orthopedic stomatology

Krok 2

Orthopedic stomatology

Variant 1

1.A 38-year-old female patient complains of pain in the 16 tooth, which appeared 3 days after placing an artificial crown over the tooth. Objectively: the 16 tooth is crowned with a full metal swaged crown. The gingiva around the tooth is hyperemic, edematous. The crown margin is submerged into gingival pocket by more than 0,5 mm. What is the cause of this complication?

A.Interdental contacts

B.Excessively tight fit of the crown

C.Excessive submergence of the crown margin into the gingival pocket

D.Contact of the crown with antagonists

E.Eating solid food

2.A 34-year-old female patient presented to a dental clinic for the prosthetics of the mandibular teeth. Objectively: the mandibular teeth exhibit the I-II class mobility. Which of the following examination methods should be applied?

A.Radiography

B.Galvanometry

C.Face-bow record

D.Rheotachygraphy

E.Myotonometry

3.A 29-year-old female patient presented to a dental clinic for prosthetics. Objectively: there is a carious cavity on the masticatory and mesial surfaces of the 24 tooth. Interdental contact is inadequate. Classify this cavity according to Black’s classification:

A.I

B.II

C.IV

D.III

E.V

4.A 70-year-old female patient complains of burning sensation under the base of her complete denture; dryness and bitterness in the mouth. The denture was fabricated 3 weeks ago. Objectively: the alveolar bone mucosa is edematous, there is diffuse hyperemia up to the margins of the denture. The tongue is hyperemic, dry and cracked. What additional study would be most appropriate in this case?

A.Allergotest

B.Urinalysis

C.Complete blood count

D.Biochemical blood analysis

E.Sialosemiology

5.A 44-year-old female patient presented to a dental clinic for prosthetics. Objectively: the 17, 16, 15, 14, 12, 25, 26 teeth are missing; the 18, 28 teeth are preserved. Make a diagnosis according to Kennedy classification of partial edentulousness:

A.Class III, subclass 1

B.Class III, subclass 2

C.Class III, subclass 3

D.Class II, subclass 2

E.Class II, subclass 4

6.A 45-year-old female patient presents to a dental clinic for prosthetics. Objectively: the 47, 46, 45, 35, 36, 37 teeth are missing. There is dentoalveolar vertical displacement of the 17, 16, 26, 27 teeth; the alveolar process is hypertrophied, the cervical margins are not exposed. When the teeth are closed, the distance between the occlusal surfaces of teeth and the alveolar process is about 6 mm. Specify the most efficient method of treatment of secondary deformation in this patient:

A.Disocclusion

B.Surgical treatment

C.Grinding

D.Hardware-associated surgical treatment

E.Pulp removal and teeth grinding

7.A month after cementing a porcelain-fused-to-metal crown for the 23 tooth, the patient complained of its decementation. On examination the tooth stump was of sufficient height, the stump walls were convergent to the vertical axis at an angle of about 30 degrees. What is the required angle of wall convergence?

A.Up to 8 degrees

B.18-20 degrees

C.20-25 degrees

D.25-30 degrees

E.27-35 degrees

8.A 65-year-old male patient undergoes fabrication of a full removable denture for the mandible. The individual tray for taking a functional impression is adjusted with the use of Herbst tests. The tray is thrown off during swallowing. This means that its edge is to be shortened in the following area:

A.From canine to canine vestibularly

B.From the space behind the mucous tubercle to the mylohyoid line

C.From canine to canine lingually

D.Along the mylohyoid line

E.In the region of the premolars on thelingual side

9.A 28-year-old female patient complains of a cosmetic defect in the anterior segment of the maxilla. Objectively: the crown of the 13 tooth is decayed nearly up to the gingival edge, the stump walls are of sufficient thickness. The stump has a slightly changed color, percussion causes no pain response. Radiographical findings: the root canal is straight, wide, and filled along the entire length. What prosthetic construction is most appropriate in this case?

A.Inlay

B.Plastic crown

C.Porcelain-fused-to-metal crown

D.Post and core

E.Micro-denture

10.A 32-year-old patient complains of constant chewing-like movements of the mandible. These movements occur with nervous excitement. The patient’s wife reports him to have gnashing of teeth at night. Objectively: the lateral teeth are worn, have no tubercles. What is the optimal treatment tactics?

A.Referral to a dental surgeon

B.Restoration with crowns

C.Pharmaceutical and non-invasive treatment following the referral to a dental surgeon

D.Night guard (Michigan-type splint), myogymnastics, self-massage

E.Alignment of teeth (selective grinding)

11.A 38-year-old female patient complains of pain in front of the external auditory meatus projection, clicking when opening the mouth, sensation of stuffiness in the ears. Objectively: the face is symmetric, the trajectory of mouth opening is straight. There is a I class Kennedy defect, the 18, 17, 16, 26, 27, 28 teeth are missing. Which anatomical structure takes the greatest load in this situation?

A.Articular head

B.Articular disc (meniscus)

C.Distal surface of the medial articular tubercle

D.Bottom of the glenoid fossa of the temporal bone

E.Articular capsule

12.A 70-year-old male patient with the completely edentulous maxilla and a hard palate defect complains of difficult eating, pouring of liquid food through the nose, frequent chronic diseases of the nasal mucosa. Objectively: the maxillary alveolar bone is atrophied (Schroeder class I), the mucosa pliability complies with Supple class I. The hard palate exhibits a cicatrically changed defect sized 2x3 cm. What denture design would be most effective in this case?

A.Complete removable denture with an internal and a peripheral valve

B.Complete removable denture with the teeth placed on the arti ficial gingiva

C.Soft-core obturator and complete removable denture

D.Complete removable denture with a thickening in the defect region

E.Complete removable denture with a metal base and soft-core obturator

13.A 28-year-old patient complains that a piece of the 23 tooth crown has broken off. Objectively: the root canal orifices contain the filling material, percussion causes no pain response. What is the tactics of choice?

A.Ortho-polymer restoration of the 23 tooth

B.Extraction of the 23 tooth

C.Fabrication of a metal insert tooth

D.Radiography of the 23 tooth

E.Restoration with Belkin crown

14.A 58-year-old patient complains of stuffiness in the ears, hearing impairment, pain in the parotid region when opening the mouth. Objectively: the 18, 17, 16, 15, 26, 27, 28 teeth are restored with swaged metal crowns. There is a 1,5-2 mm gap between the crown edges and gingiva. The 14 and 25 teeth exhibit carious cavities. Probing, percussion and thermal stimuli cause no pain response. The patient has deep incisor overbite. What is the likely cause of otologic symptoms?

A.Missing mandibular teeth

B.Complication of tooth decay in the 14, 25 teeth

C.Functional TMJ overload

D.Cervical margin exposure of the 18, 17, 16, 15, 26, 27, 28 teeth

E.Galvanosis

15.A 32-year-old patient presented to a prosthetic dentistry clinic with a diagnosis of maxillary fracture. The fracture can be treated by means of standard maxillo-mandibular Zbarzh set. What construction provides the intra-oral fixation?

A.Weber’s splint

B.Aluminium arch bar

C.Plastic biteplate

D.Standard double arch

E.Crown-supported soldered splint

16.A 44-year-old male patient needs a cast splint for the mandible. Objectively: there is a bilateral terminal defect of the mandibular dental arch. The tooth crowns are high, the teeth are intact, there is I-II class mobility. What impression material should be used?

A.Stomalgin

B.Repin

C.Gypsum

D.Stens

E.Dentafol

17.A 42-year-old patient complains of pain in the right side of her head, restricted movements of the lower jaw, clicking sound, periodic spasms of chewing muscles. Objectively: the face is symmetric, mouth opening is restricted. On palpation of the right temporo-mandibular joint (TMJ) there are crepitation and clicking that accompany the mandible movements. Examination of the oral cavity revealed also a Kennedy’s class II defect on the right. What is the most likely diagnosis?

A.Pain dysfunction of the right TMJ

B.Acute arthritis of the right TMJ

C.Sclerosing osteoarthritis of the right TMJ

D.Contracture of the right TMJ

E.Myositis ossi ficans

18.A 43-year-old male patient awaits fabrication of full swaged crowns for the 26 and 27 teeth. What material should be used for the dental dies?

A.Stainless steel

B.Low-fusible alloy

C.Cobalt-chromium alloy

D.Silver-palladium alloy

E.Solder alloy

19.Regimental aid station admitted a wounded soldier with a diagnosis of a gunshot fracture of the mandibular body. What kind of immobilization is required at this stage?

A.Smooth brace

B.Immobilization with splints for both jaws

C.Extraoral appliance for fragment fixation

D.Transport immobilization

E.Osteosynthesis of the mandible

20.A 70-year-old patient complains of inability to take food, a cosmetic and phonetic defect due to the complete loss of mandibular teeth. Objectively: the lateral segment of the alveolar process of the mandible is significantly atrophied, while the frontal segment is relatively preserved. Buccal folds are attached at the crest of the alveolar process. These clinical presentations correspond with the following class of edentulous jaws according to Keller classi fication:

A.Class I

B.Class II

C.Class III

D.Class IV

E.Class V

21.A 50-year-old male patient has a gunshot wound to the mandible and a bone defect in the mental area. What method of immobilization is indicated for this patient?

A.Extraoral Rudko apparatus

B.Two-jaw splint with wire loops and intermaxillary elastics

C.Bone suture

D.One-jaw brace

E.Immobilization by means of wires and rods

22.A female patient presented to a clinic for prosthetics. Objectively: the lower third of the face is shortened; nasolabial folds are deepened; the front teeth of both jaws are missing; the crowns of the 17, 15, 26, 27, 36, 37, 45, 47 teeth are worn by 2/3 of their height; the chewing surfaces of these teeth are smooth and pigmented; alveolar bone is not hypertrophied, interalveolar height is decreased. Specify the form of pathological dental abrasion in this patient:

A.Horizontal, compensated, III grade of severity

B.Horizontal, uncompensated, III grade of severity

C.Vertical, uncompensated, III grade of severity

D.Vertical, compensated, III grade of severity

E.Combined, uncompensated, III grade of severity

23.Following the extraction of the 12, 11, 21, 22, 23 teeth, a 50-year-old patient will receive an immediate-insertion denture. What denture should be used in this situation?

A.Clasp denture

B.Laminar denture

C.Fixed bridge denture

D.Adhesive denture

E.Removable bridge denture

24.A 55-year-old male patient presents to a dental clinic complaining of inability to use complete removable dentures fabricated a week ago. The patient also presents with muscle pain in the region of the temporomandibular joint, tooth chatter during a conversation, and difficult biting on food. Objectively: the face is elongated, nasolabial and labiomental folds are flattened, the chin is retruded, the lips do not close. What is the cause of these disorders?

A.Increased occlusal vertical dimensi on

B.Descending occlusion

C.Inadequate fixation of dentures

D.Left displacement of the mandible

E.Right displacement of the mandible

25.A female patient presented to a dental prosthetics clinic complaining of acute pain in the 26 tooth. The pain gets worse in the evening and at night. Objectively: the patient has a cantilever porcelain-fused-to-metal dental bridge supported by the 26 tooth and the 25 tooth cantilever. The tooth is live, the preparation was performed under conduction anesthesia. The prosthesis is fabricated in compliance with all requirements. What medical error might have caused this complication?

A.Cementing the bridge on the phosphate cement

B.Shaping the tooth as a truncated cone

C.Preparation of the radial shoulder in the cervical zone

D.Lack of medial support for the bridge

E.Continuous tooth preparation without cooling, no provisional crowns

26.A 50-year-old male patient with a defect of the hard palate needs a palatal plate. Objectively: the maxillary teeth are intact. What method of fixation should be used?

A.Attachment

B.Supporting clasps

C.Mesio-distal clasps

D.Bar fixation

E.Telescopic system

27.A 40-year-old male patient presents with vicious union after a fracture of the maxilla. Objectively: the remaining 13 and 14 teeth are displaced in a distal direction. What method of orthopedic treatment would be most adequate in this case?

A.Cast clasp denture

B.Removable double-arch denture

C.Removable laminar denture

D.Removable denture with metal base

E.Removable denture with bilayer base

28.Following the unilateral resection of the maxilla a 52-year-old patient received the immediate-insertion denture. What is the term of its use?

A.1-2 months

B.1-3 months

C.7-12 months

D.2-3 years

E.4-5 years

29.A 64-year-old patient with edentulous jaws has a mild uniform atrophy of the maxilla and a pronounced atrophy of lateral segments of the mandible. The mucosa in these regions makes longitudinal folds, the alveolar crest is mobile in the anterior part. The condition of mandible should be taken into consideration at the following stage of fabrication of a complete removable denture:

A.Taking a compression functional impression

B.Taking an anatomical impression

C.Taking a differentiated functional impression

D.Taking a decompression functional impression

E.Determining the centric jaw relation

30.A 41-year-old patient has been diagnosed with a fracture of the mandibular alveolar process. Objectively: the teeth are intact. When the jaws are closed, the multipoint occlusal contact is observed. The patient is to be transported to a specialized hospital. What kind of first aid is indicated in this case?

A.Ivy ligature

B.Smooth brace

C.Standard Vasilyev splint

D.Tigerstedt’s splint with wire loops

E.Stiff head-chin strap by D.O. Entin

31.A 35-year-old female patient seeks prosthetic dentistry. Objectively: the 18, 14, 13, 12, 11, 21, 22, 23, 24, 28 teeth need restoration. The crowns con fining the defect are high and stable. To restore the integrity of the dental arch, it is planned to fabricate a cast clasp denture. What kind of mechanical fixator should be used?

A.Bar fixation

B.Supporting-retaining clasps

C.Retaining clasps

D.Telescopic fixation

E.Dentoalveolar clasps

32.A 48-year-old patient has undergone unilateral resection of the maxilla. He needs a resection prosthesis. Objectively: the 21, 22, 23, 24, 25, 26 teeth are stable, hard palate is broad, flat. What kind of attachment of clasps to the base will reduce the instability of the resection prosthesis?

A.Fixed

B.Stable

C.Elastic

D.Articular

E.Does not matter

33.A 45-year-old male patient complains of bleeding gums, tooth mobility, hypersensitivity in the cervical zone. Objective examination revealed presence of all teeth, 1-2 class mobility, pathological gingival pockets with serous exudate. Radiograph shows widening of the periodontal ligament space, alveolar bone resorption by 1/3 - 1/2 of the root length. What kind of tooth stabilization is indicated?

A.Stabilization of entire dental arch

B.Front

C.Front and sagittal

D.Sagittal

E.Parasagittal

34.A 65-year-old female patient complains of complete edentulousness. Examination of the oral cavity revealed that alveolar process of the edentulous mandible was markedly atrophied in the frontal region, while it was expressed in the distal region. Specify the class of atrophy according to Keller classification:

A.Class I and III

B.Class II

C.Class I

D.Class III

E.Class IV

35.Objective examination of a 65-year-old patient with the completely edentulous mandible revealed a marked uniform atrophy of the alveolar bone; bony prominences on the lingual surface in the region where premolars had previously been. Mucosa was unevenly pliable; alveolar crest was mobile in the frontal region. The clinical condition of the mandible should be taken into consideration at the following stage of denture fabrication:

A.Taking an anatomical impression

B.Taking a differentiated impression

C.Taking a positive pressure impression

D.Taking a decompression impression

E.Measuring the centric relation of jaws

36. Prior to the preparation of a tooth for a porcelain-fused-to-metal crown, a dentist anaesthetized a patient with a history of bronchial asthma with 2% solution of novocaine. A few minutes later, the patient complained of shortness of breath (more difficult expiration), there appeared acrocyanosis, swollen neck veins, Ps-100 bpm, rhythmic, AP- 180/110 mm Hg. Percussion revealed box sound over lungs. What is the most likely diagnosis?

A. Pulmonary artery thrombosis

B. Coronary artery disease

C. Attack of bronchial asthma

D. Bronchiectasis

E. Collapse

37.Objective examination of a 67-year-old patient with the edentulous maxilla revealed minor uniform atrophy of the alveolar processes. Maxillary prominences were well preserved, the frenulum and buccoalveolar folds were attached at the base of the alveolar process, the palate was deep, the torus palatinus was expressed insigni ficantly. These clinical presentations correspond with the following class of atrophy according to Schroeder classi fication:

A.1

B.2

C.3

D.4

E.5

38.A 53-year-old male patient has a history of generalized periodontitis. It is planned to fabricate fixed splints for both jaws intended to stabilize the teeth along the entire dental arch. Which of the maxillary pillars will have the functional significance for the distribution of masticating pressure?

A.Frontonasal, zygomatic, pterygopalatine, palatine

B.Frontonasal, zygomatic, pterygopalatine

C.Zygomatic, pterygoid, palatine

D.Frontonasal, pterygoid, palatine

E.Frontonasal, zygomatic, palatine

39.A 25-year-old male patient has been diagnosed with a linear non-displaced fracture of the mandible between the 32 and 33 tooth. What splint should be used for the fixation of bone fragments?

A.Vasilyev splint

B.Splint with spacer bar

C.Brace with an oblique plane

D.Smooth brace

E.Wire anchor splint

40.6 months ago a 65-year-old patient received a permanent intracoronal splint for the front maxillary teeth. The splint was fabricated with the use of fiberglass tape. Radiograph shows that the root of the 12 tooth is localized only in the soft tissues. The splint is in a good condition. What is the optimal tactics of this patient management?

A.Extract the 12 tooth and fabricate a bridge

B.Amputate and extract the root of the 12 tooth

C.Start conservative treatment

D.Replace the 12 tooth in the splint by an arti ficial plastic tooth

E.Extract the 12 tooth and restore the defect with a porcelain-fused-to-metal crown

41.A 32-year-old patient lost the 41 and 31 teeth as a result of a sports injury. Reimplantation is impossible because the crown and root surfaces of these teeth are cracked and chipped. Clinical and radiological examination proved the possibility of immediate implantation. What material should be preferred for the implants?

A.Porcelain

B.Carbon

C.Titanium

D.Platinum

E.Sapphire

42.A patient presented to a dental clinic for the purpose of prosthetics. Objectively: completely edentulous mandible. There is marked and uniform atrophy of the alveolar portion. Frenula and folds are characterized by high attachment. Specify the type of mandibular atrophy according to Keller classi fication:

A.Class I

B.Class II

C.Class III

D.Class IV

E.Class V

43.A 45-year-old male patient working as an actor consulted a dentist about mobility of his front mandibular teeth, gingival hemorrhages during tooth brushing. Objectively: gingival hyperemia and hemorrhage, periodontal pockets in the front portion of the mandible are up to 5 mm deep, tooth mobility of the I-II class is present. What kind of splinting the mandibular front teeth will be optimal for this patient?

A.Ligature wire

B.Cap splint

C.Fiber-reinforced adhesive splint

D.Full crown splint

E.Cast pin splint

44.A 44-year-old female patient with generalized I grade periodontitis is scheduled for the selective grinding of teeth. What examination is required prior to this procedure?

A.Gnathodynamometry

B.Occlusiography

C.Radiography

D.Rheoparodontography

E.Electroodontometry

45.A 70-year-old completely edentulous patient undergoes treatment with complete removable dentures. Arti ficial teeth are placed upon a spherical surface. Specify the average radius of the spherical surface that would ensure close teeth contact during the mandible motions:

A.7 cm

B.5 cm

C.9 cm

D.12 cm

E.18 cm

46.A patient consulted a dentist about fabrication of a restorative crown for the 36 tooth. During examination the dentist revealed a roundish, hard, painless, lustrous ulcer on the left lateral surface of tongue. What is the most likely diagnosis?

A.Syphilitic ulcer

B.Decubital ulcer

C.Tuberculous ulcer

D.Vincent’s necrotizing ulcerative stomatitis

E.Lichen planus

47.Prior to installation of complete removable dentures, it is necessary to verify the occlusal relation with different movements of the mandible. What muscle is responsible for transversal movements of the mandible?

A.Inner (medial) pterygopalatine

B.Outer (lateral) pterygopalatine

C.Temporal

D.Masticatory

E.Digastric

48.A 65-year-old male patient complains of crepitation and clicking in both temporomandibular joints; pain when moving his mandible to the right; ear noise; dry mouth; glossalgia. He has been using a complete removable denture for the mandible for 6 months. The patient has no history of rheumatosis. Objectively: the lower third of the face is shortened, mental fold is strongly pronounced, mouth corners are downturned, there are angular fissures and cracks. Palpation reveals crepitation during TMJ moving. What is the most likely diagnosis?

A.Temporomandibular dislocation

B.Temporomandibular arthritis

C.Temporomandibular arthrosis

D.Costen’s syndrome

E.Temporomandibular osteoarthritis

49.A 59-year-old male patient presented to a prosthetic dentistry clinic for the purpose of prosthetics. Immediately during the manipulations the patient developed the following symptoms: weakness, prostration, skin pallor and cyanosis, clammy sweat, a decrease in systolic blood pressure down to 80 mm Hg. What is the most likely diagnosis?

A.Shock

B.Syncope

C.Collapse

D.Kussmaul’s coma

E.Myocardial infarction

50.A 60-year-old patient needs a partial removable denture for the maxilla. The centric jaw relation has been determined. What is the next stage of prosthetics?

A.Checking the wax denture construction

B.Try-in of the denture

C.Fabrication of plaster models

D.Relining the denture

E.Taking impressions

Krok 2

orthopedic stomatology

Variant 1

ANSWERS

Date: 2016-04-22; view: 1856