Diagnosis in Orthodontics

# In a patient with competent lips together at rest, the lip line is opposite the tips of the upper incisors. The lip line is then described as:
a) Average
b) High
c) Incomplete
d) Low

# Following are "essential diagnostic criteria" according to Graber except:
a) Case history
b) Facial photographs
c) Periapical x-rays
d) Lateral cephalograms

# Incompetent lips refer to:
a) Inability of the Lips to cover the incisors in the mandibular relaxed position
b) Inability of the lips to cover the incisors in occlusion
c) The lips come in between the upper and lower incisors
d) Tongue thrusts against the lips during swallowing

# Mentalis muscle contraction causes the lower lip to:
a) Retrude
b) Protrude
c) Inversion
d) Eversion

# Transposition of teeth refers to:
a) Bucco rotation of 120°
b) Hypodontia
c) Teeth erupted in unusual position i.e, one tooth erupts in place of another
d) Inverted supernumerary teeth

# Carpel radiograph is used for assessment of:
a) Bone condition
b) Chronological age
c) Treatment plan
d) Skeletal maturation

# A reliable indicator of pubertal growth spurt on hand wrist films is sought as:
a) Ossification of adductor sessamoid
b) Appearance of hook of hamate
c) Ossification of all the carpal bones
d) Ossification of pisiform

# Dolicocephalic facial pattern is associated with:
a) Broad dental arch
b) Long and narrow dental arch
c) Paraboloid dental arch
d) Square dental arch

# Broad and short type of face is known as:
a) Mesoprosopic
b) Euryprosopic
c) Leptoprosopic
d) None of above

# Convex profile is seen in:
a) Class I
b) Class II
c) Class III
d) None of above

#  Facial divergence is:
a) Anterior placement of the midface
b) Inclination of the lower third of the face in relation to the forehead
c) Inclination of the upper third of the face to the middle third of the face
d) None of the above

# Fishman's index is used in relation with:
a) Population
b) Hand wrist radiographs
c) Cephalograms
d) Periodontal disease

# Brachy cephalic individual usually has:
a) Narrow dental arches
b) Broad dental arches
c) Normal dental arches
d) B or C

# The lip is supported by:
a) Relation of lip edge and facial surfaces of teeth
b) Labial sulcus between teeth and lip
c) Relationship of tongue and teeth
d) None

# Pletoric individual will have:
a) Tall and thin physique
b) Short and obese physique
c) Average physique
d) None of above

# Normal nasolabial angle:
a) 80°
c) 70°
b) 110°
d) 140°

# Hyperactive mentalis activity is seen in:
a) Class I
b) Class II division 1
c) Class II division 2
d) Class III

# Blanch test is used in diagnosis of:
a) Abnormal frenal attachments
b) Pseudo class III
c) Tongue thrusting
d) Tnumb sucking

# Backward path of mandibular closure is seen is:
a) Class II division 2
b) Class I
c) Pseudo class III
d) Class III

# Which of the following tests are employed to diagnose the mode of respiration?
a) Mirror test
c) Water test
b) Cotton test
d) All of the above

# The normal interincisal distance is:
a) 40 - 45 mm
b) 30 - 35 mm
c) 20 - 30 mm
d) 55 - 65 mm

# In gnathostatic models:
a) Maxillary cast is parallel to mandible cast
b) Maxillary cast is parallel to FH plane
c) Mandibular cast is parallel to FH plane
d) Both casts are parallel to FH plane

# Xeroradiography was invented by:
a) Chester F. Carlson in 1937
b) Simon
c) Hudson Kampula and Dickson in 1957
d) Hofrath and broad bent in 1934

# Ectomorphic, mesomorphic and endomorphic classification of body physique was given by:
a) Sheldon
b) Angle
c) LE Fouloun
d) Kielgren

# The Moyer's analyses requires the measurement of the:
a) Mesiodistal of the erupted permanent mandibular centrals and Laterals
b) Space available in the maxillary and mandibular posterior quadrants
c) Mesiodistal diameter of the unerupted premolars
d) Mesiodistal diameter of the unerupted maxillary and mandibular permanent cuspids and premolars

# Ashley-Howe model analysis is used to predict:
a) Tooth material excess
b) Maxillo-mandibular relationships
c) Basal bone-transverse relationship
d) Growth prediction

# Study models are used:
a) As references in orthodontic cases
b) To show shape, size and position of teeth
c) As an aid in treatment planning
d) All of the above

# Arch length analysis of a dentition shows a discrepancy of more than 10 mm. This indicates:
a) No extraction required if treated at an early age
b) No extraction required
c) Extraction of posterior teeth
d) Proximal stripping

# There are difference in completing a Hixon-Old father and Moyer's analysis. Of the following which would not be correct?
a) The Moyer's analysis requires the eruption of the mandibular permanent centrals and Laterals
b) The Hixon-Old father requires the eruption of the mandibular permanent centrals and laterals
c) The Hixon-Old father analysis requires the measured space available in all four posterior quadrants
d) The Moyer's analysis requires the measurement of the space available in the four posterior quadrants

# In which one of the following mixed dentition analysis of deciduous dentition there is no use of radiographs?
a) Carey's analysis
b) Moyer's analysis
c) Nance Carey's analysis
d) Pont's index


# The following is one of the mixed dentition analysis:
a) Tanaka Johnson
b) Counterpart analysis
c) Bjork analysis
d) Plaster cast analysis

# Which of the following analysis helps in determining the disproportion in the size between maxillary and mandibular teeth?
a) Pont's analysis
b) Bolton's analysis
c) Peck and Peck analysis
d) Carey's analysis

# Four dentists did study model analysis by Johnson and Tanaka; Moyer's, Stanley and Kerber, Wits analysis. Which one will give the best results:
a) Johnson and Tanaka
b) Moyer's
c) Stanley and Kerber
d) Wits

# Mixed dentition analysis was described by
a) Graber
b) Angle
c) Tweed
d) Moyer's

# In mixed dentition analysis, which tooth is used for classification:
a) Primary 1st molar
b) Primary 2nd molar
c) Permanent lst molar
d) B or C

#  Arch perimeter can be measured with:
a) Cephalogram
b) Brass wire
c) Vernier calipers
d) Occlusal radiograph

# Bolton analysis is used to determine
a) Arch length - tooth size discrepancy
b) Apical base length to arch perimeter
c) Tooth size ratio in the maxilla
d) Upper teeth to Lower teeth size ratio

#  In Pont's analysis
a) The width of 4 maxillary incisors is calculated
b) The width of 4 mandibular incisors is calculated
c) The width of 10 teeth anterior to first molars is calculated
d) The width of 12 teeth anterior to second permanent molars is calculated
e) The mesiodistal width and faciolingual width of mandibular centrals and laterals are taken individually

# The number of sites examined to assess the stages of bone maturation in Fishman's skeletal maturation index are:
a) 4
b) 5
c) 6
d) 7

#  SVED type of tooth plane is an example of:
a) Simple anchorage
b) Reciprocal anchorage
c) Extra oral anchorage
d) Reinforced anchorage


# In Peck and Peck index, mesiodistal and buccolingual measurements of which of the following tooth is taken:
a) Maxillary central incisor
b) Mandibular central incisor
c) Maxillary premolars
d) Mandibular molars

# Andrew's 5th key of occlusion is:
a) Curve of spee
b) Rotation absent
c) Tight contacts
d) Bolton's ratio

#  Lisping is associated commonly with which of the following malocclusions:
a) Anterior deepbite
b) Anterior crowding
c) Anterior open bite
d) Anterior retroclination

# The SCAN index is generally used as a :
a) Malocclusion index
b) Treatment need index
c) Treatment change index
d) Treatment of priority index

# According to American Board of Orthodontics recommendation for colour coding of sequential tracing, end treatment ceph tracing is done in:
a) Black
b) Blue
c) Red
d) Green

# Which of the following is not a type of mouth breathing?
a) Obstructing
b) Anatomical
c) Physiological
d) Habitual

# Tooth Loss that causes the patient to bite in an abnormal relation of maxilla to mandible, in order to obtain better function during mastication is termed:
a) Convenience bite
b) Dramatic bite
c) Temporary bite
d) Squashed bite

# The term applied when it is doubtful, according to mixed dentition analysis whether there will be space for all the teeth:
a) Space maintenance
b) Space regaining
c) Space supervision
d) None of the above

# For class II div 1 malocclusion of 14 years old boy, which analysis is indicated to detect the tooth extraction:
a) Bolton's analysis
b) Pont's analysis
c) Peck & peck analysis
d) Ashley & Howe's analysis

# A lingually erupting maxillary lateral incisor:
a) Is always indicative of arch length deficiency
b) Can be corrected by using a tongue blade if sufficient space exists in the arch
c) Is a self-correcting anomaly
d) Is to be extracted as early as possible to avoid a reflective pathway of the mandible

# The orthodontic diagnosis focuses on:
a) Full smile
b) Emotional smile
c) Social smile
d) Gummy smile only

# Fishman index is used for:
a) Skeletal growth maturation index
b) Dental growth maturation index
c) Arch length discrepancy
d) Prognathism of maxilla

# Which of the following is NOT a type of mixed dentition analysis?
a) Moyer's
b) Tanaka Johnston
c) Pont & Linderharth
d) Hixon old Father

# In a perfect smile, the ratio of width to height of maxillary incisor is?
a) 8:10
b) 6:8
c) 10:14
d) 20:25

# Study model with mounted base and trimmed height is:
a) 55 mm
b) 70 mm
c) 60 mm
d) 90 mm

# Three quarter profile photograph is used to detect:
a) Lip incompetence
b) Mandibular asymmetry
c) Midline
d) Midface deformity

# Which of the following is used to measure the mineral bone density of mandible?
a) Micro radiography
b) Auto radiography
c) Finite element modeling
d) Nuclear volume morphometry

Bacteria found in two days old plaque is:

# Predominant bacteria found in two days old plaque is:
A. Streptococci
B. Bacteroides
C. Spirochetes
D. Actinomyces

The correct answer is: A. Streptococci. 

- Plaque can be defined as a complex microbial community, with greater than 10^10 bacteria per milligram. 

- The formation of pellicle is the first step in plaque formation.

- "Primary colonizers" : The pellicle coated tooth surface is colonized by Gram- Positive aerobic cocci bacteria such as Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscous. 

- Secondary colonizers: After 1 to 3 days, the secondary colonizers are gram negative anerobic rods and filaments that include Fusobacterium nucleatum, Prevotella intermedia, and Capnocytophaga species. 

Tertiary colonizers: After one week of plaque accumulation, other gram negative species may also be present in plaque. They include Porphyromonas gingivalis, Campylobacter rectus, Eikenella corrodens, Actinobacillus actinomycetemcomitans, and the oral spirochetes (Treponema species).

- The structural characteristics of dental plaque in this time period reveal complex patterns of bacterial cells of cocci, rods, fusiform, filaments, and spirochetes. 

- Particular specific associations of different bacterial forms have been observed . For example, the adherence of cocci to filaments results in a typical form referred to as "test tube brushes" or "corn cob" arrays. 

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Storiform pattern of fibrous tissue

# Storiform pattern of fibrous tissue is seen in:
a. Fibrosarcoma
b. Malignant fibrous histiocytoma
c. Neurofibroma
d. Ameloblastic fibroma

The correct answer is: B. Malignant fibrous histiocytoma.

MALIGNANT FIBROUS HISTIOCYTOMAS
- are group of aggressive malignant neoplasms, arising from undifferentiated mesenchymal cells that differentiate along both fibroblastic and histiocyte pathways.
- Histologically the neoplasm reveals actively proliferating, numerous polyhedral or oval shaped, malignant histiocytes and many spindle shaped malignant fibrous cells.
- These malignant cells are often arranged in a typical "Cart-wheel" or "Storiform" pattern or Criss cross.
- Fibrous histiocytoma: Storiform pattern (helicopter in wheat field) is seen.

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Oral Drive Theory

# The oral drive theory to explain thumb sucking habit was given by:
a) Benjamin
b) Sears and wise
c) Sigmund Freud
d) Scheldon

The correct answer is B. Sears and Wise.

According to ORAL DRIVE THEORY OF SEARS AND WISE, prolonged suckling lead to thumb sucking.

BENJAMIN'S TH EORY states that thumb sucking arises from the rooting or placing reflex. Rooting reflex is the movement of infant's head and tongue towards an object touching his cheek. The rooting reflex disappears in normal infants around 7-8 months of age.

According to SIGMOND FREUDIAN THEORY, in the oral phase of psychologic development, the mouth is believed to be an oro-erotic zone. The child has the tendency to place fingers or any other object into the oral cavity.

ORAL GRATIFICATION THEORY BY SHELDON states that if a child is not satisfied with sucking during the feeding period it will persist as a symptom of an emotional disturbance by digit sucking.

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Gonial angle at birth

# The gonial angle at birth is?
a) 110°
b) 115°
c) 175°
d) 145°

The correct answer is D. 145 degrees.

 The mandibular or gonial angle during perinatal period ranges from 135° to 150°; however, soon after birth, it decreases to 130° to 140°. In adult mandible, the gonial angle measures between 110° to 120°. Studies have also indicated that the angle value of females is 3-5° greater than that of males.

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Development of Maxilla

# Maxilla develops by:
a) Endochondral bone formation
b) Intra membranous bone formation
c) Cartilage replacement and intra membranous bone formation
d) Mostly cartilage replacement and a little by intra membranous

The correct answer is B. Intra membranous bone formation.

In endochondral type, the bone formation is preceded by formation of cartilaginous model, which is replaced by bone. Eg: Ethmoid bone, Hyoid, Incus, Stapes.

In intramembranous type, the formation of bone is not preceded by formation ot cartilaginous model. Instead bone is laid directly in a fibrous membrane. Eg: Maxilla, nasal bones, parietals, zygoma, vomer, lacrimal, zygomatic.

 Both intramembranous and endochondral ossification is seen in -occipital, temporal, sphenoid bones.

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Father of Modern Orthodontics

# Father of modern orthodontics is:
a) Dewey
b) Angle
c) Andrew
d) Clark 

The correct answer is B. Angle. 

Many inventors have significantly contributed to the fascinating science of orthodontics. The person given the most credit for pioneering modern orthodontics is Dr Edward H Angle, who is rightly honored as the “Father of Modern Orthodontics.” Publication of Angle’s classification system of malocclusion in 1899 marked a turning point in the history of orthodontics, paving way to establishment of the oldest specialty of dentistry.

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