1.

What is the chromium and cobalt composition of the stainless steel used in the manufacture
Of orthodontic brackets and archwires?
a) 18% chromium and 8% nickel
b) 80% chromium and 20% nickel
c) 8% chromium and 18% nickel
d) 20% chromium and 80% nickel
e) 50% chromium and 50% nickel

2. You have just completed orthodontic treatment involving fixed appliances for 2-year-old boy.
At the debond you noticed some areas of decalcification on the upper lateral incisors. What is
the most appropriate next step in the management of this patient?
a) advise brushing with a 1000 parts per million fluoride toothpaste.
b) advise brushing with a high fluoride toothpaste.
c) advise use of a high fluoride mouthwash.
d) apply fluoride varnish to the areas of decalcification.
e) use an acid and pumice slurry to polish the lesions.

3. This 24 -year-old female attends for assessment. She is in pain and you observe several small
ulcer on her lower lip (pictured below). These have been present for seven days. She has no
relevant medical history, but she has suffered from ulcers similar to these in the picture. What
impact will these ulcers have on the orthodontic management of this patient?
a) no impact - orthodontic treatment can be commenced immediately.
b) orthodontic treatment can be offered once antiviral therapy has been successful in
healing the ulcers.
c) orthodontic treatment can be offered once the ulcers are healed but recurrence is probable,
and the patient use a salicylic acid gel e.g. Bonjela prophylactically prior to bond up.
d) orthodontic treatment can be offered once the ulcers are healed but recurrence is probable,
and steps should be taken to minimise soft tissue trauma with the appliance.
e) orthodontic treatment cannot be offered.
4. An Il-year-old girl presents with a history of severe nickel hypersensitivity. She is keen to go
ahead with fixed appliance treatment. Which bracket and aligning archwire combination is least
likely to cause nickel hypersensitivity reaction?
a. stainless steel brackets/ nickel titanium archwire
b. stainless steel brackets/ braided stainless steel archwire
c. ceramic brackets/ nickel titanium archwire
d. ceramic brackets/ braided stainless steel archwire
e. ceramic brackets/ TMA
5. A patient attends for orthodontic review with her grandfather. During the appointment you
notice that her grandfather has become very pale and is gripping onto his left arm and chest. On
questioning he becomes very agitated and short of breath and collapses onto the surgery floor.
At this point you assess the area and call for help. You move the grandfather and lay him on his
back, he is not breathing, and you cannot detect a pulse. Your nurse runs to the receptionist to
ask her to call for an ambulance. What is the most urgent next step in the management of the
grandfather?
a) give him 300mg of Aspirin.
b) give two rescue breaths via mouth-to- mouth or mouth-to-nose.
c) give two rescue breaths with a bag and mask.
d) administer oxygen through a mask.
e) start chest compressions.

6. You see this 12-year-old girl for assessment. The swelling on the left side of her lower lip is 6mm
in diameter and fluctuant. It appeared 2 months ago after she bit her lip. What is the most
appropriate next step in the management of this child?
a) no intervention, it should spontaneously resolve within 5 days.
b) ask the patient to leave her lower appliance out for 5 days and review.
c) ask the patient to "pop" the swelling with a pin.
d) Non-urgent referral for removal of the swelling and associated salivary gland.
e) urgent referral for biopsy.
7. This 19-year-old female is nearing the end of fixed appliance treatment to correct her crowded
Class I malocclusion. She has an upper 0.017X 0.025" stainless steel archwire in place. What
movement is the archwire bend associated with the upper left central incisor most likely to
achieve?
a) mesial root movement
b) distal root movement
c) palatal root movement
d) labial root movement
e) in-out correction

8. Protocols are essential for good infection control and maintenance of equipment. Which is the
most appropriate additional step to take when sterilizing an air turbine (high speed handpiece)
compared to orthodontic pliers?
a) physically clean
b) lubricate
c) place in an ultrasonic
d) place in sterilization bag
e) use a Type B autoclave
9. 13-year-old girl presents with an un-erupted, impacted upper right permanent canine. She has
agreed to have fixed appliance treatment with the extraction of the upper right deciduous canine
and minor oral surgery to facilitate bringing the permanent canine into its correct position. What
is the most appropriate minor oral surgery procedure?
a) open exposure through unattached mucosa.
b) closed exposure with a bracket and gold chain being bonded to the labial surface of the
unerupted canine.
c) closed exposure with a bracket and gold chain being bonded to the
labial surface of the unerupted canine.
d) labial, split thickness muco-periosteal apically repositioned flap.
e) labial, full thickness muco-periosteal apically repositioned flap.

10. You are planning treatment for this 17-year-old girl. You consider extraction of upper first
premolars and camouflage of her Class Il malocclusion with upper and lower fixed appliances.
However, you have concerns about reducing her overbite. What is the most likely impact of
incomplete overbite reduction?
a) difficulty levelling and aligning the arches.
b) difficulty closing spaces.
c) excessive proclination of the upper incisors.
d) retroclination of the lower incisors.
e) difficulty in achieving good buccal segment interdigitation.

11. This 16-year-old boy has cleidocranial dysplasia and is being managed using a joint surgical and
orthodontic approach. The patient underwent surgery to remove retained deciduous teeth and
supernumerary teeth 6 months ago. Gold chains were bonded to the unerupted teeth at the
same time. What lower archwire is most appropriate at this stage of treatment with this method
of management?
a) 0.018" stainless steel
b) 0.019x 0.025" stainless steel
c) 0.018" nickel titanium
d) 0.019x 0.025" nickel titanium
e) 0.016x 0.022" nickel titanium

12. What is the most appropriate frequency for initiating the free radical polymerisation of a composite
bonding agent?
a) 120 - 200 nanometres
b) 240 - 300 nanometres
c) 360 - 400 nanometres
d) 480 - 540 nanometres
e) 600 - 720 nanometres
13. This 14-year-old girl attends for assessment. She has a Class Il division 2 malocclusion with
reasonably well aligned arches (with the exception of the lower left 2nd premolar which is
clinically missing). The space between the lower left first premolar and first permanent molar is
5mm. You take the following radiograph. What is the most appropriate plan for management
this girl?
a) monitor further development for six months
b) surgical removal of the deciduous molar, open exposure of the lower left 2nd premolar
wait for eruption
c) surgical removal of the deciduous molar followed by orthodontic treatment to make th
space for eruption of the lower left 2nd premolar
d) surgical removal of the deciduous molar, closed exposure of the lower left 2nd premolar
with bonded gold chain followed by orthodontic treatment
e) surgical removal of the deciduous molar and lower left 2nd premolar

14. This 14-year-old girl attends for assessment. She has non-painful marks on her tongue (pictured
below). She has had these as long as she can remember and occasionally her tongue is tender
on spicy foods. She has no relevant medical history. You hope to carry out fixed appliance
treatment to correct her malocclusion. What is the most appropriate plan for management f this
patient and how will the condition affect her orthodontic treatment?

a) reassurance, the lesions will not affect her orthodontic treatment

b) reassurance, Oral hygiene instruction and chlorhexidine mouthwash twice daily. Review
in seven days but onward referral if no improvement. The lesions will not affect her
orthodontic treatment.
c) reassurance, Oral hygiene instruction and chlorhexidine mouthwash twice daily. Review
in seven days but onward referral if no improvement. Orthodontic treatment cannot be
started until the condition has cleared
d) immediate onward referral for patch testing as suspected nickel allergy. Orthodontic
treatment with Nickel containing archwires is contraindicated
e) immediate onward referral for biopsy. Orthodontic treatment cannot be started until
the condition has responded successfully to treatment

15. This 12-year-old boy is in the late mixed dentition. He traumatised both upper centrals and the
upper right lateral incisor approximately 24 hours ago. The posterior occlusion is Class I and there
is mild upper and lower crowding. On examination the coronal fragment of the upper right lateral
incisor is extremely mobile and not amenable to splinting. Together with arranging restoration of
the upper right central incisor tooth, what is the most appropriate plan f immediate management
of this patient?

A) extract the upper right lateral incisor and defer orthodontic planning until the patient the full
permanent dentition
 B) extract the upper right lateral incisor and place a fixed appliance to close the upper
right incisor space
C) extract the coronal section of the upper right lateral incisor. Place an upper fixed
appliance using the coronal section of the tooth as a pontic on the archwire. Leave in
place until the patient is in the full permanent dentition
D) extract the coronal section of the upper right lateral incisor and close the wound.
Provide an upper space maintainer and defer orthodontic planning until the patient
in full permanent dentition.
E) extract the coronal section of the upper right lateral incisor and close the wound and
defer orthodontic planning until the patient in full permanent dentition.

16. A 9-year-old boy attends to start orthodontic treatment. He has a unilateral posterior
crossbite on the right side with a displacement on closure. Your lab has constructed a quad
helix appliance, which you will now fit. What is the most appropriate way to activate the
appliance before cementation?
a) expand by 1/4 molar width on the right side
b) expand by 1/4 molar width bilaterally
c) expand by 1/2 molar width on the right side
d) expand by 1/2 molar width on the left side
e) expand by 1/2 molar width bilaterally

17. A 50-year-old man attends with a sore mouth. He has recently had a deep venous thrombosis
and is taking warfarin. He completed orthodontic treatment 9 months previously and has
been wearing a Hawley retainer full time since debond. He attended his dentist 1 week ago
with a sore mouth; his dentist diagnosed oral candidiasis and prescribed miconazole gel
(Daktarin). Today you noticed bruising on his hands and face and on questioning he has had
several nosebleeds over the last few days. What is the most appropriate next step in the
management of this patient?
a) ask the patient to only wear the Hawley retainer at night times
b) replace his Hawley retainer with a vacuum formed retainer
c) replace his Hawley retainer with a bonded retainer
d) advise the patient to stop using the miconazole gel and see his doctora
e) advise the patient to stop taking his warfarin and see his doctor
18. You are planning a short course of sectional appliance to align an instanding maxillary incisor.
The patient has learning disabilities. They have previously struggled to maintain a good
standard of oral health and has some demineralisation present. However, with the help of
their carer, they have recently demonstrated good oral hygiene suitable for a fixed
appliance. What is the most important benefit of using glass ionomer cement in this patient?
a) direct adherence to bracket
b) command setting
c) leaching of fluoride ions
d) lack of moisture sensitivity
e) high bond strength
19. You have just removed fixed appliances for this 16-year-old boy:
You have advised the patient to clean with a 1450 ppm fluoride toothpaste. What additional
intervention is most appropriate at this time?
a) Use a casein phospho-peptide amorphous calcium phosphate mouthwash daily
b) brush with a casein phospho-peptide amorphous calcium phosphate paste in the morning
c) brush with a casein phospho-peptide amorphous calcium phosphate paste at bedtime
d) Rub a casein phospho-peptide amorphous calcium phosphate paste onto the teeth
before brushing
e) (Rub'p casein phospho-peptide amorphous calcium phosphate paste onto the teeth after)
brushing

20. A 12-year-old girl with moderate learning disabilities attends to have a fixed appliance fitted.
You have planned to bond her upper incisors and canines only; if she tolerates this you will
bond the rest of her upper arch at the next visit. Following every clinical step she has
cooperated and followed your instructions you praise her. At the end of her visit when she
has successfully had the appliance fitted on her anterior teeth, she is rewarded with a sticker.
Which of the following best describes the behavior management technique you have used
at this visit?
a) desensitisation
b) distraction
c) positive reinforcement
d) modelling
e) tell-show-do
21. This patient has pre-adjusted edgewise appliances with 0.022" slot. What is the most likely
reason for placement of the archwire bends shown in this patient?
a) to achieve differential intrusion of the upper incisors
b) to achieve differential extrusion of the upper incisors
c) to overcome fictional forces when space closure is slow
d) to allow simultaneous use of Class Il elastics during space closure
e) to maintain incisor torque during space closure
 22. This 7-year-old boy attends for assessment. His mother is concerned about the appearance
of his upper first permanent molar (pictured):
He has intermittent severe pain from the tooth, particularly with cold, but also with sweet foods
and drinks. An orthopantomogram shows the upper right second permanent molar to be present,
but root development has not yet started. There is no upper right third molar. What is the most
appropriate next step in the management of this patient?
A) to review in 6 months and re-x-ray (with a view to extraction of this tooth when the
bifurcation of the second molar is forming)
B) to review in 12 months and re x-ray (with a view to extraction of this tooth when the
bifurcation of the second molar is forming)
C) to ask the dentist to restore the tooth with a composite resin restoration
D) to ask the dentist to restore the tooth with a gold crown
E) to arrange for immediate extraction of the upper right first permanent molar

23. This 9-year-old boy is referred for assessment. His parents are very keen for him to have
treatment as soon as possible. You agree that interceptive treatment is appropriate and plan
to use a sectional fixed appliance to correct the anterior crossbite. What is the most important
factor in determining the likely success of treatment at this stage?
A) his motivation towards treatment
B) the presence of sufficient permanent teeth to retain the appliance
C) the severity of underlying skeletal pattern
D) his ability to achieve edge-to-edge incisors
E) the presence of an overbite

24. A 9-year-old boy attends for assessment. He is in the mixed dentition with permanent
incisors and first molars erupted. His dentist discovered an unerupted inverted mesiodens on
an occlusal radiograph. He has a crowded Class Il div 1 malocclusion and in the longer term he
will require extractions and fixed appliance treatment to correct this; however, it is too early
to get started on treatment. He is a nervous dental patient and his mother does not feel he
will be able to tolerate treatment under local anesthetic. What is the most appropriate plan
for the immediate management of this patient?
A) monitor
B) wait for the mesiodens to erupt and extract it on eruption
C) arrange for surgical removal of the mesiodens under local anesthetic with inhalation
ssedatio
D) arrange for surgical removal of the mesiodens under local anesthetic with intravenous
sedation
E) arrange for surgical removal of the mesiodens under general anesthetic
25. This patient has pre-adjusted edgewise appliances with 0.022" slot. What is the most appropriate
material for the archwire shown?
a) nickel titanium
b) heat activated nickel titanium
c) stainless steel
d) elgiloy
e) beta titanium (TMA)

26. Alginate consists of various ingredients which regulates its properties to make it a suitable material to
make impressions which are accurate to fabricate orthodontic appliances. Which ingredient
contributes to the extended working time?
a) ammonium salts
b) diatomaceous earth
c) potassium alginate
d) potassium sulphate
e) sodium phosphate

27. A 52-year-old lady attends for assessment. She has a Class Il div 2 malocclusion with a deep
overbite. she requests tooth-colored braces. Her medical history includes a nickel allergy;
however, she is able to tolerate contact with stainless steel in her everyday life. You plan upper
and lower fixed appliance treatment but do not want to place ceramic brackets on the lower
teeth because of the risk of enamel wear. Which combination of brackets and wires would you
use at the start of treatment to ensure the lowest possible chance of any hypersensitivity
reaction whilst ensuring adequate tooth alignment?
a) upper and lower stainless steel brackets; 0.016" nickel titanium wires
b) upper and lower stainless steel brackets; 0.016" teflon-coated nickel titanium wires
c) upper ceramic brackets and lower stainless steel brackets; 0.016" nickel titanium wires
d) upper ceramic brackets and lower stainless steel brackets; 0.015" teflon-coated nickel
titanium wires
e) upper ceramic brackets and lower titanium brackets; 0.015" braided stainless steel wires

28. What interceptive measure is most appropriate in this patient at this time?
a) extraction of both deciduous upper lateral incisor teeth
b) extraction of the midline supernumerary tooth
c) extraction of the lower left first deciduous molar tooth
d) extraction of both lower second deciduous molar teeth
e) reduction of width of both lower second deciduous molar teeth
29. A patient attend with a loose molar band. You fitted upper and lower fixed
appliances one month ago using a conventional glass ionomer cement for cementation
of the molar bands.They have a Class I incisor relationship and a lateral open bite on the
side where the molar band is loose. On examination, there is adhesive on the tooth and
none in the band. What is the most likely cause for this?
a. high proportion of aprismatic enamel
b. moisture contamination during setting
c. low liquid to powder ratio
d. traumatic bite
e. incomplete cure of adhesive

30. You are asked to see this newborn child who has been diagnosed with
Pierre-Robin Sequence. What intraoral feature are you most likely to see?
a) tongue tie
b) neonatal teeth
c) alveolar notching
d) Small tongue
e) Cleft palate

31. You are planning orthodontic treatment to correct a unilateral crossbite in a

12-year-old boy. Your options include conventional expansion with a quad
helix appliance or rapid maxillary expansion (RME) with a Hyrax appliance.
When considering relapse which of the following statements most
accurately describes the post expansion changes which are most likely to
occur?
a) similar degrees of relapse can be expected for both methods of expansion
b) relapse will be greater using RME than the quad helix
c) relapse will be greater using the quad helix than the RME
d) relapse will be greater with the RME if the expansion was carried out (2 turns per
day)
e) relapse will be greater with the RME if the expansion was carried more (1 turn
every two days)

32. A 13-year-old girl attends three days after having her fixed appliance fitted. She has
intra-oral signs and symptoms of a mild hypersensitivity reaction. She has stainless steel
brackets and nickel titanium aligning archwires in place. What is the most appropriate
next step in the management of this patient?
a) reassure and review in one week
b) reassure, but send the patient to their GP for patch testing
c) remove the nickel titanium archwires and replace with TMA archwires
d) prescribe antihistamines
e) debond the appliance and cease treatment
33. A 16-year-old girl with Down's syndrome attends to have her fixed appliances placed. She has a
high saliva flow rate. In addition, she has large tongue which she struggles to keep away from her
teeth. Which orthodontic adhesive is most appropriate for this patient?
A) chemical cured composite
B) conventional Glass Ionomer
C) light-cured composite
D) acrylic cement
E) light-cured Glass Ionomer

34. Presuming the optimal force levels are being used, in which of the following options is anchorage
loss most likely to occur?
a) tipping upper incisors on an 0.018" stainless steel wire
b) bodily movement of upper incisors on a 0.019 x 0.025" stainless steel wire
c) intruding upper incisors with a 0.014" nickel titanium wire
d) extruding upper incisors with a 0.014" nickel titanium wire
e) de-rotating incisors on an 0.014" nickel titanium wire

35. This 13-year-old boy is in the alignment phase of fixed appliance treatment. You notice that there
is a positioning error of the bracket on the upper right central incisor tooth. What is the most
appropriate way to manage this problem?
a. no management necessary, the positioning error is not significant enough to
warrant action
b. reposition the bracket as soon as possible
c. reposition bracket once the overbite has been fully reduced
d. place a corrective bend in this 19 x 25 nickel titanium archwire
e. Plan for a Hawley retainer and allow the tooth to settle during
retention

36. An 11 -year-old boy attends for assessment. He is missing six permanent teeth. In addition,
he has sparse hair and missing eyebrows. What condition is he most likely to have?
a) Down's syndrome
b) dentinogenesis imperfecta
c) ectodermal dysplasia
d) epidermolysis bullosa
e) Gardner syndrome
37. You are in the finishing stages of an orthodontic treatment which required extractions; all
spaces are closed. You have used a 0.022x 0.028" slot pre-adjusted edgewise bracket
system. You choose a 0.021x0.025 beta titanium alloy archwire as you require third order
expression of the bracket prescription at this finishing stage. What property of this wire is
of greatest value to you in this situation?
a. high friction
b. good formability
c. low modulus of elasticity
d. low range
e. immediate force delivery
38. You see this 9-year-old boy for assessment. As well as the features pictured, he has dry
skin. Which intraoral feature is this patient most likely to display?
a) hypoplastic enamel
b) hypodontia
c) taurodontism
d) impacted teeth
e) osteomas

39. You are carrying out upper arch alignment for this patient using a preadjusted edgewise
bracket system. The patient attends as an emergency having debonded the brackets on
the upper centrals and upper left lateral incisor teeth. This is the third time the brackets
have come off since the appliance was fitted three months ago. What is the most
appropriate next step in rebonding brackets to these teeth?
A) use al self-etch primer and a two paste composite
B) use a short etch time and short wash
C) use a self-etch primer and light cured composite resin
D) use acidulated flourophoshate (AFP)
E) use an adhesion promoter e.g. Scotchbond

40. You see this 5-year-old girl for assessment. She fell at home three days ago and knocked
her face on a step. She has lost her upper left deciduous central incisor tooth to etherwith
a segment of alveolar bone. You take the following radiograph:
What is the most appropriate next step in the management of this child?
a) no intervention, observation only
b) extraction of the upper right deciduous central incisor tooth
c) a sectional fixed appliance on the remaining upper deciduous incisors to hold left central
incisor region.
d) open exposure of the upper left central incisor with an apically repositioned flap
e) closed exposure of the upper left central incisor tooth and apply traction via a gold chain
 41. You see this 7-year-old boy for assessment. His dentist is concerned because his upper first
molars have not come through. He has good oral health and is following his dentist's
instructions to clean the visible parts of the upper 6 1 s with an interspace brush. He is
cooperative at examination, but his mum informs you that he is unlikely to accept
treatment under local anesthetic. What is the most appropriate next step in the
management of this bo ?
a. to monitor in six months' time i need a picture to answer
b. to refer for fissure sealant of visible parts d the upper first molars
c. to ask the dentist to attempt extraction d both upper second deciduous molars under
loca anesthetic
d. to refer the patient for extraction of both upper second deciduous molars under general
anesthetic
e. to fit a sectional fixed appliance to distalise and upright the first permanent molar teeth

42. A 16-year-old girl with a known and documented latex allergy attends for placement of
fixed appliances. What is the most important provision to make to ensure the safe delivery of
treatment for this patient?
a. ensure that 1:1000 adrenaline is available for administration if required
b. ensure that the patient takes antihistamine medication one hour prior to the appointment
c. ensure the presence of a medically qualified member of staff
d. offer the patient an appointment at the end of the clinical session
e. use natural rubber gloves

43. What is the most likely dental history of this 12-year-old child?

a. avulsion of the upper central incisor teeth at age of 7

b. severe root resorption of the upper central incisors following luxation at age of 7
c. amelogenesis imperfecta
d. ectodermal dysplasia
e. impaction of the upper central incisors due to supernumerary teeth

44. You are preparing to fit an orthodontic band using glass ionomer cement. Together
with fluoride salts, what is the most common component of the powder in the cement?
a. sodium alumino-silicate
b. Calcium alumino-silicate
c. aluminium calcium-silicate
d. calcium sodium-silicate
e. aluminium sodium-silicate
45. You are asked to assess a new index of assessment of orthodontic treatment need.
Which of the following options will provide the best test of its reliabjUty?
a. ask the same orthodontist to score the same patient three times on the same day
b. ask the same orthodontist to score the same patient on three separate occasions each two
weeks apart
c. ask the same orthodontist to score several patients at the same time
d. ask several orthodontists to score the same patient at the same time
e. ask several orthodontists to score the same patient at different times

46. You see a 12-year-old boy to start orthodontic treatment. You will commence
treatment with a quad helix appliance. What diameter of stainless steel is most appropriate
for construction of the quad helix?
a. 0.5mm
b. 0.7mm
c. 0.9mm
d. 1.1mm
e. 1.3mm

47. You have recently instructed a 13-year-old girl on the use of Class Il elastics with her fixed
appliances. She contacts you as she is in severe discomfort; her jaw joint is clicking and
painful and is made worse by the elastics. What is the most appropriate next step in the
management of this patient?
a) advise her to: stop wearing the elastics; exercise the jaw joint by stretching the
muscles; and take paracetamol
b) advise her to: stop wearing the elastics; rest the jaw joint and avoid wide opening;
and take a non-steroidal anti inflammatory
c) advise her to: continue wearing the elastics; exercise the jaw joint by stretching the muscles; and
take paracetamol
d) Advise her to continue wearing the elastics; exercise the jaw joint by stretching the muscles; and
take a non-steroidal anti inflammatory
e) advise her to: continue wearing the elastics; rest the jaw joint and avoid wide opening; and take
paracetamol
48. This 15-year-old girl is referred to you for assessment. She has an overjet of 11 mm. Your
clinical impression is of marked Class Il skeletal pattern. You take this lateral cephalogram
and trace it by hand, then carry out an Eastman analysis. Since the SNA is below average,
you decide to apply the Eastman correction. After correction, the ANB still does not reflect
your clinical impression. What is the most appropriate next step?
a. Re-trace the cephalogram using a digitiser since this will give more
reliable measurements
b. base your treatment planning solely on your clinical judgement
c. base your treatment planning solely on the cephalometric findings
d. use a Bolton's template superimposed on the SN plane at nasion
e. use a Wits analysis
49. You have debonded a patient's fixed appliances; you plan to provide vacuum formed
retainers. Unfortunately, It is too late to cast the impressions today and as it is the weekend,
your dental laboratory will be unable to do so for 48 hours. You have access to both
conventional and extended-storage alginates. What material and storage protocol will
allow greatest dimensional stability of the impressions?
a) conventional alginate, wrapped in wet gauze, stored at room temperature
b) conventional alginate, wrapped in wet gauze, refrigerated
c) extended-storage alginate, stored at room temperature
d) extended-storage alginate, refrigerated
e) extended-storage alginate, immersed in water
50. You are carrying out an audit of the quality of photographs taken within your training unit.
Whilst auditing one clinician's digital images you observe several photographs which look
like this. What is the important step this clinician needs to make to improve the quality of
his/her intraoral images?
a) use a higher F stop to prevent overexposure
b) using lower F stop to prevent underexposure
c) improve the background lighting
d) to move closer to the patient
e) To use the automatic rather than manual focus setting

51. This 10-year-old girl attends for assessment. Her presenting complaint is a crossbite of the
upper left lateral incisor. She has facial asymmetry with increased growth of the left side of
the mandible. You take the following orthopantomogram. Which dental feature needs most
urgent investigation at this point?
a. her crossbite
b. her ectopic teeth
c. her hypodontia
d. Her asymmetry
e. Her crowding
52. You see this 14-year-old girl for placement of pre-adjusted ed ewise fixed appliances with
an MBT prescription in both upper and lower arches. Which of the following modifications
is most appropriate at this visit?
a) Reduction of upper canine tips, to ensure bracket placement at the correct height
b) swapping of the upper canine brackets from right to left and vice versa inversion of
the upper canine brackets
d) placement of upper lateral incisor bracket on the upper canines
e) placement of the upper first premolar bracket more mesially to achieve slight rotation

This 12-year-old girl attends for assessment. Her dentist is concerned about her partially
erupted lower left second molar tooth. on examination, she has a Class I malocclusion with
moderate upper and lower arch crowding. Ideally, you would correct her malocclusion through
extraction of four premolar teeth and fixed appliances. What is the most appropriate
extraction pattern taking into account her lower left second molar tooth?

a. extraction of the premolars only

b. extraction of the premolars and the lower left second molar
c. extraction of the premolars and the lower left first molar
d. extraction of the premolars and the lower left third molar
e. extract the premolars except in the the lower left quadrant where the I
werfeftsecond molar will be removed instead

53. You are approached by a maxillofacial colleague. He is having problems with bond failures
of the button and gold chain placed during the closed exposure of canines. His protocol is:
• Etch with 37% phosphoric acid for 30 seconds
• Wash for 30 seconds
• Apply bond and light cure for 5 seconds
• Apply chemically cured composite
What change in his protocol is most likely do his bond failure rate?
a. etch for 15 seconds
b. wash for 15 seconds
c. do not use the bond
d. do not light cure the bond
e. use light cured composite
55. This 7-year-old boy has a displacement on closure. what is the most important reason f
carrying out treatment for him at this time?
a) To improve aaesthetic
b) To prevent proclination and periodontal attachment loss of his lower left central incis r tooth
c) to prevent the future development of temporomandibular joint dysfunction
d) to make sufficient space for eruption d the lower left lateral incisor
e) to maintain arch symmetry, avoiding the need for orthodontic treatment in the full
permanent dentition

56. A 32-year-old man had orthognathic surgery one year ago. He had a maxillary
impaction and mandibular advancement osteotomy to correct his high angle Class Il
skeletal problem. Following surgery there has been an increase in his overjet and you feel
there may have been some post-surgical relapse. You have two cephalometric
radiographs; one taken two days postoperatively and one taken today. You plan to
superimpose the two radiographs to assess changes in his mandibular position in the last
twelve months. where is the most appropriate place to superimpose the two radiographs?
a) the Sella- Nasion line
b) the follicle of the lower third molar
c) the inferior dental canal
d) the inner surface of the frontal bone
e) the palatal plane
57. What is the principal mechanism of adhesion of glass ionomer cements to dental structures?
a) covalent bonds
b) hydrogen bonds 1-2
c) mechanical locking
d) micro retention in porosities in the enamel
e) calcium phosphate polyalkenoate bonds
58. You have taken a lateral cephalometric radiograph for a 12-year-old girl. She has a Class Il
division 1 incisor relationship on a moderate Class Il skeletal base. On measurement her ANB
is 4 degrees, which does not fit with your clinical impression of a moderate Class Il skeletal
pattern. You are unable to carry out an Eastman correction because her Sella-
Nasion/Maxillary Plane angle is not within a normal range. Which additional cephalometric
assessment will be of most value to you in assessing the severity of her antero-posterior
skeletal discrepancy?
a. Steiner Analysis
b. Sassouni Analysis
c. Wits Analysis
d. Pitchfork Analysis
e. Functional Occlusal Plane Analysis
59. A 27-year-old female patient presents with a three dimensional enlargement of the right side of
the mandible in comparison with the left. Clinically there is a cant in the occlusal plane and
a lateral open bite. What is the most likely diagnosis?
a. hemi-mandibular elongation
b. hemi-mandibular hyperplasia
c. condylar hyperplasia
d. hemifacial microsomia
e. condylar resorption

60. A 9-year-old girl attends for 6 monthly review of her anterior openbite caused by
thumbsucking. There has been no change in her malocclusion, she has an 8mm overjet and
5mm anterior openbite. She is still in the mixed dentition with proclined maxillary
permanent incisors, a unilateral buccal crossbite with mandibular displacement on closure.
You previously explained to the patient the link between her malocclusion and her
thumbsucking habit. Her mother has placed sticking plasters and bitter tasting nail varnish
on the thumb she sucks. They have also tried a reward chart. what is the most appropriate
next step in the management of this patient?
a. discharge the patient and ask her dentist to re-refer when she is in the full permanent
dentition
b. advise to persist with the plasters and nail varnish and review in 6 months
c. provide a "habit breaker" orthodontic appliance
d. place a sectional fixed appliance on the upper incisors to retrocline them
e. place a quad helix appliance to expand the upper arch

61. You fitted a twin block functional appliance for a 13-year-old girl two days ago. She contacts
you as she is in severe discomfort; one of the Adams clasps is catching on the gingival tissues
of a lower molar. You are unable to offer her an appointment until tomorrow. What is the
most appropriate next step in the management of this patient?
a. advise her to use wax and persevere with the brace until you can see her tomorrow
b. advise her to use of bonjela and persevere with the brace until you can see her
tomorrow
c. advise non-steroidal anti-inflammatories and persevere with the brace until you can
see her tomorrow
d. advise her to remove the lower appliance for 24 hours, try again with the appliance
tomorrow and contact you if it still uncomfortable
e. advise her to remove both appliances until you can see her tomorrow
 62. A 9-year-old boy attends for assessment. At age 2 he underwent radiotherapy treatment
for a tumor in his left parotid gland. What dental feature are you most likely to observe?
a. hypoplastic enamel on occlusal surface of the upper left first permanent molar tooth
b. infraocclusion of the upper left first permanent molar tooth
c. arrested root development of the upper left first permanent molar tooth
d. submergence of the upper left second deciduous molar tooth
e. absence of the upper left third molar tooth

63. Prior to commencing orthodontic treatment you notice on the pre-treatment

orthopantomogram that the patient has upper incisor roots which are "pipette" shaped. As a
precaution 6 months into treatment you take the following radiograph. What is the appropriate
plan for immediate management of this patient?
a. with the same treatment mechanics but try to complete as quickly as possible
b. explain the problem to the patient and abandon treatment
c. stop treatment for 4-6 months and then resume treatment mechanics as before
d. Continue with treatment but use light and intermittent forces
e. stop treatment for 4-6 months and then resume using light and intermittent forces

64. You fitted upper and lower fixed appliances for a 15-year-old girl two days ago. She contacts you
as she is in severe pain; in addition to aching teeth she has several mouth ulcers where the brace
is rubbing. She has taken 4000mg of paracatemol already today but this has been ineffective. She
is currently preparing for examinations at school and the pain is disrupting her studies. She asks
for immediate removal of her brace. What is the most appropriate next step in the management
of this patient?
a. ask the patient to attend immediately and remove the appliances
b. ask the patient to attend immediately and remove the archwires until after her
examinations
c. telephone the patient and reassure her. Advise Bonjela and a paracetamol and codeine
based painkiller. Arrange to review in 1 day if symptoms have not resolved.
d. telephone the patient and reassure her. Advise wax and non-steroidal anti-inflammatories.
Arrange to review in 2 days if symptoms have not resolved
e. telephone the patient and reassure her. Advise wax and a paracetamol and codeine-based
painkiller. Arrange to review in 1 day if symptoms have not resolved
65. You are planning a course of fixed appliance treatment using bands as attachments to the first
permanent molars. You plan to use resin modified glass ionmer cement as your adhesive. What is
the most important benefit of using this compared to a conventional glass ionomer cement?
a. chemical adherence to the enamel
b. command setting
c. leaching of fluoride ions
d. lack of moisture sensitivity
e. easier removal at debond
66. This 9-year-old boy attends for assessment. His dentist is concerned about the rotation of his
lower left lateral Incisor tooth. He has a Class Ill incisor relationship on a Class I skeletal base. You
take the following radiograph. What most appropriate next step in the management of this
patient?
a. no treatment - monitor in 6 months
b. extract the lower left deciduous lateral incisor tooth and review in 6 months
c. extract the lower left deciduous lateral incisor tooth and correct the pseudo - transposition
orthodontically
d. extract the lower left deciduous lateral incisor tooth and align the lower anterior teeth
accepting the pseudo-transposition
e. extract the lower left deciduous and permanent lateral incisor tooth and review in 6 months

67. You see this 18-year-old boy on a craniofacial clinic for review. He has previously had seven
supernumerary teeth removed. This is his orthopantomogram. What is the most likely diagnosis?
a. dentinogenesis imperfecta
b. amelogenesis imperfecta
c. ectodermal dysplasia
d. cleidocranial dysplasia
e. Gardner Syndrome

68. A 35-year-old female patient presents with a class Il division 1 malo lusion on a mild Class Il
skeletal base and decreased lower facial height. The patient has a protrusive upper lip but can
achieve lip competence. She has no concerns about her facial appearance. Her overjet measures
7mm with maxillary incisors angled at 125 degrees to the maxillary plane and mandibular incisors
at 92 degrees to mandibular plane. What is the most appropriate plan for reduction of her
overjet?
a. upper incisor retroclination
b. lower incisor proclination
c. mandibular advancement surgery
d. maxillary set back surgery
e. maxillary advancement surgery

69. You have completed placement of upper and lower fixed appliances using a self-etch primer. You
placed a 0.012" martensitic stabilised nickel titanium archwire. The patient returns thirty minutes
after their appointment and all the brackets have been lost. On examination, there is no adhesive
on the enamel and all the composite is retained on the brackets. What is the most likely cause
for this?
a. high proportion of aprismatic enamel
b. incomplete light cure
c. failure to polish before bonding
d. traumatic bite
e. failure to adequately mix self-etch primer
 70. What is the most appropriate minimum lower kilovoltage for a dental x-ray set?
a. 10-12 kilovolts
b. 20-30 kilovolts
c. 30-40 kilovolts
d. 40-50 kilovolts
e. 50-60 kilovolts

71. You are nearing the end of treatment for a 15-year-old male. Prior to debond you decide
to carry out this surgical procedure. What is the main indication for carrying out this
procedure?
a. to remove hyperplastic gingival tissues to allow better fitting vacuum formed retainers
b. to remove hyperplastic gingival tissues to allow easier placement of a bonded retainer
c. to provoke reorganisation of supracrestal fibres where severe rotations have been
corrected
d. to provoke reorganisation of transeptal fibres where palatal displacement of te
corrected
e. to achieve improved cosmetics where crown length is short

72. Which of the following options best describes the stochastic effect of x-ray exposure?
a. the risk is proportional to the dose
b. risks are greater for adults than children
c. the parotid gland is of greatest concern with dental x-rays
d. examples include hair loss, skin burns or cataracts
e. they are usually associated with repeated or very prolonged exposures

73. This 18-year-old female is unhappy with the gap in the upper right central incisor region and the
shape and color of her upper left central incisor tooth. You have consulted a restorative colleague
who has confirmed that she will require space opening for the upper right central incisor tooth
followed by bridgework. The upper left central incisor will require a composite restoration and
internal and external bleaching to address her concerns regarding color. What is the most
appropriate treatment sequence to manage the upper left central incisor tooth?
a. composite restotation, alignment then bleaching
b. composite restoration, bleaching then alignment
c. alignment, composite restoration, then bleaching
d. alignment, bleaching then composite restoration
e. bleaching, alignment then composite restoration
74. This 14-year-old boy attends for assessment. What most appropriate next diagnostic test for this
patient?
a. vitality test the upper left lateral incisor
b. take a periapical of the upper left lateral incisor
c. take a periapical radiograph of the upper left first molar
d. take bitewing radiographs
e. Take an upper occlusal radiograph
75. You have decided to place a heat activated martensitic archwire for initial alignment with severe
lower arch crowding. What is the principal benefit of the wire having a transition temperature of 23
degrees centigrade?
a. reduced friction
b. reduced pain in first 24 hours
c. increased strength
d. ease of tying in
e. improved corrosion resistance
76. This 17-year-old girl attends an orthognathic clinic for assessment. Her presenting complaints are: her
prominent lower jaw, difficulties in eating certain foods and her "droopy" eyes, You plan to carry out
pre-surgical orthodontic alignment to facilitate orthognathic surgery to address these problems.
What is the most appropriate surgery to address this patient's issues?
a. bilateral sagittal split mandibular set back and Le Fort 1 maxillary advancement osteotomy
b. bilateral sagittal split mandibular set back and Le Fort 2 maxillary advancement osteotomy
c. bilateral sagittal split mandibular advancement and Le Fort 1 maxillary set back osteotomy
d. bilateral sagittal split mandibular advancement and Le Fort 2 maxillary set back osteotomy
e. Le Fort 2 maxillary set back

77. This 12-year old-boy attends for assessment. He has been referred because of delayed dental
development. You note that he has a flat facial profile, a small broad nose, abnormally shaped ears,
upward slanting eyeswith small folds of skin in the corners. Intraorally you notice that he has a large
tongue and radiographs confirm he has hypodontia. What is the most likely diagnosis?
a. Downs Syndrome
b. fetal alcohol syndrome
c. ectodermal dysplasia
d. cleidocranial dysplasia
e. Turner syndrome
78. You plan to use a heat sensitive martensitic active archwire for initial alignment during fixed appliance
treatment. What metal is responsible for the heat active properties of this archwire?
a. titanium
b. copper
c. stainless steel
d. molybdenum
e. nickel
79. You are going to carry out some simple upper incisor alignment with a sectional fixed appliance in a
patient with cerebral palsy. He finds it difficult to keep his head still and you find it difficult to maintain
isolation of the teeth from saliva. Which combination of tooth preparation and adhesive would be of
most value to you in this situation?
a. self-etch primer and a two paste composite resin
b. 37% phosphoric acid etch and a light cured composite resin
c. self-etch primer and light cured composite resin
d. silane coupling agent and light cured composite resin
e. 9.3% hydrofluoric acid and two paste composite resin
80. This patient has been transferred to you for continuation of his orthodontic care wearing the
What is the most likely reason for undergoing this treatment?
a. to correct an anterior open bite
b. to correct a unilateral posterior crossbite without displacement
c. to correct a unilateral posterior crossbite with displacement
d. to correct a bilateral posterior crossbite without displacement
e. to correct a bilateral posterior crossbite with displacement
81. You review a 17-year-old girl with mandibular asymmetry which is affecting her occlusal plane
but not the dental centerlines. The results of a technetium isotope bone scan show increased
activity of the right condyle. What is the most likely diagnosis?
a. hemi-mandibular elongation
b. juvenile rheumatoid arthritis
c. condylar hyperplasia
d. masseteric hypertrophy
e. condylar resorption

82. Which of the following best describes the setting reaction of glass ionomer cement?
a. free radical polymerisation
b. addition polymerisation
c. condensation polymerisation
d. acid base reaction
e. hydrolysis
83. This 10- year- Old girl attends for assessment. Her main complaint is the discolouration of her
teeth. She is caries free but has had two dental abscesses associated with her deciduous molar
teeth. Her dentist is concerned about rapid tooth wear. which additional feature would you be
most likely to see on her orthopantomogram?
a. supernumerary teeth
b. hypodontia
c. root elongation
d. pulp chamber obliteration
e. multiple osteomas
 84. This Il-year-old girl reports difficulties in breathing through her nose. In addition to a narrow high
vaulted palate and an anterior open bite. which occlusal feature are you most likely to find on
intraoral examination?
a. slow dental development
b. posterior crossbite
c. reverse overjet
d. Proclination of maxillary incisors
e. Proclination of mandibular incisors

85. This patient has been transferred to you for continuation of his orthodontic care wearing the
appliance pictured below:
what is the most likely reason for undergoing this treatment?
a. to correct an anterior crossbite without displacement
b. to correct a unilateral posterior crossbite without displacement
c. to correct a unilateral posterior crossbite with displacement
d. to correct a bilateral posterior crossbite without displacement
e. to correct a bilateral posterior crossbite with displacement

86. You have recently experienced a problem where several removable appliances do not fit well.
You are using the same orthodontic laboratory to manufacture the appliances and the lab manager
assures you there have been no changes in personnel or protocol for manufacture which could
explain the poor fitting appliances. You have a new orthodontic nurse and you suspect that your
alginate impressions maybe being distorted before the lab receives them.
Which error in handling the alginate impression is most likely to have caused this issue?
a. resting the impression upside down on the work surface
b. Not using a tray fixative prior to loading the alginate into the impression tray
c. disinfecting the impression for too long
d. rinsing the impression for too long
e. wrapping of the impression in dry rather than damp gauze
 87. his 14-year-old girl has recently had her fixed appliances fitted. She previously wore a
functional appliance for nine months full time, followed by two months of nights only wear. You
are confident that the patient is not posturing forward, and the photograph below represents her
true biting position. This is the third occasion she has attended with accidental debond of lower
incisor brackets. What is the most appropriate next step to prevent furthera •dental
bracket loss?
a. place the lower incisor brackets more gingivally
b. place posterior glass ionomer cement bite blocks
c. place an adjunctive upper removable appliance with a steeply inclined anterior bi e-plan
d. place an adjunctive upper removable appliance with posterior bite blocks
e. place anterior composite bite turbos

88. You are having some difficulty where often the glass ionomer cement you use to cement molar
bands is setting before the band are fully seated. Your nurse is mixing the powder and liquid
according to the manufacturer's instructions. What is the most appropriate instructions to give to
your dental nurse?
a. add additional liquid to the mix
b. add additional powder to the mix
c. mix the powder and liquid together more vigorously
d. mix the powder and liquid together more gently
e. mix on a cooled glass slab

89. An 8-year-old girl attends for assessment. She is in the mid mixed dentition with erupted
incisors and first premolars. She has a midline diastema of 2 mm at the gingival margin and 4 mm
incisally; both she and her parents are concerned about her appearance. She has a low frenal
attachment and blanching of the frenum interdentally when the upper lip is stretched.
What is the most appropriate first step in the management of this patient?
a. reassure and monitor
b. refer for a frenectomy
c. refer for a frenoplasty
d. fit an upper removable appliance to tip the central incisors together
e. fit a sectional fixed appliance to upright and approximate the central incisors
90. A 13-year-old girl is being treated with a functional appliance. She has been wearing
this for nine months and you would like to evaluate the treatment changes that have occurred
before planning your next phase of treatment. You have two cephalometric radiographs: one
taken before the start of treatment and the other taken today. Which cephalometric assessment
method is the most appropriate for comparison of the two radiographs?
a. Template Analysis
b. Pancherz Analysis
c. Wits Analysis
d. Harvold Analysis
e. Functional Occlusal Plane Analysis

91. This 24 -year-old man is undergoing orthodontic treatment in preparation for

orthognathic surgery. He has fixed appliances fitted 18 months ago although space closure in
the upper left quadrant was completed 4 months ago, there is still considerable space in the
upper right quadrant. What is the most probable reason for the slow space closure on the right
side?
a. excessive friction between archwire and brackets
b. occlusal interference from the opposing teeth
c. the low maxillary sinus floor
d. an odontome in close relationship with the root of the upper right canine
e. a root fragment of the upper right first premolar
92. You are carrying out a study to investigate the use of cannabis on incidence of cleft
lip and palate. Your study follows up all pregnant women in a large city from their initial
meeting with the midwife at 9 weeks until the birth of their child. Information is gathered
about their socioeconomic background, habits and lifestyle (including cannabis use both
before and during pregnancy). What is the most accurate description of this study design?
a. cross sectional study
b. controlled clinical trial
c. case control study
d. cohort study
e. cross over study

93. You are nearing the end of treatment for a 15-year-old boy. You have used a pre-
adjusted edgewise appliance with a 0.022xO.028" slot. You wish to achieve maximum labial
root torque to improve the aesthetics and stability of the previously palatally displaced upper
lateral incisor teeth. You plan to do this by placing third order bends in the archwire. Which
archwire is most appropriate for this purpose?
a. 0.018x 0.025" stainless steel
b. 0.018x 0.025" titanium molybdenum alloy (TMA)
c. 0.019x O, 025" titanium molybdenum alloy (TMA)
d. 0.021x 0.025" stainless steel
e. 0.021x 0.025" Nickel titanium

94. A 16-year-old girl attends for assessment on her own. Her mother has been
unwilling to bring her as she thinks her daughter's teeth are fine. You feel that she would
benefit from orthodontic treatment. What is the most appropriate first step?
a. encourage the patient to discuss treatment with her mother and have her support
b. explain that treatment is not possible unless she and her mother give verbal consent
c. explain that treatment is not possible unless she and her mother give written consent
d. arrange to proceed with treatment providing that feel she has a good understanding of
the risks and benefits of treatment
e. Arrange to proceed with treatment, because the patient is 16 and parental consent is
not required
 95. This 40-year-old female attends for treatment. She has opted for this ceramic
bracket and coated archwire combination. She is extremely concerned about aesthetics. As
well as discoloration of the elastomeric modules, what aesthetic compromise is this patient
most likely to experience?
a. discoloration of the brackets
b. staining of the composite around the brackets
c. loss of coating on the aesthetic archwire
d. interproximal staining
e. cervical staining
96. A 5 —year -old boy has a repaired left sided cleft lip and palate. Which tooth is most
likely to be missing in this patient?
a. The upper left permanent central incisor tooth
b. The upper left permanent lateral incisor tooth
c. The upper left deciduous lateral incisor tooth
d. The upper left permanent canine tooth
e. The upper left deciduous canine tooth
97. A 9-year-old girl attends for assessment. Her presenting complaint is the
appearance of linear hypoplastic lesions on the middle of her upper lateral incisor teeth and
the tips of the upper canines. At what age is a disturbance in enamel formation most likely
to have occurred?
a. birth
b. 3 months
c. 6 months
d. 10 months
e. one year
98. An 11 -year-old boy has been referred to you by a pediatric dentistry colleague for
assessment. He has severe upper arch crowding. He has continuous, involuntary movements
of his head and limbs, which have been present since birth, and compromised verbal
communication skills— What additional feature, which will impact on your ability to fit a
brace, is this patient most C.C . likely to display?
a. dry mouth
b. excessive saliva production
c. hypoplastic enamel
d. short root length
e. multiple supernumerary teeth
 99. This 8-year-old boy presents in the mixed dentition with an upper right central
fractured at the gingival margin. The trauma occurred three hours ago. His buccal segments
are Class l. A periapical radiograph shows the apex of the upper right central incisor to be open
(i.e. root development is not complete). What is the most appropriate plan for the immediate
management of this patient?
a. Extract the upper right central now, allow the remaining incisors to drift and decide
on treatment in the Permanent dentition
b. Commence endodontic treatment immediately. Manufacture an upper removable
appliance to replace the crown of the upper right central incisor and simultaneously retract
the incisors.
c. Carry out pulpotomy on the upper right central and place a temporary crown. Defer
orthodontic to allow a period of monitoring and for the patient to reach permanent dentition
d. Commence endodontic treatment immediately and restore the crown with a
temporary post crown. Defer orthodontics to allow a period of monitoring and for the
patient to reach the permanent dentition
e. Commence endodontic treatment immediately and restore the crown with a
temporary post crown. Manufacture an upper removable appliance to retract the upper
incisors

100. A 34-year-old male has been undergoing a course of removable aligner treatment
for eighteen months. He is nearing the end of treatment and returns today complaining that
his final two aligners do not fit. He has recently been ill and did not wear his aligners for 1
week. He is unhappy with the position of his teeth as they are not as straight as the computer
planning software predicted. What is the most appropriate first step in resolving this problem?
a. go back to the first aligner and start the process again
b. go back two aligners and start from that point
c. work through them one by one to find the last one that fits, then start from there
d. take new impressions and have a set of refinement aligners made
e. fit upper and lower fixed appliances
101. A patient is about to commence a course of orthodontic treatment involving rapid
maxillary expansion. Which is the most common iatrogenic effect of this treatment?
a. loss of vitality
b. 9) diastema formation
c. gingival recession
d. nosebleed
e. tooth mobility

107. What is the most likely benefit of using an x-ray machine with a higher kilovoltage?
a. less scatter
b. improved collimation
c. increased skin exposure
d. shorter exposure times
e. reduced cost
 108. You are considering changing your band cement. Literature provided by the
manufacturer shows the survival probability of your existing cement to be 0.918 at 12 months
and the new cement to be 0.879 using a log tank test. The p value of this difference in survival is
0.045. What does this tell you about the new band cement?
a. there is no clinical or statistically significant difference between the two cements
b. the new band cement has less chance of failure but this is not statistically significant at the 5% level
c. the new band cement has less chance d failure and this is statistically significant at the 5% level
d. the new band cement has more chance d failure but this is not statistically significant at the 5% level
e. the new band cement has more chance of failure and this is statistically significant at the 5% level

109. A 14-year-old girl is approaching the end of fixed appliance treatment to correct her
severely crowded Class I malocclusion. Which of the following retention regimens should be most
effective in retaining the alignment of her lower labial segment?
a. part-time wear of a vacuum formed retainer for twelve months
b. a bonded retainer canine to canine
c. a Hawley type removable retainer for 6 months full time and six months night only
d. a bonded retainer canine to canine and part-time wear of vacuum formed retainer
indefinitely.
e. a lower removable Begg retainer
110. You have been asked to review the quality of treatment outcomes for a group of local
orthodontists. You ask them to provide Peer Assessment Rating (PAR) percentage improvement
scores for 30 consecutively completed cases. One orthodontist has consistent PAR finish scores
of between 2 and 6. However, his nomogram of PAR improvement shows a high number of cases
in the "improved" zones. What is the most likely explanation for these results?
a. he treats a large number of patients with hypodontia
b. he treats a large number of orthognathic patients
c. he treats a large number of patients with cleft lip and palate
d. he treats a large number of simple cases with low initial PAR score
e. he treats a large number of patients with high initial PAR score
111. You are placing a temporary anchorage device (TAD) for a patient who requires maximum
anchorage. You have administered local anesthetic using the syringe pictured: You have
confirmed that you have achieved surface anesthesia at the site where the TAD will be
placed and you are now ready to place the TAD. What is the most appropriate management of
this local anesthetic needle?
a. place immediately in the sharps bin
b. re-sheath using a needle guard and place in the sharps bin immediately
c. place on the instruments tray for the nurse to place immediately in the sharps bin whilst
wearing heavy duty gloves
d. re-sheath using a needle guard and leave on the instrument tray in case you need to change
the site of placement of the TAD. Transfer to the sharps bin at the end of the procedure
e. re-sheath using a needle guard and leave on the instrument tray in case you need to change
the site of placement of the TAD. The nurse will transfer to the sharps bin at the end of the
procedure whilst wearing heavy duty gloves
112. You are carrying out orthodontic treatment involving fixed appliances for a 12-year-old
boy. The treatment involved the extraction of four first premolar teeth. You fitted his appliances
six months ago and today only one quarter of the extraction space in each quadrant is now closed.
His oral hygiene today is poor. You noticed some areas of decalcification at his last appointment
which you brought to the attention of him and his dad. These lesions seem to have worsened
since the last visit. Together with warning the patent that if his oral hygiene does not improve
you will be forced to remove his fixed appliance at his next visit, what is the most appropriate
step to take today in the management of this patient?
a. record plaque levels and refer him to the hygienist for a scale and polish
b. record plaque levels and place space closing loops to complete space closure as soon as
possible
c. records plaque levels and place fluoride releasing modules
d. take photographs of the decalcification and a daily fluoride mouthwash (0.005% NaF)
e. take photographs of the decalcification and prescribe a high fluoride toothpaste

113. You are starting treatment for a 9-year-old boy with bilateral posterior crossbites. He
needs 6 mm of expansion to correct his crossbites. You have fitted an upper removable appliance
with a midline expansion screw and you instruct him to activate the screw twice weekly. How
long will it take to correct his crossbite if the appliance is worn well and the screw activated as
instructed?
a. 2 weeks
b. 4 weeks
c. 6 weeks
d. 15 weeks
e. 6 months
114. This 6-year-old child attends for assessment. Their dentist has noticed the unusual
appearance of the upper right central and upper left lateral deciduous incisor teeth. What is
the most appropriate next step in the management of this patient?
a. no treatment. Take an orthopantomogram and review in six months
b. no treatment. Take an upper occlusal radiograph and review in twelve months
c. no treatment. No radiographs at this stage but assess for these at review in twelve mo
ths w
d. take an upper occlusal radiograph. Arrange for extraction of both the upper right centr
I and upper left lateral deciduous incisor teeth and review in twelve months
e. take an orthopantomogram. Arrange for extraction of both the upper right central and
upper left lateral deciduous incisor teeth and review at age of 11

115. You are planning a study of the effect of orthodontic treatment on temporomandibular
joint health in a group of school children. Two hundred schoolchildren aged 10 years will be
followed up over an eight year period. Data will be collected at baseline, 4 years and 8 years.
A clinical assessment will be made of their malocclusion together with an assessment of
temporomandibular signs and symptoms. which of the following best describes this study
design?
a. case series
b. case controlled study
c. cross sectional study
d. cohort study
e. randomised controlled trial

116. You are preparing to bond an orthodontic attachment to a patient's tooth using a
composite bonding agent. Using current evidence from the literature which is the most
appropriate procedure for preparation of the tooth surface prior to bracket placement in this
case?
a. no additional preparation
b. pumicing using rubber cup
c. pumicing using a brush
d. prophylactic paste using rubber cup
e. prophylactic paste using a brush
117. A 13-year-old boy presents with a swelling on the dento-alveolar ridge distal to the fully
erupted lower left first permanent molar tooth. He is aware that the swelling has been slowly
getting bigger over the last few months. On periodontal probing distal to the first permanent
molar there is a deep pocket which can exude a white, thick, slightly oily substance. The
radiographs show a 6-7 mm circumscribed radiolucency surrounding the crown of the
unerupted lower left second permanent molar and some distal displacement of the developing
third molar tooth. What is the most appropriate next step in the management of this patient?
a. Monitor
b. marsupialisation
c. open exposure of the lower left second permanent molar
d. closed exposure of the lower left second permanent molar and placement of gold chain
e. surgical removal of the lower left second permanent molar along with the overlying lesion

118. This 15-year-old girl attends for assessment. Her dentist is concerned that she has
unerupted teeth in the lower right, lower left and upper right quadrants. You take the
following radiograph:
What is the most likely outcome for the unerupted lower molars and premolars in this patient?
a. they are likely to erupt, given more time, without orthodontic intervention
b. the lower molars cannot be aligned but all the premolars should erupt following exposure
and orthodontic traction
c. the lower premolars cannot be aligned but the lower molars should erupt exposure and
orthodontic traction
d. the lower premolars and lower molars teeth should erupt following exposu orthodontic
traction
e. the premolars and lower molars teeth cannot be aligned

119. What is the primary advantage of the use of titanium in the manufacture Temporary
Anchorage Devices (TADS) used to reinforce orthodontic anchorage?
a. high strength
b. low cost
c. cbiocompatibility
d. low risk of infection
e. corrosion resistance
120. This 15-year-old girl attends for an orthodontic assessment. Although she has little
plaque present, a simplified Basic Periodontal Examination (BPE) shows pocketing and
bleeding on probing of the upper incisors and first permanent molar teeth. You refer this
patient to a periodontal specialist. As well as giving oral hygiene instruction and debridement
what is the most likely plan for the management of this patient?
a. Amoxycillin 500mg three times daily with Metronidazole 400mg three times daily for 7 days
b. Amoxycillin 500mg three times daily for 3 days
c. Metronidazole 400mg three times daily for 7 days
d. Metronidazole 500mg three times daily for 3 days
e. no antimicrobial therapy is indicated

121. All Your Orthodontic Therapist asks your advice about the oral health of a 12-year-old
girl she is treating. She has a crowded Class 1 malocclusion and has been treated with
extractions and fixed appliances. The oral hygiene of the patients is very good, but your
therapist is concerned as she has noticed generalized gingival recession. What is the most
appropriate first step the management of this patient?
a. stop treatment
b. review the treatment plan and consider continuation with removable appliances
c. refer to a hygienist for a full pocket charting
d. refer to a periodontist for a full periodontal assessment with view to gingival grafts
e. review the patient's toothbrushing technique
122. This is a histology slide of a tooth to which an orthodontic force has been applied. It shows
cementum, the periodontal ligament and bone. What force levels have been applied and what is
the most likely consequence?
a. high force levels have been applied to the tooth inducing hyalinasation
b. high force levels have been applied causing root resorption
c. physiological force levels have been applied allowing movement of the tooth to the right
d. physiological force levels have been applied allowing movement d the tooth to the left
e. no force has been applied - the periodontal ligament is in a resting phase

123. You plan to use a heat sensitive martensitic active archwire for initial alignment during fixed
appliance treatment. what of the following options best describes the nickel content of this archwire?
a. 10%
b. 20%
c. 30%
d. 40%
e. 50%

124. A 14-year-old girl attends for orthodontic assessment. She has a Class Il division 1 incisor relationship
which you intend to correct through extraction of upper first premolars and upper and lower fixed appliance
treatment. You estimate treatment will take 24 months to complete. She has previously traumatised her
upper incisors. Her upper left central incisor was root filled 2 years ago and has been asymptomatic since
then. A periapical radiograph shows the root filling to be poorly condensed, but there is no periapical
pathology. There is a small area of apical resorption of the upper right central incisor tooth. She bites her
nails. Which factor is of greatest concern when assessing her risk of root resorption during treatment?
a. her nail-biting habit
b. the quality of her root canal filling
c. the pre-existing resorption of her upper right central incisor
d. the expected duration of her treatment
e. the plan to bodily retract her incisors

125. This 17 -year-old patient has been referred to you for assessment. You notice there is a chin-point
asymmetry, which corresponds with her dental centre-lines. The patient mentions that she thinks the
asymmetry might be getting worse. What is the most valuable next step in helping you to assess this patient?
a. submentovertex view to ascertain the extent of asymmetry elsewhere in the facial bones
b. study models and photographs and review in six months to see if burnt out
c. cone-beam CT and review in six months to see if burnt out
d. MRI to image the TMJ soft-tissues, which are likely to be the cause of the progressive asymmetry
e. radio-isotope scan of the mandibular condyles and review in a year to see if burnt out

126. You have just bonded the brackets for this patient. Your next step is to place the archwires. What is
the most suitable material for the archwires for this patient?
a. martensitic stable
b. martensitic active
c. austenitic stable
d. austenitic active
e. braided stainless steel
127. This 14-year-old boy had a late developing, ectopically positioned lower right second premolar tooth.
The lower right second deciduous molar tooth has been extracted and the lower second premolar tooth is
being monitored radiographically. What is the main advantage of using the appliance shown, rather than a
conventional lower removable appliance, to maintain space?
a. no need for patient compliance
b. easier to keep clean
c. maintains more bone
d. allows easy radiographic monitoring
e. less chance of tipping of adjacent teeth into the extraction space

128. This 12-year-old boy attends for review. He is asthmatic and uses a beta 2 agonist inhaler
occasionally. He has been wearing a twin block appliance for one month. He is wearing the appliance full
time but is removing it to eat. What the important advice to give this patient?
a. to rinse his mouth after use of his inhaler
b. to leave his upper appliance out at night times
c. to soak his appliance in a dilute hypochlorite solution-daily—
d. to soak is appliance in a chlorhexidine solution daily
e. to use nystatin mouthwash daily

129. What is the most common complication of Temporary Anchorage Device (TAD) placement?
a. infection
b. damage to periodontium
c. loosening or loss
d. root surface damage
e. pain on placement

130. You are treating a 14-year-old male patient with fixed appliances. Around twelve months into the
treatment, the upper left central incisor becomes dark. You take a periapical radiograph and find there is
periapical pathology. There are no symptoms. You explain what has happened with the patient and their
family. What is the most appropriate next step?
a. remove the fixed appliances as soon as possible to prevent further harm
b. ask the patient's dentist to place a definitive root filling in ULI
c. ask the patient's dentist to open an access cavity in ULI then leave the tooth on open
drainage until the orthodontic treatment is complete
d. ask the patient's dentist to dress ULI with non-setting calcium hydroxide until the
orthodontic treatment is complete, then place a definitive root filling
e. monitor the situation and only intervene if the tooth becomes symptomatic

131. This 9-year-old girl attends for assessment. What is the most likely cause of the
discolouration seen on the upper and lower right central incisors?
a. enamel hypomineralisation
b. trauma
c. tetracycline
d. tobacco staining
e. caries
132. A 12-year-old boy attends for assessment. He has a mild Class Ill Incisor relationship with bilateral
posterior crossbites. Which of the following options, in conjunction with protraction headgear, is most
appropriate for correction of this patient's malocclusion?
a. an upper removable appliance with a midline expansion screw
b. an upper fixed appliance with expansion in the archwire
c. a quadhelix
d. a Rapid Maxillary Expansion (RME) appliance
e. An accessory heavy gauge archwire (E arch or jockey arch)

133. You are designing an upper removable appliance for a 10-year-old girl. She has an instanding upper
left first premolar tooth and you plan to use the removable appliance to move this tooth buccally. You will
achieve retention through Adams clasps on the upper first molars and the upper right first premolars. In
addition, she will have a Southend clasp on the upper central incisors. The appliance will also have posterior
bite capping. What is the most appropriate active component to move the upper left first premolar?
a. 'T' spring in 0.5mm stainless steel wire
b. 'T' spring in 0.7mm stainless steel wire
c. palatal finger spring in 0.5mm stainless steel wire
d. single tooth 'Zi spring in 0.5mm stainless steel wire
e. single tooth 'Z' spring in 0.7mm stainless steel Wire

134. You are investigating the effects of a new mouthwash on gingivitis in patients wearing fixed
appliances. Your study involves allocating patients wearing braces to Group A or Group B. The groups will
have their gingival health scored at the beginning of the project. Group A will then use the new mouthwash
for 4 weeks and Group B will use a placebo mouthwash. The gingival health will be reassessed. Then, after a
four-week period, the groups will be swapped and again their gingival health measured. What the most
accurate description of this study design?
a. cross sectional study
b. cross over trial
c. controlled clinical trial
d. case control study
e. randomised controlled trial

135. This 20-year-old male attends for assessment. He has a mild Class Ill skeletal pattern with
normal vertical facial proportions. Although he has no difficulty in eating, he wants orthodontic
treatment combined with orthognathic surgery. Your hospital will only fund orthognathic care to
patients with a "great" or "very great need" for treatment as det by the Index of Orthognathic
Functional Treatment Need. What is the most appropria outcome of this assessment?
a. treatment cannot be offered as he has only a mild need for orthognathic treatment
b. treatment cannot be funded as he has a moderate need for orthognathic treatme
c. treatment can be funded as he has a moderate need for orthognathic treatment
d. treatment can be funded as he has a great need for orthognathic treatment
e. treatment can be funded as he has a very great need for orthognathic treatment
136. A 15-year-old patient with a reverse overjet of ymrn and a mild Class Ill skeletal pattern
attends for assessment. He has moderate upper crowding, mild lower arch crowding and he can
achieve an edge to edge bite. His incisors are of average inclination. His father has a moderate Class
Ill skeletal pattern and a reverse overjet of 4mm. The patient thinks he is still growing.
What is the most appropriate plan for management of this patient?
a. explain that orthognathic surgery is inevitable and arrange review aged 18
b. take a height measurement and arrange to review in 1 year
c. fit an upper fixed appliance to procline the upper incisors and monitor growth during
treatment
d. fit a lower fixed appliance and use enamel stripping to allow retroclination of the lower
incisors and monitor growth during treatment
e. fit a lower fixed appliance to relieve crowding with a view to deciding on orthodontic
camouflage or orthognathic correction once aligned

137. You are designing a study to analyse space closure rates of two bracket systems.
Together with the significance level, what additional piece of information is required to
calculate the sample size?
a. the mean rate of tooth movement for one of the bracket systems
b. the difference in the mean rates of tooth movement between the bracket systems
c. the inter-examiner reliability in measurement of space closure
d. the intra-examiner reliability in measurement d space closure
e. the kappa value

138. Which of the following best describes the setting reaction of light cured composite?
a. free radical polymerisation
b. addition polymerisation
c. condensation polymerisation
d. acid base reaction
e. hydrolysis
139. A 13-year-old girl attends to have fixed appliances fitted. She has a mild form of amelogenesis
imperfecta and although she has no areas of missing enamel, her enamel is thin and prone to fracture.
What is the most appropriate enamel preparation and adhesive to use in this patient?
a. no etch and glass ionomer
b. normal etch time and composite
c. normal etch time and glass ionomer
d. increased etch time and glass ionomer
e. increased etch time and composite

140. A 60-year-old female attends for assessment. She has three maxillary incisor teeth which are root
filled and have large composite restorations; these were completed twenty years ago and have been
asymptomatic since then. She requests fixed appliance treatment with ceramic brackets. As well as normal
risks associated with fixed appliance treatment, what additional iatrogenic consequence is it most important
to discuss?
a. crown fracture
b. demineralisation
c. cracked tooth syndrome
d. periapical pathology
e. root resorption
141. This 13-year-old boy presented with a Class Il division 2 malocclusion on a moderate Class Il skeletal
base. He has been wearing a twin block appliance for nine months. He is happy to proceed with fixed
appliance treatment to complete the correction of his malocclusion. What is the most likely occlusal issue for
this patient at the end of the fixed appliance phase of treatment?
a. wear on the incisal edges of the upper central incisor teeth
b. anterior open bite
c. increased overjet
d. slightlyClass Il canine and buccal segment relationships
e. lateral open bites

142. You have fitted a bonded expansion appliance for a 12-year-old girl. You instruct her to activate the
appliance by turning the screw by one quarter turn every other day. What is the estimated force generated
across the mid palatal suture during this expansion?
a. 300 grams (1.0 pound)
b. 750 grams (1.5 pounds)
c. 900 grams (2.0 pounds)
d. 1,050 grams (2.5 pounds)
e. 1,350 grams (3.0 pounds)

143. You are carrying out orthodontic treatment involving fixed appliances for a 12-year-old boy. His
treatment has not involved extractions and upper and lower fixed appliances were fitted nine months
previously. His oral hygiene has been consistently poor despite several visits to see the hygienist. You noticed
some areas of decalcification at his last appointment which you brought to the attention of him and his dad.
This visit you notice that the decalcification has worsened noticeably and there is a cavity on the buccal aspect
of his upper right first premolar in an area of soft decalcification. What is the most appropriate next step in
the management of this patent?
a. remove his fixed appliances, take photographs, defer cleaning up the adhesive for two weeks, then
discharge him to his dentist
b. BV remove his fixed appliances, clean up the adhesive, take photographs and discharge him
to his dentist
c. take impression for the manufacture of vacuum formed retainers (ask the lab to remove the
brackets from the models), prescribe high fluoride mouthwash, then debond when the retainers
are ready
d. take photographs, apply fluoride varnish to the upper right first premolar and prescribe high
fluoride toothpaste. Review in two weeks
e. remove the attachment from the upper right first premolar, refer him to his dentist for restoration
of this tooth. Prescribe high fluoride toothpaste and review in two weeks

144. A 12-year-old autistic boy attends to have a fixed appliance fitted. His dentist has informed you that
he cannot stand the noise of the drill. You suggest that he brings his headphones with him to listen to music.
Before starting the bond up you agree on a "stop signal" whereby the patient will raise his left arm if he finds
the procedure too difficult. Which of the following best describes the behavior management technique you
have used at this visit?
a. desensitisation
b. Bf distraction
c. positive reinforcement
d. modelling
e. tell-show-do
145. The manufacturers of a new bracket adhesive advertise the mean shear bond strength to enamel at
80 Mega pascals (Mpa) in laboratory studies. Which of the following options most accurately describes the
shear bond strength of this adhesive compared to the current commercially available adhesives?
a. the new adhesive has a similar bond strength to current commercially available adhesives
b. the new material has lower shear bond strength than current commercially available adhesives
c. the new material has significantly lower shear bond strength than current commercially
available adhesives
d. the new material has higher shear bond strength than current commercially available adhesives
e. the new material has significantly higher shear bond strength than current commercially available
adhesives

146. This 8-year-old boy attends for assessment. He has been referred because of delayed dental
development. You take the following orthopantomogram. What is the most likely diagnosis?
a. dentinogenesis imperfecta
b. amelogenesis imperfecta
c. ectodermal dysplasia
d. cleidocranial dysplasia
e. Gardner Syndrome

147. You are planning a longitudinal research study which will use serial lateral cephalometric radiographs
to assess the impact of protraction headgear on maxillary growth in subjects aged 8 years, followed up over
three years. You plan to use the anterior cranial base for superimposition of successive x-rays. What is the
most appropriate structure on which to base your superimposition?
a. the anterior wall of sella turcica
b. the posterior wall of sella turcica
c. the inferior wall of sella turcica
d. sella
e. Basion

148. You have recently fitted these accessories for a patient with a Class Il division 1 malocclusion. What is
the most appropriate way to minimise lower incisor proclination when using this accessory appliance?
a. use a lingual arch
b. use a palatal arch
c. tie the lower canines to the lower first molars with a steel ligature wir
d. band the lower second molar teeth
e. add labial root torque to lower incisors

149. You have just removed fixed appliances for this 16-year-old boy:
You have advised the patient to clean with a 1450ppm fluoride toothpaste and use a casein phosphopeptide
amorphous calcium phosphate paste (tooth mousse). What is the most appropriate time period to continue with
this regime before planning micro-abrasion?
a. one week
b. one month
c. two months
d. six months
e. one year
 150. Indices are widely used in orthodontics. Which of the following indices is the most appropriate for
assessing a patient's need for orthognathic surgery?
a. PAR
b. IOTN - Dental Health component
c. IOTN - Aesthetic component
d. ICON
e. IOFTN
151. A 4-year-old boy attends for assessment. He fell at home and banged his face on a step. On
examination, he has a haematoma on his upper lip. His maxillary central incisor has been intruded,
leaving just 2 mm visible. You think the buccal alveolar plate has fractured and you can palpate the
root of the incisor buccally. What is the most appropriate next step in the management of this
child?
a. monitor - allow the tooth to re-erupt naturally
b. extrude the tooth surgically and splint
c. extrude the tooth orthodontically and splint
d. extrude the tooth orthodontically and perform a pulpotomy
e. extract the tooth as soon as possible
152. This 13-year-old boy is part way through fixed appliance treatment for correction of his mildly crowded Class
Il division 1 malocclusion. You have achieved class I molars and incisors but crowding is still present in the
lower labial segment. You are aware that this patient has a Bolton's discrepancy. What is the most
appropriate way to achieve full correction of the incisal and buccal segment relationships?
a. continue with present mechanics - no additional procedures required
b. interproximal enamel reduction of the upper central incisor teeth
c. interproximal reduction of the lower incisor teeth
d. decreased torque of the upper incisor teeth
e. increased torque of the lower incisor teeth
f.
153. You see this 45-year-old male for assessment. You wish to monitor the recession of his lower
right canine tooth. What is the most appropriate way to do this?
a. take photographs
b. take study models
c. carry out a Basic periodontal Examination (BPE)
d. measure with a CPITN probe
e. Measure with William's probe

154. This 22-year-old female patient attends complaining that she has been unable to open her
mouth properly since lunchtime yesterday. She complained of clicking and pain from her
temporomandibular joints prior to orthodontic treatment, but the frequency and severity of
symptoms has improved since her fixed appliances were fitted. She has recently been more stressed
than usual with exams. She has been wearing Class Ill inter-maxillary elastics since last week. What
is the most likely diagnosis?
a. acute temporomandibular joint dysfunction related to exam stress
b. acute temporomandibular joint dysfunction related to wearing intermaxillary elastics
c. acute temporomandibular joint dysfunction related to degenerative changes
d. chronic temporomandibular joint dysfunction related to degenerative changes
e. muscle spasm related to protruding lower archwire
155. You have corrected a 14-year-old girl's unilateral posterior crossbite with a quad helix
appliance. How much relapse likely to occur if measures are not put in place to maintain the
expansion?
a. 20%
b. 30%
c. 40%
d. 50%
e. 60%

156. This 13-year-old boy has successfully worn a Twin Block functional appliance for twelve
months. He has developed right and left posterior lateral open bites. He has decided against
completion of treatment with fixed appliances. What is the most appropriate next step in the
management of this patient?
a. fit an upper removable appliance with an inclined biteplane and wear full time
b. trim/undermine the Twin Block bite blocks and wear full time
c. trim/undermine the Twin Block bite blocks and wear night-time
d. fit a Medium Opening Activator functional appliance and wear full time
e. no further appliance treatment and monitor

157. You are fitting a lingual fixed appliance for a 30-year-old female; you will be using
accessory as part of the process. What is the most important benefit of using this accesso ?
a. isolation and moisture control
b. ensuring precision of bracket placement
c. retraction of the tongue to allow improved visualisation of the lingual surfaces of the te th
d. safe transfer of the brackets reducing risk of swallowing or inhalation of brackets
e. reduced chairside time

158. This 15-year-old boy had extraction of upper second premolars, a quadhelix and upper
and lower fixed appliances treatment. The photos above were taken before (a) and at the end
(b) of treatment. What is the most appropriate retention regime for his u
a. an upper vacuum formed retainer
b. an upper Hawley retainer
c. an upper fixed retainer extending from UL3-UR3
d. 8) an upper vacuum formed retainer in conjunction with an upper fixed retain
e. HE) an upper Hawley retainer in conjunction with an upper fixed retainer from UL3-UR3

159. This 26-year-old female attends a joint orthognathic clinic for assessment. Her presenting
complaint is her prominent lower jaw and facially you feel she will benefit from a mandibular set
back osteotomy. What is the most appropriate pre-surgical plan for this patient?
a. Referral to a periodontist for placement of free gingival grafts on the lower right central and
lower left lateral incisors prior to orthodontic treatment
b. no extractions but monitor the gingival health of the lower incisors during decompensation
c. extraction of the lower left lateral incisor tooth and space closure
d. extraction of the lower right central and lower left lateral incisors and space closure
e. extraction of the lower first premolars and space closure
160. This 7-year-old boy attends for orthodontic assessment. He is unconcerned about the
appearance Of his teeth. If interceptive treatment is not carried out what is the most significant
long-term consequence to the patient?
a. significantly increased treatment time with fixed appliances when the patient reaches the
permanent dentition due to displacement of the upper right central incisor
b. recession associated with the gingival margin of the lower right central incisor tooth due to
the traumatic bite
c. dilaceration of the upper right central incisor root due to a deflected path of eruption
d. poor periodontal health associated with the upper central incisor tooth because its eruption
through non-attached mucosa
e. impaction of the upper right permanent canine tooth due to its ectopic position

161. This 15-year-old girl attends for review. You removed her fixed appliances two weeks ago
and fitted the retainers pictured. She has been advised to wear these at night. She is a restless
sleeper and she complains that she is waking up with the retainers on her pillow each morning. The
retainers now feel very tight. What is the most appropriate next step in management of this
patient?
a. to advise the patient to persevere and review in 6 weeks
b. to advise the patient to wear the retainers during the day for a minimum of 8 hour
c. to replace the retainers increasing the depth d extension beyond the gingival margin
d. BV to replace the retainers decreasing the amount of "waxing out" prior to their manufacture
e. to replace the retainers with Hawley retainers

162. You plan to fit this fixed appliance for a 30-year-old female to correct her mildly crowded
Class Il division 2 malocclusion. What modification to the bond up protocol is of most benefit when
fitting this appliance compared to a labial fixed appliance?
a. use of a saliva ejector with labial and lingual flanges
b. use of dry-guard (moisture control pads) in the buccal sulci
c. use of a bracket positioning gauge
d. use of an indirect bonding technique
e. sandblasting the tooth surface before etching

163. What is the main advantage of filtration in dental x-ray equipment?

a. it removes hiÅner energy photons from the beam
b. it reduces the skin dose of radiation
c. it reduces stochastic radiation effects
d. it allows reduction of kilovoltage whilst maintaining radiographic contrast
e. it reduces the exposure time required

164. You see a 50-year-old female to start her orthodontic treatment. She has a metalceramic
crown on her lower left first molar teeth and a gold crown on her lower right first molar tooth. You
plan to bond stainless steel brackets to these teeth. What modification are most likely to make to
your bonding protocol for the gold crown compared to the metal-ceramic crown?
a. no modification - the same protocol is used for both
b. sandblasting
c. etching with hydrofluoric acid
d. use of a silane coupling agent
e. use of a metal bonding adhesive
165. You fitted these appliances six months ago:
Your next step is to place an upper 19*25 stainless steel archwire. What is the appropriate adaptation
to make the archwire for this patient?_
a. buccal root torque and constriction
b. palatal root torque and expansion
c. buccal crown torque and expansion
d. palatal crown torque and constriction buc
e. buccal root torque and expansion
166. Which of the following and the clinical diagnosis of a tumour?
a. quiescent period
b. dose period
c. latent period
d. stochastic period
e. deterministic period

167. You see a 14-year-old boy for continuation of his orthodontic treatment. He has
completed an eight week period of rapid maxillary expansion (RME). He has well aligned
arches and you have no immediate plans to fit fixed appliances. What is the most appropriate
next step in the management of this patient?
a. remove the RME appliance and review in three months
b. remove the RME appliance and fit a Hawley retainer
c. secure the RME appliance (by putting composite in the screw) and review in 1 month
d. secure the RME appliance (by putting composite in the screw) and review in 3 months
e. leave the RME appliance in place and review in 1 month as further activation may be required
at this time
168. A 60-year-old female attends for assessment. She has large multi-surface amalgam
restorations in all maxillary premolars and molars; these were completed twenty years ago
and have been asymptomatic since then. She requests upper arch alignment using ceramic
fixed appliances. As well as normal risks associated with fixed appliance treatment, what
additional iatrogenic consequence is it most important to discuss with this patient?
a. irreversible pulpitis
b. demineralisation
c. cuspal fracture
d. periapical pathology
e. root resorption
169. This 18-year-old female attends a joint orthodontic/orthognathic clinic. Her presenting
complaints are her sticking out teeth and her lower jaw. You plan to carry out pre-surgical
orthodontics in preparation for orthognathic surgery. What is the most appropriate surgery to
address this patient's concerns?
a. bilateral sagittal split advancement of the mandible and reduction genioplas
b. bilateral sagittal split advancement of the mandible and maxillary set back
c. bilateral sagittal split set back of the mandible and advancement genioplasty
d. maxillary set back and advancement genioplasty
e. maxillary set back and reduction genioplasty

170. You have just cemented a bonded rapid maxillary expansion (Hyrax) appliance for a
12year-old girl. What are the most appropriate instructions for activation of this appliance to
achieve rapid expansion?
a. turn screw twice per day
b. turn screw once per day
c. turn screw every other day
d. turn screw twice per week
e. turn screw once per week

171. What is the most likely reason for early removal of a Temporary Anchorage Device
a. inflammation
b. infection
c. mobility
d. pain
e. damage to root Surface of adjacent teeth

172. You have carried out a quality assessment of all orthopantomograms taken in your
practice over the last two months. These are the results: What is the most appropriate next step?
a. no action required - check again in 1 year
b. re-measure immediately
c. train staff and re-measure in 1 month
d. train staff and re-measure in 1 year
e. purchase a new machine immediately

-1.
173. You have completed placement of upper and lower fixed appliances. You placed a 0.012"
martensitic stabilised nickel titanium archwires. The patient returns thirty minutes after their
appointment and a single bracket has been lost. On examination, there is adhesive on the
enamel. What is the most likely cause for this?
a. high proportion of aprismatic enamel
b. incomplete light cure
c. failure to polish prior to bonding
d. traumatic bite
e. inadequate etching time

174. This 19-year-old female attends a joint orthodontic/orthognathic clinic. Her presenting
complaints are her flat upper lip and cheek bones. You plan to carry out pre-surgical orthodontics
followed by orthognathic surgery to correct her bite and achieve optimum facial aesthetics. What
is the most appropriate surgery to address this patient's concerns?
a. bilateral sagittal split set back of the mandible
b. maxillary advancement
c. bilateral sagittal split set back and maxillary advancement
d. maxillary advancement and reduction genioplasty
e. bilateral sagittal split set back and advancement genioplasty

175. You are carrying out interceptive fixed appliance treatment for a 9-year-old boy. His
mother has cancelled his last three appointments for adjustment of his brace. It is five months
since you last saw him. The family have difficult social circumstances. His 24-year old mother is
unemployed and has a history of drug and alcohol abuse. The family live in temporary
accommodation. You have called the mother to discuss your concerns about non-attendance but
her mobile phone constantly goes to answerphone. What is the most appropriate next step in
the management of this situation?
a. leave a message on the mother's answerphone explaining that you would like to see the
child as soon as possible for removal of his brace
b. wait until the mother contacts you and plan to remove the brace when the child next
attends
c. contact the family's doctor to check if the family have moved or there is an alternative
contact telephone number
d. write to the mother asking her to contact your receptionist as soon as possible to book a
new appointment
e. contact your local child protection team and ask for their advice on ensuring the child is
brought in soon
176. This 3-month-o!d girl is assessed on a multidisciplinary cleft lip and palate clinic. As well
as concern about her bilateral cleft lip and palate her parents have noticed an unusual
appearance of her lower lip. What is the most likely diagnosis?
a. Stickler syndrome
b. Van der Woude syndrome
c. Pierre Robin
d. DiGeorge syndrome
e. Aperts

177. This 19-year-old female has severe learning difficultie incisors. She has been brought by
her carer for advice on how to straighten and restore her teeth. She is in full-time residential care
because her mother is physically disabled and her father works long hours away from home.
After giving a clear and detailed description of the various treatment options, as well as the
consequences of leaving either her malocclusion or her traumatised teeth uncorrected, the
patient is judged not to have capacity to give consent. In this situation, who is legally the most
appropriate person to give consent for the patent?

a. no one else may consent on behalf of the patient

b. the father; especially if the mother is unable to attend the consultation and he is judged to
have capacity
c. the mother, if she is able to attend her daughter's consultation to hear the treatment
options and be judged to have capacity
d. the carer, because with the mother's disability and the father's work commitments, neither
parent can easily attend

e. the orthodontist and another independent clinician who concur on a treatment plan that
has been compiled with the best interests of the patient in mind

178. You see an adult patient to start removable aligner treatment. The appliance
manufacturers have asked you to use a rubber-based impression material. Which is the most
important advantage of using a rubber-based impression material compared to an alginate
impression in this circumstance?
a. cost
b. working time
c. setting time
d. ease of disinfection
e. stability
179. This 14-year-old girl attends for assessment. You plan to extract the lower
infraoccluded molars and close the lower arch space. Which combination of lower incisor
bracket prescription and treatment mechanics would be most effective in
maintainiwlawer-incisQLs anchorage during space closure?
a. -6 degrees incisor brackets and use of Class Il elastics
b. -1 degrees incisor brackets and use of Class Ill elastics
c. inverted -6 degrees brackets and use of Class Il elastics
d. inverted -1 degrees brackets and use of Class Il elastics
e. -6 degrees incisor brackets and use of Class Ill elastics

180. You have fitted a rapid maxillary expander (RME) for a 12-year-old girl. You
instruct her to activate the appliance by turning the expansion screw two turns every
day. What is the estimated force generated across the mid palatal suture during this
rapid expansion?
a. 300g to Ikg (1-2 pounds)
b. 900g to 1.8 kg (2-4 pounds)
c. 2.25kg to 4.5kg (5-10 pounds)
d. 4.5 to 9kg (10-20 pounds)
e. 6.8kg to 13.8kg (15-30 pounds)