RED FONT = ANSWERS ADDED AFTER RESEARCH; Green Highlighted # = REPEAT QUESTION ​ ​ May 2019: 1.Molecular mechanism for HPV (inactive protongene)? Inactivate proto-oncogene P53 ​ Expression of high-risk HPV E6 and E7 genes in primary human keratinocytes effectively ​ ​ facilitates their immortalization (59, 96). ... They can undergo malignant progression after extended growth in tissue culture or when additional oncogenes such as ras or fos are expressed ​ ​

2. Insulin- fastest acting insulin but shortest duration of action Fast acting insulin includes lispro, aspart (NovoLog), Glulisine (Apidra)

3. Articaine max carpule for 150 lb guy = 6 carpules ​ Max dose is 3.2mg/lb or 7mg/kg Math ---> (3.2mg x 150lb )= 480mg for max dose, now since Articaine is 4%, it becomes 40mg/ml. Now you will do (40mg/ml x 1.8ml)= 72mg a carpule. So do 480mg/72mg= 6.666 and round down to 6 carpules max.

4. Recommended tylenol dosage for kid (10-12mg per kg every 3 hours, 25 mg for every 6 hours) 10-15mg q 4-6 hours

5. polyacrylic acid GI component Glass-ionomer cements are based on the reaction of silicate glass-powder (calciumaluminofluorosilicate glass) and polyacrylic acid, an ionomer. ​

6. Molar uprighting (why difficult in adults) Will cause interference in occlusion/need to fix occlusion

7. Transposition (canine in lateral spot) ​

8. 38%N2O, how much is nitrogen? 25.3% Nitrogen ​ N2O is made up of 3 molecules total, and the nitrogen is 2 of the 3 molecules for 1 N2O so therefore the % of nitrogen would be ⅔ of the total % of N2O. Math → (⅔) x 38% = 25.3% of Nitrogen ( & therefore 12.7% Oxygen)

9. Ameloblastic fibro- odontoma picture

10. which teeth get caries first in children: incisors and 1st molars ​

11. if doing a prep and pulpal floor is perpendicular, which likely to expose? max 1st molar (medial ​ ​ ​ inclination of Max 1st molar makes it more susceptible to pulpal exposure)

12. what is wheezing? inflammation/vibration ​ Difficulty exhaling

13. amount of epi that you give % for anaphylaxis? 0.3% ​ 0.2-0.5mL for adults ; 0.01 mL for kids

14. Non rigid 6 unit, when can you use? (in pier FPD) ​ ​

15. what is the best casting for RPD? Strongest removable framework (gold-pallidium titanium), Type 4 Casting

16. External splinting favored over internal splinting why? Less reduction; allow healing of the PDL, ​ maintain tooth position

○ Internal Splint – inside cavity pre ○ External Splint – No involving tooth preparation, usually confined to anterior teeth – allow healing of the pdL, maintain tooth position

17. class II ANB is larger ​

18. labial bow, what does that do? Labial bow in retainer retrudes the anterior teeth

19. Calculate attachment loss Determine attachment loss by calculating measurement of CEJ to sulcus (depth of pocket) ​ Ex. recession is 2mm and probing depth is 1mm, attachment loss = 3mm

20. what most likely to injure during distal wedge? Lingual nerve ​

21. what teeth are anesthetized when IANB? Long buccal? IANB anesthetize mandibular teeth and surrounding hard and soft tissue up to the midline (does not reach buccal soft tissue of molars) ​ ​ Long buccal gets the buccal soft tissue of molars

22. Pt is getting a buccal vestibulopathy, what kind of dissection would you do? Supraperiosteal ​

23. If you give someone bag ventilation not connected to oxygen, what is the amount of oxygen they’re receiving- 21% ​

24. Proportional relationship of width of pontic in FPD related to the width of the fpd span ​ ​

25. Bacteria that causes root caries - Strep Mutans, Lactobacillus, Actinobacillus ​

26. Molar tipping- most common negative effect - occlusal interference ​ ​ ​

27. Primary teeth most involved in perio - 1st mandibular molar ​

28. Half life calculation

29. Why do you aspirate bone lesion before surgical exploration- To check if its a vascular lesion ​

06/05/19:

1.know pterygomandibular raphe and muscle junctions The pterygomandibular raphe (pterygomandibular ligament) is a ligamentous band of the ​ ​ ​ ​ buccopharyngeal fascia, attached superiorly to the pterygoid hamulus of the medial pterygoid plate and inferiorly to the posterior end of the mylohyoid line of the mandible. ● Its medial surface is covered by the mucous membrane of the mouth. ​ ​ ● Its lateral surface is separated from the ramus of the mandible by a quantity of adipose ​ ​ tissue. ● Its posterior border gives attachment to the superior pharyngeal constrictor muscle. ​ ​ ● Its anterior border attaches to the posterior edge of the buccinator. ​ ​

2. Border molding lingual flange - MYLOHYOID ​

3. radiograph of pterygomaxillary fissure- teardrop ​

4. Eagle syndrome - calcified stylohyoid ligament ​

5. radiograph stylohyoid ​

6. know ectodermal dysplasia- congenital anodontia/ hypodontia, sweat hair and skin gland ​ problems

7. % roots of MB root maxillary molar Maxillary 1st molar: 40% for 3, 60% for 4 Maxillary 2nd molar: 60% for 3 and 40 % for 4 Mandibular 1st molar: 70 % for 3, 30% for 4 Mandibular 2nd molar: 90 % for 3 and 5% for 4

8. rectangular wire in orthodontics - advantage is rotation of crown and root ​ Control crown and root movement - torque

9. know desensitization a treatment or process that diminishes emotional responsiveness to a ​ negative, aversive or positive stimulus after repeated exposure to it. Systematic desensitization- 3 steps: Construct a hierarchy, relaxation exercises, associate components of hierarchy with relaxation state

10. what does tin do in porcelain making? (has something to do with corrosion in amalgam) (In PFM, the metal has indium which is tin and iron - oxidative elements for porcelain to bond with alloy) - provide chemical bonding ​ 11. diabetic patient what do you tell him prior to IV sedation? (TQ- about eating and medications) No ​ eating or taking medication prior to sedation

12. ALOT of endo and ethics

13. Where is the A in cephalometric SNA - the deepest point in the maxillary concavity ​

14. know how to treat cytomegalovirus - Ganciclovir or valacyclovir ​

15. two questions on ectodermal dysplasia - sparse hair; missing teeth ​ ​

Ectodermal dysplasia = X-linked conditions in which there are abnormalities of 2 or more ectodermal ​ structures (ex. Hair (sparse hair), teeth, nails, sweat glands (will have hypohydrotic child = sweating dysfunction, abnormal reduction of sweating due to heat), salivary glands, cranial-facial structure, digits). During tooth bud development, it frequently results in congenitally absent teeth (in many cases, a lack ​ ​ ​ ​ ​ of a permanent set and/or in the growth of teeth that are peg-shaped or pointed.

Teeth develop abnormally causing anodontia or oligodontia (partial). Retained primary teeth. ​ ​ CONICAL shaped anterior teeth.

● Having hypodontia (FEWER number of teeth) will cause alveolar bone deficiency (prevent/undermine formation of alveolus) ● Less teeth, reduced alveolar ridge development so the vertical dimension of the lower face is reduced

16. radiograph showing dentinal dysplasia - normal color teeth, PARL, Short blunted apices ​ ​

17. adrenal gland for hair loss ​

18. drug that prevents bleeding and fibrinolysis after surgical extraction - Tranexamic Acid? ​

19. know ludwigs angina - emergency Serious bilateral cellulitis (CT infection) of the floor of the mouth (submandibular and sublingual spaces), if left untreated may obstruct the airways and has complications including edema of glottis.

20. kid skeletal class 3 what most likely decreases with age? ANB ​ ​ ​

21. gingival floor most likely recurrent caries ​ ​ ● Gingival margin of class II through class V restorations is where the recurrent caries showed up the most

22. better fracture resistance for amalgam: beveling Axio-Pulpal line angle ​ ​ ​ Resistance: 1st = Flat floors, rounded angles (bevel in axiopulpal line angles to reduce stress and ​ increase resistance) Retention: 1st = BL walls converge, 2nd = retention grooves/occlusal dovetail ​

23. Dovetail or beveling axio-pulpal line angle - Dovetail occlusal = retention for amalgam ​ ​ - Beveling axio-pulpal line angle = resistance of fracture for amalgam ​ ​

24. know substance P relation to opioids- substance P is pain receptor that is blocked by opioids ​ - Both endogenous opioids and somatostatin inhibit the release of substance P from central and peripheral endings.

25. Mandibular NOT Maxillary related to ear pain - high occlusion can refer pain to ear ​

26. Potassium (K+) sparing diuretics (Midamor, Dyrenium) ​

27. Lisinopril causes unproductive cough? Yes, Its an ACE Inhibitor. ​

28. Disadvantage of band and loop------> No vertical occlusal stop ​

29. Posterior cross bite, where you should place the bands Lingual of maxillary and buccal of ​ mandibular

30. Slob rule with vertical angulations - if same direction its lingual ​

31. What palatal groove is associated with the most periodontal disease? Palatogingival groove (or ​ radicular lingual groove (RLG)) most common on maxillary lateral incisors

32. Bisphosphonates - for multiple myeloma ​

33. OS Instruments: -Max lateral - #65 Bayonet-shaped forceps or #150 maxillary universal forceps ​ ​ -Premolar- Mandibular → #74 ash forcep or #151A; Maxillary → #150 max universal ​ -Cryer elevator and east/west elevator - to remove root tips in mandibular molars ​

Day 2 is case studies: some said they kinda got rocked and the questions dealt a lot with Orthodontics. ​

(6/05/19): -didn’t get specific questions from her (not that close to her lol) but did get the name of the docs she studied from and she said she had about 40% TQs from those on Day 1 but No TQs for Day 2 and that it was hard. -there was a lot of oral path and pharm -i also had a lot of ethics so reading the ADA code is really your best bet June 2019:

1.Know gemination, fusion and transposition

Gemination: Tooth gemination is a dental phenomenon that appears to be two teeth developed from ​ ​ ​ one. There is one main crown with a cleft in it that, within the incisal third of the crown, looks like two ​ teeth, though it is not two teeth. The number of the teeth in the arch will be normal. (1 root 2 crowns) ​ ​ ​

Fusion: Union of two adjacent teeth in both primary and permanent dentitions. The number of teeth in the ​ ​ arch will be one less. (2 roots 1 crown) ​ ​ Transposition: is used to refer to an interchange in the position of two adjacent teeth within the same ​ ​ ​ quadrant of the dental arch. ​ ​ Question: What is seen here? It was canine and PM switched positions. Transposition ​ ​

2.Know canine guidance classifications! A picture asking me what it was and mine was Class 2 ​

• Class I—the maxillary permanent canine should occlude directly in the embrasure between mandibular canine and first premolar.

• Class II—the maxillary permanent canine occludes in front of the embrasure between mandibular canine and first premolar.

• Class III—the maxillary permanent canine occludes behind the embrasure between mandibular canine and first premolar.

3.how do sealants bond on enamel? Mechanical ​ 4.Many questions with endo diagnosis of pulpal and apical. They were so easy and straightforward just know differences

○ know the symptoms for reversible, irreversible, and whether its necrosis. ■ Reversible Pulpitis: inflammation should resolve and the pulp return to normal; ​ response to thermal testing is severe, momentary pain lasting 1-2 sec after removal of stimulus ■ Symptomatic Irreversible Pulpitis: vital inflamed pulp is incapable of healing. ​ Additional descriptors include: moderate to severe pain that lingers from thermal testing, spontaneous pain, referred pain. ■ Pulp Necrosis: indicates death of the dental pulp. The pulp is usually ​ nonresponsive to pulp testing. ○ Know that percussion is how you diagnose if its symptomatic apical perio ​ ​ ​ ○ Know chronic perio has a sinus tract ​ ​ ​ ○ Know EPT doesn’t give you pulpal status nor does it not give you pulp health. ​ 5.Patient with HIV gets refused for treatment by dentist, what does this violate from ADA code of conduct? Justice ​ ○ (Know ALL codes of conduct I had diff examples about 7 questions)

6.Patient had crown and want to check pulpal diagnosis. What do you use? Thermal Test ​ 7.How to distinguish endo lesion from perio lesion? Percussion ​ 8.Silane coupling agents will bind with hydroxyl groups in filler. ​ ● The silanols coordinate with metal hydroxyl groups on the inorganic surface to form an oxane bond with elimination of water.

9.What is EDTA? Chelating agent- removes smear layer (inorganic material) ​ ​ 10.What causes ankylosis? Replacement resorption ​ 11.After RCT, you make a post space with drill and use paper point to dry canal. You see blood on paper point what does that mean? Ledge formed (was only option that would lead to a perforation) ​ ​ 12.Light transillumination shows both cracked tooth & craze lines* ​ ○ Used for diagnosing cracked tooth. ○ Cracked tooth → only half of the tooth will light up (until it hits the fracture line) ○ Craze lines → the entire tooth will light up still

13.Max dose for 2% lidocaine with 1:100,000 epinephrine? 7 mg/kg for adult; 4.4 mg/kg for pediatrics ​ 14.Critical pH of developing cavity? pH 5.5 ​ 15.What incision do you do on an edentulous patient to remove tori?Incision on ridge near tori and flap ​ it

○ Vertical flaps ○ Incision on the tori ○ Incision on ridge near tori and flap it (I chose this because I know you avoid vertical ​ flaps on lingual because of Lingual n injury. You also don’t flap right on top of tori.) if patient has teeth the answer would include an incision around teeth in sulcus and then flap it.

16.What dental anomaly would result in a delay of eruption? Dilaceration ​ 17.Which represents position on the spectral wavelength? Hue ​ 18.When get infection in premolar mandibular area and lingual plate is intact and drains where? Buccal ​ area?

○ Submental area (my brain was fried at this point and I was in between this and buccal area so didn’t care just chose this but not sure) ○ Submandibular area-----> would only drain here only if the tooth was a 2nd Molar or 3rd ​ molar that have their roots BELOW the mylohyoid m. and the LINGUAL plate gets perforated from the periapical infection. ​ ○ Sublingual area-----> would only drain here only if the tooth was a mandibular PM and 1st ​ Molar that have their roots ABOVE the mylohyoid m. and the LINGUAL plate gets perforated from the periapical infection. ​ ○ Buccal area------>should be this answer because the lingual plate was intact so it ​ ​ could not have drained in any of the areas listed above other than the buccal area.

19.Random questions, like what's "Shaping" for Behavioral management - providing positive ​ reinforcement for the approximation of behavior you are trying to achieve

20.Difference in primary root size and permanent? Slender and longer roots ​ 21.What lesion if it involved a tooth would widen the pdl? Osteosarcoma ​ 22.Mandibular molar had 3 canals, took xray from mesial aspect what’s the order you see the canals? Mesial lingual-mesial buccal-distal

23.Primary teeth most often involved in perio? 1st mandibular molar ​ ​ 24.Another question order of primary teeth most affected by caries (listed in order) 1st Mandibular ​ ​ ​ Molars > 1st Maxillary Molars > 2nd Mandibular Molars > 2nd Maxillary Molars

25.3 loss of attachment calculations - like probing 6mm, FGM 2mm apical to CEJ how much attachment was lost? 8mm ​ 26.The proportional relationship of the width of the pontic in FPD. related to the width of the fpd span ​ ​ 27.what bacteria initiates caries? S. mutans ​ 28.What bacteria progresses caries but doesn’t initiate them? lactobacillus ​ 29.bacteria in perio of pregnant lady? Prevotella intermedia ​ 30.Molecular mechanism of HPV? MOA for DNA Virus – inhibit proto-oncogenes P53, and works on ​ ​ human keratinocytes

31.articaine max carpules for 154 lb? 6 carpules ​ ​ ○ Articaine (4%) – 7mg/kg max recommended dose ■ 154/2.2 = 70kg ■ 70 x 7mg = 490 ■ 490/72 = 6.88888

32.Recommended tylenol dose for kids per day (25-50 3x a day?)? 5x daily Tylenol (10-15mg every 4-6 ​ ​ hours)

33.Something about a buccal vestibulopathy what kind of dissection? supraperiosteal ​ ​ ○ Vestibuloplasty – can be performed to increase the depth of the vestibule using skin grafts – used for denture/RPD fabrication ○ Incision made on the alveolar ridge and a supraperiosteal dissection is made to the depth.

34.Insulin short acting = lispro, Aspart & Glulisine ​ ​ ○ Short Acting: Lispro (15mins), Aspart (15min), Glulisine (15min) ○ Long Acting: NPH (1-4hr), Glargine (1-4hr), Detemir (1-4hr)

35.Glass ionomer polyacrylic Acid → is the ionomer portion of the GI ​ ​ 36.A couple questions on molar up righting → will cause interference in occlusion/need to fix ​ ​ occlusion

37.A few questions on glass ionomer (advantages/how it works)

○ Low stress bearing areas ○ Less wear resistance ○ Releases fluoride ○ High Caries Risk patients – Class V

38.Labial bow does what? Labial bow in retainer retrudes the anterior teeth ​ ​ ○ Is present anterior to the maxillary incisors, extending distally to eliminate the pressure from the buccal musculature – metal part that lays flush across the anterior incisors.

39.One advantage of External vs internal splint? allow healing of the PDL, maintain tooth position ​ ​ ○ Internal Splint – inside cavity pre ○ External Splint – No involving tooth preparation, usually confined to anterior teeth – allow healing of the pdL, maintain tooth position

40.Class 2 girl ANB will be larger? ANB ​ ​ ○ ANB – 2 to 4 degrees Class I ○ >5 degrees Class II ○ <1 degree Class III

41.Epinephrine Amount for anaphylaxis? 0.3 ​ ​ ○ 0.2 to 0.5 adults to treat anaphylaxis ○ .01 mL kids to treat anaphylaxis

42.Tipping questions (ortho)

○ Easiest/fastest tooth movement ○ Center of rotation at root apex

43.Most common reason to not do distal wedge? Not enough keratinized tissue ​ ​ ​ 44.What gets numbed with IAN and what gets numbed with lingual?

○ IAN – Everything, but soft tissue of the molars ○ Lingual - lingual gingiva and adjacent mucosa of the mandible

45.Bohn nodules

○ Multiple small gingival nodules resulting from cystification of rests of dental lamina. ○ Cysts of newborns

46.Macrocytic anemia is vitamin B deficiency ​ ○ Microcytic – Iron deficiency ○ B-12 – Pernicious anemia ○ Aplastic Anemia – Bone Marrow defect/Not enough new blood cells

47.Why do you bag instruments before sterilizing? To allow them to remain sterilized after the cycle ​ 48.Picture of geographic tongue (it was a picture with only lateral ​ ​ border of tongue showing and looked like similar to SCC but wasn’t they were tricky) it affects the filiform papilla ​

49. X-ray zygomatic process (yellow line on pano →) ​ ​

50.Two different questions pointing to pano saying what is this radiolucent line indicating? Airspace (its when patient doesn’t put ​ tongue on roof of mouth and creates airspace)

51.X-ray transposition (lateral and canine switched in x-ray →) ​ ​ ○ When teeth within the same quadrant switch position – difficult to treat

52.X-ray taurodontism (enlarged pulp chamber as seen below) ​ ​

53.Gingival margin trimmer vs hatchet: Both Enamel Hatchet and Gingival Margin Trimmer are hatches but GMT has curved blade and angled cutting edge while Enamel Hatchet has cutting edge in plane of handle. Main advantage of using GMT is the curved angle of the blade ​ ● Gingival margin trimmer – designed to produce a proper bevel on gingival enamel margins of ​ proximo-occlusal preparations. The blade is curved (similar to a spoon excavator) and the primary cutting edge is at an angle to the axis of the blade. ● Hatchet – The ordinary hatchet has the cutting edge of the blade directed in the same plane as ​ that of the long axis of the handle and is bibeveled; used primarily on anterior teeth for preparing retentive areas.

54.Lots of asthma questions

○ No NSAIDS (aspirin) – contraindicated because they produce leukotrienes that aggravate asthma ○ No Oxygen during an asthma attack - paper bag ○ Brocho-dilator for treatment – Thylophyille, Lovobuterol, ○ Adenosine is contraindicated ○ Aminophiline used to treat severe asthma ○ Wheezing on expiration

55.What exactly wheezing is in asthma patient not just noise on exhalation like how the noise is made

○ Options where about inflammation in bronchioles ○ Narrowing of the airways from swelling, mucous and muscle retention.. When asthmatic patient is breathing out ○ The overreaction or hyper-responsiveness of the airways results in bronchospasm, which is excessive contraction or spasm of the bronchial smooth muscle. The airways also become inflamed with swelling of the bronchial mucous membrane (mucosa) and secretion of excessive thick mucus that is difficult to expel. It is part of the evaluation process to identify the role of each of these physiologic components in asthma.

56.Know what causes orthostatic hypotension: a person's blood pressure suddenly falls when ​ ​ ​ standing up quickly or stretching. Can also be a side effect of nitroglycerin tablets.

57.Crevicular fluid antibody: IgG ​ 58.Most frequent oral cancer that metastasis? Squamous cell carcinoma ​ 59.Peds ortho distal step = class II molar relationship in permanent dentition ​ 60.know the billing stuff (bundling, upcoding, etc).

● Unbundling: separating of dental procedure into component parts with each part having a ​ ​ charge so that the cumulative charge of the components is greater than the total charge to patients who are NOT beneficiaries of a dental benefit plan for the same procedure. ​ ​ ​ ● Bundling: opposite of unbundling & can occur on the insurance carrier end. It’s the systematic ​ combining of distinct dental procedures by third-party payers that results in a reduced benefit for the patient/beneficiary. Ex. dentist charging separately for core build up and crown but insurance company combining the two saying a core build up is part of a crown. ● Upcoding: or overcoding is defined by the ADA as "reporting a more complex and/or higher ​ ​ cost procedure than was actually performed." ​ ● Downcoding: is defined by the ADA as "a practice of third-party payers in which the benefit code ​ has been changed to a less complex and/or lower cost procedure than was reported except ​ ​ ​ where delineated in contract agreements."

61.Pic of ameloblastic fibro-odontoma (to the right →) ​ ​ ​

62.Mostly hypertensive meds, diabetes, and hypothyroidism

63.Mumps transmission includes? Airborne pathogen ​ 64.Why is heparin given IV?

○ Contraindicated IM – due to hematomas, pain ○ To reverse heparin you give protamine sulfate ○ CI with Ginko Biloba

65.If you compare the radiation dose of person working in nuclear power plant and that of a dental assistant (or whoever takes x-ray in a dental setting), how much will the dosage of that person be? 1/5 ​ times of the nuclear worker (question and answer from DanMan file 2019 question 724) ​ ○ 50msv/year (0.05sv/year)– is the standard that people should have (the max radiation dosage for a dental professional per year) ○ Workers of nuclear plant, how much radiation permitted yearly = 5 rem/ 5000 mrem yearly (on average, a nuclear worker receives approx. 150 mrem (0.15 rem) of occupational exposure a year) ○ 1 sv = 100 rem

66.Leukoedema?

○ Bi-lateral opacification of the buccal mucosa ○ Goes away when you stretch it

67. Not a reason why a post would break- because of the material of the post ​ ​ ​ ○ (yes to not enough ferrule, parafunctional habits, occlusion).

68. MOA montelukast- is a selective leukotriene receptor antagonist of the cysteinyl leukotriene ​ ​ CysLT 1 receptor which blocks leukotrienes activities to cause asthma symptoms. ​ ○ Leukotriene receptor antagonist used to treat asthma and seasonal allergies ○ Montelukast inhibits bronchoconstriction due to antigen challenge.

Day 2

1.Old women 86 years old came in with dry mouth, red inflamed tongue with white stuff that wipes off. Her chief complaint was lower left PM area was in extreme spontaneous pain. What was the cause?

○ Xray was pano, you had to squint and see that there was radiolucency around apex, answer was symptomatic apical periodontitis ​ ○ What was her tongue issue? Candidiasis, lichen planus. ​ ​ ○ Her son called and said she fell on ice and chipped composite that was distal of #8, which you again had to squint and see it was small, and only a small composite. What do you do? I said replace composite. Options had full ceramic crown, veneer. I thought ​ ​ since she’s old and it was a small composite you wouldn’t just do a crown for it. ○ What would be the least thing you would use for a placement of crown #18? Field ​ ​ ​ Porcelain crown

2. 25 year old male came in with meds amitriptyline for depression. Chief complaint is lump on post palate. He also had lesions on tongue. cross bite on right.

○ what angle classification is he? ■ Class 1 ■ Class 2 mod 1 ■ Class 2 mod 2 (it was hard to tell but he was def this) ​ ○ What can be done to fix his cross bite? ■ Buccal tipping of max (his teeth were lingually tipped and pushing them buccal ​ would resolve it) ○ Why was his enamel white spotted? ■ Amelogenesis imperfecta ■ Dentinogenesis imperfect ■ Fluorosis ■ I was in between fluorosis and amelogenesis imperfecta. I chose Fluorosis because it didn’t seem so bad like a defect in enamel. Looked similar to this nothing severe

3.Patient came in with cervical lesions and smoking for 22 packs/years with crazy amount of cavities. #8 RCT and lingual amalgam. Know if medications cause xerosomia or was it smoking 22 packs a year.

4.Mechanism of ibuprofen- Non-selective cox-1 & cox- 2 that Reversibly Binds ​ 5.Mechanism of carbamazepine- sodium channel blocker ​ ○ Tx: Trigeminal Neuralgia and Manic depressive illness

6.RPD design which one can’t you do for distal extension of 29. 29 has existing DO composite, what ​ ​ would you do for RPD? Change restoration to amalgam or Survey crown ​ 7.Rita case

8.Man was shot. Wife is his caregiver? because he’s legally incompetent. ​ 9.Old lady with ugly teeth but good bones and gums? gingivitis? ​ ● She also was on a million meds and had impacted third molars and pain in left premolar vestibule and lower lip but couldn’t see shit in pano.. what was the cause of pain? Periocoronitis, abscess of premolar, cyst of third molars referred pain ● Other dentist told old lady to get veneers on 5 and 12, what do you tell her? “If you’re interested ​ in cosmetics let me tell you all your options” 10.Girl with a million piercings in pano, 24 and 25 feel loose? due to trauma of tongue ring ​ ○ first step- patient education ○ identify tongue ring in pano

11.Canine classifications! ​ ○ Class 1: when the mesial slope of the maxillary canine coincides with the distal slope of the mandibular canine. Maxillary Canine sits perfectly in the embrasure space between the mandibular 1st PM and canine.

12.Crossbite due to what?

○ Angle Class III malocclusion usually associated with anterior cross bite ​ ■ Reverse Overjet – Anterior crossbite (usually class III) ○ Posterior Crossbite ■ Dental – patient with adequate palatal width ■ Skeletal – inadequate palatal width ○ Unilateral crossbites are usually due to a mandibular shift

13. Not ideal overjet and overbite due to what? Pacifiers and Finger Sucking or Primary Canine Loss ​ ​ ​ ○ Pacifiers and finger sucking may cause increased overjet, decreased overbite and posterior crossbite ○ Primary canine loss – increased overbite – after lingual collapse, the mandibular incisors erupt further, increasing overbite.

14.Kid with ADHD

○ Medication could be: ■ Methylphenidate (Concerta, Ritalin, Metadate) ■ Nausea, hypertension ■ Atomoxetine (Straterra) ■ Hypertension, dry mouth, nausea ■ Amphetamine/dextroamphetamine (Adderall) ■ Adverse: Dry mouth, headache, nausea, hypertension ○ Treatment Modifications: ■ Depends on age and severity ■ Shorter Appointments ■ Step-by-Step verbal reinforcement

June 2019:

1.Ankylosis → replacement resorption ​ ​

2.Apex closes → 2.5- 3.5 years after eruption ​

3.Freys Syndrome - auriculotemporal syndrome when nerve is damaged causing sympathetic ​ fibers to cause eating and flushing of the face, while parasympathetic fibers cause increase in salivation unilaterally. Use minor’s starch- iodine test. Treatment includes surgery, atropine medication (local injections) and scopolamine creams.

4.Potassium (K+) sparing diuretics: Midamor and Dyrenium ​ ​

5.root caries → glass ionomer ​

6.glass ionomer → zinc oxide (acts as the antibacterial activity when added to glass ionomer cement) ​ ​

7.LED composite light vs halogen curing light: LED curing light faster for curing materials and more ​ ​ lightweight, portable, and effective compared to the halogen curing lights. What is NOT an advantage of LED cure in comparison to Halogen? Curing Depth ​ ● LED: produce a blue light in the 400-500 nm range, with a peak wavelength of about 460nm. ​ They are more lightweight, portable and effective compared to the halogen curing lights. They produce less heat and do not require a fan to cool it. LED curing lights cure material much faster than halogen lamps. Light intensity is 1,000 mW/cm2 ● Halogen: most frequent polymerization source used in dental offices. It provides a blue light ​ between 400- 500nm, with an intensity of 400-600 mW/cm2. Drawbacks include: large amount of heat it generates so it needs a built in ventilating fan, larger unit, must be plugged in (cannot be cordless), time needed to fully cure the material is much more than the LED curing light.

8.Monteleukast leukotrienes - inhibit leukotrienes for the treatment of asthma ​ ​

9.Sulfonamide - compete with PABA in folic acid synthesis, decreasing folic acid ​

10.Sulfonylureas → increase insulin release from beta cells of pancreas ​

11.beta 1 agonist doesn’t do what? Doesn’t act as a smooth muscle relaxant to be used for treating ​ ​ ​ asthma or COPD (that is Beta-2 Agonists job) ● Beta-1 agonist ARE medications that increases the heart rate and blood pressure. Beta-1 agonists stimulate adenylyl cyclase activity and opening of calcium channels. Cardiac stimulants. ● Beta-1 agonists are used for Bradycardia (slow heart rate), Bradyarrhythmias, Acute Heart Failure and Cardiogenic Shock.

12.acute herpetic gingivostomatitis → primary herpes, HSV 1 or 2, children and adults ​ ● Symptoms include: Malaise, fever, lymphadenopathy, vesicles in oral cavity, gingival swelling/erythema, can remain latent, reactivation with UV exposure/ trauma/ immunosuppression

13.infective mononucleosis - EBV ​

14.ludwigs angina → emergency ​ ​ ● Serious bilateral cellulitis (CT infection) of the floor of the mouth (submandibular and sublingual spaces), if left untreated may obstruct the airways and has complications including edema of glottis.

15.cleidocranial dysplasia vs. mandibulofacial Dysostosis (MDF) AKA Treacher Collins Syndrome: With ​ Treacher collins syndrome (MDF) patient will have hypoplasia (missing) zygomatic bone whereas ​ ​ with Cleidocranial dysplasia the patient will have hypoplasia (missing) clavicle. ​ ● Cleidocranial Dysplasia: Multiple unerupted supernumerary teeth, Retention of primary teeth, ​ delayed eruption of permanent teeth, Missing clavicle. It is the delayed ossification of midline structures. Will give you very narrow facial structures. ● Mandibulofacial Dysostosis (MDF) (Treacher Collins Syndrome): Mandibular hypoplasia, ​ malformed ear, lower eyelids, ear pinna. No mental retardation associated with the syndrome. Will have ear abnormalities. Loss (hypoplasia) of the zygomatic bone.

16.whose most likely to need general anesthesia? 2 year old with early childhood caries ​

17.anterior crossbite non skeletal caused by what? Maxillary tipping lingual and mandibular tipping ​ ​ buccal (Angles class III Malocclusion) ● Skeletal deformation: Maxilla not completely developed (most common tooth involved is ​ maxillary lateral, fix this ASAP regardless of age) ● Non skeletal deformation: Maxillary tipping lingual, and mandibular tipping buccal (Angles ​ Class III malocclusion)

18.class III furcation down to within 5mm of apex → extract and implant ​

19.what’s the max dose of lidocaine (in mg) for a 12 year old thats 16 kg? 70.4mg of lidocaine ​ ● Math: 16kg X (4.4 mg/kg) =70.4 mg

June 11th & 12th ***Do Mastermind (everyone who claimed they had the shitty version of the exam and had no TQs later on found out that a lot of the TQs were on this document that they hadn’t looked at…. So basically do Mastermind and Super doc and you will be gucci)

1.Bimaxillary protrusion know what it is. (Two questions) ● one a definition: Bimaxillary protrusion refers to a protrusive dentoalveolar position of maxillary ​ and mandibular dental arches that produces a convex facial profile. both mandibular and ​ maxillary dentoalveolar protruding. ● one was an answer of when to use class 2 correcting maxilla gear? Bimaxillary Protrusion ​

2.Seizures - encephalotrigeminal telangiectasia ​

3.Cognitive restructuring? psychotherapeutic process of learning to identify and dispute irrational ​ or maladaptive thoughts (talking about everything you’re afraid of) ​

4.Ameloblastoma vs fibroma: Ameloblastoma is a true odontogenic tumor whereas Fibroma is a ​ connective tissue tumor that is NOT really a tumor. ● Ameloblastoma: most common TRUE odontogenic tumor, benign but aggressive. Multilocular ​ radiolucency, superimposed over posterior teeth and more common in the posterior mandible. Often associated with impacted teeth. ● Fibroma: most common CT tumor, Reactive, NOT TRUE tumor. Caused by chronic trauma or ​ irritation. Fibrous hyperplasia of oral mucosa. (could be keratinized white nodule on palate) Firm, ​ ​ smooth, pink, elevated papule/nodule. Common site is the TONGUE → due to trauma.

5.Primary first mandibular for most cause of space loss mandibular 2nd molar cause of space loss. ​ ● Premature loss of posterior teeth priority: 2nd Molar > 1st Molar > Canine > Incisor

6.Least recurring: irritational fibroma (is most common CT tumor) AOT (Adenomatoid Odontogenic ​ ​ ​ ​ ​ ​ Tumor)

7.Lamina dura = 6 weeks in utero ​

8.Which one affects saliva production when using alpha? It will act on nicotinic or muscarinic ganglion -Anticholinergics MOA = inhibit binding of acetylcholine to muscarinic and nicotinic receptors. ​ These receptors are found in eye, secretory glands and nerve endings to smooth muscle cells.

9.PMN (Neutrophils) In crevicular fluid of periodontitis ​ ​

10.Which orthodontic appliance is tissue and tooth? Nance appliance (NOT quad helix) ​ ​

11.What doesn’t cause Hypertension? Corticosteroids? - No they cause drug-induced hypertension- TR; ​ ​ ​ maybe Mecamylamine and Hexamethonium that are ganglionic blockers and produce orthostatic HYPOtension? -TR

12.Ethics exceeds legal duties ​

13.Stimulus changes behavior for modification ​ ​

14.What % of MB2 root in maxillary 1st molar? 20,40,60,80 ​ ​ ● Maxillary 1st Molar: 40% for 3 roots, 60% for 4 roots

15. Macroglossia caused by all the following except? amyloidosis, hypothyroidism, acromegaly, or ​ ​ hyperparathyroidism

16.Lateral perio cyst → roots of mandibular premolars ​

17.Neurofibroma → mandibular Premolars ​

18. What’s stronger ibuprofen 600 or Tylenol 500------> you need RX for Ibuprofen 600mg ​ ​ ​

19.Lower canine facially positioned - gingival recession ​

20.What’s not causing her recession on 6? Systemic - (yes was brush,erosion, ortho) ​ ​ ​ ​

21.Diabetes type 1- ketoacidosis with hyperglycemia (ketone breath) ​

22. Most common dental emergency- syncope ​

23.Most common lymphoma of the jaw? The most common Primary Intraosseous Lymphoma is ​ ​ ​ non-Hodgkin's large cell type. ​

24.Histoplasmosis resembles ? Recurrent herpes, painful ulcers look like cancer ​ ​

25.Side effects of nitroglycerin - headache, orthostatic hypotension, flushing ​

26.Multiple neuro sarcomas in what disease? Neurofibromatosis (Von Recklinghausen’s disease) ​ ​

27.Lower Canine far facially positioned- mobility or recession? Recession ​ ​

28.40 year old posterior crossbite- surgery? Palatal expander - Surgery (Suture osteotomy?) ​

29.Mucocele - what to do? Exfoliative biopsy? Excisional, incisional ​ ​ ​ ​

30.Patient need analgesic- to give except: ibuprofen, tramadol, Tylenol, Tylenol 3.... I put tramadol, but ​ ​ ​ ​ it may be Tylenol 3? ● Tramadol monotherapy does not usually provide adequate analgesia. ​ ​

31.Too dark pic- too much developer ​

32.Little contrast and light pic: too little exposure time ​

33.Least affected by water? Pvs, siloxane, polyether ​ ​ ​

34.Intrusion: wait to erupt or splint ? reposition and splint if permanent tooth intruded 5mm ​

35.Where ankylosis happens- external replacement Replacement resorption ​ ​

36.Symptoms of Transient Ischemic Attack (TIA) → tingling fingers light headed and disoriented then ​ pass out

37.Most common neoplasm → adenocarcinoma ​

38.Tylenol and aspirin are antipyretic and analgesic (anti inflammatory never tylenol) ​ ​

39.ORN mandible only ​

40.Know clinical trial ● Use randomization and blinding to compare effects of treatment with non-treatment. This is the ​ Gold Standard for establishing cause and effect. Trials to evaluate the effectiveness and ​ safety of medications or medical devices by monitoring their effects on large groups of people.

41.Know cross sectional Vs cohort → cross sectional studies cannot distinguish between cause and ​ effect whereas cohort studies can. ● Cross sectional: epidemiological study that looks at the entire population at one point in time. Cross sectional studies are used to determine prevalence. They are relatively quick and easy but do NOT permit distinction between cause and effect. ● Cohort: prospective study of one or more samples. Cohort studies are used to study incidence, ​ causes, and prognosis. Because they measure events in chronological order they can be used ​ to distinguish between cause and effect.

42. Where to detect furcation maxillary molar- midfacial, mesiopalatal, mid distal ​ ​

43.Know modified Widman flap uses and procedure ● it’s full thickness ● Expose roots for planing to have direct vision.

44.First sign of multiple myeloma - bone pain ​

45.Distractive osteogenesis (DO) is hard because of time (long term follow up; 2 hospital ​ procedures) and patient/parent compliance

46.Potassium (K+) sparing diuretic- spironolactone (also aldosterone antagonist), also Midamor and ​ ​ ​ ​ ​ Dyrenium

47.If patient had kidney dialysis when do you dentally treat them? 1 day after ​ ​

48.Short abutment in FPD- what to do? Full crown (for better retention), reverse 3/4 crown, inlay, or ​ ​ onlay?

49.AOT → rare recurrence ​ ​

50.10-21 days before early periodontitis (initial early established ) ​ ​

July 2019

1.Retruded tongue- problem with retaining mandibular denture ​ ● If the tongue is in a retruded position, the denture will be unstable, has no retention and will be easily dislodged.

2.Remove hyperplastic tissue → before fabricating new complete denture ​

3.Flabby tuberosities-resect ​

4.Lateral sliding flap- increase attached gingiva for anteriors (AKA pedicle flap) ​

5.neurapraxia definition = mild injury with not axonal damage, spontaneous recovery within 4 weeks ​ ● Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.

6.First treatment for NUG- Chlorhexidine rinse with Debridement (only give antibiotics if patient has ​ ​ systemic disease like HIV or is running a fever)----> If ABX needed, use Metronidazole ​

7.Best area for osseointegration - mandibular anterior ​

8.Triad- glossoptosis, retrognathic mandibular, micrognathia (also high arch palate, cleft palate or absent gag reflex) - Pierre Robin Syndrome ​

9.Phenothiazide - tardive dyskinesia ​

10.Kelly Combination syndrome - when you have a maxillary complete denture over mandibular ​ Class 1 Kennedy RPD. ● Has 5 characteristics: overgrowth of maxillary tuberosity, papillary hyperplasia of hard palate, ​ bone loss in maxillary anterior, mandibular anteriors super erupt, and bone loss under distal extension of mandibular

11.have Hyperplastic (flabby) tissue, what kind of impression ( closed mouth impression, high adhesive material, high pressure , take at rest position) ​ ​

12.most common type of candidiasis in denture wearers? Denture stomatitis ​

13.Hypodontia face effects → mid face ​

14.know turners - most common in mandibular premolars ​

15.picture of skull of multiple myeloma (punched out lesions) → ​ ​

16.median rhomboid glossitis - candidiasis atrophy of filiform papillae ​

17.Muscle attachments (lots of these)

18.picture of kid with herpes → ​

19.Fordyce granules-sebaceous glands ​

20.Palatal groove of which tooth is associated with periodontitis - maxillary lateral incisors ​ ​ Palatogingival groove (or radicular lingual groove (RLG)) most common on maxillary lateral incisors

21.Endo lots of them

22.Recently placed gold inlay on upper tooth which is opposing lower amalgam, what is the most common reason for pain afterwards? Galvanic Shock ​ ● Galvanic shock sensitivity = choose this if only question says opposing dissimilar metal

23.different metals in alloy, decrease thermal expansion ​

24.Tooth #30 has huge MOD amalgam that is deep, it hurts when he eats french bread. What is the cause? Root Fracture (Fractured Tooth) ​

25.know signs of shock (see list below) ​ ● Cool, clammy skin ● Pale or ashen skin ● Rapid pulse ● Rapid breathing ● Nausea or vomiting ● Enlarged pupils ● Weakness or fatigue ● Dizziness or fainting ● Changes in mental status or behavior, such as anxiousness or agitation

26.know MOA of propranolol - non selective beta blocker that reduces cardiac output and inhibits ​ ​ renin secretion

27.Ptergonandibular raphe ! 4 questions! Know their muscles (mesial is the mouth, lateral is the ​ ​ ramus, anterior is the buccinator, and posterior is the superior pharyngeal constrictor)

28.needle is inserted where in IANB. (muscle - buccinator, infection - pterygomandibular space) ​

29.Dentinal dysplasia (DD) vs dentinogenesis imperfecta (DI) vs Amelogenesis imperfecta (AI) = ​ ​ ​ ​ Amelogenesis imperfecta affects the ENAMEL of teeth, Dentinogenesis imperfecta and Dentinal Dysplasia both affect the DENTIN of teeth. Imperfectas (DI & AI) can be treated with restorations whereas Dentinal Dysplasia CANNOT. ● Dentinal Dysplasia: Loss in organization of dentin in primary and permanent teeth. It is ​ Autosomal Dominant and has 2 types. Teeth are NOT good candidates for restorations. ○ Type 1 “rootless teeth”. Normal coronal enamel and dentin, roots shortened due to ​ disorganized radicular dentin, teeth mobile and premature exfoliation. Chevron pulps and short roots in permanent dentition; obliterated pulp chambers in primary teeth. ○ Type 2 (resembles dentinogenesis imperfecta) in that root length is normal, but crowns ​ are blue-brown translucent, bulbous, and have cervical constriction. Again primary teeth have obliterated pulp; permanent teeth have thistle tube and contain pulp stones. ● Dentinogenesis Imperfecta (DI): Autosomal Dominant, affects formation of dentin, may be seen ​ with osteogenesis imperfecta. Has blue brown discoloration/translucence (Blue Sclera), bulbous crowns with cervical constriction and early obliteration of pulp and canals. Shell tooth appearance (normal enamel, thin dentin, large pulp chamber). Teeth are very prone to damage and breakage like with amelogenesis imperfecta. Treatment for these teeth include full coverage of teeth with close to normal shaped crowns and roots, overlay denture. ● Amelogenesis Imperfecta (AI): Amelogenesis imperfecta is a group of rare genetic conditions in ​ ​ which the outer layer of the teeth (enamel) fails to develop properly. People with amelogenesis imperfecta will have small, yellow, or brown teeth that are very prone to damage and breakage. They will show rapid attrition, excessive calculus deposition and gingival hyperplasia. Is usually Autosomal Dominant. Can cause hypoplastic pitting enamel.

30.SNA/ SNB ● SNA This angle represents the relative anterioposterior position of the maxilla to the cranial base ​ ● SNB This angle represents the relative anterioposterior position of the mandible to the cranial ​ base ● SNA-SNB = ANB which is the angle that represents the relative A/P position of the maxilla to the mandible and is used to find skeletal class. Normal ANB is 2-3 degrees. (Class I)

31.which did point A stand for ? deepest concavity of maxilla ​ ​

32.Which LA for a pregnant person? Mepivacaine (no epinephrine in it therefore no Vasoconstrictive ​ ​ properties)

33.Which doesn’t involve ions- propranolol ​ ​ ​

34.Amicar- what is it? aminocaproic acid is used to promote blood clotting, used during or after ​ surgery when excessive bleeding is expected.

35.Benzodiazepines MOA → (Key word is FREQUENCY) Enhance GABA binding to GABA receptor, ​ ​ ​ increase frequency of chloride channel opening → decrease neuronal firing ​

36.Know recall interval for periodontitis in adults - 3 months ​

37. Ulcerated papilla- NUG (ANUG) ​

38.sedation of pulp- zinc eugenol ​

39.when do you not use calcium hydroxide? is contraindicated in pulpotomy in a child (primary teeth) ​ ​ ​ ​ ​ because it causes irritation of the pulp, leading to internal resorption in primary teeth; also contraindicated in adults whose pulp has been symptomatic for the last month. ​

40.Difference between treatment for aggressive periodontitis and NUG - attachment loss is seen much ​ more in aggressive periodontitis. ● The treatment difference would be the use of ANTIBIOTICS. For Aggressive periodontitis ​ ​ you do Surgery (SRP) with Tetracycline, Metronidazole w/ amoxicillin (different combo of antibiotics) whereas with NUG you start with Debridement, Chlorhexidine rinse and OHI (and only prescribe antibiotics if pt has HIV or fever)

41.Root canal obliteration (calcified canal) → Pulp canal obliteration (calcified canal) does not, in ​ itself, indicate need for treatment. It is seen in Dentinogenesis imperfecta and dentinal dysplasia.

42.Amyloidosis is? disease that occurs when a substance called amyloid builds up in your organs. ​ ​ ​ Oral manifestations are Macroglossia, decreased mobility, yellow nodule on lateral surface. Also has deposition on salivary gland leading to xerostomia. 43. pic of pedunculated wart ​

44.ankylosis or pulpal obliteration if extraoral dry time is long ​

45.Root canal response times ● Vitality Scanner (EPT) ○ Normal response ranges are: Incisors 10–40, Bicuspids 20–50, Molars 30–70, Necrotic 80

46.Addison’s - hypotension, hyperpigmentation due to adrenal insufficiency ​

47.Peutz-Jegher’s Syndrome- internal polyps ​

48.hypercementosis and possibly hyperparathyroidism ● Hypercementosis: excess deposition of cementum on normal radicular cementum. ​ ● Hyperparathyroidism: is a condition in which one or more of the parathyroid glands become ​ ​ overactive and secrete too much parathyroid hormone (PTH). This causes the levels of calcium in the blood to rise, a condition known as hypercalcemia. (Secondary HPT caused by renal failure)

49.Type of Anchorage and diastema closure - finger springs for mesiodistal tipping ​

50.rectangular wire purpose - movement of crown and root ​ ​

51. indirect sympathomimetic - amphetamines, tyramines, ephedrine ​

52. CDC or EPA for controlling water lines ​ ​

53.pubertal gingivitis and treatment- OHI ​

54. Definition of chronic abscess - (key word is SINUS TRACT) Chronic Apical Abscess is an ​ ​ ​ ​ ​ inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort and an intermittent discharge of pus through an associated sinus tract.

55. Turn over if long junctional epithelium → Will be formed on cementum & is re-established in 1-3 ​ weeks

56. Black men not correct for HPV highest incidence----> White girls ​ ​ ​

57. Ferric sulfate left at apex. What will happen to it? Ferric sulphate, produces local and reversible ​ inflammatory response to oral soft tissues, but no toxic or harmful effects have been published in dental or medical literature.The most common radiographic finding seen was internal resorption ​ and calcific metamorphosis. Ferric sulfate is a very strong haemostatic agent. ​

58. lateral translation mounted in semi- adjustable articulate, what movement will make---> White gurls ● Working side contact during laterotrusion ● Lateral translation movement or bennett angle ○ Bennett angle → angle described by the orbiting condyle during laterotrusive movements. Semi-adjustable articulators allow for a bennett angle movement only in a straight line.

59. occlusal waxing?

60. neurapraxia= mild injury with not axonal damage, spontaneous recovery within 4 weeks ​ ​

61. acute radiation exposure symptoms = nausea, vomiting, headache, and diarrhea ​

62. amantadine- antiviral and antiparkinson ​

63. Naloxone what type of intrinsic and affinity = NO intrinsic activity, HIGH Affinity ​ ● Used to treat morphine (opioid) overdose, antagonist ​

64. multiple questions on sign of opioid overdose ● Symptoms: respiratory depression, euphoria, sedation, dysphoria (unease), analgesia, ​ antitussive, constipation, urinary retention, vomiting/nausea (trigger medullary CTZ) ● Overdose: coma, miosis (pupil constrict, pin-point pupils), hypothermia, respiratory depression ​ ​ ​ (loss of sensitivity of medullary respiratory center to CO2), hypotension ​ ​

65. side effects of nitroglycerin = headache, orthostatic hypotension, flushing ​ ​

66. enlarged skull, dementia .... what syndrome? Alzheimer’s ​

67. Type of radiation for MRI----> Radiowaves ​

68. Bunch of questions about articulator settings

69. Red complex bacteria = P. gingivalis, Tannerella forsythia, treponema denticola ​

70. NUG with fever and lymphadenopathy do all except? chemotherapeutic rinse, debridement, steroids, ​ ​ ​ ​ antibiotics (such as penicillin or metronidazole)

71. Most likely type of root to have a ledge (short, long, curved, thin) ​ ​

72. Know all about specificity, sensitivity ● Specificity: percent of persons without the disease who are correctly classified as not having it ​ ​ ​ ​ ​ ○ True Negative (TN)-Those who are ACTUALLY disease free ○ False positive (FP)- Those that are misdiagnosed as not as being disease free ● Sensitivity: percent of persons with the disease who are correctly classified as having the ​ ​ ​ ​ ​ disease ○ True Positive (TP) - Those that actually have it ○ False negative (FN) - Those that are misdiagnosed as not having it

73.for taking CR what do you want in your bite registration ( cusp tips? Slight show-through) ​ ​ 74. Why do you adjust the articulator 1 mm open on the second molar? Had this question and went with the answer that talked about making it easier to correct the balanced occlusion or something like ​ ​ that… the other answer choices didn’t seem right. -TR

75. Which of the following only work on cyclooxygenase ​ ​

76. 14 year old boy. Did RCT #30 still painful. Osteosarcoma? (this one is painful swelling) Fibrous ​ ​ dysphasia (this one is not painful swelling)

77. Mandibular canine was more facial what will happen? ( recession, excessive mobility, overbite and ​ ​ ​ excessive?)

78. Mandibular extrusion causes what in the anterior? Causes increased anterior facial height with the ​ ​ Extrusion of posterior teeth causes the mandible to rotate downward and back in the absence of growth.

79.Relation of incisors during s-ch-z sounds( in contact, almost contacting) ---> Closest speaking ​ ​ ​ space, determines VDO.

80. Anterior teeth contact when they making s-Chris-z sound ( overbite....) ---> Excessive VDO ​ ​ ​

81. Patient has excessive scar due to electric shock on face at the angle of mouth. How does it affect dentition (move facial, improper arch form?) Scarring from electrical burn = lingual inclination of teeth ​ ​ or Decreased VDO (both correct hopefully) -- From DanMan File 2019 ​ ​ ​

82. 4 Q on prophylactic antibiotic? Preventive (prophylactic) antibiotics prior to a dental procedure are advised for patients with: 1. Artificial/prosthetic heart valves 2. History of infective endocarditis 3. Certain specific, serious congenital (present from birth) heart conditions, including: ○ unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits ○ a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the ​ procedure ○ any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device 4. Cardiac transplant that develops a problem in a heart valve.

83. Least likely in osteogenesis imperfecta → scalloping at dej? (it is considered the brittle bone ​ ​ ​ ​ disease)

84. Confidence interval because why? You need to be in the 95% ​ ● A 95% confidence interval is a range of values that you can be 95% certain contains the true mean of the population. This is not the same as a range that contains 95% of the values.

85. Null hypothesis was self study vs. conventional study (attending lecture). What is the independent variable ? Self Study or Attending Lecture = Independent Variable ​ ● A researcher conducting a research between student’s self studying and those attending lectures what is the independent variable? students participating in research, material studied, Students ​ ​ results, Lecture of self study ○ ATTENDING LECTURE or SELF STUDY (INDEPENDENT VARIABLE)** ○ STUDENTS RESULT (DEPENDENT VARIABLE)

86. Clindamycin prophylactic dose → Adults: 600mg orally 1 hour prior to appointment; Children: ​ 20mg/kg orally 1 hour prior to appointment

87. What to use when cementing veneers → dual cure (resin cement) ​

88. Fixed rpd using premolar as abutment with short clinic crown that is non various. What you do to tooth ​ ​ ​ ​ ​ ( I lay, mod only, reverse 3/4 crown, full crown) ​ ​

89. Lateral flap used for → increase attached gingiva for anteriors (AKA pedicle flap); used for root ​ ​ coverage on gingival recession teeth.

90. Radiograph makes what to bone? ( under/over estimates none change) underestimate (It cannot ​ ​ show you the F/L width of the alveolar bone -TR) Question from mastermind #217: Xray taken of a guy with a crater defect, what is true? Xray underestimates the real size of the crater. ​

91. Most common factor of caries ( decreased saliva, bacteria present) ​ ​

92. Patient has no carious lesions but has a high amount of strep mutants in biology test → means they ​ are high caries risk

93. Primary dentition first molar has something → wide contact or wide occlusal table ​ ​

94. At 4 years of age 2nd perm premolar is not coming in least likely for ( resorbed roots, has occlusal ​ ​ restoration)

95. Which is not a succedaneous tooth → first molar ​ ​ ​

96. Canine and incisor contacting at working movement but non working side does not contact ( group function , protrusive, anterior, balanced)

97. Flabby tissue anterior taking impression what do you do ( closed mouth impression, high adhesive ​ material, high pressure , take at rest position) ​ ​

98. Max complete/ man rpd where do you want contact for lateral working movement? Balanced ​ occlusion

99. Draw 2mm line for custom tray everywhere except?? Posterior palatal seal area ​ ​ ​

100. Best material for large graft (replace a lot of the mandible)? ( autogenous graft, freeze dried ​ ​ (allogenic graft))

101. Sulfonamide MOA---> interferes with folic acid synthesis by preventing addition of ​ ​ para-aminobenzoic acid (PABA) into the folic acid molecule through competing for the enzyme dihydropteroate synthetase.

102. MOA antilogust (sp?) drug?

103. Ulcers everywhere palate and throat → primary, aphthous ​ ​

104. Vertical Fractured tooth but patient is asymptomatic and pulp is healthy, what do you do? rct (contraindicated), extract, crown ​

105. Splint mandibular incisors why? patient uncomfortable with mobility, help with perio? ​ ​

106. Use for maxillary premolar #17, 23, 150,151 ​ ​ ​

107. Opaque at Incisal 1/3 of crown why? Under reduced ​

108. Facial reduction of veneer? 0.5mm ​

109. Most hygienic Pontic → Sanitary/hygienic pontic and conical (Both are most hygenic pontics, ​ but not that esthetic at all.

110. Ensure best pontic how? scratch the cast, passive fit with tissue, gold at gingival ​ ​

111. Percent of stannous fluoride given at office? 8% ​

112. Internal bleaching how long do you wait before facial bonding? 1 week ​

113. Intrusion 5 mm what do you do? Observe for primary, permanent - orthodontics ​

114. Best x-ray: short Wavelength, High Energy ● Filtration is a mechanism where the low quality, long wavelength x-rays are absorbed from the exiting beam.

115. Pulpotomy on molar, places cotton pellets but still bleeding what do you do? remove extra tissue tags and add more cotton pellet, use lido, use hemostatic agent? ​

116. Self reabsorbed suture that last the longest? chronic, chromic gut, silk ​ ​

117. What will fuse like epiphyseal plate? fontanelles, synchondrosis ​

118. 40 year old with posterior cross bite. What treatment? quad helix, palatal expander, suture ​ ​ osteotomy? ​

119. What causes hemorrhaging after radiation exposure? ( neutropenia, methem) ● radiation depletes the body of platelets.

120. Patient gets maxillary denture and immediate starts salivate. What system? ( reflexive, sympathetic.. something like that?)

121. Pedal edema, high diastolic, shortness of breath = copd, CHF (Congestive Heart Failure) ​

122. What is the mesio-distal dimension of implant from adjacent tooth? 3mm, 1.5mm ​ ​ (implant to adjacent tooth = 1.5mm; implant to implant distance = 3mm)

123. What gives ledging during endo procedure? A. Jumping too quick from small to large hand file B. Using high RPM on rotary handpiece

124. What is the purpose of a facebow?Translates relationship of maxilla to terminal hinge axis ​

July 18, 19, 20:

1.Ton of questions on CPR ● Compression rate in CPR = 120/minute ​ ● Minimum depth to which you have to compress the chest? 1.5 inches ​ ● Performing CPR and the chest is NOT rising, why? The head is not tilted and chin lifted up ​ ​ ​ enough to clear the airway from the tongue, you hand is not holding the mask all the way ​ sealed, more options I can’t remember.

2.Calculate amount of epi in 1.7cc 2% lidocaine 1:50,000 → Answer was 34mcg ​

3.A lot of questions on beta blockers

4.Worst type of force for a single implant (choices were vertical, horizontal, oblique, axial) → horizontal ​

5.Radiograph 25 year old kid giant radiopacity on distal root of molar, no symptoms tooth was vital. → didn’t know if it was cementoblastoma or complex odontoma ​ ​ ​ ​

6.Radiograph of nutrient canal → ​ ​

7.Simple endo diagnosis questions ​

8.Most frequently impacted tooth (3rd molars weren’t an option) → Mandibular 3rd Molar > Maxillary ​ 3rd Molar > Maxillary Canine

9.Most frequently missing tooth → 3rd Molars > Mandibular 2nd PM > Maxillary Lateral Incisors > ​ Maxillary 2nd PM

10.Which tooth has most consistent number of canals? Maxillary Central and Maxillary Lateral ​ Incisors

11.Fusion vs gemination question (Fusion = Two Separate Canals) ​ ​ ● Gemination: Tooth gemination is a dental phenomenon that appears to be ​ ​ ​ two teeth developed from one. There is one main crown with a cleft in it ​ that, within the incisal third of the crown, looks like two teeth, though it is not two teeth. The number of the teeth in the arch will be normal. (1 root 2 ​ ​ ​ crowns) ● Fusion: Union of two adjacent teeth in both primary and permanent ​ ​ dentitions. The number of teeth in the arch will be one less. (2 roots 1 ​ ​ crown)

12.A case scenario with a radiograph of the skull it was super hard to see but it was either multiple ​ myeloma or Paget’s disease (I believe it was Paget’s)

● Multiple Myeloma = punched out lesions

● Paget’s Disease = cotton wool appearance

13.Max 3rd molar with divergent roots → hemisection ​

14.Extracting mandibular 3rd molar and distal root disappears.. which space did it go into.. pterygomandibular space (submandibular space)

15.Trismus which muscle is affected.. Choices were lateral pterygoid, medial pterygoid, masseter, ​ ​ buccinator, temporalis

16.Some Periocoronitis question about what would it look like if it turned into chronic → a mild persistent ​ ​ ​ ​ ​ inflammation of the area; Chronic Pericoronitis is seen on x-ray as flame-like appearance distal to the mandibular 3rd molar.

17.Some random surgery (I think intraoral vertical Ramus osteotomy.. don’t quote me on that) which nerve can it damage.. inferior alveolar nerve.. other choice was lingual nerve, mylohyoid, submental ​ ​

18.You perforate the sinus during an extraction and a root tip goes in, what do you do? I put take a pano ​ and inform the patient.. other choices were make the perforation bigger and try to extract it, do nothing, ​ and some other answer that was wrong

19.Case scenario about an old lady that had radiation for cancer and has a diastema and wants to close it. #8 had an apicoectomy and the root was super short and #9 had RCT also but the root wasn’t as short. What do you do to close the space? Veneers (I put this), extract and implants (obv not), full coverage ​ ​ crowns (didn’t put this because crown:root ratio would’ve been fucked), ortho, don’t treat her

20.Another case where a guy had a huge Caries on #29 and was in pain but had 65gry of radiation or something in the past. What do you do? RCT (I put this), pulpotomy, Extract, leave it alone ​ ​

21.Question on how to extract mandibular premolar.. 151 forceps ​ ​

22.Which tooth most common for alveolar osteitis (dry socket).. choices were mandibular 3rd molar, ​ ​ mandibular 1st molar, max 3rd molar, another tooth

23.All except question on how to treat dry socket.. I think the answer dealt with prescribing antibiotics ​ ​ ​

24.Most common reason for fracture of kids 1-3 years old or something like that.. uncoordinated ​ movements

25.A question on what nerve is a branch of the (can’t remember the name of the nerve might have ​ been infraorbital) but choices were PSA, MSA, ASA, and two RANDOM fucking nerves I’ve never heard ​ of on my life I picked one of the random ones that sounded like it dealt with the upper lip ● The infraorbital nerve emerges from the infraorbital foramen and gives off four branches: the ​ ​ ​ ​ ​ ​ ​ inferior palpebral, external nasal, internal nasal, and the superior labial branches, which are ​ ​ ​ ​ sensory to the lower eyelid, cheek, and upper lip.

26.Patient had ecchymosis in her right eye after you gave a maxillary injection what happened? I put ​ blunt trauma unrelated to procedure, other choices all had to do with injecting into the artery. I don’t ​ ​ think my answer is correct but the choices all sounded the same so ♂

27.3 questions on SLOB rule ​

28.Know definition of osteotomy vs ostectomy ● Osteotomy: surgery where bone is cut to shorten, lengthen, or change its alignment as is done ​ with orthognathic surgeries and distraction osteogenesis. (LeFort 1 surgery) ● Ostectomy: An ostectomy is a procedure involving the removal of bone. In dentistry it refers ​ ​ specifically to the removal of bone surrounding a tooth in an attempt to eliminate an adjacent periodontal pocket.

29.Know definitions of Ethics terms well ● Beneficence- “Do good”. ​ ​ ● Patient Autonomy- “Self-governance”. ​ ● Non-maleficence- “Do no harm”. Dentists are to keep skills and knowledge up-to-date and ​ practice within their limits in order to protect the pt from harm. ● Justice- “Fairness”. ​ ● Veracity- “Truthfulness”. ​

30.You randomly get lip paresthesia what could it be.. Malignancy or angle fracture ​ ​ ​ ● Angle Fracture (Mandibular Fracture) ● Osteosarcoma

31.Arch length is measured from mesial of which teeth.. max 1st molars ​ ● Arch Length: Distal 2nd PM to Distal 2nd PM OR Mesial 1st Molar to Mesial 1st Molar ​ ​ ● Arch Width: Inter-canine space

32.How long do you splint Avulsion for.. 7-10 days ​

33.Peds questions on distal step, mesial step ​ ● Distal Step: class II molar relationship in permanent dentition ​ ​ ● Mesial Step: either class I or class III molar relationship in permanent dentition ​

34.Which one is most common type of occlusion in PRIMARY teeth? flush terminal plane ​

35.Which defect is best perio prognosis. Choices were 3-walled, 2-walled, 1-walled ​ ​ ​ ​

36.Which ethnic group has the most chronic periodontitis? Black males ​

37.Which cells will you find in periodontitis? PMN ​ ​

38.Which bacteria causes Caries? Strep mutants ​ ​

39.Lactobacillus TQ (doesn’t start caries but progresses them) ​ ​

40.Pregnant patient with acute apical abscess when can you treat her? Choices were immediately? ​ (since could spread and become ludwig angina?)- TR, 1st trimester, 2nd trimester, or 3rd trimester.. if ​ you do endo you have to take xrays so ♂

41.neurofibromatosis question → Multiple neuro sarcomas in what disease? ​ ​ ​

42.Peutz-Jeghers question → internal polyps (also seen in Gardner’s syndrome) ​ ​

43.Gardners syndrome question → multiple osteomas in jaws (syndrome associated with multiple ​ ​ odontomas)

44.Plaque index used for patient motivation ​

45.All are associated with perio disease except.. choices were diabetes, smoking, oral hygiene, diet ​ ​ ​ (nutritional deficiencies)

46.True false question about lowest social economic people and poor periodontal health ​ ​ ● The study revealed that oral hygiene awareness and periodontal conditions are significantly ​ associated with socio-economic status of an individual. (Lower social economic people will ​ have poorer periodontal health)

47.What is the main component of primary vs secondary occlusal trauma.. amount of force, bone ​ support (Difference between primary and secondary occlusal trauma? PDL involvement and remaining ​ ​ amount of supporting bone). ​

48.Down syndrome question what do they have...I think I put macroglossia.. forgot the answer choices ​ ​ one of them was rampant Caries (nope)

49.Definition of biological width.. choices had 2mm and 3 mm. The 3 mm choice included gingival sulcus. I went with the 2mm choice CT and JE

50.How to determine attachment loss (shoutout Dr. Sonny) calculating measurement of CEJ to sulcus ​ ​ (depth of pocket); Pocket Depth is measured from the FGM to the base of the pocket

51.How to determine attached gingiva ● Place your probe on the outside of the tissue and measure from the gingival margin to the ​ ​ ​ ​ mucogingival junction. Now measure the sulcus ​ ​ or pocket depth (probing depth). Subtract the probing depth from the outside measurement of the gingiva, and you will have the width of ​ ​ attached gingiva

52.What don’t you do at PMT appointment? Choices were → root plane pockets 1-3mm, observe oral ​ ​ ​ ​ hygiene, schedule patient for restorative work, update med hx

53.Molar with class 2 furcation what can’t you do in treatment plan? GTR, Extraction with implant ​ ​ ​ placement, hemisection with prosthetic crown placement, converting class II to a class I furcation ​

54.Contraindication of RCT? vertical root fracture ​

55.What acts as a hemostatic agent during vital pulp therapy? Calcium hydroxide or sodium ​ ​ ​ hypochlorite (NaOCl)

56.Most common seizure in kids.. Febrile ​

57.Antibiotic therapy have minimal effect for? Chronic periodontitis ​ ​ ​

58.Just did perio surgery what’s the best way to clean interproximal? Proximal brush, toothpick, ​ ​ waterpick irrigation, floss

59.What’s cause of leakage with rubber dam? Holes punched too close ​

60.First sign of pit and fissure Caries? Explorer catch, enamel discoloration ​ ​

61.Know all the different types of fluoride ● TYPE OF FLUORIDE: ● Type of fluoride in water → fluorosilicate acid (hydro fluorosilicate) – most commonly used, ​ ​ ​ sodium fluorosilicate, and sodium fluoride ● Types of Fluoride used in toothpaste → Stannous fluoride (most effective), Sodium Fluoride ​ ​ (NaF), Sodium Monofluorophosphate o Stannous fluoride may stain o Type of Fluoride NOT in toothpaste = Acidulated Fluoride (1.23% concentration → ​ ​ ​ ​ only used in dental office) ● Do NOT use this type of fluoride on a patient with multiple porcelain crowns ● Patient with lots of fillings, implants, amalgam, composite, PFMs → use 1.1% Sodium Fluoride (NaF) o However this type of fluoride is NOT useful in managing caries in the elderly ​ ​

62.What do you prescribe 4 year old with lots of Caries? All the fluorides were listed I put SDF but ♂ ​ ​

63.Know tetracycline well → Tetracycline for periodontal infections (better penetration, stays in bone ​ tissue longer) Tetracycline: bacteriostatic, protein synthesis inhibitor (30s) ; does NOT decrease gingival crevicular ​ ​ ​ ​ fluid (GCF) flow • Block activity of collagenase, bind to 30S (block AA linked tRNA) ​ ​ • Is usually NOT used because they can cause yeast infections as well as opportunistic infections • Tetracycline can be chelated with Calcium, Magnesium and Iron o Don’t take iron supplements, multivitamins, calcium supplements, antacids, or ​ laxatives within 2 hours before or after taking tetracycline. Antacids and milk reduce the ​ ​ absorption of tetracycline. ​ • Tetracycline effects the Dentin, causes intrinsic stain ​ o Age that you took tetracycline which resulted in enamel hypoplasia or tetracycline staining: § Primary teeth→ before 4 months in utero § Permanent teeth → birth Do NOT give codeine or tetracycline to lactating female ​ ​

64.Know penicillin well → Penicillin for odontogenic infections ​ Penicillin is bactericidal and inhibits peptidoglycan cell wall by binding to transpeptidase ​ ​ ​ • It is a GREAT drug to give because it is → cheap, low toxicity, and not a lot of people are ​ allergic to it • Mechanism of Action of Penicillin (Bactericidal against gram (+)) is closely related to Keflex ​ (Cephalexin) • If patient is allergic to penicillin then could have cross reactivity with Cephalosporins as well. ​ ​ • Transpeptidase enzyme is inhibited by Penicillin ​ ​ ​ ​ • Has decreased effectiveness in abscess/cyst due to Hyaluronidase (penicillin is unable to ​ ​ reach organism/ can’t penetrate the cyst barrier) ​ ​ • Penicillin CANNOT be taken with ERYTHROMYCIN or TETRACYCLINE!!! They are ​ antagonists (cidal + static) so they cancel each other out 65.Pemphigus vs pemphigoid which one causes the ocular issue? Pemphigoid ​ ● Autoantibodies target basement membrane, Ocular → ​ ​ Subconjunctival fibrosis, adhesions, scarring (blindness)

66.Question on gracey curette and how it’s shaped ● Lower ⅓ (⅓ including the tip) → edge of curette you want to be in contact at the line angle of tooth ● Apical ⅓ → part of curette that adapts to the tooth

67.Lip swells after taking an impression.. angioedema ​

68.What happens after alginate impression sets.. syneresis or imbibition ​ ​ ​ ● If the alginate impression is left out in the dry atmosphere then ​ ​ syneresis happens (exudation of liquid component of gel that ​ leads to alginate shrinkage) ​ ​ ● If the alginate impression is left in water/ wet environment then ​ ​ imbibition happens (process of absorbing water that leads to ​ alginate expansion) ​

69.ANUG (NUG) questions.. buzz word ulceration of interdental papilla ​ ​

70.Girl has her first period (menarche).. it shows signs of? Choices were emotional maturity, Dental maturity, skeletal maturity, some other maturity that was wrong ​ ​

71.Picture of ulcers above MGJ (so on the alveolar mucosa = non-keratinized).. aphthous or herpetic ​ ​ ​ ​ ● Aphthous ulcers in non-keratinized tissue ● herpes in keratinized tissue

72.All are anticonvulsant drugs except.. know them all ​ ​ Anticonvulsants: Phenytoin (Dilantin), Valproic Acid, Carbamazepine, Clobazam, Diazepam (Valium), ​ Divalproex, Eslicarbazepine Acetate, Ethosuximide, Gabapentin, Lacosamide, Methsuximide, Oxcarbazepine, Perampanel, Phenobarbital, Pregabalin, Rufinamide, Tiagabine Hydrochloride, Vigabatrin, Clonazepam, Clorazepate, Ezogabine, Felbamate, Lamotrigine, Lorazepam, Primidone, Topiramate, Zonisamide

73.Contraindication to doing a distal wedge.. no attached (keratinized) gingiva ​ ​

74.Advantage of supragingival crown prep vs subgingival.. choices were less damage to soft tissue ​ during impression or more retention ​

75. healing after flap surgery with membrane.. choices were junctional epithelium moves apically or PDL ​ cells move coronally (occlusally)

76.How many mm per day does epithelium grow over connective tissue? 0.5-1mm ​

77.What is not an advantage of porcelain veneer vs composite restoration? 2 visits required ​ ​ ​

78.Need to replace a large portion of mandible, which graft do you do? Autogenous ​ ​

79.Ortho question about osteoclast vs osteoblast activity ● Orthodontic tooth movement relies on coordinated tissue ​ resorption and formation in the surrounding bone and periodontal ligament. Tooth loading causes local hypoxia and fluid flow, initiating an aseptic inflammatory cascade culminating in osteoclast resorption in areas of ​ compression and osteoblast deposition (& increased ​ ​ fibroblastic activity) in areas of tension. Compression and ​ tension are associated with particular signaling factors, establishing local gradients to regulate remodeling of the bone and periodontal ligament for tooth displacement.

80.Which type of grafts cause bone growth? OsteoINDUCTIVE not osteoconductive ​ ​ ● Allograft and Autograft

81.Which tooth is most commonly impacted? 3rd molar not an option.. choices were Max canines or max ​ ​ ​ laterals

82.You lose a mandibular molar during development which tooth is most likely to not erupt.. I put ​ ​ mandibular 1st PM another choice was mandibular 2nd PM- TR ​ ​ ● The most common congenitally missing permanent teeth with the exception of the maxillary and mandibular third molars, are the mandibular second premolars, followed by the maxillary lateral ​ ​ incisors, and the maxillary second premolars.

83.17 year old kid has mamelons still what is this due to? Open bite ​

84.What don’t you see in combination syndrome? Increased VDO ​ ​ ​

85.Definition of Frankfort plane → Frankfort Plane The plane demonstrated by a line through the orbitale ​ ​ and porion. ● a plane used in craniometry that is used to determine the highest point on the upper margin of the opening of each external auditory canal and the low point on the lower margin of the left orbit and that is used to orient a human skull or head usually so that the plane is horizontal

86.Picture of Class 2 division 2 → ​

87.Question about do you do ortho before or after veneers→ before ​ ● In many cases it is ideal to move and align teeth before implants or veneers are installed, but for some patients it is unnecessary, and in other cases dental implants and veneers are deliberately installed before orthodontic treatments as anchors for other teeth

88.Child had ortho but bad oral hygiene what type of retainer.. Removable ​

89.When is a permanent 1st molar fully calcified .. no fucking clue the choices were wild ranged from like 6-9months to 2-4 years to 6 years to something else ​ ​ ​

90.What stage does hypodontia occur? Initiation stage ​

91.What reduces x Ray exposure? rectangular Collimator ​

92.Picture of bright (light) x ray what happened? Wasn’t exposed long enough ​ ​

93.Enterohepatic circulation definition → Enterohepatic circulation: Substances that undergo ​ ​ ​ enterohepatic circulation are metabolized in the liver (by conjugation), excreted in the bile, and passed into the intestine (where bacteria break some of the conjugated drug, releasing the unmetabolized drug again) where they are reabsorbed across the intestinal mucosa (returns to systemic circulation) and returned to the liver via the portal circulation. ● Enterohepatic circulation refers to the circulation of biliary acids, bilirubin, drugs or other ​ ​ ​ substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver.

94.First pass effect definition → First pass effect: After a drug is swallowed, it is absorbed by the ​ ​ digestive system and enters the portal circulation to the liver. First pass metabolism is the enzymatic degradation in the liver prior to drug reaching its site of action (target organ). ​ ​ ● Alternative routes of administration (e.g., intravenous, intramuscular, sublingual) avoid the first-pass effect. ● A first-pass effect is defined as the rapid uptake and metabolism of an agent into inactive ​ ​ ​ ​ compounds by the liver, immediately after enteric absorption and before it reaches the systemic circulation.

95.Bioavailability definition → Bioavailability: Highly absorbed drug (high bioavail.) requires a lower dose ​ ​ than poorly absorbed. Most important determinant of drug dose is POTENCY of drug. (the proportion of a ​ ​ drug or other substance that enters the circulation when introduced into the body and so is able to have an active effect.) It is the amount of drug that is available in blood/plasma. It is measuring how much drug is absorbed in the circulation. ● the proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect.

96.What can you see with gingival retraction cord soaked in epinephrine? increase in heart rate.. other ​ ​ choice was hemostasis which also made sense ● Increase HR and increase BP → Do NOT use in hyperthyroid or cardiac disease pts

97.What happens to a drug after conjugation? more ionic ​

98.I must’ve gotten 15 questions on Beta-blockers.. don’t remember them I blacked out but know them ​ well

99.What’s least affected by radiation? Striated skeletal muscle ​ ​ ​

100.Epinephrine + propranolol cause.. increased BP (also Decreases HR) ​ ​

101.Xerostomia what do you check for? Cervical Caries ​

102.Xylitol works best as? chewing gum ​

103.What is the first sign of hypoxia during general anesthesia? (pulse oximetry? -TR) ​

104.What’s the least effective way of telling if your Parkinson’s patient is in pain? reading his facial ​ ​ ​ expressions but ♂ the other choices seemed wrong ​

105.Most common disorder for elderly? Depression ​

106.Main sign of Dementia?.. short term memory loss ​

107.What receptor do benzodiazepines work on? GABA ​ ​

108.Some question about addiction and dependency that didn’t make sense

109.All are side effects of corticosteroids except.. Hypoglycemia ​ ​ ​

110.Temporal arteritis leads to.. vision loss ​ ● Symptoms include headaches, jaw pain, vision loss, fever, and fatigue. Diagnosis usually requires biopsy of the temporal artery. ● The condition needs prompt treatment with steroid medications to prevent permanent vision loss.

111.Sickle cell anemia is a _____ mutation? Nonsense, missense, sense ​ ​ ● Single point mutation (AKA Missense mutation)

112.Definition of panic attack.. choices included fear and anxiety was kinda tricky but key word to ​ know it was panic attack was “impending doom” ● Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing ​ ​ control. ● Increase heart rate, hypertension, light headedness, diaphoresis, and feeling of impending doom is a sign of? Panic Attack ​

113.2 year old Kid weighs like 16 pounds what’s the max dose of lidocaine? 154.88mg or (4 cartridges ​ ​ of 2% Lidocaine with 1:100,000 epinephrine) ● Math: 16lbs * 2.2 kg/lb = 35.2kg * 4.4 mg/kg = 154.88mg / 36mg (lidocaine in 1 cartridge) = 4.3 cartridges

114.A couple questions about emergencies.. each patient had a different condition then something happened to them.. what do you do first? check if conscious other choices were call 9-1-1, start CPR, ​ ​ something else

115.Area of infection how do you anesthetize? Block (IANB) ​

116.Pulse for a 4 year old.. 110 ​ ● (12 yr. old is 75; adult is 70)

117.26 month old child with 12 carious teeth, how do you treat? General anesthesia ​ ​

118.What’s false about placing pins in amalgam? Larger sized pins are better ​ ​ ​

119.How does tetracycline work? Inhibits protein synthesis ​ ​

120.Veneer done a month later is discolored what happened? Something about amine leakage ​ (microleakage)

121.Pt taking tetracycline, what’s contraindicated? Penicillin ​

122.Pt is taking penicillin, what’s contraindicated? Erythromycin (or tetracycline) ​ ​

123.Maxillary sinusitis, which antibiotic do you prescribe? Amoxicillin with clavulanic acid (Augmentin) ​

124.Kennedy class 3 what provides support? Occlusal rest ​

125.Question about what happens if no indirect retention on an RPD? Dentures lifts up away from ​ ​ ​ tissue side

126.What is not a noble metal? 4 random elements I Didn’t know the answer ​ ​ ​ ● titanium (Ti), niobium (Nb), and tantalum (Ta) are NOT considered Noble Metals ● Noble metals: gold, platinum, palladium, rhodium, ruthenium, iridium, osmium

127.Why does a chromium-cobalt framework not corrode? surface oxide layer, because of the noble ​ ​ ​ ​ metal component ● The presence of noble metals in alloys increases resistance to corrosion.

128.Primary stress bearing areas of RPD? Hard palate and Buccal shelf ​

129.Purpose of major connector? Stability and rigidity ​

130.Purpose of reciprocating arm? So the clasp doesn’t get dislodged as you’re trying to seat it ♂ ​ ● Stabilization (resists the lateral forces exerted by the retentive arm when it passes through the height of contour) ● Denture is stabilized against horizontal movements, acts as an indirect retainer (prevents minor rocking)

131. 0.3mm irregularity in your die for your crown what do you do? adjust from intaglio, retake ​ ​ ​ impression and send it back, fuck with the cement ratio (don’t do this!), and something else

132.A patient with moveable flabby inflamed tissue in the maxillary anterior and wants a new denture what do you do? place tissue conditioner and re-evaluate in 2 weeks, surgically remove tissue, take ​ ​ impression for new denture, make new denture that will immobilize flabby tissue

133.What is at the distal extension of your complete denture? Choices were Hamular notches or fovea ​ ​ palatini ● Hamular notch is the depression distal to the maxillary tuberosities. It is used as a landmark for the correct extension of the upper denture. ● Fovea Palatini are the landmark for the posterior border extension of the upper denture.

134.How do you check for fremitus? Mouth in MICP, mandible in retruded position, lateral working, or ​ ​ ​ balancing? ● As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect fremitus. ​

135.Why would you remove palatal torus? Seems easy but none of the answers made any sense so ♂ ● Remove it if it prevents seating of denture and to increase posterior palatal seal ● Should be removed if tori is 3mm anterior to vibrating line (interferes with posterior palatal seal)

136.What does facebow do? Translates relationship of maxilla to terminal hinge axis ​ ​

137.Why do you do remount index? Preserve facebow transfer ​

138.Which sounds for VDO? “S” sounds ​ ​ 139.What don’t you do at wax try-in appointment? I put take facebow.. other choices were confirm VDO, ​ ​ ​ ​ confirm esthetics, other obvious answers

140.Border molding what movement do you do to capture right and left lateral borders? Don’t remember answers I put the one that was most logical ● Massage the cheek and have the patient pucker and smile. The cheek is lifted outward, upward, inward, backward and forward to active movement of the frenum.

141.While setting condylar inclination on articulator using protrusive movements what do you do with the pin? Lift it up (the incisal guide pin on articulator should be raised out of contact with incisal guide ​ table)

142.Most commonly seen? cleft lip, amelogenesis imperfecta, ectodermal dysplasia, dentinogenesis ​ ​ imperfecta (cleft lip and palate in US is 1:700) ​

143.What resembles epiphyseal plate? Synchondrosis ​ ​

144.Sturge Webber syndrome? Port wine stain ​

145.Deaf patient how do you communicate? speak directly to him and wait for interpretation ​

146.You are least likely to get sued by a patient if you exhibit this trait? I HAVE NO IDEA choices were ​ you have a likeable personality, you are competent, you have good communication skills (answer I ​ went with today- TR), something else ​

147.How do you establish rapport? Don’t remember choices ● Understanding patient’s feeling and talking with patient

148.How to manage anxious patient? Let him speak ​

149.Patient has only had 1 cavity her whole life went to a dentist and dentist said she has 6 cavities you look at the dentists radiographs and don’t see any cavities but she does have an incipient lesion starting to form on one tooth what do you recommend the patient do? I don’t know about this one I put to have ​ her report the dentist to the national board but another choice was to defend the other dentist’s ​ opinion and treatment plan for the incipient lesion which kinda made sense but idk

150.3 questions on desensitization ​ ● a treatment or process that diminishes emotional responsiveness to a negative, aversive or positive stimulus after repeated exposure to it. ● Systematic desensitization- 3 steps: Construct a hierarchy, relaxation exercises, associate components of hierarchy with relaxation state

151.2 questions on sensitivity/specificity. Know how to calculate them ​ ● Specificity: percent of persons without the disease who are correctly classified as not having it ​ ​ ​ ​ ​ ○ True Negative (TN)-Those who are ACTUALLY disease free ○ False positive (FP)- Those that are misdiagnosed as not as being disease free ○ Specificity = TN/ TN + FP ● Sensitivity: percent of persons with the disease who are correctly classified as having the ​ ​ ​ ​ ​ disease ○ True Positive (TP) - Those that actually have it ○ False negative (FN) - Those that are misdiagnosed as not having it ○ Sensitivity = TP/ TP + FN

152.Adverse drug reaction who do you report it to? FDA ​

153.Some question about HIPPA

154.Another question about who is in charge of nitrous lines and maintenance? I put OSHA but I didn’t ​ know

155.Dentist did not accept copay.. Overbilling ​ ​ ​

156.Question about elderly abuse..it happens mostly in nursing homes ​

157.Who is least likely to get radiation exposure or something? Choices were dental assistant, dental ​ ​ ​ hygienist, dentist,.... Id assume Dentist? (don’t most dentists get their assistants to take the xrays now ​ adays? -TR)

158.What test must you get every year to work in health profession? I put TB cause we have to get one ​ ​ ​ every year but another choice was Hep B and that’s what TQs say ♂ (Final Answer = TB!!)

159.Chi square vs t-Test question that I guessed.. t-Test is for small sample size, Chi square is for ​ large sample size

160.How is Hep A transferred? Airborne, food and beverage (Fecal-Oral Contact/Route) ​ ​

161.5 material safety data sheet (MSDS) questions

162.What is trephination? Hole is drilled or scraped into the human skull ​

163.Most common cause of frequent urination during 3rd trimester? pressure of uterus on bladder ​

164.Question about a kid that falls on his bike and loses his front tooth.. neighbor brings him to you and said he witnessed it and he hit his head. Can’t get ahold of his parents. Kid’s eyes are not equally dilated and he looks confused. What do you do? arrange for him to be taken to hospital, put tooth back in and ​ ​ splint, don’t do anything until you contact his parents, some other choice

165.Easy question on cemento osseous dysplasia → AKA Cementoma ​ ● Usually 30-50 years old, african american female ● Mandibular anterior VITAL Teeth ● Asymptomatic periapical radiolucencies, which transform into radiopacities ● No treatment required

166.Radiograph of stafne bone defect but the answer choice was the other name for it. (Salivary Gland ​ ​ Depression Defect, Lingual Mandibular Salivary Gland Depression, Static Bone Cyst, Salivary ​ Bone Cyst, Salivary Inclusion Defect) ← all other names for it

Day 2 was simple! Didn’t get any TQs all the cases seemed new but use common sense and you will be ​ fine! Trust your clinical judgment. It is mostly treatment planning. Know radiographs really well, including how to read a Ceph. They will test you on Peds eruption, space maintenance. Many questions on medications that patients are taking and how that affects your treatment plan. Use this website to prepare http://drgstoothpix.com/

More questions from July 2019 (7/18/19)

1.What does the I in Pico stand for? Intervention ​

2.You do an MO on tooth #4. You check occlusion and it’s high at the margin. What choice cases this A. Buccal cusp of #29 ( I think this) B. Buccal cusp of #28 C. Lingual cusp of #29

3.Where do you place the anterior teeth for a complete denture for proper esthetics (not sure of the answer) A. Labial to the ridge B. On the ridge? - I feel like thats where they always make us set our teeth…. (this is the option I went with today- TR) C. Lingual to the ridge D. touching the opposing dentition

4.What’s the worst wall to be restored by GTR ​ ​ A. One wall defect

5.If you have an infection in the lateral pharyngeal space what muscle is involved? A. Medial pterygoid

6.Tooth is vital and there is scalloped borders (literally just that) A. Traumatic bone cyst

7.1st sign of multiple myeloma ​ A. Bone pain

8.What’s the best to replace or restore with GTR A. Wide three wall furcation B. Class 2 furcation (correct)

9.Most causes of suppurations A. Actinomycosis

10.Pediatric patient that has Carries and uncooperative A. Parents holds them down (correct) B. Pappoz restrained C. General anesthesia

11.Digitals MOA A. Positive inotropic (literally just those two words)

12.What is the treatment for SV arrhythmia A. Quinindine

13.What do you look at first in an emergency patient A. Medical history ( correct answers) B. Medication that the patient is

14.Injecting into the parotid gland causes facial paralysis. Comparing to the location of inferior alveolar nerve injection where would the needle be positioned? A. Anterior B. Posterior (if you inject too posteriorly you will enter the parotid gland) C. Higher up

15.What’s the minimum number of neutrophils you could see a pediatric patient before dismissal (no freaking clue) <1,000/mm3 : defer elective dental care. ​ A. 1300>x B. 1000>x C. 1500

16.What nerve supplies facial nerve A. V B. VIII (correct) C. II

17.Which HPV causes most cancer or related the most to the mouth. (Not sure) Research indicates that ​ approximately 70 percent of cases of oropharynx cancer is caused by HPV16. ​ ​ ​ ​ A. 6 B. 11 C. 16

18.Which has the least number of canals? ​ A. Maxillary central (correct answer) B. Mandibular central

19.What percent does the mandibular canine have 2 canals A. 5 % B. 9 % C. 16 % (15% according to some endo website)

20.Select the correct Order (neither one looked correct) A. Plaque control, caries control, SRP, Perio surgery B. Caries control, plaque control, SRP, Perio surgery

21.Which one is not a bacteriostatic ​ ​ A. Azithromycin B. Vancomycin (correct answer) C. Clarithromycin

22.Which one antibiotic can fight parasites and Fungal A. Metronidazole

23.Calculate the mean! Gave a bunch of numbers then told you the total of all of them = 30 and ​ ​ there were 10 numbers in the set so the answer was 3- TR

24.What’s the only thing your dental assistant can do A. Take a final impression for a fixed RPD B. Sign and verify lab script C. Take primary impression (correct answer)

25.What’s not true about dementia? (Asked me 3 times) ​ ​ A. Something about long term memory loss (correct answer) B. They don’t have problems comprehending and talking to people

26.Properties of glass Ionomer other than releasing fluoride (asked me 3 times) ​ A. Has high esthetic B. Has high wearing strength. C. Chemical bonding to Dentin and enamel (correct answer- also they changed it in the other question from chemical bond to ionic bond)

27.Trismus of lateral pterygoid. ​ A. Medial pterygoid

28.Primary tooth was avulsed, what do you do A. Nothing. You don’t reimplant primary teeth

29.Same tqs about direct and indirect pulp capping (4-6 questions) ​ ● Two different types of pulp cap are distinguished. ● In direct pulp capping, the protective dressing is placed directly over an exposed pulp ​ ​ ​ ○ One stage procedure ○ It is only feasible if the exposure is made through non infected dentin and there is no recent history of spontaneous pain (i.e. irreversible pulpitis) ○ Placement of Calcium Hydroxide (CaOH) or MTA over exposure and then place restoration on top. ○ Indications for Direct Pulp Cap: ■ Immature/mature permanent teeth with simple restoration needs ■ Recent trauma less than 24hours exposure of pulp / mechanical trauma exposure (during restorative procedure) ■ Minimal or no bleeding at exposure site ■ Normal sensibility test ■ Not tender to percussion ■ No periradicular pathology ■ Young patient ● In indirect pulp capping, a thin layer of softened dentin, that if removed would expose the pulp, ​ ​ ​ is left in place and the protective dressing is placed on top. ○ Stepwise caries removal is a two-stage procedure over about six months. ○ the dentist intentionally leaves the softened dentin/decay in place, and uses a layer of protective temporary material (CaOH or MTA) which promotes remineralization of the softened dentin over the pulp and the laying down of new layers of tertiary dentin in the pulp chamber. ○ A temporary filling is used to keep the material in place, and about 6 months later, the cavity is re-opened and hopefully there is now enough sound dentin over the pulp (a "dentin bridge") that any residual softened dentin can be removed and a permanent filling can be placed. ○ Indications for INdirect Pulp Cap: ■ indicated in a permanent tooth diagnosed with a normal pulp with no symptoms ​ ​ ​ of pulpitis or with a diagnosis of reversible pulpitis.

30.Use Zinc oxide Eugenia for primary teeth and the apex is NOT closed. (tq) ​

31.Alcoholic guy. What test would you do. A. INR (correct) B. Look at glucose in blood C. CBC

32.Nitrates and nitriles what’s your mechanism of action? A. Vasodilation of the arteries

33.Stafne bone cyst which is not ​ A. Located between canine and premolar mandibular (correct) B. Below IAN

34.Swelling after you spray air into pocket? A. Subcutaneous emphysema

35.Pregnant in supine position will get a lot of pressure A. Inferior vena cava

36.What position do you put this pregnant lady in? A. Left side

37.Drug of choice for status epilepticus? A. Diazepam

38.Action of benzodiazepine ​ A. They work on GABA

39.Pain medication with amoxicillin for an adult? A. 50mg B. 1g C. 2g (correct)

40.By which mechanism of action are tetracycline and penicillin antagonist? No clue ● Tetracycline is bacteriostatic whereas penicillin is bactericidal. The two mechanisms of action ​ ​ ​ ​ (CIDAL + STATIC) cancel each other out because you need bacterial growth to actually use penicillin, but you don’t have that growth when you prescribe tetracycline. Antagonists. ​ Tetracycline will DECREASE the efficacy of Penicillin.

41.Penicillin is a good antibiotic because? A. Low toxicity

42.You cannot take multivitamins when you are taking which drug? ​ ​ A. Tetracycline

43.Which medication do you take to stop excessive salivation A. Glycopyrrolate

44.Pt got an injection of prilocaine and lips became cyanotic A. Methemoglobinemia

45.Drug A is 5mg and drug B is 50mg both produce the same effect. What is Drug A A. Higher potency

46.What do you call a “depends on the level of drug binding to its receptor” Efficacy

47.Long term of corticosteroids cause what to the bone A. Osteoporosis

48.This picture and it said patient had it on palpate before. A. candidiasis

49.Patient with 1.5 diastema. Difference between direct composite veneer versus indirect porcelain veneer? A. Easy repair (maybe correct) B. Minimal prep C. Use composite to close interproximal

50.What is the main reason to change anterior composites A. Discoloration

51.Which class has the biggest overjet? A. Class 2 division 1 B. Class 1 division 2 C. Class 1 D. Class 3

52.Where is melanoma found most intraorally? A. Gingival and buccal mucosa B. Gingival and hard palate C. Tongue and buccal mucosa D. lip and hard palate → I went with this today but had no idea just kept thinking of the picture of the melanotic macule on that patient’s lip but not even sure that is the same thing as what the question was asking for… dumbass strikes again haha TR)

53.Broken root tip what do you do (tq) A. Get hemostasis so you can visualize it

54.PA of posterior maxillary showing sinus and asked what is this Inverted Y. What combines those (tq) ….. Such a dumbass sometimes I swear hahaha A. Nasal floor and maxillary sinus

55.Recurrent Ranula what do you A. Excision

56.Recurrent Ranula what do you (same question with a different answer) A. Marsupialization

57.Sialolith where do you find it? A. Wharton’s duct A2. Submandibular gland

58.When does Taurodontism occur embryonically A. Morphodifferentiation (size and shape) (occurs during tooth morphogenesis) ​

59.Cavernous sinus thrombosis happens because A. Congestive heart failure B. Subcutaneous Abscess on upper maxilla (correct)

60.Lugwig angina ​ A. Edema of the glottis

61.Where do you put the margin of the posterior crown? Not sure (I’d say either above or at the gingival ​ ​ level for purposes of gingival health- TR) A. Above the gingival → went with this option today since it said where would you place it if you can… and it would be supragingival so that it’s not messing with the gingiva - TR B. below the gingiva C. at the gingival

62.Side effect of opioids A. Constipation (correct answers) B. Hypertension

63.Target lesions A. Erythema multiforme

64.Chemo receptor target zone A. CTZ

65.Drug vs placebo all have in common except? ​ ​ A. Pharmacologic activity B. Psychological dependence

66.Dry heat and high-pressure instrumentation which one do you not do? ​ ​ A. Wrap instrument in a plastic bag B. Wrap instrument with a paper bag C. Wrapped instruments with a cloth D. Put instruments in a closed metal box? High pressure in closed box make a bomb?? TR ​

67.MOA of carbidopa A. Preventive Depletion of levodopa and replenish dopamine

68.Patient has neck injury and having difficulty breathing A. Call EMT B. Adjust head so he is able to breath C. Cricothyrotomy (maybe this)

69.Where is SNA ​ A. Point on the chin B. Pre-maxilla in between anterior nasal spine and between anterior teeth (something like that. I think this is correct) ● SNA This angle represents the relative anterioposterior position of the maxilla to the cranial base ​ ● the deepest point in the maxillary concavity is the “A” point of SNA

70.How to tell the difference between condensing osteitis versus idiopathic sclerosis A. Vitality

71.A hole in the bone showing/exposing a root A. Fenestration

72.What is considered Secondary preventative care A. Oral hygiene B. Fill pits and fissure (I think this??)

73.What happens with white spot lesions (not sure of the answer) THIS FUCKING QUESTION…. ​ A. You’ll have carries in the first year B. You’ll have caries in the second year C. Unsure of possible future outcomes → as soon as it showed up I thought fuck me I looked ​ everywhere for this answer online and couldnt find it…. But it wont show up on my exam… and then there she was…. D. Nothing will happen if you leave it

74.Which percent in the United States have fluoride in their water A. 30% B. 50% C. 74% ( I think this since the other tq said 65-70%)

75.Elementary school with kids having a lot of interproximal Caries what is the best way to go about this A. Find a near by dental office B. Take radiograph C. Apply fluoride into water

76.Community water has how much fluoride (maybe 0.2 or 0.6) ​ A. 0.2 B. 0.7 C. 1.2 ● U.S. Public Health set optimal fluoride = 0.7–1.2 ppm for public water. ● Food and Nutrition Board recommends public water supplies be fluoridated when levels are significantly below 0.7 mg/L. 77.What is associated with Osteogenesis Imperfecta? A. Dentinogenesis Imperfecta (Both have blue sclera)

78.A picture like the one to the right and asked if you take a radiograph what would you expect? A. Dentinogenesis imperfecta

79.Patient came in for an emergency with an enlarged and inflamed buccal tissue around Maxillary premolar that is necrotic. What’s the first step A. Drain and Incise (maybe correct) B. Antibiotic C. Root canal treatment

80.Pulse of a 4year old (tq) ​ A. 110

81.Bisphosphonates MOA A. Inhibition of osteoclast

82.What does the Articular disc do? (Which way is the articular disc most displaced?) A. Anterior-medially

83.What is not involved in Elevation → Lateral Pterygoid ​ ​ ​ A. Synergism between medial and lateral ptyergoid (this was a tq. Not sure if the answer) OLD TQ from Mastermind #115: you have some guy and their jaw is closing - which muscle is LEAST involved in closing the jaw? Synergism between lateral and medial pterygoids? ● Muscles elevating the jaw: masseter, temporal, medial pterygoid, and SUPERIOR belly of lateral pterygoid

84.Where do you bevel on amalgam to increase resistance ​ A. Axis pulpal (correct) B. Dovetail

85.When do you stop taking Coumadin (there was no option of continued treatment without stopping medication) A. 1 day B. 3 days C. 7 days (correct)

86.How long does Aspirin stay in your system A. 7 days. (Irreversibly inhibits platelet aggregation)

87.Patient feels nauseous on nitrous what do you do? A. Switch to 100% oxygen

88.On an articulator you set teeth at 20 degrees and then you figure out it was wrong and you change it to 45 degree. What do you do? A. Increase the compensatory curve (You could also decrease incisal guidance - TR) ​ ​ 89.Turners Tooth question A. Trauma before birth B. Trauma/infection for posterior tooth after birth (correct)

90.Drug that makes you extremely violent and have psychotic behavior except ​ A. Alcohol B. Amphetamines C. Cannabis D. Opioids

August 23rd : Day 1: All questions from Lilly Pulitzer document from the July 18, 19, and 20 section.

Day 2: Very subjective crap, horrible x-rays, etc. Can’t remember that many cases, the ones I do ​ are below:

Case 1: 8 y/o fell and loss front incisor #F and #E is slightly darker and has a sinus tract. ​ 1. what’s boil on top of gum? Sinus tract from #E ​ 2. #E was mobile, but #8 was about to erupt, extract or monitor and let #8 erupt? Monitor ​

Case 2: case where little girl has bad breath and a lot of caries with history of multiple tonsillitis ​ episode treated with abx. Radiograph shows lots of caries. Mom brought her in because she was being bullied for bad breath and hygiene is really bad. 1. How to improve her oral hygiene? OHI, demonstrate how to brush, and floss. ​ 2. What is causing bad breath? Recurrent tonsil infections. Caries don’t cause bad breath. ​ ​ 3. How to treat issue with bad breath and tonsillitis? Refer for tonsillectomy. ​ 4. What method to also help with oral hygiene? Have parents brush and floss her teeth. ​

Case 3: Guy with interim maxillary rpd that replaces only anterior teeth, complains of food ​ getting stuck on upper teeth. Has a bunch of health issues and bunch of meds. 1. #4 and #13 have really bad caries seen on radiograph, you start to excavate for caries and get pulp exposure on both, whats the next thing you do? Evaluate restorability or go ​ straight to do RCT, post, and core. 2. Radiographs show a radiolucent lesion on #12, in the PA and bitewing its in different spots (angulation), question asks what is it? Based on his caries charting it’s a smooth ​ surface caries. 3. Red mucosal tissue underneath his interim RPD in anterior/palate region, what was it? Either candida or food impaction irritation (not sure). 4. If you were to place implants in the front, which would not be a consideration? Maintenance of caries status 5. Which would be the best maxillary RPD for this patient in regards to cost, esthetics, etc.? Either replace the regular missing teeth, 6, 7 and 8 or other option was replace 6, ​ 7,8, 4 and 13 (I picked this because it mentioned cost, and it would save the patient ​ from doing RCT and crowns on 4 and 13).

Case 4: Guy who has an accident and his front teeth were slightly chipped and he wanted them ​ repaired or made even. 1. What would be the initial treatment for his chipped max incisors? Options were, resin, veneer, crown, or recontour. (I chose recontour because his teeth were very minimally ​ ​ chipped and the question made it seem like which would be your first initial treatment and that was least invasive). 2. What doesn’t this patient need? Scaling and root planning ​ 3. How to recontour mandibular teeth? Ortho extrusion and gingival graft ​

Case 5: Farmer for 40+ years, smokes, and uses smokeless tobacco. ​ 1. White lesion on lip near vermillion border, what was it? From years of working out in ​ the sun (or maybe smokeless tobacco)??? Not sure. 2. What was present on this guys lip? Excess keratin ​

Random questions that I can’t remember what cases they were linked to: 1. What crown material would you use? Lithium disilicate ​ 2. Patient has a cough due to what meds? Lisinopril ​ 3. What is albuterol? B2 agonist ​ 4. You give several carpules of LA to a kid and he started getting confused, altered consciousness, etc. why? LA overdose. ​ 5. Diabetic patient, in history it states they don’t eat often with their medication, about to start a procedure, they get altered state of consciousness, BP drops, what’s happening? Hypoglycemia 6. Bunch of crap from kids eruption, make sure to review cephs, and ortho. 7. What is the radioopacity in front of C4 on a ceph? Hyoid bone ​ 8. What is the line intersecting roots of #2 and #6? Max palatine processes ​ 9. Patient just wants denture on the upper, what don’t you do out of choices given? Maxillary ​ ​ ​ sinus lift.

August 29th

1.Know drugs that you shouldn’t give epinephrine with 2.Know drug interactions 3.Know how the drugs work (MOA) and what happens with certain diseases

Fire Drill Day:

1.What’s the concentration of acidulated phosphate fluoride is used in the dental office? 1.23% ​ 2.Sealants - mechanical micro retention binding to tooth ​ ​ 3.Prolonged, unstimulated night pain suggests which of the following conditions of the pulp? a. ​ Irreversible pulp

4.How do you test a tooth to differentiate between chronic periodontitis and supperative (acute) ​ periodontitis? Percussion ​ 5.Most reliable way to test vitality of a tooth? Thermal test ​ 6.What is the initial treatment of a combination perio and endo lesion? Perform endo with RCT first. ​

7.You do pulpotomy, check with cotton, still bleeding what do you do? Lido to get hemostasis, remove ​ ​ more pulp tissue and check again, formocresol? ​ 8.Cracked tooth w/o pulpal involvement, how u restore? RCT, crown*, amalgam, composite ​ ​ ​ 9.Necrotic tooth with open apex, why do u do specification? so u can have proper seal for obturation. ​ 10. B1 receptor effect: Beta 1 receptor for heart, vasodilator lungs (WRONG B2) ​ ​

11.Tramadol effect :confused disoriented, high bp what is pt experiencing ​ ​

12.Un treated scar on face what will it do? ​ irregular arch decreased vertical ridge and tooth development (lingual inclination of teeth or decreased VDO) ​ anterior will be flared missing teeth

13.Penicillin allergy what type of sensitivity? Type I ​ 14. How many mL in one TABLEspoon? 15mL (5mL in 1 TEAspoon) ​ ​ 15. Being out of pano trough

16. KNO3 as? Desensitizer ​ 17. Pulp capping most successful? Age, Good Seal, Anatomy of Exposure, an isolated field ​ 18. Where do you probe maxillary furcation? ML, DL, Facial ​ ​ 19. Epinephrine and Histamine what kind of reaction? Antagonist ​ 20. Intruded primary max incisor 3 year old what do you do with tooth? Leave it alone? ​ 21. How long do you splint after tooth has been avulsed? 1-2 weeks or 7-10 days ​ ​ 22. Semilunar incision? Apicoectomy of max central or premolar ​ 23.Distal pocket with minimal KG what is the CI? Gingivectomy distal wedge ​ ​ 24.Longest lasting anesthetic? Bupivacaine 1:200,000, Articaine, Lidocaine 1:20,000, Mepivacaine ​ ​ 25.Why is occlusal table of primary teeth small? BL walls converge, Short MD length, Circular cusps, ​ ​ constricted CEJ with parallel BL walls

26.5 year old loses tooth which tooth would create problem? Primary 2nd molar ​ ​ 27.Chlorox for endo → NOT chelating agent ​ 28.Peg lateral what is most likely? Unerupted max central, unerupted max lateral, impacted 3rd molars

29. pH that enamel starts to demineralize? pH 5.5 (critical pH of developing cavities) ​ ​ ​ 30. What is the most important etiologic factor in getting caries? Saliva pH, Bacteria (or Refined Sugar), ​ ​ ​ Fluoride treatment, saliva flow

31.For a lesion in enamel that has remineralized, what most likely is true?

a. The enamel has smaller hydroxyapatite crystals than the surrounding enamel b. The remineralized enamel is softer than the surrounding enamel c. The remineralized enamel is darker than the surrounding enamel d. The remineralized enamel is rough and cavitated

32.Where does caries start for proximal caries (class II)? Apical to proximal contact ​ 33.Least efficient at testing vitality: thermal test, EPT, something about dentin ​ ​ 34. 40 year old patient with all 32 teeth. No cavities. Has stain and catch in pit of molar. What do you do? Watch and observe, sealant, composite ​ 35. What would cause displacement of odontoblastic processes? Thermal, desiccation, mechanical, ​ ​ chemical

36.Burs for smoothing out preps? More flutes and shallow (this is what red burs are), more flutes and ​ ​ deeper, less flutes and shallow, less flutes and deeper

37.What is the most important thing for retention? Surface area ​ 38. What causes the most retention of crown? Axial taper, surface area, surface roughness, retention ​ ​ grooves

39.What could be the reason you see opaque white porcelain in the incisal ⅓ facial of the PFM crown? ​ Inadequate reduction of the inciso facial part of the tooth 40.The modified ridge lap pontic how should it touch the gum? Barely touch it (lightly contacts buccal ​ ​ side of ridge)

41.Most important when selecting shade? Value, translucency, chroma, hue, color ​ ​ 42.Supplies upper lateral eyelid? Lacrimal Nerve → ​ 43.Infraorbital nerve branches from? Maxillary nerve (V2) ​ 44. Red complex has 3 bacterias: P. gingivalis, Tannerella Forsythia, ​ Treponema Denticola

45.Something about permissive occlusal splints: for parafunctional, myofascial ​ ​ pain? - TR

46. 65 year old patient shows several new caries in molars and premolars class ​ V, what material would you use? Amalgam, composite, glass ionomer ​ 47. Lasers and LED lights dont cure all resins because some resins photoinitiators have required light sources out of its range. True and correct logic ​ 48. Which is NOT recommended for final FPD cast (or cast impression) impression? Reversible ​ ​ hydrocolloid, Irreversible hydrocolloid, Polysulfide, PVS ​ ​ 49.Abfraction (flexure of tooth) ​ 50. Which syndrome has rash on cheeks, ulcers, kidneys, etc? Lupus ​ 51. Separation (separation of basement membrane)? Benign mucous membrane pemphigoid ​ 52. Both systemic and topical anti-fungal? Fluconazole ​ 53. What problem causes bilateral angular cheilitis? High vertical dimension, low interocclusal space ​ (low VDO), high occlusal distance ​ 54. 85% of people have herpes ​ ​ ● 65-90% worldwide, 80-85% USA

55.Lesion on the palate that is verrucous and pedunculated? Papilloma ​ 56. Pseudoepitheliomatous hyperplasia: granular cell tumor ​ 57.Mixed density lesion in a young child? AOT ​ 58. All of the following are differential diagonsis for Dentinogenesis Imperfecta except? Ectodermal ​ ​ dysplasia, amelogenesis imperfecta, enamel dysplasia, dentinal dysplasia, enamel hypoplasia (AI) ​ 59. Malignant potential? Osteosarcoma ​ 60. What causes pseudomembranous colitis? refers to swelling or inflammation of the large intestine ​ (colon) due to an overgrowth of Clostridium Difficile (C. difficile) bacteria

61. Sialolithiasis (calcified salivary stone) is found where? Submandibular duct (wharton’s) ​ ​ 62. Sialoliths are most common in what gland? Submandibular gland and duct ​ ​ 63. What does tuberculosis lesion in the oral cavity look like? Large ulcer ​ ● Painful non-healing indurated often multiple ulcers most frequently affected sites were the tongue base and gingiva. The oral lesions look like irregular ulceration or a discrete granular mass.

64. What is primary source of radiation to the operator when taking x-rays? Radiation left in the air, scatter from the patient, scatter from the walls, leakage from the x-ray head ​ 65. What does collimation do? Reduces x-ray beam size/diameter and volume of irradiated tissue, ​ ​ ​ reduces area of exposure

66. X-ray tube target metal is made out of? Tungsten (Target = tungsten/ Filter = Aluminum) ​ ​ 67. What does it look like on a pano when your patient moves during the pano? A vertical blur line ​ (vertical distortion corresponding to when they moved) vs. horizontal defect ​ 68.What kind of x-ray to visualize a supernumerary? Panoramic? -TR ​ 69. If change from 8mm cone to 16mm, how much exposure time do you need to increase by? 2, 4, 6, 8 ​ ​ ​ ​ 70. Which is greater risk for ORN? IV bisphosphonates for a year, radiation 65 grays ​ 71. CASE: Patient on Zoledronic Acid → Osteonecrosis ​ 72. What is the best way to test clotting function on a patient taking Warfarin? INR ​ 73. Allergic to aspirin do NOT give? Acetaminophen, Codeine, Ibuprofen ​ ​ ​ 74. Ginseng is an antiplatelet (interferes with coagulation -- NOT given with aspirin) Patient on warfarin, ​ ​ aspirin (Don’t mix the two) ​ ​ ​ 75. Sign of hypoglycemia → bradycardia, Mydriasis (pupil dilation), Diaphoresis (Sweating), Mental ​ confusion

76. CI for endo? Recent MI ​ 77. Problem with Diabetes? Poor Healing ​ 78. Hyperventilation causes Tachycardia and Tachypnea (rapid breathing after injection) ​ 79. Treat Status Epilepticus: Midazolam (Versed) ​ 80. Opioids do NOT cause? Chronic Cough ​ ​ ​ 81. Biopsy → indicated when treatment doesn’t work after 14-20 days ​ ● About 2 weeks → any red or white lesion that doesn’t resolve itself in two weeks → BIOPSY THAT SHIT

82. If implant with width of 4mm is used, what should be the buccolingual width of the ridge? 7mm, 8mm, ​ ​ 4mm, 10mm

83. Implant failure? Poor oral hygiene ​ 84. Implant failure (2nd question)? Improperly cemented crown ​ 85. What speed and torque for implant is used? High Torque, Low speed ​ 86. Pediatric patients taking amphetamine every day, what can be observed in patient’s health history? ADHD

87. Patient is having sensitivity on biting after RCT? Apical tissues were hurt when doing RCT ​ 88. Decalcified freeze dried bone allograft: Has bone morphogenetic proteins (BMP) ​ 89. Best for autogenous bone graft? Iliac bone (ilium) ​ 90. LA with epinephrine contraindicated in? Hyperthyroidism ​ 91. Patient present with amalgam restorations in good shape and the dentist suggest to change them for composites due to systemic toxicity of the amalgam. What ethic principal is the dentist violating? Veracity ​ 92. What you do first before getting informed consent? Make sure the patient can sign or has ​ guardian, consult physician, discuss options with relatives, etc. ​ 93. Patient says “I do not have time to quit smoking.” What stage is s/he in? Precontemplation ​ 94. Patient with autism will usually show? Heightened sense of lights and sounds ​ 95. If you find problems with a medical condition and a certain drug (interaction), who do you contact? ​ FDA

96.Doctor billed insurance couple of procedures, when actually there is a global procedure that combines them all, what did he commit? Unbundling (FMX 20 charge for each one) ​ ​ 97. When should dentist send patient for psychological counseling? Patient tells dentist how to do job, ​ unrelenting anxiety??, can’t get numb (maybe) ​ 98. Body dysmorphic disorder? Something about patient being very aware of everything in mouth is ​ what I went with. Look up other thing about disorder.

● A mental illness involving obsessive focus on a perceived flaw in appearance. ● Body dysmorphic disorder is a mental disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that, to others, is either minor or not observable. But you may feel so ashamed and anxious that you may avoid many social situations.

99. Mycobacterium is the benchmark for? Disinfection ​ 100. What fibers are involved in pulp testing? A delta ​ 101. What is NOT included in the ADA Code of Ethics? Credential needs to be a dentist (licensure) ​ ​ ​ (Licensure by credential), advertising, patient values, fees ​ 102. Washing an X-ray film? To remove the processing chemicals ​ 103. Acute adrenal insufficiency? Hypotension ​ 104. Mode of action of ultrasonic? Vibration ​ 105. All of the following drugs cause gingival hyperplasia except? Verapamil, Diltiazem (Calcium channel ​ ​ ​ blocker), Phenytoin (Dilantin), Nifedipine, Cyclosporine. (Digoxin would be the one that does NOT ​ cause it so if it gives this option pick it)

● All of the above drugs DO CAUSE THIS, but the question asked which DOESNT so IDK which answer to go with??

106. Apical position flap are contraindicated in what location? Maxillary palatal ​ 107. Crown lengthening procedure, what would you do? Modified woodman flap or Apical reposition ​ flap with osteotomy and ostectomy?

108. Which is contraindicated in 2nd molar region to reduce deep pocket with limited attached gingiva? Gingivectomy

109. FGM 1mm apical to CEJ 3mm probing. How much Attachment loss? 4mm ​ ​ 110. What is caused by smoking? COPD, Emphysema (Emphysema is a type of COPD) ​ ​ ​ 111. CASE: 50ish year old guy needs RCT on #9 thats calcified. What would you most likely include in treatment consent? Perforation?, file separation (I put perforation but not sure though) ​ ​ ​ 112. 40 year old with posterior cross bite, how to treat? Surgery (Suture osteotomy?) ​ ​ 113. Distobuccal denture? Masseter ​ 114. Radiation to jaw? Cervical Caries ​ 115. Tuberculosis lesion? Tonsilitis and Ulceration ​ ​ 116. Anticonvulsant drug for? Myelgia, Parafunctional habits, Neuropathic pain (Glossopharyngeal ​ ​ neuralgia and Trigeminal Neuralgia [Tic Douloureux and atypical facial pain])

117. Sealant and fissures therapy retention by? Retention with groove and pit mechanically, chemical, ​ ​ ​ hybrid layer

118. Conscious Sedation? Patient can speak normally, patients eyes open, patient has body defense ​ ​ response

119. An examination of a complete denture patient reveals that the retromolar pad contacts the maxillary tuberosity at the occlusal vertical dimension. To remedy this situation, which of the following should be performed?

a. Reduce the maxillary tuberosity by surgery b. Cover the tuberosity with a metal base c. Increase the occlusal vertical dimension d. Reduce the retromolar pad by surgery

120. During try-in of mandibular denture, you want to check for? Full movement of the tongue and do ​ all working movements

121. Patient feels fullness of upper lip after delivery of complete denture. Overextended labial flange ​ 122. What will happen if mouth is opened while performing maxillary border molding? Coronoid process ​ will block buccal extension

123. Posterior buccal extension of a mandibular complete denture is limited by? Masseter muscle ​ ​ 124. Patient has sickle cell anemia and has a thrombolytic crisis, what could precipitate this? Nitrous Oxide/ Oxygen use, Cold, Trauma, Infection ​ ​ ● Sickle cell anemia is seen exclusively in black patients. Periods of unusual stress or of O2 deficiency (Hypoxia) can precipitate a sickle cell crisis.

125. Most common in third molar extraction? Fracture, dry socket, paresthesia ​ ​ ​ 126. Anti fungal effective in topical and systemic? Ketoconazole, Fluconazole ​ ​ 127. What is the effect of pKa on local anesthetic? Onset ​ 128. Pure radiolucency? Ameloblastic Fibroma, AOT, Ameloblastic Fibroma Odontoma ​ ​ 129. Lymphadenopathy + being sick for 2-3 days + Petechia + Sore Mouth? Mononucleosis ​ 130. Traumatic cyst → Aspiration biopsy ​ August 26th (pretty much Strawberry Pie File from my comparison… any answers in Red are from what the Strawberry Pie file says is the correct answer) 1. You can’t control bleeding after extraction, what to do next? simple gauze pressure ​ ​ ​ 2. Which Antibiotic can be given in gingival cervicular fluid for periodontal bacteria: doxycycline ​ 3. Not the primary bacteria for initiation of Caries? Lactobacilli ​ ​ ​ ​ 4. Green and orange discoloration of anterior teeth is due to? Bad oral hygiene ​ 5. What’s the adverse effect of using a retraction cord with epinephrine? Local necrosis, Tachycardia ​ ​ 6. What xrays are recommended for a 4 yr old kid? Bitewings depending on dental findings ​ 7. Primary bacteria for the initiation of caries? Strep. Mutans ​ ​ 8. How to communicate and establish a good relationship with a hearing impaired patient? Speak to the ​ ​ patient and allow time for interpretation 9. Most commonly impacted tooth? Maxillary Canines ​ ​ 10. Brown discoloration in porcelain gingival margin after a month of placement with resin cement, what is ​ the most likely cause? Go for silane, Microleakage ​ 11. What is the main reason we do tooth testing? To check for pulp vitality if tooth is necrotic or not ​ 12. During the extraction of an impacted mandibular third molar, the distal root went missing, where did it ​ go to most likely? submandibular space ​ 13. What is important in single implant tooth replacement? countering anatomy of opposing tooth, broad ​ contact with neighboring teeth 14. Picture of a kid’s primary front teeth, literally eaten by caries, with two symmetrical sticking out fistulas bilaterally above lateral incisors/canine area - what are those changes on mucogingival junction? Pus ​ draining fistulas

15. Which papilla is affected in geographic tongue? Filiform papilla ​ ​ 16. What’s the best treatment for a completely intruded primary tooth that does not impinge on permanent ​ tooth? Leave and observe if will re-erupt ​ 17. What age does a child develop dexterity for brushing teeth on his/her own? 2-3 years, 6-8 years ​ ​ ​ 18. Which material retards PVS? Latex gloves ​ 19. What’s advantage of using Arcon over non-arcon articulators? gives more similarity to mandibular ​ movements 20. What age is commonly affected with Primary herpetic gingivostomatitis? 1, 4 ​ 21. Anti histamines (H-antagonist) work by? Blocking histamine at the receptor ​ 22. Primary canine lost prematurely, why? arch length discrepancy ​ 23. Which occlusion is the most common in primary teeth? flush terminal plane ( AKA edge to edge) ​ ​ ​ 24. Bimaxillary effect: relation of both jaws to the cranial base both jaws proclined ​ ​ 25. Case, patient with porcelain crown, a lot of caries, what would you suggest: all overnight treatments ​ and had to pick which fluoride would be best; acidulated / 1.1% neutral fluoride / 0.4% not neutral ​ ​ 26. Which teeth most likely to be crowded/blocked out of mandibular arch? 2nd premolars ​ 27. What doesn’t affect implant treatment planning? Age, Smoking history, Quality of the bone, Location ​ ​ ​ ​ 28. Best prognosis for implant? Anterior mandible ​ ​ 29. Nitrous oxide contraindicated in? first trimester only ​ 30. Contraindication for using Nitrous oxide? Nasal congestion ​ 31. Contraindicated with asthma, what can precipitate the attack? Aspirin ​ ​ 32. MOA of ibuprofen: reversible (non selective COX1 & COX2), irreversible platelet inhibition, ​ ​ ​ 33. MRI is best used for TMJ to see: Disc ​ 34. FAS syndrome (Fetal Alcohol Syndrome), what is characteristic: mid-face discrepancy ​ 35. Most common abnormality among the following? Cleft lip and palate ​ ​ 36. diagnosis of lesion on the xray? ( stafne cyst) Salivary gland intravasation ​ ​

37. Hepatitis A route of infection?Food and drink ​ ​ 38. Additional innervation to teeth is most likely from which nerve, since the LOWER molars didn’t anesthetize well? Mylohyoid nerve ​ 39. Mandibular nerve exits the skull via? Foramen ovale ​ 40. Most dental financing is from? Self-pay ​ 41. Which cyst is not in bone? nasolabial ​ ​ ​ 42. Progressing paresthesia of the lip is most likely due to? Malignancy ​ ​ 43. Firm painful nodule next to mental foramen? Traumatic neuroma ​ 44. Neurofibromatosis - multiple neuro sarcomas, cafe au lait, lisch nodules of the iris ​ ​ 45. Hairy tongue, which papillae affected? filiform ​ 46. Large amalgam MOD restoration, crack of the restoration in the isthmus, no symptoms, what is the best approach now? replace the entire restoration ​ 47. Gutta percha outside of the apex after filling, what do you do? observe for now and wait for ​ symptoms 48. How do you put the beaks on the tooth while extracting, pick false: parallel to the long axis, on the ​ ​ ​ crown, as far as you can towards the roots ​ 49. Subgingival caries, what do you do? crown lengthening ​ 50. You are prepping the tooth for a crown, but realized, that the step is only 1 mm away from the alveolar crest, what do you do? crown lengthening ​ 51. Plaque index is used mainly for: Patient motivation ​ ​ 52. A child’s behavior problem can be managed by desensitization if the basis of the problem is Fear ​ ​ 53. Disadvantages of oral sedation include which of the following? Unpredictable absorption of drugs ​ from the GI tract 54. Auxiliary resistance from features in fixed dental prostheses such as boxes and grooves should ideally be located? Proximally ​ 55. Which of the following would be LEAST likely to lead to the development of root surface caries on ​ ​ facial surfaces? Streptococcus sanguis dominating adjacent plaque ​ 56. When a light beam passes through a mass, it reduces in intensity as it’s absorbed and reflected from different material surfaces, what does this describes? Refraction ​ 57. A displaced fracture of the mandible courses from the angle to the third molar. This fracture is potentially difficult to treat with a closed reduction because of? Distraction of the fracture segments by ​ muscle pull 58. Which of the following substances is contraindicated for a patient taking ginseng? Aspirin ​ ​ 59. What would explain leaking from rubber dam clasps on buccal surface of mandibular molar? Holes ​ ​ punched too close 60. Which term refers to a physician or dentist performing an operation for which there was no consent? Battery 61. A 32-year-old male patient reports a history of having been hospitalized for psychiatric evaluation, and is currently taking taking lithium carbonate on a daily basis. Which of the following diseases does this patient most likely have? Bipolar disorder ​ 62. The patient should sign the informed consent for surgery? After a full discussion of the surgical ​ treatment plan 63. Distinctly blue color of the sclera is a feature of which of the following conditions? Osteogenesis ​ ​ imperfecta (& Dentinogenesis Imperfecta) ​ 64. A 16-year-old patient has a long history of mild pain in the area of the mandibular left first molar. Radiographs reveal deep caries in the tooth with an irregular radiopaque lesion apical to the mesial root. Which of the following represents the most likely diagnosis? Condensing osteitis ​ 65. 6-year-old patient is uncooperative during treatment. Which of the following techniques is indicated? Voice control 66. Hypotensive effect and itching from oxycodone is due, in part, to its? Release of histamine ​ 67. Which of the following does NOT produce a pharmacologic decrease in saliva production? ​ ​ Pilocarpine (Salagen) (Atropine, Scopolamine and Glycopyrrolate all DO decrease saliva production) ​ 68. Which of the following is difficult to accomplish with extrinsic characterization of metal ceramic restorations? Increase value ​ 69. The rubber dam does NOT protect patients from which of the following? Mercury vapors when ​ ​ ​ removing old amalgams 70. Which of the following is responsible for creating a green discoloration in the marginal area of the ​ ​ ​ ​ metal ceramic restoration? Copper; (Other places of PFM turn green is due to Silver) ​ 71. Removal of amalgam overhangs should be accomplished as part of initial therapy. Re-evaluation of the periodontal case should occur 4-6 weeks after the completion of the scaling and root planning procedures. Both statements are true ​ 72. A patient has a severe tooth-size/arch-length discrepancy in the maxillary arch. Which of the patient’s ​ permanent maxillary teeth are most likely to be blocked out of the arch? Canines ​ 73. Which of the following contributes most to a successful pulp capping procedure? An isolated field ​ ​ 74. Which of the following has the greatest impact on the success of a periodontal flap procedure? Level ​ of postoperative plaque control 75. The most common form of periodontal disease seen in school-aged children is? Marginal gingivitis ​ 76. The procedure of choice for vertical maxillary excess is? LeFort I osteotomy ​ 77. Periodontal flaps are frequently extended into non-diseased areas for adequate access to the diseased sites. These non-diseased root surfaces are not instrumented. The flaps are returned to their previous level where the flap collagen fibers reunite with the Sharpey’s fibers in the cementum of the root surfaces. Which of the following types of healing is described? Reattachment ​ 78. Who is associated with the least risk of inhaling N2O? Patient ​ ​ ​ 79. When adjusting the condylar guidance for protrusive relationship? the incisal guide pin on the ​ ​ articulator should be raised out of contact with the incisal guided table. 80. Deepest part of occlusal rest for RPD? Fossa ​ 81. Swelling on lip after taking impression: Angioedema ​ ​ 82. During endodontic treatment you encounter a ledge inside the canal, What to do? Taka a smaller file ​ and try to pass by 83. For big osseous defect, which graft is better? Autologous graft (Autogeneous graft) ​ ​ 84. Case. Patient comes with bilateral bone expansion, and complains about Dentures won’t fit? Paget’s ​ disease 85. Open bite more than 8 mm, what you'll do? Le Fort 1 osteotomy ​ 86. Boys and girls in school age study (want to do a study to compare DMFT of girls and boys in school, which test to use?): T-Test ​ 87. Which medication to use for Benzodiazepines reversal: Flumazenil ​ 88. A 20 yrs old patient with multiple jaw cysts, you suspect that he has syndrome so you refer him to specialist, what’s the most probable diagnosis? Gorlin , multiple OKC ​ ​ 89. The amount of radiation on a panoramic RX is compared to? 4 bitewings ​ 90. What do you check in the wax try in Except: Obtain facebow record ​ ​ ​ ​ 91. What causes the least buccal-lingual resistance to lateral forces? One 4mm diameter implant. 2 ​ ​ 4mm diameter splinted implants 92. Antibiotic for NO- ODONTOGENIC Maxillary Sinusitis? Amoxicillin + clavelulinic acid ( Augmentin) ​ ​ 93. For an amalgam Class 2 matrix should be placed where? 1mm above marginal ridge ​ 94. Which of the following is the Most radio resistant: skeletal muscle ​ ​ 95. During an IAN not been able to achieve proper anesthesia means it went to which accessory ​ ​ ​ innervations? Mylohyoid ​ 96. What cannot be on tongue? Peripheral giant cell ​ ​ ​ 97. What’s Aspirin mechanism of action? Irreversibly inhibit platelet aggregation ​ 98. What cyst is a true cyst? Dermoid ​ 99. Most common association of osteogenesis imperfecta with? Dentinogenesis imperfecta ​ ​ 100. Mandibular nerve foramen cranium: foramen ovale ​ ​ 101. Cause of secondary hyperparathyroidism: renal failure ​ 102. Chronic pericoronitis: Seen on x-ray as flame-like appearance distal to the mand. third molar ​ ​ 103. Less recurrence tumor: AOT, Odontogenic Keratocyst? ​ ​ ​ ​ ​ 104. what you find in area of tension: Increased fibroblastic activity, increased number of osteoclast ​ ​ ​

August 30/31st

1. Liner under amalgam : calcium hydroxide ​

2. portion of enamel caries seen on x-ray: body ​

3. Occlusal caries : apex of triangle toward occlusal , base DEJ ​

4. Which has increasing in US: root caries ​

5. Difference between enamel hatchet and gmt ​ ● HATCHET: cutting edge in the plane of the handle. Designed to most effectively plane enamel of ​ the facial and lingual walls of class II amalgam preparation ● GMT: has a curved blade and angled cutting edge. Primarily used for beveling gingival margins, ​ and for rounding or beveling the axiopulpal line angle of class II preparations.

6. Self threaded pins … ● Made of stainless steel or gold plated titanium pins, provide maximum retention among all types of pins, cause craze lines and are used in VITAL teeth. ● Threads will engage in dentin as it is inserted into the dentin due to the elasticity of the dentin

7. APF which concentration:1.23% ​ ​

8. Apexification: root development of pulpless ​

9. Pain on biting or release: cracked tooth syndrome ​

10. NaCl except: chelating agent ​ ​ ​ ​

11. Continuous clockwise rotation: reaming ​

12. After RCT, how treat sinus tract: no tx ​

13. Obturates RC with chronic periodontitis: enterococcus fecalis ​

14. How to keep rapport: eye contact ​ ​

15. “You’re not afraid of.., are you “: leading question (twice) ​

16. Systemic desensitization: relaxation exercises ​ ​

17. Dental fear: related to previous bad experiences ​ ​

18. Have higher temperatures: dry heat ​

19. Something about autonomy ​ ● Which two principles of ethics will be in conflict when a dentist prescribes community water fluoridation? Autonomy & Beneficence ​ ● What principle has to do with a patient’s self-governance & privacy? Autonomy ​ ​ ● Informed Consent = Autonomy

20. Who regulates MSDS (Material Safety Data Sheet): EPA ​ ​

21. Study for incidence: descriptive (no cohort option) ​ ​

22. Plaque index: measure plaque in gingival margin ​

23. DMO: capitation ​

24. Bundling ​

25. Most common: cleft lip and palate ​ ​

26. Absence of teeth: ectodermal dysplasia ​ ​

27. Cellulitis tx → Tx with Antibiotics like penicillin ​

28. Leukemia in kids: ALL ​

29. Calcification time (know it!) → ​

30. Anodontia: initiation ​ ​

31. Lesion didn’t disappear after 30 days: biopsy ​ ​

32. Port wine stain: Sturge-Weber ​ ​

33. Mandibular gland depression: stafne bone defect ​ ​

34.globulomaxillary cyst: x-ray ​ ​

35. Melanotic macule: picture ​ ​

36. Nicotine stomatitis : picture ​ ​

37. Related to EBV: Burkitt’s ​

38. Hand-foot-mouth: herpangina ​

39. Pseudomembranous candidiasis: rubs off ​

40. Median rhomboid glossitis: picture ​ ​ ​

41. Lichen planus: picture ​ ​

42. High incidence in becoming carcinoma in situ: erythroplakia ​

43.SCC lateral border of tongue: picture ​ ​

44. Multiple skin modules, cafe au lait spots: neurofibromatosis ​ ​ 45.how to identify sialolith: occlusal x-ray (twice) ​

46. #1 salivary malignant: mucoepidermoid carcinoma ​

47. Higher 5 year survival: adenoid cystic carcinoma ​

48. NOT developmental: radicular cyst ​ ​ ​

49. Something about Gorlin Syndrome ​ Nevoid basal cell carcinoma syndrome: Gorlin syndrome • Autosomal dominant • Basal cell carcinomas (cheek, upper eyelids, nose, trunk), palmar and plantar pit, ​ hyperkeratosis palms and soles, epidermal cysts/lipomas/fibromas, multiple OKC’s, bifid ribs, ​ ​ ​ ​ kyphoscholiosis, calcification of falx cerebri ​ • Treatment: enucleation, most anomalies not life threatening

50. Ameloblastoma can developed from : dentigerous cyst ​

51. Periapical cemento osseous dysplasia: ant mandible, black female, vital teeth ​ ​

52.acute osteomyelitis: odontogenic infection ​

53: condensing osteitis tx (picture): no treatment ​ ​ ​

54. Epi- histamine type of antagonism: physiological ​

55. Epi reversal: prazosin ​

56. Asthma contraindication: aspirin/ nsaid ​ ​

57. Methemoglobinemia signs: cyanotic lips ​ ​

58. Non ionized base: more lipid soluble ​

59. Anesthetic blocks: Sodium channel ​

60. 2% lidocaine: 36 mg ​

61. Midazolam: amnesia ​

62. BDZ reversal : flumazenil ​ ​ 63. Cimetidine: H2 receptor ​

64. Sulfa, methotrexate: folic acid inhibitor ​ ​

65. Penicillin cross allergy to : cephalexin (MOA are closely related to each other) ​ ​

66. Metronidazol: do not take alcohol ​ ​ ​ ​

67. Coumadin and broad spectrum antibiotics: Broad spectrum antibiotics enhance the action of ​ coumadin anticoagulants because of the reduction of Vitamin K sources.(Antibiotic medications are ​ ​ associated with an increased risk of bleeding among patients receiving warfarin.)

68. NSAID: ceiling analgesia ​

69. Cholinergic actions: salivation, lacrimation, urination, defecation ​

70. Treats xerostomia: pilocarpine ​ ​

71. pedal edema, dyspnea, orthopnea: CHF ​ ​ ​

72. Warfarin which test: PT, INR? ​ ​ ● INR deals with PT; The higher the INR, the greater the anticoagulant effect (more bleeding, higher PT value)

73. INR:2 : do implant ​

74. After 3m extraction: ibuprofen + hydrocodone ​

75. Children controlled asthma: ASA 2 ​

76. NO contrindication: psychotic disorder ​

77. NO nausea : turn off, give 100% O2 ​ ​

78: peri -mucositis: soft tissue inflammation ​

79. Cement retained implant → Need more interocclusal space for cement retained implants ​ ​

80. Complete Denture buccal vestibule: buccinator ​

81. Combination syndrome ​ Kelly Combination syndrome - when you have a maxillary complete denture over mandibular Class 1 ​ Kennedy RPD. ● Has 5 characteristics: overgrowth of maxillary tuberosity, papillary hyperplasia of hard palate, ​ bone loss in maxillary anterior, mandibular anteriors super erupt, and bone loss under distal extension of mandibular

82. Complete Denture clicking when speaking: excessive VDO ​ ​ (or decreased interocclusal distance (freeway space) →

83. “S” sound: teeth almost touch ​ ​

84. palatal seal: compensates shrinkage of resin ​

85. Horseshoe strap: palatal torus ​

86. ClassIII MOD 1: palatal strap ​

87.prevents distal extension of rpd ‘loose’: indirect retainer ​

88.retentive clasp should seat: passively ​

89. Vitallium ● Vitallium is a trademark for an alloy of 65% cobalt, 30% chromium, 5% molybdenum, and other substances. The alloy is used in dentistry and artificial joints, because of its resistance to corrosion.

90. Less gingival tissue: facial pm ​

91. Retraction cord: epinephrine (will cause increase in HR) ​ ​ ​

92. Minimal height gingival incisal to crown: 4 mm molars ​

93 . Short clinical crown: buccal grooves for retention, proximal grooves increase ​ ​ ​ retention/resistance on short teeth

94. Connectors for pfm should increase what for resistance: height ​ ​

95. More stable: PVS ( no polyether in options) ​ ​ ​

96. Highest Coefficient of Thermal Expansion (CTE): composite ​

97. Eugenol: inhibits polymerization of resin ​

98. Zirconia: luting cement ​

99. Aging values: decreases ​

100. Non working interferences: LUBL ​

101. Biological width: JE+ CT 2mm ​ ​

102. Best for GTR: 3 wall defect ​ ​

103: LAP: 1M (IDK what the hell LAP stands for -TR) ​ 104.pellicle formation: within seconds ​

105.plaque 72 hours: anaerobic gram negative (-) bacteria ​

106. First step in perío do: plaque control and patient education ​

107. Maintenance phase: every 3 months ​ ​

108. Increase perio Risk factor: smoking ​ ​

109. Gracey 13-14: posterior distal ​

110. Split thickness: mucosa and submucosa ​

111. Gingivectomy: external bevel ​

112. Gingivectomy: secondary intention healing ​

113. Osteoplasty : non supporting bone ​

114: autograft: osteogenic (ONLY ONE) ​ ​

115: host modulation therapy: periostat ​

116. kVp: energy ​ ● kVp: ability for the beam to penetrate tissues, energy ● YOU WANT TO HAVE HIGH kVp AND LOW mA for MOST penetration

117. Latent period: from exposure to onset of symptoms ​

118. Wavelength affected by: kVp ​

119. Pterygomandibular raphe: buccinator, sup phar. Constrictor ​ ​ The pterygomandibular raphe (pterygomandibular ligament) is a ligamentous band of the ​ ​ ​ ​ buccopharyngeal fascia, attached superiorly to the pterygoid hamulus of the medial pterygoid plate and inferiorly to the posterior end of the mylohyoid line of the mandible. ● Its medial surface is covered by the mucous membrane of the mouth. ​ ​ ● Its lateral surface is separated from the ramus of the mandible by a quantity of adipose ​ ​ tissue. ● Its posterior border gives attachment to the superior pharyngeal constrictor muscle. ​ ​ ● Its anterior border attaches to the posterior edge of the buccinator. ​ ​

120. Inferior alveolar + lingual nerve block: extract entire quadrant of teeth ​

121. Distance between implants: 3mm (distance between implant and adjacent tooth = 1.5mm) ​

122. Best place for implant : anterior mandible ​ ​