Dr.

PC 1

Speedo Snail: Quick Review

Drugs: Mode/Mechanism of Action

➢ MOA of Montelukast: Inhibition of leukotrienes (Used for Asthma and seasonal allergies)
➢ MOA of Ranitidine: Reduce gastric secretion
➢ MOA of Tetracycline: Bacteriostatic
➢ MOA of Doxycycline: inhibit 30s ribosome/inhibit collagenous
➢ MOA of H-antagonist (Antihistamine): Blocking histamine at the receptor
➢ MOA of Ibuprofen: Reversible
➢ MOA of Aspirin: Irreversibly inhibit platelet aggregation, inhibit platelet cyclooxygenase by
blocking the formation of Thromboxane A2.
➢ MOA of Clopidogrel (Plavix): Alter platelet function, inhibit platelet aggregation irreversibly (Give
pt allergic to Aspirin, no ulcer side effect, given to pt with past ulcer history)
➢ MOA of Anti-depressant drug:
➢ MOA of Warfarin: Inhibit vitamin K reductase resulting in depletion of reduced form of vit K,
Decrease K+ needed to synthesize factors II, VII, IX, X
➢ MOA of Heparin: Anti-coagulant reversibly to anti-thrombin II & prevent conversion of
fibrinogen to fibrin
➢ MOA of Dicoumarol: Anti-coagulant that inhibits vitamin K reductase & affects K-dependent
coagulation factors (Tx: Coronary Infarct/MI)
➢
➢ MOA Benzodiazepines: modulate activity of inhibitory NT (GABA) at the GABA receptor
➢ MOA of Xanax:
➢ Morphine relieves pain by: Acting on opioid mu receptor on neural cell membrane
➢ MOA of Anticholinergic: inhibit binding of acetylcholine to muscarinic and nicotinic receptors
(found in eyes, secretory glands, nerve endings to smooth muscle cells)
➢ MOA of Acetaminophen: Antipyretic effect by acting on centers in hypothalamus
➢ MOA of Levodopa: Replenish deficiency of dopamine in patients with Parkinson’s
➢ MOA of Reserpine: stabilize the axon terminal membrane preventing release norepinephrine
(Used for HTN)
➢ MOA of Naloxone: Non-selective and competitive opioid receptor antagonist in case of opioid
overdose
➢ MOA of Clonidine: Centrally acting sympatholytic (alpha adrenoceptor agonist)
➢ MOA of Zoloft: Sertraline – Selective serotonin reuptake inhibitors
➢ MOA of Sulfonylurea: Increased insulin production and sensitivity by Beta cells stimulation by
binding to ATP dependent K channel/ Stimulation of pancreatic beta cells to secrete insulin.
➢ MOA of Sulfonamides: Inhibit folic acid suynthesis
➢ MOA of Periostat: Inhibit collagenase/protein synthesis
➢ MOA of Doxycycline: Inhibits MMP (Matrix Metalloproteases)
➢ MOA of Bisphosphonate: Inhibit the Osteoclast via apoptosis

Best of luck to All

 Dr. PC 2

Most Common Medication Used

➢ Allergic to Aspirin: Take Acetaminophen, not Ibuprofen
➢ Asthmatic pt: Used Acetaminophen (Tylenol), Avoid using Aspirin, can cause Hyperventilation
➢ Pregnant Women: Use Acetaminophen, No NSAIDs
➢ Antibiotic used in gingival cervical fluid for periodontal bacteria: Doxycycline
➢ HIV related oropharyngeal candidiasis: Systemic Fluconazole
➢ Antifungal for TROCHES: Clotrimazole
➢ Most common medicine for Grand mal: Dilantin
➢ Ethosuximide is most commonly used: Absence epilepsy (Petit mal)
➢ Contraindication with ginseng: Aspirin
➢ Meds used for Benzodiazepine reversal: Flumazenil
➢ Opioid antagonist: Naloxone (sign of opioid toxicity: give Naloxone)
• Morphine overdose tx: Naloxone
➢ Detoxification of Morphine addiction: Methadone
➢ Mixed agonist-antagonist analgesics: Pentazocine, Nalbuphine
➢ Use for sedation on child: Secobarbital/Pentobarbital (Don’t use Meperidine)
➢ Antibiotic for non-odontogenic maxillary sinusitis: Augmentin (Amoxicillin + clavulanic acid)
➢ Acute ulcerative periodontitis with lymphadenopathy: Metronidazole
➢ Antibiotic for mycoplasma: Erythromycin
➢ Med for Trigeminal Neuralgia: Anticonvulsive drug
➢ Child Used Amphetamine med: ADHD (if kid takes, tell him not to take prior dental
appointment)
➢ Tx for xerostomia with Sjogren’s syndrome: Cevimeline HCL
➢ Medication for:
• Grand mal seizure: Phenytoin
• Petit mal seizure: Ethosuximide & Valproic acid
• Status epilepticus: Diazepam, lorazepam, midazolam (mostly prefer)
(benzodiazepine)
➢ Coronary infarct: Dicumarol (Vit K antagonist)
➢ Antidote of Warfarin: Vit K
➢ Antidote of Heparin: Protamine sulfate
➢ The most potent & most toxic LA: Dibucaine
➢ Long acting LA with less toxic: Bupivacaine
➢ Pain medication for liver toxicity & renal toxicity: Oxycodone
➢ Tx of Myasthenia gravis: Physostigmine & Pyridostigmine
➢ Tricyclic Antidepressant: Imipramine & amitriptyline
➢ Best initial tx for TMJ muscle spasm: NSAIDS + Muscle relaxant
➢ Tx for Rheumatic arthritis: Adalimumab & infliximab (bind to TNF – alpha receptors)
➢ Percocet is class II schedule drug (Oxycodone + Acetaminophen)
➢ Motion sickness: Scopolamine, Diphenhydramine (Benadryl)
➢ Drug choice for pt with bradycardia: Atropine
➢ Asthma: Albuterol (short acting) and theophylline (long acting)
➢ Amantadine antiviral drug used for: Influenza A & Parkinson Disease

Best of luck to All

 Dr. PC 3

➢ Epi to reverse give: Prazosin or chlorpromazine

➢ Best drug to reverse effect of Benzodiazepine: Flumazenil (benzodiazepine antagonist)
➢ Best drug to reverse effect of Midazolam (Versed): Flumazenil
➢ Serotonin syndrome: Tramadol (narcotic pain killer like morphine) + SSRI
➢ Tx of Parkinson disease: Carbidopa + Levodopa
➢ Pt with sleep apnea, which pain med should give: Ibuprofen/acetaminophen
➢ Tx of Trigeminal neuralgia: Carbamazepine
➢ Tx of Grand mal seizure (febrile) (most common in child): Phenytoin (Dilantin)
➢ Tx of Status Epilepticus: Valium (Diazepam)
➢ Tx of Petit mal (absence) seizure: Ethosuximide
➢ Tx of lidocaine induced seizure: Diazepam
➢ Tx of Depression & Anxiety for Obsessive Compulsive Disorder: Xanax (Alprazolam)
➢ Best benzodiazepine for pt with liver cirrhosis: LOT (Lorazepam, Oxazepam, Temazepam) due to
not metabolized by liver, so safe for to induce liver failure.
➢ Best benzo for IV sedation: Midazolam
➢ Pt allergic to ester & amides: Use Diphenhydramine (Benadryl)
➢ Laryngospasm: Tx with Pure oxygen, if persistent use Succinylcholine, if severe then
cricothyroidism
➢ Malignant Hyperthermia: tx with Dantrolene
➢ ADHD Kid: Ritalin (methylphenidate hydrochloride)
➢ For Hirsutism: Eflornithine
➢ Adrenal Crisis: Cardiac shock, hypotension, CV collapse, 100mg 0.9% hydrocortisone with saline
➢ Adrenal insufficiency: caused by prolonged regimen of Corticosteroids, more than 2 years
➢ Thyroid Crisis: Hypertension and Increased HR
➢ Anti-anxiety in pregnant women: Promethazine

Most Common Diseases Features/Characteristics

➢ Chronic Periodontitis, Most common in Black males
➢ Most common medical emergency in dental setting: Syncope
➢ Most common seizure in kids: Febrile
➢ Most common heart condition in child: Ventricular septal defects
➢ Commonly affected with Primary Herpetic Gingivostomatitis: Age 4
➢ FAS syndrome: mid face discrepancy
➢ Most common abnormality among the following: Cleft lip & palate (Dentinogenesis imperfecta,
Amelogenesis imperfecta, Dentinal dysplasia)
➢ Combination Syndrome: increased Vertical Dimension
➢ Thyroid crisis symptoms: tachycardia
➢ Acantholysis seen: Pemphigus
➢ Most commonly associated with dysplastic cells/dysplasia: Erythroplakia
➢ Histologically, Most closely resembles normal parotid gland: Pleomorphic adenoma
➢ Most commonly associated with osteogenesis imperfecta: Dentino-genesis imperfecta
➢ Most common between Crohn’s, Peutz-Jeghers & Gardner’s syndrome: Intestinal polyps

Best of luck to All

 Dr. PC 4

➢ Gardner’s syndrome (Familial adenomas polyposis): multiple osteomas, odontoma, intestinal

polyps
➢ Peutz-Jeghers syndrome: multiple melanotic macules or pigmentation, GI polyps
➢ OKC is most commonly associated with: Nevoid basal cell Carcinoma
➢ Most common site for sialolithiasis: Submandibular gland, common duct: Wharton’s duct
➢ Warthin tumor (Papillary Cystadenoma-lymphomatosum) most common: parotid gland
➢ Most common deep fungal disease in USA: Candidiasis
➢ Perineural invasion seen: Adenoid cystic carcinoma
➢ Common features of Cleidocranial dysplasia: Delayed eruption, supernumerary teeth
➢ Peutz Jeghers syndrome: Pigmentation of face, lips, and oral cavity and intestinal polyps
➢ Treacher Choline syndrome (Mandibulofacial dysostosis): relation to Zygoma
➢ Cleidocranial dysplasia: relation to clavicle
➢ Brown tumor (Central giant cell granuloma) is associated with: Hyperparathyroidism
➢ Most common location of oral cancer in USA: Tongue
➢ Pemphigus: Suprabasilar vesicles and acantholysis
➢ Pemphigoid: Subepidermal and NO acantholysis
➢ Papillon Lefevre Syndrome: Hyperkeratosis of palms & soles of feet, premature tooth loss,
periodontitis
➢ Crouzon syndrome: Beaten metal appearance of the skull. Hypertelorism (Increased interpupil
distance), midface deficiency, cranial bones fuse too soon
➢ Steven Johnson syndrome: Disease of skin & mucous membrane, begins with flue like
symptoms, top skin layer dies & sheds off, burning eyes
➢ McCune Albright syndrome (Polycystic fibrous dysplasia): Café Au lait spots, Coast of Marine like
border is seen in pigmented lesion
➢ Neurofibromatosis: Café au lait, Liche nodule of Iris
➢ Pulmer Vinson syndrome: atrophy of gastric and pharyngeal mucosa, spoon nails (Koilonycias)
(predisposal to oral carcinoma in postmenopausal females)
➢ Frey’s syndrome: Gustatory sweating while eating and crocodile tears
➢ Melkersson Rosenthal syndrome: Facial paralysis, cheilitis granulomatosis, scrotal tongue
➢ Lupus erythematosus affects in: heart, renal
➢ Bechet’s disease ulcer resembles to: Aphthous ulcer
➢ Scleroderma: Mona-Lisa face, Widening PDL, deposition of collagen in organs lead organ failure,
loss of mandibular ramus.
➢ CREST syndrome: Limited Scleroderma, only in lower arms & Legs, sometimes face & throat.
➢ Ectodermal dysplasia: sparse hair, anodontia (partial/complete), oligodontia, hypodontia,
Hypohydrotic
➢ Max Nitrous oxide in kid: 30%
➢ Most common location of SCC (most common oral cancer): Posterior lateral border of tongue
➢ Uncontrolled diabetes inhibits osteoblastic activity
➢ Most common site of Basal cell carcinoma: Middle third of the face
➢ Most common: Cleft lip in male, cleft palate in female
➢ Multiple myeloma: Bence jones protein, punched out lesion, plasma cell infiltrate, skeletal
radiolucency (Bone pain is the 1st sign)
➢ Most common cyst in oral cavity: Peri-apical (radicular) cyst

Best of luck to All

 Dr. PC 5

➢ Cyst has highest rate of recurrences: OKC

➢ Most common tumor of minor salivary gland: Adenoid cystic carcinoma
➢ Fibrous dysplasia: Ground glass appearance
➢ Most common non-odontogenic cyst: Nasopalatine duct cyst (X-ray: Heart shaped near central
incisor, tx: Enucleation)
➢ Nevoid basal cell carcinoma (Gorlin Syndrome): seen multiple OKCs and palmar pitting, planter
kerato-cyst, causes cyst in the Jaws
➢ Verrucous carcinoma: Cauliflower, warts caused by HPV (16 & 18)
➢ Most recurrence: OKC (associated with Gorlin syndrome) , Least recurrence: Adenoid
odontogenic tumor

Most Common in Teeth/Bone

➢ Most common impacted tooth: Max 3rd molar, Mandibular 3rd molar, , Maxillary Canine (NEED
PUT MOST to Least)
➢ Most common congenital missing teeth: 3rd molar, 2nd PMs, Maxillary lateral (NEED PUT MOST
to Least)
➢ Most common occlusion in primary teeth: Edge to Edge
➢ Most common facial fracture nasal bone fracture, 2nd most mandibular fracture
➢ Most likely crowded/blocked out of mandibular arch: 2nd PM
➢ Most likely crowded/blocked out of maxillary arch: Canine
➢ Most common reason of maxillary tori removal: Prosthetic treatment
➢ Found Presence of Supernumerary teeth in: Cleidocranial dysplasia
➢ Oligodontia mostly related to: Ectodermal dysplasia (mostly seen in Alveolar bone)
➢ Odontomas mostly associated with: Gardeners syndrome
➢ Most common teeth lost by perio problem: Max molars
➢ Most common tooth have caries: mand 1st molar, Least common: Mand incisors
➢ Most common complication of extraction: Root fracture
➢ Most perforation on max lateral root during RCT: Mesial
➢ Dens invaginates is commonly seen: Max lateral
➢ Caries in radiotherapy patient mostly in: Cervical
➢ Most common pattern of osseous defect in chronic periodontitis: Horizontal (Crater, if
horizontal is not an option)
➢ Most likely cause pulp necrosis after trauma to the tooth: Pulp hyperemia
➢ Most common mid face fracture: Zygomatico-maxillary
➢ Best allograft: FDBA cadaver
➢ Most common benign tumor in oral cavity: Fibroma
➢ Lesion of alveolar ridge in infant: Bohn’s nodule
➢ Dry socket is a form of Periostitis, Pathophysiology of dry socket: Fibrinolysis
➢ Intraoral dental sinus: Parulis (made up of granulation tissues, AKA gumboil)
➢ Dens-in-dente most common in: Max lateral
➢ Most common site of osteo-fibrosis (Cementoma): Mandibular Anterior
➢ Diagnosis of OKC: Histology
➢ Hypercementosis, most common in PMs in Paget’s disease

Best of luck to All

 Dr. PC 6

➢ Discolored of teeth seen:

• Porphyria: purplish brown
• Cystic fibrosis: yellowish brown
• Erythroblastic fetalis: blue greenish
➢ Erythroblastosis fetalis: Ring like enamel hypoplasia
➢ Blue sclera is seen in: osteogenesis imperfecta, hypophosphatasia
➢ Actinomyces oral manifestation: Lumpy jaw, sulfur granules
➢ 1st sign of multiple myeloma: Bone pain (punched out lesion in X-ray)
➢ Osteosarcoma: Sun burst and uniform/symmetrical widening PDL, paresthesia
(numbness/tingling)

Disease with involved Bacteria/virus

➢ Primary bacteria for initiation of caries: Strep. Mutans
➢ Red Complex Bacteria: P. gingivalis, T. forsythia, T. denticola
➢ Oral hairy leukoplakia: EBV
➢ Condyloma Accuminata: HPV
➢ Koplik’s Spot: Rubella
➢ Ramsay Hunt Syndrome: caused by Herpes Zoster. Associated with shingles, facial nerve
damage, & loss of hearing in affected site

Contraindications
➢ Acetaminophen is contraindicated with Liver disease (cause hepatotoxicity) and alcohol
➢ Nitrous Oxide: 1st trimester only, nasal congestion
➢ Asthma, can participate with attack: Aspirin
➢ Epinephrine (Adrenalin) should NOT be used with tricyclic anti-depressant
➢ Epi is not used in: Hyperthyroidism
➢ Erythromycin and Tetracycline are prescribed carefully in patients with peptic ulcer because:
interact with Antacids
➢ Macrolides avoided in Asthma: interact with Theophylline
➢ Penicillin is cross allergenic with Cephalosporin because of Beta Lactamase
➢ Pilocarpine is not used in pt with G6PD deficiency
➢ Never give penicillin with tetracycline: due to Antagonists property
➢ Strongest glucocorticoids: Dexamethasone
➢ Benzodiazepine antagonist: Flumazenil
➢ Opioid antagonist: Naloxone
➢ Antihistamine is contraindicated with Erythromycin: Terfenadine
➢ Heparin is contraindicated to pt with taking gingko biloba
➢ In multiple sclerosis: LA with epi is contraindicated
➢ Lidocaine may show cross-allergy with: Mepivacaine
➢ Bisphosphonates are NOT used for: Multiple myeloma, Osteomyelitis
➢ Drugs caused gingival hyperplasia: Phenytoin, nifedipine, cyclosporine

Best of luck to All

 Dr. PC 7

➢ Side effect of chloramphenicol: Aplastic anemia

➢ Aspirin is contraindicated with Coumadin
➢ Ginseng is contraindicated with Aspirin, Warfarin, NSAIDs
➢ Gingko biloba is contraindicated with Heparin
➢ Glucocorticoids are contraindicated in Diabetes
➢ Benzodiazepines (Diazepam) is contraindicated for pregnant women, myasthenia gravis, acute
narrow glaucoma, COPD, emphysema
➢ Meds cause Xerostomia:
• Diuretics
• CCBs
• Antihistamine
➢ Meds cause Gingival Hyperplasia:
• Phenytoin/Dilantin
• Nifedipine/Procardia (CCBs)
• Cyclosporine
➢ Meds cause Bad taste:
• Metronidazole
• Chantix
• Carbamazepine

Other Most Common

➢ Ketone Bodies: DM1/Hyperglycemia, most common complication of DM1: Blindness
(retinopathy)
➢ Most Common:
• Caries: white
• Treated caries: White
• Untreated caries: African American
• Periodontal disease: African American
• Caries in Kid: Hispanic
➢ Most dental financing: Self-pay
➢ Most radio resistant: Skeletal muscle
➢ Secondary hypertension: Renal failure
➢ Most harmful in implant: Horizontal force
➢ Vasovagal syncope, 1st sign: Hypotension
➢ Pseudomembranous colitis caused by clindamycin (effective against most anaerobes):
Overgrowth of C. diff
➢ Interleukin related with bone destruction: IL 1
➢ Lumpy jaw appearance: Actinomycosis
➢ Osteoradionecrosis mostly seen in mandible
➢ PDL mostly affected by: Intrusion

Best of luck to All

 Dr. PC 8

➢ Lingual varicosities: Hypertension

➢ After 3rd Molar extraction, may happen: Paresthesia, trismus, infection
➢ Angioedema is mostly occurred with LA: Articaine
➢ Most common cause of rest breaking: inadequate rest seat prep
➢ Combination syndrome: Increased VDO
➢ Scleroderma: microstomia
➢ Cardiovascular Accident Stroke risk factor: Hypertension
➢ Ecchymosis of floor of the mouth after trauma indicate fracture of body of the mandible
➢ Battle’s sign: Fracture/injury to cranial base
➢ Most common caries after MO composite restoration: Gingival
➢ Most dangerous for dentist: Hepatitis B
➢ Hardest to anesthetize: Irreversible pulpitis and mandibular teeth
➢ Hallmark of peri-radicular abscess: Sinus tract drainage
➢ Automated external defibrillator best describes as: not to use under 12 years of age
➢ Healing:
• Flap: primary
• Gingivectomy: Secondary
• Graft: Tertiary
➢ Adrenalin crisis: hypotension & CV collapse
➢ Thyroid crisis: hypertension & increased HR
➢ Cholinergic crisis: Lacrimation, extreme salivation, bradycardia, weakness voluntary muscles
(SLUD)
➢ Hallmark of anticholinergic drugs: Mydriasis (pupil dilation: caused by Cocaine overdose)
➢ Opioid overdose: Miosis (constricted puplils)
➢ A drug with high LD50 and low ED50 has a high therapeutic index, and thus is relatively SAFE
➢ Articaine is the only amide metabolized in Blood stream (NOT in liver)
➢ Diphenhydramine has the MOST sedative effect (antagonism to motion sickness)
➢ Chlorpheniramine has the LEAST sedative effect
➢ Acetaminophen does not have anti-inflammatory effect
➢ Trismus is most commonly in: Sub-masseteric space (caused by Tetanus)
➢ Normal bleeding time: 1-9 minutes
➢ Normal prothrombin time: 11-16 seconds
➢ Normal partial thromboplastin time: 32-46 seconds
➢ Most common respiratory emergency: Hyperventilation
➢ Max doses of Epi for cardiac pt: 0.04 mg
➢ Ganglionic blocking agents caused: orthostatic hypotension
➢ Atropine poisoning: Burning dry mouth and orthostatic hypotension (as it is anticholinergic)
➢ Causes of death by irreversible cholinesterase: Respiratory paralysis
➢ Levodopa can cross brain barrier to treat Parkinson disease
➢ Alpha 1 stimulates vasoconstriction, mydriasis. Alpha block: vasodilation
➢ Beta stimulates: Increased HR, bronchodilation, vasodilation. Beta blocker: decrease HR,
Broncho constriction.
➢ Most common complication with LA: Vasovagal syncope
➢ In Angina pt: DO NOT put in Trendelenburg position

Best of luck to All

 Dr. PC 9

➢ Ghon’s complex (LUNGS): primary of childhood tuberculosis

➢ Histoplasmosis resembles to SCC
➢ Sign of malignancy in radiograph: Cortical bone rupture
➢ Paresthesia of lip, sign of: Malignancy, angle fracture, nerve injury
➢ Nikolsky sign: Pemphigus vulgaris, Erythema multiforme
➢ Referred pain:
• Forehead: Max Incisors
• Nasolabial: Max Canine & PMs
• Temporal: 2nd PM
• Ear: Mand Molars
• Mentalis: Mand anteriors and PMs
➢ Potassium sparing diuretics: Spironolactone
➢ Fetal Alcohol Syndrome features: Cleft palate, microcephaly, micrognathia, palpebral fissures

Abnormality:
➢ Turner incisor: trauma during pregnancy
➢ Ectodermal dysplasia: oligodontia & hypodontia
➢ Systemic condition associated with endocarditis & glomerular nephritis: SLE
➢ Gardener’s syndrome features: unerupted teeth, retained deciduous teeth, impacted
permanent teeth, see osteoma (child)
➢ Mechanism of Fetal Alcohol Syndrome: Neural crest apoptosis
➢

Research studies
➢ Evaluation of 2 groups A & B with 2 drugs for same period, what type of study: Clinical trials
➢ One month ago, a dentist studied the prevalence of dental caries among school students, what
type of study: Cross-sectional
➢ Dentist studied 4 unrelated patients with myofascial pain & myalgia, What type of study: Case
series.
➢ Sample size is irrelevant in: Case report or Case series study
➢ Study to know the effect of gastric bypass surgery on nutritional status: Cohort
➢ Prevalence is measured by: Cross-sectional study
➢ Incidence can be directly calculated from: A cohort study
➢ 3 categories of epidemiological studies:
• Descriptive: incidence & prevalence
• Analytical: cohort, cross-sectional, & case control
• Experimental: clinical trials & community trials

Best of luck to All

 Dr. PC 10

Oral Surgery
➢ Most to Least Frequent Impacted teeth: Mandibular 3rd Molars, Maxillary 3rd Molars, Maxillary
Canines
➢ Non-rigid splint is recommended for Subluxation, Luxation, Avulsion to avoid Ankylosis
➢ Most Common to Least common Congenitally missing teeth: 3rd molars, 2nd PMs, and Maxillary
Lateral Incisors.
➢ Causes of Alveolar Osteitis (Dry Socket): Active dislodgement of blood clot (Fibrinolysis of the
clot)
➢ During extraction, which direction tooth should luxate: Child: Palatally, Adult: Buccally
➢ Serial extraction required: For space deficiency in mandibular anterior region
➢ Biggest risk with extracting a lone single (ankylosed) remaining maxillary molar: Fracturing
tuberosity
➢ Minimum platelet count for oral surgery: 50,000
➢ Most difficult to extract 3rd molar: Disto-angular, 2nd most horizontal, 3rd most vertical (Mesio-
angular is the easiest one)
➢ Caudwell Luc Technique: removal of root tip from Max sinus, incision over canine fossa
➢ Osteoradionecrosis pt: Use Hyperbaric O2 for angiogenesis
➢ Most common complication or negative outcome after extraction: Alveolar Osteitis (Dry Socket),
Caused by fibrinolysis (Blood clot is not forming), main symptoms is PAIN, smokers are most
common, Tx: Irrigation with Sterile solution & Medicinal/Sedative dressing, To control pain:
Analgesics. NO ANTIBIOTICS NEEDED.
➢ Primary consequences of trauma to child Jaw: Retard growth, can cause mid facial asymmetry
➢ Most common fracture in child: Condyle
➢ Standard length of maxilla-mandibular fracture fixation is 4-6 weeks.
➢ Mandibular symphysis fuse/closed: 6-9 months
➢ Paresthesia in lower lip: Angle of mandibular fracture
➢ Guerin Sign: Ecchymosis in the greater palatine vessels region, a feature of Le Fort 1 fracture
(Lower midface, floating palate)
➢ Bilateral Sagittal Split Osteotomy (BSSO): correct malocclusion of mandible, mandibular
advancement or retraction, mandibular augmentation. Worse complication: Inferior alveolar
nerve damage, causing Paresthesia. OP complication: Neurosensory disturbance.
➢ Correct Class III: Le Fort I + BSSO (If Palatal expansion plate can’t possible due to age)
➢ Distraction Osteogenesis (DO): to reconstruct Skeletal Deformities where bigger stable
movement needed. Require Long Term Follow Up.
➢ Worst place to do graft: Canine eminence, interdental
➢ Submandibular drain into what space: Deep cervical lymph nodes
➢

Best of luck to All

 Dr. PC 11

Extraction forceps:
➢ Maxillary PMs: 150
➢ Mandibular PMs: 151
➢ Max root: 286
➢ Mand root: Cryer Elevator
➢ #65 forceps, usually used for removing root tip
➢ Elevator in OS acts as: Lever
➢ One side tissue suture: Interrupted (immobilize the flap)
➢

Radio:
➢ Collimation:
• Control size & shape of X-ray beam
• Reduce area of exposure
• Reduce amount of scatter radiation by 60%
• Reduce x-ray beam size/diameter
• Reduce volume of irradiated tissues
➢ Filtration:
• Reduced intensity of electron beam
• Selectively absorbs low energy, high wavelength x-ray/energy photons
➢ Penumbra: the fuzzy, unclear area that surrounds a radiographic image
• Larger Penumbra: Decreased CONTRAST, Decreased SHARPNESS
• Less Penumbra: Increased CONTRAST, Increased SHARPNESS
• Influenced by: Focal spot size, Film composition, Movement
• Reduce Penumbra: decrease object – film distance
➢ Reduce/Prevent Penumbra:
• Decrease size of Focal spot
• Reduce Object-Film distance (X-ray should be parallel)
• Increased Focal Spot-Object distance
• No MOVEMENT
➢ Best revealing issue for prediction about Ossification: Hand wrist radiograph
➢ View sinus/orbital rim areas: Waters (If waters is not option, then CT scan)
➢ Mid facial fracture: Waters
➢ Mandibular fracture: Panoramic
➢ Condylar fracture: Reverse Towne
➢ Zygomatic arch/Zygomatic fracture: SMV (Submentovertex)
➢ Horizontal fracture: Multiple vertical angulated radiographs
➢ Mandibular symphysis fracture, sialolithiasis in Wharton’s ducts: Occlusal
➢ Mandibular Symphysis Fracture: Antero-posterior or CT
➢ Fracture of Angle, body, and ramus: Lateral oblique
➢ On average, nuclear workers, radiation permitted yearly: 5 rem/ 5000 mrem
➢ Angulation: Central x-ray needs to be perpendicular to film & object

Best of luck to All

 Dr. PC 12

➢ Horizontal angulation causes distortion of image: Overlap

➢ Excessive Vertical angulation causes distortion of image:
• Elongation (perpendicular to object) or foreshortening (perpendicular to film)
• If head/chin is too low/down (steeper smile): max anterior teeth appear elongated &
narrow, mand anterior teeth appear foreshortened & widen
• If max/chin is to high (frown line): Max anteriors appear foreshortened and widen,
Mand anteriors elongated & narrow (Reverse smile line/ positive occlusal plane AKA
frown line). Pt head position is too far back
➢ PID length change
➢
➢ d from 16 to 8 inch: beam 4 times intense
➢ PID length changed from 8 to 16 inch: beam 1/4 times intense
➢ Kvp: ability for the beam to penetrate tissues, energy (quality & quantity), Only Kvp and
Filtration affect Contrast.
➢ mA: A beam radiation quantity, density & patient dose (quantity)
➢ Need HIGH Kvp & LOW mA for better penetration
➢ Increased density in X-ray: increased Kvp, mA, time
➢ Max permissible dose of radiation in a year:
• Occupational: 0.05 sv/year, 50 msv/year
• Non-occupational, pregnant assistant: 0.001 sv/year, 0.1 rem/year, 5msv/year
• Dental Professional: 50 msv/year, 5 rem/year, 4 msv/month, 1msv/week
➢ Radio-sensitive: Immature blood cells, Reproductive cells (#1), Lymphoid cells, Bone Marrow,
Intestine, Mucous Membrane
➢ Radio-resistant: Muscles, Nerves, heart, mature bone

Diseases in X-ray
➢ Soap bubble appearance: Odontogenic myxoma
➢ Honey combed appearance:
➢ Cotton wool appearance: Paget’s disease
➢ Ground glass appearance: Fibrous dysplasia
➢ Sunburst appearance: Osteosarcoma
➢ Swish cheese appearance: Adenoid cystic carcinoma
➢ Ghost teeth: regional odonto-dysplasia/odontogenic imperfecta
➢ Ghost cells: Keratinized odontogenic cyst
➢ Radiolucency with SPECKs: Adenoid odontogenic tumor
➢ Radiolucency around crown: Dentigerous cyst
➢
➢ Asymptomatic radiolucencies and transform radiopacities: Cemento-osseous
dysplasia/Cementoma
➢ Multiple osteomas, odontomas: Gardner’s syndrome
➢ Sequestered bone seen in Xray: Osteomyelitis
➢ Ghost cells: Keratinized Calcifying Odontogenic cysts)
➢ Ghost teeth: Regional Odontoplasia

Best of luck to All

 Dr. PC 13

Impression & Restoration materials

➢ Margin discoloration of Veneer:
• Day: Amine
• Week: Microleakage
• Month: Microcrack
➢ Green discoloration of porcelain: Silver
➢ Most stable elastic impression in moisture environment: Polyether
➢

Law and Regulation

➢ Tx without consent: Battery
➢ Tort Law: If you treat without consent then technical assault and battery
➢ FDA regulates the temperature of the autoclave
➢ Dentist is not behaving with staff, which ethical violation occurred: Beneficence
➢ In your dental practice, want to keep good harmony and relationship with all your stuff, what is
it: Justice
➢

Patient management
➢ Patient given oral habit reducing appliance to prevent an oral habit: Positive punishment
➢ Capitation is with: HMO (Health Maintenance Organization)
➢ Domestic abuse is an act of: Power of control
➢ Patient Position:
• Syncope: Trendelburge
• Asthma, COPD: Upright
• Crown in mouth: Supine
➢ How to treat manipulative Kids: Operant Extinction
➢ Dentist keeps up with recent developments and new skills, knows one’s limitations and when to
refer patient to a specialist: Non-maleficence
➢ Purpose of plaque index: patient motivation
➢ `insurance pay for your crown and core together even though were billed separately: Bundling
➢ What type of model is for IPA: Network model
➢ You let the child walk around and touch the instruments, how is that called: Systematic
Desensitizing
➢ What not to do with an uncooperative patient: Reschedule
➢

Best of luck to All

 Dr. PC 14

Medical Emergencies
➢ Most common respiratory emergency in dental chair: Hyperventilation (rapid breathing:
Tachycardia & Tachypnea)
➢ Most common dental complication/emergency: Syncope
➢ Most effective during acute asthmatic attack: Salbutamol (Albuterol) (beta-2 agonist)
➢ Medication for severe asthmatic attack: Aminophylline (bronchodilator), Albuterol
(bronchodilator), corticosteroids (for Long term asthma)
➢ No NSAIDs (Aspirin) for asthmatic patient
➢ Patient Position:
• Syncope: Trendelburge
• Asthma, COPD: Upright
• Crown in mouth: Supine
➢

Occlusion & Prostho

➢ Curve of Spee: Anterior – Posterior curvature of the mandibular occlusal plane
➢ Curve of Wilson: Mesio – lateral U-shaped curve of Upper & Lower posterior teeth
➢ Compensating curve is under dentist’s control. Helps to provide a balanced occlusion
➢ In centric position: bilateral balanced occlusion. All cusps are integrated
➢ Contacts in Balanced Occlusion:
• Cusp-to-fossa contact in centric occlusion in an ideal class I occlusion
• During lateral excursions, OPPOSING cusps contact with WORKING SIDE. (BULL)
• During lateral excursion, on the BALANCING SIDE, Maxillary lingual cusps (lingual
inclines) contact Mandibular facial cusps (lingual inclines). (LUBL)
➢ Lingual flange of mandibular denture (molar area) is determined by: Mylohyoid
➢ Mandibular flange (lateral to retromolar areas) is determined by: Masseter
➢ Most strong porcelain: firing under compression
➢

Perio
➢ Base incision of Gingivectomy: Coronal to mucogingival junction
➢ Most common donor site of free gingival graft: Palate
➢ Main reason for failure of free gingival graft: lack of blood supply, Infection (2nd most)
➢ 2 most critical parameter for prognosis perio: Attachment loss and mobility
➢ Bacteria responsible for collagenase activity: P. gingivalis
➢

Best of luck to All

 Dr. PC 15

Oral Path
➢ Nikolsky Sign: Pemphigus vulgaris (Acantholysis present) & Erythema multiforme
➢ Subepithelial vesicular disease: Pemphigoid & Lichen planus
➢ Chronic Desquamative gingivitis AKA Cicatrical pemphigoid
➢ Cauliflower like pebbly appearance: Verrucous carcinoma, Condyloma accuminatum, Papilloma
➢ Granular Cell Tumor (skin or mucosal tumor) histologically resembles to: Congenital epulis, SCC
➢ Lesion that resembles to SCC, but disappears in 16 weeks: Kerato-acanthoma (Skin tumor)
➢ Most common malignancy found in:
• Metastatic Ca (Bone)
• Basal cell ca (skin)
• SCC/Epidermoid ca (oral cavity)
• Muco-epidermoid Ca (Salivary gland)
• Adenoid cystic ca (2nd most salivary gland)
➢ Texture/Consistency of Dermoid cyst VS Ranula:
• Dermoid cyst: Doughy or rubbery
• Ranula: more fluctuant, bluish mass/nodule/swelling

Prostho

➢ Gold Type I & II: Used for Inlays, Gold type III: Used for all metal ceramic crowns & Bridges
➢ Acron Articulator: The condyle element is in the lower member, resemble most accurately the
TMJ anatomy, good for fixed prosthodontics
➢

Pharm

➢ Gingival Hyperplasia:
• Dilantin (Anti-convulsant), #1
• Phenytoin (Anti-convulsant)
• Cyclosporin
• Nifedipine
• Verapamil (Calcium Channel Blocker)
• Diltiazem (Calcium Channel Blocker)
➢ Osteonecrosis most common with IV drugs: Zolmeda (zoledronic acid) & Aredia (Palmidronate),
not with Oral (Fosamax or Boniva)

** Dental Lamina form: 6-7 weeks of utero

** Biological width: 2mm, JE + CT (0.97+1.07)

** GTR: Coronal movement of PDL

**

** Varicose tongue: Elderly, hypertensive pt

Best of luck to All