Important Note SLE Dentistry

Notes in Dentistry. SLE

Important Saudi Licensing Exam Information in (SLE) Dentistry - SLE MCQs Review for

TOPICS Tumer Branch Syndromes Periodontology and Diagnosis Surgery Operative Crown and Bridge Endodontic Orthodontics

Ahmad AL-Aouni For further information contact with me Twitter & Kik : @dr_watheg

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Important Information in Dentistry - SLE Tumors Branch 1) Osteosarcoma: Generally with malignant tumors the examiner will mention parasthesia if it is affecting area containing a nerve like angle of mandible and I.A.N. The criteria here is : A rapid growing , R.L. ill defined having sunray appearance causing parasthesia. 2) S.C.C: It is the most common malignant tumor of oral cavity mostly affecting lateral surface of the tongue or the hard palate , usually associated with fixed and firm lymph nodes. It's primary stage is an ulcer.  3) Condensing Osteitis: Associated with a large carious cavity which is asymptomatic tooth , it is a R.O area surrounded by R.L margin. 4) Cementoblastoma: Slow growing R.O surrounded by R.L margin but no caries cavity is mentioned here or associated. 5) Complex Odontoma: R.L occupied by R.O disorganized bodies (In the premolar , molar area). 6) Compound Odontoma: Mixed R.L & R.O in anterior area. 7) Melanotic Neuron Ectodermal Tumor: New born , Bluish black , displaced tooth bud , unilocular R.L. rapidly growning.  8) AOT (Adenomatoid Odontogenic Tumor): It occurs in anterior maxilla or mandible usually associated with an impacted canine.  9) Pleomorphic Adenoma: Most common benign tumor of salivary glands , (80% parotid affection) when the examiner asked me about it he mentioned first that the female patient was earlier affected by a benign tumor in the neck , so the tumor in her parotid gland is? so I said pleomorphic.  Note: The most common malignant salivary gland tumor regarding major glands is: Mucoepidermoid and regarding minor glands is Adenoidc cystic carcinoma. 10) Adenoid Cystic Carcinoma : A slow growing with per-neural invasion , under microscope there is basophilic islands of Swiss cheese appearance. 11) Cherbuism: Painless , bilateral swelling of mandible which is firm, multiple R.L. in early childhood. 12) Sialolithiasis or Salivary Gland Duct stone or Calculus: They will mention that there is a discomfort in the floor of mouth or the check which moves while eating.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

13) Hyperparathyrodism : Multiple fractures , multiple radiolucencies at the angle of mandible , usually associated with Renal Failuer. 14) Acute Osteomyelitis: Moth eaten appearance. 15) Chronic Osteomyelitis: Cotton wool appearance or onion peal appearance. 16) Epstein's Pearl: In new born affecting the mid palatine raphe only mostly in the connection between the junction of soft and hard palate. 17) Bohn's Nodule: Remnant of Salivary glands Buccal or lingual mucosa and if occurring at the hard palate it will not occur in the mid palatine raphe. 18) Dental lamina of newborn: At alveolar ridge of new born , which is proliferation of rest of serres. 19) Congenital epulis of newborn: Mostly at maxillary anterior area , it interfere with feeding or respiration and requires excision and rarely recurrent 8:1 in females. 20) Acanthosis: Diffuse epidermal hyperplasia (thickening of the skin). It implies increased thickness of the Malpighian layer (stratum basale and stratum spinosum).

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Syndromes 1) Ectodermal Dysplasia: Looking old patient , with hair loss or faint hair and having missing teeth. 2) Cledocranial Dysplasia: Clavicle is missing or underdeveloped leading to shoulders can be bend toward each others . the patient looks smaller than his relatives and shorter than his relatives , having supernumery teeth so many impactions , open skull sutures and plugging forehead . 3) Gorlin-Goletz (Multiple Basal Cell Nevi Syndrome ): a diabetic patient with multiple jaw cysts & nevi on neck and scalp. 4) Albright: Multiple nevi on neck and head , multiple bone deformities. 5) Sjorgens': Dry mouth , dry eye and high caries index. Usually associated with Rh. Arthritis. 6) Paget's : The patient have high level of potassium sulphate so : he has hypercementosis , ankylosis and scattered R.O lines and leg bowing with prominent forhead. 7) Treacher Collins: deformity in zygoma , mandibular Retrognathia , Clift palate and eye drop down , ear deformity with hearing loss & open bite ( but he is mentally normal ). 8) Van Der Waund: Same as treacher Collins but associated with hypodontia or total anodontia. 9) Papilon le Fever: Hand and foot keratosis , Periodontitis affecting both dentitions , early teeth loss , generalized bone destruction. 10) Congenital Syphilis: Hearing loss , notched incisors . bulbous molars copper stained lesions. 11) Gardener: Multiple sebaceous glands at the back of the neck and palms , osteomas in mandible , supernumery teeth and impacted teeth. 12) Reiters (or Reiter Arthritis or Reactive Arthritis): TMJ inflammation and ophthalmic disease mostly conjunctivitis , GIT and Genital pain and inflammation. 13) Downs: Low carious index , fluoride application is by varnish , inability to learn , some have cerebral palasy. 14)

Addison Disease: Have oral melanosis.

15)

Osteogensis Imperfect: Blue sclera , teeth wear and multiple fractures.

16) Erythema Multiform Disease: The patient will have bulls eye on the skin and oral ulcers. MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Periodontology and diagnosis 1) Healing occurs after SC. & Root planning by long junctional epithelium. 2) Best healing after root fracture is interposition of Bone and C.T. 3) Complete epthlilization occurs after 7-14 days , but complete maturation needs 6 months after periosurgery. 4) Membrane removal : if resorbable membrane then (9-12) Weeks Non- resorbable (3-6) W. 5) PDL attachment is to : alveolar Bone proper or called bundle bone. 6) Submandibular gland duct is Wharton duct . but parotid is stenssons duct. 7) Autoclaving : 121 Co for 15-20 min or 134 Co For 3-5 minutes. 8) Grafts : condyle : post chondral graft, Child for alveolar process : iliac crest 3 wall defects in adult : mixed cortical and cancellous from his own intraoral mixed with his blood. 9) Autograft or Autogenous : from same person. Allogenous from same species but another person and treated , xenograft is from povine or any other species. 10) Fluoridation dose required : (0.25 mg 6m-3 y) (0.5mg 3y-6y) (1mg 6y) till 12 years. 11) Fluorosis occurs at 3PPM , but lethal dosage of fluoride is at 5-10 g which is 32-64mg/ kg. 12) U.S. devices: Magnut. : 25000-40000 RPM but piezo speed is : 60000 – 80000 RPM. 13) Bacteria method to form biofilm is called : Signaling , and after plaque accumulation the next step is to Colonize , the next step is Maturation . 14) (2 hours) is the time needed after aggressive brushing for plaque to form again. 15) Maxillary sinus volume is 15 ml. 16) Fibroblasts : Are the cells responsible for remodeling during orthodontic treatment. 17) Mandible originates from 1st arch but tongue from mandibular arch and tuberculum kampar. 18) Condyler growth is by deposition endochondreal and skull is by endochondreal and intermembranous deposition . maxilla growth pattern is downward and forward , and deposition in the tuberosit pushing forward also.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

19) Some tests: A- HIV : Elissa test, but for grading HIV : CD4 t-helper cells. B- Diaphteria : Shick test. C- Streptococus : Fermentation. D- Staph Cocus : Catalase. E- P.Vulgaris : Immuno fluorescence. 20) Here is a 3 tables the first of diseases and bacteria causing it and the 2nd is for radiological examination and their usage the 3rd is for AB and their mode of action :

Disease

Causative Organism

Anug Pericronitis Endocarditis Caires Ch. Sinusitis Acute sinusitis

Fusibacteria and spirochetes Strepto. Malleri or mallery Staph. Aurues and strept viridians Strepto. Arueus and l.bacillus Mixed anerobid and aerobic Hemophilus influenza and strept. pnuemonia

Osteomylitis In air water syringe Diabetic periodontium affected by Chronic inflammation cells AB creation

Staph aures Strept. Salivaris Neutrophils Lymphocytes B-lymphocytes

Radiographic examination

Use

Spect (Photon Emission) Arhtrography Submentovertex Occipitomental Reverse town

Condyler hyperplasia TMj topography and perforation Base of skull and zygoma analysis For mid face fractures Condyler and subcondyler area fractures

Waters view

analysis of sinuses & mid face fractures

Panoramic xray PA view Later ceph. Lateral oblique

For whole teeth analysis Vertical fracture displacement Orthodontics Horizontal displacement of fractures and ramus, body of mandible tumors analysis Soft tissue and hard tissue but show soft tissue better , than CT and CT is better in hard structures Hard tissue study Salivary glands study

MRI CT Sialogram

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

AB

Mode of action

Penicillin (B-lactam) :

Inhibit cell wall synthesis

Erythromycin (Macrolids)

Bacteriostatic ( inhibit bacterial growth)

Clindamycin and tetracycline

Inhibit protein synthesis

Gentamycin (Aminoglycosides )

Bactericidal ( kill bacteria direct)

Sulfonamides

Antimetabolites inhibit folic acid and PABA , but it causes aplastic anema to the patient

Surgery 1) Walsham's Forceps: For nasal fracture treatment , and if nasal bone is deviated it will be straightened by Ach's forceps afterward. 2) Allis Forceps: To hold tissues perior to excision Addison Forceps: To hold tissues for suturing Stills Forceps: Per wisdom teeth suturing because it is longer than Addison's forceps. Artery Forceps: To ligate ruptured arteries or arteries planned to be removed. 3) Minnesota Retractor: Retract flap and cheek together. 4) Muscles of Mandibular Movement: Muscles elevation of the mandible: Masseter, Temporalis and Muscles depression of the mandible: Geniohyoid, Mylohyoid, Pterygoid and Infrahyoid. Muscles protrusion of the mandible: Lateral pterygoid, Medial Masseter. Muscle retraction (Retruded) of the mandible: Temporalis. Muscle do lateral movement of the mandible: Lateral Pterygoid,

Medial Pterygoid. Digastric, Lateral Pterygoid Assists,

Medial Pterygoid.

5) Local anesthetic agents in dentistry .. The most commonly used local anesthetic is Lidocaine (also called Xylocaine or Lignocaine). A modern replacement for procaine (also known as Novocaine). Its halflife in the body is about 1.5–2 hours. Other local anesthetic agents in current use include articaine (also called Septocaine or Ubistesin), Marcaine (a long-acting anesthetic), and Mepivacaine. A combination of these may be used depending on the situation. Also, most agents come in two forms: with and without Epinephrine (Adrenaline) or other vasoconstrictor that allow the agent to last longer and also controls bleeding in the tissue during procedures. Usually the case is classified using the ASA Physical Status Classification System before any anesthesia is given.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Operative 1) Odontoplasia : Affecting E , D , and Pulp. 2) Amelogensis Imperfecta : dun affect D or P. 3) Dentinogenesis imperfecta : Mostly have no Pulp Cavity. 4) Oligodontia : 6 or more missing teeth , lack of development of alveolar process and decreased facial height. 5) Upper E , DL cusp is the sharpest cusp in both dentitions ,and is the Largest in primary. 6) Upper 6 , ML cusp is the sharpest cusp in permanent dentition and is the Largest BL cusp. 7) Lower 6 , MB cusp is the Largest MD cusp. 8) Dentinal Tubules : Near pulp they are 2-5 micrometers and count is 45 to 60 thousands square millimeters' while away at the DEJ they are 0.2 to 0.5 micrometers diameter and count is 15 to 20 thousands / square millimeters'. 9) 1st sign of calcification occurs in 14 weeks Intra uterine while First formation of tooth bud is 6 weeks intra uterine. 10) Copper is added to Amalgam to decrease gamma 2 Phase while ZINC is added to decrease oxide layer but if ZINC increase it will LEAD to increase moisture sensitivity and late expansion and pain. 11) Dental Composite Resin Composition. Dental Composite typically consists of a Resin-based Oligomer Matrix, Such as a bisphenol A-glycidyl methacrylate (BISGMA) or urethane dimethacrylate (UDMA), and an inorganic filler such as silicon dioxide (silica). Compositions vary widely, with proprietary mixes of resins forming the matrix, as well as engineered filler glasses and glass ceramics. The filler gives the composite wear resistance and translucency. A coupling agent such as silane is used to enhance the bond between these two components. An initiator package (such as: camphorquinone (CQ), phenylpropanedione (PPD) or lucirin (TPO)) begins the polymerization reaction of the resins when external energy (light/heat, etc.) is applied. A catalyst package can control its speed.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Crown and Bridge 1) Sequence of shade selection is : VCH where V is value (Lightness or Darkness of Color) and C is chrome which is degree of saturation of color and H is the property of color itself , if you want to make a darker cervical porcelain then choose higher chroma. 2) Rochette Bridge : A type of macromechanical retention. 3) Meryland Bridge : A type of micromechanical retention bridge bonded by resin , and neM ed high oral hygiene and low caries index. 4) Impressions : A) Polyvinyl Siloxane (Addition Silicone): The best type and of highest accuracy and the type of choice for inlay and onlays , and can be poured many times. B) Polyether : The 2nd accuracy after polyvinyl siloxane , and it is rigid and having higher dimensional stability than polysulphides but they unfortunately uptake water and swell. C) Polusulphides : Of bad test unacceptable by the patient , they should be poured within the first 24 hours. D) Hydrocolloids are 2 types : Reversible hydrocolloid = Agar Agar. Irreversible hydrocolloid = Alginate. Reversible and Irreversible hydrocolloids ( agar agar and alginate ) are elastic impression materials and have the properties of syneresis and imbibition. But the difference between them: Agar Agar sets by a physical reaction and this reaction is reversible. Alginate sets by a chemical reaction and this reaction is irreversible. Syneresis and Imbibition are more in Alginate than in Agar Agar. Only, Agar Agar has the property of hysteresis. Alginate is the least accurate impression material. Alginate have Tri sodium phosphate which is retarded for the reaction and the insoluble part of alginate is calcium alginate. 5) Calcium Sulphate : Is added to gypsum to prevent inhibiting gypsum.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Endodontic 1) E. Feacales: Is the main organism during R.C.T and is killed by MTAD preparation which is mix of Tetracycline and Doxycycline . 2) File length : 21 . 25 , 31 mm. 3) Increase in taper is 0.02/ mm so along the 16 mm of active cutting part the increase in diameter is 0.02 x 16 = 0.32 mm. 4) An example is file 50 means at the tip the diameter is 0.5 mm. 5) The different between file and another is 0.05 mm from file 10 to 60 and 0.1 between files 60- 140. 6) S-files is used to remove GP but after using solvent first. 7) Rotary files used for crown down technique. 8) Intracanal Pressure is 10mm/hg and the intrapulpal arterioles diameter is 50 micrometers. 9) External Resorption is caused by necrotic pulp or forcable intrusion or extrusion in orthodontic. 10)

Internal Resorption is caused by irreversible pulpitis.

11) Indication for root canal treatment: * Post space insufficient tooth substance for normal restoration. * Over denture. * Teeth with doubtful pulp. * Periodontal disease. * Pulpal sclerosis following trauma.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)

Orthodontics 1) Functional Appliances: Tooth borne appliances : A) Bionator B) Herbest (Pin and tube device) Tissue borne appliances : Frankele is the only tissue borne functional appliance 2) Blue grass appliance : For tongue thrust and thumb sucking habits , they are used as soon as the habit is noticed and they are left for 6 months at least. 3) Cap splint device : For Clift palate . 4) (2x4 Device) : For Anterior cross bite in mixed dentition. 5) Minimal Space needed between primary and permanent dentition IS : 6 mm in mandible and 7 mm in maxilla. 6) Primate Space: Primate space is the gap between the primary teeth of a child. These are normal. They are the result of the jaws growing to accommodate the larger adult teeth. yet, spacing is normal in children, but the term "PRIMATE SPACE" is more specific : In the mandibular arch, the primate space is between the canine and the 1st molar (or 1st premolar in adults).Whereas, in the maxillary arch, it is between the lateral incisors and canine. 7) Leeway Space: it is the space deference between the combined mesiodistal width of the C , D & E teeth and that of their successors ( 3 ,4 and 5 ) which is 1.9 mm in maxilla and 3.4 mm in mandible. 8) Freeway Space: it is the space between occluding surfaces of maxillary and mandibular teeth when mandible is at rest. 9) Overjet is the measurement (usually in millimetres) between the upper incisal edge and the labial surface of the lower incisors. The normal value is considered to be approximately 2-3 mm. 10) Overbite is essentially the coverage of the upper incisors over the lower incisors and this is sometimes measured in millimetres but more usually described as reduced, normal or increased. 11) Overjet in excess of 6mm will qualify for orthodontic treatment within the NHS. Increased overbite with trauma will also qualify.

MCQ Review for Saudi Licensing Exam (SLE) by Dr. Ahmed AL-Aouni (Twitter & Kik : @dr_watheg)