Orthodontics - COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up
Subject: Orthodontics                                                                                                             Time: 2 hr. 30 mins.
Date: 6/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]
1. Enumerate therapeutic methods of gaining space. Discuss in detail about the expansion in
orthodontics. [2+4=6]

2. Explain in detail about the biology associated with orthodontic tooth movement. Add short notes
of iatrogenic effects of inappropriate forces.  [2+3=5]

3. Classification of habits. Describe the etiology, clinical features, and management of tongue
thrusting habits.   [2+3=5]

4. Write short notes on: [3*3=9]
a. Down's skeletal parameters
b. Kesling tooth positioner
c. Methods of studying growth

SECTION "C" [25 Marks]

5. 20-year male reported to the department with chief complaint of forwardly placed upper front teeth. Intra oral examination shows bilateral class II molar relation with overjet of 6mm. Cephalometric examination shows SNA angle 84 degrees and SNB 80 degrees.
[2+2+2 =6]
a. What is your diagnosis What are the investigations you advice?
b. How would you treat this case?
c. If the patient is growing than how do you manage this condition.

6. Enumerate the etiology of cleft lip and palate. Orthodontic management of cleft lip and palate [2+3=5]

7. What is myofunctional therapy Describe the mode of action of twin block appliance and how does it differ from a functional regulator. [2+3=5]

8. Write short notes on: [3*3=9]
a. School of retention
b. Management of open bite
c. Corticotomy

Periodontics - COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up
Subject: Periodontics                                                                                                             Time: 2 hr. 30 mins.
Date: 6/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]
1. Define gingiva. Describe different parts of the gingiva. Mention the name of various gingival fibers and blood supply of gingiva.    [1+3+2=6]

2. Write down the composition of calculus. Mention the important differences between supragingival and subgingival calculus. Highlight on the modes of attachment of calculus and its role in periodontal disease. [1+2+2=5]

3. A patient came with the chief complaint of progressive mobility of upper right lateral incisor since last six months. On clinical examination, there was grade II mobility of the tooth with three-degree positive fremitus test. [1+3+1=5]
a. What is your diagnosis & classify the condition?
b. What are the tissue responses seen in this case?
c.Write about possible radiographic changes in this case?

4. Write short notes on: [3*3=9]
a Local drug delivery
b. Halitosis
c. Resective osseous surgery

SECTION "C" [25 Marks]

5. A 28-year-old patient came with the chief complain of a progressive downward shift of gum exposing mandibular right central incisors. What is your differential diagnosis, investigations and
treatment plan for the case? [1+2+3=6]

6. Define Aggressive Periodontitis. Write down the causes of area-specific distribution of Localized Aggressive Periodontitis (LAP). Highlight on the clinical features of LAP. [1+2+2=5]

7. Define Furcation Involvement (FI). What are the predisposing factors for Furcation involvement?
Write about different therapeutic modalities in the management of FI.  [1+1+3=5]

8. Write short notes on:  [3*3=9]

a. Host modulation therapy (HMT)
b. Chemical plaque control
c. Modified Widmann flap

Pedodontics COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up
Subject: Pedodontics                                                                                                             Time: 2 hr. 30 mins.
Date: 8/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]
1. A 2 year old girl comes to the dental office with a chief complaint of discoloration of teeth in front tooth region. The child is Frankel's definitely negative. On examination, teeth 51, 52, 61 and 62
caries do not extend to the pulp.
a. Write the diagnosis and mention the stage of the problem.   [1]
b. What should be the preventive treatment plan for this dental problem? [2]
c. Write in detail how will you proceed with the decided treatment plan.  [3]

2. Write in detail about the clinical findings in Cleidoeranial dysplasia. Give the details of dental
management of patients.       [5]

3.Classify cleft lip and palate. Describe in detail the multidisciplinary approach to treatment planning of cleft lip and palate.   [5]

4. Write short notes on:  [3x3=9]
a. Air abrasion
b Tunnel preparation
C Compomer.

SECTION "C" [25 Marks]

5. Write in details about the concepts of operant conditioning child psychology theory and its dental
implications in a pediatric office.  [6]

6. Define preventive orthodontics. Write in details about the indications, contraindications, and construction of distal shoe space maintainer.      [5]

7. Write in detail about the planning of a pediatric dental clinic.      [5]
8. Write short notes on: [3*3=9]

• Dental Home
• Anticipatory guidance
• Recent advances in pit and fissure sealants

Oral Medicine and Radiology COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up

Subject: Oral Medicine                                                                                                              Time: 2 hr. 30 mins.
Date 4/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with a well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]

1.A 40 year old male patient visited the department with a chief complaint of pain and swelling in right side below the ear and behind the angle of the mandible. Patient gives a history of increased pain while eating food which subsides after meals. On clinical examination, there is pus discharge from a point in right buccal mucosa opposite to maxillary 2nd molar. 

Give the provisional diagnosis and discuss it in detail.               [2+4=6]

2. Define pain. Discuss in-detail about gate control theory.        [1+4=5]

3. Discuss in detail about radiotherapy. Mention the advantages and disadvantages of radiotherapy when compared with a surgical option.                                           [3+2=5]

4. Write short notes on: [3*3=9]

• Oral thrush
• Treatment of aphthous ulcers
• Corticosteroids in dentistry

SECTION "C" [25 Marks]

5. Discuss the image characteristics in detail.                              [6]
6. What is a bitewing radiograph? Give the advantages, disadvantages, indications, and uses of bitewing radiographs.      [1+4 =5]

7. Describe in detail the methods to reduce x-ray hazards.    [5]

8. Write short notes on :               [3x3=9]

• PA skull view
• Braking radiation
• Composition of fixing solution

Most common bone cancer:

# The most common bone cancer is (AlIMS 94, AIPG 99)
a) Osteosarcoma
b) Metastatic bone cancer
c) Multiple myeloma
d) Squamous cell carcinoma

The correct answer is: B. Metastatic bone cancer.

Metastatic cancers are most common cancers in bone. Multiple myeloma is the common primary bone tumor, whereas the common inherent bone cell tumor is osteogenic sarcoma or osteosarcoma.

Bifid ribs and Falx Cerebri Calcification

# Bifid ribs, multiple radiolucent lesions of the jaws, multiple basal cell nevi and falx ceribri calcification are found in (Man 98, 97)
a) Basal cell nevus syndrome
b) Sturge weber syndrome
c) Horner syndrome
d) Hereditary internal polyposis

The correct answer is A. Basal cell nevus syndrome.

Basal cell nevus syndrome is also called as Gorlin Goltz syndrome.

Horner's syndrome is characterized by miosis, ptosis and anhidrosis over face due to interruption of sudomotor and vasomotor control.

Hereditary intestinal polyposis is seen in Peutz-Jeghers syndrome.

Most aggresive odontogenic tumor

# Which of the following tumors is most aggressive? (AIPG 91, AIIMS2004)
a) Ameloblastoma
b) Odontoma
c) Odontogenic myxoma
d) Fibrocarcinoma

The answer is C. Odontogenic myxoma

ODONTOGENIC MYXOMAS

Aggressive, intraosseous neoplasms derived from embryonic odontogenic mesenchyme probably arise from the dental papilla or follicular mesenchyme. Nearly all lesions are found in the tooth bearing areas of maxillary and mandibular bone.

Mandibular lesions are commonly found in the premolar-molar area. The lesions often produce multilocular radiolucency with a "soap bubble' or "honey comb" appearance in the bone.

Thin and extremely delicate septa of bone are often seen to course through the radiolucent area and produce a "spider- web" like or "tennis racket" like appearance.

 (Ref: Shafer's Textbook of oral pathology 7h ed., p 299)

Type II Diabetes Causes

# Obesity, genetic profile, and aging all contribute to the development of Type II diabetes. Of the following, which is the most important additive factor for these three conditions in the development of Type II diabetes?

A. elevated hepatic ketogenesis
B. elevated pancreatic glucagon secretion
C. impaired renal clearance of glucose
D. muscle resistance to insulin

Answer: D - Muscle resistance to insulin is the most important additive factor for these three conditions in the development of Type II diabetes. The progressive loss of skeletal muscle sensitivity to insulin leads to increased rates of visceral cell lipolysis and pancreatic beta-cell compensation.

Parasympathetic Cranial nerves

# # All of cranial nerve have parasympathetic outflow except :
A. 5th nerve
B. 7th nerve
C. 3rd neve
D. 9th nerve

The correct answer is A. 5th nerve

Cranial nerves having parasympathetic now are 3,7,9 and 10.

Preganglionic parasympathetic neuron cell bodies are located in certain cranial nerve nuclei of the brain stem and in the grey matter of the second to fourth sacral segments of the spinal cord. Efferent fibres, which are myelinated, emerge from the CNS only in cranial nerves III, VII, IX, and X and in the second to fourth sacral spinal nerves. Preganglionic parasympathetic neurons are cholinergic. 

The only cranial nerve which arises on the dorsal aspect   -       Trochlear

The cranial nerve with longest intracranial coarse              -        Abducent

The cranial nerve with longest coarse                                 -       Vagus

The cranial nerve involved in raised intracranial tension   -       Abducent nerve

Cranial nerve carrying parasympathetic fibres                      -       3,7,9,10

Commonest cranial nerve affected in spinal anesthesia     -       Abducent nerve

Cranial nerve involved in Bell's palsy                                 -       VII Nerve

Cranial nerve involved in Ramsay Hunt Syndrome             -       VII nerve

Cranial nerve arising from the pons                                    -     V, VI, VII, VII nerves

Pure sensory nerves                                                          -       1,2,8

Branchiomeric nerves                                                       -       5.7.9,10,11

Referred pain in Orofacial region:

# ___________most often refer pain to the temporal region,
while _________most often refer pain the ear.
A. Maxillary second premolars, mandibular molars
B. Maxillary molars, mandibular molars
C.  Maxillary second premolars, mandibular premolars
D. Maxillary molars, mandibular premolars

The correct answer is A. Maxillary second premolars, mandibular molars.

If careful diagnosis does not reveal the affected tooth, other teeth and related anatomic structures

become suspect. Pulpitis in one tooth may cause pain in other areas - the pain is referred.

Site of Pain Referral                             Pulp of Tooth Causing Pain

Forehead region                                    Maxillary incisors

Nasolabial area                                      Maxillary canines. premolars

Temporal region                                     Maxillary second premolars

Ear. angle of jaw, or posterior                 Mandibular molars

regions of neck

Mental region of mandible                        Mandibular incisors, canines. and premolars

Zygomatic, parietal, and occipital              Maxillary molars

regions of head

Opposing quadrant or to other                      Maxillary and mandibular molars

teeth in the same quadrant

Important: The nerve endings of cranial nerves VII, IX, and X are widely distributed within the subnucleus caudalis of the trigeminal (V) nerve. A profuse intermingling of these nerve fibers creates the potential for the referral of dental pain to many sites.

Orofacial pain can be the clinical manifestation of a variety of diseases involving the head and neck region. The cause of the pain must be differentiated between odontogenic and nonodontogenic.

Characteristics of nonodontogenic involvement:

• Episodic pain with pain-free remissions

• Trigger points

• Pain travels and crosses the midline of the face

• Pain that surfaces with increasing stress

• Pain that is seasonal or cyclic

• Pain accompanied by paresthesia

Hydrolysis of Lactose, Maltose and Sucrose

# Which of the following statements is TRUE? (MAN-95)
a) The hydrolysis of lactose yields glucose and galactose
b) The hydrolysis of maltose yields glucose and fructose
c) The hydrolysis of sucrose yields only glucose
d) All of the above statements are true

The correct answer is A. The hydrolysis of lactose yields glucose and galactose

Carbohydrate	Products
Maltose	2 glucose units
Sucrose	1 glucose + 1 fructose
Lactose	Galactose + glucose
Starch	Water soluble amylose and a water soluble amylopectin
Inulin	Polymer of fructose

Chromic gut Suture vs Plain gut Suture

# Advantage of chromic gut over plain is:
A. Delayed resorption
B. Increased strength
C. Less irritation
D. Less tissue reaction

The correct answer is A. Delayed resorption.

• Chromic gut sutures consist of the plain gut that has been treated with chromium trioxide. This results in a delay in the absorption rate.

• Because retention of sutures beyond a few days is not recommended in endodontic surgery, the use of chromic gut sutures offers no advantage.

• Also, evidence indicates that plain gut is more biocompatible with oral soft tissues than is the chromic gut. The gut suture material is marketed in sterile packets containing isopropyl alcohol.

• When removed from the packet, the suture is hard and non-pliable because of its dehydration. Before using gut sutures should be hydrated by placing them into sterile, distilled water for 3 to 5 minutes.

• After hydration, the gut suture material will be smooth and pliable with manipulative properties similar to silk.

# Benzodiazepine antagonist is:

# Benzodiazepine antagonist is:
A. Flumazenil
B. Naloxone
C. Furazolidone
D. Dapsone

The correct answer is A. Flumazenil

Benzodiazepine act by enhancing presynaptic or postsynaptic inhibition through a specific receptor which is integral part of gabba receptor Cl-channel complex.

Flumazenil is a BZD analogue which has little intrinsic activity but it competes with BZDs as well as inverse agonists for BZD receptor and reverses their depressant or stimulant effects respectively. Flumazenil is the drug of choice for benzodiazepine overdose.

# To prevent sensitivity caused by acid etching and to protect pulp in deep cavities, which of the following should be used?

# To prevent sensitivity caused by acid etching and to protect pulp in deep cavities, which of the following should be used?
A. Calcium hydroxide liner
B. ZnO liner
C. Light cure GIC liner
D. Lining with varnish

The correct answer is A. calcium hydroxide liner

Deep caries excavation close to the pulp, which may result in either an undetected pulpal exposure or a visible pulpal exposure, should be covered with a calcium hydroxide liner that can stimulate formation of dentin bridges (reparative dentin) over the exposure.

For amalgam restorations, deep excavations not encroaching on the pulp should be covered with a glass-ionomer material that will contribute to thermal protection and provide mechanical protection from amalgam condensation forces at thicknesses of I to 1.5 mm or greater.

Bonding of Composite resin to tooth

# Bonding of composite resins to tooth structure is by: (KAR-01)
a) Covalent bond
b) Ionic bond
c) Mechanical
d) Vander waal forces

The correct answer is C. Mechanical

Bonding of composites to tooth structure occurs by micromechanical retention. Acid etching creates micro porosities into which the resin penetrates resulting in resin tag formation. These tags penetrate to a depth of 5 - 10 µm but their lengths are dependent on the enamel etching time.

Advantages of Dental Composite Resins:

# The main advantage of composites over unfilled direct filling resin is their: (KAR-97)
a) Higher solubility in saliva
b) Lower modulus of elasticity
c) Esthetic excellence
d) Lower thermal co-efficient of expansion

The correct answer is D. Lower coefficient of thermal expansion.

Advantages of composites over unfilled resins:

• Lower coefficient of thermal expansion
• Low polymerization shrinkage
• Low water absorption
• High abrasive resistance

Disadvantages of composites:

• Less color stability
• Less smooth finish than unfilled resins