and premolars
c. The width of permanent canines and premolars
d. The space needed for alignment of permanent mandibular central and lateral incisors

Pharmacology:

QUESTION: alpha 1 - leads to vasoconstriction

QUESTION: What does Alpha-1 do? A.Vasoconstriction of peripheral vessels
QUESTION: When you stimulate alpha 1 receptors what happens?

a. Vasoconstriction b. Hypertension

QUESTION: what does alpha 1 receptors do in the heart ?Vasoconstriction, increase blood pressure,
increase peripheral resistance, MYDRIASIS and urinary retention

QUESTION: Patients BP spike after EPI, what receptor? A1

QUESTION: Adrenalin stimulates alpha 1, 2 and beta 1, 2 receptors
QUESTION: Heart has beta 1 receptors
QUESTION: Vasoconstriction of the veins Alpha-1 or Alpha-2 receptors?
QUESTION: slow infusion of epinephrine will cause which of the following and know which receptor is
responsible also. Alpha 1,2, beta 1,2, a rapid increase in heart rate and pressure, decrease in heart rate,
decrease in blood pressure, etc

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 Alpha 1 (Vasoconstriction during anaphylaxis), Beta 1 (Increases cardiac output), Beta 2
(bronchodilation)
QUESTION: hemostatic agents in retraction cord target
a1 (alpha1 vasoconstriction)
b1
b2
gaba
muscarinic receptor
QUESTION: retraction cord what can cause : with epi increase HR, BP, do not use in
hyperthyroid or cardiac disease.
QUESTION: Why do have to dry the sulcus before putting retraction cord? A. so hemo is
diluted.

QUESTION: After using a gingival retraction cord, tissue reacts by recession. Where do you see this
the most? Lingual, buccal, interproximal.
QUESTION: Amphetamines lead to NE release in brain (increase neurotransmitter activity of NE &
Dopa)
QUESTION: ADHD; diagnosis boys=girls, boys > girls, girls < boys?
QUESTION: Know Methylphenidate =Ritalin, Amphetamine = Adderal.
Methylphenidate exerts many of its effects through dopamine uptake blockade of central
adrenergic neurons, in contrast to the amphetamines and cocaine that increase catecholamine
NE SERETONIN DOPAMINE release as a primary mechanism.
QUESTION: Patient is very anxious what do you do? Tell him to stop taking amphetamine on the day
appointment (Amphetamine can induce anxiety, and are contraindicated for patients who are very
nervous)
QUESTION: Side effect of Amphetamines Insomnia (difficulty of falling asleep)
QUESTION: Amphetamines- what are symptoms of it- increased heart rate and excitability
QUESTION: Kid is taking adderall (amphetamine), what should you do before the appointment? I
think you tell them not to take it that morning so that there is no adverse reaction with the
epinephrine in anesthesia (or you could just give an injection w/out epinephrine, but that wasnt an
answer choice)
QUESTION: Insomnia and loss of appatite?
Adderall : psychostimulant medication composed of amphetamine and dextroamphetamine, which is
thought to work by increasing the amount of dopamine and norepinephrine in the brain
QUESTION: Amphetamine - Indirect-acting symphathomimetics
QUESTION: Indirect sympathomimetic drug? Diphenyl amphetamine

QUESTION: ADHD : most common in boys

QUESTION: ADHD is most common in boys
QUESTION: Which one is true about ADHD? Its more common in girls than boys (wrong, boys more
than girls. Other choices were they are both same, etc) **10X MORE IN BOYS
QUESTION: Pediatric pt taking amphetamine. What can be observed in pts health history? ADHD*

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QUESTION: Which of the following is incorrect? The kid has ADHD, know the medication for ADHD.
Methylphenidate was one of the medications they asked , but don't remember the question
completely

QUESTION: Smooth muscle relaxation is caused by which of the following drugs?

a. prazosin (I think this onealpha 1 blockerallows relaxation of vascular smooth muscle..to lower
BP..)
b. atropine (anticholinergic)
c. theophylline (treat asthma, COPDit relaxes bronchial smooth muscleso I guess it does do smooth
muscle)
d. amphetamine (psychostimulantincrease wakefulness)
QUESTION: Which of the following combinations of agents would be necessary to block the
cardiovascular effects produced by the injection of a sympathomimetic drug?

Atropine and prazosin

Atropine and propranolol

Prazosin and propranolol

Phenoxybenzamine and curare

Amphetamine and propranolol

QUESTION: Each of the following drugs produces vasoconstriction of vessels if injected into the gingiva
EXCEPT one. Which one is this EXCEPTION?

Epinephrine (EpiPen)

Terazosin (Hytrin)

Levonordefrin (Neo-Nedfrin)

Phenylephrine (Neo-Synephrine) Norepinephrine (Levophed)

QUESTION: Epinephrine + Propanolol: Propranolol is a nonselective beta blocker. So epi acts

at only alpha receptors, which in the periphery are mainly alpha-1. So you get marked
vasoconstriction, which leads to reflex bradycardia. Increased BP --> increased firing and aortic
and carotid sinuses --> increased vagal activity on the heart --> decreased HR.

QUESTION: Epi and propranolol- increase BP dec HR

QUESTION: epi plus propanol: increases BP, decreases HR

QUESTION: Epi and propranolol-increase BP, decrease HR-patient taking propranolol in history;
QUESTION: If you inject a pt that is taking propranolol directly into their vein what will happen. Increase
BP and HR?
QUESTION: propanolol+ epi. bad reaction due to: Drug interaction, anxiety, allergy,...
QUESTION: Patient taking propranolol with epinephrine. What receptor caused hypertensive crisis?
-alpha 1

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 -alpha 2
-beta 1
-beta 2
If a patient on a nonselective beta-blocker receives a systemic dose of epinephrine, however, the beta-
blocker prevents the vasodilation, leaving unopposed alpha vasoconstriction. (alpha-1)

QUESTION: What is the effect seen when propranolol and epinephrine are injected simultaneously - in
cases of mild reactions it causes hypotension; in severe reaction it is malignant hypertension

QUESTION: Change propanolol for ? Metoprolol ... little change on HR, but no marked increase in
BP. METOPROLOL = selective B blocker and is ok to use with EPI!!

QUESTION: Proponolol mechanism..beta-adenergic blockers

QUESTION: Patient got LA injection and started to feel nervous, tachycardia etc: choices were CNS
effect of epi, direct cardiac effect of LA.

QUESTION: After injection of LA, pt experiences tachycardia, nausea, and nervousness: alpha blockade
of the CNS (reaction of epi), cardiac response to lido, cardio vascular peripheral response to epi
QUESTION: Main prophylactic treatment for angina? propanolol
QUESTION: Nitroglycerin, prop3onolol, and something else are all used for- cardiac arythmias, angina
QUESTION: Which is not used in tx of angina? Nitroglycerin, Ca blocker, propranolol, thiazide
(thiazides are usually diuretics)

QUESTION: All these drugs alter ionic movement except- Propanolol, others were CCB, HCTZ, and
Digoxin
QUESTION: A patient recieving propanolol has an acute asthmatic attack while undergoing dental
treatment. The most useful agent for management to the condition is?
a. Morphine
b. Epinephrine
c. Phentolamine
d. Aminophylline
e. Norepinephrine

QUESTION: The drug-of-choice for the treatment of adrenergically-induced arrhythmias is

quinidine.

lidocaine.

phenytoin.

propranolol.

QUESTION: direct alpha symphatomimetic: clonidine (alpha2), gueanethidine (indirect acts on

neurons to inhibit NE release), methyldopa (alpha2).

204
QUESTION: Epinephrine Reversal with ? Alpha adrenoceptor blockers, like phenoxybenzamine,
inhibit the vasoconstrictor effect but not the vasodilator effect of epinephrine = low BP
instead of high BP

QUESTION: Epinephrine reversal: what drugs can do this? after giving a patient epinephrine, following
hypertension, which of these drugs would cause a drop in BP? Phenoxybenzamine

Anticholinergic properties
dry mouth and throat, increased heart rate, pupil dilation (mydriasis), urinary retention,
constipation, and, at high doses, hallucinations or delirium. Other side effects include motor
impairment (ataxia), flushed skin, blurred vision at nearpoint owing to lack of accommodation
(cycloplegia), abnormal sensitivity to bright light (photophobia), sedation, difficulty concentrating,
short-term memory loss, visual disturbances, irregular breathing, dizziness, irritability, itchy skin,
confusion, increased body temperature (in general, in the hands and/or feet), temporary erectile
dysfunction, and excitability, and although it can be used to treat nausea, higher doses may cause
vomiting- anticholinenergic

Salivary secretion increases with use of Pilocarpine, Neostigmine (cholinergic agonists)

Salivary secretion DECREASES with use of atropine and scopolamine (anti-cholinergics)

Scopolamine-commonly used for motion sickness Anticholinergic drug The drug is used in eye drops to
induce mydriasis (pupillary dilation)

Remember>ANTIHISTAMINE IS ALSO USED FOR MOTION SICKNESS!

QUESTION: What is used for motion sickness? Diphenadryin (Benadryl)----I think this is
scopolamine

Neostigmine (Increases Salivation)

Neostigmine, etc. cause salivation. **CHOLINERGIC effects: increase salivation, increase urination,
bronchoconstriction, bradycardia, miosis (pupil constrict), vasodilation

Know which drugs mimic parasympathetics (cholinergics), be able to pick from a list which does
not belong (Acetylcholine, Atropine, d-tubocurarine, neostigmine, Nicotine, Physostigmine,
Pilocarpine)
Effects of cholinergic drugs slow heart, constrict pupils, stimulate GI smooth musc, stim sweat, saliva,
Belladonna derivatives anticholinergic
Neostigmine: Acetylcholinesterase inhibitor, doesnt penetrate BBB, tx of M. gravis
Physostigmine: used for atropine, scopolamine overdose, tx of glaucoma, acetylcholinesterase
inhibitor
Atropine: Muscarinic antagonist (anticholinergic), antidote for organophosphates and insecticides
Pilocarpine: Muscarinic agonist, for glaucoma and xerostomia
Scopolamine: anticholinergic agent,

QUESTION: Neostigmine and pilocarpine increase? Salivation. are parasympathomimetic that

acts as a reversible acetylcholinesterase inhibitor.

QUESTION: Glycopyrrolate effect? reduce salivary (is a muscarinic anticholinergic), as well as the
acidity of gastric secretion.

205
QUESTION: Atropine: is sympotatic decrease salivation

QUESTION: what meds to decrease saliva? Should be atropine, scopolamine, etc. Pilocarpine,
methacholine, neostigmine, etc. cause salivation. **Muscarinic effects: increase salivation, increase
urination, bronchoconstriction, bradycardia, miosis (pupil constrict), vasodilation

QUESTION: Atropine-anti cholinergic-what does it not cause/cause? Dont give if patient has
xerostomia

QUESTION: If patient has xerostomia what wont you give---Atropine- anticholinergic

QUESTION: What drug does not cause miosis of the eyes?- atropine

QUESTION: Insufficient cholinesterase leads to hypotension? (bradycardia)

Other answers: tachycardia, restlessness,

QUESTION: bradycardia: atrophine

***I think the question must have been something like pt have bradychardia what should we give him?
And answer is atrophine. Because atrophine will increase heartrate causing tachychardia.
QUESTION: Drug to decrease saliva because you want to take an impression- ATROPINE
(DECREASES) , Prilocarpine (INCREASES), Neostigmine (INCREASES)

QUESTION: Atropine poisoning tx: physostigmine

QUESTION: Patient salivates a lot, what is tx before surgery? Atropine **antimuscarinic

QUESTION: Xerostomic pt, give pilocarpaine! Or cevimeline.
QUESTION: Cimeviline just like pilocarpine to increase salivation in xerostomia
QUESTION: What drug do you give to a pt with xerostomia? Pilocarpine
QUESTION: Pilocarpine used for? Is a parasympathomimetic alkaloid, for tx of glaucoma and
xerostomia.

QUESTION: What is the side effect of pilocarpine (Tx of dry mouth)in toxic dose?

Bradycardia and hypotension

Apnea

Cardiac shock

Note: nontoxic side effects>>> excess sweating and salivation, bronchospasm

QUESTION: Propantheline bromide (pro-Banthine) is? anti-cholinergic (anti-muscarinic), relieve

cramps or spasms of the stomach, intestines, and bladder.

QUESTION: Which of the following groups of drugs is contraindicated for patients who have glaucoma?
Adrenergic, Cholinergic, Anticholinergic Adrenergic blocking

QUESTION: Which of the following drug groups increases intraocular pressure and is, therefore,
contraindicated in patients with glaucoma?

206
A. Catecholamines

B. Belladonna alkaloids (anti-cholinergic)

C. Anticholinesterases

D. Organophosphates (cholinergic)

QUESTION: A patient has a deficiency in acetyhcholinesterase. After giving her this drug, action
is prolonged. I put d-tubocurarine (inhibits acetylcholine receptorweakness of skeletal
muscles)

QUESTION: Decrease of pseudocholinesterase would lead to increase in? Succinylcholine or

tubocurare

QUESTION: Administration of succinylcholine to patient deficient in serum cholinesterase would casue

a. convulsions
b. Hypertension
c. prolonged apnea
d. Acute asthma attack

QUESTION: Only LA that is a vasoconstrictor? Cocaine

QUESTION: 2-3 questions on miosis (opioids + cholinergics) vs mydriasis (anticholinergics +

increase serotonin) and which drugs or conditions cause which?
QUESTION: Pt taking narcotic for long term what causes: headache due to increase intracranial
pressure.

Adrenergics:
QUESTION: End plate of adrenergic neuron how is it terminated?
-reuptake of NE? followed by MAO degradation in the neuron
-MAO degrades NE

QUESTION: What receptor or signaling pathway is linked most directly to 2-adrenoceptor

stimulation? Inhibition of adenylyl cyclase through Gi, resulting from stimulation of 2-
adrenergic receptor, leads to intracellular cAMP

QUESTION: A patient who has Parkinsons disease is being treated with levodopa. Which of the
following characterizes this drugs central mechanism of action?
a. it replenishes a deficiency of dopamine
b. it increases concentrations of norepinephrine
c. it stimulates specific L-dopa receptors
d. it acts through a direct serotonergic action
QUESTION: why do you need to take carbidopa with levodopa: prevents breakdown of levodopa before it
crosses the blood brain barrier **L-dopa is a precursor to neurotransmitters like dopamine, norepi, and
epi. It is used in tx of parkinsons. In parkinsons you want to raise dopamine levels.
QUESTION: How does carbidopa tx Parkinsons? I put potentiates effects of dopamine
QUESTION: Carbidopa - Use in conjunction with levodopa

207
QUESTION: Levodopa used to treat Parkinsons disease

QUESTION: Levdopa is used in parkinsons in order to do what?- increase dopamine in the CNS
Carbidopa-a drug used to treat PARKINSON'S DISEASE, but only works when combined with
LEVODOPA (treats Parkinson's Disease to replenish the brain's supply of dopamine, which is the
deficient neurotransmitter in Parkinson's.
QUESTION: Parkinsons is def of dopamine
QUESTION: Cause of Parkinson? Dopamine deficiency, give them methyldopa (levadopa)

Methyldopa competively inhibits DOPA decarboxylase decrease in dopamine and NE/EPI. Its an
anti-hypertensive, acts on A2 adrenergic as well.

QUESTION: Theraputic Index LD/ED is a measure of : safety of drug

potency - response to a drug over a given range of concentrations. Potent = depend on dose of drug-
less mg for same efficacy has more potency

efficacy - effect of a drug -efficacy is the max effect of the drug. Max effect is also called as intrinsic
activity. (antagonists are not efficient/no intrinsic activity)

Therapeutic index - is an estimate of the margin of safety of a drug.

TI = Lethal dose 50/Effective dose 50

QUESTION: LD50 means that At this does 50% of the test animals died
QUESTION: What is bioavailability of a drug? amount of drug that is available is blood. (plasma)

QUESTION: How is bioavailability measured?

How much drug is absorbed in the circulation

Blood to urine ratio

Note: efficacy of drug: level of binding a drug to its receptor

QUESTION: what pharmacokinetic factor influences the need for multiple doses in a day (dose
rate): I said half life; other option is bioavailability (maybe should have goe with this), or clearance

Elimination rate of a drug influences its half life that determines the frequency of dosing
required to maintain therapeutic plasma drug levels.

Bioavailability: Highly absorbed drug (high bioavail.) requires a lower dose that poorly absorbed.
Most important determinant of drug dose is POTENCY of drug.

QUESTION: drug dosing has to do with: half life

QUESTION: two different drugs with same dosages bind to the same receptor and cause same intrinsic
affect however they have different affinities for the receptor: In which aspect these 2 drugs are similar?

Efficacy bc they can both produce the same maximal response if enough is given

ED50

208
Potency is how much they can get response with just a little

QUESTION: There are two drugs that with the same dosages bind to the same receptor and have same
intrinsic affect however different affinities for the receptor: How are these two drugs the same?

a. ED50
b. LD50
c. Potency
d. Efficacy

QUESTION: both drug have same intrinsic effect and different receptor affinity---same potency, same
efficacy

QUESTION: Drug A has greater efficacy than Drug B Drug A will produce higher effect at lower dose
(the other answers got into receptors, but the key here is intensity of drug, not how it interacts with
receptors)

QUESTION: Drug A has greater efficacy than Drug B Drug A will produce higher effect at lower dose
(the other answers got into receptors, but the key here is intensity of drug, not how it interacts with
receptors)* depends on the answer choices. I think this person if referring to POTENCY. Potency =
relative concentrations of two drugs that produce the same effect. So a drug that produces the same effect
as another drug but at a lower dosage.. is MORE POTENT. EFFICACY deals with RECEPTORS.
EFFICACY = NUMBER OF RECEPTORS that must be ACTIVATED to yield maximal response.
Higher efficacy = activates less receptors to produce this response.

**in the Tufts packetDrug A had greater efficacy than drug B, so Drug A is capable of producing a
greater maximum effect than drug B.

QUESTION: Drug A vs Drug B question: less of drug A to produce a response than B (know efficacy,
potency, theurapeutic index)

QUESTION: Fixed dose drug A w/ low dose of Drug B increase drug B effect when same dose of drug
a is give w/ increased does of drug B: competitive antagonist, synergism , partial agonist

QUESTION: Three carpules (2 ml carpules, 40 mg/ml) of local anesthetic X are required to obtain
adequate local anesthesia. To obtain the same degree of anesthesia with local anesthetic Y, five carpules
(2 ml carpules, 40 mg/ml) are required. If no other information about the two drugs is available, then it is
accurate to say that drug X
0
is less potent than drug Y.
is more efficacious than Y.
is less efficacious than drug Y.
X&Y are = in potency & efficacy.
QUESTION: The maximal or "ceiling" effect of a drug is also correctly referred to as the drug's
A. agonism.
B. potency.
C. efficacy.

209
D. specificity.

General Anesthesia:
QUESTION: A 26 month old child w/ 12 carious teeth. How to treat? General Anesthesia
QUESTION: What would you do with a 26 month year old child and multiple decays on teeth

o General anesthesia
o Oral sedation
o Nitrous oxide

QUESTION: 26 mo old child with 12 carious teeth, how would u treat'? nitrous and local anesthesia,
oral sedative and local in one visit. GENERAL ANESTHESIA !!
QUESTION: 2 year old with 12 fillings that are deeply decayed, how do you tx patient? Under
general anesthesia

QUESTION: Kid under general anesthesia: give chloral hydrate and midazolam

QUESTION: Benzodiazepines which one is used for depression and anxiety for compulsive disorder
(Xanax= Alprazolam - used for anxiety panic disorder not depression)Out of the Benzodiazepines
the only one that has OCD is Xanax-Alprazolam but does not include depressiononly
QUESTION: Diazepam: Anticonvulsant & Sedative

QUESTION: Valium causes orofacial clefting DOES NOT!

QUESTION: Anticonconvulsants can cause cleft palate (teratogenic effect)

QUESTION: valium is used for all of following except: I picked emesis/ other option was insomnia
but im pretty sure its emesis

QUESTION: Diazepam action in GABA: antianxiety and anticonvulsant

QUESTION: hypnosis affects what? voluntary muscles, involuntary muscles, both voluntary
and involuntary muscles, glands

QUESTION: Whats the action of the Benzodiazepines?

A.Facilitates GABA receptor binding by Increasing the frequency of chloride channel opening.*
QUESTION: Mechanism of action of on GABA receptors:

increasing the frequency of chloride channels by Benzodiazepines

Barbiturates increase the duration of chloride channel opening

QUESTION: Benzodiazepines act on: I put GABA receptors

QUESTION: benzodiazepines, anxiolytics how do they work? GABA!
QUESTION: Which of the benzodiazepine you dont give to seniors? Long acting one (like diazepam,
look up)
Short to intermediate-acting benzodiazepines are preferred in the elderly such as oxazepam and
temazepam, midazolam.
QUESTION: Benzos are great for dentistry due to an action of- amnesia and little memory of the event.

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QUESTION: Best benzo for iv sedation-MIDAZOLAM.
QUESTION: What does IV Midazolam do? Amnesia

QUESTION: What does IV Midazolam do? Amnesia

QUESTION: Best benzodiazepine for pt with liver cirrhosis -oxazepam
Benzodiazepines: ones not metabolized by the liver (safe to use in liver failure)
LOT:
Lorazepam
Oxazepam
Temazepam

QUESTION: Flumazenil: Benzodiazepine antagonist ; competive GABA receptor.

QUESTION: Which drug best reverses the effect of benzodiazepines?
Flumazenil Benzo flu away
QUESTION: Flumazinil - reversal for benzo
QUESTION: contraindication of lorazepam: a)pregnancy b)diabetes ?
QUESTION: diazepam is contraindicated in pregnant lady (ALL BENZOS)
QUESTION: Who cannot take Valium (diazepam)? Pregnant women
QUESTION: Pregnancey, dont take? diazepam
QUESTION: Benzodiazepines (diazepam, lorazepam) are contraindicated in pregnancy

QUESTION: Reversal for valium (diazepam)- flumazenil

QUESTION: Why do you use benzos or a barb for antianxiety? Reduced depression, does not
propentiate depressents. (less respiratory depression)

QUESTION: How benzos are anxiolytic rebound sedation or amnesia?

QUESTION: How benzos are anxiolytic: moderate doses ANTIANXIOLYTIC and high doses is
SEDATIVE
QUESTION: Sedative rebound (or something like that) a. Antipsychotic

QUESTION: Sedative rebound (or something like that)

a. Antiphysicotic
PART OF WITHDRAWL

QUESTION: Which of the following barbiturates MOST readily penetrates the blood-brain barrier?
Thiopental

QUESTION: Sodium Thiopental rapid-onset short ultra acting barbiturate(IV) for general
anesthesia- for Desensation

QUESTION: A patient has appointment next morning, he is anxious, and the night before he had hard time
sleeping, which of the following tx would you prescribe? Ambien! (sedative and makes patient sleep).

QUESTION: Check what is Ambien (Zolpidem) !!

(Ambien is a nonbenzodiazpine hypnoticused for insomnia..so not a benzodiazepine but acts
accordingly anticonvulsant and muscle relaxant but too strong for these purposesalso reversed by
flumazenil just like BDZspotentiates GABA receptorsshort half lifenegative side efx: hallucinations
and amnesiaXtina)

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QUESTION: Chief mechanism by which the body metabolizes short-acting barbiturates is?
a. oxidation (occurs in the liverXtina)
b. reduction.
c. hydroxylation and oxidation.
d. sequestration in the body fats.

QUESTION: why are ultrashort acting(gave me an actual name of a barbiturate) barbituates so fast?
Redistribution (right answer according to previous test)
QUESTION: A patient's early recovery from an ultrashort-acting barbiturate is related primarily to
redistribution.
breakdown in the liver.
excretion in the urine.
breakdown in the blood.
binding to plasma proteins.
QUESTION: Diazepam -No effect on respiration as oppose to other BZ

QUESTION: The reversal for Versed? (versed = midazolam)

A. Narcon
B. Flumazenil**
QUESTION: Pt is under oral sedation. You should monitor everything except?
Respiration
Oxygen saturation level
*Electo cardiogram
Skin and oral mucosa color (cyanosis?)
QUESTION: #1 cause for problems during IV sedation?hypoxia

QUESTION: A 77 years old female 110 lbs weight requires removal of mandibular teeth under local
anesthesia. She is apprehensive. The appropriate dose of i/v diazepam to sedate her?
a. 5 mg
b. 10 mg
c. 15 mg
d. 20 mg

QUESTION: Drug for seizures? Dilantin (or diazepam)

QUESTION: Flumazenil combats benzos (naloxone combats opioids), disulfuriam is for alcoholics
QUESTION: Buspirone - Psychotropic w. anxiolytic; low CNS depression, low psychomotor skill
impairment ***Buspardifferent from benzodiazepines because it does NOT cause, CNS depression,
muscle relaxant, or anti-convulsant!!!!!** UNIQUE!!! Anxiolytic and antidepressant
QUESTION: Know drugs used for conscious sedation SSRIs/BDZ Diazepam and
Prozac(fluoexitine)

QUESTION: 25 yo female breast feeding 12m old child and currently pregnant-which sedative would you
give?
Halcion

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 Promethazine
Nitrous
Diazepam
Phenobarbital
QUESTION: What anxiolytic to use for anxious 25 year old pregnant woman who is breastfeeding?
Chloral hydrate (avoid), nitrous (avoid), benzo (avoid)

QUESTION: 25 yo female breast feeding 12m old child and currently pregnant-which sedative
would you give?
Promethazine
*promethazine OK for pregnancy
QUESTION: -If youre breast feeding what drug should you not take? Something prohibited in the states.
QUESTION: What drug NOT to give to lactating breast feeding mother
QUESTION: do not give which medication to lactating female? Codiene and tetracycline

QUESTION: Prozac - acts on serotonin

QUESTION: Prozac (fluoxetine) - acts on serotonin SSRI selective serotonin receptor
inhibitor this is an antidepressant
QUESTION: Fluoxetine (prozac ) Mechanism of action: SSRI

QUESTION: Patient is in her 70s, she lives alone, what could she be suffering from? Depression
QUESTION: Most common psychological problem in elderly? A: Depression
QUESTION: Geriatric population- problem with dementia or depression

QUESTION: Old people have dementia as the most prominent psychiatric issue: depression

QUESTION: What is assoc with depression; age, econ stat, prof status..
QUESTION: Most common mental illness among elderly? dementia, depression..

QUESTION: which one of the things can be seen with TMP pt in elders: Depression
QUESTION: main sign of dementia (I think it should be MEMORY LOSS, dunno short or long)
a. confusion
b. short term memory lossI think this is the answer.. if they are asking for the first main sign.
Long term loss occurs later.
c. long term memeory loss
QUESTION: 1st sign of dementia
short term memory loss
long term memory loss
QUESTION: Dementia dont retain short term memory
QUESTION: main sign of dementia -People with dementia often forget things, but they never
remember them later
confusion **
QUESTION: Dementia: which is not a sign of dementia: long-term memory loss
QUESTION: Substance in the brain where antidepressants works :decrese amine mediated
neurotranmision in the brain

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QUESTION: TCA mechanism of action: inhibit reuptake of NE and 5-HT (serotonin)
QUESTION: TCA 2nd generation- Nortriptyline (Pamelor, Aventyl)
Desipramine (Norpramin)
Protriptyline (Vivactil)
QUESTION: know the mechanism of action of TCA.? it decreases the re uptake of Norepinephrine
QUESTION: How do tricyclics work?- by not allowing reuptake of neurotransm.
QUESTION: What catecholamine do tricyclic antidepressants affect? Dopamne, serotonin,
acetylcholine
QUESTION: patient is taking TCA antidepressants what do you take into consideration? Limit
duration of procedures, keep in mind the epinephrine limit .
QUESTION: Side effect of having TCA and epi : HTN, hypotension, hyperglycemia,
hypoglycemia

QUESTION: Most common antidepressant does what?

Inhibits reuptake of NE, 5-HT, & DA (TCA)
Inhibit reuptake of 5-HT (SSRI)
Inhibit reuptake of N & 5-HT (SNRI)
Inhibit MAO; prevent breakdown of NE & 5-HT (MAOI)
Block D2 receptor (phenothiazine)
QUESTION: IF someone has a history of depression, what do you give? Zyban (Bupropion), not Chantix
(smoke cessation)
QUESTION: Amitrriptyline most common tricyclic antidepressant, inhibits reuptake of NE and
serotonin
QUESTION: Tricyclic antidepressant- didnt remember what the question was: SSRI- prevent uptake of
serotonin
QUESTION: Zoloft works on what receptor?Presynaptic monoamine transporters (inhibit reuptake
of 5-ht)
Sertraline hydrochloride (trade names Zoloft and Lustral, among others) is an antidepressant of
the selective serotonin reuptake inhibitor (SSRI) class.
QUESTION: Most common mood disorder?generalized anxiety or depression?
QUESTION: Depression causes- eating, lonliness, and something else
QUESTION: Depression-st johns wort
QUESTION: What do you use St. Johns Wart? Depression
QUESTION: St johns wort- is for depression
QUESTION: St. Johns Wart: (-) serotonin yeah because is for depression

QUESTION: What does St. John's Wort do? Decrease the body immunity

Note: there is no option anti depressant in choices. in Pt with HIV it interact with anti HIV drugs such
as Indinavir(increase immunity) and reduces their function so the immunity decreases

QUESTION: St johns wart- used for? depressionnot with benz and HIV medication

Antipsychotics

o Phenothiazines: Block DA receptors

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 Act on the extrapyramidal pathway
o Side effects
Tardive dyskinesia

QUESTION: antipsych drug does what?DA (dopamine)

QUESTION: Substance in the brain where antipsychotics works : blocking the absorption of
dopamine
QUESTION: What catecholamine does Phenothiazine (antipsychotic) affect? Dopamine, serotonin,
acetylcholine
QUESTION: Phenothiazine (anti-psychotics): SE Tardive Dyskinesia

QUESTION: tardive dyskinesia-psychosis

QUESTION: Tardigive dyskaenesia antiphyschotic (irreversible)

QUESTION: antipsychotic meds - act on dopamine
QUESTION: What acts on extrapyramidals? Phenothiazines (chlorpromazine)
QUESTION: Onset of action of antipsychotic is: 5-6 days
QUESTION: what is the most common psych disorder? (anxiety, depression, ADD,
schizophrenia)
QUESTION: lithium is used for? Manic phase of bipolar disorder
QUESTION: Lithium- bipolar disorders
QUESTION: a patient on Lithium is indicative of what? Severe depression? BIPOLAR
Anti-inflammatory/Corticosteroids: Side effect profile: gastric ulcers,immunosuppression, acute
adrenal insufissiency, osteoporosis, hyperglycemia, redistribution of body fat.

QUESTION: Strongest glucocorticoid/Long acting Corticosteroid? Dexamethasone,

QUESTION: Long acting Corticosteroid Dexamethasone

QUESTION: Stomach ulcers? Excess ..corticosteroids
QUESTION: GI with corticosteroids: Ulcers. Long term effect- osteoporosis

QUESTION: GI effect WITH CORTICOSTEROIDS-ULCERS

QUESTION: Long term side effect of corticosteroids-osteoporosis and hyperglycimea

QUESTION: What is the side effect of prolonged corticosteroid therapy?

o Osteoporosis
o Know the other side effects just in case

QUESTION: patient with long term therary corticosteroid will show?

Hyperglycemia
QUESTION: patient with long term therapy corticosteroid will show?
Osteoporosis
QUESTION: long term glucocorticoids use- shows all of following except? hypoglycemia
does lead to: osteoporosis, hyperglycemia, immunosupp.,
QUESTION: Where do you see moon facies: steroid treatment

QUESTION: Where do you see moon facies: increased steroid treatment

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QUESTION: Containdation use corticosteroid-diabetes (also: HIV, TUBERCULOSIS, CADIDIASIS,
PEPTIC ULCER)
QUESTION: Aspirin contraindicated with: corticosteroid use
QUESTION: Corticosteroid: 20 mg 2 wks
QUESTION: How much and how long of steroid insufficiency: 200mg/two weeks in last 2 years, 20
mg 2 weeks in last 2 years, 10 mg or 1 mg.no idea

QUESTION: Critical dose of steroids for adrenal insuficience- 20 mg of cortisone or its equivalent
daily, for 2 weeks within 2 years of dental treatment

QUESTION: Acute adrenal insufficiency: hypotension

QUESTION: Pt taking corticosteroid with rheumatoid arthritis, pt needs TE, why would you consult with
physician: full blood panel, assess for adrenal insufficiency (want to make sure pt can produce enough
coricosteroid with addition to what they are taking so you wont have over inflammatory response from
TE)
QUESTION: Pt on 3mo tx of steroids needs what?- no tx and consult gp for dose rase
QUESTION: if a pt. has been using 10 mg of corticosteroid for 10 years, what would you do for pt.
before any tx? Have pt continue and increase the dose
QUESTION: cortisone exerts its action on(its a steroid hormone, so binds to intracellular receptor) -
receptors on membrane, proteins in plasmaetc.
(Enter cell and bind to cytosolic receptor migrate to nucleus gene expression or With plasma membrane
on target cells)
QUESTION: if pt doesnt get steroid tx in time for their temporal vasculitis what will happened
hearling loss
vision loss
retro-ocular headache
QUESTION: What causes asthma: NSAID (aspirin)
QUESTION: longterm asthma give corticosteroid

QUESTION: Long acting Corticosteroid Dexamethasone

QUESTION: Asthma why use corticosteroids decrease inflammation

Inhaled corticosteroids are the most effective medications to reduce airway inflammation and
mucus production.

QUESTION: what Addison disease causes :pigmentation of the mucosa

chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid
hormones (glucocorticoids and often mineralocorticoids)
*Addison= lower steroid hormonespigmentation of mucosa
QUESTION: Addisons shows what in oral cavity: pigmentation on buccal mucosa
QUESTION: what Addison disease causes : a)bone loss b)pigmentation of the mucosa
QUESTION: What clinical symptoms in the mouth would you see for Addisons disease?

a. Hyperpigmentation

QUESTION: Addisons Disease

adrenal insufficiency

216
 tan skin(J.F.K.)
Tx: give cortisol

QUESTION: Nitrous oxide in blue cylinder (oxygen in green)

QUESTION: Nitrous oxide oxidizes the cobalt in vitamin B12, resulting in the inhibition of
methionine synthase. Nitrous oxide has greater analgesic potency than other inhaled anesthetics
QUESTION: Dreaming on nitrous, what is it? Overdose, normal

QUESTION: How do u check to see if the oxygen (reserve) bag is ok: It shouldn't be that full or
that collapsed

QUESTION: Contradictions of nitrous, which patient can get nitrous? Hypertention, pregnancy

QUESTION: What is an absolute contra-indication for the use of Nitrous Oxide? Sickle cell anemia
or nasal congestion?
QUESTION: Fear anxiety, which option is better? First we administer Nitrous, then papous , then
anesthesia

QUESTION: devise used in evaluation of N20 : Pulse oximeter

(CORRECTused to measure amount of oxygen in blood)
QUESTION: The correct total liter flow of nitrous oxide-oxygen is determined by the amount
necessary to keep the reservoir bag 1/3 to 2/3 full.
QUESTION: Nitrous oxide: Total flow rate 4-6 L per min

QUESTION: Nitrous to pedo at 50%-what we do? We stop giving it.

QUESTION: Nitrous safe switch happens? 50% (I think its 70 for N, 30 for O)
QUESTION: Max amount of Nitrous Oxide for a kid

a. 40 %

b. 50%

c. 70% Adult

QUESTION: Safety on nitrous tank 70%

QUESTION: A questions about the percent nitrous can NOT increase because of a safety?: 30, 70,
QUESTION: safety valve in nitrous tank no more than : a)50 % b)80% c)90%
QUESTION: Nitrous safe switch happens? 50% (I think its 70 for N, 30 for O)
QUESTION: Abuse of nitrous oxide it results in peripheral neuropathy.
QUESTION: Why is nitrous oxide used on children? alleviate anxiety
QUESTION: child with fear is best treated with : nitrous oxide
QUESTION: What is an adverse effect of nitrous? Nausea,
QUESTION: Most common side effect of nitrous oxide? Nausea
QUESTION: If patient does not have 100% oxygen after nitrous oxide: Diffusion hypoxia
QUESTION: NO2 contraindicated in I put nasal congestion, it is ok for asthma **contraindications for
NO2 includeCOPD, resp infx, pneumothorax/collapsed lung, 1st trim of pregnancy, hard to
communicate with pt, contagious disease, middle ear or sinus infx, bowel obstruction, head injury
QUESTION: Nitrous oxide and preg pt, which trimester to avoid? 1, 2, 3, all trimensters

217
QUESTION: Nitrous should not be given in 1st trimester of pregnancy
QUESTION: What trimester is nitrous use contraindicated in? first
QUESTION: When is nitrous contraindicated for a child? I put upper respiratory tract infection
QUESTION: Contraindication to nitrous- breathing disorder
QUESTION: When is nitrous contraindicated? Asthma/COPD
QUESTION: What is an absolute contra-indication for the use of Nitrous Oxide? Sickle cell anemia or
nasal congestion?**I think it is nasal congestion. Website states Nitrous is ok for sickle cell anemia, and
relaxing effects can lower chances of a crisis.

QUESTION: Why give hydralazine with chloral hydrate? Decreases nausea

QUESTION: hydroxizyne is used with chloral hydrate because decrease nausea is a first-generation
antihistamine of the piperazine class that is an H1 receptor antagonist. It was synthesized in the
early 1950s. It is used primarily as an antihistamine for the treatment of itches and irritations, an
antiemetic for the reduction of nausea, as a weak analgesic by itself and as an opioid potentiator,
and as an anxiolytic for the treatment of anxiety
QUESTION: hydroxizyne is used with chloral hydrate because decrease nausea

Local Anesthesia:
Lipophilic ring (aromatic) + intermediate chain (ester or amide link) + hydrophilic amino terminus
Esters are more prone to hydrolysis = shorter duration of action

Esters = no I before caine Amide = I before caine

Amide derivatives: Xylidine, Toluidine, Thiophene

Amides: metabolized in liver

Esters: Metabolized by plasma esterase

218
QUESTION: Know where L.A. metabolized? Amide (2 Is) met. in P450 enzyme of Liver. Esters (1 i)
met. in pseudocholinesterase of plasma.

QUESTION: How does anesthetic work? Decrease sodium influx

QUESTION: Mode of action of Lidocaine: Block sodium channels

QUESTION: What is the mechanism of local anesthetics? Blocks Na channels intracellularly

QUESTION: Mech of action of local anes on nerve axon decreases sodium uptake through sodium
channels of axon

QUESTION: What is the primary reason for putting epi in LA?- to slow its removal from the site.
PROLONG DURATION OF ACTION
QUESTION: adding a vasoconstrictor like epinephrine decreases its rate of absorption, thus
increasing the duration of action, minimizing systemic toxicity, and helps with hemostasis
QUESTION: Adding a vasoconstrictor to local anesthesia does all the following EXCEPT:

a. Decreases rate of absorption

219
 b. Increases duration of action
c. Minimizes toxicity and helps homeostasis
d. all of above
QUESTION: Anesthetics broken down by what: biotransformation
***thiopental= redistribution
QUESTION: Biotransformation, what is tendency of molecules, chemical similarities: more polar and
more ionized and less lipid soluble
QUESTION: Which best describes biotransformation: increase/decrease in polarity and water
soluble

Whatever helps its excretion polar and more water soluble

QUESTION: Conjugating the drug does what ? something about crossing brain barrio more or
other things conjugation reaction = are the Phase 2 reaction of drug biotransformation that occurs in the
liver. metabolizing to a soluble form
QUESTION: In relation to their parent drug, conjugated metabolites do what more ionized in plasma
(more water soluble)
QUESTION: What happens to a drug after conjugation- more ionic, more hydrophilic, more active...

QUESTION: What do you use sodium bicarbonate for? All drugs or alcohol (phenol barbitals)

Excretion of acidic drugs is accelerated with Sodium Bicarbonate

QUESTION: Excretion of an acidic drug will be enhanced if the patient is given which of the
following? Sodium bicarbonate
QUESTION: After drug goes through liver? More water soluble and less lipid soluble.

QUESTION: First pass metabolism? Concentration will decrease exponentially. Drug eliminated in
proportional fashion.
QUESTION: First pass effect- metabolized in liver
QUESTION: First pass metabolism:
- enzymatic degradation in the liver prior to drug reaching its site of action

QUESTION: oral meds - first pass effect on liver

QUESTION: First pass effect best describes: passing through hepatic, entering the entero-
something

QUESTION: First pass refers to: enterohepatic circulation, metabolism in liver enterohepatic
goes from bile to liver and metabolism is not decreased.
1. Enterohepatic circulation
Substances that undergo enterohepatic circulation are metabolized in the liver (usually by
conjugation), excreted in the bile, and passed into the intestinal lumen (where the intestinal
bacteria break some of the conjugated drug, releasing the unmetabolized drug again) where
they are reabsorbed across the intestinal mucosa (thus returns to systemic circulation
again) and returned to the liver via the portal circulation. Drugs may remain in the
enterohepatic circulation for a prolonged period of time as a result of this recycling process.
thus increase in their halflives.

First pass effect:

After a drug is swallowed, it is absorbed by the digestive system and enters the portal
circulation. The absorbed drug is carried through the portal vein into the liver. The liver is

220
 responsible for metabolizing many drugs. Some drugs are so extensively metabolized by the
liver that only a small amount of unchanged drug may enter the systemic circulation, so the
bioavailability of the drug is reduced. Alternative routes of administration (e.g., intravenous,
intramuscular, sublingual) avoid the first-pass effect.

QUESTION: Oral drugs undergo first pass metabolism in liver

QUESTION: what is used to determine whether a drug will cross glomerulus: I said whether its
attached to a protein or not; other option is whether the drug is acid or base; other is if its
positive or negatively charged

QUESTION: Which drug absorbs better in stomach acid? Weak acid

QUESTION: In order for a drug to do its effect in what state should it be?
Weak acid,
Weak base
Liposoluble-NON ionized drugs are soluble in lipid.
Hydrophobic
Hydrophilic-

QUESTION: When a drug does not exert its maximum effect is because its bound to ?
albumin-drugs highly bound to plasma proteins will not enter liver to be metabolized,
resulting in longer half life.
gamma
betasomething
alpha
QUESTION: what protein is used to attach to medication: alpha or beta or gabba globulin, albumin
was also choice: albumin

QUESTION: Which of the following best explains why drugs that are highly ionized tend to be more
rapidly excreted than those that are less ionized? The highly ionized are

A. less lipid soluble.

B. less water soluble.

C. more rapidly metabolized.

D. more extensively bound to tissue.

QUESTION: Patient got LA, their breathing fast, hands and finger are moving, heart rate is up You
injected into a blood vessel

QUESTION: Patient get LA injection, he started to breathe a lot, HR goes up, due to what? I said due to
vasoconstrictor acting on CNS (correct answer cardiovascular response to vasoconstrictor)

QUESTION: HTN pt. just gave 4 carpules of 2% xylocaine with 1:100k epi. BP went up to 200/100.
whats possible mechanism/cause?

QUESTION: Patient receives local anesthesia, bp goes up to 200/100, reason? Injection of

epinephrine into circulation
QUESTION: You gave Local Anesthetic, BP went up to 200/100 and HR went up too, what could be due
to? Due to vasoconstrictor injected into venous system.

221
QUESTION: You gave Local Anesthetic, BP went down to 100/50 and HR went down too, what could it
be due to? Syncope
QUESTION: signs of syncope: blood pressure falls

QUESTION: LA does not work when there is inflammation as the pH has decreased

QUESTION: Infection around a tooth but can't numb patient, why? - Infection reduces the free base
amount of anesthetic

QUESTION: Where do you inject if infiltration in the area will not be able to avoid the infection?- Block

QUESTION: Why doesnt anesthesia work when you have an infection? Decreased pH (acidic
environment) leads to more ionized form (less nonionized)

QUESTION: Abscess, give LA, decreased in effect why? LA is unstable in low pH, LA is in ionized
form, needs to be in free base form or unionized form to cross membranes

QUESTION: L.A. in inflamed tissue? Not enough free base to be effective.

QUESTION: As LA becomes more ionized, becomes more water soluble

QUESTION: If you have pain, what would be the hardest to anesthetize?

a. Irreversible pulpitis and maxillary

b. Irreversible pulpitis and mandibular
c. Necrotic pulp and maxillary
d. Necrotic pulp and mandibular

QUESTION What tooth and what condition makes it most difficult to properly anesthetize the tooth:
irreversible pulpitis/necrotic pulp in mandibular/maxillary first molar

When irreversible pulpitis is a factor, the teeth that are most difficult to anesthetize are the
mandibular molars, followed by the mandibular premolars, the maxillary molars and premolars,
and the mandibular anterior teeth. The fewest problems arise in the maxillary anterior teeth.
QUESTION: the pKA of an anesthetic will affect what. Metabolism, potency, peak effect? ONSET

QUESTION: When do you know that is it a non-odontogenic pain: When pain is not relieved with LA

QUESTION: Lidocaine calculation: a cartridge that contains 1.8 ml of solution at a 2% (20mg/ml)

concentration, how much drug? 36 mg/ml of drug (20 mg/ml X 1.8 ml/cart. = 36 mg/ml)

QUESTION: Calc of anesthetic. 2% lodicaine or 1:100,000. how much anesthetic in it? 1. 36mg (answer)

QUESTION: Know max dosage of lidocaine for a kid in mg/kg 4.4 mg/kg

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 QUESTION: Numb the kid, how many hours is the soft tissue numb? 3 hrs

QUESTION: When you numb IA nerve, which roots of primary teeth are numb, (2.3, section C),
Could not find!!

QUESTION: Kids have higher pulse, basal metabolic activity and higher respiratory rate , but lower
BP

QUESTION: Typical pulse for a 4 year old is 110 (12 yr old is 75, adult is 70)
QUESTION: 20 kg child how many mg of lidocaine: 88mg

MAXIMUM allowable dose of 2% lidocaine with 1: 100,000 EPI 7mg/kg) for adults 4.4mg/Kg for
Pedo
QUESTION: Kid is 16kg* 4.4 mg/kg max amount of lidocaine? 70mg

QUESTION: 88 lbs (40kg) patient is given 2 cartridges 1.8 ml each of 2% lidocaine with 1:100,000
epinephrine. Approximate what % of maximum dosage allowed for this patient was administered ?
a. 10%
b. 20% (8 carpules max of lido)
c. 40%
d. 60%
88lbs*2.2 kg/lb = 40 kg. 40kg*4.4mg/kg (max dose for lido) = 176mg = max dose for this patient
72mg injected/176mg = 40%
QUESTION: 50 lb patient given 5 carps of 2% lido with 1:100k epi, during procedure he convulses, why
overdose of lidocaine, overdose of the epi, allergic

Lido: convulsions
EPI: HTN
QUESTION: know the dosage of both anesthetics (4.4kg/ml) and epi(???) for child. This xxkg boy got
5 x 2% Lido with 100,000 epi, and 20 min later, started twitching his arms and legs and went
unconscious. Whats wrong? I did calculation for anesthetics, but he wasnt overdosed by
anesthetics but might be by epi, so know the pediatric dosage of epi. If its not overdosed, you can
pick other choice.
Choices were 1) this kid is overdosed with anesthetics. 2) by epi 3) some other answers I dont
remember

QUESTION: Maximum recommended dosage of lidocaine HCl injected subcutaneously ( not i/v) when
combined with 1:1,00,000 epinephrine is?
a. 100 mg
b. 300 mg
c. 500 mg
d. 1 gram[/QUOTE]
QUESTION: How do you treat lidocaine overdose? Diazepam
QUESTION: What slows metab of lidocaine?- propanalol (stays in system longer because propranolol
slows down heart blood delivery to liver is slowed metabolism of lidocaine is slowerstays in system
longer)
QUESTION: How much epi for a cardio pt? 0.04mg

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QUESTION: Max dose of epi for cardio pt----- 0.04mg, Two carps 1:100.000 (epi 1:50.000
max=1carp.; 1:200.000 max=4carps)
Max dose of epi for healthy pt---- 0.2 mg, Eight carps

QUESTION: Lidocaine-not metabolized in plasma

QUESTION: Lidocaine toxicity is due to - overdose - increased vasoconstrictor, due to preservative
(EPI)
QUESTION: which of the following anesthetic can be used as topical? benzocaine, butamben,
dibucaine, lidocaine, oxybuprocaine, pramoxine, proparacaine, proxymetacaine, and tetracaine
QUESTION: Topical anesthetic- lidocaine
QUESTION: Which pair of anesthetics is most likely to cause cross allergy? 1. Lidocaine and
mepivocaine (answer)
QUESTION: What do you give IV for ventricular arrhythmia?
a. Quinidine
b. Lidocaine
QUESTION: Muscle dystrophy after local anesthetic more likely to? Lidocaine toxicity?) Increase
duration of action? Increase onset? Cant they be supine?
QUESTION: Muscle dystrophy and oral surgery-lidocaine toxicity, duration of action, onset of
action, can they be supine

QUESTION: Pt with muscle dystrophy what can happen in concern with Local Anesthetic? Increase risk
of LA toxicity, need more dosage of LA, LA doesnt last as much , duration, onset?

Muscular dystrophy: muscle weakness, long face which is characterized by a lower vertical facial
height and open bite/

QUESTION: Pt w/ muscular dystrophy condition: lower face with open bite

QUESTION: What can be seen on a patient with muscle weakness of the face? Cross bite, buccal tilting of
molars.. long upper face??
QUESTION: Muscle dystrophy , lower face with open bite.

QUESTION: Considerations for muscular dystrophy: increase in dental disease if OHI is

neglected, weakness of muscles of mastication decrease biting force, open mouth
breathing
QUESTION: Low occlusal plane leads to what? I put decreased biting force, other options were
tongue biting, excessive bite force

QUESTION: Cocaine overdose symptoms? pinpoint pupils, mydriasis

224
QUESTION: What is not on cocaine overdose? pinpoint pupil
Vs Opiate overdose symptoms and signs include: decreased level of consciousness and pinpoint
pupils.[2] Heart rate and breathing slow down, sometimes to a stop. Blue lips and nails are caused
by insufficient oxygen in the blood. Other symptoms include seizures and muscle spasms.
*Cocaine ODmydriasis
*Opiate ODpinpoint pupil
QUESTION: Cocaine OD will cause? Mydriasis, pint point pupils.. (cocaine cause vasoconstriction to
heart so it will do Mydriasis to pupils)
QUESTION: Which LA causes vasoconstriction? Cocaine
QUESTION: Cocaine -Intrinsic vasocontrictive activity
QUESTION: Cocaine- is a natural drug
QUESTION: Reversal of cocaine overdose?
QUESTION: Pt is on rehab of cocaine. what you prescribe for pain? advil

QUESTION: Prilocaine given. Symptoms of methemoglobinemia (cyanosis, headache, confusion,

weakness, chest pain)- methemoglobinemia
QUESTION: Methemoglobinemia is caused by oexcessive doses of lido, benzocaine, but ESP
prilocaine
QUESTION: Prilocaine causes methemoglobinemia (when given over 500mg)

QUESTION: Administer 600 mg of prilocaine. What possible result? Methemoglobinemia

QUESTION: Prilocaine causes methemoglobinemia. (can be treated with methylene blueXtina)
QUESTION: 3.6ml of prilocaine contain how much anesthesia
a. 72mg
b. 80,
c.144
d. 36
QUESTION: 3.6 ml solution of 4% prilocaine contains how many mg?
3.6 36 72 144 360
QUESTION: Levonordefrin is added to certain cartridges containing mepivacaine: To increase
vasoconstriction.
QUESTION: pt has heart problem? Mepivocaine NO EPI
QUESTION: How many carps of 4% [X] anesthetic should be given if maximum amount that you want to
give is 600mg of drug? - approximately 8 carps (go over calculation)
QUESTION: The maximum allowable adult dose of mepivacaine is 300 mg. How many milliliters of 2%
mepivacaine should be injected to attain the maximal dosage in an adult patient?
a. 5
b. 10
c. 15
d. 20
e. 25
2% mepivicaine = 20mg/ml. 300mg/20 mg/ml = 15
QUESTION: calculation of 2% mepivacaine max amnt (I think its 5 cartridges for adultsand 3mg/lb in
children
QUESTION: best LA to use w/o vasoconstrictor
a. pro

225
 b. benzo
c. lido
d. articaine
e. mepivicane (carbo)

QUESTION: Maximum dose of mepivicaine? 400mg

Note: 400mg for prilocaine,300mg for lidocaine without epi,300mg for lidocaine with epi,90mg for
bupivacaine

QUESTION: 3 carps of 1.8cc of .5% bupivacaine 1:200000 epi total dose

QUESTION: Bupivicaine calc in 3 cartidges- epi and bup
QUESTION: Articaine(septocaine): metabolized in blood .**unique bc it is an Amide, but has
an ester group, and is metabolized in the bloodstream

QUESTION: Articaine - conjugated at liver 1st? (unlike other amides, it metabolized in blood stream).

QUESTION: Articaine - conjugated at liver 1st? Blood Stream, Liver. (unlike other amides, it
metabolized in blood stream).

QUESTION: Know that Articaine is metabolized by esterase in plasma.

QUESTION: Articaine - conjugated at liver 1st? unlike other amides, it metabolized in blood stream

QUESTION: Articaine (septocaine) has an ester group, unlike other amides it is metabolized in blood
stream.
QUESTION: A recently-introduced local anesthetic agent is claimed by the manufacturer to be several
times as potent as procaine. The product is available in 0.05% buffered aqueous solution in 1.8 ml.
cartridge. The maximum amount recommended for dental anesthesia over a 4-hour period is 30 mg. This
amount is contained in approximately how many cartridges?
a. 1-9
b. 10-18
c. 19-27
d. 28-36 (approx 33 cartridges)
e. Greater than 36
QUESTION: anesthesia of facial nerve will cause all but
instant muscular dysfunction in half the face
excessive salivation
inability to smile
inability to close eye
corner of mouth will droop
QUESTION: Which drug is LEAST likely to result in an allergy reaction?
a. epinephrine
b. procaine
c. bisulfite
d. lidocaine

226
QUESTION: Pt taking MAO inhibitors what you CAN NOT give him: epinephrine, opioids

Local anesthetics containing EPI are contraindicated in patients taking MAO inhibitors.

QUESTION: Mix MAOI and epi get? HTN

QUESTION: what determines max. dose for anesthetic for a child? 1. Weight (answer)

TABLE 3-5 Recommended Maximum Dosages of Epinephrine

QUESTION: What is the best indicator for success of intra-pulpal anesthesia? I put something
about backward pressure,
QUESTION: What is the best predictor for pulpal anesthesia?
Concentration of anesthetic
Volume of anesthetic
Back pressure
Type of anesthetic

QUESTION: Intrapulpal anesthesia does what back pressure anesthesia stops hemorrhage, anesthesia
after 30 sec, patient doesnt feel it
QUESTION: What is a good indication success of intrapulpal anesthesia feel the back pressure during
injection

QUESTION: Local anesthesia: PSA does not numb MB of M1

QUESTION: Which order will sensation disappear? 1. pain, 2.temp, 3.touch, 4.pressure

QUESTION: Which is incorrect: PSA numb palatal tissue

QUESTION: muscles elevating the jaw : masseter,temporal,medial pterigoid

QUESTION: Trismus includes what muscle: medial pterygoid

QUESTION: The dentist is performing a block of the maxillary division of the trigeminal nerve into which
anatomical area must the local anesthetic solution be deposited or diffused?
a. pterygomandibular space
b. pterygopalatine space
c. retropharyngeal space

227
 d. retrobulbar space
e. canine space

QUESTION: MS more or less anesthetic? Use Mepivicaine (no epi)

QUESTION: For a patient with multiple sclerosis

A. epinephrine is contraindicated in local anesthetic.

B. the amount of anesthetic needed for a given procedure is less than for a normal patient.

C. the amount of anesthetic needed for a given procedure is more than for a normal patient.

D. a single cartridge of anesthetic will most likely not last as long as it would for a normal patient.

Pre-Medication:

Premedicate these conditions artificial heart valve, previous IE, congenital heart
(valvular) defect, total joint replacement

Preventive antibiotics prior to a dental procedure are advised for patients with:

1. Artificial/prosthetic heart valves

2. a history of infective endocarditis
3. certain specific, serious congenital (present from birth) heart conditions, including
o unrepaired or incompletely repaired cyanotic congenital heart disease, including those
with palliative shunts and conduits
o a completely repaired congenital heart defect with prosthetic material or device, whether
placed by surgery or by catheter intervention, during the first six months after the
procedure
o any repaired congenital heart defect with residual defect at the site or adjacent to the site
of a prosthetic patch or a prosthetic device
4. a cardiac transplant that develops a problem in a heart valve.

Pre med with odontogenic infection:

Amox for SBE prophylaxis
Penicillin for odontogenic infections
Tetracycline for periodontal infections
QUESTION: Total joint replacement knee? Pre-medicate ??? YES or no**
QUESTION: Knee surgery-no prophylaxis
Patient with pen allergy-true or false-patient had knee replacement
True-patient needs premed and would take amox-no not true

QUESTION: What if someone has joint replacement or high risk procedures? 1. Life time prophylaxis
before dental tx (answer) (not anymorefor joint replacementswithin 2 yearsXtina)
QUESTION: Condition that DOES NOT require antibiotic prophylaxis

o Prosthetic heart valve

o Rheumatic heart valve
o Congenital heart formations
o Cardiac pacemaker

228
QUESTION: Indication for antibiotic prophylaxis: Prosthetic valve
QUESTION: Need premedication for prosthetic heart valve,
QUESTION: Prophylactic treatment for Prosthetic heart valves premedication required

QUESTION: In what situation would a pt need to premedicate? prosthetic heart valve

QUESTION: Prophylactic treatment for Pacemaker No premedication required

QUESTION: One of his patients has a pacemaker, but dont premedicate either? Just stay away from
ultrasonic and electric testing and such.
QUESTION: What precaution you need to take for patient who has cardiac pacemaker?
a. antibiotic prophylaxis
b. avoid electrocautery

QUESTION: (Again with different options) need premedication for congenital heart defect with severe
problems
QUESTION: when to give prophylaxis: congenital heart disease

3 different cases with it asking whats the premedication regimen and on all three I wrote you dont need
to premedicate because the problem was a triple bypass or angioplasty or other stuff that didnt require
prophylaxis
QUESTION: Cyanotic heart valves you must premedicate. Kid had unrepaired cyanotic something valves,
cyanotic congenital heart disease. Premedicate with amoxicillin and you need to know the dosage so that
you pick the right dosage 60 lb kid. 50mg/kg dosage.

QUESTION: premedication for child 44 lbs : 1 gram amoxicillin 1 hour prior Tx.
Amoxicillin: Clindamycin:
Adults: 2g orally 1hr prior to appointment Adults: 600mg orally 1hr prior to appointment
Children: 5Omg/kg (not to exceed adult Children: 20mg/kg orally 1hr prior to appointment
dose) orally 1hr prior to appointment
44 lbs = 20KgX 50mg/Kg= 1000mg = 1g Amoxicillin

QUESTION: Pt w/ MVP w/ regurgitation dont premedicate

QUESTION: Antibiotic prophylaxis for mitrall valve prolapsed with regurgitation- NO

QUESTION: (Patients medical tab say he is allergic to Amoxicillin), He needs to be premedicated, what
do you prescribe? Clindomycin, 600mg 1hr before the dude shows up for the appointment.

QUESTION: If patient is allergic to ampicillin, then what antibiotic should be given? Clindamycin, but
should be 600 mg and the answer choice was wrong since they said 2 g so he picked cephalomycin. Fixin
(I doubt its cephalomycinbecause similar to cephalosporin and those are cross allergenic with
penicillinXtina) --**I think he meant cephamycin, but yea similar to cephlasporin. **CEPHALEXIN
probably the answer if allergic to pen give 2 g of it.

QUESTION: one of them pt was taking penicillin everyday so I prescribed Clindamycin to avoid side
intxn

QUESTION: Man has accident and pin placed in arm. What antibiotic prophylaxis does he need?
A: None
QUESTION: Pt w/ total knee replacement but was taking Amoxicillin for a while; how do you
premedicate? (give Clindamycin b/c bacteria are probably already resistant to amox by now)

229
QUESTION: Prophylax and pt is taking penicillin already what do u give him? clindamycin
QUESTION: Regular premedication case: Give amoxicillin 2g 1hr b4

QUESTION: What is recommended prophylaxis for pt that cant take penicillinclindamycin

QUESTION: prophylaxis antibiotic: Pt with heart transplant with valvulopathy.

QUESTION: IE pre-medications definition? For patients who has cardiovascular problems and are
at risk of infection over their lifetime. (other choices were wrong). Mine had the option of benefits
of premedication outweigh potential harm associated with pennicillin- which sounds pretty right
to me.

QUESTION: definition of endocarditis : is an inflammation of the inner layer of the heart, the
endocardium. It usually involves the heart valves (native or prosthetic valves)

QUESTION: Infectious Endocarditis pre-medications definition? For patients who has cardiovascular
problems and are at risk of infection over their lifetime. (other choices were wrong)

QUESTION: when is it appropriate to prescribe antibiotic prophylaxis in patient with previous

infective endocarditis: if consequence of potential infection is dentrimental to life

QUESTION: Which of these procedures pose a risk for Infective Endocarditis?

Primary teeth shedding
RCT
Some sort of surgery *
IA injection
QUESTION: Guideline of antibiotic prophylaxis, specially for kids. ie 2g of amoxicillin, 600mg of
clindomycin. ***for kids Amox is 50mg/kg and Clinda is 20 mg/kg
QUESTION: What is AHA recommended antibiotic prophylaxis conditions?
QUESTION: What are the reasons a dentist needs to pre-medicate?
QUESTION: Know antibiotic classes pretty good, how much to pre-med, what adverse side effects they
can have
Lots of prophylaxis qs on 2nd day, about what to prescribe, amount, mitral valve prolapse with
regurgitation,

Antibiotics:
QUESTION: Most bacteriastatic ab, how does it work ? affects protein synthesis

QUESTION: Most bacteriostatic meds works by: Inhibiting protein synthesis

QUESTION: broad spectrum antibiotics : increase superinfection and resistance.

***TETRACYCLINE ARE BROAD SPECTRUM***

QUESTION: If you increase spectrum of bacteria - leads to more infections

QUESTION: antibiotics least useful: LAP, NUG, chronic periodontitis

QUESTION: Why not use broad-spec or overuse antibiots?- bacterial mutations

QUESTION: Why dont we use broad spectrum antibiotics? Produce resistant bugs

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QUESTION: Antibiotic metabolism affected by chronic tx with what drugs? Benzos, barbs, ssri, TCA

QUESTION: which antibiotics will not work well on someone taking prolonged drug for awhile. He put
TCA down.
QUESTION: pt taking antibiotic which is metabolized in the liver. Metabolism of antibiotic decreased by
which drug.
a. TCA
b. SSRI
c. phenothiazine
d. diazepam
QUESTION: Antibiotic decrease effect if pt taking? Barbiturates

QUESTION: Doxycyclone - act on 50S ribosome (there were no 30S choice, but google search
says both) (doxycyclone is a derivative of tetracycline which acts upon 30Showever after
searching it says doxy binds to 30S and also possibly 50Snot sure though)
QUESTION: doxycycline - 30S is a kind of tetracycline treats malaria!
QUESTION: 20mg doxycycline works how

a. Anti-collagenase

QUESTION: Something about periodontal dressing and that it has 20mg of Doxycycline and asks
about its mechanism: there was nothing about bacteriostatic or inhibits 30S ribosome????

a. 20 mg = no antibacterial effects
b. It inhibits collagenase

QUESTION: which antibiotic is antimicrobial and anticollagenlyctic: clindamycin, doxycycline,

metronidazole, amoxicillin
QUESTION: You give antibiotics through IV, patient experience sudden allergic reaction, whats the
FIRST thing you do? Remove the IV line. (others were clear airway, give oxygen, etc)

QUESTION: Penicillin- Why is this so good to give as an antibiotic? Low toxicity

QUESTION: If not penicillin allergic whats the adv of pen? It is not toxic, Cheap,

Gram negative anerobe rods

QUESTION: mechanism of action of pen is closely related to ? keflex ( cephalaxin )

QUESTION: What is the effect of Penicillin and Cephalosporins (cell wall synthesis) via beta
lactam ring

QUESTION: Tanspeptidase, enzyme is inhibit by penicillin. Causing effect on cell wall

QUESTION: Which of the following penicillins would be used to treat a Pseudomonas infection? Nafcillin
(Unipen) ,Amoxicillin (Amoxil), Benzathine penicillin (Bicillin), Phenoxymethyl penicillin (Pen-Vee
K), Ticarcillin (Thar)

QUESTION: why do penicillins have decreased effectivness in abscess -hyaluronidase, pen unable to
reach organism

231
QUESTION: Cyst-why doesnt penicillin work well?b/c cant penetrate cyst barrier
QUESTION: #1 dental antibiotic for an infection within 24hrs is Pen VK 1gm booster and 500mg q6h

QUESTION: For an infection: give PenVK 500mg give 1g at once and then 500 mg every 6 hours
(7 days)
QUESTION: Know the doses for someone that is allergic to penicillin, What you can give them. I put
clarithromycin 500mg but not sure if its right. THAT IS CORRECT. Geez.
QUESTION: All are true except- Cephalosporin has a broader spec then Penecillins (cephalosporin is a
beta lactam antibiotic, bactericidal, first generation more concentrated on gram positive
organismsmore resistant to penicillinaseXtina)
QUESTION: If a patient is allergic to Ampicillin, what else can you premedicate with? Clindamycin
600mg 1-hr before, Cephalexinn2000, Azithromycin 500, or Clarithromycin 500 (look at specific doses!)
all 1-hr before.
QUESTION: Whats an adverse effect of a drug that you cant mix with antibiotics? Methotrexate because it
wont clear out of the system specifically with amoxicillin.
QUESTION: AMOX AND METHOTREXANE: DONT MIX!!
QUESTION: Chlortetracycline- Broadest antibiotic effect

QUESTION: Tetracycline- SUPERINFECTION

QUESTION: tetracycline mechanism of action : protein synthesis inhibitor (30s)

QUESTION: how does tetracycline work? Block activity of collagenase, bind to 30S (block AA linked
tRNA)
QUESTION: Tetracycline is usually not used because they cause yeast infections, as well opportunistic
infect.

QUESTION: Tetracycline does not do one of the following (reduce host response, reduce bacterial
infection, reduce host collagenase; I said increase gingival crevicular fluid flow)

QUESTION: Tetracycline interferes w protein synth/bacteriostatic

QUESTION: which drug would inactivate the latter?

a. Antacids- Tetracycline
note: Do not take iron supplements, multivitamins, calcium supplements, antacids, or
laxatives within 2 hours before or after taking tetracycline. Antacids and milk reduce the
absorption of tetracyclines.

QUESTION: Tetracycline is bacteriostatic

QUESTION: Pt. has dark permanent lateral incisor. What is the cause?
A: Tetracycline, damage to primary tooth at age five, damage to permanent lateral*
QUESTION: What affects tetracycline?
-enamel
-dentin-intrinsic stain.
QUESTION: Questions about hypoplasia and integration of tetracycline into matrix: couple
questions on what age most likely get infection that resulted in enamel hypoplasia or tetracycline
staining (before 4mon in utero for primary; birth for permanent) calcification

QUESTION: Tetracycline not do: dec cervicular fluid

232
QUESTION: Minocycline & Doxcycline; all of the following are true except: (both increase GCF
secretion, both released in GCF, etc.) dont kno answer (side fact: tetracyclines are more
concentrated in GCF more than in blood)

QUESTION: What drug has the highest concentration in crevicular fluid? Tetracycline

QUESTION: which one of the following drug is chelated with C++? Tetracycline

QUESTION: X-allergenic with Pen: Cephalosporines (Cephaloxin)

QUESTION: cross allergenicity with penicillin : cephalosporin.

QUESTION: cross allergenicity with penicillin : cephalosporin.
QUESTION: Pt allergic to penicillin, what could be cross-reactive? Cephatriaxone (3rd gen
cephalosporin)

QUESTION: What drug has cross allerginicity with Penicillin? Cephalosporin- both have Beta
lactamase ring. If pt has allergic to penicllin then pt has allergy to cephalosporin
SO is ampicillin
QUESTION: Child comes in with an oral infection and is NOT allergic to Pen. What do you
prescribe?
a. Penicillin
b. Amoxicillin mosy (-)
c. Tetracyclin

QUESTION: Pt is taking tetracycline. Which of the following drugs would be contraindicated?Penicillin

QUESTION: Tetracycline-penicillin contraindication

QUESTION: Penicillin is ineffective when you give tetracycline why?

b/c it causes penicillin to be excreted in kidney (or renal reabsorption)
less penicillin absorbed in intestines
metabolized more rapidly
QUESTION: Tetracylcine interacts with? Penicillin
QUESTION: tetracycline will interefere withanswer is penicillin. Look thru tufts pharm

QUESTION: what tetracycline does to penicillin :

Tetracline is bacteriostatic whereas penicillin is bacteriocidal therefore Tetracycline will
decrease the efficacy of Penicillin.
QUESTION: What happens when you have penicillin and decide to prescribe tetracycline with it?

a. Dont do it. The two mechanisms of action (CIDAL+STATIC) cancel each other out
because when you need bacterial growth to actually use penicillin, but you dont
have that growth when you prescribe Tetracycline. ANTAGONISTS

QUESTION: penicillin and erythromycin taken together cause (cidal vs static)

summation
potentiation
antagonists
something else that I understood as meaning they do the same thing

233
**Erythromycin (Azithromycin and Clarithromycin) are macrolides. They are static and bind to 50S
ribosomal unit to inhibit protein synthesis). Penicillin is cidal and inhibits peptidoglycan cell wall by
binding to transpeptidase-CK
QUESTION: Penicillins can decrease elimination of methotrexate (cancer drug), increasing risk of
methotrexate toxicity. Methotrexate neurotoxicity can cause seizures and can be caused by
antiepileptic drugs. Methotrexate toxicity effects can be reversed by folinic acid (leukovorin) in a
process known as leukovorin rescue
QUESTION: If you have maxillary sinusitiswhat antibiotic would you give: Amoxicillin with clav.
Acid (the clav. Acid prevents the b-lactamase from breaking down)

QUESTION: what the clavulanic acid do when is mixed with amoxixillin ( augmentin) decrease
sensitivity from b-lactamase

QUESTION: clavulanic acid in amoxcillin - prevents beta lactam degradation by beta lactamase producing
bacteria

QUESTION: calvonic acid in amoxcillin - prevenst beta lactam degradation

QUESTION: Augmentin: blocks the action of penicillinase: Penicillinase resistant

QUESTION: sinusitis tract: augmentin

QUESTION: Penicillinase resistant penicillins COMN [clox, ox, methi, naf] b/c of clavulanic acid---
D.COMNDicloxacillin, Cloxacillin, Meticillin, Nafcillin!!!!!

QUESTION: what antibiotic used for endo? PEN VK (yes it actually say VK together)

QUESTION: drug of choice for pulpal involvement? Pen V

QUESTION: antibiotic used in perio: Metronidazole

QUESTION: antibiotic used in perio : Metronidazole

QUESTION: Metronidazole is commonly prescribed in necrotizing ulcerative gingivitis;

metronidazole is contraindicated in patients on alcohol causing disulfiram type of reaction and has
red urine

a. Both are true

QUESTION: Metrogiven for aggressive periodontitis. Makes your pee a different color? T/F

QUESTION: antibiotic against only anaerobes ab parasites (protozoa): metronidazole

QUESTION: Which med kills only anaerobic and parasites: metronidazole (Only parasites and
anaerobes on the metro)

QUESTION: Clostridium dificile is treated with metronidazole. Unless pt is pregnant or

breastfeeding, then use vancomycin

QUESTION: Mechanism of Metronidazole

disrupts cell wall synthesis

234
 enzyme poisoning
fungal protozoa disruption

QUESTION: best treatment of localized aggressive periodontitis: tetracycline, Doxycicline

QUESTION: Erythromycin bacteriostatic inhibits protein synthesis

QUESTION: #1 side-effect of erythromycin is?- stomach upset.

QUESTION: #1 side-effect of erythromycin is?- stomach upset.

QUESTION: In Lethal doses of erythromycin, what do you see?

e. Hepatocellular GI damage**
QUESTION: Myasthenia gravis patient, what cant you give them? Erythromycin, clarithromycin,
penicillin or Impemene

QUESTION: All of these effect the protein synthesis except: azithromycin

QUESTION: Which antibiotic is NOT inhibit cell wall synthesis?
amoxicillin
vancomycin
azithromycin** (this inhibits protein synthesis)
QUESTION: Gentamycin- May cause auditory nerve deafness
QUESTION: aminoglycosides : ototoxicity and nephro toxicity
QUESTION: aminoglycosides : oto toxicity and nepho toxicity
QUESTION: MRSA- What do you give for this? Vancomycin
QUESTION: Medicine which helps with MRSA -- vancomycin

QUESTION: Pseudomonas colitis: c.difficile and clindamycin

QUESTION: Which of the following describes clindamycin?n

inhibits cell wall synthesis
b. does not penetrate well into bony tissue
c. it usually given in combination with erythromycin
d. is effective against gram-negative bacteria only
e. is effective against most anaerobes

QUESTION: Which of the following describes ciprofloxacin (Cipro)?

Inhibits cell wall synthesis.

Effective against Pseudomonas aeruginosa.

Effective only against anaerobic bacteria.

An antibiotic-of-choice for treating otitis media in young children.

Effective against oral anaerobes.

235
QUESTION: mechanism of action of Minocycline in the Arestin :
decrease collagenases activity Minocycline, another tetracycline antibiotic, has also been
shown to inhibit MMP activity.
QUESTION: mechanism of action of minociclyn in the arrestin : broad spectrum Bacteriostatic;
Inhibits Protein Synthesis (binds to 30s ribosomal subunit)
*MINOCYCLINE(TCA)decreases collagenase activity & inhibit MMP

QUESTION: Methotrexate MTX is an? . antimetabolite and antifolate drug. tx of cancer,

autoimmune diseases, ectopic pregnancy, and for the induction of abortions. inhibiting the
metabolism of folic acid.

QUESTION: Which drug will be used to treat an overdose of methotrexate Leucovorin is

indicated to diminish the toxicity and counteract the effect of inadvertently administered
overdosages of methotrexate

***OD Methotrexategive LEUCOVORIN

QUESTION: drug agonist of folic acid : ? Sulfa, Trimethoprin, Methotrexate

QUESTION: Which medication for anticancer works on folate synthesis/ prevents folic acid
production: methotrexate

QUESTION: Methodextrate- inhibits folic acid in bacteria

QUESTION: Which medication for anticancer works on folate synthesis/ prevents folic acid
production: ***methotrexate

QUESTION: Methotrexate is an anticancer drug that inhibits folate reductase

QUESTION: Anticancer-Methatrexte- folate antagonist which one? Folate reductase
QUESTION: Anticancer drug (Mechlorethamine), that was an alkylating agent what was its affect:
neurotoxic
QUESTION: Alkalizing anti-cancer drug called procarbazine causes HEPATOXITY

QUESTION: Alkalizing anti-cancer drug called procarbazine causes : Hepatotoxicity

When combined with ethanol, procarbazine may cause a disulfiram-like reaction in some
patients. It also inhibits the liver's CYP450 microsomal system, which leads to an
increased effect of barbiturates, phenothiazenes, and narcotics normally
metabolized by the CYP450 enzymes. Has monamine oxidase inhibition properties
(MAOI), and should not be taken with most antidepressants and certain migraine
medications.
Inhibits MAO in the gastrointestinal system thus can cause hypertensive crises if
associated with the ingestion of tyramine-rich foods such as aged cheeses.
QUESTION: Nonalkylating anti cancer med side effect myelosuppression (?) BONE MARROW
SUPPRESSION

QUESTION: What race most likely to get orpharyngeal cancer: black

QUESTION: What disease is more predominate in males (hemophilia)

QUESTION: What percentage gets oral cancer? 3% of new cancers among males and 1.6% of
new cancer among females

236
QUESTION: How many people in the US get oral cancer: 30,000 SSC new cases annually

QUESTION: 1 risk factor for oral cancer Tobacco

QUESTION: What population has the worst survival rate for SCC? (whites, blacks, native Americans)

QUESTION: Lowest 5 year oral cancer survival rate- black people

QUESTION: Radiation for cancer, which cell is more effected?

Nerve, muscle, bone marrow

QUESTION: Mobile mass initially but is now sessile: indicative of malignancy
QUESTION: Discrete, non-tender, soft tissue swelling, what is it malignancy, benign tumor, bone
cancer
QUESTION: Which of the following is not a risk of oral cancer - alcohol, tobacco, HPV and HIV
QUESTION: What will cause xerostomia: chemo or radiation?

Anti-viral:
know antivirals:
amantadine-influenza A
ribavirin-hep C and resp syncytial virus
oseltamivi and zanamivir-influenza A and b
acyclovir: herpes I, II, VZV,EBV
gancyclovir: CMV
AZT,Didanosine,Zalcitabine,Abacavir-HIV
Ritonavir,saquinavir,nelfinavir,amprenair-HIV

QUESTION: Picture of lesion at corner of mouth, patient says it comes and goes now and then, what type
of infection would you suspect? Viral (other choices were Bacterial, etc)
QUESTION: What to use for a viral drug? Dont remember the answers but there were a couple ending
with azole and that not the answer (thats for fungus)
QUESTION: Amantadine is an anti-viral and anti-parkinosonian or anti-TB and its anti-viral.
QUESTION: Amantadine is an anti-viral an
QUESTION: Which one is an antiviral agent? Amantadine**
QUESTION: What anti-viral is used to for all the above: HSV, VZV, CMV: Valacyclovir

QUESTION: What virus causes postherpatic neuralgia: VZV (not HSV)

QUESTION: Garlic : lots of uses, usually assoc with CVD: CI: contraceptives and anti-virals
(HIV), caution with bleeding

QUESTION: Acyclovir selective toxicity mechanism of action:

inhibits viral mRNA, inhibits cellular mRNA in infected cells, only phosphorylated and activated
in infected cells
QUESTION: Acyclovir-inhib mRNA?-phosphorylated---cant make RNA

QUESTION: how is Acyclovir selective toxicity mechanism of action?

only phosphorylated in infected cells and inhibits viral mRNA

237
does NOT work on DNA

QUESTION: HIV patient with sinusitis due to what?murcomycosis

QUESTION: Most reliable measure of HIV progression? CD4 count, viral load

QUESTION: Cd4 count and t cell count for HIV symptoms: I put the pt had HIV
// CD4 less than 200
QUESTION: Pt has viral load of 100000 : pt has high virus load and prone to infection
QUESTION: Pts viral load was 100,000, and T cell count was 50. What is the right sentence?
Pts T cell count is too low**
QUESTION: Know what a healthy T cell count is. 500-1500units/ml
QUESTION: Need transfusion of platelets? 20,000?

QUESTION: Minimum platelet count for oral surgery?

A: Routine ok w/ 50,000 (emergency can be done w/ as little as 30,000 if work w/
hematologist and use excellent tissue management technique)
QUESTION: Which of the following is not a risk of oral cancer - alcohol, tobacco, HPV and HIV
QUESTION: Least likely to get oral cancer?

a. Tobacco
b. Alcohol
c. HPV
d. HIV

QUESTION: Which of the following agents is used for HIV infection?

amantadine (Parkinsons)
b. acyclovir (Herpes)
c. zidovudine (also called AZT)
d. ribavirin (Hep C)
e. isoniazid (TB)

QUESTION: Which of the following is not properly matching the antiviral med with the virus that
caused the disease: answer was retrovir was matched with coxsackie or something (retrovir is
used for hiv/aids)

QUESTION: Give drugs and paired it with the disease. Choose the wrong pair

o Retrovir with varicella zoster WRONG!!

Retrovir is for HIV- right

QUESTION: What oral manifestation is seen in children with HIV? A* Candidiasis #1

QUESTION: HIV pt with fungi infection systemic med- Fluconazole- diflucan

QUESTION: Fungal agent for HIV: Fluconazole or ketoconazole

QUESTION: Candisiiasis, and HIV what do you give: systemic or topical?????? Niastatin AIDS PT
likely to have candida

QUESTION: Once a year, you have to check for one of the following

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HIV
HEP B
HEP C
QUESTION: What test for every year? HepB TB

QUESTION: worker didnt get hep b vaccine because more concern about HIV? A. tell he its easier to get
hep B must sign that they legally dont want
QUESTION: workers that are at least risk for HEP B : a) food servers
QUESTION: workers that are at least risk for HEP B : a) food servers b) down syndrome c) drugs
addicts
QUESTION: Patient has HEB B antigens in surface. What state is patient? HBsAg
-chronic?
-acute hepatitis contagious
-acute hepatitis not contagious
QUESTION: If pt has ABsAb, means that he was either vaccinated or recovered form infection
QUESTION: pATIENT tests POSITIVE HEP B ANTIBODY? All of his organs will be affect except..
Pancrease
Kidney
GI
thyroid**??
QUESTION: pt gets Hep B
a. carriers for life?5-10% become carriers
b. gets active hepatitis
QUESTION: Hepatitis D through B
QUESTION: What are the hep b vaccine rules by OSHA?- all must always be offered and able to get the
vaccine

Fungal:
QUESTION: Know which ones are systemic and which ones are topical
Mycelex, nystatin, ketoconazol,Nastatin rinse and Clotrinzol-troch are topical,
Systemic Ketoconazole, Amphoteracin B.
QUESTION: Easy question on Nyastatin: swish & swallow

QUESTION: Systemic antifungal: Fluconazole

QUESTION: Which systemic antifungal would u use? Nysastin, methazole *TOPICAL: Nystatin,
Clotrimazole (dissolve and swallow) Amp B, Ketocanozole, Nystatin (Creams); SYSTEMIC: FAK
Flucanazole, Amphotericin-B, Ketocanzole

QUESTION: medication for angular chelitis: nystatin

QUESTION: Oral antifungal infection Nystatin

QUESTION: Anti fungal for oral candidiasis- no mycelex option Clotrimazole( Mycelex) and
Nystatin are oral anti-fungals
QUESTION: Griseofulvin: used for athletes foot.
QUESTION: action of clotrimazole: Alter the enzyme for synthesis of ergosterol, alters cell memb.
Permeability

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QUESTION: mechanism miconazole (antifungal) : inhibis the synthesis of ergosterol a critical component
of the cell membrane
Azoles : inhibit lanosterol conversion to ergosterol.

Polyenes : bind to ergosterol on cell membrane and create a pore.

Perio:h
QUESTION: Which one is predominant in sulcular fluid? PMNs
QUESTION: First cells to appear in gingivitis PMN was NOT an option
QUESTION: Established gingivitis- macrophages or plasma cells?
Initial = PMN, early = lymphocytes, establish plasma cells

QUESTION: Which of the following species is a usual constituent of floras that are associated with
periodontal health?

A. Streptococcus gordonii

QUESTION: What bacterial species not associated with periodontal disease

A. Actinomyces species
B. P. gingivalis
C. Capnocytophaga

QUESTION: Bacteria that is not in chronic perio answer is actinomyces viscosus (its a fungus..
NO) the other options were c. rectus, t forsytiaas and p. gingivalis

QUESTION: Which is related to periondal disease? Gram negative bacteria.

QUESTION: Which is related to periondal disease? Gram negative bacteria.
QUESTION: What the initiator of decay- plaque
QUESTION: What is the first step in bacterial plaque formation on a tooth? Pellicle formation, etc..
QUESTION: What is the first step in plaque formation? Pellicle formation (glycoproteins, enzymes,
proteins, phosphoproteins). Second step is adhesion and attachment of bacteria. Third step is
colonialization and plaque maturation
QUESTION: What does plaque depend on? Bacterial interactions and bacterial polymers. Does NOT
depend on host antigen
QUESTION: Which is not part of plaque formation? Host anigten, extracellular bacterial polymers

QUESTION: Most plaque retentive thing calculus

QUESTION: Gingival recession other than plaque is related to age, tobacco, etc?
QUESTION: Periodontal risk factor ?which one is not? Smoking, OH, malnutrition, diabetic
- between all these, malnutrition is the most correct answer for not being risk factor
QUESTION: Risk factors of periodontitis except. Nutritional, diabetes,,smoking. Oral hygiene
QUESTION: Which of the following things are associated w/ periodontal dz (all answers include list
of 3 things)?
- A: Atheroschlerosis, Diabetes Mellitus, Low birth weight of babies
QUESTION: Difference between primary and secondary occlusal trauma? I put periodontal
support

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 QUESTION: Difference between primary and secondary occlusal trauma? periodontal support/healthy
peridontium
QUESTION: Healthy patient, probing shows bleeding, what could this be due to? Gingivitis
QUESTION: Which is least likely to occur with occlusal trauma? gingivitis

QUESTION: Plaque index is used for what gingivitis progression and disease activity are options
but I picked patient motivation
QUESTION: Plaque index done forpt motivation, to track process of disease, to know plaque amt,
QUESTION: Plaque index is used for what gingivitis progression, disease activity, patient
motivation

I think the q is asking periodontal index, not plaque index: in that case, it should be disease acitivty

QUESTION: plaque index-ordinal

QUESTION: Gingival index/perio index. Know their flaws: Perio index flaws are that the
gingival recession was not taken into account

QUESTION: Gingival index 1= mild, 2 = moderate, ordinal

QUESTION: What is Gingival Plaque Index? ordinal

a. Nominal like mild, moderate, severe

b. Ordinal include numbers: like furcation involvement 1,2,3

c. Interval like Celcius degree

d. Ratio e.g Kelvin degree, or BP measurement(can not be zero), length(can not be negative),weight

QUESTION: Your office uses perio scale 1=gingivitis 2=mild perio 3=moderate/severe etc, what
type is this? Nominal, ordinal, ratio, cardinal
QUESTION: gingival index is what: ordinal, nominal, ratio, interval (where 0-normal and 3-tendency
toward spontaneous bleeding)

QUESTION: Gingivitis, nominal and ordinal?

QUESTION: Best scale for gingival index?

a. ratio
b. nominal
c. interval

QUESTION: What is the CTI?- perio incidence index

QUESTION: CPITN: Community Periodontal Index of Treatment Needs
QUESTION: What is predominant in plaque 2 days after prophy: cocci and rods

QUESTION: bacterias present in gingivitis : gram + cocci and rods

gram + cocci and rods normally present, gingivitis transition includes Gram rods and fillaments
followed by spirochetal and motile organisms.
QUESTION: With the development of gingivitis, the sulcus becomes predominantly populated by

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a. gram-positive organisms.
b. gram-negative organisms.
c. diplococcal organisms.
d. spirochetes.

QUESTION: After you clean mouth, 2 days later, what bacteria is found? Rods and Cocci
QUESTION: What kind of bacteria do you have when you have two day old plaque

a. Gram positive, gram negative, cocci, filament

b. (According to decks, its gram negative rods?)

QUESTION: Supra gingival calculus: main crystals are hydroxyl appetite 58%

QUESTION: Chronic periodontitis: has G anaerobes

QUESTION: 2.04mm is bio width

QUESTION: The biological width is. 2mm

QUESTION: Biological width: from the crest of the alveolar bone to the base of the sulcus. a.gingival
sulcus, b.epithelial attachment. c.connective tissue,

QUESTION: Biologic width definition: junctional epithelium and connective tissue attachment to
the tooth above the alveolar crest (at least 2mm)

QUESTION: measure bio width from what 2 point: base of sulcus to alv crest

QUESTION: How to determine attachemtn level? CEJ to depth of pocket

QUESTION: attach loss is from CEJ to sulcus

QUESTION: Which of the following factor is most critical in determining the prognosis of periodontal
disease? 1. Probing depth, 2. Mobility, 3. Class 3 furcation, 4. Attachment loss (answer)

QUESTION: Attachment loss: loss of conective attachment. Apical migration of the JE away
from the CEJ

QUESTION: When is the prognosis that there is no hope- class 2 mobility or deep class 2 furcation, deep
probings with suparation**Perio prognosisMOBILITY and Attachment LOSS---poor and questionable
involve class I and II furcations.
QUESTION: which has the worst prognosis? deep probing with suppuration, class II furcation or
class II mobility. ***Deep probing with suppuration= Vertical fracture
QUESTION: Class 2 furcation can treat with all but- GBR, take of enamel of root to make shallow class
2, hemisection and restore
QUESTION: Which teeth commonly relapse after perio tx? I put maxillary molars due to
furcation anatomy, but was torn between that and mandibular molars due to their cervical
enamel projections
QUESTION: Which tooth long run perio tx u will end up extracting: max pm max molar man molar

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QUESTION: How to treat endo treated mand molar that has furcation: only answer that seemed
logical was hemisection and place 2 crowns to act as 2 premolars. Root amputation is for maxillary
teeth

QUESTION: If you have a through-and-through furcation involvement on a tooth, what do you do?
Extract the tooth. (preferred treatment)
QUESTION: Molar with a III furcation with 5 mm root left in bone what do you do? Splint, extract
place implant?
QUESTION: Patient with class III furcation and 3mm exposure
Extract
QUESTION: If you have a grade III furcation, you can do all of the following except

a. Section it and crown both as PFMs,

b. Tunneling procedure
c. GTR (this is the answer)

QUESTION: Tx option is class 2 almost class 3 furcation? Main goal of tx on class 2 is converted to
class 1 furcation by doing GTR
QUESTION: treatment of a class 2 that is nearly a class III
-convert class ii to a class i(GTR)
-tunelling
-extraction

QUESTION: class 2 and 3, all of the following would be a part of tx plan except? gtr, tunnel prep,
odontoplasty the class 2 to a class 1 furc, extract + place implant, hemisection
QUESTION: Most likely shape of furcation is?- wide but still not very accessible to dental tools, others
used variations of that.
QUESTION: When you have a through and through furcation (Grade 3 at least),

a. Its wide enough and you can clean it

b. Its wide enough and the currette is too big to clean it
c. Its narrow enough and you cant clean it
d. Its narrow enough and the currete is too small to clean it
e. Wtf something like that. I would assume the currete head is too big to get to the furcation but
then I dunno

QUESTION: Furcation: Usually wide but cannot insert hand instrument

QUESTION: Root amputation of MB root cut at furcation and smooth for patient to keep clean

QUESTION: Probing furcation from facial is best. Better accesss to facio mesial furcation from facial.
QUESTION: Best way to detect furcation curve perio probe(naber probe), curette, straight perio probe

QUESTION: The normal recall appointment between periodontal treatment. 3 months,

QUESTION: best time for supportive periodontal therapy? 1, 3, 6, 9, months post srp
QUESTION: how do you treat gingivitis in puberty : debridement and OHI

QUESTION: What is not the initial treatment for gingivitis?- srp, OHI, corticosteroids

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QUESTION: Common in school kids - Marginal gingivitis

QUESTION: What is most common periodontitis in school-aged children: aggressive PD, ANUG,
marginal gingivitis I picked this even though its not technically periodontal disease

QUESTION: Black ppl hav most perio dz

QUESTION: highest incidence of chronic perio? Black males

QUESTION: Which ethnic group has the most periodontitis? Black male

QUESTION: In the US, perio dz seen more in : African american males

QUESTION: most likely to have perio disease? Black males, black females, white males, white females
QUESTION: Black males have the highest incidence of chronic perio

QUESTION: Best for interproximal plaque removal in teeth without contacts: floss, waterpick,
interproximal brush?

QUESTION: What would you use to remove interproximal plaque from a wide embrasure after perio
surgery? interproximal brush
QUESTION: Patient has big embrassure - I said use interproximal brush (other choices, floss, toothpick,
etc)
QUESTION: How do you clean wide interproximal spaces with history of recession (I said
interproximal brushes, but they also had plaque and a waterpik)

QUESTION: Best brushing technique: Sulcular (bass)

QUESTION: Best brushing technique to clean periodontal pockets (charters was an option, sulcular
was an option (they didnt have bass written, and whitmans was another option and side by side
was another option) I wrote sulcular(google says its another name for modified bass and is good
for perio pockets/mainteneance)

QUESTION: least effective for crevicular plaque: water irrigating device

QUESTION: What is not good at removing plaque? Waterpik, nylon, toothbrush

QUESTION: Whats not useful for removing plaque?-water pick

QUESTION: Water irrigation removes debirs (not plaque)
QUESTION: Class 2 furcation, what is worst at keeping area clean? tooth brush, floss, waterpik,
rubber stimulating tip
QUESTION: Brush and floss how much can reach in perio pocket (choose one for brush and one for floss
(1mm and 2-3mm)
QUESTION: Max depth of toothbrush and floss going subgingival?
Toothbrush 0mm, floss 2-3 mm Toothbrush 2-3 mm, floss 0mm Tooth brush 1mm, floss 2-3 mm
QUESTION: Ultrasonic: The type of the stroke, know the magnetostrictive and piezoelectric
ultrasonics

QUESTION: Which is true? Water and air from sonic kill bacteria

QUESTION: Which disease would you NOT have success using antibiotics for? I put chronic
periodontitis

244
QUESTION: Which therapy in adding an Ab + debridement have minimal effect for: anug, Localized
aggressive, chronic perio

QUESTION: SRP removes diseased cementum

QUESTION: Pt. just had SRP. Best way to prevent sensitivity of newly exposed root surface?
A: Keep it free of plaque
QUESTION: Have done SRP on pt w/ recession. Best way to prevent sensitivity to newly exposed
root surface?
A: Keep root surface free of plaque
QUESTION: After you do ScRP, how does new attachment form? long junctional epithelium
QUESTION: What happens after you do ScRP therapy? Dont remember details but it was about
HOW the reattachment occurs SECONDARY INTENSION
QUESTION: Direction of root planning?from base of pocket to CEJ
QUESTION: most benefits from SRP : more edematosous is the gingival will be more benefitial.
QUESTION: What kind of gingival favorable for ScRP: Erythmatous, edematous
QUESTION: most benefits from SRP : more edematosous is the gingival will be more benefitial.
QUESTION: Best results from srp will be from a patient who has: edematous gingiva vs fibrotic
gingiva vs loss of attachment (idk what answer was I said edematous)

QUESTION: What do you do if after SRP there are 2 probing sites of 6mm: surgery

QUESTION: SRP and they came back for maintenance but still 5-6 mm pocket. What to do? Open
debridement
QUESTION: If you did intial SRP and depth pocket r same what do you do? Perio surgery
QUESTION: why check occlusion in perio abscess
g. cus many perio lesions are caused by occlusion
h. cus edema can cause teeth to supra erupt **
i. some other choices were pretty good to, but I cant remember what they were

QUESTION: Whats the FIRST thing you do in maintenance appointment (recall)? Update medical
history (other choice were address patients pain, prophy, etc)
QUESTION: What do you not do at the perio maintenance apt.?- S&P pockets of 1-3mm
QUESTION: What do you NOT do at the re-eval appointment? I put root plane 1-3 mm pockets
QUESTION: What happens after the periodontal re-eval? I put that the recall interval is set but
may be changed if the patietns situation changes
QUESTION: What happens after the periodontal re-eval? the recall interval is set but may be changed if
the patients situation changes, should be less to motivate pt, more to motivate pt
QUESTION: How you determine perio maintenance recall different for each patient
QUESTION: Pt is on a periodontal recall system. What best denotes good long term prognosis:-BOP,
Plaque, Deep pockets (BOP probable answer)
QUESTION: BOP most indicative of what?
A: Inflammation
QUESTION: How long does it take to form mature plaque (I wrote 5- 10 hrs), some others included 24-
36hrs, 1hr
QUESTION: how long for plaque to mature after removed: 24-36 hours

QUESTION: mature plaque in

245
 1-2 hrs
6-8
10-12
24-48hrs
QUESTION: How many hours until plaque accumulation (after brushing or eating?): 1 hour
QUESTION: Percentage to be considered generalized perio-- *>30%
QUESTION: 40 year old fem generalized bone loss and localized vertical bone defect, gross calcium, dx?
Chronic periodontitis
QUESTION: Fusobacteria nuceatum has what specific characteristic? Bridging microorganism
between early and late colonizers

Fusobacterium nucleatumimportant bridging microorganism btwn early and late

colonizers of dental plaque
QUESTION: where perio Tx is more difficult : maxillary molars due to trifurcations.

QUESTION: Which teeth commonly relapse after perio tx? I put maxillary molars due to
furcation anatomy, but was torn between that and mandibular molars due to their cervical
enamel projections

QUESTION: Whch tooth is most commonly lost due to long term care in perio patients: max molar,
max pm, man molar, man pm

QUESTION: Where are the most teeth lost in local aggressive periodontitis? Max molars.
QUESTION: What kind of bone loss in aggressive perio? Vertical. Others, horizontal, mesial distal,
interprox.
QUESTION: Reason pts get aggressive perio- host cant fight off
QUESTION: localized or generalized aggressive perio : no too much gingival inflammation.
QUESTION: What are two things common among generalized aggressive periodontitis and chronic
periodontitis
distribution among the teeth

QUESTION: Aggressive periodontitis localized: AA . First molar & incisors, circumpubertal onset,
robust serum antibody response to infective agents: the dominant serotype antibody is IgG2

QUESTION: where you find localized aggressive periodontitis localized aggressive periodontitis in
perm dentition

o AA bacteria
o Most common in African americans
Tx: surgery, metronidazole with amoxicillin, tetracycline

incisors and first molars

Localized aggressive perio= AA

QUESTION: Know about Aggressive periodontitis: AA bacteria

QUESTION: What causes Localized Aggressive Periodontitis- AA and capnocytophaga

246
QUESTION: classical sign of aggressive perio ---> something about mobility (tooth mobility and deep
pockets with lack of inflammation are initial signs of LAP)
QUESTION: Which of the following is not associated w/ Localized Aggressive Periodontitis?
local factors (i.e. inflammation, plaque, calculus) consistent w/ bone loss*
QUESTION: localized aggressive periodontitis show bone loss on first molars and incisor

QUESTION: What is not associated with LAP(Localized aggressive periodontitis): calculus

QUESTION: Do you use antibiotics with local aggressive periodontitis? Yes
QUESTION: Initial tx for Localized aggressive periodontitis
f. Sc/RP
g. ABs
h. Sc/RP and ABs **
i. ABs for 1 week and then Sc/RP

QUESTION: How do you treat localized aggressive periodontitis? Sc/Rp and ABX
QUESTION: best to use w/ localized aggressive periodontitis
a. chlorhexidine
b. H2O2 rinse
c. systemic antibiotic
QUESTION: 18 year old fem > 5 mm pocket on central and first molars? Localized aggressive Perio

LAP AA and capnocytophaga; generalized periodontitis involves prevotella and eikenella (know
if spirochete/cocci, etc)
Know well about Localized aggressive periodontitis and ANUG.**LAP: high ab response to infecting
agents; disease on 1st M or I, with attachment loss on at least 2 teeth (one of which is a 1st M). Remmeber
that chronic includes attachment loss on at least 3 teeth (other than M or I) and there is low ab response to
infecting agents.

Aggressive periodontitis generalized: patients under 30 years of age, poor serum antibody
response,of Aggregatibacter actinomycetemcomitans, and in some cases, of Porphyromonas
gingivalis

QUESTION: Which of the following pdl disease causes rapid destruction of alveolar bone? 1. Periodontal
abcess (answer), 2. ANUG, 3. Chronic periodontitis.

QUESTION: 3 questions about ANUG: how to tx(srp/rinse/if systemic ab, if not systemic no ab
needed), Bacteria involved (Spirochetes)

QUESTION: bacterias present in ANUG: fusiform, spirochetes and prevotella intermedia

QUESTION: Which NUG or ANUG, which microorganisms predominate? Spirochetes

QUESTION: Which NUG or ANUG, which microorganisms predominate? 1. Spirochetes (answer)

QUESTION: Bacteria for anug spirocytes (fusoform, spirocytes, pervertoa intermedia)
(intermiated spirocytes- treponema denticola)
QUESTION: ANUG? Usually 15-35 years old, aka Vincents infection and trench mouth, punched out
papilla, fetid odor, prevotella intermedia.

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QUESTION: Electron microscopic examination of the bacterial flora of necrotizing ulcerative
gingivitis indicates the presence of microorganisms within non-necrotic tissues in advance of other
bacteria. The organisms involved are

A. spirochetes.

Also P.intermedia and Fuso

QUESTION: Patient comes in with gingivitis, no pocketing, pseudomembranous coating gray on gingiva:
anug

QUESTION: ANUG: Interproximal necrosis

QUESTION: Patient has interpapilla damage periodontal condition, what could this be due to?
ANUG

QUESTION: Patient has interpapilla damage periodontal condition, what could this be due to? ANUG

QUESTION: Cratered gingival = ANUG (NUG)

QUESTION: Acute ulcertaive gingivitis what could be indicated: host overreacting to infection. Bacteria is
releasing deadly toxins (no toxin in acute periodontitis or is not main reason) and the answer was normal
bacterial flora is what youd find in acute ulcerative gingivitis.
QUESTION: Which of the following is the most appropriate initial treatment for a patient with HIV-
associated necrotizing ulcerative gingivo-periodontitis?

A. Debridement and antimicrobial rinses

B. Definitive root planing and curettage

C. Administration of antibiotics

D. Gingivectomy and gingivoplasty

QUESTION: Normally, you dont give antibiotic. You only do debridement, rinse, and oral hygiene.
But if the patient has a fever or systemic indications like HIV, give Metroniadozle.

QUESTION: Metronidazole: given to someone to treat ANUG

QUESTION: Localized aggressive perio, treat with-tetracycline
QUESTION: How do you treat ANUG? Debriement, H2O2, Chlo

QUESTION: Tx for NUG pt with no systemic involvement? Debridement, chlorhexidine, OHI

QUESTION: begin tx of ANUG pt w /
a. H2O2 rinse
b. debride & instrument
c. antibiotics
QUESTION: Red complex has 3 bacterias: P. Gingivalis, Tannerella forsythia, Treponema
denticola

red complex = P. gingivalis, Tannerella forsythia, treponema denticola

i. BOP & deep pockets

248
Orange complex = fusobacterium, prevotella, campylobacter
j. Precedes red complex
k. Plaque formation and maturation

QUESTION: Least associated w/ perio disease? Hypophosphatism (related), acrodynia (related)

QUESTION: all associated w/ perio problems accept

a. stevens-johnson syndrome (target lesions, eye, mouth, skin)
b. pap-lefev syndrome (palmoplantar keratoderma with periodontitis)
c. down syndrome (related)
d. hypophosphatasia (bone disease similar to rickets, premature loss of primary teeth)
QUESTION: Least cause of bone loss around primary teeth? Hypophosphatsia, leukemia, plaque,
one other one I didnt know, I put plaque

QUESTION: The depth of sulcus is 5mm, the distance between CEJ and the base of sulcus is 2mm.what is
the attachment loss: 2mm

QUESTION: Probing depth on pt. is 7mm. Your probe passes 2mm past the CEJ. What is the CAL?
2mm

QUESTION: If recession is 2mm and probing is 1mm how much attachment loss? 0,1,2,3

QUESTION: Pocket depth of 5mm and 2mm from CEJ and gingival margin: 2mm attachment loss
QUESTION: If you have 1mm recession and can probe 3mm, how much attachment loss is
there? I put 4mm
QUESTION: Best angle to place curette on root is 45-90 (repeat)

QUESTION: Perio instrument is held at what angle on the tooth

o 45-90 degrees
o the blade is opened 45 to 90 degrees for working strokes

QUESTION: What edge of curette do u want to be in contact at line angle? Lower 1/3
QUESTION: Curette, which third adapts tooth? Apical Third, Middle Third

QUESTION: Curette, which third adapts tooth? (I think correct one was apical) --*lower third of blade??

QUESTION: Which part of instrument do you place on line angle of tooth: middle third, third
including tip, third closest to handle or entire edge

QUESTION: Periostat- twice daily 20 mg has doxycycline which works by inhibiting collegenase/protein
synthesis (30s subunit not an option) Jon put perio chipPeriochip is 2.5mg of chlorohexidine gluconate
though.
QUESTION: Periostats mechanism of action: inhibits collagenase, inhibits ribosome 50s (I put
collagenase because it says so in Mosbys)
QUESTION: Periostat mechanism of action ---- 1mg minocycline local
Reduces elevated collagenase activity in gingival crevicular fluid of patients with adult
periodontitis; no antibacterial effect reported at this dose
QUESTION: Doxycyclin use? intramicobial which inhibits MMP: matrix metaloprometase

249
 Subantimicrobial dose doxycycline (SDD, periostat) inhibits matrix metalloproteinase
(MMP)

QUESTION: How does Listerine act? Stops cells from binding, (some other choices... this is not the one I
chose) The mechanism of action of Listerine involves bacterial cell wall destruction, bacterial
enzymatic inhibition, and extraction of bacterial lipopolysaccharides.
QUESTION: Action of Listerine?
it disrupts adhesion of bacteria to plaque
is a phenolic compound
QUESTION: What type of agent is Listerine charged or noncharged?? (according to
googleunchargedXtina)
QUESTION: LISTERINE :Antiseptic mouthrinse is a broad-spectrum antimicrobial, and it kills
bacteria associated with plaque and gingivitis by disrupting the bacterial cell wall.

QUESTION: What daily oral rinse would you give to a medically compromised child for plaque control?
(choices were CHX, Listerine, Nystatin, stannous fluoride, sodium fluoride)

QUESTION: What does sodium pyrophosphate do? -Plaque removal-something about removing
crystals of Ca and magnesium, inhibits mineralization of biofilm (inhibits calcium phosphate from
biding)
QUESTION: why are inorganic pyrophasphates in anti-tartar toothpaste: In toothpaste, sodium
pyrophosphate acts as a tartar control agent, serving to remove calcium and magnesium from saliva and
thus preventing them from being deposited on teeth
a. prevent bacterial colonization
b. prevent phosphate

QUESTION: Why is inorganic pyrophosphate in tooth paste: prevent calcium phosphate crystals,
decrease number of bacteria growth

pyrophosphate, has a higher RDA and, additionally, prevents stain buildup by means of chelation
as well as abrasion.
QUESTION: The role of chlorohexidine is cause: Substantivity (anti-plaque)

QUESTION: Action of chlorhexidine: binds to cell wall cell membrane disruption/rupturefluid

leaks out, cell lysis (CHX bursts membrames)

QUESTION: The use of chlorhexidine reduce plaque accumulation (broad spectrum against gram
positive and negative bacteria and fungi Positively charged)

QUESTION: Chlorhexidine :The mechanism of action is membrane disruption

QUESTION: Each of the following is a mode of action of an ultrasonic instrument EXCEPT one.
Which one is this EXCEPTION?

A. Lavage

B. Vibration

C. Cavitation

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D. Sharp cutting edge of tip

QUESTION: Ultrasonic Instruments: active portion is the tip, 20-45k cycles/seconds

o Magnetostrictive: elliptical vibration pattern, all sides of tip are active (4 sides total)

o Piezoelectric: linear vibration pattern, 2 sides are more active (sides are only active)

o CONTRAINDICATED in patients with Pacemaker, communicable diseases, titanium implants (use

plastic tip)

QUESTION: Mode of action of ultrasonics. ANS. Vibration in elliptical (magnetostrictive) , sonics

is linear

QUESTION: Which is true? Water and air from sonic kill bacteria

QUESTION: Why dont u use Acidulated Fluoridated Toothpaste? Ruins Polish of Crown

QUESTION: Which type of fluoride not in toothpaste: acidic fluoride

QUESTION: Why you do perio before ortho: b/c perio you have gingival and osseous changes
QUESTION: Old and young person w/ same perio. Which has better prog?
Older (b/c younger pt had shorter time frame to get to the same condition so more aggressive in
nature)
QUESTION: 2 Patients, one young, one old, both have better prognosis if they both had bone loss,
periodontitis, etc? I said young (apparently old people!) **WTF???
QUESTION: 2 Patients, one young, one old, both have better prognosis if they both had bone loss,
periodontitis, etc? old people have better prognosis
QUESTION: which tooth most likely to lose from perio dz? mx molars, mx anteriors, md molars,
md anteriors
QUESTION: Lots of questions on cerebral palsy (something about whether or not it is a
developmental disorder) (2nd after autism)
s neither genetic nor a disease, and it is also understood that the vast majority of cases
are congenital, coming at or about the time of birth, and/or are diagnosed at a very
young age rather than during adolescence or adulthood. It can be defined as a central
motor dysfunction affecting muscle tone, posture and movement resulting from a
permanent, non-progressive defect or lesion of the immature brain.

QUESTION: CP patient - which is not true?

a. 95% have cognitive impairment
b. all brux
c. increase in periodontitis

QUESTION: Cerebral palsy patient will have spastic oral mucosa during treatment

QUESTION: Pt has involuntary uncoordinated movements with larynx problem? ANS. Cerebral palsy
QUESTION: Common finding in a patient with cerebral athetoid palsy. ANS. Anterior Teeth fracture

QUESTION: most benefits from SRP : more edematosous is the gingival will be more benefitial.

251
QUESTION: What condition would benefit most from sc/rp. A) edematous gingiva desquamous ging b)

QUESTION: What kind of gingival favorable for ScRP: Erythmatous, edematous

QUESTION: most benefits from SRP : more edematosous is the gingival will be more benefitial.
QUESTION: Best results from srp will be from a patient who has: edematous gingiva vs fibrotic
gingiva vs loss of attachment (idk what answer was I said edematous)

QUESTION: Which of the following is NOT a sign of periodontal inflamm: color,consistency, bop, and
attachment

QUESTION: Which of the following causes bone loss?

a. C3a, C5a
b. Endotoxin
c. Interleukin
d. B glucorinidase
QUESTION: What cytokine responsible for osteoclasts IL-1, IL-8,IL-5, IL-3

QUESTION: Root surface tx with what agents? use citric acid, fibronectin and tetracyclin

QUESTION: Which part of dental anatomy on a central collects the most plaque? Facial surface, lingual
surface, cingulum, mamelon, gingivopalatal groove
-Perio: reverse architecture (papilla is supposed to be a mound not a volcano) what is diference between
open bevel and cloesd bevel: both of them would cause the same amount of recovery pain.
QUESTION: Reverse architecture- interproximal is lower than on facial and lingual
QUESTION: Reverse architecture: Interdental bone is apical to the crestal bone

QUESTION: Define reverse architecture? When interdental bone is apical to crestal bone
QUESTION: After periodontal surgery, the dentist leaves interproximal bone apical to radicular
bone.What is this called: negative architecture.

QUESTION: What can make teeth green? Bacteria, gingival hemorrhage, medications or
hyperbilirubinemia
QUESTION: What can make teeth orange? Bacteria

QUESTION: What causes green and orange stain on teeth: Poor ohi I said that, other option are
meds and genetics

QUESTION: Green and orange stains on maxillary incisors can usually be attributed to

A. drugs.

B. diet.

C. poor oral hygiene.

D. fluoride consumption

QUESTION: What are proper ways to reinforce OHI: written and verbal, verbal and in the dental
office

QUESTION: OHI should be? written and oral, Oral in office, written, video tape,

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QUESTION: What is most difficult to maintain oral hygiene with home preventive care?
pit and fissure
proximal smooth surface
facial smooth surface
lingual smooth surface
QUESTION: Rapid tooth mobility is due to advanced perio or periapical pathology??
QUESTION: Most common to cause mobility- trauma or perio
QUESTION: Which of these is reversible with tooth movement?
Tooth mobility *
Bone resorption
Crestal bone
Gingival recession

QUESTION: Which one the following is reversible? Tooth Mobility (other were, bone loss, gingival
recession, and attachment loss)
QUESTION: Pregnant gingivitis: estrogen, estradiol, progesterone

QUESTION: Pregnant women more gingivitis why- hormones

QUESTION: Pregnancy induced hyperplasia: Progesterone induced
QUESTION: Pregnancy gingivitis has altered metabolism of progesterone
QUESTION: Which one of these bacteria are associated with pregnancy

P. intermedia
QUESTION: Pregnancy gingivitis caused by? hormones (progestrone) and P intermedia

QUESTION: Person who is pregnant,you should not give meds in the section e of page 250 .
Tetracyclin, metronidazole, gentamicin and vancomycin should be avoided

QUESTION: Puberty bacteria? P-Intermedia

QUESTION: patient inter-papilla givgiva is swollen - anticonvulsant meds (dilantin)

QUESTION: Whats the #1 cause of med induced ging hyperplasia?- dylantin-30% of all drug induced, this
was a perio test question.
QUESTION: What does NOT cause gingival hyperplasia?
a. phenytoin
b. cyclosporin
c. nifedipine
d. digoxin** (first three causes gingival hyperplasia)

QUESTION: Verapamil calcium channel blocker, hypertension

QUESTION: Does not cause gingival hyperplasia?
Cyclosporine A, phenytoin, dilti, nifedipine all cause gingival hyperplasia
NEFEDIPINE doesnt. the answer was nEfedipine instead of nIfedipine

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QUESTION: All of the following drugs cause gingival hyperplasia except? Verapamil,
diltiazem(CALCIUM CHANNEL BLOCKER), phenytoin (dilantin), nifedipine and cyclosporine
all do.
QUESTION: All the following drugs cause gingival enlargement (hyperplasia) except?
-DIGOXIN
QUESTION: Which does not cause gingival hyperplasia

o Phenytoin
o Digoxin
o Nifedipine

QUESTION: Gingival hyperplasia with which drugs? None of the answers were obvious like
phenytoin.. one of them was probably an obscure calcium channel blocker
QUESTION: which of these does not cause gingival hyperplasia: digoxin

a. CCb (vermipril), phenytoin, cyclosporine

QUESTION: All of the following drugs cause gingival hyperplasia except? I forgot what the
answer was but it was an easy question. They listed phenytoin, dylantin, nifedipine and
cyclosporine, which all cause hyperplasia. The answer was whichever I did not list above.

QUESTION: Easy picture of Gingival Hyperplasia due to patient taking drugs that causes this

QUESTION: Know drugs that cause gingival hyperplasia: Cyclosporines, phenytoin, calcium
channel blockers

QUESTION: Patient is on calcium blockers, picture show gingival hyperplasia, what do you do?
Tell them to see their doctor to switch meds
QUESTION: Patient is on calcium blockers, picture show gingival hyperplasia, what do you do? Tell
them to see their doctor to switch meds
QUESTION: When pt is on imunosupessents for transplanted liver, what happends in the mouth?- CT
overgrowth and hyperplasia.
QUESTION: When pt is on imunosupessents for transplanted liver, what happends in the mouth?- CT
overgrowth and hyperplasia. cyclosporine will lead to gingival hyperplasia
QUESTION: Picture of gingival hyperplasia on 14-year old girl hormonal induced,
QUESTION: Stress long term cause problem in periodontium bc it increases cortisone and
cortisone and brings immune system down

Dentures:
1. Retentive clasp: engages undercut below height of contour
2. Reciprocal clasp: passively touches above the height of contour
3. if you dont have good indirect retention, it lifts off the soft tissue
4. SUPPORT (rigidity): Denture base, major connector, and rests
5. STABILITY: minor connector (lingual plates, guide planes, etc)
6. RETENTION: indirect and direct retainers

QUESTION: Main purpose of major connector? support retention,

QUESTION: 2 main purposes of major connector: Rigidity and stability?

254
 QUESTION: Purpose of Major Connector Stability and Rigidity, Stability and Retention, Retention and
Rigidity, Rigidity and Esthetics

QUESTION: Requirement of a major connector? Rigidity

QUESTION: Reciprocating arm of clasp? Stabilization
QUESTION: Reciprocating arm Counteracts the effects of direct retainer
QUESTION: Purpose of reciprocal clasp: Stabilization
QUESTION: What does the reciprocal clasp do? Indirect retainer
QUESTION: what does the reciprocal brace do? Counteract retentive clasp, stabalize the tooth, indirect
retainer
QUESTION: Function of clasp arm? both stability (reciprocal arm) and retention

QUESTION: Reciprocal clasp is placed on or above the height of contour

QUESTION: Where does the retentive clasp engage on abutment: passively on the suprabulge,

**Retentive clasp-- gingival third of the crown w/I the undercut (suprabulge)
**Reciprocal Clasp-- middle third of the crown
QUESTION: Retentive clasp is not base metal alloy

QUESTION: Where does the retenetive clasp engage on abutment: passively on the suprabulge? It
exerts a positive direction movement; sits on the height of contour and another was not touch the
tooth at all (engage in undercut to resist removal of prosthesis and to help prevent dislodgement)

QUESTION: What is function of Rest? Support

QUESTION: What is the primary func of rest seats? To resist vertical tissue force (to provide vertical
support for RPD)
QUESTION: the purpose of the rest seat is: prevent displacement

QUESTION: Whats the purpouse of an indirect retainer?-to prevent distal extention from lifting up

QUESTION: What is the purpose of an indirect retainer? It is located on the opposite side of the
fulcrum line . assists direct retainer to prevent displacement of denture base in an offlucsal
direction. Consists of one or more rests, their minor connectors, and proximal plates adjacent to
edentulous areas. Should always be placed as far as possible from the distal extension base.

QUESTION: Function of minor connector? Stability

QUESTION: Main purpose of buccal flange of Mx denture?

A: Stability,

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QUESTION: What does not have an effect on clasp flexibility? Undercut
o Metal, width, and length all have an effect on clasp flexibility
QUESTION: most important in denture retention: intimate tissue contact or peripheral seal
(former)

QUESTION: most important in denture retention: intimate tissue contact or peripheral seal
(former)

QUESTION: The peripheral seal is the most important part of the denture for proper retention

QUESTION: What is the primary retention for mandibular denture? Buccal shelf
- Primary support area = buccal shelf
QUESTION: Primary retention for mand CD? Buccal shelf
QUESTION: Primary stress bearing area in mandible: buccal shelf --
and incase the residual ridge is in good shape it also contributes to primary support.

QUESTION: Primary support for denture Mand: buccal shelf Max: ridge

QUESTION: What is main area of support for distal extension RPD? Ridge, buccal shelf, external
oblique ridge
QUESTION: Primary support for denture max: ridge, 2nd-rugae
QUESTION: mand: buccal shelf, 2nd-anterior lingual border

QUESTION: Best indicator for success of denture is Ridge

QUESTION: Best indicator for success of denture is Ridge
QUESTION: Best indicator for success of denture is Ridge
QUESTION: Primary stability for an edentulous CD on maxillary? Palate and residual ridges.
QUESTION: Definition of a combination clasp: cast reciprocal arm and a wrought wire retentive clasp
QUESTION: Combination clasp: ww and cast Wrout wire, cast wire

QUESTION: What connects major connector with rest seats- Minor connector
QUESTION: What connects an occlusal rest and major connector? -->Minor connector
QUESTION: For bilateral distal extension - indirect retention because it is supported by tissue
QUESTION: How far do we extend a CD: Hamular notch

QUESTION: post extension of post palatal seal is vibrating line: 2mm past vibrating line (fovea
palatini) anterior is distal of hard palate (blow line)

QUESTION: Post extension of post palatal seal is 2mm beyond vibrating line (fovea palatini)

QUESTION: What should you consider when placing peripheral seal?

Tuberosity, throat form,

I eliminated the answer choices that included age of patient?
QUESTION: What does dentist look at before placing palatal seal vibrating line, throat configuration,
tension of tissue throat form, tissue type and fovea location.
QUESTION: Which 3 things determine the posterior palatal seal? throat form, tissue type and fovea
location
QUESTION: Which 3 things determine the posterior palatal seal? I put throat form, tissue type
and fovea location.

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QUESTION: Which of the following best explains why the dentist should provide a postpalatal seal

in a complete maxillary denture? The seal will compensate for

A. errors in fabrication.

B. tissue displacement.

C. polymerization and cooling shrinkage.

D. deformation of the impression material.

QUESTION: Purpose of placing posterior palatal seal: compensates for shrinkage

QUESTION: Excessive depth of the posterior palatal seal usually results in
A. unseating of the denture.
B. a tingling sensation.
C. greater retention.
D. increased gagging.

QUESTION: if the palatal vault is too deep : vibrating line is more pronounced and forward

QUESTION: if the palatal vault is to deep : vibrating line is more pronounced and forward The
higher the vault, the more abrupt and forward is the vibrating line.

QUESTION: If the palate is very deep, what happens to the vibrating line?
More pronounced
Forward
Backward
*From Dr. Nasrs lecture: In the class III variation (of palate forms), there is a high vault in
the hard palate. Soft palate has an acute drop and a wide range of movement. The vibrating
line is much more anterior and closer to the hard palate. This gives a narrow posterior
palatal seal area.

QUESTION: When do you remove palatin torus: Prevents seating of denture and formation of
posterior seal

QUESTION: tori patient without peripheral seal what to do? Remove tori
QUESTION: Patient is going to get dentures and he has palatine tori, why should it be removed? To
increase peripheral seal, Because the mucosa is too small and it will hurt him
QUESTION: Indication for removeing max tori: interferes w/ posterior palatal seal

QUESTION: Palatal tori-when should it be removed?

If undercut-so cant be cleaned
If posterior to vibrating line-interferes with posterior palatal seal
3mm anterior to vibrating line
When denture is created around tori and functions properly

QUESTION: Pt has bilateral max tori. Need to make an upper and lower cd. Tori extends to posterior
palatal seal. What should you do?
-make a post palatal strap

257
 make cd around tori, remove tori and allow to heal, reline denture
*remove tori than make cd
QUESTION: major connector design for large inoperable palatal torus
a. horseshoe
QUESTION: Guy has no upper teeth and palatal tori that extends to soft palate what type of major
connector to use? Horshoe, AP, Palatal strap (unless option to remove)
QUESTION: Reason for splint in palatal torus removal (prevent infxn, flap necrosis, hematoma
formation)
QUESTION: Palatal tori removal....after surgery u splint because helps stop HEMATOMA
QUESTION: Mandibular tori in first premolar and canine
If you were to remove the tori would you have the patient sign an informed consent of lingual nerve
injury
QUESTION: Hinge axis : Face-bow
QUESTION: What does the facebow do? I put translates the relationship of the maxilla to the
terminal hinge axis using a 3rd point of reference
QUESTION: Primary purpose of plaster index of occlusal surface of max denture before removing
the denture from the articulator and cast: Preserve face-bow transfer
QUESTION: what is the plaster index for? preserve facebow record
QUESTION: Why do you use plaster index on mounting for facebow: Preserve face-bow transfer

QUESTION: Why take plaster index? Teeth are then put back exactly in their original position aided
by plaster key
QUESTION: Delivered CD/CD. Why do you take impression of max denture and mount it to
articulator?(clinical remount): so you dont have to take face bow registration again (preserve
facebow)
QUESTION: lab and patient remount? Why are they done- establish and maintain VDO
QUESTION: Why is the WW clasp placed far away from its minor connector?
To have room to solder it on
More retention
QUESTION: What is reason for the altered cast technique when doing an distal extension rpd : I said
it was support but not sure (others were retention, esthetics, etc)

QUESTION: Altered cast technique. The reason for doing this procedure..

The altered cast method of impression making is most commonly used for the mandibular distal
extension partially edentulous arch (Kennedy Class I and Class II arch forms). A common clinical
finding in these situations is greater variation in tissue mobility and tissue distortion or
displaceability, which requires some selective tissue placement to obtain the desired support from
these tissues. This variability in tissue mobility is probably related to the pattern of mandibular
residual ridge resorption. Altered cast impression methods are seldom used in the maxillary arch
because of the nature of the masticatory mucosa and the amount of firm palatal tissue present to
provide soft tissue support. These tissues seldom require placement to provide the required
support. If excessive tissue mobility is present, it is often best managed by surgical resection, as this
is a primary supporting area. Carr, Brown. McCracken's Removable Partial Prosthodontics, 12th
Edition. Mosby, 062010.

258
QUESTION: SIBILANT allow maxillary incisors to nearly touch the mandibular incisors,

QUESTION: fricative sounds are made by allowing the maxillary incisors to nearly touch the
slightly inverted lower lip.

QUESTION: If doing a denture try-in: where wud teeth touch compared to vermilion border when
saying F sound they would just touch ->wet/dry lip line

QUESTION: What cant the patient not say if upper anterior are too superior and forward for denture
teeth? F and V

QUESTION: What do you use to check if VDO and anterior teeth are set correctly for denture teeth?
- F and V

QUESTION: What do you use to check if VDO and anterior teeth are set correctly for denture teeth? - F
and V ** all these file answers say F and V, but when I checked Mosbys it says to evaluate VDO you
make the sound S

QUESTION: Asked about what sound will determine VDO **S sound. This will bring teeth slightly
together with 1-1.5 mm separation. This is the closest speaking space

QUESTION: S, z, and ch sounds the teeth must beclose together, far apart
QUESTION: s/ch/z sounds formed by putting tongue between mx and mnd incisors: th

QUESTION: Denture wearer says S sounds and the post teeth are touching.why? excessive vertical
QUESTION: S, ch, sounds are made: When max and mand ant teeth barely touch Increase VDO,
decrease freeway/interocclusal space, Decrease VDO, increase freeway/interocclusal space

QUESTION: Making F sound teeth touches lip

QUESTION: Have large incisors, difficulty with F sounds

QUESTION: What cant the patient not say if upper anterior are too superior and forward for denture
teeth? **Decks say that placing anterior teeth too far superior and anteriorly make it hard to say F and
V!!!
QUESTION: If the maxillary incisors are placed too far superior and anterior, what is affected? D
and T sounds (D & T are for labial and lingual)
QUESTION: Maxillary anterior teeth too far superior and anterior: F and V sounds

QUESTION: Too labially placed upper anterior teeth. What sounds are hard to say: Fricative (F-V)

QUESTION: After a couple of months of delivery of upper and lower complete, patient complains of
burning of lower lip: Canidida or impingness of mental nerve.

QUESTION: Burning sensation lower denture? impingement of mental nerve

QUESTION: Which denture base is not light cured?? A really weird question. Never seen it before.
And none of the answers were a 100%

a. Pressure formed
b. Injectable molding
c. Some other type of molding

259
 d. Pour or fluid resin technique

QUESTION: Why dont you set denture teeth on the incline up towards the retromolar pad? Youre
impinging on it or because it dislodges the denture

QUESTION: Which of the following explains why mandibular molars should NOT be placed over the
ascending area of the mandible?
A. The denture base ends where the ramus ascends.
B. The molars would interfere with the retromolar pad.
C. The teeth in this area would encroach on the tongue space.
D. The teeth in this area would interfere with the action of the masseter muscle.
E. The occlusal forces over the inclined ramus would dislodge the mandibular
denture.
QUESTION: Why dont put posterior tooth on inclination of ramus? Occlusal forces dislodge

QUESTION: You give patient maxillary denture and they come back with generalized soreness under the
denture. no sore spots or anything visible clinically, what's causing this? allergy, significant
malocclusion(gross occlusal misalignment)

QUESTION: Soreness all along the ridges? Hyperocclusion

QUESTION: Pt has general soreness along ridges from complete denturewhat should you doreline,
adjust occlusion
QUESTION: Generalized maxillary soreness over ridge of a patient that just got a new denture what
is it due to? The options did not help Like excessive interocclusal space, decrease VOD, lack of
interocclusal space

QUESTION: Pt has worn denture for 19 years, now he has a sore on Buccal with swelling what do
you do: refer out, biopsy, cytology, Relieve denture in area and re-evaluate in 2 weeks
QUESTION: If there is a lesion under a denture, relieve the denture and do a follow up
QUESTION: A 6x3 mm white lesion seen under old man wearing a denture for 19 years. Its
aymptomatic. What is first thing done at initial treatment? adjust and check in one week
adjust denture and the observe ,Incision,excision, cytologic Relieve any trauma from
intaglio, watch for 2 weeks, then biopsy, when you biopsy, you can do incisional

QUESTION: you tell patient who has dentures to take off at night - to relieve the bone

QUESTION: What is the main reason for removing complete dentures at night? providing rest to tissues

QUESTION: you tell patient who has dentures to take off at night - to hydrate denture in water (it should
be to rest gum/bone?)

QUESTION: Patient is edentulous and has red upper palate - allergic to denture (it should be dont take it
off when they go to bed)

QUESTION: When tx planning an RPD for a pt what is the first attachment placed on the serveyor?-
analyzing rpd
QUESTION: When tx planning an RPD for a pt whats the first thing you do?- Mount casts. Others, find
undercuts, find abutments, extract hopeless and perio teeth.
QUESTION: best way to eval available space for rests-mounted casts

260
QUESTION: patient has mobile upper anterior maxillary tissue that is inflamed. Before making
new denture you do what? A) gingivectomy, B) apply conditioner to existing denture, C) make
new denture that will immobilze the existing tissue D) something else
QUESTION: pt's max denture made her tissue inflamed and weird, you decide to make her a new
denture after?
a. you place tissue conditioning material in her old denture
QUESTION: Pt. with inflamed abused tissue and needs new cd, what do u do? Tissue conditioning
QUESTION: What appointment do you check for sibbilings sounds? When verifying VDO
(basically at intermaxillary records appointment, another choice was tooth try-in) ?

QUESTION: At what point do you check the proper placement of teeth: At the wax-try in phase

QUESTION: when do you check for syllabus sounds: at the Wax rim try-in appt.

QUESTION: when do you check for silabount sounds : at the try-in appt.

QUESTION: At what visit do you test phonetics in complete denture? Tooth try-in

QUESTION: When do you check phonetics for a CD/CD? Wax try-in

QUESTION: What appointment do you check for sibilant sounds? When verifying VDO (basically at
intermaxillary records appointment, another choice was tooth try-in)
QUESTION: During try-in of denture, check for tongue to do all movements: all working movements

QUESTION: Lingual of a denture, how do u know if its good? want to have a full movement of the
tongue

QUESTION: If teeth on the wax tryin dont occlude like they did on the articulator what do you do?-
Remount, redo teeth and retry!!

QUESTION: A denture tooth falls of y is that? She put down there was some wax that was not removed
QUESTION: Which one of the following is usually an issue for denture patients? Lower denture
(other were maxillary dentures, and some other things)

QUESTION: Saliva and denture, which one is correct? (thin watery)

QUESTION: Retention of denture is impacted by saliva flow

QUESTION: Disadvantage of reduced saliva? Reduced retention

QUESTION: Saliva and denture, which one is correct? Relationship that leads to denture and tissue
adhesion, no relationship

QUESTION: Saliva and denture, which one is correct? No relationship (Of course Im wrong, there is a
relationship that leads to denture and tissue adhesion) **THIN saliva is better and aids in adhesion
QUESTION: Full denture- a lot of saliva better for retention/ worse? Less saliva worse?

QUESTION: Physiologic rest position: When mandible and all of supporting muscles are in their
resting posture, Muscle guided position

QUESTION: no posterior teeth and incisal wear on the anterior-because of absence of posterior
teeth

261
QUESTION: No posterior teeth and anterior incisal edge why? Abcense of posterior teeth

QUESTION: Patient feels fullness of upper lip after delivery of complete denture: Overextended
labial flange

QUESTION: RPD modification- to remove indirect retainer or add lingual palatoplate? It was an
palatal strap and missing some molars and premolars bilateral with circumferential clasps
QUESTION: VDR-Freeway Space=VDO
QUESTION: what happens when Vertical is lost-signs that is reduced VDO
QUESTION: Which position depends on patients posture? I put VDR
QUESTION: what changes with patient posture (sitting up vs laying down) : VDR (other options are
centric relation or vdo and someone else)

QUESTION: What problem causes bilateral angular cheliits: high vertical dimension, low
interocclusal space, high occlusal distance: Low VDO

QUESTION: Angular chielitis unbalanced Centric occlusion, or unilateral decrease VDO

QUESTION: Angular chelitis- increase interocclusal space **angular chelitis associated with overclosure

QUESTION: Angular chelitis is caused by all of the following except:

a. Fungal infection

b. Decreased VDO (causes it, b/c increase interocclusal distance; also cheek biting!!)

c. Increased VDO (causes clicking of teeth)

d. Other options

QUESTION: Patient has short lower face and sagging lips. What should you do? I put increase
VDO

QUESTION: Patient has clicking with dentures instead of saying vertical dimension too high, the
answer choice said something about inadequate resting space
QUESTION: clicking of denture teeth excessive VDO- teeth
QUESTION: Teeth clicking in dentures: excessive vertical dimension
QUESTION: If you hear clicking in denture patient it is due to? excess VDO =too little VDR

QUESTION: Reason for cheekbiting with dentures? inadequate horizontal overjet

QUESTION: Pt wearing a complete dentures pt is cheek biting: posterior teeth set up with no
horizontal overlap.
QUESTION: cheek biting not enough horizontal overlap of posterior teeth, insufficient OVD
QUESTION: You fit new completed denture and the patient complains of cheek bite, what will
you do?
a. grinding buccal of lower teeth
b. grinding buccal of upper teeth
c. grinding lingual of lower teeth
d. grindinging lingual of upper teeth

QUESTION: When find VDO-the max tuberosity touches retromolar pad-what should you do?
Make metal extension on mand RPD

262
 Surgery on max tuberosity
Surgery on retromolar pad
Open VDO

QUESTION: An examination of a complete denture patient reveals that the retromolar pad contacts
the maxillary tuberosity at the occlusal vertical dimension. To remedy this situation, which of the
following should be performed?
Reduce the maxillary tuberosity by surgery.
Cover the tuberosity with a metal base.
Increase the occlusal vertical dimension.
Reduce the retromolar pad by surgery.
Omit coverage of the retromolar pad by the mandibular denture.
QUESTION: Immediate denture and has undercuts and tuberosity, what do you do? Remove
tuberosity, remove both dont remove any?
QUESTION: A patient who has a moderate bony undercut on the facial from canine-to-canine needs
an immediate maxillary denture. There is also a tuberosity that is severely undercut. This patient is
best treated by
A. reducing surgically the tuberosity only.
B. reducing surgically the facial bony undercut only.
C. reducing surgically both tuberosity and facial bony undercut.
D. leaving the bony undercuts and relieving the denture base.
QUESTION: When find VDO-the max tuberosity touches retromolar pad-what should you do?
Surgery on max tuberosity
QUESTION: an examination of a complete denture patient reveals that the retromolar pad
contacts the maxillary tuberosity at the occlusal vertical dimension. To remedy this situation,
which of the following should be performed
a. reduced the maxillary tuberosity by surgery
b. cover the tuberosity with a metal base
c. increase the occlusal vertical dimension
d. reduce the retromolar pad by surgery
e. omit coverage of the retromolar pad by the mandibular denture.

QUESTION: When making a denture base, the hamulus is too close to the retromolar pad ? Surgery, don't
put base on hamulus don't put base on retromolar pad or increase vd?

QUESTION: In an edentulous patient, the coronoid process can

A. limit the distal extension of the mandibular denture.

B. affect the position and arrangement of the posterior teeth.

C. limit the thickness of the denture flange in the maxillary buccal space.

D. determine the location of the posterior palatal seal of the maxillary denture.

263
QUESTION: When taking impression and patient is open what can interfere with fully seating- coronoid

QUESTION: coronoid process displace upper denture if : too bulky at max distobuccal

QUESTION: Coronoid when open mouth can dislodge denture (mand denture=masseter)

QUESTION: Open mouth while maxillary border molding- Coronoid process will block buccal
extension

QUESTION: best way to prevent speech problems in complete dentures keep teeth in same position
QUESTION: Dentist mounted maxillary cast without using facebow, but now wants to increase
vertical dimension 4mm: open articulator 4mm, get new CR, take new facebow, lateral movements
QUESTION: If you want to increase patients VDO by 4mm, what do you do? - I said take new CR (other
choices were take new facebow, adjust articulator, etc)
QUESTION: Need to increase vertical dimension by 4mm in denture patient. How do you do it?
Increase VDR, retake CR, change condylar angulation

QUESTION: new CR if you raise a pin if 4mm

QUESTION: Cd/cd and want to open bite 4mm? take new centric relation
QUESTION: What to do if you increase VDO after mounting? New bite registration and remount
QUESTION: Made pt denture which shows to much of max teeth. There are 3 mm of freeway space.
What would you do?
lift up occlusal table
*?decrease VDO (not sure about thisbecause the freeway space doesnt seem excessivewould seem
like the only solution is remake the CDXtina)
QUESTION: you are correcting the VDO of a patient, your articulator emminentia is set at 20 degrees, you
later correct it to 45 degrees. What do you do next? Adjust bennet angle, new centric relation record,
increase the VDO, others? Decrease incisal guidance, or increase compensating curve. Bennet angle
is calculated using condylar incline so you can adjust bennet angle too
QUESTION: if denture teeth were set to a 20 degree condylar setting when the teeth need to be at 45
degrees, what will need to be changed?
Incisal guidance increased??
Posterior cusps decreased
Increase compensating curve
DECREASE INCISAL GUIDANCE (to compensate for increase in condylar guidance)

(Steep condylar path requires steep compensating curve, and decreased incisal guidance)
QUESTION: The condylar guidance is increased from 20 to 45 degrees,what do you do.

Increase the compensatory curve

the curvature of alignment of the occlusal surfaces of the teeth that is developed to compensate for
the paths of the condyles as the mandible moves from centric to eccentric positions.

A means of maintaining posterior tooth contacts on the molar teeth and providing balancing
contacts on dentures when the mandible is protruded.

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Corresponds to the curve of Spee of natural teeth.

QUESTION: Setting condylar inclination on articular using protrusive , what do with the pin?
Remove the pin (lift up)

QUESTION: incisal guide pin position while checking protrusive,why (determine condyle guidance)

QUESTION: purpose of incisal guidance,mount casts..? adjust condylar guidance ..begin prep

QUESTION: Reason for Incisive guide table?. Anterior guidance

QUESTION: When making a guide table.Lift the pin up about 2 mm
QUESTION: What is the best way to preserve the anterior guidance? translating the horizontal and
vertical relationship onto the incisal table
QUESTION: What is the best way to preserve the anterior guidance? I put something about
translating the horizontal and vertical relationship onto the incisal table
QUESTION: How to determine the angle of the incisal table? By the horizontal plane (occlusal plane)
of occlusion and a line in the sagittal plane between incisal edges between maxillary and
mandibular central incisiors.
QUESTION: Which plane is most important on anterior guidance.: Horizontal/occlusal

QUESTION: pt with class III will lhave the mandibular incisal angle? Increased, decreased

QUESTION: Another case, lower natural anterior teeth, upper PFM anterior teeth. Lowers had incisal wear
facts, what do you think this is due to? Heavy incisal guidance (this was the most logical answer, as
PFM vs natural teeth, natural teeth wear off)
QUESTION: Same patient from #56, a picture of him doing incisal guidance, what is this patient doing?
Incisal guidance (lower teeth and upper teeth were at edge to edge position)
QUESTION: Same patient as question 56 and 57, when he does anterior guidance, what is happening to
the TMJ? Rotational (I was wrong, its translation!)
*anterior guidanceTMJ TRANSLATES!

QUESTION: A patient presents for try-in evaluation of balanced occlusion of complete maxillary and
mandibular dentures. A dentist notes that protrusive excursion results in separation of posterior
teeth. This dentist can best correct this problem by

A. changing the condylar inclination.

B. increasing the incisal guidance.

C. increasing the compensating curve.

D. using a flat plane cusp for the posterior teeth.

QUESTION: Protrustion denture causes dislodging. Change condylar inclination increase

compensating curve!!

QUESTION: Reline for Kennedy class one: Make sure rpd is seated
QUESTION: First step in religning a distal extention denture you must first- try in the framework

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QUESTION: In Max CD opposing Mand bilateral distal extension (Kennedy class 1) why is the
anterior of the wax rim beveled? I put because the length is good esthetically but there is not
enough interocclusal space @ that length.
QUESTION: Beveling on upper occlusan rim due to? length is adequete for esthetics but inadequete
interach space

QUESTION: Patient has occlusal rims prepared and bevels the max,why?
-VDO and lenght of max occ rim was adequate
-vdo was incorrect bur length of occ rim was adequate
-Always bevel max occ rim
-Lengh of occ rim as adequate but vdo was wrong

QUESTION: How should distal extension RPD fit in comparison to other RPDs? Passive clasp fit
QUESTION: Which one of the following is usually an issue for denture patients? Lower denture (other
were maxillary dentures, and some other things)

QUESTION: what is the best way to treat a tooth supported lower denture? Use metal copings to
cover teeth
QUESTION: Retruded tongue habit with full denture means what?- difficulty swallowing

QUESTION: Retruded tongue habit with full denture means what?- difficulty swallowing

QUESTION: Denture border sitting on what muscle due to its orientation of its fiber: I think its
masseter.

QUESTION: Posterior buccal extention of a mandibular complete denture is limited by : Masseter

muscle

QUESTION: Posterior buccal extention of a mandibular complete denture is limited by: Masseter
muscle

QUESTION: What muscle can u impinge on with denture- maseteer, medial pterygoid, or lateral pterygoid
QUESTION: The denture base completely covers what muscle

a. Medial pterygoid
b. Lateral pterygoid
c. Masseter
d. Buccinator

QUESTION: The denture base completely covers what muscle

a. Medial pterygoid
b. Lateral pterygoid
c. Masseter
d. Buccinator (Fibers of buccinator and buccal shelf)

QUESTION: what muscle covers dentures flanges and no affect stability : Buccinator- the
buccinators does not affect stability!!

QUESTION: Which muscle will not interfere with the denture base?
Buccinator
Lateral pterygoid

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 Masseter

QUESTION: lower denture impression lingual area muscle mylohyoid

QUESTION: Which muscle helps border bold in the posterior lingual flange? Mylohyoid was the
answer. Other muscles that help are: palatoglossus, superior pharyngeal constrictor, genioglossus
(lingual border of mandibular impression)
QUESTION: lingual flange on lower complete is around which muscle? Geniglossus, medial
pterygoid, lateral pterygoid, mylohyoid.

QUESTION: man. Lingual flanges are affected by

geniglossal
mylohyoid
QUESTION: Mand CD interfere with what muscle in lingual side?
Mylohyoid.
QUESTION: What determines lingual border of Mandibular impression? BOTH Superior Pharyngeal
Constrictor/mylohyoid muscle and buccal is masseter.
QUESTION: lower denture impression lingual area muscle mylohyoid / superior pharyngeal
constrictor / palatoglossus, genioglossus

QUESTION: What muscles help in retention of lower complete denture : palatoglossus , superior
pharyngeal constrictor, mylohyoid and genioglossus.

QUESTION: Denture outline in border molding affected on the lingual of mandible by what?
Superior constrictor, palatoglossis, genioglossis, mylohyoid

QUESTION: Border molding of lingual mandibular portion done by what movement? Wetting of lips
with tongue

QUESTION: you would relieve a mandibular denture in the area of the buccal frenum to allow which
muscle to function properly? Buccinator? Orbicularis oris

QUESTION: pt presents with a restricted floor of the mouth, only 6 mandiblar anterior teeth and
diastama b/w several teeth, which of the following major connector is appropriate for this pt: a
lingual plate with interruptions In the palate at the diastemas

QUESTION: RPD rocks when you apply pressure on either side of fulcrum line, why? Indirect
retainer
QUESTION: RPD pops off when press on one side inadequate indirect retainer

QUESTION: Insufficient indirect retention on RPD when what happens?

A: Distal extensions lift away from mucosa
QUESTION: Edentulous bilateral and rocking of denture- inadequate seating of denture or
inadequate indirect retainers.
QUESTION: What happens when no indirect retainer on distal extension: see distal extention pop
up off of tissue

QUESTION: With mandibular bilateral distal extension RPD, when you place pressure on one sides the
opposite side lifts and vice versa, what is the problem?

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 a. no indirect retention used
b. rests do not fit
c. acrylic resin base support
QUESTION: Why is there a tissue stop under distal extension rpd acrylic resin

QUESTION: Pt complains it feels loose from a new bilateral distal extension RPD. Why? I put retainers
are passive on the abutments they should fit passive .Thin flanges bases, Occlusion , Indirect retainer

QUESTION: Pt comes in w/ new bilateral distal extension RPD thats loose. Why? I put retainers
are passive on the abutments. (retainers are supposed to be passive)

QUESTION: Pt comes in w/ new bilateral distal extension RPD thats loose. Why? Deflective
Occlusal contacts

QUESTION: Lower denture is loose whats wrong with it? (over extended, under extended????

QUESTION: Distal extention lower rpd u push on that area and the indirect retainer rest comes up.how
do u tx?
Reline (if its excessive altered cast)
Tell them to use denture adhesive
Tighten clasps
QUESTION: multiple failures in FPD : poor framework design.

QUESTION: Breaking clasp? Poorly designed something

QUESTION: The main reason of breaking of RPD clasp?
High Mudule of Elastisity
work Work Hardening
QUESTION: What property of rpd framework will limit adjustments of clasps?
a. Yield strength?
b. Ductility
c. Stiffness
QUESTION: What mechanical property effects permanent composition for RPD clasps yield strength

QUESTION: Why do you use canine for incisal rest: esthetics, surface area, cingulum

QUESTION: Base metal: Long span bridge

QUESTION: Pt comes in w/ interim; if u fabricate cast partial, how is it gonna be different?

Aesthetics of teeth, retention, resistance to occlusal loading, etc. (agus answer: resistance to
occlusal loading cuz interim doesnt have rest seats)

QUESTION: Which of the following explains why a properly designed rest on the lingual surface of a
canine is preferred to a properly designed rest on the incisal surface?

A. The enamel is thicker on the lingual surface.

B. Less leverage is exerted against the tooth by the lingual rest.

C. The visibility of, as well as access to, the lingual surface is better.

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D. The cingulum of the canine provides a natural surface for the recess.

QUESTION: How do you protect roots under an overdenture RCT with cast copings,
QUESTION: What is not important for over denture? clinical crown size
QUESTION: Which teeth roots to retain under overdentures? PICK roots from dense bone areas.. Such as
Mandibular Canine
QUESTION: Overdenturehow do you choose which teeth to retain?...which is most importantno freaking
cluebased on crown, # roots, location etc Pref = canine premolars incisors molars
Bilateral, symetrrical, with healthy attached gingiva, adequate perio support (>1/2 root in bone), limited/no mobility

QUESTION: A patient has acromegaly and needs dentures. Which denture will not fit?
Maxillary
Mandibular
QUESTION: which of the following is the endocrine involvement that is related to jaw deformity:
Acromegaly
QUESTION: If acromegaly is not controlled, lower jaw protrudes
QUESTION: Which of the following is the endocrine involvement that is related to the jaw deformity?
a. acromegaly
b. cherubism
c. Albrights
d. pagets
QUESTION: Denture patient with a big ball around canine and premolar
neurofibroma
QUESTION: First sign of increased (we think in reference to VD) occlusion? TMJ, myofascial,
attrition, abfraction

QUESTION: After surveying and designing which is the first step to do? reduction the axial for
proximal plate

QUESTION: In which is a direct retainer very important? Kennedy class 2

QUESTION: Describes a denture with bilateral edentulous space anterior to natural teeth. Kennedy
class 4

QUESTION: Which type of kennedy classification doesnt have a modification? Kennedy Class IV**
QUESTION: which kennedy class has no modification-Class IV
QUESTION: Chromium for corrosion resistance
QUESTION: What prevents corrosion on a noble metal? Chromium or nickel
QUESTION: What is expected from a high noble metal? No tarnish or corrosion??
QUESTION: RPD denture frame what metal causes allergy, nickel, chromium , cobolt and copper
QUESTION: Allergy mostly to nickel
QUESTION: Metal most likely to cause allergic rea3ction NICKEL

QUESTION: Which metal is responsible for allergic reaction? Nickel or cobalt? I THINK NICKEL

QUESTION: KELLY Syndrome=Combination syndrome (CS). pt with completely edentulous

maxilla and partially edentulous mandible with preserved anterior teeth, consists of severe anterior
maxillary resorption combined with hypertrophic and atrophic changes in different quadrants of
maxilla and mandible.

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QUESTION: Which is not a symptom of combination (Kelly) syndrome? Increased VDO
(class I mandibular RPD vs. Max CD, bone loss in anterior maxilla, overgrowth in max tuberosities,
papillary hyperplasia of hard palate, supraeruption of mandibular teeth, bone loss beneath distal
extensions: Xtina, First AID)
QUESTION: Guy has treatment plan that is going to be combination syndrome so what is the
ultimate goal when you make his cd upper and rpd lower: balanced occlusion on both anterior
and posterior teeth of mouth during centric relation;

QUESTION: Guy has treatment plan that is going to be combination syndrome so what is the
ultimate gola when you make his cd upper and rpd lower: I said you want balanced occlusion on
both anterior and posteror teeth of mouth during centric relation; (other option was wanting
balanced occlusion (didnt mention ant vs post teeth, during excursive movement)

QUESTION: Combination syndrome = Kelly syndrome : Pt with maxillary complete denture

retained mandibular anteriors and not lower RPD . Pt shows : denture anteriors teeth doesnt show
, flabby anterior ridge , tuberosities flabby and enlarged, lower anterior teeth extruded above plane
of occlusion and atrophy of lower posterior ridge.

QUESTION: Pt has flabby anterior tissue

Caused by combination syndrome
Causes decreased VDO
QUESTION: Combination syndrome = Kelly syndrome
1)denture anteriors teeth doesnt show ,
2)flabby anterior ridge ,
3)tuberosities flabby and enlarged,
4)lower anterior teeth extruded above plane of occlusion and
5)atrophy of lower posterior ridge.

QUESTION: A flabby, maxillary anterior ridge under a complete denture is frequently associated
with
A. V shaped ridges.
B. Class II patients.
C. osteoporosis.
D. retained natural mandibular anteriors.

Down Syndrome/Birth Problems:

QUESTION: Down syndrome patients have small maxillas and midface deficiency
QUESTION: DOWN syndrome:
they dont have more caries
QUESTION: Trisomy 21 face: Low Caries Risk

QUESTION: Trisomy 21

o Down syndrome
o Mandibular prognathism
o Thickened tongue (macroglossia)
o Class III profile

QUESTION: Down syndrome : midfacial hypoplasia

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QUESTION: Downssyndrome: trisomy 21, which is a description ? small mandible Mid Facial
discrepency

QUESTION: Trisomy 21 (Down syndome)

Manifestations
Mid-face deficiency, Class III
Delayed eruption
Super-numerary teeth
Does not have a higher chance of caries
HIGHER chance of periodontal disease

QUESTION: What orthomanifcastion does Turner syndrome and trisomy 21 associated with? short
midface

QUESTION: What is telurism- eyes wide apart--- example Crouzans Disease (gorlin and down
syndrome for extra info)
QUESTION: What is hypertelorism-
Wide-set eyes (seen in Crouzon, Cleidocranial dysostotosis, GOrlin Sydrome,)
QUESTION: Hypertelorism definition: Increased distance between eyes, or other body parts
QUESTION: asked of definition of hypertolerism increased distance between eyes.
(crouzons)

QUESTION: Which does NOT result in delayed development:

Trisomy 21, Trisomy 18, Hurler Syndrom (mucopolysaccharides), Cru di Chat
QUESTION: which one doesnt show late development trisomy 18(Edward syndrome),
Edwards syndrome (also known as Trisomy 18 [T18]) is a genetic disorder caused by the presence of
all or part of an extra 18th chromosome.
some physical malformations associated with Edwards syndrome include small head (microcephaly)
accompanied by a prominent back portion of the head (occiput), low-set, malformed ears,
abnormally small jaw (micrognathia), cleft lip/cleft palate, upturned nose, narrow eyelid folds
(palpebral fissures), widely spaced eyes (ocular hypertelorism), drooping of the upper eyelids
(ptosis), a short breast bone, clenched hands, choroid plexus cysts, underdeveloped thumbs and/or
nails, absent radius, webbing of the second and third toes, clubfoot or rocker bottom feet, and in
males, undescended testicles.[3][4] (sheshe added this)
Cri du chat syndrome, also known as chromosome 5p deletion syndrome, 5p- (said minus)
syndrome or Lejeunes syndrome, is a rare genetic disorder due to a missing part (deletion) of
chromosome 5.

QUESTION: Fetal alcohol syndrome

anencephaly, mid face deficiency, cleft lip
QUESTION: How it looks in a kid fetal alcohol syndrome? -midface deficiency

QUESTION: Fetal alcohol syndrome causes cleft lip

QUESTION: Teratogen definition: anything that messes with the fetal development
QUESTION: What causes problems in babies in emryo? Teratogens (Any agent that can disturb
the development of an embryo or fetus) Carcinogen
QUESTION: teratogenic definition - cause deformity / birth defects
QUESTION: Definition of teratogen: Any agent that can disturb the development of an embryo or
fetus. Teratogens may cause a birth defect in the child. Or a teratogen may halt the pregnancy outright.

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Bone & Sutures:
QUESTION: Epiphyseal plate is most like a synchondrosis
QUESTION: what resembles epi plate: synchondrosis

QUESTION: What age does the mandibular symphisis close: 6-9 months

QUESTION: Sphenooccipital synchondrosis: cartilage*

QUESTION: Sphenooccipital closurewhat kind of tissue fills it in its cartiledge

Interstitial growth occurs by the mitotic division and deposition of more matrix around chondrocytes
already established in the cartilage.
Ex CONDYLE, nasal septum, and spheno-occipital snychondrosis

QUESTION: Sphenooccipital synchondrosis: cartilage* or bone

QUESTION: which of these undergo suture closure latest?

sphenoethmoidal
Sphenoccipital
Intrasphenoid
Intraoccipital
QUESTION: What is synostosis? ABNORMAL FUSION OF BONES
QUESTION: synostosis definition:
(abnormal fusion of neighbor boneswikiXtina)
QUESTION: What is craniosynostosis? Early closure of suture

QUESTION: What is synostosis?

Abnormal fusion of two bones. Craniosynostosis is early closure of a suture between
bones.
QUESTION: What is synostosis?
Abnormal development of a joint.

QUESTION: Synostosis (fusion of 2 bones)- CROUZON

QUESTION: Patient w/ deficient synostosis mid-face, proptosis,? Crouzon syndrome
Synostosis means fusion of two bonesproptosis) - a bulging of the eye anteriorly out of the orbit
QUESTION: Patient w/ deficient mid-face, proptosis, etc? I put Crouzon syndrome, Could also
be Apert Syndrome
QUESTION: Ocular proptosis, max hypoplasia, premature suture closing? treacher-collins, crouzon,
Pierre robin, cleido cranial
BEATEN METAL SKULL

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Crouzons syndrome
The most notable characteristic of Crouzon syndrome is cranial synostosis, as described
above, but it usually presents as brachycephaly, which results in the appearance of a short and
broad head. Exophthalmos (bulging eyes due to shallow eye sockets after early fusion of
surrounding bones), hypertelorism (greater than normal distance between the eyes), and
psittichorhina (beak-like nose) are also symptoms. Additionally, a common occurrence is
external strabismus, which can be thought of as opposite from the eye position found in Down
syndrome

QUESTION: Hurler and Hunters syndromes- what do they have in common? They both have
mucopolysaccaridosis- build up of GAGs
HURLER SYNDROME = also known as mucopolysaccharidosis type I (MPS I), Hurler's disease, also
gargoylism, is a genetic disorder that results in the buildup of glycosaminoglycans (formerly known as
mucopolysaccharides) due to a deficiency of alpha-L iduronidase, an enzyme responsible for the
degradation of mucopolysaccharides in lysosomes
HUNTERS SYNDROME = It is a result of a defect in anchoring between the epidermis and dermis,
resulting in friction and skin fragility
Both are lysosomal storage diseases

QUESTION: Hurler and Hunters syndromes- what do they have in common? They both have
mucopolysaccaridosis- build up of GAGs

QUESTION: Hunter-hurler syndrome, mucopolysaccaridosis is buildup of glycosaminoglycans

QUESTION: Hunter-Hurler is mucopolysacchrides

QUESTION: Mucopolysaccharosis is a common finding in Hurler and Hunter syndrome

QUESTION: Hunter syndrome has what?

Lysosome storage disease. Get abdominal hernias, ear infections, colds, prominent forehead, enlarged
tongue, mental retardation.
Type of MCUOPOLYSACCHARIDOSIS
X-linked, appears @ 1-2 yrs of age, clear corneas, growth retardation, stiff joints, mental retard
QUESTION: hunter syndrome : build up of glycosaminoglycan due to lack of an enzyme : enzyme
iduronate-2-sulfatase (I2S).
QUESTION: Hurlers Syndrome? genetic disorder that results in the buildup of mucopolysaccharides due
to a deficiency of alpha-L iduronidase, an enzyme responsible for the degradation of

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mucopolysaccharides in lysosomes. Without this enzyme, a buildup of heparin sulfate and dermatan
sulfate occurs in the body.

QUESTION: 15 yr old edentulous and keratosis on hands and feet.

Papillon Lefevre syndrome ***Think PERIO + PALMOPLANTAR KERATODERMA********* ugly
pic of thick soled FOOT GROSS!wiki it
QUESTION: What is PapillonLefvre syndrome? You get periodontitis, keratosis on hands and soles, and
premature loss of primary teeth.
QUESTION: Hyperkeratosis in hands and feet Papillon-Lefevre Syndrome
QUESTION: Hyperkeratosis in hands and feet Papillon Le-Favre Syndrome this also cause
severe periodontal disease which cause primary tooth loss by the age of 4 and permanent
tooth loss by the age of 14
QUESTION: Papillon-Lefevre syndrome -basic question on hand and feet derm

Pierre Robin Syndrome = micrognathia, occurring in association with glossoptosis, cleft palate, and
absent gag reflex.
QUESTION: Pt. has glosoptossis (downward displacement or retraction of tongue), Mn
micrognathia, and cleft palate?
A: Pierre-Robin Syndrome
QUESTION: triad of glossoptosis, mand. Retrognathia, and cleft palate? Pierre Robins?
QUESTION: Glossoptosis = refers to the downward displacement or retraction of the tongue
QUESTION: Glossoptosis micrognathia - cleft palate? Pierre,Robin syndrome
QUESTION: Triad of cleft palate, glossoptosis and absent gag reflex. What is it? Pierre-Robin
Syndrome

QUESTION: Sturge-Weber syndrome? vascular malformation, eye and hemangioma Port-

wine stain

QUESTION: Sturger webber syndrome : Port Wine Stain.

*Sturger WebberPort Wine stain
QUESTION: Sturge Weber syndrome port wine stain; Angiomatosis of leptomeninges

QUESTION: alveolar bone is open over root, this is: fenestration, dehiscence ( I put fenestration, b/c
dehiscence refers to wounds according to wiki)
QUESTION: What is it called when you have a hole in the bone that exposes the root? Fenestration
QUESTION: Dehisense defined as? The loss of buccal or lingual bone overlying a tooth root.

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QUESTION: Dehiscence? The loss of the buccal or lingual bone overlaying the root portion of a tooth,
leaving the area covered by soft tissue only.
QUESTION: Dehiscence - dehiscence is loss of alveolar bone on the facial (rarely lingual) aspect of a
tooth that leaves a characteristic oval

QUESTION: Each of the following osseous defects would be classified as infrabony EXCEPT one. Which
one is this EXCEPTION?
A. A trough
B. A dehiscence
C. A hemiseptum
D. An interdental crater

Thyroid:
QUESTION: Which is not endocrine gland? Parathyroid, thyroid, adrenal, parotid
QUESTION: Which do you give a hypoparathyroid child for normal development of teeth: vit D
Brings in Ca+

QUESTION: Give a kid Vitamin D or calcium for hypoparathyroidism

QUESTION: Thyrotoxocosis symptoms

a. DIAPHORESIS, fever and TACHYCARDIA

QUESTION: Thyrotoxic shock and its symptoms: fever, tachycardia, hypertension, and neurological
and GI abnormalities.

QUESTION: Thyrotoxic pt. manifestation? Tachycardia,

QUESTION: Characteristic of excess thyroid?
A: Hypotension, bradycardia, restlessness, sweating probably due to heat intolerance
QUESTION: Thyroid crisis resembles.
Hyperthyroidism.thyroid storm (thyroid storm is a severe version of thyrotoxicosis)

QUESTION: Symptoms of hypothyroid

QUESTION: symptoms of hypothyroid attack: weight gain, bradycardia, cold, fatigue, constipation
QUESTION: Which endocrine system does thick hair become thin hair: thyroid hypothyroidism
(cretinism in kids and myxoedema in adults)
QUESTION: loss of weight, sweating and fine hair : hyperthyroid
QUESTION: Increase in alkaline phosphotase is related to? Hyperparathyroidism
QUESTION: Increase in alkaline phosphotase is related to? Hyperparathyroidism
QUESTION: the decreased alkaline phosphatase is related to: its hypophosphatasia
QUESTION: Hypophosphatasia leads to a Decrease in Alkp,
QUESTION: What disease causes decrease in alkaline phosphatase? Malnutrition,
hypophosphatasia, hypothyroidism, pernicious anemia

QUESTION: Central Giant Cell Granuloma is seen with pts with which condition? Hyperparathyrodisim
QUESTION: Osteoporosis is associated with which of the following diseases? Hyperparathyroidism

QUESTION: Thyroid drug, which doesn't let iodine bond to hormone? Radiated Iodide (for
hyperthyroidism)
QUESTION: Pheochromocytoma involves thyroid,

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QUESTION: Graves Disease (Hyperthyroidism) - exopthalmos

QUESTION: Thyroid hormone decrease, which drug do you give? Levothyroxine (for
hypothyroidism)

QUESTION: Pt has high cholesterol, hypertention and diabetes, metabolic problem, which does he
have: metabolic syndrome,

QUESTION: BMI of 36 what syndrome? Overweight always going to pee-; high lipids high
cholesterol; what syndrome? METABOLIC SYNDROME
QUESTION: What other organs would not be effected? Pancreas, colon, thyroid, kidney? THYROID
QUESTION: Blood tests back from together hematocrit, etc.hematocrit again

QUESTION: What is the normal %fat intake per day- 30

QUESTION: Recommended daily dose of fat: 30% of total calorie and saturated fat is 10% of daily calorie
intake

ETHICS & Patient Managament:

Beneficence- Do good.
Patient Autonomy- Self governance.
Nonmaleficence- Do no harm. Dentists are to keep skills and knowledge up-to-date and practice within
their limits in order to protect the pt from harm.
Justice- Fairness.
Veracity- Truthfulness.
LOTS OF ETHICS QUESTIONS: what to say what to do in these situations. If your patient is
looking around a lot at your masks and gloves, safety equipment, whats the most appropriate
response? Some of the answers are vague.
QUESTION: Dentist tells patient amalgam is hazardous veracity

QUESTION: Know veracity: truthfulness: tell patient that he needs to take of amalgam fillings bc
they are not good for his health: not practicing veracity.

QUESTION: If a dentist tells the patient I need to remove all your amalgams because they are
toxic he is violating? I put Veracity
QUESTION: telling truth is veracity
QUESTION: What principle has to do with patient self-governance and privacy? I put autonomy
QUESTION: Informed consent autonomy

QUESTION: Informed consent autonomy

QUESTION: Informed consent figure out if patient is able to understand and sign
QUESTION: Definition of Autonomy - patient choose to sign consent

QUESTION: Dentist lets the patient sign informed consent-autonomy

QUESTION: What you do first before choosing informed consent: make sure patient can sign or has
guardian, consult physician, discuss options with relatives

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QUESTION: 82 y/o pt comes w/ younger person who hands dentist paper saying the pt has a
legal guardian. Now what? I put that you must have consent of this guardian before
treating the 82 y/o pt
QUESTION: 90 year old patient comes in with son who has a document mentioning the guardian of
the patient- must have consent from them to treat the patient

QUESTION: The 16 yr old can take the decisions for the elder pts if: If the elders are deaf and dumb,
if the boy makes thepayment, if the elders are over 60yrs, if the kid has the power of an
attorney
QUESTION: Consent- do not need to discuss the witness signature (I think)
QUESTION: When should patient sign informed consent forms for surgery? I put AFTER there
has been a discussion w/ the dentist about the surgery

QUESTION: inform consent most contain all except : cost of Tx.

QUESTION: Treatment without informed consent is battery

QUESTION: What happen when patient doesn't sign the consent? Battery, health care provider
commits a battery if the provider performs a procedure for which the patient has not given consent.

QUESTION: Dentist keeping up with new data non-malfecence

QUESTION: Something about dentist needs to keep up to date with new technology and learn and
practice new procedures: Non-malfecience

QUESTION: Dentist keeps on current dental medicine to provide current standard of care. What part of
the ethical code does this relate to?
A: Nonmalefacence

QUESTION: Definition of non-malifacence - Knowing your limitations and referring patients out to
specialists
QUESTION: Dentist refers a difficult case to a speacialist-non malfiecence
QUESTION: Reason y we need to CE and know our limitation- forget the name the one where we do no
harm to patient (non-malfiecense)
QUESTION: Dentist keeps on current dental medicine to provide current standard of care. What
part of the ethical code does this relate to?
A: Nonmalefacence

QUESTION: Like if a child came with a history of aggressive behavior and is crying then should the
dentist show empathy or sympathy or control LOOK BACK **Apathy-indifferent; Empathy-to walk in
their shoes, share the emotional state they are feeling; Sympathy-to be concerned about someone, do not
have to share the same emotional state as them.
QUESTION: Rapport best with : empathy I put: other choices were sympathy, compassion
QUESTION: What best characterizes rapport? Understing patients feeling and talking with
patient

QUESTION: Definition of rapport? mutual openness / harmonious relationship*

Rapport = mutual sense of trust and openness between individuals that, if neglected, compromises
communication.

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QUESTION: A successful practice is built on- friendship COMMUNICATION? Good clinican-patient
relationship
QUESTION: what is the best to communicate with patient- apathy, empathy, or some other stuff
QUESTION: to show empathy you dont need which of these? An imagination, understanding.... I dont
remember what I put down though...
QUESTION: Empathy is not: shared personal experiences Imagination, understanding
QUESTION: which does not show empathy to the patient?
a. open-mindedness
b. sharing personal experiences**
c. reflection and showing understanding
QUESTION: Definition of Empathy Patient wanted to give you paperwork, and you acknowledge
their concerns
QUESTION: to paraphrase a question you do not need to agree with it
QUESTION: When should the dentist NOT use paraphrasing? When trying to speak to a patient in his
second language, When the dentist is upset with what patient says, when giving factual values.
QUESTION: When should the dentist not use para-phrasing?
a. When trying to speak to a patient in his second language
b. When the dentist is upset with what patient says
c. when giving factual values
QUESTION: Which statement is NOT correct about Paraphrasing?
to put in your own words its correct meaning of paraphrasing
there were a few other example, but cant remember
Paraphrasing=repeating, in ones own words, what someone has said. This serves to confirm ones
understanding, validate a patients feelings, convey interest in the patients experience (thereby building
rapport), and highlight important points.

QUESTION: Patient complains of pain in relation to a particular tooth.So the best answer/reply of the
dentist would be:
If you came here earlier things would not be bad
If you took more care this would not have happened
I will take care of everything
QUESTION: While the dentist is preparing a large carious lesion in Tooth #30 for a restoration, a
pulp exposure occurs. The patient angrily shouts at the dentist, "You incompetent 'creep'- -you're
responsible for this problem!"- Of the following possible responses the dentist could make, which
one is the most emphatic?
A. Calm down, I can still restore your tooth adequately.
B. Not when I'm preparing a tooth with caries like you had.
C. I can see that you're very upset. You thought the tooth could be restored and
now this problem has occurred.
D. If you took care of your mouth the way you should, I wouldn't have been close to the pulp.
E.I'm sorry this happened, but we must get on with the procedure.
QUESTION: Patient comes in and they say oh I hate the dentist, I hate being here
What would be your response

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QUESTION: if the patient tell you why you fees are so high, what would be your response:??
QUESTION: Pt complains of high fees of dentist, how should the dentist answer? Fee is fine
according to the geographic area, it is fair and reasonable, I have to make a living too
QUESTION: Patient says, Ive been brushing like you showed me but I still have cavities. What do
you do?
a. Go over OHI?
b. Tell him you understand that it is frustrating?

QUESTION: The closest a dentist should get to their patient is? 1. Tap their shoulder
QUESTION: Reason to not have parent in room with dentist and kid- communication barrier
between dentist and child, osha violation, hipaa violation,

QUESTION: Dont have parent in room with child disrupts relationship between child and dentist
QUESTION: Why a parent would be contraindicated from being in the room? barrier to
communication btwn dentist and child

QUESTION: Health behavior: Precontemplation/contemplation/action definition

QUESTION: Pt. says, I do not have time to quit smoking. What stage is s/he in?
A: Precontemplation*, contemplation, action, denial

Operant Conditioning:
o Positive reinforcement : u brush u get sticker
o Negative reinforcement: stop pain from toothache pt realizes he should brush)
o Positive punishment =Aversive Conditioning: everytime u dont brush u have to
clean ur room
o Negative punishment= dont brush no allowance
o Operant extinction= child cries dont give attention

Positive reinforcement- Positive consequence that increases behavior

a. Negative reinforcement- Removal of negative consequence that increases behavior
b. Positive punishment- (adversive conditioning)- negative consequence that
decreases negative behavior
c. Negative punishment- (adversive)- Removal of positive stimulus in order to
decrease an undesirable behavior
d. Basically, know that reinforcement is more effective than punishment because in
punishment, you have resentment, you avoid the punisher, and you are not taught
positive behavior.

Systemic desensitization

a. Relaxing strategy like diaphragmatic breathing

b. Most important component of systematic desensitization is exposure to
fearful stimulus

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QUESTION: MOST of the questions where of behavior modification techniques in children and
what would you say questions
a. Autistic kid, down syndrome
b. Kid that kicks and screams
c. Shy kid

QUESTION: During the child's first visit, the dentist requested that the parents wait in the reception
room. The child cried moderately, but tearfully, throughout the dental examination and
prophylaxis. The dentist "gave her permission" to cry while he/she worked and then took no notice
of her crying. Her crying diminished in intensity over time and then stopped. With respect ONLY to
the crying behavior, the dentist has)
A. used positive reinforcement.
B. used negative reinforcement.
C. extinguished the behavior.
D. ignored the problem.
QUESTION: Pt with manic depression disorder not willing to get treated for that is now getting dental
treatment from you. What do you see in this patient:

A) bipolar b)depression c)excitement

QUESTION: Def of Operant extinction? removal of reinforces to decrease a behavior

QUESTION: How to reduce Stress-dental anxiety? tell-show-do

QUESTION: Emancipated minor: if the kid is under 18, know exceptions of how they become
emancipated minor, page 230

- If he graduated from high schoo, has been married, has been pregnant, or
responsible for his or her own welfare and is living independently of parental control
and support.
QUESTION: How is FACT witness is different from expert specialist? fact witness just determines
the quote pg.231

QUESTION: Behavior shaping: providing positive reinforcement for approximation of behavior you
are desiring
QUESTION: Which describes a stage in Piagets model of congnitive development? I put
preoperational.
QUESTION: A behavior modification device (ie thumb sucking deterant) is an example of: choices
where things like positive or negative reinforcement and other conditioning terms POSITIVE
PUNISHMENT
QUESTION: Patient is given oral habit reducing appliance to prevent an oral habit, what is this
considered? Negative reinforcement (other choices were positive reinforcement, and some other
behavioral modification stuff. My thinking was, the lil dude was probably not going to listen to anyone
about his oral habits, so the appliance is used to modify his little addiction, so if the appliance is in the
way he has no choice but give it up, thus the desired behavior will be increased in the future, fo sho!).
POSITIVE PUNISHMENT

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QUESTION: Patient is given oral habit reducing appliance to prevent an oral habit, what is this
considered? Negative reinforcement POSITIVE PUNISHMENT
QUESTION: 6 year old mentally retarded child.Treatment is recall. Would you give sedation,
antianxiolytic, voice control or positive reinforcement.--- with int. disabledyou want to be short and
brief, explain things, tell-show-do, and REWARD. So I would think positive reinforcement.
QUESTION: What is the best way to treat a developmentally disabled patient? I put consistency
QUESTION: Autistic kids have what characteristic. Repetitive behavior
QUESTION: Autistic behavior: ?? I put they have a desire for physical contact. There was no choice
that they are sensitive to loud noise.

QUESTION: Disable patient comes in and not cooperative, how should you act? Permissiveness
(give patient freedon and treat in the way patient feel comfortable)

QUESTION: Disabled pt, should be treated by flatterness, permissible, consistent

QUESTION: Mentally disabled, approach by dentist? Strict, freedom

QUESTION: patients with autism will usually show?

a. decreased rate of caries
b. heightened sense of lights and sounds
c. the compassion to interact with people
Children with autism are easily overwhelmed by sensory overload. This can cause stimming
(flapping of arms, rocking, screaming, etc). Autistic children are hypersensitive to loud noises,
sudden movement, and things that are felt.

QUESTION: Providing reward for desired behavior: positive reinforcement

QUESTION: Eye contact, smiling, and telling pt doing good job: social reinforcement
QUESTION: Praising, smiling and congratulating is what type? Social reinforcement
QUESTION: Child patient you smile, tell him good job, and pat him on the shoulder. These
are examples of negative reinforcement, social reinforcement, token reinforcement.

QUESTION: If kid complained and whined in the beginning but at the end were very good: you
compliment how well they were at the end of the procedure

QUESTION: Voice control method used with childrens : Aversive conditioning= punishment to
deter unwanted behavior ex Hand over mouth
QUESTION: What is the purpouse of the voice control technique? Sets boundaries Aversive
conditioning

QUESTION: 8 year old patient, 1st time ever, scared of dentist? Whats the most likely answer?
d. Television
e. Parents
f. Tv
QUESTION: If pt is afraid, because of

g. Parents
h. Peers
i. Tv

QUESTION: If child is afraid: Allow the child to express fears

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QUESTION: child with fear is best treated with : nitrous oxide

QUESTION: Desensitization works if the base of the behavior problem is Fear

QUESTION: How do you treat a fearful child- use sedation, let him watch another patient,
QUESTION: Patient is scared bec he has no control what to do- I said tell him to raise his hand if he needs
a break/ you to stop

QUESTION: Dental anxiety can be caused by Pts helplessness. What would reduce it? Telling Pt
to raise her/his hand when feels pain

QUESTION: A kid is on recall appointment and is not cooperative. You should do voice control
followed by? Alternating appraisal

QUESTION: Patient is very young amd fearful first time you meet them try to talk to them going down
at their height.
QUESTION: Patient is very young and fearful first time you meet them try to talk to them going down
at their height.
QUESTION: Patient 2 yrs old and scared ask parent to position patient for you (others were get assistant
to do it, you do it yourself, the point here is knee-to-knee position)
QUESTION: Patient 2 yrs old and scared ask parent to position patient for you (others were get
assistant to do it, you do it yourself, the point here is knee-to-knee position)
QUESTION: The restraining of uncooperative 2 yr child should be done by.Dentist, Assistant, Parent
QUESTION: 2 year old kid, best technique?
Knee to knee with head on dentist lap
Knee to knee with head on parents lap
QUESTION: Patient comes in with 1 year old child, how do you do exam? parent and dentist are
knee to knee, baby's head is in dentist's lap

QUESTION: 8 year old boy, when will he behave better?

Mom inside the dental office
Dad inside the dental office
Nobody inside
QUESTION: pediatric fears correlated with age
QUESTION: what is a 2 yr old most afraid of? 4 yr old?
1-3 yr old: SEPARATION
4-6 yr old: UNKNOWN
QUESTION: Uncooperative 2 year old- separation anxiety
QUESTION: 4-5 year child scared of? unknown
QUESTION: Boy 4 yrs old: afraid of unknown.
QUESTION: You help a child help recognize what they are afraid of and make outward positive
connection:
- cognitive restructuring: is a psychotherapeutic process of learning to identify and dispute
irrational or maladaptive thoughts,
QUESTION: Modeling behavior is used when: when the kid is afraid and use a sibling or
someone older to show how they should behave

QUESTION: What is behavior modeling?

QUESTION: Patient had a flu shot done and she is afraid of dental needle even though she never had
one: what is term called (generelaization vs transference idk what answer was)

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QUESTION: A patient is going to the dentist and has never had local anesthetic. He recently got a
vaccine and is now afraid of needles.The fear is due to what?
Location
Generalization?
Translation

QUESTION: When pt say I have anxiety to pain from needle when flu needle fear is extended to dental
needle fear means general anxiety/specific anxiety

QUESTION: A 4 yr old child management-ANS .empathy and respect

QUESTION: Management of moderately apprehensive child

QUESTION: Replacing words like LA with sleepy juice is called as Euphamism (relabeling)

QUESTION: classic condition, which is an example? pain (as in, you see dentist, you assume pain is
coming
QUESTION: classic condition, which is an example? pain (as in, you see dentist, you assume
pain is coming
What is an example of stimuli in classical conditioning: DEntist (all others were responses)

QUESTION: What is an example of stimuli in classical conditioning: dental chair (all others were
responses)

QUESTION: What is conditioned stimulus with pt that had previous bad experiences: --dental chair
(dentist)
QUESTION: What is conditioned stimulus with pt that had previous bad experiences: --dental chair
QUESTION: Conditioned stimulus?
a. Dental chair
b. High blood pressure
c. Fear
d. Anxiety
QUESTION: Def of Operant extinction? removal of reinforces to decrease a behavior
Fear: results from anticipation of a threat arising from an external origin.
Anxiety: results from anticipation of a threat arising from an unknown or unrecognized origin.
Anxious patients: most difficult patients as they often cause the dentist to become anxious as
well.
QUESTION: Difference between fear and axiety- fear is on something anxiety is everythin (harder to treat)
Fear decreases pain and anxiety increases pain, fear is painful, anxiety is a disease, Fear is local,
anxiety is generalized
QUESTION: What do Freud and the other guy say about anxiety? I put something about how its
a part of personality that must be controlled to be socially acceptable. Probably wrong.
QUESTION: Define anxiety according to Freud and K- aversive inner state that people seek to
avoid or escape.
QUESTION: What do Freud and Erikson say about anxiety? I put something about how its a part of
personality that must be controlled to be socially acceptable. Probably wrong. Their inability to overcome
a conflict in a particular stage that will lead to anxiety. Inadequate resolution ->Anxiety

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 An inadequate resolution in this case would Indicate a child's insecurity and anxiety. An
Adequate Resolution would mean that a child was able to overcome the conflict in each stage and
develop properly. This applies similarly to the other 8 stages.
QUESTION: Freud anxiety concept
D. Kid overcomes it

QUESTION: Patient has dental fear, what is most likely due to? previous traumatic dental procedure.
QUESTION: what would most cause a man to have anxiety: traumatic past experience, or finances,
peers, unpleasent staff
QUESTION: Patient has dental fear, what is most likely due to? previous traumatic dental procedure.
QUESTION: constantly exposing the pt to get from the fear factor is---desensitation
QUESTION: Impending doom: panic attack, fear, anxiety, pain
QUESTION: Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear
of losing control.
QUESTION: Impinguing doom
panic attack
QUESTION: What is maturity: Environmentally dependent, environmentally independent
QUESTION: Pedo t 1st visit. Multiple carious teeth on anteriors. During anesthesia is well
cooperative and doesnt cry or move. Once begin tx, begins to cry. What do.
Keep working
Voice control **
More anesthesia **
Oral sed
N20

Included in ADA code of ethics and professional conduct:

Fees (discusses overbilling), Advertising & marketing, ethics (patient values & harm), credentials
(dentist cannot state they are certified in a speciality when theyre not)
Not included: List of credentials needed to be a dentist, licensure
QUESTION: what is not included in the ADA code of ethics?
Licensure by credential
Advertising
Issues concerning pt
Fees
QUESTION: Each of these is covered in the ADA code of ethics except:, advertisement, patient
values

QUESTION: Which one is not covered by ADA code of ethics Advertising (fees)

QUESTION: All of these are included under the code of conduct except: harm, advertising, list of
credentials needed to be a dentist, fees
QUESTION: Something about the code of ethics and what it includes- it did not include snitching on other
dentists that use electronic advertising

QUESTION: What cannot be advertised by a general dentist?

a. Cost

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b. Specialty (obviousno?...Xtina)
c. License agreement

QUESTION: A dentist has an ethical obligation to report a colleague is all situations ... except?

a. working under substance abuse

b. advertising on electronic media

c. abusing patients

QUESTION: What do you not report to the ADA? Reporting an advertisement for a colleague or an
announcement for specialty practice? Principles of ethics and conducts does not cover and you have to
pick one
QUESTION: if you find problems, medical conditions occurring with a certain drug, who do you
contact? OSHA, FDA, EPA,
QUESTION: If there is an adverse reaction to a medication in the office, who do you notify? FDA
QUESTION: allergy to meds or dental instrument - report to FDA
QUESTION: toxic reaction to a medication the dentist most contact : a) FDA b) CDC c) HIPPA d)
OSHA e) EPA.
QUESTION: Asked which statement was correct for HIPPA? Must give privacy form to pt but you
dont need confirmation of receipt, fax and email standard, etc.

QUESTION: Something about HIPAA. Something about a fax machine and who can pick up the
phone and if a patient receipt counts as something.I dont know.

QUESTION: Which example is not discussed in the HIPAA ethical privacy manual??: Something
about providing privacy information to patient and document, sending information over email and
fax, idk

QUESTION: If you need a medical record from your patients physician, your patient needs to give
you a permission to do that. Based on which principal/policy?

I picked Medicaid/medicare bc the choices were CDC, OSHA, bloodborne, some random
nonsense. There wasnt HIPAA
QUESTION: Where does the government spend all its dental money? I put Medicaid.
QUESTION: which insurance have dental coverage medicaid: Medicaid (poor people!!).
QUESTION: What sector of government provides funding for dental care? Medicaid, medicare,
grant, HMO

QUESTION: Who pays MedicAid: States and the federal government share in the cost of Medicaid,
States may pay health care providers directly on a fee-for-service basis or states may pay for
Medicaid services through prepaid, capitated payments to health plans or other entities. Within
federally imposed upper limits for certain services, each state has broad discretion to determine the
payment method and payment rate for services

QUESTION: Who pays for MediCare: federal program that pays for covered health services for
most people 65 years old and older and for most permanently disabled individuals under the
age of 65.

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QUESTION: Government spends most of the money in Medicare. Medicaid, HMO

QUESTION: Medicare cover dental routine care? NO

QUESTION: Medicare is a federal thing that provide health care for elderly . It does not cover
dental. Answer: Both statements are true

QUESTION: Most aid for finance: Medicaid, medicare, and hmo

Pt pays for service fee/insurance pays the rest:
Insurance pays a flat fee/patient pays the rest co payment
Provider is payed per patient not per procedure capitation
HMO limited to selection
PPO allows patient selection
QUESTION: Most of the dental payments are by?- cash for service-67%

QUESTION: Most dental procedures for the elderly are paid for by out of pocket cash
QUESTION: which of the following is the leading payer for dental treatment, Insurance or self pay?

QUESTION: Who pay for most of dental care?

a. government
b. insurance
c. cash (should be this one)

QUESTION: Majority of health service in USA : is private insurance.

QUESTION: who pays most of dental Tx : 56% patients. 33 % third parties private insurance

QUESTION: who pays most of dental Tx : 56% patients. 33 % third parties private insurance
QUESTION: Patient makes $23,000/year, 73yo woman, how should she receive dental care?
Medicaide
Medicare
Private insurance
QUESTION: A 65 yr old lady living on 40k pension per year, wants to get a treatment. She does not have
any other physical abnormality besides tooth pain in her molars. From where does the money covered for
her treatment come from?
a. Medicaid does not cover dental for adults
b. Medicare. - does not cover dental for elders
c. Private Insurance - private dental IF she has it
d. Others insurance.
QUESTION: What is the name of the federal funded medical care for the elderly and its coverage?
a. medicare wI dental coverage
b. medicare w/o dental coverage
c. medicaid wI dental coverage
d. medicaid w/o dental coverage
QUESTION: insurance question about adverse selection (adverse selection deals with the idea that those at
higher risk are more likely to buy an insurance policy. If the price for the policy is the same for non
smokers and smokers, it is more likely that smokers will buy the insurance, because it is more worth it

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to thembecause they are at higher risk for disease. This is adverse to the insurer. So the prices need to
be different.
only take pt with high risk
only take pt with low risk
take both
something about taking pt of all ages
QUESTION: Health care plan adverse beneficiary risk
-high risk-individuals that present a high risk for insur
-low risk
-equal

QUESTION: What is capitation? Cap off how much the dentist gets reimbursed per procedure.

QUESTION: Know about capitation: Dentist is paid a fixed fee to see patients enrolled in
program

QUESTION: Capitation= hmo

QUESTION: HMO = capitation dental plan

QUESTION: HMOs dentists are paid a fixed rate for each individual per month. Dentist is paid
regardless patient was seen or not. If value of services exceeds payments, dentists loss. If payment
exceeds value of services, dentists gain.

QUESTION: You work at a HMO office and the patient has used up all his yearly benefits, what can you
do?
a. still accept the same fee under the HMO* this is what I put, but I dont know
b. Charge your regular fee like you would for cash pt
QUESTION: Your office is fee schedule and pt needs new crown but pt used up all of her
allowance (or something like that)? what do you do?

QUESTION: Which one is related to employee insurance, where you get a discount from the insurance and
also you can go to a dentist of your preferance? PPO, HMO
QUESTION: Which one is related to employee insurance, where you get a discount from the insurance and
also you can go to a dentist of your preferance? PPO
QUESTION: Which one is related to employee insurance, where you get a discount from the
insurance and also you can go to a dentist of your preferance? PPO, at the same rate mine
didnt say anything about the company recommending any list of providers who were in in their
preferred plan or not
QUESTION: Insurance allows pt to only see certain set of providers. PPO, HMO, Closed panel
QUESTION: Which one is related to a dental insurance, that only allows you to go to a group of dentists at
a specific location? Closed Panel (other choices were open panels and other things)
QUESTION: Company offers dental insurance to its employees that can go to selected dentist, what
is this example of? Closed planel

QUESTION: Which one is related to a dental insurance, that only allows you to go to a group of dentists at
a specific location? Closed Panel (other choices were open panels and other things)

287
QUESTION: Which one is related to a dental insurance, that only allows you to go to a group of
dentists at a specific location? Closed Panel (other choices were open panels and other things)

QUESTION: On a prepayment basis, dental patients receive care at specified facilities from a limited
number of dentists. This practice plan is classified as which of the following?
A. Closed panel
B. Open panel
C. Group practice
D. Solo practice
QUESTION: Which of the following represents a dental program in which eligible patients receive
services at specified facilities from a limited number of dentists?
A. An open-panel
B. A closed-panel
C. A capitation group
D. A prepaid group
QUESTION: DR is a self-funded group dental plan in which the employee is reimbursed based
on a percentage of dollars spent for dental care provided, and which allows employees to
seek treatment from the dentist of their choice.
1. If Direct Reimbursement is there-- Pick It
QUESTION: If you are an employer and you provide your employee with reimbursements for dental care
they received from a dentist of their choice it is called: direct reimbursement,.

QUESTION: patient goes to the dentist and needs to pay something before seen
-copayment
-deductible
QUESTION: If patient agrees to pay certain percentage of treatment plan:
copayment (vs deductible?) another term

Unbundling of procedures as "the separating of a dental procedure into component parts with
each part having a charge so that the cumulative charge of the components is greater than the total
charge to patients who are not beneficiaries of a dental benefit plan for the same procedure."

Bundling is the exact opposite of unbundling and can occur on the insurance carrier end.
Bundling is defined by the ADA as "the systematic combining of distinct dental procedures by
third-party payers that results in a reduced benefit for the patient/beneficiary."

Upcoding or overcoding is defined by the ADA as "reporting a more complex and/or higher cost
procedure than was actually performed."

Downcoding on the other hand is defined by the ADA as "a practice of third-party payers in which
the benefit code has been changed to a less complex and/or lower cost procedure than was
reported except where delineated in contract agreements."

QUESTION: dentist didn't ask for copayment and he didn't report to insurance - overbilling
QUESTION: dentist didn't ask for copayment and he didn't report to insurance - overbilling
QUESTION: Dentist did not accept a copay and did not report it to the 3rd party (why would any
dentist do this? Over Billing

QUESTION: If a dentist waives the copayment and doesnt tell the third party, what is this called?
OVERBILLING.

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QUESTION: You let patient not pay copay but you tell insurance that you charged the pt
overbilling

QUESTION: Dentist charge for crown $500. insurance only covers $400.Dentist waves copayment($100)
but still let insurance he charges $500 for crown. what this action called?

a.Down coding

b. Overbilling

c.Price fixing

d.Unbundling
QUESTION: Bill out for a core build up and crown and insurance says build up is only covered, what
is this? Bundling

QUESTION: The dentist charges separately for core build up and the crown but the insurance
company says that the core build up is part of crown.what is this called? bundling

Bundleing : many procedure to a crown they only pay u for one

QUESTION: What's downcodinghad example of a dds who did 2 2 surface composites and insurance
made it 1 1 surface comp
QUESTION: Dentist do the treatment for 2 crowns but the insurance company pay the money for one
crown what is it: downcoding
QUESTION: You performed a two surface restoration and coded it that way. Insurance came back with
coding it as only one surface restoration. What is this calleddowncoding, upcoding
QUESTION: When you charge for multiple codes when you actually did one thing unbundle

QUESTION: Doctor billed insurance couple of procedures, when actually there is a global procedure that
combines them all, what did he commit? unbundling
QUESTION: One big procedure, but if you divide it to many sub procedures.. unbundling

QUESTION: Unbundling coding procedures

QUESTION: Bundling --- bundling of procedures: The systematic combining of distinct dental
procedure codes by third-party payers that results in a reduced benefit for the patient/beneficiary
QUESTION: What is it called when a patient charges several procedures instead of one?
a. upcoding
b. downcoding
c. unbundling
d. bundling
QUESTION: Pt asks u to change date of service on insurance claim, what is this called? Fraud

QUESTION: The patient retires and loses health benefits.the treatment is done on the next day.the pt
requests the dentist to enter the previous day date and the dentist does so.what is this called.ANS. Fraud
QUESTION: Whats not the reason for rising dental costs?- the number of dental students in dental schools.
QUESTION: When treating elderly patients what should be your concern?
Health of patient

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QUESTION: Whats true about abuse cases? Youll see at least 2 a year
Child abuse sign
multiple untreated injuries
lag time bt injury and tx
comminuted facial fractures
parents with different stories
Most common in children under 3
QUESTION: It is required mandatory to report all except -child abuse, reaction to drug, one more
choice
Abuses that have to be reported to authorities - colleague practicing with chemical impairment,
colleague advertising on electronic media, child abuse, domestic violence, elderly abuse
QUESTION: You suspect child abuse. Who do you call? I put social services
QUESTION: If there is an old women in ur chair and u think there might be abuse what do you have to
do?- tell family or tell human health services
QUESTION: You suspect elder abuse. Who do you call? I put dept of health and human
services
QUESTION: Which is not true of elder abuse: Most of the elder abuse is at victims home, mostly it is by
victims relative, elders abuse is often over reported and exaggerated,
QUESTION: elderly people abuse question --under reported

QUESTION: which is not true of elder abuse? Most of the elder abuse is at victims home, mostly
it is by victims relative, elders abuse is often over reported and exaggerated, un-authorized
use of ATM card is some times considered crime but not abuse
QUESTION: using ATM card of elder is not applicable but some suitation is not under consideration-
--both true,both false.1st true 2nd flase

QUESTION: Opening a dental practice what makes it more successful: Better communication
QUESTION: Finding out wether a pt is listening: Eye contact
QUESTION: Dentist report most problems with-business/financial issues, staff training, fearful
patients

QUESTION: What do general dentists report as being their biggest issue? I put fearful patients

QUESTION: Pt was bothering the dentist, dentist got upset and assistant drop instruments in the
floor, the dentist was so piss that he had it out with the assistant : how you you call that reaction ?
transference
Transference is a phenomenon characterized by unconscious redirection of
feelings from one person to another
QUESTION: Most eye injury in practice happens to who: dentist, dental assistant, hygienist,
custodian

QUESTION: Personnel most at risk for eye injury-dentist

QUESTION: Least chance of needle injury? Setting up, Cleaning up, Recap

QUESTION: When do you most likely get a puncture wound: Cleaning up

QUESTION: When do most punctures occur? pre procedure, during, post-proceduring cleanup,
needle recapping

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QUESTION: Most injury/percutaneous cuts happen when recapping needles

QUESTION: What test for every year? HepB TB

QUESTION: Dentist can diagnose which of the following? Bellumia

QUESTION: if a pt presents with a problem reflexted in the mouth , how the dentist recongnize the
problem : anorexia, bulimia etc
QUESTION: A patient comes in with rampant decay. What is the primary responsibility of the
dentist? I put figure out etiology of decay FIRST
QUESTION: Patient is in your office for a treatment plan, all of the following should be done when you
explain the proposed treatment to the patient, except? Use professional terminology. (other choices were
the risk of not getting a procedure done, the fee of the procedure, etc)
QUESTION: New patient comes into office, not of record, what do you do 1st visit?
Full exam, record probing, med history, impressions.
QUESTION: First step before/in treatment planning: make sure patient doesn't need translator, consult
with physician about pre-existing medical conditions
QUESTION: Patient is ready to hear your treatment plan, all of the following are true except? Guarantee
the success of treatment!
QUESTION: First step in tx planning is?- treat the initial pain and discomfort of the pt. others, see how
you can make a preventitive plan, treat all restorations.
QUESTION: Proper order for treatment planning emergency care, disease control,
reevaluation, definitive treatment, maintenance care

QUESTION: Which are the two most imp. steps for diagnosis: History and clinical examination

QUESTION: Best way to determine outcome of disease?

Med history of the patient (If the lab test was choose may be that)
ESR lab results

QUESTION: Patient comes to your office, complains about how other dentists did really bad job, and tells
you how you are the best dentist in the world. What mental condition is she suffering from? Paranoia.
(the definition of this is baseless or excessive suspicion of the motives of others)
QUESTION: pt comes in saying shes been to 5 different dentists the last 6 months. A few mins later
shes telling you how great of a dentist you are and that shell refer all of her friends to you. This
example isschizo, narcissistic, paranoid.
QUESTION: Patient comes to your office, complains about how other dentists did really bad job, and tells
you how you are the best dentist in the world. What mental condition is she suffering from?
Borderline, Paranoia.
QUESTION: a patient have been visiting several dentist in the past, the first time she see you she
tells you that she likes you and she will refer family and friends to your office, what type of attitude
is she showing ? borderline
QUESTION: Patient has been to multiple other dentists before you and says you are the best what
does her personality resemble: schizoid, borderline, paranoid, etc

QUESTION: Patient with bipolar disease comes in for dental care, choses not to take his medication
and states he is in the manic phase, what do you expect from treating this patient?: he will have
unpredictable reactions during the treatment, he is will be obsessed about is esthetics (not sure
if it means he is going to be continuously manic or just general bipolar disorder)

QUESTION: Trying to change person what is most importation : trying to determine whether they
are willing to change

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QUESTION: Patient who has medical history but is not debilitating but will require medical
management and dental modifications ASA 3

QUESTION: ASA2- mild systemic disease, ASA3-severe systemic disease

QUESTION: You have a test that is not accurate but gives consistent result: I said this means test is
reliable

QUESTION: Which of the following are necessary for a test to be accurate: Specificity, reliability,
validity

QUESTION: Something about nonverbal vs verbal communication nonverbal is not as reliable

QUESTION: What happened in 1997: SCHIP (state insureane health program)

QUESTION: SCHIP: The State Children's Health Insurance Program provides matching funds to
states for health insurance to families with children. cover uninsured children in families with
incomes that are modest but too high to qualify for Medicaid.

QUESTION: 1997 law passed that state must look after children that cannot afford healthcare - State
Children's Health Insurance Program (SCHIP) AKA Children's Health Insurance Program
(CHIP)

QUESTION: in 1997 there was a program which stated that all childrens needed dental coverage (
even with no insurance ) : how it this call ??? Childrens Health Insurance Program. medicaid

QUESTION: in 1997 there was a program which stated that all children needed dental coverage
(even with no insurance ): Childrens Health Insurance Program. Medicaid
QUESTION: Who is protected under Americans with disabilities act? AIDS pt. and accommodate the
handicapped.
QUESTION: Dentists have to have proper accommodations for disable people. Dentists have to treat
HIV people the same as others. Both statements are true

QUESTION: American disabilities act does not include HIV: False

QUESTION: Disinfecting spray let it sit for 10 minutes and then wipe
QUESTION: One patient left, and before getting another patient, how would you clean your
operatory?

-Gross cleaning, spray disinfectant for 10min, then wipe off

-disinfect every 10 min
-some other choices.. try to pick one that makes the most sense.

QUESTION: Disinfectants- kills mycobacterium (benchmark organism)

QUESTION: Disinfection? Destroy majority of microorganisms but not bacterial spores. Bacterial spores
= benchmark organism for sterilization
QUESTION: Definition of disinfectants Innanimate objects
QUESTION: Definition of disinfectants Innanimate objects non living
QUESTION: Asepsis antisepticcan be safely applied to tissues, but will kill most living organisms
QUESTION: Denaturation of the proteins - alcohol and autoclave; Coagulation of proteins - dry
heat

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 QUESTION: Dry heat, chemical sterilization , know about them. Autoclave, what are the exact
numbers?120 ce, 20 min, 15 Psi

QUESTION: Steam Autoclave: 20 minutes at 121C and 15 psi.

QUESTION: Which method of sterilization needs higher temperature:

steam
dry heat-320
oxide pressure
QUESTION: Temperatures for autoclaves is governed by: FDA
QUESTION: Benchmark for sterilization: =bacillus spores
(I think it is Clostriduim Botulinium) First aid page336)

QUESTION: OSHA
Hep B vaccinated
if employee does not want it need prrof that they didnt get it
QUESTION: What are the hep b vaccine rules by OSHA?- all must always be offered and able to get the
shit

QUESTION: OSHA rule on hepatitis B vaccination

QUESTION: OSHA is for inside the office to see how you handle stuff in the office. EPA is for the
outside.s OSHA IS NOT FOR BOTH INSIDE AND OUTSIDE

EPA is for transferring IN/OUT of the office

QUESTION: Whats not found on the OSHA poster?- How many days each employee is allowed to work
with that chemicals.

QUESTION: Which one applies to OSHA guideline? Update it once a year!

QUESTION: What does OSHA mandate in regards to hep b?
employers must take the vaccine
*employees have to take vaccine that are in contact with pt (I dont think soall
employers are supposed to be offered the vaccine after education of Hep B within 10 days of
employmentXtina)
Front office employees must take the vaccine

QUESTION: OSHA does all except: material safety data sheet MSDS (by manufacterur)
QUESTION: Hazard Communication Standard: Created by OSHA to make sure employees know
about hazardous/toxic materials
QUESTION: HAZARD COMMUNICATION LAW:
a)OSHA
b) what does it control:
sharps
blood
amalgam

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QUESTION: Hazardous communication regulation
a. train worker right after you hire (T/F)
b. train worker when new hazardous product in office (T/F)
QUESTION: OSHA Bloodborne pathogen standard for dentistry HIV and HBV

QUESTION: OSHA-HIV, HBV; bloodborne pathogen standard

QUESTION: MSDS manufacture directions

QUESTION: MSDS-responsible to make it-manufacture

QUESTION: Who is in control of writing the material safety data sheet (MSDS): Manufacturer

QUESTION: Which is NOT a reason for dentist becoming addicted:

Reasons: easy access to and knowledge of drugs, feel the pressure to be perfect, feeling vulnerable
QUESTION: dentist and drug abuse. all are true except: high stress, perfectionist personality,
vulnerability, knowledge and access to drugs
QUESTION: which of the following is not a reason dentists become drug addicts? Stress level, strive for
perfection, access and knowledge of drugs, (some other off the wall answer)
QUESTION: Dentist potential for abuse not likely due to
a. Vulnerability
b. Pressure of being perfect
c. Knowledge and access to drugs
d. Stress

What is t test? used to compare whether the means of two groups are statistically differentassume
that standard deviation is unknown. Small sample size
Z testto see if the means of two groups are statistically different if the variances like standard deviation
are known. Large sample size.
Know questions about Case controlRETROSPECT study. Study that compares people that have the
disease to people that do not have the disease. And also looks back to see how the risk for the disease is
compared to actually getting that disease.
Case-control (retrospective) studies - start with disease and look backwards for exposure
Cohort studystudy where there is more than one sample/cohort, and evaluations are done to see how
certain risk factors the groups have are related to developing a certain disease.
Cohort (prospective) studies - look forward from exposure to disease development
Cross sectional studystudy the entire population. Not like case control, that only studies a certain
group with a specific characteristic. Studies a population with certain characteristics.
Cross-sectional (epidemiological) studies - all variables measures simultaneously at one point in time
Example It was observed that there was less caries in certain geographic areas. Higher fluoride
in water supplies was suspected as the probable cause
Longitudinal studystudies a certain set of people (same people) over a long period of time.
Longitudinal Studies - Hypothesis Testing Observational Studies
Example Hypothesis testing observational studies supported the explanation of increased
fluoride levels causing a reduced rate of caries

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Clinical Trial - Use randomization and blinding to compare effects of treatment with non-treatment. This
is the Gold Standard for establishing cause and effect
Hypothesis Generating Observational Studies
Descriptive studies - time, place, person
Ecologic studies - use groups rather than individuals
Correlation studies - measure linear relationship between two factors within
defined groups, no cause and effect established
Clinical trials: Trials to evaluate the effectiveness and safety of medications or medical devices by
monitoring their effects on large groups of people.
Clinical research trials may be conducted by government health agencies such as NIH, researchers
affiliated with a hospital or university medical program, independent researchers, or private industry.
Typically, government agencies approve or disapprove new treatments based on clinical trial results.
While important and highly effective in preventing obviously harmful treatments from coming to market,
clinical research trials are not always perfect in discovering all side effects, particularly effects associated
with long-term use and interactions between experimental drugs and other medications.
There are four possible outcomes from a clinical trial:
Positive trial -- The clinical trial shows that the new treatment has a large beneficial
effect and is superior to standard treatment.
Non-inferior trial -- The clinical trial shows that that th

what is progressive relaxation

a. intermittent relax & tense (T/F)
b. something about visualized images or something (T/F)

QUESTION: where would you look in an article for the Dependent and Independent Variables :
Methods.

QUESTION: If a dentist is reading an article, where should he look for the definition of dependent and
independent variables? method -introduction- discussion- results summary

QUESTION: Where would you look in a scientific journal to find the dependent and independent
variables
Intro
Materials
Methods **
Conclusion
Summary

QUESTION: Introduction-where in article you find a summary (ABSTRACT)

QUESTION: What section states the purpose of the research? INTRO (ABSTRACT)

QUESTION: double blind q, except - you need 2 controls (you don't)

QUESTION: double blind q, except - you need two controls (you don't)

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QUESTION: What are the qualities of a double blind study except? I put everything EXCEPT 2
control groups.
QUESTION: Researcher wants to find incidence of oral cancer in nursing home what study
a. Cross-sectional

QUESTION: I had one about a teacher and doing a survey on kids = cross sectional

QUESTION: Research done to determine caries rate at a nursing home. What kind of study is this?
A: Cross-sectional

QUESTION: which type of study determines relative risk ratio: Cohort

QUESTION: What parameter study lets you have a risk quotient?- Cohort

QUESTION: What parameter study lets you have a risk quotient?- Cohort
QUESTION: Case control study = odds ratio

QUESTION: Efficacy, what study would u go? Cohort, longitudinal, multiple short ones, CASE
CONTROL
QUESTION: Cohort: studying for the next 10 years

QUESTION: Study among smokers and nonsmokers in a period of 6 years (2000-2006) to develop
disease? Cohort, cross sectional
By: disease/non-disease: case control

QUESTION: study how do you find causation- analytical (cross-sectional, case-control, cohort)

QUESTION: Myestena Gravis patients are involved in a study. The doctor is conducting a study and
is trying to find out how many of these patients has periodontitis. What study is he conducting?
-Cohort
-Study case
-Cross sectional?
QUESTION: Doctor conducting a study on myasthenia gravis patients wants to know how many of
these patients have periodontitis. This is a study case, maybe cross sectional

QUESTION: The problem with this study is that you dont know if the disease came from drinking or
not. What study is it?

By: drinking/nondrinking
Followed a group for 6 years cohort
Gave patients survey about their treatment cross sectional

QUESTION: Dentist is doing research on 5 unrelated patient with different background. He record data
etc. Dentist is doing what kind of research?

a. clinical trial
b. cohort
c. sectional

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QUESTION: Study group A and B give some agents for plaque control then compare which agent is
more effective. Which study is that? Clinical trial

QUESTION: A study is done to determine the affectiveness of a new antihistamine .To do this ,25
allergic pts are assigned to one of the two groups ,the new drug (13 pts) , placebo (12 pts) . The
pts are followed for 6 months . This study is called: Cohort, Cross-sectional, Case controlled,
historical cohort, clinical trial. ( assigned or give is the clue )
QUESTION: A study is designed to determine the relationship between emotional stress and ulcers.
To do this, the researchers used hospital records of pt's diagnosed with peptic ulcer disease and pt.
diagnosed with other disorders over the period of time from july 1988 to july 1998 . The amount of
emotional stress each pt. is exposed to was determined from these records. This study is:
A) Cohort B)Cross-sectional C)Case-study* D)Historical Cohort E)Clinical Trial

QUESTION: There are 4 people with a disease and guy wants to report/describe them: I said ti was
case report but idk

QUESTION: Analyze statistical difference between two means? T-test

QUESTION: Means of caries risk assessment for 3 groups: white, black, Hispanic what test do u use to
compare? t-test A) chi square b) variance c)

QUESTION: How do you compare between 2 constant variables? I put regression analysis
QUESTION: How do you compare between 2 constant variables? CHI SQUARE regression analysis

QUESTION: 2 groups of 100 ppl, gave them different foods & asked how they felt afterwards; which
test to compare the 2 groups answers chi squared test
QUESTION: Want to compare 2 groups of people, male and female for something, what test do you
look at? Multiple regression, Chi square Test, -

QUESTION: Chi test, two common variables

QUESTION: What test measures 2 nonparametric data: Chi-square
QUESTION: Which of these tests are non-parametric? Chi square test
QUESTION: calculating for a non-paramater.what test would you use? Chi-square, normal
distrubition, spearman, wilcoxin, kruskal wallis

QUESTION: Chi test (tests correlation b/w two independent variables)

QUESTION: Two common VARIABLE..what statistical test would you use? Chi-test, T-test,
correlation analysis, or standard deviance

QUESTION: what test for variability variance, standard deviation

QUESTION: Given a case what is the dependent variable? independent variable influences a
dependent variable, or variables. Ie: effect of Temperature on plant growth, temp = independent
and growth; height, weight, # of fruits = dependent

QUESTION: confounding variants? A confounding variable, also known as a third variable or a

mediator variable, can adversely affect the relation between the independent variable and
dependent variable. This may cause the researcher to analyze the results incorrectly. The results

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may show a false correlation between the dependent and independent variables, leading to an
incorrect rejectionof the null hypothesis.

QUESTION: If you have a study of confounding variable? Controlled variables are used to reduce
the possibility of any other factor influencing changes in the dependent variable, known
as confounding variables.

QUESTION: If you have a study of confounding variable minimize confounding variables by

randomizing. minimize confounding variables by randomizing groups, utilizing strict controls, and
sound operationalization practice all contribute to eliminating potential third variables.

QUESTION: Crossover study advantages? influence of confounding covariates is reduced

because each crossover patient serves as his or her own control and are statistically efficient and
so require fewer subjects than do non-crossover designs (even other repeated measures designs).

The null hypothesis (H0) is a hypothesis which the researcher tries to disprove, reject or nullify.
The 'null' often refers to the common view of something, while the alternative hypothesis is what
the researcher really thinks is the cause of a phenomenon.

QUESTION: Experiment wa done and error 0.05 was the goal but when completed it was 0.01. The
question asks what type of error was it?
-type I
-TYPE 2
-no error: Error of less or equal of 0.5 no statistical significance..
*If the observed probability is less than or equal to .05 (5%) the null hypothesis is rejected and
outcome is judged as no effect.in this case the alternative hypothesis is adopted
*If the observed probability is greated than 5% the decision is to accept the null hypothesis and the
results are called not statistically significant.

QUESTION: P-significant value is equal to 0.01, your theory should be right, so you you will reject
null hypothesis

QUESTION: Type I false rejection of null hypothesis (false negative/incorrect regection) = less
dangerous in terms of research and Type II false acceptance of null hypothesis (false
positive/failure to regect) less problematic bc no conclusion is made from a rejected null. But type
2 is more dangerous medically bc a patient is diagnosised as HEALTHY when they actually have the
HIV.

QUESTION: fail to reject, what null? TYPE II error

QUESTION: The power of a statistical analysis is ultimately to:

a. I put reject the null

Type I and Type II Null hypothesis.

Type I Error- rejecting the null hypothesis when it is true. This is an alpha error. Another way to say
this is, to reject a null that should be accepted.

Type II Error- accepting a false null hypothesis. This is a beta error. Another way to say this is, to
accept a null that should be rejected.

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 Null hypothesis (H0) is true Null hypothesis (H0) is false
Type I error Correct outcome
Reject null hypothesis
False positive True positive
Correct outcome Type II error
Fail to reject null hypothesis
True negative False negative

Sensitivity correctly identifying those ppl who have dx

Specificity correctly identifying dx free people

specificity, tn/tn+fp
Sensitivity tp/tp+fn
FN= false negative
FP= false positive
TP=sensitive
TN=Specific
sensitivity = percent of persons with the disease who are correctly classified as having the
disease
True Positive-Those that actually have it
False negative- Those that are misdiagnosed as not having it

specificity = percent of persons without the disease who are correctly classified as not having
it
a. true negative, false positive
True Negative-Those who are ACTUALLY disease free
False positive- Those that are misdiagnosed as not as being disease free

Incidence new cases

QUESTION: Incidence is when number of people like to get disease in given time

QUESTION: dentist in his clinic notice new diseases this is ? incidence

Prevalence all cases

QUESTION: What is the statistical measure for the total number of cases per population,
regardless of time of onset? I put prevalence

QUESTION: For a population, the research divides the number of disease cases by the number of people.
By so doing, this investigator will have calculated which of the following rates?
a. incidence
b. odds ratio
c. prevalence
d. specificity

QUESTION: Specificity? Proportion of truly nondiseased persons who are so identified by a screening test
(measures how good a test is at correctly identifying nondiseased persons). Sensitivity tests identifying
diseased persons.

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QUESTION: Dentist finds a group of individuals are free of (do not have the) dental disease: specificity
QUESTION: If a dentist was able to correctly ID disease free patients w/ the diagnostic study, it
has? I put high specificity.

QUESTION: investigator finds patients that dont have a disease: specificity

QUESTION: You were looking for a disease in a study, disease was not present, whats this called?
Specificity!

QUESTION: if test determines those who do not have the disease isspecificity, sensitivity,
validity.

QUESTION: Specificity, true negative !!!

QUESTION: Study says 95 out of 100 people had the disease what is lab value: I said 95%
sensitivity

QUESTION: sensitivity= sick people

QUESTION: Specificity (without disease) and sensitivity (with disease)

QUESTION: A study failed to report 5 cases of caries. What is this called? 1. True Positive, 2. True
Negative, 3. False Positive, 4. False Negative

QUESTION: Biggest difference across cultures regarding pain Variability in pain threshold rather
than pain tolerance, variability in pain tolerance rather than pain threshold, difference in stimulus
awareness rather than pain tolerance, difference in stimulus awareness rather than pain threshold

QUESTION: few questions about mean (average), median (middle number), mode (number that
shows up the most):
QUESTION: Which does not describe the spread of data? I put median.
QUESTION: Which does not describe the spread of data? median. Range. Variance, stand deviation,
standard error

QUESTION: What do you use for average Q? Mean, median, mode

QUESTION: Which of the following represents the variability about the mean-value of a group of
observations?

A. Sensitivity

B. Standard deviation

C. t-Statistic

D. Specificity

QUESTION: What most common form of standard deviation? 1. 2 stand deviations (answer)
QUESTION: Histogram is used to show (standard deviation): mean, correlation of 2 variables,
variance
QUESTION: Histogram variance
QUESTION: Histogram is used to show (standard deviation): mean, correlation of 2 variables,
variance

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QUESTION: Outliers control
a. mean
b. median
c. mode
d. standard deviation
QUESTION: An outlier has the biggest effect on which of the following?
a. Standard deviation **

QUESTION: Scale of 1, 2, 3, - is it ordinal, nominal, interval, rational. Answer is ordinal.

Nomial- categories. Just naming items.
Interval- is not constant. A constant interval but lacks true zero point.
Ratio- units of time, distance, weight.

QUESTION: GI mild, moderate severe Ordinal

QUESTION: BP and pulse Kelvin ratio

QUESTION: BP, pulse- ratio; same as Kelvin

QUESTION: pulse n bp what kind of measurement - nominal, ordinal, interval, ratio

QUESTION: temperature kelvins is ratio and Celsius is Interval (32 is freezing) is interval

Categorical (nominal) is like black hair, blonde hair

ORDINAL is like Low, medium, highor highschool, college, graduate school
Interval is like ordinal but the values are EQUALLY SPACED 10,000, 15,000, 20,000
Cardinal tells how many: 8 puppies, 14 friends
Ordinal shows ranking 3rd fastest, s
Nominal names something. Jersey number 4.

1. Which is least complicating for OH? Fixed bridge, rheumatoid arthritis, open contact?
2. Mask metal, reduce porosity, make coefficients of expansion more similar
3. Growth in buccal vestibule by flange of mandibular RPD? Most likely traumatic neuroma,
neurilemma, or neurofibroma? -_-
4. Older woman tooth extract 3 years ago, still hurts and exudate, shows cotton-wool
radiograph what is it? Residual cyst, osteomyelitis, 2 other lesions that are radiolucent
5. Macroglossia seen in all EXCEPT?
6. All of the following are an indication for putting a temporary on a deep caries and restoring
at a later time except? Lack of time due to it being an emergency appt, weakened dentin
under cusps, to assess pulp condition

7. Edema (by eye) due to? Chemotaxis, hemorrhage, chymosis

8. Pt has pain lower right 3rd molar and cant take intraoral xray, what kind of xray indicated?
Lateral oblique mandibular, reverse towns, lateral ceph, anterioposterior
9. You have pano, what cant you do without intraoral photos? I said space analysis
10. Force put on crown, where is center of translation or rotation? Halfway down root, CEJ, past
apex
o Center of resistance half the distance from alveolar crest to root apex (translation)
o Center of rotation: Apical to center of resistance (apical to halfway down root)
during translation movements and tipping movements
o During rotation movements: center of rotation=center of resistance

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 o 1st: rotation, 2nd: tipping, 3rd: torque
Anti-retraction valves for what? I put prevent patient to patient cross-contamination
11. Best to use on infected oral wound? I put hydrogen peroxide, chlorhexidine
12. Initiation of first menstruation cycle is best indicative of what? Cognitive age, dental age,
skeletal age
13. Menarche onset: before growth, during peak of growth, after peak of growth?
14. menarche begins at what point in growth spurt? Before, during, after, when completed.
15. Menarche definition: At peak of puberty (AFTER PEAK GROWTH)
Neuropraxia definition:
Neurapraxia describes nerve damage in which there is no disruption of the nerve or its sheath. In this
case there is an interruption in conduction of the impulse down the nerve fiber, and recovery takes place without
true regeneration, as Wallerian degeneration does not occur. This is the mildest form of nerve injury.
Axon damage most likely to cure on itself neuropraxia
Definition of Neuropraxia - interruption of axon, but not nerve all together (reversible nerve damage)
neuropraxia is reversible
Neuropraxia: involves both perineurium and epineurium, only perineurium, only epineurium, none
of the above

a. None of the above? (temporary damage, nerve left intact) asked in a strange way

Neuropraxia: It is a transient episode of motor paralysis with little or no sensory or autonomic

dysfunction
o Neurapraxia describes nerve damage in which there is no disruption of the nerve or its sheath

16. Tiny line noticed in an isthmus between an MO and DO amalgam. It is not a separation
between two different restorations. What tx? Re-do or leave and monitor
17. Which is more damaging to the PDL? Extrusion or intrusion, lateral luxation
18. Crazy question about a dentist putting an elastic around patients maxillary centrals to close
diastema.. I forgot options but I put: eventual loss of teeth? Due to the elastic traveling
upwards. No clue.
19. No obvious clinical caries in a child. Radiographically, interproximal caries on primary tooth
T. Best tx: MO and DO composites, MOD amalgam, stainless steel crown
20. Extract a tooth and give Penicillin, the next day patient has high fever, swelling, dysphagia,
what do you do? Change to different antibiotic, refer to OMFS, add another drug to regimen
21. Which muscle mainly responsible for positioning and translating condyles? Lateral
pterygoids
22. Cracked tooth with no pulpal involvement, what is the treatment? Endo, extracoronal
restoration, occlusion reduction, amalgam with adhesive

23. When you smile what is the black space buccal of teeth and next to cheeks? Buccal corridor or
something?
27. Picture of ulcerated tumor on palate? SSC, salivary gland tumor, tori
28. advantage of rectangular orthodontic wires
What is Trephination? Hole is drilled or scraped into the human skull

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Dentinogenesis Imperfecta

Lymphoid epithelial cyst odontogenic origin

Cemetoblastoma RO mass that replaces root; tooth is removed with lesion

Periapical Cemento-Osseous dysplasia vital, lower anteriors, middle age women, RL then RO; no
symptoms

Florid Osseous dysplasia involves entire jaw

Migratory glossitis

Nicotinic Stomatitis

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Dentinogenesis imperfecta

Coronoid process of mandible

Coronoid process of mandible

Ameloblastoma

304
 reverse polarization (follicular type), nucleous moves away
from basement membrane, seen in ameloblastoma

305
 Calcifying Epithelial Odontogenic Tumor (pindburg tumor):
calcified intracellularbridge

Odontoma (complex)

Complex odontoma

zygomatic process of maxilla on PA

306
 U, V, J radiopaque line
superior to maxillary first and second molars

Drug induced hyperplasia (cyclosporine)

Drug induced

Bells palsy

307
epilus fissuratum

Erythema multiforme

Vertical root fracture J shaped radiolucency

308