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Omar Al-Majed SDLE Notes Part 1

From Manal notes+ Bayan notes + DR.Note + Exams

1. Gingivitis Stages:
A) Stage 1: Initial, 2-4 days, Neutrophils.
B) Stage 2: Early, 4-7 days, T-lymphocytes, Erythema, Bleeding.
C) Stage 3: Established, 14-21 days, B- lymphocytes, plasma cells, Change in size,color and texture.
D) Stage 4: Advanced: Periodontitis.

2. Piezoelectric ultrasonic: Linear pattern.

3. Magnetostrictive ultrasonic: Elliptical pattern.

4. Cementum: A) Acellular: Coronal + Middle. B) Cellular: Apical.

5. Millers Classification for Mobility (Fremitus):

• Grade 1: Slight, horizontal mobility <1 mm.
• Grade 2: Moderate, horizontal mobility >1<2 mm.
• Grade 3: Severe, horizontal mobility <2 mm or vertical mobility.

6. Millers Classification (Recession):

• Class 1: Doesn’t extend to MGJ, no loss of ID Bone.
• Class 2: Extend to MGJ, no loss of ID Bone.
• Class 3: Extend to MGJ, partial ID bone loss
• Class 4: Extend to MGJ, severe ID bone loss.

7. From 15/3 exam: Lingual bar major connector is used in case of *(deep lingual vestibule). If the lingual
vestibule is less than 7 mm lingual plate is used.

8. Gutta percha components: 20% gutta-percha (matrix), 66% zinc oxide (filler), 11% heavy metal
sulfates (radiopacifiers), and 3% waxes and/or resins (plasticizers).

9. Percentage of osseous crater = of all defect one-third 35.2%, for all mandibular two-third 62%.

10. Periodontal Probes:

• A) UNC – 15 Probe: 1,2,3,4-5, 6,7,8, 9-10, 11,12,13,14,15. Color coded between 4-5 and 9-10.
• B) WHO Probe: 0.5 mm Ball, 3.5,8.5, 11.5 mm. Color coded between 3.5-5.5.
• C) Michigan O probe: 3,6, 8 mm.
• D) Michigan probe with William’s markings: 1,2,3,5,7,8,9, and 10 mm.
• E) Marquis color coded probe: 3-6, 9-12 mm.

11. Periochips: release CHX for 7-10 days.

12. After gingivectomy:

• Complete epithelial repair takes 4 weeks.
• Complete tissue repair takes 7 weeks.

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13. NAOCL - Removes Orgnaic, proteolytic irrigation.
14. EDTA – Removes Inorganic, Chelating agents.

15. Pain:
• Dentinal pain – A Delta fibers, myelinated.
• Pulpal pain – C fibers, unmyelinated.

16. Phentolamine (Oraversa,Septodent): Local injection to reverse action of LA.

17. For sinus tract tracing – GP 25-30.

18. NAOCL+ CHX – cause orange brown occludes dentinal tubules known as Parachloroanaline (PCA).

19. Best Irrigation to kill E,Feacalis – CHX, and in some references MTAD.

20. AH- Plus: 4 hours working time, 8 hours for setting, and don’t release formaldehyde.

21. AH- 26: 15 hours working time, 24-36 hours for setting, releases formaldehyde.

22. ANUG Classification:

o Stage 1: Tip of IDP.
o Stage 2: Entire DP.
o Stage 3: Gingival margin.
o Stage 4: Attached gingiva.
o Stage 5: Buccal and labial mucosa.
o Stage 6: Exposing alveolar bone.
o Stage 7: Perforating skin.

23. Gates glidden sizes: No 1: 0.5. No 2: 0.7. No 3: 0.9. No 4: 1.1. No 5: 1.3. No 6: 1.5.

24. The only tooth that shows 8 endo configurations: Maxillary 2nd Premolar.

25. Most effective solvent and fastest: Chloroform.

26. From 15/4 exam: Crown calcification of permanent teeth completes after eruption by *24 months.

27. The optimum amount of fluoride in Drinking water: 0.7-1.2 ppm.

28. The concentration of APF (Acidulated phosphate fluoride) used as gel is 1.23%

29. Aspirin can be given for children from age 16.

30. Radicular cyst is derived from the root sheath of hertwig and has the rest cell of mallasez.

31. Salivary stones are most commonly involving submandibular gland.

32. Maxillary first premolar has the steepest cuspal incline.

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 33. Mucocele are most commonly found in the lower lip.

34. Caries is the most common cause for FPD Failure.

35. From 16/3 exam: Management of excessive fluoride Intake:

• Less than 5 mg/kg: 1) Give calcium orally. 2) No need to induce vomiting.
• More than 5 mg/kg: Empty stomach by inducing vomiting. 2) Give calcium orally. 3) Admit to hospital
and observe for a few hours.
• More than 15 mg/kg: 1) Admit to hospital immediately. 2) Induce vomiting. 3) Start cardiac
monitoring. 4) Slowly administer 10 ml of 10% calcium gluconate. 5) Adequate urine output should be
maintained using diuretics if necessary. 6) General supportive measures.

36. From 16/3 exam: Hyperkeratosis of dorsal surface of palms, feet, and premature loss of primary teeth
are found in: Papillon Lefevre syndrome.

37. Tear drop appearance on X-Ray appears in: 1) Orbital fracture. 2) Lateral periodontal cyst.

38. From 17/3 exam: Most common bacteria in water line: Legionella pneumophila, Mycobacterium
spp., Pseudomonas aeruginosa, and Staphylococcus spp.
39. The recommended level of colony forming unit / ml for the dental unit should be under 500.
40. The minimum amount of time in seconds that waterline should be washed between patients is 20-30
seconds.
41. From 17/3 exam: The position of bacterial spore indicator is in the center.
42. From 17/3 exam: The shearing cusps of posterior cross bite: BULL.
43. From 17/3 exam: Infrabony defects:
• 1 wall: Hemiseptal.
• 2 walls: Crater (Most common)
• 3 walls: Trough.
• 4 walls: Circumferential (Extraction socket).

44. From 17/3 exam: The distance between papilla and labial surface of anterior teeth is 8-10 mm.

45. Eagle syndrome: A rare condition in which elongation of styloid process or calcification of stylohyoid
ligament causes a painful sensation in the head and neck region. Symptoms: Pharyngeal discomfort, painful
neck and tongue movements, increased saliva, and headache.

46. Types of GIC: Type 1: Luting. Type 2: Restorative. Type 3: Liner and bases. Type 4: Fissure sealant.
Type 5: Orthodontic. Type 6: Core buildup. Type 7: High fluoride release. Type 8: ART. Type 9: Pediatric.

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 47. Oblique ridge of maxillary molar: Distobuccal cusp to Mesiopalatal.

48. Depth of the pulpal floor gives resistance.

49. From 18/3 exam: Methyl Paraben is responsible for anaphylactic reaction by LA.

50. From 18/3 exam: The probing depth around healthy implants should be 3 mm.

51. Primate spaces: is the natural space between maxillary primary lateral and canine.

52. Dentin Dysplasia: teeth are short, conical, and may appear as rootless.

53. From 19/3 exam: Extraction is recommended to be at least 5 days in Maxilla and 7 days in Mandible
before starting Chemotherapy.

54. From 19/3 exam: In Radiotherapy the ideal time for extraction would be at least 21 days or 2 weeks
before starting.

55. From 19/3 exam: Curve of Spee: The Insical edges and the buccal cusps of posterior teeth follow a
curve which end at the anterior surface of condyle.

56. The best way to scan patients with Iodine allergy is by: MRI.

57. From 19/3 exam: Curve of Wilson: Mediolateral curve that contacts the buccal and lingual cusp tips
on each side of the arch.

58. Optimum crown/root ratio is 2:3.

59. In Pulpotomy Formocresol should be 1/5 saturated.

60. Parotid gland is the largest salivary gland.

61. Dentigerous cysts contains Straw like infiltrate.

62. Ghost cells are found in Calcifying odontogenic cyst.

63. From 20/3 exam: After organ transplantation dental treatments should be deferred to at lease after 6
months.

64. From 20/3 exam: Muscles responsible for lingual border molding are: Palatoglossus, Superior
constrictor, Mylohyoid, and Genioglossus.

65. From 20/3 exam: Florida probe: is an automated way for measurement of sulcus or pocket.

66. From 20/3 exam: Myxedema coma occurs in Hypothyroidism patients not taking medications.

67. From 22/3 exam: Molar relationship in Primary Dentition is by the primary second molar.

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 68. From 22/3 exam: The bone around the apical third of the root is Cortical.

69. From 22/3 exam: Bennet movement: bodily lateral or lateral shift of the mandible resulting from the
movement of the Condyle. This movement is recorded in the non-working side. This shift is 1-4 mm.

70. From 22/3 exam: Behcet’s syndrome: Orogenital ulcers, eye and skin lesions, Positive pathergy test.

71. From 22/3 exam: Histology of Lichen planus: 1) Hyperkeratosis. 2) Hypergranulosis. 3) Saw tooth rate.
4) Lichenoid Infiltrate.

72. From 24/3 exam: Anti-SSA Antibodies are found in Sjogren syndrome and SLE.

73. From 24/3 exam: TB stays in clinic for 4-6 hours.

74. From 24/3 exam: Recurrence of Pyogenic granuloma is 15%.

75. From 24/3 exam: Secondary TFO cause 30-50% bone loss.

76. From 24/3 exam: 12 Flutid bur is used for Microabrasion.

77. From 24/3 exam: Best Impression material for Inlay: Addition Silicone.

78. From 24/3 exam: In patients taking Aspirin: 1) if more than 325 mg stop. 2) if less no need to stop.

79. From 24/3 exam: Anterior bite plane is used for treatment of Deep Bite.

80. For Overdenture minimum 2 implants in Mandible, 3-4 implants in Maxilla.

81. Trismus after anesthesia is usually caused by intramuscular injection to lateral pterygoid or temporal
muscle.

82. The Sharps container should be disposed when it is ¾ full.

83. A clasp must encircle a tooth a minimum of 180 degree to provide adequate retention.

84. From 25/3 exam: Zone of flame that is used with gold heating: Reduced zone (hottest part of flame).

85. From 28/3 exam: Tetracycline fibers are used for 10 days and then should be removed. CHX chips
resorbs by its own after 7-10 days.

86. From 28/3 exam: Allergy to latex gloves is a type IV allergy (48-72 hours).

87. From 1/4 exam: Pemphigus vulgaris affects mostly Buccal mucosa.

88. Types of Headgears: 1) Cervical pull headgear. 2) Straight pull headgear. 3) High-pull headgear. All 3
are used for Class II div I (Distalization of maxilla). 4) Reverse pull headgear (facemask): extraoral, class III to
protract maxilla.

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 89. Frankfort plane: from Porion to Orbitale.

90. ANB: A: Maxilla, N: Nasion, B: Mandible – ANB= 2-4 degree. – 1) Increased: Class II. 2) Decreased: Class
III.

91. From 1/4 exam: In patients with severe bone resorption and prognathic appearance – use teeth with
angulation 0 degree.

92. From 1/4 exam: Most commonly impacted teeth: 1) Mandibular 3rd molar 2) Maxillary 3rd molar
3) Maxillary canine 4) Mandibular 2nd premolar 5) Maxillary 2nd premolar 6) Maxillary central incisor.

93. From 1/4 exam: The Reamer Is the most flexible between the files.
94. From 1/4 exam: Rake angle: K-file: Negative rake. H-File: Positive rake angle and has more cutting
efficiency.

95. From 1/4 exam: Direct sequalae of CD: 1) Mucosal reactions. 2) Oral galvanic currents. 3) Altered taste
4) Gagging. 5) Residual ridge reduction. 6) BMS 7) Periodontal disease and caries of abutments.

96. From 1/4 exam: The purpose of Hand and wrist radiograph analysis is to determine parameters such
as patient's skeletal age, the amount of growth left and to determine whether to use functional appliance or
to wait until growth ceased and perform extraction or surgery.

97. From 5/4 exam: Wilkes Classification of ID:

98. From 5/4 exam: Sterge – Weber syndrome:

• Port wine stains.
• Multiple red macules and papules.
• Anemia
• Unilateral involvement of soft palate.

99. From 5/4 exam: Ludwig angina spaces: Submandibular, sublingual, and submental space.

100. From 5/4 exam: Paget disease: Hypercementosis, Ankylosis, Cotton wool appearance in radiographs.
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 101. From 4/5 exam: Dentinogenesis Imperfecta types:
o Types:
o Type 1: Associated with Osteogenesis imperfecta.
o Type 2: With no systemic involvement.
o Type 3: Brandywine with large pulp chambers, bell shaped crowns, shell like appearance.

102. From 5/4 exam: The lower lip is the common site for Mucocele.

103. From 5/4 exam: Ranula: are mucoceles that occur in floor of the mouth. Blue domed shaped.
o Treatment: Removal of sublingual gland or Marsupialization.

104. From 5/4 exam: Erythema Multiforme: Bulls eyes or target lesions. Disease is self-limiting usually
takes 2-6 weeks. Treatment: Systemic or Topical steroids.

105. From 5/4 exam: Hodgkin lymphoma: Supraclavicular and cervical masses. Malignant disease.

106. From 7/4 exam: Sequence of common missing teeth:

1. Maxillary and mandibular 3rd molars.
2. Mandibular 2nd premolar.
3. Maxillary lateral incisor.
4. Maxillary 2nd premolar.

107. From 8/4 exam: No need for fluoride supplements before 6 months.

108. From 9/4 exam: S-N-A Mean = 82 degree.

A. SNA Increased - Protrusive maxilla.
B. SNA Decreased - Retrusive maxilla

109. From 9/4 exam: S-N-B Mean= 80 degree.

A. SNB Increased – Protrusive mandible.
B. SNB Decreased – Retrusive mandible.

110. From 9/4 exam: C-shaped canals are found in lower second molar.

111. From 9/4 exam: Optimal time for mouth wash rinsing with Clorhexidine 0.12% is 30 seconds.

112. From 10/4 exam: * The first step in Ressective osseous surgery is Vertical grooving.
• Steps of Ressective osseous surgery:
1. Vertical grooving.
2. Radicular blending.
3. Flattening interproximal bone.
4. Gradulizing marginal bone.

113. From 11/4 exam: Oral lichen planus is treated by Oral Corticosteroids.

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 114. From 11/4 exam: Molars have 4 occlusal centric contacts. Premolars have 2. Incisors and canines have
1.

115. From 11/4 exam: Distobuccal root is the most commonly resected root in maxillary molars.

116. From 13/4 exam: Internal resorption obturation technique: Thermoplastic technique. (Obtura 2)

117. From 13/4 exam: Fibrous dysplasia types:

1. Monostotic: One bone.
2. Polyostotic: Two or more bones.
3. Albright syndrome: Multiple, Hyperthyrodism.
4. Craniofacial.

118. From 13/4 exam: Unpasteruized milk consumption causes Scrofula.

119. From 13/4 exam: Leeway space: The combined mesiodistal width of permanent canines and
premolars is usually less than that of primary canines and molars.
o In maxillary: 1.8 mm. (0.9 mm each side).
o In mandible: 3.4 mm. (1.7 mm each side).

120. From 14/4 exam: Plummer- Vinson syndrome: Difficulty swallowing, Glossitis, and Angular chellitis.

121. From 14/4 exam: Polyether disadvantage: It absorbs water.

122. From 14/4 exam: MMPs are produced by lymphocytes and granulocytes but in particular by activated
macrophages.

123. From 15/4 exam: Oro-antral communication management:

A) <2mm: spontaneous closure.
B) 2-6 mm: suture and sinus precautions.
C) >6 mm: closure with flap.

124. From 15/4 exam: Plasma cell gingivitis: Red, friable, bleeds easily. In marginal and attached gingiva.

125. From 15/4 exam: Roots of primary molars are long and divergent.
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 126. Charters brushing technique is used for Orthodontic patients.

127. Interincisal angle mean= 130-131 degree.

o Increased angle – Class II div II
o Decreased angle – Class II div I

128. From 17/4 exam: Patients with Paget’s disease denture should be replaced from time to time because
of bone changes.

129. From 17/4 exam: Dislocation of TMJ Classification:

1. Stage 1: Early reducing disc displacement.
2. Stage 2: Late reducing disc displacement.
3. Stage 3: Non-reducing – acute, subacute.
4. Stage 4: Non-reducing – chronic.

130. From 18/4 exam: During wax-up for a cast Canine and Central incisors gingival margin is in the same
level.

131. From 18/4 exam: Hyrax and Hass Appliances:

A) Hyrax: tooth supported, rapid expansion, fixed appliance.
B) Haas: tissue supported, slow maxillary expansion by opening midpalatal suture in 10-14 days.

132. From 19/4 exam: 3D Vita shade: VALUE – HUE – CHROMA. (VHC)
133. From 19/4 exam: Vita classical shade: HUE – CHROMA – VALUE. (HCV)

134. From 20/4 exam: Multiple RCT failure + J shaped radiolucency = Vertical root fracture.

135. From 20/4 exam: Patient with Orbital floor fracture will have a double vision.

136. From 20/4 exam: After relining and rebasing – VD will increase.

137. From 20/4 exam: Compomer: physical properties is better than conventional GIC but less than
composite. Optical properties is better than GIC. Minimal fluoride release.

138. Van Der Woude syndrome: Cleft lip and palate, lower lip pits, Hypo and anodontia.

139. Metzenbaum scissors are used for flap retraction of the lip.

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140. Burning mouth syndrome mean age is 60 years.

141. Serial extraction techniques:

1. Dewel: Dec Canine – Dec 1st molar – Perm 1st premolar. (CD4)
2. Tweed: Dec 1st molar – Perm 1st premolar – Dec canine. (D4C)
3. Nance: Same as Tweed. (D4C)
4. Moyer: (BCD4).

142. Natal teeth: At birth. Neonatal: within 30 days after birth.

143. Glossopharyngeal nerve is responsible for Gag reflex.

144. Layers of lip: 3 layers.

145. Condyle rotates 10-15 degree.

146. The king of fracture: most common root fractured tooth (Maxillary 1st premolar)

147. Bubivicaine is avoided in Children and Pregnancy.

148. Osteoradionecrosis Classification:

o Type 1: Shortly after radiation.

o Type 2: After 6 years + follows trauma.
o Type 3: Spontaneous b/w 6 months to 3 years.

149. Fibroma is the most common benign tumor of oral cavity. Treatment: Excision.

150. Hairy leukoplakia is associated with EBV, and with HIV pts.

151. IANB is contraindicated in Hemophilic patients, Intraligamentary is indicated.

152. The most important test for HIV is CD4.

o Normal CD4: 500-1000.
o CD4< 500: HIV.
o CD4< 350: Risk of opportunistic infection.
o CD4< 200: AIDS.

153. Most effective percentage of CHX to kill E.feacalis is 2%.

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 154. Periodontal file: is an instrument limited to use on the enamel surfaces and the outer surfaces of
calculus deposits.

155. Listerine mouthwash can cause Hairy tongue.

156. Aspirin can cause fetal deformities (Cleft lip and palate).

157. How long virus stays in clinic:

o HIV: 5-6 days.
o HBV: 7 days to 6 months.
o TB: 4-6 hours.

158. Steam sterilization:

o 121 C – (15-20 min) – 15 psi. (Normal cycle)
o 126 C – (10 min) - 20 psi.
o 132 C – (3 min) – 30 psi (Flash cycle).

159. From 22/4 exam: Most common area for supernumerary teeth? 85% are in anterior maxilla.

160. Split thickness flap is indicated when dehiscence and fenestrations are suspected.

161. Disinfection of impressions:

o Alginate + Polyether: 0.5% NaOCl 10 min.

o ZOE + Polysulfide + PVS: 2% Gluteraldehyde.

162. NaF (Sodium Flouride) concentrations in mouthwash:

o For weekly: 0.2% NaF (900 ppmF)
o For daily: 0.05% NaF (225 ppmF)

163. Flouride varnish concentration: 5% sodium fluoride (NaF).

164. RFA (Resonance frequency analysis): is used to determine the stability of the level of osseointegration
in dental implant. (Evaluate implant stability)

165. Limit heat during implant placement: 47 C.

166. Best area to place an implant: mandibular anterior region.

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167. Trauma from occlusion:
o Primary TFO: Ex. High restoration.
o Secondary TFO: Reduced ability of tissue to resist force. 30-50% bone loss.

168. Strawberry gingivitis is found in Wegner Granulomatosis.

169. Strawberry tongue is found in Scarlet fever.

170. Critical probing depth to proceed for surgical: 5.4 mm.

171. Gutta percha is sterilized by Sodium Hypochlorite for 1 min.

172. From 24/4 exam: Matemirism: The color of an object appears different under different light sources.

173. GIC etching is done by 10% polyacrylic acid for 10 seconds.

174. Ledermix is used in avulsed teeth to prevent root resorption.

175. Ridge loss Classification:

o Class I: Loss of width
o Class II: Loss of height
o Class III: Loss of width and height.

176. Anterior palatal strap is used when small tori is not extended to the junction of hard and soft palate.

177. In case of large tori: U shape or horseshoe major connectors are used.

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178. New Periodontal Classification: Stages and Grades:
1. Stages: it depends on CAL and RBL.
o Stage 1: Mild CAL 1-2 mm, RBL<15%.
o Stage 2: Moderate CAL 3-4 mm, RBL coronal third loss.
o Stage 3: Severe CAL > 5mm, RBL middle third loss.
o Stage 4: Very severe CAL > 5mm, RBL apical third loss.
2. Grades: Percentage of bone loss/pt age
o Grade A: < 0.5, slow bone loss.
o Grade B: >0.5<1mm, moderate bone loss.
o Grade C: >1mm, severe bone loss.

179. MTA disadvantage: long setting time and can cause pulp obliteration.

180. Voxel size in CBCT: smallest voxel size = better resolution. The best voxel size for endo is 0.2 mm.

181. From 24/4 exam:

• Three-unit instrument formula:
o 1st number indicates width of blade.
o 2nd number indicates length of blade.
o 3rd number indicates angle of the blade.

• Four-Unit instrument formula:

o 1st number indicates width of blade
o 2nd number indicates cutting edge angle
o 3rd number indicates length of blade.
o 4th number indicates blade angle with the axis of the handle.

182. Type of patients:

1. Philosophical: easiest to treat, excepts needs for treatment.
2. Exacting: need explanation for every step, difficult, more treatment time.
3. Hysterical: complaining, will never wear prosthesis.
4. Indifferent: lack of motivation, uncooperative, poor prognosis.

183. Maximum epinephrine for healthy patients is 0.2 mg. For cardiac patients 0.04 mg.

184. Digoxin + epinephrine increase risk of arrythmia. Digoxin also increases gag reflex.

185. Salivary gland ducts:

o Parotid gland: Stenson Duct.
o Submandibular gland: Wharton Duct.
o Sublingual gland: Duct of Rivinus and also called Bartholin duct.

186. From 26/4 exam: Cavosurface angle for amalgam: 90 degree. For composite >= 90.

187. Minimum distance between implant and sinus space is 1 mm.

188. Minimum distance between implant and mental foramen is 5mm.
189. Minimum distance between implant and inferior alveolar nerve canal is 2mm.

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