2018 MSA Flashcards by Olivia Russell

What are two aims for raising a flap in oral surgery?

better access
better vision/view
protection of soft tissues

How well did you know this?

Not at all

Perfectly

What 4 things influence flap design in oral surgery?

the type of surgery being carried out
proximity of important structures such as nerves & muscles
area of the mouth (aesthetics may play a part)
how much access needed
personal preference of clinician

How well did you know this?

Not at all

Perfectly

What type of handpiece is used for bone removal in oral surgery?

electrical straight handpiece with saline cooled burs
round or fissure tungsten carbide burs
air driven handpiece may lead to surgical emphysema

How well did you know this?

Not at all

Perfectly

what are the three methods of debridement in oral surgery?

Physical
- bone file or handpiece to remove sharp bony edges
- mitchell’s trimmer or victory curette to remove soft tissue debridement
Irrigation
- sterile saline into socket and under flap
Suction
- aspirate under flap to remove debris
- check socket for retained apices

How well did you know this?

Not at all

Perfectly

What is the clinical name of dry socket?

Alveolar Osteitis
- inflammation of lamina dura

How well did you know this?

Not at all

Perfectly

What are 3 predisposing factors for development of dry socket?

smoking
female
molars more common
oral contraceptive pill
previous experience
excessive rinsing
female

How well did you know this?

Not at all

Perfectly

What are 3 signs & symptoms of dry socket?

dull aching pain
pain radiates to ear & is continuous
being kept up at night
bad smell/bad breath/ bad taste

How well did you know this?

Not at all

Perfectly

what are 3 treatment options for patients with dry socket?

supportive reassurance with systemic analgesia
irrigate socket with warm saline to remove any debris
curettage/debridement to encourage formation of new clot
pack the socket with antiseptic alvogyl
LA to help with pain

How well did you know this?

Not at all

Perfectly

What drug family does Apixaban belong to?

NOAC
- novel oral anticoagulant

How well did you know this?

Not at all

Perfectly

What does Apixiban inhibit to work?

Factor Xa (10a)
- inhibits conversion of prothrombin to thrombin stopping the production of the fibrin clot

How well did you know this?

Not at all

Perfectly

What else is apixaban used for?

treatment or secondary prevention of DVT
prevention of pulmonary embolism
prevention of stroke
treatment of AF
heart valve disease

How well did you know this?

Not at all

Perfectly

What blood tests should be done before treating a patient taking Apixaban?

APTT (activated partial thromboplastin time)

How well did you know this?

Not at all

Perfectly

What would you do in terms of dosage for surgical dental treatment vs simple extraction with a person taking apixaban?

Surgical dental treatment = miss morning dose for apixaban

Simple extraction = treat without interrupting (if they are very high risk of bleeding you would also miss morning dose)

How well did you know this?

Not at all

Perfectly

What are 3 methods used for achieving haemostatic control?

bite on damp gauze
LA with vasoconstrictor
suture
diathermy
bone wax

How well did you know this?

Not at all

Perfectly

What are 4 physical features of Down’s Syndrome?

broad flat face
short nose
small arched palate
macroglossia
abnormal ears
dental abnormalities
hypodontia

How well did you know this?

Not at all

Perfectly

What genetic test result would confirm a patient has Down’s Syndrome?

extra copy of chromosome 21

How well did you know this?

Not at all

Perfectly

Give 2 reasons a patient with Down’s Syndrome may have increased incidence of periodontal disease?

poor OH due to mental retardation
immunocompromised (impaired neutrophils)
less saliva/of a poorer quality

How well did you know this?

Not at all

Perfectly

What would be 2 examples of things that result in a patient not having capacity?

end stage dementia
severe learning disability

How well did you know this?

Not at all

Perfectly

What is the difference between a welfare guardian and a welfare power of attorney?

Welfare guardian has responsibility over persons health and financial status (property, finance & even marital affairs), has to be court appointed.

Welfare POA only has responsibility for health & wellbeing NOT financial decisions.

How well did you know this?

Not at all

Perfectly

What antibiotic could be prescribed for antibiotic prophylaxis & what dosage?

Amoxicillin 3g oral powder sachet 60 mins before procedure
OR
2 Clindamycin capsules (300g each, 600g total) 60 mins before procedure

How well did you know this?

Not at all

Perfectly

When should antibiotic prophylaxis be given? (timescale)

60 mins before procedure

How well did you know this?

Not at all

Perfectly

What are 3 clinical features of Parkinson’s?

bradykinesia (slow movement)
rigidity (increased muscle tone)
tremor
mask like face

How well did you know this?

Not at all

Perfectly

How does Parkinson’s differ from other cerebellar diseases?

Parkinson’s = resting tremor

Other cerebellar diseases = intentional active tremors

How well did you know this?

Not at all

Perfectly

Why might Parkinson’s patients have dry mouth?

Anticholinergic effects of drug treatment (benztropine)

How well did you know this?

Not at all

Perfectly

How could you help prevent dentures being lost in the care home?

- mark initials on denture during development - store in a labelled container

Why might you choose not to extract teeth of a Parkinson’s patient to make dentures?

Tremor could make extraction difficult Poor mouth opening due to rigidity

What would be the 2 most important things in the provision of a Parkinson’s patients future treatment?

1. prevention (OH may get compromised due to poor motor function, disease will progress) 2. relief of pain

What is local malocclusion?

A localised problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion. Tends to get worse with time, can be caused by variation of tooth number

What are 4 reasons for abnormalities of tooth number?

1. supernumerary teeth 2. hypodontia 3. retained primary teeth 4. early loss of primary teeth 5. unscheduled loss of permanent teeth

What are the 4 types of supernumerary teeth?

1. conical 2. tuberculate 3. supplemental 4. odontome

Give 2 ways to measure anterio-posterio skeletal relationship?

1. palpating the maxilla and mandible with 2 fingers and assessing if the maxilla is infront etc 2. take a lateral cephalogram and check the ANB angle

Give 2 ways to measure the vertical skeletal relationship?

1. assess FMPA (Frankfort mandibular plane angles) 2. LAFH to TAFH ratio

What position should their head be in when taking a cephalogram?

frankfort plane parallel to floor

How is porcelain surface prepped in the lab for bonding?

Hydrofluoric acid used to produce retentive surface on porcelain

What do you use to bond porcelain to composite luting resin?

Silane coupling agents

How does silane coupling agent act chemically?

Silane molecule has C=C bond which reacts with the composite resin luting agent Oxide groups on the porcelain bond with the silane

When would you use a dual cured?

when using metal restorations as light will not penetrate metal

What would you do in the lab to prepare metal?

Sandblast it

What chemical agent is used to bond metal?

MDP and 4-META

what metal can be used for an acid-etch retained bridge?

CoCr

What 4 things would you ask the patient about smoking?

- why do they smoke? - how many cigarettes a day? - how long have they been smoking? - are they thinking of quitting smoking?

what 3 things would you tell a patient that uses E-cigarettes?

- not harmless but safer than conventional cigarettes - can still cause dry mouth - can help patients to quit

what is the methodology used for helping patients to quit smoking?

5 As 1. Ask 2. Advise 3. Assess 4. Assist 5. Arrange

Give 2 advice services you could refer a patient to?

- local pharmacy - community smoking support group

What should you do if a patient does not want to quite smoking now?

- provide information/leaflet and explain if they ever think about quitting in the future we can support them - record advice given in notes

What 3mm spacing material is used & why?

Alginate - it is mucostatic & will take accurate record of tissues without displacement

Why is silicone not used?

- not effective for undercuts - mucocompressive

what are the 2 support areas on the maxillary arch?

1. hard palate 2. ridge crest

What is the primary support area of the mandible?

buccal shelf & pear shaped pad

What part of the mandible interferes during a maxillary working impression?

Coronoid process

How does PICO relate to study design?

Population Intervention Comparison Outcome

How can bias be reduced in study designs?

- randomising - double blinding

What is absolute risk difference?

difference between the observed risks in the two groups

what is the most important thing in prevention of healthcare associated infections?

PPE - gloves - aprons - visors - masks

what are the 10 SICPs?

- patient placement - hand hygiene - respiratory and cough hygiene - PPE - safe management of care equipment - safe management of care environment - safe management of linen - safe management of blood & bodily fluid spillages - safe disposal of waste - occupational safety prevention and exposure management including sharps

What is used to clean blood spillages?

- sodium hypochlorite - sodium dichloroisocyanurate

What strength of cleaning agent is used to clean blood spillage?

10,000ppm

What time should cleaning agent be used to clean blood spillage?

3-5 mins

How to break the chain of infection at transmission for use of dirty forceps?

Cleaning, disinfecting and sterilising before use

What are the Herb Schilder’s endodontic principles?

- create a continuously tapering funnel shape - maintain apical foramen in original position - keep apical opening as small as possible

Why is irrigation useful in endodontics apart from disinfection?

- dissolves organic materials - flushes out debris - lubricates root canal instruments - remove the endodontic smear layer

what is the best endodontic irrigant?

sodium hypochlorite

what is the ideal strength of sodium hypochlorite in endo procedures?

3% sodium hypochlorite (2.5-5.25 acceptable)

Give 3 features to take into account when using sodium hypochlorite:

- allergic reaction - irritate soft tissues - apical extrusion leading to tissue necrosis - discolouration of patients fabric/top

Give 4 indications that trauma isn’t accidental:

- delay in presentation of trauma - presentation not compatible with story - bilateral injury - vague story - injury untreated - previous history of violence

What are 2 effects that trauma has on the primary dentition?

- discolouration - delayed exfoliation

What are 4 effects that trauma has on the permanent dentition?

- failure of permanent successor to form - dilaceration - enamel defects - abnormal tooth/root morphology

What special investigation could be used for a child that is totally unco-operative?

OPT

When would be the ideal time to remove a child’s carious 6s? why is this?

- bifurcation of the 7s on radiograph - 5 & 8 are present - mild buccal segment crowding - prevents 7s erupting late/early - caries free dentition

What would be the disadvantage of extracting a child’s carious 6?

- loss of permanent tooth - risk of GA - bad experience could affect patients future visits

Give 4 reasons that a child may be anxious when attending the dentist:

- past negative medical/dental experience - influence of friends & family - media representation of dentists - expectation of pain

2018 MSA Flashcards

(71 cards)