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High content of cholesterol is present in:

 # High content of cholesterol is present in:
A. Coconut oil
B. Egg yolk
C. Hydrogenated fat
D. Ghee (Unsaturated)



The correct answer is B. Egg yolk.

Cholesterol is exclusively found in animals and is the most abundant animal sterol. It is a major component of cell membranes and lipoproteins.

Elevation of serum cholesterol beyond 200 mg/dL increases the risk of atherosclerosis and coronary heart diseases. 


The first heart sound is loud in all of the following EXCEPT

 # The first heart sound is loud in all of the following EXCEPT:
 A. Mitral stenosis
B. Short PR interval
C. Tachycardia
D. Mitral valve calcification




The correct answer is D. Mitral valve calcification.

The intensity of the first sound is primarily related to the position of the atrioventricular valves at the onset of ventricular systole.

The first sound is usually louder in subjects with a short PQ interval than in those with a long PQ interval.

Loud first heart sound: is seen in mitral stenosis, left atrial myxoma, conditions that increase myocardial contractility, including hyperadrenergic states (e.g. exercise, anxiety, anemia, fever, pregnancy, and thyrotoxicosis) and in patients with thin chest walls. 

A loud first heart sound is a hallmark of hemodynamically significant mitral stenosis. Mobile but stiff mitral leaflets produce a loud S1 unless the leaflets are heavily calcified. The main reason for the increase in the intensity of S1 in these conditions is the increased rate of pressure development in the ventricles. 

Instrument of choice for biomechanical preparation in fine root canals of double curved canals is

 # Instrument of choice for biomechanical preparation in fine root canals of double curved canals is:
 A. H file
B. K flex file
C. Unifile
D. Reamer


The correct answer is A. H file.

H file or S file is also used for finishing coronal third of root canal. It is also used for biomechanical preparation of fine canals. Used for flaring the fine and double curved root canals and is used in McSpadden compaction technique.



Triangular instruments while cutting canals will have to rotate how much to complete one turn?

 # Triangular instruments while cutting canals will have to rotate _______ to complete one turn.
A. ¼ turn
B. ½ turn
C. 1/3 turn
D. Full turn




The correct answer is C. 1/3 turn.

The triangular shaft requires a one-third (120 degrees) rotation of the instrument to complete a cutting circle of the root. For cutting action in a canal, a traingular shaft instrument requires 1/3 turn. These cutting points are at 120 degrees to each other and they move simultaneously. So, a 1/3 turn or 120 degree turn will bring about a complete cuttting circle. 



The best instrument for cutting dentin is:

 # The best instrument for cutting dentin is:
A. Reamer
B. File
C. Broach
D. Explorer



The correct answer is A. Reamer.

Reamer contains sharp cutting edges that are spaced further apart than the file and therefore it is engaged in dentin more rapidly and readily facilitates dentin removal.

In which region are chief cells located in the gastric gland?

 # Chief cells are located in gastric gland in the region?
 A. Fundus
 B. Isthmus
C. Neck
D. Equally spread



The correct answer is A. Fundus.

Gastric gland is composed of three types of cells:
A. Mucous neck cells - secrete mainly mucus but also some pepsinogen
B. Peptic/chief cells - Secrete pepsinogen in body and fundus
C. Parietal/Oxyntic cells- Secrete hydrochloric acid and intrinsic factor


Oral pain, erythematous gingival tissues, blunted papillae spontaneous gingival bleeding, and no attachment loss

 # A 19 year old patient presents with oral pain, erythematous gingival tissues, blunted papillae spontaneous gingival bleeding, and no attachment loss. There is also a pseudomembrane covering the gingiva. Which of the following is the diagnosis for this patient?
A. Plaque associated gingivitis
B. Necrotizing ulcerative gingivitis
C. Aggressive periodontitis
D. Chronic periodontitis
E. Necrotizing ulcerative periodontitis





The correct answer is B. Necrotozing ulcerative gingivitis.

Necrotizing ulcerative gingivitis and periodontitis usually occurs
because of the predominance of the anaerobic fusobacteria and
spirochetes within the oral cavity, specifically underneath the gingiva.

This is a case of Necrotizing ulcerative gingivitis (NUG) NOT
necrotizing ulcerative periodontitis (NUP) because the patient is not
experiencing bone loss.

Debridement of the affected gingiva with an adjunctive prescription
of chlorhexidine 0.12 % rise will help stop the progression of
necrotizing ulcerative disease.

Acute necrotizing gingivitis signs/ symptoms:
  1. Pain
  2. Interproximal necrosis of the papilla (Blunting of papilla)
  3. Bleeding gingiva
  4. Fetid odor
  5. Low-grade fever
  6. Pseudomembrane

Acute necrotizing gingivitis risk factors:
  1. Poor oral hygiene
  2. Smoking
  3. Malnutrition
  4. Fatigue
  5. Stress
  6. Immunocompromised patients


Strongest indication for splinting

 # Which of the following patient conditions is the strongest indication for splinting?
A. Mobility with a unilateral shift from centric relation to centric occlusion
B. Mobility with discomfort
C. Presence of diastemas
D. Primary occlusal trauma



The correct answer is B. Mobility with discomfort.

Unstable teeth that cannot maintain normal position during centric occlusion need additional support to maintain position and therefore must be splinted to the adjacent teeth.

Presence of a diastema does not necessarily require splinting except when the diastema is caused by the movement of teeth due a periodontally compromised status.

Primary occlusal trauma can be resolved once the cause of trauma
is removed.

Discomfort associated with tooth mobility may:
• Be due to other periodontal conditions
• Be due to pulpal conditions
• NOT be a direct indication alone for splinting therapy


Peace Dental Care Pvt. Ltd., Bharatpur -10, Chitwan

 Name of Dental Clinic: Peace Dental Care Pvt. Ltd.
Address: Bharatpur-10, Hospital Road, Chitwan
Year of Establishment: 2076
Name of the chief Dental Surgeon: Dr. Binaya Subedi
CONTACT NUMBER: 056593325

Baishdhara Dental Clinic, Balaju, Kathmandu

 Name of Dental Clinic: Baishdhara Dental Clinic
Address : Near Tarun Ma Vi, Balaju, Kathmandu, Nepal
Year of Establishment: 2021
Name of the chief Dental Surgeon: Dr Bishwo Prachanda Sedhain
CONTACT NUMBER: 9851157949

Interruption of transmission of disease is called:

 # Interruption of transmission of disease is called:
A. Disease control 
B. Disease eradication
C. Disease elimination
D. Disability limitation



The correct answer is C. Disease elimination.

Concept of Control
A. Disease control : The term 'disease control' describes (ongoing) operations aimed at reducing incidence, duration, decrease effects of disease, etc. Control activities may focus on primary prevention or secondary prevention. The concept of tertiary prevention is comparatively less relevant to control efforts. In disease control, the disease agent is permitted to persist in the community at a level where it ceases to be a public health problem according to the tolerance level of local population.

B. Disease elimination: Between control and eradication, an intermediate goal has been described, called 'regional elimination'. The term elimination is used to describe interruption of transmission of disease, eg. elimination of measles, polio and diphtheria from large geographic region or areas. Regional elimination is now seen as an important precursor of eradication.

C. Disease eradication: Eradication literally means to 'tear out by roots'. It is the termination of all transmission of infection by extermination of the infectious agent through surveillance and containment. As the name implies, eradication is an absolute process, and not a relative goal. It is an all or none phenomenon. 

Phases of Public Health - Concept of risk factor

 # The new concept of risk factor came into existence during which phase?
A. Disease control phase
B. Health promotional phase
C. Social engineering phase
D. Health for all phase


The correct answer is C. Social engineering phase.

Four phases of public health have been recognized:
A. Phase one: Disease Control Phase (1880-1920)
The 19th century Public Health- matter of sanitary legislation and sanitary reform, safe water supply and waste disposal. 

B. Phase Two: Health promotional phase (1920-1960)
At the beginning of the 20th century, the concept of health promotion emerged. As a result, in addition to disease control activities, one more goal was initiated. e.g. Maternal and child health, School health, mental health, occupational health and rehabilitation services.

C. Phase Three: Social Engineering phase (1960-1980)
Chronic conditions such as cancer, Diabetes mellitus (DM), cardiovascular diseases (CVD), and alcoholism, drug addiction occurred. These chronic health problems could not be tackled by the traditional approaches to public health i.e. isolation, immunization, and disinfection) nor they can be explained on the basis of germ theory (biomedical) of disease. The concept of risk factors (social, environmental, genetic and lifestyle) came into action as determinants of disease. 

D. Phase four: Health for all phase (1980-2000)
Primary Health care, Health for all (HFA)- Health for all meant that every individual should have access to Primary Health Care 


Bhatbhateni Dental Care Pvt. Ltd., Thirbum Sadak, Bhatbhateni, Naxal

 Name of Dental Clinic: Bhatbhateni Dental Care Pvt. Ltd.
Address: Thirbum Sadak, Bhatbhateni, Naxal
Year of Establishment: 2017
Name of the chief Dental Surgeon: Dr. Sanjay Kumar Tiwari 
CONTACT NUMBER: 9863028098 

Dent Inn the Dental Clinic, Sherpa Mall, Third Floor, Durbar Marg, Kathmandu

 Name of Dental Clinic: Dent Inn the Dental Clinic
Address: Sherpa Mall, Third Floor, Durbar Marg, Kathmandu
Year of Establishment: 2006
Name of the chief Dental Surgeon: Dr. Rima Shrestha 
CONTACT NUMBER: 9843050990

King's Dental Care Centre Pvt. Ltd, Bharatpur, Chitwan

 Name of Dental Clinic: King's Dental Care Centre Pvt. Ltd
Address: Bharatpur-9 central bus terminal, Chitwan
Year of Establishment: 2074 BS
Name of the chief Dental Surgeon: Dr.  Avishek Adhikari Sharma
CONTACT NUMBER: 056595401

Quality smile dental care, Lagankhel (opposite patan hospital)

 Name of Dental Clinic: Quality smile dental care
Address: Lagankhel (opposite patan hospital)
Year of Establishment: 2077
Name of the chief Dental Surgeon: Dr Rabin Gyawali
CONTACT NUMBER: 9851310253


Mandala Dental Clinic, Kanti Marg, Basundhara Chowki, Kathmandu

 Name of Dental Clinic: Mandala Dental Clinic
Address: Kanti Marg, Basundhara Chowki, Kathmandu 
Year of Establishment: 2021
Name of the chief Dental Surgeon: Dr Sabin Paudel
CONTACT NUMBER: 9849717709

ARS Dental Clinic, Lokanthali Bhaktapur, Lazimpat, Kathmandu

 Name of Dental Clinic: ARS Dental Clinic
Address: Lokanthali, Bhaktapur and Lazimpat, Kathmandu
Year of Establishment: 2015
Name of the chief Dental Surgeon: Dr. Shyam K. Maharjan 
CONTACT NUMBER: 9851039240 

Smerata Dental Care, Ratnanagar-2, Chitwan

 Name of Dental Clinic: Smerata Dental Care
Address : Tandi chowk,  Ratnanagar-2, Chitwan
Year of Establishment: 2076
Name of the chief Dental Surgeon: Dr Anjula Thapa
CONTACT NUMBER: 9855085545



SWASTIK DENTAL CARE AND IMPLANT CENTRE, Biratnagar

 Name of Dental Clinic: SWASTIK DENTAL CARE AND IMPLANT CENTRE
Address: Rani path, Roadcess chowk, Biratnagar-12
Year of Establishment: 2021
Name of the chief Dental Surgeon: Dr. Aditya Shah
CONTACT NUMBER: 9803050871

First person to define public health

# Who was the first person to define public health?
A. Rutherford
B. Winslow
C. Freud
D. Erikeson



The correct answer is B. Winslow.

Winslow (1920): 'Public Health' is the art and science of preventing disease.


Dhulikhel Dental Care, Dhulikhel

 Name of Dental Clinic: Dhulikhel Dental Care
Address: Dhulikhel bus station, next to Century commercial bank
Year of Establishment: 2019
Name of the chief Dental Surgeon: Amir Hamal
CONTACT NUMBER: 9851172359


Family dental home pvt. Ltd., Lagankhel, Lalitpur

 Name of Dental Clinic: Family dental home pvt. Ltd.
Address: Lagankhel buspark, lalitpur (near everest bank)
Year of Establishment: 2075/76
Name of the chief Dental Surgeon: DR. BIJAY TAJA
CONTACT NUMBER: 9849688648

Attachment loss and probing depth

 # A patient has a 5 mm probing depth on the distal of their maxillary second premolar, 2 mm of recession was also charted in that area. What is the attachment loss in that area?
A. 7 mm
B. 10 mm
C. 5 mm
D. 3 mm



The correct answer is A. 7 mm.

Periodontal health is assessed by determining how much attachment a tooth has lost. A healthy periodontium demonstrates a sulcular depth of 1-3 mm.

Recession is the distance from the CEJ to the marginal gingiva.
Probing depth is the distance betweeen the marginal gingiva and the floor of sulcus. 
Loss of attachment is measured as the distance of CEJ from the sulcular depth. 

So, Loss of Attachment (LOA) = Recession+Probing depth



A mature dental plaque is formed after:

 # How many hours after mechanical debridement with a toothbrush is a mature dental plaque found?
A. 24-48 hours
B. 3-5 hours
C. 6-10 hours
D. 12-24 hours
E. 1-2 hours


The correct answer is A. 24-48 hours.

Mature dental plaque is usually formed on the teeth within 24-48 hours after plaque removal.

The bacterial biofilm first attach to the tooth via a pellicle, consisting of glycoproteins.

The first bacteria to attach to the pellicle glycoproteins are gram positive aerobic cocci such as Streptococcus sanguinis. 

After 24 hours, anaerobic gram negative cocci, rods, and filaments begin to colonize the plaque. 

Artery supplying the buccal flap in an oroantral communication associated with maxillary third molar

 # A buccal flap used to cover an oroantral communication associated with maxillary third molar would receive nourishment from which of the following arteries?
A. Posterior superior alveolar
B. Nasopalatine
C. Greater palatine
D. Facial




The correct answer is A. Posterior superior alveolar.

The buccal flap will receive its nourishment from the blood vessel that supplies the maxillary third molar, which is the posterior superior alveolar artery.

Posterior superior alveolar artery is the blood vessel that provides blood supply to the lining of maxillary sinus, the alveolar bone, the molars and premolars of the maxilla and the gingiva.

Facial artery branches out and supplies blood to several parts of the face which includes the lips, portions of the nose, submental area and some portions of the tonsils.

Nasopalatine artery (sphenopalatine artery) branches off to the walls of nasal septum.

Greater palatine artery gives off blood supply to the nasal septum and the hard palate.



Classification of Malocclusion


# In Angle's classification for malocclusion, the key tooth is:
A. Mesiobuccal cusp of permanent maxillary forst molar
B. Distobuccal cusp of permanent maxillary first molar
C. Mesiobuccal cusp of permanent maxillary second molar
D. Mesiobuccal cusp of permanent mandibular first molar

# Andrew's 5th Key of occlusion is:
A. Curve of Spee
B. Rotation absent
C. Tight contact
D. Bolton's ratio

# Zygoma or Key ridge corresponds to:
A. Mesiobuccal root of upper first molar
B. Mesiobuccal root of upper second molar
C. Distobuccal cusp of upper first molar
D. Distobuccal cusp of second molar

  



# Angles line of occlusion are seen in which plane?
A. Sagittal
B. Vertical
C. Transverse
D. Transverse and vertical

# When Angle's classification system is used then displacement occurs in which direction?
A. Vertical
B. Transverse
C. Sagittal
D. Sagittal and transverse

# The following features are noted in a patient. The mesiobuccal cusp of right upper first molar is aligning in the mesiobuccal groove of right lower first molar. The distobuccal cusp of left upper first molar is aligning in the mesiobuccal groove of left lower first molar. The upper incisors are retroclined. You would like to classify it as:
A. Angle's class I div I subdivision
B. Angle's class II div I subdivision
C. Angle's class II div II subdivision
D. Angle's class III div I subdivision

# A patient is having edge to edge or end on relation of first molar in permanent dentition with retroclination of incisors. The malocclusion according to Angle's classification is:
A. Class I
B. Class II Div I
C. Class II Div II
D. Class III

# Anterior crossbites according to Dewey are classified in Angle's class I as:
A. Type I
B. Type II
C. Type III
D. Type IV

# Who has classified malocclusion based on etiology?
A. Angle
B. Lischer
C. Benett
D. Dewey

# Classification for skeletal malocclusion was given by:
A. Kartz
B. Salzman
C. Angle
D. Kingsley

# Transposition of teeth refers to:
A. Buccorotation of 120 degrees
B. Hypodontia
C. Teeth erupted in unusual position
D. Inverted supernumerary teeth

# Transposition of teeth is most commonly seen in the region of:
A. Maxillary central and lateral incisors
B. Mandibular canine and first premolar
C. Maxillary lateral incisor, canine and premolar
D. Mandibular first and second premolars

# The term torsiversion refers to the:
A. Impaction of the maxillary canines
B. Interchange of position of teeth
C. Rotation of teeth in their long axis
D. None of the above

# Postnormal occlusion is:
A. Class I with anterior crowding
B. Class II malocclusion
C. Class III malocclusion
D. Bimaxillary protrusion

# If the tooth has not erupted to the line of occlusion, it is called:
A. Supraversion
B. Torsiversion
C. Rotated
D. Infraversion

# The skeletal classification of malocclusion is given by:
A. Calvin Case
B. Martin Dewey
C. Paul Simon
D. Edward H. Angle

# If maxillary canines are placed forward to orbital plane, they are said to be in:
A. Protraction
B. Retraction
C. Abstraction
D. Contraction

# Which of the following system of classification gives a complete picture of malocclusion in a patient?
A. Simon
B. Ackerman
C. Dewey
D. Angle

# In Ackerman-Profitt classification, outer envelope represents:
A. Alignment
B. Profile
C. Transverse relation
D. Vertical relation

# In classifying molar relation in patient with premature loss of molar, additional relation to be noted is:
A. Incisor relation
B. Canine relation
C. Midline relation
D. Premolar relation

# Canine class I relation is:
A. Distal inclines of lower cuspid contact with mesial inclines of upper cuspid
B. Distal inclines of lower cuspid in line with distal inclines of upper cuspid
C. Mesial inclines of lower cuspid in contact with distal inclines of upper cuspid
D. Mesial inclines of lower cuspid in line with mesial inclines of upper cuspid

# Katz classification is based on:
A. Incisor
B. Canine
C. Premolar
D. Molar

# A bimax protrusion is:
A. Splitting and protrusion of maxilla into two halves
B. Forward placed upper and lower dental arches on normal skeletal bases
C. Forward placed upper dental arch and skeletal base
D. Forward placed lower dental arch and skeletal base

# The term surtrusion refers to the:
A. Backward movement of the condyle
B. Downward movement of the centric position
C. Lateral movement away from the midline
D. Upward movement of the working condyle as it moves away

Pioneer in the treatment of cleft palate

# Who among the following is named as the pioneer in the treatment of cleft palate and related problems?
A. Norman Kingsley
B. Edward H. Angle
C. Graber
D. Nance



The correct answer is A. Norman Kingsley.

Kingsley, was among the first to use extraoral force to correct protruding teeth. He was also a pioneer in the treatment of cleft palate and related problems. 



First Orthodontic Appliance was developed by:

 # Who among the following developed the first orthodontic appliance?
A. Pierre Fauchard
B. Norman Kingsley
C. Emerson C. Angell
D. Edward H. Angle



The correct answer is A. Pierre Fauchard.

Orthodontics truly began developing in the 18th and 19th centuries. In 1728, French dentist Pierre Fauchard, who is often credited with inventing modern orthodontics, published a book entitled "The Surgeon Dentist" on methods of straightening teeth. Fauchard, in his practice, used a device called a "Bandeau", a horseshoe-shaped piece of iron that helped expand the palate. In 1754, another French dentist, Louis Bourdet, dentist to the King of France, followed Fauchard's book with The Dentist's Art, which also dedicated a chapter to tooth alignment and application. He perfected the "Bandeau" and was the first dentist on record to recommend extraction of the premolar teeth to alleviate crowding and to improve jaw growth.

Pierre Fauchard, 'Father of modern dentistry', as early as 1723, developed first orthodontic appliance.

Norman Kingsley, the first to use extraoral force on teeth. He is also considered to be the first person to use orthopedic force to correct protruding teeth.

Bunon- first to use the term 'orthopedic appliances'

Emerson C. Angell - founder of 'rapid maxillary expansion'

William E. Magill - First person to band teeth for active tooth movement. 

Jackson's Triad in Orthodontics

 # Which of the following is a component of Jackson’s triad?
A. Functional efficiency
B. Structural balance
C. Aesthetic harmony
D. All of the above



The correct answer is D. All of the above.

The aims and objectives of orthodontic treatment have been summarized by Jackson as the 'Jackson's triad'. The three main objectives of orthodontic treatment are:
- Functional efficiency
- Structural balance
- Aesthetic harmony


# The term ‘Orthodontics’ was coined by:

 # The term ‘Orthodontics’ was coined by:
A. Le Foulon
B. Hunter
C. Carabelli
D. Norman Kingsley



The correct answer is A. Le Foulon.

The term orthodontics was apparently used first by the Frenchman Le Foulon in 1839.

The occipital condyle is represented by the following cephalometric point:

 # The occipital condyle is represented by the following cephalometric point:
A. Bolton’s point
B. Broadbent registration point
C. Basion
D. Articulare



The correct answer is A. Bolton's point.

Bolton's point: The highest point at the post-condylar notch of occipital bone

Few other cephalometric landmarks are:
1. Glabella: It is the most prominent point on the forehead in the mid-sagittal plane.

2. Nasion: The most anterior point midway between the frontal and nasal bone on the frontonasal suture.

3. Orbitale: The lowest point on the inferior bony margin of the orbit.

4. Porion: The highest bony point on the upper margin of external auditory meatus.

5. Sella: This point represents the mid point of the pituitary fossa or sella-turcica.

6. Basion: It is median point of the anterior margin of the foramen magnum

7. Anterior nasal spine: It is the anterior tip of the sharp bony process of the maxilla in the midline of the lower margin of anterior nasal spine.

8. Point A: It is a deepest point in the midline between the anterior nasal spine and alveolar crest between the two central incisors. It is also called as " subspinale".

9. Prosthion: The lowest and the most anterior point on the alveolar bone in the midline between the upper central incisors. It is also called as " supradentale".
.
10. The key ridge: The lower most point on the contour of anterior wall of the infra-temporal fossa.

11. Posterior nasal spine: The intersection of a continuation of the the anterior wall of the pterygopalatine fossa and the floor of the nose, marking the distal limit of the maxilla.

12. Broadbent registration point: It is the midpoint of the perpendicular from the centre of the sella turcica to the Bolton point. 
.
13 PTM point: It is the intersection of the inferior border of foramen rotundum with posterior wall of the pterygo maxillary fissure.

14. Chelion: It is the lateral terminus of the oral slit on the slit on the outer corner of the mouth.

15. Subnasal: The point where the lowest border of the nose meets the outer contour of the upper lip. 

16. Point B: It is the deepest point in the midline between the alveolar crest of mandible and the mental process. Also called as " submentale".

17. Gonion: It is a constructed point at the junction of ramal plane and the mandibular plane.

18. Pogonion: It is the most anterior point of the bony chin in the median plane.

19. Menton: It is the most inferior midline point on the mandibular symphysis.

20. Gnathion: It is the most antero-inferior point on the symphysis of the chin. It is constructed on the symphysis of the chin, by intersecting a line drawn perpendicular to the line connecting menton and pogonion.

21. Articulare: It is a point at the junction of the posterior border of ramus and the inferior border of the basilar part of the occipital bone.

22. Condylion: The most superior point on the head of the condyles.

23. Infradentale: The highest and the most anterior point on the alveolar process, in the median plane between the mandibular incisors.

Termination of skeletal maturity - Indicator

 # Which of the following bone indicates the termination of skeletal maturity?
A. Presence of Sesamoid
B. Appearance of pisiformis
C. Appearance of calcification of hook of hamate
D. Union of diaphysis and epiphysis on radius


The correct answer is D. Union of diaphysis and epiphysis on radius.


Some other important tips:
 * Absence of hamate and pisiform - Still 1 year for prepubertal growth spurt
* Presence of hamular process of the hamate, pisiform and sesamoid- Beginning of  growth spurt
* Initial ossification of  sesamoid - Peak pubertal growth spurt
* The epiphysis and diaphysis fusion/ ossification of sesamoid completed - Prepubertal growth spurt completed
* The epiphysis and diaphysis fusion on radius and ulna- Active growth completed



Fishman’s index is used in relation with:

 # Fishman’s index is used in relation with:
A. Population
B. Hand-wrist radiographs
C. Cephalograms 
D. Periodontal diseases


The correct answer is B. Hand-wrist radiographs.

The following are the most commonly used methods for determination of skeletal maturity through hand-wrist xrays: 
- Atlas method by Greulich and Pyle
- Bjork Grave and Brown method
- Singer's method of assessment
- Fishman's skeletal maturity indicators
- Hagg and Taranger method


Carpal radiograph is used for assessment of:

 # Carpal radiograph is used for assessment of:
A. Bone condition
B. Chronological age
C. Treatment plan
D. Skeletal maturation





The correct answer is: D. Skeletal Maturation.

There are different methods to assess the skeletal maturity of an indivudual which include:
1. Use of hand wrist radiographs
2. Evaluation of skeletal maturation using cervical vertebrae
3. Assessment of maturity by clinical and radiographic examination of different stages of tooth (Lower third molar)

Hand wrist radiograph is the most reliable among all these. 


Vestibuloplasty procedure

 # A vestibuloplasty procedure is performed by:
A. Reducing buccal bone from the alveolar ridge with a barrel bur and a handpiece
B. Apically repositioning the muscular and mucosal attachments of the mandible
C. Reflecting the gingiva and using Rongeurs to remove bone from the alveolar crest
D. Using a bone file to smooth rough bony projections
E. Grafting harvested iliac or rib bone onto the alveolar process



The correct answer is B. Apically repositioning the muscular and mucosal attachments of the mandible

Vestibuloplasty is a procedure performed to lengthen the residual ridge and deepen the oral vestibule.

A vestibuloplasty can only be achieved by relocating or repositioning the muscle attachments and mucous membrane covering it into a deeper or more apical position. 

Vestibuloplasties are also accompanied with the use of a mucosal graft or a skin graft. 

Most ideal finish line configuration for a porcelain veneer:

 # The most ideal finish line configuration for a porcelain veneer is:
A. Feather
B. Chamfer
C. Shoulder
D. Chisel



The correct answer is: C. Shoulder.

#Shoulder Finish Line
Indications: • All ceramic crowns • PFM crowns • Injectable porcelains 
Advantages:  • Good crown contours • Esthetics  • Less distortion • Provides adequate bulk
Disadvantages: • Least conservative • Inferior marginal adaptation

# Shoulder with bevel Finish Line
Indications: • Proximal boxes of onlays and inlays • Labial finish line of metal ceramics • Occlusal shoulder of onlays 
Advantages:  • Superior marginal adaptation • Resists distortion • Facilitates removal of unsupported enamel rods
Disadvantages: • Requires subgingival extension • Detection of post cementation caries is difficult

# Chamfer Finish Line
Indications: • Cast metal restorations • Lingual aspect of metal ceramics
Advantages:  • Conservative • Good marginal adaptation • Provides bulk
Disadvantages: • Improper fabrication may result in an unsupported tip

# Knife edge Finish Line
Indications: • Young patients • MOD onlay • Inaccessible areas • Finish lines in cementum
Advantages:  • Conservative • Ideal for marginal adaptation 
Disadvantages: • Does not provide a distinct finish line • Waxing, polishing and casting becomes critical • Overcontoured restoration in an attempt to obtain bulk


Preferred gingival finish line for veneer metal restoration

 # The preferred gingival finish line for veneer metal restoration is:
a) Shoulder 
b) Chamfer
c) Shoulder with bevel 
d) Radial shoulder



The correct answer is B. Chamfer.

#Shoulder Finish Line
Indications: • All ceramic crowns • PFM crowns • Injectable porcelains 
Advantages:  • Good crown contours • Esthetics  • Less distortion • Provides adequate bulk
Disadvantages: • Least conservative • Inferior marginal adaptation

# Shoulder with bevel Finish Line
Indications: • Proximal boxes of onlays and inlays • Labial finish line of metal ceramics • Occlusal shoulder of onlays 
Advantages:  • Superior marginal adaptation • Resists distortion • Facilitates removal of unsupported enamel rods
Disadvantages: • Requires subgingival extension • Detection of post cementation caries is difficult

# Chamfer Finish Line
Indications: • Cast metal restorations • Lingual aspect of metal ceramics
Advantages:  • Conservative • Good marginal adaptation • Provides bulk
Disadvantages: • Improper fabrication may result in an unsupported tip

# Knife edge Finish Line
Indications: • Young patients • MOD onlay • Inaccessible areas • Finish lines in cementum
Advantages:  • Conservative • Ideal for marginal adaptation 
Disadvantages: • Does not provide a distinct finish line • Waxing, polishing and casting becomes critical • Overcontoured restoration in an attempt to obtain bulk




Partial veneer crown is contraindicated in:

 # Partial veneer crown is contraindicated in:
a) Long teeth 
b) Short teeth
c) Tipped teeth 
d) Tapered teeth



The correct answer is B. Short Teeth.

Indications for partial veneer crown:

• Intact or minimally restored teeth .
• Teeth with normal anatomic crown form i.e., without excessive cervical constriction.
• Teeth with adequate crown Length.

Contraindications for partial veneer crown:

• High caries rate.
• Short teeth.
• Bell shaped teeth.
• Teeth with insufficient buccolingual width.
• Excessively restored teeth.

Retention of Partial Veneer Crown

 # In partial veneer crown, retention can be increased by:
a) Increased length of path of insertion
b) Increase in taper
c) Making path of removal parallel to long axis of adjacent teeth
d) None of the above



The correct answer is A. Increased length of path of insertion.

Crown preparation with long, parallel axial walls and grooves produces maximum retention. Increasing the taper decreases retention. A short, over tapered preparation, decreases the retention because the restoration can be removed along an infinite number of paths.



Tooth Preparation for metal crown

 # The amount of reduction required for a tooth for all metal crown restoration is:
a) So that there is proper clearance between the teeth
b) So that the tooth architecture interferes with the arch of rotation
c) So that the tooth architecture doesn't interfere with the arch of rotation
d) At least 2mm on all the surfaces




The correct answer is: B. So that the tooth architecture interferes with the arch of rotation

The longer the occlusogingival length of the preparation, the greater is the retention. This is because longer preparations interfere with the arc of the casting pivoting about a point than shorter preparations.


Finish lines of a complete coverage crown should lie:

 # Finish lines of a complete coverage crown should lie?
a) Supragingivally 
b) Subgingivally
c) Subgingival if required
d) Gingival margin

The correct answer is C. Subgingival if required. 

Whenever possible the finish lines of crowns should terminate supragingivally. Subgingival margins are required in the following situations.
• Esthetics.
• Cervical erosion and caries.
• Insufficient crown length for retention.
• Elimination of persistent root hyper sensitivity.


Paired cartilages of larynx

 # Which of the following is a paired cartilage of larynx?
A. Thyroid
B. Cricoid
C. Epiglottis
D. Arytenoid


The correct answer is D. Arytenoid.

The laryngeal skeleton is made of nine cartilages: the thyroid cartilage, cricoid cartilage, epiglottis, arytenoid cartilages, corniculate cartilages, and cuneiform cartilages. The first three are unpaired cartilages, and the latter three are paired cartilages.

Paired = Arytenoid, Corniculate, Cuneiform
Unpaired= Thyroid, Cricoid, Epiglottis

Extension of Larynx

 # Larynx extends from:
A. C2-C7
B. C1-C4
C. C5-C6
D. C3-C6


The correct answer is D. C3-C6

Larynx is the organ of voice (Phonation), an air passage sphincter at the inlet of the lower respiratory passage.

In adult male, it lies opposite to third, fourth, fifth, sixth cervical vertebrae, but in children, and in adult female, it lies at a higher level.


The arterial supply of trachea is by the:

 # The arterial supply of trachea is by the:
A. Bronchial artery
B. Tracheal artery
C. Inferior thyroid artery
D. Superior thyroid artery



The correct answer is C. Inferior thyroid artery.

Inferior thyroid artery is a branch of thyrocervical trunk, which arises from the subclavian artery. Its terminal part is related to recurrent laryngeal nerve. Apart from trachea, it also supplies lower two thirds of thyroid lobe and lower half of the isthmus, parathyroid, thymus, larynx, pharynx, and the surrounding muscles. 


Trachea bifurcates at the level of:

 # Trachea bifurcates at the level of:
A. C7
B. Lower border of T3
C. Upper border of T4
D. Upper border of T5



The correct answer is D. Upper border of T5.

Trachea begins at C6 and bifurcates at the level of T5. Trachea bifurcates at the level of sternal angle.

Carotid Sinus vs Carotid body

 # Select the incorrect statement about the carotid sinus:
A. It is a dilatation near the beginning of the internal carotid artery
B. It is innervated by the glossopharyngeal nerve
C. It acts as a chemoreceptor
D. Its wall has thick tunica adventitia



The correct answer is C. It acts as a chemoreceptor; which is incorrect because carotid sinus is a baroreceptor. 

Carotid Sinus : The termination of the common carotid artery, or the beginning of the internal carotid artery shows a slight dilatation, known as the carotid sinus which receives a rich innervation from the glossopharyngeal and sympathetic nerves. The carotid sinus acts as a baroreceptor or pressure receptor and regulates blood pressure.

Carotid Body: Carotid body is a small, oval reddish-brown structure situated behind the bifurcation of the common carotid artery. It receives a rich nerve supply mainly from the glossopharyngeal nerve, but also from the vagus and sympathetic nerves. It acts as a chemoreceptor and responds to changes in the oxygen and carbon dioxide and pH content of the blood.

The base of the submental triangle is formed by:

# The base of the submental triangle is formed by:
A. Chin
B. Anterior belly of digastric
C. Posterior belly of digastric
D. Hyoid bone


The correct answer is D. Hyoid bone.

Submental triangle is a median triangle. On each side, there is the anterior belly of the corresponding digastric muscles. Its base is formed by the body of the hyoid bone. Its apex lies at the chin. The floor of the triangle is formed by the right and left mylohyoid muscles and the median raphe uniting them.




All of the infrahyoid muscles are supplied by ansa cervicalis EXCEPT:

 # All of the infrahyoid muscles are supplied by ansa cervicalis EXCEPT:
A. Thyrohyoid
B. Sternohyoid
C. Sternothyroid
D. Inferior belly of omohyoid



The correcct answer is A. Thyrohyoid.

Infrahyoid muscles are sternohyoid, sternothyroid, thyrohyoid and omohyoid present in the superficial plane of the anterior triangle of neck. Sternohyoid, sternothyroid, omohyoid are supplied by ansa cervicalis EXCEPT thyrohyoid which is supplied by the first cervical nerve through hypoglossal nerve.

Suprahyoid Muscles and Infrahyoid Muscles

 # All of the following belongs to suprahyoid group of muscles EXCEPT:
A. Omohyoid
B. Mylohyoid
C. Stylohyoid
D. Geniohyoid



The correct answer is A. Omohyoid. 

Suprahyoid Muscles are: Digastric, Stylohyoid, Mylohyoid, Geniohyoid   @ Super Stylish Getho and Mylo Di. 

Infrahyoid muscles: Sternohyoid, Sternothyroid, Thyrohyoid, Omohyoid  (SH, ST, TH, OH)


Torticollis or Wry Neck is the result of:

 # Torticollis or Wry Neck is the result of spasm of which of the following muscles?
A. Omohyoid and sternohyoid
B. Trapezius and Sternocleidomastoid
C. Platysma and mentalis
D. Scaleneus anterior and scaleneus posterior



The correct answer is B. Trapezius and Sternocleidomastoid

Torticollis or Wry neck is a deformity in which the head is bent to one side and the chin points to the other side. This is a result of spasm or contracture of the muscles supplied by the spinal accessory nerve, these being the sternocleidomastoid and the trapezius.

Which of the following are called as ‘Signal nodes’?

 # Which of the following are called as ‘Signal nodes’?
A. Supraclavicular nodes
B. Jugulo-omohyoid
C. Jugulodigastric
D. Submandibular



The correct answer is A. Supraclavicular nodes

The left supraclavicular nodes or Virchow's or scalene nodes are also involved in malignant growths of distant organs, e.g. the stomach, the testis and other abdominal organs. Therefore, they are known as signaal nodes. Scalene node biopsy is very helpful in the early diagnosis of such malignancies. 

The origin of clavicular head of sternocleidomastoid muscle:

 # The origin of clavicular head of sternocleidomastoid muscle is from the:
A. Medial one third of the inferior surface of the clavicle
B. Lateral one third of the inferior surface of the clavicle
C. Medial one third of the superior surface of the clavicle
D. Lateral one third of the superior surface of the clavicle



The correct answer is C. Medial one third of the superior surface of the clavicle.

Origin of Sternocleidomastoid Muscle

1. The sternal head is tendinous and arises from the superolateral part of the front of the manubrium sterni.
2. The clavicular head is musculotendinous and arises from the medial one third of the superior surface of the clavicle.

Insertion of Sternocleidomastoid Muscle

It is inserted 
a) by a thick tendon into the lateral  surface of the mastoid process from its tip to its superior border, and 
b) by a thin aponeurosis into the lateral half of the superior nuchal line of the occipital bone.


Nerve Supply of Sternocleidomastoid

The spinal accessory nerve provides the motor supply. It passes through the muscle.

Blood supply of the sternocleidomastoid

One branch each from superior thyroid artery and suprascapular artery and two branches from the occipital artery.

Action of  Sternocleidomastoid muscle
# When one muscle contracts:
a) It turns the chin to the opposite side.
b) It can also tilt the head towards the shoulder. 

# When both muscles contract together:
a) They draw the head forwards as in eating and in lifting the head from a pillow. 
b) With the longus colli, they flex the neck against resistance. 
c) The reverse action helps in forced inspiration.




Action of digastric muscle:

 # Following is the action of digastric muscle:
A. Elevates the mandible and depresses the hyoid bone
B. Elevates the hyoid bone and depresses the mandible
C. Depresses the mandible as well as hyoid bone
D. Elevates the mandible as well as hyoid bone



The correct answer is B. Elevates the hyoid bone and depresses the mandible.

Digastric muscle depresses the mandible when the mouth is opened widely or against resistance and elevates the hyoid bone.

Temporalis muscle originates from:

 # Temporalis muscle originates from:
A. Side of the skull
B. Zygomatic process
C. Ramus of the mandible
D. Pterygopalatine fossa



The correct answer is A. Side of the skull.

Temporalis muscle arises from temporal fossa and temporal fascia and inserts into deep surface of coronoid and anterior border of the ramus of mandible. 




Medial pterygoid muscle is attached to:

 # Medial pterygoid muscle is attached to:
A. Medial surface of lateral pterygoid plate
B. Lateral surface of medial pterygoid plate
C. Medial surface of medial pterygoid plate
D. Lateral surface of lateral pterygoid plate



The correct answer is A. Medial surface of the lateral pterygoid plate

Deep head of the medial pterygoid muscle arises from medial surface of lateral pterygoid plate and palatine bone. The lateral pterygoid muscle arises from lateral surface of lateral pterygoid plate.


Lymphatic drainage of TMJ:

 # Lymphatic drainage of TMJ is mainly to:
A. Submandibular nodes
B. Submental nodes
C. Deep cervical nodes
D. Parotid nodes



The correct answer is D. Parotid nodes.

Nerve supply of Capsule of TMJ:

 # Which of the following supplies capsule of TMJ?
A. Facial nerve
B. Auriculotemporal nerve
C. Branch of maxillary nerve
D. First cervical nerve



The correct answer is B. Auriculotemporal nerve.

Sensory nerve supply: Sensory innervation of the TMJ is derived from the auriculotemporal and masseteric branches of V3 (otherwise known as the mandibular branch of the trigeminal nerve).

Blood supply of TMJ: Its arterial blood supply is provided by branches of the external carotid artery, predominantly the superficial temporal branch. Other branches of the external carotid artery, namely, the deep auricular artery, anterior tympanic artery, ascending pharyngeal artery, and maxillary artery, may also contribute to the arterial blood supply of the joint.

Dynamic receptors of the TMJ joint:

 # Which of the following are dynamic receptors of the TMJ joint?
A. Ruffini endings
B. Pacinian corpuscles
C. Golgi tendon
D. Free nerve endings





The correct answer is B. Pacinian corpuscles

Pacinian corpuscles  are dynamic mechanoreceptors which accelerate movement during reflexes. 

The receptors for specific mechanics of proprioception:
Ruffini endings- static  mechanoreceptors which position the mandible
Pacinian corpuscles- Dynamic mechanoreceptors which accelerate movement during reflexes
Golgi tendon organs- Static mechanoreceptors for protection of ligaments around the temporomandibular joint
Free nerve endings- Pain receptors for protection of the temporomandibular joint itself

Articular disc of TMJ is

 # Articular disc of TMJ is:
A. Fibrocartilaginous
B. Bony
C. Hyaline cartilage
D. Elastic cartilage



The correct answer is A. Fibrocartilaginous

The unique feature of the TMJ is the articular disc. The disc is composed of fibrocartilaginous tissue which is positioned between the two bones that form the joint. There is neither innervation nor vascularization within the central portion of the articular disc. Articular disc is oval fibrous plate with concavoconvex superior surface and concave inferior surface. It divides joint into upper and lower compartments. Upper compartment permits gliding and lower permits gliding as well as rotatory movements. 

Sublingual salivary gland is located:

 # Sublingual salivary gland is located superior to:
A. Genioglossus
B. Hyoglossus
C. Mylohyoid
D. None of the above



The correct answer is C. Mylohyoid.

Sublingual salivary gland lies superior to mylohyoid and lateral to the genioglossus muscle. Its duct opens directly into floor of mouth on the summit of sublingual fold.


Opening of submandibular gland duct:

 # The opening of submandibular gland duct into oral cavity is at:
A. Maxillary Second molar
B. Mandibular third molar
C. Dorsum of tongue
D. Sublinugual caruncle



The correct answer is D. Sublingual caruncle.

Submandibular duct or Warthin's duct is 5 cm long, emerges from submandibular gland and in its course runs on the hyoglossus between lingual and hypoglossal nerve and opens at the sublingual papilla at the side of frenum of tongue.




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