AHEAD Test and Discussions – ORAL PATHOLOGY

1. Double teeth is an anamoly most commonl y found in- 11. Chronic alcoholics may present with the features of
a) permanent incisors b) permanent canines a) erosion b) resorption
c) primary incisors and canines d) primary molars c) abrasion d) attrition

2. Enamel hypoplasia is presented with all except 12. It is necessary to avoi d the i ngestion of tetracyclines
a) Reduction in volu me of matrix between the age groups from
b) p its and grooves on the enamel surface a) 4months to 7 years b) 1 year to 3 year
c) enamel with fewer pris ms c) 4month to 10 month d) 7 month to 5 year
d) inco mplete calcificat ion
13. Which of the followi ng statement is incorrect about
3. Hypomineralized enamel characterizes wi th following pul pitis
except a) Carbohydrates is the most important aetiological
a) Enamel appears white and opaque factor
b) tooth may appear pig mented buff, o range, or brown b) dental caries is the commonest cause
quickly ch ipped and worn away c) bacteria can also reach the pulp by other local routes
c) organic matrix o f hypomineralized enamel remains d) trauma to dentine and/or pulp may cause pulpitis
acid-soluble and/or reactionary changes in the pulpodentinal
d) failure of the ameloblasts to fully calcify
14. Which of the followi ng cyst arises from glands of
4. Which of the following is an acquired disorder Serres
a) Gemination b ) fusion a) odontogenic keratocyst b) dentigerous cysts
c) concrescence d ) none c) radicular cysts d ) ) paradental cyst

5. All of the followi ng are the features seen in congeni tal 15. A constant feature associated with radicul ar cyst is
syphilis except a) impacted tooth b ) missing tooth
a) infection of the tooth germ by spirochaetes c) non vital tooth d) ano malous tooth
b) Hutchinson's incisors
c) hypomineralized changes in the enamel 16. High recurrence rate of keratocysts is due to all factors
d)Moon’s molars except
a) satellite cysts
6. Causes of hypercementosis can be all except: b) difficu lty of surgical removal
a) Paget’s disease b) periapical inflammat ion c) focal areas of active growth of the cyst wall
c) cleidocranial dysplasia d) mechanical stimulat ion d) cystic contents have a low soluble protein level

7. Trans mission of S. mutans occurs mainl y through 17. Epstein pearls are
a) saliva b) skin a) same as enamel pearls
c) mother to ch ild d) blood transfusion b) imperfection in the tooth bud
c) seen in vitamin D deficiency
8. Which of the following statement is incorrect about d) small keratin cysts of newborn infant
dental caries
a) Caries prevalence increases when populations 18. Cyst resembli ng the bunch of grapes is
become exposed to sucrose-rich diets a) Gingival cyst
b) Intrinsic sugars are more damaging than ext rinsic b) develop mental lateral periodontal cyst
sugars c) dentigerous cyst
c) Sucrose is the most cariogenic sugar d) OKC
d) Frequency of sugar intake is of more impo rtance than
total amount consumed 19. Most cases of pul pitis are caused by
a) injud icious cavity preparation
9. Which of the following zone is an area of acti ve b) chemical irritation fro m sterilizing agent
reminer alization c) bacterial invasion fro m b loodstream
a) surface zone d) bacterial invasion fro m carious lesion
b) body of the lesion
c) dark zone 20. Which of the followi ng lesion resembles frog’s belly
d) t ranslucent zone a) ranula
b) Retention mucocele
10. Pathol ogical attriti on may result from c) extravasation mucocele
a) excessive intake of acid beverages d) dermo id cyst
b) faulty tooth brushing
c) abnormal occlusion
d) habits of pipe s moking

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 AHEAD Test and Discussions – ORAL PATHOLOGY

1. ans: c: Double teeth are more co mmon in the primary than in the permanent dentition, the prevalence in different series
ranging fro m 0.5-2.5 per cent for the primary and 0.1-0.2 per cent for the permanent dentitions. The incisors (and also the
canines in the primary dentition) are most frequently affected and the condition may be bilaterally sy mmetrical. In the
primary dentition the majority of cases involve the anterior mandibular teeth.

2. ans: d: In enamel hypoplasia the ameloblasts fail to produce a normal volu me of matrix but any matrix which is produced
generally beco mes as fully mineralized as normal enamel. Enamel hypoplasia presents clinically as pits or grooves in the
enamel surface, or as a general reduction in the thickness of the whole enamel. The defective enamel has fewer prisms than
normal and they may run in abnormal directions. In some cases no prism structure can be seen.

3. ans: c: Hypomineralized enamel results fro m a failure of the ameloblasts to fully calcify the previously formed mat rix, and
generally such enamel appears clinically as white and opaque. After eruption it may beco me and be pig mented buff, orange,
or brown quickly ch ipped and worn away. Much of the organic matrix of hypomineralized enamel remains acid-insoluble and
is often preserved in sections of decalcified specimens.

4. ans: c: Concrescence is an acquired disorder in which the roots of one or mo re teeth are united by cementu m alone after
formation of the cro wns. This is most frequently seen in the permanent dentition where the roots of teeth develop close
together (for examp le, between maxillary second and third mo lars) or following hypercementosis associated with chronic
inflammat ion.

5. ans: c: This disease produces characteristic hypoplastic changes in the enamel of permanent incisors and first mo lars due to
infection of the tooth germ by spirochaetes. The mesial and distal surfaces of the incisors taper towards the incisal edges
rather than toward the cervical margin, giving a 'screwdriver' appearance, and the incisal edges usually have a central notch
(Hutchinson's incisors). These changes are most obvious in the maxillary central incisors. The occlusal surfaces and occlusal
thirds of the crowns of the first molars are covered by small g lobular masses of enamel (Moon's molars or mu lberry mo lars).

6. ans: c: Hypoplasia and aplasia of cementum are uncommon. In cleidocranial dysplasia there is a lack o f cellu lar cementu m
following the deposition of acellu lar cementum

7. ans: c
· species that may be associated - non-mutans streptococci, e.g. mit is group
- actino mycetes · transmission of S. mutans occurs mainly fro m mother to child
· lo w plaque pH favours proliferation of mutans streptococci and lactobacilli
· level of mutans streptococci in plaque increased by sucrose consumption

8. ans: b
· caries prevalence increases when populations become exposed to sucrose-rich diets
· ext rinsic sugars are mo re damaging than intrinsic sugars
· sucrose is the most cariogenic sugar
· frequency of sugar intake is of more importance than total amount consumed

9. ans: a
· a dynamic physicochemical process involving dissolution and repreciptation of mineral
· caries progression is usually a slow process
· zonation of the early (wh ite spot) lesion reflects different degrees of demineralization
· four zones usually seen: translucent zone (1 per cent loss), dark zone (2-4 per cent loss), body (5-25 per cent loss), surface
zone (intact)
· surface zone is an area of act ive remineralizat ion
· the morphology of the lesion differs in pits and fissures compared with approximal surfaces

10. ans: c: Pathological attrit ion may result fro m:

(1) abnormal occlusion - either developmental o r fo llo wing ext ractions;
(2) bru xis m and habits suchas tobacco andbetelchewing;
(3) abnormal tooth structure, for examp le amelogenesis imperfecta, dentinogenesis imperfecta

11. ans: a: A similar pattern oferosion may also be seen in other patients with gastro -oesophageal reflu x, for examp le
chronicalcoholics, where gastric reflu x is probably associated with chronic gastritis

12. ans: a: It is particularly important to avoid tetracyclines fro m 4 months to about 7 years of age if severe clin ical d iscoloration
of the permanent dentition is to be prevented.

13. ans: a · bacterial infection is the most important aetiological factor

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 AHEAD Test and Discussions – ORAL PATHOLOGY
· dental caries is the commonest cause
· bacteria can also reach the pulp by other local routes
· trau ma to dentine and/or pulp may cause pulpitis and/or reactionary changes in the pulpodentinal

14. ans: a
· derived fro m ep ithelial residues of the tooth-forming organ
· the main cyst types derived fro m each residue are:
- dental lamina rests/glands of Serres
(i) odontogenic keratocyst
- reduced enamel epitheliu m
(i) dentigerous cysts
(ii) paradental cyst
- rests of Malassez
(i) rad icular cysts

15. ans: c : apical, residual, or lateral sub-types

· apical is commonest type
· associated with non-vital tooth
· apical rad iolucency indistinguishable fro m a periapical granulo ma
· may be sympto mless
· enlargement of cyst leads to bone expansion

16. ans: d
· tendency to recur related to difficulty of surgical removal
- thin, easily ruptured wall
- project ions into cancellous spaces easily torn
- satellite cysts in capsule
· cyst enlargement involves
- focal areas of active gro wth of the cyst wall
- extension of proliferating areas along cancellous spaces
- production of bone resorbing factors

17. ans: d: Ging ival cysts are of little clin ical significance. They are co mmon in neonates when they are often referred to as
Bohn's nodules or Epstein's pearls. Most disappear spontaneously by 3months of age. They arise fro m remnants of the d ental
lamina wh ich proliferate to form s mall keratinizing cysts.

18. ans: b: Occasionally, developmental lateral periodontal cysts are mu ltilocular and may be described by theadjective 'botryoid'
because of their resemblance to a bunch of grapes (botryoid odontogenic cyst).

19. ans: d
· bacterial infection is the most important aetiological factor
· dental caries is the commonest cause
· bacteria can also reach the pulp by other local routes
· trau ma to dentine and/or pulp may cause pulpitis and/or reactionary changes in the pulpodentinal

20. ans : a: Ranula is a clinical term used to describe a swelling of the floor of the mouth which is said toresemble a frog's belly
.It is not a pathological diagnosis. Histologically, most ranulae are mucous extravasa tion cysts. Occasionally, a ranula may
extend through the mylohyoid muscleand present in the submandibular area or neck, referred to clinically as a plunging
ranula.

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