Target MDS Image Based Questions 9386261669, 9789386261663

Table of contents :
Frontcover
Half Title Page
Title Page
Copyrights
Dedication
Preface
Acknowledgments
Contributors
When Inspiration Speaks
Success Story
Inspiring Story
Academist TARGET MDS Test Series
Join Us on Facebook
AIPG 2015 Dec. Result
AIIMS May 2016 Result
Testimonials
Contents
Chapter 01: Conservative Dentistry and Endodontics
Chapter 02: Prosthodontics
Chapter 03: Oral and Maxillofacial Surgery
Chapter 04: Periodontics
Chapter 05: Pedodontics
Chapter 06: Orthodontics
Chapter 07: Oral Medicine
Chapter 08: Oral Radiology
Chapter 09: Oral Pathology
Chapter 10: Dental Anatomy
Chapter 11: Dental Materials
MCQs from Recent AIIMS/AIPG/NBDE Papers
Miscellaneous Questions

Citation preview

First -Ever Book Containing NEET and AllUS Pattern image Based Questions with Explanatory Answers

TARGET MDS

Image Based Questions

Momt Gautam Gaurav Anand

TARGET MDS Image Based Questions

TARGET MDS Image Based Questions

Mohit Gautam bds mds Conservative Dentistry and Endodontics Sri Guru Ram Das Institute of Dental Sciences and Research Director, Academist TARGET MDS Pvt. Ltd. Amritsar, Punjab, India

Gaurav Anand bds Genesis Institute of Dental Sciences and Research Ferozepur, Punjab, India Director, Academist TARGET MDS Pvt. Ltd. Amritsar, Punjab, India

   The Health Sciences Publisher New Delhi | London |Panama

Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd. 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 E-mail: [email protected] Overseas Offices J.P. Medical Ltd. 83, Victoria Street, London SW1H 0HW (UK) Phone: +44-20 3170 8910 Fax: +44(0)20 3008 6180 E-mail: [email protected] Jaypee Brothers Medical Publishers (P) Ltd. 17/1-B, Babar Road, Block-B, Shaymali Mohammadpur, Dhaka-1207 Bangladesh Mobile: +08801912003485 E-mail: [email protected]

Jaypee-Highlights Medical Publishers Inc. City of Knowledge, Bld. 235, 2nd Floor, Clayton Panama City, Panama Phone: +1 507-301-0496 Fax: +1 507-301-0499 E-mail: [email protected] Jaypee Brothers Medical Publishers (P) Ltd. Bhotahity, Kathmandu, Nepal Phone: +977-9741283608 E-mail: [email protected]

Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2017, Jaypee Brothers Medical Publishers The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book. This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought. Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.

Inquiries for bulk sales may be solicited at: [email protected]

TARGET MDS: Image Based Questions First Edition: 2017 ISBN: 978-93-86261-66-3

Dedication To Our Beloved Parents and Family Smt. Utemi Devi Shri Chander Shekhar Gautam Smt. Shashi Sharma              —Mohit Gautam Shri Subhash Anand Smt. Chander Kanta Dr. Aekant Anand                —Gaurav Anand

Preface From the vast array of our MDS-Book Series to our Facebook group TARGET-MDS to the nation’s leading Academist TARGET MDS Test Series, we have achieved a high watermark of being the most reliable and trusted brand for MDS Entrance exams. We, on behalf of the entire team, take the purpose of thanking one and all who have contributed to the backbone in our success. The national MDS Entrance exams have been hit by a lot of changes: from AIPGDE, State CETs, COMEDK to a single Entrance Exam NEET MDS to be conducted by NBE. So, adapting to the ever-changing exam patterns is the need of the time. We are back on the tick with yet another Blockbuster release of the year, our brand new book TARGET MDS: Image Based Questions. The book has been written gingerly keeping in view the modern exam pattern with mickle stress laid on the clinical subjects. Every effort has been made to keep the content extremely limpid and high yielding. Terse and condign explanations from standard reference books will definitely make your reading an easy and time-saving task. It is a choate guide to the flummoxing exam and is especially designed to incite your acumen in solving each question with a rational reckoning. We are sure this “Maverick Version” will wipe away all your anxieties stirred up by the sudden changes in exam pattern and will buttress your aplomb by easy-to-revise exam-oriented points. With this, we are extremely happy to place our new work in your hands. Wishing you all the success for the upcoming exam. Please do bolster our endeavors with your extremely valuable feedback. Mohit Gautam Gaurav Anand

Acknowledgments First and foremost, we must acknowledge and thank the Almighty God for blessing, protecting and guiding us throu­ghout this period. We are very grateful to Dr. Vivek Mahajan and Dr. Anagh Malhotra for their excellent suggestions and invaluable ideas during the making of this book. We express our gratitude to Dr. Sunaina Sood, Dr. Samita Gumber, Dr. Snigdha Sharma, Dr. Heena Ramnani, Dr. Lisha Thakur, Dr. Sandeep Bhullar, Dr. Richa Arora, Dr. Pallavi Goel, Dr. Tarun Mahajan, Dr. Hansa Kundu, Dr. Umesh Joshi, Dr. Amit Gupta, Dr. Devanshu Narang, Dr. Garima, Dr. Maninder Singh, Dr. Kanika Kapoor, Dr. Navdeep Walia, Dr. Pankaj Gupta, Dr. Angad Singh, Dr. Nikhil Sharma, Dr. Gauri, Dr. Pallavi Gupta, Dr. Meenakshi Jindal, Dr. Gagandeep, Dr. Rahul Wadhera, Dr. Krishan Jain, who helped us in numerous ways to bring out this book. Thanks to whole TARGET MDS team for providing us all the papers. Last but not the least, we thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and Ms Chetna Malhotra Vohra (Associate Director–Content Strategy) of Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India for giving us a go-ahead at the very beginning and helping us in every way possible to bring out this book.

Contributors Dr. Jitendra Sharan MDS Orthodontics, AIIMS Dr. Devashish MDS—Pedodontics, PGIMER, Chandigarh, PGI June 2012 (Rank 4th), AIIMS May 2012 (Rank 4th—Orthodontics—left), AIPG 2012 (AIR-40, KGMG Pedo—left), BHU 2012 (Rank 10th), AIPG 2011 (Rank 120, GDC Trivandrum—Periodontics—left), PGI Dec. 2010 (Rank 2nd), AIIMS Nov. 2010 (Rank 13th) (Ex-Junior Resident, nonacademic-AIIMS), Punjab Govt. 2010 (Rank 8th). Dr. Arun Joseph   AIPG 2014 Rank 1st

Dr. Deepika Ghai   PG Endodontics

Dr. Vanashree Takane   PG Orthodontics

Dr. Cathrine Diana   AIPG 2014 Rank 5th

Dr. Harshdeep Singh   PG Endodontics

Dr. Bharat Ahuja   MDS Endodontics

Dr. Paul Mathai   AIPG 2014 Rank 6th

Dr. Sukhmandeep   PG Endodontics

Dr. Vishal Taneja  PCMS

Dr. Mohit Galani   AIPG 2014 Rank 7th

Dr. Mintoo Dhingra   PG Endodontics

Dr. Vishal Kakar   PG Periodontics

Dr. Meghna Sapra   PG Endodontics

Dr. Varun Nayyar   PG Prosthodontics

Dr. Urvi Modi   AIPG 2014 Rank 11th Dr Abhishek Kumar   AIPG 2014 Rank 15th Dr. Rani Rana Bhatt   AIPG 2014 Rank 20th & UPPG 2014   Rank 1st Dr. Nisarg Yagnik   AIPG 2014 Rank 38th

Dr. Ankur Sharma   PG Endodontics Dr. Tawanpreet Kaur   PG Endodontics Dr. Nidhi Goel   MDS Endodontics Dr. Mohammad Akheel   MDS Oral Surgery

Dr. Sohail Arora   (3rd Rank - PGI June 2014)   PG Orthodontics Dr. Harpreet Singh   PG Pedodontics Dr. Vikram Sohar   PG Prosthodontics Dr. Utkarsh Passi   PG Pedodontics

Dr. Shraddha Saini   AIPG 2014 Rank 71th

Dr. IbadatPreet   MDS Endodontics

Dr. Bhumika Kapoor   AIPG 2014 Rank 104th

Dr. Jyoti Kumar Jha   AIIMS Nov 2013 Rank 28th

Dr. Vivek Malik   AIPG 2014 Rank 120th & PGI December   2013 4th Rank

Dr. Rajpari Kamil   PGI December 2013 3rd Rank

Dr. Navdeep Attri   PG Prosthodontics

Dr. Ashutosh Vatsyayan   PG Oral Surgery

Dr. Priyanka Gauba   PG Prosthodontics

Dr. Gourav Ahuja   MDS Oral Surgery

Dr. Deepika Sharma   PG Endodontics

Dr. Nitin Mahajan   PG Oral Surgery

Dr. Gaganpreet   PG Endodontics

Dr. Harit Talwar   PG Prosthodontics

Dr. Harshpreet   PG Endodontics

Dr. Arpit Sikri   PG Prosthodontics Dr. Muni Madhav Sharma   AIPG 2014 Rank 135th & Ex AIIMS JR Non Acad PG Oral Surgery Dr. Navneet Arora   PG Endodontics

Dr. Shewta Gupta   PG Oral Surgery

When Inspiration Speaks Most importantly ‘Believe in God’ and pray for a rank and seat which you wish to get.... Study hard.... Some day we will study 13 hours and, the other day, we may study 3 or 4 hours only...it does not matter...do not get confused about what to read.... Keep studying....Most important are the dental and medical previous papers....A Book like TARGET MDS is trustworthy and superb.... keeping going....GOD BLESS YOU ALL.... Dr. Arun Joseph AIPG 2014 Rank 1 First of all I want to congratulate the entire TARGET MDS team on the publication of the AIIMS book and also want to thank them to have let me write a recommendation. I personally do not feel that this book requires any recommendation from anybody cause its a recommendation into itself. Anybody who has read the book will know that it is a thoroughly reviewed and comprehensive book. A very few of them are there in the market today, and even fewer are as simple and yet as informative as this one. A very good feature that I found out during my preparation days was that the different forms of one question were all given together which was really a time saver in those crucial days and it saved me a lot of hassle of sorting them out myself. Also the TARGET MDS team is very prompt and helpful towards resolving queries of the aspirants. I just wish them all the best and hope that they continue doing the great job that they are. Dr. Vishwendra Singh PGI 2014 Rank 2 Rx Tab. TARGET MDS -------- Recipe for success 1-1-1 × 365 days Dr. Paul Mathai Manipal 2014 Rank 1 KLE2014 Rank 2 MHT CET 2014 Rank 3 AIPG2014 Rank 6 ASSO 2014 Rank 7 COMEDK 2014 Rank 8 Hello Students, for any aspiring PG student, authentic answers with good references are a dire need. I think TARGET MDS team has done very true to their part. Also along with dental, they are providing medical papers of recent years which are an icing on the cake. Dr. Mohit Galani AIPG 2014 Rank 7 I must say that this is an excellent book. It aided me a lot during my last minute preparation. I recommend all of you that you should get hold of it at least once. Dr. Chanchal Gupta AIIMS Nov. 2013 Rank 3

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TARGET MDS: Image Based Questions I have told this to many juniors personally but would like to mention here as well: TARGET MDS books were very helpful for my PG preparation alot many controversial questions with different versions have been discussed nicely which helps in clearing the concepts. I would highly recommend it to all the PG aspirants. Good work TARGET MDS. Dr. Urvi Modi AIPG 2014 Rank 2 Hello Readers, at the onset I extend my heartiest thanks to the authors of TARGET MDS for bringing out such a wonderful AIIMS series. TARGET MDS had been extremely useful to me throughout the process of my preparation for postgraduate exams. Especially useful and worth praising is the different version of questions discussed so nicely in the face of controversial and perplexing questions. I highly recommend this book as a must to read guide to all the aspirants looking up for cracking AIIMS and AIPG exams this year. I am also grateful to the authors for extending their help for solving my doubts and queries whenever I needed it. I also recommend every PG aspirant to join the wonderful group TARGET MDS on the Facebook. Thanks once again. NISARG S YAGNIK AIPG 2014 Rank 38 TARGET MDS book was really helpful in my MDS preparation. The way they presented the controversial questions, different ways in which such questions can be fabricated and the inclusion of standard references would help everyone to be clear about that topic. I hope the book will be even better and would help the aspirants to achieve their dream goal MDS. Dr. Abhilash Radhakrishan AIPG 2014 Rank 61 Right book to start with, blend of all recent papers, nowhere else to search for, jadibooti to success.... this book has been a boon to me that made my dream into a REALITY...have it and fulfill it..... All the Best... Dr. Shraddha Saini AIPG 2014 Rank 71 COMEDK Rank 23 Hardwork is the key to success but handwork in the right direction is even more important. Also being consistent and having faith in GOD is inevitable. I would love to thank the authors of TARGET MDS book for their best efforts. The best part of this book is authenticity of the questions. The authors have tried their level best to maintain same language of questions that come in exam. I congratulate them for their sincere efforts. Dr. Bhumika Kapoor AMU 2014 Rank 3, PGI June 2013 Rank 10 AIPG 2014 Rank 104 and COMEDK 2014 Rank 92

Success Story I commence by whole-heartedly thanking God, my parents, teachers and everyone who has been a part of this challenging journey. I especially thank the Academist TARGET MDS Test series for providing all the recent exam papers even before they were available in the market. It saved a lot of time and money and tension. The mantra of my success is DEDICATION, FOCUS, PERSISTENCE and CONFIDENCE; as a result, I got All India Rank 18 and able to bag my dream seat. For all the aspirants, I would say... “if I can do it, you too can”. I had been an average student during my BDS when one incident pushed my limits and I started studying seriously and regularly. As a result, I secured a university rank in final year and that proved to be a turning and motivating point in my life. I started studying for MDS entrance exam. Initially, I did not know what all to study and how to study. I have learned everything through my experience and hence sharing my journey with you all. My strategies included: 1. Strict schedule which I followed religiously. My schedule included NBDE papers in the morning, subject reading from standard textbooks and doing related MCQs during the day and solving previous year question papers in the evening. I followed a holistic approach for my entrance exams which not only increased my knowledge of subjects but also gave me confidence. 2. Always aim for big and do not doubt yourself. REMEMBER, it is YOUR dream…YOU have to nurture it and YOU have to make it come true. Do not compromise on your worth and ability. Always stay MOTIVATED and do NOT let anything and anyone come in between you and YOUR DREAM SEAT. 3. Read standard textbooks and make your own notes, esp. All the important topics and the ones repeatedly asked in exams. It will help you to solve any type of controversia,l image-based, a conceptual as well as twisted questions. 4. REVISE as much as you can. 5. Keep giving mock tests. I had joined online test series of the ACADEMIST TARGET MDS test series. Their unique pattern of tests but its not what the coaching institutes teach you that matters, it is YOUR SELF STUDY that takes you to the level of success. I studied for 12–14 hrs a day regularly, gave proper time to all the subjects, clinicals, para clinicals and non-clinicals because, in Entrance exam, each MCQ matters. I gave tests regularly, evaluating my mistakes and working on my weak areas. Conclusion: During your preparation, you will face lots of challenges, difficulties and hurdles. You might fail in one exam. There will be lot of mental pressure, negative thoughts and self doubts. Remember: PAIN IS TEMPORARY AND GLORY IS FOREVER.. Just do not lose HOPE and PERSISTENCE and keep praying... . “When things go wrong as sometimes they will, rest if you must but don’t you quit. Life is queer with its twists and turns, but this is how we all learn. Don’t give up though the pace seems slow, you may succeed with another blow. Because you can never tell how close you are, it may be near when it seems so far. So, stick to the fight when you are hardest hit, It’s when things seem worst that you must never quit.” With all the best wishes and thanking you all. Dr. Shikha Tayal OMFS, GDCH, Nagpur

Inspiring Story “A journey of thousand miles begins with a single step”. Sharing my success story, to begin with, I would like to highlight few things that encouraged me throughout my journey. I always wondered how hard the people might be working to get into their dream institute like PGI and AIIMS. I also made my daily schedule and started preparing accordingly. Giving equal time to each and every subject (especially clinicians). Making notes and highlighting the important points helped me a lot. Try to convert your weakness into strength. I would say consistency is the key to success. As it happened in my case, I was consistent throughout my whole journey, which was a bit longer than I thought. Gave my first exam, AIIMS Nov 2013, got 1071 Rank, Gave my last exam, PGI June 2016, Got 1st rank. Number of things happened with me during this 3 years time span that really helped me to reach my goal. Firm determination, consistency and flexibility were my key to success making my daily schedule, following it regularly, before going to bed: 15-20 minutes revision of what I read whole day, helped me in quicker and easier grasping of things. Making notes from standard textbooks and other MCQs books helped me in better understanding and simplified the things just before exams. You must learn from your mistakes, you must push yourself towards your goal, as push itself says: Persist until something happens. I would like to share my few ranks, which in the trust sense where not failure. But, a pathway to my success.

To my success AIIMS May 2013 AIIMS May 2014 AIIMS May 2015 PGI Nov 2005

- - - -

1071, 150, 49, 17

AIPG 2014 - 621 AIPG 2015 - 355 AIIMS Nov 2015 - 52

Things which I learnt from all these: • Focus on current trend of exam pattern • Try to attempt max. no. of questions • More focus on standard textbooks • Try to know the source from where question is a direct lift. Thus, I owe my success to the Almighty, to all my family members, to all my friends who encouraged me throughout my journey. Special thanks to all members of TARGET MDS group who were supportive and also encouraged me a lot. Lohit Malik (PGI, Oral and Maxillofacial Surgery) PGI June 2014 - Rank 8 AIIMS Nov 2014 - Rank 6 PGI June 2005 - Rank 3 AIPG Dec 2015 - Rank 39 PGI June 2016 - Rank 1 “Some people succeed because they are destined, But most, Because they are Determined”. Lohit Malik

Academist TARGET MDS Test Series Why to join TARGET MDS? •• BEST MDS ACADEMY with proven results. •• Maximum number of selections in every exam. In PGI June 2016, first three rankers from TARGET MDS. In AIIMS May 2016, 14 students got rank and, in AIPG 2016, 60 students (out of 200) got ranks. •• Maximum numbers of tests (almost 150 tests) •• 50 image-based test •• Testing software is same as AIIMS and AIPG. Enjoy the real feel of exams. •• All the recent papers will be provided to our students, like AIIMS Sr-Ship papers, PGI June 2017 paper and AIIMS May 2017 papers. •• TARGET MDS AIIMS is the best selling book. TARGET MDS PGI is the only book in the market containing last tenyear papers. Register for SCHOLARS batch at: targetmds.in New batch starting every month for your convenience. Online Course •• •• •• ••

Online test along with the soft copy and explanation material. Discussion at our Facebook group or exclusive Whatsapp group. Picturep-based subjectwise tests based on new trending pattern. Online videos and discussion direct.

Contact us: e-mail: [email protected] website: www.targetmds.in Mobile: 9876317850 Whatsapp: 9465380478

Regular Course •• •• •• •• ••

Online test along with the soft copy and explanation material Hard copies of all the test provided at your home address Exclusive Whatsapp group and Live video lectures and discussion. Discussion at our Facebook group or exclusive Whatsapp group. Picture-based subjectwise tests based on new trending pattern. Supreme Course

•• •• •• •• ••

For distant students who want only exclusive subjectwise study material without hard copies of the test. Online test along with soft copy and explanation material. Hard copies of the online test that will be sent directly to your home address. Subjectwise picture-based tests based on new pattern. Exclusive Whatsapp group and Live video lectures and discussion. Premium Course

•• •• •• •• •• •• ••

For distant students who want subjectwise study material with hard copies of the online test Online test along with soft copy and explanation material. Hard copies of the online test that will be sent directly to your home address. Exclusive subjectwise study material that will be sent to your address. A supplement copy of either TARGET MDS AIIMS/or TARGET MDS AIPG. Subjectwise picture-based tests based on new pattern. Online Live videos, lectures and discussion.

Note: ` 1000/- flat discount if you are enrolling after buying this book + Free Mock Test available on www.targetmds.in Our centers are all over India.

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TARGET MDS: Image Based Questions

Join Us on Facebook For any queries and doubts, join our Facebook group: TARGET MDS. Link for our group. http://www.facebook.com/groups/targetmds2425/ Be a part of us in TARGET MDS by contributing Dental PG Entrance exam question, papers, finding reference page numbers for questions from recent-edition standard textbooks and controversial questions. Those who want to give suggestion are most welcome. We request our readers to continue sending their suggestions to us for future improvement for the benefit of their friends, juniors and other future dental colleagues. Contact us: •• Mobile: +91-9465380478, +91-9876317850 •• Facebook group: TARGET MDS •• e-mail: [email protected] •• website: targetmds.in; waytotargetmds.com Best wishes Team, TARGET MDS

Academist TARGET MDS Pvt. Ltd. We congratulate our test series students for wonderful ranks. All the ranks are bagged by ATM students in AIIMS, AIPG, PGI and state exams. Heartiest congratulations to all of them.

AIPG 2015 Dec. Result AIPG Rank

Student’s Name

ATM No.

4 (1st Rank OBC)

Bikash Ranjan Das

424

9

Gaurav Pratap Singh

1249

14

Radhika A Jain

592

17

Ravathy Jayan

536

18

Shikha Tayal

145

22

Ritika

1546

23

Arpana Shekhawat

153

24

Praveen Kumar Singh

1366

31

Garima

1450

41

Pratibha Singh

451

47

Shah Trusha Pranav

1280

50

Nayantara Sud

1469

58

Mohammed Salman K

1243

59

Arunkumar Shadamarshan

539

60

Lohit Arora

1526

61

Sushmita Barik

1622

62

Neeteesh Shukla A

211

67

Jasmine

1161

68

Deshmukh Bhagyashree

1271

73

Nitisha Pal

388

75

Akanshya

28

83

Sawant Sanket Prabhakar

966

84

Toufiq Asad

159

88

Priyanka Yadav

1157

PGI June 2016 Result PGI Rank

Student’s Name

ATM No.

1

Lohit Malik

479

2

Aman Kumar

1612

3

Pradip Bhavani

2408

5

Abhishek Choudhary

1305

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TARGET MDS: Image Based Questions

AIIMS May 2016 Result Application No.

Name of Candidate

Ranking

1360

Kirti Jyoti

30

2221

Rupesh Sharma

17

1161

Jasmine

12

1546

Ritika

19

1379

Abhishek Jha

24

1804

Ritika Yadav

19

910

Anish Poorna

11

1848

Navleen Bhatia

9

400

Wakil Ahmed

7

2314

Abhijeet Ashok

6

1412

Sarita

3

2127

Mane Rohan Madhav Rao

4

1927

Manju Lata

22

157

Toufiq Asad

15

Testimonials Gayatri Ganesh 6th Rank AIPG 2015 Dedication and hardwork are certainly stepping stones to success. However, the right guidance is also extremely essential to secure a good rank. TARGET books and test papers helped to provide a direction to my studies. The detailed answers helped in understanding concepts and expedite the revision process. Nisarg S Yagnik AIPG 2014 Rank 38 Hello Readers, at the onset I extend my heartiest thanks to the authors of TARGET MDS for bringing out such a wonderful series. TARGET MDS had been extremely useful to me throughout the process of my preparation for postgraduate exams. Especially useful and worth praising is the different version of questions discussed so nicely in the face of controversial and perplexing questions. I highly recommend this book as a must to read guide to all the aspirants looking up for cracking AIIMS and AIPG exams this year. I am also grateful to the authors for extending their help for solving my doubts and queries whenever I needed it. I also recommend every PG aspirant to join the wonderful group TARGET-MDS on the Facebook. Adrita Roy Chowdhury 20th Rank, AIPG 2015 Getting through an exam like AIPG among thousands of competitors requires POSITIVE SPIRIT, HARDWORK, SELF CONFIDENCE and LUCK... . The key to study is selecting a good book and revising it N number of times... . I, myself, have been extremely benifited by TARGET-MDS, which I studied the entire year... . And the TARGET supplement at the very end was a cherry on the top... . So, a hearty congratulations to the TARGET family and all the best to all future aspirants!! As APJ Abdul Kalam says, Excellence is a continuous process, not an accident. Anoop Divakaran Pillai Finally dreams come true… . AIPG 2015 Rank 88. Thanks to all who helped me to achieve this golden opportunity, especially Almighty, my parents, and all my friends. Arjun Dhanny Thanks to all the guidance that I got from this group… . It was a complete necessity to get guidance for such as horrendous exam… . Got All India Rank 186 though not an awesome rank or something, but I am thankful to all those people who have been a part of this journey. Bhaumikk Joshi Got 202 UR Thanks to TARGET MDS Facebook and Whatsapp group, Mohit and Gaurav Sir, you guys helping aspirants like me to reach their goal. Jiju Mohan Thanks Almighty, got 34 in AIPG… . Thanks everyone in TARGET group for valuable discussions.

xxiv

TARGET MDS: Image Based Questions Meena Abhishek Singh 17th Rank, AIPG 2015 Let me take a breath before I share something here… . I always dreamed for this kind of rank… but was not sure enough that I get it or not in this neck through competition… this group helped me a lot…. Two years back when I completed my BDS... . I joined clinic due to which I couldn’t give much time to my preparation… and land up with a poor rank of 419 in 2014 AIPG… . Then I joined this group and find out that its very helpful to keep in mainstream preparation… and finally I get what I want…regarding books… yes the basic books everyone know that … . Thanks to Almighty and thanks to everyone in this journey of my success... my better half… my parents…best friends and all the members of this group. Thanks to Mohit Gautam Sir, Gaurav Anand Sir. Still cannot believe… thank God…rank 17, thank to TARGET MDS group for the discussion and support… thanks to all members of this group. Meera Vijaykumar It feels like a dream comes true…thank you TARGET MDS group for guiding me through the right path. Naveen Jain TARGET in Facebook, TARGET in Whatsapp is same as target of my life ALL INDIA PG DENTAL ENTRANCE EXAM. Thank you Mohit sir, thank you TARGET… for helping me to achieve my target … general rank 104. Naveeta Yadav I am thankful to the entire TARGET MDS to make it possible for aspirants to interact and inspire each other on such a big scale. Thank you Gaurav Anand Sir and Mohit Gautam Sir for your contributions to make it to 139 AIR. Neha Ghai Guys… I am really thankful to you people… you have made it possible for us… . Your group has inspired the aspirants, has kept the spirit of competition alive everytime…hats off…read it the most at last moment… . I do not know about others but it really worked out for me… . Once again thanks… . Parul Dadhich Hello all…Thanks TARGET Group…secured 176 rank in AIPG (your category) both the TARGET MDS supplement books contributed to this success… and your practicing questions helped me to clear exam with overall 5th rank. Rajpari Kamil First of all, I would like to thank God for his blessings as 65 rank in AIPG and secondly my family and friends, specially TARGET MDS group. For constant source of encouragement during preparation time, we faces lots of controversial questions, so book we follow become more important than our effort. So reading selected reliable book like TARGET MDS help me in achieving my goal. And special thanks and to Mohit Gautam and whole team of TARGET MDS for their excellence. Dr. Shweta Sharma TARGET MDS Facebook group and books are major part of my success, thank you Sir for your help… Facebook group especially made me aware of what I can not get in books, especially controversial questions.. Thanks to Gaurav Anand and Mohit Gautam Sir, all TARGET MDS group members… you all proved a guiding light to me. Sourav Maji As Mohit Gautam Sir asked me to share a few words…

Testimonials xxv I don’t know what words I can put forward for you all! My brain is handed right now !! Still I am writing whatever comes in mind. I think this PG rankings are representation of multiple factors… of those are: a) Luck b) Commitment c) Hardwork d) A stable mind e) Correct and logical answer selection f ) Identification of limitations and practical planning to overcome those. g) Proper book/material selection (like I have said earlier in TARGET MDS group that TARGET MDS book is the best book in the market in terms of specific material representation and overview of broader preparation). This list will never complete because every success is different and no two success strategies are similar… One must build his own strategy with keeping in mind time available, limitations, materials available and repetition of the whole process… and, at the end, God is there and there is life apart from PG preparations. We should not forget that the greatest asset we have is our Health, Family and Friends. I want to end by saying a quote that motivates me during every success or defeat: “We may not end where we desired to be, but we will definitely end where we are needed the most”. God Bless Us All Varsha Budakoti Hi everyone, firstly congratulations to all the rank holders… . It was a difficult road for me to clear this exam in my first shot, I started my preparation in April during my internship and gave me Ist exam in Nov AIIMS 14; after getting 77 rank. there I genuinely doubled my work for all India and finally I am in… its 99% hardwork and 1% luck helped me to achieve what I am today… . I want to thank TARGET MDS as there online test series helped me to know how well my preparation is… definitely this FB group… . Seriously according to me, right direction is very important to clear the entrance… . It is not about what 20% you study but is about what 80% you leave…always remember your way is the best way, only you can think best for yourself… regarding books TARGET has provided a jumble up of all the important questions and especially the controversial question… . Lastly, I think clearing the exam is total mathematics you should circulate what all subjects carry more weightage of question like dental material, oral pathology and have to plan your study accordingly. I believe that if I can clear it in my first attempt definitely you all can… . All the very best for your upcoming exams… . Viebhav Sehay My trust with MDS Entrance exams. •• AIIMS Nov 12 — Rank 183 •• AIPG 13—Rank 273 •• AIIMS no. 13—Rank 39 •• AIPG 14 — Rank 306 •• PGI June 14 — Rank 18 •• AIIMS Nov 14 — Rank 4 •• AIPG 15 — Rank 21 I am ready to help any aspiring candidate in every way possible for me… . A big thank you to this wonderful group. This is an amazing platform to keep yourself focused and motivated throughout. All the best to everyone and thanks for the sincere wishes.

Contents

1. Conservative Dentistry and Endodontics

1



2. Prosthodontics

16



3. Oral and Maxillofacial Surgery

31

4. Periodontics

51

5. Pedodontics

71

6. Orthodontics

88



7. Oral Medicine

104



8. Oral Radiology

119



9. Oral Pathology

140



10. Dental Anatomy

162



11. Dental Materials

178

  MCQs from Recent AIIMS/AIPG/NBDE Papers

193

  Miscellaneous Questions

206

Chapter

1

1j

Conservative Dentistry and Endodontics .

1

Identify the equipment present in the color plate.

a. Rubber dam sheet c. Composite dam sheet

b. d.

Mylar strip Saliva absorber

Ans a. Rubber dam sheet

.

4

a. Electric pulp tester c. Pathfinder Ans

.

2

b. d.

Identify the equipment present in the color plate.

Apex locator Obturator

a. Electric pulp tester

a. b. c. d.

Identify the equipment present in the color plate.

Rubber dam clamp Rubber dam frame Rubber dam punch Rubber dam stamp

CD

Ans a. Rubber dam clamp

.

5

.

LU

Identify the equipment present in the color plate

03

a. Magnifying loupes c. Surgical glasses Ans

.

3

b. d.

Endoscope Laser protector

CD

a. Magnifying loupes

.

Identify the equipment present in the color plate

a. b. c. d. Ans

Rubber dam clamp Rubber dam frame Rubber dam punch Rubber dam stamp

b. Rubber dam frame

CO

2

TARGET MDS: Image Based Questions 6. Identify the equipment present in the color plate.

a. b. c. d. Ans

a. b. c. d. Ans

Rubber dam clamp Rubber dam frame Rubber dam punch Rubber dam stamp

a. b. c. d.

Rubber dam clamp Rubber dam frame Rubber dam punch Rubber dam stamp

d. Rubber dam stamp

8. The image depicts which of following concept?

a. b. c. d. Ans

a. Golden proportion gauge

10. Identify the equipment present in the color plate.

c. Rubber dam punch

7. Identify the equipment present in the color plate.

Ans

Golden proportion gauge Michel proportion gauge Optimal proportion gauge Relative proportion gauge

Golden proportion Michel proportion Optimal proportion Relative proportion

a. Golden proportion

9. Identify the equipment present in the color plate.

a. b. c. d.

Tooth slooth Agate spatula Amalgam dispenser Composite dispenser

Ans a. Tooth slooth A unique pain response to chewing experienced by many patients is the pain that occurs when they release the pressure of biting, variously referred to as ‘‘rebound’’ or ‘‘relief’’ pain. This response can be duplicated diagnostically by having the patient bite on a moist cotton roll/tooth sloth and if ‘‘rebound’’ pain occurs on release, it is very likely that one of the two teeth, maxillary or mandibular, has an infraction. 11. Following endodontic treatment patient developed severe pain and ecchymosis as seen in the color plate. What can be the cause?

a. b. c. d.

Postsurgical ecchymosis Sodium hypochlorite injection Air emphysema Herpes labialis activation

Ans b. Sodium hypochlorite injection Accidental injection of NaOCl into the periapical tissues is an experience that neither the patient nor the practitioner will soon forget. The literature contains numerous case reports describing the morbidity associated with

Conservative Dentistry and Endodontics 3 such occurrences. A NaOCl accident refers to any event in which NaOCl is expressed beyond the apex of a tooth and the patient immediately manifests some combination of the following symptoms: • Severe pain, even in areas that were previously anesthetized for dental treatment. • Swelling. • Profuse bleeding, both interstitially and through the tooth.

Extreme curvature of the root canal can be difficult for the most experienced clinician to manage. The use of anticurvature filing and nickel titanium files can help avoid strip perforations and ledging. 15. The diagram presented here depicts which of the following rule?

12. Identify the equipment present in the color plate.

a. Roach carver c. Duscoid-cleoid carver Ans

b. d.

a. Roach carver

13. The radiograph is suggestive of which of following dental anomaly?

a. Dens in dente c. Dilaceration Ans

a. Simon’s rule c. Wilson’s rule

Le Cron carver Simon carver

b. Dens evaginatus d. Taurodontism

Ans b. Clark’s rule In endodontic therapy, it is imperative that the clinician know the spatial or buccal-lingual relation of an object within the tooth or alveolus. The technique used to identify the spatial relation of an object is called the cone or tube shift technique. Other names for this procedure are the buccal object rule, Clark’s rule, and the SLOB (same lingual, opposite buccal) rule. Proper application of the technique allows the dentist to locate additional canals or roots, to distinguish between objects that have been superimposed and between various types of resorption, to determine the buccal-lingual position of fractures and perforative defects, to locate foreign bodies, and to locate anatomic landmarks in relation to the root apex, such as the mandibular canal.

14. The radiograph is suggestive of which of following dental anomaly?

Ans

c. Dilaceration

Clark’s rule Bose’s rule

16. Which of the following condition is present in this radiograph?

a. Dens in dente

a. Dens in dente c. Dilaceration

b. d.

a. b. c. d.

b. Dens evaginatus d. Taurodontism Ans

Internal resorption External resorption Cervial resorption Apical resorption

a. Internal resorption

4

TARGET MDS: Image Based Questions 17. Which of the following condition is present in this radiograph?

a. Handidam c. Plasti-isolate

b. d.

Teflon dam Optra dam

Ans a. Handidam The handidam is a rubber dam system with built-in plastic frame. The disposable frame bends easily for film placement 21. Identify the equipment present in the color plate. a. b. c. d. Ans

Internal resorption External resorption Cervical resorption Apical resorption

a. Roach carver c. Discoid cleoid carver

b. External resorption

Ans

18. Which of the following modality is present in this radiograph?

a. b. c. d. Ans

a. RVG

19. Identify the equipment present in the color plate.

a. Roach carver c. Discoid cleoid carver Ans

b. d.

Le Cron carver Simon carver

c. Discoid cleoid carver

20. Identify the equipment presented in the color plate.

Le Cron carver Simon carver

b. Le Cron carver

22. Identify the technique presented in the color plate.

a. b. c. d.

RVG FOTI CBCT Magnetic frequency imaging

b. d.

Split dam technique Three-in-one technique Clampless technique Clamped technique

Ans a. Split dam technique The split-dam technique may be used to isolate anterior teeth without using a rubber dam clamp. Not only is this technique useful when there is insufficient crown structure, as in the case of horizontal fractures, but it also prevents the possibility of the jaws of the clamp chipping the margins of teeth restored with porcelain crowns or laminates. Studies on the effects of retainers on porcelainfused-to-metal restorations and tooth structure itself have demonstrated that there can be significant damage to cervical porcelain, as well as to dentin and cementum, even when the clamp is properly stabilized. Thus, for teeth with porcelain restorations ligation with dental floss is recommended as an alternate method to retract the dam and tissues, or the adjacent tooth can be clamped. In the split-dam method, two overlapping holes are punched in the dam. A cotton roll is placed under the lip in the mucobuccal fold over the tooth to be treated. The rubber dam is stretched over the tooth to be treated and over one adjacent tooth on

Conservative Dentistry and Endodontics 5 each side. The edge of the dam is carefully teased through the contacts on the distal sides of the two adjacent teeth. Dental floss helps carry the dam down around the gingiva. The tension produced by the stretched dam, aided by the rubber dam frame, secures the dam in place. The tight fit and the cotton roll produce a relatively dry field. If the dam has a tendency to slip, a premolar clamp may be used on a tooth distal to the three isolated teeth, or even on an adjacent tooth. The clamp is placed over the rubber dam, which then acts as a cushion against the jaws of the clamp. 23. Identify the equipment shown in the color plate.

26. Identify the equipment shown in the color plate.

a. b. c. d. Ans

b. Locking forceps

27. Identify the equipment present in the color plate.

a. b. c. d. a. Tiger clamp c. Universal clamp Ans

b. d.

Cat-paw clamp Incisor clamp

a. Tiger clamp

Articulating paper forceps Locking forceps Stieglitz pliers Tissue holding forceps

Ans

Gutta-Percha cone Gutta-Percha stick Gutta-Percha points Paper points

d. Paper points

28. Identify the name of test being performed with Gutta-Percher cone in the color plate.

24. Identify the equipment shown in the color plate.

a. b. c. d. Ans

Articulating paper forceps Locking forceps Stieglitz pliers Tissue holding forceps

a. Articulating paper forceps

25. Identify the equipment present in the color plate.

a. b. c. d. Ans

Composite placement instrument Cement spatula Spoon excavator Hatchet

a. Composite placement instrument

a. Thermal test c. Cold test Ans

b. d.

Test cavity EPT

a. Thermal test

29. Identify the equipment present in the color plate.

6

TARGET MDS: Image Based Questions a. b. c. d. Ans

the prepared root canal. Using excessive force may either perforate the canal or fracture the instrument. The GatesGlidden drill is designed to break high on the shaft if excessive resistance is encountered, allowing the clinician to easily remove the fragment.

Silicone stop dispenser Needle cutter Needle dispenser Glass bead sterilizer

a. Silicone stop dispenser 33. Identify the instrument present in the color plate.

30. Identify the equipment present in the color plate.

a. b. c. d. a. Electric pulp tester c. Pathfinder Ans

b. d.

Apex locator Obturator

b. Apex locator

Ans

Gates-Glidden drill Pesso reamer Piezoelectric drill Piezoelectric scaler

b. Pesso reamer

34. Identify the type of needle present in the color plate.

31. Identify the instrument present in the color plate.

a. b. c. d. Ans

a. Barbed broach

32. Identify the instrument present in the color plate.

a. b. c. d.

a. b. c. d.

Barbed broach File Reamer Gutta-Percha remover

Gates-Glidden drill Pesso reamer Piezoelectric bur Piezoelectric scaler

Ans a. Gates-Glidden drill Rotary instruments are used principally as flaring devices for the coronal portion of the canal. The most common is the Gates-Glidden drill. Sized in increasing diameters from no. 1 through no. 6, the Gates-Glidden should be used in a passive manner to enlarge the canal orifice and flare

Ans

Irrigating needle Hypodermal needle Submucosal needle Aspiration needle

a. Irrigating needle

35. Identify the instrument present in the color plate.

a. b. c. d.

Barbed broach File Reamer Gutta-Percha remover

Ans d. Gutta-Percha remover This device breaks up and removes Gutta-Percha from the canal, facilitating retreatment procedures.

Conservative Dentistry and Endodontics 7 36. Identify the instrument in the color plate.

39. Identify the instrument in the color plate.

a. Hatchet c. Hoe a. RC spreader c. Williams probe

b. d.

RC plugger Endo explorer

Ans a. RC preader Specialized instruments used in obturating the root canal with Gutta-Percha include spreaders and plungers. Spreaders are available in a wide variety of lengths and tapers and are used primarily in the lateral condensation technique to compact Gutta-Percha filling material.

Ans

b. d.

Chisel Osteotome

a. Hatchet

40. The cross-section represented in the color plate belongs to which of the following?

37. Identify the instrument in the color plate.

a. b. c. d.

RC spreader RC plugger Williams probe Endo explorer

Ans b. RC plugger Specialized instruments used in obturating the root canal with Gutta-Percha include spreaders and pluggers. Pluggers, also called condensers, are flat-ended rather than pointed and are used primarily to compact filling materials in a vertical fashion.

a. Flex-R c. Hedstrom Ans

b. d.

K-flex Unifile

c. Hedstrom

41. The cross-section represented in the color plate belongs to which of the following?

38. The following canal anatomy image represents anatomy of which tooth? a. Flex-R c. Hedstrom Ans

a. b. c. d. Ans

Maxillary molar Mandibular molar Mandibular premolar Maxillary premolar

b. Mandibular molar

d. Unifile

b. d.

K-flex Unifile

8

TARGET MDS: Image Based Questions 42. The diagrammatic representation depicts which of following canal preparation method?

44. Identify the equipment in the color plate.

a. H-file c. K-flex file Ans

b. d.

K-file Barbed broach

a. H-file

45. According to Ellis classification system, trauma to 21 is classified as? a. b. c. d. Ans

Watch winding Balanced force motion Step down Anti-curvature

a. Watch winding a. Class 1 c. Class 3

43. The diagrammatic representation depicts which of the following canal preparation method? Ans

b. d.

Class 2 Class 4

c. Class 3

46. Identify the equipment present in the color plate.

a. b. c. d. Ans

Watch winding Balanced force motion Step down Anticurvature

a. b. c. d. Ans

Composite placement instrument Cement spatula Spoon excavator Hatchet

b. Cement spatula

47. The image represents which of the following?

b. Balanced force motion

a. HBSS c. Cold milk Ans

a. HBSS

b. Viaspan d. Stem cell culture

Conservative Dentistry and Endodontics 9 A system has been developed to transport avulsed teeth that cannot readily be replanted at the site of the injury. SAVE-ATOOTH (Biological Rescue Products, Conshohocken, Pa.) contains a basket in which the teeth are suspended in HBSS, thus providing an optimal storage and transport medium. These small containers may be purchased and kept at sites such as schools, gymnasiums, sports facilities, emergency vehicles, and homes to be used if the need arises 48. Identify the equipment present in the color plate.

51. Identify the feature shown in the color plate. a. b. c. d. Ans

Nerve retractor Carr retractor Selden retractor Arens tissue retractor

b. Carr retractor

49. The diagrammatic representation of root canal morphology depicts which type of Vertucci’s classification?

a. b. c. d. Ans

Palatal groove Vertical root fracture Dens in dente Root resorption

a. Palatal groove

52. Identify the feature shown in the color plate. a. Type III c. Type VI Ans

b. d.

Type IV Type VIII

a. Type III

50. The diagrammatic representation of root canal morphology depicts which type of Vertucci’s classification? a. b. c. d. Ans

Dens evaginatus Cusp of carabelli Leonag’s premolar Mulbery molar

b. Cusp of carabelli

53. Identify the instrument present in the color plate. a. Type III c. Type VI Ans

d. Type VIII

b. d.

Type IV Type VIII

10

TARGET MDS: Image Based Questions a. b. c. d.

56. Identify the kind of tooth defect presented in the color plate.

Barbed broach File Apexum device Gutta-Percha remover

Ans c. Apexum device Simpler, approach has recently emerged with the development of a device that allows enucleation of the periapical tissue, through the root canal and the apical foramen. The Apexum TM protocol is applied just before root canal obturation. Once cleaning, shaping, and disinfection of the root canal is completed, the apical foramen is enlarged by passing a no. 35 rotary file to 1 to 2 mm beyond the apex. This passage is used to insert a specially designed nickel– titanium wire into the periapical tissue that rotates and minces the tissue.

54. Identify the kind of tooth defect presented in the color plate.

a. Abfraction c. Abrasion Ans

b. d.

Erosion Attrition

c. Abrasion

57. Identify the kind of tooth defect presented in the color plate.

a. Abfraction c. Abrasion Ans

b. d.

Erosion Attrition

d. Attrition

58. Identify the instrument in the color plate.

a. Abfraction c. Abrasion Ans

b. d.

Erosion Attrition a. Michigan probe c. WHO probe

a. Abfraction

55. Identify the kind of tooth defect presented in the color plate.

Ans

b. d.

CPIT-N probe Williams probe

d. Williams probe

59. Identify the instrument in the color plate.

a. Abfraction c. Abrasion Ans

b. Erosion

b. d.

a. Hatchet c. Hoe

Erosion Attrition Ans

b. Chisel

b. d.

Chisel Osteotome

Conservative Dentistry and Endodontics 11 60. Identify the instrument in the color plate.

a. b. c. d. Ans

64. Identify the instrument present in the color plate.

Hatchet Chisel Angle former Gingival marginal trimmer

a. b. c. d.

d. Gingival marginal trimmer

61. Identify the instrument in the color plate.

Ans

Amalgam capsule Amalgam condenser Amalgam dispener Composite dispenser

c. Amalgam dispenser

65. Identify the instrument present in the color plate.

a. Condenser c. Carver Ans

a. Hatchet b. Chisel c. Angle former d. Gingival marginal trimmer Ans c. Angle former

Ans

a. Condenser

a. Roach carver c. Discoid cleoid carver Ans

b. d.

Burnisher GMT

66. Identify the instrument present in the color plate.

62. Identify the instrument in the color plate.

a. Hatchet c. Hoe

b. d.

Chisel Osteotome

b. d.

Le Cron carver Vehe carver

d. Vehe carver

67. Identify the instrument present in the color plate.

c. Hoe

63. Identify the equipment present in the color plate.

a. Condenser c. Carver Ans

b. d.

Burnisher GMT

b. Burnisher

68. Identify the instrument present in the color plate.

a. b. c. d. Ans

Tooth slooth Agate spatula Amalgam dispenor Composite dispenser

b. Agate spatula

12

TARGET MDS: Image Based Questions a. b. c. d. Ans

Ivory 1 matrix retainer Ivory 8 matrix retainer Tofflemire retainer Ivory 7 matrix retainer

a. Ivory 1 matrix retainer

69. Identify the instrument present in the color plate.

a. b. c. d. Ans

a. Separator c. Matrix strip Ans

b. Wedge

Ivory 1 matrix retainer Ivory 8 matrix retainer Tofflemire retainer Ivory 7 matrix retainer a. b. c. d.

70. Identify the instrument present in the color plate.

Ans

Ans

Wedge Mylar strip

73. Identify the type of wedging represented in the color plate.

b. Ivory 8 matrix retainer

a. b. c. d.

b. d.

Ivory 1 matrix retainer Ivory 8 matrix retainer Tofflemire retainer Ivory 7 matrix retainer

Double wedging Wedge wedging technique Piggy back wedging Inverted wedging

a. Double wedging

74. Identify the type of wedging represented in the color plate

c. Tofflemire retainer

71. Identify the instrument present in the color plate.

a. b. c. d. Ans

Composi-tight ring Clampless separator Matrix strip Mylar strip

a. Composi-tight ring

72. Identify the instrument present in the color plate.

a. b. c. d. Ans

Double wedging Wedge wedging technique Piggy back wedging Inverted wedging

b. Wedge wedging technique

75. Identify the type of wedging represented in the color plate.

Conservative Dentistry and Endodontics 13 a. b. c. d. Ans

Double wedging Wedge wedging technique Piggy back wedging Inverted wedging

79. Identify the instrument present in the color plate.

c. Piggy back wedging

76. The color plate depicts which class of tooth preparation?

a. Crown trial forceps b. Crown remover c. Crown crimper d. Crown crusher Ans

a. Crown trial forceps

80. Identify the part of casting assembly marked with question mark. a. b. c. d. Ans

Class 1 Class 2 Class 3 Class 4

c. Class 3

77. Identify the instrument present in the color plate.

a. b. c. d. Ans

Composite placement instrument Cement spatula Excavator Hatchet

a. b. c. d.

c. Excavator

78. Identify the instrument present in the color plate.

Ans

Sprue former Crucible former Casting ring Wax pattern

a. Sprue former

81. Identify the instrument present in the color plate.

a. b. c. d. Ans

a. b. c. d.

Miniplates Amalgam capsules Amalgam globules Amalgam pins

d. Amalgam pins

Ans

Crown trial forceps Crown remover Crown crimper Crown crusher

b. Crown remover

14

TARGET MDS: Image Based Questions 82. The cross-section represented in the color plate belongs to which of the following?

a. Flex-R c. Hedstrom Ans

b. d.

Ans

83. The cross-section represented in the color plate belongs to which of the following?

Ans

a. b. c. d.

K-flex Unifile

c. Hedstrom

a. Flex-R c. Hedstrom

85. Identify the equipment present in the color plate.

b. d.

a. Carbon fiber-reinforced epoxy resin post

86. Identify the equipment present in the color plate.

a. b. c. d.

K-flex Unifile

b. K-flex

84. Identify the material present in the color plate.

Carbon fiber-reinforced epoxy resin post Glass fiber-reinforced epoxy resin posts Zirconia posts Metal post

Ans

Carbon fiber-reinforced epoxy resin Glass fiber-reinforced epoxy resin posts Zirconia posts Metal post

b. Glass fiber-reinforced epoxy resin posts

87. Identify the equipment present in the color plate.

a. Normal saline c. Dextrose solution Ans

a. Normal saline

b. d.

a. b. c. d.

Ringers lactate Hypochlorite Ans

Carbon fiber-reinforced epoxy resin Glass fiber-reinforced epoxy resin posts Zirconia posts Metal post

c. Zirconia posts

Conservative Dentistry and Endodontics 15 88. The condition seen in the color plate is associated with which of following?

a. b. c. d.

89. Following extraction of mandibular teeth patient developed severe pain and ecchymosis as seen in the color plate. What can be the cause?

External resorption Internal resorption Cervical resorption Apical resorption

Ans b. Internal resorption. Pink tooth of mummery.

a. b. c. d. Ans

Postsurgical ecchymosis Sodium hypochlorie injection Air emphysema Herpes labialis activation

a. Postsurgical ecchymosis

Chapter

2

1j O

Prosthodontics

a> LU 03 HHBHB

1 . This edentulous arch is classified according to Kennedy classification as.

3. This edentulous arch is classified according to Kennedy classification as.

V a. Class 1 c. Class 3

b. d.

Class 2 Class 4

Ans a. Class 1 Class 1: Bilateral posterior edentulous areas 2. This edentulous arch is classified according to Kennedy classification as.

a. Class 1 c. Class 3

b. d.

Class 2 Class 4

Ans c. Class 3 A unilateral tooth bounded edentulous area 4. This edentulous arch is classified according to Kennedy classification as.

CD LU 03

CD

a. Class 1 c. Class 3

d.

Class 2 Class 4

Ans b. Class 2 Class 2: An unilateral posterior edentulous area

a. Class 1 c. Class 3

Class 2 Class 4

Ans d. Class 4 An anterior tooth bounded edentulous area which crosses the midline

CO

Prosthodontics 17 5. This edentulous arch is classified according to Kennedy classification as.

a. Class 6 c. Class 5

b. d.

Class 4 Class 3

Ans c. Class 5 Applegate’s Additions Class 5: A unilateral tooth bounded edentulous area where the anterior tooth is weak and incapable of providing support for the RPD 6. This edentulous arch is classified according to Kennedy classification as.

a. Class 6 c. Class 4

b. d.

Class 5 Class 2

Ans a. Class 6 Class 6: A unilateral tooth bounded edentulous area which should be restored with a FPD 7. This edentulous arch is classified according to Kennedy classification as.

8. This edentulous arch is classified according to Kennedy classification as.

a. b. c. d.

Class 1 modification 1 Class 2 modification 1 Class 3 modification 1 Class 4 modification 1

Ans b. Class 2 modification 1 (questions 7 and 8) Rules for Classification Applegate, Swenson and Terkla have suggested rules to apply to the Kennedy Classification System to eliminate some uncertainties and to make the classification more descriptive. A simplification of these suggestions is: 1. Teeth which are to be extracted are considered as edentulous spaces when classifying the arch. 2. Edentulous spaces which are not going to be restored with the RPD are not considered in the classification of the arch. 3. The most posterior edentulous space determines the class of the arch for Classes 1 through 4. The length of the edentulous space, i.e. the number of missing teeth or the number of prosthetic teeth to be used on the denture, is not considered in the classification. 4. Edentulous areas in addition to those which determine the class for the arch are indicated as MODIFICATIONS of that CLASS and are designated by their FREQUENCY and whether they are ANTERIOR (A) or POSTERIOR (P). Only Class 1, 2 and 3 may have modifications. The length of the modification edentulous space, i.e. the number of missing teeth or number of prosthetic teeth to be used on the denture, is not considered. 9. If Implant placement is planned for the missing tooth, what type of occlusion is advisable?

a. b. c. d. Ans

Class 1 modification 1 Class 2 modification 1 Class 3 modification 1 Class 4 modification 1

c. Class 3 modification 1

18

TARGET MDS: Image Based Questions a. b. c. d.

13. Identify the anatomical landmark pointed with arrow.

Unilateral group function Bilateral group function Unilateral balanced Unilateral canine guided

Ans a. Unilateral group function (AIIMS SR JAN 15) If a canine is replaced with implant prosthesis, what type of occlusion will you prefer: Unilateral group function 10. Identify the anatomical landmark pointed with arrow.

a. Labial frenum c. Buccal frenum Ans

b. d.

Lingual frenum Alveolar ridge

d. Alveolar ridge

14. According to modified University of California Los Angeles (UCLA) classification, this Knifeshaped alveolar bone as seen in the color plate is classified as. a. Midpalatine raphe c. Posterior palatal seal Ans

b. d.

Uvula Rugae

a. Midpalatine raphe

11. Identify the anatomical landmark pointed with arrows.

a. Type 1 c. Type 3 Ans a. Midpalatine raphe c. Posterior palatal seal Ans

b. d.

Uvula Rugae

d. Rugae

12. Identify the anatomical landmark pointed with arrows.

a. Labial frenum c. Buccal frenum Ans

c. Buccal frenum

b. d.

b. d.

Type 2 Type 4

c. Type 3

15. According to modified University of California Los Angeles (UCLA) classification, a case with bone characteristic as seen in the color plate is classified as.

a. Type 1 c. Type 3

Lingual frenum Alveolar ridge Ans

a. Type 1

b. d.

Type 2 Type 4

Prosthodontics 19 16. According to modified University of California Los Angeles (UCLA) classification, a case with insufficient bone height as seen in the color plate is classified as.

18. This edentulous arch falls under which class of Cawood and Howell classification.

a. Class 1 c. Class 3 a. Type 1 c. Type 3 Ans

b. d.

Type 2 Type 4

Ans

b. d.

Class 2 Class 4

a. Class 1

19. This edentulous arch falls under which class of Cawood and Howell classification.

d. Type 4

17. According to modified University of California Los Angeles (UCLA) classification insufficient bone volume on buccal side as seen in the color plate is classified as.

a. Class 1 c. Class 3 Ans a. Type 1 c. Type 3

b. d.

b. d.

Class 2 Class 4

b. Class 2

20. This edentulous arch falls under which class of Cawood and Howell classification.

Type 2 Type 4

Ans c. Type 2 (Q-14-17) Ref: (Seriwatanachai D, et al. J Interdiscipl Med Dent Sci 2015; 3:2) Classification system

Tool used in classification

Modified UCLA classification, 2008

Clinical Observation (Bone shape and volume)

Types of bone

a. Class 1 c. Class 3

Images

Type 1: Sufficient alveolar shape for implants Type 2: Insufficient alveolar bone volume on the buccal side Type 3: Knife edge shape with sufficient alveolar bone height Type 4: Insufficient alveolar bone height

Table representing edentulous bone ridge classification followed three-dimensional (3D) quantity of alveolar bone shape and volume.

Ans

b. d.

Class 2 Class 4

c. Class 3

21. This edentulous arch falls under which class of Cawood and Howell classification.

20

TARGET MDS: Image Based Questions a. Class 1 c. Class 3 Ans

b. d.

Class 2 Class 4

d. Class 4

22. This edentulous arch falls under which class of Cawood and Howell classification.

a. b. c. d.

Groper’s appliance Nance palatal arch Halterman’s appliance Catlan’s appliance

Ans a. Groper’s appliance (Jan AIIMS Sr 15) Groper’s appliance is fixed anterior appliance 25. Which of the following appliance is used in the early loss of primary teeth such as this?

a. Class 6 c. Class 3 Ans

b. d.

Class 5 Class 4

b. Class 5

23. This edentulous arch falls under which class of Cawood and Howell classification.

a. c.

Class 5 Class 3

b. d.

Class 6 Class 4

Ans b. Class 6 (Questions 20–23) Cawood and Howell classification • Class 1: Dentate • Class 2: Immediately post ext. the alveolus has healed • Class 3: Well-rounded ridge, adequate in height and width. • Class 4: Knife edge ridge, adequate in ht. and width. • Class 5: Flat ridge, inadequate in ht. and width. 24. Identify the appliance.

a. b. c. d.

Groper’s appliance Nance palatal arch Halterman’s appliance Catlan’s appliance

Ans a. Groper’s appliance Loss of primary incisors after the eruption of primary canines is not an important consideration for space loss though occasionally in a crowded dentition there may be a rearrangement of some anterior teeth. Another consideration is the child’s speech development following extraction of primary incisors. The sounds most frequently in error are the labiolingual sounds. This is because many sounds are made with the tongue touching the lingual side of the maxillary incisors, and inappropriate speech compensations can develop if the teeth are missing. This space maintainer offers several advantages in terms of esthetics, restoration of masticatory and speech efficiency, and prevention of abnormal oral habit development. The main disadvantage is the accumulation of food debris and plaque. Hence, parents have to be instructed to supervise the maintenance of proper oral hygiene in their child. 26. This 58 years old diabetic, partially edentulous patient comes with chief complaint of burning sensation in palate. What is your line of treatment?

Prosthodontics 21 a. Start topical antiviral and advise plenty of water intake, review regularly, systemic antiviral if symptoms doesn’t subside b. Topical steroids c. Topical antifungals d. Advise avoiding denture for time period along with topical antifungals Ans d. Advise avoiding denture for time period along with topical antifungals

a. b. c. d. Ans

CAD-CAM CBCT soft-tissue reconstruction CAT Rapid prototype

a. CAD-CAM

30. Identify the type of articulator shown in the color plate.

27. Identify the appliance shown in the picture.

a. b. c. d. Ans

b. G-cuff

28. What is the function of the appliance shown in the image?

a. b. c. d. Ans

a. b. c. d.

Healing cap G-cuff Radiopaque indicator Saliva absorbent Ans

29. Which system is shown here to construct this maxillofacial prosthesis for the defect?

b. Semi-adjustable articulator

31. Identify the type of articulator shown in the color plate.

a. b. c. d.

Arresting gingival hemorrhage Gingival retractor Radiological marker Saliva absorption

b. Gingival retractor

Non-adjustable articulator Semi-adjustable articulator Fully adjustablr articulator Mean value articulator

Ans

Hinge articulator Semi-adjustable articulator Fully adjustablr articulator Mean value articulator

d. Mean value articulator

32. Identify the instrument shown in the color plate.

22

TARGET MDS: Image Based Questions a. T-Scan c. U-Impress Ans

b. d.

G-Cuff V-Impress

a. b. c. d.

a. T-Scan

33. What is the use of Instrument shown in the color plate?

Ans

Crown gauge Boley gauge Ridge mapping caliper Castroviejo caliper

a. Crown gauge

36. Identify the instrument in the color plate.

a. b. c. d.

Measure biting force Maxillary digital impression Mandibular digital impression Record mandibular movement

Ans a. Measure biting force T-Scan occlusal analysis system can help clinicians meet the needs of their patients for reliable measurements of occlusal biting forces.

a. b. c. d. Ans

Crown gauge Boley gauge Ridge mapping caliper Castroviejo caliper

b. Bolley gauge

37. Identify the instrument in the color plate.

34. Identify the instrument in the color plate.

a. b. c. d.

Bone Harvester Osteotome Sinus Lifter Bone mill

a. b. c. d. Ans

Crown gauge Boley gauge Ridge mapping caliper Castroviejo caliper

c. Ridge mapping caliper

38. Identify the instrument in the color plate.

Ans a. Bone Harvester Used to shave a thin layer of bone from a donor site. Harvesters are not used for synthetic or non-bone graft material. 35. Identify the instrument in the color plate.

a. b. c. d. Ans

Crown gauge Boley gauge Ridge mapping caliper Castroviejo caliper

d. Castroviejo caliper

Prosthodontics 23 39. Identify the instrument in the color plate.

Features precision ratchets to securely hold the bone block in place while minimizing the chance of block breakage. Aperture allows for screws to be placed while holding bone. 43. Identify the instrument in the color plate.

a. b. c. d. Ans

William’s probe Bone condensor Nerve depressor Implant depth gauge

d. Implant depth gauge

40. Identify the instrument in the color plate.

a. William’s probe b. Bone condensor c. Bone spreader d. Implant depth gauge Ans c. Bone spreader Useful to wedge donor block grafts from the chin and ramus.

a. Bone harvester b. Bone crusher c. Bone rongeur d. Bone mill Ans d. Bone mill Table top • Useful for crushing/grinding larger bone fragments into smaller particles for grafting purposes. • Available in table top and handheld versions. 44. Identify the instrument in the color plate.

41. Identify the instrument in the color plate.

a. Anterior bone block camp b. Posterior bone block clamp c. Tongue clamp d. Cheek retractor Ans b. Posterior bone block clamp 42. Identify the instrument in the color plate.

a. Anterior bone block camp b. Posterior bone block clamp c. Tongue clamp d. Cheek retractor Ans a. Anterior bone block camp (Q-41,42)

a. Bone harvester c. Bone rongeur

b. d.

Bone crusher Bone mill

Ans d. Bone mill • Useful for crushing/grinding larger bone fragments into smaller particles for grafting purposes. • Available in table top and handheld versions. 45. Identify the instrument in the color plate.

a. Bone harvester c. Bone rongeur Ans

b. Bone grinder

b. d.

Bone grinder Bone mill

24

TARGET MDS: Image Based Questions Reduces bone/graft material particle size. Place harvested bone in well of instrument. Cover bone with top, serrated side down. Use mallet to reduce bone to desired particle size.

49. Identify the instrument in the color plate.

46. Identify the instrument in the color plate. a. b. c. d.

Bone compactor Bone burnisher Bone tampers Bone material spoon

Ans a. Bone compactor Packs down graft material. Features a serrated tip and bent angle to reach difficult areas. a. Dappen dish c. Bone reservoir

b. d.

Bone basin Bone disposer

Ans b. Bone Basin Stainless steel deep dish with weighted bottom to prevent tipping. Holds 20 grams of wetted material. 47. Identify the instrument in the color plate.

50. Identify the instrument in the color plate.

a. Bone compactor b. Bone burnisher c. Bone tampers d. Graft material spoon Ans d. Graft material spoon Graft material spoons are used for mixing/preparation of graft material for bone augmentation procedures. 51. Identify the instrument in the color plate.

a. Local anesthesia syringe b. Graft syringe c. Bone tampers d. Irrigator Ans b. Graft syringe Stainless steel syringe designed to load syringe from the tip to reduce clogging. “Tamp and pack” method for placement of graft material into oral cavity. 48. Identify the instrument in the color plate.

a. Local anesthesia syringe b. Graft syringe c. Bone tampers d. Irrigator Ans c. Bone tampers Bone tampers feature a serrated tip for compacting bone or graft material.

a. Membrane forceps b. Tissue graft forceps c. Membrane placement instrument d. Blunt forceps Ans b. Tissue graft forceps 52. Identify the instrument in the color plate.

a. Membrane forceps b. Tissue graft forceps c. Membrane placement instrument d. Blunt forceps Ans a. Membrane forceps

Prosthodontics 25 53. Identify the instrument in the color plate.

a. b. c. d. Ans

56. Identify the appliance in the color plate.

Membrane forceps Tissue graft forceps Membrane placement instrument Blunt forceps

c. Membrane placement instrument

54. Identify the appliance in the color plate.

a. b. c. d.

Lingual plate Anteroposterior palatal bar Palatal strap Continuous bar major connector

Ans c. Palatal strap Palatal strap • Usually use for Class 3 and 4 cases • Wide anteroposteriorly 57. Identify the appliance in the color plate. a. b. c. d.

Lingual plate Anteroposterior palatal bar Palatal strap Continuous bar major connector

Ans a. Lingual plate Lingual plate: • Rest at each end of lingual plate • Prevents forces being directed facially • Easier denture tooth addition than bar 55. Identify the appliance in the color plate.

a. Lingual plate b. Anteroposterior palatal bar c. Palatal strap d. Continuous bar retainer Ans d. Continuous bar retainer Continuous bar retainer • Lingual bar with secondary bar above cingula • Secondary bar acts as indirect retainer 58. Identify the appliance in the color plate.

a. b. c. d.

Lingual plate Anteroposterior palatal bar Palatlal strap Continuous bar major connector

Ans b. Anteroposterior palatal bar Anteroposterior palatal bar A narrow (A-P) variation of anterior-posterior palatal strap • Double palatal bar connector • Requires greater bulk for rigidity

a. Ring clasp b. Reverse action clasp c. Double embrasure clasp d. RPI clasp Ans a. Ring clasp

26

TARGET MDS: Image Based Questions • •

Ring clasp Tilted abutments − Usually mandibular molars − Mesially/lingually tilt − Undercut close to rest − Allows use of available undercut 59. Identify the appliance in the color plate.

a. Ring clasp b. Reverse action clasp c. Double embrasure clasp d. RPI clasp Ans b. Reverse action clasp • Reverse action clasp − Undercut adjacent edentulous space − Almost impossible to adjust − Poor esthetics, hygiene − Clearance from opposing occlusion − Poor flexibility (esp. short crowns)

a. b. c. d.

Ans d. RPI clasp • “R” Rest (always mesial) • “P” Proximal Plate (distal) • “I” I - Bar (buccal) • Rest minor connector and proximal plate reciprocate • Proximal plate toward lingual • Retentive arm mid-buccal except canines (mesiobuccal) 62. Identify the instrument in the color plate.

60. Identify the appliance in the color plate.

a. Surveyor c. Cast trimmer Ans

a. Ring clasp b. Reverse action clasp c. Double embrasure clasp d. RPI clasp Ans c. Double embrasure clasp Double embrasure clasp • Two rests, two retentive arms, two bracing arms • Used in quadrants with no edentulous space • Distal approach cannot be used on most posterior tooth 61. Identify the appliance in the color plate.

Ring clasp Reverse action clasp Double embrasure clasp RPI clasp

b. d.

Cast holder Spirit lamp

a. Surveyor

63. What is ideal distance marked by “X” in the diagrammatic representation of maxillary major connector?

a. 1 mm c. 3 mm

b. d.

2 mm 4 mm

Ans b. 2 mm Position of Major Connector Junction Should be ≈ 2 mm medial to lingual surface of denture teeth Ensures bulk of resin around teeth

Prosthodontics 27 64. Identify the instrument in the color plate.

Ans

a. Surveyor

b.

Cast holder

c. Face bow

d.

Boley gauge

c. Face bow

65. Identify the appliance placed on anterior teeth.

a. Dahl appliance b. Modified Dahl appliance c. Inman appliance d. Metal-ceramic crowns Ans a. Dahl appliance

b. d.

Ridge lap Sanitary

67. Image shows which type of pontic?

a. Ovate c. Modified ridge lap Ans d. Sanitary

Image shows which type of pontic?

a. Ovate b. Ridge lap c. Modified ridge lap d. Sanitary Ans a. Ovate 69. Image shows which type of pontic?

a. Ovate b. Ridge lap c. Modified ridge lap d. Sanitary Ans c. Modified ridge lap

66. Image shows which type of pontic?

a. Ovate c. Modified ridge lap Ans b. Ridge lap

68.

b. d.

Ridge lap Sanitary

70. Image shows which type of pontic?

a. Conical c. Modified ridge lap Ans a. Conical

b. d.

Lap facing Sanitary

71. Mandibular second premolar as shown in the color plate will act as.

28

TARGET MDS: Image Based Questions a. Pier abutment b. Tilted abutment c. Distal extension abutment d. Lever abutment Ans A. Pier abutment

a. Chamfer b. Shoulder c. Shoulder with bevel d. Knife-edge preparation Ans b. Shoulder

72. Which of the following tooth will act as pier abutment if fixed partial denture is planned in this case?

75. Identify the tooth preparation finish line for the image shown here.

a. 23 c. 25 Ans c. 25

b. d.

24 27

73. Identify the tooth preparation finish line for the image shown here.

a. Chamfer b. Shoulder c. Shoulder with bevel d. Knife-edge preparation Ans c. Shoulder with bevel 76. Which type of resin bonded FPD is shown in the color plate?

a. Chamfer b. Shoulder c. Shoulder with bevel d. Knife-edge preparation Ans c. Shoulder with bevel 74. Identify the tooth preparation finish line for the image shown here.

a. Rochette bridge c. Cast mesh FPD Ans a. Rochette bridge

b. d.

Maryland bridge Virginia bridge

77. Which type of resin bonded FPD is shown in the color plate?

a. Rochette bridge c. Cast mesh FPD Ans b. Maryland bridge

b. Maryland bridge d. Virginia bridge

Prosthodontics 29 78. Which type of resin bonded FPD is shown in the color plate?

81. Identify the appliance shown in the color plate.

a. Svedopter c. Dentpop a. b. c. d. Ans

Rochette bridge Maryland bridge Cast mesh FPD Virginia bridge

Ans

b. d.

Airbug Suction tube

b. Airbug

82. Identify the appliance shown in the color plate.

c. Cast mesh FPD

79. Which type of resin bonded FPD is shown in the color plate?

a. Svedopter c. Dentpop Ans c. Dentpop

b. d.

Airbug Suction tube

83. Identify the appliance shown in the color plate. a. b. c. d. Ans

Rochette bridge Loop connector FPD Cast mesh FPD Virginia bridge

b. Loop connector FPD

80. Identify the appliance shown in the color plate.

a. Svedeptor b. Airbug c. Dentpop d. Dry angles Ans d. Dry angles Dry angles/dry aids are used to keep the mouth dry by covering the Stensen’s (parotid) duct to restrict the flow of saliva. 84. Identify the type of minor connector marked in the color plate.

a. Suction tube c. Tongue depressor

b. d.

Cheek retractor Svedopter

Ans d. Svedopter Svedopter/Speejector Svedopter consist of a metal saliva ejector with a tongue deflector. Effectively used in mandibular arch.

a. Mesh work c. Nail head Ans a. Mesh work

b. d.

Lattice work Wire

30

TARGET MDS: Image Based Questions 85. Color plate shows wax pattern for which maxillofacial prosthesis?

a. b. c. d. Ans

Lingual bar Labial bar Lingual plate Continuous bar

a. Lingual bar

88. Identify the part of cast partial denture marked with arrow.

a. Eye c. Nose Ans

b. d.

Ear Lips

b. Ear

86. Color plate shows wax pattern for which maxillofacial prosthesis?

a. Major connector b. Minor connector c. Shoulder d. Retainer Ans b. Minor connector 89. What is true for part of cast partial denture marked with arrow in the design?

a. Eye c. Nose Ans a. Eye

b. d.

Ear Lips

87. Which type of major connector is used in the cast partial denture shown in the color plate? a. Major connector b. Minor connector c. Relief area d. Retainer Ans c. Relief area

Chapter

3

1j O

Oral and Maxillofacial Surgery

a> LU 03 HHBHB

1 . Identify the instrument present in the color plate .

b. Tongue depressor a. Cheek retractor d. Cleft palate raspatory c. Laryngoscope Ans d. Cleft palate raspatory This broad, flat handled elevator is specially used to elevate the palatal mucoperiosteum while mobilizing the flaps for cleft palate repair.

prop consists of a vertical block having a concave surface on either of its ends to fit on the occlusal surfaces of maxi llary and mandibular teeth. The block is placed between the mandibular and maxillary teeth to maintain the mouth open. Usually, there are three or four blocks of varying vertical heights arranged in an ascending order, and con nected by a chain. The operator can choose the block according to the required extent of oral opening. 3. Identify the instrument present in the color plate.

2. Identify the instrument present in the color plate.

a. b. c. d.

Mouth prop Jaw stretcher Bone holding forceps Mouth gag Ans a. Mouth prop Mouth props can be of two varieties: ( A ) Rubber and ( B) Metal. The function of the mouth prop is similar to the mouth gag, i.e. to keep the mouth open during any surgical procedure performed in the oral cavity. The mouth

b. Jaw stretcher a. Mouth prop d. Mouth gag c. Bone holding forceps Ans b. Jaw stretcher Heister 's jaw stretcher: This instrument is used to forcibly open the mouth. The instrument has two flat blades that are applied between the maxillary and mandibular posterior teeth and are separated by turning a key that is positioned between the two blades. Uses 1. To force the mouth open when there is trismus due to infection, muscle spasm, hemarthrosis of the temporomandibular joint following trauma. 2. To give postoperative active jaw physiotherapy after surgery for TM joint ankylosis, submucous fibrosis. When using the above two instruments, care must be taken to prevent luxation of the teeth, especially the ante riors and dislocation of the temporomandibular joint.

CD LU

: CD

^

32

TARGET MDS: Image Based Questions 4. Identify the instrument present in the color plate.

a. Mouth prop c. Bone holding forceps

b. d.

Jaw stretcher Mouth gag

Ans d. Mouth gag Mouth gag: This instrument is used to keep the mouth open in a patient under general anesthesia, during surgeries of the oral cavity, tonsils and the pharynx. The flat blades have serrations that rest on the occlusal surfaces of the maxillary and the mandibular teeth. The handle has a catch that is fixed at the required opening. 5. Identify the instrument present in the color plate.

a. Bone file c. Chisel

b. Osteotome d. Rongeurs forceps

Ans d. Rongeurs forceps Rongeurs forceps (Blumenthal, Jensen Middleton). The rongeurs forceps have curved handles that have a spring action. The spring increases the force applied and hence efficiency of the instrument. There can be either one spring or a double spring (Jensen Middleton). When the handles are released the instrument automatically opens up. This helps the surgeon to make repeated cuts without making efforts to open the handles. The tip is angulated forward to the handle and has a concave inner surface. The beaks are sharp. They can be either side cutting (Blumenthal) or both side and end cutting. The instrument is used to remove large amounts of bone at a time using multiple, small bites. Uses 1. To nibble sharp bony margins following simple or surgical extraction of teeth, surgical procedures. 2. To peel off thinned out bone present over cystic or tumorous lesions. 3. To trim sharp bony ridges during alveoloplasty procedures. 7. Identify the instrument present in the color plate.

a. Mouth prop b. Jaw stretcher c. Bone holding forceps d. Mouth gag Ans c. Bone holding forceps Fergusson’s Lion Jaw Bone Holding Forceps: They are named so because of the appearance of the beaks sideways. The beaks have toothed margins to allow a good grip on the bone. The Crocodile bone holding forceps has a catch to stabilize the instrument in the required position. In the absence of the above instruments, a forcep type of a towel clip may also serve the purpose. Uses To hold the bony fragments of the mandible during manipulation of the bony fragments during fracture reduction, resection procedures, after osteotomy cuts, and during fixation of the bony fragments. 6. Identify the instrument present in the color plate.

a. Bone file b. Osteotome c. Chisel d. Rongeurs forceps Ans a. Bone file Miller and Colburn bone file: As the name suggests, the bone file is used to smoothen any sharp bony margin present in the surgical field. The instrument has a long curved working end and a short oval working end. The working ends have horizontal serrations. The instrument is used unidirectionally using a pull stroke. A push stoke usually causes burnishing and crushing of the bone. The working edges must be cleaned regularly to prevent clogging by bone debris, thereby reducing the efficiency of the instrument. 8. Identify the instrument present in the color plate.

Oral and Maxillofacial Surgery 33 a. Bone file b. Osteotome c. Chisel d. Rongeurs forceps Ans b. Osteotome Osteotome: The osteotome is similar to a chisel, but the edge of the working tip is bibeveled. It splits bone rather than cut or chip the bone as with the chisel. Uses 1. Various osteotomy procedures, 2. Biopsy of bony lesions, 3. Removal or recontouring of the bone.

a. Bone gouge c. Mallet

b. Cinelli osteotome  d. Gigli’s saw

Ans b. Cinelli osteotome Cinelli osteotome  is a useful tool in rhinoplasty procedures. The instrument is designed to shape the bony nasal hump. 12. Identify the instrument present in the color plate.

9. Identify the instrument present in the color plate.

a. Bone file b. Osteotome c. Chisel d. Rongeurs forceps Ans c. Chisel Chisel: Chisels are unibevelled instruments for cutting bone. They have a heavy round handle and a long flat working tip. The edge of the working tip has a bevel on one side. The working edge is sharp and is flat. To plane the bone, the bevel is kept facing the bone. To cut the bone, the bevel is kept facing away from the bone. Uses 1. To remove chips of bone as in transalveolar extractions, 2. To split the tooth in difficult extractions. 10. Identify the instrument present in the color plate.

a. Bone gouge c. Mallet

b. d.

Nasal rasp Gigli’s saw

Ans a. Bone gouge Bone gouge: The bone gouge has a round handle and a blade that has a sharp working tip that is concave on the inner side. The working tip is half round and has a long working area. Uses 1. To remove cancellous graft material during grafting procedures, 2. To make a window in the anterior wall of the maxillary sinus for access to the maxillary sinus during Caldwell Luc procedure, 3. To remove irregular pieces of bone. 11. Identify the instrument present in the color plate.

a. Bone gouge c. Mallet

b. d.

Nasal rasp Gigli’s saw

Ans c. Mallet Mallet: A mallet is made up of steel, lead or wood. It is similar to a hammer and is used for giving controlled taps on the chisel, bone gouge or osteotome. To be effective, the mallet should be used with a loose, free swinging movement of the wrist that gives maximum speed to the head of the mallet without introducing the weight of the arm or the body to the blow. The kinetic energy of a body is calculated as KE = 1/2MV2, where KE or kinetic energy stands for the energy possessed by the moving body, M stands for the mass of the body and V stands for the velocity of the body. Usually, a six inch mallet is used for minor oral surgical procedures. 13. Identify the instrument present in the color plate.

a. Bone gouge b. Nasal rasp c. Mallet d. Gigli’s saw Ans d. Gigli’s saw Gigli’s saw: The armamentarium for the use of Gigli’s saw are: 1. Gigli’s saw, 2. Two handles, 3. Introducer, 4. Guide. The Gigli’s saw is made by twisting a few pieces of wires together, so that it acquires a sharp, barbed, cutting edge when moved to and fro along it’s long axis.

34

TARGET MDS: Image Based Questions At the end, there is a ring to which the hook of the handle can be fitted. In maxillofacial surgery, the saw was usually used to cut the mandible (hemimandibulectomy procedures). Care must be taken to protect the soft tissues, while using this instrument. 14. Identify the instrument present in the color plate.

a. Mayo-Hegar needle holder b. Rowe’s disimpaction forceps c. Hayton williams forceps d. Walsham’s forceps Ans a. Mayo-Hegar needle holder Mayo-Hegar needle holder: The needle holder is a straight instrument with a short working tip. The blade of the needle holder is shorter and stronger than that of the hemostat. The working tip has cross hatched serrations with a single vertical serration to grip the needle. The handle has a catch. Usually, a six inch needle holder is used in oral surgery. The instrument is held between the ring finger and the thumb and the index and the middle finger support the needle holder. 15. Identify the instrument present in the color plate.

a. Erich’s arch bar c. Wire holder

b. d.

Bone plates Skin hook

Ans d. Skin hook Skin hook: Skin hook is a thin, long instrument, with a delicate curved tip. This tip engages the tissues. Uses 1. To stretch the edges of the skin incision during suturing to prevent dog ear formation, 2. To retract small amount of soft tissue or edges. 16. Identify the instrument present in the color plate.

a. b. c. d.

Asche’s forceps Rowe’s disimpaction forceps Hayton Williams forceps Walsham’s forceps

Ans b. Rowe’s disimpaction forceps Rowe’s disimpaction forceps: A pair of Rowe’s disimpaction forceps is used for disimpacting the maxilla in LeFort fractures. It consists of one straight and one curved blade. The blades are padded for atraumatic purpose. The straight blade is passed into the nostril and the curved blade enters the mouth and grips the palate. The operator stands behind the patient and grasps the handles of each of the forceps and manipulates the fragments into position. Uses 1. To disimpact the maxilla in fresh LeFort fractures, malunited fractures, 2. To check for free movements of the maxilla after LeFort osteotomy procedure. 17. Identify the instrument present in the color plate.

a. Asche’s forceps b. Rowe’s disimpaction forceps c. Hayton Williams forceps d. Walsham’s forceps Ans c. Hayton Williams forceps Hayton Williams forceps: This forceps has two widely divergent curved beaks that engage the maxilla behind the tuberosity. It is usually used in conjunction with the Rowe’s disimpaction forceps to mobilize the maxilla. 18. Identify the instrument present in the color plate.

a. Asche’s forceps b. Rowe’s disimpaction forceps c. Hayton Williams forceps d. Walsham’s forceps Ans d. Walsham’s forceps Walsham’s forceps: It is used to manipulate the fractured nasal fragments. The forceps has a padded blade and an unpadded blade that are curved. The unpadded blade of the Walsham Forceps is passed up the nostril, and the nasal bone and the associated fragment of the frontal

Oral and Maxillofacial Surgery 35 process of the maxilla are secured between the padded blade externally and the unpadded blade internally. The fragments are then manipulated in their correct position.

21. Identify the instrument present in the radiograph.

19. Identify the instrument present in the color plate. a. Erich’s arch bar c. Wire holder

a. Asche’s forceps b. Rowe’s disimpaction forceps c. Hayton Williams forceps d. Walsham’s forceps Ans a. Asche’s forceps The Asche’s septal forceps is used to reduce the fractures of the nasal bone and to align the nasal septum. The blades are passed on either side of the nasal septum and the vomer and the perpendicular plate of the ethmoid are ironed out. If possible the septal cartilage is then grasped and repositioned in it’s groove in the vomer. To reduce the nasal bone fracture, one blade is inserted in the nostril, holding the medial aspect of the nasal bone and the other blade is kept externally holding the lateral aspect of the nasal bone. 20. Identify the instrument present in the color plate.

b. d.

Bone plate Skin hook

Ans b. Bone plate Bone plates are usually made up of stainless steel or titanium. They are available in various sizes, lengths and shapes. In oral surgery the thickness of the plates varies from 1.5 mm, 2 to 2.5 mm. 2.5 mm plates are usually used for the mandible, whereas the former two are used for the maxilla. Depending on the requirement, they are available in different lengths, 2-hole, 3-hole, 4-hole, 6-hole, etc. and in different shapes—orbital, “L” shaped, “T” shaped, etc. 22. Identify the instrument present in the color plate.

a. Erich’s arch bar b. Bone plates c. Wire holder d. Skin hook Ans a. Erich’s arch bar It contains a thin stainless steel strip that has hooks incorporated on it. It is malleable and can be adapted to the contour of the maxillary or mandibular arch and fixed to the teeth by wires. Uses 1. To stabilize dentoalveolar fractures. 2. To stabilize mandibular or maxillary fractures, that are to be treated by closed reduction. 3. To provide means for intermaxillary ligation. 23. Identify the instrument present in the color plate.

a. Erich’s arch bar c. Wire holder

b. d.

Bone plates Skin hook

Ans c. Wire holder Wire holder (Hayton Williams): A wire holder is similar to a needle holder, except that it has a heavy tip, which may be devoid of the vertical serrations.

a. Ryle’s tube b. Foley’s self-retaining catheter c. Infant feeding tube d. Corrugated rubber drain Ans b. Foley’s self-retaining catheter

36

TARGET MDS: Image Based Questions It is a self-retaining catheter used for evacuating the bladder. The self-retaining mechanism is in the balloon near its tip. At the other end of the catheter, two tubes are present. The wider tube is meant for draining the urine, while the narrower tube communicates with the balloon and is meant for inflating and deflating the balloon. The catheter is passed through the urethra in either sex, into the bladder. The position is confirmed by the free passage of urine through the wider tube. Then the catheter is anchored within the bladder by inflating the balloon via the smaller tube, by injecting water. When the catheter is to be withdrawn, the water is aspirated through the narrower tube. The catheter is available in various sizes. The commonly used size for males is no. 16 and for females is no. 14. Indications in oral and maxillofacial surgery: 1. For evacuation of the bladder in long cases under general anaesthesia. 2. For evacuation of the bladder in unconscious patients. 3. For patients with postoperative urinary retention. 4. For nonambulatory patients with multiple fractures. 5. Foley’s catheter may also be used as a retention stent in comminuted zygomatic complex fractures. The balloon is inflated within the sinus to offer support to the bony fragments and left in position for 5 to 7 days till initial stabilization.

a. Ryle’s tube b. Foley’s self-retaining catheter c. Infant feeding tube d. Corrugated rubber drain Ans a. Ryle’s tube Nasogastric tube (Ryle’s tube): Nasogastric tube is a long hollow tube with one blunt end with multiple openings and an open end. It is made up of polyvinyl chloride. The blunt end is passed through the nostril into the stomach. To check the position of the tube air is pushed into the tube with the help of a syringe and the air entry into the stomach is checked with the help of a stethoscope. Only after confirmation of the presence of the tube into the stomach, the feeds are started. The tube is fixed to the nose with the help of sticking plaster. Uses 1. To provide feeds to the patients who cannot take oral feeds. 2. To provide gastric lavage postoperatively to flush out blood, fluids ingested intraoperatively. 3. To provide gastric lavage in case of poisoning. 26. Identify the instrument present in the color plate.

24. Identify the instrument present in the color plate.

a. Asche’s forceps b. Rowe’s disimpaction forceps c. Bone spreader d. Walsham’s forceps Ans c. Bone spreader It is used to separate the bony fragments after completion of the osteotomy cuts, like in downfracture of maxilla after LeFort I osteotomy or during sagittal spilt osteotomy procedure.

a. Ryle’s tube b. Foley’s self-retaining catheter c. Infant feeding tube d. Corrugated rubber drain Ans c. Infant feeding tube Infant feeding tube is made up of nontoxic, radiopaque, polyvinyl chloride. It is a long tube with a blunt tip with multiple openings for facilitating drainage. The other open end has a stopper that can be closed. 27. Identify the instrument present in the color plate.

25. Identify the instrument present in the color plate.

a. b. c. d.

Ryle’s tube Foley’s self-retaining catheter Infant feeding tube Corrugated rubber drain

Oral and Maxillofacial Surgery 37 Ans d. Corrugated rubber drain It is a sheet of rubber with corrugations on its surface. It is usually used as a drain following abscess drainage. Multiple holes are usually made in the drain to prevent the drain from getting obstructed. The drain is inserted with one end in the cavity and the other end is kept out of the skin or mucosa. The drain is secured by sutures and is left in place for three to five days. The drain is inserted into the dead space and can be either removed externally through the incision line or through a separate incision away from the incision line. Most operators prefer the latter. A negative pressure can be established within the space by attaching and aspirating a 20 cc syringe to the open end. The syringe must be emptied at regular intervals. The drain is fixed to the skin by sutures. It can be removed in 3 to 5 days depending on the amount of drainage. It can also be used for local instillation of antibiotic solutions in deep wounds. 28. Identify the instrument present in the color plate.

a. Hockey stick b. Apexo elevators c. Cryer’s elevator d. Winter’s elevator Ans a. Hockey stick Hockey Stick or London Hospital Elevator: This elevator is similar to the Cryer’s elevator, with the working blade at an angulation to the shank, but the blade is straight, rather than triangular, and has a convex and a flat surface. The flat surface is the working surface and has transverse serrations on it for better contact with the root stump. When viewed, the instrument looks like a Hockey stick and hence the name. The principles and functions are similar to the Cryer’s elevator. 29. Identify the instrument present in the color plate.

a. Hockey stick c. Cryer’s elevator

b. Apexo elevators d. Winter’s elevator

Ans b. Apexo elevators Apexo elevators: These are straight elevators that resemble the Cryer’s elevators, but have a biangulated and sharp, straight working tip. They are paired elevators for the mesial and the distal roots. Their uses and work principles are same as for the Cryer’s elevators. They can also be used to remove the maxillary root stumps 30. Identify the instrument present in the color plate.

a. Hockey stick c. Cryer’s elevator

b. Apexo elevators d. Winter’s elevator

Ans c. Cryer’s elevator Cryer’s elevator: Cryer‘s elevator is a straight elevator with a triangular blade. The working tip is angulated, with one convex and another flat surface. The flat surface is the working side. It is based on the lever and the wedge principle. Uses 1. For extraction of root stump of mandibular molars when one root is removed and the other is to be removed. 2. For extraction of mandibular molar root stumps when both the roots are present but one is fractured at a lower level than the other or when the bifurcation is intact. Two separate elevators are available for the mesial and distal roots. The working blade is introduced into the empty socket and moved towards the remaining root piece. In this technique the interradicular bone is fractured prior to removal of the root stump. 31. Identify the instrument present in the color plate.

a. Hockey stick b. Apexo elevators c. Cryer’s elevator d. Winter’s crossbar elevator Ans d. Winter’s crossbar elevator Winter’s Elevator: Winter’s elevator is a crossbar elevator. The shank is at right angles to the handle. The working tip

38

TARGET MDS: Image Based Questions is at an angle to the shank. The blade has a convex and a flat surface. The flat surface is the working surface and is placed facing the tooth to be elevated. It works on the wheel and axle principle. Uses to luxate the mandibular molar teeth. 32. Identify the instrument present in the color plate.

a. b. c. d.

Hockey stick Apexo elevators Cryer’s elevator Winter Cryer’s elevator

Ans d. Winter Cryer’s elevator Winter Cryer’s elevator: As the name suggests, the elevator is a crossbar elevator with a triangular blade. The uses and the applications of this instrument are similar to the Cryer’s elevator. It works on the wheel and axle and wedge principles.

a. b. c. d. Ans

One-fourth circle needle Three-eight circle needle Five-eight circle needle Compound curvature needle

b. Three-eight circle needle

35. Identify the instrument present in the color plate.

a. One-fourth circle needle b. Three-eight circle needle c. Five-eight circle needle d. Compound curvature needle Ans c. Five-eight circle needle 36. Identify the instrument present in the color plate.

33. Identify the instrument present in the color plate.

a. One-fourth circle needle b. Three-eight circle needle c. Five-eight circle needle d. Compound curvature needle Ans a. One-fourth circle needle

a. One-fourth circle needle b. Three-eight circle needle c. Five-eight circle needle d. Compound curvature needle Ans d. Compound curvature needle 37. The image represents which of the following suturing technique?

34. Identify the instrument present in the color plate.

a. Figure of 8 suture b. Sling suture c. Continuous over and over suture d. Continuous locking suture Ans a. Figure of 8 suture

Oral and Maxillofacial Surgery 39 38. The image represents which of the following suturing technique?

and distributes the tension uniformly over the suture line. It also offers a more water tight closure. 40. The image represents which of the following suturing technique?

a. b. c. d.

Interrupted suture Sling suture Continuous over and over suture Continuous locking suture

Ans b. Sling suture Interrupted suture-sling suture: The suture is passed through both the edges at an equal depth and distance from the incision, needle penetration should be 3 mm from the wound edges and the knot is tied. It is the most commonly used suture. Advantages 1. It is strong, and can be used in areas of stress. 2. Successive sutures can be placed according to individual requirement. 3. Each suture is independent and the loosening of one suture will not produce loosening of the other. 4. A degree of eversion can be controlled. 5. If the wound becomes infected or there is an hematoma formation, removal of a few sutures may offer a satisfactory treatment.

a. Interrupted suture b. Sling suture c. Continuous over and over suture d. Continuous locking suture Ans d. Continuous locking suture This technique is similar to the continuous suture, but locking is provided by withdrawing the suture through its own loop. The suture thus passes perpendicular to the incision line. The locking prevents excessive tightening of the suture as the wound closure progresses. 41. The image represents which of the following suturing technique?

39. The image represents which of following suturing technique?

a. Interrupted suture b. Sling suture c. Continuous over and over suture d. Continuous locking suture Ans c. Continuous over and over suture Continuous over and over suture: Initially, a simple interrupted suture is placed and the needle is then reinserted in a continuous fashion such that the suture passes perpendicular to the incision line below and obliquely above. The suture is ended by passing a knot over the untightened end of the suture. It provides a rapid technique for closure

a. Interrupted suture b. Sling suture c. Horizontal mattress suture d. Vertical mattress suture Ans c. Horizontal mattress suture Horizontal Mattress suture: The needle is passed from one edge of the incision to another and again from the latter edge to the first edge in a horizontal manner and a knot is tied. The distance of needle penetration from the incision line and the depth of penetration of the needle is the same for each entry point, but horizontal distance of the points of penetration on the same side of the flap differs (needle penetration through the surgical flap should be at least 8 mm away from the flap edges). This suture provides a broad contact of the wound margins, e.g. closure of extraction socket wounds.

40

TARGET MDS: Image Based Questions 42. The image represents which of following suturing technique?

a. b. c. d.

Interrupted suture Sling suture Horizontal mattress suture Vertical mattress suture

Ans d. Vertical mattress suture Vertical mattress suture: It is similar to the horizontal mattress, except that, all factors remaining constant, the depth of penetration varies, i.e. when the needle is brought back from the second flap to the first, the depth of penetration is more superficial. It is used for closing deep wounds. 43. Identify the equipment present in the color plate.

a. Autoclave b. Hot air oven c. Glass beads sterilizer d. UV chamber Ans a. Autoclave Steam sterilization involves heating water to generate steam in a closed chamber (Autoclave—in which drums and trays with the materials to be sterilized can be kept inside) producing moist heat that rapidly kills microorganisms. There is a mass heat transfer as the steam condenses. Use of saturated steam under pressure is the most practical, quickest, safest, effective, economic method of sterilization, known for the destruction of all forms of microbial life, because of its: (i) high penetrating capacity, and (ii) it gives up a large amount of heat (latent heat) to the surface with which it comes into contact, and on which it condenses as water. The advantages are: (i) The results are consistently goodand reliable, (ii) The instruments can be wrapped prior to sterilization. (iii) Time efficient. (iv) Good penetration. The main disadvantages are: (i) Blunting and corrosion of sharp instruments, and (ii) Damage to certain rubber goods.

44. The strip shown in the color plate is used to test efficacy of sterilization of which of the following?

a. b. c. d.

Autoclave Hot air oven Glass beads sterilizer UV chamber

Ans a. Autoclave Tests for efficiency for heat sterilization—sterilization monitoring: The mechanical, chemical and biological parameters are used to evaluate both the sterilizing conditions and the procedure’s effectiveness. Mechanical techniques for monitoring sterilization include assessing cycle time, temperature and pressure by observing the gauges or displays on the sterilizer and noting these parameters for each lot. Some tabletop sterilizers have recording devices that printout these parameters. Correct readings do not ensure sterilization, but incorrect readings can give first indication of a problem with sterilizer. Spore testing: Biological indicator—should be done once a week to verify proper functioning of the autoclave with the help of Geobacillus stearothermophilus strips or vials. Thermocouple: This is a thermometric testing, and a reliable gauge of efficiency. One recording is taken from a thermocouple placed inside a test pack of towels and a second one from the chamber drain. Comparison between the two recordings gives a good guide regarding the speed at which the steam penetrates the load. Brown’s test: These are ampoules that contain a chemical indicator; which changes its color; from red through amber to green at a specific temperature. Autoclave tape: This is a tape printed with sensitive ink that undergoes a color change at a specific temperature. This test forms the basis of the Bowie-Dick test for high vacuum autoclaves. Two pieces of strips are stuck onto a piece of square paper and placed in the middle of the test pack. With the application of temperature of 134°C for 3.5 minutes, there is a uniform development of bars throughout the length of the strips. This shows that the steam has passed freely and rapidly to the center of the load.

Oral and Maxillofacial Surgery 41 45. Identify the equipment present in the color plate.

a. Autoclave c. Glass beads sterilizer

b. d.

Hot air oven UV chamber

Ans b. Hot air oven Hot air oven: It is used to sterilize items which do not get damaged by high temperatures, such as laboratory glassware, glass syringes and instruments. Hot air is a poor conductor of heat and has poor penetrating capacity. It does not penetrate grease, oil, and powders; and equipment containing these substances should be sterilized by other methods. High temperature damages fabrics and melts rubber/plastic, hence should not be sterilized by this method. 46. Identify the equipment present in the color plate.

a. Autoclave b. Hot air oven c. Glass beads sterilizer d. UV chamber Ans c. Glass beads sterilizer Glass Beads Sterilizer: This method employs a heat transfer device. The media used are glass beads, molten metal or salt kept in a cup or crucible. The temperature achieved is of 220°C. The method employs submersion of small instruments such as endodontic files and burs, rotary instruments into the beads; and are sterilized in 10 seconds provided they are clean. Oliet et al (1958) reported that temperatures vary in different areas of the sterilizer. A warm-up time of at least 20 minutes is recommended to ensure uniform temperatures in these sterilizers. Grossman (1974) recommended the use of salt media sterilization, because the accidental introduction of metal or glass

clinging to the endodontic instruments into the root canal may cause blockage. Some handpieces can be sterilized by dry heat. The handpieces should be carefully cleaned and lubricated with special heat resistant oils. Other handpieces which have sealed bearings or which have been pressure lubricated with appropriate oils can be autoclaved. The instructions given by respective manufacturers regarding the cleaning, lubrication and sterilization are of importance and should be followed. 47. Identify the equipment present in the color plate.

a. Autoclave b. Hot air oven c. Glass beads sterilizer d. UV chamber Ans d. UV chamber Ultraviolet rays: It is absorbed by proteins and nucleic acids and kills micro-organisms by the chemical reactions it sets up in the bacterial cell. It has low penetrating capacity and its main application is purification of air in operating rooms viz to reduce the bacteria in air, water and on the contaminated surfaces. All forms of bacteria and viruses are vulnerable to ultraviolet rays below 3000 atmospheric pressure. Excessive exposure of skin can produce serious burns. Care must be taken to protect the eyes while using UV radiation for sterilization. Now, UV chambers are available for storage of sterilized packages. 48. Identify the equipment present in the color plate.

a. Needle cutter c. Glass beads sterilizer Ans a. Needle cutter

b. d.

Hot air oven UV chamber

42

TARGET MDS: Image Based Questions 49. The colored bag cannot be used to dispose which of the following?

a. Tooth c. Bandages Ans

b. d.

Dressings Needle

d. Needle

tooth. This is mainly used for the surgical extraction of a tooth or roots. Two-sided triangular flap: In addition to the envelope flap, a vertical releasing incision is used in order to have better access to the area. This vertical releasing incision is made on one side of the envelope flap (at the proximal or distal end) going divergent towards the buccal vestibule forming an obtuse angle at the free gingival margin. The vertical incision should be made in the interproximal area, as the tissues here are thick. To avoid periodontal defect, the incision should never lie directly on the facial aspect of the tooth. 52. The diagrammatic representation is for which of the following flap design?

50. Which of the following can be disposed in the bag shown in the color plate?

a. Needle c. Ryle’s Tube Ans a. Needle

b. Catheter d. Tracheostomy tube

51. The diagrammatic representation is for which of the following flap design?

a. Envelope flap b. Two-sided triangular flap c. Semilunar flap d. Three-sided rhomboid flap Ans a. Envelope flap Envelope flap: The most common type of flap. The incision is made to any length (depending on the amount of exposure needed) intraorally around the necks of the teeth along the free gingival margin on the buccal or lingual aspect including the interdental papillae. The entire mucoperiosteal flap is raised by using periosteal elevator to a point to the apical one-third of the

a. Envelope flap b. Two-sided triangular flap c. Semilunar flap d. Three-sided rhomboid flap Ans b. Two-sided triangular flap Two-sided triangular flap is reflected toward the base of the flap by using periosteal elevator. 53. The diagrammatic representation is for which of the following flap design?

a. Envelope flap b. Two-sided triangular flap c. Semilunar flap d. Three-sided rhomboid flap Ans d. Three-sided rhomboid flap Three-sided rhomboid flap: This is the modification of the earlier flap to improve the visibility and access. An additional vertical incision is added in the opposite direction from the earlier release. Here, care should be taken that the base of the flap must be wider than the apex to ensure good blood supply.

Oral and Maxillofacial Surgery 43 54. The diagrammatic representation is for which of the following flap design?

a. b. c. d.

Envelope flap Two-sided triangular flap Semilunar flap Three-sided rhomboid flap

Ans c. Semilunar flap Semilunar flap: Whenever the periapical area is required to be exposed to carry out periapical surgery, this flap is designed. Again the base of the flap should be broader than the apex and the suture line should not lie on the bony defect. The incision is taken at least 5 mm away from the free gingival margin. This flap is useful to avoid damage to interdental papilla and to prevent periodontal post surgical defects. In case of crowding of the teeth, the suturing is not a problem with this flap. The only disadvantage of this flap is that it often lies on the bony defect.

region. It indicates the difference in occlusal level of second and third molars. • Amber line represents the bone level. The line is drawn from the crest of the interdental septum between the molars and extended posteriorly distal to third molar or to the ascending ramus. This line denotes the alveolar bone covering the impacted tooth and the portion of tooth not covered by the bone. • Red line is drawn perpendicular from the amber line to an imaginary point of application of the elevator. It indicates the amount of bone that will have to be removed before elevation, i.e. the depth of the tooth in bone and the difficulty encountered in removing the tooth. If the length of the red line is more than 5 mm then the extraction is difficult. Every additional millimeter renders the removal of the impacted tooth three times more difficult (more than 9 mm—below the level of the apices of the second molar). 56. The airway as seen in the color plate can be classified according to mallampati’s grading as?

55. What does the red line in the presented image represent?

a. Class I c. Class III a. The occlusal plane b. The bone level c. The amount of bone that will have to be removed d. The portion of tooth not covered by the bone Ans c. The amount of bone that will have to be removed Three imaginary lines are drawn which are known as Winter’s lines. WAR lines White line corresponds to the occlusal plane. The line is drawn touching the occlusal surfaces of first and second molar and is extended posteriorly over the third molar

Ans a. Class I Mallampati’s Grading

b. d.

Class II Class IV

44

TARGET MDS: Image Based Questions 57. Identify the equipment shown in the color plate.

L-shaped and it has no catch. It is available in two sizes— adult and pediatric. 60. Identify the equipment shown in the color plate.

a. North pole tube c. Laryngeal mask airway

b. d.

South pole tube Magill’s tube

Ans a. North pole tube Nasal RAE tubes are also known as ‘north-facing’, i.e. the tube connector facing towards the patient’s head after placement. 58. Identify the equipment shown in the color plate.

a. North pole tube b. South pole tube c. Ryle’s tube d. Magill’s tube Ans b. South pole tube Oral RAE tubes are also described as ‘south-facing’, i.e. the tube connector facing towards the patient’s feet after placement.

a. North pole tube c. LMA

b. South pole tube d. Resuscitation bag

Ans d. Resuscitation bag Resuscitation bag is an assembly of equipment consisting of a self-inflating bag, a non-rebreathing valve and a facemask. As it is useful for ventilating a patient in emergency situation, it should always be available in the operation theater as handy as possible. If any problem occurs with anesthesia machine or a breathing system, which cannot be diagnosed or corrected quickly, a resuscitation bag will allow the user to ventilate the patient with room air (with or without oxygen) till the problem is solved. It is also useful and should be available during patient transport. It can also be used for administering anesthesia in the absence of an anesthesia machine, e.g. in rural set-up or field situations. 61. Identify the equipment in the color plate.

59. Identify the instrument in the color plate.

a. Magill forceps b. Cheatle forceps c. Pinchter type towel clip d. Backhaus towel clip Ans a. Magill forceps Magill’s forceps is an instrument, which is most often used for guiding an endotracheal tube, from the pharynx into the larynx during nasal intubation. It is also used to pack the throat with a roller gauze during oral and pharyngeal surgery, to pick up a broken or dislodged tooth lying in the oral cavity or to pass a Ryles (nasogastric) tube. It is

a. Pulse oximeter c. CO2 meter Ans a. Pulse oximeter

b. d.

Glucometer Pulsometer

62. The cylinder shown in the color plate will contain which of the following gas?

Oral and Maxillofacial Surgery 45 a. Oxygen c. Xenon

b. d.

CO2 Hydrogen

Ans a. Oxygen O2 is stored in black colors cylinders 63. The image represents which of the following incison?

a. Risdon incision b. Hind incision c. Al-Kayat and Bramley incision d. Bicoronal incision Ans a. Risdon incision Submandibular (risdon) approach: Here, the incision is taken about 1 cm below the angle of the mandible. It extends forward, parallel to the lower border of the mandible and curves backward slightly behind the angle. Approach to the neck of the condyle and ramus is achieved by sharply incising through the pterygomasseteric sling and reflecting the masseter muscle laterally to expose the neck of the condyle and sigmoid notch. Poor access to the condylar head region. Procedures involving the articular portion of the head and the meniscus cannot be performed by this approach. 64. The image represents which of the following incision?

a. Risdon incision b. Hind’s incision c. Al-Kayat and Bramley incision d. Bicoronal incision Ans b. Hind incision

Postramal (hind) approach indicated for surgeries involving the condylar neck and ramus area. Highly cosmetic procedure. Excellent visibility and accessibility. A skin incision is placed 1 cm behind the ramus of the mandible and extends 1 cm below the lobe of the ear to the angle of the mandible. Communicating fascia between the sternomastoid muscle and the parotid gland and masseter muscle (parotidomasseteric fascia) is carefully separated, to expose the posterior border of the ramus. Perforation of the posterior facial vein and injury to the main trunk of the facial nerve is avoided. Once the posterior border of the ramus has been exposed, the pterygomasseteric sling is incised at the angle and the masseter muscle, parotid gland are reflected upward and laterally to expose the neck of the condyle. After completion of the surgical procedure, the pterygomasseteric sling is reapproximated and sutured and the wound is closed in layers. 65. The image represents which of the following incision?

a. Risdon incision b. Hind’s incision c. Al-Kayat and Bramley incision d. Bicoronal incision Ans c. Al-Kayat and Bramley incision Al-Kayat and Bramley in 1979 described a modified preauricular approach to TMJ and zygomatic arch considering the main branches of the vessels and nerves in the vicinity. The facial nerve exits the skull through the stylomastoid foramen. It enters the parotid gland, where it usually divides into two main trunks— temporofacial and cervicofacial. The facial nerve divides at a point between 1.5 and 2.8 cm below the lowest concavity of the bony external auditory canal, according to Al-Kayat and Bramley. These measurements can be used to identify the main trunk (whenever required) and avoid it during TMJ surgery.

46

TARGET MDS: Image Based Questions The terminal branches of the facial nerve are classified as temporal, zygomatic, buccal, marginal mandibular and cervical. The location of the temporal branches is of particular importance during TMJ surgery. The temporal nerve branches lie within a dense fusion of periosteum, temporal fascia and superficial fascia at the level of the zygomatic arch. Al-Kayat and Bramley found that the nerve averaged 2 cm from the anterior concavity of the external auditory canal. But in some cases, the nerve is found as near as 0.8 cm and as far anteriorly as 3.5 cm. Protection of the nerve can be achieved by making an incision through the temporal fascia and periosteum down to the arch, not more than 0.8 cm in front of the anterior border of the external auditory canal. 66. Coronal section of CT scan presented here is suggestive of which of the following diagnosis?

a. Condylar fracture b. Condylar hyperplasia c. Ankylosis d. Condylar osteochondroma Ans c. Ankylosis Note the osseous ankylosis-obliteration of the joint space of right condyle.

They can be used for the following: i. To temporarily disengage the teeth. ii. To create a balanced joint-tooth stabilization of the mandible. iii. To reduce spasm, contracture and hyperactivity of musculature. iv. To improve/restore the vertical dimension. v. To serve as safety or protective appliance. In majority of cases, two types of occlusal splints are used. The splints should be removed while eating. 1. Stabilization splint—twelve to eighteen hours use is advocated up to 4 to 6 months. These are fabricated over the maxillary teeth, covering the occlusal and incisal surface. Similar to Hawley’s plate, but occlusal coverage is added. The splint is made up of acrylic. A flat platform is added perpendicular to the mandibular incisors, so that the splint will disengage the teeth and relax the muscles. The splint should be worn as instructed and patient should be recalled for check up at 2 weeks interval. Follow-up is done until the occlusion is stabilized and muscles are free of tenderness. If patient does not have relief at the end of 3 months, reevaluation of the original diagnosis should be done. This splint reduces the load on the retrodiskal area and thereby relieves the pain. It can be also used to eliminate occlusal interferences associated with bruxism. Instead of acrylic material, prefabricated commercially available resilient splints are also available for protection of teeth from trauma or from forces of bruxism. 2. Relaxation Splints: Relaxation splints are used for disengagement of teeth and for only short period (up to 4 weeks). They are fabricated over the maxillary incisor teeth. A platform is added to disengage mandibular anteriors. 68. Which of the following procedure is represented in the color plate?

67. Identify the equipment in the color plate.

a. Arthrocentesis c. Arthroplasty a. Occlusal splint c. Metal FPD Ans a. Occlusal splint

b. d.

Gunning splint Bleaching tray

b. d.

Arthroscopy Arthrectomy

Ans a. Arthrocentosis T emporomandibular joint arthrocentesis: Arthrocentesis (lavage or irrigation of the upper joint cavity) objectives:

Oral and Maxillofacial Surgery 47 i. Improve the disk mobility. ii. Eliminate joint inflammation. iii. Remove the resistance to condyle translation. Return to normal function. iv. Early physiotherapy. v. Eliminate pain. Indications for arthrocentesis: All patients who had proved refractory to conservative treatment (medication, bite appliance, physiotherapy and manipulation of the joint). 69. The radiograph represents which of the following procedures?

a. BSSO b. Horizontal distraction osteogenesis c. Vertical distraction osteogenesis d. Inverted L osteotomy Ans b. Horizontal distraction osteogenesis 70. The sign shown in the color plate is associated with which of the following?

a. Mandibular fracture b. Maxillary fracture c. Condylar fracture d. Basilar skull fracture Ans b. Maxillary fracture Guerin’s sign: Palatal hemorrhage due to maxillary fracture. 71. The radiograph represents which of the following procedures?

a. BSSO b. Horizontal distraction osteogenesis c. Vertical distraction osteogenesis d. Genioplasty Ans c. Vertical distraction osteogenesis 72. The image represents which of the following procedures?

a. BSSO b. Horizontal distraction osteogenesis c. Vertical distraction osteogenesis d. Genioplasty Ans d. Genioplasty 73. The image represents which of the following procedures?

a. LeFort I osteotomy b. Horizontal distraction osteogenesis c. Vertical distraction osteogenesis d. LeFort I osteotomy Ans d. LeFort I osteotomy 74. The sign shown in the color plate is associated with which of the following?

48

TARGET MDS: Image Based Questions a. Mandibular fracture c. Midface fracture

b. d.

Maxillary fracture Blow on head

Ans a. Mandibular fracture Coleman’s sign: Sublingual hemorrhage following mandibular. 75. The sign shown in the color plate is associated with which of the following?

a. b. c. d.

Mandibular fracture LeFort I fracture LeFort III fracture Condyle fracture

Ans c. LeFort III fracture Bilateral circumorbital/periorbital ecchymosis and gross edema ‘Racoon eyes’. Gross circumorbital edema will prevent eyes from opening. 78. Identify the type of wiring shown in the color plate.

a. Mandibular fracture b. Maxillary fracture c. Midface fracture d. Basilar skull fracture Ans d. Basilar skull fracture Battle’s sign 76. The sign shown in the color plate is associated with which of the following?

a. Essig’s wiring b. Gilmer’s wiring c. Risdon’s wiring d. Ivy eyelets wiring Ans a. Essig’s wiring Essig’s wiring: Essig’s wiring can be used to stabilize the dentoalveolar fractures in individual dental arches, as well as it can be used as anchoring device for IMF. The luxated teeth also can be stabilized using this wiring. Requirements for this type of wiring is that there should be sufficient number of teeth on either side of the fracture line to take the anchorage. 79. Identify the type of wiring shown in the color plate.

a. Mandibular fracture b. LeFort I fracture c. Zygomatic fracture d. Dura mater injury Ans d. Dura mater injury 77. The sign shown in the color plate is associated with which of the following?

a. Essig’s wiring b. Gilmer’s wiring c. Risdon’s wiring d. Ivy Eyelets wiring Ans b. Gilmer’s wiring Gilmer’s wiring: Gilmer’s wiring is a direct wiring method of intermaxillary fixation between the maxillary and mandibular teeth. This is the most common, simple, and practical method, as it secures the teeth and stabilizes the jaw properly.

Oral and Maxillofacial Surgery 49 80. Identify the type of wiring shown in the color plate.

a. b. c. d. Ans

Essig’s wiring Col. Stout’s multiloop wiring Risdon’s wiring Ivy eyelets wiring

b. Col. Stout’s multiloop wiring

83. Identify the equipment in the color plate.

a. Essig’s wiring c. Risdon’s wiring

b. Gilmer’s wiring d. Ivy eyelets wiring

Ans c. Risdon’s wiring Risdon’s wiring: Risdon’s wiring is a commonly utilized method of horizontal wire fixation. Certain fractures can be treated adequately by this method alone. However, in some cases, additional stabilization may be necessary. In this method, usually second molars on either sides are chosen for anchorage. 81. Identify the type of wiring shown in the color plate.

a. Occlusal splint b. Gunning splint c. Metal FPD d. Bleaching tray Ans b. Gunning splint Gunning splint: In edentulous jaws, patient’s own dentures, suitably modified can be used or specially constructed Gunning splint can be used. Circumferential wiring is used to fix the splint to the mandibular bone and upper denture or splint is fixed to the maxilla by means of peralveolar wiring. 84. The color plate shows which of the following types of fracture.

a. Essig’s wiring b. Col. Stout’s multiloop wiring c. Risdon’s wiring d. Ivy eyelets wiring Ans d. Ivy eyelets wiring Ivy eyelets wiring: The Ivy loop embraces the two adjacent teeth 82. Identify the type of wiring shown in the color plate.

a. Bucket handle fracture b. Parade ground fracture c. Horizontal favorable fracture d. Horizontal unfavorable fracture Ans a. Bucket handle fracture Bucket handle fracture: Sometimes, due to extreme alveolar resorption, the molar areas may be more prone to fracture. In some cases, it is possible to have bilateral fracture of the body of the edentulous mandible, each occurring near the posterior attachment of the mylohyoid muscle. In the

50

TARGET MDS: Image Based Questions edentulous mandible, the mylohyoid muscle attachment is relatively higher up on the lingual side. Under the influence of the diagastric and mylohyoid muscles pull, there is extreme downward and backward angulation of the anterior fractured fragment. This creates a typical ‘bucket handle’ type of displacement, which is highly unstable. 85. The color plate shows which of the following types of fracture.

a. b. c. d.

Champy’s plating Circumorbital wiring Circumzygomatic wiring Lag screw

Ans c. Circumzygomatic wiring Circumzygomatic wiring: This is mainly used in case of orbital floor fracture or zygomatic complex fracture displacement. Intraorally, the direct support can be given via the maxillary sinus, with the objective of repositioning the fragments and supporting them in position by various means until union has occurred. 87. The image represents which of the following incision?

a. Bucket handle fracture b. Parade ground fracture c. Horizontal favorable fracture d. Horizontal unfavorable fracture Ans b. Parade ground fracture Parade ground fracture: When the blow is received in the center of the chin, the distribution of force is equal to both the condyles, resulting in a bilateral indirect fracture through the necks, accompanied by a direct fracture at the symphysis (countercoup type of fractures). This type of injury is more often seen in an epileptic patients or soldiers who fall on the face during parade.

a. Caldwell luc incision b. Gilli’s incision c. Al-Kayat and Bramley incision d. Bicoronal incision Ans a. Caldwell luc incision Caldwel luc incision 88. The image represents which of the following incision?

86. The radiograph represents which of the following?

a. b. c. d.

Caldwell luc incision Gillies temporal fossa approach Al-Kayat and Bramley incision Bicoronal incision

Ans b. Gillies temporal fossa approach Gillies temporal fossa approach

Chapter

4

1j O

Periodontics

a> LU 03 HHBHB

1. A

12-year- old,

otherwise healthy male, patient, reported with complaint of failure of eruption of many teeth and irregular eruption of others as seen in the color plate. The gingiva is firm on pal pation without bleeding on probing. Which of the following can be the diagnosis?

a. Inflammatory gingival hyperplasia b. Hereditary gingival fibromatosis c. Drug- induced gingival enlargement d. Scurvy Ans b. Hereditary gingival fibromatosis 2. A 12-year- old, otherwise healthy, male patient

reported with complaint of failure of eruption of many teeth and irregular eruption of others as seen in the color plate. The Gingiva is firm on palpation without bleeding on probing. Patient's father suffered from same problem. What is its most common hereditary pattern?

a. b. c. d.

Autosomal dominant Autosomal recessive X- linked dominant X- linked recessive Ans a. Autosomal dominant Gingival hyperplasia may also be of genetic origin. Such lesions are known as hereditary gingival fibromatosis ( HGF ), which is an uncommon condition characterized by diffuse gingival enlargement, sometimes covering major parts of, or the total, tooth surfaces. The lesions develop irrespective of effective plaque removal. Most cases are related to an autosomal dominant mode of inheritance, but cases have been described with an autosomal recessive background Typically, HGF presents as large masses of firm, dense, resilient, insensitive fibrous tissue that cover the alveolar ridges and extend over the teeth, resulting in extensive pseudopockets. The color may be normal or erythema tous if inflamed. Depending on extension of the gingival enlargement, patients complain of functional and esthetic problems. The enlargement may result in protrusion of the lips, and they may chew on a considerable hyperplasia of tissue covering the teeth. If the enlargement is present before tooth eruption, the dense fibrous tissue may interfere with or prevent eruption

CD LU 03

CD

3. Identify the pathology.

CO

52

TARGET MDS: Image Based Questions a. Dehiscence c. Stillman’s cleft Ans

b. d.

Fenestration McCall festoon

6. Identify the periodontal fiber group marked with arrow.

b. Fenestration

4. Identify the pathology.

a. b. c. d. Ans a. Dehiscence b. Fenestration c. Stillman’s cleft d. McCall festoon Ans a. Dehiscene Ref: Clinical periodontology and Implant Dentistry (Lindhe), 5th Ed. At the buccal aspect of the jaws, the bone coverage is sometimes missing at the coronal portion of the roots, forming a so-called dehiscence. If some bone is present in the most coronal portion of such an area, the defect is called a fenestration. These defects often occur where a tooth is displaced out of the arch and are more frequent over anterior than posterior teeth. The root in such defects is covered only by periodontal ligament and the overlying gingiva. 5. Identify the periodontal fiber group marked with arrow.

Alveolar crest fibers (ACF) Apical fibers (APF) Horizontal fibers (HF) Oblique fibers (OF)

c. Horizontal fibers (HF)

7. Identify the periodontal fiber group marked with arrow.

a. Alveolar crest fibers (ACF) b. Apical fibers (APF) c. Horizontal fibers (HF) d. Oblique fibers (OF) Ans d. Oblique fibers (OF) 8. Identify the periodontal fiber group.

a. Alveolar crest fibers (ACF) b. Horizontal fibers (HF) c. Oblique fibers (OF) d. Apical fibers (APF) Ans a. Alveolar crest fibers (ACF)

a. Alveolar crest fibers (ACF) b. Apical fibers (APF) c. Horizontal fibers (HF) d. Oblique fibers (OF) Ans b. Apical fibers (APF)

Periodontics 53 Ref: Carranza’s clinical periodontology, 10th Ed. The tooth is joined to the bone by bundles of collagen fibers which can be divided into the following main groups according to their arrangement: 1. Alveolar crest fibers (ACF) 2. Horizontal fibers (HF) 3. Oblique fibers (OF) 4. Apical fibers (APF) Alveolar crest group. Alveolar crest fibers extend obliquely from the cementum just beneath the junctional epithelium to the alveolar crest. Fibers also run from the cementum over the alveolar crest and to the fibrous layer of the periosteum covering the alveolar bone. The alveolar crest fibers prevent the extrusion of the tooth and resist lateral tooth movements. The incision of these fibers during periodontal surgery does not increase tooth mobility unless significant attachment loss has occurred. Horizontal group. Horizontal fibers extend at right angles to the long axis of the tooth from the cementum to the alveolar bone. Oblique group. Oblique fibers, the largest group in the periodontal ligament, extend from the cementum in a coronal direction obliquely to the bone. They bear the brunt of vertical masticatory stresses and transform them into tension on the alveolar bone. Apical group. The apical fibers radiate in a rather irregular manner from the cementum to the bone at the apical region of the socket. They do not occur on incompletely formed roots. 9. Which of the following is seen in the color plate?

this association was never proved, and these indentations merely represent peculiar inflammatory changes of the marginal gingiva. 10. Which of the following structures is arrowed at in the color plate.

a. Dehiscene b. Fenestration c. Stillman’s cleft d. McCall festoon Ans c. Stillman’s cleft Ref: Carranza’s clinical periodontology, 10th Ed. Changes in gingival contour are primarily associated with gingival enlargement, but such changes may also occur in other conditions. Of historical interest are the descriptions of indentations of the gingival margin referred to as Stillman’s clefts and the McCall festoons. The term “Stillman’s clefts” has been used to describe a specific type of gingival recession consisting of a narrow, triangular-shaped gingival recession. As the recession progresses apically, the cleft becomes broader, exposing the cementum of the root surface. When the lesion reaches the mucogingival junction, the apical border of oral mucosa is usually inflamed because of the difficulty in maintaining adequate plaque control at this site. 11. A 25-year-old male patient presents with severe periodontal destruction. Patient’s physical examination revealed the condition as seen in the color plate. What is the most probable diagnosis?

a. Dehiscence b. Fenestration c. Stillman’s cleft d. McCall festoon Ans d. McCall festoon Ref: Carranza’s clinical periodontology,10th Ed. The term “McCall festoons” has been used to describe a rolled, thickened band of gingiva usually seen adjacent to the cuspids when recession approaches the mucogingival junction. Initially, Stillman’s clefts and McCall festoons were attributed to traumatic occlusion, and the recommended treatment was occlusal adjustment. However,

54

TARGET MDS: Image Based Questions a. b. c. d.

Papillon-Lefèvre syndrome Hypophosphatasia Stevens-Johnson syndrome NOMA

Ans a. Papillon-Lefèvre syndrome Ref: Carranza’s clinical periodontology, 10th Ed. Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressive periodontitis. Both the primary dentitions and secondary dentitions can be affected. PLS is caused by mutations in the cathepsin C gene, which is located on chromosome 11 (11q14-q21). Cathepsin C is a cysteine protease normally expressed at high levels in various cells, including epithelium and polymorphonuclear leukocytes (PMNs). Cathepsin C appears to play a role in degrading proteins and activating proenzymes in immune and inflammatory cells. 12. Identify the component in place present in the color plate.

a. Traumatic fibroma c. Pyogenic granuloma

b. d.

Papilloma Lipoma

Ans c. Pyogenic granuloma Ref: Carranza’s clinical periodontology, 10th Ed. Pyogenic granuloma is a tumor like gingival enlargement that is considered an exaggerated conditioned response to minor trauma The exact nature of the systemic conditioning factor has not been identified. The lesion varies from a discrete spherical, tumorlike mass with a pedunculated attachment to a flattened, keloid-like enlargement with a broad base. It is bright red or purple and either friable or firm, depending on its duration; in the majority of cases it presents with surface ulceration and purulent exudation. The lesion tends to involute spontaneously to become a fibroepithelial papilloma, or it may persist relatively unchanged for years. Histopathology. Pyogenic granuloma appears as a mass of granulation tissue with chronic inflammatory cellular infiltration. Endothelial proliferation and the formation of numerous vascular spaces are the prominent features. The surface epithelium is atrophic in some areas and hyperplastic in others. Surface ulceration and exudation are common features. 14. 51. A 30-year-old woman presented with the growth as seen in the color plate. The histopath report shows endothelial proliferation in the connective tissue. Which of the following is the ideal treatment plan?

a. Healing abutment b. Guidepins c. Auxiullary implant d. Transfer coping Ans a. Healing abutment Ref: Carranza’s clinical periodontology, 10th Ed. 13. A 30-year-old woman presented with the growth as seen in the color plate. The histopath report shows endothelial proliferation in the connective tissue. Which of the following can be the diagnosis?

a. b. c. d.

NSAIDs and observation Removal of the irritating factors and observation Removal of the lesion and observation Removal of the lesion with irritating factors and observation Ans d. Removal of the lesion with irritating factors and observation Ref: Carranza’s clinical periodontology, 10th Ed.

Periodontics 55 Treatment consists of removal of the lesions plus the elimination of irritating local factors. The recurrence rate is about 15%. Pyogenic granuloma is similar in clinical and microscopic appearance to the conditioned gingival enlargement seen in pregnancy. Differential diagnosis is based on the patient’s history.

Diagrammatic representation of an osseous crater in a faciolingual section between two lower molars. 17. The diagramatic representation shows which kind of bone defect?

15. The arrow in diagram shows extent of the pocket. This kind of periodontal pocket is called what?

a. Simple pocket b. Compound pocket c. Complex pocket d. Suprabony pocket Ans c. Complex pocket. Ref: Carranza’s clinical periodontology, 10th Ed.

16. The diagramatic representation shows which kind of bone defect?

a. Ledge b. Osseous creter c. Reverse architecture d. Bulbous bone contours Ans c. Reverse architecture Ref: Carranza’s clinical periodontology,10th Ed. Reversed architecture defects are produced by loss of interdental bone, including the facial plates and lingual plates, without concomitant loss of radicular bone, thereby reversing the normal architecture. 18. The diagramatic representation shows which kind of bone defect?

a. Ledge b. Osseous creter c. Reverse architecture d. Bulbous bone contours Ans a. Ledge Ref: Carranza’s clinical periodontology, 10th Ed. Ledges are plateau-like bone margins caused by resorption of thickened bony plates The color plate shows ledge produced by interproximal resorption. 19. The diagramatic representation shows which kind of bone defect?

a. Ledge b. Osseous creter c. Furcation involvement d. Bulbous bone contours Ans b. Osseous creter Ref: Carranza’s clinical periodontology, 10th Ed.

56

TARGET MDS: Image Based Questions a. b. c. d.

Ledge Osseous creter Furcation involvement Bulbous bone contours

Ans c. Furcation involvement Ref: Carranza’s clinical periodontology, 10th Ed. Flap elevation reveals extensive bone loss and furcation involvement in the color plate. Furcation involvements have been classified as grades I, II, III, and IV according to the amount of tissue destruction. Grade I is incipient bone loss, grade II is partial bone loss (cul-de-sac), grade III is total bone loss with throughand-through opening of the furcation. Grade IV is similar to grade III, but with gingival recession exposing the furcation to view. 20. What kind of bone loss does this IOPA reveal around 46?

a. Horizontal b. Angular c. Spiral d. Mixed Ans b. Angular Ref: Carranza’s clinical periodontology, 10th Ed. 21. What kind of bone loss does this IOPA reveal around 46?

a. Horizontal b. Angular c. Spiral d. Mixed Ans a. Horizontal Ref: Carranza’s clinical periodontology, 10th Ed.

22. The diagramatic representation shows which kind of bone defect?

a. One-wall defect b. Two-wall defect c. Three-wall defect d. Combined wall defect Ans a. One-wall defect Ref: Carranza’s clinical periodontology, 10th Ed. 23. The diagramatic representation shows which kind of bone defect?

a. One-wall defect b. Two-wall defect c. Three-wall defect d. Combined wall defect Ans b. Two-wall defect Ref: Carranza’s clinical periodontology, 10th Ed. 24. The 3DCT reconstruction shows which kind of bone defect?

a. Hemiseptum b. Two-wall defect c. Intrabony defect d. Combined wall defect Ans a. Hemiseptum Ref: Carranza’s clinical periodontology, 10th Ed.

Periodontics 57 The three-wall vertical defect was originally called an intrabony defect. This defect appears most frequently on the mesial aspects of second and third maxillary and mandibular molars. The one-wall vertical defect is also called a hemiseptum.

a. Exostoses c. Reverse architecture

b. d.

Osseous creter Ledge

Ans A. Exostoses Exostoses are outgrowths of bone of varied sizes and shapes. Palatal exostoses have been found in 40% of human skulls. They can occur as small nodules, large nodules, sharp ridges, spike-like projections, or any combination of these. Exostoses have been described in rare cases as developing after the placement of free gingival grafts. 27. Which of the following curves is presented in the diagrammatic representation here?

25. The diagrammatic representation shows which kind of bone defect?

a. One-wall defect b. Two-wall defect c. Three-wall defect d. Combined wall defect Ans d. Combined wall defect Ref: Carranza’s clinical periodontology, 10th Ed. Combined type of osseous defect. Because the facial wall is half the height of the distal (1) and lingual (2) walls, this is an osseous defect with three walls in its apical half and two walls in the occlusal half.

a. Monsoon curve c. Wilson curve Ans b. Curve of Spee

b. Curve of Spee d. Scammon’s curve

28. Which of the following curves is presented in the diagrammatic representation here?

a. Monsoon curve c. Wilson curve Ans c. Wilson curve

b. Curve of Spee d. Scammon’s curve

29. Which of the following curves is presented in the diagrammatic representation here?

26. The diagramatic representation shows which kind of bone feature?

a. Monsoon curve c. Wilson curve Ans a. Monsoon curve

b. Curve of Spee d. Scammon’s curve

58

TARGET MDS: Image Based Questions The curve of occlusion in which each cusp and incisal edge touch or conform to a segment of the surface of a sphere 8 inches in diameter with its center in the region of the glabella. 30. Which of the following is true for radiopaque structure visible interproximally?

a. Stains c. Calculus Ans c. Calculus

b. d.

Plaque Materia alba

a. b. c. d.

Localized aggressive periodontitis Generalized aggressive periodontitis Chronic localized periodontitis Chronic generalized periodontitis

Ans b. Generalized aggressive periodontitis Ref: Carranza’s clinical periodontology, 10th Ed. The radiographic picture in generalized aggressive periodontitis can range from severe bone loss associated with the minimal number of teeth. A comparison of radiographs taken at different times illustrates the aggressive nature of this disease. 33. Identify the radiograph type used to study alveolar bone level.

31. The cropped OPG of a 25-year-old male is suggestive of which of the following conditions?

a. Localized aggressive periodontitis b. Generalized aggressive periodontitis c. Chronic localized periodontitis d. Chronic generalized periodontitis Ans a. Localized aggressive periodontitis Ref: Carranza’s clinical periodontology, 10th Ed. Vertical loss of alveolar bone around the first molars and incisors, beginning around puberty in otherwise healthy teenagers, is a classic diagnostic sign of LAP. Radiographic findings may include an “arc-shaped loss of alveolar bone extending from the distal surface of the second premolar to the mesial surface of the second molar.” Bone defects are usually wider than usually seen with chronic periodontitis 32. The OPG of a 22-year-old male is suggestive of which of the following conditions?

a. IOPA c. Occlusal Ans b. Bite wing

b. d.

Bite wing Panoramic

34. The lesion seen in the color plate shows angular bone loss in around 46 in the radiographic examination. What is the most probable diagnosis out of the folowing?

a. Periodontal abscess b. Gingival abscess c. Periapical abscess with sinus tract d. Lateral periodontal cyst Ans a. Periodontal abscess Ref: Carranza’s clinical periodontology, 10th Ed. A periodontal abscess is a localized purulent inflammation in the periodontal tissues. It is also known as a lateral abscess or parietal abscess. Abscesses localized in the gingiva, caused by injury to the outer surface of the gingiva, and not involving the supporting structures are

Periodontics 59 called gingival abscesses. Gingival abscesses may occur in the presence or absence of a periodontal pocket. Periodontal abscesses are classified according to location as follows: 1. Abscess in the supporting periodontal tissues along the lateral aspect of the root. In this condition, a sinus generally occurs in the bone that extends laterally from the abscess to the external surface. 2. Abscess in the soft tissue wall of a deep periodontal pocket. 35. “Floating teeth” as seen in the radiograph of a 55-year-old female is a feature of which of the following?

It is generally limited to the marginal gingiva or interdental papilla. In its early stages, it appears as a red swelling with a smooth, shiny surface. Within 24 to 48 hours, the lesion usually becomes fluctuant and pointed with a surface orifice from which a purulent exudate may be expressed. The adjacent teeth are often sensitive to percussion. If permitted to progress, the lesion generally ruptures spontaneously. Histopathology: The gingival abscess consists of a purulent focus in the connective tissue, surrounded by a diffuse infiltration of polymorphonuclear leukocytes (PMNs), edematous tissue, and vascular engorgement. The surface epithelium has varying degrees of intracellular and extracellular edema, invasion by leukocytes, and sometimes ulceration. 37. A 40-year-old male complained of pain and mobility of noncarious 47, associated with swelling and pus discharge from gingiva. What is the diagnosis?

a. Localized aggressive periodontitis b. Gingival abscess c. Chronic localized periodontitis d. Chronic generalized periodontitis Ans d. Chronic generalized periodontitis Severe cases of generalized periodontitis cause generalized bone resorption, leading to loss of support for teeth, causing floating teeth appearance. 36. The lesion seen in the color plate does not show its existence in the radiographic examination. What is the most probable diagnosis out of the folowing?

a. Periodontal abscess b. Gingival abscess c. Periapical abscess with sinus tract d. Lateral periodontal cyst Ans b. Gingival abscess Ref: Carranza’s clinical periodontology, 10th Ed. A gingival abscess is a localized, painful, rapidly expanding lesion that is usually of sudden onset.

a. Periapical granuloma b. Periodontal abscess c. Periodontal cyst d. Periapical cyst Ans b. Periodontal abscess 38. A patient presented with a localized, painful lesion of sudden onset limited to the marginal gingiva of 47. Based on radiographic investigation. What is most probable diagnosis?

a. Periapical granuloma b. Periodontal abscess c. Periodontal cyst d. Gingival cyst Ans b. Periodontal abscess

60

TARGET MDS: Image Based Questions 39. Gingival inflammation as seen in the color plate is associated with which of the following habits?

a. Thumb-sucking c. Tongue-thrusting Ans

42. A 15-year-old girl complained of progressively enlarging gum. The growth was excised. Hostopathology report shows thickened epithelium with elongated rete pegs that penetrated deep into the connective tissue. Dense collagenous tissue bundles arranged in parallel were found scattered throughout the connective tissue. What is the most probable diagnosis?

b. Nail-biting d. Mouth-breathing

d. Mouth-breathing

40. Patient complains of bleeding gums. There is no relevant past medical history. What is the diagnosis?

a. b. c. d. Ans

a. Inflammatory gingival enlargement b. Pregnancy-induced gingivitis c. Phenytoin-induced gingival enlargement d. Nifedipine-induced gingival enlargement Ans a. Inflammatory gingival enlargement 41. An HIV-positive patient presented with the clinical condition as seen in the color plate. Which of the following is the most probable diagnosis?

a. Pyogenic granuloma b. Kaposi sarcoma c. Linear gingival erythema d. Focal epithelial hyperplasia Ans b. Kaposi sarcoma Ref: Carranza’s clinical periodontology, 10th Ed.

Inflammatory gingival hyperplasia Hereditary gingival fibromatosis Drug-induced gingival enlargement Idiopathic gingival fibromatosis

d. Idiopathic gingival fibromatosis

Gingival fibromatosis, otherwise known as gingival hyperplasia or gingival overgrowth, may occur due to a variety of etiological and pathological factors. These include inflammation, use of systemic medications, presence of systemic diseases or conditions, neoplasia or due to pseudotumors. In rare cases (1 in 750,000 people), the overgrowth can be hereditary, when it is called hereditary gingival fibromatosis (HGF). This term is synonymous with idiopathic gingival fibromatosis (IGF) as in most cases, the etiology remains unknown. IGF can occur as an isolated disease affecting only gingiva. It can occur as a part of syndrome or chromosomal abnormality and both autosomal dominant and recessive forms have been described.    It may present itself in localized or generalized form. The symmetrical generalized form of IGF is more common.  Clinically, it is a slowly progressive benign gingival enlargement of keratinized gingiva. The enlarged gingiva may be normal in color or erythematous. The consistency might be nodular or uniformly fibrous. The enlargement may potentially cover the exposed tooth surfaces to the extent of causing functional and esthetic impairment. Alveolar bone is usually not affected, but periodontal problems might result due to pseudopocketing.

Periodontics 61 43. A 20-year-old boy presents with trismus and pain. There is a partial impaction of 48. Based on clinical image. What is the most probable diagnosis?

The lesions are extremely sensitive to touch, and the patient often complains of a constant radiating, gnawing pain that is intensified by eating spicy or hot foods and chewing. There is a “metallic” foul taste, and the patient is conscious of an excessive amount of “pasty” saliva. 46. An HIV positive patient presented with the condition as seen in the color plate, which had radiographic evidence of bone resorption. Which of the following stages is diagnosed?

a. Pericoronal abscess b. Periodontal abscess c. Gingival abscess d. Lateral periodontal cyst Ans a. Pericoronal abscess 44. Identify the lesion shown in the colored image. a. NUG b. NUP c. Necrotizing stomatitis d. Vincent’s angina Ans c. Necrotizing stomatitis Ref: Carranza’s clinical periodontology, 10th Ed.

a. Linear gingival erythema b. Chronic generalized gingivitis c. Erythematous candidiasis d. Erythematous lichen planus Ans a. Linear gingival erythema Ref: Shafer’s Textbook of Oral Pathology, 7th Ed. Linear gingival erythema (LGE) is a non-plaqueinduced gingivitis exhibiting a distinct erythematous band of the marginal gingiva with either diffuse or punctate erythema of the attached gingiva. 45. Patient complains of gnawing pain that is intensified by eating spicy or hot foods and chewing. There is a “metallic” foul taste and “pasty” saliva. What is the most probable diagnosis?

a. NUG b. NUP c. NOMA d. Vincent’s angina Ans a. NUG Ref: Carranza’s clinical periodontology, 10th Ed.

47. The color plate is diagnostic of which of the following conditions?

a. Myiasis b. Mucormycosis c. Actinomycosis d. Blastomycosis Ans a. Myiasis Ref: Shafer’s Textbook of Oral Pathology, 7th Ed. Oral Myiasis (Gr. Myia: fly) is defined as a condition in which the soft tissue of different parts of the oral cavity are invaded by the parasitic larvae of flies (Moshref, Ansari and Loftfi, 2008). These larvae, commonly known as maggots, are of two-winged flies, the Diptera. Myiasis occurs mainly in the tropics and is associated with poor personal hygiene. Usually the female fly infests ova in open wounds, dead tissue, or in the natural body cavities, such as ear, nostrils, and oral cavity. The flies lay over 500 eggs directly on diseased tissue. These eggs hatch and the larvae get their nourishment from the soft tissue. Oral myasis is relatively a rare condition but cases have been reported in gingiva, palate, and extracted wounds.

62

TARGET MDS: Image Based Questions Antunes AA et al (2011) presented a series of 10 cases of oral and maxillofacial myasis and reviewd the literature. 48. What is the treatment for the condition shown in the color plate?

a. Surgical excision b. Removal of larvae and debridement c. Citric acid irrigation d. NaOH irrigation Ans b. Removal of larvae and debridement Ref: Shafer’s Textbook of Oral Pathology, 7th Ed. Oral myiasis The usual presenting symptoms are painful growth with ulceration and itching due to crawling movement of the larvae. The treatment is aimed at removal of larvae from the affected area and flushing the area with normal saline or antiseptics. 49. According to Gottlieb and Orban, this color plate represents. Which stage of passive eruption?

a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 Ans d. Stage 4 Stage 4: The junctional epithelium has proliferated farther on the cementum. The base of the sulcus is on the cementum, a portion of which is exposed. Diagrammatic representation of the four steps in passive eruption according to Gottlieb and Orban. 1, Base

of the gingival sulcus (arrow) and the junctional epithelium (JE) are on the enamel. 2, Base of the gingival sulcus (arrow) is on the enamel, and part of the junctional epithelium is on the root. 3, Base of the gingival sulcus (arrow) is at the cementoenamel line and the entire junctional epithelium is on the root. 4, Base of the gingival sulcus (arrow) and the junctional epithelium are on the root. Ref: Carranza’s Clinical Periodontology, 10th Ed. Continuous Tooth Eruption According to the concept of continuous eruption, eruption does not cease when teeth meet their functional antagonists but continues throughout life. Eruption consists of an active and a passive phase. Active eruption is the movement of the teeth in the direction of the occlusal plane, whereas passive eruption is the exposure of the teeth by apical migration of the gingiva. Although originally thought to be a normal physiologic process, passive eruption is now considered a pathologic process. Passive eruption is divided into the following four stages. Stage 1: The teeth reach the line of occlusion. The junctional epithelium and base of the gingival sulcus are on the enamel. Stage 2: The junctional epithelium proliferates, so that part is on the cementum and part is on the enamel. The base of the sulcus is still on the enamel. Stage 3: The entire junctional epithelium is on the cementum, and the base of the sulcus is at the cementoenamel junction. As the junctional epithelium proliferates from the crown onto the root, it does not remain at the cementoenamel junction any longer than at any other area of the tooth. Stage 4: The junctional epithelium has proliferated farther on the cementum. The base of the sulcus is on the cementum, a portion of which is exposed. Proliferation of the junctional epithelium onto the root is accompanied by degeneration of gingival and periodontal ligament fibers and their detachment from the tooth. The cause of this degeneration is not understood. At present, it is believed to be the result of chronic inflammation and, therefore, a pathologic process.

Periodontics 63 50. The color plate points towards which of the following?

a. b. c. d.

53. The color image represents which type of suturing technique?

Dehiscence Fenestration Stillman’s cleft Boneless window

Ans d. Boneless window Ref: Carranza’s clinical periodontology, 10th Ed. Interdental Septum If roots are too close together, an irregular “window” can appear in the bone between adjacent roots

a. b. c. d. Ans

Figure of eight Circumferential director loop Mattress—vertical Intrapapillary

a. Figure of eight

54. The color image represents which type of suturing technique?

51. Identify the type of implant in place in radiograph.

a. Endosseous c. Transosseous Ans a. Endosseous

b. d.

Periosteal Submucosal

52. The color image represents which type of suturing technique?

a. Figure of eight b. Circumferential director of loop c. Mattress—vertical d. Intrapapillary Ans b. Circumferential director loop

a. Figure of eight b. Circumferential director loop c. Mattress—horizontal d. Intrapapillary Ans c. Mattress—horizontal 55. Identify the instrument.

a. Naber’s probe c. Universal curette Ans a. Naber’s probe

b. d.

Sickle scaler Morse scaler

64

TARGET MDS: Image Based Questions 56. Identify the appliance present in the color plate.

a. b. c. d.

Primary healing abutment Guide pin Auxullary implant Transfer coping

Ans b. Guide pin Ref: Carranza’s clinical periodontology, 10th Ed. 57. Identify the instrument present in the color plate used in implant surgery.

In cases of demonstrating sufficient crestal bone height, a sinus elevation approach can be taken through the implant osteotomy (i.e. from a crestal approach). If the amount of available bone in the posterior maxilla is less than 10 mm and greater than 7 mm, the osteotome technique may be indicated. This procedure uses osteotomes (color plate) to compress bone (internally from the alveolar crest upward) against the floor of the sinus, ultimately leading to a controlled “inward fracture” of the sinus floor bone along with the Schneiderian membrane, which should remain intact with the in-fractured bone. 59. Identify the instrument present in the color plate.

a. DeMarco curettes b. #13/14 Gracey curette c. Large spoon curettes d. Medium-sized curved membrane elevators Ans d. Medium-sized curved membrane elevators Ref: Carranza’s clinical periodontology, 10th Ed. 60. Identify the instrument present in the color plate.

a. Straight osteotome b. Contra-angled condenser c. Offset osteotome d. Offset condenser Ans c. Offset osteotome Ref: Carranza’s clinical periodontology, 10th Ed. 58. For what purpose are these instruments present in the color plate used in implant surgery?

a. DeMarco curettes b. #13/14 gracey curette c. Large spoon curettes d. Medium-sized curved membrane elevators Ans a. DeMarco curettes Ref: Carranza’s clinical periodontology, 10th Ed. Elevation of the Schneiderian membrane is accomplished with hand instruments that are inserted along the internal aspect of the bony walls of the sinus. Instruments used to elevate the Schneiderian membrane through lateral window antrostomy. 61. Which of the following is presented in the color plate?

a. Sinus lifting b. Bone drilling c. Paralleling d. Bone grafting Ans a. Sinus lifting Ref: Carranza’s clinical periodontology, 10th Ed.

Periodontics 65 a. b. c. d.

ePTFE barrier membrane Anterior Iliac crest graft Titanium-reinforced (TR) membrane Cartilage greaft

Ans a. ePTFE barrier membrane Ref: Carranza’s clinical periodontology, 10th Ed. The color plate shows expanded polytetrafluoroethylene (ePTFE) barrier membrane positioned over graft and held in place with sutures. 62. Identify the instrument present in the color plate.

65. The color plate represents component of which of the following systems?

a. b. c. d.

Perioprobe Toronto automated Florida probe system Foster-miller probe

Ans c. Florida probe system Ref: Carranza’s clinical periodontology,10th Ed. 1. Handpiece for assessing probing pocket depths. 2. Handpiece for assessing relative clinical attachment levels. a. Periotest b. Osseotell c. Bonetap d. Endomate Ans a. Periotest Ref: Carranza’s clinical periodontology, 10th Ed.

66. Identify the system present in the color plate.

63. Identify the instrument present in the color plate.

a. Periosteal elevator c. Chisel Ans b. Osteotome

b. d.

Osteotome Malleet

64. Identify the instrument present in the color plate.

a. Periotest b. Periotron c. Periprobe d. Periotemp Ans b. Periotron Ref: Carranza’s clinical periodontology, 10th Ed. Sampling method for gingival crevicular fluid (GCF) analysis (Periotron), saliva is removed from the tooth surface with cotton wool before placement of a periopaper strip into the pocket to collect GCF. The moist paper strip is removed and placed between the jaws of the Periotron for assessment of fluid content. 67. The color plate is representing which brushing technique?

a. Periotest b. Osseotell c. Periprobe d. Periotemp Ans c. Periprobe Ref: Carranza’s clinical periodontology, 10th Ed. Automatic-electronic Periodontal Probe

66

TARGET MDS: Image Based Questions a. Bass Method c Leonard Method

b. Scrub Method d. Stillman method

Ans a. Bass Method Ref: Carranza’s clinical periodontology, 10th Ed. 1. Place the head of a soft brush parallel with the occlusal plane, with the brush head covering three to four teeth, beginning at the most distal tooth in the arch. 2. Place the bristles at the gingival margin, pointing at a 45-degree angle to the long axis of the teeth. 3. Exert gentle vibratory pressure, using short, back-andforth motions without dislodging the tips of the bristles. This motion forces the bristle ends into the gingival sulcus area as well as partly into the interproximal embrasures. The pressure should be firm enough to blanch the gingiva. 4. Complete several strokes in the same position. The repetitive motion cleans the tooth surfaces, concentrating on the apical third of the clinical crowns, the gingival sulci, and as far onto the proximal surfaces as the bristles can reach. 5. Lift the brush, move it to the adjacent teeth, and repeat the process for the next three or four teeth. 6. Continue around the arch, brushing about three teeth at a time. Then, use the same method to brush the lingual surfaces. 7. After completing the maxillary arch, move the brush to the mandibular arch, and brush in the same organized way to reach all the teeth. 8. If the brush is too large to reach the lingual surfaces of the anterior teeth, it should be turned vertically to press the end of the brush into the gingival sulcus area. 9. Brush the occlusal surfaces of three or four teeth at a time by pressing the bristles firmly into the pits and fissures and brushing with several short, back-and-forth strokes. 68. Identify the instrument present in the color plate.

a. b. c. d.

Powered flossing device Floss cutter Floss holder Floss cleaner

Ans c. Floss holder Ref: Carranza’s clinical periodontology, 10th Ed. Floss holders can simplify the manipulation of dental floss. Reusable floss tools require stringing the floss around a series of knobs and grooves to secure it 69. Identify the instrument present in the color plate.

a. b. c. d.

Powered flossing device Floss cutter Floss holder Floss cleaner

Ans a. Powered flossing device Ref: Carranza’s clinical periodontology, 10th Ed. Powered flossing devices can be easier for some patients to use than hand held floss. The tip is inserted into the proximal space, and a bristle or wand comes out of the tip and moves in a circular motion when the device is turned on (left). Alternately, the device moves the prestrung floss in short motions to provide interproximal cleaning (right). 70. Identify the interdental tooth cleansing aid presented in the color plate

Periodontics 67 a. b. c. d.

Toothpick Interdental brush Rubber tip stimulator Floss

73. Identify the probe.

Ans b. Interdental brush Ref: Carranza’s clinical periodontology, 10th Ed. 71. Identify the instrument present in the color plate.

a. b. c. d.

Marquis color-coded Probe UNC-15 probe University of Michigan “O” probe World Health Organization (WHO) probe

Ans a. Marquis color-coded probe Ref: Carranza’s clinical periodontology, 10th Ed. Calibrations are in 3-mm sections. 74. Identify the probe. a. b. c. d.

Powered flossing device Floss cutter Oral irrigator Floss cleaner

Ans c. Oral irrigator Ref: Carranza’s clinical periodontology, 10th Ed. For supragingival irrigation 72. Identify the probe.

a. b. c. d.

Marquis color-coded probe UNC-15 probe University of Michigan “O” probe World Health Organization (WHO) probe

Ans b. UNC-15 Probe Ref: Carranza’s clinical periodontology, 10th Ed. UNC-15 probe, a 15-mm-long probe with millimeter markings at each millimeter and color-coding at the fifth, tenth, and fifteenth millimeters. a. b. c. d.

Marquis color-coded probe UNC-15 probe University of Michigan “O” probe World Health Organization (WHO) probe

Ans d. World Health Organization (WHO) probe Ref: Carranza’s clinical periodontology, 10th Ed. World Health Organization (WHO) probe, which has a 0.5-mm ball at the tip and millimeter markings at 3.5, 8.5, and 11.5 mm and color coding from 3.5 to 5.5 mm.

75. Identify the probe.

68

TARGET MDS: Image Based Questions a. b. c. d.

Marquis color-coded probe UNC-15 probe University of Michigan “O” probe World Health Organization (WHO) probe

Ans c. University of Michigan “O” probe Ref: Carranza’s clinical periodontology, 10th Ed. University of Michigan “O” probe, with Williams markings (at 1, 2, 3, 5, 7, 8, 9, and 10 mm).

a. b. c. d.

Mini five curette Gracey curette sub-0 Langer curette Schwartz periotriever

Ans d. Schwartz periotriever Ref: Carranza’s clinical periodontology, 10th Ed. Color plate shows broken instrument tip attached to the magnetic tip of the Schwartz Periotriever.

76. Identify the explorer.

a. No. 17 b. No. 23 c. Pigtail d. No. 3 Ans a. No. 17 Ref: Carranza’s clinical periodontology, 10th Ed.

79. Identify the instrument present in the color plate.

a. Periosteal elevator c. Chisel Ans d. Mallet

b. d.

Osteotome Mallet

80. The diagram represents which instrument?

77. Identify the instrument.

a. Younger-good #7—8 b. Columbia #4R—4L universal curette c. McCall’s #17—18 d. Indiana University #17—18 universal curettes Ans b. Columbia #4R—4L universal curette Ref: Carranza’s clinical periodontology, 10th Ed. 78. Identify the instrument.

a. Hu-friedy b. Hoe scaler c. Quétin furcation curette d. Mini-bladed Gracey curette Ans b. Hoe scaler Ref: Carranza’s clinical periodontology, 10th Ed. Hoe scalers are designed for different tooth surfaces, showing “two-point” contact. The back of the blade is rounded for easier access. The instrument contacts the tooth at two points for stability. 81. The color plate represents which instrument?

Periodontics 69 a. b. c. d. Ans

Jacquet scaler Hoe scaler Uiversal scaler Mini-bladed gracey curettes

a. Jacquet scaler

82. Identify the instrument.

a. b. c. d.

Kirkland’s knife Orban’s knife Merrifield knife Hilton’s knife

Ans a. Kirkland’s knife Ref: Carranza’s clinical periodontology, 10th Ed.

The Kirkland knife is representative of knives typically used for gingivectomy. These knives can be obtained as either double-ended or single-ended instruments. The entire periphery of these kidney-shaped knives is the cutting edge. 85. Identify the instrument.

a. The perioscopy system b. The endoscopy system c. Dental microscope d. Periotest Ans a. The perioscopy system Ref: Carranza’s clinical periodontology, 10th Ed. A dental endoscope has been introduced recently for use subgingivally in the diagnosis and treatment of periodontal disease. 83. This equipment belongs to which system?

a. Kirkland’s knife b. Orban’s knife c. Merrifield knife d. Hilton’s knife Ans b. Orban’s knife Ref: Carranza’s clinical periodontology, 10th Ed. The Orban knife #1–2 and the Merrifield knife #1, 2, 3, and 4 are examples of knives used for interdental areas. These spear-shaped knives have cutting edges on both sides of the blade and are designed with either double-ended or single-ended blades. 86. Identify the instrument.

a. Periotest b. Periotron c. Prophy jet d. Periotemp Ans c. Prophy jet Ref: Carranza’s clinical periodontology, 10th Ed. 84. Identify the instrument.

a. #10 blade b. #12 blade c. #15 blade d. #15c blade Ans c. #15 blade Ref: Carranza’s clinical periodontology, 10th Ed. The #15 blade is used for thinning flaps and general purposes.

70

TARGET MDS: Image Based Questions 87. Identify the instrument.

The #12d blade is a beak-shaped blade with cutting edges on both sides, allowing the operator to engage narrow, restricted areas with both pushing and pulling cutting motions.

a. #10 blade b. #12 blade c. #15 blade d. #15c blade Ans d. #15c blade Ref: Carranza’s clinical periodontology, 10th Ed. The #15c blade, a narrower version of the #15 blade, is useful for making the initial, scalloping-type incision. The slim design of this blade allows for incising into the narrow interdental portion of the flap.

89. Identify the instrument.

a. Hoe scaler b. Ochsenbein chisel c. DeBakey tissue forceps

88. Identify the instrument.

d. Castroviejo instrument

a. #10 blade c. #15 blade

b. d.

#12 blade #15c blade

Ans b. #12 blade Ref: Carranza’s clinical periodontology, 10th Ed.

Ans b. Ochsenbein chisel Ref: Carranza’s clinical periodontology, 10th Ed. The Ochsenbein chisel is a useful chisel with a semicircular indentation on both sides of the shank that allows the instrument to engage around the tooth and into the interdental area. The Rhodes chisel is another popular back-action chisel.

Chapter

5

1j O

Pedodontics

a> LU 03 HHBHB

.

1

a. b. c. d. Ans

.

2

Thumb sucking Mouth breathing Tongue thrusting Nail biting

a . Thumb sucking

Identify the condition in 2 months old child.

a. b. c. d. Ans

.

This appliance is used as habit breaking appliance for.

3

The diagrammatic representation of cleft palate falls under which category of Veau's classification of cleft palate?

a. Class 1 c. Class 3

b. d.

a . Riga - Fede disease

Class 2 Class 4

Ans a. Class 1 Class

Description

I

Soft palate only

II

Hard and soft palate to the incisive foramen

HI

Complete unilateral of soft, hard , lip and alveolar ridge

IV

Complete bilateral of soft, hard and / or lip and alveolar ridge

CD

on on A

Riga - Fede disease Papillon - Lefevre syndrome DiGeorge syndrome Lesch - Nyhan syndrome

/O *

^

c

LU 03

CD

IB

D

CO

72

TARGET MDS: Image Based Questions 4. This appearance is associated with which of the following habits?

a. Tongue thrusting c. Thumb sucking

7. A baby comes to your clinic carried by parents in full sleeved shirt. Parents give history of fever for last 1 week. On physical examination you find this. What is your diagnosis?

b. Mouth breathing d. Masochistic habits a. b. c. d.

Ans b. Mouth breathing Adenoid facies is the facial appearance that occurs with adenoid hypertrophy in children. 5. What is the correct age of initiation of orthodontic treatment for such a case?

Ans

Target lesion of erythema multiforme Bite marks Pityriasis rosea Allergic reaction

b. Bite marks

8. Identify the appliance present in the color plate.

a. b. c. d.

No need as such. Wait and watch After eruption of permanent canine When first noted It is a self-correcting malocclusion

a. b. c. d.

Ans c. When first noted Crossbites should be corrected when first noted Ans 6. A 10 years boy presents with bilateral facial swelling along with “eyes raised to heaven appearance”. What could be the diagnosis?

a. b. c. d. Ans

d. Bilateral non-functional space maintainer

9. Identify the appliance present in the color plate.

Paget’s disease Fibrous dysplasia Cherubism Plexiform ameloblastoma

c. Cherubism

Unilateral functional space maintainer Bilateral functional space maintainer Unilateral non-functional space maintainer Bilateral non-functional space maintainer

a. b. c. d. Ans

Unilateral functional space maintainer Bilateral functional space maintainer Unilateral non-functional space maintainer Bilateral non-functional space maintainer

c. Unilateral non-functional space maintainer

Pedodontics 73 10. This 16-year-old boy has sparse hairs and complains of heat intolerance, what is your diagnosis?

a. b. c. d. Ans

a. b. c. d.

Hyperparathyroidism Ectodermal dysplasia Hypovitaminosis D Cleidocranial dysplasia Ans

b. Ectodermal dysplasia

11. A 5-year-old boy’s intraoral examination revels presence of 19 teeth, what can be the diagnosis?

a. Fusion c. Oligodontia Ans

13. Identify the appliance.

b. d.

Gemination Concrescenece

a. Fusion

Lingual arch Groper’s appliance Transpalatal arch Pendulum appliance

a. Lingual arch

14. Identify the molar relationship.

a. Mesial step c. Flush terminal planar Ans

b. d.

Distal step Angle’s class I

a. Mesial step

15. What is the use of this appliance?

12. What are the normal values of A and B, respectively in mm in Indian girls?

a. 0.9 and 1.7 c. 0.5 and 1.9 Ans a. 0.9 and 1.7 Leeway space

b. d.

1.96 and 0.94 1.8 and 0.7

a. For carrying disabled baby comfortably b. As physical restraint c. For keeping uncooperative child’s mouth open while performing restorative treatment d. For attracting frightened child towards dental chair Ans b. As physical restraint Papoose board

74

TARGET MDS: Image Based Questions 16. Identify the appliance.

Group 4: Does not progress appreciably into the mouth. Lower incisors contact thumb nail. a. b. c. d. Ans

Distal shoe space maintainer Mechanical separator Molar distalization appliance A part of lingual arch appliance

a. Distal shoe space maintainer

17. According to Subtleny (1973) this patient belongs to which group of thumb sucking?

a. Group 1 c. Group 3

b. d.

Group 2 Group 4

Ans d. Group 4 Group 1: Thumb inserted beyond first joint, lower incisors pressed.

18. What is the hereditary pattern of this syndrome?

a. b. c. d.

Autosomal dominant Autosomal recessive X-linked dominant X-linked recessive (21 trisomy)

Ans a. Autosomal dominant Treacher Collins syndrome 19. What is the best treatment plan for diastema in this 9-year-old boy?

Group 2: Up to the first joint or anterior

a. Wait and watch b. Decide from diagnostic cast and model analysis c. Extraction of 53 and 63 d. Orthognathic surgery Group 3: Fully into the mouth, lower incisors do not contact thumb.

Ans a. Wait and watch Ugly duckling stage

Pedodontics 75 20. Identify the appliance.

a. b. c. d. Ans

23. Identify the equipment.

a. Papoose board c. Posey strap

Trans palatal arch Blue grass appliance Nance palatal arch Hyrax

Ans

b. d.

Pedi wrap Velcro strap

a. Papoose board

24. Identify the appliance present in the color plate.

c. Nance palatal arch

21. Picture shows crown of 21. It falls under which class of Ellis classification?

a. b. c. d. a. Class 1 c. Class 3 Ans

b. d.

Class 2 Class 6

c. Class 3

22. Identify the appliance present in the color plate.

a. b. c. d. Ans

Ans

b. Bilateral functional space maintainer

25. According to classification of dens invaginatus by Schulze and Brand. The diagram is which class of Dens invaginatus?

Anterior mandibular bite plane Anterior maxillary bite plane Posterior mandibular bite plane Posterior maxillary bite plane

a. Anterior mandibular bite plane

Unilateral functional space maintainer Bilateral functional space maintainer Unilateral non-functional space maintainer Bilateral non-functional space maintainer

a. Type 1 c. Type 3 Ans

b. Type 2

b. d.

Type 2 Type 4

76

TARGET MDS: Image Based Questions a. Angle’s class 1 c. Angle’s class 3 Ans

b. d.

Angle’s class 2 Edge to edge

b. d.

Fusion Taurodontism

a. Angle’s class 1

29. Diagnose the condition.

26. The radiographic image is suggestive of:

a. Dilaceration c. Dens invaginatus Ans a. b. c. d.

Bird face syndrome Crouzons syndrome Robin sequence Cherubism

c. Dens invaginatus

30. This 2 months old child had the teeth erupted in oral cavity at the age of 21 days. What is the condition called?

Ans b. Crouzons syndrome Copper beaten/Beaten metal appearance of skull 27. This kind of deciduous molar relation will develop most commonly into which kind of permanent molar relationship? a. Premature teeth c. Natal teeth Ans

b. d.

Neonatal teeth Keratin plugs

b. Neonatal teeth

31. Identify the appliance. a. Angle’s class 1 c. Angle’s class 3 Ans

b. d.

Angle’s class 2 Edge to edge

b. Angle’s class 2

28. This kind of deciduous molar relation will develop most commonly in to which kind of permanent molar relationship? a. b. c. d. Ans

Distal shoe space maintainer Crown and loop space maintainer Crown and loop space regainer Lingual arch space maintainer

b. Crown and loop space maintainer

Pedodontics 77 32. Identify the appliance present in the color plate.

a. b. c. d. Ans

Unilateral functional space maintainer Bilateral functional space maintainer Unilateral non-functional space maintainer Bilateral non-functional space maintainer

a. b. c. d.

a. Unilateral functional space maintainer

33. A 10-year-old girl comes to you with swelling to raising the earlobe and history of fever and lower abdominal pain. What’s true about the condition?

a. b. c. d. Ans

35. This panaromic radiograph image is diagnostic of which condition?

Ans d. Dentinogenesis imperfecta OPG shows obliteration of pulp chambers 36. Identify the appliance.

Distal shoe space maintainer Band and loop space maintainer Band and loop space regainer Lingual arch space maintainer

a. b. c. d.

b. Band and loop space maintainer

34. Identify the appliance.

Amelogenesis imperfecta Bruxism Dentin dysplasia Dentinogenesis imperfecta

Ans

Anterior mandibular bite plane Anterior maxillary bite plane Posterior mandibular bite plane Posterior maxillary bite plane

b. Anterior maxillary bite plane

37. Which structure is the arrow pointing toward?

a. b. c. d. Ans

Nance palatal arch Pendulum appliance Transpalatal arch Rapid maxillary expansion device

b. Transpalatal arch

a. Inca c. Anterior fontanels Ans

a. Inca

b. Petrous ossicle d. Posterior fontanels

78

TARGET MDS: Image Based Questions 38. Identify the appliance.

a. b. c. d. Ans

39. Identify the equipment.

Ans

a. b. c. d.

Anterior mandibular bite plane Anterior maxillary bite plane Posterior mandibular bite plane Posterior maxillary bite plane

c. Posterior mandibular bite plane

a. b. c. d.

41. Identify the appliance.

Ans

d. Posterior maxillary bite plane

42. The facies seen in the image is suggestive of which condition?

Posey strap Velcro strap RUR’S elbow guard Groper’s appliance

a. b. c. d.

c. RURS’ elbow guard

40. What is the application of the equipment shown in the image?

Anterior mandibular bite plane Anterior maxillary bite plane Posterior mandibular bite plane Posterior maxillary bite plane

Ans

Proteus syndrome Down syndrome Treacher Collins syndrome Hurler syndrome

d. Hurler syndrome

43. This kind of deciduous molar relation will develop most commonly into which kind of permanent molar relationship?

a. b. c. d. Ans

Safety mechanism during sports Protective stabilization in cooperative patients As restrain in thumb sucking Dislocated elbow joint splinting

c. As restrain in thumb sucking

a. Angle’s class 1 c. Angle’s class 3 Ans

d. Edge to edge

b. d.

Angle’s class 2 Edge to edge

Pedodontics 79 46. A 12-year-old patient reported to the dental clinic with upper and lower complete denture. The OPG revealed details as shown in image, what is the most probable diagnosis of following?

a. Total extraction of primary teeth due to nursing bottle caries b. Papillon-Lefèvre syndrome c. Ectodermal dysplasia d. Hypovitaminosis D

44. A 30 days old baby is having difficulty in breast feeding and she is having unilateral loss expression of face as seen in the image. What is the most probable diagnosis? Ans

c. Ectodermal dysplasia

47. The 3D reconstruction image of patient’s jaw points towards diagnosis of?

a. b. c. d. Ans

Moebius syndrome Down syndrome Treacher Collins syndrome Proteus syndrome

a. Moebius syndrome

45. A 5 days old female brought to dental hospital with the features in the image. Whats most probable diagnosis of following?

a. b. c. d. Ans

a. b. c. d. Ans

b. Ectodermal dysplasia

48. A 18-year-old patient presented with palmer keratosis. This is the OPG image of same patient. What is your diagnosis?

Moebius syndrome Robin sequence Treacher Collins syndrome Proteus syndrome

b. Robin sequence

Papillon-Lefèvre syndrome Ectodermal dysplasia Hypovitaminosis D Hyperparathyroidism

a. b. c. d. Ans

Papillon-Lefèvre syndrome Ectodermal dysplasia Chronic generalized gingivitis Generalized aggressive periodontitis

a. Papillon-Lefèvre syndrome

80

TARGET MDS: Image Based Questions 49. Diagnose the pathology from clinical picture.

a. b. c. d. Ans

Long band and loop space maintainer Short band and loop space maintainer Hawley retainer Inclined plane

b. Short band and loop space maintainer

53. What is the advised treatment plan for this 8 years old boy? a. Rampant caries c. Nursing bottle caries Ans

b. Radiation caries d. Senile caries

c. Nursing bottle caries

50. Diagnose the pathology from clinical picture.

a. Wait and watch b. Extraction of 72 71 81 82 and observe c. Extraction of 72 71 81 82 and space maintenance d. Extraction of 72 71 81 82 and immediate beginning of orthodontic therapy a. Rampant caries c. Nursing bottle caries Ans

b. Occlusal caries d. Senile caries

a. Rampant caries

51. Identify the appliance in the color plate.

a. b. c. d. Ans

Long band and loop space maintainer Short band and loop space maintainer Hawley retainer Inclined plane

a. Long band and loop space maintainer

52. Identify the appliance in the color plate.

Ans

b. Extraction of 72 71 81 82 and observe

54. A 20 years old male patient visited with brachycephalic head, enamel pitting, mandibular prognathism and ability to touch both shoulders to each other, what is your diagnosis?

a. b. c. d. Ans

Ehlers-Danlos syndrome Down syndrome Cleidocranial dysplasia Crouzon syndrome

c. Cleidocranial dysplasia

55. This device is used in management of which condition?

Pedodontics 81 a. b. c. d. Ans

59. The axial section of CBCT scan is suggestive of which pathology associated with 38 and 48?

Obstructive sleep apnea Lesch-Nyhan disease Thumb sucking Robin sequence

c. Thumb sucking

56. Identify the appliance in the color plate. a. b. c. d. Ans a. b. c. d. Ans

Long band and loop space maintainer Short band and loop space maintainer Hawley retainer Inclined plane

Dentigerous cyst Pericoronal abscess Adenomatoid odontogenic tumor CEOT

a. Dentigerous cyst

60. The curve marked by ? is characterized by which of the following event during its course?

c. Hawley retainer

57. Identify the appliance in the color plate.

a. b. c. d. Ans

Ans

d. Inclined plane

58. What is the most probable age of this female patient?

a. 12 years c. 14 years Ans

a. b. c. d.

Long band and loop space maintainer Short band and loop space maintainer Hawley retainer Inclined plane

b. 10 years

Growth of the larynx Muscular growth Increased immunological capacities Cranial vault growth

a. Growth of the larynx

61. Identify the appliance.

a. Activator c. Oral screen

b. 10 years d. 18 years Ans

c. Oral screen

b. Twin block d. Lip bumper

82

TARGET MDS: Image Based Questions 62. Identify the appliance.

a. Short labial bow c. Split bow Ans

66. This OPG image is suggestive of which of the following condition?

a. b. c. d.

b. Long labial bow d. Lip bumper

a. Short labial bow Ans

63. Identify the appliance.

External root resorption of 36 and 46 Supernumerary (Paramolar) Retained deciduous 75, 85 Periapical cyst of 44

c. Retained deciduous 75, 85

67. A 14-year-old girl presented with swelling over anterior mandible. What is the diagnosis?

a. Short labial bow c. Split bow Ans

b. Long labial bow d. Lip bumper

a. b. c. d.

b. Long labial bow

64. Which of the following is marked by an arrow in given OPG image?

Ans

Compound odontoma Complex odontoma Dentigerous cyst Follicular cyst

c. Dentigerous cyst

68. Identify the appliance in place.

a. Follicular cyst c. Tooth bud Ans

b. Dentigerous cyst d. Stafne cyst a. b. c. d.

c. Tooth bud

65. Which of the following is possible most chronological age of patient? Ans

Crowns and loop space maintainer Baker’s arch Nance arch Lingual arch

d. Lingual arch

69. Identify the appliance.

a. 1 year c. 8 years Ans

b. 5 Years

b. 5 years d. 10 years

Pedodontics 83 a. Short labial bow c. Split bow Ans

b. Long labial bow d. Lip bumper

73. CT scan coronal section taken at the level of condyle of 10 years old female is suggestive of which of the following?

c. Split bow

70. Identify the appliance.

a. Short labial bow c. Split bow Ans

b. Long labial bow d. Lip bumper

d. Lip bumper

71. Identify the appliance.

a. b. c. d. Ans

a. b. c. d. Ans

c. Bilateral condylar fracture

74. Identify the appliance.

a. b. c. d.

Palatal crib Transpalatal arch Band and bar space maintainer Gerber space maintainer

a. Palatal crib

Right condyle osteochondroma Left condyle osteosarcoma Bilateral condylar fracture Bilateral mixed (fibrous and bony) ankylosis

Ans

Palatal crib Transpalatal arch Band and bar space maintainer Gerber space maintainer

b. Transpalatal arch

75. Identify the appliance. 72. Which muscle is responsible for the open bite in this patient?

a. b. c. d. Ans

Left masseter Right medial pterygoid Left lateral pterygoid Platysma

a. Left masseter

a. b. c. d. Ans

Palatal crib Transpalatal arch Band and bar space maintainer Gerber space maintainer

c. Band and bar space maintainer

84

TARGET MDS: Image Based Questions 76. Identify the appliance.

a. b. c. d. Ans

Twin block Sling shot space regainer Single cantilever spring Mayne space maintainer

c. Single cantilever spring

80. Identify the appliance. a. b. c. d. Ans

Palatal crib Transpalatal arch Band and bar space maintainer Gerber space maintainer

d. Gerber space maintainer

77. Identify the appliance. a. b. c. d. Ans a. b. c. d. Ans

Twin block Sling shot space regainer Single cantilever spring Mayne space maintainer

Twin block Sling shot space regainer Single cantilever spring Mayne space maintainer

d. Mayne space maintainer

81. Identify the appliance.

a. Twin block

78. Identify the appliance. a. b. c. d. Ans a. b. c. d. Ans

Twin block Sling shot space regainer Single cantilever spring Mayne space maintainer

Finger spring Double cantilever spring Distal shoe space maintainer Cantilever spring

a. Finger spring

82. Identify the appliance.

b. Sling shot space regainer

79. Identify the appliance. a. b. c. d. Ans

Finger spring Double cantilever spring Distal shoe space maintainer Cantilever spring

b. Double cantilever spring

Pedodontics 85 83. Identify the appliance.

a. b. c. d. Ans

Split saddle space regainer Blue grass appliance Activator Frankle appliance

b. Blue grass appliance

87. Identify the appliance. a. b. c. d. Ans

Finger spring Double cantilever spring Distal shoe space maintainer Cantilever spring

c. Distal shoe space maintainer

84. Identify the appliance.

a. b. c. d. Ans

Split saddle space regainer Blue grass appliance Activator Frankle appliance

c. Activator

88. Identify the appliance. a. b. c. d. Ans

Finger spring Double cantilever spring Distal shoe space maintainer Coffin spring

d. Coffin spring

85. Identify the appliance. a. b. c. d. Ans a. b. c. d. Ans

Split saddle space regainer Blue grass appliance Activator Frankle appliance

Split saddle space regainer Blue grass appliance Activator Frankle appliance

d. Frankle appliance

89. Identify the appliance.

a. Split saddle space regainer

86. Identify the appliance. a. b. c. d. Ans

Pendulum appliance Pendex appliance Bionator Removable expansion plate

a. Pendulum appliance

86

TARGET MDS: Image Based Questions 90. Identify the appliance.

a. b. c. d. Ans

a. b. c. d. Ans

Pendulum appliance Pendex appliance Bionator Removable expansion plate

b. Pendex appliance a. b. c. d. Ans

a. b. c. d.

Pendulum appliance Pendex appliance Bionator Removable expansion plate

Pulpotomy Pulpectomy Apexogenesis Apexification

a. Pulpotomy

95. The image depicts which of the following procedure?

c. Bionator a. b. c. d.

92. Identify the appliance.

Ans

a. b. c. d. Ans

c. Proximal stripping

94. The image depicts which of the following procedure?

91. Identify the appliance.

Ans

Polishing Finishing Proximal stripping Crown preparation

Pendulum appliance Pendex appliance Bionator Removable expansion plate

Pulpotomy Pulpectomy Apexogenesis Apexification

b. Pulpectomy

96. The image depicts which of the following procedure?

d. Removable expansion plate

93. Which procedure is being performed in the color plate? a. b. c. d. Ans

Pulpotomy Pulpectomy Apexogenesis Apexification

c. Apexogenesis

Pedodontics 87 97. The image depicts which of the following procedure?

99. Identify the instrument.

a. Crown crimping plier b. Adams plier c. Crown removing plier a. Pulpotomy c. Apexogenesis Ans

d. Apexification

98. Identify the instrument.

a. b. c. d. Ans

b. d.

Pulpectomy Apexification

d. Crown scissors Ans

100. Identify the instrument.

a. b. c. d.

Crown crimping plier Adams plier Crown removing plier Crown scissors

a. Crown crimping plier

d. Crown scissors

Ans

Crown crimping plier Adams plier Crown removing plier Crown scissors

c. Crown removing plier

6

Chapter

1j O

Orthodontics

a> LU 03 HHBHB

1 . Identify the instrument.

a. b. c. d. Ans

a. Band remover c. Adam's plier Ans

b. d.

Universal plier Wire cutter

a . Band remover

Maxilla Mandible Vascular tissue Fat tissue

b. Mandible

4. “A" in the Scammon's growth curve represents growth of which of the following? 200 -1

2. The “?" in the Scammon's growth curve repre sents which of the following?