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DE5060

2 Hours

The University of Manchester

Degree of BDS, Final Examination


Clinical Dentistry II
Tuesday 30th May 2006
9.45 11.45

All questions should be answered.

All questions are of equal value. Please write your answers in the spaces
provided. Answers written outside the provided spaces will not be marked.

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The use of electronic calculators is not permitted.


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Page 1 of 22

DE5060

1.

A three year old involved in an accident in a playground intrudes the two

upper primary incisors so that only a third of the crown is visible.

a)

What would be your immediate care? (5 marks)

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b)

What are the potential consequences to the developing permanent incisor

teeth? (5 marks)
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Page 2 of 22

DE5060

2.

An 8 year old child attends your practice for the first time. You consider

providing fissure sealants.

What are your indications for offering fissure sealants? (10 marks)
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Page 3 of 22

DE5060

3.

You examine a fifteen year old patient for the first time and notice that she

has has a number of missing permanent teeth. The parent asks you to give the
possible reasons for the teeth not being present.

Give five possible reasons for the missing permanent teeth. (10 marks)
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Page 4 of 22

DE5060

4.

Radiographs are essential in endodontic treatment.

a)

When would you take periapical radiographs during normal endodontic


procedures? (3 marks)

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b)

What features of significance can be determined from these periapical


radiographs? (7 marks)

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Page 5 of 22

DE5060

5.

A 19 year old female presents with a left sided facial swelling related to

pericoronitis around her lower third molar.

a)

Give three other clinical features of pericoronitis that may be present? (3


marks)

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b)

Describe your immediate management (3 marks)

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c)

Give four reasons for the removal of third molar teeth (4 marks)

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Page 6 of 22

DE5060
6.

A 34 year old female presents with intense pain following the extraction of
her lower first permanent molar.

a)

What is the most likely cause of her pain? (2 marks)

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b)

Give four factors that may have predisposed to this patient's condition (4
marks)

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c)

Outline your management of this patient. (4 marks)

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Page 7 of 22

DE5060
7.

A patient complains that his teeth are wearing down.

a)

What are the three main causes of tooth surface loss? (3 marks)

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b)

Describe the typical appearance of the teeth associated with an excessive

consumption of carbonated soft drinks. (5 marks)


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c)

How would you distinguish the wear described in b) from other causes? (2

marks)
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Page 8 of 22

DE5060
8.

You are fitting a full coverage gold crown to a lower first molar tooth and

the crown will not seat fully.

Give five possible reasons why the crown will not seat fully and in each case
explain your subsequent management. (10 marks)

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Page 9 of 22

DE5060
9.

A 12 year old patient attends with a missing upper left canine which you

suspect may be displaced palatally.

a)

How do you confirm your diagnosis? (6 marks)

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b)

It is confirmed that the tooth is palatally displaced. Give four possible


treatment options for the management of this tooth. (4 marks)

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Page 10 of 22

DE5060
10.

A patient has an upper central incisor inside the bite. You decide to

construct an upper removable appliance to procline the incisor over the bite. The
appliance has been constructed and the patient is now attending for you to fit this
appliance.

What are the stages you would go through at this visit?

(10 marks)

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DE5060
11.

IOTN is being used increasingly in the NHS, and all dentists need to be

familiar with it.

a)

What does IOTN stand for? (1 mark)

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b)

What are its constituent parts? (1 mark)

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c)

Give four uses of IOTN? (4 marks)

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d)

Give four limitations of IOTN? (4 marks)

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Page 12 of 22

DE5060
12.

A forty-five year old man presents with white striated lesions on the buccal

mucosa

a)

Give the characteristic histological features of oral lichenoid mucositis (3


marks).

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b)

Describe the typical clinical features of cutaneous lichen planus including


sites (3 marks).

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c)

Give two general and two local causes of lichenoid reaction (4 marks).

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Page 13 of 22

DE5060
13.

A seventy year old woman presents with dry mouth and you suspect that

she has Sjogrens syndrome.

a)

Give four autoimmune (connective tissue) diseases that may be part of


secondary Sjogrens syndrome (4 marks).

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b)

Give three potential complications of xerostomia (3 marks).

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c)

Describe three histological changes seen in salivary glands in Sjogrens


syndrome (3 marks).

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Page 14 of 22

DE5060

14.

In the examination of patients with periodontal disease it is necessary to

differentiate between chronic gingivitis and chronic periodontitis.

a)

What is the main clinical finding that differentiates between these two
conditions. (3 marks)

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b)

Give the three histological features that are diagnostic for chronic
periodontitis. (3 marks)

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c)

Give two examples of periodontal pathogens found in the red complex

described by Socransky and Hafferjee. (4 marks)

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DE5060
15.

Adjunctive antimicrobial therapy is an established treatment modality in

periodontal therapy. The antimicrobials may be delivered systemically or locally.

a)

Give four disadvantages of the systemic antimicrobial therapy. (4 marks)

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b)

Give four advantages of local delivery antimicrobial agents. (4 marks)

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c)

Give a prescription for a suitable systemic adjunctive antimicrobial


regimen for a patient with generalised aggressive periodontitis (2 marks)

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Page 16 of 22

DE5060
16.

Type 1 and 2 Diabetes are well established risk factors for chronic

inflammatory periodontitis.

a)

Give four ways in which Type 1 and 2 Diabetes modifies the host

response. (8 marks)
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b)

How does the subgingival flora differ between a diabetic patient and a non

diabetic patient? (1 mark)


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c)

What factor other than plaque control will influence the outcome of

periodontal therapy in a Diabetic patient? (1mark)


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Page 17 of 22

DE5060
17.

a)

A 50- year old man has denture stomatitis

What clinical features are usually observed in the affected mouth? (4


marks)

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b)

How might you treat this condition? (5marks)

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c)

What is the organism most commonly isolated from denture plaque in


patients with denture stomatitis? (1 mark)

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Page 18 of 22

DE5060

18.

A 65 year old patient has been successfully wearing full dentures for a

number of years. You decide to provide him with replica dentures,

a)

Give two indications for the prescription of replica dentures (2 marks)

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b)

Describe the clinical stages in the construction of replica dentures. (8


marks)

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Page 19 of 22

DE5060
19.

A 48 year old patient is diagnosed with chronic osteomyelitis following the

extraction of a lower left first molar tooth many weeks ago.

a)

Describe the clinical features of the condition. (4marks)

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b)

Describe the radiological features of the condition. (4marks)

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c.

Outline the management of this patient. (3 marks)

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Page 20 of 22

DE5060

20.

Within general practice practitioners have to comply with two sets of

radiation protection legislation.

a)

Name the two sets of radiation protection legislation (4 Marks).

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b)

Which of these two regulations relates principally to the protection of

workers and the public, but also addresses the equipment aspects of patient
protection? (2 Marks)

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c)

State which governmental body oversees these regulations: (1 Mark)

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d)

Which of these two regulations relates to patient protection? (2 Marks)

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e)

State which governmental body oversees these regulations: (1 mark)

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