Крок 2 · Стоматологія 2013 · Англійська

After examination a 5-year-old child was diagnosed with acute total pulpitis of the 74 tooth. What treatment will be most efficient in this case?

Examination of a 9-year-old child revealed chalky spots in the cervical part of the 12, 11, 21, 22 teeth. The spots appeared two weeks ago. Their surface is dull in appearance and can be stained with methylene blue. The affected teeth are nonresponsive to cold stimulus. What is the most likely diagnosis?

A 54-year-old patient complains of a tumour-like formation in the region of the lower lip which appeared 1-1,5 months ago. Objectively: on the vermilion border of the lower lip on the right there is a roundish tumour up to 1 cm in diameter with raised rolled edges. The tumour is painless, the regional lymph nodes are not enlarged. What is a provisional diagnosis?

A patient complains of spontaneous, paroxysmal, irradiating pain with short pain-free intervals. The pain arose 2 days ago and occurs only at night. Make a provisional diagnosis:

An orthopedist plans to fabricate a porcelain-fused-to-metal crown for the 23 tooth. In order to correct its abnormal position in the dental arch the orthopedist is going to use a cast post and core. What is the maximum permissible value (in degrees) of the core deviation from the tooth axis?

A 34-year-old patient had got in a car accident. The patient stayed conscious. He complains of headache, dizziness, general weakness, nausea. 12 hours after the injury the patient got 'raccoon eyes'(periorbital haematomas) within the limits of the circular muscle of eye. What fracture does the victim have?

After a car accident a patient consulted a dentist about pain at the base of the nose. Palpation reveals tenderness of the nose wall, mobility of the nasal bones. Nasal passages are filled with blood clots. What is the provisional diagnosis?

A 47-year-old female patient complains of inability to eat hot and cold food, as well as of intense pain caused by sour, sweet and salty food. Objectively: there is a slight loss of enamel on the molars and incisors. Probing and cold test cause acute pain. What is the most likely diagnosis?

A 43-year-old patient complains of a tumour in the right submandibular region which appeared two months ago after having flu. Objectively: palpation of the right submandibular region reveals a painful spherical neoplasm of dense elastic consistency with regular outlines which is not attached to the skin. Submandibular salivary gland secretes transparent saliva. Sublingual plica is unchanged. Which disease are these clinical presentations typical for?

A 40-year-old patient complains of pain caused by cold and sweet food in the 11,21 teeth, as well as of a cosmetic defect. Examination of the 11, 21 teeth revealed some oval, diagonally arranged enamel defects on the convex part of the vestibular surface of tooth crowns. The defects had smooth, glossy, dense floor. The patient has a history of thyrotoxicosis. What is the most likely provisional diagnosis?

A 36-year-old patient complains of pain under the dental bridge. After its removal the patient has been found to have an ulcer 0,3x0,5 cm large on the alveolar process. The ulcer is slightly painful and soft, the surrounding mucosa is hyperaemic, submandibular lymph nodes are not enlarged. What is a provisional diagnosis?

A 42-year-old female patient complains of tooth mobility, difficult mastication. Objectively: face configuration is unchanged. The 35,36,38,44,46,48 teeth are missing. The 31, 32, 41, 42 teeth exhibit 1-2 grade mobility. What is the most efficient denture construction in this case?

A 65-year-old patient needs prosthetic services. Objectively: the 43, 33 teeth are decayed by 2 /3. EPT result is 6 mA. Other teeth in the lower jaw are missing. What crowns should be fabricated for fixing the removable denture?

A 64-year-old patient presents with bleeding from the left nostril, mobility of the upper left teeth. For the last 2 years the patient has had dull pain in the left side of maxilla. On the left side of neck there is a dense tumour-like formation. The patient is exhausted. What is the most likely diagnosis?

A patient consulted a dental surgeon about fever up to 37,6°C, soft tissue swelling, pain in the 47 tooth on the lower jaw on the left, the pain is getting worse when the tooth is touched by the antagonist. Objectively: mucogingival fold of the alveolar process is hyperemic and flat on the vestibular side of the decayed 47 tooth. What is the most likely diagnosis?

A 40-year-old patient complains of constant intense throbbing pain in the 23 tooth lasting for 3 days. This problem hasn’t bothered him before. Vertical and horizontal percussion is positive, the tooth is mobile, mucous membrane around the 26 tooth is hyperemic and edematous. Palpation of the mucogingival fold in the root apex projection is painful. What is the most likely diagnosis?

A 48-year-old female patient had been delivered to a hospital with a cheek wound and severe headache, nausea, dizziness. It is known from the history that the patient had got a trauma as a result of a fall. After examination she was diagnosed with a contused lacerated wound of cheek, closed craniocerebral injury, brain concussion. This trauma can be qualified as:

A 12-year-old boy complains of fever up to 38 0C, weakness, headache, pain in the mouth, presence of vesicles and ulcers. The acute condition developed three days ago. The patient has a history of recent pneumonia treated with antibiotics. Objectively: oral mucosa is hyperemic and edematous. The mucosa of lips, tongue and cheeks has large erosions covered with fibrinous pellicle. The lips are covered with thick brown crusts. The back of the hand has papules of doublecontour colour. Which of the listed agents should be primarily used in the topical treatment?

A 29-year-old patient complains of decay of the 21 tooth, an aesthetic defect. Objectively: on the medial surface of the 21 tooth there is a carious cavity, the cutting edge is partly decayed. Specify the class of this cavity according to Black’s classification:

A 20-year-old patient seeks dental prosthetics. Objectively: on the occlusal surface of the 16 tooth there is a cavity, two walls of the tooth crown are intact. Method of orthopedic treatment is determined by the degree of destruction of the occlusal surface of teeth (IROPZ-index). Who suggested its definition?

A 26-year-old patient needs prosthetics. Objectively: crown of the l6 tooth is decayed by 1/3. It is planned to restore its anatomical shape with a metal inlay. What is the first stage of making a cavity for the inlay?

A 19-year-old patient needs a plastic crown for the 22 tooth. The orthopedist has already taken working and auxiliary impressions. What technological process should be next?

A 25-year-old patient complains of heavy gingival haemorrhages, pain in the oral cavity, weakness, fatigue, fever up to 38oC. These presentations appeared a week ago. Objectively: the patient is pale, adynamic. Examination of the oral mucosa reveals multiple haemorrhages, friable gums, necrotic areas on the tops of gingival papillae, as well as enlarged, soft, painless lymph nodes. The oral mucosal lesion can be a symptom of the following disease:

A 67-year-old patient consulted an orthodontist about missing of the 34, 35, 36, 37, 45, 46 teeth. Orthopantomogram of the remaining teeth shows the alveolar bone resorption in the range of 1/3 of the interdental septa height. What construction should be offered the patient?

During an armed conflict soldier K. was injured and delivered to the station of the separate medical battalion. The patient has a gunshot wound of his right cheek, splintered fracture of the body of mandible, arterial bleeding from the wound. A brigade of the separate medical battalion performed surgical debridement and final bleeding arrest. Specify the scope of further medical and evacuation actions for this patient:

Preventive examination of a 4,5-year-old child revealed some hidden cavities on the contact surfaces of the 54 and 55 teeth. After removal of the overhanging edges of the enamel the softened dentin could be easily removed with an excavator within the mantle dentin. Select the optimal material for a permanent filling:

An 18-year-old student needs prosthetic porcelain-fused-to-metal denture for the 11, 21 teeth. There are no contraindications for the use of such construction. What is the most appropriate material for taking impressions?

A 40-year-old patient complains of experiencing eating difficulties for 3 days due to the injury of the alveolar process mucosa of maxilla. Objectively: at a level of the mucogingival fold of the 14,15 teeth on the vestibular side there is a decubital ulcer sized 1x3 mm with smooth pink edges. What is the most likely diagnosis?

A 50-year-old patient complains of missing of the 37, 36, 45, 46, 47 teeth. The 35, 38, 44, 48 teeth are intact, stable, with anatomically shaped crowns, rather high, relatively parallel to each other. Boundary line has a typical direction along the 35, 44 abutment teeth. What fixation element should be used in a clasp prosthesis supported by the 35,44 teeth?

A 23-year-old serviceman needs orthopedic treatment in a specialized hospital. The patient has been diagnosed with false joint in the anterior lower jaw. The teeth are intact, stable, 3 on each side. Orthopedic treatment can be carried out using a bridge prosthesis, if the jaw defect is no bigger than:

A 22-year-old patient complains of a painful swelling in the right parotid gland. A week earlier the patient got a cheek abrasion which healed under the purulent crust. Over the past two days the patient had observed progressing pain and fever up to 38,6°C. Objectively: there is a soft tissue edema in the right parotid region, the skin is slightly strained but has not changed in colour. There is a dense painful infiltration 2,5x3,5 cm large, the skin over it exhibits limited mobility. The mouth can be fully opened, the mucous membrane around the orifice of the salivary duct is unchanged, the saliva is transparent. What is the most likely diagnosis?

A 33-year-old female patient has been admitted to the maxillofacial department for pain and edema of the right submandibular region, body temperature rise up to 39,5oC. Objectively: the patient has asymmetric face because of soft tissue edema of the right submandibular region, palpation reveals a dense infiltration, the skin over it is hyperemic, does not make a fold. The 46 tooth has a deep carious cavity. What is the most likely diagnosis?

Biopsy material obtained by puncture of a maxillary tumour looks like a foulsmelling mush. What kind of tumour is it typical for?

A 29-year-old female patient complains of peeling, dryness and burning of the lower lip. Objectively: on the vermilion border of lip there are multiple gray scales with tightly attached center and peeling off edges. The scales are found all across the mouth and from the wet-dry line to the middle of the lip. The skin is not affected. Scales removal doesn’t lead to erosions. The patient has the lability of psychoemotional sphere. What is the most likely diagnosis?

A 50-year-old patient has median lower jaw fracture with formation of a false joint. The 38, 32, 31, 41, 42, 48 teeth are missing. The remaining teeth are intact, stable. There is no displacement of lower jaw fragments. X-ray picture shows a bone tissue defect up to 1 cm large. What prosthesis is indicated?

During the examinations and everyday orthopaedic manipulations a dentist uses a dental mirror. What is the way of its sterilization?

A 59-year-old patient presented to a clinic for prosthetics. Three months ago he was treated for the fracture of the body of mandible on the left. The 18, 27, 28, 38, ,31,41,42,43,44,45,47,48 teeth are missing. The patient has left-sided cross-bite with lateral occlusal contact. What tactics should be chosen?

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 maxillomandibular Zbarzh set. Which construction provides the intra-oral fixation?

A 35-year-old patient complains about itch, burning and edema of lips. These presentations occured a week ago. Objectively: there is reddening of vermilion border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of vermilion border. What is the most likely diagnosis?

A 44-year-old male patient complains of fatigue and headache, limb numbness, dry mouth, burning and pain in the tongue. Objectively: skin and oral mucosa are pale. There are painful cracks in the corners of mouth. Dorsum of tongue is smooth, glossy, with bright red striae. Blood count: Hb- 70 g/l, RBCs -1,5 • 1012/l, colour index -1,6, leukopenia, thrombocytopenia, lymphocytosis. What is the most likely diagnosis?

Mother of a 3-year-old child consulted a dentist about discolouration and abrasion of the child’s teeth. The child has a history of enamel spalling shortly after the tooth eruption. Objectively: the crowns of all the teeth are worn by nearly a half and have yellow-gray colour. Make a provisional diagnosis:

A 78-year-old patient is completely edentulous. He has been wearing dentures for 19 years. The patient complains of poor fixation of the upper denture. Objectively: the lower third of face is shortened, the alveolar processes of both jaws are markedly atrophied, the palate is flat. Mucous membrane in the denturesupporting area is atrophied. How often should the dentures be remodelled or restored?

A male patient complains of acute pain in the 26 tooth that is getting worse when biting down on food. 4 days ago arsenic paste was applied, but the patient did not keep the appointment with the dentist. Objectively: the dressing of the 26 tooth is kept. There is pain reaction to percussion. Ro-gram shows no changes in the periapical tissues. After mechanical and pharmacological treatment of the root canals the gauze pads are moist, not stained. What drug substance must be left in the root canals for the maximal clinical effect?

A 14-year-old boy complains of rash on the lips, pain while talking and eating. These presentations showed up three days ago. Similar rash has appeared 1-4 times a year for three years. Objectively: general condition is satisfactory, the body temperature is of 36,9oC. On the vermilion border of the lower lip and the skin below there are multiple small grouped vesicles with serous content, and crusts. What is the etiology of the disease?

A 28-year-old patient hadan appointment with a dental surgeon to prepare the oral cavity for a prosthesis. Examination revealed that the 11 tooth crown was decayed, the root was stable, its percussion was painless. The mucous membrane of the alveolar process was not changed. Rogram of the alveolar process shows widening of periodontal ligament space in the region of the 11 tooth. Alveolar process structure is not changed. The root canal was passable all through. What is the most likely diagnosis?

A 44-year-old patient consulted a dental surgeon about constant acute pain in the upper jaw region on the left that is getting worse during teeth joining. The pain appeared 3 days ago. Objectively: the face is symmetric, mouth opening is not limited. The crown of the 26 tooth is half-decayed. Probing of the carious cavity is painless. Percussion of the 26 tooth provokes acute pain. Mucous membrane of the alveolar process is edematic, hyperaemic at the level of the 26 tooth. The 26 tooth had been treated before. What is your provisional diagnosis?

A 45-year-old patient came to a clinic for prosthetics. Objectively: the 47, 46, 45, 35, 36, 37 teeth are missing. There is dento-alveolar vertical displacement of the 17, 16, 26, 27 teeth, alveolar process is enlarged, tooth necks are not exposed. When the teeth are joined, the distance between the occlusal surfaces of teeth and alveolar process is about 3 mm. What is the most efficient method of secondary deformation treatment in this patient?

A 13-year-old child complains of a short-term pain caused by cold stimuli in the upper left molar tooth. Occlusal surface of the 27 tooth has a cavity with a small hole. After the overhanging enamel had been removed, the soft light dentin could be easily removed with an excavator within mantle dentin. What is the most likely diagnosis?

Parents of a 3-year-old child report that the child has constant pain in the upper front teeth. Objectively: the coronal part of the 61 tooth is gray and decayed. Probing of the root canal orifice is pai- nful and accompanied by bleeding. The tooth percussion provokes acute pain. Mucosa is hyperemic, edematic and painful. Palpation in the region of the 61, 62 teeth reveals a fistula. What is your provisional diagnosis?

A 30-year-old patient complains of toothache caused by hot and cold stimuli. The pain irradiates to the ear and temple. Previously there was spontaneous nocturnal toothache. Objectively: on the occlusal surface of the 37 tooth there is a deep carious cavity communicating at one point with the tooth cavity. Probing at the communication point, as well as cold stimulus, cause acute pain. The pain persists for a long time. Electric pulp test result is 5 mA. What is the most likely diagnosis?

A 40-year-old patient complains of discomfort in the 24 tooth. He has a history of periodical swelling in the region of the affected tooth. Objectively: the 24 tooth cavity is wide open. Probing and percussion are painless. There is positive vasoparesis symptom. Radiograph shows bone destruction with indistinct outlines. What is the most likely diagnosis?

Floating obturators (Case’s, Chasovskaya’s etc.) for the defects in the hard and soft palate are fabricated according to impressions obtained by means of S-shaped spatula. Which impression material is used in this case?

A 43-year-old patient was found to have no crown of the 13 tooth. The root protrudes above the gum by 0,51 mm. The apical part is filled. History: coronal part of the tooth broke off three weeks ago. Prior to this the tooth had been treated for chronic periodontitis. Percussion is painless. The root edges are surrounded with hard moist mucous membrane of pale pink colour. Specify the dentist’s tactics:

A 28-year-old patient complains of a painless nonhealing mouth ulcer. Objectively: regional lymph nodes are enlarged, painless, of cartilaginous consistency. On the buccal mucosa there is a round ulcer 1 cm in diameter with regular raised edges and a dense elastic infiltrate at the base. The ulcer surface is of red colour, painless on palpation. What is the most likely diagnosis?

A 32-year-old patient complains of acute spontaneous attacks of pain in the 14 tooth. The pain lasts for 10-20 minutes and occurs every 2-3 hours. Carious cavity in the 14 tooth is filled with softened dentin. Probing of the cavity floor is painful at one point. Cold stimulus causes pain. What is the most likely diagnosis?

A 42-year-old patient complains of a painful ulcer in the mouth that is getting bigger and does not heal over 1,5 months. Objectively: on the buccal mucosa there is a shallow soft ulcer 2 cm in diameter with irregular undermined edges. The ulcer floor is uneven and covered with yellow-gray coating. The ulcer is surrounded by many small yellowish tubercles. Regional lymph nodes are elastic, painful, matted together. Which disease is characterized by such symptoms?

A 24-year-old patient complains of aching pain in the 11 tooth that is getting worse during biting down on food. Two days ago the tooth was filled for pulpitis. Objectively: the 11 tooth is filled. The thermal test causes no pain, vertical percussion is slightly painful. X-ray picture of the 11 tooth shows that the endodontic filling is 1 mm above the root apex. Which of the following methods will be most effective for eliminating this complication?

A patient is 12 years old. He has been undergoing orthodontic treatment for pseudo prognathism with Angle’s fixed appliance for 10 months. What is the optimal duration of the retentive period?

A 55-year-old patient complains of general weakness, spasmodic neuralgic pain in the right side of face, rash in the mouth and on the skin. Objectively: lip and chin skin is markedly hyperemic, there are numerous vesicles with clear exudate on the right. The right cheek mucosa is hyperemic, there is a string of erosions covered with fibrinous pellicle. What is the provisional diagnosis?

According to the mother, a 5-year-old child complains about pain during swallowing, weakness, body temperature rise upt to 39,5oC, swelling of submental lymph nodes. Objectively: the child’s condition is grave, body temperature is 38,8oC. Mucous membrane of the oral cavity is markedly hyperaemic and edematic with haemorrhages and ulcerations. Pharynx is markedly hyperemic, lacunae are enlarged and have necrosis areas. Regional, cervical, occipital lymph nodes are painful, enlarged and dense. What is the most likely diagnosis?

A 19-year-old male patient consulted a dentist about gingival pain and bleeding when eating and brushing his teeth. Objectively: anterior maxillary and mandibular teeth are overcrowded, there is hyperemia, cyanosis and overgrowth of gingival papillae up to 1/3 of the crown height. The soft plaque is present. The gums bleed when touched with a tool. What is the most likely diagnosis?

A 23-year-old female patient complains of short-term pain caused by thermal stimuli in a lower jaw tooth on the right. Objectively: on the occlusal surface of the 46 tooth there is a deep cavity with softened light dentin on the floor and walls. Probing causes a slight pain across the cavity floor. Pulp electroexcitability is 10 mA. During the cavity preparation a drop of blood showed up on its floor. What paste should be applied to the cavity floor?

After the clinical and radiographic examination a 32-year-old patient was diagnosed with chronic odontogenic sinusitis, fistula between sinus and oral cavity through the socket of the 27 tooth. Specify the optimal method of surgical treatment of this disease :

A 15-month-old child diagnosed with intrusive luxation of the 51 tooth has been referred to a children’s dental surgeon. What is the optimal treatment tactics?

A 45-year-old patient complains of missing teeth in the lower jaw on the right. Objectively: the 46, 45, 38, 48 teeth are missing. The 47 tooth is mobile (1 grade mobility), the crown of the 44 tooth is decayed by 1/2. What orthopedic construction should be recommended for restoration of masticatory efficiency and prevention of periodontal overload of the 47,44 teeth?

A 57-year-old patient complains of tooth mobility, inability to eat. Objectively: the lower 35, 36, 37, 38, 44, 45, 46 and 48 teeth are missing; the 31,32,33,34, 41, 42, 43, 47 teeth exhibit II grade mobility, their clinical crowns are low, tooth equator is not pronounced. What is the optimal denture construction in this case?

A child has been admitted to a hospital with a maxillofacial trauma. It is probable that the wound has been contaminated with tetanus infection. How soon after the injury should the tetanus serum be given?

A patient working as a bricklayer complains of itching, burning, soreness of lips that show up only in the summer period. He has a 3-year history of this disease. Objectively: vermilion border of the lower lip is hyperemic, edematic, covered with blisters and painful erosions 2 mm in diameter, crusts, cracks. What is the most likely diagnosis?

Parents of a 2-month-old baby complain about caseous films on the mucous membrane of his cheeks and tongue. After examination the child has been diagnosed with acute oral candidiasis of moderate severity. Topical treatment should be started with the administration of the following agents:

A patient complains of acute shortterm toothache caused by thermal and chemical irritants. The tooth has not been treated before, the pain arose about a month ago. Objectively: on the occlusal surface of the 36 tooth there is a deep carious cavity within circumpulpal dentin with overhanging chalky enamel. Probing of the cavity floor causes a slight pain. There is also a short-term pain from the cold stimulus. The result of electric pulp test is 8 mA. What is the most likely diagnosis?

A 20-year-old male patient complains of acute pain during eating, bad breath, general weakness. Objectively: interdental papillae and marginal gingiva are covered with dirty gray film, any touch is painful. The body temperature is of 37,5oC. Blood count: RBC - 4,8 • 1012/l, Hb- 150 g/l, colour index - 0,9, WBC -10,5 • 109/l, JG - 2%, BASO - 1%, EOS -5%, segmented neut. - 8%, stabs - 47%, LYM - 35%, PLT - 250 • 109/l. ESR - 20 mm/h. What is the most likely diagnosis?

A 19-year-old patient complains of indisposition, fever, pain in the gums and oral mucosa. These presentations showed up two days ago. Objectively: body temperature is of 38,8 0C, regional lymph nodes on the right are enlarged, painful, mobile. Oral mucosa is hyperemic, edematous; gingival papillae are hemorrhagic, with grayish-white coating, on the buccal mucosa there are painful ulcers with irregular edges covered with the same grayish-white coating. What organisms are most likely to be found on microbiological study?

A 30-year-old patient has a cut wound of the upper lateral surface of tongue. The wound was given with a separating disk. Bood penetrated into the airways causing asphyxia. What form of asphyxia occurred in the patient?

A 10-year-old girl complains of a carious cavity in a lower jaw tooth. Objectively: the 26 tooth has a carious cavity within circumpulpal dentin, dentin is dense, pigmented, there is pain reaction to the cold stimulus, probing and percussion are painless. What is the provisional diagnosis?

A 12-year-old girl visited a dentist for a regular check-up. Objectively: the teeth are intact, the bite is open, the mucosa in the papillary and marginal regions is hyperemic and cyanotic, the gingival papillae are roundish, enlarged and cover one third of the crown height of the upper anterior teeth. Make a provisional diagnosis:

Parents of a 6-year-old child consulted a doctor about a swelling in his right parotid-masseteric region, dry mouth, fever up to 37, 7oC. Similar presentations turned up about 6 months ago. Examination revealed a tuberous, slightly painful infiltrate in the right parotid-masseteric region. Saliva is viscous, the right salivary gland duct discharges some secretion with whitish inclusions. What is the most likely diagnosis?

A 34-year-old patient was undergoing treatment for acute deep caries of the 37 tooth. During the tooth preparation the buccal pulp horn was accidentally opened. What is the most rational treatment of the 37 tooth?

A 21-year-old patient complains of a constant progressing throbbing pain in the 27 tooth. Objectively: a large carious cavity is filled with softened dentin, the tooth cavity is closed. Probing of the cavity floor is painless, percussion causes acute pain, there is grade II tooth mobility. Palpation of the mucous membrane in the projection of the root apex of the 27 tooth causes pain. Radiological changes are absent. What is the most likely diagnosis?

A 20-year-old patient complains of the 23 tooth sensitivity to sour or sweet food. The pain abates after the irritants are removed. The problems arose two weeks ago. Objectively: on the vestibular surface of the 23 tooth there are white spots 2-3 mm in diameter. The spots have a rough surface, methylene blue stain cannot be washed away with water. What is the most likely diagnosis?

A 24-year-old patient complains of acute pain and swelling in the submandibular triangle that is getting worse when he eats spicy food. He has been diagnosed with exacerbation of chronic calculous si-aloadenitis with the concrement localized in the median part of the salivary duct. Which method is most rational in this case?

A 38-year-old patient with chronic generalized periodontitis has been referred to orthopedic treatment. Objectively: dentitions are without gaps, the 12, 11, 21, 22 teeth are pulpless and exhibit I grade mobility. The other teeth are stable. What is the most aesthetic splint for the anterior teeth?

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 temporomandibular joint ( TMJ) there are crepi- tation and clicking accompanying 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 patient needs a clasp prosthesis. It is planned to study the jaw model by means of a parallelometer in order to determine the required depth of the undercuts on the abutment teeth. Specify the length of the measuring rods used for this purpose:

An 18-year-old male has a furuncle in the region of mandible angle. The surrounding tissues are rigid. Cyanosis and induration in form of a cord extend to the corner of the eye. General condition is deteriorated, body temperature is of 38,5oC. What complication has developed in this case?

A 30-year-old patient needs a post and core for the 36 tooth prior to the tooth restoration with a crown. Objectively: the crown of the 36 tooth is decayed down to the gums, percussion is painless. Radiograph shows that root canals are filled to the top. There are no changes of the periapical tissues. What is the optimal number of posts in this case?

A 25-year-old patient presented to a clinic on the fourth day after a face trauma complaining of pain in the lower jaw on both sides, difficult swallowing. Objectvely: there is a slight swelling in the mental region, dentitions are intact but a fragment of 44 43 42 41 31 32 33 34 teeth is displaced downwards and backwards. Single-step fragment reposition is not effective. Which appliance should be used for the fragment reposition?

A 25-year-old patient has necrosis foci along the gingival margin on both jaws. Face skin is sallow, he looks older than his age. Submandibular, mental, cervical and axillary lymph nodes are enlarged, painless, mobile. The patient leads a hectic life, abuses drugs. Over the last month he has complained of weakness, constant body temperature of 37, 3 — 37,5oC, diarrhea, weight loss of 15 kg. What is the most likely provisional diagnosis?

A 20-year-old patient was delivered to the hospital 6 hours after injury. Objectively: the patient has malocclusion due to the displacement of bone fragments. The teeth on both jaws are intact except for the missing 35 tooth. Ro-gram shows fracture of mandible. The fragments are displaced. What treatment is most appropriate?

A 6-year-old girl has unrestricted opening of the mouth. The alveolar process of the upper jaw is intact. Soft and hard palate are of a triangular shape and have a cleft up to the level of the 13 and 23 teeth. Soft palate is shortened. Speech is indistinct. The child was born with this defect. What is the most likely diagnosis?

3 days ago a 35-year-old patient underwent the extraction of the 47 tooth, which was followed by health deterioration. Objectively: the patient is pale, body temperature is of 38,1oC, the lower jaw on the left is thickened, the surrounding soft tissues are swollen, opening of the mouth is difficult. Mucogingival fold at the 48, 47, 46 teeth is edematous, mucous membrane is hyperemic. There are purulent discharges from the 47 tooth socket, percussion of the 48, 46, 45 teeth is painful. There is also paresthesia in the lower lip region. What is the most likely diagnosis?

Parents of a 6,5-year-old boy consulted an orthodontist about no contact between the front teeth. The child has a bad habit of sucking his tongue. Objectively: there is a symptom of multiple pits in his chin when the lips are closed, speech disturbance, between the front teeth there is a vertical gap up to 8 mm. Specify the occlusion anomaly:

During the extraction of the 17 tooth the distal buccal root broke off and remained in the socket. Select a tool to extract the root:

A 64-year-old patient needs a complete removable denture for the upper jaw. During fitting the Herbst appliance, the orthopedist revealed that it falls off when the patient swallows. The correction is required in the following area:

A 5-year-old child complains of acute spontaneous pain in an upper jaw tooth on the right. Hot stimuli make the pain significantly worse. The tooth had been previously treated for median caries. The pain arose a day before. On the medial occlusal surface of the 54 tooth there is a deep carious cavity, the tooth cavity is closed. Probing of the cavity floor is painless, percussion is slightly painful. After necrotomy the pulp horn was opened. Deep probing is painful. What is the provisional diagnosis?

A 7-year-old child complains of pain and swelling in the left submandibular region. The swelling in this region showed up 2 days ago. Objectively: the child is in satisfactory condition, body temperature is of 37, 3oC. Face is asymmetrical due to the soft tissue swelling in the left submandibular region. Palpation reveals a round formation sized 2x2 cm. The formation is mobile, painful, not attached to skin. The 74 tooth is changed in colour, percussion is painful. What is the provisional diagnosis?

A 21-year-old patient consulted a dental surgeon about a tumour-like formation on the left cheek. The patient noticed the swelling for the first time a year ago. Objectively: on the left cheek skin there is a painless roundish pedunculated tumour up to 0,5 cm in diameter. The surface of the formation looks like cauliflower, the surrounding skin is not changed. What is the most likely diagnosis?

A 24-year-old patient complains of a growing tumour in the body of mandible on the right. The tumour growth has been observed for 5 months. Objectively: in the angle of mandible there is a swelling. Regional lymph nodes are not enlarged. Ro-gram shows a well-defined focus of bone destruction at the level of the 46, 47, and 48 teeth and in the ramus of mandible. The lesion is in form of individual cavities with osseous septa. The roots of the 46,47, 48 teeth are resorbed. What is the provisional diagnosis?

Parents of a 6-year-old girl consulted an orthodontist about protrusion of the lower jaw. The child looks like his father. Objectively: the child has primary bite, there are diastemata and tremata on both jaws, reverse incisal overlap of front teeth, the sagittal gap is up to 3 mm, the lateral parts are characterized by mesio-occlusion. Ilyina-Markosyan test for the distal displacement of mandible is negative. What principle of treatment will be most effective?

A 52-year-old patient complains of pain and a swelling in the right parotid region. These manifestations have been present for about 2 years. Over the last month the swelling has grown bigger, pain has intensified. Objectively: the face is asymmetric due to the dense infiltrate in the right parotid region. The poorly circumscribed, painful formation infiltrates the surrounding tissues. At the right side of neck in front and behind the sternocleidomastoid muscle there are enlarged, dense, mobile lymph nodes. The right naso-buccal groove is flattened, the corner of mouth is downturned. The mouth opens freely. The are pronounced symptoms of the right facial nerve paresis. What disease can be suspected?

A 58-year-old patient complains of missing teeth on the upper jaw. Objectively: in the place of the missing central upper incisors there is a fan-shaped vestibularly located cord on the alveolar process. The cord is 1 cm wide, it makes prosthetics more complicated. What is the optimal medical tactics?

A 35-year-old patient has been diagnosed with chronic median caries of the 36 tooth. There is a Black’s class II cavity affecting masticatory surface. What material should be chosen for the tooth filling?

A 28-year-old patient complains of dull pain in the 17 tooth caused by hot meal, the pain slowly abates after removing the irritant. There is also a feeling of tooth bursting, and bad breath after the tooth suction. What is the provisional diagnosis?

Parents of an 8-year-old child with Down syndrome took the child to a doctor for oral cavity sanitation. After the examination entailing great difficulties the child was found to have four teeth decayed as a result of chronic periodontitis. What kind of anesthesia should be chosen for surgical sanitation in one visit?

A patronage nurse visited a newborn baby. Examination revealed the shortened lower part of the face, the backward-sloping chin, missing teeth, the retroposed lower jaw. What is the number of dental follicles in each jaw of a newborn baby?

A 47-year-old patient complains of a burning sensation and pain in the mouth. Objectively: on the mucous membrane of cheeks along the line of teeth contact and in the corners of mouth there are multiple polygonal bright red erosions 1,0-1,5 cm in diameter located on the hyperkeratini-zed plaque and opaque whitish mucosa. Cytological analysis revealed keratinizing epithelial cells. What is the most likely diagnosis?

A 67-year-old female patient has a burning sensation under her complete removable denture for the upper jaw which was fabricated of plastics 3 days ago. Examination revealed hyperemia and edema of the mucous membrane within the boundaries of the denturesupporting area. What is the cause of this pathology?

A 55-year-old patient consulted a dentist about a roundish tumour-like formation of about 1 cm in diameter located within the vermilion border of his lower lip. Objectively: the tumourlike formation protrudes about 5 mm above the vermilion border, it is dense and grayish-red. The surface of the formation is covered with thin scales that can hardly be removed. What is the most likely di- agnosis?

A 16-year-old male patient complains of itchy rash on the vermilion border of lips and in the mouth corners. The patient has a 4-year-old history of this disease with exacerbation periods mainly in autumn and winter. Objectively: vermilion border of lips and skin in the mouth corners is dry, peeling with small scales. Mouth corners are characterized by lichenification, deep folds and fissures, bloody crusts. What is the most likely diagnosis?

Preventive examination of a 28-year-old male patient revealed reddish smooth patches in form of different-sized circles on the back of tongue. The patches are circumscribed with a narrow whitish stripe. It is known that these tongue changes are not permanent, show up and disappear throughout a few years and don’t bother him. The patient has a history of chronic gastritis. Histological examination of the epithelium revealed hyper- and parakeratosis. What is the most likely diagnosis?

After unilateral resection of the upper jaw a 52-year-old patient received the immediateinsertion denture. What is the term of its use?

An injured patient complains of limited opening of the mouth, nose bleeding, skin numbness in the infraorbital and lower eyelid region. Objectively: there is face deformation due to the depression of soft tissues in the left cheekbone region, step deformity in the middle part of the inferior margin of the left orbit and in the area of the zygomatic alveolar crest. What is the most likely diagnosis?

A 30-year-old patient needs to have his 26 tooth extracted because of exacerbation of chronic periodontitis. Objectively: the crown of the 26 tooth is decayed by 1/3. What forceps can be used for this tooth extraction?

A patient is 56 years old. 6 months after resection of the right side of the upper jaw the patient is going to receive a permanent resection prosthesis. What device can be used to determine the optimal state of the resection prosthesis borders?

A 49-year-old patient consulted a dental surgeon about the oral cavity sanitation. He has an indication for the extraction of the 16 tooth. History: the tooth hasn’t been treated before, it has decayed within the last 4 years. Objectively: the 16 tooth’s crown is decayed by over 2/3, the mucosa exhibits no pathological changes. Which tool is required for the tooth extraction?

A patient complains of limited mouth opening, pain during swallowing, fever up to 38,5oC, weakness, indisposition. Objectively: the mouth opens up to 1 cm. After Berchet anesthesia examination of the oral cavity revealed edema, hyperemia, tenderness of the pterygomandibular fold. Lateral and posterior pharyngeal walls are intact. The 38 tooth is semi-impacted. Palpation of the internal surface of the mandibular angle is painful. What is the most likely diagnosis?

A 6-year-old patient complains of a long-lasting pain in a lower right tooth that is getting worse when biting down on food. The tooth has been previously treated for caries. Objectively: the cavity on the occlusal surface of the 36 tooth is filled, percussion is painful. Along the mucogingival fold in the projection of the 36 tooth roots there is a fistula with purulent discharge. What is the most likely diagnosis?

A 35-year-old patient complains of a neoplasm on the tip of his tongue which he injures with his teeth. The neoplasm sometimes increases, and sometimes decreases in size. Objectively: on the tip of tongue there is a roundish well-defined neoplasm 0,5 cm in diameter with broad base. The neoplasm is the same colour as the mucosa of tongue. What is the most likely diagnosis?

A patient presented to a doctor with a red spot on her chin skin. Two months ago the patient suffered a chin injury. After resorption of traumatic edema there appeared a black punctum which was gradually increasing in size. Objectively: the face is symmetric, on the chin skin there is an irregular wine-coloured pai- nless spot sized 2x1,5 cm that turns white when pressed. What is the most likely diagnosis?

X-ray examination of the oral cavity revealed a pronounced damage of the compact bone, mild osteoporosis of apices of interalveolar septa and widened periodontal ligament space around the dental necks. What is the most likely diagnosis?

Preventive examination of a 13,5-year-old child revealed congestive hyperemia and a slight edema of the gingival margin in the region of the front teeth on both jaws. The patient has periodic gingival haemorrhages during tooth brushing. DMF index is 2. What kind of toothpaste should be recommended for the individual oral hygiene?

A 64-year-old patient with edentulous jaws has a minor uniform atrophy of maxilla and a pronounced atrophy of lateral parts of mandible. The mucosa in these parts 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 24-year-old female patient consulted a dentist about pain in the 26 tooth. After a physical examination the patient was diagnosed with exacerbation of chronic periodontitis of the 26 tooth. During the tooth extraction the coronal part of the tooth was accidentally broken. Further manipulations with bayonet forceps failed to extract the tooth roots. What actions are to be taken for the successful root extraction?

A 30-year-old female patient complains of limited mouth opening. She has a history of a trauma received at the time when her jaws were closed. Objectively: mouth opening is limited to 1,5 cm, the bite is normal, mouth opening causes the displacement of mandible to the left. Palpation reveals pain in the left temporomandibular joint (TMJ). X-ray picture shows that the bone integrity is preserved. What is the most likely diagnosis?

Preventive examination of a 5-year-old child revealed a habit of lower lip biting. What malocclusion may develop if the child keeps this habit?

A 14-year-old girl complains of indistinct pronunciation that developed at the age of 14 after the acute respiratory viral disease. Examination revealed normal face and normal teeth alignment, occlusal disharmony was not found. Palpation didn’t reveal cleft palate. Uvula doesn’t move during pronunciation of sounds, its palpation does not cause gag reflex. What is the reason for indistinct pronunciation of sounds?

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 confining the defect are high and stable. To restore the integrity of the dentition it is planned to fabricate a cast clasp denture. What kind of mechanical fixator should be used?

A 22-year-old patient presented to a prosthetic dentistry clinic because of missing of the 21 tooth, the 11 and 22 teeth are intact. The 21 tooth was extracted 2 months ago. What construction is most suitable in this case?

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

A 47-year-old patient needs dental prosthetics. Objectively: the 24, 25 teeth are missing, there is a slight dento-alveolar lengthening in the region of the 34, 35 teeth. Which of the following methods of the occlusal surface correction should be applied?

It is planned to open a city dental clinic to serve 200,000 of adult population. How many positions of dentists should be provided for the orthopedic department?

A 25-year-old patient consulted a dentist about orthopedic treatment of the 17 tooth. After the patient had been given local anesthesia, his condition suddenly deteriorated (he developed anxiety, general weakness, acute headache, nausea, loss of consciousness, poor pupillary reaction to light, abrupt drop of arterial pressure. What is the most likely diagnosis?

The department of maxillofacial surgery admitted a patient who needs repair of a posttraumatic defect of nose wing up to 3,0 cm in diameter. The trauma occured six months ago. What kind of grafting is indicated in this clinical situation?

A 25-year-old female patient consulted a dentist about acute pain in the upper jaw on the left. The pain occurs during eating. Objectively: on the distal approximal surface of the 26 tooth there is a cavity filled with light soft dentin. Probing causes a slight pain along the dentinenamel junction, percussion is painless. Cold water causes quickly abating pain. What is the most likely diagnosis?

At a prosthetics dentistry clinic a 35-year-old patient received a porcelain-fused-to-metal crown for the 21 tooth. What is the minimum warranty period for porcelain-fused-to-metal crowns under the current legislation?

During the surgical removal of a retention cyst of the lower lip a 14-year-old boy complained of sudden weakness, dizziness, nausea. Objectively: the skin is covered with cold sweat. Respiration is frequent, pulse is weak, AP is decreased (90/60 mm Hg), the hands are cold. What is the most likely diagnosis?

Parents of a 7,5-year old child brought him to a dentist for oral cavity sanitation. Objectively: DEF (for primary teeth) + DMF (for permanent teeth) index = 4, Green-Vermillion index = 2,5. Fissures of the first permanent molars are open, intact, non-pigmented. What method of primary prevention of dental caries may be appropriate in this case?

A 28-year-old patient complains of experiencing gum discomfort, gingival haemorrhages and pain, especially during eating, for a week. Objectively: the gums are swollen and markedly hyperemic, especially within the 43, 42, 41, 31, 32, 33 teeth, soft plaque and tartar are present, gingival sulcus is up to 2 mm deep. What is the most likely diagnosis?

A 35-year-old patient complains of gingival hemorrhage during tooth brushing. Objectively: gums of both jaws are hyperemic and cyanotic, supragingival and subgingival tartar is present. The periodontal pockets are 4-6 mm deep. What is the most likely provisional diagnosis?

A 27-year-old male patient complains of aching long-lasting pain in the 15 tooth during having meals, especially cold food. Sometimes the pain occurs when the temperature changes. Objectively: on the distal surface of the 15 tooth there is a cavity filled with softened dentin. Probing is painful. Electroexcitability of the pulp is 35 nA. What is the most likely diagnosis?

A 12-year-old child presents with body temperature of 38oC, chills, nausea, vomiting, delirium, weakness. In the middle third of face there is butterfly-shaped rash. Regional lymph nodes are enlarged, slightly painful. Blood count: WBC- 12 • 109/l, LYMP - 8,0 • 109/l, ESR - 26 mm/h. Make a diagnosis:

A 37-year-old patient had an appointment with his orthopaedist about dental prosthetics. During the preparation of hard dental tissues for a fixed denture he was given conduction anesthesia. During the injection the patient developed cold sweat, sudden pallor and cyanosis, thready pulse. The patient stayed conscious, but became relaxed and lethargic. What is the provisional diagnosis?

A 25-year-old patient complains of a light brown spot in the upper front tooth. Objectively: the 23 tooth has a single light brown spot in the precervical region. Probing reveals smooth surface. The tooth is nonresponsive to cold and probing. What is the most likely diagnosis?

A 48-year-old patient is in grave condition: body temperature is of 39,8oC, the face is asymmetric due to the infiltration of the submental and both submandibular triangles. Speech is difficult as the tongue is displaced upwards. Swallowing is painful. Sublingual plicae are markedly hyperemic and edematous. What is the most likely diagnosis?

During the dental care procedures a 4-year-old child has been found to have a carious cavity in the 64 tooth. The cavity filled with softened dentin is located within parapulpal dentin and doesn’t communicate with the tooth cavity. Probing of the cavity floor is painless. Gingival mucosa in the projection of the root apices of the 64 tooth exhibits a healed fistula. What is the most likely diagnosis?

A 20-year-old patient in the 8th month of pregnancy complains about an aesthetic defect, speech disturbance due to the missing upper front tooth. Objectively: the 12 tooth is missing. The 11, 13 teeth are intact, stable, of anatomi- cal shape. The patient has orthognathic bite. What prosthesic design should be preferred?

A 62-year-old patient diagnosed with TMJ arthritis presented to a clinic. The patient underwent radiography. Specify the radiological presentations of TMJ arthritis:

A 24-year-old patient consulted a dentist about a cavity in an upper jaw tooth, which appeared three months ago. The tooth had not ached before. Objectively: on the occlusal surface of the 15 tooth there is a small carious cavity within the mantle dentin filled with leftover food. Probing revealed that the cavity walls and floor were dense. The response to thermal stimuli is absent. What is the most likely diagnosis?

A 45-year-old patient has a bilateral mental mandibular fracture with a typical displacement of fragments. What actions should be taken to eliminate asphyxia?

A 42-year-old patient consulted a dentist about a swelling on the left cheek, redness of its skin. 2 months ago he noticed an induration on the left cheek which has been eventually enlarging. The skin over it turned bluish-red and soft in the center. Objectively: the left cheek skin has a lesion sized 2,5x1, 5 cm with regular edges, the skin is dramatically thinned, cyanotic, glossy, makes folds and bumps. Intraoral palpation reveals a cord going from the 37 tooth to the cheek lesion. The 37 tooth is filled. What is the most likely diagnosis?

A 40-year-old patient consulted a dental surgeon about difficult mouth opening. Clinical examination revealed mouth opening limited to 1 cm. The 48 tooth crown is decayed by 2/3, percussion is strongly positive. What kind of peripheral conduction anesthesia should be applied for the surgical extraction of the 48 tooth?

A 39-year-old patient had been admitted to the maxillofacial surgery unit for a swelling and bursting pain in the left submandibular region. The swelling appeared after eating spicy foods. After a physical examination, palpation and X-ray the patient was diagnosed with sialoli-thiais of submandibular gland with the concrement localized in the anterior duct. What tactics should be chosen by a dental surgeon after removal of the concrement from the duct?

A 14-year-old child has been lately complaining about overgrowth and permanent bleeding of gums during tooth brushing. Objectively: gingival papillae in the anterior part of both jaws are swollen, hyperemic, overlap the tooth crowns by 1/3 of their height, bleed easily during the instrumental examination. Caries intensity is of average level. Hygiene of the oral cavity is not satisfactory. In this case it is advisable to recommend a toothpaste containing:

During examination of a 5-year-old child the orthodontist revealed no wear of teeth, no tremata and diastemata, orthogenic occlusion. Which of the following symptoms in a 5-year old child is a sign of future teeth overcrowding?

An 8-year-old child has been clinically diagnosed with exacerbation of chronic periodontitis of the 84 tooth. The crown is decayed by 1/2. What is the dentist’s optimal tactics?

A 21-year-old patient complains of blood that oozes from a cavity in an upper jaw tooth during eating. Objectively: the approximal occlusal surface of the 27 tooth has a deep carious cavity filled with soft tissue overgrowth of purple-red colour that bleeds easily when touched by the probe. Probing causes a slight pain. There is a slight pain reaction to cold stimuli. EPT result is 60 mA. Ro-gram shows no pathological changes. What is the most likely diagnosis?

A 20-year-old female patient complains of sore gums, purulent discharges from under the gums, tooth mobility. Objectively: the gums are markedly hyperemic, cover the tooth crowns by 1/3. Periodontal pockets are 7-8 mm deep with moderate purulent discharge. The 16, 26, 36, 31, 46, 41 teeth are missing. The remaining teeth are characterized by the 2 grade mobility. Ro-gram shows root exposure by 2/3, the deep bone niches in the alveolar bone. The skin keratinization of the extensor surfaces of the elbows and knees is present, as well as limb keratoderma. Nails are rough, dull. What disease can be suspected?

Examination of a 5-year-old child revaled reverse overlap of the incisors and canines. What is the most effective way of abnormal bite prevention at this age?

A 67-year-old patient consulted a doctor about a formation on his upper lip on the left, which appeared two months ago. Objectively: on the border of skin and vermilion border of the upper lip on the left there is a roundish cone-shaped formation up to 1 cm at the base, narrowing towards the apex, up to 1.3 cm high, gray, dense, painless. What is the most likely diagnosis?

A 13-year-old child has been taken to an orthodontist. Objectively: the child has permanent dentition. The 13 tooth with mesio-distal dimensions of 8,9 mm erupted vestibularly outside the dental arch, the interval between the 14 and 12 tooth is 9,2 mm. Select a rational plan of treatment: