MDCN Dental Assessment flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Reversible pulpitis

Provoked pain that resolves quickly after stimulus removal; pulp remains vital and responsive to cold testing. Treatment is removal of cause and conservative restoration, not root canal treatment.

Irreversible pulpitis

Spontaneous or lingering pain, often nocturnal, with prolonged response to cold or nonresponsive pulp. Requires pulpectomy or extraction; analgesics and antibiotics do not resolve pulpal inflammation.

Avulsion extraoral time

Replantation within 60 minutes gives best periodontal healing. Dry time over 60 minutes causes root resorption and ankylosis; store tooth in milk or saline during transport.

Lidocaine maximum dose

Lidocaine 2% with 1:100,000 adrenaline: maximum 4.4 mg/kg, capped at 500 mg for adults. One 2.2 mL cartridge contains 44 mg, so roughly 11 cartridges reach the adult cap.

Alveolar osteitis

Dry socket occurring 2-4 days after extraction with severe throbbing pain, empty socket, and exposed bone. Risk factors include smoking, oral contraceptives, and traumatic extraction.

Infective endocarditis prophylaxis

Amoxicillin 2 g orally 30-60 minutes before invasive dental procedures for high-risk cardiac patients such as prosthetic valves or previous endocarditis. Clindamycin is no longer first-line alternative.

Gow-Gates technique

Alternative mandibular anaesthetic targeting the condylar neck, anaesthetising inferior alveolar, lingual, mylohyoid, and buccal nerves. Useful when conventional inferior alveolar block fails due to accessory innervation.

Le Fort I fracture

Horizontal maxillary fracture above tooth apices producing a mobile maxilla, malocclusion, and palatal ecchymosis (Guerin sign). Managed by reduction and internal fixation with miniplates.

Zygomatic complex fracture

Presents with subconjunctival haemorrhage, infraorbital paraesthesia, flattened malar prominence, diplopia, and trismus. Orbital floor entrapment requires urgent assessment and repair.

Pell and Gregory classification

Classifies mandibular third molar difficulty by depth relative to occlusal plane (A-C) and ramus relationship (I-III). Winter classification describes angulation: mesioangular, distoangular, horizontal, vertical.

BSSO

Bilateral sagittal split osteotomy of the mandible used in orthognathic surgery for mandibular advancement or setback. Allows rigid internal fixation and rapid return to function.

MRONJ

Medication-related osteonecrosis of the jaw linked to bisphosphonates, denosumab, and antiangiogenics. Staged 0-3; conservative treatment with chlorhexidine and antibiotics; surgery for stage 3.

Pleomorphic adenoma

Most common benign salivary gland tumour, typically in the parotid superficial lobe. Treated by superficial parotidectomy with facial nerve preservation due to recurrence risk if enucleated.

TMJ dislocation reduction

Condyle lies anterior to articular eminence. Reduce by applying downward and backward pressure on the mandible with thumbs on molars; recurrent cases may need eminectomy or botulinum toxin.

Osteoradionecrosis

Bone necrosis after radiotherapy, usually dose above 60 Gy, often triggered by extraction. Avoid elective extractions for about 3 years post-radiotherapy; hyperbaric oxygen remains controversial.

Crown preparation reduction

Full metal crown: 1.5-2.0 mm occlusal and 1.0-1.5 mm axial reduction with chamfer margin. Ceramic crowns require 1.5-2.0 mm occlusal and 1.0-1.5 mm axial reduction.

Ferrule effect

A circumferential collar of at least 1.5-2.0 mm of sound dentine above the restoration margin improves fracture resistance of endodontically treated teeth with posts and cores.

Working length determination

Established with an apex locator and confirmed radiographically. Instrumentation stops 0.5-1.0 mm short of the radiographic apex; the master cone should show tug-back at this length.

Sodium hypochlorite irrigation

Irrigant at 1-5.25% dissolves organic tissue and is antimicrobial. Never extrude beyond the apical foramen; extrusion causes severe pain, swelling, and tissue necrosis (hypochlorite accident).

EDTA in endodontics

17% EDTA chelates inorganic debris and removes the smear layer, opening dentinal tubules. Used as a final rinse after sodium hypochlorite to improve sealer adaptation.

Selective caries removal

In deep lesions, soft infected dentine is removed peripherally while affected dentine is left over the pulp to avoid exposure. Stepwise excavation is completed at a later visit.

Post space preparation

Retain 4-5 mm of apical gutta-percha for seal; post length should at least equal crown height. Excessive removal of gutta-percha risks apical leakage and root perforation.

RPD rest seat

Prepared on abutment teeth to provide support and direct occlusal forces along the long axis. Usually saucer-shaped, at least 1 mm deep, with no undercuts.

DMFT index

Counts decayed, missing, and filled permanent teeth per person. DMFT at age 12 is the WHO global caries indicator, with a target below 3.

dmft index

Equivalent of DMFT for primary teeth, counting decayed, missing, and filled primary teeth. Used in surveys of preschool and young children.

CPI scoring

Community Periodontal Index scores sextants 0-4: 0 healthy, 1 bleeding, 2 calculus, 3 pocket 4-5 mm, 4 pocket 6 mm or more. Used in WHO oral health surveys.

Water fluoridation

Adjusting community water to about 1 ppm fluoride reduces dental caries by 20-40%. It is a population-level measure recommended by WHO and public health bodies.

Fluoride varnish

Contains 22,600 ppm fluoride, applied 2-4 times yearly to prevent caries in children and high-risk adults. Safe and effective; avoid in active ulceration.

Fissure sealants

Resin applied to pits and fissures of erupting permanent molars reduces caries by up to 80%. Best applied soon after eruption when the tooth is fully visible.

Ottawa Charter

WHO 1986 framework for health promotion: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient health services. Basis for oral health promotion.

Free sugars recommendation

WHO advises free sugars below 10% of energy intake, ideally below 5%. Sugar-sweetened beverage taxation is a recognised population prevention measure.