SNA angle describes the relationship of the:

 # SNA angle describes the relationship of the:

A. Maxilla to the cranial base

B. Mandible to the cranial base

C. Maxilla to mandible

D. Maxilla to the upper incisors

The correct answer is A. Maxilla to the cranial base. 

SNA: the angle between the sella/nasion plane and the nasion/A plane (normal value at the end of growth 82 ± 2°). This angle assesses the antero-posterior position of the maxilla relative to the upper cranial structures.

Analysis of skull shape and size, supraorbital ridge, extension of zygomatic arch beyond external meatus, measurement of angle of mandible helps in:

 # Analysis of skull shape and size, supraorbital ridge, extension of zygomatic arch beyond external meatus, measurement of angle of mandible helps in:

A. Sex determination

B. Racial determination

C. Age determination

D. Ethnicity determination

The correct answer is A. Sex determination.

Skull and facial features like mastoid process, supraorbital ridges, size and architecture of skull can help in determining the sex of patient in 94% cases. 

Sex differentiation (Sexing) of a specimen: It can be done using methods as below: 

 Using craniofacial morphology: The following 6 traits give accurate results 94% times: 

- Mastoid process 

- Supraorbital ridge \

- Size and architecture of skull 

- Extension of the zygomatic arch beyond the external auditory canal 

- Nasal aperture and 

- Gonial angle (on the mandible) (Including more features increases accuracy by 2%) 

Prolonged retention is usually needed in:

 # Prolonged retention is usually needed in:

A. Diastema

B. Mild crowding

C. Anterior cross bite

D. Deep bite

The correct answer is A. Diastema.

Fixed (bonded) orthodontic retainers are normally used where intra-arch instability is anticipated and prolonged retention is planned. There are three major indications:

• Maintenance of lower incisor position during late growth

• Diastema maintenance

• Maintenance of posterior tooth position in adults

Reference: Proffit's Contemporary Orthodontics, 6th Edition.

Root shape before and after orthodontic treatment with radiographic evidence was first given by:

 # Root shape before and after orthodontic treatment with radiographic evidence was first given by:

A. Kaley and Phillip

B. Newman and Proffit

C. Ketcham AH

D. Malmgren and Lavendar

The correct answer is C. Ketcham AH.

Albert H. Ketcham was born on August 3, 1870, and grew up in Whiting, Vermont. He graduated from the Boston Dental School in 1892, then moved to Colorado due to ill health. Inspired by the challenges

of the young profession of orthodontics, he chose to enter the Angle School of Orthodontia in 1902. As a deep thinker with an inquiring mind, Ketcham explored many of the philosophical and mechanical

problems, as well as the controversies of the profession of his day. He was one of the first to investigate root resorption, which continues to be a challenge today. He began to question some of Angle’s arbitrary pronouncements, causing Angle to attack him vehemently as a deviationist. He was smart enough to travel his own way from that time on. He worked hard to improve the American Society of Orthodontists (ASO) and served as their president in 1929. He was also instrumental in founding the American Board of Orthodontists (ABO), serving as its first president. In recognizing his lifetime of service, the Albert H. Ketcham Memorial is made to the individual member annually in recognition

of contributions made to the art and science of orthodontics. This award was meant to perpetuate and inspire the member as a leader in orthodontics following the example set by Dr. Ketcham. 

He pioneered dental radiography and was the first US orthodontist to install an x-ray laboratory. He delivered the first paper on x-rays in orthodontics to the American Society of Orthodontists in 1910. In 1926 he presented the first comprehensive data on root resorption.46 Although the earliest mention of root resorption in permanent teeth goes back to 1856, it was a report by Ketcham in 1927 (followed by a second in 1929) that finally aroused the concern of orthodontists.

Reference: ORTHODONTICS Current Principles and Techniques, Lee W. Graber, 7th Edition.

Non caseating granuloma with bilateral Hilar lymphadenopathy is a feature of:

 # Non caseating granuloma with bilateral Hilar lymphadenopathy is a feature of:

A. Histoplasmosis

B. Sarcoidosis

C. Silicosis

D. Tannosis

The correct answer is B. Sarcoidosis.

Sarcoidosis is described as a multisystem granulomatous disease of unknown origin characterized by the formation of uniform, discrete, compact, non-caseating epithelioid granulomas. It is more common in blacks than in whites. Though many investigators have regarded this disease, of unknown etiology, both infective and noninfective agents have been implicated. Currently the infectious etiology is more favored with focus on Mycobacterium and Propionibacterium. It is interesting to note that there was a belief that sarcoidosis is in some way related to tuberculosis. The factors which stood against were inability to culture the bacteria from the pathological tissues and difficulty in identifying them in stained sections.

Reference: Shafer's Textbook of Oral Pathology 7th Edition.

Resistance of mini screw to dislodgement comes from contact with:

 # Resistance of mini screw to dislodgement comes from contact with:

A. Soft tissue

B. Teeth

C. Medullary bone

D. Cortical bone

The correct answer is D. Cortical bone.

The quality and quantity of the alveolar bone are considered important influential factors affecting the success rate of orthodontic mini-implants. The cortical bone thickness is considered a decisive factor in the overall success/failure of the mini-implant. It has been shown that an increase in the cortical bone thickness in the alveolar bone of maxilla and mandible significantly increases the primary stability of the mini-implant. A recent meta-analysis showed positive association between mini-implant stability and amount of cortical bone. 

Reference: Temporary Anchorage Devices in Orthodontics, SECOND EDITION, Ravindra Nanda, BDS, MDS, PhD

Understanding Gingival Stippling: What It Is and What It Signifies

Introduction

Gingival stippling is a term commonly used in dentistry to describe the texture or appearance of the gums. These stippled gums can tell dental professionals a lot about a person's oral health. While it might not be a topic of everyday conversation, understanding gingival stippling is crucial for both dental practitioners and patients. In this article, we will explore what gingival stippling is, its significance, and how it relates to oral health.

What is Gingival Stippling?

Gingival stippling refers to the small, dimpled, or pebbled texture that is often seen on the surface of healthy gums. This stippled appearance is caused by the presence of tiny, raised dots or projections on the gingival tissue, creating a finely textured, orange-peel-like appearance. Gingival stippling is most commonly found on the gums that surround the teeth in the upper and lower arches of the mouth.

Significance of Gingival Stippling:

Indication of Gingival Health:

Gingival stippling is primarily a sign of healthy gum tissue. When gums are stippled, it generally indicates that the underlying gingival tissue is firm, well-attached to the teeth, and free from inflammation or disease. Healthy gums play a crucial role in supporting the teeth and protecting them from harmful bacteria.

Assessment of Periodontal Health:

Dentists and dental hygienists use gingival stippling as one of the indicators to assess a patient's periodontal (gum) health. The absence of stippling, or a smooth, shiny appearance of the gums, may suggest an underlying issue like gum disease (periodontitis) or other oral health concerns.

Measurement of Gingival Recession:

Gingival stippling also helps in measuring gingival recession, which is when the gums start to pull away from the teeth. By comparing the stippled and non-stippled areas of the gums, dental professionals can determine the extent of gum recession, which is crucial for diagnosing and treating various oral conditions.

Aesthetic Considerations:

While the primary focus of gingival stippling is on gum health, it also has aesthetic implications. Well-stippled gums can contribute to an attractive smile by providing a uniform and textured appearance. Many people with naturally stippled gums are often perceived to have healthier-looking smiles.

Clinical Considerations:

In restorative and cosmetic dentistry, gingival stippling can influence treatment planning and the outcome of procedures like dental crowns, veneers, and dental implants. Dentists may need to replicate the stippled texture to create a natural-looking and harmonious smile.

Causes of Gingival Stippling:

Gingival stippling is primarily due to the arrangement and orientation of the connective tissue fibers beneath the gum tissue. These fibers create the characteristic raised dots on the gum surface. The presence of stippling can also be influenced by factors such as genetics, age, and overall gum health.

Conclusion:

Gingival stippling is a subtle but significant aspect of oral health and aesthetics. Understanding what it is and its significance can help individuals and dental professionals identify and address potential oral health issues in a timely manner. Regular dental check-ups and proper oral hygiene practices are key to maintaining gingival stippling and overall gum health. If you notice changes in the appearance of your gums, it's advisable to consult with a dentist to ensure the health and vitality of your oral tissues.

References:

1. Newman, M. G., Takei, H. H., & Klokkevold, P. R. (2015). Carranza's Clinical Periodontology (12th ed.). Elsevier.

2. Darby, M. L., & Walsh, M. M. (2014). Dental Hygiene Theory and Practice (4th ed.). Saunders.

3. Lang, N. P., & Bartold, P. M. (2018). Periodontal health. Journal of Clinical Periodontology, 45(Suppl 20), S9-S16. doi:10.1111/jcpe.12938.