Collagen turnover rate in the gingiva is:

 # Collagen turnover rate in the gingiva is:

A. lower than that in the periodontal ligament

B. Higher than that in the periodontal ligament

C. Equal to that in the periodontal ligament

D. Very less as collagen fibrils are mature cell components

The correct answer is A. Lower than that in the periodontal ligament.

Overall, collagen turnover rate in the gingiva is lower than that in the periodontal ligament. Slow gingival fiber turnover may result from the lowered functional stress on this tissue as the transseptal fibers function in a manner similar to tendons, providing firm anchorage of the tooth. Remodeling and regeneration of gingival epithelium can also be slow. This is evidenced by the appearance of a red patch in the soft tissue region away from which a tooth is moved, which is caused by exposure of tissues underneath the epithelium.

Commonest type of lung carcinoma in non smokers:

# Commonest type of lung carcinoma in non smokers:

A. Squamous cell carcinoma

B. Adenocarcinoma

C. Alveolar cell carcinoma

D. Small cell carcinoma

The correct answer is B. Adenocarcinoma. 

Types of Lung Carcinoma:

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type, accounting for about 80% of all lung cancers. Here's a breakdown of the options you provided:

Squamous cell carcinoma: This is a type of NSCLC that typically starts in the flat cells lining the airways of the lungs. Smoking is a major risk factor for squamous cell carcinoma.

Adenocarcinoma: This is also a type of NSCLC, and it's the most common type of lung cancer diagnosed in both smokers and non-smokers. It starts in the gland cells that make mucus in the lungs.

Alveolar cell carcinoma: This is a rare type of lung cancer that starts in the air sacs of the lungs. It's more common in smokers than non-smokers.

Small cell carcinoma: This is an aggressive type of lung cancer that can spread quickly. It's less common than NSCLC and is also more likely to occur in smokers.

Why Adenocarcinoma in Non-Smokers:

While smoking is the leading cause of lung cancer,  adenocarcinoma can develop in people who have never smoked. Here's why it's the most common type in non-smokers:

Risk Factors: Non-smoking related risk factors for adenocarcinoma include exposure to radon gas, secondhand smoke, air pollution, and a family history of lung cancer.

Cell Type: Adenocarcinoma originates in the gland cells lining the lungs, which are less affected by smoking compared to the cells targeted by squamous cell carcinoma.

Mutations:  Non-smokers with lung cancer are more likely to have specific gene mutations, particularly in the EGFR gene, which can drive the development of adenocarcinoma.

Capacitation occurs in:

 # Capacitation occurs in:

A. Female genital tract

B. Sertoli cells

C. Rete testis

D. Seminiferous tubules

The correct answer is A. Female genital tract.

Capacitation is the process that sperm undergo in the female reproductive tract to become able to fertilize an egg. It does not happen in the male reproductive organs. 

Capacitation occurs in the female reproductive tract. It’s a crucial step in the maturation of mammalian spermatozoa, rendering them competent to fertilize an oocyte. During capacitation, the sperm undergo biochemical changes that prepare them for the acrosome reaction, allowing penetration of the egg’s outer layer for fertilization. So, the correct answer is A. Female genital tract.

Dental Solution Pvt Ltd , Kirtan chowk baluwatar Kathmandu nepal

 Name of Dental Clinic: Dental Solution Pvt Ltd 

Address (Full) Kirtan chowk baluwatar Kathmandu nepal

Year of Establishment: 2022

Name of the chief Dental Surgeon: Dr Abhishek Kumar

CONTACT NUMBER: 9818174710

NMC Number of Dental Surgeon: 5703

CLICK HERE TO VIEW ALL DENTAL CLINICS OF BAGMATI PROVINCE

Which among the following is not a feature of Mediterranean anemia?

 # Which among the following is not a feature of Mediterranean anemia?

A. Rodent like facies

B. Fessa bodies

C. Rib within rib appearance

D. Platybasia

The correct answer is D. Platybasia.

Mediterranean anemia, also known as thalassemia, is a group of inherited blood disorders characterized by reduced or absent production of normal hemoglobin. This leads to various clinical manifestations, including skeletal changes due to bone marrow expansion. However, platybasia (flattening of the skull base) is not typically associated with thalassemia.

Rodent-like facies: This is a characteristic of sickle cell anemia, not thalassemia. It refers to the overgrowth of the maxillary bones and protrusion of the upper incisors.

Fessas bodies: In heterozygotes, the disease is mild and is called thalassemia minor or thalassemia trait. It represents both α-and β-thalassemia. Homozygotes may exhibit a severe form of the disease that is called thalassemia major or homozygous -thalassemia, in which the production of β-chains is markedly decreased or absent, and a consequent decrease in synthesis of total hemoglobin occurs. This results

in severe hypochromic anemia. Furthermore, excess α-chains, which synthesize at the normal rate, precipitate as insoluble inclusion bodies within the erythrocytes and their precursors.

The presence of such intracellular inclusion bodies (Fessas bodies) leads to increased erythrocyte hemolysis and severe ineffective hematopoiesis. Approximately 70–85% of marrow normoblasts are destroyed in severely affected patients. These processes result in profound anemia and an associated increase in marrow activity, which is estimated to increase 5- to 30-fold.

Rib within rib appearance: This is also known as "rib notching" and is caused by bone marrow expansion eroding the undersurface of the ribs.

Reference:

Radiopaedia: https://radiopaedia.org/articles/thalassaemia

All are features of Keratocystic odontogenic tumor EXCEPT:

# All are features of Keratocystic odontogenic tumor EXCEPT:

A. Most common location is the posterior body of the mandible

B. Shows evidence of a cortical border, when not secondarily infected

C. Internal structure is most commonly radiopaque

D. Curved internal septa may be present

The correct answer is C. Internal structure is most commonly radioopaque.

Keratocystic odontogenic tumors (KCOTs) are benign but locally aggressive lesions. Their radiographic appearance is typically:

Radiolucent: KCOTs appear as dark areas on radiographs, indicating that they are less dense than the surrounding bone.

Well-defined borders: They usually have clear and distinct margins.

Unilocular or multilocular: They can be single-chambered (unilocular) or multi-chambered (multilocular).

Scalloped borders: The edges of the lesion may have a wavy or scalloped appearance.

Curved septa: If multilocular, the internal septa may appear curved.

Reference:

Odontogenic keratocyst | Radiology Reference Article | Radiopaedia.org: https://radiopaedia.org/articles/odontogenic-keratocyst

# Soldering and welding is not possible in:

 # Soldering and welding is not possible in:

Stainless steel wire

Elgiloy

Nitinol

TMA

The correct answer is C. Nitinol.

Limitations of NiTi wires

NiTi wires have very low formability in the clinical setting. These wires cannot be welded or soldered due to the passivating nature of titanium dioxide which is strongly adhered to the metal surface. The frictional forces in the nitinol wire are very high due to high Ti content, and therefore these wires are unsuitable for sliding tooth movements such as retraction on the wire.

NiTi wires have highest nickel content among the appliances used in orthodontics which is 55%. Although they are greatly biocompatible, however, high nickel content could be disadvantageous by causing hypersensitive reactions.

Reference: Orthodontics: Diagnosis and management of malocclusion and dentofacial deformities, OP Kharbanda, 2020

STOP USING DABUR LAL DANT MANJAN ! Why you should not use Dabur Lal Dant Manjan?

 Dabur Lal Dant Manjan is not fluoridated. It is an Ayurvedic toothpaste made with traditional herbs and ingredients. While it's popular in many countries, including India, its legal sale in the USA might be limited due to the lack of fluoride, which is a standard ingredient in toothpaste for cavity prevention.

Here's why it's still sold legally in many countries:

Cultural Preference: Ayurvedic practices are deeply ingrained in many cultures, and people trust and prefer traditional remedies like Dabur Lal Dant Manjan.

Alternative Ingredients: While not containing fluoride, Dabur Lal Dant Manjan includes ingredients like clove and other herbs that are believed to have antibacterial and oral health benefits.

Focus on Gum Health: Some users believe that the toothpaste is effective in maintaining gum health and preventing gum diseases.

Lack of Awareness: In some regions, there might be a lack of awareness about the importance of fluoride in preventing tooth decay.

Important Note: The American Dental Association (ADA) recommends using toothpaste with fluoride for effective cavity prevention. If you're concerned about tooth decay, consult your dentist for advice on the most suitable toothpaste for your oral health needs.

A 17 year old male, who has been using Dabur Lal Dant Manjan since his early childhood and has never used fluoridated toothpaste has developed dental caries as depicted in the image below. Though there could be many other contributory factors like poor oral hygiene, low salivary flow, mouth breathing habit, use of drugs causing xerostomia, radiation-induced salivary gland aplasia or some unknown factors, use of fluoridated toothpaste could have reduced the severity of the decay.

The contour of the incisal edges of the maxillary anterior teeth relative to the curvature of the lower lip during a social smile is called:

# The contour of the incisal edges of the maxillary anterior teeth relative to the curvature of the lower lip during a social smile is called:

Line of occlusion

b. Curve of Spee

c. Curve of Monson

d. Smile arc

The correct answer is D. Smile arc.

The smile arc is defined as the contour of the incisal edges of the maxillary anterior teeth relative to the curvature of the lower lip during a social smile. For best appearance, the contour of the incisal edges of these teeth should parallel the curvature of the lower lip. If the lip and dental contours match, they are said to be consonant.

A flattened (non-consonant) smile arc can pose either or both of two problems: It is less attractive, and it tends to make you look older (because older individuals often have wear of the incisors that tends to flatten the arc of the teeth). The characteristics of the smile arc must be monitored during orthodontic treatment because it is surprisingly easy to flatten it in the pursuit of other treatment objectives. The data indicate that the most important factor in smile esthetics, the only one that can change the rating of a smile from acceptable to unesthetic, is the smile arc.

Ref: Contemporary Orthodontics, William R. Proffit, 6th Edition.

# Concept of cortical anchorage given by:

# Concept of cortical anchorage given by:

a. Angle 

b. Kingsley 

c. Ricketts 

d. Newton 

The correct answer is C. Ricketts. 

Rickets technique by intentionally bringing the buccal roots of the anchor teeth into contact with the cortical plates of bone thus increasing the anchorage value of such teeth. It should be appreciated that this process should be carried out with great care and precision since overzealous torque can produce root resorption or in extreme cases cortical perforation. (Brezniak& Wasserstein, 2008)

One of the following procedures falls under high bacteremia risk for infective endocarditis:

 

# One of the following procedures falls under high bacteremia risk for infective endocarditis: 

a. Post-operative suture removal 

b. Intraligamentary and intra-osseous local anesthetics injections 

c. Intracanal endodontic treatment 

d. Placement/ removal of removable orthodontic appliances 

The correct answer is B. Intraligamentary and intra-osseous local anesthetics injections.

All dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa are the procedures for which endocarditis prophylaxis is reasonable.

The following procedures and events do not need prophylaxis: 

• routine anesthetic injections through noninfected tissue,  
• taking dental radiographs, 
• placement of removable prosthodontic or orthodontic appliances, 
• adjustment of orthodontic appliances, 
• placement of orthodontic brackets, 
• shedding of deciduous teeth, 
• and bleeding from trauma to the lips or oral mucosa. 

Fenestration as an adverse effect of Fixed Orthodontic Treatment

 Fenestration is a notable adverse effect associated with fixed orthodontic treatment. It refers to the formation of a window-like defect in the alveolar bone, where the root of a tooth becomes partially exposed due to the bone's resorption. This condition can occur when excessive or improperly directed orthodontic forces are applied, causing the tooth to move outside the limits of the alveolar bone housing.

The main factors contributing to fenestration include:

Excessive Force Application: Applying too much force during orthodontic treatment can lead to undue stress on the bone, resulting in resorption and fenestration.

Unfavorable Tooth Movement: Moving teeth in directions that extend beyond the anatomical boundaries of the alveolar bone can cause this adverse effect.

Pre-existing Bone Deficits: Patients with naturally thin or compromised alveolar bone are more susceptible to fenestration when undergoing orthodontic treatment.

Fenestration above left maxillary canine in a female patient undergoing fixed orthodontic treatment

The clinical implications of fenestration include increased risk of periodontal problems, potential tooth sensitivity, and aesthetic concerns. Early detection and careful planning of orthodontic forces are crucial to minimize the risk of fenestration. Regular monitoring through clinical and radiographic evaluations can help in identifying early signs of this adverse effect, allowing for timely intervention to prevent further complications.

Detecting fenestration clinically involves a combination of visual examination, palpation, and radiographic assessment. Here are the primary methods used:

1. Visual Examination

Gingival Recession: Look for areas where the gum line appears lower than usual, which may indicate underlying bone loss.

Tooth Root Visibility: In severe cases, the root of the tooth might be visible through the gum tissue.

2. Palpation

Probing: Gently probing the gum tissue around the suspected area can help identify soft spots or depressions that suggest bone loss.

Tactile Sensation: Feeling for irregularities in the bone contour by gently pressing the gingiva around the suspected area.

3. Radiographic Assessment

Intraoral Periapical Radiographs: These provide detailed images of the tooth and surrounding bone, which can help identify areas of bone loss.

Cone Beam Computed Tomography (CBCT): Offers a three-dimensional view of the alveolar bone, making it easier to detect fenestration accurately.

Panoramic Radiographs: These can be used for a broader view, though they are less detailed compared to periapical radiographs and CBCT.

4. Additional Diagnostic Tools

Periodontal Probing Depths: Increased probing depths around a tooth can indicate bone loss.

Bone Scanning: In some cases, advanced imaging techniques like bone scans might be used for a more detailed assessment.

Clinical Signs to Watch For

Localized Inflammation: Swelling or redness around the affected area.

Pain or Discomfort: Patients may report unusual sensitivity or pain in the area, especially when pressure is applied.

Changes in Tooth Position: Shifts in tooth alignment may also indicate underlying bone issues.

Regular follow-up appointments and careful monitoring are essential for early detection and management of fenestration during orthodontic treatment.

The daily requirement of vitamin B12 is:

 # The daily requirement of vitamin B12 is: 

A. 0.25-0.67 mcg per day

B. 3-5 mcg per day

C. 0.5-0.7 mcg per day

D. 1-2 mcg per day

The correct answer is D. 1-2 mcg per day.

Vitamin B12 plays a crucial role in maintaining healthy nerve function, supporting red blood cell production, and aiding in DNA synthesis. This range is in line with the daily recommended intake for vitamin B12 for most adults, which is typically around 2.4 mcg per day according to various health guidelines.

Organism most commonly seen in lung abscesses is:

 # Organism most commonly seen in lung abscesses is: 

A. Candida albicans 

B. Herpes zoster virus 

C. Oropharyngeal flora 

D. Staphylococcus aureus

(PSC KOSHI 2081)

The correct answer is C. Oropharyngeal flora. 

Lung abscesses are typically caused by aspiration of bacteria from the oropharyngeal flora. This flora includes a mix of aerobic and anaerobic bacteria normally found in the mouth and throat. When these bacteria are aspirated into the lungs, they can cause an infection leading to a lung abscess.

While the other options listed can cause infections in the lungs, they are not the most common cause of lung abscesses:

Candida albicans (A): This fungus is a common cause of opportunistic infections, but it is not the most common cause of lung abscesses.

Herpes zoster virus (B): This virus causes shingles and can rarely lead to lung complications, but it is not a common cause of lung abscesses.

Staphylococcus aureus (D): While this bacterium can cause pneumonia and other lung infections, it is not the most common cause of lung abscesses.

Tetany is caused by:

 # Tetany is caused by:

A. Hyperglycemia 

B. Hypocalcemia 

C. Clostridium tetani 

D. Low oxygen level

The correct answer is B. Hypocalcemia.

Tetany is a condition characterized by involuntary muscle contractions, cramps, and spasms. The primary cause of tetany is hypocalcemia, which is a low level of calcium in the blood. Calcium plays a crucial role in muscle contraction and nerve function. When calcium levels are low, nerves become hyperexcitable, leading to the uncontrolled muscle contractions seen in tetany.

Hyperglycemia (A): High blood sugar levels are associated with diabetes, not tetany.

Clostridium tetani (C): This bacterium causes tetanus, a different condition characterized by muscle stiffness and spasms.

Low oxygen level (D): While low oxygen can cause various symptoms, it is not the primary cause of tetany.

Reference: Hypocalcemia and Tetany: Causes, Symptoms, and Treatment (webmd.com)

Intrusion of tooth is resisted by:

 # Intrusion of tooth is resisted by:

A. Apical and interradicular fibers

B. Oblique and horizontal fibers

C. Alveolar crest and oblique fibers

D. All Periodontal fibers

The correct answer is C. Alveolar crest and oblique fibers.

The principal fibers of periodontal ligament are arranged in six groups and are named according to their

location and direction of attachment. 

1. Transseptal group

Location: These fibers run into the interproximal space over the crest of alveolar bone and get inserted in the cementum of neighboring tooth.

Function: They have the innate capacity to reconstruct themselves in periodontal disease even there is destruction of the alveolar bone. This unique property of fibers is responsible for returning teeth to their original state after orthodontic therapy.

2. Alveolar crest group (apico-oblique)

Location: Cervical root to alveolar crest of alveolar bone proper

Function: Prevent extrusion and lateral tooth movements

3. Horizontal group

Location: Mid root to adjacent bone proper

Function: Resists horizontal forces

4. Oblique group (coronal-oblique)

Location: Apical one-third of root to adjacent bone proper

Function: Resists vertical masticatory stresses and convert them into tension on alveolar bone

5. Apical group

Location: Apex of root to fundic proper

Function: Prevent tooth tipping, resist luxation and protect neurovascular supply to the tooth

6. Interradicular group

Location: Between roots to alveolar bone proper

Function: Prevent luxation, torquing and tooth tipping

The Unsung Hero of Dentistry: Why Dental Practice Management Software is Essential

 The world of dentistry is a constant hustle. Between patient appointments, procedures, and administrative tasks, it's easy for crucial aspects of running a smooth practice to fall by the wayside. This is where dental practice management software (PMS) steps in as the unsung hero, streamlining operations and boosting efficiency.

Why is Dental Practice Management Important?

Imagine juggling appointment scheduling, billing, insurance verification, patient records, and inventory management – all manually. It would be a logistical nightmare. Dental practice management software automates these tasks, freeing up valuable time for dentists and staff to focus on what matters most: patient care.

Here's how a PMS empowers your practice:

• Enhanced Patient Experience: Streamlined scheduling allows patients to book appointments online, reducing wait times and improving convenience. Electronic health records (EHR) ensure accurate and readily available patient information. Secure communication tools within the PMS facilitate appointment reminders and follow-up communication.
• Improved Efficiency: Tasks like scheduling, billing, and insurance verification are automated, saving valuable time and reducing errors. Staff can focus on providing excellent patient care without getting bogged down in paperwork.
• Boosted Revenue: Timely and accurate billing with integrated insurance processing ensures you get paid faster. Automated appointment reminders minimize missed appointments and lost revenue. Efficient inventory management helps avoid stockouts and unnecessary purchases.
• Data-driven Decision Making: PMS software provides valuable reports and insights on practice performance. Analyze appointment trends, track patient demographics, and identify areas for improvement.
• Compliance with Regulations: Secure storage of patient data and streamlined documentation processes help your practice stay compliant with HIPAA and other regulations.

Popular Dental Practice Management Software Options

With a plethora of PMS options available, choosing the right one for your practice depends on several factors, including practice size, budget, and specific needs. Here's a glimpse into some of the most commonly used dental practice management software solutions:

• Dentrix: A comprehensive solution catering to practices of all sizes, Dentrix offers a robust set of features including scheduling, billing, charting, reporting, and patient engagement tools. It also integrates with various third-party applications.
• Eaglesoft: Renowned for its user-friendliness and focus on clinical workflows, Eaglesoft streamlines patient charting, treatment planning, and practice management. It caters well to smaller and mid-sized practices.
• CareStack: Cloud-based and scalable, CareStack offers a modern platform with a focus on patient engagement and practice analytics. It is particularly well-suited for practices looking for a flexible and customizable solution.
• Open Dental: An open-source option gaining traction, Open Dental is a cost-effective solution that offers a decent feature set. However, it requires some technical expertise for setup and customization.
• Dentiflow: Another cloud-based platform, Dentiflow caters specifically to dental practices. It offers modules for scheduling, charting, billing, and patient communication, along with features like online appointment booking and mobile app access.

Choosing the Right Dental PMS

Before diving in, consider these factors:

• Practice Size and Needs: A solo practitioner might not require the same level of functionality as a large group practice. Identify your specific needs and budget accordingly.
• Ease of Use: User-friendliness for both dentists and staff is crucial. Consider user interfaces, training options, and technical support offered by the software provider.
• Scalability: Will your practice grow in the future? Choose software that scales with your needs.
• Integration with Existing Systems: Ensure the PMS integrates seamlessly with your existing dental imaging software, EHR systems, and lab management tools.
• Security: Data security is paramount. Look for HIPAA-compliant software with robust security features.

Investing in a Dental Practice Management Software is an investment in your practice's future. By automating tasks, improving efficiency, and boosting patient satisfaction, a PMS can be the key to unlocking the full potential of your dental practice.

The term which indicate teeth or other maxillary structures too low down in the face is called:

 # The term which indicate teeth or other maxillary structures too low down in the face is called:

A. Attraction

B. Abstraction

C. Distraction

D. Protraction

The correct answer is B. Abstraction.

When the dental arch is closer to the Frankfort plane than normal, it is called attraction. When the dental arch is farther from the Frankfort horizontal plane (i.e. lower than normal) it is called abstraction.

Torque prescription for maxillary central incisor according to MBT in degrees is:

 # Torque prescription for maxillary central incisor according to MBT in degrees is:

A. 17

B. 10

C. -7

D. 0

The correct answer is A. 17.

Torque in orthodontics refers to the buccopalatal crown-root inclination of a tooth. To implement torque, larger dimensional archwires are inserted and engaged into brackets. This generates an activating force as the wire is manipulated into the bracket slot. Torque is not directly “in the wire.” Instead, it results from torsion in an archwire when it interacts with a bracket slot. When the wire twists compared to the bracket slot, it creates a couple (a rotational force) that affects the tooth’s inclination. Torque is not related to the angle of the bracket slot or the axial inclination of the tooth. In orthodontic treatment, torque control is often required, especially for maxillary incisors. Proper torque helps achieve an ideal inter-incisal angle, adequate incisor contact, and sagittal adjustment of the dentition for an ideal occlusion. The goal is to achieve the desired buccopalatal inclination of the crowns and roots. The MBT system is a popular pre-adjusted edgewise appliance system.

In the MBT system, torque prescription is based on the specific bracket design and the desired tooth movement. Orthodontists select brackets with predetermined torque values to achieve the desired crown-root inclination. The torque values are typically printed on the bracket prescription chart provided by the manufacturer. According to MBT, torque prescription for maxillary central incisor in degrees is 17 degrees. 

Which cusp on a maxillary first molar has two ridges: one that forms part of a transverse ridge and the other that forms part of an oblique ridge?

 # Which cusp on a maxillary first molar has two ridges: one that forms part of a transverse ridge and the other that forms part of an oblique ridge?

a. Mesiobuccal

b. Mesiolingual

c. Distobuccal

d. Distolingual

The correct answer is B. Mesiolingual. 

The mesiolingual cusp has triangular ridge as well as buccal ridge as shown in the figure of right maxillary first molar. 

From which view are only two roots visible on a maxillary first molar?

 # From which view are only two roots visible on a maxillary first molar?

a. Mesial

b. Distal

c. Buccal

d. Lingual

The correct answer is A. Mesial.

On both the maxillary first and second molars from the mesial view, two roots can be seen: the lingual

root and the mesiobuccal root, which is considerably wider buccolingually than the hidden distobuccal root.  On the first maxillary molar, the convex buccal outline of the mesiobuccal root often extends a little buccal to the crown outline, but the apex of this root is in line with the tip of the mesiobuccal cusp.

The furcations are likely to be farthest away from the cervical portion of the tooth in which of the following teeth?

 # The furcations are likely to be farthest away from the cervical portion of the tooth in which of the following teeth?

A. Mandibular first molar

B. Mandibular second molar

C. Mandibular third molar

D. Maxillary first molar

The correct answer is C. Mandibular third molar. 

Both maxillary and mandibular third molar roots are noticeably shorter than on firsts or seconds. They are very crooked, often curving distally, and more commonly fused most of their length resulting in a long root trunk with the furcation located only a short distance from the apices of the roots. 

What is the main purpose of miniplates in orthodontic practice?

 # What is the main purpose of miniplates in orthodontic practice?

A. To manage skeletal discrepancy without dental adverse effects 

B. To serve as an alternative anchorage system for mini-implants 

C. To withstand torsional force 

D. To anchor soft tissue to root apices

The correct answer is: A. To manage skeletal discrepancy without dental adverse effects. 

Miniplates are an alternative form of orthodontic TADs. They are anchored on skeletal bone using monocortical titanium screws and are indicated for orthopaedic traction to manage skeletal discrepancy without dental adverse effects. They can also be used as an alternative anchorage system when mini-implant insertion is unsatisfactory. While miniplates can be used as an alternative anchorage system, their primary purpose is not specifically to serve as an alternative to mini-implants.

Unlike mini-implants, miniplates can resist various types of force applications and have a lower failure rate. They are able to withstand force with a magnitude of 400–500 g. Additionally, the portion of a miniplate covered by soft tissue can be anchored apically to root apices, helping to avoid potential root damage and reduce soft tissue irritation.

Skeletal class II growth pattern 18 years old Female

 # Mr. Baburam Bhattarai brought his two children one female and one male for dental checkup. The female was 18-years-old & the male was 12 years old. Both had a skeletal class II growth pattern. The growth modification can be done only for the following: 

A. Only in male 

B. Only in female 

C. In both the male & female 

D. Cannot be done 

The correct answer is A. Only in Male.

Though the chronological age may be misleading and the status of growth has to be evaluated through CVM stages, growth modulation is possible in 12 year males and it's not possible in 18 year females. 

Test done when midline diastema and high frenal attachment is present

 # Prachanda, a 20-year-old boy went to his dentist with a complaint of spacing between his upper central incisors. On examination there was presence of mid line diastema. There was a high frenal attachment. Which test will the dentist do to confirm it?

 A. Montoux test 

B. Cotton test 

C. Ganong’s test 

D. Blanch test

The correct answer is D. Blanch Test.

To confirm the high frenal attachment in the presence of a midline diastema, the dentist would perform the Blanch test. This test involves lifting the lip and pulling it outward. If blanching (whitening) occurs in the soft tissue palatal to or between the central incisors, it indicates a high labial frenum attachment. Therefore, the correct answer is D. Blanch test.

Lesions within the basal ganglia produce the following signs except:

 # Lesions within the basal ganglia produce the following signs except: 

A. Hypotonia 

B. Tremor 

C. Hemiballisumus 

D. Athetosis

Lesions within the basal ganglia can lead to various motor disturbances. Let's analyze the given signs:

1. Hypotonia: This refers to reduced muscle tone or decreased resistance to passive movement. It is associated with basal ganglia dysfunction.

2. Tremor: Tremors are rhythmic, involuntary movements. Basal ganglia lesions can indeed cause tremors.

3. Hemiballismus: Hemiballismus is characterized by sudden, wild, and flinging movements of one side of the body. It specifically results from damage to the subthalamic nucleus within the basal ganglia.

4. Athetosis: Athetosis involves slow, writhing, and twisting movements, often affecting the hands and fingers. It is also associated with basal ganglia dysfunction.

Given the options, the sign that is not directly associated with basal ganglia lesions is Hypotonia. Hypotonia is more commonly related to other brain regions or spinal cord abnormalities.

Remember, basal ganglia play a crucial role in motor control, coordination, and movement regulation. Any disruption in this area can lead to various motor symptoms. 

Perfusion of oxygen supply in a free flap can be correctly estimated by:

 # Perfusion of oxygen supply in a free flap can be correctly estimated by:

a) Pulse oximetry 

b) Laser Doppler flowmetry 

c) Prick test 

d) Fluroscopy

The correct answer is B. Laser doppler flowmetry.

Let's go through each option:

a) Pulse oximetry: Pulse oximetry measures the oxygen saturation of hemoglobin in arterial blood non-invasively. However, it may not provide an accurate estimation of oxygen supply in a free flap because it only measures the oxygen saturation of blood and does not directly assess tissue perfusion. While it can indicate overall oxygenation status, it may not reflect the oxygen supply to a specific tissue like a free flap.

b) Laser Doppler flowmetry: Laser Doppler flowmetry is a non-invasive technique used to measure tissue perfusion by detecting the movement of red blood cells. It can provide real-time information about blood flow in the microcirculation of tissues, including free flaps. Therefore, it is often used to monitor the perfusion of oxygen supply in free flaps during surgery and postoperative care. This option is correct because it directly assesses tissue perfusion, which is crucial for evaluating the viability of free flaps.

c) Prick test: A prick test, also known as a pinprick test, is typically used to assess sensory nerve function by evaluating the patient's ability to perceive pain or touch in a specific area. It is not a suitable method for estimating oxygen supply in a free flap. While changes in sensation may indicate compromised blood flow to the flap, the prick test itself does not directly measure tissue perfusion or oxygen supply.

d) Fluoroscopy: Fluoroscopy is a medical imaging technique that uses a continuous X-ray beam to create real-time moving images of the internal structures of a patient. While fluoroscopy can provide valuable information about blood flow and vascular anatomy, it is not commonly used to estimate oxygen supply in free flaps. Fluoroscopy is more often utilized for guiding interventional procedures or diagnosing vascular issues but is not specifically tailored for assessing tissue perfusion in free flaps.

Hence, Laser Doppler flowmetry is the correct choice for estimating the perfusion of oxygen supply in a free flap as it directly measures tissue perfusion and is commonly used in clinical practice for this purpose.

The teeth most likely to be transposed are:

 # The teeth most likely to be transposed are:

A. Mandibular Premolars and maxillary incisors

B. Maxillary premolars and mandibular incisors

C.  Maxillary molars and canines

D. Mandibular molars and canines

The correct answer is B. Maxillary premolars and mandibular incisors.

Transposition is a rare positional interchange of two adjacent teeth. It occurs with a prevalence of approximately 0.3% and equally affects males and females. The teeth most likely to be transposed

are mandibular incisors and maxillary premolars, and this usually occurs as a consequence of ectopic eruption. There appears to be a genetic component to this problem. In the early mixed dentition years, transposition can develop when distally directed eruption of the permanent mandibular lateral incisor leads to loss of the primary mandibular canine and primary first molar. If left untreated, this can result in a true transposition of the permanent lateral incisor and canine.

The first material used for orthodontic TADs was:

 # The first material used for orthodontic TADs was:

A. Titanium

B. Stainless Steel 

C. Vitallium

D. Nickel - Chromium

The correct answer is C. Vitallium.

To date, three types of materials have been used for orthodontic TADs: titanium alloy, stainless steel

and vitallium. Vitallium was the first material used for orthodontic TADs. However, due to undesirable biocompatibility and a higher failure rate, vitallium was gradually replaced by titanium alloy. Stainless steel is also used for orthodontic mini-implants and recent evidence indicates that the success rate is similar between titanium alloy and stainless steel mini-implants. Nowadays, due to high biocompatibility of titanium, orthodontic TADs made of titanium alloy are most frequently used in clinical practice.

Reference: Clinical Insertion Techniques of Orthodontic Temporary Anchorage Devices, Wiley Blackwell

Who first advocated the opening of mid palatal suture to expand the dental arch?

 # Who first advocated the opening of mid palatal suture to expand the dental arch?

Emerson C. Angell 

B. Pierre Fauchard

C. Edward H. Angle 

D. Raymond Begg

The correct answer is A. Emerson C. Angell.

In 1860 Emerson C. Angell was probably the first person to advocate opening of the midline suture to provide space in the maxillary arch, because he took a very strong stand against extraction.

Ref: Graber, 7th Edition

Double lip is a feature of:

 # Double lip is a feature of:

 A. Aschers syndrome

B. Parry Romberg syndrome

C. Pierre Robin Syndrome

D. Mieschers syndrome

The correct answer is A. Aschers syndrome.

Ascher syndrome was first described in 1920 by an ophthalmologist. This syndrome presents as blepharochalasis(swelling of the eyelids), double lip and nontoxic thyroid enlargement. The thyroid enlargement is not present in all cases of this syndrome. The syndrome is often undiagnosed because of its rarity.

Otocephaly is a developmental disorder of:

 # Otocephaly is a developmental disorder of:

 A. Zygoma

B. Jaw bone

C. Occipital bone

D. Parietal bone

The correct answer is B. Jaw bone.

Otocephaly, also known as agnathia–otocephaly complex, is a very rare and lethal cephalic disorder characterized by the absence of the mandible (agnathia), with the ears fused together just below the chin (synotia). It is caused by a disruption to the development of the first branchial arch. It occurs in every 1 in 70,000 embryos.  

Reference: WIKIPEDIA

MCQs on Pharmacology - Drugs acting on Autonomic Nervous System

# The highest seat of regulating autonomic functions is located in:
A. Hypothalamus
B. Medulla
C. Spinal cord
D. Midbrain

# Catecholamines are synthesized from which amino acid?
A. Histamine
B. Phenylalanine
C. Tryptophan
D. Glycine

MCQs in Pharmacology - Drugs acting on Central Nervous System

# CNS depressant drug which reduces excitement without much effect on sleep is (also called anti anxiety drug):
A. Anticholinergic
B. Antipsychotic
C. Sedative
D. Hypnotic

# CNS depressant drug which produces sleep but patient may be awakened by inducing pain. This type of drug is called:
A. Antileptic
B. Antisympathetic
C. Sedative
D. Hypnotic

MCQs in General Pathology - Cardiovascular Pathology

# All of the following are examples in which active hyperemia is seen EXCEPT:
A. Inflammation and high grade fever
B. Blushing of face following emotion
C. Muscular exercise
D. Cardiac congestive failure

# Which of the following is true of heart failure cells?
A. Hemosiderin pigment laden alveolar macrophages present in venous congestion of lungs
B. Also called as Aschoff nodules present in endocardium seen in rheumatic fever
C. Also called as Mallory bodies seen in alcoholic cirrhosis of liver
D. Cells responsible for cardiac failure in congestive cardiac failure

MCQs in General Pathology - Acute and Chronic Infections

# Adenopathy is clinically manifested by:
A. Hyposalivation
B. Swelling
C. High grade fever
D. All of the above

# Lepra cells are seen in abundance in:
A. Tuberculoid leprosy
B. Lepromatous leprosy
C. Histoid leprosy
D. Intermediate leprosy

Psammoma bodies are associated with:

 # Psammoma bodies are associated with:

 A. Metastatic calcification

B. Dystrophic calcification

C. Apoptosis

D. Necrosis

The correct answer is B. Dystrophic calcification.

Psammoma bodies are round microscopic calcific collections. It is a form of dystrophic calcification. They are the characteristic feature of papillary carcinomas. 

A young adult shows non fluctuant, tender and red swelling in the marginal gingival lesion. This is most likely to be a:

 # A young adult shows non fluctuant, tender and red swelling in the marginal gingival lesion. This is most likely to be a:

 A. Periodontal abscess

B. Periapical abscess

C. Gingival abscess

D. Periapical sinus

The correct answer is C. Gingival abscess.

Gingival abscess

■ Localized, painful rapidly expanding lesion of sudden onset. 

■ It is limited to marginal gingival or interdental papilla. 

■ It is due to foreign substances carried deep into the tissues such as a toothbrush bristle, a piece of apple core, or a lobster shell. 

■ Gingival abscess involves marginal and interdental gingiva, whereas periodontal abscess involves attached gingiva. 

Palmar and plantar hyperkeratosis is a feature of:

 # Palmar and plantar hyperkeratosis is a feature of:

 A. Down syndrome

B. Papillon Lefevre Syndrome

C. Chediak-Higashi Syndrome

D. Klinefelter syndrome

The correct answer is B. Papillon Lefevre Syndrome.

Papillon-Lefevre Syndrome 

1. This is characterized by hyperkeratotic skin lesions and severe destruction of the periodontium. 

2. These changes may appear before the age of 4 years. 

3. Skin lesions are—hyperkeratosis of localized areas on palms, soles, knees, and elbows. 

4. Periodontal involvement is early inflammatory changes that lead to bone loss and exfoliation of teeth. Primary teeth are lost by 5 or 6 years of age. The permanent dentition erupts normally but the permanent teeth are lost within a few years. 

Ions participating in clotting mechanism are:

 # Ions participating in clotting mechanism are:

 A. Iron

B. Copper

C. Calcium

D. Aluminium

The correct answer is C. Calcium.

In the presence of calcium ions and other clotting factors, factor X activates an enzyme called prothrombin activator. This enzyme then converts the plasma protein prothrombin into thrombin. Thrombin is an enzyme that, in turn, converts fibrinogen to fibrin which causes the blood to clot.

Side effects of Phenytoin do not include:

 # Side effects of Phenytoin do not include:

 A. Osteomalacia

B. Gum hypertrophy

C. Folate deficiency

D. Blindness

The correct answer is D. Blindness. 

Adverse effects:  After prolonged use numerous side effects are produced at therapeutic plasma concentration; others occur as a manifestation of toxicity due to overdose.

At therapeutic levels

• Gum hypertrophy is common (20% incidence), especially in younger patients. It is due to the overgrowth of gingival collagen fibers. This can be minimized by maintaining oral hygiene.

• Hirsutism, coarsening of facial features (troublesome in young girls), acne.

• Hypersensitivity reactions are—rashes, DLE, and lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.

• Megaloblastic anemia: Phenytoin decreases folate absorption and increases its excretion.

• Osteomalacia: Phenytoin interferes with metabolic activation of vit D and with calcium

absorption/metabolism.

• It can inhibit insulin release and cause hyperglycemia.

• Used during pregnancy, phenytoin can produce ‘fetal hydantoin syndrome’ (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.

Reference: Essentials of medical pharmacology, KD Tripathi.

At what temperature is blood stored in blood banks?

 # At what temperature is blood stored?

 A. -4 degrees

B. 4 degrees

C. 6 degrees

D. 8 degrees

The correct answer is B. 4 degrees celsius.

With the modern surgical and medical procedures, the demand for blood has greatly increased. It is for this reason that blood banks were started where blood from voluntary donors could be stored, so that it was always available on demand. Most blood banks have lists of would-be donors so that they may be contacted when required.

Storage of blood: After a donor has been screened for donation, one unit of blood (450 ml) is collected, under aseptic conditions, from the antecubital vein directly into a special plastic bag containing 63 ml of CPD-A (citrate-phosphate-dextrose-adenine) mixture. The blood bag is suitably sealed, labeled, and stored at 4 degree C, where it can be kept for about 20 days. (Faulty storage, i.e. overheating or freezing can lead to gross infection and hemolysis). The citrate prevents clotting of blood, sodium diphosphate acts as a buffer to control decrease in pH, dextrose supports ATP generation via glycolytic pathway and also provides energy for Na+- K+ pump that maintains the size and shape of red cells and increases their survival time, and adenine provides substrate for the synthesis of ATP, thus improving post-donation viability of red cells.

Blood is stored at low temperatures for 2 reasons: one, it decreases bacterial growth, and two, it decreases the rate of glycolysis and thus prevents a quick fall in pH.

Reference: A TEXTBOOK OF PRACTICAL PHYSIOLOGY Eighth Edition CL Ghai

Which mandibular plane is considered while calculating FMA (Frankfort mandibular plane angle) in cephalometry?

The mandibular plane used for FMA measurement is : A plane tangent to the lower border of mandible which connects with the menton anteriorly and posteriorly it bisects the distance between the right and left lower borders of the mandible in the region of the gonial angle. See Figure. 

The FMA angle is defined as the angle formed by the following two reference planes:

i. FH plane (Frankfort horizontal plane—A line between the most superior point of the external auditory meatus and inferior border of the orbit).

ii. Mandibular plane (A plane tangent to the lower border of mandible which connects with the menton anteriorly and posteriorly it bisects the distance between the right and left lower borders of the mandible in the region of the gonial angle). 

In most cephalometric analyses, the occlusal and mandibular planes are measured relative to the sella-nasion (SN) line, the basion-nasion (BaN) line, or the Frankfort horizontal plane. Ideally, according to Tweed, the incisor mandibular plane angle (IMPA) should be 90 degrees, the Frankfort mandibular angle (FMA) 25 degrees, and thus the Frankfort mandibular incisor angle (FMIA) 65 degrees. (The sum of three angles of a triangle equals 180 degrees.) Moreover, the IMPA angle also relates to creating additional space in the mandibular arch in that for each 3 degrees advancement of the lower incisor, 2.5 mm of space is gained in the mandibular dental arch. Conversely, reduction of the IMPA from 90 degrees, for example, to 87 degrees would decrease the available space for tooth alignment in the mandibular dental arch by 2.5 mm. 

Gangrene due to known infectious agent is:

 # Gangrene due to known infectious agent is:

 A. Wet gangrene

B. Dry gangrene

C. Pyoderma granulosum

D. Fournier gangrene

The correct answer is D. Fournier gangrene. 

Fournier gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease that affects the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Named after Dr. Alfred Fournier, the French dermatology and venereal specialist, it was initially described in 1883 as necrotizing fasciitis of the external genitalia, perineal, and perianal region in five of Dr. Fournier’s patients. Also known as necrotizing fasciitis, the disease involves the rapid spread of severe inflammatory and infectious processes along fascial planes affecting adjacent soft tissue; therefore, the disease may initially go unnoticed or unrecognized as there may be minimal or no skin manifestations in its early stages.

This disease process results from polymicrobial aerobic and anaerobic synergistic infection of the fascia and subcutaneous soft tissue. Gram-positive bacteria such as Group A Streptococci and Staphylococcus aureus and gram-negative bacteria such as E. Coli and Pseudomonas aeruginosa are organisms most commonly grown in wound cultures of Fournier gangrene patients as it is usually polymicrobial. These bacteria can be introduced through several sources, including urinary, bowel, or dermal. Urinary tract infections and other infectious processes of the perineum, such as perianal abscesses or even a simple pimple, may also provide a starting point for the infection. 

Surgical manipulation of the genital and perineal area similarly can provide the initial insult required to develop Fournier gangrene. Any traumatic insult or localized area of skin breakdown to the perineum or scrotum can lead to bacterial access to the subcutaneous tissues and begin the process, ultimately resulting in Fournier gangrene. About 25% of cases had no known or identifiable etiology.

Reference: Leslie SW, Rad J, Foreman J. Fournier Gangrene. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549821/

Biosafety level 4 (BSL-4) pathogen is:

 # Biosafety level 4 (BSL-4) pathogen is:

 A. XDR strain of Mycobacterium tuberculosis

B. SARS CoV-2

C. Ebola

D. Measles

The correct answer is C. Ebola.

Biological Safety Levels (BSL) are a series of protections relegated to the activities that take place in particular biological labs. They are individual safeguards designed to protect laboratory personnel, as well as the surrounding environment and community.

These levels, which are ranked from one to four, are selected based on the agents or organisms that are being researched or worked on in any given laboratory setting. For example, a basic lab setting specializing in the research of nonlethal agents that pose a minimal potential threat to lab workers and the environment are generally considered BSL-1—the lowest biosafety lab level. A specialized research laboratory that deals with potentially deadly infectious agents like Ebola would be designated as BSL-4—the highest and most stringent level.

The Centers for Disease Control and Prevention (CDC) sets BSL lab levels as a way of exhibiting specific controls for the containment of microbes and biological agents. Each BSL lab level builds upon on the previous level—thereby creating layer upon layer of constraints and barriers. These lab levels are determined by the following:

• Risks related to containment
• Severity of infection
• Transmissibility
• Nature of the work conducted
• Origin of the microbe
• Agent in question
• Route of exposure

 Summary of Biological Agents and BSL levels

Reference: The University of Texas Rio Grande Valley