AHEAD Test and Discussions – ORAL PATHOLOGY 1. Double teeth is an anamoly most commonl y found ina) permanent incisors b) permanent canines c) primary incisors and canines d) primary molars
11. Chronic alcoholics may present with the features of a) erosion b) resorption c) abrasion d) attrition
2. Enamel hypoplasia is presented with all except a) Reduction in volu me of matrix b) p its and grooves on the enamel surface c) enamel with fewer pris ms d) inco mplete calcificat ion
12. It is necessary to avoi d the i ngestion of tetracyclines between the age groups from a) 4months to 7 years b) 1 year to 3 year c) 4month to 10 month d) 7 month to 5 year
3. Hypomineralized enamel characterizes wi th following except a) Enamel appears white and opaque b) tooth may appear pig mented buff, o range, or brown quickly ch ipped and worn away c) organic matrix o f hypomineralized enamel remains acid-soluble d) failure of the ameloblasts to fully calcify 4. Which of the following is an acquired disorder a) Gemination b ) fusion c) concrescence d ) none 5. All of the followi ng are the features seen in congeni tal syphilis except a) infection of the tooth germ by spirochaetes b) Hutchinson's incisors c) hypomineralized changes in the enamel d)Moon’s molars 6. Causes of hypercementosis can be all except: a) Paget’s disease b) periapical inflammat ion c) cleidocranial dysplasia d) mechanical stimulat ion 7. Trans mission of S. mutans occurs mainl y through a) saliva b) skin c) mother to ch ild d) blood transfusion 8. Which of the following statement is incorrect about dental caries a) Caries prevalence increases when populations become exposed to sucrose-rich diets b) Intrinsic sugars are more damaging than ext rinsic sugars c) Sucrose is the most cariogenic sugar d) Frequency of sugar intake is of more impo rtance than total amount consumed 9. Which of the following zone is an area of acti ve reminer alization a) surface zone b) body of the lesion c) dark zone d) t ranslucent zone 10. Pathol ogical attriti on may result from a) excessive intake of acid beverages b) faulty tooth brushing c) abnormal occlusion d) habits of pipe s moking
13. Which of the followi ng statement is incorrect about pul pitis a) Carbohydrates is the most important aetiological factor b) dental caries is the commonest cause c) bacteria can also reach the pulp by other local routes d) trauma to dentine and/or pulp may cause pulpitis and/or reactionary changes in the pulpodentinal 14. Which of the followi ng cyst arises from glands of Serres a) odontogenic keratocyst b) dentigerous cysts c) radicular cysts d ) ) paradental cyst 15. A constant feature associated with radicul ar cyst is a) impacted tooth b ) missing tooth c) non vital tooth d) ano malous tooth 16. High recurrence rate of keratocysts is due to all factors except a) satellite cysts b) difficu lty of surgical removal c) focal areas of active growth of the cyst wall d) cystic contents have a low soluble protein level 17. Epstein pearls are a) same as enamel pearls b) imperfection in the tooth bud c) seen in vitamin D deficiency d) small keratin cysts of newborn infant 18. Cyst resembli ng the bunch of grapes is a) Gingival cyst b) develop mental lateral periodontal cyst c) dentigerous cyst d) OKC 19. Most cases of pul pitis are caused by a) injud icious cavity preparation b) chemical irritation fro m sterilizing agent c) bacterial invasion fro m b loodstream d) bacterial invasion fro m carious lesion 20. Which of the followi ng lesion resembles frog’s belly a) ranula b) Retention mucocele c) extravasation mucocele d) dermo id cyst
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AHEAD Test and Discussions – ORAL PATHOLOGY 1.
ans: c: Double teeth are more co mmon in the primary than in the permanent dentition, the prevalence in different series ranging fro m 0.5-2.5 per cent for the primary and 0.1-0.2 per cent for the permanent dentitions. The incisors (and also the canines in the primary dentition) are most frequently affected and the condition may be bilaterally sy mmetrical. In the primary dentition the majority of cases involve the anterior mandibular teeth.
2.
ans: d: In enamel hypoplasia the ameloblasts fail to produce a normal volu me of matrix but any matrix which is produced generally beco mes as fully mineralized as normal enamel. Enamel hypoplasia presents clinically as pits or grooves in the enamel surface, or as a general reduction in the thickness of the whole enamel. The defective enamel has fewer prisms than normal and they may run in abnormal directions. In some cases no prism structure can be seen.
3. ans: c: Hypomineralized enamel results fro m a failure of the ameloblasts to fully calcify the previously formed mat rix, and generally such enamel appears clinically as white and opaque. After eruption it may beco me and be pig mented buff, orange, or brown quickly ch ipped and worn away. Much of the organic matrix of hypomineralized enamel remains acid-insoluble and is often preserved in sections of decalcified specimens. 4.
ans: c: Concrescence is an acquired disorder in which the roots of one or mo re teeth are united by cementu m alone after formation of the cro wns. This is most frequently seen in the permanent dentition where the roots of teeth develop close together (for examp le, between maxillary second and third mo lars) or following hypercementosis associated with chronic inflammat ion.
5.
ans: c: This disease produces characteristic hypoplastic changes in the enamel of permanent incisors and first mo lars due to infection of the tooth germ by spirochaetes. The mesial and distal surfaces of the incisors taper towards the incisal edges rather than toward the cervical margin, giving a 'screwdriver' appearance, and the incisal edges usually have a central notch (Hutchinson's incisors). These changes are most obvious in the maxillary central incisors. The occlusal surfaces and occlusal thirds of the crowns of the first molars are covered by small g lobular masses of enamel (Moon's molars or mu lberry mo lars).
6. ans: c: Hypoplasia and aplasia of cementum are uncommon. In cleidocranial dysplasia there is a lack o f cellu lar cementu m following the deposition of acellu lar cementum 7. ans: c · species that may be associated - non-mutans streptococci, e.g. mit is group - actino mycetes · transmission of S. mutans occurs mainly fro m mother to child · lo w plaque pH favours proliferation of mutans streptococci and lactobacilli · level of mutans streptococci in plaque increased by sucrose consumption 8. ans: b · caries prevalence increases when populations become exposed to sucrose-rich diets · ext rinsic sugars are mo re damaging than intrinsic sugars · sucrose is the most cariogenic sugar · frequency of sugar intake is of more importance than total amount consumed 9. ans: a · a dynamic physicochemical process involving dissolution and repreciptation of mineral · caries progression is usually a slow process · zonation of the early (wh ite spot) lesion reflects different degrees of demineralization · four zones usually seen: translucent zone (1 per cent loss), dark zone (2-4 per cent loss), body (5-25 per cent loss), surface zone (intact) · surface zone is an area of act ive remineralizat ion · the morphology of the lesion differs in pits and fissures compared with approximal surfaces 10. ans: c: Pathological attrit ion may result fro m: (1) abnormal occlusion - either developmental o r fo llo wing ext ractions; (2) bru xis m and habits suchas tobacco andbetelchewing; (3) abnormal tooth structure, for examp le amelogenesis imperfecta, dentinogenesis imperfecta 11. ans: a: A similar pattern oferosion may also be seen in other patients with gastro -oesophageal reflu x, for examp le chronicalcoholics, where gastric reflu x is probably associated with chronic gastritis 12. ans: a: It is particularly important to avoid tetracyclines fro m 4 months to about 7 years of age if severe clin ical d iscoloration of the permanent dentition is to be prevented. 13. ans: a · bacterial infection is the most important aetiological factor Academy of Higher Education and Advancements in Dentistry (A.H.E.A.D) 2 R-704, New Rajinder Nagar, New Delhi – 110060. Ph: 011 - 28743814, 25716297, 9810187297. Email-
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AHEAD Test and Discussions – ORAL PATHOLOGY · dental caries is the commonest cause · bacteria can also reach the pulp by other local routes · trau ma to dentine and/or pulp may cause pulpitis and/or reactionary changes in the pulpodentinal 14. ans: a · derived fro m ep ithelial residues of the tooth-forming organ · the main cyst types derived fro m each residue are: - dental lamina rests/glands of Serres (i) odontogenic keratocyst - reduced enamel epitheliu m (i) dentigerous cysts (ii) paradental cyst - rests of Malassez (i) rad icular cysts 15. ans: c : apical, residual, or lateral sub-types · apical is commonest type · associated with non-vital tooth · apical rad iolucency indistinguishable fro m a periapical granulo ma · may be sympto mless · enlargement of cyst leads to bone expansion 16. ans: d · tendency to recur related to difficulty of surgical removal - thin, easily ruptured wall - project ions into cancellous spaces easily torn - satellite cysts in capsule · cyst enlargement involves - focal areas of active gro wth of the cyst wall - extension of proliferating areas along cancellous spaces - production of bone resorbing factors 17. ans: d: Ging ival cysts are of little clin ical significance. They are co mmon in neonates when they are often referred to as Bohn's nodules or Epstein's pearls. Most disappear spontaneously by 3months of age. They arise fro m remnants of the d ental lamina wh ich proliferate to form s mall keratinizing cysts. 18. ans: b: Occasionally, developmental lateral periodontal cysts are mu ltilocular and may be described by theadjective 'botryoid' because of their resemblance to a bunch of grapes (botryoid odontogenic cyst). 19. ans: d · bacterial infection is the most important aetiological factor · dental caries is the commonest cause · bacteria can also reach the pulp by other local routes · trau ma to dentine and/or pulp may cause pulpitis and/or reactionary changes in the pulpodentinal 20. ans : a: Ranula is a clinical term used to describe a swelling of the floor of the mouth which is said toresemble a frog's belly .It is not a pathological diagnosis. Histologically, most ranulae are mucous extravasa tion cysts. Occasionally, a ranula may extend through the mylohyoid muscleand present in the submandibular area or neck, referred to clinically as a plunging ranula.
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