ore1 HELP NEEDED

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1. A 43year old patient is missing on the upper right the first premolar and

molar. He has good oral hygiene and requests a fixed replacement for these

teeth. The other teeth on the same side are all moderately restored with MOD

amalgam restorations and are vital, except the canine, which has a very large

restoration and is root-filled. He has group function. Radiographs show a large

sinus cavity and no peri-apical pathology. What would be the restoration of

choice for replacement of the missing teeth?

A. Implant supported crowns

B. A conventional fixed bridge using the 7 and 5 as abutments

C. Two conventional cantilevered bridges, using the 7 and 3 as abutments

D. A resin-bonded bridge, using the 7 and 5 as abutmen

E. A conventional fixed-moveable bridge using the 7 and 5 as abutments

2. Bruxism is a common form of parafunctional activity of which the patient may

or may not be aware. It may be important in the development of a treatment plan

to determine whether the patient is an active bruxist. The principle clinical

sign of active bruxism is:

A. Head and / or neck pain

B. Excessive tooth wear

C. Temporomandibular joint clicking

D. Sensitive teeth

E. Cheek ridging and tongue scalloping

3. An adult patient attends your practice complaining of pain and swelling

associated with a previously restored upper first premolar tooth. The pain has

been present for a number of days and is no longer responding to analgesics. His

dentition is otherwise well maintained and his periodontal health is good.What

is the most appropriate approach to treatment?

A. Antibiotics and analgesics.

B. Extract the tooth

C. Carry out a pulpotomy. Temporary dressing.

D. Carry out a pulpectomy. Temporary dressing

E. Establish open drainage

4. A patient reports that his post crown has fallen out. This crown had been

present for many years. You note that there appears to be a hairline vertical

fracture of the root. The tooth is symptomless.What is the most sensible

approach to treatment?

A. Replace the post crown using a resin-reinforced glass ionomer material

B. Replace the post crown using a polycarboxylate cement

C. Replace the post crown using a dentine bonding agent and a resin-reinforced

glass ionomer material

D. Replace the post crown using a resin composite luting agent

E. Arrange to extract the tooth

5. A patient says that he does not like the appearance of his previously root

filled upper central incisor tooth. His dentition is otherwise well maintained

and his periodontal health is good. The tooth appears to be darker than the

adjacent teeth. What is the most appropriate approach to treatment?

A. Provision of a post crown

B. Provision of an all ceramic crown

C. Provision of a metal bonded to ceramic crown

D. Carry out a non vital bleaching procedure

E. Provision of a porcelain veneer

6. A 25 year old male attends for the first time complaining of sensitivity of a

number of teeth. On examination, the occlusal surfaces of all the teeth are worn

with obvious wear facets on the canines and premolars. Posterior amalgam

restorations are proud of the surrounding tooth. What would be the first stage

management?

A. Take impressions for study models

B. Prescribe fluoride mouth rinse

C. Replace the amalgam restorations

D. Dietary analysis

E. Placement of resin sealant to sensitive teeth

7. A 35 year old male patient who admits to grinding his teeth at night has a

number of wedge-shaped cervical (Class V) lesions on his upper premolar teeth.

These are causing some sensitivity and are approximately 3mm deep. What is the

correct management option?

A. Provide tooth brushing instruction and fluoride

B. Restore the lesions with compomer

C. Restore the lesions with micro-filled composite

D. Restore the lesions with a hybrid composite

E. Restore the lesions with conventional glass-ionomer

8. A patient attends with pain of four days duration in a carious upper molar

tooth. The pain is constant and is not relieved by paracetemol. Sleep has been

disturbed by the pain. The tooth is tender to percussion and gives a positive

response to Ethyl Chloride. What is the most likely diagnosis?

A. Pericoronitis

B. Apical periodontitis

C. Marginal periodontitis

D. Reversible pulpitis

E. Irreversible pulpitis

9. A 14 year old patient attends with a decayed and extensive hypoplastic LL7.

He is a very irregular attender with poor oral health habits. A radiograph shows

the presence of an unerupted LL8 and the LL6 is sound. What would be the most

appropriate long-term treatment for this tooth?

A. Amalgam restoration

B. Antibiotics

C. Extraction

D. Root canal therapy

E. Sedative dressing

10. A 30 yr-old patient attends complaining of occasional pain from the lower

left quadrant. Clinical examination reveals an extensively restored dentition

with generally good oral hygiene. There is no significant periodontal pocketing

other than an isolated defect in the region of the furcation of lower left first

molar which is non-mobile. The gingival tissue in this area appears erythematous

and slightly hyperplastic with a purulent exudate on probing. From the list

below, which is the most appropriate next step?

A. Obtain a radiograph

B. Biopsy the gingival tissue

C. Remove the restoration

D. Vitality testing

E. Prescribe antibiotics

11. A 40 yr old patient had root-canal treatment to his upper first molar. This

was performed 6 months ago using contemporary techniques under rubber dam and

was crowned after completion of treatment. He attends complaining of continued

discomfort from this tooth. Radiographic examination shows each of the three

roots to be obturated with a well-condensed filling to the full working length

though there is no evidence of in-fill of the periapical lesion when compared to

the pre-op view. There is crestal bone loss and no furcal involvement. What is

the most likely cause of the continued problem?

A. Extra-radicular infection

B. Contamination of canal(s) with E.faecalis

C. Uninstrumented canal

D. Vertical root fracture

E. Perio-endo problem

12. An eight-year-old boy presents with pain of three days duration that has

kept him awake. On examination you see a grossly carious lower left 6 and some

associated buccal swelling. Which of the following is the most appropriate to

give immediate relief of his pain?

A. Extract the LL6.

B. Gently excavate the caries and obtain drainage.

C. Give antibiotics.

D. Incise any swelling

E. Refer for general anaesthetic

13. A 21 year old female presents for the first time to your practice. She is

very upset with the appearance of her upper left central incisor. On examination

you find healthy oral hard and soft tissues and excellent oral hygiene. On close

examination you can see that the upper left central incisor is slightly greyer

than the upper right central incisor and has a composite restoration placed

palatally.What is the most appropriate form of treatment given the information

you have?

A. Bleaching with carbamide peroxide in custom formed trays of upper and lower

arches

B. A bonded crown

C. A composite veneer

D. A porcelain veneer

E. Non-vital bleaching with carbamide peroxide

14. EDTA (ethylene diamine tetra-acetate) has useful roles in certain situations

in clinical dentistry.

When would you use EDTA?

A. As a root end filling material

B. As a pulp capping agent

C. As a root canal chelating agent

D. As a mouthwash

E. As a dentine bonding agent

15. A patient presents with a history of clicking from their temporomandibular

joint. This click occurs mid way through the opening cycle and is consistent.

There is some pre-auricular pain and the lateral pterygoid muscle on the

affected side is tender to resisted movement test. There is no trismus and the

click is not present when the patient opens from an incisor edge to edge

relationship, instead of her normal Class I occlusion. The patient would like

treatment. The most appropriate occlusal splint for this patient would be:

A. Stabilisation splint

B. Localised Occlusal Interference Splint

C. Bite Raiser

D. Soft Bite Guard

E. Anterior Repositioner Splint

16. A patient presents with a history of a post-crown having fallen out. The

post-crown was originally placed fifteen years ago and had been successful up

until four months ago since when it has come out and been recemented four times.

At recementation there was no evidence of any caries. The patient had been a

regular attender and not needed any restorative treatment for the last eight

years. Which of the following is the most likely cause for the failure of this

crown?

A. The post was to narrow

B. The post was to short.

C. The root canal treatment was failing.

D. A vertical root fracture was present.

E. There were excessive occlusal loads on the tooth