Growth of maxilla in the vertical direction is due to:

 # Growth of maxilla in the vertical direction is due to:

A. Growth of alveolus

B. Growth of sutures

C. Growth of cranial base

D. Growth of synchondrosis

The correct answer is B. Growth of sutures

Vertical growth of the maxilla occurs primarily through inferior displacement facilitated by bone apposition and remodeling at the circum-maxillary sutures (e.g., fronto-maxillary, zygomatico-maxillary, and spheno-maxillary sutures), allowing the maxilla to elongate downward while adapting to surrounding structures like the expanding nasal septum and orbital contents. This mechanism accounts for the majority of vertical maxillary development from infancy through adolescence, with contributions from alveolar apposition around erupting teeth but not as the primary driver. Cranial base growth (via synchondroses) contributes indirectly by providing anteroposterior expansion that influences displacement, but sutural growth is the direct enabler of vertical changes, as supported by classic orthodontic principles (e.g., Enlow's remodeling concepts and Björk's implant studies showing downward vector at ~51° to the cranial base).

Additional parameter in five characteristics of Ackerman-Proffit Classification?

 # Which is added as an additional parameter in five characteristics of Ackerman-Proffit Classification?

A. Curve of Spee

B. Esthetic line of occlusion

C. Smile arc

D. Smile line

The correct answer is B. Esthetic line of occlusion

The Ackerman-Proffit classification evaluates malocclusion using Angle's anteroposterior relationships plus five key characteristics—alignment (perimeter/crowding), transverse relationship (arch width discrepancies), vertical relationship (open/deep bite), overjet (incisor protrusion), and midline deviation (asymmetry)—often visualized via a Venn diagram for comprehensive diagnosis. To enhance esthetic analysis, the esthetic line of occlusion is incorporated as an additional parameter, assessing the curved alignment of the maxillary incisor edges relative to the lower lip during smiling or repose, which helps predict treatment outcomes for facial harmony beyond functional aspects. This addition addresses limitations in purely skeletal classifications by integrating soft-tissue esthetics. Options A (Curve of Spee) relates to occlusal curvature but isn't added here; C (Smile arc) and D (Smile line) are related esthetic features but not specifically the parameter in this system.

Gene therapy targeting the germ-line is:

 # Gene therapy targeting the germ-line is:

A. Heritable

B. Non heritable

C. Sometimes heritable

D. Unrelated to heritability

The correct answer is: A. Heritable

Germ-line gene therapy involves modifying DNA in germ cells (sperm, ova, or their precursors), which integrate into the genome and are transmitted to future generations, making the genetic changes heritable. This contrasts with somatic gene therapy, which targets non-reproductive cells and is non-heritable (option B). Option C is incorrect as heritability is inherent to germ-line targeting, and option D is irrelevant since heritability is the defining feature. Ethical and regulatory concerns limit germ-line therapy in humans, but the biological principle remains clear.

Raw erythematous areas with bleeding spots on a boy with juvenile diabetes mellitus

 # A 9 year old boy visited OPD for soreness in the mouth. He had history of juvenile diabetes mellitus and was on insulin therapy. On intraoral examination, a large white scrapable lesion was noted on the soft palate. Raw erythematous areas with bleeding spots were seen after scraping the lesion. What is the most likely diagnosis to be?

A. Diphtheria

B. Oral Thrush

C. White Spongy Nevus

D. Vincent’s stomatitis

E. Chronic Hyperplastic Candidiasis

The correct answer is B. Oral Thrush

Oral thrush (pseudomembranous candidiasis) is the most likely diagnosis, characterized by white, creamy plaques on mucosal surfaces like the soft palate that scrape off easily, revealing underlying erythematous, raw tissue prone to bleeding—directly matching the presentation. Juvenile diabetes mellitus predisposes to this via hyperglycemia impairing immune response and promoting Candida albicans overgrowth, common in children on insulin. Diagnosis is clinical, confirmed by microscopy if needed (hyphae in KOH prep). Treatment involves topical antifungals (e.g., nystatin suspension) and glycemic control; systemic options if refractory. Other options are less fitting: diphtheria involves adherent gray membranes with systemic toxicity; white spongy nevus is non-scrapable and hereditary; Vincent’s stomatitis targets interdental gingiva with necrosis; chronic hyperplastic candidiasis forms adherent, non-scrapable plaques.