Rubber Dam

# In Which dental procedure is a rubber dam most indicated?
A. Deep caries
B. Direct pulp capping
C. Indirect pulp capping
D. Preparing a crown

The correct answer is: B. Direct Pulp capping. 

In direct pulp capping, it is essential to have adequate access, visibility, and isolation of the operating field.

Direct pulp capping is indicated if a pin-point pulp exposure is made during cavity preparation.

Teeth should be properly isolated to avoid saliva and bacterial contamination during direct pulp caps.

Proper isolation of the operating field also allows proper sealing of the cavity of the tooth. 

Single most important factor in producing cariogenic plaque

# The single most important factor in producing cariogenic plaque is:
A. High amount of glucose exposure
B. High frequency of glucose exposure
C. High amount of sucrose exposure
D. High frequency of sucrose exposure

The correct answer is: D. High frequency of sucrose exposure.

High-frequency exposure to fermentable carbohydrates such as sucrose may be the most important factor in producing cariogenic biofilm and ultimately caries lesions. Frequent ingestion of fermentable carbohydrates begins a series of changes in the local tooth environment, essentially changing the composition of the biofilm, thus favoring the growth of highly acidogenic bacteria that eventually leads to caries lesion formation. In contrast, when ingestion of fermentable carbohydrates is severely restricted or absent, biofilm growth typically does not lead to caries lesions.

Sucrose in particular allows the formation of extracellular polysaccharides, which render the biofilm viscous and sticky. Because the eventual metabolic product of cariogenic diet is acid, in addition to caries lesions the exposure to acidity from other sources (e.g., dried fruits, fruit drinks, or other acidic foods and drinks) also may result in dental erosion.

Liquid system of glass ionomer restorative material

# The liquid system of glass ionomer restorative material is essentially:
A. Polyalkanoic acid
B. Phosphoric acid
C. Polyacrylic-itaconic acid
D. Hydrochloric acid

The correct answer is C. Polyacrylic-itaconic acid.

COMPOSITION OF GLASS IONOMER CEMENTS

Powder/liquid materials

Powder -  Sodium aluminosilicate glass with about 20% CaF and other minor additives

Liquid - Aqueous solution of acrylic acid/itaconic acid copolymer or Aqueous solution of maleic acid polymer or maleic/acrylic copolymer and Tartaric acid in some products to control setting characteristics

Powder/water materials

Powder - Glass (as above) + vacuum-dried polyacid (acrylic, maleic or copolymers)

Liquid - Manufacturers supply a dropper bottle which the operator fills with water or The manufacturer supplies a dilute aqueous solution of tartaric acid

Toothbrush trauma usually occurs on:

# Toothbrush trauma (cervical abrasion) usually occurs on:
A. Centrals and laterals
B. Canines and premolars
C. Second and third molar
D. First and second molars

The correct answer is: B. Canines and premolars.

Toothbrush trauma (abrasion) usually occurs on teeth that are the most prominent in the dental arch.

Trauma from toothbrushing may result in the following:

• Recession of the marginal gingiva

• Lacerations of the soft tissues including the attached gingiva and the alveolar mucosa

• V-shaped notches in the cervical areas of teeth

• Gingival clefts: which are narrow grooves that extend from the crest of the gingiva to the attached gingiva

The location of the above alterations is frequently inversely related to the right or left handedness of the patient.