Progress

Notes: There are 3 documents:

- this one (containing categorized questions)
- an anatomy study guide (containing any "visual" anatomy questions)
- a case study guide (for the questions related to the case portion of the exam)

The purpose of this document is to collect all of the scattered memories from all of the board "review" sources that we can find. If a question is a repeat, just add that source
to the sources list (so that you have a sense of how many years it showed up on the test - some questions repeat more than others). Also, by combining related questions
together, they can share the same discussion so people aren't looking up the same information over and over. There are still some duplicates in the database that need to
be combined. Some of this is because the question was categorized in 2 different locations. Try to combine these. Be on the lookout for questions that are probably the
same but improperly remembered so they read differently. You can put different phrasings of the same question together if you're not certain of which is most accurate.

We used background color to group related questions together. There is no significance to any of the colors except yellow which means we wanted to look up that question
in more sources.

Keep in mind that if a question lacks a "discussion" (or the discussion looks less than reputable) it is fair to say that it hasn't been looked up. The answer marked as
"correct" is likely just from the original source. Also, if you are adding new questions, please review the categories that are available before you start - some questions are
harder to categorize than others. I put a description of the groups at the bottom of this page.

This is a database for us only. Do NOT share with anyone else even if you know them well and trust them (because there is always someone that person knows and trusts
and it could eventually run into someone careless). It would be a big deal if this got out so be responsible not only for your sake but also out of respect for your colleagues.

The 2011 tab are unsorted questions remembered from that year. I would recommend sorting those into the database first. I'll also upload all other sources we have to the
orthodatabase account. As you all get more sources, just add them to this account and the "owner" of this account will share them with the class for entry into the database.
This way, everything is in one place and everyone has access to it.

UNK 2010 COMPLETED

ABO 2010 (RandomU) COMPLETED
ABO 2009, Michigan 2009, ABO COMPLETED
Pearls 2009
61 page file COMPLETED
ABO/UT 2008 COMPLETED
2007 (ABO Tennessee)
2007 review ("Remembered Board COMPLETED
Questions")
2010 UNK Boards Study Guide COMPLETED
PLUS Special Edition

Anatomy Study Guide Already added:

UNK 2010 (complete)
ABO 2010 (RandomU) complete
61 page file (56-68)
ABO 2009, Michigan 2009 (complete)
ABO 2008 (complete)
2007 (complete)
Case Study Guide ABO 2008 (not started yet)

Already added:
UNK 2010 (complete)
ABO 2010 (RandomU) complete
ABO 2009, Michigan 2009 (complete)
Unkown Source from DDay file (complete)
2007 complete

1
 Progress

Groups for categorizing questions: Bone Biology & Physiology: this one includes orthodontic tooth movement

Anatomy

Growth/Development & Orthopedics: if it is a question about growth modification, it goes here but if it is a general question about a functional appliance, I put it in
"Techniques/Appliances" - in my opinion, we should just make a separate category for "Functional Appliances"

Radiography/Photography: just questions about procedure, process, and protocol. Radiographic analysis would go in "Cephalometrics & Analysis". I would probably prefer
to break this up as separate "Radiography" and "Photography" groups and just dump everything from "Cephalometrics & Analysis" into the "Radiography" group just to
simplify things but that may be more trouble than it's worth.

Cephalometrics & Analysis: any type of radiographic interpretation outside of pathology and disease states

Pathology & Disease: any aberrant growth or disease including cleft lip

Pharmacology/Pain/Anxiety: drugs and drug related questions including anything related to endocarditis prophylaxis

Occlusion

TMD (not to be confused for "normal" joint growth found in Growth & Development)

Preventive Dentistry/Hygiene

Behavior/Pt Mgmt

Speech Pathology

Orthodontic History

Dx/Analysis/Tx Planning (not the same as "Techniques/Appliances" below)

Biomaterials

Techniques/Appliances (not the same as "Dx/Analysis/Tx Planning" above)

Biomechanics (it can get fuzzy what goes here and what goes in "Techniques/Appliances" but my general rule of thumb is that if it involves an appliance other than the
archwire, it goes in "Techniques/Appliances" even if it is clearly a biomechanics question so that we can eventually start grouping the questions eg. headgear, elastics, etc.)

Surgery (this includes any surgical procedures not just the jaw rearranging ones)

Perio

Endo

TADs/Implants

Restorative

CPR

Risk, Practice, & Ethical Mgmt

Bio-statistics (a category someone invented to hold all of those little statistics we are supposed to remember so I can't really give you a better definition so please edit this if
you can describe it better - it would be easy to put a lot of questions here but I would personally prefer them in the descriptive categories if they fit)

Statistics & Research

2
2012 had two new cases, the other cases were the same as the previous
year. The questions with the cases are remembered from the exam; thus
not exact. Exam had lots of except questions. Knowing this material and
understanding it will totally make sense once you see the actual question.
No real way to study for the cases. Just think "What would Tweed do"
and keep it simple.
Teen Missing lower 5’s, Lateral open bite
a) What is the DI based on the molar occlusion? Class III, 4 on each side,
total 8
b) Do you need to do? Best choice is expansion (orthopedic), not SARPE
c) Best tx: Extract upper 5’s, expand, mesialize the roots of the upper 6’s
(1,2,4)
d) How to close lateral open bite: ans: erupt the buccal segments
e) If he had a lot of growth left what will be least detrimental?: Gonial angle
Mixed dentition Case, 8 years old Class III w. anterior cross bite;
a. Would you do anything to correct the diastema? Delay space closure
(leave spaces open)
b. What is the best tx option: Facemask, reverse pull face mask
c. It you place a bite plate what are you helping correcting: Jumping the
bite (Correcting the anterior cross bite)
d. How do you treat non-surgically? Extract of premolars
e. If no future surgery, how would you camouflage: extracts 4’s
Class II Bimax
a. Worst treatment for this patient: Non-extraction with Herbst
b. Will premolars need to be take out? (yes)
c. Best treatment option: Lower 5’s, upper 4’s
d. How to treat diastema: Close retain (close during treatment)(no
fenectomy)
e. Worst way to level the curve of Spee: Intrude Maxillary posterior (best
intrude lower incisor)
Functional shift and Transposed UR3,4
a. Her asymmetry is due to: functional shift, CR/CO shift
b. CR/CO is latero-occlusion (true), Correcting the shift early will prevent
skeletal problems (True)
c. Evaluate for a functional shift, what do you want to next? Flat plane
splint
d. Best treatment: UR 4 UL5, Lower 5’s
e. Multiple choice question: All are true about Transposition EXCEPT :
a. Supernumerary teeth (this is correct)
b. Mostly occurring between upper canine and premolar
c. Associated with other dental anomalies: missing, small or peg laterals,
congenitally missing teeth (not thirds), severe rotations or malpositions of
adjacent teeth
d. Underlying genetic basis

Missing Laterals
Female, missing laterals, edge to edge anterior, flat upper lip, low smile line
a. If surgery not an option, what is a good treatment: Canine substitution
and lower incisor
b. If you close all space, do not distolingualize the upper first molar
c. If only 1mm between implant and adjacent root: Lost of papilla

3
 d. How to fix open bite: extrude lower incisor
e. Worst quality about her face? Buccal corridor
Cleft Patient
a. Golson yard stick is…(t), graft before canines come in (t)
b. What is most appropriate expander: fan shape.
c. Worse prognosis surgery is: Narrowing of mandible
d. Would you do an implant? No!
b. lip positon question like e line 0 and -1: Resident said it looked fine
Anterior Open Bite (Surgery Case)
a. What would be good tx: 3 piece maxilla with possible mandible
advancement
b. What is bad or everything is good except: buccal corridors and
excessive posterior gingival display
c. What is striking about her: Incisal display
d. CVMS, how much growth left: None
e. T/F: RPE in adult causes gingival clefting (True); doing SARPE in adult
is stable in comparison to RPE (TRUE)
Hispanic: Blocked out lower Caines, Impacted Upper 5’s
a. What is off with his smile: Flat smile and buccal corridors
extraction of lower
3's and upper 5's
and 6's was also
b. Best treatment option: Extract upper and lower 5’s chosen by a few
c. What do you not want to do? Retract lower incisors
d. Two part T/F: Lay people can see small changes in buccal corridors
(FALSE) and this kid needs Rapid palatal expansion (FALSE)

4
 To study for ABO, Begin with this document. Go
through once, write down things you are not sure
about, look up answers from the ABO reading list
first, if it is not covered on the list, search AJO-
DO. If you have conflicting research, go with
Proffit or Graber. Try to meet with residents
periodically to discuss things and go through
These are highted questions from previous years Google docs again and again, it is all here.
that are on 2012 test
sphenopalatina a.
Palatoglossus m.
sphenoid sinus.
lingual a
spinal cord.
superior oblique capitis m.
Jugal point is the interection of what bones?
Dry skull: lesser wing.
orbicularis oris
PA ceph: lesser wing of sphenoid
PA ceph: adenoids (most likely lateral ceph)
Lat.ceph : they ask to point to the place where the ant.belly
of digastic inserts.(Hyoid)
Buccinator
Lingual Nerve
Which of the following structures is closest to the adenoidal
pad? Had letters labels on a ceph and you had to pick a
letter.
Internal acoustic meatus
What is the best structure for superimposition of cranial
base:
a. anterior clinoid, cribiform plate, and greater wing of
sphenoid
b. Sella on S-N Line
c.Planum sphenoidale, lesser wing, sella a
Where to superimpose for 10 year plus longitudinal study:
a.SN at S
b.ethmoid, ant clinoid, GW of sphenoid
a
Springback is useful because
a.Wire maintains its stiffness
b.Wire deflected beyond yeild-point till the arbitary clinical
leading point, but no longer return to it original shape
c.Wire is resistant to permanent deformation
b
HIPAA stands for:
a.Health Insurance Portabilityand Accountability Act
b. Health Information Privacyand Accountability Act
c. Health Insurance Privacy and Accountability Act
a

5
What are the advantages to giving plateletrich plasma
during surgery?
a.You are in a hospitalized setting
b.Because the plasma has a platelet count of over 250,000
c.Because it contains all the nutrients necessary for healing
except _? (can't remember) and fibronectin.
d.Because it contains platelet-derived growth factor,
transforming growth factor (TGF), and insulin-like growth
factor.
d
What are the benefits of giving platelet rich plasma during
surgery
a. because plasma has platelet cound more than 250000
b. growth factors
b
a positive tuberculin means the person was previously
exposed to TB. Positive result does not indicate the level of
current activity.
A) First statement is true, second false
B) First statement false, second true
C) Both True
D) Both False
c
If a person has a positive TB test what doe that mean?
a.Patient is contagious
b.Patient is active
c.Patient has been exposed
c
The physician should be concerned if a child's growth
pattern is above which of the following:
a. 25th percentile
b. 50th percentile
c. 75th percentile
d. 95th percentile
d
When the cranium complete growth to maximum
5,7,9,11,13
7
Most rapid somatic growth occurs:
a. Birth to 2 yrs (before birth, conception to birth)
b. 4-7 yrs
c. 7-9 yrs
d. 12-15 yrs
a

6
Which is NOT one of the four cardinal symptoms of TMJ
disorder?

Which of the following is NOT a common symptom of TMD?

a.pain in TMJ
b.joint sounds
c.ADD
d.impaired mobility of joints
e..headaches
f. crepitus
c
Pt with open bite, can open 27mm, deviates left upon
opening. What is the diagnosis? internal disc derrangement without reduction
Pt w/a paralyzed rt lateral pterygoid muscle is instructed to
open his mouth wide. Which direction will the mandible
deviate on opening?
a.To the left
b.To the right
c.Straight (no deviation)
d.None of the above
b
Right side anterior disc displacement without reduction, On opening jaw deviates to right and Cannot move jaw to
what do u see? left lateral –limited left lateral movement
How many mm can a patient open if they have a closed
lock
a.42mm
b.60mm
c.11mm
d.23mm
d
Which is NOT seen in acute closed lock patients?
a. deviation upon opening
b. range of motion 27mm or less
c. joint sounds
d. pain with forced maximum opening
c
Maturity of bone
Order of bone
a.woven, composite, lamellar
b.woven, lamellar, composite
c.woven, composite, lamellar, bundle
a
isphosphonates cause all of the following except:
a. diminished osteoblast activity
b. inhibits tooth movement
c. osteoradionecrosis
d. reduced wound healing
e. increased mineral density
a

7
For NiTi what gives it its special properties?
a. Phase transformation
b. Elasticity
c. Strength
a
Which of the following allows application of constant force
a. A-NiTi
b. M-NiTi
a
What wire would you use to apply a constant force over a
long period of time?
a. Martensitic Niti
b. Austenitic Niti
c.Braided
d.SS
b
Multiple T/F:
Gorlick states that significant decalcification occurs in 50%o
of orthodontic patients.
These patients should avoid large amounts of flouride to
allow the enamel to remineralize.
TT
Where is the Crot if you close a Maxillary diastema with
finger springs?
a. apical 2/3
b. apical 1/3
c. middle ½
b
If you tip maxillary central incisors toward each other with
springs on a Hawley to close a diastema, where is the
center of rotation?
a.In the apical 1/3 of the root
b.In the center of the root
c.In the center of the entire tooth
a
NSAIDs inhibit tooth movement by inhibiting prostaglandins.
Decreased prostaglandin levels raise the pain threshold. TT
Hypertelorism is seen in?
a. Oro-ocular
b. Lateral
c. Oblique
d. Midline
d
16 years old boy who is class III. What do you do to stop
the class III progression?
a. Chin cup
b. High condylectomy
b

8
Studies show that 50% elasticity of powerchains is lost
within
a. 1 day
b. 3 days
c. 5 days
d. 7 days
a
Wormian bones are seen in which of the following:
a.Paget’s diease
b.cleidocranial dysplasia
c.Osteogenesis Imperfecta
b,c
In digital photography, use 8 bit, there are 256 shades of
gray. This is ok bc human eye can only distinguish 40
shades TF
True or False: Human eye sees 16 shades of gray. Digital
camera sees 256 shades (if 8 bit only) TT
What percentage of openbites self-correct? %80
TMJ is different from other joints by:
a. presence of a meniscus
b. fibrous CT in disc instead of hyaline
b
What are the articular surfaces of the TMJ lined by?
a. Synovial fluid
b. A thin synovial membrane
c. TMJ ligament
b
Histologic tetracylcline (tetracycline) studies of implants
show that:
a. Lamellar bone at interface with slow turnover of bone
b. rigid within supporting bone (Look up in Graber, we had some discussion and came to a
c. composite bone at interface consensus
at Composite bone at high turn-over)

tetracycline stained bone studies show that osseointegrated

implants for anchorage show
a-implants do not move at all
b-remodeling is minimal
c-implants move 0.1mm/?
d-osteointegration is not necessary
a
Which of the following imaging methods is best for
perforated disc?
a. arthrography
b. arthoscropy
c. mri
d. ct
a

9
Which gingival fiber is associated with the most relapse?
a.Apical
b.Principal
c.Transseptal
d.Supracrestal
d
Perio patients should have steel ties, and they have more
bacterial concentration in gingival plaque TT
When replacing a lateral incisor with a canine, which of the
following is NOT important
a) Color and size of opposite lateral
b) Color and size of opposite canine
c) Posterior occlusion on opposite side
d) Posterior occlusion on same side
b
Which of the following is a correct statement:
a. apposition is seen on anterior border of chin
b. apposition on lower anterior border of mandible at
pogonion
c. resorption seen at posterior symphysis
d.lingual apposition at the symphysis d
Which of the following is NOT a characteristic of Gardner’s?
a. Facial clefts(2012 had Osteosarcoma as the Not choice)
b. Colon polyps
c. Supernumerary teeth
d. Multiple osteomas

During the finishing stages of orthodontics, your patient has

a CR to CO slide of 2mm into a good Cl I relationship, what
is the appropriate treatment?
How do you finish with 2mm CR-CO discrepancy?

a.Equilibrate the mandibular distal inclines and the maxillary

mesial midlines
b.Cl II elastics
c.Cl III elastics
d.Functional appliance 2mm equilibrate
a >2mm class II elastics
What initiates the polymerization of the light-cure bonding: camphoquionone.
What is the best statistical measure to predict the
mandibular growth based on 3 variables:
a. Analysis of Variance aka ANOVA
b. Correlation
c. Student t-test
d. Chi-square
a
Primary failure of eruption is seen more frequently in the
anterior region. When orthodontic forces are applied,
ankylosis often occurs with such teeth when extrusive force
is placed on them FT
CBCT: increase in voxel size, increases magnification. An
increase in voxel size, increases resolution FF

10
Smaller Voxel size is favorable for good resolution.
Increased voxel size can cause more magnification. TF
If a second mandibular molar needs buccal crown torque
and you placed a heavy rectangular wire. Where would the
wire pass on the other molar side: Below
How much force on a TAD? 100-200 grams
Best surgical procedure in a patient with TMD problems?
What is best surgery for pt with TMD?
Class 3 prognathic with TMD. What surgery is best?
a. IVRO
b. VRO
c. BSSO
d. TOVRO
a
Which of the following is a midline point on PA ceph:
a. Menton
b. Opisthion
c. A point
d. Jugulae
e. ANS
b
Adult in maintenance periodontal therapy: When do you
start:
a.Immediately after tx,
b.1 month after tx,
c.6 months after tx,
d.when periodontist tells you to start, orthodontist decides
d
CBCT is better for TMJ than CT, CT has more radiation
dosage than CBCT
a. first statement is true, second is false
b. first statement is false, second is true
c. both true
d. both false
c
Which of the following is not true if missing one 3rd molar:
a. 13x more likely to be missing others Wont have increased chance of supernumerary when missing
b. 3.5% chance missing 2nd premolar other
c.increased rate of small laterals and supernumerary c teeth
Extract the b to guide eruption of the
Congenitally missing laterals with retained b and c. canine into the lateral space (for bone preservation until it is
How do you manage the time to distalize the
primary dentition for the erupting canine? canine and prepare for implant.)

Which of the following will not fulfill ABO requirement for

patients
18 yo and older? (PSR, FMX, full charting, Pan/FMX) PSR
What is important to look at when restoring teeth that have
good bone level with black triangles?
a. Height of U1s
b. Width of U1s
c. Height/Width ratio
c

11
How would you eliminate black triangle between normally
shaped central incisors:
a. Distal root
b. IPR/ARS (at the contact area_
c. Intrude teeth until blk triangle goes away
d. Free gingival graft
e. Extrude
f. Torque incisors
b
True false: When going from cr/co and get a midline shift,
is it called a laterocclusion? T
Which derived from fronto nasal process
Philtrum,
alla of nose
maxillary process
Philitrum
Having a Bolton discrepancy would not affect?
Transverse posterior discrepancy,
end on anterior,
spacing in anterior. Transverse posterior discrepancy
When does mineralization of permanent first molars begin?
a. At birth
b. 4 months in utero
c. 6 yrs
a
The right and left sides of the mandible fuse:
a. Just before birth
b. Shortly after birth
c. Near the end of the 1st year of life
d. Near the end of the 2nd year of life
b
when do the two halves of mandibular symphysis fuse?
a. 3 months before birth
b. 3 months after birth
c. At 1 year
d. At 2 years
b
How long should you retain a tooth that was extruded in a
month:
a. 1 month
b. 3 months
c. 6 months

T/F: Fx appliances accelerate the growth of the mandible.

Treated patients have longer mandibles
a. First statement is true, second false
b. First statement false, second true
c. Both true
d. Both false
a

12
Which of the following changes from 8-18 yrs

a. Facial angle
b Facial axis
c. Broadbent registration point
d. Y axis

The sequence of giving CPR to an adult is? 30 compressions 2 breaths

Where are chest compressions given when performing
CPR in an adult?
a. lower third of sternum
b. lower half of sternum
c. middle third of sternum
d. between sternum and navel
b
What radiographs should be submitted to ABO for a patient
over 18 yrs?
a. Pano plus bitewings
b. CBCT scan
c. FMX
d. Pano
c
According to the ABO, which of the following represents
the mandibular plane:
a. Lower border of mandible to Menton
b. Gonion to Menton
c. Constructed gonion to Menton
c
Clockwise moment around maxillary molar, where do you
put your force in HPHG.
a. Distal to Center of resistance
b. Mesial to Center of resistance
c. Above center of resistance
d. Below center of resistance
a
Hyperdivergent phenotype should be treated early. The
phenotype can be diagnosed early.
a) First statement is true, second false
b) First statement false, second true
c) Both true
d) Both false
c
Prostaglandins are associated with all of the following
except:
a. IFN-gamma
b. IL-1
c. neocytokines
d. TNF-alpha
c

13
Which of following is NOT included on ABO analysis(or DI
analysis)
a. FMA
b. ANB
c. IMPA
a
Which of the following affects both maxilla and mandible
and occurs due to a disturbance in the first trimester:
a. Hemifacial microsomia
b. Mandibulofacial Dysostosis aka Treacher Collins
c. Crouzon's
a
Tongue thrust in transitional dentition with some openbite
a) Crib
b) Myofunctional exercise
c) No Tx
c
Which is not a growth site?
a. synostosis
b. syndesmosis
c. synarthrosis

Maxium opening is measured from incisal edge to:

a. incisal edge
b. incisal edge + overbite
c. incisal edge - overbite
b
In an adolescent, which of the following can be expected: in
terms of RMO
a. 50 mm opening and greater then 7mm lateral
excursions
b. 50mm and 12mm
b
A patient presents with a unilateral x-bite without a
detectable functional shift, what else can be done to
evaluate a functional shift?
a. Take a PA x-ray
b. Mount the models
c. Flat plane splint
d. evaluate dental midlines
c
A patient has prolonged history of internal derangement
with no joint sounds. Patient developed pain in the TMJ
area:
a. Posterior capsulitis
b. Disc derangement without reduction
c. Disc derangment with reduction
a
Patient has fever, multiple blisters
a. Primary Herpetic Stomatitis
b. ANUG
a

14
Anterior cranial base stops growing and become stable for
use in superimposition:
a. Birth
b. 3 years
c. 5 years
d. 7 years
e. 18 years
d
cleft lip formed by failure of fusion of the following:

Bilateral cleft lip occurs from lack of fusion of what?

medial nasal process and maxillary process
Diode laser works by:
a. ablation
b. protein degeneration
c. Heat
a
Gingival clefting is seen when the following procedure is
attempting in adults:
a. SARPE
b. Orthopedic maxillary expansion
c. Surgery
b
when can orthodontic treatment be initiated in a tooth that
received apexification
a. simultaneously
b. wait for 2 yrs
a
VTO predictions are accurate and can be used in
orthodontic tx planning. VTO predictions of soft tissue are
accurate. TT
In the CR definition, more agreement lies in the following
a. Superior position
b. Superior anterior position
c. No exact position
d. no consensus d
Most magnification is seen with the following:
You are most likely to get a magnified image if?
What is the most common error causing magnification?

a. increased object/midsagittal plane to film distance

b. increased anode to patient distance
c. Decreased object to film distance
a
Which of the following is not seen in Downs syndrome:

a. Premature eruption of teeth

b. Slanting epicanthal folds
c. Trisomy 21
a

15
Mandibular intercanine width changes from primary to
permanent dentition:

a. Slightly increases
b. Significantly increases
c. Slightly decreases
a
PTH and Thyroxin does what?

a. inhibit tooth movement

b. enhance tooth movement
b
Which of the following is the worst for vertical control
a. CPHG
b. HPHG
c. TPA
a
T/F?: Nocturnal bruxism not associated with occlusal
interferences, but is associated with high anxiety and stress TT
TMD pt with open lock. When she moves laterally to the
left she get a loud pop. Which joint and is it anterior or
posterior disc displacement?
a. Anterior displaced disk on left
b. Anterior displaced disk on right
c. Posterior displaced disk on left
d. Posterior displaced disk on right c
What is the immediate short term effects of low-calcium
levels?
a. low cardiac output
b. hyperactivity of nerves and muscles

it was both multiple multiple answer

a and b
Greatest somatic increase is ...
a. conception to birth
b. birth to 2 years
c. 12-15 years
a
Implant placed within 1mm of adjacent tooth:
a. horizontal bone loss
b. loss of papilla
c. lack of osseointegration
b
Herbst and Mara have what effects
See helpful hints doc
open bite
Teeth that have been treated endodontically, prior to the
start of orthodontic treatment will display:
a. A greater tendency for root resorption
b. A lesser tendency for root resorption
c. No predictable pattern of root resorption
b

16
When to bond peg lateral
A. during tx when there is a little more space than the size
of the other lateral
B. after tx
c. a long time after tx to allow for settling
a
Standard of care question options
A. ABO
B. Dental assoc
c. Courts
b
Most important factor for successful TAD?
a. Diameter
b. Length
c. Force/direction/placement
c
how to counteract effects on molar in intrusion arch-
The question about clockwise rotation of the molar with
HPHG wasn't on there thank God.
a. HPHG with short outer bow
b. HPGH, short outer bow w/TPA
b
Multiple T/F - C2 and C1 articulate to allow rotation of the
head, RO structure (referring to odontoid process) is formed
by C1 AND C2 TF
Stem Cells: Which of the following is true
A. Can multiple on its own
B. differentiate into at least 2 types of cell
C. A and B of a stem cell
c
Who was the first to use cephalometrics in diagnosis and
treatment planning Tweed
How does a Twin Block help correct a Class II Div 1, all true
except?
(it wasn’t worded exactly like this)

a. it allows for a horizontal component of md growth

b. it allows you to increase VDO by removing acrylic from
lower part of appliance so that md teeth will erupt
c. it allows for primarily dental correction of OJ
d. the acrylic coverage on the lower anteriors is to prevent
flaring of lower incisors
c
The most common error in cephalometric tracing is what?
a. Poor films
b. Magnification
c. Proper identification of landmarks

Wavelength of curing light is? 460-480

Trigeminal nerve originate from?
Medulla
Pons
Pons

17
Remembered Questions and materials from exam
What is not taken into consideration for cbct dosage of
radiation:
a. definition of microseverts
b.??
c.definition of grays
d. absorbe dose doesn't use tissue factor and effective
dose of X-rays to calculate(something like that) d
Most radiation is
a. bone scan Tech 99
b. CT
c.CBCT
d.MRI bone scan
Marfans is caused a by what gene miscoding: fibrinillin-1
Long nasalmaxillary segment associate with except:
a. Clockwise mnd is correct
b. Long mandibular length (this is the exception) b
Open bite patients usually display:
a. stomion superiors below incisal edge
b. stomion superiors above icisal edge b
Sleep apnea mandibular positions device side affects:
tmd
minor occlusal changes what does the MPA cause, answer minor occlusal changes
discomfort problem Minor occlusal changes (verified with article, it helps tmd acts like a splint
Tension side what type of bone? Fibrous tissue and woven both
Twin block, best time to treat: late mix dentition
First brachial branch includes what? Mx and mnd
Most common odontogenic cyst: Odontoma
The archform of the wires are based on all except?
a. mnd shape is determined by the mx
b.bader,
c.Canterbury
d.Hawley a
What is not used in smiling? Orbicularis oris
Apert’s: all true except:
a. suture fusion
b. mental deficiency
c. synadactly
d. hypoplastic supraorbital d
Patients treated with arch length expansion procedures in Lose arch length, in the majority of cases, until the arch
the mixed dentition what do you see: length is less than the pretreatment arch length
In a patient that started with significant lower crowding,
when you remove the retention, what happens? Arch length and arch perimeter decreases
Functional matrix question: sutural growth is affected by? Answer: response to Soft tissue
Short class II elastics through mx center rest and distal to
mandible center rest what happens? Steeper mnd occl plane
What causes apical rt resorption? intrusion and lingual torque,
What does the DI measure? answer: Case complexity
Most stable curve of spee
Banding molar with mitral valve need premedication (f),and
u give rx with pen allergy clindamycin 600g 1 hour before(t)
TMA deflection compared to SS twice as much deflection as SS

18
What percentage of the time does phase 1 patient have
improvement of there class II corrected?
25%
50%
75% 25%
What organ is used to regulate calcium? Kidney
What do amphetamine do: vasoconstriction and pupil dilation
Scaphocephaly is caused my early fusion of what suture? mid-saggital suture
Best time to do nasalalveolar molding: within 3 months after birth
Osteoarthritic changes in tmj: best imaging is:
mri
ct
arthogram CT
1) Clear tray: 5 choices: be carefull to use it in all
except:
a) cr/co discprency, greater than 2mm ap skeletal
discprency,
b) if there is more than 5mm crowding in mnd and mx
arch,
c) short clinical crown with missing teeth,
d) (less than 2mm of open bite and minimal crowding)
(good clear tray option)
d
After mnd vertical setback lower lip droops, what nerve is
the cause? facial
Most common cause of skeletal class II: normal mx and mnd retrognathic
Which part of the face has both intramembranous and
endochondral growth? Neurocranium and midface
6) Condyle: which is true,
a) relocates up and back
b) growth of condyle causes downward and forward
movement of the mnd
c) condyle grow intrmamebraneously (false it is
endochonrdal),
d) cartilage is growth center (false, site), last choice is not sure about this because of wording, bring mandible
cartilage something.. down and forward seemed to be the best choice
What would u do to get rid of exagerrated curve of Wilson buccal crown torque
Condyle is _______ as wide as its AP dimension
Same
2X
4X 2x
Bones that contribute to floor of orbit?
Sphenoid
Other wrong answers
Palatine Palatine
If you rotate mx and mnd clockwise ANB increases
Perio: plaque plays a role in perio and the reason u know
this is because:
a) Removal of plaque reduce gingivitis
b) Change in flaura
A

19
Dosimetry: what is false: answer: the tissue absorping dose
does not reflect the radiation weighing factor of xray, other
choice defines microseveret , defines gray,
Later ceph shows ptm: is border of mx posterior and
pterygoid plate of sphenoid
What dervies from semilunar ganglion
Super impose on the mandible: anterior symphysis and
best fit on mnd canal
What is best to prevent relapse: answer is intercanine and
intermolar width
Mucocelle is not a true cycst because: no epithelium lining
Mx central incisor impacted 5mm from cej: closed eruption
Le fort 1 what happens with growth: same as before
surgery, more vertical More vertical
Molar retraction put tad distal to caine (t), more stable with
pilot hole (f)
How to determine the amount of impaction for VME doing 2
jaw surgery
a. incisal position determined by smiling
b. Incial postion determined with lips at rest
c. something about lower jaw
d. VTO Incisal position determined with lip at rest
Class III extraction pattern camouflage upper 5/ lower 4
Class III pre orthodontic for surgery
Bisphosphonates cause all of the following except:
a. diminished osteoblast activity (correct)
b. inhibits tooth movement
c. osteoradionecrosis
d. reduced wound healing
e. increased mineral density a
Which dimension finishes growing first?
a. Width/breadth (correct)
b. Depth
c. Vertical a
Maxilla grows by (combo question)
a. apposition posterior
b. apposition superior
c. resorption anterior abc
Patient with condylar hyperplasia, what is best way to
monitor active growth?
a. CT
b. serial cephs
c. Tech 99 bone scan b
Digital radiographs offer all the advantages EXCEPT:

a. decrease operating costs

b. decrease radiation
c. less storage space for films
d. greater resolution d

20
Meckel's cartilage forms?
a. Incus
b. Malleous
c. Sphenomandibular ligament
d. All of the above d
In Posselt’s diagram what is the final motion?
a. Pure Hinge
b. Pure Rotation
c. Half rotation, half hinge
d. None of the above
a
When a vertical discrepancy begins to form between the
adjacent teeth
When to extract a retained primary tooth?
Rest of the questions somewhere in Google docs

21
 Answers Sources Discussion
Anatomy diagram: Superior Oblique Capitis
know the facial muscles
muscles in back of the head
Cadaver: a) vertebral arteries she put 3rd dorsal rami, It's probably SPINAL CORD
b) spinal cord
Asked to identify a structure: c) trachea
d) 3rd dorsal rami
e) and a 5th one
a lot of surgical questions
a case where consolidating midline not necessary because canines had not
erupted
an obvious extraction case
impacted canine question: shouldnt palatal impaction be open eruption???
closed eruption for both b/c palatally impacted with force vector distopalatal Yes, it's open eruption for Palatal canines ... Kokich Articles #9 and #18.
(away from root)?
lat ceph:
sphenoid sinus
hyoid bone
adenoid pad
base of skull:
internal acoustic meatus
lesser wing of sphenoid
trigeminal originates from pons
know headgear mechanics
know wavelength of curing light: Correct AOs webiste says 430-480
photo intitiator used in orthodontic adhesives: camphorquinone (CQ)? Correct (AO website) Most composites utilize camphoroquinone(CQ) polymerizing initiators that are activated by
light emitted in and around 468 nm. Other composites,including some flowable resins, require
initiation in the 429 nm range.
ask DI index of a case- 3, 5, 7, 8, 10 (most likely 10) impacted canines DI = 8
biomechanics mostly repeats
most common salivary gland tumor: Pleomorphic adenoma
most common odontogenic tumor Odontoma (Neville Text)
most common cephalometric error: difficulty in locating landmarks Correct
most common error in getting a ceph: positioning of head Vertical position?
know twin block 55% Skeletal (Article # 34 The skeletal contribution to overjet correction was predominant (54%).
Baccheti) Skeletal contribution to molar correction also was predominant (67%)
Great skeletal contribution to the correction of the molar relation. (61%)
The skeletal contribution to overjet correction was predominant (55%) due exclusively to
mandibular changes.
expansion: RPE in adults and stability
tooth movement as it relates to thyroxin, pth, nsaids Thyroxin, PTH increase,
NSAID decrease (Article #3)
force that can placed immediately on tad 100-200 grams, 300 or more
results in failure (Article # 2 by
Chen)
best anchorage = tads
best vertical control = headgear
standard questions about treacher, crouzon, aperts
how much growth remaining from CVM = moderate growth remaining
agenesis: Agenesis in order most Article # 35 Peg lateral incisors or rudimentary third molars may reflect incomplete expression
know the common teeth common to least. Third Molars of a gene defect that causes tooth agenesis; unilateral agenesis may be a result of reduced
is there a connection between 3rd molar agenesis and peg laterals > Lower 2nd Premolars > penetrance
Upper Lateral Incisors (Article
#35 and Mosby's)

22
 Answers
if finishing in class 2 where does 2nd premolar occlude
who came up with cephalometrics? Broadbent in US 1934 (Proffit
Pg 201)
What are the limits of SARPE Expansion Zygomatic Buttress (Suri
Article # 7)
what is the concentration of sodium fluoride in mouthwash recommended 0.05%
for ortho patients? .05% or 5%
Sources Discussion
If Upper 4's are removed and finished in Class II, the lower 2nd premolar will contact the
Upper 1st molar's mesial marginal ridge / Upper 2nd Premolar's Distal Marginal Ridge
The Upper 2nd premolar will contact between the lower first and second premolars .... If that's
what this question is asking
p208 Proffit
Straight from Graber (2000) pg. 603
Extensive overviews of the different methods of fluoride administration rinsing with dilute
(0.05%) sodium fluoride solution throughout the periods of treatment and retention, plus
regular use of a fluoride dentifrice, is recommended as a routine procedure for all orthodontic
patients orthodontichave been presented

Multiple T/F - C2 and C1 articulate to allow rotation of the head, RO T&F

structure (referring to odontoid process) is formed by C1 AND C2
15 yo w/a little bit Cl III, Edge to edge molars, probably a border line rpe,
surgical case. The lower incisors were already back in the 80's so the extractions
chances of retroclining them even more to compensate for the class III was wait and do surgery* (he went
unlikely. with this)
ID on anatomy a. superior splenious capitus* Superior splenius capitis is vertical muscle fibers
muscle that attached to a vertebrae and back of the head (he thought it was this) Inferior splenius capitis is horizontal muscles fibers
b. inferior splenious capitus
a muscular sling(muscle arching over the tongue), - palatoglossus
muscle that looked liked the geniohyoid or anterior digastric probably ant. Belly of the
digastric
other options included
genioglossus
looked like the disection was inside the dural sheath spinal cord-
biological markers not associated with periodontal and fibroblast breakdown neocytokines*
TNF
IL 1
PGE
multiple T/F: golson ruler is measure arch perimeter tooth mass (second statement false, b/c "Treatment outcome after one-stage repair in children with complete unilateral cleft lip and
discrepancies in unilateral cleft patients? there was a big hole on the palate assessed with the Goslon Yardstick" Cleft Palate Craniofac J. 2009 Jul;46(4):374-80.
Is bone graft sufficient? PAN) Epub 2009 Jan 1.
DI based on molar class: pt was full step cl III He put 8=4 pts/side since it
just said based on molar class
twin block, multiple T/F, just know that skeletal change and intermediate
growth acceleration
how to counteract effects on molar in intrusion arch- a. HPHG with short outer bow Nanda 1997 Biomechanics Chapter 5 ... To counteract a 2x4 intrusion on upper incisors with
The question about clockwise rotation of the molar with HPHG wasn't on b. HPGH, short outer bow a Short bow HPHG and TPA
there thank God. w/TPA (correct)
curing light range - a. 400-410, Most sources say 450-490, 420-480nm
b. 460-480
what is associated with geographic tongue? a. psoriasis Females are 3x more likely to have geographic tongue
b. monroe abscess
c. males > females (correctly Oral Pathology: Fissured tongue is most commonly associated with Geographic tongue
false) (needs source for ABO reading)
d. fissured tongue
case with open bite and 5 lower incisors be sure to count the teeth and
it will make the tx plan a lot
easier

23
 Answers Sources Discussion
Case: 15 y.o. male, straight profile, bilat posterior crossbite, lateral open
bite on both sides, severe COS, crowding, blocked out canines, mesially
tipped mand first molars, missing lower 5s, super class I molars, moderate
MPA
1. what is DI index based on angle classification? (I didnt understand
question so I put 10 for his DI index)
2. do you need to use SARPE?
3. best tx option if sx is not an option: upright lower 6s by mesializing
roots? erupt posterior teeth to close posterior open bite?
28 Y.O AA female, ANB 7, mand retrognathic, L1s proclined. U1s normal a. open bite
angulation, good upper lip position, anterior open bite, no upper crowding b. rotation
1. most difficult to retain? c. crowding
2. Tx plan should include extractions. T
3. extractions will improve her convex profile. T
adolescent female, Class III tending, anterior open bite tending, end-on
molars, missing U2s, slight upper constriction/crowding, U/L canines are
very pointy, proclined U incisors, smile line ok (U1s fall a little below lower
lip)
1. What is best tx plan? (I had no clue, so I put something w/ lower incisor
extraction and upper canine substitution (did not want to procline U1s out
anymore by opening space for implant)
2. What is least acceptable about her? smile line, buccal corridors,
8 y.o. boy, severe skeletal Class III, no crowding in either arch, mixed
dentition
1. How do you tx? protraction facemask
2. If he did not seek tx until after growth was done and his jaw relationship
stayed the same what would be tx option? I really didnt have a good answer
so I think I put ext L4s
adolescent asian female, flat profile, severe facial asymmetry - chin is Seemingly the same case:
deviated to one side, anterior/posterior crossbite on left side, severe Asian girl - asymmetric Cl III. One x-ray in CR, one X-ray in CO. Transposed UL3/4. Lower
crowding, lower 5s lingually inclined out of arch, U3 and 4 on one side are 5s in broadie bite.
transposed/on top of each other 1. Is her facial asymmetry more skeletal or dental?
1. most likely cause for the way she looks? options are facial trauma. Questions seemed to lead you to think CR/CO shift
mandibular skeletal assymmetry, arch form 2. What is ext pattern w/out surgery?
2. what should you extract? options are all 4s, all 5s, lower 5s and U4s 3. T/F Importance of correcting CR/CO shift early before skeletal changes occur.
12yo, convex profile, bimax protrusive, diastema , U1 and L1 severely What is the best treatment? Surgery? Extracting 4 premolars.
proclined, large OJ, crowding, large COS, ANB of 7 Best way to treat Class II Malocclusion? TADs to retract? Herbst? Extract U 4's L5's
1. What is worst treatment option: I put non-ext. w/ Herbst b/c lower
incisors were already proclined
2. how do you level arch? intrude lower incisors, extrude lower molars,
Adult w/ cleft lip and palate REPAIRED, high angle, missing lateral incisor Which would have the least Golson Ruler was asked, TRUE.
in cleft area, anterior crossbite, slightly maxilary retrognathic, favorable outcome? Lefort On PANO, it was radiolucent in the cleft area and asked if you thought if the graft was
advancement, mandibular acceptable? Graft was not acceptable for implant
setback, maxilllary expansion, T/F, Maxillary expansion can cause hypernasality. T
mandibular narrowing sx (went
with this one),

What have studies on TAD shown (the answer choices were a combo of 2 1) No movement(4/12/12)
questions from the 2010 test 2) .1mm/mo,
Implants for orthodontics have shown that ... 3) Lamellar bone w/low
turnover
How much force on a TAD? 100-200g
Most important factor for successful TAD? 1) Diameter
2) Length
3) Force/direction/placement
(Correct)
Is movt from CR to CO considered lateralretrusive if there is a shift? TRUE
Id say no movement and lamellar with high turnover?
TADs DO have movement. "despite the fact that mini-screws increase anchorage, they do
not remain absolutely stationary throughout orthodontic loading." (Mosby's)
Osseointegrate implants for orthodontics do NOT have movement
----- Depends if they are asking for TADs or Implants for orthoodntics.
I think Placement.
I would agree
Article #8: "Implant failure remains largely unexplained and varied from 0% to 19% in the
included studies.However, factors such as implant site, surgical technique, healing period,
and magnitude of force might influence the success rate."
Okeson.Pg. 549

24
 Answers Sources Discussion
What is CR ? Superior or No consensus Okeson Pg 111. He says "The most superior condylar position from which a hinge axis
movement can occur is the centric relation (CR) position"

then "it has been suggested that the condyles are in their most superior position in the
articular fossae, Some researchers suggest that non of these definitions of CR is the most
physiologic position, and that the condyles should be ideally positioned downward and
forward on the articular eminences. The controversy regarding the most physiologic position
of the condyles will continue until conclusive evidence exists that one position is more
physiologic than the others"
Which will not fulfill ABO requirements? PSR PSR : Periodontal Screening and Recording is a screening form and not a comprehensive
periodontal evaluation
What time is lower 1st molar calcification most related to? Birth Proffit says 32 weeks IU, which is closest to birth. Other choice was 6 months IU.
Who was the first to use cephalometrics in diagnosis and treatment Broadbent (Maybe) Broadbent invented the cephalograph in 1934
planning Angle (Maybe) Tweed was the first to use it for diagnosis and treatment in 1946
Tweed Depends on the question, read it.
Steiner
Kingsley
Stem Cells: Which of the following is true of a stem cell? A. Can multiple on its own adult stem cells are undifferentiated and CAN multiply BOTH A AND B
B. differentiate into at least 2
types of cell
C. A and B
What is the most common Intraoral finding in HIV patients a. canidiasis (correct) 50% of HIV patients have intraoral candidiasis - not sourced.
b. kaposi's
TMD- not one of 4 cardinal SYMPTOMS answer was ADD
TMD- pt w/limited opening, tenderness to palpation, no clicking I put Posterior capsulitis
TMD- ADD pt will have what kind of deviation I put deviation on opening to
effected side
CP pts. - what is the reason for speech problems I put difficulty obtaining an
intraoral seal or something like
that
Stats- they were doing a test to measure something and they were ANOVA
comparing 3 factors
Standard of care question options A. ABO B
B. Dental assoc.
(correct4/12/12)
c. Courts (inforces4/12/12)
When to bond peg lateral A. during tx when there is a A
little more space than the size
of the other lateral
B. after tx
c. a long time after tx to allow
for settling
ENDO - when comparing endo tx teeth to normal teeth what does research a. significantly more resorption B
b. no difference
c. significantly less resorption
(4/12/12)
On one of the cases, the 15 kid has 2 MX impacted canines and they want a. start tx, extract primary A
to know how you would tx it. The roots were almost completely developed canines and make room for the
permanent canines, and
expose to let them erupt
b. Expose and wait until they
erupt to start
c. I don't know I thought A was
the right answer

25
 Answers
How does a Twin Block help correct a Class II Div 1? (it wasn't worded this a. it allows for a horizontal
way, so it made the answer choices harder to choose from, Read the component of md growth
conclusions from this article to help you out) (correct)
b. it allows you to increase
VDO by removing acrylic from
lower part of appliance so that
md teeth will erupt(False)
(remove acrylic from the
upper)
c. it allows for primarily
DENTAL correction of OJ
(FALSE)
d. the acrylic coverage on
the lower anteriors is to
prevent flaring of lower incisors
(TRUE)
Herbst and Mara have what effects a. decrease MP or something
like that
b. increase MD corpus length
Adult in maintenance periodontal therapy: When do you start? When Periodontist says so
Implant placed within 1mm of adjacent tooth: a. horizontal bone loss
b. loss of papilla
c. lack of osseointegration
Sources Discussion
answer choices were:
a&b
a, b, c, and d
and some other combinations, so you need to figure out if all of these are true or not)
- D is FALSE
- C depends on whether its skeletal or dental, if dental, then FALSE
corpus length probably answer.
Article # 84 by Kokich " The periodontist will determine if the patient is stable enough
periodontally to proceed with orthodontic treatment. Some areas in the mouth may require
periodontal surgical treatment betore the initiation of orthodontic treatment.
For satisfactory implant placement, there must be enough room for both the implant and
interproximal bone between it and adjacent teeth. The narrowest implants currently available
are 4 mm wide at the shoulder or platform. Approximately 1 mm of space is required between
the implant and the adjacent tooth to allow for proper healing and to ensure adequate space
for the papilla, so 6 mm is the minimum space. Space is needed not only at the crest of the
ridge, but also between the roots of the adjacent teeth. The apices of the adjacent teeth must
be far enough apart to allow the surgeon to place the implant without damaging the root or
apical tissues (Figure 20-31).
(Proffit, William R.. Contemporary Orthodontics, 3rd Edition. C.V. Mosby, 012000. p. 637).

Chapter 25 Kokich
The width of the edentulous space should allow at least I mm between the implant and the
adjacent teeth. If the distance between implant and tooth is less than I mm, the interproximal
bone could be jeopardized, and the space for the papilla between the implant crown and the
adjacent teeth will be constricted and could appear much shorler than the contralateral
papillae.' This situation will make the implant crown more obvious and appear less esthetic.
Greatest somatic increase is ... a. conception to birth
b. birth to 2 years
c. 12-15 years
What is the immediate short term effects of low-calcium levels? a. low cardiac output(4/12/12)
b. hyperactivity of nerves and
muscles
Most detrimental movement to root resorption. a. intrustion Graber says Intrusion and Torque
b. torque
c. intrusion and torque
(4/12/12)
Know definition of capsulitis ...
Inferior Oblique Capitis or Superior Oblique Capitis

26
 Answers Sources Discussion
Nasal epithelial cells (look up the exact type of cells) a. Goblet UNK 2010 Dr. Kahn stated that nasal epi cells are goblet, ciliated and pseudostratified columnar
What type of cells found in nasal cavity? b. Ciliated ABO 2009
c. Pseudostratified Columnar
d. All of the above (correct)
A calcific barrier a. Type of treatment is most important 61 page file
b. Duration of treatment is more important
than type (correct)
c. Can be prevented with straight wire
appliances
d. None of the above
Histologically, undermining resorption shows? a. cell free zone UNK 2010 Proffit 4th ed
ABO 2009 cell free zone is mentioned in Graber
What are characteristics of hyalinization? 61 page file
Undermining resorption is not associated with the a. frontal resorption (correct) UNK 2010 ABO breakdown:
following: b. physiologic tooth movement (correct) frontal resorption =response to light continuous force
c. clear free cell zone
Undermining resorption occurs: a. In PDL 61 page file
b. In medullary spaces (correct) 3.14.12
c. Is physiologic
Undermining resorption during tooth movement is a.The process by which osteoclasts remove 61 page file (P303)
bone on the compressed part of the PDL.
b.The process by which osteoclasts remove
bone on the stretched part of the PDL.
c.The process by which osteoclasts attack
the necrotic area of the PDL (correct)
d.None of the above
What is true about hyalinization? whats there whats not? it occurs in the are of undermining resorption ABO 2008
What does not happen in undermining resorption? a.Hyalinization 61 page file
b.physiologic tooth movement *
c.resorption in adjacent marrow spaces
d.Cell free zone in PDL
What does not occur in hyalinization? a. physiologic tooth movement (correct) ABO 2008
b. bone resorption 61 page file
c. pdl resorption 2007
d. medullary resorption
Maturity of bone a.woven, composite, lamellar (true) UNK 2010 Angle Ortho, 1987, Roberts, Rigid Endosseous Implants for Orthodontic and orthopedic anchorage.
Order of bone b.woven, lamellar, composite ABO 2009 - there are three microscopic types of bone tissue: woven, lamellar and composite bone.
c.woven, composite, lamellar, bundle ABO 2008 1. Woven (embryonic, new ortho bone) bone is poorly organized tissue that is formed rapidly (30-50 ± JLm/day) in response to skeletal wounding and overload.
2007 2. Lamellar bone (cortical, compact), the principal load bearing tissue of the skeleton, is formed relatively slowly (0.6JLm/day) and has considerable strength
because
of a high degree of matrix maturation prior to mineralization.
3. Composite bone is a biological compromise of woven bone for rapid healing which is subsequently filled-in with lamellar bone to improve strength.

Ten Cate's oral histology pg 253:

-Bundle bone = non-lamellar; immature; directly lines socket; penetrated by collagen Sharpey's fibers of the PDL

what kind of bone is fetal bone? a.Lamellar 61 page file This is also the type of bone that is formed after initial ortho tx
b.Woven (correct)
c.Spongy
Which organ is responsible for calcium conservation ? a.Liver 61 page file
b.Kidney (correct)
c.Spleen
d.Brain
What is the difference between primary osteons and a.Primary osteons is woven bone (correct) 61 page file The adult bone is remodeled to form secondary osteons
secondary osteons? b.Primary bone is fine woven bone
c.Primary osteon has ordered osteocytes
d.Primary osteons has canaliculi
perpendicular to medullary canal
Adult bone remodeling due to formation of secondary TRUE ABO 2008
osteons.
Secondary osteon what makes up the adult bone ABO 2008
Most of the osteoclasts present in the PDL are: a.Of hematogenous origin. (correct) 61 page file ABO Breakdown
b.Derived from stem cells found in the local
area.
c.Highly differentiated fibroclasts.
d.Always associated with an inflammatory
condition
Osteoclasts come from? a. Bone marrow ( possibly answering this if ABO 2008 Evidence for choice A:
question asks where osteoclasts originate 61 page file Graber 2000 pg248: Osteoclasts thrive in an inflammatory environ-ment because they originate in the marrow, a protective site removed from the localized lesion.
from)
b.Blood (correct) "Stromal cells in the marrow cavity also support the differentiation and maturation of hematopoietic cells and the differentiation of osteoclasts via secreted molecules
c.PDL and via direct cell-to-cell interaction. Important molecular aspects of this interaction have been elucidated recently, such as the role of the receptor activator of
d.Bone nuclear factor κB (RANK) and RANK ligand (RANKL) system. The interaction of RANKL, expressed on the plasma membrane of stromal cells, with RANK expressed
on the plasma membrane of osteoclast progenitors induces the differentiation of osteoclasts. A soluble decoy for RANKL, secreted by osteoblastic cells,
osteoprotegerin (a glycoprotein belonging to the TNF receptor superfamily), blocks this interaction and prevents osteoclast differentiation, thus playing an important
role in the regulation of osteoclastogenesis. Because the bone marrow stroma includes direct progenitors of osteoblasts and regulates the differentiation of
osteoclast progenitors, the bone marrow stroma is a tissue of critical importance for skeletal physiology. The main cell type in the bone marrow stroma is a cell with a
reticular morphology, which expresses alkaline phosphatase and resides at the abluminal side of sinusoids and arterioles"
(Nanci, Antonio. Ten Cate's Oral Histology: Development, Structure, and Function, 6th Edition. Mosby, 072003. p. 130).

27
 Answers Sources Discussion
From where do cells for bone deposition originate? a.Osteoclasts 61 page file
b.Blood
c.Mesenchymal cells (correct)
d.Chondrocytes
Bone tissue grows by: a.Interstitial growth 61 page file Apposition only (intramembranous or endochondral)
b.Osteoclastic activity ABO Breakdown
c.Proliferation of endodermal tissues
d.Differentiation of cartilaginous tissue
(correct)
Which of the following tissues does NOT grow a. Muscle 61 page file
interstitially? b. Bone (correct)
c. Nerve
d. Connective tissue
Intramembranous bone formation comes from: a.Condensation of mesenchyme (correct) 61 page file Google
b.Endoderm
c.Ectoderm
Rate of bone remodeling: a.Increases with age 61 page file No reference
b.Decreases with age (correct)
c.Remains the same
d.None of the above
Which organ helps retain Ca2+? a. Heart 61 page file
b. Skin
c. Kidney (correct)
d. Spleen
Elevation of alkaline phosphatase occurs during growth of a.Following major bone fractures 61 page file
bone in children: b.During diseases followed by bone
destruction
c.Increases in osteoblastic activity
d.All of the above (correct)
In a growing child if you increase the loading forces of a.Increase haversian turnover (correct) 61 page file
mandible, does this cause: b.decrease haversian turnover
c.no effect
How is bone affected by loading it with greater forces? a. greater turnover (correct) 2007 review
b. less turnover
c. same turnover
Why is platelet Growth Factor good? It includes many things, which help in wound 61 page file
healing
ACTH is from what gland? a.Pituitary (correct) 61 page file
b.Adrenal
c.Thyroid
Parathyroid hormone acts by: a. Increasing calcium ion concentration in 61 page file
bone
b. Decreasing calcium ion concentration in
blood
c. Increasing calcium ion concentration in
extracellular fluids (correct)
d. None of the above
Where are adrenocorticosteroids produced? a. Thalamus 61 page file
b. Pituitary
c. Thyroid
d. Adrenal gland (correct)
In orthodontic tooth movement, the sites of greatest a.Hyalinization 61 page file
pressure in the periodontal ligament are characterized by: b.Infiltration of osteoclasts
c.Infiltration of macrophages
d.Infiltration of neutrophiles
i.a, b and c
ii.a, b and d
iii.a, c and d
iv.b, c and d
v.all of the above (correct)
Why is there a greater break down of bone in patients a. Osteoporosis 61 page file
with gingival inflammation? b. Higher prostaglandin levels (correct)
c. Higher phosphatase levels
When a tooth is moved bodily: a. Osteoblastic activity occurs on the 61 page file
compression side and osteoclastic occurs on
the tension side
b. Osteoclastic activity occurs on the
pressure side and osteoblastic occurs on the
tension side (correct)
The tension side of tooth movement has what a. Woven bone 61 page file
components histologically? b. Fibrous tissue
c. Both (correct)
Histochemically basal bone and alveolar bone: a. Are vastly different 61 page file As stated earlier, teeth are attached to bone by the PDL. This bone, the alveolar bone, constitutes the alveolar process, which is firmly attached to the basal bone of
b. Basal bone is more resistant to resorption the jaws. The alveolar process forms in relation to the teeth. When teeth are lost, the alveolar process is gradually lost as well, creating the characteristic facial profile
c. Are no different (correct) of the edentulous person whose chin and nose approximate because of a reduction in facial height. Although the histologic structure of the alveolar process is
d. Alveolar bone is less cancellous essentially the same as that of the basal bone, practically it is necessary to distinguish between the two. The position of teeth and supporting tissues, which include
the alveolar process, can be modified rather easily by orthodontic therapy.
(Nanci, Antonio. Ten Cate's Oral Histology: Development, Structure, and Function, 6th Edition. Mosby, 072003. p. 7).

28
 Question Answers Sources Discussion
What did NOT originate from ectoderm? a.Enamel 61 page file
b.Dentin
c.Cementum
d.Hair
e.Nails
i.a and b
ii.b and c (correct0
iii.d and e
Which of the following is formed by mesoderm? a. Nails 61 page file
b. Skin
c. Hair
d. Cementum (correct)
The tuberculum impar gives rise to what structure? a.Tongue (correct) 61 page file
b.Thyroid gland
c.Thymus
The muscles of facial expression develop from: a.First brachial arch 61 page file
b.Second brachial arch (correct)
c.Both arches
d.None of the above
All of the following are formed from the first branchial a.Malleus 61 page file The styloid process is derived from the 2nd branchial arch.
arch except? b.Maxilla UT 2008
c.Condyle
d.Styloid process(correct)
Other wrong options:
Coronoid (UT 2008)
The tongue reaches is maximum size at age? a.5 61 page file Wolford article
b.8 (correct) 2007
c.11 ABO 2008
At what point does the palate close in fetal life? a.2 weeks 61 page file
b.6 weeks
c.12 weeks (correct)
d.20 weeks
Which system is the first formed in the embryo? a. Muscular 61 page file
b. Vascular
c. Neural (correct)
d. Lymph
Cranial vault increases rapidly in size the first few yrs a.Neural (correct) 61 page file
postnatal & completes approx 90% of its growth by b.Dental
age 6. Tissue growth is: c.Genital
d.Lymphoid
e.Somatic
When is neural growth complete a. 3 months into conception ABO 2010 #2
b. birth
c. 6-7 yrs old(correct)
At what age does brain have the most number of a. 3 mo. After conception (Correct) ABO 2010 Biological Psychology By James W. Kalat Chapter 5, Development of the Brain
neurons? b. Birth The nueron number is greatest before birth at 10 weeks after conception. The greatest number of synapses occurs at 2-
c. 2-3 years 3 years of age.
d. 8-9 years
Growth of the mandible is between what two growth a.General and neural (correct) 61 page file
curves? b.General and genital
c.Neural and lymphoid
d.None of the above
The facial growth curve parallels most closely: a. The neural growth curve 61 page file
b. The somatic growth curve (correct)
c. The fatty growth curve
d. The lymphoid growth curve
e. The pubertal growth curve
The growth of the lower face occurs most parallel to: a. The neural growth curve 61 page file
b. The lymphoid growth curve
c. The general growth/somatic curve
(correct)
d. All of the above
e. None of the above
Most rapid somatic growth occurs: a. Birth to 2 yrs (correct) UNK 2010 Fig. 2.2 Proffit, If the questions asks Before Birth, at Birth, or After birth ... the answer will be before birth.
b. 4-7 yrs
c. 7-9 yrs
d. 12-15 yrs

29
 Question Answers
The physician should be concerned if a child's growth a. 25th percentile
pattern is above which of the following: b. 50th percentile
c. 75th percentile
d. 95th percentile (correct)
Physicians use height/weight charts when there is a. 20%
how much deviation from norm? b. 40%
c. 50%
d. 90% (correct)
when do the two halves of mandibular symphysis a. 3 months before birth
fuse? ( also called symphyseal suture) b. 3 months after birth (correct)
c. At 1 year
d. At 2 years
The right and left sides of the mandible fuse: a. Just before birth
b. Shortly after birth (correct)
c. Near the end of the 1st year of life
d. Near the end of the 2nd year of life
According to Moss functional matrix theory, bone a. capsular matrix (correct)
translation occurs due to the following? b. periosteal matrix
What results in displacement of cranial bones c. both
causing sutural growth?
Movement of bony segments in space, without any a.Translation (correct)
internal or localized changes, is called: b.Conduction
c.Transformation
d.Does not occur
According to the functional matrix theory, “primary a. Cause expansion and growth
growth sites” such as the condyle and sutures: b. Respond by compensating for
translational forces (correct)
c. Are the primary genetic basis for all
growth and development
d. In addition to the bony skull are the
major influences in growth
Functional matrix theory. What causes bone growth? periosteal matrix
Which of the following is NOT a growth SITE: a. synostoses (answer)
b. synchondrosis
c. syndesmosis
d. synarthrosis
Which growth sites are NOT in cranium? a. Syndesmoses - Joint by 2 ligaments 61 page file
(4/12/12)
b. Periosteum
c. Synchondroses - Union of 2 bones
by hyaline cartilage
d. Synostoses - Early closure of sutures
(4/12/12)
Which is NOT a growth CENTER in the craniofacial a. synostosis (correct)
complex? b. synchondrosis
c. syndesmosis (correct)
Sources Discussion
UNK 2010 Proffit 4th Edition pg. 32 A child who falls beyond the range of 97 percent should receive special study and not just
accepted as an extreme.
ABO 2009 Same source as above.
UNK 2010 Journal of Forensic Sciences, 2003 "Tooth Formation and the Mandibular Symphysis During the First Five Postnatal
ABO 2009 Months"
"The mandibular halves were separated at birth. Complete fusion had occurred in the majority of infants aged four
months" ... so 3 months sounds good.
61 page file
2007
UNK 2010 http://www.journals.elsevierhealth.com/periodicals/ajorth/article/0002-9416(69)90209-7/abstract
ABO 2008 The morphogenetic role of two types of functional matrix-periosteal and capsular—in craniofacial growth is examined.
The term growth is defined inclusively to include the changes in size and shape as well as changes in spatial position in
time. The periosteal matrices are responsible for transformative growth, the changes in size and shape. The capsular
matrices are responsible for translative growth, the changes in position. The role of oronasopharyngeal functioning
spaces as competent, primary, morphogenetic agencies is detailed. The volumetric expansion of these capsular
functional matrices is capable of accurate quantitative description.
61 page file
61 page file
ABO 2010 periosteal matrix = transformation = change in size and shape
UNK 2010 Proffit 4th ed. pg.53:
ABO 2008 Growth centers: epiphyseal plates, synchondrosis, nasal septum
61 page file Growth sites: any area where growth occurs (sutures, condyle)
synarthrosis: broad category for any connective tissue joint that permits little/no movement (sutures of the cranial vault
and gomphosis (PDL)
syndesmosis: fibrous joint; partially mobile (ex. wrist, ankle)
synchondrosis: hyalin cartilaginous joint; ex: bones of the cranial base and epiphyseal plates in long bones; it is a growth
center
synostoses: fusion of 2 bones (found in adult skull)
sphenooccipital is a growth center that drives the majority of growth in the cranial base
sphenooccipital synchondrosis (closes last - 15-20)
intersphenoidal synchondrosis (closes first - at birth)
sphenoethmoidal synchondrosis (closes second - 7-8 yrs)
Synostoses>Syndesmoses
UNK 2010 synostosis and syndesmosis are not growth centers, therefore A and C would be correct
Proffit 4th ed. pg.53:
Growth centers: epiphyseal plates, synchondrosis, nasal septum
Growth sites: any area where growth occurs (sutures, condyle)
30
 Question
Which of the following is a correct statement:
How does chin remodel?
Sutural growth, endochondral and intramembranous
growth are all seen in
Which of the following has endochondrial,
intramembranous, sutural and apposition/resorption? b.mandible
Which part of the face has both intramembranous
and endochondral sutures?
The cranial base grows by what mechanism?
Source of growth at the cranial base is where?
The cranial base develops by :
What is the time that the spheno-occipital
synchondrosis unites?
Which bone is purely intramembranous?
Answers Sources Discussion
a. apposition is seen on anterior border UNK 2010 all of these are false
of chin ABO 2010 #2 only slight apposition at lingual of symphysis
b. apposition on lower anterior border of only apparent growth of the chin by resorption at B point
mandible at pogonion
c. resorption seen at posterior Bjork ABO article #54 (p587, 597)
symphysis "thickening of symphysis takes place by apposition on its posterior surface...on its lower border there is likewise
apposition, which contributes to increase in height of the symphysis"
Correct statements on RandomU are "periosteal apposition below the symphysis is extended posteriorly, to the anterior part of the lower border of the
apposition below symphysis mandible, and when it is marked this area is characteristically rounded"
resorption above symphysis "In vertical condylar growth, the pronounced apposition below the symphysis and the anterior part of the mandible
produces an anterior rounding, with a thick cortical layer"
Profitt p113
"At one time, it was thought that this occurred primarily by addition of bone to the chin, but that is incorrect. Although
small amounts of bone are added, the change in the contour of the chin itself occurs largely because the area just
abovet he chin, between it and the base of the alveolar process is a resorptive area"
"Subsequent to the deciduous dentition period of childhood growth, however, the alveolar bone on the labial side in the
forward part of the arch undergoes a reversal to become resorptive, and the opposite lingual side becomes uniformly
depository. This change occurs in conjunction with the unique lingual direction of incisor movement in the child's
mandible. From this time, the chin begins to take on a progressively more prominent form; the mental protuberance
continues to remodel anteriorly, while the alveolar bone above it remodels posteriorly until the lower permanent incisors
reach their definitive positions."
(Enlow, Donald H.. Essentials of Facial Growth. Enlow Hans, 07/1996. p. 232).
SABURO KURIHARA, DONALD H. ENLOW and ROSALBA D. RANGEL (1980) Remodeling Reversals in Anterior Parts
Of the Human Mandible and Maxilla. The Angle Orthodontist: April 1980, Vol. 50, No. 2, pp. 98-106.
a. resorption of inferior surface of ABO 2009 see Q #10: Bjork article
symphysis answers A and C are def. not correct
b. buccal apposition at pogonion
c. resorption on lingual surface of
symphysis
a) the neurocranium and the midface UNK 2010 Neurocranium = chondrocranium (cranial base) + membranous neurocranium (calvaria/cranial vault); grows by all 3
(correct) ABO 2009 methods
b) the neurocranium only The maxilla grows by intramembranous (apposition at sutures and surface remodeling), but the midface includes other
c) the neurocranium, the midface and structures (it's basically the opposite side of the cranial base from the cranial vault) therefore the midface also grows by
the mandible all three methods
Sutural growth in the mandible (though there is a suture) is virtually non-existent
Board breakdown states :Neurocranium + midface: all three types of growth occur: sutural, endochondral and
appositional.(Pg.15)
a.midface ABO 2008 A and c(4/12/12)
c.neurocranium (correct)
a. Upper and middle (correct) 61 page file
b. Upper and lower
c. Middle and lower
d. Upper only
a.Intramembranous 61 page file
b.Endochondral (correct)
c.Appositional
Synchondroses (intershenoid, 61 page file
sphenoethmoid)
a.Proliferation at the synchondroses 61 page file
(correct)
a. 8 to 10 years 61 page file Proffit: fuses at age 15-20
b. 10 to 12 years
c. 12 to 14 years
d. 15 to 16 years (correct)
a.parietal and frontal (correct) 61 page file Intramembranous- Frontal, Parietal, Nasal, Lacrimal, Zygomatic, Vomer, Palantine, Maxilla
b.ethmoid Purely Endochondral- Incus, Stapes, Ethmoid, Inferior Concha, Hyoid
c.temporal Mixed- Maleus, Temporal, Spenoid, Mandible, Occipital
31
 Question Answers Sources Discussion
How are the parietal and frontal bones formed? a. Partly by endochondral bone 61 page file
formation
b. Partly by intramembranous bone
formation
c. Entirely by endochondral bone
formation
d. Entirely by intramembranous bone
formation (correct)
The palate grows down by: a. Apposition on the lingual (correct) 61 page file Palate growth by Apposition on lingual, resoprtion on superior and sutural
b. Sutural
c. All of the above
d. None of the above
How is the sphenoid bone form? a.Partly by endochondral bone 61 page file
formation *
b.Entirely by endochondral bone
formation
c.Entirely by intramembranous bone
formation
Development of the body of the mandible involves: a. Reichert’s cartilage 61 page file
b. A complete cartilage model
c. Intramembranous bone formation
(correct)
d. All of the above
e. None of the above
The major growth in the body of the mandible: a.Depends on the condyle
b.Occurs in the symphysis
c.Is appositional (correct)
d.Is endochondral
e.Depends on Meckel’s cartilage
Growth directions Maxilla grows up and back but is displaced down and forward
Mandible grows on the posterior extent of the ramus and condyle (displacing the mandible downward and forward).
Simultaneous resorption on the anterior of the ramus and coronoid process.
Pogonion has apparent growth by resorption at B point but no actual deposition at Pog (slight amount of deposition on
lingual of symphysis).
The normal downward and forward direction of facial a.Upward and backward growth of the 61 page file
growth results from: maxillary sutures and the mandibular
condyle
b.Vertical eruption and mesial drift of
the dentition
c.Interstitial growth in the maxilla and
mandible
d.Epithelial induction at the growth
centers
i.a and b (correct)
ii.a and c
iii.a and d
iv.b and c
v.b and d
How does mandible grow AP? a.Resorption of anterior ramus, 61 page file
apposition of posterior ramus
How does the body of the mandible lengthen? Remodeling of the anterior ramus 61 page file
(correct)
Resorption of the anterior border of the ramus allows a.Increase in mandibular corpus length 61 page file
for what kind of growth? (correct)
b.Allows for vertical growth
c.Decrease in ramal height
d.Allows for tuberosity growth

32
 Question Answers
What describes growth of the condyle a.Mandible displaces down & forward
Growth of the condyle how? Up and back
Historically, which is the best method to study growth a. Structural method (implants)
changes: b.Longitudinal method (serial cephs)
(correct)
c. Metric
What is the best method to measure mandibular a. Serial superimpositions (longitudinal
growth changes? method)
b. Cephs of parents
c. Ceph at one point in time (metric
method)
d. Implant study (structural method) (
correct?)
Which is most beneficial for 10 year growth study? structural implant study, We think this
should be longitudinal
What is the best to determine growth rotation? a.Implant studies (correct)
Which is best to determine direction of mandibular Curvature of the mandibular canal and
growth from Bjork study? inclination of condylar head.
Curve of the mandibular canal and inclination of the a.Rotation of the mandible (correct)
condylar head is acharacteristic of what? b.A Class III malocclusion
c.A skeletal open bite
d.A skeletal deep bite
What shows the rotational growth of the mandible? a.bending of canal and condylar neck
angle (correct)
b.increase in vertical dimension
c.increase in the length of the mandible
3.What measurements gives evidence of rotation of a.Angle of condyle
mandible? b.???? of condylar head
c.Mandibular canal curvature
d.All of the above (correct)
Which suture fuses early in dolichocephalic patients? a. coronal
b. sagittal (correct)
c. lambdoidal
Which bone ossifies upon termination of growth in a. Palatal bone
the distal phalanges? b.Sesamoid bone (correct)
c.Occipital bone
d.Femur bone
Looking at a hand-wrist XR determine how much a.2 years with sesamoid ossification
growth still remains? (Correct)
Ossification of sesamoid bone occurs 1 year before maximum growth spurt -
(60-70%) of growth remaining
Shown picture of wrist film and asked how much a.None
growth is left? b.Limited *
c.A lot
Sources Discussion
61 page file "ABO 2008 comments after question states: (that it pushes mandible down and forward is false... condyles contribute
ABO 2008 horizontal ""pushing""; there are other components of growth that cause the vertical ""pushing"")
Does condylar growth only contribute to forward displacement of mandible and not downward displacement?"
Proffit 4th ed. pg 46:
- body of mandible grows horizontally in length via APPOSITION AT POSTERIOR BORDER OF RAMUS
- ramus grows vertically in height via ENDOCHONDRIAL REPLACEMENT AT C the condyle accompanied by surface
remodeling
- Conceptually, it is correct to view the mandible as being translated down-ward and forward, while at the same time
increasing in size by growing upward and backward. The translation occurs largely as the bone moves downward and
forward along with soft tissues in which it is embedded.
ABO 2008
ABO 2010
UNK 2010 (Q#55) Profitt, pgs 144, 206, 216, 270
ABO 2009 Major growth studies (Bolton-Brush, Ontario) etc have used serial cephs. p270 has strongest evidence for choice "b".
ABO 2008
Bjork ABO article #54 provides evidence for choice "a"
Implants are good for measuring growth rotation. Serial cephs are good for growth changes.
61 page file md rotations implants, growth changes study serial cephs, growth potential hand wrist. growth cessation serial cephs, 10
2007 yr longitudinal study serial cephs 4/12/12
4/15/12 We now say serial cephs
ABO 2009 Michigan
ABO 2008 Bjork ABO article #54
ABO 2008
61 page file article #53: The seven signs are related to the following features: (1) inclination of the condylar head, (2) curvature of the
mandibular canal, (3) shape of the lower border of the mandible, (4) inclination of the symphysis, (5) interincisal angle,
(6) intcrprcmolar or intermolar angles, and (7) anterior lower face height.
61 page file See above
61 page file See above
ABO 2009 -fusion of saggital suture would cause cranium to be long in A-P direction and narrow in width (dolichocephalic)
ABO 2010 #2 -fusion of coronal suture would cause cranium to be short A-P and wide (brachycephalic)
61 page file Article #71. "Radiographical Evaluation of Skeletal Maturation" Fishman
ABO 2010 #2 Ossification of the sesamoid bone occurs approx 1 year before the adolescent growth spurt
Ossification of the Sessamoid bone at SMI (skeletal maturation index) 4 is followed by:
SMI 5 - capping of the distal phalanx of the third finger
SMI 6 - Capping of the middle phalanx of the third finger
SMI 7 - Capping of the middle phalanx of the fifth finger
SMI 8 - FUSION OF THE DISTAL PHALANX OF THE THIRD FINGER
SMI 9 - Fusion of the PROXIMAL phalanx of the third finger
SMI 10 - Fusion of the MIDDLE phalanx of the third finger
SMI 11 - Fusion of the Radius
Peak growth velocity occurs around SMI 6/7
Order of SMI in Hand Wrist: Width of Epiphysis as wide as diaphysis --> Ossification of Sessamoid --> Capping -->
Fusion
61 page file see above
ABO 2009 Michigan ABO Breakdown
61 page file Not enough info to answer question
33
 Question Answers Sources Discussion
The hand bone most closely associated with the a.Hammate 61 page file
onset of puberty is: b.Radius
c.Ulna
d.Sessamoid (correct)
e.Lunate
Showed lateral ceph and asked how much growth a. growth done ABO 2008 CVM: stage2: concavities onC2 and C3. stage 3: concavities on C2-C4.
you should expect based on the vertebrae (CVM): b. very little left maximum growth occurs between 2 and3.
c.2-3 years left (3rd molar crowns were
mineralized)
As skeletal age matures what changes to you see in A concave curvature in the inferior ABO 2008
the vertebrae? border.
How much growth remaining if C2 and C3 have peak mandibular growth will occur ABO 2009 Michigan ABO Breakdown
inferior curvature and C4-C5 are square? within 1 year (stage CVMS II) ABO 2010 #2
What is the significance of a long posterior cranial a.Mandibular prognathism 61 page file Proffit 4th ed pg214: Enlow's counterpart analysis
base? (S-Ba) b.Anterior x-bite - anterior cranial base lengthening assoc w/ enlargement of nasomax. complex in anterior direction
c.Maxillary retrognathism - spheno-occipital synchondrosis/complex growth assoc. w/ enlargement of nasopharynx and ramus
d.All of the above
Should be a mandible retrognathism, so
none of the above
Which part of the maxilla does growth increase the a. Condyle 61 page file
arch length? b. Tuberosity (correct)
c. Alveolus
A shorter horizontal distance measured from Ar to a. Maxillary hyperplasia 61 page file Admittedly, this is just personal reasoning but essentially PTM corresponds closely with the posterior limit of the maxilla.
PTM indicates what? b. Maxillary hypoplasia (correct) If the distance between Ar and PTM is short, the maxilla is retruded in relation to the cranial base.
c. Mandibular hyperplasia
d. Mandibular hypoplasia
What happens to the MPA when downward growth of a.It increases (correct) 61 page file "Prediction of mandibular growth rotation evaluated from a longitudinal implant sample"Skieller
the maxilla plus tooth eruption is greater than growth b.It decreases
of the ramus? c.It stays the same
Creation of bone on the maxilla for maxillary molars Apposition of bone at the sutural area 61 page file
comes from: behind the tuberosity
In an 11 YO male, in a two year period the a. 3 mm 61 page file
mandibular molars are expected to erupt? b. 4 mm
c. 1.5 mm (correct)
d. 2.5 mm
In an 11 YO male, the lower facial height is expected a.3 mm/ year 61 page file Board breakdaown
to increase? b.1 mm/ year (correct)
c.2 mm/ year
d.2.5 mm/ year
Which of the following is true? a.Height is achieved early on in 61 page file
development more than bredth or depth
b.Depth is achieved early on in
development more than bredth or
height
c.Bredth is achieved early on in
development more than height or depth
(correct)
Which dimension of infants most closely resembles a.Width (correct) 61 page file
adults? b.Depth
c.Height
What is the largest in an infant? a. Width of head ( going with this on the 61 page file Or width?
test)
b. Depth of head (correct)????
c. Vertical size of head
Which dimension finishes growing first? a. Width/breadth (correct) 61 page file
b. Depth
c. Vertical
Post-natal incremental changes in the face are: a.Most in height 61 page file
b.Most in width
c.Least in width
d.Greatest in width
i.a and c (correct)
ii.b and c
iii.c and d
iv.a and d
Maximum age for width of skull? 7-8 yrs ABO 2010

34
 Question Answers Sources Discussion
Which dimension completes growth first, second, Transverse 1st 61 page file
third? A-P 2nd
Vertical 3rd
Studies by Behrents from participants in the Bolton a.Facial growth ceases at age 21 61 page file
study indicate: b.No antero-posterior changes or
vertical changes in adult life
c.There is no increase in facial
dimensions in adults
d.There is an increase in all facial
dimensions in adults (correct)
A comparison of changes from the teens to the adult a. Changes in the facial skeleton equal 61 page file
indicates: those in the facial soft tissue profile
b. Changes in the facial skeleton are
greater than those in the facial soft
tissue profile
c. Changes in the soft tissue profile are
greater than those in the facial skeleton
(correct)
d. There is very minimal change in the
soft tissue or facial skeleton
Which structure is most likely to grow into a person’s a.Chin 61 page file
twenties? b.Nose (correct)
c.Maxilla
d.Mandible
When does the nose stop growing in males? a.Age 18 61 page file
b.Age 30
c.Never (correct)
d.Age 12
According to reviews of database at University of a.To the right side in 90% of the cases 61 page file (P687)
North Carolina, deviation of the chin in pts w/deficient b.To the left side in 90% of the cases
or excessive mand growth is: (correct)
c.Present in all cases
d.Hardly ever present
Soft tissue thickness in females: a. Increases the same as in males 61 page file
b. Increases less than in males
c. Increases more than in males
(correct)
d. None of the above
Surgical removal of tonsil and adenoid tissue in a 13 a.Is excellent timing 61 page file
YO female with long face syndrome: b.Is too late to aid in correction *
c.Is too early
d.None of the above
True or False: Chin doesn’t stop growing a.True 61 page file
The percentage of growth completed at 10 years of a. 20 % 61 page file
age is : b. 35 %(4/15/12)(correct)
c. 65 % (correct)
d. 96 %
Where does growth occur in order to make room for a. Alveolar process 61 page file
the maxillary molars? b. Maxillary tuberosity (correct)
c. Ramus
d. All of the above
The best genetic prototype for predicting facial a.The mother 61 page file
growth of a child is: b.The father
c.The grandparents
d.The same sex sibling (correct)
Which of the following combos are likely to result in a 1. Normal Maxillary and mandibular 61 page file
skeletal Cl II at the end of growth: lengths with a long cranial base.
2. Excessive maxillary lengths, normal
mandibular length and a normal cranial
base.

a. 1 only
b. 2 only
c. 1 & 2 (correct)
d. None of the above

35
 Question Answers Sources Discussion
The following statements are correct: a. Final facial size is attained earlier in 61 page file
females than males
b. Male facial growth continues into the
second decade
c. Facial growth is likely to be at the
time final height was attained in
females and continues after in male
d. All of the above (correct)
e. None of the above
The alterations in the adult facial skeleton indicate: a.Little changes from age 21 61 page file
b.Deceleration of growth in females
continued in the 20’s
c.The cumulative effect over time was
small
d.The cumulative effect over time was
large (correct)
What is the peak height velocity? a.12 for girls 61 page file
b.14 for boys
c.both (correct)
What is Peak Height Velocity? a. maximal growth spurt from birth to 61 page file
puberty
b. birth to 2 years
c. conception to birth
d. from puberty for up to 24 months
after (correct)
What is peak velocity age (PVK) ? a.Highest growth rate at any age 61 page file
(correct0
b.Growth rate in infancy
c.Growth rate in adolescence
In late maturing girls, PVH occurs? a.6-11 months before menstruation 61 page file p32-33, Proffit, 4th edition
b.18-24 month before menstration
(correct)
c.more than 24 months before
menstration
Which are most related? a.Dental age, peak height velocity, 61 page file
skeletal age
b.Dental age, skeletal age, sexual age
c.Peak height velocity, skeletal age,
sexual age (correct0
d.Peak height velocity, dental age,
sexual age
Maximum rate of facial growth occurs a.slightly after peak growth in statural 61 page file
height.
On the PHV curve, the onset of puberty correlates a. 9 years for boys 61 page file
best with the maximum growth spurt at the following b. 12 years for girls (correct)
age: c. 14 years for boys (correct)
d. none of the above
e. all of the above
The mandibular growth rate in females has been a.Twice as large for 14 to 16 year olds 61 page file
found to be: when compared to 16 to 20 year olds
b.Similar for 14 to 16 year olds when
compared to 16 to 20 year olds
c.Primarily in the mandibular plane area
d.Greater in vertical growth than in
anterior-posterior (correct)
What are the best ways to determine a person’s a.Serial cephs, family history, dental 61 page file
growth potential? age
b.Serial cephs, hand-wrist film,
chronological age
c.Serial cephs, family history, hand-
wrist film (correct)
d.Family history, chronological age,
dental age
Which is the BEST way to determine a person’s a. Serial cephs ( less correct) 61 page file Serial cephs can't determine growth potential, only cessation of growth
remaining growth potential? b. Hand-wrist (**more correct)
c. Family history
d. Chronological age

36
 Question Answers Sources Discussion
What is a diagnostic tool to distinguish between a. plaster models 61 page file
skeletal, sexual and PVH maturity? b. hand/wrist film (correct)
c. PA ceph
d. Photographs
The peak height velocity curve indicates: a. Number of centimeters (inches) 61 page file
grown per year (correct)
b. Height in centimeters (inches) per
year
c. Growth in the neurocranium
d. Weight in grams per year
e. Calcification of the epiphyseal plates
Indicators of maturity? a. Dental age, chronological age, 61 page file
skeletal age
b. Dental age, peak velocity age,
skeletal age
c. Dental age, chronological age, peak
velocity age
d. Skeletal age, chronological age,
peak velocity age (correct)
For a female at menarche, which statement is true? a. Most growth is complete (correct) 61 page file amount of growth? cumulative growth?
b. Most growth is yet to come
When are the growth peaks? a. First two years of life 61 page file
b. Early infancy and adolescence
(correct)
c. Early Childhood
Individuals who are late in their maturation show a. True (correct) 61 page file
larger increments of growth than those individuals b. False
who mature early.
Which genes are associated with hereditary tooth MSX1 and PAX9 (correct) ABO 2008 Articles #35 + #76
agenesis?
Which of the following are responsible for familial a.MSX1 61 page file
dental anomalies, agenesis b.PAX9 2007
c.A and B (correct)
When does primary teeth start to calcify in the fetus? a. 4 weeks 61 page file Proffit 4th ed. pg 76, table 3-2
b. 14 weeks (correct - U & L centrals)
c. 24 weeks
d. 8 months
At birth the crowns of which primary teeth have been a. Mandibular incisors (correct) 61 page file
calcified? b. Mandibular 1st molars
c. Maxillary canine
d. Maxillary 1st molars
When does mineralization of permanent first molars a. At birth (correct) UNK 2010 Profit 4th ed. pg. 94, Table 3-3
begin? b. 4 months in utero ABO 2009 1st molar starts calcification 32 wks in utero
c. 6 yrs ABO 2010 #2
Calcification of the upper and lower third molars a.Occurs at the same time 61 page file
b.Varies greatly (correct)
c.Is related to calcification of the other
teeth
The mechanism of tooth eruption is best explained a. Hormonal stimulation 61 page file
on the basis of: b. Primary tooth exfoliation
c. Programmed cell death at the base
of the crypt
d. Proliferation of cells at the base of
the crypt (correct)
When a tooth erupts, how much root has been a. 2/3 (correct) 61 page file
formed? b. ¾
c. 1/3
d. ½
How long does it take for the root apex to be a. 6 months 61 page file
completely formed after tooth eruption? b. 1 year
c. 2-3 years (correct)
d. 5 years
What does not happen during tooth eruption a.Elongation of the roots 61 page file
b.Occlusal movement
c.Mesial movement (correct)
d.Growth of the alveolar bone
e.Resorption of deciduous tooth roots

37
 Question Answers Sources Discussion
Which of the following is least likely to influence the a. Size of the apical base 61 page file How does anterior cranial base influence maxillary incisor angulation?
anteroposterior position of the maxillary incisors? b. Tongue-buccinator mechanism
c. Being a concert clarinetist
d. Congenital absence of third molars
(correct)
e. Continuing growth of the anterior
cranial base
Congenital absence of teeth results from 1.Initiation stage 61 page file
disturbances during which stages of tooth formation: 2.Proliferation stage
3.Bell stage
4.Calcification stage
A-1 & 2 only(correct) B-1 & 4onlyC-2 &
3 onlyD-1,2,3 & 4
Minimum number of lobes to make a a.4 ABO 2008
61 page file
Correlation between tooth size and dental arch form a. Very close 61 page file
is: b. Very poor (correct)
c. Off by one year
Recent studies according to Profitt indicate that late a.Pressure from erupting third molars 61 page file
mandibular incisor crowding is due to: b.Failure to extract third molars
c.Late mandibular growth *
d.All of the above
What is the most common cause of mandibular a.Late mandibular growth (correct) 61 page file
anterior crowding? b.Poor orthodontics
c.Third molars erupting
d.None of the above?
In patients with tight anterior occlusion, when late a.Distal displacement of the mandible 61 page file p125 Proffit
mandibular growth occurs the contact relationship of b.Flaring of the maxillary incisors
the incisors may cause: c.Crowding of the mandibular incisors
d.Marked mesial movement of the
maxillary incisors
i.a, b and c *
ii.b, c and d
iii.a, b and d
Which of the following will result in the greatest loss a.Loss of maxillary second primary ABO 2008
of arch length molar at 6 ½ (Correct) 61 page file
b.Loss of maxillary second primary 2007
molar at 11
c.Loss of mandibular first molar
The greatest amount of mandibular arch length a.3 61 page file Proffit fig. 3-40 and pg. 119
measured from the mesial of one molar to the mesial b.6 (correct)
of the other will occur at what age? c.9
d.12
e.18
What happens in arch length from deciduous to a. increases a lot 61 page file
permanent dentition when measuring from the mesial b. increases a little 2007
of the first molars? c. decreases a lot
d. decreases a little (correct)
e. stays the same
there is both arch width and length loss from primary TRUE ABO 2009 Michigan Proffit 4th edition pg 100:
to permanent dentition transition Both arch length (L) and arch circum-ference tend to decrease during the transition (i.e., some of the leeway space is
used by mesial movement of the molars).
Mandibular intercanine width changes from primary a. Slightly increases (correct) UNK 2010 Profit 4th ed. pg. 99: A slight increase in the width of the dental arch across the canines. As growth continues, the teeth
to permanent dentition: b. Significantly increases ABO 2009 erupt not only upward but also slightly outward. This increase is small, about 2 mm on the average, but it does contribute
c. Slightly decreases 61 pg file to the resolution of early crowding of the incisors.
ABO 2008 Proffit 4th ed. pg. 100 Fig 3-40 also states a "slight" increase
Moorees & Reed, J. dent. Res. January-February 1965: Showed ~1.75mm increase in Mand intercanine width from
primary to permanent dentition.
How much increase in arch width across the canines 2mm ABO 2009 Michigan Proffit 4th ed pg 99
is there from primary to permanent
The narrower the arch width, (versus a patient with a a.Greater for the narrow arch (correct) 61 page file McNamara - Orthodontics and Dentofacial Orthopedics 2001 pg 37:
wider arch width) the arch perimeter increase is : b.Less for the narrow arch - Narrow width group had an initial transpalatal width < 31 mm
c.No difference - Neutral group had initial trans-palatal width 31-35 mm
- Wide group had an initial transpalatal width > 35 mm
The narrow group had an increase in transpalatal width of 3.3 mm. That increase was greater than the neutral (2.5
mm) or the wide (1.7 mm) subgroups.A favorable finding was that the narrow group expanded to a greater extent
(from age 7 to age 15) without treatment than did the wider group
Prediction of growth / growth potential Hand Wrist

38
 Question Answers Sources Discussion
Analyzing growth Cessation of growth Longitudinal
Mandibular rotation or 10 year growth study Implant Study

39
 Question
What radiographs should be submitted to ABO
for a patient over 18 years?
CBCT is good for most hard tissues and some
soft tissues. CBCT is less expensive and less
radiation than CT.
CT has better resolution than CBCT. CBCT is
faster, less exposure, less time.
CBCT is better for TMJ than CT, CT has more
radiation dosage than CBCT
What is the best Radiographic technique to see
TMJ soft tissue?
Which of the following imaging methods is best
for perforated disc?
Which gives off the most radiation?
Digital radiographs produce 256 shades of gray.
Human eye can only see 16 shades of gray.
Multiple T/F: You can use an 8 bit monitor to
display a picture taken from a camera that has 8
bits and 256 shades of grey (is this an
appropriate display?).
This is an appropriate monitor because the
human eye can only see this many shades of
grey. Any higher of a resolution will not be picked
up by the human eye.
Answers Sources Discussion
a. Pano plus bitewings UNK 2010 ABO article #5 - Radiographic and periodontal requirements of the american board of orthodontics
b. CBCT scan
c. FMX (correct)
d. Pano
a. First statement is true, second false UNK 2010 Jacobsen text p. 236
b. First statement false, second true.
c. Both true (correct)
d. Both false
F/T ABO 2009 Michigan The quality of the images of the TMJ with CBCT machines is comparable to conventional CTs, but the image-taking is faster
and less expensive and provides less radiation exposure. (Mosby's)
Graber Chapter 2: CBCT and CT have same image quality
a. first statement is true, second is false UNK 2010 Dr. Hatcher: "CBCT and CT theoretically should be about equal for looking at the TMJ but practically the CBCT is best. The
b. first statement is false, second is true (correct) goals of TMJ CT/ CBCT imaging are to show the size, shape, quality and spatial relationships of the osseous components of
c. both true (more likely correct) the TMJs. Neither system allows you to visualize the disc. The CBCT images in an upright position and is better than a
d. both false supine position in CT. CBCT is a much lower dose than CT"
- From CDA Journal article Jan 2010: "TMJ positional relationships can be more accurately evaluated (by CBCT) than in a
CT examination where the patient is supine. Images generated via CBCT are not distorted and provide good bone density
evaluation"
a.CAT scan 61 page file
b.Tomogram
c.MRI *
d.Bitewing
a. arthrography (correct) UNK 2010 Jacobsen text p. 236; ABO Breakdown:
b. arthoscropy ABO 2008 Arthrogram - inject dye; internal derrangements, ADD
c. mri 2007 MRI - best for TMJ soft tissues (disc, ligaments, muscle, internal disc derangement)
d. ct 61 page file CT - best for bone/hard tissues
Tomogram - osseous parts of TMJ
Transcranial XR - lateral pole of condyle; least reliable for condylar shape
a.CT UNK 2010 Asked a radiologist
b.Bone scan (4/15/12) ABO 2009
c.transorbital
d.bunch of other techniques
True, True. (correct) x Gray scale resolution is how many shades of gray are in the image; also known as contrast or bit depth. The imaging system
is capable of capturing and separating literally thousands of shades of gray Contrast is expressed in bits. A 1-bit image has
only 2 shades (pure black and white—the darkest and lightest shades of gray in the imaging scale) and is expressed as "I to
the power of 1." A 2-bit image is expressed as "1 to the power of 2," or 1 × 2 = 2 × 2 = 4 shades of gray. A 3-bit image has 8
shades of gray, or 1 × 2 = 2 × 2 = 4 × 2 = 8. A 4-bit image has 16 shades of gray, and so on. In an 8-bit image, there are 256
shades of gray and this is the standard. However, systems capable of up to 12 bits or 4098 shades of gray presently exist.
The more bits in the image, the greater are the storage needs for the images. The human eye of the person in the street can
commonly separate 16 shades of gray, a photographer or radiologist can separate about 25 shades of gray, and under
laboratory conditions the maximum for the unaided eye to separate is somewhere around 64 shades of gray. The image itself
usually does not occupy the entire gray scale as can be seen by viewing the histogram. The image may be confined to about
30 shades of gray. For best results it is desirable to have a system capable of at least 256 shades of gray. This way there is
space on the scale to lighten or darken the image (histogram shift) or spread the shades of gray over a bigger part of the
scale (histogram stretch). Remember, 8 bits or 256 shades of gray represents the limit of most monitors.
(Langlais, Robert. Exercises in Oral Radiology and Interpretation, 4th Edition. W.B. Saunders Company, 122003. p. 68).
This means that the detector can theoretically capture 256 (28) to 65,536 (216) different densities. In practice the actual
number of meaningful densities that can be captured is limited by inaccuracies in image acquisition; these inaccuracies are
given the generic term of noise. Regardless of the number of density differences that a detector can capture, conventional
computer monitors are capable of displaying a gray scale of only 8 bits. Because operating systems such as Windows
reserve a number of gray levels for the display of system information, the actual number of gray levels that can be displayed
on a monitor is 242. A more important limiting factor is the human visual system, which is capable of distinguishing only about
60 gray levels at any time under ideal viewing conditions.
(White, Stuart C.. Oral Radiology: Principles and Interpretation, 5th Edition. Mosby, 122003. p. 232).
Jacobson text (2nd edition), p54
"computers use brightness values of varying numbers of bits. for example, in an 8 bit system each pixel has a range of 256 (2
to the 8th) values of grey. 0 being the darkest black and 255 being the whitest white...human eye can detect detail 0.1mm x
0.1mm"
True, True. (correct) ABO 2008
40
 Question
In digital photography, use 8 bit, there are 256
shades of gray. This is ok bc human eye can
only distinguish 40 shades
True or False: Human eye sees 16 shades of
gray. Digital camera sees 256 shades (if 8 bit
only)
How should a patient be positioned for taking a
cephalometric XR?
Most magnification is seen with the following:
You are most likely to get a magnified image if?
What is the most common error causing
magnification?
What causes most error in radiographs?
The most common error in cephalometric tracing a.Poor films
is what?
The major source of error in cephalometrics is? a.Magnification
Most common source of error on a ceph
How far is the film from the midsagital plane in a a. 15 cm (correct)
ceph?
If you buy a new ceph machine, but it’s 5 mm
greater distance between object and film-what
happens? (15.5 cm instead of 15.0cm)
In a standard lateral cephalogram, which side of b.Left
the mandibular border is lower and more
magnified?
Which is correct when looking at a developed
lateral cephalogram?
Patient has antegonial notch on ceph, how do
you know if right or left side when the notch is on b. Left side will be magnified
the inferior border of the mandible?
What is the usual cause of two lines at the
mandibular border?
When you see a double border to the mandible, a. Right (correct)
which side is lower to distortion? (assuming the b. Left
patients head is positioned properly)
Answers Sources Discussion
T/F ABO 2009 Jacobsen pg 54:
In an 8-bit system, each pixel has a range of of 256 values of gray (first statement true)
Second statement is false, bc human eye can max of 16 shades of gray (lay person) 25 for radiologist
a.Both statements True 61 page file The human eye can see 16 shades of gray. second statement is true (see above)
Gray scale resolution is how many shades of gray are in the image; also known as contrast or bit depth. The imaging system
is capable of capturing and separating literally thousands of shades of gray Contrast is expressed in bits. A 1-bit image has
only 2 shades (pure black and white—the darkest and lightest shades of gray in the imaging scale) and is expressed as "I to
the power of 1." A 2-bit image is expressed as "1 to the power of 2," or 1 × 2 = 2 × 2 = 4 shades of gray. A 3-bit image has 8
shades of gray, or 1 × 2 = 2 × 2 = 4 × 2 = 8. A 4-bit image has 16 shades of gray, and so on. In an 8-bit image, there are 256
shades of gray and this is the standard. However, systems capable of up to 12 bits or 4098 shades of gray presently exist.
The more bits in the image, the greater are the storage needs for the images. The human eye of the person in the street can
commonly separate 16 shades of gray, a photographer or radiologist can separate about 25 shades of gray, and under
laboratory conditions the maximum for the unaided eye to separate is somewhere around 64 shades of gray. The image itself
usually does not occupy the entire gray scale as can be seen by viewing the histogram. The image may be confined to about
30 shades of gray. For best results it is desirable to have a system capable of at least 256 shades of gray. This way there is
space on the scale to lighten or darken the image (histogram shift) or spread the shades of gray over a bigger part of the
scale (histogram stretch). Remember, 8 bits or 256 shades of gray represents the limit of most monitors.
(Langlais, Robert. Exercises in Oral Radiology and Interpretation, 4th Edition. W.B. Saunders Company, 122003. p. 68).
a.Patient staring at a distant point in the horizon 61 page file Jacobsen: FH should be parallel to floor
(Natural head position) *
b.Alert feeding position
c.Chin parallel to the floor
d.None of the above
a. increased object/midsagittal plane to film UNK 2010 "Bilateral structures close to the midsagittal plane demonstrate less discrepancy in size when compared with bilateral
distance (correct) 2007 structures farther away from the midsagittal plane. Structures close to the midsagittal plane (e.g., the clinoid processes and
b. increased anode to patient distance ABO 2008 inferior turbinates) should be nearly superimposed."
c. Decreased object to film distance 61 page file (White, Stuart C.. Oral Radiology: Principles and Interpretation, 5th Edition. Mosby, 122003. pp. 211 - 212).
Jacobson text (p34, 2nd edition):
"The degree of magnification is determined by the ratio of the distance from the xray source ot the object and the distance
from the xray source to film. The larger the distance from the object being imaged to the film plane, the greater the
magnification. To minimize this effect, the distance from the x-ray source to the midsagittal plane of the patient's head in ceph
units should be 5 feet"
a. ear rods ABO 2009 ABO Breakdown:
b. distance from midsaggital plane to film (correct) - film to midsaggital plane = 15cm
- source to midsaggital plane = 60 in (5 ft)
61 page file
b.Magnification
c.Proper identification of landmarks (correct)
61 page file taking cephs or tracing cephs? what are they asking for?
b.Distortion
c.Indentification of landmarks **
a.Source-film distance 61 page file The machine should be calibrated so that a. and b. remain consistent
b.Patient-film distance 2007
c.Vertical position of the head (correct)
61 page file
b. 20 cm
c. 4 feet
d. 5 feet
a.Slightly enlarged * 61 page file
b.Significantly enlarged
c.No change
a.Right * 61 page file
c.Depends on the asymmetry
d.None of the above right side will be positioned further from film and thus will appear more magnified (increased object:film distance)
a. Left mandible is higher and bigger 61 page file An alternative choice would be: left mandible higher and smaller
b. Left mandible is lower and smaller
c. Right mandible is higher and smaller
d. Right mandible is lower and bigger (correct)
a. Right side will be magnified (correct) 61 page file
c. You won’t
a.Asymmetry 61 page file
b.Magnification *
c.Incorrect positioning of patient
61 page file
c. Neither

41
 Question Answers Sources Discussion
a.Head rotated 61 page file Does pt to source distance affect magnification?
Why would the mandible be smaller on a ceph b.Patient moved
taken 3 years later? c.Patient too close to x-ray source on initial *
Post ortho treatment the patients mandible looks a. Patient moved 61 page file
smaller on the ceph. What happened? b. Change in object to film distance (correct)
c. Patient rotated head
What is the most reasonable explanation when a. The first one is wrong 61 page file
the mandible appears smaller on a successive b. The patient didn’t grow
cephalometric radiograph? c. The patient’s head was tilted (Correct)
If you are doing research on cephs, but one a. Factor in a magnification between the two 61 page file
group is on one machine & the 2nd group is on machines *
another machine. What affect on your results? b. Can’t use the data
c. No effect
Digital radiographs versus traditional radiographs Silver halide (traditional) has better resolution. Article "A revision of the adult intraoral radiograph protocol for ABO clinical examinations," Dykhouse:
"A comparison of conventional intraoral films and digital intraoral radiographs demonstrated that alveolar bone measurements
are reproducible in either imaging modality. Hence, either system or both systems can be used to accurately evaluate crestal
bone levels"

Jacobsen pg. Ch.5: disadvantages of digital = initial cost of machine, training, accuracy, security and stability of files
Not including CBCT what is the downfall to a. operating costs ABO 2008 see above
digital? b.resolution (correct)
Digital radiographs offer all the advantages a. decrease operating costs 2007 review
EXCEPT: b. decrease radiation
c. less storage space for films Jacobsen pg 55:
d. greater sharpness (correct) advantages of digital: less radiation, less time, lower operating costs, less storage needed
Radiographic film emulsion is a. Cellulose acetate 61 page file
b. Sodium thiosulfate
c. Hydroquinone
d. Gelatin and silver bromide (correct)
e. Calcium tungstate
What is the x-ray filter made of? a. Copper 61 page file
b. Tungsten
c. Aluminum (correct)
d. Carbide
Filters are used in the XR beam to? a.Reduce film density 61 page file
b.Correct the XR beam size
c.Reduce the exposure time
d.Remove low energy XR’s *
e.Increase contrast
What metal is used for the target in the XR tube? a.Copper 61 page file
b.Tungsten *
c.Aluminum
d.Molybdenum
What is the minimum total filtration that is a. 1.5 mm of aluminum equivalent 61 page file
required by an XR machine that can operate in b. 5/8 (16 mm) of gypsum
ranges greater than 70 KVP? c. 2.5 mm of aluminum equivalent (correct)
d. 1/32 in. (0.8mm) of lead
Whats a filter and intensifying screen used for? Reduce exposure to pt (correct) ABO 2008
When taking lateral cephalograms, double a.Density 61 page file intensifying screens also increase contrast
intensifying screens and screen films are used to b.Contrast
reduce: c.Exposure times *
d.Secondary radiation
e.Target-skin distance
Which of the following is the correct description a.Thicker phosphor layer result in faster screens 61 page file Fast screens - thick layer, and relatively large crystals used, maximum speed is
of intensifying screens? **correct ABO 2010 #2 attained but with some sacrifice in definition
b.Thinner phosphor layer result in more
unsharpness
A very light radiograph is caused by the following a.Too short exposure time 61 page file
EXCEPT b.Wrong side of film being toward the tube
c.White light being leaked into the darkroom**
An exposed radiographic film should remain in a. As long as it remained in the developer 61 page file
the fixer solution b. Until the film first clears
c. For 5 min at 70 degrees F
d. For at least 10 minutes (correct)
A latent image is: “invisible change” a. An image that is very late in its development 61 page file
b. A very light radiographic image
c. Produced after exposure but before
development (correct)
d. A very dark radiographic image

42
 Question Answers Sources Discussion
What is the most important factor for digital a. Sensor resolution UNK 2010 - Jacobsen p. 220: lists 2 things as important for photography: 1. control over magnification/distortion 2. lighting
cameras when using for intraoral photography? b. Lighting (correct) ABO 2009 Michigan Graber: The resolution of a captured image depends on the camera sensor's pixel count; for clinical purposes, sensors in the
c. Standardized focal distance 2007 range of 1.4 million to 1.8 million pixels are sufficient to record subtle facial and intraoral detail Resolutions higher than this
may be clinically undesirable because they significantly increase storage requirements without meaningfully improving image
quality
What loses most resolution? a. JPEG (correct) - unless GIF is an answer ABO 2009 Jacobsen pg. 56 - Image compression and google search
b. Lossless JPEG
c. TIFF (saves most info)
b. Lead JPEG

Which type of file do you lose the most a.Jpeg (we think it's correct- in CDABO packet) ABO 2008
information upon compression. b.Lead Jpeg
c.tif
d.raw
Which type of file has the least amount info lost? TIFF ABO 2010
What is the worst for filing JPEG 61 page file
Which of the following structures do NOT appear a.Median palatine suture 61 page file No reference
radiolucent on a radiograph? b.Anterior nasal spine (correct)
c.Mandibular canal
Which of the following structures appear a. 1 & 3 only (correct) 61 page file No reference
radiolucent on an oral radiograph: b. 1, 3 & 5
1.Medial palatine suture c. 4 & 5 only
2.Anterior nasal spine d. 2 & 3 only
3.Mandibular canal
4.Genial tubercles
5.Hamular process
What should you change when you use a double a.Increase the mA, but not the kVp 61 page file
film packet for a periapical radiograph? b.Decrease the mA, and increase the kVp
c.Decrease the kVp, but not the mA
d.Do nothing **
When taking an extraoral PA with two films a.Increase kVP 61 page file
(duplicates), what do you need to adjust to b.Decrease kVP
ensure quality? c.Increase milliamps ** (Jacobsen: 2 extraoral films will have 1/2 the density, so must increase either ma or exposure time)
d.Decrease milliamps
What affects the penetration to the patient the a.KVp * 61 page file
most? contrast b.Distance
c.Intensifying screens
d.Exposure time
What has no effect on the penetrating power? a. KVp 61 page file
b. Mamps (possibly also correct)
c. Wavelength of the photons
d. Exposure time (correct) ma and exposure time affect # of photons produced (density) so BOTH should not have effect on penetrating power
What should you do to decrease the contrast? a. Increase the kVp * (correct) 61 page file Jacobsen: Higher Kv (kilivolts) increase penetration leading to higher density (overall blackness) and lower contrast (more
b. Decrease the kVp 2007 review shades of gray). Higher Ma (miliamps) and exposure time increase density only
c. Increase the mA
d. Decrease the mA
What would you do to the kVp or mA to visualize a. Increase kVp 61 page file ABO Breakdown: you want more shades of gray, so less contrast, which means increased Kvp. no change in ma b/c do not
a root fracture? b. Decrease kVp (correct) need to change density
c. Increase mA
d. Decrease mA
The density of a radiograph is decreased by a.increasing the milliamperes 61 page file
b.Increasing the exposure time
c.Increasing the developing time
d.Increasing the tube-patient distance *
CBCT: increase in voxel size, increases F/F ABO 2010 Dr. Hatcher:
magnification. An increase in voxel size, - Voxel size affects resolution and accuracy NOT the magnification. There is no significant magnification in CBCT or CT
increases resolution scans.
- Decreased voxel size, decreased field of view, increased scan time = increased resolution. CBCT generally has small voxel
size.

Smaller Voxel size is favorable for good T/F UNK 2010 see above
resolution. Increased voxel size can cause more ABO 2009
magnification.
Paroramic radiographs are least useful in a.Supernumerary teeth 61 page file No reference as of yet
demonstrating which of the following: b.Arch perimeter deficiencies (correct)
c.Congentially missing teeth
d.Axial inclination of teeth
e.Apical development of permanent teeth

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 Question Answers Sources Discussion
Advantages of intraoral periapical radiographs 1. Better ability to detect root resorption. 61 page file (P163)
over panoramics in ortho diagnostic process 2. Better ability to detect carious lesions.
include: 3. Less exposure to radiation. ABO Article #63 Sameshima - "Assessment of Root Resorption and root shape: Periapical vs Panoramic Films"
4. Pathologic lesions, supernumerary and
impacted teeth are more easily detected using
periapicals.
A - 2 & 3 only
B - 1& 2 only **
C - 1, 2 & 3
D - 1, 2,3 & 4
How should a patient be positioned for taking a a. Chin parallel to the floor 61 page file Dr. Hatcher lecture
panoramic XR? b. Frankfort horizontal parallel to the floor (correct)
c. Occlusal plane parallel to the floor
d. None of the above
Which term describes the area of the dental a. Rotation center 61 page file
anatomy that is reproduced distinctly on the b. Focal trough (correct)
panoramic radiograph? c. Sagittal plane
d. Laminograph
A picture of a panorex is shown and you are Caries 61 page file
asked what is obvious?
When eval radiographically which teeth show a. Maxillary canines 61 page file
greatest variation relative to the onset of b. Mandibular second molars
mineralization of the crowns of permanent teeth? c. Mandibular second premolars (correct)
d. Maxillary lateral incisors
e. Maxillary first molars
SLOB Rule (They tell you tooth is lingual and that same lingual, opposite buccal ABO 2009 Michigan -if you take x-ray from the mesial, the buccal root/object will appear distal on the radiograph
they are taking xray from distal) 61 page file
Transcranial XR’s are for viewing what structure? a. Lateral pole of the condyle * 61 page file
What is the transcranial XR least reliable for a.Condyle shape 61 page file Breakdown states that answer is condylar shape
viewing? b.Glenoid fossa
c.Joint space The transcranial projection provides a sagittal view of the lateral aspects of the condyle and temporal component.
d.Range of motion The image of the condyle, temporal component, and joint space is distorted, and condylar position cannot be reliably
determined, particularly if the horizontal beam angle is not individualized for each patient. The transcranial projection is useful
for identifying gross osseous changes on the lateral aspect of the joint only, displaced condylar fractures, and range of motion
(open views).
(White, Stuart C.. Oral Radiology: Principles and Interpretation, 5th Edition. Mosby, 122003. p. 543).
AAO standard for facial pictures 1/4 photo size 61 page file
What does the ABO recommend for scale of 1/4 size ABO 2008
photography?
When cropping pictures what pixel does ABO a. 1/4 61 page file
recommend pics: 24-bit (bits/pixel) color-depth, 300-dpi JPEG
images w/ medium compression
Xray: 8-bit grayscale, 200-dpi JPEG with medium
compression
Factors that contribute to optimal detail a. A small focal spot area 61 page file
sharpness include: b. Increase kilovoltage
c. A long focal-spot film distance
d. A short object film distance

i. a and b
ii. a and c
iii. a and d (correct)
iv. c and d
v. a,c and d
X-rays do not affect all tissues equally T ABO 2010
The oral tissues most sensitive to x-radiation a.Muscles of mastication 61 page file
are? b.Gingival
c.Fifth nerve
d.Developing tooth buds and salivary glands *
Which of the following is mandatory in radiation a.Gonadal shields 61 page file
protection for the patient? b.High-speed film
c.Collimator * narrows a beam
d.Use of long, lead-lined cones
The radiation protection guide advocates that the a.100 milliroentgens per week * 61 page file
XR dose to operators of the dental machines b.10 roentgens per week
should not exceed? c.100 roentgens per week
d.300 roentgens per week

44
 Question Answers Sources Discussion
Which radiograph would you use to see the a. Tomogram 61 page file
maxillary sinuses? b. Lateral Cephalogram
c. Posterior-Anterior Cephalogram
d. Waters View (correct)
The first clinically observable reaction to radiation a. Loss of hair 61 page file
is: b. Erythema of the skin (correct)
c. Agenesis of the blood cells
d. Loss of elementary epithelium

45
 Question Answers Sources Discussion
Cephalometrics is best used to determine a.Skeletal pattern 61 page file
b.Dental pattern
c.Dental pattern related to the skeletal pattern (Correct)
d.None of the above
Cepalometric analysis is: a.Used as an aid in the total diagnosis of an orthodontic 61 page file
case
b.Used for longitudinal growth studies
c.Used for orthodontic treatment planning
d.Used for evaluating results of therapy
e.All of the above (correct)
The major advantage of cephalometric radiographs in treatment of a.Evaluation of dentofacial proportions. 61 page file
children & adolescents is: (P171) b.Screening for pathologies.
c.Study changes in jaw and tooth position brought about
by growth and treatment (correct)
d.None of the above
According to the ABO, which of the following represents the a. Lower border of mandible to Menton (Downs) UNK 2010 from clinical exam guide of the ABO 2010 Fifth Edition pg 50;
mandibular plane: b. Gonion to Menton 2010 #2
c. Constructed gonion to Menton (correct) ABO 2009
How does ABO define Mandibular plane angle? SN-MP angle between 27-37 degrees. ABO 2010
What ceph measurements are used in the ABO discrepancy index: a. ANB (correct) 2010 #2 article "The ABO discrepancy index: A measure of case complexity," Thomas J. Cangialosi:
b. SN-MP (correct) These entities summarize the clinical features of a patient’s condition with a quantifiable, objective list of target disorders that
c. FMA represent the common elements of an orthodontic diagnosis: overjet, overbite, anterior open bite, lateral open bite,
d. IMPA (correct) crowding, occlusion, lingual posterior crossbite, buccal posterior crossbite, ANB angle, IMPA, and SN-GoGn angle.
Which of the following is NOT included on ABO analysis a. FMA (correct if question asks about discrepancy UNK 2010 According to discrepancy index in the Cangialosi article stated above, FMA is NOT used.
(This might have been wrongly remembered and as the question index) The DI form can be seen here:
above, I think this should say ABO discrepancy index) b. ANB http://americanboardortho.com/professionals/downloads/Example%20Case%20Presentation.pdf
c. IMPA (possible answer) The only ceph measures that are awarded points are ANB, SN-MP, and /1-MP
d. Sn-MP
Everyone got this wrong in 2010
We guessed IMPA because ABO example tracing labels IMPA as "/1 to MP" and ABO defines the mandibular plane
differently (using constructed gonion instead of gonion)
http://www.americanboardortho.com/professionals/clinicalexam/casereportpresentation/preparation/tracings.aspx#
http://www.americanboardortho.com/professionals/clinicalexam/casereportpresentation/preparation/CephTraceExample1.
aspx

ABO uses:
SNA, SNB, ANB, SN-MP, FMA, SN-U1, MP-L1, 1/-NA, /1-NB, E-plane

What two bones meet at Articulare? a. zygomatic bone 61 page file Mosby's Dental Dictionary
b. mandible (correct) articulare: the point of intersection of the dorsal contour of the mandibular condyle and the temporal bone
c. sphenoid
d. temporal (correct)
Which of these points is a constructed point: a. Subnasale 61 page file Jacobsen
b. Articulare (correct) Ar: point at the junction of the posterior border of the ramus and the inferior border of the posterior cranial base (occipital
bone)
Which point is associated with the occipital condyle? a.Fulcrum point Jacobson 2nd ed. page 49
b.Bolton point (correct) Bolton point is the intersection of the outline of the occipital condyle and the foramen magnum at the highest point on the
c.Basion point notch posterior to the occipital condyle.

61 page file Basion point is the lowest point on the anterior rim of the foramen magnum.
What is the posterior border of the foramen magnum called on a a. basion 61 page file
cephalogram? b. opisthion (correct)
c. axithion
d. post border of the foramen magnum
Which is most closely associated with opisthion? a.Bolton 61 page file No reference
b.Basion (anterior point on foramen magnum) Bolton point is much closer to opisthion than any of the others listed
c.Condylion
d.Occipital condyle
The most difficult to point locate on a ceph is? a.A point (correct) 61 page file Not sure about this question could not find a reference.
b.B point P59 Jacobson; "statistically significant differences in landmark idenification were found along the x coordinate for point A and
c.Sella along the y coordinate for anterior nasal spine (ANS) and condylion (Co)"
d.Ar
Which of the following is a midline point on PA ceph: a. Menton (correct) UNK 2010 Jacobsen.
b. Opisthion 61 page file
c. A point 2007
d. Jugulae
e. ANS (supposedly an answer choice as well)

46
 Question Answers Sources Discussion
Which of the following is a midline point on a lateral ceph: a. Opisthion UNK 2010 A Point correct because it's directly from the Jacobson definition of A Point.
b. Point A (correct) 61 page file
c. Menton 2007 Other midline points on lat ceph (incomplete):
d. Orbitale A point
e. Porion ANS
B Point
Cervical Point
Glabella
Gnathion
Opisthion

A unilateral (non mid sagittal) point would be:

Incison Inferious (incisor tip)
Which of the following is not a bilateral structure: a. A point UNK 2010 A point is not an actual anatomic structure (its mainly on x-rays) therefore we believe that opisthion is a better answer for this
b. Opisthion (correct) ABO 2008 question (they didn't specify a specific ceph)
c. Porion
d. Orbitale
On a PA ceph, if the patient does not have a mandibular a. Menton (correct) ABO 2009 Jacobsen Pg 268 - doesn't list a-point as a midline structure
asymmetry, which structure is NOT bilateral? b. A point Menton = most inferior point of the mandibular symphysis, in the midsagittal plane. (midsagittal)
c. pterygomaxillary fissure (PTM) A point = midsaggital on lateral ceph only (not PA)
PTM = bilateral, inverted teardrop-shaped radiolucency (most inferior point of the fissure)
Distance between SN and natural head position is usually a. 7 degrees (correct) UNK 2010 Jacobsen txt chapter on Natural head position
b. 5 degrees
c. zero degrees
What is the average difference between S-N and Frankfort a.3 degrees 61 page file
horizontal? b.7 degrees (Correct)
c.10 degrees
d.13 degrees
What are common and stable reference lines when tracing a.Nasion-B point 61 page file
successive cephs? b.Nasion –A point
c.Frankfort horizontal (correct)
d.Facial Axis
When looking at a ceph, what is level with Frankfort Horizontal? a.zygomatic arch (correct) 61 page file Google
b.Go-Gn
c.S-N
d.ANS-PNS
What is the best structure for superimposition of cranial base: a. anterior clinoid, cribiform plate, and greater wing of UNK 2010 ABO website:
sphenoid (correct) ABO 2009 1.Craniofacial Composite - register on Sella with the best fit on the anterior cranial base bony structures (Planum
b. Sella on S-N Line 2007 Sphenoidum, Cribiform Plate, Greater Wings of the Sphenoid, and Occiput) to assess overall growth and treatment changes.
2.Maxillary Composite - register on the lingual curvature of the palate and the best fit on the maxillary bony structures to
assess maxillary tooth movement.
3.Mandibular Composite - register on the internal cortical outline of the symphysis with the best fit on the mandibular canal to
assess mandibular tooth movement and incremental growth of the mandible.

Graber (2000) pg. 214 & Graber (2005) pg. 245: Through the systematic study ... the most stable osseous structures in the
anterior cranial base of growing children and adolescents were defined anatomically (Figure 3-38, A). This research
established that the three most stable osseous landmarks for superimposition of cephalometric radiographs are
(1) the anterior curvature of the sella turcica,
(2) the cribriform plate, and
(3) the internal curvature of the frontal bone (Figure 3-38, B).
In effect, this research established the gold standard for reliable superimposition on the anterior cranial base
For cranial base superimpositions, what are the landmarks? a.Sella-nasion on sella 61 page file McNamara's Orthodontics and Orthopedics Chapter 25 by Kokich
b.Anterior clinoid, greater wing of sphenoid, cribiform oThe best means for assessing the completion of facial growth is to superimpose sequential lateral cephalometric head
plate (correct) radiographs. By registering the superimposition on the base of the skull (sella, greater wings of the sphenoid. and cribriform
c.Planum sphenoidale, lesser wing, sella plate), the clinician may determine if the distance between nasion and menton has increased between successive films
Where to superimpose for longitudinal data: a.SN at S UNK 2010
b.ethmoid, ant clinoid, GW of sphenoid (correct) ABO 2008 Jacobson states to superimpose on SN at Sella (p146), but not on ABO reading list
ABO 2010 #2
At what age can you start to superimpose on S-N? a. 5 ABO 2010 #2
b. 7 (correct)
c. 9
d. 11
Jugal Point UNK 2010 Jacobson Pg. 269: Jugale (J), at the jugal process, the intersection of the outline of the maxillary tuberosity and the zygomatic
buttress.
On a lateral ceph, arrow is pointing to: a. Ethmoid sinus UNK 2010 Arrow was pointing to the orbital floor but posterior to frontal bone just above ethmoid sinus. Options for orbital floor of
b. Sphenoid Sinus ethmoid bone or bridge formed by frontal and ethmoid were not given.
c. Orbital floor of frontal bone
On a view of a lateral ceph with the second molars and E’s present, a.13 years 61 page file Think about it
how old is the pt? b.9 years
c.11 years (correct)
d.15 years
If a lower incisor to GoGn changed from 105 to 95, how many mm a.10mm 61 page file The answer says 4mm is correct. But according to the MBT book, the calculation is .8mm/1 degree proclination. Which
of mand. space is necessary? b.8mm (Correct) means the answer should be 8mm
c.6mm
d.4mm 1mm/2.5 degrees 2mm/5 degrees

47
 Question Answers Sources Discussion
Wits analysis uses which plane for reference? a.Frankfort 61 page file see above
b.Occlusal (correct)
c.SN
d.Palatal
In utilizing, which appraisal is a determination of the relationship a.Wits (correct) 61 page file SNA is maxilla only, Facial axis is growth direction, E line is Soft tissue
between the maxilla and the mandible? b.SNA
c.Facial Axis (NaBa-PtGn)
d.E-line
Increase clockwise rotation of A and B ANB increases ABO 2009 Michigan Article "The “Wits” appraisal of jaw disharmony," Jacobsen:
-Counterclockwise rotation of jaws relative to SN = Class III (ANB decreases)
-Clockwise rotation of jaws relative to SN = Class II (ANB increases)
In utilizing, which appraisal is a determination of the relationship a.Wits (correct) 61 page file
between the maxilla and the mandible? b.SNA
c.Facial Axis (Ba-Pt-Gn)
d.E-line
The major limitation of the Wits analysis is: a.Unreliability of using the functional occlusal plane in 61 page file Wits is dependent on the pitch of the occl plane. The inclination of the occl plane will effect the measurements rendered by
open-bite cases. Wits. So 2 given patients, A point and B point could be in the same AP position, but if the occl planes are very different have
b.Failure of distinguishing between skeletal and dento- contrasting wits appraisal. Therefore the dental effect is not taken into account.
alveolar discrepancies.(correct)
c.Lack of normative data for various ethnic groups.
d.None of the above.
On a ceph you are asked if you use machine porion instead of a.FMA and y-axis increases (Correct) 61 page file Machine porion will always be inferior and anterior on a ceph than anatomical proion
anatomic porion what will change?
When superimposing on the mandible, what do you NOT a.symphysis 61 page file Bjork Article:
superimpose on? b.angle of the mandible (correct) 4 stable references for superimposition:
c.the mandibular canal 1. chin tip
d.mental foramen (correct) 2. inner cortical structure at inferior border of symphysis
3. mandibular canal trabeculae
4. lower contour of molar crypt until roots begin to form
Where do you superimpose the mandible on? a. The third molar crypt, the outer cortical part of the 61 page file see bjork article
symphysis and on the lower border of the mandibular
canal
b. The third molar crypt, the inner cortical part of the
symphysis and on the lower border of the mandibular
canal
c. The third molar crypt, the inner cortical part of the
symphysis and on the lower border of the mandibular
canal (correct)
d. The third molar crypt, the outer cortical part of the
symphysis and on the mandibular canal

Where do you superimpose to know changes in maxillary dentition? a.Palate (arrow was pointing at the palate on the lateral 61 page file
ceph) 2007
168.What is the ideal percentage of the lower facial height? a.45% 61 page file
b.55% (correct)
c.35%
d.65%
In a 16 YO female, the normal ratio of upper facial height (nasion a.63:35 61 page file Jacobson 2nd ed.
to ANS) to lower facial height (ANS to menton) is: b.30:79
c.50:50
d.43:57 (correct)

48
 Question Answers Sources Discussion
Which is not an esthetic line? a. z-line ABO 2008 Ricketts E Line - Line drawn from the tip of the nose to the soft tissue pogonion
b. s-line 2007 review Holdaway’s H Line - Line tangent to the upper lip from the soft tissue pogonion
Which of these is not used in soft-tissue analysis? c. Gb-subnasale 61 page file Burstone's B Line - A Line joining the soft tissue subnasale as the upper point and skin pogonion as the lower point
d. I-line (correct) Steiner’s S1 Line - Line drawn from the center of the S - shaped curve between the tip of the nose and the skin subnasale to
the soft tissue pogonion
Sushner's S2 Line - Line drawn from the soft tissue nasion to the skin pogonion

A good measure of the severity of a malocclusion is the AB line to a.Occlusal plane 61 page file Answer key says Occl plane. However, there do not seem so be any analysis that measure A-B to occl plane. Wits does AO
b.Mandibular plane to BO
c.Frankfort horizontal Downs analysis uses A-B to Facial plane, so that seems to be the only thing that is measured against A-B.
d.Facial plane (N-Pg) (Correct)
the facial plane remodels? ABO 2010 they wrote: "forward Md growth with resorption on frontal and supraorbital (not sure if this is correct, but all the other choices
talked about the Mx being displaced backwards)"
What 2 lines make up the facial angle? FH and N-Pog 2007 Jacobsen 2nd edition
What happens to the facial angle and the mandibular plane angle a.The facial angle increases and the mandibular plane 61 page file Vertical dimension decreases as you age, rotating the mandible forward
as a person ages? angle decreases (correct)
b.The facial angle decreases and the mandibular plane
angle increases
c.The facial angle decreases and the mandibular plane
angle decreases
d.The facial angle increases and the mandibular plane
angle increases
Which of the following increases with time/age? a. Facial angle (correct) ABO 2008
b. FMA/MPA 2007 review
c. angle of convexity
d. y-axis
Which of the following changes from 8-18 yrs: a. Facial angle (correct) UNK 2010 Jacobsen:
ABO 2010 #2 - Facial Axis (NaBa - PtGn): from Ricketts (angular measurement Nasion-Basion plane and the Foramen Rotundum to
Gnathion. Avg 90; > 90 is a protrusive chin. You grow along your facial axis.

- Facial (depth) Angle (FH - NPog): avg. 90; > 90 is protrusive chin; increases w/ age

- MPA (FH - MP): avg. 26 at 9yo and decreases 1 degree/3yrs

- Y-axis (FH - SGn): avg 60; larger angle indicates more vertical and backward position of chin; remains stable

- Angle of convexity (NA - APog): avg 0; positive angle indicates maxillary prominence; neg. angle indicates maxillary
retrusion; should decrease w/ age

Dimensions that do not change:

- mx transverse
. What is LEAST likely to change from 8-18? a. y-axis (correct) ABO 2008
b. FMA 2007 review
Which of the following remains relatively constant with age c. Facial angle 61 page file
Facial axis does NOT change from (NaBa-PtGn) 8 to 18 61 page file
What increase in male from 8-18 (question should probably say a.Facial angle convexity (soft tissue glabella to 61 page file This question and answer seem incorrect. From Jacobsen text: Angle of convexity is intersection of the two lines N-A and A-
decrease) subnasale to soft tissue pogonion) Pog): avg 0; positive angle indicates maxillary prominence; neg. angle indicates maxillary retrusion. this should DECREASE
w/ age
If angle of convexity is normally zero & you measure –5, what type a.Class I 61 page file Positve Angle of convexity indicates a convex profile (Cl II)
of malocclusion is it? (N-A-Pg) b.Class II div I Negative angle of convexity indicates a concave profile (Cl III)
c.Class II div 2 See Downs analysis
d.Class III (correct)

49
 Question Answers Sources Discussion
Unreliability of Frankfort Horizontal (FH) as horizontal reference line 1. Difficulty of locating point Suborbitale 61 page file Proffit 4th Edition:
in cephalometrics stems from: 2. Difficulty of locating point Porion "Establishing whether the jaws are proportionately positioned in the anteroposterior plane of space requires placing the
3. The true horizontal may show a divergence of up to patient in the physiologic natural head position, the head position the individual adopts in the absence of other cues. This can
10º from FH be done with the patient either sitting upright or standing, but not reclining in a dental chair, and looking at the horizon or a
distant object. With the head in this position, note the relationship between two lines, one dropped from the bridge of the nose
a. 1 & 2 only to the base ofthe upper lip, and a second one extending from that point downward to the chin. These line segments should
b. 2 & 3 only form a nearly straight line. An angle between them indicates either profile convexity (upper jaw prominent relative to chin) or
c. 1 & 3 only profile concavity (upper jaw behind chin). A convex profile therefore indicates a skeletal Class II jaw relationship, whereas a
d. 1, 2 & 3 (correct) concave profile indicates a skeletal Class III jaw relationship. If the profile is approximately straight, it does not matter whether
it slopes either anteriorly (anterior divergence) or posteriorly (posterior divergence). Divergence of the face (the term was
coined by the eminent orthodontist-anthropologist Milo Hellman) is influenced by the patient's racial and ethnic background.
American Indians and Asians, for example, tend to have anteriorly divergent faces, whereas whites of northern European
ancestry are likely to be posteriorly divergent. A straight profile line, regardless of whether the face is divergent, does not
indicate a problem. Convexity or concavity does." pg 181

"An international congress of anatomists and physical anthropologists was held in Frankfort, Germany in 1882, with the
choice of a horizontal reference line for orientation of skulls an important item for the agenda. At the conference, the Frankfort
plane, extending from the upper rim of the external auditory meatus (porion) to the inferior border of the orbital rim (orbitale),
was adopted as the best representation of the natural orientation of the skull. This Frankfort plane was employed for
orientation of the patient from the beginning of cephalometrics and remains commonly used for analysis.
In cephalometric use, however, the Frankfort plane suffers from two difficulties. The first is that both its anterior and posterior
landmarks, particularly porion, can be difficult to locate reliably on a cephalometric radiograph. A radiopaque marker is placed
on the rod that extends into the external auditory meatus as part of the cephalometric head positioning device, and the
location of this marker, referred to as "machine porion" is often used to locate porion. The shadow of the auditory canal can
be seen on cephalometric radiographs, usually located slightly above and posterior to machine porion. The upper edge of this
canal can also be used to establish "anatomic porion," which gives a slightly different (occasionally, quite different) Frankfort
plane.
An alternative horizontal reference line, easily and reliably detected on cephalometric radiographs, is the line from sella
turcica (S) to the bones (N). In junction between the nasal and frontal the average individual, the SN plane is oriented at 6 to
7 degrees upward anteriorly to the Frankfort plane. Another way to obtain a Frankfort line is simply to draw it at a specific
inclination to SN, usually 6 degrees. However, although this increases reliability and reproducibility, it decreases accuracy.
The second problem with the Frankfort plane is more fundamental. It was chosen as the best anatomic indicator of the true or
physiologic horizontal line. Everyone orients his or her head in a characteristic position, which is established physiologically,
not anatomically. As the anatomists of a century ago deduced, for most patients the true horizontal line closely approximates
the Frankfort plane. Some individuals, however, show significant differences, up to 10 degrees.
For their long-dead skulls, the anatomists had no choice but to use an anatomic indicator of the true horizontal. For living
patients, however, it is possible to use a "true horizontal" line, established physiologically rather than anatomically, as the
horizontal reference plane. This approach requires taking cephalometric radiographs with the patient in natural head position
(i.e., with the patient holding his head level as determined by the internal physiologic mechanism). This position is obtained
when relaxed individuals look at a distant obiect or into their own eyes in a mirror and incline their heads up and down in
increasingly smaller movements until they feel comfortably positioned. The natural head position can be reproduced within 1
or 2 degrees. In contemporary usage, cephalometric radiographs should be taken in the natural head position (NHP), so that
the physiologic true horizontal plane is established. Although NHP is not as precisely reproducible as orienting the head to
the Frankfort plane, the potential errors from lower reproducibility are smaller than those from inaccurate head orientation." pg
207
Most stable position in head: a. Look into mirror or distant object (correct) 61 page file see above
What can be used as a substitute to locate porion: a. Internal meatus 61 page file see above
b. Maxillary tuberosity
c. Ear rod (correct)
d. Frankfort Horizontal
The temporal bone on a PA ceph appears as a line on? a. Superior 1/3 of the orbit 61 page file Jacobsen: The Petrous portion of the temporal bone appears as a radiopaque line which is superimposed in on the lower 1/3
b. Middle 1/3 of the orbit of the orbit on a PA ceph
Where does the petrous bone lie on a PA ceph radiograph? c. Inferior 1/3 of the orbit (correct)
d. roof of orbit
e. floor of orbit
f. None of the above
The radiopaque line that passes obliquely through the orbits on a a. Ethmoid 61 page file Jacobsen: Greater wing of the Sphenoid passses obliquely through the orbit of a PA Ceph
posterioanterior ceph is which bone? b. Sphenoid (correct)
c. Temporal
d. Parietal
Downs anaylsis use as reference plane: a. S-N 61 page file p63 Jacobson Text
b. FH (correct)
c. N-Ba
Downs used what for superimposition? a. Broadbent registration point (correct) 61 page file
What is the name of the intersection between the Bolton-nasion line a. Witz registration point 61 page file
and a perpendicular from sella? b. Broadbent registration point (correct)
c. Jarabak registration point
d. Holdaway registration point
Steiner uses: L1 - N-B/Pg – N-B (holdaway) 61 page file
190.Which ratio is used to see the relationship between the lower a.Holdaway ratio (correct) 61 page file Jacobson
incisors and the chin? b.Ricketts ratio
c.Bolton ratio Good description and picture of Holdaway Ratio:
d.Jarabak ratio http://books.google.com/books?
id=u6vkzOHH7FAC&pg=PA219&lpg=PA219&dq=holdaway+ratio&source=bl&ots=Px01lEYiNm&sig=dYBVrB_e-
lOv57kjVUZM6fvYqsI&hl=en&ei=IoCvTcDIFYGasAP_v6mSAw&sa=X&oi=book_result&ct=result&resnum=10&ved=0CFMQ6AEwCQ#v=one

50
 Question Answers Sources Discussion
One of the major strengths of the McNamara analysis is: a. Any one measurement is not affected by others within 61 page file
the same face.
b. The difference in sagittal positions of the jaws is
projected to S-N line.
c. The normative data are based on a well defined
sample. (correct)
d. None of the above.
Ricketts a.FH - N-PG (facial angle) 61 page file
According to Ricketts, the Frankfort Horizontal most closely a. Palatal plane (correct) 61 page file
parallels b. SN 2007
c. Occlusal Plane
d. Mandibular Plane
What does Rickett’s measure? a.Frankfort horizontal (correct) 61 page file
b.SN
c.Palatal plane
d.Occlusal plane
What is Rickett’s E-line? Soft tissue Po to tip of nose 61 page file
What is the best point from which to measure the protrusion of the a. SNA (correct) 61 page file
upper incisor? b. Facial angle
c. Frankfort horizontal
NLA norms 94-110 61 page file
What is the name of the midline point at the most inferior point ofa.Supradentale (correct) (prosthion) 61 page file
the maxillary alveolus? b.Subdentale
c.Labialdentale
Strengths of a template cephalometric analysis include all of the a.Easy use of age-related standards.(P184) 61 page file
following, except b.Quick overall impression of dentofacial structures.
c.Non-utilization of linear measurements. (correct)
d.Readily integration for computer use.
Which malocclusion is commonly found with an interincisal angle of a.Class I 61 page file
165 degrees? b.Class II div 1
c.Class II div 2 (correct)
d.Class III
Class III, MPA= 17. What is the lower incisor angle? they think answer is 78 or 87 b/c Class III will have higher ABO 2010 Tweed CH, The Frankfort-mandibular plane angle in orthodontic diagnosis, classification, treatment planning, and prognosis:
FMIA Frankfort-mandibular plane angle (FMA)--16-28
Frankfort-mandibular incisor angle (FMIA)--68
Incisor-mandibular plane angle (IMPA)—90 +/- 5˚
- article says that the above doesn't apply to severe Class II or III patients. it states that Class III pts have acute IMPA

Which of the following landmarks is NOT recognizable in periapical a. External oblique ridge 61 page file No reference
radiographs of the mandible: b. Coronoid process (correct)
c. Mylohyoid ridge
d. Mental foramen
Which of the following anatomic structures is frequently a.Maxillary sinus 61 page file No reference
superimposed on periapical or occlusal radiographs of the anterior b.Vomer
maxilla: c.Anterior nasal spine (correct)
d.Cribiform plate
The radiopacity that frequently obliterates the apices of maxillary a. Zygoma and the zygomatic process of the maxilla 61 page file No reference
molars when using bisecting principle of intra-oral radiography is (correct)
the: b. Orbital process of the zygomatic bone
c. Palatine bone and the zygoma
d. Maxillary sinus

51
Question Answers Sources Discussion
What did NOT originate from ectoderm? a.Enamel 61 page file
b.Dentin
c.Cementum
d.Hair
e.Nails
i.a and b
ii.b and c (correct0
iii.d and e
Which of the following is formed by mesoderm? a. Nails 61 page file
b. Skin
c. Hair
d. Cementum (correct)
The tuberculum impar gives rise to what structure? a.Tongue (correct) 61 page file
b.Thyroid gland
c.Thymus
Meckel's cartilage forms? a. Incus 61 page file http://en.wikipedia.org/wiki/Meckel%27s_cartilage
b. Malleous
c. Sphenomandibular ligament also genial tubercles?
d. All of the above (correct)
All of the following are formed from the first branchial arch a.Malleus 61 page file The styloid process is derived from the 2nd branchial arch.
except? b.Maxilla UT 2008
c.Condyle
d.Styloid process(correct)
Other wrong options:
Coronoid (UT 2008)
From where is the incus derived? a. Meckel's cartilage 61 page file 1st branchial arch
b. The first branchial arch (correct) http://en.wikipedia.org/wiki/Pharyngeal_arch
c. tuberculum impar http://en.wikipedia.org/wiki/Meckel%27s_cartilage
Which of the following is NOT part of branchial arch 1? a. Coronoid process 2007 The first arch (mandibular a.) differentiates into the sphenomandibular and anterior malleolar ligaments, malleus, and incus;
b. Maxilla the second (hyoid a.) into the stapes, styloid process, stylohyoid ligament, lesser horn of the hyoid bone, and cranial part of
c. styloid process (correct) the hyoid body; the third into the greater horn of the hyoid bone and the caudal part of its body; and the fourth and sixth into
d. malleus the laryngeal cartilages. In the human embryo, the sixth arch is actually the fifth in number but is so named for reasons of
comparative anatomy and evolution; it does not appear on the surface. (Dorland, Dorland. Dorland's Illustrated Medical
Dictionary, 30th Edition. W.B. Saunders Company, 052003. 1).
The muscles of facial expression develop from: a.First brachial arch 61 page file
b.Second brachial arch (correct)
c.Both arches
d.None of the above
Where did hyoid originate: from 2nd branchial arch with greater horns of ABO 2009 The cartilage of the first arch is called Meckel's cartilage, and that of the second Reichert's, after the anatomists who first
hyoid derived from branchial arch 3 described them. The other arch cartilages are not named. The contributions of Meckel's and Reichert's cartilages are
discussed subsequently. The cartilage of the third arch gives rise to the body and greater horns of the hyoid bone and that of
the fourth arch to the cartilages of the larynx.
(Nanci, Antonio. Ten Cate's Oral Histology: Development, Structure, and Function, 6th Edition. Mosby, 072003. p. 34).
What is NOT formed from the median nasal process? a. Ala of the nose (correct) 61 page file Ala of the nose is formed from the lateral nasal process
-philtrum is formed by fusion of 2 medial nasal processes
which of the following participates in the formation of the ala of a. Medial nasal process 61 page file No refernce
the nose? b. Lateral nasal process (correct)
c. Premaxilla
How many bones are in the craniofacial complex? a.8 cranial 61 page file Board Breakdown:
b.14 facial ABO 2008 8 Cranial: 2 parietal, 2 temporal, frontal, occipital, sphenoid, ethmoid
c.22 total 14 Facial: 2 maxillae, 2 zygomatics, 2 nasals, 2 lacrimals, 2 palatines, 2 inferior conchae, vomer, mandible
d.all of the above (correct)
Which of the facial bones are not paired? a. Palatal 61 page file Netter
b. Maxilla
c. Vomer (correct)
d. Nasal
What bones form the Lambdoidal suture? a. 2 occipital and one parietal 61 page file The lambdoid suture (or lambdoidal suture) is a dense, fibrous connective tissue joint on the posterior aspect of the skull that
b. 2 parietal and one occipital (correct) connects the parietal and temporal bones with the occipital bone.
c. 2 frontal and one parietal Its name comes from its lambda-like shape.
d. 2 parietal At birth, the bones of the skull do not meet.
If the lambdoid suture closes too soon on one side, the skull will appear asymmetrical (plagiocephaly).
What is the smallest bone in the head? a.Lacrimal 61 page file Wikipedia
b.Frontal
c.Stapes (correct)
d.Mandible
Which bones have air in them? a.Ethmoid 61 page file No reference
b.Temporal
c.Sphenoid
d.Frontal
e.All of the above (correct)

52
Question
What lies bewtween temporal bone and posterior base of orbit?
Where does the frontal sinus drain?
What is the lacrimal sac between?
Key ridge
Which bone is NOT a part of the orbit?
The maxillary and zygomatic bones make up the inferior orbital
wall. What other bone makes up the inferior orbital wall?
The floor of the orbit is made of processes from 3 bones; the
maxillary, the zygomatic, and which other bone?
Lateral wall of orbit is made up of which bones?
How many cartilages are in the inferior 1/3 of the nose?
Answers Sources Discussion
Ethmoid sinus or orbital plate of frontal bone ABO 2010
a.Inferior nasal meatus 61 page file American Rhinologic Society:
b.Middle nasal meatus (correct)
c.Superior nasal meatus The inferior turbinate, which is larger than the other turbinates, runs parallel to the floor of the nose. The nasolacrimal duct
d.All of the above drains tears into the inferior meatus. (This explains why one develops nasal congestion when one cries.)
The middle turbinate is located above the inferior turbinate. The anterior (or front) ethmoid cells open into the middle meatus.
The term "frontal recess" refers "ante-chamber" just below the frontal sinus ostium. Therefore, the frontal sinus drains into the
middle meatus. The frontal recess contains a variable number of ethmoid cells.
The superior turbinate, which is the smallest turbinate, is above the middle turbinate. The posterior (or back) ethmoid cells
drain into the superior meatus. The space between the superior turbinate, the septum and the sphenoid sinus front wall is
known as the sphenoethmoid recess. The sphenoid drains here.
The paranasal sinuses are covered with a special lining (or epithelium). The lining secretes mucus, a complex substance that
keeps the nose and sinuses moist. The sinus epithelium is ciliated; that is, each cell on its surface has a cilium, which is a
relatively long structure that has the capacity to push sinus mucus. This movement of mucus (which is known as mucociliary
clearance) is not random; rather, it is programmed so that the mucus moves along in a specific pattern. The sinus do not
'drain' by gravity-it is an active process.
a. Maxilla and lacrimal bones (correct) 61 page file a depression in the lacrimal bone and frontal process of maxilla
Indiana review
zygomatic process of maxilla Indiana review
a.sphenoid 61 page file Wikipedia
b.frontal
c.vomer (correct)
d.maxilla
a. palatine bone (correct) ABO 2008 The inferior wall (floor) is formed mainly by the maxilla and partly by the zygomatic and palatine bones. The thin inferior wall
b. frontal UT 2008 is shared by the orbit and maxillary sinus. It slants inferiorly from the apex to the inferior orbital margin. The inferior wall is
c. ethmoid 2007 demarcated from the lateral wall of the orbit by the inferior orbital fissure.
d. sphenoid ABO 2010 #2 (Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 958).
61 page file
http://en.wikipedia.org/wiki/Orbit_(anatomy)
frontal process of zygomatic bone and Indiana review The base of the orbit is outlined by the orbital margin that surrounds the orbital opening. The bone forming the orbital margin
greater wing of sphenoid is reinforced to afford protection to the orbital contents and provides attachment for the orbital septum, an interrupted fibrous
sheet that extends into the eyelids.
•The superior wall (roof) is approximately horizontal and is formed mainly by the orbital part of the frontal bone, which
separates the orbital cavity from the anterior cranial fossa. Near the apex of the orbit, the superior wall is formed by the lesser
wing of the sphenoid. Anterolaterally, a shallow depression in the orbital part of the frontal bone, called the fossa for the
lacrimal gland (lacrimal fossa), accommodates the lacrimal gland.
•The medial walls of the contralateral orbits are essentially parallel and are formed primarily by the ethmoid bone, along with
contributions from the frontal, lacrimal, and sphenoids. Anteriorly, the medial wall is indented by the lacrimal groove and fossa
for the lacrimal sac. Much of the bone forming the medial wall is paper thin; the ethmoid bone is highly pneumatized with
ethmoidal cells, often visible through the bone of a dried cranium.
•The inferior wall (floor) is formed mainly by the maxilla and partly by the zygomatic and palatine bones. The thin inferior wall
is shared by the orbit and maxillary sinus. It slants inferiorly from the apex to the inferior orbital margin. The inferior wall is
demarcated from the lateral wall of the orbit by the inferior orbital fissure.
•The lateral wall is formed by the frontal process of the zygomatic bone and the greater wing of the sphenoid. This is the
strongest and thickest wall, which is important because it is most exposed and vulnerable to direct trauma. Its posterior part
separates the orbit from the temporal and middle cranial fossae. The lateral walls of the contralateral orbits are nearly
perpendicular to each other.
•The apex of the orbit is at the optic canal in the lesser wing of the sphenoid just medial to the superior orbital fissure.
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 958).
a. 1 61 page file septum, greater/major alar, lesser/minor alar
b. 3 (correct)
c. 5
53
Question Answers Sources Discussion
Nasal septum is usually deviated where? a. Superior 1/2 61 page file No reference
b. Inferior 1/2
c. Inferior 1/3 (correct)
Three pairs of large salivary glands pour their secretions into the a.Parotid is the smallest 61 page file No reference
oral cavity: b.Sublingual is the largest
c.Parotid is the largest (correct)
d.Submandibular is the largest
he parotid duct (Stensen’s duct) enters the oral a. Orbicularis oris 61 page file
Tcavity by penetrating through the: b. Zygomaticus major
c. Buccinator (correct)
d. RisoriusMasseter
Where is the articular tubercle located relative to the sigmoid a.Anterior 61 page file Netter's
notch? b.Posterior (correct)
c.Middle
Which of the following does NOT occur when a person swallow? a. Masseters contract 61 page file No reference
b. Tongue is on the roof of mouth
c. The teeth are in occlusion
d. Suprahyoid relax (correct)
The fibrocartilage between the temporal are and basion around a. For lateral growth 61 page file No reference
the occipital condyle and functions; b. for frontal growth
c. For cushioning any direct forces or to
protect from pressure of transfer forces
(correct)
The position of the mandibular foramen is where? a.Above the occlusal plane (correct) 61 page file No reference
b.Below the occlusal plane
Where does the mandibular foramen lie? a.Below and anterior to the mandibular 61 page file No reference
molars
b.Below and posterior to the mandibular
molars
c.Above and posterior to the mandibular
molars (correct)
d.Above and anterior to the mandibular
molars
Which of the following structures points at the point where the a.mental foramen at area of premolars on the 61 page file No reference
nerve that innervates the lower lip comes out of the mandible? lateral ceph. (correct) ABO 2008
ABO 2009
What muscle is primarily responsible for smiling? a. zygomaticus major (correct) 2007 review Gray's Anatomy 36'" Edition Page 532-533:
b. risorius -Acting together, the main elevators -levator labii superioris alequae nasi, levator labii superioris,and zygomaticus minor -
curl the upper lip in smiling and in expressing smugness, contempt or disdain .
- Risorius: Inappropriately named: it is not more associated with laughter than any other modiolar muscle. Conversely it
participates in numerous facial activities other than laughter.
-Zygomaticus Major draws the angle of the mouth upwards and laterally as in laughing.
Which muscle pulls lip up when smiling? a.Risorius 61 page file see above
b.Orbicularis oris
c.Labialis superioris (correct)
What muscle draws the corners of the mouth laterally when a.Risorius 61 page file No refernce
smiling?
Function of the temporalis. a. close and retrude mandible (correct) 61 page file Goggle
The temporalis muscle acts as a: a. Periosteal (correct) 61 page file Board Breakdown: as part of the periosteal matrix of functional matrix theory, the temporalis attachment to bone influences
b. Capsular the bone's size and shape
c. Neurocranial
d. Orofacial
e. Genetic matrix upon the coronoid process
Origin and insertion of Digastrics -Origin of ant. digatric-close to the lingual 61 page file Wikipedia
symphysis
-Origin of pos. diagatric- medial surface of
the mastoid process of the temporal bone
and a deep groove between the mastoid
process and the styloid process called the
digastric groove.
Inertion: Both muscles insert into the
intermediate tendon of the hyoid bone
What is the insertion of digastric? hyoid bone (at junction of lesser horn/cornu ABO 2008 see below
and body) ABO 2009 Pearls
Anterior belly of digastrics is innervated by trigeminal. Posterior True, True. (correct) UNK 2010 "Each digastric muscle has two bellies, joined by an intermediate tendon, that descends toward the hyoid. A fibrous sling
belly is innervated by derived from the pretracheal layer of deep cervical fascia allows the tendon to anteriorly and posteriorly as it connects this
facial nerve. tendon to the body and greater horn of the hyoid. The difference in nerve supply between the anterior and posterior bellies of
the digastric muscles results from their different embryological origin from the 1st and 2nd pharyngeal arches, respectively
(Moore and Persaud, 2003). CN V supplies derivatives of the 1st arch, and CN VII supplies those of the 2nd arch."
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. pp. 1066 - 1067).

54
Question Answers Sources Discussion
A muscle which inserts on the mandible is the: a.Anterior belly of the digastric (correct) 61 page file The anterior belly of the digastric is the only answer choice here that attaches to the mandible, however, the symphysis is
b.Posterior belly of the digastric technically an origin not an insertion.
c.Hyoglossus
d.Thyrohyoid
e.Superior belly of the omohyoid
The muscle to protrude the tongue is? a.The temporalis 61 page file No reference
b.The medial pterygoid Styloglossus and Hyoglossus help to RETRUDE tongue;
c.The hyoglossus
d.The genioglossus (correct)
The hammock ligament is related to a.Eruption (correct) 61 page file There is a periodontal ligament that usually surrounds the tooth and at the tip of the root it widens. This is often referred to as
b.The TMJ the “hammock ligament”. The hammock ligament is the primary entrance that the nerve tissue and blood vessels must go
c.The digastrics through in order to supply the dental pulp located inside of the tooth
What bone bridges the cranial base and the facial skeleton? a.Sphenoid (correct) 61 page file No reference
b.Maxilla
c.Temporal
d.Frontal
The parts of the sphenoid bone include all of these EXCEPT: a.Anterior clinoid process 61 page file the cribiform plate is an ethmoid structure
b.Dorsum Sellae
c.Cribriform plate (correct)
d.Hypophyseal fossa
The anterior clinoid is a sagittal suture. The anterior clinoid is the a.Both statements are true. 61 page Te anterior clinoid is part of the sphenoid bone
posterior part of the lesser wing of the ethmoid bone b.Both statements are false.
c.The first statement is true and the second
false.(correct)
d.The first statement is false and the second
true.
The midpoint between the anterior and posterior a. Sphenoid 61 page file
clinoid process is the : b. Basion
c. Sella Turcica (correct)
The paranasal sinus which lies directly beneath the sella turcica a.Sphenoid (correct) 61 page file ABO breakdown:
is the? b.Maxillary -sphenoid drains into superior nasal meatus
c.Posterior ethmoidal -ethmoid, frontal, maxillary, temporal drain into middle meatus
d.Frontal
e.Mastoid
The medial pterygoid muscle attaches to the maxillary tuberosity sphenoid (correct) ABO 2008 Wedged between the frontal, temporal, and occipital bones is the sphenoid, an irregular unpaired bone that consists of a
and the lateral pterygoid plate of what bone? UT 2008 body and three pairs of processes: greater wings, lesser wings, and pterygoid processes. The greater and lesser wings of the
sphenoid spread laterally from the lateral aspects of the body of the bone (Fig. 7.5C). The pterygoid processes, consisting of
lateral and medial pterygoid plates, extend inferiorly on each side of the sphenoid from the junction of the body and greater
wings.
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 896).
What is the origin of the medial pterygoid muscle? a.Lateral pterygoid plate of Sphenoid 61 page file Wikipedia, Netter's
(correct)
b.Condyle
c.Ramus
From which bone does the medial pterygoid muscle arise from a. Sphenoid (correct) 61 page file Origin of superficial head: tuberosity of maxilla
the pterygoid fossa? b. Ethmoid Origin of deep head: that's what she said... medial surface of lateral pterygoid plate and palatine bone
c. Temporal Insertion: Medial surface of ramus and angle of mandible
d. Nasal
Attachment of superior head of the lateral pterygoid a.From the sphenoid to disc of TMJ 61 page file Superior head origin: greater wing of sphenoid
Inferior head origin: lateral surface of lateral ptyregoid plate
Insertion: pterygoid fovea under the condylar process of the mandible and TMJ
The muscle to protrude the mandible is? a.The internal pterygoid 61 page file Wikipedia:
b.The lateral pterygoid (correct) The primary function of the lateral pterygoid muscle is to pull the coronoid process anteriorly, forcing the condylar process out
c.The hyoglossus of the mandibular fossa along the articular eminence to protrude the mandible. A concerted effort of the lateral pterygoid
d.All of the above muscles acts in helping lower the mandible and open the jaw whereas unilateral action of a lateral pterygoid produces
contralateral excursion (a form of mastication), usually performed in concert with the medial pterygoids.
Unlike the other three muscles of mastication, the lateral pterygoid is the only muscle of mastication that assists in depressing
the mandible (opening the jaw). At the beginning of this action it is assisted by the digastric, mylohyoid and geniohyoid
muscles.
The cribriform plate is part of which bone? a.Sphenoid 61 page file Wikipedia
b.Ethmoid (correct)
c.Mastoid
d.Temporal
Articulation of the below with C1 permits the rotation of the head a.Odontoid process (Dens) 61 page file
ABO 2010 #2

55
Question Answers Sources Discussion
What does the odontoid process consist of? a. C1 ABO 2009 Michigan The first vertebra ("atlas") supports and balances the head. It has practically no body or spine and appears as a bony ring
b. C2 (correct) ABO 2010 #2 with two transverse processes. On its upper surface, the atlas has two kidney-shaped facets that unite with the occipital
c. both condyles of the skull. The second vertebra is the "axis," which bears a tooth-like "odontoid process" on its body. This process
projects upward and lies in the ring of the atlas. As the head is turned from side to side, the atlas pivots around the odontoid
process.

What is the widest cervical vertebrae from C1 to C5? a.C1 (correct) 61 page file
b.C2
c.C4
d.C5
hyoid bone is located: between C3-C4 Indiana review
What is the name of the midline point at the most inferior point of a.Supradentale (prosthion) (correct) 61 page file
the maxillary alveolus? b.Subdentale
c.Labialdentale
In reality, how far is the CEJ from the alveolar crest? a. 1 mm 61 page file
b. 2 mm (correct)
c. 3 mm
d. 4 mm
What is the facial artery a branch of? a. External carotid artery (correct) 61 page file No refernce
b. Internal carotid artery
c. Lingual artery
d. Thyroid artery
the foramen that borders the petrous portion of the temporal a. lacerum (true) UNK 2010 The foramen lacerum (lacerated or torn foramen) is not part of the crescent of foramina. This ragged foramen lies
bone: b. jugular ABO 2009 posterolateral to the hypophysial fossa and is an artifact of a dried cranium. In life, it is closed by a cartilage plate. Only some
c. spinosum ABO 2008 meningeal arterial branches and small veins are transmitted vertically through the cartilage, completely traversing this
d. rotundum 61 page file foramen. The internal carotid artery and its accompanying sympathetic and venous plexuses pass across the superior aspect
e. ovale ABO 2010 #2 of the cartilage (i.e., pass over the foramen), and some nerves traverse it horizontally, passing to a foramen in its anterior
2007 boundary. Extending posteriorly and laterally from the foramen lacerum is a narrow groove for the greater petrosal nerve on
the anterosuperior surface of the petrous part of the temporal bone. There is also a small groove for the lesser petrosal nerve.
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 901).

At the base of the petrous ridge of the temporal bone is the jugular foramen, which transmits several cranial nerves in
addition to the sigmoid sinus that exits the cranium as the IJV.
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 901).

foramen lacerum - borders petrous portion of temporal bone and sphenoid bone
jugular foramen - borders petrous portion of temporal bone and occipital bone
Which of the following nerves does NOT go through the superior a. CN III ABO 2009 Michigan Superior orbital fissure: Located between the greater and lesser wings, it communicates with the orbit and transmits the
orbital fissure? b. CN IV 2007 ophthalmic veins and nerves (CN III, CN IV, CN V1, CN VI, and sympathetic fibers) entering the orbit.
c. CN V1 (Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 899).
d. CN V2 (correct)
e. CN VI Foramen rotundum (round foramen): Located posterior to the medial end of the superior orbital fissure, it transmits the
maxillary nerve (CN V2) that supplies the skin, teeth, and mucosa related to the maxilla (i.e., lining the upper jaw and
maxillary sinus).
(Moore, Keith L.. Clinically Oriented Anatomy, 5th Edition. Lippincott Williams & Wilkins, 052005. p. 899).
What foramen does V2 pass through? a. Ovale 61 page file No reference
b. Rotundum (correct) ABO 2008 (#15)
c. Spinosum
d. Magnum
Trigeminal nerve originates? a. Pons (correct) ABO 2009 Nerve cells originate in the trigeminal neucleus which runs through the midbrain, pons and medulla (wikipedia)
b. Medulla (nucleus is a collection of cell bodies in the CNS - ganglion is collection of nerve cell bodies in the PNS)
The pons is essentially where the nerve branches off from the CNS
The fifth cranial nerve (trigeminal) or branch thereof passes a. Ovale 61 page file No reference
through all the foramen listed below except: b. Rotundum
c. Spinosum
d. Mandibular
e. Lacerum (correct)
What cranial nerve comes from Semilunar ganglion? Trigeminal nerve ABO 2010 Netters
- Gasserian ganglion and semilunar ganglion are other names for trigeminal ganglion
What Nerve is sensory to anterior 2/3 of tongue? Trigeminal (V) ABO 2010
What gives sensory innervation to anterior 2/3 tongue? lingual nerve of Trigeminal ABO 2009 Netter's. I think the answer here is Lingual nerve. General sensation of the anterior 2/3 is supplied by the Lingual nerve
which is a branch of V3 of the Trigeminal nerve CN V. http://en.wikipedia.org/wiki/Tongue
What innervates taste of the anterior 2/3 of the tongue? Facial n. (specifically, it is the chorda tympani ABO 2008
branch)

56
Question Answers Sources Discussion
Geniculate ganglion Facial Nerve (contains cell bodies for taste to ABO 2010 #2 Wikipedia
anterior 2/3s of tongue) enters the petrous temporal bone into the internal auditory meatus (intimately close to the inner ear), then forms the
geniculate nucleus prior to entering the facial canal, emerges from the stylomastoid foramen and passes through the parotid
gland, where it divides into five major branches. Though it passes through the parotid gland, it does not innervate the gland
(This is the responsibility of cranial nerve IX, the glossopharyngeal nerve).

Where does the facial nerve exit? a.Stylomastoid foramen (correct) ABO 2009 see above
ABO 2010 #2
How many branches does the facial nerve have a. 2 61 page file temporal, zygomatic, buccal, mandibular, cervical ("Two Zebras Bit My Crack")
b. 3
c. 4
d. 5 (correct)
Which nerve gives taste sensation to the anterior two thirds of the a. Facial (correct) 61 page file No reference
tongue?
What nerve is the special sensory to anterior 2/3 of tongue? Facial (VII) - Chorda tympani ABO 2010
Inability to closes the eyelids indicates a possible lesion of which
a. Trochlear 61 page file Obicularis oculi muscle closes eyelid and is innervated by temporal and zygomatic brances of CN VII. Patients with facial
nerve? b. Abducens nerve paralysis (Bell's Palsy) typically complain of acute (24 to 48 hours) unilateral facial weakness with a widening of the
c. Occulomotor palpebral fissure and impaired ability to close the eye.
d. Facial (correct)
e. Opthalmic
Patient complains that food accumulates in the vestibule of mouth a. the mandibular division of trigeminal nerve 61 page file Buccinator muscle compresses cheek and is innervated by buccal branch of CN VII
during chewing. This symptom is consistent with the diagnosis of b. a branch of the facial nerve (correct)
a lesion in: c. the glossopharyngeal
d. the accessory nerve
e. the hypoglossal
What is not a branch of inferior division of glossopharyngeal? a. pharynx ABO 2009 Netter's
b. lingual
c. subclavian (correct)
d. tympanic
Cranial nerve XII a. Hypoglossal (correct) 61 page file Netter's
b. Glossopharyngeal
c. Accessory
d. Mandibular
Know which artery goes into the pterygomaxillary fissure: maxillary ABO 2010 #2 Wikipedia
sphenopalatine (correct) The sphenopalatine artery is a branch of the maxillary artery which passes through the sphenopalatine foramen into the
cavity of the nose, at the back part of the superior meatus. Here it gives off its posterior lateral nasal branches. Crossing the
under surface of the sphenoid, the sphenopalatine artery ends on the nasal septum as the posterior septal branches. Here it
will anastomose with the branches of the greater palatine artery.
What touches the anterior and posterior of the ptyregomaxillary maxillary tuberosity borders the anterior part ABO 2009 Michigan http://www.emory.edu/ANATOMY/AnatomyManual/fossae.html:
fissure? of fissure and lateral pterygoid plate borders ABO 2010 Pterygomaxillary fissure lies anterior to lateral ptyregoid plate and posterior to maxilla. At its base is a fossa, the
the posterior part of fissure pterygopalatine fossa, and an opening, the sphenopalatine foremen. The pterygopalatine fossa is a place where several
pathways converge: The sphenopalatine foremen, the pterygoid canal, greater palatine foremen, and the inferior orbital
fissure all communicate with it directly.
Which of the below is the anterior border of the pterygoid plate? a.The posterior part of the pterygomaxillary 61 page file the pterygomaxillary fissure formed by the divergence of the maxilla from the pterygoid process of the sphenoid
suture (correct)
b.The anterior part of the pterygomaxillary
suture
Which of the below is the posterior border of the maxillary a.The posterior part of the pterygomaxillary 61 page file see above
tuberosity? suture
b.The anterior part of the pterygomaxillary
suture (correct)
Which suture is NOT at the posterior border of the maxillary a.Zygomatico (probably correct) 61 page file see above - pterygomaxillary suture/fissure (also known as pterygopalatine) is located at posterior border of max tuberosity,
tuberosity? b.Pterygo so answer A is the most incorrect
c.Palatine
d.Sphenoid
e.None of the above (correct)?
Which of the following structures is closest to the adenoidal pad? nasopharyngeal airway ABO 2010 Adenoids are enlarged pharyngeal tonsils.
adenoid is located: in posterior pharyngeal wall Indiana review

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 Question Answers Sources Discussion
What does Hep B Ag mean? a. pt not infectious ABO 2009 ABO Breakdown
b. potentially infectious (correct)
c. cannot be infected w/ Hep
The usual incubation period for Hepatitis B virus infection is: a.1-2 days 61 page file
b.1-2 weeks
c.1-6 months (correct)
d.1 year
e.5 years
What are the symptoms of a Hep B infection? a.None 61 page file
b.Juandice
c.Fever
d.All of the above (correct)
What is most commonly seen in Hepatitis B? a. Jaundice 61 page file
b. High fever
c. Weakness
d. No symptoms (correct)
A newly employed personnel should have Hep. B shots made available a. After six months of work 61 page file
to him/her: b. As soon as possible (correct)
c. Never
a positive tuberculin means the person was previously exposed to TB. A) First statement is true, second false UNK 2010 http://www.webmd.com/a-to-z-guides/tuberculin-skin-tests
Positive result does not indicate the level of current activity. B) First statement false, second true ABO 2009
C) Both True (correct)
D) Both False
If a person has a positive TB test what does that mean? a.Patient is contagious 61 page file
b.Patient is active
c.Patient has been exposed (correct)
If a patient is found positive for TB test they are immune, but it does not a. TT 2007 review
describe the extent of progression or level of the disease? b. TF
c. FT (correct)
d. FF
Teratogens are: a. Chemicals and other agents capable of 61 page file
producing genetic defects. (correct)
b. Functional and environmental agents capable of
producing genetic defects.
c. Genetic code disturbances capable of producing
genetic defects.
d. None of the above
Most anomalies occur in which period a. Pre-embryonic (<5 weeks) 61 page file Proffit
b. Embryonic (5-10 weeks) (correct) 1. Germ layer formation and initial organization of structures - Day 17: fetal alcohol syndrome
c. Fetal (>10 weeks) 2. Origin, migration, and interaction of cell populations - Days 19-28/3-4 weeks: Hemifacial microsomia, Mandibulofacial
d. Neonatal dysostosis (Treacher Collins syndrome)
3. Formation of organ systems - primary palate Days 28-38/4-5 weeks - Cleft lip and/or palate, other facial cleft; Secondary
palate days 42-55/6-8 weeks - cleft palate
4. Final differentiation of tissues - Day 50-birth: Achondroplasia, Synostosis syndromes (Crouzon's, Apert's, etc.)
fetal alcohol syndrome occurs by day 17 i.u. ABO 2010 #2 see above
Coloboma and ear issues treacher collins ABO 2010 #2
All of the following are seen in Treacher-Collins Syndrome EXCEPT: A) Malar hypoplasia UNK 2010 Board Breakdown
B) Mandibular prognathism (correct)
C) Maxillary retrognathism
Treacher-Collins pt would be expected to have all of the following a.ANB of greater than 5 ABO 2010
EXCEPT: b.Downward slanting eyes
c.Missing zygomatic arch
d.Md hyperplasia (correct)
e.Hearing impairment
Which of the following is NOT associated with Treacher Collins: a. Downward slanting eyes ABO 2008 Individuals with mandibulofacial dysostosis exhibit a characteristic facies (Figure 1-87). The zygomas are hypoplastic,
b. Missing or hypoplastic zygoma UT 2008 resulting in a narrow face with depressed cheeks and downward-slanting palpebral fissures. In 75% of patients, a coloboma,
c. High ANB or notch, occurs on the outer portion of the lower eyelid. About half of the patients have no eyelashes medial to the coloboma.
d. Hypoplastic maxilla (correct) Often the sideburns show a tongue-shaped extension toward the cheek.

The ears may demonstrate a number of anomalies. The pinnae often are deformed or misplaced, and extra ear tags may be
seen. Ossicle defects or absence of the external auditory canal can cause conductive hearing loss.

Which of the following affects both maxilla and mandible and occurs
due to a disturbance in the first trimester:
Which syndrome has a problem with neural crest cell migration and
under-formation of the Mx and Md?
The mandible is underdeveloped, resulting in a markedly retruded chin. Radiographs often demonstrate hypoplasia of the
condylar and coronoid processes, with prominent antegonial notching. The mouth is downturned, and about 15% of patients
have lateral facial clefting (see page 2) that produces macrostomia. Cleft palate is seen in about one third of cases. The
parotid glands may be hypoplastic or may be totally absent.
(Neville, Brad W.. Oral & Maxillofacial Pathology, 2nd Edition. W.B. Saunders Company, 012002. pp. 42 - 43).
a. Hemifacial microsomia UNK 2010 They all seem to be possible. Proffit 4th pg 73
b. Mandibulofacial Dysostosis aka Treacher ABO 2009 Michigan Crouzon's occurs the latest.
Collins (correct) ABO 2010 #2 Hemifacial microsomia because the mandible is more effected than the maxilla.
c. Crouzon's This means mandibulofacial dysostosis is somewhat favored.
Answer could also be all of the above but B is the best answer
a. Treacher Collins – mutation of TCOF1 gene on ABO 2010 Proffitt 4th ed pg 74
chromosome 5q32-q33.1 (correct) - both have problems with neural crest cells, but T.C. is listed as underdevelopment of max and mand, whereas Hemifacial
b. Hemifacial microsomia microsomia is listed as unilateral with lateral and lower part of face (ramus) underdeveloped

58
 Question Answers Sources Discussion
Neural crest a.Treacher Collins ABO 2010 #2 Proffit 4th ed pg 74
b. Hemifacial microsomial Altered neural crest development also has been impli-cated in mandibulofacial dysostosis (Treacher Collins syn-drome)
c. both (correct) and hemifacial microsomia.
Which of the following is NOT a characteristic of Gardner’s? a. Facial clefts (correct) 61 page file
b. Colon polyps
c. Supernumerary teeth
d. Multiple osteomas
What are characteristics of Gardners? supernumerary teeth and polyps ABO 2009 remember that no clefts are present in this syndrome
Which of the following is NOT seen in Down's syndrome? a. premature eruption of teeth (correct) UNK 2010 ABO Breakdown
b. slanting epicanthial folds ABO 2010 #2 - they have delayed tooth eruption
c. trisomy 21
What is NOT a characteristic of Down's syndrome? a. wormian bones ABO 2009 ABO Breakdown
b. mental retardation
c. fissured tongue
d. hypoplastic maxilla
e. early eruption of teeth (correct)
Children with which of the following conditions have the greatest a. Autism 61 page file
tendency toward delayed eruption of teeth: b. Down’s syndrome (correct)
c. Cerebral palsy
d. A seizure disorder
Down’s Syndrome prevalence in US 1 in 800 births. ABO 2010
Aperts has all of the following except: a. hypoplastic orbital rim UNK 2010
b. syndactyly
c. premature fusion of sutures
d. all of the above (correct)
What is NOT a feature of Apert's? a. Premature suture closure ABO 2009 ABO breakdown pg 8 - mental retardation is the only debatable of all answers
b. fusion of phalanges All of these are true
c. mx hypoplasia
d. mental retardation
e. all of the above (correct)
All of the following are true about Apert's and Crouzon's EXCEPT: a. Asymmetric mandible (correct) UNK 2010 Crouzon's and Apert's syndrome are most commonly characterized by premature fusion of coronal and lamdoid sutures
b. Supernumeraries ABO 2008 Early fusion of just lamdoid is plagiocephally
c. Craniosynostosis 61 page file Coronal fusion results in brachi appearance
d. Cleft Palate 2007 Sagital suture premature fusion results in dolicofacial appearance
e. class III Trigonocephaly results from premature fusion of metopic suture
f. midface hypoplasia Only difference between Apert's and Crouzon's is that Apert's has syndactally
Supernumeraries can be seen in Crouzon's and Aperts
What is the major difference between Apert’s and Crouzon’s syndromes? a. Slant of the eyes 61 page file
b. Syndactyly *
c. One is Class II and the other is Class III
d. None of the above
What suture fuses prematurely in Apert's and Crouzons? coronal suture (correct) ABO 2008 see above
UT 2008
2007
61 page file
Wormian bones are seen in which of the following: a.Paget’s diease UNK 2010 Textbook "Human malformations and related anomalies," Stevenson and Hall:
b.Cleidocranial dysplasia (correct) ABO 2009 Michigan -Wormian bones = extra irregularly shaped bones w/in a suture (usually found in lambdoid, sagittal, and coronal sutures)
c.Osteogenesis Imperfecta (correct) ABO 2008 -Syndromes w/ wormian bones: cleidocranial dysplasia, osteogenesis imperfecta, Downs syndrome, hypophosphatasia,
2007 hypothyroidism, ricketts, cretinism, minky pinky
61 page file
A 21 YO female presents with complete absence of the clavicles, a a. Osteopetrosis 61 page file
narrow arched palate, and prolonged retention of the primary dentition. b. Achondroplasia
The most probable diagnosis is: c. Marfan’s syndrome
d. Pierre-Robin’s syndrome
e. Cleidocranial dysostosis *
Which is NOT seen in cleidocranial dysplasia? a. delayed eruption ABO 2009 Michigan ABO breakdown
b. premature eruption (correct)
c. supernumerary teeth
d. wormian bones
Which of the following is not associated with Cleidocranial? missing teeth (correct) ABO 2008
2007 review
Which of the following is NOT associated with cleidocranial dysostosis? a.Missing clavicles 61 page file
b.Frontal and Parietal bossing
c.Many unerupted supernumerary teeth
d.Protrusive maxilla *
In which of the following syndromes is cyanosis common at birth? a.Ehlers-Danlos UNK 2010 The Pierre Robin sequence (Pierre Robin anomalad) (Figure 1-5) is a well-recognized presentation characterized by CP,
b.Pierre-Robin (correct) ABO 2008 mandibular micrognathia, and glossoptosis (airway obstruction caused by lower, posterior displacement of the tongue). The
2007 Pierre Robin sequence may occur as an isolated phenomenon, or it may be associated with a wide variety of syndromes or
61 page file other anomalies. It has been theorized that constraint of mandibular growth in utero results in failure of the tongue to
descend, thus preventing fusion of the palatal shelves. (Neville, Brad W.. Oral & Maxillofacial Pathology, 2nd Edition. W.B.
Saunders Company, 012002. p. 4).
Pierre-Robin Syndrome is associated with the following condition: a. Cleidocranial dysplasia 61 page file
b. Basal cell nevus
c. Mandibular micrognathia *
d. Down’s syndrome
e. Gardner’s syndrome

59
 Question Answers Sources Discussion
Cleft lip formed by failure of fusion of the following: a. medial nasal and maxillary process (correct) UNK 2010 Proffit 4th ed pg 74:
b. medial nasal and lateral nasal ABO 2008 Clefting of the lip occurs because of a failure of fusion between the median and lateral nasal processes and the max-illary
Bilateral cleft lip occurs from lack of fusion of what? 2007 prominence, which normally occurs in humans during the sixth week of development. At least theoretically a midline cleft
61 page file of the upper lip could develop because of a split within the median nasal process, but this almost never occurs. Instead,
clefts of the lip occur lateral to the midline on either or both sides (Figure 3-7). Since the fusion of these processes during
primary palate formation creates not only the lip but the area of the alveolar ridge containing the central and lateral
incisors, it is likely that a notch in the alve- olar process will accompany a cleft lip even if there is no cleft of the secondary
palate.

- philtrum = 2 medial nasal processes

At what time during fetal development does CL/CP occur? a. 4-5 wks ABO 2009 Michigan Proffit p73
b. 6-8 wks (correct) ABO 2008 primary palate Days 28-38
When does the primary palate fuse with the secondary palate in utero? c:10-12 wks 61 page file secondary palate Days 42-55
d.14-16 wks 2007
Cleft palate develops: a.During the first trimester of pregnancy (correct) 61 page file
b.During the second trimester of pregnancy
c.During the third trimester of pregnancy
d.At birth
What are some possible causes of a cleft palate? a.Heredity 61 page file
b.Drugs
c.All of the above (correct)
d.None of the above
What is the incidence of Cleft Palate? a. 1 in 100 61 page file Text: Atlas of genetic diagnosis and counseling By Harold Chen:
b. 1 in 500 CL only - 20% (18% unilateral, 2% bilateral)
c. 1 in 750 (correct) Unilateral CL: left 2x more common than right; 9x more common than bilat.; 68% assoc. w/ CP
d. 1 in 1500 Bilateral CL: 86% assoc. w/ CP
CL/CP - 50% (1/1000) (38% unilateral, 12% bilateral); males > females
CP only - 30% (1/2500); females > males
What is the incidence of Cleft palate in American Indian population? a.Higher than whites (correct) AI>C>AA 61 page file Breakdown: Indian>Asian>White>Black
b.Less than whites
Which is reduced in cleft patients? a.Upper facial height (correct) 61 page file Breakdown
b.Lower facial height
c.Neither
d.Both
Which is NOT found in cleft palates? a. Impacted centrals (correct) 61 page file Breakdown: also commonly find ectopic eruption and supernumeraries
b. Rotated incisors
c. Missing laterals
d. Posterior crossbite
The most effective time to surgically close a cleft palate is: a. 6 months after birth 61 page file Proffit 4th ed
b. at birth Lip repair: 2-3 mo (10 wks, 10 lbs, Hg level 10)
c. one year after birth (correct) Palate repair: 10-14 mo.
d. two years after birth Secondary Alveolar Bone Graft + orthodontics: 6-10 yrs
Orthognathic Surgery: 13-18 yrs
Implants and other prosthetic procedure: 18 or when growth is complete
What causes a problem in a cleft patients’ speech? a.An inability to build up intraoral pressure 61 page file Breakdown
(correct)
b.A large tongue
c.A narrow mandible
d.All of the above
What are some effects of a clefted soft palate? a. hypernasal speech 61 page file
b. Snoring
c. All of the above (correct)
d. None of the above
Which of the following is indicative of velopharyngeal insufficiency? a. Hypernasality(correct) ABO 2008
b. snoring 61 page file
Which of the following is associated with velopharyngeal insufficiency c. sleep apnea 2007
(VPI)?
Infants with repaired clefts of lip and palate: a.Have normal development of hard and soft 61 page file Breakdown
tissue
b.Have normal development of the soft palate
c.Have a deficiency of the soft palate (correct)
d.None of the above
When should an alveolar bone graft in a cleft site be performed? a. When the canine root is 1/3 formed 61 page file
b. When the canine root is 2/3 formed (correct)
c. When the central root is 1/3 formed
d. When the central root is 2/3 formed
The recent consensus is that grafting of alveolar process in cleft palate a.Infancy (correct) 61 page file
patient is contradicted during: b.Late primary and early mixed dentition
c.Late mixed and early permanent dentition
d.Late teens
What is effective bone graft for alveolar cleft? a. Bone from cadaver 61 page file iliac>calvarium>rib
b. Bone from chin
c. Bone from calvaria (correct)
d. Bone from rib (correct)
e. Bone from iliac (correct)

60
 Question Answers Sources Discussion
A patient with a cleft palate only is best retained with a.An anterior bridge 61 page file
b.A posterior bridge
c.Partial denture
d.Retainer with a pontic (correct)
Syndromes associated with clefts include: a. Pierre Robins 61 page file
b. Treacher Collins
c. Crouzon’s
d. Aperts
e. All the above *
Hypertelorism is seen in: a. Oro-ocular (hypotelorism) UNK 2010 Breakdown pg 7
b. Lateral ABO 2009 Michigan
c. Oblique ABO 2008 Midline cleft causes hypertelorism
d. Midline (correct) 2007 Oroocular cleft (aka oblique lateral cleft or orbitomaxillary) causes hypotelorism (failure of fusion of maxillary process with the
61 page file lateral nasal)
Patient has fever, multiple blisters? a. Primary Herpetic Gingivostomatitis (correct) UNK 2010 HSV1 - initial infection generally occurs between 3-5 yrs, incubation 2-12 days. Symptoms : fever, sore throat, small vesicles
What has erythematous gingivitis? b. ANUG ABO 2009 Michigan develop on pharyngeal and oral mucosa, rapidly ulcerate and increase in number to involve soft palate, buccal mucosa,
ABO 2010 #2 tongue, floor of mouth, and often lips and cheeks; tender gums may bleed; fetid breath, swollen lymph nodes in the neck
What is associated with primary herpetic gingivostomatitis? a. Fever 61 page file
b. Lymphadenopathy
c. Gingival lesions
d. All of the above (correct)
e. None of the above
The causitive organism for shingles is: a. Varicella zoster (correct) UNK 2010 VZV is one of eight herpes viruses known to infect humans (and other vertebrates). It commonly causes chicken-pox in
b. Variola children and Herpes zoster (shingles) in adults and rarely in children.
c. HSV WebMD
Shingles is related to: a. chicken pox (correct) ABO 2009 Michigan see above
b. HSV
c. small pox
Controlled type 2 diabetes not a contraindication for ortho ABO 2009 Michigan
ABO 2010 #2
An arrow points to calcified styloid process on dry skull or radiograph. a. Eagle Syndrome UT 2008 Eagle syndrome is a pain syndrome resulting from calcification of the stylohyoid ligament: pain upon yawning or turning head
What syndrome is associated with this? due to nerve impingement
Calcification of what is associated with Eagle’s syndrome? a.Stylohyoid ligament * 61 page file
b.Sphenomandibular
c.Lateral pterygoid
d.Digastric
On a lateral ceph, what is elongated in Eagle’s Syndrome? a. Styloid process * 61 page file
b. Coronoid process
c. Tuberosity
d. Symphysis
AIDS patient shows all of the following except: a. Weight loss UNK 2010 all of these seem correct
b. Kaposis sarcoma http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001620/ :
c. Lymphadenopathy "Common symptoms are:
•Chills
•Fevers
•Sweats (particularly at night)
•Swollen lymph glands
•Weakness
•Weight loss

Common with CD4 count below 350 cells/mm3:

•Herpes simplex virus
•Tuberculosis
•Oral or vaginal thrush
•Herpes zoster (shingles)
•Non-Hodgkin's lymphoma
•Kaposi's sarcoma"
And it just keeps getting worse as the CD4 goes down. Man AIDS sucks
Karposi’s sarcoma in HIV patient’s is: a.A transitory condition 61 page file HHV-8 is a cause
b.Caused by the papilloma virus
c.Multifocal in orgin *
d.The result of a staph infection
The most common oral manifestation of HIV infection is: a. Loss of alveolar bone 61 page file
b. Loosening of teeth
c. Candidiasis *
d. Hairy leukoplakia
What happens in osteopetrosis? a.Increased radiopacity (correct) 61 page file
b.Decreased radiopacity ABO 2008
c.A honeycombed appearance of bone
Osteopetrosis (aka marble bone disease and Albers-Schonberg disease) a. Radiolucency 61 page file
appears on the XR as: b. Radioopacity (correct)
c. Honeycomb appearance
d. Ground glass appearance
Sialolith a.Submandibular gland (correct) ABO 2008 No reference
61 page file

61
 Question Answers Sources Discussion
What is most common type of salivary gland tumor? a. pleomorphic adenoma (correct) ABO 2009 Dr. Kahn Pathology Lecture:
b. mucoepidermoid carcinoma ABO 2010 #2 - most common salivary tumor in mouth; benign, but can turn into malignancy called Ex-pleomporphic adenoma; age 40s;
c. Warthin's - most to least common site: Parotid > posterior lateral hard palate > submandibular > upper lip > buccal mucosa
d. clear cell carcinoma - Pleomorphic Adenoma occurs 80-90% of salivary gland tumors.
- mucoepidermoid carcinoma is the 2nd most common salivary tumor and the 1st most common malignant salivary tumor
- adenoid cystic carcinoma is second most common malignant salivary gland tumor
Osteomyelitis is most commonly caused by: a.Actinomyces bovis 61 page file Dr. Kahn:
b.Borrelia vincenti Actinomyces (gram +) cause israeliis?
c.Staphylococcus aureus (correct) Borrelia causes ANUG
d.Mycobacterium tuberculosis Mycobacterium causes TB
Juvenile fibrous dysplasia displays: ground glass/orange peel appearance ABO 2010 #2
61 page file
Fibrous dysplasia: ABO 2009 Michigan
ABO 2008
2007
Geographic Tongue is associated with all of the following EXCEPT: a. fissured tongue UNK 2010 Geographic tongue is females > males. Munro abscesses is intraepithelial abscess seen in psoriasis.
b. more common in males (correct)
c. show munro abscesses histologically
d. psoriasis
A differential diagnosis for a multilocular radiolucency includes all of the a. Ameloblastoma 61 page file
following except? b. Central giant cell granuloma 2007
c. Cementoblastoma (correct)
Which of the following is the most common odontogenic tumor? a. Odontoma (correct) UNK 2010 Neville, Oral and Maxillofacial Pathology, 3rd Ed., pg 702:
b. Ameloblastoma ABO 2008 "The ameloblastoma is the most common clinically significant odontogenic tumor. Its relative frequency equals the combined
frequency of all other odontogenic tumore, excluding odontomas."
AND on Pg. 724
"Odontomas are the most common types of dontogenic tumors. Their prevalence exceeds that of all other odontogenic
tumors combined. Odontomas are hamartomas rather than true neoplasms."

*Addendum: according to Dr. Kahn's (USN path instructor) ppt on odontogenic cysts/tumors, "ameloblastoma is the most
common true odontogenic tumor" whereas "Odontoma is the most common MIXED (epithelial and mesenchymal origin)
odontogenic tumor" and it is "a hamartoma, not a true 'tumor'." Therefore, I believe the answer should be
AMELOBLASTOMA
Most common odontogenic tumor a.Odontoma (70%, average age – 14, unerupted 61 page file
teeth)
b.Cementoma (AA women middle age,
radiolucent around opaque lesion, vital teeth)
c.Ameloblastoma (10%, radiolucent, age 30-50,
likely to recur) (correct)
Which of the following is true about Ameloblastomas? a. They fluctuate in size 61 page file
b. They are radiopaque
c. They do not frequently metastasize (correct)
What are the characteristics of an Ameloblastoma? a. Occurs in the third molar area/posterior 61 page file
mandible 2007 review
b. High recurrence after removal
c. Usually occurs after age 20 (20-40)
d. multilocular
f. more common in males
d. All of the above (correct)
Where is ameloblastoma more common? a.In females and in the angle of the mandible 61 page file
b.In males and in the angle of the mandible
(correct)
Periapical cemental dysplasia (PCD), what do cyst look like on x-ray radiolucent (middle aged AA women) 61 page file
Female patient has multiple radiolucencies apical to #23-25. All teeth a. Periapical cemento dysplasia (correct) ABO 2008
tested vital with no reported pain. What is the diagnosis?
Identify a radiolucency 5mm in diameter and 5mm below alveolar crest. a.Primordial ? (where a tooth should be 61 page file
but didn’t form)
b.Residual ? (periapical cyst
remaining after extraction)
c.Dentigerous ? (crown of unerupted
tooth)
How does a mucocele differ from a true cyst? a.It lacks saliva 61 page file
b.It lacks an epithelial lining (correct)
c.It fluctuates in size
The etiologic agent of the majority of Subacute Bacterial Endocarditis a. Streptococcus Aureus (correct) 61 page file
cases is: b. Staphylococcus Aureus
c. Staphylococcus epedemitis
d. All of the above
Problems with heart valves can cause… a. Infective endocarditis 61 page file
b. Rheumatic Fever
c. Aortic Stenosis
d. All of the above *
What is affected early in Rheumatoid Arthritis? a. Cartilage 61 page file
b. Bone
c. Synovia (correct)
What happens with hypocalcemia? a.Muscle hyperactivity (correct) 61 page file hypocalcemia causes tetany?
b.Decrease in cardiac output (correct)

62
 Question Answers Sources Discussion
Which of the following has the potential of undergoing “spontaneous” a.Osteomalacia 61 page file Paget's can become osteosarcoma?
malignant transformation? b.Albright’s syndrome
c.Paget’s disease of bone *
d.Osteogenesis imperfecta
e.Von Recklinghausen’s disease of bone
Which of the following would be considered to have a cotton wool a.fibrous dysplasia 61 page file
appearance? b.Paget’s disease *
c.Eosinophilic granuloma
In Paget’s disease which of the following lab tests are elevated? a. Serum Alkaline phosphatase * 61 page file
b. WBC count
c. PTT
d. Serum glucose
Acromegaly is caused by a disturbance in the a.Anterior pituitary gland * 61 page file
b.Posterior pituitary gland
c.Hypothalamus
A patient with achondroplasia in which midfacial structures are most a. Class I 61 page file
affected is likely to have which of the following malocclusions: b. Class II
c. Class III *
d. None of the above
What is most likely the cause of malocclusion in cerebral palsy? a.Bone malformation 61 page file
b.Neural dysfunction
c.Muscular dysfunction *
The characteristic oral clinical features of Peutz-Jegher’s syndrome is: a. Macrognathia 61 page file
b. Supernumerary teeth
c. Melanin pigmentation of the lips *
d. Macroglossia
e. Constricted palate
Ectodermal dysplasia has which of the following clinical manifestations? a. Blue sclera (OI) 61 page file all of the above, cannot pick because blue sclera is for osteogenesis imperfecta
b. Missing teeth *
c. No sweat glands *
d. All of the above
Micrognathia is a common feature in which of the following syndromes i. a and b 61 page file None of the se answers seems correct. only D has micrognathia
a.Paget’s disease of bone ii. a and c
b.Ectodermal dysplasia iii. a and d
c.Fibrous dysplasia iv. b and c
d.Craniofacial dysostosis

Therapeutic radiation for cancer of the oral region may result in which of a.Abnormal growth of the mandible 61 page file
the following side effects: b.Early exfoliation of the primary teeth
c.Temporomandibular joint dysfunction
d.Osteoradionecrosis *
e.High palatal vault
Which of the following are characteristics of adenoid faces? a. High palate and constricted maxillary arch 61 page file ABD(4/12/12)
(correct)
b. Flared incisors(correct)
c. Class III tendencies
d. Open bite (correct)
Osteomyelitis is most commonly caused by: a.Actinomyces bovis 61 page file
b.Borrelia vincenti
c.Nocardia asteroids
d.Staphyloccus aureus *
e.Mycobacterium tuberculosis
What can manifest itself as myositis? a. Osteosarcoma 61 page file
b. condensing osteitis
c. osteomyelitis*
What causes the metabolic rate to increase? a.Thyroid 61 page file
b.Growth Hormone
c.All the above (correct)
d.None of the above
Children with which of the following conditions have the greatest a.Hypothyroidism * 61 page file
tendency towards delayed eruption of the teeth? b.Hyperthyroidism
c.Hypoparathyroidism
d.Hyperparathyroidism
e.None of the above
Exam of a mixed dentition malocclusion reveals an abnormal resorption a.Addision’s disease 61 page file
pattern of the primary teeth, delayed eruption of permanent teeth, b.Hypothyroidism *
incompletely formed roots of permanent teeth & large tongue. Which of c.Hypoparathyroidism
the following etiological factors is probable cause of the condition: d.Von Recklinghausen’s disease
e.History of severe febrile disease
Hypothyroidism in a growing child exhibits? a. Retardation of growth of long bones 61 page file
b. Mental retardation
c. Late in eruption of dentition
d. All of the above *
Arthritic changes- a.synovial fluid 61 page file

63
 Question Answers Sources Discussion
Gemination vs. fusion ABO 2010 -fusion: union of two separately developing tooth germs; 2 roots, 2 pulp, 1 crown
ABO 2009 -gemination: incomplete division of 1 tooth germ; 1 root, 1 pulp, 2 crowns/notched crown
ABO 2008
2007 Proffit p138
Occasionally, tooth buds may fuse or geminate (partially split) during their development. Fusion results in teeth with separate
pulp chambers joined at the dentin, whereas gemination results in teeth with a common pulp chamber. If the other central and
both lateral incisors are present, a bifurcated central incisor is the result of either gemination or, less probably, fusion with a
supernumerary incisor. On the other hand, if the lateral incisor on the affected side is missing, the problem probably is fusion
of the central and lateral incisor buds. Normal occlusion, of course, is all but impossible in the presence of geminated, fused
or otherwise malformed teeth
What is gemination? a. The upper 1/3 of the crown is notched, one pulp 61 page file Gemination: one root, one pulp, two crowns
chamber (correct) Fusion: two roots, two pulp, one crown
b. The pulp chamber is obliterated
c. The roots are short
Where do you find supernumerary teeth? a.Gardner’s Syndrome 61 page file http://orthocj.com/2011/02/an-overview-of-classification-diagnosis-and-management-of-supernumerary-teeth/
b.Cleidocranial dysostosis Syndromes commonly associated with supernumerary teeth are: Cleft lip & palate, cleidocranial dysplasia and Gardners
c.All of the above * syndrome.
d.None of the above
Multiple T/F: Supemumerary more common in the posterior (T/F). F/T ABO 2008
Supernumeraries are usually associated with syndromes. (T/F).
Supernumerary teeth are most common in posteriors a.False 61 page file Think Mesiodens
What are the chances that a child will inherit the trait if an autosomal a.25% 61 page file
dominant individual and a non-carrier have a child? b.50% (correct)
c.75%
What are the chances that a second child will have the characteristic if a. 25% 61 page file
one parent is affected by an autosomal dominant characteristic and the b. 50% (correct)
other is not and they already have one child with the characteristic? c. 75%
d. 100%
Treacher Collins autosomal dominant. If one of the parents and the first a. 1% 61 page file
child is affected, what is chance next child will be affected? b. 25%
c. 50% (correct)
d. 100%
If both parents have no cleft but one sibling does, what are the chances a.100% 61 page file
that a cleft will occur in a new sibling? b.50%
c.5% (correct)
d.0%
How many chromosomes are there in a somatic cell? a.23 61 page file
b.1
c.46 (correct)
d.47
What process creates a cell with 23 chromosomes? a. meiosis (correct) 2007 review
b. mitosis
Meiosis- know that it is division of the cells with half the ABO 2008
chromosomes
Meiosis (46 chromosomes – 23 pairs) Sex cells ½ # of chromosomes 61 page file
Decrease in cell number is: a.Metaplasia 61 page file
b.Hypertrophy
c.Hyperplasia
d.Atrophy
e.Hypoplasia (correct)
Oligodontia refers to the: a.Absence of all teeth. 61 page file
b.Absence of many but not all teeth.(correct)
c.Absence of only few teeth.
d.None of the above.
Patient with caries and radiopacity in lower right molar? a.Hypercementosis - an excessive formation of 61 page file
cementum on the roots of one or more teeth
b.Malignant sclerosis
c.Benign sclerosis
What are some characteristics of taurotantism? a.Bull shaped molars 61 page file

64
 Question Answers Sources Discussion
Bisphosphonates cause all of the following except: a. diminished UNK 2010 checked (forces osteoclasts into apoptosis)
osteoblast activity ABO article #3 Medication Effects on Rate of Orthodontic Tooth Movement
(correct) Pg. 343 Proffit
b. inhibits tooth
movement
c.
osteoradionecrosis
d. reduced wound
healing
e. increased mineral
density
Which of the following meds is used to temporarily a. banthine, UNK 2010 Graber, Current Principles and Techniques textbook (2000) pg. 560:
decrease salivary flow for bonding, and what is its glaucoma (correct) ABO 2009 Anti-sialagogues - competitive antagonists of muscarinic actions of acetylcholine; block
contraindication for use? b. probanthine, high ABO 2008 attachment of Ac to salivarHy gland receptors and saliva is not produced
intracranial pressure ABO 2010 #2 1. Pro-Banthine (Propantheline bromide): sublingual injection; no longer advised if patients can
c. epinephrine, take oral form.
glaucoma 2. Banthine (Methantheline bromide): oral tablets (50 mg per 100 lb [ 45 kg] body weight) in a
d. phenylephrine, sugar-free drink, 15 minutes before bonding
glaucoma 3. Atropine Sulfate (Sal-Tropine)

antimuscarinic and anticholinergic

PTH and Thyroxin a. inhibit tooth UNK 2010 ABO Article #3 - "Medication effects on rate of orthodontic tooth movement" pg 21 PTH
movement increases orthodontic tooth movement (OTM) (PTH increases serum Ca levels), pg. 22
b. enhance tooth Thyroxine (T4) - a significant increase in the rate of OTM was found. (Thyroxine increases cell
movement (correct) metabolism and affects intestinal calcium absorption (reduces it))
Which of the following medications has been a.Aspirin 61 page file
shown to cause gingival enlargement? b.Epinephrine
c.Procardia
(nifedipin) (correct)
d.Motrin (ibuprofen)
e.Aldomet
(methydopa)
Phenytoin gingival hyperplasia ABO 2009
NSAIDs inhibit tooth movement by inhibiting T/T UNK 2010 Proffit 4th Ed. Pg 343. Fortunately, although potent prostaglandinin hibitors like indomethacin
prostaglandins. Decreased prostaglandin levels 2007 can inhibit tooth movement, The common analgesics( ibuprofen, aspirin) seem to have little or
raise the pain threshold. no inhibiting effect on tooth movement at the dose levels used with orthodontic patients.

Article "Medication effects on the rate of orthodontic tooth movement," Bartzela:

"Studies on the effects of NSAIDs during experimental OTM in animals all evaluate the effects
of relatively short administrations.They showed decreases in the number of osteoclasts, since
prostaglandins are involved either directly or indirectly in osteoclast differentiation or in
stimulating their activity.This has been shown for acetylsalicylic acid and flurbiprofen,
indometacin (indomethacin), and ibuprofen. Whether this also leads to a reduction in the rate of
OTM is less clear."

NSAIDs inhibit production of prostaglandins. This
causes an increase in threshold to pain causing
analgesia.
Prostaglandin E2, inflammation and pain threshold in rat paws. D. C. KUHN and A. L. WILLIS.
British Pharmacological Society: Pg. 184p
Repeated injection of prostaglandin E2 in rat paws induces chronic swelling and a marked
decrease in pain threshold, disappearance of the PGE2 allowed pain threshold to rise.
a. T/T** ABO 2009
b. T/F 61 page file

65
 Question Answers Sources Discussion
Ibuprofen reduces inflammation by inhibiting a. T/T 2007 review
prostaglandin synthesis. It produces b. T/F (correct)
analgesia because prostaglandins increase the
threshold of nociceptors.
Prostaglandins are associated with all of the a. IFN-gamma UNK 2010
following except: b. IL-1
c. neocytokines
(correct)
d. TNF-alpha
What effect does prostaglandins have on a. Arachiadonic 61 page file
osteoblasts and osteoclast acid,
prostaglandins,
stimulate
osteoclastic
production (correct)
A possible effect of taking high doses of a.Increasing the 61 page file (P150)
prostaglandin inhibitors during orthodontic tx is: incident of root
resorption.
b.Causing
periodontal
breakdown.
c.Impeding
orthodontic tooth
movement. (correct)
d.None of the
above.
Low doses of analgesics w/prostaglandin inhibitors a. No inhibiting 61 page file
for control pain after orthodontic appts have: effect whatsoever
on tooth movement.
b. Little or no
inhibiting effect on
tooth movement.
(correct)
c. Mild inhibiting
effect on tooth
movement.
d. Severe inhibiting
effect on tooth
movement
Which one of the following analgesics acts a.Acetaminophen 61 page file (P312)
centrally rather than as a prostaglandin inhibitor: (correct)
b.Aspirin
c.Ibuprofen
d.None of the above
Arachodonic acid metabolite that plays a role in a. Interleukin ABO 2008 Article#3
tooth movement? b. BMP "Four families of eicosanoids can be distinguished: leukotrienes, thromboxanes, prostacyclins,
c. Leukotriene and prostaglandins. They are all derived from arachidonic acid by various enzymatic
(correct) conversions."
Arachadonic acid pathway produces? Leukotriene 6 ABO 2010 know something about arachadonic acid
ABO 2010 #2

66
 Question Answers Sources Discussion
Arachodonic acid pathway is activated by a. IL-1 ABO 2009 Michigan wikipedia
b. IL-6
c. TNF-alpha
d. all of the above
(correct)
Which cell mediators increase prostaglandin IL-1 and BMP ABO 2009 Michigan article "Effect of Non-Steroidal Anti-Inflammatory Drugs on Bone Healing," Cottrell; http://www.
production (i.e. activate AA pathway)? mdpi.com/1424-8247/3/5/1668/pdf:
"Zhang et al. found that bone marrow cell cultures from COX-2 knockout mice produced less
osteoblasts than wild-type mice but that treatment with BMP-2 and prostaglandin E2 could
reverse this effect [93]"
BMP found in bone and ABO 2009 Pearls
potent inducer of de
novo bone synthesis
The American heart association currently a. In all orthodontic 61 page file
recommends antibiotic prophylaxis in cardiac procedures
patients: b. In patients
undergoing simple
orthodontic
procedures
c. In patients
undergoing
extensive
orthodontic
procedures (correct)
d. None of the
above
AHA guidelines for banding molars in a patient no prophylaxis UNK 2010 JADA, Vol. 139 http://jada.ada.org January 2008: Current guidelines recommend prophylaxis
with mitral valve prolapse needed ABO 2009 for the following:
1. Prosthetic cardiac valve or prosthetic material used for cardiac valve repair
2. Previous infective endocarditis
3. Congenital heart disease (CHD)
4. Cardiac transplantation recipients who develop cardiac valvulopathy

Procedures requiring prophylaxis:

1. "Procedures that involve manipulation of gingival tissue or the periapical region of teeth or
perforation of the oral mucosa" (placement of orthodontic bands)
2 gram amoxicillan 1 hour before treatment: prophylaxis 61 page file
If patient allergic to penicillin, when would you give a. 1 hour before UNK 2010 Doses:
clindamycin 600mg? procedure (correct) 1. Amoxicillin 2g 1hr before procedure
b. 1 hour before and 2. Allergic to amox: Clindamycin 600mg 1hr before procedure
after procedure
In a penicillin allergic pt with a medical history of a.Pen VK 61 page file JADA, Vol. 139 http://jada.ada.org January 2008:
previous Rheumatic fever, the premedication of b.Erythromycin - only need to premedicate a pt with Rh fever if they have one of the four criteria listed in
choice would be: (correct) discussion of row 20.
c.Amoxicillin - "Patients who take an oral penicillin for secondary prevention of rheumatic fever or for other
purposes are likely to have viridans
group streptococci in their oral cavity that are relatively resistant to penicillin or amoxicillin. In
such cases, the provider should select either clindamycin, azithromycin or clarithromycin for IE
prophylaxis for a dental procedure, but only for patients shown in Box 3. Because of possible
cross-resistance of viridans group streptococci with cephalosporins, this class of antibiotics
should be avoided.

67
 Question Answers Sources Discussion
As a result of dental prophylaxis, microorganisms a. Pyeria 61 page file
around teeth enter the bloodstream. This b. Toxemia
condition is an example of: c. Bacteremia
(correct)
d. Septicemia
e. Focal infection
What is the risk of bacteremia? a.Septicemia 61 page file
b.Infective
endocarditis
(correct)
c.Meningitis
The relationship of a bacteremia to infective a.The magnitude of
endocarditis depends on: the bacteremia
b.The virulence of
the organism
c.The resistance of
the host
d.All of the above
(correct)
e.None of the above
The portal of entry to the bloodstream of bacteria a.Mucosal of 61 page file
in SBE is: gingival bleeding
(correct)
b.Salivary glands
c.Lymphatics
d.a and c
e.a, b, and c
What is responsible for detecting discomfort and a.Proprioceptors 61 page file
pain? b.Nociceptor *
c.None of the above
d.All of the above

68
 Question Answers Sources Discussion
Tall cusps UNK 2010 Generally, tall cusps and deep fossae promote a predominantly
vertical chewing stroke, whereas flattened or worn teeth
encourage a broader chewing stroke.
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 48).

Okeson Summary on Z drive

I. Angle of eminence vs. occlusal plane
A. steeper the eminence—the longer the post. tooth cusps may
be.
B. flatter eminence—shorter the post. tooth cusps must be.
II. Curve of spee
A. flatter curve of spee—the longer the post. cusps may be
B. steeper curve of spee—the shorter the post. cusps must be
III. Vertical overlap of anterior teeth
A. the greater the vertical overlap—the longer the post. cusps
may be.
B. the lesser the vert. overlap—the shorter the post. cusps
must be.
IV. Functional horizontal overlap of anterior teeth
A. when functional horizontal overlap is 0-.5 mm—the post.
cusps may be long.
B. when functional horizontal overlap is greater than .5 mm—
the post. cusps must be short.

TABLE 6 - 1 VERTICAL DETERMINANTS OF

OCCLUSAL MORPHOLOGY (CUSP HEIGHT AND FOSSA
DEPTH)
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 145).

TABLE 6 - 2 HORIZONTAL DETERMINANTS OF OCCLUSAL

MORPHOLOGY (RIDGE AND GROOVE DIRECTION)
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 145).
If a person has steep premolar cusps, then the a.Equilibration 61 page file
orthodontist should finish this patient with…. b.Open bite
c.Deeper overbite
(correct)
d.Sharper canines
With tall cusps you need to finish with a deeper bite to TRUE ABO 2008
prevent interferences.

69
 Question
Bruxism (question is worded funny)
Answers Sources Discussion
Multiple T/F: UNK 2010 Okeson pg.44
Nocturnal bruxism not ABO 2009 "it has likewise been demonstrated that the occlusal contact
associated with occlusal Michigan pattern of the teeth does not influence nocturnal bruxism"
interferences, but is ABO 2008
associated with high "At one time in dentistry, a widely held belief was that
anxiety and stress malocclusion caused nocturnal bruxism.However, well-
controlled studies have suggested that the occlusal condition
exerts little influence on nocturnal muscle activity. Levels of
emotional stress appear to have greater influence. It has been
repeatedly demonstrated that occlusal appliances decrease the
level of nocturnal muscle activity, at least in the short term."
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 428).
"Several types of parafunctional activities are notable; however,
clenching and bruxism seem to be the most significant and can
be either diurnal or nocturnal.
1. Diurnal activity may be more closely related to an altered
occlusal condition, to an increased level of emotional stress, or
both. Because diurnal activity can usually be brought to the
patient's level of awareness, often it is managed well with
patient education and cognitive-awareness strategies.
2. Nocturnal bruxism, however, seems to be different. It
appears to be influenced less by tooth contacts and more by
emotional stress levels and sleep patterns.Because of these
differences, nocturnal bruxism responds poorly to patient
education, relaxation and biofeedback techniques, and occlusal
alterations. In many cases it can be effectively reduced (at
least for short periods of time) with occlusal appliance therapy.
49-51,80 The mechanism by which occlusal appliances reduce
bruxism is not clear."
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 384).
70
 Question Answers
Extended curve of wilson and incisors are edge to a. balancing/non-working
edge? interferences
b. working interferences
Edge to edge patient with severe curve of Wilson what c. lack of anterior
are you most likely to see? guidanace posterior
disclusion
Maxillary lingual 2nds for curve of Wilson with edge to
edge?
3mm OB w/ exaggerated curve of Wilson..what problem a.working interference
would you encounter? b.non-working
interference (correct)
c.protrusive interference
Big Curve of Wilson and openbite: Posterior teeth will not
disocclude
Curve of Monson
Which teeth only contact one tooth in opposing arch? Max 8s and Md 1s
2 teeth that contact only one other tooth a.Mandibular central and
maxillary 3rds
71
Sources Discussion
UNK 2010 No Reference
ABO 2008 If pt is edge to edge in the anterior, then they will have no
ABO 2009 anterior guidance. Therefore, as they protrude, there will likely
Michigan be no posterior disclusion (lack of the so-called Christiansen's
Phenomenon).
Accentuated curve of wilson, refers to the MD lingual cusps
sitting at a more inferior level than the buccal cusps. One would
think that this would also mean there is an corresponding
excessive Curve of Monson on the Maxillary arch, however as
stated this question does not specifically state that so one
cannot infer that we would see posterior non-working
interferences from MX buccal cusps. Working interferences are
also highly unlikely, as someone who has no anterior guidance
would also probably be in group function.
Therefore, given these options, C is likely the best choice.
ABO 2010
61 page file
ABO 2009 Is the upper arch curve of wilson
http://medical-dictionary.thefreedictionary.com/Monson+curve
Etymology: George S. Monson, American dentist, 1869-1933;
L, curvus, a bend
the curve of occlusion in which each tooth cusp and incisal
edge lie on the surface of a sphere 8 inches (20 cm) in
diameter, with its center in the region of the glabella.
-provides balancing side contact during lateral excursions
ABO 2009 ABO breakdown
61 page file
 Question Answers Sources Discussion
During the finishing stages of orthodontics, your patient a.Equilibrate the ABO 2008 "The shorter the slide, the more likely it is that selective
has a CR to CO slide of 2mm into a good Cl I mandibular distal inclines 2007 grinding can be accomplished within the confines of the
relationship, what is the appropriate treatment? and the maxillary mesial ABO 2009 enamel. Normally an anterior slide of less than 2 mm can be
How do you finish with 2mm CR-CO discrepancy? midlines (this is correct if Michigan successfully eliminated by a selective-grinding procedure.
minimal shift) 61 page file
b.Cl II elastics (this is The direction of the slide in the sagittal plane can also influence
correct if over 2mm) the success or failure of selective grinding. Both the horizontal
c.Cl III elastics and the vertical components of the slide should be examined.
d.Functional appliance Generally, when the slide has a great horizontal component, it
is more difficult to eliminate within the confines of the enamel
(Fig. 19-2). If it is almost parallel with the arc of closure (i.e.,
large vertical component), eliminating it is usually easier.
Therefore both the distance and the direction of the slide are
helpful in predicting the outcome of selective grinding."
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 591).
When patients with various malocclusions are given Class III is worst, then 2007 Does Malocclusion Affect Masticatory Performance? - Engish &
carrots, almonds, and firm meat, which describes the class II, than class I 61 page file Buschang
order in which these patients had difficulty chewing. malocclusion, normal
class I occlusion = best
Rank the following in order from worst to best in terms Class III malocclusion, ABO 2008
of chewing functional efficiency: Class II malocclusion,
Class I malocclusion,
Class I normal.
What prevents attaining an ideal Angle Cl I posterior a.Axial inclination of the 2007 A makes sense
occlusion? canine (correct) ABO 2008
b.Excessive mandibular ABO 2009
lingual torque Michigan
c.Excessive maxillary 61 page file
buccal torque
d.Steep premolar cusps
e.Procumbent maxillary
incisors
Excessive wear of the incisal edge of a lower left cuspid a. Interference on the left 61 page file
indicates: side
b. Incisal interference
c. Interference on the right
side (correct)
d. All of the above
Which of the following permanent posterior teeth has a a.Maxillary first premolar 61 page file
mesial marginal ridge that is located more cervical that b.Maxillary second molar
its distal marginal ridge? c.Mandibular first
premolar (correct)
d.Mandibular second
molar

72
 Question Answers Sources Discussion
What does the upper second premolar occlude with in a a.Mandibular second 61 page file
Class III? premolar and first molar
b.Mandibular first molar
only (correct)
c.Mandibular first and
second molar
d.Mandibular second
molar only
Curve of Spee is a.Dental compensation ABO 2008
61 page file
Which cusp of the mandibular right second molar moves a.Mesobuccal 61 page file
through the buccal cusps of the maxillary right second b.Distobuccal (correct)
molar when a person moves from right lateral excursion c.Mesolingual
to centric occlusion? d.Distolingual
What happens to the balancing side in canine protected a.The canine is the only 61 page file
occlusion? thing touching
b.Group function
c.It is out of occlusion
(correct)
Non-centric cusps in a posterior crossbite are the… a.Upper lingual and the 61 page file
lower buccal (correct)
b.Upper lingual and the
lower lingual
In Posselt’s diagram what is the final motion? a. Pure Hinge 61 page file
(correct)
b. Pure Rotation
c. Half rotation, half
hinge
d. None of the above
Which tooth has the potential to touch both anterior and a.Mandibular canine 61 page file
posterior antagonists in an ideal centric occlusion? b.Mandibular lateral
c.Maxillary canine
(correct)
d.Maxillary first premolar
On lateral excursions, which cusps contact on the non- a.Buccal cusps of the 61 page file
working side during non-working side interferences? lower
b.Lingual cusps of the
upper
c.Both (correct)
d.Neither
Def. of functional occlusal plane a.Line thru occlusal ABO 2008 -Funcional OP used in Wits analysis
surface of 1st molar and 61 page file -Bisected OP used in Downs analysis - bisects incisor overbite
premolars ABO 2010 #2 and passes over distal cusps of most posterior teeth
2007 review

73
 Question Answers Sources Discussion
In response to heavy pressure against a tooth, pain is a.Immediately 61 page file
normally felt: b.After 3-5 seconds
(correct)
c.After 3-5 minutes
d.After 3-5 hours
In the primary dentition, a terminal plane occlusion a.Class I* 61 page file
usually turns into… b.Class II
c.Class III
What is the result of a distal step relationship in the a. Class I 61 page file
primary dentition with no mandibular growth? b. Class II (correct)
c. Class III
d. None of the above
Where are the primate spaces? a.mesial of maxillary 61 page file
canine and distal of
mandibular canine *
b.distal of maxillary and
mandibular lateral incisors
c.distal of maxillary and
mandibular canines
d.mesial of maxillary
lateral incisors and distal
of mandibular canine
Under normal conditions, the presence of mamelons in a.Fluorosis 61 page file
a 14 YO patient is indicative of: b.Malnutrition
c.Malformation
d.Malocclusion (correct)
e.Enamel composition
Which cusp of the maxillary 1st molar occludes on the a. Mesobuccal 61 page file
mesial marginal ridge of the mandibular 2nd molar in an b. Distobuccal
ideal centric occlusion? c. Mesolingual
d. Distolingual (correct)
Which of the following cause frequent balancing side a. Lingual cusps of the 61 page file
contacts? maxillary first premolars 2007 review
b. Lingual cusps of the
Which cusp is most likely the cause of a balancing mandibular first premolars
interference? c. Lingual cusps of the
maxillary second molars
(correct)
d. Lingual cusps of the
mandibular second molars
Which are not centric cusps in posterior crossbite? a. Lingual cusps of the 61 page file
maxillary first molar
(correct)
b. Buccal cusps of the
maxillary first molar

74
 Question Answers Sources Discussion
When a person goes from centric occlusion to centric a. Overbite decreases 61 page file
relation, which of the following is true? b. Overjet increases
c. Vertical dimension
increases
d. All of the above
(correct)
e. None of the above
Of the following, which is true? a. A 1mm CO/CR shift is 61 page file
acceptable (correct)
b. A 1mm lateral shift is
acceptable
What is the most stable tooth position? a. Maximum 61 page file aren't IC and CO the same thing?
intercuspation - IC
(correct)
b. Centric Relation - CR
c. Centric Occlusion - CO
What is location for CR? superior anterior position 61 page file
of condyle
A line drawn through central fossa of maxillary teeth. buccal (correct) 2007 review Line of occlusion on maxilla = central fossas
Where are the interproximal contacts relative to this Line of occlusion on mandible = buccal cusps; interproximal
line? contacts are lingual to that line

"Once the CF (central fossa) line is established, it is worth-

while to note an important relationship of the proximal contact
areas. These areas are generally located slightly buccal to the
CF line (Fig. 3-19), which allows for a greater lingual
embrasure area and a smaller buccal embrasure area. During
function, then, the larger lingual embrasure will act as a major
spillway for the food being masticated. When the teeth are
brought into contact, the majority of the food is shunted to the
tongue, which is more efficient in returning food to the occlusal
table than is the buccinator and perioral musculature."
(Okeson, Jeffrey P.. Management of Temporomandibular
Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 78).

75

How does the condyle move on the balancing
side?
How does the nonworking condyle move?
TMJ is different from other joints by:
Answers Sources Discussion
a.upward, forward, and medial 61 page file
b.downward, forward, and medial*
c.upward, backward, and laterally
d.downward, backward and
laterally
a.Downward forward, and medially 61 page file
*
b.Downward, backward, and
medially
c.Downward, forward, and laterally
d.Downward, backward, and
laterally
a. presence of a meniscus UNK 2010 The surfaces of the condyle and fossa are made up of dense fibrous connective tissues supported by a small area of
b. fibrous CT in disc in stead of ABO 2008 undifferentiated mesenchyme and growth cartilage, which is not visible radiographically. The surface seen is actually
hyaline (correct) subarticular bone. The articular disc, likewise, is composed of dense fibrous connective tissue, which also is not visible on
standard radiographs.
The articular surfaces of the mandibular condyle and fossa are composed of four distinct layers or zones (Fig. 1-15): (1)
articular, (2) proliferative, (3) fibrocartilaginous, and (4) calcified cartilage.
The most superficial layer is called the articular zone. It is found adjacent to the joint cavity and forms the outermost
functional surface. Unlike most other synovial joints, this articular layer is made of dense fibrous connective tissue rather than
hyaline cartilage.
(Okeson, Jeffrey P.. Management of Temporomandibular Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 11).

What type of tissue found in condyle? ABO 2009 Dense fibrous connective tissue on articulating surfaces and in disc
What makes the TMJ different from any other No hyaline cartilage on the ABO 2008
joint in the body? articular surface.
What makes the TMJ joint unique? a. Presence of the articular disc 61 page file
b. Presence of fibrous linings
(4/12/12)
What tissue makes the disc? Fibrous CT Okeson Ch1 pg 9:
"The articular disc is composed of dense fibrous connective tissue, for the most part devoid of any blood vessels or nerve
fibers."
What covers the condyle? a. Loose connective tissue 61 page file see above
b. Dense fibrous connective tissue
(correct)
The articular disc is composed of which type of a.Elastic 61 page file
tissue? Fibrocartilage b.Fibrous (correct)
c.Cartilaginous
d.Hyaline
What are the articular surfaces of the TMJ a. Synovial fluid 61 page file
lined by? b. A thin synovial membrane *
c. TMJ ligament
The articular disk of the TMJ consists of: a.And outer fibrous layer and inner 61 page file
synovial layer 2007
b.Areolar tissue covered by dense
fibrous connective tissue
c.An outer layer of mesothelium
and an inner layer of calcified
cartilage
d.dense fibrous connective tissue
which may be associated with
condrocytes (correct)
The condyle is wider mediolaterally than AP by a.Half as much 2007 Okeson page 7 - " The total mediolateral length of the condyle is 15 to 20 mm, and the anteroposterior width is between 8
what? b.Twice as much (correct) and 10 mm."
The condyle is wider mediolaterally than AP by a.Half as much 61 page file
what? (8:20) AP 8-10mm, MD 15-20mm b.Twice as much *
Movement of the upper synovial cavity of the a.Condyle and articular capsule 61 page file
TMJ occurs between the b.Articular fossa-eminence and
articulating disc *
c.Condyle and mandibular fossa
d.Condyle and articular disc
e.Coronoid process and articular
tubercle

76
 Answers Sources Discussion
In the definition of CR, more agreement lies in a. Superior position UNK 2010 The complete definition of the most orthopedically stable joint position therefore is when the condyles are in their most
the following: b. Superior anterior position superoanterior position in the articular fossae, resting against the posterior slopes of the articular with the discs properly
(Correct) interposed. The condyles assume this position when all of the elevator muscles are activated with no occlusal influences.
c. No exact position Therefore this position is considered to be the most musculoskeletally stable (MS) position of the mandible.
(Okeson, Jeffrey P.. Management of Temporomandibular Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 113).
What usually happens if you seat the mandible a.decrease the vertical dimension 61 page file
from CO to CR? b.increase the vertical dimension*
TMD is primary reason for ortho tx. Ortho tx F/F ABO 2009 Proffit 4th ed pg 17:
causes TMD - orthodontics as the primary treatment for TMD is almost never indicated

Article "Orthodontics and temporomandibular disorder:A meta-analysis," Kim:

- data does not indicate that traditional orthodontic treatment increased prevalence of TMD

Article “The risk of orthodontic treatment for producing temporomandibular disorders: A literature overview,” Sadowsky:
- Ortho tx during adolescence does not increase or decrease risks of developing TMD later in life
The assessment of mandibular movements as a.Has no bearing on the functional 61 page file ABO Breakdown
a diagnostic procedure in evaluating TMJ capacity of the stomatognathic
disorders system
b.Is necessary to determine
whether the TMD is muscular or
intracapsular or a combination of
both
c.Is critical for the evaluation of
mandibular dysfunction *
d.Is unreliable
TMJ problems in the general population: a.Occur the same or more than in 61 page file
the orthodontically treated
population
b.Occur more in females than
males
c.Are often stress related with
accompanying muscle spasms
and trismus
d.Are usually due to pathology or
derangements
e.All of the above *
Tooth most likely to cause TMJ a.Lingual of maxillary 2nd molar 61 page file
Which of the following may not be used in a. Class III elastics (correct) UNK 2010 An anteriorly displaced disc will be worsened
TMD? b. Class II elastics ABO 2009
c. Herbst ABO 2008
d. HG 61 page file
ABO 2010 #2
Which is NOT one of the four cardinal a.pain in TMJ UNK 2010 p654 proffit, fig 18-24, Okeson pg 161
symptoms of TMJ disorder? b.joint sounds ABO 2008 says TMD symptoms are: pain in joint and muscles, joint sounds, limited opening/range of movement
c.ADD (correct) 2007 review
Which of the following is NOT a common d.impaired mobility of joints 61 page file ABO breakdown:
symptom of TMD? e..headaches - symptom = observed by patient; subjective (pain, headache)
f. crepitus - sign = observed by dr.; objective (ADD, locking, condylar dislocation)

JADA, Vol 139, No 6, 664. 2008:

What are symptoms of TMD?
The most important single indicator of TMJ
dysfunction is:
Four cardinal signs and symptoms of TMD:
1. pain in the TM joints, muscles of mastication and adjacent soft tissue
2. TM joint sounds that occur during mouth opening and closing and moving the lower jaw to either side or forward
3. Tenderness of the TM joints, muscles of mastication and adjacent soft tissues on digital palpation
4. Limitation on opening the mouth and moving the lower jaw to either side or forward.
a.Pain * 61 page file see above
b.Locking
c.Condyle Dislocation
d.All of the above
a. The presence of a Sunday bite. 61 page file
b. The presence of joint noise.
c. Reduced amount of maximum
opening.*
d. Excessive clenching and
grinding.

77
 Answers Sources Discussion
If a TMD patient has pain that starts in the right this is probably psychosocial in ABO 2008 psychogenic pain can occur bilaterally. true neuralgia occurs unilaterally
TMJ area and they describe that it extends to origin. (we think that normally, TMJ
the left anterior portion of the mandible: pain radiates up and back, and
doesn't cross the midline)
What is the primary cause of TMD? a. Parafunctional habits 61 page file
ABO 2010
TMJ pain can be caused by a. Myositis 61 page file
b. Trauma
c. Dental problems
d. Intracapsular problems
e. All of the above *
f. None of the above
What does NOT cause TMD Answer: Extraction of Upper 61 page file
bicuspids
Myofacial Pain dysfunction syndrome has at its a. Anatomy and occlusion 61 page file
base etiologies of: b. Occlusion, physiological factors
and trauma *
c. Malocclusion and structure
d. None of the above
What can cause myofacial pain? a. Myocardial infarction 61 page file 4/15/12: some thought just C, but majority going with D
b. Parotitis
c. Myositis
d. All of the above***
Patient is a severe bruxer, has pain and a. Flat plane UNK 2010 ABO believes in the flat plane for symptomatic patients. An anterior positioning splint would only be used for a recapturable
crepitation. Which one would you NOT do? b. Anterior positioning splint 61 page file anteriorly displaced disc (which is highly unlikely in cases of crepitus)
(correct)
c. NSAIDS
What should you use for conservative a. anterior repositioning splint ABO 2009
treatment of TMD? b. flat occlusal splint (correct)
Which of the following approaches to relieve a. Reducing the amount of patients 61 page file (P655)
myofacial pain symptoms be attempted last: stress.
b. Reducing the amount of
reaction to stress.
c. Alteration of occlusal
relationships (correct)
d. Occlusal splint therapy.
Treatment of joint dysfunction usually requires: a.Condylar repositioning 61 page file
b.Mandibular appliance which is
flat or indented for position
c.Maxillary appliance which is flat
or indented for position
d.All of the above *
Treatment of muscle dysfunction usually a.Flat appliances for muscle 61 page file
requires a combination of: relaxation
b.Stress management
c.Physical therapy
d.All of the above *
If a child is hit in the jaw where is the fracture? Subcondylar contralateral (correct) 61 page file
2007
Where does the mandible fracture with a blow body of the affected side and 2007 review
to the side of the jaw? below the condyle on the opposite
side
Condylar resorption causes what a. facial asymmetry 61 page file
What is a clinical sign of idiopathic resorption Anterior open bite UNK 2010 Other signs: decreased ramus height; progressive mand retrusion
of condyle?
Most common sign of developing anterior a. degenerative osteoarthritis UNK 2010 Profitt Pg 319: FIg 8-50: Shows anterior Openbite patient with Severe condylar degeneration due to rheumatoid arthritis
openbite he also states on Pg 319: "adult onset rheumatoid arthritis can destroy the condylar process and create a deformity"
Correct( Rheumatoid Arthritis)
most common cause of TMD 4/12/12 ABO breakdown: osteoarthritis (degenerative joint disease) - open bite, change in occlusion, pain
A sudden change in occlusion, open bite and a. Rheumatoid arthritis 61 page file
pain (parafunction), internal derangement are (4/12/12)
associated with b. Osteoarthritis
c. The psyche

78

When is condylar hypoplasia most common?
In one of the studies done as part of the NIDR a.
contract on the long-term effects of orthodontic different in both studies. One of
treatment, Sadowsky and BeGole compared
subjects who where treated with full fixed
appliances as adolescents approximately 20
years previously, with a similar group of adults b.
with untreated malocclusions. Subsequently, 75% of joint sounds in the treated
Sadowsky and Polsen contrasted the findings patients
from other studies in which subjects who
received orthodontic treatment a minimum of
10 years previously were compared with 111
adults with untreated malocclusions. Non-
extraction and extraction cases were
represented. Which of the following best
describe their findings?
Most TMJ problems are induced by:
The conclusion from the above studies was
that
Panchrz evaluated the effects of the Herbst
fixed functional appliance in the treatment of
22 growing patients with Class II, Division 1
malocclusions and reported that:
Answers Sources Discussion
a.Early childhood 61 page file
b.Early adult- late adolescent *
c.Late adult
The findings were very 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
Sadowsky, BDS, MS (1999) - Pg 79
them showed a significant
difference between treated and "The findings were very similar in both studies with the prevalence of symptoms varying between 15% to 21% and 29% to
untreated patients. 42% for signs (joint sounds), there being no statistically significant differences between treated and untreated subjects in
The first study showed either of the studies. The conclusion from the above two studies was that orthodontic treatment performed during
adolescence did not generally increase or decrease the risk of developing TMD later in life"
c. There were no statistically
differences between treated and
untreated subjects in either of the
studies. (Correct)
d. Untreated subjects showed
a higher prevalence of TMD
symptoms.
a. Poor occlusion or malocclusion 61 page file
b. Orthodontic treatment
c. Orthodontic treatment with 4 first
premolar extraction
d. All of the above
e. None of the above *
a. There was a significant 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
difference in TMD symptoms Sadowsky, BDS, MS (1999) - Pg 79
between orthodontically treated
patients and the normal See above
population.
b. Treatment performed during
adolescence will increase the risk
of developing TMD symptoms.
c. Treatment performed during
adolescence did not generally
increase or decrease the risk of
developing TMD in later life.
(correct)
d. Patients should be treated
in adulthood to decrease the risk
of developing TMD symptoms
a. The number of subjects 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
with tenderness to palpation Sadowsky, BDS, MS (1999) - Pg 79-80
decreased during the first three
months. "Pancherz evaluated the effects of the Herbst fixed functional appliance in the treatment of 22 growing patients with Class II,
b. Twelve months Division I malocclusions and reported that the number of subjects with tenderness to palpation doubled during the initial 3
posttreatment the number of months of treatment. However, after appliance removal, most muscle symptoms disappeared and 12 months posttreatment
subjects with symptoms increased the number of subjects with symptoms was the same as before treatment."
when compared to the number of
subjects before treatment.
c. There were no symptoms
detected before or after treatment.
d. The number of subjects
with TMD symptoms increased
during the first 3 months of
treatment but mostly disappeared
after appliance removal. (Correct)
79

Smith and Freer examined 87 patients who
received full fixed appliances during
adolescence, approximately two-thirds
involving extractions, and who were an
average of 52 months after retention and
compared with the untreated control group of
28 subjects. Which of the following was NOT a
finding reported by this study
Dibbets and van der Weele reported the
findings from their prospective longitudinal
study in the Netherlands over 15-year period.
Removable appliances (functional) were used
in 39%, fixed appliances (Bedd) in 44%, and
chin cups in 17% of cases. A non-extraction
approach was used in 34% of cases, four
premolars were extracted in 29%, and other
extractions in 37%. They evaluated
subjectively perceived symptoms, identified as
clicking/ crepitation and the radiographic
appearance of the condyle. Which of the
following is TRUE about this study?
In the above study they concluded that:
Answers Sources Discussion
a. There was no significant 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
difference in the rate of soft clicks Sadowsky, BDS, MS (1999) - Pg 80-81
between the two groups. (correct)
b. There was no significant "Their results rejected the hypothesis of a significant association between orthodontic treatment and occlusal or TMJ
difference in the rate of hard clicks dysfunction. The one exception was the finding of a higher rate of soft clicks in the post-orthodontic group (64% compared
between the two groups. with 36%)."
c. There was a higher rate of
soft clicks in the postorthodontic
group.
d. There was so significant
association between orthodontic
treatment and occlusal or TMJ
dysfunction.
a. For the first 10 years there 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
was a significant difference Sadowsky, BDS, MS (1999) - Pg 81 (top of Right column)
between the three types of
treatment with regard to subjective Word for Word
clicking.
b. Objective clicking was
always more frequent in the four-
premolar extraction group at all
time points, but the frequency
paralleled the other two groups.
(CORRECT)
c. After 15 years, the four-
premolar extraction group showed
the lowest subjective clicking
among all groups.
d. Clicking frequency,
subjective or objective, was always
lower in the four-premolar even
before treatment was started
a. The original growth pattern 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
rather than an extraction treatment Sadowsky, BDS, MS (1999) - Pg 81 (top of Right column)
strategy was the most likely factor
responsible for the frequency of Word for Word
CMD reported many years
posttreatment. (Correct)
b. Four-premolar extractions
should be contraindicated as an
orthodontic treatment alternative.
c. Fixed appliance treatment
causes increased CMD symptoms
if use in conjunction with four-
premolar extractions.
d. A functional appliance in
conjunction with four-premolar
extractions is detrimental for the
TMJ.
80

Larsson and Ronnerman studied adolescent
patients who were treated orthodontically 10
years previously, 18 of whom had fixed
appliances and 5 whom had functional
appliance (activator). In 31% of the subjects
mild dysfunction was recorded clinically and
only one subject (4%) had severe dysfunction
according to the Helkimo index. In comparing
their results with other published epidemiologic
studies, they concluded that:
Which of the following is FALSE:
According to some studies, temporomandibular
joint sounds are a common finding in
approximately ____% of the population,
including patients before orthodontic treatment.
Orthodontic treatment, particularly involving
premolar extractions, has also been implicated
in producing a posteriorly positioned condyle.
Gianelly et al. evaluated condylar position with
corrected tomograms before orthodontic
treatment in 37 consecutive patients ages 10-
18 years and compared them with 30
consecutively treated four premolar extraction
cases at the completition of treatment. All
patients were treated with fixed appliances.
They found that:
Pt with open bite, can open 27mm, deviates
left upon opening
What happens to an open bite pt with anteriorly deviation to left side upon opening ABO 2009 Michigan
displaced disc on left side?
Answers Sources Discussion
a. Extensive orthodontic 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
treatment caused severe Sadowsky, BDS, MS (1999) - Pg 79
dysfunction of the TMD.
b. Extensive orthodontic "In comparing their results with other published epidemiologic studies, they concluded that extensive orthodontic treatment
treatment can be performed can be performed without fear of creating complications of TM dysfunction. They suggested that orthodontic therapy may
without the fear of creating possibly prevent TMD."
complications of TM dysfunction.
(Correct)
c. Functional appliances can
cause severe dysfunction of the
TMD.
d. There were no differences
in symptoms between the subjects
that were treated with fixed
appliances compared with the
ones treated with fixed appliances.
a. After an extensive review of the 61 Page File ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
literature, Seligman and Pullinger Sadowsky, BDS, MS (1999) - Pg 82 - General Comments 2nd paragraph
concluded that published research
suggests a limited role for Answers A-D are all word for word except answer B. The paragraph states: "However, as pointed out by Greene and others,
intercuspal occlusal factors in the a prudent orthodontist should identify and document findings related to the TMJ and mandibular function"
cause of TMD.
b. It is not important for
orthodontics to identify and
document findings related to TMJ
and mandibular function, since
there is little association between
orthodontic treatment and TMD.
(correct)
c. If painful symptoms arise during
orthodontics, therapy may have to
be modified
d. Orthodontic mechanotherapy
produces gradual changes in an
environment that is generally quite
adaptive.
a. 50 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
b. 75 Sadowsky, BDS, MS (1999) - Page 82 section "TMJ sounds and Orthodontic Treatment"
c. 87 "Temporomandibular joint sounds are a common finding and occur in approximately 20-30% of the population including
d. 25 (correct) patients before orthodontic treatment"
a. The untreated group 61 page file ABO Article #43 - The Risk of orthodontic treatment for producing temporomandibular disorders: A literature overview Cyril
showed more distally positioned Sadowsky, BDS, MS (1999) - Page 81-82
condyles
b. The extraction group "It was concluded that extraction therapy did not appear to be an iatrogenic cause of distally positioned condyles. Condylar
showed more distally positioned position tended to be centered on average; however, a wide variation in position was noted. Similar wide variations in normal
condyles condylar position has been reported by several authors as discussed by Tallents et al. in a critical review of the literature."
c. There was no difference in
condylar positions between the
extraction and the untreated
groups (Correct)
d. Extraction therapy
appeared to be an iatrogenic
cause of distally positioned
condyles.
internal disc derrangement without ABO 2009 Michigan -ADD without reduction (closed lock) = disc is displaced anteriorly at all times; usually no sound produced and limited mouth
reduction opening (23mm)
- ADD with reduction = disc slides into and out of its normal position as jaw opens and closes; pop/click sound is produced
after 30mm of opening
jaw deviates to side w/ internal derrangement
81
 Answers Sources Discussion
What do you suspect is happening when a a. Trigeminal Neuralgia 61 page file ADD with reduction
patient has clicking after 30mm of opening? b. Anterior displaced disc *
c. Torn disc
d. Arthritic condyle
Pt w/a paralyzed rt lateral pterygoid muscle is a.To the left 61 page file
instructed to open his mouth wide. Which b.To the right *
direction will the mandible deviate on opening? c.Straight (no deviation)
d.None of the above
If a patient was in an accident and the chin a. Left * 61 page file
deviates to the right, which lateral pterygoid is b. Right
working? c. Neither
d. Both
Disc displacement without reduction. What Deviation to the right (if this is the ABO 2010
happens to opening? affected side)
Right side anterior disc displacement without Answer: On opening jaw deviates 61 page file
reduction to right 2. Cannot move jaw to left
lateral –limited left lateral
movement
ADD Which way does jaw deviate on opening Answer: To the same side 61 page file
(correct)
Closed lock is defined as what? ADD without reduction * 61 page file
How many mm can a patient open if they have a.42mm 61 page file ABO Breakdown and Dr Hatcher lecture
a closed lock? b.60mm
c.11mm
d.23mm*
Which is NOT seen in acute closed lock a. deviation upon opening ABO 2008 Closed lock pts do not usually produce joint sounds according to Dr. Hatcher lecture. There is deviation upon opening and
patients? b. range of motion 27mm or less limited opening usually less than 23mm
c. no joint sounds (we think this is
correct)
d. pain with forced maximum
opening
Perception of pain in the TMJ usually is a.Lesser occipital 61 page file
accociated with which of the following nerves? b.Transverse cervical
c.Auriculotemporal *
d.Buccal
e.Great auricular
If a patient opens and their mandible deviates a. Right lateral pterygoid (correct) 2007 review
to the right, which muscle isn't functioning b. Left lateral pterygoid
properly? c. Right medial pterygoid
d. Left medial pterygoid
When a patient attempts protrusion of the a.Left medial pterygoid 61 page file
mandible, the jaw deviates markedly to the b.Right medial pterygoid
right. This would indicate that which of the c.Left lateral pterygoid
following muscles is unable to contract? d.Right lateral pterygoid *
Pt said that pain started from right TMJ down a. Physchogenic pain * 61 page file
to masetter area then across midline to left b. Myosistitis
angle of the mandible. What do you suspect? c. Internal derangement
A patient who develops an open bite and slow a. Right condylar resorption * 61 page file
shifting of the mandible to the right has? (anterior)
b. Left condylar resorption
c. Right condylar hyperplasia
d. Left condylar hyperplasia *
(posterior)
During a 1 year period treatment of a female a. Resorption of the right condyle 61 page file
pt, she’s shifting to the right w/an open bite on or hyperplasia of the left condyle
the right getting worse. What is the cause? (correct)
b. Resorption of the left condyle or
hyperplasia of the right condyle
A patient comes to you after an auto accident a.Trigeminal Neuralgia 61 page file
with a shift to the right, what is the cause? b.Left condylar fracture
c.Right condylar fracture *
d.Bell’s Palsy

82

Dislocation of the mandible can occur only in
which of the following directions?
A patient has prolonged history of internal
derangement with no joint sounds. Patient
developed pain in the TMJ area:
TMD pt with open lock. When she moves
laterally to the left she get a loud pop. Which
joint and is it anterior or posterior disc
displacement?
A patient opens wide and their jaw locks. If
she moves the mandible to the left she hears a
click and is able to close. What is happening?
A TMD patient opens wide/yawns and her jaw
locks open, she moves her jaw to the left and
the left joint pops, what has happened?
Person yawns with open lock. How is disc
displaced?
Open lock, pain on palpation
Answers
a. Laterally 61 page file
b. Medially
c. Anteriorly *
d. Posteriorly
e. Superiorly
a. Posterior capsulitis (correct) UNK 2010
b. Disc derangement without
reduction
c. Disc derangment with reduction
a. Anterior displaced disk on left UNK 2010
b. Anterior displaced disk on right ABO 2008
c. Posterior displaced disk on left 2007 review
(correct)
d. Posterior displaced disk on
right
a. Posterior (correct)
b. No disc displacement
c. Anterior
a. posterior capsulitis. Not sure
about this ? b/c pt has click/lock ABO 2010 #2
history, opening <27mm, I put ant
displacement w/out reduction
b. Closed lock--associated with the
inability of the condyle to slide
under the displaced
meniscus when the patient tries to
open the mouth beyond a certain
point
c. Open lock-- associated with the
inability of the condyle to slide
back under the meniscus
when trying to close the mouth.
(correct)
Sources Discussion
the thinking is that pain requires some type of inflammation (people can live pain free with derangements)
The entire TMJ is surrounded and encompassed by the capsular ligament (Fig. 1-18). The fibers of the capsular ligament are
attached superiorly to the temporal bone along the borders of the articular surfaces of the mandibular fossa and articular
eminence. Inferiorly, the fibers of the capsular ligament attach to the neck of the condyle. The capsular ligament acts to resist
any medial, lateral, or inferior forces that tend to separate or dislocate the articular surfaces. A significant function of the
capsular ligament is to encompass the joint, thus retaining the synovial fluid. The capsular ligament is well innervated and
provides proprioceptive feedback regarding position and movement of the joint.
(Okeson, Jeffrey P.. Management of Temporomandibular Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 14).
When the capsular ligament becomes inflamed, the condition is called capsulitis. It usually presents clinically as tenderness
when the lateral pole of the condyle is palpated. Capsulitis produces pain even in the static joint position, but joint movement
generally increases the pain. Although a number of causes can contribute to capsulitis, the most common is macrotrauma
(especially an open-mouth injury). Thus whenever the capsular ligament is abruptly elongated and an inflammatory response
is detected, it is likely that trauma will be found in the patient's history. Capsulitis can also develop secondary to adjacent
tissue breakdown and inflammation.
(Okeson, Jeffrey P.. Management of Temporomandibular Disorders and Occlusion, 5th Edition. Mosby, 012003. p. 225).
-Without reduction = disc is displaced in incorrect position at all times; usually no sound produced and limited mouth opening
-With reduction = disc slides into and out of its normal position as jaw opens and closes; pop/click sound is produced after
30mm of opening
Okeson Ch10 Pg:353 Imaging of the TMJ in the open lock position has demonstrated that the disc is posterior to the condyle.
The loud pop is the left condyle being reduced into the socket.
Spontaneous dislocation (i.e., open lock) represents a hyperextension of the TMJ resulting in a condition that fixes the joint in
the open position, preventing any translation. This condition is clinically referred to as an open lock because the patient
cannot close the mouth. Like subluxation, it can occur in any joint that is forced open beyond the normal restrictions provided
by the ligaments. It occurs most often in joints with anatomic features that produce subluxation.
When the condyle is in the full forward translatory position, the disc is rotated to its fullest posterior extent on the condyle and
firm contact exists between it, the condyle, and the articular eminence. In this position the strong retracting force of the
superior retrodiscal lamina, along with the lack of activity of the superior lateral pterygoid, prevents the disc from being
anteriorly displaced. The superior lateral pterygoid normally does not become active until the turn around phase of the closing
cycle. If for some reason it becomes active early (during the most forward translatory position), its forward pull may overcome
the superior retrodiscal lamina and the disc will be pulled through the anterior disc space, resulting in a spontaneous anterior
dislocation (Fig. 10-18). This premature activity of the muscle can occur during a yawn or when the muscles are fatigued from
maintaining the mouth open for a long time.
(Okeson, Jeffrey P.. Management of Temporomandibular Disorders and Occlusion, 5th Edition. Mosby, 012003. pp. 352 -
353).
ABO 2010
61 page file
83
 Question Answers Sources Discussion
Gorelick fluorosis First statement: true ABO 2008 #67 Graber (2000), pg: 603-604
Multiple T/F: Second statement: true 2007 "Gorelick et all' found that 50% of the patients experienced an increase in white spots. The highest incidence was in the
Gorlick states that significant decalcification occurs in 50%o of orthodontic patients. maxillary incisors,..."
These patients should avoid large amountsof flouride to allow the enamel to remineralize. "The surface-softened lesions remineralize faster and more completely than subsurface lesions, which remineralize extremely
slowly, probably because of lesion arrest by widespread use of fluoride. Visible white spots that develop during orthodontic
therapy should therefore not be treated with concentrated fluoride agents immediately after debonding because this
procedure will arrest the lesions and prevent complete repair. At present it seems advisable to recommend a period of 2 to 3
months of good oral hygiene but without fluoride supplementation associated with the debonding session."

If you administer fluoride throughout treatment such as theres continuous remineralization of surface enamel the white spot
lesion will never penetrate deeper than the surface but if the lesion has already penetrated deeper than .5 mm, you will
mineralize the surface layer which will prevent the remineralization of the deeper level so you'll still have the white spot lesion,
if you use MI paste you can mineralize the deeper surface and work outward.
50% of patients develop white spots (true) - these patient should avoid high amounts of fluoride (after debonding true) (during
treatment - false depending on the timing)
Does putting fluoride on immediately after treatment helps (NO) - it helps during but not after
Highest incidence of white spots was maxillary lateral incisors

Half of the pts developed white spots. However, this number reduced if they used Fl tx regularly while bands/bonds were on.
However, if you placed Fl once immediately after debonding or debanding it did not help. Avoid Fl initially after debonding. -
This is straight from Gorelick's article. All his articles can be found in AJO.

Gorelick states 50% have decalcification. Wait 2-3 months before fluoride T/T 61 page file
How does fluoride prevent dental caries? a.Increases remineralization of enamel 61 page file
b.Increase hardness of enamel
c.Decreases solubility of enamel (correct)
Inverse correlation between caries and fluoride. No correlation between endo success & brushing. a. Both statements True 61 page file
Fluoride applied to the teeth prior to bonding: a. Increases bond strength 61 page file
b. Decreases bond strength (correct)
c. Increases caries susceptibility
d. None of the above
Recent research shows the mean shear bond strength of bracket adhesive using Fluoride-releasing etching a. True(4/15/12) 61 page file (look up)
gel is significantly higher than when using a non-fluoridated gel? b. False
50% show decalcify when debonding, Usually resolve spontaneously with out fluoride First statement true, second statement false 61 page file
T/F: Tartar control reduces supragingival calculus by 50%. This is due to the active ingredient pyrophosphate. first statement - true (correct) ABO 2010
second statement - true (correct) 2007
Tartar control toothpaste controls 50% of tartar build-up, b/c it contains pyrophosphate.(Triclosan a. First statement is true, second is false 61 page file
antibacterial) b. First statement is false, second is true
c. Both false
d. Both true (correct)

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 Question Answers Sources Discussion
For demanding patient: To alleviate distrust can recommend a 61 page file
second opinion
In prioritizing realistic treatment objectives, a compromise could be made on the following, except: a. Establishing ideal occlusion. 61 page file
b. Addressing the patient’s chief complaint.
(correct)
c. Achieving ideal facial esthetics.
d. Maximizing stability.
Lack of cooperation with orthodontic treatment in an adult patient usually stems from: 1. Personal choice of disagreement or poor
understanding of the treatment modality.
2. Passive attitude or carelessness.
3. Low tolerance of discomfort.
4. Higher social demands and constraints

a. 1,2 & 3
b. 1,3 & 4 (correct)
c. 2,3 & 4
d. 2 & 3
Cooperation is more likely to be a problem in a patient with a.External motivation for seeking treatment. 61 page file
(correct)
b.High degree of parental control.
c.Multi-cultural background.
d.Any of the above.
An adult patient who seeks orthodontic treatment tends to have: a.Less positive self-image than average. 61 page file
b.An average self-image.
c.More positive self-image than average.
(correct)
If a child swallows a band and is conscious with coughing, the doctor should: a.Rush the child to the nearest emergency 61 page file
room
b.Perform the Heimlich maneuver
c.Stay with the patient and encourage
coughing (correct)
d.Watch and wait

85
 Question Answers
Which causes impairment in speech? a. Class II Div I
Which is most common with speech problems? b. Anterior Open Bite (correct)
When an anterior open-bite is associated with a speech difficulty in a child, the speech sound that is more a.T and D
likely to be affected is: b.Th, S and Z (correct)
c.F and V
d.All of the above
Sources Discussion
ABO 2009 Proffit 4th ed - Ch 6 p. 175 - Table 6-1:
Anterior Open bite, large gap between incisors = lisp /s/, /z/ sibilants
Irregular incisors, esp. lingual position of mx. incisors = difficulty in production of linguoalveolar stops, /t/, /d/
Skeletal class III = distortion of labiodental fricatives, /f/, /v/
Anterior open bite = distortion of linguodental fricatives, th, sh, ch
61 page file Pg 175 Proffit:
Anterior open bite (lisp with “s” “z” & distortion with “th” “sh” “ch”)
Class III (distortion “f” “v”)
Irregular incisors or lingually positioned mx incisors “t” and “d”
So, if I had to say one with certainty, I would say it’s the open bite, not the class II div 1.

86
 Question Answers Sources Discussion
Where was the first meeting of ABO? a. 1929 Estes Park, Colorado (answer) ABO 2009 1929 - Estes Park, CO - First meeting of ABO
b. 1938 Estes Park, Colorado UNK 2010 1900 - St. Louis, MO - First meeting of AAO
c. 1929 Denver, Colorado 1st ABO President: Ketchum
d. 1932 St. Louis 1st AJO Editor: Dewey
Edward Angle invented all of the following except: a.E-Arch ABO 2008 Profitt pg 407-408:
b.Pin and tube 2007 Angle invented:
c.Ribbon arch E-arch
d.Edgewise Pin and tube
e.Universal (correct) ribbon arch
Edgewise

87
 Question Answers Sources Discussion
What is NOT a major cause of malocclusion? a. Drugs 61 page file
b. Habits
c. Hereditary
d. Endocrine imbalances
e. None of the above (correct)
Place the following steps of adjunctive orthodontic treatment 1. Establishing the occlusion 61 page file (P620)
planning in the correct sequence: 2. Definitive periodontal/restorative treatment.
3. Disease control.
4. Maintenance.
A- 1,3,4,2
B- 3,2,1,4
C- 2,1,3,4
D- 3,1,2,4**
Which of the following is NOT usually a goal of adjunctive a. Facilitating restorative treatment. 61 page file (P 616)
orthodontic treatment for adults: b. Improving periodontal health.
c. Treating temporomandibular disorders.
(correct)
d. Establishing favorable crown-to-root ratio.
Adjunctive orthodontic treatment is a: a.Treatment with a complete fixed appliance for 61 page file (P611)
no more that 6 months.
b.Tooth movement carried out to facilitate other
dental procedures.**
c.Treatment with a removable orthodontic
appliance.
d.Treatment that must be carried out by an
orthodontist but requires a careful coordination
with other dental specialties.
Primary failure of eruption is seen more frequently in the multiple T/F UNK 2010 Profitt 4th Edition pg. 461 Fig 12-47 caption: "Primary failure of eruption is characterized by a posterior open bite due to
anterior region. When orthodontic forces are applied, ankylosis 1st statement is FALSE ABO 2009 Michigan failure of some or all posterior permanent teeth to erupt even though their eruption path has been cleared. It can involve any
often occurs with such teeth when extrusive force is placed on 2nd statement is TRUE ABO 2008 or all posterior quadrants."
them 2007 Profitt 4th Edition pg.457: "The affected teeth are not ankylosed, but do not erupt and do not respond normally to orthodontic
force. If tooth movement is attempted, usually the teeth will ankylose after 1- 1.5 mm of movement in any direction."
Primary Failure of Eruption occurs more in ant. region & teeth a.First statement is true, second false, etc. 61 page file see above
in PFE don’t become ankylosed til extrusive b.False, true (correct)
c.Both true
d.Both false
Hyperdivergent phenotype should be treated early. The a) First statement is true, second false UNK 2010 ABO article #31 - (Sankey, Buschang) Early treatment of vertical skeletal dysplasia (Patterns of facial growth are established
phenotype can be diagnosed early. b) First statement false, second true ABO 2009 early in development/ if left untreated the only alternative may be surgery)
c) Both true (correct)
d) Both false
10.The treatment of hyperdivergent, open bite in the primary a.The phenotype does not self-correct (correct) 2007 Im assuming the answer might be a, since 80% of anterior open bite do self correct and we only treat about 20%
dentition is predicated on what? b.The phenotype
Early treatment of hyperdivergent, open bite in the primary a.(T/T) 61 page file
dentition, b/c the phenotype will not self correct
Several questions on Buchang/English hyperdivergant article. a.Use chin cup (or High pullHG, we're not sure) ABO 2008
with RPE and lip sealing exercises (look it up)
Where do upper incisors fall in relation to stomion superioris in a. at same level ABO 2009 Proffit 4th ed pg 227:
skeletal open bite? b. 4mm apical to lip - "skeletal open bite will usually have exces-sive eruption of posterior teeth, downward rotation of mandible and maxilla, and
c. 3mm below lip (correct) normal (or even excessive) erup-tion of anterior teeth" (normal = max 3mm of incisal display at rest)
d. there is no relationship between incisors and
open bite
Skeletal open bite malocclusions usually have: a.Decreased height of incisors 61 page file see above
b.Decreased height of maxillary molars
c.Increased height of maxillary molars (correct)
d.None of the above
What are some characteristics of a skeletal open bite? a. A tall person 61 page file
b. Antegonial notching and a low mandibular
plane angle
c. Antegonial notching and a high mandibular
plane angle (correct)
d. Antegonial notching and a high Wits
Which is not characteristic of openbite? a. Long Corpus length (correct) ABO 2010 Bjork article:
(Other choices were Bjork’s indicators)

88
 Question Answers Sources Discussion
Most common sign of developing anterior openbite a. degenerative arthritis UNK 2010 Profitt Pg 319: FIg 8-50: Shows anterior Openbite patient with Severe condylar degeneration due to rheumatoid arthritis
ABO 2008 he also states on Pg 319: "adult onset rheumatoid arthritis can destroy the condylar process and create a deformity"

Graber Text: Orthodontics current principle and techniques (2000) - references an open bite patient with arthritis
What percentage of openbites self-correct? a. 20% UNK 2010 "Skeletal morphologic features of anterior open bite" Cangialosi
b. 80%(correct)
c. 100%
What % of open bites spontaneously close in pre-pubescent 80 ABO 2008
children?
What percentage of young kids w/ anterior open bite do we a. 20% (correct) ABO 2009
have to treat? b. 40%
c. 60%
d. 80%
The incidence of open bite malocclusions in post-pubertal age a.Increases 61 page file
groups: b.Decreases (correct)
c.Stays the same
d.All of the above
A) Contemporary research shows that tongue thrust swallow in a. 1st statement is correct, 2nd statement 61 page file Graber 2000 pg 27
early permanent dentition is more an adaptation to the false.(correct) It is tempting to blame some instances of open bite and incisor protrusion on the tongue, which often seems to have pushed
openbite than the cause of it. B) Elimination of the tongue b. 1st statement is false, 2nd statement is the teeth into an unfortunate position and makes correcting the prob- lem difficult. However, tongue function has little or
interference often leads to a spontaneous correction of the correct. nothing to do with tooth position, although the resting posture of the tongue can be important.
openbite in this age group. c. Both statements are correct.(correct)
(4/12/12)
d. Both statements are false.
What is more likely to cause an anterior open-bite in a 10 a. Forward resting position of the tongue. 61 page file McNamara Ch. 8:
years old child: (correct) Tongue thrust must be considered as a secondary phenome-non that provides seal of the oral cavity, essential for the
b. Tongue thrust swallowing. swallow in conditions of anterior open bite. "tongue thrust " is adaptive, not causal.
c. Thumbsucking habit with duration of about
3h/day. - also see above from Graber text
d. None of the above
10 y.o. w/ tongue thrust ; 0mm OJ and OB; no speech do nothing (unless lip seal training is listed as ABO 2010
problems answer
Patient presents with toneue thrust. OB 0 and OJ 0. what a. Myofunctional tongue therapy ABO 2008 McNamara Ch. 8:
would be an appropriate treatment? b.Crib appliance -Proffit and Mason reported that a poor correlation existed btn tongue thrust and open bite malocclusion. Their rec-
c.No treatment (correct, unless lip seal training is ommendations concerning myofunctional therapy were more guarded and pessimistic. stating in general that
listed as an answer) myofunctional therapy was not effective.
d.Speech Therapy -Tongue-inhibiting appliances were developed to counteract the forward movement of the tongue during function, including
tongue-restraining devices. Graber reported an initial 92% success rate with palatal crib treatment, but the occlusions of
many pa-tients relapsed following removal of the "tongue habit " appliance.
-Lip seal training. as advocated by Frankel is necessary to over-come an abnormal postural behavior of the tongue and to
strengthen the lip musculature
Tongue thrust in transitional dentition with some openbite a) Crib UNK 2010 pg 154 Proffit - Tongue thrust is normal in transitional dentition
b) Myofunctional exercise
c) No Tx (correct)
Mixed dentition kid w/no signs of skeletal openbite, good a. Tongue Crib, 61 page file see above
posterior occlusion, no speech probs, but has tongue thrust. b. Speech Pathology,
What do you do? c. Myofunctional therapy
d. NO treatment (correct)
Treatment for a 4 y.o. thumb sucker? ABO 2009 Michigan McNamara Ch.8
We do not become too concerned about a digital sucking habit until about the time of the eruption of the permanent
anterior teeth, and intervention usually is deferred until that developmental stage.
A wide range of therapeutic possibilities including the use of digit inhibiting appliances similar in appearance to the
tongue crib. Other treatment approaches include painting a foul-tasting or annoying substance (e.g.. hot pepper solut i on)
on the offending digit as well as covering the hand with a sockduring sleeping hours.

Proffit 4th ed pg 151-153

- sucking habits during the primary dentition years have little if any long-term effect
- Mild displacement of the primary incisor teeth is often noted in a 3- or 4-year-old thumbsucker, but if sucking stops at this
stage, normal lip and cheek pressures soon restore the teeth to their usual positions.

- If the habit persists after the permanent incisors begin to erupt, ortho-dontic treatment may be necessary to overcome the
result-ing tooth displacements. The constricted maxillary arch is least likely to correct sponta-neously. In many children, if the
maxillary arch is expanded transversely, both the incisor protrusion and anterior open bite will improve spontaneously There
is no point in beginning orthodontic therapy, of course, until the habit has stopped.
do nothing
4 yr old with digit habit with 3mm open bite. a.break the habit even if unpleasant. ABO 2008 see above
b.no treatment (4/12/12)
c.tell the parent not to worry
d.refer them for psychiatric issues
What is your treatment for a 5 year old with a thumbsucking a. RPE 61 page file
habit? b. Crib
c. Extraction
d. Do nothing (correct)

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 Question Answers Sources Discussion
VTO predictions are accurate and can be used in orthodontic True, True UNK2010 Article #66
tx planning. VTO predictions of soft tissue are accurate. ABO 2010 #2 "The computer-generated cephalometric VTO predictions were found to be accurate in simulating the outcomes of adult
extraction treatment. Although the lower lip was consistently predicted to be 1 mm anterior to its actual posttreatment
position, these errors were still small enough to allow for accurate treatment planning."
Is computerized VTO accurate? yes ABO 2009
VTO after extraction makes patient look better then in real life a.Accurate to be reliably used 61 page file
Little's studies show: relapse is unpredictable UNK 2010 Article #47 - "Evaulation of changes in mandibular anterior alignment from 10-20 yrs post retention"
ABO 2008 1. Long-term alignment was variable and unpredictable.
2007 2. No descriptive characteristics-such as Angle Class, length of retention, age of the initiation of treatment, or gender-nor
61 page file measured
variables-such as initial or end-of-activetreatment alignment, overbite, overjet, arch width, or arch length-were of value in
predicting the long-term result.
3. Arch dimensions of width and length typically decreased after retention, whereas crowding increased. This occurred in
spite of treatment
maintenance of initial intercanine width, treatment expansion, or constriction.
4. Success at maintaining satisfactory mandibular anterior alignment is less than 30% with nearly 20% of the cases likely to
show marked crowding many years after removal of retainers.
Post-treatment studies of malocclusions treated with extraction a. 20% relapse of mandibular incisors 61 page file
of teeth by Little et al found: b. 1/3 relapse of mandibular incisors
c. 50% relapse of mandibular incisors
d. 2/3 relapse of mandibular incisors (correct)
Which of the following is least likely to recur? a. Leveling the Curve of Spee (correct) 61 page file
b. OB 2007
What is the most stable: a. RPE ABO 2008
b. COS (correct) 61 page file
c. deep bite
Patient with rotated maxillary incisors, deep bite, large OJ. a. OJ 61 page file rotations>deepbite>cos Most likely to relapse(4/12/12)
What is most likely to relapse after treatment? b. OB
c. Rotations (correct)
Which characteristic of a Class II division 2 malocclusion that a.Rotated centrals 61 page file Breakdown (answer might also be rotated centrals)
is most prone to relapse? b.Mesially rotated maxillary first molars
c.Deep bite *
Stability of deep overbite correction is: a. More favorable in growing individuals (correct) 61 page file
b. More favorable in nongrowers
c. Not related to whether the deep bite was
corrected during the growth phase
What is the normal intermolar width for adolescents? a.33-35 (correct) 61 page file
b.36-39
c.39-42
d.none
The arch length from mesial of mandibular 2nd molar to mesial a.50% 61 page file article 55 - Clinical application of a tooth size analysis
of contralateral 2nd molar should be about what percentage of b.73%
that distance in the max arch? c.91% Definition of BOLTON discrepancy
(correct)
d.100%
The Bolton % 6-6 lower vs upper is ... a. 76% 61 page file Mosby's Review - pg. 33 - Mean anterior ratio is 77.2 and the mean overall 6-6 is 91.3
b. 78%
c. 91% (Correct)
d. 94%
From mesial of upper 7 to opposite arch, what is average a.91% (don’t word it as bolton) 77% anterior 61 page file
percent of Bolton
Your pt has Cl I molar, canine occl in both arches & everything a. Mandibular teeth are too large 61 page file
is normal. There’s spacing in the anterior max segment. The b. Maxillary teeth are too small (correct)
problem is: c. Basal bone in the maxillary arch is too large
d. None of the above
Which of the following is the LEAST desirable treatment option a. Maxillary incisor intrusion (correct) 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 101
to decrease the gingival display in a gummy smile patient with b. Orthognatic surgery Consonant smile arc = parallel to the curvature of the lower lip upon smile
a consonant smile arc? c. Functional appliance Pg 99 - "The smile arc should be defined as the relationship of the curvature of the incisal edges of the maxillary incisors and
(bad question we think its remembered wrong) d. Mandibular incisor extrusion canines to the curvature of the lower lip in the posed smile. The ideal smile arc has the maxillary incisal edge curvature
parallel to the curvature of the lower lip upon smile; the term consonant is used to describe this parallel relationship."
Which of the following is most likely to create a consonant a. Overemphasized canine guidance 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 100-101
smile arc? b. Maxillary incisor intrusion to open the bite
c. Mandibular incisors brackets placed too
gingival
d. Maxillary incisors brackets placed more
gingival in an open bite patient. (correct)
The most important factor when creating the ideal smile arc is: a. The shape of the teeth 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 100
b. The position of the lower lip "It is important to assess and visualize the incisor-smile arc relationship and place brackets so as to extrude the maxillary
c. Bracket placement according to case incisors in flat smiles and to maintain the smile arc where it is appropriate. A set formula for bracket placement based on
evaluation (correct) tooth measurements...is not appropriate for maximum esthetics...Just as patients get individualized treatment plans, they also
d. The length of the teeth should have individualized designs for appliance placement."

90
 Question Answers Sources Discussion
The ideal smile arc: a. Is a flat symmetrical smile 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 99
b. Has the maxillary incisal edge curvature
parallel to the curvature of the lower lip upon
smile (correct)
c. Is also called nonconsonant smile
d. Is defined with a spontaneous smile
Which of the following is described as a youthful smile? a. Incisal edges appear straight across the smile 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 99
b. Shorter front teeth
c. Longer front teeth that create a line that comes
slightly downward in the middle of the smile
(correct)
d. Maxillary teeth that followed the curvature of
the upper lip
Which of the following is FALSE a. Males show more maxillary incisors and more 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 98
mandibular incisors at rest and on smile than do
females. (correct)
b. In orthodontic smile analysis, we usually
evaluate the posed smile on the basis of amount
of incisor and gingival display and the transverse
dimension of the smile.
c. Some amount of gingival display is esthetic and
youthful in appearance
d. Lack of gingival display is not as attractive as
complete tooth display
Which of the following is FALSE: a. It is possible that growth in the brachyfacial 61 page file ABO #30 - The importance of incisor positioning in esthetic smile: The smile arc, Page 101 - a, b, c are word for word. D is
pattern may lead to a flat smile arc. not.
b. Patients with brachyfacial skeletal pattern
might, theoretically, have a tendency for the
anterior maxilla to lack the clockwise tilt needed
for an ideal smile arc
c. In some cases brachyfacial patients might
exhibit a counterclockwise tilt that results in a flat
smile arc.
d. Dolicofacial patients tend to have more ideal
smile arcs. (correct)
What are the landmarks for vertical facial thirds? ABO 2009 Proffit 4th ed pg 177:
vertical thirds = hairline (trichion) - eyebrows (glabella); eyebrows - base of nose (subnasale); base of nose - chin (menton)

Upper lip soft tissue to chin a. 1:2 61 page file Profit 4th ed. pg.180
lower third of face (subnasale - menton) is divided into upper lip 1/3 and chin 2/3
In complete nasal obstruction, there’s an immediate change of a.5 degrees (correct) 61 page file Profitt 4th ed. pg. 156
head posture measured by an increase in craniofacial angle of b.15 degrees
about: c.25 degrees
d.50 degrees
What is most associated with mandibular asymmetries in trauma (correct) ABO 2008 p172 proffit fig 6-3
children? 61 page file

What is the most common cause of mandibular asymmetry in

children
Cross bite, asymmetric mandible trauma and congenital ABO 2009 Michigan Proffit 4th ed pg 133-134
"An old condylar fracture is the most likely cause of asym-metric mandibular deficiency in a child, but other destruc-tive
processes that involve the temporomandibular joint such as rheumatoid arthritis or a congenital absence of tissue as in
hemifacial microsomia also can produce this problem."
When extracting maxillary first bi’s only and leaving the molars a.also leave the maxillary first molars mesially 61 page
in Class II…. rotated (correct)
b.tip the maxillary first molar crowns mesially
c.do not close all the extraction space
d.also extract the mandibular first bi’s

91
 Question Answers Sources Discussion
Often in the treatment of a Cl II case in a nongrowing pt with a. The maxillary first molars are meant to be left 61 page file
upper premolar extractions, which of the below are possible with a small amount of mesial rotation (correct)
outcomes? b. There is a small space between the canine and
the premolar meant to be left
c. The maxillary first molar occludes with the
buccal groove of the mandibular first molar
If you take out upper 4's what do you have to do to the 6's Rotate them mesially (correct) ABO 2008
usually?
Space discrepancies greater than 10 mm ______ require a.Sometimes 61 page file
extraction? b.Never
c.Almost always (correct)
d.None of the above
Space discrepancies of up to ___ mm can usually be resolved a. 2 61 page file
without extraction of some teeth other than third molars? b. 4 (correct)
c. 6
c. 8
In its classic form, serial extraction applies to pt who meet all a.No skeletal disproportions. 61 page file
of the following criteria, except: b.Cl. I molar relationship.
c.Normal overbite.
d.Mild arch perimeter deficiency.(correct)
The goal of serial extraction is to: a.Transfer incisor crowding posteriorly to the PM 61 page file
extraction site *
Ideal situations for serial extraction: a. Class I molars 61 page file
b. Moderate OJ/OB
c. Severe crowding - 10mm or more
d. Slight protrusion
e. All of the above (correct)
The key to success of serial extraction is to extract the first a. Before the canines erupt (correct) 61 page file
PM’s: b. after the canines erupt
c. never
A study evaluating serial extraction cases at least 10 years out a. A more stable result achieved in the serial 61 page file
of retention indicated that: extraction cases than in cases that had premolars
extracted after they fully erupted
b. No decrease in post retention intercanine width
c. That only 23% of the sample demonstrated
clinically unsatisfactory mandibular alignment by
the post-retention stage
d. All of the above
e. None of the above (correct)
A patient has lost a mandibular first molar, the second molar is a. Presence of maxillary third molar on that side 61 page file
tipped mesially, and you want to upright the second molar. b. Pontic space needed
Which should be evaluated in your decision whether to extract c. Distance of the mandibular third molar to the
the third molar? ramus
d. All of the above (correct)
The impaction of mandibular third molars after orthodontic a.The vertical component of growth 61 page file
treatment is associated with: b.Higher than usual mandibular plane angles
c.Excessively large ascending rami
d.Short mandibular bodies
e.All of the above (correct)
When swallowing, the amount of force applied when the teeth a.20 grams 61 page file
are in contact is: b.50 grams
c.100 grams (correct) ?
d.150 grams
Which tooth is lowest in the mandible at age 8? a.Lateral incisor 61 page file
b.First bicuspid
c.Second bicuspid (correct)
d.Canine
a.Extract 2 maxillary premolars
b.Extract 2 mandibular premolars
Which of the following is a viable treatment plan when there is c.Extract 1 lower incisor (correct)
less tooth mass on the upper? d.Extract 4 premolars 61 page file
When is the best time to take out a lower incisor? a.Maxillary excess 61 page file
b.Mandibular deficiency
c.None of the above (correct)
d.Never do it! Get the idea! *
If two bicuspids are extracted in a Class II Div 1 non-growing 1.DL cusp of maxillary first molar 61 page file Why not choice 3?
patient, what functional cusp lies in an embrasure? 2.ML cusp of maxillary first molar (correct)
3.ML cusp of maxillary second molar
4.L cusp of mandibular premolar
Extraction of primary canine too early may cause: a. Teeth to shift (correct) 61 page file
b. Increase OJ/OB

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 Question Answers Sources Discussion
Which arch form would more closely approximate normal a.Bonwill-Hawley 61 page file Proffit 4th edition p427
position of the 2nd & 3rd molars b.Catenary Curve
c.Brader (correct)
d.Arch Blanks
Based on bone density, which teeth are the best for a.Maxillary second molars 61 page file
anchorage? b.Maxillary first molars
c.Mandibular first molars (correct)
What are possible reasons for a patient to have a Class I a.Arch asymmetry 61 page file
occlusion on one side and a Class II on the other? b.Skeletal asymmetry
c.Midline discrepancy
d.All of the above (correct)
Major cause of Cl I crowding is NOT early loss of dental a. Forces of occlusion prevent any spontaneous 61 page file Proffit 4th ed, p140
material in primary dentition because: space closure.
b. Decrease in primary teeth loss due to
fluoridation in the US had little or no impact on the
prevalence of malocclusions. (correct)
c. Use of a space maintainer often does not
prevent eventual crowding in the permanent
dentition.
d. None of the above
Which of the following best characterizes a skeletal crossbite? a.Maxillary molars tipped lingual, mandibular 61 page file Dental compensation
molars tipped buccal
b.Maxillary molars tipped buccal, mandibular
molars tipped lingual (correct)
A patient with no spacing of the deciduous dentition will have a.Crowding in the permanent dentition * 61 page file
b.Normal permanent dentition
c.Spacing of the permanent dentition
d.A Class III malocclusion
You notice a patient that is 9 years old with a space between a. Normal (correct) 61 page file Ugly duckly and normal (4/12/12)
the incisors. This condition is: b. Caused by the frenum
c. The ugly duckling stage
d. Pathologic
1.5 mm diastema with a thick fibrous frenum which blanches Do nothing. Wait till the 3 erupt. ABO 2008
the tissue when pulling in the late transitional dentition. what
do you do?
Active stabilization of teeth is: a.The ability of the PDL to generate a force 61 page file Proffit 4th ed. p148
contributing to the equilibrium situation.(correct)
b.Why lower incisors continue to move labially
under tongue pressure.
c.What sets the threshold of orthodontic forces at
2-3 gm/cm².
d.Prevention of orthodontic treatment relapse
using active removable appliances
On an articulator, change in the anterior-posterior is controlled a. Condylar angulation (correct) 61 page file
by what? b. Bennett angle
c. Either angle
What additional piece of information would you gather at your a. A CR bite 61 page file
records visit to obtain condylar inclination? b. A CO bite
c. A Protrusive wax bite (correct)
d. Lateral excursive wax bites
There is little point in articulator mount of ortho casts for a. The contours of the TMJ are not fully 61 page file (P164)
preadolescent & early adolescent pts b/c: developed yet.
b. Mature canine function is not reached yet.
c. A only
d. B only
e. Both of the above (correct)
f. Neither of the above
Incisor liability refers to: a. The space needed for the maxillary incisors 61 page file
(correct)
b. The proclination of the maxillary incisors
c. The retroclination of the maxillary incisors
High angle female crossbite- use bonded RPE to control a. Before Tx (correct) ABO 2008
vertical. If you used banded RPE the mandible would rotate b. During tx
down and back as a result of expansion. She had c. After tx
supemumerary teeth in mandible near canineswhen should
you extract them?
Most likely cause of tooth loss external resorption ABO 2009 Michigan
How long should you retain a tooth that was extruded in a A) 1 month UNK 2010 Chapter 25 - McNamara's Orthodontics Book written by Kokich says 6 months retention due to oblique periodontal fibers.
month? B) 3 months ABO 2009
C) 6 months (correct) 2007

93
 Question Answers Sources Discussion
Definition of ankylosis? a. two mineralized surfaces fused together ABO 2008 Proffit p566
(correct) "Ankylosis of an unerupted tooth is always a potential problem. If an area of fusion to the adjacent bone develops, orthodontic
b. osteointegration movement of the unerupted tooth becomes impossible, and displacement of the anchor teeth will ccur. Occasionally, an
unerupted tooth will start to move and then will become ankylosed, apparently held by only a small area of fusion. It can
sometimes be freed to continue movement by anesthetizing the area and lightly uxating the tooth, breaking the area of
ankylosis"
What is the cause of a midline diastemma? Tooth size arch length discrepancy 61 page file
Which of the below are possible arch forms? a. Bonwill-Hawley – based on a mathematical 61 page file
model
b. Catenary – based on a pendulum swinging
from two points
c. Bradey Trifocal – based on trifocal ellipse
d. All of the above (correct)
Extraction of primary canine too early may cause: a. Teeth to shift (correct) 61 page file
b. Increase OJ/OB

94
 Question Answers Sources Discussion
The use of zinc phosphate cements for ortho purposes a. The liquid for orthodontic 61 page file
differs from its use in restorative dentistry in that: purposes contains less free
phosphoric acid.
b. The cement for orthodontic
purposes is mixed thicker.(4/12/12)
c. Mixing techniques for
orthodontic purposes do not use a
frozen slab.
d. Little bare metal not coated
with cement is tolerated on interior
surfaces of an orthodontic band.
37% phosphoric acid etch, 30 secs: How much enamel a. 3-10 microns(correct) UNK 2010 Graber: 30 secs->3-10 microns
loss? b. 1-2 microns ABO 2008 4/12/12 15 sec 37% 8-10 microns
37% phosphoric acid etch for 15 seconds, how much 2007 30 sec 16-18 microns
enamel loss?
How many microns of enamel removed when etch 15 a. 8-10 (correct)(4/12/12)
seconds with 37% phosphoric acid? b. 12-16 ABO 2009
24.Which of the following is used to etch a ceramic crown? a.37% phosphoric acid ABO 2008 Graber pg 579
b.9% HF (correct) 2007
The safest and preferred site of failure when brackets are a.The interface between enamel 61 page file Profitt 4th ed. page 416
removed is: surface and bonding material.
b.Within the bonding material itself.
c.The interface between brackets
surface and bonding material.
(correct)
d.Any of the above.
Thermal debond of brackets is an alternative to usual a. True (correct) 61 page file Proffit 4th edition pg 419
technique. Ceramic brackets debonded by thermal means, b. False "Quite effective and reduces the chance of enamel damage. Rarely used
both more time & a higher temp are required than for now due to risk of pulpal damage"
debonding of SS brackets, assuming a two paste adhesive
system used.
All the following are current recommendations for safer a.Selecting brackets with mechanical 61 pagefile Profitt 4th ed. page 419.
debonding of ceramic brackets, except: retention between the base and the There should be a shearing effect not torquing.
adhesive.
b.Inducing an asymmetric torquing
stress on the bracket.(correct)
c.Using a laser to weaken the
adhesive.
d.Concentrating the force at the
bracket-adhesive interface.
For surgical instruments that can’t be heat sterilized, the a.Phenol 61 page file Ethylene oxide inhibits growth of microorganisms (disinfectant properties)
method of choice would be: b.Ethyl alcohol and when present in high concentrations, can completely destroy them.
c.Autoclave Ethylene oxide is used as a fumigant and disinfecting agent, as a mixture
d.Ethylene oxide (correct) with carbon dioxide (8.5–80% of ethylene oxide), nitrogen or
dichlorodifluoromethane (12% ethylene oxide). It is applied for gas-phase
sterilization of medical equipment and instruments, packaging materials and
clothing, surgical and scientific equipment.

95
 Question Answers Sources Discussion
Studies show that 50% elasticity of powerchains is lost a.1 day (correct) UNK 2010 p211 Nanda Biomechanics (Ch10)
within b.3 days ABO 2008 Hershey and Reynolds" compared three commercially available elastomeric
c. 5 days 2007 review chains and found a 60% loss after four weeks. Fifty
d. 7 days 61 page file percent of the loss in force was after the very first day.

-Effects of prestretching on force degradation of synthetic elastomeric chains

Steel ligatures are better in adult orthodontic patients TRUE
because elastomeric chains harbor several
microorganisms
If you bond ceramic brackets on anterior 3-3 and stainless a. Loss of anchorage (true)
steel brackets on posteriors,
what would you expect?
A pt you are treating w/premolar ext has ceramic brackets a. Poor maxillary anterior torque
3-3 & SS brackets on the posterior teeth, what should be b. Teeth will move slower
of concern during tx? c. Loss of anchorage during canine
retraction (correct)
Stress release definition in a NiTi wire
Which of the following should be used in a patient with a a.NiTi
Nickel allergy b.TMA (correct)
c.SS
d.Elgiloy – chrome cobalt
What wire can you use with a nickel sensitive patient? TMA
Which statement regarding allergic reactions associated w/ a.They are almost always caused by 61 page file
ortho appliances is true: Latex or Nickel. (correct)
b.These allergic reactions are never
life threatening.
c.Only 5% of the US population
shows some skin reaction to Nickel.
d.All children with skin allergy to
Nickel will show a mucosal response
to orthodontic appliances.
Which of the following wires has the MOST resistance to a. A-Niti
deformation b. Copper Niti
c. TMA
d. Multi-strand(4/12/12)
e. SS
AJODO 2005
“Previous studies have shown that it might lose 50% to 70% of its initial force
during the first day of load application
and 10% more by 3 weeks, and retain only 30% to 40% of the original force
after 4 weeks.”
ABO 2010 Proffit 4th edition pg. 658 (we are assuming the question meant "adult ortho
pts w/ perio dz)
"Self-ligating brackets or steel ligatures are preferred for periodontally
involved patients rather than elastomeric rings to retain orthodontic
archwires, because
patients with elastomeric rings have higher levels of microorganisms in
gingival plaque."
UNK 2010 Article #86
ABO 2009 "When using sliding mechanics, the relatively rough surfaces of the ceramic
slot significantly increases frictional resistance when
compared with stainless steel brackets. A decrease in the efficiency of
canine retraction was estimated at 25% to 30% when ceramic and stainless
steel brackets were compared"
ABO 2008
61 page file
2007
UNK 2010 Article #27b "Pseudoelasticity..."
ABO 2009 Michigan talks about stress-induced martensite (SIM)...
61 page file Proffit pg 361 & 365
2007 SS and Elgiloy have 8% nickel
TMA only does not contain nickel, only titanium and molybdenum
ABO 2008 ABO article #67 says "Stabilized beta-phase titanium alloys contain about
80% titanium. In addition, they include 11.5% molybdenum, 6% zirconium,
and 4.5% tin.
Proffit pg 348
2007 Article "Review of contemporary AW" Kusy:
"copper additions increase its strength and reduce the energy lost"
The Textbook of Orthodontics by Singh (Google Book) pg 334:
Copper NiTi:
1. more resistant to permanent deformation
2. better springback as compared to other NiTi alloys
3. More constant forces exerted over small activations
Proffit: pg362

96
 Question Answers Sources Discussion
Which of the following wires has the LEAST resistance to a.A-Niti 61 file page Proffit 4th ed pg 363:
deformation b.Copper Niti SS has highest stiffness, lowest springiness and therefore less resistant to
c.TMA permanent deformation
d.Multi-strand
e.SS (correct)
What is most likely to have permanent deformation a. Twist-flex 61 page file Twist-flex (Ormco): 3 strand twisted SS wire; moderately light forces and is
b. Stainless steel (Correct) used for initial leveling and alignment.

Proffit 4th ed pg 370:

TMA has double the deflection of SS a. True (correct)
b. False
Springback is useful because a. Wire maintains its stiffness
b. Wire remains flexible (4/12/12)
c. Wire is resistant to permanent
deformation (correct)
What is the application of spring back? The ability to deform the wire and
return to
its original shape.(wrong 4/12/12)
Know Strength vs Springiness: a. Strength = Stiffness x Range
b. Springiness = 1/Stiffness
Asperities are: Areas that actually contact along a
wire, roughness, microscopic bumps
on wire were it binds
"Another way to obtain a better combination of springi-ness and strength is
to combine two or more strands of a small, and therefore springy, wire. Two
10 mil steel wires in tandem, for instance, could withstand twice the load
as a single strand before permanently deforming"
UNK 2010 Pg 365 Proffit Table 10-3, pg. 362-363
TMA has double the range of SS.
SS has Triple the stiffness of TMA
Range is the distance that a wire will bend elastically before permanent
deformation occurs (Breakdown)
Range is the linear measurement of deflection until plastic deformation
occurs (range and deflection are pretty much synonymous)
Force = stress (y-axis), Strain = Deflection (x-axis)
Stiffness is the slope of the line
Proportioanl limit - the point at which the first plastic deformation occurs
Yield strength = 0.1% of plastic deformation (comes after the proportional
limit)
Strength = stiffness x range
2007 Definition/diagram of springback in Proffit pg 361- think C
Web defintion: "tendency to partially return to its original shape because of
the elastic recovery of the material"
ABO 2008 Spingback: wire deflected beyond yeild-point till the arbitary clinical
leading point, but no longer return to it original shape
61 page file Proffit 4th ed page 360
Pg. 360 "For orthodontic purposes, three major properties of beam materials
are critical in defining their clinical usefulness: strength, stiffness (or its
inverse, springiness), and range."
Pg 361 "Strength = Stiffness x Range"
2007 Proffit 4th ed pg 377
"Interestingly, friction is independent of the apparent area of contact. this is
because all surfaces, no matter how smooth, have irregularities that are
large on a molecular scale, and real contact occurs only at a limited number
of small spots at the peaks fo the surface irregularities (Figure 10-24).
These spots, called asperities, carry all the load between the two surfaces.
Even under light loads, local pressure at the asperities may cause
appreciable plastic deformation of those small areas. Because of this, the
true contact area is to a considerable extent determined by the applied load
and is directly proportional to it."

NiTi>TMA>SS
Asperities are area of contact between two surfaces and ABO 2008
friction is due to the interaction of asperities.
Which has the most friction in a SS slot? a. niti 2007 review Breakdown: TMA>NiTi>SS
b. TMA (correct)
c. ss

97
 Question Answers Sources Discussion
The point which any permanent deformation is first a.The ultimate tensile strength. 61 page file Proffit 4th ed pg 360:
observed in an elastic material upon receiving a load is: b.The proportional limit. (correct) "The most conservative measure is the proportional limit, the point at
c.The range. which any permanent deformation is first observed."
d.Springiness
First sign of permanent deformation is known as what? a.Threshold 61 page file Proffit 4th ed pg 360:
b.Proportional limit (correct) "Although there is a slight difference in the engineering def-inition of the
c.Elastic limit (correct) term elastic limit, it is essentially the same point, and elastic and
proportional limit may be used inter-changeably"
Properties of an ideal wire material for orthodontic a.High strength 61 page file Proffit 4th ed pg 361
purposes include all of the following EXCEPT: b.Low stiffness The properties of an ideal wire material for orthodontic purposes can be
c.High formability described largely in terms of these criteria: it should possess (1) high
d.Low range (correct) strength, (2) low stiffness (in most applications), (3) high range, and (4)
high formability
The typical formation of stainless steel for use in a.18% Chromium and 8% Nickel 61 page file Proffit 4th ed pg 361
orthodontic wires has: (correct)
b.8% Chromium and 18% Nickel
c.80% Chromium and 18% Nickel
d.None of the above.
Most stainless steel wires are made of ? a.18% Chromium 61 page file
b.10% Nickel
c.8 % Nickel
d.a & b
e.a & c (correct)
In 18/8 Stainless Steel wires: a. Chromium prevents corrosion Proffit 4th ed pg 361 and ABO Breakdown
b. Cobalt adds stiffness
c. Titanium adds strength
d. Nickel adds flexibility
i. a and b
ii. b and c
iii. c and d
iv. a and d (correct)
Stiffest wire? Stainless Steel ABO 2008 Proffit p362; Table 10-1
When a round stainless steel wire is used as a a. Twice as much 61 page file Proffit 4th ed pg 369
fingerspring, doubling the diameter of the wire increases b. 4 times as much 2x diameter = 8x strength, 1/16 springiness, 1/2 range
the force it delivers to: c. 6 times as much
d. 8 times as much (correct)
When a round stainless steel wire is used as a a.½ as much (correct) 61 page file Proffit 4th ed pg 370
fingerspring, doubling the length of the wire decreases the b.¼ as much 2x Length = 1/2 strength, 8x springiness, 4x range
force it delivers to: c.1/6 as much
d.1/8 as much
Place the following closing loops in an order from the least 3 < 1< 2 < 5 < 4 (correct) 61 page file
springy to the springiest given that they are made from the
same wire with similar dimensions:

98
 Question Answers
Compared to a standard stainless steel wire, a NiTi wire a.Higher load/deflection ratio, greater 61 page file
possesses: springback and higher formability.
b.Lower load/deflection ratio, greater
springback and lower formability.
(correct)
c.Lower load/deflection ratio, lower
springback and lower formability.
d.Higher load/deflection ratio, greater
springback and lower formability
Benefit of NiTi is what? low load deflection rate
When wire is increased in length the load deflection rate a.Increases
b.Decreases (correct)
c.Stays the same
d.None of the above
For NiTi what gives it its special properties? a. Phase transformation
Which of the following allows application of constant force a. A-NiTi (correct)
b. M-NiTi
What wire would you use to apply a constant force over a a. Martensitic Niti
long period of time? b. Austenitic Niti (correct)
c.Braided
d.SS
Which Niti wire gives a soft gradual force? a. Austenitic niti (correct)
b. Martensitic Niti
The activation phase of a superelastic NiTi involves what a.Austenitic
state? b.Martensetic *
c.Crystalline to amorphous
d.Amorphous to crystalline
When NiTi is activated it goes from? a.Austenitic to martensitic (correct)
b.Martensitic to austenitic
c.Big repeat
Sources Discussion
Proffit 4th ed pg 361-362
"Nitinol exceptionally springy and quite strong but has poor forma-bility"
"A-NiTi has a con-siderably flatter load-deflection curve and greater
springback than M-NiTi, which in turn has much more springback than steel."
61 page file Proffit 4th ed pg 555
ABO 2010 #2 "The flat load-deflection curve of superelastic NiTi (see Figure 14-4)
makes it ideal for initial alignment"
61 page file Increased length = increased springiness = decreased load deflection rate
UNK 2010 (knowing definition of phase transformation helps)
ABO 2008 Proffit 4th edition pg. 362:
"NiTi alloys have two remarkable properties that are
unique in dentistry: shape memory and superelasticity. Both shape
memory and superelas-ticity are related to phase transitions within NiTi alloy
between the martensitic and austenitic forms that occur at a relatively low
transition temperature.
UNK 2010 Proffit 4th ed. pg. 363:
"over a considerable range of deflection, the force produced by A- NiTi
hardly varies. This means that an initial arch wire would exert about the
same force whether it were deflected a rela-tively small or a large distance"
Article #27b.
"The initial activation force required for austenitic NiTi can be 3 times greater
than the force required to deflect a classic work-hardened martensitic wire.
However, once the SIM is formed, the horizontal plateau appears and the
alloy “absorbs” any additional load stress and releases it in constant
amounts during the deactivation phase."
ABO 2008
61 page file ABO article #27a - Pseudoelasticity and thermoelasticity of Nickel-titanium
alloys: A clinically oriented review. Part I: Temperature transitional ranges -
Pg. 592
"Austenite presents a higher modulus of elasticity that results in a greater
stiffness of the wire. In Austenitic alloys, the formation of SIM [stress-
induced martensite] will guarantee the presence of the superelastic behavior
necessary for the relase of light and continuous forces."
61 page file Proffit 4th ed pg 363: see figures 10-6 and 10-7
61 page file Proffit 4th ed pg 363: see figures 10-6 and 10-7
99
 Question
How is superelastic NiTi deactivated?
Heat treated elgiloy has the same stiffness as ?
When you compare Elgiloy with SS
If Chromium-Cobalt alloys are not heat treated, they have? a.Same stiffness as SS (correct)
What is Youngs Modulus of Elasticity?
Where is the Crot if you close a Maxillary diastema with
finger springs?
Answers
a.From martensitic to austenetic
(correct)
b.From austenstic to martensetic
a.NiTi
b.Stainless Steel (correct)
c.TMA
d.Copper NiTi
Elgiloy strength and resilience
improves/increases when you heat
treat it (stiffness stays the same)
b.1/3 stiffness of SS
c.2/3 stiffness of SS
a.Expressed in the stress and strain
curve, deflection and stiffness, Slope
of stress and strain curve to which
stiffness and springiness are
proportional
a. apical 1/3
100
Sources Discussion
61 page file Proffit 4th ed pg 363: see figures 10-6 and 10-7
61 page file Proffit 4th ed pg 361 and ABO Breakdown:
"The heat treatment increases strength significantly. After heat treatment, the
softest Elgiloy becomes equivalent to regular stainless steel"
Article, "Review of contemporary archwires," Kusy:
"In addition to having similar stiffness characteristics as stainless steel,
{Elgiloy} was capable of hav-ing its strength, and more importantly its
formability, modified by heat treatment. This so-called precipitation
hardening heat treatment increased the ultimate strength and resilience of
these archwires without changing the stiffness"
2007 Profitt page 361
ABO 2008 - see reference from Kusy article above
ABO 2010 #2
ABO 2008 says Elgiloy is more brittle than stainless steel. Is this true? Proffit
p362 says they have the same modulus of elasticity and same stiffness.
61 page file see reference from Kusy article above
Article "Review of contemporary archwires" Kusy:
elastic modulus - An engineering property of a material that equals the ratio
of stress to strain, when deformation is totally elastic. In tension or bending
the elastic modulus is of-ten called "Young's modulus."
(low modulus of elasticity = low stiffness and high springiness)
review 2007 Nanda Principles of Biomechanics Ch.1
this is example of uncontrolled tipping where root and crown rotate in
opposite directions
 Question Answers Sources Discussion
Functional appliances accelerate the growth of the mandible. a) First statement is true, second false UNK 2010 ABO article 1 - Early treatment for Class II Division I,
Treated patients have longer mandibles. (correct) ABO 2008
B) First statement false, second true
similar question from different exam: Functional appliances C) Both true
accelerate the growth of the mandible. After 4 years following D) Both false
funitional appliances, treated patients have bigger mandibles
than controls
Both functional appliance pts and surgical pts showed stable TRUE ABO 2009 Pearls article "Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy," Berger
results over time
Clark's twin block is mostly dental false (skeletal>dental) ABO 2009 Article "Treatment timing for Twin-block therapy," Baccetti
ABO 2010 #2T • Greater skeletal (than dental) contribution to correction of molar relation and overjet (occurs via increased mandibular length and ramus height and more posterior direction of condylar
growth.) Skeletal is 55%-61% while dental is 39-45%)

Article "A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst," Schaffer
- Twin block slightly more efficient than Herbst in correcting:
1. molar relationship
2. sagittal maxillomandibular skeletal differential
3. greater elongation of mand ramus

How does a Twin Block help correct a Class II Div 1? a.it allows for a horizontal component ABO 2010 All are true except dental correction
of md growth (correct)
b.it allows you to increase VDO by
removing acrylic from lower part of
Answer:a, b, d appliance so that md teeth will erupt
c.it allows for primarily dental
correction of OJ
d.the acrylic coverage on the lower
anteriors is to prevent flaring of lower
incisors
which of the following explain correction of overjet by the a. length in body of mandible ABO 2008
Twin block? increased (T)
b. most of the class II correction is
Answer:a, c, d dental (F)
c. the lower incisors are capped to
prevent flaring and extrusion (T)
d. vertical ramus growth (T)
Primary effects of a twin-block? a. dentoalveolar tipping 2007 review
b. lengthens mandible (correct)
When to do Twin block? during or slightly after onset of pubertal ABO 2009 Article "Treatment timing for Twin-block therapy," Baccetti:
peak in growth velocity Optimum treatment timing for Twin-block therapy appears to be during or slightly after the onset of the pubertal peak in growth velocity
- late mixed - early permanent dentition
Which are NOT effects of Twin block? a. significant horizontal maxillary ABO 2009 Michigan Article: "Herbst v. T Block" Schaefer et al:
movement - U6 horizontal/maxillary molars were near their original sagittal position
b. maxillary proclination - labial inclination of the maxillary incisors (U1 to vertical point A and U1 horizontal) was reduced significantly
c. mandibular retroinclination -mandibular incisors tipped labially (L1 to mandibular plane, L1 horizontal)
d.all of the above (correct)
What is the worst/poorest for vertical control/anchorage? a. CPHG (correct) UNK 2010 CPHG has distal and extrusive vectors
b. HPHG ABO 2010 #2
c. TPA ABO 2009
d. Nance ABO 2008
e. Twin block
What do you have least vertical control with: Stopped arch 61 page file
With a high-pull headgear, to achieve clockwise movement of a. Distal (correct) UNK 2010 Proffit pg. 530
molar, where should the line of force action be with reference b. Mesial Center of resistance mx: above premolar roots
to the center of resistance? c. Above Center of resistance upper molar: Midroot area
d. Below A force above the CR of the molar will result in distal root movement (aka bodily movement).
Forces below CR of the molar causes distal crown tipping.
Unless the line of force is through the CR of the maxilla, you get rotation of the jaw itself.

Nanda 1997 edition CH7, pg 129-130, fig 7-28

See 4th diagram, which illustrates long outerbow bent down with force distal to CRes

Too much missing from the question (Dr. R) - but the way it is the best answer might be A. (long arm bent down with upward pull)
If its a short arm parallel to the inner bow would have distal root rotation
long arm parallel to the inner bow would have mesial root rotation
Clockwise moment around maxillary molar, where do you put a. Distal to Center of resistance 61 page file
your force? (correct)
b. Mesial to Center of resistance
c. Above center of resistance
d. Below center of resistance
How would you position the arm in a high pull head gear Distal to the CR (correct) ABO 2008
relative to the center of
resistance in order to achieve clockwise rotation of the
MAXILLA?
Where do you put outer bow of HPHG if want to close a. Distal (correct) ABO 2010 -to move palatal plane clockwise, you would want outer bow to be distal to CR of maxilla (this would cause anterior part of palatal plane to tip downward closing open bite) - this would require
anterior open bite and palatal plane clockwise? b. Mesial ABO 2009 a long outer bow bent down so it is below the CR
c. Above
d. Below
e. through center of resistance
High pull occipital HG, how does it correct open bite? Palatal plane tips down anteriorly 61 page file
If you have an open bite patient and elect to treat with high Bend outer bow down (correct) 61 page file need long outer bow bent down (below CR of maxilla) so force is distal to CR
pull HG, what adjustments do you make to the HG?
If you want to counteract the distal tipping of max. molar a.Shorter and more gingival (correct) 61 page file
w/high pull headgear, what should you do to length & position b.Longer and more occlusal
of outer bow? c.Nothing
How can you counter the effects on the molars of a tip-back a. Use a high pull headgear with a long 61 page file
bend? outer bow
b. Use a high pull headgear with a
short outer bow (correct)

101
 Question Answers Sources Discussion
How do you counter balance the tip-back effect of the molars a.Longer outer bow and away from the 61 page file don't think this answer is correct, b/c would want outer bow to be shorter so it is mesial to CR thereby producing a counterclockwise moment
with a high pull headgear? cheek *
In order to produce a counterclockwise rotation of the maxilla a.Mesial (correct) 61 page file
w/ a high pull headgear the force must be ____to the center b.Distal
of resistance? c.Occlusal
d.Gingival
Where must the force be to produce a counter clockwise a. Distal to the center of resistance 61 page file
rotation of the maxilla with high pull headgear? b. Mesial to the center of resistance
(correct)
c. Through the center of resistance
What wouldn't be good for a deep bite: HPHG ABO 2010 #2
Effect of cervical HG: a.Mandible rotates backward 61 page file
b.Palatal plane tipping
c.Both (correct)
How to adjust cervical pull HG to get translation? a.Bend outer bow up (correct) 61 page file needs to go thru CR of molar
b.Bend outer bow down
Using a cervical pull head gear, where would you place outer above CR molar (gingivally) ABO 2008 need long outer bow bent up (above molar CR) so force is distal to CR (will get counterclockwise moment)
bow to prevent distal tipping of the crown? ABO 2009 Pearls
How can you prevent molar crown tip with a Kloehn type a.Lifting the inner bow occlusally 61 page file
cervical headgear? b.Lifting the inner bow gingivally
c.Lifting the outer bow gingivally
(correct)
d.Lifting the outer bow occlusally
With a cervical headgear Kloen type with the bows bent lower a. It would extrude the teeth 61 page file
than the occlusal plane: b. Intrude the molar while distalizing
c. Produce a distal movement with
extrusion of the crowns by moving the
roots to a larger arc (correct)
In an asymmetric head-gear what do you do the bow on the a. Close to cheek 61 page file Nanda 1997 pg 130:
side you want to distalize more? b. Away from cheek 2007 distal forces exist on both sides, but are 3x greater on the long outer bow side than on the short outer bow side
c. Longer
d. Shorter
e. B and C (correct)
f. A and C
In order to distalize a maxillary right molar with an asymmetric a.Cut the left side short (correct) 61 page file
headgear you must? b.Cut the right side short
If using a unilateral headgear to correct Cl II molar on the a. Right - buccal crossbite 61 page file Nanda 1997 pg 130:
right side, a possible side effect would be crossbite b. Left - lingual crossbite lateral forces are directed toward short outer bow side. in this question, the right side would have the long outer bow, so lateral forces should be directed towards the left, which could create a
developing on which side? c. Neither (correct) lingual crossbite on the right side and a buccal crossbite on the left. so answer would be NEITHER
d. Both
What is a side effect of an asymmetric headgear? a. (lingual) Crossbite of the molar of 61 page file
the same side of the longer outer bow
b. (buccal)Crossbite of the molar
of the opposite side of the longer outer
bow
Both correct 4/12/12
Early vs late facemask therapy early = more orthopedic effect; begin ABO 2009 Article "Managing the developing Class III malocclusion with palatal expansion and facemask therapy," Turley:
Ideal time to begin facemask therapy? either in the deciduous or at the - earlier intervention might provide better orthopedic response, but treatment in the late mixed or early permanent dentition can still produce positive results
beginning of the mixed dentition - Younger patients show significantly greater advancement of maxillary structures and more upward and forward growth of the condyle.
(before loss of deciduous molars)
Which are effects of facemask therapy? A. maxillary skeletal protraction ABO 2009 Pearls article “Maxillary development revisited: relevance of the orthopaedic treatment of class III malocclusions,” Delaire
B. forward movement of maxillary
dentition
C. set back of bony menton
D. increase facial height (extrusion of
upper molar limits use in Cl.III with
vertical facial excess)
E. lingual tipping of the lower incisors
F. all of the above (correct)
Facemask tx is contraindicated if upper incisors are proclined. T/T ABO 2010 see above
Greater dental effects are seen in facemask tx of adolescent
pt As children come closer to adolescence, mandibular rotation and displacement of maxillary teeth-not forward movement of the maxilla-are the major components of the treatment result.
Proffit pg 504-505
Which of the following occurs with short Class II elastics: a. Steeper occlusal plane (correct) UNK 2010 because there is a more vertical vector of force
b. No net effect on maxilla
c. Flat occlusal plane
Class II elastics do all of the following EXCEPT: a. close the bite/deepen bite (correct) ABO 2008
b. move the maxilla back ABO 2009 Michigan
Which is NOT an effect of Class II elastics? c. erupt the molars (lower) and incisors 2007
(upper)
d. position the lower jaw forward
e. tip the occlusal Plane
Class III elastic effects a.Counterclockwise 61 page file
b.retrocline lowers
c.procline uppers
d.all of the above (correct)
Straightwire appliances are intended to achieve perfect a. First statement true, second false UNK 2010 Proffit 4th ed pg 603
finishing. However, most cases need some adjustment. b. First statement false, second true) 61 page file "If the appliance prescription and bracket positioning were perfect, such adjustments would be unnecessary. Given both the varia-tions in individual tooth anatomy and the modest precision
c. Both True (correct) of bracket placement, many cases need some adjustment of tooth positions at this stage."
Also worded from other sources as "Pre-adjusted appl are d. Both False
designed to give ideal alignment of teeth, but in finishing Pg 410 Proffit - Straight wire prescriptions section: states that in the edgewise appliance they needed to make in-out bends, tipping bends, and torque bends which the straight wire
some adjustment is needed." prescription makes virtually unnecessary. (therefore we assume this means that the straight wire appliance is supposed to try to eliminate the need for finishing bends and is designed for
perfect finishing)
As for the second portion of the question Proffit p.410 also states "In the contemporary appliance[straightwire appliance], this compensation is built into the base of the bracket itself. This
reduces the need for compensating bends but does not
eliminate them, because of individual variations in tooth thickness."
Muliple T/F: A preadjusted appliance almost always (F- but not certain b/c it seems to ABO 2008
guarantees a good fit of contradict the next statement!)
occlusion but you almost always need to bend the wire to (T)
finish properly.

102
 Question Answers Sources Discussion
50% of expansion is achieved with a lip bumper in: a. 100 days (correct) UNK 2010 ABO article #59- (Murphy) A longitudinal study of incremental expansion using a mandibular lip bumper
b. 200 days ABO 2009 50% of total arch length expansion in the first 100 days, 40% in the next 200 days, (90% over 300 days) and 10% after 300 days
2007
Which are effects of lip bumper? a. 45-55% incisor proclination ABO 2009 Pearls article "The effects of lip bumper therapy in the mixed dentition," Davidovitch:
b. 35-50% molar distalization and distal significant differences in mandibular incisor inclination, molar position, arch length, and arch perimeter existed between treated and untreated subjects.
tipping
c. 5-10% transverse increase in the
intercanine and deciduous
molar/premolar distances
d. all of the above (correct)
Gingival clefting is seen when the following procedure is a. SARPE UNK 2010 Article #7. Surgically assisted rapid palatal expansion. (Suri)
attempting in adults: b. Orthopedic maxillary expansion ABO 2009
(correct) 2007
c. Surgery
a. SARPE
When do you see the greater incidence of a dehiscence in b. RPE (correct)
an adult? c. Poor OH 2007 review
When maxillary expansion is carried out without crossbite, a. Transverse expansion of the 2007 Article #58
which of the following is correct? maxillary arch
b. Transverse expansion the
mandibular arch
c. Significant increase in the
mandibular arch to correct 3-4 mm of
crowding
d. The expansion in the
mandibular arch is insignificant
e. a
f. a,b
g. a,b,c (correct)
h. d
When maxillary expansion is carried out without crossbite, a.Significant increase in the 61 page file
which of the following is correct? mandibular arch to correct 3-4 mm of
crowding *
One millimeter (1mm) increase in intermolar width results in a.1 mm increase in arch perimeter (for 61 page file looked up AJO-DO
approximately: intercanine) (4/12/12)
b.2 mm increase in arch perimeter Maxilla: .7 both molar and premolar
(none) Md:molar .25, premolar .5, canine 1
c.0.25 mm increase in arch perimeter *
(correct if mandibular molars, 0.7mm
for maxillary)
d.none of the above
** .5mm increase in arch perimeter for
interpremolar
The greatest increase in arch perimeter is achieved by: rpe 61 page file No reference
Where is palatal expansion more pronounced? a.Inferiorly and posteriorly ABO 2008 ABO 2008 question comments says "It separates in a pyramidal fashion (fans out), wider in the anterior and wider in
b.Inferiorly and anteriorly * 61 page file the inferior dimension."
c.Superiorly and posteriorly
d.Superiorly and anteriorly Proffit p284-285
"The maxilla opens as if on a hinge,with its apex at the bridge of the nose. The suture also opens on a hinge anteroposteriorly separating more anteriorly than posteriorly"
Which of the below is true about the suture expanding in a. It expands more anteriorly than 61 page file
maxillary expansion? posteriorly and more inferiorly than
superiorly (correct)
b. It expands more posteriorly than
anteriorly and more inferiorly than
superiorly
c. It expands more anteriorly than
posteriorly and more superiorly than
inferiorly
d. It expands more posteriorly than
anteriorly and more superiorly than
inferiorly
After maxillary expansion, how long does it take to re- a.4-6 weeks 61 page file
establish the suture? b.2-3 months
c.4-6 months *
d.9 months
What is limit of RPE? a. zygoma ABO 2009 Article "Surgically assisted rapid palatal expansion:A literature review," Suri
b. Coronoid process(4/15/12) ABO 2008 "The areas of resistance have been classified as anterior support (piriform aperture pillars), lateral support (zygomatic
c. lateral ptyregoid plate 61 page file buttresses), posterior support (pterygoid junctions), and median support (midpalatal synostosed suture)"

The limit of maxillary expansion is dictated by a. The amount of tipping you can get 61 page file
by the teeth
b. Nothing, you can get all the
expansion you want
c. Zygomatic arches (correct)
d. How large the palatal suture is
What limits your RPE? a.Coronoid process of mandible * 61 page file
b.Sutures
c.Etc.
Maximum expansion of maxilla {limited by} a.Pterygoid Plate 61 page file
RPE is used, it is necessary to take radiographs to check that a. True 61 page file
the midpalatal suture has split: b. False (correct)
Bonded RPE is important for: controlling vertical and freeway space ABO 2009 Michigan prevents max molar extrusion and mandible from moving down and back
Opened RPE .5 mm/day, teeth start moving mesially, what a.Normal effect * 61 page file
happened?
RPE. What happens to A-point? a.Stays the same 61 page file Breakdown: moves slightly forward and down
b.Moves forward slightly *
c.Moves backward slightly

103
 Question Answers Sources Discussion
Patients treated with arch length expansion procedures in the a.Maintain the expansion for an 61 page file
mixed dentition: indefinite time period after treatment
b.Relapse to the original arch length
immediately after treatment
c.Lose arch length, in the majority of
cases, until the arch length is less than
the pretreatment arch length (correct)
d.Relapse to the original arch length
after an average time of 7 years
posttreatment
In a patient that started with significant lower crowding, when a.Arch length and arch perimeter 2007
you remove the retention, what happens? decreases 61 page file

What happens when canines expand? a. Highly prone to relapse (correct) 61 page file
TPA can be used for all of the following except: a. vertical anchorage ABO 2009 Michigan Proffit 4th ed. pg 476
b maintaining Leeway space (correct) 2007 review The best indication for a transpalatal arch is when one side of the arch is intact and several primary teeth are missing on
c. A-P anchorage the other side. In this situation, the rigid attachment to the intact side usually pro-vides adequate stability for space maintenance. When primary molars have been lost bilaterally,
d. Rotate molars around the palatal however, both per- manent molars may tip mesially despite the transpalatal arch, and a conventional lingual arch or Nance arch is preferred.
root
e. Transverse stability
What are the sequela of having inadequate lingual crown a. Creates crossbites 61 page file
torque on mandibular molars? b. Elongation of lingual cusps
c. All of the above (correct)
d. None of the above
The distance between two magnets decreases by 50%, the a.50% 61 page file (1/d)2
force increases by? b.100%
c.200%
d.400% (correct)
Which of the following statements about orthodontic a. Intrusion is often required in leveling. 61 page file
mechanotherapy in adult patients is false: b. Forces must be kept very light.
c. Orthodontic space closure is often
contraindicated. (correct)
d. Successful camouflage of jaw
discrepancies requires very careful
planning.
A pt you are treating w/premolar ext has ceramic brackets 3-3 a. Poor maxillary anterior torque ABO 2008
& SS brackets on the posterior teeth, what should be of b. Teeth will move slower 61 page file
concern during tx? c. Loss of anchorage during canine 2007
retraction (correct)
After partial anterior diastema closure & space redistribution a. Remove fixed appliances, place 61 page file (4/15/12)
in adult female, best approach is: fixed retention, 3 months recall. Depends on space opened was ideal, or space was left after the builds.
b. Remove fixed appliances, do Protrocol: Open Spaces for laterals, removed brackets from laterals, after restorations place brackets back on and close space
composit build-ups, 3 months recall. If space was ideal before treatment, do immediately
c. Do composite build-ups, remove
fixed appliances, 3 months recall.
d. Remove fixed appliances, do
composite build-ups, place fixed
retention. (correct)
When treating a cl II malocclusion it is favorable to decrease T/F 61 page file
the SN-MP angle(true), because it will prevent long term
relapse(false).(4/12/12)
Maxillary incisor retraction during orthodontic treatment leads 1. Forward mandibular displacement 61 page file
to: 2. Distal mandibular displacement
3. Condylar displacement
4. Growth of the nose and chin

a) 1 and 4
b) 2 and 3
c) 4 only
d) None of the above (correct)
Pain associated with orthodontic treatment is: a. More commonly found when heavy 61 page file (P312)
forces are used. (correct)
b. Increased by repetitive chewing.
c. Typically persistent until the next
activation.
d. Of unknown source.
How do you correct a deep bite: Extrude posterior teeth, intrude 61 page file
anteriors

104
 Question Answers Sources Discussion
How to purely rotate a tooth? a. 1st order bends (correct) ABO 2009
b. 2nd order bends ABO 2008
c. third order 2007
d. 1st and 2nd order
Why do you have to do 1st order bend in the traditional edgewise appliance To compensate for the B-L thickness of the teeth 2007 Profitt page 420
61 page file
To align marginal ridges what kind of bend? a. 1st order 61 page file
b. 2nd order (correct)
c. 3rd order
d. 4th order
The duration threshold of a light force capable of producing tooth movement in a.4-6 minutes /day 61 page file Proffit 4th ed p335
humans is b.4-6 hours/day (correct)
c.8-12 hours/day
d.18-24 hours/day
In a physiologic response to sustained pressure against a tooth, movement begins a. 1 hour of force application 61 page file Proffit 4th ed p337, table 9-2
after: b. 24 hours of force application
c. 48 hours of force application (correct)
d. 72 hours of force application
In a straight wire bracket what happens to the root of a canine when the slot is a.Goes mesially 61 page file
engaged? b.Goes distally (correct)
c.Nothing
The normal eruptive force of a tooth has been estimated at? a. 75-100 grams 61 page file
b. 50-75 grams
c. 25-30 grams
d. 2-10 grams (correct)
Which of the following canine movements would be ideally achieved w/ a force of 35- a. Tipping, rotation, extrusion (correct) 61 page file Proffit 4th ed p340, table 9-3
60gm: b. Tipping, intrusion , extrusion
c. Tipping, translation, extrusion
d. Extrusion, intrusion , rotation
The optimum force to retract a canine is a.50 to 75 grams 61 page file
b.75 to 100 grams
c.100 to 150 grams (correct)
d.150 to 300 grams
The average force necessary to intrude a mandibular central incisor is? a. 250 grams 61 page file
b. 200 grams
c. 20 grams (correct)
d. 50 grams
a.250 grams 61 page ABO Breakdown 15-25g
The average force necessary to intrude a maxillary central incisors is? b.300 grams
c.25 grams (correct)
d.40 grams *
Lingual torque in mandibular anterior, what happens posterior a.Intrusion and mesial 61 page file
In order to have bodily movement you need: a.A force and a counter-moment (correct) 61 page file
b.A force
c.A moment
d.A couple
How do you minimize tipping when retracting canines? a. Use narrow bracket 61 page file
b. Maximize intrabracket moment (correct)
c. Use uprighting spring
d. Something else
Where is the Crot if you close a Maxillary diastema with finger springs? a. apical 1/3 review 2007 Nanda Principles of Biomechanics Ch.1
this is example of uncontrolled tipping where root and crown rotate in opposite directions
Diastema closure of crowns of 2 centrals tipped away from eachother: where is the Apical 1/3 of root ABO 2008
center of rotation when tipping 2 centrals together with removable appliance?
If you tip maxillary central incisors toward each other with springs on a Hawley to a.In the apical 1/3 of the root (correct0 61 page file
close a diastema, where is the center of rotation? b.In the center of the root
c.In the center of the entire tooth
In a straight wire appliance, adding labial root torque in the segment of the wire a. Intrusion force on the incisors and extrusion force on the 61 page file
engaged in maxillary incisors brackets will cause an: posterior teeth. (correct)
b. Extrusion force on the incisors and intrusion force on the
posterior teeth.
c. Intrusion force on incisors and posterior teeth.
d. Extrusion force on incisors and posterior teeth.
What is parallel forces in opposite directions? a.Moment 61 page file
b.Couple (correct)
c.Rotation
What happens to the friction in sliding mechanics when forces are parallel to the a. Increase 61 page file
archwire? b. Decrease (correct)
c. Stays the same
a.Closer to the lesser bending moment?
Helices in archwire. Where should they be located to decrease the force? b.Area of the largest bending moment?(think this is correct) 61 page file
Which is true if you provide a lingual force and lingual root torque to a maxillary a. Crown tip 61 page file Proffit 4th ed p375
incisor depending on the M/F ratio? b. Root tip
c. Bodily movement
d. All of the above (correct)
Where are helicies placed? a. In areas of the smallest bending moment 61 page file
b. Anywhere
c. In areas of the largest bending moment (correct)
d. All of the above
A helix is placed in the wire when leveling: a. Where wire will easily bend 61 page file
b. Where wire will not easily bend (correct)
c. In the center of the wire

105
 Question Answers Sources Discussion
What is a distance along any given axis? a. A force (4/12/12) 61 page file Force definition action applied to a body, determined my magnitude and direction
(not a complete question) b. A couple Moment: force that cause rotation
c. A moment
Stationary anchorage refers to: a.Equal movement of the dental units on both sides of an 61 page file Proffit 4th ed p345 Fig 9-18
extraction site toward each other.
b.More movement of the dental units on one side of an
extraction side than the other.
c.Bodily movement of dental units on one side of the
extraction site and tipping of dental units on the other side.
(correct)
d.None of the above
First molar rotates, mesial goes lingual relative to 2nd PM. If you put straight wire a. Premolar extrusion 61 page file
in, what will happen? b. Molar moves buccally (correct)
c. Molar moves lingually
The anchorage value of a tooth is function of all of the following, except: a. Root surface area 61 page file
b. PDL area
c. Tooth’s inclination relative to the direction of the force
d. Crown anatomy (correct)
A force is applied to the crown of a tooth (Moment of the force is MF), and a a. MC/MF = 0 61 page file a. uncontrolled tipping
counterbalancing moment is generated by a couple within the bracket (Moment of b. 0 < MC/MF < 1 (correct) c. translation
the couple is MC), the resulting tooth movement is a controlled tipping when: c. MC/MF = 1 d. torque
d. MC/MF > 1
In an .022 slot size system, the maximal slot size measurements are: a. 18 x 25 61 page file .018 slot is 18x25
b. 22 x 22
c. 22 x 28 (correct)
d. 22 x 25
e. 25 x 22
f. 25 x 22
You want to tip the root of a premolar distally. Given the following 2 options 1) Both if an option. ABO 2008
rebonding counterclockwise 2) gable bends (bending the wire), which is better?
PM bracket is off can correct by reposition clockwise and V bend put bracket more clockwise, place V bend so that wire 61 page file
contacts the bracket on gingival aspect on distal and incisal
apect on mesial

106
 Question Answers Sources Discussion
Type of resorption associated with autotransplantation: a. external resorption (correct) UNK 2010 Panos exaggerate root resorption by up to 20% so PAs are preferred. The worst area of a pan. Most accurate location of a pan is the mx anterior. Both of these are caused
b. internal resorption ABO 2008 Resorption and ankylosis are seen so it is likely external resorption.
ABO 2010 #2
2007
What is the most likely cause of loss of a tooth following a. External resorption (correct) 61 page file
autotransplantation? b. Internal resorption
c. Ankylosis
What is the limiting factor for SARPE? a. zygomatic buttress (correct) UNK 2010 Support for zygomatic buttress as answer:
b. Coronoid process Article "Surgically assisted rapid palatal expansion:A literature review," Suri
"The areas of resistance have been classified as anterior support (piriform aperture pillars), lateral support (zygomatic
buttresses), posterior support (pterygoid junctions), and median support (midpalatal synostosed suture)"
The limit of maxillary expansion is dictated by a. The amount of tipping you can 61 page file
get by the teeth
b. Nothing, you can get all the
expansion you want
c. Zygomatic arches (correct)
d. How large the palatal suture is
What is limit of RPE? a. zygoma (correct?) ABO 2009 Article "Surgically assisted rapid palatal expansion:A literature review," Suri
b. Coronoid process ABO 2008 "The areas of resistance have been classified as anterior support (piriform aperture pillars), lateral support (zygomatic
c. lateral ptyregoid plate 61 page file buttresses), posterior support (pterygoid junctions), and median support (midpalatal synostosed suture)"
(correct?) 4/15/12
Assuming this is an orthopedic RPE then coronoid would be a limiting factor
SARPE: Zygomatic buttress(lateral) and lateral pterygoid plates(posterior)

15 yo male needs SARPE. Expansion is predictable and stable F/F ABO 2009 Michigan
ABO 2010 #2
Which procedure does not use hinge axis a. SARPE 61 page file
Latency period after SARPE. Latency period forms callus. T/T ABO 2009 Article "Surgically assisted rapid palatal expansion:A literature review," Suri:
"The surgical corticotomy and the initial appliance activation intraoperatively are followed by a period of rest before starting expansion of the appliance This rest period is called the latency period.This
gives the tissues time to form a callus but is too short to allow for
consolidation. Callus distraction has been reported to create a regenerate that readily ossifies and stabilizes and thus provides increased stability. Most authors agree that the latency period is essential,
but slight variations in its exact duration were seen in the literature"

- latency period time ranged 5-7 days

Best surgical procedure in a patient with TMD problems? a. IVRO (correct) UNK 2010 Text: Oral and Maxillofacial Surgery: Orthognathic surgery, Raymond J. Fonseca
b. VRO ABO 2009 -pts tend to have fewer TMJ complaints after IVRO than after BSSO
What is best surgery for pt with TMD? c. BSSO ABO 2008
d. TOVRO(setbacks only) Article #29 (p98-99)
Class 3 prognathic with TMD. What surgery is best?
A patient w/severe Class III malocclusion w/ TMD symptoms, a. BSSO 61 page file
what’s the best surgical procedure? b. Vertical ramus osteotomy 2007
(correct)
c. Maxillary impaction
If you have a TMD patient going for surgery and you find a.Delay until both are fixed ABO 2008 Proffit 4th ed p710
interferences and open space the appointment before her b.Delay until space is closed
scheduled surgery. then what should you do? (4/12/12)
c.Delay until interferences are
fixed but not spaces
d.Do not delav for either reason
The orthognathic surgical procedure most likely to cause post- a. Lefort I osteotomy 61 page file breakdown
operative TMJ sounds such as popping or crepitation is: b. Mandibular subapical
osteotomy
c. Mandibular advancement *
d. Mandibular set-back
e. Mandibular alveolar
advancement
A 28 YO female presents w/ skeletal Class III open bite, a. Lefort osteotomy for maxillary 61 page file
maxillary deficiency, and mandibular prognathism. After intrusion
appropriate ortho tx with b. Mandibular set-back
leveling & aligning, the skeletal condition remained the same. c. Maxillary osteotomy for
The hand articulated models occlude well. The surgical maxillary advancement
treatment of choice is: d. Anterior maxillary segmental
osteotomy
e. Reduction genioplasty
f. Mandibular osteotomy for
autorotation
i. b, d, and e
ii. b, c and e
iii. a, b, c, and e *
iv. a, b, and e
In open bite malocclusions, surgery is usually performed: a. Only in the maxillary arch * 61 page file
b. Only in the mandibular arch
c. In both arches
d. In the premaxillae
The presurgical orthodontics preparation of an 18 YO male with a. Alignment and leveling of the 61 page file
Class III mandibular prognathism requires: arches
b. Expansion of the upper and
lower arches
c. Decompensation of the dental
arches
d. Lingual tipping of the lower
incisor teeth
i. a and b
ii. c and d
iii. a and c *
iv. a and d
What are the benefits of giving platelet rich plasma during a. because plasma has platelet UNK 2010
surgery cound more than 250000
b. growth factors (correct)

107
 Question Answers Sources Discussion
What are the advantages to giving platelet rich plasma during a.You are in a hospitalized ABO 2008
surgery? setting
b.Because the plasma has a
platelet count of over 250,000
c.Because it contains all the
nutrients necessary for healing
except _? (can't remember) and
fibronectin.
d.Because it contains platelet-
derived growth factor,
transforming growth factor (TGF),
and insulin-like growth factor.
(correct)
What is the order of a 2-jaw surgery? a. ABCDE 2007 Proffit-Contemporay Management of Craniofacial Deformities; Chapter 11Combining Surgical procedures in the Mandible and Maxilla:
a. maxillary downgraft b. CDABE 61 page file LeFort I osteotomy completed. With an intermediate occlusal splint (or the combined two-stage splint) in place and the jaws held together in maxillomandibular fixation (MMF), the maxilla is repositioned
b. maxillary fixation c. ABCED (correct) and stabilized with RIF (Fig. 11-4). At this point, the MMF is released. Sagittal-split osteotomies are completed bilaterally in the mandible with osteotomes.The distal tooth-bearing segment of the mandible
c. BSSO is repositioned, with the final occlusal splint used as a guide. With the patient's teeth again held firmly together in MMF, the mandibular osteotomy sites are stabilized and fixed with RIF.
d. Mandibular fixation
e. Intermaxillary fixation
Order of 2 jaw surgery: a.BSSO, LeFort 1, fix maxilla, ABO 2009 Michigan
intermaxillary fixation, fix ABO 2008
mandible
b.Maxillary Lefort 1, fix maxilla,
Mandibular BSSO, fix mandible,
intermaxillary fixation neither answer seems correct, but if had to pick an answer, choose B
How do you minimize amount of mand growth in a 16 yo pt a. wait till pt is 22 yo ABO 2009
when doing surgery? b. take serial cephs until no
growth for 1 yr (correct)
Which of the following is false about placement of RIF (Rigid a. Is required for all orthognatic 61 page file ABO Article #17 - Bailey - Stability and predictability of orthognathic surgery - Page 275
Internal Fixation): surgeries, including the highly "For acceptable stability, RIF does not appear to be required for procedures in the highly stable or stable categories. RIF does make a difference, however, when both jaws are repositioned
stable. (correct) simultaneously. The combination of maxilla up plus mandible forward and its class III counterpart, maxilla forward plus mandible back, can be considered stable (by the same criteria listed above) only if
b. Can displace the condyles. RIF is used"
c. Has been suggested as a
factor of postsurgical TMD.
d. Makes a difference when both
jaws are repositioned
simultaneously.
Mandibular advancement, what procedure is best a.BSSO 61 page file
What would you want presurgically if a patient were to have a a. Maximum retraction of the 61 page file
mandibular advancement only? lower incisors *
b. Maximum retraction of the
upper incisors
If you are preparing for a mandibular advancement which is the a.Extract lower 1st PM’s * 61 page file
best treatment? b.Extract lower 2nd PM’s
c.Extract upper 1st PM’s
d.Extract lower incisor
According to the review presented in this study [Bailey et al.], a. Condylar resorption 61 page file ABO Article #17 - Bailey - Stability and predictability of orthognathic surgery - Page 276
which of the followings postsurgical changes is most likely to be b. Increased mandibular length "Condylar resorption after mandibular advancement and relapse into anterior open bite have been reported as potential long-term clinical problems. Our long-term data now have placed these concerns in
observed in Class II patients with mandibular advancements and c. Anterior open bite perspective: condylar changes occur in 5%-10% of patients who have surgery to advance the mandible, but a long-term increase in mandibular length (ie, growth at the condyles) is as likely as a decrease
open bite corrections: d. Long-term increase in overbite because of resorption, and, AFTER OPEN BITE CORRECTION, A LONG-TERM INCREASE IN OVERBITE IS MORE LIKELY THAN RETURN OF OPEN BITE."
(correct)
Which is most unstable surgical procedure? a. max downfracture ABO 2009 ABO breakdown pg 14 and Proffit 4th edition:
b. max transverse expansion -max transverse expansion is furthest down the list in terms of stability, but Proffit lists max downfracture and max transverse expansion both in the "Least stable category with 40-50% relapse"
(correct)
c. Le Fort I
d. Both A and B
Which is the least stable surgical procedure(s)? a. Mandibular advancement ABO 2008
b.Maxillary downgraft (correct)
c.Maxillary expansion (correct)
According to Bailey et al., a surgical treatment that has less than a.Highly stable 61 page file ABO Article #17 - Bailey - Stability and predictability of orthognathic surgery - Page 273
20% chance of significant posttreatment change and almost no b.Stable (correct) HIGHLY STABLE - less than a 10% chance of significant posttreatment change
chance of major posttreatment change is considered: c.Stable if modified STABLE - less than a 20% chance of significant post-treatment change and almost no chance of major posttreatment change
d.Problematic STABLE IF MODIFIED IN A SPECIFIC WAY - eg. rigid internal fixation (RIF) after surgery
PROBLEMATIC - a considerable probability of major posttreatment change.
According to Bailey et al., the most stable orthognathic a)Mandibular set back 61 page file ABO Article #17 - Bailey - Stability and predictability of Orthognathic surgery pg 273
procedure is: b)Mandibular advancement Most stable: Maxillary Impaction>mandible forward>maxilla forward
c)Superior reposition of the Least stable: Maxillary transverse expansion>Maxilla down>Mandible retraction
maxilla (correct)
d)Maxillary advancement
Which is the most stable surgical procedure? a. Mandibular advancement 61 page file
b. Maxillary impaction *
c. Maxillary downfracture
d. Mandibular setback
What is the least stable surgical movement? a. Mandibular advancement 61 page file
b. Mandibular setback
c. Maxillary downfracture
d. Maxillary expansion (Proffit
705)
Most unstable sx. a.Maxilla down 61 page file
b.Maxilla expanded
c.A & B *

108
 Question Answers Sources Discussion
Answer questions - according to the Hierarchy of predictability 1. Downward movement of the 61 page file ABO Article #17 - Bailey - Stability and predictability of orthognathic surgery (2004) -
and stability for orthognathic surgical procedures. maxilla
a) Highly stable Answer: d
b) Stable
c) Stable if modified in a specific way 2. Asymmetry surgeries
d) Problematic Answer: c

__ 1. Downward movement of the maxilla 3. Superior reposition of the

maxilla
__ 2. Asymmetry surgeries Answer: a

__ 3. Superior reposition of the maxilla 4. Advancement of the maxilla

(<8mm)
__ 4. Advancement of the maxilla (<8mm) Answer: b

__ 5. Maxilla up and mandible forward 5. Maxilla up and mandible

forward
__ 6. Maxillary expansion Answer: c

__ 7. Maxilla forward and mandible back 6. Maxillary expansion

Answer: d
__ 8.Mandibular advancement in patients with short or normal
face height and less than 10 mm of advancement 7. Maxilla forward and mandible
back
__ 9. Surgical repositioning of the chin via lower border Answer: c
osteotomy
8.Mandibular advancement in
__ 10. Mandibular set back patients with short or normal face
height and less than 10 mm of
advancement
Answer: a

9. Surgical repositioning of the

chin via lower border osteotomy
Answer: a

10. Mandibular set back

Answer: d

Orthodontic presurgical treatment of Class III malocclusions a.Labial movement of the 61 page file
often consist of: mandibular incisors
b.Lingual movement of the
maxillary incisors
c.Rapid palatal expansion
d.a and b *
e.a and c
Long term stable results of a transverse 9 mm palatal deficiency a.Palatal expansion device 61 page file
in a 22 YO female is best achieve when treated by: b.Surgical expansion and
orthodontics *
c.Lefort osteotomy and
orthodontics
d.Corticotomies and anterior
maxillary segmentalization
e.Bone grafting of the posterior
maxilla and vomer bone
In the surgical treatment of Class II open bite via bilateral a.Widening of the palate 61 page file
posterior maxillary intrusion procedure, relapse is minimized by: (midsagittal split)
b.Overcorrection of the freed
segments during surgery
c.Skeletal wire fixation through
the buttresses
d.Passive repositioning of the
segments during surgery *
In the adult skeletal Class III open bite malocclusion, occlusal, a.Maxillary advancement, 61 page file
functional and esthetic results can be obtained with a posterior intrusion of the maxilla
combination of orthodontics and surgery. The most likely and mandibular advancement
surgical procedures applied are: b.Mandibular set-back reduction
genioplasty
c.Maxillary advancement,
posterior maxillary intrusion and
mandibular set-back *
For distraction osteogenesis a. Allow 5-7 days before 1st 61 page file ABO Breakdown
activation
What is the latency period following the distraction for 5-7 days ABO 2008
osteogenesis osteotomy?
Symphysis distraction causes buccal tipping of condyle (lateral ABO 2009 Michigan Angle Orthodontist, Vol 73, No 2, 2003 "Symphyseal Distraction and Its Geometrical Evaluation"
condylar rotation) "effect of the procedure on the condyle was only 3 degrees of distolateral rotation"

Graber pg 931: there is rotational movement of condyle when symphysis is widening and lengthening are performed through distraction
What is NOT a side effect in mandibular symphysial distraction? Buccal tipping of mandibular ABO 2010
posterior segments
How can the maxilla be overimpacted? a. Poor Planning 61 page file
b. lack of boney contact
c. increased masticatory function
d. all of the above*
When doing a maxillary impaction, what factors are taken into a. Resting lip/tooth 61 page file
consideration? b. Full smile lip tooth
c. All of the above *
d. None of the above
What is NOT a desirable side effect after maxillary impaction a. Nasal tip rises(correct) 61 page file Proffit 4th ed pg 704:
surgery? b. Alar base widens (correct) Maxillary surgery via LeFort I osteotomy rarely has a positive effect on the appearance of the nose and may com-promise it. Moving the maxilla up and/or forward can have two major deleterious effects on
c. Nasal tip drops the nose; rotation of the nasal tip upwards resulting in deepening of the supratip depression, and widening of the alar base.
d. Alar base narrows 4/14/12: Both tip goes up and alar widens

109
 Question Answers Sources Discussion
What is the result of a VY closure for surgery? increase vermillion show and 2007 review Graber 2000 pg 72
lengthen philtrum
If you do a maxillary impaction for a hyperdivergent patient who a.Mandibular advancement 61 page file
already has a class I occlusion, then you also need to consider? b.Maxillary advancement or
mandibular reduction *
c.Nothing
With maxillary expansion, widening of the alar base is due to: a. Unpredictable side effect 61 page file
b. Encroachment of the nasal
septum
c. Improper reattachment of the
muscles around ANS
d. None of these seem right
(correct)
Lefort I osteotomy in combination with orthodontic treatment is a.Maxillary intrusion 61 page file
usually used for the following maxillofacial corrections: b.Widening of the palate
c.Correction of facial asymmetry
d.Closing an anterior open bite
e.All of the above *
Which procedure is rarely necessary when performing a Le Fort a. Removal of bone from the 61 page file Proffit 4th ed p688, fig19-3
I downfracture of the maxilla: (P679) lateral walls of the nose.
b. Partial resection of the inferior
turbinate**
c. Shortening the nasal septum
d. Removal of bone from the
lateral walls of the maxillary sinus
Which of the following surgical procedures is likely to require a a.Le Fort I downfracture.** 61 page file (P679)
graft for stabilization: b.Bilateral sagittal split osteotomy
c.Transoral vertical oblique
ramus osteotomy
d.Segmental retraction of the
anterior maxilla
Which procedure would you perform for a hyperdivergent patient a. 2 jaw, maxillary downgraft and 61 page file
with a long anterior face height? mandibular advancement
b. 2 jaw, maxillary 3 piece and
mandibular advancement
c. At least maxillary impaction *
What is the ratio of the amount of bony vs. soft tissue a.1:1 * 61 page file ABO Breakdown
advancement in an advancement genioplasty? b.1:2
c.1:3
d.1:4
The sagittal split osteotomy is the procedure of choice for the a. Relapse, posterior open bite 61 page file
advancement of the mandible. The following complications are and numbness of the tongue
often associated with this surgical procedure b. Numbness of the lower lip,
laterognathia and Class III
relations
c. Condylar sagging and post-
surgical trismus *
d. Numbness of the lower lip,
facial paralysis and anterior open
bite
When do you not have to level the curve of spee pre-surgically? a.Brachyfacial 61 page file Proffit 4th ed. pg 711.
b.Short lower facial height "The guideline is that extrusion generally is done more easily postsurgically
c.Deep bite
d.all of the above *
When wouldn’t you level the curve of spee? a. In maxillary downfracture 61 page file
surgery
b. In mandibular surgery (unless
brachyfacial)
c. All of the above
d. None of the above*
When do you level the curve of Spee in a brachyfacial patient? a. Before surgery 61 page file
b. During surgery
c. After surgery *
In what type of surgery do you not need to level both maxillary a. Mandibular advancement 61 page file
and mandibular arches? b. Maxillary downgraft
c. Three piece maxillae**
Limits of surgical procedures? (Proffit p. 675) a. Max impaction: anterior limit = 61 page file Don't count on these numbers
9-10mm
b. Maxillary advancement = 7-8
mm (9-10mm)
c. Maxillary expansion = 5-6 mm
(9-10mm)
d. Mandibular advancement = 9-
10 mm
e. Mandibular setback = 10 mm
Soft tissue responses after a double jaw surgical procedure, a. Show greater changes in 61 page file
when compared with a single jaw double jaw surgery, with more
fullness of the lips
b. Show fewer changes in single
jaw surgery, due to less
movement *
c. Show similar changes, except
in the lower lip and chin.
d. Show a greater reduction in
the upper and lower lip with the
double jaw surgical procedure

110
 Question Answers Sources Discussion
Gingival grafting is often required before a genioplasty a. A genioplasty is often 61 page file Proffit pg.710
procedure because: associated with use of Cl II
elastics (P694)
b. A genioplasty often causes
labial tipping of the lower incisors
c. Incision lines for genioplasty
can stress gingival attachment as
the healing leads to recession.*
d. Grafting minimizes post-
surgical pull of gingival fibers and
guarantees more stability.
Which genioplasty techniques is considered the current best a. Lower border osteotomy* 61 page file
approach for chin augmentation: b. Silicon implants
c. Porous hydroxylapatite
implants
d. Bone grafts
All the following are advantages to mandibular setback using a. Excellent control of the 61 page file (P679)
(BSSO), except: condylar segments 4/15/12
b. Osteosynthesis screws can be BSSo or TOVRO, if you do BSSO you have these complications, setbacks have higher changes of neural sensory
employed for fixation TOVRO: less time and less neural changes
c. Early mobilization of the jaw
d. Low incidence of producing
neurosensory changes*
A patient with a severely retrognathic mandible will undergo a. Masticatory efficiency will 61 page file
surgery to advance her mandible, which of the following are increase* 2007
true? b. No change in masticatory
efficiency
c. Bite force will increase?
Post surgical alterations in the position of the hyoid bone a. No significant changes in A-P 61page file ABO Breakdown
following correction of mandibular prognathism include: position of the hyoid bone in
relation to the anterior pharyngeal
wall
b. Hyoid bone was directed
downward but not backward
c. Physiologic adaptations
occurred to insure maintenance
of the airway
d. All of the above (4/15/12)
e. None of the above
In the adult Class II Div 1 malocclusion with an ANB of 8 a. In the maxillary arch 61 page file
degrees and a favorable nasolabial angle surgery is usually b. In the mandibular arch *
performed: c. In both arches
d. At pogonion
What teeth would you extract in a Class II patient which has Upper 5'so Lower 4's and 8's. ABO 2008
mild-moderate
crowding in both arches and retruded mandible to prepare them
for surgery?
A- It’s better for pt to have rhinoplasty & orthognathic surgery in a. A- 1st statement is correct, 61 page file (P693)
same procedure. B- Simultaneous max surgery & rhinoplasty 2nd statement false. (correct 4/15/12:T/F
can easily be accomplished. according to proffit) A True it is possible but not easy
b. B- 1st statement is false,
2nd statement is correct.
c. C- Both statements are
correct.
d. D- Both statements are
false
Which is an advantage to mand. setback using transoral vertical a.Excellent control of the 61 page file
oblique ramus osteotomy (TOVRO): condylar segments
b.Osteosynthesis screws can be
employed for fixation
c.Early mobilization of the jaw
d.Requires relatively less time
than a (BSSO) procedure w/
lower incidence of neurosensory
changes*
Which of the following are most common post-op occlusal probs a.Posterior open bite, bilaterally, 61 page file
noted in pts who have combined surgical & ortho tx for mand immediately after removing
excess: fixation **
b.Appearance of Class II
malocclusion or mandibular
asymmetry soon after functions
resumed
c.Condyles are located
posteriorly in the fossa creating
and anterior open bite
Which sutures get split with an RME? a. Palatal 61 page file
b. Circummaxillary
c. Circumzygomatic
d. All of the above (correct)
What happens to A point during an RME? a. Moves forward (correct) 61 page file
b. Moves downward (correct)
c. Moves backward
d. Moves upward
e. Doesn’t move
What is the most predictable site to get a bone graft from? a.Ramus 61 page file
b.Iliac crest of the hip (correct)
c.Chin
Sx Scenerio: Mx and Md “mild to moderate” crowding”, Md L4s (U5s only if max arch needs ABO 2010
retrognathic with dental compensations. to be decompensated
Which teeth do you extract?

111
 Question Answers Sources Discussion
All are reasons to extract before surgery EXCEPT: a. transverse issues (correct) ABO 2010
b. crowding
c. dental decompensation
d. overjet
e. excessive protrusion
What type of bone can you not use for ridge augmentation? a. Hydroxyapetite (correct) ABO 2010
b. FDDB freeze dried bone
allograft?
c. Hip graft
After maxillary down fracture. What happens to growth? a. the maxilla continues to grow ABO 2010 also worded as a "maxillary impaction" rather than "maxillary down fracture" depending on the source
vertically as normal (correct) 61 page file
b. the maxilla can still grow ABO 2010 #2 "Considerations for Orthognathic Surgery During Growth Part 2" Wolford AJODO 2001 pg 105:
horzontally "The LeFort 1 osteotomy, will inhibit further AP maxillary growth while allowing vertical mx growth to continue."
c. the maxilla can still grow both "Mandibular growth continues normally after mx surgery and so a Class 3 relationship can develop"
vertically and horizontally "A high condylectomy will arrest AP mandibular growth however with all other md surgeries you can expect the same rate of growth as the pt presented presurgically."

Know Wolford articles

Following LeForte I surgery what growth potential remains? a. Vertical (correct) ABO 2008 see above
b. Horizontal
c. Normal Growth
d. None
16 years old boy who is class III. What do you do to stop the a. Chin cup ABO 2010
class III progression? b. High condylectomy (correct)
high condylectomy ABO 2009 Pearls article "Consideration for orthognathic surgery during growth, Part 1: Mandibular Deformities" Wolford:
- surgically eliminate further MN growth with High Condylectomy to remove the active growth center(s) and prevent further MN growth.
- If orthognathic and TMJ sx are performed at same time, BSSO is the choice b/c it maintains the best soft tissue attachment and thus vascularity to the proximal segment
- Consists of surgically removing the superior 3-5mm of the condylar head
- Will predictably stop vertical and anterior growth.
- TMJ function after surgery will remain normal if the condylar head is appropriately recontoured and disk is repositioned and stabilized on the condyle and in the fossa..
- Except in select cases, procedure should generally be deferred until age 14 in girls and age 16 in boys (when normal MX and MN growth is closer to completion)
Which surgical procedure do you NOT need to mount models? a. SARPE (correct) 2007 review
b. Lefort I
c. BSSO

112
 Question Answers Sources Discussion
a.Vertical Bitewing *
b.Horizontal Bitewing
To check the periodontal condition in the posterior, which c.Occlusal
would you use? d.Panorex 61 page file
The fluid found in the PDL space: a. Is derived from the vascular system during 61 page file (P297)
inflamation.
b. Contains unique elements not found in
other tissues.
c. Acts as shock absorber. (correct)
d. Is never present under normal
physiological circumstances.
All adult patients undergoing orthodontic treatment should a. The same frequency they would require 61 page file (P238)
typically have careful scaling at: without orthodontic treatment.
b. Twice the frequency they would require
without orthodontic treatment. (correct)
c. Three times the frequency they would
require without orthodontic treatment.
d. None of the above.
Periodontal disease is caused from all but which of the a.Biologic width impingement 61 page file
following? b.Occlusion (correct)
c.Poor OH
d.Increase in virulent oral flora
Among the population of adult ortho pts w/perio disease what a. 10% (correct) 61 page file Proffit 4th ed pg 658:
is the percentage of pts expected to show rapid progression of b. 50% There appear to be at least three risk groups in the population: those with rapid progression (about 10%) , those
the disease: c. 75% with moderate progression (the great majority, about 80%), and those with no progression despite the presence
d. 90% of gingival inflammation (about 10%)
What is the bacteria that is the cause of bone loss during a.Bacteroides Gingivalis (correct) 61 page file Bacteroides Gingivalis is an old name for Porphyromonas gingivalis
orthodontic treatment? b.Actinomyces
c.Porphyromonas gingivalis (correct)
d.Staphylococcus areus
What is the bacteria that causes periodontal disease? a.Stapholococcus areus 61 page file Graber 2000 pg 804:
b.Streptococcus albicans Porphyromonas gingivalis, Prevotella intermedia, and Bacteroides forsythus
c.Porphyromonas gingivalis *
Which bacterium is involved in juvenile periodontitis? a. Stapholococcus areus 61 page file
b. Streptococcus albicans
c. Porphyromonas gingivalis
d. Actinobactilus actinomycetemcomitans
(correct)
What is released during the breakdown of periodontal fibers? a. Interleukin 1 (correct) UNK 2010 Am J Orthod Dentofacial Orthop 2006;130:7.e1-7.e6 "Interleukins 2, 6, and 8 levels in human gingival sulcus
b. Interferon during orthodontic treatment"
c. Neocytokines Proinflammatory = TNF alpha, IL-1 beta, IL-2, IL-6, IL-8, PGE-2, IFN gamma; MMP
Anti-inflammatory = IL-4, 10, 13.
Which of the following are true for teeth with perio a.Can be caused by ortho treatment 61 page file
involvement? b.Has periods of remission and exacerbation
c.Bacteria can be transmitted from one
patient to the other
d.All of the above *
e.None of the above
Why do patients with active periodontitis have more bone loss a.There is more bone turn-over 2007 Graber 2000 pg 248
with Ortho treatment? b.Osteoblast can not function in an 61 page file Most skeletal deficits probably are errors in bone formation rather than resorption. A good example of the fragility
inflammatory environment. (correct) of bone formation is suppression of osteoblast differentiation by inflammatory disease processes. Osteoclasts
c.Osteoclast activity is increased (correct) thrive in an inflammatory environ-ment because they originate in the marrow, a protective site removed from the
localized lesion. Preosteoclasts are attracted to the inflammatory site by cytokine mediators. Vascularly mediated
osteoblast histogenesis, on the other hand, is strongly suppressed by inflammatory disease. Therefore when teeth
are moved in the presence of active periodontal disease, resorption is normal or even enhanced and bone
formation is inhibited. In a patient who has periodontitis, orthodontics may exacerbate the disease process,
resulting in a rapid loss of supporting bone
All the following statements regarding excessive mobility of a a. It could be due to the use of heavy forces. 61 page file
tooth in ortho mov’t are true, except b. It could be due to traumatic occlusion
c. It is self-correcting when the cause is
eliminated
d. It is an expected response to most
orthodontic treatments. (correct)
How would you eliminate black triangle between normally a. Distal root UNK 2010 Proffit 4th Edition pg 315
shaped central incisors: b. IPR/ARS (correct) ABO 2008
c. Intrude teeth until blk triangle goes away 2007
d. Free gingival graft ABO 2010 #2
e. Extrude
f. Torque incisors

113
 Question Answers Sources Discussion
What is important to look at when restoring teeth with black a. bone level (4/15/12) UNK 2010
triangles? b. Height of U1s ABO 2008
c. Width of U1s ABO 2010 #2
Height/Width ratio
Open gingival embrasure, what is the most important? alveolar bone height ABO 2010
Most important factor for U1s? horizontal bone level ABO 2009 Michigan relates to papilla levels
less than 1mm between implant and tooth leads to black To avoid black triangle, IPR or cosmetic ABO 2009 Michigan Article, “Interdisciplinary Management of Single-Tooth Implants,” Spear, Kokich
triangle bond or diverge roots - space between the implant and the adjacent tooth should be at least 1 mm for proper healing and to ensure
adequate space for the development of a papilla.
- must move the apices of the teeth apart to provide adequate space for the surgeon to position the implant
between the roots of the teeth.
What causes black triangles? a. Crown shape 61 page file
b. Bone loss
c. Root position
d. All the above (correct)
A problem of a missing papilla between teeth is probably due a. Unfavorable root position 61 page file
to? b. Crown shape
c. Perio bone loss
d. All of the above (correct)
e. None of the above
What does root proximity cause? a. Inadequate papilla UNK 2010 Kokich article "Managing Tx for the Ortho Pt with Perio Problems:"
b. Reduces bone level (correct) -Areas of root proximity are difficult for the patient to clean and restrict the hygienist during periodontal
c. Root length maintenance. However, in the upper molar region, a root proximity problem is more difficult to maintain. Access
for home care, and a wider buccolingual width make these areas more prone to osseous breakdown.

Graber 2000 text pg 846 & 2005 text pg 942:

Adequate embrasure space and proper root position: This allows for better periodontal health, especially when the
placement of restorations is necessary (Figure 19-7). The anatomic relation of the roots is important in the
pathogenesis of periodontal disease, interproximal cleaning, and placement of restorative materials

ABO Breakdown pg. 17:

- 2-3mm root separation will provide adequate bone and embrasure space for perio health
Increased root proximity of the lower anterior teeth a.causes perio problems/bone loss** 61 page file see above
b.no effect
Does root proximity affect perio status? yes ABO 2008 see above
Is there more of a risk of bone loss and periodontal disease if a. Yes (correct) 61 page file it's a risk in more so in posterior teeth, not anterior
the roots are not parallel and are too close? b. No
Root resorption is seen more with: a. intrusion & lingual torque(4/15/12) UNK 2010 Article "Predicting and preventing root resorption: Part 2" Samishima
b. torque ABO 2009 Michigan "Patients who underwent first premolar extraction therapy had more resorption than those patients who had no
c. intrusion extractions or had only maxillary first premolars removed. Duration of treatment and the horizontal (but not
vertical) displacement of the incisor apices were significantly associated with root resorption."

Graber, Current principles and techniques, 2000 pg 183 & 2005 pg 212:
"intrusion and torque are probably the most detrimental to the tooth involved."

Proffit 4th ed. pg 309:

A major risk factor for severe resorption of maxillary incisor roots during orthodontic treatment is contact of the
roots with the lingual cortical plate. What causes the roots to contact the lingual cortical plate? Two
circumstances, pri-marily: torquing the upper incisors back during Class II camouflage and tipping them facially
in Class III camouflage (because the roots go lingually as the crowns go facially).
Future prediction of root resorption lenth of treatment ABO 2009 Proffit 4th ed pg 350
root shape
prior root resorption
Severe generalized root resorption during orthodontic 1. Of unknown etiology 61 page file
movement is: 2. Sometimes induced by hormonal
imbalances.
3. Influenced by the type of tooth movement.
4. Not influenced by root or apices
morphology.

A-1&3
B- 1&2 (correct)
C- 3&4
D- 2&4

Which of the following is not a risk factor for root resoption? a. Endodontically treated tooth 61 page file
b. Long, thin roots
c. Gender (correct)

114
 Question Answers Sources Discussion
Resorption is influenced by a. Hypothyroidism * 61 page file
b. Nutrition
c. Appliance type
Tooth with the most root resorption a.Upper laterals 61 page file U2>U1>U3>L1>L2>L3
After root resorption has occurred during orthodontic a.It slowly stops 61 page file
treatment and treatment is stopped, what happens to the root b.It continues to get worse
resorption? c.It stops *
Root resorption stops: a.In active retention 61 page file
b.In passive retention (correct) 2007
As a cause of root resorption: a.Type of treatment is most important 61 page file
b.Duration of treatment is more important
than type *
c.Can be prevented with straight wire
appliances
d.None of the above
What is the greatest indicator of root resorption? a.Previous history of root resorption (correct) ABO 2008
b.Not root morphology or length
Shown a periapical film of pt with long, thin roots on max, man a.Increase risk of root resorption * 61 page file
incisors, what are possible complications with orthodontics
treatment?
Which gingival fiber is associated with the most relapse? a.Apical UNK 2010 Lindhe Perio Ch. 31:Whereas the fibers of the periodontal ligament and transseptal groups remodel efficiently
b.Principal ABO 2009 Michigan and histologically com-pletely in only 2 to 3 months after orthodontic rotation of teeth, the supraalveolar fibers are
c.Transseptal ABO 2008 apparently more stable, with a slow turnover
d.Supracrestal (correct) 61 page file
2007
Article #46 "A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating
orthodontic relapse," Edwards:
"relapse potential in the supracrestal soft tissues is one of the more important factors in relapse."
supracrestal tissues include free gingival and transseptal fibers
- "supraalveolar soft tissues seemingly do contri-bute to the relapse of orthodontically treated teeth-
specifically, orthodontically rotated teeth. Edwards reported on a simple and apparently effica-cious surgical
technique to alleviate the influence that the supracrestal periodontal fibers presumably have on rotational
relapse."

PDL fibers (5): (remodel within 2-3 mo after tooth movement - in intro of article)
1. Oblique
2. Horizontal
3. Periapical
4. alveolar crest
5. interradicular

Supralveolar/supracrestal gingival fiber groups (5):

1. transseptal (tooth-tooth)
2. Circumferential/free gingival
3. Dentoperiosteal
4. Dentogingival
5. Alveologingival
CSF a. is more successful in maxilla (correct) 61 page file "A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating orthodontic
b. heals in 7-10 days. (correct) relapse," Edwards:

115
 Question Answers Sources Discussion
Diode laser works by: a. ablation (correct) UNK 2010 "The laser cuts the tissue through ablation, where the energy is absorbed in the cells and is immediately subjected
b. protein degeneration ABO 2009 to heating, welding, coagulation, protein denaturization, drying vaporization, and carbonization. (Mosby's and
c. Heat ABO 2010 #2 AJODO 2005 Sarver - Soft tissue laser tecnology and cosmetic gingival contouring."

If you have to pick one - pick ablation but all of them could be correct
Profit Pg 316 - "[Diode laser] in comparison to the CO2 or erbium-YAG lasers also used now in dentistry, has
two primary advantages: (1) it does not cut hard tissue, so that there is no risk of damage to the teeth or alveolar
bone
if it is used for gingival contouring, and (2) it creates a "biologic dressing" because it coagulates, sterilizes and
seals
the soft tissue as it is used. There is no bleeding, no other dressing is required, and there is no waiting for a
healing
period

http://www.dentistryiq.com/index/display/article-display/177451/articles/woman-dentist-journal/volume-1/issue-
3/science/emerging-applications-for-the-soft-tissue-diode-laser.html
Interaction of the laser with tissue is a photo-thermal event, in which light is transformed into heat. When the laser
beam penetrates tissue and is absorbed, a designated amount of energy is removed per unit of time, with a
resultant temperature rise. Coagulation begins at over 50°C, with protein denaturation at 60°C. At temperatures
100°C to 200°C, vaporization of water occurs. (Note: Water is the chief component of soft tissue.) Laser surgery is
achieved by the process of ablation, removing this tissue by converting it to a gaseous state or plume.8 The plume
is considered to be a biohazard and should be removed with high-volume evacuation

AJODO 2008, Kravitz, "Soft-tissue lasers in orthodontics: An overview"

"Lasers cut by thermal ablation—decomposition of tissue through an instantaneous process of absorption, melting,
and vaporization.1 Essentially, the cells of the target tissue absorb the concentrated light energy, rapidly rise in
temperature, and produce a micro-explosion known as spallation.1 Thermal ablation depends on the amount of
light energy absorbed.4 The degree of absorption is determined by the wavelength (, measured in nanometers
[nm]) of the laser, the electrical power of the surgical unit (measured in watts [W]), the time of exposure, and the
composition of the tissues."
How much bone lost in 6 yrs? a. 20% UNK 2010 (Case) ABO Breakdown pg 17:
b. 30% (correct ?) ABO 2009 Max B-L ridge reduction after extraction:
c. 40% ABO 2008 23% in 6 mo
2007 33-34% in 5 yrs
ABO article #85d (p50)
Also on article #85d (p53) Kokich states that in the Mandibulular arch congenitally missing a lower 2nd premolar..."
If the primary molar is extracted, the ridge thickness will decrease by about 30%."
After maxillary tooth extraction in anterior region the ridge a. 11% 61 page file
width is reduced in buccolingual dimension over next 6 b. 18%
months by what %? c. 23% (correct) ( 1st 6 months)
d. 33% (over 5 years)
What is the best way to tell if a tooth is ankylosed? a.Looking at the bone level compared to 61 page file
adjacent teeth (correct)
b.Tapping on it, listening to the way it sounds
compared to others
c.Luxating it
When is the best time to extract a submerged (ankylosed) Right away ABO 2008
tooth?
When a tooth is ankylosed the amount of the ridge defect a. The amount of facial growth after 61 page file
depends mainly upon: ankylosis (correct)
b. The adjacent teeth
Moving a molar through an atrophic ridge…what is the most a. Root resorption 2007 Proffit 4th ed pg 665:
likely outcome? b. Gingival loss 3mm "resorption results in a decrease in the vertical height of the bone, but more importantly, remodeling produces a
c. Furcation involvement buccolingual narrowing of the alveolar process as well. When this has happened, closing the extraction space
d. Bone loss 3mm requires a reshaping of the cortical bone that comprises the buccal and lingual plates of the alveolar process.
e. No movement will happen Cortical bone will respond to orthodontic force in most instances, but the response is significantly slower."
f. (Best answer is contraindicated, but that - Often it is better judgment to open a partially closed old extraction site and replace the missing tooth with a
was not available) bridge or implant.
- As a general rule, however, it is better to move teeth away from such an area, in preparation for a prosthetic
replacement, because of the risk that normal bone formation will not occur as the tooth moves into the defect.

4/15/12 if question asked what will most likely not occur, furcation involvement
If you move a lower second molar into the first molar place a. 3mm gingival cleft (seems like best 2007 review Text Linde Perio Ch. 31: Orthodontics and Periodontics pg 754
with an atrophic ridge answer) Mandibular second molars can be moved mesially through remodeled edentulous first molar areas in adults
what happens? b. Severe bone loss with only a limited reduc-tion in vertical bone height, averaging -1.3 mm. Space closure is possible also in eden-
c. Furcation problem tulous maxillary first molar areas, although vertical bone loss and some space re-opening ca n be a compli-
d. Space re-opens cation. Marked gingival invaginations and buccal and lingual bone dehisences are sometimes seen
What is the treatment of a tooth with a sulcus depth of 5mm a. Apical repositioning 61 page file
and uneven gingival margins with adjacent teeth? b. Distal wedge
c. Gingivectomy (correct)

116
 Question Answers Sources Discussion
A patient wants longer crowns of the upper incisors, labial a.Gingivectomy (correct) 61 page file
sulcus is 4 mm, what will you do? b.Gingivectomy and osseous surgery
c.Extrude incisors
A patient has a 2 mm gingival discrepancy of the upper central a.Build up the edges 61 page file
incisors and the incisal edges. If the upper right central b.Extrude the incisor (correct)
incisors gingival margin is more apical than that of the canine c.Intrude the canine
what should you do? d.Nothing
What is the treatment of an abraded maxillary central incisor a.Intruding the abraded tooth and restoring 61 page file
with a gingival margin lower than the other central? that tooth*
b.Apical repositioning
c.Gingivectomy on the other central
upper central incisor located 5mm apical to CEJ of other tooth a. CE (correct) ABO 2009 Michigan Article "Uncovering labially impacted teeth: apically positioned flap and closed eruption techniques," Vermette,
b. APF Kokich, Kennedy:
- "Some clinicians believe that the closed- eruption method replicates natural tooth erup-tion and therefore
produces the best esthetic and periodontal results."

CE - If tooth is impacted in the middle of the alveolus or high in the ves-tibule near the nasal spine {significantly
apical to MGJ}
APF - If tooth requires more attached gingiva or is displaced lateral to the edentu-lous area
Apically repositioned flap for an impacted central located 5mm False (should be CE) ABO 2010
over CEJ of adjacent central
Patient with impacted canines 3mm above mucogingival a.Expose using closed eruption technique 61 page file
junction, what should you do? (correct)
b.Bracket and graft later
c.Bracket and bring into arch
d.Nothing
What is the best treatment for an impacted maxillary central a.Extract it 61 page file
incisor? b.Expose it and perform the closed eruption
technique (correct)
c.Expose it and allow it to come in on its own
Closed eruption of UR1, 10 yrs old girl: Begin orthodontics, refer for closed eruption 61 page file
Best method to extract palatally impacted max canines? a. APF UNK 2010 (Case) Article "Periodontal response to early uncovering,autonomous eruption, and orthodontic alignment of palatally
b. CE impacted maxillary canines," Schmidt, Kokich:
c. open eruption (correct) -palatally impacted maxillary canines that were surgically exposed, allowed to erupt freely into the palate, and
orthodontically aligned have good consequences compared with closed exposure and early traction

Canine impactions - 1-2% incidence of max impacted canines ABO 2009 Michigan Bishara “Impacted maxillary canines: A review”
- 8% bilateral
- 2/3 are palatal
- 1/3 are facial
- 2x more common in females
All of the following are true about canine impactions except: a. 1/3 are palatal (30%) (correct) 2007 Bishara “Impacted maxillary canines: A review”
b. 2:1 female to male
c. 1-3 % of population
worst worry with impacted canine? ankylosis determined by radiograph ABO 2009
Orthodontic traction to pull an unerupted tooth toward the line a.No later than 48h after surgical exposure. 61 page file
of the arch should begin: b.No later than 2-3 weeks after surgical
exposure.(correct)
c.No later than 2-3 months after surgical
exposure.
d.At anytime post-surgically.
Steel ligatures are better in adult orthodontic patients because TRUE ABO 2010 Proffit 4th edition pg. 658 (we are assuming the question meant "adult ortho pts w/ perio dz)
elastomeric chains harbor several microorganisms "Self-ligating brackets or steel ligatures are preferred for periodontally involved patients rather than elastomeric
rings to retain orthodontic archwires, because patients with elastomeric rings have higher levels of
microorganisms in gingival plaque."
No o ties on perio because o ties have been found with more TRUE ABO 2008
plaque.
Perio patients should have steel ties, and they have more T/T ABO 2009 Michigan
bacterial concentration in gingival plaque
a.Avoid using elastomerics because perio 61 page file
A patient with perio disease disease exaggerated

117
 Question Answers Sources Discussion
When considering the option whether to band or bond the a. The gingival attachments are severely 61 page file text, Linde - Perio Ch. 31:
permanent molars, which of the following statements is true? damaged by judicious banding Bonded molars shovv less plaque accumulation, gin-givitis and loss of attachment interproximally than banded
b. The plaque index in banded permanent molars during orthodontic treatment of adults.
second molars is the same as bonded
second molars
c. Bonded second permanent molars exhibit
the same gingival reactions as banded
permanent second molars
d. In the long run there is no difference in the
gingival health of banded or bonded
permanent second molars (correct)
a. Virtual cessation of gingival papillary 61 page file
bleeding(4/15/12)
b. Limited effect on gingival papillary
bleeding
c. Greater effect with chlorhexidine than
Subgingival irrigation of orthodontically banded first molars w/ with isotonic saline
either a solution of chlorhexidine or isotonic saline solution d. Greater effect with isotonic saline than
produces a: with chlorhexidine
Molar has pocket on buccal surface up to furcation, treatment a.Extract 61 page file
of choice would be? b.Tissue regeneration *
c.Hemisection tooth
d.Orthodontically intrude tooth to eliminate
pocket
If you have a 5mm deep probing depth on buccal surface of a. Guided Tissue Regeneration (correct) 61 page file
molar and it does not go through furcation what do you do? b. Osseous recontouring
c. Nothing
d. Hemisection
A type III furcation is detected before orthodontic treatment a.Open flap curettage * 61 page file
what do you do? b.Intrude the tooth
c.Bone graft
d.Membrane regeneration
A molar with a perio condition and a furcation involvement of a. Decreased 61 page file
III, you intend to upright and intrude it, what happens to the b. Increased
furcation? c. Same or not changed (correct)
d. Gingival recession
Three walled defect, what will happen if start orthodontics? a.Nothing 61 page file
b.Get better
c.Get worse *
What is the treatment of a three-walled defect? a. Apical repositioning 61 page file
b. Distal wedge
c. Guided tissue regeneration (correct)
How do you fix a one wall defect? a.Orthodontics 61 page file Kokich: if mesially tipped - upright and extrude. if supererupted - intrude and level CEJ w/ adjacent teeth
(assuming bone levels are not flat btn adjacent teeth)
What is the treatment of a one-walled defect? a. Uprighting 61 page file
b. Extrusion
c. All of the above (correct)
d. None of the above
How do you fix a vertical defect? a. Extrude (correct) 61 page file
If there is a significant crater between the maxillary PM’s, what a.Osseous recountouring * 61 page file
do you do? b.Extrude the PM
c.Extract
d.Nothing
Which of the following describes gingival recession when it a.It occurs approximately 68% of the time 61 page file
occurs in adults? b.It occurs in the mandibular teeth more than
in the maxillary
c.It occurs more symmetrically than
asymmetrically
d.All of the above *
The percentage of ortho pts w/mucogingival probs that require a.1-5% of children and 10-15% of adults 61 page file Proffit 4th ed pg 657 FIG 18-29
perio treatment before orthodontic therapy is: b.5-10% of children and 5-10% of adults
c.5-10% of children and 20-25% of adults
(correct)
d.None of the above
Intrusion of incisors in adult patient’s with marginal bone loss a. True 61 page file
should be avoided due to increase risk of bone loss: b. False (correct)

118
 Question Answers
when can orthodontic treatment be initiated in a tooth that a. simultaneously (correct)
received apexification b. wait for 2 yrs
Multiple T/F: Two questions on apexification and can you move Yes, you can move teeth orthodontically
the tooth? during apexification.
A) - There is no contraindication to the orthodontic movement of a.A- 1st statement is correct, 2nd statement
endodontically treated teeth. B) - Attempting to move a pulpally false.
involved tooth, however, is likely to cause a flare-up of the b.B- 1st statement is false, 2nd statement is
periapical condition. correct.
c.C- Both statements are correct.
(CORRECT)
d.D- Both statements are false.
119
Sources Discussion
UNK2010 Article "Ortho and endo tx of traumatized teeth", Steiner
ABO 2008
61 page Proffit 4th ed - Pg 658 - under Moderate Periodontal Involvement
file "Disease control also requires endodontic treatment of any pulpally involved
teeth. There is no contraindication to the orthodontic movement of an
endodontically treated tooth, so root canal therapy before orthodontics will
cause no problems. Attempting to move a pulpally involved tooth, however, is
likely to cause a flare-up of the periapical condition."
 Question Answers
Trauma to incisors and tooth fracture down to alveolar crest, you a.Root length
want to extrude it. What factors should be considered? b.Root shape
c.Root canal width
d.Inclination of root relative to crown
e.Amount of alveolar crest
f.All the above (Correct)
Sources Discussion
61 Page Proffit 4th ed. - Pg. 352
file "On occasion, it is desirable to elongate the root of a fractured tooth, to enable
its use as a prosthetic abutment without crown-lengthening surgery. If heavy
forces are used to extrude a tooth quickly, a relative loss of attachment may
occur, but this deliberately nonphysiologic extrusion is at best traumatic and at
worst can lead to ankylosis and/or resorption. Physiologic extrusion or
intrusion that brings the alveolar bone along with the tooth, followed by
surgical recontouring of gingiva and bone, is preferable."

Proffit 4th ed. - Pg. 458

"Immediately following a traumatic injury, teeth that have not been irreparably
damaged usually are repositioned with finger pressure and stabilized (with a
light wire or nylon filament) for 7 to 10 days. At this point, the teeth usually
exhibit physiologic mobility, and the prognosis is better if they are not splinted
any longer. If the teeth are not in ideal positions and orthodontic treatment to
reposition them is indicated, it should begin at that time, using light force. Prior
to treatment, multiple radiographs at numerous vertical and horizontal
angulations should be obtained to rule out vertical, and horizontal root
fractures that may make it impossible to save the tooth or teeth"

Proffit 4th ed. - Pg. 645

"The distance the tooth should be extruded is determined by three things: (1)
the location of the defect (fracture line, root perforation, etc.); (2) space to
place the margin of the restoration so that it is not at the base of the gingival
sulcus (typically, 1 mm is needed); and (3) an allowance for the biological
width of the gingival attachment (about 2 mm)...The crown-to-root ratio at the
end of treatment should be 1 : 1 or better. A tooth with a poorer ratio can be
maintained only by splinting it to adjacent teeth."
"In general, extrusion can be as rapid as 1 mm per week without damage to
the PDL, so 3 to 6 weeks is sufficient for almost any patient. Too much force,
and too rapid a rate of movement, runs the risk of tissue damage and
ankylosis."

Proffit 4th ed. - Pg 664

"When tooth structure has been lost all the way to beyond the normal contact
point, the tooth becomes abnormally narrow, and restoration of the lost crown
width as well as height is important. The orthodontic positioning obviously
should provide adequate space for the appropriate addition of the restorative
material. The ideal position may or may not be in the center of the space
mesio-distally-this would depend on whether the most esthetic restoration
would be produced by symmetric addition on each side of the tooth, or
whether a larger build-up on one side would be better."

"If only a small amount of tooth structure has been lost, as for instance if the
incisal edge of one incisor has been fractured, it may be possible to smooth
the fractured area and elongate the damaged tooth so that the incisal edges
line up. The result, however, will be uneven gingival margins-which means that
elongation of a fractured tooth must be done with caution, and with
consideration of the extent to which the gingival margins are exposed when
the patient smiles. Before acceptably esthetic composite resin build-ups of
anterior teeth were available, orthodontic elongation of fractured teeth was a
more acceptable treatment approach than it is at present. Now, more than 1-2
mm of elongation rarely is a good plan unless the patient never exposes the
gingiva."

120
 Question Answers Sources Discussion
A radiolucency appears inside the pulp canal and is expanding. a.External resorption and endodontic therapy 61 page Unknown
The patient has pain in this tooth. What is it and how should it be should be initiated file
treated? b.Internal resorption and endodontic therapy
should be initiated (Correct)
c.External resorption and orthodontic
treatment should stop immediately
d.Internal resorption and orthodontic
treatment should stop immediately
If you find internal resorption, what is your treatment? a.Watch and wait 61 page
b.Immediate RCT * file
c.Extract
d.Stop all orthodontic treatment
All the following are indications for controlled orthodontic extrusion a.Teeth with defects in the cervical third of 61 page (P 628)
of a single tooth, except: the root. file
b.Teeth with defects in the apical third of the
root. (correct)
c.Isolated teeth with one-walled vertical
periodontal defect.
d.Isolated teeth with two-walled vertical
periodontal defect.
If you have an open apex with necrosis… a.You can commence ortho treatment right 61 page
away file
b.You should have endo done and then ortho
c.You should do apexification and then ortho
*
d.You should do nothing
A patient had a horizontal root fracture at the apex 5 years ago, a.You can begin ortho treatment right away * 61 page
no treatment was done, and there are no symptoms b.You should have endo done and then file
commence ortho treatment
c.You should do endo, and an apicoectomy
and then commence ortho treatment
d.You should do nothing
What do you take into consideration for closed eruption technique a.Length of root 61 page
file
4/15/12
We think the question was remembered wrong, it should be what
would you not consider for closed eruption technique.
A fractured tooth that has been extruded 4 mm in a 1 month, what a.1 month 61 page
is the minimal amount of time it should be stabilized b.3 months file
c.6 months (correct)
d.12 months
How do you treat a vertical root fracture? a. Extract (correct) 61 page
b. Root Canal Therapy file
c. RCT & Crown
d. Nothing
In an endodontically treated tooth you will have: a. significantly less root resorption (correct) 2007 AJO 1990 says endo tx'd teeth less resorption. But other articles from
b. significantly more resorption c. the review international journals state that endo tx'd teeth either have same or more.
same amount of resorption as a normal
tooth
d. slightly more resorption
e. slightly less resorption
Teeth that have been treated endodontically, prior to the start of a. A greater tendency for root resorption 61 page
orthodontic treatment will display: b. A lesser tendency for root resorption file
(correct)
c. No predictable pattern of root resorption )

121
 Question Answers Sources Discussion
A tooth with trauma and a necrotic pulp should have what done a. Nothing 61 page
prior to ortho treatment? b. Root canal therapy (correct) file
c. Extraction
d. None of the above
What are some contraindications to orthodontic movement when a. If it had endo performed 61 page
a patient presents with a maxillary incisor that had previously had b. If it had apicoectomy performed file
a c. All of the above
horizontal fracture in the apical third of the root, which has now d. No worsening of prognosis of tooth
healed? (correct)
Root fracture 1 mm below CEJ, what is primary thing to look at a. Length of root (correct) 61 page
file
Peak incidence of dental trauma occurs between what ages? a. 6-7 61 page Graber p. 640)
b. 8-10 (correct;) file
c. 12-14
d. 15-16

122
 Question Answers
Histologic tetracylcline (tetracycline) studies of implants show that: a. Lamellar bone at interface with slow
turnover of bone
(4/15/12)
b. rigid within supporting bone
c. composite bone at interface
How is the interface between implant and bone? 1. Compact bone with high turnover rate
2. Compact bone with low turnover rate.
(4/15/12)
3. Cancellous bone with high turnover rate
tetracycline stained bone studies show that osseointegrated a.a-implants do not move at all (correct))
implants for anchorage show b.b-remodeling is minimal
c.c-implants move 0.1mm/?
d.d-osteointegration is not necessary
Which is a correct statement regarding inplant research if using it a. There is no movement of the implant
for anchorage? (correct)
b. There was slight movement (<.1
microns/yr)
c. There is little movement
d. There is moderate movement
Studies show that osseointgerated TADs show: a. no movement (correct)
b. slight movement (0.1 micron/yr)
What is the minimum osseointegration required for successful a. 5% (correct)
TADS: b. 85%
c. 50%
Place TAD distal to canine for molar protraction. Pilot hole is more T/T
stable in mandibular bone.
Most reliable method to protract a mandibular molar with a TAD is T/F (Pilot holes make TADs more stable in
to place it distal to canine. TADs more stable with a pilot hole. posterior mandible, but not necessarily in
other areas)
What is the most predictable way to protract a molar? a.Use the rest of the arch as anchorage
b.Use a TPA
c.Use an implant (correct)
When 300 gms of force is applied for 3 mos to titanium implants for a. 99 %
anchorage in animals, they are successful approx what % of time? b. 94 % *
c. 72 %
d. 58 %
e. 30 %
What is the force to dislodge an implant? a.100g
b.250g
c.500g
d.600g
e.None of the above *
Maximum force on an implant to cause osseous degeneration? a. 200 grams
b. 400 grams
c. 100 grams
d. none of the above (correct)
Sources Discussion
UNK 2010 http://www.angle.org.pinnacle.allenpress.com/doi/pdf/10.1043/0003-3219(1989)059%3C0247:REIFOA%3E2.0.CO;2
ABO 2009 pg. 249 (Figure 1)
Woven = new bone, non-lamellar
cancellous = trabecular
Lamellar = cortical/compact
Angle Orthodontist, 1987, Roberts, Endosseus Implants for Orthodontics and Orthopedics:
Polarized light microscopy showed that composite bone (woven bone matrix filled with lamellar bone) was the predominant type of mineralized
tissue located <1.0 millimeter from the endosseous interface (Figure 2).
article "Managing Complex Orthodontic Problems: The Use of Implants for Anchorage," Kokich:
When an implant is initially placed, nonlamellar bone is deposited adjacent to the implant. This is weak bone. It will not withstand occlusal
forces. Over time, this bone will undergo remodeling and form secondary osteons. The latter strength-ens the bone.
St. Louis Graber 2000 pg 250:
-the rate of bone remodeling near the implant was higher compared with the basilar mandible only a few millimeters away.
- Histologic analysis of implants recovered after completion of treatment has revealed important information about the continuous remodeling
process that maintains the rigid integration and anchorage value of the endosseous device. Two intravital bone labels, administered within 2
weeks of implant recovery, have shown a continuing high rate of bone remodeling (over 500% per year) within 1 mm of the implant surface
(Figure 3-94, C and D). This biologic mechanism apparently is the means by which rigid osseous integration is maintained indefinitely.Well-
integrated endosseous implants remain rigid despite continued remodeling of the bone supporting them because only a portion of the osseous
resorbed interface is turned over at any given time."
ABO 2008 C. listed as answer with question mark
61 page Support for answer A:
file
Graber 2000 pg248-249:
- Both animal studies and clinical trials of custom orthodontic devices have established that rigidly integrated implants do NOT move in response
to conventional orthodontic and orthopedic forces.
-From an orthodontic and orthopedic perspective, titanium implants can resist substantial continuous loads (1 to 3 N superimposed on function)
indefinitely. Histologic analysis with multiple fluorochrome labels and microradiography confirm that rigidly integrated implants do NOT move
relative to adjacent bone (see Figure3-89). By definition, maintaining a fixed relationship with supporting bone is true osseous anchorage.
article "Managing Complex Orthodontic Problems: The Use of Implants for Anchorage," Kokich:
In hu-mans, it appears that 6 months is satisfactory to ensure that the implants will remain immobile during the application of orthodontic force.
61 page see above
file
UNK 2010 Dr. R
UNK 2010 Osseointegration should increase with loading time
ABO 2009
Levels as low as 5% can provide adequate osseointegration for orthodontic loading (ABO article #8 - pg 6 2nd conclusion of "Systematic Review
of Temprorary Skeletal Anchorage Devices" by Cornelis 2007)
regular implants 75% osseointegrated
ABO 2009 Article "Critical factors for the success of orthodontic mini-implants: A systematic review," Chen:
"self-drilling (no pilot hole) mini-implants at the posterior and inferior aspects of the mandible were not recommended because they have been
reported to have a high breakage rate."
. . . implies that a pilot hole is recommended in mandible. mand has denser bone than max, so need to lower insertion torque via pilot hole for TAD
stability in mand
ABO 2010 Article "Critical factors for the success of orthodontic mini-implants: A systematic review," Chen:
The self-drilling method, a new technique, was used in 2 studies. Its placement procedure is simplified, without pilot drilling and incision. Even
though success rates were diverse, it was believed that failure rates might be further reduced with increasing clinical experience and perfecting of
the placement technique.
61 page
file
61 page
file
61 page
file
2007
61 page
file
123
 Question Answers Sources Discussion
What is the minimum amount of force needed to cause a. 50g 61 page
disintegration of bone around an implant? b. 100g file
c. 200g
d. 400g
e. none of the above (correct)
The estimated healing time for an implant in the mandible is? a.1-2 months 61 page
b.3-4 months file
c.4-6 months *
d.6-8 months
The estimated healing time for an implant in the maxilla is? a. 1-2 months 61 page
b. 3-4 months file
c. 4-6 months
d. 6-8 months (correct)
What are some possible problems associated with implants? a.Dehiscence 61 page
b.Unfavorable crown/root ratio file
c.All of the above *
d.None of the above
What should the interface between an implant and bone be? a.Such that the implant does not move 61 page
relative to adjacent bone * file
b.Such that it acts like a pdl
c.Such that it absorbs the shock of
mastication
Best time for an implant: a. When growth has ceased (correct) 61 page
b. Boys after 18-19 years of age file
c. Girls after 16 years
A 13 year old patient needs an implant of the maxillary incisor, at a. Immediately following orthodontic 61 page
what time should it be done? treatment file
b. Once growth is completed *
c. In two years
d. Never
The complications of single tooth implants include: a.Narrow alveolar bone 61 page
b.Poor crown/ root ratio file
c.Cervical bone loss
d.Need for bone augmentation
e.All the above *
Esthetically, how much room do you need for an implant? a. 3mm 61 page
b. 5mm file
c. 7mm (correct)
d. 10mm
18 YO Patient is missing upper lateral incisor, how much space is a.2/3 width of the central 61 page
needed for the replacement with an implant? b.same as contralateral lateral file
c.7 mm
d.all of the above *
When placing an implant the head of the fixture should be how a. 2 61 page
many mm apical to the desired gingival margin? b. 3 file
c. 4 (correct)
d. 5

124
 Question Answers
How many months do you keep [retain] a tooth after extrusion for a. 1
restorative? b. 2
c. 4
d. 6 (correct)
When restoring peg laterals, create more space than needed. Close space
after restoration is complete (restore it as soon as space is available)
When to bond peg lateral? restore as soon as space available,
deband, immediately retain
What amount of overbite is necessary for a bonded bridge? a. 0.5mm (correct)
b. 1-2 mm
c. 2-3 mm
d. 3-4 mm
Maryland bridge, how much overbite do you need? a.1 mm or less (correct)
b.1-2 mm
c.2-3 mm
d.4-5 mm
Congenitally missing laterals with retained b and c. How do you manage the Extract the b to guide eruption of the
primary dentition for the erupting canine? canine into the lateral space (for bone
preservation until it is time to distalize the
canine and prepare for implant.)
What to do if missing laterals? allow canines to erupt mesially and then
distalize
When replacing a lateral incisor with a canine, which of the following is NOT a) Color and size of opposite lateral
important b) Color and size of opposite canine
(correct)
c) Posterior occlusion on opposite side
d) Posterior occlusion on same side
All of the following favor canine substitution EXCEPT: a. minimal crowding on lower
b. class II molar (with no lower crowding)
c. large canines (correct)
d. low gingival margin on canines w/ no
canine eminence
Sources Discussion
ABO 2008 Also under Dx/Analysis/Tx Planning
ABO 2009 Pg. 647 Proffit - tooth should be stabilized for at 6 weeks but "retention" takes 6 months?
UNK2010 "With any technique for forced eruption, the patient must be seen every 1 to 2 weeks to reduce the occlusal surface of
the tooth being extruded if this is needed (see Figure 18-17), control inflammation and monitor progress. After active
tooth movement has been completed, at least 3 but not more than 6 weeks of stabilization is needed to allow
reorganization of the periodontal ligament. If periodontal surgery is needed to recontour the alveolar bone and/or
reposition the gingiva, this can be done 1 month after completion of the extrusion. As with molar uprighting, it is better
to complete the definitive prosthetic treatment without extensive delay"
ABO 2009 Michigan Kokich
2007
ABO 2009 Article "Guidelines for Managing the Orthodontic-Restorative Patient," Kokich
61 page file McNamara Ch. 25:
Bridges and full crowns: minimal OB and OJ 0.5-0.75mm (just enough to disclude posterior teeth in protrusion)
Veneers: no OJ needed
61 page file McNamaral Ch. 25
centrals should be more upright and vertically oriented
ABO 2008 ABO article #85d (p50)
"Based on this information, the orthodontist should allow tile permanent canines to erupt mesially if the maxillary lateral
incisors are congenitally absent (Fig 8). As the canines are moved distally, an edentulous ridge will be created. Over time,
this ridge will not resorb as much as a ridge resorbs following tooth extraction."
ABO 2009 Michigan Textbook: McNamara, Chapter 25 Managing Orthodontic Restorative treatment for the Adolescent Patient:
A bone graft can be avoided if the central incisor and canine erupt adjacent to one another (Fig. 25-16). As the space is
opened orthodontically for the future im-plant, bone is laid down along fiber tracks of lhe peri-odontal membrane. The
labiolingual width of the alve-olar ridge formed in this manner generally is stable over time. Therefore, if implant placement
is delayed u n til an adolescent has completed facial growth, the ridge will not become narrower.
UNK 2010 Possibly in Kokich (regarding posterior occlusion being important)
61 page file (#160) Opposite lateral is important because you want the canine substitution to match the lateral
ABO 2010 #2 the posterior occlusion on the opposite side isn't as important as the posterior occlusion on the same side but it still matters
2007 more than the color and size of the opposite canine
ABO 2008
Textbook: McNamara, Chapter 25 Managing Orthodontic Restorative treatment for the Adolescent Patient:
Three criteria should be evaluated for canine substitution:
1. Occlu-sion or malocclusion must be appropriate. The ideal sit-uation for canine substitution is a patient with a Class II
molar relationship, minimal crowding of the mandibular teeth, and acceptable facial profile.
2. Anterior tooth-size relationship. When canines are substituted for lateral incisors, maxillary anterior tooth size excess is
created. The widths of the maxillary six anterior teeth often must be reduced in size to create the correct overbite and
overjet relationships. A diagnostic wax set- up is necessary.
3. Length. shape, and color of the maxillary canine crowns. If canines are substituted for lateral incisors, their gingival
margins must be posi-tioned more incisally relative to the central incisors, be-cause the crown lengths of lateral incisors
typically are shorter than central incisors. Therefore. the canine must be erupted, and their cusps must be equilibrated. If
the shape of the canine cusp is unusually long and pointed, it could be impossible to reduce the cusp enough to simulate
the incisal edge of a lateral incisor
ABO 2010 see above
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The sequence of giving CPR to an adult: a. 30 comrpessions for 2 breaths (correct) UNK 2010 says its 30-2 for both adults, children, and infants for single rescuer except if you have 2 rescuers and it's 15-2 just for
b. 15 compressions to 2 breaths children and infants
http://guidelines.ecc.org/pdf/90-1043_ECC_2010_Guidelines_Highlights_noRecycle.pdf (look on pg 8)
Where are chest compressions given when performing CPR in an adult? a. lower third of sternum UNK 2010 http://www.emts911.com/cpr_chart.htm
Where do you put your hands for CPR? b. lower half of sternum (correct) ABO 2008 http://www.peppsite.com/docs/26540_prc17_prc18.pdf
c. middle third of sternum 2007 Infants <1 yr old: lower 1/3 of sternum would work
d. between sternum and navel For everyone else you need to be at lower 1/2 to avoid breaking off their xyphoid and stabbing them.
How many minutes without oxygen can the brain survive? a. 2 61 page file
b. 4
c. 6 (correct)
d. 7
If you see an unconscious person lying on the floor what do you do first? a. Activate EMS (correct) 61 page file
b. Look for ID
c. Start CPR
d. Nothing
In an adult, a rescue breath (CPR) is given every: a. 2 seconds 61 page file
b. 3 seconds
c. 4 seconds
d. 5 seconds (correct)
e. 10 seconds
Abdominal thrusts on a child should be performed a.Above the navel and above the sternum 61 page file
b.Above the navel and below the sternum
(correct)
c.Below the navel and above the sternum
d.Below the navel and below the sternum

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 Question Answers Sources Discussion
Is bilateral impacted? a. 20% ABO 2009 This didn't make sense to us.
If you're looking for what percentage of CANINES are bilaterally impacted - it's 8%
This is found in ABO #42 - Bishara article: Impacted maxillary canines (a review)
Canine impactions - 1-2% incidence of max impacted canines ABO 2009 Michigan Bishara “Impacted maxillary canines: A review”
- 8% bilateral
- 2/3 are palatal
- 1/3 are facial
- 2x more common in females
Which one is not true about Impacted canines a.30% of them come palatal 61 page file
All of the following are true about canine impactions except: a. 1/3 are palatal (30%) (correct) 2007 Bishara “Impacted maxillary canines: A review”
b. 2:1 female to male
c. 1-3 % of population
What percentage of impacted canines self-correct if the tip is distal to the middle of a. 10 ABO 2008 Bishara “Impacted maxillary canines: A review”
the lateral incisor? b. 30 61 page file Incidence of max canine impactions ranges from approx. 1% to 2% depending on
c. 50 2007 the source.
d. 70 Impactions are twice as common in females (1.2%) as in males (0.51%).
e. 90 (correct) 8% of impactions are bilateral
Mand. canine impaction incidence is 0.35%.
Causes can be general or localized (most common reason)
Generalized causes: endocrine deficiencies, febrile diseases, irradiation
Localized causes: Tooth size-arch length discrepancies, Prolonged retention or
early loss of the dec. canine, Abnormal tooth bud position, Alveolar cleft, Ankylosis,
Cystic or neoplastic formation, Dilaceration or the root, Iatrogenic, Idiopathic,
Missing lateral or abnormal lateral root

0.71% of children between 10-13 have resorbed permanent incisors due to ectopic
eruption of max canine.
Clinical signs of impacted canines: Delayed eruption of perm. canine beyond 14-15
y.o., Absence of labial canine bulge, Presence of palatal bulge, Delayed eruption,
distal tipping, or migration of lateral incisor

Prevention of max 3 impaction: extract the decid. 3 by age 11->91% normalization

of perm. cuspid eruption if the crown is distal to the middle of 2. Only 64%
normalization if crown is mesial to middle of 2.

When to extract perm. 3: Ankylosed, External or internal root resorption, Severely

dilacerated root, If impaction is severe (lodged between the roots of the central and
lateral incisors), Pathology, Patient doesn’t want to attempt to save

Palatal impactions occur 66% of time, other 33% are labial

85% of palat. Imp. 3’s have sufficient space, whearas labially imp. 3’s have
sufficient space only 17% of time.
Most common transpositioned tooth a.Canine 61 pagefile Profitt 4th ed. page 139
Ectopic eruption of other teeth is rare but can result in transposition of teeth or
bizarre eruption positions. Mandibular second premolars sometimes erupt distally,
and can end up beneath the permanent molars or even in the ramus (Figure 5-15).
12 A poor eruption direction of other
teeth, especially maxillary canines, usually is due to the eruption path being altered
by a lack of space
Pts w/severe nasopharyngeal obstruction who undergo adenoidectomy will go from a.10% of the time 61 page file
mouth-open to mouth-closed breathing approx b.50% of the time
c.80% of the time (correct)
d.Rarely
When asymptomatic non-ectopic impacted mand 8’s are followed from age 20-24 a. 70 % 61 page file
yrs, what % of molars are expected to erupt normal? b. 57 %
c. 45 %
d. 33 % (correct)
e. 20 %
What is the normal intermolar width in adults? a. 33-35 mm 61 page file 33-35mm in adolescents
b. 36-39 mm (correct)
c. 39-42mm
d. none
What percentage of contemporary U.S & northern European population exhibit Cl II a. 0-5% 61 page file
malocclusion? b. 15-20% (correct)
c. 50-75%
d. 75-90%

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 Question Answers Sources Discussion
If you remove upper 7's what usually happens to the 8's? They come in adequate occlusion ABO 2008 Proffit 4th Ed, pg 581
Existing data show that with careful use of headgear to distalize first molars after
second molar extraction, despite the potential problems, there is an excellent
chance of clinical success and a 75 to 80% chance of maxillary third molars
erupting into an acceptable position to replace the second molars
Multiple T/F: The oral temperature changes dramatically when consuming hot or T/T ABO 2008 (95-99 degrees F)
cold beverages but studies have shown that oral temperature is approximately 35-
37 degrees C.

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 Question Answers Sources Discussion
HIPAA stands for: a. Health Insurance Portability and Accountability Act UNK 2010
(correct) 61 page file
b. Health Information Privacy and Accountability Act ABO 2010 #2
c. Health Insurance Privacy and Accountability Act ABO 2008
2007 review
Who establishes standard of care? a. dental associations (correct) ABO 2009 ABO breakdown pg 18
b. courthouses ABO 2008 FYI, ABO 2008 - correct answer given is "courts"
61 page file
Providing pt w/enough information to make important decisions about what orthodontic or a.A moral obligation 61 page file (P696)
orthognathic procedure he or she will accept is: b.An ethical obligation
c.A legal obligation
d.Only A &B
e.A, B & C (correct)

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 Question Answers Sources Discussion
What is the best statistical measure to predict the mandibular growth based a. Analysis of Variance aka ANOVA (correct) UNK 2010 remembered from stat class
on 3 variables: b. Correlation 61 page file Statistical Tests for data types:
c. Student t-test ABO 2010 #2 ANOVA = Nominal (3 or more groups) vs. Scale
d. Chi-square Chi squared = Nominal vs Nominal
T-test = Nominal vs. Scale (comparison of 2 means)
Linear Regression (Pearson's correlation) = Scale vs Scale
Anova is used to do what? a.A table of the analysis of variance * 61 page file more than 2 nominal variables
An experimental situation was given in which the researcher wanted to a.Chi-square 61 page file
determine the effects of three continuous variables on a fourth variable. b.T-test
Which statistical test would you use here? c.Analysis of variance *
How much is SD of + 1 66-68% or 2/3 ABO 2010 Remembered from stats class
2007
The mean +1 and -1 SD includes how much of the population? 61 page file
How much is SD of + 2 96% 61 page file
How much is SD of + 3 99.7 % 61 page file
Specificity is: a.The percent of persons without the disease 61 page file Specificity is the probability of a negative new test result when there is no disease truly present.
b.True negatives/ patients without the
disease *
Sensitivity is: a. Positive if disease present * 61 page file the proportion of true positives of all diseased cases in the population. It is a parameter of the test.
b. Positive if disease absent True positives/patients with the disease*
Prevalence tells us what? the total number of cases of the disease in the a. The amount of disease at any given time* 61 page file
population at a given time, or the total number of cases in the b. Number of cases / number of persons*
population, divided by the number of individuals in the population
Incidence usually indicates what? a.How many new cases of a disease are 61 page file
occurring relative to the whole population *
The T-test is used for what? a. To compare the results of two different 61 page file Nominal vs scale data
treatments (correct)
Student t test used when comparing 2 means ABO 2008
Which would you use to compare 2 means? a.t-test * (parametric) non-parametric – 2007 Stats Class handout:
analyze median, two words 61 page file "T-Test=comparision of 2 means"
b.Chi square
c.Correlation
What does the Chi-Square test measure? a.Observed versus expected frequency * 61 page file nominal vs nominal data
Correlation is generally expressed as a: a. Whole number 61 page file
b. Ratio
c. Fraction (correct)
d. Percentage
What statistical find analysis would you use to find the relation between a.Regression analysis 61 page file
brushing and gum disease? b.Correlation analysis *
c.T-test
d.Chi-square test
If there is no correlation between two sets of data, what is the coefficient of a. 0 (correct) 61 page file
correlation? b. 1
c. 10
d. 100
What is the correlation coefficient when two variables are linearly related? a.0 61 page file
b.1 *
c.10
d.100
You want to predict the ceph measurement with mandibular rotation, what a.Correlation** indicates the strength & 61 page file
stat will you use? direction of a linear relationship between two
random variables.
b.ANOVA
c.T-test
d.P-value
If you know the value of X and with which test you can find out the value of a. Coefficient of variance (a measure of 61 page file
Y: dispersion of a probability distribution - ratio
of standard dev to mean)
b. Regression * can be used for prediction,
inference, hypothesis testing, and modeling
of causal relationships. (correct)
Mean = 100 Variance = 64, how many standard deviation is 116? a. 1 61 page file
b. 2 (correct)
c. 3
d. 4
What variable do you change if you want to observe changes in the a. Confounding variables 61 page file
experiment? b. Independent variables (correct)
c. Dependent variables
d. None of the above
Which variable does research measure after manipulating things in the a.Independent 61 page file
experiment? b.Dependent * independent variables are
deliberately manipulated to invoke change in
the dependent variables
c.None of the above

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 Question Answers Sources Discussion
Which of the following is the ability to detect a disease if the disease is a. Sensitivity (correct) 61 page file
present? b. Plausibility
c. Variance
The best measure of the limits of a sample are a.Range (correct) 61 page file
b.Standard Deviation
c.Mean
d.Specificity
What is affected the most by extreme values? a. Median 61 page file
b. Mean (correct)
c. Sensitivity
What will be affected the most is you have a larger sample? a. Mean 61 page file
b. Median (correct)
c. Mode
Heterogeneity of an orthodontic study sample can relate to: a. Age and gender. 61 page file
b. Ethnic origin.
c. Demographic characteristics.
d. All of the above. (correct)
The sample size in a cephalometric study aiming to produce data for clinical a. 15 patients (correct) 61 page file
decisions has to be at least: b. 25 patients
c. 50 patients
d. None of the above
P value.05 a.95% chance they are different 61 page file
For a research hypothesis to be accepted, statistical analysis has to show a.1% (p<0.01) 61 page file (P242)
that the chance a difference between groups could have arisen due to b.5% (p<0.05) (correct)
random variation is: c.10% (p<0.1)
d.None of the above.
If Standard deviation is ±1, and mean is 10, 34% of people would be a.11.5 61 page file
included in range from 11 to ___? b.12
c.10**
d.9
The gold standard for evaluating clinical procedures in orthodontics is: a.Randomized clinical trial. (correct) 61 page file (P241)
b.Case reports.
c.Retrospective study, inclusion based only
on pretreatment characteristics.
d.None of the above
Rank the following study designs from least to most power: Expert opinion, case series, case study, ABO 2008 Proffit 4th edition, P269
cohort, randomized.

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