MCQ’s for Dental PG Entrance , , Examinations Arranged Chapter- (b iP 2 ~ wise with Explanatory AnswersDENTAL Pulse MCQ’s for Dental PG Entrance Examinations Arranged Chapter wise — with Explanatory Answers Volume — 2 NINTH EDITION Authors, SATHEESH KUMAR Reopy. K mps SWAPNA MUNAGA mbps Co-Author DR. VENUGOPAL. T mps SWAPNA MEDICAL PUBLISHERSDENTAL PULSE © By Dr. Satheesh Kumar K. EIGHTH EDITION - JULY 2014 NINTH EDITION - JUNE 2015 AlLrights reserved, No part of this publication may be reproduced, stored in a retrieval system, or transmitted, ‘in any form or by any means, electronic, mechanical, photocopying, recording or atherwise, without the prior written permission of the publisher. The author and publisher have taken care in preparation of this book, but make no expressed or implied warranty of any kind and assume no responsibility for errors or omissions. No Uability is assumed for incidental or consequential damages with or arising out of the use of the information contained herein. AlL legal matters to be settled under Hyderabad jurisdiction only. Price: 1150.00 Published by: Swapna Medical Publishers FLAT NO 101, H.No. 3-2-844, Rajeswari Gayatri Sadan, Kachiguda, Hyderabad - 500 027. Ph: 92471 88244, 095338 63720 e-mail: smp_hyd@yahoo.co.in, swapnamedicalpublishers@yahoo.com Website: wivw.swapnabooks.com Exclusively distributed by Sri Venkateshwara Books Hyderabad. Mob: 9533863720, 9247188244 e-mail: svbookshyd@gmail.com Printed at: Hyderabad.ORTHODONTICS 1 Growth And Developmert...... 2 Development Of Dentition....... 3 Etiology Of The Malocclusion 4 Diagnosis... 5 Cephalometry 6 7 8 Occlusion & Classification Ot Malocclusion Biomechanics - Tooth Movement ....-.-ee oe Preventive & Interceptive Orthodontics....... 9 Removable And Fixed Appliances. 10 Myofunctional & Orthopedic Appliances... 11 Treatment Planning 12 Synopsis. PEDODONTICS Child Psychology Caries And Restorative Dentistry. Traumatology roc Pediatric Endodontics. Diseases Of Child... Miscellaneous... Synopsis Noaanson+ COMPLETE DENTURE Impression Procedures... . Border Moulding And Posterior Paltal Seal Jaw Relations... ost Teeth Setting And Articulators.... 2 Special Techniques In Complete Dentures. Miscellaneous... Synopsis. Nouron- 001 013 019 036 072 084 091 106 116 130 141 147 = 153 160 474 188 196 - 200 . 208 218 1. 222 2351V_ FIXED PARTIAL DENTURE vi vi 4 eononrkon Principles Of Tocth Preparation ..... Complete And Partial Veneer Crowns Metal Ceramics. Laminates, Maryland Bridge. Allceramics, Cementations And Tissue Dilation... Pontics. Finish Lines Miscellaneous Synopsis... REMOVAL PARTIAL DENTURE oor on Introduction And Classification Major And Minor Connectors... Rests, Direct And Indirect Retainers. Survey And Design... Miscellaneous. Synopsis ORAL AND MAXILLOFACIAL SURGERY ©MONONPRONS Exodontia and Impactions..............0s00 Local and General Anesthesia Mandibular Fractures... Middle Third Fractures TMU and Maxillary Sinus Cysts and Tumours, Odontogenic Infections Preprosthetic & Orthognathic Surgery and Miscellaneous Synopsis GENERAL SUGERY 1 2 3 4 5 6 Diseases Of Salivary & Thyroid Glands IMFECtIONS soc sascssessesnesntenesveninstnsstnseesoessisenseetsghnnsinesteetsnetnacisoensee Trauma i Cleft Lip And Palate Swellings, Ulcers And Tumors Of Head And Neck Diseases Of Larynx And Pharynx. = 245 250 254 258 -. 262 266 .. 269 .. 278 298 soo 299) .. 805 315 .. 321 323 .. 838 .. 880 .. 396 .. 409 418 427 440 503 514 519 523 .. 528 587vit Transfusion, Shock, Bums And Wound Healing. 8 Arterial And Venous Disorders... 9 Miscellaneous. 10 Synopsis ORAL PATHOLOGY AND MEDICINE 1 Developmental Disturbances paces 2 Benign And Malignant Tumours Of Oral Cavity 3 Odontogenic Cysts And Tumours 4 Diseases Ot Salivary Glands... 5 Dental Caries 6 Pulp And Periapical Infections sags 7 Physical And Chemical Injuries. 8 Diseases Of Bones & Joints 9 Diseases Of Nerves & Muscles 10. Skin And Vesiculobullous Lesions ......0... 00 41. Bacterial Infections. 12 Viral Infections....... 413° Mycotic Infections... 14 Oral Aspects Of Metabolic Diseases. 15 Tongue Disorders... 16 Pigmentation 17 Diseases Ot Blood 48 Miscellaneous 19. Synopsis..... ORAL RADIOLOGY ON On kon Radiation Physics. si Biological Effects Of Radiation sess enenne Ese Radiation Safety And Protection X-ray Film, Intensifying Screen And Processing Of X-ray Films. Projection Geometry And Intraoral Radiography Extraoral Radiography. Radiographic Diagnosis Synopsis. 541 552 556 564 594 610 632 Bat 649 655 661 668 673 679 689 696 702 706 713 716 718 725 732 760 768 775 779 785 789 796 805x xl xi PATHOLOGY Noon oON a Cell in health and disease. Inflammation, immunity & hypersensitivity... Healing......... Fluid and haemodynamic disorders.......... Growth disorders and neoplasia Diseases of blood and lymphnodes. Systemic Pathology & Miscellaneous Synopsis... GENERAL MEDICINE oye Hk oN Infections Central Nervous System GIT, Liver And Kidney Hematology And Endocrinology Respiratory System Cardiovascular System Miscellaneous... ‘Synopsis. PHARMACOLOGY PNOWhRONW a Chemotherapy... A.N.S, Blood and Endocrinal drugs NSAIDs and other CNS drugs General Pharmacology... Drugs acting on CVS, GIT And Respiratory systems... Local And General Anesthetics. Miscellaneous Synopsis pe tkeg 8i7 on 822 .. 834 .. 838 845 . 854 .. 867 878 890 908 912 922 940 951 .. 967 .. 978 .. 981 1005 1021 1039 1047 1057 1063 1080FEEDBACK FORM Students are requested to use this table if they find any mistakes in this book and I welcome feedback so that our juniors will be benefited. As an attempt to make this book error free and as a token of appreciation, Dental Pulse Team has decided to reward the students for sending the corrections. Each first received correction with proper reference will attract a reward of %.1,000/-. — Dr. Satheesh Kumar K.‘Our Sincere thanks to Dr, Sai Santhosh ‘Dr. Lalithya Dr. Aditya Talwar qos) Dr. Ankush Garg for sending us the correctionsin 8th ed of Dental Pulse. As per our promise, you will be receiving the following cheques shortly, You are requested to call 92462 10072 and update your communication details so that we can send the cheques by courier. m 257795 SOOzeROOEH DB eee 24————————— ORTHODONTICS Hoe ORTHODONTICS |. REFERENCE BOOKS TAKEN: 1. PRINCIPLES AND PRACTICE OF ORTHODONTICS by GRABER — 3rd & Sth editions 2. TEXTBOOK OF ORTHODONTICS by M.S.RANI~ 3rd edition 3. THE ART AND SCIENCE OF ORTHODONTICS by BHALAJI— 3rd, 4th & 5th editions 4, TEXTBOOK OF ORTHODONTICS by GURKEERAT SINGH - ‘st & 2nd editions 5. TEXTBOOK OF PEDODONTICS by SHOBHA TANDON - 1st edition © CONTEMPORARY ORTHODONTICS BY WILLIAM R. PROFFIT ~ 4th & 5th editions 1. GROWTH AND DEVELOPMENT Growth site of the mendible is in the body a) Boay b) Condylar eztiage ©) Coronoid 2) Ramus (NAN -2k) “Epigenetic factor’ controling the growth of skeleton 2) Genatc factors present within the skeleton 1) Genetic factors present outside the skeleton 2. Maxilla develops by €), Local nan ganatic factor: 2) Endachondral bane formation 4) Genesal aon genetic factors 1) Intra merrbrancus bore fermation (nan 97) «) Camitage replacement and intra membranous bone. Searnmon’s growth curve. False is formetion 2) Neural issues Most ofthe gronth is completed by 6 years ©) Mostlycartiagerepticementand.atitlebyinvamembranous __b)-Lympheld tissues - growth reaches 200% by ace 13 and (Hatt -86) regress alverwards «Which of the organ/system increases te 260% the adult c) Genital tissues ~ most ofthe growth is competed by the size before puberty age 9-10 years age of puberty 2) Lymphoid 8) Somatic 6) None ofthe ebove ) Genitals 9) Neural (wan -97, ALS -94) (MAN -00) 9. Age of closure of sphenovectpital synchondresis 4, Servo system theaty of growth was given by 4) 6years 8) 12 years 4) Seott 5) Petre €) ta years 8) 25 yaar 6) Limborgh ©) Van der lagu (man 26) (WAN 01) 40, Persistent part of the envelope of Meckels cartilage is 5 Greatest amount of cranial growth occurs by 2) Stylomanditular iganent 2) Birth te Five years b) 5 ~6 years 8) Tempero modibalar igartent 6) 8-7 years ) 7 10yeas 6). Spheno waneibular ligament (HAN-97) 6) Siloti igament & At birth which of the folloming structures is nearest the (Han -26) size jt will eventually attain in adulthood 11, Mecko’s cartilage gives rise to: 2) Cranium 1) Mandible 2) Condyler process) Coronoid process ) Middle Face 4) Nasal capsule €), st of ramus 4) None of the above (NaN -97,98) (waness) yey! PAO! HAHA DS) © Pe me wo=v AA Growth of oval structures is mainly influenced by factors: 8) Hereditary 5), Environmental Dental Pulse ee 1b) Intramerranous growth ©) Appositional gronth —d) Periosteal growth ©) Wereditary-influenced by environmental (A1PG -96) «) None of the above 24, The pharyngeal muscle which forms a part of buccinator {MAN ~2001) mechanism is: 13. Duration of adotescent stage in boys is ) Inferior constrictor) Middle constrictor 8) 3 years 9) 3-5 years ©) Superior constrictor) Falatopinryngeus ©) years @) 5 years (KAR -02) (Ps1-2011) Premaxilla is derived from 14, An early prepubertal growth spurt indicates: 8) Maxilary protuberance b) Palatine bones 8} Longer treatment time ) Fast maturing child 9) Frontonasal process) Median process ©) Slow maturing child) An endocrine dysfunetion (arins 96) (MAN-2001) 26. Differential growth means: 15. Sphenooccipital synchondrosis closes at the age of 4) Difference between growth and developrent. 28) G years of age b) Early puberty ace »b) Difference between individual growth ©) Early adult age a) Tenever closes «)_ Acceleration in growth. (aP -99) 4) Different tissues grow at different times rate and amount. 16. At birth, the palate is relatively flat: in adults; itis (KAR -02) vault-shaped. By which of the following does this change 27. In a newborn child we generally see: occur: a) Maxillary protrusion) Maxillary retrusion 3), Bone resorption in the paletal veut ©) Mandibular protrusion) Mandibular retusion b) Gromth of the maxilary sinuses (Pat 98) ©) Deposition of the alveoler crestal bone 28, The implant method of studying growth was proposed by: ) Bone éeposition on the postarar wall of the maxillary a) Scammon b) Borg. tuberosity ©) Belch 1) Bor {AIPG -87) (A1?6 -04) 17. Ifa chile’ taeth do not form, this would primarily affect 29. Earlier closure of a suture is called the growth of the: 4) Synchondwsis by. Ankylsis a) Maxita b) Mandible «)Synostosis ).Epiphysis ©) Whole Face 4) Alveoiar hone (rar -88) {AIPG -03) 30. The '" principte of growth is best illustrated by the 18, After the age of six the inereace in the size of mandible 4) Body of Mancibte —b) Mandibular ramus occurs at: ©) Mandibular symphysis 8) Symatysis b) Between canines 4) Spheno-occipital synchondresis ©) Along the lower border i) istal to 1" molars (KAR 98, AP ~04, 14) (AIPG -01, KAR -04) 34, The first ossification center of the mandible in a 6 weeks 109. Vital staining was introduced by ‘old human embryo is found in which one of the feltowing a) Entow by Wott locations? ©} ohn Hunter 8) Petrovie 2) Future coreneid process (av-z012) 8) Future condylar process 20. Growth of the maxilla in the vertical direction is due to: 9) Future mental foremen 2} Growth ofthe alveolus b)Gronth at sutures 4) Future mandibular foremen ©) Groth of the cranial base (aPsc -99) 4) Gronth of the synchondrosis 432. Functional matrix theory is hypothesized by (ALIMS -99) a) Seat b) Sichar ty ©) Petrovic ) Moss {CONEDX -03) ©) 18 ys 4) Grows equally 33. Bjork used the implants for predicting facial growth (aP 14) changes. This approach is called as: 22, Absence of sesmoid bone in girl of age about normal ) Longitudinal approach. b) Metric approach. range of puberty is said to have ©) Structural appinach. —b) Computerized predication 2) Completed the growth b) Cver growth (AIPG -08) 6} Belay in reaching puberty 34, The functional Matrix concept as revised by Moss does @) Al of the aove not include: (ap -03) 4) Connected cellar network 23. In sutures there is proliferation of connective tissue ) Mechano transduction followed by replacement of bone this is called: ©) Epigenetic-Epithesis. d) Genomic thesis 2} Endockondrat bone growth (AIPG -04) eo) d MB uC ie 1) 0 i) 1) ¢ BA mC BO a) 8 we 2) C2) 0 27) D 78) De) 30) B HA) C32) O33) A 30)36. 37. a a, as. Negative growth is a characteristic oft a) Testi b) Brain ©) Mandibie ) Thymus (als -04) ‘The bedy tissue that grows rapidly but shows minimal grouth after the age of 6-7 years is: 8) Neural tissue 1b) Lymphoid tissue. ©) Skeletal tissue. a) Genital tissue, (AIPG -04) Combinations of deposition and resorption occurring in the different bones of the skull which result in a growth movement towards the depository surface is termed as a) Remodeling Displacement ) Physiologic resorption) Drift (Pst-97) Enlows 'Y’ principle of growth is found in 2) Cranial base 1) Masilla only ¢) Maxi and mandible) Mone of the above (Pst 03) Oral and Masal capsule of functional growth related to 4) Perisieal matiix—) Sutural matiix ©) Capsular matrix a) Mone ofthe above (Pot -03) In sichers theory, suture acts as 2) Has independent growth potential 1) Dependent on cranial base ©) Used for growth adjustment @) None ef above (P61 -03) ‘The movement of bone in response to its own growth is termed as: ) Rotation b) Secondary displacement ©) Primary displacement a) Differentiation (atPs -04) The “Suture dominance theory” of craniofacial growth was given by a) Moss by) Sicher ©) Profit ) Petrovic (KAR 98) Cranial voutt volume at 7 years is: a) 13 b) 1/6 Qn 4) 3/6 (P61-05) ‘Skull at birth contains: a) 22 bones b) 34 bones: ©) 45 bones ) 54 bones (COMEDK-06) Spheno cecipital synchendrases carries the grovth of anterior half of the gonial base of the cranium and upper part of the face in: 4) Formatd and downward divections bb) Fermaté and \eteral ditection ©} Upward and forward directions 2) Only forward direction (COMEDK-06) All of the following are examples of fibrous joint except: 8) Symphysis bb) Gomphesis = ORTHODONTICS Hoan )— «) Suturat ) Syndasmosis (KaR-04) 47. Wore than 80% of growth of the brain or brain vault has ‘been achieved by: 2) T2yearsoflife ——_b) 5 years of life ©) 18yearsof life ¢).-2L.yearsof life (COMEDK-05) 48, Mechanism of bone gromth is by: #8) Bone deposition and resorption ) Cortical arte 6) Displacement 4) Allof the shove (KAR-04) 49. A change in the intensity and direction of functional forces would produce demonstrable change in the internat architecture and external form of bone was stated by: ) Melvin ross ») Ell anle ©) Zadmison 1) duties Wott (CONFDK-06) 50, Development of face occurs in the following planes: 8) Tansverse, sagittal, vertical 1) Transverse, vertical, sagittal €) Sagittal, vertical, transverse 6) Vertical, transverse, sagittal (AP-06) 51. Read the following carefully: 2) Spheno-occipital synchondrosis 2) Mancibutar condyle 3) rontomaxiary suture 44) Nasal septum 5) Alveolar precesss Which of the following are sites of cartilaginous growth postnatally a) 1k2 ») L286 9 2385 38s (A1P6-06) 52. Father of modem orthodontics is: 8) Dewey b) Angle «)Andcow a) Clan (ae-o7) 53. All of the following are considered microsketetal units of ‘the mandibe as per the matrix theory EXCEPT: 2) Chin ) Glenoid fossa 4) Coronoid process) Angle of the mandible {KCET-07) 54, Growth estimation is done by: 4) Frontal tone bb) Cervical vertebrae. ©) Capitate 8) Clavicle {alPs-07) 55. Functional matrix theory suggests that the determinant ‘growth of skeletal issues resides ins 2) Skeletat 'b) Sutures ©) Cantilages 4) Non-skelatal tissues (KCET-07) ‘56. The thie main vertical pillars of trajectories of force arising from the alveolar process and ending in tine base of the skull are all except: 2) Canine pillar 'b) Zygomatic pillar BD) A HD 3) c RPE 4) A Me a2 6 MPD) ct Me a) A a 48) D4) 0 5) A 51) 6 52) 8 53) B54) B55) D6) 0=(( See Dental Pulse ©) Pterygold pillar 4) Coneytar pillar (kceT-07) ee ©) Vander Linden @) Lathan (COMEDK-09, 11) 57. The Condylar Cartilage in the mandible is held to be a 69. The groove separating the gum pad from the palate is 8) Primary cartilage 5). Secondary catiace called ©) Tertiary certlage 4) Non-growing cartilage ) Gingival groove) Dental groove (KCET-08) ) lateral sulcus ) Transverse groove 58 Growth activity at which of these synchondroses (ecerz011) completes fist? 70. Who proposed the “trajectory theory of bone formation”? 5) Spheno-occipital by) _Intersphenaidet ) An anatomist Meyer) @ mathematician, Cullman ©) Intra-oceipital 4) Sphenoethmoidal 6) Both e and b «) None ofthe atove (COMEDK-v8) (alPG-2012) 59. Arch space for eruption of 2nd 8 31d molar created by: 74. Anthropometry is 2) Appesition of Hamular processes 8) Measurement of skeletal dimensions on human skeletal ) Resorption of anterior Border of ramus remains ©) Resorption of posterior border cf remus 'b) Measurement of skeletal dimensions on tiving individuals 4) Apposition of lower border of mancible )_ Measurement of skeletal dimensions on radiographs (ATIMs-07) 4) Measurement of steleta dimensions on photographs 60, First growth spurt takes place at what age (aP-2012) a) Ist year 0) 3rd year 72, The mandible grows longer by apposition of new bone on ©) 6th year a) 901 year the posterior surface of (ap-08) a) Coronefd process) Condyle 61. Growth sites in maxilla Is / are ©) Ramus ) Syrphysis 3) maxilary tuberosity 6) sutures (BHU-2012) ©) nasal septum 4) all ofthe above 73. The initial sign of sexual maturity in boys is usually (aP-09) 2) Fat span 1) Development of Adam's apple 62. Growth treads show that in most patients <) Ghange in voiced) Appearence of facia hai a}, maxila and mandible grow in unison (aP-2012) b) mexile grons more rapidly 74, Which one of the following undergoes predominantly 6) mandible grows at fate rate than the middle third ofthe face ‘endochondrial ossification? «) o Such conclusion could be made a) Maxila b) alate (aP-09) ©) Cranial base ) Cranial vaut 63, The first evidence of cartilage getting converted to bone (aP-2012) In craniofacial skeleton occur during 75. Nore than 90% of growth of brain or brain vault has 8) Fourth Postratal week b) Eighth Prenatal week achieved by? ©) Fourth Prenatal week) Fighth Postnatal week a) years 212 years (COMEDK-10) ©) 18 years cd) 21 Weeks 64. In child development, the embryo period fe? (weer-2013), 9) 0-2 weeks b) 23 weeks 76. Remodelling theory of craniofacial growth nes given by ©) 28 weeks a) 9 weeks to birth 8) Brosh 1) doha hunter (Pst-o8) ©) Vander Klauuw dd) Sichar & Weinmann 65, Growth is generally completed (AIINS-2o12) 3) Fist in head and last in depth of face 72. Normal growth of maxilla occurs by b) First in head and last in width of face 4) Displacement and drift b) Drift only ©} First in head and lat in hefaht of face )_ Apposition| 1) Replacement resorption 4) Fist in depth and last in width of face (ALINS MAY-13) (COMEDK-10) 78. Lip thickness reaches maximum at what age Is males? 66. Growth of Conde is by a) 16 years b) 18 years ) Membranous growth) Interstitial grouth ©) 25 years dd) 13 years ©) Cartlaginous proliferation (atr6-t4) ) Bory Appositien 79, Cartilage differs from bone in that, the cartilage can (aP-10) increase tn size by 67, The gonial angle at birth i? 2) Appasition bb) Interstitial growth 3) no" b) aus ©) Selective resergtion d) Endosteal remodelling ms" a) 145° (COMED-14) (AP-10) 80. In a preadotescent child the maximum midline diastema 68. Who proposed the nasal septum “thoery of craniofacial ‘that willbe closed spontaneously after canine eruption growth”? 2) mn 8) 2 mum a) Mass ) Sicher S) S's) @ 59) B 60) A 61) 0 62) C 63) E 64) ¢ BB) e 66) C GAD 68) D eo) A. 7) € 71) 8 7) € 7s) ARC 74) C75) ATH) A 77) A 7B) B79) BBO) B—__—____ 9 ¢nm 2) 5mm (coneD-14) Anterior arch width of the dental arches increases upto the age of 8) 6 to 8 years b) 10 to 12 years ©) 12 to 16 years 9) 14 to 16 years (6cET-14) Which of the following is true? 8) Uppar lip applies more pressure on upper teeth and tongue on lover teeth bb) Tongue apply more pressure on upper teeth and tower lips on lower teeth ©) Up pressure is more 4) Tongue pressure is more (PGE IUNE-2014) In assessment of skeletal age based on cervical vertebrae ‘a5 seen in lateral cephalometric radiograph, stage 3 indicates 8) More than one year beyond peak growth b) No grewth )_ Less than one year prior to peak growth 2) Peak growth still a year or s9 ahead (aPp6-15) Corpus rotation in relation to cranium is known as a) Matric ) Intramatrix ©) Internal rotation) Apparent rotation (PGC JUNE-2013) The pharyngeal structure established in early age and remain constant throughout if a) Depth of oropharynx b) Depth of nasopharynx ©). Width of nasopharynx) Width of oropharynx (PGE JUNE-2011) Period of adolescant growth in beys ie? a) 3 years b) 3.8 years ©) 4 years 3) 5 years (Pst vec-2011) Hemifacial microsomio occurs during? 8) Fermation of germ layer b) Migration of neural ciest cells ©) At the tine of orgen formation ©) Final differentiation of tissue (PGE UNE-2012) ORTHODONTICS By Ae) A we 8) Ca) ae) Dae—(0-"A Dental Suse 1. H AND DEVELOPMENT ~ ANSWER: 1. 'B [Bhalajhi 3rd ed 36] vec Functional matrix theory alvin Nove Usually bone grows by apgostion and cartitage hy intrstitiat growtn. Mandibular condyle is the only bone that shows Servo system theory of growth, — | Petrovic and Chartier Both apposition and interstitial growth, (Cybernatics) Nulti-factoril theory Van Linborgh 2. [Ghatajhi 3rd e4 27] ith Brodie In endochondral type, the bone formation ts preceded by Sree tees formaticn of cartilaginous model, which is replaced by bone. Neurotovism Betvents a: Ethrold bone, Hyotd,Tneus, Stapes. 3. (8 [Shalajhi ard ed 23] In fotramenbranous type, the formation of kone is not 6 ’ (GRABER 3ré e451) preceded by Formation of cartilaginous model. Instead bone At birth. cranium is ahout 55-60% of adult size. By the ape Trail catty Rbrous monrane. of 67 years, almost 95% of adult size is attained. At birth 7 {fant skal composed of 45 bores which ate reduced to a: Maxie, nasal bones, parietal 2ygome, vomer, lacrimal, 22 in aut. zygomatic = 7.‘ [GRABER 3rd ed 41] Both intemenbianous and endechondial ossification ic According to “Yan Limborah’s" multifactorial theory, growth Sean Gerla, teseiral sehen beri {is uncer contia af genetic and environmental factrs : team Intense genetic Factors are the factors present within the Scammon's growth curve classifies body tissues nto 4 types. —_staleton Each of these tzever grow at ciHerent ies and rates ee eee een a _piganatic Factors present outside the skull arc: manifests ralferates rapidly in lain childhood their influence in indiect way by intermediary action on reaches 200% adult size. This is seusuatstouctvea Eye Coen Nias: Lymphoid an adaptation to protect chilen trom Tissue fections 8 ‘C [Bhalajhi 3rd ed 10) By the age of 18 years, ymphota tissue Genital tizvee show negligible growth until puberty. They undergoes invalution to reach adult size. iow rapidly after puberty weaching allt size after which © Grows vary rapldly and reaches maximum | roth ceases, Neural size by 6-7 years (AIINS- 2012) of age , tissue | Vary trie growth of neural issue occure| % “© (GRABER 3rd-ed 29) aoe rene ee 20. °C [Shalajhi 3rd ed 28] ene, | EAVBIE an "3" shaped cuve wih maple The sphenomandibular ligament extends from the lingula of Genel | sronth up to 23 yeors followed by ‘mandible to the spine of sphenoia tone and forms 2 remnant ar visceral | Siow ghase of arewth between 3-10 years Sen caaiee hee! _,_ {COMED-09) mec After 108 yas, a cap phase of growth Benes) occrstaminatig by the 18-20th yeas oe eeaE WUE Gentat 7 SR2MS pehcible growth until puberty. See ABTS Gesues 7 GIONS repidly at pubertal age and reaches ae arch catilage | tahyoid tigement, lesser alt siae after which orowth cases, (Releherts Cartage) ee eae pat at MSEC body of hyo'd For which of the following tissue systems Scammon's : Gastar connate) car shew an'S shaped cave? COMED-2012 Sach cage Oe ld 9) Lymphoid tissue ) Hear issues ae 3 Netectotien — G) Grialtie Reet ties ms 4, BUTMS.RAND 3ed 0477] 44. “D![Dhalajhi 3ed ed 28] Nandinle cevelops. as Intramembranous hone, lateral to Suturaltheowy Sicher teckel cattilage. The proxinel end of meckel's cartilage eRe EY ars dives te to maleus and incus and later disappears without contributing to the formation of mandible,| 12, 2B. 14, 15. 16. 1. 19, a1. 22. 23. 24. 25. 26. 2. 28. ‘© [Bhalajhi 3rd ed 18,19] ‘D [Proffit 4th ed 109] “ae °C [Bhalajhi 3ed ed 32) s °C [M.S.RANI 3rd ed 73] ‘D [Bhatajhi 3 rd ed 35] ‘D’ [GRABER 3rd ed 67) ‘The mandible grows in length by resorption at the anterior border and bone deposition at the posterior horder of ramus. ‘This provices the requited space for the developing and ‘erupting permanent teeth 31. C [Proffit 4th ed 36) ‘Agents for vital straining: = Alizarin + Tetracycline ‘© Techricium isotope (99070) ‘K (Bhalajhi 3d e433] ‘© [GRABER 3rd ed 51] a2. “© [Bhatahi rod 168] The sesanoid is @ small nodular bone most often present embedied in tendons in the region of the thum Calcification of sesamoid sone is one of important features of pubertal growth spurt, which is eae in Femeles than in males. Absence of sesamotd bone indicates delay in reaching puberty 33. ‘W [Bhatajhi 31d ed 16) “© [Bhalajhi 3rd °C [Bhalajhi 3rd ed 26) 34, D’ [Bhatajhi 3 vd ed 10) ‘D [Bhalajhi 34d ed 40} “D [Bhatajht 3rd ed 13] Tantalum implants are embedded in certain aveas of the maxilla and rrandible to study the growth of skull Implants and vital staining techniques ate used to study the dynamic changes occurring during bone deposition and resorption where as radiographs show static changes. © (MS.RANI 3rd 04 56) ~—_ Fusion of tno adjacent bones by a cartilage Eg: sphieno-occipital. | Synichondrosis: ORTHODONTICS a5. 2. Fusion of two adjacent bones by a fibrous Ligament Early closure of a suture or early fusion of | ‘wo adjacent bones by a bone. Eg: Syraphysis menti ‘8 [GRABER 31d ed 65, 66] According to Enlaw’s expanding 'V principle many facet bones will have a ‘V shaped pattern of growth. Bone {eposition oceurs on inner side of wide end of 'Y and bore resorption occurs on the outer surface. This results in growth movement towards the ends. Eg: Ramus of mandible, palate. covonoid and Condylar process ete ‘© [Bholajhi 3rd e¢ 28] A single essification center For each half of mandible arises in the area of future mental foramen lateral. to meckels cartilage here te inferior alveolar nerve bifurcates into rental and incisive nerve branches, Maxila has 3 ossifcation centers. One primary ossification center is for maxilla proper (Which arises at infraorb tal foramen, above the canine fossa) and the remaining two ‘ossification centers are for pre-maxila - ‘D' [Bhalajhi 3rd ed 17) The function matrix concept of Melvin moss is based on the original concept of functional cranial component by vander Klagus (PGI June- 13). According to moss, the Growth and maintenance of all skeletal tissues is always secondary to certain responses that occur in non-skeletal tissues. .'R [Proffit 2nd ed 28) ‘C [American Journal Of Orthodontics} Functional matrix theory revisited by Moss includes concepts 1) The role of mechanotransduction 2) The tole of an osseous cormected cellular network 3) The genomic thesis 4) The epigenetic antithesis and the resolving synthesis ‘DY [Bhalajhi 3rd ed 10) Thymus is 2 lymphoid Ussue which proliferates rapidly in late childhood and reaches 200% of adult size. After 18 years, it undergoes involution to reach adult size. ‘® [Bhatajhi 3rd e¢ 10) ‘DY [Bhalajhi 3rd ed 15) ‘Combinations of deposition and resorption ‘occurring in different bones of skull resulting in growth movement towers depositary suctace ==38. 39. 40. a 42. 43. Dental Pulse AAA, 1 ie the movement of whale Bone as] a unit In primary displacement, the bone is gg Displacement | displaced as a result ofits own growth. |“ * In secondary displacement, the bone ets displaced as a result of gewth ane snlargenent of adjacert bane 4s, [Bhalajhi 3rd od 19,20] [Bhalajhi 3rd ed 18] PERIOSTEAL MATRICES Eg: Blcod vessels, newves, glands et. These act actively upon their related skeletal units and produce transformation of size or shape. This transformation is brought about by deposition and resorption. 5) CAPSULAR MATRICES: fg: Neuco-cranial capsule, oto facial eapeute Capsular matrices act passively and produce secondary translation. This translation 1 not Erought about by deposition and resorption ‘8 [Bhalajhs 3rd 04 36) HEOR ENT = Growth i= controled by genetic] Genetic theory | innuence and is pepianned. ‘Sichers sutarat | Growth 49 the sutures 1s responsible theory ‘for craritecial gronth “A moltofectoral thoory, which | 48. Gaus lll the ee Sea) Van Linborgh’s | theories theory * States that growth is under contiol of intrinsic genetic, epigenetic and environmental factors, + Cortilaginous part of stl are primary centers of gcnth with sutures being Seat aus |__ only secondary in nature theo | Acortng co scot he nasa septal cartilage is the pacemaker for growth of entire naso-mailary complex | 47. Moss = The growth of skeletal components Functional fs largely depends on functional mate taaory | matrices or non-skelatl issues, Scot? Hypothesis i emphasized on (KAR 2033) Ans: Nasal septum 4. © [Bhalajhi 3rd 04 15] 4s. Refer 0. No. 37 Bhalajhi 3ed ed 16) 1D’ [Gray's Anatomy 39th ed 484) e ‘The size of cranial vault is almost of adult size by the end of 7 year. “C [MS. Rant 3rd ed 67) ‘The skull at birth contains 45 separate bores; many af these bbones are ‘used together and are reduced to 22 bones in adult. °C [Ahalajhi aed ed 31) The important synchondroses found in cranial base ‘are spheno-occipital_synchondrosis, — spheno:ethmoid syrihondrosis, inter-spheneié synchondkosis and. intia- ‘occipital synchondrosis, * Principalgrowth cartilage of the cranial bese during chilchood. spheno-occiptat | Itis cartilaginous junction between sgichonerosis | sphenoié ane the occipital bone (Last synchon- | + The civection of growth of the Grosis to fuse |” spheno-occipital synchandrosis 4-10) Upwards and forwards It closes at an average age of 28 yeas * It is a cartilaginous band between ‘Spheno-ettimo'd | the sahencid and ethrnoid bones. sprchonerasis | i aster by 6:25 years of age + Its e cartilaginous band between Inter spheroidal | the 2 parte ofthe spheno bone. Surchonerasis | 1 osifes at birth Tnba-oceipital | Ossfied by 3-5 years of age simchonaross “X [Gray's Anatomy 39th ed 103] Consists mainly oF collagenous Junctions betveen bones. Hirai feats ‘Eg: Sutures, gumphoses and pene Synchondroses (primary CO ee Seer te (secondary catiaginous joints) ‘Syenphyses: All symphyses are median and almost confined to aya skeleton ‘B [Bhelajhi 31d ed 31) ‘Timing of cranial base growth By birth, 55 - 60% of adult size fs achieved By the age of 4-7 years, 94% of adult size is attained. * By B13 years of age, 98% of adult size is reached, D [Bhelajhi 3rd ed 14-15] “D [Bhalajhl 3rd ed 54) In the late 1600s, Wolff, a German physiologist, observed ‘that the internal architecture of bones reflects the stress patterns on them (KERALA -2015). According to Wolf's lan ‘of transformation of bone, unlike other connective tissues, bone responds to mild degrees of pressure and tension. Those changes are accomplished by means of resorption of existing| 51. 52. 53. 56. bone and deposition of new bone and these changes takes place on the surface of bone under the periosteum, or in the case of cancelous bone on the surface of the trabeculae or on the walls of marrow spaces. e ‘B [M.S Rani 3nd ed 70, 76] ‘B [Bhalajhi 3rd ed 5} ‘8 [Bhotajhi 3ed ed 17/8) ‘The functeral matrix hypothesis sugeests that the origin, form, position, gromth and maintenance of skeletal tissues are alvays secondary to specifically related non-sieletal 7 tissues, Functional Cranial component is divided ito Functional ati Sheetal ants onsite of " Periosteat Capsular matrix Macrosteletal inatix fy: Neuro uinits fs Muscles, cenit capsule, Eg. maneibe, Blood vastels, Oo-tacal mails Nerves. capsule. Glands ete, + Aierokatetat + ‘Act indirectly ulnits thee Act directly & —& passively on Misses detively pon macrovaietal Seat Inlcoleletal units cout i. wits + Goniat 1 fringe about et Brings about passive Pens axtive and tronlotiog il sprapereatogy Maxilla { Pneumatic transformation mu | 6. °B! [Bhatajhi 3rd ed 172) ‘The shapes of the cervical vertebrae differ at each level af 2, sKeletal development, and this hls to detervine the skeletal maturity operon, Tis ta bass of Haeeel and Farman system of evlasting skeletal matrty using cervical vertebrae The ose of cervical verlebrow oF skeletal maturity indicators was first done by (KAR-2013) Ast Hassel and Farman ‘D’ [Bhatajhi 3rd ed 17) 6. °D’ [M.S. Rani 3rd ed 101, 102] Benninghoff studied the natural lines of stress in the skull by plercing small holes into fresh skull. Later, when the skulls were dried, he observed that the holes assumed a Linear form in the direction ef bony trabeculae. These lines were called Benninghoff's Lines or trajectories. ORTHODONTICS Trajectories of the maxillae run from the maxillary alveolar process tothe base ofthe skul, The three vertical trajectories ‘include: © Frontenasal or canine buttress + Mala:-rygomatic buttress + Pterygotd buttress In mandible, Benninghotf’s trafectorias are essentially parallel, A line of stress extends from condyle te symphysis and from ramus that run through spongiosa. The lower border of mandible and the myalohyoid ridges are the other prominent buttresses of the mandible, ‘B [Proftt 4th od 50, 51) Meckle’s carilage is the primary cartilage of mancible, The cartilages at the condyle, comoid and syrmohysis are the secondary cartilages, The condylar cartilage is considered 4s the pacemaker for growth of thet bone. Nesal septum is considered as the pacemaker for growth of maxilla. “8 [Bhaleji 3rd ed 32] ‘+ Intersphenoidal synchondrosis is believed to ossify at birth. ‘+ Intra-occipital synchondrosis ossifies by 3~5 years of age. + Sphenio-ethmoidel synchondioses ossifies by 5 ~ 25 years of age. + Spheno-occipital synchrdoses ossifies by 17 - 20 years of age. ‘B [Bhaloji rd ed 34, 35] Rescrption cccurs on the anterior part of ramus while eposition occurs at the posterior region, This Facilitates the lengthening of the mandibular Body, whien tn turn ‘accommadates the erupting molars °K [Bhalays 20 od 9) “D' [Bhalajhi 4th ed 18, 33, 34) ‘C' [Proffit 4th ed 29] The concept of "Cephalo-caudal gradient of growth” cays thet thete is an axis of increased growth extending from the head towards the fet i.e, structures, which are far From brain grew more compared to other parts. hen the facial ‘roth pattem is viewed ageinst the perspective of cephelom ‘caudal gradient, it not surprising that the mandible, being farther aay from the brain tends to grow more and later than the mavilla, which is close to brain, ‘B' [Bhalajhi 4th ed 25] ‘The cranial base will bein cartilaginous form tll 7" week of prenatal form. After that, the hones of cranfal hase undergo both endochondral as well as intramembrane ossification. The first bone te show both endochondral and intra reribranous ossification is occipital bone. The supranuchal ‘squamous part of occipital bone ossifies intramerbrenously ‘uring the 8! week of intra-uterine life heer o——( PrA 64, 65. 67. 70. nn Dental Pulse © [Bhatajni 4th ed 23) m2 The prenatal life is arbitrarily divided into three periods. They are ‘© Period of ovum - exterds for a period of approximately 2 weeks ftom the time of fertilization. + Period of embryo - 2” week-to-8" week Period of foetus - 9° week-to-birth 7. © [Profit 4th eé 113) (C [Bhalajhi 4th od 39) 1D’ [Chek Explanation Beton] The mandibular or gonial angle during perinatal period ranges from 135° to 150°: however, soan after birth, it decreases to 130° to 140°. In adult mandible, the gonial angle measures hetween 110° to 120°. Studies have also indicated that the engle value of females is 3-5° greater than that of males. Note: Eventhough we could ret find any direct reference ln supert of 175 degrees, If the same question Is asked for AIPG or ALIMS exams, the answer shall be marked as 175 as it is a direct pick trom Rita Duggal 'D' (M.S. Rani 34 ed 77] “K [Dhalaji 4 ed 44] Gum pads are developed in 2 patts, They are the labio bucesl portion and lingual portion. The two portions ate separated by 2 groove called dental groove. The dental gioove corresponds to the formation ef dental Lamina. (PGI Juni 13). The gingival groove separates the gum pad fiom the palate and floor of the mouth, 7. 75. C’ [Bones and cartilage: developmental and evolutionary skeletal biology By Brian Keith Hall Pg 409) © 1867 Meyer (anatomist) 8 Culman (mathematician): Propounded the Trajectorial theoyy of tone formation, which says that the architecture of bone is cetermined by booth pressure and tension, irazeculae develop along lines of stracces calculated mathematically that enable it te bast resist stresses to which it is subjected durine function, ‘© 1870'S Julius Wollf: trabecular arrangement can change with a chenge in intensity & ditection of forces © 1925 Beninghoft Studied architecture of craal & facial skeleton & 50 called stress trajectories. [he trajectories ‘obeyed no bone Limits but rather the demands of the Functional forces 76. 8’ [Protft 4th ed 33] Anthropometry is the measurement of skeletal dimensions on living individuals, Various land marks established on dry (dead) skulls are measured in living individuals simply by sing sefe tiseue points over'ying these ony Landmatk. Measuring skeletal dimensions directly on lWving individuals is known as_(KERALA-2015) a) Craniometry ') Anthroporsetry ©) Cephalemetry 4) Tomography n a ‘C [Bhalaji Sth ed 46] Resorption eccurs on the anterior part of the ramus while bbone deposition occurs on the posterior region. This results {naa drift ofthe ramus in a posterior ditection. This facilitates lengthening of the mandibular body. ‘N and ‘C’ [Proffit 4th ed 109] The initial sign of sexual maturation in boys is usually the “fat spurt. Adolescence in Girls | * © Breast buds | Fat spurt S981) pubic har ~Tereast "> Pubic hair Stag2 2 | development. | » spurt in height begins: eee lea Stage | maturation | 6 peak velecity in height : + Height spurt ends en | tnease in muscular strength The key given for this question is both A ard C. Puberty ‘in boys begins (ater and extends over a longar period than girls. Duration of adolescence is 5 years in boys and 3% years in girls, “C [Proffit 4th ed 42] Intramembranous ossification occurs in the cranial vault and both Jans. Also wefer O.Mo.2 for further reading. By ‘clusion, cranial base is the correct answer. Text book of Orthodontics by Bishora Po 461 Cranium 85% 11% 6% axils | asm 20% 35% Nenditte [40% 25% 35% ‘X [Text book of craniofacial growth by Sridhar Pg 64] Brash remodeling theory of craniofacial gronth is the frst ‘general tasory of craniofacial grewth. Principles: © Bone only arows appositionaly at surfaces, © Growth of the jans 1s characterized by deposition of bone at the posterior surfaces of maxilla and mandible (Hunterian growth) and ‘+ Deposition of bone on the ectocranial surface of the cranial vault and resorption of bone endocranially (calvarial growth) °K [Balaji Sth ed 18 fig. 5 / Profit Sth ed 37] '* Until the age of 6, primary displacement from cranial base growth is important part of maxilla’s forward growth, Failure of the cranial base to lengthen normally, as {in achondroplasia and other congenital synéromes create 2 characteristic midface deficiency.