Impacted Tooth Extraction

Surgery

• The most common impacted tooth is the lower 8.
• Cleft is not a local factor to etiology of impaction.
• The most common indication for removing an impacted tooth is prevention or treatment of dental disease.
• Shooting or stabbing pain symptoms indicate trigeminal neuralgia.
• Advanced age >40y is the most common contraindication for extraction of an impacted tooth.
• Advanced age is not an indication for extracting 8.
• C3/3C, is the Pell and Gregory classification that would be hardest to extract based on impacted lower 8.
• Pell & Gregory classification is based on the relationship of 8 to the anterior border of the ramus and the adjacent 2nd molar.
• Mesioangular is the easiest to extract according to Winter's classification of impacted lower 8 molar.
• Distoangular is the most difficult to extract based on Winter's classification of impacted lower 8 molars.
• B1/1B would be the Pell and Gregory classification if an impacted lower third molar is anterior to the ascending border of the ramus and its occlusal plane is halfway between the occlusal plane and CEJ of the adjacent 7.
• Horizontal is the type of impaction shown based on Winters classification.
• Low bone density is not a difficult factor for extracting impacted teeth.
• One does not have to remove bone lingually while extracting impacted lower 8 to avoid injury of LN.
• Impacted upper canines are not mainly bilateral
• Checking for bulge is the first method to determine the location of an impacted upper canine.
• A full-thickness flap is not true for the open technique of extracting an impacted canine.
• Orthodontists do not have direct visual access and this is not an advantage of an apically positioned flap
• Superior to MGJ it may cause loss of keratinized gingival or a perio defect as the tooth is guided into place, this is not a disadvantage of the closed technique for impacted upper canines.
• Healing is more rapid and requires less follow up in marsupialization than in enucleation, is untrue regarding the differences between enucleation and marsupialization
• All of the above are signs of IAN involvement: Diversion of path of canal by root, Darkening and narrowing of root, Deflection of roots at the region of the canal, Narrowing of canal outlines
• Exposure of IAC and M3 angulation are examples of intra-op anatomical factors
• Firm continuous strokes are false for incision principles.
• All of the above: Trismus, Bleeding, Pain and swelling, Alveolar osteitis, are a complication that occurs AFTER extraction?
• Applying pressure and gauze for 30-45 min, is the most effective and common way to stop bleeding after extraction?
• Surgical approach and mucosal transpositional flap is necessary when extracting an upper first molar and noticing an oroantral communication greater than 5mm in the sinus
• The Right lung is the most likely place for a foreign body to end up if it was aspirated during extraction.
• All of the above: Pt age,Smoking, Length and difficulty of extraction, Premature mouth rinsing and hot liquids, are associated risks for developing dry socket

Cons & Prostho

• 5.5 enamel / 6.2 dentin is the critical pH of enamel and dentin.
• Arrested caries appears smooth, shiny and black.
• Both incipient and hidden caries have intact surfaces.
• S. mutans is mainly responsible for enamel caries and Lactobacilli for root caries.
• Incipient carious lesions don't need operative treatment.
• Tertiary dentin has two types: reactionary and reparative.
• All caries grades on radio need operative treatment.
• Exposure to water which leads to dissolution is a disadvantage of GIC
• Marginal seal is not an advantage of amalgam.
• 90 degrees, no bevel is the cavosurface angle in amalgam enamel wall prep and does it need beveling.
• There is no need to extend the gingival floor and break contact with adjacent teeth gingivally which is not true for a class 2 cavity preparation.
• We should extend to include contact area incisally which is not true for class 3 cavity preparation.
• 5th gen is the most commonly used etching generation system.
• The letter is hue, number is chroma if a composite color shade is said to be A2 in the Vita Classic shade system
• A Rubber dam is the most successful method of isolation in dentistry.
• Wingless is the best clamp to use in this case if wanting to place a clamp before RD sheet.
• Vinyl polysiloxane or addition silicone is the impression material used for the secondary impression.
• It's only done for vital teeth as it avoids pain and sensitivity not true for temporization
• 6 degrees per wall, is the maximum inclination allowed to not lose rentention, axial wall inclination has to be kept at minimum so as to not increase total occlusal convergence which would lower the retention
• If the goal is to create a finish line on a posterior tooth where esthetics are not a concern, a supragingival finish line would be best and most hygienic.
• Chamfer for all-metal, shoulder for all-ceramic is the best type of finish line for all-metal crown, all-ceramic or porcelain crown?
• Gold is/are ductile and malleable and less strong than the rest.
• PFM crowns are where non-noble metal are mainly used because of their strength and oxidization properties.
• The biggest disadvantage of Zirconia is it is hard to cement.
• IPS Emax would be the most ideal all-ceramic material to use for an anterior 3-unit bridge
• It requires acid etching with hydrofluoric acid is untrue of Zirconia
• Metal/gold is the most conservative regarding finish line preparation and only requires a feather-edge
• Minimum of 1mm is the required reduction of the incisal/occlusal surface for a Zirconia preparation.
• Erosion is the most likely kind of tooth wear occuring if a pregnant patient came with yellowing and wear of palatal surfaces of her anterior teeth and says she has been puking more regularly.

Endo

• Chief complaint, medical and dental history, examination, treatment plan are steps for proper diagnosis.
• The management of inter-appointment flare-ups following is instrumentation and irrigation of the tooth and the incision and drainage of the abscess.
• TMJ pain, sinusitis, and cardiac problems are cases that can cause referred pain to teeth.
• There are no medical problems that contraindicate endo rx is false regarding endo prescriptions.
• C fibers are most likely responsible for rxn in the presence of inflammatory mediators.
• A-delta fibers are located apically while C fibers are located coronally is false regarding the differences between A delta fibers and C fibers.
• Recruitment of non-pain fibers is defined by hyperalgesia.
• All sensory afferent nerves of trigeminal N. first converge at the trigeminal ganglia.
• Convergence causes pain referral
• Cellulitis is chronic while abscess is acute for differences between cellulitis and abscess
• it is inconclusive: Test Cavity / Dentin stimulation, the only useful test option requires drilling into the tooth without giving anesthesia.
• LDF / laser doppler flowmetry test is not an aspect of sensibility testing.
• The pulp is irreversibly when there is a severe, intense response that continues after the removal of stimulus
• Same lingual, opposite buccal are indications of the SLOB rule
• Internal Resorption is what it shows
• Pulp cap is not an option for treatment therapy for symptomatic irreversible pulpitis
• All of the following help gag reflex pts: rubber dam, benzocaine topical gel on hard palate , metoclopramide 1hr before rx
• All of the above: Severe gag reflex, Placement of MTA plug in open apex immature tooth, Cracked tooth, Failure to heal even with no visible cause of failure
• Law of centrality relates to maintaining the marginal ridge integrity and starting to work from the centre of the tooth?
• Ni-Ti is less flexible than stainless steel, is false regarding the differences between Ni-Ti and stainless steel files
• Sodium hypochlorite is the most commonly used and effective irrigant in RCT.
• EDTA is commonly used to remove the inorganic component of the smear layer.
• Central sensitization, pain threshold differences, opioids released from pulp cause some people to experience symptomatic IP while some experience asymptomatic IP.
• It increases the effect of canal curvature is not true for the crown-down technique/
• Crown down has more iatrogenic mishaps is not true, in terms of the advantages of the crown down over the step back technique?

Pedo

• Evidence of human teeth development appears at 6th week IU
• The 1st macroscopic indication of morphologic development is at 11th week IU.
• Calcification of primary max central incisor happens at 14th week IU
• Calcification continues in primary teeth for 2 years after eruption.
• An infant is categorized as 0-2 years old.
• The first dental visit should be within 6 months of the eruption of the first primary tooth or the first year of life.
• Allowing a child to sleep with a bottle is one is false regarding anticipatory guidance for parents of infants.
• The initiation/bud stage is responsible for supernumerary teeth.
• Proliferation / cap stage is responsible for an odontoma.
• Histodifferentiation & morphodifferentiation is responsible for amelogenesis imperfects and peg teeth
• Calcification is responsible for hypoplasia or fluorosis?
• Lacking in cooperative ability: a 3yr old child would fall under this category in Wright's classification
• Tell-show-do is the gold standard rule in basic behavior guidance techniques
• Protective stabilization is indicated only in pt w/ uncontrolled movements due to disease or uncooperative pt who need emergency or limited rx?
• The recommended level of nitrous oxide is 30% nitrogen, 70% oxygen
• Lymphoadenopathy is apparent with Cellulitis
• The management for odontoma or what it shows
• Rickets, Cherubism and cyclic neutropenia is which of the listed is a cause of early exfoliation.
• Brain injury, Rubella or radiation, nutritional deficiency causes enamel hypoplasia
• .ABDCE the eruption order of primary teeth
• Macroglossia what you see in Down syndrome pts as tongue anomaly
• Education not related to primary dental caries formation
• Nutritional deficiency is NOT associated locally with delay in eruption of teeth
• Presence of 1 or more decayed, missing or filled tooth surfaces in a primary tooth in a child 71 months or younger is ECC
• The application of fluoride gel takes 4 minutes and one must not let the eat for 30 mins.
• The concentration of NaF in varnish is at 5%, applied twice a year.
• Community water fluoridation is the most common source of fluoride readily available.
• 38% is the percentage of fluoride in silver diamine fluoride?
• First 3 years of child's life, is when Fluorosis happens
• Threshold: 0.1mg/kgwt, Toxic: 5mg/kgwt.
• All of the above are indicated for stainless steel crown application: Extensive decay, Pulp therapy, Developmental defects,Crown fracture or general anesthesia
• Vitapex is made of calcium hydroxide and iodoform
• Partial or CVEK pulpotomy is a therapy using 1-3mm of pulp, indicated for trauma of vital immature teeth
• Apexification is process used to induce an MTA plug
• Flexible- 2 weeks a preferred splint if lateral luxation
• Rigid, Splint, 4 Month Splint If we have coronal root fracture
• A Lingual arch is a space maintainer for bilateral missing posterior units.
• It is okay to reimplant after the avulsion incident if the tooth has been re-implanted w/I 60min.

Perio, OM, Implants

• Gingiva is masticatory or keratinized mucosa
• Mucogingival junction is the part separating attached gingiva from a movable alveolar mucosa
• No stippling present is not a clinical factor of a healthy gingiva
• All of the above are risk factors that increase the risk of gingivitis (overhanging resto, calculus, smoking or DM, ortho brackets or crowding)
• There is a change in color, size, texture found in the Established staging of gingivitis
• Class 2 in Miller's classification is when the recession reaches the MGJ but there is no bone loss!
• Mobility Grade 3 is if horizontal mobility> 2mm or there is vertical mobility?
• Grade 3 is Glickman's grading of furcation involvement when there is furcation involvement with through and through loss of bone, but no clinical opening/exposure
• Herpetic gingivostomatitis is if diffuse or vesicular eruptions, and vesicle ruptures leaving ulcers in the mouth
• Reticular Lichen Planus shows
• Aphthous Ulcer
• Candida what lesion shows here.
• Discoid Lupus Erythematous is pre-malignant.
• The ideal distance between 2 implants is 3mm.
• The ideal distance of an implant to a tooth is 1.5mm?
• 1.2 mm is the bone loss expected in the first year of implant placement.

Ortho

• Class 3 Angle's classification: The central groove of the lower first molar is mesial to the MB cusp of the upper first molar,
• Class 2 (retrognathic) what the skeletal relationship of the mandible to the maxilla, and the resulting Angle’s Class.
• refers to the horizontal distance between the upper and lower front Overjet teeth, while an refers to the vertical overlap of the upper front teeth Overbite

Cysts

Most common inflammatory cyst:

• Periapical/Radicular Most Common Developmental Cyst:
• Dentigerous/Follicular