ORAL PHYSIOLOGY

RESPIRATION (M1)
RESPIRATION
- exchange of gases between air and environment

2 TYPES OF ENVIRONMENT
1. EXTERNAL- exchange of gases between air in lungs and environment.
2. INTERNAL- exchange of gases between air in the alveoli and in blood circulation

2 PARTS INVOLVED IN RESPIRATION

1. CONDUCTING SYSTEM- nose, pharynx & larynx
2. TRUE RESPIRATORY- trachea, bronchi, bronchioles, alveoli, alveolar sac, & alveolar
duct

3 ANATOMICAL STRUCTURES INVOLVED IN R.S.

1. THORAX
2. ABDOMEN
3. MAXILLOFACIAL STRUCTURES

THESE ANATOMICAL STRUCTURES PROVIDE FUNCTIONS:

1. Provides portal of entry of air to and from the lungs
2. Preserves physical properties of inspired air for the protection of the sensitive.

STRUCTURES RESPONSIBLE FOR MAINTENANCE OF AIRWAYS TO PROTECT THE

LUNGS
1. Larynx
2. Pharynx
3. Nasal Structures

CHARACTERISTICS OF NORMAL RESPIRATION

● Should have normal seal
● Should have normal contact of upper & lower lip
● Should have normal atmospheric pressure
● Space of donders are established
● TMJ is in normal relationship
● Should have physiologic rest position of mandible
● Should have normal muscular pressure
● Should have normal relationship of dento-maxilla to facilitate
● Should have antero-postero relationship of maxillary and mandibular
● Centric occlusion is established

CHARACTERISTIC OF ABNORMAL RESPIRATION

● Absence of normal oral seal
● Muscles of the face are stretched beyond their normal limit
 ● Mandibular thrusting

Tongue thrust​ - (also called reverse swallow or immature swallow)

FACTORS INFLUENCING CONTROL OF RESPIRATION

1. NEUROGENIC CONTROL - administration of drugs (during surgery “anesthesia”)
2. MECHANICAL ASPECT - normal things, exchange of gases between thoracic cavity &
abdomen
3. CHEMICAL REGULATION - regulates breathing in relation with H-ion concentration to
arterial blood & CO2 retention

2 PHASES OF RESPIRATION
1. INSPIRATION- there is a change in the volume of the thoracic cavity, increase in size &
shape, diaphragm involved in respiration. CONCAVE in shape, it descends downward
compressing the abdominal viscera that become CONVEX.
2. EXPIRATION- due to elasticity where in muscle are relax, diaphragm will go to its
normal shape and decreased in diameter of M that will allow the passage of air.

PROTECTIVE REFLEXES IN RESPIRATION

1. SNEEZING
2. COUGHING

MOUTH BREATHER​ - emergency organ for respiration due to:

1. Severe cold
2. Asthma attack
3. Nasal polyps - (NP) represent inflammatory masses that originate in the paranasal
sinuses of patients with CRS and evaginate into the nasal airway.

● There is dryness of the mouth that will cause ​HALITOSIS

● There is massive​ MALOCCLUSION
● Anterior teeth will become ​LABIO-VERTED​ (more labially oriented)

ARTIFICIAL RESPIRATION
1. Mouth-to-mouth resuscitation
2. Mouth-to-nose resuscitation

\
DEGLUTITION=SWALLOWING

PT. OF DIFFERENTIATION MASTICATION DEGLUTITION

Organ involved Teeth Esophagus

Teeth Relationship Centric, Eccentric Centric

Nervous Control Voluntary Involuntary, Voluntary

Nervous involved T-I-M-E ms Intrinsic tongue muscle

Muscles of Occurence Only with presence of food Continuous & well

coordinator

Position of Mandible Functional, Symmetrical, Centric , Symmetrical

Asymmetrical

Nature of Action Acquired and Learned Inborn

Influence of Growth Less powerful & influential More powerful & influential

Frequency of Action Only with presence of food Frequent

End product Bolus Bolus Ingesta

SPEECH AND SOUND

● Biological function of the maxilla-facial structure
● Also learned function associated with hearing and vision
● Does not only involve respiration but also:
1. Some nerves or specific nerves in cerebral cortex
2. Respiratory centers of the brain
3. Articulators and resonance structures of mouth and nasal cavities

COMPONENTS OF THE PRODUCTION OF SOUNDS AND SPEECH

1. RESPIRATION​ - In normal speech, the respiratory apparatus especially during
exhalation provides a continuous stream of air with sufficient volume and pressure to
produce phonation
- The air being modified as it passes through the lungs by the facial and oral
structure resulting to sound symbol.
2. PHONATION ​- production of sounds with the help of LARYNX (voice box) which act as
a vibrator and vibrating elements is the VOCAL CORDS. This cords can be stretched,
modifies the air with different degree of tension and space to produce sound.
3. RESONANCE​ - it is the resonators that give characteristics qualities to the voice.
● PHARYNX -
● AIR SINUSES
 ● Nasal Cavities
● Chest walls
4. ARTICULATORS - these are arranged opposite to each other
● Upper and lower lip
● Upper and lower teeth in conjunction with the root the mouth
● Dorsum of the tip of the tongue with the palate
● Tip of the tongue with the lingual surfaces of the teeth.
● Tip of the tongue with the alveolar ridges
● Uvula and lymphoid tissue
● Marginal ridges of upper and lower teeth
5. NEUROGENIC FACTORS - production of sounds are coordinated by CNS

CEREBRUM ​- center for speech

SPEECH PRODUCTION CONFLICT WITH REFLEX ACTION LIKE:

1. During ​HICCUPS
2. When ​COUGHING
3. During ​SNEEZING
4. In ​REGURITATION

T​HE NORMAL PRODUCTION OF SOUNDS AND SPEECH DEPEND UPON:

1. Normal growth and development of dento-cranial structures
2. CNS coordinates with certain activities like Stomatognathic system, respiratory system,
circulatory system and neuromuscular function
- Any failure of these organs/ system will result to defective speech

ORGANS WHICH AFFECT SPEECH DUE TO THE PRESENCE OF ABNORMALITY

1. LARYNX
2. PARANASAL SINUSES
3. TEETH

CLASSIFICATION OF CONSONANTS
1. ACCORDING TO ABSENCE OR PRESENCE OF VOICE
● B C D J V Z TH ZH
● Are voiceless:​ Sh Ch K Pc

2. ACCORDING TO ORGAN INVOLVED

A. LIP CONSONANT/ LABIAL
● B M P W HW
B. LIP- TEETH CONSONANTS (LABIO-DENTAL)
● F V
C. TONGUE- PALATE
● J
D. TONGUE BLADE AND GUM RIDGE CONSONANT
 ● S SH Z ZH
E. TONGUE- TEETH/ LINGUO DENTAL
● TH
F. GLUTTARAL CONSONANTS / TONGUE ELEMENTS
● E G NG

3. ACCORDING TO MANNER OF PRODUCTION

A. PLOSIVES - complete blockade with sudden explosive escape of breath
● PETDBG
B. NASALS - breath through the nose
● M N NG
C. SIBILANTS - produced without stopping breath stream
● S SH Z ZH
D. GLIDES or ROLL
● W WH Y R
E. VOWEL like
● D R M N NG
F. FRICATIVES-FRICTION SOUND PRODUCE
● V P PH S SH

DISORDERS AND ABNORMALITIES IN PRODUCTION OF SPEECH

1. Occlusion is involved
2. Cleft Palate
● Harelip/ Cleft lip - ​CHEILOSCHISIS
● Cleft palate
- URANOCHISIS​ - HARD PALATE
- STAPHYLOCHISIS​ - SOFT PALATE
- URANOSTAPHYLOCHISIS​ - SOFT AND HARD PALATE
- CHEILOSURANOSTAPHYLOCHISIS​ - LIP, HARD AND SOFT PALATE
● Protrusion of maxilla
● Protrusion of Mandible
● Anterior open bite
● Cleft Lip
● Missing Teeth

Cerebrum not functioning due to accident

​CAUSES OF PHONATION PROBLEMS

1. Abnormality in pharynx
2. Inflammation

CAUSES OF DEFECTS OF ARTICULATION

1. Dental in origin missing teeth

2. Cleft palate and cleft lip
 3. Size of the tongue

Macroglossia​- large tongue

Microglossia​- small tongue

4. Occlusion
5. Maxillary and mandibular protrusion

CAUSES OF DEFECTS OF LINGUISTIC FUNCTIONING

● There is utilization of verbal factors in thoughts of facts and expression of thoughts by

verbalization
1. Damage of the cerebrum due to trauma
2. Cardiovascular accidents
3. DIARTHROSIS​- paralysis
4. ANOMIA​- difficulty of recalling names esp. those common objects
5. DYSLEXIA​- difficulty of reading aloud
6. DYSGRAPHIA​- difficulty to write

CAUSES OF DEFECTS OF AUDITION

1. Deafness
2. Otitis media

DENTAL ABNORMALITIES IN SPEECH DISORDERS

1. Missing teeth- due to congenitally missing or extraction

● Linguo-dental consonants are affected
2. Malocclusion- Lip-Teeth- consonants are affected
3. Malposition of Teeth
4. Abnormal size of the tongue
5. Inflammation of the oral cavity
● Tonsillitis
● Pharyngitis
6. Artificial teeth
A. III fitting denture
B. Failure to establish space of donders
PRELIM

ORAL PHYSIOLOGY
What is STOMATOGNATHIC SYSTEM?

o ​Also known as Human Masticatory Apparatus

o ​These are parts of the body that involves different processes.

ORAL PHYSIOLOGY

o ​Is the study of physiologic function of stomatognatic system of man.

o ​Includes the process of mastication, deglutition, respiration and other functions associated with
posture and gait ​(walking & sitting)

3 MAJOR FUNCTIONS

1. ​NUTRITIONAL – mastication

2. ​INTELLECTUAL – sound and speech

3. ​EMOTIONAL – facial expressions

2 MINOR FUNCTIONS (animals)

1. ​PROTECTION

2. ​HOLDING & GRASPING

FACTORS IN FORMING HMA

1. ​OSSEUS – bones

2. ​MUSCULAR – muscles

➢ ​2.1 MUSCLES OF MASTICATION

o ​Temporalis

o ​Internal Pterygoid/ Medial pterygoid

o ​Masseter

o ​External Pterygoid/ Lateral Pterygoid muscle

➢ ​2.2 PERIORAL MUSCLES

o ​Glossus muscle – attached to the tongue

➢ ​2.3 MUSCLES OF EXPRESSION

o ​Orbicularis oris – “kissing muscle”

3. ​MUCOSA

- ​Lines the oral cavity

 ➢ ​3 TYPES OF MUCOSA

i. ​Lining (Alveolar Mucosa, Cheek, Soft palate) – loosely attached to the bone.

ii. ​Specialized (Tongue) – keratinized & non-keratinized.

iii. ​Masticatory (Attached gingiva, Hard palate) – firmly attached to the bone.

4. ​DENTAL TISSUES

- ​Maxillary and mandibular

5. ​ORAL FLUIDS

- ​Saliva contains salivary amylase or also known as “Ptyalin”.

- ​Lymph is a fluid within the blood.

TOOTH BUD

- ​The first sign of enamel formation

- ​OEE, IEE

- ​Stratum intermedium is located between OEE and IEE

- ​Stellate reticulum is a star shaped cell

PHYSIOLOGIC STAGES OF TOOTH FORMATION

o ​C​alcification – hardening of the teeth

o ​E​ruption

o ​R​esorption

o ​E​xfoliation or shedding

o ​R​eplacement

NOLLA’S STAGES OF CALCIFICATION

0 – absence of bony crypt

1 – presence of bony crypt

2 – initial calcification
3 – 1/3 crown calcified

4 – 2/3 crown calcified

5 – crown almost complete
6 – crown completed

7 – 1/3 root calcifies

8 – 2/3 calcified root

9 – root almost completed with open apex

10 – root completed

4 FACTORS OF CALCIFICATION

1. ​Genes/ hereditary

2. ​Environmental condition

3. ​Nutrition/ diet

4. ​Endocrine disturbance – Parathyroid hormone (growth hormone)

ERUPTION

- ​Is a series of gradual movement of tooth incisally or occlusally until it reaches its antagonistic.

2 TYPES:

1. ​ACTIVE – actual movement of tooth incisally and occlusally.

2. ​PASSIVE – gradual exposure of tooth due to recession of gingiva.

4 STAGES OF ERUPTION

1. ​PRE-ERUPTIVE – presence of bony crypts

2. ​ERUPTIVE – presence of tooth bud but still embedded in gingiva

3. ​INTRAORAL – presence of tooth inside the oral cavity

4. ​OCCLUSAL - antagonistic effect; upper and lower comes in contact.

5 FACTORS THAT INFLUENCE ERUPTION

1. ​Genes/ Hereditary

2. ​Environmental

3. ​Nutrition

4. ​Gen. physical condition of individual

5. ​Physiological activity of stomatognathic system

CAUSE OF DENTAL CARIES

1. ​Host (tooth)

2. ​Time

3. ​Carbohydrates

4. ​Microorganism (Streptococcus mutans)

DEGREE OF CALCIFICATION OF DENTAL TISSUES

o ​ENAMEL – 96% to 98% inorganic substance

o ​DENTIN – 75% to 85% inorganic substance

o ​CEMENTUM – 45% to 55% inorganic substance

o ​PULP – 0% inorganic substance

2 FACTORS RELEVANT TO ERUPTION

1. ​NORMAL PERIOD OF ERUPTION – actual time by which tooth emerge in the oral cavity.

2. ​NORMAL SEQUENCE OF ERUPTION – usual order by which the teeth emerge in oral cavity.

​NORMAL PERIOD OF ERUPTION

o ​PRIMARY/ DECIDUOUS

o ​PERMANENT

NORMAL SEQUENCE OF ERUPTION

*FIRST PERMANENT MOLAR – first to be extracted tooth

RESORPTION

- ​Occurs on the roots of deciduous teeth only

- ​2-4 years of age after root has been completed

- ​Age 6 root resorption stops due to the eruption of 1​st permanent molar ​(No resorption during 6
years old)

- ​ACCESSIONAL (1M,2M,3M) – do not replace any of the deciduous teeth

- ​SUCCEDANOUS (CI to 2PM) – those permanent teeth that replace deciduous teeth.

*ROOT CANAL TREATMENT – adults

* PULPECTOMY/ PULPOTOMY – RCT on babies

WHEN TO EXTRACT?

o ​Pathological condition

o ​Infection

o ​No way to save the tooth; Trauma, Fractured, Below the limit of restoration

EXFOLIATION OR SHEDDING

- ​Physiologic elimination of deciduous teeth prior to their replacement of permanent teeth

- ​“Early extraction will delay eruption” unless gingivae is affected.

REPLACEMENT

- ​Eruption of permanent teeth

4 STAGE OF OCCLUSAL PERIOD

1. ​PRE- DENTITIONAL PERIOD – from time of conception up to 5 months after birth

o ​Presence of gum pad

 ➢ ​Gum pad – gingiva of baby

➢ ​Gingiva – presence of teeth

➢ ​Edentulous alveolar ridge – portion of the residual bone and soft tissue covering that
remains after the removal of teeth; gingiva of adult with no teeth

o ​Presence of inter-occlusal spaces or gap

o ​Presence of 24 developmental tooth bud

o ​Rapid growth, maxillary and mandibular bone in order to accommodate erupting deciduous teeth.

2. ​DECIDUOUS – DENTITIONAL

DECIDUOUS DENTITION

CHARACTERISTICS

o ​*Guides permanent teeth as it erupts*

o ​Generalized spacing - for Normal Dentition

o ​Flush terminal plane – imaginary line found on distal surface of permanent 2​nd​molar

Importance:

➢ ​Guide for occlusion/ molar relationship

• ​CLASS I – CUSP TO FOSSA RELATIONSHIP

• ​CLASS II – DISTAL STEP (backward jaw)

• ​CLASS III – MESIAL STEP (forward jaw)

o ​Presence of primate space

➢ ​Maxillary – space between Distal of Lateral Incisor and Mesial of Canine

➢ ​Mandibular - space between Distal of Canine and Mesial of lower 1st Molar

o ​Correlation of Maxilla and Mandible teeth in relation to occlusion – Mandibular space between
Distal surface of Canine & Mesial of 1​st​ Molar – cusp to fossa

SIGNIFICANCE

o ​Guide the permanent teeth – generalized spacing of deciduous teeth is normal

o ​For masticatory action

o ​Malocclusion

3. ​MIXED/ TRANSITIONAL (6-14)

o ​Ugly duckling stage – Diastema in between CI

 o ​Distally flared root

o ​Permanent canine not yet erupted

o ​Normal overlapping of max. &man. incisors

o ​Further growth and development of max. & man. bone

o ​OVERBITE – overlapping vertically

o ​OVERJET – overlapping horizontally

4. ​PERMANENT DENTITION (15 – death)

o ​32 teeth

o ​Normal cusp to fossa relationship

o ​Normal triangular ridge into groove contact and cusp

o ​Normal surface to surface contact of lingual surface of maxilla in contact with facial over the
surface of mandibular incisors

o ​Normal triangular ridge into embrasure contact

*Maxillary canine falls on the embrasure of mandibular canine and 1​st​premolar

*If 1​st​ molar was removed, look for the canine to 1​st​ premolar relationship to know the case

FIRST MOLAR IMPORTANCE

o ​Key to normal occlusion

o ​First permanent tooth to erupt

o ​First permanent tooth to extract

o ​Largest and strongest tooth

o ​Occupies the strategic position in the oral cavity

FACIAL PROFILES

1. Straight profile

2. Concave profile

3. Convex profile

DIPHYODONT – 2 sets of dentition

TRANSPOSITION – change in position of teeth

NEONATAL TEETH – babies who were born with teeth

ANODONTIA – absence of teeth

IMPACTED TEETH – most common for 3​rd​ molars

SPINN BARKIET- THREAD LIKE PROJECTION OF SALIVA

SIALOLITHIASIS - BLOCKING OF SALIVARY DUCT DUE TO STONE SIALOLITH

XEROSTOMIA- DRYNESS OF MOUTH

GROWTH SITE

BODY OF MANDIBLE

ANGLE OF MANDIBLE

HEAD OF CONDYLE

ALVEOLAR PROCESS/ BONE

ADULT (RIGHT ANGLE)

CONDYLE HIGHER THAN CORONOID

CHILD( OBTUSE ANGLE)

CORONOID HIGHER THAN CONDYLE

3 IMPORTANT SUTURAL GROWTH SITE

1. ​FRONTO- MAXILLARY SUTURE

2. ​ZYGOMATIC- MAXILLARY SUTURE

3. ​PTERYGOPALATINE SUTURE

MANDIBULAR BONE

- MOVABLE PARTS

- FORMATION IS DUE TO BONE DEPOSITION

MAXILLARY BONE

-GIVE ARCHITECTURAL STRUCTURE OF THE FACE AND HEAD

-DIRECT COMMUNICATION IN THE BONE OF THE SKULL

GROWTH AND DEVELOPMENT COMES FROM SUTURE ( 2 UNION OF BONE)

3 THEORIES

1 SUTURAL DOMINANCE- ACCORDING TO SICHER, ACCORDING TO DEVELOPMENT OF SUTURE

2. ​CARTILAGE AND PERIOSTEUM - ACCORDING TO SCOTT

3. ​FUNCTIONAL MATRICES - ACCORDING TO MOSS

SALIVARY GLANDS

PAROTID GLANDS -STENSET’ DUCT (LARGEST)

SUBMANDIBULAR - WHARTON’S DUCT

SUBLINGUAL - BARTHOLIN’S DUCT

TONSIL (WALDEYER’S RING) - FOR IMMUNIZATION

PALATINE TONSIL (2)

PHARYNGEAL TONSILS / ADENOIDS

LINGUAL TONSILS

MINOR GLANDS

SEROUS GLANDS / ALBUMINOUS GLAND - FOUND IN PAROTID

MUCOUS GLAND - FOUND IN SUBLINGUAL (THICK & ROPEY)

MIXED SALIVARY GLAND - FOUND IN SUBMANDIBULAR & SUBMAXILLARY (SEROMINOUS)

4 PROTECTIVE FUNCTIONAL FORMS

1 .CONTACT POINT- MEETING POINT OF 2 TEETH AT THE SAME ARCH

2. ​INTERPROXIMAL SPACE- TRIANGULAR SPACE FOUND BELOW THE CONDUCT POINT

OCCUPIED BY INTERDENTAL PAPILLA

3. ​EMBRASSRE/ SPILLWAYS - Y-SHAPED STRUCTURE

4. ​CURVATURES - FOUND AT THE LINGUAL, BUCCAL, MESIAL, DISTAL SURFACE OF THE TOOTH
PRELIM EXAM

1. Saliva has the ability to flow. Its specific gravity is : ​1.002-1.004

2. The statements below are true about the stomatognathic system: ​D
a. Includes the diff. parts of the body for physiologic functions
b. Includes mastication with the help of saliva
c. Includes deglutition or swallowing, respiration and production of sound and
speech
d. All of the above.

3. Tooth 45 and 46 erupts at what age? A

a. 6-7 and 11-12 years old

b. 7-8 and 12-13 years old
c. 6-7 and 9-10 years old
d. 11- 12 and 10-12 years old

4. Which is lined by masticatory mucosa? ​CHEEK

5. Stomatognathic system of the body consists of the following, EXCEPT : D

a. Bones of oral structure

b. Maxillary and mandibular teeth
c. Saliva
d. None of the above

6. In a 6 yr.old child the following teeth are present: C

a. 12CDE
b. ABCDE
c. ABCDE6
d. 12CDE6

7. The following are characteristics of permanent dentition, EXCEPT: D

a. 32 teeth are present

b. 15 yrs. Up to death
c. Cusp to fossa molar relationship
d. Further growth and development of the maxillary and mandibular bone.

8. The protective functional form of teeth that protect the periodontium and prevent food
impaction, and is the meeting point between 2 teeth at the same arch is ​CONTACT AREA

9. Parotid salivary glands consist of what types of cells? ​ALBUMINOUS CELLS

10. Tooth 37 and 47 start root resorption at what age? ​10 -12 years old
11. ⅔ of the root calcify at what stage? ​4

12. The following are the growth site of the mandible EXCEPT: ​CONDYLAR PROCESS

13. Deciduous dentitional period is characterized by the following EXCEPT: ​6 months to 5 yrs
old.

14. Deciduous lateral incisor starts root resorption at the age of 7 years old and completes
resorption at the age of 10. Deciduous anine starts root resorption at the age of 9 years old and
completes resorption at the age 12. ​THE FIRST STATEMENT IS FALSE AND SECOND IS
TRUE.

15. The following are TRUE for transitional period, EXCEPT: ​TEMPORARY TEETH ONLY ARE
PRESENT

16. Important growth site of maxilla ​: FRONTOMAXILLARY SUTURE AND

PTERYGOPALATINE SUTURE

17. Mean pH of saliva is?​ 6.8 pH

18. Daily secretion of saliva is? ​1,500-2000cc

19. The following are statement are FALSE for mucous salivary gland EXCEPT:​ FOUND IN
THE SUBMANDIBULAR GLAND

20. Tonsils are for immunization and consists of the following structures . EXCEPT: TWO
LINGUAL TONSILS

21. Aptyalism is a term for? ​DECREASE SALIVARY FLOW

22. Bartholin’s duct is present in which gland? ​SUBLINGUAL GLAND

23. The following are true regarding para-oral tissues, EXCEPT: ​BECAUSE OF THE NORMAL
MUSCULAR PRESSURE, THERE IS GROWTH AND DEVELOPMENT OF DENTOALVEOLAR
BONE STRUCTURE AND JAW BONE.

24. Fungiform papillae perceive what taste?​ IT HAS NO TASTE BUDS

25. The following are factors which influences eruption EXCEPTION :​ GENES

26.the following are factors of calcification EXCEPT:​ EMOTIONAL CONDITIONAL

27. Eruption of mandibular 2nd deciduous molars: ​20 MONTHS

28. Roots of tooth 16 and 26 start resorption at what age? ​NONE

29. Predentional period is characterized by the following EXCEPT:

A. presence of maxillary and mandibular gum pad

B. Presence of inter occlusal space

C. rapid growth in the maxillary and mandibular in order to accommodate the incoming
permanent teeth

D. all of the above

30. Intra alveolar stage of eruption is characterized in which stage of calcification? ​STAGE 7

31. Maxillary primate space is present in:​ BETWEEN B AND C RIGHT AND LEFT

32. The child’s mandible id different from the adult mandible because: ​ CHILD CONDYLE IS
HIGHER THAN CORONOID

33. Ugly duckling stage is characterized by the following EXCEPT? ​DIASTEMA IN ALL TEETH

34. In active eruption there is actual movement of the tooth in the oral cavity. In passive eruption
there is gradual exposure of crown due to deposition of the gingiva. ​1st TRUE 2nd FALSE

35. Permanent dentition is characterized by the following EXCEPT: ​NORMAL SURFACE TO

SURFACE CONTACT OF LABIAL OF MAXILLARY INCISORS INTO LINGUAL OF
MANDIBULAR INCISORS

36. Growth and development of the cranial bone is by cartilage and periosteum was introduced
by: ​DR.SCOTT

37. Mandibular bone has the ability to grow by: ​BONE DEPOSITION
38. The following are factors influencing normal occlusion EXCEPT:

a. Normal TMJ
b. Normal cell function and ability
c. Normal muscular pressure with the atmospheric air inside
d. None of the above

39. Triangular spaces found above the contact area which is covered by the normal giingiva for
the protection of the periodontium is?
A. interdental groove

B. interproximal groove

C. a and b

D. none of the above

40. Tooth number 14 and 34 erupts at the age of? ​10-11 and 10-12 years
41. When the tooth becomes visible in the oral cavity but not touching its touching its opposing it
is in the stage of: ​INTRA ALVEOLAR STAGE

42. Physiological elimination of the deciduous teeth prior to their replacement by the permanent
is? ​EXTRACTION

43. The following factors that influence the secretion of saliva EXCEPT: ​GENES

44. The following are inorganic contents of the saliva EXCEPT:

a. Fluoride
b. Sodium
c. Potassium
d. None of the above

45..the following are TRUE regarding salivary glands EXCEPT:

a. Contains serous and mucous cells

b. Found in all minor salivary glands
c. Found in submandibular gland
d. None of the above

46. The human masticatory apparatus is involved in the following EXCEPT: ​ENVIRONMENTAL

47. Importance of permanent first molar are the following EXCEPT: ​ACCESSIONAL TEETH
WHICH REPLACE THE DECIDUOUS

48. The following are TRUE regarding resorption EXCEPT: ​OCCURS AT THE DECIDUOUS
AND PERMANENT TEETH

49. The following are functions of embrasures EXCEPT:​ ALLOWS UNIFORM DISTRIBUTION
OF BONE AROUND THE ROOT.

FINALS

POSTURE and GAIT

POSTURE ​- is the position of the body wherein the head is in upright position, it is associate
with the development of the trunk and appendicular skeleton.

- Occlusion is developed when head is in correct position.

- Centric Occlusion and Centric Relation is related to correct position.
CHARACTERISTICS OF NORMAL POSITION

1. Shoulder and Pelvis are eye level.

2. Feet in sagittal position.
3. Spinal column are straight.
4. Feet are in position wherein the median line divides the body.
5. Feet flat on the floor, and hands are lying on the side.

FUNCTION OF NORMAL POSTURE

1. For the development of normal occlusion

2. Normal respiration
3. Development of normal vertical dimension
4. Normal blood circulation
5. Normal dentro cranial structure

MAINTENANCE OF NORMAL POSTURE

- Leverage and Activating System

1. LEVERAGE SYSTEM​- facilitate the positional relationship influenced by the muscles of
the head, elbow and foot.
2. ACTIVATING SYSTEM​- where the action of the activating muscle, maintain its upright
position.
a. Retractor of the head
b. Masseter Muscle
c. Internal Pterygoid Muscle
d. Extensor (Spine, Hips, Knee)

SPINE - flex, extend, sometimes rotates and deviates laterally.

- Keystone of body posture

● SCOLIOSIS- lateral curvature of spine
● LORDOSIS- lumbar curvature is increased
● KYPHOSIS- dorsal curvature is increased
● HUNCHBACK- entire spine is curved
- Normal position of the spine.

STRAIGHT LINE from front and back.

*laterally has 4 curves:

1. DORSAL SPINE- posterior

2. CERVICAL- anterior
3. LUMBAR
4. ISSACROCCYGEAL- posterior
FACTORS OF BODY POSTURE

- OCCUPATIONAL- due to the nature of work • Dentist > Slipped Disk (common back
problem)
- CULTURAL- upbringing the child at home
- EMOTIONAL- moods of the individual changes
- MECHANICAL- atmospheric pressure of the individual

GAIT

- Position of the body in relation to the head while walking.

MAINTENANCE OF NORMAL GAIT

● LEVERAGE SYSTEM- bones of the extremities

● MUSCULAR SYSTEM- muscles of the legs and arms

PARTS OF THE BODY RESPONSIBLE FOR GAIT

● Upper and
● Lower Extremities

VARIOUS AGE GROUPS IN MAN

- Childhood - is the period in time of conception to adolescent period.

STAGES:

● PRENATAL – 1st month to 1 yr. old

● PREPUBERTAL – 1st yr. to 6 yrs. Old
● PUBERTAL- 6 to 12 yrs. Old
● ADOLESCENT – 12 to 18 yrs. Old

FACTORS THAT AFFECT “CHILD ORAL STRUCTURE”

- Genetic/ Hereditary- adopt the bone structure from the parents.

- Environmental- during pregnancy the mother took drugs.

PRENATAL

- From first month to 1 yr.

- OROFACIAL STRUCTURE is evolved in embryo
- OROFACIAL ANOMALIES results from the disease
 ● GERMAN MEASLES:
1. Cleft/ Lip Palate
2. Ectodermal Dysplasia- “less supporting bone”
3. Anodontia- “congenital absence of all teeths”

NATAL

- Newborn baby
- Need nutrients to survive (water, electrolytes, oxygen)
- Skeletal are flexible

INFANCY

- 1st month and 12 months

1ST MONTH

- Begin to smile
- Production of cooing sound

3RD MONTHS

- Control the head posture

- Able to lift the head in supine position
- Hands begin to open and hold things

6TH MONTHS

- Trying sit up by themselves

- Sit in a short period of time and holds head in correction position.

8TH MONTHS

- Development of prehension and selective grasping using thumb and index fingers.
- Bites and chew toys.

10 MONTHS

- Begins to walk and guided

- Head posture begin steady
- Says “mama” and “papa:

12 MONTHS

- Begins to walk and guided

- Head posture is now part of the skin of gait
- Anterior teeth are generally present.
PRESCHOOL

- 1 to 6yrs.Old
- Express growth by osseous tissues, and muscles development.
- Dental occlusion and muscles activity

MATURES

- Deciduous dentition is COMPLETED.

MIDDLE CHILD SCHOOL / SCHOOL STAGE

- 6to12yrs.Old
- The child’s height, weight, and personality moves progressively.

ADULTHOOD

- Maintenance of occlusion by restorative and preventive procedure.

- Periodontal problems occurs.
- Restoration of loss of the endodontic is needed.

Midterm exam :

1. The following are organs which speech when there is presence of abnormality EXCEPT:
a. Larynx
b. Teeth
c. Paranasal sinuses
d. Cheek

2. There are voices produced by the friction of the opposing structures of the oral cavity.

a. Resonance
b. Functional
c. Consonants
d. Articulators

3. The position of the mandible during mastication are the following EXCEPT:

a. Symmetrical
b. Functional
c. Asymmetrical
d. Voluntary

4. Which of the following are the reflexes for the protection of the respiratory organ from the
foreign body?

a. Hiccups and sneezing

 b. Coughing and sneezing
c. Coughing and regurgitation
d. All of the above

5. Which of the following statement/s is/are true during inspiration of air?

a. There is increased change in the size of the thoracic cavity and expanded diaphragm,
from concave in shape to convex
b. There is decreased change in the size of the thoracic cavity and expanded
diaphragm,from convex in shape to concave
c. Both and b are correct
d. Both a and b incorrect

6. The following are conditions where the oral cavity is used as respiratory organ, EXCEPT:

a. Persons suffering from severe colds

b. Persons suffering from asthmatic attack
c. Persons having pul polyps
d. Persons that are mouth breathers suffering from malocclusion

7. The muscle of mastication are:

a. Internal pterygoid, temporalis,external pterygoid,digastric

b. External pterygoid, temporalis,lateral pterygoid,mylohyoid
c. Internal pterygoid, external pterygoid,masseter,digastric
d. Lateral pterygoid, medial pterygoid, masseter, temporalis

8. The following are muscles of mastication that elevate the mandible:

a. Temporalis, external pterygoid, internal pterygoid

b. Temporalis, masseter, internal pterygoid
c. Masseter, temporalis, external pterygoid
d. Masster, lateral pterygoid, medial pterygoid

9. The following are True conducting systems of respiration:

a. Nose, pharynx,larynx
b. Nose, trachea, bronchii
c. Pharynx,thorax,abdomen
d. Nose,bronchii,alveoli

10. Exchange of gases between the air in the lungs and environment is called:

a. Respiration
b. Internal pterygoid
c. External pterygoid
 d. All of the above

11. The following are treatment for a cleft palate EXCEPT:

a. Surgery
b. Obturators
c. Dentures
d. None of the above

12. Which of the consonants affect the production of speech when there is anterior open bite?

a. Fricatives
b. Sibilants
c. Nasal
d. Plosives

13. Which of the consonants affect the production of speech when persons is suffering from
protrusion of the maxillary and mandibular teeth?

a. Fricatives
b. Sibilants
c. Nasals
d. Plosives

14. A 25 year old patient came to your clinic for consultation. He exhibited difficulty in
pronouncing words. Upon mouth exam, it was revealed that he had an abnormally large tongue.
This condition caused a defect in his:

a. Pronation
b. Audition
c. Articulation
d. All of the above

15. A mother was relation about how her son who was already 10 years old. He still found
difficulty in reading aloud. His son may be suffering from:

a. Dyplexia
b. Dyslexia
c. Dyspnea
d. Dyspnexia

16. A mother approached the teacher of her 8 year old son about his low grades. The teacher
explained to the mother that the son had a hard time catching up in his class. It was found that
his son had difficulty in writing. The condition is called.

a. Agraphia
 b. Dysphagia
c. Dysgraphia
d. Anomia

17. Difficulty in recalling names especially those of common objects?

a. Anemia
b. Anomia
c. Dyslexia
d. Dyspnea

18. Paralysis of one or more articulator is:

a. Arthrosis
b. Diarthrosis
c. Biarthrosis
d. diarthrosiasis

19. Pathological condition like otitis media and abnormally like deafness will not affect the
production of sounds and speech especially audition

a. True
b. False
c. I don’t care
d. Maybe

20. The following are True regarding speech and sound EXCEPT:
A. learned function associated with hearing and vision

B. Involved biological function of maxillofacial structure

C. does not involved respiration

D. None of the above

21. The following are True characteristics of phonation EXCEPT:

a. Produces sounds with the help of larynx

b. Produces sounds with the help of voice box
c. All of the above
d. None of the above

22. What part of the brain is the center of speech?

a. Cerebellum
b. Cerebrum
c. Brainstem
 d. All of the above

23. The normal production of sound and speech is with the help of CNS. it does not coordinate
with the different systems of the body like respiratory and circulatory system. Any damage to
this system will not affect phonation.

a. True
b. False
c. Partially true
d. Partially false

24. B,P,M,W,HW sounds are examples of what consonants?

a. Tongue-palate consonants
b. Tongue-teeth consonants
c. Lip consonants
d. Guttural consonants

25. S,E,Sh,Zh, sounds are examples of what consonants?

a. Tongue-palate consonants
b. Tongue-teeth consonants
c. Tongue-gum ridge consonants
d. Lip-teeth

26. U,Ph,Sh,S sounds are examples of what consonants?

a. Fricatives
b. Sibilants
c. Nasals
d. Glides or roll

27. D,R,M,N,W,Y sounds are examples of consonants?

a. Plosives
b. Vowels
c. Nasals
d. Sibilants

28. Consonants where there is articulation of sounds without stopping of breath stream is?

a. Plosives
b. Nasals
c. Sibilants
d. Vowels
29. The following are structures involved in articulation which are arranged opposite to each
other, EXCEPT:

a. Uvula and lymphoid tissues

b. Tip of the tongue with the lingual surface of the teeth
c. Dorsum of the tip of the tongue with the uvula
d. Upper and lower lip

30. The following are the reflexes that conflict speech, EXCEPT:

a. Hiccups
b. Sneezing
c. Coughing
d. None of the above

31. A fan-shaped muscle which originates at the temporal bone and inserted at the coronoid
process is what muscle of mastication?

a. Masseter
b. Temporalis
c. Internal pterygoid
d. External pterygoid

32. Teeth relationship during mastication:

a. Centric
b. Centric and accentric
c. Centric,functional,symmetrical
d. Centric. Eccentric, symmetrical

33. The following are growth sites of maxilla:

a. Frontopalatine, zygomatico platine,pterygopalatine sutures

b. Faciomaxillary, zygomaticomaxillary,pterygomaxillary sutures
c. Faciomaxillary, zygomaticomaxillary, pterygopalatine sutures
d. Frontopalatine,zygomatico palatine,pterygomaxillary sutures

34. Tooth nos. 45 and 47 erupt at what age?

a. 9-10 and 10-12 yrs.old

b. 10-12 and 11-12 yrs.old
c. 10-12 and 11-13 yrs.old
d. 11-12 and 11-13 yrs.old
35. Tooth nos. 13 and 15 erupt at age of?

a. 8-9 and 10-12 yrs.old

b. 9-10 and 11-12 yrs.old
c. 10-12 and 11-12 yrs.old
d. 11-12 and 10-12 rs.old

36. Tooth nos.63 and 65 erupt at the age of?

a. 9 and 14 months
b. 12 and 20 months
c. 16 and 20 months
d. 18 and 24 months

37. Tooth nos. 74 and 85 erupt at the age of?

a. 12 and 16 months
b. 12 and 20 moths
c. 14 and 18 months
d. 16-20 months

38. Tooth nos. 75 and 85 undergo complex tooth resorption at the age of?

a. 9 yrs.old
b. 10 yrs.old
c. 11 yrs.old
d. 12 yrs.old

39. Tooth nos 53 and 63 undergo complete root resorption at the age of?

a. 9 yrs.old
b. 10 yrs.old
c. 11 yrs.old
d. 12 yrs.old

40. Tooth nos. 62 and 72 start root resorption at the age of?

a. 4 yrs.old
b. 5 yrs.old
c. 6 yrs.old
d. 7 yrs.old

41. Nolla’s stage no.1 is?

a. Absence of crypt
b. Initial calcification
 c. ⅓ of the crown calcified
d. Presence of crypt

42. Tooth nos. 74 and 84 start root resorption at the age of?

a. 6 yrs.old
b. 7 yrs.old
c. 8 yrs.old
d. 9 yrs.old

43. Nolla’s stage no. 7 is?

a. ⅓ of the root calcified

b. ⅔ of the root calcified
c. Crown almost calcified
d. Crown completely calcified

44. Nolla’s stage no.3 is ?

a. ⅓ of the crown calcified

b. ⅔ of the crown calcified
c. Initial calcification
d. Crown almost calcified

45. Pre-dentitional period is characterized by the following EXCEPT:

a. Absence of gumbad
b. Absence of interocclusal gap
c. Rapid growth of maxilla and mandible for the eruption of the permanent teeth
d. All of the above

46. Part of the TMJ that is concave in shape and receives, the head of the condyle?

a. Coronoid process
b. Anterior articulator eminence
c. Glenoid fossa
d. Posterior glenoid tubercle

47. Ugly duckling is characterized by all of the following EXCEPT:

a. Diastema in all teeth

b. Distally flared root in radiograph
c. Permanent canine not yet erupted
d. Present in mixed dentition
48. In active eruption there is actual movement of the locatio tooth in the oral cavity, while in the
passive eruption there is the gradual exposure of the crown due to deposition of the gingiva.

a. 1st statement is true, 2nd statement is false

b. 1st statement is false, 2nd statement is true
c. Both statement are true
d. Both statement are false

49. Masseter muscle originates at the zygomatic bone and is inserted at?

a. Coronoid process
b. Neck of the condyle
c. External surface of the mandible
d. Internal surface of the mandible

50. The following are factors of calcification EXCEPT:

a. Environmental condition
b. Nutrition
c. Genes
d. Emotional conditions