DENTISTRY

Hygienist Appointment (20 mins Maintenance Phase)

noreply@blogger.com (Unknown) — Sun, 20 Aug 2023 02:59:00 -0700

Hygienist Appointment under PSD, (20 mins, AGP)

Provisional diagnosis of periodontal health: Chronic generalised periodontitis

Patient Engagement: fully/partially/not engaging with OHI

Plaque score:

Bleeding Score:

PPE used as per Practice's SOP

Nurse Support:

CO: Regular check-up

MH: checked- No change.

SH:

Smoking: nil

Alcohol: Within Guidelines

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brushes

EOE: NAD

IOE: NAD

Oral Cancer Screening: NAD, Risk: Low/ Moderate / High

Diet: Explained the effects of sugary and acidic food on teeth and gums. OHI given accordingly.

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present

Contour : knife edged

Plaque: grade: ++ present: interdentally - generalised and at the tooth-gum margins

Calculus: grade: ++ present: interdentally- present in lower lingual 3-3 region and at the tooth gum margins.

Stains: Grade: ++ present: generalised

Type: tannin and wine /mouthwash stains?

BOP: Present in lower lingual

BPE: as recorded in chart today.

Deep pockets: No deep pocket more than 3.5mm today

Annual 6PPC: Clinically not required today.

Current oral hygiene: fair

Other finding:

Risk factor: Suboptimal oral hygiene

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gum health.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

Verbal Consent Gained

1. Full mouth scaling using hand scaler and ultrasonic scaler used to remove calculus and disrupt supra and sub subgingival biofilm.

2. Polishing done using prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. Contact points checked with floss.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inter-dental brushing given today, (shown in the mirror) and samples given to take away. Colour:

Advice given:

Emphasised importance of excellent oral hygiene and maintenance to help achieve optimal treatment results. Pt explained more than 2 minutes is likely to be required to perform all oral hygiene measures.

Toothbrush: Recommended brushing twice a day with fluoridiated tooth paste. To place the brush at tooth-gum junction to clean the sulcus area clean. (modified Bass technique).
Other aids: Flossettes / Interspace brush

Adv. warm salt water rinses 3 times a day for next 3 days.

Recommended 6/12 recall for hygiene appointment

TCA: 6/12 appointment for 20 mins. pt. happy with it.

Hygienist notes Diabetic patient

noreply@blogger.com (Unknown) — Sun, 25 Jun 2023 14:50:00 -0700

Hygienist Appointment (30 mins, AGP)

PPE used as per Current COVID-19 Guidelines and Practice's SOP

Nurse Support:

CO: Regular check-up

MH: checked- No change, No symptoms of COVID-19 present today.

SH:

Smoking: nil

Alcohol: Within Guidelines

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brush TePe colour:

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/ red erythematous gingiva

Contour: knife edged

Plaque: grade: + present: interdentally - generalised and at the tooth-gum margins

Calculus: grade: + present: interdentally- present in lower lingual 3-3 region and at the tooth gum margins.

Stains: Grade: + present: generalised

Type: tannin and mouthwash stains?

BOP: Present in lower lingual

BPE: as recorded in chart today.

Deep pockets: No deep pocket more than 3.5mm today / present :

Annual 6PPC: completed on __ / as recorded today and discussed with patient/ To be completed on next appointment (reason: maximum time spent on removing calculus today)/Clinically not required today.

Current oral hygiene: fair

Other finding:

Provisional Diagnosis: Chronic Generalised Periodontitis

Stage: |I Early, II Moderate, III Severe, IV Very Severe(bone loss unto apical 1/3

Grade: A, B, C

Status: Stable, Unstable, Remission

Risk factor: Suboptimal oral hygiene / Diabetes.

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gum health.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

Verbal Consent Gained

1. Full mouth scaling using hand scaler and ultrasonic scaler used to remove calculus and disrupt supra and sub subgingival biofilm.

2. Polishing done using NUPRO prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. Non surgical RSD done without LA in deep pockets and furcation areas. Pt. tolerated well. Chx. irrigation done.

4. Contact points checked with floss.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inter-dental brushing given today, (shown in the mirror) and samples given to take away. Colour:

Advice given:

Adv. warm salt water rinses 3 times a day for next 3 days.

Diabetes advice: Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.

Recommended 3/12 Hyg appt.

TCA: 3/12 appointment for 30 mins. pt. happy with it.

Hygienist notes Initial assessment of Perio patient

noreply@blogger.com (Unknown) — Sun, 25 Jun 2023 14:50:00 -0700

Hygienist Appointment under PSD (30 mins, AGP) Initial Assessment and Step 1 of S3 treatment guidelines

PPE used as per practice's SOP

Provisional diagnosis of periodontal health: Chronic generalised periodontitis

Patient Engagement: fully/partially/not engaging with OHI

Plaque score:

Bleeding Score:

Nurse Support:

CO: referred by the Dentist

MH: checked- No change

SH:

Smoking: yes /ex smoker / nil

Alcohol: Within Guidelines

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brush TePe colour:

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/ red erythematous gingiva

Contour: knife edged

Gingival Recession according to Miller's Classification):

Class I (does not extend MG junction, no interdental bone loss)

Class II (upto or beyond MG junction, no interdental bone loss)

Class III (extend beyond MG junction with interdental bone loss)

Class IV (extends beyond MG junction with severe boneloss in interdental areas)

Plaque: grade: +++ present: interdentally - generalised and at the tooth-gum margins

Calculus: grade: +++ present: interdentally- present in lower lingual 3-3 region and at the tooth gum margins.

Stains: Grade: +++ present: generalised

Type: tannin and smoking / wine /mouthwash stains?

BOP: Present in lower lingual

BPE: as recorded in chart today.

Deep pockets: No deep pocket more than 3.5mm today / present : as recorded in 6PPC

Oral Cancer Screening: NAD, Risk: High / Moderate / Low

Current oral hygiene: Good/ fair/ poor

Other finding:

Provisional Diagnosis: Generalised Periodontitis

Stage: I Early, II Moderate, III Severe, IV Very Severe(bone loss unto apical 1/3

Grade: A(< 0.5), B(0.5-1), C(>1)

Status: Stable, Unstable, Remission

Explained about the active periodontal condition and the bone loss around the teeth.

Discussed the following options with the patient:

1. To have sessions of non surgical RSD under LA with 2 weeks gap and review after 3 months. Discussed the risks and benefits of it.

2. To have 3 monthly Hygiene and non Surgical RSD under LA where needed, Discussed the risk of delaying to 3 monthly and benefits of it.

3. Referral to specialist, Explained the option to referral to specialist

4. To do nothing. Explained the higher risk of losing teeth of if continued to have no treatment at all.

Patient opted 2. To have 3 monthly hygiene appointment with deep cleaning.

Risk factor: Suboptimal oral hygiene / Smoking/Diabetes.

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gum health.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

Verbal Consent Gained

Xylonor gel used.

LA used: Lignocaine with Adr. Expiry and Batch number:

Number of Cartridges: 1

Technique used: Local infiltration in buccal vestibular areas of

1. Full mouth scaling using hand scaler and ultrasonic scaler used to remove calculus and disrupt supra and sub subgingival biofilm.

2. Polishing done using prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. Non surgical RSD done without LA in deep pockets and furcation areas. Pt. tolerated well. Chx. irrigation done.

4. Contact points checked with floss.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inter-dental brushing given today, (shown in the mirror) and samples given to take away. Colour:

Advice given:

Adv. warm salt water rinses 3 times a day for next 3 days.

Diabetes advice: Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.

Smoking cessation advice: Pt advised of poorer response to periodontal therapy if continues to smoke.

Recommended 3/12 recall for hygiene appointment

TCA: 3/12 appointment for 30 mins. pt. happy with it.

TCA: 2 weeks time for Non Surgical RSD session

Hygienist notes Smoking history

noreply@blogger.com (Unknown) — Sun, 25 Jun 2023 14:48:00 -0700

Hygienist Appointment (30 mins, AGP)

PPE used as per Current COVID-19 Guidelines and Practice's SOP

Nurse Support:

CO: Regular check-up

MH: checked- No change, No symptoms of COVID-19 present today.

SH:

Smoking: yes

Alcohol: Within Guidelines

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brush TePe colour:

Oral Cancer Screening: NAD, Risk: High explained about smoking and risk of cancer is high.

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/

Contour: knife edged

Plaque: grade: ++ present: interdentally - generalised and at the tooth-gum margins

Calculus: grade: ++ present: interdentally- present in lower lingual 3-3 region and at the tooth gum margins.

Stains: Grade: ++ present: generalised

Type: tannin and smoking / wine /mouthwash stains?

BOP: Present in lower lingual

BPE: as recorded in chart today.

Deep pockets: No deep pocket more than 3.5mm today / present :

Current oral hygiene: fair

Other finding:

Provisional Diagnosis: Chronic Generalised Periodontitis

Stage: |I Early, II Moderate, III Severe, IV Very Severe(bone loss unto apical 1/3

Grade: A, B, C

Status: Stable, Unstable, Remission

Risk factor: Suboptimal oral hygiene / Smoking

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gum health.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

Verbal Consent Gained

1. Full mouth scaling using hand scaler and ultrasonic scaler used to remove calculus and disrupt supra and sub subgingival biofilm.

2. Polishing done using NUPRO prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. Non surgical RSD done without LA in deep pockets and furcation areas. Pt. tolerated well. Chx. irrigation done.

4. Contact points checked with floss.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inter-dental brushing given today, (shown in the mirror) and samples given to take away. Colour:

Advice given:

Adv. warm salt water rinses 3 times a day for next 3 days.

Smoking cessation advice: Pt advised of poorer response to periodontal therapy if continues to smoke.

Recommended 3/12 recall for hygiene appointment

TCA: 3/12 appointment for 20/30 mins. pt. happy with it.

ORE exam feedback questions

noreply@blogger.com (Unknown) — Sun, 5 Jun 2022 17:05:00 -0700

1. ANATOMY

2. PHYSIO

3. GEN PATH / IMMUNOLOGY

4. MICRO

5. ORAL PATH / ORAL MED

6. GEN MED

7. DM

8. EMBRYO

9. PHARMA

10. OS

11. OPERATIVE/ ENDO/ PEDO

12. ORTHO

13....

14.RADIOLOGY

15.SYNDROMES

16....

17....

18.PERIO

19.PREVENTIVE

20.ETHICS

1.Anatomy

[17:41:33] ayaa hariri: hi gays .this is the answer i have for this sutures question.lip trauma vicryl if it is at the vermillon border nylon .

orontralfistula could be both vicyl or silk.biobsy vicryl .

if you want to hol biopsy then with black silk 3/0

- Pictures of arteries?? : facial artery and transverse facial artery(branch of superficial temporal artery) and facial muscles,tongue muscles https://en.wikipedia.org/wiki/File:Unterkiefer_dorsal.png

https://en.wikipedia.org/wiki/File:Gray177.png

- Diagram of hyoid bone?? : Greater horn, Lesser horn, Body .......p133 Netters , p185 Moore https://en.wikipedia.org/wiki/File:Gray186.png

- Cranial nerves?? .....p20-21 BB

- Blood supply of parotid gland and type of saliva ?? : serous saliva …..artrial supply :Superfacial temporal and tranverse facial artry from facial artery(branches of external carotid artery).bb60

- Nerve supply from muscle involved on swallowing?? : genioglossus, styloglossus, hyioglossus(12th cranial nerve). tenser velipalatini(5th n it originates from scaphoid fossa of sphenoid and auditory tube n attaches at palatini aponeuroses, supplied )levator veli palatini 11th nerve........p166-167 BB

- Lots of questions about damage of the cranial nerves, specially related to the eyes...... p319 Scully

- Nerve supply Muscle Levator Palatinie(muscle of sof palate)?? : pharyngeal plexus 10th nerve 55bb

- Function and innervations of the tongue muscle (extrinsic)bb59

- Rx to identify sinuses….pg 300 netter

- Muscle of the soft palate?? : tensor veli palatini, levator veli palatini, palatoglossus, palatopharyngeus, musculus uveoli…all supplied by palatophryngeal except tensor veli palatine(V3)

- Anatomy of cranial nerves,inervation-especially tongue……sbko hypoglossal krti hai excpt palatoglossus isko pharyngeal plexus krti hai

- Nerve passing through optic canal??optic nerve/opthalmic artery also passes through it

- Questions on muscles in the floor of the mouth?? : mylohyoid and geniohyoid

- Questions on tongue musculature, their nerve supply and movements??

- Muscles involved in snoring?? : muscule uvula http://www.nhs.uk/Conditions/Snoring/Pages/Causes.aspx

- Eye muscles and their nerve supply?? : Optic N(supply eye ball), Occulomotor N(muscles ko krti) , motor supply by Abducent N, Trochlear N. .LR6,SO4 yad krlo

- Muscle attached to the auditory tube?? :Tensor tympani, Levator paltini, Tensor veli paltini, salphingopharngeus0............p55, p82 BB, p199 Moore

- Questions about small arterioles, terminal arterioles, venules, capillaries, lymphatic vessels.

- Structures passing through parotid gland?? : parotid lymph nodes, 5 branche s of facial nerve(BMC ZT) retromandibular vein, superficial temporal artery and maxillary artery.......p60 BB

- Muscle involved in closing the oropharyngeal isthmus---palatoglossus(also help in swallowing)

- Nerve supplying skin over forehead----opthalmic….divedes further ino 3 branches…frontal,lacrimal and nasociliary …... supply >>eye orbit face nose scalp nasal cavity

- Type of saliva secreted by the glands ..parotid(serous) sub mandibular(mixed) and,sub lin( mucos)

At rest submandibular secretes most…..at during stimulation parotid does more

- Branch of superficial temporal artery-ant..which anastomose with supratrochlear and supraorbital of opthalmic artery…...frontal and parietal.tranverse facial artery.middle temporal artery.

- Something about jugular venous pressure . 6-8 cm water

- Where does the duct of the parotid gland open?upper second molar

- Name of area behind the mandibular 3rd molar-retromolar

- A lot of questions on eye muscles and their nerve supply

- Muscle attached to the auditory tube:Tensor tympani.tensor vali palatani,levator vali palatani,salpingopharnygeus

- A lot of questions on tongue musculature, their nerve supply and movements

- Nerve passing through optic canal- optic nerve

- Structures passing through parotid gland- nerve-facial, vein- retromandibular, artery- external carotid

- Type of saliva secreted by the glands- mucous, serous; also, if glands on one side are stimulated what will the response be like? Options- bilateral, ipsilateral(correct), contralateral, etc.,

- Branch of superficial temporal artery- transverse facial,frontal and parietal,parotid,middle temporal,orbital,anterior auricular and middle temporal

- Nerve supplying skin over forehead- Ophthalmic branch of trigeminal nerve

- Questions on afferent and efferent lymphatics..see wiki

- A lot of questions on muscles in the floor of the mouth ….Genihyoid.mylohyoid

- Muscles involved in snoring…uvula

- Muscle involved in closing the oropharyngeal isthmus- palatoglossus

- indirect question on muscles of tongue, their supply and actions?

- emq on eye muscles supply and thier damage effects? Ptosis -OCULOMOTOR

- emq on cranial nerve damage and their effects

- muscle involved in snoring ? uvula

- structure passing through parotid gland ?

- Lesion of a nerve in the cavernous sinus that supplies muscles to the eye and divides into two branches. What nerve is this? OCCULOMOTOR

- While doing a third molar surgery the lingual nerve was damaged, what will this cause

a. The taste sensation to the tip of the tongue will be affected

b. The taste sensation to the tip of the tongue will be spared because it is supplied by the glosspharyngeal nerve.

c. The taste on the same side of the tongue will be lost-yes

- What is the parasympathetic supply to salivary glands?

a. Glosspharyngeal (parotid) and facial(sub ling/mand)-yes

b. Hypoglossal and facial

c. Glosspharyngeal and trigeminal

d. Facial and trigeminal

- Which nerve passes through the optic canal? – Optic nerve

- Which structure gives guidance to the placement of maxillary incisors – Incisive papilla

- What type of secretion is the parotid gland? – serous

- Where does the duct of the parotid gland open? – buccal to which tooth? – maxillary second molar 7

- Which nerve passes through the parotid gland? – facial nerve

- Which artery passes through the parotid gland? – external carotid artery

- Which vein passes near the base of the parotid gland? – retromandibular vein

- What area is present behind the mandibular third molars? – retromolar area

- Which is the branch of superficial temporal artery? – Transverse facial artery

- Which muscle is required to close the oro-pharyngeal isthmus? – Palatoglossus

- Mandibular nerves and its branches read which one is sensory and which one is

a motor branch. Sensory - mnemonic BAIL (buccal,deep tempolaral,lingual.inf alv n) see wiki

anterior div: BDML>>> buccal,auricotmprl.massetric n lateral ptrygoid hai

post div sy: >>NILA> lingual,inf alv n,nerv to mylohoid,auricotemprl

frm main trunk:>>> n to medial ptergoid(to tensor tympani ,tensor veli palatni),+nervus spinosus

- General sensory and taste sensation to tongue by which nerves.

Ant 2/3 : -genrl is by LINGUAL N (br of mand n) -taste is by chorda tympani (7)

Post 2/3:: both genrl or taste ko glssophrngeal kry ga ….57 bb

- Facial nerve and its branches>>> BRANCHES>>>wikiii…inside skull n outside skull

- Parasympathetic supply of parotid gland? glossophyrangeal

- Ques. on Buccinator: buccal phlange and Orbicularis Oris relating to denture.(associated with buccal frenum.recorded as bucal notch,they shd be considerded while taking impression)

- Nerve passing through foramen rotandum? maxillary branch of trigeminal n

Ovale>>>mand n

- Nerve supply to Temporalis muscle…..mand br of trigeminal

- Anaesthetic for flap elevation for apicectomy on lateral incisor ? Anterior superior dental nerve ko numb kry gy by nasopalantine nerve block

– Nerve passing through nasopalatine canal (picture) ? Nasopalatine nerve

- Lingual muscles extrinsic and intrinsic ones shown and you have to select their names

- Head drawing showing superficial temporary artery or external carotid artery ( you have to know exactly where is the division of this artery in its two terminal branches

- Facial muscles, there was a drawing and you have to recognise many of them; major zigomatic, depressor of angle of mouth, orbicularis oris, levator labialis superiori and alae nasi.

- Diagram showing muscles of facial expression. Orbicularis oris, depressor anguli oris, levator labii superioris alaque nasi

- Diagram where hyoid bone was marked

- Diagram showing transverse facial artery, superficial temporal artery & facial artery

- Picture of an embryo marked with maxillary process & lateral nasal process

- Diagram of mucles showing geniohyoid, styloglossus, stylohyoid

- Nerve emerging from the incisive foramen.,,, Nasopalatine nerve

- Which nerve supplies the muscles of facial expression? Nerve VII

- Arteries and veins to identify: retromandibular, external carotid, maxillary, facial, etc

- Nerve supply for salivary glands

- Bones and structures to identify: medial and lateral pterygoid plates, mastoid process, styloid process, incisive foramen, greater palatine foramen ovale,rotundum spinosum foramen (what passes inside )spinosu>>middle mingeal artry,mid mengeal vein,recurent meningeal nerve(meningeal branch of mandibular nerve)

- What muscles are attached to: condyles(lat ptrygoid), coronoid process(temporalis), max tuberosity(medial ptergoid), ramus of mandible(massettr)

- Lingual nerve( BRANCH OF MANDIBULAR DIV OF TRIGEMINAL NERVE) sensory branch

- Nerve supply to muscles

- Muscles of mastication, their origin, insertion etc.

- Facial nerve.5 branches on face +nerve to stapedius,greater perosal.chorda tympani…inside skull n outside skull

- Lingual nerve…br of mandbilr div of 5^th nerv

- Parasympathetic supply of salivary glands.

- Cranial nerves just do the signs when they get damaged, especially, facial nerve, hypoglossal nerve,

- Muscles used in the process of swallowing.

- Do the nerve supply completely of face , teeth , tongue

- Origin & insertion of all muscles of mastication.

- Which muscle is responsible for moving food from the buccal sulcus in between

the teeth during mastication- Buccinator

- Which nerve is affected if a patient is unable to gaze laterally to the left

a)right abducens (b) left abducens (c)right trochlear (d)left trochlear

- Which nerve is affected if the tongue deviates to the right when protruded

a)right hypoglossal (b)left hypoglossal (c)right glossopharyngeal (d) left

glossopharyngeal

jahan damage hota hai woi side ki nerve hoti hai

- Parasympathetic nerve supply to the salivary glands is by

a)Vagus and glossopharyngeal nerves

b)facial and glossopharyngeal

c)facial and lingual

- CRANIAL NERVES AND BRANCHES..

- MUSCLES OF THE MASTICATION AND FACIAL

- CRANIAL NERVES – many questions related to clinical manifestations after damage

- Drawing of mandible to identify muscles – mentalis, genioglossus, lateral pterygoid, buccinator

- Picture of skull to identify – infraorbital and mental foramina

- Maxilla and nerves pictures – identify nerves

- Skull – identify points (greater palatine foramen, foramen ovale, internal carotid foramen)

2. Physio

- Action of glucagon :….all true
a)increases glycogen breakdown(true) b) increases gluconeogenesis c) increased sysnthesis of ketone and ultimately raises plasma glucose levels

Glucagon just converts glycogen to glucose..itself glucagon will not produce glucose..imp itra

- Stroke volume : end diastolic - end systolic (120-50) =70ml and respiratory volumes :(stroke vol...volume of blood ejected from each ventricle during systole)..all true

- Hormones produced by pituitary?? : theeek hai

Ant lobe: TSH,FSH,MSH,ACTH,GH,LH.

Post lobe: ADH(vasopressin)and Oxytocin,

(Pituitary: (MNEOMIC. GOAT FLAM)...Growth hormone,Oxytocin….Anti diuretic i.e; Vasopressin,TSH

Foliclle stimulating hormone,Luteinizing hormone,Adrenocorticotropic hormone,Melanocyte stimulating hormone)

Hypothalamus: secrete hypophysiotrophic hormones (,gowth hormone releasing hormone,thyrotropin releasing hormone,corticotropin releasing hormone,gonadotropin releasing hormone,dopamine,somatostatin(also called growth hormone inhibiting hormone))

Kidneys: Erythropoietin ~ controls erythrocyte production by acting on bone marrow to increase RBCs production, Renin ~ controls formation of angiotensin which influences BP and sodium balance : i-e BP increases if renin secretion drops, 1,25-di hydroxyvitamin D3 aka Calcitriol ~ increases the level of calcium in the blood by

(1) increasing the uptake of calcium from the gut into the blood,

(2) decreasing the transfer of calcium from blood to the urine by the kidney, and

(3) increasing the release of calcium into the blood from bone

- Cells in exocrine and endocrine glands like in apocrine glands etc and where they secrete their products..itra ko aya tha

- Adrenal cortex hormones : cortisol,aldosterons,androgens

- Haemophilia types : Haemophilia A (def of fac VIII,anti haemophilic factor) Haem B (Fact IX def,christmas factor) Haem C ( def of fact XI,plasma thromboplastin atecedent)..itra ko aya

434 11^th ed

- Questions about Membrane potentials, resting membrane potential-70mV, action potential, refractory, generation and propagation of action potentials….boht silly ques aya tha itra ko..konsy channel witout o2 chalty hain…

- Heart anatomy (valves)...Four Valves, 2 Aterio Ventricular (Tricuspid: b/w RIGHTatrium and ventricle, Bicuspid aka Mitral:b/w left atrium and ventricle) 2 semilunar(Aortic : b/w aorta and left ventricle, Pulmonary b/w rt vent and pulmonary artery)

- Circulation pressures (values)386…pulse pressur systole diastole parho

- Lung volume and capacities:Lung volumes and lung capacities refer to the volume of air associated with different phases of the respiratory cycle

tidal volume:500ml

expiratory reserve vol:1200ml,residual volume:1200,inspiratory reserve volume:3000ml.pg447ed12

- Rate of respiration per minute (adult and child)

Newborns: Average 44 breaths per minute

Infants: 40-60 breaths per minute

Preschool children: 20–30 breaths per minute

Older children: 16–25 breaths per minute

Adults: 12–20 breaths per minute (12-14 male/16-18)

Adults during strenuous exercise: 35–45 breaths per minute

Athletes' peak: 60–70 breaths per minute

- Arteries and veins- their elasticity :arteries more elastic…less complaince.more smooth muscle so called pressure reserviour

Veins less elastic but more compliance and are blood reservoir…less smooth muscles

Compliance ka mtlb ye k essily stretch hoti hain

- Lots of histology-striated muscle....cardiac and skeletal

- types of connections between cells..

.gap(heart )transmits elrctrical signals,

tight(GITmai ) and

desmosomes(skin n mucosa)…..oral mucosa mai hemidesmosomes

- even basic cell biology

- Blood cells-types of anemia

- Some questions on hormones- addisons disease,(adrenal insufficiency)diabetes types I,II, insulin role

- Tidal volume - definitions : volume of air inspired during single inspiration is equal to volume of air expired during subsequent expiration called Tidal volume. resting tidal volume is 500ml

- Hormone produced by the islet of Langerhans by the beta cells?? : Insulin

Alpha cells…glucagon

- Hormone produced in the adrenal cortex & which increases in stress?? : Cortisol

- If gland on one side are stimulated what will the response be like?? : Both sides are stimulated.

- Which one is responsible for buffering capacity in saliva?? : bicarbonate

- The average respiratory rate for adults and for children?? : adults 12-20,children 20-30

- Valve between right atrium and right ventricle?? : tricuspid

- All-or-nothing” phenomenon?? : Refers to the phenomenon where the strength of a nerve impulse is not dependent on the strength of the stimulus.(correct) Instead, there is a threshold level of stimulus strength that must be reached before the nerve will fire an impulse (at full capacity). Below the threshold, the nerve will not fire at all….

- Potential at the SA node; options- , pacemaker, etc.,pacemaker 100 bpm….pacemaker mai koi resting membrane potential nahi hota..also called pacemaker potential..itra

- Substance controlling Ca2+ metabolism?? : parathyroid hormone,

Calcitonin has opposite effect to parathyroid

- Most of the part from physio was from:

- Endocrine.. lot of things related to ACTH n corticosteroids....i mean cushing's syndrom n disease.....

- Respiration....plz dont forget to study tidal volume & all that stuff...they hav asked that many time in past even

- A lot of questions on lung capacities- respiratory volumes

- A lot of questions on physiology of arterioles and capillaries

- Percentage of blood that can be lost without causing hypovolemia- options- 5%, 10%, 20%), 40%, 50% : 15-30 % in range otherwise say 20%

- Jugular venous pressure indicates what pressure?? Options- left ventricular pressure, etc.itra had no answer

- Irreversible shock…btana kya hota hai vander mai given hai wiki kr lena wrna

[01:45:45] Mujtaba Choudhry: a condition in which shock does not respond to available forms of treatment and in which recovery is impossible as a result of massive cellular damage.

- Potential at the SA node?? ; options- saltatory, pacemaker, etc., : pacemaker

- Lots of questions on action potential and conduction through the myelinated nerves…pochay gy fast conduction hoge….

- All or none phenomenon in conduction mechanism

: Refers to the phenomenon where the strength of a nerve impulse is not dependent on the strength of the stimulus.(correct) Instead, there is a threshold level of stimulus strength that must be reached before the nerve will fire an impulse (at full capacity). Below the threshold, the nerve will not fire at all….

- Principle substances controlling Ca2+ metabolism?? ; options- calcitonin, PTH, Vitamin D, etc., : PTH

Calcitonin controls Ca+ balance in blood

- Questions on various hormones like insulin, adrenal medullary and cortical hormones.

- Respiratory rates in adults and children

- Definition of lung volumes (vital capacity inspiratory reserve volume, expiratory reserve vol etc)

Vital capacity: maximal volume a person can expire after a forceful inspiration.Its the sum of resting tidal volume,inspiratory reserve volume and expiratory reserve volume….4700ml

INSPIRATORY reserve volume : the maximum amount of air that can be increased above resting tidal volume value during deepest inspiration i-e 3000 ml.

Expiratory reserve volume : Through maximal active contraction of expiratory muscles it is possible to expire the volume of air remaining 1500ml after resting tidal volume has been expired this additional expired volume is called expiratory reserve volume and is about 1500 ml.

Residual Volume : Even after maximal atcive expiration,approx 1000 ml of air still remains in the lungs which is called residual volume.

- Which vessels:

a.Dilate during vasodilation?? : arterioles

Small arterioles, terminal arterioles, venules, arteriovenous shunts, capillaries, lymphatic vessels

b.Play a role in thermo regulation?(choices as above)arterioles

c.Carry filtered fluid?lymphatic vessels

- Jugular venous pressure is best described as(the choices may not be accurate, they were something like this:).........p3 , p422 8 Vander CVS…(this is sign of rite atrium..itra did from wiki)

a. Pulse pressure

b. 10 mmHg more than ventricular Pressure

c. 10 mmHg less than ventricular pressure...... (correct)

d. 20 mmHg less than ventricular pressure

e. 20 mmHg more than ventricular pressure

- EMQ on lung capacities and volume definations

- EMQ about what ions are more available extracellularly, intracellularly??, what ions are responsible for action potential, what channels does lignociane block?? Extracellularly: Na (150),Cl (110) K (5) Intracellularly: Na (15),Cl (10) K (150). Na and K responsible for action potential…itra ko aya tha..LA voltage gated Na channels

Lignocaine blocks binds to voltage gated Na channels and blocks them preventing their opening in response to depolarization.

- EMQ about muscle fibres’, what is the A band made of, what combines with calcium, what protein has I,T and c subcomponents

A-band is made of myosin.

Calcium binds to Troponin C.

Troponin has 3 types...I.T.C

C: binds to Ca to bring conformational change in tropomysoin

T: binds to Tropomyson to hold Troponin-Tropomysoin in place

I: binds to the site on actin in thin filaments to hold Troponin-tropomyosin in place…..not given in vanders..itra ny btaya ye theek hai..n sent a pic

- Haemophilia A is due to absence of what factor?? : Anti haemophilic factor VIII(8)

- What ion is factor 4?? : Calcium 206 BB

- What ion acts as a second messenger?? : Ca.....p131 BB

- What blood vessels have the most amount of smooth muscles?

a. Arteries -yes

b. Arterioles

c. Capillaries

d. Veinules

e. Veins

- What vessels are the capacitance vessels and hold most of the blood volume?? Same options as above. : Veins…hold upto 61% of blood and artries 11%

- What neurotransmitter is responsible for closing pre capillary sphincters??kisi ko nhi pta iska answer…itra ended up with opt C…..but lala read gyton said A

a. Acetylcholine

b. Serotonin

c. Nor-adrenaline….ye ok hai

d. Substance p

- What part of the nervous system is responsible for fight or flight?? : Sympathetic

- What part of the nervous system causes increased salivary secretion?? : Parasympathetic

- What part of the nervous system increases heart rate?? : Sympathetic

- What hormone increases blood glucose?? : glucagon

- What hormone reduces blood glucose?? : Insulin

- What hormone increases blood glucose and potassium?? ,Cortisol(correct),growth hormone,stomatostatin,thyroxine,epinephrine,ACTH…boht search kia itra ny

- At rest what gland produces 2/3 of saliva?? : Sub mandibular….imp sawal

- What is the commonest cause of Cushing’s disease??

a. Adrenal disease

b. Pituitary adenoma -yes

- Lack of what vitamin causes sub acute degeneration of the spinal cord??

a. Vit B 12 - yes (cobalmin)

b. Thiamine

c. Vit D

- Functions of gap junctions, tight junction’s : main controllers of passage of ions and water e.t.c

Three types :

Desmosomes :- consist of a disk shaped region between two adjacent cells where apposed plasma membranes are separated by about 20 nm and have a dense accumulation of protein at the cytoplasmic surface of each membrane and in the space between two membranes. Function to hold adjacent cells together in areas that are subject to considerable stretching such as in skin.

Tight Junctions:- formed when extracellular surfaces of two adjacent plasma membranes are joined so there is no extracellular space between them. Unlike the desmosome which is limited to a disk shaped area of the membrane,the tight junction occurs in a band around the entire circumference of the cell. Most epithelial cells are joined by tight junctions e.g epithelial cells covering the inner aspect of intestinal tract.Only ions and water can move with ease.

Gap junctions :- Consists of protein channels linking cytosols of adjacent cells.In the region of gap junction,the two opposing plasma membrane come within 2-4nm of each other,which allows specific proteins from the two membranes to join forming small protein lined channels linking the two cells. Small diameter (1.5 nm) limits movements of different substances to small molecules and ions such as Na and K. Muscle cells of the heart and smooth muscle cells.Also co ordinate the activity of adjacent cells by allowing chemical messengers to move from one cell to the other.

- Buffering action of saliva is due to?? : Bicarbonates

- Hormone produced by the islet of Langerhans by the beta cells?? :

Alpha cells producing glucagon (15-20% of total islet cells)

Beta cells producing insulin and amylin (65-80%)

Delta cells producing somatostatin: inhibits growth hormone secretion in hypothalamus

- Hormone produced in the adrenal cortex & which increases in stress?? : Cortisol

- Which valve is present between the right atrium & the right ventricle?? : Tricuspid valve

- Actin ,myosin ,troponin, Z line and i line ...all in an emq so pls read it chapter on muscle….do it !!!!

- From Respiration they asked values of CO2 and Oxygen in blood like venous and arterial…chart bna lo itra said

- which vessels in the circulatory system carry most of the blood and which carries least?? eg. venules ,veins, arteries, arterioles : veins carry most and arterioles and capillaries carry least

- Which of the above vessels are most stretchable so pls read it. I followed (chapter on heart) in Vander i.e; basic anatomy of heart : veins most…

- Which is the most abundant Extracellular cation?? eg K ,Na.,,, : Na(150)

- Symathetic and Parasympathetic which acts in fright and flight situations?ans:Sympathetic

- Salivary buffers?? : Bicarbonates

- Deficiency of vitamin B 12 causes what?? : Spinal cord damage.

Refer to blue book back pages for vitamin deficiency topic

- Which are the normal levels of glucose?? , different options given normal 3.5-5mmlol/l( 4-6 in fasting itra said)

- What does glucogen produce in the body?? : transform “glycogen” to glucose (BNF)

- Exocrine gland characteristics:

Exocrine glands are glands that secrete their products (excluding hormones and other chemical messengers) into ducts (duct glands) which lead directly into the external environment

Exocrine glands are named apocrine gland, holocrine gland, or merocrine gland based on how their product is secreted.

Apocrine glands - a portion of the plasma membrane buds off the cell, containing the secretion,an example is fat droplet secretion by mammary gland.

Holocrine glands - the entire cell disintegrates to secrete its substance,an example is sebaceous glands for skin and nose.

Merocrine glands - cells secrete their substances by exocytosis an example is pancreatic acinar cells.

Typical exocrine glands include: sweat glands(itra doesn’t agree she says it should be apocrine ), salivary glands, mammary glands, stomach, liver, pancreas

- Which of the following options given is a typical exocrine gland?? : option: sweating gland

- Where does the exocrine gland puts its secretion?? : duct

- Which is the acid produced in the stomach?? : Hydrochloric acid

Stomach releses gastrin

- Pituitary gland, hormone of middle part?? : thin layer of cells,rudimentry in humans,produces melanocyte stimulating hormone….MSH itra said

- Precursor cells of platelets?? : Megakariocytes…itra ko aya b tha

- Posterior lobe of pituitary gland secretes?? : Oxytocin and vasopressin (antidiuretic hormone)

- Which hormone is secreted by the middle lobe of the pituitary gland?? : melanocyte stimulating hormone

- Which glands secrete hormones into ducts?? : Exocrine glands

- Which glands secrete hormones in ducts?? : Sebaceous glands

- Which gas is inhaled from cupped hands?? : CO2

- In hyper-ventilation, which gas has high concentration?? : O2

- In which blood cell is the nucleus lost in the early stages?? : Erythrocytes/rbc

- what is the action of glucagon?? : causes liver to converts glycogen to glucose.increases blood glucose levels…IMP ITRA KO B AYA

- Cellularity of exocrine glands?? : mostly Multi-cellular.in humans only important unicellular gland is goblet cells…..mini gyuton mai tha ye lala said…chiknay aanso lol

- Which gland excretes hormones into ducts?? : exocrine

- Which acid is involved in gastric reflux disease?? : Hydrochloric acid

- Which enzyme acts on fats?? : Lipase

- Which enzyme acts on proteins?? : Pepsin

- Which cell is responsible for carrying oxygen & nutrients?? : Erythrocytes(Hemoglobin)

- Hemoglobin combines irreversibly with what?? : Carbon monoxide binds allosterically(change shape kry ga mtlb) with HB and modifies it.Thats why in CO toxicity person goes all pink

- What is the amount of gas in the lungs at the end of tidal volume?? : Functional Residual Capacity=2400

- Which salivary gland gives the major contribution at rest?? : Submandibular 60-65%

- And when stimulated (more than 2/3 contribution)?? : Parotid…158bb

- Blood supply interfere in salivation. How?? : Sympathetic(thick saliva hoga), parasymphatetic(watery saliva hoga), etc..activate dono ho gy.pr consistency pochay gy wo…531 vander ch15 digestion and asorption of food

- Lots of neurophysiology (even alpha, beta, gamma, delta something)..itra ny file bheji…ch 6 table 6.35 kart

- Lung: exams, tidal volume, residual volume, etc

- Lots of physiology of endocrine system: pituitary and adrenal hormones

- Systole, dyastole

- If you stimulate the salivary flow in 1 side of the mouth, where does the saliva appear?? : Bilateral, ipsilateral(correct), contralateral, etc

- Function of intermediate zone of Adrenal Gland?? Histo daikho to 3 zones milay gy…intermediate zone CORTISOL/GLUCOCORTICOID bnaye ga..dono nam yad kro

- Neutrophils family : Granulocytes

- When neutrophils are present the most?? Bacterial, viruses, fungi, etc... : Bacterial

- Buffering in saliva?? : Bicarbonate ions ch4 pg 98 mov of molecues

- Thick muscle fiber thin muscle fiber : A-band represents over lapping of thick n thin filaments,H band- present in the middle part of A-band represent thick filaments.

I- band represents thin filaments and is present b/w ends of the A-bands of two adjacent sarcomeres.Each I-band surrounds one Z-line

M-line is the dark line in the middle of the H-band that represents the protein that links the central parts of the thick filaments together.

Thick filaments contain mysoin and thin contain actin.

- Qs about ions????

- Composition of saliva….confusing sawal aya tha is mai sy koi konsa ion kya kray gab la bla itra said…check online…kya effect of ion on hormone kafi dept mai tha sawal….365 366 bb

- Gas released during fat and carbohydrate metabolism?? : (CO2)

[01:58:42] Mujtaba Choudhry: Cellular respiration, for instance, is the oxidation of glucose (C6H12O6) to CO2 and the reduction of oxygen to water. The summary equation for cell respiration is:

C6H12O6 + 6 O2 → 6 CO2 + 6 H2O

The process of cell respiration also depends heavily on the reduction of NAD+ to NADH and the reverse reaction (the oxidation of NADH to NAD+). Photosynthesis and cellular respiration are complementary, but photosynthesis is not the reverse of the redox reaction in cell respiration:

6 CO2 + 6 H2O + light energy → C6H12O6 + 6 O2

- What is the role of HCO3 in saliva?? : buffering

- What is the role of NaCl in saliva?? : ability to taste salt....p159 BB

- What makes saliva, isotonic, hypotonic?? : bicarbonate..159 bb

- What enzymes are present in saliva and its actions?? Imp…saray…emq askta hai

Amalyse lysozyme lactoferrin sialoperoxidase

- What is the type of secretion of salivary glands mucous(Submandibular+Sublingual+Minor SG), serous(Parotid) etc ..parotid is serous

Submandibular is serous mucos both…sublingual is mucous….pg 60bbb

- Effect of exercise on systole, diastole, cardiac output , peripheral resistance, que were what increase and what decreases.5 to 6 questions CO increases,TPR decreases

- What are the end products of CO2 metabolism?? : hydrogen carbonate or carbonic acid….pg458 resp phsyio ch13

- What combines with O2?? : heamoglobin

- What is the arterial pressure for 02and C02?? O2 is 100, Co2 40

- Do the O2 dissociation curve then you will not have problem answering the questions! as there were questions related to it…..itrany kaha bsss parh lena..pg 455vander..ch 13 fig 13.26

- Which anion is present in bone?? : phosphate n bicarbonate …..itra has no idea

Pg 250bb

- What is the effect of exercise on Systolic pressure, Diastolic pressure and Total Peripheral resistance?? : Systolic increases, Diastolic remains same in normal aerobic but in athletes decreases and coronary disease increase, TPR decreases.

- Which clotting factors are associated with the following conditions…EMQ aya tha

i) Christmas disease… factor 9 (ii)Von williebrrands disease..factor 8 (iii) Haemophilia A…factor 8

iv)Diseminated intravascular coagulopathy ..1(fibronign) (v)Vitamin k deficiency.factor 2(factor 7,9.10 b invove hotay pr mostly 2)..scully

- Machine used to measure lung functions?? : Spirometer

- The total amount of air that can be exhaled after a maximum inspiration?? : Vital capacity 4700

- The volume of air remaining in the lungs at the end of a maximal expiration?? : Residual volume1200

- The amount of air breathed in or out during normal respiration?? : Tidal volume500

- The volume of gas contained in the lung at the end of maximal inspiration?? : Total lung capacity5900

- What part pituitary partially controls the adrenal?? : Anterior (ACTH)

- what increases pulse rate during exs?? : Stroke vol

- SALIVA CONTENT AND FUNCTION

- SALIVARY GLANDS; LOCALIZATION, TYPE OF SALIVA, COMMON DISEASES FOR EACH.

- EVERYTHING IN ANEMIAS

- EVERYTHING IN CARDIOVASCULAR SYSTEM

- EVERYTHING ABOUT ENDOCRINE SYSTEM

- STRUCTURE OF THE MUSCLE: CARDIAC AND SKELETAL

- Clotting factors and formation of clot – Fibrinogen, Fibrin, Prothrombin, Thrombin, Factor XIII (stabilising factor

- Blood PH – 7.36 – 7.44…wiki blood

- Oxygen pressure within the alveoli – 105mmHg..vander mai table hai

- ACTH production – where: anterior pituitary

- Cortisol production - adrenal cortex

- Saliva main role – lubrication

- Saliva – 5 questions

- buffering responsible: bicarbonate

b- Immunoglobulin present: IgA

3 others

- Neurophysiology – Na+, Ca++, Excitatory () and Inhibitory (+70mSv) Synaptic, neurotransmitters liberation process: exocytosis…lala ny youtue dekhi thi aik video.itra ko lgta ye oppsite lgta hai so she said isko chek krlo…..SYNAPSES 156 latest ed ch 6 neurosignalling…meray pas pg 197 in 11^th ed

Resting mem potential -70

Action pot 50-60

- Noradrenaline – catecholamine produced by adrenal medulla thats works in stress and increases B.P

- Glycogen –polysacchride molecule that store glucose

- Monosaccharide and disaccharide – glucose, galactose, sucrose, lactose, maltose : pg 30 table 3-4

Polysacchrides (starch,cellulose,glycogen

Disacchrides(lactose,maltose sucrose……ye b pochtay hain…..

Monosacchrides(galacose,glucose,fructose)

3. Gen Patho/Immuno

- Immunology-hypersensitivity reactions,types of Ig,and where they’re found

- Which immunoglobin is pentameric-IgM…

J chains are found in both IGA and IGM…but go for A.agay depnd on option

- Questions of cells in immunity

- Questions about hypersensitivity

- Lot of things...... starting from when different Ig r formed n what they do n all stuff... i would say that everything from this was asked.....

checkout http://www.webmd.com/a-to-z-guides/immunoglobulins

- Structure of Immunoglobulins (Ig) - J-chain is seen in which Ig?? : IgA

- Pentameric structure relates to which Ig??- IgM

- Salivary buffer? Bicarbonate.......p368 BB

- hypersensitivity type 3 present in ? SLE and RA, serum sickness

- hypersensitivity in anaphylaxis?? : type1

- hypersensitivity in rhinitis ?? : 1

- hypersensitivity in allergic ahinitis ?? : type 1

- Abo blood reaction is what type of hypersensitivity?? : type 2

- Most abundant immunoglobulin in saliva during infections?? : IgE..khud search krlo.coz salive mai igA hota hai..its confusing coz of infection….final IGA.

- Which immunoglobin is pentameric?? – IgM

- Hypersentivity ques eg . - which immunoglobin will increase in gingival inflammation?? : , inside gingiva IgM??? Itra said IGG..if they ask what is made first in infection then go for IgM

- What type of hypersensitivity in Rhematoid arthritis?? : 3

- Which immunoglobin is abundant in saliva?? : IgA

- Lymphocytes(viral infections), Neutrophil(bacterial infections), Macrophage(mediators TB), Monocytes(acute infections) will increase

- Anaphylaxis , Eosionophils increased in which type of hypersenstivity?? : Type 1 & IgE, Eosionophils in parasitic infections & Type 1 & IgE.

- which IG increase in periodontitis?? : IgG???itra said usko nhi pta

- which immunoglobin is Dimeric?? : IgA

- In delayed hypersensitivity reaction the patch test should be checked after 48 hours.

- What type of hypersensitivity do you find in Anaphylaxis?? : Type 1

- What will you see in a patient with Penicillin Allergy?? : Skin rashes, (others; swelling of face, laryngospasm, tachycardia, hypertensive)

- Immunoglobin in reaction to perfume?? : IgE & type 1 hypersenstivity

- Lots of questions on hypersensitivity reactions and cells mediating them; e.g. Grave’s disease is what type of hypersensitivity reaction: (type 2)

- Immunoglobulin in mucosa?? : IgG…isko confm krlo itra said.IGA doubt hai

- Immunoglobulin which crosses placenta?? : IgG

Baby k pa 1^st immunity IgM ati hai…be careful is sy miltay jultay qusetn atay hain..phir mother se igG baby ko aata hai..

- Hypersensitivity I, II, III, IV, V : rubber dam reaction typ1 , anaphylactic shock typ 1, contact dermatitis typ 4, etc ...............p419 Scully

Latex recation breathing related type 1 hota hai..waisy latex mai typ1 n 4 dono atay hai

- Which tissue heals without Scar?? : Oral mucosa..itra said can be bone.n kafi confusing she said

- cells seen in chronic Inflamation?? : Macrophages, Plasma cells, Lymphocytes........p487 BB PML

-cells seen in acute Inflamation?? : Neutrophils.....p487 BB

- Antibody IgG(type 3 hyper) seen in which conditions?? : Chronic Inflammation, Periodontitis, Reumatoid Artritis, Kidney Disorders

-Which type of antibodies are more in saliva?? : IgA

- Examples of of each type of immunity reactions?? : T.B.(type 4 hyper)T-cell mediated reaction, R.A.(type 3 hyper), Reumatc Fever(type 2 hyper)

- Type of hypersensitivity, like what is type 1(Immediate hyper), type 2, etc??

- Lot of Qs on Immunoglobulins, which is most abundant in saliva?? : IgA

- Which immunoglobulin is present after a bacterial and viral infection?? : IgM(in acute infection), IgG(in chronic infection)…..remember MA GC

- Which immunoglobulin is pentameric?? : IgM

- Which cells are present in chronic inflammation?? : Macrophages, plasma cells, Lymphocytes

- What all can be seen during the process of healing?? : Collagen, Fibroblasts, vascular endothelial cells(angiogenesis)

- Level of IgA

a) saliva>serum>breastmilk>tears

b)serum>saliva>breastmilk>tears

c)saliva>breastmilk>tears>serum

http://en.wikipedia.org/wiki/Immunoglobulin_A

- What percentage of uk population have type 1 hypersensitivity?? : 20-30%.....p411 Scully

Percentage of population which is allergic then its 10 %...itra said ye confuse met kro.phir b have final look!!!

- Which type of hypersensitivity is seen in tuberculosis?? : type 4

- Which type of hypersensitivity is seen in a patient who is allergic to latex and Kiwi ?? : type 4(chronic) & type 1(acute)

- Several questions on hypersensitivity rxn…… which type involved in blood transfusion etc?? : type 2

- Hypersensitivity (Ig + diseases)

- What type of defence cells you see in different diseases?? :

- Ig responsible for type 2 hypersensitivity response?? : Ig G

- A lot of Qs on cells of immunity- e.g. cells seen in infection, etc.,

- Hypersensitivity types 5 questions - diseases related to it – Grave’s disease and others

4. Micro

- Hepatitis antigens….itra said infection control BD sheet parhna 2013/12 wali pg 5 …us mai acha given hai…572 bb

- Instrument spreading prions : endodontic files and reamers therefore its single use now…583 bb

- Most common cause of food poisoning bacteria in the UK may be salmonella : camphylobacter (its micro aerophil type) then salmonella>listeria>e coli…

http://www.nhs.uk/Conditions/Food-poisoning/Pages/Causes.aspx

- Bacteria in urinary tract :E.coli (facultative anerbe),N gonorrhoea,treponema pallidum,chlamydia trachomatis…all ok hain per more common e coli

- Most stable virus outside the body : HAV coz it spreads by oral fecal route and stays in feces for long..hep e is also oro fecal but most stable HAV hai

HEP C k liye no antigen wagera required///Hep B C survive outside body for very short time…mode of transmission is needle stick ijury or body fluids

http://hepatitis.about.com/od/questions/f/Virus_live.htm

- Micro organism resilient to decontamination and sterilization : prions

- Streptococcus is positive and facultative anaerobe- Gram positive/negative; …..aerobe/anaerobe? Facultative is anerobic……..ita said just do the table..us ny file bheji hai…..

- Organism associated with hairy leukoplakia- EBV..580bb

Ebv also causes infectious mononuclsis(some cytomegalovirus also causes IM)

- What type of virus is hepatitis A….572bb…all hep are RNA except B

a. DNA

b. RNA : yes

- Prions are associated with what disease? CJD.583 bb

a. Creutzfeldt Jacob's disease..blue book mai acha likha hoa hai viruses wagera .. n its enuff there

- What type of organism is streptococcus viridans?? : gram positive cocci,facultative anaerobes

- Infection in urinary tract, which bacteria?? : Escherichia colli

- Bacteria that most commonly cause infection in digestive system in the UK? camphylobacter

- Number of candida in smear? We do not know yet the answer

Itra ko ye questn b paper mai b aya hai pr usko aj tk ye nhi mila,emq aya tha scenario…questn mai number of candida 100 likha hoa tha,denture wearer tha plus dry mouth tha.phir end mai diagnosis pocha hoa tha k its normal ,sjogrn syndrome ya candidaal infection...ab asal mai normal nuber and pathological number pta hoga to diagnosis pta lagy ga….

- What causes food poisoning?camphylobacter

- Which organism is most stable outside the body?HepAV..basic questn hai..koi file hai wo daikhna

- How many exposures of hepatitis vaccine is required for immunity?hep A-( 2 doses :1 and then 2nd is given after 6-12 months of the first one)

Hep B - 3doses (1st dose and then 2nd given 1month after 1st and 3rd after 6 months of the 1st dose)in scully241

- Hepatitis A, B, C, D, E

- Most commom oro-faecal route hepatitis?A….E is also Orofecal but not as common as A

- What cells do you see in parasitic infection? , eosinophils, etc

Basophil allergic condion mai hotay hai n histamine relese krtay hain

- Which cell release histamine? Mast cells…wiki.mainly seen in type 1 hyp..very similar to basophil but are differnt

- Which immunoglobulin is present in hypersensitivity type I? IgE…472bb

- Which virus is more stable out side the body:A

- Which virus is least stable out side the body : HIV.emq bna ho skta hai…hep B b ho skta hai…itra said HIV …still confusing

- (Cjd prions) what organisams not killed by sterilization

- Which virus is stable outside the body …A

- Significance of the surface marers in hepatitis b…itra ko b nhi pta..khud krna..gul sent a link

- What are Prions…they are proteins..see BB

- Which virus causes hand foot and mouth disease.coxsackie A and Entero virus 580 BB

- Some question on EBV…bb 580//scully 488…saliva is main trasmitter ..causes infectious mononucleosis,burkitt lymphoma,nasophryngeal carcinoma,oral hairy leukoplakia

- Viruses – HIV, HPV, HBV(((study from 572 BB)

Cd4 cells zeyda effect hotay hai HIV mai..is tarah k sawal pochtay hai.HIV mai kya zeyda cell konsy km..itra said

Hpv: genitial warts ,conduloma acculamotumcause krta hai

5. Oral Path/Oral Med

- Sjorgen primary and secondary , different scenarios between primary and secondary associations......p295 cawson.it

Secndry mai koi disease assoiated hoge eg rh arthritis.ita said straight forward pocha tha paper mai

- Questions on Salivary gland diseases, very confusing unilateral bilateral ,bacterial and viral infections are called wha .......p291 cawson.....unilateral e.g; Frey Syndrome p728 PB

- Sarcoidosis-.........(persistent, painless enlargement) Systemic Chronic Granulamatous disorder of parotid & minor salivary glands of unknown etiology. Heerfordt Syndrome (uveaparotoid fever) + Melkersson–Rosenthal syndrome is associated with it. .......p729 PB, p386 cawson, p194 soameshttp://en.wikipedia.org/wiki/Melkersson%E2%80%93Rosenthal_syndrome

- Shingles(herpes zoster): HHV-3 ( Vericella-zoster virus)- (also in chickenpoxin children), Facial pain. Rx: antiviral drugs. Ramsay Hunt Syndrome..... OM p155 soames…syndromes atay hai paper mai itra said..patho boht i thi

Sarcidosis mai swelling or lower lip..or conditions jin mai lower lip swelling ho wo b parh lena..337 cwson 194 soames…associated with heerforth syndrom

- Orofacial oedema.... Melkersson–Rosenthal syndrome is associated with it

Heerforths syndrome se b associated hota hai. OM p729 PB…soames 139 itra said do it!!!

Cells involved b pochtay hain

- Xeroderma pigmentosa: Autosomal Recesiive disorder in which ability to repair damage caused by ultraviolet light sun occurs.Characterised by multiple basal cell carcinoma, melanoma and squamous cell carcinoma are the two most common causes of death in XP victims. This disease involves both sexes and all races. (http://en.wikipedia.org/wiki/Xeroderma_pigmentosum)

Itra said paper mai bachy ki pic I thi..google mai daikh lo.dark spots hotay hai…also called solar keratosis,japnese mai zeyda,children of night

- Cells present in Acute and Chronic infection...acute: Neutrophils,raised ESR.... chronic: Macrophages, lymphocytes,plasma cells,monocytes...... p486-487 BB

- Cells in granulomatous inflammation : giant cells.MACROPHAGES....in TB, Sarcoidosis & Crohn`s disease Granulomatous Inflammation is found....... p487 PB EXAM mai aya itra k

- T1N0M0 % of survival: Stage 1: 80-85% STAGE 2: 65% STAGE3: 30- 40% Stage 4: 10% ...... table 22.8 p524 Scully..soames 146…he book mai diffrnt hai

- Notched upper incisors: Congenital Syphilis, treponema pallidum, Rx: .....p160 soames, p397 PB

- Coeliac disease,oral characteristics..minor type ulcers....404 .p432 PB, p393 cawson

Crohns disease mai minor ulcers hotay hain

- Erythroplakia and leukoplakia,their sites of occurence.....Leukoplakia: buccal musosa most common Floor of mouth,ventral surface of the tongue......... p414 PB Erthroplakia: Floor of mouth, ventral surface of tongue, lingual alveolar mucosa, soft palate.....p458 Churchill

- Pleomorphic adenoma. Parotid gland tumor....p301 cawson p215 master1

- Torus.......p378 PB, p5 + p156 cawson

- Raynaud’s phenomenon ....p426 scully (http://en.wikipedia.org/wiki/Raynaud's_phenomenon)

- Histopath of dentinal and enamel caries......p50 table 3.2 + p57 cawson. p25 soames

- Treatment of trigeminal neuralgia, tension headache,facial dysgeusia.....OM/odell313

- Lots of questions on different types of facial pains.....OM/odell

- Lichen Planus diagnosis.....p430 PB, p226 cawson, p182 master1

BIOPSY kry gy….Clinically whickams striae…histo : saw tooth like

- Picture of dentinogenesis imperfect, fluorosis, tetracycline staining
(see pictures)......p28 + p32+p33 cawson, p10+p11+p13 soames

- Candidiasis in denture wearing patients and in HIV patient .....p213+p215 cawson, p324 +p400 PB, p180 Master1

- Mumps…295 cwson..paramyxovirus can be uni or bilateral

- Lots of questions on parotid swelling 1-Gorlin-Goltz Syndrome.....p127 cawson, p728 PB

1.basal cell nevai ….2) OKC 3)jaw n skeletal anomlies….frontal parital bossig,clef lip palate,bifid ribs,intracranial abnormalities including calcification of falx cerebri and abnormally shaped sella turcica

- Papillon Lefvre Syndrome (basal cell nevus syndrome)........p90 cawson, p730 PB, p34 Master2

Hyperkeratosis of palm n soles,effect both dentition,aggrssin gingivitis>periodontits

- Cliedocranial dyostosis...........p727 PB, p174 cawson

Hypoplasia /aplsia of clavicle,short stature,frontal bossig,failue of eruption of teeth,supernumry teeth,pnumtized air sinus,high arch palate

- Fibrous Dysplasia (characteristic X-ray features) :early lesion*ground glass appearance, Well-established lesion*orange peel or thumb-print appearance. it causes Albright`s syndrome......p183 cawson, p378 PB, p108 Master

- Torus

- Carcinoma(squamous cell carcinoma) Etiology: Alcohal, Tobacco (HIV + Betel nut, paan).....p277 cawson, p416 PB

- Pleomorphic Adenoma

- Questions with photos of : herpes simplex(Peutz- Jeghers Syndrome), herpes zosteror shingles(Ramsay-Hunt syndrome) , scleroderma- THICK AND STIFF PDL FIBRES (small rima oris=limited mouth opening), lichenoid reaction, mucocelae, frictional keratosis,........p153, p156 soames, p195 cawson, p228 cawson, p83 soames, p252 cawson p121 soames..485 scully mai photos of herpes hain types bhi kro

LICHENOID REACTION

HHV1 HHV2 HHV3(zoster) HHV4 HHV5 HHV6 HHV7 HHV8(KAPSOI)

- Other questions on oral medicine, hepatitis,

- Cells found in herpetic stomatitis, lichen planus and other conditions......Tzanck cells ,infection of Epithhelial cells(Lipshutz bodies)in herp stomatitis…….., T-lymphocytes(both cd4 n 8…but more cd8(lichen planus)....p398 PB, p225 cawson

- Composition of amalgam causes black tattoo, corrosion : silver become associated with Sulphur causes tatoo.......p199 soames amalgm can also cause lichnoid reaction

- Organism associated with hairy leukoplakia - EBV-HHV 4 (Epstin-Barr Virus); viral mucosal infection in HIV......p356 cawson///179 master1

- Question about multiple myeloma...... neoplasm of plasma cells(marrow tumor) increases ESR and IgG 50% increases and IgA increases 25%.....cawson p163

Palate mai common hai(melanin is more common in keratinized mucosa or palate zeyda keratnized hota hai is liye multiple melanoma(pepper pot appearance) ki common intraoral site is palate) amna told scully mai given hai

- Picture of notched maxillary incisors.....congenital shpylis.....(cawson 31)

- Picture of ectodermal dysplasia.....baby pic.....cawson p21-22, p4 soames…289scully

- Picture of the palate with torus palatinus......posterior of the midline of hard palate.....p158 cawson

- Most common reason for missing upper central incisors... trauma*, supernumerary(coz they prevent normal teeth from erupting), hypodontia…..see65 pb

- Effect of radiation therapy – post treatment

(Xerostemia,leukocytosis, osteoradionecrosis, mucosal & skin atrophy,scarring & fibrosis, malignancy)........cawason p285

- Questions about xerostomia : cholinesterase inhibitors pilocarpine.....p295,p298 cawson

- Treatment to pemphigoid when no response to corticosteroid?? : DAPSONE(1st line Rx in preference to systemic steroids)......p234 cawson

- Picture of a lesion near the eye : Erythema multiforme- HERPETIC INFECTION AND DRUGS ......p182 soames //some say BCC

- Picture buccal mucosa close to the comissure – Pt come from India after 6 months, he tried chewing paan, he doesn’t smoke, but he drinks alcohol very often and He’s HIV positive. Options: SCC, TB, Syphilis, Oral submucous fibrosis..... (oral submucous fibrosis)......p197 soames, p269 cawson

- Picture of hypoplastic defects of teeth : amelogenesis imperfecta.....p11 soames, p25 soames

http://lesleypaulvj.hubpages.com/hub/Enamel-Hypoplasia-Causes-Symptoms-and-Treatment

-Picture of 15 year old with gingival swelling : herpetic gingivostomatitis or puberty related coz 15 year boy >>>adoloscent....p94 cawson…..most probably its PUBERTY in this case

- Swelling of lower lip + linear ulceration buccally - Orofacial granulomatosis…. Its right and it can be associated with.. Chron`s disease............. (cawson 394, soames p194)

http://www.bsom.org.uk/PatientInformation/BSOM_OFG_PIL_-_final.pdf LEARN

- Treatment of acute dental abscess?? : DRAINAGE…..222pb..its severe pain,TTP

Chronic abcess is symptomless

- Picture of child with apical abscess…..questin incomplete.to pora krlo

- Child with dry mouth – salivary gland aplasia (http://www.ncbi.nlm.nih.gov/pubmed/21703060) (http://onlinelibrary.wiley.com/doi/10.1111/j.1365-263X.1993.tb00070.x/abstract)

SalivRy gland aplasia is usually UNILATERAL,lack of development of organ/tissue…it can be one of the reason

- Lot related to oro facial granulomatosis even

- Picture of ectodermal dysplasia

- Picture of palatine torus

- Identification of age from a lateral skull radiograph……

- Picture of teeth effected with syphilis

- Most common reason for missing upper central incissors?? : trauma, supernumerary teeth, hypodontia

- Picture of hypoplastic defects of teeth

- Picture of 15 year old with gingival swelling…...herpatic gingivostomatitis

- Picture of basal cell carcinoma........... p 147 soames///wiki too

Usually on face under eye and nose…also see 272 my scully

- Histopathology of salivary gland disorders : infiltration, inflammation of glands, acinar destruction or necrosis

- Why do sometimes periapical granulomas become asymptomatic? : Pulp necrosis

- Effects of radiotherapy?? : osteo-radionecrosis, rampant caries, XEROSTOMIA,LEUKOCYTOSIS,SCARRING,ATROPHY etc

- Treatment to pemphigoid when no response to corticosteroid?? : Dapsone or drugs from sulphonamide group (i.e; cyclophosphamide)

- Which leukoplakia is most likely to turn malignant?

a. Erosive

b. Ulcerated

c. Speckeled-yes

- What percentage of oral submucous fibrosis become malignant? : 10%....p268 cawson

10% in 10-15yrs pb415…agay options py depnd krta hai

- What percentage of lichen palnus/leukoplakia ( i don’t rem) turn malignant?

a. 0%(less then 1%) lichen planus(very low risk of malignance) , 5%pink book ......... depnd upon years

- Patient presents with ulcer which he’s had for 4 weeks. What will you do?

a. Refer to specialist.......p14 Master

b. Perform incisional biopsy

- not a feature of malignant melanoma ......p329 cawson

a.hair growth

- Fig of hutchinsons teeth and mulberry molars......congenital syphillis.

- treatement of candidiasis in hiv patient?? pseudomembranus so fluconazole.......p217 cawsom

- risk of malignant transformation of leukoplakia in 10 year period ?? 2.5 (1-2%) ......p264 cawson

5% in 20yrs time

- questions on type of cells in inflamation ,lip swelling(acute) , sarciodosis(chronic) ,rheumatiod arthritis(chronic p196 cawson)?? : Acute(Neutrophils) Chronic(macrophages, lymphocytes, plama cells=PML)

- type of cells in gingivostomatitis?? : virus damaged epithelial cells TZANK CELLS

e swalloen nuclaei, multicucleated cells & marginated chromatin(balloning degeneration).......p207 cawson.....{tzanck(acantholytic) cells >pemphigus vulgaris, herpes zoster, herpes simplex, cytomegalo virus. }

- What enzyme assists microorganisms when they are causing dentine caries?

a. Collagenase

b. Enolase - YES

c. Latoferin

- Questions on mucocele, where is it usually found??

a. Upper lip

b. Lower lip -yes

c. Floor of the mouth

d. Palate

- How would you treat a mucocele??

a. Excise it with the salivary gland

- Which of these infections would cause congenital deafness??

a. Rubella -yes

b. Measles

- Questions on apthous ulceration(RAS)........ p176 soames

- What kind of lichen planus is more likely to turn malignant?...........p193 Master

a. Bullous

b. Erosive / NON-RETICULAR TYPE-yes

c. Papillary

d. Atrophic-yes

- What cell attachments are affected in Pemphigus?

a. Desmosomes – yes DESMOGLEIN 1&3

b. (Hemi desmosomes - in pemphigoid)

- Picture of the tongue with an ulcer on the lateral border- what drug causes it

a. ACE inhibitors –yes CAPTOPRIL,ANAPRIL

b. Calcium channel blockers- NIFEDIPINE

c. Potassium sparing drugs

NICORANDRIL, AZYTHROPRIN, PHENYTOIN,CHLORAMPHENICOL

- Picture of the buccal mucosa with a white line at the level of the teeth- what causes it

a. Lichen planus

b. Lichenoid reaction

c. Traumatic keratosis -yes LINEA ALBA

- Picture of a tooth with rampant(or acute) caries, how would you manage it

a. Extract the tooth (if poor prognosis)

b. Use fluoride (if elderly pt.)

- First stage in management of rampant caries

a. Excavation and temporization

b. Prevention and stabilization

- Picture of a man with a whitish growth on his upper lip, what is it?

a. Squamous cell papilloma- (CORRECT)

b. Squamous cell carcinoma- ULCERATION

c. Basal cell carcinoma-ULCERATION

- Picture of a swollen gingiva, what can cause it?

- Questions on the symptoms of reversible and irreversible pulpitis, acute and chronic periapical periodontitis, and periapical abscess. ......p70 cawson

- A picture of the gingiva of a black person with melanin pigmentation and a white line across the central incisors alone

3 questions,

What is the cause of the pigmentation

a. Racial......correct

b. Addison’s disease

What is the cause of the white line

a. Amelogenesis imperfecta

b. Dentinogenesis imperfecta

c. Hypomineralization....(CORRECT)

d. Flourosis

How would you manage this white line

a. Composite veneers

b. Porcelain veneers- ANSWER

c. Porcelain crowns......p8 soames

The picture was obviously that of a young person because the lower incisors still had their mamelons and the canines were still erupting.

- A picture of a man who can’t open his mouth properly for treatment, what condition does he have?

a. Scleroderma.....p195 –MASK LIKE FACE,STIFFNING,COLLAGEN DEFECT,DIFFICULTY IN EXTRACTION AND MOUTH OPENING

b. Sarcoidosis

- Acute pseudomembranous candidiasis is associated with which disease?? : HIV (Anemia).....p162 soames

- Picture of notched maxillary incisors – congenital syphilis

- Which antibiotic causes rash if given in infectious mononeuleosis – : Ampicillin or Amoxycillin(aspirin)......irritating macular rashes....p371 cawson

- What percentage of patients with oral submucous fibrosis become malignant?? : 10% ....p268 cawson

- Picture of a child suffering from ectodermal dysplasia.....

- Picture of a lesion near the eye of a man??......CAN BE HERPES....(Erythema multiforme- TARGET LESION).....p182 soames…can be BCC

- Picture of the palate with torus palatinus....

- Most common reason for missing upper central incisors?? : SUPERNUMERY

- What is the post-treatment effect of radiation therapy?? : osteoradionecrosis

- microscopic view(ground sections) of tooth, We had to diagnose till which layer caries has spread and treatment options..... Cawson & Odell chapter on caries.

- Which of them will u treat eg.dentin caries ,enamel caries there was a ques like this...

- Picture of a lady having SCLERODERMA : (CREST AND RAYNAUD’s)........p195 cawson, soames

- Pemphigus and Pemphigoid which one has subepithelial antibodies : Pemphigoid.......... p408 PB, p285-p286 Scully

- Picture was given and they asked whether it is frictional keratosis ,fordeyces spots ,lichen planus, squamous cell carcinoma..........p121 soames, p253, p226, p281 cawson, p128 soames

- EMQ on Pulpitis rev and irreversible ,Periodontal abcess ,Periapical abcess they had given signs /clinical scenarios........p192 PB

- which disease is most infectious?? Options were AIDS , hepatitis etc : Hepatitis

– Biopsy – white patches (: leukoplakia, lichen planus,etc)

- What do you find in the caries tissue?......... Not clear

- Lateral periodontal abscess – to confirm diagnosis what test do you use? Cold and hot which give positive result, showing that is only periodontal and does not have pulpal involvement??.......p192 PB : Electric pulp test,usually tooth vital :it responds cold test well.............p88 cawson

- Cleidocranial dysostosis or dysplasia?? (lot of questions, the ones that were given) ability to appose shoulders, mandibular retrognatism(wrong), delayed eruption(ok), supernumerary (ok)

**Remember also: hyperdontia, twisted roots, malformed crowns,persistence of deciduous dentition, multiple unerupted teeth, high percentage of dentigerous cyst, mandibular prognathism, persistence of deciduous teeth................p384-385 Scully, p242 soames

- Cleft palate- 3 MONTHS and lip- 1 MONTH. There was a picture of a baby and lot of questions , time of surgery options, prevention maxilla growth after the surgery, graft surgery at what time?..........p170 -p472 PB

- Picture with ulcers in ventral part of the tongue, herpetiform type ulcers(Minor Apthous Ulcers - RAS) : options given , coeliac disease, etc...(ulcerative colitis, Crohn`s disease).........p178 Master1, p405 PB, p179 soames

- Behcet’s disease..... p224 cawson, p726 PB ORAL AND GENITAL ULCER, UVEITIS

- Primary and secondary sjogren

- Picture of leukoedema to recognise.....p252 -p275 cawson, p175 master1

ON STRETCHING IT DISAPPEARS

- Picture of White Sponge Naevus to recognise.....p256 cawson, 120 soames – BASKET WEAVE APPERANCE/ INTRACELLEULAR ODEMA

- Pyogenic granuloma on gingivitis(=pregnancy epulis).......p316 cawson

- Desquamative gingivitis : found in 1.Lichen planus, 2.Pempigous Vulgaris, 3.Mucuos membrane pemphigoid...........p235 cawson

- Picture with missing maxillary lateral incisors : Ectodermal dysplasia, Hypodontia...p64 PB

- Picture with mid-line supernumerary teeth : Mesiodens .......p64 PB

- Patient has oral & genital ulcerations & problems with his eye-sight : Behcet’s syndrome(Rx. Thalidomide)

- What is found in a patient with cleidocranial dysotosis?? : Failure of eruption of teeth, supernumery teeth, dentrigous cyst, absence of clavicle

- Patient has scarce hair & missing teeth?? : Ectodermal dysplasia

- Picture of a man with radiation burns on his cheeks. Intra-orally you will find acute mucositis?? : after effects of radiotherapy........p201 master.....{Mucositis is commonly seen in high dose chemotherapy protocols for hematologic malignancies (ie conditioning or induction regimens for leukemia), or aggressive chemo-radiation for head and neck cancers. It is a term physicians use to describe a wide range of oral complications related to cancer treatment.This may include redness, pain, ulceration, swelling and surface lesions (pseudomembrane, hyperkeratosis, lichenoid lesions)}

- What is a long-term effect of a patient who has had radiation therapy for carcinoma?? : Xerostomia

- Which dental procedure will you perform most carefully in a patient who has had radiation therapy?? : Dental extractions

- Patient complains of pain near the salivary glands while eating & there is reduction in the flow of saliva?? : Salivary calculus

- Patient complains of enlargement of both parotid glands?? : Mumps (MMR vaccination)

- Patient complains of pain on one side of the palate?? : Herpes zoster…..

- Reactivation of the herpes zoster virus causes Shingles.......p398 PB

- Condition with irregular Thick White patches?? : White sponge neavus (bilateral & symmetrical)......p275 cawson

- White lesions with Reticular striae?? : Lichen planus

- Man with white lesions which when scrapped off leaves an erythematous area?? : Acute pseudomembranous candidiasis(Thrush)

- Condition in which Epithelium separates from the Connective tissue?? : Mucous membrane pemphigoid(also found Desquamatic Gingivitis)

- Which condition has the most tendency to become malignant??..... Nodular leukoplakia, Speckled leukoplakia(Non-homogenous) Speckled has basically higher incidence of erythmatous & epithelial dysplasia, thus mialignant chances..... p414 PB, p194 master1, p127 soames

- What is the percentage of survival of TIN0M0 tumour?? : 85%.......p524 Scully

- What is sclerotic dentine?? Dentine in reaction to caries. Occluded dentine tubules thats sclerotic dentine...

- Picture of a patient with dentinogenesis imperfecta.....p13 soames

- Lesion on the lower lip?? : Mucocele

- Cyst in which white paste is seen?? : Dermoid Cyst...... p171 Master1

- Lesion on the palate in a smoker?? : Stomatitis nicotina (Pipe Smoker`s Keratosis).....p254 cawson

- Picture of notched incisors : Congenital syphilis

- Viral infection for which there is a vaccine?? : Mumps (MMR vaccine)

- Soft swelling near the lower premolar which bleeds on probing?? : Pyogenic granuloma

- Most common Odontogenic cyst?? : Radicular cyst

- Stephen’s curve’s most important feature?? : Critical pH 5.5........p43 cawson

- Histological section showing dorsum of tongue. Papilla

- Patient with fever, malaise, lymphaedenopathy?? : Acute Herpetic Gingivostomatitis

- Most common site for Squamous Cell carcinoma in a patient exposed to sun-light?? : Lower lip...... p280 cawson

- Acute pseudomembranous candidosis(thrush)......peel off erythymatous skin.

- Minor, major aphthous ulcers, herpetiform ulcers.

- Most frequent site of intra oral cancer : lateral border of tongue ...... p280 cawson

- Erythema multiforme......table13.15 p235 cawson, p182 soames

- HIV

- Site of oral cancer in a farmer exposed to sun light?? : Lower lip

- Most frequent site of Kaposi’s sarcoma : Palate

- Where a salivary gland tumour has more chance to be malignant?? : Sublingual & Minor SG(mostly Adenoid cystic carcinoma~swiss cheese appearance ), >50%, (floor of the mouth)

- Chronic and acute periodontitis, chronic and acute gingivatis, early onset / aggressive periodontitis, periapical periodontitis (association with given cases)

- Hand foot and mouth disease : Coxsackie virus

- Measles

- Paramyxovirus =Measels+ Mumps

HHV-1, HHV-2 = Herpes Simplex virus HSV types

- Squamous cell carcinoma diagnosis

- Herpes labialis cause?? : Sun light(UV light)

- Pemphigus vulgaris

- Mucous membrane pemphigoid

- Osteoradionecrosis

- Actinomycosis

- Pulp stones – Ehlers-Danlos Syndrome

- Pleomorphic adenoma

- Premalignant lesion in palate of 65 years-old. What’s the best thing to do not to progress the disease?? : Stop smoking, stop drinking alcohol, , photograph to compare later, etc

Excision : IF GROWTH STOPS

- Rheumatoid Arthritis and osteoarthroses(JOINT DISEASE : KNEE ELBOW N TMJ

- Tumour in salivary gland which spreads along nerve sheaths : Adenoid cystic carcinoma(Swiss cheese appearance histologically, minor SG)

- Bilateral swelling of slow growth : warthins tumour(Adeno lymphoma, monomorphic)

- Lichen planus

- Lichenoid reaction

- Fluorosis, tetracycline staining, bilirubin(yellowish pigmentation hue of oral mucosa in Jaundice due to haematoma #p201 soames), amelogenesis / dentinogenesis imperfecta

- Kaposi sarcoma

- Extracranial causes of facial palsy (Neuropathy)?? : Adenoid cystic carcinoma, Bells palsy, Sarcoidosis, Parotid surgery, Misplaced LA, Meikerson-Rosenthel syndrome

INTRACRANIAL CAUSES : STROKE,TUMOURS

- Nerve lesions abdusent,hypoglossal nerve.......p508 PB

- Herpes zoster infections

- Cushings disease and syndromes........p502 PB

- Questions about salivary gland diseases

- Pic of denture stomatitis was given and many ques related to the organism, its treatment etc were asked.

Drug used for its treatment : Nystatin / Amphoteracin......p324 PB , p217 cawson

- Do treatment of candidiasis very nicely as they asked a lot which drug is used for chronic, etc

FLUCONAZOLE , MICONAZOLE

AMPHOTERACIN

- Do herpes, its treatment signs, and its treatment as it was asked in indirect way

- Cushing`s disease and its effects

- Epilepsy : HYPERPLASIA

- Acromegaly :

- Gigantism: SAME AS ACROMEGALY

- Haemophillia A, B

- Vit k

- Von Willebrands disease.

- Sickle cell anaemia : HAIR ON END APPEARENCE

BONY TRABACULAE IN JAWS

- Thalaessemia

- What causes AIDS?? : HIV

- What are commonly seen in HIV eg…kaposis sarcoma

- Treatment of Rheumatic fever?? :

- What happens in tetanus : JAW LOCK

- Sjogrens syndrome

- Clinical features were given and we had to match them like

- Planar erythema, Splinter haemorrhage, Silicosis, Sharp shooting pain radiating to the shoulder etc etc Do angina very thoroughly

- Pemphigus and its method of investigation?? 1.Immunologial studies(circulating autoantibodies to desmosomal proteins) 2.Biopsy( Immunoflorescent technique).........p181 soames

- Lymphoma.........p491 PB, p113 soames

- Pleomorrhic adenoma.

- Sialolithiasis.

- Sjogrens syndrome,

- Behcets disease.

- Squamous cell ca2, Malignant melanoma 4 prevalance in oral cavity : 2. 70% cases involve the post maxillary alveolar ridge & hard palate(dark brown & bluish black slightly raised lesions by UV light)............. p148 soames

- Facial pain in detail, pain in pulpitis, in neuralgias, in temporal arteritis.etc.(Good in Scully)

- A lot was asked on the type of pain in sinusitis?? : Sudden onset of pain,poorly localized with tenderness of overlying skin......p383 cawson

- Which is the most benign lymphoma?? :

- What is the extrcranial cause(LMN lesion=paralysis of lower face) of facial palsy?? : p440 cawson

- UML and LML and what signs are seen in them. : p440 cawson

UML : UPPER SAVED

LML : FULL FACE EFFECTED EG: BELLS PALSY

- Erythema multiforme

- Lichenoid reaction

- Herpes Zoster

- Lichen planus

- What type of lesion occurs in the following;.............p13 Master1

i)a patient with deviation of the corner of his mouth when he smiles but wrinkling of his forehead is normal : UMN lesion

ii) a patient with bell’s palsy LMN lesion(=paralysis of all the Facial muscles on theaffected side)

iii)a patient with deviation of the corner of his mouth when he smiles and cannot

wrinkle his forehead : LMN lesion

iv) damage to the facial nerve following superficial parotidectomy : LMN lesion

- Which one of the following is an extracranial cause of facial palsy

a)Stroke (b)Melkerson- Rosenthal syndrome -YES (c) Bells palsy (yes)

- Ramsey Hunt’s syndrome is a complication of

a)herpes simplex infection

b)herpes zoster infection -yes

c)coxsackie virus infection

- Hand, foot & mouth disease is caused by which virus?? : coxsackievirus A, especially type 16

- Infectious mononucleosis is caused by which virus?? : EBV

- Which of the following salivary gland tumours is most likely to occur bilaterally

a)pleomorphic adenoma

(Adenolymphoma=Warthins tumor) - ANS

b)mucoepidermoid carcinoma

c)adenoid cystic carcinoma

d)acinic cell carcinoma

- Tetany is caused by

a) increased calcium (b) decreased calcium- YES (c) decreased potasium

........p193, p409, p440 cawson.....: decreased calcium

- For the following questions the options were Cushing Syndrome, Acromegaly, Cushing Disease and Gigantism...........p406 Cawson, p136 scully

i)a 55yr old lady with increased production of growth hormone.......Acromegaly

ii)a 2yr old boy with increased production of growth hormone......Gigantism

iii)a patient with iatrogenic overproduction of ACTH......Cushing syndrome p146 scully

iv)a patient with endogenous overproduction of ACTH......Cushing disease

- A patient with skin pigmentation is most likely to have

a) Addisons disease- YES (b) Crohns disease (c) Cushings syndrome

........: Addisons disease.....p409 cawson

- Commonest site for oral cancer

a)palate (b) buccal mucosa (c) FLOOR OF MOUTH ventral surface of tongue- YES(d) lips
(c)=intraoral , (d)=extraoral......

- Commonest site for Malignant Melanoma in the mouth. (Options as above) : (a)Palate & upper alveolar ridge.........p329 cawson

- In which condition is there a separation of epithelium at the basement membrane

a)pemphigus

b)benign mucous membrane pemphigoid.....correct

c)erythema multiforme

- In which condition will direct AND INDIRECT immunoflourescence reveal binding of autoantibodies to the intercellular substance of epithelial cells.(Options as above)......... : pemphigus

ONLY DIRECT : PEMPHIGOID

TZANK CELLS – BALLOONING DENERATION : LP, PEMPHIGUS,PEMPHIGOID, HEPATITIS C ETC

- What are u most likely to see in a patient with erythema multiforme?? : target skin Lesions.....p235 cawson

- kaposi’s sarcoma is associated with which virus?? : human herpes virus 8.......p485-486 scully

- Which of these is the most benign??

a)kaposi’s sarcoma (b)adenolymphoma(warthin`s tumor)- ANS (c)burkitts lymphoma(EBV) : (b)......p302 cawson

- Symptoms of secondary sjogrens syndrome??

- A picture showing denture stomatitis, asked to identify it........

- a young boy with oral ulcers in the mouth and on lip which is bloody crusted?? : Erythema multiform –TARGET LESION

- A picture of red lesion on border of tongue in a patients who had heavy amalgam fillings on that side.asked what is the dagnosis: opt: SCC, traumatic ulcer,….....: Traumatic Ulcer, LICHENOID REACTION

- A picture of 30 years old man with a lip lesion. he had come back from holiday recently and his new partner had this lesion as well that healed recently. What is the diagnosis?? Tuberculosis, herpes, erythema multiform,…....... : Herpes

- A picture of palate with many vesicle-like lesions on only left side.asked what is the diagnosis?? Herpes zoster, pemphigus,…......... : Herpes zoster (MIDLINE CROSS)

- what is the best treatment for a pt with cured denture stomatitis but resisted angular cheilitis? Opt, miconazole lozenge, fluconazole, nystatin,…….. : Systemic Fluconazole..............p215 cawson, p181 Master1, p492 scully

- what is the best treatment for a patient with denture stomatitis? (Opts as above)......Nystatin!!........... p215 cawson

- Bilateral parotid cancer…… : Mucoepidermoid Carcinoma.....chronic lymphocytic leukemia p219 Master1, p313 cawson........ adenoid cystic, if asked just for tumour go for warthin(Adenolymphoma).

- Cancer in Sjogren`s Syndrome??…….: Lymphoma, :Non-Hodgkin`s lymphomaSjogren's syndrome increases risk of developing non-Hodgkin’s lymphoma, which is a cancer of the lymph glands. However, the chances are still low, at around 5%....by NHS website......p296 cawson

- Person with swollen Salivary Glands+swollen lips+ swollen gingiva…diagnosis??....... : Sarcoidosis or eatforth syndrome ........p387 cawson p419 PB

- FACIAL PAIN CAUSES IE; BLOOD VESSELS, MUSCLES, MEDICATION, SYSTEMIC DISEASE.

- ORAL MANIFESTATIONS IN THE TREATMENT OF GENERAL CANCER........ table p527 scully

RADIOTHERAPY

- HEADACHE AND MIGRAINE.......

- FULL BLOOD VALUES AND WHAT THEY INDICATE??......

- Aphtous Stomatitis......

- Acute Herpetic Stomatitis......

- Herpes simplex.......

- Ulcer picture (lower lip) and clinical situation?? : Syphilis.........p212 cawson

- Upper Canine??

- ACE-inhibitors oral manifestations – 2 questions (lip swelling) : Burning sensation, ulceration, loss of taste, Angioedema, Dry mouth, Sinusitis, Lichenoid reactions...............p113 scully

- Microstomia cause?? : Scleroderma....(small rima oris)....

- Cysts of jaw (3 questions, radiological features?, how to differentiate?).......p157 Master1, Eric Whaites.

- Radicular(most common)

- OKC

- Dentigerous

- Rash on the palate, identify the most possible cause?? : Glandular fever, smoking, thrush......... p399 PB

- Denture Stomatitis – 4 Feature –1. confined to denture area, 2. Dentures over occluded

- Stomatitis treated but angular cheilitis treatment?? : Miconazole gel

- Picture of primary dentition with large Diastema - main pathology and treatment : Hyperdontia(supernumeroray teeth)...........p65 PB

Ugly duckling stage but that is in mixed may be hypodontia

Among five-year old children, during the period of primary dentition, maxillary midline diastema appears in 97% of cases1 and, along with primate spaces, predicts a future development of the mixed and permanent dentition without crowding.2

Moyers (1988)19 studied 82 patients that presented maxillary midline diastema and reported the following causes: a) imperfect fusion at midline of premaxilla (32.9%), b) enlarged or malposed upper labial frenum (24.4%), c) midline diastema as part of normal growth (23.2%), d) congenitally missing lateral incisors (11%), e) supernumerary teeth at the midline (3.7%), f) unusually small teeth (2.4%), and g) combination of imperfect fusion and congen itally missing lateral incisors (2.4%). Other causes for the development of the maxillary midline.

- Picture of an ulcer on mucosa at 1st/2nd lower molar, medical history (aspirin, B-blockers after MI recently) – cause?? : chemical burning by aspirin ..........p443 cawson

- 4 or 5 different questions about (clinical cases) – adenoma, adenocarcinoma, pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma

- Sjogren’s main malignancy: BURKITT lymphoma

- Features to identify: lip swelling, hyperplastic tags in the labial sulcus, buccal fissured appearance : Orofacial Granulomatosis

- Orofacial granulomatosis manifestation more common of : Crohn’s disease

- Picture of ulcer on lateral aspect of tongue and pt has a large amalgam restoration on lower molar – :traumatic apthous ulcer

6. Gen. Medicine

- Dputyren’s sign and other conditions like this: alcoholic liver disease//or seen in liver cirrhosis(goggle kro pic dekho)236 scully + wiki palmer erythema(iska feature hai)

- Diagnostic test for infectious mononucleosis : Paul bunnel and Mono spot tests…bachy ko rash hai ulcer hai fever hai is tarak k sawal atay hai imp hai

- percentage of leucocytes for an extraction : itra thinks around 40-50 not sure…CC545

Normal 4-11 *10 raise to power 9

- Best pulse taken from?? : Carotid

- When is pulse not felt?? : coarctation of aorta, aortic disection

- Glucose levels during fasting and random...normal fasting- < 6 mmol/l random- < 8 mmol/l ..

in diabetics fasting >7mmol/l Random >11.1 mmol/l….141 in scully

- Asthma, angina treatment….recent guidelines

Angina : glyceryl trinitrate 400mcg(sublingual),Ca channel blockers,asprin,Percutaneous transluminal angioplasty (PTCA),Coronary artery bypass grafts (CABG) all ok pg 4 scully

Asthma : Beta agonist such as Salbutamol (safest and most effective bronchodialator for routine control, Antimuscuranics such as Ipratropium

(for those who have asthma with bronchitis),Corticosteroids (if there are daily symptoms of asthma).Systemic steroids,O2 and hospitalization for severe recalcitrant patients.

- What type of test should you ask for a patient with: Diabetes(Fasting plasma glucose,random and oral glucose tolerance test) ,141 scully

Anaemia 203scully (blood tests and blood film,schilling test fro vit b12 def(210 scully),ESR,plasma viscosity,hb,bone marrow biopsy)

on warfarin - INR (normal :1,for dento alveolar extractions : <3.5)PT time (normal)….

1.3 and for dento al veolar surgery < 2.5).. scully195 table

- What kind of Ag should detected to check if the infected dentist with hepatitis B can still work. (skully)If HBe Ag is +ve or HBe Ag is -ve but have greater than 1000 HBV viral particles per ml of blood should discontinue practice involving exposure prone procedures…………infection control BDA sheet sy kro//245 scully…see pgs 220 also my scully

- Questions about inform consent (age)654 pb

- Medical Emergency (Angina 400mcg/2 sprays , asthma 100 mcg/6 sprays, MI aspirin)…pg 4 scully mai hai1

- Questions about rheumatic fever…141 scully…type 2 strp pyogenes,after scarlet fever itraaa told…see which valves are effective..mostly mitral valv…imp points note krlo

- Cushing's disease : excessive glucocorticoid .production by adrenal hyperplasia secondary to excess ACTH production by pituitary hyperplasia…DAP SAC…..146scully

- Tuberculosis (secretion with blood) 373 sculy

- Picture gigantism (IN child b4 puberty) and acromegaly (OLD AGE)

- Tetany : Contracture of the muscles due to low serum Ca levels…

- Leukaemia in adults : acute non lymphoblastic(myeloblastic) leukaemia and chronic lymphocytic leukemia….imp……acute is mature//chronic is immature

- Graves Disease (Primary Hyper thyroidism with a diffuse goitre-toxic goiter basically due to excessive thyrxine hota hai)it also has nonfittng edema

- Trigeminal Neuropathy Medication used…311 scully…also see file kart sent..not sure answer put in FB

- Cranial arteritis/temporal arteritis (ESR is raised)tmj k agay pain ki co krta pt

- Vaccinations (when should we take them scully 511)imp hai polio hep BCG k pochtay hai

- which analysis(tests) to prescribe in certain conditions in patients..

- Rheumatoid arthritis – ulnar deviation,morning stiffness thi n subha brush nhi kiap t ny to yad rakho its RA..pic dekh l google py…ETB is adv to such pts…396 scully

- Osteoarthritis – swelling of joints-herbenden's nodes….2 type k name hain koi..yad krna kon c joint mai konsa hota hai itra said

- Crushing pain in the chest radiating to arm & relieved by sub-lingual GTN – angina…107scully

- Tightness in the chest, wheezing, shortness of breath – Asthma

- Crushing pain in the chest accompanied by vomiting- MI

MI mai hamesha pain n vomit hoge….angina mai pain radiate in arm n jaw..is tarah yad kro

- Patient with breathlessness and sleeps with 4 pillows, associated medical condition-COPD/heart failure: LEFT HEART FAILURE

- After what percentage of blood loss should transfusion be given?20%...542pb

- Tuberculosis - weight loss, fever, cough….ye pochtay hai casseting hai non casseting hai n kon sy test krty..cawson parho

- Treatment for Basilar Artery Aneurism….clpping and tissue plasmin activator…427scully

- Couple of questions on leukemia n its age of occurance..V IMPORTANT

Classified as Acute or chronic or acc to cells of origin (lymphoblast or non lymphoblast)

* Acute lymphoblastic leukemia-peak incidence 2-4yrs but can affect any age grp.Most common childhood leukemia.Tx :cytotoxic drugs,BM transplantation if chemo fails

* Adult Acute lymphoblastic leukemia - worse pognonsis than chilhood rest all the same as above

* Acute non lymphoblastic (myeloblastic) leukemia - most common acute leukemia of adults.esp causes gingival enlargement

* Chronic lymphocytic leukemia - most common type of leukemia.Men particularly affected.Asymptomatic patients may not need tx.symptomatic- with radio and chemo therapy.Prognosis better than acute.

* Chronic myeloid leukmia - proliferation of myeloid cells in bone marrow, peripheral blood and tissues. Have philepedia chromosome.>40 yrs age grp affected. lymphadenopathy is rare.

- study different GIT conditions...especially GIT infections.....

- Questions on SLE(butterfly rash..itra ko oral findings aye ge), scleroderma(mask face,rima oris), rheumatoid arthritis like what does swelling of distal interphalyngeal joints indicate?PIX

RA mai swelling of joints hoga….SLE Raynaud phenomenon parho frm scully

- Sjogren’s syndrome

- Questions on lichen planus and desquamative gingivitis`:also caused by phemphigoid..v imp..pix

- Oral features of Gardener’s syndrome ..imp: multiple osteomas particularly of jaws and facial bones.,epidermoid cyts and fibromas of the skin,lipomas,adenocarcinomas colon polyps,dental anomalies(missing and supernumerary abnormal teeth)pb 728

- Questions on various types of ulcerations…biopsy kro gy to kb kro gy kb bhejogy

- Association of carious teeth in 16 year old with intake of high sugar content and foods with low calorific value; options- schizophrenia, depression, anxiety, etc.,not sure itra…see wiki

- Questions on hypo and hyperthyroidism….

- Questions on Multiple myeloma imp hai:disseminated plasma cell neoplasm (uncommon grp of B lympho disorders).detected by electrophoresis by over production of

specific IG.(IgG 50%,IgA 25%).Predominantly causes bone lesions.Malignant plasma cells produce defective Igs which release osteoclast activating factors

that cause bone resorption and pain.Disease of middle aged and elderly.Detected by high ESR,leucopenia,thromocytopenia in routine blood tests and bence jones proteinuria

.Causes bone destruction ,hypercalcemia,suppression of haemopoiesis,normochromic anemia.Osteolytic lesions in skull radiographs.

(round discrete punched out osteolytic lesions). Amyloid may be deposited in oral soft tissues causing macroglossia.Tx ,chemotherapy with corticosteroids and Bisphosphonates.

- Lots of questions on Candidiasis; related questions on angular chelitis, pseudomembranous Candidiasis treatment in immunocompromised patients………..IMP see Scottish guidelines

- Questions on asthma

- Questions on TB and the side effects the drugs used to treat it cause.rifmapcin use krty for TB per isky sidefcct shotay hai…parh lena wiki sy

- Various questions on conscious sedation and GA; their applications in various clinical settings; inhalational and iv sedation……..pharma

- Questions on infectious mononucleosis :EBV

- Picture of comparatively large hands of a woman.acromegly

- Woman with hiatus hernia with tooth sirface loss. Best treat. Option: (surgery wasn’t an option)

a. Medicine

b. Dietary advice

c. Occlusal splint

- reason for tingling of hands and feet during treatement of long standing procedures … orthostatic hypertension….itra wwasnt sure

- question on sleep apnoea ?left heart failure.pt 4 pillows sath sota hai

- What vaccine is used to prevent tb?BCG

- In which condition would elective surgery be contraindicated for 6 months?

a. Myocardial infarction

b. Angina

c. Cardiac failure

d. Infective endocarditis

- What is the age of onset for type 1 diabetes? bachpan sy hota hai..agay options py depnd kryga

- What is used for the management of type 1 diabetes?can b A or D…vander mai hoga endo sec mai wahan ys confrm kr lena

a. Insulin

b. Oral hypo glycaemic drugs.

c. Diet alone

d. Drugs and diet-yes

- What substances are increased in a diabetic coma? ketoacidosis hoga inc ketones

a. ketones

- Clinical presentation of

a. Asthma

b. Chronic bronchitis

c. Tumour in the upper lobe of the lungs

d. Codeine use

e. Pethidine use

f. Carbamazepine use

The options were: inspiratory wheeze (COPD/ASTHMA), expiratory wheeze, stridor (above larynx), daily mucus production (bronchitis), dry airway, dry cough, constipation (codeine use) …...

- Which communicable disease should be informed to the consultant?scully..itra ko pocha tha

- After what percentage of blood loss should transfusion be given? – 20%

- What is the average respiratory rate for adults? – 12/min-20/min range …

- What is the average respiratory rate for children? – 25/min…….

- In a patient with colonic polyps diagnosed by colonoscopy, which other feature is present? – osteomas..GARDNER SYNROME

- Ulnar deviation is seen in which condition? – rheumatoid arthritis

- A patient who is under-weight, has a diet high in sugar with very few calories has – anorexia nervosa

- Tightness in the chest, wheezing, shortness of breath – Asthma

- Crushing pain in the chest accompanied by vomiting – Myocardial infarction

- Swelling of inter-pharngeal joints – ra

- Condition which is relieved by sleeping on 3-4 pillow ….sleep apnoea

- Weight loss, fever, cough – tuberculosis

- Weight gain & intolerance to cold – Hypothyroidism

- Picture of a lady with very large hands – acromegaly

- Ques on cranial nerve examination like when they are damaged what happens eg

occulomotor and abducens. Pls read from scully

- Investigations used for different types of Anemias options were MRI,CT

Scan ,Bone Marrow Scan,FBC etc..boht weird tests k nam aye thay itra ko….

- Investigations for Coeliac disease, Chrons, IBS etc……itra ny nhi ki

- ASTHMA what happens to the airway?bronchosspasm

PLS read emphysema, upper respiratory tract infections ,COPD they had asked

indirect QUES on them…itra said pochtay hain

- Which of the following would u not Notify?so need to read Notifiable

Diseases.sully

- A Patient had angina in past six months would u continue treatment, refer, not treat etc. Pls read Angina and MI

- Type 1 Diabetese features like patients age?usually underweight.

Type 2 Diabtese :pt would be overweight ,age?elder age

Also, if u r treating a diabetic patient ask him to take his dose normally before appointment .I dont remember the exact ques but these were the answers I guess.

- What would u give in Hyperglycemic collapse/dizziness situation? Insulin 0.1 IU/mg/ml daikh lena itra said

- Ulnar deviation: Rheumatoid arthritis options SLE, Pemphigus, Pemphigoid etc.

- Sjogrens syndrome triad .type 1 and 2.

- causes and features for Addisons and Cushing diasease. they had given options like Rickets, graves disease etc…pochay gy konsy gland se related hai

- Microcytic anaemia, ferritin levels normal what exam to check probable cause? Name of exam requested to check thalassemia??? Cooleys anemia ko thalsmia major kehtay hai(no pubertal growth sp etc features from scully krl…n test google kro)

Test mai HBF increase, HBA2 will also increase pr km zeyda hoga, TIBC normal hoga,basophilic stppling of erythrocyte hoge bold mai, target cell milay gy, pokiliocytosis

– Asthma, emphysema, cystic fibrosis

- Hands signs related with diseases, koilonichia, ulnar deviation, etc………imp

- Dental characteristics in patient with bulimia…erosion

- Test to determine infectious mononeucleosis. Paul Bunnel test

- What is the normal fasting blood sugar level? 3.5 – 5.5 mmol/L

- Patient with NIDDM diabetes undergoing dental procedure. Eat normally & take regular dose of metformin …type 2 diabetes hai ye

- Hand sign in mitral valve problems. Splinter hemorrhages….pic dekhna .nails mai blood clots nazar atay hain

- Hand sign in rheumatoid arthritis. Ulnar deviation

- Hand sign in inflammation of hand joints. Heberden’s nodes…ist finger joint distal inter phangeal joint wahan ye hota hai…..n proximal py BOUCHARD hoga…..BP HD

Oeteo arthritis

- Most difficulty in brushing teeth? In rheumatoid arthritis

- Antibiotic prophylaxis required in mitral valve defect..ab koi prophylactxs nhi detay

- Patient with rheumatoid arthritis and biliary cirrhosis has secondary rheumatoid arthritis…symptms decrese hojatay hai secndry mai

- Hand sign in mitral valve problems. Splinter hemorrhages

- Hand sign in rheumatoid arthritis. Ulnar deviation

- Hand sign in inflammation of hand joints. 2

- Most difficulty in brushing teeth? In rheumatoid arthritis

- Antibiotic prophylaxis required in mitral valve defect

- Patient with rheumatoid arthritis and biliary cirrhosis has secondary rheumatoid arthritis

- Patient has bilateral involvement of joints and pain in the morning & weight-bearing joints are involved. Rheumatoid arthritis

- Patient with splenomegaly & intra-oral lesions. Infectious mononucleosis..young bacha…488 scully

- 65-year old lady with forgetfulness & difficulty in doing daily tasks? Alzheimer’s Disease.is mai ACTH decrease hoga

- Picture of tongue with several small white lesions…. Caeliac disease

- Which test will you perform in an Afro-Caribbean if the tests for anemia are normal? Sickle cell test,electrophoresis b krtay hai…212 scully new

- Cleft lip & palate increases with maternal intake of antibiotics..itra ko emq aya tha..kis age mai close krna hai…pink 170/scully new 358

- Anemia in rheumatoid arthritis? Anemia of chronic disease and Iron def anemia..pta nhi… new scully

- In which condition is intra-articular bleeding minimal? Von Williebrand disease

And sb se zeyda kis mai hai???ask itra ko aya tha…fb py post kia kk ny

- Factor VIII is reduced in Hemophilia A

- Period of vaccination (Scully)…age

- What is the minimum platelet count required in a patient undergoing extraction? 50 X 10 raised to 9 /I

- Patient with fatigue & excessive bleeding? Leukaemia

- Most commom bleeding disorder?von willibrands.warfarin and asprin

- Haemophilia A: factor VIII deficiency

- Becet’s disease :recurrent oral ulcers,uveitis and genital ulcers

- Sarcoidosis-granulomatous disease..lip swelling

- Tuberculosis

- Kaposis’s sarcoma: HHV-8.aids mai hoga

- Burkitt’s lymphoma: EBV

- Temporal arteritis.raise ESR hoga

- Trigeminal neuralgia

- Atypical facial pain…without any reson.psycological hoga….231 md1

- Where can you assess masseter? CT scan, etc….itra sy pocho she said to highlite…md1 240

- Most commom cause of chronic renal disease? Pyelonephritis, hepatitis, etc….answer nhi ata,…. ans - Diabetes

- Paget’s disease: alkaline phosphatase increased

- Osteitis

- Osteomyelitis

- What’s is increased in elderly? Systole, dyastole, stroke volume, etc

- Iron deficiency anaemia…microcytic and hypochronc..TIBC increase hoga,serum iron will decraese

- What’s the most frequent site of endocarditis? Aortic valve, tricuspid, bicuspid, mitral(isi ko biscspid kehty hai, etc

- Emphysema: destruction of alveoli…wiki

- Faint

- Sign of asthma: wheezing(expiratory)

- Lung silicosis clinical features and diagnosis…382 scully…occupational related..wikipedia

- Fev1/fev what happens is lung silicosis…wiki…its going to be increased or normal..kartik put in group…vander 475

- c/f of heart burn, mi, angina,rib fracture pg 162

- heart burn is it worse lying down? lying

- hypoglycaemia, adisonian crisis,epilepsy(343)box13-30, mi c/f

[21:06:16] Karthik Pk: An "Addisonian crisis" or "adrenal crisis" is a constellation of symptoms that indicate severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage), or an intercurrent problem (e.g. infection, trauma) in someone known to have Addison's disease. It is a medical emergency and potentially life-threatening situation requiring immediate emergency treatment…. Scully343 n wiki

Characteristic symptoms are:[4]

Sudden penetrating pain in the legs, lower back or abdomen

Severe vomiting and diarrhea, resulting in dehydration

Low blood pressure

Syncope (loss of consciousness and ability to stand)

Hypoglycemia (reduced level of blood glucose)

Confusion, psychosis, slurred speech

Severe lethargy

Hyponatremia (low sodium level in the blood)

Hyperkalemia (elevated potassium level in the blood)

Hypercalcemia (elevated calcium level in the blood)

Convulsions

Fever

- Hand signs match with disease eg Ra ulnar deviation etc…already done kartkh said

- Diabitis insipidus(hypo osmolar urine) 134 scully..dilute urine(polyuria)thirst polysypsia..bla bla

- haemoglobinopathy …212 scully…condition pochtay hai…is mai thalesmia n sickle cell anemia atay hai

- haemo A….thalemia

- Infection in a man who travelled to asia…….treponema pallidum …..Syphilis is no longer commonplace in the developed world but it is still widespread in Asia…it can be TB kk said.agay depnds on choice…GONORHEA MORE COMMON THEN SYPHILIS..372scully

Read link sent by kk SILK ROUTE/ROAD

- woman with bloody sputum 82 scully…expotraction of blood is haemoptsias blab la…

Tb(infectious/pulmonary) is more common in female so the answer can be tb coz in tb there is bloody sputum,

Conditind like Lung cancer, broncheatesis, copd they have bloody sputum.answer not sure!!!..go for TB

- man with candidiasis, generalised lymphadenopathy 492 scully

- Bilateral parotid swelling… options Sarcoidosis313 cawson, etc http://www.gpnotebook.co.uk/simplepage.cfm?ID=624230412

- Infection with weight loss in an afro-carribean….TB

- Man with pain in the phalanges……r.arthritis…395 scully

- treatment for sinusitis…metro+amoxicillin/erythromycin/clindamycin….diffnt trt for diffnt sinusitis(discussed in pharma)

- Pain worsened by bending forward…diagnosis..sinusitis

- Lady with swelling of buccal mucosa and other symptoms……?Chron’s…cobble stone apparnce of Buccal mucosa is seen in crohns diaeasa..agay options py depnd krta hai….168 scully

Other condition jahan buccal mucosa ki swelling milti hai eg orofacial granulmatosis, malker rosnthal syndrome

- Pain in interphalangeal joints…osteoathritis(u see heberdons nodes) 394 scullu..table hai wo parhO.will clear doubts……can be rheumatoid tooo …not sure..gropu concluded R.ARTHRITIS

"http://books.google.co.uk/books?id=Pms0hxH8f-sC&pg=PA1122-IA4&dq=pain+in+interphalangeal+joints&hl=en&sa=X&ei=hrevUf6CO"q=pain%20in%20interphalangeal%20joints HYPERLINK "http://books.google.co.uk/books?id=Pms0hxH8f-sC&pg=PA1122-IA4&dq=pain+in+interphalangeal+joints&hl=en&sa=X&ei=hrevUf6CO"& HYPERLINK

- Deformed finger joint….RA(ulnar)

- Disease with progressive cartilage destruction…….RA…google it

http://books.google.co.uk/books?id=VyyGSO-orYwC&pg=PA52&dq=disease+with+progressive+cartilage+destruction&hl=en&sa=X&e#v=onepage&q=disease%20with%20progressive%20cartilage%20destruction&f=false

- AB COVER IN SURGERY AND HOSPITAL…..PB chap11 548…scottish gulines…see file kart sent

- SIGN AND SYMPTOMS IN MEDICAL EMERGENCIES…in 1^st chapter scully..go through all of it..kk will add file on medical emergny on google drive

- MANIFESTATIONS IN THE HAND OF SOME ILLNESS OR SYNDROMES..all are hand manifestation

- Different values of FBC were given and type of anaemia was asked…already done!!!

- Questions on hypothyroidism and hyperthyroidism..done b4 !!!136 scully new//97 my scully

- Clinical situations (5 questions) – tests: fasting glucose <6mmol/l, FBC, INR for Warfarin - <3.5, etc…seen!!! scully

- Asthma acute attack best medication – salbutamol

- Medical Emergencies clinical situations (2 questions with 5 sub questions each) – MI, Anaphylaxis, Addisonian’s crisis, Angina, Hypoglycaemia…seen !!!

- Prosthetic valves – AB prophylaxis: not, but increased risk of Infective Endocarditis…don’t giv prophylaxis….see NICE guidelines for inf endcrditis

http://www.nice.org.uk/nicemedia/pdf/CG64NICEguidance.pdf

- Infective Endocarditis causative micro organism in the UK– Streptococcus viridans….pg 123..or b hai pr mostly viridians

Rhematic fever mai pyogenes bacteria hota hai..dont get confused!!!

- Psychiatric disorders – claustrophobia pg 262(fear of close spaces), hypochondriasis 265(chronic candidosis and mercury syndrome.read this and remember)!!!, obsessive compulsive disorder OCD, mania 274 , schizophrenia pg 275(inc dopamine activity)….seen before !!!wiki….274 scully also

Consult Wikipedia for DILUSION

inky dental aspects,c/f and agr surgry mai aye to kaisy manage kry.ye pta hona chiye about these condition..pg 257 scully..personality disorders mai

- Pain and diagnostic …pta nhi :/ questn not clear..they havnt asked which condition

- Crohn’s disease – main GI part affected: terminal ileum

- Parkinson disease.329 scully…brain disorder problem b/w balance n coordination etc..decrease level of dopamine…boxing guy mohammed ali has this disease..and amitab bachan has graves disease some say Parkinson disease loll…….329

- What’s the most frequent cause of dementia? Alzheimer’s, etc.337 table13.24 causes of dementia

- What’s more likely to cause sickle cell crisis? Exercise is wrong, cirurgic trauma, etc..212 sickle cell disease present 6 characteristcs…gives pain..itra ny hypoxia kia tha…kk put it in fb!!!

Table 8.12 mai crisis given hai

- Which one is a hemoglobulinopathy? Sickle cell trait , thalassemia, both

Kk said thalesmia…agay depends on opts

- Rheumatoid arthritis

- Osteoarthroses: Heberden’s nodes

- Most likely to suffer from hypoglycemia during dental treatment: young diabetic patient insulin dependent during mealtimes..type1

Administer glucose first then glucagon agr hypoglycemia..

Hyperglycemia mai sugar level boht zeyda hota hai.pt ka sugar level chek krna hota hai coz diabetic pt mai healing slow hoti hai

Hyperglycemia is not very common in surgry,,hypo is medical emrgncy

http://www.diabetes.co.uk/Diabetes-and-Hypoglycaemia.html

7. Dental Materials

[20:51:00] Divya: A PATIENT ATTENDS YOUR PRACTICE COMPLAINING OF PAIN AND SWELLING ASSOCIATED WITH A PREVIUSLY RESTORED UPPER FIRST PREMOLAR TOOTH. THE PAIN HAS BEEN PRESENT FOR A NUMBER OF DAYS AND IS NO LONGER RESPONDING TO ANALGESICS. HIS DENTITION IS OTHERWISE WELL AND MAINTAINED AND HIS PERIODONTAL HEALTH IS GOOD……ques divya ny btaya.options:

[20:51:27] Divya: a. antibiotics and analgesic

B:carry out pulpectomy and temporary dressing

C: open drainage

D: extraction

Agr pulpctmy n dressing kry gy to usky bd dressing ko open nhi chor sktay more thn 24hours..read acute pulpitis 222 pb

- Lots of questions about amalgam, composition (%) and the whole of the components….pink 608

High copper can eliminate effct of gamma 2 phase..all written in pb

- Percentage in weight of silver in amalgam-65 %.....copper….do the table on 609imp/119 CC

Zinc is not used any more imp

- Glass ionomer composition- powder:Sodium alminosilicate glass with 20% ca F and other minor additives … liquid::.Aqueos solution of acylic acd or maleic and tartaric acid…………….618pb/cc 123 in some products to control setting characteristics

- Indication of the type of ceramic: Very strong procera…..636 pb…itra no idea!!

Porcera company hai..so zirconia is strongest then aluminia…or u can also say porcera zirconia..company koi b hoskti hai…..see PPT kart sent…..

INCERAM

PROCERA

IMPRESS

- Dental materials-few questions on alginates and other impression materials,amalgam,matrix,….636pb/132cc……..classification kro cc sy

Also 270 pb/230

- Get urself prepared for questions on amalgam, composites n GIC....

- Lots of questions on amalgam, e.g. what component of amalgam causes tooth blackening/tatoo? What increases its strength? silver

: Gamma—strongest…tin n silver …. Ag3Sn

Gamma1 intermediate…silver n merury…. Ag2Hg3

Gamm2 : weakest n crodes…tin n mecrcuru.---- SnHg

Eta phase CuSn(copper tin) …..causes corrosion when reacts with gold restoration

- Questions on comparative applications of GIC (greater bond strenth with enamel than dentine; RMGIC used in root caries..erosion cavities) Amalgam, Composites and other cements in treating various types of caries in adults and children……………618pb

- What is composition of GIC? Also see 269 under erosion n resin

a. Aluminosilicate glass & polyacrylic acid? yes

b. Flouroaluminosilicate glass & polyacrylic acid

c.Flouroaluminosilciate glass & polyalkenoate acid

- What provides strength to amalgam? silver

- what makes amalgam black after sometime? silver

- what causes amalgam expansion ? silver..but delayed expansion by ZINC…go for zinc

- what cements are used in stepwise excavation?cavity lined with calcium hydroxide and restore with GIC….

- What component of amalgam gives it strength

a. Copper-

b. Silver-

c. Zinc

d. Mercury

- What component of amalgam was formerly used as a scavenger but is no longer widely used?

a. Copper

b. Zinc-yes

c. Silver

d. Tin

- What is the main constituent of Gutta percha points?

a. Gutta percha(correct) 18-22%

b. Resins

Gutta-percha endodontic filling points were

found to contain approximately 20% guttapercha(matrix)

, 66% zinc oxide (filler),

11% 7 heavy metal sulfates (radiopacifier), and

3% waxes and/or resins (plasticizer).

- Black stain of amalgam tattoo is caused by – silver

- Strength of amalgam depends on – silver

- Ques ON ALGINATE :

Synersis...squeezing out of water from between polysaccharide chains as a result one can observe small droplets of water on the surface of an agar impression.

Imbibition phenomenon.in the presence of excess water agar gel may absorb water by this phenomena

q1:when the impression is stored and sent to the lab covered with a wet cotton what happens to

the alginate material?synersis is decreased

IMPORTANT - Compostion of Alginate and the Setting reaction sodium and k salts ?

composition-

Sodium or potassium salt of alginic acid NA3po4(11-16 %),

gypsum caso4.2h20 (11-17%),

intert filler(enables easy manipulation n gives body65-75%),

reaction indicators(colour change),

sodium phosphate Na3PO4 1-3% (controls working time)

Setting reacting- Sodium alginate + calcium sulphate ----> sodium sulphate + calcium alginate

- Amalgam: which of the following materials is not added to amalgam now? The answer was Zinc as it causes secondary expansion.

- at what temperature Gutta pecha softens? softens at 65 C and melts at 100

( softens at 40-45 degree in master)itra said rechek

- Which Impression material cannot be used for crown and bridge impressions?– alginate

- Cement for cementing porcelain veneers? Resin composite cement

- Cement which requires polyacrylic acid? Conventional glass inonomer cement

- impression in a patient with resorbed lower ridge? Special tray with spacer-Admix(: mix of green stick and impression compound.).see pg 627pink

- Cement for cementing temporary bridge? zinc Polycarboxylate cement…626pb then second option ZOE

- Cement for temporary crown: GIC, zinc phosphate, zinc polycarboxylate, resin, ZOE:::: :ZOE…624pb/131cc

- Where does GIC bond better to? Dentine, enamel(correct), colagen, etc :enamel………….618pb says enamel n dentine…per enamel k sath seyda acha bond krta hai coz enamel mai inorganic content zeyda hai

http://www.slideshare.net/drabbasnaseem/glass-ionomer-cement-gic-science-of-dental-materials

- Ca hydroxide its action and its uses:antibacterial and calcific bridge formation 289pb/251CC mode of action of caoh is given there..forms within 4weeks

- Irrigating solutions other than sodium hypochlorite::: :EDTA,chlorhexidene..,EDTA and urea peroxide………283/.289PB/cc 292 all are corrct

Edta ki paste form ko GLIDE kehty hain

- Lots, of questions about indications of crowns like: what is the choice of crown for a tooth with MOD amalgam filling and fractured palatal cusp? Opt:::full gold crown, ¾ gold crown, porcelain bonded crown…pg20/28 smith howe…depnd kry ga kya option I hai..genrlly aisy case mai 3/4^th crwn dy gy….per more then one cusp cusp involve ho to give gold cr…

- what cement you use to glue a alumina core ceramic crown? GIC , Panavia, zinc phosphate, RMGI, Poly carboxylate,…..625pb/131cc…not gic…panavia ceramic crown k liye use krtay hai,metal crwn k liye koi b cement…but pb says RMGIC 263pb…panavia k liye see katik sent file

- which impression material is not used to make a crown? Irriversible colloid

- which paste is resin based ? AH Plus 286pb

- what is the depth of curing composite? 2 mm pg 612pb

- which one is polished the best? Microfilled, ,glass ionomer ,resin modified glass ionomer,…. So many options……610 PB

NANOFILLED ki high resistance b hai and best polished b…then 2^nd go for microfilled for good surface polishing…if both options then go for nanofilled

- greatest wear resistance….HYBRID 611pb

- setting contraction of composite(6% by volume can be reduced by using small increments) versus GIC 3% ……..Conventional GICs have NO polymerization shrinkage……

GUL said 1-4%..pB

Pg610 says shrinkage of composite is 1-4 %

- 2-paste zink oxide eugenol system…..tubliseal…….given under sealers 289pb

- GIC and composites 5 sub questions – composite cure length (2mm), GIC not need to be cured, others..

More then 2mm hoga to cure krna hoga

- Amalgam – AMA angle (more than 70°-90) and CVS angle (more than 90°-110), Nayyar core (3mm preparation in the canals)

Ama is amalgm margin angle….245CC and see pic kart sent

http://student.ahc.umn.edu/dental/2012/6436/6-8.Cl1%20amal.principles HYPERLINK "http://student.ahc.umn.edu/dental/2012/6436/6-8.Cl1%20amal.principles&tchnq.09.ppt.pdf"& HYPERLINK "http://student.ahc.umn.edu/dental/2012/6436/6-8.Cl1%20amal.principles&tchnq.09.ppt.pdf"tchnq.09.ppt.pdf

http://www.codental.uobaghdad.edu.iq/uploads/lectures/operative%203rd%20grade/class%20II%20amalgam.pdf

- Impression materials 5 sub questions - irreversible hydrocolloid, others

Panavia both ceramic and metal k liye hota hai

Imp technique b pochtay hain

8. Embryology

- Failure of closure of vertebral arches

- What condition is caused by failure of closure of vertebral arches: spina bifida

- Palatal formation – frontonasal and palatal processes

- Fontanelles closure – after birth (6 months?)

- Branchial arches – tongue (1st, 3rd and 4th)

- Branchial arches – mandible (1st)

9. Pharmacology

- Different types of anaesthetics like in which condition which anaesthesia .multiple extractions(GA),pregnant mother(LIGNOCAINE/LIDOCAINE)),molar extraction(LIGNoCANE most common) : inhalation is not contrindicated in second n third trimester .......p53,56, 61 Scully, p358

- Picture of LA cartridge asking which anaesthetic?? : Xylocaine was written on it….lignocaine he hota hai ye

- Anaesthetic that produces toxicity,longest acting and which to be given to heart patients : Articain- neurotoxic, bupivacaine- cardiotoxic, prilocaine is for Ischemic heart disease, longest acting- bupivacaine, prilocaine-given for cardiac pt ........p53 Scully

- Action of lidocaine : Lidocaine alters signal conduction in neurons by blocking the fast voltage gated sodium (Na+) channels in the neuronal cell membrane that are responsible for signal propagation. With sufficient blockage the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential. This creates the anesthetic effect by not merely preventing pain signals from propagating to the brain but by stopping them before they begin.

FAST ACTING IS SODIUM CHANEL AND POTASSIUM IS SLOW CHANNEL.

ORDER OF SENSATION LOST :-

1. AUTONOMIC FUNCTIONS FIRST BLOCKED

2. TEMPERATURE

3. PAIN

4. TOUCH

5. PRESSURE

6. MOTOR FUNCTION

- Antibiotic for a patient allergic to penicillin that can’t swallow pills?? : Azithromycin / Erythromycin 200MG/ 5ML............p352 BNF, p572,574 PB

- drug that causes constipation?? Codeine phosphate...codine causes dry mouth...p49 Scully

Codine is not given under 18 new regulations as it has more side effects

- Antagonist of heparin?? : Protamine sulphate...8hours...ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) blood test krwaye gy...p492 PB

- Definition of INR(International Normalized Ratio)?? :normal in 1…more then 5 hoga then pt bleeds..less then 1 to clot formation ho skti hai ......... p503 Churchill

- Have to know the main medication used for the most important diseases.......p46 Scully

- Drug Interaction.........p45 Scully

- Collateral effects (dry mouth, gingival growth for example )............p638-640 Scully

- Antifungal (Thrush) : topical Nystatin or Ampotericin (for localized inf), Nystatin suspension or systemic Fluconazole...........p492 Scully, p573 PB

- Drug is most likely to cause rashes in infectious mononucleosis(Glandular fever) : by EBV(human herpesvirus 4) virus : ampicilline / amoxicilline............p399 PB, p488 Scully

- Which drug is given three times a day??boht sari hoti..depnds on options

- Which drug should be avoided in patient on warfarin?? : Metronidazole(antibiotics).....table hai aik...p195 Scully…clindamycin dy sktay hain

[14:10:45] Itra: Contraindications for warfarrin: ibuprufen, erythromycin, metronidazole ,tetracycline ,penicillins ,anti fungals flucinazole ,miconazole,ketoconazole.....now alternatives : painkiller paracetamol ,antibiotic amoxicillin ,clindamycin but effects should b monitored.antifungal nystatin can b given.

[14:13:09] Itra: So in short .. Aspirin, NSAIDS = AVOID

Metronidazole = Caution(dose change may be necessary)

Amoxicillin, Erythromycin = Vigilant for signs of increased bleeding

Clindamycin = no interaction

Antifungals = increases warfarin effect

Antivirals = increases warfarin effect

- Which medicine to avoid in asthmatics?? : NSAIDs and aspirin boht

- Dose of aspirin for angina?? : 300mg (For Angina GTN 400 mcg, For MI Aspirin 300mg)......p4 Scully

- Dose for adrenaline for anaphylaxis?? : 0.5ml (or 500microgram) .given I/M......p4 Scully,p529 PB

- Drug avoid in asthmatics?? : NSAIDS

- Way of 1 mg of glucagon is given in hypoglycemia?? : IM........p520 PB, p6 Scully

- Which antibiotic is contraindicated in lactating mothers?? : METRONIDAZOLE,TETRACYCLINE,antihistamine aspirin. Benzodipine carbamezpine....p578 PB

- Age of MMR vaccine?? : 12 months ..then 4-5 years bd review…….polio in 2months age DPT vaccine...p511 Scully

- Antibiotic alone to granuloma? Options: mixed infections, antibiotic doesn’t penetrate in the bone…no answer!!!!!!! itra gul…..

Drainage+metronidazole+ no bone penetration

- Questions on conscious sedation and GA; their applications in various clinical settings; inhalational and iv sedation

- A lot of questions on warfarin, its interactions with various drugs and INR scully pg 147

- Emergency drugs and their modes of administration…scully

- Amount of adrenaline in emergency dosage; options- 50µgms,500µgms, 50mg, 500mg (I think it should be 500µgms- the calculation

as per me is- Adrenaline in emergency is 0.5mg/ml in concentration of 1:1000, i.e., 1/1000x1000000µgms= 1000µgms/ml; if 1ml of solution

contains 1000µgms then 0.5 ml should contain 500µgms; Please cross check, I may be wrong!)

- Lots of questions on Penicillins, their modes of administration and doses…BNF kon c oral kon c IV ye parh lena…penicillin g wagera itra ko aye thay

- Drugs causing xerostomia….atropine,alpha receptor antagonist,anti cholinegics,anti depressant,antipsychotic,muscranic receptor antagonist…scully

- Drugs used to treat Candidiasis in HIV infected condition- fluconazole

- Lots of questions on NSAIDS

- Drugs exacerbating Asthma.::::.nsaids n aspirin

- Drug is most likely to cause a rashes in infectious mononucleosis (glandular fever) ?ampicillin

a.Aspirin

b.Penicilllin G

c.Peniicillin V bhi theeek hai …pr it depnds on option…first go for ampicillin

- Which drug should be avoided in pt. On warfarin?

a.Fluconazole-yes

b.Miconazole.also second option.waisy avoid all AZOLES….ok

c.Nystatin

d.Amphoterecin

- Which medicine to avoid in asthmatics?

a. Aspirin-yes

b. Paracetamol/panadol

c. Tramodol

d. Penicillin

- antibiotic for ear use …aminopenicillin(amoxicillin),topically gentamycin kry gy..337 scully

- antibiotic which can be given thrice daily ?amoxcillin…or b hain waisy

- antibiotic resistant to beta -lactamase producing organisms? co amoxiclav

- analgesic that can be given in warfarin ? paracetamol,codeine both ok

- drug to be avoided in warfarin in antifungals? flucanozole….all azoles too

- What drug potentiates warfarin? antifungal and anti virals

- What drugs should not be given in pregnancy?

a. Nalixdicic acid

b. Metronidazole,tetracyclines,benzopeines -yes and many more

- What antibiotic is used to treat ANUG? metronidazole

- What antibiotic is used to manage a super infected herpetic lip lesion?

a. Ciprofloxacin

b. Metronidazole

c. Cefuroxime(TRUE)- UTI

- What is the dose of aspirin for myocardial infarction?

a. 100 mg

b. 200 mg

c. 300mg

d. 400mg

e. 500mg

- What drugs are inhibited by beta lactamase? ???scully 193..beta lactum drugs are inhibited by beta lactmase enzyme (penicillin,cephalosporins)

- Side effects of dapsone

a. Reticulocytosis

Reticulocytosis is a condition where there is an increase in reticulocytes, immature red blood cells. It is commonly seen in anemia

- Side effects of Azathioprine (IMMUNOSUPPRESANT), same options as side effects of dapsone…reticulocytosis

- What drug should not be given to asthmatics?

a. Aspirin

- What analgesics cause

a. Ringing in the ears after overdose…aspirin

b. Liver damage after overdose…paracetamol

c. Constipation….codiene

- A 60 year old man on anti-hypertensive has gingival enlargement what drug can cause it

a. Ciclosporin

b. Phenytoin

c. Amlodipine-yes…is CA channel blocker

- What LA has the longest duration of action?? bupivicaine

- Which drug causes bronchospasm in asthmatic?? : ibuprofen (nsaid)

- Dose of aspirin for angina?? : 300mg

- Dose for adrenaline for anaphylaxis..500mcg yaphir 0.5 mg…both are same

- Crushing pain in the chest radiating to arm & relieved by sub-lingual glyceryl trinitrate

- Angina

- Drug given 3 times a day?? : amoxycillin

- 1 mg of glucagons to be given to an unconscious diabetic patient?? : Intra-muscularly

- Which antibiotic is contraindicated in lactating mothers?? : Tetracycline

- What is the drug of choice for candidiasis?? : systemin is fluconaxole…..normaly nyststin n amhotercin

- Drugs causing gingival hyperplasia?? : phenotyin

- MRSA which medicine is effective eg. Vancomycin etc..482 scully

- Antibiotic which is contraindicated in lactating mother??tetracycline

- An EMQ on use of antibiotics in various clinical scenarios eg in asthma, uppser resp tract infection, TB ,which drug in overdose causes hepatotoxicity?? etc whereas the options for the drugs were Aspirin, Ibuprofen, Paracetamol, Diazepam, tetracycline............the drug which are c/i in asthma are NSAID,Mefenamic acid (NSAIDS) and opiates, Upper(ampicillin)...... p355 Scully, list of hepatotoxic drugs(paracetamol)…..,,carbamaepine, erythromycin, etretinate, ketoconazole, NSAID, rifampcin are cause hepatotoxity)........p247 Scully ..itra ko nahi pata!!!

- Which drug interacts with Warfarin??..........p195 Scully Table…brufen,erythromycin ,metronidazole ,tetracycline ,penicillins ,anti fungals flucinazole ,miconazole,ketoconazole.....now alternatives : painkiller paracetamol ,antibiotic amoxicillin ,clindamycin but effects should b monitored.antifungal nystatin can b given.

- Longer acting LA?? : Bupivacaine

- Patient with peptic ulcer which analgesic would you prescribe : aspirin, ibuprofen, PARACETAMOL is the right one.........p47 Scully

- Which of the following analgesics produce constipation after 5 days of taking it?? : Codeine was the correct answer

- Child that cannot swallow and need antibiotic prophylaxis but is allergic to penicillin?? : Azythromicin, ERYTHROMYCIN oral suspension

- Which drug causes severe abdominal cramps?? : Clindamycin

http://www.wisegeek.com/what-is-the-connection-between-clindamycin-and-colitis.htm

- Which drug causes constipation?? : Dihydrocodeine

- Which LA is neurotoxic at 4%?? ARTICAINE go for it blindly!!!..itra said..but lignocaine given in .p49 Master1..atricaine is best for bone

- Picture of a vial marked Xylocaine. Contains lidocaine/lignocaine

- Which LA do you give a patient with cardiac arrythmias?? : 3% mepivecaine(carbocaine k nam sy ati hai)

- Which is a long acting LA?? : Bupivacaine

- Which LA will you use in a child to do pulpotomy? Lignocaine 2%

- LA for a normal & healthy adult?? : Lignocaine

- Which analgesic is given in a patient with peptic Ulcers?? : Paracetamol

- Picture of medial surface of mandible with a syringe? : Inferior alveolar nerve block

- Intra-ligamentary injection of LA is an adjunct to the inferior alveolar nerve block....ok....p55 Scully

- Picture with a dot marked on maxillary canine. Which type of anesthesia?? : Nasoplatine(Buccal & palatal infiltration).can be both......

- Drug given to a patient with dry socket?? : systemic conditions /space infection Metronidazole........p371 PB

- Drug for a patient after 3rd molar extraction?? : Ibuprofen........p395 churchill

- Drug for angular cheilitis?? : Miconazole........p493 Scully

- What is the role of Aspirin in MI?? : …its bascilly antiplatelet drug

- Which antibiotic is prescribed in chronic sinusitis?? : Penicillin G(not orally, v less in dentistry).........p355 Scully, p75 churcill…amoxicillin given hai Scottish guidelines mai…so both ok…

http://www.courses.ahc.umn.edu/pharmacy/6124/remmel_notes/penicillins.pdf

- Vitamin K antagonist?? : Warfarin...............p492 PB

- Test to be done in a patient taking warfarin?? : INR...........p195 Scully, p503 churchill

- Which drug potentiates the effect of warfarin?? : Erythromycin........p195 Scully

- Patient with allergy to penicillin?? : Clindamycin 600mg (Erythromycin) Cefuroxime axetil or erythromycin can be used for persons allergic to penicillin or who cannot take tetracyclines.............p402 Scully

- Drug for herpes zoster?? : Acyclovir........p398 PB

- Which drug do you prescribe to a patient 2 days after the extraction of a 3rd molar if the socket has not yet healed & there are 2extra-oral draining sinuses?? : Penicillin...........p

- Which nerve block for upper first premolar?? : middle superior alveolar nerve block

- Along with inferior alveolar nerve block & lingual nerve block, which other nerve has to be anesthetised?? : Buccal nerve

- While writing a report after LA what should be noted?? : Blood aspiration

- Best drug for asthma?? : Salbutamol

- Drug for trigeminal neuralgia?? : Carbamezepine

- What should be added to beta-lactamase to make it more efficient against anerobes?? : Co-amoxyclav (Augmentin)

- How do you know that a patient has penicillin allergy?? : Skin rashes,wheezing anaphylaxis..depnds on options

- Salbutamol : β2-adrenergic agonist….dialtes bronciolus smooth muscles

- Lot of medicines (reactions in the mouth) – Scully not enough!!!no answer

- Analgesic for asthmatic?? : Aspirin, NSAID, paracetamol, etc

- Healthy young patient. What’s the INR??? 1

- What’s the depth of topical anaesthetic?? 2-3mm

- What’s the concentration of lignocaine in topical anaesthetic??

2.5% EMLA CREAM- LIGNOCAINE

5% GEL

10% SPRAY

- What can you reach during ID block?? : Parotid

- What’s chlorhexidine family?? bisgunaides…

- Everything about intraligamentary anaesthesia: can it affect permanent tooth germ?? Yes it can effect tooth germ

Does the needle need to be smaller than periodontal ligament?? Yes… Is it painful??yes

- What’s the most predictable anaesthetic technique for lower lateral incisor(infiltration)? And for lower molars(block)?? ID block, intraligamentary, infiltration,

http://en.wikipedia.org/wiki/Inferior_alveolar_nerve_anaesthesia

- Phenytoin X gingival hyperplasia

- Aspirin function?? : anti-platelet,

- Warfarin antagonist?? : vitamin K

- Infective endocarditis ab cover several questions....no prophylaxis now ok........p124 scully

- Cholhexidine mouth wash 0.2 % and gel percentage..1%

- If ID block is given for a restoration on 6 then what would u ask the pt not to do?? Chewing bcz cheek/lip bite can occur

- ID block which muscle is pierced?? : Buccinator.....p366 scully

- Mast cell stabiliser : ANTIHISTAMINE

triacendone acentonide (CORTICOSTEROIDS)

- Do all the areas which will be anaesthetisized when giving blocks inferior dental.infraorbital

http://www.dentalorg.com/inferior-alveolar-nerve-block-ian.html

- Which drug causes a fixed ulcer?? : nicorandil (ANTI-ANGINA) , CYCLOSPORIN(IMMUNOSUPPRESANT?) PHENYTOIN

- Which drug interacts with warfarin, , metronidazole etc(drug interactions are good in Scully)

- Antibacterial in toothpaste?? triclosan

- Chlorhexidine its side effects …staining,taste alterations

- %used in mouthwash and gel both?? 0.2% mouthwash, 1% gel

- Indications and contraindications of sedation?? : .........p56 scully table

- Where is iv sedation indicated where contraindicated?? : ...........p56 scully table

- nitrous oxide is insoluble in blood..ok : ....aplastic anemia mai nahi dena nitros oxide.......p653 scully p590 PB

NOT GIVEN IN ANY ANAEMIA/ URTI

- Local anaesthesia short acting(mupivcaie) long acting(bupvicane), which is good for bone(articaine) which is present in the topical preparation..........p584 PB

- Prophylaxsis of infective endo carditis different scenarios, for eg-dose in kids, dose with allergy

- Inhalational anaesthesia is of most benefit to which of the following: anxious pts maid y sktay hain..

a)medically compromised

b)teenagers

c)pregnant women not in 1 trimester but can in 2 and 3

d)children

- Concerning local anaesthetics which one

i) has d longest duration of action(bupivacaine) (ii) has shortest duration of action(mepivicain)

iii) is commonly used for topical anaesthesia(xylocaine) (iv)penetrates bone the most(articaine)

v)causes methaemoglobinaemia(prilocaine)

- Concentration of chlorhexidine solution commonly used in uk?? : 0.2%

- Concentration of chlorhexidine gel commonly used in uk?? : 1%

- Which of these drugs stabilizes mast cells, stopping release of histamine

a)adrenaline (b)salbutamol (c)ipratropium (d)triamcenolone acetonide

- Which drug is used for the systemic treatment of candidiasis?? : Fluconazole

- Several questions with different clinical scenarios for prophylaxis of infective

Endocarditis..no prophylaxis

- what is the best LA for a pregnant woman in last semester?? opt: lignocaine(lidocaine), mepivacaine, bupivacaine, amethocaine, perilocaine,.............. 1st trimester : IV but no inhalation 2nd trimester : inhalation 3rd trimester : inhalation but no IV as it is CI in pregnancy(Scully)

- Lots of questions about the Sedation and GA,with different scenario for children,for pregnant,for anxious pts.like: -what is the best opt for extraction of wisdom teeth?? Which one you use if you want to have anaesthetic longer after operation?? (bupivacaine)dekh lena

- what is the flavoured topical( I cannot remember exactly) anaesthetic?? BENZOCAINE 20% Opt as ques 26

- how many ml of lignocaine 2% 1/80000 can be injected to a 20 kilogram person?? 2.2ml, 4.4ml , 6.6ml, 12ml,…….KOI IDEA NAHI ITRA KO….PR is walay ka answer 4.4 hai

- how many ml of lignocaine 2% 1/80000 can be injected to a 125 kilogram person?? opt: 16ml, 24ml,26ml,30ml,…....... absolute maximum of Lidocaine. 1 vial has 44mg Lidocaine. So (500/44)*2.2 ml = 24ml….shayd 24 hai itra said

- which options is mandatory during doing inhalation sedation?? Pulse oxymetre,…..

- another Qs similar above but about have access to emergency.............p55 scully

- Soft tissue anaesthesis in intraligamental anaesthesis…… limited ajeeeb sawal hai

- Special syringe for soft tissue anaesthesia…. : Intraligamental…not sure smjh ni ara sawal itra

- INR in a 70kg man not under anticoagulation… : 1

- SEDATION; DRUGS, INDICATION CONTRAINDICATIONS......p56 scully

- VITAMINS AND ORAL MANIFESTATIONS.............p606 scully

- LOCAL AND GENERAL ANAESTHETICS.............p

- WARFARIN

- Antibiotics action: - Trimethoprim…use for trt of urinary infection and prophylaxis (inhibit folate/Inhibitor of nucleotide synthesis)

http://en.wikipedia.org/wiki/Trimethoprim

- Ciprofloxacin (inhibit DNA metabolism)

- Aciclovir action – causes inactivation of DNA polymerase

http://en.wikipedia.org/wiki/Aciclovir

- Medicaments action - competitive, not competitive, functional, etc. (I don’t remember the medications… ACE inhibitor).not sure itra!!!

- Bacterial resistance – plasmids

- Vaccine more common with inactivated virus – Influenza,polio hep A rabies cholera

HEP B is attenuated vaccination

TETANUS ki immunization passive hai

- MMR vaccine age – after 13 months

- Chronotropic,ionotropic definitions and what does adrenaline do?chrono n inotropic dono heart rate increase krtay hai…chronotropic heart ki rhythm incese krta hai..inotropic hart ki contraction krta hai

- Local anaesthesia – many different questions

a- maximum dose for child 5 years with 20 kg – 4ml

b- maximum dose for adult 125 kg – 20ml (10 ampoules)

c- longest duration – bupivacaine

d- you’re not using adrenaline but requires vasoconstrictor for long duration – prilocaine

e- Substance that causes allergy - ? Sodium bisulphite

f- Spray local anaesthesia in practice – lignocaine 10 %

g- Anaesthetic solution for child with herpetic gingivostomatitis before eating – benzocaine 20%, lignocaine…

h- More toxic anaesthetic - : bupvicaine

- Medication for sinusitis (not direct asking, gave us clinical situation to identify sinus: headache, pressure on moving head) – Amoxicillin//penicillin...........p355 scully

- Anaesthesia and Sedation 5 sub questions for different clinical situations – anxious pregnant woman(nitrous oxide inhalation...but IV nahi deni...p Master1), not-cooperating child with 4 molars to be treated GA….., nervous patient for extraction IV conscious sedation…, normal pt for simple restorative procedure LA

- asthmatic patient analgesic medication after extraction - paracetamol

- child with 12 years medication after extraction – paracethamol

- Anaesthesia indicated for patients with COPD…IV sedation

- Anaesthesia indicated for pregnant woman…..lignocane

- Anaesthesia indicated for epileptic patient…...concious sedation either IV or inhalation..both ok

- EMQ on indications of various kinds of anaesthesia (GA, LA, Inhalational sedation..pg 19 scully itra

10. Oral Surgery

-Different facial fractures, their diagnosis based on symptopms and x-rays to diagnose them.do in detail

134 MD1

Mandibular Fractures: Can simple(closed),Compound(open to mouth or skin),pahalogical(area weakened by pathology) or comminuted.

Or can be classified according to site i-e symphyseal, para, dentoalveolar, body, angle, coronoid and condylar, ramus (condylar most common and often associated with the

fracture of canine region of the opposite side of jaw) bilateral condylar (guard man's) associated with symphyseal fracture.

Cl features: pain n swelling, deranged occlusion, paraesthesia in distribution area of inferior alveolar nerve, Floor of mouth heamatoma…..

xrays: PA of mandible and panoramic, condylar-reverse towne's, fracture of body or symphysis-true occlusal …

sequence:::OPG >PA mandible> lateral oblique

Zygomatic # :Flattening of cheekbone prominences,subconjunctival haemorrhage,diplopia,restricted eye movements,limited lateral excursions of mandible,palpable step in infra orbital bony margins,paresthesia in ifra orbital nerve area

.xrays:OM views 30 deg and submentovertex (where # is found to be limited in zygomatic arch)

Maxilla :

lefort I: detaches the tooth bearing part of the maxilla via a # line from the anterior margin of the anterior nasal aperture running laterally and back to the lower 3rd of the pterygoid plate

.Lefort II: detaches the true mid face in pyramid shape involving nasal bones and infra orbital rims.

Lefort III:detaches the entire facial skeleton from base of the skull…involves orbit

xrays:OM 10 and 30 deg,lateral skull views….SMV b letay hai,CTscan

cl features:maxilla mobile,deranged occlusion,bilateral circumorbital bruising,sub conjunctival haemorrhage,CSF leak from nose or ear

-What is the most toxic LA? Bupivicane …scully 52

> 2. cells in acute(Neutrophils) and chronic infection…PML.436 bb/487

For chronic inflammation the cells involve are plasma cells, macrophages and lymphocytes but are they same chronic infection….acute mai neutrophils

> 3. cells in granulomatosis infection……185 md……MACROPHAGES

> 4. LA for a pt with congenital heart disease in a dental emergency….(120/53/103 scully)most probably prilocaine answer ho ga…..KAFI DHOOONDA!!! :/

LIGNoCAINE is contraindicated in pts with conginteal heart disese

PRILOCAINE is for ISCHEMIC heart disease

For cardiac arrythmis its MEPVICAINE 3%

> 5. how many mg of lidocaine in 3 cartridges of 2.2? please explain…calculation on 52

Every cartilage has 44..so 3 will be 44 multiply by 3

1 >Cardiotoxic- bupivacaine also ( long.acting)

for cardiac arrythmias- Lignocaine

causes methhaemoglobinaemia – prilocaine…(dapsone also causes methmglobenmia)

2>.Acute- PMN, chronic- Lympocytes, plasma cells, macrophages

3>.Granulomatous infection- macrophages… 185 master

4>.

5>.1 cartrige has 1.8 ml of 2 % which is 20mg in 1 ml

hence 1.8 * 3 = 54mg

1.8 ml mai 36 hoga…..2.2 mai 44..ye yad krlo

1 catridge has 2.2ml has 44mg lidocaine…so 3 cartridge mai 44*3 hoga

Daikhna hai aik cartrge mai kitni lidocaine hai…usko phir nuber of cartiges sy multiply krdo

- Zygomatic and orbital and mandibular fractures,do it from pink book

- Types of forceps-their exact names…..

http://dentistryandmedicine.blogspot.co.uk/2011/09/equipments-instruments-and-materials.html

- Dry socket questions-management -Re assure,irrigate with normal salina/0.12% chlorhexidine,place a dressing (Bismuth Iodoform paraffin paste BIPP and lidocaine gel on a ribbon guaze),ZOE…90 master/PB371

- A man with multiple myeloma comes for an extraction and comes back 6 weeks later and his socket has not healed what can cause this?MM mai bisphohonates b detay hain hai chemothrpy b krtay hain

a. Multiple myeloma of the mandible

b. Drug induced/ osteoradionecrosis (doo alag alag hain.dono ok hai)

c. Dry socket

d. Drug induced osteosclerosis

- Pictures of forceps: know different types of forceps eg eagles beak, cow horns e.t.c. 2 questions came out with pictures of the forceps and we were asked to identify which one was eagles beak and which was cow horns

- picture of forceps used for extraction.eg cawhorn,root,eagle beak were the options

- What does Fracture of zygomatic arch cause? – causes trismus,limitation of lateral excursion.diplopia,step deformity and paresthesia of infraorbital nerve,subconjictaval heamorrhage…462pb

Zyg arch fracture comes under zygoma fracture

- What does Le Fort 1 fracture cause? – causes maxilla loosening/detached

- What does Fracture of 2 condyles cause? – causes class III

- case: extraction of 3rd molar with dentigerous cyst in the angle of the mandible , sup and

inf border of mandible very thin. What can happen during the extraction? Fracture of the mandible

- Least level of platelets that you can do extraction? >50 x 10 raise to power 9

- All maxillary teeth moving together? Le Fort I #

- Bilateral condylar # causes trismus

- Zygomatic arch # causes anterior open-bite…see file kart sent????

- Orbital blow-out # causes paresthesia of infra-orbital nerve-orbital floor fracture..136 master

See link neha sent

- Condition expected after extracting a tooth in a smoker? Dry socket

- # of mandible at the angle causes inferior alveolar nerve paresthesia….134 md

- Fracture of skull more likely to cause meningitis: Orbit, Nasal, Zygomatic Complex, Le Fort III, etc...lefort iii

http://rlbatesmd.blogspot.co.uk/2008/01/le-fort-fractures.html

- Maxilla moves together with teeth away from the skull: Le Fort I

- Suture material which is used for various oral surgery procedures and Which is not used in uk cat gut

http://en.wikipedia.org/wiki/Suture_materials_comparison_chart

- Throbbing pain present for days relived by staying in quiet room : migraine

- Mandible Fracture signs…..pg135

- Suture materials, which are used where for eg in biopsy , in lip trauma, in oroantral fistula(vicryl) biopsy(vicryl)….lip trauma(vicryl) vascular surgery (prolene) vermilion border of lip (prolene) skin(prolene)

- Which suture material in banned in UK?cat gut

- ALL ABOUT SUTURES AND THE ONES NO LONGER USE IN THE UK…catgut

- POSSIBLE NERVE THAT CAN BE DAMAGED DURING ALL DIFFERENT DENTAL PROCEDURES INCLUDING REMOVAL OF ADENOMAS OR CYSTS(facial nerve)….cysts(inf alv nerve)

- MEDICAL EMERGENCIES IN DENTISTRY, ALL OF THEM

- Extraction of 3rd Molar main complication – alveolitis

- Periosteal elevator and lingual flap (damage) – lingual nerve paraesthesia

- Extractions in 5 different situations (different teeth) and possibility of infection spread of which subspace –

submasseteric, submandibular, sublingual, submental, pharyngeal

- Picture of splint about upper right central incisor – 2 questions –one about more successful reimplantation if immature root apex

- Most important in reimplantation – PDL fibres and cement preserved

- Dry socket treatment – irrigation with antiseptic solution,BIPP,alvo gel,ZOE

http://www.patient.co.uk/doctor/Zygomatic-Arch-and-Orbital-Fractures.htm

link for trismus

11. Operative/Endo/Paedo

- Questions on crowns ,they gave clinical scenarios like missing lateral with sound adjacent teeth,restored adjacent teeth,missing premolars,missing molars,missing lower incisors….MD2 pg 101

242/254 PB

Yahan sy ind/contraind krna crown k http://www.scribd.com/doc/123380282/Planning-and-making-of-Crowns-and-Bridges?secret_password=1sjr6ii1yej31zaaxyov....

- Restoration to be given if marginal ridge is to be protected,contact point is to be retained…..resin modified GIC resin tunnel preparation

- Cements used for cementation of different crowns….,very nicely given in churchill under choice of cements….625 PB..i non vital tooth use zinc phosphate cement..for vital tooth use zinc polycarboxylate

Page-108 churchill

- Restoration of lingual cavity in 65 years old class V:GIC…..232 pb

- Indications of fissure sealants one of the options was : brother of child with high risk caries…34pb/168 md2…..gic used where moisture control is difficult and composites used …also see Churchill 176

- Stephen’s curves ….37pb shows ph drop after sugary drink is consumed..factors influcincing are type of food,buffering potential,drinks ingested

OXYGEN DISSOCIATION CURVE:::IMP::: WIKI…ITS SIGMOID CURVE…partial pressure of oxygen(x axis) and oxyhemeglobin(saturation oxygen)on y axis

- Periapical with approximal (class 2,3) caries in incisor(palatal approach) and molar, what is the best access to the cavity? Direct access for incisor ….. Oclussal access(molar) etc. (amlgm hai 230 pb)….245 churchill

Occlusal via marginal ridge--most commonly used-aim to form scoop form of cavity using pear shaped bur

Direct access---when adjacent tooth is missing

Occlusly leaving marginal ridge intact--tunnel prep (for small lesions n don’t touch margin of root)

-PROXIMAL SURFACE WITH SMALL CARIES; TUNNEL TO LESION- OCCLUSALLY;2MM

Buccally/lingually--when teeth are tilted

- Butt joint preparation in which material-- porcelain jacket crown(not used any more as they are fragile) 257 churchill

Gul said that butt joint is in PMS too when you are not giving metal collar(metal ko hide krny k liye btt joint dy detay hai)so agr question aya to they will be asking about PFM hopefully

- How to identify caries of enamel? Eye sight, dry tooth, wet tooth, .blunt probe and then B/W then fibroptic transilumination then diagnodent laser …. Same question repeated several times with different types of caries so make a list of the diagnosis aids for different types of caries….26pb

Pit and fissure difficlut to diagnose…don’t use sharp probe. USE BLUNT PROBE

-Best properties of NiTi files ,shape memory,corrosion resistant,elasticity?resistance to torsional failure,can be used it 360 degrees rotation and increased….PB 278,Churchill 291

Flexibility…niti for curved canals in endo

Niti wires used in ortho for memory…first is FLEXIBILTY then rest of properties shape memory n stuff

- % of hypochlorite for irrigation in RCT? 2.5% says 289 pb…..cc 292 says

- Behaviour management techniques fro children…58 pb….tell show do

- Child with several caries, anxious. Which anaesthetic to use? Nitrous oxide..bacho mai IV nahi krygy sedation

- Anxious child:-desensitization ( provide sense of control),modelling..churhill 171..pb58

- Indication for stainless steel crown:most durable restoration for primary…86 pb

* badly broken down primary molars

* after pulp therapy in primary molars

* in secondary molars as an interim restoration where crowns are required but the patient is too young

* in developmental anomalies

* severe tooth loss due to bruxism/erosion

* as a temporary coverage

- Best treatment planning (patient 15 years lost incisor 6 months ago – RPD, implants, bridges) rpd best option….112pb

Gul said rpd until 16 yrs n usky bd can give imlants or resin bonded bridges..depends on opts kk

- indication for different types of crowns (3/4, full etc) 242 pb/254

Ind for ¾ crown: For posterior teeth as a single restoration for teeth that have lost moderate amount of tooth structure with intact buccal wall or as retainer for posterior FPD

http://dentistryandmedicine.blogspot.co.uk/2011/07/three-quarter-posterior-crown.html

256 churchill//246pb

- Nayar core (needs or not a crown afterwards)kk put in group…..3mm

http://www.evidencebasedendo.com/index.cfm?fuseaction=pub.article HYPERLINK "http://www.evidencebasedendo.com/index.cfm?fuseaction=pub.article&aid=149"& HYPERLINK "http://www.evidencebasedendo.com/index.cfm?fuseaction=pub.article&aid=149"aid=149

- Faults with crowns (fits on the die but not on the tooth or does not fit on both)my CC 225- PAGE 253 PB

Overhanging margins,negative margin by overtrimming dye or over polishing of crown margin, and more

- Indication for bridges…cc276..239 my CC

- Patient with Bulimia – treatment 517..also in scully.268/269 pink…psylogical trt dy gy

START WITH DIETARY ADVICE, FILLING ON PALATAL SURFACE WITH OPEN BITE

- Patient with anorexia nervosa treatment option…268 pb..under erosion…need psylogical counselling

- When choose amalgam than composite resin?posterior extensive cavity ,load bearing areas,bruxism give amalgam in such cases 230pb

- Question about nayyar core!!!!! 3mm

- Use of Gates-Glidden drill..master 65//77 hartys…to remove GP,to give coronal flare for RCT

- Stepwise excavation-indirect pulp cap…excavate and then put GIC 179 master///251CC

- Patency filing-small flexible files are used to prevent apical blockage without enlarging apical foramen

PUSH FILE 0.5 -1 MM BEYOND APEX

-the disadvantes are longer appointments and inability to control exudates…66 master

- Shape of access cavity in maxillary first molar:63 md…

thru occlusal surface,triangular shaped with base buccally and apex palatally….63 master

mand molars :trapezoid shaped.base mesially and apex distsally.

max and mand canines and incisors: close to incisal edge on a palatal or lingual surface.triangular with broadest portion incisally.

max mand premolars : ovoid buccolingually

- What would you do when a patient comes with an asymptomatic root canal treated tooth with periapical radioluscency treated by some other dentist? Will wait and then really depnds on opts…as iwe have to wait for apical bone remodling…wii keep on review coz its asymptomatic

- few questions on dates of eruption.... i mean v wer asked to tell the age of giving child ptt...

- A lot of questions on fluorides in children with various types of caries risks in various age groups…3-4 times yearly floride varnidh 2.2% NaF….DBOH

- Lots of questions on crown fabrication; treatment options in various age groups and clinical conditions..

Under 16 temprary crwn n SS….agr lower mai missing ho to go for PD as wahan zeyda bone resorpion hogi

- Materials used for crowns in various conditions….search!!

PJC : OPPOSITE SHUD BE PRESENT

- Disadvantages of patency preparation …hartys…push material down beyond apex

- Uses of Gates glidden drills…….remove GP and coronal flareup and also wen preparing post

- Shape of access cavity in maxillary first molar-triangular,base buccal apex palatal….

- Questions on deep caries management….234 pink, incipient dentinal caries(it will require preventive trt as its very small so go for minimum preparation …composite and GI can be used…228 pb

- Preventive resin restorations : If occlusal contacts are retained,the composite resin is used to seal the non carious fissures…228 pb

FISSUROTOMY

DYCAL

GIC

- Restorative complexity index…not in pink

Complexity code 1 Able to be performed by any dental graduate

Complexity code 2 Able to be performed by any experienced dentist

Complexity code 3 Able to be performed by any dentist with skills developed following specialist training

http://www.nature.com/bdj/journal/v190/n9/pdf/4801010a.pdf

- Definition of freeway space--rest-ovd…pink238....md2 pg 102

Freeway space/ Inter-occlusal rest space- definition

The space that exists between the upper and lower articulatory members at rest.

The difference between the occlusal vertical dimension and the vertical dimension of Rest.

- Problem caused by palatine torus in complete denture fabrication…388 pink

Not removed until its large ,n agr soft palate tm extend nahi hoa

- Questions on calcium hydroxide 624 PB/289pb

- Questions on inlays(232 pb), onlays(md 96), nayyer core(see kart link… Nayar core is only for post teeth

http://en.wikipedia.org/wiki/Inlays_and_onlays

- Figure with RPD- labeling … https://open.umich.edu/sites/default/files/1029/JShotwell-Week6.pdf

See pg 8 of link…299 PB…do components and labeling

http://www.slideshare.net/Blindsided/rpi-syst HYPERLINK "http://www.slideshare.net/Blindsided/rpi-system"em

http://removpros.dentistry.dal.ca/RemovSite/Manuals_files/RPD%20Manual%2011.pdf

- BPE scoring pg10 MD2/182 pb

- Lots of questions on various clinical scenarios depicting different types of periodontitis…master 14

- Young adult with tooth surface loss. Best treatment option?

ab daikhna ye b hai k kis type ka surface loss hai abrasion,erosion,attrition….crowns and composites can be option discuss kr ry they sb..pg 89 /269 pb..primary teeth mai permanent creon nhi day gy.will wait for all tooth formation atlest age 15 tk...more likely option goes temporary for composite buildup then after growth completes or the age is ok phir crown kr dy gy… :/

[20:43:58] bhavana ag: .in bruxism cuz of the abnormal forces there is a tendency for ceramic # when compared to metal which is strong

agay it depends upin choices

- Patient with Bulemia(eating disorder). Best treatment option?depends on opts like mild mod sevre

maintain these pts dentition,monitoring,photos,take study models,GI,refer physciatrist

- Patient with anorexia nervosa. High caries rate. High sugar intake. Best treatment option?602 scully..table 7.7………..see SCULY FOR ALL THESE

- Picture of a fractured central incisor with the pink pulp showing and a few drops of blood, how would you manage it? ye red highlite hint hai ques mai

mtlb pulp is being exposed..so in adults we don’t worry about rot formation but agr child hai to we’l wait for root formation SO DIRCT PULP CAPPING KR DY GY…pb100

a. Non setting calcium hydroxide and composite

b. Non setting calcium hydroxide and gic(jb more then 1mm ho n more then 24hours)

c. Setting calcium hydroxide and gic

d. Setting calcium hydroxide and composite(less then 1mm n 24hurs) 100pb..ye correct answer hai not C

is case mai tooth vital lg ra hai n hm pulp capping kr ry hain

nonseting CAOH hum GIC k sth use krtay hai pulpotomy mai

- Same picture, the question was what kind of injury is it?

a. Fracture of enamel

b. Fracture of enamel and dentine

c. Fracture of enamel and dentine in close proximity to the pulp

d. Fracture of enamel and dentine with minimal pulp exposure-yes

- What behaviour method will you choose in a co-operative, accompanied child – Tell, show, do

- QUES.ON Avulsion :time period for reimplantation…within 30min 109 PB

- Root caries what u use?GIC 233 pb ….rooot caries mai remember GIC

- EMQ: case-1: A 9yr old cooperative patient(tell show do)

Case 2-patient having tendency to gag but under control (anwer was u will just use Distraction methods so as to divert his attention eg ask the patient to wriggle his toes.) Churchill 232…….sedation for over active gag reflex…172 CC

Case 3: Patient who had Epilepsy 10yrs ago but now under control…..in cases mai nitrous oxide detay hain…1/v n ihalational…gul said that 10yrs hai so is case mai pt ko explain care gy n reassure n carry out trt go for this

Case4: Child patient 4 or 5 yr old had a sibling (answer was Show off) modeling

Options were: which technique will u use inhalational sedation, intravenous sedation ,carry on with treatment with explanation(case 3), modeling(4) , ask patient to wriggle toes and talk to him(2) etc

- Better restoration material for class V in Sjogren syndrome – ?pg 233 pb..resin modified GIC ..gul

– Lingual cavity in posterior teeth in Parkinson patient, which material is better to use? Glass ionomer…scully 330,cwson 426…tremor ki wja sy koi aisi fill kry gy jo jaldi ho jai islye amlgm nhi kry gy NA HE COMPOSITE COZ ISLOTAION MUSHKIL HAI…..

- How do you proceed to eliminate approximal caries in anterior teeth? Access from palatal aspect….246cc

- The same question in posterior teeth, an x- ray was shown with decay in enamel and dentine, options given : occlusal access with removing marginal ridge,…245 cc its class 2

Depends kitni bari cavity hai…decide on cases…zeyda bari hoge to remove marginal ridge

- Pigmented fissure , which is the best way of caries diagnosis, options given: sharp probe, bitewing?166 master 2 and 26pb….fissuretomy with small burs/or namel biopsy…depends on opts gul said….bitewing mai fissyre nhi aye gy..

1^st visual tactile n blunt probe..if caries involved then B/W

We shoulnt use sharp probe..pigmented fissure is occlusal caries

- Little cavity in mesial of upper first molar, how do you access decay? Options: briault probe, bitewing, etc….coz is mai cavity mention hai

The Briault probe is used in the detection of cavities on mesial or distal tooth surfaces. This probe has two angled ends useful in detecting decay between teeth, according to "Basic Guide to Dental Instruments."

– Cavity test ( drilling) , when do you use it ?– When all other tests have failed…pg 14 pb

- Sodium hypochlorite concentration used in endo? –range 1-5%......or ideally 2.5 …discussed b4

- Ideal length of post ? 5 MM should be left

[21:42:45] bhavana ag: 2/3rd the root length…least last 1/3^rd for post

– Characteristic for best retention of post – taper, length and superficial texture? length ..same para

– Ni-ti files, why it is used? No memory, more difficult to break?discussed yesterday….more flexible,shape memory…if have to select one then go for flexbility 291 cc

- Initial caries lesion surface characteristic? WHITE SPOT Pg 24 pb…options nhi hain…depnd krta hai..

Gul said first it is Initial white spot>>dull n matt >> pittng….so porosity is wrong

For arrested caries its SHINY and BLACK

– Stephan curve what does it shows? Plaque ph over time… 37pb

– 13 years old lateral incisor crown fracture without pulp exposure, what kind of restoration? Composite

- Which is the function of posts? – increase retention of core…pg 50 smith howe//246pb

– Which restoration is used in tooth with amalgam nayar core? Porcelain fused to metal(metallic ceramic)..50smith

– Internal bleaching , which is the most common material that is used for that?– carbamide peroxide(35%) potency boht km honi chiye

Home bleaching>>use carbamide peroxide,hydrogen peroxide……go for these opts first then sodium perborate …carbamide ajkal use hota

- What is the concentration of sodium hypochlorite used as an irrigating agent? 2.5%

- The method of drilling a cavity without LA is the last resort when all other vitality tests fail…ok

- NiTi instruments are preferred to stainless steel instruments because of hyperflexibility…ok

- Which method of behaviour control is used in a child with a minimal occlusal cavity? Tell, show, do(most conservative one isky bd baki atay hain behavour changing n modlling stuff)58 pink/5cc

- Which access for mesial cavity on upper incisor? Palatal

- Pic of a small cavity on the mesial surface of lower premolar which has not invaded the enamel surface. Phly go for preventive measure coz it hasn’t invaded>>then laterAccess occlusally with marginal ridge intact

- Restoration in a MOD cavity which has caries below the contact point? Amalgam

- Restoration of the cervical area of a high caries incidence patient? Resin modified glass ionomer cement

- Walking bleach? It is internal bleaching…either sodium perborate or carbamide peroxide

- Pulpotomy – which is the best material to use, especially because of its low toxicity? Formocresol, ferric sulphate, etc (calcium hydroxide was not an option!!!)ferric sulphate 15.5 % 92pink

- Root filled tooth with no symptoms. When do you take the first x-ray for the follow-up? 6 months, 12 months, 18 months, etc..12months

- Root caries diagnosis…visual n probe

-How old is the patient most likely to have a trauma that damages tooth germ of permanent incisor? In years: 1, 2, etc….pink 99….less then 4 yrs…in this case go for 1 year…likelihood is more when small age

- Tooth wear: erosion, attrition

- What’s more likely to cause erosion? Diet cola, sweet stuff, etc depnds on opts…acids sy hoti hai erosion..is mai closest diet cola hai….gastrointistinal,industrial are causes too

- What’s the best protection for the pulp? Dentine, lining, etc..dentine

- Which root filling technique use a handpiece? Thermomechanical compaction 293cc/287pb

- Class III very small. What’s the best treatment? Lining, composite filling (no lining), etc if very small then composite without lining 233pb

- Which root filling material comes in 2 pastes? Tubli Seal, etc pb 286 eugenol based

- Diet advise for a child. What’s the most effective method? tell the parents not to give sweets for the child, dentist tells the child which are good and bad foods, nurse talk to the child, send the child to a dietician, etc….42pb….scottish guideline say dentist….pink says someone who isn’t dentist…controversial !!!

- Crown fracture with pulp exposure. Patient comes 5 days later. What’s the treatment? Pulp cap, pulpotomy, superficial pulpotomy, pulpectomy (in nonvital)….question incpmplete hai!!!

Jb tooth k nonvutality k chances ho tb go for pulpectmy/rct….agr question mai age aye more thn 40yrs something then go for pulpectomy..pulpotmy goes for youngs…so age dekho in scenario n vitality/nonvitality…gul……

- Endo files: single use! Same pt mai reuse kr letay hai

- Preparation techniques for endo: crown-down, stepback, stepdown, etc..now adays crown down use hoti n step back

- What’s “greater taper” instruments made from? NiTi…pink278 flare increased by every 1mm

- How do you identify decayed dentine? hard and wet, soft and wet, soft, etc...soft wet

http://orenkes.tripod.com/cariology/id10.html

- Cracked tooth syndrome: use cotton wool, pain on release of biting…62 md/221pb

Pain on releasing bite ok

- Trauma to tooth with closed apex. In which one the tooth is more likely to maintain vitality? Concussion(pt ko soft diet py rakho gy), subluxation, intrusive luxation, avulsion,….194 master//98pb

luxation : concussion 5 year survival reate in closed apex 96%..

- Dull pain with vital pulp various questions:chronic periapical periodontitis…..222PB DULL PAIN with vital pulp..periodontal abscess is vtal 192 pb

- Dental caries which is more imp frequency of sugar intake? Or time of intake…..frequncy and total time is imp ?36 pb///167 md

Ordr is::::: frequency,time interval b/w them,amount,concentrationof sugar ,stickness of food are imp

- Calcification and eruption dates of primary and permanent dentition..churchill 541,489 my cc

- How can u locate the apex other than a radiograph : Electronic apex locator….289 CC

Apex locatr is safe n pacemaker pt.in sculy119

- Many different scenarios were given and we had to choose which is the best like what is indicated in a 15 year old boy who has lost his front tooth, …….112 pb managmnt of missing incisors

RPD than iplant wen he is 16yrs

No final answer coz pt growth stage mai hai :/

what is indicated in a 26 year old lady who has lost her front tooth……IMPLANT best opi

is mai growth hoti hai to is mai opts bridge ya implant kr sktay hain…resin bonded bridge dy sktay hai agr toth healty hai takay minimum prep krni paray

or implant k liye agr bone healthy hai enuff hai n willing have hai to implants dy gy,contra for implant if pt taking bisphosphonates(ref 134 masters2/330 pb) , sportsman (agr mouth guard pehnta hai implant dy sktay hai otherwise koi fixed kuch nhi detay/refer anna smith black color book on fb grop book divya ny btaya ), poor prognosis:::pd disease,smoker ,DM mtlab uski M/H and D/h b daikhy gy

main thing is space closure and maintainance

implant for female 18-19//male 21

- Different values of pulp tester were given and we had to diagnose the condition, pulpitis, sinusitis )416 cc), abscess etc there were a lot of questions on it………………14pb pr conditions nhi mention is pg py

http://en.wikipedia.org/wiki/Electric_pulp_test

http://www.endoexperience.com/documents/eptplacement.pdf

kart ny aik book btai uskay pg 23 py secion hai pulp testr ka.bok in fb group hartey endo pg 23 pulp testr given

http://www.authorstream.com/Presentation/saurabhchandra-230709-Endodontic-Diagnosis-class-Science-Technology-ppt-powerpoint/

see this link…slide25

in abscess and necrosis there is no response neither for sinusitis

hypractive pulp is jb koi trauma hoga

the longer the pulp tester takes it means the tooth pulp is towards dead side…but if resopnses quicker so matlb k its not dead

- A pt has an old Ag filling and there is occlusal wear what are the causes bruxism , attrition, abrasion .etc...bruxism

- There were questions on erosion abrasion and its causes.

Conditions where they are seen

- There were many questions on iatrogenic trauma, like what can happen if the matrix band is not placed properly,.. what can happen if we use a old diamond bur(increases the temp but doesn’t cut cavity)… why do we use a rubber dam 224pb

Matrix band not placed properly then causes cervical overhang>>>poor contact point

- Rampant caries Diagnosis, Treatmant…pg 90 pb

http://www.mndental.org/features/2009/01/01/93/management_of_rampant_caries

- Stephans Curve and effect on plaque ph etc….pb36…different book say different…some say time and plaque and some say time and saliva ph…..confusing…go for PLAQUE PH TO TIME.final answer…so cawson also says plaque

- Pic were given and we had to diagnose what it is Rampant caries…usually kids

http://www.mndental.org/features/2009/01/01/93/management_of_rampant_caries

- What advise we will give to pt….

What will we ask in history, social medical etc etc

- which one can be prevented by using matrix band? Options: Open contact point(with wedge), overhang(with matrix band)

- How long Nayarr core should go through root? Opt: 3mm, 6mm, half of the root,….3mm 250 CC/272pb

Nayar core is for post teeth only…..porclain bonded /porcelain fused metal (pfm)crown or ggold crown can be used as final restoration …written under crowning of rot filles teeth @end

- which one can be prevented by using wedge for filling? overhang , open contactpoint,under contouring,…….not sure!!!!gul says open contact…

- thermomechanical compaction with handpiece…………….287pb/71 md2 more clear

- greatest polish composite-microfilled… ……….pb610…but if nanofilled ki option hai then go for NANO

- Cause of pain 2 years after RCT……………288pb

- Nayarr core…. Where used..after RCT when sufficient tooth structure available.amalgam is packed 3 mm into the root canal and pulp chamber to give mechanical retention………

- Best protection for the pulp ,…..dentine

A comparative evaluation of pulp response to glass lonomer cement with zinc oxide eugenol and silicate cements : a histological study. …iska link upper walay k sath hai..in sb mai naturally sb sy phly to dentine proactive hai bd mai materials atay hai jaisy ZOE

-- Endodontology. 1989 Dec.; 1(2): 11-5

Toxic root canal sealants:…(ye sara paragraph is qustn k sath hai)(toxic RCT sealnt parh lena from books)….AH26 toxic……. A review of the literature reveals that this represents the largest

published case series of endodontically related injuries to the inferior alveolar nerve. Studies have shown that all root canal sealants are neurotoxic to some degree. The most neurotoxic appear to be those containing paraformaldehyde6 or one of its analogs, including Sargenti paste (N2) or Endomethasone (Spécialtiés Septodont, Saint-Maurdes Fosses, Cedex, France; available only in Canada and Europe).11,21 Other sealants contain analogs of formaldehyde, particularly before they have set (for example, AH 26 [Dentsply Maillefer, Tulsa, Okla

- ENDO IRRIGANTS AND ALTERNATIVES……sodium hypochlorite….289pb EDTA 17%,,also use chlorhexidene 0.2 %...gul

- ANOREXIA AND BULIMIA IN DENTISTRY

- ATTRITION, ABRASION, EROSION

- ROOT AND CANALS DISTRIBUTION AND ANATOMY IN BOTH DENTITIONS…read entire chapter in harteys endo for canal morphology

- CAOH2 SETTING AND NON-SETTING; INDICATIONS……………100pb

For direct pulp cappng use setting CAOH,for pulpotmy use non setting CAOH

- ACCESS PREPARATION FOR RCT..given in detail in master…shapes

- Question about posts with 5 sub questions – different clinical situation, cement for indirect post(zinc phosphate or GIC), types ..246pb/42smith howes

- What is more important in a successful post – length

- Matrix band poor technique 5 sub questions – marginal overconstruction, underconstruction, open contact point, overhang

- Matrix band other questions with some alternatives

- Wedge not placed what happens – overhang…,open contact point

- Rubber dam isolation – protect pt airway in a Upper Central Incisor RCT..isolate…225pb

- Rubber dam sub questions – moisture control in lower teeth (2 different situations and teeth presented)…

- Sealants for 1st Molars best age – as soon as first molar erupts and isolation is possible usually 6-7 years……….34pb…use resin GIC and resin modified composites

- RCT sealer resin-based – AH Plus.286 pb

Seal apex –CAOH…….tubliseal-eugeonal based

- Crowns indications for 5 different clinical situations – gold onlay, gold ¾, MC, Porcelain Jacket Crown, All-ceramic Alumina crowns…….

- which one is the best option about amalgam filling?

* The floor should be flat,…* the internal line angle should be rounded,….* the angle between filling and the cavity wall should be 90 degrees, …. So many similar options .cavosurface angleto prevent ditching…….227PB(90-110)

http://bdshelp.wordpress.com/category/4th-year/operative-dentistry/

- what is most useful for a molar filling in a woman? Opt as above..kart ko smjh nhi aya sawal.he said this qustn doesn’t make any sense.more ifo honi chiye thi…..probably composite coz lady esthetics prefer kry gy…..COMPOSITE

Line angle:needed for amlgm fills and sath sat resistance form wagera chiye hoti hai coz amlgam ko mechanical retention chiye hoti hai.

http://orenkes.tripod.com/cariology/id10.html …………chek it out too

-cracked tooth syndrome:::::..sharp pain on biting…..mast 61…divya told questn

[21:17:47] Karthik Pk: 6% hydrogen pero 16% carbamide….for walking bleach

Cold>electric>hot………

In high point there is pain on biting

[21:23:45] Bimpe A'Salam: material used in pulpotomy for low toxicity pls…..Ferric sulfate or formocresol……………but got banned in many places

12. Orthodontics

http://09dent.com/wp-content/uploads/2012/09/OrthoScript4classisfications-of-malocclusion..pdf

malocclusion

- Ceph angles ….128pb/md2 pg229

http://www.scielo.br/scielo.php?pid=S2176-94512010000200009&script=sci_arttext&tlng=en

- Pictures of cephs to tell the angle’s classification…220md

- classification of occlusion on the basis of incisors…220md

- IONT 221md

- Loads of questions from ortho! IOTN-at least 20 , Angle classification-characteristics of I,II,III clases

- Lateral cephalometric – determine the age of patient.see teeth erupted and not erupted..CC mai dekho appendix540………

- Pt. Lateral ceph. Mixed dention stage, determine pt. Age

- Lateral Ceph of mixed dentition, identify the labelled tooth.

- FIG of lateral ceph to identify age and second molar

- An EMQ on the management of crowding, mild, moderate and severe. (about 5 questions)…..254md

Moderate crowding mai 1^st premolar xla krty hain

- Questions on the use of headgear……….. 291md/138pb

http://www.columbia.edu/itc/hs/dental/D5300/Headgear%20Appliances%20-%20Columbia%20New_BW.pdf

- A picture of a childs mouth with an anterior open bite, what is the cause?148pb AOB

a. Cleft lip and palate

b. Tongue thrusting

c. Thumb sucking it can be both b and c …depnds on pic…both will cause it but one is symmetrical and one is asymmetrical(thumb sucking)

http://www.ncbi.nlm.nih.gov/pubmed/17853727

tounge thursting is secondary..phly its thumb sucking for AOB

- Effects of thumb sucking

a. Bilateral posterior open bite

b. Reduced over bite

http://www.taysideorthodonticmcn.scot.nhs.uk/documents/guidelines/advice_on_dummy_digit_sucking.pdf

http://www.slideshare.net/PARTHPMT/tonguethrusting

- Questions of angles classification of malocclusion

- Age of the patient was asked from a lateral cephalogram

- IOTN : EMQ

- Eruption sequence as there was a picture of the skull with teeth in the jaws

http://www.mchoralhealth.org/OpenWide/media/flash/eruption_flash.htm

and u had to tell the age of the patient

- lots of ques on orthodontics twin block appliances ,reverse overjet, open bite ,thumb sucking.

- EMQ :in which case u hv to extract first premolar or second premolar in upper

or lower arch,when not to etc.eg in mild crowding with class 2 div 1.pls read

abt it.

- Classification of malloclusion, angle and british

- Picture of the skull of a child, what age is he?

- Picture of teeth with chronological enamel hypoplasia affecting different parts of different teeth. How old is the patient?

- About 10 or 15 EMQ’s on questions on iotn

- In which case is the highest IOTN score? Submerged deciduous teeth (IOTN score: 5

- Picture of occlusion with increased over-bite

- Picture of occlusion with increased proclination of maxillary incisors

- What is the position of lower incisors in Class I malocclusion? They lie immediately below or just posterior to the cingulum plateau of the maxillary incisors

- What is the position of the lower incisors in Class II div I malocclusion? Procline incisor

They lie posterior to the cingulum plateau of the maxillary incisors and the maxillary incisors are proclined.

- Position of the lower incisors in Class III malocclusion? They lie anterior to the cingulum plateau of the maxillary incisors.

- What has to be considered the most in diagnosing malocclusion? Developmental age

- Picture of Class II div II malocclusion

- which grade of IOTN is the cleft lip and palate? Grade 5

- which grade of IOTN is the hypodontia(more than one tooth missing in every quad)? Grade 5

- A picture of diastema in a mixed dentition were shown and asked what is the diagnosis ? what is the best treatment plan? opt: monitor,

orthodontic appliance extraction

- IOTN index 5 sub questions – clinical situations

- Which teeth to extract in different classes

http://www.google.co.uk/imgres?imgurl=http://archform.co.uk/wp-content/uploads/2011/08/Andresen.jpg&imgrefurl=http://archform.co.uk/products/functional-apps/&h=530&w=716&sz=94&tbnid=v3k4jIwdu1qxsM:&tbnh=90&tbnw=122&zoom=1&usg=__er0Zo34M4OFGz6zpeWcS8t_Wv9M=&docid=1sobk2O6Eoa9ZM&sa=X&ei=iefJUfbxPILV0QX3uICICA&ved=0CDkQ9QEwAg&dur=793#imgdii=_

13. Prostho

- Definition of freeway space : The difference b/w rest and intercuspal position usually 2-4 mm....Rest-OVD…..238 PB difference b/w rest n intercuspal position

- Pt with dentures that don’t fit,so diagnose the cause…acromegaly,denture fault…all dependa on options

- Chroma-intensity of colour (hue...red blue green colors)

- Teeth setting in relation to ridge and papilla: 312 pink

Natural teeth lie 10mm from papilla ; with resorption this comes to lie on ridge so the anterior teeth should be placed labial and buccal to the ridge…(lower teeth should be in neutral zone)

to give adequate lip support and naso labial angle of 90 degrees.Normally 8-10 mm infront of the centre of incisive papilla.

Incisal edges of upper central incisors,canines,both cusps of 1st and 2nd premolars and mesiopalatal cusp of the 1st max molar should touch occlusal plane.

Mandibular teeth should be placed in the centre of the crest of ridge such that the central fossa of mandibular teeth should lie at the centre of the crest.

The bucal cusp of mand 2nd premolar should engage the embrasure b/w max 1st and 2nd premolar and mesiobuccal cusp of mand 1st molar should engage the embrasure

b/w maxillary 1st molar and max 2nd premolar.The lingual cusps of the max 1st molar should occlude in central fossa of mand 1st molar and same is for max and mand 2nd.

- Factor affecting retention of teeth……major abutment ,clasp(retentive arm)

- Lots of questions about the components of the Removable partial denture…298 pink see manual RPD Mnual saddle clasp rest connectors wagera parh lo

-saddle,clasps,rests and connectors

- How to measure the vertical dimension : Vertical dimension = rest - free way space

can be mearsured by facial musculature,willies guage,spring dividers.This is to ensure there is an adequate interocclusal clearance.

- Recording the occlusion in an edentulous patient, full denture..(fox plane)

- Prosthodontics- crowns ,partial dentures- Kenedy classification…122 master

- Which structure gives guidance to the placement of maxillary incisors on dentures?incisive papilla…maxillary incisor shoulb be 8-10mm away from incisive papilla

- Picture of lady with large hands and complaining of unfitted dentures :::: acromegaly 116 master

- Picture of RPD…labelling

- Problems caused by palatine torus….peripheral seal ka problem hota hai,ulcerate ho skta hai kbhi kbhi

- Die fail to fit prepare and cast – die damage + distorted(lab fault)

- Inlay fail to fit to prepare – undercuts……

- Various clinical scenarios, different age groups – treatment options – crowns, bridges, RPD, acrylic denture, implant

- Picture of an upper denture with Adam’s cribs on the 6’s what kind of denture is it?

a. Spoon denture(called flipper)

b. Every’s denture

c. Tooth supported denture(correct)

A Spoon Denture : is a small denture usually to replace just one or two front teeth. The palate part of the denture on suction to hold it in place as it does

not make contact with the inner surfaces of the back or side teeth. This means that it tends to be unstable and requires skill on the part of the patient

to use their tongue to stabilise it while eating. This lack of stability is the main disadvantage and the subsequent movement can lead to gum recession

and further loosening. The advantages are that it is cheap and easy to make and as the gum margins of the other teeth are not contacted by the denture

base, there is less likelihood of decay or gum disease occurring.

Every Denture: is a mucosa borne denture with a specific design to ensure gingival health.Restricted to the use in upper arch.

- 5 Questions on Kennedy’s classification of dentures

- A picture of a man whose central incisor has just been extracted and who is going to get an implant in the next 6 months what is the best way to preserve the space

a. Chromium cobalt denture

b. Acrylic denture-yes….Rrpd PB 113

c. Orthodontic wire

- The same picture and the question was what traumatic injury could have occurred

a. Avulsion

b. Concussion

c. Luxation(CORRECT GUL)

d. Subluxation

- Kennedy classification and pics of diff cast

- Picture of two casts with wax blocks having teeth in occlusion they asked what

can u identify from the picture options were. bite registration,there is class 2

or 3, etc…..DEPEND KRTA HAI pic py

- Trial wax :

– what you can check outside patients mouth in articulator - read page 114 master dentistry

On articulator before trial on the patient,we can check complete teeth set up.The occlusion is then assessed,checking balance in excursive movements….

– Willis bite gauge and surveyor pictures shown and you need to say their names

- When making Dentures, what you cannot change? – condylar guidance

– Fixed- movable bridge – read page 101 master dentistry

– Second impression for resorbed ridge in denture ,which is the best material to use? – ZOE with low space tray….admix is primary

- Butt joint margin in buccal surface for porcelain bonded crown, what for? Aesthetics

- Picture anterior crown, which characteristic cause gingival inflammation? Subgingival margin 102 master….dont invatde biological width

– Pontic design shown and need to be identified ?– modified ridge lap…102 master

– Name of instrument for survey models, options given - Surveyor?

http://www.docstoc.com/docs/82661065/CHAPTER-11-THE-DENTAL-SURVEYOR-AND-ITS-USES

- Picture of surveyor

- Surveyor cannot determine where occlusal rests have to be placed.

- The best restoration for a missing maxillary central incisor in an otherwise healthy, caries-free mouth is an implant

- When will you use a butt joint in a crown preparation? When an increased thickness of material is required…for porcelain n metal both

- Which is the first step to be taken after taking an impression? -washing under running water and then immersing in 10000 ppm Sodium hypochloride for 10 mins…629pb

- Lower premolar is set on the alveolar ridge…………..neutral zone

- Upper incisors are set 8-10 mm anterior to the incisive papilla…to compensate any resorption….31cc

- Where do you take support while restoring a tooth? On the tooth

- Picture of a 3-unit fixed fixed bridge

- Picture of a pontic in a 3 unit fixed bridge. ….saddle…shayd is case mai saddle wali pic dekhi ho

- A 16-year old boy requires a crown with minimal caries…..246CC it should be filling composite

- Restoration for peg lateral?263 CC..phla jawab composite buildup then all ceramic crown(PJC)

- Most difficult to achieve? Inter-condylar guidance…………238

http://books.google.co.uk/books?id=6qD5QFn-f9kC&pg=PA35&dq=intercondylar+guidance&hl=en&sa=X&ei=W8q4UdLJMIq8rAesp4C4Cw&ved=0CDYQ6AEwAQ#v=onepage&q&f=false

- Picture of Willis gauge…….done kart

- What can be adjusted on a cast before the patient comes? Anatomical tooth position.balance and excursive movements on an articulator before trial..phly b tha ye sawal

- Adjusting the over-jet & over-bite will alter incisal guidance of occlusion….gul

- When do you use in prosthesis only 1 rim? To do OVD, rest vertical dimension, etc………..114 mD

http://www.youtube.com/watch?v=AMaQGmPF-Ng

- Prosthesis – neutral zone technique………310cc

http://www.dentistry.bham.ac.uk/cal/impress/nz.htm

- Articulators……see all types…. Fully adhustabe,semi adjustable

http://www.slideshare.net/seragelhamadi/dental-articulators

- Bridge

- Trauma by denture in buccal sulcus…116MD

- Group function, canine-guided occlusion :…all given in PB238

http://www.youtube.com/watch?v=qk1v_IxAaWA

Group function : multiple tooth contacts on working side during lateral excursions but no contact on non working side…..isko group function kehtay hain..see vdo kart sent…think its used in full denture atlest one arch…

239 churchill/241 divya…184 in nellswamy (ye link is book http://books.google.co.in/books?id=ZGvegIdicUoC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

Canine guided occ: During lateral excursions there is disculsion of all teeth on the working side except for canine and no contact on non working side….

Normal occlusion mai canine guidance hoti hai

- Bur to prepare “rest” in prosthesis

- Prostho rpd two designs identify support and indirect retension…………..296 pb

- Implants ,fpd indications…….390pb ……...

- Partial denture..What does P stand in RPI system :distal guiding plate..pic bheji thi gul ny

occlusal rest (R) distal guide plate (P) and gingivally approaching I bar clasp (I)

http://www.nature.com/bdj/journal/v189/n12/fig_tab/4800854a_F26.html

- Many pics were given and we had to mark the rest , bars clasps….see file kart sent…and also given in 366 nalaswamy

- What is an Akers clasp :

a classic clasp with

An Akers' clasp is the classic direct retainer for removable partial dentures. Named after its inventor, Polk E. Akers, this suprabulge clasp consists

of a rest, a guide plate, a retentive arm and a reciprocal arm. Akers' clasps, as a rule, face away from an edentulous area. Should they face the

edentulous area, they are termed reverse Akers' clasps

- What is the length of a clasp..

A retentive clasp should be at least 15 mm in length if it is constructed in cast cobalt-chromium alloy

A retentive clasp should be at least 7 mm in length if it is constructed in wrought wire.

-> When is a crown indicated?rct,abutment for bridge…ask mujtaba

-> A picture showing a partial denture design and we were asked to identify the indirect

Retention(302 pb), support(256pb), rest and clasps…..

RPD manual 11 mai components given hai in diagram pg 8(major/minor connctr/retainer atc)in drive

- Several questions with different clinical scenarios and we were asked to choose the

most appropriate for the patient-a conventional fixed fixed bridge,a minimal preparation fixed fixed bridge, a conventional cantilever bridge,a minimal preparation cantilever bridge,a denture or an implant.

> For example a 21 yr old male with a missing upper central incisor,good abutment teeth with well developed alveolar ridge;implants

> a 70yr old woman with missing central incisor as a result of periodontal problems…..cantilever??ask mujtaba

- some questions about treatment plan with different cases,like:

a 15 years old boy has lost his central tooth in skiing,what is the best opt for him? resin based fixed bridge

Ext, implant,resin bonded bridge

- MANAGEMENT OF MISSING INCISORS IN ADULTS AND CHILDREN….113 pb

- BRIDGE PARTS AND CR/CO DENTURE. KENNEDY CLASS….

- TYPE OF BRIDGES AND INDICATIONS

- Partial denture design 5 sub questions – abutment (mesial rest, distal rest), increase/decrease occlusal plate, increase/decrease………….

support on mucosa area (saddle), stress-breaking design………..302pb

http://www.wiziq.com/tutorial/125375-STRESS-BREAKER-OR-STRESS-EQUALIZATION

- Picture - Patient complains about her lower canines (last teeth)iska mtlb yhi teeth reh gya hai, she has a nice partial denture, canines pocketing less then 2mm and 50% bone support, what treatment is the best – implant-based overdenture, extraction and wait for healing to make a new denture, extraction and immediate dentures, RCT if Canines treatable and overdenture

2mm pocket is very less mtlb its ok healthy not bad …kart said

Rct first n oerdentures….gul…rct kry gy for overdenture

- Kennedy classification figures – 5 sub questions (look up for classes and modification 1)

- 2 different clinical cases of need to be extracted upper central incisor and the best way to replace it – options: acrylic dentures, chrome-cobalt partial denture, implant, adhesive bridge, fixed-fixed bridge

a- for a 45years courier with other lost upper molars and PMs – acrylic denture

and other quite well-financial situated guy, for immediate replacement – acrylic denture first then implant later

- Picture of 2 cast models – first management – occlusal diagnostic mounting……..302pb/240pb

Ye sawal incomplete lg ra hai

14. Radio

- X-ray faults.there were so many questions about this.need thorough reading…723pb/209 eric

- OPGs to tell the main important features like caries and fractures of bones to be identified…387eric/402

- X-ray and question about the patients age

http://dmfr.birjournals.org/content/40/4/199.full.pdf+html

- X-ray where you should identify the sinus….336eric pdf

- Cone beam CT of upper jaw-4 projections- longitudinal,axial,sagital with question on external resorption that is showed on one of them????mark it phir will discuss

http://endoexperience.com/userfiles/file/unnamed/Patel_2007_The%20use%20of%20cone%20beam.pdf

- Few PA radiograms –to diagnose condition-supernumerary tooth ,caries….264 3^rded/274pdf/302 my book

- OPG- name certain structures-hard,soft palate,tongue,floor of maxillary sinuses,hyoid bone

- Radiograph given – identify various sinuses and other structures in skull…isky liye skull n maxillofacial radiology wala chapter krna hoga…128 eric3rd ed/149 ed4….sari figs dekho

- Radiographic relevance of swiss cheese pattern, ground glass appearance (fibrous dysplasia 368eric fig) swiss cheese is histo feature of adenoid cystic carcinoma

- Indications of periapical radiography….91 eric4th

- Radiographic faults – film blackening, least likely cause?

- Lesion 20mm on upper central incisor – type of Xray? Upper OCCLUSAL…135 eric

- Also keep this in mind that they usually keep only one or two radiographs n ask everything abt it at different stages... so look on the radiograph properly

- Radiographic relevance of swiss cheese pattern, ground glass appearance

- Indications of periapical radiography

- Radiographic faults

- Radiograph given in which various sinuses and other structures in skull given

- method of detection of proximal caries? Bitewings…..101 eric 3rd

- X-ray of anterior teeth, one of them has a periapical lesion. Identify the tooth

- Opg, identify labelled structures….196eric/31 CC

https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKlNG5SLYo1IX8SHSsSTWEcVMiTG9pubtlUffrxpy3Y3Y-rf-mug6tn9ddqdsD85WvbjnFZkU-YePxHNhdrv89wv2VSzR9Lpux6MZYAkrSvxrCX9BjhHgGfZkx1kg0oFD5xS4lOFkMzGo/s1600/Adult+Mandible+-+Orthopantogram+%2528OPG%2529.jpg

- Bite wing identify tooth with carious lesion…106 3^rd ed/130 4thed..no answer found

- Picture of a ct scan of the upper teeth, we were asked to identify the different types of sections e.g. sagittal, coronal e.t.c…234 ed4th

- Radiographs showing caries v had to diagnose which tooth was carious,Not

very obvious though in the radiograph

- Landmarks in OPG

- Anatomical landmarks of upper and lower jaw like maxillary tuberosity,retromolar area…google

http://openi.nlm.nih.gov/detailedresult.php?img=3162870_JOMFP-13-97-g004 HYPERLINK "http://openi.nlm.nih.gov/detailedresult.php?img=3162870_JOMFP-13-97-g004&req=4"& HYPERLINK "http://openi.nlm.nih.gov/detailedresult.php?img=3162870_JOMFP-13-97-g004&req=4"req=4

- RADIOGRAPHS :>>> occlusal and IOPA u had to idetify what it is?root fracture,resorption,apical pathology etc.lots of ques on radiographs ...233/236

It has not been asked so much in detail in the past i think but now the pattern is getting a bit modified so pls do have a look at different views eg. CT scan…232 ed4th +wiki and cone beam CT

- Which Xray is needed for implants?

- Huge ameloblastoma xray image to identify…300 eric

- Diagnosis of interproximal caries, what would you use? Bitewings, briault probe ..26 PB..…waisy dono theek hain..confusing!!!koi final answer nahi. Eye>blunt probe>b/w

- Position of unerupted canine , which is the best xray technique to identify its position? – parallax techinique ( Whaites book very useful….277……….SLOB

FOR CANINE HORIZONTAL PARALLX///FOR mesioden vertical parallex..but rule same SLOB

- OPG, you have to know everything, this time was shown, floor of the sinus, hyoid bone, pharynx, nasal septum.

- Periapical xrays with different types of problems, reason of failure: double exposure, wrong side exposed, conning off, blurred ( patient moves), . etc

- X-ray with defect x-ray placed on the wrong side (there were foil impressions)

- X-ray showing caries in lower molars

- X-ray defect in which the patient has moved.blurred

- X-ray defect in which there are fixer splashes.white blotches

- X-ray defect in which there is double speed.(MTLB FASTER FILM) 41 eric…e and f films bla bla bla

- X-ray defect in which there is double exposure. (both upper & lower teeth seen in same an IOPA)

- Patient comes to you after 2 years of not visiting a dentist, which radiograph will you take? Bite-wings…master says that regular chekups mai B/W krtay hain aaya told….also 78 eric 4^thed

http://www.nice.org.uk/nicemedia/live/10952/29486/29486.pdf

- X-ray in a child to see the presence of tooth-buds? bimolar

- X-ray in which 2 cm radioluscency around the apex of a upper incisor? Occlusal view

- X-ray in TMJ pain? Not sure……413/416/419/422 see indications

- What should be done after taking an x-ray? Report of the radiograph…see in advice sheets…no filanl answer

- X-ray showing thickened trabecular bone….osteopetrosis/MARBLE ONE DISEASE433

- X-ray for a patient with flattened zygoma & bilateral black eyes? Occipitomental view…366eric3rd/408 ed4th

- Best radiograph to diagnose approximal and occlusal caries…bitewings

- 3 year-old child, baby teeth to be extracted. You want to check permanent germs. Which ragiograph? Panoramic, periapical, bimolar, occlusal, lateral skull view, etc….122 3^rd ed

OPG nahi kr dktay under 5 years child

Choices py b depnd krta hai

- radiograph of mixed dentirion identify age and abnormalities

- Radiograph of primary molar was given and asked what radiograph was it options were horizontal bitewing,vert bitewing,iopar,bimolar view…..no answer!!!depends on the pic…mite b vertical or IOPA

- Radiolucent lesions

- There were a lot of conditions and we had to correlate them with the type of xrays reqd for their diagnosis, like bitewings, periapical, dpt , cephalogram

- Many time they showed us bitewing xrays, we had to give the age of the patient tell what type of bitewing horizontal, vertical etc…age ka nadaza teeth se lagana hai n type of image ka b pic dekh k pta lagy ga

- There were two bitewing radiographs showing resorption of the roots of a

Lower deciduous molar because of an erupting premolar and we were asked

the type of radiographs-vertical bitewings and radiograph showed resorption of root

- On radiograph , a mutilocular radioluscency in the region of the angle/ramus of the

mandible is most likely

a)ameloblastoma(multidimensional expansion hoti hai..can be both multi n uni…usually mltilcular..in children n young ault)

(b)pleomorphic adenoma((OKC milay ge can b multi or uni lcular))

(c) staphne’s idiopathic bone cavity

Ye points yad rakho

- A radioluscency in the angle of the mandible located beneath the inferior dental

canal is most likely- staphne’s idiopathic bone cavity..108 master

- Which radiographic view will you use for orthodontic assessment-Cephalometric.CEPHALOGRAM

- Several questions with different clinical scenarios we were asked which views of

radiographs will be most appropriate- OM view,PA skull,PA mandible,Oblique

laterals or standard occlusals

- If you are carrying out RCT for a patient and you are unable to take a radiograph in

order to determine the working length because of limited mouth opening but you have

a pre-op assessment radiograph what will you do

a)take a dental panoramic radiograph

b)use an electronic apex locator

c)use tactile means to determine the apical stop

- which one ……………………………………………………? Radiation protection……incomplete

- what is the best radiograpgy for TMJ ? options: CT, MRI, OPG…NOT SURE…can be OPG

- 4 or 5 questions about land marks of OPG. Hard palate, ID nerve canal, zygomatic matress, ……

- A bitewing was given and asked about the caries in that .like: which one still doeasn’t need filling? Or which starge is the pts is? Early mixed dentition,……….

- something about equivalent dose of 2 bitewings? !!!!!!!!!!!38CC 6.4 hours f speed//e speed 8 hours

- X- RAYS FOR DIFFERENT TYPES OF FACIAL TRAUMA…pg361 table 28.2//352 table 28.1

- INTRAORAL AND EXTRAORAL X-RAYS AND INDICATIONS….75 indi/contraind of periapical given there

Bitewing 101// lower oblique occlusal 109//111//112 vertx occlusal/lower oblique((intraoral)

Extraoral k lie pg 127 n onwards

- Radiology – person responsible for written protocols – Employer…..720 pb/254 master

- Radiology secondary radiation for how long – 2, 4, 8, 16, 32 hours??? 38 CC…NOT SURE ANSWER

- Radiology – responsible for justification, quality assurance and control x-rays (not sure about how the question was) – practitioner….720 pb

- DPT identify structures – very complicated (tonsils(wiki), ID canal, hard palate, zygomatic buttress)

- DPT x-ray showing mixed dentition – identify 5 teeth

CYSTS::: pg 293 ed3//331 ed 4

15. Syndromes

(pink book-page 760)

- Many questions on cleidocranial dysplasia,its associations and same picture was given everytime,about 6-7 times

- Picture of patient with bilateral cleft and lip palate and association with down syndrome and its treatment

- Gardener’s syndrome

- Ectodermal dysplasia

- Alzheimer disease

- Gardener’s syndrome:gardner maali hota hei,gardners hamesha mun phula ker rakhtey hein so osteomas hotey hein unko

saath mein hamesha chutti kerhtey hein so pait mein bhi koi masla hota hei ( polyposis)and.. then daanth bhi kharab hotey hein .. delayed eruption

etcplus .. plants mein kantey chubtey hein.. tou phir skin lesions and cysts bhi ho jatey heinintestinal polypoises

- Sjogren’s syndrome

- Features of epithelial dysplasia

a. Hypo chromatism

b. Atypical mitosis

- Question on Sjogren’s syndrome

- Down syndrome characteristics ( to know all of them

- Picture of a young patient with cleidocranial dysotosis

- Picture of a child with bilateral cleft lip & unilateral cleft palat

- Patient with Down’s syndrome has immune defects

- Down Syndrome – trissomy of which chromosome? 21

- Down Syndrome – intraoral characteristic? Macroglossia

- Sjogrens syndrome

- Ramsay hunt syndrome

- Grinspan syndrome

- Down – Trisomy of 21

16. Oral Anatomy/Histology

- Width of periodontal ligament : 0.21mm(0.15-2.38 p221 TC)......p101 BB(decrease e increase in age)

- fibres in periodontal ligament : oblique fibers...............p103 BB

- Periodontal ligament,its composition like fibres in it like most abundant,that bears maximum occlusal stress,collagen type

- Lamina to identify bone, PL, primary and permanent teeth.........p113 BB also TC

- Questions on types of cells in perio ligament - quite few of these questions.....p102 BB

- Width of periodontal ligament, fibres and type of collagen.......p103 BB

- Histology – structures of erupting tooth slides......TC slides & FB group slides by Nadia Hasan

- Which cells are usually not seen in the pulp?? :.B lymphocytes are not present in normal pulp.................p98 BB, p169 Master 3 baki jo jonsy cells present hai wo yad krlo coz it will depend on optons

- Type of collagen in Periodontal ligament : Type I(80 %), type III(20%)......p103 BB

- More blood vessels seen in which area of pulp? Options- close to dentin, centre of pulp chamber, above furcation area, etc. : close to dentin.........p194 TC

- Cells that cannot be seen in the pulp; options - odontoclasts, odontoblasts, fibroblasts, schwann cells : odontoclasts.........p98 BB

- Junctional epithelium is derived from; options- reduced enamel epithelium of tooth germ, etc.,............p308-p310 TC: my TC369…..normal depth of gingival sulcus 0.5-3mm(average 1.8mm)more then this is pocket

Blood supply of oral mucosa on 358TC my book…wo b parh lena

- Periodontal width and fibres.

- Questions on dentinal tubules........p171 Master3, p97 BB, p162?

- Histology slide of erupting tooth. Identify different structures. (cementum of primary/permanent, enamel, PDL of primary/permanant, alveolar bone, crestal bone)........FB group slides

- type of collagen in PDL?? : type1 & 3

- Average width of periodontal ligament?? : 0.21mm(decrease e increase in age)

- Histological section of primary & permanent tooth with different parts labelled......FB group slides

- Which cells are usually not seen in the pulp?? : osteoclasts

- There was questions on desmosomes pg 59 my TC.. cell junctions eg. What type of cell junctions are seen in oral mucosa....3 types mucocutaneos,mucogingival,dentinogingival.......p49 TC, p236-p287 Master3

- Emq about diff cells that form the tooth plz read in detail because it was confusing and i dont remember the question. eg.they were asking about osteoclast, cementoblasts, fibroblasts cells etc. where they are found and what do they make?? .........p102 BB

- Size of periodontal ligament, options given 0.1, 0.2, 0.3 mm ( answer 0,15 to 0.38 mm) Ten Cate

- Type of collagen most common in PDL? Type I

- Type of collagen second most common in PDL? Type III

- PDL is thinnest at the middle third of the root region.........Ch 9 Fig 9.20 p256 TC

- PDL is thicker in adolescents as compared to adults......p256 TC

- The direction of PDL fibres is oblique......p257 TC

- PDL fibres are attached to the cementum : sharpy's fibers......p100 BB

- Bone formed totally intramembranously. options; frontal, parietal, occipital, mandible, sphenoid, temporal : frontal and parietal.......p111 BB +wiki http://en.wikipedia.org/wiki/Human_skull

- Name of the first formed dentine(outer)?? : in(mantle dent30-150 um)........p94 BB

- Where does Hertwig’s epithelial root sheath come from-cervical loop

- Which one is not a developmental line of teeth? Von Ebner, neonatal, perikymata, etc

Perikymata are like shallow ripples..von ebner n neonatal lines are incremental lines..BB

- Enamel organ: everything! (identify in the figure) Where does the cells for enamel and dentine come from? Cells from neural crest…..ectoderm of the first arch and ectomesechyme of neural crest

- Cells that give rise for the permanent germ? Cells that connect enamel organ to the oral epithelium….permanent tooth germ develops fom dental lamina extension after cap stage

Tooth germ is made by:dental organ dental papilla and dental follicle

- Inorganic or organic component in dentine (don’t remember exactly) inorganic70(hydroxylapetite),organic 20(type 1 collagen)water 10%,and small amount of proteoglycans,phospoproteins,plasma proteins

- Bud stage,cap stage,bell stage

- Do arches and its derivatives indirect question was asked on Digastric and its nerve supply . 1^st and 2^nd arch

- Development of parotid gland. 299 my TC

- Development of tooth, all stages be very thorough questions were asked in a very tricky manner and also do the the weeks properly .which stage when ?Atleast 5 to 6 questions

- Calcification of primary and secondary teeth, their time of development and their eruption be very thorough.

- There were questions on cementum, enamel, and dentin mainly composition. 100bb

- Which cells are more in pdligament:fibroblasts

- Junction epithelium. Its anatomy and position

- What is passive eruption

- anatomy no of canals and access prep for different teeth like molars, incisors etc Dental

- Development of the parotid gland begins in utero at what month

- Bud stage of tooth development begins at-8th week

- Dates of calcification and eruption of various permanent teeth were asked.

- Bud stage of upper 1st permanent molar begins at-8th week in utero

- The number and names of the root canals most commonly seen in the following

i)upper central incisors-1

ii)upper 1st premolar-2

iii)lower 2nd premolar-1

iv)upper 1st molar-4

v)lower 1st molar-3

- nWhat does the transcluscent/sclerotic zone in dentine represent…dead tracts ,empty dentinal tubules appear as dark bands,…bb

- Which dental hard tissue is 45% mineralized and resorbs slower than bone

a)enamel (b)dentine (c) cementum

- EVERYTHING ABOUT INTRA AND EXTRA UTERIN TOOTH DEVELOPMENT OF BOTH DENTITIONS.

- HISTOLOGY ABOUT ENAMEL, DENTINE, PERIODONTAL LIGAMENT, CEMENTUM AND PULP

- TOOTH FORMATION AND ERUPTION OF BOTH DENTITIONS

- Root formation – Hertwig root Sheath

- Enamel – 5 questions (stellate reticulum bell stage mai bnta hai,star shape and is in center of dental organ n help support function of enamel and then disappears,…. Ameloblasts from Inner enamel Epithelium Cells……, Buccal mucosa and lips from vestibular lamina

- Osteoblasts deposit bone

- Osteoclast bone resorption

17. Biochem

- BIOCHEMISTRY: OUTCOME OF LIPIDS, CARBS AND PROTEIN METABOLISM

18. Perio

http://www.slideshare.net/friendsofhufriedy/curettes-clinical-application-guide

- Biologic width :,junctional epithelium and connective tissue upto the level of alveolar crest bone.normally 2-2.5 from the base of the gingival sulcus to the alveloar crest…pg6

- Pregnancy tumour and epulis: A local gingival swelling due to chronic irritation or mild trauma to the soft tissues…376 pb/12 md

- Extraoral finger rest: two types

knuckle rest palm up technique: clinician rests his knuckles agains patient's chin or cheek.

wiW6P67t6&sig=E5_MfBmfYU6ukvgUO2xDhRVL42w&hl=en&sa=X&ei=LEMdUaS9PMrU0QWC4YDoBg&sqi=2&ved=0CC0Q6AEwAA#v=onepage&q=finger%20rest%20in%20%20periodontics&f=false

Palm down or chin-cup technique:clinician cups the patient's chin with his palm.

advantages: facilitates intrumentation of proximal surface of maxillary root surfaces.

disadvantages : least effective of all fulcrum technique.Stroke control is more difficult and decreases tactile information.

- Sub gingival scalers and their angulation :45-90 degrees(39 master).The ideal angulation for calculus removal is b/w 70-90 deg

- What part of the instrument is parallel to the tooth when doing scaling? Middle shank, upper shank, lower shank of curette?lower shank

- What makes scaling easier and less exhausting like length of instrument,breadth,grip?breadth imp lgta hai

http://www.adelaide.edu.au/arcpoh/dperu/cpep/info/hand.html

Dentists and dental hygienists who spend much of their work time on manual scaling can modify their work practice to reduce their risk of developing MSDs(muscl skeletal disorder) by the careful scheduling of patients with heavy calculus, taking appropriate breaks and ensuring that instruments are kept sharp. In addition, this study demonstrates that the risk associated with the high level of pinch force required for scaling can be reduced by selecting instruments with a large diameter and a light weight.

http://www.cdha.org/downloads/ce_courses/homestudy_Reinforced_Periodontal_Therapy.pdf

- BPE :0-no bleeding on probing 1-bleeding on probing no pocketing 2- bleeding ,plaque retentive areas found 3-probing depth greater than 3.5 less than 5.5… class 4-probing depth exceeds5.5

Pg10md/182pb

- Diabetes Mellitus……35master….more prone to periodontitis

[20:59:01] Kathy Velmor: Joint prostheses and dental treatment

Advice of a Working Party of the British Society for Antimicrobial Chemotherapy is that patients with prosthetic joint implants (including total hip replacements) do not require antibiotic prophylaxis for dental treatment. The Working Party considers that it is unacceptable to expose patients to the adverse effects of antibiotics when there is no evidence that such prophylaxis is of any benefit, but that those who develop any intercurrent infection require prompt treatment with antibiotics to which the infecting organisms are sensitive.

The Working Party has commented that joint infections have rarely been shown to follow dental procedures and are even more rarely caused by oral streptococci.

So prophlaxitc antibiotic wagera nhi dy gy as its given in latest BNF n NICE gulidelines…

https://www.evidence.nhs.uk/formulary/bnf/current/5-infections/51-antibacterial-drugs/table-2-summary-of-antibacterial-prophylaxis/joint-prostheses-and-dental-treatment

http://www.nice.org.uk/nicemedia/pdf/CG64NICEguidance.pdf

http://pathways.nice.org.uk/pathways/prophylaxis-against-infective-endocarditis#content=view-node%3Anodes-risk-of-developing-infective-endocarditis

- Gram positive bacteria causing periodontitis :Streptcoccus(its also positive) and actinomyces(is positive) ….18 MASTER

Periodontits is cause by anaerobes…also see 174 PB/178pb

Plaque>gingivitis>periodontitis…hr stage mai atay hoay bacterias change hotay rehty hai..plaque jo initial cause hai us mai streptococcus hota hai n its positive so it should also be considered as causative gm positive organism for periodontitis along with actinomyces

- Questions about BPE and treatment….01234

- Pt with acute fatigue, night sweats, gingival enlargement and bleeding :leukemia..217

- Various clinical scenarios in different types of periodontitis

- 1-2 questions about BPI

- What is the greatest predisposing factor for necrotizing periodontitis?mster 22

a. Smoking-yes

b. HIV

- Questions on BPE

- If a person has pockets of 6mm what bpe score does the person have?4

- BPE scores

- Curettes – shank, which part of it has to be parallel to the long axis of the tooth?. Checked internet, is last part………….terminal shank/ LOWER SHANK

http://en.wikipedia.org/wiki/Periodontal_curette

– Where do you put your fingers while scaling?fourth finger/ring finger –adjacent tooth(intraoral rest) + extraorally opposie arch sometimes 39MD

_ What helps not to get tired while scaling related with the size of the handle of the curette ?light weight handles &thicker handles…both are rite

Diameter>weight order yad rakho

Diameter zeyda hona chiye for grip

- Which instrument will you use for a patient with periodontal pockets of 2mm? UNIVERSAL CURRETTE

http://www1.umn.edu/perio/dent5612-04/module_07.pdf

also in carranza

- How will you confirm that a patient has periodontitis? (4MM POCKETS MD14)……2MM pockets184 pb mai true false pocket parho/187….still not sure

- The long axis of the tooth should be parallel to the tip of the probe…okay

- For minimum discomfort & maximum efficiency, the instrument should be sharp

- The diameter of the scaler should be MORE to have more efficiency

- Best interdental cleaning for perio patients(PERIODONTITIS):mini interdental brushes, 37md

- Where the bone is lost the most in periodontal disease? Buccal, Lingual, Mesial, Distal, Approximal...approximal…14md..INTERDENTAL BONE LOSS is answer

- Patient well motivated, good OH, furcation lesion Class II. What’s the best treatment? Guided tissue regeneration(gtr@208 pb/43 MD DECIDED THIS), scale and root planing, etc..26 MD chart/210pb

- Pulpitis and periodontis various c/f…194pb/220pb/188

- Plaque scores, debris index loe scores…modified gingival index…...pg9 MD/208 CC/182pb

- Which cells are present in chronic periodontitis-machrophages and lymphocytes…AND ALSO PLASMA CELL..PR YAHAN UNHO NY JUST IMMUNE SY RELATED CELLS POCHAY HAIN…20MD/180PB..ADVANCED is periodontitis okay

- Which cells are present in acute periodontitis-neutrophils

- Gingival index, plaque index, Loe and Sillness index many questions were asked...0-no plaque,1- plaque seen with disclosing solution or running probe

2,moderate accumulation seen with naked eye 3-abundance of plaque in pocket and on tooth surface

- What can happen if while doing gingival cautery you notice its casing is broke n or something choices were gingival trauma, mucosal burn(most likely), lip burn

http://www.youtube.com/watch?v=GyhJFI8lV8I

- A picture of a patient with rampant caries,we were asked to identify it and which will

be most beneficial to the patient

a)scaling and polishing b)dietary advice c)tooth brushing advice 90 PB

- Questions on plaque index, bleeding index(BPE wala table) and Gingival index

- periodontitis affecting PMs and molars in a 35 year old lad….chronic periodontitis

- Periodontitis affecting molars and PMs 4-5 mm pocket, +++plaque

- Man 70+ with generalised recession, 5-6mm pockets--- score 4

- man with 2-3 mm pocket measurements & plaque---socre 2

- MINERAL STRUCTURE OF THE TOOTH, CALCULUS….18MD…4 type of crystal hain

- PLAQUE, BLEEDING, POCKET AND BPE INDEX

- ORAL MICROBIOLOGY IN PERIODONTITIS, GINGIVITIS, PULPITIS, PERIODONTAL LIGAMENT …18md

http://www.ncbi.nlm.nih.gov/pubmed/12656508

- Gram positive bacteria causing periodontitis

- Periodontal calculus removal – 5 questions about instruments (Push Scaler, Curette, Sickle, Hoe, other different

names that I don’t have any idea what are…)

- Best solution to control subgingival bacteria – clorhexidine 0.2%...198pb

- Periodontal condition 5 sub questions – localised, aggressive periodontitis, ANUG, gingivitis, chronic periodontitis…

https://www.facebook.com/groups/oreapril2013/permalink/500196383372111/

http://www.ecvv.com/product/921144.html

19. Preventive/Community

- Condition which prevents to maintain oral hygiene

- Fluoride doses in different age groups..upto 3 yrs 1000ppm. See copy

- Concentration of fluoride on the tooth paste for different ages: < 6 years 500 ppm and >7 years 1000

- Restoration of fissures (preventive??)secondary mai restore kry gy…is tarah yad krlo

- Dental health education :the key messages are

reduce the intake of sugar containing foods and drinks

reduce the consumption of sugar intake

Avoid btween -meal sugar snacks

Brush teeth twice daily wd tothpaste containing floride

Attend the dentist regularly

Donot smoke

- Percentage of UK fluoridated water….:10 percent…6 million ppl

- Fluoride content in toothpaste for 8yrs old, high caries :1450 ppm /topical gel/varnish/mouthrinse

- Questions of fluorides associated with caries risk

- Examples on various levels of prevention- primary(education,OHI), secondary(S/P,restoration of fissure by sealents,review of OH) and tertiary levels of prevention(ORTHO TRT,CROWNS)

- Couple of questions from community dentistry... like defin prevelenc n all....

- also study the hierarchy of evidenc.

- few questions again from epidemiology.... study UK epi for caries since 2002-03

- Definitions of sensitivity and specificity

- Loads and tons of questions on community dentistry and dental statistics; they were straight forward like what is the percentage of adults who could develop SCC after they develop leukoplakia in UK? 5%

N candida leukoplakia converts malignant in 10-40%

- Evidence based dentistry

- CPD hours requirements …250hours….pb714

- Examples on various levels of prevention- primary, secondary and tertiary levels of prevention

- What would you do when a patient comes with an asymptomatic root canal treated tooth with periapical radioluscency treated by some other dentist?all depnds upon history..it takes 12 months to heal already rct tooth ki..us sy phly re endo nahi kr sktay

- Aim of GDC…662 pb

- Waste disposal- where would you dispose wooden wedges?sharps

- Questions on consent given by parents of 14-16 year olds who participated in an oral health survey..pt itself or parents…ot sure..bda she b2..pb 654

- Percentage of UK fluoridated water. 10 %

- 8 yr old, high caries rate. Prescribe floride content of toothpaste?1350

a. 500 ppm

b. 800 ppm

c. 1000 ppm

d. 1350 ppm

- What kind of organisms cannot be destroyed by sterilization?

a. Spores

b. Prions..719pb

c. Thermophiles

- What groups of people were at higher risk of being infected by Prions?

a. People who received blood transfusions before 1985

b. People who received Dural grafts before 1985-yes

- % of 5 year olds with dental caries…45%...n 55% mai caries hoge

- Fluoride treatment for a child with high caries rate

a. 2,800 ppm Tooth paste

b. 5,000 ppm toothpaste

c. Application of 2.2% duraphat 2 time yearly

d. Application of 2.2% duraphat 3-4 times yearly-yes

- Average number of 15 year olds who have lost 6-7 teeth…SEE CHILD DENTAL HELATH FILE..pg 11 table 1.12 6% for UK ,5% in England(ye yad krlo standard sa coz hr jga diffrnt hai)

a. 1.1

b. 3.1

c. 4.7..

- A man who smokes 2 packets of cigarettes a day and drinks would have an increase risk of developing oral cancer of………see pg 37 delivering OH2009 says 35 times

a. 11 times

b. 13 times-

c. 47 times

- What is the percentage of patients who get nosocomial infections?10%..anwer nhi mila!!!

- What is the percentage of children getting cavities after applicat ion of sealants?

%age of fissure sealants that fail and get carious >85% - after one year >50% - after 5 years

- Cancer, referral in how many days should be seen in secondary care?see cancer NICE guidelines…urgent and non urgent referral ….see .within 14 days and make diagnosis within 31 days

Non urgent all other referrals 4-6 weeks

- Percentage of edentulous patients in England and Scotland: 6% kk told

- Percentage of tooth loss ( wear) in 2003?

http://www.ons.gov.uk/ons/search/index.html? HYPERLINK "http://www.ons.gov.uk/ons/search/index.html?&newquery=child+dental+health+survey&pageSize=100&applyFilters=true&sortBy=pubdate&sortDirection=ASCENDING"newquery=child+dental+health+survey HYPERLINK

see word document of stats kartik sent…

[02:42:00] Mujtaba Choudhry: Tooth Wear (Attrition): 16-24yr old – 36% 65 yr and over – 89%

- Percentage of people without decay between 10 to 12 years old in 2003?see kk file…38% with decay

Rest %without decay 62%

- What is the most effective method of fluoridation? Water fluoridation

- In order to avoid fluorosis in children supervise brushing till 7 years

- Quantity of fluoridation in water? 1ppm

- Quantity of fluoridation in adults? 1350-1500

- Quantity of fluoridation in 8 year olds? 1350ppm

- Quantity of fluoridation in 5 year olds?13500ppm

- Most effective method of reducing infection is sterilisation….prions

- Most commonly used hand-was is chlorhexidene gluconate….correct hai

BDA sheet > chlorhexidine 4%,,povidone iodine 7.5% for surgical scrub…kk still posted in FB

SEE HTML FILE pg 85

- Most transmission of prions is by the remers n files(((steam sterlizatio is done for its inactivity but still they r not killed)

- Experimentally the most proven method of disinfection is the washing of hands before see a patient.

Pg33 HTML doc

- Per centage of 12-year olds with erosion? 27%

[16:59:46] Ifza: Tooth erosion: 6 year old 52% 15 year old 27%

- 12-year old children with caries experience. 38%

- Which factor is least important in caries detection? No. of teeth….seems ok but no ref

- What is the most effective method of fluoridation? Water fluoridation

- What is the first step in a patient who has erosion? Dietary record…see delivery better oral health 40pg of file..remove cause first eg acidic drink jo erosion ki cause hai

Advice >see diet record>habits

- Best indication for fissure sealants (lots of caries?)pg 34 pb..its based on requirment

- Patient arrives saying “I don’t like dentists”. What do you do? Say “I don’t like dentists either”(for scared pts who have white colour phobia)), ask what the reasons are, suggest IV sedation, etc

- How many grams of sugar is recommended a day? 60 for adult///33 for child…see DBOH file pg 25

- What’s the percentage of >25 years with periodontitis in UK? 45

- What’s the percentage of edentulous in UK?13% for all uk///but for England and wales its 8%

- What’s the percentage of tooth erosion in 6 years-old and 15 years-old in uk?52 % in 5 year old and 27 % in 15 years old

- Database definition, etc (association of situations)wiki… Research databases: An organized collection of information designed to allow users easy access to data.

: Some examples of the research databases at Briarcliffe College Library include Academic Search Premier, ProQuest Central, LexisNexis Academic, Westlaw, and CINAHL.

- What’s the maximum of time the GDC leaves the dentist physically impaired away from his profession? 12 month amna said…..and kartik said 5yrs or more ok in exceptional health circumstances…663 pb

- How many of all the cancers in UK are oral in percentage? 2%.....and 30—40%in indian subcontinent

- How many deaths in UK each year caused by oral cancer? 1700…but pink book says 1000…???1985 is ok coz its latest as given in following link

http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oral/mortality/uk-oral-cancer-mortality-statistics

see this link kart sent..it has 2008 table

- What’s the percentage of fluorinated water in UK? 10%

- Fluorinated water in UK (ppm): 1ppm

- Adult toothpaste: 1350-1500 ppm range…

- Children toothpaste: 3yrs>1000ppm above 3 yrs-6 yrs1350-1500ppm

- What’s the BMI (body mass index) for obesity? 30 or greater…598 sculy

- Dentist thinks he can be HIV-positive. What’s the first thing to be done? double gloves, go to GP, go to the emergency department, etc…518pb..oozing out blood n wash then go to occupational health

- You are going to do a biopsy in HIV-positive patient. Which of the following exams would be of better use? White cells count, platelet count, etc…in HIV pts WBC usually less and cd4 cells also low,platelets usually fine gul told….also see wiki…very confusing kart said…so posted in FB

- Desensitizing in toothpaste:strontium or potassium chloride…pb31

- How often should you review the smoking status, 12 months,

- Emergency box colour: white cross on a green background

- Maternity leave

https://www.gov.uk/maternity-pay-leave/leave

Statutory Maternity Leave is 52 weeks. It’s made up of:

26 weeks of Ordinary Maternity Leave

26 weeks of Additional Maternity Leave

You don’t have to take 52 weeks but you must take 2 weeks’ leave after your baby is born (or 4 weeks if you work in a factory).

- What % of population are allergic type 1 (20-30%) see kart file for UK stats word doc hai

- What % of bacterial load will decrease by cleaning…in UK stats upto 80%

- What is primary prevention, sec, and tertiary.4 to 5 questions were on it…pb42

- Who can give dental health education….42 pink..all health professional can giv(hyg/nurse usually)

- What is% of Duraphat fluoride varnish…2.26%…31 pb

- What will be the dose for a4 year old child where the level of fluoride is less than 0.1ppm…pg 23 of DBOH see floride tablet dose…..500 microgrm fluoride which is equal yo 1.1mg tablet dose of NaF

- for the coming question chose the best concentration of fluoride?

- tooth paste for an adult : 1350 ppm

- tooth paste for a 4 years old : 13 50-1500 ppm

- so many question about psychiatry:

-a man ,unshaved with inappropriate dresses coming to the surgery,and complaining that gets

Up early in the morning? Options : schizophrenia, mania, depression, anxiety neurosis, obsessive disorders,…..check scully 268/276 they have given schizophrenia/table on 257…no answer!!!

-a man that is putting a plate at dinner time for his dead wife? Option were as above.

-some other this type of questions

- how many hours of CDP should be verifiable for dentists over a 5-years cycle?75 hrs

- which one is the core subject that PCDs should know about? Emergencies

- what is the percentage of people who is benefit from the uk fluoride? 10 %

- PREVENTIVE DENTISTRY AND DENTAL HEALTH EDUCATION IN THE UK

- HISTORY AND EXAMINATION, TREATMENT PLANNING

- LEARN ABOUT PULP TESTERS AND THE READINGS.. ..pb 14 but no values there

- APEX LOCATOR..fb group mai bs aik sawal tha…usky ilawa kahin nhi mila kuch khas…just to determine working length in pt in which there is limited mouth opening during RCT

- FLUORIDE SUPPLEMENTATION. (PINK BOOK)

- SUGAR AND EFFECTS IN DENTAL CARIES (PINK BOOK)36 pb

- CROSS INFECTION AND THE DIFFERENT TYPE OF BACTERIA IE; MOST INFECTIOUS, MOST RESISTANT TO STERILIZATION ETC….WIKI

[20:00:15] Karthik Pk: Geobacillus stearothermophilus….MOST RESISTANT SAYS WIKI

Ifza said clostridium difficlie(highly infectious),,nessiria gonorrhea…remember these for now…if virus then go for hepatitis

- ALL PHARMACEUTICS IN DENTISTRY…

- CONSENT, FORENSIC DENTISTRY, CPD…665 pink

- FUNCTIONS OF THE GDC

- HEALTH AND SAFETY IN SURGERY, PROTOCOLS FOR CLINICAL AND NON CLINICAL WASTE AND THE DIFFERENTS COLOURS FOR THE BAGS USED IN THE UK

20. Law & Ethics/Stats

- classification and definitions from stats

- Statistics questions from surveys

- Consent different types like who can give consent in which circumstances….654 pb+BDA adv sheet

- CPD hours..250 hours for dentist in 5yr cycle(75 verifiable..other non verifiable) DCP 150hrs total(50 verifable/100 non verifable) …714 pink

- function of NICE guidelines

http://www.nice.org.uk/aboutnice/

- Lots of questions about statistics

- Lots of questions about Law…648 pb

- Infection control: dispose wooden wedges(sharps)

- Who’s not exempt of NHS charges

http://www.nhs.uk/chq/Pages/1786.aspx?CategoryID=74 HYPERLINK "http://www.nhs.uk/chq/Pages/1786.aspx?CategoryID=74&SubCategoryID=742"& HYPERLINK "http://www.nhs.uk/chq/Pages/1786.aspx?CategoryID=74&SubCategoryID=742"SubCategoryID=742

- Time of hand wash(3 types given in cross infection advice sheets)

10-15 secs SOCIAL

15-30secs HYGIENIC

2-3 mins SURGICAL SCRUB

- statistics-how many 15 year olds with 6 decayed teeth  ???

- how many hazardous drinkers in UK?23%...DOWNLOAD ONLINE…32%MEN N 15% WOMEN…3:1

http://www.avon.nhs.uk/dental/publications/deliveringbetteroralhealth.pdf

- Units and pints- how many units of alcohol contan certain drinks?21 unitmen 14 women/week

PER DAY: MEN 2-3/ WOMEN 1-2UNITS

http://www.drinkaware.co.uk/understand-your-drinking/unit-calculator

- Questions about behaviour management…58pink

- Statistics question

- Which container is used to dispose waste amalgam, wooden wedges?amalgam container///sharps

Toth n weges with amagm on them also go in amlam container

- CPD hours requirements for dentists(250) and DCPs(150)

- What happens if the dentist does not pay annual retention fee?£576 fee hai..nai dy gy to will remove off from register

http://www.gdc-uk.org/Dentalprofessionals/Fees/Pages/Annual-retention-fee.aspx

- Core subject for CPD – all staff…details from pink individually 714 PINK

- Aim of GDC…pink662…regulatory body// protection of pt

http://www.gdc-uk.org/Aboutus/Thecouncil/Pages/whoweare.aspx

The Council of the GDC is made up of 24 members - 12 appointed registrants and 12 appointed lay members.

- Time for hand washing

- Adult regular check up:61%........question not clear

- Can’t consider patient complaint? Pink650…see advice sheet B10 handling complaints

<12 month of event complain consider hoge//<6 months after the complaint guy realizes ....lakin over 12months nahi hoge…BUT where there is good case thentime bar can be extended

- Percentage of patients indicated to hospital by infection? 5%, 10%(correct), 15%, 20%

- Who’s not exempt of NHS charges? Adults on benefits, older people on retirement…..

- Waste management

- In which year is GDC going to conduct revalidation?2014

a. 2010

b. 2011

c. 2012

d. 2013

e. 2014

- Number of CPD hours for dentist? 250

- Number of CPD hours for DCPs? 150 i think

- Which container is used to dispose off waste amalgam?

a.Sharps container

b.White container with lid

c.Open container, placed under water

- Which container is used to dispose off radiology chemicals?separate containers hotay hain…suitable liscence comapnay collect krti hain n recycle it

- disposal of waste amalgam? seal tight container

- No of hours of CPD for dentists

- How many CPD hours are verifiable?

- Which of the following is the major function of the GDCpink

A. Regulating dental practice

B. Maintaining a register of dentists

- How many CPD hours for radiation protection?5 hrs….pink 714

- A 15 year old girl in boarding school comes to your surgery for an extraction which of the following cannot give consent on her behalf?

a. Her grandfather with legal guardianship

b. Her biological father who has separated from her mother

c. The girl herself

d. Her older sister

- Consent is needed from a patient to share information, which of the following needs explicit consent?see B2 advice sheet pg12

a. To share information with an insurance company can be this…not sure

b. To share information with other doctors in the practice

c. To share information with the therapist treating the patient

d. To share information with the patients GMP

- Impression taking in an apprehensive adult with gag reflex …311 pink

- An informed consent should be taken from subjects of a study for it to be - valid

- What is the percentage of water fluoridation in UK? – 10%

- At what age is the MMR vaccine given? – 12 months

- What happens if the dentist does not pay his annual retention fees on time?taken off registers

- Where do you dispose clinical wedges? sharp

- How do you dispose amalgam?sealed white container

- How many hours do dentists have to do for CPD? – 250 hours

- How many hours do DCPs have to do for CPD? 150 hours

- What is the core subject for CPD? – Medical Emergencies

- In which year will GDC undergo revalidation? 2014

- From which month & year did CPD come into force – September 2008…714PINK…

- What job hygenist, technician and dental therapist can do…48 pink

- ques on T -TEST from stats they asked

- Percentage of caries in children in the united kingdom:40%

- Ques on consent:if a patient under 16yrs, parents not present whom will u

take consent from?was not direct so pls read in detail about it….advic sheet pg10

- Infection control new guidelines pls read the sign for single use

instruments,chronological order for sterilisation cycle,washer disinfector

system,hand washing…PG 11 bda SHEET

- Before sending impression to lab, what is the most important thing to do? Disinfection? Put in running water? See advice sheet…phly disinfect then under then clean running water

- How many hours of C.P.D. do dentists have to complete in order to avoid being struck off the register? 250 hours

- What is the hand-washing time that is most effective and practical? 2 minutes…BDA sheet(social,hygienic,surgical)

- What is the per centage of edentulous patients in UK? 6%

- What sort of working surface is best in a clinical working environment? Impervious and surfaces that can be cleaned…BDA SHEET

- Which type of consent is not present? Delegated…PG 9 ADV SHEET

- From what age can a person give consent for treatment? 16 years

- Is there an age limit for confidentiality of information? No age limit

- What type of consent is required for conscious sedation? INFORMED CONSENT +WRITTEN(WRITTEN CONSENT ACTUALLY INFORMED CONSENT HE HOTA HAI)

- To whom is the dentist obliged to give a patient’s confidential information? Court of law..DATA PROTECTION SHEET..PG 12

- The most valid consent is given by the mother of a 4-year old child.

- Pit and fissure sealants are indicated in children whose siblings have a high caries rate…see 34pink!!!!

- The best way of giving information. Written information is more effective than verbal information

- How will you take an impression in an anxious patient? Distraction…pink 311…not sure anser!!!

- What is not important in consent taking? Whether the patient can read or write

- What is not intended in consent taking?

And what is intended>>>informing patient pg654 pink

- Why is making a dental chart important? Helps in future diagnosis

- According to Data Protection Act, the patient has access to all computerised records..ok yes they have access only to their records..not 3^rd party…pt 13 BDA ADV SHEET

- Functions of GDC

- Fluoride supplement for a 4yr old when water fluoride level is less than 0.1….pg31 pink

6month-3yrs 0.25mg/day

3-6yrs 0.5 mg/day >6yrs 1.0 mg/day

- Statistics question about prevelance

- NaF varnish,name of fluoride tablets and APF…..pg 30pink DURAPHAT …flride tablet ka koi nam nahi hai bs floride tablet e kehtay hain

- 1ry 2ty,teritiary prevention several questions on what is meant by each eg:

http://www.iwh.on.ca/wrmb/primary-secondary-and-tertiary-prevention

http://www.wisegeek.com/what-is-preventive-dentistry.htm#

Primary Prevention

Primary prevention aims to AVOID the development of a disease or disability in healthy individuals.1 Most population-based health promotion activities, such as encouraging less consumption of sugars to reduce caries risk, are primary preventive measures. Other examples of primary prevention in medicine and dentistry include the use of fluoridated toothpaste, and vaccinations for infectious diseases like measles, mumps, rubella, and polio.

Secondary Prevention

The focus of Secondary prevention is EARLY disease detection, making it possible to prevent the worsening of the disease and the emergence of symptoms, or to minimize complications and limit disabilities before the disease becomes severe.1 Secondary prevention also includes the detection of disease in asymptomatic patients with screening or diagnostic testing and preventing the spread of communicable diseases. Examples in dentistry and medicine include screening for caries, periodontal screening and recording for periodontal disease, and screening for breast and cervical cancer.

Tertiary PreventionThe goal of Tertiary prevention is to REDUCE the negative impact of an already-established disease by restoring function and reducing disease-related complications.1 Tertiary prevention also aims to improve the quality of life for people with disease. In medicine and dentistry, tertiary prevention measures include the use of amalgam and composite fillings for dental caries, replacement of missing teeth with bridges, implants, or dentures, or insulin therapy for Type II diabetes.

- Prophylaxis, pit anf fissure selants, review etc

- GDC and its function.

- Consent

- NICE guidelines

- Clinical Audit

- How many cpd hrs do the nurses need from july 2008

- How many cpd hrs do the dentist need-250-75 verifiable

- Who all in a dental surgery should be able to deal with emergency all

- How will you treat a spillage of less than 30 ml blood?

- How will you dispose news paper?

- How will you dispose clinical waste……..orange…..

- What is presterilization, how is it done

- What amount of fluoride supplement should be given to a 4yr old child receiving 0.1ppm of fluoride from water – 0.5mg F/day

- What concentration of sodium hypochlorite should be used to clean a small splatter of blood in the dental surgery?

- Which colour of bag is used to dispose of paper in the waiting room of a dental Surgery?

- Which colour of bag is used to dispose of clinical waste?

- The number of hours of CPD recommended for dentist to avoid removal from the dental register

- which group of people are not required to be registered with the GDC by July 2008

a)dentist b)dental nurses c)dental technicians d)practice managers

- A dentist is carrying out electrosurgery on a patient and the patient sneezes with his

head moving forward, which is most likely to occur

a)gingival trauma b)mucosal burn c)mucosal trauma d)trauma to adjacent tooth

e) gingival laceration

- A dentist is using a soflex disc on an upper molar & lacks finger support. What is

most likely to occur. Options same as above

- Stephan’s curve represents

a)change in pH of saliva with time

b)change in pH of plaque with time

c)change in pH of saliva with sugar intake

- Which of the following is most important in the development of dental caries

a)time of sugar intake

b)frequency of sugar intake

c)amount of sugar intake

- A patient with xerostomia will benefit more from

a)tooth brushing advise

b)fluoride rinses

c)scaling and polishing

- Several questions on primary, secondary and tertiary prevention and options were

a)scaling & polishing-secondary

b)oral health education-primary

c)early detection of caries and treatment-secondary

d)replacement of missing teeth with dentures-teritary

- questions about Fitness to practice and Professional Performance Committee and their duty.

- what is the percentage of plaque in the uk?

- what is the percentage of calculus in the uk?

- how many unite of alcohol is in one pint of beer? 2

- what is the maxmimun unite of alcohol for woman per week?14

- what is the maxmimum unite of alcohol for men per week?21

- recomm daily sugar intake…… 40g

- % of fluoridated water in UK….10%

- % edentulous in UK-

- %oral cancer compared to other ca in UK 2 %

- Colour of first aid box…..green + white cross

- At what BMR are you considered obese….. 30

- Statistics – case studies (terminology) – 2 questions

- Behaviour management – tell-show-do, distraction, reinforcement, desensitisation, etc

- GDC main function –

- GDC revalidation year - ? 2014

- GDC registration not needed by 31st July – Dental Practice Manager

- CPD requirements – 4 different questions

a- 250 hours

b- 75 verifiable hours

c- Medical Emergencies training obligated-10 hours

d- Ionising and Radiation updating obligated-5 hours

- GDC – conduct – Fitness to Practice Panel

- GDC – health illness (dentist) – Practice Committee

- Fluor – toothpaste concentrations for high risk 17 years and 27 years, varnish 5% concentration (23000ppm)

- 1998 study in the UK – 72% visible plaque

- 1998 study in the UK – 73% calculus (at least 1 tooth)

- Water fluoridation in the UK – 10%

- Maximum recommended alcohol units for men – 21

- Max. Rec. alcohol units for women – 14

- Alcohol units in a pint – 2

- Instruments management 2 questions (5 sub questions) – autoclave, disinfection, sharps bin, clinical waste (yellow

- Dental treatment 5 questions –

a- Intact dentition and xerosthomia after radiotherapy – OHI and dietary advice

b- High caries risk and teenager – OHI and fluoride mouthwash

c- Erosion (1l of Coca-cola per day) – Dietary advice and fluoride mouthwash

d- Gingivitis but not other problems – OHI?

- 1st importance of consent – care of the patient

http://www.slideshare.net/friendsofhufriedy/curettes-clinical-application-guide

see thi slink for perio

BPE Chart

noreply@blogger.com (Unknown) — Wed, 12 May 2021 11:13:00 -0700

BPE Charting

Source: British society of periodontology

Hygienist Maintenance Phase notes

noreply@blogger.com (Unknown) — Wed, 14 Apr 2021 14:01:00 -0700

Hygienist Appointment (30 mins, AGP)

PPE used as per Current COVID-19 Guidelines and Practice's SOP

Nurse Support:

CO: Regular check-up

MH: checked- No change, No symptoms of COVID-19 present today.

SH:

Smoking: nil

Alcohol: Within Guidelines

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brush TePe colour:

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/ red erythematous gingiva

Contour: knife edged

Plaque: grade: +++ present: interdentally - generalised and at the tooth-gum margins

Calculus: grade: +++ present: interdentally- present in lower lingual 3-3 region and at the tooth gum margins.

Stains: Grade: +++ present: generalised

Type: tannin and smoking / wine /mouthwash stains?

BOP: Present in lower lingual

BPE: as recorded in chart today.

Deep pockets: No deep pocket more than 3.5mm today / present :

Current oral hygiene: Good/ fair/ poor

Other finding:

Risk factor: Suboptimal oral hygiene / Smoking/Diabetes.

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gum health.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

Verbal Consent Gained

1. Full mouth scaling using hand scaler and ultrasonic scaler used to remove calculus and disrupt supra and sub subgingival biofilm.

2. Polishing done using NUPRO prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. Non surgical RSD done without LA in deep pockets and furcation areas. Pt. tolerated well. Chx. irrigation done.

4. Contact points checked with floss.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inter-dental brushing given today, (shown in the mirror) and samples given to take away. Colour:

Advice given:

Adv. warm salt water rinses 3 times a day for next 3 days.

Diabetes advice: Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.

Smoking cessation advice: Pt advised of poorer response to periodontal therapy if continues to smoke.

Recommended 3-6/12 recall for hygiene appointment

TCA: 6/12 appointment for 30/45 mins. pt. happy with it.

Periodontal Classifications and guidelines

noreply@blogger.com (Unknown) — Wed, 3 Mar 2021 04:58:00 -0800

Important dental notes

noreply@blogger.com (Unknown) — Wed, 3 Mar 2021 04:55:00 -0800

Partial edentulous ridges- Classification

Dental Instruments

noreply@blogger.com (Unknown) — Wed, 3 Mar 2021 04:53:00 -0800

Oral Hygiene Tips

noreply@blogger.com (Unknown) — Wed, 3 Mar 2021 04:51:00 -0800

When you see the Bristles are Flared, them its time to change your tooth brush/brush head

Chair position for Hygienists

noreply@blogger.com (Unknown) — Wed, 3 Mar 2021 04:45:00 -0800

Wrist Exercises for Dentists to get rid from wrist Pain

Root Surface Debridement

noreply@blogger.com (Unknown) — Wed, 25 Nov 2020 11:41:00 -0800

Structure of Gingiva

noreply@blogger.com (Unknown) — Tue, 11 Aug 2020 06:33:00 -0700

GINGIVA

Brushing Technique By Dr. Karanpal Singh

noreply@blogger.com (Unknown) — Tue, 11 Aug 2020 06:23:00 -0700

Stages of Periodontitis

noreply@blogger.com (Unknown) — Tue, 11 Aug 2020 06:23:00 -0700

Periodontitis. RSD Template

noreply@blogger.com (Unknown) — Tue, 11 Aug 2020 06:22:00 -0700

Periodontal diseases RSD NOTES

Hygienist Appointment(45mins AGP)

PPE used as per Current COVID-19 Guidelines and Clinics SOP

CO: Regular check-up/ Bleeding/ stains/ loose teeth/ halitosis/ Bad taste/ Difficulty in eating/ Sensitivity/ Pain/ Swelling/ gum boils/ aesthetics

HPC: N/A

MH: checked- No change, No symptoms of COVID-19 present today.

Family history: any family history of Perio-/diabetes?

SH:

Smoking: Nil

Alcohol: within guidelines

Occupation:

Stress Level:nil

DH:

Toothbrush: Brushes two times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss and Interdental brush TePe colour:

Dental anxiety: nil

When was last scaling done ?

EOE:

TMJ : NAD/ clicking sound/ deviation of jaw

Lips: NAD competent lips / fordyce granules.

Symmetry: NAD

IOE:

Labial mucosa: NAD

Buccal mucosa: NAD /ulcer/petechial/ trauma/ linea alba/fordyce`s granules

FOM: NAD, mandibular tori present

Tongue: NAD / geographic tongue

Hard and soft palate: NAD

Oropharyngeal region: NAD

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/ erythematous gingiva

Contour: knife edged/ blunt/ round/ shiny margins

BOP: absent/present: in lower lingual/ interdentally-generalised/ upper palatal/

Plaque: grade: +++ present: interdentally / generalized

Calculus: grade: +++ present: interdentally / present lingially 3-3 region

Stains: grade: +++ present: generalized/ in front teeth/ 3-3 region.

Type: tannin/ coffee/smoking / wine

BPE: as recorded in chart

Deep pockets: present/ absent in

Annual 6PPC: completed on __ / as recorded today/ to be completed on next appointment (reason: maximum time spent on removing calculus today)

Current oral hygiene: Good/ fair/ poor

Other finding:

Risk factor: Suboptimal oral hygiene / Smoking/ Medical condition/ Stress.

Discussed diagnosis (Chronic Generalised Periodontitis and its severity) and reason for it is poor plaque control.

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gingival tissue.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Discussed the treatment options with the patients

a) To do nothing. Risks: If no treatment is done, then higher risk that this active periodontal disease can progress further leading to further bone loss around the teeth and can ultimately lead to loss of teeth.

b) To Continue with 3/12 months appointment (this is recommended according to NICE guidelines risk factors being -smoking/diabetes/active periodontal disease). Risk: Less risk as compared to no treatment at all or 6/12 appointment. Benefits: periodontal health can be assessed on every 3/12 appointment and oral hygiene can be monitored, tailored oral hygiene instructions on every visit and deep scaling which eventually can lead to improvement of periodontal health.

d) Non-surgical, Root Surface Debridement(RSD) treatment sessions under LA, in 4? sessions with one week gap. Benefits: It is only recommended after improving skills of daily oral hygiene and when Plaque score is reduced. There are good chances that bleeding deep pockets can be improved. Risk: There are higher chances of failure when Plaque control is not reduced and smoking is not reduced.

e) Referral to Periodontist: Benifits: Periodontist are specialist in managing the periodontal disease, they have many non surgical and surgical options. Referral is highly recommended when all above discussed options fails. Risk: Periodontists can be of help if the basic Oral hygiene is fist improved and the risk factor like smoking, uncontrolled diabetes is improved.

Patient opted option ? and happy to book appointment. Written Treatment plan with charges given to patient.

Treatment Plan:

Treatment done today:

1. Full mouth scaling using hand scaler and ultrasonic scaler.

2. Polishing done using NUPRO prophy paste course / medium and EPITEX strips for lower 3-3 region.

3. Contact points checked with floss

4. RSD done without LA in deep pockets and furcation areas. Pt. tolerated well. peroxyl irrigation done.

Advice given:

Toothbrush: Demonstrated/ recommended, modified Bass technique in the mouth

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inderdental brusing given today.(shown in the mirror). samples given to take away.

Tepe sizes chosen:

Other aids: Flossettes / Interspace brush

Diabetes advice: Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.

Smoking cessation advice: Pt advised of poorer response to periodontal therapy if continues to smoke.

TCA: 3/12 6/12. Pt. happy with it.

RSD Treatment Plan

1. Explain the need of of Initial assessment using 6PPC before starting RSD treatment

2. Explained the gums may remain sore for few days due to instrumentation.

3. following the course of this non surgical debridement course, the condition would need to be reassessed with 6PPC after three months.

4. Explained referral to specialist might become appropriate if there is no improvement at all.

5. Once stable, emphasized the importance of life-long regular (to be defined according to risk but initially 3 monthly) maintenance appointments to ensure periodontal condition remain stable/ pickup any relapse and treat as early as possible.

RSD Upper left/right, Lower left/right quadrant
LA administered:
Topical applied- (Benzocaine 17.9%)
… x 2.2 ml 2% Lidocaine hydrochloride + 1:80,000 adrenaline as ID block
… x 2.2 ml 4 % Articaine hydrochloride + 1:100,000 adrenaline as infiltrations

Full mouth supragingival debridement with ultrasonic
RSD using hand instruments-Gracey curette and ultrasonic scaler.

Irrigation done with chlorhexidine using monomer syringe.

Emphasised need to be careful not to bite the lip or have anything too hot till the numbness has worn off.

Dental Hygienist Notes

noreply@blogger.com (Unknown) — Wed, 8 Jul 2020 13:42:00 -0700

Dental Hygienist Detailed notes

Hygienist Appointment

PPE used as per Current COVID-19 Guidelines and Clinics SOP

CO: Regular check-up/ Bleeding/ senstivity

HPC: N/A

MH: checked- No change.

Family history: any family history of Perio-/diabetes?

SH:

Smoking:

Alcohol:

Stress Level:

DH:

Toothbrush: Brushes 2 times a day with fluoridated toothpaste using ETB/MTB

Interdental cleaning: Floss/interdental brush TePe colour:

Dental anxiety:

When was last scaling done ?

EOE:

TMJ & muscles of mastication: NAD

Lips: NAD

Symmetry: NAD

Scars: NAD

IOE:

Soft tissue:

Labial mucosa: NAD

Buccal mucosa: NAD /ulcer/petechial/ trauma/ linea alba/ fordy`s granules

FOM: NAD

Tongue: NAD / geographic tongue/ stained/ fissured/ scalloped margins

Other findings: Mandibular tori present

Hard and soft palate: NAD

Oropharyngeal region: NAD

Periodontal examination:

Gingivae:

Colour: Pink gingiva, stippling present/ erythematous gingiva

Contour: knife edged/ blunt/ round/ shiny margins

Plaque: grade: +++ present: interdentally / generalized / at the margins

Calculus: grade: +++ present: interdentally / present lingially 3-3 region / at the margins.

Stains: grade: +++ present: generalized/ in front teeth/ 3-3 region / interdenal areas

Type: tannin/ coffee/smoking / wine

BPE: as recorded in chart

Deep pockets: present/ absent in

Annual 6PPC: completed on __ / as recorded today/ to be completed on next appointment (reason: maximum time spent on removing calculus today)

Current oral hygiene: Good/ fair/ poor

Other finding:

Diagnosis:

Risk factor: Suboptimal oral hygiene / Smoking/ Medical condition/ Stress.

Discussed diagnosis (Chronic Generalised Gengivitis / Chronic Generalised periodontitis and its severity) and reason for it is poor plaque control.

Discussed the role of plaque in relation to periodontal disease and reason for bleeding.

Pt. knows excellent plaque control at home consistently, is essential in stabilisation of gingival tissue.

Discussed the risk of post-treatment sensitivity of the teeth, explained this usually last for few weeks.

Emphasised that during treatment the gums may shrink back due to reduction in inflammation as recession and so the teeth can look longer with gaps in between teeth.

Treatment done today:

1. Full mouth scaling using hand scaler and ultrasonic scaler.

2. Polishing done using NUPRO prophy paste (medium) and EPITEX strips for lower 3-3 region.

3. RSD done without LA in pockets and furcation areas. Pt. tolerated well. chlorhexidine irrigation done.

4. Contact points checked with floss in crowded lower 3-3 region, for smooth interdental surfaces for efficient flossing.

Demonstration of flossing given to patient today. (shown in the mirror).

Demonstration of inderdental brusing given today.(shown in the mirror) and samples given to take away. Colour:

Advice given:

Adv. warm salt water rinses 3 times a day for next 3 days.

Diabetes advice: Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis.

Smoking cessation advice: Pt advised of poorer response to periodontal therapy if continues to smoke.

Adv. 6/12 appoitment pt. happy with it.

Mandibular Second Premolar

noreply@blogger.com (Unknown) — Mon, 12 Dec 2016 01:52:00 -0800

Mandibular Second Premolar Anatomy

Mandibular Second Premolar

Figures 10-13 through 10-21 illustrate the mandibular second premolar from all aspects. The mandibular second premolar resembles the mandibular first premolar from the buccal aspect only. Although the buccal cusp is not as pronounced, the mesiodistal measurement of the crown and its general outline are similar (Table 10-2). The tooth is larger and has better development in other respects. This tooth assumes two common forms. The first form, which probably occurs most often, is the three-cusp type, which appears more angular from the occlusal aspect (see Figure 10-17). The second form is the two-cusp type, which appears more rounded from the occlusal aspect (see Figure 10-20, 1, 2, 7, and 10).

Figure 10-13 Mandibular left second premolar, buccal aspect. (Grid = 1 sq mm.)

Figure 10-14 Mandibular left second premolar, lingual aspect. (Grid = 1 sq mm.)

Figure 10-15 Mandibular left second premolar, mesial aspect. (Grid = 1 sq mm.)

Figure 10-16 Mandibular left second premolar, distal aspect. (Grid = 1 sq mm.)

Figure 10-17 Mandibular left second premolar, occlusal aspect. (Grid = 1 sq mm.)

Detailed Description of the Mandibular Second Premolar From All Aspects

To describe the separate aspects of this tooth, direct comparisons are made with the mandibular first premolar except for the occlusal aspect.

Buccal Aspect

From the buccal aspect, the mandibular second premolar presents a shorter buccal cusp than the first premolar, with mesiobuccal and distobuccal cusp ridges showing angulation of less degree (see Figures 10-13 and 10-18). The contact areas, both mesial and distal, are broad. The contact areas appear to be higher because of the short buccal cusp.

The root is broader mesiodistally than that of the first premolar, the extra breadth appearing for most of its length, and the root ends in an apex that is more blunt. In other respects, the two teeth are quite similar from this aspect.

Lingual Aspect

From the lingual aspect, the second premolar crown shows considerable variation from the crown portion of the first premolar (see Figure 10-14). The variations are as follows:

Figure 10-18 Mandibular second premolar, occlusal aspect. Ten typical specimens are shown.

Figure 10-19 Mandibular second premolar, mesial aspect. Ten typical specimens are shown.

Figure 10-20 Mandibular second premolar, occlusal aspect. Ten typical specimens are shown.

Figure 10-21 Mandibular second premolar. Ten specimens with uncommon variations are shown. 1, Root extremely long. 2, Root dwarfed. 3, Malformed root; developmental groove on buccal surface. 4, Contact areas on crown high and constricted. 5, Crown oversize; developmental groove buccally on root. 6, Root oversize. 7, Root malformed and of extra length. 8, Root very long with blunt apex; extreme curvature at apical third. 9, Crown and root oversized; developmental groove buccally on root. 10, Crown narrow buccolingually; very little curvature buccally and lingually.

1. The lingual lobes are developed to a greater degree, which makes the cusp or cusps (depending on the type) longer.

2. Less of the occlusal surface may be seen from this aspect. Nevertheless, because the lingual cusps are not as long as the buccal cusp, part of the buccal portion of the occlusal surface may be seen.

3. In the three-cusp type, the lingual development brings about the greatest variation between the two teeth. Mesiolingual and distolingual cusps are present, with the former being the larger and the longer one in most cases. A groove is between them, extending a very short distance on the lingual surface and usually centered over the root (see Figure 10-20, 8).

In the two-cusp type, the single lingual cusp development attains equal height with the three-cusp type. The two-cusp type has no groove, but it shows a developmental depression distolingually where the lingual cusp ridge joins the distal marginal ridge (see Figure 10-20, 2 and 3).

The lingual surface of the crown of all mandibular second premolars is smooth and spheroidal, having a bulbous form above the constricted cervical portion.

The root is wide lingually, although not quite as wide as the buccal portion. Less difference in dimension is evident here than was found on the first premolar, so that much less convergence toward the lingual is seen.

Because in most instances the lingual portion of the crown converges little from the buccal portion, less of the mesial and distal sides of this tooth may be seen from this aspect than are seen from the lingual aspect of the first premolar.

The lingual portion of the root is smoothly convex for most of its length. Considered overall, the second premolar is the larger of the two mandibular premolars.

Mesial Aspect

From the mesial aspect (see Figures 10-15 and 10-19), the second premolar differs from the first premolar as follows:

1. The crown and root are wider buccolingually.

2. The buccal cusp is not as nearly centered over the root trunk, and it is shorter.

3. The lingual lobe development is greater.

4. The marginal ridge is at right angles to the long axis of the tooth.

5. Less of the occlusal surface may be seen.

6. No mesiolingual developmental groove is present on the crown portion.

7. The root is longer and in most cases slightly convex on the mesial surface; however, this convexity is not always present (see Figure 10-19, 6, 7, and 8).

8. The apex of the root is usually more blunt on the second premolar.

Distal Aspect

The distal aspect of the mandibular second premolar is similar to the mesial aspect, except that more of the occlusal surface may be seen (see Figure 10-16). This is possible because the distal marginal ridge is at a lower level than the mesial marginal ridge when the tooth is posed vertically. The crowns of all posterior teeth are tipped distally to the long axes of the roots, so that when the specimen tooth is held vertically, more of the occlusal surface may be seen from the distal aspect than from the mesial aspect. This is a characteristic possessed by all posterior teeth, mandibular and maxillary. The angulation of occlusal surfaces to long axes of all posterior teeth is an important observation to remember, not only in the study of individual tooth forms but also later, in the study of alignment and occlusion.

Occlusal Aspect

As mentioned earlier, two common forms of this tooth are evident. The outline form of each type shows some variation from the occlusal aspect (see Figures 10-17 and 10-20). The two types are similar in that portion that is buccal to the mesiobuccal and distobuccal cusp ridges.

The three-cusp type appears square lingual to the buccal cusp ridges when highly developed (see Figure 10-20, 8). The round, or two-cusp, type appears round lingual to the buccal cusp ridges (see Figure 10-20, 3).

The square type (see Figure 10-20, 8) has three cusps that are distinct; the buccal cusp is the largest, the mesiolingual cusp is next, and the distolingual cusp is the smallest.

Each cusp has well-formed triangular ridges separated by deep developmental grooves. These grooves converge in a central pit and form a Y shape on the occlusal surface. The central pit is located midway between the buccal cusp ridge and the lingual margin of the occlusal surface and slightly distal to the central point between mesial and distal marginal ridges.

Starting at the central pit, the mesial developmental groove travels in a mesiobuccal direction and ends in the mesial triangular fossa just distal to the mesial marginal ridge. The distal developmental groove travels in a distobuccal direction, is somewhat shorter than the mesial groove, and ends in the distal triangular fossa mesial to the distal marginal side. The lingual developmental groove extends lingually between the two lingual cusps and ends on the lingual surface of the crown just below the convergence of the lingual cusp ridges. The mesiolingual cusp is wider mesio-distally than the distolingual cusp. This arrangement places the lingual developmental groove distal to center on the crown.

Supplemental grooves and depressions are often seen, radiating from the developmental grooves. Occasionally, a groove crosses one or both of the marginal ridges. On a tooth of this type, the point angles are distinct. Developmental grooves are often deep.

Figure 10-20, 8 is representative. Variations of this development may be seen in Figure 10-20, 4, 5, 6, and 9.

The round or two-cusp type (see Figure 10-20, 3) differs considerably from the three-cusp type when viewed from the occlusal aspect. It is a true typal form of the two-cusp type. Variations may be seen in Figure 10-20, 1, 2, 7, and 10.

The occlusal characteristics of the two-cusp type are as follows:

1. The outline of the crown is rounded lingual to the buccal cusp ridges.

2. Some lingual convergence of mesial and distal sides occurs, although no more than is found in some variations of the square type.

3. The mesiolingual and distolingual line angles are rounded.

4. One well-developed lingual cusp is directly opposite the buccal cusp in a lingual direction.

A central developmental groove on the occlusal surface travels in a mesiodistal direction. This groove may be straight (see Figure 10-20, 3), but it is most often crescent-shaped (see Figure 10-20, 1, 7, and 10). The central groove has its terminals centered in mesial and distal fossae, which are roughly circular depressions having supplemental grooves and depressions radiating from the central groove and its terminals. The enamel surface inside these fossae and around their peripheries is very irregular, acting as a contrast to the smoothness of cusp ridges, marginal ridges, and the transverse ridge from buccal cusp to lingual cusp.

Some of these teeth show mesial and distal developmental pits centered in the mesial and distal fossae instead of an unbroken central groove (see Figure 10-20, 2).

Although photographs do not demonstrate it very well, most of these two-cusp specimens show a developmental depression crossing the distolingual cusp ridge.

Mandibular First Premolar

noreply@blogger.com (Unknown) — Mon, 12 Dec 2016 01:30:00 -0800

Mandibular First Premolar

Figure 1: Mandibular First Premolar

Mandibular First Premolar

Figure illustrate the mandibular first premolar from all aspects. The mandibular first premolar is the fourth tooth from the median line and the first posterior tooth in the mandible. This tooth is situated between the canine and second premolar and has some characteristics common to each of them.

The characteristics that resemble those of the mandibular canine are as follows:

1. The buccal cusp is long and sharp and is the only occluding cusp.

2. The buccolingual measurement is similar to that of the canine.

3. The occlusal surface slopes sharply lingually in a cervical direction.

4. The mesiobuccal cusp ridge is shorter than the distobuccal cusp ridge.

5. The outline form of the occlusal aspect resembles the outline form of the incisal aspect of the canine.

The characteristics that resemble those of the second mandibular premolar are as follows:

1. Except for the longer cusp, the outline of crown and root from the buccal aspect resembles that of the second premolar.

2. The contact areas, mesially and distally, are near the same level.

3. The curvatures of the cervical line mesially and distally are similar.

4. The tooth has more than one cusp.

Although the root of the mandibular first premolar is shorter generally than that of the mandibular second premolar, it is closer to the length of the second premolar root than it is to that of the mandibular canine.

Figure 2: Mandibular right first premolar, mesial and occlusal aspects. BC, Buccal cusp; BTR, buccal triangular ridge; LC, lingual cusp; MLDG, mesiolingual developmental groove; CL, cervical line; BCR, buccal cervical ridge; MCA, mesial contact area; MMR, mesial marginal ridge; DBCR, distobuccal cusp ridge; DMR, distal marginal ridge; CDG, central developmental groove; MBCR, mesiobuccal cusp ridge.

Figure 3: Mandibular right first premolar, buccal aspect. The specimen in this photograph shows a mesial inclination of the root. Mandibular premolars and canines have this tendency, although most of the roots of these teeth will curve, if at all, in a distal direction. (Grid = 1 sq mm.

Figure 4: FIGURE 10-3 Mandibular right first premolar, lingual aspect. (Grid = 1 sq mm.)

FIGURE 5: Mandibular right first premolar, mesial aspect. (Grid = 1 sq mm.)

FIGURE 6: Mandibular right first premolar, distal aspect. (Grid = 1 sq mm.)

FIGURE 7: Mandibular right first premolar, occlusal aspect. (Grid = 1 sq mm.)

Figure 8: Mandibular right first premolar. Graph outlines of five aspects are shown. (Grid = 1 sq mm.)

Detailed Description of the Mandibular First Premolar From All Aspects

Buccal Aspect

From the buccal aspect, the form of the mandibular first premolar crown is nearly symmetrical bilaterally (see Figures ). The middle buccal lobe is well developed, which results in a large, pointed buccal cusp. The mesial cusp ridge is shorter than the distal cusp ridge.

The contact areas are broad from this aspect; they are almost at the same level mesially and distally, this level being a little more than half the distance from cervical line to cusp tip. The measurement mesiodistally at the cervical line is small compared with the measurement at the contact areas.

From the buccal aspect, the crown is roughly trapezoidal (see Figure). The cervical margin is represented by the shortest of the uneven sides.

The crown exhibits little curvature at the cervical line buccally, because of the slight curvature of the cervical line on the mesial and distal surfaces of the tooth. The crest of curvature of the cervical line buccally approaches the center of the root buccally.

The mesial outline of the crown is straight or slightly concave above the cervical line to a point where it joins the curvature of the mesial contact area. The center of the contact area mesially is occlusal to the cervical line, a distance equal to a little more than half the crown length. The outline of the mesial slope of the buccal cusp usually shows some concavity unless wear has obliterated the original form.

The tip of the buccal cusp is pointed and, in most cases, is located a little mesial to the center of the crown buccally (see Figure ). The mandibular canine has the same characteristic to a greater degree.

The distal outline of the crown is slightly concave above the cervical line to a point where it is confluent with the curvature describing the distal contact area. This curvature is broader than that describing the curvature of the mesial contact area. The distal slope of the buccal cusp usually exhibits some concavity.

The cervix of the mandibular first premolar crown is narrow mesiodistally when compared with the crown width at the contact areas.

The root of this tooth is 3 or 4 mm shorter than that of the mandibular canine, although the outline of the buccal portion of the root bears a close resemblance to that of the canine.

The buccal surface of the crown is more convex than in the maxillary premolars, especially at the cervical and middle thirds.

The development of the middle buccal lobe is outstanding, ending in a pointed buccal cusp. Developmental depressions are often seen between the three lobes (see Figure )The continuous ridge from the cervical margin to the cusp tip is called the buccal ridge.

In general, the enamel of the buccal surface of the crown is smooth and shows no developmental grooves and few developmental lines. If the latter are present, they are seen as very fine horizontal cross lines at the cervical portion.

Lingual Aspect

The crown of the mandibular first premolar tapers toward the lingual, since the lingual measurement mesiodistally is less than that buccally. The lingual cusp is always small (see Figures ). The major portion of the crown is made up of the middle buccal lobe (see Figure ). This makes it resemble the canine.

The crown and the root taper markedly toward the lingual so that most of the mesial and distal surfaces of both may be seen from the lingual aspect.

The occlusal surface slopes greatly toward the lingual in a cervical direction down to the short lingual cusp. Most of the occlusal surface of this tooth can therefore be seen from this aspect.

The cervical portion of the crown lingually is narrow and convex, with concavities in evidence between the cervical line and the contact areas on the lingual portion of mesial and distal surfaces. The contact areas and marginal ridges are pronounced and extend out above the narrow cervical portion of the crown.

Although the lingual cusp is short and less developed (resembling a strongly developed cingulum at times), it usually shows a pointed tip. This cusp tip is in alignment with the buccal triangular ridge of the occlusal surface, which is in plain view. The mesial and distal occlusal fossae are on each side of the triangular ridge (see Figure ).

A characteristic of the lingual surface of the mandibular first premolar is the mesiolingual developmental groove. This groove acts as a line of demarcation between the mesiobuc-cal lobe and the lingual lobe and extends into the mesial fossa of the occlusal surface.

The root of this tooth is much narrower on the lingual side, and there is a narrow ridge, smooth and convex, the full length of the root. This formation allows most of the mesial and distal surfaces of the root to be seen. Often, developmental depressions in the root may be seen with developmental grooves mesially. The root of this tooth tapers evenly from the cervix to a pointed apex.

Mesial Aspect

From the mesial aspect (see Figures ), the mandibular first premolar shows an outline that is fundamental and characteristic of all mandibular posterior teeth when viewed from the mesial or distal aspect. The crown outline is roughly rhomboidal (see Figure), and the tip of the buccal cusp is nearly centered over the root. The convexity of the outline of the lingual lobe is lingual to the outline of the root. The surface of the crown presents an overhang above the root trunk in a lingual direction. The tip of the cusp is on a line approximately with the lingual border of the root. This differs from the situation found in maxillary posterior teeth, where both buccal and lingual cusp tips are well within the confines of the root trunks.

The mandibular first premolar, when viewed from the mesial aspect, often shows the buccal cusp centered over the root (see Figure ). In other instances, the buccal cusp tip is a little buccal to the center, corresponding to the typical placement of buccal cusps on all mandibular posterior teeth.

The buccal outline of the crown from this aspect is prominently curved from the cervical line to the tip of the buccal cusp; the crest of the curvature is near the middle third of the crown. This accented convexity and the location of the crest of contour are characteristic of all mandibular posterior teeth on the buccal surfaces.

The lingual outline of the crown, representative of the lingual outline of the lingual cusp, is a curved outline of less convexity than that of the buccal surface. The crest of curvature lingually approaches the middle third of the crown, with the curvature ending at the tip of the lingual cusp, which is in line with the lingual border of the root.

The distance from the cervical line lingually to the tip of the lingual cusp is about two thirds of that from the cervical line buccally to the tip of the buccal cusp.

The mesiobuccal lobe development is prominent from this aspect; it creates by its form the mesial contact area and the mesial marginal ridge, which in turn has a sharp inclination lingually in a cervical direction. The lingual border of the mesial marginal ridge merges with the developmental depression mesiolingually; this harbors the mesiolingual developmental groove.

Some of the occlusal surface of the crown mesially may be seen with the mesial portion of the buccal triangular ridge. The slope of this ridge parallels that of the mesial marginal ridge, although the crest of the triangular ridge is above it. The sulcus formed by the convergence of buccal and lingual triangular ridges is directly above the mesiolin-gual groove from this aspect.

The cervical line on the mesial surface is rather regular, curving occlusally. The crest of the curvature is centered buccolingually, the average curvature being about 1 mm in extent. It may, however, be a fraction of a millimeter, or the line may be straight across buccolingually.

The surface of the crown mesially is smooth except for the mesiolingual groove. The surface is plainly convex at the mesial contact area, which is centered on a line with the tip of the buccal cusp. Immediately below the convexity of the contact area, the surface is sharply concave between that area and the cervical line. The distance between the contact area and the cervical line is very short.

The root outline from the mesial aspect is a tapered form the cervix, ending in a relatively pointed apex in line with the tip of the buccal cusp. The lingual outline may be straight, the buccal outline more curved.

The mesial surface of the root is smooth and flat from the buccal margin to the center. From this point, it too converges sharply toward the root center lingually, often displaying a deep developmental groove in this area. Shallow grooves are nearly always in evidence, and occasionally a deep developmental groove will end in a bifurcation at the apical third.

Distal Aspect

The distal aspect of the mandibular first premolar differs from the mesial aspect in some respects (see Figures ). The distal marginal ridge is higher above the cervix, and it does not have the extreme lingual slope of the mesial marginal ridge, being more nearly at right angles to the axis of crown and root. The marginal ridge is confluent with the lingual cusp ridge; it has no developmental groove on the distal marginal ridge. The major portion of the distal surface of the crown is smoothly convex, the spheroidal form having an unbroken curved surface.

Below this curvature and just above the cervical line, a concavity is to be noted that is linear in form and that extends buccolingually. The distal contact area is broader than the mesial, although it is centered in the same relation to the crown outlines. The center of the distal contact area is at a point midway between buccal and lingual crests of curvature and midway between the cervical line and the tip of the buccal cusp.

The curvature of the cervical line distally may be the same as that found mesially, although less curvature distally is the general rule when one is describing all posterior teeth.

The surface of the root distally exhibits more convexity than was found mesially. A shallow developmental depression is centered on the root, but rarely does it contain a deep developmental groove.

The distal surface slopes from the buccal margin toward the center of the root lingually, but the slope is more gradual than that found mesially.

Occlusal Aspect

The occlusal aspects of many specimens show considerable variation in the gross outlines of this tooth. Both mandibular premolars exhibit more variations in form occlusally than do the maxillary premolars

The usual outline form of the mandibular first premolar from the occlusal aspect is roughly diamond-shaped and similar to the incisal aspect of mandibular canines (see Figure ). Some of these teeth have a circular form similar to that of some mandibular second premolars (see Figure ); others conform to the gross outlines of the more common second premolars (see Figure ).

The characteristics common to all mandibular first premolars, regardless of type, when viewed from the occlu-sal aspect are as follows:

1. The middle buccal lobe makes up the major bulk of the tooth crown.

2. The buccal ridge is prominent.

3. The mesiobuccal and distobuccal line angles are prominent, although rounded.

4. The curvatures representing the contact areas, immediately lingual to the buccal line angles, are relatively broad, with the distal area being the broader of the two.

5. The crown converges sharply to the center of the lingual surface, starting from points approximating the mesial and distal contact areas. This formation makes that part of the crown represented by buccal cusp ridges, marginal ridges, and lingual lobe triangular in form, with the base of the triangle at the buccal cusp ridges and the point of the triangle at the lingual cusp.

6. The marginal ridges are well developed.

7. The lingual cusp is small.

8. The occlusal surface shows a heavy buccal triangular ridge and a small lingual triangular ridge.

The occlusal surface harbors two depressions. These are called the mesial and distal fossae because of their irregular form, even though they correspond in location to the mesial and distal triangular fossae of other posterior teeth.

The most common type of mandibular first premolar shows a mesiolingual developmental depression and groove. These constrict the mesial surface of the crown and create a smaller mesial contact area that is in contact with the mandibular canine. The distal portion of the crown is described by a larger arc that creates a broader contact area in contact with the second mandibular premolar, which has a broader proximal surface than the canine (see Figures ).

The mesial fossa is more linear in form, being more sulcate and containing the mesial developmental groove, which extends buccolingually. This groove is confluent with its extension, which becomes the mesiolingual developmental groove as it passes over the mesiolingual surface. The distal fossa is more circular in most cases and is circumscribed by the distobuccal cusp ridge, the distal marginal ridge, the buccal triangular ridge, and the distolingual cusp ridge.

The distal fossa may contain a distal developmental groove that is crescent-shaped (see Figure ). It may harbor a distal developmental pit with accessory supplemental grooves radiating from it, or it may contain a linear groove running mesiodistally with an arrangement resembling the typical triangular fossa.

Because of the position of this crown over the root, most of the buccal surface may be seen from the occlusal aspect, whereas very little of the lingual surface is in view.

Maxillary Second Premolar

noreply@blogger.com (Unknown) — Thu, 8 Dec 2016 23:46:00 -0800

Maxillary Second Premolar

MAXILLARY SECOND PREMOLAR

Buccolingual Section

Most maxillary second premolars have only one root and canal. Two roots are possible, although two canals within a single root may also be found.

The pulp cavity may demonstrate well-developed pulp horns (Figure 13-12, A, 1, 2, 6, 7, and 8; D, 10, 11, 12, 14, 16, and 17 ); others may have blunted or nonexistent pulp horns (Figure 13-12, A, 3, 4, 5, and 9; D, 13, 15, and 18). The pulp chamber and root canal are very broad in the buc-colingual aspect of teeth with single canals. The pulp cavity does not show a well-defined demarcation between the root cavity and the pulp cavity because of the large buccolingual extent of the pulp cavity in the upper half of the tooth. In the apical half or third of the tooth, the pulp cavity often narrows abruptly (Figure 13-12, A, 1, 2, 4, 6, and 8; D, 11, 12, 13, and 18) and then tapers gently toward the apex. Some teeth possess dentinal islands in the apical third of the root; this situation essentially forces the clinician to treat these as teeth with two canals (Figure 13-22, A, 5; D, 15 and 17). Other maxillary second premolars have a canal that bifurcates at the apical third of the root (Figure 13-12, D, 10, 15, and 16). It should also be noted that buccal and lingual pulpal projections or fins are present at the level of the CEJ (Figure 13-12, A, 2; D, 12 and 18). Some teeth show a constriction at this same level (Figure 13-12, D, 10).

The apical foramen often appears to exit at the tip of the root (Figure 13-12, A, 1, 2, 5, 6, and 8; D, 11, 12, and 14 through 18). Some apical foramina appear to exit on the buccal aspect of the root (Figure 13-12, A, 4; D, 13), on the lingual aspect of the root (Figure 13-12, A, 7 and 9), or on both sides of the root tip (Figure 13-12, A, 3; D, 10 and 15).

Mesiodistal Section

The view of the pulp cavity in the mesiodistal section of the second maxillary premolar does not vary from that found in the maxillary first premolar. The pulp horns are blunted, and the pulp cavity tapers slightly from the occlusal aspect to the apex. The apical foramen may appear to be located off center of the root tip (Figure 13-12, A, 2, 6, and 9; D, 10 and 13) or appear to exit at the root tip (Figure 13-12, B, 1, 3, 4, 5, 7, and 8; E, 11, 12, and 14 through 18).

Cervical Cross Section

The cervical cross section of the maxillary second premolar is usually oval (Figure 13-12, C, 2 and 4 through 9), with some teeth having a kidney-shaped cross section (Figure 13-12, C, 1 and 3). The pulp cavity is centered in the root and may have a constriction in the middle of the canal space (Figure 13-12, C, 1, 4, 6, and 9), an entire separation (Figure 13-12, C, 2), or an elliptical pulp cavity (Figure 13-12, C, 3, 5, 7, and 8).

Figure 13-12 Maxillary second premolar. A, Buccolingual section, exposing the mesial or distal aspect of the pulp cavity. This aspect does not appear on dental radiographs. B, Mesiodistal section, exposing the buccal or lingual aspect of the pulp cavity. C, Cervical cross section at the cementoenamel junction exposing the pulp chamber. These are the openings to root canals that will be seen in the floor of the pulp chamber. D, Buccolingual section, exposing the mesial or distal aspect of the pulp cavity. E, Mesiodistal section, exposing the buccal or lingual aspect of the pulp cavity.

Maxillary Premolar Anatomy

noreply@blogger.com (Unknown) — Thu, 8 Dec 2016 23:38:00 -0800

Maxillay First Premolar Anatomy

Figure 1.1 : Maxillary First Molar

Most commonly birooted, the maxillary first premolar is a transitional tooth between incisor and molar.

Cervical Cross Section

The cross section at the cervical level shows the kidney-shaped outline form characteristic of the maxillary first premolar (Figure 1.2, C). A mesial developmental groove is usually present, giving this tooth its classic indentation. The pulp cavity may demonstrate a constriction adjacent to the developmental groove (Figure 1.2, C, 2, 3, 5, 6, and 9), or it may follow the general outline of the root surface (Figure 1.2, C, 1, 4, 7, and 8). Some roots demonstrate two separate root canals (Figure 1.2, C, 7 ), whereas a cross section of a three-rooted maxillary first premolar will show three separate canals (Figure 1.2, C, 3).

Figure 1-2: Maxillary first premolar A, Buccolingual section, exposing the mesial or distal aspect of the pulp cavity. This aspect does not appear on dental radiographs. B, Mesiodistal section, exposing the buccal or lingual aspect of the pulp cavity. C, Cervical cross section at the cementoenamel junction exposing the pulp chamber. These are the openings to root canals that will be seen in the floor of the pulp chamber. D, Buccolingual section, exposing the mesial or distal aspect of the pulp cavity. E, Mesiodistal section, exposing the buccal or lingual aspect of the pulp cavity.