Dentosphere : World of Dentistry: April 2022

The average length of maxillary cuspid is:

# The average length of maxillary cuspid is:

A. 26 mm

B. 33 mm

C. 21 mm

D. 18 mm

The correct answer is: A. 26 mm.

The average crown length of maxillary permanent canine is 10 mm and average root length is 17 mm. Hence, the average length of permanent maxillary canine is 27 mm.

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Best radiographic technique for demonstration of internal derangements of the TMJ

# The best radiographic technique for demonstration of internal derangements of the TMJ is:

A. MRI

B. CT scan

C. Arthrography

D. Conventional radiographs

The correct answer is A. MRI.

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to generate images of the organs in the body. MRI does not involve X-rays or the use of ionizing radiation, which distinguishes it from CT and PET scans. MRI is a medical application of nuclear magnetic resonance (NMR) which can also be used for imaging in other NMR applications, such as NMR spectroscopy.

MRI is widely used in hospitals and clinics for medical diagnosis, staging and follow-up of disease. Compared to CT, MRI provides better contrast in images of soft-tissues, e.g. in the brain or abdomen. However, it may be perceived as less comfortable by patients, due to the usually longer and louder measurements with the subject in a long, confining tube. Additionally, implants and other non-removable metal in the body can pose a risk and may exclude some patients from undergoing an MRI examination safely.

MRI: Distinguishes blood vessels and nerves from surrounding soft tissues.

MRI should not be used in patients with cardiac pacemakers, metallic restorations, and ortho-appliance

Internal derangement of TMJ can be best diagnosed by MRI.

Orthodontist's Tips on How to Get Relief From Dental Pain due to Braces

Six Simple & Effective Tips on How to Get Relief From Braces Pain

Are you afraid of the braces pain coming your way? First of all, congratulations on taking the first steps towards a perfect bite and smile! As far as braces pain is concerned, there are a lot of unnecessary misconceptions around it.

Getting orthodontic braces on your teeth is worth the effort, but you are likely to experience pain and discomfort right after you put the braces on for the first time or when you get your braces tightened. But it goes away after you get used to wearing them. And there are ways to get rid of braces pain to help you through it.

6 Tips to Reduce Braces Pain

Here are the 6 ways to get relief from braces pain that your orthodontist will agree with!

Eat & Drink Cold Stuff

Braces are a blessing in disguise for the fans of cold foods & drinks. Eat as many ice creams and popsicles as you can. Cold foods and drinks work as numbing agents to ease the discomfort due to braces. They also reduce inflammation. You can also apply an ice pack, drink ice-cold water, or suck on an ice cube for relief.

Apply Heat

Extreme heat is also your friend to get relief from braces pain and soreness. You can apply a heating pad against your jaw as often as possible. Apply it from inside or outside according to your comfort. A warm washcloth also does the trick in the absence of a heating pad.

Maintain Oral Hygiene

It’s crucial to maintain good oral hygiene to reduce the pain and discomfort of braces. You don’t want tooth decay or gum inflammation to hamper your braces treatment or aggravate your pain.

Therefore always follow the dental hygiene routine of brushing and flossing after every meal. This will help eliminate morsels stuck in the brackets and wires after eating.

Ditch the Hard Foods for Soft Foods

Eating soft food and avoiding hard food is one of the essential tips to reduce braces pain. Your teeth and gums become sensitive because of the tightening of the braces.

You don’t want to add up the trouble by chewing hard and crunchy foods like pretzels, hard fruits, etc. Eat soft foods only like smoothies, bananas, mashed potatoes, etc.

Apply Numbing Agent

Your orthodontist may prescribe you some general pain medication like ibuprofen. If those are not working, you can try the OTC oral numbing agents. You can take any good brand suggested by the pharmacist. These numbing agents are to be swished around the mouth. You can also apply them topically to the specific troubling area.

Massage Your Gums

A gum massage is immensely soothing when you are struggling with soreness. To massage your gums, gently rub your fingers on the affected area. It is one of the best relaxing ways to get rid of braces pain. Therefore the drooling because of the gum massage won’t matter much. Gum massage is as soothing as a foot or shoulder massage if you are on braces.

Parting Words

Braces pain and discomfort are only for a few days. But the bite correction and smile beautification you get is forever! So it’s a small price to pay. And now you are equipped with multiple remedies to get relief from braces pain. So sail through your treatment duration with patience and a bright smile.

Author Bio:

Dr. Satish Pai is an orthodontist and Ivy League trained dentist who has served as a faculty at Columbia University. He believes a perfect smile not only makes a person look great but feel great. As the founder of Putnam Orthodontics and a Partner at Brite Orthodontics, he is dedicated to providing the best orthodontic treatments to his patients. He also writes to educate people about everything orthodontics and the importance of correctly aligned teeth along with good oral health. In his free time, you can find him golfing, doing yoga or surfing, and spending time with his family.

A patient of head injury should be carried in ________ position.

# A patient of head injury should be carried in ________ position.

A. Prone

B. Supine

C. Lateral

D. Sitting

The correct answer is C. Lateral.

Patients with head injury should be carried in semiprone position and never on their back. This prevents the accumulation of blood and secretions and pulls the tongue forward in semi or unconscious patients.

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In modified radical neck dissection, the structure preserved is:

# In modified radical neck dissection, the structure preserved is:

A. Submandibular gland

B. Spinal accessory nerve

C. Sternocleidomastoid muscle

D. Internal jugular vein

The correct answer is A. Submandibular gland.

Radical neck dissection (RND)

Removal of all cervical lymphatics and lymph nodes from level IV, with sacrifice of the spinal accessory nerve, the sternocleidomastoid muscle and the internal jugular vein.

Modified radical neck dissection (MRND)

Involves the removal of cervical lymphatics and lymph nodes from levels IV along with one or more of the non lymphatic structures mentioned below:

• The spinal accessory nerve (SAN)

• The internal jugular vein (IJV)

• The sternocleidomastoid muscle (SCM)

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The principal action of ammonia in syncope is as a:

# The principal action of ammonia in syncope is as a:

A. Respiratory stimulant

B. Vagal stimulant

C. Vasomotor stimulant

D. Inhibitor of vasomotor tone

The correct answer is A. Respiratory Stimulant.

Aromatic ammonia is used to treat vasodepressor syncope as well as respiratory depression not induced by opioid analgesics

Aromatic ammonia is the agent of choice for inclusion in the emergency kit as a respiratory stimulant. It is available in a silver-gray vaporole, which is crushed and placed under the breathing victim’s nose until respiratory stimulation is effected. Aromatic ammonia has a noxious odor and irritates the mucous membrane of the upper respiratory tract, stimulating the respiratory and vasomotor centers of the medulla. This action in turn increases respiration and blood pressure. Movement of the arms and legs often occurs in response to ammonia inhalation; these movements further increase blood flow and raise blood pressure, especially in the patient who has been positioned properly (e.g., supine with feet elevated slightly).

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Flap with no vertical incision is called:

# Flap with no vertical incision is called:

A. Triangular

B. Semilunar

C. Envelope

D. Trapezoidal

The correct answer is: C. Envelope

Basic requirements of a flap:

• Flap must be designed to provide an adequate exposure of the surgical area.

• Flap must have a broad base and good vascular supply.

• When placed back, flap should rest on healthy bone.

Envelop flap: Incision along free gingival margin with no vertical incision.

Two sided triangular flap: It is an envelop flap with a releasing incision on one side.

Three sided rhomboid flap: It is modification of two sided flap with addition of a second vertical incision.

Semilunar flap: is designed when periapical area is required to be exposed. It is always kept 5mm away from the gingival margin.

Pedicle flap; It is a flap based on a particular blood vessel. Eg:- Palatal flap along the length of greater palatine artery.

Random flaps: Flaps that are not based on a specific blood vessel.

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Extraction of tooth during acute infection:

# Extraction of tooth during acute infection:

A. Can cause extensive spread of infection

B. Helps drainage and relieves pain if proper antibiotic is given and its adequate blood level is reached

C. Can cause sudden death due to pulmonary embolism

D. Can lead to trigeminal neuralgia in postoperative period

The correct answer is B. Helps drainage and relieves pain if proper antibiotic is given and its adequate blood level is reached

The most rapid resolution of an infection secondary to pulpal necrosis is obtained, when the tooth is removed as early as possible. Therefore acute infection should not be a contraindication to extraction. If access and anesthetic considerations can be met, the tooth should be removed as early as possible after maintaining proper antibiotic level.

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Saw toothed Rete Pegs are seen in:

# Saw toothed Rete Pegs are seen in:

A. Lichen planus

B. Lichenoid reaction

C. Leukoplakia

D. Leukoedema

The correct answer is A. Lichen Planus.

Histopathologic examination of lesional tissue is the most relevant investigation in cases of Oral Lichen Planus. Typical findings include hyperparakeratosis or hyperorthokeratosis with thickening of the granular layer, acanthosis with intracellular edema of the spinous cells in some instances, the development of a ‘saw tooth’ appearance of the rete pegs. Band-like subepithelial mononuclear infiltrate consisting of T-cells and histiocytes; increased numbers of intraepithelial T-cells; and degenerating basal keratinocytes that form colloid (Civatte, hyaline, cytoid) bodies, which appear as homogenous eosinophilic globules are consistently seen.

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Bleeding joints is a characteristic feature of:

# Bleeding joints is a characteristic feature of:

A. Vitamin C deficiency

B. Vitamin K deficiency

C. Hemophilia

D. Thrombocytopenia

The correct answer is C. Hemophilia.

Patients with hemophilia exhibit persistent bleeding, either spontaneous or following even slight trauma that produces the mildest of abrasions or cuts. Hemorrhage into the subcutaneous tissues, internal organs, and joints is also a common feature and may result in massive hematomas.

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An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This mass is most likely to be:

# An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This mass is most likely to be:

A. Cementoma

B. Condensing osteitis

C. Chronic apical periodontitis

D. Acute apical periodontitis

The correct answer is B. Condensing osteitis.

In condensing osteitis, radiographs demonstrate radiopacity which is not attached to tooth, entire root outline is visible, lamina dura intact and periodontal ligament is widened. These features differentiate it from cementoblastoma, in which the radiopacity is attached to tooth, lamina dura absent and root outline is not visible. In condensing osteitis the tooth may be vital or non-vital.

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In a leukemic patient, bleeding does not stop because:

# In a leukemic patient, bleeding does not stop because:

A. Decreased platelet count

B. Increased WBC count

C. Decreased calcium level

D. Decrease in coagulation level

The correct answer is A. Decreased Platelet Count

The sign and symptoms of acute leukemia result from either bone marrow suppression or infiltration

of leukemic cells into organs tissues. These changes cause anemia, thrombocytopenia and a decrease in

neutrophils. Thrombocytopenia causes spontaneous bleeding such as petechiae, ecchymoses, epistaxis,

melena. It may necessary to perform surgery on patients with platelet counts in the range of 25,000

because of the difficulty in achieving platelet levels due to circulating platelet antibodies.

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Diamond Blackfan anemia is characterized by:

# Diamond Blackfan anemia is characterized by:

A. Inherited thrombocytopenia

B. Inherited leucopenia

C. Erythroid aplasia

D. All of the above

The correct answer is C. Erythroid aplasia.

Diamond–Blackfan anemia (DBA) is a congenital erythroid aplasia that usually presents in infancy. DBA causes low red blood cell counts (anemia), without substantially affecting the other blood components (the platelets and the white blood cells), which are usually normal. This is in contrast to Shwachman–Bodian–Diamond syndrome, in which the bone marrow defect results primarily in neutropenia, and Fanconi anemia, where all cell lines are affected resulting in pancytopenia.

First noted by Hugh W. Josephs in 1936, the condition is however named for the pediatricians Louis K. Diamond and Kenneth Blackfan, who described congenital hypoplastic anemia in 1938.

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Reduction of flow of saliva is not generally seen in:

# Reduction of flow of saliva is not generally seen in:

A. Elderly diabetes

B. Patient undergoing radiation

C. Patient suffering from parkinsonism

D. Patient of Phenothiazine drugs

The correct answer is C. Patient suffering from Parkinsonism.

Xerostomia : It is the subjective clinical condition of less than normal amount of saliva. It is dryness of mouth, which is a clinical manifestation of salivary gland dysfunction.

Causes:

- Radiation induced

- Pharmacologically induced xerostomia—there are about 500 drugs which can cause xerostomia. The classes of drugs which cause xerostomia include anticonvulsants, antiemetics, antihistaminics, anti-hypertensives and antispasmodics. The mode of action for decreased salivary flow is generally related to the para-sympathetic activity, usually an antimuscarine effect.

- Smoking, Mouth breathing

- Developmental—developmental abnormalities of salivary glands, tumors, autoimmune states and certain diseases which affect afferent or efferent portions of neural transmission reflex

- Systemic alternations resulting in xerostomia

• Nutritional—certain deficiency states like pernicious anemia, iron deficiency anemia and deficiency of

vitamin A and hormones can cause xerostomia.

• Fluid loss—fluid loss associated with hemorrhage, sweating, diarrhea, vomiting.

• Diabetes mellitus—it is associated with xerostomia.

• Sjögren syndrome—xerostomia is also common in Sjögren syndrome.

• Other disease—systemic diseases, which are accompanied by high temperature and dehydration, usually result in diminished salivation. Xerostomia may also be found in HIV infection, sarcoidosis, and graft versus host resistance.

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Marked reduction in the amount of dentin, widening of predentin layer, presence of large areas of interglobular dentin and irregular pattern of dentin

# Which of the following condition shows marked reduction in the amount of dentin, widening of predentin layer, presence of large areas of interglobular dentin and irregular pattern of dentin?

A. Hypocalcified dentin

B. Regional odontodysplasia

C. Dentin dysplasia

D. Dentinogenesis imperfecta

The correct answer is B. Regional odontodysplasia.

The most characteristic features of Regional odontodysplasia are the marked reduction in the amount of dentin, the widening of the predentin layer, the presence of large areas of interglobular dentin, and an irregular tubular pattern of dentin.

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Dentigerous cyst is likely to cause:

# Dentigerous cyst is likely to cause:

A. Ameloblastoma

B. Fibrosarcoma

C. Adenocarcinoma

D. All of the above

The correct answer is A. Ameloblastoma.

Several relatively serious potential complications exist stemming from the dentigerous cyst, besides simply the possibility of recurrence following incomplete surgical removal. These include:

􀁏 The development of an ameloblastoma either from the lining epithelium or from rests of odontogenic epithelium in the wall of the cyst.

􀁏 The development of epidermoid carcinoma from the same two sources of epithelium.

􀁏 The development of a mucoepidermoid carcinoma, basically a malignant salivary gland tumor, from the lining epithelium of the dentigerous cyst which contains mucus secreting cells, or at least cells with this potential, most commonly seen in dentigerous cysts associated with impacted mandibular third molars.

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Cancer which most commonly metastasizes to jaw bone is:

# Cancer which most commonly metastasizes to jaw bone is:

A. Breast

B. Prostatic

C. Lung

D. Kidney

The correct answer is A. Breast

Metastasis to the jaw bones mainly occurs in the posterior region of the mandible, ramus, and the condyle, which are rich in red bone marrow. Metastasis to the maxilla is rare and comprises one-fifth of all metastatic tumors to the jawbones.[1] The male-to-female ratio is almost equal with a ratio of 1:1.1. The mean age of patients is 45 years.[2] The primary focus in women is usually located in the breasts, reproductive organs, thyroid gland, and kidneys, whereas in men it is in the lungs, prostate, kidneys, bones, large intestine, and suprarenal glands.[3,4,5] Metastases to the jaw bones almost originate from infraclavicular regions. The diffusion through Batson's venous system is the principal process of the oral cavity metastasis.[6] Histologically, the primary foci are usually carcinomas, and among them adenocarcinomas are more common. Adenocarcinoma is usually a metastasis from the breasts in women or from the lungs, alimentary canal, or prostate in men.

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References:

1. Antunes AA, Antunes AP. Gnathic bone metastasis: A retrospective study of 10 cases. Braz J Otorhinolaryngol. 2008;74:561–5. [PubMed] [Google Scholar]

2. Singh H, Kumar P, Nirwan A, Kaur R. Possible pathogenetic mechanisms and overview of metastatic tumours to the oral cavity. Internet J Oncol 8 [Google Scholar]

3. Friedrich RE, Abadi M. Distant metastases and malignant cellular neoplasms encountered in the oral and maxillofacial region: Analysis of 92 patients treated at a single institution. Anticancer Res. 2010;30:1843–8. [PubMed] [Google Scholar]

4. Kaugars GE, Svirsky JA. Lung malignancies metastatic to the oral cavity. Oral Surg Oral Med Oral Pathol. 1981;51:179–86. [PubMed] [Google Scholar]

5. Shin SJ, Roh JL, Choi SH, Nam SY, Kim SY, Kim SB, et al. Metastatic carcinomas to the oral cavity and oropharynx. Korean J Pathol. 2012;46:266–71. [PMC free article] [PubMed] [Google Scholar]

6. Batson OV. The function of the vertebral veins and their role in the spread of metastases. 1940. Clin Orthop Relat Res. 1995:4–9. [PubMed] [Google Scholar]

In trauma or surgery which of the following fluids should be avoided?

# In trauma or surgery which of the following fluids should be avoided?

A. 5% Dextrose

B. Isotonic saline

C. Ringer lactate

D. Blood

The correct answer is B. Isotonic saline.

Hypovolemic shock due to hemorrhage results in cellular anaerobic metabolism and lactic acidosis. This acidosis leads to decreased function of the coagulation proteases, resulting in coagulopathy

and further haemorrhage. Underperfused muscle is unable to generate heat and hypothermia ensues. Coagulation functions poorly at low temperatures and there is further haemorrhage, further hypoperfusion and worsening acidosis and hypothermia. These three factors result in a downward spiral leading to physiological exhaustion and death.

Intravenous blood and fluids are cold and exacerbate hypothermia. Further heat is lost by opening body cavities during surgery. Surgery usually leads to further bleeding and many crystalloid

fluids are themselves acidic (e.g. normal saline has a pH of 6.7).

So, identification and stoppage of hemorrhage should be done immediately and physiological exhaustion from coagulopathy, acidosis and hypothermia should be avoided or limited.

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Which of the following inhalational anesthetic has analgesic property?

# Which of the following inhalational anesthetic has analgesic property?

A. Nitrous oxide

B. Halothane

C. Enflurane

D. Sevoflurane

The correct answer is A. Nitrous oxide

The use of nitrous oxide to relieve the pain of surgery was suggested by Humphrey Davy in 1800. He was the first person to make nitrous oxide, and he tested its effects on several people, including himself and the Prime Minister, noting that it caused euphoria, analgesia and loss of consciousness. The use of nitrous oxide, billed as ‘laughing gas’, became a popular fairground entertainment and came to the notice of an American dentist, Horace Wells, who had a tooth extracted under its influence, while he himself squeezed the inhalation bag.

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A diabetic patient in the waiting room develops giddiness, sweating and confusion, he is suffering from:

# A diabetic patient in the waiting room develops giddiness, sweating and confusion, he is suffering from:

A. Hypertension

B. Ketoacidosis

C. Hypoglycemia

D. Hyperglycemia

The correct answer is C. Hypoglycemia.

Signs and symptoms of low blood sugar (happen quickly)

Feeling shaky.

Being nervous or anxious.

Sweating, chills and clamminess.

Irritability or impatience.

Confusion.

Fast heartbeat.

Feeling lightheaded or dizzy.

Hunger.

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Carcinoma due to chronic irritation is:

# Carcinoma due to chronic irritation is:

A. Kangri cancer

B. Countryman’s injury

C. Chimney-sweepers cancer

D. All of the above

The correct answer is D. All of the above.

Kangri cancer is a type of squamous-cell carcinoma of the skin. It is found only in Kashmir in the northwest of the Indian subcontinent. It occurs on the lower abdomen and inner thighs and is due to the use of a kanger, a ceramic pot covered with wicker-work, carried as a source of warmth during cold weather.

Actinic cheilitis is cheilitis (lip inflammation) caused by long term sunlight exposure. Essentially it is a burn, and a variant of actinic keratosis which occurs on the lip. It is a premalignant condition, as it can develop into squamous cell carcinoma (a type of mouth cancer). This is also known as sailor's lip or farmer's lip or countryman's lip.

Chimney sweep's cancer, also called soot wart, is a squamous cell carcinoma of the skin of the scrotum. It has the distinction of being the first reported form of occupational cancer, and was initially identified by Percivall Pott in 1775. It was initially noticed as being prevalent amongst chimney sweeps.

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Therapy of choice for diffuse toxic goiter in a patient over 45 years is:

# Therapy of choice for diffuse toxic goiter in a patient over 45 years is:

A. Surgery

B. Antithyroid drugs

C. Radioiodine

D. Antithyroid drugs first, followed by surgery

The correct answer is C. Radioiodine

Diffuse toxic goiter Treatment:

a) Above 45 years - Radioiodine

b) Below 45 years

- Surgery - for large goitre

- Antithyroid drugs or radioiodine - for small goiter

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Which of the following is the first sign that appears in hemorrhagic shock?

# Which of the following is the first sign that appears in hemorrhagic shock?

A. Hypotension

B. Tachycardia

C. Vasoconstriction

D. Syncope

The correct answer is B. Tachycardia

Hypovolemic shock develops after the loss of 40% of blood.
Tachycardia is earliest sign of hemorrhagic shock.
Hypovolemic shock is the most common type of shock in the victim of maxillofacial trauma.

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Pain due to gallstone can be perceived in all areas except:

# Pain due to gallstone can be perceived in all areas except:

A. Right shoulder

B. Right hypochondrium

C. Right iliac fossa

D. Epigastrium

The correct answer is C. Right iliac fossa.

Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:

Sudden and rapidly intensifying pain in the upper right portion of your abdomen (right hypochondrium)
Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone (epigastrium)
Back pain between your shoulder blades
Pain in your right shoulder
Nausea or vomiting

Gallstone pain may last several minutes to a few hours.

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Crown and loop space maintainer is a procedure in:

# Crown and loop space maintainer is a procedure in:

A. Interceptive orthodontics

B. Preventive orthodontics

C. Corrective orthodontics

D. Orthodontic camouflage

The correct answer is B. Preventive Orthodontics

Following are some of the most commonly undertaken preventive orthodontic measures:

Parent education
Caries control
Care of deciduous dentition
Maintenance of shedding and eruption timetable
Management of premature loss of deciduous teeth
Management of ankylosis of deciduous teeth
Management of prolonged retention of deciduous teeth
Extraction of supernumerary teeth
Management of oral habits
Management of deeply locked first permanent molars
Treatment of occlusal prematurities
Management of abnormal frenum attachments
Prevention of Milwaukee braces damage
Space maintainers

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The Knutson’s technique of fluoride application is done in the years:

# The Knutson’s technique of fluoride application is done in the years:

A. 3,7,11,13

B. 2,6,10,16

C. 8,13,18,31

D. 2,7,11,18

The correct answer is A. 3,7,11,13

It is the technique recommended by Knutson for the application of 2% neutral sodium fluoride. It consists of 4 applications at weekly intervals in a year at age group of 3, 7, 11, and 13 years. This age group was selected depending on the eruption of deciduous dentition, first permanent molar and incisors, premolar and canines and second molars respectively.

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Interceptive orthodontics does not include:

# Interceptive orthodontics does not include:

A. Space maintainer

B. Oral hygiene measure

C. Frenectomy

D. Serial extraction

The correct answer is: B. Oral Hygiene Measure.

Various interceptive orthodontic procedures that will help in the correction or reduction of the severity of malocclusions are listed below:

Serial extraction/guidance of occlusion
Correction of developing crossbites
Control of abnormal oral habits
Proximal stripping of deciduous teeth to facilitate the eruption of adjacent permanent teeth
Correction of occlusal interferences
Interception of skeletal malrelations
Space regaining
Muscle exercises
Removal of soft tissue and bony barriers

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In case of rampant caries, the ideal procedure to perform in the first visit is to:

# In case of rampant caries, the ideal procedure to perform in the first visit is to:

A. Diet control instructions

B. Topical fluoride application

C. Gross excavation and restoration of teeth

D. Oral hygiene instructions

The correct answer is C. Gross excavation and restoration of teeth

RECOMMENDED TREATMENT PROTOCOL FOR RAMPANT CARIES

First visit:

• Lesions should be excavated and restored with ZOE.

• Drainage of abscess.

• Radiographs

• Diet chart should be given to record diet for 1 week.

• Parent counseling.

• Also topical fluoride administration.

Second visit: (one week after first week)

• Analysis of diet chart.

• Isolate sugar factors from the diet chart and control sugar exposure (diet instructions).

• Caries activity tests.

Third visit:

• Endodontic treatment.

• Extraction of unrestorable teeth followed by space maintenance.

• Crowns.

• Recall every 3 months.

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The periodontal disease index was given by:

# The periodontal disease index was given by:

A. Russel

B. Ramfjord

C. Silness and Loe

D. Dean

The correct answer is B. Ramjford.

A method of assessing the periodontal status, first defined by Ramfjord in 1967, and used to establish the need for treatment and to evaluate the results following treatment. It is a modification of the periodontal disease index of Russell. Six teeth are examined and scored for gingivitis, calculus and plaque deposits, mobility, lack of tooth contact, and depth of gingival crevice (mobility and lack of tooth contact may be omitted). The PDI is the total of the scores for each tooth divided by the number of teeth examined: the higher the score, the more severe the periodontal disease.

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Atraumatic restorative treatment (ART) was introduced first in:

# Atraumatic restorative treatment (ART) was introduced first in:

A. USA

B. Tanzania

C. China

D. New Zealand

The correct answer is B. Tanzania.

Atraumatic Restorative Treatment (ART) was initiated in the mid-eighties in Tanzania in response to an inappropriately functioning community oral health programme that was based on western health care models and western technology. The approach has evolved to its present standing as an effective minimal intervention approach mainly because the originators anticipated the great potential of ART to alleviate inequality in oral health care, and because they recognised the need to carry out research to investigate its effectiveness and applicability. Twenty-five years later, ART was accepted by the World Health Organisation (1994) and the FDI World Dental Federation (2002). It is included in textbooks on cariology, restorative dentistry and minimal intervention dentistry. It is being systematically introduced into public oral health service systems in a number of low- and middle income countries.

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Incidence can be best studied by:

# Incidence can be best studied by:

A. Cross sectional study

B. Longitudinal study

C. Cohort study

D. Case control study

The correct answer is B. Longitudinal Study.

At the most basic level, epidemiologic study designs are cross-sectional or longitudinal. A cross sectional study is one in which both exposure to risk factors and the health outcomes in a group of people who are, or are assumed to be, a sample of a particular population (a “cross section”) are assessed at the same time. A longitudinal study is one in which the same group of people is studied on two or more occasions so that incidence, the change in a condition over time, can be assessed.

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Pulp horn that is most likely to be exposed during cavity preparation on deciduous molars is:

# Pulp horn that is most likely to be exposed during cavity preparation on deciduous molars is:

A. Mesiobuccal of first molar

B. Distobuccal of first molar

C. Mesiobuccal of second molar

D. Distobuccal of second molar

The correct answer is A. Mesiobuccal of first molar

The mesiobuccal pulpal horn of the primary first molars occupies a prominent portion of the pulp chamber. It is the largest pulp horn in both the maxillary and mandibular first primary molar and is commonly exposed during cavity preparation.

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The mean daily eruption velocity of tooth is _______ micrometer/day.

# The mean daily eruption velocity of tooth is _______ micrometer/day.

A. 51

B. 71

C. 61

D. 81

The correct answer is B. 71 micrometer per day.

The mean daily eruption velocity was seen to be 71µm / day. It is also believed that the effect of eruption significantly increases in supine position overnight.

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Which periodontal fibers are consistent and are reconstructed even after the destruction of alveolar bone?

# Which periodontal fibers are consistent and are reconstructed even after the destruction of alveolar bone?

A. Apical

B. Oblique

C. Alveolar crest group

D. Transseptal

The correct answer is D. Transseptal.

Transseptal group: Extends interproximally over alveolar bone crest and are embedded in the cementum of adjacent teeth. They are reconstructed even after destruction of the alveolar bone has occurred in the periodontal disease and are responsible for returning teeth to their original state after orthodontic therapy.

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Gracey curette number 17/18 is used for:

# Gracey curette number 17/18 is used for:

A. Mesial surfaces of anterior teeth

B. Distal surfaces of anterior teeth

C. Mesial surfaces of posterior teeth

D. Distal surfaces of posterior teeth

The correct answer is D. Distal surfaces of posterior teeth.

Double-ended Gracey curettes are paired in the following manner:

Gracey #1-2 and 3-4: Anterior teeth

Gracey #5-6: Anterior teeth and premolars

Gracey #7-8 and 9-10: Posterior teeth: facial and lingual

Gracey #11-12: Posterior teeth: mesial

Gracey #13-14: Posterior teeth: distal

Single-ended Gracey curettes can also be obtained; a set of these curettes comprises 14 instruments. Although these curettes are designed to be used in specific areas, an experienced operator can adapt each instrument for use in several different areas by altering the position of his or her hand and the position of the patient.

Recent additions to the Gracey curette set have been the Gracey #15-16 and 17-18. The Gracey #15-16 is a modification of the standard #11-12 and is designed for the mesial surfaces of posterior teeth.

The Gracey #17-18 is a modification of the #13-14. It has a terminal shank elongated by 3 mm and a more accentuated angulation of the shank to provide complete occlusal clearance and better access to all posterior distal surfaces.

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