Крок 2 · Стоматологія 2014 · Англійська

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

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 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 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 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:

A 40-year-old female patient complains of swelling of the left submandibular region which appeared three days ago; elevation of body temperature up to 37,4oC. Objectively: the left submandibular region exhibits a soft tissue edema, the skin color is not changed. Palpation reveals a roundish dense elastic node with a smooth surface sized 2,0 x1,5 cm. The node is mobile, somewhat tender. Mouth opening is not restricted, oral mucosa exhibits no visible changes, the crown of the 36 tooth is decayed by 2/3, its percussion causes pain response. What is the most likely diagnosis?

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 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 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 25-year-old female patient consulted a dentist about acute pain in the mandible on the right that occurs during eating. Objectively: the approximate distal surface of the 45 tooth exhibits a carious cavity filled with light softened dentin. Probing causes a minor pain response across the entire floor. Percussion causes no pain. Cold water causes transient pain. What is the most likely diagnosis?

A 45-year-old male patient has been admitted to the maxillofacial department with complaints of general weakness, pain and swelling in the left submandibular region, elevation of body temperature up to 39oC. He has a history of frequent pain in the 36 mandibular tooth on the left. The face is asymmetric due to the swelling of the left submandibular region, where a dense infiltrate is palpable; the overlying skin is hyperemic, doesn’t make a fold. There is a deep carious cavity in the 36 tooth, its percussion causes pain response; the surrounding mucosa is hyperemic, edematous. What is the most likely diagnosis?

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 5-year-old child has been diagnosed with chronic granulating periodontitis of the 85 tooth. What is the optimal material for the root canal filling?

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 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 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 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 17, 16, 26, 27, 28 teeth are missing. Which anatomical structure takes the greatest load in this situation?

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 7-year-old child complains of fever up to 38,30C, headache, sore throat and general weakness. Objectively: the mucosa of the soft palate, tonsils and palatine arches is edematous and hyperemic, there are numerous small painful erosions with red bottom. The erosions are not covered with any plaque. The submandibular lymph nodes are enlarged, painful on palpation. What is the most likely diagnosis?

A 22-year-old patient complains of a painful swelling in the right parotid gland region. A week before the pati- ent got a cheek abrasion which was healing under the purulent crust. Over the past two days, the patient had had progressing pain and fever up to 38,6oC. Objectively: there is a soft tissue edema in the right parotid region, the skin is slightly tense but has not changed in colour. There is a dense painful infiltration 2,5x3,5 cm large, the overlying skin 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 42-year-old female patient consulted a dentist about a sudden dramatic enlargement of gingiva, bleeding sores on the mucous membrane, lymph node enlargement. There is body temperature elevation up to 38oC, weakness, pain in the bones. What disease can be suspected in this patient?

A 56-year-old male patient presents to a dental clinic for complex dental treatment prior to prosthetic procedures. Objectively: there is a pathological grayish-white triangular lesion sized 0,5x1,5 cm on the buccal mucosa in the mouth corners. The lesion cannot be removed. There are no signs of inflammation, regional lymph nodes are unchanged. Make a diagnosis:

A 24-year-old female patient presented to a dental clinic for the extraction of the maxillary wisdom tooth root. Following the posterior superior alveolar nerve block, a post-injection hematoma occurred. What structure was damaged during anesthesia?

What is the most adequate surgical approach for a submandibular phlegmon dissection?

A 12-year-old patient has chronic catarrhal gingivitis. The oral vestibule is 7 mm deep. Fedorov-Volodkina hygiene index is 4. Examination revealed no abnormalities of lip frenulum attachment. What measures should be taken in the first place?

On the basis of subjective complaints, anamnesis and objective examination, a 5-year-old child has been diagnosed with impacted dislocation of the 71 tooth. What is the most appropriate treatment tactics?

A 26-year-old male patient presents to a prosthetic dentistry clinic for a swaged metal crown for the 26 tooth. This is his third visit. During examination he has been found to have a hole on the medial buccal tubercle of the crown which appeared as a result of polishing. What tactics should be chosen?

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 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 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 25-year-old male complains of pain, a sensation of heaviness in the maxilla on the left. He has a history of the 25 tooth extraction followed by health deterioration. There appeared purulent discharge from the left nasal meatus. He was diagnosed with acute odontogenic leftsided sinusitis. Which nasal meatus should the maxillary sinus be punctured through?

A 22-year-old male patient presented to a dental clinic with a cavity in the 11 tooth. The patient had no previous history of this tooth treatment. Objective examination revealed a carious cavity filled with light softened dentin on the approximate medial surface. The carious cavity was located within the mantle dentin. The tooth is slightly sensitive to the cold stimuli. What is the most likely diagnosis?

A patient consulted an oral surgeon about maxillary pain on the left, which arose three days ago. After examination, the patient was diagnosed with exacerbation of chronic periodontitis of the 17 tooth. The 17 tooth is indicated for extraction. What nerves should be blocked for a painless extraction of the 17 tooth?

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 lip skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks accompanied by erythematous lesion of vermilion border. What is the most likely diagnosis?

A 6-year-old child complains of pain in a mandibular tooth on the left during eating. Objectively: masticatory surface of the 36 tooth exhibits a carious cavity within the mantle dentin. The cavity is full of light softened dentin which can be easily removed with an excavator. Probing of the cavity walls causes pain response. The teeth are sensitive to thermal stimuli, the pain is of short-term nature. There is no response to percussion. Select the optimal filling material:

A patient undergoes orthopedic treatment for bounded edentulous spaces in the upper jaw with fixed full-cast dentures. At the second appointment it is necessary to check whether the inner surface of the metal frame of the future porcelain-fused-to-metal bridge fits the surface of the prepared teeth. How can this be done?

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 35-year-old male complains of short-term pain caused by thermal stimuli in the 46 and 47 teeth. Objectively: masticatory surfaces of the 46, 47 teeth are intact, approximate surfaces could not be examined because of a very close arrangement of teeth. What methods of study can be used in this case if you suspect the presence of hidden cavities?

A 13-year-old child complains of having a cavity in the front maxillary teeth. Contact medial surfaces of the 11 and 21 teeth exhibit cavities found within the mantle dentine and filled with dense pigmented dentin. Probing of the cavity floor causes no pain response, neither does dental percussion. Select the best filling material for the permanent seals:

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

A 15-year-old teenager consulted an orthodontist about misalignment of teeth. Objectively: the face is unremarkable. The patient has permanent dentition. There are no abnormalities of jaw relationship in three dimensions. The 23 tooth has a vestibular position and is located above the occlusal plane, the space in the dental arch is less than 1/3 of crown. The space for the misaligned 23 tooth can be gained due to:

An 11-year-old boy complains of a carious cavity in a mandibular tooth on the right. Objectively: the 46 tooth exhibits a carious cavity within the mantle dentin. The dentin is dense, pigmented; there is pain response to the cold stimulus, probing and percussion cause no pain response. Make a provisional diagnosis:

A 45-year-old male patient complai- ns of inertness, headache, fever up to 39oC, burning neuralgic pain in the mandible on the right. Objectively: the skin of chin on the right is hyperemic, there is vesicular rash with a vesicle diameter of 1 to 6 mm. Similar vesicles can be found on the hyperemic oral mucosa on the right. They burst easily making erosions which are covered with fibrinous pellicles. Regional lymphadenitis is present. What is the most likely diagnosis?

A 50-year-old patient complains of dryness and burning sensation in the mouth, pain during eating, taste perversion. The symptoms occurred a week ago after taking the course of antibiotics for acute bronchitis. Objectively: oral mucosa is covered with patches of white caseous deposit. The deposit can be easily removed when scraped, revealing hyperemic areas of mucous membrane. Which is the most likely diagnosis?

A 56-year-old female patient complains of burning neuralgic pain in the left half of the mandible, which appeared two days ago. There is also rash in form of tense vesicles on the reddened skin and mucosa of the lower lip on the left, accompanied by malaise, headache, body temperature elevation up to 38oC, left-sided lymphadenitis. What is the most likely diagnosis?

A 21-year-old dental patient has been found to have a circular ulcer on the tongue dorsum. The ulcer is up to 1 cm in diameter, has demarcated raised edges and a deep inflammatory infiltrate at the base. The ulcer floor is flat, clean, of crimson color. The regional lymph nodes are of cartilaginous density, mobile, painless. The ulcer appeared a week ago and doesn’t cause any discomfort. What kind of ulcer should be suspected in the first place?

An 11-year-old boy complains of a short-term pain from the cold in a left mandibular tooth. Objectively: the medial surface of the 36 tooth exhibits a carious cavity within parapulpar dentin. The cavity is filled with light, softened dentin and does not communicate with the cavity of the tooth. Probing the of the 36 tooth floor causes pain response, the tooth is not sensitive to percussion, the response to the cold stimulus does not stay long after its removal. What is the most likely diagnosis?

A 36-year-old patient with the face and neck burns resulting from gasoline ignition has been delivered to the emergency room. Palpebral fissures are closed due to the eyelid edema. The face skin is erythematous, there are large tense blisters on the skin of the chin, cheeks, nose, forehead, superior surface of neck. Specify the degree of burns:

A 9-year-old child has a symmetrical maxillary diastema with crown divergence. The relationship of the lateral teeth is neutral. In the anterior segment the depth of incisal overbite is 1/3 of the crown height. What appliance can be used for simultaneous treatment of diastema and crown divergence?

A 52-year-old female patient complains of a persistent burning sensation at the tip and lateral surface of the tongue. The burning occurs in the morning and gets worse in the evening, the sensation disappears when eating. The patient reports having had these symptoms for about a year and associates the disease with wearing removable dentures. The patient has a history of anacid gastritis, a surgery for uterine fibroids, second degree hypertension, poor sleep, anxiety. Objectively: the tongue is slightly swollen, the tongue dorsum is covered with a thin white plaque, filiform papillae are atrophied. The rest of the mucosa exhibits no visible pathological changes. Pharyngeal reflex is suppressed. What is the most likely diagnosis?

A 28-year-old female patient consulted a dentist about pain caused by thermal and chemical stimuli in the mandibular and maxillary teeth. Objectively: in the cervical zone of mandibular and maxillary incisors and canines there are irregularly shaped defects of hard dental tissues within the amelodentinal junction in form of tissue softening. In this clinical case a dentist will find it difficult to differentiate between the following diseases:

A 52-year-old male patient working as a driver consulted a dentist about pain, difficult mouth opening. The patient had been diagnosed with ulcerative leukoplakia. After a 10-day course of therapy sluggish granulation began. On the periphery of the ulcer the keratini-zation processes became more active. Which of the following tests must be conducted in the first place?

4 hours after application of arsenic paste to the 36 tooth pulp, a 27-year-old patient complained of pain in the treated tooth. Objectively: on the distal surface of the 36 tooth the temporary filling is present. Percussion causes no pain response. Gingival papilla in the region of the 36, 37 teeth is hyperemic and edematous, its apex is necrotized. What is the optimal tactics of this patient management?

A 43-year-old female patient has been diagnosed with generalized periodontitis. What examination is most informative for determining the severity grade of the disease?

A 7,5-year-old boy fell down on his face and damaged his front maxillary teeth. Objectively: the crowns of the 11 and 12 teeth are destroyed by 1/4. The tooth cavity is closed. Probing causes pain along the break-off line, percussion of the 11 and 12 teeth causes no pain response. Mucosa around the 11 and 12 teeth is slightly hyperemic. Radiograph of the 11 and 12 teeth shows the intactness of the dental tissues and alveolar process. What tactics of a dentist would be optimal in the first hours after the injury?

A 9-year-old child complains of pain in the left mandibular molar that occurs during eating. The masticatory surface of the 75 tooth exhibits a carious cavitiy filled with softened dentin and localized within parapulpar dentin. The cavity communicates with the tooth cavity. Probing at the site of communication causes acute pain and moderate bleeding. Percussion of the tooth causes no pain response. Radiography revaled no periodontal alterations in the 75 tooth. Select the method of treatment:

Preventive examination a 6-year-old child revealed that the child had deciduous dentition, direct incisor contact in the frontal segment, no gaps between teeth; contact of homonymous canines and molars; abrasion of masticatory tubercles of the molars. The child’s condition corresponds with the followi- ng period:

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 anterior maxillary teeth. Make a provisional diagnosis:

A 29-year-old male patient complai- ns of gingival hemorrhages during tooth brushing, and bad breath. Objectively: gingival papillae and marginal gingiva are hyperemic with a cyanotic tint, bleed on probing. Periodontal pockets are 3-3,5 mm deep, with serous exudate expressed from them. The sub- and supragingival calculus is present. Orthopantomograph shows osteoporosis of the alveolar process, resorption of interalveolar septa to 1/3. What is the most likely diagnosis?

A 40-year-old patient complains of fever up to 38oC, and a roundish infiltration on the upper lip. Objectively: the upper lip on the left exhibits a round infiltrate, the overlying skin is deep crimson. The infiltrate adheres to the surrounding tissues and has a necrotic core in the center. The upper lip is hyperemic, edematous. What di- agnosis can be made?

A 20-year-old female patient consulted a dentist about a short-term pain in the 22 tooth caused by cold stimuli or contact with food. The pain had been observed for several months. After the examination, the patient was diagnosed with acute deep caries of the 22 tooth. What material should be used as a base for the cavity filling?

A 48-year-old female patient underwent parotidectomy for a benign tumor of the parotid gland. Postoperatively, the patient was observed to have mouth downturning, midline deviation towards the unaffected side, speech disturbance. Which branch of the facial nerve was damaged during the surgical intervention?

On examination a 42-year-old patient was diagnosed with acute suppurative periostitis of the mandible beginning from the 35 tooth. What is the most rational method of anesthesia for the 35 tooth extraction and dissection of the subperiosteal abscess?

Examination of a 31-year-old patient revealed perforation of the pulp chamber floor of the 36 tooth with a minor radiolucency of the interradicular septum. Which of the following methods of surgical treatment should be applied in order to save the 36 tooth and use it as an abutment tooth for a bridge denture?

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 40-year-old patient complains of malaise, weakness, headache, fever up to 38,5oC. Objectively: there is a symmetric red lesion in form of butterfly-wing rash on the face around the nose and cheeks. The lesion is clearly demarcated, tender on palpation, does not disappear when pressed upon. The skin is raised and glossy. Submandibular and parotid superficial lymph nodes are enlarged, tender to palpation. What is the most likely diagnosis?

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?

Examination of a 9-year-old child revealed chalky spots in the cervical zone of the 12, 11, 21, 22 teeth. The spots appeared two weeks ago. Lustreless surface of the spots is stainable with methylene blue. The affected teeth are not sensitive to the cold stimulus. Specify the physician’s tactics in respect of the affected teeth:

An 18-year-old male has a furuncle in the region of the 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?

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 17-year-old male patient complains about having a fistula on the anterior surface of his neck. The fistula has been present since birth. Periodically there appears a small amount of mucoid discharge. The patient has been diagnosed with a middle cervical fistula. What tactics of treatment should be preferred for this patient?

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 classification:

A 24-year-old male who had been injured in a fight was delivered to the maxillofacial department. The patient was diagnosed with a fracture of the left zygomatic bone with a displacement; a fracture of the anterior wall of the maxillary sinus. What kind of surgery is indicated for this patient?

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?

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 mandible on the left is thickened, the surrounding soft tissues are swollen, mouth opening is difficult. Mucogingival junction at the 48, 47, 46 teeth is edematous, mucous membrane is hyperemic. There are purulent discharges from the 47 tooth socket, the 48, 46, 45 teeth are sensitive to percussion. There is also paresthesia in the lower lip region. What is the most likely diagnosis?

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:

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

A 10-year-old child was undergoing complex dental care. During the procedures, a deep carious cavity communicating with the tooth cavity was revealed in the 36 tooth. The tooth was not sensitive either to probing, percussion, or temperature stimuli. The patient was diagnosed with chronic periodontitis. During the treatment, the accidental perforation of the tooth cavity floor occurred. What measures should be taken in this case?

Dental examination of a 19-year-old girl revealed white spots in the cervical zone of the 11, 21 teeth. According to the patient, the spots appeared about two months ago and had slowly enlarged since that time. Which of the following diseases is characterized by such history?

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 a dense infiltrate in the right parotid region. The poorly circumscribed, tender to palpation lump infiltrates the surrounding tissues. On 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 24-year-old patient was undergoing the extraction of the 25 tooth roots for the exacerbation of chronic periodontitis. During the operation the roots were dislocated into the maxillary sinus. What would be the surgeon’s optimal tactics?

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?

Parents of a 10-year-old boy consulted an orthodontist about misali- gnment of the 21 tooth. Objectively: the 21 tooth is in a vestibular position, there is enough space for it in the dental arch. What additional methods of examination should be applied to specify the treatment plan?

A 38-year-old chemical plant worker, a smoker, with a history of chronic enterocolitis, was undergoing preventive medical examination. In the posterior third, along the midline of the tongue dorsum there is an area with no papillae. The area is 2x1cm large, slightly dense on palpation. What is the most likely diagnosis?

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 64-year-old patient had a myocardial infarction a month ago. He presents to a dental office for the treatment of pulpitis of the 12 tooth. Select the optimal method of anesthesia:

A 45-year-old female patient complains of fever, appearance of rash in the mouth cavity and on the lips. She has a 4-year history of this disease which occurs mainly in autumn and spring. Objectively: oral mucosa is hyperemic, there are painful erosions covered with gray plaque. There are also hemorrhagic crusts on the lips. The skin of the forearm flexor surfaces exhibits maculo-papular rash. What is the most likely diagnosis?

A 27-year-old female patient consulted a dentist about pain in the 35 tooth. The pain is caused by cold stimuli and quickly abates after the stimulus is removed. Objectively: in the cervical region of the 35 tooth there is a dental tissue defect within the enamel. The defect has white crumbling edges. Electroexcitability of the pulp was 5 mkA. What is the most likely diagnosis?

A patient has an indication for the 12 tooth extraction for the exacerbation of chronic periodontitis. It was decided to apply infraorbital and incisive anesthesia in this patient. What nerve structures are blocked by this anesthesia?

A 52-year-old patient consulted a dentist about a tumor-like neoplasm in the region of the lower lip vermilion border. Examination of the vermilion border on the left revealed a roundish tumor about 0,5 cm in diameter on a thin pedicle. The tumor had a smooth surface, was mobile, soft, and painless. What is the most likely diagnosis?

A 21-year-old male patient undergoes treatment for chronic catarrhal gingivitis. There is a significant amount of soft dental plaque, high speed of its production. The patient knows how to practice good oral hygiene. Recommend a mouthrinse for this patient:

A male patient should have the root of the 17 tooth removed prior to prosthetic procedures. The crown of the tooth is decayed beneath the gum line. What tool should be used?

A patient consulted a dentist about pain in the 47 tooth. X-ray examination revealed fragments of endodontic instruments in the canals of the medial and distal root. In the periapical zone there are well-defined areas of bone destruction. Select the most appropriate method of treatment:

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 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?

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

A 28-year-old patient complains of pain in the 37 tooth when eating hot food. Objectively: the 37 tooth has changed in color, there is a carious cavity filled with softened dentin, the tooth cavity is open, probing of the root pulp causes pain response, percussion causes no pain. What is the most likely di- agnosis?

A 16-year-old female patient complains of gingival pain and hemorrhage, a gingival deformity. Over the last 2 years the gums periodically bleed during tooth brushing. Objectively: in the region of the front mandibular teeth the gingival papillae are enlarged and reach 1/2 of the tooth crown height. The gums are swollen and tender, bleed when touched. Radiographic alterations were not revealed. What is the most likely diagnosis?

A patient presented to a dental clinic for complex dental care. Objectively: the 37 tooth exhibits a deep carious cavity communicating with the tooth cavity. There is no response to stimuli. Radiography reveals widening and deformation of the periodontal ligament space in the apical region. What is the most likely diagnosis?

A 49-year-old patient consulted a dental surgeon about complex dental care. 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 crown is decayed by over 2/3, the mucosa exhibits no pathological changes. What tool is required for the tooth extraction?

A 16-year-old female patient complains of a deformation and restricted mouth opening since birth. Objectively: the face is symmetrical, disproportionate, there is a bird-like face symptom. The mouth opens up to 1 cm. The patient has an occlusal abnormality, namely deep incisal overbite. What pathology is found in this patient?

A 13-year-old boy complains of pain in the region of the extracted 46 tooth, irradiating to the ear and temple; halitosis. The tooth was extracted 3 days ago. Objectively: submandibular lymph nodes are enlarged, tender on palpation. Mucosa around the extracted tooth is hyperemic, edematous. The socket of the 46 tooth is filled with a gray clot. What is the most likely diagnosis?

A 47-year-old male patient consulted a dental surgeon about a slowly growing tumor on his lower lip which appeared six months ago. Objectively: on the lower lip there is a single horny conical projection above the surface of the skin up to 1,5 cm wide. The neoplasm adheres to the skin. Palpation reveals dense keratinous masses. What is the provisional diagnosis?

A 45-year-old patient has a dense semicircle neoplasm 1 cm in diameter on his lower lip. The tumor projects above the vermilion border by 0,5 cm. The surface is grayish- pink with a small number of closely arranged whitish scales. The tumor is not tender on palpation. What is the most likely diagnosis?

Parents of an 8-year-old child complain about the presence of chalky spots on the child’s front maxillary teeth which have recenly erupted. Objectively: the vestibular surfaces of the 11 and 12 teeth exhibit white spots in the cervical zone. Enamel at these sites is not transparent. What additional test can be used?

An 11-year-old boy complains of having a painful lesion in the mouth cavity, which makes it difficult to eat. Such symptoms were first noticed two years ago. Examination of the mouth floor reveals a tender oval erosion sized up to 0,8 cm, and covered with grayish-white plaque. The erosion has a hyperemic rim. Make a provisional diagnosis:

A 3-year-old girl has been diagnosed with acute odontogenic mandibular periostitis beginning from the 74 tooth. It is required to perform periostomy and extract the 74 tooth. The child is excited. Select the optimal type of anesthesia for the surgery:

A 7-year-old child has been diagnosed with chronic periodontitis of the 64 and 65 teeth. The child has a history of hemophilia A. What is the medical tactics of choice?

A 3-year-old child has a hard and soft palate defect. It is planned to fabricate a 'floating'Cese obturator (Chasovskaya modification). What impression material should be used?

Examination of a child hospitalized for scarlet fever revealed alterations of the tongue mucosa which turned bright red, glossy, and dry. At the same time the fungiform papillae were enlarged. The described appearance of tongue is referred to as:

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 30-year-old female patient complains of limited mouth opening. She has a history of an injury 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 confirms bone intactness. What is the most likely diagnosis?

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?

In a 7-year-old child the right mandibular molars overlap the maxillary molars, there are no other occlusion abnormalities. Size and shape of the lower dental arch are normal. Specify the appliance for the treatment of this abnormality:

Parents of a 5-year-old child consulted an orthodontist about mispronunciation of sounds by the child. Objectively: the child’s face is unremarkable. The patient has deciduous dentition. There are 1-1,5 mm gaps in the frontal segment from 53 to 63. Occlusion in the sagittal and transversal planes is normal. What type of Frankel’s functional regulator is used to treat the above-described malocclusion?

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 dental arch, it is planned to fabricate a cast clasp denture. What kind of mechanical fixator should be used?

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?

Residents of a remote settlement need prosthetic care. What health care facility should provide it?

A 24-year-old hemophiliac has been diagnosed with exacerbation of chronic pulpitis of the 11 tooth. Select the best method of tooth treatment in this case:

A 25-year-old female patient consulted a dentist about acute pain in the maxilla on the left. The pain occurs while eating. Objectively: on the distal approximate surface of the 26 tooth there is a cavity filled with light softened dentin. Probing causes a slight pain along the dentin-enamel junction, percussion causes no pain response. Cold water causes quickly abating pain. What is the most likely diagnosis?

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?

During mandibular anesthetization with 4% solution of Ultracain-forte, a 13-year-old girl complained of sudden weakness, laboured respiration, nausea, fear. Objectively: the patient has pale skin covered with cold sweat, hyperemic spots on the face and neck. Respiration is frequent, the pulse is weak, blood pressure is 60/40 mm Hg, hands are cold. What is the most likely diagnosis?

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 28-year-old patient complains of tender gums, gingival hemorrhages and pain, especially while eating, for a week. Objectively: the gums are swollen and markedly hyperemic, especially in the region of the 43,42,41, 31, 32, 33 teeth, soft plaque and tartar are present, gingival sulci are up to 2 mm deep. What is the most likely diagnosis?

A 24-year-old male patient complains of acute gingival pain, the inability to eat, bad breath, fever up to 38oC, general weakness. Objectively: the patient is pale, lymph nodes are enlarged. Gingival papillae are swollen and hyperemic, there are individual ulcers covered by necrotic coating. What additional study is required in the first place in order to clarify the 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 causes pain reaction. Electroexcitability of the pulp is 35 iA. What is the most likely diagnosis?

A 25-year-old patient undergoes treatment at the clinic of maxillofacial surgery for the mandibular ameloblastoma localized in the angle. The patient has been scheduled for a partial resection of the mandible with a single-stage bone autoplasty. It is most expedient to take a bone graft from:

A 36-year-old female patient complains of headache, inability to close the jaws. She has a history of an injury followed by loss of consciousness, nausea. Objectively: the midface tissues are edematous, there is bilateral eyelid hemorrage, open bite. Palpation of the midface bones causes acute pain. In the back of nose there is marked symptom of step deformity, nasal hemorrhage is present. Palpation of the oral cavity reveals mobility of the maxilla. Make a diagnosis:

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:

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 bucco-alveolar folds were attached at the base of the alveolar process, the palate was deep, the torus palatinus was expressed insignificantly. These clinical presentations correspond with the following class of atrophy according to Schroeder classification:

A 2-year-old boy has a brown spot with a rough surface covered with coarse hair on his left cheek. According to parents, the neoplasm has been present since birth and exhibits a slight enlargement as the child grows. What is the most likely diagnosis?

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 12-year-old girl complains of white spots on the vestibular surfaces of teeth and mouth soreness that occurs during eating sour foods. It is known from the history that the spots appeared about 3 months ago. Objectively: the vestibular surfaces of the front maxillary teeth exhibit chalky spots that are stainable with 2% methylene blue. What is the most likely diagnosis?

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

A 46-year-old patient complains of a periodic swelling in the right submandibular region when eating, dry mouth. Bimanual palpation of the middle portion of the hyoid region on the right revealed a moderately painful dense lump. From the excretory duct of the submandibular gland some muco-purulent exudate is expressed. The patient should be referred to the following roentgenologic examination:

An 8-year-old boy complains of a defect in the 11 tooth crown. Objectively: 1/3 of the 11 tooth crown is broken off, the pulp chamber is closed. Radiograph shows incomplete root formation. Select the optimal way of prosthetics for the 11 tooth:

A 9-year-old boy requires complex dental care. Objective examination revealed chalky spots with lustrous surface on the vestibular surfaces of the 22, 21, 11, 12 teeth, as well as on the tubercles of the 26, 26, 46 teeth. The affected teeth are not sensitive to thermal and chemical stimuli. The child has a previous history of rickets. He lives in a locality where the fluoride concentration in drinking water is 0,5 mg/l. What is the most likely diagnosis?

A 6-year-old child with contused forehead laceration had been taken to the emergency room at a children’s hospital. The child was examined by the maxillofacial surgeon who performed primary surgical debridement and closed the wound with immediate primary sutures. The child was recommended to undergo further treatment on an outpatient basis at a district polyclinic. Specify the first-priority measure in this case:

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

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 55-year-old male patient diagnosed with chronic median caries of the 33 tooth presented to a dental clinic. It is known from the history that the patient has a cardiac pacemaker What would be the optimal material for a permanent filling?

A 14-year-old patient complains of moderate non-irradiating pain in the region of the 37 tooth. Objectively: the 37 tooth exhibits a deep carious cavity communicating with the pulp chamber. Probing and thermal stimulation cause no pain response, vertical percussion is positive. Radiograph shows no pathological alterations. What is the most likely diagnosis?

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?

Radiography of the 46 tooth in a 7-year-old child revealed parallel root walls with a gradual decrease of their thickness resulting in pointed ends. There is a root canal narrowing in the region that is adjacent to the tooth cavity, and a widening at the nascent apical aperture. Periodontal ligament space has a uniform width over the entire root length. In the periapical region it merges with the growth zone. Specify the stage of the root development:

A 5-year-old child complains of spontaneous pain in a maxillary tooth on the right. The pain gets worse at night and during eating cold food. Objectively: the 65 tooth has a deep carious cavity communicating with the tooth cavity. Probing causes pain response, the tooth is not sensitive to percussion. Cold water causes long-lasting pain. Make a provisional diagnosis:

A 4-year-old child complains of acute spontaneous pain in a mandibular tooth on the right. The pain is aggravated by cold stimuli. Objectively: the 84 tooth exhibits a deep carious cavity that does not communicate with the tooth cavity. Probing causes pain response all over the cavity floor, percussion causes pain. The mucosa in the region of the 84 tooth is hyperemic, edematous. Regional lymph nodes are enlarged. What is the most likely diagnosis?

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 classification:

A 43-year-old patient consulted a dentist about numbness of the left half of his tongue, which developed 10 days ago after the atypical extraction of the 38 tooth. What nerve was damaged during the surgery?

Soon after anesthetization a 55-year-old patient reported severe weakness, retrosternal pain that irradiated to his left arm and scapular region, palpitations. Objectively: the patient is conscious, adynamic, pale, the forehead is covered with cold sweat. AP- 90/60 mm Hg, cardiac sounds are muffled, the pulse is thready and arrhythmic. What condition developed in the patient?

During tooth extraction a 55-year-old female patient reported dull retrosternal pain, feeling of chest compression. The dental surgeon who was performing the tooth extraction made a diagnosis of angina. What drugs should be given the patient for the relief of this condition?

A 1-month-old child has been brought to a maxillofacial surgeon for examination. Objectively: there is a fissure running transversely from the right corner of mouth through the full thickness of cheek up to the anterior edge of the masseter muscle. What is the patient’s diagnosis?

A 38-year-old female complains of experiencing pain in her lower lip for half a year, difficult eating and talking. The patient sought medical help at place of residence, but the administered treatment was ineffective. Examination of the lower lip revealed a deep fissure in the centre which affected the vermilion border and partly the mucous membrane of lips. The fissure was covered with a brown crust, after its removal the fissure started bleeding. The fissure edges are hyperkeratinized, infiltrated. Select the optimal treatment tactics:

A 48-year-old female patient complains of hard tissue defects found on the maxillary incisors. The defects appeared about a year ago and have been enlarging since that time. Objectively: on the convex portion of the vestibular surface of the maxillary incisors there are oval varisized enamel defects. The defect surface is smooth, lustrous, solid. In order to prevent progression of this process, the patient should be advised to limit consumption of:

During local anesthetization with 2 ml of 10% lidocaine a 9-year-old girl suddenly screamed, lost consciousness and developed generalized convulsions. The skin is pale and cyanotic. The pulse is not palpable because of convulsions. What is the provisional diagnosis?

A 56-year-old patient was undergoing treatment for pulpitis of the 47 tooth. For the purpose of the pulp devitalization arsenic paste was used. The patient failed to keep an appointment with the dentist for further treatment. As a result, toxic arsenic periodontitis developed. Which of the physiotherapy methods should be applied to address the complication?

Following an uncomplicated extraction of the 37 tooth, a 60-year-old patient has profuse phatnorrhagia. The patient has a 6-year history of essential hypertension. AP- 180/110 mm Hg. What kind of emergency care should be rendered?

A child is 11 years old. Examination of the oral cavity revealed that the front maxillary teeth completely overlap the mandibular ones. Lateral teeth in the sagittal and transversal planes have a normal contact. The child has been diagnosed with a deep overbite. This abnormality is typically accompanied by the dysfunction of:

A 25-year-old male patient presented to the department of maxillofacial surgery with complaints of pain during eating, which arose three days ago after an injury. Objectively: the face is asymmetric due to the swelling of the buccal and infraorbital regions on the left. Mouth opening is slightly restricted because of pain. Maxillary alveolar process and left maxillary teeth are mobile. There is a hemorrhage along the left mucogingi-val junction in the region of the said teeth; the site is tender to palpation. What diagnosis can be assumed?