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Omar Al-Majed SDLE Notes Part 2

From Manal notes+ Bayan notes + AlanoudGZ January 2021 + Exams

1. Composite types:
1) Macrofill composite: 4-40 microns. Not polishable. If more polished – more roughed.
Poor resistance.
2) Microfill composite: 0.04 microns. Very polishable, better esthetics. Contraindicated in
Class IV and posteriors.
3) Hybrid: 1-2 microns. Combination of large and small fillers. Excellent for anterior and
posteriors. Ex. Packable composite.

2. Clasps:
1) RPI Clasp: The RPI is a current concept of bar clasp design, and refers to:
1."R" Rest (always mesial) 2."P" Proximal Plate (distal) 3."I" I -Bar (buccal).It is
used when there is an Undercut.

2) Ring clasp: Is used usually with isolated mesially and lingually tilted mandibular
molars or mesially and buccally tilted maxillary molars.

3) Embrasure (Double Akers) Clasp: may be used on the posterior teeth, with an
infrabulge retainer on the anterior abutment. Is used also in Kennedy class II
and III without any modifications. (Q on 3/5).

4) Akers /Circumferential clasp: used on molars & premolars of normal shape and
position. It is contraindicated in long distal extension cases.

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3. Flourosis:
 Dental fluorosis: 1.5- 3 ppm.
 Skeletal fluorosis: 3-10 ppm.
 Crippling skeletal fluorosis: >10 ppm.

4. From 28/4 exam: Back pressure should be felt in Intrapulpal injection.

5. From 28/4 exam: H2 gas is a byproduct of PVS.

6. Width of attached gingiva:

o Greatest: In maxillary anterior region. 3.5 to 4.5mm.
o In the maxillary 1st premolar: 1.9mm.
o Narrowest: In mandibular 1st premolar: 1.8mm.

7. After scaling and root planning pocket depth result in gain of attachment if pocket is
deeper than 2.9mm. If less than 2.9mm it will result in loss of attachment.

8. Widman flap can cause recession.

9. Pulp stones are removed by ultrasonic scaler.

10. Cusp of carabelli can be found in mesiopalatal side of maxillary 1st molar.

11. Margins of restoration:

o Chamfer: 0.3-0.5 mm: Full metal crowns, Resin bonded crowns.
o Shoulder: 1 mm: Metal ceramic crowns, All ceramic/porcelain crowns.

12. Percentage of Palatal tori: 20-35%

13. Orthognathic surgery is indicated when:

o Overjet > 9mm.
o Reverse overjet > 3mm.

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14. Radiographic appearances:
o Onion skin appearance: Ewing Sarcoma
o Cotton wool appearance: Paget’s disease, Gardner syndrome, and
Cementosseous dyplasia.
o Ground glass appearance: Fibrous dysplasia, and Hyperparathyroidism.
o Sunburst appearance: Osteosarcoma, and Intraosseous hemangioma.

15. From 29/4 exam: Clindamycin is safe for pregnant patients at third trimester.

16. From 29/4 exam: Patients with episodes of EM recurrence from herpes – Acyclovir and
Valacyclovir can be given.

17. From 29/4 exam: Difference between Bone and cementum: Cementum has no lymph
and blood vessels.

18. Lefort II is also known as Floating maxilla.

19. From 30/4 exam: Teeth that can be extracted by rotational movement are: Maxillary
central incisor and Mandibular 2nd premolar.

20. From 30/4 exam: Stephan curve: a graph that shows what happen after consumption of
sugar in relation to dental caries.

21. From 1/5 exam: Waterline should be washed for 20-30 seconds after every patient.
Bacteria should be <500.

22. From 1/5 exam: Collar less PFM: Porcelain end with the contact finish line.

23. From 1/5 exam: HBV can stay in room temperature for 6 months.

24. Furcation involvement in maxillary 1st premolar regardless of the degree always
necessitates extraction due to poor prognosis.

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25. To evaluate Periodontitis:
o Stable pocket depth: < 4mm healthy, and bleeding on probing < 10%
o In progress pocket depth: <4mm healthy, and bleeding on probing > 10%
o Unstable pocket depth: >4 mm, unhealthy, and bleeding on probing >10%.

26. Collagen fibers in presence of an implant will be parallel to the surface.

27. An implant is considered osseointegrated when bone is attached to 40-70% of the

implant surface.

28. Management of laryngospasm during GA: Succinylcholine.

29. Dietary fluoride supplementation schedule:

30. From 30/5 exam: In hypovolemic and hypotension shock the patient should be
positioned in Trendelenburg position.

31. From 3/5 exam:

 If upper anterior teeth are too short: V sound will be like F.
 If upper anterior teeth are too long: F sound will be like V.

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32. From 3/5 exam: Monoplane occlusion is the occlusion choice for patients with severe
ridge resorption.

33. From 3/5 exam:

o Pemphigus vulgaris: Positive nikolsky sign, Intraepithlial clefting (Q about on 5/5),
Positive Immunofluorescence biopsy.
o Bullous pemphigoid: Deep, Negative nikolsky sign, Subepithelial clefting.

34. From 4/5 exam: Which teeth normally have bifurcations:

 Mandibular molars
 Maxillary 1st premolar

35. From 4/5 exam: If there is an undercut in cast: Black code.

36. Aspirin is avoided in renal failure patients.

37. From 5/5 exam: In patients taking Amoxicillin with vomiting and Diarrhea –
Metronidazole (Flagyl) is the drug of choice for replacement.

38. From 5/5 exam: Freeway space = RVD – OVD.

 RVD – Rest vertical dimension
 OVD – Occlusal vertical dimension.

39. From 5/5 exam: Cells in gingival inflammation:

 Initial stage: PMNs.
 Early: Lymphocytes.
 Established: Plasma cells.

40. From 6/5 exam: Material with acid/base reaction: GIC + ZOE + Polycarboxylate.

41. Material with acid base reaction + chemical activation: RMGI

42. From 6/5 exam: Primary teeth roots are narrower than permanent.

43. Factor Deficiencies:

o Hemophilia A: Factor VIII.
o Hemophilia B: Factor IX
o Hemophilia C: Factor IX.

44. Most teeth affected with Dens invaginatus are Maxillary lateral incisors.

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45. Patient with 12 primary and 12 permanent teeth at what age? 8.5 years and in some
references 9 years.

46. Tranexamic acid is given as mouthwash before dental extractions for patients on
Anticoagulants.

47. Maximum lidocaine without vasoconstrictor: 4.4 mg/kg.

Maximum lidocaine with vasoconstrictor: 7 mg/kg.

48. Vincent angina is also called as Trench mouth. It is a progressive painful infection with
ulceration, swelling and sloughing off of dead tissue from the mouth and throat due to
the spread of infection from the gums.
49. Hand- foot - mouth disease is caused by Coxsackie viruses.

50. From 7/5 exam: Self threading pins depth in Dentin: 2mm.

51. From 7/5 exam: Thixotropic material: a liquid that becomes less viscous and more fluid
under repeated application of pressure. Ex. Prophy paste, plaster of paris.

52. From 7/5 exam: Posterior palatal seal can be located by:
o In patient mouth by: T-Burnisher.
o In cast by: Indelible pencil.

53. From 7/5 exam: Steps in trying CD:

1. Accuracy of the cast and denture on articulator and intraorally.
2. Checking of jaw relation records.
3. Esthetic
4. Speech
5. Protrusive record (Last step and the Q was about it).

54. From 7/5 exam: Anterior- posterior strap has the worst rigidity when compared to
other connectors.

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55. From 7/5 exam: GCF is measured by Periopaper.

56. From 7/5 exam: Disinfection of PVS: By 2% Gluteraldehyde. (ZOE+ polysulfide also).
57. All access preparations for teeth are Oval except:
1. Upper centrals and molars: Triangular
2. Lower molars: Treapezoidal.

58. Percentage of presence of second canal: Upper 4 – Lower 4 – Lower 2

(4-4-2)
 Upper 4: 91%
 Lower 4: 27%
 Lower 2: 44%

59. Percentage of MB2 for Upper 1st molar: 56%

60. Copal varnish is used under amalgam.

61. Starry sky appearance in histology is found in Burkitt lymphoma.

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62. Bone density: Type D2 bone is the best for osseointegration of an implant.

63. Cross section of Files:

 1) K-reamer: Triangular.
 2) K-File: Square.
 3) H-file: Teardrop.

64. Apical periodontitis types:

1. Primary: microbial colonization of necrotic pulp tissues.
2. Secondary: persistent infection of incorrectly root canal treated tooth.

65. From 8/5 exam: External root resorption is treated by RCT + Calcium hydroxide.

66. From 8/5 exam: During wax up Central incisors and Canine gingival level should be the
same.

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 67. From 9/5 exam: Peutz–Jeghers syndrome (often abbreviated PJS): Hyperpigmented
macules on lips, oral mucosa, hand and feet, and anogenital region.

68. From 10/5 exam: Palatogingival groove in maxillary lateral incisor can cause an increase
in probing depth till 10 mm or more.

69. From 10/5 exam: Trismus is associated with Multiple sclerosis and Parkinson’s disease.

70. From 10/5 exam: During pulpotomy or (coronal pulp amputation) if hemostasis is not
achieved then tooth is not a candidate for pulpotomy. So, the treatment of choice
would be by either 1) Extraction or 2) Pulpectomy.

71. Dentigerous cyst: unilocular radiolucent area that is associated with the crown of an
unerupted tooth. Tx: Enucleation.
Types:
1. Central: cyst surrounds the crown.
2. Lateral: mesioangular impacted mandibular third molars that are partially
erupted.
3. Circumferential: cyst surrounds the crown + significant portion of the root.

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72. Adenomatoid odontogenic tumor (AOT) : circumscribed radiolucency, crown of
unerupted tooth, most often Canine, Snow flake calcifications.

73. Dentigerous cyst encloses only coronal portion whereas AOT surrounds coronal +
radicular portion.

74. Fibrous dysplasia – Ground glass appearance.

75. Hairy leukoplakia is by EBV and associated with HIV patients.

76. Lateral incisor is the most common cause for palatal abscess.

77. Cyst sites:

1) Lateral periodontal cyst: Mandible from the lateral incisor to the first premolar.
2) Globulomaxillary cyst: Maxilla between lateral and canine
3) Ameloblastoma: Mandibular molar-ramus area.
4) AOT: Canine area in Maxilla.
5) Periapical cemento-osseous dysplasia: Mandibular incisors around the apices.
6) Dentigerous cyst: Third molars.

78. Schirmer’s test is a test in Sjogren syndrome which determines whether the eye
produces enough tears.
 Normal > 10 mm in 5 min.
 Sjogren <= 5mm in 5 min.

79. ALARA in radiography stands for: As low as reasonably achievable.

80. A patency file: small K-file #10 or #15 passively extended beyond the apical foramen. Is
used with most rotary to remove accumulated debris.

81. Hyperalgesia is an exaggerate response to painful stimuli.

82. Allodynia is a painful response to non-painful stimuli.

83. In intraoral periapical radiographs – 2 mm of bone below root should be visible.

84. Thermocatalytic technique in walking bleaching can cause Cervical resorption.

85. Steroid inhalation in Asthma patients is a risk factor for getting Oral thrush (Oral
candidiasis).

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 86. Hutchinson incisor and Mulberry molars: are associated with Congenital syphilis.

87. Most common adverse effect after chemotherapy is Mucositis.

88. Ethics:

 1) Non- maleficence: No harm

 2) Beneficence: Do good.
 3) Autonomy: respect for patient’s rights/decisions.
 4) Justice: Treat everyone equally.
 5) Congeniality: Do not reveal patient records to others.
 6) Fidelity: Faithfulness.
 7) Veracity: Truthfulness.

89. From 11/5 exam: Composition of Amalgam:

1. Silver: 63-70%
2. Tin: 26-28%
3. Copper: 2-5%
4. Zinc: 0-2%

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90. From 11/5 exam: During brushing bristles penetrate 0.5-1 mm below gingival margin.

91. From 11/5 exam: Gracey curettes:

92. From 11/5 exam: Tooth with amalgam and you want to get rid of where to put?
Hazardous waste.
93. From 11/5 exam: Finger rests:

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94. From 11/5 exam: Type of wounds:

95. From 11/5 exam: Bulimia nervosa causes erosion in palatal and lingual surfaces.

96. From 11/5 exam: Osseous Crater picture:

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97. From 11/5 exam: Well defined radiolucency around the apices of premolar?
Mental foramen.

98. From 11/5 exam: Porcelain crowns can cause clicking sound during speech.

99. From 11/5 exam: Implant components:

100. From 11/5 exam: Patients with last stage renal failure may feel ammonia taste in
mouth.

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101. From 11/5 exam: A minimum of 7 mm from the implant head to the opposing tooth is
advised for adequate retention of a cement-retained restoration.

102. A screw-retained implant prosthesis may be provided with 4 mm of interocclusal

space.

103. From 11/5 exam: If IAN and lingual nerve are anesthetized for primary teeth which
teeth can be extracted without pain? ABCDE.

104. Local anesthesia agents:

Bupivacaine Longest duration, avoided in pregnancy and children.

Cocaine Most vasoconstrictor action
Procaine Slow onset and best vasoconstrictor effect.
Mepivicaine Fastest onset and safe.
Lidocaine Minimal toxicity
Articaine Can be used safely with patients with hepatic and renal diseases

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105. Trauma to teeth is common at what age?
 Primary teeth: 1.5-3 years
 Permanent teeth: 8-12 years

106. Recommended splinting time:

107. Best root canal material for primary teeth: Iodoform based paste.

108. Most common complication of CaoH pulpotomy in primary teeth: Internal resorption

109. Angulation during instrumentation:

1) Subgingival blade insertion: 0.
2) scaling and root planning: 45-90.
3) gingival curettage :>90.

110. DG-16 probe is used to locate canal orifices.

111. Nabers probe is used for furcation involvement.

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 112. Kennedy classification:
 CLASS I: Bilateral edentulous areas located posterior to the remaining natural
teeth.
 CLASS II: A unilateral edentulous area located posterior to the remaining
natural teeth
 CLASS III: A unilateral edentulous area with natural teeth remaining both
anterior and posterior to it
 CLASS IV: A single, but bilateral (crossing the midline), edentulous area located
anterior to the remaining natural teeth

113. Relining and Rebasing:

Relining Rebasing
 Resurface the tissue side of RPD with new base material.  Replacing the entire denture base material on
 Can be done in *chair or laboratory* existing prosthesis.
 Indications:  Or changing the position of the teeth/occlusion
and relation of denture.
o Patient with immediate denture.  A laboratory process.
o Patient wears upper complete denture against lower
natural teeth.

 Contraindication: If there is an extreme over closure of vertical  Indications: Fractured or stained denture.
dimension.  - Material used: Heat- cure Acrylic.
 Material used: Self-cure Acrylic.

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114. Lateral cephalometric landmarks:

115. Medication related osteonecrosis of the jaw (MRONJ staging and treatment):

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116. Andrews six keys of Occlusion:

117. Color coding of endodontic files:

118. Pontic design classification:

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119. Maximum recommended doses of LA:

120. Stafne defect: The classic Stafne defect presents as an asymptomatic radio- lucency
below the mandibular canal in the posterior mandible, between the molar teeth and
the angle of the mandible.

121. Classification of Hypertension:

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