Prometric

Dental Exam
Important Notices
It’s important to understand that this is a reference source and it’s based on people’s experience
and referred to some sources for verification none the less … we are human and we can
do mistakes… but this is the best we can do
– OziDent Team.
We cannot guarantee Success but we are the best possible choice with the highest success rate.

Authors
Original Edit
Dr Mohammed Talaat Dr Doaa abdulhafeez
Dr Duaa Salih Mkawi Dr Basel Hisham
Dr. Yousef Ali Dr. Alyaa Yousef
Dr Nagwan Dr Fiesal hassan
Dr Mona Dr Mohammed Alsaadany
Dr Fayez Nofal Dr amoona abdulraheem
Dr al kharaz Dr Mahmoud zuheir
Dr omar baraa Dr. Alyaa
Dr Mohsen S. Ozaibi Dr. Fajer

Special Thanks to all the dentists that contrubutued the questions
Edited by Dr. Mohsen S. Ozaibi (OziDent.com)

Contact

Please contact me at [email protected] for further information or correction
Aslo visit our website

http://www.ozident.com






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Anesthesia
• anesthesia at buccal mucosa of upper arch and buccal mucosa of lower arch between mental foramen
is (supra-periosteal)..
- anesthesia at palate (sub-periosteal).
- at lingual (sub-mucosa).
- block (is anesthesia of large terminal branch of nerve.)

Flouride
• fluoride supplement for children from 6 months to 3 years if fluoride less than 0.3ppm we give him 250
um (0.25 mg).
• If children 3-6 years less than 0.3ppm we give him 0.5 mg. If from 0.3 to 0.7ppm we give him 0.25mg...
if more than 6 years if less than 0.3ppm we give him 1mg if 0.3 to 0.7 ppm we give him 0.5 mg.
• Types professional applied flouride: soultion -gel - foam.

Forceps
• tringular elevator (Cryer) are pairs of instruments and are therefore used for mesial or distal roots.
• Crane pick is heavy instruments used to elevate whole roots or even teeth.
• Addison forceps: is used to (gently) stabilize soft tissue for suturing or dissection. For anterior region.
• stillies forcep: is longer than Addison and is used to handle tissue in more posterior aspects.
• Allis forceps: for grasping and holding tissues that will be excised. So if question said which forceps hold
tissue ( firmly) answer would be Allis because other 2 types hold tissue gently.

Ulcers
V. Imp to differentiate between herpetic and aphtous ulcer:

• The development of vesicles (small blisters) within 24-48 hours will help to validate the occurrence
of a recurrent herpes outbreak.
• Common sites for recurrent aphthous ulcers include labial and buccal mucosa, floor of the mouth,
oropharynx, vestibule, and lateral tongue. With the exception of sites of frequent trauma, there
appears to be no predilection for aphthous ulcers to recur at a previous location.
• In contrast, RIH generally appears on keratinized tissues such as the vermillion borders of the lips,
hard palate, attached gingivae, and alveolar ridges. The initial lesion can be at any of these
locations with subsequent outbreaks often manifesting at or very near the original site.
• minor aphthous ulcer: shallow ,2-4 mm in size. Usually appears as a single lesion, although 1-5
ulcers may be present. The initial lesion may begin as an erythematous macule, but it quickly
• progresses to an ulcer characterized by white to yellow or gray center of necrosis surrounded by a
smooth, symmetrical, round or elliptically shaped
• erythematous perimeter often described as a "red halo.
• Need 7-10 days for healing.
• Major aphtha: heals slowly over 10-40 days. very rarely more than 10 mm.. 1-6 ulcer at a time.

Varnish
o reduce microlikage
o prevent corrosion products to move from amalgam to dentain
o prevent discoloration.

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Bleeding Factors
‫ ﺛﻢ ﻋﻮاﻣﻞ اﻟﺘﺨﺜﺮ ﺛﻢ‬Platelets ‫ ﺗﻘﻠﺺ اﻟﻮﻋﺎء اﻟﺪﻣﻮي ﺛﻢ ارﺗﺼﺎص اﻟﺼﻔﯿﺤﺎت اﻟﺪﻣﻮﯾﺔ‬:‫• اﻟﻌﻮاﻣﻞ اﻟﺘﻲ ﺗﺆدي اﻟﻰ ﺗﻮﻗﻒ اﻟﻨﺰف‬
.‫اﻧﺤﻼل اﻟﻔﯿﺒﺮﯾﻦ‬
• BT 2 - 8 min. (Aspirin).
• PT ( prothrombin time): 10 - 13,5 sec. (Warfarin).
• PTT ( partial thromboplastin time): 25-35sec.(heparin)
• Platelets count: 150,000— 400,000/mm3.
• complete blood count includes the red blood cell (RBC) count, white blood cell (WBC ) count,
hemoglobin (Hgb), hematocrit (Hct).
.‫ ﯾﺘﻌﻠﻖ ﺑﺎﻟﺴﺒﯿﻞ اﻟﺪاﺧﻠﻲ‬PTT ‫ ال‬..‫ ﯾﺘﻌﻠﻖ ﺑﺎﻟﺴﺒﯿﻞ اﻟﺨﺎرﺟﻲ‬PT ‫ ال‬..‫ ﯾﺘﻌﻠﻖ ﺑﺎﻟﺼﻔﯿﺤﺎت‬BT ‫ال‬
• Extrinsic related to PT time elongate by warfarin or chomarin because of tissue injury that (tissue
factor release) and activate VII factor which is activated (X).
• Intrinsic related to PTT elongated by heparin : XII- XI - IX then (X).
• Aspirin and NAID and some Antibiotic which is effect on flora of stomach and some antidepressants
and diabetes patients and some medicine of herat diseases effect on Platelets accumulation.
.‫ اﻟﻒ ﻟﺘﻌﺪاد اﻟﺼﻔﯿﺤﺎت ﻻﻧﻘﻮم ﺑﺎﻟﺠﺮاﺣﺎت ﻛﺒﺮى‬150 ‫ﺗﺤﺖ ال‬
block anestheia. ‫ اﻟﻒ ﻣﻦ ﺗﻌﺪاد اﻟﺼﻔﯿﺤﺎت ﻻﻧﻘﻮم ﺑﺎﻟﻌﻤﻠﯿﺎت اﻟﺼﻐﯿﺮة او‬70 ‫ﺗﺤﺖ ال‬
• topical Hemostatic: surgery.. Gelfoam.. pressure..suturing.. adrenaline.
• glanzmann syndrome ( genetic platelet disorder).
• Hemophilia A (factor VIII) elongate time of PTT but BT and PT not affected.
• Hemophilia B (factor IX).
• Hemophilia C (XII).
.‫ اﯾﺎم ﻣﻦ اﻟﺠﺮاﺣﺔ‬3 ‫ اﻟﻰ‬2 ‫• ﯾﺠﺐ ان ﻧﻮﻗﻒ دواء اﻟﻮرﻓﺎرﯾﻦ ﻋﻨﺪ اﻟﻤﺮﯾﺾ ﻗﺒﻞ‬
.‫ اﯾﺎم ﻣﻦ اﻟﺠﺮاﺣﺔ‬7 ‫ اﻟﻰ‬5 ‫• اﻻﺳﺒﺮﯾﻦ ﯾﻮﻗﻒ ﻗﺒﻞ‬
.‫ ﺳﺎﻋﺎت ﻗﺒﻞ اﻟﺠﺮاﺣﺔ‬6 ‫• اﻟﮭﯿﺒﺎرﯾﻦ ﯾﻜﻔﻲ‬

Prostheses
• The removable partial denture is useful for intrusive, extrusive, tipping and rotational type
movement.
• FPD for bodly movement.
• best retentive shape of alveolar ridge for complete denture is rounded prominent
• Best palatal shape: u shape.
• Best arch shape: square.
• palate that not resist vertical forces is v-shape.
• Palate don't resist lateral forces is flat.

Cleidocarnial dysplasia:
‫ ﻋﺪم او ﺳﻮء ﺗﻜﻮن ﻓﻲ اﺣﺪ او ﻛﻞ‬..‫اﻟﻄﻔﻞ ﯾﻜﻮن ﻗﺼﯿﺮ اﻟﻘﺎﻣﺔ‬p21.. 6 ‫ ﯾﺤﺪث ﺗﻐﯿﺮ ﻓﻲ اﻟﻤﻮﻗﻊ‬..‫ھﻮ ﻣﺮض وراﺛﻲ ذو ﺻﻔﺔ ﺟﺴﻤﯿﺔ ﺳﺎﺋﺪة‬
cementum ‫ ﻏﯿﺎب ال‬...‫ ﺗﺄﺧﺮ ﺑﺰوغ اﻻﺳﻨﺎن ﻛﻠﮭﺎ‬..‫ﻧﻘﺺ اﻟﻨﻤﻮ اﻟﻔﻚ اﻟﻌﻠﻮي‬...‫ ﺑﺮوز ﺟﺒﮭﻲ‬..‫ وﺟﻮد اﺳﻨﺎن زاﺋﺪة‬..‫ﻣﻦ ﻋﻈﻤﻲ اﻟﺘﺮﻗﻮة‬
.‫ ﺗﺄﺧﺮ ﺗﻌﻈﻢ اﻟﺪروز ﺑﺎﻟﺠﻤﺠﻤﺔ‬...‫او ﺗﻐﯿﺮه‬

causes of white lines:

o traumatic finishing and polishing technique.
o Improper etching and bonding.
o high intensity light curing which cause polymerization.

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Cements
• Types of Glass ionomer Type I for the cementation of metal restorations and direct bonded ortho
brackets.
• Type II for restoring areas of erosion near the gingiva
• Type III used as a liner and dentin bonding agent.
• Cement not irritant to pulp is zinc polycarboxylate and least cement cause irritation to pulp Zoe.
• best cement is resin cement and useful for all types of crowns and for onaly and inlay and
orthodontic bands.

Ventilations
• hyperventilation: dizziness -syncope- Numbness - chist pain - shortness of breath - increase rate
and depth of breaths - tachycardia.
• Hypoventilation:fatigue, daytime sleepiness, anxiety, and slow or shallow breathing
• As the condition worsens, cyanosis (blue lips, fingers, and toes) or paleness may occur. Severe
disease may cause confusion, extreme fatigue, seizures, and mental status changes, and may
ultimately lead to impairment of other organ.

Teeth Development
• calcification of first molar start at birth and anterior permanent incisors at 2-4 months canines at 4-
5 months premolars at 2.5 years second molar at 3 years third molar ar 6 yrs.

Cysts
• Lateral periodontal cyst: related to vital tooth occurs frequently at lower jaw. Well defined round or
ovoid RL with sclerotic margin. Most is smaller than 1 cm.

Muscles
• muscles: lateral pterygoid (depress the lower jaw) for open the mouth.
• Middle pterygoid: act with lateral at one sode to bring the lower jaw forward.
• Temporal and masseter: (raise lower jaw) to close the mouth.
• Mylohyoid: forms floor of the mouth elevates tongue and depresses lower jaw.

• HbcAg: Hepatic cells are affected.
• HbeAg: acute infection.
• Anti HBS immunity.
• HbsAg: chronic infection.
‫طﻮل اﻟﻔﻼب ﯾﺠﺐ ان ﻻﺗﻜﻮن اﻛﺜﺮ ﻣﻦ‬apex... ‫ اﻋﺮض ﻣﻦ ال‬flap ‫ ﯾﺠﺐ ان ﺗﻜﻮن ﻗﺎﻋﺪة ال‬flap‫ ﻟﻞ‬necrosis ‫ﻟﻤﻨﻊ ال‬ •
‫ﺿﻌﻔﻲ اﻟﻄﻮل‬

Bleaching
10..15...20 ‫ ﺑﺘﺮاﻛﯿﺰ ﻣﺨﺘﻠﻔﺔ‬carbamide peroxide ‫ﻧﺴﺘﺨﺪم ﻓﻲ اﻟﺘﺒﯿﺾ اﻟﻤﻨﺰﻟﻲ‬ •
hydrogen peroxide 25 - 35%. ‫ﻧﺴﺘﺨﺪم ﻓﻲ ﺗﺒﯿﺾ اﻟﻌﯿﺎدة‬ •

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Tongue Sensory
• sensory innervation and taste of tongue:
- posterior 1/3: Glossopharyngeal nerve.
- -Anterior 2/3 lingual nerve and taste chorad tympani.
- motor innervation: Hypoglossal nerve.

Oral Lesions
• Leukoplakia: any site at mouth - very little pain and ulceration and secondary infection may occur.
the lesion vary from fine, white transparency to heavy& thick& warty plaque.. the lesion should
firmly attached to mucosa unable to remove... maybe caused second to chronic irritation or
trauma. like from use of smokeless tobacco, poorly fitting denture or cheek biting. (Often pre-
malignant lesion).
• Lichen planus: is a benign chronic disease that affects the skin ( red spots) and oral mucosa, circles
and interconnecting lines called wichhams striae bilateral. Second type can cause erosive lesion of
givinga.
• Candida: can result from antibiotic therapy, diabetes, xerostomia, weak immunity. With AIDs
patients.
necrotizing sialometaplasia •
‫ﺑﻮﺳﻄﮭﺎ وﻗﺪ‬necrosis) ) ‫ اﻛﺜﺮ ﻣﻜﺎن ﺷﺎﺋﻊ وﻋﺎدة ﯾﻜﻮن اﺣﺎدي اﻟﺠﺎﻧﺐ ﺗﻜﻮن ﺑﺎﻟﺒﺪاﯾﺔ ﻣﺆﻟﻤﺔ وﻗﺪ ﯾﺘﻄﻮر ﺗﻨﺨﺮ‬hard palate
‫ وھﻲ ﻻﺗﺤﺘﺎج ﻣﻌﺎﻟﺠﺔ ﻋﺎدة وﻟﻜﻦ ﻓﻲ ﺑﻌﺾ اﻷﺣﯿﺎن ﺗﺤﺘﺎج اﻟﻰ ﺧﺰﻋﺔ ﻟﺘﺤﺪﯾﺪ اﻟﺘﺸﺨﯿﺺ‬.‫ﯾﻤﺘﺪ اﻟﻰ اﻟﻨﺴﺦ اﻟﺮﺧﻮة وﻋﻈﻢ اﻟﺤﻨﻚ‬
.‫اﻟﻀﺮوري‬

Teeth Lesion
• Attration: occurs by tooth to tooth when increase of age.
• Abrasion: occurs by tooth to other objects. V shape on gingival 1/3 of tooth.
• Erosion: wear of teeth by chemical soultion usually at palatal tooth surfaces of upper anterior
teeth.

Biopsy
• if lesion more than 1 cm ( incisional biopsy). ‫وﺧﺼﻮﺻﺎ ﻓﻲ اﻟﺤﺎﻻت اﻟﺸﻚ ﺑﻮﺟﻮد‬malignancy.
• if lesion less than 1 cm ( Excisional biopsy).
• most common biopsy ( punch biopsy).
• best biopsy ( Excisional biopsy).

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