DSE 4/9/12

1. Pt has difficulty turning neck – Eagle syndrome

2. Syncope vs. anaphylactic shock – Pt with anaphylaxis has wheezing
(trouble breathing)
3. Pt has hepatitis A – You can work on him after a week of having it.
4. Slide with ulcers with other episodes – recurrent aphthae
5. PA of tooth with weird trabeculae (decreased maybe) – sickle cell anemia
6. Slide of blue sclera but answer choices were dentin dysplasia and
amelogenesis imperfecta. did not include osteogenesis imperfect or
dentinogenesis imperfect - amelogenesis imperfecta ???
7. Big diastema – leave alone
8. Pan with RL around an impacted molar – dentigerous cyst
9. Painful big swelling adjacent to extraction site – dry socket ???
10. Treat dry socket – irrigate and pack with iodoform with eugenol
11. Before relining the complete denture, you – build up posterior occlusion
12. HIV pt what do you do – treatment that does not cause bleeding
13. OSHA requires autoclaves to be tested - weekly
14. Kidney patient , prescribe – acetaminomphen
15. Arrow to RPD clasp that is cervical to HOC – retentive clasp
16. Arrow to the reciprocal clasp in above RPD, what’s purpose –
counterbalance the retentive clasp
17. Diabetes pt with burning tongue due to – malnutrition
18. High blood pressure is related to her – being overweight
19. Main reason why sealants fail – contamination
20. Why do you do perio cleaning before extracting for an immediate
denture? Healthy gingiva heals faster
21. Xray ID – Remants of primary teeth
22. Lip with bluish lump – mucocule
23. RP lesion in sinus on pan – mucocele
24. Sinus view – Waters
25. Big cavity what’s best for pulp and gingival health – gold onlay or pfm. I
put gold onlay but not sure.
26. Acid etching does all EXCEPT – increase surface area, make surface for
bonding agent, increase tags, create bond chemically (worded weirdly)***
27. ID – taurodontism
28. Large central incisor – germination
29. Herringbone slide, what do you do -Reverse the film
30. White lesion with red border, healed with SCARRING – MAJOR aphthae
31. Tx major aphthous - corticosteroids
32. Pic of opalescent teeth (lucent) – dentinogenesis imperfecta
33. X ray of obliterated pulps – dentinogenesis imperfecta
34. BW of teeth with no enamel – amelogenesis imperfecta
35. Disadvantage of a resin bonded denture (Maryland Bridge) – debonding
36. Max ant teeth missing, best implant – endosseous
37. Possible complication for implant above – penetrate nasal cavity
38. What would you expect after perio cleaning with chronic generalized
perio pt – reduction of inflammation and pocket depth decrease of 1-
2mm***, other choices: just reduction of inflammation, reduction of
inflammation pocket depth and attachment loss (this was asked 2x)
39. Spaces between teeth after perio cleaning. Why? From removing
calculus, decreases pocket depth and inflammation
40. After cleaning, 1 month recall there is still bleeding. Why? Retained
subgingival plaque
41. Poorly controlled diabetic with caries and bad looking gums. Best to –
hold off on restorative and perio cleaning and refer to physician for
consult.
42. Slide with scalloping RL on roots. Tx – leave along and observe. Dx –
aspiration (traumatic bone cyst)
43. Xray with maxillary central incisors with huge RL around both roots.
Endo is done on #9 but pt still feels pain. Tx – Do endo on #8
44. Slide of tongue, swollen lesion. What do you do dx – Palpate to see if firm
and indurated
45. Xray with RL behind permanent M2 (no M3). Dx – primordial cyst
46. OSHA requires that patient and dentist wear – eyewear
47. Someone requires that - dentist washhands before putting on gloves
48. Blurred x ray – patient moved
49. Pan with half regular sized teeth, other half was larger – head twisted or
turned (weirdly worded)
50. Dark PA – too much developer
51. Which one is NOT required for a PAN – thyroid collar
52. X ray Left max central is impacted. Big RP ball. Why is it impacted –
odontoma
53. Tx – surgical removal and ortho to bring central down
54. Slide of smokers pouch keratosis (White wavy folds in the buccal mucosa)
you ask – do you use smokeless tobacco
55. Alkaline phosphatase is elevated, phosphorus normal – Pagets
56. Xray ID – Mucous retention cyst in sinus (RP)
57. ID pic Ranula
58. Inside would be – mucous or purulent (I put mucous)
59. Dilantin gingival hyperplasia. Tx – gingivectomy
60. GTR best for - furcation II #30
61. Xray ID – mental ridge
62. Under tongue, blue lines due to – aging
63. Vital tooth, RP around PA, blunted apex – hypercementosis
64. Frontal view of teeth. They occlude on left. Lower right mandible has a
step. Where is fracture – midline fracture
65. What do you do next – pulp test and then do xrays, xrays and then do
pulp tests, complete clinical exam and then take xrays, or take xrays and
then do complete clinical exam (I put latter)
66. PA of Max Posteriors, one missing tooth with dark lesion-looking area. Its
is the sinus floor moved down in extraction site. ID – sinus
pneumatization
67. Anterior teeth in occlusion – class III
68. SLOB rule. Pic from the mesial – Mesiolingual
69. Minimum labial reduction for PFM premolar prep – 1.5mm
70. Bridge from 6-11. Might fracture because of – bending of metal
71. Under tongue is – Wharton
72. Upper and lower casts in occlusion with max tuberosity. Recommend –
removing tuberosity
73. Liver spot tx – remove it, irrigate, pressure, reevaluate
74. Lingual tori that needs denture tx – surgical removal (not cut denture
short of tori)
75. C. Albicans – fluconazole
76. Lateral incisor is negative to vitality test and is asymptomatic – leave
alone
77. Condylar inclination on articulator – protrusive record
78. Mass in posterior palate, benign – pleomorphic adenoma
79. Tx above – surgical removal
80. Mass in mandibular angel – pleomorphic adenoma
81. Lower central incisor x ray, asymptomatic, no caries, negative vitality, RL
around apices. Cause and tx – trauma, endo
82. Pregnant with swollen gums, Bop – better OHI and perio cleaning
83. Ranula tx – surgical removal
84. Pic of abrasion (on upper canine and lower pm and canine) – abrasion??
85. Pic of yellow lesions on teeth – bulimia?
86. White stains on teeth – fluorosis
87. Dark stains on teeth, tetracycline, tx – no treatment
88. X ray of RL lateral to vital tooth – periodontal cyst
89. Tx above – surgical removal
90. Biggest goal for flap surgery – access for sc/rp (I put this) other choice
was pocket reduction
91. Immediate denture – extract posteriors first
92. Immediate denture – extract posteriors except 12 and 21 (NOT EXCEPT 5,
28, 12, and 21 – oneside only)
93. Why above – preserve vertical dimension
94. Purpose of immediate try in? I put to establish VDO, but it may be to
approve esthetics and phonetics???
95. Swelling at mandible angle. What next – x ray
96. U shaped major connector, biggest function is to provide – rigidity (NOT
reciprocation, retention,etc)
97. Contraindicated in hyperthyroidism – vasoconstrictor in anesthetic (epi)
98. Improving gingival health – undercontouing of temporaries
99. Blunted roots in x ray cause be – orthodontic forces
100. What can you not determine in this case – facial-lingual width of alveolar
bone
101. Longest dimensional stability – pvs
102. Replacing an anterior crown, what do you need – 2mm incisal reduction.
Other choices – 2mm lingual, 1mm facial reduction
103. Close oro-antral fistula - surgery
104. Pic of prep, what cement is most harmful to the pulp tissue – zinc
phosphate
105. Remove immediate – next day by the dentist
106. Normal reaction to cold testing, no percussion sensitivity, no x ray – I put
normal tooth??
107. Normal reaction to cold testing (did not specify how long it lasted), no
percussion sensitivity, x ray had caries – I put reversible pulpitis??
(maybe normal)
108. Perio pack should be removed how long after surgery – 1 week
109. CCB – hyperplasia
110. Pic ID – nicotinic stomatitis
111. Pt is taking aspirin – additional bleeding
112. Phlebitis – pulmonary emboli
113. Healing after surgical flap – long junctional epithelium
114. Healing after ScRP – long junctional epithelium
115. HIV ELISA test is negative – No antibodies for HIV present
116. Check sterilizer by – biological indicators
117. Worst crown:root – I think it was 9, but it was obvious (either 8 or 9, not
6 or 11)
118. DB cusp 30 occludes – central fossa 3
119. Most important consideration for implants – space between roots
120. Afraid of needles and faints – Trendenberg position
121. To match the shade – polish first
122. If youre unsure about shade – less gray and less color saturation
123. Final denture impression – I put PVS (Polysulfide rubber wasn’t an
answer choice – polyether was tho.)
124. Red around gingiva cause – anaerobic bacteria
125. Pic of big DO amalgam in 3 or 14. Had a crack in M area. Tx – PFM crown
126. Denture reline indicated – when ridges resorb (NOT broken tooth, NOT
broken denture base)
127. When is perio problem severe – when perio PD get worse
128. Most important feature of cement – strength against solubility and
disintegration
129. What is PD of tooth from this x ray – cannot tell pocket depth from x ray
130. Spacing btwn teeth after scrp, reduction of – edema
131. Dialysis pt with left shunt – do not do BP on left arm
132. After cementing crown, thermal sensitivity, why – microleakage
133. Epulis – from bad fitting denture
134. Tx – excise
135. Precision or semiprecision not indicated for – low manual dexterity
136. Hard reline – 6 months after insertion
137. Temporary relines can be done – anytime
138. Blood test for Coumadin – PT
139. Sequence for removing immediates – 1 day, 3 days, one week, 1 month
140. Pt is taking aspirin, penicillin, naproxen, and estrogen. What contributes
to increased pd – I put estrogen (not sure)
141. Contraindications for apically positioned flap in the anteriors – I put bone
loss, but I think it’s esthetics
142. Monitor autoclave – weekly
143. Best cement to improve retention for a short crown – resin cement
144. Before trimming teeth on stone cast for immediate – mark a line 3mm
above free gingival margin
145. BW what is problem – I put pulp stones (couldn’t really see them but
thought that’s what they were getting at)
146. Anterior pontic – modified ridge lap pontic
147. Slow growing mandible – hyperpituitarism
148. Weight gain, deep voice, dry skin – hypothyroidism
149. Exophalmos – hyperthyroidism
150. Best way to communicate to lab and patient – I put study cast (diagnostic
wax up maybe)
151. Best way to communicate with someone else – maybe diagnostic wax up
here
152. Pic of Basal Cell Carcinoma
153. Patient with no hair, no teeth – ectodermal dysplasia
154. Sealants fail – contamination
155. Lichen planus treatment if symptomatic – corticosteroids
156. Lichen planus with no symptoms, but the answer choices did not include
no tx, so I put corticosteroids
157. Reline of immediate performed by lab – 6 months
158. Final lab reline of immediate – 3 months
159. Advantage of immediate denture – patient doesn’t want to be without
teeth
160. Hyperemia – dark, reddish tooth
161. Red spots on arm pic – penicillin
162. Dark spots on palate – Kaposi (maybe sturge weber, not sure)
163. Direct pulp cap works better in – young teeth
164. GP in sinus tract, does not go to apex – periodontal abscess
165. Anterior to earlobe swollen, inflammation of stenson – stimulate parotid
gland check for exudate
166. Picture ID – focal sclerosing osteomyelitis (did not use word condensing
osteitis but they are the same thing)
167. Post should not exceed – 1/3 width of canal
168. Root is 16mm, post should be at least – 11mm
169. Splinted teeth – perio stabilization for more comfort
170. Hereditary telangiestasia – blanching
171. Tongue sticking out with laceration on it – I put result of a previous
laceration (other choices were granular cell tumor…)
172. Pic of tongue with purple dots – lymphangioma maybe
173. Purplish lesion on lip – hemangioma
174. Inside ranula – mucous
175. RINN x ray holders – parallel film and cone is perpendicular
176. When setting denture teeth what do you not consider – tongue space
177. What do you not consider for esthetics when setting maxillary teeth –
midline, tooth position, arch form (not sure)
178. Lingual tonsil pic (bumps on lateral tongue) – Do nothing (Salt water
rinses was not a choice)
179. Mandibular teeth with lingual appliance, what’s it doing – tipping labially
180. Build up posterior teeth, then reline cd
181. Impression for most predictable results – custom tray with tooth stops
(individualized trays without tooth stops was not a choice)
182. Relines, small projections of impression material are projecting – trim
projections flush with ridge
183. Pic ID swollen maxilla– Pagets
184. Pic of RL balls around Mandibular incisors – periapical cemental
dysplasia
185. Tx above – nothing
186. Pic Nonvital anterior tooth with periapical raiolucency – root canal tx
187. Pic Exophytic pedunculated lesion interfering with eating – papilloma
188. Cluster of balls on buccal mucosa on line of maxillary dentition – fibroma
or papilloma (I put fibroma not sure)
189. Pic of lingual bone cavity (Staphne defect pic)
190. X ray Tooth under mandibular anteriors – supernumerary tooth
191. X ray of mandible with sialolith what view is this – I put occlusal (what is
subvertex idk)
192. Pic of fissured tongue
193. 2 RP next to roots – retained primary roots
194. Least important when trimming teeth – age
195. Pain on swallowing when rpd is remove – lingual impingement (I put DB
overextension but I think that’s wrong)
196. Staining of teeth – does not affect perio prognosis
197. Difficulty swallowing – insufficient interocclusal space (I don’t think that
was a choice though)
198. First diagnostic procedure at recall – update medical history
199. INH – TB
200. X ray ID multilocular RL lesion posterior mandible – ameloblastoma
201. Chelitis happens in increased interocclusal space. Tx by decreasing
interocclusal space and increasing vdo
202. Cheek biting happens when teeth are – end to end. Same as cheilitis and
increased interocclusal space
203. Pic of Tetracycline Teeth problem with taking it – in childhood (years 1 to
5 maybe), not in utero, not mom was taking it when pregnant
204. Glucose is 360 – get med consult maybe, not do tx then get med consult
205. Yellow defects on facial surfaces of anteriors – bulimia, abrasion (not
sure)
206. Vertical root fracture with radiolucency at apex – extract
207. Arrows pointing to first pillars near tonsils – palataglossus muscle was
not an answer choice. I put something along the lines of “first pillar” I
think “second pillar” was an answer choice too… weird
208. Pic of erosive lichen planus on cheek
209. Description of Nasopalatine cyst – excise
210. Impacted third molar impinging on 2nd molar (mandible), tx – either
etract 3rd molar bc its impinging on 2nd molar or extract 2nd molar and 3rd
will erupt into position
211. Periodontal probe pic probing anterior maxillary – Is it correctly
positioned? IDK Look up
212. 29 yo, retained primary molar with no problems – No tx???
213. Leukoplakia – biopsy
214. Pic of osteoradionecrosis
215. Seizure – protect from injury
216. Allergy tx – corticosteroid
217. Dentures cannot be seated – Relieve until they seat
218. Bleeding – aspirin
219. Disadvantage of PFM vs resin bonded – removal of tooth structure
220. Pre vs post ortho pics show – root resorption
221. Most important reason for doing ortho on this patient – tooth movement
and spacing
222. Unconcious patient – check breathing first
223.