What is best during placement of Crown?

A ceramic crown being placed over a tooth. The excess cement is protruding at margin [1].

The placement of crown is an important step in the longevity of the crown and the comfort of the patient. There are certain points that should be taken into consideration by a dentist during placement i.e. cementation.

The gingival margins should not be inflamed at the time of crown cementation. This may happen due to gingivoplasty or crown lengthening. For a common man, it means, the gum margins of the tooth receiving the artificial crown should not have redness, swelling or puffiness. If there is any, better to wait till it subsides.

The choice of cement/luting agent should be decided based on the type and material of the crown. The available materials are Zinc phosphate, Glass ionomer, Polycarbonate, Zinc silicophosphate, and resin luting agents. The anterior crowns need different cementing material than that of posterior crowns. The all ceramic crowns are best cemented by resin luting agents, but the use is limited to the cementation of anterior crowns. The reason is, after cementation, it becomes extremely difficult to remove set resin from the interproximal area of posterior teeth. Rest luting materials are brittle enough to break and remove, therefore, they can be used in all areas-anterior as well as posterior.

1. ADC Examination: Initial Assessment Process Explained

The ADC examination process along with initial assessment has been explained in this article. You can also watch the video for the same if you are unwilling to read the text.

The dentist who has got his or her bachelor dental degree from a non-Australian institution needs to pass the skill assessment test/examination conducted by the Australian Dental Council and register themselves in Dental Board of Australia to practice as a general dentist in Australia or to get a job in public or private sector.

The ADC test/examination is a screening examination to establish that dentists trained in dental schools which have not been formally reviewed and accredited by the ADC have the necessary knowledge and clinical competence to practice dentistry. 

Following are the steps, an overseas dentist needs to go through to qualify the ADC examination: 

Exopsure Time for Dental Radiography

The exposer time for dental radiography is dependent upon the speed of the film whether its ‘D’ or ‘E’. The exposer time for various areas is given in the table below.

For exact data, you can see the instructions written on the inner side of the carton of the film. The modern microprocessor controlled radiography machines are coming with software that takes care of everything. You need to place the film properly, choose whether the patient is an adult or child, choose the tooth/area desired and shoot the film. You must take care of yourself and your staff for radiation protection. For radiation protection, read the article given below:

Radiography: Radiation Safety

 

Ref:

1. Oral Radiology Principles and Interpretation 5th Ed

Overseas Registration Examination (ORE)

If you do not want to read the text, you can listen this presentation on YouTube at this link Overseas Registration Examination

What is the Overseas Registration Examination (ORE)?

ORE means Overseas Registration Examination. It is an exam that overseas qualified dentists have to pass because their dental bachelor degrees are not recognised by GDC. After passing ORE, a dentist can get registration in GDC and he or she will be allowed to practise dentistry unsupervised in the UK. The ORE tests the clinical skills and knowledge of overseas dentists who  are referred to as a candidate. Candidates are expected to be at equal or above the standard of a ‘just passed’ UK BDS graduate. A candidate should be able to show competence, knowledge and familiarity in the different aspects of dentistry in the exam. 

The ORE has two parts

The​ Part 1 is designed in such a way that it tests candidates’ application of knowledge to clinical practice. ORE part 1 consists of two computer-based exam papers:

Paper A covers clinically applied dental science and clinically applied human disease. Basically it will check your ability to apply your knowledge of non clinical subjects to understand its role in human diseases.

Paper B covers aspects of clinical dentistry, including law, ethics, health and safety. It means paper B will check your ability to treat patients taking care of existing laws of the UK, ethics, and safety. Each paper lasts three hours and is made up of multiple short answer questions. They will contain extended matching questions and single best answer questions. A candidate is expected to be able to show competence, knowledge and familiarity in the different aspects of dentistry.

You need to achieve a minimum 50% marks in each paper to pass the part 1 of ORE. There are a maximum of 200 places available at each examination period. You must pass both papers in order to progress to Part 2. 

Location and Cost of Overseas Registration Examination

The Part 1 exam is held at King’s College London and costs £806. There are currently no confirmed dates for 2021. Your exam results will be sent to you by email. Generally it is declared within 20 working days of the examination. You will be given a percentage mark out of 100 for paper 1 as well as paper 2. Also, you will get an overall pass or fail award. Approximately 40 working days after the examination, the Part 1 Supplier, King’s College London, will provide you with result feedback. Upon passing Part 1, your name will be added to the Part 2 candidate list. You will be allowed four attempts for Part 1. 

Part 2 of ORE 

Part 2 is designed for candidates to demonstrate practical clinical skills. For each examination period, a maximum of 144 candidates are able to undertake the Part 2 exam. The current cost of the examination is £2,929 per candidate, payable at the time of booking. 

Part 2 Examination Dates: 

There are currently no confirmed dates for 2021 part 2.

Four Components of Part 2 of the ORE:

1. DM,
2. OSCE,
3. DTP &
4. EM 

First component is An operative test on a dental manikin: Candidates are required to perform three procedures over a period of three hours. These procedures primarily involve the preparation and restoration of teeth, but may also include other procedures where appropriate simulation can allow assessment of operative skills. 

Second component is An objective structured clinical examination (OSCE).  This is where candidates visit a series of ‘stations’ which test their clinical skills. These may include history-taking and assessment, communication skills such as an explanation of problems and treatment plans, judgement and decision making, ethics and attitudes, and clinical examination. The series of stations will cover aspects of behavioural sciences, human disease, law, ethics, professionalism, clinical dentistry, restorative dentistry, paediatric dentistry, orthodontics, preventive dentistry, dental public health, comprehensive oral care, oral surgery, oral medicine, oral pathology, oral microbiology, dental radiology and imaging.

Third component is A diagnostic and treatment planning exercise (DTP):  This involves an actor who will provide an appropriate history. You will be provided relevant additional information such as photographs, radiographs, study models or results of other special tests. You will not examine the actor. The exercise may involve any of the above aspects of clinical dentistry I just mentioned.

Fourth component is a practical examination in medical emergencies (ME).  This assessment consists of two parts: First is a structured scenario-based oral and the second is a demonstration of single handed basic life support. This will include cardiopulmonary resuscitation using a resuscitation manikin. You will be allowed four attempts for Part 2. Your exam results will be sent to you by email. The result will be declared within 20 working days of the exam. If you only fail the medical emergencies exercise during the ORE Part 2 , you will be able to re-sit this component only at a future exam. Sitting the ME only exam costs £300. If you pass the ME component at this sitting, you will have passed Part 2 of the ORE. If you fail, you will need to retake the full ORE Part 2 exam, if you are eligible to do so. The ME only exam is held at the same time as the full Part 2 exam. Once you have passed Part 2, you will be able to apply for registration with the GDC.   

Books Recommended for ORE Preparation

• Oxford Handbook of Applied Dental Science
• Oxford Handbook of Clinical Dentistry 6
• Scully’s Medical Problems in Dentistry, 7 e
• Master Dentistry: Volume 1
• Master Dentistry: Volume 2
•  Essentials of Dental Radiography and Radiology-Eric Whaites
• Vanders Physiology
• BD Chaurasia for Anatomy

 

 

Measures to Evaluate a Screening Test

For ADC examination, both prelims and practical viva voce, and NEET MDS,  the various measures of evaluating a screening test must be known to the students.

There are various measures to evaluate a screening test that are as follows:

Vitamin D: Functions & Diseases

In Australian Dental Council’s examination, the indirect question related with Vitamin D are asked but in NEET MDS there may be direct question.

Terminology:

Calciferol: Vitamin DCalcidiol : 25-hydroxyvitamin D [25(OH)D]Calcitriol: 1,25-dihydroxyvitamin D [1,25(OH)2D]Vitamin D2: ErgocalciferolVitamin D3: Cholecalciferol

NEET MDS Practice Course

This is a course that aims to help you practice the MCQs on a weekly basis topic wise. In this course you can study on your own and keep on tracking your progress by taking weekly test. In case you need any help, you may be provided by an experienced faculty.

To buy this course with 40% off, click HERE.

 

Buccinator Muscle

 

 

 

Image source: Internet