ADEX OSCE Exam with complete solutions

thickness of minor RPD connectors - Answer- 1.5 mm Minimum space between vertical components of RPD - Answer- 5 mm Kennedy Class I - Answer- bilateral distal extension Kennedy Class II - Answer- unilateral distal extension Kennedy Class III - Answer- entirely tooth born with teeth anterior and posterior Kennedy Class IV - Answer- edentulous area anterior to remaining teeth Lingual bar distance from gingival margin - Answer- 3 mm Lingual bar width (minimum) - Answer- 4 mm Maxillary major connectors, how far from gingival margin - Answer- 6 mm Max RPD bead line width and depth - Answer- .75-1 mm Anterior-posterior palatal strap, minimum distance between straps and minimum width for each strap - Answer- 15 mm between, 6 mm anterior and 8 mm posterior Palatal plate advised when? - Answer- The last abutment on either side is a canine or premolar Main function of indirect retainers - Answer- prevents vertical dislodgement of the distal extension base away from tissues (sticky food) Minimum number of rests for RPD - Answer- 3 For a distal extension where is the rest on the most posterior tooth - Answer- mesial rest seat depth - Answer- 1.5 mm at marginal ridge and 2 mm in center, at least 2.5 mm wide what is prepared first? Guide planes or seats - Answer- guide planes extended occlusal rests used when? - Answer- used when most posterior molar abutment is mesially tipped in class II (mod I) and class III Cingulum rest depths - Answer- 2 mm wide (F-L), 2.5-3 mm (M-D), 1.5 mm deep Guide plane position relative to height of contour for classes of RPD - Answer- Class III and IV can end above the height of contour because there is no functional movement. Class I and II must be below the height of contour (to prevent torquing). With I-bars and mesial rests on premolars, must end exactly at the height of contour. how to determine number of clasps - Answer- kennedy classification + 1 (except for class IV) Undercut of 0.01 - Answer- cast clasp Undercut of 0.02 - Answer- wrought wire (0.5 mm and must be at least 8 mm long, 18 gauge) chromium provides what - Answer- corrosion resistance cobalt provides what - Answer- rigidity Nickel provides what - Answer- ductility What muscle dictates the DB of the mand flange of a denture - Answer- masseter What muscle dictates the DL of the mand flange of a denture - Answer- superior constrictor muscle how far to trim back the custom tray from the mucosal reflection - Answer- 2 mm occlusion rim heights - Answer- maxillary 22 mm, mandibular 18 mm The inferior surface of the maxillary occlusal rim should be parallel to... - Answer- Camper's Line (Ala-tragus Line) and inter-pupillary line primary and secondary support for mand denture - Answer- primary - buccal shelf, secondary - alveolar ridge Posterior palatal seal - Answer- extends through the hamular notches, 2 mm in front of fovea palatinae, carried 5 mm anterior to the vibrating line if denture falls down when smiling - Answer- buccal notch and buccal flange are excessively thick Golden Proportion Ratio - Answer- 1.6:1:0.6 (central:lateral:canine) S sounds like "th" - Answer- either max anteriors are too far palatal or palate is too thick. S sounds bring the max and mand closest together (than other sounds) Occlusal clearance gold - Answer- 1.5 mm functional, 1 mm non-functional Occlusal clearance PFM - Answer- 1.5-2 mm functional, 1-1.5 non-functional all ceramic clearance - Answer- 2 mm Percentages for PFM copings - Answer- high noble (98% gold, platinum and palladium - these metals do not oxidize on casting), Noble (50-60% palladium, 30-40% silver - silver will oxidize), Base (70-80% nickle, 15% chromium - these both oxidize on casting) Coping thickness - Answer- noble metal is 0.3-0.5, base as thin as 0.2 Implant overdenture minimum space - Answer- locator - 8.5 mm, ball and o-ring - 10-12 mm, bar clip - 13-14 mm Polysulfide impression material - Answer- rubber base, setting time of 12-14 min PVS - Answer- poured up to 1 week, hydrophobic, do not wear latex gloves, 6-8 min setting time, temperature sensitive (sets faster in heat) polyether - Answer- impregnum, hydrophillic4-6 min setting time, most stiff, gypsum made of? types? - Answer- calcium sulfate hemihydrate; type I - rarely used, plaster of paris, type II - ortho casts, not very strong, type III - dentures, type IV - use for stone dies, type V - stone dies, most popular today PDL types of elastin - Answer- No mature elastin, 2 types of immature: oxytalan (regulates vascular flow, parallel to root surface) and eluanin attached gingiva - narrowest bands - Answer- buccal mand canines and 1st premolars, lingual mand incisors and canines Junctional epithelium - Answer- 2 basal laminas (internal faces the tooth) and external (faces the connective tissue) Proliferative cell layer - responsible for most cell divisions and located next to external basal lamina long junctional epithelium - Answer- refers to junctional epithelium in disease, as JE gets longer and moves apically the coronal portion detaches ANUG (acute necrotizing ulcerative gingivitis) - Answer- treponema denticola (spirochete), predominately neutrophils involved First cells involved in acute inflammation (start of gingivitis) - Answer- Polymorphonuclear neutrophils (PMNs) Acute inflammation - Answer- vascular phase (mast cells, basophils and platelets release histamine) and cellular phase (PMNs, then eventually macrophages) main cell components of chronic inflammation - Answer- polymorphonuclear leukocytes (PMLs) pregnancy gingivitis has increased levels of - Answer- prevotella intermedia Generalized Aggressive Periodontitis - Answer- At least *3* permanent teeth other than the *1st molar* and *incisors* are involved Localized aggressive periodontitis - Answer- -Disease that begins at age 11 to 13 with strong familial tendency - attachment loss at first molars and incisors - AA bacteria Hyperthyroidism - Answer- Graves disease - most common, goiter and exopthalmos Plummer's disease - multiple adenomas of the thyroid gland, exopthalmos is rare Hypothyroidism - Answer- myxedema - puffiness of face and eyelids, swelling of tongue and larynx cretinism - in a child, severe mental retardation, large tongue, under-developed mandible, over-developed maxilla, delayed teeth eruption and deciduous teeth retained longer hyperparathyroidism - Answer- common complaint of kidney stones; osteoporosis and giant cell granulomas, usually caused by adenoma but could occur if there is excessive loss of calcium in the urine (parathyroid will increase in size to compensate) Clinically - cystic bone lesions(Recklinghausen's) Hypoparathyroidism - Answer- usually due to accidental excision during thyroidectomy, congenital (DiGeorge's syndrome) Pituitary diseases - Answer- excess (from adenoma) - acromegaly (giganitism if before growth plates fuse) too little - achondroplasia (dwarfism) osteogenesis imperfecta - Answer- inherited condition when bone formation is incomplete, leading to fragile, easily broken bones blue sclera bulbous crowns, obliterated pulps, narrow short roots Hypophosphatasia - Answer- Rare metabolic bone disease characterized by the deficiency of alkaline phosphatase Paget's disease - Answer- a bone disease of unknown cause characterized by the excessive breakdown of bone tissue, followed by abnormal bone formation cotton wool appearance osteomalacia - Answer- disease marked by softening of the bone caused by vitamin D deficiency Adult or children (Ricket's) Cleidocranial dysplasia - Answer- Delayed tooth eruption Retention of primary teeth Supernumerary teeth hypoplastic/aplastic clavicles Pierre Robin Syndrome - Answer- Syndrome of oral facial abnormalities, micrognathia (a small jaw) and glossoptosis (tongue often blocks airway). Cleft palates are common. Difficulty maintaining the airway frequently causes feeding problems. cherubism - Answer- -benign -radiolucencies in all 4 quadrants -symmetrical, firm, jaw swellings of the jaw -Males -self limiting... will resolve later in life -histologically the same as CGCG -radiotherapy contraindicated -possible early exfoliation of primary teeth and delayed eruption of permanent cystic fibrosis - Answer- often have stained teeth (due to tetracycline use) and greatly reduced caries risk multiple neuromas of the oral cavity, medullary carcinoma - Answer- Men III syndrome SSC involving lymphoid tissues in the tonsils - Answer- lymphoepithelioma, very poor prognosis symmetrically widened PDL space around teeth and sun-burst appearance - Answer- osteosarcoma moth eaten bones, adolescent boys - Answer- ewings sarcoma Punched out lesions, elevated bence-jones protein - Answer- Multiple myeloma (plasma cell myeloma) 4 types of melanoma - Answer- superficial spreading - radial & vertical growth phase, most common nodular - no radial growth phase lentigo maligna - very slow growing, elderly acral lentiginous - on hands and feet amelogenesis imperfecta types - Answer- Type 1 - hypoplastic: not enough or sometimes any enamel, defective enamel matrix Type2 - hypomaturation: enamel can be pierced by explorer and chipped away , immature crystallites Type 3 - hypocalcified: correct amount but soft and wipes off with prophy cup, defective mineralization dentinogenesis imperfecta - Answer- incomplete or improper development of dentin tissue, bulbous crowns, narrow roots, obliterated pulp Type 1 - pts with osteogenesis imperfecta, blue sclera Type 2 - most common, only dentin involvement Type 3 - Brandywine type, only dentin involvement, multiple pulp exposures in primary dentition Dentin Dysplasia - Answer- "rootless teeth", pulpal obliteration, PARLs, early exfoliation white patch on the buccal mucosa that goes away when stretched - Answer- leukoedema Hairy Leukoplakia - Answer- White, rough patch that arises on the lateral border of the tongue. Usually seen in immunocompromised (HIV) and is due to Epstein Barr Virus papillae of tongue - Answer- filiform - most numerous, no taste buds fungiform - have taste buds circumvallate - least numerous, have taste buds foliate - folds on the lateral margins, have taste buds Peutz-Jeghers syndrome - Answer- Hamartomatous (benign) polyps throughout GI tract and mucocutaneous hyperpigmentation (freckle-like spots) on lips, oral mucosa, and genital skin; autosomal dominant disorder Chronic Myelogenous Leukemia (CML) -