{churchill Livingstone + MCQs in IDIIN HES HAs R.A.Cawson CMScullyMCQs In Dentistry R. A. Cawson MD FDS RCPS FACPath Professor, Consultant, and Head of Department of (ral Medicine and Pathology, Guy's Hospital Medical and Dental Schools: Visiting Professor, Baylor Dental College and University Medical Center, Dallas, Texas C. M. Scully ‘mB 85 FO Pn MRCPath Professor, Consultant and Head of Deparment of Gr Medina and Oral Surgery, Bisel Dota ovott and Schoo! with contributions from Churchill Livingstone EDINBURGH LONDON MELEOURNE AND NEW YORK 1985,Contents 1 Prosthetics {including materials) 1 2 Restorative dentistry 23 3 Orthodontics and children’s dentistry 55 4 Periodontology 103 5 Radiology ng 6 Oral pathology (including microbiology and immunology) 127 7 Oral medicine and the medically-compromised patient 167 8 Therapeutics 189 9 Minor and major oral surgery including traumatology 205Prosthetics (including materials) Epidemiology. In a 1978 Adult Dental Health Survey it was, found that A over 45% of the adult population of England and Wales were edentulous B a significantly higher proportion of men than women were ‘edentulous © the proportion of adults wearing partial dentures was increasing D more adults wear upper partial dentures than lowers In which one of these situations following extraction is alveolar ridge resorption least? ‘Anterior edentulous mandible with denture B Anterior edentulous maxilla with denture © Anterior mandible with 3/3 retained to support an overdenture D Anterior edentulous maxilla with denture opposed toa lower complete overdenture Following extraction of all teeth A half of the total change in alveolar ridge form will be complete after 1 month B in the mandible a greater loss of ridge height occurs in the incisor region than in the molar region © the zone of attached gingiva is lost the centre of the incisive papillae remains between 8 10mm behind the original position of upper central incisal edges During the setting of alginate impression materials A trisodium phosphate reacts preferentially with calcium sulphate B trisodium phosphate reacts preferentially with sodium alginate © the colloidal gel state changes to a sol D the material in contact with the sof tissues sets last (Answers overleaf)2 MCOs in Dentistry Answers 11 A False False False Twe 12 False A 8 c o A 8 c D 13 A 8 c D A 8 c 5 29% of the adult population of England and Wales were edentulous 32% of females over the age of 16 were edentulous ‘compared to 24% males in 1978 20% of the population had partial dentures compared to 22% in 1968 resorption is greatest in A followed by D, then B and least in C approximately one-third of the total change in ridge contour will be complete after the first month the zone often remains as a band of keratinised epithelium on the alveolar ridge see A the sol state changes to a gel the material in contact with the soft tissues is at a higher temperature and sets first 18 7 19 1.10 Prosthetics 3 ‘An alginate impression A should be rapidly displaced from the mouth B_may exhibit fluid exudate on the surface as a result of imbibition € will take up water and expand if kept wet D will shrink as a result of syneresis, Alginate impression materials A are hydrophilic B are mucostatic in comparison to zinc oxide/eugenol paste are more dimensionally accurate than reversible hydrocolloids D can be sterilised in formaldehyde when set Reversible hydrocolloid impression mi following propertic A Contain potassium sulphate to promote the setting of dental stone. B The material in contact with the soft tissues sets first © Hysteresis. D They can be reused after use in the mouth ils have the Impression plaster (plaster of Paris) Avis calcined calcium sulphate hemihydrate prepared by heating the dindyrate under steam pressure B produces less mucosal displacement than alginate © contains borax to control the setting expansion B should be cast up on removal from the mouth without any further treatment. ‘The setting of plaster of Paris is accelerated by A the addition of potassium sulphate B mixing with hot water © rapid vigorous mixing D increasing the ratio of water to powder Zine oxide/eugenol impression paste ‘A cannot be used to record undercut areas B is a thermoplastic impression material © has a setting time, the rate of which decreases ae humility increases D is both an irritant and an allergen (Answers overleaf)4 MCOsin Dentistry Prosthetics 5 15 A True B False imbibition is the uptake of water. Fluid exudate js a result of syneresis, C Tue True © True 16 A True B True C False seversibie hydrocolloids exhibit a high Jevel of dimensional accutacy and may be used for crown and bridge impressions D False they undergo surface deterioration and dimensional changes, 17 A True B False C True D False the materiat cannot be satistactorily sterilised 1.8 A False heating the dihydrate under steam pressure at 120-130°C produces dental stone which is chemically identical to plaster of Paris but has different physical properties 8 True C False borax is added ta retard the rate of setting BD 2 separating agent such as alginate mould seal is required to prevent bonding with the modet material 19 A Tue B False setting is gradually retarded as the temperature increases above S0°C until itis completely inhibited by water close to boiling point c True D False increasing the proportion of water decreases the ‘number of nuclei of crystallisation per unit volume. resulting in a longer setting time 1.10 A True B False it is not used as a thermoplastic impression material but may be heat-softened to aid removal, from the cast € False the opposite is true wn a2 113 144 115 116 17 A separating agent is used when flasking and packing acryfic resin dentures A 80 that investing plaster in one half of the flask will not adhere to that in the other half & {0 prevent water from the investing plaster affecting polymerisation of the resin © to minimise the thickness of the flash D to prevent monomer from soaking into the investing plaster The follawing materials are effective as plaster separating agents ‘A A solution of potassium alginate B Tin © Liquid paraffin D Soap solution ‘The lingual extension of a lower denture is limited by A the sublingual salivary gland B the modiolus © the mylohyoid muscle D the arigin of the genioglossus muscle Occlusal rims for complete dentures provide the following information when trimmed A centtic jaw relationship B dimension of the freeway space © overfet oF horizontal incigar overtan D orientation of the occlusal plane ‘The resting face height A Is equal to the occluding face height together with the interocclusal clearance B remains constant through life iis increased when @ lower denture is placed in the mouth D jis decreased when the head is tilted back The ala-tragal line is A the line running from the tragus of the nose to the ala of the ear 8 paraliet to the Frankfort plane © a guide to the occluding face height in complete dentures D a guide to the orientation of the occlusal plane in complete dentures. A face bow records the following information ‘A. The relationship of the upper jaw to the hinge axis of the condyle B The sagittal condyle angie © The orientation of the occlusal plane to the axis-orbital and Frankfort planes D The relationship of the upper and lower jaws to each other6 MCQsin Dentistry Prosthetics 7 un 116 True True False True True True True True True False True True True False True True => 90@> On w> DOB> Oo OOD True False 90 A False False True True False True False ooa> 9 0 @ excess acrylic dough or flash must be removed after a trial closure of the flask the modiolus is a decussation of muscles fibres at the comer of the mouth longitudinal studies have shown that it may increase with age in dentate subjects and decrease in the edentulous the line runs from the inferior border of the ala of the nose to the tragus of the ear. The point on the tragus may be taken as the superior border or more commonly the mid-point of the tragus the line forms an angle of approximately 8° with the Frankfort plane the vertical dimension is independent of the ala- tragal line this must be done using a protrusive record this must be done using an occlusal record 1.18 The Bennett angle A is the angle between the sagittal condylar path and the Frankfort plane B is the angle which the path of the balancing side condyle makes with the sagittal plane during lateral excursion is measured using a face bow D hes an average value of 150 steral balanced occlusion is dental articulation which is unobstructed by cuspal interference B is simultaneous contact of the occluding surfaces of the teeth of both sides of the mouth in the retruded jaw relationship € is simultaneous contact of the occluding surfaces of the teeth of both sides of the mouth in various jaw positions D results in Christensen's phenomenon 1.20 When setting up teeth for complete dentures having bilateral balanced occlusion, separation of the posterior teeth during protrusion can be reduced by A increasing the antero-posterior occlusal curve B using teeth with a shallow cusp angle ¢ increasing the angle of orientation of the occlusal plane D increasing the incisal guidance angle 1.21. Which of the following features of the masticatory system are stated by Hanau to determine the articulation of the teeth? A condyle guidance B incisal guidance € interocclusal clearance or freeway space D irclination or orientation of the occlusal plane 1.22 Porcelain denture teeth A have @ higher coefficient of thermal expansion than acrylic teeth B have a lower abrasion resistance than enamel © should be used where inter-alveolar clearance is small D have a higher abrasion resistance than gold 1.23. The stability of a mandibular complete denture will be enhanced when A the level of the occlusal plane is above the dorsum of the tongue B the tongue rests on the occlusal surface the lingual contour of the denture is concave D the posterior teeth on the denture have a broad buco: Tingual width (Answers overleaf)8 MCQsin Dentistry Prosthetics 9 1.18 A False this is the sagittal condyle angle 5 True € False the Bennett angle is estimated from a protrusive ‘occlusal record or set from lateral records D True 119 A this is a definition of free articulation 8 balanced occlusion refers to various jaw positions c ‘of which the retruded position is only ane D Christensen’s phenomenon is the development of @ wedge-shaped gap between the posterior ends of ‘opposing occlusal rims during mandibular protrusion 1.20 A True B False teeth with a steeper cusp angle could be used or the effective cusp angle increased by tilting the teeth © True D False this would result in greater separation 1.21 A True 8 True C False the interocclusal clearance cannot influence articulation since the teeth are apart when the ‘mandible is in the rest position True Hanau's five determinants also include the curvature of the occlusal surfaces (compensating curves) and the cusp height and inclination ° 1.22 A False the coefficient of thermal expansion of porcelait ‘much lower (7 x 10°* per °C) than that of acrylic resin (81 x 10° per °C). This differential causes stress in the denture base 8 False the abrasion resistance of dental porcelain is very high and when used for jacket crowns the porcelain may show less wear than adjacent natural teeth € False acrylic teeth which have a chemical bond to the denture base should be used as they can be ground to fit the limited space D True 1.23 A False restriction of the tongue space both vertically and laterally reduces stability 8 True € False the tongue tends to engage the concavity causing displacement D False see A 1.24 Methyl methacrylate A has a boiling point below that of water B has a boiling point above that of water © does not react with fully polymerized acrylic resin, D has the chemical formula i — CH, — a CH; — c I Och, 1.25 The polymer/monomer ratio for heat-cured acrylic A is about 1 to 35 by volume B is about 35 to 1 by volume © if too low will result in excessives shrinkage D if too high will result in granularity of the acrylic 1.26 The liquid (monomer) component of heat cured acrylic resin has the following components ‘A Hydroquinone B Methyl methacrylate © Dimethyl-p-toluidine D Ethylene glycol dimethacrylate 1.27 Self polymer ‘that they A have a higher molecular weight B have a higher residual monomer content © are more porous D have a greater transverse strength 19 acrylic resins differ from heat-cured resins in 1.28 The advantages of cold-cured resins over heat-cured resins for the repair of acrylic dentures are A better colour stability B shorter processing time © warpage of the denture is less likely D repair of the denture can safely be carried out in the mouth 1.29 Porosity in an acrylic denture ‘A may result from failure to apply adequate pressure to the flask during processing B may result from a short curing cycle with rapid temperature build up © contraction porosity is found mainly in thicker sections of D the denture {gaseous porosity appears as small buboles evenly distributed throughout the denture (Answers overleaf)10 1.24 125 1.28 127 1.28 1.29 MCOs in Dentistry oom> > 9 a@> On@> one > vow» False True False Fal False True True False True True False the boiling point of the monomer is 19° monomer acrylic resin razos on contact with mer hes the this is the polymeric form. The mo! formula CH I CH. = ¢ I =0 | OCH, see B din self-cure dimethyl-p-toluidine is an activator U5" |” selt-cure resins the motecular weight of cold-cured ™#ter=ls lower the strength of cold-cured resins is #°0U" 69% of that of heat-cured sor tends to the tertiary amine used as an activatet ‘oxidise resulting in poor colour sta?! .g pecause of the se in the mouth is contraindicate: Vf free monomer possibility of mucosal irritation fro and heat of polymerisation sey ctu contraction porosity (as in A) is di ‘gaseous porosity (as in B) is seen sections where the polymerisation greatest and monomer volatizes Prosthetics 11 1.30 The residual monomer level in denture bases A is about 3% in correctly polymerised heat cured resin B jis about 0.3% in correctly polymerised heat cured resin © is likely to be high if a short curing cycle is employed D iis higher in thick sections of acrylic than in thin sections 1.31 The bonding of denture teeth to denture base materials A is stronger with heat-cured base materials than cold-cured materials, B is chemical when the teeth are constructed of cross-linked acrylic € is entirely mechanical in porcelain teeth D is weaker for lateral incisors than for canines 1.32 An anterior open oxsusion (open bit) in complete dentures may result from A the posterior of the lower occlusal rim lifting away from the mucosa during the recording of the jaw relationship B the anterior of the lower occlusal rim lifting away from the mucosa during the recording of the jaw relationship © the use of anterior teeth of too short a length D interferences between the heels of the opposing casts as they are mounted on the articulator 1.33. The (occluding) vertical dimension of acrylic complete dentures may increase during processing as a result of ‘A a high ratio of monomer to polymer B the resin being packed at the advanced dough stage © an incorrect powder to water ratio in the investing plaster D failure to coat the investing plaster with a separating agent 1.34 Split cast remounting on an articulator is carried out A to correct acolusal errors arising during the processing of dentures to verify the occlusal records for study casts when the record of the jaw relationship is found to be incorrect, in conjunetion with a pre-centric check record 1.35. The stability of complete dentures is ‘the ability to resist horizontal and rotational displacing forces the ability to resist vertical dislodging forces dependant upon an effective postdam in maxillary dentures increased in mandibular dentures by raising the level of the occlusal plane vom >4 0 of (Answers overleaf)10 MCQs in Dentistry 1.24 A False 1.26 127 128 1.29 8 c 5 > 0 A@> omer one False True Tru False True True False the boiling point of the monomer is 100.3° acrylic resin crazes on contact with monomer this is the polymeric form. The monomer has the formula CH, see B dimethyl-ptoluidine is an activator used in self-cure resins the molecular weight of cald-cured materials is lower the strength of cold-cured resins is about 80% of, that of heat-cured the tertiary amine used as an activator tends to oxidise resulting in poor colour stability se in the mouth is contraindicated because of the possibility of mucosal iritation from free monomer and heat of polymerisation contraction porosity (as in A) is diffusely distributed ‘gaseous porosity (as in B) is seen in the thicker sections where the polymerisation exotherm is greatest and monomer volatizes 1.30 131 132 1.33 1.34 1.35 Prosthetics 11 ‘The residual monomer level in denture bases Ais about 3% in correctly polymerised heat cured resin B is about 0.3% in correctly polymerised heat cured resin € is likely to be high if a short curing cycle is employed iis higher in thick sections of acrylic than in thin sections. ‘The bonding of dent is stronger with hee ‘materials B iis chemical when the teeth are constructed of cross-linked acrylic C iis entirely mechanical in porcelain teeth is weaker for lateral incisors than for canines ‘teeth to denture base materials ‘cured base materials than cold-cured ‘An anterior open occlusion (open bite) in complete dentures may result from A the posterior of the lower occlusal rim lifting away from the mucosa during the recording of the jaw relationship B the anterior of the lower occlusal rim lifting away from the mucosa during the recording of the jaw relationship © the use of anterior teeth of too short a length D interferences between the heels of the opposing casts as, they are mounted on the articulator ‘The (occluding) vertical dimension of acrylic complete dentures may increase during processing as a result of A a high ratio of monomer to polymer B the resin being packed at the advanced dough stage © an incorrect powder to water ratio in the investing plaster D failure to coat the investing plaster with a separating agent, Split cast remounting on an articulator is carried out A to correct occlusal errors arising during the processing of dentures B to verify the occlusal records for study casts © when the record of the jaw relationship is found to be incorrect D in conjunction with a pre-centric check record The sta ¥y of complete dentures is A the ability to resist horizontal and rotational displacing forces. B the ability to resist vertical dislodging forces © dependant upon an effective postdam in maxillary dentures D increased in mandibular dentures by raising the level of the ccclusal plane (Answers overleaf)12 MCQs in Dentistry 1.30 131 1.32 1.33 1.34 A one com> 0 Aer vom com> True True True True False True False True False True True see B the opposite is true since the exotherm is greater in thicker sections resulting in more complete polymerisation this results in @ posterior open bite the length of the teeth does not affect the dimension of the overbite this would result in contraction separating agents are used to prevent water entering the acrylic which would result in crazing, and also to prevent monomer from entering the plaster, which would result in a rough denture surface the split cast technique uses the original plaster ‘mounting bases on the articulator to verify and reproduce the jaw record. Errors in the jaw record may be corrected using a pre-centric record and. new plaster mounts, this is 9 definition of retention the postdam aids retention rather than stability lowering the level of the occlusal plane should Increase stability Prosthetics 13, 1.36 Pain with diffuse distribution under a mandibular complete denture is most likely to be caused by A overextension of the denture flange B occlusal plane too high © occluding face height too great D mental foramen near crest of ridge 1.37 Overdentures have the following advantages over conventional complete dentures ‘A Proprioception via the periodontal membrane facilitates denture contro! B The minimum threshold at which loading on the denture can be detected is higher © They are stronger and less liable to fracture D The rate of alveolar bone resorption is reduced 1.38 Tissue conditioning materials A should remain plastic B should exhibit elastic recovery © can be cleaned by immersion in alkaline peroxide denture cleansers D can be cleaned by immersion in 0.2% aqueous chiothexidine 1.39 Silicone re advantages over plasticised acrylic materials ‘A A higher tond strength to the acrylic denture base B They are more resilient © They remain resilient longer D They do not support the growth of Candida albicans the following 1.40 Denture stomatiti A is usually associated with a sore mouth B iis usually associated with wearing a denture at night © is more common in diabetics D is more common in men than women 1.41 Candida albicans A has a similar quantitative prevalence in dentate subjects to that in denture wearing subjects B can be isolated more frequently from the tongue than the palate in non-denture wearers € is inhibited by polyene antibiotics D is dimorphic and can exist in two forms, one a budding ‘yeast, the other a filamentous hyphal form (answers overleaf}MCQs in Dentistry Prosthetics 15 1.36 A False False True False 137 A True False @> 00 w> ° False 1.38 A False True False True 1.39 A False True True False oom » 9 om > oO 1.40 A False True True False oom > 1.41 A False True True True vee may result in localised areas of discomfort is more likely to result in a complaint of looseness unless combined with C may result in localised areas of discomfort studies have shown that the anterior natural teeth, ‘can detect loads as iow as | gram, whereas the minimum for complete denture wearers is in the region of 125 grams overdentures are relatively thinner over the supporting teeth and this results in areas of stress ‘concentration tissue conditioners must not undergo substantial Permanent deformation this cleanser results in porosity of the tissue conditioner the bond strength of silicone to acrylic is weak so @ ‘cross linking adhesive agent must be used both types of materials are slightly porous and thus have a tendency to encourage the growth of Candida albicans although some materials may have an inhibitory effect, ‘most patients are unware of the condition. The term ‘denture sore mouth’ is a misnomer most surveys indicate a ratio of females to males of about 2:1 it has been shown that there is # greater density of candidal colonisation in denture wearers compared with dentate subjects 142 143 144 145 1.46 147 Midsline fracture of a maxillary complete denture A is usually a result of a impact fracture B_most commonly follows after about 3 years in use is usually a result of fatigue fracture D can be prevented by incorporating a metal mesh strengthener within the acrylic Plaque and partial dentures A wearing a denture at night protects the teeth against plaque ‘accumulation B the introduction of a partial denture into a enouth will induce qualitative as well as quantitative changes in plaque plaque accumulation on lower teeth is the same with a lingual bar connector as itis with a lingual piate design D gingival relief areas on partial dentures result in gingival enlargement Support foro partial denture is A the ability to withstand vertical occlusal loading a function of clasp arms the ability (0 resist displacement away from the supporting tissues a function of occlusal rests ow> free end saddle partial denture will exert less load on the supporting mucosa if the extension of the base is reduced wil be most effectively retained when the clasps engage Undercut nearest the saddle will usually have a path of insertion produced by tilting the anterior part of the cast upwards on the surveyor table will have support more evenly distributed between teeth land soft tssues if a mucostatic impression technique is employed cae po ‘The magnitude of the load transmitted by a free end saddle partial denture to the abutment teeth may be reduced by A using teeth having a narrow bucco-lingual dimension B using a mucocompressive impression technique © using a mucostatic impression technique D leaving a tooth off the saddle The indirect retainer of a partial denture A should resist rotatory forces about a fulcrum B engages undercut areas © is most effective when remote from direct retainers D must be constructed in a metal alloy (Answers overleaf)16 McOs in Dentistry 1.42 143 148 1.45 1.46 a7 A False impact fracture (for example in accidental dropping) is less commmon than crack propagation due to fatigue developing when the denture is in the ‘mouth 8 True C True D False metal inclusions within acrylic may result in areas of stress concentration and predispose to fracture ‘A False night time wear results in increased plaque ‘accumulation B True C False lingual plates are associated with higher plaque indices than lingual bar dentures D True A B clasp arms provide retention c this is a definition of retention D ‘A False the load per unit area will be increased B True C False the anterior part of the cast will invariably be tilted down in order that the undercut distal to the abutment teeth may be employed D False A 8 c the loading is shared most evenly between the teeth and the mucosa when some degree of compression of the soft tissues is exerted by the impression material D True A True 8 this is a function of direct retainers C True D False 1.48 152 153 Lingual bars ‘A may be used where the distance betweon thn inlamit the mouth and the gingival margin is minimal B are associated with less plaque accumulation than « lingual plate © should be increased in thickness when long D may be used to provide indirect retention Cast cobslt chromium alloys A contain about 30% cobalt and 60% chromium B contain about 60% cobalt and 30% chromium contain molybdenum to increase the grain size D have a melting point of 1250° to 1450°C. Cast cobalt chromium alloys A have a modulus of elasticity twice that of gold alloys B are more rigid than gold elloys © have a higher ductility than gold alloys D have a lower proportional limit than gold alloys, Gypsum-bonded investment ms shrinkage in the following ways A Setting expansion B Loss of water of crystallisation during heating © Hygroscopic expansion D Thermal expansion ials compensate for casting Clasp arms cast in cobalt chromium A should be positioned to engage 0.25 mm (0.01 in) of horizontal undercut B should be positioned to engage 0.5 mm (0.02 in) of horizontal undercut © may engage deeper horizontal undercuts than gold clasps of, similar proportions without permanent deformation D exert less loading on the abutment tooth during insertion ‘and removal than a cast gold clasp of similar proportions The following may incr to displace a clasp A Increasing the length of the clasp arm B Using an alloy with a higher modulus of elasticity © Employing a clasp arm which is gingivaly rather than occlusally approaching D Increasing the thickness of section of the clasp arm @ the magnitude of a force required (Answers overleaf)18 MCQs in Dentistry 2 lingual plate connector should be used in this ‘molybdenum is included to reduce grain size the opposite is true 8 c D A B c 3 a 8 c 3D A 8 heating calcium sulphate hemihydrate resul loss of water of crystallisation which, if taken in isolation, results in shrinkage gold has a lower modulus of elasticity and thus May be used to engage deeper undercuts since cobalt chrome is the stiffer of the two materials it will exert the greater load 9 a@> oo this will usually result in a more flexible, hence less retentive, clasp com > ‘The following are characteristic features of the ‘Every’ partial denture ‘A Point contact between adjacent natural and artificial B Tooth support rather than mucosal support Wide embrasures between adjacent natural and artticial teeth D Primarily applicable to mandibular denture design A partial denture which fits the master cast may fail to soat correctly in the mouth due to A insufficient expansion of the investment material B distortion of the impression © contraction of the metal framework during casting D failure to block out unwanted undercuts Attrition is A the loss by wear of tooth substance resulting from tooth brushing B the loss by wear of tooth substance resulting from ‘mastication and bruxism © the dissolution of enamel after gastric regurgitation D iis usually accompanied by periodontal breakdown Angular stomatitis A is usually caused by faulty vertical dimension of dentures B can be a concommitant of any oral candidal infection € is seen mainly in adults D may be associated with Staphylococcus aureus E may be a sign of anaemia ‘Temporomandibular joint dysfunction is more commonly seen in ‘A women than men B patients with other chronic minor illnesses © association with radiographically detectable change D patients over 45 years of age Temporomandibular joint dysfunction may (it precipitated by A mandibular overciosure in full denture wearers B bruxism intraoral osculation D prolonged dental treatment is thought) be (Answers overleaf)MCQs in Dentistry w True False True False 1.55 A False True False False 1.56 A False True False False com> cam > oo a> 187 A False True True True True moow> 1.58 A True True False ° o@> False 1.59 A True True True True com> the ‘Every’ design is for a mucosa-borne upper partial denture see B in each case the denture would not fit the master cast see A see A this is abrasion this is erosion attrition is frequently associated with low plaque levels and healthy periodontal tissues this only increases folds at the angles patients rarely have radiographically detectable lesions ‘most studies suggest a peak incidence of 20 to 30, years 1.60 Which of the following statements are/is true? ‘A The mental foramen may become more superficial d resorption of the alveolus but never lies on the alved) crest, B The mandible unlike other bones is spared the effects of osteoporosis © In the mandible the maximal rate of resorption in within 1 year of extraction D Alveoloplasty increases postoperative bone loss ‘Answers overleaf)22 MCOs in Dentistry 1.60 A False B False C True D False this is a common painful complaint 2 Restorative dentistry A. Intracoronal restorations 2.1 The main object of cavity preparation is A to decrease plaque formation B to increase masticatory efficiency © to prevent caries D tc prevent periodontal disease 2.2 Which permanent teeth are most susceptible to dental ca A Lower first molars B Upper incisors © Upper third molars D Upper premolars 23. The floor of the occlusal portion of a Class Il cavity for amalgam should be A in enamel B at least 2 mm into dentine © extended to the enamel-dentine junction extended just beyond the enamel-dentine junction 24 Retention in a Class V amaigam cavity is obtained A by grooves mesially and distally B by undercutting all the walls © by undercutting the occlusal and gingival walls D by sharp internal line angles 25 /, what shape is the axial wall of a Class V cavity in a 'as seen in transverse section? A Straight B Convex © Kidney shaped D Concave (Answers overleaf)24 MCQs in Dentistry Answers A, Intracoronal restorations 2.1 A False The object of cavity preparation is the treatment of 8 False caries C False D False 22 8 8 c 5 23 8 ‘The enamel ~ dentine junction must be completely B ‘exposed to ensure the cavity is caries free and the c restoration should be based on dentine. 2mm into D dentine would be excessively deep 24 A Undercuts or grooves in the mesial and distal walls 8 will undermine enamel and sharp internal line c angles form points of stress concentration, 5 weakening the tooth 25 A False The axial wall should follow the external surface B True contour to avoid exposing the pulp © False D False Restorative dentistry 25 2.6 The cavo-surface line angle for an amalgam restoration may be A 90° B10 ¢ a5° D 135° 2.7 Pulpal trauma during cavity cutting can be reduced by A water spray B intermittent pressure on the bur € using a cross cut as opposed to a plain cut bur D using anew bur 2.8 A Black's Class I cavity may originate A in occlusal fissures B on lingual fissures € in cingulum pits of anterior teeth D on labial surfaces 29 Unsupported enamel should be A reduced in height B protected by the restoration € finished at 90° to the tooth surface D removed Restoring @ mesio-occlusal cavity in an upper premolar is A the canine fossa B the small palatal cusp © avsthetics D the large mesio-buccal pulp horn 2.11 The proximal portion of a minimal Class i! amalgam cavity A should always be extended into the gingival crevice B should always be extended to just below the contact area € should not have sharp external point angles, D should extend at least 2 mm into dentine 2.12 A matrix band used in packing a Class ll amalgam restoration should A be higher than the occlusal surface of the tooth, to allow ‘overpacking of the amalgam B support the marginal ridge of the restoration during packing © fitthe cervical margin of the box tightly D provide a physiological contour for the proximal surface of the restoration (Answers overleaf)26 MCQs in Dentistry 26 27 28 29 2.10 an 2a2 [o@> vowr GOB> CAe> VOB> COw> Goer True True False False True True True True ‘Amalgam has roughly similar edge strength to enamel; a 45° cavo-surface angle would weaken the enamel and a 135° angle would leave a thin section ‘of amalgam exposed to stress A and B reduce the heat b more efficiently up and C and D cut Black's original definition of Class | cavities was those carious lesions arising in the pits and fissures of the teeth Unsupported enamel is, by definition, weak B and D are complete red herrings The cavity must clear the potentially carious area of the contact completely and sharp angles weaken the tooth by causing stress concentrations All are essential features of a matrix band Restorative dentistry 27 214 215 216 2a7 218 speed rotary instruments should not be used A without a water spray B without a local anaesthetic 40 remove soft caries to remove unsupported enamel ¢ D A Black's Class IV cavity is A acarious lesion on the proximal surface of an incisor or canine extending as far as the incisal edge B a cavity affecting only the incisal edge of an anterior tooth © a large Class Ill cavity D a cavity in the proximal surface of an incisor or canine Which includes the incisal angle ‘A Class il amalgam restoration, after carving, should ‘A reproduce the sluiceways in the region of the marginal ridge B be just out of occlusion with the opposing tooth € have its marginal ridge at the same level as that of the adjacent tooth D reproduce the anatomical form of the tooth as nearly as possibie When amalgam is used for the restoration of @ cusp A it should be supported by a pin B iit should be at least 2mm thick © the original cusp should be reduced to the level of the proximal box D it should be carved so that itis free of the occlusion The minimal Class Ill cavity for a composite restoration ‘A should be roughly trianguier in outline B should extend subgingivally © should remove the proximal contact D has its direction of access determined by the position of the adjacent tooth Leakage of sal may be due to A holes which are too small B holes which are too close together € irregularities of the enamel surface at the dam margin D holes which are too far apart und teeth isolated with a rubber dam ‘What is the optimum depth for a pin hole in a tooth with a vital pulp? A 45mm B 23mm © Less than 2mm D1-1.5mm (answers overleaf)28 243 214 215 2.16 247 2.18 219 MCQs in Dentistry True Ulta-speed instruments cut hard tissue very False efficiently, but not soft caries. The use of a local True anaesthetic should be the patient's choice False False D is Black's original definition in that @ Class IV False cavity is the progression from a Class Ill cavity Fractured incisal angles, in the absence of caries, are not, strictly speaking, Class IV lesions ‘The restoration should restore function; if there is no occlusal contact, teeth will move Pins provide additional retention and if enough sound tooth tissue remains, a pin will not be necessary. The cusp should be reduced only to provide for 2mm of amalgam and remove unsupported enamel. The restoration should restore function 90@> Goe> GO@E Goer ‘True The margin of the restoration should not be in the False gingival crevice; the proximal contacts of anterior False teeth are provided by the incisal corners and to True remove these would lead to large restorations False The margins of the dam must adapt tightly to the True — tooth and will be stretched if the holes are too close together False The pin hole must provide stability and retention ‘True without jeopardising the pulp or periodontal False ligament com> com> com> z 220 224 222 223 224 225 Restorative dentistry 29 Which of the following indicates with the gre that the pulp is non-vital? ‘ANo response when an electric potential is applied to the enamel B_ No response when gutta percha is applied to the enamel © No response when ice crystals are applied to the tooth D An area of radiolucency surrounding the apex of the tooth test reliability Occlusal amalgam cavities should be prepared so that A carious tissue only is removed B undercuts, particularly by the marginal ridges, are provided for retention © caries and all potentially carious sites such as pits and fissures are removed D Cusps are undercut to provide retention Why do you bevel the pulpoaxial line angle in a Class Il inlay cavity? A To assist withdrawal of a wax pattern B To give greater strength in that region of the inlay © To prevent recurrent caries D To avoid a weak sharp edge in the investment mould ‘An irregularly shaped void on the surface of a gold casting ‘would indicate that Aa fragment of investment had been cartied into the mould B air had been carried into the mould © the burning out of wax was inadequate D the powder/water ratio for the investment had been too high ‘The greatest improvement in the marginal adaptation of ‘composite restorations is achieved by ‘A ensuring that the cavity is free of moisture B goad packing of the restoration © acid etching D maintaining pressure during setting The main reason for localised shrinkage porosity in dental castings A over-heating of the alloy B the sprue being too thin G over-heating of the investment D there being no reservoir (Answers overleaf)30 220 221 222 223 2.24 225 MCQs in Dentistry False False False True False False True True False False False True True False False False False False True False False False False True Com> com> com> com> ON@> coor Vitality tests are not infallible and must be interpreted with other clinical observations The marginal ridge would be weakened if undercut Air inclusions would be spheroidal, wax would aot remain at cesting temperatures and @ high Powder{water ratio would give an incomplete casting due to back pressure All these do improve adaptation but acid etching causes the greatest improvement All will give rise to porosity but only D is localised in relation to shrinkage . Restorative dentistry 31 2.26 Which of the following is not important in relation to the retention of Class | gold inlays? A The length of the cavity walls B The area of the pulpal floor © The angulation of the cavity walls to each other D Sharp line angles between the cavity walls and the pulpal floor 2.27 Cavo-surface angles for gold restorations A if greater than 135°, should be bevelled B if less than 135°, should be bevelled © are shaped to minimise casting discrepancies D are designed to allow burnishing of gold margins to the tooth, B. Endodontics 2.28 A root filling should reach A to the radiographic apex B_ 1 mm beyond the radiographic apex € 1mm shart of the radiographic apex D the dentino-cemental junction 2.28 The origin of the calcium ions in a calcific bridge over an exposure covered with calcium hydroxide is, A the calcium hydroxide B local coll debris € the blood stream via the pulp D the surrounding dentine by redeposition 2.30 A satisfactory apical seal of a straight root canal can usually be obtained with A gutta percha points and sealer B amalgam © a silver point alone D a paste root filling material 2.31 The Immediate treatment of an acute periapical abscess may include A analgesics B local dressing of the root canal with antibiotics € drainage of the abscess via the root canal D the administration of a local anesthetic to facilitate treatment (Answers overleaf)32 MCQs in Dentistry 0 Restorative dentistry 33, 2.26 A False Near parallelism of walls and a single long path of B True insertion provide good retention C False D True 2.27 A False A cavo-surface angle of more than 135° is a ‘natural B True bevel’ and the gold margin may be burnished ¢ True without incorporating @ cut bevel in the cavity. A True bevel or chamfer margin provides @ ‘slip joint so that small shrinkages will not jeopardise the fit of the casting B. Endodontics 228 A False A root filing should reach the apical constriction 8 False which, on average, is 1mm short of the anatomical C True apex D True 229 The calcium hydroxide creates favourable conditions for secondary dentine formation, Probably by virtue of its high pH (9-11) 230 A True Sealer is necessary to fill roughnesses in the B True prepared canal wall and paste fillings cannot be condensed adequately 231 Drainage of pus will be obstructed by antibiotics in the canal and a local anaesthetic may encourage ‘spread of infection by mechanically breaking down tissue barriers and reducing blood supply 232 233 234 235 236 237 238 Extirpation of the pulp of an upper incisor with a carious exposure in a Class lll cavity should be achieved A via the exposure B via a triangular access cavity on the palatal surface © after restoration of the cavity D via the proximal surface The commonly use A Savion B Normal saline © Camphorated monochloropheno! D Sodium hypochlorite Which root canal of the upper first molar would you expect to be most difficult to prepare for root filing? A Disto-palatal B Mesio-buccal © Disto-buccal D Palatal ‘An extensive carious lesion associated with a hyperaemic pulp should normally be treated in the first instance by removing A all the caries possible but avoiding exposure of the pulp B all the caries and dressing any exposure produced the minimum of caries and dressing with a sedative D all the caries and leaving the pulp open to drain What are the main constituents of most root ca ‘A Gutta percha and zinc oxide B Zinc oxide and an anti-inflammatory agent © Zinc oxide and eugeno! D Zine oxide and formocresol I sealers? In what circumstances in a pulp capping procedure indicated? ‘A Alarge carious exposure in a posterior tooth B A small exposure in an otherwise symptomless, vital posterior tooth © Asmall exposure in a non-vital tooth DA small exposure in a vital tooth with pulpit ‘The initial treatment for a periapical lesion associated with a non-vital and symptomless tooth should be A filling the canal B to gain access to pulp chamber and leave open to drain € to gain access to pulp chamber and estimate the working length D to relieve the occlusion (Answers overleaf)34 MCOs in Dentistry 2.82 A False Access cavities should be designed to permit direct B True access to the apical constriction. A Class Ill cavity, € True would dictate bending of the instruments. The D False original cavity must be restored immediately to permit complete isolation of the root canal 233 A False Camphorated monochlorphenol is a root canal B True dressing and Savion might be an effective irrigant, C False but is not commonly used D True 234 A False To enter the mesio-buccal canal, the instrument has B True to be passed upwards and forwards. Ina small C False percentage of cases there are two mesio-buccal D False canals 2.35 A True Pulpal hyperaemia is considered to be reversible B False after removal of the caries. The success of indirect € False pulp capping depends on treating the tooth in the D False early stages of pulp reaction and removing all infected dentine 2.36 A False Whilst some root sealers contain active components 8 such as steroids or mummifying agents, these are C True not common D False 2.37 A False Successful pulp capping requires a healthy pulp. B True The greater the exposure and the extent of the C False inflammation, the less likely this is to be the case 238 A False A tooth should be left open only when pus or B False exudate is draining. Mechanical preparation should € True _ be done only after the working length has been D True estimated Restorative dentistry 35 2.39 Corticosteroids are used in endodontic practi to reduce pulp inflammation to reduce pulp infection to treat periapical infection to reduce pulp symptoms 2.40 A pulp polyp may arise in connection with ‘chronic open pulpitis pulp necrosis, ‘acute pulpitie, D a chronic periapical lesion eur> ocoar 2.41 Internal resorption may follow ‘A trauma B root fracture © successful root canal filing D enamel fracture 2.42 Which of the following may indicate periapical surgery? A Periapical infection associated with an obliterated canal B Crown fracture involving the pulp © Pulp necrosis with a patent root canal D A fractured instrument perforating the apex and preventing {an apical seal 2.43. Which of the following conditions may be symptomless? A Acute puipitis B Chronic open pulpitis © Chronic closed pulpitis D Pulp polyp 2.44. Which of the following conditions may be effectively treated with corticosteroids? 2'A small traumatic exposure B Pain trom pulpitis where immediate extirpation is impossible ¢ A small carious exposure in a symptomless tooth D Interna resorption 2.48 Predisposing factors to under‘filing of a root canal include A ledge formation B lateral perforation € apical perforation D short length estimation (Answers overleaf)36 MCOs in Dentistry Restorative dentistry 37 2.39 2.40 241 242 243 244 2.45 20@> caw> vom> oAE> CAw> Onm> ooa> True False False True True Fe False True True False True Tr False False True False True False True False True True False True Corticosteroids are anti-inflammatory agents which relieve the symptoms of pulpitis but cause pulp rRecrosis in the long term A pulp polyp can only arise from a vital pulp that is ‘open to the oral environment Internat resorption requires the presence of vital Pulp tissue; trauma is believed to stimulate resorption Apical surgery is indicated when an apical seal cannot be achieved by an orthograde approach and, there is evidence of pathology Acute pulpitis, or an acute exacerbation of chronic pulpitis, always gives tise to pain ‘The application of a corticosteroid relieves pain by reducing inflammation but causes necrosis of the Pulp in the long term. Where vitality is to be maintained, calcium hydroxide should be used Internal resorption should be treated by pulp extirpation Any obstruction or off-line preparation may interfere with proper canal preparation and filling. Apical perforation predisposes to an over-fill 246 247 249 250 251 282 If 8 sinus is associated with chronic periapical infection of a non-vital tooth the treatment includes. A enlargement of the sinus surgically B irrigation of the sinus © dressing the sinus D no active treatment for the sinus Factors which predispose to over‘ A wrong length estimation B repeated perforation of the apical foramen © lateral perforation D ledge formation ing of a root canal i "tment on a vital tooth may be indicated in ion with A acute pulpitis B a traumatic exposure © a pulp polyp D the need for a post crown to restore the tooth ‘Mummification of the pulp may be indicated for a ‘A traumatic exposure of an anterior tooth with open apex B carious exposure on a non vital tooth carious exposure on a vital tooth D deep cavity on a symptomless vital tooth ‘The fracture of root canal instruments may be caused by A using damaged instruments B over vigorous instrumentation © incorrect access to the root canal D using a reamer that is too large ‘Treatment of a symptomless under filled root canal may include A apical surgery B periodic observation with radiographs © prophylactic antibiotics D removal of the root filling Possible contraindi A controlled diabetes mellitus B the danger of damage to adjacent structures © a history of rheumatic fever D congenital heart disease (Answers overleaf)38 MCQs in Dentistry Restorative dentistry 39 2.46 The source of the infection is the root canal of the 2a7 2.48 249 250 251 affected tooth. Complete root canal therapy removes the organisms, which are not accessible to the white blood cells, and the sinus will then heal Lateral perforation and ledge formation are likely to lead to under-flling of the canal A tooth with acute pulpit is unlikely to be classed as vital ‘Mummification fixes vital tissue but does not sterlise infected or necrotic tissue, Calcium hydroxide should be applied in A to encourage root formation; B has no vital tissue to mummify and O requires pulp capping with calcium hydroxide If the root filing is new and short in a fully prepared canal, it should be removed and a new ‘one placed. In the absence of symptoms and signs ‘of pathology over a period, no treatment is indicated C. Crown and bridgework 2.53 When constructing a core for a full gold crown Aa minimum of two pins is required Ba minimum of four pins is required all enamel-dentine junction caries should be removed D some staining of the enamel-dentine junction is acceptable since the crown will cover it 2.54 The walls of a full gold crown preparation should A be parallel B have an angle of convergence of about 10-12° © have a taper of about 5° D be roughened to increase retention 2.55 Cervical finishing lines of full veneer crown preparations should be placed A just supra-gingivally whenever possible B according to the depth of the gingival crevice © sub-gingivally to reduce the liability of recurrent caries at the junction of the tooth and amalgam core 2.56 The retention of a full veneer crown i A lengthening the path of insertion B using a chamfer instead of a shoulder finishing line © ensuring that the path of insertion is in the long axis of the adjacent teeth D reducing the taper of the preparation creased by 257 A special tray for an elastomeric impression of crown preparations A should allow a consistent thickness of elastomer throughout I 252 A False Patients with stable medical conditions should be the impression / B True ‘treatment planned’ as normal patients. Their B should be slightly flexible to facilitate removal of the C False management, however, may differ from normal; the impression from tooth D False diabetic should be treated immediately after a meal © allows economy of impression material and antibiotic cover may be necessary for C and D D should everywhere extend into the sulcus 2.58 The indications for the provision of a porcelai may include the restoration of A a recent enamel/dentine fracture B fractured incisal angles associated with large Class M) restorations © aesthetics in a patient of 14 years with tetracycline staining D areas of erosion of enamel and dentine on the labial surfaces of incisors jacket crown (answers overleaf)40 MCQs in Dentistry C. Crown and bridgework 253 2.54 255 256 287 258 A v0@> one com> goa com> coer True False True False False False True False The rule of thumb Is one pin for each cusp lost, with ‘a minimum of two for stability. Staining of the tenamel-dentine junction is likely to be caries and may progress under the crown Absolute parallelism would give the maximum retention, but this could not be achieved accurately in the mouth. An angle of convergence of about 10° causes a rapid decrease in retention and whilst rough walls would increase retention, the technician would have difficulty in removing a pattern from the die ‘The integrity of the epithelia! attachment, gingiva and enamel should be preserved to maintain gingival health. The margin of the crown must be based on dentine beyond the core for stability and prevention of recurrent caries Retention is generated by the opposing walls of the preparation, irrespective of the finishing line. It may bbe necessary to have the path of insertion in the long axis of adjacent teeth but this will not increase retention ‘The tray must be rigid to prevent distortion of the impression. Reproduction of the sulcus is not necessary for crown models The vitality of the pulp must be assured before further trauma from the preparation; at least 6 weeks should elapse. Patients under the age of 18-20 years are likely to have large pulps that would be in jeopardy in a jacket preparation 259 260 261 2.62 263 264 Restorative dentistry 41 The indications for the provision of a post crown may include A the realignment of tilted anterior teeth B a root filled anterior tooth of normal appearance © the preparation for a jacket crown which would jeopardise pulp vitality D the use of the tooth as a bridge abutment Factors in the failure of porcelain jacket crowns may be A cracks arising from flaws on the fitting surface of the crown B cracks arising from incomplete glazing of the outer surface of the crown © a short preparation, allowing porcelain to be unsupported at the incisal half of the crown D the poor adaptation caused by the presence of the platinum foil during manufacture When considering the design for a post-crown preparation, the following should be borne in mind Aa cast gold post is stronger than a wrought nickel/chromium wire of equivalent diameter B a parallel-sided post is more retentive than a tapered post € the core should be the same size that the preparation for @ D vital jacket crown would have been on that tooth lateral perforations are more commonly associated with parallel sided posts than with tapered posts When cementing & post crown Jr'coment should be placed on the post only and not into the B eating the walls ofthe canal with EDTA incresses ts © the crown must be cemented immediately with the same ° mix of cement an ethoxy benzoic acid cement is preferred to zinc, phosphate When a gold casting fails to fit on a stone die A pressure should be applied to see if it will seat completely B the inside may be eased by grinding © the stone die may be relieved by scraping D the casting should be boiled in hydrochloric acid Gingival retraction cord for use during impression taking ‘A may be left in situ while taking the impression B increases the likelihood of gingival recession © may be impregnated with a vaso-constrictor D may be used to control gingival haemorrhage (Answers overleat)42 MCOs in Dentistry Restorative dentistry 43, 259 2.60 261 2.62 2.63 2.64 com> com> com> voe> vom» gom> True False True False True False True Fi False True False True False True False False False True False True True True True False Post crowns are not indicated just because a tooth is rootfilled. Vital anterior teeth are preferred as bridge abutments to rootfilled ones, The stress applied to a porcelain crown tends to propagate cracks from the inside. Ifthe foil is properly adapted during fabrication, adaptation of the final crown should be good Wrought posts are stronger and the cores should be smaller to permit a greater thickness of porcelain to be used for strength and aesthetics, Cement must be placed in the canal as well as on the post, since cement on the post only will not reach the end of the preparation. If required, a second mix of cement for the crown is acceptable and zinc phosphate gives better retention The die must have its surface detail preserved at all costs Gingival haemorrhage is usually beyond the capability of cord. Electro-surgery may be indicated, alternatively place temporary restorations to permit healing before trying again 2.65 2.66 267 268 When considering porcelain bonded to metal restorations A the preparation is more conservative than that required for porcelain alone B a shoulder finishing line is required in all areas © where only a facing of porcelain is provided, the ceramo- metal bond is weaker than that achieved with total porcelain coverage D metal sub-frames with a low gold content provide less, consistent bonding to porcelain When considering the use and preparation of a partial (3/4) ‘veneer crown the following points should be considered A the restoration conserves some of the natural appearance of the tooth B the casting lacks rigidity and therefore the preparation should include proximal and occlusal grooves © the restoration cannot be constructed in porcelain tonded to metal D a disc provides the correct shape for the proximal reductions of the preparation ‘A bridge or precision-retained partial denture may be indicated A to prevent further disruption of the occlusion B for patients with a high caries incidence to relieve temporomandibular joinymyofacial pain dysfunction syndrome D to splint teeth that have lost bone support due to periodontal disease ‘A temporary bridge constructed from a synthetic resin A should restore the occlusion to the same extent as the permanent bridge B is not required when the missing tooth is provided on a partial denture © Should have the same buccal and lingual contours as the permanent bridge D should be cemented with a polycarboxylate cement to ensure retention between the preparation and fitting stages (Answers overleaf)44 MCQs in Dentistry 2.65 2.66 267 2.68 ooa> oee> comp com> False False False True True True True False True False True False True False False False The preparation is more radical to permit layers of ‘metal and porcelain to be accommodated within the original tooth contour. A shoulder is only required in the areas on direct view and low gold elloys exhibit bonding at least as good as that obtained with high gold alloys. A sliced’ mesial reduction will expose more gold to direct view in comparison with a ‘feathered’ edae which can be achieved with a fine tapered diamond instrument ‘Active caries and existing periodontal disease and bbone loss contraindicate advanced conservation. A multi-unit casting of which a bridge forms part may bbe used as a splint The abutment teeth must be locked in the position recorded by the impression; the denture tooth should be removed and a temporary bridge used. Bulbous contours of synthetic resin are required for strength and a temporary cement should be used to Permit easy removal Restorative dentistry 45 2.69 When making pontics for bridges A the model should be relieved to provide adaptation to the soft tissues B the shape and size of the occlusal surface should reproduce that of the missing tooth © the connecting solder should extend from the occlusal, surface to the gingival margin to provide a broad area of, attachment for strength D itis best to avold occlusal contacts to reduce the stress on the abutments 270 19 upper right canine in an ise sound mouth with a canine guided occlusion A a suitable design would be a fixed-fixed bridge 4-2) B the occlusion should be reproduced by the bridge € the bridge should incorporate the upper premolars and provide group function D a cantilever design should not be used because of the likely stress on the soldered joint 2.71 An intra-coronal inlay without occlusal coverage is suitable for a bridge retainer and may be used in a fixed-fixed design should always be a mesio-occlusal-distal restoration may be used in 6 as part of a bridge 654l only requires 2 bevelled margin when the cavo-surface angle is less than 135° com> 2.72. A spring cantilever bridge should be considered to replat when A there is spacing between the anterior teeth B there is a steep vault to the palate © there is overeruption of 21112 D the 54) are heavily restored D. Conservation materials 2.72 Tin is incorporated in conventional silver amalgam alloy to A reduce setting expansion B produce more gamma-1 phase © increase the compressive strength D increase the tensile strength 2.74 The main constituent of a conventional silver amalgam alloy is A Ag3Sn B Agsn Cc Ag D Ag:Has (Answers overleaf}46 MCQs in Dentistry True The pontic must restore function and maintain the B False relationships of the opposing teeth but C False the occlusal area is smaller to reduce stress. The © False solder must be shaped to permit flossing and avoid the gingival margin 2 has insufficient root area to be an end abutment for the bridge. To reduce the stress on the bridge, the canine guidance must be converted to aroup function and in doing this, a soldered cantilever design is correct Cementation failure is probably due to occlusal 8 toading on the unprepared cusps not being € False transferred to the bridge. If a proximo-occlusal inlay D True were used, the life of the bridge might be shortened by caries of the uncut proximal surface. The inlay should be a minor retainer and is. therefore not correct for the molar ‘The bar requires support from a shallow, flat palate 8 False and with over-eruption there would be no space for € False the bar. Heavily restored teeth may not have ‘ D False healthy pulps and should be avoided, if possible, in bridge designs D. Conservation materials 2.73 & True False False False Gamma-1 is the silver-mercury phase; tin weekens the final amalgam 275 2.76 an 278 279 2a Restorative dentistry 47 Zine phosphate cement powder may contain A zine oxide B zinc phosphate © zinc polycarboxylate D magnesium oxide Mechanical trituration of amalgam A generates heat B results in a 1:1 final mercury: alloy ratio in the set material © reduces the risk of mercury contamination D increases the hardness of the set amalgam sive strength of zinc oxide-eugenol cements may ised by A ortho-ethoxybenzoie acid B polystyrene c D zine acetate silicon dioxide Copper is incorporated in conventional silver amalgam alloy A to increase the hardness. B to increase the edge strength © to increase the compressive strength D to decrease the setting expansion Dynamic creep is A the spread of amalgam during packing B the deformation of set amalgam during function © the process whereby alloy is ‘wetted’ by mercury D the continuing alloying between silver-tin alloy and mercury during the life of the restoration In comparison with conventional amalgam, the inclusion of silver-copper spheres in a high copper alloy ‘A reduces the creep of the set amalgam B increases the condensation pressure required © increases the corrosion resistance D requires matrix bands to be wedged tightly Zine phosphate cement sets ‘A’’by the formation of hydrated zinc phosphate B by the formation of hydrated zinc oxide © with the evolution of heat D by losing water (Answers overleaf)48 MCQs in Dentistry Restorative dentistry 49 275 276 an 278 279 2.80 A 8 c D A 8 c 5 A 8 c 5 A 8 c D A 8 c D A 8 c D 2a a 8 c 5 True False False True True False The mercury-alloy ratio is determined before mixing and the method of mixing will nat change it. Mechanical mixing has litle or no influence on the strength of the amalgam Zine acetate is an accelerator for ZOE cements Copper, in general, improves the physical properties but causes an increase in setting expansion Creep is a time-dependent permanent deformation ‘The presence of spherical particles causes the ‘amalgam to handle in a similar manner to conventional spherical amalgam. Less condensation pressure is required All the water of reaction is taken up in hydration of the zinc phosphate 282 2.83 284 288 2.88 287 2.88 In comparison with other bases plain zinc-oxide eugenol cements A only set in contact with water B have @ high compressive strength © have a long setting time D have @ higher thermal conductivity than dentine Which of the following would result in a decreased setting time for amalgam? A Increasing the mercury:alioy ratio from 6:5 to 6:5 B Using spherical particle amalgam alloy © Using coarse grained amalgam alloy D Reducing the trituration time The pH of zine phosphate cement when fully set is The filler in a composite filing mat A quartz B barium glass © organo-silane D alumino-silicate glass Composite restorative materials in comparison with acrylic have A lower compressive strength B higher abrasion resistance © a lower coefficient of thermal expansion D higher polymerisation shrinkage Composite restorative mat cement have A a longer working time B a shorter setting time © a smaller setting contraction D a higher water uptake ials in comparison with silicate Copal ether varnish may be used to A prevent water absorption by glass ionomer cement B reduce microleakage around composite materials © prevent water loss from silicate cements D prevent discolouration of silicate cement (answers overleaf)50 MCQs in Dentistry 282 2.83 2.84 2.85 2.86 287 2.88 A com GO@> GoOB> DAw> 9OB> Gom> True False True True ZOE cement will not set in a desiccator; often a metallic hydroxide may be incorporated in the Powder to provide water. Reinforcing agents are incorporated to provide an adequate compressive strength for the material's role as a base and dentine is a better insulator than most lining materials ‘A ‘wet’ amalgam will set more slowly as will 3 coarse grained alloy — there Is a smalier surface area to the volume of alloy in comparison with spherical particles. Over-triturated amalgam sets more rapidly Whilst the pH is 3-4 on insertion, when fully set, the material is almost neutral. This takes 28 days 'gano-silane is the coupling agent between the filler and the resin and alumino-silicate glass is a component of glass ionomer cement Copal ether varnish should be applied to glass ionomer cements to prevent water uptake between the initial set and the final set. It may be used as a cavity varnish and should be applied to silicate cement if restorations of that material are isolated during subsequent operations Restorative dentistry 51 A higher compressive strength B greater resistance to recurrent caries F colour stability lity to remain unaffected by oral fluids 2.90 Water absorption by, the composite materials results in A expansion 8 discolouration © increased surface roughness D decreased strength 2.91 The liquid supplied for a cold-ci material may contain A ethylene glycol dimethacrylate B tertiary amine © benzoyl peroxide D hydroquinone 2.92 Composite restorations may be finished with A aluminium oxide coated discs B diamond burs © steel finishing burs D smooth tungsten carbide (Baker-Curson) burs 2.93 Polysulphide rubber impression materials set with the formation of A ethyl alcohol B water © heat D insoluble lead compounds from elastomeric impressions of inlay cavities may be achieved by A deposition of metal by electrolysis B condensing amalgam into the impression © making a stone cast of the cavity D spraying a low fusing alloy into the impression 295 High copper amalgams Atnay sontain dispersed tin/copper eutectic before mixing B do hat form garnma2 phase on setting have higher cep values than conventional sver amalgam D Should be used with 2 1:1 mereuryalloy ratio (answers overleaf)52 MCQs in Dentistry 289 A False The compressive strengths ofthe two materials are @ False ver Sar and silat restortone tno ue Yecurrent cris by the difusion of furide tothe D True surrounding enamel erie rot 2.90 A True Surface roughness only occurs following abrasion C False © True 291 A True 8 Tm False Benzoyl is usually blended with the poly D True powder : cil 292 A True 8 True G False Stee is abraded by composite and wil there D True — discolour the surface ms Miherelore 293 A False Ethyl alcohol is formed duri A False Ethyl alcohol is formed during the sexing of Type | 294 False Condensation of amalgam would cause distortion of he impression a 8 c 5 295 AA False The eutectic is silvercopper and the cr 8 True Nigh copes amalgams are fower Pee D 2.96 Dimensional change Restorative dentistry 53 influence the construction of an indirect inlay. Which of the following occur? ‘A Setting shrinkage of the impression rubber B Setting shrinkage of the model stone © Thermal expansion of the inlay gold D Water absorption by the investment after its final set 2.97. Type I silicone rubber impression materials set with the formation of A ethyl alcohol B water crosstinked polymer chains D insoluble lead compounds 2.98 Casting investments used for inlay golds contain A silica B gypsum © ethyl silicate D alumina 2.99 Which of the following are appropriate for use as tooth conditioners before the placement of glass ionomer cement? ‘A 30% orthophosphoric acia B S0%eitric acid © 10 volume hydrogen peroxide 1D 50% polyacrylic acid 2.100 Composite materials containing a microfine filler in ‘comparison with conventional filler A in general, have a higher filler content B can be polished to achieve a smoother surface have a higher water absorption D cannot be cured by external energy because of the filler composition 2.101. Type It silicone rubber impression materials A’evolve hydrogen when cast if they are not fully cured B set by condensation polymersation exhibit a very low setting shrinkage D have a lower tear resistance than polysulphide rubbers n, ean be made from 2.102 Metal dies, formed by electro depo: impressions taken in A polysulphides B silicones © polyethers D reversible hydrocolloids (Answers overleaf}84 MCQs in Dentistry 2.96 297 298 2.99 2.100 2.101 2.102 True False True False True False True False True True False False 90@> Gow> DOB> Dewy DOB> coer OOOr ‘The model stone expands on setting and investment materials only absorb water before their final set is reached See question 2.22 Ethyl silicate is 2 binding agent for high temperature investments; alumina is not refractory Because of difficulties in manufacture, @ minimum of 65% filler has been achieved with microfine materials They set by addition polymerisation Polyethers and hydrocolloids would absorb water during plating 3 32 33 34 35 Orthodontics and children’s dentistry A the canine is labial to the arch B the canine is partially erupted € the canine is distally inclined D the canine is disto-labially rotated E the canine is transposed Lower removable appliances are generally less satisfactory than their Upper counterparts because A the buccal undercut is less accessible on 876 than 616 B 313 are usually distally inclined 313 are usually mesially inclined D low labial bows are not retentive in the lower arch E lower incisors are usually imbricated where 4[4 are extracted ‘Adams cribs can fracture in use if A the wire is too soft B the wire is too hard © the tags are high on the bite D the baseplate is too thick E the arrowheads are too small ‘An anterior bite plane should be trimmed so that A itis inclined at 10° to the occlusal plane B it is inclined at 30° to the occlusal plane © the posterior teeth are kept 5 mm apart D the posterior teeth are kept 2mm apart E there is free lateral excursion without occlusal interference Which of the following can be classified as a myofunctional appliance? A An anterior bite plane B Begg appliance © Andresen appliance D Extra-oral appliance E Oral screen (Answers overleaf hl56 MCQs in Dentistry Answers 3.1 A True B False cannot be engaged satisfactorily € False requires fixed appliance treatment D False requires fixed appliance treatment E False irrelevant 32 A True B False they are usually mesially inclined C False this aids retention via the activated springs D True E False irrelevant 33 A False will bend easily but not fracture 8 Tru True D False E Fal 3.4 A False should be either parallel to the occlusal plane or at right angles to the lower incisal axes B False should be either parallel to the occlusal plane or at right angles to the lower incisal axes € False too great 5 E hhas never been proposed 3.5 A True as 21/12 are slightly intruded B False this is a fixed appliance C True D False does not use muscle forces E True Orthodontics and children’s dentistry 57 3.6 Which of these would you expect of find in a severe Class IW case? A An ANB angle of +8° B An ANB of -8° © An ANB of +2° D A Frankfort/Mandibular angle of >35° 3.7 The corrected incisor relationship on a lateral skull radiograph is ‘A the incisor relationship that can be expected after treatment B useful for serial growth studies © an aid to skeletal assessment D used for determining Angle's classification E none of the above 3:8 Which of the following gives the best description of erupted permanent teeth typically seen in a 9-year old? Only 1/1 Ie ea 76421112467 76421112467 621 1126 621 li26 only st 3.9 First permanent molars begin to calcify at A6 months intrauterine life B at birth € before deciduous incisors D about 1 year after birth E 3 years of age z moo @D> 3.10 The Frankfort plane joins hasion and porion anterior nasal spine and pogonion porion and orbitale ofbitale and posterior nasal spine fla of nose and tragus moom> 3:11 Supernumerary teeth are found in the upper anterior region ‘where they frequently lie A palatal to 111 B distal to 111 © distal to 212 D between 111 roots E buccal to 117 (Answers overleaf)58 MCQs in Dentistry Orthodontics and children's dentistry 59 36 37 38 39 3.10 an A True 8 2 severe Skeletal Class I € False within range of Skeletal Class | D False unrelated to antero-posterior relationship of the arches False tooth position depends on other factors such as soft tissues. False Angle's classification is based on molar occlusion False 7's seldom erupt before 12 years moom> moow > g A 8 c D E A 8 c D E a particularly applies to tuberculate supernumeraries c D Usually of conical supernumeraries E False the majority are palatal 312 a3 a8 3.15 3.16 307 ‘An initial contact between malposed teeth in a child aged 8 ‘can lead to A pain B an abnormal path of mandibular closure © atraumatic occlusion D movement of the malposed teeth E the development of a close bite Which of the following are typical consequences of dental ‘crowding. assuming no primary teeth have been lost prematurely A Overlapping of lower incisors B Palatal displacement of upper canines © Impaction of 515 between 414 and 616 D 7 7 erupting buccal to the line of the dental arch E Rotation of 616 To ‘tongue to lower lip’ swallow is more commonly seen in cases where A the lips are competent B there has been early loss in the labial segment € the Frankforymandibular planes angle is low D the lower incisors are retroclined E the lips are incompetent Which show a greater incidence of class Illthan the general population? A Patients with ectodermal dysplasia B Patients with cleft palate © Achondroplastic dwarfs D Patients with fibrous dysplasia ‘A retained lower deciduous incisor will usually: ‘A deflect the permanent tooth labially B deflect the permanent tooth lingually © cause ankylosis of the underlying permanent tooth D cause impaction of the underlying permanent tooth E cause dilaceration of the underlying permanent tooth Which one of the following does not lie on the mandible? ‘A Pogonion B Gnathion © Menton. D 8’ point E Porion (answers overleaf)60 312 313 314 315 316 aa7 MCQs in Dentistry ‘True True True True False True False crowded canines are buccally displaced rane, this can only follow loss of EE " False follows loss of EE A 8 c D E a 8 c 5 E A 8 c D E A 8 c D A 8 c D False | no evidence E A 8 c D E Orthodontics and children’s dentistry 61 3.18 Between 11 and 14 years incompetent lips ‘A become more incompetent B become more everted © tend to be held together more D upright the lower incisors E show no significant changes in form or behaviour 3.19 In the context of orthodontics, morphology means A behaviour during function B shape end size © relationship D development 3.20 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 high B low © incomplete D competent E average 3.21 Would you bend the wire to activate a correctly made palatal canine retractor [A between the coil and its insertion into the base of the plate B by opening out the coil © between the coil and the tooth but close to the coil D between the coil and the tooth but close to the tooth E midway between (Cland (D) 3.22 Hf the incisor overjet increases during treatment of a Class 11 case you may be seeing A loss of anchorage B loss of retention (fixation) © collapse of the lower arch D unfavourable growth 3.23 A boy aged 14 years attends with a Class | malocclusion in ‘which there is mild crowding in the upper arch and moderate inciver on in the lower labial eogment. CIC are retained but radiographs show these teeth to have had helf ‘their roots resorbed by 313 which are slightly palatally misplaced. Would you A Wait another 6 months to see if CIC are shed naturally B Extract CIC and wait for 313 to erupt © Extract 4C/C4 and fit an upper appliance to maintain space a while awaiting eruption of 313, D Arrange for CIC to be removed and 313 surgically exposed E Extract CIC and 4ld to make space for the eruption of 313 (answers overleaf)es ee 62 MCQs in Dentistry 318 A False B False no evidence é D although lower incisors tend to become more Upright during this time no evidence exists to implicate soft tissue behaviour av'a couse E aig A 8 e 5 320A the average is half way up the labial sutace ofthe 8 é 5 these terms do not sppiy to lp tine aan should be insufficient space in correctly made spring 8 False will hasten fracture in use C True D False wil introduce a dramatic change inthe direction of retraction E False butt incorrectly positioned and you may attempt to correct the direction of the applied force by adjustment inthis region 322 A Tue 8 False c tower incisors do not change ther labio-ingual Dosition significantly unless actively retracted D False growth is never 80 unfavourable es to produce this tect 2.23 A False something is already wrong, there is no point in delaying ° . 8 False 313. aro short of space in which to erupt (arch is crowded) C Tus D False (a) space must be provided in addition to CIC (b) exposure not required as 33 are resorbing | E False what about lower arch crowding? nee Orthodontics and children’s dentistry 63, | spring is repeatedly flexed below its elastic A it shows no change in structure B it may eventually fatigue © it will work harden D the grain size will be reduced E the grain structure will become fibrous 3.25 The 18/8 stainless steel used in orthodontic wire contains A 18% iron: 8% nickel B_ 18% nickel: 8% chromium © 18% chromium: 8% nickel D 18% chromium: 8% cobalt E 18% nickel: 8% cobalt 3.26 An appropriate wire size for the fabrication of palatal canine springs would be 03mm B07 mm. © 08mm. DO5mm 3.27 Which of the following is not found in flux for soldering stainless steel A Borax B Boric acid © Magnesium carbonate D Potassium fluoride 3.28 The main form of iron carbide found in 18/8 stainless steel is A martensite B austenite ¢ ferrite D peariite 3.29 If stainless steel wire used in making orthodontic springs is. heated to red he: A it becomes brittle if quenched B its properties improve € it becomes softened D E it will acquire an inert layer of chromium oxide it becomes brittle if allowed to cool slowly (Answers overleaf64 MCQs in Dentistry Orthodontics and children’s dentistry 65 3.24 ‘True A B True 3.30 Model plaster (white) used to cast study models before & False requires plastic deformation ining with water, lrgely composed of alse only follows cold working and heat treatment aCOs E False already possesses this B CaO © (CaSO,)2H,0 which is CaSO44H,0 325 A D CaS0,Caco; c 3.31 Which of the following is found in a solder suitable for 5 \ stainless stee!? E A Silver B Aluminium 3.26 A False too flexible © Copper 8 False 100 rigid D iron rue if large coils are used D True — the most usual size of choice 3.32 Compared with tipping movements produced by removable appliances, teeth retracted bodily by means of fixed 327 A ppliances. 8 ‘A move more slowiy c B move more quickly ° © have a higher incidence of root resorption D require higher forces 3.28 A E show evidence of hypercementosis B c 3.33 Stationary anchorage refers to anchor teeth which D & are banded B cannot move 329 A © are not free to tilt 8 D are supported by extra-oral forces | ¢ E gain anchorage from their opponents already present E 3.34. The lag phase of tooth movement is caused by the time taken for | A hydrostatic changes in periodontal membrane B periodontal fibres to be elongated € hyalinisation to be removed | D new periodontal fibres to form force level for tipping a single rooted tooth 3.35 The appropr lies betweer 10 and 12 grams B 20 and 50 grams © 50 and 70 grams D 70 and 100 grams E 100 and 150 grams (Answers overleaf)66 MCOs in Dentistry Orthodontics and children’s dentistry 67 roel 3.36 An upper incisor inside the bite should be treated False A before 7 years (dental age) pa B as soon as the maxillary premolars first can be clasped False © at 12 years to keep treatment to a minimum D as soon as possible True E before root growth is complete False True 3.37 Anterior bite planes should be adjusted so that in occlusion ee the first molars are A just touching False similar rates can be achieved B 1mm apart False similar rates can be achieved © 2-3mm apart False no evidence D 4-5:inm apart True False 3.38 Which of the these may adversely affect the outcome of removable appliance trestment of a Class Il division 1 banded teeth are still free to tilt unless specific ‘malocclusion? steps are taken to prevent this A Incompetent lips ‘but when prevented from tilting their movement is B Thumb habit greatly reduced © Skeletal 2 base D Average FM angle E Short upper tip 3.39 To produce a stable correction of an upper 3.34 these take place quite rapidly during first few hours inguo occlusion it is essential to | ‘Av use fixed appliances B have adequate overbite © treat during growth D use posterior capping ! 3.38 rate of movement will be less than optimum t stage of Classi 1no increase in rate of movement is achieved but there is increased likelihood of anchorage loss A. prevent traumatic overbite B disengage buccal cusps © allow lower space to close D permit full overjet reduction MO0@> GN®> moO @ > MoOw> GOB> Doe 3.41. Where a Class Il division 1 malocclusion is seen on a skeletal 1 base the incisor malocclusion is likely to be due to A crowding } B soft tissue factors © an increased ANB angle B tnusual maxillary incisor crownyroot angles (Answers overleaf)68 MCQs in Dentistry 3.36 337 3.38 3.38 3.40 31 False False False True False False False Tr False False Fal ‘True False False False True False False False False True False True False False ‘upper incisors will not have erupted DID can be clasped delay to this age often complicates and lengthens ‘treatment no overbite reduction will occur as molar eruption is prevented molar contact will soon be re-established excessive for patient comfort these invariably adapt usually given up without problems irrelevant to stability proclination by removable appliances is frequently all that is required ‘adult treatment is quite feasible Upper incisor teeth can be proclined without this of which teeth and why?! ‘who said anything about lower spacing? crowding does not cause an increased overjet this indicates a skeletal 2 base no evidence Orthodontics and children’s dentistry 69 3.42, 343 344 345 3.48 3.47 Which of the following factors may contribute to the severity Of the incisor overbite in Class 1U2 malocclusion A lip activity B overclosure € the AP dental base relationship D the degree of lower crowding E the reduced lower face height In most Class 1/2 cases the lower lip when at rest {A just below the upper incisors tips B just above the upper incisor tips © half way up upper incisor crowns D more than halfway up the upper incisor crowns Upper arch crowding in Class IV2 cases may be seen as A buccal occlusion of first premolars B labial crowding of lateral incisors © impacted first molars D palatal misplaced canines The removal of 217 in preference to 4i4 is indicated A in some mild Class Il Div.1 cases B in adult patients © when a quick result is required as good co-operation is unlikely D when 88 are congenitally absent E when 68 are inclined distally ‘When 313 are being moved di 21112 will space out: A if the appliance carries a short labial bow with tags passing distal to 212 B if the interdental spurs of acrylic are carefully trimmed away € because of lip pressure D if there is an anterior bite plane E only if buccal canine retractors are used lly into 44 extraction spaces, A patient aged 8 Hincisor sors and Djand|D recently extracted due to caries. All remaining teeth are of ‘good prognosis although the deciduous molars are restored. Would you ‘A await eruption of premolars and review Fs attends with a Clas arrange to extract IC B arrange to extract EE € fit space maintainers © exact (Answers overleaf)70 MCs in Dentistry Orthodontics and children’s dentistry 71 342 A Fake 8 False C True D False no offect on overbite E 343 A 8 c D 344 A 8 c ° 3.45 A B c ‘good co-operation with headgear usually required D extraction of 2/7 contraindicated E 36 appliance design prevents this c no evidence DB E 347 8 centre lines will become displaced 8 inappropriate c contraindicated in a caries prone mouth D balances eariy loss 348 3.49 350 351 382 ‘A-Class I malocclusion with a severe Skeletal 2 base is treated conventionally using removable appliances. The lower ineisor and Franktort/mandibular planes angles are typical values. The result after full overjet reduction will be A a Class | incisor relationship B a Class It incisor relationship € bimaxillary retroclination D a Class IV/2 incisor relationship E an increased interincisal angle “Difficult cases’ are often more successfully treated with fixed appliances than removable appliances because A they cannot be taken out by the patient B they apply greater forces © they do not lose anchorage D they can perform a wider range of movements E many movements can be carried out simultaneously Which of the following would suggest to you that anchorage was being lost during retraction of canines into 4/4 spaces in ‘treatment of a Class Il1 case which required no lower arch treatment? ‘A The canine relationship unchanged butl35 space closing B Molar relationship unchanged © Molar relationship becoming more Class I! D Overjet increasing E Upper incisors becoming spaced ‘The extraction of upper first molars may be indicated A when the removal of 414 provides insufficient space B where they are rotated © when their prognosis is poor D when §I6 are palatally placed E to provide space for the eruption of 22 ‘The purpose of post-treatment retention of an orthodontic A (o allow bony changes B to prevent tongue thrusting € to let the patient get used to the new functional position of the teeth E to encourage space closure (Answers overleaf)72 MCQs in Dentistry 3.48 A False not possible on a Skeletal 2 base without fixed appliance therapy False the overjet is fully reduced False lower incisor angle average True False a determined patient can easily damage a fixed appliance False greater than what? False anchorage is just as easily lost True True True False True True False False because of anchorage problems extraction of 616 provides less space than 414 False True False False 717 always erupt regardless of crowding 362 A True False tongue thrusts do not follow tooth movement False no evidence True False retaining appliances usually interfere with space moow> moow > moom> 383 354 3.85 356 387 358 Orthodontics and children’s dentistry 73, You are examining a case with a Class I incisor relationship (reverse overjet of 3 mm). Which of the following could contribute to a poor prognosis? A Forward path of closure B Crowding in the lower arch © Reduced overbite D Retroclined 212 E Absence of B18 Most Class Ill incisor occlusions have A reversed (negative) overjets B competent lips © open bites D skeletal il bases Which of the following is not appropriate for incisor retraction? A a Roberts retractor B a divided labial bow (sp! © a self straightening wire D an undivided labial bow an apron spring labial bow) In response to a single force applied to their crowns, upper incisor teeth typically tip about points which are A located at their apices B within the apical 1/3 of root © within the middle 1/3 of root D within the coronal 1/3 of root If the coil and tag of a palatal retractor are placed too far distally A the baseplate will be weakened B tooth movement will be slowed € the tooth will tend to be moved bucally D the tooth will tend to be moved palatally Incompetent lip morphology may be associated with A an increased face height B alisp © flaccid lips D enlarged adenoids E a tooth together swallow (Answers overleaf)74 MCQs in Dentistry 353 A False 3.55 356 387 3.58 mon@> oom > moo@> GA@> com> once this is eliminated the sagittal discrepancy is reduced ‘once crowding is relieved the most labially positioned teeth tend to drop lingually proclination of 21112 will not be accompanied by @ eduction of the overbite irrelevant Class il incisors include mildly reduced overjetsioverbites no evidence quite suitable this is far too rigid to apply appropriate force levels quite suitable strength is not dependent on this the rate of movement is not dependent on this no evidence 359 361 3.62 3.63 Orthodontics and children’s dentistry 75 Which of the following is a valid indication for the use of fixed appliances? A Correction of rotations B Bodily retraction of incisors © Extrusion of unerupted teeth D For a patient who has proved to be unreliable about wearing removable appliances E Where many teeth require alignment in one arch At some time, thumb sucking is noted i A under 10% B 10-50% € over sor | of pre-school children D all Unilateral buccal crossbite may be associated with A bottle feeding in infants B enlarged adenoids © skeletal Ill dental base relationship D Bin lingual occlusion E endogenous tongue thrust Which of the following lips’? A Lips which do not seal when their possessor is in occlusion Lips which do not seal when relaxed with the mandible in its rest position Lips that are separated by the upper incisors Lips against which the tongue always thrusts during swallowing E Lips that contract during swallowing 2 correct definition of ‘incompetent vo @ The mouths of dentate 65 year olds who have retained (al!) their teeth show A less crowding than young adults B fewer extreme overjets than in untreated children © fewer extreme overbites than in untreated children D no significant differences in crowding, overbite and overjet, when compared with A-C above A 10 year old has a Class | dental base relationship, slight spacing and competent lips. He has a slightly increased overjet and sucks his thumb. If he stops this habit which of the following is most likely to happen? A The overjet will reduce B The Frankforl/mandibular plane angle will decrease © The lower incisors will retrocline D The upper incisors will imbricate E The upper buccal segments will come forward (Answers overleaf)76 MCOs in Dentistry 3.59 A True True True Fi very good co-operation is required True 3.60 A False False True False 3.61 A False False True True _ because of associated displacement False 3.62 A False Tru False False False moom> mon@> GN@> moo@D> 3.63 A False False False True 3.64 A True False FM angle remains virtually constant despite small changes in face height False no evidence False occasionally they may proctine False any forward movement would have already taken place moo @> com> Orthodontics and children’s dentistry 77 365 3.67 3.68 3.69 3.70 ‘Supernumerary teeth are commonly found A associated with hypodontia B where there is a cleft palate © in about 0.5% of the population. D in Passavant’s ridge E preceding the deciduous dentition For the purpose of skeletal assessment by the method of incisor angle correction, (Ballard’s method) the relationship between lower incisor inclination with respect to the ‘mandibular plane and the maxillary mandibular plane angle is: inversely proportional directly proportional unrelated dependent upon upper incisor angulation dependent upon the skeletal form moow> ‘Where one or more anterior teeth are in linguo-occlusion ther is usually A a reduced overbite B proclined upper incisors © a mandibular displacement D overciosure of mandible ‘The low labial bow of the maxillary removable appliance is usually made from A 0.7 oF 0.8 mm hard stainless steel wire B 0.5 0r 0.6 mm hard stainless steel wire © 0.6 0r0.7 mm hard stainless steel wire D 0.8 or 0.9 mm hard stainless steel wire Hf an anterior biteplane does not reduce the overbite the most probable explanation is that the patient A is not wearing the appliance fulltime B is not growing € is not wearing the appliance at all D has a small lower face height The mentalis muscle has the following effect on the lower lip retrusion inversion elevation depression protrusion moom> (Answers overleaf)78 MCQs in Dentistry 3.65 3.66 367 3.68 3.69 3.70 False monw> 00 @> on@> com> mooe> moo @> very rare (0.4%) you must be joking. Consult your anatomy textbook these are rare this method of skeletal assessment is based on the fact that if incisor angulations are correct with respect to the facial skeleton any mal relationship Of the dental bases in the sagittal plane will be reflected in the incisor occlusion. For this reason the angulation of 71 to the mandibular plane is inversely proportional to the size of the maxillary/mandibular plane angle may be so but not usually there is doubt as to whether this entity exists sometimes used in Andresen appliances overbites can be reduced slightly even in the non. growing patient possible but very unlikely reduced lower face heights do seem more difficult but initially the same changes are achieved unless the subject happens to be standing on his head! am a7 373 376 375 Orthodontics and children’s dentistry 79 Posterior capping is used on an upper removable appliance in preference to an anterior bite plane & to produce intrusion of the upper posterior teeth B when additional retention is required © to eliminate a mandibular deviation D when an incisor has to be moved ‘over the bite’ E when a spontaneous forward movement of lower buccal segments is required Flat anterior bite planes used in the treatment of typical Class IV malocclusion A produce lower incisor depression B allow upper molars to erupt € allow lower molars to erupt D produce a decrease in the overbite E increase anchorage Acrylic (cold curing) A melts at 100°C B softens at 100°C © produces heat during curing D stil requires some heat to initiate curing E is damaged by dilute acids Expansion screws used in the treatment of crossbites typically produce about ‘A 1mm expansion per month B_ 1mm expansion per quarter turn © 1mm expansion per half turn D_0.20mm expansion per quarter turn Ha lateral incisor is prevented from spontaneously following a ‘canine during its retraction A the canine will move more slowly B the gingival attachment of both teeth will be damaged © there will be no detectable effect on the rate of retraction of the canine D E anchorage will be lost the canine will become intruded (Answers overleaf)80 MCQs in Dentistry 3.71 A False _ intrusion of the upper posterior teeth cannot be achieved by this means B False has no effect on retention C True © Truc E False cuspal locks are quickly re-established as the acrylic becomes faceted 3.72 A True but very slight B True C True D True E False no evidence 3.73 A False B True C True © False E False 3.74 A False the amount of expansion depends entirely on the instructions given by the clinician to the patient. ‘The rate of expansion appropriate to a particular case depends on the use to which the screw is being put 8 c DB 375 & no evidence 8 no evidence c D no evidence E ro evidence Orthodontics and children’s dentistry 81 3.76 With lower incisor crowding the ‘canine rule’ A gives too much space B gives too little space € gives the correct space D gives the correct space on near normal skeletal bases E cannot be applied 3.77 A suitable extra-oral force for retraction of buccal segments is A 1015 B 4oz ¢ 2ib D 100 grams E 500 grams 3.78 You have successfully treated a Class Il1 malocclusion. The al Class | incisor relationship has been produced and 414 were extracted. The arches are now well aligned. What molar ‘occlusion will there be at the end of treatment when all spaces are closed? ‘A Full unit Class I B {unit Class i! © Class | D funit Class it! E Full unit Class I 3.79 Which of the following are valid reasons for the removal of an upper second premolar as part of treatment with removable appliances? When it is palatally misplaced When it is palatally excluded and first molar and first premolar are in contact Where the lower second premolar is congenitally absent, and the greater part of its space has been lost When less than | of a premolar unit is required for incisor alignment When the upper second molar is short of space a 8 c > E incisor extractions should usually be avoided A aesthetic problems B shift of centre line € the difficulty of fitting the upper labial segment around the lower D recurrence of crowding in this region E collapse of the lower arch (Answers overleaf)MCQs in Dentistry Orthodontics and children's dentistry 83 377 378 3.79 3.80 but lower canines must be mentally repositioned (to allow sufficient space for the lower incisors to be aligned) before the ‘rule’ can be applied too large too small 2 ib (900 grams) is about the maximum force which should be applied too small 500 grams (1.1 Ib) is widely accepted as being the most appropiate force level for this purpose mo omD> fl impossible c D False P Fae } impossible A it is easy to align 8 c where extractions are appropriate in both arches it 's usually a good principle to extract opposing teeth D False E False A False the absence of a lower central incisor is frequently missed even by the clinician B False what ‘centre line’? C True © True E False labiolingual position of the lower incisors is relatively stable following extraction 3.81 Thumb sucking habits usually A cease spontaneously B produce a distal displacement of the mandible € limit forward growth of the mandible D need appliances to discourage them E indicate psychological disturbances 3.82 Transposition of teeth means A surgical repositioning of teeth B inverted supernumerary © tooth bearing teratoma © teeth erupted in unusual positions, e.g. 231) E teeth rotated through more than 90° 3.83 H a permanent successor fails to develop, the corresponding deciduous molar will probably A be lost at the usual time B be lost earlier than normal € be retained until the third decade of life D be delayed in its eruption E submerge in later ife 3.84 WEIE are lost due to caries at 8 years in a crowded mouth, 515 will probably impact be outlocked buccally {ail to erupt be accidentally removed as the follicle of these teeth is embraced by the roots of the deciduous tooth be deflected palatally m com> 3.85 The prevalence of Class Il! malocclusion in British schoolchildren i A less than 20% B 25-35% © 35-40% D 40-50% E greater than 80% ce of Class Ill malocclusion in British A less than 1% B less than 2% © 3-5% D 510% E 10-15% (Answers overleaf!3.81 3.84 3.85 3.86 84 MCQs in Dentistry True False 3a7 few cases require this rarely evidence for tis 388 th apparent submerge of esined dsduous toot fs coused by the erustion of surrounding teeth. This compensatory eruption continues as 389 Tong av ine patent's fae fs growing. Once growth hae coased no further apparent submergence Seeure, Hence submergence is not seen i later fe {A False the preeruptive postion of the second premolar 8 False cnebles an unimpeded palatal path of eruption € False 5 False although this sometimes isthe case in the lower arch & Tue A 390 8 c D e \ A 8 c D e Orthodontics and children’s dentistry 85 ‘An incisor is said to be dilacerated when it ‘A bas a small crown B is misplaced and unorupted © has a sharply bent root D is inverted E jis impacted ‘The SNA SNB method of assessing antero-posterior skeletal relationship is unreliable because A point A ig not on basal bone B of the difficulty of determining the S point on the radiograph Tar acwount is taken of the width of the dental base Tn cases of incomplete overbite centric cannot be ‘guaranteed fhe angle ANB is affected by variation in facial form © D Fluoride-containing dentifrices Aare the most widely used means Used for caries prevention by which fluorides are B require calcium carbonate in the formulation to provide stability © have 2'declining level of available fluoride with the passage of time p have been shown on average to reduce caries incidence By 30% in controlled trials E have 2 purely local effect on the enamel with which the fluoride comes into contact Fluoride tablets ‘A when taken during pregnancy ‘aries resistance on the infant {anon taken by an infant have no adverse effects if gross overdose is avoided have occezionally lead to fatal overdose in infancy Ghould not be given in a dose greater than 0.25 mg fluoride per day up to the age of 6 months Psually contain 2.2 mg of sodium fluoride, the equivalent of ‘hg fluoride ion confer a useful degree of moo @ (answers overlesf)86 MCOs in Dentistry 3.87 A False False T™ e False moom> 3.88 True False mooa> 3.89 moo a> z 3.90 A False False False True True moo @ 2 very reliable landmark irrelevant to A/P assessment no less “guaranteed! then with any other occlusion the calcium carbonate binds to and inactivates fluoride infants especially probably swallow sufficient for the fluoride to have a systemic effect, the extra fluoride tends to be taken up by the maternal skeleton and does not appear to cross the placenta in useful amounts mottling has proved to be a complication of the earlier regimens that were suggested as far as is known, fluoride tablets have never caused fatalities in infants Orthodontics and children's dentistry 87 391 3.92 393 394 3.95 Water fluoridation A Fluoride was first detected in human enamel by Berzelius in 1805 B The association of mottled enamel with an excessively high fuoride level in the drinking water was conclusively established in the United States by Dean and McKay in 1939 © Statistical confirmation that caries experience was lower than average in high fluoride areas was provided by McKay in 1941 in the United States D The hypothesis that fluoride would make teeth more resistant to caries was put forward by Erhardt in 1874 E The first tril of artificial fluoridation of the water supply was initiated in Muskegan, Michigan in 1944 Fluoridation of water at a level of 1 part per million A is not associated with mottling of the teeth B iis available to about 25% of the population of Britain © reduces caries prevalence by 70% D has a greater caries-preventive effect on anterior teeth than fon molar pits and fissures E depends on OHSS decisions in Britain for implementation Chronic overdosage of fluoride from drinking water with a high natural level of fluoride ‘Avis most reliably indicated by mottling of the permanent teeth B does not cause mottling of the deciduous teeth € is not seen in Britain D leads to increased radiodensity of the skeleton E can lead to paraplegia For the prevention of dental caries A fluoride-containing dentifrices are of proven effectiveness B regular chlorhexidine mouthrinses are effective by virtue of their plaque inhibiting effect © application of fissure sealants is overall the most cost- effective method D vaccination against Strep. mutans is likely to replace all currently available methods E fluoride containing dentifrices were available in 1902 The caries-preventive effect of fluorides depends on A their incorporation uniformly throughout the enamel B their antibacterial effect on dental plaque © rendering enamel significantly less soluble in acid D promoting remineralisation of the early enamel lesion E lowering the pH of plaque (Answers overleaf)88 MCQs in Dentistry Orthodontics and children's dentistry 89 391 392 393 394 3.98 A True 8 True C False D True E False moow > C False mo True False False ° 0 o> False True False False Falco True mo om > False this was established by Ainsworth in Britain in 1933 Muskegan was the control town; Grand Rapids was the first to have artificial fluoridation as fluoride tablets in particular may be being taken 2s well itis only about 10% the reduction is approximately 50% the decision depends on local authorities where fluoride levels are exceptionally high (about 1 ppm) even the deciduous teeth can become mottled moderately severe mottling can still be seen particularly in Maldon (Essex), where the fluoride level was over 4 ppm, among older people as a result of bony exostoses pressing on the cord but only when fluoride levels are enormously high chlorhexidine does not reach stagnation areas; the sites of caries attack it is expensive and is only applicable to pit and fissure caries ‘or at least unlikely in view of the decreasing incidence of caries and the problems of convincingly establishing the safety of such ves really! fluoride tends to be concentrated in the surface enamel this has not been convincingly demonstrated at least tho offect doce not oom to be eufficiontly Strong to be significant (or at least this is probably the most widely accepted belief now this has not been convincingly demonstrated 396 397 3.98 3.99 3.100 Dental fluorosis can result from use of fluoride tablets is associated with increased resistance to caries if mild in severe, pitting, form, decreases resistance to caries was a common finding in Malden, Surrey is currently seen more frequently in immigrants fetracycline pigmentation of permanent teeth typically causes brownish grey discolouration develops between birth and 8 years can be bleached out can be recognised by yellow fluorescence under UV light is associated with staining of bone mona>a moow> Tooth discolouration A by chlorhexidine affects embrasures predominantly B in children by ‘black stain’ is associated with low caries prevalence © by tetracycline is maximal in the anterior teeth D is a recognised complication of excessive ingestion of Cola drinks E is a recognised complication of the use of strontium chloride dentifrices Which of the following statements regarding development of the dentition is true? A Calcification of all the deciduous teeth starts between 4 and 6 months in utero B Calcification of the permanent upper central incisors starts in utero © the permanent central incisor root is typically complete by 9 years D The permanent canines start to calcity at or very soon after birth E The root of the permanent canines is typically not complete before 12 to 14 years the case of pulpitis of a deciduous molar ‘subsequent interradicular periodontitis can damage the extraction is usually the most appropriate treatment Pulpotomy is rarely justified antibiotics should be given if the child has congenital heart disease E pulp dressings based on paraformaldehyde are obsolete vow >s (Answers overleaf)0. MC0s in Deniry Ondontie and chiens dents 81 396 A True 3.101 Delayed eruption of at least part of the dentition is a 8 True ! recognised feature of C True A rickets Dane wes in Malin, ame 8 Congenital nypertyriism & € cleidocranial dysplasia § cicero sercctinan tees 8 3.102 In the case of a Class Ill fracture of a central incisor in an 8 c year old boy e B pulpotomy should be carried out to allow root formation pao 398 A C immediate root filling is the most appropriate form of 8 management c D an antibiotic pulp dressing is likely to improve the chance e E a caicium hydroxide preparation is the preferred pulpal or 399 A 7 : 8 3.103 re impacted maxillary canine c in a 13 year old is best transplanted into the correct site ei oe aay etre crm nea rather than being moved orthodontically E B should not be approached with a posterior palatal creel Important causes of hypodontia include E Pelee B Down's syndrome 2.105. Which o the flowing tataments are tus? Cee an an aera nce bone in the (Answers overleaf!92 MCQs in Dentistry 3.101 3.102 3.103 3.104 3.105 True False True True False A 8 c D E a 8 c 5 E A 8 c . A 8 c D E A 8 c D ‘eruption is typically delayed in eretinism (congenital hypothyroidism) the prognosis after transplant as after orthodontic movement the blood supply is hazarded prognosis is better where the apex is open before transplantation n is not as good there is hyperdontia, but most teeth fail to erupt the mandible receives a blood supply from other sources, such as the periosteal membrane Orthodontics and children’s dentistry 93 3.108 3.107 3.108 3.109 3.110 ‘Which of the following are true? A The cartilage of the 1st branchial arch gives rise to the stapes, styloid process and part of the hyoid bone B The cartilage of the 2nd branchial arch gives rise to the incus and malleus © The cartilage of the 3rd branchial arch gives rise to the part of the hyoid The cartiage ofthe 4h, Sth and 6th branchial archos give rise to the manubrium sterni Which of the following are true? A The muscles of mastication and facial expression are first branchial arch derivatives B The external auditory meatus is derived from the first arch clef © The thymus and inferior parathyroids are third arch derivatives D The pulmonary artery and ductus arteriosus is the artery of the fifth branchial arch Chromosomal abnormalities are features of ‘A Down's syndrome (mongolism) B cleft lip/palate © haemophilia A most cases of chronic myeloid leukaemia E Turmer's syndrome (gonadal dysgenesis) Congenital cardiac disease A may produce central cyanosis. B_may cause finger clubbing © produces cyanosis if there is more than 5 g/dl reduced haemoglobin in the blood D may predispose to infective endocarditis E after cardiac surgery does not predispose to infective ‘endocarditis Which of the following statements is/are true? ‘A The karyotype of a normal female is 46 XY and that of a male 46 XX. 1B Down's syndrome has associated defects of many systems including the facial skeleton and dentition © A buccal smear is useful for the diagnosis of Down's syndrome as it shows the presence in squames of Barr bodies D Edward's syndrome is trisomy of chromosome 18 (Answers overleaf)94 MCQs in Dentistry Orthodontics and children’s dentistry 95 3.108 3.107 3.108 3.109 3.10 A vom moo @ False False True False True True False True False False True True True True True True False False True False True these are derivatives of the 2nd arch these are derivatives of the Ist arch these arch cartilages give rise to laryngeal cartilages. the muscles of facial expression are derivatives of the second arch the pulmonary artery and ductus arteriosus is the artery of the sixth branchial arch Down's syndrome is usually trisomy 21 There is usually a chromosome anomaly of chromosome 22 (Philadelphia chromosome) in chronic myeloid leukaemia Turner's syndrome is XO central cyanosis can also be caused by cardiovascular or respiratory disease (or ‘methaemoglobinaemia). Some congenital cardiac defects do not cause cyanosis finger clubbing can also be caused by, for ‘example, respiratory disease or malabsorption but the level of risk is minute in some types the risk of endocarditis may persist after cardiac surgery since defects may nat be completely rectified or foreign material may be inserted, However the risk of infective endocarditis can be removed in some cases, female karyotype is 46 XX, male is 48 XY Barr bodies are female sex chromatin aan a.n2 3.13 a4 3.115 3.116 ‘Typical features of Down's syndrome (mongolism) are ‘multiple immunodeficiencies severe caries but minimal periodontal disease susceptibility to infections ‘multiple missing teeth and malocclusion hepatitis B carriage in institutionalised patients he following diseases are usually sex-linked factor IX deficiency von Willebrand's disease chronic granulomatous disease ‘colour biindness achondroplasia moowry moow> ‘The following are more common in children than adults A African Burkitt's lymphoma B cherubism © dentigerous cysts D hand foot and mouth disease E progonoma (pigmented neuroectodermal tumour) Which show a greater incidence of Class ll occlusion than the general population? A patients with ectodermal dysplat B patients with cleft palate © achondroplasia D patients with fibrous dysplasia Cleft palate A may be submucous B is more common in males than females © predisposes to speech defects, orthodontic problems and hearing loss D patients are more likely to have cardiovascular defects, than the general population E patients should be managed by a team including orthodontist, surgeon and speech therapist Bilateral symmetrical swelling of the mandible in a child is likely to be caused by ‘A acromegaly B Paget's disease © giant cell lesions D primordial cysts E dental cysts (Answers overleaf}96 MCOs in Dentistry 3a 3.2 313 aaa ans 3.116 True False True True True mo o> True False mO0B> MOO@> OAB> mona> mooBD> the reverse is true respiratory, cutaneous and gastrointestinal infections ‘are common autosomal dominant autosomal dominant left palate is more commen in females cherubism 3an7 aa18 aa19 3.120 3.21 3422 323 Orthodontics and children’s dentistry 97 Patients with cerebral palsy A are predisposed to hepatitis B carriage B are characterised by siowness in learning to talk and by failure in interpersonal relationships © of the choreoathetoid type are usually also deaf D are also mentally handicapped Anhidrotic ectodermal dysplasia Is characterised by A scanty hair B hypodontia or anodontia © dry skin D blistering and scarring of epithelial surfaces E severe immunological defects Cherubism typically Ais inherited as a simple dominant B presents with symmetrical sweling of the jaws © regrosses after puberty D is distinguishable from a giant cell grenuloma histologically E resembles multilocular cysts on radiographs Cletts of the secondary palate A may be associated with heart defects B often cause defective speech © cause cleft lip D can involve both hard and soft palates E are more common in males Incisors which taper towards the incisal edge (peg shaped) typical of ‘congenital syphilis, rickets anhidrotic ectodermal dysplasia epidermolysis bullosa supernumerary teeth A 8 c D E Tooth eruption may be ‘A complete in the deciduous dentition by the age of 4 years B retarded in acromegaly impaired in cleidocrannial dysplasia D impaired because of thyroxine therapy E retarded in congenital hypothyroidism Eruption of teeth is typically delayed in A rickets, B cherubism © dentinogenesis imperfecta D cretinism E dentigerous cysts (Answers overleaf)98 MCQs in Dentistry 3.117 3.118 3.n9 3.120 3121 3.122 anza A False B False C True D moow> moow> moow> : moow> Z mooe> moow> : these are characteristics of autism ‘often caused by congenital rubella infection or kernicterus many patients with cerebral palsy are of normal of high intelligence although the frequency of mental handicap in patients with cerebral palsy is higher than in the general population 3.124 3.125 3.126 3.127 3.128 3.129 Orthodontics and children’s dentistry 99 ‘Amelogenesis imperfecta may result typically in hhypocaleified enamel scanty, irregular but well-calcified enamel different effects in male and female siblings condylar hypoplasia rampant caries mooo> Osteogenesis imperfecta A is a sex-linked disorder of bones that develop in cartilage in which the development of the skull vault is normal B manifests with blue sclerae which are pathognomonic of this disease © may be associated with deafness D has associations with amelogenesis imperfecta Vitamin D A deficiency in children causes rickets B is metabolised in the liver to the active 1,25- dinydroxycholecaleiferol (1,25-OHCC) € levels are high in green vegetables. D resistance is found in renal rickets because the kidney fails to metabolise it to 1,25 dihydroxycholecalcifero! Primary herpetic gingivo-stomatitis A is caused by herpes simplex virus (HSV) type 1 or type 2 B iis followed by herpes labialis in about 30% of cases is an increasingly common disease in children D shows ballooning degeneration of epithelial cell nuclei and giant cells in smears from lesions. E is accompained by a rising titre of serum antibodies against HSV Following facial trauma in children A. vitality tests of traumatised incisors are a good early method of deciding if the pulp has been damaged, significanthy B Any fractures of the facial skeleton rarely require fixation © blood loss may be significant D the possibilty of child abuse should be considered Concerning battered babies (child abuse) facial trauma is uncommon parent or sibling may be responsible ‘bused children are quickly brought for medical attention, careful documentation is mandatory ‘an ‘at risk’ register is kept by the local social services department moo> (Answers overleaf}100 MCQs in Dentistry Orthodontics and children’s dentistry 101 3.124 3.125 3.126 327 3.128 3.129 A 8 c 5 E A 8 c DB mon@> oo o> moom> 9 Om > True True True False False False False True this is achondroplasia, usually inherited in an autosomal dominant mode of inheritance several other conditions are associated with blue sclerae, and the latter are normal in early infancy from otosclerosis the association is between osteogenesis, imperfecta and dentinogenesis imperfecta although the liver metabolises vitamin D, it is the kidney that undertakes metabolism to 1,25-DHCC. but rarely type 2 the incidence has greatly declined in children early results are unreliable unlike adults who rarely lose a significant amount of blood from facial fractures there is often a delay in seeking medical attention 3.130 3.131 3.132 Haemophilia A A is about 10 times as common as Haemophilia B (Christmas disease) B and B are both sex-linked recessive traits is only found where there is a positive family history D patients with a factor Vill level above 25% may have litle ‘apparent bleeding tendency In children with leukaemi A the 5-year survival with treatment is now over 50% B gingival bleeding is common € platelet infusions should not be given before dental or oral surgery D infection with herpes viruses is common E cytotoxic agents may produce oral ulceration ‘Acute leukaemia in children A characteristically causes gross gingival swelling B may be manifested by mucosal pallor can cause obvious purpura D shows enlargement of the lymph nodes E iis usually lymphoblastic, (Answers overleaf)102 MCQs in Dentistry 3.130 A B c in only 65% of cases is a positive family history found D A B c platelet infusions may well be needed to ensure haemostasis > E A False this is particularly a feature of acute myelo- monocytic leukaemia, which typically affects adults 4 Periodontology an 42 43 44 4s ‘The primary cause of periodontal disease is: systemic disease vitamin deficiency plaque occlusal trauma ‘mouthbreathing moow> Gingi A invetably progresses to periodontitis B affects approximately 40% of adolescents G is characterised by true pocketing D iis evident on X-rays E is a reversible lesion The attached gingiva in disease ‘extends from the gingival margin to the base of the pocket extends from the gingival margin to the mucogingival junction extends from the level of the base of the pocket to the ‘mucogingival junction consists of non-keratinised epithelium Js of uniform width around the mouth 4a mo 9 o> he sulcular epithelium ‘extends from the gingival margin to the base of the clinical sulcus or pocket is keratinised is attached to the tooth surface contains no stratum spinosum extends from the base of the histological sulcus to the gingival margin moom > Junetional epithelium 4 ines the gingival sulcus B is permeable is derived initially from the outer enamel epithelium D iis attached to enamel by desmosomes. E is keratinised (Answers overleaf)104 MCQs in Dentistry Answers 4a 42 43 4a 45 moo @> moO A@> moom> moos > mone> False False True ‘no evidence, may modify but not a primary cause ‘no evidence but host factors affect the rate of tissue damage may modify but not the cause no firm evidence observed in almost all mouths the inflammatory swelling of gingivitis produces false pockets this is the definition of pocket depth includes gingiva adjacent to the pocket which is not attached keratinised varies in width only rarely does the probe tip stop at the coronal surface of the junctional epithelium. suleular epithelium inner enamel epithelium hemidesmosomes non-keratinised 46 47 48 49 410 an Periodontology 105 The junctional epithelium Ais attached to the tooth surface by hemidesmosomes. B is not adherent to the tooth surface © is not found at the base of a pocket D cannot reform after periodontal surgery E is keratinised Gingival collagen A is very susceptible to attack by all proteolytic enzymes B iis secreted as fibres © has a rapid rate of turnover D is predominantly Type 3 E jis predominantly Type 2 Tie periodontal igament [A derives its blood supply primarily from branches of vessels entering the pulp hhas a slow rate of turnover contains epithelial cells comprises primarily Type 2 collagen becomes wider around non-functional teeth moos Which of the following fibre groups a bone? A Transseptal B Oblique © Horizontal D Apical E Dentoperiosteal not attached to alveolar Which of the following are the predominant connective tissue cells of the periodontal ligament? A Fibroblasts B Rests of Malassez © Osteoblasts D Cementoblasts E Osteoclasts Comentum Ais derived from the Sheath of Hertwig B is acellular in the apical third of the tooth © often overlaps the enamel 1D does not contain collagen fibres E ceases formation once the tooth has erupted (Answers overleaf)the tooth has lost § mm of connective tissue attachment the tooth is likely tq be mobile the probe passes 5 mm beyond the cementoenamel junction the probe passes 5 mm beyond the gingival margin 106 MCOs in Dentistry Periodontology 107 46 A True 4.12 Gingival recession B False is firmly attached A is more likely to be found in a well maintained mouth than C False itis present at the base of all pockets, fone with periodontal disease D False B always implies the presence of chronic periodontal disease E False C is always associated with pocketing D requires the insertion of a graft a7 a only susceptible to certain proteolytic enzymes E is an important cause of tooth loss B fibre aggregation is an extracellular process c 4.13. Gingival recession is D Type 1 ‘A common in young children E Type 1 B always associated with gingival inflammation frequently caused by fraenal pull 4g A derives blood supply primarily from lateral wall of D more prevatent on buccal than palatal surfaces socket E frequently the result of orthodontic tooth movement 8 high turnover rate c rests of Malassez 4.14 Gingival swelling D Type 1 ‘A causes increased stippling of the attached gingiva E becomes narrower B isa side effect of occlusal trauma € is a side effect of sodium valproate therapy 49 8 attached to adjacent root surfaces not bone D is commonly the result of inflammatory oedema B attached to bone E jis associated with gingival recession c attached to bone D attached to bone 4.18 A false pocket E attached to bone Ais a feature of periodontitis, B has its base on the root surface 4.10 A © may be associated with bone loss 8 D iis associated with tooth mobility c E is a feature of gingivitis D E 4.16 A true pocket is diagnosed when ‘A bone loss is evident on radiographs ana dental follicle B probing elicits bleeding 8 cellular © the base of the pocket is apical to the cementoenamel c junction D intrinsic and extrinsic fibres D the probing depth is 4 mm E vital tissue E pus is oxpressed on applying gentle pressure 4.17 A pocket depth of 5 mm means that B c D E the patient has periodontitis, (Answers overleaf)108 MCOs in Dentistry Periodontology 109 42 413 ana 46 436 4a7 moom > moow> moom> moow > moo @ > mo om > True False False False False False True False False False False False True False False True False False False False False True False not always by any means recession often prevents pocket formation rarely ‘no evidence gingivae often not inflamed fo evidence — secandary factor ‘except in fibrous hyperplasia, particularly phenytoin-induced no evidence no evidence false pockets are typical of gingivitis or gingival hyperplasia by definition it has not progressed on to the root surface unless periodontitis is associated unusual — occasionally in pregnancy ‘not necessarily — pocketing may have been eliminated by treatment may not bleed the pocket may be false with no loss of attachment not necessarily pocket depth is measured from the gingival margin and provides no indication of attachment loss not necessarily only if gingival margin located at cementoenamel Junction not necessarily — could be false pocketing 439 420 42 az 423 424 Radiography will show depth of periodontal pocketing presence of bone loss alveolar fenestration alveolar dehiscence periodontal disease activity gingival index score of 1 means that the gingivae are clinically healthy probing elicits bleeding probing does not elicit bleeding there is spontaneous bleeding there is no colour change dehiscence is 9 circumscribed defect of alveolar bone is more likely to affect teeth with prominent roots hhas no influence on disease progress is most likely to be associated with lower premolars is commonly traumatic in origin \brasion lesions are caused by acid regurgitation are caused by toothbrushing must always be restored are more common on lingual/palatal surfaces than buccal and labial surfaces fre @ common cause of tooth loss m GOm>D moouEy moom>> moomD The predominant bacteria in 2 day old supragingival plaque A Streptococci B Actinomyces © Bacteroides E Filamentous bacteria E Fusiforms. Supragingival plaque can be dislodged with a water spray contains 2 > 10° microorgonisme per gram wet weight forms only in the presence of food consists initially of lactobacilli begins to form within minutes of a tooth being cleaned moou> ‘Supragingival calculus ‘may be mechanically irritating to the gingiva derives its mineral content from saliva forms more readily in an acid environment is randomly distributed around the mouth only forms after the onset of disease moow> (Answers overteat)