Understanding Gingival Stippling: What It Is and What It Signifies

Introduction

Gingival stippling is a term commonly used in dentistry to describe the texture or appearance of the gums. These stippled gums can tell dental professionals a lot about a person's oral health. While it might not be a topic of everyday conversation, understanding gingival stippling is crucial for both dental practitioners and patients. In this article, we will explore what gingival stippling is, its significance, and how it relates to oral health.

What is Gingival Stippling?

Gingival stippling refers to the small, dimpled, or pebbled texture that is often seen on the surface of healthy gums. This stippled appearance is caused by the presence of tiny, raised dots or projections on the gingival tissue, creating a finely textured, orange-peel-like appearance. Gingival stippling is most commonly found on the gums that surround the teeth in the upper and lower arches of the mouth.

Significance of Gingival Stippling:

Indication of Gingival Health:

Gingival stippling is primarily a sign of healthy gum tissue. When gums are stippled, it generally indicates that the underlying gingival tissue is firm, well-attached to the teeth, and free from inflammation or disease. Healthy gums play a crucial role in supporting the teeth and protecting them from harmful bacteria.

Assessment of Periodontal Health:

Dentists and dental hygienists use gingival stippling as one of the indicators to assess a patient's periodontal (gum) health. The absence of stippling, or a smooth, shiny appearance of the gums, may suggest an underlying issue like gum disease (periodontitis) or other oral health concerns.

Measurement of Gingival Recession:

Gingival stippling also helps in measuring gingival recession, which is when the gums start to pull away from the teeth. By comparing the stippled and non-stippled areas of the gums, dental professionals can determine the extent of gum recession, which is crucial for diagnosing and treating various oral conditions.

Aesthetic Considerations:

While the primary focus of gingival stippling is on gum health, it also has aesthetic implications. Well-stippled gums can contribute to an attractive smile by providing a uniform and textured appearance. Many people with naturally stippled gums are often perceived to have healthier-looking smiles.

Clinical Considerations:

In restorative and cosmetic dentistry, gingival stippling can influence treatment planning and the outcome of procedures like dental crowns, veneers, and dental implants. Dentists may need to replicate the stippled texture to create a natural-looking and harmonious smile.

Causes of Gingival Stippling:

Gingival stippling is primarily due to the arrangement and orientation of the connective tissue fibers beneath the gum tissue. These fibers create the characteristic raised dots on the gum surface. The presence of stippling can also be influenced by factors such as genetics, age, and overall gum health.

Conclusion:

Gingival stippling is a subtle but significant aspect of oral health and aesthetics. Understanding what it is and its significance can help individuals and dental professionals identify and address potential oral health issues in a timely manner. Regular dental check-ups and proper oral hygiene practices are key to maintaining gingival stippling and overall gum health. If you notice changes in the appearance of your gums, it's advisable to consult with a dentist to ensure the health and vitality of your oral tissues.

References:

1. Newman, M. G., Takei, H. H., & Klokkevold, P. R. (2015). Carranza's Clinical Periodontology (12th ed.). Elsevier.

2. Darby, M. L., & Walsh, M. M. (2014). Dental Hygiene Theory and Practice (4th ed.). Saunders.

3. Lang, N. P., & Bartold, P. M. (2018). Periodontal health. Journal of Clinical Periodontology, 45(Suppl 20), S9-S16. doi:10.1111/jcpe.12938.

The movement of bone in response to its own growth is termed as:

 # The movement of bone in response to its own growth is termed as:

A. Rotation

B. Primary displacement

C. Secondary displacement

D. Differentiation

The correct answer is B. Primary displacement.

Displacement is described as the change in position of an object following the application of force. In this chapter, the term will be used for body tissues (namely, bone), and force is the growth of body tissues. The displacement of bones occurs with growth in two ways:

1. Primary displacement of a bone occurs due to its growth, which causes it to move from its original position. For example displacement of the chin anteriorly due to the increasing mandibular length.

2. Secondary displacement (also called translatory growth) is an illustration of growth at a location subsequent to actual growth occurring in a distant part of the skeletal system. The structure in question is displaced from its position due to- the growth of adjacent structures. For example, growth of the spheno-occipital synchondrosis leads to anterior displacement of the front maxillary complex.

Reference: OP Kharbanda

Next to third molars, the most frequently impacted teeth are the:

 # Next to third molars, the most frequently impacted teeth are the: 

a) second molars 

b) upper canines 

c) lower canines 

d) upper incisors

The correct answer is B. Upper canines. 

The most commonly impacted teeth are third molars, followed by the maxillary canines and mandibular second molars. 

Reference: Graber 7th Edition

Miniscrew-assisted rapid palatal expansion (MARPE) is used primarily in:

 # Miniscrew-assisted rapid palatal expansion (MARPE) is used primarily in: 

a) young children 

b) the mixed dentition 

c) older adolescents and adults 

d) adults who cannot tolerate other devices

The correct answer is C. Older adolescents and adults.

In late adolescents and adults, more force is required to open the midpalatal suture due to its increased interdigitation. Treatment with a conventional RPE (Rapid Palatal Expansion) could lead to unwanted dental side effects. Therefore, from the age of 16 onwards, surgically-assisted RPE (SARPE) is commonly applied to overcome these limitations by surgically releasing the interdigitated suture prior to maxillary expansion with an RPE (Rapid Palatal Expansion) device, such as a hyrax or a Trans-Palatal Distractor (TPD). However, the inherent risks of a surgical operation, together with the cost, the hospitalization, and attendant morbidity may pose a constraint for patients to undergo this procedure.

The ensuing quest for a non-surgical treatment for maxillary transverse deficiency in patients who would normally apply for a SARPE stimulated the development of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) by Lee et al. in South Korea and by Moon et al. in the USA. MARPE is either a tooth-bone-borne or a solely bone-borne RPE device with a rigid element that connects to mini-screws inserted into the palate, delivering the expansion force directly to the basal bone of the maxilla. It was designed to maximize skeletal effects and to minimize dentoalveolar effects of expansion, based on the findings of previous histological studies revealing that the mid-palatal suture does not fully ossify in humans even at an elderly age, possibly due to the constant mechanical stress that it undergoes. MARPE has received widespread attention in recent years and several researchers have studied the efficacy of MARPE. However, to our knowledge, a systematic review on this topic has not yet been published.

Reference: Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod. 2021;43(3):313-323. doi:10.1093/ejo/cjab005

Registered Dental Clinics in the United Arab Emirates: Ensuring Quality Dental Care

The United Arab Emirates (UAE) is renowned for its commitment to excellence in all sectors, including healthcare. When it comes to dental care, the UAE is home to a multitude of registered dental clinics that adhere to stringent quality standards. In this article, we will explore the significance of registered dental clinics in the UAE, their role in providing top-notch oral healthcare, and how they contribute to the nation's overall well-being.

The Importance of Registration

Dental clinics in the UAE must undergo a rigorous registration and accreditation process to operate legally. This process is overseen by various regulatory bodies, including the UAE Ministry of Health and Prevention (MOHAP) and the respective health authorities of each emirate. The registration of dental clinics serves several crucial purposes:

Ensuring Compliance: Registered clinics are required to comply with strict regulations related to hygiene, equipment, and the qualifications of their dental staff. This helps maintain a high standard of care.

Patient Safety: The foremost concern of registered dental clinics is patient safety. These clinics are regularly inspected to ensure that all infection control measures are in place, minimizing the risk of disease transmission.

Quality Assurance: Registration also involves assessing the qualifications and expertise of dental professionals working in the clinic. This guarantees that patients receive treatment from well-trained, licensed, and experienced practitioners.

Ethical Practices: Registered clinics are expected to follow ethical guidelines in their operations, including transparent billing practices and maintaining patient confidentiality.

Wide Range of Services

Registered dental clinics in the UAE offer a wide range of services to cater to the diverse needs of the population. These services include:

General Dentistry: Routine check-ups, cleanings, fillings, and extractions.

Specialized Care: Services such as orthodontics, endodontics, periodontics, oral surgery, and pediatric dentistry are readily available.

Cosmetic Dentistry: Clinics offer cosmetic procedures like teeth whitening, veneers, and dental implants to enhance smiles.

Emergency Care: Many registered dental clinics are equipped to handle dental emergencies, providing timely treatment for injuries or sudden oral health issues.

Preventive Care: Emphasis is placed on preventive care, including fluoride treatments and dental sealants, to maintain optimal oral health.

Patient-Centered Approach

One of the hallmarks of registered dental clinics in the UAE is their patient-centered approach. They prioritize patient comfort, education, and involvement in treatment decisions. This fosters a positive patient experience and encourages individuals to take an active role in their oral health.

Cutting-Edge Technology

Registered dental clinics in the UAE often invest in state-of-the-art dental technology and equipment. This includes digital X-rays, intraoral scanners, and laser dentistry tools. The integration of advanced technology enhances diagnostic accuracy, treatment precision, and overall patient satisfaction.

Conclusion

In the United Arab Emirates, registered dental clinics play a pivotal role in providing high-quality dental care to residents and visitors alike. Through stringent registration processes, adherence to international standards, and a commitment to patient well-being, these clinics contribute significantly to the nation's healthcare infrastructure. When seeking dental care in the UAE, patients can have confidence in the professionalism, expertise, and dedication of dental professionals working in registered clinics. Access to quality dental care is essential not only for oral health but also for the overall well-being of the population. 

Succinylcholine prevents bronchospasm by:

 # Succinylcholine prevents bronchospasm by:

A. Depolarising block

B. Direct muscle relaxation

C. Centrally acting muscle relaxation

D. Dual action

The correct answer is A. Depolarising block.

A depolarizing neuromuscular blocking agent, succinylcholine adheres to post-synaptic cholinergic receptors of the motor endplate, inducing continuous disruption that results in transient fasciculations or involuntary muscle contractions and subsequent skeletal muscle paralysis. Following pharmacological onset, further neuromuscular transmittance across the neuromuscular junction is interrupted, given the medication dosage is sufficient and remains bound to the cholinergic receptor sites of the motor endplate. Depolarization of the postjunctional membrane deactivates sodium avenues resulting in inhibited responses to acetylcholine normally released. The mechanism of action is apparent within 60 seconds of intravenous administration and continues up to 360 seconds or 6 minutes.

Tic douloureux is synonymous with:

 # Tic douloureux is synonymous with:

A. Trigeminal neuralgia

B. Temporal lobe epilepsy

C. Glossopharyngeal neuralgia

D. Todds paralysis

The correct answer is A. Trigeminal neuralgia.

Trigeminal neuralgia (TN or TGN), also called Fothergill disease, tic douloureux, or trifacial neuralgia is a long-term pain disorder that affects the trigeminal nerve, the nerve responsible for sensation in the face and motor functions such as biting and chewing. It is a form of neuropathic pain. There are two main types: typical and atypical trigeminal neuralgia. The typical form results in episodes of severe, sudden, shock-like pain in one side of the face that lasts for seconds to a few minutes. Groups of these episodes can occur over a few hours. The atypical form results in a constant burning pain that is less severe. Episodes may be triggered by any touch to the face. Both forms may occur in the same person. It is regarded as one of the most painful disorders known to medicine and often results in depression.

First to classify malocclusion on structural basis:

 # First to classify malocclusion on structural basis:

A. Salzmann

B. Kingsley

C. Angle

D. Katz

The correct answer is A. Salzmann.

Salzmann in 1950 was the first to classify malocclusion based on skeletal structures. 

• Skeletal Class I: These are purely dental malocclusions. The jaws are in harmony with one another. The profile is orthognathic. 

• Skeletal Class II: Subnormal and distal mandibular development in relation to maxilla 

• Skeletal Class III: Overgrowth of the mandible with a prognathic mandible. 

Indications of Hydroxyapatite coated implants over titanium or metal-surfaced implants include all of the following except

 # Indications of Hydroxyapatite coated implants over titanium or metal-surfaced implants include all of the following except?

A. The need for greater bone-implant interface contact area

B. The ability to place the implant in type I bone

C. Fresh extraction sites

D. Newly grafted sites

The correct answer is B. The ability to place the implant in type I bone. 

Indications of HA-coated implants over titanium- or metal-surfaced implants include: 

• Need of more contact area at bone-implant interface 

• Implant can be given in type IV bone 

• Implant can be given at fresh extraction sites 

• Implant can be given at newly grafted sites 

Surfactant is secreted by:

 # Surfactant is secreted by:

A. Pneumocyte I

B. Pneumocyte II

C. Goblet cells

D. Pulmonary vessels

The correct answer is B. Pneumocyte II.

Surfactant lowers the surface tension of the fluid lining of the alveoli and prevents the collapsing tendency of the lungs. It is a phospholipid. The absence of surfactant results in Hyaline membrane disease (or) respiratory distress syndrome. 

Scleroderma is associated with:

 # Scleroderma is associated with:

A. Parry Romberg Syndrome

B. Pierre Robin Syndrome

C. Gardner Syndrome

D. Peutz Jegher Syndrome

The correct answer is A. Parry Romberg Syndrome.

Hemifacial atrophy or Parry Romberg syndrome consists of slow progressive atrophy of soft tissues of essentially half the face, characterized by progressive wasting of subcutaneous fat, accompanied by atrophy of skin, cartilage, bone, and muscle. This syndrome is accompanied usually by contralateral Jacksonian epilepsy, trigeminal neuralgia, and changes in hair and eyes. It is also reported that hemifacial atrophy is a form of localized scleroderma which is supported by its concurrence with scleroderma. 

Samaya Dental Care Pvt.Ltd., Kadaghari Kathmandu

 Name of Dental Clinic: Samaya Dental Care Pvt.Ltd.

Address (Full): Medical chowk, Kadaghari-9,Kathmandu

Year of Establishment: 2079 B. S.

Name of the chief Dental Surgeon: Dr.Nisha Sapkota

CONTACT NUMBER: 014492979

NMC Number of Dental Surgeon: 29031

CLICK HERE TO VIEW ALL DENTAL CLINICS OF BAGMATI PROVINCE

Some Sample Intraoral Photograph in Orthodontics

 Intraoral photography involves capturing a series of detailed images of the inside of a patient's mouth to document their oral health, aid in diagnosis, and monitor treatment progress. To provide a comprehensive view of the patient's oral structures, several different views or types of intraoral photographs are commonly taken. These views offer orthodontists and other dental professionals a well-rounded understanding of the patient's dental condition. Here are some of the most common views included in intraoral photography: 

Frontal View (Full-Arch View): This view captures the entire arch of teeth from the front, providing a comprehensive overview of tooth alignment, spacing, and symmetry. It helps orthodontists assess the overall aesthetics of the smile and identify any irregularities. 

Right Lateral View: The right lateral view is taken from the side to evaluate the profile of the teeth and jaws from the right angle. This view is essential for diagnosing issues like overbites, underbites, and jaw discrepancies.

Left Lateral View: Similar to the right lateral view, the left lateral view provides a profile perspective from the left side. It aids in assessing the relationship between the upper and lower jaws and identifying any asymmetries.

Upper Occlusal View: The upper occlusal view captures the biting surfaces of the upper teeth when the patient bites down. It helps orthodontists evaluate the alignment of upper teeth, spacing, and the overall occlusal relationship.

Lower Occlusal View: Similar to the upper occlusal view, the lower occlusal view focuses on the biting surfaces of the lower teeth. This view assists in evaluating lower arch alignment, spacing, and occlusal considerations.

These five specific views are crucial for orthodontists to accurately diagnose dental conditions, plan appropriate treatments, and monitor progress throughout the orthodontic journey.

Intraoral Photography in Orthodontics

 Orthodontics, the field of dentistry dedicated to correcting misaligned teeth and jaws, has evolved significantly over the years. With the advent of cutting-edge technologies, orthodontists now have a vast array of tools at their disposal to provide more accurate diagnoses, personalized treatment plans, and improved patient experiences. Among these tools, intraoral photography stands out as a valuable technique that has revolutionized the way orthodontic professionals document, analyze, and communicate treatment progress.

The Power of Intraoral Photography

Intraoral photography involves capturing high-quality images of the inside of a patient's mouth, allowing orthodontists to closely examine teeth, gums, and oral structures in intricate detail. This technique offers a multitude of advantages that contribute to more effective orthodontic treatments and enhanced patient satisfaction.

1. Precise Documentation:

Gone are the days of relying solely on hand-drawn diagrams or vague written descriptions to document a patient's oral condition. Intraoral photography provides orthodontists with clear, high-resolution images that accurately record a patient's initial condition and subsequent progress. These images can be easily stored in digital patient files and referred to at any stage of treatment, aiding in comprehensive case analysis and treatment evaluation.

2. Visual Communication:

One of the challenges in orthodontics is effectively communicating treatment plans and progress to patients. Intraoral photographs allow orthodontists to show patients visual evidence of their oral health status, making it easier for them to understand the issues that need to be addressed. Patients can see exactly what the orthodontist sees, fostering a sense of trust and understanding between the patient and the healthcare provider.

3. Treatment Planning and Monitoring:

Intraoral photographs offer orthodontists a unique perspective into a patient's oral structures that might not be as apparent during a routine clinical examination. These detailed images aid in the accurate diagnosis of various dental conditions and help orthodontists devise precise treatment plans tailored to each patient's needs. Moreover, the ability to capture images at different stages of treatment enables orthodontists to monitor progress closely and make any necessary adjustments to ensure the desired outcomes are achieved.

4. Education and Informed Consent:

When patients are well-informed about their treatment options and the expected outcomes, they are more likely to comply with treatment plans and experience greater satisfaction. Intraoral photographs allow orthodontists to visually explain different treatment modalities, potential challenges, and expected results. This informed consent process empowers patients to actively participate in their treatment journey, leading to more positive treatment experiences.

5. Research and Collaboration:

Intraoral photography not only benefits individual patients but also contributes to the advancement of orthodontic research. The ability to capture standardized, high-quality images aids in data collection and analysis for research studies aimed at improving orthodontic techniques and outcomes. Additionally, these images can be shared efficiently among colleagues and specialists, promoting collaborative discussions and multidisciplinary approaches to complex cases.

Incorporating Intraoral Photography into Practice

Implementing intraoral photography into orthodontic practice requires specialized equipment, including intraoral cameras capable of capturing detailed images of the oral cavity. These cameras are designed to be comfortable for patients and easy for orthodontic professionals to use. The images captured by these cameras can then be integrated into digital patient records and treatment planning software for seamless organization and analysis.

Orthodontists and their teams can benefit from training in proper intraoral photography techniques to ensure consistent, high-quality image capture. Learning how to position the camera, control lighting conditions, and select appropriate settings are all essential skills for obtaining accurate images that provide meaningful diagnostic and treatment information.

Conclusion

Intraoral photography has emerged as a powerful tool in orthodontics, enhancing how orthodontic professionals diagnose, plan, and monitor treatments. By providing detailed visual records, facilitating patient communication, aiding in treatment planning, and contributing to research endeavors, intraoral photography has become an indispensable aspect of modern orthodontic practice. As technology continues to advance, intraoral photography will likely continue to evolve, further improving the precision and efficacy of orthodontic treatments for patients of all ages.

Determining the Need for Dental Scaling: A Guide for Home Assessment

 Maintaining optimal oral hygiene is vital for overall health and well-being. One crucial aspect of oral care is dental scaling, a professional procedure aimed at removing stubborn plaque and tartar buildup from your teeth and gums. While it's always best to consult a dentist for a proper assessment, there are several indicators you can consider to gauge whether your teeth might need scaling. Here's a guide to help you assess the need for dental scaling at home:

Understanding Dental Scaling: Dental scaling, also known as deep cleaning, is a preventive dental procedure designed to remove accumulated plaque and tartar that regular brushing and flossing can't eliminate. Plaque is a sticky film of bacteria that adheres to your teeth and, if not removed, can lead to tooth decay, gum disease, and other oral health issues. Over time, plaque can harden into tartar, which cannot be removed through regular brushing and requires professional intervention.

Signs That Your Teeth Might Need Scaling: While self-assessment can provide some insight, it's essential to remember that only a qualified dentist can provide a definitive diagnosis. However, here are some signs that might suggest the need for dental scaling:

             1. Visible Tartar Buildup: Gently examine your teeth in a well-lit area using a mirror. If you notice a yellowish or brownish substance adhering to the tooth surfaces, especially near the gumline, as shown in the picture below, this could be tartar buildup.

              2. Bleeding Gums: If your gums bleed while brushing, flossing, or eating, it might be a sign of gum inflammation, commonly known as gingivitis. While bleeding gums can result from various factors, it can be an indication that plaque and tartar are irritating your gums.

             3. Persistent Bad Breath: Foul breath that doesn't improve with regular brushing, flossing, and mouthwash might be an indicator of bacteria buildup in hard-to-reach areas of your mouth. These bacteria could be residing in plaque and tartar.

              4. Receding Gums: If you notice that your gums are pulling away from your teeth, making your teeth appear longer, it could be a sign of advanced gum disease. Scaling might be necessary to remove tartar below the gumline and prevent further damage.

               5. Sensitivity: Increased tooth sensitivity to hot, cold, sweet, or acidic foods and beverages might suggest gum recession due to tartar accumulation. The exposure of sensitive tooth surfaces can lead to discomfort.

               6. Visible Cavities: If you can see or feel small holes or pits in your teeth, these could be cavities. Dental scaling might be needed to remove the plaque and tartar surrounding the cavities before they worsen.

Steps to Maintain Good Oral Hygiene:

While self-assessment can be helpful, it's important to consult a dentist for a professional evaluation and treatment recommendations. In the meantime, follow these steps to maintain excellent oral hygiene:

- Brush Regularly: Brush your teeth at least twice a day with a fluoride toothpaste to remove plaque and prevent tartar buildup.

- Floss Daily: Flossing helps remove food particles and plaque from between your teeth and along the gumline.

- Use Mouthwash: An antimicrobial mouthwash can help reduce bacteria in your mouth, promoting fresher breath and healthier gums.

- Maintain a Balanced Diet: Consume a diet rich in fruits, vegetables, lean proteins, and whole grains. Limit sugary and acidic foods and beverages that can contribute to tooth decay.

- Stay Hydrated: Drinking water helps rinse away food particles and bacteria from your mouth, reducing the risk of plaque buildup.

- Regular Dental Checkups: Visit your dentist for regular checkups and cleanings every six months. Professional cleanings can prevent tartar accumulation and catch dental issues early.

Final Thoughts:

While these self-assessment methods can give you some indication of your oral health status, they are not a substitute for professional dental care. If you notice any signs of plaque, tartar buildup, gum inflammation, or other oral health concerns, it's crucial to schedule an appointment with a dentist. Dental scaling, if recommended, can prevent more severe oral health issues and contribute to your overall well-being. Remember, proactive oral care is the key to a healthy smile.

For best result in class III malocclusion correction the orthopedic appliance should be worn at least:

 # For best result in class III malocclusion correction the orthopedic appliance should be worn at least:

A. 12-16 hours per day

B. 8-10 hours per day

C. 5-8 hours per day

D. Throughout night

The correct answer is A. 12-16 hours per day.

Chin cup and  face mask are the orthopedic appliances that can be given to correct skeletal class III malocclusion. At least 12 to 14 hours of wear per day produces desired results.

An ANB angle of 2 degrees on the cephalogram usually indicates:

 # An ANB angle of 2 degrees on the cephalogram usually indicates:

A. An unfavorable relationship of mandible to maxilla

B. A favorable relationship of maxillary alveolar base to mandibular alveolar base

C. Poor cranial growth with poor prognosis

D. Retruded maxillary incisor

The correct answer is B. A favorable relationship of maxillary alveolar base to mandibular alveolar base.

SNA angle relates the maxilla to the cranial base. The mean value is 82°. A larger value indicates a prognathic maxilla while a smaller value suggests a retrognathic maxilla. SNB angle relates the mandible to the cranial base. Its average value is 80°. Larger values indicate a prognathic mandible while smaller values indicate a retrusive mandible. ANB angle denotes the relative position of the maxilla and mandible to each other. The mean value is 2°. An increase in this angle indicates class-II skeletal tendency while an angle that is less than normal or a negative angle suggests a skeletal class-III relationship. 

Which condition is associated with mulberry molars in children?

 # Which condition is associated with mulberry molars in children?

A. Autism

B. Down’s syndrome

C. Syphilis

D. Diabetes mellitus

The correct answer is C. Syphilis.

Mulberry molars are a dental condition typically linked with congenital syphilis, characterized by multiple rounded rudimentary enamel cusps on the permanent first molars. Mulberry molars are actually defective permanent molars. 

In a hand wrist radiograph, which of the following carpal bones appears first?

 # In a hand wrist radiograph, which of the following carpal bones appears first?

A. Hamate

B. Triquetral

C. Lunate

D. Naviculare

The correct answer is A. Hamate. 

Sequence of Appearance of 8 Carpal bones: Capitate < Hamate < Triquetral < Lunate < Trapezium, Trapezoid, Scaphoid (Three of them appear together) < Pisiform 

Difference of width of four maxillary permanent incisors and primary incisors is about:

 # Difference of width of four maxillary permanent incisors and primary incisors is about:

A. 7 mm

B. 6 mm

C. 6.5 mm

D. 8.5 mm

The correct answer is A. 7 mm. 

Permanent incisors develop lingual to the primary incisors. For incisors to erupt in normal alignment, there is an obligate space requirement in the anterior part of both the arches which is termed as incisor liability or difference between the amount of space needed for the permanent incisors and the amount available for them is called the incisor liability. The total sum of the mesiodistal width of four permanent incisors is larger than that of primary incisors by 7.6 mm in maxilla and 6 mm in mandible. 

Excessive Soft Drink Consumption

Determining the exact threshold for what constitutes excessive or harmful soft drink consumption can be challenging, as it depends on various factors such as an individual's overall diet, lifestyle, and health status. However, health experts generally recommend limiting the intake of sugary beverages, including soft drinks, due to their negative impact on health. Here are some data on national average soft drink consumption in a few countries for comparison:

United States: According to data from the Beverage Marketing Corporation, the average American consumed approximately 38.87 gallons (about 147 liters) of carbonated soft drinks per year in 2019. This translates to roughly 1 to 2 servings per day, depending on portion size.

Mexico: Mexico has one of the highest average soft drink consumption rates globally. According to a report by Euromonitor International, Mexicans consumed an average of 121.2 liters of carbonated soft drinks per person in 2019, equivalent to over 2 servings per day.

Australia: The Australian Bureau of Statistics reported that the average Australian consumed around 85 liters of carbonated soft drinks per year in 2017-2018, indicating a daily average of approximately 232 ml or less than one serving per day.

United Kingdom: In the UK, the average soft drink consumption varies. According to data from the British Soft Drinks Association, the average per capita soft drink consumption was approximately 87 liters in 2019, equivalent to less than one serving per day.

It is important to note that these figures represent average consumption rates and may vary among individuals within each country. The World Health Organization (WHO) recommends limiting added sugar intake to less than 10% of total daily calorie intake, and further reducing it to below 5% for additional health benefits. This includes sugar from all sources, including soft drinks. Based on these guidelines, regular or excessive consumption of soft drinks, particularly those high in added sugars, can be harmful to health.

It is advisable for individuals to prioritize healthier beverage choices such as water, unsweetened tea, and natural juices, and to consume soft drinks in moderation or consider alternatives with lower sugar content. Consulting with a healthcare professional or registered dietitian can provide personalized guidance on optimal beverage consumption based on individual health needs and goals.

Harmful Effects of Soft Drinks on Health: Short-Term and Long-Term Consequences

 Harmful Effects of Soft Drinks on Health: Short-Term and Long-Term Consequences

Introduction:

Soft drinks have become a ubiquitous part of modern lifestyles, with their consumption on the rise worldwide. These sugary beverages are enjoyed for their taste, convenience, and marketing appeal. However, the excessive consumption of soft drinks has been linked to a range of detrimental health effects. This essay aims to delve into the harmful consequences of soft drink consumption on overall health, examining both the short-term and long-term impacts.

Short-Term Effects:

a) Weight Gain and Obesity: Soft drinks are laden with added sugars and calories, contributing significantly to weight gain. The consumption of sugary beverages provides excess energy without offering substantial nutritional value, leading to an increased risk of obesity. Rapid weight gain in the short term can have detrimental effects on metabolic health and increase the likelihood of developing chronic conditions such as diabetes and cardiovascular diseases.

b) Blood Sugar Spikes and Energy Slumps: Soft drinks, particularly those with high sugar content, cause rapid spikes in blood sugar levels. This can lead to a surge of energy, followed by a sudden crash, leaving individuals feeling fatigued and lethargic. The rollercoaster effect on blood sugar levels not only affects energy levels but also impacts cognitive function and overall productivity.

c) Dental Erosion and Cavities: Soft drinks contain high levels of acids, such as phosphoric acid and citric acid, which erode tooth enamel. Regular consumption of these acidic beverages can result in dental erosion, weakening the teeth and increasing the risk of cavities. The combination of acids and sugars creates an optimal environment for the growth of oral bacteria, further exacerbating dental problems.

Long-Term Effects:

a) Increased Risk of Chronic Diseases: Consistent consumption of soft drinks over time significantly raises the risk of developing chronic diseases. The high sugar content in soft drinks contributes to the development of insulin resistance, potentially leading to type 2 diabetes. Additionally, the excessive calorie intake from soft drinks can contribute to weight gain, obesity, and subsequent health issues such as cardiovascular diseases, certain cancers, and metabolic disorders.

b) Weakened Bone Health: Soft drinks contain phosphoric acid, which, when consumed in excess, can negatively impact bone health. High intake of phosphoric acid is associated with reduced calcium absorption, increasing the risk of osteoporosis and weakened bone density. Prolonged consumption of soft drinks, especially during critical growth stages, can compromise bone health and increase the likelihood of fractures and skeletal abnormalities.

c) Nutritional Deficiencies: Soft drinks often displace healthier alternatives like water, milk, and natural juices, leading to nutritional deficiencies. The empty calories provided by soft drinks contribute little to no nutritional value, depriving the body of essential vitamins, minerals, and fiber. Over time, this can result in poor overall nutrition, compromised immune function, and an increased susceptibility to various illnesses.

Conclusion:

Soft drinks, with their high sugar content and detrimental additives, pose significant risks to health both in the short term and the long term. Regular consumption of these beverages can lead to weight gain, obesity, blood sugar imbalances, dental erosion, and increased risks of chronic diseases such as diabetes and cardiovascular ailments. Furthermore, long-term consumption can negatively impact bone health and cause nutritional deficiencies. Promoting awareness of the harmful effects of soft drinks is crucial in encouraging individuals to make informed choices about their beverage consumption and prioritize their long-term health and well-being.

Which of the following elements are the constituents of white gold alloys?

 # Which of the following elements are the constituents of white gold alloys?

A. Gold and copper

B. Silver and palladium

B. Palladium and platinum

D. Copper and Palladium

The correct answer is B. Silver and palladium.

White gold is an alloy of gold and at least one white metal (usually nickel, silver, or palladium). Like yellow gold, the purity of white gold is given in karats.

White gold's properties vary depending on the metals used and their proportions. As a result, white gold alloys can be used for many different purposes: while a nickel alloy is hard and strong, and therefore good for rings and pins; gold–palladium alloys are soft, pliable, and good for white-gold gemstone settings, sometimes with other metals, like copper, silver, and platinum, added for weight and durability (although this often requires specialized goldsmiths). The term white gold is used very loosely in the industry to describe karat gold alloys with a whitish hue. The word white covers a broad range of colors that borders or overlaps pale yellow, tinted brown, and even very pale rose. The jewelry industry often conceals these off-white colors by rhodium plating; thus it is a common misconception that the color of the rhodium plating, which is seen on many commercial pieces, is the actual color of white gold.

Which of the following is the gene for sex determination?

 # Which of the following is the gene for sex determination?

A. HOX

B. Shh

C. SRY

D. Rb gene

The correct answer is C. SRY.

Some species (including humans) have a gene SRY on the Y chromosome that determines maleness. Members of SRY-reliant species can have uncommon XY chromosomal combinations such as XXY and still live. Human sex is determined by the presence or absence of a Y chromosome with a functional SRY gene. Once the SRY gene is activated, cells create testosterone and anti-müllerian hormone which typically ensures the development of a single, male reproductive system. In typical XX embryos, cells secrete estrogen, which drives the body toward the female pathway.

Torque in orthodontics refers to:

 # Torque in orthodontics refers to:

a. The change in mesiodistal inclination of teeth

b. The change in labiolingual inclination of teeth

c. The rotation of teeth

d. None of the above

The correct answer is B. The change in labiolingual inclination of teeth.

Torquing is considered as reverse tipping during which there is movement of root only without the movement of the crown. This type of tooth movement is usually used to correct the effects of uncontrolled tipping. 

Orchid Multispeciality Dental Clinic, Damak Jhapa

 Name of Dental Clinic: Orchid Multispeciality Dental Clinic

Address (Full): Province 1, Jhapa Damak-8 

Year of Establishment: 2080

Name of the chief Dental Surgeon: Dr. Pawan Singh

CONTACT NUMBER: 9819239757

NMC Number of Dental Surgeon: 17464

CLICK HERE TO VIEW ALL DENTAL CLINICS OF NEPAL LISTED PROVINCE-WISE

Which of the following materials used in orthodontics commonly causes sensitivity?

 # Which of the following materials used in orthodontics commonly causes sensitivity?

A. Steel

B. Ceramic

C. Nickel

D. Plastic

The correct answer is C. Nickel.

Most allergies in orthodontics are related to latex and nickel. Nickel can evoke IgE-mediated (immediate) and cell-mediated (delayed) hypersensitivity reactions. 

Double cantilever spring OR Z-spring

 Z-Spring

Double cantilever/Z-spring can be used for the labial movement of palatally locked incisors and also for correcting minor rotations of these teeth.

Parts of Z-Spring

a. Square loop

b. Two helices

c. Retentive arm

d. Retentive tag

Helices of Z-spring

There are two helices of small internal diameter.

Squarsh loop: Active arm with squarsh loop is incorporated at the free end of active arm and it helps in preventing soft tissue damage.

Retentive arm: It has a long retentive arm of about 10 to 12 mm length, which gets embedded in acrylic base material.

Retentive tag: Retentive tag of Z-spring is perpendicular to the retentive arm and is of 2 to 3 mm in length.

Fabrication

 Stainless steel wire of 0.5 mm or 23 gauge isn used for the fabrication of Z-spring.

 Pliers used: Universal pliers can be used for the fabrication of Z-spring.

 Z-spring can be designed to more one or two incisor in a labial direction over equal distances.

 The spring is constructed such that it is perpendicular to the palatal surface of the teeth to be moved.

 Z-spring is a supported spring and needs boxing in the wax prior to acrylization. However, the helices are kept free from acrylic so that they can be activated.

Activation of Z-Spring

 For labial movement of incisors, the Z-spring is activated by simultaneously opening both helices by 2 to 3 mm.

 For correction of minor rotations, activation is done by opening only upper helix by 2 to 3 mm.

Uses

Z-spring is used for:

a. Labial movement of one or two incisors. It is often used for correction of anterior crossbite occurring due to palatally locked upper incisors.

b. It can also be used for the correction of mild rotation of incisors.

MCQs in Endodontics - Biomechanical Preparation

# The root canal instrument most likely to break during use is a:
A. File
B. Broach
C. Reamers
D. Spreaders

# While root canal biomechanical preparation apical constriction is enlarged to 50 sized instrument. You would like to:
A. Use reverse filling technique
B. Reinstrument with larger instrument 1 mm short of previous preparation
C. Fit a 50 mm cone and condense carefully
D. Fill with 40 sized cone

Dental Implants: Choosing the Right Dental Specialist

Dental implants have revolutionized the field of restorative dentistry, offering patients a reliable and long-lasting solution for missing teeth. When considering dental implants, it is essential to choose the right dental specialist to ensure a successful and comfortable treatment outcome. In this essay, we will explore the various dental specialists involved in the dental implant process and discuss the factors to consider when selecting the most suitable specialist for your implant procedure.

1. Periodontist:

Periodontists specialize in the prevention, diagnosis, and treatment of gum diseases and conditions affecting the supporting structures of teeth. They play a crucial role in dental implant treatment by ensuring the health of the gums and jawbone. Periodontists are skilled in procedures such as bone grafting and gum tissue manipulation, which are often necessary for successful implant placement. If you have periodontal issues or inadequate bone density, consulting a periodontist is essential for evaluating your implant candidacy.

2. Prosthodontist:

Prosthodontists are dental specialists who focus on the restoration and replacement of teeth. They have extensive training in the diagnosis, treatment planning, and placement of dental implants. Prosthodontists are skilled in designing and creating custom-made prostheses, such as implant-supported crowns, bridges, and dentures. Their expertise in restorative dentistry makes them an excellent choice for complex implant cases requiring extensive rehabilitation.

3. Oral and Maxillofacial Surgeon:

Oral and maxillofacial surgeons are dental specialists who specialize in surgical procedures involving the mouth, jaw, and face. They possess advanced training in dental implant surgery, including the placement of implants into the jawbone. These specialists are equipped to handle complex cases that require bone grafting, sinus lifts, or other surgical procedures to ensure the success of dental implants. If your implant treatment plan involves extensive surgical interventions, an oral and maxillofacial surgeon may be the ideal choice.

4. General Dentist:

General dentists, although not specialists, can also perform dental implant procedures. They typically have foundational knowledge and experience in restorative dentistry, including implant placement. General dentists are well-suited for straightforward implant cases with sufficient bone volume and healthy gum tissues. However, for complex cases or patients with specific oral health concerns, a referral to a specialist may be recommended.

Factors to Consider When Choosing a Dental Specialist:

a. Experience and Expertise: Look for a specialist who has extensive experience and a proven track record in dental implant procedures. Review their qualifications, training, and any specialized certifications related to implant dentistry.

b. Referrals and Recommendations: Seek recommendations from trusted sources, such as your general dentist, friends, or family members who have undergone successful implant treatments. Their experiences can provide valuable insights into the expertise and quality of care provided by different specialists.

c. Consultation and Communication: Schedule consultations with potential dental specialists to discuss your treatment needs and goals. Pay attention to their ability to communicate clearly, address your concerns, and provide a comprehensive treatment plan.

d. Technology and Facilities: Inquire about the technology and equipment available at the dental practice. State-of-the-art facilities often indicate a commitment to delivering advanced and efficient implant treatments.

e. Patient Comfort and Support: Consider the level of care and support offered by the dental specialist and their team. A comfortable and supportive environment can significantly impact your implant experience.

Choosing the right dental specialist is crucial when considering dental implant treatment. Prosthodontists, oral and maxillofacial surgeons, periodontists, and general dentists all play important roles in the implant process. Evaluating their experience, expertise, referrals, communication skills, facilities, and patient support will help you make an informed decision. By selecting the most suitable dental specialist, you can ensure a successful and satisfactory dental implant experience. Remember, each case is unique, and the complexity of your situation will determine the most appropriate specialist to choose. Consulting with multiple specialists and gathering as much information as possible will help you make an informed decision and ultimately achieve a beautiful and functional smile through dental implants. Prioritize your oral health and seek the expertise of a qualified dental professional to guide you through this transformative journey.

Maximizing Patient Satisfaction: Offering Dental Discounts without Revenue Loss

 In the competitive world of dentistry, attracting and retaining patients is crucial for a thriving dental practice. One effective strategy to achieve this is by offering discounts to patients. However, many dentists worry about the potential revenue loss associated with implementing such discounts. In this essay, we will explore several key strategies that dental practices can employ to provide discounts to patients without compromising revenue.

Analyze Treatment Margins:

To offer discounts without affecting revenue, dental practices should first conduct a comprehensive analysis of their treatment margins. By evaluating the profitability of various procedures, dentists can identify areas where discounts can be implemented without significant financial impact. For example, procedures with higher profit margins could be targeted for discount offers.

Implement Strategic Discount Packages:

Instead of offering discounts on individual procedures, dental practices can create bundled treatment packages. These packages can combine several services at a discounted rate, attracting patients while ensuring that the overall revenue remains stable. For instance, a package that includes teeth whitening, dental cleaning, and a comprehensive oral exam could be offered at a reduced price, encouraging patients to opt for multiple services.

Focus on New Patient Acquisition:

Another effective approach to offering discounts without revenue loss is by targeting new patient acquisition. Providing discounts exclusively to new patients allows dental practices to attract a larger customer base without impacting existing patient revenue. Implementing this strategy alongside exceptional patient care and service can turn new patients into loyal, long-term customers.

Leverage Collaborative Partnerships:

Dental practices can establish partnerships with local businesses or dental suppliers to create mutually beneficial discount programs. By partnering with orthodontists, periodontists, or dental laboratories, practices can offer discounted services to their patients without sacrificing revenue. These collaborations not only widen the range of services available to patients but also provide additional exposure and referrals.

Employ Time-Limited Promotions:

Time-limited promotions can create a sense of urgency and encourage patients to take advantage of the offered discounts promptly. By setting clear start and end dates for promotional offers, dental practices can instill a fear of missing out, prompting patients to schedule appointments sooner. This time-bound approach ensures a consistent stream of patients seeking discounted treatments without compromising long-term revenue.

Focus on Value-Added Services:

Rather than solely relying on monetary discounts, dental practices can offer value-added services as incentives. For instance, complimentary teeth whitening kits, oral hygiene education sessions, or preventive care packages can be provided alongside regular treatments. These extra benefits enhance the patient experience and increase perceived value without directly reducing prices.

Enhance Referral Programs:

Referral programs can be an effective way to generate new patients while maintaining revenue levels. By encouraging existing patients to refer friends and family members, dental practices can offer discounts on future treatments as a reward. This approach not only attracts new patients but also increases patient loyalty and retention.

Providing discounts to dental patients does not have to result in a drop in revenue. By employing a strategic approach and implementing the strategies mentioned above, dental practices can offer discounts without compromising their financial stability. Analyzing treatment margins, implementing bundled packages, targeting new patient acquisition, fostering partnerships, using time-limited promotions, focusing on value-added services, and enhancing referral programs are all effective ways to offer discounts while maintaining a thriving dental practice. With careful planning and execution, dental practices can optimize patient satisfaction, attract new clients, and achieve long-term financial success.

Modification of Adam's clasp with distal extension

  In orthodontics, the modification of Adam's clasp with distal extension refers to a technique where the distal end of the Adam's clasp is extended to engage elastics or auxiliary components.

Adam's clasp is a commonly used intraoral auxiliary component in orthodontic treatment. It consists of a rectangular wire arm that extends from the buccal surface of a molar tooth and curves occlusally to engage an undercut on an adjacent tooth. It provides anchorage and stability to the orthodontic appliance or archwire.

The modification of Adam's clasp with distal extension involves extending the clasp arm distally beyond the last tooth involved in the clasp. This extended portion is used to attach elastics, which are commonly used in orthodontics to apply additional forces and aid in tooth movement.

The distal extension of Adam's clasp allows for the placement of elastics from the extended arm to various areas in the mouth, such as hooks on brackets or other auxiliary attachments. The elastics exert the desired force vectors, assisting in achieving the desired tooth movements and occlusal adjustments.

By incorporating the distal extension into the Adam's clasp design, orthodontists can apply forces in different directions to address specific tooth movements, such as closing gaps, correcting malocclusions, or aligning the bite. It provides versatility in treatment mechanics and enhances the precision and control of orthodontic tooth movements.

It's important to note that the modification of Adam's clasp with distal extension is specific to certain orthodontic cases and treatment plans. The decision to utilize this modification is made by the orthodontist based on the individual patient's needs and treatment goals.

In summary, the modification of Adam's clasp with distal extension in orthodontics involves extending the clasp arm beyond the last tooth to engage elastics. This modification allows for the application of additional forces to achieve specific tooth movements and optimize treatment outcomes.

Sensory nerve supply to the base of the tongue:

 # Sensory nerve supply to the base of the tongue:

A. Facial nerve

B. Trigeminal nerve

C. Glossopharyngeal nerve

D. Optic nerve

The correct answer is C. Glossopharyngeal nerve.

The hypoglossal nerve (CN XII) provides motor innervation to all of the intrinsic and extrinsic muscles of the tongue except for the palatoglossus muscle, which is innervated by the vagus nerve (CN X). It runs superficial to the hyoglossus muscle. Lesions of the hypoglossal nerve cause deviation of the tongue to the ipsilateral (i.e., damaged) side.

Taste to the anterior two-thirds of the tongue is achieved through innervation from the chorda tympani nerve, a branch of the facial nerve (CN VII). General sensation to the anterior two-thirds of the tongue is by innervation from the lingual nerve, a branch of the mandibular branch of the trigeminal nerve (CN V3). The lingual nerve is located deep and medial to the hyoglossus muscle and is associated with the submandibular ganglion.

On the other hand, taste perception in the posterior third of the tongue is accomplished through innervation from the glossopharyngeal nerve (CN IX), which also provides general sensation to the posterior one-third of the tongue. Taste perception also is performed by both the epiglottis and the epiglottic region of the tongue, which receives taste and general sensation from innervation by the internal laryngeal branch of the vagus nerve (CN X). Damage to the vagus nerve (CN X) causes contralateral deviation (away from the injured side) of the uvula.

Reference: Dotiwala AK, Samra NS. Anatomy, Head and Neck, Tongue. [Updated 2022 Aug 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507782/

Sensory nerves supply to the body of the tongue:

 # Sensory nerves supply to the body of the tongue:

A. Optic nerve

B. Trigeminal nerve

C. Facial nerve

D. Glossopharyngeal nerve

The correct answer is B. Trigeminal nerve.

The hypoglossal nerve (CN XII) provides motor innervation to all of the intrinsic and extrinsic muscles of the tongue except for the palatoglossus muscle, which is innervated by the vagus nerve (CN X). It runs superficial to the hyoglossus muscle. Lesions of the hypoglossal nerve cause deviation of the tongue to the ipsilateral (i.e., damaged) side.

Taste to the anterior two-thirds of the tongue is achieved through innervation from the chorda tympani nerve, a branch of the facial nerve (CN VII). General sensation to the anterior two-thirds of the tongue is by innervation from the lingual nerve, a branch of the mandibular branch of the trigeminal nerve (CN V3). The lingual nerve is located deep and medial to the hyoglossus muscle and is associated with the submandibular ganglion.

On the other hand, taste perception in the posterior third of the tongue is accomplished through innervation from the glossopharyngeal nerve (CN IX), which also provides general sensation to the posterior one-third of the tongue. Taste perception also is performed by both the epiglottis and the epiglottic region of the tongue, which receives taste and general sensation from innervation by the internal laryngeal branch of the vagus nerve (CN X). Damage to the vagus nerve (CN X) causes contralateral deviation (away from the injured side) of the uvula.

Reference: Dotiwala AK, Samra NS. Anatomy, Head and Neck, Tongue. [Updated 2022 Aug 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507782/

From which arch is hypobranchial eminence derived?

 # Hypobranchial eminence is derived from:

A. 1st arch 

B. 2nd arch

C. 3rd arch 

D. 4th arch

The correct answer is C. 3rd arch.

During embryonic development, the pharyngeal arches play a crucial role in the formation of various structures in the head and neck region. The third pharyngeal arch gives rise to several important structures, including the hyoid bone, the posterior one-third of the tongue (base of the tongue), and the associated muscles and nerves.

The hypobranchial eminence is a swelling within the third pharyngeal arch that contributes to the formation of the base of the tongue. It gives rise to the posterior part of the tongue, while the anterior part of the tongue is formed by the first pharyngeal arch.

Therefore, the correct option is C. 3rd arch.

Development of coronoid process of mandible occurs at:

 # Development of coronoid process of mandible occurs at:

A. 10-12 weeks 

B. 12-16 weeks

C. 10-14 weeks 

D. 14-16 weeks

The correct answer is C. 10-14 weeks.

The development of the coronoid process of the mandible occurs during the embryonic period of gestation. Specifically, it takes place between 10 and 14 weeks of gestation. Therefore, the correct option is C. 10-14 weeks.

During this time frame, the mandible undergoes various developmental processes, including the formation of the mandibular body, the ramus, and the coronoid process. The coronoid process is a bony prominence located on the anterior aspect of the ramus of the mandible. It serves as an attachment site for muscles involved in chewing and jaw movement.

Options A and B (10-12 weeks and 12-16 weeks) and Option D (14-16 weeks) do not accurately represent the developmental period when the coronoid process of the mandible forms. The correct time frame is 10-14 weeks.

Posterior one third of the tongue or base is formed by:

 # Posterior one third of the tongue or base is formed by:

A. Two lingual swelling

B. Hypobranchial eminence

C. Copula

D. Tuberculum impar

The correct answer is B. Hypobranchial eminence.

The hypobranchial eminence is a swelling in the embryonic development of the tongue that gives rise to the base of the tongue. It is located in the midline and forms the posterior part of the tongue. It develops from the third and fourth pharyngeal arches during embryonic development.

The other options mentioned are not specifically related to the formation of the posterior one third of the tongue.

A. Two lingual swellings: These refer to the anterior two-thirds of the tongue, which are formed by a pair of lingual swellings that merge during development.

C. Copula: The copula is a structure in embryonic development that contributes to the formation of the posterior part of the tongue, but it does not specifically form the base of the tongue.

D. Tuberculum impar: The tuberculum impar is a small median swelling in the embryonic development of the tongue, located at the midline in the anterior part of the tongue, and it does not contribute to the formation of the base of the tongue.

Therefore, the correct option is B. Hypobranchial eminence.