A prosthodontist plans to make a porcelain-fused-to-metal crown for the 23 tooth. In order to correct its abnormal position in the dental arch the prosthododntist is going to use a cast post and core. What is the maximum permissible value (in degrees) of the core deviation from the tooth axis?
What impression material is used to obtain impressions for making orthodontic appliances?
A 45-year-old woman consults a dentist 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 the teeth and alveolar process is approximately 6 mm. Specify the most efficient method of treatment of secondary deformation in this patient:
A 35-year-old patient has made an appointment with a doctor to have oral cavity sanation. Objectively: the vestibular surface of the 22 tooth has a hard tissue defect localized in the mantle dentin; the dentin is hard, dark-coloured, the floor of the cavity is coarse. Cold stimulus and probing are painless. What is the most probable diagnosis?
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 42-year-old patient complains of pain in the submaxillary and sublingual areas that aggravates during eating, body temperature rise up to 37,6oC. He has been suffering from this for 2 months. Objectively: infiltration along the right sublingual torus, hyperemia, soft tissue edema, acute pain during palpation. The duct of the right submandubular salivary gland excretes turbid saliva mixed with pus. What is the most likely diagnosis?
A patient consulted a dental surgeon about fever up to 37,6oC, soft tissue swelling, pain in the 47 tooth on the lower jaw on the left, the pain aggravates when the tooth is touched by its antagonist. Objectively: mucogingival fold of the alveolar process is hyperemic and flat on the vestibular side of the decayed 47 tooth. What is the most likely diagnosis?
A 12-year-old boy complains of a cavity in the tooth on the lower left jaw. Objectively: 1/3 of the 36 tooth is destroyed, the carious cavity opens into the dental cavity; reaction to cold stimulus is positive; 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?
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 patient complaining of constant dull pain in the 38 tooth has made an appointment with a dentist. Mouth opening is restricted to 1 cm. The patient is prescribed extraction of the 38 tooth. What kind of anesthesia should be administered?
A 67-year-old patient consulted an orthodontist about missing of the 34, 35, 36, 37, 45, 46 teeth. Orthopantomogram of the remaining teeth shows the alveolar bone resorption in the range of 1/3 of the interdental septa height. What construction should be offered to the patient?
A 22-year-old student complains of gingival hemorrhage during tooth brushing. Objectively: hyperemia and edema of marginal gingiva of the front teeth on both jaws, periodontal pockets are absent. X-ray reveals no pathological changes. What is the most likely 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 46-year-old patient complains of spontaneous pain in the 36 tooth. Its crown is decayed. The patient presented with edema of soft tissues adjacent to the mandible. Body temperature rose up to 39,0°C, the patient has chill. Examination of the oral cavity revealed a pronounced edema of the left mandibular alveolar process on the vestibular and oral side (acute periostitis); the 35, 36, 37 teeth are mobile, subgingival pockets contain purulent exudate; their percussion causes acute pain. Positive Vincent’s symptom is present. What is the presumptive 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 20-year-old patient addressed a dentist for treatment of the destroyed teeth. Examination revealed round painless papulae with hyperemic infiltrated crown 7 mm in diameter on the palatine arches, soft palate, tonsils, tongue. Regional lymph nodes are enlarged, dense, elastic, painless and mobile. What tactics should a doctor choose?
A week ago an 18-year-old girl complained of pain in the 22 tooth which was treated and filled several years ago. Over the past two days the pain increased. Objectively: the 22 tooth is filled, percussion is pai- nful, mucous membrane is hyperaemic and edematic. Spot-film roentgenograph of the 22 tooth shows an ill-defined periapical bone rarefaction 0,4x0,5 cm large. What is the most likely diagnosis?
A 22-year-old patient complains of a painful swelling in the right parotid gland. A week earlier the patient received a cheek abrasion that healed under the purulent crust. Over the past two days the patient had observed progressing pain and fever up to 38,6°C. Objectively: there is a soft tissue edema in the right parotid region, the skin is slightly strained but has not changed in colour. There is a dense painful infiltration 2,5x3,5 cm large, the skin over it exhibits limited mobility. The mouth can be fully opened, the mucous membrane around the orifice of the salivary duct is unchanged, the saliva is transparent. What is the most likely diagnosis?
A 3-year-old girl complains of pain and swelling in the region of the decayed 51, 52 teeth, body temperature rise up to 37,5-37,9°C. Objectively: the face is asymmetric because of a swelling in the upper lip region and right infraorbital region. The crown of the 51 tooth is completely decayed. Mucous membrane in the region of the 52,51,1 teeth is edematic, mucogingival fold is smoothed, palpation provokes pain, mobility of I-II grade of the 51, 52 teeth is also present. What is the most likely diagnosis?
A 50-year-old patient has median lower jaw fracture with formation of a false joint. The 38, 32, 31, 41, 42, 48 teeth are missing. The remaining teeth are intact, stable. There is no displacement of lower jaw fragments. X-ray picture shows a bone tissue defect up to 1 cm large. What prosthesis is indicated?
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 25 tooth is destroyed. The tooth root is stable, and its percussion is painless. Mucosa of the alveolar process is unchanged. X-ray reveals slight widening of the periodontal fissure. What provisional diagnosis can be made?
A 45-year-old man complains about liquid outpouring from his nose, inability to blow his nose, inflated cheeks. Objectively: there is a perforating defect (1x1,5 cm) of alveolar process at a level of the extracted 26th tooth in the lateral part of his upper jaw. Air inhalation through the nose with held nostrils is accompanied by generation of bubbles in the area of perforation. What denture construction should be recommended?
A 25-year-old patient presents with fluorosis of vestibular surfaces of the upper incisors. Which of the following constructions will provide the maximum aesthetic result?
A 6-year-old child complains of pain in the 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 48-year-old patient complains of subfebrile temperature and a growing ulcer on the gingival mucosa around the molars; teeth mobility in the affected area, cough. Objectively: gingival mucosa in the region of the lower left molars has two superficial extremely painful ulcers with undermined edges. The ulcers floor is yellowish, granular, covered with yellowish and isolated pink granulations. The ulcers are surrounded by the tubercles. Dental cervices are exposed, there is a pathological tooth mobility. Regional lymph nodes are enlarged and make dense matted together groups. What is the most likely diagnosis?
A 78-year-old patient is completely edentulous. He has been wearing dentures for 19 years. The patient complains of poor fixation of the upper denture. Objectively: the lower third of the face is shortened, the alveolar processes of both jaws are markedly atrophied, the palate is flat. Mucous membrane in the denture-supporting area is atrophied. How often should the dentures be remodelled or restored?
A 56-year-old man complains of pain in the left parotidomasticatory region, progressing face asymmetry that was noticed a month ago. Objectively: left-sided paresis of mimic muscles. To the fore of earflap there is an ill-defined infiltration, the skin above it is tense and cyanotic; left lymph nodes are enlarged. Opening of mouth is limited down to 2,5 cm. The left parotid duct doesn’t excrete saliva. What is the most likely diagnosis?
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 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 dentin 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:
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, causes acute pain. The pain persists for a long time. Electric pulp test result is 55 microamperes. What is the most likely diagnosis?
An 11-year-old boy complains of a carious cavity in the 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 the provisional diagnosis:
During preventive examination an 11-year-old girl presents with slight hyperemy, cyanosis, swollen gums, gingival papilla are loose, not adjacent to teeth cervices. Fedorov-Volodkina dental hygiene index is 4 points. Schiller’s test is positive. Make the diagnosis:
A 22-year-old medical student complains of the changed colour of his central upper incisor on the right. Two years ago the tooth became gray. Objectively: the 2 tooth is filled, changed in colour, stable, percussion is painless. The patient has closed bite. What is the absolute contraindication to making porcelain crowns for this patient?
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 ci-rcumpulpar dentin. The dentin is softened. Probing of the carious cavity floor is painful. What is the most probable diagnosis?
A 27-year-old patient complains of the long-term pain in the 22 tooth caused by cold and hot food, as well as of spontaneous pain lasting for 30 minutes and occurring 34 times per day, aggravating at night. Pain arose 3 days ago after preparation of the tooth for the acrylic crown. Objectively: the 22 tooth is intact, the thermal test causes acute long-lasting pain, percussion is painless. What is the optimal treatment tactics?
An 11-year-old boy complains of a shortterm pain from the cold in the left mandi- bular 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 remain long after its removal. What is the most likely diagnosis?
A 46-year-old patient after the recovery from a case of influenza has suddenly started suffering from pain in the 36 tooth, the crown of which had been destroyed. The soft tissues surrounding the lower jaw are swollen. There are high fever up to 39°C and chills. Objectively: there is prominent swelling of the left lower jaw alveolar mucosa (both oral and vestibular surfaces). The 34, 35 and 37 intact teeth are mobile. Percussion is painful. The gingival pockets produce purulent exudate. Vincent’s symptom is observed. What diagnosis can be suspected?
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 57-year-old patient complains of tooth mobility, inability to eat. Objectively: the lower 35, 36, 37, 38, 44, 45, 46 and 48 teeth are missing; the 31, 32, 33, 34, 41, 42, 43, 47 teeth exhibit II grade mobility, their clinical crowns are low, tooth equator is not pronounced. What is the optimal denture construction in this case?
A 7-year-old boy complains of increased body temperature up to 38oC, headache, sore throat. Objectively: there are erosions on the slightly hyperemic mucosa of the soft palate, anterior pillars of the fauces, tonsils. The submandibular lymph nodes are slightly enlarged, painless. Name the causative agent of this disease:
A patient complains of dull ache in the 16 tooth, which occurs during eating cold food. Anamnesis: the tooth had been filled due to deep caries, the filling was lost 1 year ago. Objectively: a deep carious cavity that does not penetrate the tooth cavity is present; percussion is painless, probing is painful along the whole floor of the carious cavity. Electric pulp test - 50 microamperes. Thermodiagnosis is painful. Make the diagnosis:
A patient complains of acute short-term toothache caused by thermal and chemical irritants. The tooth has not been treated before, the pain arose about a month ago. Objectively: on the occlusal surface of the 36 tooth there is a deep carious cavity within circumpulpal dentin with overhanging chalky enamel. Probing of the cavity floor causes slight pain. There is also shortterm pain from the cold stimulus. The result of electric pulp test is 8 microamperes. What is the most likely diagnosis?
A 65-year-old patient needs complete removable dentures for both jaws. At the stage of ’’testing the denture construction” the doctor checks the pronunciation of sounds ”S” and ”Z” Which method of normalization of speech functions should be applied in this case?
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 intactness of the dental tissues and alveolar process. What tactics of a dentist would be optimal in the first hours after the injury?
A 56-year-old man 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 acute pain during eating, bad breath, general weakness. Objectively: interdental papillae and marginal gingiva are covered with dirty gray film, any touch is painful. The body temperature is of 37, 5oC. Blood count: RbC- 4,8 • 1012/l, Hb- 150 g/l, colour index - 0,9, WBC- 10, 5 • 109/l, JG- 2%, BASO-1%, EOS- 5%, segmented neut. - 8%, stabs - 47%, LYM- 35%, PLT- 250 • 109/l. ESR- 20 mm/hour. What is the most likely diagnosis?
A 68-year-old patient, having suffered from stroke, suffers from periodical bouts of retching, which lead to unilateral dislocation of the temporormandibular joint. Setting the joint was possible only with anesthesia. Objectively the following teeth are absent: from the 21 to the 28,15,16,17,18, 36, 37, 44, 46,47 What kind of denture construction will be optimal for the duration of treatment?
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:
A 40-year-old patient complains of fever up to 38°C, 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 diagnosis can be made?
A 25-year-old patient received a trauma to the chin region. On the basis of X-ray he was diagnosed with bilateral mental fracture of mandible. Specify the direction of displacement of the minor fragment:
A 38-year-old patient with chronic generalized periodontitis has been referred to orthopedic treatment. Objectively: dentitions are without gaps, the 12, 11, 21, 22 teeth are pulpless and exhibit I grade mobility. The other teeth are stable. What is the most aesthetic splint for the anterior teeth?
A 42-year-old patient has been hospitalized with Le Fort II fracture of maxilla. Select an appliance for the treatment of this patient:
A 25-year-old patient complains of brief pain attacks during eating sweet, hot or cold food. Objectively: on the contact surface of the 36 tooth there is a carious cavity within parapulpar dentin. The dentin is softened. Probing of the cavity is painful. Vertical and horizontal percussion is painless. Electric pulp test - 9 microamperes. What diagnosis is most likely?
A 39-year-old patient suffers from microstomia. What impression tray should be used?
In a prostodontic clinic a partial laminar denture for the upper jaw is being made for a 53-yearold patient. Objectively: dental formula is 14, 13, 12, 11, 21, 22, 23, 24, 27 The teeth are firm, clinical crowns are tall with pronounced equator. X-ray shows no periapical changes in the periodontium of the abutment teeth. What clammer fixation is optimal for this patient?
An intradental splint for the 33, 32, 31, 41, 42, 43 teeth is being made for a 50-year-old patient. During its installation in the oral cavity hemorrhage occurred from the 41 tooth root canal. What caused the hemorrhage?
A 34-year-old male patient complains of acute spasmodic pain in the region of his upper jaw on the left that is aggravating when affected by cold stimuli. Toothache irradiates to the ear and temple. He had acute toothache of the 37 tooth one year ago, but he did not consult a dentist. Pain recurred three days ago. Objectively: the 37 tooth has a carious cavity communicating with the dental cavity. Probing of the opened carious cavity is extremely painful. X-ray picture shows widening of periodontal fissure at the root apex of the 37 tooth. What is the most likely diagnosis?
A 79-year-old female patient consulted a prosthodontist about denture replacement. The patient has a history of a stroke. Objectively: acute irregular atrophy of the alveolar processes of both jaws is present; mucous membrane of the oral cavity is dry and nonmobile. The previous dentures cannot be fixed. What is the most appropriate prosthetic construction?
A 56-year-old patient complains of frequent breakage of the basis of the partial laminar denture of the upper jaw. Objectively: only the 23 tooth is retained on the upper jaw. Cracks in the deture basis appear in the area of the 23 tooth. What should be done to reinforce the denture basis?
A patronage nurse visited a newborn baby. Examination revealed the shortened lower part of the face, the backward-sloping chin, missing teeth, the retroposed lower jaw. What is the number of dental follicles in each jaw of a newborn baby?
A 47-year-old patient complains of a burning sensation and pain in the mouth. Objectively: on the mucous membrane of cheeks along the line of teeth contact and in the corners of mouth there are multiple polygonal bright red erosions 1,0-1,5 cm in diameter located on the hyperkerati-nized plaque and opaque whitish mucosa. Cytological analysis revealed keratinizing epithelial cells. 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 27-year-old female patient has her 26 tooth cavity accidentially breached along the mesial buccal line angle during treatment of acute deep caries of the 26. Choose the optimal method of treatment:
A 55-year-old patient consulted a dentist about a roundish tumour-like formation of about 1 cm in diameter located within the vermilion border of his lower lip. Objectively: the tumor-like formation protrudes about 5 mm above the vermilion border, it is dense and grayish-red in color. The surface of the formation is covered with thin scales that can hardly be removed. What is the most likely diagnosis?
A 45-year-old man complains of dryness and painfulness of the lower lip. On examination: the lower lip is swollen, dry, covered in small scales and fissures. In the Klein area (wet-dry line) there are dilated openings of salivatory glands observed as red dots producing clear substance. The lower lip mucosa is lumpy. What is the most likely diagnosis?
A 50-year-old patient has a defect of the lower dental arch. It is planned to make an implantsupported bridge for its restoration. X-ray picture shows that the height of the bone mass from projection of mandibular canal up to the top of alveolar crest is 2 cm. What type of implant should be applied?
A 40-year-old man, a chemical industry worker, notes the development of soreness of the mouth, pain response to thermal and chemical stimuli. On examination: on the vestibular surface and cutting edge of the front teeth there are enamel defects with uneven scalloped margins, chalk-like in color. Make the diagnosis:
A 57-year-old female patient complains of burning pain, dry mouth, sensation of a 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 psychological 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?
An 18-year-old patient complaining of large diastem has made an appointment with a prosthodontics specialist. Objectively: there is full lateral displacement of the central incisors due to absence of the 12 and 22 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 60-year-old patient addressed a dentist with complaints of a conic protrusion appearing on the skin of his chin on the left. Height of the protrusion is 1,5 cm, width - 0,8 cm. Palpation is painless; there are clear margins; the protrusion is gray-brown in color; on palpation of the soft tissues near the protrusion base a thickening can be detected. What preliminary diagnosis can be made?
A 30-year-old patient needs to have his 26 tooth extracted because of exacerbation of chronic periodontitis. Objectively: the crown of the 26 tooth is decayed by 1/3. What forceps can be used for this tooth extraction?
A patient complains of restricted 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 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 3-year-old child suffers from extreme gingivitis with slight teeth mobility; the 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?
A 49-year-old patient has a tooth removed from the left upper jaw under plexus anesthesia with articaine-forte (Arti-caine + Epinephrine). After the operation the tooth socket did not fill with blood clot. How to prevent alveolitis in this case?
A 24-year-old woman consulted a dentist about pain in the 26 tooth. After a physical examination the patient was diagnosed with exacerbation of chronic periodontitis of the 26 tooth. During the tooth extraction the coronal part of the tooth was accidentally broken. Further manipulations with bayonet forceps failed to extract the tooth roots. What actions are to be taken for the successful root extraction?
Preventive examination of a 5-year-old child revealed a habit of lower lip biting. What malocclusion may develop if the child keeps this habit?
A 7-year-old child has protruding chin, the lower lip overlaps the upper one. There are diastemas and tremas between the lower incisors, the lower incisors overlap the upper incisors by 2/3 of the crown height. First permanent molars demonstrate Angle’s class III relation. Sagittal gap is 3 mm. The correct doctor’s tactics will be to:
A 5-year-old child was found to have missing upper molars. Lower incisors are in contact with the mucous membrane of palate. Specify the doctor’s tactics:
A 14-year-old girl complains of indistinct pronunciation that showed up 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 did not reveal cleft palate. Uvula does not move during pronunciation of sounds, its palpation does not cause gag reflex. What is the cause of indistinct pronunciation of sounds?
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 15-year-old girl complaining of moderate swelling of the left parotic-masticatory area is being examined by a dental surgeon. Palpation revealed the left parotid gland to be bulgy, dense, and painless. Turbid saliva is being secreted from the duct. The duct orifice is dilated, the surrounding mucosa is cyanotic, pastose, with teeth imprints. What disease is it?
A 39-year-old patient complains of experiencing pain in the region of the 21 tooth for 2 days. It is known from the history that the indicated tooth had been treated before for caries. Objectively: the 21 tooth is covered with metal-ceramic crown, mucous membrane in apex projection is edematic and hyperemic. Percussion of the tooth is extremely painful. X-ray picture shows improperly filled root canal. It is planned to remove the 21 tooth crown. What kind of anesthesia should be administered?
At a prosthetics dentistry clinic a 35-year-old patient received a porcelain-fused-to-metal crown for the 21 tooth. What is the minimum warranty period for porcelain-fused-to-metal crowns under the current legislation?
During the preparation of a tooth a patient had an epileptic seizure. The seizure was arrested. What mistake did the orthopaedist make?
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, BP is low (90/60 mm Hg), the hands are cold. What is the most likely diagnosis?
A 56-year-old patient addressed a dental surgeon for extraction of the 27 tooth. What anesthesia should be applied?
A 28-year-old patient has been suffering from gum discomfort, gingival hemorrhages and pain, especially during eating, for a week. Objectively: the gums are swollen and markedly hyperemic, especially in the area of 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 23 tooth, which is slightly painful when cold stimulus is applied. Objectively: the vestibular surface near dental cervix of the 23 tooth has a white spot 2-3 mm in size. Probing is painless and reveals coarseness of the surface. Thermal stimulus causes slight pain. What is the most probable diagnosis?
A 12-year-old child presents with body temperature of 38°C, chills, nausea, vomiting, delirium, weakness. In the middle third of the face there is butterfly-shaped rash. Regional lymph nodes are enlarged, slightly painful. Blood count: WBC- 12 • 109/l, lymphocytes - 8,0 • 109/l, ESR- 26 mm/hour. Make the 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:
A 62-year-old patient diagnosed with TMJ arthritis presented to a clinic. The patient underwent radiography. Specify the radiological presentations of TMJ arthritis:
A 45-year-old patient has a bilateral mental mandibular fracture with a typical displacement of fragments. What actions should be taken to eliminate asphyxia?
A 53-year-old patient complains of absent 12, 11, 21 and 22 teeth. On examination it is decided to make a porcelain-fused-to-metal bridge with the 13 and 23 as abutment teeth. During preparation ledges are created in abutment teeth. Ledge width can vary within the following range:
A 16-year-old girl complains of cosmetic defect of the front teeth - there are dark spots' and hard tissue 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 16,11,12, 22, 26, 31, 32, 36, 41, 42, 46 teeth. Choose the method of treatment :
Parents of a 6-year-old boy complain of his high body temperature, decrease of his general well-being, painful swelling of the right cheek. Objectively: the skin is pale, the face is asymmetric due to swelling of the soft tissues of the right cheek. The maxillary alveolar process is bilaterally thickened in the area of the 55, 54 and 53 teeth, painful on palpation, these teeth are partially destroyed by caries, mobile (II-III degree), their dentogingival pockets produce pus. What is the most likely 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 is the most advisable first aid approach?
A 53-year-old patient complains of an ulcer on the lateral surface of the tongue. The ulcer appeared 6 months ago in the result of a trauma caused by sharp tip of the 37 tooth metal crown. A dentist replaced the crown with the one of better quality and prescribed keratoplastic drugs. Despite these measures the ulcer continues to grow. Lately there has been pain during talking, chewing, swallowing; sometimes the pain irradiates to the pharynx. Objectively: on the lateral surface of the tongue there is a painful ulcer with uneven raised dense margins and lumpy floor covered with grayish necrotic coating. What diagnosis is most likely?
An 8-year-old child has been clinically diagnosed with exacerbation of chronic periodontitis of the 84 tooth. The crown is decayed by 1/2. What is the dentist’s optimal tactics?
A laminar denture for the lower jaw is being made for a 54-year-old patient. Base plate wax is used during laboratory stage for wax templates. What group of accessory materials does such wax belong to?
A 28-year-old patient has been scheduled for the surgical resection of the root apex of the 12 tooth for chronic granulomatous periodontitis. What kind of anesthesia should be administered before the surgery?
A 11-year-old child complains of pain during eating food, especially hot, in the lower right lateral tooth. On the masticatory surface of the 46 tooth there is a large carious cavity filled with softened light-brown dentin. The cavity is located within parapulpar dentin. In the projection of medial buccal pulp horn the carious cavity communicates with the pulp chamber. Deep probing is painful. Electric pulp test - 60 microamperes. Make the diagnosis:
A 34-year-old male patient complains of a cosmetic defect, a cavity on the vestibular surface in the cervical part of the 21 tooth. Objectively: the carious cavity is within the enamel, the floor and the walls are pigmented, probing and percussion and painless. There is no pain reaction to stimuli. What is the most likely diagnosis?
A 12-year-old boy complains of dull ache in the upper right tooth. The pain aggravates during biting. Objectively: in the 16 tooth there is a deep carious cavity penetrating into the tooth cavity, cold test and probing are painless, mucosa is swollen, hyperemic. X-ray reveals areas of bone tissue destruction with blurred margins near root apices. What diagnosis is most likely?
To fill a medium depth carious cavity in the 37 tooth (Black class II) of a 35-year-old male patient a doctor has chosen a technique of layer-by-layer tooth restoration. What composite material should be applied for covering the carious cavity walls and floor to create the initial super adaptive layer?
A patient suffered a facial trauma. On examination and X-ray the patient was diagnosed with fracture of the maxillar alveolar process. What treatment would be most advisable in this case?
A 20-year-old male patient complains of spontaneous pain in the 24 tooth, which arose suddenly and persists for about 15 minutes at a time. Objectively: the distal surface of the 24 tooth exhibits a deep carious cavity with overhanging walls. The cavity is filled with lightcolored softened dentin and communicates with the tooth cavity. The cold stimulus causes acute, slowly abating pain. Percussion causes no pain response. Select the best method of treatment:
A 9-year-old girl has been suffering from gingival hemorrhages, cracks in the mouth angles for a month. She has a history of frequent nosebleeds, rapid fatigability. Objectively: the skin of the face and oral mucosa are pale. In the mouth angles there are cracks reaching the red border. Gingiva in the region of the 11 and 12 teeth is hyperemic and edematous, bleeds when touched. DMF/dmf = 10. Back of the tongue is bright red, smooth, glossy. Submandibular lymph nodes are slightly enlarged, mobile, painless. What specialist should be consulted in the first place?
A 25-year-old patient complains of pain when biting on the 15 tooth. The pain arose two days ago, has a constant aching nature and increased significantly over the last day. Objectively: the crown of the 15 tooth is gray, the medial contact surface exhibits a deep carious cavity communicating with the tooth cavity. Percussion causes acute pain, the gingival mucosa in the projection of the 25 tooth root apex is hyperemic. The regional lymph node is tender. Radiograph shows an ill-defined zone of periapical bone destruction. What is the most likely diagnosis?
A 27-year-old patient has been referred by a prosthodontist for endodontic treatment of the 45 tooth. Objectively: the 45 tooth crown is destroyed; the lateral surface of the tongue and the buccal mucosa have patches of grayish macerated epithelium slightly rising above the mucosa surface at the points of direct contact with the 45 tooth. The uvula and palatine arches are stagnant-red in color; hard palate has papulae surrounded with red margin and covered in grayish epithelium. The submandibular, cervical, supraclavicular, and subclavicular lymph nodes are enlarged and painless. What is the provisional diagnosis?
A 20-year-old male patient with insulin-dependent diabetes mellitus has been given anesthesia with Ultracain DS-forte for surgical oral sanitation. What complications may develop in this case?
As a result of an injury the 51and 61 teeth of a 3-year-old child have completely cut into the alveolar bone. Medical history record: the teeth were partially decayed, changed in colour. Select an appropriate treatment tactics:
A 5-year-old girl complains of pain in the mouth angles occurring during mouth opening. She has a history of acute bronchitis and prolonged antibiotic therapy. Objectively: the red border is dry, the mouth angles are downturned. In the mouth angles there are cracks covered with white plaque and surrounded by slightly hyperemic elevation, painful on palpation and mouth opening. Oral mucosa exhibits no pathological changes, decay-missing-filled index - 2, hygiene index - 2,0. What is the most likely diagnosis?
A 43-year-old patient complains of mobility and significant neck exposure of the lower front teeth. Objectively: the gums in the region of the 44, 43, 42, 41, 31, 32, 33, 34 teeth are pale and cyanotic, non-bleeding. The 42,41,31,32 teeth exhibit the I-II grade mobility. The overcrowding of the 42, 41, 31, 32 teeth is present. The necks of the 42, 41, 31, 32 teeth are exposed by 1/2 of the root length, the necks of the 43, 33 teeth are exposed by 1/4. What kind of dental prosthesis should be applied in this case?
A patient complains of fever up to 38°C, headache, pain in the joints anf muscles, vesicles in the oral cavity, mainly in the frontal part. Eating is sharply painful. For the last several years the disease recurred during wet anf windy weather. The patient often suffers from cases of URTI. Objectively: on the buccal, lingual, labial mucosa there are confluent erosions against the erythematous background, covered in gray-white coating. There are bloody scabs on the red border and in the angles of the mouth. Make the diagnosis:
A 14-year-old adolescent complains of bleeding and pain during eating occurring in the 36 tooth. Anamnesis states intense pain in the past. Objectively: the crown is severely damaged; carious cavity is large, penetrates into the tooth cavity, and is partially filled with overgrown pulp. The tissues demonstrate low sensitivity to touch, bleed upon touching. There are significant soft dental deposits on the 35 and 34 teeth. Make the diagnosis:
The 47, 46, 45, 35, 36, 37, 38 teeth of a 57-year-old patient are missing. It is planned to make a clasp denture. The 48 tooth inclines to the lingual side and forwards. On the lingual side of the 48 tooth the border line is diagonal, on the buccal side it runs on a level with gingival edge. What type of Ney’s clasp should be applied?
A 12-year-old boy due to trauma of the 44 and 45 teeth area suffers from the following: pathologic displacement of the mandibular alveolar process; rupture of the alveolar process mucosa. What additional examination is necessary to specify the diagnosis?
A 5-year-old child has sustained a trauma. Objectively: the crowns of the 51 and 61 teeth are shorter then the adjacent crowns. The mucosa surrounding the 51 and 61 teeth is hyperemic and swollen. X-ray imaging shows the periodontal fissure to be absent in the apical area of the 51 and 61 roots, the 51 and 61 roots apexes are submerged in the spongy bone of the body of the lower jaw. Choose the optimal treatment:
During teeth preparation a patient developed an epileptic attack. What measures should a prostodontist take?
A 34-year-old dental patient has an indication for the extraction of the 38 tooth for chronic fibrous periodontitis. The dental surgeon used torusal (Weisbrem’s) anesthesia. What nerves are blocked by this anesthesia?
A 26 year-old woman suffers from bleeding gums. For 3 years she has been suffering from pancreatic diabetes. Objectively: gingival papillas of all the teeth are hyperemic, swollen and overlap with the teeth crowns by 1/3 of the crowns height. What method of examination must be conducted for differentiated diagnostics?
An orthodontist has been addressed by parents of a 5-year-old child. The child has the 54 tooth extracted, all the other deciduous teeth are present. The doctor made a thin-wall crown for the 55 tooth with interdental wedge to the 53 tooth. What is the purpose of such treatment?
A 30-year-old patient, a lecturer, complains of periodical dislocations of the lower jaw. Objectively: direct occlusion, continuous dentition is retained. During mouth opening there is a clicking sound in the temporomandibular joint. What apparatus can prevent recurrent dislocation?
A 37-year-old patient complains of severe pain in the gums, difficult chewing, smell of rot from the mouth, bleeding gums, along with general fatigue, headaches, body temperature up to 37,9°C. Objectively: large amout of soft dental deposit, shape of the gingival margin is abnormal, the gingival margin is covered with gray coating, regional lymph nodes are painful on palpation. What is the most likely diagnosis?
Parents of a 5-year-old boy addressed a dental surgeon with complaints of hemorrhage occurring from the boy’s mouth. According to the mother the boy had accidentally bit his tongue. Objectively: the tongue apex is damaged, the wound is 5 mm deep and is bleeding profusely. What aid should be provided?
A 49-year-old patient was hospitalised to an oral surgery department with a gunshot wound of the left side of the face. There is a 3,5 cm long defect of the body of the mandible on the left. After the initial surgical d-bridement and stabilization of the patient’s general state it is planned to perform plastic correction of the defect. What treatment method is optimal in the given case?
Before performing a surgery a dental surgeon treats his hands according to SpasokukotskyKochergin method. What antiseptic is basic in this kind of treatment and how is it applied?
A 37-year-old patient addressed a dental surgeon with complaints of deteriorating welbeing, high fever up to 38,1oC, headache, painful swelling on the chin. Objectively: there is a dense painful infiltration 3x4 cm in size on the skin of the chin. The skin over the infiltration is bluish in color. There are four necrosis areas in the focal center around the hair follicles. The submental lymph nodes are enlarged and painful on palpation. Make the diagnosis:
A 43-year-old woman complains of periodical facial assymetry and bursting stabbing pain in the submandibular area on the right, which increases after eating spicy and sour food. Eventually these clinical presentations disappear. The patient notes periodical exacerbations. Objectively: the face is symmetrical, mouth opening is unrestricted, mucosa of the oral cavity floor is without pathologies. In the area of the sublingual fold a thickening of soft tissues can be palpated. Excretory duct of the submandibular gland produces no saliva. What preliminary diagnosis can be made?
Parents complain of painfulness and mobility of the tooth of their 4-year-old child, which developed after the impact with a wooden object. Objectively: the face is asymmetrical due to swollen tissues of the upper lip. The 51 tooth is intact, with vestibular displacement and the II degree mobility, gums around the 51 tooth are hyperemic. What preliminary diagnosis can be made?
During preventive examination of a 19-year-old man it was revealed that there are carious lesions in the fissures of the 37 and 47 teeth, sealant is fully retained in the 16 and 26 but absent in the closed intact fissures of the 36. The 46 was extracted due to complicated caries. Determine the degree of caries in this patient:
A dentist performs endodontic treatment of the 31 tooth of a 62-year-old patient. The root canal is narrow, extremely calcificated. Choose the optimal tool to pass through the root canal in this case:
A crown inlay for the patient’s 46 tooth is being prepared. At the first clinical stage the cavity preparation is completed with design of an incline. What material can be used for the inlay?
A 54-year-old patient complains of frequent crunching sound in the right temporomandibular joint, which developed one month ago. In the morning the crunching is more frequent and decreases towards the evening. Objectively: the face is symmetrical, the skin above the joint is without changes, the mouth opens at 2,9 mm. What diagnosis is most likely in this case?
On examination of a 27-year-old patient the tip of the dental probe caught on the fissures of the 36, 37, 38 teeth. Margins of the enamel defect are dark, the surface is coarse. Teeth transillumination with photopolymer lamp revealed the defect to be limited to the enamel. What diagnosis is most likely?
A 21-year-old woman addressed a doctor with complaints of bleeding gums and foul smell from her mouth. Objectively: the gums are congestively hyperemic, with cyanotic color. X-ray revealed resorption of interalveolar septa up to 1/3 of their height. What is the most likely diagnosis?
A 68-year-old patient addressed a surgical department of a dental clinic for extraction of the 45 tooth. During procedure the patient developed burning retrosternal pain attack irradiating to the left shoulder, scapula, hand. The skin is pale, BP is 140/100 mm Hg, heart rate is rapid. Skin hyperplasia can be observed in the Zakharin-Head’s zones. What emergency condition did the patient develop?
During administration of Ultracain solution for infiltration anesthesia the condition of a 22year-old patient sharply deteriorated. The patient became inert, silent, developed cough attacks, expiratory dyspnea, wheezing. Viscous slimy sputum is expectorated. What urgent condition did the patient develop?
A 2,5-year-old boy has been delivered to an oral surgery. The patient has the upper lip cleft into three fragments, the palate is whole. Specify the period when cheiloplasty should be performed:
A 7-year-old boy has hyperemic gums; bleeding can be detected. The teeth are mobile, with roots exposed and covered with a layer of coating. Periodontal pockets demonstrate granulation. The child is registered with a pediatrician for diabetes insipidus. The child’s mother states that her son’s condition has deteriorated lately. The child suffers from periodontal syndrome characteristic of:
A 40-year-old patient addressed a prosthodontist with complaints of absent crown of the 24 tooth due to trauma. If the crown is broken off at the gum level, the tooth should be restored with:
During extraction of the 36 tooth the tooth crown was fractured. What tool should be applied to extract tooth roots?
A patient after the surgery for phlegmon of the pterygomandibular space was prescribed compresses with a membrane perforating drug. Which of the given below is a membrane perforating drug?
A 64-year-old patient complains of spots' on the mucosa of the cheeks, mouth angles, palate. Objectively: on the oral cavity mucosa there are white growths that cannot be removed with spatula. The mucosa around the spots' is pale pink in color. The patient has been smoking for 40 years. What is the most likely diagnosis?
An 8-year-old girl complains of burning pain in her tongue during eating spicy and sour food. Objectively: there are red irregular-shaped spots' on the tongue apex and dorsum. Filiform papillae are absent in the affected areas. The girl states that the spots' periodically grow and migrate. Make the diagnosis:
A 70-year-old patient addressed a hospital with complaints of poorly stabilized complete dentures of the upper and lower jaws. What method of artificial teeth arrangement is preferable in making of a new denture?
A 2,5-year-old child has fever up to 38, 5oC, low appetite, rash inside the oral cavity. The disease onset was 3 days ago. Objectively: the skin of the perioral area is covered in scarce vesicles with clear content. Within the oral cavity on the buccal and lingual mucosa there are sharply painful erosions, 2-3 mm in size, with white coating and hyperemic crown. The gums are swollen, hyperemic. The submandibular lymph nodes are enlarged, painful on palpation. Make the diagnosis:
A 9-year-old girl complains of peeling lips and sensation of dryness, strain and burning in them. Objectively: on the red border from angle to angle of the mouth and from Klein area ( wet-dry line) to the red border middle there are gray scales. The scales can be removed without erosions. Make the preliminary diagnosis:
A patient addressed a dental surgeon with complaints of increased body temperature up to 37,6oC, swelling of the soft tissues, pain in the 65 tooth, which aggravates upon touching it with its antagonist tooth. On examination there are hyperemy and smoothing out of the mucogi-ngival fold of the alveolar process in the area of the destroyed 65 tooth. What diagnosis is most likely?
A 17-year-old patient has been suffering for 2 years from periodical painful swelling and fistula appearing on the skin of gonial angle area. After cleaning the fistula of its purulent content pain and swelling disappear leaving a small concave scar. Objectively: there is a small scar on the skin in the gonial angle area. Palpation of the oral cavity floor reveals a dense band in the buccal soft tissues, which connects fistula with projection of the 47 tooth roots. Crown of the 47 is destroyed. What diagnosis is most likely?
A 30-year-old woman addressed a dental surgeon with complaints of uncomfortable sensation of pressure in her upper right tooth, which aggravates due to hot stimulus, and foul smell from the mouth. Objectively: there is a deep carious cavity in the 17 tooth, which penetrates into the tooth cavity. Deep probing causes severe pain, percussion of the 17 tooth is painful. X-ray: there is slight widening of the periodontal fissure near the root apex. Electric pulp test - 70 microamperes. What final diagnosis can be made?
A 20-year-old patient has made an appointment with a dentist. On external examination the patient is pale, complains of long-term fever, insomnia, weight loss of 13 kg within 5 months. The patient is homeless. The therapist’s consultation states: all groups of the lymph nodes are enlarged, hepatolienal syndrome. Blood test: leukocytes - 2,2 • 109/l. Make the diagnosis:
A 45-year-old patient complains of itching gums, pain in the area of the 43, 42, 41, 31, 32, 33 teeth caused by chemical and thermal stimuli. Objectively: the gums are pale, no bleeding, the roots of affected teeth are exposed by 0,4 mm. The 43 and 33 demonstrate cuneiform defect. The teeth are intact. X-ray: regular resorption of interalveolar septa at 1/4 of their height. Make the diagnosis:
An 18-year-old woman complains of gum growth, pain and bleeding during eating solid food. Objectively: hyperemy and swelling of the gums, gingival margin hypertrophy of the 12,13,14 teeth up to 1/2 of the crown height. Formalin test is painless. What diagnosis is most likely?
A 48-year-old patient has made an appointment for extraction of the 35 tooth due to exacerbation of chronic periodontitis. Specify the most advisable method of peripheral conduction anesthesia in this case:
During application of an impression tray to the upper jaw of a 62-year-old patient the tray falls out when the patient opens his mouth wide. What edge of the tray should be shortened?
During objective examination of the patient’s oral cavity the lower jaw is revealed to be toothless, in the front area there is a mobile band of mucosa, irregular atrophy of the alveolar process. What method of obtaining functional impression would be most advisable in the given case?
A 46-year-old man complains of constant losing of a filling in his lower right tooth. Objectively: in the 16 tooth on the approximal masticatory surface there is a defect of crown hard tissues at 1 /3. The tooth has no discoloration, percussion is painless. What construction should be prescribed?
A 37-year-old patient complains of an aesthetic defect. Objectively: the 13 tooth is destroyed by 2/3. The tooth is pulpless, the root canal is filled. How deep should be the root canal opened for pivot crown in this patient?
A 7-year-old girl hit her forehead one day ago. Several hours after the sustained trauma a swelling developed in the left superciliary area. General condition of the child is not disrupted. Objectively: swelling of forehead tissues spreading towards the left eyelids; the swelling is soft, fluctuation sign is present. Make the preliminary diagnosis:
Mother of a 10-year-old girl complains of a cosmetic defect of the child’s 22 tooth that erupted with damaged enamel. Anamnesis states premature extraction of the 62 tooth due to caries complication. There is a white-yellow spot with clear margins on the vestibular surface of the 22 tooth. Enamel retains glossiness, no surface roughness can be detected on probing. Make the diagnosis:
A 2-year-old child has suffered a teeth trauma. Objectively: the crowns of the 51 and 61 teeth are by 1/3 shorter than the others. Mucosa in the area of the 51 and 61 is hyperemic, swollen. X-ray reveals absence of the periodontal fissure in the root apex areas of the 51 and 61. What treatment tactics would be optimal?
A mother of a newborn complains that the child cannot be breastfed. After objective examination the child was diagnosed with complete submucous cleft palate. What surgical procedure should be prescribed and when is the optimal time for such a surgery?
A 19-year-old girl addressed an oncologist with complaints of slowly growing tumor-like mass on the tip of her tongue. The mass was first noticed 5-6 years ago. The patient requested no medical help. Objectively: there is a pale pink round growth with wide pedicle on the tongue apex; the growth is painless, elastic; there are no changes of mucosa surrounding the pedicle. Submandibular lymph nodes cannot be palpated. What kind of tumor is it?
A 48-year-old patient has addressed a hospital with complaints of defects in the paragingival area and slight sensitivity to thermal stimuli. Objectively: there are hard tissue defects that resemble a wedge with smooth polished walls on precervical vestibular surface of the 23 and 24 teeth. Thermal test is slightly positive. What is the most likely diagnosis?
Parents of a 7-year-old child addressed a hospital with complaints of the child having no permanent teeth in the front area of the mandible. Anamnesis states that the first deciduous teeth erupted at the age of 11 months. Objective clinical examination revealed the following: appearance is without changes; milk occlusion; there are physiological diastemas and tremas; edge-to-edge incisor contact. What preliminary diagnosis can be made according to Kalvelis classification?
Parents of a 4-year-old child have made an appointment with an orthodontist for preventive examination of the child. In the oral cavity: scissor bite is observed in the front area in the place of inscisor contact; distal surfaces of the second temporary molars are situated in one plane. Teeth in the dental arch are placed tightly, without intervals. Determine, what period of occlusion development is described:
A 22-year-old patient addressed an orthodontist with complaints of incorrect teeth placement on the upper jaw. The appearance is without changes. Occlusion is permanent. The first molar relation is of the 1st type according to Angle’s classification. Analysis of the control diagnostic models revealed the disturbance of the Andrews’ second key of optimal occlusion of the 12 and 22 teeth. The patient suffers from :
A 15-year-old girl complains of brief pain attacks in her teeth due to chemical stimuli. Objectively: on the contact surfaces of the 11, 21, 22 teeth there are enamel areas matt white in color, with lost shine, covered in large amount of dental deposit. Enamel is softened and can be easily chipped off with excavator. Probing of lesions is painless. Percussion is painless. No reaction to cold stimuli. Make the diagnosis:
A 5,5-year-old child is undergoing preventive examination. No complaints from the patient. Objectively: in the precervical area of buccal surface of the 75 tooth there is an enamel patch with loss of natural glossiness. The enamel surface is coarse, painless on probing. Tooth percussion is painless. Thermodiagnosis is negative. Damaged enamel stains with 2% water solution of methylene blue. Make the diagnosis:
A 13-year-old girl undergoes preventi- ve examination. No complaints from the patient. Objectively: on the 36 masticatory surface there is a carious cavity within enamel with wide inlet. Enamel of the cavity floor and walls is dense and pigmented. Probing of the carious lesion is painless. No reaction to thermal stimuli. Tooth percussion is painless. The girl belongs to the I group according to her health status. Make the diagnosis:
A 57-year-old patient adressed a prosthodontic clinic to have a denture made for him. After objective examination the patient was prescribed single-unit crowns for the 46, 47, 36, 37 teeth. What maximal angle of a tooth stump can be allowed during preparation?
A 25-year-old woman, a teacher, addressed a prosthodontics clinic with complaints of cosmetic defect, inability to take a bite, disrupted enunciation. The teeth are lost due to trauma. Dental formula: 87654300100345678. 3!3 are firm, intact, percussion is painless. What anesthesia should be administered for this group of teeth in preparation for making a porcelain-fused-tometal bridge?
A 58-year-old patient after examination in a prostodontic clinic has been advised to make a full-arch prosthesis. The treatment plan was developed, the impressions of both jaws were obtained, central occlusion was determined with block method. What stage is next?
A 25-year-old patient addressed a hospital and upon examination was diagnosed with unilateral fracture of the body of the mandible in the area of 43, 44 teeth with persistent vertical displacement of the bone ends. Choose the functional type of prosthodontic apparatus required for the patient’s treatment:
A 32-year-old patient addressed a dentist with complaints of inability to close his mouth. Objectively the mouth is half-open, the chin is protruding forwards and is displaced to the left. Such condition occurred after the mouth was opened wide. What diagnosis is most likely?
A 37-year-old patient has symmetrical face; the mucosa in the area of the 12 tooth root apex projection is pale pink; palpation is painless; the tooth crown is destroyed by 1/3; percussion is painless. X-ray: the root canal of the 12 tooth is filled to the apex; granuloma 4 mm in diameter surrounds the root apex. Choose the method of surgical treatment:
During preventive examination a patient was diagnosed with precancerous hyperkeratosis of the lower lip red border. What treatment should be prescribed?
In the district dispensary center for children with cleft lip and palate a child was diagnosed with congenital incomplete cleft upper lip on the left with malformed cutaneo-cartilaginous portion of the nose. What dispensary group does the child belong to?
Preventive examination of the oral cavity of a 9,5-year-old child revealed bilateral cross bite without displacement of the lower jaw. What biometric method of dentition model investigation should be applied in this case?
For a 30-year-old patient a composite inlay for the 37 tooth is being made. Objectively: there is a carious cavity of medium size (Black’s classification I class) on the masticatory surface of the 37 tooth. What specifics are required for the tooth preparation in this case?
A bugle denture for the lower jaw is planned to be made for a 53-year-old patient. Objectively: the 38, 37, 35, 34, 45, 46, 47 teeth are absent. The retained teeth are firm, with low clinical crowns. What fixation method of bugle denture would be optimal in this case?
A 30-year-old patient complains of spontaneous pain attacks in the lower left tooth, which occurred 2 hours ago during travel by plain. Objectively: there is pathological abrasion of the 36 tooth, tooth percussion is slightly painful. After additional investigation the diagnosis is made: chronic pulpitis. What investigation allows to make such a diagnosis?
A 22-year-old student arrived for an appointment with a dentist in the afternoon after his classes were over. The patient is registered for regular check-ups with an endocrinologist. During treatment the patient developed excited state followed by loss of consciousness. Objectively: tremor of the extremities, moist skin, heart rate - 100/min., BP- 100/60 mm Hg. What diagnosis is most likely?
A 32-year-old patient consulted a dentist with complaints of tooth crown discoloration on the upper right jaw. Anamnesis: 3 weeks ago the patient suffered a trauma of the upper jaw. On examination: crown of the 11 tooth is intact, gray, painless on percussion, no changes of mucosa in the area of root apex projection of the 11 tooth. Electric pulp test -100 microamperes. The patient was diagnosed with traumatic periodontitis of the 11 tooth. What method of removing tooth discoloration would be advisable after endodontic treatment?
A 39-year-old patient was diagnosed with chronic generalized periodontitis, initial stage. After undergoing complex treatment the patient received instructions and was registered for regular check-ups. How often should the patient undergo these regular check-ups?
A 22-year-old patient is diagnosed with chronic granulomatous periodontitis of the 46 tooth. During the first appointment the patient was prescribed a temporary filling made of antibacterial mateterial that stimulates osteo-, dentino- and cement genesis. Specify the material that satisfies this requirements:
A 24-year-old patient addressed a first-aid center with complaints of facial pain on the left, restricted mouth opening. Objectively: there is moderate swelling and hematoma in the left malar arch area. On palpation there is bone tissue retraction and moderate painfulness. Occlusion is intact. Mouth opening is 1-1,5 cm. Upon attempt to open the mouth further there are a sensation of mechanical obstructon and pain aggravation. What is the most likely diagnosis?
A 22-year-old patient has suffered unilateral linear fracture in the area of the gonial angle. Immobilization was provided with full dental brace with loops and intermaxillary elastic expansion. Recovery was uncomplicated. The brace should be removed after:
A 19-year-old woman complains of aesthetic defects, dry lips, unpleasant sensation of strain in the lower lip and its constant peeling. The patient often bites her lips, rips and bites off peeling flakes, which sometimes results in bleeding; she notes her increased irritability. On examination there are numerous transparent scales between the red border and mucosa. The scales are tightly adjacent in the center and loose at the periphery. They can be easily removed, produce no erosion. Regional lymph nodes cannot be palpated. What diagnosis is most likely?
A 73-year-old man is registered for regular check-ups in an oncological clinic after completion of the combined treatment for oral mucosa cancer stage II (radiation therapy and surgery). During one of the routine check-ups an area of exposed mandibular bone is detected. There are no inflammatory changes of surrounding mucosa. A sinus tract with weak granulation is observed. Mandibular X-ray shows sequestrum without clear margin between healthy and necrotic bone. What diagnosis is most likely?
A patient with odontogenic phlegmon of the oral cavity floor and neck has been delivered into an oral surgery department. The patient’s general condition is severe, labored breating, inflammatory masticatory muscles contracture II degree, swallowing is impossible. There can be determined dense sharply painful infiltration of the lower face, oral cavity floor and neck; the skin is strained and cannot be pinched in a fold; fluctuation can be palpated in the oral cavity. After 30 minutes of the patient’s stay in the in-patient department the patient’s neck swelling significantly enlarged, breati-ng deteriorated. What kind of asphyxia can develop in the patient?
A 16-year-old girl suffers from enlarged gums. Objectively: gingival margin of the vestibular surface of the gums is diffusely thickened, dense, pale pink in color. Gingival papilla cover crowns of all the teeth up to 1/2 of their height, hemorrhage is absent. X-ray reveals no pathological changes of periodontal tissues. Make the diagnosis:
A 40-year-old patient complains of pain in the tragus area, clicking during mouth opening, stuffed ears. Objectively: the face is symmetrical, mouth opening path is straight. Dentition defect can be estimated as the I class by Kennedy; the 18, 17, 16, 26, 27, 28 teeth are absent. In this case the load would be the most traumatizing for the following anatomical structure:
A 34-year-old patient complains of pain in the lower right jaw, reduced mouth opening. Objectively: dentition is intact both on the upper and lower jaw, there is premature contact between the 46 and 47 teeth. Diagnosis: traumatic fracture of the mandible in the area of the 46 tooth with fragment displacement. What construction would be advisable for temporary immobilization of the mandible fragments?
A 55-year-old patient addressed a prostodontic clinic to have a denture made. During preparation of the 44 and 47 teeth for crown installation the patient became unwell: he developed vertigo, nausea, tinnitus, blurred vision, dyspnea. Unconsciousness followed, the pupils were dilated, heart rate was weak. After 1 minute the patient’s condition improved. What condition occurred in the patient?
A 23-year-old woman complains of carious cavity present in the 27 tooth, where food particles are retained. Objectively: there is a deep carious cavity on the masticatory surface of the 27 tooth filled with dense dark-brown dentin. Probing of the cavity floor and walls is painless, thermometry and percussion are painless. Electric pulp test - 10 microamperes. X-ray reveals no pathological changes. Make the diagnosis: