Крок 2 · Стоматологія 2015 · 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 55-year-old female patient complains of pain during eating food, erosions covering oral mucosa. The disease onset was more than one month ago. Objectively: the mucosa of the gums, soft palate and dental arches is unchanged, but has large bright-red erosions. The mucosa is easily damaged and exfoliates when rubbed. The pain is slight. Impression smears contain Tzanck cells. What is the most probable diagnosis?

A 17-year-old female patient complains of gingival growth in the area of the upper and lower front teeth. When examined, the gingival papilla appear to be hyperemic, swollen, cover the teeth crowns up to 1/2, bleed when touched. Pathology of the following system is important in etiology of this disease:

A 48-year-old male patient complains of itching gums. Objectively: the gums are firm; cold water causes short-time pain in the teeth. X-ray imaging shows osteosclerosis of the alveolar septum: close-meshed bone structure, the alveolar septum height and intactness of the cortical plates is retained.What is the most probable diagnosis?

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

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?

In the process of root extraction of the 38th tooth with Lecluse root elevator a dentist has pushed the root through into the perimandibular soft tissues. The root is situated under the alveolar arch mucosa and can be clearly palpated. What approach should the doctor choose in the given case?

An 8-year-old girl complains of bleeding gums. The child suffers from pancreatic diabetes. Objectively: gingival papillas in the area of the upper and lower jaw teeth are hyperemic, swollen, cover 1/3 of the crown. What tests are necessary to determine severity of the illness?

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 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 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 58-year-old patient has made an appointment to make a denture. Objectively: the 22nd tooth is stable and intact. The alveolar crest is atrophied; palate is flat. Removable denture is to be made.What approach regarding the 22nd tooth should be chosen by a dentist?

A 35-year-old patient has made an appointment with a doctor to have oral cavity sanation. Objectively: the vestibular surface of the 22nd tooth has a hard tissue defect localised in the mantle dentin; the dentin is hard, darkcoloured, the floor of the cavity is coarse. Cold stimulus and probing are painless. What is the most probable diagnosis?

A 12-year-old boy complains of a cavity in a tooth on the lower left jaw. Objectively: 1/3 of the 36th tooth is destroyed, the carious cavity opens into the dental cavity; there is sensitivity to cold stimulus; probing and percussion are painless. X-ray imaging shows the periodontal fissure of the 36th tooth roots to be widened. What is the provisional diagnosis?

An 11-year-old girl complains of a cosmetic defect: the placement of the 23rd tooth is incorrect. Objectively: the face is symmetrical. The 24th tooth has buccal placement above the occlusion area. The space between the 22nd and 24th is 3 mm. What additional examination is required?

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:

Parents of a 6-year-old child are concerned about their child refusing to eat and having grey-and-yellow coating in the oral cavity. The symptoms are observed over a period of one year. The child complains of sharp dryness and burning pain in the mouth. The anamnesis states chronic bronchitis and systematic treatment using anitibiotics. Objectively: swollen and hyperemic mucous membranes of lips and cheeks are covered in yellow and pale-grey coating. There is coating on the tongue, which is connected with the tissue, cannot be removed and has infiltration basis.What is the most probable diagnosis?

A 24-year-old female patient has Richmond crown being made to restore the crown of the central maxillar incisor. The cap is completed.What step should be the next?

A patient complaining of constant dull pain in the 38th tooth has made an appointment with a dentist. Mouth opening is restricted to 1 sm. The patient is prescribed the extraction of the 38th tooth. What kind of anaesthesia should be administered?

A 67-year-old patient complains of recurrent erosion on the red border of the lower lip. Objectively: the erosion is oval in shape, 0,8*1,3 sm in size, covered in thin scabs that reveal glossy surface with punctate bleeding when removed. There are atrophic areas of the red border detected. Infiltration elements are absent. The submandibular lymph nodes are not enlarged. What diagnosis can be assumed?

A 66-year-old patient complains of dense raised induration at the tip of the nose. Protruding part of the induration often breaks off and then continues to grow. Objectively: there is an affected area with focus up to 1 sm in diameter at the tip of the nose. There is a protrusion growing from the focus; the protrusion is 1-1,2 sm high, brownish-grey in colour, with dense consistency. What diagnosis can be assumed?

A 53-year-old patient complains of pain and clicking in the left temporomandibular joint. Objectively: the face is symmetrical, palpation of the lateral pterygoid muscles is painful on the left side. Mouth opening is restricted. Tomogram shows the bone outline of joint surfaces to be smooth. Which disease of those given below corresponds with this clinical presentation?

A 38-year-old male patient complains of carious cavity. Prior to that there were attacks of toothache with no external cause. Objectively: the distal masticatory surface of the 37th tooth has deep carious cavity filled with softened pigmented dentine. Percussion is painless. Upon the extraction of the degenerated tissue cold water stimulus causes pain lasting about 1 minute. X-ray imaging shows deformation of the periodontal fissure in the area of the root apexes of the 37th tooth. What is the most probable diagnosis?

A 32-year-old male patient complains of dryness and burning pain in the back of the tongue. The symptoms have been lasting for 1 week. The pain increases when spicy food is taken. A day prior to that the patient had suffered from pneumonia and had been taking antibiotics. Objectively: the skin and mucosa of oral cavity are pale. The tongue mucosa is hyperemic and swollen; there is crumbling grey-and-white coating in the folds of the back of the tongue; the lateral surfaces of the tongue are desquamated. The saliva is thick and drags in threads after a spatula. Choose the most effective drug complex for topical treatment.

A 37-year-old woman has made an appointment to extraxt the 25th tooth. What kind of anaesthesia is the most advisable?

A 70-year-old patient with all his lower jaw teeth lost is undergoing the process of fitting individual dental spoon using Herbst tests. When the mouth is opened slowly the spoon rises in the front area. What area requires correction of the spoon placement?

Preventive examination of a 4,5-yearold 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:

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

An 11-year-old child complains of pain and bleeding gums when eating, bad breath, weakness and headache that have been lasting for two days. Objectively: gingival mucosa in the area of front lower teeth is swollen, brightly hyperemic, easily bleeds when touched. Gingival papillas are covered with dirty-grey coating; when coating is removed the underlaying surface is bleeding and painful. The occlusion is deep. There are significant deposits of soft dental plaque. The regional lymph nodes are slightly enlarged and painful when palpated. Body temperature is 37, 6oC. What is the provisional diagnosis?

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 67-year-old patient complains of pain, bleeding, chewing disorder. The anamnesis states domestic injury of the lower jaw.Objectively: the upper jaw dentition is retained. The lower jaw has no teeth, there is central fracture of the lower jaw with bone defect, the place of the fracture is swollen.What construction is the most advisable in this case?

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 degrees. 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 2,5-3,5 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 44-year-old patient complains of painful and restricted mouth closing, inability to take food and sharp pain in the temporomandibular joint. Objectively: the mouth is half-open, the lower jaw is displaced in the distal projection, the lower jaw processes are displaced upwards; trismus of the masticatory muscles and swelling in the temporomandibular joint areas are observed. What is the most probable diagnosis?

A 58-year-old patient has significantly narrowed mouth opening due to trauma and burns of the face. He is prescribed partial removable denture. What denture construction is the most advisable in the given case?

A 40-year-old patient complains of pain in the lower jaw, malocclusion. He sustained a trauma 6 hours ago. Examination revealed a singular lower jaw fracture between the second incisor and the left canine. Fragments displacement is insignificant. All teeth are retained and stable.What is the optimal treatment?

Having recovered from acute respiratory disease, a patient has made an appointment with a dentist. The patient complains of pain in the gums, bad breath, inability to take food, general weakness. Objectively: the gums are hyperemic, swollen, covered in necrotic dirtygrey coating; the gums bleed when the coating is removed. Microbiological study of tissues revealed a great number of cocci, bacilli, fusobacteria, and spirochaete. Specify the drug for etiotropic treatment.

A 4-year-old boy has been diagnosed with acute purulent periostitis of the upper jaw from the 64th tooth. Choose the correct approach in treatment.

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

A 45-year-old patient has central defect of the hard palate. The defect is 2х3 sm in size. Dentition is intact. What construction of obturator is the the most advisable in this case?

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. Which construction provides the intra-oral fixation?

A 32-year-old patient has made an appointment with a dental surgeon to have oral cavity sanation performed prior to denture installation. During examination the doctor stated the following: the crown of the 25th tooth is destroyed. The tooth root is stable, and its percussion is painless. Mucosa of alveolar process is unchanged. X-ray imaging reveals slight widening of periodontal fissure. What provisional diagnosis can be made?

A 10-year-old girl complains of an aesthetic flaw. The anamnesis states, that she had been sucking her right thumb up to the age of 7. Objectively: the face lower third is somewhat reduced. The sagittal fissure between the upper and lower incisors, is 9 mm wide, class 2 according to the Angle classification. Eshler-Bittner test leads to initial temporary improvement of the girl's face, followed by renewed deterioration. What clinical malocclusion is the most probable in this case?

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?

A 35-year-old male patient is prescribed adhesive dental bridge. Objectively: the 15th tooth is lost. The 14th and 16th abutment teeth are stable. The teeth crowns are of medium height. The teeth equator is pronounced. Occlusion is orthognathic. What area of the abutment teeth MUST NOT be covered with denture framework?

When a prosthodontist was preparing the patient's tooth, the patient had epileptic seizure that was subsequently terminated. What mistake had been made by the doctor?

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 55 mA. What is the most likely diagnosis?

A 34-year-old-patient complains of hard tissues defect of the 21st and 22nd teeth. He is referred for porcelain-fused-to-metal crowns installation for his 21st and 22nd teeth without removal of tooth pulp. What kind of anaesthesia administration should be used in tooth preparation?

An 8-year-old child needs his 74th tooth extracted due to exacerbation of chronic periodontitis. What kind of anaesthesia should be used?

A 25-year-old patient complains of pain caused by eating sweet, hot and cold food; pain ceases, when stimulation stops. Objectively: the adjoining surface of the 36th tooth has a deep carious cavity localised in the circumpulpar dentin. The dentin is softened. Probing of the carious cavity floor is painful. What is the most probable diagnosis?

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 removable denture is being made for a patient. At the stage of designinig the denture accessory material isocol is used. What group does it belong to?

A 46-year-old patient, after his recovery from flu, has suddenly started suffering from pain in the 36th tooth, the crown of which had been destroyed. The soft tissues surrounding the lower jaw are swollen. There are high fever up to 39 degrees and chill observed. Objectively: there is prominent swelling of the left lower jaw alveolar mucosa (both oral and vestibular surfaces). The 34th, 35th and 37th intact teeth are mobile. Percussion is painful. The gingival pockets produce purulent exudate. Vincents symptom is observed. What diagnosis can be assumed?

A doctor treating an AIDS-positive patient has accidentally pierced his own skin of the palm with a root needle. What should be the first course of actions?

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 53-year-old female patient complains of feeling of tightness and coarseness in the mucosa, the red border and the skin of the face. Objectively: the skin of the face has butterflyshaped damage, the red border is infiltrated and tightly covered in hyperkeratinized scales. When an attempt is made to remove them, they bleed and are painful.What disease is this clinical presentation characteristic of?

A 7-year-old boy complains of increased body temperature, up to 38 degrees, headache, sore throat. Objectively: there are erosions on the slightly hyperemic mucosa of the soft palate, anterior palatal bars, tonsils. The submandibular lymph nodes are slightly enlarged, painless. Name the causative agent of this disease.

A 12-year-old girl has complaint of carious cavity in a tooth. Objectively: there is class 1 carious cavity according to the Blacks classification in the 36th tooth; it is localised in the parapulpar dentin; the mouth of the cavity is wide. The dentin is dense and pigmented. It is sensitive to cold stimulus, percussion is painless. What is the most probable diagnosis?

A 35-year-old female patient has complaints of cosmetic defects of the front upper teeth crowns. The defects have been increasing for the last 10 years. The patient suffers from unpleasant sensations when brushing her teeth, and when chemical stimuli are applied. Objective examination revealed defects localised in the enamel of the front upper teeth vestibular surface. The defects are oval, saucershaped, and have clear margins. Probing and cold stimuli sensitivity test resulted in positive reaction. Make the diagnosis.

A prosthodontist uses a mouth mirror for examination and manipulation during regular appointments. How are mouth mirrors sterilized?

A 56-year-old male patient complains of pain in the left parotid-masticatory area and progressing facial asymmetry first noticed one month ago. The diagnosis is the cancer of parotid gland - T2N2. What method of treatment is optimal in the given case?

A 20-year-old male patient complains of sharp pain in the mouth, increase of body temeperature up to 38, 5oC, headache and aching joints, general weakness. The disease onset was 3 days ago due to overexposure to cold. Objectively: the lips red border has hemorrhagic scabs, oral mucosa has large erosions and ulcers merging with each other and covered with greyish-white coating on the background of diffuse hyperemia. Conjunctivitis is observed. The skin of the forearms has erythematous spots sized 1,5 cm in diameter, with blisters in their center. What is the most probable diagnosis?

A 36-year-old female patient has complaint of the 23rd tooth filling constantly falling out. Objectively: the 23rd tooth has carious cavity of the V class according to the Black's classification of caries lesions. A dentist has made a decision to restore anatomical shape of the tooth with dental inlay. What is the specific feature of the cavity preparation for dental inlay in this case?

A 68-year-old patient, having suffered from stroke, has time to time bouts of retching, which lead to unilateral diclocation of the temporormandibular joint. Setting the joint was possible only with anaesthesia. Objectively: absent are the following teeth - from the 21st to the 28th, 15th, 16th, 17th, 18th, 36th, 37th, 44th, 46th, 47th. What kind of denture construction will be optimal for the duration of treatment?

Parents of a 12-year-old child are concerned about the child having white spots on the frontal teeth of the upper jaw; the spots appeared half a year ago. Objectively: there are chalky spots detected in the cervical zone of the 11th, 12th, 13th, 21st, 22nd, 23rd teeth vestibular surface. The enamel in those spots is dull; probing revealed it to be pliant and coarse. The anamnesis states short-time pain caused by chemical stimuli. What is the provisional diagnosis?

A 47-year-old patient is undergoing dental treatment of erosive ulcerative form of lichen ruber planus. 1-month-long conservative therapy was inefficiently. What physiotherapeutic method is the most effective as a part of complex therapy?

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 child is 13 years old. The third upper tooth is fully cut, but situated slightly above the occlusion surface. What kind of abnormal placement is it?

A 47-year-old patient complains of ulcer on the back of the tongue. The anamnesis states that the ulcer had been preceded for a long term by protruding infiltrate that was gradually growing until the ulcer appeared. Objectively: the back of the tongue has shallow oblong ulcer surroundedwith bumps with undermined edge.What is the most probable diagnosis?

A 16-year-old patient has made an appointment with a doctor due to the following complaints: enlarged lymph nodes and fistula in the submandibular area; general weakness; low grade fever. Objectively: the submandibular lymph nodes are dense and slightly painful, with clearly detectable margins. Caseous substance is produced from the fistulous tract. What is the most probable diagnosis?

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 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 13-year-old child suffers from odontogenic osteomyelitis starting from the 36th tooth and complicated by abscess of the pterygomandibular space. The 36th tooth is to be extracted; it is necessary to open the pterygomandibular space. These operations require the following type of anaesthesia:

Clinical stage of checking the clasp (bugel) dental prosthesis framework as it should be placed in the oral cavity revealed the denture arch to come off unevenly from the hard palate and alveolar process creating the gap up to 0,8 mm in width. What method can be applied to remove this defect?

A 48-year-old man has an X-ray image of his lower jaw made during sanation of the oral cavity. Destruction of the bone tissue in the gonial angle area is detected, the pathology is not connected with tooth roots. The affected area has clear margins. Puncture consists of brown exudate without cholesterol crystals. What is the provisional diagnosis?

A 20-year-old female patient complains of pain caused by eating sweet or sour food. Objectively: the vestibular surface of the 11th tooth has a chalky spot, coarse when probed. The centre of the spot has defect localised in the enamel. Fedorov-Volodkina index equals 2,5 (Oral Hygiene Index). What is the most probable diagnosis?

A 50-year-old male patient complains of small sore on the sublingual mucosa. Pathomorphologic study of tissue sampling revealed the following: polymorphism of spiny epithelial cells has progressed into atypism; increased mitosis; giant and multinucleate cells; acanthosis; hyperkeratosis and parakeratosis; basal membrane and basal layer are retained. What is the most probable diagnosis?

A 15-year-old adolescent complains of high body temperature up to 39, 5 ? 40, 0oC, vomiting, headache and sore throat, especially when swallowing. Objectively: oral mucosa is swollen, hyperemic. The patient is diagnosed with acute catarrhal gingivitis. The tonsils are hypertrophic and covered with yellow-grey coating that does not spread from lymphoid tissue and is easily removed. Submandibular, cervical, and occipital lymph nodes are significantly enlarged since the very first day of illness and are painful when palpated. The liver and spleen are enlarged. What is the most probable diagnosis?

A patient complains of loss of feeling in the left side of his lower lip and chin, which occurred after the complicated extraction of the 37th tooth. Electric pulp test (EPT) revealed decrease in electroexcitability of the left lower jaw teeth.What is the most probable diagnosis?

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 partial removable denture is being made for a 50-year-old patient. What impression trays are the more advisable?

An obturator is being made using Ilyina- Markosyan technique for a 45-year-old-patient to compensate for the defect of the hard and soft palate. What type of connection between the fixing and obturating parts will be used?

A 10-year-old child has fallen and hit stairs with his teeth. An appointment with a dentist was made only 2 days later. There are complains of cold stimulus causing sharp pain.Objectively: the 11th tooth has transversal defect at two third of the crown, the pulp is significantly exposed. Probing causes sharp pain. Percussion is painful, the tooth is mobile. The gums are slightly hyperemic. What method of treatment should be used in this case?

A 33-year-old patient complains of slowly growing tumor mass in the left submandibular area. Objectively: a tumor with soft elastic consistency can be palpated in the left submandibular area; the tumor changes its configuration when squeezed with fingers and is painless. The skin covering the tumor has no changes in colour, movable. There are no changes detected in the oral cavity. Salivary glands function normaly. Shrinking-inflation symptom is absent. What is the most probable diagnosis?

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 48-year-old patient complains of the lower jaw teeth mobility. Van Thiel dental splint is to be made for prosthodontic treatment. What construction elements are supposed to fix it in place?

A 38-year-old patient has made an appointment with a dentist to extract the 46th tooth in preparation for prosthetics. Objectively: the 46th tooth is destroyed by 2/3. What kind of anaesthesia is the most advisable for the extraction of the 46th tooth?

A 13-year-old boy complains of general weakness, high body temperature up to 39degrees, lack of appetite, constant pain in the body of the lower jaw. Objectively: observed is significant asymmetry of the face caused by soft tissues swelling in the left buccal and submandibular areas. Mouth opening is restricted. Intraoral examination revealed the following: the 34th, 35th, 36th and 37th teeth are mobile; teeth percussion is painful. The crown of the 36th tooth is completely destroyed. The mucosa of those teeth is hyperemic and painful when palpated. Muff-like enlargement of the lower jaw alveolar process is detected.What is the most probable diagnosis?

A 25-year-old woman complains of pain in the 15th tooth, which is caused by thermal stimuli and quickly ceases, when stimulation stops. Objectively: visually detected is a defect with smooth walls that join under an angle, which is located in the cervical zone of the 15th tooth vestibular surface. Thermometry is painful; percussion is painless. What is the most probable diagnosis?

A 40-year-old female patient complains of short-term pain in the 34th tooth caused by thermal stimuli. Objectively: the distal surface of the 34th tooth has a carious cavity localised in the circumpulpar dentin. The walls and floor of the cavity are softened, faintly pigmented; probing of the floor is slightly painful. Cold stimulus causes pain that ceases when stimulation stops.What is the most probable diagnosis?

A 24-year-old patient complains of new growth in the right lateral surface of the neck. The new growth was first noticed 4 months ago, no appointment with doctor was made. Objectively: the face is asymmetrical due to the new growth in the upper third part of the right lateral surface of the neck. Palpation allows to detect the painless rounded new growth sized 3*3,5 cm; its consistency is dence and elastic; the skin abowe the growth has no changes of colour and can be folded. The new growth is not melded with its surrounding tissues and is situated along the front edge of the sternocleidomastoid muscle. Puncture consists of pale yellow viscous fluid. What is the most probable diagnosis?

A female patient is 51-year-old, with immobile teeth. The marginal periodontium in the area of the 14th-11th, 21st-23rd teeth has inflammation symptoms; gingival and periodontal pockets are 4-5 mm deep.Whole piece metal and plastic denture construction is to be made for the patient. What are the specifics of the construction edge placement relative to the marginal periodontium in this case?

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?

During examination of the 11-year-old childs oral cavity the 23rd tooth vestibular position was detected. Correlation of the 16th and 46th is Angle class 1, and 26th and 36th is Angle class 2. The width of the 23rd crown is 8 mm. The dentition lacks 4 mm to place the 23rd properly. Front teeth occlusion is normal. Choose the optimal treatment approach.

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 hyperkeratinized plaque and opaque whitish mucosa. Cytological analysis revealed keratinizing epithelial cells. What is the most likely diagnosis?

A 24-year-old female patient complains of the 15th tooth being lost. The defect is of aesthetic nature. Objectively: the 14th and 16th teeth are intact, stable, clinical crowns are tall with pronounced equators and normal orthognathic overlapping; X-ray image shows no pathologies in the periapical tissues. What kind of denture should be recommended for the patient?

A12-year-old child has a carious cavity on the surface of the 12th tooth. The cavity is localised in the mantle dentin; its floor and walls are covered with pale softened dentin. Probing the enamel-dentin border is painful. Thermal stimuli cause short-term painful reaction. Vertical percussion is painless, horisontal percussion is slightly painful. Gingival papilla between the 12th and 13th teeth is swollen, hyperemic, bleeds when touched. What is the most probable diagnosis?

A 27-year-old female patient has her 26th tooth cavity accidentially breached along the mesial buccal line angle during treatment of acute deep caries of the 26th. Choose the optimal method of treatment.

A 54-year-old patient complaining of tumor-like growth on the red border of the left lower lip has made an appointment with a dentist. Examination revealed the affected area to be sized 1х1,5 cm, and have irregular shape with clear margins. Focus of the affected area does not protrude from the surrounding red border; the affected area is greyish-white in colour and covered in thin closely placed scales.What is the most probable diagnosis?

A 23-year-old male patient complains of gum bleeding when he brushes his teeth or eats tough food. Objectively: the gums of the front lower jaw are hyperemic, swollen and bleed when palpated. The oral and gingival mucosa in other areas are not affected. The occlusion is deep. The teeth are firm, except for the 41st and 31st (class 1 mobility). X-ray imaging shows resorption of the alveolar septum in the area of the 41st, 42nd, 32nd and 31st teeth up to one third of the root length. What is the most probable diagnosis?

A 78-year-old patient complains of difficulties when taking food and deformity of the dentition. The anamnesis states the lower jaw fracture 2,5 month ago. Objectively: there is a deformity of the lower jaw front area, which equals 19 mm (artificial joint). Both fragments of the lower jaw have 3 stable teeth each.What prosthesis construction is the most advisable in this case?

A 3,5-year-old child has symmetrical face, the middle part is predominant in proportions, swallowing is infantile, breathing is nasal. In the oral cavity the dentition corresponds with the age norms, the sagittal fissure is 3 mm, every tooth in the lateral part has its anatagonist, the lower teeth touch the hard palate. Miogymnastics with Dassa orbicularis oris activator is recommended. What function is normalised by this apparatus in the given case?

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:

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

A 57-year-old female patient complains of burning pain, dry mouth, feeling of foreign body on the tongue back and lateral surfaces, which disappears in the process of eating. The first case of such symptoms was noted a year ago after psychic trauma. The patient suffers from pancreatic diabetes and sleep disturbance. Examination revealed the following: the tongue mucosa is without significant changes, moderately moistened. What is the most probable 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 patient with post-resection upper jaw defect that invades the nasal cavity has made an appointment with a prosthodontic clinic. What denture is recommended in the given case?

An 18-year-old patient with complaint of large diastem has made an appointment with prosthodontics specialist. Objectively: there is full lateral displacement of central incisors due to absence of the 12th and 22nd teeth. What instrument is the most advisable for moving the central incisors closer together?

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 patient has sustained blunt object trauma to the face central area. Objectively: the nasal bones are mobile, there is significant swelling of the left temporal region soft tissues, uneven "stair-like"shape of bones is observed in the lower edges of both eyesockets and maxillo-zygomatic sutures, bleeding, open bite. The central part of the face is elongated. What is the most probable diagnosis?

A 44-year-old female patient has complaints of the face swelling at the right lower jaw area and teeth mobility. Objectively: soft tissues are without changes, the regional lymph nodes cannot be palpated. The alveolar process and the body of the lower jaw near the 46th, 47th and 48th teeth are thickened, painless when palpated, have bulges. The teeth in the thickened area are mobile. Puncture consists of brown fluid without cholesterol crystals. What is the provisional diagnosis?

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 39-year-old patient, who works in a printing house, complains of burning pain, metallic taste in the mouth and bad breath. Objectively: the skin is sallow in colour. The oral mucosa has black-and-blue spots. The gums are hyperemic and swollen. The edge of the gums has black-and-blue band. The palate is of yellow shade. Intoxication symptoms are observed. What is the most probable diagnosis?

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?

To perform a differentiated diagnostics of the lower jaw displacement a patient was asked to open his mouth as wide as possible, and then the lateral displacement of the lower jaw and face asymmetry were measured. What clinical test is it?

What measurements are necessary to determine the width of dental arch according to the Pont's method of analysis?

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 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 37-year-old patient complains of bleeding gums, bad breath, loose teeth, difficulties with chewing food. Objectively: gums are bluish-red in colour; periodontal pockets are 6 mm deep and contain serous substance; class II teeth mobility; moderate deposits of subgingival and supragingival dental calculus; Oral Hygiene Index equals 3 points; there is traumatical occlusuion along all the length of the dental arches. What is the provisional diagnosis?

A 6,5-year-old child has closed nonpigmented fissures in the first permanent molar, which have been revealed during preventive examination. Enamel transparency is retained, its probing does not reveal any coarseness. Choose the optimal method of treatment in this case.

A 3-year-old child suffers from extreme gingivitis with slight teeth mobility; teeth are intact. The skin is dry, the hair is brittle, the skin of the palms and soles of the feet is rough and covered in small cracks.What is the provisional diagnosis?

Parents of an 8-year-old child have made and appointment with an orthodontist. There are complaints of their child having traumas of oral mucosa. Objectively: decreased height of the face lower part, everted lower lip, deep labiomental furrow, milk occlusion. The upper incisors fully cover the lower ones; cutting surface of the lower incisors make contact with the anterior third of the palate. Mesiodistal ratio of the canines and the first permanent molars is normal. Grouping of the upper and lower front teeth is dissimilar. Make the diagnosis according to the Kalvelis classification.

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 46-year-old patient complains of mastication disruption caused by the lack of the 34th, 35th and 36th teeth. The antecedent anamnesis is as follows: the teeth were extracted 3 months ago due to complication of cariosity. The patient anamnesis: the history of tonsillitis, rheumatoid arthritis and Botkin's disease. After the appointment with this patient instruments should be sterilized in the following way:

A 49-year-old patient has a tooth removed from the left upper jaw under plexus anaesthesia with articaine-forte (Articaine + Epinephrine). After the operation the tooth socket did not fill with blood clot. How to prevent alveolitis in this case?

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. Furthermanipulations with bayonet forceps failed to extract the tooth roots. What actions are to be taken for the successful root extraction?

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?

Parents of an 8-year-old girl are concerned that she is chewing food too slowly. Objectively: it is a period of transitional dentition. The first permanent molars has neutral relationship; sagittal fissure is 2 mm wide. The upper front teeth cover the lower ones by two thirds. Name the pathology.

When checking construction of the soldered dental bridge with the 35th and 38th abutment teeth the following was detected: pores in the place of soldering together abutment crowns with the intermediate part; masticatory tubercules are sharply defined; there is early contact with tooth-antagonists; the intermediate part makes tight contact with the alveolar process mucosa. How can those flaws be corrected?

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 53-year-old male patient has made a repeat appointment after 3 days upon the extraction of the 36th tooth. Spot X-ray of the 36th tooth made from within the oral cavity revealed the remainingmesial root.What tools should be used to extract this root?

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 42-year-old female patient has made an appointment with a prosthodontic office to make a denture. Objectively: dental formula is as follows: 18 . . . . 13 12 11 21 22 23 . . . . 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 . The patient has deep occlusion; clinical crowns are low; equator is not pronounced. The patient suffers from epileptic seizures. What kind of denture should be prescribed for this patient?

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 15-year-old girl complaining of moderate swelling of the left paroticmasticatory area has made an appointment with a dental surgeon. Palpation revealed the left parotid gland to be bulgy, dense, and painless. Its duct secretes turbid saliva. The duct orifice is dilated, the surrounding mucosa is cyanotic, pastose, with teeth imprints.What disease is it?

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 dentin-enamel junction, percussion is painless. Cold water causes quickly abating pain. What is the most likely diagnosis?

A 40-year-old female patient has made an appointment with a dentist. She complains of pain in her front teeth of the upper and lower jaws, which is caused by thermal, chemical and mechanical stimuli. Temporomandibular joint is also slightly painful. Objectively: the patient has deep occlusion; the enamel of lingual surface of the front upper teeth and vestibular surface of the front lower teeth is rubbed off exposing the glossy pigmented dentin. What is the most probable diagnosis?

Whan conduction anaesthesia had been administerd by a dentist, in 2 seconds a patient developed the following symptoms: loss of consciousness, seizures, dilated pupils, absent pupillary response to light, low arterial pressure, laboured breathing, muffled heart sounds.What is the most probable diagnosis?

A 13-year-old boy needs his 46th tooth extracted due to chronic granulomatous periodontitis. He has pancreatic diabetes as a concomitant disease. Choose the most advisable anaesthetic and its way of administration.

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?

A 10,5-year-old child complains of painful rash on his lips. Objectively: the red border of the lips is swollen, hyperemic, covered in fissures and numerous scabs of dried blood. The skin of the upper lip has small blisters containing serous substance, which merge with each other in some places. Maceration and weeping skin also can be observed, especially in the corners of the mouth. What is the most probable diagnosis?

An 11-year-old child complains of dryness and tightness of the lips, which the child is licking constantly. Objectively: red border of the lips is dry, infiltrated, hyperemic and covered in numerous thin scales. The skin of the lips is undamaged. What is the provisional 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?

Parents of a 5-year-old child has made an appointment with a dentist for preventive examination of their child. Objectively: the DMF index (Decayed, Missing, Filled)=5, the gingival mucosa is pale pink in colour, Fedorov-Volodkina index is 2,5. For oral hygiene the child should use a toothbrush with the following kind of bristle:

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?

An 18-year-old patient complains of chalky spot in the 23rd tooth, which is slightly painful when cold stimulus is applied. Objectively: the vestibular surface near dental cervix of the 23rd tooth has a white spot 2-3 mm in size. Probing is painless and reveals coarseness of the surface. Thermal stimulus causes slightly painful feeling. What is the most probable diagnosis?

A 7-year-old child is diagnosed with complete dislocation of the 11th tooth caused by a trauma that happened 24 hours ago. The tooth was brought along. Objectively: the socket edges are slightly hyperemic, bone walls are intact; the tooth socket is filled with blood clot. What approach is the most advisable for the therapy?

A 56-year-old patient suffering from exacerbation of schizophrenia has been hospitalised in an oral in-patient department with a diagnosis of the lower jaw displaced fracture in the area of the 34th-35th teeth. What method of treatment should be prescribed?

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 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?

A 32-year-old patient is hospitalised in an oral surgery department with perforating wound of the cheek. The size of the wound opening is 1,5х4,0 mm. What kind of restorative surgical operation is the most advisable in this case?

A 60-year-old patient has been undergoing the procedure of checking the complete removable dentures construction and fixing teeth on wax bases. The following flaws have been detected: fissure between the teeth on the frontal area and tubercule contact in the lateral area.What mistake had been made?

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 anatomical shape. The patient has orthognathic bite. What prosthesic design should be preferred?

A 30-year-old patient complains of pain and swelling in the area of the left parotid salivary gland, which occurred 7 days after he had undergone abdominal cavity surgery. Objectively: body temperature equals 39oC, restricted mouth opening; dry mouth; when the gland is massaged, there is purulent exudate being secreted from its duct. The patient can be diagnosed with the following disease:

A 16-year-old girl complains of cosmetic defect of the front teeth - there are dark spots and hard tissues defects. The spots were detected in the process of teething, the defects developed later. The following diagnosis was made: erosive form of fluorosis of the 16th, 11th, 12th, 22nd, 26th, 31st, 32nd, 36th, 41st, 42nd, 46th teeth. Choose the method of treatment.

An 8-year-old boy has thickening of the lower jaw body in the area of the 83rd, 84th and 85th teeth. In the given area a rounded painless tissue protrusion can be detected; the Dupuytren's symptom is positive. Deciduous teeth are intact. X-ray image of the lower jaw made in lateral projection shows the focus of bone destruction with clear margins in the area of the 83rd, 84th and 85th teeth. The 44th tooth follicle is shifted down in distal direction, the crown is projected on the destruction focus. What is the clinical diagnosis?

In the process of the 26th tooth extraction a 34-year-old patient suddenly developed the following symptoms: tinnitus, weakness, paleness of skin. Vertigo was diagnosed. What first aid approach is the most advisable?

A 15-year-old adolescent complains of a two-day long sharp pulsing pain in the tooth, which intensifies when biting or touching the tooth with the tongue. Objectively: the 26th tooth contains composite material filling. Vertical and horisontal percussion of the tooth are painful, the tooth is slightly mobile in vestibular-oral projection. Gingival mucosa of the affected area is hyperemic, swollen, sharply painful when palpated. X-ray imaging shows no changes. What is the most probable diagnosis?