MCQ’s for Dental PG Entrance se Examinations Arranged Chapter- ] .—° wise with Explanatory Answers Also Ask for... MCQs in Prosthodontics & Dental Materials |DENTAL Pulse MCQ’s for Dental PG Entrance Examinations Arranged Chapter wise — with Explanatory Answers Volume — 2 NINTH EDITION Authors SATHEESH KUMAR REDDY. K mps SWAPNA MUNAGA mbps Co-Author DR. VENUGOPAL. T mps SWAPNA MEDICAL PUBLISHERSDENTAL PULSE © By Dr. Satheesh Kumar K. EIGHTH EDITION - JULY 2014 NINTH EDITION - JUNE 2015 AlLrights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. The author and publisher have taken care in preparation of this book, but make no expressed or implied warranty of any kind and assume no responsibility for errors or omissions. No liability is assumed for incidental or consequential damages with or arising out of the use of the information contained herein. All legal matters to be settled under Hyderabad jurisdiction only. Price: 1150.00 Published by: Swapna Medical Publishers FLAT NO 101, H.No. 3-2-844, Rajeswari Gayatri Sadan, Kachiguda, Hyderabad - 500 027. Ph: 92471 88244, 095338 63720 e-mail: smp_hyd@yahoo.co.in, swapnamedicalpublishers@yahoo.com Website: www.swapnabooks.com Exclusively uted by Sri Venkateshwara Books Hyderabad. Mob: 9533863720, 9247188244 e-mail: svbookshyd@gmail.com Printed at: Hyderabad.Table of Contents 1 ORTHODONTICS 1 Growth And Development. oot 2 Development Of Dentition 013 3 Etiology Of The MalocclUsion .......cccnsssssnenesnnensnnennennanennsnnensnnses O19 4 Diagnosis. 028 5 Cephalometry 036 6 — Occlusion & Classification Of Malocclusion, 7 Biomechanics - Tooth Movement 8 Preventive & Interceptive Orthodontics... 9 Removable And Fixed Appliances 10 Myotunctional & Orthopedic Appliances. 11 Treatment Planning 12 Synopsis... I PEDODONTICS 1 Child Psychology 116 2 — Caries And Restorative Dentistry 130 3 TraUMAtOlOgY......nssennnennisnnnintnniinanianensisneess sosontnieineneee 141 4 Pediatric Endodontics 147 5 Diseases Of Child... coscnenenennneninentntninnnininnenennenenenimnee 158 6 MiscellaneOUus...........cnesnnssninnnniinnininnniniannninnannnannss 160 7 Synopsis 174 Ml COMPLETE DENTURE 1 Impression ProcedureS......0c0.000 eR 1) 2 Border Moulding And Posterior Palatal Seal 196 3 Jaw Relations... ontuinntisteitneninitirensnesesteseseese 200 4 Teeth Setting And Articulators......... so . 208 5 Special Techniques In Complete Dentures..... 218 6 Miscellaneous. 222 eS 235IV_ FIXED PARTIAL DENTURE vi vil 1 aNounsoen Principles Of Tooth Preparation. Complete And Partial Veneer Crowns Metal Ceramies......ecccnecsies sostsnetsatianenensniese . oe Laminates, Maryland Bridge, Allceramics, Cementations A And Tissue Dilation. Pontics, Finish Lines Miscellaneous. ‘Synopsis. REMOVAL PARTIAL DENTURE eanroens Introduction And Classification Major And Minor Connectors Rests, Direct And Indirect Retainers. Survey And Design.....ce Miscellaneous. Synopsis ORAL AND MAXILLOFACIAL SURGERY ©RNOne wna Exodontia and Impactions, Local and General Anesthesia. Mandibular Fractures Middle Third Fractures TMJ and Maxillary Sinus Cysts and Tumours... Odontogenic Infections Preprosthetic & Orthognathic Surgery and Miscellaneous Synopsis GENERAL SUGERY onrens Diseases Of Salivary & Thyroid Glands... Infections Trauma Cleft Lip And Palate. ‘Swellings, Ulcers And Tumors Of Head And Neck Diseases Of Larynx And Pharynx. 245 250 254 258 262 266 269 278 .. 298 299 305 315 321 323 338 . 354 380 396 409 418 427 440 463 503 514 519 -. 523 528 537vit 7 Transfusion, Shock, Burns And Wound Healing 8 Arterial And Venous Disorders. 9 Miscellaneous 10 Synopsis ORAL PATHOLOGY AND MEDICINE Developmental Disturbances Benign And Malignant Tumours Of Oral Cavity . Odontogenic Cysts And Tumours Diseases Of Salivary Glands Dental Caries Pulp And Periapical Infections Physical And Chemical Injures... Diseases Of Bones & Joints OYH9 HARON H+ 9 Diseases Of Nerves & Muscles... 10 Skin And Vesiculobullous Lesions 11 Bacterial Infections. 12. Viral Infections 13 Mycotic Infections 14. Oral Aspects Of Metabolic Diseases. 15 Tongue Disorders... 16 Pigmentation 17. Diseases Of Blood 18 Miscellaneous 19. Synopsis... ORAL RADIOLOGY Radiation Physics Biological Effects Of Radiation Radiation Safety And Protection. X-ray Film, intensifying Screen And Processing Of X-ray Films. Projection Geometry And Intraoral Radiography Extraoral Radiography... Radiographic Diagnosis ‘Synopsis. eNonnron 541 552 556 564 594 610 632 641 649 655 661 668 673 679 689 696 702 706 713 716 718 725 . 732 760 768 775 779 785 789 796 805x XI xi PATHOLOGY Cell in health and disease Inflammation, immunity & hypersensitivity Healing Fluid and haemodynamic disorders Growth disorders and neoplasia... Diseases of blood and lymphnodes NOOAROPH Systemic Pathology & Miscellaneous 2 ‘Synopsis GENERAL MEDICINE 1 Infections Central Nervous System. GIT, Liver And Kidney... Hematology And Endocrinology Cardiovascular System 2 3 4 5 Respiratory System 6 7 Miscellaneous 8 ‘Synopsis. PHARMACOLOGY Chemotherapy... A\N.S, Blood and Endoerinal drugs NSAIDs and other CNS drugs General Pharmacology Drugs acting on CVS, GIT And Respiratory systems. Local And General Anesthetics Miscellaneous eNoaanpon Synopsis Sie 817 822 .. 834 838 . 845 854 867 878 .. 890 903 912 922 940 951 967 . 978 .. 981 1005 1021 1039 1047 1057 1063 1080FEEDBACK FORM Students are requested to use this table if they find any mistakes in this book and Iwelcome feedback so that our juniors will be benefited. As an attempt to make this book error free and as a token of appreciation, Dental Pulse Team has decided to reward the students for sending the corrections. Each first received correction with proper reference will attract a reward of %.1,000/-. — Dr. Satheesh Kumar K. i explanation)Our Sincere thanks to os) for sending us the corrections in 8th ed of Dental Pulse. As per our promise, you will be receiving the following cheques shortly. You are requested to call 92462 10072 and update your communication details so that we can send the cheques by courier. wesy7aae soozeqouae Geese 29 wes7?aue soozeq00BE OeBbeeR” w2s7 79S" soozeqooaH OzBEeer 29 \—SS ORTHODONTICS ORTHODONTICS |. REFERENCE BOOKS TAKEN: 1. PRINCIPLES AND PRACTICE OF ORTHODONTICS by GRABER - 3rd & Sth editions 2. TEXTBOOK OF ORTHODONTICS by M.S.RANI~ 3rd edition 3. THE ART AND SCIENCE OF ORTHODONTICS by BHALAJI~ 3rd, 4th & Sth editions 4. TEXTBOOK OF ORTHODONTICS by GURKEERAT SINGH - 1st & 2nd editions 5. TEXTBOOK OF PEDODONTICS by SHOBHA TANDON - 1st edition 6. CONTEMPORARY ORTHODONTICS BY WILLIAM R. PROFFIT ~ 4th & 5th editions 1, GROWTH AND DEVELOPMENT a) Body b) ¢) Coronoid a) Condylar cartilage Ramus (MAN -2K) 2. Maxilla develops by 2). Endochondral bone formation ) Tatra membranous bone formation ¢) Cartilage replacement and intre membranous bone formation 4) Mostly cartilage replacement anda little by intra membranous (MAN 3. Which of the organ/system increases to 200% the size before puberty age 9-10 years 8). Lymphoid b) Somatic b) Genitals a) Neural (MAN -00) 4. Servo system theory of growth was given by 2) Scott b) Petrovie ¢)_Limborgh 4) Van der klaauw (MAN -01) 5 Greatest amount of cranial growth occurs by 8) Birth to five years b) 5 ~ 6 years 6-7 yeas 4) 7~10 years (MAN-97) 6. At birth which of the following structures is nearest the size ft will eventualy attain in adulthood b) Mandible 4) Nasal capsule (MAN -97,98) “Epigenetic factors’ control are? 8) Genetic factors present within the skeleton b) Genetic factors present outside the skeleton ©) Local non genetic factors 18) General non genetic factors the growth of skeleton (MAN -97) 8. Scammon’s growth curve. False is 8) ‘Neural tissues-Host of the growth is completed by 6 years Lymphoid tissues ~ growth reaches 200% by age 13 and regresses afterwards ©) Genital tissues - most ofthe growth is completed by the age of puberty 4) None of the above (MAN -97, ALINS -94) 9. Age of closure of sphenooccipital synchondrosis 8) 6 years b) 12 years ©) 18 years ) 25 years (MAN -28) Persistent part of the envelope of Meckels cartilage ts @) Stylomandibular ligament ) Tempero madibular tigament ©). Spheno mandibular tigament 4) Stylohyofd ligament 10. (MAN -28) 11, Meckel’s cartilage gives rise 8) Condylar process _-b) Coronoid process )_ Rest of ramus «) None of the above (Nan-s8) 7 8 A 8 AS) AD 4) ¢ oe 10) © aD ASS(0S Dental Pulse _ 12. Growth of oral structures is mainly influenced by factors: b) Intramembranous growth a) Hereditary 1) Environmental ) Appositional growth d) Periosteal growth )_Hereditaryinfluenced by environmental {AIPG -96) 4) None of the above 24. The pharyngeal muscle which forms a part of buccinator (MAN -2001) mechanism 13. Duration of adolescent stage in boys is a} Inferior constrictor b) Middle constrictor a) Byears b) 3-5 years ©) Superior constrictor 4) Palatophryngeus ) years 4) 5 years (KAR -02) (P6I-2011) 25. Premaxilla is derived from 14, An early prepubertal growth spurt indicates: 2) Maxillary protuberance b) Palatine bones 4) Longer treatment time b) Fast maturing child ) Frontonasal process 4) Median process «) Slow maturing child d) An endocrine dysfunction (AlIMs 94) (MAN-2001) 26. Differential growth means: 15. Sphenooccipital synchondrosis closes at the age of 8) Difference between growth and development. 8) 6 years of age b) Early puberty age b) Difference between individual growth «) Early adult age 4) Tenever closes ) Acceleration in growth. (ar -99) 4) Different tissues grow at different times rate and ammount. 16. At birth, the palate is relatively flat: in adults; it is (KAR -02) vault-shaped. By which of the following does this change 27. In.a newborn child we generally see: occur a) Maxillary protrusion b) Maxillary retrusion 4) Bone resorption in the palatal vault ) Mandibular protrusion) Mandibular retrusion 5) Growth of the maxillary sinuses (Ps -95) Deposition ofthe alveolar crestal bone 28, The implant method of studying growth was proposed by: 44) Bone deposition on the posterior wall of the maxillary a) Scammon ») Borg. tuberosity )_Belchier 4) Bjork (AtPG -97) (APG -04) 17, Ifa child's teeth do not form, this would primarily affect 29. Earlier closure of a suture is called the growth of th a), Synchondrosis b). Ankylosis 2) Maxila b) Mandible €) Synostosis 4) Epiphysis ©) Whole face 4) Alveolar bone (KAR -98) (AIPG -03) 30. The 'V' principle of growth is best ilustrated by the 18. After the age of six the increase in the size of mandible 2) Body of Mandible b) Mandibular ramus occurs at: )_ Mandibular symphysis 2) Symphysis 1) Between canines 4) Spheno-occipital smnchondtosis «) Along the lower border d) Distal to 1* molars (KAR -98, AP -06, 14) (AIPG -01, KAR -04) 31. The first ossification center of the mandible in a 6 weeks 19, Vital staining was introduced by old human embryo is found in which one of the following 2) Enlow ) Wolf locations? 6) doha Hunter 4) Petrovie a), Futurecoronoid process (aP-2012) ) Future condylar process 20. Growth of the maxilla in the vertical direction is due to: )_ Future mental foramen a) Growth of the alveolus b) Growth at sutures 4) Future mandibular foramen ©) Growth of the cranial base (APPSC -99) 4d) Growth ofthe synchondrosis 32. Functional matrix theory is hypothesized by (AIINS -99) a) Scott ») Sicher 241. Growth of cranium continues upto ) Petrovic 4) Moss a) 2yts b) 10 ys {COMEDK -03) ©) 15 yrs 4) Grows equally 33. Bjork used the implants for predicting facial growth (AP 18) changes. This approach is called as: 22. Absence of sesmoid bone in git of age about normal 2} Longitudinal approach. b) Metric approach. range of puberty is said to have ) Structural approach. b) Computerized predication 8) Completed the growth b) Over growth (AIPG -04) «)_ Delay in reaching puberty 34, The functional Matrix concept as revised by Moss does 4) All of the above not include: (ar -03) 8) Connected cellular network 23, In sutures there is protiferation of connective tissue b) Mechano transduction followed by replacement of bone this is called: ) EpigeneticEpthesis. d) Genomic thesis a) Endochondral bone growth (AIPG -04) eG) 0 mB 1) C ie i) 0 TD W)C MA Aye Me we Me 25) C26) 027) D2) 02) C30) B 31) C32) 033) A 34)ont 0nrxes 35. Negative growth isa characteristic of 6) Sutuat 4) Syndesmosis 2) Tests ») Brain (1a8-o6) 3) Mandible ) Thymus 47, More than 80% of growth of the bran or bran vault has (APS -04) been achieved by: 36. The body tissue that grows rapidly but shows minimal) T2yearsof feb) S years of froth after the age of 67 yeas i: 3) tByeasoftife ——d} 22 years of fe ) Neural tissues b) Lymphoid sue, (coneoK08) 6) Steletal issue. d) Genta sue 48, Mechanism of bone gronth i by: (ates 04) 0) one deposton and resrpion 237. Combinations of deposition and resorption occuring in) Cortical dit the differen bones of he skall which result ina growth c) Dispacement——_-d) Alf the above movement towards the depository surface is termed as (KAR-04) 2) Remodeting B) isslacement 49. change in the Sntensty and direction f funcional ) Phyloge resorption d) Drift forces would produce demanstable change inthe internal (Pst-s7) architecture and enteral form of bone vas stated by, 38 _Enlows'V principe of growth s found in 2) Melvin moss by EM angle 2) ala base 3) Maxila ony 6) adinison 4) Salis Wot {} Moxila and mandible) None of the above (comeox-08) (P6103) 50. Development of face occurs inthe following planes 38. ral and Nasa capsule of functional growth elated to 2) Transverse, sagittal vertical 2) Pelsteal matin b) Sutra mati 0) Transverse, vera, sagt 5) Capsular matix, 4) None of he above ©) Sagi, vera, nansvere (PGI -03) d) Vertical, transverse, sagittal 40. In sicher’s theory, suture acts as (AP-06), 2) a independent growth potential 5A. Read the following carefully: b) Dependent on cranial base 1) Spheno-occipital synchondrosis, 6) Used for growth adjustment 2} Mandibular conde 8) None of above 3) Fontomarlaysiure (Pot03) 4) Nasal septum 44. The movement of bone in response to its own growth is 5) Alveolar rocesss terme 2) Rotation b) Secondary displacement Which ofthe following are sites of cartilaginous growth Primary csplacement ) Diferentation postnatally (arog 1) 182 ) 286 42. the “Suture dominance theory" of canafacal growth 0) 2,385 a) 34s was given by (atrs-06) 23 Hoss b) sicher 52. Father of modem orthodontics ts: rat 8} Petrovic 2) Dewey 0) Angie (1aR-05) 5) Anion 4 Clk 463, Cranial vault volume at 7 years: (aP-07) os bye 53, Allof the following are considered microskeletal units of oun 8) 3/4 the mandible as per the matrix theory EXCEPT: (7si-05) 2) chin 1) lene fossa 4h. Skala birth contains 8) Coron process 4) Angle ofthe mandible 2) 22 bones 6) 34 bones (KCet-07) 6) 5 bones 8) 54 bones 54, Growth estimation ts done by: (coneok-o8) ”” 2) Hontal bone +) Cervical vertebrae 45, Spheno occipital synchondroses caries the growth of <)Capitate ) Clvte anterior half of the gonial base of the cranium and upper (AIPG-07) porto the face 55. Functional matrix theory suggests thatthe determinant 2) Forward and downward directions frowth of seleta sues resides ins b) Forward and lateral direction a) Skeletal b) Sutures 6) Upward and forward ivections ©) Cartlages 4) Nonsheleta tissues 8) Only forward ection (icet-07) (COMEDK-06) 56. The three main vertical pillars of trajectories of force 46, Allo the following are examples of fbrous joint except: arising from the alveolar process and ending inthe base 2) Symohyis 3) Gomphoss Of the skal ae al excep a) Canine pillar b) Zygomatic pillar BL A ae) © EL) A ee) SRO) © BEL A ae we) 049) 0 SO) Asi) 8 52) 8 53) 8 54) B55) 0 oe) 0 (Se o==" Dental Pulse ©) Plerygoid pillar 4) Condylar pillar (KcET-o7) _ ©) Vander Linden 4) Latham (COMEDK-09, 11) 57. The Condylar Cartilage in the mandible is held to be a 69. The groove separating the gum pad from the palate is ) Primary cartilage —b) Secondary cartilage called ) Tertiary cartilage) Non-growing cartilage a) Gingival groove») Dental groove (KCET-08) ) Lateral sulcus ) Transverse groove 58. Growth activity at which of these synchondroses (KceT-2011), completes first? 70. Who proposed the “trajectory theory of bone formation”? a) Spheno-occipital _b).Intersphenoidat 2} An anatomist Meyer b) a mathematician, Cullman )_Int-occiptal 4) Sphenoethmoidat ) Both a and b 4) None ofthe above (COMEDK-08) (AIPG-2011) 59, Arch space for eruption of 2nd & 3rd molar created by: 71. Anthropometry is 8) Apposition of Hamular processes a), Measurement of skeletal dimensions on human skeletal 5) Resorption of anterior border of ramus remains «Resorption of posterior border of ramus b) Measurement of skeletal dimensions on living individuals 4) Apposition of lower border of mandible )_ Measurement of skeletal dimensions on radiographs (AIIMs-07) 4) Measurement of skeletal dimensions on photographs 60. First growth spurt takes place at what age (aP-2012) a) Ist year b) 3rd year 72. The mandible grows longer by apposition of new bone on 6th year 4) 9th year the posterior surface of (AP-08) 2) Coronoid process b) Condyle 641. Growth sites in maxilla is / are ) Ramus 4) Symphysis 2) maxilary tuberosity b) sutures (BHU-2012) ©) nasal septum 4) all ofthe above 73. The initial sign of sexual maturity in boys is usually (AP-09) 2) Fat spurt ») Development of Adam’ apple 62. Growth trends show that in most patients ) hange in voice 4). Appearance of facial hair ) maxilla and mandible grow in unison (aP-2012) 5) maxilla grows more rapidly 74, Which one of the following undergoes predominantly )_ mandible grows at fester rate than the middle hid ofthe Face endochondral ossification? 44) no such eonelusion could be made a) Maxilla ») Palate (AP-09) ©) Cranial base 4) Cranial vault 63, The first evidence of cartilage getting converted to bone (aP-2012) {in craniofacial skeleton occur during 75, More than 90% of growth of brain or brain vault has a) Fourth Postnatal week b) Eighth Prenatal week achieved by? ) Fourth Prenatal week 4) Eighth Postnatal week 2) S years bb) 12 years (COMEDK-10) ) 18 years 4) 21 Weeks 64, In child development, the embryo period is? (NEET-2013) a) 0-2 weeks b) 2-3 weeks 76. Remodelling theory of craniofacial growth was given by ©) 2-8 weeks 4) 9 weeks to birth a) Brash ») John hunter (P61-08) ) Vander Klauuw 4) Sicher & Weinmann 65. Growth is generally completed (ATINS-2012) a) First in head and last in depth of face 77, Normal growth of maxilla occurs by +) First in head and last in width of face 2} Displacement and drift b) rift only 6) First in head and last in height of face ©) Appesition 4) Replacement resorption 4) First in depth and last in width of face (AIIMS MAY-13) (COMEDK-10) 78. Lip thickness reaches maximum at what age is males? 56. Growth of Condyle is by 2) 18 years b) 18 years a) Membranous growth b) Interstitial growth ) 25 years 4) 13 years «) Cartilaginous proliferation (AIPG-14) 4d) Bony Apposition 79. Cartilage differs from bone in that, the cartilage can (aP-10) increase in size by 67. The gonial angle at birth is? 2). Apposition b) Interstitial growth a) 110° b) 115° ) Selective resorption d) Endosteal remodelling 9 175° a) 145° (COMED-14) (AP-10) 80. In preadolescent child the moximum midline diasteme 68. Who proposed the nasal septum “thoery of craniofacial that will be closed spontaneously after canine eruption growth”? 2) 1mm b) 2mm a) Mass ) Sicher 7) 858) 8 So) B 6) A GYD 2) c eB 6) C OYE 66) c GHD 6) 0D @)A 3) € 71) 8 72) C_73)A8C_74) C75) A_76) A 77) A 78) B75) 8 80) Bee | a1. 82. 83. 84. 85. 36. a7. 6) 4mm @) 5mm (comeo-14) [Anterior arch width of the dental arches increases upto the age of 8) 6 to 8years ) 20 to 12 years ©) 12to téyears ——d) 14 to 16 years (ocer-14) Which of the following is true? 4) Upper lip applies more pressure on upper teeth and tongue on lower teeth b) Tongue apply more pressure on upper teeth and lower lips on lower teeth ©) Up pressure is more d) Tongue pressure is more (PGI JUNE-2014) In assessment of skeletal age based on cervical vertebrae as seen in lateral cephalometric radiograph, stage 3 indicates |) More than one year beyond peak growth b) No growth )_Less than one year prior to peak growth 4d) Peak growth still a year or so ahead (aPPs-15) Corpus rotation in relation to cranium is known as a) Matrix b) Tntramatrix ) Internal rotation d)_ Apparent rotation (PGT JUNE-2013) ly age and 2) Depth of oropharynx b) Depth of nasopharynx 2) Width of nasopharynx d) Width of eropharynx (PGT JUNE-2011) Period of adolescent growth in boys is? 2) 3 years b) 3.5 years ©) 4 years 4) 5 years (Pot 0€¢-2011) Hemifacial microsomia occurs during? 4) Formation of germ layer b) Migration of neural crest cells ) At the time of organ formation «) Final cfferentiation of tissue (P61 JUNE-2012) ORTHODONTICS BSS) = a) A a2) A mC 8) C 85) B86) 0 BN) OB=e Dental Pulse _ 1. GROWTH AND DEVELOPMENT — ANSWERS. ‘B [Bhalajhi 3rd ed 36] Usually bone grows by apposition and cartilage by interstitial growth. Mandibular condyle is the only bone that shows both apposition and interstitial growth “W [Bhalajhi 3rd ed 27] In endochondral type, the bone formation is preceded by formation of cartilaginous model, which is replaced by bone. Eg: thmoid bone, Hyoid, Incus, Stapes. In intramembranous type, the formation of bone is not preceded by formation of cartilaginous model. Instead bone ‘is laid directly in a fibrous membrane. laxilla, nasal bones, parietals, zygoma, vomer, lacrimal, zygomatic. Both intiamembranaus and endochondrial ossification is seen in ~ occipital, temporal, sphenoid bones ‘K (Bhalajhi 3 rd ed 10) ‘Scammon's growth curve classifies body tissues into & types. Each of these tissues grow at different times and rates. * Prolifeates rapidly in late childhood and reaches. 200% adult size, This is Lymphoid | an adaptation to protect children. from Tissue | infections * By the age of 18 years, lymphoid tissue undergoes involution to reach adult sie, Grows very rapidly and reaches maximum Neurat | size by 6-7 years (AIIMS- 2012) of age. tissue | 6 Very tle growth of neural tissue occurs after 6-7 years. (AIPG-14) * Exhibit an “SY shaped cuve with rapid General |" growth up to 2-3 years followed by a er visceral) Siow phase of growth between 3-10 years. tects] _(COMED-09) tones | After 20th yeas, a rapid phase of growth occurs terminating by the 18-20th years, “ca _ |= Shows negligible growth until puberty GEMS | rows rapiaty at pubertal age and reaches adult size after which gromth cases. For which of the following tissue systems Scammon’s ‘curve shows an ‘S' shaped curve? [COMED-2012] a) Lymphoid tissue ) Neural tissues ©) Muscle & Bone tissues) Genital tissues [M.S.RANI 3rd ed 77] Sutural theory Cartilaginous theory Sicher Scott 9. 10. a Functional matrix theory Melvin Moss Servo system theory af growth, | Petrovic and Chartier (Cybernatics) Mult-factorial theory Van Limborgh. Genetic theory Brodie Neurotropism Behrents [Bhalajhi 3rd ed 31) 'X (GRABER 3rd ed 51] At birth, cranium is about 55-60% of adult size, By the age of 6-7 years, almost 95% of adult size is attained. At Infant skull is composed of 45 bones which are reduced to 22 in adults, “B [GRABER 3rd ed 41] According to “Van Limborgh’s” multifactorial theory, growth 's under control of genetic and environmental factors. Intrinsic genetic factors are the factors present within the skeleton, Epigenetic factors present outside the skull and manifests their influence in indirect way by intermediary action on associated structures Eg:- Eyes, brain etc. °C [Bhalajhi 3rd ed 10) Genital tissues show negligible growth until puberty. They grow rapidly after puberty reaching adult size after which growth ceases (C [GRABER 3rd ed 39) “C [Bhalajhi 3rd ed 28] The sphenomandibular ligament extends from the lingula of ‘mandible to the spine of sphenoid bone and forms a remnant cof meckels's cartilage. ach (neces | sptenomadinlrUgonet, aaa ies tet ace ach cartlage ‘Stapes, stylohyoid process, ee en eee ean or a sper pat saa atl : cetera eat ‘inferior part of body of hyoid ee eee ‘D [Bhalajhi 3rd ed 28) Mandible develops as intramembranous bone, lateral to meckel's cartilage. The proximal end of meckel’s cartilage ives rise to malleus and incus and later disappears without contributing to the formation of mandible.ee | 22. 3B. “C [Bhalajhi 3rd ed 18,19) Y [Proffit 4th ed 109) 15. 16. vw. 18. 19, 20. a 22. 23. 24. 25. 26. an. 28. 29. [Bhalajhi 3rd ed 32) (C [MS.RANI 3rd ed 73] ‘D' [Bhalajhi 3 rd ed 35] ‘D [GRABER 3rd ed 67] ‘The mandible grows in length by resorption at the anterior border and bone deposition at the posterior border of ramus. This provides the required space for the developing and erupting permanent teeth. ‘C [Proffit 4th ed 36] Agents for vital straining: * Alizarin Tetracycline * Technicium isotope (99mTc) [Bhalajhi 3 rd ed 33) “C [GRABER 3rd ed 51] ‘C [Bhalajhi 3rd ed 168] The sesamaid is a small nodular bone most often present embedded in tendons in the region ef the thumb, Calcification of sesamoid bone is one of important features ‘of pubertal growth spurt, which is earlier in females than in males, Absence of sesamoid bone indicates delay in reaching puberty. 33. 1" [Bhalajhi 3rd ed 16] [Bhalajhi 3rd ed 53) ‘C [Bhalajhi 3rd ed 26] Y [Bhalajhi 3 rd ed 10] Y [Bhalajhi 3rd ed 40) ‘D’ [Bhalajhi 3rd ed 13] Tantalum implants are embedded in certain areas of the maxilla and mandible to study the growth of skull, Implants and vital staining techniques are used to study the dynamic changes occurring during bone deposition and 3, resorption where as radiographs show static changes. ‘C [W.S.RANI 3rd ed 56] Fusion of two adjacent bones by @ cartilage Eg: spheno-occipital. ‘Synchondrosis ORTHODONTICS Fusion of two adjacent bones by a fibrous Syndesmesis | igament Early closure ofa suture or early fusion of Symostosis | two adjacent bones by a bone. Eg: Symphysis menti 30. 31, 32, 34, 35. “BY [GRABER 3rd ed 65, 66] ‘According to Enlow’s expanding 'V' principle many facial bones will have a ‘V' shaped pattern of growth. Bone deposition occurs on inner side of wide end of Vand bone resorption occurs on the outer surface. This results in growth mavement towards the ends. Eg: Ramus of mandible, palate, coronoid and Condylar process etc. °C [Bhalajhi 3rd ed 28) A single ossification center for each half of mandible arises in the area of future mental foramen lateral to. meckel’s cartilage where the inferior alveolar nerve bifurcates into ‘mental and incisive nerve branches. Maxilla has 3 ossification centers. One primary ossification center is for maxilla proper (which arises at infraorbital foramen above the canine fossa) and the remaining two ossification centers are for pre-maxilla ‘D’ [Bhalajhi 3rd ed 17] The function matrix concept of Melvin moss is based on the original concept of functional cranial component by vander klaaus (PGI June- 13). According to moss, the growth and maintenance of all skeletal tissues is always secondary to certain responses that occur in non-skeletal tissues. “A [Proffit 2nd ed 28] °C [American Journal Of Orthodontics] Functional matrix theory revisited by Moss includes 4 concepts 1) The rale of mechanotransduction 2) The role of an osseous connected cellular network 3) The genomic thesis 4) The epigenetic antithesis and the resalving synthesis D' [Bhalajhi 3rd ed 10] Thymus is a lymphoid tissue which proliferates rapidly in late childhood and reaches 200% of adult size. After 18, years, it undergoes involution to reach adult size °K [Bhalajhi 3rd ed 10) ‘D [Bhalajhi 3rd ed 15) Type of Bone growth Combinations of deposition and resorption cceurring in different bones of skull resulting in growth movement tows depositary surface Dei (ee o=SUA 38, 39. 40. a 42. 43. Dental Pulse It is the movement of whole bone as a unit © In primary displacement, the bone is displaced as a result ofits own growth. * In secondary displacement, the bone gets displaced as a resutt of growth and enlargement of adjacent bone. Displacement ‘C [Bhalajhi 3rd ed 19,20] “€ [Bhalajhi 3rd ed 18] 1a) PERIOSTEAL MATRICES: Eg: Blood vessels, nerves, glands ete. ‘These act actively upon thelr related skeletal units and produce transformation of size ot shape. This, tuansformation is brought about by deposition and resorption 1b) CAPSULAR MATRICES: Eg: Neuro-cranial capsule, oro facial capsule, Capsular matrices act passively and produce secondary translation, This translation is not brought about by deposition and resorption. ‘X [Bhalajhi 3rd ed 16] fi Bn ; ‘ Gromth is controlled by genetic Genetic theory | influence and is preplanned. Sicher’s sutural | Growth in the sutures is responsible theory for craniofacial growth =A multfoctorat theory, which combines all the three existing Van Limborgh’s | theories. theory States that growth is under control ‘of intrinsic genetic, epigenetic and environmental factors. * Cartlaginous part of skull are primary ‘enters of growth with sutures being ae nous | _ only secondary in nature they ‘+ According to Scott, the nasal septal ‘artilage is the pacemaker for growth of entite naso-maxillary complex Woss's * The growth of skeletal components Functional fs largely depends on functional tmatrix theory | matrices or non-skeletal tissues. ‘Scott's Hypothesis is emphasized on (KAR-2013) ‘Ans: Hasal septum “C [Bhalajhi 3rd ed 15] Refer Q. No. 37 ‘ [Bh i 3rd ed 16] ‘D' [Gray's Anatomy 39th ed 486] 44 45. 46. 47. 43. 49. _ The size of cranial vault is almost of adult size by the end of 7 year, ‘¢ [MS. Rant 3rd ed 67] The skull at birth contains 45 separate bones; many of these bones are fused together and are reduced to 22 bones in adult. “C [Bhalajhi 3rd ed 31] The important synchondroses found in cranial base are spheno-occipital synchondrosis, spheno-ethmoid synchondrosis, inter-sphenoid synchondrosis and intra- occipital synchondrosis, * Principalgronth cartilage of the cranial base during childhood. «= Itis cartilaginous junction between Spheno-occipital synchondrosis | sphenoid and the occipital bone (Last synchon- | + The direction of growth of the drosis to fuse | spheno-occipital _synchondrosis AP-10) ‘upwards and forwards It closes at an average age of 18 years. =, |e It isa cartilaginous band between Sohwroetinoid "the phen en eta Sones sunchondrosis | ie ossfies by 5-25 years of age. |, |e itis a cartilaginous band between pera tthe 2 parts of the sphenoid bone. Ssmchoncrosis | « it ossfies at birth Tntra-occipital |» Ossified by 3-5 years of age. synchondrosis 'X [Gray's Anatomy 39th ed 103] Consists mainly of collagenous Junctions between bones. Fibrous joints gg. Sutures, gumphoses and syndesmoses ‘tea Eg: Synchondioses (primary Cartilaginous ara cartilaginous joint) and symphyses (secondary cartilaginous joints) ‘Al symphyses are median and almost Symphyses | confined to axial skeleton 8B [Bhalajhi 3rd ed 33] By birth, 55 - 60% of adult size is achieved By the age of 4-7 years, 94% of adult size is attained, ‘© By 8 13 years of age, 98% of adult size is reached, 1! [Bhatajhi 3rd ed 14-15] ‘D' [Bhalajhi 3rd ed 54) In the late 1800s, Wolff, a German physiologist, observed that the internal architecture of bones reflects the stress patterns on them (KERALA -2015). According to Wolf's aw of transformation of bone, unlike other connective tissues, bone responds to mild degrees of pressure and tension. Those changes are accomplished by means of resorption of existingee | 50. 51. 52. 53. 54. 55. 56. bone and deposition of new bone and these changes takes place on the surface of bone under the periosteum, or in the ‘ase of cancellous bone on the surface of the trabeculae or on the walls of marrow spaces x ‘B (M.S. Rani 3rd ed 70, 74] [Bhalajhi 3rd ed 5] ‘8! [Bhalajhi 3rd ed 17/8) ‘The functional matrix hypothesis suggests that the origin, form, position, growth and maintenance of skeletal tissues are always secondary to specifically related non-skeletal tissues. Functional Cranial component Functional matrix consists of Skeletal units Glands, ee. + Microskeletal units ‘ Gonial ‘B [Bhalajhi 3rd ed 171] The shapes of the cervical vertebrae differ at each level of skeletal development, and this helps to determine the skeletal maturity of a person. This isthe basis of Hassel and Farman system of evaluating skeletal maturity using cervical vertebra. The use of cervical vertebrae as skeletal maturity indicators was first done by (KAR-2013) Ans: Hassel and Farman Y [Bhalajhi 3rd ed 17] ‘D'[M.S, Rani 3rd ed 101, 102] Benninghoft studied the natural lines of stress in the skull by piercing small holes into fresh skull. Later, when the skulls were dried, he observed that the holes assumed a Linear form in the direction of bony trabeculae. These lines were called Benninghoff's lines or trajectories, ORTHODONTICS 57. 58. 59. 61. 62. 63. Trajectories of the maxillae tun from the maxillary alveolar process to the base ofthe skull. The three vertical trajectories include: ‘© Frontonasal or canine buttress ‘© Malar-zygomatic buttress = Pterygotd buttress In mandible, Benninghoff’s trajectories are essentially parallel. A line of stress extends from condyle to symphysis, and from ramus that run through spongiosa, The lower border of mandible and the myalohyoid ridges are the other prominent buttresses of the mandible. “By [Profit 4th ed 50, 51] Meckle’s cartilage is the primary cartilage of mandible. The cartilages at the condyle, cornoid and symphysis are the secondary cartilages. The condylar cartilage is considered as the pacemaker for growth of that bone. Nasal septum is Considered as the pacemaker for growth of maxilla 8 [Bhalajt 3rd ed 31] ‘+ Intersphenoidal synchondrosis is believed to ossify at birth ‘+ Intra-occipital synchondrosis ossifies by 3 ~ § years of age. + Sphena-ethmofdal synchondrases ossifies by 5 ~ 25 years of age. ‘+ Spheno-occipital synchrdoses ossifies by 17 - 20 vyears of age. B [Bhalaji 3rd ed 34, 35] Resorption occurs on the anterior part of ramus while deposition occurs at the posterior region. This facilitates the lengthening of the mandibular body, which in turn accommodates the erupting molars. “K [Bhalaji 3rd ed 9] ‘D' [Bhalajhi 4th ed 28, 33, 34) °C [Proffit 4th ed 29] The concept of “Cephalo-caudal gradient of growth” says that there is an axis of inereased growth extending from the head towards the feet i.e, structures, which ate far from brain grow mote compared to other parts, When the facial growth pattern is viewed against the perspective of cephalo- caudal gradient, itis not surprising that the mandible, being farther away from the brain tends to grow more and later than the maxilla, which is close to brain, 5" [Bhalajhi 4th ed 25] The cranial base will be in cartilaginous form till 7® week of prenatal form. After that, the bones of cranial base undergo both endochondral as well as intramembrane ossification. The first bone to show both endochondral and intra- ‘membranous ossification is occipital bone. The supranuchal squamous part of occipital bone ossifes intramembranously during the 8" week of intra-uterine life BSS) ==(222A 64, 65. 66. 67. 68. 69. 70. n. Dental Pulse °C [Bhalajhi th ed 23) The prenatal life is arbitrarily divided into three periods. They are ‘+ Perlod of ovum ~ extends for a period of approximately 2 weeks from the time of fertilization ‘+ Period of embryo ~ 2° week-to-8 week ‘+ Period of foetus - 9 week-to-birth “C’[Profit 4th ed 113] “C”[Bhalajhi Gth ed 39) ‘D! [Chek Explanation Below] ‘The mandibular or gonial angle during perinatal period ranges ftom 135° to 150°; however, soon after birth, it ‘decreases to 120° to 140°. In adult mandible, the gonial langle measures between 110° to 120°. Studies have also indicated that the angle value of females is 3-5° greater than that of males Note: Eventhough we could not find any direct reference in suport of 175 degrees, If the same question is asked for AAIPG or AIIMS exams, the answer shall be marked as 175 as itis a direct pick from Ritu Duggal. ‘D' [M.S. Rani 3% ed 77] “K [Bhalaji 4° ed 44] {Gum pads are developed in 2 parts. They are the labio buccal portion and lingual portion, The two portions are separated by 2 groove called dental groove. The dental groove corresponds to the formation of dental lamina. (PGI June- 13). The gingival groove separates the gum pad from the Palate and floor of the mouth. “€ [Bones and cartilage: developmental and evolutionary skeletal biology By Brian Keith Hall Pg 409] #1857 Meyer (anatomist) & Culman (mathematician): propounded the Tiajectoril theory of bone formation, which says that the architecture of bone fs determined by both pressure and tension. Trbeculae develop along lines of stresses calculated mathematically that enable it to best resist stresses to which it is subjected during function + 1870's Julius Woll: trabecular arrangement can change with @ change in intensity & direction of forces. + 1925 Beninghoff: Studied architecture of cranial & facial skeleton & so called stress trajectories. The trajectories ‘obeyed no bone limits but rather the demands of the functional forces. ‘B [Proffit 4th ed 33] Anthropometry is the measurement of skeletal dimensions ‘on living individuals. Various land marks established on dry (dead) skulls are measured in living individuals simply by using soft tissue points overiying these bony landmarks. Measuring skeletal dimensions directly on tiving {Individuals is known as. (KERALA-2035) 4) Craniometry b) Anthropometry ©) Cephatometry 4) Tomography 2. 2. Th. 75. 76. 1. _ °C [Bhalaji Sth ed 46] Resorption occurs on the anterior part of the ramus while bone deposition occurs on the posterior region. This results ina drift of the ramus in a posterior direction. This facilitates lengthening of the mandibular body. ‘NX and’C [Proffit 4th ed 109] The initial sign of sexual maturation in boys is usually the “fat spurt. [Adolescence in Girls and Boys | = cn Boys Stage 1 | 7 test bus | Fe spurt 29° | Pubic hair Breast | Puble hair Stage 2 | development | » spurt in height begins Onset of [Facial ha stage 3 : ‘9° 3 | maturation | « peak velocity in height Height spurt ends a * Increase in muscular strength The key given for this question is both A and C. Puberty in boys begins later and extends over a longer period than Girls. Duration of adolescence is 5 years in boys and 3% years in gids ‘C [Proffit 4th ed 42] Intramembranous ossification occurs in the cranial vault and both jaws. Also refer (.No.2 for further reading. By exclusion, cranial base is the correct answer. book of Orthodontics by Pg 46) years 10-20 years Cranium | 25% 11% a Maxila | 45% 20% | 35% Mandible | 40% 25% 35% ‘R’ [Text book of craniofacial growth by Sridhar Pg 64] Brash remodeling theory of craniofacial growth is the first, general theory of craniofacial growth. Principles: ‘© Bone only grows appositionaly at surfaces. ‘+ Growth of the jans is characterized by deposition of bone at the postetior surfaces of maxilla and mandible (Hunterian growth) and ‘+ Deposition of bone on the ectocranial surface of the cranial vault and resorption of bone endocranially (calvaral growth) jalaji Sth ed 18 fig. 5 / Proffit Sth ed 37] ‘Until the age of 6, primary displacement from cranial base growth is important part of maxila’s forward growth. Failure of the cranial hase to lengthen normally, as in achondroplasia and other congenital syndromes create a characteristic midface deficiency.