Bones of the skull which permit free movement are all except:

 # Bones of the skull which permit free movement are all except:

(a) Mandible

(b) Malleus

(c) Incus

(d) Vomer

The correct answer is D. Vomer.

The vomer is involved in all three types of Le Fort fractures of midfacial skeleton. The vomer is paper thin. A transverse fracture of vomer due to direct blow on the nose leads to deviated nasal septum (DNS).

Reference: TEXTBOOK OF ANATOMY HEAD, NECK AND BRAIN, Volume III, 2nd Edition Vishram Singh, Page No. 40

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Sternocleidomastoid divides the neck into:

 # Sternocleidomastoid divides the neck into which cervical triangles?

(a) Medial and lateral

(b) Superior and inferior

(c) Anterior and posterior

(d) Proximal and distal

The correct answer is C. Anterior and Posterior.

The neck is conventionally divided into various triangles. The sternocleidomastoid muscle transects the side of neck obliquely on each side and divides it into anterior and posterior cervical triangles.

Reference: TEXTBOOK OF ANATOMY HEAD, NECK AND BRAIN, Volume III, 2nd Edition Vishram Singh, Page No. 10

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Most prominent part of occipital regions of the head:

 # The most prominent part of occipital regions of the head is called:

(a) Inion

(b) Opisthocranion

(c) Superior nuchal lines

(d) Basion

The correct answer is B. Opisthocranion.

The occipital region is an area of cranium behind the parietal eminences, and above the external occipital protuberance and superior nuchal lines.

The most prominent point in the occipital region is called opisthocranion or occiput. The external occipital protuberance can be felt in the median line just above the nuchal furrow. The superior nuchal line, one on either side of external occipital protuberance, runs laterally with its convexity facing upwards. The soft tissue covering frontal, parietal, and occipital regions forms the scalp.

Reference: TEXTBOOK OF ANATOMY HEAD, NECK AND BRAIN, Volume III, 2nd Edition Vishram Singh, Page No. 2

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The smooth elevated area between the eyebrows is called:

 # The smooth elevated area between the eyebrows is called:

A. Bregma

B. Glabella

C. Nasion

D. Medial canthus

The correct answer is B. Glabella.

The smooth nonhairy elevated area between the eyebrows is called glabella, which tends to be flat in children and adult females, and forms a rounded prominence in adult males. Indian married Hindu females apply bindi at this site to enhance their beauty. It is important to note that the pineal gland lies about 7 cm behind the glabella. The prominence of forehead, the frontal eminence is evident on either side above the eyebrow. The frontal prominence is typically more pronounced in children and adult females.

Reference: TEXTBOOK OF ANATOMY HEAD, NECK AND BRAIN, Volume III, 2nd Edition Vishram Singh, Page No. 2

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Recommended concentration of fluoride in a community water supply is:

 # The recommended concentration of fluoride in a community water supply is:

A. 0.1 ppm

B. 0.5 ppm

C. 1 ppm

D. 2 ppm

The correct answer is C. 1 ppm.

A formula given by Galagan and Vermillion is used to decide the amount of fluoride that should be added to the drinking water and is as follows: 

Galagan and Vermillion formula: Amount of fluoride in ppm = 0.34/E

Where E = – 0.038+0.0062 × temperature in °F. 

Recommended= 0.7 to 1.2 ppm (0.7 ppm in tropical climate and 1.2 ppm in cold climate).

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Teeth least affected with the nursing bottle syndrome

 # Which teeth are least affected with the nursing bottle syndrome?

A. Maxillary molars

B. Maxillary and mandibular canines

C. Mandibular incisors

D. Maxillary incisors

The correct answer is C. Mandibular incisors.

EARLY CHILDHOOD CARIES

Early childhood caries was historically attributed to inappropriate and prolonged use of sweetened liquid in the bottle. Hence the older terms of “baby-bottle tooth decay” and “nursing caries. Early caries involvement of the maxillary anterior teeth, the maxillary and mandibular posterior teeth and mandibular canines is seen.

FEATURES:

• Mandibular incisors are unaffected due to the protection by the tongue.

• Seen as white or dark brown collar of caries around the neck o f the incisors, which develops into

faciolingual caries and may also fracture the tooth.

• The main etiology is that the child is put to bed with a nursing bottle containing milk or sugar containing beverages. The child falls asleep and the milk or sweetened liquid becomes pooled around the maxillary anterior teeth. This provides an excellent culture medium for acidogenic microorganisms.

Salivary flow is reduced during sleep and clearance of the liquid from the oral cavity is slowed.

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Maxillary second primary molar with a necrotic pulp

 # A healthy six year old child presents with carious maxillary second primary molar with a necrotic pulp. Which treatment would be preferred?

A. Extraction

B. Indirect pulp treatment

C. Pulpotomy

D. Pulpectomy

The correct answer is D. Pulpectomy.

PULPECTOMY: “Removal of the entire pulp and subsequent filling of the canals of the primary teeth with a suitable resorbable material.”

INDICATIONS

1. Primary teeth with pulp inflammation extending beyond the coronal pulp

2. Roots and alveolar bone with minimum pathologic resorption

3. Primary teeth with necrotic pulp and or periapical abscess

4. Pus at the clinical pulp exposure site.

CONTRAINDICATIONS

1. Grossly destroyed tooth that is nonrestorable clinically

2. Periradicular involvement extending to the permanent tooth bud, where the risk of damage to the permanent tooth is high.

3. Root resorption—internal or external

4. Extensive mobility

5. Gross bone loss at the apex or at the furcation.

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