Gulfie Dentists Students
Evergreen Performance Test
Exams in alternate weeks to test your level of preparation.
Test of the Week
Scheduled for alternate Week
Test of the Week
PERFORMANCE TEST
Quiz-summary
0 of 150 questions completed
Questions:
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100
- 101
- 102
- 103
- 104
- 105
- 106
- 107
- 108
- 109
- 110
- 111
- 112
- 113
- 114
- 115
- 116
- 117
- 118
- 119
- 120
- 121
- 122
- 123
- 124
- 125
- 126
- 127
- 128
- 129
- 130
- 131
- 132
- 133
- 134
- 135
- 136
- 137
- 138
- 139
- 140
- 141
- 142
- 143
- 144
- 145
- 146
- 147
- 148
- 149
- 150
Information
Click start to practice this Evergreen Performance Test.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
0 of 150 questions answered correctly
Time has elapsed
You have reached 0 of 0 points, (0)
| Average score |
|
| Your score |
|
Categories
- KDLE 0%
| Pos. | Name | Entered on | Points | Result |
|---|---|---|---|---|
| Table is loading | ||||
| No data available | ||||
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100
- 101
- 102
- 103
- 104
- 105
- 106
- 107
- 108
- 109
- 110
- 111
- 112
- 113
- 114
- 115
- 116
- 117
- 118
- 119
- 120
- 121
- 122
- 123
- 124
- 125
- 126
- 127
- 128
- 129
- 130
- 131
- 132
- 133
- 134
- 135
- 136
- 137
- 138
- 139
- 140
- 141
- 142
- 143
- 144
- 145
- 146
- 147
- 148
- 149
- 150
- Answered
- Review
-
Question 1 of 150
1. Question

A 52-year-old male with a 15-year history of tobacco chewing presents with a well-defined, non-scrapable white patch on the left buccal mucosa. The lesion has a homogeneous appearance, measures about 1.5 cm, and shows no induration or ulceration. A clinical diagnosis of leukoplakia is made. The lesion is small and appears amenable to complete removal. What is the appropriate management?
Correct
ANSWER
Excisional biopsyOTHER OPTIONS
⢠Laser ablation ā Destroys tissue
⢠Cryosurgery ā Tissue lost, not ideal for premalignant lesions
⢠Incisional biopsy ā used for large or suspicious lesions onlySYNOPSIS
⢠Small, clinically well-defined leukoplakic lesions should be completely removed and sent for histopathological examination
⢠Excisional biopsy is both diagnostic and therapeutic
⢠Allows evaluation of dysplasia or early carcinomaREFERENCE
Shaferās Textbook of Oral Pathology – 10th EditionIncorrect
ANSWER
Excisional biopsyOTHER OPTIONS
⢠Laser ablation ā Destroys tissue
⢠Cryosurgery ā Tissue lost, not ideal for premalignant lesions
⢠Incisional biopsy ā used for large or suspicious lesions onlySYNOPSIS
⢠Small, clinically well-defined leukoplakic lesions should be completely removed and sent for histopathological examination
⢠Excisional biopsy is both diagnostic and therapeutic
⢠Allows evaluation of dysplasia or early carcinomaREFERENCE
Shaferās Textbook of Oral Pathology – 10th Edition -
Question 2 of 150
2. Question
A 48-year-old woman complains of a persistent scalding/burning sensation of the gingiva for the past 6 months. She also reports altered and metallic taste. On examination, the oral mucosa appears completely normal, with no erythema, ulceration, or pseudomembrane.
What is the most likely diagnosis?Correct
ANSWER
Burning mouth syndromeOTHER OPTIONS
⢠Bismuth toxicity – causes black line (bismuth line)
⢠Candidiasis – erythema or white patches present
⢠Anemia – pallor, glossitis, angular cheilitis usually seenSYNOPSIS
⢠Burning mouth syndrome (BMS) is characterized by
– Burning/scalding sensation
– Dysgeusia (metallic taste)
– Normal-appearing oral mucosa
⢠Common in middle-aged and post-menopausal womenREFERENCE
Shaferās Textbook of Oral Pathology – 10th EditionIncorrect
ANSWER
Burning mouth syndromeOTHER OPTIONS
⢠Bismuth toxicity – causes black line (bismuth line)
⢠Candidiasis – erythema or white patches present
⢠Anemia – pallor, glossitis, angular cheilitis usually seenSYNOPSIS
⢠Burning mouth syndrome (BMS) is characterized by
– Burning/scalding sensation
– Dysgeusia (metallic taste)
– Normal-appearing oral mucosa
⢠Common in middle-aged and post-menopausal womenREFERENCE
Shaferās Textbook of Oral Pathology – 10th Edition -
Question 3 of 150
3. Question
A 30-year-old patient with a history of bronchial asthma presents for dental treatment. He reports breathlessness on lying down. What is the best position to treat this patient?
Correct
ANSWER
Semi SupineOTHER OPTIONS
⢠Supine – Supine position may precipitate asthma symptoms.
⢠Prone – compromises respiration
⢠Decubitus – not practical for dental treatmentSYNOPSIS
⢠Semi-supine position
– Facilitates lung expansion
– Prevents respiratory distressREFERENCE
Little and Falace ā Dental Management of the Medically Compromised PatientIncorrect
ANSWER
Semi SupineOTHER OPTIONS
⢠Supine – Supine position may precipitate asthma symptoms.
⢠Prone – compromises respiration
⢠Decubitus – not practical for dental treatmentSYNOPSIS
⢠Semi-supine position
– Facilitates lung expansion
– Prevents respiratory distressREFERENCE
Little and Falace ā Dental Management of the Medically Compromised Patient -
Question 4 of 150
4. Question
A 45 years old female patient presented with sudden, severe facial pain triggered by touching the face, chewing or speaking.What may be the diagnosis?
Correct
ANSWER
Trigeminal NeuralgiaOTHER OPTIONS
⢠TMJ Disorder – can cause pain in your jaw joint and in the muscles that control jaw movement
⢠Postherpetic neuralgia – Postherpetic neuralgia isĀ the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.
⢠Cluster headache – strikes quickly, usually without warning, although you might first have migraine-like nausea and aura. Common signs and symptoms during a headache include: Excruciating pain that is generally situated in, behind or around one eye, but may radiate to other areas of your face, head, and neck.SYNOPSIS
⢠Trigeminal neuralgia, also called tic douloureux, is a chronic pain condition that affects the trigeminal or 5th cranial nerve.
⢠TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.)
⢠The typical or classic form of the disorder (called Type 1 or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.Ā
⢠The atypical form of the disorder (called Type 2 or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.Ā Both forms of pain may occur in the same person, sometimes simultaneously.Ā The intensity of pain can be physically and mentally incapacitating.Ā
⢠Pain varies, depending on the type of TN, and may range from sudden, severe, and stabbing to a more constant, aching, burning sensation. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. The pain may affect a small area of the face or may spread. Bouts of pain rarely occur at night, when the affected individual is sleeping.
⢠Treatment includes :
– Anticonvulsant medicines-used to block nerve firing are generally effective in treating TN1 but often less effective in TN2.Ā These drugs include carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine, and valproic acid.
– Tricyclic antidepressants such as amitriptyline or nortriptyline can be used to treat pain.Ā Common analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN1, although some individuals with TN2 do respond to opioids. Ā Eventually, if medication fails to relieve pain or produces intolerable side effects such as cognitive disturbances, memory loss, excess fatigue, bone marrow suppression, or allergy, then surgical treatment may be indicated.Ā Since TN is a progressive disorder that often becomes resistant to medication over time, individuals often seek surgical treatment.REFERENCE
Trigeminal Neuralgia Fact Sheet – National Institute of Neurological Disorders and StrokeIncorrect
ANSWER
Trigeminal NeuralgiaOTHER OPTIONS
⢠TMJ Disorder – can cause pain in your jaw joint and in the muscles that control jaw movement
⢠Postherpetic neuralgia – Postherpetic neuralgia isĀ the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.
⢠Cluster headache – strikes quickly, usually without warning, although you might first have migraine-like nausea and aura. Common signs and symptoms during a headache include: Excruciating pain that is generally situated in, behind or around one eye, but may radiate to other areas of your face, head, and neck.SYNOPSIS
⢠Trigeminal neuralgia, also called tic douloureux, is a chronic pain condition that affects the trigeminal or 5th cranial nerve.
⢠TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.)
⢠The typical or classic form of the disorder (called Type 1 or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.Ā
⢠The atypical form of the disorder (called Type 2 or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.Ā Both forms of pain may occur in the same person, sometimes simultaneously.Ā The intensity of pain can be physically and mentally incapacitating.Ā
⢠Pain varies, depending on the type of TN, and may range from sudden, severe, and stabbing to a more constant, aching, burning sensation. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. The pain may affect a small area of the face or may spread. Bouts of pain rarely occur at night, when the affected individual is sleeping.
⢠Treatment includes :
– Anticonvulsant medicines-used to block nerve firing are generally effective in treating TN1 but often less effective in TN2.Ā These drugs include carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine, and valproic acid.
– Tricyclic antidepressants such as amitriptyline or nortriptyline can be used to treat pain.Ā Common analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN1, although some individuals with TN2 do respond to opioids. Ā Eventually, if medication fails to relieve pain or produces intolerable side effects such as cognitive disturbances, memory loss, excess fatigue, bone marrow suppression, or allergy, then surgical treatment may be indicated.Ā Since TN is a progressive disorder that often becomes resistant to medication over time, individuals often seek surgical treatment.REFERENCE
Trigeminal Neuralgia Fact Sheet – National Institute of Neurological Disorders and Stroke -
Question 5 of 150
5. Question
A young patient came to you after a bicycle accident with trauma of the central incisor. EPT showed a negative pulp response. Radiographic examination shows the tooth is having an open apex. What is the next step?
Correct
ANSWER
Observe over timeOTHER OPTIONS
⢠Extraction – Only done if there is no means of saving the tooth.
⢠Endodontic management – Done in closed apex cases with necrotic pulp changes.
⢠Pulpotomy – A pulpotomy isĀ a dental procedure in which the pulp in the crown of a tooth is removed in order to save the tooth from infection or decay.ĀSYNOPSIS
⢠Electric pulp testing is based on stimulation of sensory nerves and requires and relies on subjective assessments and comments from the patient. These can lead to false-positive and false-negative results.
⢠Younger or anxious patients can have false-positive results due to psychological factors.
⢠Likewise, false-negative results are possible in teeth with incomplete apical development, trauma, root canal calcification, periodontal disease, or in patients undergoing orthodontic treatment.
⢠So it’s always better to wait and observe for some time and evaluate the pulp status of the tooth.REFERENCE
Grossman’s endodontic practice pg 378.Incorrect
ANSWER
Observe over timeOTHER OPTIONS
⢠Extraction – Only done if there is no means of saving the tooth.
⢠Endodontic management – Done in closed apex cases with necrotic pulp changes.
⢠Pulpotomy – A pulpotomy isĀ a dental procedure in which the pulp in the crown of a tooth is removed in order to save the tooth from infection or decay.ĀSYNOPSIS
⢠Electric pulp testing is based on stimulation of sensory nerves and requires and relies on subjective assessments and comments from the patient. These can lead to false-positive and false-negative results.
⢠Younger or anxious patients can have false-positive results due to psychological factors.
⢠Likewise, false-negative results are possible in teeth with incomplete apical development, trauma, root canal calcification, periodontal disease, or in patients undergoing orthodontic treatment.
⢠So it’s always better to wait and observe for some time and evaluate the pulp status of the tooth.REFERENCE
Grossman’s endodontic practice pg 378. -
Question 6 of 150
6. Question
A patient presented with a history of trauma shows fractured tooth 11 had undergone RCT and scheduled for post and core treatment. But the dentist noted that the tooth has narrow canal. What will be the choice of post and core?
Correct
ANSWER
Cast post and coreOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The only tapered post design that is clinically recommended is the custom-cast post and core system.
⢠Custom-cast post and cores adapt well to extremely tapered canals or those with a non-circular cross-section or irregular shape and roots with minimal remaining coronal tooth structure.REFERENCE
Custom-made post and core in Endodontics – Slideshare Article.Incorrect
ANSWER
Cast post and coreOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The only tapered post design that is clinically recommended is the custom-cast post and core system.
⢠Custom-cast post and cores adapt well to extremely tapered canals or those with a non-circular cross-section or irregular shape and roots with minimal remaining coronal tooth structure.REFERENCE
Custom-made post and core in Endodontics – Slideshare Article. -
Question 7 of 150
7. Question
A patient came with a large caries tooth with exposed pulp. While excavating the pulp, there was no bleeding, Why?
Correct
ANSWER
Pulp necrosisOTHER OPTIONS
Not applicableSYNOPSIS
⢠Necrosis is death of the pulp.
⢠It may be partial or total.
⢠Necrosis will result in dry gangrenous necrotic pulp.
⢠A necrotic pulp may not show painful symptoms and may not bleed while removing the pulp.
⢠Treatment is complete removal of pulp and obturation of root canals.REFERENCE
Grossman’s Endodontic Practice – 13th Edition Page No 108.Incorrect
ANSWER
Pulp necrosisOTHER OPTIONS
Not applicableSYNOPSIS
⢠Necrosis is death of the pulp.
⢠It may be partial or total.
⢠Necrosis will result in dry gangrenous necrotic pulp.
⢠A necrotic pulp may not show painful symptoms and may not bleed while removing the pulp.
⢠Treatment is complete removal of pulp and obturation of root canals.REFERENCE
Grossman’s Endodontic Practice – 13th Edition Page No 108. -
Question 8 of 150
8. Question
Which is the best material used for recording mandible maxilla relation without producing pressure?
Correct
ANSWER
Bite registration paste.OTHER OPTIONS
⢠Modeling compound and wax hold many comparable characteristics. Once the record is made, it is subject to being blunted, distorted, scraped, and compressed.SYNOPSIS
⢠Bite registration materials
– Waxes
– Quick setting plaster
– Impression compound
– Bite registration paste (ZnO-E)
– Bite registration silicone
⢠Zinc oxide and eugenol type of bite registration paste is one material of choice for the maxillomandibular record.
⢠Advantages
– Fluidity before setting – fluidity is a critical quality of a bite recording material because it provides nominal interference with mandibular closure during record-making procedures.
– Adherence to its carrier.
– After the final set, there is rigidity and inelasticity.
– Accuracy in recording occlusal and incisal surfaces of the teeth.
– High intensity of repeatability.
⢠Disadvantages
– Long setting time.
– Highly brittle.REFERENCE
Interocclusal recording materials – A review.- Journal of Advanced Clinical and Research Insights (2019), 6, 20-23.Incorrect
ANSWER
Bite registration paste.OTHER OPTIONS
⢠Modeling compound and wax hold many comparable characteristics. Once the record is made, it is subject to being blunted, distorted, scraped, and compressed.SYNOPSIS
⢠Bite registration materials
– Waxes
– Quick setting plaster
– Impression compound
– Bite registration paste (ZnO-E)
– Bite registration silicone
⢠Zinc oxide and eugenol type of bite registration paste is one material of choice for the maxillomandibular record.
⢠Advantages
– Fluidity before setting – fluidity is a critical quality of a bite recording material because it provides nominal interference with mandibular closure during record-making procedures.
– Adherence to its carrier.
– After the final set, there is rigidity and inelasticity.
– Accuracy in recording occlusal and incisal surfaces of the teeth.
– High intensity of repeatability.
⢠Disadvantages
– Long setting time.
– Highly brittle.REFERENCE
Interocclusal recording materials – A review.- Journal of Advanced Clinical and Research Insights (2019), 6, 20-23. -
Question 9 of 150
9. Question
For the preparation of the rest seat the marginal ridge of a molar tooth is reduced by 2 mm to achieve the correct depth of the rest seat. The marginal ridge is then rounded in order to?
Correct
Answer
Reduce the chances of fracture of the metal seatOTHER OPTIONS
Not applicableSYNOPSIS
⢠The most common mistake in occlusal rest seat preparation is the insufficient reduction of the marginal ridge.
⢠This leads to the construction of a rest that is extremely thin and subject to fracture.
⢠An occlusal rest must be at least 0.5 mm thick at its thinnest point and should be between 1.0 and 1.5 mm thick where it crosses the marginal ridge.
⢠The marginal ridges are rounded off to reduce the chances of fracture of the metal seatReference Stewarts clinical RPD 3rd ed, pg 48
Incorrect
Answer
Reduce the chances of fracture of the metal seatOTHER OPTIONS
Not applicableSYNOPSIS
⢠The most common mistake in occlusal rest seat preparation is the insufficient reduction of the marginal ridge.
⢠This leads to the construction of a rest that is extremely thin and subject to fracture.
⢠An occlusal rest must be at least 0.5 mm thick at its thinnest point and should be between 1.0 and 1.5 mm thick where it crosses the marginal ridge.
⢠The marginal ridges are rounded off to reduce the chances of fracture of the metal seatReference Stewarts clinical RPD 3rd ed, pg 48
-
Question 10 of 150
10. Question
What is the proper cavity preparation for V-shaped cervical erosion lesionĀ to be restored with glass ionomer cement?
Correct
ANSWER
No mechanical preparation is necessaryOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The special characteristics of these lesions are the presence of dentin or cementum in the gingival margins,
⢠Along with the lack of mechanical retention and difficulty in controlling moisture contamination in doing these restorations, longevity and marginal sealing are challenged.
⢠GICs are very durable in cervical restorations and compete with the composites, particularly where bonding to cervical dentin is required.
⢠Class V caries occur on the buccal and lingual aspects and may extend subgingivally, limiting the therapist’s ability to remove them completely and place a proper restoration.
⢠GICs have very low shrinkage and are thermally compatible with tooth structure.
⢠They can even bond to dentin surfaces without the removal of the smear layer and their biological compatibility is well proved.REFERENCE
Sturdevant’s Art and Science of Operative DentistryIncorrect
ANSWER
No mechanical preparation is necessaryOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The special characteristics of these lesions are the presence of dentin or cementum in the gingival margins,
⢠Along with the lack of mechanical retention and difficulty in controlling moisture contamination in doing these restorations, longevity and marginal sealing are challenged.
⢠GICs are very durable in cervical restorations and compete with the composites, particularly where bonding to cervical dentin is required.
⢠Class V caries occur on the buccal and lingual aspects and may extend subgingivally, limiting the therapist’s ability to remove them completely and place a proper restoration.
⢠GICs have very low shrinkage and are thermally compatible with tooth structure.
⢠They can even bond to dentin surfaces without the removal of the smear layer and their biological compatibility is well proved.REFERENCE
Sturdevant’s Art and Science of Operative Dentistry -
Question 11 of 150
11. Question
If a canal is prepared to a 5 percent taper, why not use a 5 percent master cone instead of the standard 2percent?Ā
Correct
ANSWER
Cold lateral condensation would be very difficultOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Cold lateral condensation would be very difficult if a GP cone with a different taper than the taper of prepared canal is used.
⢠With the introduction of standardized endodontic instruments, standardized master cones were also made available, with various ISO sizes and a 2 percent taper.
⢠The standardized sizes are designed to match the size and taper of the corresponding stainless steel or nickel-titanium instruments employed for shaping the canals.
– ISO 2 percent from size Nos. 15 to 140
– Greater taper gutta-percha cones such as 4 or 6 percent taper
– Variable taper gutta-percha points suiting the taper of variable taper shaping instruments such as the ProTaper F1, F2, and F3.REFERENCE
Grossman’s endodontics pg 317.Incorrect
ANSWER
Cold lateral condensation would be very difficultOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Cold lateral condensation would be very difficult if a GP cone with a different taper than the taper of prepared canal is used.
⢠With the introduction of standardized endodontic instruments, standardized master cones were also made available, with various ISO sizes and a 2 percent taper.
⢠The standardized sizes are designed to match the size and taper of the corresponding stainless steel or nickel-titanium instruments employed for shaping the canals.
– ISO 2 percent from size Nos. 15 to 140
– Greater taper gutta-percha cones such as 4 or 6 percent taper
– Variable taper gutta-percha points suiting the taper of variable taper shaping instruments such as the ProTaper F1, F2, and F3.REFERENCE
Grossman’s endodontics pg 317. -
Question 12 of 150
12. Question

A 35 year old patient comes with a bluish hue, soft, painless, and flexible lip swelling. It’ s content being tested as mucous. What is your diagnosis?
Correct
ANSWER
MucocoeleOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠A mucocele or mucous retention cyst is a benign pathologic lesion.
⢠The lesion is a result of the extravasation of saliva from an injured minor salivary gland.
⢠The collection of extravasated fluid develops a fibrous wall around itself forming a pseudocyst.
⢠The lesion can fluctuate in size depending on its fluid-filled state.
⢠The lesion is nonpainful, soft, doughy, and fluctuant to palpation.
⢠Clinically the overlying mucosa may have the same coloration as the lower lip or have a bluish hue.
⢠Lesions of longer duration may appear firmer and fibrotic and be difficult to distinguish from a fibroma.
⢠A mucocele most likely results secondary to a traumatic event that in most situations goes unrecognized.
⢠The lower lip is the most common location.REFERENCE
The Mucous Retention Cyst – Surgery of Salivary Glands-2021Incorrect
ANSWER
MucocoeleOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠A mucocele or mucous retention cyst is a benign pathologic lesion.
⢠The lesion is a result of the extravasation of saliva from an injured minor salivary gland.
⢠The collection of extravasated fluid develops a fibrous wall around itself forming a pseudocyst.
⢠The lesion can fluctuate in size depending on its fluid-filled state.
⢠The lesion is nonpainful, soft, doughy, and fluctuant to palpation.
⢠Clinically the overlying mucosa may have the same coloration as the lower lip or have a bluish hue.
⢠Lesions of longer duration may appear firmer and fibrotic and be difficult to distinguish from a fibroma.
⢠A mucocele most likely results secondary to a traumatic event that in most situations goes unrecognized.
⢠The lower lip is the most common location.REFERENCE
The Mucous Retention Cyst – Surgery of Salivary Glands-2021 -
Question 13 of 150
13. Question
Patient with history of heart valve surgery wants to extract his tooth. Which test is important when he is under low dose aspirin medication?
Correct
ANSWER
BTOTHER OPTIONS
⢠Explained belowSYNOPSIS
⢠If the patient is otherwise normal, the patient usually prolongs the bleeding time by 1.5 – 2 minutes.
⢠Low-dose aspirin therapy (150 mg daily) does not affect either preoperative coagulation tests or postoperative blood loss.
⢠Only BT is affected in Patients under aspirin therapy no effect on other tests.REFERENCE
Medical Emergencies – Stanley F MalamedIncorrect
ANSWER
BTOTHER OPTIONS
⢠Explained belowSYNOPSIS
⢠If the patient is otherwise normal, the patient usually prolongs the bleeding time by 1.5 – 2 minutes.
⢠Low-dose aspirin therapy (150 mg daily) does not affect either preoperative coagulation tests or postoperative blood loss.
⢠Only BT is affected in Patients under aspirin therapy no effect on other tests.REFERENCE
Medical Emergencies – Stanley F Malamed -
Question 14 of 150
14. Question
A 65 years old man under bisphosphonate therapy presented with non healed extraction socket after 2 months of extraction. What will be the possible reason?
Correct
ANSWER
OsteonecrosisOTHER OPTIONS
⢠Chronic osteomyelitis – Bone infection that is mainly caused by Staphylococcus bacteria
⢠Metastasis – The spread of cancer cells from the place where they first formed to another part of the bodyDry socket
⢠Alveolar osteitis – Dry socket is a painful dental condition that happens as a complication of extractionSYNOPSIS
⢠Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a condition in which bones of the maxillofacial skeleton, in particular the tooth-bearing areas, become necrotic and exposed to the oral cavity.
⢠Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is thought to be caused by trauma to dentoalveolar structures that have a limited capacity for bone healing due to the effects of bisphosphonate therapy.
⢠Panoramic and plain radiography of the mandible reveal areas of sclerosis, destruction, sequestration, or pathologic fractures.
⢠Delayed or persistent tooth sockets after extraction may also be revealed in these patients.
⢠Management of bisphosphonate-related osteonecrosis of the jaw
– Nonsurgical management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) may consist of the following:
1. Antimicrobial rinses
2. Systemic antibiotics
3. Systemic or topical antifungals
4. Discontinuation of bisphosphonate therapy
5. No dental therapy or minimally invasive dental therapy (ie, root canal therapy instead of extraction)
– Surgical intervention for bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains limited because of the impaired ability of the bone to heal.REFERENCE
Bisphosphonate-Related Osteonecrosis of the Jaw-Jan 08, 2021 – MedscapeIncorrect
ANSWER
OsteonecrosisOTHER OPTIONS
⢠Chronic osteomyelitis – Bone infection that is mainly caused by Staphylococcus bacteria
⢠Metastasis – The spread of cancer cells from the place where they first formed to another part of the bodyDry socket
⢠Alveolar osteitis – Dry socket is a painful dental condition that happens as a complication of extractionSYNOPSIS
⢠Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a condition in which bones of the maxillofacial skeleton, in particular the tooth-bearing areas, become necrotic and exposed to the oral cavity.
⢠Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is thought to be caused by trauma to dentoalveolar structures that have a limited capacity for bone healing due to the effects of bisphosphonate therapy.
⢠Panoramic and plain radiography of the mandible reveal areas of sclerosis, destruction, sequestration, or pathologic fractures.
⢠Delayed or persistent tooth sockets after extraction may also be revealed in these patients.
⢠Management of bisphosphonate-related osteonecrosis of the jaw
– Nonsurgical management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) may consist of the following:
1. Antimicrobial rinses
2. Systemic antibiotics
3. Systemic or topical antifungals
4. Discontinuation of bisphosphonate therapy
5. No dental therapy or minimally invasive dental therapy (ie, root canal therapy instead of extraction)
– Surgical intervention for bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains limited because of the impaired ability of the bone to heal.REFERENCE
Bisphosphonate-Related Osteonecrosis of the Jaw-Jan 08, 2021 – Medscape -
Question 15 of 150
15. Question
A 7 years old child patient visits your clinic with multiple carious teeth. What radiograph should be adviced if its his first visit?
Correct
ANSWER
Selected periapical and posterior bite wingsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠For first time visit a 7-year-old is recommended to take posterior bitewings and panoramic exam OR posterior bitewings and selected periapical
⢠For first visit , children of 1-5 year age group – posterior bitewings and periapical x-ray of anteriors. Bitewing x rays every 6-12 months for child with high caries risk and every 12-24 months for low caries risk children
⢠For 6-12 years old – posterior bitewings, selected periapical of anteriors or a Panoramic x ray and posterior bite wings .Bitewings are recommended every 6-18 months in high risk patients and every 12-36 months in low caries risk patients
⢠For those above 12 years of age with permanent teeth but no wisdom teeth,the Dentist might take bitewing x rays of posteriors, selected periapical x rays or a panoramic x ray, or a full mouth survey of x rays if there is evidence of widespread disease. Bitewings are recommended every 6- 18 months for high risk cases and every 12-36 months for low risk cases.REFERENCE
AAPD Guidelines for use of Radiographs in ChildrenIncorrect
ANSWER
Selected periapical and posterior bite wingsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠For first time visit a 7-year-old is recommended to take posterior bitewings and panoramic exam OR posterior bitewings and selected periapical
⢠For first visit , children of 1-5 year age group – posterior bitewings and periapical x-ray of anteriors. Bitewing x rays every 6-12 months for child with high caries risk and every 12-24 months for low caries risk children
⢠For 6-12 years old – posterior bitewings, selected periapical of anteriors or a Panoramic x ray and posterior bite wings .Bitewings are recommended every 6-18 months in high risk patients and every 12-36 months in low caries risk patients
⢠For those above 12 years of age with permanent teeth but no wisdom teeth,the Dentist might take bitewing x rays of posteriors, selected periapical x rays or a panoramic x ray, or a full mouth survey of x rays if there is evidence of widespread disease. Bitewings are recommended every 6- 18 months for high risk cases and every 12-36 months for low risk cases.REFERENCE
AAPD Guidelines for use of Radiographs in Children -
Question 16 of 150
16. Question
What is the cause for marginal deterioration of amalgam restoration?
1. Not enough bulk of dentine
2. Corrosion
3. Overcarving
4. Improper manipulation of amalgamCorrect
ANSWER
All the aboveOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The marginal deterioration refers to poor marginal adaptation which may produce marginal discoloration, post-operative sensitivity, and secondary caries. These are the most frequent reasons to replace or repair an adhesive restoration.
⢠Amalgams that are corroded or have inadequate bulk to distribute stresses may fracture. At margins, where amalgams are thinner, extrusion may have occurred, and corrosion may have compromised the integrity of the amalgam, fracture is even more likely.
⢠Other factors include faulty manipulation and finishing of the filling.REFERENCE
Deterioration of Restorative Materials and the Risk for Secondary Caries – A.J. GoldbergIncorrect
ANSWER
All the aboveOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The marginal deterioration refers to poor marginal adaptation which may produce marginal discoloration, post-operative sensitivity, and secondary caries. These are the most frequent reasons to replace or repair an adhesive restoration.
⢠Amalgams that are corroded or have inadequate bulk to distribute stresses may fracture. At margins, where amalgams are thinner, extrusion may have occurred, and corrosion may have compromised the integrity of the amalgam, fracture is even more likely.
⢠Other factors include faulty manipulation and finishing of the filling.REFERENCE
Deterioration of Restorative Materials and the Risk for Secondary Caries – A.J. Goldberg -
Question 17 of 150
17. Question
What will happen to the supracrestal connective tissue after scaling and root planing?
Correct
ANSWER
IncreaseOTHER OPTIONS
Not applicableSYNOPSIS
⢠The periodontal disease progression has an inverse correlation with the dimension of the supracrestal connective tissue(SCTA).
⢠So after therapy attachment increases.
⢠The SCTA regains its original dimensions after periodontal therapy, in cases of shallow pockets (3-5 mm) treated with scaling and root planing, it takes 3 months.
⢠It may take 6 months in moderate pockets (5-7 mm) treated by periodontal flap surgery.
⢠Most changes in the SCTA occur within first 3 months and remain stable up to 6 months irrespective of the treatment protocol.REFERENCE
Assessment of Supracrestal Tissue Attachment Variation in Patients with Chronic Periodontitis Before and After Treatment – A Clinical Radiographic Study.Incorrect
ANSWER
IncreaseOTHER OPTIONS
Not applicableSYNOPSIS
⢠The periodontal disease progression has an inverse correlation with the dimension of the supracrestal connective tissue(SCTA).
⢠So after therapy attachment increases.
⢠The SCTA regains its original dimensions after periodontal therapy, in cases of shallow pockets (3-5 mm) treated with scaling and root planing, it takes 3 months.
⢠It may take 6 months in moderate pockets (5-7 mm) treated by periodontal flap surgery.
⢠Most changes in the SCTA occur within first 3 months and remain stable up to 6 months irrespective of the treatment protocol.REFERENCE
Assessment of Supracrestal Tissue Attachment Variation in Patients with Chronic Periodontitis Before and After Treatment – A Clinical Radiographic Study. -
Question 18 of 150
18. Question
A 42-year-old patient reports with discomfort during chewing in the posterior region. Clinical examination reveals fremitus on occlusion, progressive tooth mobility, and widening of the periodontal ligament space on radiograph. There is no active periodontal pocketing, but occlusal analysis shows premature contacts during functional movements.
In which of the following conditions is occlusal therapy most appropriately indicated?Correct
ANSWER
Increasing tooth mobility due to trauma from occlusionOTHER OPTIONS
⢠Bruxism without periodontal involvement – Bruxism alone requires occlusal splints but does not always mandate occlusal adjustment unless periodontal damage is evident.
⢠An extruded molar without functional interference – An extruded molar requires occlusal therapy only if it causes functional interference or traumatic occlusion.
⢠Stable occlusion with generalized gingivitis – Gingivitis with stable occlusion is managed primarily by plaque control, not occlusal therapy.SYNOPSIS
⢠Occlusal therapy (occlusal adjustment, splinting, bite guards) is indicated when occlusal forces contribute to periodontal tissue injury, known as trauma from occlusion.
⢠Increasing mobility, fremitus, widened PDL space, and discomfort on chewing are classic signs where occlusal therapy is beneficial.
⢠Thus, occlusal therapy is most clearly indicated in increasing mobility caused by traumatic occlusal forces.REFERENCE
Carranzaās Clinical Periodontology, 13th EditionIncorrect
ANSWER
Increasing tooth mobility due to trauma from occlusionOTHER OPTIONS
⢠Bruxism without periodontal involvement – Bruxism alone requires occlusal splints but does not always mandate occlusal adjustment unless periodontal damage is evident.
⢠An extruded molar without functional interference – An extruded molar requires occlusal therapy only if it causes functional interference or traumatic occlusion.
⢠Stable occlusion with generalized gingivitis – Gingivitis with stable occlusion is managed primarily by plaque control, not occlusal therapy.SYNOPSIS
⢠Occlusal therapy (occlusal adjustment, splinting, bite guards) is indicated when occlusal forces contribute to periodontal tissue injury, known as trauma from occlusion.
⢠Increasing mobility, fremitus, widened PDL space, and discomfort on chewing are classic signs where occlusal therapy is beneficial.
⢠Thus, occlusal therapy is most clearly indicated in increasing mobility caused by traumatic occlusal forces.REFERENCE
Carranzaās Clinical Periodontology, 13th Edition -
Question 19 of 150
19. Question
A 35-year-old patient is planned for periodontal surgical therapy. Clinical examination reveals adequate ridge height and thick keratinized gingiva in the surgical area. The dentist decides to place a crestal incision rather than a mucogingival flap. What is the primary advantage of using a crestal incision in this situation?
Correct
ANSWER
Decreased postoperative edema and discomfortOTHER OPTIONS
⢠Less tissue reflection – Less tissue reflection is not the primary advantage; reflection depends on flap design and extent.
⢠Increased apical displacement of gingiva – Apical displacement is a feature of apically positioned flaps, not crestal incisions.SYNOPSIS
⢠A crestal incision is placed within the keratinized gingiva and avoids crossing the mucogingival junction.
⢠Because the flap remains confined to attached gingiva
– Surgical trauma is minimized
– Blood supply is better preserved
– Postoperative edema, pain, and patient discomfort are reducedREFERENCES
Carranzaās Clinical Periodontology, 13th EditionIncorrect
ANSWER
Decreased postoperative edema and discomfortOTHER OPTIONS
⢠Less tissue reflection – Less tissue reflection is not the primary advantage; reflection depends on flap design and extent.
⢠Increased apical displacement of gingiva – Apical displacement is a feature of apically positioned flaps, not crestal incisions.SYNOPSIS
⢠A crestal incision is placed within the keratinized gingiva and avoids crossing the mucogingival junction.
⢠Because the flap remains confined to attached gingiva
– Surgical trauma is minimized
– Blood supply is better preserved
– Postoperative edema, pain, and patient discomfort are reducedREFERENCES
Carranzaās Clinical Periodontology, 13th Edition -
Question 20 of 150
20. Question
A 28-year-old PhD student reports with a fractured maxillary central incisor following trauma. The tooth is deemed non-restorable. The patient requests speedy management, has a high smile line, and is very self-conscious about esthetics. Clinical and radiographic examination reveals intact socket walls, adequate bone volume, and healthy surrounding soft tissues. What is the most appropriate management in this case?
Correct
ANSWER
Extraction with immediate implant placementOTHER OPTIONS
⢠Socket preservation – It delays final rehabilitation and may compromise soft-tissue esthetics.
⢠Removable denture – Poor esthetics and unacceptable for a self-conscious patient.
⢠Early implant placement – It requires healing time (4ā8 weeks), delaying esthetic rehabilitation.SYNOPSIS
⢠In the esthetic zone, especially in patients with a high smile line, preservation of soft tissue contours and papillae is critical.
⢠Immediate implant placement
– Reduces overall treatment time
– Preserves alveolar bone height and gingival architecture
– Avoids the need for removable interim prosthesis
– Provides superior esthetic outcomes when case selection is ideal
⢠This option best fulfills the patientās demands for
– Speed
– Esthetics
– Psychological comfortREFERENCES
Carranzaās Clinical Periodontology, 13th EditionIncorrect
ANSWER
Extraction with immediate implant placementOTHER OPTIONS
⢠Socket preservation – It delays final rehabilitation and may compromise soft-tissue esthetics.
⢠Removable denture – Poor esthetics and unacceptable for a self-conscious patient.
⢠Early implant placement – It requires healing time (4ā8 weeks), delaying esthetic rehabilitation.SYNOPSIS
⢠In the esthetic zone, especially in patients with a high smile line, preservation of soft tissue contours and papillae is critical.
⢠Immediate implant placement
– Reduces overall treatment time
– Preserves alveolar bone height and gingival architecture
– Avoids the need for removable interim prosthesis
– Provides superior esthetic outcomes when case selection is ideal
⢠This option best fulfills the patientās demands for
– Speed
– Esthetics
– Psychological comfortREFERENCES
Carranzaās Clinical Periodontology, 13th Edition -
Question 21 of 150
21. Question
Which principle does ensure that professionals have a duty to be fair in their dealings with patients?
Correct
ANSWER
JusticeOTHER OPTIONS
⢠Nonmaleficence – Considered to be the foundation of social morality. Actions of the healthcare provider should not harm the patients in anyway
⢠Autonomy – It is the principle that dictates that health care professionals respects patients right to make decisions concerning the treatment plan.
⢠Veracity- The patient – doctor relationship is based on trust.SYNOPSIS
⢠Justice provide equal treatment to all without any prejudice
⢠Violation of justice – Discrimination between patients based on caste, creed, socioeconomic status, health condition .
⢠Principle of justice is to protect the weak and to ensure equality in rights and benefits, for both groups and individuals.REFERENCE
Textbook of community dentistry Soben peterIncorrect
ANSWER
JusticeOTHER OPTIONS
⢠Nonmaleficence – Considered to be the foundation of social morality. Actions of the healthcare provider should not harm the patients in anyway
⢠Autonomy – It is the principle that dictates that health care professionals respects patients right to make decisions concerning the treatment plan.
⢠Veracity- The patient – doctor relationship is based on trust.SYNOPSIS
⢠Justice provide equal treatment to all without any prejudice
⢠Violation of justice – Discrimination between patients based on caste, creed, socioeconomic status, health condition .
⢠Principle of justice is to protect the weak and to ensure equality in rights and benefits, for both groups and individuals.REFERENCE
Textbook of community dentistry Soben peter -
Question 22 of 150
22. Question
A patient came to your clinic after some days of initiating fixed orthodontic treatment. Patient had pain amd ulcer on right upper buccal mucosa due to protruding arch wire. What should you do?
Correct
ANSWER
Clipping the wireOTHER OPTIONS
Not applicableSYNOPSIS
⢠Thin wire called archwire runs through brackets that are attached to teeth.
⢠Sometimes, archwires can pop out of place.
⢠Archwires can be broken or protruded due to many reasons like hard or sticky foods, mechanical injuries etc.
⢠Protruded arch wires can cause discomfort, ulcer and even infection.
⢠Clinically, protruding archwires are clipped.REFERENCE
Article on What to do If Braces Wires Broke.Incorrect
ANSWER
Clipping the wireOTHER OPTIONS
Not applicableSYNOPSIS
⢠Thin wire called archwire runs through brackets that are attached to teeth.
⢠Sometimes, archwires can pop out of place.
⢠Archwires can be broken or protruded due to many reasons like hard or sticky foods, mechanical injuries etc.
⢠Protruded arch wires can cause discomfort, ulcer and even infection.
⢠Clinically, protruding archwires are clipped.REFERENCE
Article on What to do If Braces Wires Broke. -
Question 23 of 150
23. Question
Developmental defect in which stage of tooth development is responsible for formation of peg laterals?
Correct
ANSWER
MorphodifferentiationOTHER OPTIONS
⢠Initiation – Supernumerary tooth and congenitally missing tooth develops due to defect in initiation.
⢠Apposition – Enamel hypoplasia develops due to disturbances during apposition.
⢠Histodifferentiation – Dentinogenesis imperfecta and amelogenesis imperfecta develops due to disturbances during histodifferentiation.SYNOPSIS
⢠In morphodifferentiation stage, formative cells are arranged to outline the form and size of tooth.
⢠Morphologic pattern of tooth becomes established when inner epithelium epithelium is arranged so that boundary between it and odontoblasts outlines duture DEJ.
⢠Disturbances during this stage results in peg laterals, microdontia and macrodontia.REFERENCE
Article on Development and Morphology of Teeth.Incorrect
ANSWER
MorphodifferentiationOTHER OPTIONS
⢠Initiation – Supernumerary tooth and congenitally missing tooth develops due to defect in initiation.
⢠Apposition – Enamel hypoplasia develops due to disturbances during apposition.
⢠Histodifferentiation – Dentinogenesis imperfecta and amelogenesis imperfecta develops due to disturbances during histodifferentiation.SYNOPSIS
⢠In morphodifferentiation stage, formative cells are arranged to outline the form and size of tooth.
⢠Morphologic pattern of tooth becomes established when inner epithelium epithelium is arranged so that boundary between it and odontoblasts outlines duture DEJ.
⢠Disturbances during this stage results in peg laterals, microdontia and macrodontia.REFERENCE
Article on Development and Morphology of Teeth. -
Question 24 of 150
24. Question
You extracted a tooth which is decayed for so long without any restoration. A dental student wants to use it for preclinical purposes. How will you sterilize the tooth to store for educational settings?
Correct
ANSWER
Autoclave for 40 minOTHER OPTIONS
⢠10 percent formalin for 2 weeks – Extracted tooth with amalgam restoration is sterilized by storing in formalin for 2 weeks.
⢠Sodium hypochlorite and Saline – Sodium hypochlorite, water or saline can be used but is not effective in reducing bacterial accumulation during storage.SYNOPSIS
⢠Extracted teeth are collected to be used in dental education settings.
⢠Extracted teeth is placed in container with secure lid to prevent leakage during transport.
⢠Teeth without amalgam restoration should be heat sterilized for safe handling.
⢠Pantera and Shuster demonstrated elimination of microbial growth using autoclave for 40 minutes.REFERENCE
Article on Safe Handling of Extracted teeth.Incorrect
ANSWER
Autoclave for 40 minOTHER OPTIONS
⢠10 percent formalin for 2 weeks – Extracted tooth with amalgam restoration is sterilized by storing in formalin for 2 weeks.
⢠Sodium hypochlorite and Saline – Sodium hypochlorite, water or saline can be used but is not effective in reducing bacterial accumulation during storage.SYNOPSIS
⢠Extracted teeth are collected to be used in dental education settings.
⢠Extracted teeth is placed in container with secure lid to prevent leakage during transport.
⢠Teeth without amalgam restoration should be heat sterilized for safe handling.
⢠Pantera and Shuster demonstrated elimination of microbial growth using autoclave for 40 minutes.REFERENCE
Article on Safe Handling of Extracted teeth. -
Question 25 of 150
25. Question
A patient with a dental implant came to your clinic for removing calculus. Which type of scaler will you prefer when scaling around titanium implants?
Correct
ANSWER
Plastic scalerOTHER OPTIONS
Not applicableSYNOPSIS
⢠All metal instruments and ultrasonic scalers increase the surface roughness of titanium.
⢠Use of plastic, teflon coated and carbon coated scalers and nonmetal ultrasonic tips are advocated for scaling titanium implant from contamination by other metals and reduce scratching the surface.REFERENCE
Newman and Carranza’s Clinical Periodontology – 13th Edition Page No 864.Incorrect
ANSWER
Plastic scalerOTHER OPTIONS
Not applicableSYNOPSIS
⢠All metal instruments and ultrasonic scalers increase the surface roughness of titanium.
⢠Use of plastic, teflon coated and carbon coated scalers and nonmetal ultrasonic tips are advocated for scaling titanium implant from contamination by other metals and reduce scratching the surface.REFERENCE
Newman and Carranza’s Clinical Periodontology – 13th Edition Page No 864. -
Question 26 of 150
26. Question
How does pencillin inhibits bacterial growth?
Correct
ANSWER
Inhibits synthesis of cell wall proteoglycanOTHER OPTIONS
Not applicableSYNOPSIS
⢠Penicillin is a narrow spectrum antibiotic.
⢠It is effective against some gram positive bacteria.
⢠It kills bacteria by blocking transpeptidase which in turn inhibits cell wall proteoglycan formation.
⢠Commonly used in pneumonia, ear infections, strep throat, otitis media etc.REFERENCE
Essentials of Pharmacology for Dentistry, KD Tripathi – 3rd Edition.Incorrect
ANSWER
Inhibits synthesis of cell wall proteoglycanOTHER OPTIONS
Not applicableSYNOPSIS
⢠Penicillin is a narrow spectrum antibiotic.
⢠It is effective against some gram positive bacteria.
⢠It kills bacteria by blocking transpeptidase which in turn inhibits cell wall proteoglycan formation.
⢠Commonly used in pneumonia, ear infections, strep throat, otitis media etc.REFERENCE
Essentials of Pharmacology for Dentistry, KD Tripathi – 3rd Edition. -
Question 27 of 150
27. Question
A patient came to your clinic for some treatment. While oral examination, you noticed a metallic sound on percussion of tooth 21, which otherwise looked normal. Patient had a history of trauma 10 years back. What type of trauma to permanent tooth is mainly responsible for this sound?
Correct
ANSWER
AvulsionOTHER OPTIONS
⢠Extrusion and Root fracture – Extrusion and root fracture rarely cause ankylosis.
⢠Intrusion – Intrusion, if left untreated can cause ankylosis.SYNOPSIS
⢠Ankylosis or external replacement resorption is resposible for the metallic sound on percussion followed by trauma.
⢠Mainly caused by replantation of avulsed teeth.
⢠In ankylosis, the root structure is replaced by bone.
⢠Extraction of ankylosed tooth is considered to be very difficult an might need surgical approach.REFERENCE
Grossman’s Endodontic Practise – 13th Edition Page No 139.Incorrect
ANSWER
AvulsionOTHER OPTIONS
⢠Extrusion and Root fracture – Extrusion and root fracture rarely cause ankylosis.
⢠Intrusion – Intrusion, if left untreated can cause ankylosis.SYNOPSIS
⢠Ankylosis or external replacement resorption is resposible for the metallic sound on percussion followed by trauma.
⢠Mainly caused by replantation of avulsed teeth.
⢠In ankylosis, the root structure is replaced by bone.
⢠Extraction of ankylosed tooth is considered to be very difficult an might need surgical approach.REFERENCE
Grossman’s Endodontic Practise – 13th Edition Page No 139. -
Question 28 of 150
28. Question
Which among the following is radiographic appearance seen commonly in paget’s disease?
Correct
ANSWER
Cotton wool appearanceOTHER OPTIONS
⢠Orange peel appearance – Monostotic fibrous dyplasia is radiographically has a orange peel appearance.
⢠Soap bubble appearance – Ameloblastoma shows soap bubble or honey comb appearance.
⢠Sunburst appearance – Osteosarcoma shows sunburst appearance radiographically.SYNOPSIS
⢠Paget’s disease is a chronic progressive disease of bone.
⢠Usually seen after 50 years of age.
⢠Affected bones show expansion and deformity.
⢠Mainly causes frontal bossing, headache, parasthesia, blindness, hearing loss and facial nerve palsy.
⢠Radiographically shows a cotton wool appearance.
⢠No specific treatment is done.REFERENCE
Shafer’s Textbook of Oral pathology – 8th Edition Page No 470.Incorrect
ANSWER
Cotton wool appearanceOTHER OPTIONS
⢠Orange peel appearance – Monostotic fibrous dyplasia is radiographically has a orange peel appearance.
⢠Soap bubble appearance – Ameloblastoma shows soap bubble or honey comb appearance.
⢠Sunburst appearance – Osteosarcoma shows sunburst appearance radiographically.SYNOPSIS
⢠Paget’s disease is a chronic progressive disease of bone.
⢠Usually seen after 50 years of age.
⢠Affected bones show expansion and deformity.
⢠Mainly causes frontal bossing, headache, parasthesia, blindness, hearing loss and facial nerve palsy.
⢠Radiographically shows a cotton wool appearance.
⢠No specific treatment is done.REFERENCE
Shafer’s Textbook of Oral pathology – 8th Edition Page No 470. -
Question 29 of 150
29. Question
A patient in your dental clinic develops discomfort and warmth after receiving local anesthesia. On examination, blood pressure is 100-75 mmHg. The patient also reports being on arthritis medication (likely long-term corticosteroids). What condition does this most likely represent?
Correct
ANSWER
Adrenal crisisOTHER OPTIONS
ā Hyperglycemia – Symptoms are polyuria, polydipsia not sudden hypotension.
ā Adrenal insufficiency – Chronic form, acute emergency is adrenal crisis.
ā Hyperthyroidism – It causes tachycardia, anxiety, and hypertension not hypotension.SYNOPSIS
ā If the patient is on long-term steroid therapy for arthritis (e.g., prednisolone), their adrenal gland may be suppressed.
ā Stress from dental treatment can lead to acute adrenal crisis.,
ā Hypotension is the earliest and most important sign.
– BP 100-75 mmHg is low for a stressed state.
– Warm or weak feeling and discomfort further support a circulatory collapse picture.
ā Patients on long-term steroids need stress dose steroid supplementation before major dental procedures to prevent adrenal crisis.REFERENCE
Medical Emergencies in the Dental Office – Stanley F Malamed 7th EditionIncorrect
ANSWER
Adrenal crisisOTHER OPTIONS
ā Hyperglycemia – Symptoms are polyuria, polydipsia not sudden hypotension.
ā Adrenal insufficiency – Chronic form, acute emergency is adrenal crisis.
ā Hyperthyroidism – It causes tachycardia, anxiety, and hypertension not hypotension.SYNOPSIS
ā If the patient is on long-term steroid therapy for arthritis (e.g., prednisolone), their adrenal gland may be suppressed.
ā Stress from dental treatment can lead to acute adrenal crisis.,
ā Hypotension is the earliest and most important sign.
– BP 100-75 mmHg is low for a stressed state.
– Warm or weak feeling and discomfort further support a circulatory collapse picture.
ā Patients on long-term steroids need stress dose steroid supplementation before major dental procedures to prevent adrenal crisis.REFERENCE
Medical Emergencies in the Dental Office – Stanley F Malamed 7th Edition -
Question 30 of 150
30. Question
A 32-year-old female patient reports to your clinic with a grossly decayed, non-restorable mandibular first molar (46) indicated for extraction. She gives a medical history of Crohnās disease and reports a positive ANA profile.
What is the most appropriate management during dental extraction?Correct
ANSWER
Double the dose of steroids on day of extractionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Patients with Crohnās disease are commonly on long-term corticosteroid therapy.
⢠Chronic steroid use can cause suppression of the hypothalamicāpituitaryāadrenal (HPA) axis.
⢠Dental extraction of a grossly decayed molar is considered a minorāmoderate surgical stress.
⢠In patients on long-term steroids, failure to provide stress-dose steroid supplementation may precipitate acute adrenal insufficiency (Addisonian crisis).
⢠Therefore, the recommended protocol is to Double the usual daily dose of steroids on the day of extraction, then return to the normal dose the following day.REFERENCE
Article on Potentional Relationship between the Dosage of Prednisolone and Delayed Healing at Tooth Extraction.Incorrect
ANSWER
Double the dose of steroids on day of extractionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Patients with Crohnās disease are commonly on long-term corticosteroid therapy.
⢠Chronic steroid use can cause suppression of the hypothalamicāpituitaryāadrenal (HPA) axis.
⢠Dental extraction of a grossly decayed molar is considered a minorāmoderate surgical stress.
⢠In patients on long-term steroids, failure to provide stress-dose steroid supplementation may precipitate acute adrenal insufficiency (Addisonian crisis).
⢠Therefore, the recommended protocol is to Double the usual daily dose of steroids on the day of extraction, then return to the normal dose the following day.REFERENCE
Article on Potentional Relationship between the Dosage of Prednisolone and Delayed Healing at Tooth Extraction. -
Question 31 of 150
31. Question
A 25-year-old patient undergoing tooth extraction suddenly becomes pale, sweaty, and complains of dizziness before losing consciousness. His pulse is weak and slow, and blood pressure drops. What is the most likely cause?
Correct
ANSWER
Vasovagal SyncopeOTHER OPTIONS
⢠Hyperglycemia – It can occur as a complication after extraction if the extraction site is prone to infection.
⢠LA overdose – Confusion, dizziness, tinnitus, and perioral numbness which may progress to seizures, respiratory arrest, or coma.SYNOPSIS
⢠Syncope is the most common emergency in dental practices.
⢠Psychogenic factors seem to play an important role in provoking syncope.
⢠Many individuals faint (vasovagal response) at the sight of a needle, the removal of a bandage, or even the discussion of a surgical procedure.
⢠Key signs are Pallor, sweating, nausea, bradycardia, hypotension, and loss of consciousness
⢠Placing the patient in a supine reclined position with raised legs in combination with the administration of oxygen seems effective for regaining consciousness.REFERENCE
Medical emergencies in the Dental Office – Stanley F MalamedIncorrect
ANSWER
Vasovagal SyncopeOTHER OPTIONS
⢠Hyperglycemia – It can occur as a complication after extraction if the extraction site is prone to infection.
⢠LA overdose – Confusion, dizziness, tinnitus, and perioral numbness which may progress to seizures, respiratory arrest, or coma.SYNOPSIS
⢠Syncope is the most common emergency in dental practices.
⢠Psychogenic factors seem to play an important role in provoking syncope.
⢠Many individuals faint (vasovagal response) at the sight of a needle, the removal of a bandage, or even the discussion of a surgical procedure.
⢠Key signs are Pallor, sweating, nausea, bradycardia, hypotension, and loss of consciousness
⢠Placing the patient in a supine reclined position with raised legs in combination with the administration of oxygen seems effective for regaining consciousness.REFERENCE
Medical emergencies in the Dental Office – Stanley F Malamed -
Question 32 of 150
32. Question
In how many days does established gingivitis occur?
Correct
ANSWER
21 daysOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Gingivitis Development Timeline (Löe et al. study)
⢠Initial lesion – 2-4 days
Subclinical inflammation (not visible yet)
⢠Early lesion – 4-7 days
Clinical signs begin (redness, bleeding)
⢠Established lesion – 14-21 days
Clear gingival inflammation, edema, bleeding, possibly pseudopocket formationREFERENCE
Carranza’s Clinical Periodontology (13th ed.)Incorrect
ANSWER
21 daysOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Gingivitis Development Timeline (Löe et al. study)
⢠Initial lesion – 2-4 days
Subclinical inflammation (not visible yet)
⢠Early lesion – 4-7 days
Clinical signs begin (redness, bleeding)
⢠Established lesion – 14-21 days
Clear gingival inflammation, edema, bleeding, possibly pseudopocket formationREFERENCE
Carranza’s Clinical Periodontology (13th ed.) -
Question 33 of 150
33. Question
At which age parent should go to the orthodontist for consultation?
Correct
ANSWER
When permanent centrals erupt.OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The American Association of Orthodontists (AAO) recommends an evaluation with an orthodontist no later than age 7.
⢠By that age, a child will have a mix of baby and permanent teeth, and the orthodontist will be able to recognize orthodontic problems (malocclusions) even in their earliest stages.
⢠The best age varies from patient to patient.REFERENCE
Early Treatment for Malocclusion-Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & William F. Hohlt DDS – Orthodontics-October 27, 2020.Incorrect
ANSWER
When permanent centrals erupt.OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The American Association of Orthodontists (AAO) recommends an evaluation with an orthodontist no later than age 7.
⢠By that age, a child will have a mix of baby and permanent teeth, and the orthodontist will be able to recognize orthodontic problems (malocclusions) even in their earliest stages.
⢠The best age varies from patient to patient.REFERENCE
Early Treatment for Malocclusion-Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & William F. Hohlt DDS – Orthodontics-October 27, 2020. -
Question 34 of 150
34. Question
Type 1 hypersensitivity reaction is mediated predominantly by?
Correct
ANSWER
IgE antibodiesOTHER OPTIONS
⢠IgG or IgM antibodies – Type II is caused by cytotoxic reaction mediated by IgG or IgM antibodies.
⢠Immune complex mediated – Type III is reaction mediated by immune complexes.
⢠Cell mediated – Type IV is delayed reaction mediated by cellular response.SYNOPSIS
⢠Hypersensitivity is immune and inflammatory responses that are harmful to the host.
⢠Type 1 hypersensitivity is IgE mediated.
⢠Antigen induces cross linking of IgE bound to mast cells and basophils with release of vasoactive mediators.
⢠It occurs immediately after contact with allergens or antigens.
⢠Response to the antigen occurs in two stages – the sensitization and the effect stage.
⢠In the sensitization stage, the host experiences an asymptomatic contact with the antigen.
⢠Subsequently, in the effect period, the pre-sensitized host is reintroduced to the antigen, which then leads to a type I anaphylactic or atopic immune response.
⢠Typical manifestations include systemic anaphylaxis, localized anaphylaxis such as hay fever, asthma, hives, food allergies and eczema.REFERENCE
Type I Hypersensitivity Reaction by National Library of Medicine.Incorrect
ANSWER
IgE antibodiesOTHER OPTIONS
⢠IgG or IgM antibodies – Type II is caused by cytotoxic reaction mediated by IgG or IgM antibodies.
⢠Immune complex mediated – Type III is reaction mediated by immune complexes.
⢠Cell mediated – Type IV is delayed reaction mediated by cellular response.SYNOPSIS
⢠Hypersensitivity is immune and inflammatory responses that are harmful to the host.
⢠Type 1 hypersensitivity is IgE mediated.
⢠Antigen induces cross linking of IgE bound to mast cells and basophils with release of vasoactive mediators.
⢠It occurs immediately after contact with allergens or antigens.
⢠Response to the antigen occurs in two stages – the sensitization and the effect stage.
⢠In the sensitization stage, the host experiences an asymptomatic contact with the antigen.
⢠Subsequently, in the effect period, the pre-sensitized host is reintroduced to the antigen, which then leads to a type I anaphylactic or atopic immune response.
⢠Typical manifestations include systemic anaphylaxis, localized anaphylaxis such as hay fever, asthma, hives, food allergies and eczema.REFERENCE
Type I Hypersensitivity Reaction by National Library of Medicine. -
Question 35 of 150
35. Question
An 8-year-old child presented with retained lower left central incisor and gives a history of trauma few years back on the lower chin region. Radiographic examination shows dentoalveolar ankylosis of the deciduous left central incisor. What will be the cause of ankylosis?
Correct
ANSWER
Replacement resorptionOTHER OPTIONS
⢠Internal resorption – Internal resorption isĀ an uncommon resorption of the tooth, which starts from the root canal and destroys the surrounding tooth structure.Ā
⢠External resorption – External root resorption isĀ when the body’s own immune system dissolves the tooth root structure. It can occur following tooth infection, orthodontic treatments or in the presence of unerupted teeth in the jaw.
⢠Inflammatory resorption – Inflammatory resorption isĀ one of the potential consequences of trauma to the teeth. It occurs when there has been a loss ofĀ cementumĀ due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria.SYNOPSIS
⢠Replacement Resorption is characterized by a pathologic loss of tooth substance (cementum, dentin, and PDL) with subsequent replacement of these tissues by bone, which results in the fusion of the root to the surrounding bone(ankylosis).
⢠It is usually a late complication of after trauma and is asymptomatic.
⢠A tooth undergoing external replacement resorption is ankylotic and gives metallic sound to percussion with a mirror handleREFERENCE
External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors – a review and case presentation – Dental TraumatologyIncorrect
ANSWER
Replacement resorptionOTHER OPTIONS
⢠Internal resorption – Internal resorption isĀ an uncommon resorption of the tooth, which starts from the root canal and destroys the surrounding tooth structure.Ā
⢠External resorption – External root resorption isĀ when the body’s own immune system dissolves the tooth root structure. It can occur following tooth infection, orthodontic treatments or in the presence of unerupted teeth in the jaw.
⢠Inflammatory resorption – Inflammatory resorption isĀ one of the potential consequences of trauma to the teeth. It occurs when there has been a loss ofĀ cementumĀ due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria.SYNOPSIS
⢠Replacement Resorption is characterized by a pathologic loss of tooth substance (cementum, dentin, and PDL) with subsequent replacement of these tissues by bone, which results in the fusion of the root to the surrounding bone(ankylosis).
⢠It is usually a late complication of after trauma and is asymptomatic.
⢠A tooth undergoing external replacement resorption is ankylotic and gives metallic sound to percussion with a mirror handleREFERENCE
External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors – a review and case presentation – Dental Traumatology -
Question 36 of 150
36. Question
A CD patient visited your clinic complaints of loss of retention of upper denture. On examination there are bubbles coming from the post palatal seal area while pressing denture in midpalatal area. Borders from other area are fine with proper resistance. What would be the reason?
Correct
ANSWER
Under extended post damOTHER OPTIONS
⢠Increased vertical dimension – Increased vertical dimension cause, TMJ pain, muscle pain, and clicking of posterior teeth.
⢠Over extended post dam – Overextended post dam causes gagging reflux and dislodging of denture.SYNOPSIS
⢠Under post-damming is usually caused by the inaccurate depth of post-damming and improper application of the technique in obtaining PPS
⢠Recording PPS with a widely opened mouth causes tautness of the pterygomandibular fold, which leads to the spacing between the denture base and tissue when the fold is no longer activated.
⢠It can be diagnosed using two tests
1. When the denture is inserted in the patient’s mouth, examine the presence of space in the posterior border of the denture base when the patient is saying ‘ah’
2. Check for the presence of bubbles escaping when the wet denture base is placed and pressed in the midpalate regionREFERENCE
The Post Dam – A Review – Indian Journal of DentistryIncorrect
ANSWER
Under extended post damOTHER OPTIONS
⢠Increased vertical dimension – Increased vertical dimension cause, TMJ pain, muscle pain, and clicking of posterior teeth.
⢠Over extended post dam – Overextended post dam causes gagging reflux and dislodging of denture.SYNOPSIS
⢠Under post-damming is usually caused by the inaccurate depth of post-damming and improper application of the technique in obtaining PPS
⢠Recording PPS with a widely opened mouth causes tautness of the pterygomandibular fold, which leads to the spacing between the denture base and tissue when the fold is no longer activated.
⢠It can be diagnosed using two tests
1. When the denture is inserted in the patient’s mouth, examine the presence of space in the posterior border of the denture base when the patient is saying ‘ah’
2. Check for the presence of bubbles escaping when the wet denture base is placed and pressed in the midpalate regionREFERENCE
The Post Dam – A Review – Indian Journal of Dentistry -
Question 37 of 150
37. Question
A patient with a newly delivered removable partial denture (RPD) returns complaining that it feels unstable during chewing.What is the most likely cause?
Correct
ANSWER
Passive claspOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠A passive clasp does not engage the undercut properly, reducing retention and allowing for movement. This is a common reason for instability in RPDs.REFERENCE
Stewart’s Clinical Removable Partial Prosthodontics, 5th ed.Incorrect
ANSWER
Passive claspOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠A passive clasp does not engage the undercut properly, reducing retention and allowing for movement. This is a common reason for instability in RPDs.REFERENCE
Stewart’s Clinical Removable Partial Prosthodontics, 5th ed. -
Question 38 of 150
38. Question
A 28-year-old male with known inflammatory bowel disease (IBD) presents with painful snail-track ulcers on the soft palate. These lesions are erythematous with central ulceration and pseudomembrane formation.
What is the best treatment approach for his oral lesions?Correct
ANSWER
Systemic steroidsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠IBD-associated oral lesions (like snail-track ulcers in ulcerative colitis) are immune-mediated and may require systemic immunosuppression.
⢠Systemic steroids are the treatment of choice in moderate to severe cases.REFERENCE
Scully C. Oral and Maxillofacial Medicine, 3rd ed.Incorrect
ANSWER
Systemic steroidsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠IBD-associated oral lesions (like snail-track ulcers in ulcerative colitis) are immune-mediated and may require systemic immunosuppression.
⢠Systemic steroids are the treatment of choice in moderate to severe cases.REFERENCE
Scully C. Oral and Maxillofacial Medicine, 3rd ed. -
Question 39 of 150
39. Question
Which muscle is present in the capsule of TMJ?
Correct
ANSWER
Lateral PterygoidOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The superior head of the lateral pterygoid inserts into the articular disc and capsule of the TMJ and plays a role in disc stabilization during movement.REFERENCE
Okeson JP. Management of Temporomandibular Disorders and Occlusion, 8th ed.Incorrect
ANSWER
Lateral PterygoidOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The superior head of the lateral pterygoid inserts into the articular disc and capsule of the TMJ and plays a role in disc stabilization during movement.REFERENCE
Okeson JP. Management of Temporomandibular Disorders and Occlusion, 8th ed. -
Question 40 of 150
40. Question
A known diabetic woman becomes dizzy and shows signs of near-syncope while seated during treatment.
What is the first step in management?Correct
ANSWER
Place her in supine position with elevated legsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠This is likely a hypoglycemic episode or vasovagal syncope.
⢠The initial management is to increase cerebral perfusion by positioning her supine with legs elevatedREFERENCE
Malamed SF. Medical Emergencies in the Dental Office, 7th ed.Incorrect
ANSWER
Place her in supine position with elevated legsOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠This is likely a hypoglycemic episode or vasovagal syncope.
⢠The initial management is to increase cerebral perfusion by positioning her supine with legs elevatedREFERENCE
Malamed SF. Medical Emergencies in the Dental Office, 7th ed. -
Question 41 of 150
41. Question
A healthy 12-week-old exclusively breastfed infant is brought in for a routine pediatric visit. The parents live in an area where the fluoride content in drinking water is below 0.3 ppm. They ask whether they should give their baby any fluoride supplements.What is the most appropriate recommendation?
Correct
ANSWER
No fluoride supplementation is needed until 6 monthsOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Fluoride supplementation is not recommended for infants under 6 months of age, regardless of fluoride content in drinking water.
⢠For children 6 months to 3 years living in areas with less than 0.3 ppm fluoride, the AAP and ADA recommend 0.25 mg per day.
⢠Before 6 months, the risk of fluorosis outweighs the benefits, and systemic supplements are not beneficial.REFERENCE
American Academy of Pediatrics (AAP) ā Fluoride Use in Caries Prevention in the Primary Care Setting, Pediatrics 2014.Incorrect
ANSWER
No fluoride supplementation is needed until 6 monthsOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Fluoride supplementation is not recommended for infants under 6 months of age, regardless of fluoride content in drinking water.
⢠For children 6 months to 3 years living in areas with less than 0.3 ppm fluoride, the AAP and ADA recommend 0.25 mg per day.
⢠Before 6 months, the risk of fluorosis outweighs the benefits, and systemic supplements are not beneficial.REFERENCE
American Academy of Pediatrics (AAP) ā Fluoride Use in Caries Prevention in the Primary Care Setting, Pediatrics 2014. -
Question 42 of 150
42. Question
An 11-year-old patient presents with an ankylosed primary molar. Clinical examination shows infraocclusion of the affected tooth. Given the absence of a periodontal ligament (PDL) in ankylosed teeth, how does the rate of periodontal pocket formation compare to normal teeth?
Correct
ANSWER
True periodontal pocket will not formOTHER OPTIONS
⢠Faster than normal – Pocket formation is dependent on periodontal ligament detachment, which is absent in ankylosed teeth.
⢠Slower than normal – There is no true periodontal attachment to detach from, so a pocket cannot form at any rate.
⢠Both at the same rate – True periodontal pockets form in teeth with a periodontal ligament; since ankylosed teeth lack this, the rate is not comparable.SYNOPSIS
⢠Ankylosed teeth are characterized by the fusion of the cementum or dentin directly to the alveolar bone, leading to the absence of a functional periodontal ligament (PDL)
⢠Lack of PDL – No normal periodontal attachment
⢠No normal bone resorption and remodeling – These teeth remain fixed in position while adjacent teeth continue to erupt, leading to infra occlusion
⢠Since the periodontal ligament is absent, true periodontal pockets do not form, as pockets require detachment of the gingival fibers from the root surface.REFERENCE
Carranza FA, Newman MG. Carranzaās Clinical Periodontology, 13th ed. Elsevier, 2018.Incorrect
ANSWER
True periodontal pocket will not formOTHER OPTIONS
⢠Faster than normal – Pocket formation is dependent on periodontal ligament detachment, which is absent in ankylosed teeth.
⢠Slower than normal – There is no true periodontal attachment to detach from, so a pocket cannot form at any rate.
⢠Both at the same rate – True periodontal pockets form in teeth with a periodontal ligament; since ankylosed teeth lack this, the rate is not comparable.SYNOPSIS
⢠Ankylosed teeth are characterized by the fusion of the cementum or dentin directly to the alveolar bone, leading to the absence of a functional periodontal ligament (PDL)
⢠Lack of PDL – No normal periodontal attachment
⢠No normal bone resorption and remodeling – These teeth remain fixed in position while adjacent teeth continue to erupt, leading to infra occlusion
⢠Since the periodontal ligament is absent, true periodontal pockets do not form, as pockets require detachment of the gingival fibers from the root surface.REFERENCE
Carranza FA, Newman MG. Carranzaās Clinical Periodontology, 13th ed. Elsevier, 2018. -
Question 43 of 150
43. Question
A 38-year-old HIV-positive male presents to your dental clinic with a white, non-removable, corrugated lesion on the lateral border of the tongue. He reports no pain or discomfort. His most recent CD4 count is 180 cells/mm³, and he is not currently on antiretroviral therapy.
What is the most appropriate next step in management?Correct
ANSWER
Refer the patient to an oral medicine specialist for further evaluationOTHER OPTIONS
⢠Reassure the patient that the lesion is benign and no treatment is required – Reassurance without further evaluation is not ideal due to the systemic implications.
⢠Prescribe antifungal medication and review in two weeks – HIV is viral infection.SYNOPSIS
⢠The lesion described is characteristic of oral hairy leukoplakia (OHL), which commonly appears on the lateral tongue and is strongly associated with Epstein-Barr Virus (EBV) in immunocompromised patients, especially those with HIV/AIDS.
⢠OHL is not premalignant, but its presence may indicate HIV disease progression or poor immune function
⢠It does not typically require biopsy if the clinical diagnosis is clear, but a referral to a specialist is appropriate for confirmation, monitoring, and coordination of HIV care.REFERENCE
Wilkinsā Clinical Practice of the Dental Hygienist, 13th Edition (2020). Chapter on oral manifestations of systemic disease.Incorrect
ANSWER
Refer the patient to an oral medicine specialist for further evaluationOTHER OPTIONS
⢠Reassure the patient that the lesion is benign and no treatment is required – Reassurance without further evaluation is not ideal due to the systemic implications.
⢠Prescribe antifungal medication and review in two weeks – HIV is viral infection.SYNOPSIS
⢠The lesion described is characteristic of oral hairy leukoplakia (OHL), which commonly appears on the lateral tongue and is strongly associated with Epstein-Barr Virus (EBV) in immunocompromised patients, especially those with HIV/AIDS.
⢠OHL is not premalignant, but its presence may indicate HIV disease progression or poor immune function
⢠It does not typically require biopsy if the clinical diagnosis is clear, but a referral to a specialist is appropriate for confirmation, monitoring, and coordination of HIV care.REFERENCE
Wilkinsā Clinical Practice of the Dental Hygienist, 13th Edition (2020). Chapter on oral manifestations of systemic disease. -
Question 44 of 150
44. Question
A blue-gray discoloration of teeth, accompanied by translucent or opalescent dentin. The enamel is prone to chipping, resulting in a characteristic appearance. What is the most likely diagnosis?
Correct
ANSWER
Dentinogenesis imperfectaOTHER OPTIONS
⢠Amelogenesis Imperfecta – It is usually characterized byĀ smaller than normal teeth, the color of which may range from white to yellow-brown, and teeth that appear to be mottled or spotted. The enamel is thinner than normal with areas that are clearly less dense (hypomineralized) and pitted.
⢠Enamel hypoplasia – It can appear asĀ a white spot, yellow to brown staining, pits, grooves, or even thin, chipped, or missing parts of enamel.
⢠Hypocalcification – Enamel hypocalcification is the presence of white, brown or yellow stains on teeth and opaqueness on the tooth enamel.SYNOPSIS
⢠Dentinogenesis imperfecta is a condition characterized by teeth that are translucent and discolored (most often blue-grey or yellow-brown in color).
⢠Individuals with this disorder tend to have teeth that are weaker than normal, which leads to wear, breakage, and loss of teeth.
⢠This damage can include teeth fractures or small holes (pitting) in the enamel.
⢠Dentinogenesis imperfecta can affect both primary (baby) teeth and permanent teeth.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
Dentinogenesis imperfectaOTHER OPTIONS
⢠Amelogenesis Imperfecta – It is usually characterized byĀ smaller than normal teeth, the color of which may range from white to yellow-brown, and teeth that appear to be mottled or spotted. The enamel is thinner than normal with areas that are clearly less dense (hypomineralized) and pitted.
⢠Enamel hypoplasia – It can appear asĀ a white spot, yellow to brown staining, pits, grooves, or even thin, chipped, or missing parts of enamel.
⢠Hypocalcification – Enamel hypocalcification is the presence of white, brown or yellow stains on teeth and opaqueness on the tooth enamel.SYNOPSIS
⢠Dentinogenesis imperfecta is a condition characterized by teeth that are translucent and discolored (most often blue-grey or yellow-brown in color).
⢠Individuals with this disorder tend to have teeth that are weaker than normal, which leads to wear, breakage, and loss of teeth.
⢠This damage can include teeth fractures or small holes (pitting) in the enamel.
⢠Dentinogenesis imperfecta can affect both primary (baby) teeth and permanent teeth.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 45 of 150
45. Question
A 35-year-old patient presents with a painless swelling in the lower jaw that has been slowly enlarging over the past year. The patient reports no significant medical history and denies any trauma to the area. On clinical examination, there is a firm, non-tender mass in the posterior mandible. Radiographic examination reveals a multilocular radiolucent lesion with a soap bubble appearance. Fine-needle aspiration biopsy reveals clusters of epithelial cells with reverse polarity and stellate reticulum-like areas. Based on these findings, what is the most likely diagnosis?
Correct
ANSWER
AmeloblastomaOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Ameloblastoma is a benign but locally aggressive odontogenic tumor that commonly occurs in the mandible.
⢠The classic radiographic appearance is a multilocular radiolucent lesion with a soap bubble or honeycomb appearance.
⢠Histopathologically, ameloblastomas show epithelial cells with reverse polarity and stellate reticulum-like areas, which are characteristic findings.
⢠Treatment typically involves surgical resection due to the tumor’s potential for local recurrence.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
AmeloblastomaOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Ameloblastoma is a benign but locally aggressive odontogenic tumor that commonly occurs in the mandible.
⢠The classic radiographic appearance is a multilocular radiolucent lesion with a soap bubble or honeycomb appearance.
⢠Histopathologically, ameloblastomas show epithelial cells with reverse polarity and stellate reticulum-like areas, which are characteristic findings.
⢠Treatment typically involves surgical resection due to the tumor’s potential for local recurrence.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 46 of 150
46. Question
Which one of the following instruments is used to create palatal posterior seal in cast?
Correct
ANSWER
Kingsley scraperOTHER OPTIONS
⢠Lecron carverĀ – LeCron carver is popular for the carving of inlay wax in the production of crowns. This carver is used cold to shape modeling wax in the production of dentures.
⢠Small wax knife – A small wax knife is most commonly used in the fabrication of crowns for placing and carving inlay wax.
⢠Large wax knife Used for melting, placing, and carving modeling wax in the production of dentures.SYNOPSIS
⢠Techniques for recording PPS
1. Conventional technique.
2. Fluid wax technique.
3. Arbitrary scrapping of the mastercast.
⢠Using a Kingsley scraper, the area between the anterior and posterior vibrating line is scraped in the master cast to a depth of 1 to 1.5 mm on either side of the mid-palatine raphe. In the region of the mid-palatine raphe, it should be only 0.5 to 1mm in depth.REFERENCE
Boucher, Prosthodontic Treatment for Edentulous Patients, pg 118-120Incorrect
ANSWER
Kingsley scraperOTHER OPTIONS
⢠Lecron carverĀ – LeCron carver is popular for the carving of inlay wax in the production of crowns. This carver is used cold to shape modeling wax in the production of dentures.
⢠Small wax knife – A small wax knife is most commonly used in the fabrication of crowns for placing and carving inlay wax.
⢠Large wax knife Used for melting, placing, and carving modeling wax in the production of dentures.SYNOPSIS
⢠Techniques for recording PPS
1. Conventional technique.
2. Fluid wax technique.
3. Arbitrary scrapping of the mastercast.
⢠Using a Kingsley scraper, the area between the anterior and posterior vibrating line is scraped in the master cast to a depth of 1 to 1.5 mm on either side of the mid-palatine raphe. In the region of the mid-palatine raphe, it should be only 0.5 to 1mm in depth.REFERENCE
Boucher, Prosthodontic Treatment for Edentulous Patients, pg 118-120 -
Question 47 of 150
47. Question
What is the best parameter for detecting the severity of periodontitis?
Correct
ANSWER
Attachment level or Attachment lossOTHER OPTIONS
⢠NILSYNOPSIS
⢠The severity of the disease is based on the amount of clinical attachment loss (CAL).
⢠It is described as
– Mild when the CAL is 1 to 2 mm,
– Moderate the CAL is 3 to 4 mm, or
– Severe when the CAL is more than 5 mmREFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
Attachment level or Attachment lossOTHER OPTIONS
⢠NILSYNOPSIS
⢠The severity of the disease is based on the amount of clinical attachment loss (CAL).
⢠It is described as
– Mild when the CAL is 1 to 2 mm,
– Moderate the CAL is 3 to 4 mm, or
– Severe when the CAL is more than 5 mmREFERENCE
Carranza’s Clinical Periodontology -
Question 48 of 150
48. Question
A patient presented with mild to moderate pain in relation to root canal treated tooth on the next day. On examination tooth is tender to percussion. Radiographic examination shows no relevent findings. What will you do?
Correct
ANSWER
Pain will resolve on its ownOTHER OPTIONS
⢠NILSYNOPSIS
⢠After completion of root canal treatment, patients usually complain of pain, especially on biting and chewing.
⢠More postoperative discomfort is encountered in endodontic treatment of posterior teeth.
⢠Etiology
– Overinstrumentation
– Persistent periapical inflammation
– Overfilling
– Missed canal
– Hyperocclusion
– Poor coronal seal
– Fracture of crown or root
⢠Management
– Generally, there is some discomfort following obturation that subsides in 2-5 days.
– Pain that persists beyond this period should make the operator reassess the treatment performedREFERENCE
Grossman’s Endodontic Practice-14th.ed.Incorrect
ANSWER
Pain will resolve on its ownOTHER OPTIONS
⢠NILSYNOPSIS
⢠After completion of root canal treatment, patients usually complain of pain, especially on biting and chewing.
⢠More postoperative discomfort is encountered in endodontic treatment of posterior teeth.
⢠Etiology
– Overinstrumentation
– Persistent periapical inflammation
– Overfilling
– Missed canal
– Hyperocclusion
– Poor coronal seal
– Fracture of crown or root
⢠Management
– Generally, there is some discomfort following obturation that subsides in 2-5 days.
– Pain that persists beyond this period should make the operator reassess the treatment performedREFERENCE
Grossman’s Endodontic Practice-14th.ed. -
Question 49 of 150
49. Question
A 35-year-old male presents with painless cervical lymphadenopathy, fever, night sweats, and weight loss. A lymph node biopsy is performed, and Reed-Sternberg cells are identified on histopathological examination. Which of the following conditions is most likely associated with these findings?
Correct
ANSWER
Hodgkinās lymphomaOTHER OPTIONS
⢠Non-Hodgkinās lymphoma – NHL does not characteristically show Reed-Sternberg cells.
⢠Burkittās lymphoma – It is associated with Epstein-Barr virus (EBV) and presents with aggressive jaw involvement in endemic cases.
⢠Multiple myeloma involves plasma cells and does not exhibit Reed-Sternberg cells.SYNOPSIS
⢠Reed-Sternberg (RS) cells are large binucleated or multinucleated cells with prominent nucleoli, classically seen in Hodgkinās lymphoma (HL).
⢠HL typically presents with painless lymphadenopathy, fever, weight loss, and night sweats.REFERENCE
Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease. 10th ed. Elsevier; 2020.Incorrect
ANSWER
Hodgkinās lymphomaOTHER OPTIONS
⢠Non-Hodgkinās lymphoma – NHL does not characteristically show Reed-Sternberg cells.
⢠Burkittās lymphoma – It is associated with Epstein-Barr virus (EBV) and presents with aggressive jaw involvement in endemic cases.
⢠Multiple myeloma involves plasma cells and does not exhibit Reed-Sternberg cells.SYNOPSIS
⢠Reed-Sternberg (RS) cells are large binucleated or multinucleated cells with prominent nucleoli, classically seen in Hodgkinās lymphoma (HL).
⢠HL typically presents with painless lymphadenopathy, fever, weight loss, and night sweats.REFERENCE
Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease. 10th ed. Elsevier; 2020. -
Question 50 of 150
50. Question
A 5-year-old child weighing 20 kg requires local anesthesia for a restorative dental procedure. The dentist plans to use 2% Lidocaine with 1:100,000 epinephrine.What is the maximum number of cartridges that can be safely administered to this child?
Correct
ANSWER
2OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠MRD of Lidocaine for children = 4.4 mg/kg
⢠For a 20 kg child – 20Ć4.4=88Ā mgĀ
⢠2% Lidocaine = 20 mg/mL
⢠Each cartridge (1.8 mL) contains, 20Ć1.8=36Ā mgĀ ofĀ Lidocaine
⢠No of catridge = 88/36 = 2.4 catridgesREFERENCE
Malamed SF. Handbook of Local Anesthesia. 7th ed. Elsevier; 2020.Incorrect
ANSWER
2OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠MRD of Lidocaine for children = 4.4 mg/kg
⢠For a 20 kg child – 20Ć4.4=88Ā mgĀ
⢠2% Lidocaine = 20 mg/mL
⢠Each cartridge (1.8 mL) contains, 20Ć1.8=36Ā mgĀ ofĀ Lidocaine
⢠No of catridge = 88/36 = 2.4 catridgesREFERENCE
Malamed SF. Handbook of Local Anesthesia. 7th ed. Elsevier; 2020. -
Question 51 of 150
51. Question
A 45-year-old male presents with tooth mobility, wear facets, and localized gingival recession. He reports pain on biting and sensitivity in certain teeth. Clinical examination reveals premature contacts and fremitus in the anterior region. Radiographic evaluation shows widening of the periodontal ligament (PDL) space without significant bone loss.When does an occlusion become traumatic?
Correct
ANSWER
When there is excessive force on a tooth exceeding its adaptive capacityOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Traumatic occlusion occurs when excessive occlusal forces exceed the toothās adaptive capacity, leading to damage to the periodontium.
⢠Primary occlusal trauma occurs when excessive force is applied to a tooth with a normal periodontium.
⢠Secondary occlusal trauma occurs when normal occlusal forces cause damage due to a weakened periodontium (e.g., due to periodontitis).
⢠Clinical Signs of Traumatic Occlusion:
Increased tooth mobility
Widening of the PDL space
Fremitus (vibration of teeth during occlusion)
Tooth migration and abfraction lesionsREFERENCE
Carranza FA, Newman MG. Carranzaās Clinical Periodontology. 13th ed.Incorrect
ANSWER
When there is excessive force on a tooth exceeding its adaptive capacityOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Traumatic occlusion occurs when excessive occlusal forces exceed the toothās adaptive capacity, leading to damage to the periodontium.
⢠Primary occlusal trauma occurs when excessive force is applied to a tooth with a normal periodontium.
⢠Secondary occlusal trauma occurs when normal occlusal forces cause damage due to a weakened periodontium (e.g., due to periodontitis).
⢠Clinical Signs of Traumatic Occlusion:
Increased tooth mobility
Widening of the PDL space
Fremitus (vibration of teeth during occlusion)
Tooth migration and abfraction lesionsREFERENCE
Carranza FA, Newman MG. Carranzaās Clinical Periodontology. 13th ed. -
Question 52 of 150
52. Question
A 14-year-old male presents with a long face, increased lower facial height, and open bite. Clinical examination reveals
– Steep mandibular plane angle
– Increased anterior facial height
– Posterior teeth overeruption
– Skeletal Class II malocclusion with clockwise mandibular rotation
The orthodontist decides to use an appliance to control vertical growth and improve mandibular positioning.Which appliance is most suitable for managing this patientās hyperdivergent mandible?Correct
ANSWER
High pull headgearOTHER OPTIONS
⢠Twin Block appliance – Twin Block Appliance is used for Class II malocclusion correction but does not effectively control vertical growth.
⢠Herbst appliance – Herbst Appliance is primarily used to advance the mandible in Class II cases but does not control vertical facial height.
⢠Frankel II Appliance – It is a functional regulator for Class II malocclusion, but it does not specifically address vertical growth control.SYNOPSIS
⢠Hyperdivergent mandible (skeletal open bite) is characterized by excessive vertical growth of the face, often due to overeruption of molars and clockwise rotation of the mandible.
⢠The goal of treatment is to control vertical maxillary growth, restrict molar eruption, and reduce mandibular clockwise rotation.
⢠High-Pull Headgear applies an upward and backward force on the maxilla, limiting downward growth and controlling the occlusal plane.REFERENCE
Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary Orthodontics. 6th ed. Elsevier; 2018.Incorrect
ANSWER
High pull headgearOTHER OPTIONS
⢠Twin Block appliance – Twin Block Appliance is used for Class II malocclusion correction but does not effectively control vertical growth.
⢠Herbst appliance – Herbst Appliance is primarily used to advance the mandible in Class II cases but does not control vertical facial height.
⢠Frankel II Appliance – It is a functional regulator for Class II malocclusion, but it does not specifically address vertical growth control.SYNOPSIS
⢠Hyperdivergent mandible (skeletal open bite) is characterized by excessive vertical growth of the face, often due to overeruption of molars and clockwise rotation of the mandible.
⢠The goal of treatment is to control vertical maxillary growth, restrict molar eruption, and reduce mandibular clockwise rotation.
⢠High-Pull Headgear applies an upward and backward force on the maxilla, limiting downward growth and controlling the occlusal plane.REFERENCE
Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary Orthodontics. 6th ed. Elsevier; 2018. -
Question 53 of 150
53. Question
A patient came with pain on lower right molar. On examination you found a decayed 46. You advised RCT but the patient wants extraction. He reported that he is under heparin therapy. If you want to extract the tooth, heparin should be stopped before?
Correct
ANSWER
6 hoursOTHER OPTIONS
⢠NilSYNOPSIS
⢠Preoperatively, the heparin should be stopped 6 hours before the procedure.
⢠Postoperatively, the heparin can be restarted when the surgeon agrees it is safe, usually 6-12 hours postoperatively.REFERENCE
Preoperative Anticoagulation Management – MedscapeIncorrect
ANSWER
6 hoursOTHER OPTIONS
⢠NilSYNOPSIS
⢠Preoperatively, the heparin should be stopped 6 hours before the procedure.
⢠Postoperatively, the heparin can be restarted when the surgeon agrees it is safe, usually 6-12 hours postoperatively.REFERENCE
Preoperative Anticoagulation Management – Medscape -
Question 54 of 150
54. Question
A 50-year-old patient presents with a swollen, red tongue and reports difficulty in swallowing (dysphagia). The patient’s medical history reveals a vegan diet for the past 10 years. What is the most likely diagnosis for these symptoms?
Correct
ANSWER
Vit B12 deficiencyOTHER OPTIONS
⢠Geographic tongue – Geographic Tongue is characterized by map-like, red patches on the tongue with white borders, but it typically does not cause significant swelling or difficulty in swallowing.
⢠Candidiasis – Oral Thrush (candidiasis) presents as white, creamy plaques that can be scraped off, often accompanied by soreness, but not typically a swollen, red tongue with dysphagia.
⢠Herpetic gingivostomatitis – Herpetic Stomatitis is caused by herpes simplex virus and presents with multiple painful vesicles and ulcers in the oral cavity, not specifically with glossitis and dysphagia.SYNOPSIS
⢠Glossitis (inflammation of the tongue) accompanied by dysphagia can be indicative of a nutritional deficiency, particularly Vitamin B12 deficiency.
⢠This condition is common in individuals following a strict vegan diet, as Vitamin B12 is primarily found in animal products.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
Vit B12 deficiencyOTHER OPTIONS
⢠Geographic tongue – Geographic Tongue is characterized by map-like, red patches on the tongue with white borders, but it typically does not cause significant swelling or difficulty in swallowing.
⢠Candidiasis – Oral Thrush (candidiasis) presents as white, creamy plaques that can be scraped off, often accompanied by soreness, but not typically a swollen, red tongue with dysphagia.
⢠Herpetic gingivostomatitis – Herpetic Stomatitis is caused by herpes simplex virus and presents with multiple painful vesicles and ulcers in the oral cavity, not specifically with glossitis and dysphagia.SYNOPSIS
⢠Glossitis (inflammation of the tongue) accompanied by dysphagia can be indicative of a nutritional deficiency, particularly Vitamin B12 deficiency.
⢠This condition is common in individuals following a strict vegan diet, as Vitamin B12 is primarily found in animal products.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 55 of 150
55. Question
A 4 years old patient visits your hospital after bicycle accident. In clinical examination you found the primary tooth intruded into the permanent follicle. What is the effect it will cause to permanent tooth?
Correct
ANSWER
Turner’s hypoplasiaOTHER OPTIONS
⢠Dens in dente – A condition resulting from invagination of the inner enamel epithelium producing the appearance of a tooth within a tooth.
⢠Dens evagenatus – Describes an outfolding of the enamel organ that results in an extra cusp, usually in the central groove or ridge of posterior teeth and in the cingulum area of the anterior teeth, sometimes called a talon cusp.
⢠Ankylosis – Fusion of tooth to boneSYNOPSIS
⢠Trauma to the primary teeth may progress to cellulitis, and may result in aborted development or enamel hypoplasia of the succedaneous tooth.
⢠Enamel hypoplasia or hypomineralization can be generalized throughout the dentition or it can be localized.
⢠Enamel development, or amelogenesis, is an exquisitely regulated process at the molecular level but can be disrupted by many environmental factors, such as fever, infection, trauma, changes in oxygen saturation, antibiotics, and many other factors.
⢠Trauma leads to hypomineralization to marked enamel hypoplasia, which manifests as blue-gray to yellow-brown color.
⢠The altered tooth is called Turner’s tooth.REFERENCE
Pediatric dentistry Arthur.J.Nowak PageIncorrect
ANSWER
Turner’s hypoplasiaOTHER OPTIONS
⢠Dens in dente – A condition resulting from invagination of the inner enamel epithelium producing the appearance of a tooth within a tooth.
⢠Dens evagenatus – Describes an outfolding of the enamel organ that results in an extra cusp, usually in the central groove or ridge of posterior teeth and in the cingulum area of the anterior teeth, sometimes called a talon cusp.
⢠Ankylosis – Fusion of tooth to boneSYNOPSIS
⢠Trauma to the primary teeth may progress to cellulitis, and may result in aborted development or enamel hypoplasia of the succedaneous tooth.
⢠Enamel hypoplasia or hypomineralization can be generalized throughout the dentition or it can be localized.
⢠Enamel development, or amelogenesis, is an exquisitely regulated process at the molecular level but can be disrupted by many environmental factors, such as fever, infection, trauma, changes in oxygen saturation, antibiotics, and many other factors.
⢠Trauma leads to hypomineralization to marked enamel hypoplasia, which manifests as blue-gray to yellow-brown color.
⢠The altered tooth is called Turner’s tooth.REFERENCE
Pediatric dentistry Arthur.J.Nowak Page -
Question 56 of 150
56. Question
How to prevent rusting of burs occurs while autoclaving burs?
Correct
ANSWER
Put in 2 percent sodium nitrate in an open or perforated containerOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Autoclaving burs can cause rusting.
⢠Spraying or dipping instruments with solutions containing sodium nitrite decreases rust.
⢠Burs can be protected during autoclave by keeping them submerged in a small amount of 2 percent sodium nitrite solution, 1cm above the burs.REFERENCE
Decontamination Methods Used for Dental Burs – A Comparative StudyIncorrect
ANSWER
Put in 2 percent sodium nitrate in an open or perforated containerOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Autoclaving burs can cause rusting.
⢠Spraying or dipping instruments with solutions containing sodium nitrite decreases rust.
⢠Burs can be protected during autoclave by keeping them submerged in a small amount of 2 percent sodium nitrite solution, 1cm above the burs.REFERENCE
Decontamination Methods Used for Dental Burs – A Comparative Study -
Question 57 of 150
57. Question
A 45-year-old male patient with a history of a prosthetic heart valve took antibiotic prophylaxis (amoxicillin) before undergoing endodontic surgery. Shortly after taking the antibiotic, he develops a widespread rash, itching, and mild swelling. The patient appears anxious but is otherwise stable. What is the immediate first step in the management of this patient’s allergic reaction?
Correct
ANSWER
Administer intramuscular epinephrineOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Although the patientās reaction appears to be mild, it is prudent to treat any potential allergic reaction to antibiotics, especially in a patient with a prosthetic heart valve, as anaphylaxis can develop rapidly.
⢠Epinephrine is the first-line treatment for anaphylaxis and can prevent progression to a more severe reaction.
⢠After the administration of epinephrine additional management may be considered.
⢠H1 antihistamines (e.g., diphenhydramine) can help alleviate itching and rash. H2 antihistamines (e.g., ranitidine) can provide additional symptomatic relief. Corticosteroids (e.g., prednisone) can help prevent a biphasic allergic reaction.
⢠Continuous monitoring and supportive care are essential to ensure the patientās condition does not worsen.REFERENCE
Medical Emergencies in Dental Practice – Stanley F MalamedIncorrect
ANSWER
Administer intramuscular epinephrineOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Although the patientās reaction appears to be mild, it is prudent to treat any potential allergic reaction to antibiotics, especially in a patient with a prosthetic heart valve, as anaphylaxis can develop rapidly.
⢠Epinephrine is the first-line treatment for anaphylaxis and can prevent progression to a more severe reaction.
⢠After the administration of epinephrine additional management may be considered.
⢠H1 antihistamines (e.g., diphenhydramine) can help alleviate itching and rash. H2 antihistamines (e.g., ranitidine) can provide additional symptomatic relief. Corticosteroids (e.g., prednisone) can help prevent a biphasic allergic reaction.
⢠Continuous monitoring and supportive care are essential to ensure the patientās condition does not worsen.REFERENCE
Medical Emergencies in Dental Practice – Stanley F Malamed -
Question 58 of 150
58. Question
A 55-year-old male patient presents to the dental clinic complaining of loose teeth and difficulty chewing. On clinical examination, several teeth exhibit varying degrees of mobility. According to Miller’s classification, what defines a tooth with Grade 2 mobility?
Correct
ANSWER
Movement greater than 1 mm horizontallyOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Grade 0 – No physiological mobility.
⢠Grade 1 – Slight mobility of less than 1mm horizontally.
⢠Grade 2 – Movement of more than 1mm in the horizontal direction.
⢠Grade 3 – More than 1mm mobility in the horizontal and vertical direction.REFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
Movement greater than 1 mm horizontallyOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Grade 0 – No physiological mobility.
⢠Grade 1 – Slight mobility of less than 1mm horizontally.
⢠Grade 2 – Movement of more than 1mm in the horizontal direction.
⢠Grade 3 – More than 1mm mobility in the horizontal and vertical direction.REFERENCE
Carranza’s Clinical Periodontology -
Question 59 of 150
59. Question
A 5 year old child ingested around half bottle of fluoride containing mouthwash. What is the best method to immediately treat acute fluoride toxicity?
Correct
ANSWER
Give milkOTHER OPTIONS
Not applicableSYNOPSIS
⢠Accidental ingestion of excessive amounts of fluoride containing products can lead to acute or chronic toxicity.
⢠Acute toxicity can cause a sudden onset of nausea, abdominal pain, vomiting, diarrhea, cytotoxic effects, hyperkalemia, seizures and multiple organ failure.
⢠Treatment includes inducing vomiting, give 1 percent calcium chloride or tolerated levels of milk orally and inform emergency department.REFERENCE
Pediatric Dentistry Infancy through Adolescence – 6th Edition Page No 292.Incorrect
ANSWER
Give milkOTHER OPTIONS
Not applicableSYNOPSIS
⢠Accidental ingestion of excessive amounts of fluoride containing products can lead to acute or chronic toxicity.
⢠Acute toxicity can cause a sudden onset of nausea, abdominal pain, vomiting, diarrhea, cytotoxic effects, hyperkalemia, seizures and multiple organ failure.
⢠Treatment includes inducing vomiting, give 1 percent calcium chloride or tolerated levels of milk orally and inform emergency department.REFERENCE
Pediatric Dentistry Infancy through Adolescence – 6th Edition Page No 292. -
Question 60 of 150
60. Question
A patient came with a slow growing rubbery painless swelling in front of his ear on right side. Swelling is related to superficial lobe of pleomorphic adenoma. Which tumour can be this most probably?
Correct
ANSWER
Pleomorphic adenomaOTHER OPTIONS
⢠Warthin’s tumour – Warthin’s tumour is the second most frequent benign neoplasm of the salivary glands after pleomorphic adenoma.
⢠Adenoid cystic carcinoma – Adenoid cystic carcinoma is a malignant neoplasm affecting salivary gland manifested as early local pain, facial nerve paralysis, swelling with marked tendency to spread through perineural spaces.
⢠Mucoepidermoid carcinoma – Mucoepidermoid carcinoma is the most common malignant salivary gland tumor, accounting for 10-15 percent of all salivary gland tumors and one-third of all salivary gland malignancies.SYNOPSIS
⢠Pleomorphic adenoma is the most common salivary gland tumor, is also known as benign mixed tumors.
⢠It is the commonest of all salivary gland tumors constituting up to two-thirds of all salivary gland tumors.
⢠Pleomorphic adenoma mostly presents as a solitary mobile slow growing, painless mass, which may be present for many years.
⢠In the parotid gland, signs of facial nerve weakness occur when the tumor is large.
⢠Histology will reveal proliferation of myoepithelial and epithelial cells of the ducts.
⢠Presently pleomorphic adenoma of the parotid gland is treated either with superficial or total parotidectomy or excision.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 266.Incorrect
ANSWER
Pleomorphic adenomaOTHER OPTIONS
⢠Warthin’s tumour – Warthin’s tumour is the second most frequent benign neoplasm of the salivary glands after pleomorphic adenoma.
⢠Adenoid cystic carcinoma – Adenoid cystic carcinoma is a malignant neoplasm affecting salivary gland manifested as early local pain, facial nerve paralysis, swelling with marked tendency to spread through perineural spaces.
⢠Mucoepidermoid carcinoma – Mucoepidermoid carcinoma is the most common malignant salivary gland tumor, accounting for 10-15 percent of all salivary gland tumors and one-third of all salivary gland malignancies.SYNOPSIS
⢠Pleomorphic adenoma is the most common salivary gland tumor, is also known as benign mixed tumors.
⢠It is the commonest of all salivary gland tumors constituting up to two-thirds of all salivary gland tumors.
⢠Pleomorphic adenoma mostly presents as a solitary mobile slow growing, painless mass, which may be present for many years.
⢠In the parotid gland, signs of facial nerve weakness occur when the tumor is large.
⢠Histology will reveal proliferation of myoepithelial and epithelial cells of the ducts.
⢠Presently pleomorphic adenoma of the parotid gland is treated either with superficial or total parotidectomy or excision.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 266. -
Question 61 of 150
61. Question
What is the inter-arch height required to place an anterior implant?
Correct
ANSWER
9 mmOTHER OPTIONS
Not applicableSYNOPSIS
⢠A reduced interarch space can be treated by osteoplasty, selective grinding, root canal and crown of opposing tooth or by surgical reduction of tuberosities.
⢠Interarch space required for fixed implant in anterior region is around 8-10 mm and posterior region 7mm.
⢠Interarch space required for removable implant prosthesis in anterior region is around 12 mm and posterior region 12 mm.REFERENCE
Textbook of Prosthodontics, V Rangarajan – Page No 769.Incorrect
ANSWER
9 mmOTHER OPTIONS
Not applicableSYNOPSIS
⢠A reduced interarch space can be treated by osteoplasty, selective grinding, root canal and crown of opposing tooth or by surgical reduction of tuberosities.
⢠Interarch space required for fixed implant in anterior region is around 8-10 mm and posterior region 7mm.
⢠Interarch space required for removable implant prosthesis in anterior region is around 12 mm and posterior region 12 mm.REFERENCE
Textbook of Prosthodontics, V Rangarajan – Page No 769. -
Question 62 of 150
62. Question
A patient with pain localized with tooth 47. On examination you noticed a 7 mm deep pocket on buccal aspect. Tooth is RC treated and on further examination tooth appears to have good crown and obturation. What treatment will you prefer?
Correct
ANSWER
ExtractionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Vertical root fracture is longitudinal fractures that originate in roots of teeth and with few exceptions, these fractures occurs mostly in endodontically treated teeth.
⢠Characterized by dull, spontaneous pain, tooth mobility, bony radiolucencies.
⢠Tooth becomes hopeless after vertical root fracture and hence extraction is treatment of choice.
⢠In multirooted teeth, hemisection can be done.REFERENCE
Grossman’s Endodontic Practise – 13th Edition Page No 152.Incorrect
ANSWER
ExtractionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Vertical root fracture is longitudinal fractures that originate in roots of teeth and with few exceptions, these fractures occurs mostly in endodontically treated teeth.
⢠Characterized by dull, spontaneous pain, tooth mobility, bony radiolucencies.
⢠Tooth becomes hopeless after vertical root fracture and hence extraction is treatment of choice.
⢠In multirooted teeth, hemisection can be done.REFERENCE
Grossman’s Endodontic Practise – 13th Edition Page No 152. -
Question 63 of 150
63. Question
Which type of bone graft is used for a two-walled defect?
Correct
ANSWER
Cortical decalcified freeze dried bone graftOTHER OPTIONS
⢠Explained belowSYNOPSIS
⢠If the defect is lined by only two walls of bone, the defect is a two-wall defect.
⢠Cortical decalcified freeze-dried bone allograft is used for 2 walled osseous defects
⢠Cortical bone contains pure cortex-dense bone, hence it is used for weight or force-bearing areas
⢠Freeze drying decreases antigenicity and facilitates long-term storage
⢠Decalcifying improves osteostimulatory properties
⢠Cancellous bone provides more open spaces for faster revascularisation, but it lacks mechanical strength, particularly when used for non-weight or non-force-bearing areasREFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
Cortical decalcified freeze dried bone graftOTHER OPTIONS
⢠Explained belowSYNOPSIS
⢠If the defect is lined by only two walls of bone, the defect is a two-wall defect.
⢠Cortical decalcified freeze-dried bone allograft is used for 2 walled osseous defects
⢠Cortical bone contains pure cortex-dense bone, hence it is used for weight or force-bearing areas
⢠Freeze drying decreases antigenicity and facilitates long-term storage
⢠Decalcifying improves osteostimulatory properties
⢠Cancellous bone provides more open spaces for faster revascularisation, but it lacks mechanical strength, particularly when used for non-weight or non-force-bearing areasREFERENCE
Carranza’s Clinical Periodontology -
Question 64 of 150
64. Question
Which among the following has a high rate of recurrence?
Correct
ANSWER
OKCOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of the dental lamina.
⢠It can occur anywhere in the jaw but is commonly seen in the posterior part of the mandible.
⢠Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for a radicular or lateral periodontal cyst.
⢠The exact reason for the high recurrence rate of OKC has not been established, it is thought to be due to incomplete removal of the primary lesion with thin epithelial lining, the presence of satellite cysts, and epithelial remnants.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
OKCOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of the dental lamina.
⢠It can occur anywhere in the jaw but is commonly seen in the posterior part of the mandible.
⢠Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for a radicular or lateral periodontal cyst.
⢠The exact reason for the high recurrence rate of OKC has not been established, it is thought to be due to incomplete removal of the primary lesion with thin epithelial lining, the presence of satellite cysts, and epithelial remnants.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 65 of 150
65. Question
A patient reported to dentist with complaint of severe pain. On examination its found a tooth with severe periradicular pain and necrotic pulp. On radiographic examination the findings are broken lamina dura and a circumscribed radiolucency of long duration. The periradicular diagnosis is?
Correct
ANSWER
Acute exacerbation of chronic apical periodontitisĀOTHER OPTIONS
⢠NilSYNOPSIS
⢠An acute exacerbation of a chronic periapical lesion is called phoenix abscess.
⢠It is a dental abscess that can occur immediately following root canal treatment.
⢠Another cause is due to untreated necrotic pulp (chronic apical periodontitis).
⢠It is also the result of inadequate debridement during the endodontic procedure.
⢠Risk of occurrence of a phoenix abscess is minimized by correct identification and instrumentation of the entire root canal ensuring no missed anatomy.
⢠Clinical Features
– Pain Loss of Vitality
– Tender to Touch
– Mobility.
⢠Radiographically there will be a periapical lesion associated with the tooth.
⢠This lesion is normally existent prior to this episode.
⢠Widened periodontal ligament (PDL) space is visible.
⢠For most situations urgent treatment is required to eliminate the pain and swelling.REFERENCE
Grossman’s Endodontic practiceIncorrect
ANSWER
Acute exacerbation of chronic apical periodontitisĀOTHER OPTIONS
⢠NilSYNOPSIS
⢠An acute exacerbation of a chronic periapical lesion is called phoenix abscess.
⢠It is a dental abscess that can occur immediately following root canal treatment.
⢠Another cause is due to untreated necrotic pulp (chronic apical periodontitis).
⢠It is also the result of inadequate debridement during the endodontic procedure.
⢠Risk of occurrence of a phoenix abscess is minimized by correct identification and instrumentation of the entire root canal ensuring no missed anatomy.
⢠Clinical Features
– Pain Loss of Vitality
– Tender to Touch
– Mobility.
⢠Radiographically there will be a periapical lesion associated with the tooth.
⢠This lesion is normally existent prior to this episode.
⢠Widened periodontal ligament (PDL) space is visible.
⢠For most situations urgent treatment is required to eliminate the pain and swelling.REFERENCE
Grossman’s Endodontic practice -
Question 66 of 150
66. Question
A 26-year-old pregnant lady came to your clinic with a chief complaint of pain in relation to the lower right back tooth. On examination, there was a deep carious lesion on 46. You decided to do RCT for the patient. What is the best local anesthesia for pregnant women in the second trimester?
Correct
ANSWER
LidocaineOTHER OPTIONS
⢠NilSYNOPSIS
⢠The second trimester is weeks 14 through 27 in terms of gestational age. The risk of the teratogenic effects of drugs is lower during this period than during the first trimester.
⢠Elective dental treatment has been reported to be relatively safe during this period.
⢠Anesthesia is safer to perform in pregnant women for non-obstetric surgery in the second trimester than in the first or third trimester.Ā
⢠Lidocaine with adrenaline is considered safe in pregnancy.
⢠Vasoconstrictors, mostly epinephrine, are added to lidocaine to reduce the absorption of the local anesthetic, reduce toxicity, and increase the analgesic effects.
⢠Vasoconstriction induced by epinephrine delays the absorption of local anesthetics by the mother, allowing the absorption of lidocaine to gradually occur in the maternal systemic circulation, while also allowing blood levels of lidocaine to gradually increase. The local anesthetic is transferred to the fetus slowly, and its margin of safety is also increased.REFERENCE
Use of local anesthetics for dental treatment during pregnancy, safety for parturient -Journal of Dental Anesthesia and Pain MedicineIncorrect
ANSWER
LidocaineOTHER OPTIONS
⢠NilSYNOPSIS
⢠The second trimester is weeks 14 through 27 in terms of gestational age. The risk of the teratogenic effects of drugs is lower during this period than during the first trimester.
⢠Elective dental treatment has been reported to be relatively safe during this period.
⢠Anesthesia is safer to perform in pregnant women for non-obstetric surgery in the second trimester than in the first or third trimester.Ā
⢠Lidocaine with adrenaline is considered safe in pregnancy.
⢠Vasoconstrictors, mostly epinephrine, are added to lidocaine to reduce the absorption of the local anesthetic, reduce toxicity, and increase the analgesic effects.
⢠Vasoconstriction induced by epinephrine delays the absorption of local anesthetics by the mother, allowing the absorption of lidocaine to gradually occur in the maternal systemic circulation, while also allowing blood levels of lidocaine to gradually increase. The local anesthetic is transferred to the fetus slowly, and its margin of safety is also increased.REFERENCE
Use of local anesthetics for dental treatment during pregnancy, safety for parturient -Journal of Dental Anesthesia and Pain Medicine -
Question 67 of 150
67. Question
A patient presents with persistent discomfort around an endodontically treated tooth (36). Radiographs show a halo-like radiolucency extending from the apical area to the furcation. What is the most likely diagnosis?
Correct
ANSWER
Vertical root fractureOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The radiographic halo appearance is a classic sign of a vertical root fracture (VRF).
⢠This fracture typically occurs in endodontically treated teeth due to excessive force during obturation or post-placement.
⢠Other signs include isolated deep periodontal pockets and persistent sinus tracts.REFERENCE
Cohen S, Hargreaves KM. Pathways of the Pulp – 11th edition, Elsevier, 2015.Incorrect
ANSWER
Vertical root fractureOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The radiographic halo appearance is a classic sign of a vertical root fracture (VRF).
⢠This fracture typically occurs in endodontically treated teeth due to excessive force during obturation or post-placement.
⢠Other signs include isolated deep periodontal pockets and persistent sinus tracts.REFERENCE
Cohen S, Hargreaves KM. Pathways of the Pulp – 11th edition, Elsevier, 2015. -
Question 68 of 150
68. Question
A patient presents with a fractured maxillary central incisor. The fracture extends subgingivally and involves the pulp chamber. What is the most significant factor that makes the prognosis poor?
Correct
ANSWER
Subgingival fracture extensionOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Subgingival fracture extension compromises the biological width and makes restorability difficult.
⢠It can lead to periodontal complications and poor aesthetics.
⢠Endodontic and restorative procedures may be challenging or impossible without crown lengthening or orthodontic extrusionREFERENCE
Andreasen JO, Andreasen FM. Textbook and Color Atlas of Traumatic Injuries to the Teeth. 4th Edition, Wiley-Blackwell, 2007.Incorrect
ANSWER
Subgingival fracture extensionOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Subgingival fracture extension compromises the biological width and makes restorability difficult.
⢠It can lead to periodontal complications and poor aesthetics.
⢠Endodontic and restorative procedures may be challenging or impossible without crown lengthening or orthodontic extrusionREFERENCE
Andreasen JO, Andreasen FM. Textbook and Color Atlas of Traumatic Injuries to the Teeth. 4th Edition, Wiley-Blackwell, 2007. -
Question 69 of 150
69. Question
A patient with HIV and a CD4 count of 150 cells/mm³ presents with oral ulcers unresponsive to topical steroids. What is the next best step?
Correct
ANSWER
Initiate systemic antifungal treatmentOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Patients with HIV are prone to fungal infections like oral candidiasis, which may not respond to topical steroids.
⢠Systemic antifungal treatment (e.g., fluconazole) is recommended in such cases.REFERENCE
Neville BW, Damm DD, Allen CM, Chi AC.Oral and Maxillofacial Pathology. 4th Edition, Elsevier, 2015.Incorrect
ANSWER
Initiate systemic antifungal treatmentOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Patients with HIV are prone to fungal infections like oral candidiasis, which may not respond to topical steroids.
⢠Systemic antifungal treatment (e.g., fluconazole) is recommended in such cases.REFERENCE
Neville BW, Damm DD, Allen CM, Chi AC.Oral and Maxillofacial Pathology. 4th Edition, Elsevier, 2015. -
Question 70 of 150
70. Question
A patient presents with a missing mandibular first molar (36) and a mesially tilted second molar (37). Why might a prosthetic replacement fail in the long term in this case?
Correct
ANSWER
Difficulty in achieving parallelismOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The mesial tilt of 37 can make it challenging to create parallel abutments for fixed prostheses, leading to improper load distribution and eventual failure.
⢠Orthodontic uprighting may be required before prosthetic placement.REFERENCE
Shillingburg HT. Fundamentals of Fixed Prosthodontics. 4th Edition, Quintessence Publishing, 2012.Incorrect
ANSWER
Difficulty in achieving parallelismOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The mesial tilt of 37 can make it challenging to create parallel abutments for fixed prostheses, leading to improper load distribution and eventual failure.
⢠Orthodontic uprighting may be required before prosthetic placement.REFERENCE
Shillingburg HT. Fundamentals of Fixed Prosthodontics. 4th Edition, Quintessence Publishing, 2012. -
Question 71 of 150
71. Question
A 50-year-old male patient presents to the clinic with complaints of fatigue, fever, and generalized lymphadenopathy. Blood tests reveal atypical lymphocytosis, and further serological testing confirms a recent Epstein-Barr Virus (EBV) infection. The clinician considers the potential EBV-associated diseases while reviewing the patient’s medical history and symptoms. Which of the following diseases is NOT associated with Epstein-Barr Virus (EBV)?
Correct
ANSWER
Kaposi SarcomaOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Kaposi sarcoma is always caused by an infection with a virus called human herpesvirus 8, which is also known as Kaposi sarcoma-associated herpesvirus (KSHV). The virus, which is in the same family as Epstein-Barr virus.
⢠Hodgkins lymphoma, Burkits lymphoma and Infectious mononucleosis are caused by EBV virus.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
Kaposi SarcomaOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Kaposi sarcoma is always caused by an infection with a virus called human herpesvirus 8, which is also known as Kaposi sarcoma-associated herpesvirus (KSHV). The virus, which is in the same family as Epstein-Barr virus.
⢠Hodgkins lymphoma, Burkits lymphoma and Infectious mononucleosis are caused by EBV virus.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 72 of 150
72. Question
A 4-year-old child presents to the pediatric dental clinic with a fever, irritability, and painful sores in the mouth. The parent reports that the child has not been eating well due to the pain. Upon examination, the dentist observes multiple small vesicles on the lips, gums, and inside the mouth in posterior pharyngeal area, some of which have ruptured to form ulcers. The child also has swollen, tender lymph nodes. What is the most likely diagnosis.
Correct
ANSWER
Primary herpetic gingivostomatitisOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The symptoms of fever, irritability, painful oral sores, and swollen lymph nodes are characteristic of primary herpetic gingivostomatitis, which is caused by the herpes simplex virus (HSV).
⢠HSV-1 is most commonly responsible for primary herpetic gingivostomatitis in children. HSV-2 is typically associated with genital infections.
⢠Management includes antiviral medication (such as acyclovir) to reduce the duration and severity of the infection, pain relief (analgesics or topical anesthetics), and ensuring the child stays hydrated, as oral intake can be challenging due to pain.REFERENCE
Shafer’s textbook of Oral PathologyIncorrect
ANSWER
Primary herpetic gingivostomatitisOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The symptoms of fever, irritability, painful oral sores, and swollen lymph nodes are characteristic of primary herpetic gingivostomatitis, which is caused by the herpes simplex virus (HSV).
⢠HSV-1 is most commonly responsible for primary herpetic gingivostomatitis in children. HSV-2 is typically associated with genital infections.
⢠Management includes antiviral medication (such as acyclovir) to reduce the duration and severity of the infection, pain relief (analgesics or topical anesthetics), and ensuring the child stays hydrated, as oral intake can be challenging due to pain.REFERENCE
Shafer’s textbook of Oral Pathology -
Question 73 of 150
73. Question
A 12-year-old child presents to the pediatric clinic with complaints of fever, malaise, and joint pain. The child’s parents report that the symptoms started about two weeks ago. A recent laboratory test shows a positive result for Streptococcus sanguinis. The child also exhibits signs of migratory arthritis, with inflammation and pain moving from one joint to another. An echocardiogram reveals a thickened mitral valve. What is the most likely diagnosis for the patient’s symptoms and findings?
Correct
ANSWER
Rheumatic feverOTHER OPTIONS
⢠SLE – Systemic lupus erythematosus can present with fever and arthritis but usually involves multiple organ systems and specific autoantibodies, which are not mentioned here.
⢠Infective endocarditis – Infective endocarditis can cause heart valve abnormalities and fever but is typically associated with a more severe systemic illness and not migratory arthritis.SYNOPSIS
⢠Rheumatic fever is an inflammatory disease that can develop after an infection with Streptococcus bacteria.
⢠It commonly presents with fever, malaise, joint pain (migratory arthritis), and carditis, which can lead to valvular heart disease, such as a thickened mitral valve.
⢠The Jones criteria for the diagnosis of rheumatic fever include major criteria such as carditis (evidenced by the thickened mitral valve) and polyarthritis (migratory joint pain), along with a positive streptococcal infection test.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
Rheumatic feverOTHER OPTIONS
⢠SLE – Systemic lupus erythematosus can present with fever and arthritis but usually involves multiple organ systems and specific autoantibodies, which are not mentioned here.
⢠Infective endocarditis – Infective endocarditis can cause heart valve abnormalities and fever but is typically associated with a more severe systemic illness and not migratory arthritis.SYNOPSIS
⢠Rheumatic fever is an inflammatory disease that can develop after an infection with Streptococcus bacteria.
⢠It commonly presents with fever, malaise, joint pain (migratory arthritis), and carditis, which can lead to valvular heart disease, such as a thickened mitral valve.
⢠The Jones criteria for the diagnosis of rheumatic fever include major criteria such as carditis (evidenced by the thickened mitral valve) and polyarthritis (migratory joint pain), along with a positive streptococcal infection test.REFERENCE
Shafer’s Textbook of Oral Pathology -
Question 74 of 150
74. Question
A 10-year-old patient presents with a deep overbite where the lower incisors are touching the palate and causing ulceration. The patient also has a leeway space discrepancy. Which removable appliance is most appropriate for managing the deep overbite and preventing palatal ulceration in this patient?
Correct
ANSWER
Anterior Bite planeOTHER OPTIONS
⢠Z-spring – A Z-spring is typically used for minor tooth movements, such as tipping or aligning individual teeth or single tooth crossbite. It is not designed to address deep overbites or prevent palatal trauma.
⢠Labial bow – A labial bow is a component of some removable appliances, used primarily for retention or minor tooth movement in the anterior segment. It is not sufficient alone to manage a deep overbite or prevent palatal ulceration.
⢠Hawley retainer – While it can include a bite plane feature, a standard Hawley retainer is primarily used for retention after orthodontic treatment and does not specifically address deep overbites or palatal trauma without modifications.SYNOPSIS
⢠A removable bite plane is designed to provide immediate relief from the deep overbite by preventing the lower incisors from contacting the palate.
⢠This helps to open the bite and reduce the risk of further palatal ulceration.
⢠It can be either anterior (fitted to the upper arch) or posterior (fitted to the lower arch), depending on the specific case requirements.REFERENCE
Removable Appliance – Orthodontics Art and Science SI BhalajiIncorrect
ANSWER
Anterior Bite planeOTHER OPTIONS
⢠Z-spring – A Z-spring is typically used for minor tooth movements, such as tipping or aligning individual teeth or single tooth crossbite. It is not designed to address deep overbites or prevent palatal trauma.
⢠Labial bow – A labial bow is a component of some removable appliances, used primarily for retention or minor tooth movement in the anterior segment. It is not sufficient alone to manage a deep overbite or prevent palatal ulceration.
⢠Hawley retainer – While it can include a bite plane feature, a standard Hawley retainer is primarily used for retention after orthodontic treatment and does not specifically address deep overbites or palatal trauma without modifications.SYNOPSIS
⢠A removable bite plane is designed to provide immediate relief from the deep overbite by preventing the lower incisors from contacting the palate.
⢠This helps to open the bite and reduce the risk of further palatal ulceration.
⢠It can be either anterior (fitted to the upper arch) or posterior (fitted to the lower arch), depending on the specific case requirements.REFERENCE
Removable Appliance – Orthodontics Art and Science SI Bhalaji -
Question 75 of 150
75. Question
A patient presents with gingival overgrowth and clinical attachment loss of 2 mm. The dentist needs to determine the next steps in managing the patient’s condition. What should be the next step in managing this patient?
Correct
ANSWER
Plaque controlOTHER OPTIONS
⢠Sensibility test – This test assesses the vitality of the tooth’s pulp and is typically used when symptoms suggest endodontic issues, not for initial management of periodontal conditions.
⢠Radiographs – Radiographs can be helpful to assess the extent of bone loss and other periodontal conditions. However, plaque control is a more immediate and fundamental step in managing the condition.
⢠Referral to periodontist – Referral to a periodontist may be necessary if the condition does not improve with initial management or if the case is complex. However, starting with plaque control is critical before considering a referral.SYNOPSIS
⢠Effective plaque control is essential in managing gingival overgrowth and attachment loss.
⢠It is the first step in periodontal treatment and helps in controlling the underlying cause of gingival overgrowth and attachment loss.
⢠Improving the patientās oral hygiene can reduce inflammation and improve periodontal health.REFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
Plaque controlOTHER OPTIONS
⢠Sensibility test – This test assesses the vitality of the tooth’s pulp and is typically used when symptoms suggest endodontic issues, not for initial management of periodontal conditions.
⢠Radiographs – Radiographs can be helpful to assess the extent of bone loss and other periodontal conditions. However, plaque control is a more immediate and fundamental step in managing the condition.
⢠Referral to periodontist – Referral to a periodontist may be necessary if the condition does not improve with initial management or if the case is complex. However, starting with plaque control is critical before considering a referral.SYNOPSIS
⢠Effective plaque control is essential in managing gingival overgrowth and attachment loss.
⢠It is the first step in periodontal treatment and helps in controlling the underlying cause of gingival overgrowth and attachment loss.
⢠Improving the patientās oral hygiene can reduce inflammation and improve periodontal health.REFERENCE
Carranza’s Clinical Periodontology -
Question 76 of 150
76. Question
A 24 year old male patient came with complaint of recurrent ulcers in his oral cavity. He has ocular, genital and skin lesions as well. Patient had a positive pathergy test. What condition do you suspect here?
Correct
ANSWER
Behcet’s syndromeOTHER OPTIONS
⢠Reiter’s syndrome – Reiter’s syndrome is characterized by urethritis, arthritis and conjuctivitis.
⢠Lichen planus – Lichen planus is a mucocutaneous lesion mainly seen as greyish white striae on skin and oral cavity.SYNOPSIS
⢠Behcet’s syndrome is a multisystemic chronic disorder.
⢠Mainly seen between 25-40 years and predominantly in males.
⢠Characterized by oral and genital aphthous ulcers, ocular lesions and skin lesions.
⢠Initially begins with oral or genital ulcers.
⢠A positive skin pathergy test is characterised by erythematous induration at the site of the needle stick with a small pustule containing sterile pus at its centre, is among the criteria required for a diagnosis of Behcet’s disease.
⢠No specific treatment other than supportive measures.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 595.Incorrect
ANSWER
Behcet’s syndromeOTHER OPTIONS
⢠Reiter’s syndrome – Reiter’s syndrome is characterized by urethritis, arthritis and conjuctivitis.
⢠Lichen planus – Lichen planus is a mucocutaneous lesion mainly seen as greyish white striae on skin and oral cavity.SYNOPSIS
⢠Behcet’s syndrome is a multisystemic chronic disorder.
⢠Mainly seen between 25-40 years and predominantly in males.
⢠Characterized by oral and genital aphthous ulcers, ocular lesions and skin lesions.
⢠Initially begins with oral or genital ulcers.
⢠A positive skin pathergy test is characterised by erythematous induration at the site of the needle stick with a small pustule containing sterile pus at its centre, is among the criteria required for a diagnosis of Behcet’s disease.
⢠No specific treatment other than supportive measures.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 595. -
Question 77 of 150
77. Question
A 28-year-old male presents to the emergency department with severe facial trauma following a high-speed motor vehicle accident. The patient exhibits midface flattening, bilateral periorbital ecchymosis, and mobility of the midface relative to the cranial base. CT scans confirm a Le Fort III fracture. What is the most appropriate initial management for this patient?
Correct
ANSWER
Airway management and stabilization, followed by surgical interventionOTHER OPTIONS
⢠Immediate open reduction and internal fixation – Immediate open reduction and internal fixation (ORIF) without first ensuring airway management can be dangerous if the patient’s airway is compromised.
⢠Placement of intermaxillary fixation (IMF) and observation – Placement of intermaxillary fixation (IMF) and observation may not address the complexity and instability of a Le Fort III fracture and is not sufficient for definitive management.
⢠Antibiotic therapy and analgesics only – Antibiotic therapy and analgesics only do not address the critical need for surgical repair and stabilization of the facial fractures.SYNOPSIS
⢠In the management of Le Fort III fractures, which involve a complete craniofacial disjunction, the most critical initial step is to ensure the patient’s airway is secure and that the patient is hemodynamically stable.
⢠This is crucial because these fractures can significantly impact the airway and breathing due to the displacement of facial structures.
⢠Airway management and stabilization – Ensuring a clear airway and addressing any immediate life-threatening conditions take precedence. This might involve intubation or tracheostomy if necessary.
⢠Once the airway is secured and the patient is stabilized, surgical intervention (such as open reduction and internal fixation) is necessary to repair the fractures and restore the structural integrity and function of the facial skeleton.REFERENCE
Le Fort III fractures – An approach to resuscitation and management – Annals of Medicine and SurgeryIncorrect
ANSWER
Airway management and stabilization, followed by surgical interventionOTHER OPTIONS
⢠Immediate open reduction and internal fixation – Immediate open reduction and internal fixation (ORIF) without first ensuring airway management can be dangerous if the patient’s airway is compromised.
⢠Placement of intermaxillary fixation (IMF) and observation – Placement of intermaxillary fixation (IMF) and observation may not address the complexity and instability of a Le Fort III fracture and is not sufficient for definitive management.
⢠Antibiotic therapy and analgesics only – Antibiotic therapy and analgesics only do not address the critical need for surgical repair and stabilization of the facial fractures.SYNOPSIS
⢠In the management of Le Fort III fractures, which involve a complete craniofacial disjunction, the most critical initial step is to ensure the patient’s airway is secure and that the patient is hemodynamically stable.
⢠This is crucial because these fractures can significantly impact the airway and breathing due to the displacement of facial structures.
⢠Airway management and stabilization – Ensuring a clear airway and addressing any immediate life-threatening conditions take precedence. This might involve intubation or tracheostomy if necessary.
⢠Once the airway is secured and the patient is stabilized, surgical intervention (such as open reduction and internal fixation) is necessary to repair the fractures and restore the structural integrity and function of the facial skeleton.REFERENCE
Le Fort III fractures – An approach to resuscitation and management – Annals of Medicine and Surgery -
Question 78 of 150
78. Question
Patient came with pain in the lower tooth. On pulp testing, the results gives with respect to lower 6 cold test 5 sec, control tooth 4 sec, hot test 4 sec, control teeth 3 sec. The tooth is not sensitive to percussion. What is the status of the pulp?
Correct
ANSWER
Reversible pulpitisOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠There are three primary outcomes of a pulp sensitivity test, as described.
a)Normal Response – Healthy pulps are expected to respond to sensitivity testing by eliciting a short, sharp pain that subsides when the stimulus is removed, indicating that the nerve fibers are present and responsive. Teeth with clinically normal pulps do not respond to heat they only respond to heat when they are inflamed. Hence, the heat test cannot be used to differentiate a normal pulp from a necrotic pulp or a tooth with a pulpless and infected root canal system.
b) A Heightened or Prolonged Response – An exaggerated or lingering response to sensitivity testing indicates some degree of pulpal inflammation. If the pain is pronounced yet subsides once the stimulus has been removed, a diagnosis of reversible pulpitis may be probable. However, a lingering pain that continues despite the removal of the stimulus is indicative of irreversible pulpitis.
c) No Response – A lack of response to sensitivity testing suggests that the nerve supply to the tooth has been diminished, as in the case of pulpal necrosis or in previously root-treated canals.
⢠The AAE diagnostic standards for Reversible Pulpitis is as follows
– No spontaneous pain, sensitive responses to cold and heat tests compared with those of control teeth ,which lasts for only 1 to 2 seconds or no more than 10 seconds after the removal of the stimulus, and no significant radiographic changes in the periapical region.
– Because the pulp is sensitive to temperature changes, particularly cold, the application of cold is an excellent method of locating and diagnosing the involved tooth.
– A tooth with reversible pulpitis reacts normally to percussion, palpation, and mobility, and the periapical tissue is normal on radiographic examination.REFERENCE
Dental Pulp Testing, A Review – International Journal of Dentistry. 2009Incorrect
ANSWER
Reversible pulpitisOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠There are three primary outcomes of a pulp sensitivity test, as described.
a)Normal Response – Healthy pulps are expected to respond to sensitivity testing by eliciting a short, sharp pain that subsides when the stimulus is removed, indicating that the nerve fibers are present and responsive. Teeth with clinically normal pulps do not respond to heat they only respond to heat when they are inflamed. Hence, the heat test cannot be used to differentiate a normal pulp from a necrotic pulp or a tooth with a pulpless and infected root canal system.
b) A Heightened or Prolonged Response – An exaggerated or lingering response to sensitivity testing indicates some degree of pulpal inflammation. If the pain is pronounced yet subsides once the stimulus has been removed, a diagnosis of reversible pulpitis may be probable. However, a lingering pain that continues despite the removal of the stimulus is indicative of irreversible pulpitis.
c) No Response – A lack of response to sensitivity testing suggests that the nerve supply to the tooth has been diminished, as in the case of pulpal necrosis or in previously root-treated canals.
⢠The AAE diagnostic standards for Reversible Pulpitis is as follows
– No spontaneous pain, sensitive responses to cold and heat tests compared with those of control teeth ,which lasts for only 1 to 2 seconds or no more than 10 seconds after the removal of the stimulus, and no significant radiographic changes in the periapical region.
– Because the pulp is sensitive to temperature changes, particularly cold, the application of cold is an excellent method of locating and diagnosing the involved tooth.
– A tooth with reversible pulpitis reacts normally to percussion, palpation, and mobility, and the periapical tissue is normal on radiographic examination.REFERENCE
Dental Pulp Testing, A Review – International Journal of Dentistry. 2009 -
Question 79 of 150
79. Question
A 42 year old healthy woman presents with moderate pain in the upper left side of the jaw while biting. On examination, application of endo ice to tooth 25 elicited a sharp, momentary pain. Tooth 25 responds normally to percussion, while 26 is tender to percussion. Which of the following is the source of patient complaint?
Correct
ANSWER
Periapical tissues of tooth 26OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠As the tooth 26 is tender to percussion, the source of pain should be due to periapical changes in relation to 26
⢠Pain on percussion is the diagnostic feature of primary symptomatic apical periodontitis.
⢠It is distinguishable from asymptomatic apical periodontitis in which the tooth has no pain on percussion and has distinct radiographic periradicular bone changes.REFERENCE
Grossmans Endodontic Practice Page No 74Incorrect
ANSWER
Periapical tissues of tooth 26OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠As the tooth 26 is tender to percussion, the source of pain should be due to periapical changes in relation to 26
⢠Pain on percussion is the diagnostic feature of primary symptomatic apical periodontitis.
⢠It is distinguishable from asymptomatic apical periodontitis in which the tooth has no pain on percussion and has distinct radiographic periradicular bone changes.REFERENCE
Grossmans Endodontic Practice Page No 74 -
Question 80 of 150
80. Question
Patient came with severe throbbing pain on 16 which increases during night. On examination, it is noticed that the tooth is tender on percussion and localised periodontitis on the mesiobuccal side. What is the type of lesion here?
Correct
ANSWER
True combined lesionOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠In certain cases, the signs and symptoms of pulpal and periodontal involvement are such that it is clinically not possible to differentiate which started first. Such a chronic lesion with gross pulpal and periodontal destruction is referred to as a true combined lesion.
⢠It is recommended that endodontic treatment should precede periodontal therapy, regardless of the cause of disease.REFERENCE
Grossmans endodontic practice pg 410Incorrect
ANSWER
True combined lesionOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠In certain cases, the signs and symptoms of pulpal and periodontal involvement are such that it is clinically not possible to differentiate which started first. Such a chronic lesion with gross pulpal and periodontal destruction is referred to as a true combined lesion.
⢠It is recommended that endodontic treatment should precede periodontal therapy, regardless of the cause of disease.REFERENCE
Grossmans endodontic practice pg 410 -
Question 81 of 150
81. Question
A 60-year-old patient is being fitted with a removable partial denture (RPD) for the replacement of missing posterior teeth. The patient has all anterior teeth and one molar remaining in each quadrant. The dentist plans to use a clasp to help retain the RPD. The patient desires a clasp design that provides maximum support from the existing teeth. Which type of clasp design is most appropriate for a fully tooth-supported removable partial denture?
Correct
ANSWER
Circumferential claspOTHER OPTIONS
⢠I bar clasp – This clasp is commonly used for anterior teeth restoration in several countries as it requires minimal tooth contact compared to circumferential clasps and provides adequate retention with minimal undercut.
⢠Ring clasp – These retentive clasp arms are used in situations where the most distally located tooth in the arch is a tipped molar.
⢠Combination clasp – Used when additional flexibility is needed.SYNOPSIS
⢠A circumferential clasp is the most appropriate design for a fully tooth-supported removable partial denture.
⢠This type of clasp encircles the tooth and provides excellent retention and stability, leveraging the support from the remaining teeth.
⢠For a fully tooth-supported situation, a circumferential clasp is preferred for its reliability and effectiveness.REFERENCE
Stewart clinical Removable Partial DentureIncorrect
ANSWER
Circumferential claspOTHER OPTIONS
⢠I bar clasp – This clasp is commonly used for anterior teeth restoration in several countries as it requires minimal tooth contact compared to circumferential clasps and provides adequate retention with minimal undercut.
⢠Ring clasp – These retentive clasp arms are used in situations where the most distally located tooth in the arch is a tipped molar.
⢠Combination clasp – Used when additional flexibility is needed.SYNOPSIS
⢠A circumferential clasp is the most appropriate design for a fully tooth-supported removable partial denture.
⢠This type of clasp encircles the tooth and provides excellent retention and stability, leveraging the support from the remaining teeth.
⢠For a fully tooth-supported situation, a circumferential clasp is preferred for its reliability and effectiveness.REFERENCE
Stewart clinical Removable Partial Denture -
Question 82 of 150
82. Question
A patient with generalized mild gingival recession came to your clinic for scaling. You completed full mouth oral prophylaxis. Now the patient want to know best method of toothbrushing. Which method will you suggest?
Correct
ANSWER
Modified stillman techniqueOTHER OPTIONS
⢠Fones technique – Fones technique is indicated in children, physically and emotionally handicapped children.
⢠Charter’s technique – Charter’s technique is used in open interdental spaces with missing papilla, temporary cleaning in areas of healing wounds after periodontal surgery and in patients with orthodontic appliances or fixed partial dentures.
⢠Modiļ¬ed bass technique – Modiļ¬ed bass technique is commonly used for general brushing.SYNOPSIS
⢠Modified stillman’s technique is indicated in patients with gingival recession, as it provides good gingival massage.
⢠It is also used in root exposure cases to minimize abrasive tissue destruction.
⢠Bristles are placed partly over the cervical portion of the teeth and partly over attached gingiva with sweeping movement of bristles in a coronal direction.
⢠But this technique is difficult to learn and implement.REFERENCE
Toothbrushing Techniques by PerioBasics.Incorrect
ANSWER
Modified stillman techniqueOTHER OPTIONS
⢠Fones technique – Fones technique is indicated in children, physically and emotionally handicapped children.
⢠Charter’s technique – Charter’s technique is used in open interdental spaces with missing papilla, temporary cleaning in areas of healing wounds after periodontal surgery and in patients with orthodontic appliances or fixed partial dentures.
⢠Modiļ¬ed bass technique – Modiļ¬ed bass technique is commonly used for general brushing.SYNOPSIS
⢠Modified stillman’s technique is indicated in patients with gingival recession, as it provides good gingival massage.
⢠It is also used in root exposure cases to minimize abrasive tissue destruction.
⢠Bristles are placed partly over the cervical portion of the teeth and partly over attached gingiva with sweeping movement of bristles in a coronal direction.
⢠But this technique is difficult to learn and implement.REFERENCE
Toothbrushing Techniques by PerioBasics. -
Question 83 of 150
83. Question
6-month-old baby presents with a white lesion on the labial frenum. The parents report no systemic symptoms such as fever or irritability. The lesion was noticed after the baby started gnawing on toys. Upon examination, the lesion is localized, non-tender, and has no surrounding erythema or vesicles. What is the most likely diagnosis?
Correct
ANSWER
Traumatic UlcerOTHER OPTIONS
⢠Herpetic Gingivostomatitis – Caused by primary herpes simplex virus (HSV-1) infection. Painful vesicles that rupture to form ulcers, diffuse involvement of the oral cavity and gingiva is typical. Fever, irritability, and lymphadenopathy are commonly seen.
⢠Herpangina – Caused by Coxsackievirus, typically seen in young children. Vesicular lesions are primarily located on the soft palate, tonsils, and pharynx, not the labial frenum. High fever and malaise are common.
⢠Allergy – Allergic reactions to substances such as foods or oral hygiene products. Usually diffuse erythema or vesicular eruptions, often involving multiple areas of the oral mucosa.SYNOPSIS
⢠Traumatic ulcer typically caused by repetitive trauma, such as gnawing on toys, as described in this case.
⢠Presents as a localized white lesion or ulcer, often on the labial frenum or other areas prone to contact injury.
⢠Usually absent unless secondary infection occurs.
⢠Resolves with removal of the traumatic stimulus, no specific treatment is needed unless secondary infection occurs.REFERENCE
Pinkham JR, Casamassimo PS, McTigue DJ, et al. Pediatric Dentistry: Infancy through Adolescence. 5th ed. Elsevier; 2018.
Neville BW, Damm DD, Allen CM, Chi AC. Oral and Maxillofacial Pathology. 4th ed. Elsevier; 2016.Incorrect
ANSWER
Traumatic UlcerOTHER OPTIONS
⢠Herpetic Gingivostomatitis – Caused by primary herpes simplex virus (HSV-1) infection. Painful vesicles that rupture to form ulcers, diffuse involvement of the oral cavity and gingiva is typical. Fever, irritability, and lymphadenopathy are commonly seen.
⢠Herpangina – Caused by Coxsackievirus, typically seen in young children. Vesicular lesions are primarily located on the soft palate, tonsils, and pharynx, not the labial frenum. High fever and malaise are common.
⢠Allergy – Allergic reactions to substances such as foods or oral hygiene products. Usually diffuse erythema or vesicular eruptions, often involving multiple areas of the oral mucosa.SYNOPSIS
⢠Traumatic ulcer typically caused by repetitive trauma, such as gnawing on toys, as described in this case.
⢠Presents as a localized white lesion or ulcer, often on the labial frenum or other areas prone to contact injury.
⢠Usually absent unless secondary infection occurs.
⢠Resolves with removal of the traumatic stimulus, no specific treatment is needed unless secondary infection occurs.REFERENCE
Pinkham JR, Casamassimo PS, McTigue DJ, et al. Pediatric Dentistry: Infancy through Adolescence. 5th ed. Elsevier; 2018.
Neville BW, Damm DD, Allen CM, Chi AC. Oral and Maxillofacial Pathology. 4th ed. Elsevier; 2016. -
Question 84 of 150
84. Question
What is the amount of adrenaline in 1.8cc of 1:80,000 solution of 2% lidocaine?
Correct
ANSWER
0.018OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠To calculate the amount of adrenaline in 1.8cc of 1:80,000, 2% lidocaine
⢠1:80,000 means 1 gram of adrenaline in 80,000 mL of solution
⢠Concentration of adrenaline = 1 gram / 80,000 mL = 0.0125 mg/mL
⢠Amount of adrenaline in 1.8 mL = 0.0125 mg/mL à 1.8 mL = 0.0225 mg
⢠So, the amount of adrenaline in 1.8cc of 1:80,000, 2% lidocaine is 0.0225 mg.
⢠The nearest value here is 0.018REFERENCE
Clinical Anesthesia by Barash et al.Incorrect
ANSWER
0.018OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠To calculate the amount of adrenaline in 1.8cc of 1:80,000, 2% lidocaine
⢠1:80,000 means 1 gram of adrenaline in 80,000 mL of solution
⢠Concentration of adrenaline = 1 gram / 80,000 mL = 0.0125 mg/mL
⢠Amount of adrenaline in 1.8 mL = 0.0125 mg/mL à 1.8 mL = 0.0225 mg
⢠So, the amount of adrenaline in 1.8cc of 1:80,000, 2% lidocaine is 0.0225 mg.
⢠The nearest value here is 0.018REFERENCE
Clinical Anesthesia by Barash et al. -
Question 85 of 150
85. Question
65-year-old patient with a history of atrial fibrillation visits the dental clinic for the extraction of a lower molar. The patient is on a daily morning dose of an oral anticoagulant (e.g., warfarin or a direct oral anticoagulant like apixaban or rivaroxaban) to prevent thromboembolic events. The dentist needs to decide whether the medication should be stopped or adjusted before the procedure to minimize the risk of bleeding complications while maintaining thromboembolic protection. What is the appropriate management of the patientās anticoagulant medication before the dental extraction?
Correct
ANSWER
No need to stop the anticoagulant.OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠For most routine dental extractions, there is no need to stop anticoagulant medication in patients with atrial fibrillation.
⢠Studies have shown that the risk of significant bleeding is minimal when the extraction is performed under local measures, such as using hemostatic agents (e.g., collagen sponges, sutures) and applying pressure post-operatively.
⢠Stopping anticoagulants increases the risk of thromboembolic events, which can be life-threatening.
⢠The dentist should consult the patient’s physician if there is any uncertainty, but routine anticoagulant therapy should generally be continued.REFERENCE
Guidelines on the Management of Anticoagulant Therapy in Dental Procedures by the American College of Cardiology.Incorrect
ANSWER
No need to stop the anticoagulant.OTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠For most routine dental extractions, there is no need to stop anticoagulant medication in patients with atrial fibrillation.
⢠Studies have shown that the risk of significant bleeding is minimal when the extraction is performed under local measures, such as using hemostatic agents (e.g., collagen sponges, sutures) and applying pressure post-operatively.
⢠Stopping anticoagulants increases the risk of thromboembolic events, which can be life-threatening.
⢠The dentist should consult the patient’s physician if there is any uncertainty, but routine anticoagulant therapy should generally be continued.REFERENCE
Guidelines on the Management of Anticoagulant Therapy in Dental Procedures by the American College of Cardiology. -
Question 86 of 150
86. Question
In guided tissue regeneration (GTR), which tissues must be excluded to allow proper periodontal regeneration?
Correct
ANSWER
Connective tissue and epitheliumOTHER OPTIONS
⢠Bone and connective tissue – Bone and connective tissue are critical for periodontal regeneration and are not excluded.
⢠Epithelium and bone – Bone is essential for periodontal healing, so excluding it would impair regeneration.
⢠Cementum and periodontal ligament – These tissues are the primary targets for regeneration and must not be excluded.SYNOPSIS
⢠Guided tissue regeneration (GTR) aims to regenerate the periodontal apparatus, including the cementum, periodontal ligament, and alveolar bone.
⢠To achieve this, the procedure involves the placement of a barrier membrane to selectively exclude epithelium and connective tissue from rapidly proliferating into the defect site, as these tissues can interfere with the slower regeneration of periodontal tissues.
⢠By blocking epithelial and connective tissue invasion, the membrane allows the periodontal ligament and bone cells to repopulate the area, facilitating true regeneration rather than repair.REFERENCE
Carranzaās Clinical Periodontology G. Newman et al., 13th Edition.Incorrect
ANSWER
Connective tissue and epitheliumOTHER OPTIONS
⢠Bone and connective tissue – Bone and connective tissue are critical for periodontal regeneration and are not excluded.
⢠Epithelium and bone – Bone is essential for periodontal healing, so excluding it would impair regeneration.
⢠Cementum and periodontal ligament – These tissues are the primary targets for regeneration and must not be excluded.SYNOPSIS
⢠Guided tissue regeneration (GTR) aims to regenerate the periodontal apparatus, including the cementum, periodontal ligament, and alveolar bone.
⢠To achieve this, the procedure involves the placement of a barrier membrane to selectively exclude epithelium and connective tissue from rapidly proliferating into the defect site, as these tissues can interfere with the slower regeneration of periodontal tissues.
⢠By blocking epithelial and connective tissue invasion, the membrane allows the periodontal ligament and bone cells to repopulate the area, facilitating true regeneration rather than repair.REFERENCE
Carranzaās Clinical Periodontology G. Newman et al., 13th Edition. -
Question 87 of 150
87. Question
Which of the following is a key biochemical feature of hypophosphatasia?
Correct
ANSWER
Decreased alkaline phosphatase and increased phosphoethanolamineOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Hypophosphatasia is a rare metabolic disorder characterized by defective bone and tooth mineralization due to mutations in the ALPL gene, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). This condition is marked by
⢠Decreased levels of alkaline phosphatase (ALP) – The enzyme responsible for breaking down substances like pyrophosphate, which inhibits bone mineralization, is deficient.
⢠Increased levels of phosphoethanolamine (PEA) in blood and urine – Due to the reduced activity of ALP, PEA, one of its substrates, accumulates.
⢠These biochemical markers are critical for the diagnosis of hypophosphatasia.REFERENCE
Pathophysiology of Hypophosphatasia – The New England Journal of Medicine by Whyte, M. P. (2017).Incorrect
ANSWER
Decreased alkaline phosphatase and increased phosphoethanolamineOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Hypophosphatasia is a rare metabolic disorder characterized by defective bone and tooth mineralization due to mutations in the ALPL gene, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). This condition is marked by
⢠Decreased levels of alkaline phosphatase (ALP) – The enzyme responsible for breaking down substances like pyrophosphate, which inhibits bone mineralization, is deficient.
⢠Increased levels of phosphoethanolamine (PEA) in blood and urine – Due to the reduced activity of ALP, PEA, one of its substrates, accumulates.
⢠These biochemical markers are critical for the diagnosis of hypophosphatasia.REFERENCE
Pathophysiology of Hypophosphatasia – The New England Journal of Medicine by Whyte, M. P. (2017). -
Question 88 of 150
88. Question
25-year-old patient with sickle cell anemia visits the dental clinic for extraction of a grossly decayed mandibular molar. The patient reports frequent vaso-occlusive crises requiring hospitalization but is currently stable. Vital signs are within normal limits, and no acute symptoms are present during the consultation. What is the ASA (American Society of Anesthesiologists) classification for this patient?
Correct
ANSWER
ASA IIIOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The ASA classification system is used to determine the physical status of a patient and assess their anesthetic risk. It ranges from ASA I (healthy patient) to ASA VI (brain-dead patient).
– ASA I – A healthy patient with no systemic disease.
– ASA II – A patient with mild systemic disease that does not limit daily activities (e.g., controlled hypertension, mild asthma).
– ASA III – A patient with severe systemic disease that limits daily activity but is not incapacitating (e.g., poorly controlled diabetes, sickle cell anemia with frequent crises).
– ASA IV – A patient with severe systemic disease that is a constant threat to life (e.g., unstable angina, recent myocardial infarction).
⢠The patient has sickle cell anemia, a severe systemic condition.
⢠Frequent vaso-occlusive crises indicate the condition significantly impacts daily life.
⢠However, the patient is stable at the time of the consultation and not in acute crisis, so they do not fall into the ASA IV category.
⢠Thus, the patient is classified as ASA III.REFERENCE
Chapter 1 – Patient Assessment and Risk Management – Malamed SF. Handbook of Local Anesthesia, 7th Edition,Incorrect
ANSWER
ASA IIIOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠The ASA classification system is used to determine the physical status of a patient and assess their anesthetic risk. It ranges from ASA I (healthy patient) to ASA VI (brain-dead patient).
– ASA I – A healthy patient with no systemic disease.
– ASA II – A patient with mild systemic disease that does not limit daily activities (e.g., controlled hypertension, mild asthma).
– ASA III – A patient with severe systemic disease that limits daily activity but is not incapacitating (e.g., poorly controlled diabetes, sickle cell anemia with frequent crises).
– ASA IV – A patient with severe systemic disease that is a constant threat to life (e.g., unstable angina, recent myocardial infarction).
⢠The patient has sickle cell anemia, a severe systemic condition.
⢠Frequent vaso-occlusive crises indicate the condition significantly impacts daily life.
⢠However, the patient is stable at the time of the consultation and not in acute crisis, so they do not fall into the ASA IV category.
⢠Thus, the patient is classified as ASA III.REFERENCE
Chapter 1 – Patient Assessment and Risk Management – Malamed SF. Handbook of Local Anesthesia, 7th Edition, -
Question 89 of 150
89. Question
What does the red line in the Winter WAR line of impaction typically indicate on radiographs of impacted teeth?
Correct
ANSWER
Depth at which elevator should be appliedOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Winter’s WAR lines (1926)
⢠White Line – Provide information regarding the depth & inclination
⢠Amber Line – Indicate the margin of the alveolar bone enclosing the teeth.
– One must differentiate betweenthe external oblique ridge and bone lying distal tothe impacted tooth.
⢠Red Line – Provides information about depth at which elevator should be applied
⢠Longer the line difficult to remove or access the tooth
⢠Length: difficulty: 1:3REFERENCE
Winter GD. Surgical Removal of Impacted Third Molars. Oral Surgery, Oral Medicine, Oral Pathology, 1926.Incorrect
ANSWER
Depth at which elevator should be appliedOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠Winter’s WAR lines (1926)
⢠White Line – Provide information regarding the depth & inclination
⢠Amber Line – Indicate the margin of the alveolar bone enclosing the teeth.
– One must differentiate betweenthe external oblique ridge and bone lying distal tothe impacted tooth.
⢠Red Line – Provides information about depth at which elevator should be applied
⢠Longer the line difficult to remove or access the tooth
⢠Length: difficulty: 1:3REFERENCE
Winter GD. Surgical Removal of Impacted Third Molars. Oral Surgery, Oral Medicine, Oral Pathology, 1926. -
Question 90 of 150
90. Question
How can pontics in fixed partial dentures be designed to maintain the health of the tissues beneath them?
Correct
ANSWER
Have passive contact with the ridge tissue with no blanchingOTHER OPTIONS
⢠NilSYNOPSIS
⢠Pontic is the artificial tooth in the fixed or removable partial dentures, that is, the suspended portion of the fixed partial denture (bridge) replacing the missing natural tooth or teeth.
⢠Designing a pontic is not simple, an exact anatomic replica of the tooth in the space would be difficult to manage.
⢠The ridge lap is the gingival part of the pontic which contacts and has a direct relation to soft tissue and the edentulous ridge
⢠The pontic should touch the ridge passively rather than making pressure
⢠Pontic selection depends primarily on aesthetics and oral hygiene
⢠In the anterior region where aesthetics is a concern, the pontic should be well adapted to the tissue to make it appear that it emerges from the gingiva, conversely, in the posterior regions oral hygiene is the prime goal.
⢠The recommended designs for the anterior maxillary region are ovate and modified ridge lap pontics.
⢠The ovate pontic has high aesthetic value, therefore, is considered most suitable in the anterior maxillary region.
⢠This gives the illusion that the replaced tooth emerges from the gingiva like a natural tooth.REFERENCE
Different pontic design for porcelain fused to metal fixed dental prosthesis – Contemporary guidelines and practice by general dental practitioners.Incorrect
ANSWER
Have passive contact with the ridge tissue with no blanchingOTHER OPTIONS
⢠NilSYNOPSIS
⢠Pontic is the artificial tooth in the fixed or removable partial dentures, that is, the suspended portion of the fixed partial denture (bridge) replacing the missing natural tooth or teeth.
⢠Designing a pontic is not simple, an exact anatomic replica of the tooth in the space would be difficult to manage.
⢠The ridge lap is the gingival part of the pontic which contacts and has a direct relation to soft tissue and the edentulous ridge
⢠The pontic should touch the ridge passively rather than making pressure
⢠Pontic selection depends primarily on aesthetics and oral hygiene
⢠In the anterior region where aesthetics is a concern, the pontic should be well adapted to the tissue to make it appear that it emerges from the gingiva, conversely, in the posterior regions oral hygiene is the prime goal.
⢠The recommended designs for the anterior maxillary region are ovate and modified ridge lap pontics.
⢠The ovate pontic has high aesthetic value, therefore, is considered most suitable in the anterior maxillary region.
⢠This gives the illusion that the replaced tooth emerges from the gingiva like a natural tooth.REFERENCE
Different pontic design for porcelain fused to metal fixed dental prosthesis – Contemporary guidelines and practice by general dental practitioners. -
Question 91 of 150
91. Question
What is the minimum mesiodistal distance recommended between a dental implant and an adjacent natural tooth?
Correct
ANSWER
1.5 mmOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The recommended minimum mesiodistal distance between tooth and implant is 1.5mm
⢠Maintaining at least 1.5 mm of distance from a natural tooth helps prevent damage to the periodontal ligament and supports the long-term stability of the gingiva and bone.
⢠Ensuring this space reduces the risk of bone loss and promotes healthy remodeling around the implant and adjacent structures.REFERENCE
Biomechanics of Implant Design and Placement – Contemporary Implant Dentistry – Carp E MischIncorrect
ANSWER
1.5 mmOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠The recommended minimum mesiodistal distance between tooth and implant is 1.5mm
⢠Maintaining at least 1.5 mm of distance from a natural tooth helps prevent damage to the periodontal ligament and supports the long-term stability of the gingiva and bone.
⢠Ensuring this space reduces the risk of bone loss and promotes healthy remodeling around the implant and adjacent structures.REFERENCE
Biomechanics of Implant Design and Placement – Contemporary Implant Dentistry – Carp E Misch -
Question 92 of 150
92. Question
Which drug among the following can cause lichenoid reaction?
Correct
ANSWER
AntimalarialOTHER OPTIONS
Not applicableSYNOPSIS
⢠Lichenoid reaction is similar to lichen planus but associated with an underlying cause.
⢠Drugs like antimalarials, NSAIDS, antihypertensives, antiretrovirals, dental restorative materials like amalgam, gold, chromium, cobalt, epoxy resins etc can trigger lichenoid reactions.
⢠Seen as greyish white streak or even ulcerations.
⢠Lesions are usually unilateral.
⢠Treatment is to identify and eliminate trigger factors.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 548.Incorrect
ANSWER
AntimalarialOTHER OPTIONS
Not applicableSYNOPSIS
⢠Lichenoid reaction is similar to lichen planus but associated with an underlying cause.
⢠Drugs like antimalarials, NSAIDS, antihypertensives, antiretrovirals, dental restorative materials like amalgam, gold, chromium, cobalt, epoxy resins etc can trigger lichenoid reactions.
⢠Seen as greyish white streak or even ulcerations.
⢠Lesions are usually unilateral.
⢠Treatment is to identify and eliminate trigger factors.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 548. -
Question 93 of 150
93. Question
Which of the following is the morphology of periodontal ligament fibres?
Correct
ANSWER
WavyOTHER OPTIONS
⢠NILSYNOPSIS
⢠Periodontal ligament fibers have a wavy structure, which allows them to stretch slightly and accommodate the forces exerted during chewing and biting.
⢠This wavy morphology helps in shock absorption and maintains the attachment of the tooth to the alveolar bone, preventing damage during normal function.REFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
WavyOTHER OPTIONS
⢠NILSYNOPSIS
⢠Periodontal ligament fibers have a wavy structure, which allows them to stretch slightly and accommodate the forces exerted during chewing and biting.
⢠This wavy morphology helps in shock absorption and maintains the attachment of the tooth to the alveolar bone, preventing damage during normal function.REFERENCE
Carranza’s Clinical Periodontology -
Question 94 of 150
94. Question
Several application has been suggested to increase the effectiveness of prophylactic application of topical fluoride which include all EXCEPT?
Correct
ANSWER
Increase PH of fluorideOTHER OPTIONS
⢠Increase Fluoride ions in solution – Increasing the concentration of fluoride ions in the solution enhances its effectiveness in strengthening enamel and reducing caries.
⢠Increase exposure time to topical fluoride – Increasing exposure time allows for better fluoride uptake by the enamel, improving the remineralization process
⢠Pre-treat enamel with 0.5 percent phosphoric acid – Pre-treating enamel with phosphoric acid helps demineralize the enamel slightly, allowing better penetration of fluoride into the tooth surface.SYNOPSIS
⢠Increasing the pH of fluoride is not a suggested method to increase the effectiveness of topical fluoride application.
⢠Fluoride is more effective at a lower pH.
⢠Fluoride solutions are typically more effective in acidic conditions because lower pH facilitates the release of fluoride ions that integrate with enamel.
⢠Increasing pH would reduce the efficacy of fluoride.REFERENCE
Essentials of Public Health Dentistry – Soben PeterIncorrect
ANSWER
Increase PH of fluorideOTHER OPTIONS
⢠Increase Fluoride ions in solution – Increasing the concentration of fluoride ions in the solution enhances its effectiveness in strengthening enamel and reducing caries.
⢠Increase exposure time to topical fluoride – Increasing exposure time allows for better fluoride uptake by the enamel, improving the remineralization process
⢠Pre-treat enamel with 0.5 percent phosphoric acid – Pre-treating enamel with phosphoric acid helps demineralize the enamel slightly, allowing better penetration of fluoride into the tooth surface.SYNOPSIS
⢠Increasing the pH of fluoride is not a suggested method to increase the effectiveness of topical fluoride application.
⢠Fluoride is more effective at a lower pH.
⢠Fluoride solutions are typically more effective in acidic conditions because lower pH facilitates the release of fluoride ions that integrate with enamel.
⢠Increasing pH would reduce the efficacy of fluoride.REFERENCE
Essentials of Public Health Dentistry – Soben Peter -
Question 95 of 150
95. Question
What is not included as consideration when constructing a complete denture prosthesis for orthognathic ridge relationship?
Correct
ANSWER
Require minimum interocclusal distance.OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠When constructing a complete denture prosthesis for an orthognathic ridge relationship, the following considerations are typically included
Support and Retention – Ensuring that the denture provides adequate support and retention based on the anatomy of the ridge and surrounding soft tissues.
Esthetics – Designing the denture to achieve natural appearance, considering factors such as lip support, tooth shape, and shade.
Occlusion – Achieving a functional occlusion that allows for proper chewing and minimizes movement or instability of the denture during function. This includes careful planning of tooth arrangement and occlusal relationships.
Jaw Relationships – Accurately determining the maxillomandibular relationship to ensure that the dentures align properly with the patient’s occlusal plane and facial aesthetics.
Comfort – Ensuring the denture is comfortable for the patient to wear, with consideration for any anatomical changes due to orthognathic surgery.
Functional Movement – Ensuring the denture accommodates functional movements such as chewing, speaking, and swallowing without discomfort or dislodgement.
Material Selection – Choosing appropriate materials for the denture base and teeth that provide durability and biocompatibility.
Mucosal Health – Considering the health of the oral mucosa and ensuring that the denture design does not irritate or cause pressure points.
⢠These considerations help in creating a complete denture prosthesis that is functional, comfortable, and aesthetically pleasing for patients with orthognathic ridge relationships.
⢠While maintaining appropriate space is important, a strict minimum interocclusal distance is not a primary focus. The emphasis is on overall fit and function rather than a specific distance.REFERENCE
Occlusal Considerations in Complete Dentures-Sandro Palla-Restorative and Prosthodontic Therapy.Incorrect
ANSWER
Require minimum interocclusal distance.OTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠When constructing a complete denture prosthesis for an orthognathic ridge relationship, the following considerations are typically included
Support and Retention – Ensuring that the denture provides adequate support and retention based on the anatomy of the ridge and surrounding soft tissues.
Esthetics – Designing the denture to achieve natural appearance, considering factors such as lip support, tooth shape, and shade.
Occlusion – Achieving a functional occlusion that allows for proper chewing and minimizes movement or instability of the denture during function. This includes careful planning of tooth arrangement and occlusal relationships.
Jaw Relationships – Accurately determining the maxillomandibular relationship to ensure that the dentures align properly with the patient’s occlusal plane and facial aesthetics.
Comfort – Ensuring the denture is comfortable for the patient to wear, with consideration for any anatomical changes due to orthognathic surgery.
Functional Movement – Ensuring the denture accommodates functional movements such as chewing, speaking, and swallowing without discomfort or dislodgement.
Material Selection – Choosing appropriate materials for the denture base and teeth that provide durability and biocompatibility.
Mucosal Health – Considering the health of the oral mucosa and ensuring that the denture design does not irritate or cause pressure points.
⢠These considerations help in creating a complete denture prosthesis that is functional, comfortable, and aesthetically pleasing for patients with orthognathic ridge relationships.
⢠While maintaining appropriate space is important, a strict minimum interocclusal distance is not a primary focus. The emphasis is on overall fit and function rather than a specific distance.REFERENCE
Occlusal Considerations in Complete Dentures-Sandro Palla-Restorative and Prosthodontic Therapy. -
Question 96 of 150
96. Question
Gingivectomy is indicated in all of the cases, except?
Correct
ANSWER
Infrabony pocketsOTHER OPTIONS
⢠Explained in synopsisSYNOPSIS
⢠Gingivectomy is the excision of gingival tissue, usually to remove the diseased wall of a periodontal pocket (true pocket or pseudopocket). The term gingivectomy was coined by Pickerill in 1912.
⢠The basic prerequisites for gingivectomy are as follows
– There should be an adequate zone of attached gingiva so that the excision of part of it will still leave a functionally adequate zone.
– The underlying alveolar bone must be in normal or nearly normal form.
– There should be no infrabony defects or pockets.
⢠Indications
– Elimination of supra bony fibrous and firm pockets.
– Elimination of gingival enlargement.
– Increase clinical crown height.
– Need for bone surgery.
– When the bottom of the pocket is apical to the Mucogingival junction.
– Aesthetic considerations, particularly in the anterior region of the Maxilla.
– Surgical gingivectomy.
⢠Contraindications
– In the presence of thick alveolar edges, interdental craters.
– Presence of infrabony pockets.
– Situations in which the bottom of the pocket is apical to the mucogingival junction.
– Inadequate oral hygiene maintenance by the patients.
– Medically compromised patients.
– Dentinal sensitivity before the surgical procedure.REFERENCE
Carranza’s Clinical PeriodontologyIncorrect
ANSWER
Infrabony pocketsOTHER OPTIONS
⢠Explained in synopsisSYNOPSIS
⢠Gingivectomy is the excision of gingival tissue, usually to remove the diseased wall of a periodontal pocket (true pocket or pseudopocket). The term gingivectomy was coined by Pickerill in 1912.
⢠The basic prerequisites for gingivectomy are as follows
– There should be an adequate zone of attached gingiva so that the excision of part of it will still leave a functionally adequate zone.
– The underlying alveolar bone must be in normal or nearly normal form.
– There should be no infrabony defects or pockets.
⢠Indications
– Elimination of supra bony fibrous and firm pockets.
– Elimination of gingival enlargement.
– Increase clinical crown height.
– Need for bone surgery.
– When the bottom of the pocket is apical to the Mucogingival junction.
– Aesthetic considerations, particularly in the anterior region of the Maxilla.
– Surgical gingivectomy.
⢠Contraindications
– In the presence of thick alveolar edges, interdental craters.
– Presence of infrabony pockets.
– Situations in which the bottom of the pocket is apical to the mucogingival junction.
– Inadequate oral hygiene maintenance by the patients.
– Medically compromised patients.
– Dentinal sensitivity before the surgical procedure.REFERENCE
Carranza’s Clinical Periodontology -
Question 97 of 150
97. Question
A patient reports numbness of the chin and lower lip following the extraction of a deeply impacted mandibular premolar. Which branch is likely to be injured here?
Correct
ANSWER
Inferior alveolar nerveOTHER OPTIONS
⢠Lingual nerve – Supplies tongue and lingual gingiva.
⢠Buccal nerve – Supplies buccal gingiva of molars and cheek mucosa.
⢠Mylohyoid nerve – Motor to mylohyoid & anterior digastric, minimal sensory fibers.SYNOPSIS
⢠Sensory supply to the chin and lower lip is provided by the mental nerve, which is a terminal branch of the inferior alveolar nerve (IAN).
⢠If paresthesia occurs but the mental nerve is not directly listed, the injury must be on the main trunk proximal to the mental nerve’s exit.
⢠Therefore, damage to the Inferior Alveolar Nerve before it enters or emerges from the mental foramen will result in:
– Loss of sensation in the lower lip
– Loss of sensation in the chin
– Sometimes also the labial gingiva of anterior teethREFERENCE
Malamed ā Handbook of Local Anesthesia – 7th EditionIncorrect
ANSWER
Inferior alveolar nerveOTHER OPTIONS
⢠Lingual nerve – Supplies tongue and lingual gingiva.
⢠Buccal nerve – Supplies buccal gingiva of molars and cheek mucosa.
⢠Mylohyoid nerve – Motor to mylohyoid & anterior digastric, minimal sensory fibers.SYNOPSIS
⢠Sensory supply to the chin and lower lip is provided by the mental nerve, which is a terminal branch of the inferior alveolar nerve (IAN).
⢠If paresthesia occurs but the mental nerve is not directly listed, the injury must be on the main trunk proximal to the mental nerve’s exit.
⢠Therefore, damage to the Inferior Alveolar Nerve before it enters or emerges from the mental foramen will result in:
– Loss of sensation in the lower lip
– Loss of sensation in the chin
– Sometimes also the labial gingiva of anterior teethREFERENCE
Malamed ā Handbook of Local Anesthesia – 7th Edition -
Question 98 of 150
98. Question

Which of the following oral findings is most characteristic of the given condition?
Correct
ANSWER
Macroglossia with fissured tongueOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Patients with Down syndrome (Trisomy 21) commonly exhibit
– Relative macroglossia / protruding tongue (due to small oral cavity and hypotonia)
– Fissured tongue
– Delayed eruption of teeth
– Microdontia
– Anterior open bite
– Periodontal disease is more common, but dental caries incidence is typically LOWER than the general population
– Taurodontism may also be present
⢠Lower caries due to altered saliva, microdontia, and better caregiver-controlled diet.REFERENCE
Burketās Oral Medicine, 12th editionIncorrect
ANSWER
Macroglossia with fissured tongueOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Patients with Down syndrome (Trisomy 21) commonly exhibit
– Relative macroglossia / protruding tongue (due to small oral cavity and hypotonia)
– Fissured tongue
– Delayed eruption of teeth
– Microdontia
– Anterior open bite
– Periodontal disease is more common, but dental caries incidence is typically LOWER than the general population
– Taurodontism may also be present
⢠Lower caries due to altered saliva, microdontia, and better caregiver-controlled diet.REFERENCE
Burketās Oral Medicine, 12th edition -
Question 99 of 150
99. Question

A 55-year-old patient presents with complaints of discomfort while wearing their dentures. Upon intraoral examination, you observe bilateral bony protuberances along the lingual aspect of the mandible. The patient reports occasional irritation during mastication. What is the most likely cause of the patient’s discomfort?
Correct
ANSWER
Mandibular toriOTHER OPTIONS
⢠Fibroma – Fibromas are firm smooth papule in the mouth most often appear on the inside of the cheek where the upper and lower teeth meet.
⢠Gingival hyperplasia – Gingival (Gum) enlargement, also known as gingival hyperplasia or hypertrophy, isĀ an abnormal overgrowth of gingival tissues.
⢠Ameloblastoma – Ameloblastoma is a rare, noncancerous (benign) tumor that often develops in the jaw near the molars.SYNOPSIS
⢠Torus mandibularis is a nontender, bony outgrowth located on the lingual side of the mandible, in the canine or premolar region, above the attachment of the mylohyoid muscle.
⢠In most cases, bilateral tori are present.
⢠Usually asymptomatic with very slow growth and may stop spontaneously.Ā
⢠Surgical resection is seldom necessary but is indicated when ulceration, articulation disorder, or problems inserting dentures are present.REFERENCE
Mandibular tori – Canadian Medical Association JournalIncorrect
ANSWER
Mandibular toriOTHER OPTIONS
⢠Fibroma – Fibromas are firm smooth papule in the mouth most often appear on the inside of the cheek where the upper and lower teeth meet.
⢠Gingival hyperplasia – Gingival (Gum) enlargement, also known as gingival hyperplasia or hypertrophy, isĀ an abnormal overgrowth of gingival tissues.
⢠Ameloblastoma – Ameloblastoma is a rare, noncancerous (benign) tumor that often develops in the jaw near the molars.SYNOPSIS
⢠Torus mandibularis is a nontender, bony outgrowth located on the lingual side of the mandible, in the canine or premolar region, above the attachment of the mylohyoid muscle.
⢠In most cases, bilateral tori are present.
⢠Usually asymptomatic with very slow growth and may stop spontaneously.Ā
⢠Surgical resection is seldom necessary but is indicated when ulceration, articulation disorder, or problems inserting dentures are present.REFERENCE
Mandibular tori – Canadian Medical Association Journal -
Question 100 of 150
100. Question

On a mandibular periapical radiograph, a dense radiopaque line is seen running downward and forward from the anterior border of the ramus, often overlapping the roots of the mandibular molars. This structure represents which anatomical landmark?
Correct
ANSWER
Internal oblique ridgeOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Also called the internal oblique line.
⢠A bony ridge on the medial surface of the mandible.
⢠Formed by the mylohyoid muscle attachment but anatomically located superior and posterior to the mylohyoid line.
⢠On radiographs
– Appears as a radiopaque line
– Runs downward and forward from the ramus toward the mandibular molars
– Often superimposed on the roots of the mandibular molarsREFERENCE
Oral Radiology – Principles and Interpretation – Stuart C. White & Michael J. Pharoah – 8th EditionIncorrect
ANSWER
Internal oblique ridgeOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Also called the internal oblique line.
⢠A bony ridge on the medial surface of the mandible.
⢠Formed by the mylohyoid muscle attachment but anatomically located superior and posterior to the mylohyoid line.
⢠On radiographs
– Appears as a radiopaque line
– Runs downward and forward from the ramus toward the mandibular molars
– Often superimposed on the roots of the mandibular molarsREFERENCE
Oral Radiology – Principles and Interpretation – Stuart C. White & Michael J. Pharoah – 8th Edition -
Question 101 of 150
101. Question
A 38-year-old female patient undergoes root canal treatment for a mandibular molar. During the procedure, an endodontic instrument fractures, and the fragment is retained in the apical 3rd of the root canal. The dentist now needs to assess the prognosis and consider the management options for the fractured instrument. What will be the prognosis in this case?
Correct
ANSWER
PoorOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
a) Instrument fractured in the apical part of the canal – Removal of the fractured file fragment should not be attempted. One should change the working length prepare canal up to the fragment use some type of NaOCl agitation and obturate the canal in the same visit. Prognosis is generally poorer for a fractured instrument located in the apical third because it is more difficult to access,remove or bypass. Additionally, it may impede proper cleaning and sealing of the canal.
b) Instrument fractured in the middle part of the canal – One should try to bypass the broken instrument. If bypass is impossible the recommendation is to obturate the canal up to the instrument. The prognosis for a fractured instrument in the middle third is generally better compared to the apical third due to easier access and a high likelihood of successful removal or bypass. However, follow-up is obligatory and in case of post-treatment endodontic disease apical surgery should be considered.
c) Instrument fractured in coronal part of canal – Removal of a fractured instrument should be attempted with minimal dentin removal, different types of grasping equipment can be used.
⢠If instrument fracture occurs in the cervical third during RCT it shows a better prognosis because of better visualisation, and accessibility making the removal easier.REFERENCE
Broken Instruments – Clinical Decision Making Algorithm- American Association of Endodontists.Incorrect
ANSWER
PoorOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
a) Instrument fractured in the apical part of the canal – Removal of the fractured file fragment should not be attempted. One should change the working length prepare canal up to the fragment use some type of NaOCl agitation and obturate the canal in the same visit. Prognosis is generally poorer for a fractured instrument located in the apical third because it is more difficult to access,remove or bypass. Additionally, it may impede proper cleaning and sealing of the canal.
b) Instrument fractured in the middle part of the canal – One should try to bypass the broken instrument. If bypass is impossible the recommendation is to obturate the canal up to the instrument. The prognosis for a fractured instrument in the middle third is generally better compared to the apical third due to easier access and a high likelihood of successful removal or bypass. However, follow-up is obligatory and in case of post-treatment endodontic disease apical surgery should be considered.
c) Instrument fractured in coronal part of canal – Removal of a fractured instrument should be attempted with minimal dentin removal, different types of grasping equipment can be used.
⢠If instrument fracture occurs in the cervical third during RCT it shows a better prognosis because of better visualisation, and accessibility making the removal easier.REFERENCE
Broken Instruments – Clinical Decision Making Algorithm- American Association of Endodontists. -
Question 102 of 150
102. Question

A patient presents with complaints of discomfort and burning sensation in the mouth. On examination, you observe white, lacy streaks on the buccal mucosa with areas of erythema (see image). The patient mentions difficulty in eating spicy foods due to oral pain. There is no history of recent medication use. What is the most likely diagnosis?
Correct
ANSWER
Lichen planusOTHER OPTIONS
⢠Candidiasis – Oral thrush, also known as oral candidiasis, is a fungal infection that can affect the mouth. Symptoms include a white or yellow buildup on the tongue, or mucosa and an unpleasant taste, and discomfort.
⢠Geographic tongue – Geographic tongue (also known as benign migratory glossitis) is an inflammatory disorder that usually appears on the top and sides of the tongue. Usually asymptomatic.
⢠Oral lichenoid reaction – Lichenoid reaction (LR) isĀ an adverse effect that may be caused by the systemic administration of drugs including antihistamines, corticosteroids, and some other triggers.ĀSYNOPSIS
⢠Lichen planus is a chronic inflammatory disease that affects the mucus membrane of the oral cavity.
⢠It is a T-cell mediated autoimmune disease in which the cytotoxic CD8 T cells trigger apoptosis of the basal cells of the oral epithelium.
⢠Symptoms include white patches or lacy threads on the inside of the cheeks.
⢠Burning sensation is common.
⢠For mild cases no treatment is needed. In severe cases, corticosteroids can aid in relieving the pain.REFERENCE
Shafer’s Textbook of Oral Pathology 8th EditionIncorrect
ANSWER
Lichen planusOTHER OPTIONS
⢠Candidiasis – Oral thrush, also known as oral candidiasis, is a fungal infection that can affect the mouth. Symptoms include a white or yellow buildup on the tongue, or mucosa and an unpleasant taste, and discomfort.
⢠Geographic tongue – Geographic tongue (also known as benign migratory glossitis) is an inflammatory disorder that usually appears on the top and sides of the tongue. Usually asymptomatic.
⢠Oral lichenoid reaction – Lichenoid reaction (LR) isĀ an adverse effect that may be caused by the systemic administration of drugs including antihistamines, corticosteroids, and some other triggers.ĀSYNOPSIS
⢠Lichen planus is a chronic inflammatory disease that affects the mucus membrane of the oral cavity.
⢠It is a T-cell mediated autoimmune disease in which the cytotoxic CD8 T cells trigger apoptosis of the basal cells of the oral epithelium.
⢠Symptoms include white patches or lacy threads on the inside of the cheeks.
⢠Burning sensation is common.
⢠For mild cases no treatment is needed. In severe cases, corticosteroids can aid in relieving the pain.REFERENCE
Shafer’s Textbook of Oral Pathology 8th Edition -
Question 103 of 150
103. Question
When will be the right time to treat skeletal class 2 cases?
Correct
ANSWER
From 12-16 yearsOTHER OPTIONS
⢠5-9 years – Mixed dentition period, not advisable for treatment.
⢠After 18 years – can be done. Always a second option if the growth period is missed.SYNOPSIS
⢠Comprehensive orthodontic care in the adolescent permanent dentition again includes both orthopedic and orthodontic components.
⢠There are three basic alternatives for treating skeletal discrepancies- growth modification, camouflage, and orthognathic surgery.
⢠Growth modification is a means to change skeletal relationships by using the patient’s remaining growth to alter the size or position of the jaws.
⢠Growth modification during the early mixed-dentition years is effective in treating skeletal malocclusions.
⢠It is easiest to correct skeletal problems if a child is undergoing maximal facial growth during treatment.
⢠Girls tend to enter the adolescent growth spurt as defined by obvious somatic growth at approximately 10 years and boys at approximately 12 years.
⢠Growth modification appliances change the absolute size of one or both jaws. For example, a class II skeletal profile may be treated by making a deficient mandible larger to fit a normal-sized maxilla or by limiting the size of an oversized maxilla.
⢠The right time to treat skeletal class II falls from 12 to 16 years during growth spurtsREFERENCE
Pediatric dentistry Arthur.J.Nowak page 512,513Incorrect
ANSWER
From 12-16 yearsOTHER OPTIONS
⢠5-9 years – Mixed dentition period, not advisable for treatment.
⢠After 18 years – can be done. Always a second option if the growth period is missed.SYNOPSIS
⢠Comprehensive orthodontic care in the adolescent permanent dentition again includes both orthopedic and orthodontic components.
⢠There are three basic alternatives for treating skeletal discrepancies- growth modification, camouflage, and orthognathic surgery.
⢠Growth modification is a means to change skeletal relationships by using the patient’s remaining growth to alter the size or position of the jaws.
⢠Growth modification during the early mixed-dentition years is effective in treating skeletal malocclusions.
⢠It is easiest to correct skeletal problems if a child is undergoing maximal facial growth during treatment.
⢠Girls tend to enter the adolescent growth spurt as defined by obvious somatic growth at approximately 10 years and boys at approximately 12 years.
⢠Growth modification appliances change the absolute size of one or both jaws. For example, a class II skeletal profile may be treated by making a deficient mandible larger to fit a normal-sized maxilla or by limiting the size of an oversized maxilla.
⢠The right time to treat skeletal class II falls from 12 to 16 years during growth spurtsREFERENCE
Pediatric dentistry Arthur.J.Nowak page 512,513 -
Question 104 of 150
104. Question
A 45-year-old male presents with a flat erythematous lesion on the lateral tongue for 3 weeks. He has already used chlorhexidine mouthwash and analgesics prescribed by a general physician with no improvement. He is a non-smoker. What is the next appropriate step?
Correct
ANSWER
Refer for biopsy to rule out dysplasiaOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠An erythematous lesion persisting for >2 weeks, unresponsive to local measures, must be evaluated for erythroplakia or epithelial dysplasia or early SCC.
⢠Immediate referral for biopsy is indicated in this case.REFERENCE
Neville BW. Oral & Maxillofacial PathologyIncorrect
ANSWER
Refer for biopsy to rule out dysplasiaOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠An erythematous lesion persisting for >2 weeks, unresponsive to local measures, must be evaluated for erythroplakia or epithelial dysplasia or early SCC.
⢠Immediate referral for biopsy is indicated in this case.REFERENCE
Neville BW. Oral & Maxillofacial Pathology -
Question 105 of 150
105. Question
A 40-year-old patient presents with sharp pain to cold on a mandibular molar restored with amalgam. The restoration shows a visible crack. Periodontal condition is normal. The tooth is not tender to percussion, and cold pain subsides immediately after removal. What is the best management?
Correct
ANSWER
Replace restoration and monitorOTHER OPTIONS
⢠Extraction – Indicated only if prognosis hopeless. Not supported here.
⢠RCT – Indicated in irreversible pulpitis (lingering pain).
⢠Analgesics only – Symptomatic relief without removing the cause.SYNOPSIS
⢠Pain that goes away immediately – reversible pulpitis.
⢠Cracked restoration can cause microleakage leading to sensitivity.
⢠First step is remove defective restoration, evaluate crack, and place a bonded restoration.REFERENCE
Hargreaves & Cohen. Pathways of the Pulp, 12th edition.Incorrect
ANSWER
Replace restoration and monitorOTHER OPTIONS
⢠Extraction – Indicated only if prognosis hopeless. Not supported here.
⢠RCT – Indicated in irreversible pulpitis (lingering pain).
⢠Analgesics only – Symptomatic relief without removing the cause.SYNOPSIS
⢠Pain that goes away immediately – reversible pulpitis.
⢠Cracked restoration can cause microleakage leading to sensitivity.
⢠First step is remove defective restoration, evaluate crack, and place a bonded restoration.REFERENCE
Hargreaves & Cohen. Pathways of the Pulp, 12th edition. -
Question 106 of 150
106. Question
A 52-year-old woman reports generalized bone pain and recurrent renal stones. She also complains of mobility of multiple teeth. Intraoral radiographs reveal loss of lamina dura around several teeth and a āground-glassā trabecular pattern. Serum investigations show elevated PTH and hypercalcemia. What is the most likely diagnosis?
Correct
ANSWER
Primary hyperparathyroidismOTHER OPTIONS
⢠Osteoporosis – Does not cause loss of lamina dura or elevated PTH.
⢠Fibrous dysplasia – Ground-glass bone but normal PTH and usually unilateral craniofacial involvement.
⢠Pagetās disease – Cotton wool appearance, not ground-glass, elevated ALP, not PTH.SYNOPSIS
⢠The specific combination of clinical and radiological findings – loss of the lamina dura and a ground-glass appearance in bones, along with elevated parathyroid hormone (PTH) and hypercalcemia is indeed a classic presentation forĀ primary hyperparathyroidism.
⢠These signs are indicative of significant bone resorption due to excess PTH, a condition often caused by a benign tumor (adenoma) on one of the parathyroid glands.
⢠The radiological features are sometimes referred to as osteitis fibrosa cystica, a severe manifestation of the disease.REFERENCE
Neville BW et al. Oral & Maxillofacial Pathology, 4th editionIncorrect
ANSWER
Primary hyperparathyroidismOTHER OPTIONS
⢠Osteoporosis – Does not cause loss of lamina dura or elevated PTH.
⢠Fibrous dysplasia – Ground-glass bone but normal PTH and usually unilateral craniofacial involvement.
⢠Pagetās disease – Cotton wool appearance, not ground-glass, elevated ALP, not PTH.SYNOPSIS
⢠The specific combination of clinical and radiological findings – loss of the lamina dura and a ground-glass appearance in bones, along with elevated parathyroid hormone (PTH) and hypercalcemia is indeed a classic presentation forĀ primary hyperparathyroidism.
⢠These signs are indicative of significant bone resorption due to excess PTH, a condition often caused by a benign tumor (adenoma) on one of the parathyroid glands.
⢠The radiological features are sometimes referred to as osteitis fibrosa cystica, a severe manifestation of the disease.REFERENCE
Neville BW et al. Oral & Maxillofacial Pathology, 4th edition -
Question 107 of 150
107. Question
The barriers in communication like difficulties in hearing, seeing, or understanding and self-expression is known as?
Correct
ANSWER
Physiological barriersOTHER OPTIONS
⢠Psychological barriers – Psychological barriers are due to the emotional character and mental limitations of human beings. These barriers result in absent-mindedness, the fear of expressing one’s ideas to others, excitement, and emotional instability-all accounting for an overwhelming number of communication problems.
⢠Environmental Barriers – They often limit or prevent a person with a disability from fully participating in social, occupational, and recreational activities. For a wheelchair user, environmental barriers may include stairs, narrow doorways, heavy doors, or high countertops.
⢠Cultural barrier – A cultural barrier is an issue arising from a misunderstanding of meaning, caused by cultural differences between sender and receiver.SYNOPSIS
⢠Physiological barriers to communication are related to the limitations of the human body and the human mind (memory, attention, and perception).
⢠Physiological barriers may result from individuals’ personal discomfort, caused by ill-health, poor eyesight, or hearing difficulties.REFERENCE
Oxford clinical dentistry 7th edition pg 678Incorrect
ANSWER
Physiological barriersOTHER OPTIONS
⢠Psychological barriers – Psychological barriers are due to the emotional character and mental limitations of human beings. These barriers result in absent-mindedness, the fear of expressing one’s ideas to others, excitement, and emotional instability-all accounting for an overwhelming number of communication problems.
⢠Environmental Barriers – They often limit or prevent a person with a disability from fully participating in social, occupational, and recreational activities. For a wheelchair user, environmental barriers may include stairs, narrow doorways, heavy doors, or high countertops.
⢠Cultural barrier – A cultural barrier is an issue arising from a misunderstanding of meaning, caused by cultural differences between sender and receiver.SYNOPSIS
⢠Physiological barriers to communication are related to the limitations of the human body and the human mind (memory, attention, and perception).
⢠Physiological barriers may result from individuals’ personal discomfort, caused by ill-health, poor eyesight, or hearing difficulties.REFERENCE
Oxford clinical dentistry 7th edition pg 678 -
Question 108 of 150
108. Question
While adjusting a complete denture, a dentist ensures simultaneous bilateral contact of posterior teeth during eccentric movements. Which concept of occlusion is being applied?
Correct
ANSWER
Bilateral balanced occlusionOTHER OPTIONS
⢠Lingualized occlusion – Maxillary lingual cusps contact mandibular central fossae useful for resorbed ridges.
⢠Monoplane – Flat teeth no cuspal interdigitation.
⢠Group function – Natural dentition concept, not for complete dentures.SYNOPSIS
⢠In complete dentures, bilateral balanced occlusion ensures simultaneous contact of teeth on both working and non-working sides during all excursive movements, enhancing denture stability and retention.REFERENCE
Prosthodontic Treatment for Edentulous Patients (Zarb & Bolender), 13th edIncorrect
ANSWER
Bilateral balanced occlusionOTHER OPTIONS
⢠Lingualized occlusion – Maxillary lingual cusps contact mandibular central fossae useful for resorbed ridges.
⢠Monoplane – Flat teeth no cuspal interdigitation.
⢠Group function – Natural dentition concept, not for complete dentures.SYNOPSIS
⢠In complete dentures, bilateral balanced occlusion ensures simultaneous contact of teeth on both working and non-working sides during all excursive movements, enhancing denture stability and retention.REFERENCE
Prosthodontic Treatment for Edentulous Patients (Zarb & Bolender), 13th ed -
Question 109 of 150
109. Question
A dentist had instrument separation in the apical third after cleaning and shaping. He attempted to bypass and retrieve the file but failed. What will be the next treatment option?
Correct
ANSWER
Obturate till the file separation and follow upOTHER OPTIONS
Not applicableSYNOPSIS
⢠The common approach for dealing with a broken instrument is its removal.
⢠If instrument fractured after major cleaning and shaping in apical third of the canal, removal of the fractured file fragment should not be routinely attempted.
⢠Obturation up to the fragment is recommended.
⢠A broken file by itself does not induce inflammation.
⢠Periapical healing takes place if during Endodontic treatment disinfection decreases microbial load beneath the specific threshold.REFERENCE
Broken Instruments ā Clinical Decision Making Algorithm by American Association of Endodontists.Incorrect
ANSWER
Obturate till the file separation and follow upOTHER OPTIONS
Not applicableSYNOPSIS
⢠The common approach for dealing with a broken instrument is its removal.
⢠If instrument fractured after major cleaning and shaping in apical third of the canal, removal of the fractured file fragment should not be routinely attempted.
⢠Obturation up to the fragment is recommended.
⢠A broken file by itself does not induce inflammation.
⢠Periapical healing takes place if during Endodontic treatment disinfection decreases microbial load beneath the specific threshold.REFERENCE
Broken Instruments ā Clinical Decision Making Algorithm by American Association of Endodontists. -
Question 110 of 150
110. Question
A 52-year-old male with a history of chronic liver cirrhosis presents for extraction of a grossly decayed molar. He reports a known allergy to acetaminophen (rash and swelling after use). His physician notes impaired liver function (elevated INR and bilirubin). You plan to prescribe a postoperative analgesic. Which of the following is the most appropriate analgesic choice for this patient?
Correct
ANSWER
Ibuprofen at standard dosesOTHER OPTIONS
⢠Regular-dose acetaminophen – Acetaminophen is primarily metabolized by the liver. In patients with liver impairment and acetaminophen allergy, it must be avoided.
⢠Aspirin 325 mg every 6 hours – Aspirin is avoided because it can increase bleeding risk (especially dangerous in cirrhosis patients who often have coagulation problems).
⢠Codeine with acetaminophen combination – Codeine with acetaminophen is contraindicated because of the acetaminophen allergy and the liver metabolism concerns.SYNOPSIS
⢠Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can be used with caution
⢠It does not rely on liver metabolism as heavily as acetaminophen.
⢠However, NSAIDs should still be used carefully in liver patients because they can cause renal issues and gastrointestinal bleeding – but if short-term pain control is needed and bleeding risk is managed, standard-dose ibuprofen is the better choice among the options provided.REFERENCE
Little JW, Falace DA, Miller CS, Rhodus NLIncorrect
ANSWER
Ibuprofen at standard dosesOTHER OPTIONS
⢠Regular-dose acetaminophen – Acetaminophen is primarily metabolized by the liver. In patients with liver impairment and acetaminophen allergy, it must be avoided.
⢠Aspirin 325 mg every 6 hours – Aspirin is avoided because it can increase bleeding risk (especially dangerous in cirrhosis patients who often have coagulation problems).
⢠Codeine with acetaminophen combination – Codeine with acetaminophen is contraindicated because of the acetaminophen allergy and the liver metabolism concerns.SYNOPSIS
⢠Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can be used with caution
⢠It does not rely on liver metabolism as heavily as acetaminophen.
⢠However, NSAIDs should still be used carefully in liver patients because they can cause renal issues and gastrointestinal bleeding – but if short-term pain control is needed and bleeding risk is managed, standard-dose ibuprofen is the better choice among the options provided.REFERENCE
Little JW, Falace DA, Miller CS, Rhodus NL -
Question 111 of 150
111. Question
A patient who has a regular habit of consuming non smokeless tobacco with areca nuts came to your clinic with a complaint of limited mouth opening and burning sensation of mouth. You noticed fibrous bands in oral cavity and diagnosed condition as oral submucous fibrosis. What treatment can be given for the condition?
Correct
ANSWER
Intralesional corticosteroid injectionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Oral submucous fibrosis is a chronic, progressive, scarring disease.
⢠Habitual chewing of areca nut is an important factor in etiology of OSF.
⢠Burning sensation in mouth, excessive salivation or dryness of mouth, trismus and defective gustatory sensations are features.
⢠In advanced cases, fibrous bands are seen in buccal mucosa, causing fixation and shortening of uvula and soft palate.
⢠Management includes reduction or elimination of habit with nutritional support with proteins, vitamin B and other vitamins, physiotherapy, immunomodulatory drugs, local drug delivery with local injections of corticosteroids hyaluronidase or collagenase etc.
⢠Surgical management by resection of fibrotic bands and replacement with partial thickness skin or mucosal graft but it seems to be a poor option in overall management as it may result in more fibrosis and disability.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 151.Incorrect
ANSWER
Intralesional corticosteroid injectionOTHER OPTIONS
Not applicableSYNOPSIS
⢠Oral submucous fibrosis is a chronic, progressive, scarring disease.
⢠Habitual chewing of areca nut is an important factor in etiology of OSF.
⢠Burning sensation in mouth, excessive salivation or dryness of mouth, trismus and defective gustatory sensations are features.
⢠In advanced cases, fibrous bands are seen in buccal mucosa, causing fixation and shortening of uvula and soft palate.
⢠Management includes reduction or elimination of habit with nutritional support with proteins, vitamin B and other vitamins, physiotherapy, immunomodulatory drugs, local drug delivery with local injections of corticosteroids hyaluronidase or collagenase etc.
⢠Surgical management by resection of fibrotic bands and replacement with partial thickness skin or mucosal graft but it seems to be a poor option in overall management as it may result in more fibrosis and disability.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 151. -
Question 112 of 150
112. Question
What should be the minimum distance between mandibular nerve and apex of implant(in mm)?
Correct
ANSWER
2 mmOTHER OPTIONS
Not applicableSYNOPSIS
⢠A safety distance of 2 mm has been widely accepted as the standard measurement to prevent implant related nerve injuries.
⢠Implant placement is the second most common cause for IAN damage, following the removal of impacted wisdom teeth.
⢠New studies says that if one can avoid thermal, pressure, and traumatic damage to the IAN, then implants can be placed closer than 2 mm to the Inferior Alveolar Canal.REFERENCE
A New Concept of Safety Distance to Place Implants in the Area of the Inferior Alveolar Canal to Avoid Neurosensory Disturbance.Incorrect
ANSWER
2 mmOTHER OPTIONS
Not applicableSYNOPSIS
⢠A safety distance of 2 mm has been widely accepted as the standard measurement to prevent implant related nerve injuries.
⢠Implant placement is the second most common cause for IAN damage, following the removal of impacted wisdom teeth.
⢠New studies says that if one can avoid thermal, pressure, and traumatic damage to the IAN, then implants can be placed closer than 2 mm to the Inferior Alveolar Canal.REFERENCE
A New Concept of Safety Distance to Place Implants in the Area of the Inferior Alveolar Canal to Avoid Neurosensory Disturbance. -
Question 113 of 150
113. Question
A 6-year-old child has premature loss of both mandibular second primary molars. The first permanent molars have erupted and are well aligned. Which is the most appropriate space maintainer?
Correct
ANSWER
Bilateral band and loopOTHER OPTIONS
⢠Lingual arch – When the permanent molars and incisors erupt, a lower lingual holding arch can replace the band and loop appliances.
⢠Distal shoe – If the loss occurs just before the eruption of the first permanent molar, that is, when the first molar crown is still covered with oral mucosa and a thin partial covering of bone, a space maintainer to guide the positioning of the first permanent molar into normal occlusion is desirable.SYNOPSIS
⢠Indications of Band and Loop space maintainer
– In case of premature loss of any primary molar in primary dentition or primary molar in transitional dentition with permanent successor not erupting clinically for the next two years and its root length is less than one-third mature.
– Premature loss of a primary second molar as the permanent first molar is erupted clinically.
– Bilateral loss of single primary molar before the eruption of the permanent incisors.⢠Contraindications
– A dentition that is extremely crowded or already exhibits marked space loss
– High caries risk
– Replacement of primary anteriors
– Replacement of primary second molars in transitional dentition with permanent molar tooth not erupted.REFERENCE
Pediatric dentistry – Arthur.J.NowakIncorrect
ANSWER
Bilateral band and loopOTHER OPTIONS
⢠Lingual arch – When the permanent molars and incisors erupt, a lower lingual holding arch can replace the band and loop appliances.
⢠Distal shoe – If the loss occurs just before the eruption of the first permanent molar, that is, when the first molar crown is still covered with oral mucosa and a thin partial covering of bone, a space maintainer to guide the positioning of the first permanent molar into normal occlusion is desirable.SYNOPSIS
⢠Indications of Band and Loop space maintainer
– In case of premature loss of any primary molar in primary dentition or primary molar in transitional dentition with permanent successor not erupting clinically for the next two years and its root length is less than one-third mature.
– Premature loss of a primary second molar as the permanent first molar is erupted clinically.
– Bilateral loss of single primary molar before the eruption of the permanent incisors.⢠Contraindications
– A dentition that is extremely crowded or already exhibits marked space loss
– High caries risk
– Replacement of primary anteriors
– Replacement of primary second molars in transitional dentition with permanent molar tooth not erupted.REFERENCE
Pediatric dentistry – Arthur.J.Nowak -
Question 114 of 150
114. Question
A premolar with a recently placed crown shows grade II mobility. But the periodontal and periapical findings were normal. What is the reason ?
Correct
ANSWER
Primary occlusal traumaOTHER OPTIONS
⢠Secondary occlusal trauma – Secondary occlusal traumaĀ is injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced periodontal support.Ā It occurs in the presence of attachment loss, bone loss, and normal or excessive occlusal force(s).
⢠Insufficient ferrule – leads to poor fracture resistance
⢠Periodontitis – Periodontitis isĀ a severe gum infection that can lead to tooth loss and other serious health complications.SYNOPSIS
⢠Occlusal trauma is a term used to describe an injury resulting in tissue changes within the attachment apparatus, including periodontal ligament, supporting alveolar bone, and cementum, as a result of occlusal force(s).
⢠Occlusal trauma may occur in an intact periodontium or in a reduced periodontium caused by periodontal disease.
⢠Primary occlusal trauma is an injury resulting in tissue changes from excessive occlusal forces applied to a tooth or teeth with normal periodontal support.
⢠It occurs in the presence of normal clinical attachment levels, normal bone levels, and excessive occlusal force(s)
⢠The signs and symptoms experienced by patients with occlusal trauma areĀ
– Mobility of teeth,
– Temperomandibular joint pain,
– Pain on mastication
⢠Early diagnosis, proper treatment plan and correction of malocclusion can lead to a successful outcome.REFERENCE
Carranzas Clinical PeriodontologyIncorrect
ANSWER
Primary occlusal traumaOTHER OPTIONS
⢠Secondary occlusal trauma – Secondary occlusal traumaĀ is injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced periodontal support.Ā It occurs in the presence of attachment loss, bone loss, and normal or excessive occlusal force(s).
⢠Insufficient ferrule – leads to poor fracture resistance
⢠Periodontitis – Periodontitis isĀ a severe gum infection that can lead to tooth loss and other serious health complications.SYNOPSIS
⢠Occlusal trauma is a term used to describe an injury resulting in tissue changes within the attachment apparatus, including periodontal ligament, supporting alveolar bone, and cementum, as a result of occlusal force(s).
⢠Occlusal trauma may occur in an intact periodontium or in a reduced periodontium caused by periodontal disease.
⢠Primary occlusal trauma is an injury resulting in tissue changes from excessive occlusal forces applied to a tooth or teeth with normal periodontal support.
⢠It occurs in the presence of normal clinical attachment levels, normal bone levels, and excessive occlusal force(s)
⢠The signs and symptoms experienced by patients with occlusal trauma areĀ
– Mobility of teeth,
– Temperomandibular joint pain,
– Pain on mastication
⢠Early diagnosis, proper treatment plan and correction of malocclusion can lead to a successful outcome.REFERENCE
Carranzas Clinical Periodontology -
Question 115 of 150
115. Question
What type of molar relation is when the mesiobuccal cusp of the maxillary first molar occluding in line with the buccal groove of the mandibular first molar?
Correct
ANSWER
Class IOTHER OPTIONS
⢠Class II Molar relationship – where the lower first molar is posterior (or more towards the back of the mouth) than the upper first molar. Convex profile
⢠Class III Molar relationship -.where the lower first molar is anterior (or more towards the front of the mouth) than the upper first molar. Concave profile.SYNOPSIS
⢠Class 1 Molar Relationship – According to Angle, the mesiobuccal cusp of the maxillary first molar aligns with the buccal groove of the mandibular first molar.
⢠Canine Relationship – The maxillary canine occludes with the distal half of the mandibular canine and the mesial half of the mandibular first premolar.
⢠Line of Occlusion – The teeth all fit on a line of occlusion which, in the upper arch, is a smooth curve through the central fossae of the posterior teeth and cingulum of the canines and incisors, and in the lower arch, is a smooth curve through the buccal cusps of the posterior teeth and incisal edges of the anterior teeth.
⢠There is a perfect alignment of the teeth, normal overbite and overjet, and coincident maxillary and mandibular midlines.REFERENCE
ANGLEāS CLASSIFICATION OF MALOCCLUSION. Dr. Samuel WallaceIncorrect
ANSWER
Class IOTHER OPTIONS
⢠Class II Molar relationship – where the lower first molar is posterior (or more towards the back of the mouth) than the upper first molar. Convex profile
⢠Class III Molar relationship -.where the lower first molar is anterior (or more towards the front of the mouth) than the upper first molar. Concave profile.SYNOPSIS
⢠Class 1 Molar Relationship – According to Angle, the mesiobuccal cusp of the maxillary first molar aligns with the buccal groove of the mandibular first molar.
⢠Canine Relationship – The maxillary canine occludes with the distal half of the mandibular canine and the mesial half of the mandibular first premolar.
⢠Line of Occlusion – The teeth all fit on a line of occlusion which, in the upper arch, is a smooth curve through the central fossae of the posterior teeth and cingulum of the canines and incisors, and in the lower arch, is a smooth curve through the buccal cusps of the posterior teeth and incisal edges of the anterior teeth.
⢠There is a perfect alignment of the teeth, normal overbite and overjet, and coincident maxillary and mandibular midlines.REFERENCE
ANGLEāS CLASSIFICATION OF MALOCCLUSION. Dr. Samuel Wallace -
Question 116 of 150
116. Question
A 17 years old male patient came to your clinic for orthodontic treatment. On full mouth radiographic examination you noted a radiolucent area with sclerotic border involving the roots of 45 and 46 as seen in the diagram below. All his teeth are vital. What is the condition?
Correct
ANSWER
Traumatic bone cystOTHER OPTIONS
⢠Stafne bone cyst – Stafne bone cyst is developmental abnormality seen as asymptomatic radiolucency at angle of mandible below mandibular canal.
⢠Dentigerous cyst – Dentigerous cyst is odontogenic cyst seen as pericoronal radiolucency around unerupted tooth.SYNOPSIS
⢠Traumatic bone cyst is a pseudocyst and non odongenic.
⢠May develop due to trauma.
⢠Found in young patients mean age of 18 years.
⢠Clinically, it is asymptomatic and discovered in routine radiographic examination.
⢠Radiographically, it is seen as radiolucent area with sclerotic border sometimes involving the roots of teeth in the region , especially in posterior mandible.
⢠All associated teeth will be vital and treatment involves surgical exploration of cavity with enucleation of lining and reestablish bleeding into cavity.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 95.Incorrect
ANSWER
Traumatic bone cystOTHER OPTIONS
⢠Stafne bone cyst – Stafne bone cyst is developmental abnormality seen as asymptomatic radiolucency at angle of mandible below mandibular canal.
⢠Dentigerous cyst – Dentigerous cyst is odontogenic cyst seen as pericoronal radiolucency around unerupted tooth.SYNOPSIS
⢠Traumatic bone cyst is a pseudocyst and non odongenic.
⢠May develop due to trauma.
⢠Found in young patients mean age of 18 years.
⢠Clinically, it is asymptomatic and discovered in routine radiographic examination.
⢠Radiographically, it is seen as radiolucent area with sclerotic border sometimes involving the roots of teeth in the region , especially in posterior mandible.
⢠All associated teeth will be vital and treatment involves surgical exploration of cavity with enucleation of lining and reestablish bleeding into cavity.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 95. -
Question 117 of 150
117. Question
A 26 years old male patient came to your clinic for orthodontic consultation. On clinical examination, you noticed that his mediobuccal cusp of upper first molar occludes with mesiobuccal groove of lower first molar with anterior teeth crowding. What is the class of malocclusion?
Correct
ANSWER
Class IOTHER OPTIONS
Refer synopsis.SYNOPSIS
⢠Angle classified malocclusion depending on the molar relation.
⢠Class I – Mesiobuccal cusp of upper first molar occludes on mesiobuccal groove of lower first molar.
⢠Class II – Mesiobuccal groove of lower first molar occludes distal to mesiobuccal cusp of upper first molar.
⢠Division 1 – Upper central incisors are proclined.
⢠Division 2 – Upper central incisors are retroclined with proclined upper lateral incisors.
⢠Class III – Mesiobuccal groove of lower first molar anterior to mesiobuccal cusp of upper first molar.REFERENCE
Orthodontics The Art and Science – 6th Edition.Incorrect
ANSWER
Class IOTHER OPTIONS
Refer synopsis.SYNOPSIS
⢠Angle classified malocclusion depending on the molar relation.
⢠Class I – Mesiobuccal cusp of upper first molar occludes on mesiobuccal groove of lower first molar.
⢠Class II – Mesiobuccal groove of lower first molar occludes distal to mesiobuccal cusp of upper first molar.
⢠Division 1 – Upper central incisors are proclined.
⢠Division 2 – Upper central incisors are retroclined with proclined upper lateral incisors.
⢠Class III – Mesiobuccal groove of lower first molar anterior to mesiobuccal cusp of upper first molar.REFERENCE
Orthodontics The Art and Science – 6th Edition. -
Question 118 of 150
118. Question
A 60 years old male patient with CD came to your clinic with a complain of clicking of teeth. What is the type of material with which his CD is fabricated?
Correct
ANSWER
PorcelainOTHER OPTIONS
Not applicableSYNOPSIS
⢠Different types of teeth can be used in CD fabrication.
⢠Acrylic teeth shows more artificial teeth wear but produce less clicking sound.
⢠Porcelain teeth resembles natural teeth more but these are brittle, heavy, cause opposing natural teeth wear and produce clicking sounds.
⢠Porcelain are noisy while chewing.REFERENCE
Prosthodontic Treatment for Edentulous Patients, Complete Dentures and Implant Supported Prostheses – Page No 303.Incorrect
ANSWER
PorcelainOTHER OPTIONS
Not applicableSYNOPSIS
⢠Different types of teeth can be used in CD fabrication.
⢠Acrylic teeth shows more artificial teeth wear but produce less clicking sound.
⢠Porcelain teeth resembles natural teeth more but these are brittle, heavy, cause opposing natural teeth wear and produce clicking sounds.
⢠Porcelain are noisy while chewing.REFERENCE
Prosthodontic Treatment for Edentulous Patients, Complete Dentures and Implant Supported Prostheses – Page No 303. -
Question 119 of 150
119. Question
A 45 year old male patient came to your clinic. He has severe periodontitis. He is a heavy smoker with halitosis and poor oral hygiene. What would be the main cause for progression of periodontitis?
Correct
ANSWER
Heavy smoking habitOTHER OPTIONS
Not applicableSYNOPSIS
⢠Smoking results in increased periodontal destruction.
⢠It alters neutrophil chemotaxis, phagocytosis and oxidative burst.
⢠It increases TNF alpha and prostaglandin E2 in GCF.
⢠Immunoglobulin G2 level is reduced suggesting reduced protection against periodontal infection.
⢠Nicotine suppresses osteoblast production and stimulates alkaline phosphatase activity.
⢠Smoking in turn can also result in poorer oral hygiene.REFERENCE
Essentials of Clinical Periodontology and Periodontics – 5th Edition Page No 151.Incorrect
ANSWER
Heavy smoking habitOTHER OPTIONS
Not applicableSYNOPSIS
⢠Smoking results in increased periodontal destruction.
⢠It alters neutrophil chemotaxis, phagocytosis and oxidative burst.
⢠It increases TNF alpha and prostaglandin E2 in GCF.
⢠Immunoglobulin G2 level is reduced suggesting reduced protection against periodontal infection.
⢠Nicotine suppresses osteoblast production and stimulates alkaline phosphatase activity.
⢠Smoking in turn can also result in poorer oral hygiene.REFERENCE
Essentials of Clinical Periodontology and Periodontics – 5th Edition Page No 151. -
Question 120 of 150
120. Question
A 27-year-old patient presents with localized aggressive periodontitis. Subgingival plaque samples reveal the presence of Aggregatibacter actinomycetemcomitans. The clinician considers adjunctive systemic antibiotic therapy. Which of the following is the only antibiotic in periodontal therapy to which all strains of A. actinomycetemcomitans are susceptible?
Correct
ANSWER
CiprofloxacinOTHER OPTIONS
⢠Erythromycin – Many strains show resistance.
⢠Amoxicillin – Effective against some oral pathogens but not reliably against A. actinomycetemcomitans alone.SYNOPSIS
⢠Aggregatibacter actinomycetemcomitans is a key pathogen in aggressive periodontitis.
⢠Ciprofloxacin is unique because all strains of A. actinomycetemcomitans are susceptible to it.REFERENCE
Carranzaās Clinical Periodontology, 13th EditionIncorrect
ANSWER
CiprofloxacinOTHER OPTIONS
⢠Erythromycin – Many strains show resistance.
⢠Amoxicillin – Effective against some oral pathogens but not reliably against A. actinomycetemcomitans alone.SYNOPSIS
⢠Aggregatibacter actinomycetemcomitans is a key pathogen in aggressive periodontitis.
⢠Ciprofloxacin is unique because all strains of A. actinomycetemcomitans are susceptible to it.REFERENCE
Carranzaās Clinical Periodontology, 13th Edition -
Question 121 of 150
121. Question
To minimize the risk of black triangles between teeth, the distance from the contact point to the alveolar bone should be
Correct
ANSWER
Less than 5mmOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠To minimize the risk of black triangles between teeth, the distance from the contact point to the alveolar bone should beĀ 5 mm or less.Ā
⢠The iconic study by Tarnow et al. who produced the 5 mm rule, states that when the distance from the contact point to the interproximal osseous crest is 5 mm or less, there is complete fill of the gingival embrasures with an interdental papilla.
⢠For every 1 mm above 5 mm, the chance of complete fill is progressively reduced by 50 percent.
⢠For square-shaped teeth with wide contact points, the chances of black triangles is minimal compared with triangular teeth having narrow, more incisally positioned contact points.REFERENCE
Black triangle dilemma and its management in esthetic dentistry – Dental Research Journal 2013 JuneIncorrect
ANSWER
Less than 5mmOTHER OPTIONS
⢠Refer SynopsisSYNOPSIS
⢠To minimize the risk of black triangles between teeth, the distance from the contact point to the alveolar bone should beĀ 5 mm or less.Ā
⢠The iconic study by Tarnow et al. who produced the 5 mm rule, states that when the distance from the contact point to the interproximal osseous crest is 5 mm or less, there is complete fill of the gingival embrasures with an interdental papilla.
⢠For every 1 mm above 5 mm, the chance of complete fill is progressively reduced by 50 percent.
⢠For square-shaped teeth with wide contact points, the chances of black triangles is minimal compared with triangular teeth having narrow, more incisally positioned contact points.REFERENCE
Black triangle dilemma and its management in esthetic dentistry – Dental Research Journal 2013 June -
Question 122 of 150
122. Question
60-year-old female, presents with dry mouth and dry eyes. Lab tests reveal positive anti-SSA (Ro) and anti-SSB (La) antibodies. Which additional diagnostic test should be considered for confirming Sjƶgren syndrome?
Correct
ANSWER
Minor salivary gland biopsyOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Sjögren syndrome diagnosis is confirmed with a positive salivary gland biopsy showing focal lymphocytic sialadenitis.
⢠Positive anti-SSA and anti-SSB antibodies further support the diagnosis.REFERENCE
Incorrect
ANSWER
Minor salivary gland biopsyOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Sjögren syndrome diagnosis is confirmed with a positive salivary gland biopsy showing focal lymphocytic sialadenitis.
⢠Positive anti-SSA and anti-SSB antibodies further support the diagnosis.REFERENCE
-
Question 123 of 150
123. Question
What will you do for an 8 year old child patient with obliteration in the central permanent incisor?
Correct
ANSWER
Careful monitoringOTHER OPTIONS
⢠No need for any particular treatment until symptomatic.SYNOPSIS
⢠Occurrence of obliteration in permanent teeth increased over time, with most cases diagnosed more than 3 years following the trauma.
⢠Although pulp canal obliteration is a pathologic process, it has no known deleterious effects and therefore does not necessitate any treatment in primary or permanent teeth except follow-up.
⢠In teeth with an open apex, there is a greater possibility of maintaining pulp vitality or revascularization of the neurovascular supply compared to mature teeth, due to the intense cell activity capable of promoting the defense and regeneration of affected tissues.REFERENCE
Pulp canal obliteration to primary and permanent teeth following trauma-Bianca SantosIncorrect
ANSWER
Careful monitoringOTHER OPTIONS
⢠No need for any particular treatment until symptomatic.SYNOPSIS
⢠Occurrence of obliteration in permanent teeth increased over time, with most cases diagnosed more than 3 years following the trauma.
⢠Although pulp canal obliteration is a pathologic process, it has no known deleterious effects and therefore does not necessitate any treatment in primary or permanent teeth except follow-up.
⢠In teeth with an open apex, there is a greater possibility of maintaining pulp vitality or revascularization of the neurovascular supply compared to mature teeth, due to the intense cell activity capable of promoting the defense and regeneration of affected tissues.REFERENCE
Pulp canal obliteration to primary and permanent teeth following trauma-Bianca Santos -
Question 124 of 150
124. Question
A 36-year-old male reported with a history of painful ulcerations involving the palate and gingiva for the past 2 weeks. History revealed that the ulcerations started initially as blisters and were associated with pain that was aggravated by chewing food. The ulcerations caused considerable discomfort, affecting his normal oral functions. Personal and family histories were uneventful. Direct immunoflurescence showed prominent intercellular deposition of antibodies directed against IgG and C3. What is your diagnosis?
Correct
ANSWER
Pemphigus VulgarisOTHER OPTIONS
⢠Epidermolysis bullosa- inherited diseases that are characterised by blistering lesions on the skin and mucous membranes.
⢠Lichen planus- chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes.SYNOPSIS
⢠Pemphigus Vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes.
⢠The initial clinical manifestation is frequently the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin.
⢠These antibodies are targeted against the adhesion proteins of keratinocytes, leading to acantholysis (disruption of spinous layer, leading to intraepidermal clefting) and blister formation.Ā
⢠The histopathological sections showed the following features.
– Suprabasilar clefting of surface epithelium
– Characteristic tombstone appearance of the basal cell layer on the floor of the bulla.
– Spongiosis with acantholysis,
– Tzanck cells and the focal influx of neutrophils, eosinophils and lymphocytes.
⢠Direct Immuno Fluorescence showed prominent intercellular deposition of antibodies directed against IgG and C3
⢠Nikolsky sign is positiveREFERENCE
Shafer’s Textbook of Oral PathologyIncorrect
ANSWER
Pemphigus VulgarisOTHER OPTIONS
⢠Epidermolysis bullosa- inherited diseases that are characterised by blistering lesions on the skin and mucous membranes.
⢠Lichen planus- chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes.SYNOPSIS
⢠Pemphigus Vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes.
⢠The initial clinical manifestation is frequently the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin.
⢠These antibodies are targeted against the adhesion proteins of keratinocytes, leading to acantholysis (disruption of spinous layer, leading to intraepidermal clefting) and blister formation.Ā
⢠The histopathological sections showed the following features.
– Suprabasilar clefting of surface epithelium
– Characteristic tombstone appearance of the basal cell layer on the floor of the bulla.
– Spongiosis with acantholysis,
– Tzanck cells and the focal influx of neutrophils, eosinophils and lymphocytes.
⢠Direct Immuno Fluorescence showed prominent intercellular deposition of antibodies directed against IgG and C3
⢠Nikolsky sign is positiveREFERENCE
Shafer’s Textbook of Oral Pathology -
Question 125 of 150
125. Question
A patient came to the clinic complaining of severe pain on biting, related to a certain tooth. Upon examination, there were no pulpal or periodontal findings, and pulpal vitality is positive. What is the diagnosis?
Correct
ANSWER
Cracked tooth syndromeOTHER OPTIONS
⢠Acute apical periodontitis -Pain, tenderness to biting pressure, percussion or palpation as well as swellings are typical clinical expressions of symptomatic apical periodontitis
⢠Chronic apical periodontitis – Long-standing infection, patient may not have pain. Presence of sinus tract.
⢠Periapical abscess – Presence of purulent swellingSYNOPSIS
⢠The most common causes of a cracked tooth are
– Age,Ā with many tooth cracks happening at age 50 and older.
– Biting hard foods,Ā such as candy, ice, or popcorn kernels.
– Habits,Ā such as gum chewing, and ice chewing.
– LargeĀ dental fillingsĀ or a root canal,Ā that weaken the tooth.
– Teeth grinding (bruxism).
– Trauma,Ā including falls, sports injuries, bike accidents, car accidents, or physical violence.
⢠Cracked teeth do not always cause symptoms. When they do, the main symptoms include
– Pain that comes and goes, particularly when chewing.
– SensitivityĀ to temperature changes or eating sweet foods.
– Swelling around the tooth.
– ToothacheĀ when biting or chewing.REFERENCE
Cracked tooth syndrome: Overview of literature – International Journal of Applied and Basic Medical ResearchIncorrect
ANSWER
Cracked tooth syndromeOTHER OPTIONS
⢠Acute apical periodontitis -Pain, tenderness to biting pressure, percussion or palpation as well as swellings are typical clinical expressions of symptomatic apical periodontitis
⢠Chronic apical periodontitis – Long-standing infection, patient may not have pain. Presence of sinus tract.
⢠Periapical abscess – Presence of purulent swellingSYNOPSIS
⢠The most common causes of a cracked tooth are
– Age,Ā with many tooth cracks happening at age 50 and older.
– Biting hard foods,Ā such as candy, ice, or popcorn kernels.
– Habits,Ā such as gum chewing, and ice chewing.
– LargeĀ dental fillingsĀ or a root canal,Ā that weaken the tooth.
– Teeth grinding (bruxism).
– Trauma,Ā including falls, sports injuries, bike accidents, car accidents, or physical violence.
⢠Cracked teeth do not always cause symptoms. When they do, the main symptoms include
– Pain that comes and goes, particularly when chewing.
– SensitivityĀ to temperature changes or eating sweet foods.
– Swelling around the tooth.
– ToothacheĀ when biting or chewing.REFERENCE
Cracked tooth syndrome: Overview of literature – International Journal of Applied and Basic Medical Research -
Question 126 of 150
126. Question
Which of the following disinfectants is most commonly used to sterilize dental impressions, such as alginate, before sending them to the lab?
Correct
ANSWER
IodophorOTHER OPTIONS
⢠Glutaraldehyde – Preferred for elastomeric impression materials.
⢠Alcohol-based disinfectants – They are not recommended, as they cause rapid surface drying and poor disinfection.SYNOPSIS
⢠Alginate impressions are hydrophilic and dimensionally unstable, hence, the disinfectant must be effective yet gentle.
⢠Glutaraldehyde, while effective, can be too aggressive for certain impression materials and may cause deformation.
⢠For effective disinfection, alginate impressions should typically be immersed in an iodophor solution for around 10 minutes.
⢠This time frame is sufficient to kill most microorganisms without compromising the quality or accuracy of the impression.REFERENCE
Evaluation of the Effectiveness of Disinfectants on Impression Materials CureusIncorrect
ANSWER
IodophorOTHER OPTIONS
⢠Glutaraldehyde – Preferred for elastomeric impression materials.
⢠Alcohol-based disinfectants – They are not recommended, as they cause rapid surface drying and poor disinfection.SYNOPSIS
⢠Alginate impressions are hydrophilic and dimensionally unstable, hence, the disinfectant must be effective yet gentle.
⢠Glutaraldehyde, while effective, can be too aggressive for certain impression materials and may cause deformation.
⢠For effective disinfection, alginate impressions should typically be immersed in an iodophor solution for around 10 minutes.
⢠This time frame is sufficient to kill most microorganisms without compromising the quality or accuracy of the impression.REFERENCE
Evaluation of the Effectiveness of Disinfectants on Impression Materials Cureus -
Question 127 of 150
127. Question
You dispose waste materials after doing treatment for a hepatitis B patient carelessly. Your dental clinic cleaning staff was got needle prick injury. Which infection control is failed here?
Correct
ANSWER
Active infection controlOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Without proper infection control techniques, many of the things in a dental clinic, including people, instruments, and even computer components can be carriers for cross-contamination and contribute to the spreading of germs and disease.
⢠Active Infection control prevents or stops the spread of infections in healthcare settings.
ā¢.Non-disposable items like dental tools are cleaned and sterilized between patients.
⢠Disposable dental tools and needles are never reused.
⢠Infection control precautions also require all dental staff involved in patient care to use appropriate protective equipment such as gloves, masks, gowns, and eyewear when needed.
⢠Failure to follow any of the above guidelines means failure of active infection control.REFERENCE
Hepatitis B- Penina Haber, MPH and Sarah Schillie, MD, MPH, MBAIncorrect
ANSWER
Active infection controlOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Without proper infection control techniques, many of the things in a dental clinic, including people, instruments, and even computer components can be carriers for cross-contamination and contribute to the spreading of germs and disease.
⢠Active Infection control prevents or stops the spread of infections in healthcare settings.
ā¢.Non-disposable items like dental tools are cleaned and sterilized between patients.
⢠Disposable dental tools and needles are never reused.
⢠Infection control precautions also require all dental staff involved in patient care to use appropriate protective equipment such as gloves, masks, gowns, and eyewear when needed.
⢠Failure to follow any of the above guidelines means failure of active infection control.REFERENCE
Hepatitis B- Penina Haber, MPH and Sarah Schillie, MD, MPH, MBA -
Question 128 of 150
128. Question
A young patient is worried about proclination. On examination you noticed that the patient has class I molar malocclusion. What would be the main reason for this proclination?
Correct
ANSWER
Arch length tooth size discrepancyOTHER OPTIONS
Not applicableSYNOPSIS
⢠Class I malocclusions is a situation where the anteroposterior occlusal
relationship is normal and there is a discrepancy either within the arches or in the transverse or vertical relationship between the arches.
⢠Dental factors are the main aetiological influences in Class I malocclusions.
⢠The most common are tooth or arch size discrepancies, leading to crowding or, less frequently, spacing.
⢠Local factors also include displaced or impacted teeth, and anomalies in the
size, number and form of the teeth, all of which can lead to a localized
malocclusion.
⢠Soft tissue and skeletal factors can cause this malocclusion.REFERENCE
Arch Size and Tooth Size in Class I malocclusion by JDAT.Incorrect
ANSWER
Arch length tooth size discrepancyOTHER OPTIONS
Not applicableSYNOPSIS
⢠Class I malocclusions is a situation where the anteroposterior occlusal
relationship is normal and there is a discrepancy either within the arches or in the transverse or vertical relationship between the arches.
⢠Dental factors are the main aetiological influences in Class I malocclusions.
⢠The most common are tooth or arch size discrepancies, leading to crowding or, less frequently, spacing.
⢠Local factors also include displaced or impacted teeth, and anomalies in the
size, number and form of the teeth, all of which can lead to a localized
malocclusion.
⢠Soft tissue and skeletal factors can cause this malocclusion.REFERENCE
Arch Size and Tooth Size in Class I malocclusion by JDAT. -
Question 129 of 150
129. Question
A patient came to your clinic with deep infrabony pocket and recession in 46. What is the treatment of choice
Correct
ANSWER
GTR (guided tissue regeneration)OTHER OPTIONS
⢠Open Flap Debridement – Only cleans the defect, does not regenerate lost bone or attachment.
⢠Apically Repositioned Flap – Used for pocket elimination but worsens recession, making it unsuitable.SYNOPSIS
⢠A deep infrabony pocket (defect within bone) suggests vertical bone loss, which requires regeneration rather than just resection.
⢠Recession indicates soft tissue loss, which may need coverage or preservation.
⢠GTR promotes new attachment of periodontal ligament and bone, preventing epithelial down-growth.
⢠Bone grafting enhances bone fill, improving long-term stability.REFERENCE
Carranzaās Clinical Periodontology, 14th EditionIncorrect
ANSWER
GTR (guided tissue regeneration)OTHER OPTIONS
⢠Open Flap Debridement – Only cleans the defect, does not regenerate lost bone or attachment.
⢠Apically Repositioned Flap – Used for pocket elimination but worsens recession, making it unsuitable.SYNOPSIS
⢠A deep infrabony pocket (defect within bone) suggests vertical bone loss, which requires regeneration rather than just resection.
⢠Recession indicates soft tissue loss, which may need coverage or preservation.
⢠GTR promotes new attachment of periodontal ligament and bone, preventing epithelial down-growth.
⢠Bone grafting enhances bone fill, improving long-term stability.REFERENCE
Carranzaās Clinical Periodontology, 14th Edition -
Question 130 of 150
130. Question
A patient complaints of a feeling of toothache, with swelling of nasal mucosa, watering of eyes, bloodshot eyes and woke him from sleep. On intraoral examination, you couldn’t find any caries or tooth related problems. What can be the most probable diagnosis for this case?
Correct
ANSWER
Cluster headacheOTHER OPTIONS
⢠Migraine – Migraine is characterized by deep, aching, throbbing pain that is usually unilateral with visual aura, anorexia and even vomiting.
⢠Trigeminal neuralgia – Trigeminal neuralgia is associated with trigger zones and usually arises from acts like eating, smiling or even exposure to strong breeze.SYNOPSIS
⢠Sphenopalatine neuralgia or cluster headache is characterized by attacks of severe, strictly unilateral pain in orbital, supraorbital, temporal or in any combination.
⢠There is no trigger zone.
⢠Patients usually described their pain as toothache.
⢠Pain is also associated with swelling of mucosa, severe nasal discharge, watering of eyes, bloodshot eyes and epiphora.
⢠It can also wake up patient from sleep and is referred as alarm clock headache.
⢠Cocainization of ganglion or alcohol injection can reduce pain.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 573.Incorrect
ANSWER
Cluster headacheOTHER OPTIONS
⢠Migraine – Migraine is characterized by deep, aching, throbbing pain that is usually unilateral with visual aura, anorexia and even vomiting.
⢠Trigeminal neuralgia – Trigeminal neuralgia is associated with trigger zones and usually arises from acts like eating, smiling or even exposure to strong breeze.SYNOPSIS
⢠Sphenopalatine neuralgia or cluster headache is characterized by attacks of severe, strictly unilateral pain in orbital, supraorbital, temporal or in any combination.
⢠There is no trigger zone.
⢠Patients usually described their pain as toothache.
⢠Pain is also associated with swelling of mucosa, severe nasal discharge, watering of eyes, bloodshot eyes and epiphora.
⢠It can also wake up patient from sleep and is referred as alarm clock headache.
⢠Cocainization of ganglion or alcohol injection can reduce pain.REFERENCE
Shafer’s Textbook of Oral Pathology – 8th Edition Page No 573. -
Question 131 of 150
131. Question
What is the best test for tooth with amalgam restoration?
Correct
ANSWER
Cold testOTHER OPTIONS
Not applicableSYNOPSIS
⢠Cold pulp testing has generally high diagnostic accuracy and can be considered the pulp testing method in clinical practice.
⢠Diagnostic accuracy in 86 percent.
⢠Cold pulp test is the simplest and most accurate pulpal sensibility test available to clinicians and hence should be the primary diagnostic tool to assess pulpal status.
⢠Materials used are endo ice, CO2 snow, pencil of ice, ice cold water under rubber dam isolation and ethyl chloride.REFERENCE
Cold Pulp Testing is the Simplest and Most Accurate of all Dental Pulp Sensibility Tests by PMC.Incorrect
ANSWER
Cold testOTHER OPTIONS
Not applicableSYNOPSIS
⢠Cold pulp testing has generally high diagnostic accuracy and can be considered the pulp testing method in clinical practice.
⢠Diagnostic accuracy in 86 percent.
⢠Cold pulp test is the simplest and most accurate pulpal sensibility test available to clinicians and hence should be the primary diagnostic tool to assess pulpal status.
⢠Materials used are endo ice, CO2 snow, pencil of ice, ice cold water under rubber dam isolation and ethyl chloride.REFERENCE
Cold Pulp Testing is the Simplest and Most Accurate of all Dental Pulp Sensibility Tests by PMC. -
Question 132 of 150
132. Question
A 45 year old patient came to your clinic with caries. You noticed gingival recession with respect to tooth 45 and associated root caries. Which restorative material will you used to restore this caries?
Correct
ANSWER
RMGICOTHER OPTIONS
Not applicableSYNOPSIS
⢠In a root caries procedure, lack of dentin and poor isolation may present restoration challenges.
⢠Resin modified glass ionomer cement (RMGIC) is a restorative material that can be used effectively in this situation.
⢠Clinical studies have demonstrated that RMGIC have very good retention over time due itās chemical and mechanical adhesion.
⢠It shows low polymerization shrinkage and is less adversely affected by moisture.
⢠Release fluoride to the dental structure is an important feature of RMGIC that makes it more effective in root caries.REFERENCE
What kind of restoration material is best recommended for root caries, especially where isolation is a problem by CDA Oasis.Incorrect
ANSWER
RMGICOTHER OPTIONS
Not applicableSYNOPSIS
⢠In a root caries procedure, lack of dentin and poor isolation may present restoration challenges.
⢠Resin modified glass ionomer cement (RMGIC) is a restorative material that can be used effectively in this situation.
⢠Clinical studies have demonstrated that RMGIC have very good retention over time due itās chemical and mechanical adhesion.
⢠It shows low polymerization shrinkage and is less adversely affected by moisture.
⢠Release fluoride to the dental structure is an important feature of RMGIC that makes it more effective in root caries.REFERENCE
What kind of restoration material is best recommended for root caries, especially where isolation is a problem by CDA Oasis. -
Question 133 of 150
133. Question
A 60 year old male patient came for extraction of a tooth with grade 2 mobility. Patient is on warfarin medication since 2 years. On the day before extraction her INR was 3.5. What will you do?
Correct
ANSWER
Continue taking warfarinOTHER OPTIONS
Not applicableSYNOPSIS
⢠Dentist should consult with the patientās physician to determine the level of anticoagulation being maintained with warfarin therapy.
⢠If invasive procedures or minor oral surgery are planned and the patientās INR is between 2.0 and 3.5, no adjustment in warfarin dosage is indicated.
⢠If the INR is greater than 3.5, the dentist should request that the dosage be reduced to allow the INR to fall in the range of 2.0 to 3.5.
⢠If major oral surgery is planned and the patientās INR is between 3.0 and 3.5, the dentist may request that the dosage be reduced to allow the INR to fall in the range of 2.0 to 3.0.
⢠If the dosage of warfarin is reduced by the patientās physician it will take 3 to 5 days for the desired reduction to occur.
⢠The reduction should be confirmed by INR before the dental or surgical procedure.REFERENCE
Little and Falace’s Dental Management of Medically Compromised Patients – 9th Edition Page No 450.Incorrect
ANSWER
Continue taking warfarinOTHER OPTIONS
Not applicableSYNOPSIS
⢠Dentist should consult with the patientās physician to determine the level of anticoagulation being maintained with warfarin therapy.
⢠If invasive procedures or minor oral surgery are planned and the patientās INR is between 2.0 and 3.5, no adjustment in warfarin dosage is indicated.
⢠If the INR is greater than 3.5, the dentist should request that the dosage be reduced to allow the INR to fall in the range of 2.0 to 3.5.
⢠If major oral surgery is planned and the patientās INR is between 3.0 and 3.5, the dentist may request that the dosage be reduced to allow the INR to fall in the range of 2.0 to 3.0.
⢠If the dosage of warfarin is reduced by the patientās physician it will take 3 to 5 days for the desired reduction to occur.
⢠The reduction should be confirmed by INR before the dental or surgical procedure.REFERENCE
Little and Falace’s Dental Management of Medically Compromised Patients – 9th Edition Page No 450. -
Question 134 of 150
134. Question
Which of the following are important factors that must be evaluated before performing a laterally repositioned flap?
Correct
ANSWER
All of the aboveOTHER OPTIONS
⢠NilSYNOPSIS
⢠Before performing a laterally repositioned flap (laterally positioned flap, LRP) for root coverage or gingival augmentation, the following factors must be evaluated
⢠Presence of bone on the facial surface of the donor tooth – Adequate bone support is crucial to ensure flap survival and prevent recession.
⢠Thickness of the gingiva at the donor site – Thicker gingiva enhances vascular supply and flap stability, leading to better healing.
⢠Width of attached gingiva at the donor site – A wider band of attached gingiva ensures sufficient donor tissue for successful flap mobilization.REFERENCE
Lindhe 6th edition chapter 39
Carranza 11th edition chapter 63Incorrect
ANSWER
All of the aboveOTHER OPTIONS
⢠NilSYNOPSIS
⢠Before performing a laterally repositioned flap (laterally positioned flap, LRP) for root coverage or gingival augmentation, the following factors must be evaluated
⢠Presence of bone on the facial surface of the donor tooth – Adequate bone support is crucial to ensure flap survival and prevent recession.
⢠Thickness of the gingiva at the donor site – Thicker gingiva enhances vascular supply and flap stability, leading to better healing.
⢠Width of attached gingiva at the donor site – A wider band of attached gingiva ensures sufficient donor tissue for successful flap mobilization.REFERENCE
Lindhe 6th edition chapter 39
Carranza 11th edition chapter 63 -
Question 135 of 150
135. Question
A 5 year old child was brought to your clinic for pulpectomy of tooth 85. Patient has high caries index. You completed pulpectomy. What is the most appropriate definite restoration to avoid future fracture of the remaining few surfaces of tooth left?
Correct
ANSWER
Stainless steel crownOTHER OPTIONS
Not applicableSYNOPSIS
⢠Stainless steel crowns are indicated after pulpotomy or pulpectomy specially for primary first molar.
⢠Used when three or more surfaces need restoration.
⢠Used as an abutment for fixed appliances.
⢠SCCs are also used in high caries index patient.
⢠Strong consideration should be given to the use of stainless steel crowns in children who require general anesthesia.REFERENCE
The Use of Stainless Steel Crowns by AAPD.Incorrect
ANSWER
Stainless steel crownOTHER OPTIONS
Not applicableSYNOPSIS
⢠Stainless steel crowns are indicated after pulpotomy or pulpectomy specially for primary first molar.
⢠Used when three or more surfaces need restoration.
⢠Used as an abutment for fixed appliances.
⢠SCCs are also used in high caries index patient.
⢠Strong consideration should be given to the use of stainless steel crowns in children who require general anesthesia.REFERENCE
The Use of Stainless Steel Crowns by AAPD. -
Question 136 of 150
136. Question
What will be the size of pontic design of an FPD?
Correct
ANSWER
Smaller than missing tooth buccolinguallyOTHER OPTIONS
⢠Wider buccolingually – Wider pontics are difficult to cleanse and decrease chewing efficiency.SYNOPSIS
⢠Reducing the buccolingual width of the pontic by as much as 30 percent has been suggested as a way to lessen occlusal forces on, and thus the loading of, abutment teeth.
⢠Critical analysis reveals that forces are lessened only when chewing food of uniform consistency and that a mere 12 percent increase in chewing efficiency can be expected from a one-third reduction of pontic width.
⢠Decreasing the buccolingual width leads to a decrease in interferences in eccentric movements.
⢠Narrowing the occlusal table may actually impede or even preclude the development of a harmonious and stable occlusal relationship.
⢠Like a malposed tooth, it may cause difficulties in plaque control and may not provide proper cheek support. For these reasons, pontics with normal occlusal widths (at least on the occlusal third) are generally recommended.REFERENCE
Rosenstiel, Contemporary Fixed Prosthodontics, pg 527Incorrect
ANSWER
Smaller than missing tooth buccolinguallyOTHER OPTIONS
⢠Wider buccolingually – Wider pontics are difficult to cleanse and decrease chewing efficiency.SYNOPSIS
⢠Reducing the buccolingual width of the pontic by as much as 30 percent has been suggested as a way to lessen occlusal forces on, and thus the loading of, abutment teeth.
⢠Critical analysis reveals that forces are lessened only when chewing food of uniform consistency and that a mere 12 percent increase in chewing efficiency can be expected from a one-third reduction of pontic width.
⢠Decreasing the buccolingual width leads to a decrease in interferences in eccentric movements.
⢠Narrowing the occlusal table may actually impede or even preclude the development of a harmonious and stable occlusal relationship.
⢠Like a malposed tooth, it may cause difficulties in plaque control and may not provide proper cheek support. For these reasons, pontics with normal occlusal widths (at least on the occlusal third) are generally recommended.REFERENCE
Rosenstiel, Contemporary Fixed Prosthodontics, pg 527 -
Question 137 of 150
137. Question
What is the ideal angle between rest and minor connector?
Correct
ANSWER
Less than 90 degreesOTHER OPTIONS
⢠More than 90 degrees – An angle greater than 90 degrees fails to transmit occlusal forces along the supporting vertical axis of the abutment tooth. This also permits slippage of the prosthesis away from the abutment, which can result in orthodontic-like forces being applied to an inclined plane on the abutment, with possible tooth movement.SYNOPSIS
⢠The angle formed by the occlusal rest and the vertical minor connector from which it originates should be less than 90 degrees.
⢠Only in this way can the occlusal forces be directed along the long axis of the abutment tooth.REFERENCE
Chapter 6 Rests and Rest Seats. Pocket dentistry.Incorrect
ANSWER
Less than 90 degreesOTHER OPTIONS
⢠More than 90 degrees – An angle greater than 90 degrees fails to transmit occlusal forces along the supporting vertical axis of the abutment tooth. This also permits slippage of the prosthesis away from the abutment, which can result in orthodontic-like forces being applied to an inclined plane on the abutment, with possible tooth movement.SYNOPSIS
⢠The angle formed by the occlusal rest and the vertical minor connector from which it originates should be less than 90 degrees.
⢠Only in this way can the occlusal forces be directed along the long axis of the abutment tooth.REFERENCE
Chapter 6 Rests and Rest Seats. Pocket dentistry. -
Question 138 of 150
138. Question
What is resonance frequency analysis used for?
Correct
ANSWER
Check implant stabilityOTHER OPTIONS
Not applicableSYNOPSIS
⢠One of the direct methods for evaluating osteointegration is the resonance frequency analysis (RFA) that provides valuable clinical objective data of implant stability.
⢠The technique of resonant frequency analysis is noninvasive and nondestructive, essentially a test of the stability for the dental implant.
⢠It is equivalent in terms of the direction and the type of application of fixed lateral forces to the implant and the measurement of the implant displacement.REFERENCE
Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device by PMC.Incorrect
ANSWER
Check implant stabilityOTHER OPTIONS
Not applicableSYNOPSIS
⢠One of the direct methods for evaluating osteointegration is the resonance frequency analysis (RFA) that provides valuable clinical objective data of implant stability.
⢠The technique of resonant frequency analysis is noninvasive and nondestructive, essentially a test of the stability for the dental implant.
⢠It is equivalent in terms of the direction and the type of application of fixed lateral forces to the implant and the measurement of the implant displacement.REFERENCE
Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device by PMC. -
Question 139 of 150
139. Question
Which space lies between myelohyoid and platysma?
Correct
ANSWER
SubmentalOTHER OPTIONS
⢠Submandibular – Submandibular space is located beneath the mandible and above the mylohyoid muscle, but it extends laterally rather than being confined to the midline.
⢠Sublingual – Sublingual space is situated above the mylohyoid muscle and below the tongue, within the oral cavity.
⢠Buccal – Buccal space lies in the cheek area, lateral to the buccinator muscle and is not related to the mylohyoid muscle.SYNOPSIS
⢠The submental space is located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline.
⢠The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck.REFERENCE
Submental space – e-AnatomyIncorrect
ANSWER
SubmentalOTHER OPTIONS
⢠Submandibular – Submandibular space is located beneath the mandible and above the mylohyoid muscle, but it extends laterally rather than being confined to the midline.
⢠Sublingual – Sublingual space is situated above the mylohyoid muscle and below the tongue, within the oral cavity.
⢠Buccal – Buccal space lies in the cheek area, lateral to the buccinator muscle and is not related to the mylohyoid muscle.SYNOPSIS
⢠The submental space is located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline.
⢠The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck.REFERENCE
Submental space – e-Anatomy -
Question 140 of 150
140. Question
The width of normal periodontal ligament space is?
Correct
ANSWER
0.15 to 0.5mmOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Normal Range – The width varies depending on the tooth and functional load, typically ranging from 0.15 mm to 0.38 mm.
ā Hourglass Shape – The space is not uniform; it is generally narrowest at the mid-root level (the fulcrum of movement) and wider near the alveolar crest and apex.
ā Functional Adaptation – The PDL space is wider in teeth subjected to heavy occlusal stress (hyperfunction) and narrower in non-functional or un-erupted teeth.
ā Age-Related Changes – The width tends to decrease with age.
ā Radiographic Appearance – On dental radiographs, it appears as a radiolucent (dark) line between the tooth root and the radiopaque (white) lamina dura.REFERENCE
Essentials of Oral Medicine and RadiologyIncorrect
ANSWER
0.15 to 0.5mmOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Normal Range – The width varies depending on the tooth and functional load, typically ranging from 0.15 mm to 0.38 mm.
ā Hourglass Shape – The space is not uniform; it is generally narrowest at the mid-root level (the fulcrum of movement) and wider near the alveolar crest and apex.
ā Functional Adaptation – The PDL space is wider in teeth subjected to heavy occlusal stress (hyperfunction) and narrower in non-functional or un-erupted teeth.
ā Age-Related Changes – The width tends to decrease with age.
ā Radiographic Appearance – On dental radiographs, it appears as a radiolucent (dark) line between the tooth root and the radiopaque (white) lamina dura.REFERENCE
Essentials of Oral Medicine and Radiology -
Question 141 of 150
141. Question
The incision angle in Gingivectomy is?
Correct
ANSWER
45° to the tooth in an apical directionOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Gingivectomy is performed using an external bevel incision
ā The incision is directed
– Apically
– At about 45° to the long axis of the tooth
ā This
– Removes the pocket wall
– Creates a thin, tapering gingival margin
– Allows proper adaptation and healingREFERENCE
Carranzaās Clinical Periodontology – 10th EditionIncorrect
ANSWER
45° to the tooth in an apical directionOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Gingivectomy is performed using an external bevel incision
ā The incision is directed
– Apically
– At about 45° to the long axis of the tooth
ā This
– Removes the pocket wall
– Creates a thin, tapering gingival margin
– Allows proper adaptation and healingREFERENCE
Carranzaās Clinical Periodontology – 10th Edition -
Question 142 of 150
142. Question
The MOST common place for initiation of gingivitis is?
Correct
ANSWER
Interdental papillaeOTHER OPTIONS
ā Refer SynopsisSYNOPSIS
ā Gingivitis clinically involves the marginal gingiva, but it is most commonly initiated in the interdental papillae.
ā Pathogenesis
– Plaque accumulates interdentally – inflammation starts in papilla – spreads to marginal gingivaREFERENCE
Carranzaās Clinical Periodontology – 10th EditionIncorrect
ANSWER
Interdental papillaeOTHER OPTIONS
ā Refer SynopsisSYNOPSIS
ā Gingivitis clinically involves the marginal gingiva, but it is most commonly initiated in the interdental papillae.
ā Pathogenesis
– Plaque accumulates interdentally – inflammation starts in papilla – spreads to marginal gingivaREFERENCE
Carranzaās Clinical Periodontology – 10th Edition -
Question 143 of 150
143. Question
Incisive foramen when superimposed over apex of root on radiograph may be mistaken to be?
Correct
ANSWER
CystOTHER OPTIONS
ā Cementoma – Usually radiopaque or mixed, not purely radiolucent
ā Odontoma – Radiopaque with radiolucent rim
ā Fibroma – Soft tissue lesion, not a periapical radiolucency on IOPASYNOPSIS
ā Incisive foramen (nasopalatine foramen) is a normal anatomical radiolucency
ā When it is superimposed over the apex of maxillary central incisors, it may
– Mimic a periapical radiolucent lesion
– Especially resemble a radicular (periapical) cyst.
ā This is common when
– Radiograph angulation is altered
– Foramen is large
ā Vitality testing of the tooth helps differentiate.REFERENCE
Oral Radiology – Principles and InterpretationIncorrect
ANSWER
CystOTHER OPTIONS
ā Cementoma – Usually radiopaque or mixed, not purely radiolucent
ā Odontoma – Radiopaque with radiolucent rim
ā Fibroma – Soft tissue lesion, not a periapical radiolucency on IOPASYNOPSIS
ā Incisive foramen (nasopalatine foramen) is a normal anatomical radiolucency
ā When it is superimposed over the apex of maxillary central incisors, it may
– Mimic a periapical radiolucent lesion
– Especially resemble a radicular (periapical) cyst.
ā This is common when
– Radiograph angulation is altered
– Foramen is large
ā Vitality testing of the tooth helps differentiate.REFERENCE
Oral Radiology – Principles and Interpretation -
Question 144 of 150
144. Question
Which of the following factors can affect the shape and size of the pulp canal?
Correct
ANSWER
All of the aboveOTHER OPTIONS
ā NilSYNOPSIS
ā Chemical irritation and caries
– Chronic irritation – secondary or tertiary dentin formation
– Leads to narrowing or distortion of the pulp canal
ā Trauma and function
– Occlusal trauma, parafunction – reparative dentin deposition
– Alters canal shape and size
ā Attrition, wear and aging
– Continuous dentin deposition with age causes reduced pulp chamber size and narrow, sometimes obliterated canalsREFERENCE
Cohen’s Pathways of the PulpIncorrect
ANSWER
All of the aboveOTHER OPTIONS
ā NilSYNOPSIS
ā Chemical irritation and caries
– Chronic irritation – secondary or tertiary dentin formation
– Leads to narrowing or distortion of the pulp canal
ā Trauma and function
– Occlusal trauma, parafunction – reparative dentin deposition
– Alters canal shape and size
ā Attrition, wear and aging
– Continuous dentin deposition with age causes reduced pulp chamber size and narrow, sometimes obliterated canalsREFERENCE
Cohen’s Pathways of the Pulp -
Question 145 of 150
145. Question
Following a periodontal surgery, the primary function of a periodontal dressing will be?
Correct
ANSWER
Decrease the patientās discomfortOTHER OPTIONS
ā Refer SynopsisSYNOPSIS
ā Periodontal dressing is a protective aid, not a healing enhancer.
ā It decreases patient discomfort. It is the primary and most consistent indication.
Other secondary benefits are,
ā Helps in tissue adaptation
– Supports the flap in position during early healing
Controls bleeding and maintains blood clot – Provides mild pressure and protectionREFERENCE
Incorrect
ANSWER
Decrease the patientās discomfortOTHER OPTIONS
ā Refer SynopsisSYNOPSIS
ā Periodontal dressing is a protective aid, not a healing enhancer.
ā It decreases patient discomfort. It is the primary and most consistent indication.
Other secondary benefits are,
ā Helps in tissue adaptation
– Supports the flap in position during early healing
Controls bleeding and maintains blood clot – Provides mild pressure and protectionREFERENCE
-
Question 146 of 150
146. Question
What is the MOST important role of saliva in preventing dental caries?
Correct
ANSWER
Buffering actionOTHER OPTIONS
ā Kills bacteria – Saliva has antimicrobial components (IgA, lysozyme, lactoferrin). But it does not sterilize the mouth
ā Neutraliser – This is essentially part of buffering. Not a separate or superior functionSYNOPSIS
ā Dental caries is initiated by acid production from plaque bacteria
ā Saliva protects teeth mainly by
– Neutralizing acids
– Raising plaque pH
– Bringing pH back above the critical pH (~5.5)
ā This buffering (mainly by bicarbonate ions) is the primary and most effective anticaries mechanism of saliva.REFERENCE
Essentials of Public Health Dentistry – Soben PeterIncorrect
ANSWER
Buffering actionOTHER OPTIONS
ā Kills bacteria – Saliva has antimicrobial components (IgA, lysozyme, lactoferrin). But it does not sterilize the mouth
ā Neutraliser – This is essentially part of buffering. Not a separate or superior functionSYNOPSIS
ā Dental caries is initiated by acid production from plaque bacteria
ā Saliva protects teeth mainly by
– Neutralizing acids
– Raising plaque pH
– Bringing pH back above the critical pH (~5.5)
ā This buffering (mainly by bicarbonate ions) is the primary and most effective anticaries mechanism of saliva.REFERENCE
Essentials of Public Health Dentistry – Soben Peter -
Question 147 of 150
147. Question
A patient comes with a lactobacillus count of more than 100000. What is your advice?
Correct
ANSWER
Reduce sugar in dietOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Lactobacilli are
– Highly acidogenic
– Strongly associated with dietary carbohydrate (especially sucrose) intake
ā A count more 100,000 CFU per mL indicates
– High caries activity
– Excess fermentable sugar exposure
ā Diet modification (reducing sugar) is the most important advice.REFERENCE
Essentials of Public Health Dentistry – Soben PeterIncorrect
ANSWER
Reduce sugar in dietOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Lactobacilli are
– Highly acidogenic
– Strongly associated with dietary carbohydrate (especially sucrose) intake
ā A count more 100,000 CFU per mL indicates
– High caries activity
– Excess fermentable sugar exposure
ā Diet modification (reducing sugar) is the most important advice.REFERENCE
Essentials of Public Health Dentistry – Soben Peter -
Question 148 of 150
148. Question
The MOST cariogenic sugar is?
Correct
ANSWER
SucroseOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Sucrose is the most cariogenic dietary sugar because it promotes extracellular polysaccharide formation and plaque adherence.REFERENCE
Essentials of Public Health Dentistry – Soben PeterIncorrect
ANSWER
SucroseOTHER OPTIONS
ā Not applicableSYNOPSIS
ā Sucrose is the most cariogenic dietary sugar because it promotes extracellular polysaccharide formation and plaque adherence.REFERENCE
Essentials of Public Health Dentistry – Soben Peter -
Question 149 of 150
149. Question
In regards to connectors on dentures which of the following is correct?
Correct
ANSWER
Both A and BOTHER OPTIONS
⢠Not applicable
.
SYNOPSIS
⢠A major connector unites all components of the denture
⢠Rigidity is essential to:
– Distribute functional loads evenly
– Provide cross-arch stabilization
– Prevent torqueing of abutment teeth
⢠A flexible major connector leads to tissue trauma and abutment damage.
⢠Minor connectors connect rests, clasps, and other components to the major connector
⢠They engage undercuts of the denture framework
– For mechanical retention
– For stabilization of componentsREFERENCE
McCrackenās Removable Partial ProsthodonticsIncorrect
ANSWER
Both A and BOTHER OPTIONS
⢠Not applicable
.
SYNOPSIS
⢠A major connector unites all components of the denture
⢠Rigidity is essential to:
– Distribute functional loads evenly
– Provide cross-arch stabilization
– Prevent torqueing of abutment teeth
⢠A flexible major connector leads to tissue trauma and abutment damage.
⢠Minor connectors connect rests, clasps, and other components to the major connector
⢠They engage undercuts of the denture framework
– For mechanical retention
– For stabilization of componentsREFERENCE
McCrackenās Removable Partial Prosthodontics -
Question 150 of 150
150. Question
Which of the following control tooth or teeth should be used when testing a suspected pulpally involved tooth?
Correct
ANSWER
Adjacent tooth and contralateral teethOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Pulp tests (thermal or electric) are subjective
⢠A control tooth is needed for comparison
⢠Best controls are
– Adjacent tooth – same arch, similar anatomy
– Contralateral tooth – same tooth type on opposite sideREFERENCE
Cohen’s Pathway of PulpIncorrect
ANSWER
Adjacent tooth and contralateral teethOTHER OPTIONS
⢠Not applicableSYNOPSIS
⢠Pulp tests (thermal or electric) are subjective
⢠A control tooth is needed for comparison
⢠Best controls are
– Adjacent tooth – same arch, similar anatomy
– Contralateral tooth – same tooth type on opposite sideREFERENCE
Cohen’s Pathway of Pulp
Last Test Performance Board
Leaderboard: EVERGREEN TEST FEB - 1
| Pos. | Name | Entered on | Points | Result |
|---|---|---|---|---|
| Table is loading | ||||
| No data available | ||||
Ready to book for the next Evergreen test?
The test will be announced 1 week prior so that you will not miss it.
