Target Mds Image Based Questions
Target Mds Image Based Questions
Target Mds Image Based Questions
TARGET MDS
Image Based Questions
Momt Gautam
Gaurav Anand
TARGET MDS
Image Based Questions
TARGET MDS
Image Based Questions
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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).
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
xiv 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 - 1071, AIPG 2014 - 621
AIIMS May 2014 - 150, AIPG 2015 - 355
AIIMS May 2015 - 49, AIIMS Nov 2015 - 52
PGI Nov 2005 - 17
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 ten-
year papers.
Register for SCHOLARS batch at: targetmds.in
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.
xx 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: targetmdsaiims@gmail.com
•• 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.
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.
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
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.
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
1-
Conservative Dentistry j
o
and Endodontics a>
LU
03
HHBHB
1. Identify the equipment present in the color plate. a. Rubber dam sheet b. Mylar strip
c. Composite dam sheet d. Saliva absorber
Ans a. Rubber dam sheet
6. Identify the equipment present in the color plate. a. Golden proportion gauge
b. Michel proportion gauge
c. Optimal proportion gauge
d. Relative proportion gauge
Ans a. Golden proportion gauge
a. Rubber dam clamp 10. Identify the equipment present in the color plate.
b. Rubber dam frame
c. Rubber dam punch
d. Rubber dam stamp
Ans c. Rubber dam punch
a. Tooth slooth
7. Identify the equipment present in the color plate.
b. Agate spatula
c. Amalgam dispenser
d. 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 pres-
sure of biting, variously referred to as ‘‘rebound’’ or ‘‘relief’’
pain. This response can be duplicated diagnostically by
a. Rubber dam clamp
having the patient bite on a moist cotton roll/tooth sloth
b. Rubber dam frame and if ‘‘rebound’’ pain occurs on release, it is very likely
c. Rubber dam punch that one of the two teeth, maxillary or mandibular, has an
d. Rubber dam stamp infraction.
Ans d. Rubber dam stamp 11. Following endodontic treatment patient devel-
8. The image depicts which of following concept? oped severe pain and ecchymosis as seen in the
color plate. What can be the cause?
a. Golden proportion
b. Michel proportion
c. Optimal proportion
d. Relative proportion a. Postsurgical ecchymosis
b. Sodium hypochlorite injection
Ans a. Golden proportion
c. Air emphysema
9. Identify the equipment present in the color plate. d. 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 practi-
tioner 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 Extreme curvature of the root canal can be difficult for the
which NaOCl is expressed beyond the apex of a tooth and most experienced clinician to manage. The use of anticur-
the patient immediately manifests some combination of vature filing and nickel titanium files can help avoid strip
the following symptoms: perforations and ledging.
• Severe pain, even in areas that were previously anes- 15. The diagram presented here depicts which of the
thetized for dental treatment. following rule?
• Swelling.
• Profuse bleeding, both interstitially and through the
tooth.
Ans a. Dens in dente 16. Which of the following condition is present in this
radiograph?
14. The radiograph is suggestive of which of following
dental anomaly?
a. Internal resorption
b. External resorption
a. Dens in dente b. Dens evaginatus c. Cervial resorption
c. Dilaceration d. Taurodontism d. Apical resorption
Ans c. Dilaceration Ans a. Internal resorption
4 TARGET MDS: Image Based Questions
17. Which of the following condition is present in this a. Handidam b. Teflon dam
radiograph?
c. Plasti-isolate d. Optra dam
Ans a. Handidam
The handidam is a rubber dam system with built-in plastic
frame. The disposable frame bends easily for film place-
ment
a. Internal resorption
b. External resorption
c. Cervical resorption a. Roach carver b. Le Cron carver
d. Apical resorption c. Discoid cleoid carver d. Simon carver
Ans b. External resorption Ans b. Le Cron carver
18. Which of the following modality is present in this
22. Identify the technique presented in the color plate.
radiograph?
each side. The edge of the dam is carefully teased through 26. Identify the equipment shown in the color plate.
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 a. Articulating paper forceps
has a tendency to slip, a premolar clamp may be used on b. Locking forceps
a tooth distal to the three isolated teeth, or even on an c. Stieglitz pliers
adjacent tooth. The clamp is placed over the rubber dam, d. Tissue holding forceps
which then acts as a cushion against the jaws of the clamp. Ans b. Locking forceps
23. Identify the equipment shown in the color plate. 27. Identify the equipment present in the color plate.
a. Gutta-Percha cone
b. Gutta-Percha stick
c. Gutta-Percha points
d. Paper points
a. Tiger clamp b. Cat-paw clamp Ans d. Paper points
c. Universal clamp d. Incisor clamp
28. Identify the name of test being performed with
Ans a. Tiger clamp Gutta-Percher cone in the color plate.
24. Identify the equipment shown in the color plate.
a. Silicone stop dispenser the prepared root canal. Using excessive force may either
b. Needle cutter perforate the canal or fracture the instrument. The Gates-
c. Needle dispenser Glidden drill is designed to break high on the shaft if exces-
d. Glass bead sterilizer sive resistance is encountered, allowing the clinician to
easily remove the fragment.
Ans a. Silicone stop dispenser
33. Identify the instrument present in the color plate.
30. Identify the equipment present in the color plate.
a. Gates-Glidden drill
b. Pesso reamer
c. Piezoelectric drill
d. Piezoelectric scaler
32. Identify the instrument present in the color plate. 35. Identify the instrument present in the color plate.
a. Gates-Glidden drill
b. Pesso reamer
c. Piezoelectric bur
d. Piezoelectric scaler a. Barbed broach
b. File
Ans a. Gates-Glidden drill
c. Reamer
Rotary instruments are used principally as flaring devices
d. Gutta-Percha remover
for the coronal portion of the canal. The most common
is the Gates-Glidden drill. Sized in increasing diameters Ans d. Gutta-Percha remover
from no. 1 through no. 6, the Gates-Glidden should be used This device breaks up and removes Gutta-Percha from the
in a passive manner to enlarge the canal orifice and flare 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 b. Chisel
c. Hoe d. Osteotome
a. RC spreader b. RC plugger
Ans a. Hatchet
c. Williams probe d. Endo explorer
40. The cross-section represented in the color plate
Ans a. RC preader
belongs to which of the following?
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.
a. Flex-R b. K-flex
a. RC spreader
c. Hedstrom d. Unifile
b. RC plugger
c. Williams probe Ans c. Hedstrom
d. Endo explorer 41. The cross-section represented in the color plate
Ans b. RC plugger belongs to which of the following?
Specialized instruments used in obturating the root canal
with Gutta-Percha include spreaders and pluggers. Plug-
gers, also called condensers, are flat-ended rather than
pointed and are used primarily to compact filling materi-
als in a vertical fashion.
a. Flex-R b. K-flex
c. Hedstrom d. Unifile
Ans d. Unifile
a. Maxillary molar
b. Mandibular molar
c. Mandibular premolar
d. Maxillary premolar
Ans b. Mandibular molar
8 TARGET MDS: Image Based Questions
42. The diagrammatic representation depicts which 44. Identify the equipment in the color plate.
of following canal preparation method?
a. H-file b. K-file
c. K-flex file d. Barbed broach
Ans a. H-file
a. Watch winding
b. Balanced force motion
c. Step down
d. Anti-curvature
Ans a. Watch winding
a. Class 1 b. Class 2
43. The diagrammatic representation depicts which
of the following canal preparation method? c. Class 3 d. Class 4
Ans c. Class 3
a. HBSS b. Viaspan
c. Cold milk d. Stem cell culture
Ans a. HBSS
Conservative Dentistry and Endodontics 9
a. Barbed broach 56. Identify the kind of tooth defect presented in the
b. File color plate.
c. Apexum device
d. Gutta-Percha remover
Ans c. Apexum device
Simpler, approach has recently emerged with the devel-
opment of a device that allows enucleation of the periapi-
cal 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 a. Abfraction b. Erosion
the root canal is completed, the apical foramen is enlarged
c. Abrasion d. Attrition
by passing a no. 35 rotary file to 1 to 2 mm beyond the
apex. This passage is used to insert a specially designed Ans c. Abrasion
nickel– titanium wire into the periapical tissue that rotates
and minces the tissue. 57. Identify the kind of tooth defect presented in the
color plate.
a. Abfraction b. Erosion
54. Identify the kind of tooth defect presented in the c. Abrasion d. Attrition
color plate.
Ans d. Attrition
a. Abfraction b. Erosion
c. Abrasion d. Attrition
a. Michigan probe b. CPIT-N probe
Ans a. Abfraction
c. WHO probe d. Williams probe
55. Identify the kind of tooth defect presented in the
color plate. Ans d. Williams probe
a. Hatchet b. Chisel
a. Abfraction b. Erosion
c. Abrasion d. Attrition c. Hoe d. Osteotome
60. Identify the instrument in the color plate. 64. Identify the instrument present in the color plate.
a. Hatchet
b. Chisel
c. Angle former a. Amalgam capsule
d. Gingival marginal trimmer b. Amalgam condenser
c. Amalgam dispener
Ans d. Gingival marginal trimmer
d. Composite dispenser
61. Identify the instrument in the color plate. Ans c. Amalgam dispenser
65. Identify the instrument present in the color plate.
a. Condenser b. Burnisher
c. Carver d. GMT
a. Hatchet Ans a. Condenser
b. Chisel
66. Identify the instrument present in the color plate.
c. Angle former
d. Gingival marginal trimmer
Ans c. Angle former
Ans c. Hoe
63. Identify the equipment present in the color plate.
a. Condenser b. Burnisher
c. Carver d. GMT
Ans b. Burnisher
a. Tooth slooth
b. Agate spatula
c. Amalgam dispenor
d. Composite dispenser
Ans b. Agate spatula
12 TARGET MDS: Image Based Questions
a. Double wedging
b. Wedge wedging technique
c. Piggy back wedging
a. Composi-tight ring d. Inverted wedging
b. Clampless separator Ans b. Wedge wedging technique
c. Matrix strip
d. Mylar strip 75. Identify the type of wedging represented in the
color plate.
Ans a. Composi-tight ring
72. Identify the instrument present in the color plate.
Conservative Dentistry and Endodontics 13
a. Class 1
b. Class 2
c. Class 3
d. Class 4
Ans c. Class 3
82. The cross-section represented in the color plate 85. Identify the equipment present in the color plate.
belongs to which of the following?
88. The condition seen in the color plate is associated 89. Following extraction of mandibular teeth patient
with which of following? developed severe pain and ecchymosis as seen in
the color plate. What can be the cause?
a. External resorption
b. Internal resorption a. Postsurgical ecchymosis
c. Cervical resorption b. Sodium hypochlorie injection
d. Apical resorption c. Air emphysema
d. Herpes labialis activation
Ans b. Internal resorption.
Pink tooth of mummery. Ans a. Postsurgical ecchymosis
Chapter 2
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1 . This edentulous arch is classified according to 3. This edentulous arch is classified according to
Kennedy classification as. Kennedy classification as.
V
a. Class 1 b. Class 2
a. Class 1 b. Class 2
c. Class 3 d. Class 4
c. Class 3 d. Class 4
Ans c. Class 3
Ans a. Class 1
A unilateral tooth bounded edentulous area
Class 1: Bilateral posterior edentulous areas
4. This edentulous arch is classified according to
2. This edentulous arch is classified according to CD
Kennedy classification as.
Kennedy classification as.
LU
03
CD
a. Class 1 Class 2
a. Class 1 Class 2 c. Class 3 Class 4 CO
c. Class 3 d. Class 4
Ans d. Class 4
Ans b. Class 2 An anterior tooth bounded edentulous area which crosses
Class 2: An unilateral posterior edentulous area the midline
Prosthodontics 17
5. This edentulous arch is classified according to 8. This edentulous arch is classified according to
Kennedy classification as. Kennedy classification as.
a. Class 1 modification 1
b. Class 2 modification 1
c. Class 3 modification 1
d. Class 4 modification 1
a. Unilateral group function 13. Identify the anatomical landmark pointed with
b. Bilateral group function arrow.
c. Unilateral balanced
d. 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 b. Lingual frenum
c. Buccal frenum d. Alveolar ridge
Ans d. Alveolar ridge
a. Type 1 b. Type 2
c. Type 3 d. Type 4
Ans c. Type 3
a. Midpalatine raphe b. Uvula
15. According to modified University of California
c. Posterior palatal seal d. Rugae
Los Angeles (UCLA) classification, a case with
Ans d. Rugae bone characteristic as seen in the color plate is
12. Identify the anatomical landmark pointed with classified as.
arrows.
16. According to modified University of California 18. This edentulous arch falls under which class of
Los Angeles (UCLA) classification, a case with Cawood and Howell classification.
insufficient bone height as seen in the color plate
is classified as.
a. Class 1 b. Class 2
c. Class 3 d. Class 4
a. Type 1 b. Type 2 Ans a. Class 1
c. Type 3 d. Type 4
19. This edentulous arch falls under which class of
Ans d. Type 4 Cawood and Howell classification.
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 b. Class 2
c. Class 3 d. Class 4
Ans b. Class 2
20. This edentulous arch falls under which class of
a. Type 1 b. Type 2 Cawood and Howell classification.
c. Type 3 d. Type 4
Ans c. Type 2
(Q-14-17)
Ref: (Seriwatanachai D, et al. J Interdiscipl Med Dent Sci
2015; 3:2)
a. Class 6 b. Class 5
c. Class 3 d. Class 4
Ans b. Class 5
a. Groper’s appliance
23. This edentulous arch falls under which class of b. Nance palatal arch
Cawood and Howell classification. c. Halterman’s appliance
d. 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 considera-
tion is the child’s speech development following extraction
a. Class 5 b. Class 6 of primary incisors. The sounds most frequently in error
c. Class 3 d. Class 4 are the labiolingual sounds. This is because many sounds
are made with the tongue touching the lingual side of the
Ans b. Class 6 maxillary incisors, and inappropriate speech compensa-
(Questions 20–23) tions can develop if the teeth are missing.
Cawood and Howell classification This space maintainer offers several advantages in terms
• Class 1: Dentate of esthetics, restoration of masticatory and speech efficiency,
• Class 2: Immediately post ext. the alveolus has healed and prevention of abnormal oral habit development. The
main disadvantage is the accumulation of food debris and
• Class 3: Well-rounded ridge, adequate in height and
plaque. Hence, parents have to be instructed to supervise
width.
the maintenance of proper oral hygiene in their child.
• Class 4: Knife edge ridge, adequate in ht. and width.
• Class 5: Flat ridge, inadequate in ht. and width. 26. This 58 years old diabetic, partially edentulous
patient comes with chief complaint of burning sen-
24. Identify the appliance. sation in palate. What is your line of treatment?
Prosthodontics 21
29. Which system is shown here to construct this 32. Identify the instrument shown in the color plate.
maxillofacial prosthesis for the defect?
22 TARGET MDS: Image Based Questions
a. Crown gauge
b. Boley gauge
a. Bone Harvester c. Ridge mapping caliper
b. Osteotome d. Castroviejo caliper
c. Sinus Lifter Ans c. Ridge mapping caliper
d. Bone mill
38. Identify the instrument in the color plate.
Ans a. Bone Harvester
Used to shave a thin layer of bone from a donor site. Harvest-
ers are not used for synthetic or non-bone graft material.
a. Crown gauge
b. Boley gauge
c. Ridge mapping caliper
d. Castroviejo caliper
Ans 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. William’s probe
b. Bone condensor
c. Nerve depressor
d. Implant depth gauge
Ans d. Implant depth gauge
40. Identify the instrument in the color plate.
Reduces bone/graft material particle size. Place harvested 49. Identify the instrument in the color plate.
bone in well of instrument. Cover bone with top, serrated side
down. Use mallet to reduce bone to desired particle size.
a. Bone compactor
b. Bone burnisher
c. Bone tampers
d. 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 b. Bone basin
50. Identify the instrument in the color plate.
c. Bone reservoir d. Bone disposer
Ans b. Bone Basin
Stainless steel deep dish with weighted bottom to prevent
tipping.
Holds 20 grams of wetted material.
a. Bone compactor
47. Identify the instrument in the color plate. 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.
53. Identify the instrument in the color plate. 56. Identify the appliance in the color plate.
a. Membrane forceps
b. Tissue graft forceps
c. Membrane placement instrument
d. Blunt forceps
a. Lingual plate
Ans c. Membrane placement instrument
b. Anteroposterior palatal bar
54. Identify the appliance in the color plate. c. Palatal strap
d. 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. Lingual plate
b. Anteroposterior palatal bar
c. Palatal strap
d. Continuous bar major connector
Ans a. Lingual plate
Lingual plate:
• Rest at each end of lingual plate a. Lingual plate
• Prevents forces being directed facially b. Anteroposterior palatal bar
• Easier denture tooth addition than bar c. Palatal strap
d. Continuous bar retainer
55. Identify the appliance in the color plate. 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. Lingual plate
b. Anteroposterior palatal bar
c. Palatlal strap
d. Continuous bar major connector
Ans b. Anteroposterior palatal bar a. Ring clasp
Anteroposterior palatal bar b. Reverse action clasp
A narrow (A-P) variation of anterior-posterior palatal strap c. Double embrasure clasp
• Double palatal bar connector d. RPI clasp
• Requires greater bulk for rigidity Ans a. Ring clasp
26 TARGET MDS: Image Based Questions
64. Identify the instrument in the color plate. 68. Image shows which type of pontic?
a. Ovate
a. Surveyor b. Cast holder b. Ridge lap
c. Modified ridge lap
c. Face bow d. Boley gauge
d. Sanitary
Ans c. Face bow
Ans a. Ovate
65. Identify the appliance placed on anterior teeth. 69. Image shows which type of pontic?
a. Dahl appliance
b. Modified Dahl appliance a. Ovate
c. Inman appliance b. Ridge lap
d. Metal-ceramic crowns c. Modified ridge lap
Ans a. Dahl appliance d. Sanitary
Ans c. Modified ridge lap
66. Image shows which type of pontic?
70. Image shows which type of pontic?
72. Which of the following tooth will act as pier abut- 75. Identify the tooth preparation finish line for the
ment if fixed partial denture is planned in this image shown here.
case?
a. 23 b. 24
c. 25 d. 27 a. Chamfer
Ans c. 25 b. Shoulder
c. Shoulder with bevel
73. Identify the tooth preparation finish line for the
d. Knife-edge preparation
image shown here.
Ans c. Shoulder with bevel
a. Chamfer
b. Shoulder a. Rochette bridge b. Maryland bridge
c. Shoulder with bevel c. Cast mesh FPD d. Virginia bridge
d. Knife-edge preparation Ans a. Rochette bridge
Ans c. Shoulder with bevel
77. Which type of resin bonded FPD is shown in the
74. Identify the tooth preparation finish line for the color plate?
image shown here.
78. Which type of resin bonded FPD is shown in the 81. Identify the appliance shown in the color plate.
color plate?
a. Svedopter b. Airbug
c. Dentpop d. Suction tube
a. Rochette bridge Ans b. Airbug
b. Maryland bridge
c. Cast mesh FPD 82. Identify the appliance shown in the color plate.
d. Virginia bridge
Ans c. Cast mesh FPD
a. Svedopter b. Airbug
c. Dentpop d. Suction tube
Ans c. Dentpop
83. Identify the appliance shown in the color plate.
a. Rochette bridge
b. Loop connector FPD
c. Cast mesh FPD
d. Virginia bridge
Ans b. Loop connector FPD a. Svedeptor b. Airbug
c. Dentpop d. Dry angles
80. Identify the appliance shown in the color plate.
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.
85. Color plate shows wax pattern for which maxillo- a. Lingual bar
facial prosthesis? b. Labial bar
c. Lingual plate
d. Continuous bar
Ans a. Lingual bar
a. Eye b. Ear
c. Nose d. Lips
Ans b. Ear
86. Color plate shows wax pattern for which maxillo-
facial prosthesis? a. Major connector
b. Minor connector
c. Shoulder
d. Retainer
Ans b. Minor connector
a. Major connector
b. Minor connector
c. Relief area
d. Retainer
Ans c. Relief area
Chapter 3
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1 . Identify the instrument present in the color plate . 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 -
a. Cheek retractor b. Tongue depressor nected by a chain. The operator can choose the block
c. Laryngoscope d. Cleft palate raspatory according to the required extent of oral opening.
Ans d. Cleft palate raspatory
This broad, flat handled elevator is specially used to elevate 3. Identify the instrument present in the color plate.
the palatal mucoperiosteum while mobilizing the flaps for
cleft palate repair.
4. Identify the instrument present in the color plate. a. Bone file b. Osteotome
c. Chisel 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
a. Mouth prop b. Jaw stretcher efficiency of the instrument. There can be either one
c. Bone holding forceps d. Mouth gag spring or a double spring (Jensen Middleton). When the
Ans d. Mouth gag handles are released the instrument automatically opens
Mouth gag: This instrument is used to keep the mouth up. This helps the surgeon to make repeated cuts without
open in a patient under general anesthesia, during sur- making efforts to open the handles. The tip is angulated
geries of the oral cavity, tonsils and the pharynx. The flat forward to the handle and has a concave inner surface. The
blades have serrations that rest on the occlusal surfaces of beaks are sharp. They can be either side cutting (Blumen-
the maxillary and the mandibular teeth. The handle has a thal) or both side and end cutting. The instrument is used
catch that is fixed at the required opening. to remove large amounts of bone at a time using multiple,
small bites.
5. Identify the instrument present in the color plate. 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.
At the end, there is a ring to which the hook of the a. Asche’s forceps
handle can be fitted. In maxillofacial surgery, the saw was b. Rowe’s disimpaction forceps
usually used to cut the mandible (hemimandibulectomy
c. Hayton Williams forceps
procedures). Care must be taken to protect the soft tissues,
d. Walsham’s forceps
while using this instrument.
Ans b. Rowe’s disimpaction forceps
14. Identify the instrument present in the color plate. Rowe’s disimpaction forceps: A pair of Rowe’s disimpac-
tion 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
a. Mayo-Hegar needle holder 1. To disimpact the maxilla in fresh LeFort fractures, malu-
b. Rowe’s disimpaction forceps nited fractures, 2. To check for free movements of the max-
c. Hayton williams forceps illa after LeFort osteotomy procedure.
d. Walsham’s forceps 17. Identify the instrument present in the color plate.
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 nee-
dle holder is shorter and stronger than that of the hemo-
stat. The working tip has cross hatched serrations with a
single vertical serration to grip the needle. The handle has a. Asche’s forceps
a catch. Usually, a six inch needle holder is used in oral b. Rowe’s disimpaction forceps
surgery. The instrument is held between the ring finger c. Hayton Williams forceps
and the thumb and the index and the middle finger sup- d. Walsham’s forceps
port the needle holder. Ans c. Hayton Williams forceps
15. Identify the instrument present in the color plate. 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.
a. Erich’s arch bar b. Bone plates 18. Identify the instrument present in the color plate.
c. Wire holder d. Skin hook
Ans d. Skin hook
Skin hook: Skin hook is a thin, long instrument, with a deli-
cate curved tip. This tip engages the tissues.
Uses 1. To stretch the edges of the skin incision during a. Asche’s forceps
suturing to prevent dog ear formation, 2. To retract small b. Rowe’s disimpaction forceps
amount of soft tissue or edges. c. Hayton Williams forceps
16. Identify the instrument present in the color plate. 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 21. Identify the instrument present in the radiograph.
blade externally and the unpadded blade internally. The
fragments are then manipulated in their correct position.
a. Ryle’s tube
b. Foley’s self-retaining catheter
a. Asche’s forceps
c. Infant feeding tube
b. Rowe’s disimpaction forceps
d. Corrugated rubber drain
c. Bone spreader
Ans c. Infant feeding tube
d. Walsham’s forceps
Infant feeding tube is made up of nontoxic, radiopaque,
Ans c. Bone spreader polyvinyl chloride. It is a long tube with a blunt tip with
It is used to separate the bony fragments after completion multiple openings for facilitating drainage. The other open
of the osteotomy cuts, like in downfracture of maxilla after end has a stopper that can be closed.
LeFort I osteotomy or during sagittal spilt osteotomy pro-
cedure. 27. Identify the instrument present in the color plate.
a. Ryle’s tube
b. Foley’s self-retaining catheter
c. Infant feeding tube
d. Corrugated rubber drain
Oral and Maxillofacial Surgery 37
is at an angle to the shank. The blade has a convex and a. One-fourth circle needle
a flat surface. The flat surface is the working surface and b. Three-eight circle needle
is placed facing the tooth to be elevated. It works on the
c. Five-eight circle needle
wheel and axle principle. Uses to luxate the mandibular
d. Compound curvature needle
molar teeth.
Ans b. Three-eight circle needle
32. Identify the instrument present in the color plate.
35. Identify the instrument present in the color plate.
a. Hockey stick
a. One-fourth circle needle
b. Apexo elevators
b. Three-eight circle needle
c. Cryer’s elevator
d. Winter Cryer’s elevator c. Five-eight circle needle
d. Compound curvature needle
Ans d. Winter Cryer’s elevator
Winter Cryer’s elevator: As the name suggests, the eleva- Ans c. Five-eight circle needle
tor is a crossbar elevator with a triangular blade. The uses 36. Identify the instrument present in the color plate.
and the applications of this instrument are similar to the
Cryer’s elevator. It works on the wheel and axle and wedge
principles.
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 sut- and distributes the tension uniformly over the suture line.
uring technique? It also offers a more water tight closure.
a. Interrupted suture
b. Sling suture
c. Continuous over and over suture
d. Continuous locking suture
Ans b. Sling suture a. Interrupted suture
Interrupted suture-sling suture: The suture is passed b. Sling suture
through both the edges at an equal depth and distance c. Continuous over and over suture
from the incision, needle penetration should be 3 mm d. Continuous locking suture
from the wound edges and the knot is tied. It is the most
Ans d. Continuous locking suture
commonly used suture.
This technique is similar to the continuous suture, but
Advantages 1. It is strong, and can be used in areas of stress. locking is provided by withdrawing the suture through
2. Successive sutures can be placed according to individual its own loop. The suture thus passes perpendicular to the
requirement. 3. Each suture is independent and the loosen- incision line. The locking prevents excessive tightening of
ing of one suture will not produce loosening of the other. the suture as the wound closure progresses.
4. A degree of eversion can be controlled. 5. If the wound
41. The image represents which of the following sut-
becomes infected or there is an hematoma formation,
uring technique?
removal of a few sutures may offer a satisfactory treatment.
a. Interrupted suture
b. Sling suture
c. Horizontal mattress suture
d. Vertical mattress suture
Ans c. Horizontal mattress suture
a. Interrupted suture Horizontal Mattress suture: The needle is passed from one
b. Sling suture edge of the incision to another and again from the latter
c. Continuous over and over suture edge to the first edge in a horizontal manner and a knot is
d. Continuous locking suture tied. The distance of needle penetration from the incision
Ans c. Continuous over and over suture line and the depth of penetration of the needle is the same
Continuous over and over suture: Initially, a simple inter- for each entry point, but horizontal distance of the points
rupted suture is placed and the needle is then reinserted of penetration on the same side of the flap differs (needle
in a continuous fashion such that the suture passes per- penetration through the surgical flap should be at least
pendicular to the incision line below and obliquely above. 8 mm away from the flap edges). This suture provides a
The suture is ended by passing a knot over the untightened broad contact of the wound margins, e.g. closure of extrac-
end of the suture. It provides a rapid technique for closure tion socket wounds.
40 TARGET MDS: Image Based Questions
42. The image represents which of following suturing 44. The strip shown in the color plate is used to test
technique? efficacy of sterilization of which of the following?
45. Identify the equipment present in the color plate. 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 hand-
pieces which have sealed bearings or which have been
pressure lubricated with appropriate oils can be auto-
claved. The instructions given by respective manufacturers
regarding the cleaning, lubrication and sterilization are of
importance and should be followed.
46. Identify the equipment present in the color plate. 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 avail-
a. Autoclave b. Hot air oven
able for storage of sterilized packages.
c. Glass beads sterilizer d. UV chamber
Ans c. Glass beads sterilizer 48. Identify the equipment present in the color plate.
Glass Beads Sterilizer: This method employs a heat trans-
fer 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 sec-
onds 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. Gross- a. Needle cutter b. Hot air oven
man (1974) recommended the use of salt media steriliza- c. Glass beads sterilizer d. UV chamber
tion, because the accidental introduction of metal or glass Ans a. Needle cutter
42 TARGET MDS: Image Based Questions
49. The colored bag cannot be used to dispose which tooth. This is mainly used for the surgical extraction of a
of the following? 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 relea-
sing 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 gin-
gival 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
a. Tooth b. Dressings on the facial aspect of the tooth.
c. Bandages d. Needle 52. The diagrammatic representation is for which of
Ans d. Needle the following flap design?
a. Envelope flap
b. Two-sided triangular flap
c. Semilunar flap
d. Three-sided rhomboid flap
a. Needle b. Catheter Ans b. Two-sided triangular flap
c. Ryle’s Tube d. Tracheostomy tube Two-sided triangular flap is reflected toward the base of
the flap by using periosteal elevator.
Ans a. Needle
53. The diagrammatic representation is for which of
51. The diagrammatic representation is for which
the following flap design?
of the following flap design?
a. Envelope flap
b. Two-sided triangular flap a. Envelope flap
c. Semilunar flap b. Two-sided triangular flap
d. Three-sided rhomboid flap c. Semilunar flap
Ans a. Envelope flap d. Three-sided rhomboid flap
Envelope flap: The most common type of flap. The inci- Ans d. Three-sided rhomboid flap
sion is made to any length (depending on the amount of Three-sided rhomboid flap: This is the modification of the
exposure needed) intraorally around the necks of the teeth earlier flap to improve the visibility and access. An addi-
along the free gingival margin on the buccal or lingual tional vertical incision is added in the opposite direction
aspect including the interdental papillae. from the earlier release. Here, care should be taken that
The entire mucoperiosteal flap is raised by using peri- the base of the flap must be wider than the apex to ensure
osteal elevator to a point to the apical one-third of the good blood supply.
Oral and Maxillofacial Surgery 43
54. The diagrammatic representation is for which of region. It indicates the difference in occlusal level of sec-
the following flap design? ond 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 alveo-
lar bone covering the impacted tooth and the portion
of tooth not covered by the bone.
• Red line is drawn perpendicular from the amber line
a. Envelope flap to an imaginary point of application of the elevator.
b. Two-sided triangular flap It indicates the amount of bone that will have to be
c. Semilunar flap removed before elevation, i.e. the depth of the tooth
d. Three-sided rhomboid flap in bone and the difficulty encountered in removing
Ans c. Semilunar flap the tooth. If the length of the red line is more than
Semilunar flap: Whenever the periapical area is required 5 mm then the extraction is difficult. Every additional
to be exposed to carry out periapical surgery, this flap is millimeter renders the removal of the impacted tooth
designed. Again the base of the flap should be broader three times more difficult (more than 9 mm—below
than the apex and the suture line should not lie on the the level of the apices of the second molar).
bony defect. The incision is taken at least 5 mm away from
the free gingival margin. This flap is useful to avoid damage 56. The airway as seen in the color plate can be classi-
to interdental papilla and to prevent periodontal post sur- fied according to mallampati’s grading as?
gical 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.
a. Class I b. Class II
c. Class III d. Class IV
a. The occlusal plane Ans a. Class I
b. The bone level Mallampati’s Grading
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 Win-
ter’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
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.
The terminal branches of the facial nerve are classi- They can be used for the following: i. To temporarily dis-
fied as temporal, zygomatic, buccal, marginal mandibular engage the teeth. ii. To create a balanced joint-tooth stabi-
and cervical. The location of the temporal branches is of lization of the mandible. iii. To reduce spasm, contracture
particular importance during TMJ surgery. The temporal and hyperactivity of musculature. iv. To improve/restore
nerve branches lie within a dense fusion of periosteum, the vertical dimension. v. To serve as safety or protec-
temporal fascia and superficial fascia at the level of the tive appliance. In majority of cases, two types of occlusal
zygomatic arch. Al-Kayat and Bramley found that the splints are used. The splints should be removed while eat-
nerve averaged 2 cm from the anterior concavity of the ing. 1. Stabilization splint—twelve to eighteen hours use is
external auditory canal. But in some cases, the nerve is advocated up to 4 to 6 months. These are fabricated over
found as near as 0.8 cm and as far anteriorly as 3.5 cm. Pro- the maxillary teeth, covering the occlusal and incisal sur-
tection of the nerve can be achieved by making an incision face. Similar to Hawley’s plate, but occlusal coverage is
added. The splint is made up of acrylic. A flat platform is
through the temporal fascia and periosteum down to the
added perpendicular to the mandibular incisors, so that
arch, not more than 0.8 cm in front of the anterior border
the splint will disengage the teeth and relax the muscles.
of the external auditory canal.
The splint should be worn as instructed and patient should
66. Coronal section of CT scan presented here is sug- be recalled for check up at 2 weeks interval. Follow-up is
gestive of which of the following diagnosis? 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. Relaxa-
tion Splints: Relaxation splints are used for disengagement
of teeth and for only short period (up to 4 weeks). They are
a. Condylar fracture fabricated over the maxillary incisor teeth. A platform is
b. Condylar hyperplasia added to disengage mandibular anteriors.
c. Ankylosis
68. Which of the following procedure is represented
d. Condylar osteochondroma
in the color plate?
Ans c. Ankylosis
Note the osseous ankylosis-obliteration of the joint space
of right condyle.
a. Arthrocentesis b. Arthroscopy
c. Arthroplasty d. Arthrectomy
a. Occlusal splint b. Gunning splint Ans a. Arthrocentosis
c. Metal FPD d. Bleaching tray T emporomandibular joint arthrocentesis: Arthrocentesis
Ans a. Occlusal splint (lavage or irrigation of the upper joint cavity) objectives:
Oral and Maxillofacial Surgery 47
a. BSSO
a. BSSO
b. Horizontal distraction osteogenesis b. Horizontal distraction osteogenesis
c. Vertical distraction osteogenesis c. Vertical distraction osteogenesis
d. Inverted L osteotomy d. Genioplasty
Ans d. Genioplasty
Ans b. Horizontal distraction osteogenesis
73. The image represents which of the following pro-
70. The sign shown in the color plate is associated
cedures?
with which of the following?
a. Mandibular fracture
b. Maxillary fracture a. LeFort I osteotomy
c. Condylar fracture
b. Horizontal distraction osteogenesis
d. Basilar skull fracture
c. Vertical distraction osteogenesis
Ans b. Maxillary fracture
d. LeFort I osteotomy
Guerin’s sign: Palatal hemorrhage due to maxillary frac-
Ans d. LeFort I osteotomy
ture.
74. The sign shown in the color plate is associated
71. The radiograph represents which of the following
with which of the following?
procedures?
48 TARGET MDS: Image Based Questions
a. Mandibular fracture
a. Essig’s wiring b. Gilmer’s wiring
b. Maxillary fracture
c. Risdon’s wiring d. Ivy eyelets wiring
c. Midface fracture
Ans a. Essig’s wiring
d. Basilar skull fracture
Essig’s wiring: Essig’s wiring can be used to stabilize the
Ans d. Basilar skull fracture dentoalveolar fractures in individual dental arches, as well
Battle’s sign as it can be used as anchoring device for IMF. The luxated
76. The sign shown in the color plate is associated teeth also can be stabilized using this wiring. Require-
with which of the following? ments for this type of wiring is that there should be suffi-
cient number of teeth on either side of the fracture line to
take the anchorage.
a. Mandibular fracture
b. LeFort I fracture
c. Zygomatic fracture
d. Dura mater injury
Ans d. Dura mater injury
80. Identify the type of wiring shown in the color plate. a. Essig’s wiring
b. Col. Stout’s multiloop wiring
c. Risdon’s wiring
d. Ivy eyelets wiring
Ans b. Col. Stout’s multiloop wiring
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
a. Bucket handle fracture
82. Identify the type of wiring shown in the color plate.
b. Parade ground fracture
c. Horizontal favorable fracture
d. Horizontal unfavorable fracture
Ans a. Bucket handle fracture
Bucket handle fracture: Sometimes, due to extreme alveo-
lar resorption, the molar areas may be more prone to frac-
ture. 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
03
HHBHB
CO
52 TARGET MDS: Image Based Questions
Ref: Carranza’s clinical periodontology, 10th Ed. this association was never proved, and these indentations
The tooth is joined to the bone by bundles of collagen merely represent peculiar inflammatory changes of the
fibers which can be divided into the following main groups marginal gingiva.
according to their arrangement:
1. Alveolar crest fibers (ACF) 10. Which of the following structures is arrowed at in
2. Horizontal fibers (HF) the color plate.
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 alveo-
lar crest fibers prevent the extrusion of the tooth and resist
lateral tooth movements. The incision of these fibers dur- a. Dehiscene b. Fenestration
ing periodontal surgery does not increase tooth mobility c. Stillman’s cleft d. McCall festoon
unless significant attachment loss has occurred.
Ans c. Stillman’s cleft
Horizontal group. Horizontal fibers extend at right
Ref: Carranza’s clinical periodontology, 10th Ed.
angles to the long axis of the tooth from the cementum to
Changes in gingival contour are primarily associated
the alveolar bone.
with gingival enlargement, but such changes may also
Oblique group. Oblique fibers, the largest group in the
periodontal ligament, extend from the cementum in a cor- occur in other conditions.
onal direction obliquely to the bone. They bear the brunt Of historical interest are the descriptions of indenta-
of vertical masticatory stresses and transform them into tions of the gingival margin referred to as Stillman’s clefts
tension on the alveolar bone. and the McCall festoons.
Apical group. The apical fibers radiate in a rather irreg- The term “Stillman’s clefts” has been used to describe
ular manner from the cementum to the bone at the apical a specific type of gingival recession consisting of a narrow,
region of the socket. They do not occur on incompletely triangular-shaped gingival recession. As the recession pro-
formed roots. gresses apically, the cleft becomes broader, exposing the
cementum of the root surface. When the lesion reaches the
9. Which of the following is seen in the color plate? mucogingival junction, the apical border of oral mucosa is
usually inflamed because of the difficulty in maintaining
adequate plaque control at this site.
Treatment consists of removal of the lesions plus the Diagrammatic representation of an osseous crater in
elimination of irritating local factors. The recurrence rate a faciolingual section between two lower molars.
is about 15%. Pyogenic granuloma is similar in clinical
17. The diagramatic representation shows which kind
and microscopic appearance to the conditioned gingival
of bone defect?
enlargement seen in pregnancy. Differential diagnosis is
based on the patient’s history.
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
a. Simple pocket
of interdental bone, including the facial plates and lin-
b. Compound pocket gual plates, without concomitant loss of radicular bone,
c. Complex pocket thereby reversing the normal architecture.
d. Suprabony pocket
18. The diagramatic representation shows which kind
Ans c. Complex pocket. of bone defect?
Ref: Carranza’s clinical periodontology, 10th Ed.
a. Ledge
b. Osseous creter
c. Reverse architecture
16. The diagramatic representation shows which kind d. Bulbous bone contours
of bone defect?
Ans a. Ledge
Ref: Carranza’s clinical periodontology, 10th Ed.
Ledges are plateau-like bone margins caused by resorp-
tion of thickened bony plates
The color plate shows ledge produced by interproxi-
mal 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. One-wall defect
b. Two-wall defect
a. Horizontal b. Angular c. Three-wall defect
c. Spiral d. Mixed d. Combined wall defect
Ans b. Angular Ans b. Two-wall defect
Ref: Carranza’s clinical periodontology, 10th Ed. Ref: Carranza’s clinical periodontology, 10th Ed.
21. What kind of bone loss does this IOPA reveal 24. The 3DCT reconstruction shows which kind of
around 46? bone defect?
a. Hemiseptum
b. Two-wall defect
a. Horizontal b. Angular c. Intrabony defect
c. Spiral d. Mixed d. Combined wall defect
Ans a. Horizontal Ans a. Hemiseptum
Ref: Carranza’s clinical periodontology, 10th Ed. Ref: Carranza’s clinical periodontology, 10th Ed.
Periodontics 57
The three-wall vertical defect was originally called an a. Exostoses b. Osseous creter
intrabony defect. This defect appears most frequently on c. Reverse architecture d. Ledge
the mesial aspects of second and third maxillary and man-
Ans A. Exostoses
dibular molars. The one-wall vertical defect is also called
Exostoses are outgrowths of bone of varied sizes and
a hemiseptum.
shapes. Palatal exostoses have been found in 40% of
human skulls. They can occur as small nodules, large nod-
ules, sharp ridges, spike-like projections, or any combina-
tion of these. Exostoses have been described in rare cases
as developing after the placement of free gingival grafts.
The curve of occlusion in which each cusp and incisal edge a. Localized aggressive periodontitis
touch or conform to a segment of the surface of a sphere 8 b. Generalized aggressive periodontitis
inches in diameter with its center in the region of the glabella. c. Chronic localized periodontitis
30. Which of the following is true for radiopaque d. Chronic generalized periodontitis
structure visible interproximally? 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.
called gingival abscesses. Gingival abscesses may occur in It is generally limited to the marginal gingiva or inter-
the presence or absence of a periodontal pocket. dental papilla. In its early stages, it appears as a red swell-
Periodontal abscesses are classified according to loca- ing with a smooth, shiny surface. Within 24 to 48 hours,
tion as follows: the lesion usually becomes fluctuant and pointed with
1. Abscess in the supporting periodontal tissues along a surface orifice from which a purulent exudate may be
the lateral aspect of the root. In this condition, a sinus expressed. The adjacent teeth are often sensitive to percus-
generally occurs in the bone that extends laterally sion. If permitted to progress, the lesion generally ruptures
from the abscess to the external surface. spontaneously.
2. Abscess in the soft tissue wall of a deep periodontal Histopathology: The gingival abscess consists of a
pocket. purulent focus in the connective tissue, surrounded by
a diffuse infiltration of polymorphonuclear leukocytes
35. “Floating teeth” as seen in the radiograph of a
(PMNs), edematous tissue, and vascular engorgement.
55-year-old female is a feature of which of the fol-
The surface epithelium has varying degrees of intracellu-
lowing?
lar 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 swell-
ing 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 gener-
alized bone resorption, leading to loss of support for teeth,
causing floating teeth appearance. a. Periapical granuloma
b. Periodontal abscess
36. The lesion seen in the color plate does not show c. Periodontal cyst
its existence in the radiographic examination. d. Periapical cyst
What is the most probable diagnosis out of the
Ans b. Periodontal abscess
folowing?
38. A patient presented with a localized, painful
lesion of sudden onset limited to the marginal
gingiva of 47. Based on radiographic investiga-
tion. What is most probable diagnosis?
a. Periodontal abscess
b. Gingival abscess
c. Periapical abscess with sinus tract
d. Lateral periodontal cyst a. Periapical granuloma
Ans b. Gingival abscess b. Periodontal abscess
Ref: Carranza’s clinical periodontology, 10th Ed. c. Periodontal cyst
A gingival abscess is a localized, painful, rapidly expan- d. Gingival cyst
ding lesion that is usually of sudden onset. Ans b. Periodontal abscess
60 TARGET MDS: Image Based Questions
39. Gingival inflammation as seen in the color plate 42. A 15-year-old girl complained of progressively
is associated with which of the following habits? enlarging gum. The growth was excised. Hostopa-
thology report shows thickened epithelium with
elongated rete pegs that penetrated deep into the
connective tissue. Dense collagenous tissue bun-
dles arranged in parallel were found scattered
throughout the connective tissue. What is the
most probable diagnosis?
a. Thumb-sucking b. Nail-biting
c. Tongue-thrusting d. Mouth-breathing
Ans d. Mouth-breathing
43. A 20-year-old boy presents with trismus and pain. The lesions are extremely sensitive to touch, and the
There is a partial impaction of 48. Based on clini- patient often complains of a constant radiating, gnawing
cal image. What is the most probable diagnosis? 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.
Antunes AA et al (2011) presented a series of 10 cases of of the gingival sulcus (arrow) and the junctional epithe-
oral and maxillofacial myasis and reviewd the literature. lium (JE) are on the enamel. 2, Base of the gingival sulcus
(arrow) is on the enamel, and part of the junctional epithe-
48. What is the treatment for the condition shown in lium is on the root. 3, Base of the gingival sulcus (arrow) is
the color plate? at the cementoenamel line and the entire junctional epi-
thelium 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 antago-
nists but continues throughout life. Eruption consists of an
a. Surgical excision active and a passive phase. Active eruption is the move-
b. Removal of larvae and debridement ment of the teeth in the direction of the occlusal plane,
c. Citric acid irrigation whereas passive eruption is the exposure of the teeth by
d. NaOH irrigation apical migration of the gingiva.
Although originally thought to be a normal physiologic
Ans b. Removal of larvae and debridement
process, passive eruption is now considered a pathologic
Ref: Shafer’s Textbook of Oral Pathology, 7th Ed.
process. Passive eruption is divided into the following four
Oral myiasis
stages.
The usual presenting symptoms are painful growth
Stage 1: The teeth reach the line of occlusion. The junc-
with ulceration and itching due to crawling movement
tional epithelium and base of the gingival sulcus are on the
of the larvae. The treatment is aimed at removal of larvae
enamel.
from the affected area and flushing the area with normal
Stage 2: The junctional epithelium proliferates, so that
saline or antiseptics. part is on the cementum and part is on the enamel. The
49. According to Gottlieb and Orban, this color plate base of the sulcus is still on the enamel.
represents. Which stage of passive eruption? Stage 3: The entire junctional epithelium is on the
cementum, and the base of the sulcus is at the cementoe-
namel 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 fib-
ers 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
a. Stage 1 b. Stage 2 pathologic process.
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 pas-
sive eruption according to Gottlieb and Orban. 1, Base
Periodontics 63
50. The color plate points towards which of the foll- 53. The color image represents which type of suturing
owing? technique?
a. Dehiscence
a. Figure of eight
b. Fenestration
b. Circumferential director loop
c. Stillman’s cleft
c. Mattress—vertical
d. Boneless window
d. Intrapapillary
Ans d. Boneless window
Ans a. Figure of eight
Ref: Carranza’s clinical periodontology, 10th Ed.
Interdental Septum 54. The color image represents which type of suturing
If roots are too close together, an irregular “window” technique?
can appear in the bone between adjacent roots
a. Figure of eight
a. Endosseous b. Periosteal b. Circumferential director loop
c. Transosseous d. Submucosal c. Mattress—horizontal
Ans a. Endosseous d. Intrapapillary
Ans c. Mattress—horizontal
52. The color image represents which type of suturing
technique? 55. Identify the instrument.
a. Figure of eight
b. Circumferential director of loop
c. Mattress—vertical a. Naber’s probe b. Sickle scaler
d. Intrapapillary c. Universal curette d. Morse scaler
Ans b. Circumferential director loop Ans a. Naber’s probe
64 TARGET MDS: Image Based Questions
56. Identify the appliance present in the color plate. 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 tech-
nique may be indicated. This procedure uses osteotomes
(color plate) to compress bone (internally from the alveo-
lar 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.
a. Primary healing abutment
59. Identify the instrument present in the color plate.
b. Guide pin
c. Auxullary implant
d. Transfer coping
Ans b. Guide pin
a. DeMarco curettes
Ref: Carranza’s clinical periodontology, 10th Ed.
b. #13/14 Gracey curette
57. Identify the instrument present in the color plate c. Large spoon curettes
used in implant surgery. 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
a. DeMarco curettes
b. Contra-angled condenser
b. #13/14 gracey curette
c. Offset osteotome
c. Large spoon curettes
d. Offset condenser d. Medium-sized curved membrane elevators
Ans c. Offset osteotome
Ans a. DeMarco curettes
Ref: Carranza’s clinical periodontology, 10th Ed. Ref: Carranza’s clinical periodontology, 10th Ed.
Elevation of the Schneiderian membrane is accom-
58. For what purpose are these instruments present
plished with hand instruments that are inserted along the
in the color plate used in implant surgery?
internal aspect of the bony walls of the sinus.
Instruments used to elevate the Schneiderian mem-
brane through lateral window antrostomy.
61. Which of the following is presented in the color
plate?
a. ePTFE barrier membrane 65. The color plate represents component of which
b. Anterior Iliac crest graft of the following systems?
c. Titanium-reinforced (TR) membrane
d. Cartilage greaft
Ans a. ePTFE barrier membrane
Ref: Carranza’s clinical periodontology, 10th Ed.
The color plate shows expanded polytetrafluoroethyl-
ene (ePTFE) barrier membrane positioned over graft and
held in place with sutures.
a. Perioprobe
62. Identify the instrument present in the color plate. b. Toronto automated
c. Florida probe system
d. 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 66. Identify the system present in the color plate.
c. Bonetap d. Endomate
Ans a. Periotest
Ref: Carranza’s clinical periodontology, 10th Ed.
a. Periotest b. Periotron
c. Periprobe d. Periotemp
a. Periosteal elevator b. Osteotome Ans b. Periotron
c. Chisel d. Malleet Ref: Carranza’s clinical periodontology, 10th Ed.
Ans b. Osteotome Sampling method for gingival crevicular fluid (GCF)
analysis (Periotron), saliva is removed from the tooth sur-
64. Identify the instrument present in the color plate. face 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. Hu-friedy
a. Younger-good #7—8 b. Hoe scaler
b. Columbia #4R—4L universal curette c. Quétin furcation curette
c. McCall’s #17—18 d. Mini-bladed Gracey curette
d. Indiana University #17—18 universal curettes
Ans b. Hoe scaler
Ans b. Columbia #4R—4L universal curette Ref: Carranza’s clinical periodontology, 10th Ed.
Ref: Carranza’s clinical periodontology, 10th Ed.
Hoe scalers are designed for different tooth surfaces,
78. Identify the instrument. showing “two-point” contact. The back of the blade is
rounded for easier access. The instrument contacts the
tooth at two points for stability.
a. Periotest b. Periotron
c. Prophy jet d. Periotemp
Ans c. Prophy jet
Ref: Carranza’s clinical periodontology, 10th Ed. a. #10 blade b. #12 blade
84. Identify the instrument. 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.
03
HHBHB
a. Thumb sucking
a. Class 1 b. Class 2
b. Mouth breathing c. Class 3 d. Class 4
c. Tongue thrusting
Ans a. Class 1
d. Nail biting
Ans a . Thumb sucking Class Description
I Soft palate only CD
2. Identify the condition in 2 months old child.
II Hard and soft palate to the incisive foramen
LU
HI Complete unilateral of soft, hard , lip and alveolar ridge
IV Complete bilateral of soft, hard and / or lip and alveolar 03
ridge
on CD
on
A IB
a. Riga - Fede disease
b. Papillon - Lefevre syndrome CO
c. DiGeorge syndrome
d. Lesch - Nyhan syndrome
c D
Ans a . Riga - Fede disease
72 TARGET MDS: Image Based Questions
4. This appearance is associated with which of the 7. A baby comes to your clinic carried by parents
following habits? in full sleeved shirt. Parents give history of fever
for last 1 week. On physical examination you find
this. What is your diagnosis?
10. This 16-year-old boy has sparse hairs and compla- 13. Identify the appliance.
ins of heat intolerance, what is your diagnosis?
a. Lingual arch
a. Hyperparathyroidism
b. Groper’s appliance
b. Ectodermal dysplasia
c. Transpalatal arch
c. Hypovitaminosis D
d. Pendulum appliance
d. Cleidocranial dysplasia
Ans a. Lingual arch
Ans b. Ectodermal dysplasia
14. Identify the molar relationship.
11. A 5-year-old boy’s intraoral examination revels
presence of 19 teeth, what can be the diagnosis?
a. Group 1 b. Group 2
a. Autosomal dominant
c. Group 3 d. Group 4
b. Autosomal recessive
Ans d. Group 4 c. X-linked dominant
Group 1: Thumb inserted beyond first joint, lower incisors d. X-linked recessive (21 trisomy)
pressed.
Ans a. Autosomal dominant
Treacher Collins syndrome
19. What is the best treatment plan for diastema in
this 9-year-old boy?
a. Dilaceration b. Fusion
c. Dens invaginatus d. Taurodontism
Ans c. Dens invaginatus
a. Bird face syndrome 30. This 2 months old child had the teeth erupted in
b. Crouzons syndrome oral cavity at the age of 21 days. What is the condi-
c. Robin sequence tion called?
d. Cherubism
Ans b. Crouzons syndrome
Copper beaten/Beaten metal appearance of skull
32. Identify the appliance present in the color plate. 35. This panaromic radiograph image is diagnostic of
which condition?
33. A 10-year-old girl comes to you with swelling to Ans d. Dentinogenesis imperfecta
raising the earlobe and history of fever and lower OPG shows obliteration of pulp chambers
abdominal pain. What’s true about the condition? 36. Identify the appliance.
a. Posey strap
b. Velcro strap
c. RUR’S elbow guard a. Proteus syndrome
d. Groper’s appliance b. Down syndrome
Ans c. RURS’ elbow guard c. Treacher Collins syndrome
d. Hurler syndrome
40. What is the application of the equipment shown
Ans d. Hurler syndrome
in the image?
43. This kind of deciduous molar relation will develop
most commonly into which kind of permanent
molar relationship?
a. Moebius syndrome
b. Down syndrome
c. Treacher Collins syndrome a. Papillon-Lefèvre syndrome
d. Proteus syndrome b. Ectodermal dysplasia
Ans a. Moebius syndrome c. Hypovitaminosis D
d. Hyperparathyroidism
45. A 5 days old female brought to dental hospital
Ans b. Ectodermal dysplasia
with the features in the image. Whats most prob-
able diagnosis of following? 48. A 18-year-old patient presented with palmer
keratosis. This is the OPG image of same patient.
What is your diagnosis?
49. Diagnose the pathology from clinical picture. a. Long band and loop space maintainer
b. Short band and loop space maintainer
c. Hawley retainer
d. Inclined plane
Ans b. Short band and loop space maintainer
53. What is the advised treatment plan for this 8 years
old boy?
a. Ehlers-Danlos syndrome
a. Long band and loop space maintainer b. Down syndrome
b. Short band and loop space maintainer c. Cleidocranial dysplasia
c. Hawley retainer d. Crouzon syndrome
d. Inclined plane Ans c. Cleidocranial dysplasia
Ans a. Long band and loop space maintainer 55. This device is used in management of which con-
52. Identify the appliance in the color plate. dition?
Pedodontics 81
a. Obstructive sleep apnea 59. The axial section of CBCT scan is suggestive of
b. Lesch-Nyhan disease which pathology associated with 38 and 48?
c. Thumb sucking
d. Robin sequence
Ans c. Thumb sucking
56. Identify the appliance in the color plate.
a. Dentigerous cyst
b. Pericoronal abscess
c. Adenomatoid odontogenic tumor
d. CEOT
Ans a. Dentigerous cyst
a. Long band and loop space maintainer 60. The curve marked by ? is characterized by which
b. Short band and loop space maintainer of the following event during its course?
c. Hawley retainer
d. Inclined plane
Ans c. Hawley retainer
57. Identify the appliance in the color plate.
58. What is the most probable age of this female 61. Identify the appliance.
patient?
62. Identify the appliance. 66. This OPG image is suggestive of which of the fol-
lowing condition?
a. 1 year b. 5 years
c. 8 years d. 10 years
Ans b. 5 Years
Pedodontics 83
a. Short labial bow b. Long labial bow 73. CT scan coronal section taken at the level of con-
c. Split bow d. Lip bumper dyle of 10 years old female is suggestive of which
of the following?
Ans c. Split bow
a. Palatal crib
a. Palatal crib b. Transpalatal arch
b. Transpalatal arch c. Band and bar space maintainer
c. Band and bar space maintainer d. Gerber space maintainer
d. Gerber space maintainer
Ans b. Transpalatal arch
Ans a. Palatal crib
75. Identify the appliance.
72. Which muscle is responsible for the open bite in
this patient?
a. Finger spring
b. Double cantilever spring
c. Distal shoe space maintainer
d. Cantilever spring
Ans b. Double cantilever spring
Pedodontics 85
a. Pendulum appliance
b. Pendex appliance
c. Bionator
d. Removable expansion plate
Ans a. Pendulum appliance
86 TARGET MDS: Image Based Questions
97. The image depicts which of the following proce- 99. Identify the instrument.
dure?
03
HHBHB
Genital
General
Lymphoid tissues proliferate far beyond the adult amount
in late childhood , and then undergo involution at the same
0
Birth 10 Years 20 Yeajy time that growth of the genital tissues accelerates rapidly.
Orthodontics 89
11. The image depicts which of the following princi- 14. Identify the part marked with arrow.
ple?
a. Dental groove
a. Enlow’s expanding “V” principle
b. Transverse groove
b. Carry away phenomenon
c. Lateral sulcus
c. Surface remodeling principle
d. Retromolar pad
d. Cartilage growth principle
Ans c. Lateral sulcus
Ans c. Surface remodeling principle
15. Identify the part marked with arrow.
12. The image depicts which of the following princi-
ple?
a. Dental groove
b. Transverse groove
c. Lateral sulcus
a. Enlow’s expanding “V” principle
d. Retromolar pad
b. Carry away phenomenon
Ans b. Transverse groove
c. Surface remodeling principle
d. Cartilage deposition principle 16. Identify the area marked with arrow in the image.
Ans b. Carry away phenomenon
a. Primate space
b. Leeway space
c. Black space
d. Diastema
Ans a. Primate space
Orthodontics 91
17. Identify the area marked with arrow in the image. a. Early shift b. Intermediate shift
c. Late shift d. Ugly duckling stage
Ans c. Late shift
21. The image depicts which of the following?
a. Frontonasal buttress
b. Malar-zygomatic buttress
c. Pterygoid buttress
d. Alveolar buttress
Ans c. Pterygoid buttress
92 TARGET MDS: Image Based Questions
a. Openbite b. Openjet
c. Overjet d. Overbite a. Openbite b. Deepbite
c. Crossbite d. Edge to edge
Ans c. Overjet
Ans b. Deepbite
27. The image represents which of the following inter-
arch relationship? 31. The image represents which type of class II
according to Moyers classification?
Orthodontics 93
a. Type A b. Type B 33. Identify the condition present in the color plate.
c. Type C d. Type D
Ans b. Type B
Type B: It exhibits a midface prominence with a mandi-
ble of normal length. The maxilla is prognathic, while the
mandible is in normal anteroposterior relationship.
32. The image represents which type of class II accor- a. Unilateral crossbite
ding to Moyers classification? b. Bilateral crossbite
c. Buccal non-occlusion
d. Lingual non-occlusion
Ans c. Buccal non-occlusion
a. Type A b. Type B
c. Type C d. Type D
Ans d. Type D a. Unilateral crossbite
Type D: It shows a retrognathic skeletal profile with maxil- b. Bilateral crossbite
lary and mandibular retrognathism. The maxillary incisors c. Buccal non-occlusion
are typically proclined, and the mandibular incisors are d. Lingual non-occlusion
either upright or lingually inclined.
Ans d. Lingual non-occlusion
a. Angle’s class 1
b. Angle’s class 2 div 1
c. Angle’s class 2 div 2
d. Angle’s class 3
Ans c. Angle’s class 2 div 2
a. Scissor bite b. Transposition 40. The image depicts which of the following plane?
c. Crossbite d. Open bite
Ans a. Scissor bite
a. Angle’s class 1
b. Angle’s class 2 div 1
c. Angle’s class 2 div 2
d. Angle’s class 3
Ans b. Angle’s class 2 div 1
a. Angle b. Moyer
c. Ackerman and Proffit d. Derby
Ans c. Ackerman and Proffit
Ackerman and Proffit represented the five major charac-
a. Frankort horizontal plane
teristics of malocclusion via a Venn diagram. The sequen-
b. Midsagital plane tial description of the major characteristics, of their
c. Orbital plane graphic representation, is the key to this classification sys-
d. Wilson’s plane tem; but the interaction of the tooth and jaw relationships
Ans a. Frankort horizontal plane with facial appearance must be kept in mind.
Orthodontics 95
42. Identify the condition evident in the radiograph. a. Thumb sucking b. Mouth breathing
c. Nail biting d. Lip bIting
Ans b. Mouth breathing
a. Supraeruption b. Transposition
c. Ankylosis d. Open bite
Ans c. Ankylosis
a. Thumb sucking b. Mouth breathing
43. Identify the condition evident in the radiograph.
c. Nail biting d. Lip biting
Ans c. Nail biting
a. Supraeruption b. Transposition
c. Ankylosis d. Open bite
Ans a. Supraeruption
a. Thumb sucking b. Mouth breathing
44. The condition shown in the image is associated c. Nail biting d. Lip biting
with which of the following habit? Ans d. Lip biting
a. Nasion b. Pogonion
c. ANS d. PNS
Ans b. Pogonion
a. Nasion b. Pogonion
c. ANS d. PNS
Ans c. ANS
55. Identify the landmark marked in the cephalogram.
a. EEG b. EMG
c. EEG d. EOG
Ans b. EMG
a. Nasion b. Pogonion
c. ANS d. PNS
Ans d. PNS
56. Identify the plane marked in the cephalogram.
a. Nasion b. Pogonion
c. ANS d. PNS
Ans a. Nasion
Orthodontics 97
a. S-N plane b. F-H plane 60. Identify the plane marked in the cephalogram.
c. Occlusal plane d. Palatal plane
Ans a. S-N plane
57. Identify the plane marked in the cephalogram.
a. Mandibular plane
b. Basion nasion plane
c. Facial plane
d. A-Pog plane
Ans a. Mandibular plane
a. S-N plane
61. Identify the plane marked in the cephalogram.
b. F-H plane
c. Occlusal plane
d. Palatal plane
Ans b. F-H plane
58. Identify the plane marked in the cephalogram.
a. Mandibular plane
b. Basion nasion plane
c. Facial plane
d. A-Pog plane
Ans b. Basion nasion plane
62. Identify the plane marked in the cephalogram.
a. S-N plane
b. F-H plane
c. Occlusal plane
d. Palatal plane
Ans c. Occlusal plane
59. Identify the plane marked in the cephalogram.
a. Mandibular plane
b. Basion nasion plane
c. Facial plane
d. A-Pog plane
Ans c. Facial plane
63. Identify the plane marked in the cephalogram.
a. S-N plane
b. F-H plane
c. Occlusal plane
d. Palatal plane
Ans d. Palatal plane
98 TARGET MDS: Image Based Questions
a. Tipping b. Intrusion
c. Extrusion d. Bodily movement
Ans a. Tipping
a. Wits appraisal b. Tweed analysis
68. The black area marked in the image represents
c. Nance analysis d. Cary analysis hyalinization. Based on the site of hyaliniza-
Ans a. Wits appraisal tion. Identify the type of tooth movement being
attempted.
65. The image depicts which of the following analysis?
71. Identify the type of tooth movement shown in the 74. Identify the type of anchorage shown in the image.
image.
a. Simple b. Stationary
c. Reciprocal d. Extraoral
a. Controlled tipping Ans a. Simple
b. Uncontrolled tipping
c. Rotation 75. Identify the type of anchorage shown in the image.
d. Intrusion
Ans b. Uncontrolled tipping
a. Simple b. Stationary
c. Reinforced d. Extraoral
Ans c. Reciprocal
100 TARGET MDS: Image Based Questions
76. The appliance shown in the image provides which a. Sved appliance
kind of anchorage?
b. Roger appliance
c. Anterior inclined plane
d. Posterior bite plane
Ans c. Anterior inclined plane
a. Simple b. Stationary
c. Reinforced d. Extraoral
Ans c. Reinforced
77. Identify the appliance shown in the color plate.
a. Sved appliance
b. Catlan’s appliance
c. Anterior inclined plane
d. Posterior bite plane
Ans d. Posterior bite plane
a. Sved appliance 81. The technique shown in the color plate is used to
b. Catlan’s appliance manage which of the following condition?
c. Anterior inclined plane
d. Posterior bite plane
Ans a. Sved appliance
78. Identify the appliance shown in the color plate.
83. What is not true for the appliance shown in the a. Tongue thrust
image? b. Thumb sucking
c. Mouth breathing
d. Nail biting
Ans c. Mouth breathing
a. Wilkinson b. Nance
c. Tweed d. Dewel
Ans c. Tweed
86. The appliance shown in the color plate is used to
treat which of the following habit?
a. Jones jig appliance 94. Idetify the appliance shown in the image.
b. Jasper jumper appliance
c. Hyrax appliance
d. Herbst apliance
Ans d. Herbst apliance
a. Derichsweiler appliance
b. Haas appliance
c. Isaacson appliance
d. Coffin spring
Ans d. Coffin spring
a. Derichsweiler appliance
b. Haas appliance 95. Identify the appliance shown in the image.
c. Isaacson appliance
d. Coffin spring
Ans a. Derichsweiler appliance
a. Quad helix
b. Haas appliance
c. Isaacson appliance
d. Coffin spring
a. Derichsweiler appliance Ans a. Quad helix
b. Haas appliance 96. Identify the appliance.
c. Isaacson appliance
d. Coffin spring
Ans b. Haas appliance
a. Adam’s clasp
b. Southend clasp
c. Crozat clasp
d. Mill retractor
Ans a. Adam’s clasp
Orthodontics 103
a. Adam’s clasp
a. Ring separator
b. Southend clasp
c. Crozat clasp b. Brass wire separator
d. Mill retractor c. Kessling spring retractor
Ans b. Southend clasp d. G cuff
98. Identify the appliance. Ans a. Ring separator
100. Identify the appliance.
03
HHBHB
1. A 52-year-old known case of psoriasis comes to 2. What is the diagnosis for the condition shown in
you for routine dental check up when you find the color plate?
this non scrapable condition on patient 's tongue.
A
What's your diagnosis?
a. Heck's disease
b. Fordyces granules
c. Verruciform xanthoma
a. Psoriasis vulgaris d. Papilloma of buccal mucosa
b. Erythema migrans Ans b. Fordyces granules.
c. Fissured tongue Ref: Shafer 's Textbook of Oral Pathology, 7th edition.
d. Hairy tongue A developmental anomaly characterized by heterotopic
collections of sebaceous glands at various sites in the oral CD
Ans b. Erythema migrans. cavity. It has been postulated that the occurrence of seba -
Ref: Shafer 's Textbook of Oral Pathology, 7th edition. ceous glands in the mouth may result from inclusion in the LU
Benign migratory glossitis is a psoriasiform mucositis of oral cavity of ectoderm having some of the potentialities
03
the dorsum of the tongue. Its dominant characteristics is of skin in the course of development of the maxillary
a constantly changing pattern of serpiginous white lines and mandibular processes during embryonic life.
surrounding areas of smooth, depapillated mucosa. The .
3 A 20-year-old male comes with complaint of burn -
changing appearance has led some to call this the wan - .
ing sensation over left retromolar region What CD
dering rash of the tongue, with the depapillated areas can be the diagnosis?
have reminded others of continental outlines on a globe,
hence the use of the popular term geographic tongue. As
with psoriasis, the etiology of benign migratory glossitis
CO
is unknown, but it does seem to become more prominent
during conditions of psychological stress and it is found
with increased frequency (10% ) in persons with psoriasis
of the skin.
Oral Medicine 105
a. Mucocele b. Papilloma
c. Fibrous epulis d. Pyogenic grauloma
Ans a. Mucocele
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
The retention phenomenon involving accessory salivary
gland structures occurs most frequently on the lower lip,
but may also occur on the palate, cheek, tongue (involv- a. Pemphigus vulgaris b. Lichen planus
ing the glands of Blandin-Nuhn), and floor of the mouth.
c. Fever blister d. Bed sores
Traumatic severance of a salivary duct, such as that pro-
duced by biting the lips or cheek or pinching the lip by Ans a. Pemphigus vulgaris
106 TARGET MDS: Image Based Questions
Ref: Shafer’s Textbook of Oral Pathology, 7th edition. 9. Which of following condition can lead to appear-
The loss of epithelium occasioned by rubbing apparently ance as seen in the color plate?
unaffected skin is termed Nikolsky’s sign. It is a character-
istic feature of pemphigus and is caused by perivascular
edema which disrupts the dermal-epidermal junction
11. Which of the following condition is seen on the Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
color plate? The lesion is usually an elevated, pedunculated or sessile
vascular mass with a smooth, lobulated, or even a warty
surface, which commonly is ulcerated and shows a ten-
dency for hemorrhage either spontaneously or upon slight
trauma.
The lesions are more common in the facial aspect than
the lingual or palatal aspects of gingiva and can occur
involving both sides including interdental papilla. It may be
single or occurs at more than one site, unilateral or bilat-
eral especially when it involves gingiva.
a. Herpes zoster Sometimes there is exudation of purulent material, but
b. Denture stomatitis this is not a characteristic feature despite the suggestive
c. Pemphigoid name of this lesion.
d. Multiple aphthous ulceration
13. The condition seen in the color plate can be des-
Ans b. Denture stomatitis cribed as:
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
The mucosa beneath the denture becomes extremely red,
swollen, smooth or granular and painful. Multiple pin-
point foci of hyperemia, usually involving the maxilla,
frequently occur. A severe burning sensation is common.
The redness of the mucosa is rather sharply outlined and
restricted to the tissue actually in contact with the denture.
Herpes Zoster—will be unilateral
Pemphigoid—involves oral cavity widely
Multiple Aphthous Ulceration—presents on nonkeratini- a. Danger space infection
zed mucosa b. Ludwig angina
c. NOMA
12. A 40-year-old male patient reported with the
d. Fever blister
lesion, which is present since past 1 month. It is
tender and does not fade upon compression. What Ans a. Danger space infection
is most probable diagnosis? Dangerous area of face comprises of upper lip, lower part
of nose and adjacent area. This area has been so named
because boils, infections of the nose and injuries around
the nose, especially those that become infected can read-
ily spread to cavernous sinus resulting in cavernous sinus
thrombosis.
14. The lesion as seen in color plate on the dorsum of
tongue is appropriately addressed as:
a. Pyogenic granuloma
b. Lipoma
c. Hemangioma
d. Pericoronal abscess
Ans a. Pyogenic granuloma
108 TARGET MDS: Image Based Questions
a. Median rhomboid glossitis Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
b. Fissured Tongue The patient with Ludwig’s angina manifests a rapidly
c. Hairy tongue developing board-like swelling of the floor of the mouth
d. Posterior midline atrophic candidiasis and consequent elevation of the tongue. The swelling is
firm, painful and diffuse, showing no evidence of locali-
Ans d. Posterior midline atrophic candidiasis zation and paucity of pus. There is difficulty in eating and
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
swallowing as well as in breathing. Patients usually have
Median rhomboid glossitis (central papillary atrophy, post-
a high fever, rapid pulse and fast respiration. A moderate
erior lingual papillary atrophy) is a focal area of susceptibil-
leukocytosis is also found.
ity to recurring or chronic atrophic candidiasis, prompting
a recent shift toward the use of posterior midline atrophic 17. Which of following is the most common cause of
candidiasis as a more appropriate diagnostic term. death for appearance as seen in the color plate?
a. Meningitis
b. Dyspnea
c. Dysphagia
a. Greenspan lesion b. Kissing lesion
d. Aspiration pneumonia
c. Kissing disease d. Verruca vulgaris
Ans b. Dyspnea
Ans b. Kissing Lesion
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
As the disease continues, the swelling involves the neck,
Infected cases may also demonstrate a midline soft palate
erythema in the area of routine contact with the underly- and edema of the glottis may occur. This carries the serious
ing tongue involvement; this is commonly referred to as a risk of death by suffocation.
kissing lesion. 18. Which of the following is not used as treatment
16. The clinical appearance as seen in the color plate plan for the condition seen in the color plate?
can be due to which of the following?
22. Identify the lesion seen in the color plate. a. Herpetic gingivo stomatitis
b. Recurrent aphthous ulcer
c. Pemphigus
d. Lichen plnus
Ans b. Recurrent aphthous ulcer
Ref: Burket’s Oral Medicine, 11th ed.
The first episodes of RAS most frequently begin during
the second decade.
a. Traumatic ulcer The individual lesions are round, symmetric, and shal-
b. Pemphigus low (similar to viral ulcers), but no tissue tags are present
c. Lichen planus
from ruptured vesicles, which helps distinguish RaS from
d. Herpetic gingivostomatitis
diseases that start as vesicles, such as pemphigus, and
Ans a. Traumatic ulcer pemphigoid.
Ref: Burket’s Oral Medicine, 11th ed.
In the color plate one can see the attrited posterior teeth 25. A 21-year-old boy presented with the lesion on
with sharp occlusal margins. alveolar mucosa as seen in the color plate with
Single mucosal ulcers may be caused by direct physi- history of recurrence. Which of the following is
cal/mechanical, thermal, or chemical trauma to the not included in the treatment plan?
mucosa causing tissue damage and ulceration.
23. Treatment plan for the lesion seen in the color
plate includes all, except:
Ans a. Excision 26. A 45 years old lady presented with loss of hairs
Ref: Burket’s Oral Medicine, 11th ed. from scalp and vesicle formation following scrat-
ching. Which of the following can be the diagnosis?
24. A 21-year-old boy presented with the lesion on
alveolar mucosa as seen in the color plate with
history of recurrence. Which of the following can
be the diagnosis?
Ref: Shafer’s Textbook of Oral Pathology, 7th edition. Smear from the infected area, which comprises epithelial
The loss of epithelium occasioned by rubbing apparently cells, creates opportunities for detection of the yeasts.
unaffected skin is termed Nikolsky’s sign. It is a character- The material obtained is fixed in isopropyl alcohol and
istic feature of pemphigus and is caused by perivascular air-dried before staining with periodic acid–Schiff (PAS).
edema which disrupts the dermal-epidermal junction The detection of yeast organisms is considered a sign of
infection. This technique is particularly useful when pseu-
27. A 45-year-old lady presented with loss of hairs
domembranous oral candidiasis and angular cheilitis are
from scalp following scratching and vesicle for-
suspected. To increase the sensitivity, a second scrape can
mation. This phenomenon is known as:
be transferred to a transport medium followed by cultiva-
tion on Sabouraud agar. To discriminate between different
Candida species, an additional examination can be per-
formed on Pagano-Levin agar. Imprint culture technique
can also be used where sterile plastic foam pads (2.5 × 2.5 cm)
are submerged in Sabouraud broth and placed on the
infected surface for 60 seconds. The pad is then firmly
pressed onto Sabouraud agar, which will be cultivated at
a. Nikolsky’s sign 37°C. The result is expressed as colony forming units per
b. Koebner’s phenomenon cubic millimeter (CFU/mm2). This method is a valuable
c. Auspitz sign adjunct in the diagnostic process of erythematous can-
d. Tinnel sign didiasis and denture stomatitis as these infections consist
of fairly homogeneous erythematous lesions. Salivary cul-
Ans a. Nikolsky’s sign ture techniques are primarily used in parallel with other
Ref: Burket’s Oral Medicine, 11th ed. diagnostic methods to get an adequate quantification of
Characteristic sign of the disease is that pressure to an Candida. Patients who display clinical signs of oral can-
apparently normal area results in the formation of a new didiasis usually have more than 400 CFU/mL.
lesion. This phenomenon, called the Nikolsky’s sign, Chronic plaque-type and nodular candidiasis, culti-
results from the upper layer of the skin pulling away from vation techniques have to be supplemented by a histo-
the basal layer. The Nikolsky’s sign is most frequently asso- pathologic examination. This examination is primarily
ciated with pemphigus but may also occur in other blister- performed to identify the possible presence of epithelial
ing disorders.
dysplasia and to identify invading Candida organisms by
28. Which of the following technique is not used for PAS staining. However, for the latter, there is a definitive
the diagnosis of the lesion seen in the color plate? risk of false-negative results.
Dentigerous cyst Aspirate: with atrophy of the filiform and later the fungiform papil-
Clear pale, straw colored fluid lae, and dysphagia limited to solid food resulting from
Cholesterol crystals. an esophageal stricture or web. These oral findings are
Total protein in excess of 4.0 g per 100 mL (resembling reminiscent of those seen in pernicious anemia. The
serum). mucous membranes of the oral cavity and esophagus are
Dentigerous cysts have the potential, to attain a large atrophic and show loss of normal keratinization. Koilo-
size, often it is the pronounced facial asymmetry or the nychia (spoon-shaped fingernails) or nails that are brittle
problem of ill-fitting dentures that forces a patient to seek and break easily have been reported in many patients;
treatment. Pain may be a presenting symptom, if secondary splenomegaly has also been reported in 20–30% of the
infection supervenes. Clinically, a tooth from the normal cases.
series, will be found to be missing, unless the cause is a
35. Aspiration of a swelling of mandible yielded blood
supernumerary tooth, sometimes, other adjacent teeth
as aspirate as seen in the color plate. Which of fol-
may also fail to erupt, may be tilted or otherwise be out of
lowing pathologies will show such result?
alignment. The lateral expansion causes a smooth, hard,
painless, prominence, later as the cyst expands the bone,
covering the center of the convexity, becomes thinned and
can be indented with pressure on palpation, with further
expansion. This fragile outer shell of bone becomes frag-
mented and the sensation imparted and sound produced
on palpation over the area is described aptly as eggshell
crackling, which is also true for other large odontogenic a. Dentigerous cyst b. KOT
cysts. Still later the cyst lining may come to lie immediately c. AV malformation d. Ranula
beneath the oral mucosa and fluctuation can be elicited.
Ans c. AV malformation
34. The clinical condition shown in the color plate is Ref: Textbook of Oral and Maxillofacial Surgery (Neelima
suggestive of which of following syndrome: Anil Malik).
1. Dentigerous cyst: Clear pale, straw colored fluid Cho-
lesterol crystals Total protein in excess of 4.0 g per 100 ml
(resembling serum).
2. Keratocystic odontogenic tumor: Dirty, creamy white
viscoid suspension Parakeratinized epithelium Total
protein less than 5.0 g per 100 mL most of which is
albumin.
3. Periodontal cysts: Clear, pale yellow straw colored
fluid Varying amounts of cholesterol crystals Total
protein content is between 5 and 11g per 100 ml.
a. Plummer-Vinson syndrome 4. Infected cyst: Pus or brownish fluid, seropurulent/
b. Pernicious anemia sanguinopurulent fluid, at times paste like or case-
c. Greenspan syndrome ous consistency Polymorphonuclear leukocytes Foam
d. Acquired immunodeficiency syndrome cells Cholesterol clefts.
5. Mucocele, ranula: Mucus
Ans a. Plummer-Vinson syndrome 6. Gingival cysts: Clear fluid
Ref: Shafer’s Textbook of Oral Pathology, 7th edition. 7. Solitary bone cyst: Serous or sanguineous fluid, blood
Plummer-Vinson syndrome occurs chiefly in women in or empty cavity Necrotic blood clot
the fourth and fifth decades of life. Presenting symptoms of 8. Stafne’s bone cavity: Empty cavity will yield air
the anemia and the syndrome are cracks or fissures at the 9. Dermoid cysts: Thick sebaceous material
corners of the mouth (angular cheilitis), a lemon-tinted 10. Fissural cysts: Mucoid fluid
pallor of the skin, a smooth, red, painful tongue (glossitis) 11. Vascular cyst walls: Fresh blood
114 TARGET MDS: Image Based Questions
a. Phycomycosis
b. North American blastomycosis
c. South American blastomycosis
d. Actinomycosis
Ans a. Phycomycosis
Two main types of phycomycosis infection occur in human
beings: (1) superficial and (2) visceral, although it is some-
times also classified as localized and disseminated. The a. Lichen planus b. Leukoplakia
superficial infection includes involvement of the external
c. Erythroplakia d. Psoriasis
ear, the fingernails, and the skin. The visceral forms of phy-
comycosis are of three main types: (a) pulmonary, (b) gas- Ans a. Lichen planus
trointestinal, and (c) rhinocerebral. Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
The tissue involved by this infection shows a vari- The disease assumes a somewhat different clinical appe-
able amount of necrosis, some of which may be related arance than on the skin, and classically is characterized
to infarction brought about by thrombi consisting of the by lesions consisting of radiating white or gray, velvety,
organisms. This fungus has an apparent predilection for thread-like papules in a linear, annular or retiform
blood vessels; it is able to penetrate their walls and thereby arrangement forming typical lacy, reticular patches, rings
produce thrombosis. The organisms appear as large, non- and streaks over the buccal mucosa and to a lesser extent
septate hyphae with branching at obtuse angles. on the lips, tongue and palate. A tiny white elevated dot
37. Identify the non-scrapable lesion on the buccal is frequently present at the intersection of the white lines,
mucosa of a chronic smoker as presented in the known here also as the striae of Wickham. When plaque-
color plate: like lesions occur, radiating striae may often be seen on
their periphery.
Shklar and McCarthy have reported the following dis-
tribution of oral lesions: buccal mucosa, 80%; tongue, 65%;
lips, 20%; gingiva, floor of mouth and palate, less than 10%.
These oral lesions produce no significant symptoms,
although occasionally patients will complain of a burning
sensation in the involved areas.
Oral Medicine 115
39. The patient presented with complaint of burning Ref: Burket’s Oral Medicine, 11th ed.
sensation of oral mucosa. Examination revealed Angular cheilitis is infected fissures of the commissures
erythematous areas surrounded by radiating striae of the mouth, often surrounded by erythema. The lesions
at the periphery. What can be the diagnosis? are frequently coinfected with both Candida and Staphy-
lococcus aureus. Vitamin B12, iron deficiencies, and loss of
vertical dimension have been associated with this disor-
der. Atopy has also been associated with the formation of
angular cheilitis. Dry skin may promote the development
of fissures in the commissures, allowing invasion by the
microorganisms. Thirty percent of patients with denture
stomatitis also have angular cheilitis, which only affects 10%
of denture-wearing patients without denture stomatitis.
a. Erosive lichen planus
b. Plaque-like lichen planus 41. Identify the condition present in the color plate:
c. Reticular lichen planus
d. Annular lichen planus
Ans a. Erosive lichen planus
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
LP is characterized by lesions consisting of radiating white
or gray, velvety, thread-like papules in a linear, annular
or retiform arrangement forming typical lacy, reticular
patches, rings and streaks over the buccal mucosa and to
a lesser extent on the lips, tongue and palate. A tiny white
elevated dot is frequently present at the intersection of
the white lines, known here also as the striae of Wickham.
When plaque-like lesions occur, radiating striae may often
be seen on their periphery. a. Hairy tongue
b. Anemic glossitis
40. Patient complains of difficulty opening the mouth.
c. Pseudomembranous candidiasis
Patient’s medical history reveals that he is anemic
d. Hairy leukoplakia
and there is no other medical history.What is your
diagnosis for the lesion as shown in color plate? Ans b. Anemic glossitis
Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
While an iron-deficiency anemia may occur at any age, the
Plummer-Vinson syndrome occurs chiefly in women in
the fourth and fifth decades of life. Presenting symptoms of
the anemia and the syndrome are cracks or fissures at the
corners of the mouth (angular cheilitis), a lemon-tinted
pallor of the skin, a smooth, red, painful tongue (glos-
sitis) with atrophy of the filiform and later the fungiform
papillae, and dysphagia limited to solid food resulting
a. Stomatitis medicamentosa secondary to drugs from an esophageal stricture or web.
for anemia
42. A growth present on lateral border of tongue of a
b. Angular cheilitis
chronic tobacco chewer with indurated periphery
c. Petechiae due to ITP
and tendency to bleed on provocation associated
d. Oral submucous fibrosis
with palpable neck masses. What is most prob-
Ans b. Angular cheilitis able diagnosis?
116 TARGET MDS: Image Based Questions
a. Carcinoma of tongue
b. Hairy leukoplakia
c. Pyogenic granuloma
a. Herpes zoster
d. Eruucous leukoplakia
b. Herpes simplex
Ans a. Carcinoma of tongue c. Cytomegalovirus
Ref: Burket’s Oral Medicine, 11th ed.
d. Human papillomavirus
Unfortunately, patients are most often identified only after
the development of symptoms at advanced stages of dis- Ans b. Herpes zoster
ease. Discomfort is the most common symptom that leads Ref: Harrison’s Principles of Internal Medicine, 18th edi-
a patient to seek care and may be present at the time of tion.
diagnosis in up to 85% of patients. Patients also may pre- Herpetic whitlow—HSV infection of the finger—may occur
sent with an awareness of a mass in the mouth or neck. as a complication of primary oral or genital herpes.
Dysphagia, odynophagia, otalgia, limited movement, oral
bleeding, neck masses, and weight loss may occur with 45. The clinical picture shown in the color plate is due
advanced disease. to heterotopic accumulation of which of follow-
ing?
43. The color plate shows which of the following pro-
cedures being performed:
a. Punch biopsy
b. Brush biopsy a. Minor salivary gland
c. Exfoliative cytology
b. Lipid globules
d. Excisional biopsy
c. Sebaceous glands
Ans A. Punch biopsy d. Candidia albicans
Ref: Textbook of Oral and Maxillofacial Surgery (Neelima
Ans c. Sebaceous glands
Anil Malik).
A small part of the lesion is obtained as specimen using Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
a punch. This technique is of particular use in mucosal Fordyces granules are developmental anomaly character-
lesions from inaccessible regions that cannot be reached ized by heterotopic collections of sebaceous glands at vari-
by conventional methods. The technique produces some ous sites in the oral cavity.
amount of crushing or distortion of the tissues. 46. This aspirate sample showed cholesterol crystals
44. Which of the following organism is responsible under the microscope and had no keratin content
for the condition of a child patient with habit of within. Most probable diagnosis for the lesion
thumb sucking seen in the color plate? from which it was aspirated?
Oral Medicine 117
a. Odontogenic keratocyst
a. Dominant b. Recessive
b. Dentigerous cyst
c. Mitochondrial d. X-linked
c. Peripheral hemangioma
d. Actinomycosis Ans a. Dominant
a. Leukoplakia b. Leukoedema
c. Lichen planus d. Erythroplakia
Ans a. Leukoplakia
Ref: Burket’s Oral Medicine, 11th ed.
Oral leukoplakia is defined as a predominantly white
a. Dominant b. Recessive
lesion of the oral mucosa that cannot be characterized as
c. Mitochondrial d. X-linked
any other definable lesion. This disorder can be further
divided into a homogeneous and a nonhomogeneous Ans d. X-linked
type. The typical homogeneous leukoplakia is clinically Modes of Inheritance
characterized as a white, well-demarcated plaque with Ref: Shafer’s Textbook of Oral Pathology, 7th edition.
an identical reaction pattern throughout the entire lesion. Population genetics deals with the study of the mode of
The demarcation is usually very distinct, which is different inheritance of traits and the distribution of genes in popu-
from an oral lichen planus (OLP) lesion, where the white lations.
components have a more diffuse transition to the normal All chromosomes exist in pairs so our cells contain two
oral mucosa. copies of each gene, which may be alike or may differ in
118 TARGET MDS: Image Based Questions
their substructure and their product. Different forms of gene responsible, along with one normal allele, the mode
genes at the same locus or position on the chromosome of inheritance of the trait is called dominant (question
are called alleles. If both copies of the gene are identical, no. 48). If two copies of the defective gene are required for
the individual is described as homozygous, while if they expression of the trait, the mode of inheritance is called
differ, the term used is heterozygous. recessive (question no. 49). The special case of genes car-
ried on the X chromosome produces yet different pedi-
The exception to the rule that cells contain pairs of
grees. Since male-to-male transmission is impossible and
chromosomes applies to the gametes, sperm and ovum,
since females do not express the disease when they carry
which contain only single representatives of each pair of
only one copy of the diseased gene (since it is modified by
chromosomes, and therefore, of each pair of genes. When the homologous X chromosome), the usual pedigree con-
the two gametes join at fertilization, the new individual sists of an affected male with clinically normal parents and
produced again has paired genes, one from the father and children, but with affected brothers, maternal uncles, and
one from the mother. If a trait or disease manifests itself other maternal male relatives (question no. 50). This mode
when the affected person carries only one copy of the of inheritance is described as X-linked recessive.
Chapter o
1-
j
O
Oral Radiology a>
LU
03
HHBHB
1. What is the significance of component of radio- a. Stabilizes patients head during exposure
graph machine marked with an arrow in the color
b. Provides reference for Frankfort horizontal plane
plate?
c. Provides reference for sagittal plane
d. Provides stabilized anteroposterior position
Ans d. Provides stabilized anteroposterior position
Ref: Oral radiology principles and interpretation, 6th
edition.
I The arrow points toward the notched bite block on which
a. Stabilizes patient 's head during exposure patient is asked to bite on.
b. Provides reference for Frankfort horizontal plane The anteroposterior position radiograph of the patient
is achieved typically by having patients place the incisal
c. Provides reference for sagittal plane
edges of their maxillary and mandibular incisors into
d. Keeps occlusal surfaces apart so as to disoc- a notched positioning device ( the bite block). Patients
clude and avoid superimposition of images should not shift the mandible to either side when making
Ans a. Stabilizes patient 's head during exposure this protrusive movement. The midsagittal plane must be
Ref: Oral radiology principles and interpretation, 6th centered within the image layer of the particular X- ray unit.
n
edition.
The arrow points toward lateral head supports. 3. Identify the film presented in the color plate. CD
Each unit has a unique method of head stabilization, LU
varying from chin cups to posterior or lateral head sup-
ports to head restraints. Patient motion can be minimized 03
by application of one or more methods simultaneously.
E
Image quality is severely degraded by head movement, so E
CD
it is important to obtain patient compliance. N
CD
2. What is the significance of component of radio-
graph machine marked with an arrow in the color
plate? 57 mm
a.
Occlusal film
CO
b.
Intraoral periapical film
c.
Bitewing film
d.
Conventional OPG film
Ans a. Occlusal film
120 TARGET MDS: Image Based Questions
Ref: Oral radiology principles and interpretation, 6th Ref: Oral radiology principles and interpretation, 6th
edition. edition.
Occlusal film is more than three times larger than size 2 Cassette for 8 × 10 inch film.
film (57 × 76 mm) When the cassette is closed, the film is supported in
It is used to show larger areas of the maxilla or mandi- close contact between two intensifying screens.
ble than may be seen on a periapical film. These films also 6. Identify the part marked with arrow in the color
are used to obtain right-angle views to the usual periapical plate.
view.
Ref: Oral radiology principles and interpretation, 6th Ref: Oral radiology principles and interpretation, 6th
edition. edition.
Moisture- and light-proof packet contains an opening tab Between the wrappers in the film packet is a thin lead foil
on the side opposite the tube. Inside is a sheet of lead foil backing with an embossed pattern. The foil is positioned in
and a black, lightproof, interleaf paper wrapper that is the film packet behind the film, away from the tube. This
folded around the film. Film is packaged with one or two lead foil serves several purposes. It shields the film from
sheets of film. backscatter (secondary) radiation, which fogs the film and
reduces subject contrast (image quality). It also reduces
8. Identify the structure marked with “x” in the color patient exposure by absorbing some of the residual X-ray
plate. beam. Perhaps most important, however, is the fact that if
the film packet is placed backward in the patient’s mouth
so that the tube side of the film is facing away from the X-ray
machine, the lead foil will be positioned between the sub-
ject and the film. In this circumstance most of the radiation
is absorbed by the lead foil and the resulting radiograph is
light and shows the embossed pattern in the lead foil.
10. Select the correct sequence of arrangement of
components of intraoral film shown in the color
a. Interleaf paper wrapper
plate from side facing toward X-ray source to the
b. Moisture- and light-proof packet
side facing tooth.
c. Lead foil
d. Film
Ans d. Film
Ref: Oral radiology principles and interpretation, 6th
edition.
X-ray film has two principal components: Emulsion and
base. The emulsion, which is sensitive to X-rays and visible
light, records the radiographic image. The base is a plastic
supporting material onto which the emulsion is coated. a. S-R-Q-P b. P-S-R-Q
c. P-Q-R-S d. P-R-S-Q
9. Which of following is not true for the component
Ans c. P-Q-R-S
of intraoral film shown in the color plate.
Ref: Oral radiology principles and interpretation, 6th
edition.
Moisture- and light-proof packet (P) contains an opening
tab on the side opposite the tube. Inside is a sheet of lead
foil (S) and a black, lightproof, interleaf paper wrapper (Q)
that is folded around the film (R). Film is packaged with
one or two sheets of film.
11. What is not true regarding the structure marked
with an arrow in the color image?
a. Indicates the tube side of the film The primary components of an X-ray machine are the X-ray
b. Identifies the patient’s right and left sides tube and its power supply. The X-ray tube is positioned
within the tube head, along with some components of the
c. Convex side of the dot faces tongue
power supply. Often the tube is recessed within the tube
d. Concave side of the dot faces tongue
head to improve the quality of the radiographic image. The
Ans c. Convex side of the dot faces tongue tube head is supported by an arm that is usually mounted
Ref: Oral radiology principles and interpretation, 6th on a wall. A control panel allows the operator to adjust the
edition. time of exposure and often the energy and exposure rate of
The raised film dot (arrow) indicates the tube side of the the X-ray beam.
film and identifies the patient’s right and left sides.
The corner of each dental film has a small, raised dot 14. Identify the component of X-ray tube marked with
that is used for film orientation. The manufacturer ori- the arrow.
ents the film in the packet so that the convex side of the
dot is toward the front of the packet and faces the X-ray
tube. The side of the film with the depression is thus ori-
ented toward the patient’s tongue. After the film has
been exposed and processed, the dot is used to identify the
image as showing the patient’s right or left side. When the
films are mounted with the images of the teeth in the ana-
tomic position, each film is first oriented with the convex
a. Anode b. Cathode
side of the dot toward the viewer.
c. Filament d. Yoke
12. What does this symbol represent? Ans b. Cathode
Ref: Oral radiology principles and interpretation, 6th
edition.
The cathode in an X-ray tube consists of a filament and a
focusing cup. The filament is the source of electrons within
the X-ray tube. It is a coil of tungsten wire about 2 mm in
diameter and 1 cm or less in length. It is mounted on two
stiff wires that support it and carry the electric current.
These two mounting wires lead through the glass enve-
a. Recycling of waste products lope and connect to both the high- and low-voltage elec-
b. Biohazard trical sources. The filament is heated to incandescence by
c. Radiohazard the flow of current from the low-voltage source and emits
d. Green energy electrons at a rate proportional to the temperature of the
Ans b. Biohazard filament.
13. Which of the following is represented in the color 15. Identify the component of X-ray tube marked with
plate? the arrow.
Ref: Oral radiology principles and interpretation, 6th Ref: Oral radiology principles and interpretation, 6th
edition. edition.
The anode consists of a tungsten target embedded in a Position-and-distance rule. If no barrier is available, the
copper stem. The purpose of the target in an X-ray tube is operator should stand at least 6 feet from the patient when
to convert the kinetic energy of the colliding electrons into the exposure is made.
X-ray photons.
18. What does this symbol represent?
16. Which of following angulation marked with “X”
is correct for “safe position” during exposure of
radiograph?
a. Periapical cyst
b. Globulomaxillary cyst
c. Nasopalatine cyst
d. Nasoalveolar cyst
Ans b. Globulomaxillary cyst
Ref: Shafer’s Textbook of Oral Pathology, Seventh Edition.
Globullomaxillary cyst, on the intraoral radiograph, charac-
a. 5 ft b. 6 ft teristically appears as an inverted, pear-shaped radiolu-
c. 7 ft d. 8 ft cent area between the roots of the lateral incisor and cus-
Ans b. 6 ft pid, usually causing divergence of the roots of these teeth.
124 TARGET MDS: Image Based Questions
20. Identify the supernumerary tooth presented in observed attenuation (the egg-shell effect). Developmen-
the color plate. tally, the lamina dura is an extension of the lining of the
bony crypt that surrounds each tooth during development.
a. Paramolar b. Distomolar
c. Mesiodens d. Mulberry molar
Ans c. Mesiodens
Mesiodens—it is located at or near the midline in the incisal a. Lt. ramal fracture
region of maxilla between central incisors. It may occur b. Rt. ramal fracture
singly or paired, erupted or impacted or even inverted. It c. Lt. parasymphysis fracture
is a small tooth with cone-shaped crown and short root. It d. Rt. parasymphysis fracture
may cause retarded eruption, displacement or resorption Ans d. Rt. parasymphysis fracture
of adjacent root. It frequently causes improper alignment. Coronal section of head CT scan shows discontinuity at
parasymphysis level and displacement of fractured frag-
21. Which of the following represents a radiopaque
ment.
lining of empty socket shown in the radiograph?
23. Incidental finding on IOPA of a 16 years old
patient points toward which of the following?
a. CT sialogram b. CT angiogram
c. MRI sialogram d. PET scan
Ans b. CT angiogram
25. The arrow points toward which of the following a. Common carotid artery
structure is presented CT angiogram? b. Internal carotid artery
c. External carotid artery
d. Inernal jugular vein
Ans c. External carotid artery
a. Mucositis b. Sinusitis
c. Periostitis d. Periapical abscess
Ans a. Mucositis
Thickened sinus mucosa is portrayed as a hyperdense
band paralleling the contour of the maxillary wall.
The image of thickened mucosa is readily detectable in
the radiograph as a noncorticated band noticeably more
radiopaque than the air-filled sinus, paralleling the bony
wall of the sinus.
126 TARGET MDS: Image Based Questions
29. 3D CBCT image presented in the color plate is 32. What is the ideal treatment plan for 46 shown in
diagnostic of which of the following? the radiograph?
a. Extraction b. Pulpectomy
a. Impacted right maxillary canine
c. Pulpotomy d. Bicuspidization
b. Impacted right mandibular canine
Ans b. Pulpectomy
c. Impacted left maxillary canine
IOPA reveals tooth with periapical radiolucent lesion sug-
d. Impacted left mandibular canine
gestive of abscess that should be ideally treated endodon-
Ans a. Impacted right maxillary canine tically.
3DCT image shows presence of canine in right maxillary
sinus area 33. Identify the supernumerary tooth presented in
the color plate.
30. Identify the supernumerary tooth presented in
the color plate.
a. Paramolar b. Distomolar
a. Paramolar b. Distomolar c. Mesiodens d. Mulberry molar
c. Mesiodens d. Mulberry molar
Ans c. Mesiodens
Ans a. Paramolar IOPA shows inverted conical supernumerary between
It is supernumerary molar, usually small and rudimentary maxillary incisors .
and is situated buccally or lingually to one of the maxillary
molars or interproximally between 1st, 2nd and 3rd maxil- 34. 3DCT image of a 15 years old patient, presented
lary molars. with swelling. Aspiration did not yield any aspi-
rate. What’s the most probable diagnosis?
31. The occlusal radiograph presented here shows
which of following artifact?
a. Odontogenic keratocyst
a. Phalangioma b. Cone cut
c. Elongation d. Double exposure b. Ameloblastoma
Ans b. Cone cut c. Dentigerous cyst
Partial image caused by poor alignment of the tube head d. Central hemangioma
with the film. Ans b. Ameloblastoma
Oral Radiology 127
3DCT demonstrating expansion of the cortex with areas of and gives negative response to EPT. What is the
erosion. diagnosis based on the clinical and radiographic
The ameloblastoma is usually well defined and fre- findings?
quently delineated by a cortical border. The border is often
curved, and in small lesions the border and shape may be
indistinguishable from a cyst. The periphery of lesions in
the maxilla is usually more ill defined.
In this case, absence of aspirate rules out other 3
options.
a. Odontogenic keratocyst
b. Ameloblastoma
c. Dentigerous cyst
d. Central hemangioma
Ans b. Ameloblastoma
An axial section demonstrating bicortical expansion with
maintenance of a thin outer shell of bone.
a. Periapical cyst
36. Identify the artifact present in the IOPA as seen in
b. Periapical abscess
the color image.
c. Periapical granuloma
d. Follicular cyst
Ans a. Periapical cyst
Radiograph of a radicular cyst reveals a lesion with a well-
defined cortical boundary and radiolucent internal struc-
ture.
39. Occlusal radiograph presented in the color plate
is diagnostic of which of the following?
a. Impacted right and left mandibular canine a. Coronal section b. Sagittal section
b. Impacted righ and left maxillary canine c. Axial section d. 3D reconstruction
c. Impacted right and left maxillary lateral incisor Ans b. Sagittal section
d. Impacted right and left mandibular lateral
incisor 42. CBCT image showed in the color plate is repre-
Ans b. Impacted right and left maxillary canine senting which of the following section?
a. Dentigerous cyst b. KOT 43. CBCT image showed in the color plate is repre-
c. CEOC d. Periapical cyst senting which of the following section?
Ans a. Dentigerous cyst
The epicenter of a dentigerous cyst is found just above the
crown of the involved tooth, most commonly the man-
dibular or maxillary third molar or the maxillary canine.
An important diagnostic point is that this cyst attaches at
the cementoenamel junction. Some dentigerous cysts are
eccentric, developing from the lateral aspect of the folli-
cle so that they occupy an area beside the crown instead
of above the crown. Cysts related to maxillary third molars a. Coronal section b. Sagittal section
often grow into the maxillary antrum and may become c. Axial section d. 3D reconstruction
quite large before they are discovered. Cysts attached to the
Ans c. Axial section
crown of mandibular molars may extend a considerable
distance into the ramus. Dentigerous cysts typically have 44. Image showed in the color plate is representing
a well-defined cortex with a curved or circular outline. If which of the following radiograph?
infection is present, the cortex may be missing. The inter-
nal aspect is completely radiolucent except for the crown
of the involved tooth.
a. Anteroposterior view
b. Reverse Towne view
c. PA Waters view
d. Submentovertex view
Ans a. Anteroposterior view
Oral Radiology 129
45. The radiograph presented here shows which of The most common location of KOT is the posterior body
the following finding? of the mandible (90% occur posterior to the canines) and
ramus (more than 50%). The epicenter is located superior
to the inferior alveolar nerve canal. This type of cyst occa-
sionally has the same pericoronal position as, and is indis-
tinguishable from, a dentigerous cyst.
Periphery and shape: As with cysts, KOTs usually
show evidence of a cortical border unless they have
become secondarily infected. The cyst may have a smooth
a. Zygomatic arch fracture round or oval shape identical to that of other cysts, or it
b. Mandibular angle fracture may have a scalloped outline (a series of contiguous arcs).
c. Mandibular body fracture Internal structure: The internal structure is most
d. Mandibular parasymphysis fracture commonly radiolucent. The presence of internal keratin
Ans a. Zygomatic arch fracture does not increase the radiopacity. In some cases, curved
The image presented is a submentovertex radiograph internal septa may be present, giving the lesion a multi-
which shows fractured zygomatic arch. locular appearance.
46. Image showed in the color plate is representing Effects on surrounding structures: An important
which of the following radiograph? characteristic of the KOT is its propensity to grow along the
internal aspect of the jaws, causing minimal expansion.
This occurs throughout the mandible except for the upper
ramus and coronoid process, where considerable expan-
sion may occur.
KOTs can displace and resorb teeth but to a slightly
lesser degree than dentigerous cysts. The inferior alveolar
nerve canal may be displaced inferiorly. In the maxilla,
a. Anteroposterior view this cyst can invaginate and occupy the entire maxillary
b. Reverse Towne view antrum.
c. PA Waters view
48. 3D reconstruction of CT scan presented here is
d. Submentovertex view suggestive of which of the following diagnosis?
Ans d. Submentovertex view
47. A 35 years old male patient reported with the
complaint of lower lip paresthesia and displace-
ment of tooth. Aspiration revealed presence dirty,
creamy white viscoid suspension with keratin and
protein content of 1 gm/100 ml. What is the diag-
nosis based on this OPG findings?
a. Condylar fracture
b. Condylar hyperplasia
c. Ankylosis
a. Dentigerous cyst d. Condylar osteochondroma
b. Residual cyst Ans c. Ankylosis
c. Keratocystic odontogenic tumor Note the osseous ankylosis: presence of mass with bony
d. Unicystic ameloblastoma consistency in place of joint space leading to obliteration
Ans c. Keratocystic odontogenic tumor of the joint space of TMJ.
130 TARGET MDS: Image Based Questions
a. Condylar fracture
b. Condylar hyperplasia
c. Ankylosis
d. Condylar osteochondroma
Ans c. Ankylosis a. Mandibular body fracture
Note the osseous ankylosis: Obliteration of the joint space b. Zygomatic arch fracture
of right condyle. c. Right condylar fracture
d. Bilateral condylar fracture
50. The 3DCT chest feature presented is associated Ans c. Right condylar fracture
with which of the following?
53. What is the diagnosis for the radiograph?
a. Cloaca b. Sequestrum
c. Involucrum d. Residual cyst
a. Mandibular body fracture
Ans b. Sequestrum
b. Symphysis fracture
The necrosed bone is known as sequestrum: Sequestra
c. Right condylar fracture
may be present but usually are more apparent and numer-
d. Bilateral condylar fracture ous in chronic forms. Sequestra can be identified by closely
Ans b. Symphysis fracture inspecting a region of bone destruction (radiolucency) for
56. Which of the following shows radiological fea- an island of bone.
tures as seen in the radiograph?
58. The patient complains of chronic pus discharge
from left mandibular body region. Presence of
draining fistula extraorally along with the findings
seen in the radiograph are suggestive of which of
the following?
a. Focal sclerosis
b. Sialolith
c. Proliferative periostitis
d. Metal restoration artifact
a. Suppurative osteomyelitis
Ans c. Proliferative periostitis
Acute osteomyelitis can stimulate either bone resorp- b. KOT
tion or bone formation. Portions of cortical bone may c. Periapical cyst
be resorbed. An inflammatory exudate can lift the peri- d. Ameloblastic fibroma
osteum and stimulate bone formation. Radiographically, Ans a. Suppurative osteomyelitis
this appears as a thin, faint, radiopaque line adjacent to Panoramic film reveals large sequestra and a periosteal
and almost parallel or slightly convex to the surface of the reaction at the inferior border of the mandible in a case of
bone. A radiolucent band separates this periosteal new chronic osteomyelitis.
bone from the bone surface. As the lesion develops into a Very early in the disease, no radiographic changes may
more chronic phase, cyclic and periodic acute exacerba- be identifiable. The bone may be filled with inflammatory
tions may produce more inflammatory exudate, which exudate and inflammatory cells and may show no radio-
again lifts the periosteum from the bone surface and graphic change.
stimulates the periosteum to form a second layer of bone. Location: The most common location is the posterior
This is detected radiographically as a second radiopaque
body of the mandible. The maxilla is a rare site. Periphery.
line almost parallel to the first and separated from it by
A cute osteomyelitis most often presents an ill-defined
a radiolucent band. This process may continue and may
periphery with a gradual transition to normal trabeculae.
result in several lines (an onion-skin appearance), and
Internal structure. The first radiographic evidence of
eventually a massive amount of new bone may be formed.
the acute form of osteomyelitis is a slight decrease in the
This is referred to as proliferative periostitis and is seen
more often in children. density of the involved bone, with a loss of sharpness of the
existing trabeculae. In time, the bone destruction becomes
57. Identify the part of lesion marked with arrow in more profound, resulting in an area of radiolucency in one
the radiograph of a patient of osteomyelitis? focal area or in scattered regions throughout the involved
132 TARGET MDS: Image Based Questions
a. Osteoma b. Sialolithiasis
c. Warthin tumor d. Ameloblastoma
Ans a. Osteoma
3D CT image shows a calcifies structure arising from the
parietal bone that is suggestive of Osteoma.
a. Basal cell nevus syndrome The bilateral structures marked with the arrow are mental
b. Gardner’s syndrome foramen.
c. Down syndrome 66. What is the diagnosis for the radiograph?
d. Cleidocranial dysplasia
Ans d. Cleidocranial dysplasia
Note the absence of clavicles in the radiograph. Typi-
cally the clavicles are underdeveloped to varying degrees
in cleidocranial dysplasia and, in approximately 10% of
cases, they are completely absent.
a. Ameloblastoma
b. Central giant cell granuloma
c. Cherubism
d. Paget’s disease
Ans c. Cherubism
OPG showing lesions in mandible. The epicenter of the
lesion is in mandibular ramus; note the anterior displace-
ment of the unerupted teeth. The internal structure con-
tains septa.
Although the radiographic appearance of cherubism a. Occlusal film
may be similar to that of giant cell granuloma, the fact b. Intraoral periapical film
that cherubism is bilateral with an epicenter in the ramus c. Bitewing film
should provide a clear differentiation. d. Conventional OPG film
Ans c. Bitewing Film
65. Identify the structure marked with the arrows in
Ref: Oral radiology principles and interpretation, 6th
the radiograph.
edition.
Bitewing (interproximal) views are used to record the
coronal portions of the maxillary and mandibular teeth in
one image. They are useful for detecting interproximal car-
ies and evaluating the height of alveolar bone. Size 2 film
is normally used in adults; the smaller size 1 is preferred in
children. In small children, size 0 may be used. A relatively
long size 3 also is available. Bitewing films often have a
a. Residual cyst paper tab projecting from the middle of the film on which
b. Periapical cyst the patient bites to support the film. This tab is rarely visu-
c. Periapical cemental dysplasia alized and does not interfere with the diagnostic quality of
d. Mental foramen the image. Film-holding instruments for bitewing projec-
Ans d. Mental foramen tions also are available.
134 TARGET MDS: Image Based Questions
68. The OPG of an asymptomatic hard bony swelling 71. A radiopaque structure present in the OPG in left
over ramus is suggestive of which of following? mandibular body region is diagnostic of which
of the following?
a. Osteoma
b. Osteosarcoma a. Complex odontome
c. Fibrous dysplasia b. Compound odontome
d. Pleomorphic adenoma c. Osteoma
Ans a. Osteoma d. Osteosarcoma
An osteoma on the mandibular ramus Ans a. Complex odontome
Osteomas have well-defined borders. Location. More of the compound type (62%) occur in
Osteomas composed solely of compact bone are uni- the anterior maxilla in association with the crown of an
formly radiopaque; those containing cancellous bone unerupted canine. In contrast, 70% of complex odontomas
show evidence of internal trabecular structure. are found in the mandibular first and second molar area.
69. Which of the following is correct for multiple radi- Periphery: The borders of odontomas are well defined
olucencies present periapical to teeth in OPG? and may be smooth or irregular. These lesions have a cor-
tical border, and immediately inside and adjacent to the
cortical border is a soft-tissue capsule.
Internal structure. The contents of these lesions are
largely radiopaque. Compound odontomas have a number
of toothlike structures or denticles that look like deformed
teeth. Complex odontomas contain an irregular mass of
calcified tissue. The degree of radiopacity is equivalent to
a. Multiple periapical cemental dysplasia or exceeds that of adjacent tooth structure and may vary
b. Central ossifying fibroma in the degree of radiopacity from one region to another,
c. Permanent tooth buds reflecting variations in amount and type of hard tissue that
d. Multiple KOT has been formed. A dilated odontoma has a single calcified
Ans c. Permanent tooth buds structure with a more radiolucent central portion that has
The OPG represents erupted deciduous dentition and an overall form like a donut.
developing permanent dentition.
72. Identify the mandibular 3rd condition present in
70. What is approximate dental age of the patient the radiograph.
based on the radiographic finding?
73. Identify the mandibular 3rd condition present in 76. The equipment presented in the color plate is
the radiograph. used while following which technique?
a. Vertical impaction
b. Mesoangular impaction
c. Distoangular impaction a. Paralleling technique
d. Horizontal impaction b. Bisecting technique
c. Bitewing radiograph
Ans d. Horizontal impaction
d. Occlusal radiogaph
74. Identify the mandibular 3rd condition present in Ans a. Paralleling technique
the radiograph.
77. Identify the equipment presented in the color
plate.
a. Vertical impaction
b. Mesoangular impaction
c. Distoangular impaction a. Collimator b. Grid
d. Horizontal impaction c. XCP film holder d. Bite block
Ans b. Mesoangular impaction Ans c. XCP film holder
XCP film-holding instrument: The aiming ring aligns a cir-
75. Identify the structure marked with arrow in the
cular aiming cylinder from an X-ray machine with the sen-
radiograph image.
sor to assure that the image plane is perpendicular to the
central ray and in the middle of the beam. Note notches to
align rectangularly collimated aiming devices.
The structure marked with the arrow is the raised dot pre- a. Ameloblastoma
sent on corner of radiograph that is meant for side deter-
b. Traumatic bone cyst
minaton
c. KOT
79. Patient presented with restricted mouth with d. Hemangioma
opening, an ulcerative growth in retromolar
Ans b. Traumatic bone cyst
region along with bleeding as well as palpable
stony hard lymph nodes. What is the provisional Almost all SBCs are found in the mandible, in rare cases
diagnosis based on the provided details? they develop in the maxilla. The lesion can occur any-
where in the mandible but is seen most often in the ramus
and posterior mandible in older patients. SBCs also fre-
quently occur with cemento-osseous and fibrous dyspla-
sia. Periphery and Shape: The margin may vary from a
well-defined, delicate cortex to an ill-defined border that
blends into the surrounding bone. The boundary usually
is better defined in the alveolar process around the teeth
a. Malignancy b. Benign tumor than in the inferior aspect of the body of the mandible. The
c. Soft tissue cyst d. Osseous cyst shape most often is smooth and curved, like a cyst, with an
Ans a. Malignancy oval or scalloped border. The lesion often scallops between
OPG shows destruction of bone in the mandibular retro- the roots of the teeth.
molar area by a squamous cell carcinoma.
Squamous cell carcinoma may erode into underlying 81. This is a 15-year-old white female presented with
bone from any direction, producing a radiolucency that is a history of increasing swelling without pain in
polymorphous and irregular in outline. Invasion occurs in the left mandible. Surgical exposure of the lesion
half of cases and is characterized most commonly by an yielded empty cavity. What is next line of treat-
ill-defined, noncorticated border. Rarely, the border may ment?
appear smooth without a cortex, indicating underlying
erosion rather than invasion. If bone involvement is exten-
sive, the periphery appears to have finger like extensions
preceding a zone of impressive osseous destruction. If
pathologic fracture occurs, the borders show sharpened
thinned bone ends with displacement of segments and an
adjacent soft-tissue mass. Sclerosis in underlying osseous
structures (likely from secondary inflammatory disease) a. Autologus bone grafting
may be seen in association with erosions from surface car- b. Allogenous bone grafting
cinomas.
c. Curettage and inducing of blood
80. This is a 15-year-old white female presented with d. No intervention
a history of increasing swelling without pain in Ans c. Curettage and inducing of blood
the left mandible. Surgical exposure of the lesion
The customary treatment is a conservative opening into
yielded empty cavity. What is most probable diag-
the lesion and careful curettage of the lining; this usu-
nosis?
ally initiates bleeding and subsequent healing. Spon-
taneous healing has been reported. Periodic follow-up
radiographic examinations are advisable, especially if the
patient declines treatment. These lesions can recur but it
is rare.
82. Which treatment modality is presented here in
the color plate?
Oral Radiology 137
a. Lead collar b. Lead apron Periphery and shape: In most cases, the periphery of
a PCD lesion is well defined. Often a radiolucent border
c. Aluminum collar d. Alluminum apron
of varying width is present, surrounded by a band of scle-
Ans b. Lead apron
rotic bone that also can vary in width. The sclerotic bone
Radiation protection equipment for patients and radio-
represents a reaction of the immediate surrounding bone.
logist.
The lesion may be irregularly shaped or may have an over-
87. Identify the equipment presented in the color plate. all round or oval shape centered over the apex of the tooth.
Internal Structure: The internal structure varies,
depending on the maturity of the lesion. In the early stage,
normal bone is resorbed and replaced with fibrous tis-
sue that usually is continuous with the periodontal liga-
ment (causing loss of the lamina dura). Radiographically,
this appears as a radiolucency at the apex of the involved
tooth in the mixed stage, radiopaque tissue appears in the
radiolucent structure. This material usually is amorphous;
a. Lead collar b. Lead apron has a round, oval, or irregular shape; and is composed
c. Aluminum collar d. Alluminum apron of cementum or abnormal bone. Sometimes the cemen-
Ans a. Lead collar tum-like material forms a swirling pattern. These struc-
Radiation protection equipent to protect thyroid from tures sometimes are called cementicles; however, this is
unwanted exposure. a radiographic term that does not necessarily represent
the histologic appearance. In rare cases, the radiopaque
88. Identify the mixed radiolucency attached to vital material resembles the abnormal trabecular patterns
teeth apices. seen in fibrous dysplasia. In the mature stage, the internal
aspect may be totally radiopaque without any obvious pat-
tern. Usually, a thin radiolucent margin can be seen at the
periphery because this lesion matures from the center out-
ward). Occasionally, this radiolucent margin is not appa-
rent, which makes the differential diagnosis more difficult.
The internal structure may appear dramatically radiolu-
cent if cavities resembling simple bone cysts form within
the cemental lesions. In some cases, the simple bone cyst
extends beyond the original margin of the cemental lesion.
a. Periapical abscess All other 3 lesions are associated with nonvital teeth.
b. Periapical cemental dysplasia
89. The skull view is suggestive of which of the follow-
c. Periapical cyst
ing diagnosis?
d. Periapical granuloma
Ans b. Periapical cemental dysplasia
Location: The epicenter of a PCD lesion usually lies at
the apex of a tooth. In rare cases, the epicenter is slightly
higher and over the apical third of the root. The condition
has a predilection for the periapical bone of the mandibu-
lar anterior teeth, although any tooth can be involved, and,
in rare cases, the maxillary teeth may be involved. In most
cases, the lesion is multiple and bilateral, but occasion- a. Basal cell nevus syndrome
ally a solitary lesion arises. If the involved teeth have been b. Crouzon syndrome
extracted, this lesion can still develop but the periapical c. Treacher Collins syndrome
location is less evident. In these cases, the term cemental d. Cleidocranial dysplasia
dysplasia may be more appropriate. Ans b. Crouzon syndrome
Oral Radiology 139
Skull view demonstrating the short anterior-posterior 90. The radiograph of skull is suggestive of which of
dimension of the skull, digital impressions, and hypoplas- the following diagnosis?
tic maxilla.
The earliest radiographic signs of cranial suture syno-
stosis are sclerosis and overlapping edges. Sutures that
normally should look radiolucent on the skull film will not
be detectable or will show sclerotic changes. Interestingly,
on rare occasions the facial features may present before
radiographic evidence of sutural synostosis. Premature
a. Malignant melanoma
fusion of the cranial base leads to diminished facial growth.
b. Multiple myeloma
In some cases, prominent cranial markings are noted,
c. Sickle cell anemia
which are also seen in normally growing patients, but are
d. Langerhans cell histiocytosis
more prominent because of an increase in intracranial
pressure from the growing brain. These markings may be Ans c. Sickle cell anemia
seen as multiple radiolucencies appearing as depressions Radiograph of a patient with sickle cell anemia showing a
(so-called digital impressions) of the inner surface of the thickened diploic space and thinning of the skull cortex.
cranial vault, which results in a beaten metal appearance. Skull showing the hair-on-end bone pattern.
Chapter 9
1-
j
O
Oral Pathology a>
LU
03
HHBHB
a. Fusion
b. Gemination
c. Dilaceration
d. Concrescence
Ans a. Fusion
3. Identify the structure marked with an arrow in
the color plate.
a. Lingual thyroid
b. Lingual varices
c. Reactive lymphoid aggregate
d. Thyroglossal duct cyst
Ans a. Lingual thyroid
It appears to arise in females during puberty, adolescence,
a. Dens in dente
s CD
LU
pregnancy, or menopause.
b. Cingulum
The lingual thyroid may be manifested clinically as a 03
c. Talon cusp
nodular mass in or near the base of the tongue in the gene-
d. Dens invaginatus
ral vicinity of the foramen caecum and often, but not
Ans c. Talon cusp
always, in the midline. This mass, which more commonly
The talon cusp, an anomalous structure resembling an CD
appears as deeply situated rather than as a superficial
exophytic lesion, tends to have a smooth surface. In some Eagle's talon, projects lingually from the cingulum areas
cases, it may appear vascular, while in others, the color of of a maxillary or mandibular permanent incisor. This cusp
the mucosa is not atypical. blends smoothly with the tooth except that there is a deep
developmental groove where the cusp blends with the
CO
2. A 12-year- old male patient came with a large tooth sloping lingual tooth surface.
as seen in the color plate. On examination, no. of It is composed of normal enamel and dentin and con-
teeth is one less than normal. What is the diagnosis? tains a horn of pulp tissue.
Oral Pathology 141
a. Down’s syndrome
b. Greenspan syndrome
c. Van der Woude syndrome
d. Progeria
Ans c. Van der Woude syndrome
Van der Woude syndrome is an autosomal dominant syn- a. Cleft tongue b. Macroglossia
drome typically consisting of a cleft lip or cleft palate and c. Ankyloglossia d. Fissured tongue
distinctive pits of the lower lips. Ans a. Cleft tongue
142 TARGET MDS: Image Based Questions
A completely cleft or bifid tongue is a rare condition that a. Greenspan lesion b. Kissing lesion
is apparently due to lack of merging of the lateral lingual c. Kissing disease d. Verruca vulgaris
swellings of this organ. A partially cleft tongue is consi-
Ans b. Kissing lesion
derably more common and is manifested simply as a deep
Infected cases may also demonstrate a midline soft palate
groove in the midline of the dorsal surface.
erythema in the area of routine contact with the under-
10. Identify the pathology. lying tongue involvement; this is commonly referred to as
a kissing lesion.
15. Identify the condition shown in the radiograph. 18. The equipment showed in the image is used to
evaluate which of the following?
a. Cleidocranial dysplasia
a. Bleeding time b. Ectodermal dysplasia
b. Clotting time c. Odontodysplasia
c. Erythrocyte sedimentation rate d. Chondroectodermal dysplasia
d. Capillary fraglity Ans a. Cleidocranial dysplasia
Ans d. Capillary fraglity 20. The condition show in the color plate is associa-
17. Which test is presented in the image? ted with all of the following except?
21. The diagrammatic representation shows which of The wrinkles and grooves visible on the lips have been
the following tests? named by Tsuchihashi as ‘sulci labiorum rubrorum’. The
imprint produced by these grooves is termed ‘lip print’, the
examination of which is referred to as ‘cheiloscopy’. These
grooves are heritable and are supposed to be individualis-
tic. Lip prints, therefore, can constitute material evidence
left at a crime scene, similar to fingerprint.
Congenital facial diplegia is a nonfamilial deficient deve- nerve (CN III) that innervate the levator superioris mus-
lopment of cranial muscles consisting of facial diplegia cle of the upper eyelid.
with bilateral paralysis of the ocular muscles, particularly
27. Patient complains of closing of the left upper eye-
the abducens. Congenital facial diplegia is usually mani-
lid during movement of the mandible to the con-
fested in infancy during the first few days of life by failure
to close the eyes during sleep. Because of the partial or tralateral side as seen in the color plate. What is
the most probable diagnosis?
complete facial paralysis, the infant exhibits no change in
facial expression even when crying or laughing. The pro-
minent lips are often everted, and the mouth may remain
partially opened.
There is difficulty in mastication; saliva frequently
drools from the corners of the mouth, and speech is sev-
erely impaired.
The majority of patients have other associated con-
genital deformities, including external ophthalmoplegia,
a. Marcus Gunn Jaw-winking syndrome
deformity of the external ears, deafness, defects of the pec-
toral muscles, paresis of the tongue, soft palate or jaw mus- b. Frey syndrome
cles, clubfoot, mental defects and epilepsy. c. Marin Amat syndrome
d. Eagle’s syndrome
26. Patient complains of retraction of the left upper Ans c. Marin Amat syndrome
eyelid during movement of the mandible to the An interesting condition known as the Marin Amat syn-
contralateral side as seen in the color plate. What drome or inverted Marcus Gunn phenomenon is usually
is the most probable diagnosis? seen after peripheral facial paralysis. In this condition, the
eye closes automatically when the patient opens his/her
mouth forcefully and fully, as in chewing, and tears may
flow.
glossodynia, headache, vague orofacial pain or pain along wrinkle or the eyebrow raise (Fig.). The patient has a typi-
the distribution of the internal and external carotid arteries. cal mask like or expressionless appearance. Speech and
Probably, the most consistent symptom is pharyngeal eating usually become difficult, and occasionally the taste
pain. It is common for the difficulty to arise following ton- sensation on the anterior portion of the tongue is lost or
sillectomy, presumably from fibrous tissue that forms and altered.
is stretched and rubbed over the elongated styloid process.
30. The patient complains of sweating while eating
However, many cases are not preceded by tonsillectomy,
and this is especially true of the form known as the carotid as seen in the color plate. What can be the most
probable diagnosis?
artery syndrome, in which pressure exerted by either a
deviant styloid process or an ossified ligament causes
impingement on the internal or external carotid arteries
between which the styloid process normally lies.
31. The characteristic appearance as seen in the color by mucosal erosions of raised atypical target lesions. These
plate is associated with which of following? are usually located on the extremities and/or on the face.
The characteristic findings of SJS are mucosal erosions
plus widespread distribution of flat atypical targets or pur-
puric macules. The lesions may be present on the trunk,
the face, and on the extremities.
The oral lesions may be widespread, often involving 36. A known case of scleroderma presents with fol-
the cheeks, palate, gingiva, floor of the mouth and portions lowing finding. What is the diagnosis?
of the tongue. The mucosa appears thickened and folded
or corrugated with a soft or spongy texture and a peculiar
white opalescent hue.
38. The condition shown in the color image is associ- 40. The characteristic discoloration of teeth as seen
ated with which of the following? in the color plate is associated with which of the
following?
a. Scurvy b. Rickets
c. Thalassemia d. Pernicious anemia
Ans c. Thalassemia a. AML b. CML
In the skull, there is extreme thickening of the diploe c. ALL d. CLL
(medulla), the inner and outer plates (cortices) become Ans a. AML
poorly defined, and the trabeculae between the plates Ref: Carranza’s clinical periodontology, 10(e).
become elongated, producing a bristle like crew-cut Leukemic enlargement may be diffuse or marginal and loca-
or hair-on-end appearance of the surface of the skull. lized or generalized It may appear as a diffuse enlargement
Because of the lack of hematopoietic marrow, the occipital of the gingival mucosa, an oversized extension of the mar-
bone usually is not involved. ginal gingival or a discrete tumor like interproximal mass.
150 TARGET MDS: Image Based Questions
a. Abfraction b. Erosion
c. Abrasion d. Attrition
Ans a. Abfraction
Grippo, in 1991, coined the term abfraction to describe a. Odontolith b. Pulp stone
the pathologic loss of both enamel and dentin caused by c. Fibrolith d. Phlebolith
biomechanical loading forces. He stated that the forces Ans b. Pulp stone
could be static, such as those produced by swallowing and The two chief morphologic forms of pulp calcifications are
clenching; or cyclic, as in those generated during chew- discrete pulp stones (denticles, pulp nodules) and diffuse
ing action. The abfraction lesions were caused by flexure calcification. Pulp stones have been classified as either
and ultimate material fatigue of susceptible teeth at loca- true or false stones, depending upon their microscopic
tions away from the point of loading. The breakdown was structure.
152 TARGET MDS: Image Based Questions
True denticles are made up of localized masses of cal- Ans a. Linea alba
cified tissue that resemble dentin because of their tubular Linea Alba: Linea Alba is a white line seen on the buccal
structure. mucosa extending from the commissures posteriorly at
True denticles may be subdivided further according the level of the occlusal plane. It is caused by the physical
to whether or not they are attached to the wall of the pulp irritation and pressure exerted by the posterior teeth. It is
chamber. Denticles lying entirely within the pulp tissue usually bilateral and is more pronounced in persons who
and not attached to the dentinal walls are called ‘free den- have clenching habit or bruxism.
ticles’, while those that are continuous with dentinal walls 53. Identify the lesion present in the color plate that
are referred to as ‘attached denticles.’ developed following extraction of a tooth.
False denticles are composed of localized masses of
calcified material, and unlike true denticles, do not exhibit
dentinal tubules. The false denticle also may be classified
as free or attached.
51. Identify the condition shown in the radiograph.
a. Vitamin D deficiency
b. Dilantin administration
a. Cavernous sinus thrombosis
c. Poor hygiene
d. Cyclosporine therapy b. Ludwig angina
c. Vincent angina
Ans b. Dilantin administration
d. Mandibular fracture
Gingival hyperplasia may begin as early as two weeks after
dilantin therapy has been instituted, although usually it Ans b. Ludwig angina
takes two to three months. The first change noted is a pain- The patient with Ludwig’s angina manifests a rapidly
less increase in the size of the gingiva, starting with the developing board-like swelling of the floor of the mouth
enlargement of one or two interdental papillae. The sur- and consequent elevation of the tongue. The swelling is
face of the gingiva shows an increased stippling and finally firm, painful and diffuse, showing no evidence of locali-
a cauliflower, warty, or pebbled surface. As enlargement zation and paucity of pus. There is difficulty in eating and
increases, the gingival tissue becomes lobulated, and clefts swallowing as well as in breathing. Patients usually have
remain between each enlarged gingiva in many cases. Pal- a high fever, rapid pulse and fast respiration. A moderate
pation reveals that the tissue is dense, resilient and insen- leukocytosis is also found.
sitive. It shows little tendency to bleed. As the disease continues, the swelling involves the
neck, and edema of the glottis may occur. This carries the
59. The condition shown in the color plate is associ- serious risk of death by suffocation. Next, the infection
ated with which of the following? may spread to the parapharyngeal spaces, to the carotid
sheath or to the pterygopalatine fossa. Cavernous sinus
thrombosis with subsequent meningitis may be sequela to
this type of spread of the infection.
61. Patient developed the condition following infec-
tion in the dangerous area of face. Which of the
following communication is responsible for spread
of infection here?
a. Acrodynia b. Rickets
c. Scurvy d. Pernicious anemia
Ans a. Acrodynia
Acrodynia occurs most frequently in young infants before
the age of two years, although children are occasionally
affected up to the age of five or six years. The skin, particu-
larly of the hands, feet, nose, ears, and cheeks, becomes
red or pink and has a cold, clammy feeling. The appear- a. Pterygoid plexus
ance has been described as resembling raw beef. Patients b. Basilar artery
with acrodynia exhibit profuse salivation and often much c. Angular veins
‘dribbling.’ The gingiva be comes extremely sensitive or d. Postero superoalveolar artery
painful and may exhibit ulcerations. Ans c. Angular veins
Oral Pathology 155
Cavernous sinuses are bilateral venous channels for the of tissue resistance and reactivity, and readily respond
content of middle cranial fossa, particularly the pituitary to proliferative lesions. It involves teeth with large, open
gland. Areas drained by cavernous sinus include the orbit, carious lesions. A pulp so affected appears as a pinkish red
paranasal sinuses, anterior mouth, and middle portion globule of tissue protruding from the pulp chamber and
of the face. Cavernous sinus thrombophlebitis is a seri- not only fills the caries defect but also extends beyond.
ous condition consisting in the formation of a thrombus
63. The tetrad for etiological factor for caries doesn’t
in the cavernous sinus or its communicating branches.
Infections of the head, face, and intraoral structures above involve which of the following?
the maxilla are particularly prone to produce this disease.
There are many routes by which the infection may reach
the cavernous sinus. The facial and angular veins carry
infection from the face and lip, while dental infection is
carried by way of the pterygoid plexus.
The patient with cavernous sinus thrombophlebitis is
extremely ill and manifests the characteristic features of
exophthalmos with edema of the eyelids as well as che-
mosis. Paralysis of the external ocular muscles is reported, a. Time b. Tooth
along with impairment of vision and sometimes photo- c. Substrate d. Hygiene
phobia and lacrimation. There are also headaches, nausea Ans d. Hygiene
and vomiting, pain, chills and fever. Orbital cellulitis and Dental caries is a multifactorial disease with interplay of
cavernous sinus thrombosis can have similar signs and three primary factors: The host, the microbial flora, and
symptoms, and differentiation between them sometimes the substrate with time, as an inevitable fourth factor. In
is impossible on clinical basis alone. Neuroimaging with other words, caries requires a susceptible host, a cario-
CT, MRI or magnetic resonance angiography may help to genic flora and a suitable substrate that must be present
distinguish these entities. for a sufficient length of time.
62. The growth seen in the color plate doesn’t show 64. The condition shown in the color plate points
any movement while interdental papillae are toward which of the following?
moved. It points towards which of the following?
directly on diseased tissue. These eggs hatch and the lar- a. HHV2 b. HHV8
vae get their nourishment from the soft tissue. c. HIV d. HPV
Oral myasis is relatively a rare condition but cases have
Ans b. HHV8
been reported in gingiva, palate, and extracted wounds.
Kaposi’s sarcoma is a multifocal neoplasm of vascular
65. The condition shown in the color plate points endothelial origin. Human herpes virus type 8 is involved
toward which of the following? in the pathogenesis of Kaposi’s sarcoma. Commonly
affected sites include palate, gingiva, tongue, and oropha-
rynx or the skin. The clinical appearance of oral Kaposi’s
sarcoma can be macular, nodular, or raised and ulcerated,
the color of which can range from red to purple. Early
lesions tend to be flat, red and asymptomatic, with the
color becoming darker as the lesion ages. As lesions pro-
gress, they can interfere with the normal functions of the
oral cavity and become symptomatic secondary to trauma
a. Myiasis b. Actinomycosis
or infection. Bacillary angiomatosis often mimics Kaposi’s
c. Phycomycosis d. Candidiasis
sarcoma, but diagnosis can be made from a biopsy from
Ans c. Phycomycosis the lesion, examined with the Warthin-Starry stain. Treat-
Two main types of phycomycosis infection occur in human ment features intralesional vinblastine or surgical removal.
beings: (1) superficial and (2) visceral, although it is some- Systemic chemotherapy is indicated for widespread or dis-
times also classified as localized and disseminated. The seminated form.
superficial infection includes involvement of the external
ear, the fingernails, and the skin. The visceral forms of phy- 67. The condition more commonly seen in HIV-
comycosis are of three main types: (a) Pulmonary, (b) gas- infected patients as seen in the color plate is
trointestinal, and (c) rhinocerebral. Although all forms of caused by which of the following?
phycomycosis are important, the rhinocerebral is of great-
est interest to the dental profession, and only this variety
will be discussed here.
Infections of the head by these organisms are charac-
terized by the classical syndrome of uncontrolled diabetes,
cellulitis, ophthalmoplegia and meningoencephalitis. The
infection apparently enters the tissues through the nasal
mucosa and extends to the paranasal sinuses, pharynx, a. EBV b. HHV8
palate, orbit, and brain. c. HIV d. HPV
One early clinical manifestation of the disease is the Ans a. EBV
appearance of a reddish-black nasal turbinate and sep- Oral hairy leukoplakia (OHL) was first reported by
tum with a nasal discharge. The necrosis may extend to the Greenspan and coworkers in 1984 on the lateral margin
paranasal sinuses and orbital cavity, with the development of the tongue among young homosexual males. The term
of sinus tracts and sloughing of tissue. hairy leukoplakia was given because of the corrugated sur-
face of the epithelium. Initially this lesion was observed
66. The condition more commonly seen in HIV-
exclusively in male homosexuals. Further reports indi-
infected patients as seen in the color plate is caused
cated their prevalence among other risk groups for AIDS
by which of the following?
(IDUs, transfusion recipients, hemophiliacs) and in cer-
tain immunocompromised HIV-seronegative patients.
The association of these lesions with Epstein-Barr virus
(EBV) has been demonstrated by immuno histochemis-
try, electron microscopy and in situ hybridization. It has
been hypothesized that basal epithelial cells of the lateral
margin of the tongue normally harbor latent EBV and
Oral Pathology 157
significant diminution of Langerhans cells by HIV, in the a. Herpes stomatitis b. Aphthous minor
affected site permits reactivation of EBV with subsequent c. Aphthous major d. Cat scratch disease
epithelial hyperplasia.
Ans a. Herpes stomatitis
68. A 12 years old male patient reports with the con- Initially, the adult patient exhibits fever, a general malaise,
dition as seen in the color plate. What is the most and pain and tenderness along the course of the involved
probable diagnosis? sensory nerves, usually unilaterally. Often the trunk is
affected. Within a few days, the patient has a linear papular
or vesicular eruption of the skin or mucosa supplied by the
affected nerves. It is typically unilateral and dermatomic
in distribution. After rupture of the vesicles, healing com-
mences, although secondary infection may intervene and
slow the process considerably. Occasionally, herpes zoster
may resemble the lesions of herpes simplex, but the two
diseases can be separated since the zoster virus cannot
be transmitted to animals, e.g. the rabbit cornea, as can
a. Herpes zoster stomatitis the simplex virus. Herpes zoster may involve the face by
b. Primary herpetic gingivostomatitis infection of the trigeminal nerve .This usually consists of
c. Self inflicted injuries unilateral involvement of skin areas supplied by either the
d. Necrotizing ulcerative gingivitis ophthalmic, maxillary or mandibular nerves. Lesions of
the oral mucosa are fairly common, and extremely pain-
Ans b. Primary herpetic gingivostomatitis
ful vesicles may be found on the buccal mucosa, tongue,
Herpes labialis is clinically seen as vesicles on the lip and
uvula, pharynx, and larynx. These generally rupture to
adjacent facial skin which rapidly breakdown to produce leave areas of erosion. One of the characteristic clinical
shallow ulcers. Intraoral lesions on the gingiva are referred features of the disease involving the face or oral cavity is
to as acute herpetic gingivostomatitis. the unilaterality of the lesions. Typically, when large, the
lesions will extend up to the midline and stop abruptly.
69. Identify the condition more commonly seen in
HIV-infected patients. 71. The finding in the measles patient as seen in the
color plate is known as which of the following?
macules or papules which enlarge and coalesce to form NOMA usually begins as a small ulcer of the gingival
blotchy, discolored, irregular lesions which blanch upon mucosa which rapidly spreads and involves the surround-
pressure and gradually fade away in four to five days with ing tissues of the jaws, lips, and cheeks by gangrenous
a fine desquamation. necrosis. The initial site is commonly an area of stagna-
tion around a fixed bridge or crown. The overlying skin
Oral Manifestations becomes inflamed, edematous and finally necrotic, with
The oral lesions are prodromal, frequently occurring two the result that a line of demarcation develops between
to three days before the cutaneous rash, and are pathog- healthy and dead tissue, and large masses of the tissue
nomonic of this disease. These intraoral lesions are called may slough out, leaving the jaw exposed.
Koplik’s spots and have been reported to occur in as high
74. The lesion seen in the color plate is present in
as 97% of all patients with measles. The Koplik’s spots are-
which stage of syphilis?
white papules resembling table salt like crystals with red
base which appear usually on the buccal mucosa opposite
to first and second molar teeth.
a. Primary b. Secondary
c. Latent d. Tertiary
Ans a. Primary
In the primary stage, a lesion known as chancre develops
at the site of inoculation approximately 3–90 days after
a. Smoker melanosis b. Herpangina contact with the infection. Chancre is usually solitary but
c. Herpes zoster d. Cat scratch disease may be multiple at times. It most commonly occurs on the
Ans b. Herpangina penile in the male and on the vulva or cervix in the female.
The clinical manifestations of herpangina are compara- About 95% of chancres occur on the genitalia, but they are
tively mild and of short duration. It begins with sore throat, also found in other areas. In recent years, there appears to
cough, rhinorrhea, low-grade fever, headache, sometimes have been an increase in the occurrence of extragenital
vomiting, prostration, and abdominal pain. The patients syphilis as result of an increase in altered sexual activity
soon exhibit small vesicles which rupture to form crops of and increased contact among infected male homosexuals.
ulcers, each showing a gray base and an inflamed periphery Of particular interest to the dentist are those lesions occur-
on the anterior faucial pillars and sometimes on the hard ring on the lips, tongue, palate, gingiva, and tonsils. The
and soft palates, posterior pharyngeal wall, buccal mucosa chancre has been reported developing even at the site of
and tongue. a fresh extraction wound. The usual primary lesion is an
elevated, ulcerated nodule showing local induration and
73. Identify the condition shown in the color plate.
producing regional lymphadenitis. Such a lesion on the lip
may have a brownish, crusted appearance.
75. The lesion seen in the color plate is present in
which stage of syphilis?
a. NUG b. NUP
c. NOMA d. Cyclic neutropenia
Ans c. NOMA
Oral Pathology 159
a. P. gingivalis
b. Actinobacillus actinomycetemcomitans
c. Fusospirochetes
d. Candida albicans
a. Klinefelter syndrome b. Progeria
Ans c. Fusospirochetes c. Treacher collins d. Down’s syndrome
Mild NUG case with erythematous marginal and inter-
Ans b. Progeria
proximal gingival with slightly cratered papillae
Ref: Carranza’s clinical periodontology, 10(e) 84. This genetic mapping gives diagnosis of:
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.
81. The appearance as seen in the color plate is sug-
gestive of which of the following?
a. Klinefelter syndrome
b. Cri du chat syndrome
c. Eagle’s syndrome
d. Down’s syndrome
Ans b. Cri du chat syndrome
Oral Pathology 161
85. This genetic mapping gives diagnosis of: a. Klinefelter syndrome (xxy)
b. Turner syndrome
c. Down syndrome
d. Cri du chat syndrome
Ans b. Turner syndrome
a. Klinefelter syndrome
b. Cri du chat syndrome
c. Eagle’s syndrome
d. Down’s syndrome
Ans d. Down’s syndrome (21 trisomy)
86. This chromosome map is diagnostic of:
03
HHBHB
1 . Identify the anatomical structures marked with 3. Identify the part of gingiva marked with question
question marks. mark.
Palatine
glands
Palatine
nerve
2 1 2 3 CD
I - C- P - M— = 1 6
2 1 2 3
a. Deciduous human dentition CO
b. Permanent human dentition
a. Marginal gingiva b. Attached gingiva c. Deciduous canine dentition
c. Sulcular gingiva d . Interdental papilla d. Permanent canine dentition
a. Enamel hypoplasia
b. Dentin dysplasia
c. Hypoplastic amelogenesis imperfecta
d. Hypomineralized amelogenesis imperfecta
19. Identify the condition shown in the colour plate. 22. Image defines which stage of tooth development?
Patient history record gives information that
patient suffered severe illness for which patient
underwent antibiotic therapy.
a. Cusp initiated
b. Cusp coalescence
c. Cusp outline complete
d. Cusp complete
Ans b. Cusp coalescence
166 TARGET MDS: Image Based Questions
a. 12 months b. 16 months
c. 20 months d. 24 months
Ans b. 16 months
27. Identify the tooth numbering system. a. The enamel rods at the cervix slope occlusally
instead of gingivally as in the permanent teeth
b. The enamel rods at the cervix slope gingivally
instead of occlusally as in the permanent teeth
c. The enamel rods at the cusp edge occlusally
instead of gingivally as in the permanent teeth
d. The enamel rods at the cusp edge gingivally
instead of occlusally as in the permanent teeth
Ans a. The enamel rods at the cervix slope occlusally
instead of gingivally as in the permanent teeth
a. Universal b. FDI 30. The image shows lingual aspect of the deciduous
c. Zsigmondy/Palmer d. WHO tooth. Identify the tooth.
Ans a. Universal
28. What is true for area marked with question mark
comparing deciduous to permanent dentition?
31. What is true for the image shown in the colour 33. The image shows mesial of the deciduous tooth.
plate? Identify the tooth.
a. 0–1% b. 30%
c. 60–65% d. 50%
Ans c. 60–65%
168 TARGET MDS: Image Based Questions
a. Haplodent
b. Triconodont
c. Tritubercular molar
d. Quadritubercular molar
Ans a. Haplodent a. Enamel hypoplasia
37. Identify the cusp form. b. Radiograph of dog teeth
c. Osteopetrosis
d. Osteoporosis
Ans b. Radiograph of dog teeth
a. Attached gingiva
b. Alveolar mucosa
c. Marginal gingiva
d. Mucogingival junction
Ans d. Mucogingival junction
a. Transseptal fibers
b. Interradicular fibers
c. Apical fibers
d. Alveolar crest fiber
Ans a. Transseptal fibers
170 TARGET MDS: Image Based Questions
49. Identify the periodontal group of fiber marked a. Curve of Spee b. Curve of Wilson
with arrow. c. Curve of Monsoon d. Curve of Williams
a. Transseptal fibers
b. Interradicular fibers
c. Apical fibers
d. Alveolar crest fiber
Ans b. Interradicular fibers
a. Maxillary central incisor
50. Identify the periodontal group of fiber marked b. Maxillary lateral incisor
with arrow. c. Mandibular central incisor
d. Mandibular lateral incisor
Ans b. Maxillary lateral incisor
54. Identify the tooth.
a. Transseptal fibers
b. Interradicular fibers
c. Apical fibers
d. Alveolar crest fiber
Ans d. Alveolar crest fiber
51. Identify the structure marked with arrow in the a. Mandibular canine
colour plate. b. Maxillary lateral incisor
c. Mandibular central incisor
d. Mandibular lateral incisor
Ans a. Mandibular canine
55. Identify the tooth.
a. Mandibular canine
b. Mandibular first premolar
c. Mandibular second premolar
d. Mandibular lateral incisor
Ans b. Mandibular first premolar
Dental Anatomy 171
a. Mandibular canine
b. Mandibular first premolar
c. Mandibular second premolar
d. Mandibular lateral incisor
Ans b. Mandibular first premolar
57. Identify structure marked in the image. a. Orbicularis occuli b. Orbicularis oris
c. Zygomaticus major d. Buccinator
Ans b. orbicularis oris
63. Identify the structure marked with arrow. 66. Identify the structure marked with arrow.
69. Identify the structure marked with arrow. 72. Identify the structure marked with arrow.
a. Mental foramen
b. Inferior alveolar canal
c. Coronoid process
d. Condyle
Ans b. Inferior alveolar canal
77. Identify the structure marked with arrow. a. Styloid process b. Hyoid bone
c. Mallus d. Inca
Ans b. Hyoid bone
82. Identify the structure marked with arrow. 85. Identify the structure marked with arrow.
a. Incisal third
b. Junction of incisal and middle third
a. IAN canal foramen c. Middle third
b. Lingula d. Middle of middle third
c. Sigmoid notch Ans a. Incisal third. Since the mesioincisal third of maxil-
d. Internal oblique ridge lary central incisor approaches a right angle, incisal
embrasure is very slight
Ans c. Sigmoid notch
87. Identify the structure marked with arrow.
84. Identify the structure marked with arrow.
88. Identify the structure marked with arrow. 91. Identify the structure marked with arrow.
a. Nasal septum
b. Crestal plate
c. Floor of maxillary sinus
d. Inverted Y of ennis
a. Nasal septum
b. Median palatal suture
c. Floor of maxillary sinus
a. Accessory canal d. Inverted Y of ennis
b. Lamina dura Ans c. Floor of maxillary sinus
c. Median maxillary suture
d. Incisive foramen 100. Identify the structure marked with arrow.
Ans d. Incisive foramen
a. Nasal septum
a. Nasal septum
b. Median palatal suture b. Median palatal suture
c. Floor of maxillary sinus c. Floor of maxillary sinus
d. Inverted Y of ennis d. Inverted Y of ennis
Ans a. Nasal septum Ans d. Inverted Y of ennis
C h a pte r 11
1-
j
O
Dental Materials a>
LU
03
HHBHB
1 . The image shows which type of enamel etching? 3. Image shows which procedure being performed?
a. Etching b. Priming
a. Type 1 c. Bonding d. Curing
b. Type 2 Ans a. Etching
c. Type 3
d. Type 4 4. Image shows which form of deformation?
Ans a . Type -1
( Preferential prism core etching)
Ans a. Torsion 03
CD
a. Type 1
b. Type 2
c. Type 3
V* CO
d. Type 4 a. Torsion b. Shear
c. Compression d. Bending
Ans b. Type 2
( Preferential prism periphery etching) Ans b. Shear
Dental Materials 179
a. Plastic deformation
b. Elastic deformation
c. Necking
d. Fracture
Ans a. Plastic deformation
a. Bioreactor
b. Needle disposer
c. Amalgamator
d. Vaccume former
Ans b. Needle disposer
a. Plastic deformation
b. Elastic deformation
c. Necking
d. Fracture
Ans a. Plastic deformation
12. Identify the instrument.
Ans a. Bioreactor
13. Identify the instrument.
Ans c. Amalgamator
14. Identify the instrument.
Ans b. Slot
36. Identify the component of bracket.
a. Edgewise b. Begg
c. Ribbon arch d. Combined
Ans a. Edgewise
33. Identify the bracket type. a. Wing b. Slot
c. Buccal tube d. Lock pin
Ans c. Buccal tube
a. Edgewise b. Begg
c. Ribbon arch d. Combined
a. Wing b. Slot
c. Buccal tube d. Lock pin
Ans d. Lock pin
a. Wing b. Slot
c. Buccal tube d. Lock pin
Ans a. Wing
a. Wing b. Slot
c. Archwire d. Lock pin
Ans c. Archwire
184 TARGET MDS: Image Based Questions
Ans a. Beading
Ans b. Boxing
42. Which procedure is being performed in the image? Ans b. Paint scraper
a. Automatrix band
b. S-shaped Matrix band
c. T Bands
d. Mylar strip
Ans a. Automatrix band
a. Sectional matrix system b. Ring matrix
56. Identify the instrument. c. Garrison matrix d. Sectional matrix
a. Automatrix band
b. S-shaped Matrix band
c. T Bands
a. Sectional matrix system b. Ring matrix
d. Mylar strip
c. Garrison matrix d. Sectional matrix
Ans b. S Separators
Ans b. Ring matrix
57. Identify the instrument.
61. Identify matrix system.
Ans d. Vibrator
67. Identify the equipment/method.
Ans c. Tensilometer
188 TARGET MDS: Image Based Questions
Ans a. Crown
a. Subperiosteal b. Endosseous
c. Transosseous d. Mini implant
Ans a. Subperiosteal
Ans b. Abutment
a. Subperiosteal b. Endosseous
c. Transosseous d. Mini implant
Ans b. Endosseous
a. Crown b. Abutment
c. Implant post d. Abutment Screw
a. Crown
b. Abutment
c. Implant post
d. Abutment screw
Ans d. Abutment screw
190 TARGET MDS: Image Based Questions
a. Autograft b. Allograft
c. Xenograft d. Alloplast
Ans a. Autograft
a. Single use only b. MR safe
84. Identify the type of grafting material.
c. Conditionally MR safe d. MR unsafe
Ans b. MR safe
a. Autograft b. Allograft
c. Xenograft d. Alloplast
a. Single use only b. MR safe
Ans b. Allograft c. Conditionally MR safe d. MR unsafe
85. Identify the type of grafting material. Ans c. Conditionally MR safe
a. Casting ring
a. Ringless casting system b. Crucible
b. Vaccum former c. Sprue
c. Crucible former d. Ring liner
d. Ring casting system
Ans b. Crucible
1-
MCQs from Recent o
AIIMS/ AIPG/NBDE Papers a>
LU
03
HHBHB
1. What type of angle is the nasolabial angle as shown 3. Identify the anomaly in figure? ARMS May 2016
in the given picture? AIIMS May 2016
^
a. Gemination
b. Fusion
c. Concrescence
a. Acute b. Obtuse d. Supernumerary teeth
c. Normal d. Ideal Ans b. Fusion
Ans a. Acute
4. This molar relation of primary dentition will never
2. A 7-month pregnant lady comes to your clinic with convert into which of the following in permanent
CD
.
the following lesions all over the body Which of dentition? ARMS May 2016
these drugs is the appropriate treatment ? LU
ARMS May Medical 2015
03
CD
a. Class I
CO
b. Class III
a. Methotrexate b. Retinoids c. Class II
c. Azathioprime d. Cyclosporine d. End -to-end relation
Ans d. Cyclosporine Ans b. Class III
194 TARGET MDS: Image Based Questions
a. BB b. BT
c. LL d. BL
Ans a. BB a. Esmarch’s b. Gap arthroplasty
c. Champy’s d. Ilizarov’s
6. In cleidocranial dysplasia, there is impaired sutu-
Ans d. Ilizarov’s
red growth of maxilla leading to retrognathic maxi
lla and normal mandible. All are true except: 9. What is this used for? AIIMS Nov 2015
AIIMS Nov 2015
a. Osteotomy
b. Sequestrectomy
c. Removing maxillary root fragments
d. Maxillary disimpaction
a. CFBA1 mutation
Ans b. > a. Sequestrectomy > a. Osteotomy
b. Prognostic maxilla and retrognathia mandible
c. Crowding of teeth 10. This instrument is used for: AIIMS Nov 2015
d. Hypertelorism
Ans b. Prognostic maxilla and retrognathia mandible
> c. Crowding of teeth
a. TMJ ankylosis
b. Condylar #
c. Normal TMJ morphology
d. TMJ osteoarthritis
Ans a. TMJ ankylosis a. 1 b. 2
c. 3 d. 4
13. A 60-year-old petient came with h/o itchy tense Ans b. 2
blisters whose roof settled as above. Diagnosis is:
AIIMS May Medical 2015 16. A 9-year-old girl underwent a surgery with cos-
tochondral grafting at mandibular condyle. He
reported to clinic after 4 months as seen in the pho-
tograph. Probable cause for this: AIIMS May 2016
17. A 9-year-old boy with complicated crown fracture 20. Identify the procedure: AIIMS May 2016
with abscess formation in 12. EPT is negative for
11, 12 and 21. What would be the management of
patient? AIIMS May 2016
a. Activator b. Bionator
c. Functional regulator d. Twin block
Ans b. Bionator
a. MBT b. Dynamometer
c. Boon’s gauge d. Dontrix gauze
Ans a. MBT
198 TARGET MDS: Image Based Questions
a. Rapidly progressive
b. Severe early childhood caries a. Osteoma
c. Nursing bottle caries b. Odontoma
d. Juvenile caries c. Fibrous dysplasia
Ans b. Severe early childhood caries d. Dentigerous cyst
Ans b. Odontoma
32. A CT scan of a patient with swelling in left angle
of ramus shows a bony growth that is painless and 35. Following instrument used for advancement of
present on the lateral surface of ramus indicates: maxilla is also known as: AIPG Dec 2015
AIPG Dec 2015
a. Distraction osteogenesis 40. Following appliance is used for: AIPG Dec 2015
b. Obstructive sleep apnea
c. Neck stabilization appliance
d. Retrognathia
Ans a. Distraction osteogenesis
a. Hypophosphatemia b. Fluorosis 41. The below patient is affected with: AIPG Dec 2015
c. Chickenpox d. Paget’s disease
Ans b. Fluorosis
a. Down’s syndrome
b. Treacher Collins
c. Pierre Robin
d. Angelman syndrome
a. Southend b. Schwarz
c. Crozats d. Delta clasp Ans b. Treacher Collins
Ans c. Crozats 42. In the following mixed dentition analysis, distal
surface of both 2nd molar of primary teeth shows:
39. A diagrammatic question. Best approach of inci-
AIPG Dec 2015
sion for subcondylar fracture correction is:
AIPG Dec 2015
43. Which procedure is shown in this figure? 46. Histology image of lymphatic tissue. Identify:
AIPG Dec 2015 AIIMS May Medical 2016
a. Anterior interosseous
a. Lymphoid b. Posterior interosseous
b. Brain and neck and neural c. Median
c. General
d. Ulnar
d. Reproductive
Ans d. Ulnar
Ans b. Brain and neck and neural
45. Identify the organism in the image given below: 48. Identify the appliance: AIIMS May 2015
AIIMS May Medical 2015
49. A 5-year-old child showing evidence of juxta-artic- 52. Identify the suturing technique: AIIMS May 2015
ular bone deposition, if subjected to trauma to the
TMJ, is to be treated with maintaining adequate
ramal length and full mouth opening. What should
be the treatment plan? AIIMS May 2015
a. Lymphoid
b. Brain and neck and neural
c. General
a. Titanium surgical insert
d. Reproductive
b. Sinus lift insert
Ans b. Brain and neck and neural
c. Piezoelectric osteotomy insert
d. Periapical surgical osteotome 54. The following OPG shows fracture parasymphysis
Ans c. Piezoelectric osteotomy insert in a 50-year-old man. What will be your treatment
plan? AIIMS May 2015
51. Auxillary wire used in fixed mechanotherapy:
AIIMS May 2015
55. A patient comes to your clinic with the following 58. Identify insula in the transverse section of brain:
OPG after road traffic accident. What will be your AIIMS May Medical 2016
treatment? AIIMS May 2015
a. A b. B
a. 2 plate anterior, 1 plate posterior c. C d. D
b. 1 plate anterior, 2 plate posterior Ans c. C
c. 1 plate anterior, 1 plate posterior
59. Identify the type of gland:
d. IMF
AIIMS May Medical 2016
Ans a. 2 plate anterior, 1 plate posterior
a. Apocrine b. Endocrine
c. Holocrine d. Merocrine
Ans c. Holocrine
a. Wedge b. Lever 3
c. Lever 1 d. Wheel and axle 60. The given histology of the cartilage is found in which
of the following areas of human body?
Ans d. Wheel and axle
AIIMS May Medical 2016
57. Expansion appliance is made of: AIIMS May 2015
a. Epiphyseal plate
a. NiTi b. NiCr b. Ear pinna
c. NiAl d. NiCo c. Articular discs
Ans a. NiTi d. Intervertebral discs
Ans a. Epiphyseal plate (Growth plate)
MCQs from Recent AIIMS/AIPG/NBDE Papers 203
61. The rate of diffusion of a substance is plotted against Ans a. First order bend
concentration gradient in the following graph. The For Color diagram, refer to : Color palate, Diagram Number: 1
substance is: AIIMS May Medical 2016
64. Comminuted fracture in symphyseal area. Manage-
ment. AIPG Dec 2015
a. Load-bearing plate
a. O2 b. Na+ b. Load-sharing
c. CO2 d. Glucose c. Semi-rigid fixation
Ans d. Glucose d. IMF with open reduction
62. Which of the following cells secretes HCl? Ans a. Load-bearing plate
AIIMS May Medical 2016
65. There are two pictures shown below. According to
Ackerman classification of normal spontaneous
smile or posed smile, which is true: AIPG Dec 2015
a. Sp 1 is posed smile
b. Sp 2 is posed smile
a. A b. B
c. Both are posed smiles
c. C d. D
d. Both are spontaneous smiles
Ans a. A
Ans a. Sp 1 is posed smile
63. In given orthodontic model, a wire is shown adapted
over the teeth. It shows which order of bends? 66. A young girl came to the hospital with severe swell-
AIPG Dec 2015 ing and redness on all affected areas. On intraoral
examination, 24 was severely infected with signs
of acute alveolar abscess. Cellulitis occurs in this
patient most probably due to which space infection?
AIPG Dec 2015
a. Osteoma b. Odontoma
c. Fibrous dysplasia d. Dentigerous cyst
Ans b. Odontoma
72. Which of the following data is missing in given com- a. Anterior communicating branch
mon risk factor approach diagram? b. Vertebral artery
AIIMS SRSHIP Community Dentistry July 2016 c. Posterior communicating branch
d. Basilar artery
Ans c. Posterior communicating branch
75. A radiograph is shown below. This type of root mor-
phology has the highest incidence in which popula-
tion? AIIMS SRSHIP Endodontic July 2016 Paper
a. Apexogenesis
b. Revascularization
c. Calcium hydroxide apexification
d. MTA barrier formation
Ans b. Revascularization >> D. MTA barrier formation
Directly lifted from AIIMS research article.
VT
1.
j
o
Miscellaneous Questions CD
LU
TO
1 . For what purpose is the following used? 3. What are the splayed lines, which are being shown
in the following CBCT?
a. Intermaxillary fixation
b. LeFort 1 osteotomy a. Poor resolution Poor contrast
c. Genioplasty c. Subtraction radiography d. Metal artifact
d. None of the above Ans d. Metal artifact
Ans b. Lefort 1 osteotomy CBCT is cheaper than the CT, but the resolution and con -
It is a thermodrape L- plate, which is used in the ortho - trast of CT is better than CBCT Metal artifact is its one of
gnathic surgeries, as in lefort osteotomy. the other shortcomings. The radiation exposure of CT is
Ref : Textbook of Oral and Maxillofacial Surgery by 2000 pSv and that of CBCT is 20-314 pSv.
Neelima Anil Malik Ref: Oral radiology, 7th edition: White and Pharoah CD
2. What is the radiographic technique being shown in 4. When is the following removed in the case of uni -
the following color plate? lateral mandibular body fracture in a 50-year- old
TO
patient?
CD
a. Computed tomography CO
b. Cone beam computed tomography a. 1- 2 weeks 2-3 weeks
c. 'a' and ' b c. 3- 4 weeks d. 4-6 weeks
d. PSP Ans c. 3- 4 weeks
Ans c. la and ' b' Normally immobilization is done for 2- 3 weeks. For chil-
It can be CT or CBCT because both look the same. dren 1 week is subtracted. While in cases of 40 years and
Ref : Oral radiology, 7th edition: White and Pharoah above patients, 1 week is added.
Miscellaneous Questions 207
Ref: Textbook of Oral and Maxillofacial Surgery by cells. This view is also known as the occipitomental view
Neelima Anil Malik or the PA axial view.
Ref: Oral radiology, 7th edition: White and Pharoah
5. A 6-year-old female came with lesion as seen in the
color plate. Patient had a fall 4-5 hours ago, having 7. At what angle the X-Ray beam is made to strike at
an impact with the ground. Mild swelling is seen the canthomeatal line in the below given radio-
under the chin. Radiograph is being shown in the graphic view?
color plate. No step is being found on palpation at
the lower border of the mandible. Even the occlu-
sion is normal. What will be the treatment?
a. 10° b. 20°
c. –10° d. –20°
a. Open reduction with mini plate and immobili-
Ans a. 10°
zation and soft diet
Ref: Oral radiology, 7th edition: White and Pharoah
b. Immobilization for 6 weeks and soft diet
c. Soft diet and patient under observation 8. Identify the immobilization technique in the color
d. Open reduction with dynamic plates and soft plate.
diet
Ans c. Soft diet and patient under observation
As seen in the radiograph, the fracture is not complete.
Moreover, there is no step formation, or the fracture is
undisplaced. So, there is no need to immobilize the max-
illa and mandible or any open reduction. Patient is given
antibiotics, analgesics and asked to be on soft diet as well a. Ivy loops b. Essig wire
as under observation. c. Bridal wire d. Erich arch bar
Ref: Textbook of Oral and Maxillofacial Surgery by Ans a. Ivy loops
Neelima Anil Malik Ref: Textbook of Oral and Maxillofacial Surgery by
Neelima Anil Malik
6. What view of radiograph is the following?
9. Identify the article shown in the color plate.
10. Identify the crown in the color plate. 13. The category of waste collected in the bag shown
below:
a. Type I b. Type II
c. Type III d. Type IV
Ans c. Type III
a. Kazanjian Button
b. Ivy loop
c. Risdon
d. Gilmer
Ans b. Ivy loop
a. Kazanjian Button
b. Ivy loop
c. Risdon
d. Gilmer
Ans d. Gilmer
a. IMF screws
b. Locking screws
c. Heavy duty bicortical screws
d. Lag screws
Ans a. IMF screws
210 TARGET MDS: Image Based Questions
a. Chance b. Division
c. Parents d. Staff
Ans a. Chance
a. Word bank b. WHO 34. In the palsy the muscle which is paralyzed is.
c. UNICEF d. UNDP
Ans b. WHO
a. 1948
b. 1971
a. Sialendoscope c. 1986
b. Duct opening dilator d. 1996
c. Lithotripsy handpiece
Ans c. 1986
d. Sialolith retractor
Ans a. Sialendoscope 36. What kind of illusion will shifting the height of con-
tour more gingivally create in the appearance of the
33. Name the isolation shown in the Figure. tooth?
a. Lengthening
b. Shortening
c. Narrowing
a. Optradam b. Instidam d. Widening
c. Handidam d. Liquidam Ans a. Lengthening.
Ans c. Handidam Indirect - Repeat from AIIMS SRSHIP PAPERS.
212 TARGET MDS: Image Based Questions
37. Identify this instrument. 40. A. If no root or bone resorption is evident, prepara-
tion should terminate 1.0 mm from the apical fora-
men. B. If bone resorption is apparent but there is
no root resorption, shorten the length by 1.5 mm.
C. If both root and bone resorption are apparent,
shorten the length by 2.0 mm. This recommenda-
tion was given by:
a. Pink
b. Grey a. Lingua nigra
c. Purple b. Benign migratory glossitis
d. Teal c. Fissured tongue
Ans c. Purple d. Median rhomboid glossitis
• No. 6 is pink Ans a. Lingua nigra
• No. 8 is grey
42. Identify the image.
• No.10 is purple
by measuring from the midline (incisors) to the angle of 46. The following rubber dam clamp is used for:
the jaw. Adult sizes are 90–110 mm in length (size 3-5).
In adults the airway is inserted upside-down (convexity
downwards) until the soft palate is reached and it is then
rotated 180 degrees and advanced into place.
49. The below image represents: 50. Identify the instrument/device shown in photograph?