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- Answered
- Review
- Question 1 of 300
1. Question
Imagine a scenario where a dental clinic has been encountering a concerning pattern among a group of patients. These patients consistently complain of lingering dental pain that not only persists but also becomes severe enough to awaken them from their sleep during the night. As a healthcare professional, you are puzzled by this consistent presentation and are tasked with determining the potential underlying cause or condition that could be responsible for this specific pattern of dental discomfort. Taking into consideration the patients’ descriptions of their symptoms, their demographic information, and any relevant medical history, what would be your diagnostic assessment and potential hypotheses regarding the most likely ailment or condition these patients might be suffering from?
CorrectANSWER
Irreversible pulpitisOTHER OPTIONS
• Reversible Pulpitis – Non lingering pain that subsides on removal of stimuli
• Pulp necrosis – No response to vitality testSYNOPSIS
• Irreversible pulpitis is when the inflammation has completely damaged the pulp, which can’t be saved.
• Symptoms of irreversible pulpitis include
– Nocturnal pain
– Spontaneous pain
– Sensitivity to cold that lasts more than 30 seconds
– Sensitivity to heat
– Pain when the tooth is tapped
– Swelling around tooth and gums
– Fever
– Pain on lying down
– Pain that is radiating
– Trouble finding which tooth is causing the pain
• As inflammation builds in the tooth, the pulp can die. This can happen with irreversible pulpitis and, once this occurs, the pain will stop.REFERENCE
Dental Pulp Testing, A Review.- International Journal of Dentistry. 2009IncorrectANSWER
Irreversible pulpitisOTHER OPTIONS
• Reversible Pulpitis – Non lingering pain that subsides on removal of stimuli
• Pulp necrosis – No response to vitality testSYNOPSIS
• Irreversible pulpitis is when the inflammation has completely damaged the pulp, which can’t be saved.
• Symptoms of irreversible pulpitis include
– Nocturnal pain
– Spontaneous pain
– Sensitivity to cold that lasts more than 30 seconds
– Sensitivity to heat
– Pain when the tooth is tapped
– Swelling around tooth and gums
– Fever
– Pain on lying down
– Pain that is radiating
– Trouble finding which tooth is causing the pain
• As inflammation builds in the tooth, the pulp can die. This can happen with irreversible pulpitis and, once this occurs, the pain will stop.REFERENCE
Dental Pulp Testing, A Review.- International Journal of Dentistry. 2009 - Question 2 of 300
2. Question
You come across a perplexing case involving a patient who presents with a specific set of symptoms related to their dental health. The patient reports experiencing sharp and transient pain when consuming cold beverages or food, particularly when they come into contact with a specific tooth exhibiting mesial caries. However, what strikes you as unusual is that the pain, although intense, does not linger after the cold stimulus is removed. Drawing upon your dental expertise, medical history evaluation, and clinical observations, can you accurately diagnose this patient’s condition and provide a comprehensive explanation of the underlying process causing these distinct pain sensations?
CorrectANSWER
Reversible pulpitisOTHER OPTIONS
• Irreversible pulpitis – Sensitive to heat and percussion
• Acute periodontal disease – Percussion test will be positive
• Dentinal hypersensitivity – Short intense pain while having hot or cold food stuffsSYNOPSIS
• Pulpitis is an inflammation of the pulp.
• It usually happens when there’s an irritation inside a tooth due to things such as grinding or a cavity
• There are two types of pulpitis.
– Reversible pulpitis – In this early stage, pulpitis is reversible if treated
– Irreversible pulpitis – In this stage, the inflammation is more advanced and the tooth can’t recover. The pulp tissue will eventually die. This is pulp necrosis.
• Symptoms of reversible pulpitis include
– No pain when your dentist taps the tooth.
– No sensitivity to heat.
– Sensitivity to cold or sweets that goes away quickly or non lingering pain
• For reversible pulpitis, removal of the the cause can reverse the condition.
• Often, this involves the removal of the decay and sealing the tooth with a normal filling.REFERENCE
Grossman’s Endodontic PracticeIncorrectANSWER
Reversible pulpitisOTHER OPTIONS
• Irreversible pulpitis – Sensitive to heat and percussion
• Acute periodontal disease – Percussion test will be positive
• Dentinal hypersensitivity – Short intense pain while having hot or cold food stuffsSYNOPSIS
• Pulpitis is an inflammation of the pulp.
• It usually happens when there’s an irritation inside a tooth due to things such as grinding or a cavity
• There are two types of pulpitis.
– Reversible pulpitis – In this early stage, pulpitis is reversible if treated
– Irreversible pulpitis – In this stage, the inflammation is more advanced and the tooth can’t recover. The pulp tissue will eventually die. This is pulp necrosis.
• Symptoms of reversible pulpitis include
– No pain when your dentist taps the tooth.
– No sensitivity to heat.
– Sensitivity to cold or sweets that goes away quickly or non lingering pain
• For reversible pulpitis, removal of the the cause can reverse the condition.
• Often, this involves the removal of the decay and sealing the tooth with a normal filling.REFERENCE
Grossman’s Endodontic Practice - Question 3 of 300
3. Question
A 45-year-old individual presents with a routine dental examination. As you examine their dental radiographs, you notice a distinctive pattern in one of their teeth. Specifically, you observe a prominent and excessive cementum deposition along a particular tooth’s roots. Upon further discussion with the patient, you learn that they have been visiting the dentist regularly and maintaining a diligent oral hygiene routine. They deny any history of significant trauma to the affected tooth or the surrounding area. Additionally, the patient does not report any noticeable discomfort, pain, or swelling associated with the tooth exhibiting hypercementosis. Given the intriguing nature of this case, what might be the cause of hypercementosis of teeth?
CorrectANSWER
Cementum deposition on apexOTHER OPTIONS
• Not applicableSYNOPSIS
• Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth.
• A thicker layer of cementum can give the tooth an enlarged appearance, which mainly occurs at the apex or apices of the tooth.
• The local factors implicated to cause hypercementosis are occlusal trauma, inflammation secondary to pulpal or periodontal disease, tooth mobility, repair of root fracture and transplantation of teeth
• Patients with hypercementosis require no treatment.
• Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrectANSWER
Cementum deposition on apexOTHER OPTIONS
• Not applicableSYNOPSIS
• Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth.
• A thicker layer of cementum can give the tooth an enlarged appearance, which mainly occurs at the apex or apices of the tooth.
• The local factors implicated to cause hypercementosis are occlusal trauma, inflammation secondary to pulpal or periodontal disease, tooth mobility, repair of root fracture and transplantation of teeth
• Patients with hypercementosis require no treatment.
• Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth.REFERENCE
Shafer’s Textbook of Oral Pathology - Question 4 of 300
4. Question
A 7-year-old patient arrives with their concerned parents. Upon examination, you find that the child has recently lost their primary first molar due to severe decay. The adjacent primary second molar is intact, and there is a significant space between these two teeth. The parents express their worries about the gap left by the lost tooth and inquire about the best course of action to ensure proper dental development for their child. They are particularly concerned about the possibility of crowding and misalignment of permanent teeth as the child grows. Given the clinical scenario, you consider the potential benefits of using a band and loop space maintainer. Which is the best indication for band and loop space maintainer?
CorrectANSWER
Single molar spaceOTHER OPTIONS
• Not applicableSYNOPSIS
– Indications of Band and loop Space maintainers
• In case of premature loss of any primary molar in primary dentition, or mixed dentition with permenant successor not erupting clinically for the next 2 years and its root length is formed less than one third
• Premature loss of a primary second molar as the permanent first molar is erupted clinically
• Bilateral loss of single primary molar before eruption of permanent incisorsREFERENCE
Textbook of Pedodontics – Shobha TandonIncorrectANSWER
Single molar spaceOTHER OPTIONS
• Not applicableSYNOPSIS
– Indications of Band and loop Space maintainers
• In case of premature loss of any primary molar in primary dentition, or mixed dentition with permenant successor not erupting clinically for the next 2 years and its root length is formed less than one third
• Premature loss of a primary second molar as the permanent first molar is erupted clinically
• Bilateral loss of single primary molar before eruption of permanent incisorsREFERENCE
Textbook of Pedodontics – Shobha Tandon - Question 5 of 300
5. Question
You encounter a challenging case involving a young patient who presents with a noticeable and persistent enlargement of the gingival tissues. As you examine the patient’s oral cavity, you observe a significant overgrowth of the gum tissue, which seems to extend beyond the normal boundaries and cover a considerable portion of the tooth surfaces. Further inquiry into the patient’s medical history reveals that this condition has been present since childhood, raising concerns about its potential implications for both oral health and overall well-being. The patient’s parents also share their worries about the impact of this gingival enlargement on the child’s self-esteem and quality of life. Considering this intriguing case, you begin to explore the various syndromes associated with gingival fibromatosis. Which of the following may show gingival fibromatosis?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported.
• Clinical syndromic presentation includes
– Zimmermann-Laband syndrome,
– Ramon syndrome,
– Rutherford syndrome,
– Cowden syndrome,
– Cross syndrome,
– Gohlich-Ratmann syndrome,
– Avani syndrome, and
– I-cell disease.
• However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported.
• Treatment of choice is usually gingivectomy with gingivoplasty.
• Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.REFERENCE
Current concepts on gingival fibromatosis-related syndromesIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported.
• Clinical syndromic presentation includes
– Zimmermann-Laband syndrome,
– Ramon syndrome,
– Rutherford syndrome,
– Cowden syndrome,
– Cross syndrome,
– Gohlich-Ratmann syndrome,
– Avani syndrome, and
– I-cell disease.
• However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported.
• Treatment of choice is usually gingivectomy with gingivoplasty.
• Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.REFERENCE
Current concepts on gingival fibromatosis-related syndromes - Question 6 of 300
6. Question
65-year-old individual, presents with a distinct concern – the noticeable loss of horizontal overlap between their upper and lower teeth. This condition has been causing difficulty in chewing, speaking, and maintaining proper oral hygiene.
Upon examination, you observe a significant lack of anterior guidance due to the absence of proper horizontal overlap. The patient’s upper and lower teeth do not come together harmoniously during various jaw movements, resulting in a compromised occlusal relationship. The patient expresses their frustration with the functional challenges they face and their desire to regain the ability to eat comfortably and communicate effectively.What will be caused by loss of horizontal overlap between upper and lower teeth in complete dentures?CorrectANSWER
Cheek bitingOTHER OPTIONS
• Tongue bite – Lack of lingual overjet – teeth generally placed lingual to lower ridge. Treated by remove lower lingual cusps, or reset teeth.
• Gagging – Over extended post damSYNOPSIS
• The most common cause of cheek biting is due to presence of inadequate overjet between the maxillary and mandibular anterior teeth.
• It can be corrected by increasing the over jet by reducing the buccal surface of lower posterior teeth.
• Cheek biting is also due to loss of vertical dimension, because of this cheeks tend to occlude between the occlusal surface of the dentureREFERENCE
Identification of complete denture problems – A summary – J. F. McCordIncorrectANSWER
Cheek bitingOTHER OPTIONS
• Tongue bite – Lack of lingual overjet – teeth generally placed lingual to lower ridge. Treated by remove lower lingual cusps, or reset teeth.
• Gagging – Over extended post damSYNOPSIS
• The most common cause of cheek biting is due to presence of inadequate overjet between the maxillary and mandibular anterior teeth.
• It can be corrected by increasing the over jet by reducing the buccal surface of lower posterior teeth.
• Cheek biting is also due to loss of vertical dimension, because of this cheeks tend to occlude between the occlusal surface of the dentureREFERENCE
Identification of complete denture problems – A summary – J. F. McCord - Question 7 of 300
7. Question
A patient approaches you with a complaint that he consistently experiences painful cheek bites caused by the newly inserted complete denture. This issue has been significantly impacting their ability to eat, speak, and maintain their daily activities without discomfort.Upon examination, you notice signs of trauma and inflammation on the inner cheek mucosa that are consistent with the patient’s complaints of cheek biting. What would you do if the patient complains of cheek bite when you fit a new complete denture?
CorrectANSWER
Grind buccal of lower teethOTHER OPTIONS
• NilSYNOPSIS
• Cheek biting usually occurs due to
– Insufficient overjet, in the posterior region
– Very lax cheek
– Reduced vertical dimension
• Treatment includes
– Increase buccal overjet
– Remove the last molars
– Grind the buccal surface of lower posteriorsREFERENCE
Textbook of Prosthodontics – Deepak NallaswamyIncorrectANSWER
Grind buccal of lower teethOTHER OPTIONS
• NilSYNOPSIS
• Cheek biting usually occurs due to
– Insufficient overjet, in the posterior region
– Very lax cheek
– Reduced vertical dimension
• Treatment includes
– Increase buccal overjet
– Remove the last molars
– Grind the buccal surface of lower posteriorsREFERENCE
Textbook of Prosthodontics – Deepak Nallaswamy - Question 8 of 300
8. Question
You are a dentist working in a family dental practice, and you have a pregnant patient, Mrs. Fatin, who is in her first trimester. She presents with severe pain and swelling on the right side of her face. After reviewing her medical history and performing a dental examination, you diagnose an acute infection in her right first molar.Mrs. Fatin is visibly distressed due to the pain and swelling, and she expresses concern about receiving treatment while pregnant. As a responsible and informed dentist, you must carefully consider her condition and the potential risks to both her and the developing fetus before deciding on an appropriate treatment plan.Which of the following is safe in a pregnant patient in the first trimester with an acutely infected first molar?
CorrectANSWER
PenicillinOTHER OPTIONS
• Radiograph – Taking radiographs during the first trimester of pregnancy affects the development of the fetus.
• Extraction – Extraction is contraindicated in the first trimester of pregnancy.SYNOPSIS
• Penicillin is the antibiotic of choice for a pregnant woman.
• Penicillin is not harmful to the fetus when taken by pregnant mothers.
• It is not incorporated into the bony tissue or in the teeth of children.REFERENCE
Dental Decks part 2IncorrectANSWER
PenicillinOTHER OPTIONS
• Radiograph – Taking radiographs during the first trimester of pregnancy affects the development of the fetus.
• Extraction – Extraction is contraindicated in the first trimester of pregnancy.SYNOPSIS
• Penicillin is the antibiotic of choice for a pregnant woman.
• Penicillin is not harmful to the fetus when taken by pregnant mothers.
• It is not incorporated into the bony tissue or in the teeth of children.REFERENCE
Dental Decks part 2 - Question 9 of 300
9. Question
Related question – In the above case which medication should be avoided ?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Some antibiotics are known to be teratogenic and should be avoided entirely during pregnancy. These include streptomycin and kanamycin (which may cause hearing loss) and tetracycline (which can lead to weakening, hypoplasia, and discoloration of long bones and teeth).
• If valproate is taken during pregnancy, know that there is a higher risk that the child may have birth defects or may score lower on cognitive tests (tests that measure mental ability and capacity, such as IQ tests) in childhood than any other anti-seizure medicine during pregnancy.REFERENCE
Medicines in PregnancyIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Some antibiotics are known to be teratogenic and should be avoided entirely during pregnancy. These include streptomycin and kanamycin (which may cause hearing loss) and tetracycline (which can lead to weakening, hypoplasia, and discoloration of long bones and teeth).
• If valproate is taken during pregnancy, know that there is a higher risk that the child may have birth defects or may score lower on cognitive tests (tests that measure mental ability and capacity, such as IQ tests) in childhood than any other anti-seizure medicine during pregnancy.REFERENCE
Medicines in Pregnancy - Question 10 of 300
10. Question
Which of the following may cause secondary dentin deposition?
CorrectANSWER
TraumaOTHER OPTIONS
• Explained belowSYNOPSIS
• Secondary dentin is dentin deposited in the pulp chamber after the formation of primary dentin has been completed.
• Secondary dentin deposition may be part of physiologic aging and may result from such innocuous stimuli as chewing or slight trauma.
• Tertiary dentin (also referred to as reactive or reparative dentin) is produced in reaction to various stimuli, such as attrition, caries, or a restorative dental procedureREFERENCE
Dentin Deposition – Ten Cate’s Oral HistologyIncorrectANSWER
TraumaOTHER OPTIONS
• Explained belowSYNOPSIS
• Secondary dentin is dentin deposited in the pulp chamber after the formation of primary dentin has been completed.
• Secondary dentin deposition may be part of physiologic aging and may result from such innocuous stimuli as chewing or slight trauma.
• Tertiary dentin (also referred to as reactive or reparative dentin) is produced in reaction to various stimuli, such as attrition, caries, or a restorative dental procedureREFERENCE
Dentin Deposition – Ten Cate’s Oral Histology - Question 11 of 300
11. Question
What is the treatment of choice for a patient under IV bisphosphonate therapy with badly decayed molar shows pain?
CorrectANSWER
RCT to root stumpsOTHER OPTIONS
• Explained belowSYNOPSIS
• The most common complication in patients on bisphosphonate therapy is osteonecrosis of the jaw which occurs after any surgical dental procedure.
• According to the information currently available, risk for developing bisphosphonate associated osteonecrosis of jaw is higher in patients on IV bisphosphonate therapy than the patients on oral bisphosphonates as orally they are poorly absorbed
• In IV administered bisphosphonates, Zolendronate is the most potent bisphosphonate because of its high mineral binding affinity and FPPS enzyme inhibition
• For patients who have already started with the therapy, any elective procedures should be avoided if possible to avoid the risk of bisphosphonate induced osteonecrosis of jaw.
• Root canal treatment should be done rather than dental extraction when possible.
• Patients in which dental extractions are unavoidable should be first consulted with the prescriber of bisphosphonate therapy for possible temporary interruption of drug if beneficial.
• Extraction should be done as atraumatically as possible and flap raising should be avoided.
• Sterile technique has to be followed.
• Patient should be kept on chlorhexidine mouthwash twice daily for two months and postoperatively 2 month follow up should be done.
• In some cases it has been recommended to do a root canal of the teeth followed by coronal amputation and leave the roots.REFERENCE
Dental complications and management of patients on bisphosphonate therapy- A review article -Journal of Oral Biology and Craniofacial ResearchIncorrectANSWER
RCT to root stumpsOTHER OPTIONS
• Explained belowSYNOPSIS
• The most common complication in patients on bisphosphonate therapy is osteonecrosis of the jaw which occurs after any surgical dental procedure.
• According to the information currently available, risk for developing bisphosphonate associated osteonecrosis of jaw is higher in patients on IV bisphosphonate therapy than the patients on oral bisphosphonates as orally they are poorly absorbed
• In IV administered bisphosphonates, Zolendronate is the most potent bisphosphonate because of its high mineral binding affinity and FPPS enzyme inhibition
• For patients who have already started with the therapy, any elective procedures should be avoided if possible to avoid the risk of bisphosphonate induced osteonecrosis of jaw.
• Root canal treatment should be done rather than dental extraction when possible.
• Patients in which dental extractions are unavoidable should be first consulted with the prescriber of bisphosphonate therapy for possible temporary interruption of drug if beneficial.
• Extraction should be done as atraumatically as possible and flap raising should be avoided.
• Sterile technique has to be followed.
• Patient should be kept on chlorhexidine mouthwash twice daily for two months and postoperatively 2 month follow up should be done.
• In some cases it has been recommended to do a root canal of the teeth followed by coronal amputation and leave the roots.REFERENCE
Dental complications and management of patients on bisphosphonate therapy- A review article -Journal of Oral Biology and Craniofacial Research - Question 12 of 300
12. Question
Which of the following may determine the quality of a good dentist?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The most important qualities a good dentist should have are
– Being knowledgeable,
– Being an expert in their field,
– Being trustworthy.
– A dentist should have excellent communication skills and be compassionateREFERENCE
Qualities of a Good Dentist. By Global Pre-MedsIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The most important qualities a good dentist should have are
– Being knowledgeable,
– Being an expert in their field,
– Being trustworthy.
– A dentist should have excellent communication skills and be compassionateREFERENCE
Qualities of a Good Dentist. By Global Pre-Meds - Question 13 of 300
13. Question
Which is the best medium for storage of avulsed teeth?
CorrectANSWER
MilkOTHER OPTIONS
• Saline – may be used for short-term storage but is not the best medium
• Water – has inadequate characteristics to be used as a storage medium for avulsed teeth because it has bacterial contamination, hypotonicity and nonphysiological pH, and osmolality, which favors the PDL cell lysisSYNOPSIS
• Milk can be employed as a storage media for avulsed teeth. It meets the following criteria for an interim storage media
(1) It has physiologic pH,
(2) Ability to preserve the viability of PDL cells,
(3) It has a low bacterial count and
(4) Commonly available.
• Milk cannot revitalize the dead cells but helps in preserving the vitality of PDL cells.
• Milk can maintain the viability, mitogenicity, and clonogenic capacity of PDL cells for as long as 24 hours.
• The fat content of milk has an effect on its ability to maintain PDL cell viability. The milk with low-fat content was found to be better than the milk with high-fat content.
• According to Saglas et al., storage of teeth in low-fat milk with ice as storage media is more effective than at room temperature
• In the presence of ice in milk, the apoptotic cell death of the periodontal ligament is further inhibited.
• In conclusion HBSS and chilled milk are the most appropriate, clinically recommended storage media for avulsed teeth.REFERENCE
Natural products as storage media for avulsed tooth- Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore,IncorrectANSWER
MilkOTHER OPTIONS
• Saline – may be used for short-term storage but is not the best medium
• Water – has inadequate characteristics to be used as a storage medium for avulsed teeth because it has bacterial contamination, hypotonicity and nonphysiological pH, and osmolality, which favors the PDL cell lysisSYNOPSIS
• Milk can be employed as a storage media for avulsed teeth. It meets the following criteria for an interim storage media
(1) It has physiologic pH,
(2) Ability to preserve the viability of PDL cells,
(3) It has a low bacterial count and
(4) Commonly available.
• Milk cannot revitalize the dead cells but helps in preserving the vitality of PDL cells.
• Milk can maintain the viability, mitogenicity, and clonogenic capacity of PDL cells for as long as 24 hours.
• The fat content of milk has an effect on its ability to maintain PDL cell viability. The milk with low-fat content was found to be better than the milk with high-fat content.
• According to Saglas et al., storage of teeth in low-fat milk with ice as storage media is more effective than at room temperature
• In the presence of ice in milk, the apoptotic cell death of the periodontal ligament is further inhibited.
• In conclusion HBSS and chilled milk are the most appropriate, clinically recommended storage media for avulsed teeth.REFERENCE
Natural products as storage media for avulsed tooth- Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore, - Question 14 of 300
14. Question
Which of the following conditions is characterized by enamel fracture and yellowish- brown discoloration of tooth?
CorrectANSWER
Enamel hypoplasiaOTHER OPTIONS
• Dentinogenesis imperfecta (DI) – It is a genetic disorder of tooth development. It is inherited in an autosomal dominant pattern, as a result of mutations on chromosome 4q21, in the dentine sialophosphoprotein gene (DSPP). It is one of the most frequently occurring autosomal dominant features in humans.
• Amelogenesis imperfecta – Amelogenesis imperfecta is a tooth development disorder. It causes the tooth enamel to be thin and abnormally formed. Enamel is the outer layer of the coronal, or crown portion of the teeth
• Dental dysplasia – Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pupal morphology. The teeth appear clinically normal in morphologic appearance and color.SYNOPSIS
• Enamel hypoplasia – An incomplete or defective formation of the organic enamel matrix of teeth. Local and systemic factors that interfere with normal matrix formation can cause enamel surface defects and irregularities.
• Clinical features of enamel hypoplasia are
– pits, tiny groves, depressions, and fissures
– White spots
– Yellowish-brown stains (where the underlying layer of dentin is exposed)
– Sensitivity to heat and cold
– Lack of tooth contact, the irregular wearing of teeth
– Susceptibility to acids in food and drink
– Retention of harmful bacteria
– Increased vulnerability to tooth decay and cavitiesREFERENCE
Shafers Textbook of Oral pathologyIncorrectANSWER
Enamel hypoplasiaOTHER OPTIONS
• Dentinogenesis imperfecta (DI) – It is a genetic disorder of tooth development. It is inherited in an autosomal dominant pattern, as a result of mutations on chromosome 4q21, in the dentine sialophosphoprotein gene (DSPP). It is one of the most frequently occurring autosomal dominant features in humans.
• Amelogenesis imperfecta – Amelogenesis imperfecta is a tooth development disorder. It causes the tooth enamel to be thin and abnormally formed. Enamel is the outer layer of the coronal, or crown portion of the teeth
• Dental dysplasia – Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pupal morphology. The teeth appear clinically normal in morphologic appearance and color.SYNOPSIS
• Enamel hypoplasia – An incomplete or defective formation of the organic enamel matrix of teeth. Local and systemic factors that interfere with normal matrix formation can cause enamel surface defects and irregularities.
• Clinical features of enamel hypoplasia are
– pits, tiny groves, depressions, and fissures
– White spots
– Yellowish-brown stains (where the underlying layer of dentin is exposed)
– Sensitivity to heat and cold
– Lack of tooth contact, the irregular wearing of teeth
– Susceptibility to acids in food and drink
– Retention of harmful bacteria
– Increased vulnerability to tooth decay and cavitiesREFERENCE
Shafers Textbook of Oral pathology - Question 15 of 300
15. Question
What is the treatment of choice for vital tooth with open apex which shows pulp exposure of greater than 1mm?
CorrectANSWER
ApexogenesisOTHER OPTIONS
• Apexification – For non-vital tooth
• Direct pulp capping – For incipient pulp exposure
• RCT – In closed apex casesSYNOPSIS
• Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end in young permanent tooth in cases of large traumatic exposure of pulp.
• It is a procedure where vital tissue within the tooth is maintained to facilitate the continued development of the immature root.
• A portion of the inflamed pulp is removed and filled with a bioceramic material that maintains vitality in the roots. Healthy tissue then allows for continued root development.
• Vital pulp capping with MTA in apexogenesis has superior long-term sealing ability and stimulates the formation of a higher quality and greater amount of reparative dentin.
• The calcified bridge formed by MTA is continuous and has no evidence of tunnel defects.REFERENCE
Apexogenesis and apexification with mineral trioxide aggregate (MTA)- a report of two cases -Endodontic PracticeIncorrectANSWER
ApexogenesisOTHER OPTIONS
• Apexification – For non-vital tooth
• Direct pulp capping – For incipient pulp exposure
• RCT – In closed apex casesSYNOPSIS
• Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end in young permanent tooth in cases of large traumatic exposure of pulp.
• It is a procedure where vital tissue within the tooth is maintained to facilitate the continued development of the immature root.
• A portion of the inflamed pulp is removed and filled with a bioceramic material that maintains vitality in the roots. Healthy tissue then allows for continued root development.
• Vital pulp capping with MTA in apexogenesis has superior long-term sealing ability and stimulates the formation of a higher quality and greater amount of reparative dentin.
• The calcified bridge formed by MTA is continuous and has no evidence of tunnel defects.REFERENCE
Apexogenesis and apexification with mineral trioxide aggregate (MTA)- a report of two cases -Endodontic Practice - Question 16 of 300
16. Question
What are the main goals to be considered in periodontal therapy?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The goals of periodontal therapy are to
– Eliminate the local etiologic factors
– Preserve the natural dentition, periodontium and peri-implant tissues
– To maintain and improve periodontal and peri-implant health, comfort, esthetics, and function.
• Currently accepted clinical signs of a healthy periodontium include
– The absence of inflammatory signs of disease such as redness, swelling, suppuration, and bleeding on probing
– Maintenance of a functional periodontal attachment level
– Minimal or no recession in the absence of interproximal bone loss and functional dental implants.REFERENCE
Carranza’s Clinical PeriodontologyIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The goals of periodontal therapy are to
– Eliminate the local etiologic factors
– Preserve the natural dentition, periodontium and peri-implant tissues
– To maintain and improve periodontal and peri-implant health, comfort, esthetics, and function.
• Currently accepted clinical signs of a healthy periodontium include
– The absence of inflammatory signs of disease such as redness, swelling, suppuration, and bleeding on probing
– Maintenance of a functional periodontal attachment level
– Minimal or no recession in the absence of interproximal bone loss and functional dental implants.REFERENCE
Carranza’s Clinical Periodontology - Question 17 of 300
17. Question
Upon extraction of a lower molar, the dentist wants to achieve hemostasis and retain the clot. Which suture
is advised?CorrectANSWER
Figure of 8 sutureOTHER OPTIONS
• Horizontal mattress suture – This technique tightens both sides of the wound. This is beneficial to close soft tissues. This is the easiest way to fix two papillae with a single knot
• Interrupted suture – This is the most commonly used suture technique in Dental procedures like Impactions, Tooth extractions, etc.
• Continuous Suture – If there is a long incision, the continuous suture technique is preferredSYNOPSIS
• Figure of 8 suture
• This is a modified version of the horizontal mattress suture.
• While closing both sides of the soft tissue, this suture helps preserve the position of the clotREFERENCE
Suture techniques And Materials in Oral SurgeryIncorrectANSWER
Figure of 8 sutureOTHER OPTIONS
• Horizontal mattress suture – This technique tightens both sides of the wound. This is beneficial to close soft tissues. This is the easiest way to fix two papillae with a single knot
• Interrupted suture – This is the most commonly used suture technique in Dental procedures like Impactions, Tooth extractions, etc.
• Continuous Suture – If there is a long incision, the continuous suture technique is preferredSYNOPSIS
• Figure of 8 suture
• This is a modified version of the horizontal mattress suture.
• While closing both sides of the soft tissue, this suture helps preserve the position of the clotREFERENCE
Suture techniques And Materials in Oral Surgery - Question 18 of 300
18. Question
Which drug is used for trigeminal neuralgia?
CorrectANSWER
Any of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Carbamazepine and oxcarbazepine are considered first-line therapy in trigeminal neuralgia (TN).
• Lamotrigine and baclofen are second-line therapy.
• Other treatments are third line and the evidence for their efficacy is scant.REFERENCE
Essentials of Pharmacology for Dentistry – K D TripathiIncorrectANSWER
Any of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Carbamazepine and oxcarbazepine are considered first-line therapy in trigeminal neuralgia (TN).
• Lamotrigine and baclofen are second-line therapy.
• Other treatments are third line and the evidence for their efficacy is scant.REFERENCE
Essentials of Pharmacology for Dentistry – K D Tripathi - Question 19 of 300
19. Question
Which is the newest technique for treatment of Trigeminal neuralgia?
CorrectANSWER
Microvascular DecompressionOTHER OPTIONS
• Not applicableSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Microvascular decompression (MVD) surgery has become the suggested treatment for trigeminal neuralgia which is the result of impingement on the nerve by a blood vessel.
• It is considered microsurgery, meaning it requires a much smaller incision, surgical site, and instruments to perform.
• It also means there is a shorter recovery time than other intracranial procedures.REFERENCE
MVD as a Trigeminal Neuralgia Treatment – Neurosurgeons of New JersyIncorrectANSWER
Microvascular DecompressionOTHER OPTIONS
• Not applicableSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Microvascular decompression (MVD) surgery has become the suggested treatment for trigeminal neuralgia which is the result of impingement on the nerve by a blood vessel.
• It is considered microsurgery, meaning it requires a much smaller incision, surgical site, and instruments to perform.
• It also means there is a shorter recovery time than other intracranial procedures.REFERENCE
MVD as a Trigeminal Neuralgia Treatment – Neurosurgeons of New Jersy - Question 20 of 300
20. Question
Which is the cellular layer that is absent in alveolar mucosa but present in attached gingival mucosa?
CorrectANSWER
Stratum corneumOTHER OPTIONS
• Not applicableSYNOPSIS
• Alveolar mucosa
– The area of tissue beyond the mucogingival junction.
– It seems less firmly attached and redder than the attached gingiva.
– It is non-keratinized and provides a softer and more flexible area for the movement of the cheeks and lips.
• Attached gingiva
– This tissue is adjacent to the free gingiva
– It is keratinized and firmly attached to the bone structure.
– It can range from 3-12 mm in height.
• The keratinized epithelium possesses a stratum corneum layer
• The stratum corneum is made up of flattened non-viable, non-nucleated epithelial cells containing keratin which is absent in non-keratinized epitheliumREFERENCE
Carranza’s Clinical PeriodontologyIncorrectANSWER
Stratum corneumOTHER OPTIONS
• Not applicableSYNOPSIS
• Alveolar mucosa
– The area of tissue beyond the mucogingival junction.
– It seems less firmly attached and redder than the attached gingiva.
– It is non-keratinized and provides a softer and more flexible area for the movement of the cheeks and lips.
• Attached gingiva
– This tissue is adjacent to the free gingiva
– It is keratinized and firmly attached to the bone structure.
– It can range from 3-12 mm in height.
• The keratinized epithelium possesses a stratum corneum layer
• The stratum corneum is made up of flattened non-viable, non-nucleated epithelial cells containing keratin which is absent in non-keratinized epitheliumREFERENCE
Carranza’s Clinical Periodontology - Question 21 of 300
21. Question
You are scheduled to perform a tooth extraction on a 30-year-old patient named Mr.Alex. His tooth has been causing him significant pain and discomfort due to decay and infection. As you assess his oral health and discuss the upcoming procedure, you notice that he is concerned about the possibility of post-operative swelling. Mr. Alex has important plans in the coming days and is worried that excessive swelling might impact his ability to fulfill his responsibilities. He expresses a strong desire to minimize post-operative swelling as much as possible. It’s essential for you to provide him with detailed instructions and guidance on how to manage and reduce swelling effectively after the tooth extraction. How to reduce post-operative swelling after extraction?
CorrectANSWER
Apply cold for 24 hrs and hot pads after 24 hours intermittentOTHER OPTIONS
• NilSYNOPSIS
• Apply ice packs to the face in the area of extraction for a few minutes on, then a few minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.
• Most importantly, for 48 hours following your extraction, do not smoke, spit, use a straw, drink carbonated beverages, or alcohol, and avoid strenuous exercise.
• Avoid blowing your nose and sneezing (if you must sneeze, do so with your mouth open to prevent any sinus damage) for the first week.
• These activities can dislodge the blood clot and result in a very painful dry socket.REFERENCE
Post Operative Instructions for Extraction Patient .IncorrectANSWER
Apply cold for 24 hrs and hot pads after 24 hours intermittentOTHER OPTIONS
• NilSYNOPSIS
• Apply ice packs to the face in the area of extraction for a few minutes on, then a few minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.
• Most importantly, for 48 hours following your extraction, do not smoke, spit, use a straw, drink carbonated beverages, or alcohol, and avoid strenuous exercise.
• Avoid blowing your nose and sneezing (if you must sneeze, do so with your mouth open to prevent any sinus damage) for the first week.
• These activities can dislodge the blood clot and result in a very painful dry socket.REFERENCE
Post Operative Instructions for Extraction Patient . - Question 22 of 300
22. Question
Radiographic evidence of a 20 yr old female patient revealed a radioopaque lesion with some expansion giving an orange peel appearance in the posterior aspect of the maxilla. Histologically, it shows fibrous growth. What is your diagnosis?
CorrectANSWER
Fibrous dysplasiaOTHER OPTIONS
• Paget’s Disease – The cotton wool appearance is a plain film sign of Paget disease and results from thickened, disorganized trabeculae which lead to areas of sclerosis in a previously lucent area of bone, typically the skull. These sclerotic patches are poorly defined and fluffy
• Hyperparathyroidism – The common symptomatic osseous findings include subperiosteal and subchondral joint resorption, acroosteolysis, the salt-and-pepper skull, the brown tumors, and osteopenia.
• Osteosarcoma – The characteristic radiological features are sun-burst appearance, periosteal lifting with formation of Codman’s triangleSYNOPSIS
• Fibrous dysplasia is a non-neoplastic hamartomatous developmental lesion of the bone of unknown origin.
• It is characterized by the replacement of bone with fibro-osseous tissue,
• The maxilla is more frequently involved than the mandible.
• The most common radiographic pattern observed was the ground-glass appearance, followed by orange peel, cotton wool, sunray and thumbprint appearance, which leads to a perplex differential diagnosis.REFERENCE
The radiological versatility of fibrous dysplasia An 8-year retrospective radiographic analysis in a north Indian population – Indian Journal of DentistryIncorrectANSWER
Fibrous dysplasiaOTHER OPTIONS
• Paget’s Disease – The cotton wool appearance is a plain film sign of Paget disease and results from thickened, disorganized trabeculae which lead to areas of sclerosis in a previously lucent area of bone, typically the skull. These sclerotic patches are poorly defined and fluffy
• Hyperparathyroidism – The common symptomatic osseous findings include subperiosteal and subchondral joint resorption, acroosteolysis, the salt-and-pepper skull, the brown tumors, and osteopenia.
• Osteosarcoma – The characteristic radiological features are sun-burst appearance, periosteal lifting with formation of Codman’s triangleSYNOPSIS
• Fibrous dysplasia is a non-neoplastic hamartomatous developmental lesion of the bone of unknown origin.
• It is characterized by the replacement of bone with fibro-osseous tissue,
• The maxilla is more frequently involved than the mandible.
• The most common radiographic pattern observed was the ground-glass appearance, followed by orange peel, cotton wool, sunray and thumbprint appearance, which leads to a perplex differential diagnosis.REFERENCE
The radiological versatility of fibrous dysplasia An 8-year retrospective radiographic analysis in a north Indian population – Indian Journal of Dentistry - Question 23 of 300
23. Question
28 years old female patient having mild gingivitis, is very keen to know how she can keep her oral cavity plaque free and asked for the type of floss used.
CorrectANSWER
Ease of use and personal preferenceOTHER OPTIONS
• Not applicableSYNOPSIS
• Using a specific type of dental floss is a matter of personal choice because all of them effectively remove plaque when used appropriately.
– Waxed vs. Unwaxed floss – Waxed floss is slightly thicker than regular floss but slides easily between tight teeth contacts because of its waxy coating. You may want to use waxed floss to prevent fraying if you have braces. However, be mindful that the wax coating may cause sensitivity reactions in rare cases.
– Dental tape vs. floss – Since the dental tape is broad and flat it is recommended when there are significant gaps between the teeth or if your regular floss slides in too easily.
– Water floss vs. floss – Pressurized water jets can flush out food and debris trapped in the gum spaces. Thus water floss is an easy-to-use alternative when people lack the manual dexterity to use regular string floss or under braces and implants.
– String floss vs. Floss Picks – Floss picks are a convenient option to carry with you when traveling. However, floss picks are not as effective as regular string floss in reducing plaque since they cannot reach all the corners and surfaces of your teeth. So only use them if you don’t have string floss around.
– Super floss vs. Floss Threader – Both super floss and floss threaders have a stiff end that helps to insert the floss between braces under bridges and retainers. The main difference is that you have to buy your string floss separately with a floss threader.REFERENCE
Best Dental Floss And Types How To Choose The Right One For You? – Dr. Shaista SalamIncorrectANSWER
Ease of use and personal preferenceOTHER OPTIONS
• Not applicableSYNOPSIS
• Using a specific type of dental floss is a matter of personal choice because all of them effectively remove plaque when used appropriately.
– Waxed vs. Unwaxed floss – Waxed floss is slightly thicker than regular floss but slides easily between tight teeth contacts because of its waxy coating. You may want to use waxed floss to prevent fraying if you have braces. However, be mindful that the wax coating may cause sensitivity reactions in rare cases.
– Dental tape vs. floss – Since the dental tape is broad and flat it is recommended when there are significant gaps between the teeth or if your regular floss slides in too easily.
– Water floss vs. floss – Pressurized water jets can flush out food and debris trapped in the gum spaces. Thus water floss is an easy-to-use alternative when people lack the manual dexterity to use regular string floss or under braces and implants.
– String floss vs. Floss Picks – Floss picks are a convenient option to carry with you when traveling. However, floss picks are not as effective as regular string floss in reducing plaque since they cannot reach all the corners and surfaces of your teeth. So only use them if you don’t have string floss around.
– Super floss vs. Floss Threader – Both super floss and floss threaders have a stiff end that helps to insert the floss between braces under bridges and retainers. The main difference is that you have to buy your string floss separately with a floss threader.REFERENCE
Best Dental Floss And Types How To Choose The Right One For You? – Dr. Shaista Salam - Question 24 of 300
24. Question
A 10-year-old child with Chronic kidney disease underwent extraction of a retained primary tooth. Which analgesic is safe for pedo patients with renal failure after tooth extraction?
CorrectANSWER
AcetaminophenOTHER OPTIONS
• Aspirin – Aspirin has analgesic and anti-inflammatory effects only at intermediate and large doses. At larger doses, the chronic use of aspirin leads to renal vasoconstriction, interstitial nephritis, and a decline in renal function.
• Meperidine – Meperidine is a synthetic opioid that is hepatically metabolized and renally excreted. Normeperidine, its major metabolite, accumulates in chronic kidney disease and causes central nervous system excitability, predisposing patients to seizures.
• Morphine – Morphine-6-glucuronide, an active metabolite of morphine, can accumulate in patients with chronic kidney disease and can have dangerous sedating effects. It crosses the blood-brain barrier slowly, and its effects are not quickly reversed by hemodialysis.SYNOPSIS
• The preferred medication for analgesia in patients with chronic kidney disease unless otherwise contraindicated is acetaminophen.
• Although its mechanism is not fully understood, acetaminophen is believed to reduce pain by inhibiting the cyclooxygenase isoenzyme at the peroxidase site, ultimately resulting in a reduction of prostaglandin production.
• It is 20 percent to 50 percent protein bound and undergoes hepatic metabolism, making accumulation to toxic concentrations or kidney damage in the setting of chronic kidney disease less likely.
• Some recent case reports suggest that acetaminophen may be dialyzable.REFERENCE
Pain Management in Pediatric Chronic Kidney Disease – The Journal of Pediatric Pharmacology and TherapeuticsIncorrectANSWER
AcetaminophenOTHER OPTIONS
• Aspirin – Aspirin has analgesic and anti-inflammatory effects only at intermediate and large doses. At larger doses, the chronic use of aspirin leads to renal vasoconstriction, interstitial nephritis, and a decline in renal function.
• Meperidine – Meperidine is a synthetic opioid that is hepatically metabolized and renally excreted. Normeperidine, its major metabolite, accumulates in chronic kidney disease and causes central nervous system excitability, predisposing patients to seizures.
• Morphine – Morphine-6-glucuronide, an active metabolite of morphine, can accumulate in patients with chronic kidney disease and can have dangerous sedating effects. It crosses the blood-brain barrier slowly, and its effects are not quickly reversed by hemodialysis.SYNOPSIS
• The preferred medication for analgesia in patients with chronic kidney disease unless otherwise contraindicated is acetaminophen.
• Although its mechanism is not fully understood, acetaminophen is believed to reduce pain by inhibiting the cyclooxygenase isoenzyme at the peroxidase site, ultimately resulting in a reduction of prostaglandin production.
• It is 20 percent to 50 percent protein bound and undergoes hepatic metabolism, making accumulation to toxic concentrations or kidney damage in the setting of chronic kidney disease less likely.
• Some recent case reports suggest that acetaminophen may be dialyzable.REFERENCE
Pain Management in Pediatric Chronic Kidney Disease – The Journal of Pediatric Pharmacology and Therapeutics - Question 25 of 300
25. Question
A 28 weeks pregnant lady came with a large pedunculated gingival mass protruding from the maxilla around 2 x 2 mm. On history, the lady said the lesion she noticed 2 months back and is frequently bleeding. Diagnosis?
CorrectANSWER
Pregnancy tumorOTHER OPTIONS
• Periodontal cyst – It is a relatively uncommon cyst that is slow growing, non-expansile developmental odontogenic cyst derived from one or more rests of the dental lamina, containing an embryonic lining of 1-3 squamouspercuboidal cell thickness and distinctive focal thickenings
• Carcinoma in situ – It is a term used to define and describe cancer that is only present in the cells where it started and has not spread to any nearby tissues.
• Radicular cyst – It is the most common inflammatory odontogenic cyst. It is associated with non-vital teeth. The tooth might be deeply carious, traumatized, or improperly restored.SYNOPSIS
• The pregnancy-associated pyogenic granuloma is not a tumor but an exaggerated inflammatory response during pregnancy to an irritation resulting in a solitary polypoid capillary hemangioma which can easily bleed on mild provocation.
• These granulomas present clinically as a painless, protuberant, mushroom-like exophytic mass attached by a sessile or pedunculated base arising from the gingival margin or more commonly from an interproximal papilla.
• It is more common in the maxilla and may develop as early as the first trimester ultimately regressing or completely disappearing following parturition.REFERENCE.
Textbook of Oral Medicine Oral Diagnosis and Oral Radiology- Ravikiran OngoleIncorrectANSWER
Pregnancy tumorOTHER OPTIONS
• Periodontal cyst – It is a relatively uncommon cyst that is slow growing, non-expansile developmental odontogenic cyst derived from one or more rests of the dental lamina, containing an embryonic lining of 1-3 squamouspercuboidal cell thickness and distinctive focal thickenings
• Carcinoma in situ – It is a term used to define and describe cancer that is only present in the cells where it started and has not spread to any nearby tissues.
• Radicular cyst – It is the most common inflammatory odontogenic cyst. It is associated with non-vital teeth. The tooth might be deeply carious, traumatized, or improperly restored.SYNOPSIS
• The pregnancy-associated pyogenic granuloma is not a tumor but an exaggerated inflammatory response during pregnancy to an irritation resulting in a solitary polypoid capillary hemangioma which can easily bleed on mild provocation.
• These granulomas present clinically as a painless, protuberant, mushroom-like exophytic mass attached by a sessile or pedunculated base arising from the gingival margin or more commonly from an interproximal papilla.
• It is more common in the maxilla and may develop as early as the first trimester ultimately regressing or completely disappearing following parturition.REFERENCE.
Textbook of Oral Medicine Oral Diagnosis and Oral Radiology- Ravikiran Ongole - Question 26 of 300
26. Question
Which among the following is the contraindication of pregnancy in the first trimester?
CorrectANSWER
X-rayOTHER OPTIONS
• Acetylsalicylic acid – Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months.
• Penicillins – Generally considered safe during pregnancy.SYNOPSIS
• Exposure to extremely high-dose radiation in the first two weeks after conception might result in a miscarriage.
• During the first-trimester different body organs in the fetus are forming. It is the most critical time for teratogenicity.
• Dental prophylaxis with detailed instructions and a visual examination of the oral cavity without x-rays should be performed if the patient is pregnant.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation – 8th EditionIncorrectANSWER
X-rayOTHER OPTIONS
• Acetylsalicylic acid – Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months.
• Penicillins – Generally considered safe during pregnancy.SYNOPSIS
• Exposure to extremely high-dose radiation in the first two weeks after conception might result in a miscarriage.
• During the first-trimester different body organs in the fetus are forming. It is the most critical time for teratogenicity.
• Dental prophylaxis with detailed instructions and a visual examination of the oral cavity without x-rays should be performed if the patient is pregnant.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation – 8th Edition - Question 27 of 300
27. Question
What is the function of the antiseptic action of a soap?
CorrectANSWER
Kills bacteriaOTHER OPTIONS
Refer synopsisSYNOPSIS
• Most antimicrobial soaps use either triclosan or triclocarban as an ingredient to kill microorganisms.
• Triclosan is labeled a biocide, which means that it uses a non-specific mode of action to kill microbes.
• It is thought to destroy biological structures at random.REFERENCE
WikipediaIncorrectANSWER
Kills bacteriaOTHER OPTIONS
Refer synopsisSYNOPSIS
• Most antimicrobial soaps use either triclosan or triclocarban as an ingredient to kill microorganisms.
• Triclosan is labeled a biocide, which means that it uses a non-specific mode of action to kill microbes.
• It is thought to destroy biological structures at random.REFERENCE
Wikipedia - Question 28 of 300
28. Question
What is the acceptable clotting time?
CorrectANSWER
2 to 8 minutesOTHER OPTIONS
Not acceptableSYNOPSIS
• Clotting time is defined as the time interval between puncture to the blood vessel to the formation of fibrin thread.
• The normal range of clotting time is 2 to 8 minutes.REFERENCE
Laboratory Diagnosis and Test ProtocolsIncorrectANSWER
2 to 8 minutesOTHER OPTIONS
Not acceptableSYNOPSIS
• Clotting time is defined as the time interval between puncture to the blood vessel to the formation of fibrin thread.
• The normal range of clotting time is 2 to 8 minutes.REFERENCE
Laboratory Diagnosis and Test Protocols - Question 29 of 300
29. Question
A patient presented to the clinic seeking for replacement of missing teeth 24, 25, 14 and 15 with RPD. Examination revealed high smile line. The patient was concerned about the esthetic appearance of the future provided treatment. Which of the following options is the most likely to meet the patients concern?
CorrectANSWER
I bar claspOTHER OPTIONS
• Twin flex clasp – This consists of a wire clasp soldered into a channel that is cast in the major connector. This clasp is flexible it does not generate as much as torque when the distal extension is depressed. The ability to adjust this clasp and its conventional path of insertion provides an excellent design option for retention to an adjacent edentulous segment.
• Casted Akers clasp – These clasps embrace more than half of the abutment tooth. They may show continuous or limited three-point contact with the tooth.
• Wrought wire clasp – They are more flexible and kinder to the abutment tooth.SYNOPSIS
• It is a modified I-type roach clasp introduced by Kratochvil.
• It has a mesial rest arising from a major connector an I-bar retentive arm and a long proximal plate.
• It is designed to reduce tooth contact.
• Krol in 1973 modified the I-bar system and introduced the RPI and RPA systems.
• The rest is on the proximal side away from the edentulous space.
• An I-bar retainer is used instead of an occlusally approaching retainer for direct retention.REFERENCE
Textbook of Prosthodontics-Deepak NallaswamyIncorrectANSWER
I bar claspOTHER OPTIONS
• Twin flex clasp – This consists of a wire clasp soldered into a channel that is cast in the major connector. This clasp is flexible it does not generate as much as torque when the distal extension is depressed. The ability to adjust this clasp and its conventional path of insertion provides an excellent design option for retention to an adjacent edentulous segment.
• Casted Akers clasp – These clasps embrace more than half of the abutment tooth. They may show continuous or limited three-point contact with the tooth.
• Wrought wire clasp – They are more flexible and kinder to the abutment tooth.SYNOPSIS
• It is a modified I-type roach clasp introduced by Kratochvil.
• It has a mesial rest arising from a major connector an I-bar retentive arm and a long proximal plate.
• It is designed to reduce tooth contact.
• Krol in 1973 modified the I-bar system and introduced the RPI and RPA systems.
• The rest is on the proximal side away from the edentulous space.
• An I-bar retainer is used instead of an occlusally approaching retainer for direct retention.REFERENCE
Textbook of Prosthodontics-Deepak Nallaswamy - Question 30 of 300
30. Question
The cusp of Carebelli is seen in?
CorrectANSWER
Mesiopalatal cusp of maxillary permanent molarsOTHER OPTIONS
• Refer synopsisSYNOPSIS
• The Cusp of Carabelli is a characteristic morphological trait often seen on the palatal surface of the mesiopalatal cusp of maxillary permanent molars.
• The cusp of Carabelli, is also known as Carabelli tubercle, tuberculum anomaly of Georg Carabelli.
• This is a morphological variation that takes the form of a fifth cusp or it can grade down to a series of grooves, depressions, or pits on the mesial portion of the lingual surface.
• This cusp is found lingual to the mesiolingual cusp of the maxillary first permanent molar.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition.IncorrectANSWER
Mesiopalatal cusp of maxillary permanent molarsOTHER OPTIONS
• Refer synopsisSYNOPSIS
• The Cusp of Carabelli is a characteristic morphological trait often seen on the palatal surface of the mesiopalatal cusp of maxillary permanent molars.
• The cusp of Carabelli, is also known as Carabelli tubercle, tuberculum anomaly of Georg Carabelli.
• This is a morphological variation that takes the form of a fifth cusp or it can grade down to a series of grooves, depressions, or pits on the mesial portion of the lingual surface.
• This cusp is found lingual to the mesiolingual cusp of the maxillary first permanent molar.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition. - Question 31 of 300
31. Question
All of the following about bone loss in completely edentulous patient are true except?
CorrectANSWER
Direction of bone resorption in maxilla is similar to that in mandibleOTHER OPTIONS
• NilSYNOPSIS
• Alveolar ridge resorption after teeth extraction is a chronic progressive and cumulative disease of bone reconstruction. Extensive residual ridge resorption is one of the many problems in prosthetic dentistry rehabilitation .
• Residual ridge resorption starts with the tooth and its periodontal membrane loss responsible for the bone formation . Periodontal membrane loss leads to decreasing metabolism in the alveolar ridge and to biochemical resorption of the bone caused by the dental plaque endotoxines prostaglandines and human stimulating factors of alveolar ridge resorption.
• Tooth loss causes resorption of the upper part of the mandible (alveolar ridge) and is the main factor influencing the clinical height of the residual mandible.
• According to Klemetti initially resorption starts on the alveolar part of the mandible and the rest of the mandible remains unchanged . Factors such as resorption post-menopause or osteoporosis do not change the lower part of the mandible. The main reason for this may be the function of the chewing muscles.
• According to Klemetti’s investigation if frontal teeth remain in the mandible the bite forces in the distal part of the mandible are not strong enough to produce greater resorption both in denture wearers and non-wearer.REFERENCE
Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers- DubravkaIncorrectANSWER
Direction of bone resorption in maxilla is similar to that in mandibleOTHER OPTIONS
• NilSYNOPSIS
• Alveolar ridge resorption after teeth extraction is a chronic progressive and cumulative disease of bone reconstruction. Extensive residual ridge resorption is one of the many problems in prosthetic dentistry rehabilitation .
• Residual ridge resorption starts with the tooth and its periodontal membrane loss responsible for the bone formation . Periodontal membrane loss leads to decreasing metabolism in the alveolar ridge and to biochemical resorption of the bone caused by the dental plaque endotoxines prostaglandines and human stimulating factors of alveolar ridge resorption.
• Tooth loss causes resorption of the upper part of the mandible (alveolar ridge) and is the main factor influencing the clinical height of the residual mandible.
• According to Klemetti initially resorption starts on the alveolar part of the mandible and the rest of the mandible remains unchanged . Factors such as resorption post-menopause or osteoporosis do not change the lower part of the mandible. The main reason for this may be the function of the chewing muscles.
• According to Klemetti’s investigation if frontal teeth remain in the mandible the bite forces in the distal part of the mandible are not strong enough to produce greater resorption both in denture wearers and non-wearer.REFERENCE
Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers- Dubravka - Question 32 of 300
32. Question
You were presented with a child who shows brownish-blue discoloration of primary teeth. On examination, it shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance. Identify the diagnosis?
CorrectANSWER
Dentin dysplasia type IIOTHER OPTIONS
• Dentinogenesis imperfecta – It is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – This is a rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type I – Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation. The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.SYNOPSIS
• Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color.
• The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.
• Dentin dysplasia type II shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
Dentin dysplasia type IIOTHER OPTIONS
• Dentinogenesis imperfecta – It is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – This is a rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type I – Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation. The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.SYNOPSIS
• Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color.
• The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.
• Dentin dysplasia type II shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 33 of 300
33. Question
The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen in?
CorrectANSWER
Dentin dysplasia type IOTHER OPTIONS
• Dentinogenesis imperfecta – is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – Is a Rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type II – Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color. The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.SYNOPSIS
• Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation.
• The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
Dentin dysplasia type IOTHER OPTIONS
• Dentinogenesis imperfecta – is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – Is a Rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type II – Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color. The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.SYNOPSIS
• Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation.
• The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 34 of 300
34. Question
Which is the correct order of sterilisation?
CorrectANSWER
Cleaning, disinfection, packing, sterilization, and storageOTHER OPTIONS
• Not applicableSYNOPSIS
Order of sterilization
• Cleaning
• Disinfection
• Packing
• Sterilization
• StorageREFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Cleaning, disinfection, packing, sterilization, and storageOTHER OPTIONS
• Not applicableSYNOPSIS
Order of sterilization
• Cleaning
• Disinfection
• Packing
• Sterilization
• StorageREFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 35 of 300
35. Question
A patient who has a hepatitis B infection came to the clinic for extraction of a decayed tooth. What is the most appropriate way to manage the case?
CorrectANSWER
Consult with physician and then decide.OTHER OPTIONS
• Refer synopsisSYNOPSIS
• No dental treatment other than urgent care should be rendered for a patient with acute viral hepatitis
If a patient with active hepatitis, positive-HBsAg (HBV carrier) status, or positive HCV status requires emergency treatment, use the following precautions
• Consult the patient’s physician regarding status.
• If bleeding is likely during or after treatment, measure prothrombin time (PT) and bleeding time. Hepatitis may alter coagulation- change treatment accordingly
• All personnel in clinical contact with the patient should use full barrier technique, including masks, gloves, glasses or eye shields, and disposable gowns
• Use as many disposable covers as possible, covering light handles, drawer handles, and bracket trays. Headrest covers should also be used
• All disposable items (e.g., gauze, floss, saliva ejectors, masks, gowns, gloves) should be placed in a lined wastebasket. After treatment, these items and all disposable covers should be bagged, labeled, and disposed of, following proper guidelines for bio-hazardous waste
• Aseptic techniques should be followed at all times. Minimize aerosol production by not using ultrasonic instrumentation, air syringe, or high-speed handpieces. Remember that saliva contains a distillate of the virus. Pre-rinsing with chlorhexidine gluconate for 30 s is highly recommended
• When the procedure is complete, all equipment should be scrubbed and sterilized. If an item cannot be sterilized or disposed of, it should not be used.
• All working surfaces and environmental surfaces should be wiped with 2 percent activated glutaraldehyde (Cidex).REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson.IncorrectANSWER
Consult with physician and then decide.OTHER OPTIONS
• Refer synopsisSYNOPSIS
• No dental treatment other than urgent care should be rendered for a patient with acute viral hepatitis
If a patient with active hepatitis, positive-HBsAg (HBV carrier) status, or positive HCV status requires emergency treatment, use the following precautions
• Consult the patient’s physician regarding status.
• If bleeding is likely during or after treatment, measure prothrombin time (PT) and bleeding time. Hepatitis may alter coagulation- change treatment accordingly
• All personnel in clinical contact with the patient should use full barrier technique, including masks, gloves, glasses or eye shields, and disposable gowns
• Use as many disposable covers as possible, covering light handles, drawer handles, and bracket trays. Headrest covers should also be used
• All disposable items (e.g., gauze, floss, saliva ejectors, masks, gowns, gloves) should be placed in a lined wastebasket. After treatment, these items and all disposable covers should be bagged, labeled, and disposed of, following proper guidelines for bio-hazardous waste
• Aseptic techniques should be followed at all times. Minimize aerosol production by not using ultrasonic instrumentation, air syringe, or high-speed handpieces. Remember that saliva contains a distillate of the virus. Pre-rinsing with chlorhexidine gluconate for 30 s is highly recommended
• When the procedure is complete, all equipment should be scrubbed and sterilized. If an item cannot be sterilized or disposed of, it should not be used.
• All working surfaces and environmental surfaces should be wiped with 2 percent activated glutaraldehyde (Cidex).REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson. - Question 36 of 300
36. Question
Which anesthesia gives a prolonged duration of action?
CorrectANSWER
BupivacaineOTHER OPTIONS
• Lidocaine – Lidocaine is known to have an onset of less than 2 min, a duration of 1 h to 2 h, and a maximum dose of 5 mg per kg, which improves to the onset of less than 2 min, a duration of 2 h to 6 h and toxicity of 7mgperkg with the addition of epinephrine.
• Articaine – Articaine pulpal anesthesia lasts between 30 and 120 min, duration longer than lidocaine, mepivacaine, and prilocaine.
• Novocaine – Since Novocaine by itself has a very short duration of action lasting 30 to 60 minutes.SYNOPSIS
• Compared with lidocaine, bupivacaine has a significantly longer duration of action and a slower time to onset.
• Bupivacaine has an onset of 5 min, a duration of 2 h to 4 h, and a maximum dose of 2 mg per kg.REFERENCE
Handbook of Local Anesthesia Stanley F. Malamed 5th edition.IncorrectANSWER
BupivacaineOTHER OPTIONS
• Lidocaine – Lidocaine is known to have an onset of less than 2 min, a duration of 1 h to 2 h, and a maximum dose of 5 mg per kg, which improves to the onset of less than 2 min, a duration of 2 h to 6 h and toxicity of 7mgperkg with the addition of epinephrine.
• Articaine – Articaine pulpal anesthesia lasts between 30 and 120 min, duration longer than lidocaine, mepivacaine, and prilocaine.
• Novocaine – Since Novocaine by itself has a very short duration of action lasting 30 to 60 minutes.SYNOPSIS
• Compared with lidocaine, bupivacaine has a significantly longer duration of action and a slower time to onset.
• Bupivacaine has an onset of 5 min, a duration of 2 h to 4 h, and a maximum dose of 2 mg per kg.REFERENCE
Handbook of Local Anesthesia Stanley F. Malamed 5th edition. - Question 37 of 300
37. Question
Which tooth does show contact area in incisal third?
CorrectANSWER
Mandibular incisorsOTHER OPTIONS
• Mandibular posteriors – The mandibular molar teeth contact areas, are located more in the center of the proximal area.SYNOPSIS
• A labial view indicates that the contact areas of the mandibular anterior teeth are uniform in nature and occur at the incisal third of the tooth crowns.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition.IncorrectANSWER
Mandibular incisorsOTHER OPTIONS
• Mandibular posteriors – The mandibular molar teeth contact areas, are located more in the center of the proximal area.SYNOPSIS
• A labial view indicates that the contact areas of the mandibular anterior teeth are uniform in nature and occur at the incisal third of the tooth crowns.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition. - Question 38 of 300
38. Question
Biological width of healthy gingiva is?
CorrectANSWER
2 mmOTHER OPTIONS
• NilSYNPOSIS
• The natural seal that develops around both protecting the alveolar bone from infection and disease is known as the biologic width.
• The biological width is defined as the dimension of the soft tissue which is attached to the portion of the tooth coronal to the crest of the alveolar bone.
• This term was based on the work of Gargiulo et al. who described the dimensions and relationship of the dentogingival junction in humans.
• The biologic width is essential for preservation of periodontal health and removal of irritation that might damage the periodontium .
• The millimeter that is needed from the bottom of the junctional epithelium to the tip of the alveolar bone is held responsible for the lack of inflammation and bone resorption and as such the development of periodontitis.
• The dimension of biologic width is not constant it depends on the location of the tooth in the alveolus varies from tooth to tooth and also from the aspect of the tooth. It has been shown that 3 mm between the preparation margin and alveolar bone maintains periodontal health for 4 to 6 months.REFERENCE
Biologic width and its importance in periodontal and restorative dentistry – Babitha NugalaIncorrectANSWER
2 mmOTHER OPTIONS
• NilSYNPOSIS
• The natural seal that develops around both protecting the alveolar bone from infection and disease is known as the biologic width.
• The biological width is defined as the dimension of the soft tissue which is attached to the portion of the tooth coronal to the crest of the alveolar bone.
• This term was based on the work of Gargiulo et al. who described the dimensions and relationship of the dentogingival junction in humans.
• The biologic width is essential for preservation of periodontal health and removal of irritation that might damage the periodontium .
• The millimeter that is needed from the bottom of the junctional epithelium to the tip of the alveolar bone is held responsible for the lack of inflammation and bone resorption and as such the development of periodontitis.
• The dimension of biologic width is not constant it depends on the location of the tooth in the alveolus varies from tooth to tooth and also from the aspect of the tooth. It has been shown that 3 mm between the preparation margin and alveolar bone maintains periodontal health for 4 to 6 months.REFERENCE
Biologic width and its importance in periodontal and restorative dentistry – Babitha Nugala - Question 39 of 300
39. Question
What will be the complications if a hyperthyroidism patient has given local anesthesia with adrenaline?
CorrectANSWER
ThyrotoxicosisOTHER OPTIONS
• NilSYNOPSIS
• Hyperthyroidism results from abnormally high production of thyroid hormones.
• Hyperthyroid patients are often anxious with warm and sweaty hands and an occasional tremor. They also may have increased blood pressure and heart rate.
• Thyroid diseases have a high probability of inducing cardiovascular disease owing to the direct action of thyroid hormones on the myocardium.
• Angina can be worsened by thyrotoxicosis.
• Epinephrine and other vasoconstrictors in local anesthetic drugs cause cardiovascular stimulation and hyperthyroid patients can develop dysrhythmias tachycardia and thyrotoxic crisis when administered these drugs.
• Therefore if local anesthesia is required minimal doses of epinephrine should be administered with aspiration prior to injection.
REFERENCE
Management of hyperthyroid patients in dental emergencies a case report- Kyung-Jin LeeIncorrectANSWER
ThyrotoxicosisOTHER OPTIONS
• NilSYNOPSIS
• Hyperthyroidism results from abnormally high production of thyroid hormones.
• Hyperthyroid patients are often anxious with warm and sweaty hands and an occasional tremor. They also may have increased blood pressure and heart rate.
• Thyroid diseases have a high probability of inducing cardiovascular disease owing to the direct action of thyroid hormones on the myocardium.
• Angina can be worsened by thyrotoxicosis.
• Epinephrine and other vasoconstrictors in local anesthetic drugs cause cardiovascular stimulation and hyperthyroid patients can develop dysrhythmias tachycardia and thyrotoxic crisis when administered these drugs.
• Therefore if local anesthesia is required minimal doses of epinephrine should be administered with aspiration prior to injection.
REFERENCE
Management of hyperthyroid patients in dental emergencies a case report- Kyung-Jin Lee - Question 40 of 300
40. Question
A patient underwent class II MOD onlay next to a composite restoration. The patient came back with sensitivity to cold and pain on the pressure after 3 days. What may be the cause?
CorrectANSWER
Polymerisation shrinkageOTHER OPTIONS
• NilSYNOPSIS
• Post-operative sensitivity in teeth after doing a composite restoration is caused by residual stress buildup due to polymerization shrinkage resulting in de-bonding of the restoration ensuing in an enamel crack microleakage at the margins of the restoration and secondary caries resulting in postoperative sensitivity.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher MosbyIncorrectANSWER
Polymerisation shrinkageOTHER OPTIONS
• NilSYNOPSIS
• Post-operative sensitivity in teeth after doing a composite restoration is caused by residual stress buildup due to polymerization shrinkage resulting in de-bonding of the restoration ensuing in an enamel crack microleakage at the margins of the restoration and secondary caries resulting in postoperative sensitivity.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher Mosby - Question 41 of 300
41. Question
What should be done to prevent fracture of the Porcelain fuse to gold restoration?
CorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• Diagnosing causes of porcelain fractures
• When fracture or dislodgement of porcelain facing occurs the dentist should be able to identify one of the following apparent causes of the failure and recommend changes in future restorations to the appropriate person
• Fracture of the total porcelain facing leaving metal surface only.
Causes
– Incorrect degassing of metal by technician.
– Incorrect placement of metal conditioner by technician.
• Fracture of the majority of the porcelain facing leaving slight amount of opaque.
Causes
– Incorrect placement of m etal conditioner by technician.
– Incorrect firing of opaque coat of porcelain by technician usually the temperature is too low .
– Inadequate bulk of metal connector.
• Fracture of porcelain only not exposing any metal.
Causes
– Trauma to crowns caused by occlusion or external force.
– Metal framework cast too small by the technician. Frameworks should be only 1 m m to 1.5mm less in contour than the eventual crown or pontic.REFERENCE
How to avoid problems with porcelain-fused-to-metal restorations- Council on Dental Materials and DevicesIncorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• Diagnosing causes of porcelain fractures
• When fracture or dislodgement of porcelain facing occurs the dentist should be able to identify one of the following apparent causes of the failure and recommend changes in future restorations to the appropriate person
• Fracture of the total porcelain facing leaving metal surface only.
Causes
– Incorrect degassing of metal by technician.
– Incorrect placement of metal conditioner by technician.
• Fracture of the majority of the porcelain facing leaving slight amount of opaque.
Causes
– Incorrect placement of m etal conditioner by technician.
– Incorrect firing of opaque coat of porcelain by technician usually the temperature is too low .
– Inadequate bulk of metal connector.
• Fracture of porcelain only not exposing any metal.
Causes
– Trauma to crowns caused by occlusion or external force.
– Metal framework cast too small by the technician. Frameworks should be only 1 m m to 1.5mm less in contour than the eventual crown or pontic.REFERENCE
How to avoid problems with porcelain-fused-to-metal restorations- Council on Dental Materials and Devices - Question 42 of 300
42. Question
Which is the early sign of alveolar osteitis?
CorrectANSWER
Bad odor and pain.OTHER OPTIONS
• Refer synopsisSYNOPSIS
Signs and symptoms of dry socket include the following
1. Moderate to severe pain localized to the area or frequently radiating to the ear.
2. A foul odor or taste in the absence of purulence or suppuration.
3. Symptoms that occur 3 to 5 days after tooth extraction.
4. Absence of swelling, purulence, or lymphadenitis.
5. Duration of 5 to 40 days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Bad odor and pain.OTHER OPTIONS
• Refer synopsisSYNOPSIS
Signs and symptoms of dry socket include the following
1. Moderate to severe pain localized to the area or frequently radiating to the ear.
2. A foul odor or taste in the absence of purulence or suppuration.
3. Symptoms that occur 3 to 5 days after tooth extraction.
4. Absence of swelling, purulence, or lymphadenitis.
5. Duration of 5 to 40 days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 43 of 300
43. Question
What would be the management of a patient having Miller Class II recession on his upper canine?
CorrectANSWER
Connective tissue graft under split-thickness flapOTHER OPTIONS
• NilSYNOPSIS
• Gingival recession presents when the gingival margin is located apical to the cementoenamel junction (CEJ), resulting in exposure of the root surface
• The use of a subepithelial connective tissue graft (SCTG) in conjunction with a coronally advanced flap (CAF) is a successful method of gaining root coverage and augmenting gingival thickness
• After giving LA, a sulcular incision is placed and a full-thickness flap was carefully elevated using a Kirkland knife.
• Beneath the mucosa, a split-thickness flap was created. Adequate tension-free coronal advancement that permitted full root coverage was verified.
• Root surface irregularities were reduced using sharp hand instruments until they were smooth.
• Graft is placed with connective tissue side facing facially
• The gingiva was secured into position by weaving the suture distally. The final suture knot was tied over the original suture knotREFERENCE
Treatment of a Miller Class II Gingival Recession Defect – Inside DentistryIncorrectANSWER
Connective tissue graft under split-thickness flapOTHER OPTIONS
• NilSYNOPSIS
• Gingival recession presents when the gingival margin is located apical to the cementoenamel junction (CEJ), resulting in exposure of the root surface
• The use of a subepithelial connective tissue graft (SCTG) in conjunction with a coronally advanced flap (CAF) is a successful method of gaining root coverage and augmenting gingival thickness
• After giving LA, a sulcular incision is placed and a full-thickness flap was carefully elevated using a Kirkland knife.
• Beneath the mucosa, a split-thickness flap was created. Adequate tension-free coronal advancement that permitted full root coverage was verified.
• Root surface irregularities were reduced using sharp hand instruments until they were smooth.
• Graft is placed with connective tissue side facing facially
• The gingiva was secured into position by weaving the suture distally. The final suture knot was tied over the original suture knotREFERENCE
Treatment of a Miller Class II Gingival Recession Defect – Inside Dentistry - Question 44 of 300
44. Question
Identify the true statement about kinematic face bow?
CorrectANSWER
Kinematic face bows are used to locate the terminal hinge axis of condylar rotationOTHER OPTIONS
• Not applicableSYNOPSIS
• The hinge axis face-bow with adjustable caliper ends that indicates the exact axis of rotation of the condyles.
• This face bow record the true hinge axis
• Used for the fabrication of fixed partial dentures and full mouth rehabilitation.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillinburg.IncorrectANSWER
Kinematic face bows are used to locate the terminal hinge axis of condylar rotationOTHER OPTIONS
• Not applicableSYNOPSIS
• The hinge axis face-bow with adjustable caliper ends that indicates the exact axis of rotation of the condyles.
• This face bow record the true hinge axis
• Used for the fabrication of fixed partial dentures and full mouth rehabilitation.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillinburg. - Question 45 of 300
45. Question
A 20 years old female presented with trismus, lymphadenopathy, and pain in the lower left the mandibular area. On examination, unerupted tooth 38 is noted. Identify the diagnosis?
CorrectANSWER
PericoronitisOTHER OPTIONS
• Periodontal abscess – A smooth, shiny swelling of the gingiva pain, with the area of swelling tender to touch a purulent exudate, and an increase in probing depth.
• Reversible pulpitis – Sharp sensitivity to cold, sometimes to sweets, and sometimes to biting.
• Irreversible pulpitis – Difficulty locating the tooth from which the pain originates, even confusing the maxillary and mandibular arches.SYNOPSIS
• The symptoms of acute pericoronitis include
– Severe pain near back teeth.
– Swelling of gum tissue.
– Pain when swallowing.
– The discharge of pus.
– Trismus.
• Chronic pericoronitis can include the following symptoms
– Bad breath.
– Bad taste in your mouth.
– Mild or dull ache lasting for one or two days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
PericoronitisOTHER OPTIONS
• Periodontal abscess – A smooth, shiny swelling of the gingiva pain, with the area of swelling tender to touch a purulent exudate, and an increase in probing depth.
• Reversible pulpitis – Sharp sensitivity to cold, sometimes to sweets, and sometimes to biting.
• Irreversible pulpitis – Difficulty locating the tooth from which the pain originates, even confusing the maxillary and mandibular arches.SYNOPSIS
• The symptoms of acute pericoronitis include
– Severe pain near back teeth.
– Swelling of gum tissue.
– Pain when swallowing.
– The discharge of pus.
– Trismus.
• Chronic pericoronitis can include the following symptoms
– Bad breath.
– Bad taste in your mouth.
– Mild or dull ache lasting for one or two days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 46 of 300
46. Question
Deposition of cementum throughout root?
CorrectANSWER
HypercementosisOTHER OPTIONS
• Condensing osteitis – Condensing osteitis consists of abnormal bone growth and lesions that may result from tooth inflammation or infections.
• Secondary cementum deposition – The secondary cementum develops mainly on the apical portion of the root in mammals, when the tooth reaches the occlusal plane.SYNOPSIS
• The excessive buildup of cementum on the roots of a tooth is a pathological condition known as hypercementosis.
• Cementum thickness can increase on the root end to compensate for attritional wear of the occlusalperincisal surface and passive eruption of the tooth.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W., Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
HypercementosisOTHER OPTIONS
• Condensing osteitis – Condensing osteitis consists of abnormal bone growth and lesions that may result from tooth inflammation or infections.
• Secondary cementum deposition – The secondary cementum develops mainly on the apical portion of the root in mammals, when the tooth reaches the occlusal plane.SYNOPSIS
• The excessive buildup of cementum on the roots of a tooth is a pathological condition known as hypercementosis.
• Cementum thickness can increase on the root end to compensate for attritional wear of the occlusalperincisal surface and passive eruption of the tooth.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W., Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 47 of 300
47. Question
Which is the age changes seen in pulp?
CorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• As tooth matures, the pulp size and volume are gradually reduced.
• Instead of a large wide open apical root, the dental pulp is closed and the pulp is diminished.
• There is an overall reduction of cellular components.
• Other age-related changes in the pulp are compromised circulation and innervation, fat droplet deposition, odontoblastic vacuolization, reticular atrophy, pulpal fibrosis, hyaline degeneration, mucoid degeneration, and diffuse calcification.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• As tooth matures, the pulp size and volume are gradually reduced.
• Instead of a large wide open apical root, the dental pulp is closed and the pulp is diminished.
• There is an overall reduction of cellular components.
• Other age-related changes in the pulp are compromised circulation and innervation, fat droplet deposition, odontoblastic vacuolization, reticular atrophy, pulpal fibrosis, hyaline degeneration, mucoid degeneration, and diffuse calcification.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 48 of 300
48. Question
How will you differentiate pulpal and periodontal pathology?
CorrectANSWER
Vitality test.OTHER OPTIONS
• Palpation test – The sensitivity of the gums around the tooth by palpating, or gently massaging the gums over the roots of the tooth or teeth suspected of causing your pain.
• Percussion test – Tapping gently along the long axis of the tooth with a blunt instrument.
• Radiographs – Help to diagnose tooth-related problems like caries, fractures, rct, or any previous restorations, abnormal appearance of pulp cavity, or peri radicular tissues periodontal diseases, and the general bone pattern.SYNOPSIS
• Pulp testing is often referred to as vitality testing. Pulp testers should only be used to assess the vital or non-vital pulp.
• Various types of pulp tests are
1 Thermal test – Painful sensation even after removal of stimulus or no response is considered abnormal.
– Cold test – spray with cold air, use ethyl chloride, frozen carbon dioxide(dry ice), wrap an ice piece in the wet gauge, dichlorodifluoromethane(freon)
– Heat test – warm air, heated gutta- percha stick, hot burnisher, hot compound, frictional heat produced by rotating polishing rubber disc, use of laser beam,
2 Electric pulp test.
3 Test cavity
4 Anesthesia testing
5 Bite testREFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
Vitality test.OTHER OPTIONS
• Palpation test – The sensitivity of the gums around the tooth by palpating, or gently massaging the gums over the roots of the tooth or teeth suspected of causing your pain.
• Percussion test – Tapping gently along the long axis of the tooth with a blunt instrument.
• Radiographs – Help to diagnose tooth-related problems like caries, fractures, rct, or any previous restorations, abnormal appearance of pulp cavity, or peri radicular tissues periodontal diseases, and the general bone pattern.SYNOPSIS
• Pulp testing is often referred to as vitality testing. Pulp testers should only be used to assess the vital or non-vital pulp.
• Various types of pulp tests are
1 Thermal test – Painful sensation even after removal of stimulus or no response is considered abnormal.
– Cold test – spray with cold air, use ethyl chloride, frozen carbon dioxide(dry ice), wrap an ice piece in the wet gauge, dichlorodifluoromethane(freon)
– Heat test – warm air, heated gutta- percha stick, hot burnisher, hot compound, frictional heat produced by rotating polishing rubber disc, use of laser beam,
2 Electric pulp test.
3 Test cavity
4 Anesthesia testing
5 Bite testREFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 49 of 300
49. Question
Which is the rationale for IOPAR?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All answers are true regarding IOPARSYNOPSIS
• In diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used.
• Clinically common radiograph used to determine the position of an impacted canine is the occlusal radiograph or Clark’s method using two periapical radiographs.
• Periapical X-rays detect any unusual changes in the root and surrounding bone structures.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation 8th Edition.IncorrectANSWER
All of the aboveOTHER OPTIONS
• All answers are true regarding IOPARSYNOPSIS
• In diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used.
• Clinically common radiograph used to determine the position of an impacted canine is the occlusal radiograph or Clark’s method using two periapical radiographs.
• Periapical X-rays detect any unusual changes in the root and surrounding bone structures.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation 8th Edition. - Question 50 of 300
50. Question
Which of the following is found in dental caries?
CorrectANSWER
Streptococcus sabrinusOTHER OPTIONS
• Staphylococcus aureus – Skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis.
• E Coli – Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), and traveler’s diarrhea, and other clinical infections such as neonatal meningitis and pneumonia.SYNOPSIS
• Streptococcus mutans and Streptococcus sabrinus, are associated with dental caries in humans.
• Their acidogenic and aciduric capacity is directly associated with the cariogenic potential of these bacteria.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Rob.IncorrectANSWER
Streptococcus sabrinusOTHER OPTIONS
• Staphylococcus aureus – Skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis.
• E Coli – Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), and traveler’s diarrhea, and other clinical infections such as neonatal meningitis and pneumonia.SYNOPSIS
• Streptococcus mutans and Streptococcus sabrinus, are associated with dental caries in humans.
• Their acidogenic and aciduric capacity is directly associated with the cariogenic potential of these bacteria.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Rob. - Question 51 of 300
51. Question
Obturation is done to achieve fluid tight seal at?
CorrectANSWER
Apical and coronal orifice of the root canalOTHER OPTIONS
• Not applicableSYNOPSIS
• Three-dimensional well-fitted root canal with a fluid-tight seal is the main objective of root canal obturation.
• Three-dimensional fluid-tight seal of the root canal system
– Prevents percolation and microleakage of periapical exudate into the root canal space.
– Prevents infection by completely obliterating the apical foramen and other portals of communication.
– Creates a favorable environment for the process of healing to take place.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
Apical and coronal orifice of the root canalOTHER OPTIONS
• Not applicableSYNOPSIS
• Three-dimensional well-fitted root canal with a fluid-tight seal is the main objective of root canal obturation.
• Three-dimensional fluid-tight seal of the root canal system
– Prevents percolation and microleakage of periapical exudate into the root canal space.
– Prevents infection by completely obliterating the apical foramen and other portals of communication.
– Creates a favorable environment for the process of healing to take place.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 52 of 300
52. Question
Which of the following is a disadvantage of GP?
CorrectANSWER
All of the aboveOTHER OPTIONS
• Not applicableSYNOPSIS
Disadvantages of gutta-percha
• Lack of rigidity – bending of gutta-percha is seen when lateral pressure is applied. so difficult to use in smaller canals
• Inability to control the obturating material – easily displaced by pressure.
• Lack of adhesive quality.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All of the aboveOTHER OPTIONS
• Not applicableSYNOPSIS
Disadvantages of gutta-percha
• Lack of rigidity – bending of gutta-percha is seen when lateral pressure is applied. so difficult to use in smaller canals
• Inability to control the obturating material – easily displaced by pressure.
• Lack of adhesive quality.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 53 of 300
53. Question
What is the disadvantage of autoclaving endodontic instruments?
CorrectANSWER
Moisture retentionOTHER OPTIONS
• Not applicableSYNOPSIS
• Carbon Steel can get damaged due to moisture exposure.
• Only Stainless Steel instruments and plastics that can bear the heat be sterilized.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Moisture retentionOTHER OPTIONS
• Not applicableSYNOPSIS
• Carbon Steel can get damaged due to moisture exposure.
• Only Stainless Steel instruments and plastics that can bear the heat be sterilized.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 54 of 300
54. Question
What is the benign condition involving the formation of stones within the ducts of the major salivary gland called?
CorrectANSWER
SialolithiasisOTHER OPTIONS
• Mucocele – Oral mucocele is a painless fluid-filled cyst on the inner surface of the mouth.
• Pleomorphic adenoma – Pleomorphic adenoma, the most common salivary gland tumor, is also known as a benign mixed tumor.
• Fibroma – Fibromas are noncancerous tumors made up of fibrous tissue.SYNOPSIS
• Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands.
• Symptoms of Sialolithiasis
– Swelling of the affected saliva glands which normally occurs with meals.
– Difficulty opening the mouth.
– Difficulty swallowing.
– A painful lump under the tongue.
– Gritty or strange-tasting saliva.
– Dry mouth.
– Pain and swelling usually around the ear or under the jaw.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
SialolithiasisOTHER OPTIONS
• Mucocele – Oral mucocele is a painless fluid-filled cyst on the inner surface of the mouth.
• Pleomorphic adenoma – Pleomorphic adenoma, the most common salivary gland tumor, is also known as a benign mixed tumor.
• Fibroma – Fibromas are noncancerous tumors made up of fibrous tissue.SYNOPSIS
• Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands.
• Symptoms of Sialolithiasis
– Swelling of the affected saliva glands which normally occurs with meals.
– Difficulty opening the mouth.
– Difficulty swallowing.
– A painful lump under the tongue.
– Gritty or strange-tasting saliva.
– Dry mouth.
– Pain and swelling usually around the ear or under the jaw.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 55 of 300
55. Question
You noticed extruded GP on a dental X-ray. What would you do if the patient is symptomatic?
CorrectANSWER
ApicoectomyOTHER OPTIONS
• Inform the patient and do follow-up – Not applicable in this case.
• Re-RCT – May be needed when the symptoms persist on an RCT-treated tooth.SYNOPSIS
• Overextended gutta-percha cones could increase the failure of endodontic therapy. • Commonly surgical procedures are indicated to remove this overextended material if symptomatic.
• The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
ApicoectomyOTHER OPTIONS
• Inform the patient and do follow-up – Not applicable in this case.
• Re-RCT – May be needed when the symptoms persist on an RCT-treated tooth.SYNOPSIS
• Overextended gutta-percha cones could increase the failure of endodontic therapy. • Commonly surgical procedures are indicated to remove this overextended material if symptomatic.
• The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.REFERENCE
Endodontics By Ingel 6th edition - Question 56 of 300
56. Question
Which is the most common complication in an insulin-dependent diabetic patient during tooth extraction?
CorrectANSWER
Hypoglycemic shockOTHER OPTIONS
• Keto acidosis – Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The condition develops when the body can’t produce enough insulin.
• Syncope – Hypoglycemic syncope is uncommon, affecting 1.9 percent of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone.SYNOPSIS
• The most common intraoperative complication of DM is a hypoglycemic episode.
• The risk is highest during peak insulin activity when the patient does not eat before an appointment, or when oral hypoglycemic medication and or insulin levels exceed the needs of the body.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Hypoglycemic shockOTHER OPTIONS
• Keto acidosis – Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The condition develops when the body can’t produce enough insulin.
• Syncope – Hypoglycemic syncope is uncommon, affecting 1.9 percent of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone.SYNOPSIS
• The most common intraoperative complication of DM is a hypoglycemic episode.
• The risk is highest during peak insulin activity when the patient does not eat before an appointment, or when oral hypoglycemic medication and or insulin levels exceed the needs of the body.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 57 of 300
57. Question
What is the emergency management of acute periradicular abscess?
CorrectANSWER
Incision and drainage.OTHER OPTIONS
• Not applicableSYNOPSIS
• Acute periradicular abscess, is highly symptomatic. inflammatory response of the periapical connective tissues.
• It originates when the pulpal tissues initiate an inflammatory response to trauma or caries and may eventually lead to pulpal necrosis.
• In the management of localized acute apical abscess in the permanent dentition, the abscess should be drained through a pulpectomy or incision and drainage.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Incision and drainage.OTHER OPTIONS
• Not applicableSYNOPSIS
• Acute periradicular abscess, is highly symptomatic. inflammatory response of the periapical connective tissues.
• It originates when the pulpal tissues initiate an inflammatory response to trauma or caries and may eventually lead to pulpal necrosis.
• In the management of localized acute apical abscess in the permanent dentition, the abscess should be drained through a pulpectomy or incision and drainage.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 58 of 300
58. Question
What is the cause for late lower incisor crowding?
CorrectANSWER
Late lower jaw growthOTHER OPTIONS
• Not applicableSYNOPSIS
• Late lower incisor crowding is thought to be due to late lower jaw growth.
• The Lower jaw growth occurs well into adulthood.
• The magnitude of these adult,s growth changes is small (1-2mm) however they are significant enough to cause movement in the lower incisors that results in crowding.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Late lower jaw growthOTHER OPTIONS
• Not applicableSYNOPSIS
• Late lower incisor crowding is thought to be due to late lower jaw growth.
• The Lower jaw growth occurs well into adulthood.
• The magnitude of these adult,s growth changes is small (1-2mm) however they are significant enough to cause movement in the lower incisors that results in crowding.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 59 of 300
59. Question
At 9 years of age, interdental papillary necrosis, ulceration, pain, bleeding, and pseudomembrane formation are seen in?
CorrectANSWER
ANUGOTHER OPTIONS
• Herpetic gingivostomatitis – Herpetic gingivostomatitis is a manifestation of herpes simplex virus type 1 (HSV-1) and is characterized by high-grade fever and painful oral lesions.
• Erythema multiforme – a skin reaction that can be triggered by an infection or some medicines.
• Streptococcal gingivostomatitis – an acute inflammation of the oral mucosa caused by beta-hemolytic streptococcus from Group A.SYNOPSIS
• ANUG has been defined as an acute recurring gingival infection of complex etiology, characterized by necrosis of the tips of the gingival papillae, spontaneous bleeding, and pain.
• Several names have been assigned to it such as trench mouth, acute ulcerative gingivitis, vincents stomatitis, vincents angina, Plaut-vincent’s stomatitis, fusospirocheatal gingivitis, necrotic gingivitis, putrid stomatitis.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, IncIncorrectANSWER
ANUGOTHER OPTIONS
• Herpetic gingivostomatitis – Herpetic gingivostomatitis is a manifestation of herpes simplex virus type 1 (HSV-1) and is characterized by high-grade fever and painful oral lesions.
• Erythema multiforme – a skin reaction that can be triggered by an infection or some medicines.
• Streptococcal gingivostomatitis – an acute inflammation of the oral mucosa caused by beta-hemolytic streptococcus from Group A.SYNOPSIS
• ANUG has been defined as an acute recurring gingival infection of complex etiology, characterized by necrosis of the tips of the gingival papillae, spontaneous bleeding, and pain.
• Several names have been assigned to it such as trench mouth, acute ulcerative gingivitis, vincents stomatitis, vincents angina, Plaut-vincent’s stomatitis, fusospirocheatal gingivitis, necrotic gingivitis, putrid stomatitis.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, Inc - Question 60 of 300
60. Question
What is the function of the kinematic facebow?
CorrectANSWER
Record mouth opening and closingOTHER OPTIONS
• Refer synopsisSYNOPSIS
• To record the anteroposterior and mediolateral spatial positions of the maxillary occlusal cusps in relation to the transverse opening and closing of the patient’s mandible.
•Two types of face bows are recognized in the field of prosthodontics, arbitrary and kinematic.
• Kinematic face bows are used to locate the terminal hinge axis of condylar rotation.
• An arbitrary face bow called the earbow, uses the ear canal as a locating point.
• One of the important movements the facebow helps to recreate is the arc of opening and closing.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by ShillingburgIncorrectANSWER
Record mouth opening and closingOTHER OPTIONS
• Refer synopsisSYNOPSIS
• To record the anteroposterior and mediolateral spatial positions of the maxillary occlusal cusps in relation to the transverse opening and closing of the patient’s mandible.
•Two types of face bows are recognized in the field of prosthodontics, arbitrary and kinematic.
• Kinematic face bows are used to locate the terminal hinge axis of condylar rotation.
• An arbitrary face bow called the earbow, uses the ear canal as a locating point.
• One of the important movements the facebow helps to recreate is the arc of opening and closing.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillingburg - Question 61 of 300
61. Question
A routine radiographic examination of a 50 year old patient showed thickening of the root, of molars and diagnosed to be hypercementosis. Which is the synonym you can use for hypercementosis?
CorrectANSWER
Cemental hyperplasiaOTHER OPTIONS
• Cemental dysplasia – Cemento-osseous dysplasia (COD) is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments.
• Cementoma – Cementomas are benign jaw tumors that originate from periodontal ligament elements.SYNOPSIS
• Hypercementosis (cemental hyperplasia) is a nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum.
• It may affect a single tooth or multiple teeth.
• The condition is asymptomatic and is detected on radiographic examination.REFERENCE
Shafer’s Textbook of PathologyIncorrectANSWER
Cemental hyperplasiaOTHER OPTIONS
• Cemental dysplasia – Cemento-osseous dysplasia (COD) is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments.
• Cementoma – Cementomas are benign jaw tumors that originate from periodontal ligament elements.SYNOPSIS
• Hypercementosis (cemental hyperplasia) is a nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum.
• It may affect a single tooth or multiple teeth.
• The condition is asymptomatic and is detected on radiographic examination.REFERENCE
Shafer’s Textbook of Pathology - Question 62 of 300
62. Question
A patient who comes with a history of trauma 1 hour before, complains of sensitivity. On examination, the tooth shows a large dentin exposure but it is vital. How will you manage it?
CorrectANSWER
Smoothen the surface and place calcium hydroxideOTHER OPTIONS
• Not applicableSYNOPSIS
• Goal to cover exposed dentin, can use calcium hydroxide composition.
• Smoothen the surface and place calcium hydroxide.REFERENCE
IncorrectANSWER
Smoothen the surface and place calcium hydroxideOTHER OPTIONS
• Not applicableSYNOPSIS
• Goal to cover exposed dentin, can use calcium hydroxide composition.
• Smoothen the surface and place calcium hydroxide.REFERENCE
- Question 63 of 300
63. Question
Which antibiotics can be prescribed for a patient who has a penicillin allergy?
CorrectANSWER
ClarithromycinOTHER OPTIONS
• Ampicillin, Amoxicillin-clavulanate, and Nafcillin are penicillin antibiotics.SYNOPSIS
Clarithromycin is a macrolide antibiotic. It can be taken by people who are allergic to penicillin.SYNOPSIS
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
ClarithromycinOTHER OPTIONS
• Ampicillin, Amoxicillin-clavulanate, and Nafcillin are penicillin antibiotics.SYNOPSIS
Clarithromycin is a macrolide antibiotic. It can be taken by people who are allergic to penicillin.SYNOPSIS
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 64 of 300
64. Question
What is the crtical pH of dentin?
CorrectANSWER
6 to 6.5OTHER OPTIONS
• Not applicableSYNOPSIS
• The lower the pH, the higher the calcium and phosphate concentrations required to reach saturation with respect to hydroxyapatite.
• This is called the critical pH, the point where equilibrium exists.
• There is no mineral dissolution and no mineral precipitation.
• The critical pH of enamel is around 5.5 and that of fluorapatite is around 4.5.
• Root dentin is more vulnerable to acidic dissolution than enamel because of its higher critical pH for demineralization (6.2 to 6.4) than that of enamel (5.5)
• This varies with individual patients.
• Below critical pH, demineralization occurs while above critical pH, remineralization occurs.
• The critical pH is significantly higher for children than for adultsREFERENCE
Dental Remineralisation to Oral HealthIncorrectANSWER
6 to 6.5OTHER OPTIONS
• Not applicableSYNOPSIS
• The lower the pH, the higher the calcium and phosphate concentrations required to reach saturation with respect to hydroxyapatite.
• This is called the critical pH, the point where equilibrium exists.
• There is no mineral dissolution and no mineral precipitation.
• The critical pH of enamel is around 5.5 and that of fluorapatite is around 4.5.
• Root dentin is more vulnerable to acidic dissolution than enamel because of its higher critical pH for demineralization (6.2 to 6.4) than that of enamel (5.5)
• This varies with individual patients.
• Below critical pH, demineralization occurs while above critical pH, remineralization occurs.
• The critical pH is significantly higher for children than for adultsREFERENCE
Dental Remineralisation to Oral Health - Question 65 of 300
65. Question
What is the mechanism of action of LA?
CorrectANSWER
Decrease the permeability of ion channel to sodiumOTHER OPTIONS
• Not applicableSYNOPSIS
• LA prevents the generation and conduction of nerve impulses by blocking sodium ion influx through voltage-gated sodium channels and preventing the transmission of the advancing wave of depolarization down the length of the nerve.
• LA does not alter the resting transmembrane potential and has little effect on the threshold potential.REFERENCE
Local Anesthesia in DentistryIncorrectANSWER
Decrease the permeability of ion channel to sodiumOTHER OPTIONS
• Not applicableSYNOPSIS
• LA prevents the generation and conduction of nerve impulses by blocking sodium ion influx through voltage-gated sodium channels and preventing the transmission of the advancing wave of depolarization down the length of the nerve.
• LA does not alter the resting transmembrane potential and has little effect on the threshold potential.REFERENCE
Local Anesthesia in Dentistry - Question 66 of 300
66. Question
Which is the best option for a 20 year old young patient presented with missing lateral incisor?
CorrectANSWER
ImplantOTHER OPTIONS
• Not relevant in this caseSYNOPSIS
• Long-term success of oral implants in partially edentulous cases has been the basis for other clinicians to broaden the use of implants to younger patients in whom teeth are missing due to agenesis and or trauma.
• Anodontia either primary or acquired occasionally creates the opportunity for the use of dental implants.
• Since removable dentures and acid etch bridges are uncomfortable and cumbersome, young patients and their parents often insist to reduce the waiting time and insert implants as soon as possible.
• Furthermore, the risk of ongoing alveolar bone resorption after tooth extraction encourages the clinician to go ahead with the oral implants immediately.REFERENCE
Implants in adolescents- Rohit A. Shah, Dipika K. MitraIncorrectANSWER
ImplantOTHER OPTIONS
• Not relevant in this caseSYNOPSIS
• Long-term success of oral implants in partially edentulous cases has been the basis for other clinicians to broaden the use of implants to younger patients in whom teeth are missing due to agenesis and or trauma.
• Anodontia either primary or acquired occasionally creates the opportunity for the use of dental implants.
• Since removable dentures and acid etch bridges are uncomfortable and cumbersome, young patients and their parents often insist to reduce the waiting time and insert implants as soon as possible.
• Furthermore, the risk of ongoing alveolar bone resorption after tooth extraction encourages the clinician to go ahead with the oral implants immediately.REFERENCE
Implants in adolescents- Rohit A. Shah, Dipika K. Mitra - Question 67 of 300
67. Question
How to check subgingival calculus on a shallow area with pus discharge?
CorrectANSWER
Ball end probeOTHER OPTIONS
• Universal currete – A universal curette is a double-ended instrument used for periodontal scaling, calculus debridement, and root planing.
• Double-end perio probe – The periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium.SYNOPSIS
• CPITN assesses the presence or absence of gingival bleeding on probing, supra or subgingival calculus, and periodontal pockets by using a 0.5 mm ball tip WHO probe.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. OdontIncorrectANSWER
Ball end probeOTHER OPTIONS
• Universal currete – A universal curette is a double-ended instrument used for periodontal scaling, calculus debridement, and root planing.
• Double-end perio probe – The periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium.SYNOPSIS
• CPITN assesses the presence or absence of gingival bleeding on probing, supra or subgingival calculus, and periodontal pockets by using a 0.5 mm ball tip WHO probe.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. Odont - Question 68 of 300
68. Question
Epinephrine used in LA causes?
CorrectANSWER
All of the aboveOTHER OPTIONS
• Explained belowSYNOPSIS
• Addition of epinephrine to lidocaine causes
– Increases the duration of anesthesia
– Reduces the risk of bleeding during surgery.
– Reduce toxicityREFERENCE
Use of local anesthetics with an epinephrine additiveIncorrectANSWER
All of the aboveOTHER OPTIONS
• Explained belowSYNOPSIS
• Addition of epinephrine to lidocaine causes
– Increases the duration of anesthesia
– Reduces the risk of bleeding during surgery.
– Reduce toxicityREFERENCE
Use of local anesthetics with an epinephrine additive - Question 69 of 300
69. Question
A 13-year-old child was brought to your clinic with an avulsed incisor tooth before 45 minutes. What is the treatment of choice?
CorrectANSWER
RCT and splintOTHER OPTIONS
• Other options doesnot applySYNOPSIS
• Golden time for replantation is 20-30 minutes,if it is not possible, the tooth should be stored in an appropriate storage media for
preserving the viability of PDL cells
• In closed apex case-extra oral time less than 20 minutes-replant immediately after gentle washing and extra oral time more than 20 minutes endo treatment should be performed before replantationREFERENCE
Therapeutic Protocols for Avulsed Permanent Teeth- Review and Clinical Update Diana Ram, Dr OdontIncorrectANSWER
RCT and splintOTHER OPTIONS
• Other options doesnot applySYNOPSIS
• Golden time for replantation is 20-30 minutes,if it is not possible, the tooth should be stored in an appropriate storage media for
preserving the viability of PDL cells
• In closed apex case-extra oral time less than 20 minutes-replant immediately after gentle washing and extra oral time more than 20 minutes endo treatment should be performed before replantationREFERENCE
Therapeutic Protocols for Avulsed Permanent Teeth- Review and Clinical Update Diana Ram, Dr Odont - Question 70 of 300
70. Question
Which is the most superior analgesic among the following?
CorrectANSWER
IbuprofenOTHER OPTIONS
• Ampicillin – AntibioticSYNOPSIS
• Ibuprofen alone is statistically superior to aspirin.
• Ibuprofen is used as an analgesic in painful conditions, antipyretic, soft tissue injuries, fractures, postoperative pain arthritis and gout, chronic pulpitis, periodontal abscess, and gingival abscess.REFERENCE
Essentials of Dental Pharmacology – K D TripathiIncorrectANSWER
IbuprofenOTHER OPTIONS
• Ampicillin – AntibioticSYNOPSIS
• Ibuprofen alone is statistically superior to aspirin.
• Ibuprofen is used as an analgesic in painful conditions, antipyretic, soft tissue injuries, fractures, postoperative pain arthritis and gout, chronic pulpitis, periodontal abscess, and gingival abscess.REFERENCE
Essentials of Dental Pharmacology – K D Tripathi - Question 71 of 300
71. Question
Which part of the implant holds the fixture to prosthesis?
CorrectANSWER
AbutmentOTHER OPTIONS
• Connector – corresponds to the connection site where the implant body connects to the abutment and restoration,
• Retainer – Imp-lants can also act as retainers for dentures and partials if you have issues with them falling or slipping out of place
• Pontic – 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 teethSYNOPSIS
• In dentistry, an abutment is a connecting element.
• The abutment is the connector piece between a dental implant and an artificial tooth.
• It links the crown, dental bridge, or denture to the implant.REFERENCE
Contemporary Implant Dentistry- Carl E MischIncorrectANSWER
AbutmentOTHER OPTIONS
• Connector – corresponds to the connection site where the implant body connects to the abutment and restoration,
• Retainer – Imp-lants can also act as retainers for dentures and partials if you have issues with them falling or slipping out of place
• Pontic – 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 teethSYNOPSIS
• In dentistry, an abutment is a connecting element.
• The abutment is the connector piece between a dental implant and an artificial tooth.
• It links the crown, dental bridge, or denture to the implant.REFERENCE
Contemporary Implant Dentistry- Carl E Misch - Question 72 of 300
72. Question
Why it is advised to remove the crown for re-endodontic treatment?
CorrectANSWER
The crown may be straight but the tooth may be tiltedOTHER OPTIONS
• NilSYNOPSIS
• Getting access to root canal space may require the removal of a crown, posts, and other restorative materials first.
• Then the original root canal filling is removed, and the root canal space is re-cleaned and sealed.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
The crown may be straight but the tooth may be tiltedOTHER OPTIONS
• NilSYNOPSIS
• Getting access to root canal space may require the removal of a crown, posts, and other restorative materials first.
• Then the original root canal filling is removed, and the root canal space is re-cleaned and sealed.REFERENCE
Endodontics By Ingel 6th edition - Question 73 of 300
73. Question
How will you sterilize the clinic after a hepatitis patient visited you for a treatment?
CorrectANSWER
Standard sterilization with prolonged disinfectionOTHER OPTIONS
• NilSYNOPSIS
• HBs Ag-positive serum is easily inactivated by boiling and by steam under pressure however, HBs Ag-coated beads require increased steam under pressure.
• For sterilizing HBs Ag-contaminated materials, 30 minutes at 132 degrees C is recommended.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Standard sterilization with prolonged disinfectionOTHER OPTIONS
• NilSYNOPSIS
• HBs Ag-positive serum is easily inactivated by boiling and by steam under pressure however, HBs Ag-coated beads require increased steam under pressure.
• For sterilizing HBs Ag-contaminated materials, 30 minutes at 132 degrees C is recommended.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 74 of 300
74. Question
What is the aim of obturation?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All options are correctSYNOPSIS
• The aim of obturation is to establish a fluid-tight barrier with the aim of protecting the periradicular tissues from microorganisms that reside in the oral cavity.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All of the aboveOTHER OPTIONS
• All options are correctSYNOPSIS
• The aim of obturation is to establish a fluid-tight barrier with the aim of protecting the periradicular tissues from microorganisms that reside in the oral cavity.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 75 of 300
75. Question
What is the important personal conduct of a dentist?
CorrectANSWER
HonestyOTHER OPTIONS
• NilSYNOPSIS
• Honesty, integrity, and fairness form the cornerstones of accepted professional and personal behavior.REFERENCE
Textbook of preventive and community dentistryIncorrectANSWER
HonestyOTHER OPTIONS
• NilSYNOPSIS
• Honesty, integrity, and fairness form the cornerstones of accepted professional and personal behavior.REFERENCE
Textbook of preventive and community dentistry - Question 76 of 300
76. Question
A 38 year old male presented with an 18 month history of an asymptomatic swelling in the anterior mandibular vestibule. The clinical exam revealed a firm and expansile lesion involving the buccal cortical plate. The lesion extended from tooth 23 to 27.Microscopic examination from the capsule was done which showed numerous ghost cells. Which of the following show ghost cells?
CorrectANSWER
Calcifying odontogenic cystOTHER OPTIONS
• Not related to ghost cellsSYNOPSIS
• Highman and Ogden (1944) first described ghost cell in pilomatricomas.
• They described ghost cells as dyskeratotic cells, which are similar to viable cells but have a distinct outline.
• It was also found that the origin of ghost cells were from the epithelium.
• It can originate from any layer of the epithelium.
• These cells do not have intercellular junctions
• Ghost cells generally lack nuclear and cytoplasmic details and are characteristically seen in CCOT, craniopharyngiomas, and pilomatricomas.
• Other lesions exhibiting ghost cells are odontomas, dentinogenic ghost cell tumors, dentinogenic ghost cell carcinoma, ameloblastoma, ameloblastic fibroma.
• During the development of CCOT, the transformation of an odontogenic epithelial cell into a ghost cell first starts by the enlargement of mural cells, followed by other epithelial cells in the cystic lining into abnormally keratinized cells.REFERENCE
Ghost cell lesions – Journal of Pharmacy Bioallied SciencesIncorrectANSWER
Calcifying odontogenic cystOTHER OPTIONS
• Not related to ghost cellsSYNOPSIS
• Highman and Ogden (1944) first described ghost cell in pilomatricomas.
• They described ghost cells as dyskeratotic cells, which are similar to viable cells but have a distinct outline.
• It was also found that the origin of ghost cells were from the epithelium.
• It can originate from any layer of the epithelium.
• These cells do not have intercellular junctions
• Ghost cells generally lack nuclear and cytoplasmic details and are characteristically seen in CCOT, craniopharyngiomas, and pilomatricomas.
• Other lesions exhibiting ghost cells are odontomas, dentinogenic ghost cell tumors, dentinogenic ghost cell carcinoma, ameloblastoma, ameloblastic fibroma.
• During the development of CCOT, the transformation of an odontogenic epithelial cell into a ghost cell first starts by the enlargement of mural cells, followed by other epithelial cells in the cystic lining into abnormally keratinized cells.REFERENCE
Ghost cell lesions – Journal of Pharmacy Bioallied Sciences - Question 77 of 300
77. Question
When does a baby start toothbrushing?
CorrectANSWER
When first primary tooth eruptsOTHER OPTIONS
• NILSYNOPSIS
• As soon as the child has a tooth, plaque can begin building up on the surface of the tooth and causing decay.
• The American Academy of Pediatric Dentistry recommends to start brushing a child’s teeth as soon as the very first tooth comes in.REFERENCE
Tips for Brushing Baby and Toddler TeethIncorrectANSWER
When first primary tooth eruptsOTHER OPTIONS
• NILSYNOPSIS
• As soon as the child has a tooth, plaque can begin building up on the surface of the tooth and causing decay.
• The American Academy of Pediatric Dentistry recommends to start brushing a child’s teeth as soon as the very first tooth comes in.REFERENCE
Tips for Brushing Baby and Toddler Teeth - Question 78 of 300
78. Question
Which of the following may show more chance for fracture?
CorrectANSWER
Class II div 1OTHER OPTIONS
Not applicableSYNOPSIS
• The etiology of maxillary incisor trauma includes oral predisposing factors, which have been identified as
– Increased overjet
– Incompetence lip coverage of the upper anterior teeth in Class II division 1 malocclusion.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Class II div 1OTHER OPTIONS
Not applicableSYNOPSIS
• The etiology of maxillary incisor trauma includes oral predisposing factors, which have been identified as
– Increased overjet
– Incompetence lip coverage of the upper anterior teeth in Class II division 1 malocclusion.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 79 of 300
79. Question
Obturation of a root canal should achieve?
CorrectANSWER
Hermetic sealOTHER OPTIONS
• Tug back – Tug back is defined as a slight frictional resistance of a master point to withdrawal.
• Fluid-free seal – Resin cement sealed the root canals significantly better when compared with zinc oxide eugenol and glass ionomer sealers.SYNOPSIS
• The aim of root canal obturation is to provide a hermetic seal and thus prevent reinfection of the root canal space, which will lead to treatment failure.
• The tricalcium silicate-based sealer cement was introduced due to its hydraulic nature.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
Hermetic sealOTHER OPTIONS
• Tug back – Tug back is defined as a slight frictional resistance of a master point to withdrawal.
• Fluid-free seal – Resin cement sealed the root canals significantly better when compared with zinc oxide eugenol and glass ionomer sealers.SYNOPSIS
• The aim of root canal obturation is to provide a hermetic seal and thus prevent reinfection of the root canal space, which will lead to treatment failure.
• The tricalcium silicate-based sealer cement was introduced due to its hydraulic nature.REFERENCE
Endodontics By Ingel 6th edition - Question 80 of 300
80. Question
What is the purpose of a root canal sealer?
CorrectANSWER
Fill the space between the solid core material and pulp canal walls.OTHER OPTIONS
• Not applicableSYNOPSIS
• The main function of a sealer is to fill the spaces between the core material and the walls of the root canal and between the gutta-percha cones, in an attempt to form a coherent mass of obturating material without voids.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
Fill the space between the solid core material and pulp canal walls.OTHER OPTIONS
• Not applicableSYNOPSIS
• The main function of a sealer is to fill the spaces between the core material and the walls of the root canal and between the gutta-percha cones, in an attempt to form a coherent mass of obturating material without voids.REFERENCE
Endodontics By Ingel 6th edition - Question 81 of 300
81. Question
Which has the worst prognosis?
CorrectANSWER
Aggressive periodontitisOTHER OPTIONS
• Occlusal trauma – It is the injury to the periodontium resulting from occlusal forces that exceed the reparative capacity of the attachment apparatus. It is reversible if identified and treated properly.
• Chronic periodontitis – In cases of chronic Periodontitis in which the clinical attachment loss is not very severe (slight-to-moderate periodontitis), the prognosis is good, provided the inflammation can be controlled through the removal of local plaque-retentive factors and good oral hygiene.SYNOPSIS
• The prognosis for patients with aggressive periodontitis depends on whether the disease is generalized or localized.
• The generalized form which is usually associated with some systemic diseases has a worse prognosis
• Early radiographs have to be obtained to get a prognosis of the disease.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. OdontIncorrectANSWER
Aggressive periodontitisOTHER OPTIONS
• Occlusal trauma – It is the injury to the periodontium resulting from occlusal forces that exceed the reparative capacity of the attachment apparatus. It is reversible if identified and treated properly.
• Chronic periodontitis – In cases of chronic Periodontitis in which the clinical attachment loss is not very severe (slight-to-moderate periodontitis), the prognosis is good, provided the inflammation can be controlled through the removal of local plaque-retentive factors and good oral hygiene.SYNOPSIS
• The prognosis for patients with aggressive periodontitis depends on whether the disease is generalized or localized.
• The generalized form which is usually associated with some systemic diseases has a worse prognosis
• Early radiographs have to be obtained to get a prognosis of the disease.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. Odont - Question 82 of 300
82. Question
Which of the following may show bad breath as a symptom?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All are trueSYNOPSIS
• Halitosis is a term used to describe a noticeably unpleasant odor exhaled in breathing.
• Causes of physiologic halitosis
– Mouth breathing
– Medications
– Aging and poor dental hygiene fasting or starvation
– Tobacco
– Foods
• Causes for pathologic halitosis
– Oral and other contributing factors such as
1 Periodontal infection – odor from the subgingival dental biofilm. ANUG, pericoronitis.
2 Tongue coating harbors microorganisms
3 Stomatitis xerostomia
4 Faulty restorations retaining food and bacteria
5 Unclean dentures.
6 Oral pathologic lesions like oral cancers, and candidiasis.
7 Parotitis, cleft palate.
8 Aphthous ulcers dental abscesses.
– Systemic and extra-oral factors
1 Nasal infections like rhinitis, sinusitis, tumors, and foreign bodies.
2 Diseases of GIT like hiatus hernia, carcinoma, and GERD.
3 Pulmonary infections like bronchitis pneumonia, TB, carcinomas
4 Certain hormonal changes occur during ovulation menstruation, pregnancy, and menopause.
5 Systemic diseases like diabetic Mellitus, hepatic failure, renal failure, uremia, blood dyscrasias, rheumatic diseases, dehydration and fever, and cirrhosis of the liver.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermi A. Carranza Dr. OdontIncorrectANSWER
All of the aboveOTHER OPTIONS
• All are trueSYNOPSIS
• Halitosis is a term used to describe a noticeably unpleasant odor exhaled in breathing.
• Causes of physiologic halitosis
– Mouth breathing
– Medications
– Aging and poor dental hygiene fasting or starvation
– Tobacco
– Foods
• Causes for pathologic halitosis
– Oral and other contributing factors such as
1 Periodontal infection – odor from the subgingival dental biofilm. ANUG, pericoronitis.
2 Tongue coating harbors microorganisms
3 Stomatitis xerostomia
4 Faulty restorations retaining food and bacteria
5 Unclean dentures.
6 Oral pathologic lesions like oral cancers, and candidiasis.
7 Parotitis, cleft palate.
8 Aphthous ulcers dental abscesses.
– Systemic and extra-oral factors
1 Nasal infections like rhinitis, sinusitis, tumors, and foreign bodies.
2 Diseases of GIT like hiatus hernia, carcinoma, and GERD.
3 Pulmonary infections like bronchitis pneumonia, TB, carcinomas
4 Certain hormonal changes occur during ovulation menstruation, pregnancy, and menopause.
5 Systemic diseases like diabetic Mellitus, hepatic failure, renal failure, uremia, blood dyscrasias, rheumatic diseases, dehydration and fever, and cirrhosis of the liver.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermi A. Carranza Dr. Odont - Question 83 of 300
83. Question
What will be the most critical problem due to the negligence of a loss of a primary tooth?
CorrectANSWER
SpeechOTHER OPTIONS
• Refer synopsisSYNOPSIS
• Premature loss of primary teeth can cause orthodontic problems such as crowding, ectopic eruption, or tooth impaction, which can result in malocclusion.
• It can also affect children’s phonation, causing speech distortionREFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, IncIncorrectANSWER
SpeechOTHER OPTIONS
• Refer synopsisSYNOPSIS
• Premature loss of primary teeth can cause orthodontic problems such as crowding, ectopic eruption, or tooth impaction, which can result in malocclusion.
• It can also affect children’s phonation, causing speech distortionREFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, Inc - Question 84 of 300
84. Question
How do the bony ridges are palpated during intraosseous recontouring?
CorrectANSWER
Using finger over the ridgeOTHER OPTIONS
• Not applicableSYNOPSIS
• Sharp bony edges are assessed by replacing the flap and palpating over it with a finger.
• A rongeur or bone file may be used to smooth all sharp edges.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Using finger over the ridgeOTHER OPTIONS
• Not applicableSYNOPSIS
• Sharp bony edges are assessed by replacing the flap and palpating over it with a finger.
• A rongeur or bone file may be used to smooth all sharp edges.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 85 of 300
85. Question
What is the critical temperature of bone to be kept in degree Celsius?
CorrectANSWER
50OTHER OPTIONS
• NILSYNOPSIS
• Eriksson and Albrektsson found that bone heated at 47 degrees C for one minute leads to significantly reduced bone regeneration and that bone temperatures of 50 degrees C almost completely impair it.
• Cell death as a result of heat damage is immediately apparent at 70 degrees C.
• Krause’s findings support this, he found that osteoclasts began to die when bone temperatures reached 50 degrees C and that protein cannot be regenerated once temperatures reach 70°C.
• As a result of this, 50 degrees C has been defined as the critical value below which bone temperature must be kept.REFERENCE
Thermal Osteonecrosis Caused by Bone Drilling in Orthopedic Surgery- Alexander MuacevicIncorrectANSWER
50OTHER OPTIONS
• NILSYNOPSIS
• Eriksson and Albrektsson found that bone heated at 47 degrees C for one minute leads to significantly reduced bone regeneration and that bone temperatures of 50 degrees C almost completely impair it.
• Cell death as a result of heat damage is immediately apparent at 70 degrees C.
• Krause’s findings support this, he found that osteoclasts began to die when bone temperatures reached 50 degrees C and that protein cannot be regenerated once temperatures reach 70°C.
• As a result of this, 50 degrees C has been defined as the critical value below which bone temperature must be kept.REFERENCE
Thermal Osteonecrosis Caused by Bone Drilling in Orthopedic Surgery- Alexander Muacevic - Question 86 of 300
86. Question
You were presented with pink tooth discoloration of the maxillary right central incisor with mesial and distal caries. What is the diagnosis and what will be the treatment?
CorrectANSWER
Internal resorption and RCTOTHER OPTIONS
• Not applicableSYNOPSIS
• Internal resorption is an unusual form tooth resorption that begins centrally within the tooth, apparently initiated in most cases by a peculiar inflammation of the pulp.
• Etiology of internal resorption
– Long-standing chronic inflammation of the pulp
– Caries-related pulpitis
• Traumatic injuries
• Luxation injuries
• Iatrogenic injuries (Preparation of tooth for a crown, deep restorative procedure, application of heat over pulp, pulpotomy using calcium hydroxide).
• Idiopathic.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
Internal resorption and RCTOTHER OPTIONS
• Not applicableSYNOPSIS
• Internal resorption is an unusual form tooth resorption that begins centrally within the tooth, apparently initiated in most cases by a peculiar inflammation of the pulp.
• Etiology of internal resorption
– Long-standing chronic inflammation of the pulp
– Caries-related pulpitis
• Traumatic injuries
• Luxation injuries
• Iatrogenic injuries (Preparation of tooth for a crown, deep restorative procedure, application of heat over pulp, pulpotomy using calcium hydroxide).
• Idiopathic.REFERENCE
Endodontics By Ingel 6th edition - Question 87 of 300
87. Question
You were presented with bony spicules on the mandibular lingual side. You planned for an alveoloplasty. Which nerve is affected when the incision is given on the crest of the ridge?
CorrectANSWER
Lingual nerveOTHER OPTIONS
• Other options do not applySYNOPSIS
• The lingual nerve carries sensory innervation from the anterior two-thirds of the tongue. It contains fibers from both the mandibular division of the trigeminal nerve (CN V3 ) and the facial nerve (CN VII).
• The lingual nerve lies at first beneath the lateral pterygoid muscle, medial to and in front of the inferior alveolar nerve.
• The nerve then passes between the medial pterygoid muscle and the ramus of the mandible, and crosses obliquely to the side of the tongue beneath the constrictor pharyngis superior and styloglossus, and then between the hyoglossus and deep part of the submandibular gland, it finally runs from laterally to medially inferiorly crossing the duct of the submandibular gland, and along the tongue to its tip becoming the sublingual nerve, lying immediately beneath the mucous membrane.
• So as the spicule is over the lingual side, the chances of lingual nerve injury are more.REFERENCE
Lingual nerve- AnatomyIncorrectANSWER
Lingual nerveOTHER OPTIONS
• Other options do not applySYNOPSIS
• The lingual nerve carries sensory innervation from the anterior two-thirds of the tongue. It contains fibers from both the mandibular division of the trigeminal nerve (CN V3 ) and the facial nerve (CN VII).
• The lingual nerve lies at first beneath the lateral pterygoid muscle, medial to and in front of the inferior alveolar nerve.
• The nerve then passes between the medial pterygoid muscle and the ramus of the mandible, and crosses obliquely to the side of the tongue beneath the constrictor pharyngis superior and styloglossus, and then between the hyoglossus and deep part of the submandibular gland, it finally runs from laterally to medially inferiorly crossing the duct of the submandibular gland, and along the tongue to its tip becoming the sublingual nerve, lying immediately beneath the mucous membrane.
• So as the spicule is over the lingual side, the chances of lingual nerve injury are more.REFERENCE
Lingual nerve- Anatomy - Question 88 of 300
88. Question
Which of the following force is acted on the vertical component to resist tissueward movement?
CorrectANSWER
SupportOTHER OPTIONS
• Stability – It is defined as, the quality of a denture to be firm, steady, or constant, to resist displacement by functional stresses, and not to be subject to change of position when forces are applied.
• Retention – It is the ability of the denture to withstand displacement against its path of insertion.SYNOPSIS
• Support is defined as, the resistance to vertical forces of mastication, occlusal forces, and other forces applied in a direction towards the denture-bearing area.REFERENCE
Textbook of Prosthodontics- Deepak NallaswamyIncorrectANSWER
SupportOTHER OPTIONS
• Stability – It is defined as, the quality of a denture to be firm, steady, or constant, to resist displacement by functional stresses, and not to be subject to change of position when forces are applied.
• Retention – It is the ability of the denture to withstand displacement against its path of insertion.SYNOPSIS
• Support is defined as, the resistance to vertical forces of mastication, occlusal forces, and other forces applied in a direction towards the denture-bearing area.REFERENCE
Textbook of Prosthodontics- Deepak Nallaswamy - Question 89 of 300
89. Question
A patient presented with missing tooth 22 shows well-maintained oral hygiene and non-restored adjacent teeth. What is the treatment of choice for the missing tooth?
CorrectANSWER
Implant-supported prosthesisOTHER OPTIONS
• RPD – instability of the restoration during both speech and function
• FPD – have to compromise adjacent teethSYNOPSIS
• Single missing teeth with adjacent strong teeth can be replaced by implants.
• Placing implant abutments in sufficient numbers to fabricate a completely implant-supported prosthesis has several advantages.
– Caries free abutments.
– No need for endodontic therapy.
– Greater survival rate.
– Hygienic.REFERENCE
Contemporary Implant Dentistry- Carl E. Misch- 3rd EditionIncorrectANSWER
Implant-supported prosthesisOTHER OPTIONS
• RPD – instability of the restoration during both speech and function
• FPD – have to compromise adjacent teethSYNOPSIS
• Single missing teeth with adjacent strong teeth can be replaced by implants.
• Placing implant abutments in sufficient numbers to fabricate a completely implant-supported prosthesis has several advantages.
– Caries free abutments.
– No need for endodontic therapy.
– Greater survival rate.
– Hygienic.REFERENCE
Contemporary Implant Dentistry- Carl E. Misch- 3rd Edition - Question 90 of 300
90. Question
A patient diagnosed with iron deficiency anemia, esophageal webs, and difficulty in swallowing. Identify the condition.
CorrectANSWER
Plummer Vinson SyndromeOTHER OPTIONS
• Malignant tumors are cancerous (ie, they invade other sites). They spread to distant sites via the bloodstream or the lymphatic system.
• Benign esophageal stricture – It is the narrowing of the esophagus.
• Esophageal rings – An abnormal ring of tissue that forms where the esophagus (the tube from the mouth to the stomach) and stomach meet.SYNOPSIS
• A disorder marked by anemia caused by iron deficiency, and a web-like growth of membranes in the throat that makes swallowing difficult.
• Having Plummer-Vinson syndrome may increase the risk of developing esophageal cancer.
• Also called Paterson-Kelly syndrome and sideropenic dysphagia.REFERENCE
Plummer-Vinson syndrome – NIHIncorrectANSWER
Plummer Vinson SyndromeOTHER OPTIONS
• Malignant tumors are cancerous (ie, they invade other sites). They spread to distant sites via the bloodstream or the lymphatic system.
• Benign esophageal stricture – It is the narrowing of the esophagus.
• Esophageal rings – An abnormal ring of tissue that forms where the esophagus (the tube from the mouth to the stomach) and stomach meet.SYNOPSIS
• A disorder marked by anemia caused by iron deficiency, and a web-like growth of membranes in the throat that makes swallowing difficult.
• Having Plummer-Vinson syndrome may increase the risk of developing esophageal cancer.
• Also called Paterson-Kelly syndrome and sideropenic dysphagia.REFERENCE
Plummer-Vinson syndrome – NIH - Question 91 of 300
91. Question
Which of the following is used for buccal canine retraction in the maxilla?
CorrectANSWER
Intraoral intramaxillary applianceOTHER OPTIONS
• Not applicableSYNOPSIS
• It is indicated in the case of buccally placed canines and canines placed high in the vestibule. they are used to move the canine in a distal as well as palatal direction.
• It consists of a coil of 3 mm diameter, an active arm, and a retentive arm.
• The buccal canine retractor can be of two types supported and self-supported.
• The supported canine retractors lack stability and are therefore enclosed for a time, while the supported canine retractors can be activated up to 2 mm at a time.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Intraoral intramaxillary applianceOTHER OPTIONS
• Not applicableSYNOPSIS
• It is indicated in the case of buccally placed canines and canines placed high in the vestibule. they are used to move the canine in a distal as well as palatal direction.
• It consists of a coil of 3 mm diameter, an active arm, and a retentive arm.
• The buccal canine retractor can be of two types supported and self-supported.
• The supported canine retractors lack stability and are therefore enclosed for a time, while the supported canine retractors can be activated up to 2 mm at a time.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 92 of 300
92. Question
What is the cause of pain during root canal treatment?
CorrectANSWER
B and COTHER OPTIONS
• Refer synopsisSYNOPSIS
• Over instrumentation and Wrong working length determination can cause pain during root canal treatment.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
B and COTHER OPTIONS
• Refer synopsisSYNOPSIS
• Over instrumentation and Wrong working length determination can cause pain during root canal treatment.REFERENCE
Endodontics By Ingel 6th edition - Question 93 of 300
93. Question
You were presented with a case of an HIV-infected patient who has a white plaque-like lesion, which was not removable when scraped, poorly demarcated, and presented a flat, corrugated or hairy surface, located on the lateral border of the tongue. What is your diagnosis?
CorrectANSWER
Oral hairy leukoplakiaOTHER OPTIONS
• Oral Lichen planus – Oral lichen planus may appear as white, lacy patches, red, swollen tissues, or open sores. These lesions may cause burning, pain, or other discomforts.
• Hairy tongue – Black hairy tongue is caused by an overgrowth of dead skin cells, causing lengthening of the papillae, and staining from bacteria, yeast, food, tobacco, or other substances in the mouth
• Benign migratory glossitis -Geographic tongue (also known as benign migratory glossitis) is an inflammatory disorder that usually appears on the top and sides of the tongue. Typically, affected tongues have a bald, red area of varying sizes that are surrounded, at least in part, by an irregular white borderSYNOPSIS
• Oral hairy leukoplakia is a condition triggered by the Epstein-Barr virus (EBV).
• White patches are the main symptom of oral hairy leukoplakia. The patches are
– White and corrugated, or folded, in appearance
– Hairy, hair-like growths come from the folds in the patches
– Permanent, you can’t remove the patches with a toothbrush or with another oral care tool
– Sometimes, the patches cause discomfort and taste changes.
• Because oral hairy leukoplakia is usually related to an HIV infection, complications are related to HIV.
• Sticking to the prescribed HIV treatment plan and dental hygiene routine can control the discomfort.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrectANSWER
Oral hairy leukoplakiaOTHER OPTIONS
• Oral Lichen planus – Oral lichen planus may appear as white, lacy patches, red, swollen tissues, or open sores. These lesions may cause burning, pain, or other discomforts.
• Hairy tongue – Black hairy tongue is caused by an overgrowth of dead skin cells, causing lengthening of the papillae, and staining from bacteria, yeast, food, tobacco, or other substances in the mouth
• Benign migratory glossitis -Geographic tongue (also known as benign migratory glossitis) is an inflammatory disorder that usually appears on the top and sides of the tongue. Typically, affected tongues have a bald, red area of varying sizes that are surrounded, at least in part, by an irregular white borderSYNOPSIS
• Oral hairy leukoplakia is a condition triggered by the Epstein-Barr virus (EBV).
• White patches are the main symptom of oral hairy leukoplakia. The patches are
– White and corrugated, or folded, in appearance
– Hairy, hair-like growths come from the folds in the patches
– Permanent, you can’t remove the patches with a toothbrush or with another oral care tool
– Sometimes, the patches cause discomfort and taste changes.
• Because oral hairy leukoplakia is usually related to an HIV infection, complications are related to HIV.
• Sticking to the prescribed HIV treatment plan and dental hygiene routine can control the discomfort.REFERENCE
Shafer’s Textbook of Oral Pathology - Question 94 of 300
94. Question
A 54-year-old patient with poor oral hygiene was subjected to nonsurgical periodontal treatment. Patient-reported pain in the buccal gingival area of lower premolars. Which is the nerve block used to anesthetize soft tissue in that area?
CorrectANSWER
Incisive nerve blockOTHER OPTIONS
• Anterior superior alveolar nerve block – It is a maxillary nerve block
• Other options are explained below.SYNOPSIS
• The incisive nerve block anesthetizes both the mental and incisive nerves.
• It provides anesthesia to pulpal, periosteum, and buccal soft tissues, but not lingual soft tissues.
• Often, we prefer not to provide a mandibular block (inferior alveolar block, Gow-Gates block) if the patient does not require anesthesia for molar teeth.
• The incisive block is a good alternative in such cases.
• It provides very good anesthesia to the teeth anterior to the mental foramen on one side without the discomfort of anesthesia to the tongue.
• This is particularly useful when we wish to complete the mandible in one visit, and for at least one side, molar anesthesia is not indicated.
• Advantages of this technique are
– Easy injection
– A high success rate
– Sufficient hemostasis
– Largely atraumatic.REFERENCE
Handbook of LA – Stanley F MalamedIncorrectANSWER
Incisive nerve blockOTHER OPTIONS
• Anterior superior alveolar nerve block – It is a maxillary nerve block
• Other options are explained below.SYNOPSIS
• The incisive nerve block anesthetizes both the mental and incisive nerves.
• It provides anesthesia to pulpal, periosteum, and buccal soft tissues, but not lingual soft tissues.
• Often, we prefer not to provide a mandibular block (inferior alveolar block, Gow-Gates block) if the patient does not require anesthesia for molar teeth.
• The incisive block is a good alternative in such cases.
• It provides very good anesthesia to the teeth anterior to the mental foramen on one side without the discomfort of anesthesia to the tongue.
• This is particularly useful when we wish to complete the mandible in one visit, and for at least one side, molar anesthesia is not indicated.
• Advantages of this technique are
– Easy injection
– A high success rate
– Sufficient hemostasis
– Largely atraumatic.REFERENCE
Handbook of LA – Stanley F Malamed - Question 95 of 300
95. Question
What is the most common cause of class I malocclusion?
CorrectANSWER
Arch length tooth size discrepancyOTHER OPTIONS
• NILSYNOPSIS
• Angles class I malocclusion is characterized by the presence of a normal interarch molar relation.
• The mesiobuccal cusp of the maxillary first permanent molar occludes in the buccal groove of the mandibular first molar.
• Class I malocclusion can be a discrepancy either within the arches or in the transverse or vertical relationship between the arches.
• The patient may exhibit dental irregularities such as crowding, spacing, rotations, and a missing tooth.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Arch length tooth size discrepancyOTHER OPTIONS
• NILSYNOPSIS
• Angles class I malocclusion is characterized by the presence of a normal interarch molar relation.
• The mesiobuccal cusp of the maxillary first permanent molar occludes in the buccal groove of the mandibular first molar.
• Class I malocclusion can be a discrepancy either within the arches or in the transverse or vertical relationship between the arches.
• The patient may exhibit dental irregularities such as crowding, spacing, rotations, and a missing tooth.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 96 of 300
96. Question
A patient has swelling and acute pericoronitis. He had the same symptoms 2 months ago and took treatment. How will you manage this time?
CorrectANSWER
Antibiotics and Extraction of the offending toothOTHER OPTIONS
• Explained belowSYNOPSIS
• Pericoronitis is an inflammation of the soft tissue surrounding the partially erupted or impacted mandibular third molars.
• Pericoronitis symptoms range from mild to severe and may include bad breath, pus, and facial swelling.
• Management of pericoronitis may be done by the following methods
– Irrigation of the affected area to flush out any food particles, bacteria, or other debris.
– Oral antibiotics can help clear up a pericoronitis infection.
– Use of mouthwash that contains chlorhexidine, a topical antiseptic.
– Some cases may recommend removing the gum flap (operculum).
– In case of persistent discomfort, extraction of the offending tooth is associated with a faster clinical and biological resolution of the infection.
• Thus, when the causative tooth is non-restorable or impacted, it should be extracted without delay.
• The timing of the follow-up appointment after prescribing antibiotics may be a factor in lowering the number of complications and improving the outcomes for patients experiencing pain or discomfortREFERENCE
Pericoronitis – Gloria Kwon, Marc Serra.IncorrectANSWER
Antibiotics and Extraction of the offending toothOTHER OPTIONS
• Explained belowSYNOPSIS
• Pericoronitis is an inflammation of the soft tissue surrounding the partially erupted or impacted mandibular third molars.
• Pericoronitis symptoms range from mild to severe and may include bad breath, pus, and facial swelling.
• Management of pericoronitis may be done by the following methods
– Irrigation of the affected area to flush out any food particles, bacteria, or other debris.
– Oral antibiotics can help clear up a pericoronitis infection.
– Use of mouthwash that contains chlorhexidine, a topical antiseptic.
– Some cases may recommend removing the gum flap (operculum).
– In case of persistent discomfort, extraction of the offending tooth is associated with a faster clinical and biological resolution of the infection.
• Thus, when the causative tooth is non-restorable or impacted, it should be extracted without delay.
• The timing of the follow-up appointment after prescribing antibiotics may be a factor in lowering the number of complications and improving the outcomes for patients experiencing pain or discomfortREFERENCE
Pericoronitis – Gloria Kwon, Marc Serra. - Question 97 of 300
97. Question
A patient returns within 24 hours after the insertion of a complete denture with redness on the palate. What is the diagnosis?
CorrectANSWER
Hypersensitivity to denture materialOTHER OPTIONS
• Denture stomatitis – Denture stomatitis, a common disorder affecting denture wearers, is characterized as inflammation and erythema of the oral mucosal areas covered by the denture.
• Candidiasis – It is known that denture stomatitis may occur in response to plaque accumulation on dentures. One of the chief pathogenic microorganisms causing this type of inflammation is Candida albicans. A common symptom of oral candidiasis is a pain in the oral mucosa complicated by angular stomatitisSYNOPSIS
• The most common and frequently reported problem with patients having allergic reactions to denture base acrylic resin is mouth soreness and burning sensation.
• Areas presenting with burning sensation include the palate, tongue, oral mucosa, and the oropharynx
• Allergic tests carried out on the skin of patients have also confirmed that the denture base acrylic resin is responsible for allergic reactions. • Thus, whenever a denture wearer presents with the signs and symptoms outlined above, the possibility of an allergic reaction must always be considered, and a thorough investigation carried out to achieve an accurate diagnosis.
• For the immediate and delayed type of hypersensitivity reactions, patch testing, blood tests, or allergen-specific IgE tests can be carried out.
• The cytotoxic effects caused by denture base acrylic resins are mainly caused by the substances leaching out from these resins.
• The main substance which is leached out by the process of diffusion from these materials is the unreacted residual monomer.
• Constant contact of saliva with the material causes expansion of the openings present between the polymer chains causing the unreacted monomer to diffuse out.
• Thus, the substances which are leached out from the denture bases into the saliva are transferred to the oral structures causing adverse allergic reactions.REFERENCE
Allergic effects of the residual monomer used in denture base acrylic resins – European Journal of DentistryIncorrectANSWER
Hypersensitivity to denture materialOTHER OPTIONS
• Denture stomatitis – Denture stomatitis, a common disorder affecting denture wearers, is characterized as inflammation and erythema of the oral mucosal areas covered by the denture.
• Candidiasis – It is known that denture stomatitis may occur in response to plaque accumulation on dentures. One of the chief pathogenic microorganisms causing this type of inflammation is Candida albicans. A common symptom of oral candidiasis is a pain in the oral mucosa complicated by angular stomatitisSYNOPSIS
• The most common and frequently reported problem with patients having allergic reactions to denture base acrylic resin is mouth soreness and burning sensation.
• Areas presenting with burning sensation include the palate, tongue, oral mucosa, and the oropharynx
• Allergic tests carried out on the skin of patients have also confirmed that the denture base acrylic resin is responsible for allergic reactions. • Thus, whenever a denture wearer presents with the signs and symptoms outlined above, the possibility of an allergic reaction must always be considered, and a thorough investigation carried out to achieve an accurate diagnosis.
• For the immediate and delayed type of hypersensitivity reactions, patch testing, blood tests, or allergen-specific IgE tests can be carried out.
• The cytotoxic effects caused by denture base acrylic resins are mainly caused by the substances leaching out from these resins.
• The main substance which is leached out by the process of diffusion from these materials is the unreacted residual monomer.
• Constant contact of saliva with the material causes expansion of the openings present between the polymer chains causing the unreacted monomer to diffuse out.
• Thus, the substances which are leached out from the denture bases into the saliva are transferred to the oral structures causing adverse allergic reactions.REFERENCE
Allergic effects of the residual monomer used in denture base acrylic resins – European Journal of Dentistry - Question 98 of 300
98. Question
Which of the following is used for making the least polished surface?
CorrectANSWER
Crosscut at low speedOTHER OPTIONS
• 3 by 4 coarse garnet disc at low speed – Produces smooth finish.
• Plain cut bur at high speed – For producing preparations with straight parallel sides and flat floors, gaining access to carious dentin, establishing preparation form, and creating retentive locks. Cross-cut burs have more cutting edges.
• Flutted carbide bur – Ideal for contouring the gingiva post scalpel, electrosurgical or laser excision of excessive gingival overgrowth. Used commonly in veterinary dentistry for dogs with gingival hyperplasia.SYNOPSIS
• Crosscuts at low speed produce rough surfaces.REFERENCE
Sturdivant’s Art AND Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher MosbyIncorrectANSWER
Crosscut at low speedOTHER OPTIONS
• 3 by 4 coarse garnet disc at low speed – Produces smooth finish.
• Plain cut bur at high speed – For producing preparations with straight parallel sides and flat floors, gaining access to carious dentin, establishing preparation form, and creating retentive locks. Cross-cut burs have more cutting edges.
• Flutted carbide bur – Ideal for contouring the gingiva post scalpel, electrosurgical or laser excision of excessive gingival overgrowth. Used commonly in veterinary dentistry for dogs with gingival hyperplasia.SYNOPSIS
• Crosscuts at low speed produce rough surfaces.REFERENCE
Sturdivant’s Art AND Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher Mosby - Question 99 of 300
99. Question
Trauma to primary teeth occur most commonly at the age of?
CorrectANSWER
2 to 4 yearsOTHER OPTIONS
• Not applicableSYNOPSIS
• The majority of trauma occurred between the ages of 2 and 4.
• The most commonly affected tooth was the maxillary left central incisor, followed by the maxillary right central incisor.
• The majority of dental trauma is tooth (crown) fracture, tooth avulsion, or tooth subluxation.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, IncIncorrectANSWER
2 to 4 yearsOTHER OPTIONS
• Not applicableSYNOPSIS
• The majority of trauma occurred between the ages of 2 and 4.
• The most commonly affected tooth was the maxillary left central incisor, followed by the maxillary right central incisor.
• The majority of dental trauma is tooth (crown) fracture, tooth avulsion, or tooth subluxation.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, Inc - Question 100 of 300
100. Question
The disadvantage of screw-retained Implant prosthesis lies in its
CorrectANSWER
PassivityOTHER OPTIONS
• Explained belowSYNOPSIS
• Implant restorations can be screw-retained or cement retained.
• In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations.
• The factors that influence the type of fixation of the prostheses to the implants are as follows.
1) Passivity of the framework.
2) Ease of fabrication and cost.
3) Occlusion.
4) Complications.
5) Esthetics.
6) Accessibility.
7) Retention.
8) Retrievability.
9) Cementation.
• Advantages of Screw-retained implant restorations
– Predictable retention,
– Retrievability and
– Lack of potentially retained sub-gingival cement.
• Disadvantages
– Precise placement of the implant for the optimal and esthetic location of the screw access hole and
– Obtaining passive fit.REFERENCE
Factors influencing the success of cement versus screw-retained implant restorations A clinical review – Journal of OsseointegrationIncorrectANSWER
PassivityOTHER OPTIONS
• Explained belowSYNOPSIS
• Implant restorations can be screw-retained or cement retained.
• In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations.
• The factors that influence the type of fixation of the prostheses to the implants are as follows.
1) Passivity of the framework.
2) Ease of fabrication and cost.
3) Occlusion.
4) Complications.
5) Esthetics.
6) Accessibility.
7) Retention.
8) Retrievability.
9) Cementation.
• Advantages of Screw-retained implant restorations
– Predictable retention,
– Retrievability and
– Lack of potentially retained sub-gingival cement.
• Disadvantages
– Precise placement of the implant for the optimal and esthetic location of the screw access hole and
– Obtaining passive fit.REFERENCE
Factors influencing the success of cement versus screw-retained implant restorations A clinical review – Journal of Osseointegration - Question 101 of 300
101. Question
A 14 years old boy presented with an unerupted permanent upper canine that shows radiolucency around the same tooth on radiographic examination. How will you manage the case if the tooth shows 3 – 4th of the root development has been completed?
CorrectANSWER
Remove the dentigerous cystOTHER OPTIONS
• Extraction – not recommended in this caseSYNOPSIS
• An unerupted canine is common.
• The radiolucency seen in the radiograph of an unerupted canine indicates the presence of a dentigerous cyst around the unerupted crown.
• If failed to treat there is a chance to increase fluid accumulation in the cyst and will cause jaw enlargement resulting in irregular dentition, facial deformity, and other serious consequences
• Treatment, in this case, will be
– Surgical removal of dentigerous cyst
– Orthodontic correction of impacted canineREFERENCE
The correlation between the three-dimensional radiolucency- Junliang ChenIncorrectANSWER
Remove the dentigerous cystOTHER OPTIONS
• Extraction – not recommended in this caseSYNOPSIS
• An unerupted canine is common.
• The radiolucency seen in the radiograph of an unerupted canine indicates the presence of a dentigerous cyst around the unerupted crown.
• If failed to treat there is a chance to increase fluid accumulation in the cyst and will cause jaw enlargement resulting in irregular dentition, facial deformity, and other serious consequences
• Treatment, in this case, will be
– Surgical removal of dentigerous cyst
– Orthodontic correction of impacted canineREFERENCE
The correlation between the three-dimensional radiolucency- Junliang Chen - Question 102 of 300
102. Question
Extracting a patient’s premolar, a dentist administers an inferior alveolar nerve block. Three minutes after receiving this block patient develops paralysis of his forehead muscles and his eyelids and upper and lower lips on the same side. These findings are most likely associated with the administration of LA in?
CorrectANSWER
Facial nerveOTHER OPTIONS
• Auriculo temporal nerve – Injury causes Freys Syndrome
• Maxillary artery – If local anesthetic with a vasoconstrictor is mistakenly administered intravascularly, expected consequences can include inadequate anesthesia, shooting pain, skin pallor or ischemia, andor heart palpitationsSYNOPSIS
• The inferior alveolar nerve block is a Mandibular nerve block given to anesthetize the Mandibular teeth, due to its proximity to other Nerves and muscles, and salivary glands it has many complications if the technique in which it is given is wrong.
• Due to the proximity of the Inferior alveolar nerve block needle position to the facial nerve and the Parotid through which it passes is the result of this complication where we can see the characteristic complications when the Facial nerve is anesthetized
• Transient Hemifacial Paralysis – the muscles supplied by that side of the facial nerve are affected and cannot contract, resulting in loss of muscle action of the affected side of the face.
– Where the eyelids cannot be closed by the patient
– Loss of maintaining of lips position on the affected side and drooping of the lips on the affected side is seen
• If this condition is ever encountered, be calm and explain the problem and assure him or her that it is temporary and will be back to normal in 3 hours after the effect of local anesthesia is gone.
• Prescribe any Lubricating Eye drops and ask the attendant or the patient to keep putting 2 drops every 15 mins on the affected eye to keep the eyes wet as the eyelids cannot be closed due to paralysis of the facial nerve.
• Ask the patient to use a clean cloth to keep over the eye to prevent dust from entering the open eye.
• Lastly, ask the patient to stay in the clinic for 3 hours if possible to monitor the condition after the effect of local anesthesia wears offREFERENCE
IANB Complications – Junior DentistIncorrectANSWER
Facial nerveOTHER OPTIONS
• Auriculo temporal nerve – Injury causes Freys Syndrome
• Maxillary artery – If local anesthetic with a vasoconstrictor is mistakenly administered intravascularly, expected consequences can include inadequate anesthesia, shooting pain, skin pallor or ischemia, andor heart palpitationsSYNOPSIS
• The inferior alveolar nerve block is a Mandibular nerve block given to anesthetize the Mandibular teeth, due to its proximity to other Nerves and muscles, and salivary glands it has many complications if the technique in which it is given is wrong.
• Due to the proximity of the Inferior alveolar nerve block needle position to the facial nerve and the Parotid through which it passes is the result of this complication where we can see the characteristic complications when the Facial nerve is anesthetized
• Transient Hemifacial Paralysis – the muscles supplied by that side of the facial nerve are affected and cannot contract, resulting in loss of muscle action of the affected side of the face.
– Where the eyelids cannot be closed by the patient
– Loss of maintaining of lips position on the affected side and drooping of the lips on the affected side is seen
• If this condition is ever encountered, be calm and explain the problem and assure him or her that it is temporary and will be back to normal in 3 hours after the effect of local anesthesia is gone.
• Prescribe any Lubricating Eye drops and ask the attendant or the patient to keep putting 2 drops every 15 mins on the affected eye to keep the eyes wet as the eyelids cannot be closed due to paralysis of the facial nerve.
• Ask the patient to use a clean cloth to keep over the eye to prevent dust from entering the open eye.
• Lastly, ask the patient to stay in the clinic for 3 hours if possible to monitor the condition after the effect of local anesthesia wears offREFERENCE
IANB Complications – Junior Dentist - Question 103 of 300
103. Question
While examining a patient, a student was asked to take the DMFT index and he got a score of 4. Caries risk status for a DMFT score of 4 is
CorrectANSWER
ModerateOTHER OPTIONS
• Explained belowSYNOPSIS
• .According to WHO Global Data Bank
• DMFT – 0-1.1 – Very Low Risk
• DMFT – 1.1-2.6 – Low Risk
• DMFT – 2.7-4.4 – Moderate Risk
• DMFT – 4.5 – 6.5 – High Risk
• DMFT – 6.6 and above – Very High RiskREFERENCE
A Textbook of Public Health Dentistry – CM MaryaIncorrectANSWER
ModerateOTHER OPTIONS
• Explained belowSYNOPSIS
• .According to WHO Global Data Bank
• DMFT – 0-1.1 – Very Low Risk
• DMFT – 1.1-2.6 – Low Risk
• DMFT – 2.7-4.4 – Moderate Risk
• DMFT – 4.5 – 6.5 – High Risk
• DMFT – 6.6 and above – Very High RiskREFERENCE
A Textbook of Public Health Dentistry – CM Marya - Question 104 of 300
104. Question
A pear-shaped radiolucency causing displacement of roots of vital maxillary lateral and cuspid teeth is characteristic of ?
CorrectANSWER
Globulomaxillary cystOTHER OPTIONS
• Apical periodontal cyst – Lateral periodontal cyst (LPC), originating from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically
• Primordial cyst – Primordial cysts are infrequent cystic mandibular lesions, which are thought to result from the degeneration of dental follicles. No tooth is therefore present, and the cyst is a well-defined, small and static lesion, most commonly located posteriorly in the region of the third molar or angle of the mandible.SYNOPSIS
• The globulomaxillary cyst is a cyst that appears between a maxillary lateral incisor and the adjacent canine. It exhibits an inverted pear-shaped radiolucency on radiographs or X-ray films.
• The globulomaxillary cyst often causes the roots of adjacent teeth to diverge.REFERENCE
Shafer’s Tetbook of Oral PathologyIncorrectANSWER
Globulomaxillary cystOTHER OPTIONS
• Apical periodontal cyst – Lateral periodontal cyst (LPC), originating from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically
• Primordial cyst – Primordial cysts are infrequent cystic mandibular lesions, which are thought to result from the degeneration of dental follicles. No tooth is therefore present, and the cyst is a well-defined, small and static lesion, most commonly located posteriorly in the region of the third molar or angle of the mandible.SYNOPSIS
• The globulomaxillary cyst is a cyst that appears between a maxillary lateral incisor and the adjacent canine. It exhibits an inverted pear-shaped radiolucency on radiographs or X-ray films.
• The globulomaxillary cyst often causes the roots of adjacent teeth to diverge.REFERENCE
Shafer’s Tetbook of Oral Pathology - Question 105 of 300
105. Question
Features of multiple neurofibromas with cafe-au-lait spots of the skin are typical of?
CorrectANSWER
Von Recklinghausen’s disease of the skinOTHER OPTIONS
• Paget’s disease of skin – Paget’s disease is an uncommon epidermal cancer, affecting all skin regions wherever apocrine glands are present, It appears as a red, scaly rash on the skin of the nipple and areola.
• Hereditary ectodermal dysplasia – Ectodermal dysplasias (ED) are a group of disorders in which two or more of the ectodermal derived structures – the skin, sweat glands, hair, nails, teeth and mucous membranes – develop abnormally.
• Papillon-Lefèvre syndrome – Papillon-Lefevre syndrome is a rare autosomal recessive disorder caused by cathepsin C gene mutation leading to the deficiency of cathepsin C enzymatic activity. The disease is characterized by palmoplantar hyperkeratosis, loss of deciduous and permanent teeth and increased susceptibility to infectionsSYNOPSIS
• .Neurofibromatosis 1 (NF1), historically called von Recklinghausen’s disease, is a genetic disorder characterized by an increased risk of developing noncancerous (benign) and cancerous (malignant) tumors, as well as various other physical and neurological manifestations
• Over half of the patients with Von Recklinghausen disease will show abnormal findings on imaging of the brain, the orbit, or both.
• The lesions may consist of hamartomas or of neoplasms, such as gliomas of the optic nerve and of the parenchyma of the brain
• Symptoms of VRD affecting the skin include the following
– Cafe au lait macules are tan spots in different sizes and shapes.
– They can be found in multiple places on the skin.
– Freckles can occur under the arms or in the groin area.
• There is no known treatment or cure for neurofibromatosis or schwannomatosis. Medication can be prescribed to help with pain. In some cases, growths may be removed surgically or reduced with radiation therapy.REFERENCE
Shafer’s Textbook of oral pathologyIncorrectANSWER
Von Recklinghausen’s disease of the skinOTHER OPTIONS
• Paget’s disease of skin – Paget’s disease is an uncommon epidermal cancer, affecting all skin regions wherever apocrine glands are present, It appears as a red, scaly rash on the skin of the nipple and areola.
• Hereditary ectodermal dysplasia – Ectodermal dysplasias (ED) are a group of disorders in which two or more of the ectodermal derived structures – the skin, sweat glands, hair, nails, teeth and mucous membranes – develop abnormally.
• Papillon-Lefèvre syndrome – Papillon-Lefevre syndrome is a rare autosomal recessive disorder caused by cathepsin C gene mutation leading to the deficiency of cathepsin C enzymatic activity. The disease is characterized by palmoplantar hyperkeratosis, loss of deciduous and permanent teeth and increased susceptibility to infectionsSYNOPSIS
• .Neurofibromatosis 1 (NF1), historically called von Recklinghausen’s disease, is a genetic disorder characterized by an increased risk of developing noncancerous (benign) and cancerous (malignant) tumors, as well as various other physical and neurological manifestations
• Over half of the patients with Von Recklinghausen disease will show abnormal findings on imaging of the brain, the orbit, or both.
• The lesions may consist of hamartomas or of neoplasms, such as gliomas of the optic nerve and of the parenchyma of the brain
• Symptoms of VRD affecting the skin include the following
– Cafe au lait macules are tan spots in different sizes and shapes.
– They can be found in multiple places on the skin.
– Freckles can occur under the arms or in the groin area.
• There is no known treatment or cure for neurofibromatosis or schwannomatosis. Medication can be prescribed to help with pain. In some cases, growths may be removed surgically or reduced with radiation therapy.REFERENCE
Shafer’s Textbook of oral pathology - Question 106 of 300
106. Question
You were presented with a case of erythematous and hyperkeratotic deep hemorrhagic bullae. On examination, other mucosal surfaces including ocular, nasal, pharyngeal, laryngeal, and upper respiratory were included. Identify the diagnosis?
CorrectANSWER
Erythema multiformeOTHER OPTIONS
• Herpes simplex virus (HSV) infection – The herpes simplex virus, also known as HSV, is a viral infection that causes genital and oral herpes.
• Mycoplasma pneumoniae infection – Mycoplasma pneumoniae are bacteria that can cause illness by damaging the lining of the respiratory system (throat, lungs, windpipe).
• Urticaria – a rash of round, red welts on the skin that itch intensely, sometimes with dangerous swelling, caused by an allergic reaction.SYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion. These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran OngoleIncorrectANSWER
Erythema multiformeOTHER OPTIONS
• Herpes simplex virus (HSV) infection – The herpes simplex virus, also known as HSV, is a viral infection that causes genital and oral herpes.
• Mycoplasma pneumoniae infection – Mycoplasma pneumoniae are bacteria that can cause illness by damaging the lining of the respiratory system (throat, lungs, windpipe).
• Urticaria – a rash of round, red welts on the skin that itch intensely, sometimes with dangerous swelling, caused by an allergic reaction.SYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion. These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole - Question 107 of 300
107. Question
Related question . What are the triggering factors that cause recurrence of the above condition
CorrectANSWER
Both A and BOTHER OPTIONS
• EBV – Burkitts LymphomaSYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion. These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran OngoleIncorrectANSWER
Both A and BOTHER OPTIONS
• EBV – Burkitts LymphomaSYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion. These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole - Question 108 of 300
108. Question
Related question. Typical dermal lesions of the condition is called ?
CorrectANSWER
Target lesionOTHER OPTIONS
• Whickham striae – Lichen planus
• Cafe-au-lait spots – NeurofibromatosisSYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion.
• These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole.IncorrectANSWER
Target lesionOTHER OPTIONS
• Whickham striae – Lichen planus
• Cafe-au-lait spots – NeurofibromatosisSYNOPSIS
• Erythema multiforme (EM) is an acute, reactive, self-limiting and recurring mucocutaneous disorder that causes blistering and ulceration of the skin and mucous membranes.
• The face, oral mucosa, dorsal surface of the hands, feet, elbows and knees are the sites that are commonly affected.
• EM are triggered by HSV 1 and 2 infections.
• The typical dermal lesions of EM are target, iris or bull’s eye lesion.
• These are asymptomatic, discrete, erythematous macules or papules set in a concentric ring pattern usually comprising a central bulla.REFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole. - Question 109 of 300
109. Question
Related question. How will you manage the above mentioned condition?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The management of erythema multiforme involves
– symptomatic treatment with topical steroids or antihistamines and
– treating the underlying etiology, if known.
– Recurrent erythema multiforme associated with the herpes simplex virus should be treated with prophylactic antiviral therapy.
– Severe mucosal erythema multiforme can require hospitalization for intravenous fluids and repletion of electrolytesREFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole.IncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The management of erythema multiforme involves
– symptomatic treatment with topical steroids or antihistamines and
– treating the underlying etiology, if known.
– Recurrent erythema multiforme associated with the herpes simplex virus should be treated with prophylactic antiviral therapy.
– Severe mucosal erythema multiforme can require hospitalization for intravenous fluids and repletion of electrolytesREFERENCE
Textbook of Oral medicine, Oral diagnosis and Oral radiology- Ravikaran Ongole. - Question 110 of 300
110. Question
In examining a 12-year-old boy, the dentist finds a deep anterior overlap, maxillary central incisors are lingually inclined, and maxillary lateral incisors protruded. Maxillary molars are in an anterior relationship with mandibular molars. The patient is likely to be?
CorrectANSWER
Class II Div IIOTHER OPTIONS
• Class I – A normal molar relationship is present, but there is crowding, misalignment of the teeth, rotations, cross-bites, and other alignment irregularities.
• Class II Div I – The mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.The anterior maxillary teeth are tilted forward or proclined, presenting a large overjet.SYNOPSIS
• Class II Div II
• The mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.
• The anterior maxillary teeth are retroclined, creating a deep overbite.REFERENCE
Textbook of Orthodontics- Gurkeerat SinghIncorrectANSWER
Class II Div IIOTHER OPTIONS
• Class I – A normal molar relationship is present, but there is crowding, misalignment of the teeth, rotations, cross-bites, and other alignment irregularities.
• Class II Div I – The mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.The anterior maxillary teeth are tilted forward or proclined, presenting a large overjet.SYNOPSIS
• Class II Div II
• The mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.
• The anterior maxillary teeth are retroclined, creating a deep overbite.REFERENCE
Textbook of Orthodontics- Gurkeerat Singh - Question 111 of 300
111. Question
Related question. What are the objectives of early interceptive orthodontics for the management of the above-mentioned condition?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• In Class II Div II the mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.
• The anterior maxillary teeth are retroclined, creating a deep overbite.
• Treatment Objectives of early interceptive orthodontics in a developing Class II div II are
– Correction of inclination of anterior teeth,
– Correction of the retrognathic mandible by growth modulation.
• Treatment Plan
a) Phase 1
– Correction of inclination of central incisor and deep bite.
– Growth modulation for the retro-positioned mandible.
b) Phase 2
-Fixed orthodontic treatment for final finishing and detailing, and retention.REFERENCE
Management of Angle’s Class II Division 2 Malocclusion with Early Interceptive Orthodontics, A Case Report- Journal of Postgraduate Medicine, Education, and ResearchIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• In Class II Div II the mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal groove of the mandibular first molar.
• The anterior maxillary teeth are retroclined, creating a deep overbite.
• Treatment Objectives of early interceptive orthodontics in a developing Class II div II are
– Correction of inclination of anterior teeth,
– Correction of the retrognathic mandible by growth modulation.
• Treatment Plan
a) Phase 1
– Correction of inclination of central incisor and deep bite.
– Growth modulation for the retro-positioned mandible.
b) Phase 2
-Fixed orthodontic treatment for final finishing and detailing, and retention.REFERENCE
Management of Angle’s Class II Division 2 Malocclusion with Early Interceptive Orthodontics, A Case Report- Journal of Postgraduate Medicine, Education, and Research - Question 112 of 300
112. Question
19-year-old male patient presented with a swelling on the right side of the face. On clinical examination, 48 were unerupted and on radiographic examination, a pericoronal radiolucency was noticed. Histopathological examination showed that the epithelial lining was of variable thickness with certain few features resembling Gorlin and Vicker’s criteria. The probable diagnosis is?
CorrectANSWER
AmeloblastomaOTHER OPTIONS
• Dentigerous cyst – Non Keratinized Epithelium of 2-3 cell layers thick, Lining Epithelium similar to Reduced Enamel Epithelium,Cyst Attached to Neck of the Tooth, Odontogenic Epithelial Islands in Capsule, Presence of Rushton Bodies, radiographically Dentigerous cyst encloses only the coronal portion of the impacted tooth
• Adenomatoid Odontogenic cyst – AOT shows radiolucency usually surrounding both the coronal and radicular aspects of the involved toothSYNOPSIS
• The radiographic appearances of ameloblastoma are variable. U• • Nilocular lesions associated with an impacted tooth can often be mistaken for a dentigerious cyst radiographically.
• It may present as a multilocular cystic lesion with well-defined corticated margins. Scalloping of margins is common.
• Vickers and Gorlin criteria were originally described to help diagnose early ameloblastomas in cysts, they are useful when examining other lesions that are suspected of being ameloblastomas
• Vickers and Gorlin criteria state that nuclear hyperchromatism, nuclear palisading with reverse polarization, and cytoplasmic vacuolization with intercellular spacing, when observed together, constitute histopathologic evidence of neoplasia
• The Vickers and Gorlin criteria are indeed helpful for differential diagnosis, but not enough to establish the diagnosis of ameloblastomas in very incipient lesions.REFERENCE
The Onset of a Peripheral Ameloblastoma – Case reports on Oncological MedicineIncorrectANSWER
AmeloblastomaOTHER OPTIONS
• Dentigerous cyst – Non Keratinized Epithelium of 2-3 cell layers thick, Lining Epithelium similar to Reduced Enamel Epithelium,Cyst Attached to Neck of the Tooth, Odontogenic Epithelial Islands in Capsule, Presence of Rushton Bodies, radiographically Dentigerous cyst encloses only the coronal portion of the impacted tooth
• Adenomatoid Odontogenic cyst – AOT shows radiolucency usually surrounding both the coronal and radicular aspects of the involved toothSYNOPSIS
• The radiographic appearances of ameloblastoma are variable. U• • Nilocular lesions associated with an impacted tooth can often be mistaken for a dentigerious cyst radiographically.
• It may present as a multilocular cystic lesion with well-defined corticated margins. Scalloping of margins is common.
• Vickers and Gorlin criteria were originally described to help diagnose early ameloblastomas in cysts, they are useful when examining other lesions that are suspected of being ameloblastomas
• Vickers and Gorlin criteria state that nuclear hyperchromatism, nuclear palisading with reverse polarization, and cytoplasmic vacuolization with intercellular spacing, when observed together, constitute histopathologic evidence of neoplasia
• The Vickers and Gorlin criteria are indeed helpful for differential diagnosis, but not enough to establish the diagnosis of ameloblastomas in very incipient lesions.REFERENCE
The Onset of a Peripheral Ameloblastoma – Case reports on Oncological Medicine - Question 113 of 300
113. Question
Which no BP blade is used for incising an abscess?
CorrectANSWER
No 11OTHER OPTIONS
• No 3 – Bard Parker style scalpel handle with metric ruler is used for cutting gingival tissue and making surgical incisions.
• No 12 – A small, pointed, crescent-shaped blade used typically as a suture cutter. It is most sharp on the inside edge of its curve.
• No 15 – has a small curved cutting edge and is the most popular blade shape ideal for making short and precise incisions.SYNOPSIS
• A long, triangular blade with the hypotenuse as its sharpest edge.
• Because of its pointed tip, it is typically used for stabbing incisions and or short, precise cuts that are shallow.
• They are used for incision and drainage.REFERENCE
SURGICAL BLADES – WHICH SCALPELS ARE RIGHT FOR YOUR OPERATING ROOMIncorrectANSWER
No 11OTHER OPTIONS
• No 3 – Bard Parker style scalpel handle with metric ruler is used for cutting gingival tissue and making surgical incisions.
• No 12 – A small, pointed, crescent-shaped blade used typically as a suture cutter. It is most sharp on the inside edge of its curve.
• No 15 – has a small curved cutting edge and is the most popular blade shape ideal for making short and precise incisions.SYNOPSIS
• A long, triangular blade with the hypotenuse as its sharpest edge.
• Because of its pointed tip, it is typically used for stabbing incisions and or short, precise cuts that are shallow.
• They are used for incision and drainage.REFERENCE
SURGICAL BLADES – WHICH SCALPELS ARE RIGHT FOR YOUR OPERATING ROOM - Question 114 of 300
114. Question
Disinfection of Gutta Percha is done by?
CorrectANSWER
Chemical solutionOTHER OPTIONS
• Autoclave – Autoclaves are also known as steam sterilizers, and are typically used for healthcare or industrial applications. An autoclave is a machine that uses steam under pressure to kill harmful bacteria, viruses, fungi, and spores on items that are placed inside a pressure vesselSYNOPSIS
• A large variety of chemical disinfectants have been used to sterilize gutta-percha cones before root canal filling including
– sodium hypochlorite (NaOCl),
– glutaraldehyde,
– alcohol,
– chlorhexidine (CHX),
– hydrogen peroxide,
– polyvinylpyrrolidone iodine, and
– a mixture of tetracycline citric acid and detergent (MTAD)REFERENCE
Gutta-percha disinfection A knowledge, attitude, and practice study among endodontic postgraduate students in India. Venugopal PanugantiIncorrectANSWER
Chemical solutionOTHER OPTIONS
• Autoclave – Autoclaves are also known as steam sterilizers, and are typically used for healthcare or industrial applications. An autoclave is a machine that uses steam under pressure to kill harmful bacteria, viruses, fungi, and spores on items that are placed inside a pressure vesselSYNOPSIS
• A large variety of chemical disinfectants have been used to sterilize gutta-percha cones before root canal filling including
– sodium hypochlorite (NaOCl),
– glutaraldehyde,
– alcohol,
– chlorhexidine (CHX),
– hydrogen peroxide,
– polyvinylpyrrolidone iodine, and
– a mixture of tetracycline citric acid and detergent (MTAD)REFERENCE
Gutta-percha disinfection A knowledge, attitude, and practice study among endodontic postgraduate students in India. Venugopal Panuganti - Question 115 of 300
115. Question
A 33-year old man presents with the swelling on the upper arm which has been growing slowly for a number of years. Examination reveals a small, compressible, non-tender, lobulated mass and histopathology shows adipocytes enclosed within areolar tissue surrounded by a fibrous capsule. The most likely lesion to reveal these features is?
CorrectANSWER
LipomaOTHER OPTIONS
• Fibroma – is a noncancerous (benign) tumor or growth consisting of fibrous, connective tissue. Since you have tissue all over your body, they can appear almost anywhere.
• Neurofibroma – is a type of peripheral nerve tumor that forms soft bumps on or under the skin. A neurofibroma can develop within a major or minor nerve anywhere in the body. This common type of benign nerve tumor tends to form centrally within the nerve.
• Osteoma – Osteomas are benign head tumors made of bone. Theyre usually found in the head or skull, but they can also be found in the neck.SYNOPSIS
• Lipomas are defined as a common subcutaneous tumor composed of adipose (fat) cells, often encapsulated by a thin layer of fibrous tissue.
• Clinically, they are often present in the bodys cephalic part, specifically in the head, neck, shoulders, and backs of patients.
• Asymptomatic, slow-growing usually circumscribed, sessile, or pedunculated.
• Usually soft and compressive with a doughy consistency.
• When it is located superficially, a yellowish texture can be seen. In rare instances, bilateral or multiple occurrences has been reported.REFERENCE
Lipoma Pathology- Charifa A – Textbook of oral medicine,oral diagnosis and oral radiology-Ravikaran OngoleIncorrectANSWER
LipomaOTHER OPTIONS
• Fibroma – is a noncancerous (benign) tumor or growth consisting of fibrous, connective tissue. Since you have tissue all over your body, they can appear almost anywhere.
• Neurofibroma – is a type of peripheral nerve tumor that forms soft bumps on or under the skin. A neurofibroma can develop within a major or minor nerve anywhere in the body. This common type of benign nerve tumor tends to form centrally within the nerve.
• Osteoma – Osteomas are benign head tumors made of bone. Theyre usually found in the head or skull, but they can also be found in the neck.SYNOPSIS
• Lipomas are defined as a common subcutaneous tumor composed of adipose (fat) cells, often encapsulated by a thin layer of fibrous tissue.
• Clinically, they are often present in the bodys cephalic part, specifically in the head, neck, shoulders, and backs of patients.
• Asymptomatic, slow-growing usually circumscribed, sessile, or pedunculated.
• Usually soft and compressive with a doughy consistency.
• When it is located superficially, a yellowish texture can be seen. In rare instances, bilateral or multiple occurrences has been reported.REFERENCE
Lipoma Pathology- Charifa A – Textbook of oral medicine,oral diagnosis and oral radiology-Ravikaran Ongole - Question 116 of 300
116. Question
A patient who is on dicumarol therapy require a tooth extraction. Which laboratory test is the most valuable in evaluating this patient’s surgical risk?
CorrectANSWER
Prothrombin timeOTHER OPTIONS
• NilSYNOPSIS
• Dicumarol like warfarin, is a 4-hydroxycoumarin derived anticoagulant that is used for treatment of thromboembolic conditions
• PT and INR is used to monitor the effectiveness of these anticoagulants
• It is used to assess the risk of bleeding or the coagulation status of patients undergoing dental surgical procdures
• There is no need to alter the dosage of these anticoagulants prior to dental extractions provided the INR is within the therapeutic range of 2- 4.
• Dental extractions should be done in least traumatic manner and local measures should be used to control post operative hemorrhage if any.REFERENCE
Extraction in patients on Oral Anticoagulant therapy – Journal of OMFSIncorrectANSWER
Prothrombin timeOTHER OPTIONS
• NilSYNOPSIS
• Dicumarol like warfarin, is a 4-hydroxycoumarin derived anticoagulant that is used for treatment of thromboembolic conditions
• PT and INR is used to monitor the effectiveness of these anticoagulants
• It is used to assess the risk of bleeding or the coagulation status of patients undergoing dental surgical procdures
• There is no need to alter the dosage of these anticoagulants prior to dental extractions provided the INR is within the therapeutic range of 2- 4.
• Dental extractions should be done in least traumatic manner and local measures should be used to control post operative hemorrhage if any.REFERENCE
Extraction in patients on Oral Anticoagulant therapy – Journal of OMFS - Question 117 of 300
117. Question
A mother bought a 6 years old child for filling. The dentist asked to place amalgam filling for that tooth. The mother said the child has done tooth coloured filling from another dentist before and she wants the same material to be done for her son. The dentist convinced her for amalgam and she got convinced. Which ethical principle is violated here?
CorrectANSWER
AutonomyOTHER OPTIONS
• Beneficiance – Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being
• Justice – means giving each person what he or she deserves or, in more traditional terms, giving each person his or her due
• Non maleficiance – The principle of nonmaleficence holds that there is an obligation not to inflict harm on othersSYNOPSIS
• Autonomy is the innate human right of a patient to control access to his or her body and what is done to him or her.
• It involves the right to choose who treats him or her, where heorshe is treated, and what treatment is used.
• It also involves authorization of the treatment.
• It is not enough for the patient to consent to a course of treatment- he must actually authorize the physician to go ahead with the chosen treatment.REFERENCE
Professionalism and Ethics Handbook for Residents (PEHR)- A Practical Guide.
Saudi Commission for Health Specialties, Riyadh – 2015IncorrectANSWER
AutonomyOTHER OPTIONS
• Beneficiance – Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being
• Justice – means giving each person what he or she deserves or, in more traditional terms, giving each person his or her due
• Non maleficiance – The principle of nonmaleficence holds that there is an obligation not to inflict harm on othersSYNOPSIS
• Autonomy is the innate human right of a patient to control access to his or her body and what is done to him or her.
• It involves the right to choose who treats him or her, where heorshe is treated, and what treatment is used.
• It also involves authorization of the treatment.
• It is not enough for the patient to consent to a course of treatment- he must actually authorize the physician to go ahead with the chosen treatment.REFERENCE
Professionalism and Ethics Handbook for Residents (PEHR)- A Practical Guide.
Saudi Commission for Health Specialties, Riyadh – 2015 - Question 118 of 300
118. Question
Inflammation and bleeding on probing around an implant are usually less than with natural teeth because
CorrectANSWER
Less blood vesselsOTHER OPTIONS
• NilSYNOPSIS
• Surrounding soft tissues around implants have fewer blood vessels than teeth, therefore, inflammation is typically less around implants than around natural teethREFERENCE
Dental Implant Prosthetics – Carl.E. MischIncorrectANSWER
Less blood vesselsOTHER OPTIONS
• NilSYNOPSIS
• Surrounding soft tissues around implants have fewer blood vessels than teeth, therefore, inflammation is typically less around implants than around natural teethREFERENCE
Dental Implant Prosthetics – Carl.E. Misch - Question 119 of 300
119. Question
Behaviour modification is based on the principle of
CorrectANSWER
Social learning theoryOTHER OPTIONS
• NilSYNOPSIS
• Behaviour shaping is a form of behaviour modification technique based on principles of Social learning
• It is the procedure that slowly develops desired behaviour
• The behaviour shaping techniques are
– Desensitisation(TSD)
– Modelling
– Contingency ManagementREFERENCE
Textbook of Pedodontics by Shobha TandonIncorrectANSWER
Social learning theoryOTHER OPTIONS
• NilSYNOPSIS
• Behaviour shaping is a form of behaviour modification technique based on principles of Social learning
• It is the procedure that slowly develops desired behaviour
• The behaviour shaping techniques are
– Desensitisation(TSD)
– Modelling
– Contingency ManagementREFERENCE
Textbook of Pedodontics by Shobha Tandon - Question 120 of 300
120. Question
What is the way of treatment called if you have rewarded a 5 years old child who behaved well in treatment?
CorrectANSWER
Positive ReinforcementOTHER OPTIONS
• Tell show do – for easy learning
• Negative reinforcement – is the removal of a negative outcome to strengthen a behavior.SYNOPSIS
• Positive reinforcement occurs when a certain behavior results in a positive outcome, making the behavior likely to be repeated in the future. This behavioral psychology concept can be used to teach and strengthen behaviors.
• Examples-
– Praise- After you execute a turn during a skiing lesson, your instructor shouts out, Great jobI
– Monetary rewards- At work, you exceed this months sales quota, so your boss gives you a bonus.REFERENCE
Positive reinforcement and operant conditioning- Kendra CherryIncorrectANSWER
Positive ReinforcementOTHER OPTIONS
• Tell show do – for easy learning
• Negative reinforcement – is the removal of a negative outcome to strengthen a behavior.SYNOPSIS
• Positive reinforcement occurs when a certain behavior results in a positive outcome, making the behavior likely to be repeated in the future. This behavioral psychology concept can be used to teach and strengthen behaviors.
• Examples-
– Praise- After you execute a turn during a skiing lesson, your instructor shouts out, Great jobI
– Monetary rewards- At work, you exceed this months sales quota, so your boss gives you a bonus.REFERENCE
Positive reinforcement and operant conditioning- Kendra Cherry - Question 121 of 300
121. Question
A 44-year-old man with a noncontributory medical history visited the clinic for reconstruction of the right edentulous posterior maxilla, he was a non-smoker. Radiographic examination revealed a partially pneumatized right maxillary sinus requiring sinus floor elevation and an available bone height of approximately 4–6 mm. The treatment plan included the simultaneous placement of dental implants and sinus augmentation, because the patient had sufficient residual bone to ensure primary stability of the dental implants. Clinical and radiographic screening before the sinus augmentation procedure showed neither history nor acute signs of sinus-related pathology. Which is the most common complication during sinus surgery?
CorrectANSWER
Sinus perforationOTHER OPTIONS
• NilSYNOPSIS
• The most frequent intraoperative complication with sinus elevation is perforation of the Schneiderian membrane.
• The repair of this perforation is necessary to contain particulate grafting material and complete the procedure.
• A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a pouch that can completely contain the particulate material.
• Solutions proposed to treat the problems associated with sinus membrane perforations include the following
1. Abort the procedure and attempt after the perforation has healed.
2. Use a stabilized block graft without attempting to repair the perforation.
3. Repair the perforation with collagen membranes or lamellar bone.REFERENCE
Repair of Large Sinus Membrane Perforations Using Stabilized CollagenBarrier Membranes – Surgical Techniques with Histologic and Radiographic evidence of success.IncorrectANSWER
Sinus perforationOTHER OPTIONS
• NilSYNOPSIS
• The most frequent intraoperative complication with sinus elevation is perforation of the Schneiderian membrane.
• The repair of this perforation is necessary to contain particulate grafting material and complete the procedure.
• A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a pouch that can completely contain the particulate material.
• Solutions proposed to treat the problems associated with sinus membrane perforations include the following
1. Abort the procedure and attempt after the perforation has healed.
2. Use a stabilized block graft without attempting to repair the perforation.
3. Repair the perforation with collagen membranes or lamellar bone.REFERENCE
Repair of Large Sinus Membrane Perforations Using Stabilized CollagenBarrier Membranes – Surgical Techniques with Histologic and Radiographic evidence of success. - Question 122 of 300
122. Question
Related question. How will you manage the above mentioned condition?
CorrectANSWER
Stabilised block graftOTHER OPTIONS
• NilSYNOPSIS
• The most frequent intraoperative complication with sinus elevation is perforation of the Schneiderian membrane.
• The repair of this perforation is necessary to contain particulate grafting material and complete the procedure.
• A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a pouch that can completely contain the particulate material.
• Solutions proposed to treat the problems associated with sinus membrane perforations include the following
1. Abort the procedure and attempt after the perforation has healed.
2. Use a stabilized block graft without attempting to repair the perforation.
3. Repair the perforation with collagen membranes or lamellar bone.REFERENCE
Repair of Large Sinus Membrane Perforations Using Stabilized CollagenBarrier Membranes – Surgical Techniques with Histologic and Radiographic evidence of success.IncorrectANSWER
Stabilised block graftOTHER OPTIONS
• NilSYNOPSIS
• The most frequent intraoperative complication with sinus elevation is perforation of the Schneiderian membrane.
• The repair of this perforation is necessary to contain particulate grafting material and complete the procedure.
• A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a pouch that can completely contain the particulate material.
• Solutions proposed to treat the problems associated with sinus membrane perforations include the following
1. Abort the procedure and attempt after the perforation has healed.
2. Use a stabilized block graft without attempting to repair the perforation.
3. Repair the perforation with collagen membranes or lamellar bone.REFERENCE
Repair of Large Sinus Membrane Perforations Using Stabilized CollagenBarrier Membranes – Surgical Techniques with Histologic and Radiographic evidence of success. - Question 123 of 300
123. Question
A70-year-old attended your office for the replacement of his missing teeth. On intraoral examination, completely edentulous maxillary and mandibular arches. In making a final impression, in this case, the most important area of the impression is?
CorrectANSWER
Junction of the hard and soft plate of maxilla and distolingual area of mandible.OTHER OPTIONS
• NilSYNOPSIS
• Junction of the hard and soft palates on which pressure within the physiological limits of the tissues can be applied by a denture to aid in the retention of the denture is the Posterior Palatal Seal Area.
• This area aids in retention by maintaining constant contact with the soft palate during functional movements like speech, mastication and deglutition.
• The lingual flange of the mandibular denture (distolingual area) should be turned into the anteroinferior part to produce maximum stability for the denture since no muscle lies directly underneath.REFERENCE
Textbook of Prosthodontics- Deepak Nallaswamy.IncorrectANSWER
Junction of the hard and soft plate of maxilla and distolingual area of mandible.OTHER OPTIONS
• NilSYNOPSIS
• Junction of the hard and soft palates on which pressure within the physiological limits of the tissues can be applied by a denture to aid in the retention of the denture is the Posterior Palatal Seal Area.
• This area aids in retention by maintaining constant contact with the soft palate during functional movements like speech, mastication and deglutition.
• The lingual flange of the mandibular denture (distolingual area) should be turned into the anteroinferior part to produce maximum stability for the denture since no muscle lies directly underneath.REFERENCE
Textbook of Prosthodontics- Deepak Nallaswamy. - Question 124 of 300
124. Question
Which of the following factor does not help to make a crown most retentive?
CorrectANSWER
Crown with short axial wallsOTHER OPTIONS
• Large preparation taper reduced the load at fracture of monolithic zirconia crowns. A larger pre-defined cement space improved seating but did not affect the load at fracture.
• The estimated cement thickness – values of crowns with 15° taper and different settings for cement space measured by the replica method,SYNOPSIS
• Crown retention and resistance form are primarily related to crown length, total occlusal convergence degree, and axial surface area.
• Secondary retention and resistance form may be derived from boxes, grooves, or pins placed in solid tooth structure.
• The relationship of axial wall height to prepared tooth width also greatly influences crown retention and resistance form.
• The axial wall height must be great enough to prevent the rotation of the casting around a point on the opposite margin.
• A crown on a short tooth preparation has a greater tendency toward displacement than a crown on a tooth of the same axial wall height with a smaller diameter.
• Sound tooth structure should provide the principal source of retention.
• When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult.REFERENCE
Short clinical crowns (SCC) – treatment considerations and techniques. Ashu SharmaIncorrectANSWER
Crown with short axial wallsOTHER OPTIONS
• Large preparation taper reduced the load at fracture of monolithic zirconia crowns. A larger pre-defined cement space improved seating but did not affect the load at fracture.
• The estimated cement thickness – values of crowns with 15° taper and different settings for cement space measured by the replica method,SYNOPSIS
• Crown retention and resistance form are primarily related to crown length, total occlusal convergence degree, and axial surface area.
• Secondary retention and resistance form may be derived from boxes, grooves, or pins placed in solid tooth structure.
• The relationship of axial wall height to prepared tooth width also greatly influences crown retention and resistance form.
• The axial wall height must be great enough to prevent the rotation of the casting around a point on the opposite margin.
• A crown on a short tooth preparation has a greater tendency toward displacement than a crown on a tooth of the same axial wall height with a smaller diameter.
• Sound tooth structure should provide the principal source of retention.
• When the clinical crowns of teeth are dimensionally inadequate, esthetically and biologically acceptable restoration of these dental units is difficult.REFERENCE
Short clinical crowns (SCC) – treatment considerations and techniques. Ashu Sharma - Question 125 of 300
125. Question
A 12-year-old child complains of pain in lower left back tooth region since 2 weeks. On examination, 75 is decayed and having intraoral sinus without mobility. On radiographic examination, radiolucency involving enamel, dentin and pulp. There is absence of premolar tooth bud. Hence, in the absence of premolar tooth bud, the roots of the primary molar will most likely?
CorrectANSWER
Resorb more slowly than normalOTHER OPTIONS
• NilSYNOPSIS
• When a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc.
• Such congenital missing of permanent teeth is a commonly observed phenomenon in human beings, and it often accompanies delayed retention of primary teeth.
• The etiologic factors for congenital missing include not only systemic diseases, but also local factors and human evolution process.
• In the radiographs of such cases of primary teeth without succeeding permanent teeth show pathologic root resorption which progresses at a slower rate than normal.REFERENCE
ROOT RESORPTION OF PRIMARY TEETH WITHOUT PERMANENT SUCCESSORS – Journal of Korean Academy of Pediatric DentistryIncorrectANSWER
Resorb more slowly than normalOTHER OPTIONS
• NilSYNOPSIS
• When a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc.
• Such congenital missing of permanent teeth is a commonly observed phenomenon in human beings, and it often accompanies delayed retention of primary teeth.
• The etiologic factors for congenital missing include not only systemic diseases, but also local factors and human evolution process.
• In the radiographs of such cases of primary teeth without succeeding permanent teeth show pathologic root resorption which progresses at a slower rate than normal.REFERENCE
ROOT RESORPTION OF PRIMARY TEETH WITHOUT PERMANENT SUCCESSORS – Journal of Korean Academy of Pediatric Dentistry - Question 126 of 300
126. Question
A 60 year old female patient wants a complete denture for the upper and lower arch. Few periodontally compromised incisors, lone standing molars and root stumps were present. You decided to do a total extraction followed by prosthetic rehabilitation by complete denture. A figure of eight motion is used for extraction of which tooth?
CorrectANSWER
Lower molarOTHER OPTIONS
• Upper incisors – have single, conical roots and are therefore rotated with a purposeful action, the forceps turning through as wide an arc as possible without damaging adjacent teeth.
• The upper canine – because its root is slightly flattened mesiodistally, can be extracted by an outward buccal movement if it is resistant to rotation.
• Lower premolars – and canines have conical roots and are therefore rotated.SYNOPSIS
• It is better to use Figure 8 movements in extraction of bulky lower molar teeth.
• The lower molar teeth are the most common teeth extracted, and many complications occur during and after extraction of these teeth.
• It was found that using figure 8 movements gives better results in comparison to the using of bucco – lingual rocking movements and this may be due to the exertion of less force during extraction, and the socket was less expanded which results in less complications and promote healing.REFERENCE
Manual of Minor Oral Surgery – Karl R KoernerIncorrectANSWER
Lower molarOTHER OPTIONS
• Upper incisors – have single, conical roots and are therefore rotated with a purposeful action, the forceps turning through as wide an arc as possible without damaging adjacent teeth.
• The upper canine – because its root is slightly flattened mesiodistally, can be extracted by an outward buccal movement if it is resistant to rotation.
• Lower premolars – and canines have conical roots and are therefore rotated.SYNOPSIS
• It is better to use Figure 8 movements in extraction of bulky lower molar teeth.
• The lower molar teeth are the most common teeth extracted, and many complications occur during and after extraction of these teeth.
• It was found that using figure 8 movements gives better results in comparison to the using of bucco – lingual rocking movements and this may be due to the exertion of less force during extraction, and the socket was less expanded which results in less complications and promote healing.REFERENCE
Manual of Minor Oral Surgery – Karl R Koerner - Question 127 of 300
127. Question
Retention in class 3 is achieved by?
CorrectANSWER
Acid etchingOTHER OPTIONS
• NilSYNOPSIS
• Class III tooth preparations – By definition, are located on proximal surfaces of anterior teeth.
• Conventional Class III Tooth Preparation – The primary indication for this type of Class III preparation is for the restoration of root surfaces, and preparation of the portion on the root surface that has no enamel.
• Because the bond of composite to enamel and dentin is so strong, most Class III composite restorations are retained only by the micromechanical bond from acid-etching and resin bonding, so no additional preparation retention form is usually necessary.REFERENCE
Retention of Class 3 composite restorations retention grooves versus enamel bonding. J B SummittIncorrectANSWER
Acid etchingOTHER OPTIONS
• NilSYNOPSIS
• Class III tooth preparations – By definition, are located on proximal surfaces of anterior teeth.
• Conventional Class III Tooth Preparation – The primary indication for this type of Class III preparation is for the restoration of root surfaces, and preparation of the portion on the root surface that has no enamel.
• Because the bond of composite to enamel and dentin is so strong, most Class III composite restorations are retained only by the micromechanical bond from acid-etching and resin bonding, so no additional preparation retention form is usually necessary.REFERENCE
Retention of Class 3 composite restorations retention grooves versus enamel bonding. J B Summitt - Question 128 of 300
128. Question
What is loss of interdental bone including the facial plates, lingual plates or both without concomitant loss of radicular bone called?
CorrectANSWER
Reverse bone architectureOTHER OPTIONS
• Buttressing bone formation – Buttressing bone formation has been described as the development of thickened or exostotic buccal alveolar bone in response to heavy occlusal forces.
• Hemiseptal defect – Hemiseptal defects provide very little source of osteoblasts and lack of support from bony wall which results in collapse of wound space thereby limiting the amount of regeneration.SYNOPSIS
• Reverse architecture is the marginal bone loss which occurs in such a way that the interdental gingiva or bone crest is apically located to the margins of their midfacial or mid-lingual levels.
• Reverse architecture is more commonly observed in the maxilla compared to the mandible.
• This occurs as a result of the loss of interdental bone of the facial, lingual and palatal plates, while radicular bone is preserved. Thus, bone heights appear reversed from the normal architecture of alveolar boneREFERENCE
Periodontal Osseous Defects A Review. – CODS Journal of DentistryIncorrectANSWER
Reverse bone architectureOTHER OPTIONS
• Buttressing bone formation – Buttressing bone formation has been described as the development of thickened or exostotic buccal alveolar bone in response to heavy occlusal forces.
• Hemiseptal defect – Hemiseptal defects provide very little source of osteoblasts and lack of support from bony wall which results in collapse of wound space thereby limiting the amount of regeneration.SYNOPSIS
• Reverse architecture is the marginal bone loss which occurs in such a way that the interdental gingiva or bone crest is apically located to the margins of their midfacial or mid-lingual levels.
• Reverse architecture is more commonly observed in the maxilla compared to the mandible.
• This occurs as a result of the loss of interdental bone of the facial, lingual and palatal plates, while radicular bone is preserved. Thus, bone heights appear reversed from the normal architecture of alveolar boneREFERENCE
Periodontal Osseous Defects A Review. – CODS Journal of Dentistry - Question 129 of 300
129. Question
A patient supposed to undergo chemotherapy in coming days sent to you by his physician for routine dental check up. You planned to extract grossly decayed teeth 45 and 46. When will you give appointment for him?
CorrectANSWER
Before 2 weeksOTHER OPTIONS
• NilSYNOPSIS
Before Head and Neck Radiation Therapy
• Conduct a pretreatment oral health examination and prophylaxis.
• Schedule dental treatment in consultation with the radiation oncologist.
• Extract teeth in the proposed radiation field that may be a problem in the future.
• Prevent tooth demineralization and radiation caries
– Fabricate custom gel-applicator trays for the patient.
– Prescribe a 1.1 percent neutral pH sodium fluoride gel or a 0.4 percent stannous, unflavored fluoride gel (not fluoride rinses).
– Use a neutral fluoride for patients with porcelain crowns or resin or glass ionomer restorations.
– Be sure that the trays cover all tooth structures without irritating the gingival or mucosal tissues.
– Instruct the patient in home application of fluoride gel. Several days before radiation therapy begins, the patient should start a daily 10-minute application.
– Have patients brush with a fluoride gel if using trays is difficult.
• Allow at least 14 days of healing for any oral surgical procedures.
• Conduct prosthetic surgery before treatment, since elective surgical procedures are contraindicated on irradiated bone.REFERENCE
Dental Provider’s Oncology Pocket Guide Prevention and management of oral complications Head and Neck Radiation Therapy. U.S. Department of Health and Human Services National Institutes of Health
National Institute of Dental and Craniofacial ResearchIncorrectANSWER
Before 2 weeksOTHER OPTIONS
• NilSYNOPSIS
Before Head and Neck Radiation Therapy
• Conduct a pretreatment oral health examination and prophylaxis.
• Schedule dental treatment in consultation with the radiation oncologist.
• Extract teeth in the proposed radiation field that may be a problem in the future.
• Prevent tooth demineralization and radiation caries
– Fabricate custom gel-applicator trays for the patient.
– Prescribe a 1.1 percent neutral pH sodium fluoride gel or a 0.4 percent stannous, unflavored fluoride gel (not fluoride rinses).
– Use a neutral fluoride for patients with porcelain crowns or resin or glass ionomer restorations.
– Be sure that the trays cover all tooth structures without irritating the gingival or mucosal tissues.
– Instruct the patient in home application of fluoride gel. Several days before radiation therapy begins, the patient should start a daily 10-minute application.
– Have patients brush with a fluoride gel if using trays is difficult.
• Allow at least 14 days of healing for any oral surgical procedures.
• Conduct prosthetic surgery before treatment, since elective surgical procedures are contraindicated on irradiated bone.REFERENCE
Dental Provider’s Oncology Pocket Guide Prevention and management of oral complications Head and Neck Radiation Therapy. U.S. Department of Health and Human Services National Institutes of Health
National Institute of Dental and Craniofacial Research - Question 130 of 300
130. Question
Which appliance is not used for class III skeletal growth pattern?
CorrectANSWER
ActivatorOTHER OPTIONS
• Several appliances are used for early treatment of skeletal Class III, including
– Bionator
– Frankel (FR-III)
– Chin cup
– Double-plate appliance
– Eschler appliance progenic appliance
– Protraction face mask.SYNOPSIS
• Activator is a functional appliance used to correct Class II malocclusion in growing patients.
• It corrects the malocclusion stimulating mandibular growth and determining a palatoversion of the upper incisors and a vestibularization of the lower incisors.
• Uses of activator
– Helps to grow jaws into normal position.
– Corrects Deep bite.
– Overjet treatment.
– Prevents open bite.
– Stops bad habits like using the tongue to touch and push teeth and thumb sucking habits in children.
– It can act as a nightguard to prevent sleep clenching and bruxism.
– Prevents eruption of overcrowded back teeth.
– Activator can also be used as a retainer.REFERENCE
Activator appliance definition uses and important tips – KIDODENTIncorrectANSWER
ActivatorOTHER OPTIONS
• Several appliances are used for early treatment of skeletal Class III, including
– Bionator
– Frankel (FR-III)
– Chin cup
– Double-plate appliance
– Eschler appliance progenic appliance
– Protraction face mask.SYNOPSIS
• Activator is a functional appliance used to correct Class II malocclusion in growing patients.
• It corrects the malocclusion stimulating mandibular growth and determining a palatoversion of the upper incisors and a vestibularization of the lower incisors.
• Uses of activator
– Helps to grow jaws into normal position.
– Corrects Deep bite.
– Overjet treatment.
– Prevents open bite.
– Stops bad habits like using the tongue to touch and push teeth and thumb sucking habits in children.
– It can act as a nightguard to prevent sleep clenching and bruxism.
– Prevents eruption of overcrowded back teeth.
– Activator can also be used as a retainer.REFERENCE
Activator appliance definition uses and important tips – KIDODENT - Question 131 of 300
131. Question
Which is false about internal resorption?
CorrectANSWER
Moth eaten appearanceOTHER OPTIONS
• NilSYNOPSIS
• Internal root resorption is the progressive destruction of intraradicular dentin and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities.
• It is seen as a radiolucent area around the pulpal cavity, usually of incisors and mandibular molars.
• They are discovered by chance on routine radiographs or by the clinical sign of a pink spot on the crown. The pulp can either show partial or complete necrosis.
• Internal root resorption is managed by root canal treatment followed by restoration.
• Internal root resorption is rare in permanent teeth.REFERENCE
Shafer’s textbook of Oral PathologyIncorrectANSWER
Moth eaten appearanceOTHER OPTIONS
• NilSYNOPSIS
• Internal root resorption is the progressive destruction of intraradicular dentin and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities.
• It is seen as a radiolucent area around the pulpal cavity, usually of incisors and mandibular molars.
• They are discovered by chance on routine radiographs or by the clinical sign of a pink spot on the crown. The pulp can either show partial or complete necrosis.
• Internal root resorption is managed by root canal treatment followed by restoration.
• Internal root resorption is rare in permanent teeth.REFERENCE
Shafer’s textbook of Oral Pathology - Question 132 of 300
132. Question
How do you manage porous denture base?
CorrectANSWER
RebaseOTHER OPTIONS
• Re-lining is a temporary solution for ill-fitting dentures
• Indications for relining
1. Loss of retention
2. Instability
3. Food trapping
4. Abused mucosa
5. As a temporary measure to maintain the function of an immediate dentureSYNOPSIS
• The rebasing of prosthetic bases find its indication in the re-adapting of a used prosthesis, (recent or old) to the support surfaces in order to promote better prosthetic integration and to improve the aesthetic and function of the oral system.
• Indications
– Porous or artifact of the denture base
– Loss of retention and stability
– Should have correct jaw relations
– When the patient cannot afford a new denture
– Geriatric or chronically ill patients who cannot withstand the physical and mental stress of the construction of new dentures.REFERENCE
Rebasing as a Problem-Solving in Complete Dentures – Saudi Journal of Oral and Dental ResearchIncorrectANSWER
RebaseOTHER OPTIONS
• Re-lining is a temporary solution for ill-fitting dentures
• Indications for relining
1. Loss of retention
2. Instability
3. Food trapping
4. Abused mucosa
5. As a temporary measure to maintain the function of an immediate dentureSYNOPSIS
• The rebasing of prosthetic bases find its indication in the re-adapting of a used prosthesis, (recent or old) to the support surfaces in order to promote better prosthetic integration and to improve the aesthetic and function of the oral system.
• Indications
– Porous or artifact of the denture base
– Loss of retention and stability
– Should have correct jaw relations
– When the patient cannot afford a new denture
– Geriatric or chronically ill patients who cannot withstand the physical and mental stress of the construction of new dentures.REFERENCE
Rebasing as a Problem-Solving in Complete Dentures – Saudi Journal of Oral and Dental Research - Question 133 of 300
133. Question
A 20 years old boy presented with increased overjet without crowding. How to camouflage?
CorrectANSWER
Extraction of the maxillary first premolarOTHER OPTIONS
• NilSYNOPSIS
• The classical features of class II, div 1 malocclusion include a mild to severe class II skeletal base with an Angles class II molar relation and class II canine and incisor relations, proclined maxillary incisors and an increased overjet and it generally has convex profile with incompetent lips.
• Its management frequently involves the use of a myofunctional appliance in growing patients, but in the nongrowing, adult patients, it usually includes an orthognathic surgery or selective removal of the permanent teeth, with a subsequent dental camouflage to mask the skeletal discrepancy.
• For the correction of the class II malocclusions in non-growing patients, the extractions can involve 2 maxillary premolars or 2 maxillary and 2 mandibular premolars
• The extraction of only 2 maxillary premolars is generally indicated when there is no crowding or cephalometric discrepancy in the mandibular arch.
• The extraction of 4 premolars is indicated primarily for crowding in the mandibular arch, a cephalometric discrepancy, or a combination of both, in growing patients.
• Recent studies have shown that patient satisfaction with a camouflage treatment is similar to that which is achieved with a surgical mandibular advancement and that the treatment with two maxillary premolar extractions gives a better occlusal result than the treatment with four premolar extractionsREFERENCE
Orthodontic Camouflage Treatment in an Adult Patient with a Class II, Division 1 Malocclusion – A Case Report -Journal of Clinical and Diagnostic ResearchIncorrectANSWER
Extraction of the maxillary first premolarOTHER OPTIONS
• NilSYNOPSIS
• The classical features of class II, div 1 malocclusion include a mild to severe class II skeletal base with an Angles class II molar relation and class II canine and incisor relations, proclined maxillary incisors and an increased overjet and it generally has convex profile with incompetent lips.
• Its management frequently involves the use of a myofunctional appliance in growing patients, but in the nongrowing, adult patients, it usually includes an orthognathic surgery or selective removal of the permanent teeth, with a subsequent dental camouflage to mask the skeletal discrepancy.
• For the correction of the class II malocclusions in non-growing patients, the extractions can involve 2 maxillary premolars or 2 maxillary and 2 mandibular premolars
• The extraction of only 2 maxillary premolars is generally indicated when there is no crowding or cephalometric discrepancy in the mandibular arch.
• The extraction of 4 premolars is indicated primarily for crowding in the mandibular arch, a cephalometric discrepancy, or a combination of both, in growing patients.
• Recent studies have shown that patient satisfaction with a camouflage treatment is similar to that which is achieved with a surgical mandibular advancement and that the treatment with two maxillary premolar extractions gives a better occlusal result than the treatment with four premolar extractionsREFERENCE
Orthodontic Camouflage Treatment in an Adult Patient with a Class II, Division 1 Malocclusion – A Case Report -Journal of Clinical and Diagnostic Research - Question 134 of 300
134. Question
Which is the narrowest canal found in molars?
CorrectANSWER
DistobuccalOTHER OPTIONS
• Not applicableSYNOPSIS
• Distobuccal canal system of the maxillary first molar is the smallest.
• It is the smallest of the canals present in terms of volume, length, and surface area with around 2.25 mm3, 24 mm, and 18.75 mm2, respectively.REFERENCE
Permanent Maxillary Molars. By Said Dhaimy.IncorrectANSWER
DistobuccalOTHER OPTIONS
• Not applicableSYNOPSIS
• Distobuccal canal system of the maxillary first molar is the smallest.
• It is the smallest of the canals present in terms of volume, length, and surface area with around 2.25 mm3, 24 mm, and 18.75 mm2, respectively.REFERENCE
Permanent Maxillary Molars. By Said Dhaimy. - Question 135 of 300
135. Question
Where you can find the interproximal caries?
CorrectANSWER
At or below the contact pointOTHER OPTIONS
• Not applicableSYNOPSIS
• Interproximal caries lesions develop between the contacting proximal surfaces of two adjacent teeth, at or just below the contact point.
• They first appear clinically as opaque regions and are caused by the loss of enamel translucency at the outermost enamel between the contact point and the top of the free gingival margin.REFERENCE
Grossman’s Endodontic PracticeIncorrectANSWER
At or below the contact pointOTHER OPTIONS
• Not applicableSYNOPSIS
• Interproximal caries lesions develop between the contacting proximal surfaces of two adjacent teeth, at or just below the contact point.
• They first appear clinically as opaque regions and are caused by the loss of enamel translucency at the outermost enamel between the contact point and the top of the free gingival margin.REFERENCE
Grossman’s Endodontic Practice - Question 136 of 300
136. Question
A patient underwent third molar surgical extraction and develop swelling post-operatively. How to reduce post-operative swelling?
CorrectANSWER
Ice and hot packsOTHER OPTIONS
• Steroids – use of the steroid has been applied for the reduction of facial swelling after oral surgery and 3rd molar extraction. Cyclooxygenase-1 (COX1) and COX2 have been reported to be important enzymes for the inflammatory process, and steroids inhibit their synthesis, consequently reducing postoperative edema
• Antibiotics – The use of antibiotics is generally recommended before surgery to prevent post-operative infectionsSYNOPSIS
• In case of post-operativee swelling – apply ice packs to the face in the area of extraction for 30 minutes on, then 10 minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.REFERENCE
Post Operative Instructions for Extraction Patient – Stanley F MalamedIncorrectANSWER
Ice and hot packsOTHER OPTIONS
• Steroids – use of the steroid has been applied for the reduction of facial swelling after oral surgery and 3rd molar extraction. Cyclooxygenase-1 (COX1) and COX2 have been reported to be important enzymes for the inflammatory process, and steroids inhibit their synthesis, consequently reducing postoperative edema
• Antibiotics – The use of antibiotics is generally recommended before surgery to prevent post-operative infectionsSYNOPSIS
• In case of post-operativee swelling – apply ice packs to the face in the area of extraction for 30 minutes on, then 10 minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.REFERENCE
Post Operative Instructions for Extraction Patient – Stanley F Malamed - Question 137 of 300
137. Question
A chronic liver failure patient came for a routine dental check-up. His oral hygiene status was satisfactory. Which supplement we can give a chronic liver failure patient?
CorrectANSWER
Vitamin DOTHER OPTIONS
• Vitamin K deficiency is caused by decreased liver storage levels and is associated with increased risk of bleeding
• Vitamin A – Because high doses of vitamin A are potentially hepatotoxic, care must be taken to avoid excessive supplementationSYNOPSIS
• A proposed guideline is to supplement all patients who have chronic liver disease with calcium (1 g per day) and vitamin D3 (800 IU per day).
• Vitamin D deficiency results from ingest reduction, decreased absorption (due to cholestatic disease or portal hypertension enteropathy), and reduction of exposure to UV light.
• Since vitamin D is hydroxylated in the liver to produce calcidiol, patients with severe parenchymal or obstructive hepatic disease may have reduced production of this metabolite.
• The majority of the liver must be dysfunctional before calcidiol synthesis is reduced. Thus, these patients rarely manifest biochemical or histological evidence of osteomalacia, unless concomitant nutritional deficiency or interruption of the enterohepatic circulation occurs.
• Extremely low serum levels of vitamin D are associated with increased mortality in patients with chronic liver disease.REFERENCE
Nutrition in Chronic Liver Disease. – Marco Silva.IncorrectANSWER
Vitamin DOTHER OPTIONS
• Vitamin K deficiency is caused by decreased liver storage levels and is associated with increased risk of bleeding
• Vitamin A – Because high doses of vitamin A are potentially hepatotoxic, care must be taken to avoid excessive supplementationSYNOPSIS
• A proposed guideline is to supplement all patients who have chronic liver disease with calcium (1 g per day) and vitamin D3 (800 IU per day).
• Vitamin D deficiency results from ingest reduction, decreased absorption (due to cholestatic disease or portal hypertension enteropathy), and reduction of exposure to UV light.
• Since vitamin D is hydroxylated in the liver to produce calcidiol, patients with severe parenchymal or obstructive hepatic disease may have reduced production of this metabolite.
• The majority of the liver must be dysfunctional before calcidiol synthesis is reduced. Thus, these patients rarely manifest biochemical or histological evidence of osteomalacia, unless concomitant nutritional deficiency or interruption of the enterohepatic circulation occurs.
• Extremely low serum levels of vitamin D are associated with increased mortality in patients with chronic liver disease.REFERENCE
Nutrition in Chronic Liver Disease. – Marco Silva. - Question 138 of 300
138. Question
What is the color of no 6 k file?
CorrectANSWER
PinkOTHER OPTIONS
• Purple – k file 10 no.
• Gray – K file 8 noSYNOPSIS
• The color band enables easy identification by the supervising faculty.
• The method of color coding suggested will assist dental hygienists and clinicians in their everyday practice, not only in inventory control but in chairside practice.
• The color code makes each instrument readily recognizable.REFERENCE
Grossman’s Endodontic practiceIncorrectANSWER
PinkOTHER OPTIONS
• Purple – k file 10 no.
• Gray – K file 8 noSYNOPSIS
• The color band enables easy identification by the supervising faculty.
• The method of color coding suggested will assist dental hygienists and clinicians in their everyday practice, not only in inventory control but in chairside practice.
• The color code makes each instrument readily recognizable.REFERENCE
Grossman’s Endodontic practice - Question 139 of 300
139. Question
Which of the following consequences may occur when an amalgam restoration is not polished?
CorrectANSWER
Greater risk of tarnish and corrosionOTHER OPTIONS
• NilSYNOPSIS
• Amalgam restorations often tarnish and corrode in oral environment.
• The degree of tarnish and the resulting discoloration appear to be very dependent upon every individual’s oral environment and to a certain extent, upon the particular alloy employed.
• The polished group of each type of commercial amalgam possesses the lowest corrosion current density and the carved group shows the highest corrosion current density.
• This trend was not affected by the chemical composition of commercial amalgams.REFERENCE
A Review on Dental Amalgam Corrosion and Its Consequences M. Fathi PhD.IncorrectANSWER
Greater risk of tarnish and corrosionOTHER OPTIONS
• NilSYNOPSIS
• Amalgam restorations often tarnish and corrode in oral environment.
• The degree of tarnish and the resulting discoloration appear to be very dependent upon every individual’s oral environment and to a certain extent, upon the particular alloy employed.
• The polished group of each type of commercial amalgam possesses the lowest corrosion current density and the carved group shows the highest corrosion current density.
• This trend was not affected by the chemical composition of commercial amalgams.REFERENCE
A Review on Dental Amalgam Corrosion and Its Consequences M. Fathi PhD. - Question 140 of 300
140. Question
A patient came to the clinic complaining of pain and soreness in his jaw early in the morning. Upon history taking, the patient’s spouse informed the dentist that he grinds his teeth while sleeping. Which of the following is the name of this parafunctional habit?
CorrectANSWER
BruxismOTHER OPTIONS
• Clenching – Teeth grinding and jaw clenching (also called bruxism) is often related to stress or anxiety. It does not always cause symptoms, but some people get facial pain and headaches, and it can wear down your teeth over time
• Thumb sucking – Thumb sucking can cause changes in the palate (roof of the mouth) and jaw and can affect when the teeth erupt through the gums.
• Tongue thrusting – causes macroglossia (enlarged tongue), thumb sucking, large tonsils, hereditary factors, ankyloglossia (tongue tie), and certain types of artificial nipples used in feeding infants.SYNOPSIS
• Bruxism may involve teeth grinding, gnashing the teeth, or tightening the jaw and jaw clenching.
• It can also mean mastication (chewing) in one’s sleep.
• Sleep bruxism is considered a sleep-related movement disorder.
• People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).REFERENCE
Bruxism (teeth grinding) – Ravikiran Ongole 2nd edition.IncorrectANSWER
BruxismOTHER OPTIONS
• Clenching – Teeth grinding and jaw clenching (also called bruxism) is often related to stress or anxiety. It does not always cause symptoms, but some people get facial pain and headaches, and it can wear down your teeth over time
• Thumb sucking – Thumb sucking can cause changes in the palate (roof of the mouth) and jaw and can affect when the teeth erupt through the gums.
• Tongue thrusting – causes macroglossia (enlarged tongue), thumb sucking, large tonsils, hereditary factors, ankyloglossia (tongue tie), and certain types of artificial nipples used in feeding infants.SYNOPSIS
• Bruxism may involve teeth grinding, gnashing the teeth, or tightening the jaw and jaw clenching.
• It can also mean mastication (chewing) in one’s sleep.
• Sleep bruxism is considered a sleep-related movement disorder.
• People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).REFERENCE
Bruxism (teeth grinding) – Ravikiran Ongole 2nd edition. - Question 141 of 300
141. Question
A dentist accidentally got needle prick injury while suturing a patient after extraction. What will be the first thing to be done?
CorrectANSWER
Wash with soap and waterOTHER OPTIONS
• NilSYNOPSIS
• Needlestick injuries are associated with a number of blood-borne infections and are common among dental health professionals.
• Percutaneous exposure incidents facilitate the transmission of bloodborne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV).
• The UK Health And Safety Executive has a guideline to deal with needle stick injuries
– If you suffer an injury from a sharp which may be contaminated
1. Encourage the wound to gently bleed, ideally holding it under running water
2. Wash the wound using running water and plenty of soap
3. Don’t scrub the wound while you are washing it
4. Don’t suck the wound
5. Dry the wound and cover it with a waterproof plaster or dressing
6. Seek urgent medical advice (for example from your occupational health service) as effective prophylaxis (medicines to help fight infection) are available
7. Report the injury
8 Assess the patient’s RiskREFERENCE
Guidelines to deal with needle stick injuries -The UK Health And Safety ExecutiveIncorrectANSWER
Wash with soap and waterOTHER OPTIONS
• NilSYNOPSIS
• Needlestick injuries are associated with a number of blood-borne infections and are common among dental health professionals.
• Percutaneous exposure incidents facilitate the transmission of bloodborne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV).
• The UK Health And Safety Executive has a guideline to deal with needle stick injuries
– If you suffer an injury from a sharp which may be contaminated
1. Encourage the wound to gently bleed, ideally holding it under running water
2. Wash the wound using running water and plenty of soap
3. Don’t scrub the wound while you are washing it
4. Don’t suck the wound
5. Dry the wound and cover it with a waterproof plaster or dressing
6. Seek urgent medical advice (for example from your occupational health service) as effective prophylaxis (medicines to help fight infection) are available
7. Report the injury
8 Assess the patient’s RiskREFERENCE
Guidelines to deal with needle stick injuries -The UK Health And Safety Executive - Question 142 of 300
142. Question
You were presented with a 10 years old boy who showed missing tooth 36. Identify the pathology from the given image?
CorrectANSWER
Dentigerous cystOTHER OPTIONS
• Other options do not applySYNOPSIS
• Dentigerous cyst is a developmental odontogenic cyst associated with impacted teeth.
• The cyst can be seen surrounding impacted teeth.
• Mostly involves mandibular third molars, followed by maxillary canines.
• Frequently found in younger patients.
• Small cysts are asymptomatic.
• Large cysts can be associated with a painless expansion of the bone.
• Upon aspiration, the content of the cyst lumen is usually thin, watery yellow fluid.
• More extensive lesions can cause facial asymmetry.
• Some can become infected, swollen, and painful.
• Unilocular radiolucency associated with an unerupted tooth, well-defined sclerotic border.
– Management
• Enucleation of cyst and removal of associated tooth
• Occasionally, orthodontic treatment can help with tooth eruption
• Large cysts can be treated initially with marsupialization and excision laterREFERENCE
Shafer’s textbook of oral pathology,- 8th editionIncorrectANSWER
Dentigerous cystOTHER OPTIONS
• Other options do not applySYNOPSIS
• Dentigerous cyst is a developmental odontogenic cyst associated with impacted teeth.
• The cyst can be seen surrounding impacted teeth.
• Mostly involves mandibular third molars, followed by maxillary canines.
• Frequently found in younger patients.
• Small cysts are asymptomatic.
• Large cysts can be associated with a painless expansion of the bone.
• Upon aspiration, the content of the cyst lumen is usually thin, watery yellow fluid.
• More extensive lesions can cause facial asymmetry.
• Some can become infected, swollen, and painful.
• Unilocular radiolucency associated with an unerupted tooth, well-defined sclerotic border.
– Management
• Enucleation of cyst and removal of associated tooth
• Occasionally, orthodontic treatment can help with tooth eruption
• Large cysts can be treated initially with marsupialization and excision laterREFERENCE
Shafer’s textbook of oral pathology,- 8th edition - Question 143 of 300
143. Question
What is the main cause of white spots after braces removal?
CorrectANSWER
Demineralization of enamelOTHER OPTIONS
• Other options do not applySYNOPSIS
• Demineralization is an inevitable side-effect associated with fixed orthodontic treatment, especially when associated with poor oral hygiene.
• White spot lesions develop in association with brackets, bands, arch wires, ligatures, and other orthodontic devices that complicate conventional oral hygiene measures, leading to prolonged plaque accumulation.
• The acidic byproducts of the bacteria in plaque are responsible for the subsequent enamel demineralization and formation of white spot lesions.
• These can cause caries thereby leading to poor esthetics, patient dissatisfaction, and legal complications.
• Orthodontists must take up the active responsibility to educate patients about the importance of maintaining good dietary compliance and an excellent oral hygiene regimeREFERENCE
Risk factors and management of white spot lesions in orthodontics – Journal of Orthodontic Science. 2013IncorrectANSWER
Demineralization of enamelOTHER OPTIONS
• Other options do not applySYNOPSIS
• Demineralization is an inevitable side-effect associated with fixed orthodontic treatment, especially when associated with poor oral hygiene.
• White spot lesions develop in association with brackets, bands, arch wires, ligatures, and other orthodontic devices that complicate conventional oral hygiene measures, leading to prolonged plaque accumulation.
• The acidic byproducts of the bacteria in plaque are responsible for the subsequent enamel demineralization and formation of white spot lesions.
• These can cause caries thereby leading to poor esthetics, patient dissatisfaction, and legal complications.
• Orthodontists must take up the active responsibility to educate patients about the importance of maintaining good dietary compliance and an excellent oral hygiene regimeREFERENCE
Risk factors and management of white spot lesions in orthodontics – Journal of Orthodontic Science. 2013 - Question 144 of 300
144. Question
Which of the following is a disadvantage of polyvinyl siloxane impression materials?
CorrectANSWER
Inhibition of setting caused by some brands of latex glovesOTHER OPTIONS
• NilSYNOPSIS
• Some brands of latex gloves as received from the distributor caused severe retardation or complete inhibition of setting in most vinyl polysiloxane putties, other brands of latex gloves affected the setting in the vinyl polysiloxane putties to varying degrees.
• Polyvinyl siloxane impression materials have one major disadvantage – They have a significant interaction with latex (rubber dam and latex gloves).
• Direct inhibition of polymerization also can occur if the impression material is in contact with a rubber dam.REFERENCE
Polyvinyl Siloxane – Philips Science of Dental MaterialsIncorrectANSWER
Inhibition of setting caused by some brands of latex glovesOTHER OPTIONS
• NilSYNOPSIS
• Some brands of latex gloves as received from the distributor caused severe retardation or complete inhibition of setting in most vinyl polysiloxane putties, other brands of latex gloves affected the setting in the vinyl polysiloxane putties to varying degrees.
• Polyvinyl siloxane impression materials have one major disadvantage – They have a significant interaction with latex (rubber dam and latex gloves).
• Direct inhibition of polymerization also can occur if the impression material is in contact with a rubber dam.REFERENCE
Polyvinyl Siloxane – Philips Science of Dental Materials - Question 145 of 300
145. Question
Screening for oral cancer comes under which level of prevention?
CorrectANSWER
SecondaryOTHER OPTIONS
• Primary – In primary prevention, a disorder is actually prevented from developing. Vaccinations, counseling to change high-risk behaviors, and sometimes chemoprevention are types of primary prevention.
• Tertiary – In tertiary prevention, an existing, usually chronic disease is managed to prevent complications or further damage
• Primordial – Primordial prevention is defined as preventing the risk factor.SYNOPSIS
• In secondary prevention, the disease is detected and treated early, often before symptoms are present, thereby minimizing serious consequences
• Secondary prevention can involve screening programs, such as mammography to detect breast cancer and dual x-ray absorptiometry (DXA) to detect osteoporosis.
• It can also involve tracking down the sex partners of a person diagnosed with a sexually transmitted infection (contact tracing) and treating these people, if necessary, to minimize the spread of the disease.REFERENCE
Essentials of Public Health Dentistry – Soben PeterIncorrectANSWER
SecondaryOTHER OPTIONS
• Primary – In primary prevention, a disorder is actually prevented from developing. Vaccinations, counseling to change high-risk behaviors, and sometimes chemoprevention are types of primary prevention.
• Tertiary – In tertiary prevention, an existing, usually chronic disease is managed to prevent complications or further damage
• Primordial – Primordial prevention is defined as preventing the risk factor.SYNOPSIS
• In secondary prevention, the disease is detected and treated early, often before symptoms are present, thereby minimizing serious consequences
• Secondary prevention can involve screening programs, such as mammography to detect breast cancer and dual x-ray absorptiometry (DXA) to detect osteoporosis.
• It can also involve tracking down the sex partners of a person diagnosed with a sexually transmitted infection (contact tracing) and treating these people, if necessary, to minimize the spread of the disease.REFERENCE
Essentials of Public Health Dentistry – Soben Peter - Question 146 of 300
146. Question
Lack of space in primary dentition predisposes to?
CorrectANSWER
Crowding in permanent dentitionOTHER OPTIONS
• Delayed eruption of permanent teeth – Can be due to retained primary teeth, due to any underlying syndromes, or supernumerary teethSYNOPSIS
• The premature loss of primary teeth may cause space loss.
• This can reduce the arch length required for the succeeding tooth and, hence, predisposes crowding, rotation, and impaction of the permanent teeth.REFERENCE
Prevalence of early loss of primary teeth in 5–10-year-old school children – S. Syed Shaheed AhmedIncorrectANSWER
Crowding in permanent dentitionOTHER OPTIONS
• Delayed eruption of permanent teeth – Can be due to retained primary teeth, due to any underlying syndromes, or supernumerary teethSYNOPSIS
• The premature loss of primary teeth may cause space loss.
• This can reduce the arch length required for the succeeding tooth and, hence, predisposes crowding, rotation, and impaction of the permanent teeth.REFERENCE
Prevalence of early loss of primary teeth in 5–10-year-old school children – S. Syed Shaheed Ahmed - Question 147 of 300
147. Question
Mr. Dawood, a 54-year-old man with a history of type 2 diabetes. He arrives at the clinic with complaints of tooth sensitivity and decay in his lower right molars. As you begin to review his medical history and vital signs, you notice that his blood sugar level is recorded at 65 mg per dL. Mr. Dawood appears to be conscious and responsive, though slightly pale and sweaty. He mentions feeling a bit dizzy but attributes it to nervousness about the dental procedure. You are now faced with the decision of how to proceed with his restorative treatment, considering his low blood sugar levels and his history of diabetes. What are the basic treatment considerations for such patients?
CorrectANSWER
Early morning appointmentsOTHER OPTIONS
• NilSYNOPSIS
• In general morning appointments are advisable since endogenous cortisol levels are generally higher at this time.
• Dentists need to measure the blood glucose level before beginning a procedure.
• Patients with low plasma glucose levels below 70 mg per dl should be given an oral carbohydrate before treatment to minimize the risk of a hypoglycemic event.REFERENCE
Dental management consideration for the patient with diabetic Mellitus – Rajesh VIncorrectANSWER
Early morning appointmentsOTHER OPTIONS
• NilSYNOPSIS
• In general morning appointments are advisable since endogenous cortisol levels are generally higher at this time.
• Dentists need to measure the blood glucose level before beginning a procedure.
• Patients with low plasma glucose levels below 70 mg per dl should be given an oral carbohydrate before treatment to minimize the risk of a hypoglycemic event.REFERENCE
Dental management consideration for the patient with diabetic Mellitus – Rajesh V - Question 148 of 300
148. Question
A 12-year-old child rushes into your clinic accompanied by their distressed parent. The child has just experienced a traumatic incident during a sporting event, resulting in the complete avulsion of one of their front teeth. What medication is advised for a case of avulsed tooth for connective tissue regeneration?
CorrectANSWER
EmdogainOTHER OPTIONS
• Amlodipine – It is used with or without other medications to treat high blood pressure.
• Ibuprofen – Ibuprofen did not affect muscle mass or muscle fiber regeneration.SYNOPSIS
• Emdogain is used to help treat and reverse the effects of periodontal disease and gum recession in conjunction with periodontal surgery.
• Emdogain is made up of a unique group of proteins called enamel matrix proteins.
• These proteins are the same proteins that helped the teeth develop in the early development stage.REFERENCE
Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects – M EspositoIncorrectANSWER
EmdogainOTHER OPTIONS
• Amlodipine – It is used with or without other medications to treat high blood pressure.
• Ibuprofen – Ibuprofen did not affect muscle mass or muscle fiber regeneration.SYNOPSIS
• Emdogain is used to help treat and reverse the effects of periodontal disease and gum recession in conjunction with periodontal surgery.
• Emdogain is made up of a unique group of proteins called enamel matrix proteins.
• These proteins are the same proteins that helped the teeth develop in the early development stage.REFERENCE
Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects – M Esposito - Question 149 of 300
149. Question
Why do dental procedures are recommended the next day after dialysis for a patient with renal disease?
CorrectANSWER
Anticoagulant effect of heparin used in dialysis have dissipatedOTHER OPTIONS
• NilSYNOPSIS
• Patients typically receive dialysis three times a week.
• Dental treatment for a patient on dialysis should be done on the day between dialysis appointments to avoid bleeding difficulties.
• Patients on dialysis receive heparin, which can increase the risk of bleeding in these patients.REFERENCE
Dental secrets, 4th edition, page number 37.IncorrectANSWER
Anticoagulant effect of heparin used in dialysis have dissipatedOTHER OPTIONS
• NilSYNOPSIS
• Patients typically receive dialysis three times a week.
• Dental treatment for a patient on dialysis should be done on the day between dialysis appointments to avoid bleeding difficulties.
• Patients on dialysis receive heparin, which can increase the risk of bleeding in these patients.REFERENCE
Dental secrets, 4th edition, page number 37. - Question 150 of 300
150. Question
An 8-year-old child is referred to your care due to limited mouth opening and difficulty in jaw movement. The child’s parents report that this issue has been present for a few years after an accidental fall, gradually worsening over time.Upon examination, you notice a restricted range of jaw movement, with the patient’s mouth opening being significantly limited. Palpation reveals stiffness and minimal mobility of the temporomandibular joint (TMJ) area. The child displays difficulty in speaking, eating, and maintaining proper oral hygiene due to these limitations. Additionally, facial asymmetry is evident, with the affected side showing reduced development compared to the unaffected side.Considering the clinical findings and the young age of the patient, the potential diagnosis will be?
CorrectANSWER
AnkylosisOTHER OPTIONS
• Trismus – Trismus, also sometimes called lockjaw, is a painful condition in which the chewing muscles of the jaw become contracted and sometimes inflamed, preventing the mouth from fully opening.
• Subluxation – A subluxation will occur in a TMJ whose articular eminence has a relatively short steep posterior slope (the functional side of the joint), whereas the anterior surface of the articular eminence has longer and less steep slope
• Muscle contraction – It is the activation of tension-generating sites within muscle cells.SYNOPSIS
• Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues.
• This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life-threatening when struggling to acquire an airway in an emergency.
• The management goal in TMJ ankylosis is to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent ankylosis.REFERENCE
Management of temporomandibular joint ankylosis. – Reza MovahedIncorrectANSWER
AnkylosisOTHER OPTIONS
• Trismus – Trismus, also sometimes called lockjaw, is a painful condition in which the chewing muscles of the jaw become contracted and sometimes inflamed, preventing the mouth from fully opening.
• Subluxation – A subluxation will occur in a TMJ whose articular eminence has a relatively short steep posterior slope (the functional side of the joint), whereas the anterior surface of the articular eminence has longer and less steep slope
• Muscle contraction – It is the activation of tension-generating sites within muscle cells.SYNOPSIS
• Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues.
• This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life-threatening when struggling to acquire an airway in an emergency.
• The management goal in TMJ ankylosis is to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent ankylosis.REFERENCE
Management of temporomandibular joint ankylosis. – Reza Movahed - Question 151 of 300
151. Question
Imagine a scenario where a dental clinic has been encountering a concerning pattern among a group of patients. These patients consistently complain of lingering dental pain that not only persists but also becomes severe enough to awaken them from their sleep during the night. As a healthcare professional, you are puzzled by this consistent presentation and are tasked with determining the potential underlying cause or condition that could be responsible for this specific pattern of dental discomfort. Taking into consideration the patients’ descriptions of their symptoms, their demographic information, and any relevant medical history, what would be your diagnostic assessment and potential hypotheses regarding the most likely ailment or condition these patients might be suffering from?
CorrectANSWER
Irreversible pulpitisOTHER OPTIONS
• Reversible Pulpitis – Non lingering pain that subsides on removal of stimuli
• Pulp necrosis – No response to vitality testSYNOPSIS
• Irreversible pulpitis is when the inflammation has completely damaged the pulp, which can’t be saved.
• Symptoms of irreversible pulpitis include
– Nocturnal pain
– Spontaneous pain
– Sensitivity to cold that lasts more than 30 seconds
– Sensitivity to heat
– Pain when the tooth is tapped
– Swelling around tooth and gums
– Fever
– Pain on lying down
– Pain that is radiating
– Trouble finding which tooth is causing the pain
• As inflammation builds in the tooth, the pulp can die. This can happen with irreversible pulpitis and, once this occurs, the pain will stop.REFERENCE
Dental Pulp Testing, A Review.- International Journal of Dentistry. 2009IncorrectANSWER
Irreversible pulpitisOTHER OPTIONS
• Reversible Pulpitis – Non lingering pain that subsides on removal of stimuli
• Pulp necrosis – No response to vitality testSYNOPSIS
• Irreversible pulpitis is when the inflammation has completely damaged the pulp, which can’t be saved.
• Symptoms of irreversible pulpitis include
– Nocturnal pain
– Spontaneous pain
– Sensitivity to cold that lasts more than 30 seconds
– Sensitivity to heat
– Pain when the tooth is tapped
– Swelling around tooth and gums
– Fever
– Pain on lying down
– Pain that is radiating
– Trouble finding which tooth is causing the pain
• As inflammation builds in the tooth, the pulp can die. This can happen with irreversible pulpitis and, once this occurs, the pain will stop.REFERENCE
Dental Pulp Testing, A Review.- International Journal of Dentistry. 2009 - Question 152 of 300
152. Question
You come across a perplexing case involving a patient who presents with a specific set of symptoms related to their dental health. The patient reports experiencing sharp and transient pain when consuming cold beverages or food, particularly when they come into contact with a specific tooth exhibiting mesial caries. However, what strikes you as unusual is that the pain, although intense, does not linger after the cold stimulus is removed. Drawing upon your dental expertise, medical history evaluation, and clinical observations, can you accurately diagnose this patient’s condition and provide a comprehensive explanation of the underlying process causing these distinct pain sensations?
CorrectANSWER
Reversible pulpitisOTHER OPTIONS
• Irreversible pulpitis – Sensitive to heat and percussion
• Acute periodontal disease – Percussion test will be positive
• Dentinal hypersensitivity – Short intense pain while having hot or cold food stuffsSYNOPSIS
• Pulpitis is an inflammation of the pulp.
• It usually happens when there’s an irritation inside a tooth due to things such as grinding or a cavity
• There are two types of pulpitis.
– Reversible pulpitis – In this early stage, pulpitis is reversible if treated
– Irreversible pulpitis – In this stage, the inflammation is more advanced and the tooth can’t recover. The pulp tissue will eventually die. This is pulp necrosis.
• Symptoms of reversible pulpitis include
– No pain when your dentist taps the tooth.
– No sensitivity to heat.
– Sensitivity to cold or sweets that goes away quickly or non lingering pain
• For reversible pulpitis, removal of the the cause can reverse the condition.
• Often, this involves the removal of the decay and sealing the tooth with a normal filling.REFERENCE
Grossman’s Endodontic PracticeIncorrectANSWER
Reversible pulpitisOTHER OPTIONS
• Irreversible pulpitis – Sensitive to heat and percussion
• Acute periodontal disease – Percussion test will be positive
• Dentinal hypersensitivity – Short intense pain while having hot or cold food stuffsSYNOPSIS
• Pulpitis is an inflammation of the pulp.
• It usually happens when there’s an irritation inside a tooth due to things such as grinding or a cavity
• There are two types of pulpitis.
– Reversible pulpitis – In this early stage, pulpitis is reversible if treated
– Irreversible pulpitis – In this stage, the inflammation is more advanced and the tooth can’t recover. The pulp tissue will eventually die. This is pulp necrosis.
• Symptoms of reversible pulpitis include
– No pain when your dentist taps the tooth.
– No sensitivity to heat.
– Sensitivity to cold or sweets that goes away quickly or non lingering pain
• For reversible pulpitis, removal of the the cause can reverse the condition.
• Often, this involves the removal of the decay and sealing the tooth with a normal filling.REFERENCE
Grossman’s Endodontic Practice - Question 153 of 300
153. Question
A 45-year-old individual presents with a routine dental examination. As you examine their dental radiographs, you notice a distinctive pattern in one of their teeth. Specifically, you observe a prominent and excessive cementum deposition along a particular tooth’s roots. Upon further discussion with the patient, you learn that they have been visiting the dentist regularly and maintaining a diligent oral hygiene routine. They deny any history of significant trauma to the affected tooth or the surrounding area. Additionally, the patient does not report any noticeable discomfort, pain, or swelling associated with the tooth exhibiting hypercementosis. Given the intriguing nature of this case, what might be the cause of hypercementosis of teeth?
CorrectANSWER
Cementum deposition on apexOTHER OPTIONS
• Not applicableSYNOPSIS
• Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth.
• A thicker layer of cementum can give the tooth an enlarged appearance, which mainly occurs at the apex or apices of the tooth.
• The local factors implicated to cause hypercementosis are occlusal trauma, inflammation secondary to pulpal or periodontal disease, tooth mobility, repair of root fracture and transplantation of teeth
• Patients with hypercementosis require no treatment.
• Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth.REFERENCE
Shafer’s Textbook of Oral PathologyIncorrectANSWER
Cementum deposition on apexOTHER OPTIONS
• Not applicableSYNOPSIS
• Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth.
• A thicker layer of cementum can give the tooth an enlarged appearance, which mainly occurs at the apex or apices of the tooth.
• The local factors implicated to cause hypercementosis are occlusal trauma, inflammation secondary to pulpal or periodontal disease, tooth mobility, repair of root fracture and transplantation of teeth
• Patients with hypercementosis require no treatment.
• Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth.REFERENCE
Shafer’s Textbook of Oral Pathology - Question 154 of 300
154. Question
A 7-year-old patient arrives with their concerned parents. Upon examination, you find that the child has recently lost their primary first molar due to severe decay. The adjacent primary second molar is intact, and there is a significant space between these two teeth. The parents express their worries about the gap left by the lost tooth and inquire about the best course of action to ensure proper dental development for their child. They are particularly concerned about the possibility of crowding and misalignment of permanent teeth as the child grows. Given the clinical scenario, you consider the potential benefits of using a band and loop space maintainer. Which is the best indication for band and loop space maintainer?
CorrectANSWER
Single molar spaceOTHER OPTIONS
• Not applicableSYNOPSIS
– Indications of Band and loop Space maintainers
• In case of premature loss of any primary molar in primary dentition, or mixed dentition with permenant successor not erupting clinically for the next 2 years and its root length is formed less than one third
• Premature loss of a primary second molar as the permanent first molar is erupted clinically
• Bilateral loss of single primary molar before eruption of permanent incisorsREFERENCE
Textbook of Pedodontics – Shobha TandonIncorrectANSWER
Single molar spaceOTHER OPTIONS
• Not applicableSYNOPSIS
– Indications of Band and loop Space maintainers
• In case of premature loss of any primary molar in primary dentition, or mixed dentition with permenant successor not erupting clinically for the next 2 years and its root length is formed less than one third
• Premature loss of a primary second molar as the permanent first molar is erupted clinically
• Bilateral loss of single primary molar before eruption of permanent incisorsREFERENCE
Textbook of Pedodontics – Shobha Tandon - Question 155 of 300
155. Question
You encounter a challenging case involving a young patient who presents with a noticeable and persistent enlargement of the gingival tissues. As you examine the patient’s oral cavity, you observe a significant overgrowth of the gum tissue, which seems to extend beyond the normal boundaries and cover a considerable portion of the tooth surfaces. Further inquiry into the patient’s medical history reveals that this condition has been present since childhood, raising concerns about its potential implications for both oral health and overall well-being. The patient’s parents also share their worries about the impact of this gingival enlargement on the child’s self-esteem and quality of life. Considering this intriguing case, you begin to explore the various syndromes associated with gingival fibromatosis. Which of the following may show gingival fibromatosis?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported.
• Clinical syndromic presentation includes
– Zimmermann-Laband syndrome,
– Ramon syndrome,
– Rutherford syndrome,
– Cowden syndrome,
– Cross syndrome,
– Gohlich-Ratmann syndrome,
– Avani syndrome, and
– I-cell disease.
• However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported.
• Treatment of choice is usually gingivectomy with gingivoplasty.
• Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.REFERENCE
Current concepts on gingival fibromatosis-related syndromesIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported.
• Clinical syndromic presentation includes
– Zimmermann-Laband syndrome,
– Ramon syndrome,
– Rutherford syndrome,
– Cowden syndrome,
– Cross syndrome,
– Gohlich-Ratmann syndrome,
– Avani syndrome, and
– I-cell disease.
• However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported.
• Treatment of choice is usually gingivectomy with gingivoplasty.
• Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.REFERENCE
Current concepts on gingival fibromatosis-related syndromes - Question 156 of 300
156. Question
65-year-old individual, presents with a distinct concern – the noticeable loss of horizontal overlap between their upper and lower teeth. This condition has been causing difficulty in chewing, speaking, and maintaining proper oral hygiene.
Upon examination, you observe a significant lack of anterior guidance due to the absence of proper horizontal overlap. The patient’s upper and lower teeth do not come together harmoniously during various jaw movements, resulting in a compromised occlusal relationship. The patient expresses their frustration with the functional challenges they face and their desire to regain the ability to eat comfortably and communicate effectively.What will be caused by loss of horizontal overlap between upper and lower teeth in complete dentures?CorrectANSWER
Cheek bitingOTHER OPTIONS
• Tongue bite – Lack of lingual overjet – teeth generally placed lingual to lower ridge. Treated by remove lower lingual cusps, or reset teeth.
• Gagging – Over extended post damSYNOPSIS
• The most common cause of cheek biting is due to presence of inadequate overjet between the maxillary and mandibular anterior teeth.
• It can be corrected by increasing the over jet by reducing the buccal surface of lower posterior teeth.
• Cheek biting is also due to loss of vertical dimension, because of this cheeks tend to occlude between the occlusal surface of the dentureREFERENCE
Identification of complete denture problems – A summary – J. F. McCordIncorrectANSWER
Cheek bitingOTHER OPTIONS
• Tongue bite – Lack of lingual overjet – teeth generally placed lingual to lower ridge. Treated by remove lower lingual cusps, or reset teeth.
• Gagging – Over extended post damSYNOPSIS
• The most common cause of cheek biting is due to presence of inadequate overjet between the maxillary and mandibular anterior teeth.
• It can be corrected by increasing the over jet by reducing the buccal surface of lower posterior teeth.
• Cheek biting is also due to loss of vertical dimension, because of this cheeks tend to occlude between the occlusal surface of the dentureREFERENCE
Identification of complete denture problems – A summary – J. F. McCord - Question 157 of 300
157. Question
A patient approaches you with a complaint that he consistently experiences painful cheek bites caused by the newly inserted complete denture. This issue has been significantly impacting their ability to eat, speak, and maintain their daily activities without discomfort.Upon examination, you notice signs of trauma and inflammation on the inner cheek mucosa that are consistent with the patient’s complaints of cheek biting. What would you do if the patient complains of cheek bite when you fit a new complete denture?
CorrectANSWER
Grind buccal of lower teethOTHER OPTIONS
• NilSYNOPSIS
• Cheek biting usually occurs due to
– Insufficient overjet, in the posterior region
– Very lax cheek
– Reduced vertical dimension
• Treatment includes
– Increase buccal overjet
– Remove the last molars
– Grind the buccal surface of lower posteriorsREFERENCE
Textbook of Prosthodontics – Deepak NallaswamyIncorrectANSWER
Grind buccal of lower teethOTHER OPTIONS
• NilSYNOPSIS
• Cheek biting usually occurs due to
– Insufficient overjet, in the posterior region
– Very lax cheek
– Reduced vertical dimension
• Treatment includes
– Increase buccal overjet
– Remove the last molars
– Grind the buccal surface of lower posteriorsREFERENCE
Textbook of Prosthodontics – Deepak Nallaswamy - Question 158 of 300
158. Question
You are a dentist working in a family dental practice, and you have a pregnant patient, Mrs. Fatin, who is in her first trimester. She presents with severe pain and swelling on the right side of her face. After reviewing her medical history and performing a dental examination, you diagnose an acute infection in her right first molar.Mrs. Fatin is visibly distressed due to the pain and swelling, and she expresses concern about receiving treatment while pregnant. As a responsible and informed dentist, you must carefully consider her condition and the potential risks to both her and the developing fetus before deciding on an appropriate treatment plan.Which of the following is safe in a pregnant patient in the first trimester with an acutely infected first molar?
CorrectANSWER
PenicillinOTHER OPTIONS
• Radiograph – Taking radiographs during the first trimester of pregnancy affects the development of the fetus.
• Extraction – Extraction is contraindicated in the first trimester of pregnancy.SYNOPSIS
• Penicillin is the antibiotic of choice for a pregnant woman.
• Penicillin is not harmful to the fetus when taken by pregnant mothers.
• It is not incorporated into the bony tissue or in the teeth of children.REFERENCE
Dental Decks part 2IncorrectANSWER
PenicillinOTHER OPTIONS
• Radiograph – Taking radiographs during the first trimester of pregnancy affects the development of the fetus.
• Extraction – Extraction is contraindicated in the first trimester of pregnancy.SYNOPSIS
• Penicillin is the antibiotic of choice for a pregnant woman.
• Penicillin is not harmful to the fetus when taken by pregnant mothers.
• It is not incorporated into the bony tissue or in the teeth of children.REFERENCE
Dental Decks part 2 - Question 159 of 300
159. Question
Related question – In the above case which medication should be avoided ?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Some antibiotics are known to be teratogenic and should be avoided entirely during pregnancy. These include streptomycin and kanamycin (which may cause hearing loss) and tetracycline (which can lead to weakening, hypoplasia, and discoloration of long bones and teeth).
• If valproate is taken during pregnancy, know that there is a higher risk that the child may have birth defects or may score lower on cognitive tests (tests that measure mental ability and capacity, such as IQ tests) in childhood than any other anti-seizure medicine during pregnancy.REFERENCE
Medicines in PregnancyIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Some antibiotics are known to be teratogenic and should be avoided entirely during pregnancy. These include streptomycin and kanamycin (which may cause hearing loss) and tetracycline (which can lead to weakening, hypoplasia, and discoloration of long bones and teeth).
• If valproate is taken during pregnancy, know that there is a higher risk that the child may have birth defects or may score lower on cognitive tests (tests that measure mental ability and capacity, such as IQ tests) in childhood than any other anti-seizure medicine during pregnancy.REFERENCE
Medicines in Pregnancy - Question 160 of 300
160. Question
Which of the following may cause secondary dentin deposition?
CorrectANSWER
TraumaOTHER OPTIONS
• Explained belowSYNOPSIS
• Secondary dentin is dentin deposited in the pulp chamber after the formation of primary dentin has been completed.
• Secondary dentin deposition may be part of physiologic aging and may result from such innocuous stimuli as chewing or slight trauma.
• Tertiary dentin (also referred to as reactive or reparative dentin) is produced in reaction to various stimuli, such as attrition, caries, or a restorative dental procedureREFERENCE
Dentin Deposition – Ten Cate’s Oral HistologyIncorrectANSWER
TraumaOTHER OPTIONS
• Explained belowSYNOPSIS
• Secondary dentin is dentin deposited in the pulp chamber after the formation of primary dentin has been completed.
• Secondary dentin deposition may be part of physiologic aging and may result from such innocuous stimuli as chewing or slight trauma.
• Tertiary dentin (also referred to as reactive or reparative dentin) is produced in reaction to various stimuli, such as attrition, caries, or a restorative dental procedureREFERENCE
Dentin Deposition – Ten Cate’s Oral Histology - Question 161 of 300
161. Question
What is the treatment of choice for a patient under IV bisphosphonate therapy with badly decayed molar shows pain?
CorrectANSWER
RCT to root stumpsOTHER OPTIONS
• Explained belowSYNOPSIS
• The most common complication in patients on bisphosphonate therapy is osteonecrosis of the jaw which occurs after any surgical dental procedure.
• According to the information currently available, risk for developing bisphosphonate associated osteonecrosis of jaw is higher in patients on IV bisphosphonate therapy than the patients on oral bisphosphonates as orally they are poorly absorbed
• In IV administered bisphosphonates, Zolendronate is the most potent bisphosphonate because of its high mineral binding affinity and FPPS enzyme inhibition
• For patients who have already started with the therapy, any elective procedures should be avoided if possible to avoid the risk of bisphosphonate induced osteonecrosis of jaw.
• Root canal treatment should be done rather than dental extraction when possible.
• Patients in which dental extractions are unavoidable should be first consulted with the prescriber of bisphosphonate therapy for possible temporary interruption of drug if beneficial.
• Extraction should be done as atraumatically as possible and flap raising should be avoided.
• Sterile technique has to be followed.
• Patient should be kept on chlorhexidine mouthwash twice daily for two months and postoperatively 2 month follow up should be done.
• In some cases it has been recommended to do a root canal of the teeth followed by coronal amputation and leave the roots.REFERENCE
Dental complications and management of patients on bisphosphonate therapy- A review article -Journal of Oral Biology and Craniofacial ResearchIncorrectANSWER
RCT to root stumpsOTHER OPTIONS
• Explained belowSYNOPSIS
• The most common complication in patients on bisphosphonate therapy is osteonecrosis of the jaw which occurs after any surgical dental procedure.
• According to the information currently available, risk for developing bisphosphonate associated osteonecrosis of jaw is higher in patients on IV bisphosphonate therapy than the patients on oral bisphosphonates as orally they are poorly absorbed
• In IV administered bisphosphonates, Zolendronate is the most potent bisphosphonate because of its high mineral binding affinity and FPPS enzyme inhibition
• For patients who have already started with the therapy, any elective procedures should be avoided if possible to avoid the risk of bisphosphonate induced osteonecrosis of jaw.
• Root canal treatment should be done rather than dental extraction when possible.
• Patients in which dental extractions are unavoidable should be first consulted with the prescriber of bisphosphonate therapy for possible temporary interruption of drug if beneficial.
• Extraction should be done as atraumatically as possible and flap raising should be avoided.
• Sterile technique has to be followed.
• Patient should be kept on chlorhexidine mouthwash twice daily for two months and postoperatively 2 month follow up should be done.
• In some cases it has been recommended to do a root canal of the teeth followed by coronal amputation and leave the roots.REFERENCE
Dental complications and management of patients on bisphosphonate therapy- A review article -Journal of Oral Biology and Craniofacial Research - Question 162 of 300
162. Question
Which of the following may determine the quality of a good dentist?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The most important qualities a good dentist should have are
– Being knowledgeable,
– Being an expert in their field,
– Being trustworthy.
– A dentist should have excellent communication skills and be compassionateREFERENCE
Qualities of a Good Dentist. By Global Pre-MedsIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The most important qualities a good dentist should have are
– Being knowledgeable,
– Being an expert in their field,
– Being trustworthy.
– A dentist should have excellent communication skills and be compassionateREFERENCE
Qualities of a Good Dentist. By Global Pre-Meds - Question 163 of 300
163. Question
Which is the best medium for storage of avulsed teeth?
CorrectANSWER
MilkOTHER OPTIONS
• Saline – may be used for short-term storage but is not the best medium
• Water – has inadequate characteristics to be used as a storage medium for avulsed teeth because it has bacterial contamination, hypotonicity and nonphysiological pH, and osmolality, which favors the PDL cell lysisSYNOPSIS
• Milk can be employed as a storage media for avulsed teeth. It meets the following criteria for an interim storage media
(1) It has physiologic pH,
(2) Ability to preserve the viability of PDL cells,
(3) It has a low bacterial count and
(4) Commonly available.
• Milk cannot revitalize the dead cells but helps in preserving the vitality of PDL cells.
• Milk can maintain the viability, mitogenicity, and clonogenic capacity of PDL cells for as long as 24 hours.
• The fat content of milk has an effect on its ability to maintain PDL cell viability. The milk with low-fat content was found to be better than the milk with high-fat content.
• According to Saglas et al., storage of teeth in low-fat milk with ice as storage media is more effective than at room temperature
• In the presence of ice in milk, the apoptotic cell death of the periodontal ligament is further inhibited.
• In conclusion HBSS and chilled milk are the most appropriate, clinically recommended storage media for avulsed teeth.REFERENCE
Natural products as storage media for avulsed tooth- Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore,IncorrectANSWER
MilkOTHER OPTIONS
• Saline – may be used for short-term storage but is not the best medium
• Water – has inadequate characteristics to be used as a storage medium for avulsed teeth because it has bacterial contamination, hypotonicity and nonphysiological pH, and osmolality, which favors the PDL cell lysisSYNOPSIS
• Milk can be employed as a storage media for avulsed teeth. It meets the following criteria for an interim storage media
(1) It has physiologic pH,
(2) Ability to preserve the viability of PDL cells,
(3) It has a low bacterial count and
(4) Commonly available.
• Milk cannot revitalize the dead cells but helps in preserving the vitality of PDL cells.
• Milk can maintain the viability, mitogenicity, and clonogenic capacity of PDL cells for as long as 24 hours.
• The fat content of milk has an effect on its ability to maintain PDL cell viability. The milk with low-fat content was found to be better than the milk with high-fat content.
• According to Saglas et al., storage of teeth in low-fat milk with ice as storage media is more effective than at room temperature
• In the presence of ice in milk, the apoptotic cell death of the periodontal ligament is further inhibited.
• In conclusion HBSS and chilled milk are the most appropriate, clinically recommended storage media for avulsed teeth.REFERENCE
Natural products as storage media for avulsed tooth- Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore, - Question 164 of 300
164. Question
Which of the following conditions is characterized by enamel fracture and yellowish- brown discoloration of tooth?
CorrectANSWER
Enamel hypoplasiaOTHER OPTIONS
• Dentinogenesis imperfecta (DI) – It is a genetic disorder of tooth development. It is inherited in an autosomal dominant pattern, as a result of mutations on chromosome 4q21, in the dentine sialophosphoprotein gene (DSPP). It is one of the most frequently occurring autosomal dominant features in humans.
• Amelogenesis imperfecta – Amelogenesis imperfecta is a tooth development disorder. It causes the tooth enamel to be thin and abnormally formed. Enamel is the outer layer of the coronal, or crown portion of the teeth
• Dental dysplasia – Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pupal morphology. The teeth appear clinically normal in morphologic appearance and color.SYNOPSIS
• Enamel hypoplasia – An incomplete or defective formation of the organic enamel matrix of teeth. Local and systemic factors that interfere with normal matrix formation can cause enamel surface defects and irregularities.
• Clinical features of enamel hypoplasia are
– pits, tiny groves, depressions, and fissures
– White spots
– Yellowish-brown stains (where the underlying layer of dentin is exposed)
– Sensitivity to heat and cold
– Lack of tooth contact, the irregular wearing of teeth
– Susceptibility to acids in food and drink
– Retention of harmful bacteria
– Increased vulnerability to tooth decay and cavitiesREFERENCE
Shafers Textbook of Oral pathologyIncorrectANSWER
Enamel hypoplasiaOTHER OPTIONS
• Dentinogenesis imperfecta (DI) – It is a genetic disorder of tooth development. It is inherited in an autosomal dominant pattern, as a result of mutations on chromosome 4q21, in the dentine sialophosphoprotein gene (DSPP). It is one of the most frequently occurring autosomal dominant features in humans.
• Amelogenesis imperfecta – Amelogenesis imperfecta is a tooth development disorder. It causes the tooth enamel to be thin and abnormally formed. Enamel is the outer layer of the coronal, or crown portion of the teeth
• Dental dysplasia – Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pupal morphology. The teeth appear clinically normal in morphologic appearance and color.SYNOPSIS
• Enamel hypoplasia – An incomplete or defective formation of the organic enamel matrix of teeth. Local and systemic factors that interfere with normal matrix formation can cause enamel surface defects and irregularities.
• Clinical features of enamel hypoplasia are
– pits, tiny groves, depressions, and fissures
– White spots
– Yellowish-brown stains (where the underlying layer of dentin is exposed)
– Sensitivity to heat and cold
– Lack of tooth contact, the irregular wearing of teeth
– Susceptibility to acids in food and drink
– Retention of harmful bacteria
– Increased vulnerability to tooth decay and cavitiesREFERENCE
Shafers Textbook of Oral pathology - Question 165 of 300
165. Question
What is the treatment of choice for vital tooth with open apex which shows pulp exposure of greater than 1mm?
CorrectANSWER
ApexogenesisOTHER OPTIONS
• Apexification – For non-vital tooth
• Direct pulp capping – For incipient pulp exposure
• RCT – In closed apex casesSYNOPSIS
• Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end in young permanent tooth in cases of large traumatic exposure of pulp.
• It is a procedure where vital tissue within the tooth is maintained to facilitate the continued development of the immature root.
• A portion of the inflamed pulp is removed and filled with a bioceramic material that maintains vitality in the roots. Healthy tissue then allows for continued root development.
• Vital pulp capping with MTA in apexogenesis has superior long-term sealing ability and stimulates the formation of a higher quality and greater amount of reparative dentin.
• The calcified bridge formed by MTA is continuous and has no evidence of tunnel defects.REFERENCE
Apexogenesis and apexification with mineral trioxide aggregate (MTA)- a report of two cases -Endodontic PracticeIncorrectANSWER
ApexogenesisOTHER OPTIONS
• Apexification – For non-vital tooth
• Direct pulp capping – For incipient pulp exposure
• RCT – In closed apex casesSYNOPSIS
• Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end in young permanent tooth in cases of large traumatic exposure of pulp.
• It is a procedure where vital tissue within the tooth is maintained to facilitate the continued development of the immature root.
• A portion of the inflamed pulp is removed and filled with a bioceramic material that maintains vitality in the roots. Healthy tissue then allows for continued root development.
• Vital pulp capping with MTA in apexogenesis has superior long-term sealing ability and stimulates the formation of a higher quality and greater amount of reparative dentin.
• The calcified bridge formed by MTA is continuous and has no evidence of tunnel defects.REFERENCE
Apexogenesis and apexification with mineral trioxide aggregate (MTA)- a report of two cases -Endodontic Practice - Question 166 of 300
166. Question
What are the main goals to be considered in periodontal therapy?
CorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The goals of periodontal therapy are to
– Eliminate the local etiologic factors
– Preserve the natural dentition, periodontium and peri-implant tissues
– To maintain and improve periodontal and peri-implant health, comfort, esthetics, and function.
• Currently accepted clinical signs of a healthy periodontium include
– The absence of inflammatory signs of disease such as redness, swelling, suppuration, and bleeding on probing
– Maintenance of a functional periodontal attachment level
– Minimal or no recession in the absence of interproximal bone loss and functional dental implants.REFERENCE
Carranza’s Clinical PeriodontologyIncorrectANSWER
All of the aboveOTHER OPTIONS
• NilSYNOPSIS
• The goals of periodontal therapy are to
– Eliminate the local etiologic factors
– Preserve the natural dentition, periodontium and peri-implant tissues
– To maintain and improve periodontal and peri-implant health, comfort, esthetics, and function.
• Currently accepted clinical signs of a healthy periodontium include
– The absence of inflammatory signs of disease such as redness, swelling, suppuration, and bleeding on probing
– Maintenance of a functional periodontal attachment level
– Minimal or no recession in the absence of interproximal bone loss and functional dental implants.REFERENCE
Carranza’s Clinical Periodontology - Question 167 of 300
167. Question
Upon extraction of a lower molar, the dentist wants to achieve hemostasis and retain the clot. Which suture
is advised?CorrectANSWER
Figure of 8 sutureOTHER OPTIONS
• Horizontal mattress suture – This technique tightens both sides of the wound. This is beneficial to close soft tissues. This is the easiest way to fix two papillae with a single knot
• Interrupted suture – This is the most commonly used suture technique in Dental procedures like Impactions, Tooth extractions, etc.
• Continuous Suture – If there is a long incision, the continuous suture technique is preferredSYNOPSIS
• Figure of 8 suture
• This is a modified version of the horizontal mattress suture.
• While closing both sides of the soft tissue, this suture helps preserve the position of the clotREFERENCE
Suture techniques And Materials in Oral SurgeryIncorrectANSWER
Figure of 8 sutureOTHER OPTIONS
• Horizontal mattress suture – This technique tightens both sides of the wound. This is beneficial to close soft tissues. This is the easiest way to fix two papillae with a single knot
• Interrupted suture – This is the most commonly used suture technique in Dental procedures like Impactions, Tooth extractions, etc.
• Continuous Suture – If there is a long incision, the continuous suture technique is preferredSYNOPSIS
• Figure of 8 suture
• This is a modified version of the horizontal mattress suture.
• While closing both sides of the soft tissue, this suture helps preserve the position of the clotREFERENCE
Suture techniques And Materials in Oral Surgery - Question 168 of 300
168. Question
Which drug is used for trigeminal neuralgia?
CorrectANSWER
Any of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Carbamazepine and oxcarbazepine are considered first-line therapy in trigeminal neuralgia (TN).
• Lamotrigine and baclofen are second-line therapy.
• Other treatments are third line and the evidence for their efficacy is scant.REFERENCE
Essentials of Pharmacology for Dentistry – K D TripathiIncorrectANSWER
Any of the aboveOTHER OPTIONS
• NilSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Carbamazepine and oxcarbazepine are considered first-line therapy in trigeminal neuralgia (TN).
• Lamotrigine and baclofen are second-line therapy.
• Other treatments are third line and the evidence for their efficacy is scant.REFERENCE
Essentials of Pharmacology for Dentistry – K D Tripathi - Question 169 of 300
169. Question
Which is the newest technique for treatment of Trigeminal neuralgia?
CorrectANSWER
Microvascular DecompressionOTHER OPTIONS
• Not applicableSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Microvascular decompression (MVD) surgery has become the suggested treatment for trigeminal neuralgia which is the result of impingement on the nerve by a blood vessel.
• It is considered microsurgery, meaning it requires a much smaller incision, surgical site, and instruments to perform.
• It also means there is a shorter recovery time than other intracranial procedures.REFERENCE
MVD as a Trigeminal Neuralgia Treatment – Neurosurgeons of New JersyIncorrectANSWER
Microvascular DecompressionOTHER OPTIONS
• Not applicableSYNOPSIS
• Trigeminal neuralgia is a neurological condition in which the trigeminal nerve (the nerve that controls facial sensation) is damaged or compressed by a nearby blood vessel.
• Microvascular decompression (MVD) surgery has become the suggested treatment for trigeminal neuralgia which is the result of impingement on the nerve by a blood vessel.
• It is considered microsurgery, meaning it requires a much smaller incision, surgical site, and instruments to perform.
• It also means there is a shorter recovery time than other intracranial procedures.REFERENCE
MVD as a Trigeminal Neuralgia Treatment – Neurosurgeons of New Jersy - Question 170 of 300
170. Question
Which is the cellular layer that is absent in alveolar mucosa but present in attached gingival mucosa?
CorrectANSWER
Stratum corneumOTHER OPTIONS
• Not applicableSYNOPSIS
• Alveolar mucosa
– The area of tissue beyond the mucogingival junction.
– It seems less firmly attached and redder than the attached gingiva.
– It is non-keratinized and provides a softer and more flexible area for the movement of the cheeks and lips.
• Attached gingiva
– This tissue is adjacent to the free gingiva
– It is keratinized and firmly attached to the bone structure.
– It can range from 3-12 mm in height.
• The keratinized epithelium possesses a stratum corneum layer
• The stratum corneum is made up of flattened non-viable, non-nucleated epithelial cells containing keratin which is absent in non-keratinized epitheliumREFERENCE
Carranza’s Clinical PeriodontologyIncorrectANSWER
Stratum corneumOTHER OPTIONS
• Not applicableSYNOPSIS
• Alveolar mucosa
– The area of tissue beyond the mucogingival junction.
– It seems less firmly attached and redder than the attached gingiva.
– It is non-keratinized and provides a softer and more flexible area for the movement of the cheeks and lips.
• Attached gingiva
– This tissue is adjacent to the free gingiva
– It is keratinized and firmly attached to the bone structure.
– It can range from 3-12 mm in height.
• The keratinized epithelium possesses a stratum corneum layer
• The stratum corneum is made up of flattened non-viable, non-nucleated epithelial cells containing keratin which is absent in non-keratinized epitheliumREFERENCE
Carranza’s Clinical Periodontology - Question 171 of 300
171. Question
You are scheduled to perform a tooth extraction on a 30-year-old patient named Mr.Alex. His tooth has been causing him significant pain and discomfort due to decay and infection. As you assess his oral health and discuss the upcoming procedure, you notice that he is concerned about the possibility of post-operative swelling. Mr. Alex has important plans in the coming days and is worried that excessive swelling might impact his ability to fulfill his responsibilities. He expresses a strong desire to minimize post-operative swelling as much as possible. It’s essential for you to provide him with detailed instructions and guidance on how to manage and reduce swelling effectively after the tooth extraction. How to reduce post-operative swelling after extraction?
CorrectANSWER
Apply cold for 24 hrs and hot pads after 24 hours intermittentOTHER OPTIONS
• NilSYNOPSIS
• Apply ice packs to the face in the area of extraction for a few minutes on, then a few minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.
• Most importantly, for 48 hours following your extraction, do not smoke, spit, use a straw, drink carbonated beverages, or alcohol, and avoid strenuous exercise.
• Avoid blowing your nose and sneezing (if you must sneeze, do so with your mouth open to prevent any sinus damage) for the first week.
• These activities can dislodge the blood clot and result in a very painful dry socket.REFERENCE
Post Operative Instructions for Extraction Patient .IncorrectANSWER
Apply cold for 24 hrs and hot pads after 24 hours intermittentOTHER OPTIONS
• NilSYNOPSIS
• Apply ice packs to the face in the area of extraction for a few minutes on, then a few minutes off for the first 24 hours following surgery.
• After the first 24 hours, discontinue ice and use a heating pad or moist heat compress to bring the swelling down.
• Most importantly, for 48 hours following your extraction, do not smoke, spit, use a straw, drink carbonated beverages, or alcohol, and avoid strenuous exercise.
• Avoid blowing your nose and sneezing (if you must sneeze, do so with your mouth open to prevent any sinus damage) for the first week.
• These activities can dislodge the blood clot and result in a very painful dry socket.REFERENCE
Post Operative Instructions for Extraction Patient . - Question 172 of 300
172. Question
Radiographic evidence of a 20 yr old female patient revealed a radioopaque lesion with some expansion giving an orange peel appearance in the posterior aspect of the maxilla. Histologically, it shows fibrous growth. What is your diagnosis?
CorrectANSWER
Fibrous dysplasiaOTHER OPTIONS
• Paget’s Disease – The cotton wool appearance is a plain film sign of Paget disease and results from thickened, disorganized trabeculae which lead to areas of sclerosis in a previously lucent area of bone, typically the skull. These sclerotic patches are poorly defined and fluffy
• Hyperparathyroidism – The common symptomatic osseous findings include subperiosteal and subchondral joint resorption, acroosteolysis, the salt-and-pepper skull, the brown tumors, and osteopenia.
• Osteosarcoma – The characteristic radiological features are sun-burst appearance, periosteal lifting with formation of Codman’s triangleSYNOPSIS
• Fibrous dysplasia is a non-neoplastic hamartomatous developmental lesion of the bone of unknown origin.
• It is characterized by the replacement of bone with fibro-osseous tissue,
• The maxilla is more frequently involved than the mandible.
• The most common radiographic pattern observed was the ground-glass appearance, followed by orange peel, cotton wool, sunray and thumbprint appearance, which leads to a perplex differential diagnosis.REFERENCE
The radiological versatility of fibrous dysplasia An 8-year retrospective radiographic analysis in a north Indian population – Indian Journal of DentistryIncorrectANSWER
Fibrous dysplasiaOTHER OPTIONS
• Paget’s Disease – The cotton wool appearance is a plain film sign of Paget disease and results from thickened, disorganized trabeculae which lead to areas of sclerosis in a previously lucent area of bone, typically the skull. These sclerotic patches are poorly defined and fluffy
• Hyperparathyroidism – The common symptomatic osseous findings include subperiosteal and subchondral joint resorption, acroosteolysis, the salt-and-pepper skull, the brown tumors, and osteopenia.
• Osteosarcoma – The characteristic radiological features are sun-burst appearance, periosteal lifting with formation of Codman’s triangleSYNOPSIS
• Fibrous dysplasia is a non-neoplastic hamartomatous developmental lesion of the bone of unknown origin.
• It is characterized by the replacement of bone with fibro-osseous tissue,
• The maxilla is more frequently involved than the mandible.
• The most common radiographic pattern observed was the ground-glass appearance, followed by orange peel, cotton wool, sunray and thumbprint appearance, which leads to a perplex differential diagnosis.REFERENCE
The radiological versatility of fibrous dysplasia An 8-year retrospective radiographic analysis in a north Indian population – Indian Journal of Dentistry - Question 173 of 300
173. Question
28 years old female patient having mild gingivitis, is very keen to know how she can keep her oral cavity plaque free and asked for the type of floss used.
CorrectANSWER
Ease of use and personal preferenceOTHER OPTIONS
• Not applicableSYNOPSIS
• Using a specific type of dental floss is a matter of personal choice because all of them effectively remove plaque when used appropriately.
– Waxed vs. Unwaxed floss – Waxed floss is slightly thicker than regular floss but slides easily between tight teeth contacts because of its waxy coating. You may want to use waxed floss to prevent fraying if you have braces. However, be mindful that the wax coating may cause sensitivity reactions in rare cases.
– Dental tape vs. floss – Since the dental tape is broad and flat it is recommended when there are significant gaps between the teeth or if your regular floss slides in too easily.
– Water floss vs. floss – Pressurized water jets can flush out food and debris trapped in the gum spaces. Thus water floss is an easy-to-use alternative when people lack the manual dexterity to use regular string floss or under braces and implants.
– String floss vs. Floss Picks – Floss picks are a convenient option to carry with you when traveling. However, floss picks are not as effective as regular string floss in reducing plaque since they cannot reach all the corners and surfaces of your teeth. So only use them if you don’t have string floss around.
– Super floss vs. Floss Threader – Both super floss and floss threaders have a stiff end that helps to insert the floss between braces under bridges and retainers. The main difference is that you have to buy your string floss separately with a floss threader.REFERENCE
Best Dental Floss And Types How To Choose The Right One For You? – Dr. Shaista SalamIncorrectANSWER
Ease of use and personal preferenceOTHER OPTIONS
• Not applicableSYNOPSIS
• Using a specific type of dental floss is a matter of personal choice because all of them effectively remove plaque when used appropriately.
– Waxed vs. Unwaxed floss – Waxed floss is slightly thicker than regular floss but slides easily between tight teeth contacts because of its waxy coating. You may want to use waxed floss to prevent fraying if you have braces. However, be mindful that the wax coating may cause sensitivity reactions in rare cases.
– Dental tape vs. floss – Since the dental tape is broad and flat it is recommended when there are significant gaps between the teeth or if your regular floss slides in too easily.
– Water floss vs. floss – Pressurized water jets can flush out food and debris trapped in the gum spaces. Thus water floss is an easy-to-use alternative when people lack the manual dexterity to use regular string floss or under braces and implants.
– String floss vs. Floss Picks – Floss picks are a convenient option to carry with you when traveling. However, floss picks are not as effective as regular string floss in reducing plaque since they cannot reach all the corners and surfaces of your teeth. So only use them if you don’t have string floss around.
– Super floss vs. Floss Threader – Both super floss and floss threaders have a stiff end that helps to insert the floss between braces under bridges and retainers. The main difference is that you have to buy your string floss separately with a floss threader.REFERENCE
Best Dental Floss And Types How To Choose The Right One For You? – Dr. Shaista Salam - Question 174 of 300
174. Question
A 10-year-old child with Chronic kidney disease underwent extraction of a retained primary tooth. Which analgesic is safe for pedo patients with renal failure after tooth extraction?
CorrectANSWER
AcetaminophenOTHER OPTIONS
• Aspirin – Aspirin has analgesic and anti-inflammatory effects only at intermediate and large doses. At larger doses, the chronic use of aspirin leads to renal vasoconstriction, interstitial nephritis, and a decline in renal function.
• Meperidine – Meperidine is a synthetic opioid that is hepatically metabolized and renally excreted. Normeperidine, its major metabolite, accumulates in chronic kidney disease and causes central nervous system excitability, predisposing patients to seizures.
• Morphine – Morphine-6-glucuronide, an active metabolite of morphine, can accumulate in patients with chronic kidney disease and can have dangerous sedating effects. It crosses the blood-brain barrier slowly, and its effects are not quickly reversed by hemodialysis.SYNOPSIS
• The preferred medication for analgesia in patients with chronic kidney disease unless otherwise contraindicated is acetaminophen.
• Although its mechanism is not fully understood, acetaminophen is believed to reduce pain by inhibiting the cyclooxygenase isoenzyme at the peroxidase site, ultimately resulting in a reduction of prostaglandin production.
• It is 20 percent to 50 percent protein bound and undergoes hepatic metabolism, making accumulation to toxic concentrations or kidney damage in the setting of chronic kidney disease less likely.
• Some recent case reports suggest that acetaminophen may be dialyzable.REFERENCE
Pain Management in Pediatric Chronic Kidney Disease – The Journal of Pediatric Pharmacology and TherapeuticsIncorrectANSWER
AcetaminophenOTHER OPTIONS
• Aspirin – Aspirin has analgesic and anti-inflammatory effects only at intermediate and large doses. At larger doses, the chronic use of aspirin leads to renal vasoconstriction, interstitial nephritis, and a decline in renal function.
• Meperidine – Meperidine is a synthetic opioid that is hepatically metabolized and renally excreted. Normeperidine, its major metabolite, accumulates in chronic kidney disease and causes central nervous system excitability, predisposing patients to seizures.
• Morphine – Morphine-6-glucuronide, an active metabolite of morphine, can accumulate in patients with chronic kidney disease and can have dangerous sedating effects. It crosses the blood-brain barrier slowly, and its effects are not quickly reversed by hemodialysis.SYNOPSIS
• The preferred medication for analgesia in patients with chronic kidney disease unless otherwise contraindicated is acetaminophen.
• Although its mechanism is not fully understood, acetaminophen is believed to reduce pain by inhibiting the cyclooxygenase isoenzyme at the peroxidase site, ultimately resulting in a reduction of prostaglandin production.
• It is 20 percent to 50 percent protein bound and undergoes hepatic metabolism, making accumulation to toxic concentrations or kidney damage in the setting of chronic kidney disease less likely.
• Some recent case reports suggest that acetaminophen may be dialyzable.REFERENCE
Pain Management in Pediatric Chronic Kidney Disease – The Journal of Pediatric Pharmacology and Therapeutics - Question 175 of 300
175. Question
A 28 weeks pregnant lady came with a large pedunculated gingival mass protruding from the maxilla around 2 x 2 mm. On history, the lady said the lesion she noticed 2 months back and is frequently bleeding. Diagnosis?
CorrectANSWER
Pregnancy tumorOTHER OPTIONS
• Periodontal cyst – It is a relatively uncommon cyst that is slow growing, non-expansile developmental odontogenic cyst derived from one or more rests of the dental lamina, containing an embryonic lining of 1-3 squamouspercuboidal cell thickness and distinctive focal thickenings
• Carcinoma in situ – It is a term used to define and describe cancer that is only present in the cells where it started and has not spread to any nearby tissues.
• Radicular cyst – It is the most common inflammatory odontogenic cyst. It is associated with non-vital teeth. The tooth might be deeply carious, traumatized, or improperly restored.SYNOPSIS
• The pregnancy-associated pyogenic granuloma is not a tumor but an exaggerated inflammatory response during pregnancy to an irritation resulting in a solitary polypoid capillary hemangioma which can easily bleed on mild provocation.
• These granulomas present clinically as a painless, protuberant, mushroom-like exophytic mass attached by a sessile or pedunculated base arising from the gingival margin or more commonly from an interproximal papilla.
• It is more common in the maxilla and may develop as early as the first trimester ultimately regressing or completely disappearing following parturition.REFERENCE.
Textbook of Oral Medicine Oral Diagnosis and Oral Radiology- Ravikiran OngoleIncorrectANSWER
Pregnancy tumorOTHER OPTIONS
• Periodontal cyst – It is a relatively uncommon cyst that is slow growing, non-expansile developmental odontogenic cyst derived from one or more rests of the dental lamina, containing an embryonic lining of 1-3 squamouspercuboidal cell thickness and distinctive focal thickenings
• Carcinoma in situ – It is a term used to define and describe cancer that is only present in the cells where it started and has not spread to any nearby tissues.
• Radicular cyst – It is the most common inflammatory odontogenic cyst. It is associated with non-vital teeth. The tooth might be deeply carious, traumatized, or improperly restored.SYNOPSIS
• The pregnancy-associated pyogenic granuloma is not a tumor but an exaggerated inflammatory response during pregnancy to an irritation resulting in a solitary polypoid capillary hemangioma which can easily bleed on mild provocation.
• These granulomas present clinically as a painless, protuberant, mushroom-like exophytic mass attached by a sessile or pedunculated base arising from the gingival margin or more commonly from an interproximal papilla.
• It is more common in the maxilla and may develop as early as the first trimester ultimately regressing or completely disappearing following parturition.REFERENCE.
Textbook of Oral Medicine Oral Diagnosis and Oral Radiology- Ravikiran Ongole - Question 176 of 300
176. Question
Which among the following is the contraindication of pregnancy in the first trimester?
CorrectANSWER
X-rayOTHER OPTIONS
• Acetylsalicylic acid – Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months.
• Penicillins – Generally considered safe during pregnancy.SYNOPSIS
• Exposure to extremely high-dose radiation in the first two weeks after conception might result in a miscarriage.
• During the first-trimester different body organs in the fetus are forming. It is the most critical time for teratogenicity.
• Dental prophylaxis with detailed instructions and a visual examination of the oral cavity without x-rays should be performed if the patient is pregnant.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation – 8th EditionIncorrectANSWER
X-rayOTHER OPTIONS
• Acetylsalicylic acid – Aspirin and other drugs containing salicylate are not recommended during pregnancy, especially during the last three months.
• Penicillins – Generally considered safe during pregnancy.SYNOPSIS
• Exposure to extremely high-dose radiation in the first two weeks after conception might result in a miscarriage.
• During the first-trimester different body organs in the fetus are forming. It is the most critical time for teratogenicity.
• Dental prophylaxis with detailed instructions and a visual examination of the oral cavity without x-rays should be performed if the patient is pregnant.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation – 8th Edition - Question 177 of 300
177. Question
What is the function of the antiseptic action of a soap?
CorrectANSWER
Kills bacteriaOTHER OPTIONS
Refer synopsisSYNOPSIS
• Most antimicrobial soaps use either triclosan or triclocarban as an ingredient to kill microorganisms.
• Triclosan is labeled a biocide, which means that it uses a non-specific mode of action to kill microbes.
• It is thought to destroy biological structures at random.REFERENCE
WikipediaIncorrectANSWER
Kills bacteriaOTHER OPTIONS
Refer synopsisSYNOPSIS
• Most antimicrobial soaps use either triclosan or triclocarban as an ingredient to kill microorganisms.
• Triclosan is labeled a biocide, which means that it uses a non-specific mode of action to kill microbes.
• It is thought to destroy biological structures at random.REFERENCE
Wikipedia - Question 178 of 300
178. Question
What is the acceptable clotting time?
CorrectANSWER
2 to 8 minutesOTHER OPTIONS
Not acceptableSYNOPSIS
• Clotting time is defined as the time interval between puncture to the blood vessel to the formation of fibrin thread.
• The normal range of clotting time is 2 to 8 minutes.REFERENCE
Laboratory Diagnosis and Test ProtocolsIncorrectANSWER
2 to 8 minutesOTHER OPTIONS
Not acceptableSYNOPSIS
• Clotting time is defined as the time interval between puncture to the blood vessel to the formation of fibrin thread.
• The normal range of clotting time is 2 to 8 minutes.REFERENCE
Laboratory Diagnosis and Test Protocols - Question 179 of 300
179. Question
A patient presented to the clinic seeking for replacement of missing teeth 24, 25, 14 and 15 with RPD. Examination revealed high smile line. The patient was concerned about the esthetic appearance of the future provided treatment. Which of the following options is the most likely to meet the patients concern?
CorrectANSWER
I bar claspOTHER OPTIONS
• Twin flex clasp – This consists of a wire clasp soldered into a channel that is cast in the major connector. This clasp is flexible it does not generate as much as torque when the distal extension is depressed. The ability to adjust this clasp and its conventional path of insertion provides an excellent design option for retention to an adjacent edentulous segment.
• Casted Akers clasp – These clasps embrace more than half of the abutment tooth. They may show continuous or limited three-point contact with the tooth.
• Wrought wire clasp – They are more flexible and kinder to the abutment tooth.SYNOPSIS
• It is a modified I-type roach clasp introduced by Kratochvil.
• It has a mesial rest arising from a major connector an I-bar retentive arm and a long proximal plate.
• It is designed to reduce tooth contact.
• Krol in 1973 modified the I-bar system and introduced the RPI and RPA systems.
• The rest is on the proximal side away from the edentulous space.
• An I-bar retainer is used instead of an occlusally approaching retainer for direct retention.REFERENCE
Textbook of Prosthodontics-Deepak NallaswamyIncorrectANSWER
I bar claspOTHER OPTIONS
• Twin flex clasp – This consists of a wire clasp soldered into a channel that is cast in the major connector. This clasp is flexible it does not generate as much as torque when the distal extension is depressed. The ability to adjust this clasp and its conventional path of insertion provides an excellent design option for retention to an adjacent edentulous segment.
• Casted Akers clasp – These clasps embrace more than half of the abutment tooth. They may show continuous or limited three-point contact with the tooth.
• Wrought wire clasp – They are more flexible and kinder to the abutment tooth.SYNOPSIS
• It is a modified I-type roach clasp introduced by Kratochvil.
• It has a mesial rest arising from a major connector an I-bar retentive arm and a long proximal plate.
• It is designed to reduce tooth contact.
• Krol in 1973 modified the I-bar system and introduced the RPI and RPA systems.
• The rest is on the proximal side away from the edentulous space.
• An I-bar retainer is used instead of an occlusally approaching retainer for direct retention.REFERENCE
Textbook of Prosthodontics-Deepak Nallaswamy - Question 180 of 300
180. Question
The cusp of Carebelli is seen in?
CorrectANSWER
Mesiopalatal cusp of maxillary permanent molarsOTHER OPTIONS
• Refer synopsisSYNOPSIS
• The Cusp of Carabelli is a characteristic morphological trait often seen on the palatal surface of the mesiopalatal cusp of maxillary permanent molars.
• The cusp of Carabelli, is also known as Carabelli tubercle, tuberculum anomaly of Georg Carabelli.
• This is a morphological variation that takes the form of a fifth cusp or it can grade down to a series of grooves, depressions, or pits on the mesial portion of the lingual surface.
• This cusp is found lingual to the mesiolingual cusp of the maxillary first permanent molar.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition.IncorrectANSWER
Mesiopalatal cusp of maxillary permanent molarsOTHER OPTIONS
• Refer synopsisSYNOPSIS
• The Cusp of Carabelli is a characteristic morphological trait often seen on the palatal surface of the mesiopalatal cusp of maxillary permanent molars.
• The cusp of Carabelli, is also known as Carabelli tubercle, tuberculum anomaly of Georg Carabelli.
• This is a morphological variation that takes the form of a fifth cusp or it can grade down to a series of grooves, depressions, or pits on the mesial portion of the lingual surface.
• This cusp is found lingual to the mesiolingual cusp of the maxillary first permanent molar.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition. - Question 181 of 300
181. Question
All of the following about bone loss in completely edentulous patient are true except?
CorrectANSWER
Direction of bone resorption in maxilla is similar to that in mandibleOTHER OPTIONS
• NilSYNOPSIS
• Alveolar ridge resorption after teeth extraction is a chronic progressive and cumulative disease of bone reconstruction. Extensive residual ridge resorption is one of the many problems in prosthetic dentistry rehabilitation .
• Residual ridge resorption starts with the tooth and its periodontal membrane loss responsible for the bone formation . Periodontal membrane loss leads to decreasing metabolism in the alveolar ridge and to biochemical resorption of the bone caused by the dental plaque endotoxines prostaglandines and human stimulating factors of alveolar ridge resorption.
• Tooth loss causes resorption of the upper part of the mandible (alveolar ridge) and is the main factor influencing the clinical height of the residual mandible.
• According to Klemetti initially resorption starts on the alveolar part of the mandible and the rest of the mandible remains unchanged . Factors such as resorption post-menopause or osteoporosis do not change the lower part of the mandible. The main reason for this may be the function of the chewing muscles.
• According to Klemetti’s investigation if frontal teeth remain in the mandible the bite forces in the distal part of the mandible are not strong enough to produce greater resorption both in denture wearers and non-wearer.REFERENCE
Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers- DubravkaIncorrectANSWER
Direction of bone resorption in maxilla is similar to that in mandibleOTHER OPTIONS
• NilSYNOPSIS
• Alveolar ridge resorption after teeth extraction is a chronic progressive and cumulative disease of bone reconstruction. Extensive residual ridge resorption is one of the many problems in prosthetic dentistry rehabilitation .
• Residual ridge resorption starts with the tooth and its periodontal membrane loss responsible for the bone formation . Periodontal membrane loss leads to decreasing metabolism in the alveolar ridge and to biochemical resorption of the bone caused by the dental plaque endotoxines prostaglandines and human stimulating factors of alveolar ridge resorption.
• Tooth loss causes resorption of the upper part of the mandible (alveolar ridge) and is the main factor influencing the clinical height of the residual mandible.
• According to Klemetti initially resorption starts on the alveolar part of the mandible and the rest of the mandible remains unchanged . Factors such as resorption post-menopause or osteoporosis do not change the lower part of the mandible. The main reason for this may be the function of the chewing muscles.
• According to Klemetti’s investigation if frontal teeth remain in the mandible the bite forces in the distal part of the mandible are not strong enough to produce greater resorption both in denture wearers and non-wearer.REFERENCE
Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers- Dubravka - Question 182 of 300
182. Question
You were presented with a child who shows brownish-blue discoloration of primary teeth. On examination, it shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance. Identify the diagnosis?
CorrectANSWER
Dentin dysplasia type IIOTHER OPTIONS
• Dentinogenesis imperfecta – It is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – This is a rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type I – Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation. The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.SYNOPSIS
• Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color.
• The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.
• Dentin dysplasia type II shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
Dentin dysplasia type IIOTHER OPTIONS
• Dentinogenesis imperfecta – It is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – This is a rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type I – Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation. The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.SYNOPSIS
• Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color.
• The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.
• Dentin dysplasia type II shows obliteration of the pulp chambers and the erupting secondary central incisors are of normal appearance.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 183 of 300
183. Question
The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen in?
CorrectANSWER
Dentin dysplasia type IOTHER OPTIONS
• Dentinogenesis imperfecta – is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – Is a Rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type II – Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color. The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.SYNOPSIS
• Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation.
• The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
Dentin dysplasia type IOTHER OPTIONS
• Dentinogenesis imperfecta – is a disorder of tooth development. This condition causes the teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent.
• Amelogenesis imperfecta – Is a Rare group of hereditary conditions that affect enamel tissue intrinsically. All teeth of both dentitions are affected. Enamel is typically yellow in color, reduced in volume, and pitted. Dentin and pulps are normal.
• Dentin dysplasia type II – Dentin dysplasia type II is a dental abnormality characterized by abnormal development (dysplasia) of dentin. primary teeth may be discolored appearing to be yellow, brown, grey-amber, or a brownish-blue color. The teeth are sometimes having a translucent opalescence. In most cases, the permanent teeth have a normal color.SYNOPSIS
• Dentin dysplasia Type I is a rare hereditary disturbance in dentin formation characterized by teeth with short blunted roots, complete pulpal obliteration, periapical abscesses or cysts without an obvious causative factor, and spontaneous exfoliation.
• The normal enamel but atypical dentin formation with abnormal pupal morphology and the half-moon-shaped pulp chamber is seen.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W, Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 184 of 300
184. Question
Which is the correct order of sterilisation?
CorrectANSWER
Cleaning, disinfection, packing, sterilization, and storageOTHER OPTIONS
• Not applicableSYNOPSIS
Order of sterilization
• Cleaning
• Disinfection
• Packing
• Sterilization
• StorageREFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Cleaning, disinfection, packing, sterilization, and storageOTHER OPTIONS
• Not applicableSYNOPSIS
Order of sterilization
• Cleaning
• Disinfection
• Packing
• Sterilization
• StorageREFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 185 of 300
185. Question
A patient who has a hepatitis B infection came to the clinic for extraction of a decayed tooth. What is the most appropriate way to manage the case?
CorrectANSWER
Consult with physician and then decide.OTHER OPTIONS
• Refer synopsisSYNOPSIS
• No dental treatment other than urgent care should be rendered for a patient with acute viral hepatitis
If a patient with active hepatitis, positive-HBsAg (HBV carrier) status, or positive HCV status requires emergency treatment, use the following precautions
• Consult the patient’s physician regarding status.
• If bleeding is likely during or after treatment, measure prothrombin time (PT) and bleeding time. Hepatitis may alter coagulation- change treatment accordingly
• All personnel in clinical contact with the patient should use full barrier technique, including masks, gloves, glasses or eye shields, and disposable gowns
• Use as many disposable covers as possible, covering light handles, drawer handles, and bracket trays. Headrest covers should also be used
• All disposable items (e.g., gauze, floss, saliva ejectors, masks, gowns, gloves) should be placed in a lined wastebasket. After treatment, these items and all disposable covers should be bagged, labeled, and disposed of, following proper guidelines for bio-hazardous waste
• Aseptic techniques should be followed at all times. Minimize aerosol production by not using ultrasonic instrumentation, air syringe, or high-speed handpieces. Remember that saliva contains a distillate of the virus. Pre-rinsing with chlorhexidine gluconate for 30 s is highly recommended
• When the procedure is complete, all equipment should be scrubbed and sterilized. If an item cannot be sterilized or disposed of, it should not be used.
• All working surfaces and environmental surfaces should be wiped with 2 percent activated glutaraldehyde (Cidex).REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson.IncorrectANSWER
Consult with physician and then decide.OTHER OPTIONS
• Refer synopsisSYNOPSIS
• No dental treatment other than urgent care should be rendered for a patient with acute viral hepatitis
If a patient with active hepatitis, positive-HBsAg (HBV carrier) status, or positive HCV status requires emergency treatment, use the following precautions
• Consult the patient’s physician regarding status.
• If bleeding is likely during or after treatment, measure prothrombin time (PT) and bleeding time. Hepatitis may alter coagulation- change treatment accordingly
• All personnel in clinical contact with the patient should use full barrier technique, including masks, gloves, glasses or eye shields, and disposable gowns
• Use as many disposable covers as possible, covering light handles, drawer handles, and bracket trays. Headrest covers should also be used
• All disposable items (e.g., gauze, floss, saliva ejectors, masks, gowns, gloves) should be placed in a lined wastebasket. After treatment, these items and all disposable covers should be bagged, labeled, and disposed of, following proper guidelines for bio-hazardous waste
• Aseptic techniques should be followed at all times. Minimize aerosol production by not using ultrasonic instrumentation, air syringe, or high-speed handpieces. Remember that saliva contains a distillate of the virus. Pre-rinsing with chlorhexidine gluconate for 30 s is highly recommended
• When the procedure is complete, all equipment should be scrubbed and sterilized. If an item cannot be sterilized or disposed of, it should not be used.
• All working surfaces and environmental surfaces should be wiped with 2 percent activated glutaraldehyde (Cidex).REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson. - Question 186 of 300
186. Question
Which anesthesia gives a prolonged duration of action?
CorrectANSWER
BupivacaineOTHER OPTIONS
• Lidocaine – Lidocaine is known to have an onset of less than 2 min, a duration of 1 h to 2 h, and a maximum dose of 5 mg per kg, which improves to the onset of less than 2 min, a duration of 2 h to 6 h and toxicity of 7mgperkg with the addition of epinephrine.
• Articaine – Articaine pulpal anesthesia lasts between 30 and 120 min, duration longer than lidocaine, mepivacaine, and prilocaine.
• Novocaine – Since Novocaine by itself has a very short duration of action lasting 30 to 60 minutes.SYNOPSIS
• Compared with lidocaine, bupivacaine has a significantly longer duration of action and a slower time to onset.
• Bupivacaine has an onset of 5 min, a duration of 2 h to 4 h, and a maximum dose of 2 mg per kg.REFERENCE
Handbook of Local Anesthesia Stanley F. Malamed 5th edition.IncorrectANSWER
BupivacaineOTHER OPTIONS
• Lidocaine – Lidocaine is known to have an onset of less than 2 min, a duration of 1 h to 2 h, and a maximum dose of 5 mg per kg, which improves to the onset of less than 2 min, a duration of 2 h to 6 h and toxicity of 7mgperkg with the addition of epinephrine.
• Articaine – Articaine pulpal anesthesia lasts between 30 and 120 min, duration longer than lidocaine, mepivacaine, and prilocaine.
• Novocaine – Since Novocaine by itself has a very short duration of action lasting 30 to 60 minutes.SYNOPSIS
• Compared with lidocaine, bupivacaine has a significantly longer duration of action and a slower time to onset.
• Bupivacaine has an onset of 5 min, a duration of 2 h to 4 h, and a maximum dose of 2 mg per kg.REFERENCE
Handbook of Local Anesthesia Stanley F. Malamed 5th edition. - Question 187 of 300
187. Question
Which tooth does show contact area in incisal third?
CorrectANSWER
Mandibular incisorsOTHER OPTIONS
• Mandibular posteriors – The mandibular molar teeth contact areas, are located more in the center of the proximal area.SYNOPSIS
• A labial view indicates that the contact areas of the mandibular anterior teeth are uniform in nature and occur at the incisal third of the tooth crowns.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition.IncorrectANSWER
Mandibular incisorsOTHER OPTIONS
• Mandibular posteriors – The mandibular molar teeth contact areas, are located more in the center of the proximal area.SYNOPSIS
• A labial view indicates that the contact areas of the mandibular anterior teeth are uniform in nature and occur at the incisal third of the tooth crowns.REFERENCE
Wheeler’s Dental Anatomy, Physiology, and Occlusion, 11th Edition. - Question 188 of 300
188. Question
Biological width of healthy gingiva is?
CorrectANSWER
2 mmOTHER OPTIONS
• NilSYNPOSIS
• The natural seal that develops around both protecting the alveolar bone from infection and disease is known as the biologic width.
• The biological width is defined as the dimension of the soft tissue which is attached to the portion of the tooth coronal to the crest of the alveolar bone.
• This term was based on the work of Gargiulo et al. who described the dimensions and relationship of the dentogingival junction in humans.
• The biologic width is essential for preservation of periodontal health and removal of irritation that might damage the periodontium .
• The millimeter that is needed from the bottom of the junctional epithelium to the tip of the alveolar bone is held responsible for the lack of inflammation and bone resorption and as such the development of periodontitis.
• The dimension of biologic width is not constant it depends on the location of the tooth in the alveolus varies from tooth to tooth and also from the aspect of the tooth. It has been shown that 3 mm between the preparation margin and alveolar bone maintains periodontal health for 4 to 6 months.REFERENCE
Biologic width and its importance in periodontal and restorative dentistry – Babitha NugalaIncorrectANSWER
2 mmOTHER OPTIONS
• NilSYNPOSIS
• The natural seal that develops around both protecting the alveolar bone from infection and disease is known as the biologic width.
• The biological width is defined as the dimension of the soft tissue which is attached to the portion of the tooth coronal to the crest of the alveolar bone.
• This term was based on the work of Gargiulo et al. who described the dimensions and relationship of the dentogingival junction in humans.
• The biologic width is essential for preservation of periodontal health and removal of irritation that might damage the periodontium .
• The millimeter that is needed from the bottom of the junctional epithelium to the tip of the alveolar bone is held responsible for the lack of inflammation and bone resorption and as such the development of periodontitis.
• The dimension of biologic width is not constant it depends on the location of the tooth in the alveolus varies from tooth to tooth and also from the aspect of the tooth. It has been shown that 3 mm between the preparation margin and alveolar bone maintains periodontal health for 4 to 6 months.REFERENCE
Biologic width and its importance in periodontal and restorative dentistry – Babitha Nugala - Question 189 of 300
189. Question
What will be the complications if a hyperthyroidism patient has given local anesthesia with adrenaline?
CorrectANSWER
ThyrotoxicosisOTHER OPTIONS
• NilSYNOPSIS
• Hyperthyroidism results from abnormally high production of thyroid hormones.
• Hyperthyroid patients are often anxious with warm and sweaty hands and an occasional tremor. They also may have increased blood pressure and heart rate.
• Thyroid diseases have a high probability of inducing cardiovascular disease owing to the direct action of thyroid hormones on the myocardium.
• Angina can be worsened by thyrotoxicosis.
• Epinephrine and other vasoconstrictors in local anesthetic drugs cause cardiovascular stimulation and hyperthyroid patients can develop dysrhythmias tachycardia and thyrotoxic crisis when administered these drugs.
• Therefore if local anesthesia is required minimal doses of epinephrine should be administered with aspiration prior to injection.
REFERENCE
Management of hyperthyroid patients in dental emergencies a case report- Kyung-Jin LeeIncorrectANSWER
ThyrotoxicosisOTHER OPTIONS
• NilSYNOPSIS
• Hyperthyroidism results from abnormally high production of thyroid hormones.
• Hyperthyroid patients are often anxious with warm and sweaty hands and an occasional tremor. They also may have increased blood pressure and heart rate.
• Thyroid diseases have a high probability of inducing cardiovascular disease owing to the direct action of thyroid hormones on the myocardium.
• Angina can be worsened by thyrotoxicosis.
• Epinephrine and other vasoconstrictors in local anesthetic drugs cause cardiovascular stimulation and hyperthyroid patients can develop dysrhythmias tachycardia and thyrotoxic crisis when administered these drugs.
• Therefore if local anesthesia is required minimal doses of epinephrine should be administered with aspiration prior to injection.
REFERENCE
Management of hyperthyroid patients in dental emergencies a case report- Kyung-Jin Lee - Question 190 of 300
190. Question
A patient underwent class II MOD onlay next to a composite restoration. The patient came back with sensitivity to cold and pain on the pressure after 3 days. What may be the cause?
CorrectANSWER
Polymerisation shrinkageOTHER OPTIONS
• NilSYNOPSIS
• Post-operative sensitivity in teeth after doing a composite restoration is caused by residual stress buildup due to polymerization shrinkage resulting in de-bonding of the restoration ensuing in an enamel crack microleakage at the margins of the restoration and secondary caries resulting in postoperative sensitivity.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher MosbyIncorrectANSWER
Polymerisation shrinkageOTHER OPTIONS
• NilSYNOPSIS
• Post-operative sensitivity in teeth after doing a composite restoration is caused by residual stress buildup due to polymerization shrinkage resulting in de-bonding of the restoration ensuing in an enamel crack microleakage at the margins of the restoration and secondary caries resulting in postoperative sensitivity.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Roberson (Editor), Harold O. Heymann (Editor), Edward J. Swift Jr.(Editor)Publisher Mosby - Question 191 of 300
191. Question
What should be done to prevent fracture of the Porcelain fuse to gold restoration?
CorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• Diagnosing causes of porcelain fractures
• When fracture or dislodgement of porcelain facing occurs the dentist should be able to identify one of the following apparent causes of the failure and recommend changes in future restorations to the appropriate person
• Fracture of the total porcelain facing leaving metal surface only.
Causes
– Incorrect degassing of metal by technician.
– Incorrect placement of metal conditioner by technician.
• Fracture of the majority of the porcelain facing leaving slight amount of opaque.
Causes
– Incorrect placement of m etal conditioner by technician.
– Incorrect firing of opaque coat of porcelain by technician usually the temperature is too low .
– Inadequate bulk of metal connector.
• Fracture of porcelain only not exposing any metal.
Causes
– Trauma to crowns caused by occlusion or external force.
– Metal framework cast too small by the technician. Frameworks should be only 1 m m to 1.5mm less in contour than the eventual crown or pontic.REFERENCE
How to avoid problems with porcelain-fused-to-metal restorations- Council on Dental Materials and DevicesIncorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• Diagnosing causes of porcelain fractures
• When fracture or dislodgement of porcelain facing occurs the dentist should be able to identify one of the following apparent causes of the failure and recommend changes in future restorations to the appropriate person
• Fracture of the total porcelain facing leaving metal surface only.
Causes
– Incorrect degassing of metal by technician.
– Incorrect placement of metal conditioner by technician.
• Fracture of the majority of the porcelain facing leaving slight amount of opaque.
Causes
– Incorrect placement of m etal conditioner by technician.
– Incorrect firing of opaque coat of porcelain by technician usually the temperature is too low .
– Inadequate bulk of metal connector.
• Fracture of porcelain only not exposing any metal.
Causes
– Trauma to crowns caused by occlusion or external force.
– Metal framework cast too small by the technician. Frameworks should be only 1 m m to 1.5mm less in contour than the eventual crown or pontic.REFERENCE
How to avoid problems with porcelain-fused-to-metal restorations- Council on Dental Materials and Devices - Question 192 of 300
192. Question
Which is the early sign of alveolar osteitis?
CorrectANSWER
Bad odor and pain.OTHER OPTIONS
• Refer synopsisSYNOPSIS
Signs and symptoms of dry socket include the following
1. Moderate to severe pain localized to the area or frequently radiating to the ear.
2. A foul odor or taste in the absence of purulence or suppuration.
3. Symptoms that occur 3 to 5 days after tooth extraction.
4. Absence of swelling, purulence, or lymphadenitis.
5. Duration of 5 to 40 days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Bad odor and pain.OTHER OPTIONS
• Refer synopsisSYNOPSIS
Signs and symptoms of dry socket include the following
1. Moderate to severe pain localized to the area or frequently radiating to the ear.
2. A foul odor or taste in the absence of purulence or suppuration.
3. Symptoms that occur 3 to 5 days after tooth extraction.
4. Absence of swelling, purulence, or lymphadenitis.
5. Duration of 5 to 40 days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 193 of 300
193. Question
What would be the management of a patient having Miller Class II recession on his upper canine?
CorrectANSWER
Connective tissue graft under split-thickness flapOTHER OPTIONS
• NilSYNOPSIS
• Gingival recession presents when the gingival margin is located apical to the cementoenamel junction (CEJ), resulting in exposure of the root surface
• The use of a subepithelial connective tissue graft (SCTG) in conjunction with a coronally advanced flap (CAF) is a successful method of gaining root coverage and augmenting gingival thickness
• After giving LA, a sulcular incision is placed and a full-thickness flap was carefully elevated using a Kirkland knife.
• Beneath the mucosa, a split-thickness flap was created. Adequate tension-free coronal advancement that permitted full root coverage was verified.
• Root surface irregularities were reduced using sharp hand instruments until they were smooth.
• Graft is placed with connective tissue side facing facially
• The gingiva was secured into position by weaving the suture distally. The final suture knot was tied over the original suture knotREFERENCE
Treatment of a Miller Class II Gingival Recession Defect – Inside DentistryIncorrectANSWER
Connective tissue graft under split-thickness flapOTHER OPTIONS
• NilSYNOPSIS
• Gingival recession presents when the gingival margin is located apical to the cementoenamel junction (CEJ), resulting in exposure of the root surface
• The use of a subepithelial connective tissue graft (SCTG) in conjunction with a coronally advanced flap (CAF) is a successful method of gaining root coverage and augmenting gingival thickness
• After giving LA, a sulcular incision is placed and a full-thickness flap was carefully elevated using a Kirkland knife.
• Beneath the mucosa, a split-thickness flap was created. Adequate tension-free coronal advancement that permitted full root coverage was verified.
• Root surface irregularities were reduced using sharp hand instruments until they were smooth.
• Graft is placed with connective tissue side facing facially
• The gingiva was secured into position by weaving the suture distally. The final suture knot was tied over the original suture knotREFERENCE
Treatment of a Miller Class II Gingival Recession Defect – Inside Dentistry - Question 194 of 300
194. Question
Identify the true statement about kinematic face bow?
CorrectANSWER
Kinematic face bows are used to locate the terminal hinge axis of condylar rotationOTHER OPTIONS
• Not applicableSYNOPSIS
• The hinge axis face-bow with adjustable caliper ends that indicates the exact axis of rotation of the condyles.
• This face bow record the true hinge axis
• Used for the fabrication of fixed partial dentures and full mouth rehabilitation.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillinburg.IncorrectANSWER
Kinematic face bows are used to locate the terminal hinge axis of condylar rotationOTHER OPTIONS
• Not applicableSYNOPSIS
• The hinge axis face-bow with adjustable caliper ends that indicates the exact axis of rotation of the condyles.
• This face bow record the true hinge axis
• Used for the fabrication of fixed partial dentures and full mouth rehabilitation.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillinburg. - Question 195 of 300
195. Question
A 20 years old female presented with trismus, lymphadenopathy, and pain in the lower left the mandibular area. On examination, unerupted tooth 38 is noted. Identify the diagnosis?
CorrectANSWER
PericoronitisOTHER OPTIONS
• Periodontal abscess – A smooth, shiny swelling of the gingiva pain, with the area of swelling tender to touch a purulent exudate, and an increase in probing depth.
• Reversible pulpitis – Sharp sensitivity to cold, sometimes to sweets, and sometimes to biting.
• Irreversible pulpitis – Difficulty locating the tooth from which the pain originates, even confusing the maxillary and mandibular arches.SYNOPSIS
• The symptoms of acute pericoronitis include
– Severe pain near back teeth.
– Swelling of gum tissue.
– Pain when swallowing.
– The discharge of pus.
– Trismus.
• Chronic pericoronitis can include the following symptoms
– Bad breath.
– Bad taste in your mouth.
– Mild or dull ache lasting for one or two days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
PericoronitisOTHER OPTIONS
• Periodontal abscess – A smooth, shiny swelling of the gingiva pain, with the area of swelling tender to touch a purulent exudate, and an increase in probing depth.
• Reversible pulpitis – Sharp sensitivity to cold, sometimes to sweets, and sometimes to biting.
• Irreversible pulpitis – Difficulty locating the tooth from which the pain originates, even confusing the maxillary and mandibular arches.SYNOPSIS
• The symptoms of acute pericoronitis include
– Severe pain near back teeth.
– Swelling of gum tissue.
– Pain when swallowing.
– The discharge of pus.
– Trismus.
• Chronic pericoronitis can include the following symptoms
– Bad breath.
– Bad taste in your mouth.
– Mild or dull ache lasting for one or two days.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 196 of 300
196. Question
Deposition of cementum throughout root?
CorrectANSWER
HypercementosisOTHER OPTIONS
• Condensing osteitis – Condensing osteitis consists of abnormal bone growth and lesions that may result from tooth inflammation or infections.
• Secondary cementum deposition – The secondary cementum develops mainly on the apical portion of the root in mammals, when the tooth reaches the occlusal plane.SYNOPSIS
• The excessive buildup of cementum on the roots of a tooth is a pathological condition known as hypercementosis.
• Cementum thickness can increase on the root end to compensate for attritional wear of the occlusalperincisal surface and passive eruption of the tooth.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W., Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi.IncorrectANSWER
HypercementosisOTHER OPTIONS
• Condensing osteitis – Condensing osteitis consists of abnormal bone growth and lesions that may result from tooth inflammation or infections.
• Secondary cementum deposition – The secondary cementum develops mainly on the apical portion of the root in mammals, when the tooth reaches the occlusal plane.SYNOPSIS
• The excessive buildup of cementum on the roots of a tooth is a pathological condition known as hypercementosis.
• Cementum thickness can increase on the root end to compensate for attritional wear of the occlusalperincisal surface and passive eruption of the tooth.REFERENCE
Oral Pathology A Textbook of Oral Pathology by Shafer W., Hine M.and Levy B. 4th edition, W.B Saunders Co. Philadelphia 2009 Edu. Elsevier India, New Delhi. - Question 197 of 300
197. Question
Which is the age changes seen in pulp?
CorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• As tooth matures, the pulp size and volume are gradually reduced.
• Instead of a large wide open apical root, the dental pulp is closed and the pulp is diminished.
• There is an overall reduction of cellular components.
• Other age-related changes in the pulp are compromised circulation and innervation, fat droplet deposition, odontoblastic vacuolization, reticular atrophy, pulpal fibrosis, hyaline degeneration, mucoid degeneration, and diffuse calcification.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All the aboveOTHER OPTIONS
• NilSYNOPSIS
• As tooth matures, the pulp size and volume are gradually reduced.
• Instead of a large wide open apical root, the dental pulp is closed and the pulp is diminished.
• There is an overall reduction of cellular components.
• Other age-related changes in the pulp are compromised circulation and innervation, fat droplet deposition, odontoblastic vacuolization, reticular atrophy, pulpal fibrosis, hyaline degeneration, mucoid degeneration, and diffuse calcification.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 198 of 300
198. Question
How will you differentiate pulpal and periodontal pathology?
CorrectANSWER
Vitality test.OTHER OPTIONS
• Palpation test – The sensitivity of the gums around the tooth by palpating, or gently massaging the gums over the roots of the tooth or teeth suspected of causing your pain.
• Percussion test – Tapping gently along the long axis of the tooth with a blunt instrument.
• Radiographs – Help to diagnose tooth-related problems like caries, fractures, rct, or any previous restorations, abnormal appearance of pulp cavity, or peri radicular tissues periodontal diseases, and the general bone pattern.SYNOPSIS
• Pulp testing is often referred to as vitality testing. Pulp testers should only be used to assess the vital or non-vital pulp.
• Various types of pulp tests are
1 Thermal test – Painful sensation even after removal of stimulus or no response is considered abnormal.
– Cold test – spray with cold air, use ethyl chloride, frozen carbon dioxide(dry ice), wrap an ice piece in the wet gauge, dichlorodifluoromethane(freon)
– Heat test – warm air, heated gutta- percha stick, hot burnisher, hot compound, frictional heat produced by rotating polishing rubber disc, use of laser beam,
2 Electric pulp test.
3 Test cavity
4 Anesthesia testing
5 Bite testREFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
Vitality test.OTHER OPTIONS
• Palpation test – The sensitivity of the gums around the tooth by palpating, or gently massaging the gums over the roots of the tooth or teeth suspected of causing your pain.
• Percussion test – Tapping gently along the long axis of the tooth with a blunt instrument.
• Radiographs – Help to diagnose tooth-related problems like caries, fractures, rct, or any previous restorations, abnormal appearance of pulp cavity, or peri radicular tissues periodontal diseases, and the general bone pattern.SYNOPSIS
• Pulp testing is often referred to as vitality testing. Pulp testers should only be used to assess the vital or non-vital pulp.
• Various types of pulp tests are
1 Thermal test – Painful sensation even after removal of stimulus or no response is considered abnormal.
– Cold test – spray with cold air, use ethyl chloride, frozen carbon dioxide(dry ice), wrap an ice piece in the wet gauge, dichlorodifluoromethane(freon)
– Heat test – warm air, heated gutta- percha stick, hot burnisher, hot compound, frictional heat produced by rotating polishing rubber disc, use of laser beam,
2 Electric pulp test.
3 Test cavity
4 Anesthesia testing
5 Bite testREFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 199 of 300
199. Question
Which is the rationale for IOPAR?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All answers are true regarding IOPARSYNOPSIS
• In diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used.
• Clinically common radiograph used to determine the position of an impacted canine is the occlusal radiograph or Clark’s method using two periapical radiographs.
• Periapical X-rays detect any unusual changes in the root and surrounding bone structures.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation 8th Edition.IncorrectANSWER
All of the aboveOTHER OPTIONS
• All answers are true regarding IOPARSYNOPSIS
• In diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used.
• Clinically common radiograph used to determine the position of an impacted canine is the occlusal radiograph or Clark’s method using two periapical radiographs.
• Periapical X-rays detect any unusual changes in the root and surrounding bone structures.REFERENCE
White and Pharoah’s Oral Radiology Principles and Interpretation 8th Edition. - Question 200 of 300
200. Question
Which of the following is found in dental caries?
CorrectANSWER
Streptococcus sabrinusOTHER OPTIONS
• Staphylococcus aureus – Skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis.
• E Coli – Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), and traveler’s diarrhea, and other clinical infections such as neonatal meningitis and pneumonia.SYNOPSIS
• Streptococcus mutans and Streptococcus sabrinus, are associated with dental caries in humans.
• Their acidogenic and aciduric capacity is directly associated with the cariogenic potential of these bacteria.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Rob.IncorrectANSWER
Streptococcus sabrinusOTHER OPTIONS
• Staphylococcus aureus – Skin and soft tissue infections such as abscesses (boils), furuncles, and cellulitis.
• E Coli – Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), and traveler’s diarrhea, and other clinical infections such as neonatal meningitis and pneumonia.SYNOPSIS
• Streptococcus mutans and Streptococcus sabrinus, are associated with dental caries in humans.
• Their acidogenic and aciduric capacity is directly associated with the cariogenic potential of these bacteria.REFERENCE
Sturdivant’s Art and Science of Operative Dentistry (Hardcover) by Theodore M. Rob. - Question 201 of 300
201. Question
Obturation is done to achieve fluid tight seal at?
CorrectANSWER
Apical and coronal orifice of the root canalOTHER OPTIONS
• Not applicableSYNOPSIS
• Three-dimensional well-fitted root canal with a fluid-tight seal is the main objective of root canal obturation.
• Three-dimensional fluid-tight seal of the root canal system
– Prevents percolation and microleakage of periapical exudate into the root canal space.
– Prevents infection by completely obliterating the apical foramen and other portals of communication.
– Creates a favorable environment for the process of healing to take place.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
Apical and coronal orifice of the root canalOTHER OPTIONS
• Not applicableSYNOPSIS
• Three-dimensional well-fitted root canal with a fluid-tight seal is the main objective of root canal obturation.
• Three-dimensional fluid-tight seal of the root canal system
– Prevents percolation and microleakage of periapical exudate into the root canal space.
– Prevents infection by completely obliterating the apical foramen and other portals of communication.
– Creates a favorable environment for the process of healing to take place.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 202 of 300
202. Question
Which of the following is a disadvantage of GP?
CorrectANSWER
All of the aboveOTHER OPTIONS
• Not applicableSYNOPSIS
Disadvantages of gutta-percha
• Lack of rigidity – bending of gutta-percha is seen when lateral pressure is applied. so difficult to use in smaller canals
• Inability to control the obturating material – easily displaced by pressure.
• Lack of adhesive quality.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All of the aboveOTHER OPTIONS
• Not applicableSYNOPSIS
Disadvantages of gutta-percha
• Lack of rigidity – bending of gutta-percha is seen when lateral pressure is applied. so difficult to use in smaller canals
• Inability to control the obturating material – easily displaced by pressure.
• Lack of adhesive quality.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 203 of 300
203. Question
What is the disadvantage of autoclaving endodontic instruments?
CorrectANSWER
Moisture retentionOTHER OPTIONS
• Not applicableSYNOPSIS
• Carbon Steel can get damaged due to moisture exposure.
• Only Stainless Steel instruments and plastics that can bear the heat be sterilized.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Moisture retentionOTHER OPTIONS
• Not applicableSYNOPSIS
• Carbon Steel can get damaged due to moisture exposure.
• Only Stainless Steel instruments and plastics that can bear the heat be sterilized.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 204 of 300
204. Question
What is the benign condition involving the formation of stones within the ducts of the major salivary gland called?
CorrectANSWER
SialolithiasisOTHER OPTIONS
• Mucocele – Oral mucocele is a painless fluid-filled cyst on the inner surface of the mouth.
• Pleomorphic adenoma – Pleomorphic adenoma, the most common salivary gland tumor, is also known as a benign mixed tumor.
• Fibroma – Fibromas are noncancerous tumors made up of fibrous tissue.SYNOPSIS
• Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands.
• Symptoms of Sialolithiasis
– Swelling of the affected saliva glands which normally occurs with meals.
– Difficulty opening the mouth.
– Difficulty swallowing.
– A painful lump under the tongue.
– Gritty or strange-tasting saliva.
– Dry mouth.
– Pain and swelling usually around the ear or under the jaw.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
SialolithiasisOTHER OPTIONS
• Mucocele – Oral mucocele is a painless fluid-filled cyst on the inner surface of the mouth.
• Pleomorphic adenoma – Pleomorphic adenoma, the most common salivary gland tumor, is also known as a benign mixed tumor.
• Fibroma – Fibromas are noncancerous tumors made up of fibrous tissue.SYNOPSIS
• Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands.
• Symptoms of Sialolithiasis
– Swelling of the affected saliva glands which normally occurs with meals.
– Difficulty opening the mouth.
– Difficulty swallowing.
– A painful lump under the tongue.
– Gritty or strange-tasting saliva.
– Dry mouth.
– Pain and swelling usually around the ear or under the jaw.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 205 of 300
205. Question
You noticed extruded GP on a dental X-ray. What would you do if the patient is symptomatic?
CorrectANSWER
ApicoectomyOTHER OPTIONS
• Inform the patient and do follow-up – Not applicable in this case.
• Re-RCT – May be needed when the symptoms persist on an RCT-treated tooth.SYNOPSIS
• Overextended gutta-percha cones could increase the failure of endodontic therapy. • Commonly surgical procedures are indicated to remove this overextended material if symptomatic.
• The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
ApicoectomyOTHER OPTIONS
• Inform the patient and do follow-up – Not applicable in this case.
• Re-RCT – May be needed when the symptoms persist on an RCT-treated tooth.SYNOPSIS
• Overextended gutta-percha cones could increase the failure of endodontic therapy. • Commonly surgical procedures are indicated to remove this overextended material if symptomatic.
• The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.REFERENCE
Endodontics By Ingel 6th edition - Question 206 of 300
206. Question
Which is the most common complication in an insulin-dependent diabetic patient during tooth extraction?
CorrectANSWER
Hypoglycemic shockOTHER OPTIONS
• Keto acidosis – Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The condition develops when the body can’t produce enough insulin.
• Syncope – Hypoglycemic syncope is uncommon, affecting 1.9 percent of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone.SYNOPSIS
• The most common intraoperative complication of DM is a hypoglycemic episode.
• The risk is highest during peak insulin activity when the patient does not eat before an appointment, or when oral hypoglycemic medication and or insulin levels exceed the needs of the body.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Hypoglycemic shockOTHER OPTIONS
• Keto acidosis – Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The condition develops when the body can’t produce enough insulin.
• Syncope – Hypoglycemic syncope is uncommon, affecting 1.9 percent of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone.SYNOPSIS
• The most common intraoperative complication of DM is a hypoglycemic episode.
• The risk is highest during peak insulin activity when the patient does not eat before an appointment, or when oral hypoglycemic medication and or insulin levels exceed the needs of the body.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 207 of 300
207. Question
What is the emergency management of acute periradicular abscess?
CorrectANSWER
Incision and drainage.OTHER OPTIONS
• Not applicableSYNOPSIS
• Acute periradicular abscess, is highly symptomatic. inflammatory response of the periapical connective tissues.
• It originates when the pulpal tissues initiate an inflammatory response to trauma or caries and may eventually lead to pulpal necrosis.
• In the management of localized acute apical abscess in the permanent dentition, the abscess should be drained through a pulpectomy or incision and drainage.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Incision and drainage.OTHER OPTIONS
• Not applicableSYNOPSIS
• Acute periradicular abscess, is highly symptomatic. inflammatory response of the periapical connective tissues.
• It originates when the pulpal tissues initiate an inflammatory response to trauma or caries and may eventually lead to pulpal necrosis.
• In the management of localized acute apical abscess in the permanent dentition, the abscess should be drained through a pulpectomy or incision and drainage.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 208 of 300
208. Question
What is the cause for late lower incisor crowding?
CorrectANSWER
Late lower jaw growthOTHER OPTIONS
• Not applicableSYNOPSIS
• Late lower incisor crowding is thought to be due to late lower jaw growth.
• The Lower jaw growth occurs well into adulthood.
• The magnitude of these adult,s growth changes is small (1-2mm) however they are significant enough to cause movement in the lower incisors that results in crowding.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Late lower jaw growthOTHER OPTIONS
• Not applicableSYNOPSIS
• Late lower incisor crowding is thought to be due to late lower jaw growth.
• The Lower jaw growth occurs well into adulthood.
• The magnitude of these adult,s growth changes is small (1-2mm) however they are significant enough to cause movement in the lower incisors that results in crowding.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 209 of 300
209. Question
At 9 years of age, interdental papillary necrosis, ulceration, pain, bleeding, and pseudomembrane formation are seen in?
CorrectANSWER
ANUGOTHER OPTIONS
• Herpetic gingivostomatitis – Herpetic gingivostomatitis is a manifestation of herpes simplex virus type 1 (HSV-1) and is characterized by high-grade fever and painful oral lesions.
• Erythema multiforme – a skin reaction that can be triggered by an infection or some medicines.
• Streptococcal gingivostomatitis – an acute inflammation of the oral mucosa caused by beta-hemolytic streptococcus from Group A.SYNOPSIS
• ANUG has been defined as an acute recurring gingival infection of complex etiology, characterized by necrosis of the tips of the gingival papillae, spontaneous bleeding, and pain.
• Several names have been assigned to it such as trench mouth, acute ulcerative gingivitis, vincents stomatitis, vincents angina, Plaut-vincent’s stomatitis, fusospirocheatal gingivitis, necrotic gingivitis, putrid stomatitis.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, IncIncorrectANSWER
ANUGOTHER OPTIONS
• Herpetic gingivostomatitis – Herpetic gingivostomatitis is a manifestation of herpes simplex virus type 1 (HSV-1) and is characterized by high-grade fever and painful oral lesions.
• Erythema multiforme – a skin reaction that can be triggered by an infection or some medicines.
• Streptococcal gingivostomatitis – an acute inflammation of the oral mucosa caused by beta-hemolytic streptococcus from Group A.SYNOPSIS
• ANUG has been defined as an acute recurring gingival infection of complex etiology, characterized by necrosis of the tips of the gingival papillae, spontaneous bleeding, and pain.
• Several names have been assigned to it such as trench mouth, acute ulcerative gingivitis, vincents stomatitis, vincents angina, Plaut-vincent’s stomatitis, fusospirocheatal gingivitis, necrotic gingivitis, putrid stomatitis.REFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, Inc - Question 210 of 300
210. Question
What is the function of the kinematic facebow?
CorrectANSWER
Record mouth opening and closingOTHER OPTIONS
• Refer synopsisSYNOPSIS
• To record the anteroposterior and mediolateral spatial positions of the maxillary occlusal cusps in relation to the transverse opening and closing of the patient’s mandible.
•Two types of face bows are recognized in the field of prosthodontics, arbitrary and kinematic.
• Kinematic face bows are used to locate the terminal hinge axis of condylar rotation.
• An arbitrary face bow called the earbow, uses the ear canal as a locating point.
• One of the important movements the facebow helps to recreate is the arc of opening and closing.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by ShillingburgIncorrectANSWER
Record mouth opening and closingOTHER OPTIONS
• Refer synopsisSYNOPSIS
• To record the anteroposterior and mediolateral spatial positions of the maxillary occlusal cusps in relation to the transverse opening and closing of the patient’s mandible.
•Two types of face bows are recognized in the field of prosthodontics, arbitrary and kinematic.
• Kinematic face bows are used to locate the terminal hinge axis of condylar rotation.
• An arbitrary face bow called the earbow, uses the ear canal as a locating point.
• One of the important movements the facebow helps to recreate is the arc of opening and closing.REFERENCE
Fundamentals of Fixed Prosthodontics 3rd Edition by Shillingburg - Question 211 of 300
211. Question
A routine radiographic examination of a 50 year old patient showed thickening of the root, of molars and diagnosed to be hypercementosis. Which is the synonym you can use for hypercementosis?
CorrectANSWER
Cemental hyperplasiaOTHER OPTIONS
• Cemental dysplasia – Cemento-osseous dysplasia (COD) is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments.
• Cementoma – Cementomas are benign jaw tumors that originate from periodontal ligament elements.SYNOPSIS
• Hypercementosis (cemental hyperplasia) is a nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum.
• It may affect a single tooth or multiple teeth.
• The condition is asymptomatic and is detected on radiographic examination.REFERENCE
Shafer’s Textbook of PathologyIncorrectANSWER
Cemental hyperplasiaOTHER OPTIONS
• Cemental dysplasia – Cemento-osseous dysplasia (COD) is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments.
• Cementoma – Cementomas are benign jaw tumors that originate from periodontal ligament elements.SYNOPSIS
• Hypercementosis (cemental hyperplasia) is a nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum.
• It may affect a single tooth or multiple teeth.
• The condition is asymptomatic and is detected on radiographic examination.REFERENCE
Shafer’s Textbook of Pathology - Question 212 of 300
212. Question
A patient who comes with a history of trauma 1 hour before, complains of sensitivity. On examination, the tooth shows a large dentin exposure but it is vital. How will you manage it?
CorrectANSWER
Smoothen the surface and place calcium hydroxideOTHER OPTIONS
• Not applicableSYNOPSIS
• Goal to cover exposed dentin, can use calcium hydroxide composition.
• Smoothen the surface and place calcium hydroxide.REFERENCE
IncorrectANSWER
Smoothen the surface and place calcium hydroxideOTHER OPTIONS
• Not applicableSYNOPSIS
• Goal to cover exposed dentin, can use calcium hydroxide composition.
• Smoothen the surface and place calcium hydroxide.REFERENCE
- Question 213 of 300
213. Question
Which antibiotics can be prescribed for a patient who has a penicillin allergy?
CorrectANSWER
ClarithromycinOTHER OPTIONS
• Ampicillin, Amoxicillin-clavulanate, and Nafcillin are penicillin antibiotics.SYNOPSIS
Clarithromycin is a macrolide antibiotic. It can be taken by people who are allergic to penicillin.SYNOPSIS
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
ClarithromycinOTHER OPTIONS
• Ampicillin, Amoxicillin-clavulanate, and Nafcillin are penicillin antibiotics.SYNOPSIS
Clarithromycin is a macrolide antibiotic. It can be taken by people who are allergic to penicillin.SYNOPSIS
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 214 of 300
214. Question
What is the crtical pH of dentin?
CorrectANSWER
6 to 6.5OTHER OPTIONS
• Not applicableSYNOPSIS
• The lower the pH, the higher the calcium and phosphate concentrations required to reach saturation with respect to hydroxyapatite.
• This is called the critical pH, the point where equilibrium exists.
• There is no mineral dissolution and no mineral precipitation.
• The critical pH of enamel is around 5.5 and that of fluorapatite is around 4.5.
• Root dentin is more vulnerable to acidic dissolution than enamel because of its higher critical pH for demineralization (6.2 to 6.4) than that of enamel (5.5)
• This varies with individual patients.
• Below critical pH, demineralization occurs while above critical pH, remineralization occurs.
• The critical pH is significantly higher for children than for adultsREFERENCE
Dental Remineralisation to Oral HealthIncorrectANSWER
6 to 6.5OTHER OPTIONS
• Not applicableSYNOPSIS
• The lower the pH, the higher the calcium and phosphate concentrations required to reach saturation with respect to hydroxyapatite.
• This is called the critical pH, the point where equilibrium exists.
• There is no mineral dissolution and no mineral precipitation.
• The critical pH of enamel is around 5.5 and that of fluorapatite is around 4.5.
• Root dentin is more vulnerable to acidic dissolution than enamel because of its higher critical pH for demineralization (6.2 to 6.4) than that of enamel (5.5)
• This varies with individual patients.
• Below critical pH, demineralization occurs while above critical pH, remineralization occurs.
• The critical pH is significantly higher for children than for adultsREFERENCE
Dental Remineralisation to Oral Health - Question 215 of 300
215. Question
What is the mechanism of action of LA?
CorrectANSWER
Decrease the permeability of ion channel to sodiumOTHER OPTIONS
• Not applicableSYNOPSIS
• LA prevents the generation and conduction of nerve impulses by blocking sodium ion influx through voltage-gated sodium channels and preventing the transmission of the advancing wave of depolarization down the length of the nerve.
• LA does not alter the resting transmembrane potential and has little effect on the threshold potential.REFERENCE
Local Anesthesia in DentistryIncorrectANSWER
Decrease the permeability of ion channel to sodiumOTHER OPTIONS
• Not applicableSYNOPSIS
• LA prevents the generation and conduction of nerve impulses by blocking sodium ion influx through voltage-gated sodium channels and preventing the transmission of the advancing wave of depolarization down the length of the nerve.
• LA does not alter the resting transmembrane potential and has little effect on the threshold potential.REFERENCE
Local Anesthesia in Dentistry - Question 216 of 300
216. Question
Which is the best option for a 20 year old young patient presented with missing lateral incisor?
CorrectANSWER
ImplantOTHER OPTIONS
• Not relevant in this caseSYNOPSIS
• Long-term success of oral implants in partially edentulous cases has been the basis for other clinicians to broaden the use of implants to younger patients in whom teeth are missing due to agenesis and or trauma.
• Anodontia either primary or acquired occasionally creates the opportunity for the use of dental implants.
• Since removable dentures and acid etch bridges are uncomfortable and cumbersome, young patients and their parents often insist to reduce the waiting time and insert implants as soon as possible.
• Furthermore, the risk of ongoing alveolar bone resorption after tooth extraction encourages the clinician to go ahead with the oral implants immediately.REFERENCE
Implants in adolescents- Rohit A. Shah, Dipika K. MitraIncorrectANSWER
ImplantOTHER OPTIONS
• Not relevant in this caseSYNOPSIS
• Long-term success of oral implants in partially edentulous cases has been the basis for other clinicians to broaden the use of implants to younger patients in whom teeth are missing due to agenesis and or trauma.
• Anodontia either primary or acquired occasionally creates the opportunity for the use of dental implants.
• Since removable dentures and acid etch bridges are uncomfortable and cumbersome, young patients and their parents often insist to reduce the waiting time and insert implants as soon as possible.
• Furthermore, the risk of ongoing alveolar bone resorption after tooth extraction encourages the clinician to go ahead with the oral implants immediately.REFERENCE
Implants in adolescents- Rohit A. Shah, Dipika K. Mitra - Question 217 of 300
217. Question
How to check subgingival calculus on a shallow area with pus discharge?
CorrectANSWER
Ball end probeOTHER OPTIONS
• Universal currete – A universal curette is a double-ended instrument used for periodontal scaling, calculus debridement, and root planing.
• Double-end perio probe – The periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium.SYNOPSIS
• CPITN assesses the presence or absence of gingival bleeding on probing, supra or subgingival calculus, and periodontal pockets by using a 0.5 mm ball tip WHO probe.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. OdontIncorrectANSWER
Ball end probeOTHER OPTIONS
• Universal currete – A universal curette is a double-ended instrument used for periodontal scaling, calculus debridement, and root planing.
• Double-end perio probe – The periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium.SYNOPSIS
• CPITN assesses the presence or absence of gingival bleeding on probing, supra or subgingival calculus, and periodontal pockets by using a 0.5 mm ball tip WHO probe.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. Odont - Question 218 of 300
218. Question
Epinephrine used in LA causes?
CorrectANSWER
All of the aboveOTHER OPTIONS
• Explained belowSYNOPSIS
• Addition of epinephrine to lidocaine causes
– Increases the duration of anesthesia
– Reduces the risk of bleeding during surgery.
– Reduce toxicityREFERENCE
Use of local anesthetics with an epinephrine additiveIncorrectANSWER
All of the aboveOTHER OPTIONS
• Explained belowSYNOPSIS
• Addition of epinephrine to lidocaine causes
– Increases the duration of anesthesia
– Reduces the risk of bleeding during surgery.
– Reduce toxicityREFERENCE
Use of local anesthetics with an epinephrine additive - Question 219 of 300
219. Question
A 13-year-old child was brought to your clinic with an avulsed incisor tooth before 45 minutes. What is the treatment of choice?
CorrectANSWER
RCT and splintOTHER OPTIONS
• Other options doesnot applySYNOPSIS
• Golden time for replantation is 20-30 minutes,if it is not possible, the tooth should be stored in an appropriate storage media for
preserving the viability of PDL cells
• In closed apex case-extra oral time less than 20 minutes-replant immediately after gentle washing and extra oral time more than 20 minutes endo treatment should be performed before replantationREFERENCE
Therapeutic Protocols for Avulsed Permanent Teeth- Review and Clinical Update Diana Ram, Dr OdontIncorrectANSWER
RCT and splintOTHER OPTIONS
• Other options doesnot applySYNOPSIS
• Golden time for replantation is 20-30 minutes,if it is not possible, the tooth should be stored in an appropriate storage media for
preserving the viability of PDL cells
• In closed apex case-extra oral time less than 20 minutes-replant immediately after gentle washing and extra oral time more than 20 minutes endo treatment should be performed before replantationREFERENCE
Therapeutic Protocols for Avulsed Permanent Teeth- Review and Clinical Update Diana Ram, Dr Odont - Question 220 of 300
220. Question
Which is the most superior analgesic among the following?
CorrectANSWER
IbuprofenOTHER OPTIONS
• Ampicillin – AntibioticSYNOPSIS
• Ibuprofen alone is statistically superior to aspirin.
• Ibuprofen is used as an analgesic in painful conditions, antipyretic, soft tissue injuries, fractures, postoperative pain arthritis and gout, chronic pulpitis, periodontal abscess, and gingival abscess.REFERENCE
Essentials of Dental Pharmacology – K D TripathiIncorrectANSWER
IbuprofenOTHER OPTIONS
• Ampicillin – AntibioticSYNOPSIS
• Ibuprofen alone is statistically superior to aspirin.
• Ibuprofen is used as an analgesic in painful conditions, antipyretic, soft tissue injuries, fractures, postoperative pain arthritis and gout, chronic pulpitis, periodontal abscess, and gingival abscess.REFERENCE
Essentials of Dental Pharmacology – K D Tripathi - Question 221 of 300
221. Question
Which part of the implant holds the fixture to prosthesis?
CorrectANSWER
AbutmentOTHER OPTIONS
• Connector – corresponds to the connection site where the implant body connects to the abutment and restoration,
• Retainer – Imp-lants can also act as retainers for dentures and partials if you have issues with them falling or slipping out of place
• Pontic – 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 teethSYNOPSIS
• In dentistry, an abutment is a connecting element.
• The abutment is the connector piece between a dental implant and an artificial tooth.
• It links the crown, dental bridge, or denture to the implant.REFERENCE
Contemporary Implant Dentistry- Carl E MischIncorrectANSWER
AbutmentOTHER OPTIONS
• Connector – corresponds to the connection site where the implant body connects to the abutment and restoration,
• Retainer – Imp-lants can also act as retainers for dentures and partials if you have issues with them falling or slipping out of place
• Pontic – 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 teethSYNOPSIS
• In dentistry, an abutment is a connecting element.
• The abutment is the connector piece between a dental implant and an artificial tooth.
• It links the crown, dental bridge, or denture to the implant.REFERENCE
Contemporary Implant Dentistry- Carl E Misch - Question 222 of 300
222. Question
Why it is advised to remove the crown for re-endodontic treatment?
CorrectANSWER
The crown may be straight but the tooth may be tiltedOTHER OPTIONS
• NilSYNOPSIS
• Getting access to root canal space may require the removal of a crown, posts, and other restorative materials first.
• Then the original root canal filling is removed, and the root canal space is re-cleaned and sealed.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
The crown may be straight but the tooth may be tiltedOTHER OPTIONS
• NilSYNOPSIS
• Getting access to root canal space may require the removal of a crown, posts, and other restorative materials first.
• Then the original root canal filling is removed, and the root canal space is re-cleaned and sealed.REFERENCE
Endodontics By Ingel 6th edition - Question 223 of 300
223. Question
How will you sterilize the clinic after a hepatitis patient visited you for a treatment?
CorrectANSWER
Standard sterilization with prolonged disinfectionOTHER OPTIONS
• NilSYNOPSIS
• HBs Ag-positive serum is easily inactivated by boiling and by steam under pressure however, HBs Ag-coated beads require increased steam under pressure.
• For sterilizing HBs Ag-contaminated materials, 30 minutes at 132 degrees C is recommended.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Standard sterilization with prolonged disinfectionOTHER OPTIONS
• NilSYNOPSIS
• HBs Ag-positive serum is easily inactivated by boiling and by steam under pressure however, HBs Ag-coated beads require increased steam under pressure.
• For sterilizing HBs Ag-contaminated materials, 30 minutes at 132 degrees C is recommended.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 224 of 300
224. Question
What is the aim of obturation?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All options are correctSYNOPSIS
• The aim of obturation is to establish a fluid-tight barrier with the aim of protecting the periradicular tissues from microorganisms that reside in the oral cavity.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and BurnsIncorrectANSWER
All of the aboveOTHER OPTIONS
• All options are correctSYNOPSIS
• The aim of obturation is to establish a fluid-tight barrier with the aim of protecting the periradicular tissues from microorganisms that reside in the oral cavity.REFERENCE
Pathways of the Dental Pulp 10th Edition by Cohen and Burns - Question 225 of 300
225. Question
What is the important personal conduct of a dentist?
CorrectANSWER
HonestyOTHER OPTIONS
• NilSYNOPSIS
• Honesty, integrity, and fairness form the cornerstones of accepted professional and personal behavior.REFERENCE
Textbook of preventive and community dentistryIncorrectANSWER
HonestyOTHER OPTIONS
• NilSYNOPSIS
• Honesty, integrity, and fairness form the cornerstones of accepted professional and personal behavior.REFERENCE
Textbook of preventive and community dentistry - Question 226 of 300
226. Question
A 38 year old male presented with an 18 month history of an asymptomatic swelling in the anterior mandibular vestibule. The clinical exam revealed a firm and expansile lesion involving the buccal cortical plate. The lesion extended from tooth 23 to 27.Microscopic examination from the capsule was done which showed numerous ghost cells. Which of the following show ghost cells?
CorrectANSWER
Calcifying odontogenic cystOTHER OPTIONS
• Not related to ghost cellsSYNOPSIS
• Highman and Ogden (1944) first described ghost cell in pilomatricomas.
• They described ghost cells as dyskeratotic cells, which are similar to viable cells but have a distinct outline.
• It was also found that the origin of ghost cells were from the epithelium.
• It can originate from any layer of the epithelium.
• These cells do not have intercellular junctions
• Ghost cells generally lack nuclear and cytoplasmic details and are characteristically seen in CCOT, craniopharyngiomas, and pilomatricomas.
• Other lesions exhibiting ghost cells are odontomas, dentinogenic ghost cell tumors, dentinogenic ghost cell carcinoma, ameloblastoma, ameloblastic fibroma.
• During the development of CCOT, the transformation of an odontogenic epithelial cell into a ghost cell first starts by the enlargement of mural cells, followed by other epithelial cells in the cystic lining into abnormally keratinized cells.REFERENCE
Ghost cell lesions – Journal of Pharmacy Bioallied SciencesIncorrectANSWER
Calcifying odontogenic cystOTHER OPTIONS
• Not related to ghost cellsSYNOPSIS
• Highman and Ogden (1944) first described ghost cell in pilomatricomas.
• They described ghost cells as dyskeratotic cells, which are similar to viable cells but have a distinct outline.
• It was also found that the origin of ghost cells were from the epithelium.
• It can originate from any layer of the epithelium.
• These cells do not have intercellular junctions
• Ghost cells generally lack nuclear and cytoplasmic details and are characteristically seen in CCOT, craniopharyngiomas, and pilomatricomas.
• Other lesions exhibiting ghost cells are odontomas, dentinogenic ghost cell tumors, dentinogenic ghost cell carcinoma, ameloblastoma, ameloblastic fibroma.
• During the development of CCOT, the transformation of an odontogenic epithelial cell into a ghost cell first starts by the enlargement of mural cells, followed by other epithelial cells in the cystic lining into abnormally keratinized cells.REFERENCE
Ghost cell lesions – Journal of Pharmacy Bioallied Sciences - Question 227 of 300
227. Question
When does a baby start toothbrushing?
CorrectANSWER
When first primary tooth eruptsOTHER OPTIONS
• NILSYNOPSIS
• As soon as the child has a tooth, plaque can begin building up on the surface of the tooth and causing decay.
• The American Academy of Pediatric Dentistry recommends to start brushing a child’s teeth as soon as the very first tooth comes in.REFERENCE
Tips for Brushing Baby and Toddler TeethIncorrectANSWER
When first primary tooth eruptsOTHER OPTIONS
• NILSYNOPSIS
• As soon as the child has a tooth, plaque can begin building up on the surface of the tooth and causing decay.
• The American Academy of Pediatric Dentistry recommends to start brushing a child’s teeth as soon as the very first tooth comes in.REFERENCE
Tips for Brushing Baby and Toddler Teeth - Question 228 of 300
228. Question
Which of the following may show more chance for fracture?
CorrectANSWER
Class II div 1OTHER OPTIONS
Not applicableSYNOPSIS
• The etiology of maxillary incisor trauma includes oral predisposing factors, which have been identified as
– Increased overjet
– Incompetence lip coverage of the upper anterior teeth in Class II division 1 malocclusion.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc.IncorrectANSWER
Class II div 1OTHER OPTIONS
Not applicableSYNOPSIS
• The etiology of maxillary incisor trauma includes oral predisposing factors, which have been identified as
– Increased overjet
– Incompetence lip coverage of the upper anterior teeth in Class II division 1 malocclusion.REFERENCE
Contemporary Orthodontics, Fourth Edition, William R. Proffit, Henry W. Fields and David M. Sarver 2006, Saint Louis Mosby, Inc. - Question 229 of 300
229. Question
Obturation of a root canal should achieve?
CorrectANSWER
Hermetic sealOTHER OPTIONS
• Tug back – Tug back is defined as a slight frictional resistance of a master point to withdrawal.
• Fluid-free seal – Resin cement sealed the root canals significantly better when compared with zinc oxide eugenol and glass ionomer sealers.SYNOPSIS
• The aim of root canal obturation is to provide a hermetic seal and thus prevent reinfection of the root canal space, which will lead to treatment failure.
• The tricalcium silicate-based sealer cement was introduced due to its hydraulic nature.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
Hermetic sealOTHER OPTIONS
• Tug back – Tug back is defined as a slight frictional resistance of a master point to withdrawal.
• Fluid-free seal – Resin cement sealed the root canals significantly better when compared with zinc oxide eugenol and glass ionomer sealers.SYNOPSIS
• The aim of root canal obturation is to provide a hermetic seal and thus prevent reinfection of the root canal space, which will lead to treatment failure.
• The tricalcium silicate-based sealer cement was introduced due to its hydraulic nature.REFERENCE
Endodontics By Ingel 6th edition - Question 230 of 300
230. Question
What is the purpose of a root canal sealer?
CorrectANSWER
Fill the space between the solid core material and pulp canal walls.OTHER OPTIONS
• Not applicableSYNOPSIS
• The main function of a sealer is to fill the spaces between the core material and the walls of the root canal and between the gutta-percha cones, in an attempt to form a coherent mass of obturating material without voids.REFERENCE
Endodontics By Ingel 6th editionIncorrectANSWER
Fill the space between the solid core material and pulp canal walls.OTHER OPTIONS
• Not applicableSYNOPSIS
• The main function of a sealer is to fill the spaces between the core material and the walls of the root canal and between the gutta-percha cones, in an attempt to form a coherent mass of obturating material without voids.REFERENCE
Endodontics By Ingel 6th edition - Question 231 of 300
231. Question
Which has the worst prognosis?
CorrectANSWER
Aggressive periodontitisOTHER OPTIONS
• Occlusal trauma – It is the injury to the periodontium resulting from occlusal forces that exceed the reparative capacity of the attachment apparatus. It is reversible if identified and treated properly.
• Chronic periodontitis – In cases of chronic Periodontitis in which the clinical attachment loss is not very severe (slight-to-moderate periodontitis), the prognosis is good, provided the inflammation can be controlled through the removal of local plaque-retentive factors and good oral hygiene.SYNOPSIS
• The prognosis for patients with aggressive periodontitis depends on whether the disease is generalized or localized.
• The generalized form which is usually associated with some systemic diseases has a worse prognosis
• Early radiographs have to be obtained to get a prognosis of the disease.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. OdontIncorrectANSWER
Aggressive periodontitisOTHER OPTIONS
• Occlusal trauma – It is the injury to the periodontium resulting from occlusal forces that exceed the reparative capacity of the attachment apparatus. It is reversible if identified and treated properly.
• Chronic periodontitis – In cases of chronic Periodontitis in which the clinical attachment loss is not very severe (slight-to-moderate periodontitis), the prognosis is good, provided the inflammation can be controlled through the removal of local plaque-retentive factors and good oral hygiene.SYNOPSIS
• The prognosis for patients with aggressive periodontitis depends on whether the disease is generalized or localized.
• The generalized form which is usually associated with some systemic diseases has a worse prognosis
• Early radiographs have to be obtained to get a prognosis of the disease.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermin A. Carranza Dr. Odont - Question 232 of 300
232. Question
Which of the following may show bad breath as a symptom?
CorrectANSWER
All of the aboveOTHER OPTIONS
• All are trueSYNOPSIS
• Halitosis is a term used to describe a noticeably unpleasant odor exhaled in breathing.
• Causes of physiologic halitosis
– Mouth breathing
– Medications
– Aging and poor dental hygiene fasting or starvation
– Tobacco
– Foods
• Causes for pathologic halitosis
– Oral and other contributing factors such as
1 Periodontal infection – odor from the subgingival dental biofilm. ANUG, pericoronitis.
2 Tongue coating harbors microorganisms
3 Stomatitis xerostomia
4 Faulty restorations retaining food and bacteria
5 Unclean dentures.
6 Oral pathologic lesions like oral cancers, and candidiasis.
7 Parotitis, cleft palate.
8 Aphthous ulcers dental abscesses.
– Systemic and extra-oral factors
1 Nasal infections like rhinitis, sinusitis, tumors, and foreign bodies.
2 Diseases of GIT like hiatus hernia, carcinoma, and GERD.
3 Pulmonary infections like bronchitis pneumonia, TB, carcinomas
4 Certain hormonal changes occur during ovulation menstruation, pregnancy, and menopause.
5 Systemic diseases like diabetic Mellitus, hepatic failure, renal failure, uremia, blood dyscrasias, rheumatic diseases, dehydration and fever, and cirrhosis of the liver.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermi A. Carranza Dr. OdontIncorrectANSWER
All of the aboveOTHER OPTIONS
• All are trueSYNOPSIS
• Halitosis is a term used to describe a noticeably unpleasant odor exhaled in breathing.
• Causes of physiologic halitosis
– Mouth breathing
– Medications
– Aging and poor dental hygiene fasting or starvation
– Tobacco
– Foods
• Causes for pathologic halitosis
– Oral and other contributing factors such as
1 Periodontal infection – odor from the subgingival dental biofilm. ANUG, pericoronitis.
2 Tongue coating harbors microorganisms
3 Stomatitis xerostomia
4 Faulty restorations retaining food and bacteria
5 Unclean dentures.
6 Oral pathologic lesions like oral cancers, and candidiasis.
7 Parotitis, cleft palate.
8 Aphthous ulcers dental abscesses.
– Systemic and extra-oral factors
1 Nasal infections like rhinitis, sinusitis, tumors, and foreign bodies.
2 Diseases of GIT like hiatus hernia, carcinoma, and GERD.
3 Pulmonary infections like bronchitis pneumonia, TB, carcinomas
4 Certain hormonal changes occur during ovulation menstruation, pregnancy, and menopause.
5 Systemic diseases like diabetic Mellitus, hepatic failure, renal failure, uremia, blood dyscrasias, rheumatic diseases, dehydration and fever, and cirrhosis of the liver.REFERENCE
Carranza’s Clinical Periodontology by Michael G. Newman DDS, Henry Takei DDS, Fermi A. Carranza Dr. Odont - Question 233 of 300
233. Question
What will be the most critical problem due to the negligence of a loss of a primary tooth?
CorrectANSWER
SpeechOTHER OPTIONS
• Refer synopsisSYNOPSIS
• Premature loss of primary teeth can cause orthodontic problems such as crowding, ectopic eruption, or tooth impaction, which can result in malocclusion.
• It can also affect children’s phonation, causing speech distortionREFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, IncIncorrectANSWER
SpeechOTHER OPTIONS
• Refer synopsisSYNOPSIS
• Premature loss of primary teeth can cause orthodontic problems such as crowding, ectopic eruption, or tooth impaction, which can result in malocclusion.
• It can also affect children’s phonation, causing speech distortionREFERENCE
Dentistry for the Child and Adolescent By Macdonald, R.E.AND Avery, D.R 8TH Edition, 2005 Mosby Co, Inc - Question 234 of 300
234. Question
How do the bony ridges are palpated during intraosseous recontouring?
CorrectANSWER
Using finger over the ridgeOTHER OPTIONS
• Not applicableSYNOPSIS
• Sharp bony edges are assessed by replacing the flap and palpating over it with a finger.
• A rongeur or bone file may be used to smooth all sharp edges.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By PetersonIncorrectANSWER
Using finger over the ridgeOTHER OPTIONS
• Not applicableSYNOPSIS
• Sharp bony edges are assessed by replacing the flap and palpating over it with a finger.
• A rongeur or bone file may be used to smooth all sharp edges.REFERENCE
Peterson Principle of Oral and Maxillofacial Surgery By Peterson - Question 235 of 300
235. Question
What is the critical temperature of bone to be kept in degree Celsius?
CorrectANSWER