ADC Preliminary Examinations 7./8.

September 2006 Paper 1
1. A. B. C. D. The term abrasion best describes: Loss of substance by chemical agent Loss of substance by external agent Loss of substance by the movement of tooth against tooth The rapid loss of substance that is seen in the movement of porcelain crowns aganist natural teeth Some days after preparation and filling of a shallow class I amalgam cavity the patient complains of pain on biting. You would: Perform vitality test Replace filling with lining Check for premature contacts Remove all occlusal contacts from this filling Tell the patient to wait 2-4 weeks, the pain will go away In a composite filling, the matrix band is for

2.

A. B. C. D. E. 3.

A. Help shaping and contouring the filling B. Prevent material to be pushed under the gingival margin 4. The advantage of guttapercha over silver points is

A. The possibility for lateral condensation 5. When do you make a fixed-moveable bridge?

A. When the abutment teeth don’t have the same path of insertion 6. In a class II.2 malocclusion, which bridge design would be contraindicated for a missing lateral upper incisor?

A. Cantilever bridge B. Maryland bridge

7.

Which is the best cantilever bridge design for missing maxillary canine? Abutment on

A. Both premolars B. Lateral and central incisor C. Lateral incisor

D. First premolar 8. A 9 years-old child who has sustained a fracture of a maxillary permanent central incisor in which 2 mm of the pulp is exposed, presents for treatment 30 minutes after injury. Which of the following should be considered? Remove 1-2 mm of the pulp tissue surface, place calcium hydroxide and fill with resin Remove 1-2 mm of the pulp tissue surface and cover with ledermix Place calcium hydroxide directly on the exposed pulp Pulpotomy using formocresol Pulpectomy and immediate root filling In a flouridated toothpaste with 0.304% sodium fluoride the amount of flouride ions is 400 ppm 1000 ppm 1500 ppm 4000 ppm

A. B. C. D. E. 9. A. B. C. D.

10. The most important diatary habit for caries development is A. Amount of sugar intake B. Frequency of sugar intake C. Form of sugar intake 11. The normal unstimulated salivary flow rate is A. 0.02 ml/min B. 0.2 ml/min C. 2 ml/min 12. Titanium is used in dentistry A. B. C. D. E. In a very pure form in implants In an alloy with aluminium in casting for crowns and bridges In an alloy with nickel in orthodontic wires A and B A, B and C

13. What is the reason for a tooth to develop pulpitis several years after setting of a full veneer gold crown? A. Bacterial microleakage 14. How is the regeneration process after damage by injury to odontoblasts working? A. Proliferation of the remaining odontoblasts

B. C. D. E.

Differentiation from fibroblasts Regeneration from undifferentiated mesenchymel cells Histodifferentiation from ectodermal cells Differentiation from the inflammation cells

15. In construction of full dentures, what does the term “too low vertical dimension” refer to? A. A situation in which there is too much interocclusal space between upper and lower artificial teeth when the mandible is in rest position. 16. Reversible pulpitis is characterized by A. Pain lasts longer on hot or cold stimulus than normally B. Patient can’t localize pain C. Will have periapical involvement in radiograph 17. Irreversible pulpitis is characterized by A. B. C. D. There is often a history of spontanous pain Sudden throbbing pain Pain can’t be localised when it reaches the periapical area There is pain which lingers for a short duration after romoval of stimulus

18. What are the symptoms of internal resorption? A. Very painful B. Symptom-free or only mild pain 19. What kind of root fracture in a tooth has the best prognosis? A fracture at the A. B. C. D. Apical third Coronal third Middle third Vertical fracture

20. What will develop after prophylaxis? A. B. C. D. Acellular pellicle is formed immediately after Cellular pellicle is formed immediately after Acellelar pellicle is formed after 48 hours Cellular pellicle is formed after 48 hours

21. What is the purpose of making a record of protrusive relation and what function does it serve after it is made?

A. To register the condylar path and to adjust the inclination of the incisal guidance. B. To aid in determining the freeway space and to adjust the inclination of the incisal guidance. C. To register the condylar path and to adjust the condylar guides of the articulator so that they are equivalent to the condylar paths of the patient. D. To aid in establishing the occlusal vertical dimension and to adjust the condylar guides of the articulator so that they are equivalent to the condylar paths of the patient. 22. A 50 years-old patient presents with pain from time to time on light cervical abrasions. What is your first management to help patient in preventing pain in the future? A. Change diatary habits B. Change brushing habits C. GIC fillings 23. In planning and construction of a cast metal partial denture the study cast A. facilitates the construction of custom trays B. minimizes the need for articulating C. provides only limited information about inter ridge distance, which is best assessed clinically D. can be used as a working cast when duplicating facilities are not available 24. What are the artificial teeth in removable dentures made of? A. B. C. D. Porcelain Cross-linked methyl-methacrylate Ethyl-methacrylate Acrylic

25. Following extraction of the molar teeth A. B. C. D. The ridge height is lost more from the maxilla than from the mandible The maxillary ridge will get more bone lost from the palatal aspect than the buccal The mandibular arch is relatively narrower than the maxillary arch Compared with the pre-resorption state, the mandibular ridge will lose more bone from the lingual aspect than the buccal one.

26. Which anatomical landmark is important to include in impressions for lower full dentures? A. Mylohyoid ridge B. Lower incisive papilla 27. Wrought metal is to be, A. Marble

B. Quenched C. Has undergone cold treatment during processing 28. Which of the following is ONE indication for indirect pulp capping? A. When further excavation would lead to pulp exposure B. Excavation of a very deep caries 29. How does fluoridation work in theory? A. Fluoride ions are integrated by changing Hydoxylapatite to Fluorapatite 30. A major difference between light cured and chemical cured composite is that during setting or in function the light cured materials tend to: A. B. C. D. E. Seal the margins better and completely Exhibit less wear on time Undergo greater colour change Shrink more rapidly Posses greater fracture toughness

31. What consideration is important in deciding if a bridge for upper missing incisors should be made in pontic design or with gingiva imitation? A. Wishes of patient B. Bone resorption in edentoulos span 32. The most common cause of porosity in porcelain jacket crowns is, A. B. C. D. E. Moisture contamination Excessive firing temperature Failure to anneal the platinum matrix Excessive condensation of the porcelain Inadequate condensation of the porcelain

33. How should the occlusion in partial removable dentures be designed? A. Artificial teeth should be out of occlusion B. Artificial teeth should not interfere with the incisal guidance established by the remainig natural teeth. 34. The minimal labial tooth reduction for satisfactory aesthetics with porcelain fused to metal crown is, A. 1mm B. The full thickness of enamel C. 1.5 mm

D. 2.5mm E. One third of the dentine thickness 35. In removable partial denture, the principle of an indirect retainer is to: A. B. C. D. Stabilise against lateral movement Prevent settling of major connectors Restrict tissue movement at the distal extension base of the partial denture Minimise movement of the base away from the supporting tissue

36. When a removable partial denture is terminally seated the retentive clasps tips should: A. B. C. D. Apply retentive force into the body of the teeth Exert no force Be invisible Resist torque through the long axis of the teeth

37. Glass Ionomer Cement sets because of, A. B. C. D. E. Acid-Base reaction Addition polymerisation reaction Growth of glass crystals Slip plane locking Solvent evaporation

38. The reflex in gagging patients is caused by: A. B. C. D. Trigeminal nerve Glossopharyngeal Facial nerve Recurrent laryngeal

39. The use of nickel chromium in base plate should be judiciously considered because: A. A significant number of females are allergic to nickel B. A significant number of females are allergic to chromium C. A significant number of males are allergic to nickel 40. Which of the following liquids is not suitable for prolonged immersion of cobalt chrome partial dentures: A. B. C. D. Alkaline peroxidase Sodium hypochlorite Soap solutions Water

41. In complete dentures, cheek biting is most likely a result of:

A. Reduced Overjet of posterior teeth B. To high vertical dimension C. Teeth have large cusp inclines 42. The most common cause of fracture at the isthmus of a class II dental amalgam restoration is: A. B. C. D. E. Insufficient condesation Fracture line developing from pulpal-axial angle of the cavity Underconturing of the isthmus area Moisture contamination of the amalgam during placement Inadequate bulk of amalgam at pulpo-axial line angle

43. Why do you overpack amalgam fillings? A. To remove excess mercury 44. What is CORRECT in regard to the periodontal surface area in maxillary teeth: A. B. C. D. central incisor > first premolar> second premolar Canine> first premolar> central incisor Canine> lateral incisor> second premolar Canine> central incisor> first premolar

45. When restoring with composite resins, why do we do the cavo-surface bevelling: A. B. C. D. E. Aesthetic To open enamel rods for acid attack To smooth preparation A and B All of the above

46. A well constructed complete denture: A. Needs little maintenance B. Needs less than a week for adjustment and total success C. Has adverse effects and decreases taste sensations 47. On examination of a composite restoration you find a dark attain: A. Replace the composite B. Repair with unfilled resin C. Apply topical fluoride at the margin 48. A patient complains of sensitivity, on examination you find a composite filling restoring a good cavity preparation without any secondary caries; what is your next

step: A. B. C. D. Extirpate the pulp that is obviously inflamed Place ZOE dressing to sedate the pulp Ask patient to come back in six months Repeat restoration

49. What is the best way to cement a Maryland bridge, A. B. C. D. E. GIC Resin cement Composite resin Zinc Phosphate cement Oxide Zinc and eugenol

50. The ideal length of a post in the fabrication of crown and core of endodontically treated tooth is: A. B. C. D. E. 2/3 of tooth the tooth length 1.5 times that of the crown ½ root length The length of the crown

51. While you finish a class I cavity, the enamel is sound but you notice a thin brown line in the dentine and on the dentino-enamel junction, what is your response, A. You leave it and complete the final restoration B. You extend your preparation and clean it C. You apply a cover of varnish 52. Dental caries of the proximal surfaces usually starts at, A. B. C. D. Somewhere between the ridge and the contact area Just gingival to contact areas Just above the gingival margin At the contact point

53. The Frankfort plane is defined by which anatomocal landmarks, A. Porion, orbitale B. Sella, orbitale C. Nasion, Tragus 54. The biting load of a denture base to the gingival tissues compared to teeth are, A. Ten times more

B. Ten times less C. Equal 55. The difference between normal stone and the dye stone is, A. In the size and shape of the particles B. The mixing 56. The advantage of the silicone in soft relining material over hard plastic acrylic materials is, A. B. C. D. Capability to flow Prevents the colonization of Candida albicans Resilient in long run Better bond strength

57. A female patient comes to you complaining of persistent pain in a heavily restored central incisor; you suspect irreversible pulpitis and you have been told that she is in transit leaving by plane next day. Your treatment will be, A. B. C. D. Remove filling and place a sedative dressing Pulpectomy and Ledermix dressing Pulpectomy and calcium hydroxide dressing Prescribe analgesics and systemic antibiotic

58. The flexibility of the retentive clasp arm does not depend on: A. B. C. D. E. Length of the arm The cross section shape The material used Degree of taper The exerted force

59. Following calcium hydroxide pulpotomy, the dentist would expect dentine bridge to form at, A. B. C. D. The exact level of amputation Level somewhere below the amputation Half way between amputation and apex At the apical region of the tooth

60. In the construction of a full veneer gold crown, future recession of gingival tissue can be prevented or at least minimised by, A. Extension of the crown 1 mm under the gingival crevice B. Reproduction of normal tooth incline in the gingival one third of the crown C. Slight over contouring of the tooth in the gingival one fifth of the crown

D. Slight under contouring of the tooth in the gingival one fifth of the crown 61. What is correct in regard to high copper amalgam, A. B. C. D. Reacts and strengthens the amalgam by its dispersion properties Reacts to form copper-tin phase thereby eliminating the tin-mercury phase Reacts to form copper-silver phase thereby eliminating the silver mercury phase Reacts and strengthens the amalgam by its grain diffusion

62. The removable partial denture requires relining,what would be the most appropriate action, A. take an impression by asking the patient to occlude on it B. Provide equal space between denture and gingival tissues. C. Make sure the framework and retainers are seated in place before taking impression 63. Stiffness of material is measured by A. B. C. D. Proportional unit Modulus of elasticity Stress/ strain Ultimate tensile strength

64. Two central incisors on a radiograph are showing with what looks like eye drop radiolucency. You decided to start endodontic treatment on these teeth but when you tried to open access to the root canal you find clearly closed orifices with what look like secondary dentine. What is your initial management? A. Leave as it is and start a permanent restoration. B. Start systemic antibiotic C. Try to ream and file canals 65. After the initial development stage and in the absence of pathology, the size of the pulp chamber has been reduced by, A. B. C. D. E. Deposition of primary dentine Deposition of secondary dentine Reparative dentine Pulp fibrosis Deposition of reparative dentine

66. Denture stomatitis is commonly associated with, A. B. C. D. The continuous wearing of removable orthodontic appliances in otherwise healthy patient The proliferation of hypertrophic tissue at the denture periphery The overgrowth of some constituents of oral normal microflora Allergy to denture base material

67. The light emitted by the polymerization lamp has to be checked from time to time. The meter used for this only measures light in the range of: A. B. C. D. 100-199 nm 200-299 nm 300-399 nm 400-499 nm

68. Which is correct in regard to shade selection of crowns: A. B. C. D. It should be selected before starting preparation Chroma is the lightness/darkness of colours Value is the colour itself Hue is the concentration of colours

69. Where would you expect to find the mylohyoid muscle in relation to the periphery of a full lower denture: A. B. C. D. Mandibular buccal in the midline Mandibular lingual in the first premolar area Mandibular lingual in the midline Mandibular disto buccal area

70. After reimplantation of an avulsed tooth the prognosis may be poor because of A. External resorption B. Internal resorption 71. 2.2 mg of NaF contains how many mg of fluoride ions? A. 0.5mg B. 1.0 mg C. 1.5mg D. 10mg 72. How would you treat denture stomatitis? A. Nystatin B. Tell the patient to leave the denture out for some days 73. What is true about third molar surgery? A. Swelling is maximum after 24 - 48 hours B. Mental paraesthesia indicates careless technique 74. ?

A. Extension of denture beyond mylohyoid ridge leads to pain in swallowing 75. ? A. Plaque removal in case of exposed roots is important as plaque opens the dentinal tubules and causes spread of caries.

Paper 2
1. During swallowing, a) suprahyoid muscles relax b) masseter muscle contracts c) tongue touches the palate d) teeth have contact a and b a, c and d a, b and c None of the above All of the above In anaesthizing a 70 kg healthy man with Lignocaine 2% with 1:100,000 vasoconstrictor,what is correct? The toxic threshold is 22 ml 2.2 ml is the maximum you can give in one session Lignocaine has the same anaesthizing capacity as Benzocain and A... Lignoscain is 5 times less potent than Bupivacain Lignocain is more dangerous in Hypothyreodism than Bupivacain A suddenly swollen upper lip that lasts for 48 hours or more is most likely Haemangioma Agioneurotic oedema Mucocele Cyst What is the most important factor to reduce radiation in dental radiographs? Speed of film Collimation Filtration Cone shape and length Use of lead apron What is the best way for a permanent decline in caries of a population? Change diatary habits Topic and water fluoridation Awareness of dental health matters Better tooth brushing A patient in your dental chair shows chest pain, weak pulse and dysponea, what is your initial management,

A. B. C. D. E. 2.

A. B. C. D. E. 3. A. B. C. D. 4. A. B. C. D. E. 5. A. B. C. D. 6.

A. Administer nitro-glycerine and keep the patient up seated B. Put the patient in supine position C. Wait until the symptoms go away 7. Developer was contaminated with other chemical and was not mixed properly. What is the effect on the X-ray film?

A. Too dark film B. Light film C. Foggy 8. Branchial Cleft cyst is located

A. In front of the neck B. On anterior border of the Sternocleidomastoid muscle C. Shows when swallowing 9. A. B. C. D. What is the approximate unstimulated salivary flow rate, 2 ml/min 0.2 ml/min 0.02 ml/min 20 ml/min

10. Some hours after the extraction of a lower molar the patient complains of prolonged post operation bleeding and pain, how would manage this, A. Prescribe analgesics and ask the patient to follow a strict oral hygiene B. Administer 5% Marcaine Local Anaesthetic, prescribe analgesics and pack the socket with alvogyl C. Administer 5% Marcaine Local Anaesthetic, suture the socket and prescribe analgesics D. Suture and give pressure packs 11. A Gracey curette is characterized by A. B. C. D. The blade and the shank form a 90º angle Can be used on both sides Can be used on any tooth surface It is specific for each surface of the tooth

12. A patient with no positive history came along for scaling. The moment you pick up your anterior scaler you punch your finger, what should you do? A. B. C. D. Complete the procedure as if nothing has happened Check dentist’s blood for Hepatitis B antibody HBsAb Check dentist’s blood for Hepatitis B antigen HBsAg Check patient’s blood for Hepatitis B antibody HBsAb and HIV antigen HIVAg

E. Check patient’s blood for Hepatitis B antigen HBsAg and HIV antibody HIVAb F. Dentist should go and take a HBsAb vaccine 13. A patient on the dental chair has cardiac arrest. What is INCORRECT, A. Observing the vital signs and check that the air way is clear is at high importance B. Expired air has 15% O2 only, and cardiac compressions achieve 30-40% of cardiac output C. Intermittent positive pressure at the rate of 40/min will reduce the chances of cerebral hypoxia D. Intermittent positive pressure is better than mouth to mouth when it has been given at the same rate. E. You check the pulse and respiration of the patient before starting any resuscitation 14. The best radiograph for investigating the maxillary sinus is, A. B. C. D. E. Periapical radiograph Panoramic view Lateral cephaloghraph Occipitomental view Reverse Towne’s view

15. Which is true in regard to osseointegration of implants in dentistry? A. The osseointegration is directly between titanium and bone B. Following insertion, implants can be immediately loaded without problem C. The success of the implants is directly proportional to its area of contact with bone and the bond is mechanical in nature D. The success of the implants depends mostly on low torque preparation and insertion of the fixture E. The success of integration is accurately investigated by immediate radiographic examination 16. Loss of sensation/paraesthesia in the lower lip may be produced by, A. B. C. D. E. Bell’s palsy Traumatic bone cyst Trigeminal neuralgia Osteomyelitis Ludwig’s angina

17. In anxoius and psychologically stressed patients gingivitis is often more severe because of A. Stress causes histamine and serotonine release B. Stress causes catecholamine and corticosteroid release C. Stressed people neglect their oral hygiene

18. A retained lower primary incisor causes the permanent incisor to A. erupt buccally B. erupt lingually C. ankylise 19. What is the least probable consequence in thumb-sucking? A. Reclining of lower incisors B. Protrusion of upper incisors C. Formation of deep palate with big overbite 20. Ankylosis of teeth is often found after changes in the continuity of the occlusal plane. These changes are caused by A. Overeruption of opposing teeth B. Localised growth inhibition of the alveolar bone C. Sinking of ankylised tooth into the bone 21. What is not important in obduration materials for primary teeth? A. B. C. D. Good apical seal Radioopacity Antibacterial Resorbable

22. What is your first consideration in the treatment of dry socket? A. Prevention of osteomyelitis B. Pain relief 23. A patient presents with pain in the upper left segment. On inspection you find a localized alveolar abcess distal 27. What will be you management? A. Drainage B. Extraction of tooth 24. What does not help in establishing the caries risk in children? A. B. C. D. E. History of caries Lactobacillus count Dietary habits Brushing habits Genetic predisposition

25. Opioid drugs are similar to which endogenous substances?

A. B. C. D. E.

Bradykinins Peptides Prostaglandins Serotonins Enkephalins

26. Which of the following have a tendency to recur if not treated correctly? A. B. C. D. E. Giant cell granuloma Lipoma Fibrous epulis Haematoma Pulp polyps

27. A 22 year old woman has acute gingival hypertrophy, spontaneous bleeding from the gingiva and complains of weakness and anorexia. Her blood analysis was as follows: HB=12gm, Neutrophils=90%, Monocytes=1%, Platelets=250000, WBC=100000, Lymphocytes=9%, Eosinophils=0%. The most likely diagnosis is: A. B. C. D. E. Myelogenous leukaemia Infectious mononucleosis /glandular fever/ Thrombocytopenic purpura Gingivitis of local aetiological origin Pernicious anaemia /Vitamin B12 deficiency/

28. When no radiation shield is available, the operator should stand out of the primary xray beam at a distance from the patient’s head of at LEAST: A. B. C. D. E. 0.5 metres 1 metre 1.5 metres 2 metres 3 metres

29. Which of the following is a typical consequence of dental crowding, assuming no primary tooth has been lost prematurely? A. B. C. D. E. Overlapping of lower incisors Palatal displacement of upper canines Impaction of 15 and 25 between first premolars and first molars Mesial tipping of 16 and 26 Rotation of 16 and 26

30. What is the dominant microflora in acute necrotic ulcerative gingivitis (ANUG)? A. Spirochaetes and fusobacterium SP

B. C. D. E.

Spirochaetes and eikenella corrodes Polymorphs and lymphocytes Actinobacillus actinomycetes comitans oral capnocytophaga Porphyromonas gingivalis and prevotella intermedia

31. Which of the following is true regarding gingivosis (Desquamative gingivitis) A. B. C. D. E. It is caused by hormononal imbalance Is seen only at or after menopause Is frequently caused by lichen planus Is a variant pregnancy gingivitis Is related to nutritional disturbance

32. What are the points that determine the facial line in cephalometric points (The angle of the convex facial line)? A. Nasion, pronasale, pogonion. B. Sella, nasion, pogonion 33. A 10 year old boy presents with small greyish white lesion surrounded by a red halos on the soft palate and tonsillar pillars, small vesicles are found. He has fever and pain in the ear and won’t eat. The MOST probable diagnosis is? A. Herpangina B. Measles C. Primary herpetic stomatitis 34. A 12 years-old child presents with symptoms of widespread gingivitis with bleeding and general malaise for several weeks. How would you manage this patient? A. B. C. D. E. Prescribe Metronidazole 100mg Locally debride, give oral hygiene instruction and prescribe H2O2 mouth wash. Give a prophylaxis with ultra sonic scaling Refer for haematological screening Advise for bed rest with supportive and palliative treatment

35. What is the effect of office dental prophylaxis of regular six month intervals on children’s oral health? A. B. C. D. E. Reduced caries incidence by approximately 30% Provide a long term improvement in oral hygiene Provide a short term improvement in oral hygiene Prevent gingivitis Reduce the need for patient cooperation

36. What is the most frequent cause of pain which occurs several days after obturation?

A. Entrapped Bacteria in the periapical region B. Underfilling the root canal system C. Overfilled root canal

37. A diabetic patient with moist skin, moist mouth and weak pulse; what would you do: A. B. C. D. Give glucose orally Administer O2 Administer adrenaline Inject insulin

38. The laboratory findings in Paget’s disease show: A. B. C. D. E. Elevated calcium, elevated phosphate, and elevated alkaline phosphate. Normal calcium, normal phosphate and elevated alkaline phosphate Decreased calcium, increased phosphate and elevated alkaline phosphate Increased calcium, normal phosphate and decreased alkaline phosphate Normal calcium, increased phosphate and elevated alkaline phosphate

39. A patient has developed a sever chest pain and difficulties in breathing while in the dental chair. Your initial response is: A. B. C. D. Administer glycerine trinitrate and monitor patient in upright position Patient has an acute episode of angina as demonstrated by curve in ECG No treatment is required until confirmed as MI by ECG Patient has myocardial infarction as confirmed by ECG

40. In the case of malignant melanoma occurring intraorally, which of the following is true: A. B. C. D. E. Uncommon on the palate Should not be biopsied, as this will increase metasis The 5 years survival rate is 20% The incidence of oral melanoma is the same as those on the skin Commonly occurs intra orally

41. What is NOT TRUE in relation to the use of diazepam for sedation? A. Patient commonly complain of post operative headache B. An acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively C. There is a profound amnesic action and no side effects D. Active metabolites can give a level of sedation up to 8 hours post operatively E. Can be used safely for children 42. Topical fluoridation in a 14 years-old boy will not lead to mottling because

A. Teeth are already calcified 43. Patient on anti-coagulant therapy requires an extraction to be performed. Which of the following is NOT true: A. B. C. D. Minor leedings bleeding can be reduced somehow by using tranexamic acid Prothrombin value above 2.5 is required to perform extraction It takes up to 12 hours for Vitamin K reverse effects of warfarin Heparin can be administered sub-cutaneous and acts rapidly

44. A physician refers a nine year old boy to you to confirm diagnosis. The boy has a fever of 40°C and coughing. When you focus your light into his eyes he turns away. Intraorally there are white spots surrounded by red margins. The disease and lesions are: A. Measles and the spots are Koplik’s spots B. AHGS vesicles C. Rubella and the spots are Fordyce’s spots 45. What is true in TMJ dysfunction therapy? A. Should be treated surgically B. Appliances that raise the bite usually relief the symptoms and are used prior to any surgery 46. What is true regarding pregnancy gingivitis? A. It is due to increased gingival microcirculation B. Elevated oestrogen and gestagen levels are directly responsible C. Hormonal changes cause the growth of anaerobic bacteria (Prevotella intermedia)

47. 5 mm probing depth means: A. Patient has periodontitis B. Probe is 5 mm beyond gingival margin C. Probe is 5 mm beyond dentino-enamel junction 48. A middle aged woman gives a history of intermittent unilateral pain in the sub mandibular region, most probable cause is, A. B. C. D. Calculus in the salivary duct resulting in sialolithiasis. Ranula Cyst Mucocele

49. By which of the following mechanism reduces Aspirin pain:

A. It is anti inflammatory by the release of histamine B. It blocks the cyclo-oxygenase pathway. 50. What is the danger of using air as a cooler during cavity cutting: A. B. C. D. E. Hypersensitivity Odontoblasts are drawn into the tubules Dehydrates the tooth A+B A+B+C

51. The first forming microbial elements of plaque are: A. B. C. D. E. Aerobic gram positive G+ Aerobic gram negative GAnaerobic gram negative GSpirochetes Anaerobic gram positive G+

52. A patient is resistant to caries but has a periodontal disease. In this case, sucrose in diet is important because: A. B. C. D. Sucrose is greatly involved in plaque development S. mutans produces Levans frictions which are used by periodontal pathogens The streptococcus mutans cannot survive with a continual supply of sucrose Existing plaque must continue to get sucrose in order to grow

53. In minor oral surgery, what is TRUE in regard to antibiotics: A. B. C. D. Amoxil satisfactorily covers the dental spectrum Metronidazole and Amoxil have the same penetrating power It is evident that it will reduce post operative swelling There is convincing evidence that Prophylactic prescription of antibiotics will reduce postoperative infections E. Most oral infections get anaerobic after 2 to 3 days 54. A patient comes with a firm, painless swelling of lower lobe of parotid which has grown progressively for the past year. He complains of paresthesia for the past 2 weeks. This is most likely to be: A. Pleomorphic adenoma B. Carcinoma of the parotid C. Lymphoma of parotid 55. What is true in treating a patient with secondary herpes simplex:

A. Acyclovir inhibits viral transcription when applied in the prodromal phase B. Idoxuridine is better than acyclovir when applied topically C. Antivirals are contraindicated in immuno-compromised patient 56. During extraction of a maxillary third molar the tuberosity is fractured; however, it remains in place attached to the mucoperiosteum. Which of the following procedures should be employed: A. B. C. D. Remove the tuberosity and suture Leave the tuberosity and stabilize if required Remove the tuberosity and fill the defect with Gelfoam then suture. If fractured tuberosity is greater than 2 cm, leave in place and suture

57. An incision biopsy of an ulcerated and intruded clinically suspicious lesion in a 50 year old female reveals chronic inflammation; you would: A. Inform the patient and her physician of your findings and instruct the patient to return in six months B. Surgically excise the entire lesion since you know it is not malignant C. Dismiss the patient with instructions for warm saline rinses and re-examination D. Repeat the biopsy 58. Reducing the size of the focal spot will: A. increase sharpness B. increase density 59. The initial priority in treatment of horizontal fractures is: A. B. C. D. Preservation of pulp Immobilisation Root canal treatment Calcium hydroxide treatment

60. Which of the following has proven to be the MOST important in community preventive program: A. Dental awareness of the community B. Institution of oral hygiene measures C. Water fluoridation

61. What effect has placing a sealant over pits and fissures on the progression of caries? 1. 2. 3. Decreased new caries Increased new caries Progression of exististing caries

4. 5.

Decreased progression of existing caries No effect on existing caries

A. 1 and 3 B. 1 and 4 C. 1 and 5 62. In advanced periodontitis with marked mobility, teeth may be splinted: A. To improve comfort for the patient B. Splinting helps in transmitting the force to the adjucent teeth to reduce the load on the involved teeth 63. Use of inhalation general anaesthesia: A. Halothane should not be less than 5% B. Oxygen must not be less than 30% 64. Swallowing will aid in the diagnosis of: A. B. C. D. F. Branchial cyst Thyroglossal duct cyst Ranula Retention cyst Glossothyroid cyst

65. Which of the following will increase sharpness: A. B. C. D. Larger focal spot Smaller focal spot Increase object-film distance Decrease patient-source distance

66. In severe periodontitis the probe will eventually be: A. B. C. D. E. prevented to go deeper by calculus beyond connective tissues in the junctional epithelium at the end of the junctional epithelium Touching the middle of junctional epithelium Touching sulculuar epithelium

67. A 58 year old male has been treated with radiation for carcinoma of tongue. The patient complains of pain associated with poor dentition. The dental management would be: A. Immediate extraction of any poor teeth under local anaesthetic with antibiotic coverage B. Segmental dental clearance and closure to eliminate problems

C. No dental treatment may be due to neuronic of neoplasms D. Clearance of poor dentition followed by hyperbaric oxygen treatment plus a primary closure of wounds under antibiotic coverage E. No extraction as radionecrosis is an important sequelae

68. Which of the following is NOT true about anticoagulation therapy? A. B. C. D. INR of 3 is enough to start any extraction Affects extrinsic system and increases prothrombin time Heparin can be given subcutaneously and acts rapidly It takes at least 12 hours for Vitamin K to reverse the effects of coumarin

69. In a radiograph the roots of the upper teeth are too short because of: A. Inadequate horizontal angulation B. Too high vertical angulation C. Too small vertical angulation 70. Characteristic of Squamous Cell Carcinoma of the tongue A. more in white skinned people B. more in alcohol drinking smoking males C. associated with Plummer-Wilson-Syndrome 71. Characteristic of Squamous Cell Carcinoma of the lips A. It reacts far simply to radiotherapy B. metastizes mainly by blood C. relatively rare in Australia 72. Which type of dentin is not formed due to pulp pathology? A. B. C. D. E. Reparative dentin Secondary dentin Primary dentin Reaction dentin Tertiary dentin

73. In children a disease with enzyme deficiency is A. hypophosphatasia B. Cyclic neutropenia C. Juvenile periodontits 74. Which is not true in sickle cell anaemia?

A. B. C. D. E.

Deformed cells with less oxygen transport capacity Higher infarction risk Have wide bone marrow spaces with narrow trabeculae in the alveolar bone of oral cavity Resistant to malaria parasites More common in mediterranean people

75. What is correct regarding Hydrocortisol therapy? A. B. C. D. E. 10 mg per day does not make a significant adrenergic depression Hydrocortisone can be given parenterally only Glucocorticoids have antiinflammatory action Hydrocortisone has only glucocorticoid action Corticosteroids cause a decrease in blood sugar

76. A patient reports to you with an exophytic lesion on the tongue and a raised white blood cell count of 2 x 109 per ml. You would A. Do a biopsy B. Refer for serologic testing C. Give acyclovir 77. Normal prothrombin time and elevated partial thromboblastin time is seen in A. B. C. D. Factor VIII deficiancy (Haemophilia) Thrombocytic pupura Leukemia Von Willebrand disease

78. Which of the following describes best a 9 years-old child permanent dentition? A. 16 12 11 | 21 22 26 -----------------------46 42 41 | 31 32 36 12 11 | 21 22 ---------------42 41 | 31 32

B.

79. What is the best reason to promote tooth brushing to the public? A. Less fissure caries B. Less gingivitis C. Gingival massage 80. What is untrue about diabetes?

A. Hypoglycaemia is more common than hyperglycaemia B. Insulin-dependend patients are of more concern than non insulin-dependend C. Adrenalin causes a decrease in the blood glucose level 81. Which of the following is a feature of Streptococcus mutans? A. It does not require a special environment to grow B. It can be easily transported from one part of the oral cavity to another C. It has the ability to restructure carbohydrates 82. What does the term “caries prevalence” mean? A. The total number of carious areas affected and any present caries B. The individual risk for a patient to acquire caries 83. Which of the following are features of herpetic gingivostomatitis? 1. Irritability 2. Fever 3. Occurs in teenagers 4. Vesicles occur only on buccal mucosa and tongue A. 1+2+3 B. 1+2+4 C. 1+4 D. All of the above 84. What is the most important aspect of root canal treatment? A. Complete debridement of the root canals

85. What is true about halothane? A. It depresses the myocard B. Reflex trigeminal stimulation is uncommon 86. What is true about nitrous oxide? A. It is rapidly absorbed and rapidly eliminated 87. A patient in your dental chair suddenly becomes agitated with shallow breathing, full pulse and a blood pressure of 150/80. You would A. Give oxygen B. Give insulin C. Give glucose

D. Place patient in supine position 88. After periodontal surgery, the regeneration of the periodontal ligaments takes place by A. Formation of long junctional ligament

___________________________________________________________________________ Actually, there were 80 MCQs in each of the two papers. I probably put some questions in the wrong paper.

SAQ in September 2006 in Sydney
1) Patient gives history of Warfarin treatment in the assessment. What will be the considerations in the dental management of such patient? ( compulsory ) 2) Patient has missing upper lateral incisor. What are the different treatment options? 3) 55 years-old Patient has mobile upper anterior teeth and a diastema is starting to develop. What will be the differential diagnosis and its management? 4) Patient has apical abscess in 46 and needs extraction. Already 4.4 ml. of 2% lignocaine with adrenaline 1: 80.000 is injected, but when you try to extract tooth it is still painful. Discuss the possible management options. 5) How do you manage a 2 ½ year old child patient who is visiting a dental clinic for the first time, and what will you discuss with the parents? Answers can be found in Odell: “Clinical Problem Solving in dentistry” (except 4)

Alternative SAQs in September 06 (Egypt&Iran) 1. 2. 3. (compulsory) management of pregnant lady smoking and its effects and how to motivate patient to leave the habit management of tooth avulsion - mother calls you from home and only 20 mins have elapsed since injury. advice on phone on long term and short term management (this one is in Odell’s book, too) your patient has read about tooth whitening. tell her about bleaching management of female patient on bisphosphonates

4. 5.

1. while taking a medical history u get to know that the patient is 10 weeks
pregnant.what precautions will u take while treating and how will u manage the patient? {this was the compulsory question}

2. what are the effects of smoking on oral health.how will you help the patient stop
smoking?

3. a patient says that he heard of tooth whitening and wants his teeth whitened.
a>how will you explain the different types(something like this) b>how will you manage the patient?

4. A mother rings u up at office and says that her 9 yr old has fallen down and his front
tooth has come out?what are the instructions u will give over phone and how will u manage this patient?

5.

A 40 yr old female patient says that she has been taking bisphosphonates for the past 5 years and now has come for check up.some teeth have to be removed,What prosthetic considerations will u make and how will u manage?

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