5th year BDS IX Semester February 2019 - CONSERVATIVE DENTISTRY AND ENDODONTICS, BPKIHS

15th FEB 2019

B.P. Koirala Institute of Health Sciences, Dharan, Nepal

5th year BDS

IX Semester Internal Assessment, February 2019

Paper - III 

(CONSERVATIVE DENTISTRY AND ENDODONTICS)

Time - 1 Hour 20 minutes

 Total Marks: 60

SHORT ANSWER QUESTIONS

SECTION - 'A'

Maximum Marks - 30

1.  Discuss Gingival Marginal Trimmer with its number, use, and way to identify the sides.   (5)

2. Discuss the component present in 5th generation Bonding agent, Hybrid layer and ways to get a better Hybrid layer. (5)

3. Discuss the management of mercury pertaining to environmental issues using a flow chart. (5)

4. Write briefly about lateral condensation. (5)

5. What is crown down preparation of the root canal? (5)

6. What Precautions are to be taken to prevent ledging and apical transportation of root canals?
(5)

SECTION 'B'

MODIFIED ESSAY QUESTIONS

Maximum Marks: 30

I. A 42-year female patient visited dental OPD with severe spontaneous pain in the right upper back region of mouth for 5 days. Patient avoided chewing food from right side due to pain for several months.
Q1. Enlist the several causes of intraoral pain. (3)

Upon examination, there was poor oral hygiene, bleeding on probing, carious lesion in 15,16,17. IOPAR revealed dental caries in 15, deep dental caries approximating pulp in 16,17. 
Q2. Describe the investigation process to diagnose the case. (3)
Q3. Mention the diagnosis of the case. (2)
Q4. Outline the treatment plan. (2)

Prompt diagnosis and removal of the reservoir of infection are important for treatment of endodontic infections. 
Q5. Explain the crown down pressureless technique with its advantages for root canal shaping. (5)

II. Mr. Subash Limbu, 18-year male from Dharan-7, came to the Department of Conservative Dentistry and Endodontics with the chief complaint of decayed tooth on the left lower jaw region. He noticed a blackish discoloration on the chewing surface of left lower first molar yesterday evening during brushing and being a British Army aspirant, he didn't wan't to take any chances. So, today, he showed up for a checkup. After brief history, general examination was carried out. 
Q6. Outline the method for oral examination. (2)

On examination, the dentist noticed white spots over upper anterior teeth, and features associated with increased caries risk.
Q7. Mention the method for diagnosing a white spot. (2)
Q8. Describe the clinical examination findings associated with increased caries risk. (5)
Q9. Outline the treatment strategies in caries prevention program. (5)
Q10. Best measures for preventing both caries and periodontal disease are? (1)

***

#MCQ 21 - During the Master cone fitting procedure in the endodontic treatment of a patient's tooth, the patient says he has a "sharp shooting pain in the same tooth that ached earlier". What should be your response and why?

#MCQ 21- During the Master cone fitting procedure in the endodontic treatment of a patient's tooth, the patient says he has a "sharp shooting pain in the same tooth that ached earlier". What should be your response and why?

A. Continue with obturation, the anesthetic is simply wearing off
B. Continue with obturation, this is a normal complaint during this part of the procedure
C. Consider looking for an accessory canal and re-filing, there is likely pulpal tissue that has not been properly debrided
D. Irrigate further, the Sodium Hypochlorite should take care of this problem
E. Temporize the tooth and obturate at a later date

Answer: C. Consider looking for an accessory canal and re-filing, there is likely pulpal tissue that has not been properly debrided

This indicates inadequate debridement, as a pulpless tooth should not respond to any stimuli.
The most important consideration before filling a root canal is proper cleaning (debridement)and shaping (instrumenting) of the canal. Once the canal is obturated, any organisms
that have entered the periapical tissues from the canal are eliminated by the natural defenses
of the body.

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Dentosphere Gems - Must Know Points in Oral Surgery

MOST COMMON:

1. The most common cause of anemia is iron deficiency due to decreased intake of essential compounds, viz. vitamin B1, B6, B12, iron, vitamin C.

2. The most commonly used Bard Parker Blade handle in oral surgery is no. 3.

3. Lagenbeck's retractor is the most commonly used retractor in oral surgery.

4. There are three work principles applicable to the elevators, viz. Lever principle, Wedge principle and Wheel and axle principle. Lever principle is the most commonly used principle.

5. The half circle curved needles are the most commonly used needles in oral surgical procedures.

6. Vicryl plus antibacterial suture is the world’s first and only antibacterial suture, which offers protection against bacterial colonization of the suture. It contains Triclosan which is a broad spectrum antibacterial agent and effective against the most common pathogens associated with surgical site infections.

7. Interrupted Suture is the most commonly used Suture.

8. Tetracyclines are the most common antibiotics responsible for causing superinfection, because they cause marked suppression of the normal intestinal flora.

9. The dentigerous cyst is the most common type of developmental odontogenic cyst, making up about 20 percent of all epithelium lined cysts of the jaws.

#MCQ 20 - Gingival Extension for a restoration should be:

#20 - Gingival Extension for a restoration should be:
A. At the gingival crest
B. At least 1 mm above the alveolar crest
C. At least 3 mm above the alveolar crest
D. Doesn't have any relation with the alveolar crest height

Answer: C. At least 3 mm above the alveolar crest
In a proper restoration, gingival margin of restoration should be at least 1 mm occlusal to the free marginal gingiva. Also, the free gingiva is approximately 2 mm coronal to the alveolar crest. So, margin of restoration should be 2mm (biological width) + 1 mm (distance away from free gingival margin) = 3 mm away from the alveolar crest.

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