PGCEE MDS 2022: Papules, vesicles and macules all are seen in:

 # Papules, vesicles and macules all are seen in:

a) Measles 

b) Herpangina

c) Rubella 

d) Hand foot and mouth disease

The correct answer is D. Hand foot and mouth disease. 

Individuals with HFMD present with oral pain, often with accompanying fever and flu‐like symptoms (e.g., malaise, myalgia). As with herpangina, prodrome is usually absent. The oral ulcers resemble herpangina ulcers, but are more numerous. The location of the oral ulcers in HFMD also differs

from herpangina and they are located anterior to the faucial pillars, most commonly on the tongue, labial, and buccal mucosa. The hand lesions are located on the dorsum of the fingers, interdigital spaces, and palms. The foot lesions are typically on the dorsum of the toes, sole, heel, and lateral borders of the foot. In infants, toddlers, and preschool children, lesions may occur on the buttocks. The skin lesions may be macular, maculopapular, or vesicular. The skin vesicles contain a clear or turbid fluid surrounded by a halo of erythema. HFMD caused by enterovirus A71 and a novel coxsackievirus

A6 genotype are associated with more severe disease patterns (Enterovirus 71: CNS disease, heart failure; Coxsackievirus A6: wider distribution, longer duration).

Ref: Burket.

PGCEE MDS 2022: The host modulation therapy that may be used as adjunctive therapy for aggressive periodontitis is

 # The host modulation therapy that may be used as adjunctive therapy for aggressive periodontitis is:

a) Clindamycin

b) Metronidazole

c) Doxycycline

d) Ciprofloxacin

The correct answer is C. Doxycycline.

Host Modulatory Therapy (HMT) is a treatment concept that aims to reduce tissue destruction and stabilize or even regenerate the periodontium. Doxycycline hyclate is available as a 20mg capsule for use by patients twice daily. The mechanism of action is by suppression of the activity of collagenase, particularly that produced by PMNs. NSAIDs inhibit the formation of prostaglandins, including prostaglandin (PGE2). PGE2 is found to upregulate bone resorption by osteoclasts. Flurbiprofen, an NSAID, significantly inhibits radiographic alveolar bone loss compared to a placebo. A recent study suggested that concomitant administration of doxycycline and flurbiprofen may result in

enhancement of the anti collagenase effects of doxycycline. 

Subantimicrobial-dose doxycycline (SDD) may help to prevent the destruction of the periodontal attachment by controlling the activation of matrix metalloproteinases, primarily collagenase and gelatinase, from both infiltrating cells and resident cells of the periodontium, primarily the neutrophils.

PGCEE MDS 2022: Preventive and therapeutic measures for dealing with the periodontal problems during fixed appliance therapy

 # Which of the following are typical and acceptable preventive and therapeutic measures for dealing with the periodontal problems during fixed appliance therapy?

a) Elimination of gingivitis prior to placing orthodontic appliances

b) Home care instruction regarding the use of the toothbrush and water pik during orthodontic treatment

c) Megavitamin therapy

d) Scaling and curettage immediately after appliance removal

The correct answer is A. Elimination of gingivitis prior to placing orthodontic appliances

Maintaining oral hygiene becomes more challenging once the fixed orthodontic brackets are placed. Pre-existing gingivitis should be treated and eliminated before placing the brackets. 

PGCEE MDS 2022: The common site for necrotizing sialometaplasia:

 # The common site for necrotizing sialometaplasia:

a) cheeks 

b) dorsum of tongue

c) palate 

d) gingival

The correct answer is C. Palate.

Necrotising sialometaplasia is a benign, inflammatory reaction of salivary gland that mimics a salivary gland malignancy. Etiology is mostly due to local ischemia. Most common intraoral site is palate followed by buccal mucosa and the type of necrosis is coagulative necrosis. Similar type of lesions in skin are called as syringometaplasia. 

PGCEE MDS 2022: The preferred gingival finish line for veneer is:

 # The preferred gingival finish line for veneer is:

a) Shoulder 

b) Chamfer

c) Shoulder with bevel 

d) Radial shoulder

The correct answer is B. Chamfer.

The preferred gingival finish line for veneer metal restorations is the chamfer. This finish line has been

shown experimentally to exhibit the least stress, so the cement underlying it will have less likelihood of failure. It can be cut with the tip of a round-end diamond while the axial reduction is being done with the side of that instrument.

PGCEE MDS 2022: Vasoconstrictor in local anesthetic (LA) solution:

 # Vasoconstrictor in local anesthetic (LA) solution:

a) Reduces toxic effects of LA solution. 

b) Decreases depth & duration of LA. 

c) Increases bleeding. 

d) Has no effect on efficacy of LA solution.

The correct answer is A. Reduces toxic effects of LA solution.

Vasoconstrictors are drugs that constrict blood vessels and thereby control tissue perfusion. They are added to local anesthetic solutions to oppose the inherent vasodilatory actions of the local anesthetics. Vasoconstrictors are important additions to a local anesthetic solution for the following

reasons:

1. By constricting blood vessels, vasoconstrictors decrease blood flow (perfusion) to the site of drug administration.

2. Absorption of the local anesthetic into the cardiovascular system is slowed, resulting in lower

anesthetic blood levels.

3. Local anesthetic blood levels are lowered, thereby decreasing the risk of local anesthetic toxicity.

4. More local anesthetic enters into the nerve, where it remains for longer periods, thereby increasing (in some cases significantly, in others minimally) the duration of action of most local anesthetics.

5. Vasoconstrictors decrease bleeding at the site of administration; therefore they are useful when increased bleeding is anticipated (e.g., during a surgical procedure).

PGCEE MDS 2022: In winter's WAR line, Amber line represents the:

 # In winter's WAR line, Amber line represents the:

a) Relative depth of the III molar

b) Point of application of the elevator

c) Bone level covering the impacted tooth

d) Axial inclination of the impacted tooth relative to Second molar

The correct answer is C. Bone level covering the impacted tooth.

Winter's lines include 3 imaginary lines that are drawn on the radiographs.

• White line

• Amber line

• Red line

White Line: It is drawn touching the occlusal surfaces of 1st and 2nd molars and is extended posteriorly over the 3rd molar region. It indicates the difference in occlusal level of 2nd and 3rd molars.

Amber Line: It is drawn from the crest of interdental bone between 1st and 2nd molars and extends posteriorly distal to 3rd molar or to the ascending ramus. It indicates the amount of alveolar bone covering the impacted tooth and the portion of tooth that is not covered by the bone.

Red line: It is drawn perpendicular from the amber line to an imaginary point of application of elevator.

It indicates the depth of the tooth in the bone and the difficulty encountered in removing of the tooth.