Molar relation in primary dentition is determined by:

 # Molar relation in primary dentition is determined by:

A. Mesiobuccal cusp of maxillary first molar

B. Buccal groove of mandibular first molar

C. Distal surface of maxillary and mandibular second molar

D. Distal surface of maxillary and mandibular first molar

The correct answer is:

C. Distal surface of maxillary and mandibular second molar

Explanation:

In primary dentition, the molar relationship is determined by the alignment of the distal surfaces of the maxillary and mandibular second molars. This is used to describe the primary occlusion as either:

Flush terminal plane: The distal surfaces of the second molars are aligned in a straight plane.

Mesial step: The mandibular second molar’s distal surface is mesial to the maxillary second molar’s distal surface.

Distal step: The mandibular second molar’s distal surface is distal to the maxillary second molar’s distal surface.

These relationships are important because they influence the development of the permanent molar occlusion.

Clinical sign that is always positive in bone fracture is:

 # Clinical sign that is always positive in bone fracture is:

A. Crepitus

B. Tenderness

C. Abnormal mobility

D. All of the above

The correct answer is:

B. Tenderness

Explanation:
Tenderness is always present in fractures, as it reflects localized periosteal irritation and soft tissue damage.

Other signs, such as:

• Crepitus and abnormal mobility, may not be present in minor or incomplete fractures. These are typically seen in displaced or severe fractures but are not universal findings.

Endocrine disorder is the primary cause of:

 # Endocrine disorder is the primary cause of:

A. Acromegaly

B. Albright’s syndrome

C. Paget’s disease

D. Fibrous dysplasia

The correct answer is A. Acromegaly.

Explanation:

Acromegaly is primarily caused by an endocrine disorder, specifically excess growth hormone (GH) secretion, usually due to a pituitary adenoma. This leads to abnormal growth of bones and soft tissues, particularly in adults.

Other options explained:

B. Albright’s syndrome (McCune-Albright Syndrome): A genetic disorder caused by post-zygotic mutations in the GNAS gene, leading to fibrous dysplasia, café-au-lait spots, and endocrine abnormalities. It is not primarily an endocrine disorder but has endocrine manifestations.

C. Paget’s disease: A bone remodeling disorder of unclear etiology, possibly involving genetic and environmental factors, not primarily endocrine.

D. Fibrous dysplasia: A developmental bone disorder caused by activating mutations in the GNAS gene, not related to endocrine dysfunction as a primary cause.

The view which best demonstrates inflammation and temporomandibular joint effusion are:

 # The view which best demonstrates inflammation and temporomandibular joint effusion are:

A. T2 weighted MR images

B. T1 weighted MR images

C. Lateral tomogram

D. Panoramic radiograph

The correct answer is:

B. Unilateral and bilateral crossbite

Explanation:
After cleft palate repair, patients often experience unilateral or bilateral crossbite due to maxillary growth deficiencies. Surgical intervention and scarring can inhibit the forward and lateral growth of the maxilla, leading to discrepancies between the maxillary and mandibular arches. This results in crossbites, which are common in individuals with repaired cleft palate.

Other options explained:

• A. Normal occlusion: Rarely achieved without orthodontic intervention due to maxillary growth issues.
• C. Anterior open bite: Not a typical finding unless associated with other conditions or habits.
• D. Anterior deep bite: Uncommon in cleft palate cases as the maxillary hypoplasia usually prevents such occlusion.

DiGeorge syndrome is due to:

 # DiGeorge syndrome is due to:

A. Congenital thymic aplasia

B. Deficiency of complement factors

C. Inborn error of metabolism

D. Chromosomal anomaly

The correct answer is D. Chromosomal anomaly.

The correct answer is:

D. Chromosomal anomaly

Explanation: DiGeorge syndrome is caused by a chromosomal anomaly, specifically a 22q11.2 deletion. 

This deletion leads to developmental defects in the pharyngeal pouches, resulting in: Congenital thymic aplasia or hypoplasia (leading to T-cell deficiency).

Parathyroid hypoplasia (causing hypocalcemia).

Cardiac defects (e.g., Tetralogy of Fallot, interrupted aortic arch).

Facial dysmorphisms.

Other options explained:

A. Congenital thymic aplasia: While thymic aplasia is a feature of DiGeorge syndrome, it is secondary to the chromosomal deletion.

B. Deficiency of complement factors: Seen in complement pathway defects, not in DiGeorge syndrome.

C. Inborn error of metabolism: DiGeorge syndrome is not related to metabolic enzyme deficiencies.

Chronic use of nasal decongestants, presented with abrupt onset of fever with chills and rigor, diplopia on lateral gaze

 # A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills and rigor, diplopia on lateral gaze, moderate proptosis and chemosis. On examination, the optic disc is congested. Most likely diagnosis is:

A. Cavernous sinus thrombosis

B. Orbital cellulitis

C. Acute ethmoid sinusitis

D. Orbital apex syndrome

The correct answer is:

A. Cavernous sinus thrombosis

Explanation:
The clinical presentation described—abrupt onset of fever with chills, diplopia, proptosis, chemosis, and optic disc congestion—is characteristic of cavernous sinus thrombosis (CST). This condition is often secondary to infections in the medial canthus (commonly from facial infections or sinusitis), which can spread to the cavernous sinus via valveless facial veins.

Key Differentiation:

• B. Orbital cellulitis: Also presents with proptosis and chemosis but typically lacks systemic signs like severe fever with chills and is not associated with optic disc congestion or diplopia on lateral gaze.
• C. Acute ethmoid sinusitis: May cause pain over the medial canthus and fever but does not typically lead to proptosis, chemosis, or optic nerve involvement.
• D. Orbital apex syndrome: Involves cranial nerve deficits (II, III, IV, V, and VI) and visual loss, but the history of prior medial canthus pain and sinusitis with systemic signs strongly points to CST.

Cavernous sinus thrombosis is a medical emergency requiring immediate intervention with antibiotics and sometimes anticoagulation.

A 48 years old male reported to you with fractured central incisor with fracture line extending 4 mm gingival below CEJ with thin bone CEJ with thin bone buccally and thick apicopalatally, treatment of choice is:

 # A 48 years old male reported to you with fractured central incisor with fracture line extending 4 mm gingival below CEJ with thin bone CEJ with thin bone buccally and thick apicopalatally, treatment of choice is: 

A. Socket shield technique

B. Post and core

C. Extraction and implant

D. Socket preservation

The correct answer is:

Socket shield technique

Explanation: The socket shield technique is the preferred treatment in this scenario because it preserves the  buccal bone by retaining a thin section of the root (the "shield") after extraction. This technique is ideal for  cases where the buccal bone is thin, as it minimizes bone resorption and supports the soft tissue contour, especially in the aesthetic zone.

Other options explained:

B. Post and core: Suitable for coronal fractures but not when the fracture extends significantly below the CEJ.

C. Extraction and implant: A viable option but may lead to buccal bone loss in cases with thin buccal bone.

D. Socket preservation: Preserves the socket after extraction but does not directly address aesthetic or functional concerns in this case.

A patient has hypoplasia, microdontia, hypodontia, multiple unerupted teeth, numbness in oral cavity, peripheral paresthesia. This is most likely due to:

 # A patient has hypoplasia, microdontia, hypodontia, multiple unerupted teeth, numbness in oral cavity, peripheral paresthesia. This is most likely due to:

A. Hyperparathyroidism

B. Hypoparathyroidism

C. Hyperthyroidism

D. Hypothyroidism

The correct answer is:

B. Hypoparathyroidism

Explanation:
Hypoparathyroidism can cause a range of dental and neurological symptoms, including:

• Dental manifestations: Hypoplasia, microdontia, hypodontia, delayed eruption, and multiple unerupted teeth are associated with impaired calcium metabolism.
• Neurological symptoms: Numbness in the oral cavity and peripheral paresthesia occur due to hypocalcemia, which leads to increased neuromuscular excitability.

Other options explained:

• A. Hyperparathyroidism: May cause brown tumors, loss of lamina dura, and tooth mobility due to increased bone resorption, but not hypoplasia or unerupted teeth.
• C. Hyperthyroidism: Can lead to accelerated dental development but does not cause hypoplasia or hypodontia.
• D. Hypothyroidism: May cause delayed eruption and macroglossia but does not typically result in hypoplasia or paresthesia. 

The most well recognized technique for orthodontic bonding to porcelain surfaces is:

 # The most well recognized technique for orthodontic bonding to porcelain surfaces is:

A. Traditional acid-etch technique with phosphoric acid.

B. Chemical retention using 4-META coupling agent.

C. Chemical and micro-mechanical retention using hydrofluoric acid and a silane coupling agent.

D. Chemical retention using hydrofluoric acid only.

The correct answer is C. Chemical and micro-mechanical retention using hydrofluoric acid and a silane coupling agent

Explanation:
The most effective and well-recognized technique for bonding to porcelain involves etching the porcelain surface with hydrofluoric acid to create micro-mechanical retention, followed by the application of a silane coupling agent to enhance chemical adhesion. This combination ensures a strong bond between the orthodontic bracket and the porcelain surface.

• A: Phosphoric acid etching is effective for enamel but not adequate for porcelain bonding.
• B: 4-META is less commonly used for porcelain.
• D: Hydrofluoric acid alone provides micro-mechanical retention but lacks the chemical bond achieved with silane.

How many hours after appliance placement does orthodontic pain peak?

 # How many hours after appliance placement does orthodontic pain peak?

A. 10 minutes.

B. 1 hour.

C. 24 hours.

D. 48 hours.

The correct answer is C. 24 hours.

It is generally considered that orthodontic pain starts at around 2 hours after appliance placement, with some studies reporting that this is the case for between 91% and 97% of orthodontic patients. It then usually peaks at 24 hours before gradually subsiding over the next 5 to 7 days. Interestingly, it would seem that up to 25% of orthodontic patients report experiencing pain for longer than 7 days.

In pain pathways the smaller primary unmyelinated fibres are called:

 # In pain pathways the smaller primary unmyelinated fibres are called:

 A. A fibres. 

B. B fibres. 

C. C fibres. 

D. D fibres.

The correct answer is:

C. C fibres

Explanation: C fibres are small, unmyelinated nerve fibers that conduct pain signals slowly. They are primarily responsible for transmitting dull, burning, or aching pain (slow pain) and are involved in the prolonged, less localized pain sensation.

A fibres: Include A-delta fibers, which are myelinated and transmit sharp, localized pain quickly (fast pain).

B fibres: Small, myelinated fibers mainly involved in autonomic functions.

D fibres: This category does not exist in standard nomenclature for nerve fibers.

Enzyme marker of acute alcohol toxicity

 # A person with a long history of alcohol intake reports with acute alcohol intoxication. Which of the following enzymes is a marker of acute toxicity?

A. AST

B. ALT

C. GGT

D. Alkaline phosphatase

The correct answer is:

C. GGT (Gamma-Glutamyl Transferase)

Explanation:
Gamma-glutamyl transferase (GGT) is a sensitive marker for alcohol consumption and acute alcohol toxicity. It is elevated in conditions involving liver damage, particularly from chronic alcohol use. While AST and ALT may also be elevated in liver damage, GGT is more specific for alcohol-related effects. Alkaline phosphatase is primarily associated with biliary obstruction or bone disorders.

Calcium hydroxide applied directly to the exposed pulp to preserve its vitality

 # A patient with pulp exposure has calcium hydroxide applied directly to the exposed pulp to preserve its vitality. What is this procedure called?

A. Indirect pulp capping

B. Partial pulpotomy

C. Direct pulp capping

D. Cvek pulpotomy

The correct answer is:

C. Direct pulp capping

Direct pulp capping involves the application of a biocompatible material, such as calcium hydroxide, directly onto an exposed pulp to preserve its vitality and encourage the formation of reparative dentin.

Soreness of the muscles after wearing the denture for sometime

 # A newly fabricated complete denture patient reports with the complaint of soreness of the muscles after wearing the denture for sometime. What could be the probable cause?

A. Increased interocclusal space

B. Decreased interocclusal space

C. Excessive muscular force on the denture

D. Repeated muscle trauma

The correct answer is: B. Decreased interocclusal space

Explanation:

Soreness of the muscles after wearing newly fabricated complete dentures is often due to a decreased interocclusal space (or excessive occlusal vertical dimension). When the interocclusal space is inadequate:

1. The denture teeth are set too far apart, increasing the vertical dimension of occlusion (VDO).
2. This forces the muscles of mastication to remain overly contracted, leading to muscle fatigue and soreness over time.
3. The patient may also experience difficulty closing their mouth comfortably or feel that the dentures are "too tall."

Other options:

• A. Increased interocclusal space: Excessive interocclusal space (reduced VDO) might cause overclosure of the jaws but typically leads to different problems like angular cheilitis and lack of proper function, rather than muscle soreness.
• C. Excessive muscular force on the denture: While excessive force can cause issues, it is usually secondary to improper fit or function, not a primary cause related to soreness.
• D. Repeated muscle trauma: This is uncommon with new dentures unless associated with improper extension or faulty design, but it is not the primary explanation in this case.

Key Takeaway:

Proper assessment of the vertical dimension and interocclusal space is crucial in denture fabrication to avoid muscular discomfort and ensure comfort during function.

 # RPI clasp in a distal extension cast partial denture:

A. Used for buccally tilted molar

B. Provides push type retention

C. Provides pull type retention

D. Is contraindicated

The correct answer is:

B. Provides push type retention

Explanation:

The RPI clasp (Rest, Proximal plate, I-bar) system in a distal extension removable partial denture provides push-type retention because the I-bar clasp moves in a downward direction towards the gingiva when the denture base moves occlusally during function. This ensures that forces are directed in a manner that minimizes torque on the abutment tooth and enhances tissue support.

Breakdown of Key Features:

1. Rest: Positioned mesially to redirect forces along the long axis of the abutment tooth.
2. Proximal Plate: Contacts the guiding plane to stabilize the denture and control path of insertion and removal.
3. I-bar clasp: Engages an undercut and moves gingivally (pushes) as the denture is seated or when occlusal forces displace the denture base.

The push-type action of the I-bar helps maintain a stress-relieving design by allowing movement and reducing torque on the abutment during function.

Mass chemoprophylaxis for anemia in a population

 # What is recommended for mass chemoprophylaxis for anemia in a population?

A. Ferrous sulphate

B. Ferrous fumarate+ vit B12 + Folic acid + Vit. C

C. Intravenous iron

D. Oral iron supplements

The correct answer is: B. Ferrous fumarate + Vitamin B12 + Folic acid + Vitamin C

Explanation:

Mass chemoprophylaxis for anemia in a population focuses on addressing the most common causes of anemia, such as iron deficiency, folate deficiency, and vitamin B12 deficiency. The combination of Ferrous fumarate, Vitamin B12, Folic acid, and Vitamin C is recommended because:

• Ferrous fumarate: Provides a bioavailable form of iron.
• Vitamin B12 and Folic acid: Address common deficiencies leading to megaloblastic anemia.
• Vitamin C: Enhances the absorption of iron from the gastrointestinal tract.

Other options:

• A. Ferrous sulphate: Provides iron but does not address other nutritional deficiencies like folic acid or vitamin B12.
• C. Intravenous iron: Used for individuals with severe anemia or malabsorption but not practical for mass chemoprophylaxis.
• D. Oral iron supplements: Covers iron deficiency only and lacks the broader nutritional supplementation needed for population-wide anemia control.

Public Health Context:

In population-level interventions, a combination therapy like in option B is effective and feasible to address the multifactorial nature of anemia in resource-limited settings.

The patient has a nasal fracture. What will be the test for confirmation of CSF leakage?

 # The patient has a nasal fracture. What will be the test for confirmation of CSF leakage?

A. CT scan 

B. Decreased glucose

C. Increased glucose

D. Transferrin beta

The correct answer is: D. Transferrin beta

Explanation:
Beta-2 transferrin is a specific marker for cerebrospinal fluid (CSF). It is not found in blood, nasal mucus, or other bodily fluids, making it a reliable test for confirming CSF leakage in cases like nasal fractures or head trauma.

Other options:

• A. CT scan: Useful for identifying fractures or other structural damage but not specific for confirming CSF leakage.
• B. Decreased glucose: Not a specific marker; glucose levels in nasal secretions can vary for other reasons.
• C. Increased glucose: Similarly nonspecific; glucose levels alone are not definitive for detecting CSF leakage.

Note: CSF leakage is often suspected if clear fluid drains from the nose (rhinorrhea) or ears (otorrhea), especially after trauma. Beta-2 transferrin testing is the gold standard for confirmation.

Civil Braces and Dental Care pvt. ltd - Dental Clinic in Kathmandu

 Name of Dental Clinic: Civil Braces and Dental Care pvt. ltd 

Address (Full): Anamnagar, Kathmandu (Infront of Bajeko Sekuwa)

Year of Establishment: 2024

Name of the chief Dental Surgeon: Dr. Seeta Sapkota

CONTACT NUMBER: 9845592841

NMC Number of Dental Surgeon: 20943

CLICK HERE TO VIEW ALL DENTAL CLINICS OF BAGMATI PROVINCE

Which one of the following drug does not cause gingival hyperplasia?

 # Which one of the following drug does not cause gingival hyperplasia?

A. Cyclosporine

B. Phenytoin

C. Phenobarbital

D. Nifedipine

The correct answer is: C. Phenobarbital

Explanation:

Gingival hyperplasia is a common side effect of certain drugs due to their impact on fibroblast activity and collagen metabolism.

• Cyclosporine: An immunosuppressant commonly associated with gingival hyperplasia.
• Phenytoin: An antiepileptic drug that frequently causes gingival overgrowth.
• Nifedipine: A calcium channel blocker linked to gingival hyperplasia, especially in patients with poor oral hygiene.
• Phenobarbital: An antiepileptic and sedative-hypnotic drug that does not typically cause gingival hyperplasia.

Which lesion is easy to detect radiographically?

 # Which lesion is easy to detect radiographically?

A. An incipient lesion 

B. One that crosses the dentinoenamel junction (DEJ) 

C. One confined to enamel 

D. One with enamel demineralization 

The correct answer is: B. One that crosses the dentinoenamel junction (DEJ)

Explanation:

Lesions that cross the DEJ are easier to detect radiographically because:

1. Density Difference: When the lesion progresses beyond the DEJ, the change in tissue density between enamel and dentin becomes more pronounced, making it visible on radiographs.
2. Dentin Involvement: Dentin is less mineralized than enamel, so demineralization in this layer appears more distinctly on radiographs.

Other options:

• A. An incipient lesion: These are confined to the outer enamel and are challenging to detect radiographically due to minimal density changes.
• C. One confined to enamel: These may be faint or undetectable on radiographs, especially if demineralization is minor.
• D. One with enamel demineralization: Early enamel demineralization is often too subtle for reliable radiographic detection.

 

Malignant hyperthermia is caused by:

 # Malignant hyperthermia is caused by:

A. Suxamethonium

B. Thiopentone

C. Propofol

D. Cis-atracurium

The correct answer is A. Suxamethonium.

Malignant hyperthermia (MH) is a rare but life-threatening condition triggered in susceptible individuals by certain anesthetic agents. Suxamethonium (succinylcholine), a depolarizing neuromuscular blocker, and volatile anesthetic agents (e.g., halothane, sevoflurane) are common triggers. MH is caused by a genetic mutation in the ryanodine receptor (RYR1) or calcium channel, leading to uncontrolled calcium release in skeletal muscle, resulting in hypermetabolism, muscle rigidity, hyperthermia, and rhabdomyolysis.

The other options are not known to cause malignant hyperthermia:

• Thiopentone: A barbiturate used for induction of anesthesia, not a trigger for MH.
• Propofol: An intravenous anesthetic, considered safe in MH-susceptible individuals.
• Cis-atracurium: A non-depolarizing neuromuscular blocker, not associated with MH.

Sodium hypochlorite irrigation depends upon:

 # Sodium hypochlorite irrigation depends upon:

1. pH

2. Temperature

3. Volume

4. Concentration

A. 1 and 2

B. 2 and 3

C. 1 and 3

D. 2 and 4

The correct answer is: D. 2 and 4 (Temperature and Concentration)

Explanation:

The effectiveness of sodium hypochlorite (NaOCl) irrigation in endodontics depends significantly on:

1. Temperature: Increasing the temperature of sodium hypochlorite enhances its tissue-dissolving ability and antibacterial efficacy.

2. Concentration: Higher concentrations of sodium hypochlorite are more effective in tissue dissolution and microbial elimination. However, they can also increase the risk of cytotoxicity and irritation.

While pH and volume affect sodium hypochlorite's properties, they are not the primary factors affecting its irrigation efficacy.

Stain used to diagnose premalignant lesions of lip is:

 # Stain used to diagnose premalignant lesions of lip is:

A. Crystal violet

B. Giemsa

C. H and E

D. Toluidine blue

The correct answer is: D. Toluidine blue

Explanation:

Toluidine blue is a metachromatic dye that stains acidic tissue components and is commonly used to identify premalignant and malignant lesions. It has an affinity for DNA and RNA, highlighting areas of increased nuclear activity, such as dysplastic or malignant cells. This makes it particularly useful in diagnosing premalignant lesions of the lip and oral mucosa.

Cleft lip and palate is associated with all, EXCEPT:

 # Cleft lip and palate is associated with all, EXCEPT:

A. Van der Woude Syndrome

B. Gardner syndrome

C. Treacher Collin Syndrome

D. Pierre Robin Syndrome

The correct answer is:

B. Gardner syndrome

Explanation:

Van der Woude Syndrome:

This is a genetic condition commonly associated with cleft lip and/or palate. It is characterized by lip pits and other oral anomalies.

Gardner syndrome:

This syndrome is primarily associated with intestinal polyps, osteomas, and soft tissue tumors. It does not typically involve cleft lip or palate.

Treacher Collins Syndrome:

This genetic disorder affects craniofacial development and can be associated with cleft palate (though cleft lip is less common).

Pierre Robin Syndrome:

This condition is characterized by mandibular hypoplasia, glossoptosis, and cleft palate. Cleft palate is a hallmark feature of this syndrome.

Which of the following is not a systemic disorder causing delayed eruption of permanent teeth?

 # Which of the following is not a systemic disorder causing delayed eruption of permanent teeth?

A. Segmental odontomaxillary dysplasia

B. Celiac disease

C. Cerebral palsy

D. Ichthyosis

The answer is A. Segmental odontomaxillary dysplasia.

Explanation:

Segmental odontomaxillary dysplasia:

This is a localized developmental disorder, not a systemic disorder. It affects the maxilla segmentally, often leading to delayed eruption of teeth in that specific area. However, it is not classified as a systemic disorder.

Celiac disease:

This is a systemic condition that can cause nutritional deficiencies (e.g., calcium, vitamin D), leading to delayed dental development and eruption.

Cerebral palsy:

A systemic neurological disorder that can indirectly delay the eruption of permanent teeth due to associated developmental challenges.

Ichthyosis:

Though primarily a skin disorder, certain severe systemic forms might cause delayed eruption due to associated developmental issues.

In falciparum malaria, causes of anemia are due to all EXCEPT:

 # In falciparum malaria, causes of anemia are due to all EXCEPT:

A. Hemolysis

B. Malabsorption

C. Spleen sequestration

D. Bone marrow depression

The correct answer is B. Malabsorption.

In falciparum malaria, the causes of anemia include:

Hemolysis: Destruction of red blood cells.

Spleen sequestration: Trapping of red blood cells in the spleen.

Bone marrow depression: Reduced production of red blood cells in the bone marrow.

However, malabsorption is not typically a cause of anemia in falciparum malaria. 

Acute angled cusps in permanent maxillary first molar are:

 # Acute angled cusps in permanent maxillary first molar are:

A. Distobuccal and mesiolingual

B. Mesiobuccal and distolingual

C. Mesiobuccal and distobuccal

D. Mesiolingual and distolingual

The correct answer is B. Mesiobuccal and distolingual.

Explanation:

In the permanent maxillary first molar:

The mesiobuccal and distolingual cusps form acute angles.

The mesiolingual and distobuccal cusps form obtuse angles.

These acute and obtuse angles contribute to the rhomboid-shaped occlusal outline typical of the maxillary first molar.

Most common side effect of long term heavy dose of carbamazepine is:

 # Most common side effect of long term heavy dose of carbamazepine is:

A. Aplastic Anemia

B. Fluid retention

C. Renal toxicity

D. Gingival hyperplasia

The correct answer is: A. Aplastic Anemia.

Explanation:

Carbamazepine is an antiepileptic drug with several potential side effects. The most common long-term serious side effect associated with heavy doses of carbamazepine is hematological toxicity, including aplastic anemia and agranulocytosis, though these are rare.

A. Aplastic Anemia: Correct. Long-term use of carbamazepine can suppress bone marrow, leading to aplastic anemia.

B. Fluid Retention: While carbamazepine can cause hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), this is not the most common severe long-term side effect.

C. Renal Toxicity: Carbamazepine is not primarily known for causing renal toxicity.

D. Gingival Hyperplasia: This is more commonly associated with drugs like phenytoin, not carbamazepine.

# All are true about dental anomalies in cleft patients EXCEPT:

 # All are true about dental anomalies in cleft patients EXCEPT:

A. Hypodontia is the most commonly observed dental anomaly

B. Incidence of dental anomalies is strongly correlated with cleft severity

C. Maxillary lateral incisor is the most frequently affected tooth in the cleft area

D. Dental anomaly occurs more frequently on the non cleft side

The correct answer is D. Dental anomaly occurs more frequently on the non cleft side.

Explanation:

A. Hypodontia is the most commonly observed dental anomaly: True. Hypodontia, particularly in the maxillary lateral incisors, is frequently observed in cleft patients.

B. Incidence of dental anomalies is strongly correlated with cleft severity: True. More severe clefts are often associated with a higher prevalence of dental anomalies.

C. Maxillary lateral incisor is the most frequently affected tooth in the cleft area: True. This tooth is commonly missing, malformed, or displaced in cleft patients.

D. Dental anomaly occurs more frequently on the non-cleft side: False. Dental anomalies occur more frequently on the cleft side due to the disruption of normal development in the region of the cleft.

If retromolar pad and tuberosity contact, what should be done?

 # If retromolar pad and tuberosity contact, what should be done?

A. Surgical reduction of tuberosity

B. Do not extend dentures to retromolar area

C. Denture fabrication not possible

D. Has no effect on denture

The correct answer is A. Surgical reduction of tuberosity.

A. Surgical reduction of tuberosity

If the retromolar pad and tuberosity contact, it can hinder proper denture seating and stability. Surgical reduction of the tuberosity creates space for the denture to fit properly and function effectively.

Sanjivani Dental Clinic Ghorahi Dang

 Name of Dental Clinic: Sanjivani Dental Clinic Ghorahi Dang

Address (Full): Main Road, Infront of Krishi Bikash Bank, Ghorahi-15, Dang

Year of Establishment: 2024

Name of the chief Dental Surgeon: Dr Aashish Upreti

CONTACT NUMBER: 082590731

NMC Number of Dental Surgeon: 27536

MCQs in Orthodontics - Myofunctional and Orthopedic appliances

# All of the following can be classified as myofunctional appliances EXCEPT:
A. Anterior bite plane
B. Andersen appliance
C. Begg appliance
D. Oral screen

# All the following are passive tooth-borne functional appliances except:
A. Andersen activator
B. Woodside and Hawley activator
C. Expansion activator
D. Herbst appliance

MCQs in Orthodontics - Removable and Fixed appliances

# Adams cribs can fracture in use if the:
A. Wire is too soft
B. Tags are high on the bite
C. Base plate is too thick
D. Arrowheads are too small

# How/where should wire be bent to activate a correctly made palatal canine retractor?
A. Between the coil and tooth, but close to the coil
B. Between the coil and tooth, but close to the tooth
C. Between the coil and its insertion into the base of the palate
D. By opening out the coil

Removable Orthodontic Appliance MCQs

1. Adams cribs can fracture in use if the:

A. Wire is too soft
B. Tags are high on the bite
C. Base plate is too thick
D. Arrowheads are too small

2. How/where should wire be bent to activate a correctly made palatal canine retractor?

A. Between the coil and tooth, but close to the coil
B. Between the coil and tooth, but close to the tooth
C. Between the coil and its insertion into the base of the palate
D. By opening out the coil

3. An anterior bite plane is used in correction of:

A. Anterior cross bite
B. Deep bite
C. Open bite
D. All of the above

4. Posterior bite plane is used in correcting:

A. Deep bite
B. Anterior open bite
C. Anterior cross bite
D. Posterior cross bite

5. Example of a semifixed orthodontic appliance is:

A. Kesslings wrap around retainer
B. Hawley's retainer
C. Lip bumper
D. Pin and tube appliance

6. The diameter of labial bow of the maxillary plate is:

A. 0.5 - 0.6 mm
B. 0.6 - 0.8 mm
C. 0.7 - 0.8 mm
D. 0.8 - 1.0 mm

7. A buccal canine retractor is better than a palatal canine retractor when:

A. The maxillary canine is distally placed
B. The maxillary canine is partially impacted
C. The maxillary canine is distally placed and rotated
D. The maxillary canine is buccally placed

MCQs in Orthodontics - Biomechanics of Tooth Movement

# '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

# Resorption in case of ideal orthodontic tooth movement should be:
A. Undermining
B. Frontal
C. Indirect
D. Necrotic

# In orthodontic tooth movement which is involved:
A. Osteoblast
B. Osteoclast
C. Both A and B
D. None

MCQs on Dental Cements- Dental Materials MCQs

# Fluoride rich materials include:
A. Silicate cement
B. Glass ionomer cement
C. Poly carboxylate cement
D. All of the above

# Glass ionomer cements are composed of:
A. Alumina silicate powder and phosphoric acid
B. Aluminosilicate powder and polyacrylate
C. Zinc oxide powder and phosphoric acid
D. Zinc oxide powder and polyacrylate Liquid

# Which one of the following dental cement accelerates the formation of reparative dentin?
A. Eugenol
B. Calcium hydroxide
C. Zinc oxide
D. Silica

# Minimum thickness for type I zinc phosphate cement should be:
A. 15 microns
B. 25 microns
C. 50 microns
D. 100 microns

The bone of tooth socket is called:

 # The bone of tooth socket is called:

A. Alveolar process

B. Alveolus

C. Gomphosis

D. Cancellous bone

The correct answer is A. Alveolar process.

The bone of the tooth socket is called the Alveolar process.

Here’s a brief explanation of the terms:

Alveolar process: The bony ridge in the jaw that contains the sockets (alveoli) for the teeth.

Alveolus: Refers specifically to the individual tooth socket itself.

Gomphosis: The fibrous joint between a tooth and its socket.

Cancellous bone: A type of bone tissue that is spongy and found within the alveolar process, but it is not specifically the term for the socket.

So the correct answer is A. Alveolar process.

Number of surfaces of an anterior tooth is:

 # Number of surfaces of an anterior tooth is:

A. 5

B. 3

C. 4

D. 6

The correct answer is C. 4.

The number of surfaces of an anterior tooth is typically 4. Anterior teeth, which include incisors and canines, generally have the following surfaces:

1. Facial (or Labial): The surface facing the lips.
2. Lingual: The surface facing the tongue.
3. Mesial: The surface closest to the midline of the dental arch.
4. Distal: The surface farthest from the midline.

Therefore, the correct answer is C. 4.

Universal tooth numbering system was given by:

 # Universal tooth numbering system was given by:

A. ADA in 1968

B. WHO adopted

C. Adolph Zsigmondy

D. Palmer

The correct answer is A. ADA in 1968.

The Universal Tooth Numbering System, developed by the American Dental Association (ADA) in 1968, is a standardized method used primarily in the United States for identifying and labeling teeth. Here’s a detailed breakdown of its components and significance:

Overview of the System

Numbering Convention:

• The system assigns a unique number to each tooth, starting from the upper right third molar (tooth #1) and moving across the upper arch to the upper left third molar (tooth #16).
• The numbering then continues with the lower left third molar (tooth #17) and goes across the lower arch to the lower right third molar (tooth #32).
• This creates a simple, sequential numbering system that allows for easy identification of each tooth.

Tooth Types:

The system includes all types of teeth: incisors, canines, premolars, and molars.

For example, incisors are numbered as follows:

Upper right central incisor: #7

Upper left central incisor: #9

Similarly, for molars:

Upper right first molar: #3

Lower left first molar: #19

Importance of the System

Communication:

The Universal Tooth Numbering System facilitates clear communication among dental professionals. By using a standardized number for each tooth, practitioners can avoid confusion that may arise from differing naming conventions.

Record Keeping:

This system is particularly useful for patient records, treatment planning, and documentation. It allows dentists to efficiently reference specific teeth during consultations, procedures, and follow-ups.

Education:

Dental students and practitioners benefit from learning this system as it is widely used in clinical practice. Mastery of tooth numbering is crucial for accurate diagnosis and treatment.

Alternatives to the Universal System

While the Universal Tooth Numbering System is prevalent in the U.S., other countries may use different systems, such as:

• FDI World Dental Federation Notation: This system uses a two-digit code where the first digit represents the quadrant and the second digit represents the tooth within that quadrant.
• Palmer Notation: This method employs a symbol to indicate the quadrant and numbers to denote the teeth within that quadrant.

Conclusion

The Universal Tooth Numbering System established by the ADA has become an integral part of dental practice in the U.S. Its simplicity and efficiency help streamline communication and improve the overall quality of dental care.

What is the area of biopsy of an ulcer?

 # What is the area of biopsy of an ulcer?

A. Center of ulcer 

B. Edge of ulcer 

C. Adjacent mucosa 

D. Margins of ulcer

The correct answer is B. Edge of ulcer.

The edge of the ulcer is the preferred site for biopsy because it is most likely to contain a mixture of both the pathological tissue and relatively healthy tissue, making it easier to assess the nature of the lesion. The center of the ulcer may contain necrotic tissue, which can obscure diagnosis, while adjacent mucosa and margins might not provide the necessary diagnostic material.

While the terms "edge" and "margin" may seem similar, in the context of ulcer biopsy, they refer to different areas:

Edge of the ulcer: This refers to the transitional zone where the ulcerated tissue meets the adjacent normal or mildly affected tissue. It contains a mix of pathological changes (inflammation, dysplasia, or neoplastic transformation) and some relatively intact tissue. This makes it ideal for biopsy because it provides a clearer picture of the disease process.

Margin of the ulcer: This term typically refers to the boundary or outer rim of the ulcer where the surrounding tissue is largely unaffected or healthy. A biopsy from the margin might miss the abnormal cellular changes that are occurring in the active disease area.

In summary, the edge includes both ulcerated and transitioning tissue, making it more useful for diagnosis, whereas the margin is often farther out in the healthier tissue, which may not show the necessary pathological changes.

Posterior triangle of neck is subdivided into two parts by which muscle?

 # Posterior triangle of neck is subdivided into two parts by which muscle?

A. Sternocleidomastoid

B. Superior belly of Omohyoid

C. Inferior belly of Omohyoid

D. Pulley of Trapezius

The correct answer is C. Inferior belly of Omohyoid.

The posterior triangle of the neck is divided into two smaller triangles: the occipital triangle and the subclavian (supraclavicular) triangle. This division is created by the inferior belly of the omohyoid muscle.

Here’s a breakdown of the other options:

A. Sternocleidomastoid: Forms the anterior border of the posterior triangle, but does not subdivide it.

B. Superior belly of Omohyoid: Lies more anteriorly and is not involved in subdividing the posterior triangle.

D. Pulley of Trapezius: The trapezius muscle forms the posterior boundary of the posterior triangle but does not subdivide it.

Which of the following clinical features is not seen in Bell’s palsy?

 # Which of the following clinical features is not seen in Bell’s palsy?

A. Lacrimation

B. Xerostomia

C. Drooling of saliva

D. Sensory loss over affected side

The correct answer is D. Sensory loss over affected side.

Bell’s palsy primarily affects the motor function of the facial nerve (cranial nerve VII), leading to muscle weakness or paralysis on one side of the face. Sensory loss is typically not a feature of Bell’s palsy, as the facial nerve is primarily motor, with only a small contribution to sensory function (taste sensation on the anterior two-thirds of the tongue). Sensory loss over the face would more likely be associated with trigeminal nerve issues (cranial nerve V).

Here’s a breakdown of the other options:

Lacrimation (A): The facial nerve affects the lacrimal gland, and changes in tearing can occur in Bell's palsy.

Xerostomia (B): The facial nerve also has parasympathetic fibers that innervate salivary glands, so dry mouth (xerostomia) can be a symptom.

Drooling of saliva (C): Muscle weakness can lead to drooling due to poor control of the facial muscles.

Anti caries vaccine is based on which immunoglobulin?

 # Anti caries vaccine is based on which immunoglobulin?

A. IgA

B. IgE

C. IgM

D. IgG

The correct answer is A. IgA.

The major immunoglobulin in saliva is secretory IgA. whereas IgG, which comprises about 80% of the total immunoglobulin in serum, is found only in low level in salivary secretions. The molecular configuration renders the secretory IgA antibody exceptionally resistant to digestion by proteolytic enzymes. Consequently, it can function highly effectively in an oral environment which contains microbial proteases. Salivary IgA plays an important role in the defense of the host against colonization of streptococci by agglutination of the organisms. 

Increased ketone bodies are seen in:

  # Increased ketone bodies are seen in:

1. Uncontrolled diabetes

2. Protein deficiency

3. Well fed state

4. Prolonged starvation

A. 2 and 4

B. 1, 2 and 3

C. 1 and 2

D. 1 and 4

The correct answer is D. 1 and 4.

1. Uncontrolled diabetes: In uncontrolled diabetes, especially type 1 diabetes, there is a lack of insulin, leading to increased lipolysis and subsequent production of ketone bodies, resulting in diabetic ketoacidosis. 

4. Prolonged starvation: During prolonged starvation, the body depletes its glucose stores and starts breaking down fats, leading to an increase in ketone bodies for energy. 

2. Protein deficiency (Incorrect) 

Protein deficiency does not typically lead to an increase in ketone bodies. 

3. Well-fed state (Incorrect) 

In a well-fed state, the body has sufficient glucose for energy, so ketone body production is minimal. 



A 5 year old child is diagnosed with leukocyte adherence deficiency and is also affected with generalized severe bone loss adjacent to his primary teeth. What is the diagnosis?

 # A 5 year old child is diagnosed with leukocyte adherence deficiency and is also affected with generalized severe bone loss adjacent to his primary teeth. What is the diagnosis?

A. Generalized aggressive periodontitis

B. Generalized chronic periodontitis

C. Gingival diseases modified by systemic factors

D. Periodontitis as a manifestation of systemic disease

The correct answer is D. Periodontitis as a manifestation of systemic disease.

Leukocyte adhesion deficiency (LAD) is a rare immunodeficiency disorder that impairs the body's ability to fight infection. This condition is associated with early, severe periodontitis due to the inability of leukocytes (white blood cells) to migrate to infection sites, leading to impaired immune responses and increased susceptibility to bacterial infections. The severe bone loss around the primary teeth is a manifestation of this systemic disease. Therefore, the periodontitis is secondary to the systemic condition, which makes D the most appropriate choice.



Which of the following premalignant conditions has the highest potential to become malignant?

  # Which of the following premalignant conditions has the highest potential to become malignant?

A. Proliferative verrucous leukoplakia

B. Speckled leukoplakia

C. Lichen planus

D. Tobacco pouch keratosis

The correct answer is A. Proliferative verrucous leukoplakia.

Which of the following contains all three germ layers?

  # Which of the following contains all three germ layers?

A. Teratoid cyst

B. Hamartoma

C. Dermoid cyst

D. Sebaceous cyst

The correct answer is A. Teratoid cyst.

 In 1955, Meyer updated the concept of dermoid cyst to describe three histological variants, that is, the true dermoid, epidermoid and teratoid cyst. True dermoid cysts are cavities  lined with epithelium with keratinization and skin appendages  in cyst wall. Epidermoid cysts do not show skin appendages. 

The lining of teratoid cyst varies from stratified squamous to a ciliated respiratory epithelium containing derivatives of  ectoderm, mesoderm and endoderm.

Teratoid cyst rarely arises in the head and neck region, in the  oral cavity; these cysts occur in the area of the floor of the  mouth and may also occur on the tongue, lips, buccal mucosa or the interior of the bone.