Table of Contents 1 ORTHODONTICS 1 Growth And Development. oot 2 Development Of Dentition 013 3 Etiology Of The MalocclUsion .......cccnsssssnenesnnensnnennennanennsnnensnnses O19 4 Diagnosis. 028 5 Cephalometry 036 6 — Occlusion & Classification Of Malocclusion, 7 Biomechanics - Tooth Movement 8 Preventive & Interceptive Orthodontics... 9 Removable And Fixed Appliances 10 Myotunctional & Orthopedic Appliances. 11 Treatment Planning 12 Synopsis... I PEDODONTICS 1 Child Psychology 116 2 — Caries And Restorative Dentistry 130 3 TraUMAtOlOgY......nssennnennisnnnintnniinanianensisneess sosontnieineneee 141 4 Pediatric Endodontics 147 5 Diseases Of Child... coscnenenennneninentntninnnininnenennenenenimnee 158 6 MiscellaneOUus...........cnesnnssninnnniinnininnniniannninnannnannss 160 7 Synopsis 174 Ml COMPLETE DENTURE 1 Impression ProcedureS......0c0.000 eR 1) 2 Border Moulding And Posterior Palatal Seal 196 3 Jaw Relations... ontuinntisteitneninitirensnesesteseseese 200 4 Teeth Setting And Articulators......... so . 208 5 Special Techniques In Complete Dentures..... 218 6 Miscellaneous. 222 eS 235IV_ FIXED PARTIAL DENTURE vi vil 1 aNounsoen Principles Of Tooth Preparation. Complete And Partial Veneer Crowns Metal Ceramies......ecccnecsies sostsnetsatianenensniese . oe Laminates, Maryland Bridge, Allceramics, Cementations A And Tissue Dilation. Pontics, Finish Lines Miscellaneous. ‘Synopsis. REMOVAL PARTIAL DENTURE eanroens Introduction And Classification Major And Minor Connectors Rests, Direct And Indirect Retainers. Survey And Design.....ce Miscellaneous. Synopsis ORAL AND MAXILLOFACIAL SURGERY ©RNOne wna Exodontia and Impactions, Local and General Anesthesia. Mandibular Fractures Middle Third Fractures TMJ and Maxillary Sinus Cysts and Tumours... Odontogenic Infections Preprosthetic & Orthognathic Surgery and Miscellaneous Synopsis GENERAL SUGERY onrens Diseases Of Salivary & Thyroid Glands... Infections Trauma Cleft Lip And Palate. ‘Swellings, Ulcers And Tumors Of Head And Neck Diseases Of Larynx And Pharynx. 245 250 254 258 262 266 269 278 .. 298 299 305 315 321 323 338 . 354 380 396 409 418 427 440 463 503 514 519 -. 523 528 537vit 7 Transfusion, Shock, Burns And Wound Healing 8 Arterial And Venous Disorders. 9 Miscellaneous 10 Synopsis ORAL PATHOLOGY AND MEDICINE Developmental Disturbances Benign And Malignant Tumours Of Oral Cavity . Odontogenic Cysts And Tumours Diseases Of Salivary Glands Dental Caries Pulp And Periapical Infections Physical And Chemical Injures... Diseases Of Bones & Joints OYH9 HARON H+ 9 Diseases Of Nerves & Muscles... 10 Skin And Vesiculobullous Lesions 11 Bacterial Infections. 12. Viral Infections 13 Mycotic Infections 14. Oral Aspects Of Metabolic Diseases. 15 Tongue Disorders... 16 Pigmentation 17. Diseases Of Blood 18 Miscellaneous 19. Synopsis... ORAL RADIOLOGY Radiation Physics Biological Effects Of Radiation Radiation Safety And Protection. X-ray Film, intensifying Screen And Processing Of X-ray Films. Projection Geometry And Intraoral Radiography Extraoral Radiography... Radiographic Diagnosis ‘Synopsis. eNonnron 541 552 556 564 594 610 632 641 649 655 661 668 673 679 689 696 702 706 713 716 718 725 . 732 760 768 775 779 785 789 796 805x XI xi PATHOLOGY Cell in health and disease Inflammation, immunity & hypersensitivity Healing Fluid and haemodynamic disorders Growth disorders and neoplasia... Diseases of blood and lymphnodes NOOAROPH Systemic Pathology & Miscellaneous 2 ‘Synopsis GENERAL MEDICINE 1 Infections Central Nervous System. GIT, Liver And Kidney... Hematology And Endocrinology Cardiovascular System 2 3 4 5 Respiratory System 6 7 Miscellaneous 8 ‘Synopsis. PHARMACOLOGY Chemotherapy... A\N.S, Blood and Endoerinal drugs NSAIDs and other CNS drugs General Pharmacology Drugs acting on CVS, GIT And Respiratory systems. Local And General Anesthetics Miscellaneous eNoaanpon Synopsis Sie 817 822 .. 834 838 . 845 854 867 878 .. 890 903 912 922 940 951 967 . 978 .. 981 1005 1021 1039 1047 1057 1063 1080FEEDBACK FORM Students are requested to use this table if they find any mistakes in this book and Iwelcome feedback so that our juniors will be benefited. As an attempt to make this book error free and as a token of appreciation, Dental Pulse Team has decided to reward the students for sending the corrections. Each first received correction with proper reference will attract a reward of %.1,000/-. — Dr. Satheesh Kumar K. i explanation)Our Sincere thanks to os) for sending us the corrections in 8th ed of Dental Pulse. As per our promise, you will be receiving the following cheques shortly. You are requested to call 92462 10072 and update your communication details so that we can send the cheques by courier. wesy7aae soozeqouae Geese 29 wes7?aue soozeq00BE OeBbeeR” w2s7 79S" soozeqooaH OzBEeer 29 \—SS ORTHODONTICS ORTHODONTICS |. REFERENCE BOOKS TAKEN: 1. PRINCIPLES AND PRACTICE OF ORTHODONTICS by GRABER - 3rd & Sth editions 2. TEXTBOOK OF ORTHODONTICS by M.S.RANI~ 3rd edition 3. THE ART AND SCIENCE OF ORTHODONTICS by BHALAJI~ 3rd, 4th & Sth editions 4. TEXTBOOK OF ORTHODONTICS by GURKEERAT SINGH - 1st & 2nd editions 5. TEXTBOOK OF PEDODONTICS by SHOBHA TANDON - 1st edition 6. CONTEMPORARY ORTHODONTICS BY WILLIAM R. PROFFIT ~ 4th & 5th editions 1, GROWTH AND DEVELOPMENT a) Body b) ¢) Coronoid a) Condylar cartilage Ramus (MAN -2K) 2. Maxilla develops by 2). Endochondral bone formation ) Tatra membranous bone formation ¢) Cartilage replacement and intre membranous bone formation 4) Mostly cartilage replacement anda little by intra membranous (MAN 3. Which of the organ/system increases to 200% the size before puberty age 9-10 years 8). Lymphoid b) Somatic b) Genitals a) Neural (MAN -00) 4. Servo system theory of growth was given by 2) Scott b) Petrovie ¢)_Limborgh 4) Van der klaauw (MAN -01) 5 Greatest amount of cranial growth occurs by 8) Birth to five years b) 5 ~ 6 years 6-7 yeas 4) 7~10 years (MAN-97) 6. At birth which of the following structures is nearest the size ft will eventualy attain in adulthood b) Mandible 4) Nasal capsule (MAN -97,98) “Epigenetic factors’ control are? 8) Genetic factors present within the skeleton b) Genetic factors present outside the skeleton ©) Local non genetic factors 18) General non genetic factors the growth of skeleton (MAN -97) 8. Scammon’s growth curve. False is 8) ‘Neural tissues-Host of the growth is completed by 6 years Lymphoid tissues ~ growth reaches 200% by age 13 and regresses afterwards ©) Genital tissues - most ofthe growth is completed by the age of puberty 4) None of the above (MAN -97, ALINS -94) 9. Age of closure of sphenooccipital synchondrosis 8) 6 years b) 12 years ©) 18 years ) 25 years (MAN -28) Persistent part of the envelope of Meckels cartilage ts @) Stylomandibular ligament ) Tempero madibular tigament ©). Spheno mandibular tigament 4) Stylohyofd ligament 10. (MAN -28) 11, Meckel’s cartilage gives rise 8) Condylar process _-b) Coronoid process )_ Rest of ramus «) None of the above (Nan-s8) 7 8 A 8 AS) AD 4) ¢ oe 10) © aD ASS(0S Dental Pulse _ 12. Growth of oral structures is mainly influenced by factors: b) Intramembranous growth a) Hereditary 1) Environmental ) Appositional growth d) Periosteal growth )_Hereditaryinfluenced by environmental {AIPG -96) 4) None of the above 24. The pharyngeal muscle which forms a part of buccinator (MAN -2001) mechanism 13. Duration of adolescent stage in boys is a} Inferior constrictor b) Middle constrictor a) Byears b) 3-5 years ©) Superior constrictor 4) Palatophryngeus ) years 4) 5 years (KAR -02) (P6I-2011) 25. Premaxilla is derived from 14, An early prepubertal growth spurt indicates: 2) Maxillary protuberance b) Palatine bones 4) Longer treatment time b) Fast maturing child ) Frontonasal process 4) Median process «) Slow maturing child d) An endocrine dysfunction (AlIMs 94) (MAN-2001) 26. Differential growth means: 15. Sphenooccipital synchondrosis closes at the age of 8) Difference between growth and development. 8) 6 years of age b) Early puberty age b) Difference between individual growth «) Early adult age 4) Tenever closes ) Acceleration in growth. (ar -99) 4) Different tissues grow at different times rate and ammount. 16. At birth, the palate is relatively flat: in adults; it is (KAR -02) vault-shaped. By which of the following does this change 27. In.a newborn child we generally see: occur a) Maxillary protrusion b) Maxillary retrusion 4) Bone resorption in the palatal vault ) Mandibular protrusion) Mandibular retrusion 5) Growth of the maxillary sinuses (Ps -95) Deposition ofthe alveolar crestal bone 28, The implant method of studying growth was proposed by: 44) Bone deposition on the posterior wall of the maxillary a) Scammon ») Borg. tuberosity )_Belchier 4) Bjork (AtPG -97) (APG -04) 17, Ifa child's teeth do not form, this would primarily affect 29. Earlier closure of a suture is called the growth of th a), Synchondrosis b). Ankylosis 2) Maxila b) Mandible €) Synostosis 4) Epiphysis ©) Whole face 4) Alveolar bone (KAR -98) (AIPG -03) 30. The 'V' principle of growth is best ilustrated by the 18. After the age of six the increase in the size of mandible 2) Body of Mandible b) Mandibular ramus occurs at: )_ Mandibular symphysis 2) Symphysis 1) Between canines 4) Spheno-occipital smnchondtosis «) Along the lower border d) Distal to 1* molars (KAR -98, AP -06, 14) (AIPG -01, KAR -04) 31. The first ossification center of the mandible in a 6 weeks 19, Vital staining was introduced by old human embryo is found in which one of the following 2) Enlow ) Wolf locations? 6) doha Hunter 4) Petrovie a), Futurecoronoid process (aP-2012) ) Future condylar process 20. Growth of the maxilla in the vertical direction is due to: )_ Future mental foramen a) Growth of the alveolus b) Growth at sutures 4) Future mandibular foramen ©) Growth of the cranial base (APPSC -99) 4d) Growth ofthe synchondrosis 32. Functional matrix theory is hypothesized by (AIINS -99) a) Scott ») Sicher 241. Growth of cranium continues upto ) Petrovic 4) Moss a) 2yts b) 10 ys {COMEDK -03) ©) 15 yrs 4) Grows equally 33. Bjork used the implants for predicting facial growth (AP 18) changes. This approach is called as: 22. Absence of sesmoid bone in git of age about normal 2} Longitudinal approach. b) Metric approach. range of puberty is said to have ) Structural approach. b) Computerized predication 8) Completed the growth b) Over growth (AIPG -04) «)_ Delay in reaching puberty 34, The functional Matrix concept as revised by Moss does 4) All of the above not include: (ar -03) 8) Connected cellular network 23, In sutures there is protiferation of connective tissue b) Mechano transduction followed by replacement of bone this is called: ) EpigeneticEpthesis. d) Genomic thesis a) Endochondral bone growth (AIPG -04) eG) 0 mB 1) C ie i) 0 TD W)C MA Aye Me we Me 25) C26) 027) D2) 02) C30) B 31) C32) 033) A 34)ont 0nrxes 35. Negative growth isa characteristic of 6) Sutuat 4) Syndesmosis 2) Tests ») Brain (1a8-o6) 3) Mandible ) Thymus 47, More than 80% of growth of the bran or bran vault has (APS -04) been achieved by: 36. The body tissue that grows rapidly but shows minimal) T2yearsof feb) S years of froth after the age of 67 yeas i: 3) tByeasoftife ——d} 22 years of fe ) Neural tissues b) Lymphoid sue, (coneoK08) 6) Steletal issue. d) Genta sue 48, Mechanism of bone gronth i by: (ates 04) 0) one deposton and resrpion 237. Combinations of deposition and resorption occuring in) Cortical dit the differen bones of he skall which result ina growth c) Dispacement——_-d) Alf the above movement towards the depository surface is termed as (KAR-04) 2) Remodeting B) isslacement 49. change in the Sntensty and direction f funcional ) Phyloge resorption d) Drift forces would produce demanstable change inthe internal (Pst-s7) architecture and enteral form of bone vas stated by, 38 _Enlows'V principe of growth s found in 2) Melvin moss by EM angle 2) ala base 3) Maxila ony 6) adinison 4) Salis Wot {} Moxila and mandible) None of the above (comeox-08) (P6103) 50. Development of face occurs inthe following planes 38. ral and Nasa capsule of functional growth elated to 2) Transverse, sagittal vertical 2) Pelsteal matin b) Sutra mati 0) Transverse, vera, sagt 5) Capsular matix, 4) None of he above ©) Sagi, vera, nansvere (PGI -03) d) Vertical, transverse, sagittal 40. In sicher’s theory, suture acts as (AP-06), 2) a independent growth potential 5A. Read the following carefully: b) Dependent on cranial base 1) Spheno-occipital synchondrosis, 6) Used for growth adjustment 2} Mandibular conde 8) None of above 3) Fontomarlaysiure (Pot03) 4) Nasal septum 44. The movement of bone in response to its own growth is 5) Alveolar rocesss terme 2) Rotation b) Secondary displacement Which ofthe following are sites of cartilaginous growth Primary csplacement ) Diferentation postnatally (arog 1) 182 ) 286 42. the “Suture dominance theory" of canafacal growth 0) 2,385 a) 34s was given by (atrs-06) 23 Hoss b) sicher 52. Father of modem orthodontics ts: rat 8} Petrovic 2) Dewey 0) Angie (1aR-05) 5) Anion 4 Clk 463, Cranial vault volume at 7 years: (aP-07) os bye 53, Allof the following are considered microskeletal units of oun 8) 3/4 the mandible as per the matrix theory EXCEPT: (7si-05) 2) chin 1) lene fossa 4h. Skala birth contains 8) Coron process 4) Angle ofthe mandible 2) 22 bones 6) 34 bones (KCet-07) 6) 5 bones 8) 54 bones 54, Growth estimation ts done by: (coneok-o8) ”” 2) Hontal bone +) Cervical vertebrae 45, Spheno occipital synchondroses caries the growth of <)Capitate ) Clvte anterior half of the gonial base of the cranium and upper (AIPG-07) porto the face 55. Functional matrix theory suggests thatthe determinant 2) Forward and downward directions frowth of seleta sues resides ins b) Forward and lateral direction a) Skeletal b) Sutures 6) Upward and forward ivections ©) Cartlages 4) Nonsheleta tissues 8) Only forward ection (icet-07) (COMEDK-06) 56. The three main vertical pillars of trajectories of force 46, Allo the following are examples of fbrous joint except: arising from the alveolar process and ending inthe base 2) Symohyis 3) Gomphoss Of the skal ae al excep a) Canine pillar b) Zygomatic pillar BL A ae) © EL) A ee) SRO) © BEL A ae we) 049) 0 SO) Asi) 8 52) 8 53) 8 54) B55) 0 oe) 0 (Se o==" Dental Pulse ©) Plerygoid pillar 4) Condylar pillar (KcET-o7) _ ©) Vander Linden 4) Latham (COMEDK-09, 11) 57. The Condylar Cartilage in the mandible is held to be a 69. The groove separating the gum pad from the palate is ) Primary cartilage —b) Secondary cartilage called ) Tertiary cartilage) Non-growing cartilage a) Gingival groove») Dental groove (KCET-08) ) Lateral sulcus ) Transverse groove 58. Growth activity at which of these synchondroses (KceT-2011), completes first? 70. Who proposed the “trajectory theory of bone formation”? a) Spheno-occipital _b).Intersphenoidat 2} An anatomist Meyer b) a mathematician, Cullman )_Int-occiptal 4) Sphenoethmoidat ) Both a and b 4) None ofthe above (COMEDK-08) (AIPG-2011) 59, Arch space for eruption of 2nd & 3rd molar created by: 71. Anthropometry is 8) Apposition of Hamular processes a), Measurement of skeletal dimensions on human skeletal 5) Resorption of anterior border of ramus remains «Resorption of posterior border of ramus b) Measurement of skeletal dimensions on living individuals 4) Apposition of lower border of mandible )_ Measurement of skeletal dimensions on radiographs (AIIMs-07) 4) Measurement of skeletal dimensions on photographs 60. First growth spurt takes place at what age (aP-2012) a) Ist year b) 3rd year 72. The mandible grows longer by apposition of new bone on 6th year 4) 9th year the posterior surface of (AP-08) 2) Coronoid process b) Condyle 641. Growth sites in maxilla is / are ) Ramus 4) Symphysis 2) maxilary tuberosity b) sutures (BHU-2012) ©) nasal septum 4) all ofthe above 73. The initial sign of sexual maturity in boys is usually (AP-09) 2) Fat spurt ») Development of Adam’ apple 62. Growth trends show that in most patients ) hange in voice 4). Appearance of facial hair ) maxilla and mandible grow in unison (aP-2012) 5) maxilla grows more rapidly 74, Which one of the following undergoes predominantly )_ mandible grows at fester rate than the middle hid ofthe Face endochondral ossification? 44) no such eonelusion could be made a) Maxilla ») Palate (AP-09) ©) Cranial base 4) Cranial vault 63, The first evidence of cartilage getting converted to bone (aP-2012) {in craniofacial skeleton occur during 75, More than 90% of growth of brain or brain vault has a) Fourth Postnatal week b) Eighth Prenatal week achieved by? ) Fourth Prenatal week 4) Eighth Postnatal week 2) S years bb) 12 years (COMEDK-10) ) 18 years 4) 21 Weeks 64, In child development, the embryo period is? (NEET-2013) a) 0-2 weeks b) 2-3 weeks 76. Remodelling theory of craniofacial growth was given by ©) 2-8 weeks 4) 9 weeks to birth a) Brash ») John hunter (P61-08) ) Vander Klauuw 4) Sicher & Weinmann 65. Growth is generally completed (ATINS-2012) a) First in head and last in depth of face 77, Normal growth of maxilla occurs by +) First in head and last in width of face 2} Displacement and drift b) rift only 6) First in head and last in height of face ©) Appesition 4) Replacement resorption 4) First in depth and last in width of face (AIIMS MAY-13) (COMEDK-10) 78. Lip thickness reaches maximum at what age is males? 56. Growth of Condyle is by 2) 18 years b) 18 years a) Membranous growth b) Interstitial growth ) 25 years 4) 13 years «) Cartilaginous proliferation (AIPG-14) 4d) Bony Apposition 79. Cartilage differs from bone in that, the cartilage can (aP-10) increase in size by 67. The gonial angle at birth is? 2). Apposition b) Interstitial growth a) 110° b) 115° ) Selective resorption d) Endosteal remodelling 9 175° a) 145° (COMED-14) (AP-10) 80. In preadolescent child the moximum midline diasteme 68. Who proposed the nasal septum “thoery of craniofacial that will be closed spontaneously after canine eruption growth”? 2) 1mm b) 2mm a) Mass ) Sicher 7) 858) 8 So) B 6) A GYD 2) c eB 6) C OYE 66) c GHD 6) 0D @)A 3) € 71) 8 72) C_73)A8C_74) C75) A_76) A 77) A 78) B75) 8 80) Bee | a1. 82. 83. 84. 85. 36. a7. 6) 4mm @) 5mm (comeo-14) [Anterior arch width of the dental arches increases upto the age of 8) 6 to 8years ) 20 to 12 years ©) 12to téyears ——d) 14 to 16 years (ocer-14) Which of the following is true? 4) Upper lip applies more pressure on upper teeth and tongue on lower teeth b) Tongue apply more pressure on upper teeth and lower lips on lower teeth ©) Up pressure is more d) Tongue pressure is more (PGI JUNE-2014) In assessment of skeletal age based on cervical vertebrae as seen in lateral cephalometric radiograph, stage 3 indicates |) More than one year beyond peak growth b) No growth )_Less than one year prior to peak growth 4d) Peak growth still a year or so ahead (aPPs-15) Corpus rotation in relation to cranium is known as a) Matrix b) Tntramatrix ) Internal rotation d)_ Apparent rotation (PGT JUNE-2013) ly age and 2) Depth of oropharynx b) Depth of nasopharynx 2) Width of nasopharynx d) Width of eropharynx (PGT JUNE-2011) Period of adolescent growth in boys is? 2) 3 years b) 3.5 years ©) 4 years 4) 5 years (Pot 0€¢-2011) Hemifacial microsomia occurs during? 4) Formation of germ layer b) Migration of neural crest cells ) At the time of organ formation «) Final cfferentiation of tissue (P61 JUNE-2012) ORTHODONTICS BSS) = a) A a2) A mC 8) C 85) B86) 0 BN) OB=e Dental Pulse _ 1. GROWTH AND DEVELOPMENT — ANSWERS. ‘B [Bhalajhi 3rd ed 36] Usually bone grows by apposition and cartilage by interstitial growth. Mandibular condyle is the only bone that shows both apposition and interstitial growth “W [Bhalajhi 3rd ed 27] In endochondral type, the bone formation is preceded by formation of cartilaginous model, which is replaced by bone. Eg: thmoid bone, Hyoid, Incus, Stapes. In intramembranous type, the formation of bone is not preceded by formation of cartilaginous model. Instead bone ‘is laid directly in a fibrous membrane. laxilla, nasal bones, parietals, zygoma, vomer, lacrimal, zygomatic. Both intiamembranaus and endochondrial ossification is seen in ~ occipital, temporal, sphenoid bones ‘K (Bhalajhi 3 rd ed 10) ‘Scammon's growth curve classifies body tissues into & types. Each of these tissues grow at different times and rates. * Prolifeates rapidly in late childhood and reaches. 200% adult size, This is Lymphoid | an adaptation to protect children. from Tissue | infections * By the age of 18 years, lymphoid tissue undergoes involution to reach adult sie, Grows very rapidly and reaches maximum Neurat | size by 6-7 years (AIIMS- 2012) of age. tissue | 6 Very tle growth of neural tissue occurs after 6-7 years. (AIPG-14) * Exhibit an “SY shaped cuve with rapid General |" growth up to 2-3 years followed by a er visceral) Siow phase of growth between 3-10 years. tects] _(COMED-09) tones | After 20th yeas, a rapid phase of growth occurs terminating by the 18-20th years, “ca _ |= Shows negligible growth until puberty GEMS | rows rapiaty at pubertal age and reaches adult size after which gromth cases. For which of the following tissue systems Scammon’s ‘curve shows an ‘S' shaped curve? [COMED-2012] a) Lymphoid tissue ) Neural tissues ©) Muscle & Bone tissues) Genital tissues [M.S.RANI 3rd ed 77] Sutural theory Cartilaginous theory Sicher Scott 9. 10. a Functional matrix theory Melvin Moss Servo system theory af growth, | Petrovic and Chartier (Cybernatics) Mult-factorial theory Van Limborgh. Genetic theory Brodie Neurotropism Behrents [Bhalajhi 3rd ed 31) 'X (GRABER 3rd ed 51] At birth, cranium is about 55-60% of adult size, By the age of 6-7 years, almost 95% of adult size is attained. At Infant skull is composed of 45 bones which are reduced to 22 in adults, “B [GRABER 3rd ed 41] According to “Van Limborgh’s” multifactorial theory, growth 's under control of genetic and environmental factors. Intrinsic genetic factors are the factors present within the skeleton, Epigenetic factors present outside the skull and manifests their influence in indirect way by intermediary action on associated structures Eg:- Eyes, brain etc. °C [Bhalajhi 3rd ed 10) Genital tissues show negligible growth until puberty. They grow rapidly after puberty reaching adult size after which growth ceases (C [GRABER 3rd ed 39) “C [Bhalajhi 3rd ed 28] The sphenomandibular ligament extends from the lingula of ‘mandible to the spine of sphenoid bone and forms a remnant cof meckels's cartilage. ach (neces | sptenomadinlrUgonet, aaa ies tet ace ach cartlage ‘Stapes, stylohyoid process, ee en eee ean or a sper pat saa atl : cetera eat ‘inferior part of body of hyoid ee eee ‘D [Bhalajhi 3rd ed 28) Mandible develops as intramembranous bone, lateral to meckel's cartilage. The proximal end of meckel’s cartilage ives rise to malleus and incus and later disappears without contributing to the formation of mandible.ee | 22. 3B. “C [Bhalajhi 3rd ed 18,19) Y [Proffit 4th ed 109) 15. 16. vw. 18. 19, 20. a 22. 23. 24. 25. 26. an. 28. 29. [Bhalajhi 3rd ed 32) (C [MS.RANI 3rd ed 73] ‘D' [Bhalajhi 3 rd ed 35] ‘D [GRABER 3rd ed 67] ‘The mandible grows in length by resorption at the anterior border and bone deposition at the posterior border of ramus. This provides the required space for the developing and erupting permanent teeth. ‘C [Proffit 4th ed 36] Agents for vital straining: * Alizarin Tetracycline * Technicium isotope (99mTc) [Bhalajhi 3 rd ed 33) “C [GRABER 3rd ed 51] ‘C [Bhalajhi 3rd ed 168] The sesamaid is a small nodular bone most often present embedded in tendons in the region ef the thumb, Calcification of sesamoid bone is one of important features ‘of pubertal growth spurt, which is earlier in females than in males, Absence of sesamoid bone indicates delay in reaching puberty. 33. 1" [Bhalajhi 3rd ed 16] [Bhalajhi 3rd ed 53) ‘C [Bhalajhi 3rd ed 26] Y [Bhalajhi 3 rd ed 10] Y [Bhalajhi 3rd ed 40) ‘D’ [Bhalajhi 3rd ed 13] Tantalum implants are embedded in certain areas of the maxilla and mandible to study the growth of skull, Implants and vital staining techniques are used to study the dynamic changes occurring during bone deposition and 3, resorption where as radiographs show static changes. ‘C [W.S.RANI 3rd ed 56] Fusion of two adjacent bones by @ cartilage Eg: spheno-occipital. ‘Synchondrosis ORTHODONTICS Fusion of two adjacent bones by a fibrous Syndesmesis | igament Early closure ofa suture or early fusion of Symostosis | two adjacent bones by a bone. Eg: Symphysis menti 30. 31, 32, 34, 35. “BY [GRABER 3rd ed 65, 66] ‘According to Enlow’s expanding 'V' principle many facial bones will have a ‘V' shaped pattern of growth. Bone deposition occurs on inner side of wide end of Vand bone resorption occurs on the outer surface. This results in growth mavement towards the ends. Eg: Ramus of mandible, palate, coronoid and Condylar process etc. °C [Bhalajhi 3rd ed 28) A single ossification center for each half of mandible arises in the area of future mental foramen lateral to. meckel’s cartilage where the inferior alveolar nerve bifurcates into ‘mental and incisive nerve branches. Maxilla has 3 ossification centers. One primary ossification center is for maxilla proper (which arises at infraorbital foramen above the canine fossa) and the remaining two ossification centers are for pre-maxilla ‘D’ [Bhalajhi 3rd ed 17] The function matrix concept of Melvin moss is based on the original concept of functional cranial component by vander klaaus (PGI June- 13). According to moss, the growth and maintenance of all skeletal tissues is always secondary to certain responses that occur in non-skeletal tissues. “A [Proffit 2nd ed 28] °C [American Journal Of Orthodontics] Functional matrix theory revisited by Moss includes 4 concepts 1) The rale of mechanotransduction 2) The role of an osseous connected cellular network 3) The genomic thesis 4) The epigenetic antithesis and the resalving synthesis D' [Bhalajhi 3rd ed 10] Thymus is a lymphoid tissue which proliferates rapidly in late childhood and reaches 200% of adult size. After 18, years, it undergoes involution to reach adult size °K [Bhalajhi 3rd ed 10) ‘D [Bhalajhi 3rd ed 15) Type of Bone growth Combinations of deposition and resorption cceurring in different bones of skull resulting in growth movement tows depositary surface Dei (ee o=SUA 38, 39. 40. a 42. 43. Dental Pulse It is the movement of whole bone as a unit © In primary displacement, the bone is displaced as a result ofits own growth. * In secondary displacement, the bone gets displaced as a resutt of growth and enlargement of adjacent bone. Displacement ‘C [Bhalajhi 3rd ed 19,20] “€ [Bhalajhi 3rd ed 18] 1a) PERIOSTEAL MATRICES: Eg: Blood vessels, nerves, glands ete. ‘These act actively upon thelr related skeletal units and produce transformation of size ot shape. This, tuansformation is brought about by deposition and resorption 1b) CAPSULAR MATRICES: Eg: Neuro-cranial capsule, oro facial capsule, Capsular matrices act passively and produce secondary translation, This translation is not brought about by deposition and resorption. ‘X [Bhalajhi 3rd ed 16] fi Bn ; ‘ Gromth is controlled by genetic Genetic theory | influence and is preplanned. Sicher’s sutural | Growth in the sutures is responsible theory for craniofacial growth =A multfoctorat theory, which combines all the three existing Van Limborgh’s | theories. theory States that growth is under control ‘of intrinsic genetic, epigenetic and environmental factors. * Cartlaginous part of skull are primary ‘enters of growth with sutures being ae nous | _ only secondary in nature they ‘+ According to Scott, the nasal septal ‘artilage is the pacemaker for growth of entite naso-maxillary complex Woss's * The growth of skeletal components Functional fs largely depends on functional tmatrix theory | matrices or non-skeletal tissues. ‘Scott's Hypothesis is emphasized on (KAR-2013) ‘Ans: Hasal septum “C [Bhalajhi 3rd ed 15] Refer Q. No. 37 ‘ [Bh i 3rd ed 16] ‘D' [Gray's Anatomy 39th ed 486] 44 45. 46. 47. 43. 49. _ The size of cranial vault is almost of adult size by the end of 7 year, ‘¢ [MS. Rant 3rd ed 67] The skull at birth contains 45 separate bones; many of these bones are fused together and are reduced to 22 bones in adult. “C [Bhalajhi 3rd ed 31] The important synchondroses found in cranial base are spheno-occipital synchondrosis, spheno-ethmoid synchondrosis, inter-sphenoid synchondrosis and intra- occipital synchondrosis, * Principalgronth cartilage of the cranial base during childhood. «= Itis cartilaginous junction between Spheno-occipital synchondrosis | sphenoid and the occipital bone (Last synchon- | + The direction of growth of the drosis to fuse | spheno-occipital _synchondrosis AP-10) ‘upwards and forwards It closes at an average age of 18 years. =, |e It isa cartilaginous band between Sohwroetinoid "the phen en eta Sones sunchondrosis | ie ossfies by 5-25 years of age. |, |e itis a cartilaginous band between pera tthe 2 parts of the sphenoid bone. Ssmchoncrosis | « it ossfies at birth Tntra-occipital |» Ossified by 3-5 years of age. synchondrosis 'X [Gray's Anatomy 39th ed 103] Consists mainly of collagenous Junctions between bones. Fibrous joints gg. Sutures, gumphoses and syndesmoses ‘tea Eg: Synchondioses (primary Cartilaginous ara cartilaginous joint) and symphyses (secondary cartilaginous joints) ‘Al symphyses are median and almost Symphyses | confined to axial skeleton 8B [Bhalajhi 3rd ed 33] By birth, 55 - 60% of adult size is achieved By the age of 4-7 years, 94% of adult size is attained, ‘© By 8 13 years of age, 98% of adult size is reached, 1! [Bhatajhi 3rd ed 14-15] ‘D' [Bhalajhi 3rd ed 54) In the late 1800s, Wolff, a German physiologist, observed that the internal architecture of bones reflects the stress patterns on them (KERALA -2015). According to Wolf's aw of transformation of bone, unlike other connective tissues, bone responds to mild degrees of pressure and tension. Those changes are accomplished by means of resorption of existingee | 50. 51. 52. 53. 54. 55. 56. bone and deposition of new bone and these changes takes place on the surface of bone under the periosteum, or in the ‘ase of cancellous bone on the surface of the trabeculae or on the walls of marrow spaces x ‘B (M.S. Rani 3rd ed 70, 74] [Bhalajhi 3rd ed 5] ‘8! [Bhalajhi 3rd ed 17/8) ‘The functional matrix hypothesis suggests that the origin, form, position, growth and maintenance of skeletal tissues are always secondary to specifically related non-skeletal tissues. Functional Cranial component Functional matrix consists of Skeletal units Glands, ee. + Microskeletal units ‘ Gonial ‘B [Bhalajhi 3rd ed 171] The shapes of the cervical vertebrae differ at each level of skeletal development, and this helps to determine the skeletal maturity of a person. This isthe basis of Hassel and Farman system of evaluating skeletal maturity using cervical vertebra. The use of cervical vertebrae as skeletal maturity indicators was first done by (KAR-2013) Ans: Hassel and Farman Y [Bhalajhi 3rd ed 17] ‘D'[M.S, Rani 3rd ed 101, 102] Benninghoft studied the natural lines of stress in the skull by piercing small holes into fresh skull. Later, when the skulls were dried, he observed that the holes assumed a Linear form in the direction of bony trabeculae. These lines were called Benninghoff's lines or trajectories, ORTHODONTICS 57. 58. 59. 61. 62. 63. Trajectories of the maxillae tun from the maxillary alveolar process to the base ofthe skull. The three vertical trajectories include: ‘© Frontonasal or canine buttress ‘© Malar-zygomatic buttress = Pterygotd buttress In mandible, Benninghoff’s trajectories are essentially parallel. A line of stress extends from condyle to symphysis, and from ramus that run through spongiosa, The lower border of mandible and the myalohyoid ridges are the other prominent buttresses of the mandible. “By [Profit 4th ed 50, 51] Meckle’s cartilage is the primary cartilage of mandible. The cartilages at the condyle, cornoid and symphysis are the secondary cartilages. The condylar cartilage is considered as the pacemaker for growth of that bone. Nasal septum is Considered as the pacemaker for growth of maxilla 8 [Bhalajt 3rd ed 31] ‘+ Intersphenoidal synchondrosis is believed to ossify at birth ‘+ Intra-occipital synchondrosis ossifies by 3 ~ § years of age. + Sphena-ethmofdal synchondrases ossifies by 5 ~ 25 years of age. ‘+ Spheno-occipital synchrdoses ossifies by 17 - 20 vyears of age. B [Bhalaji 3rd ed 34, 35] Resorption occurs on the anterior part of ramus while deposition occurs at the posterior region. This facilitates the lengthening of the mandibular body, which in turn accommodates the erupting molars. “K [Bhalaji 3rd ed 9] ‘D' [Bhalajhi 4th ed 28, 33, 34) °C [Proffit 4th ed 29] The concept of “Cephalo-caudal gradient of growth” says that there is an axis of inereased growth extending from the head towards the feet i.e, structures, which ate far from brain grow mote compared to other parts, When the facial growth pattern is viewed against the perspective of cephalo- caudal gradient, itis not surprising that the mandible, being farther away from the brain tends to grow more and later than the maxilla, which is close to brain, 5" [Bhalajhi 4th ed 25] The cranial base will be in cartilaginous form till 7® week of prenatal form. After that, the bones of cranial base undergo both endochondral as well as intramembrane ossification. The first bone to show both endochondral and intra- ‘membranous ossification is occipital bone. The supranuchal squamous part of occipital bone ossifes intramembranously during the 8" week of intra-uterine life BSS) ==(222A 64, 65. 66. 67. 68. 69. 70. n. Dental Pulse °C [Bhalajhi th ed 23) The prenatal life is arbitrarily divided into three periods. They are ‘+ Perlod of ovum ~ extends for a period of approximately 2 weeks from the time of fertilization ‘+ Period of embryo ~ 2° week-to-8 week ‘+ Period of foetus - 9 week-to-birth “C’[Profit 4th ed 113] “C”[Bhalajhi Gth ed 39) ‘D! [Chek Explanation Below] ‘The mandibular or gonial angle during perinatal period ranges ftom 135° to 150°; however, soon after birth, it ‘decreases to 120° to 140°. In adult mandible, the gonial langle measures between 110° to 120°. Studies have also indicated that the angle value of females is 3-5° greater than that of males Note: Eventhough we could not find any direct reference in suport of 175 degrees, If the same question is asked for AAIPG or AIIMS exams, the answer shall be marked as 175 as itis a direct pick from Ritu Duggal. ‘D' [M.S. Rani 3% ed 77] “K [Bhalaji 4° ed 44] {Gum pads are developed in 2 parts. They are the labio buccal portion and lingual portion, The two portions are separated by 2 groove called dental groove. The dental groove corresponds to the formation of dental lamina. (PGI June- 13). The gingival groove separates the gum pad from the Palate and floor of the mouth. “€ [Bones and cartilage: developmental and evolutionary skeletal biology By Brian Keith Hall Pg 409] #1857 Meyer (anatomist) & Culman (mathematician): propounded the Tiajectoril theory of bone formation, which says that the architecture of bone fs determined by both pressure and tension. Trbeculae develop along lines of stresses calculated mathematically that enable it to best resist stresses to which it is subjected during function + 1870's Julius Woll: trabecular arrangement can change with @ change in intensity & direction of forces. + 1925 Beninghoff: Studied architecture of cranial & facial skeleton & so called stress trajectories. The trajectories ‘obeyed no bone limits but rather the demands of the functional forces. ‘B [Proffit 4th ed 33] Anthropometry is the measurement of skeletal dimensions ‘on living individuals. Various land marks established on dry (dead) skulls are measured in living individuals simply by using soft tissue points overiying these bony landmarks. Measuring skeletal dimensions directly on tiving {Individuals is known as. (KERALA-2035) 4) Craniometry b) Anthropometry ©) Cephatometry 4) Tomography 2. 2. Th. 75. 76. 1. _ °C [Bhalaji Sth ed 46] Resorption occurs on the anterior part of the ramus while bone deposition occurs on the posterior region. This results ina drift of the ramus in a posterior direction. This facilitates lengthening of the mandibular body. ‘NX and’C [Proffit 4th ed 109] The initial sign of sexual maturation in boys is usually the “fat spurt. [Adolescence in Girls and Boys | = cn Boys Stage 1 | 7 test bus | Fe spurt 29° | Pubic hair Breast | Puble hair Stage 2 | development | » spurt in height begins Onset of [Facial ha stage 3 : ‘9° 3 | maturation | « peak velocity in height Height spurt ends a * Increase in muscular strength The key given for this question is both A and C. Puberty in boys begins later and extends over a longer period than Girls. Duration of adolescence is 5 years in boys and 3% years in gids ‘C [Proffit 4th ed 42] Intramembranous ossification occurs in the cranial vault and both jaws. Also refer (.No.2 for further reading. By exclusion, cranial base is the correct answer. book of Orthodontics by Pg 46) years 10-20 years Cranium | 25% 11% a Maxila | 45% 20% | 35% Mandible | 40% 25% 35% ‘R’ [Text book of craniofacial growth by Sridhar Pg 64] Brash remodeling theory of craniofacial growth is the first, general theory of craniofacial growth. Principles: ‘© Bone only grows appositionaly at surfaces. ‘+ Growth of the jans is characterized by deposition of bone at the postetior surfaces of maxilla and mandible (Hunterian growth) and ‘+ Deposition of bone on the ectocranial surface of the cranial vault and resorption of bone endocranially (calvaral growth) jalaji Sth ed 18 fig. 5 / Proffit Sth ed 37] ‘Until the age of 6, primary displacement from cranial base growth is important part of maxila’s forward growth. Failure of the cranial hase to lengthen normally, as in achondroplasia and other congenital syndromes create a characteristic midface deficiency.ee | 78. 79. 80. a1. 82. 83. # At about age 7, cranial base growth stops, and then sutural growth fs the only mechanism for bringing the maxilla forward. For explanation of drift and displacement, refer Q.No.37 ‘B' [Proffit Sth ed 40] Lip thickness in both male and females reaches its maximum during adolescence, then decreases in their 20's and 30's; ‘some women consider that loss of lip thickness a problem and seek treatment. In females lip thickness reaches a maximum at age 14 and males at age 16; in both sexes lip thickness begins to reduce after 16 years of age. ‘B' [Proffit sth ed 33] Hard tissues are bones teeth and cartilages. According to profit, cartilage, particularly the cartilage significantly involved in growth (uncalcfied) behaves like soft tissue rather than as hard tissues. In uncalcified cartilage and soft tissues, growth occurs primarily by interstitial growth. Interstitial growth means that growth occuts in all points within the tissue. Hyperplasia and hypertrophy are secondary growth characteristics. In contrast when mineralization takes place and hard tissue is formed, interstitial growth is not possible and growth occurs by apposition of bone. Interstitial growth is a prominent aspect of overall skeletal ‘growth because a major part of the skeletal system is originally modelled in cartilage like base of skull, trunk and limbs. ‘B' [Proffit Sth ed 442] Whatever might be the etiology, diastema greater than 2 mm is unlikely to close spontaneously. In these cases there is necessity for bodily tooth movement af incisors. ‘x [Proffit Sth ed 212 table] Anterior arch width (incisors and canines) of both maxilla ‘and mandible arches increases upto 8 years, thereafter shows only a little change. This inerease in interior arch Width provides a space of about 2 mm on average. ‘NX [Proffit 5th ed 280 Fig. 8-3] The resting pressures from the lip or cheeks and tongue are not balanced. In the maxillary incisor region, lip pressure is ‘greater than the tongue pressure. But, in mandibular incisor region, the tongue pressure is greater than the lip pressure. This imbalance causes the teeth to be stable, which would otherwise, cause tooth movement. ‘C [Proffit Sth ed 75 Fig. 3-12] Vertebral ages can be calculated from the images of cervical vertebrae seen in lateral cephalometric radiograph. Indicates the peak growth at adolescence is still a year or so ahead Less than one year prior to peak growth Typically a year or so beyond peak growth Stage 2 Stage 3 Stage 4 ORTHODONTICS 84, 85. 86. 87. More than 1 year beyond the peak of the Stage 5 | growth spurt, probably with more vertical than antero posterior growth remaining, More than 2 years beyond peak growth (But in a patient with a severe skeletal problem, stage 6 | e0ecially excessive mandibular growth, not necessarily ready for surgery-the best way to determine the cessation of growth is serial cephalometric radiographs). ‘C [Proffit Sth ed 100 Table 4-2] ‘B' [Graber Sth ed 169] Multiple recent researches have concluded that the depth of the nasopharynx is established during the fist two years of life and this dimension remains constant thereafter. “D' [Proffit 5th ed 160] eee fo Stage 1 “Appearance of breast buds”, Beginning of {nitial pubic hai. adolescent growth Stage 2 (About 12 | Noticeable breast development, ‘months later) ailary hair, dark/more PEAK VELOCITY IN _| abundant pubic hair. HEIGHT Stage 3 (12-18 Menses, broadening of hips ‘months later) with adult ft distribution, Growth spurt ending ret breasts completed, Stage 1 “Fat spurt weight gain, Beginning of feminine fat distribution adolescent growth Stage 2 (about 12 | Redistribution/reduction in fat, ‘month later) pubic har, growth in penis. Height spurt beginning Stage 3 (8-12 months | Facial hair appears on upper later) lip only, axilary hait, muscular PEAK VELOCITY IN | growth with harder/more HEIGHT {angular body form. Stage 4 (15-24 Facial hair on chin and lip, ‘months later) ‘adult distribution/color oF Growth spurt ending | pubic and axillary hair, adult body form. B’ [Proffit Sth ed 116 Last Paragraph] Important joints _on disturbs The five principal stages in craniofacial development are: 4) Formation of getm layer and initial organization of craniofacial structures ) Formation of Neural tube and oropharynx ) Origins, migration and interactions of cell populations, especially neural crest cells 4) Formation of organ systems (pharyngeal arches, primary and secondary palates) So =AA A_~CCoentat Sutse ) Final differentiation of tissues (skeletal, muscular and nervous elements Stages of embryonic craniofacial development as fermntonand | —tay:7 | relat sone orien . “nia oi, scone migration and 519-28 | « Mandibulofacal Free era 28) rete cell populations: a + Limb abnormalities Cleft lip and/or Palate, other facial clefts Primary Palate | Days 28-38 Secondary eS Days 42-55 | Cleft palate * Achondroplasia| Final ee differentiation | Day 50- birth | * S¥nostosis of tissues ‘syndromes (Crouzon, Apert's etc)Sr 2. DEVELOPMENT OF DENTITION In children median diastema between maxillary Permanent centrals closes with the eruption of 2) Maxillary permanent first premolar b) Maxillary permanent central incisor ©) Maxillary permanent canines 4) Maxillary permanent second molars ORTHODONTICS ) The same 4d) Not related (APs -98) Primate spaces are between: a) Band C b) Cand 0 ©) Aand C 4) Options A and 8 (AIMS -95) (AP-2K, PGI-2k,98) 10. Spacing seen between the maxillary deciduous teeth in a 2. The average “Leeway space” available in each half of the 6-year old child indicate maxilla is approximately a) Good growth 3b) Class II tendency 2) 0.9 mm b) 2.9mm ©) Class TT tendency 4). Presence of mesiodens <) 4.0. mm 4) 69mm {AIPG -98) (MAN -94, AIPG -05) 21. Intercanine width in maxilla is increased with 3. If a flush terminal plane is present in the deciduous a) Eruption of lateral incisors dentition then the molars will erupt. ) Eruption of permanent canines 2) Initaly in class I occlusion ©) Eruption premolars 4) Eruption of peg laterals ) Initially in class TF occlusion (AIPG 96, AP -97) )_Initaly in class II occlusion 12, Transitional phase of dentition i) End to end a) During eruption of permanent and exfoliation of (MAN -2k, AIPG -06) deciduous teeth 4, The primate spaces are related to the position of the b) Afterall permanent teeth have erupted diastema that are ©) Phase during correction of malocclusion 4) Distal to the maxillary primary canines and mesial to the 4) None of the above mancibular primary canines {AIPG -26) 'b) Mesialto the maxillary primary canines and distal to the 13. Ugly duckling stage affects mandibular primary canines. 2) Maxillary anterior teeth ) Distal to both the maxillary and Mandibular primary a) Mandibular anterior teeth canines b) Both Maxillary and mandibular teeth <4) Mesial to both maxillary and mandibular primary canines. ) Cause decrease in vertical height (KAR, PGI -03, COMEDK -06) (AIPG -02) 5 Which of the following can be predicted from a flush 14. Which terminal plane is favorable for E/E to have class I terminal plane of primary dentition molar relationship? 2) Always results in Class I molar relation a) Flush terminal plane b) Mesial step 'b) Always results in class If molar relation ) Distal step «d) None ofthe above <)_ Always results in class ILI molar relation (KceT-09) 4) Final molar relation cannot be predicted definitely 15. Good contacts in primary teeth with lack of spacing (MAN-98) predicts? 6. The “Ualy duckling” stage of the transitional dentition '@) Normal occlusion in permanent teeth is characterized by all of the following except ) Crowding in permanent teeth 2) Deep overbite )_ Anterior cross bite 5) Distoangular axial inclination of the maxilay incisors ) Spaced permanent dentition ) Mandibular lateral incisors erupting lingual to the (AIINS-92) mandibular central incisors 16. After mixed dentition stage the arch length from first 4) Possible overjet molar to first molar usually: (Ox) The arch length from (MAN -95) mixed dentition to permanent dentition Late mesial shift is due to 1) Remains same 1b) Increases 2) Closure of primate spaces ) Decreases 4) Doubles 8) Eruption of frst permanent molars (AIPG -95, PGI JUNE- 12) «Related to end on - molar relation 17. Which of the following is a self correcting anomal 4) Closure of lee way space a) Ualy duckling stage b) Deep bite (MAN -02, AIPG-96) ©) Retrusion 4) Protrusion 8. With respect to their permanent successors, the sum (P61 -97, 98) of the mesio distal diameters of the first and second 18. Leeway space of Nance is utilized in deciduous molars is generally: a) Early mesial shift of fist permanent molars 2) less ) Greater b) Incisal ability ye) A D4) 8 BD 6) ¢ MO 8 8 BD 1) Ape 12) A ADA 14) 8 15) 8 16) © 17) A148) C SS ==((222A Dental Pulse _ ©) Late mesial shift of ist permanent molars 29. The average leeway space available in each half of 4) Secondary spacing of frst permanent molars mandible is (COMEDK -06, 05) ) 3.8mm ») 17 mm 19, The ugly duckling stage is seen at the age of ©) 24mm 4) 09 mm a) 6-7 years b) 9 -10 years (aR -02) ©) 10-12 years @) 12-14 years 30. Mesial step formation in deciduous dentition is (AP -98) indication of future 20. Spacing in anterior teeth in deciduous dentition a} Class 1 malocclusion b) Class 111 malocclusion 2) Common and desirable 6) Anterior crowding) Anterior ross bite ®) Uncommon and undesirable (KAR -01) ©) Common and undesirable 31. Ina newborn child we generally see 2) Uncommon 2) Maxillary protusion —b) Maxillary retrusion (P61-03) 6) Mandibular protrusion 4). Mandibular retusion 21. AO yr od child came to the dental clinic with spacing in (PI -95) anterior teeth. The line of treatment is 32. Which of the following is used in mixed dentition 2) Fixed appliance) Removable appliance classification of malocclusion «) Inclined plane 2) Angles classification b) Simon's orbital plane 4) No treatment, observation of patient ©) Flush terminal planed) All of the above (Pst -03) (1-98) 22. Difference in width of permanent and primary incisors is 33. Which ofthe following is correct 2) Tncisal guidance b) ncsalinctnation 2} The primary teth begin to erupt at the age of, «) Overet 4) Incisalbitey 5 months (PSI-02) __b) The eruption of al primary teeth is completed by 2 % 23. Leeway space is = 3 Se ys a) 1.7 mm and greater in mandible 6) The sequence of eruption of deciduous dentition is A-B- 8) 1.7 mm and least in mandible DCE. «) 344 mm and greater in mandible 4) All of the above 4) 3.4mm and least in mandible (PSI-02) 34. Which of the following i correct 24, Into how many segments the infant's gum pads divided a) Adeep bite may be seen in initial stages of development 2) Two in each quadrant b) Three in each quadrant 1b) The order of eruption of maxilary permanent teeth is <) Two ineach jaw) Five in each quadrant 651-2:6:3-5-7 (AIPG -04) _¢) The order of eruption of mandibular permanent teeth is 25. Spaces in deciduous dentition 61-23-4657 8) Physiological 2) pathological 4) Al of the above «) Incisal lability d)-none of above (ATIMS -04) 35. Most of leeway space is contributed by 26. An Byrold child has Ast molar cusp-to-cusp relation. The a) Second primary molar b) Primary canine treatment is ¢) Fiest primary molar) None of above 2) Fixed appliance —_b)_ Removable appliance ©) Continuous ecall and observe 36. Eruption of the permanent maxillary second molar prior 4) None of above to the maxillary second premolar (PSI-01) a) Normal and desirable 6). Abnormal and undesirable 27. In primary dentition the anatomic structure used to) Abnormal and desirable d) Normal and undesivable determine the molar relationship (KAR-06) 4) Mesio buccal cusp of primary 2nd molar 37. According to Wolfs law: 8) Distal plane of primary 1st molar 2} Human teeth drift mesially as interproximal wear occurs )_Mesial surface of primary 1st molar ®) Pressure causes bone resorption 4) Distal plane of primary 2nd molar )_ The optimal level of force for moving teeth is 10 to 200 («aR -03) rams 28. Grooves, which are present in gum pads between the d) Bone trabeculae lineup in response to mechanical stresses canine and the 1st molars and relates the upper and (AIP6-05) lower gum pads are called as 38. The commonest teth involved in transposition are ) Gingival groove ——b) dental groove 2} Naxilary central inesor and lateral incisor «) Vestibular sulcus) lateral suleus 5) Maxillary canine and frst premolar (AP-99) oc) Maxilary 1" premolar and 2% premolar 4) Naxilary canine and lateral incisor (Aa1P6-05) BE aA Md m0 Be mod BA MC MO wd we ms MO 32) C3) 0 3) 033) A 36) B37) D3) Bee | 39. 40. a 42. 43. 46. 45. 46. 47. 48. Incisal liability on an average in the maxillary arch is: 2) 3mm b) 6mm ©) 4mm a) 7.5mm (comeDK-05) Gum pads ate divided into following segments: a) 3ineach quadrant b) 2 in each jaw ¢) Sineach quadrant d) 2 in each quadrant (AIIMS-06) Usly duckling stage of dentition in children is corrected by eruption of which tooth? 4) Central incisor b) Lateral incisor ©) Canine 4) Second molar (COMEDK-07, GCET-14) 19 of mandible occurs After 6 years of age, the lengthe mainly 4) at the symphysis _b)_between the canines ) Distal to first permanent molar 4) Along the tower border (KAR-04) Ualy duckling stage coincides with transitional phase 4) Ist transitional phase.) Inter transitional ) 2nd transitional d) Allo the above (aHu-07) Which ofthe following is NOT transient self correcting malocclusion? 2) Spaced primary dentition +b) Deep overbite in primary dentition )_ Flush terminal planes in primary dentition 4) Anterior crosbit in primary dentition (xcer-08) Safety valve mechanism is? 8) The anteroposterir increment in the maxilla at 14 yes 8) Increase in the mandibular inter-cnine width at 14 ys <} Increase in the mandibular height at 12 yrs 4) Increase in the maxilary inter-canine width at 12 yrs (KceT-09) Midtine diastema present in children is self correcting if diastema is not more than a) 2.0mm b) 1.5mm ) 1.0 mm 4) 0.5 mm (ct-2011) [At which stage of Nolla’s, the tooth starts erupti 3) Stage 5 b) Stage 6 ©) Stage 7 a) Stage 8 (altms.2012) Leeway space is due to? 2) Space difference between deciduous canine and molar and their succedaneous permanent teeth b) Space difference between deciduous incisors and their succedaneous permanent teeth «) Difference between deciduous and permanent maxillary 4) None (atPo-14) ORTHODONTICS RSS = 3a) 040) cM) © 42) CB) CM) 0 mB) D ae) A a) 8 a) A=(222A Dental Pulse _ 2. DEVELOPMENT OF DENTITION - ANSWERS “C [Bhalajhi 3rd ed 48] % The condition is ualy duckling stage, @ transient or self correcting malocclusion seen in maxilary incisor region between 8-9 years age. It is seen during eruption of permanent canines. °K [Bhalajhi 3rd ed 48] The combined mesiodistal width of the permanent canines 8 and premolars is usually less than that of deciduous canines and molars and this difference is knawn as Leeway Space ‘of Nancy. This space is used by the permanent lower molars during late mesial shift from end-on occlusion to class-1 relation. The amount of leeway space is about 1.8 mm (0.9 mm on each sie of arch) in maxillary arch and about 3.4 mm in mandibular arch (1.7 mm on each side of arch. ‘D' [Bhalajhi 3rd ed 43) runes ae + The distal surface of upper and Lower second Fuish | deciduous molars are in one vertical plane. ‘terminal a plane '* The permanent molars will erupt in a flush or end on relationship. The distal surface of lower second deciduous mmlar is more mesial to that of upper second deciduous molar. + Mesialstep- (normal mesial step of < 2mm, which is more common)- The permanent molars will erupt in Angle's class occlusion | 4 + Exaggerated Mesa step of >2 mm- The permanent molars willerupt in Angle's class) 33, IT occlusion The distal surface of lower second deciduous molar is distal to that of upper second Sut | deciduous molar P |e The permanent molars may erupt fn Angle's class occlusion ‘B'[Bhalajhi 3rd ed 1] Primate spaces or Simian spaces or Anthropoid. spaces are seep mesial to the maxilary canines and distal to the mmandilar canines. The primate space of maxillay arch is also kown as Baum space (SCET-14). These spaces are Used during early mesial shi of molars fom endan t0 4 class-I relation. ue ‘D' [Bhalajhi 3rd ed 43) Initially the permanent molars wil erupt in end-on relation, Later itis converted into clase relaton by utizng the physiologial primate spaces ana eeway space in the lower arch and also by differential forward growth of mandible, 5 The final molar relation cannot be definitely predicted. © 10. ‘D [Bhalajhi 3rd ed 43) Early mesial shift of permanent molars from end-on to class relation occurs by utilizing primate spaces. Late mesial shift of permanent molars from end-on to class-I relation occurs by utilizing leeway spaces, 8 [Bhalajhi 3rd ed 48] 1 [Bhalajhi 3rd ed 41) “ [Bhalajhi 3rd ed 41) Spacing in primary dentition is normal and desirable for the rormal development of the permanent dentition. Absence of physiologic spaces indicates the possibility of crowding after the eruption of larger permanent teeth. B' [Bhalajhi 3rd ed 44] Maximum inter canine width in maxilla coincides with the eruption of canines. It is completed by the 10-12 years with an average increase of 5.5 mm. In mandible, maximum Intercanine width occurs with eruption of incisors. It is completed by 9-10 years of age with an average increase of only 3 mm. Inter canine width increase is more in closed arches than in spaced arches. ‘N [Bhalajhi 3rd ed 42] ‘ [Bhalajhi 3rd ed 48] Ualy duckling stage is seen in maxillary central inelsor region between 8 -9 years of age. This condition is seen during eruption of permanent canines. The developing canines displaces the roots of central and lateral incisors mesially and causes distal divergence of the crowns of the central incisors resulting in midline diastema, This type of malocclusion is not seen in lower arch because lower anteriors erupt almost simultaneously. Also, the path of eruption of mandibular canine is different from that of maxillary canines 8’ [Check Explanation Below] According to shobha tandon and Mcdonalds, iF the deciduous arches terminate in a mesial step, the permanent molars ‘may erupt directly into a normal angle class I relationship, in few cases it may develop into class 111 relationship. B’ [Bhalajhi 3rd ed 41] ‘C [Bhalajhi 3rd ed 43] The decreased arch length is due to mesial drifting of permanent molars.ee | vw. 18. 19. a. 22. 23. 24. 25. 26. ar. 28. 29. 30. 31 °X [Bhalajhi 3rd ed 48] 32, ‘The condition is corrected by itself after complete eruption of permanent canines. 33. ‘©’ [Bhalajhi 3rd ed 43) 34. 1 the deciduous dentition is spaced dentition, the end-on relation is converted intaclass-l molar telation by utilizing 35. the physiological primate spaces. Since this accurs early in the mised dentition period itis called as early mesial shift. When no spaces exst aftr exfliation deciduous 2nd molars, the permanent molars migrate mesially to use up the leeway 36. spaces and establish class elation, This oceurs in late mixed dentition period and iz known as late mesial shift, 37. 3 [Bhalajhi 3rd ed 48] 38. Bhalajhi 3rd ed 41) 1" [Bhalajhi 3rd ed 48) ‘0’ [Bhalajhi 3rd ed 44) The permanent incisors are usualy larger than the deciduous teeth they replace. This difference between amount of space needed for the accommodation of the incisors and 39. the amount of space available is called incisl ability. The incisal ability is about. 7mm in maxillary arch and about 40, 5mm in mandibular arch (GCET-14). a The incisal labiity is overcome by: ‘+ Using physiologic spaces in primary dentition a. ‘+ Increase in inter canine width a. 4 More labial inclination of permanent incisors. 4A. ‘© [Bhalajhi 3rd ed 48] ‘0’ [Bhalajhi 3rd ed 40} The gum pads are divided into 10 segments (5 in each quadrant) by transverse grooves. The transverse grooves between the canine and the fist deciduous molar is called the lateral sulcus. The lateral sulci are used in judging the inter-arc relationship at avery early stage [Bhalajhi 3rd ed 43] “© [Bhalajhi 3rd ed 43] os. 1! [Bhalajhi 3rd ed 43] Y [Bhalajhi 3rd ed 40] [Bhatajhi 3rd ed 48) ‘8 [Bhalajhi 3rd od 44) Mesial step terminal plane leads Class-1 occlusion. If the differential growth of mandible in forwaré direction persist, it ean lead to angles Class-III malocclusion. 46. Y [Bhalajhi 3rd ed 40] ORTHODONTICS °C [Bhalajhi 3rd ed 43) 'D’[Bhatajhi 3rd ed 4a] 'D’ [Bhalajhi 3rd ed 42, 48] °K [Check Explanation Below] Most of the leeway space is contributed by primary second molar due to significant difference in size between it and second premolar. °B [Bhalajhi 3° ed 48 D' [Bhalajhi 3% ed 54] B [Profit 4th ed 457] Canine-frst premolar transposition is the most common transposition Canine-tateral transposition, incisor is the second most commen Transposition is never sean in primary dentition. ‘D [M.S. Rani 3rd ed 40) ‘C [Bhalajhi 3% ed 31] “C [Bhalajhi 3” ed 48 Fig. 10] [Bhalaji 3rd ed 48) 0 [Bhalajé 3rd ed 213] Some of the transient malocclusions are Open bite seen in gum pads + Deep bite ‘© Spacing in deciduous dentition ‘© Flush terminal plane + Ualy duckling stage Any crossbite should be corrected at the earliest without waiting ‘D’ [Text book of Orthodontics by Sridhar Prem Kumar 1* ed 20) In both males and females, the maxilary intercanine dimension serves as a safety valve mechanism to control mandibular growth (MCET-14, AP-14) during pubertal growth spurts, where there is a basal horizontal mandibular growth partly unmatched by the growth of maxila, as the mandibular grows downward and forward. The maxillary itercanine dimension adjusts as the mandibular dentition {is brought forward, thus eliminating the flush terminal plane relation or residual clase II tendencies, “K [Proffit 4th ed 247] If the diastema (space) between maxillary central incisors is >2mm, self-correction is unlikely BS)(AAA _~—Coental Sulse 47, 48. “® [Gurukeerat Singh 2nd ed 40] Nolla arbitrarily divided the development of each tooth into 10 stages. (0 Absence of Crypt Presence of Crypt Init 1/31d of crown completed 2/31d of crown completed Crown almost completed Crown completed 1/314 of root completed 2rd of root completed Root almost completed, open apex ‘Apical end of root completed calcification Bleole|slolalajels|= Note: After the completion of crown, the tooth starts its ‘eruptive movements. So stage 6 is appropriate. 'K [Check Explanation of 0.No.2] _ORTHODONTICS ee | 3, ETIOLOGY OF THE MALOCCLUSION Retained mandibular deciduous central incisors will 10. Abnormally thick maxillary labial frenum results in result in a) Maxillary Midtne diastema 2) Lingual eruption of mandibular permanent incisors b) Imbrication of incisors ) Labial eruption of mandibular permanent incisors ©) Labial inclination of incisors }_Impaction of mandibular permanent incisors 4) Anterior deep bite 4) Ankyiosis of mandibular permanent incisors (COMEDK 04) (MAN -99) 21. The abnormal swallowing pattern with the poorest 2. The most common local cause of malocclusion is prognosis is: 2) Premature exfoliation of deciduous maxillary central a) Simple tongue thrust b) Complex tongue thrust incisors ) Infantile swallow) Retained infantile swallow ») Prolonged retention of primary teeth (Ps1-99) }_ Ankyiosis of permanent teeth 12, Treatment of diastema because of a thick labial frenum 4) Impaction of permanent teeth is done: (MAN -99, AP -06, 05) a) After frenectomy _b)_ Before eruption of canines 3. The most common cause of maxillary central incisor to ©) After eruption of canines be in cross-bite is 4) Before frenectomy 2) Premature exfoliation of deciduous maxillary central {AIMS -92) incisors 413, The most probable cause of crowding in lower anterior ) Prolonged retention of deciduous maillary central incisors region is: «High labial frenum a) Protonged retention of lower primary incisors 4) Early loss of deciduous mandibular ) Premature exfoliation of lower primary incisors (MAN -99, AP -04) ©). Presence of supernumerary teeth 4, Tooth in the mandibular arch which is most likely to be 4) Tooth-size-arch length discrepancy displaced due to arch size discrepancy is (Pot -99) 2) First molar b) Second molar 14, Prolonged retention of primary tooth may lead to «First premolar 4) Second premolar a) Altered path of permanent tooth eruption {ATINS -01) b) Root resorption of adjacent tooth 5 Whichone ofthe following has maximum familial tendency? «)_Ankylosis of permanent tooth 2) Protruded maxilary incisors 4) Warping of roots of adjacent teeth ») Open bite (Pst-99) )_ Deep bi 4) Upper and lower cross bite 15. A child is brought to the clinic with complaint of irregular (KCET-09) teeth. The maxillay central incisor is rotated in an The cause of pseudoclass III malocdlusion otherwise normal occlusion. What should the next step be 2) Developmental deficiency ) Check for supernumerary teeth 5) Increased mandibular growth b) Resection of supracrestal fibers )_ Functional abnormatity d) Hormonal disturbance ©) Bxert a couple on tooth {AIPG -01, AP-05) 4) Fixed orthodontic appliances given Mouth breathing with enlarged adenoids and tonsils may {ATIMS-94) be best described as: 16. A malocelusion is characterized by protrusion of 8) Anatomie b) Obstructive maxilla, labioversion of maxillary incisors deep overbite )_ Physiologie a) Habitual and overjet. These are typical characteristic of which (Por -98) malocclusion 8. A child who had a congenital defect of cleft lip and a) Class 1 ) Class 1 va left palate is most likely to suffer from which kind of ) Class 1 bv 2 ) Class HIT malocelusion (AP -98) 2) Bilateral posterior cross bite 17, A 9-year-old patient exhibits left maxillary central 8) collapsed anterior mandibular arch incisor in cross bite. Supporting bone isin harmony with )_Protrusion and spacing of maxillary anterior teeth tooth size, The most probable cause 4) Class II diviston I malocclusion a) Premature extraction of primary right central. incisor (ar -99) b) Prolonged retention of primary let central incisor 9. Aeromegaly is associated with: )_ Absence of mandibular left central incisor 2) Class malocclusion b) Class. T ross bite @) Allof the above ) lass. H malocclusion d) Class. 111 malocclusion (AIP6 -89) (AIMS -97) TAL) A Soe) 0 Boel) © Me) A Um A MO) © MD 14) A 15) A146) B17) B= 222A Dental Pulse _ 18, The most common cause of class II malocelusion 28, Earnest Klein has dassified habits into 8) Sleeping habits —__b) Growth discrepancy 2), Compulsive and non-compulsve habits «)_ Thumb and tongue thrusting b) Intentional and non-intentional habits 4) Tooth to jaw size discrepancy. )_ Primary and secondary habits (AP 14, MAN -97) ) Pressure and non-pressure habits 19. Bruxism bears which one of the following relationships (uPse-ot) to malocclusion 29, Breathing is termed anatomic mouth breathing if 4) Malocclusion is only cause of bruxism a) Short upper tip ——b)- Enlarged Adenoid 5) Matocclusion may be the cause of bruxism ¢) Enlarged Tonsil) Both A and 8 ©) Comection of occlusal discrepancy always eliminate (P61-03, 05) bruxism 30. The positioning of tongue in infantile swallowing is 4) None of above 2} Posterior ») Medial (kar-98) €) Lateral 4) Anterior 20. A 10 year-old patient with class II relationship stops (aP-2012) thumb - sucking 31, The patients with class IT division 1 malocclusion have a) Over-jet will decrease 4) Hypertonic ower tip b)_Hypotonic lower lip 5) Upper incisors wil become up right ©) Hypertonic upper ip 4) Hypotonic upper lip )_ There willbe crowding of the lower incisors {AIIMS-94) 4) Aand 8 32. In thumb-sucking habit, posterior cross bite occurs due to (MAN -96, 99) 2), Loss of normal outward thrust ofthe tongue 24, Which ofthe following is not a features of simple tongue 1b) Negative pressure within the oral cavity, which causes thrust swallowing buccinator to force the maxillary molar palatally 4) Contraction of facial muscle ) A&B 4) Loss of oral seal 8) Contraction of mandibular elevators (AtP6-98) ©) Teeth apart swallow d) Anterior open bite 33. Lalloo, a 13-year old child has a severe thumb-sucking (MAN -01) habit. On examination he has a Class-ll malocclusion, 22. The oral drive theory to explain thumb sucking habit was anterior open bite with an over-jet of 12mm. His siven by cephatogram will show: 8). Benjamin b) Sears and wise a) Normal anterior and posterior facial heights ©) Sigmund freud 4) Scheldon b) Increased anterior facial height and normal posterior (HAN -01) facial height 23, Abnormal muscle activity results in ) Increased posterior facial height and normal anterior 2) Bruxism 1) nail biting facial height «Tongue thrusting) thumb sucking ) Increased posterior facial height and increased anterior (MAN-2K) facial height 24, In adenoid facies, the facial profile is (AIIMS -99) ) Long and wide 1) Long and narrow 34, The effect of enlarged Adenoids on the maxillary growth ©) Short and wide «) Short and narrow is by (MAN-00, KAR-03) 2}, Narrowing of maxila 6) Widening of maxila 25. Which of the following statements is False «) Palatal plane tipped upwards at PNS ) Heredity plays an important role in the development of 4) Palate descends down ‘normal occlusion. (AIMS -2k) 5) A tongue thrusting habit may cause an open bite 35. Which of the cephalometric parameter is used to ) Mouth breathing is a recognized contributing cause of diagnose a Long face syndrome patient? malocclusion a) ANB angle ) SNA angle 44) The cuspids are the most useful teeth for the anchorage €) Saraback ratio 4) Saddle angle of appliances (AIPG -04) (MAN.95) 36. More than 80% cephalic index of a patient indicates 26. In the pre-school stage what % of the children show which of the following thumb-sucking a) Brachycephatic ——_‘b).-Mesocephalic a) Less than 10% b) 10-20% )_Doticocephalic 4) Depends on age ©) More than 50% ——) all children (aIIMs -2«) (MAN-99) 37. Soft tissue profile of a thumbsucking patient is 27. Rooting reflex disappears in normal infants by the age of a) convex ») concave 4) 4months after birth b) 7 months after «) normal 4) anterior divergent ©) Smonths after birth) 12 months after birth (APG -99) (MAN-01, KAR-99) 7) 819) 8 2) D 2%) mB 2) c eB %) 0 Me 7) 8 eB 2) A 3D 5i) D_ 32) C33) B34) A_35) C36) A_37) Aont 0nrxes 38, Relative toa heterogenous population, the incidence of) The tongue thrust seen inthis case is malocclusion na homogenous population generally i: s) Retained Infante swallow 2) Lower b) Slightly higher b) Simple tongue thrust. 6) Significant higher) About the some Complex tongue thrust d) Compound tongue thst (arrs-06) 39. The supervision ofa chilé’s development of oclision is) Usually gt sucking hablts are outgrown by most ental at ages? 2) bays Daves a) 3-6 years b) 7-10 years co) 12 yts d) 11-12 yrs: ©) M=thyears—d) 16-47 yeas (AIPG-06) 46. A 5-year-old residential school child walks in te your 40, Anterior openbite& maxillary consticton is caused tlinie with the habit of thumb sucking in association 2) thumb sucking b) Nailing with bruxism 8) Bruns 3} ip biting (coneo.2012) (KCE-07) A) What would be probable cause 41, The mest common variant of rsleccuson sen te 2) food habits 2) Angle's class-I occlusion with anterior crowding >) Nasal septal deviation b) Angle's das occlision vith posterior crowding O) Habito 6) Anglés cass iv). Angle's case Tl dv I 8} Payholgical (a-08) 42. A patient is involved in chronic mouth breathing, the 8) Usually sucking digit wll be Raving ‘lista examination ofthe patient reveals 2) fibrous oughened cals 5) Conver profi, long face, narrow arches 8) laceration of iit b) Concave profile, long face, broad arches c) Cut wound on digit £) Came profile, short face, brood aches ©) Long finger bali 4) Concave prof, shor face, now arches (AIINS-o9) ©) Chemical approach for reminder therapy is 43, Which of the following is the most common erfacal 3) Fem malformation that produces malocclusion? ©) Femite 2 Cf tip and palate b) Eetodermaldyoplasia ©) Nat plsh €) Pete Robin syndome 4) Osteogenesis imperfecta 9} Nal polish with Ravor (aP-09) 4. Which ofthe fllowing are NOT associated with complex 0) Following eects are seen on maxilla exept tongue thrusting acti? 2) Increased Sto ANS = PHS ole 2) Nasorespiratary distress 6) Tncreasedpretnation 2) Contaton ofthe temporatis muscle ©) heresed manila ach length €) Cantaction oF the mentale and lower tip during sallow) Increased SA 4), Absence of contac of teth during swalow (8627-10) 47. Haloceusion canbe progressive in: 45. Ab yearold female child reported with a chief complaint 2) Classi ) class fprodined upper anterior. Ports give a History ¢) Clase 4) Combination ofboth ABC Sf prolonged bottle feeding and a pesstent thumb (arts MAY 2012) ‘sucking habit. Clinical examination reveals anterior open 48. A 21 year old male healthy patient reported with & bite with proclined upper anterior and retroclined lower prognathic mandible, intraorally he has anterior crossbite anterior teeth and associated tongue thrusting. tnd clats Il molar relationship, cephalometrically has (COMEDK2011, 15) an SHA o 78 degrees, SNB of 89 depres 1) In thumb sucking protracion of the maxillary teeth (coneon2013) is seen when 484, What would be the treatment of choice forthe adult 2) Menthe pilex held upward ageins the palate Class It seletal malocclusion wth prominent chin? b) When the pollex is held downward against the tongue a) Functional Appliance b) Fixed Orthodontics c) When the pollex is held inward against the cheek c) Functional jaw orthopedic correction d) None of the above d) Surgical Orthodontics 8) The fremost tne of treatment inthis patient is 488, The prsuricalerthodentic procedures involves 5) No veatnent: Watt and waten 2) Decampersation Compensation b) Exveton of ist premolars followed by Hawles appliance) Setting eases a) Imublaton €) yeh consultation prior to any therapy 4) Bataction of second prmlas flowed by Haviys aorliance BAL SALA A LAL) A EL GHA RHEL Ge TRIE eNO VA st) c0)A_ a7) C438) 0 GB)A (eeo=——/2 A AAA Dental Pulse 48C. The surgical procedure of choice for correction of ‘mandibular excessive prognathism is a) Le Fort I osteotomy ») Bilateral sagittal split osteotomy ©) Caldwell-lue surgery 4) Ramal distraction osteogenesis 49. Profile during chronic thumb sucking a) Concave & narrow b) Wide & concave ©) Nartow & convex d) Convex & wide (NEET-2013) 50. Ina child, diagnosis of tongue thrusting is made by 8) Observing digits of patient ») Lower lip is held lightly by thumb and finger and asked to swallow water 2) Holding paper in between lips 4d) Paper wick test (holding a piece of paper in front of nose) (ATIMS Nov-13) 51, The suckling reflex and infantile swallow normally disappear by the a) First year b) Second year ©) Sixth year Eight year (comeD-14) 52, Clinical feature of mouth breathing is 4) Pigeon face appearance ) Proctined mandibular anteriors ©). Shallow and Flat maxillary arch 4) Retroclined maxillary anteriors (Gcer-14) 53. Mature swallow pattern is characterized by all of the following EXCEPT a) Relaxation of lips b) Placement of tongue behind the maxilary incisors ©) Placement of the mandible until posterior teeth are in contact 4) Relaxation of the elevator muscles of mandible (COMEDK-15) moe) CBS) A SAAT SH) Dee | ORTHODONTICS 3. ETIOLOGY OF THE MALOCCLUSION — ANSWERS halajhi 3rd ed 92] Petr ETIOLOGY Imbrcation or tower |# Arch length-tooth size incisor crowding is due | discrepancy. to ‘© Arch length discrepancy is mostly due to premature exfoliation of primary teeth Premature exfaliation of primary teeth Most common local cause of malocclusion Main etiological factor for class-II malocclusion Main etiological factor for class-IIlalocclusion Development of mandibular crowding in late teen and early ‘twenties is due to Growth discrepancy Hereditary Pressure from erupting third molar. Most common cause of rnon-skeletal anterior cross bite Retained primary incisors, ‘°K [Bhalajhi 3rd ed 91] Early loss of deciduous teeth can cause migration of adjacent teeth into the space and thus prevent the eruption of permanent successor. 1" [Bhalajhi 3rd ed 425] ‘0’ [Bhalajhi 3rd ed 392] Mandibular Second Premalar * Tooth that shows greatest variation in eruption timing, * Shows greatest variation in occlusal form next to ‘maxillary third molar. * The only premolar tooth that shows 3 cusps more frequently * Tooth in the mandibular arch that is most Likely to be displaced due to arch size discrepancy. 'C [GRABER 3rd ed 261] ‘€ [Bhalajhi 3rd ed 75,409) Dares eee) Mostly due to presence of occlusal prematurities or due to premature loss of deciduous posteriors Lower ‘are forwardly inclined ores Mostly hereditary in nature Lower anteriors are Lingually inclined Normal path of closure anteriors Deviated or forward path of closure of manaible Increased gonial Normal gonial angle wae BY [Bhalajhi 3rd ed 104] Lip morphology does not permit complete closure of mouth (incompetent lips) Continues mouth breathing even though the nasal obstruction is removed Complete or partial obstruction of nasal passage due to deviated nasal septum, obstructive adenoids etc. Seen jn ectomorphous individuals with tong narrow faces and nasopharyngeal passages ‘Anatomic Habitual Obstructive The type of malocclusion associated with mouth breathing is called Long face syndrome or the classic adenoid facies. 8. °N [Bhalajhi 3rd ed 425,443] In cleft lip and cleft palate patients, both anterior cross bite and bilateral buccal crossbites are seen due to collapse of maxillary arch. Anterior cross bite should be treated using Z spring. Buccal segment crossbites can be treated by using quad helix or expansion screws, 1D [GRABER 3rd ed 288 FIG. 6-39] Accelerated development of mandible macroglossia, hhypercementosi, erly eruption of dentition are the features of Acromegaly ‘Jaw abnormality Disease Underdeveloped maxilla | Cleidocranial dysplasia (Gass III malocclusion) |» craniofacial dysostosis ‘+ Achondroplasia = Doven syndrome Underdeveloped mandible |» Treacher Collin syndrome (Gass 1 malocclusion) |» pierre Robin syndrome ‘ “Leontiasis ossea” or a type of monestotic fisrous dysplasia Enlargement of maxilla Enlargement of mandible (Skeletal Class TI) Enlargement of both maxilla and mandible ‘+ Acromegaly «= Pagets disease 10. 'X' [Bhalajhi 3rd ed 386) Presence of a notching in the interdental alveolar bone and positive blanch test ae diagnostic of abnormally thick labial frenum. In these patients, frenectomy is usually done even if the eruption of permanent lateral incisors and canines fails to clase the diastema, Frenectomy can be done either before or after the appliance therapy has approximated the central incisors. (SSs2o ={a A AAA Dental Pulse Yo 11, ‘D [Bhalajhi 3rd ed 50,102] Simple tongue ° Contraction of ips, mentalls muscle Normal infantile swallowing pattern is seen prior to the ET © wad casndiear breton, ‘ruption of buceal teeth in primary dentition, The suckin see face ee npr deen, ewan? (Tet ae |«arteror open ite wth good ecson the frst year of life. Here the tongue is placed between the aralow) of posterior teeth ts present, upper and lower gum pads andthe mandible Is stabilized by Contraction of tip, fail and mentais strong contraction of muscles of facial nerve. Complex muscles is present. ongue | «Absence of contraction of mandibular In case of retained infantile swallowing the tongue thrusts: rusting ‘elevators. violent between thetesth nthe font andaterallyon bath | (Teeth apart) | Sides. The patients will have poor expressionless appearance swallow) ee oe Rela ences ‘and have difficulty in mastication due to presence of poor present eclsal stability. Persistence of infantile swallowing even. after the eruption of the Retained ‘The retained infantile swallowing is a rare occurrence and {infantile permanent teeth. shows poorest prognosis. Swallowing | * Tongue trusts violently between the ‘teeth in font and laterally on both the 12, °C [GRABER 3rd ed 667/ Refer Question No.10] sides. Please Note that this question was also asked in 2016 APPG MDS CET, in which the answer was given NTR university as According to McDonald th ed, Humans show 2 types of both €& swallow patterns; 2) Infantile and neonates swallow 13, ‘D’ [Bhalajhi 3rd ed 392) b) Mature/adult swallow: 14, ‘W [Bhalajhi 3rd ed 92) Infantile swallow is characterized by tong tip activity 15, 'X [Bhalajhi 3rd ed 86] * vigorous mandibular thrust Unerupted mesiodens and the presence of thick abialfrenum between the central incisors are common causes of midline diastema, ‘+ tongue is placed between the gum pads and tongue tip 's brought forward into contact with the lower lip ‘+ relaxation of the elevator muscles of mandible Before attempting to close midline diastema, radiographs should be taken to rule out supemumerary teeth as the Mature swaliow is seen usually by 4-5 years and occurs with ‘cause of diastema, the addition of semisolid and solid food to diet. Mature swallow is charcteriz 16. ‘8 [Bhalajhi 3rd ed 71] ‘gradual activation of the elevator muscles of mandible in swallowing 47. ‘8 [Bhalajhi 3rd ed 425) ‘cessation of lip activity, ie lips are relaxed placement of tongue tip behind the upper incisors 418, 'B [GRABER 3rd ed 572] ‘+ elevation of mandible until posterior teeth contact in The main cause for class-T malocelusion is disproportionate occlusion, growth between maxilla and mandible. . 22, ‘8’ [Bhalajhi 3rd ed 98] 19, ‘8 [Bhalajhi 3rd ed 106] ; According to ORAL DRIVE THEORY OF SEARS AND WISE, Psychological stress and occlusal discrepancy between prolonged suckling lead to thumb sucking, centric ‘elation and centric ocelusion are the common ‘causes of bruxism. ‘BENJAMIN'S THEORY states that thumb sucking arises from , , the rooting or placing reflex. Rooting reflex is the movement 20, ‘D’ [Bhalajhi 3rd ed 99, 100] of infants head and tongue towards on object touching his cheek. The rooting reflex disappears in normal infants 24. 'C [Bhalajhi 31d ed 103] around 7-8 months of age. Garo ‘According to SIGMOND FREUDIAN THEORY inthe ora phase of psychologic development, the mouth is believed to be an oro-erotic zone. The child has the tendency to place fingers or any other object into the oral cavity. ‘Seen only prior to the eruption of| bbuccal teeth in primary dentition. * During swallowing the jaws are apart and the tongue is placed between the ORAL GRATIFICATION THEORY BY SHELDON states that if a upper and lower gum pads. child is not satisfied with sucking during the feeding period it will persist as a symptom of an emotional disturbance by digit suckinga | 23. 'C [Bhalajhi 3rd ed 103] 24, ‘B [Bhalajhi 3rd ed 104] ‘The type of malocclusion assaciated with mouth breathing is called long face syndrome or the classic adenoid facies. Long and narrow (Dolicocephalic and lepto- prosopic) face, short and flaccid upper tip, constricted upper arch, frequent ‘occurrence of tonsilits, allergic rhinitis and otitis media, and anterior marginal gingivitis ae the features. Which one of the following is not a feature of long standing mouth breathing habit? (COMEDK-2013) a) Adenoid facies b) Large nose )_ Upper anterior labial gingivitis 4) Frequent occurrence of tonsilitis,allergie rhinitis and otitis media 25. 'D'[Bhalajhi 3rd ed 204) Multiooted teeth with large roots have greater ability to withstand stress than single rooted teeth. But the triangular roots of canines and maxillary central and lateral incisors offer the maximum resistance to displacement compared to round (seen in bicuspids and palatal root of maxillary molars) or flat (Buccal roots of maxillary molars and roots of mandibular incisors and molars) root forms. 26. [SHOBHA TANDON - ast ed 431) 27. [Bhalajhi 3rd ed 98) 28. 'B [SHOBHATANOON ist ed 428] ‘Author cla * Intentional or meaningful habits ‘Unintentional or emgty habits * Useful habits Harmful habits = Compulsive habits ‘= Non compulsive habits (on) Primary habits ‘= Secondary habits = Functional © Muscular = Postural Combined * Pressure habits Non pressure habits Thumb sucking ‘Tongue thrusting ete. EARNEST KLEIN WILLIAM JAMES, FINN AND SIM KINGSLEY MORRIS AND BOHNNA GRABER (Based on etialogy) 29. °X [Bhalajhi 3rd ed 104] Option 8 & C results in obstructive type of mouth breathing, 30. ‘0’ [Bhataji 5th ed 64) Tongue thrusting, simply defined, is the habit of thrusting the tongue forward (anterior) against the teeth or in ORTHODONTICS BSS? =—= between while swallowing. Tt is an infantile pattern of swallowing that hasbeen ctained by an individual 31, ‘D’ [Bhalajhi 3rd ed 71] Hypotonic upper lip is seen both in mouth breathers (AIPG- 14) and class-IIdivision-1 malocclusion cases. 32. 'C [Bhalajhi 3rd ed 99,100} 33.8 34. ‘R'[Bhalajhi 3rd ed 104) 35. 'C’ [Gurkeerat Singh 1st ed 470] Posterior facial height ‘atabak rato = preeior fatal Right X 100 A ratio of less than 62% expresses vertical growth pattern (long face patients) whereas ratio of more than 65% indicates horizontal growth pattern, 36. ‘R [Gurkeerat Singh 1st ed 63) The shape of head can be evaluated based on cephalic index of head which was formulated by MARTIN and SALLER osterir facial height ‘Aaterior facial hight Cephalic Index = Index values + Mesocephalic 76.0 - 81.0 © Brachycephalic = — 81.0- 85.4 (Broad and short skul) © Dolicocephalic = = 75.0 37. 'N [Gurkeerat Singh 1st ed 543] Convex profile is seen in class-II division 1 and in thumb sucking patients. In thumb sucking cases, the increased pressure fom buccinator mechanism acts at the pterygomandibular raphae just behind the dentition ‘and forces the maxillary apical base and maxillary teeth anteriorly, The SNA angle i increased than normal. Concave profile is seen in lass-III patient 38. 'N [Profit 4% ed 143, 144] 39. 8 During 7-10 years period exchange of deciduous dentition with permanent successor teeth takes place 40.‘ [Bhalajhi 3% ed 99, 100) 44,‘ [Bhalajhi 3° ed 385] 42, ‘A’ [Bhalajhi 4th ed 219] 43. ‘A’ [Proffit 4th ed 74] Cleft lip and palate is the most common congenital defect of facial structures and the second most congenital defect in the entire spectrum of congenital deformities (fist common is clubfoot)=(222A 44, 458. 458. 45C. 450. 464. 468. 46c. 460. 47. 48a. Dental Pulse “B [Bhalajhi 4th ed 117] ‘K [Bhalaji 4 ed 114) Pollex means thumb. “C [Bhalaji 4" ed 115) Psychologie management should be done prior to using mechanical aids while treating thumi sucking. ‘B [Bhalaji 4% ed 114] Complex tongue thrusting is due to the result of open bite in this case. For types of tongue thrustings, Refer Q. No 21 Jn chapter “Etiology OF Malocelusion” ‘B [Check Explanation Below] Thumb Finger sucking one of the most important factors in producing and maintaining malocclusion. It begins at birth and outgrown by 3-4 years. ‘D [Bhalaji Sth ed 127] Psychological stress is the most common cause of bruxism. ‘Sigmond freud suggested psychological development as the etiology of thumb sucking. ‘ (Bhalaji Sth ed 134) Presence of clean nails and callus on the Finger is commonly associated with thumb sucking ‘B [Check explanation Below] Femite liquid applied on the thumb and nail of child discourages sucking due to the bitter taste. Itis an alkaloid al mb sul = Quinine * Asafoetida # Pepper dissolved i volatile medium ‘K (Bhalaji Sth ed 130) ‘There sna change in SW to ANS-PNS angle in thumb sucking Effects of thumb sucking + Proctination of maxillary anteriors. SNA angle is increased. © If there is lingual tipping of mandibular incisors, ANB angle is increased + Anterior open bite Narrow and tong maxillary arch + Hypotonic upper lip ‘€ [Gurukeerat Singh 2nd ed 631] Class I malocclusion is a therapeutic challenge. It is usually progressive, which makes it difficult for the clinician to predict the future growth of such patients both in ‘magnitude and direction. Even after good results, there is a high tendency for relapse. ‘D’ [Neclima Malik 2nd ed 267, 274] Normal SNA angle is 82 degrees and SNB is 80 degrees with ANB angle of 2 degrees. In this case the ANB is~ 11 degrees, which means the patient is having severe class TIL. This malocclusion can be corrected with surgical orthodontics aac. 49. 50. 51, 52. _ keeping also the age (21) in mind where growth is almost completed, \ [Fonseca oral and maxillofacial surgery Vol. 2 Pg 83] The teeth naturally compensate in an effort to mask the skeletal discrepancy and establish the best occlusion. This 's called dental camouflage or compensation. Decompensation: To unmask the compensation, orthodontic preparation for orthognathic surgery involves the ‘decompensation’ of the teeth, so that the skeletal discrepancy is fully revealed. Note: During decompensation, the malocclusion worsen ‘more and the patient should be informed of this. ‘B [Peterson 2nd ed 1291/ Neclima Malik 2nd ed 298] ‘+ In this case, itis severe mandibular prognathism. So the surgical procedure should be aimed on mandibular set back, ‘© Bilateral sagittal split osteotomy splits the ramus and ‘the posterior body of the mandible sagitally allowing cither setback or advancement. ‘+ Lefort T osteotomy is used for surgical repositioning of the entire dentoalveolar segment of the maxilla superiorly, inferiorly, anteriorly and posteriorly. ‘© Rama distraction osteogenesis is used for lengthening ‘the mandibular ramal height in patients with mandibular deformities [Explanation of Q. No. 37] 8’ [Check Explanation Below] Diagnosis of tongue thrust can be done by two tests. 1. Alittle water is placed in patient mouth and patient is asked to swallow water. If there is abnormal swallowing, ‘then there willbe the following signs: © Teeth are apart © Lips do not touch each other ‘+ Facial muscles show marked contraction. 2. The lower lip is lightly held with thumb and finger and the patient is asked to swallow water. In tongue thrust, ‘the swallow will be inhibited as strong mentalis and lip contraction are needed for mandible stabilization and water will spill out of mouth [Profit 5th ed Pg 72] [Balaji Sth ed 135) Clinical features of mouth breathing: Long and n ‘+ Nartow nose and nasal passage ‘© Short and flaccid tip ‘+ Nartow and deep V shaped palatal vault (Maxilla) ‘© Proclained masillary anteriors ow face. ‘+ Blank lke or expressionless faceorton ontcs 53. Deformity of jaw resulting in pigeon face appearance. * Marginal gingivitis Anterior open bite. © In adenoids due to nasal obstruction the lungs are insufficiently expanded and chest assumes the characteristic deformity called ‘Pigeon breast’ ‘D’ [Check Explanation of 0.No.21] bee 7 NW— ("4 Dental Pulse —e —————— 1. _ Ina patient with competent ips together at rest, the lip, Line is opposite the tips of the upper incisors. The lip line is then described as a) Average ©) Incomplete b) High a) Low (AIIMS ~93; MAN -94) bb) Inclination of the lower thd of the face in relation tthe fore head )_ Inclination of the upper third of the face to the middle third ofthe face 4) None of the above (KAR -02) Following are “essential diagnostic criteria” according to 12. Fishman’s index is used in relation with raber except 2) Population ') Hand wrist radiographs a) Case history 1b) Facial photographs )_Cephatograms 4) Periodontal diseases ) Periapical x-rays 4) Lateral cephalograms (AP, ATIMS -2K) (MAN -01) 13. Brachy cephalic individual usually has Incompetent lips refer to a) Narrow dental arches b) Broad dental arches 4) Inability of the lipsto cover the incisors in the mandibular ) Normal dental arches d) B or € relaxed position (KAR -01) 8) Inability ofthe tips to cover the incisors in occlusion 14. The lip is supported by )_The lips come in between the upper and lower incisors 2) Relation of lip edge and facial surfaces of teeth 4) Tongue thrusts against the lips during swallowing b) Labial sulcus between teeth and tip (MAN -99) )_ Relationship of tongue and teeth 4, Mentatis muscle contraction causes the Lower lip to 4) Wone a) Retrude 1) Protrude (st -2002) «)_ Inversion 4) Eversion 15, Pletoric individual will have (HAN -99) 2) Tall and thin physique b) Short and obese physique 5 Transposition of teeth refers to ) Average physique) None of above a) Bucco rotation of 120° ) Hypodontia 16, Normal nasolabial angle «) Teeth erupted in unusual position i.e, one tooth erupts a) 80° b) 110° in place of another ©) 70° 4) 140° 4) Inverted supernumerary teeth (MAN-97, AP -05) 17. Hyperactive mentalis activity is seen in 6. Carpet radiograph is used for assessment a) Class T Class IL division 1 ) Bone condition b) Chronological age ) Class I division 2d) Class IID ©) Treatment plan 4) Skeletal maturation (KAR 01,99) 18, Blanch testis used in diagnosis of, 7. A reliable indicator of pubertal growth spurt on hand a), Abnormal frenal attachments rst films is sought as: 1b) Pseudo class IT 8) Ossification of adductor sessamoid ) Tongue thrusting 4) Thumb sucking ) Appearance of hook of hamate ©) Ossification of all the carpal bones 19, Backward path of mandibular closure is seen is 4) Ossification of pisiform a) Class Il division 2b) Class 1 (KAR -03) ) Pseudo class Id) Class 117 8. Doticocephatic facial pattern is associated with: ) Broad dental ach b) Long and narrow dental arch 20. Which of the following tests are employed to diagnose ©) Paraboloid dental arch) Square dental arch the mode of respiration (AIPG -96, P61 -00) 2) Minor test| ») Cotton test 9. Broad and short type of face is known as ©) Water test 4) AlLof the above 4) Mesoprosopic 1b) Euryprosopie ©) Leptoprosopie 4) None of above 21, The normal interincisal distance is (AlP6 -97) a) 40-45 mm b) 30-35 mm 10. Convex profile is seen in ©) 20-30 mm ) 55-65 mm a) Class T b) Class 12 6) Class 11 4) None of above 22. In gnathostatic models (kar-99) a), Maxillary cast is parallel to mancible cast 11, Facial divergence is b) Maxillary cast is parallel to FH plane ) Anterior placement of the midface ), Mandibular cest is parallel to FH plane yo 2 0 as A 4) 8 SO 6) 0 DA 8 8 OB 1) 8 MB ms MB 14) A 15) 8 16) B17) 8 18) A_ 19) A_20) 071) A_2) Ba | 4d) Both casts are parallel to FH plane ORTHODONTICS a1, The following is one of the mixed dentition analysis a) Tanaka Johnson ——_b). Counterpart analysis, 23. Xeroradiography was invented by ©) Bjork analysis 4) Plaster cast analysis 2) Chester F. Carson in 1937 (KAR 28) 8) Simon 32. Which of the following analysis helps in determining }_ Hudson Kampula and Dickson in 1957. the disproportion in the size between maxillary and 4) Nofrath and broad bent in 1934 mandibular teeth? a) Fonts analysis) Bolton’ analysis 24, Ectomorphic, —mesomorphic and endomorphic_——_c) Peck and Peck analysis) Care's analysis dlassification of body physique was given by (AIINS -01) 2) Sheldon ) Angle 33. Four dentists did study model analysis by Johnson and }_ UE Fouloun ) Kielgren Tanaka; Moyer’, Stanley and Kerber, Wits analysis, Which cone will give the best results: 25. The Moyer’s analyses requires the measurement of the: 2) Johnson and Tanaka b) Moyer's 2) Mesindistal of the erupted permanent mandibular) Stanley and Kerber_—) Wits centals and laterals (alP6 -02) 8) Space avallable in the maxilary and mandibular posterior 34, Mixed dentition analysis was described by quadrants a) Graber 5) Angle )_ Mesiodstal diameter ofthe unerupted premolars c) Tweed 4) Moyer's 4) Mesiodistal diameter of the unerupted maxillary and mandibular permanent cuspds and premolars 35. In mixed dentition analysis, which tooth is used for (AIPG -03) classification 26. Ashley-Howe model analysis is used to predict: a) Primary 1" molar) Primary 2* molar 8) Tooth material excess ¢) Permanent 1" molar a) Bor 8) Maxille-mandibular relationships (P61 -95) )_ Basal bone-transverse relationship 36. Arch perimeter can be measured with: ) Growth prediction a) Cephalogram ) Brass wire {AIINS 98) ) Vernier calipers d)_ Occlusal radiograph 27. Study models are used: {AIINS -03) 2) As references in orthodontic eases 37. Bolton analysis is used to determine 8) To show shape, size and position of teth a) Arch length ~ tooth size discrepancy «)_ Asan aid in treatment planning 1) Apical base length to arch perimeter 4) AlLof the above ¢) Tooth size ato in maxilla {AIINS -88) __d)_Upper teeth to lower teeth size ratio 28. Arch Length analysis of a dentition shows a discrepancy (a? -06) ‘of more than 10 mm. Ths indi 38. In pont’s analysis 8) No extraction requited if ueated at an early age a) The width of & maxillary incisors is calculated 8) No extraction required ) The width of « mandibular incisors is calculated }_ Extraction of posterior teeth ) The width oF 10 teeth anterior to frst molars is calculated 4) Proxima stripping ) The width of 12 teeth anterior to second permanent (atIMS -92) molars is calculated 29, There are difference in completing a Hixon-Old father e) The _mesiodstal_width and. faciolingual_ width of and Moyer’ analysis. Of the following which would not mandibular central and laterals are taken individually be correct? 2) The Moyers analysis requires the eruption of the 39. The numberof sites examined to assess the stages of bone mandibular permanent centrals and laterals maturation in Fishman’ skeletal maturation index are: 8) The Hivon-Old father requires the eruption of the a) & ») 5 mandibular permanent centrals and laterals 6 a7 ) The Hison-Old father analysis requires the measured {ATINS -01) space available in all four posterior” quadrants 40. SVED type of tooth plane is an example of 4) The Moyers analysis requires the measurement of the a) Simple anchorage) Reciprocal anchorage space available inthe four posterior quadrants €) Extea onal anchorage 4) Reinforced anchorage (KAR -98) (CoMEDK-06) 30. In which one of the following mixed dentition analysis 41. In Peck and Peck index, mesiodistal and buecolingual ‘of deciduous dentition there is no use of radiographs? measurements of which of the following tooth is taken: 2) Care/s analysis) Moyer analysis 2) Mavilary central inc ar central incisor } Nance Carey’s analysis d) Pont’ index ©) Manillary premolars ular molars {ATINS -94, KAR -98) (61-05) BAL) *§ AL) © A) © EL) 6 SAL) © SEL) 0 Be 36) 837) 038) A 39) C4) D4) 8 Ss)=a Ad Dental Pulse Andrew's 5th key of occluston is a) Curve of spee b) Rotation absent _ 8) Prognathism of maxilla (NEET-2013) «Tight contacts €) Bolton's ration 53. Which of the following is NOT a type of mixed dentition (Pst-2011) analysis? 43, Lisping is associated commonly with which of the 2) Moyers ») Tanala Johnston following malocelusions: ) Pont & Linderharth d) Hixon old father 4) Anterior deepbite —b) Anterior erowding (MCET-14) «) Anterior open bite d) Anterior retroctnation 54, In a perfect smile, the ratio of width to height of maxillary incisor is? 44, The SCAN index is generally used as a a) 8:10 ») 68 4). Malocclusion index ©) 10:16 4) 20:25 ») Treatment need index (PGI JUNE-2011) ©) Treatment change index 55, Study model with mounted base and trimmed height is, 4) Treatment of priority index 9) 55mm ) 70 mm (KceT-07) ©) 60 mm 4) 90 mm 45. According to American Board of Orthodontics (AIIMS Nov-14) recommendation for colour coding of sequential tracing, 56. Three quarter profile photograph fs used to detect? ‘end treatment ceph tracing is done in: 2) Lipin competence b) Mandibular asymmetry a) Black ) Blue c) Midline 4) Mid face deformity ) Red 4) Green (PGI JUNE-2011) (COMEDK-05) 57. Which of the following is used to measure the mineral 46. Which ofthe following isnot a type of mouth breathing? bone density of mandi a) Obstructing 1b) Anatomical 8) Micro radiography b) Auto radiography ©) Physiological 4) Habitual ©) Finite element modelting (KceT-08) 4), Nuclear volume morphometry 47. Tooth loss that causes the patient to bite in an abnormal (PI QUNE-2011) relation of marilla to mandible, inorder to obtain better function during mastication is termed a) Convenience bite b) Dramatic bite ©) Temporary bite 4) Squashed bite (comeo-2012) 48, The term applied when itis doubtful, according to mixed dentition analysis whether there will be space for all the teeth 8) Space maintenance) Space regaining ) Space supervision d) None ofthe above (KcET-2012) 49, For class I dlv 1 malocclusion of 16 years old boy, which analysis is indicated to detect the tooth extraction ) Bolton's analysis b) Ponts analysis, )_ Peck & peck analysis d) Ashley & Howe's analysis (AIIMS-2011, 13) 50, A Uingually erupting maxillary lateral incisor 4) Is always indicative of arch length deficiency 5) Can be corrected by using a tongue blade if sufficient space exists inthe arch «Isa self-correcting anomaly 4) Istobe extracted as early a possible to avoid adeflective pathway of the mandible (KceT-2012) 54, The orthodontic diagnosis focuses on a) Full smile ) Emotional smile «) Social smile 4) Gummy smile only (comeDk-2013) 52. Fishman index is used for: 4) Skeletal growth maturator index 8) Dental growth maturator index Ach length discrepancy ye 4) C mB 4) C Me) A yO 4) 0 5) B51) C SA 5) C BAA 55) B56) 0 57) Aee | 3 4. DIAGNOSIS — ANSWERS ORTHODONTICS i550) ‘D’ [Bhalajhi 3rd ed 125] 9, ‘BY [Bhalajhi 3rd ed 121) Wally the upper lip covets the anterior bil sutace of jue coma Rca upper anterior except for the incisal 2 - 3 mm. The lower lip presopke_| Normal fecal form hres the ene ua ace one artery and’? Eup rod and shot ai om mm of incisal edge of upper anteriors. Long and narrow face form, which is. Leptoprosopic | characteristic of adenoid facies or long In oral patents with competent tps, the Up ine atthe fice syntone, inca thd of upper incurs. Th these patents, rng romol swallowing there stp to ip seal and the tongue 10, "8 [Bhaajh ed ed 122] Touches the har palate Behind the incisors Fada rte s xamined by vewig the patient fom side Seinng the Flowing two reference nes assesses In patients with incompetent tips, (seen in class-ll tne joining forehead and point A (deepest point in division cases and tn patients with increased Facial height) curvature of upper lip) the tp seat can oly be seheved by active contraction of the perioral and mentalis muscles. In these patients, the lip + Aline Biting point and the pogonion (mest anterior seal is produced by tongue to lip contact. Point of chin) Bhan ee Convex pole (cus ether due to pogratic mxla or 1 [Bhalajhi 3rd ed 115] retrognathic mandible) is seen in class division-1 cases. ve ohalsp 8 08 125 Coneave ote ts assviated wth clase malocclusion, ‘Competent [The lips are fn alight contact when the] 11, “B’ (Bhalajhi 3rd ed 123) eS eee oer Facial divergence is defined as anterior or posterior TeesmeTEN) Morton shore pra dovmae] —ncnation of lowe face wate bs the oe bea tis alpaca Potent] Normal lps tht ito form aipseat ue] guage [A Ue down Brien the Feead nd incompetent |to pocined upe incr or incensed) | Atte |” chins inne anerrt twars the chin ts facil height verse | «rail angle i290 Desree Hypertophied is with weak musclar Th ine sug and perpendetr to verted is laomity Staightor |" foor orthognatie 1 Facial angle 80 Degee ‘BY [Bhalajhi 3rd ed 125) eo Posterior '* The line slants posteriorly towards chin. © [Bala 3d ea 66) divergent | «Facial angle ie <90 Degree [Bho Sed ed 162] 12. [hola Sed ed 168) ‘8 [Bala rod 67) 13, [Bholajh Sed ed 124] Shsiention of hook of hanete and psform mats the onset of reba growth spurt. Ossfeation of ulnar or 14. ‘A’ (Bhalajhi ded 125) educa sesamold mars the onset of pubertal growth Spur (AIMS HAY 2012). Searels smal nodular one 15: ‘B [Bhalajhi Sed ed 120) Thvedted in tendons nthe region of te un area SSeS Escaped (aaa ‘Ossification of ulnar-sesamoid begins: (AIIMS-2012) ‘Aesthetic / | Tall and thin persone with narrow dental a) At birth b) At prenatal stage Ectomorphic_| arches. 6) Onset of pubertal growth) at Syst fast SE a 3 [Bhalajhi 3rd ed 121] -mesomorphic | and normal dental arches. + fverabe shape of ead 16. "8 [Bhaaji Sed ed 126) ‘Mesocephali ut Pratl | Normal dental arches ‘The nasolabial angle is formed between the lower border/ Boal and short bead bose of nove and a line connecting nose and upper ip Brocycepatc | Broad and short he (GaIWS 13) Nomoto 0" recat asia angle ie tedveed sacocephae coal angle Is redved In patients with prodines eocephae | jaro demtl ches relay enters or prgnate mesa Tes nase a= 222A patients with retrognathic maxilla or retroctined maxilary anteriors. 17, ‘B’ [Bhalajhi 3rd ed 126] Hyperactive mentalis activity and abnormal. buccinator activity is seem in class-Ifdivision-1 cases, Over closure of jaws is associated with accentuated temporalis muscle activity. 18. 'W [Bhalajhi 3rd ed 127] In blanch test, the upper lip is stretched upwards and ‘outwards for a period of time. The presence of blanching in the region of interdental papilla is diagnostic of abnormal frenum, 19,‘ [Bhalajhi 3rd ed 129] ‘+ Backward path of mandibular closure is seen in class-IT division 2 cases. ‘+ Forward path of mandibular closure is seen pseudoclass-IIT ‘© Lateral path of closure is seen in unilateral cross bites. 20. '' [Bhalajhi 3rd ed 129) a1. (6 hi 3rd ed 129) 22, 'W [Bhalajhi 3rd ed 130) 23. 'K [Bhalajhi 3rd ed 138] Option’C” Hudson, Dickson and Kampula in 1957 developed (0P6 or panorex. 24, 'N [Bhalajhi 3rd ed 121] 25. °K [Bhalajhi 3rd ed 179] Moyer’s mixed dentition analysis predicts the combined width of unerupted 3,4,5 based on the mesio-distal width of four mandibular incisors, by referring the probability chart The predicted tooth size of 3,4,5 is compared with arch length available, If the predicted value is greater, crowding of the teeth can be expected, 26. [Bhalajhi 3rd ed 176] Ashley Howe's analysis considers tooth crowding is due to deficiency in arch width rather than arch length. 27, ‘D' [Bhalajhi 3rd ed 130) 28, C [Bhalajhi 3rd ed 176] Inference in arch perimeter analysis (performed on upper ‘ast)/ carey’s analysis (performed on lower cost Dental Pulse Cen ie 0-2.5 mm | Proximal stripping 25-5 mm _| Extraction of 2nd premolars =5mm | Extraction of Ist premolars 29, 'C [M.S.RANI 3rd ed 139] 30. 31, 32. 33. _ * Size of mandibular incisors is measured from the cast. Size of mandibular premolars is Hixon - old | measured from the radiograph father * From a given chart, the width of canine analysis and premolar can be read based on the width of incisors. * Used on mandibular arch only ([.e, used in two quadrants). Moyers mixed dentition analysis predicts the combined width of 3,4 and 5 based on the widths of four lower permanent incisors. © Using the moyers chart, for a given width of mandibular incisors, the total width of upper and lower canine and premolars can be found. ‘© Thus the space availability and space required for all four quadrants can be compared to determine arch length discrepancy. Moyer’ mixed analysis 8’ [Bhalajhi 3rd ed 179] ‘1 [Gurkeerat Singh 2st ed 83] Moyer's analyses, Tanaka Johnson analysis, Huckaba’s radiographic methods of analysis are examples of mixed dentition analysis. Tanaka Johnson analysis, (i) This analysis does not require any radiographs or reference tables (ii) The width of unerupted canines and premolars (in both arches) can be predicted based on the width of mandibular incisors (IGW0U -10) Width of maxillary canine and premolars = 11 + 1/2 of width of mandibular incisors jv). Width of mandibular canine and premolars ~ 10.5 + 1/2 of width of mandibular incisors ° [Bhalajhi 3rd ed 178] According to Bolton, tooth size is an important factor to be taken into consideration for diagnosis and there exists a ratio. between mesio-distal widths of maxillary and mandibular teeth, Boltons overall ratio is 91.3%, If the overall ratio is less than 91.3%, it indicates maxillary tooth material excess. Boltons anterior tooth ratio is 77.2%. Ifthe anterior ratio is, less than 77.2%, it indicates maxillary anterior excess. Boltons ratio is considered as 7 key to normal occlusion. (atPs-04) “C’ [Check Explanation Below] Stanley and kerber method of cast analysis is used for mandibular atch only, It is similar to Hixon ~ Old father analysis and require radiographs.a | 34. 35. 36. 38. 39. 40. a 42. ORTHODONTICS Stanley-kerber methods will give the best prediction of [i] keane tonto tooth size followed by Tanaka Johnson and moyers analyses. 5 Key 5 | Tight contacts Option ‘0’ wits anaisis is a cephalometric analysis. ANB Key 6 | Curve of Spee should not exceed 1.5mm {angle is the most commonly used reading for the appraisal ey 7 | Boltons ratio ‘of horizontal disharmony of the face. The wits analysis is used in cases where the ANB angle is not considered so reliable. 43. [Bhalajhi 3rd ed 179] “C [Gurkeerat Singh ist ed 82, 83] In mixed dentition period, only the permanent 1 molar is completely erupted and the space mesial to 1° permanent molar is considered as “available arch length” 5 [Bhalajhi 3rd ed 175) [Bhalajhi 3rd ed 179] ‘K [Bhalajhi 3rd ed 172] ‘+ Option ‘is for Ponts analysis ‘© Option ‘B’ is for moyer’s mixed dentition analysis and Hixon ~ Old father analysis. ‘+ Option CIs for care/s or arch perimeter analysis ‘© Option ‘0’ for Bolton's and Ashley Howe's analysis ‘© Option’€’ i for peck and peck index 45. “C [Bhalajhi 3rd ed 168] The fish man's system of interpretation makes use of six anatomical sites located on the thumb, third finger (3 sites), fifth finger and radius. This index uses four stages ‘of bone maturation. They are ‘+ Capping of epiphysis ‘+ Fusion of epiphysis ‘+ Epiphysis in equal width to diaphysis ‘+ Appearance of adductor sesamaid of the thumb. 46. an. In this index, eleven discrete adolescent skeletal maturity indicators (SMS) covering the entire period of adolescent development have been described. Y [Bhalajhi 3° ed 208, Fig. 6] ' [M.S. Rani 3rd ed 138] Refer synopsis Point 38 43. “C [ohalajt sth ed 74] oz ey 1 [Cass I molar relationship 2 | Sinaivat par of the long axis of crown should be Key 2| sistal to occlusal part of the line Maxillary incisors exhibit ¢ve crown inclination, Mandibular incisors exhibit ~ve crown inclination, Maxillary and mandibular posterors have a negative crown inclination. 1 keys of normal Draw table 49. Key 3 ‘C (M.S. Rani 3rd ed 41] Lisping of teeth if associated with spacing of teeth such as class II div. I and open bite, etc. Lisping associated with interdental spacing is called as interdental sigmatism. ‘B' [European Journal of Orthodontics 26 (2004) Pq 268] SCAN index is the synonym for Index for orthodontic tueatment needs (IOTN). IOTN index was developed by BROOK and SHAW (MCET-14) to link dentofacial variation to perceived esthetic imapairement. ‘The other Orthodontic treatment need indices are: © Handi Deviation Index (LO) (Draker) Dental Aesthetic index (DAI) (Cons et al) ‘+ Index of Complexity, Outcome and Need (ICON) (Daniels & Richmond) pring Labio-lingual °C [Athanasios E. Athansiow Cephalometric Book] In order to facilitate identification of consecutive cephalogram, the following colour code for tracing has been suggested by American Board of Orthodontics. Pretreatment Black Progress Blue End of treatment/ Post m treatment tracing (MHCET-15) Retention Green [Bhalaji 3rd ed 104) 'K [Dentistry for Children by Charles Brauer Sth ed 213,214) ‘Abnormal position assumed by the mandible to. permit complete closure or better masticating function is often referred to as a “convenience bite” (Wigley, 1945). This is seen in true skeletal posterior cross bites and exhibited as unilateral crossbites due to this convenience bite or comfort bite, ‘C (Moyers Orthodontic Text book 4th ed 364] Space supervision is the term applied when it is doubtful, according to the mixed dentition analysis, whether there will be room for all the teeth, The prognosis for space supervision is always questionable, whereas prognosis is always good for regaining space and for space maintenance, [Bhalaji Sth ed 230] ‘© Option ‘X’ Boltons analysis proposes that tooth size abnormalities cause malocclusions. This question says there is class II div 1 malocclusion i.e, maxillary prognathism (SSss0 ==A 50. 51, 52. 53. Dental Pulse Option ‘8’ Ponts analysis indicates the need for expansion rather than extraction, * Option’ Peck & Peck is a model analysis of mandibular arch * Option ‘D' Ashley & Howe's analysis indicate tooth extraction if the premolar basal arch width (PMBAM) is, less than 37%, “8 [Bhalaji Sth ed 552] “C [Check Explanation Below] Facial attractiveness is defined more by smile than by soft tissue relationships at rest. So it is important to analyze the characteristics of smile and to think about how the dentition relates to the facial soft tissues dynamically and statically. There are 2 types of smiles. 1) Social or posed smile: It is voluntary expression made when introduced to someone or when taking a passport photograph or orthodontic records © It can be sustained and reproducible. 2) Emotional smile: = Involuntary and is driven by emations. With all the muscles of final expression involved, @ spontaneous smile always has more lip elevation than social smile, °K [Bhalaji 4th ed 185) Skeletal maturity indi © Handewrist radiographs (most accepted) Eg. Fishman’s index, Greulich and Pyle method and Singers method. * Skeletal maturation using cervical vertebrae Clinical and radiographic examination of stages of tooth development. This system evaluates hand-wrist radiographs making tse of anatomical sites located on the thumb, third finger, fifth finger and radius. + 11 skeletal maturity indicators were described covering the entire period of adolescent development. + Interpretation uses four stages of bone maturation = Epiphysis equal in width to diaphysis, ~ Appearance of abductor sesamoid of the thumb. = Capping of epiphysis = Fusion of epiphysis 'C [Check Explanation of Q. No.31] Ponts analysis, Linderharth’s ratio and Ashley Howe's are analysis to study relationship of teeth size to the size of supporting structures. They are nat mixed dentition analysis. 54, —e [Proffit Sth ed 173 Fig 6-26] Some important points about esthetics: a) For the best appearance, the apparent width of the lateral incisor should be 62% of the width of central incisor, the apparent width of canine should be 62% of ‘the width of lateral incisor, and the apparent width of the fist premolar should be 62% of that of the canine. This ratio of recurring 62% proportions appears to be jn a number of other relations in human anatomy and sometimes is refered as the “Golden proportion’. bb) The width of maxillary incisor should be about 80% of ‘ts height i.e, the ratio of width to height of maxillary incisor is 8:10. ) Smile are: It is defined as the contour of the incisal edges of the maxillary anterior teeth relative to the curvature of the lower lip during a social smile. For best appearances, the contour of these teeth should match that of lower lip. If the lip and dental contour match, they are said to be consonant. A fattened (non- consonant) smile arc makes the smile less attractive and makes the people look older. 4) Gingival heights, shape and contour: Generally, the central incisor has the highest gingival level, the lateral incisor fs approximately 1.5 mm lower, and the canine Gingival margin again at the level of central incisor Maintaining these gingival relationships becomes particularly important when canines are used to replace ng lateral incisors ©) Both lay persons and dentists differences of more than 2 mm readily recognize igiva shape: It refers to the curvature of the gingiva at the margin of tooth. For best appearance, the gingival shape of * Mavillary centrals and canines - more elliptical and oriented distally to the long axis ofthe tooth. © Maxillary laterals - symmetric half oval or halfcicle 4) Gingival zenith is the most apical point of gingival tissue. It should be located distal to longitudinal axis, of the maxilary centrals and canines, while the gingival zenith of the maxillary laterals should coincide with ‘thelr longitudinal axis. hh) Embrasures/Black triangles: Short interdental papillae leave on open gingival embrasure, above the connectors (nothing but interdental contact area) and these “black triangles” can detract significantly from the appearance of the teeth on smile, Black triangles in adults usually arise From: Loss of gingival tissue related to periodontal disease ‘© When crowded and rotated maxilary incisors are corrected orthodonticaly in adults. These black triangles should be noted during the orthodontic examination, and the patient should be prepared for reshaping of the teeth to minimize this esthetic problem,ee | 55. 87. i) Tooth shade and colour: The brightness of the teeth during smile isin the following order. © Maxillary central incisors ~ brightest + Maxillary canines ~ least bright + Maxillary incisors, first and second premolars ~ less brighter than maxillary central incisors “B! [Gurkeerat Singh 2nd ed 80] ‘The finished height of the occluded models should be 7 cm. ‘0’ [Graber 5th ed 64] Oblique/three quarter/45 degree photograph: + In this type of photograph, the patient is in natural head postion, looking 45 degrees tothe camera. Oblique facial photographs are taken in thee views, + Oblique at rest: Useful for identification of midface deformities ineluding nasal deformity + Oblique on smile: This view reveals the characteristics of the smile not obtainable on the frontal view and certainly not obtainable through any cephalometric analysis. + Oblique close-up smile: Helps in more precise evaluation of the tip relationship of the teeth and jaw that is posible using the full oblique view. Note: + Profile facial photograph ~ 2 views * Profile photograph at rest needs the lips to be released * Profile smile helps in assessment of angulations of ‘maxillary incisors. ‘R (Graber Sth ed Pg 298] Microradiograph (also known as historadiography) provides semi quantitative information regarding the density of a tissue sample. Ths is achieved by layering a ground section ‘of mineralized tissue (such as bone) with photographic ‘emulsion on a glass side and exposing the sample to a beam of X-rays. After developing the emulsion, the resultant radiograph can be viewed with a microscope. ‘A. side-by-side comparison with a slide containing radiographs of various substances of known mass provides {2 rough approximation of the concentration of calcium salts jn a sample. Eg: Changes in bone density of mandible with ae. ORTHODONTICS BS)——[« A AAA Dental Pulse Yo 5. CEPHALOMETRY Important lateral cephalometric landmarks: N= Nasion Ss - Sella 0 - onbitale ANS. ~ Anterior nasal spine NS. ~ Posterior nasal spine A Point A B= Point Pog ~ Pogonion Gn - Gnathion Me Menton Go - Gonion Ba - Basion Bo ~ Bolton's point ‘Ar ~ Articulare P Porion PTM. ~ Pterygomaxillary point FUPA = 25° IMPA = 90° FIA = 65° Y~ Axis (growth axis) = 59° Downs analysis SNA angle = 82° SNB angle - 80° ANB angle = 2° Steiner Analysis Steiner Analysis Steiner Analysisa | 1. FHP ie formed by joining 4) Porion and Orbitale ©) Porion and sella b) Nasion and sella 4) Porion and Nasion (MAN -28) Most anterior 2) Gonion ) Menton et of the chin is b) Pogonion 4) Gnathion (AN 2K, AIPG -99) 3. Gonion, menton and pogonion are located on ) Midline landmarks b) Mandible ©) Maxila 4) Skeletal profile (MAN-2K, PGI -03) 4. Ina lateral cephalogram, the distance at which the film placed from the mid-sagittal plane i a) 10.ems b) 12 ems ©) 15cms 4) 18 cms (Malt -2k) 5 The three landmarks which determine skeletal convexity 2) Glabella, prosthion and supramentale ») Nason, sella and articlare ©) Nasion, subspinale and pogonion 4) Orbital, anterior nasal spine and pogonion (MAN-95) 6. Which of the following is a bilateral landmark on the lateral cephalogram a) Basion ©) Gonion b) Pogonion 4) Nasion (MAN -2001) 7. Pogonion is 4) Most inferior point on the contour of the chin ) Lowest point on the symphyseal outline )_ Most posterior inferior point on the angle of the mandible 4) Anterior most point on the contour of the chin (MAN ~2001) ‘An ANB angle 2° on the cephalogram usually indicates, ') An unfavorable relationship of mandible to maxilla ») A favorable relationship of maxillary alveolar base to ‘mandibular alveolar base ©) Poor cranial growth with poor prognosis 4) Retruded maxillary incisor (MAN -97) In cephalometric analysis of children with malocclusion, The angle ANB is frequently used in patients with s lass IT malocelusions, This angle is a) Large b) Small «) Normal 4) Negative (MAN -97, APPSC -99) Frankfort — horizontal is a reference plane constructed by joining which of the following landmarks? 4) Nasion and Sella —_b)Porion and Sella ©) Porion and Nasion —d) Porion and Orbitale (PGI -98, KAR -02,ALIMS -03) Which of the maxillary is a MISMATCH? 4) Bolton point: highest point on the concavity behind occipital condyles ) Gonion: anterior point of the angle of the mandible 10. 1 ORTHODONTICS 12, 3B. 14, 15. 16. a. 18, 19. 20. a1. 22, 1) Porion: Highest point on the soft tissue (superior surface) of the external auditory meatus (MAN-95) Open bite on cephalogram shows as: a) Increased MP angle b) Decreased MP angle ©) Increased ANB angled) None of the above (alrs-97) X-rays were discovered by 8) Madam eurie b). Roentgen ©) Rutherford 4) Becquerel (AP-2003) The highest point of the concavity behind the occipital condyles ist a) Botton point. ©) Prosthion b) Glabella 4) Basion (atPG- 10) S.N.A. angle describes the relationship of the: fa) Maxilla to the cranial base ) Mandible to the cranial base ©) Maxilla to mandible) Maxilla to the upper incisors (KAR ~02) Y axis is used to analyse a) Maxillary growth b) Mandibular growth ©) Both maxillary and mandibular growth 4) To design appliance (KAR 2K, PGI -98) ce a) Margolis and William Wilson in 1925 ) Tweed and Mills in 1940 ©) Bjork and sassount in 1995 4) Broadbent and Hofrath in 1932 (KAR-2001) ‘The deepest point between the anterior nasal spine and superior prosthion is a) Subspinale ©) Infa spinate b) Supranasate 4) gnathion (AP -28) Which of the following cannot be assessed with cephalometric radiograph? ) Mandibular retrusion b) Vertical facial disproportion ©) Incisor position & angulation 4) Adequacy of dental arch perimeter (KAR-2k) The angle of convexity is: a) SNA b) ANB ©) NA+ Pog ) SHB (AIP -92, PGI -95) Which of the following conditions cannot be assessed by a cephalogra a) Mandibular lateral asymmetry ) Vertical facial discrepancy )_ Increase posterior height. 1) Decreased anterior height, (AlPG 2001) Tweed triangle denotes: a) The position of mavilla and mandible to each other ) The angle between the mandibular plane and mandibular ¢) Orbital: lowest point on the left infraorbital margin incisors DADS BD ©) © WO a) 8 DA 1) D MB i) A ts) B 14) A 15) A_16) B17) D_ 18) A 19) 020) C21) A_2) 8 BS)= 222A Dental Pulse _ 6) Relationship between maxillary central and mandibular 33. Which ofthe following planes can be examined clinically central incisor 2) Frankfort horizontal plane 4) Profile ofan individual ) Botton plane (P6120) c)_ Slane @) AiLof the above 23, Theanterior cranial base isa suitable for superimposition (KAR -99) of serial cephalograms because of its. 34. Which of the following cephalometric analysis does not a) Anatomic confgurationb) Attachment to maxila reveal the severity of anteroposterior jaw dysplasia? «)_ Early cessation of growth, 2) Down’ analysis ——_b) Steiner analysis. 4) Being the most anterior aspect of the cranial base «) Tweed’s analysis) Wit's analysis (KAR -97) {AIINS -2001) 24, The point of intersection of dorsal contours of Mandibular 35. Angle between FH plane & occlusal plane processes ar ») 10° 8) Supramentale ) Articutare ©) er 4) Parallel to each other «)Condyion «)Pterygomaxilary point (P61-2011) (KAR -2003) 36. Cephalometric analysis are used to evaluate growth 25. Down’scephalometricanalysis uses_line asareference changes by superimposing on: plane: a) Sella ~Nasion plane b) Mandibular plane 2), ANS-PNS 1) SW plane ©) FHP 4) Occlusal plane ©) Porion - Orbitale ——d)Gonion- Menton (ATIMS -95) (PSI-99) 37. Ima skeletal Class IL, the value of ANB willbe: 26. Ona cephalogram if FMA angle is 25° the patient 2) -10 ») 42 2) Long face 1b) Short face o) +4 446 c) Average face (AIIMS -98) 4) Mandibular growth is rotated backwards 38, High ange case f (PGI -99) a) FMIA > 65 ‘b) IMP > 100 27. Which of following does not lie on the mandible: 6) FNP» 35° 4) SNA >a 4) Pogonion ) Porion (AmINS -98) ©) Menton €) Gnathion 39. SNB angle describes the relationship of the (P61-2002, COMEDK ~04) a), Masia to the cranial base 28. If s normal SNA ~ 82°. A patient has SNA ~ 90°. This) Mandible tothe cranial base suggests: ) Maxilato the mandible d) All of the above 4) Maxillary teeth protrusion (COMEDK 04) 5) Maxillary protrusion 40. ANB angle refers to ) Mandibular protrusion). Mandibular retusion 2} Skeletal relation) Transverse discrepancy (PSI-99, KAR-99) ©) Dental malocclusion d) None of above 29. Registration point: (P61 -03) 8) Point? 461. Nasion is situated at 5) A point half way on the perpendicular from sella to a) Frontonasal suture _b) Zygomatic process Boltons plane €) Orbital oor 4) None of above «) Nason €) Point 8" (1-98) (KAR 2k) 42. Faclal planets formed by 30. Ina patient of Class II Div 1 which of the following a). Sella gnathion ») Sella nasion features is present: ¢) Nasion pogonion 4) Nasionsubspinale 2) ANB of 2° b) ANB of + 8° (esi -97) )_ ANB of - 9° «) FUR» 35° 43. Decreased interincisal angle indicates {AIPG -2001, MAN-98) a) Retvusin of teeth _b) Pratrusion of teeth 31. Angle formed between mandibular plane and the long __—«) Vertial overlap) Horizontal overlap axis of mandibular central incisor i (1 -95) a) 90 25° ) 25° 44. Mid point from sella to bolton point is ©) 0 é) 80°42" 2) Registration point b) Basion (AIPG -94) c) Nasion, d) Condytion 32. A cephalogram of a 10-year-old child shows ANB = ~4" (a? -99) and facial angle of 98°. The case is of: 45. Anteroposterior relation of jaws is measured by: ) Maxillary hypoplasia b) Pseudoclass [1] malocclusion a) ANB angle 'b) Angle between SN & FH Plane «) True Class IIT malacelusion ) Angle between SN & mandibular plane 4) Maxillary prognathism ¢) Facial angle (AIIMS ~99) (ALIMS - 97) BoM) 8 Bye) © ee) 8 eyes) e MPAs) c GAs) C SB 36) A 37) A_38) C39) 8 A) A 41) A_42) C43) BMA) A 45) Aa | ORTHODONTICS 46. Difference between the size of the cranium and the 58. The average angle of convexity asin Downs Cephalometric cephalogram is: analysis is: 2) No difference ) 5% reduction a) 0 degree 8) 25 degree ) Sthenlargement ——d)_ 10% enlargement ©) 82 degree 4) 86 degree (AIINS -88) 47. What fs wits analysis 59. Witts analysis fs used f 4) Cephalometric analysis b) Model analysis 2) Lateral jaw telation b)_Antero-posterior jaw relation «) Computer analysis d) Space calculation analysis )_Superioinferior jaw relation (INPSC-99) ad) None ofthe above 48 In bimaxillary malocclusion (aP-07) 8) SNA‘sincreased —_b) SNB is increased 60. Which cephalometric point represents centre of ramus of ‘)_ Both SNA and SNB are increased MANDIBLE? 4) Both SNA and SNB ae decreased 8) Kipoint b) Pm-paint (UPSC-99)—«)_Ptm-point 4) Nepoint 49, Im skeletal class II malocelusion will show (AaTP6-10) 2) ANB of +8" 3b) ANB of 6° 61. Which of the following cephalometric point can be «)_ ANB of o* @) ANB of 42° altered by orthodontic tooth movement? (AIPG-03) a) Point-& b) ANS 50, In class II malocclusion, ANB angle is ¢)Nasion «) Gonion 4) Greater than normal b) Less than normal (A1P6-07,10) ) Not altered ) None ofthe above 62, Skeletal maturity is indicated by: (AIIMS -92) 0) Carpals 3) Rats, Una 51, Fishman’s SMI is a method of evaluation of: ©) Both «@) None 8) Symmetry ofthe dental arch cet-07) 8) Skeletal maturity 63. Which ofthe following bone(s) are used for determination «) Arch length discrepancy of growth pattern in an individual? 4) Prognathsim of maxila a) Clavicle »b) Capitate ©) Cervical spine 4) Mandible 52. Which is the most often and most stable used plane for (AaNINS-07) the superimposition of lateral cephalograms in studying 64. Hand wrist radiograph provides a view of the growth of a child? 2) 25 bones 3) 26 bones 8) Frankfort plane b) S.N Plane «) 30 bones 4) 32 bones } Mandibular planed) Occlusal plane (KCET-08,09) (AIPG-06) 65. Nasal width/length ratio is? 53, The Yeaxis is also known as growth axis because: 2) 62.5% 5) 70% 2) Its axis is parallel to patient's growth in height ) 65% 4) 66% 8) It isan indicator of te direction of growth pattem (arec-14) ) Tt isan indicator of the amount of facial growth 66. Cephalometrics is useful in 4) increases in size as the growth increases 8) Treatment of malocclusion (AIPG-06) __) Diagnosis and case study 54, Considering the growth of the face in all three planes, _c)_ Diagnosis and treatment plan srowth ceases last in which direction? 4) Allthe above 3) Antero posterior) Sagittal (aP-10) ) Transverse 4) Vertical 67. The Broadbent - Bolton cephalometer was devised in (atP6-05) a) 1930 8) 1927 55. Cephalometrics i useful in assessing al of the following) 1931 4) 1946 relationships except: (KeeT-20) 2) Tooth to tooth ——_b)_ Bone to bone 68. Value of mandibular plane angle is: «} Tooth to bone 4) Soft palate to gingiva a) 17.30 3) 100-120 (AIPG-08) «) 53-66 4) 82.95 56, The AO & BO in Wits appraisal is relationship of 4) Maxllato cranium —b) Mandible to cranium 69. The medial confluence of stress lines on the medial «) Maxilato mandible) Maxila & mandible surface of the ramus that represents the acial growth of (P6I-2011) surface of the mandible ts known 33 57. More than normal posterior angle indicate 8) X Point 3) Pm Point 8) Horizontal growth b) Vertical growth ) Me point 4) Eva point } Sagittal growth) No significance (coueok-2013) (aP-08) me) § es) 8 SOUAD Ss) © Ses) © SAL) 0 TSE) 8 BALA 58) 8 60) A_ 61) A_62) C_63) C_ 64) C_65) B66) C_67) C68) A_69) D (Seo =—/ 0 A AAA Dental Pulse 70. n 72. 23. 14 75. 76. Long face syndrome patient with increase lower facial height, the palatal plane will be: a) Posteriory downward b) Upward posteriorly ©) Downward anteriorly d) No change (AlIMs-2012) 5 years and 4 month child having smaller chin, he clinically present distal step 2nd molar relation and narrow width of maxilla, having normal SNA angle, decreased SNB angle, with low FMA angle, then: ) Wait and watch for 6 years 5) Klohen head gear to treat maxillary protrusion ©) FRU appliance 1d) Twin block appliance (AlIMS-2012, AIPG-14) The interincisal angle between deciduous incisors a) 100 degrees b) 120 degrees ©) 150 degrees 4) 170 degrees (KAR-2013) In Ricketts esthetic plane lower lip rests a) 1mm anterior to plane ») Rest on plane ©) 2mm posterior to plane 4) 11mm posterior to plane (AIMS NOv-13) 's analysis, if FMA is 35 degrees, what will be by 63 a) 68" (Pot JUNE-2011) During time that the core of the mandible rotates forward fan average of 15 degrees, the mandibular plane angle, representing the orientation of the jaw to an outside observer? 4) Decreases only by 2-6 degrees on the average b) Increase only 2-4 degrees on the average ©) Increase only to 6-8 degrees on the average 4) Decrease only to 6-8 degrees on the average (P61 DEC-2013) The occipital pull chin cup is frequently used to treat a) Maxillary prognathism ) Mild moderate mandibular prognathism ) Class Tskeletal cases d) Class IT skeletal eases (APP6-15) _ TO) A 71) A Ye 73) © MYA TS) A 7) Ba | 5, CEPHALOMETRY — ANSWERS a 'K [Bhalajhi 3rd ed 148] FHP or Frankfort | Formed by joining Porion and horizontal plane | orbitale SN plane or anterior cranial base Cranial base length Upper facial height Lower facial height Total facial height Formed by joining nasion and sella Nasion and Botton line Nasion to ANS (anterfor nasal spine) ‘ANS to menton Nasion to menton ‘B [Bhalajhi 3rd ed 148) Pogonion | Most anterior point of bony chin Constructed point at the junction of ramal Gonion | and mandibular plane Menton | Most inferior point on mandibular symphysis Gathion | It 5 the most antero-inferior point on the symphysis of the chin ‘B [Bhalajhi 3rd ed 148] Ceres Conan Ceres * Nasion * Gonion Menton * Prion * Gnathion «= Atticulare = Basion * Pogonion ‘D’ [Check Explanation Below] The distance between X-ray film and midsagittal plane of patient's head is The distance between X-ray tube and midsagittal plane of patients approximately 18 cm or 7 inches. 5 feet (KERALA-15)/ 60 inches/ 152.4 cm. head is While taking radiographs the operator should stand at a 6 feet distance of °C [Bhalajhi 3rd ed 151] ‘Angle of convexity (N-A-Poq) is formed by intersection of 2 line from nasion to point A (subspinale) and a tine from point A to pogonion, ‘The average value is 0° while the range is -8.5 to 10° (0+ 10) [A positive angle or an increased angle suggests a prominent maxillary dentute base relative to mandible, [A decreased angle of convexity or negative angle is indicative of @ prognathie mandible ORTHODONTICS 10. a 22, 2B. 14 15. 16. “C [Bhalajhi 3rd ed 148 Fig 3(8)] In lateral cephalometric, left side of the patient is towards the cassette and when compared to right side, left side of face is viewed more clearly “D[Bhalajhi 3rd ed 148) ‘B [Bhalajhi 3rd ed 154] SNA angle relates maxilla to the cranial base. The mean value is 82°. A larger value indicates prognathic maxilla while a smaller value is suggestive of retrognathic maxi NB angle relates mandible to cranial base. It average value fs 80°. Larger values indicate prognathic mandible while smaller values indicates retrusive mandible. ANB angle denotes the relative position of maxilla and ‘mandible to each other. Mean value is 2° ‘An increase in this angle indicates class-II skeletal tendency (AIIMS-14) while an angle that is less than normal or a negative angle is suggestive of a skeletal class- II relationship. K [Bhalajhi 3rd ed 154] °D' [Bhalajhi 3rd ed 148] “B' [Bhalajhi 3rd ed 148] Gonion is @ constructed point at the junction of remal and ‘mandibular plane. °K [Bhalajhi 3rd ed 151,417] Mandibular plane angle is the angle between mandibular plane and Frankfort horizontal (FH) plane. ‘lower angle indicates hypo divergent or horizontal growing face while an increased angle is suggestive of vertical grower with hyper divergent facial pattern B [Bhalajhi 3rd ed 143] Roentgen discovered X-rays in 1895 'N (Bhalajhi 3rd ed 147) ‘N [Bhalajhi 3rd ed 154] ‘B [Bhalajhi 3rd ed 151] Y-axis is the angle obtained by joining the sella gnathion| line with the FH plane. The mean value is 59° with a range of 53 to 66°, The angle is larger in clase-I facial patterns than in patients exhibiting class-III pattern eo =—( rr 7. 18. 9. 20. an 22, 23. 26, 25. 26. Dental Pulse If the angle > normal, it indicates vertical growth of mandible. Tf the angle < normal, it indicates horizontal 4grovth of mandible. ‘D' [Bhalajhi 3rd ed 143) [Bhalojhi 3rd ed 147) | Se Prion | Eat bn tie See ae upper central incisors. . rN ad to a epee er Cer “Steen te, mwa cere TE i dnp pot ele Pinca eee eer (subs le) , . See superior prosthion. Tr ln rpat pe He iin rain ea arecc see Se eed infradentale, ° “€ [Bhalajhi 3rd ed 151] ” 27. ‘B [Bhalajhi 3rd ed 158) The main objective of tweeds analysis includes the determination ofthe position of lower incisor and evaluation ‘of prognosis of a case. The angles in tweeds analysis are FPA, FMIA, and IMPA. 28. 29. Incisor mangibular plane angle (IMPA) is the angle between long axis of lower incisor with the mandibular plane. The mean value is 90°. It indicates the inclination of lower incisor. © ‘W [Bhalajhi 3rd ed 148) Option C, condytion is the most superior point on the head of condyle 31, Option ‘D’ pterygomaxillayy point (Ptm point) is the {intersection of foramen rotundum with the pterygomanillary fissure. 32, « ewan singh 29010 Downs Porion - orbitale (FH) line Steiner's _| Sella - Nasion line (SN line) ‘€ [Bhalajhi 3rd ed 158] FMA/FUPA/Frenkfort mandibular plane angle the angle formed by intersection of the FH plane with the mandibular plane. 33, _ "Average angle is 25° (25-35) ‘= The Frankfort horizontal plane and the mandibular plane meet at the occipital region. Angle is < 25° '* Low FMA cases lead to deep bite ‘+ Are associated with decreased lower facial height and horizontal growth pattern, ‘Low angle cases respond well as most myofunctional appliances causes vertical development of posterior teth, * Angle i > 30 Degree ‘High FMA cases lead to open bite ‘Associated with increased lower facial height and vertical gronth pattern. ‘© In high FMA cases with mandibular retrognathism, activator should be used with high pull headgear. ‘8 In high FMA cases with mandibular prognathism, anterior open bite and excessive anterior facial height, vertical pull chin cap is used, Average Low angle (Short face) High angle cases, (Long face) [Bhalajhi 3rd ed 147] Porion is the highest bony point on the upper margin of extemal auditory meatus. 8! [Bhalajhi 3rd ed 154] 8" [Bhalajhi 3rd ed 148] Broadbent registration point is the midpoint of the perpendicular from the center of sella tursica to the Bolton's plane, SUPERIMPOSITION in cephalometric studies is done from “registration point” and it demonstrates growth of structures farthest from the point. [Bhalajhi 3rd ed 154] 'N (Bhalajhi 3rd ed 158) “C [Bhalajhi 3rd ed 153) ANB angle (normal value is 2°) denotes the relative position of maxilla and mandible to each other. Negative value is suggestive of skeletal class-III malocclusion. Facial angle (normal value is 88° while the range is 82 to 95°) gives an indication of anterior posterior positioning ‘of mandible in relation to upper face. High values indicate skeletal class-III while low values indicate skeletal class-II 'N (Bhalajhi 3rd ed 148) FH plane connects the lowest point of orbit (orbitale) and the superior par of the external auditory meatus (Porion).ee | 34. 35. 36. a7. 38. 39. 40. a 42. “C [Bhalajhi 3rd ed 158] Facial angle, angle of convexity and A-8 plane angle in downs ‘analysis and SNA, SNB and ANB angles in steiners analysis reveal the severity of anteriar posterior jaw dysplasia, Wit's analysis fs a measure of extent to which the maxilla land the mandible ate related to each other in the anterio- posterior or mid sagittal plane. The wits appraisal is used ‘only when the ANB angle is not considered as reliable. ‘8! [Text book of Orthodontics Gowrisankar 1st ed 238-240] This is from Dove's analysis. The cant measures the slope of ‘occlusal plane to the Frankfort horizontal plane. When the anterior part of plane is lower than the posterior, the angle would be positive. Large positive angles are found in Class 1 facial patterns. A long mandibular ramus also tends to decrease this angle. The mean value is +9.3° with a range of 41,5" to 49.3" “X [Check Explanation Below] Sella-Nasion plane / SN plane represent the anterior cranial base. The growth of anterior cranial base is completed much earlier to facial structures. So, the SN plane is taken as most stable area to compare the growth changes of facial structures and jaws. ‘X [Bhalajhi 3rd ed 154] ‘€ [Bhalajhi 3rd ed 158 Table 2] 3 [Bhalajhi 3rd ed 154] Bhalajhi 3rd ed 154) [Bhalajhi 3rd ed 147) “C [Bhalajhi 3rd ed 149] [A Pog line, facial plane, facial axis are vertical planes, wile SN plane, FH plane, occlusal plane, palatal plane, mandibular plane and Bolton’s planes are included under horizontal planes. fone Facial planes | Connects Nasion and pogonion Facial axis | Connects ptm point and gnathion Esthetic plane | Line Between most anterior point of sore tissue nose and soft tissue chin fed TA plane_—_[omrecs fae and Pen SHepane [Sela and Rasion lane Ten Sea ana pane | Ht) she aa poreor ha sino pata bone A dere plane hat cs Se peter ec of pram mle and premolars and extents anteriorly. ORTHODONTICS 43. 44, 45. 46. an. 43. 49. 50. 51, 52. 53. 34, 55. 56. 57. 59. 60. ‘+ Tangent to the lower border af mandible (Tweeds analysis) '* Gonion ~ Gnathion line (steiners) + Gonion ~ Menton tine (Downs) Mandibular plane B’ [Bhalajhi 3rd ed 151,157] The inter incisal angle isthe angle formed between the long axis of upper and lower incisors. The average value is 138.4° in downs analysis and 131° in Steines analysis Increased inter incisal angle indicates retruded incisors (seen in class-II division 2 cases) where as decreased Interincisal angle indicates protruded incisors (seen in clase division-1 and elass-1 bimaxillary protrusion cases) (P6I-08). 'W (Bhalajhi 3rd ed 148) °K [Bhalajhi 3rd ed 154] © ‘A magnification of 5-7% is considered normal (PGI -05). ‘N’[Bhalajhi 3rd ed 158] ‘C’[Bhalajhi 3rd ed 154) °B [Bhalajhi 3rd ed 154] ‘K [Bhalajhi 3rd ed 154] ‘B’[Bhalajhi 3% ed 168] “B [Profitt 4" ed 207] Compared to Frankfort plane, S-N plane can be easily and reliably detected on cephalometric radiographs. ‘B [M.S. Rani 3rd ed 149-150] Y-axis indicates the direction of growth pattern of mandible, ‘DT IMSS. Rani 31d ed 81] The growth of face occurs in the order of TSV (Transverse, saggital, vertical) or WOH (Width, depth and height) ‘D’ [M.S Rani Sed ed 242] “C [Bhalaji Sth ed 208], 8 [Bhalajhi 3% ed 154] 1X [Bhalajhi 3“ ed 252] B" [Bhalajhi 3 ed 158] Refer Q. No. 34 'W [Jacobson Radiographic Cephalometry Pg 88, 89] Seo ==(222A 61, 62. 83. 64, 65. 66. 67. 68. Dental Pulse °K [Profitt 4% ed 349] Point-A is the deepest point in the midline between anterior nasal spine and alveolar crest between two maxillary central incisors. Orthodontic treatment causes resorption and apposition of bone adjacent to root structure of teeth, °C [Bhalaji 3rd ed 162) The hand-wrist region is made up of the following four ‘groups of bones ‘© Distal ends of long bones of forearm (radius and ulna) © Carpals ‘= Metacarpals + Phalanges Thus, option ‘Cis the correct answer. “C [Bhalaji 3rd ed 171] ‘The shapes of cervical vertebrae were seen to differ at ‘each level of skeletal development. This provides @ mean to determine the skeletal maturity or Growth estimation [AIPG-2010} of a person and thereby determine whether the possibility of potential growth existed “C [Profitt 4th ed 103] A radiograph of the hand and wrist provides a view of 30 small bones, all of which have 2 predictable sequence of ‘ossification. Although a view af no single bone is diagnostic, an assessment of the level of development of the bones in the wrist, hand and fingers can give an accurate picture of child's developmental status. 'B [Check Explanation Below] Nasal height (Nasal to subnasal) is approximately 45% of lower anterior face height. Nasal width should be approximately 1/3¢d of intercanthal distance. The ratio of nasal width to nasal length is 70%. This means the width is approximately 70% of the length of nose, ‘€ [Bhalajhi 4th ed 160] “C [Bhalajhi 4th ed 159) 'K [Refer Synopsis point 21] ‘D’ [Text book of craniofacial growth by Sridhar Pg 199] Accial growth of ms + Proposed by Ricketts The advantage was that the arc of growth can be constructed for every individual depending the length of, the core of the mandible In order to locate the central cote which Is immune to surface deposition and resorption, he introduced 2 land- marks Xi point and Eva point on the mandibular ramus, + Xi Point: Represents geometric centre of ramus. ‘Eva point: In dried mandible, the stress tines run on the medial aspect parallel to the external oblique ridge and ascend up the ramus, The stress lines fork into two at a particular point that was named as Eva point. 70. nm. 72. 7. Th. 75. _ [Proffit 4th ed 137] excessive lower anterior face height: ‘= Palatal plane ~ Rotates down posteriorly, often creating a negative rather than the normal positive inclination to ‘the true horizontal. ‘+ Mandible ~ Ac it rotates backward, anterior face height ‘increases, thereby having a tendency for anterior open bite, 'N [Refer Explanation Below] Smaller chin, distal step, and decreased SNB and low FMA (horizontal growth) suggests that mandible is small and Fetrognathic. But the age of the child is only 5 years and ample amount of mandible growth is remaining which will bring the mandible to a more forward position. This retrognathic appearance is transient. So wait and watch is the best answer ‘C [Tilakraj essentials of Pedodontics Pg 43] Normal inter-incisal angle in in permanent incisors is 135.4 degrees. The angle decreases if the teeth are proclined . The normal inter-incisal angle in in primary incisors the angle is about 150°, This means the peimanent incisors in both the ‘maxilla and mandible are inctined to the labial much more than primary incisors. “C [Facial plastic and reconstructive surgery 3rd ed 130] The E-line (esthetic line) was described by Ricketts. This {s the line between nasal tip and the pogonoion, It is also called as Naso-mental line, The ligs should lie posterior to this line. The lower tip ideally falls 2 mm posterior to this Line and upper lip falls 4 mm posterior to this line. [Graber 5th ed 447] Tweed’s Analysis: a) FMA 16 to 28 degrees; prognosis is good. Approximately 60 percent malocclusions have between 16 and 28 degrees b) FMA from 28 to 35 degrees: prognosis fair at 28 degrees. Extractions are necessary in majority of cases at 35 degrees. ©) FMA above 35 degrees: prognosis is bad and extractions frequently complicate problems. 4) Tweed analysis has established the relationships: © When the FMA is between 21 and 29 degrees, the FIA should be 68 degrees. '* When the FMA is 30 degrees or greater, the FMIA should be 65 degrees. ‘+ When the FMA is 20 degrees or less, the incisor mandibular plane angle should not exceed 92 degrees. following 'N [Proffit Sth ed 100 Fig. 4-14) One of the features of internal rotation of the mandible is the variation between individuals, ranging upto 10 to 15, degrees. Foran average individual with normal vertical facial proportions, however, there is about a 15 degree intemala | 76. rotation from age & to adult life. OF this, about 25% results| from rotation at the condyle and 75% results from rotation within the body of the mandible, During the time that the core of the mandible rotates forward on average of 15 degrees, the mandibular plane ‘angle, representing the orientation of the jaw to an outside observer, decreases only 2 to 4 degrees on the average, 3 [Bhalajhi 5th ed 469] ORTHODONTICS bee io YG—(« A AAA dental tase . OCCLUSION IFICATION OF MALOCCLUSION Ackerman profit classification - outer envelope represent 12. Ange’ class II maloclusion fs found in India 2) Alignment 6) Profle 2) 60% 1b) 30% ©) Transverse relation 6) Vertical relation 3 oe 3) <% nan -26 (uan -26) The term orthodontics was coined by: 13, ‘Seisors bite is aterm used to describe 2) Lefelon of Famce b) Hunter 2) Amtrior posterior crowing with de bite 9) Gabel €) Norman Kingsley 6) Posterior cos bite (KAR -03) 6) The type of css tite were maxillary segments contains Which of the following condition ts usually present in fall mandibular segments lass 1 div 2 maloclasion: 4) typeof anterior cos bite 2) Open tite wan-s7) 2) Retroctned malay later incisors 14, Which of the fllowing condition is always presen ‘c) Retroctined maxillary central incisors Class II, Division 2 malocclusion? d) Retroctined maxillary molars a) Closed bite +b) Cross bite (AIPG -89) ) Deep overbite d) Open bite 4: _Torsvesion refers to (wan-95) a) Change in axial inclination 15. Most damaging feature of Class III malocclusion is 2) change in postion 2) Rtroclined upper anterior teth 6} Impaetion of tooth d) Rotation aound its ass 2) rowing of lower incisors (WAN -96, AP-o4) _c)Devated path of closure) Reduced over ite 5 Pseudo class It condition occurs due to (an -02) 2) Linguallyinctined mandibular incisors 16, Scissor bite is seen in b) Lingually inclined maxillary molars a) Anterior cross-bite —b) Complete deep-bite 6) lay inctned malay incisors 2) Total aviary lingual cross bite 8) None of these 6) Total manila bueeal cose bite (TNPSC-99) (MAN -98) 6 Maxilo mandibular relation ina newly born child is 17. Which of the following maloccusions are more prone to a) Retruded maxilla b) Retruded mandible fracture of incisors. c) Protruded maxilla d) Protruded mandible a) Class I Crowding +b) Class II Div. 1 ©) Gass 02”) Class The skeletal classification of maloclusion is given by (umi-98) 2) Gavin ese 1) Martin Dewey 18. Cross bite isa 3) Pau Simon EW angle 2) Nesio distal malocclusion (KAR -98) b) Buco lingual malocclusion Which matoctsion will not lead to straining of ips? 6) Vertical malocclusion)" None ofthe above a) Cassie 1b) Classll Dv. 2 (HAN =02, KAR -02) ©) Bimaxilayprotreston ¢) Hone 19. The condition in which the occlusal plane of the teeth (esr-05) "ies nearer the Frankfurt plane than it does in normal Host prominent feature of Angle dass 1 div. 2: ecclason is cl 2) Lingually placed maxilary central elsrs 2). Abstraction 1) Contraction ©) Labity placed mailary cmt incsos Protection 1) None of the above ©) Large overbite 4) High palatal vault (MAN -95) (AIP -92; HAN -2K) 20. Canine placed anterior to orbital plane 10, An 1tyear-sld boy complains of spacing between 9) Prtraction 5) Abstetion masilary incisors. The appropriate treatment i with: 6) traction 4) Expansion 2) Hawleys appliance b) Feed appliance (wan -02) 3) Notentnent d) Ol sceen 21. Jacksons triad in orthodontic treatment includes (AIIMS -01) a) Structural balance ‘b) Esthetics harmony 11, The inctination of teeth towards Frankfort horizontal c) Functional efficiency 4) AlLof the above plane in Simen’s classification ts (uan-26) 5) attection 3). Provaction 22. Achild hasan extreme open bite ony the most posterior 6) Retraction 6) Distraction teeth contact in the opposite arch. The best procedure (P95, KAR-04) for dentist would be to 2), Refer the eld to an oxthodontis for treatment TAD * Boe) 0 WH 8 De] § MAC MA we VE 4) 15) D 16) D7) 8 1a) B19) 0 20) A 2) 0 2) Aa | b) Remove the posterior teeth in each quadrant co) Make an overlay denture to create occlusion 4) Place bands on the teeth and place elastics to close the bite (MAN -97) ORTHODONTICS 33. In classifying malocclusion (Class I, I, & Ill), the premature loss of a primary molar adjuvant observation ‘to reinforce initial evaluation is by a) Molar relation b) Canine relation ©) incisor relation «) Midline relation 23. Uniform loading of periodontal ligament occurs in which (kaR -98) of the following tooth movements 34, Incomplete overbite is: 2) Tipping b) Translation a) Open bite ) Deep overbite ) Intrusion @) Extrusion ©) Overbite with no overjet (NAN -01) 4) Overjet with no overbite 24, New born infants are (KAR 2K) 2) Obligatory oral breathers 35. Ina patient of operated cleft lip and palate with anterior ) Obtigatory nasal breathers cross-bite cephalogram will show: )_ Predominantly oral breathers a) Maxillary retrusion —b) Mandibular protrusion 4d) Nasal and oral breathers ©) Maxillary protusion 4) Aand B (MAN -01) {AIPG -01) 25. Which of the following classification uses the “canine 36. An angle class 2 malocclusion is worsened by: law” malocclusion in a sagittal direction 2) Over closure 1b). Short facial height 2) Bonnet’ classification b) Simon classification ©) Decreased mandibular growth } Dewey classification d) Lischer's classification 4) Decreased lip activity (AIIMS -01, 06) (AIPG -92, TNPSC -99) 26. The angle’s system of classification of malocclusion was 37. The key ridge useful in assessing malocclusion is present on: modified by: a) Maxilla 4} Zygomatic buttress 8) Simon b) Dewey's ©) Sphenoid bone 4) Mandible )lischer A) Ackerman Profit {AIMS -92) (AIPG -97) 38. Most common malocclusion found in people is: 27. If the tooth has not erupted to the line of occlusion itis 2) Class I with incisor crowding called: ») Class I division 1 2) Supraversion b) Torsiversion ) Class I division 2 a) Class IT ) Rotated 4) Infraversion (PI 2K, AIPG- 06) (AIPG -89) 39. The six keys to normal occlusion was introduced by: 28. Dewey's Modification of the Angle's Class-l Type 2 is? a) Dewey b) Andrews. 2) Crowded Anteriors —_b) Anterior Crossbite ) Tweed ) Angle )_Anteriors in Labioversion (KAR -2K, AIPG-05, COMEDK-25) 4) Posterior Crossbite 40. The role of antiflux in soldering stainless steel is (61-08) 2) To remove the chromium oxide layer 29. A patient suffers from contraction of maxillary arch, b) To increase the flow of solder labioversion of maxillary incisors with deep overbite and ) To reduce the fusion temperature of solder ‘overjet. These are features 4) To limit the flow of solder 2) Class I malocclusion b) Class Il iv 2 malocclusion (KAR -99) ), Class I div 1 malocelusion 41. Which of following is used as antiflux 4) Class I malocclusion 3) Borax 3) Boric acid (atP6 -91) ©) Carbonate 4) Graphite 30. In angle’s classification for malocclusion, key tooth is: (P61 -03) 2). MB cusp of Permanent Max. 1* molar 42. Flux used in stainless steel solder are all except 5) 0B cusp of Permanent Nax.1* molar 2) Borax b) Borie acid )_ MB cusp of Permanent Max. 2% molar ) Potassium fluoride dl) Sodium fluoride 4) MB cusp of Permanent Mand. 1* molar (KAR -99) {PGI -99) 43, Surgery of the cleft tip should be carried out at: 31. Closed bite is seen in which type of malocclusion a) 20-30 weeks 1b) 2-12 months 4) Class 1 b) Class Il div I ©) 36 months ) 5 years ) Class I div 2 4) Class 1 (AIMS -98) (AIPG -96) 44. The Line passing through the cingulate of the anterior 32. Three dimensional classification of occlusion was given teeth and central fossa of the posterior teeth is 2) Angle b) Simon a). Angles line of occlusion ) Dewey 4) Baume b) Andrew's line of occlusion (AIPG -99, PI -01) )Catenary curve «All of the above (ka. 2023) Bee) 8 Bye) 8 aD) ¢ ye 3) A Se MB SB) 0 BELA 36) C37) 8 38) A 39) 8 4) D4) 02) O43) CA) A (Seo ==a Ad Dental Pulse Prolonged thumb sucking following Except tly results in all of the _ 4) Gingivally supported open bite (coMEDK-2013) a) Deep over bite 55. Decreased collum angle is seen in 5) Proctination of upper centrals a) Class I bimaxillary protusion «) Anterior open ited) Consrition of maxilla ) Class I div (COMEDK-05) ) Class UI div 2 4) Class 111 46. Which of the following is the only posterior dental cross (ALIMS May-13) bite? 56. Which of the following is not a self-correcting anomaly 4) Maxillary anterior alveolus is overlapped by mandibular in a9 year old child? anterior alveolus a} End on molar relation b) Uply-duckling stage 1). Mandibular posterior jaw segment is displaced to overtap ¢)_ Anterior open bite maxilary posterior jaw segment @) Anterior mandibular crowding ©) Maxillary posterior dental segment is overlapped by the (ALIMS Nov-13) ‘mandibular posterior teeth 57. First to classify malocclusion on structural basis? 44) None of the above 2), Salzmann Kingsley (wcer-07) c) Angle 4) Katz 47. AUL of the following are dental characteristics of @ (AIP6-14) skeletal class IIT malocclusion, except: 58. E.M. Angle introduced his classification of malocclusions a) Anterior cross bite b) Distocclusion in «)_Linguoversion of the mandibular molars a) 1876 b) 1900 4) Posterior ross bite ©) 1899 4) 1903, (kaR-04) (COMEDK-15) 48. Which of the following is a feature of Class I type 3. 59. Angle's tine of occlusion tells malocclusion in which malocclusion? direction? 4) Posterior ciossbite —b) Anterior crossite a) Saggital b) Vertical ©) Mesial drifting of molars ) Transverse 4) ‘Transverse and vertical 4) Protrusion of mandibular incisors (PGI DEC-2013) (KAR-04) 60. A sound which is most affected in patient of Class IIT 49. Malocclusion representing a transverse deficiency is rmalocelusion? often referred to a 2}, Linguoalveotar consonants 2) Open bite b) Closed bite ») Sibilant sounds ©) Cross bite 4) Deep bite )_Linguoalveotarfricatives (AIPG-06) 4) Labio dental ficatives 50, Thumb sucking is normal upto: (P61 DE¢-2011) 2) upto 1% years b) 38 4 years ) 6-8 years @) 4-6 years {(AP-06, GCET- 14) 51, The tooth that is used to identify the type of occlusion universally is: ) Second molar 1b) Central incisor 6) Canine 4) First molar AlPG-06) 52, Curve of occlusion touching the buccal and tingual surfaces of mandibular buccal cuspal teeth is cae a) Cure of Wilson —-b) Curve of Spee ©) Curve of Monsoon) Caterne curve (AIIS-06) 53. Which ofthe following is most common trigger factor for BRUXISH? 4). Temporomandibular joint dysfunction 8) Pericoronitis ©) Discrepancy between centric relation and centric occlusion 4) Acute periodontal disease (alP6-07) 54, Vertical matocclusions include a) Lateral deep bite b) Complex deep bite ©) Gingivally supported deep bite @ A 4%) C MB &) 8 W)C 5) 8 SD 52) A BO 5) C SDE HC BPA 58) € 59) C60) 0a | ORTHODONTICS Who yo 6. OCCLUSION & CLASSIFICATION OF MALOCCLUSION - ANSWERS “haat 3d 0 79] 5. [Bolt Sed ed 75, 609] SST Cort Sea Pan no posal ee poly eee ames ech cuit ward movement of ie monde ding Sow sure IIs Seon Poo cose malocsin chats by presence « Profle is described as convex/ of occlusal prematurities resulting in habitual. forward straight/concave positioning of mandible. step2 (Patsy |e facial dvegence abo Considered i. anteor or| 6. 8" [Bhaljhi 3d ed 40] poser pence The upper gu pas both wider as well as longer then Tae bes we cansfed iw] menule gum ped When the upper and ower gum pes ‘Step-3 (Type) Scien eer are approximated, there is a complete overjet all around, (Cransverse Se and contact occurs between upper and lower pads in the felationship) bilateral first molar region, Sap (Cas) __| Cased a angles cane “e tohtens (sagital lationship) | class-I1/class-I11 malocclusion. | 7° © Bhalaihi 3rd ed 77) Clascfedaarteororperedor| -‘inghacentsibutan Serthadansica incu | penal roomate easieaton ot tee dimensional system en ba and antarior ep ie ; (erical relationship) | $Peeseror elapsed te of easiertin + Law of canine «fates 3) * crthostae clsiation of alodsion “© tohaohi 8 0870 8.8 [Pat the 182,186 Fg 6-16) Fee ase. kas I ivision 2 Conpued to Cs It dsian 2 muloecsion in patents Important Festares Of Class Dison with Class I Dison 1 and imatay potion, te Us Laity tipped poe late inco sre separated hen fend. So the poents must san © Lingually inclined upper central incisors bring the lips together. For such patients, retracting the + beep anterior overt tceh tends toimpove ath iptnction ad fact estes = Normal muscle activity + Prominent malar process 9 '® [Bhalajhs 3rd ed 74) Option ‘D’ high palatal vault is seen in class-II division-1 * Abnormal backward path of closure (due to excessively where as the palate is normal in clas-II division 2 cases. tipped central incisors) 410. 'C [halajhi 3rd ed 48] 11.’ [Bhalajhi 3rd ed 77) Simon's classification of malocclusion uses of three anthropometric plane i.e. the FH plane, the orbital plane Perversion | Impacted tooth and the mid sagittal plane Torsiversion | Rotation around its axis Apertognathia_| Open bite - - Transposition | Changed in sequence of position, for eee Te ental rc is cover to FH plone example, eruption of canine in place of| Abstraction _| The dental arch is away from FH plane a lateral incisor Protraction | Dental arch i farther from orbital plane Labia version [Labial to normal position Retraction | Dental arch is posteriorly placed in relation Tafraversion _ | Inferior to line of occlusion to orbital plane. Supraversion | Supra eruption of teeth Distraction | The arch is away fom midsagital plane Closed bite | Deep bite Contraction |The arch is closer to midsagittal plane ‘Sunday bite | Bite achieved by patient by bringing his mandible forward in class-II diviston-1 Scissors bite | Mandibular arch is present within the Core foes (Buccal non- | maxillary arch where the maxilary Class-T 60-70% occlusion) | posteriors occlude entirely on buccal 7 aspect of mandibular posteriors clase TLS es Imbrication | Lower anterior teeth crowding 412, 'B [M.S.RANI 3rd ed 22] Class-II div2 510% Class-I01 3%(rrr 3. 14. 15. 16. rT 18. 19. 20. a1 22. 23. 24. 25. 26. 27. 28. Dental Pulse ‘Open bite in chien me Thumb sucking habit n pre-school children mc Teal occlusion 23% “C [Bhalajhi 3rd ed 424] ‘C [Bhalajhi 3rd ed 74] v Deep bites the most damaging feature of class-II malocclusion. Reduced deepbite is most damaging feature of class TI. 3rd ed 426] the teeth are in scissors bite, the condition is called as Bodie syndrome (COMEDK-08) ‘W [Bhalajhi 3rd ed 72] Fractures of incisors are due to proclained maxillary incisor. [Bhatajhi 3rd ed 421) ‘0’ [Bhalajhi 3ed ed 77] (ei jlajhi 3ed ed 78) ‘D [Bhalajhi 3rd ed 2] x e “B [Bhalajhi 3rd ed 51] ‘B [Bhalajhi 3rd ed 78] According to Simon, the orbital plane should pass through the distal third of upper canine in high percentage of cases jn normal occlusion. This finding was termed as Simon’s law of cuspid. ‘B [Bhalajhi 3rd ed 76) Dewey subdivided angles class-I into 5 types and angles class-II into 3 types. ‘D [Bhalajhi 3rd ed 77) °C! [Bhalajhi 4th ed 83) Dewey divided Angle's class I into 5 types and Angle's class UL into three types Type I | Class 1 malocclusion with crowded anterior teeth Type 2 Type 3 Type 4 Class I with protrusive maxillary incisors Class I with anterior cross bite Class T molar relation with posterior cross bite The permanent molar has drifted mesially due to early extraction of second deciduous molar of second premolar Type 5 30. 31, 32. 33. 36, 36. 37. 38. _ Stone eT The upper and lower dental arches ate in norma alignment when viewed separately. But when the arches ae made to occlide the patient shows an edge to edge incisor alignment, suggestive of forwardly moved mandibular dental arch. The mandibular incisors are crowded and are in Lingual relation tothe maxiary incisors The maxilry incisors are crowded and ave in cross bite elation to the mandibular anteiors Type Tpe2 Type 3 “C [Bhataj 3rd ed 71] ' [Bhalajhi 3rd ed 69] "© [Bhalajhi 3rd ed 74] Closed bite or deep bite is a consistent finding of class-II division 2 8° [Bhalajhi 3rd ed 77) 8" [H.S.RANI 3rd ed 17] CANINE RELATIONSHIP. ‘+ Class-I: The mesial incline of upper canine over laps the distal incline of lower canine. ‘© Class-II: As the maxillary arch is place forward, the distal incline of upper canine contacts the mesial incline of loner canine, ‘+ Class-III: The lower canine is placed forward to the upper canine and there is no overlapping. 'D’ [Bhalajhi 3rd ed 433 Fig (1)] Incomplete overbite isan incisor relationship in which the lower incisors fail to occlude with either the upper incisors or the mucosa of the palate. Complete overbite is a relationship in which the lower incisors contact the palatal surface of the upper incisor or the palatal tissue when the teeth are in centric occlusion. ‘NX [Bhalajhi 3rd ed 463] Maxillary retrusion may be due to inhibition of growth centers in maxilla, The facial profile of the patient will become concave. “C [Bhalajhi 3rd ed 399) B' [Bhalajhi 3rd ed 148] Key ridge fs the lowest point on the outline of zygoma. In deciduous dentition, zygoma corresponds to maxillary second molar where as in permanent dentition, zygoma corresponds to mesio buccal root of maxilay frst molar. 'X (WS.RANI 3rd ed 22] The type of malocclusion most common among Indian population is crowded teeth.ee | 39. 40. 4 42. 44. 45. 46. ‘ ‘ Molar inter-arch relationship *Mesio- distal crown angulation * Labio-{ingual crown angulation * Absence of rotation # Tight contacts © Curve of spee “Bolton ratio” is considered as 7 key to normal occlusion ‘D' [Bhalajhi 3rd ed 474] ‘Antiflux is used to confine the flow of molten solder over the metals being joined, The commonly used antfluxes are lead pencil markings, graphite tines and fron gouge [Bhalajhi 3rd ed 474] Y [Bhalajhi 3rd ed 474 flux us # Borax glass ~ 55% * Boric acid ~ 35% + Silica - 10% Fluoride fluxes contain Boric acid and potas a1 tio. Bhalajhi 3rd ed 446) “X [Orthodontics prep manual by Sridha 120] 1 of occlu Edward angle © Maxillary: Smooth, parabolic curve passing through the central fossa of each upper molar and along the cingulum of upper canines and incisors. ‘© Mandibular: Runs along the buccal cusps of posteriors and incisal edges of the anteriors. remkumar Pg lescribed Catenary curver * This curve could be described as formed by a metal chain when hung from its two ends at a given width and length. * Ieis stated as the simplest form in which the teeth can be arranged. ‘Te forms the basis of human dental arch-form. “K (M.S, Rani 3rd ed 172] C [Bhalaji 3rd ed 423-425] The term crossbite is applied when there is abnormal Dbuccolingual relationship of teeth (CONEDK-08). It can be anterior or posterior. Posterior erossbite is due to abnormal ‘tansverse relationship between the upper and lower posterior teeth. In this condition, instead of mandibular cusps ‘occluding in the central fossae of the maxillary posterior teeth, they occlude buccal to the maxillary buccal cusps. ORTHODONTICS [Bhatajhi 3rd ed 59] ar. 4. 4s. 50, 51. 52. 53. 54, 55. “B’ [M.S. Rani 3rd ed 22) Distoocclusion is synonymous with skeletal class IIT malocclusion: B [Bhalajhi 3+ ed 75] °C [Bhalajhi 3% ed 67] B [Bhalajhi 3° ed 97) ‘D’ [Bhalajhi 3 ed 69) ‘A [Bhalajhi 3% ed 56, 57] ‘Tk contacts the buccal and lingual cusp tips of the mandibular buccal teeth ‘The curve of Wilson is medio-lateral on ac side of arch and it results from inward inclination of lower posterior teeth. ‘It refers to anterio-posterior curvature of the occlusal surfaces starting from lower cuspids, molars continuing as an arc through condyle. Ifthe curve is extended, it will form a circle of about 4 inch diameter. ‘© It results from axial alignment of lower teeth, ‘his the curve of occlusion in which each cusp and incisal edge conforms toa segment of sphere of & inch in diameter with its center in the region of glabella. Cure of Witson Cure of spe |e Curve of ‘monsoon °C [Bhalajhi 3% ed 106] °C [Orthodontic diagnosis by Thomas Rakosi and Thomas M. Graber Pg 45) Sagittal _| Disto-occlusion and Nesio-occlusion Transverse | Crossbite, buccal non occlusion, lingual malocclusion Vertical | Deep bite, open bite Deep overbite anamolies are categorized into: ‘© Dentally supported and ‘© Gingivally supported Open bite anamolies are categorized depending on the location as: © Anterior = Lateral ana = Complex ‘C [Orthodontics by Om Prakash Ast ed Pg 396] The angle formed by the intersection of the long axes of the crown and root angulation or column angle. It is decreased in Class 11 iv 2 cases. iS(AAA ental Pulse 56. 57. 58. 59. 60. Due to this reason the crown appears to be lingual from the long axis of the roots in class IT div 2 cases. Collum angle has been confused with interincisal angle. In many big textbooks it is also given interchangeably with interincisal angle. Interincisal angle is decreased in Class II div 1 and increased in class IL div 2 ‘C [Balaji Sth ed 533) Anterior open bite is not self-correcting orthodontic problem. Tt has to be intercepted and treated early. The ‘treatment for open bite ranges from simple habit control procedures to complex surgical procedures. ‘'X [Gurukeerat Sing 2nd ed 170] Salzamen in 1950 was the first to classify malocclusion based on skeletal structures. * Skeletal Class Is These are purely dental malocclusions, The jaws are in harmony with one another. The profile is, erthognathic. * Skeletal Class Hl: Subnormal and distal mandibular evelopment in relation to maxilla * Skeletal Class Ill: Over growth of mandible with @ prognathic mandible. “C [Bhalaji Sth ed 87] ‘C [Bhalaji Sth ed 88) ‘D' [Proffit 5th ed 158 Table 6-1) er Et a “Anterior open bite, Js}. 21 (sibitants) | Lisp large gap between incisors Inegular incisors, el Difficulty in | especialy tingual (nguoalveclar | production | position of maxilary stops) incisors LN (labiodentat Distortion | Skeletal Class I Iriatives) th, sh, ch [linguodentat Hinaiees (eakced or | Distortion | Anterior open bite voiceless)] _Sr , i. BIOMECHANICS ae TOOTH MOVEMENT ORTHODONTICS 1. Torque’ in orthodontics refers to ©) Intrusion a) Bac 4) The change in mesiodistal inctnation of teeth {AIPG -96) 5) The change in labiolingual inclination of teeth 412, Optimum orthodontic force should not exceed the: ) The rotation of teeth —d) None of the above 1) Arterial blood pressure b) Venous blood pressure (HAN -97) ©) Capilay blood pressure di) Masticatory pressure 2. Resorption in case of ideal orthodontic tooth movement (P61 -2«) should be 413, The tipping of a tooth results in the fibers of the PDL to 2) Undermining ) Frontal be: ) Indirect A) Necrotic 2) All compressed ) All stretched (wan -02) ©) Half compressed half stretched 3. In orthodontic tooth movement which is involve A) Wo effect 2) Osteoblast b) Osteoelast (altMs -99) «) Both A and 8 4) None 14, The appropriate force required to tip a tooth (Pst -95) a) 10 - 20mg b) 20- 25mg ._Torquing movement in orthodontics: «) 50 - 70mg ) 70 ~ 100mq 2) Is movenent ofthe root without moving the crown (AIINS -99) ») Cannot be accomplished in cinical practice 415. Which of the following enzymes decreases the orthodontic )_ Ts always deleterious to the tooth movement? 4) None of the above a) Cyclo-oxygenase _b)-Metalloprotein (KAR -98) ) Alkaline phosphatase d) Protein kinase 5. Fora bodily movement ofa small tooth the force required (AIMS 01) is 16. The force applied to cause root movement should be 2) 25-309 b) 40-759 a) Positive intermittent force <) 120-1509 4) More than 1509 ) Torque or moment (Pst -2001) ©) Extra - oral 4) Gentle action . Tooth movement easily accompanied by use of removable (AIMS -2«) ‘orthodontic appliance is: 17, The first tissue to react when orthodontic forces are 2) Translation ») Tipping applied is: <) Rotation 4) Extrusion a) POL ») Cementum (COMEDK. 05) ©) Dentine «) Alveolar bone Heavy forces on periodontal ligament causes: (61-98, 03) 2) Hyalinization 418. During orthodontic tooth movement, periodontal ») Osteoclastic activity around tooth ligament provide: )_Osteoblastc activity around tooth 2) Osteoblasts b) Osteoclasts 4) Crest bone resorption ©) Both Aand B 4d) Nome ofthe above {ALIMS -97) (Pot -98) . In orthodontic treatment, rapid tooth movement will 19. If during an application of an orthodontic force, the ‘cause all except: level declines to zero between activations then the force 2) Devitalisaton of teeth b) Resorption of roots duration is classified as: )_ Diffuse calcification of pulp a) Continuous force b) Interrupted force a) Ankyiosis ) Intermittent forced). Differential force (ATMs -95) (ATIMS -01) .Assingle force is applied to the crowns ofthe upper incisors. 20. Frontal resorption is caused due to: Tipping is around the point of rotation present a) Light continuous force b). Heavy continuous force 2) Infinity b) Apical 1/3rd ©) Heavy interrupted force d) Light interrupted force ) middle 1/314 4) Coronal 1/3ed {AIPG -97) (PGI-02, 06, AP-08) 21. Most easiest movement during orthodontic treatment is: 10, A300 gm force is applied through a canine retractor, the a) Intrusion ») Tipping following change will be noticed: ©) Bdtrusion 4) Bodily movement 2) Hyalinzation b) Rapid tooth movement (P6198) ©}, Frontal rt resorption d) None ofthe above 22, Resorption of cementum as compared to bone occurs: (AIPG -99) a) Less readily b) More readily 11, The tooth movement most difficut to accomplish is: ©) Same 4d) Undermining resorption 2) Tipping ) Bodily movement {AIMS -95) De) 8 oe) A GB 6) 8 MAS) € OB MA MD mc mye 14) B15) C16) B17) &_18) C19) 8 20) A 71) B22) A SS? === Dental Pulse _ 23. Which of the following statements concerning the wires 33. Closing of midline diastema by using a removable used in tooth movement is most accurate? apptiance a) The larger the diameter ofthe wie, the greater the force a) Reciprocal single simple anchorage and the faster the movement of the toath ) Reciprocal simple compound anchorage b) The longer the wire, the greater the force andthe faster _c)_Reciprocal stationary single anchorage the movement of the tooth 4) Reciprocal stationary compound anchorage 6) The more rectangular the shape of the wie, the greater (AP -98, AIPG 94) the force andthe faster the movement ofthe tooth 34, Stationary anchorage refers to the anchor teeth which 44) The longer the wire, the more gentle the force and the are faster the movement of the tooth. a) Are banded Cannot move (KAR -97) ©). Are not free to tit 24. In which orthodontic movement utmost control is required dl) Are supported by extra oral forces 8) Intrusion 3) Extrusion (KAR -02, ALPS -92) «) Tipping €) Rotation 35. Reinforced anchorage. Example is (PSt-97) a) Bite plane anterior 5) Posterior bite plane 25. Dominant movement of root with relatively less c) Inclined plane 4) Allof the above movement of the crown is called (ae -28) a) Couple 1) Torque 36. Anchorage is better provided by «) Intrusion ) Extrusion 2) Single rooted teeth) Mult ooted (CONEDK-04) —_«). ‘Narrow rooted 4) Small rooted teeth 26. The relative mesial or distal angulations of the crown (aP 01) and the root along the line of occlusion is called: 37. Which ofthe following is not inter maxillary anchorage ) Torque ) Tp 3) Max incisors to maxilary molars «) Offset 4) Inctination of teeth b) Maxillary incisors to mandibular molars (KAR 03) ) Bakers anchorage) AlLof the above 27. In tranalation, center of rotation is at ) Apical 1/3" ) Coronal 1/3, 38. When anchor unit is allowed to tip, it is called Infinity 4) Apex anchorage (AIPG -04, MAN-97) a). Simple ») Compound 28, Hyalinisation of the periodontal ligament, due to <) Complex 4) Reciprocal excessive orthodontic forces results in (P61 -2001) 8) Frontal resorption b) Undermining resorption 39. Simple anchorage refers to «)Cementum remaining intact 28) Closure by tipping b) Closure by bodily movement 4) Dentine remaining intact ) Closure by rotation d) Closure by intrusion (CONEDK -04) (AP6 -97) 29, Which of the following isan intramatrix procedure? 40, Reciprocal anchorage is exhibited by 4) Rotation of mandibular base in relation to cranium 3) Split expansion appliance 8) Rotation of mandibular plane in relation to cranium b) Inter maxillary elastics «) Rotation of mandibular lane relative to core ofmandible ——c) ABB. 4) Inte arch elastics 4) Rotation of mandibular base in relation to maxila (APs -97) (PI-2011) 61. The type of anchorage in which two groups of teeth move 30, The incisor over-jetis increased fora cass Il case that is in equal and opposite direction is called as undergoing treatment. The reason is 2) Stationary ») Reciprocal a) Loss of anchorage b) Arch collapse c) Simple 4) Compound ©) Gowding inthe lower arch (aps -99) 4) None ofthe above 42. Bakers anchorage is a type of (MAN-99) a) Intra maxillary anchorage 31, In Stationary anchorage, anchorage is obtained from 5) Inter maxillary anchorage 4) More stable teeth b) Extra oral ) Extra ora anchorage) Muscular anchorage «) Teeth fom the opposite arch (AIMS -01, 2012) 4) Stationary teeth 43. Reciprocal anchorage is offered by (HAN -99) a) Activator +) Inter maxillary elastics 32. Which of the following is related to occipital anchorage ) Maxillary expansion appliance 4) Intraoral force b) Tipping a toath 6) Catalan’s appliance ©) Extra oral forced). Bodily movement of anchor (atP6 94) (MAN -97) 44, The greatest advantage of using extra oral anchorage is that: 23) More force can be applied BO mA we %) 8 Me ws We WA MA MC SPA MC SDE 36) 837) A_ 38) A_39) AAA 1) 8 42) Bs) CMEa | b) Tthas a direct reciprocal action on opposing arch ) It permits posterior movement of teeth in one arch without disturbing the opposing arch adversely 4) Any of the above ORTHODONTICS ©) apical 273% 4) middle 4/3* of root (CoMEDK-05) 55. The optimal orthodontic force per square centimeter of the root surface area is held to b (AIP -92) 8) 18-22 ams 3) 18-26 gms 45. It is normal response to orthodontic treatment for c) 20-26 gms 4) 26-30 ams periodontal space to (xcet-07) 2) Widen ) Narrow 56. Optimum force for orthodontic bodily moveme «) Shorten €) Elongate (translation) i: (BHU-2012) a) 50-75 ams 1) 100-150 gms 46. The type of resorption seen when light continuous c) 200 25qms_— di) 300-400 gms orthodontic forces are applied: (coMEDK-07) 8) Apical ) Frontal or direct 57. The first bone formed in response to orthodontic loading is: «)_Indivector undermining d) No resorption is seen 2) Bundle bone 8) Composite bone (KAR-06) ——c) Lamellar bone 4) Woven bone 47. Extrusive movements ideally would produce no areas of (coMEDK-07) compression within PDL, but will produce 58. During orthodontic movement of maxillary central incisor, 4) Only contusion b) Only tension centre of rotation i applied to apex then it shows: <} Onlyretaction _—_d)- Only extraction a) Controlled tipping b) Uncontrolled tipping (8HU-2012) ©) Translation 4) Intrasion 48. A single force applied at which point of a tooth will (alP6-10) allow complete translation of the tooth: 59. Band and loop space maintainer is: 2) At the apex a) Unilateral fixed non functional 5) At the incisal stage ») Unilateral removable functional }_ At the center of resistance ) Bilateral fixed non functional 4) At the center of rotation 4) Bilateral removable functional (a1P6-05) (sxu-07) 49. During which orthodontic tooth movement center of 60. A distinctive clinical manifestation ofa successful Rapid rotation is at the bracket slot: Maxillary Expansion is 8) Controlled movement b) Torque 2) Antero crosbite b). Posterior crossbite «) Rotation 4) Translation «) Midline diastema a) Open bite (AlP6-10) (KcET-08) 50. The first reaction that takes place when an orthodontist. 61. What is the effect of doubling the diameter of a attempts active tooth movement with a removable cantilever spring? appliance 8) Strength increases by 4 times, Springiness increases by 4) Pressure and tension zones form in the periodontal 8 times ligament b) Strength decreases by & times, Springiness decreases by 8) Force is applied on the tooth 8 times )_Osteoclasts create undermining resorption ) Strength decreases by 8 times, Springiness increases by 4) Tooth moves by direct resorption 46 times (AIPG-08) Strength increases by & times, Springiness decreases by 51. The histological section of tooth under orthodontic 16 times force representing an avascular area in the periodontal (KceT-20) ligament is often referred as: 62. Simple retraction of maxillary incisors using maxillary 2) Frontal zone )Hyalanized zone molars as anchorage is an example of } Undermining zone) Clear zone a) Simple anchorage b) Reciprocal anchorage (AIPG-06) _) Stationary anchorage 4) Intermaxilary anchorage 52. Anchorage obtained from the nape of the neck represents: (COMEDK-10) 2) Occipital anchorage b) Cerveal anchorage 63. Moment : Force Ratio for bodily movement of tooth is? «) Facial anchorage d) Parietal anchorage 2) 6 b) 20 (AIPG-06) c) 14 4) Zero 53. Most efficient orthodontic tooth movement is obtained by: (51-08) 2) Light continuous force b) Large intermittent force 64._Type of force in a patient activated appliance is? ) ight interrupted force d) Heavy continuous force a) Intenupted b) Intermittent (AP-05) ©) Continuous Interupted d) Continuous Intermittent 54, The centre of rotation for bodily movement of tooth is (PsI-08) located at: 65. Intrusion is best produced by ~ 2) apical 1/3* of root b) at infinity a) Light intermittent forces BAL) 8 Bs) CB 5) A SBS) © ATS) 8 TODS) 8 ED 58) A 55) A 60) € 61) 0 62) C63) 8 64) B65) C ees =ss A AAA Dental Pulse Yo b) Heavy intermittent forces 76, Following metal alloy held in reducing hardness of 6) light continuous forces orthodontic wires? 4) Heavy continuous forces *) Chromium 4) Cobate {COMEDK-09) ——«) Silicon 4) Carbon 66. During orthodontic movement of maxillary Centrat (AatIMs Mat-14) Incisor, centre of rotation is present at apex, it shows 77. Which of the following chrome cobalt wire is highly a) Controlled tipping —_b). Uncontrolled tipping ductile and become resitient on heating? ©) Translation 4) Intwusion 2) Yellow egiloy 1) Blue elgiloy (a1PG-10) —_) Green elgloy 4) Red egiloy 67. In Orthodontic treatment, placing the tooth inte its (061 0et-2013) normal position results in 78. The play (degrees) for 21.5 x 28 wire size used in 22- 2) Esthetic slot bracket is? 5) Esthetics, Function and Tooth placement 2) 28 ») os 6) Esthetics and Delusion ot 18 4) Esthetics, Occlusion and Stability (AP-10) 79. Tooth movement i primarily @ phenomenon involving 68, Light orthodontic forces produce 2) Pulp 5) Periodontal tigament 2)" Light forces will not have any effect 6) Dentin 4) Cementum ) Brings up osteoclasts with 10 seconds (comeDK-15) ©) Compression of blood vessel within 3-5 seconds on the 80. Center of resistance of six maxillary anterior teeth is? pressure side 2) Malin between two central inczors 4) Compression of blood vesselin 2 hours onthe tension side +b) Between central and lateral incisor (KCET-2012) c) Between first and second premolar 69, Hyalinization in orthodontic movement means: 4) Between canine and premolar 2) A cell fee zone histologically similar to hyaine (Pot ane-2013) appearance 8) Change to hyaline cartilage ©) Lamina dura converts into hyaline cartilage 4) Periodontal tigament changes to hyaline cartilage (AIMS HAY 2012) 70. The lag phase of tooth movement usually lasts for: a) 2-3 mins b) 2-3 hrs: c) 2-3 day d) 2-3 weeks (AIIMS- 2012) 71. Which characteristic of orthodontic wire describe energy storage capacity: 2) Range 1) Resiliency ©) Formabilty 4) Proportional fimit (ATIMS MAY 2012) 72. Centre of rotation during intrusion is at: 2) Infinity 5) idle third of tooth eB €) Outside the tooth (AIMS Hay 2012) 73. Which of the following material used in orthodontics, commonly causes sensitivity a) Steel, b) Ceramic ©) Niche 4) Plastic (comer-14) 74. Recording to the type of movement of the anchorage unit, tt can be classified as all except 2) Simple 1) Compound ©) Reciprocal d) Stationary (wacer-a5) 75. Which of the following orthodontic wire has least modulus of elasticity? 2) sit Beta titanium ) Stainless set d) Cosh (ats-2014) GAL) 0 YEO) A ODT) 8 DT) CYB I) A TBM A ayo 3) Bcee | ORTHODONTICS 7. BIOMECHANICS — TOOTH MOVEMENT — ANSWERS ‘8! [Bhalajhi 3rd ed 199] Torquing is considered as reverse tipping during which there is movement of root only without the movement of the crown. This type of tooth movement is usually used to corect the effects of uncontrolled tipping. ‘8! [Bhalajhi 3rd ed 183] [Application of light orthodontic forces will result in frontal/ direct resorption. Frontal resorption occurs only when the forces applied are close to the capillary pressure, i.e. 20 26 gm/ sq. cm of root surface area Oppenheim and Schwarz have been given credit for discovering the optimum orthodontic force levels usualy light continuous forces are recommended for tooth movement. Minimum pressure required to initiate a biological process to orthodontic force for initiation of a tooth movement (AIIMS MAY 2032) a) Less than capillary vessel pressure b) Equal to the capillary vessel pressure ) Mote than capillary vessel pressure 1) No relation “C [Bhalajhi 3rd ed 183] ‘ [Bhalajhi 3rd ed 199] Refer question no.1 [M.S.RANI 3rd ed 216] Ces retary —_ reortg a Tipping, rotation (COMEDK-15), 35-60 extrusion Bodily movement or translation 70-120 Root uprighting 50-100 Intrusion (KCET-10, KERALA-15) 10 - 20 No tooth movements occurs over a haat 400 gms Normal orthopedic forces = 400 ams Optimal or minimal orthodontic | 20-26 ams per forces (should be equivalent to ‘sq. cm. of root, capillary pressure) surface area, (AIIMS -2012) ‘8! [Bhalajhi 3rd ed 278,198) Application of a single force to the crown results in movement of crown in the direction of force and the root in ‘opposite direction. Remavable appliances act by tipping the teeth around its center of resistance. If the line of action of force passes through the center of resistance, the tooth will be translated in the direction of force, n 9. 10. 11. 12, Bodily type of tooth movement is the ideal type of tooth movement and is preferable to the tipping movement. Translation fs brought about by appropriate combination of force and couple. ‘R [Bhalajhi 3rd ed 185] Application of heavy forces will result in occlusion of blood vessels and the ligament is deprived of its nutritional supply leading to regressive changes called hyatinization (KCET- 2010). In this case, the bone cannot resorb in the frontal portion. Rather bone resorption occurs in adjacent marrow spaces behind and above the hyalinized zones. This kind of resorption is called undermining or rearward resorption, °C [Bhalajhi 3rd ed 185) “B' [Bhalajhi 3rd ed 198] CENTER OF ROTATION is a variable point, about which a body appears to have rotated. For tipping movements, the center of rotation will be at the apical one third of root while in case of perfect translation it will be at infinity Center of resistance (geometric center) isa fixed point and is analogous to center of gravity or center of mass. The CENTER OF RESISTANCE of a single rooted teeth is present between the one third and one half of root length. For a multirooted tooth, the center of resistance is probably between the roots 1 to 2 mm apical to the furcation. \ [Bhalajhi 3rd ed 185] Undermining or rearward resorption is a type of bone resorption that occurs when extreme forces are applied to teeth If heavy forces are used, the area of hyalinization is large and a longer log phase without tooth movement occurs to eliminate the hyalinized tissue, [Check Explanation Below] ‘= Tipping is most common and most easiest type of movement ‘Intrusion requires least amount of ight (COMEDK-15) orthodontic forces (KCET-O7) and is difficulty to achi ‘© Translation or bodily movement of tooth can be accomplished by the use of couple or application of force at more than one point. Both intrusion and translatary movements are very dificult to achieve Rotation is a dificult type of tooth movement to correct and retain, correction of rotation requires couple force. [Bhalajhi 3rd ed 186) Seo ==a Ad 14. 15. 16. ”. 18, 19, Dental Pulse “C [Bhalajhi 3rd ed 183] Compression occurs on pressure side and stretching occurs fon tension side. [M.S.RANI 3rd ed 215] © High levels of serum alkaline phosphatase are a marker for osteoblastic activity. ‘8 [Bhalajhi 3rd ed 199] Different types of orthodontic fore ‘© Results in the movement of the root without significant movement of crown used to correct the effects of uncontrolled tipping * Couple is pair of parallel forces having equal ‘magnitude but acts in opposite direction ‘Brings about pure rotation * The potential for rotation fs measured as @ ‘moment, ‘© The magnitude of movement is equal to ‘the magnitude of the force multiplied by perpendicular distance of the body to the line of force. Torquing force Couple Moment if force ‘K [Bhalajhi 3rd ed 183] “C [Bhalajhi 3rd ed 183] “W [Proffit 4th ed 342] ‘The orthodontic forces between appointments shows a little decrease in ‘magnitude. gr Light wire appliance, Elastics * Light continuous forces are recommended 25 they bring out physiologic tooth ‘movement with frontal resorption Continuous Torces ‘Heavy continuous forces are to be avoided because of their potential deleterious effects like root resorption, tooth mobility, resorption of dentin and devitalisation of tooth ete, ‘ Force levels decline to zero between Interuptea | @tvtions forces ‘Both continuous and intertupted forces ‘can be produced by fixed appliances that are constantly present, Force levels decline abruptly to zero intermittently, when the appliance removed by the patient or perhaps when a fixed apliance is temporarily deactivated, and ‘then return to the original level sometime later. Intermittent forces Eg: All patient activated appliances such as removable plates, head gear and elastics aa. 22. 8’ [M.S.RANI 3rd ed 216] Option “8 tipping is the also most common type of tooth movement 25. 26. 2. 28. 29, B’ [Bhalajhi 3rd ed 199] B’ [Bhalajhi 3rd ed 199] [Bhalajhi 3rd ed 198] B’ [Bhalajhi 3rd ed 185] [Proffit 6th ed 135] ay Err ali green on | Food anterior ‘tation . - eter art Teco ‘greater than ao - - posterior Rotation of ‘mandibular Total Internal core relative to | rotation | M™¥®#°"40" | oration cranial base Rotation of ‘mandibular Mauix | Apparent | Total plane relative to | rotation | rotation _| rotation cranial base Rotation of Angular mandibular | Intramatrix | Remodelling | External plane relative to | rotation | of lower | rotation core of mandible Border Core of the mandible is the bone that surrounds the inferior alveolar nerve Bjork Formula: Matrix Rot = Total rotation ~Intramatrix rotation Proffit Formula: Total rotation = Internal rotation ~ External rotation Solow Formula: Apparent _ Tue rotation rotation ‘Angular remodelling of lower bhorderee | 30. 31 32. 33. Note: ‘According to Bjork, based on the type of rotation, the centre of rotation the growth of the mandible can be divided into ‘Forward rotation: Type I, Type II and Type IIT © Backward rotation (less common):~ Type I, Type I Pine een Type Eforward rotation | Condyles of TMI Incisal edges of the lower incisors (PGI JUNE 2014) Center of premolars fn ‘Type TI forward rotation Type Ill forward rotation Type Lbackward rotation | Condyles of 13 Type backer rotation | THe me tay oc “Forward and backward rotation” terminology is given by (P61 June-2013) a) Bjork and keller) Profitt «) Shudy 4) Solow and Houston Difference between total and Matrix rotation representing angular remodelling of lower border of mandible is (PGI Dec-2013) a) Intramatrix rotation 6) Internal rotation ¢) External rotation 4) Remodeling of lower border of mandible ‘X [Check Explanation Below] Features of anchorage loss in class-II cases: Increase in overjet Molar relation becoming more class-IE Normal canine relation without any change. ‘'X [Bhalajhi 3rd ed 205) The tesistance of @ tooth or group of teeth to bodily movement is used in stationary anchorage. “C [Bhalajhi 3rd ed 206] Occipital anchorage is a example of extraoral anchorage Various anatomic sites used for extra oral anchorage are ‘occipital region, cervical region, parietal region and face etc Advantages of Extraoral anchorage * Greater forces can be applied Permits movement of teeth in one arch without ‘movement of teeth in another arch.(AIPG- 06) “8 [GRABER 3rd ed 520] * Closure of midline diastema by using 3 removable appliance and correction of cross bites by intraarch elastics an example of Reciprocal single simple anchorage or option’A. © Closure of midline diastema by fixed appliance is an example of reciprocal single stationary anchorage ot option'c ORTHODONTICS 34, ‘C’ [Bhalajhi 3rd ed 205) 35. ‘C [Bhalajhi 3rd ed 208) In reinforced or multiple anchorage, more than one type of resistance unit is utilized. Orthopedic appliances, anterior inclined plane and transpaatal arch are examples of reinforced or multiple anchorage. 36. ‘8’ [Bhalajhi 3rd ed 206] 37. ‘K [Bhalajhi 3rd ed 207] 38. ‘K [Bhalajhi 3rd ed 205] 39, ‘K [Bhalajhi 3rd ed 205] 40, ‘W [Bhalajhi 3rd ed 205,206] Reciprocal anchorage is the resistance offered by two malposed units when equal and opposite forces tends to move each unit towards a more normal occlusion, Closure of midline diastema (KERALA-15), split expansion appliance and correction of cross bite by elastics are examples of reciprocal anchorage 44. ‘B’ [Bhalajhi 3rd ed 205] 42. 'B’ [Bhalajhi 3rd ed 207] 43. 'C [Bhalajhi 3rd ed 206] 4a 45. 'W [Bhalaji th ed 241] 46. ‘B’ [Bhalajhi 3* ed 183] 47, 'B’[Proffit 4th ed 340] Extrusive movements ideally would produce no areas of compression within the POL. They produce only tension. 48. ‘C [Bhalajhi 3% ed 199] ‘Tipping is simple type of tooth movement where a single force is applied to the crown, which results in movement of the crown in the direction of the force andthe root in opposite direction = Pure translation is brought about when the tine of action of an applied force passes through the centre of resistance of a tooth. 49, ‘8’ [Profitt 4" ed 375] 50,‘ [Bhalajhi 3“ ed 183] 51, ‘B’[Bhalajhi 3 ed 185, 187] 52. 'B" [Bhalajhi 3” ed 204] Seo == 222A 53. 54. 55. 56. 57. 58. 59. 60. a. 62, Dental Pulse °K [Bhalajhi 3% ed 201/M.S, Rani 3rd ed 221] Light continuous forces causes physiologic tooth movement without any root resorption. They bring about direct resorption of root socket and do not occlude more than a small percentage af blood vessels and do not substantially interfere with their nutritional supply. Exapnsion Screws utilize option Bie, Large intermittent forces (COMED-10) ‘W [Bhalajhi 3” ed 198] ‘€ [Bhalajhi 3" ed 186) ‘B [Profitt 4 ed 340, Tab. 9-3] ‘D’ [Bhalajhi 3° ed 183] When a force i applied, there is stretching of the periodontal fibres on the tension side with raised vascualarity. This raised vascularity causes mobilization of fibroblasts and osteoblasts {nto that area, which form osteoid. This lightly calcified bone in due course of time matures to form woven bone, ‘K (Bhalajhi 3% ed 198, 199] In controlled tipping, the tooth tips about centre of rotation atts apex (AIIMS-07). In controlled tipping, the movement of a tooth occurs about a centre of rotation apical to and very close to centre of resistance, uncontrolled tipping is characterized by movement of crown in one direction while the root maves in the opposite direction (ei fi 3rd ed 223] ‘C [Bhalaji 3rd ed 250) The appearance of a midline spacing between the two maxillary central incisors is the most reliable clinical evidence of maxillary separation. The incisor separation is about half of the distance the screw ‘opened. The midline diastema will be closed in 3-5 months because of transeptal fibre traction, ‘D! [Proffit 4th ed 369] The relation between diameter, strength, springiness and range is given by the following formula: Strength* Diameter « ———_*wengt _ Springness* x range According tothe above equation, ifthe diameter is doubled, the strength increases by 8 times, springiness reduces by 16 times and the range fs reduced to half. “C! [Gurkeerat Singh 2° ed 261] 'B' [Proffit 4th ed 375] Cons ns Controlled tipping 1to7 Bodily movement | @ to 10 (Depending on root length) Torque 10 64, 65. 66. 67. 63. _ “B [Proffit ath ed 341] Intermittent forces are produced by all patient-activated appliances, such as removable plates, head gear, and elastics. Even forces generated during normal function (chewing, swallowing and speaking, etc.) can be viewed as 8 special ease of intermittently applied forces. The types of forces produced by fixed appliances are continuous and interrupted 'C [Proffit 4th ed 340/ Refer Q.No. 11 & 19] Light continuous forces produce the most efficient tooth movement. When a tooth is intruded, the force is concentrated over a small area at the apex. For this reason, extremely light forces are needed to produce appropriate pressure within the periodontal ligament during intrusion. “A [Bhalajhi th ed 235) Tipping is the simplest of all tooth movements and can be of 2 type 2} Controlled tipping, which occurs when 2 tooth tips about a centre of rotation at its apex. Here, the crown shows tingual movement with minimal movement of root in labial direction ) Uncontrolled tipping, in which the movement of a tooth occurs about a centre of rotation apical to and very close tothe centre of resistance. It is characterized by the crown moving in one direction while the root moves in the opposite direction, °' [Bhalajhi 4th ed 2] The three main objectives of orthodontic treatment are summarized by Jackson as Jackson's triad. They are: a) Esthetic harmony (esthetics) bb) Functional efficiency (achieving normal occlusion) ) Structural balance (stability between skeletal tissue, soft tissue and the dento-alveolar system) 'C [Proffit 4th ed 335, 337] Light but protonged force when applied to a tooth, blood flow through the partially compressed periodontal ligament decreases as soon a5 the fluids are expressed from the POL space and the tooth moves in its socket in a very few seconds. 'N' (Bhalaji 4th ed 202) ‘+ Hyalinization in orthodontic movements is characterized by tissue degeneration, acellular, avascular area with deposition of clear eosinophilic homagenous substance jn the periodontal tigament. ‘© This term hyaline has nothing to do with the formation of hyaline connective tissue or cartilage. ‘Conventional pathologic process of hyalinization is irreversible but in periodontal ligament, itis a reversible process,ee | 70. mn 7. 73. y [Bhalafi 4th ed 205] Initial: © Very rapid tooth movement over a short distance and then stops. ‘Tooth movement is between 0.4-0.9 mm © Usually occurs in a weeks time Lag: * Characterized by hyalinization in periodontal tigament, * Little oF no tooth movement accu, © Extends for 2-3 weeks but may at times be as long as 10, weeks. ized zone is removed, bone undergoes resorption. Tooth moves rapidly [Profit 4th ed 361] Range is the distance that the wire will bend elastically before permanent deformation occurs. Resiliency is the area under the stress-strain that curve ut to the proportional limit. It represents the energy storage capacity of the wire. *Formabilty represents the amount of permanent bending the wire will tolerate before it breaks. Under stress-strain graph it extends from yield strength to failure point Note: Whole area under stress = strain graph fs toughness ‘D' [Orthodontics principles and practice by Basavaraj Subhash Chandra Phulari 1st ed 230) Ec movement Centre of rota nis at ORTHODONTICS 74, ‘B [Bhalajhi 5th ed 269] ‘pes of anchorage based on type of force: 75. 76. m7. ‘© Simple: The anchor unit is permitted to tip or change its axial inclination in the plane of space of force application ‘= Stationary: Characterized by bodily movement of anchor unit. ‘+ Reciprocal: The force applied tends to move both the anchor units in opposite direction. Anchorage according to the number of anchorage units: ‘© Single or primary: Single tooth is used as resistance unit. ‘© Compounds Here the anchor unit is formed by more than one tooth. ‘N [Proffit Sth ed 316 Table 9-1] onictotewte ty (heat treated) [Ortho materials by William Bantley 83] ‘© Option ‘A: Chromium gives resistance from tarnish and ‘© Option ‘8's Cobalt helps in reducing the hardness of material Option ©: Silicon acts as scavenger ‘© Option ‘0’ Carbon increases the hardness ‘K [Gurkeerat Singh 2nd ed 331] Elgiloy wires are supplied in the softer and more formable state and then could be hardened by heat treatment, The standard heat treatment involves heating to 483 degrees centigrade for 7 to 12 minutes, Elgiloy is manufactured in four tempers depending on the amount of cold work: Torquing movement | Incisal edge —— = Intrusion & extrusion | Outside the tooth Sue Sofood easy ts end ‘oping | Neat centre of resistance of the valor ee Uncontrolled tipping | oath Green Semi-restient Controlled tipping | At root apex Red Eoneas “C [Clinical cases Orthodontics by Martin T Cuobourne ast ed 5] Most allergies in orthodontics are related to latex and nickel Nickle is capable of evoking both TgE mediated (immediate) and cell mediated (delayed) hypersensitivity reactions 78. 589 Table 16-1] orn 18-slot bracket 6x6 10.9 16122 93 Seo =79. “W [Proffit 5th ed 5th ed 278] During the orthodontic treatment, the tooth moves through ‘the bone carrying its attachment apparatus with it, as the socket of the tooth migrates. Because the bony response is ‘mediated by the periodontal ligament, tooth movement is primarily @ periodontal ligament phenomenon, “C [Check Explanation Below] According to various journals: Pederson et al reported that the centre of resistance (CR) of six anterior teeth was located on a line 3 mm behind the distal surface of canine, 4 Helsen et al reported that the CR of six anterior teeth located halfway between the midpoint of the four {incisors CR and the canine's CR. * According to angle orthod 2010 Nov;80(6); 1023- B article about “Locating the center of resistance of maxillary anterior teeth retracted by double J retractor with palatal mini screws”, the authors have concluded ‘that the centre of resistance of six maxilary anterior ‘teeth was estimated to be 12.2 mm apically from the ‘incisal edge of the central incisor.ee, 8. PREVENTIVE & INTERCEPTIVE ORTHODONTICS ORTHODONTICS Space maintainers are ususlly needed in the 9, In an-B-year-old child there is insufficient space in the 2) Mandibular primary incisor teeth area upper anterior segment for the upper permanent lateral. 5) Mandibular primary canine teth area incisors to erupt. Treatment ist «) Mandibular primary second molar area 2) Disk the proximal surface of malar incisors 4) Maxillary primary incisor teeth area ) isk deciduous canines and first molars (WAN-8¢) ——_c) Extract the deciduous 1* molars The term space maintenance refers to 4) No treatment required but observe 1) The preservation ofa space fora peimanent tooth ina (a6 -01) chil’s mouth 10, The appliance used to treat thumbsuckn ») The preservation ofthe total arch Length or of all the a) Crib apiance——b) Frankel appbance permanent teeth in the arch in a child's mouth 6) Bonator 4) Activator ) The prevention of mesial drift after the loss ofa tooth (airs -02) 4) None af the above 11, A distal shoe type of space maintainer is indicated (MAN -94) a) Loss of primary anterior tooth 3. The space maintainer which is contraindicated in a child b) If the primary 2™ molar is lost before the eruption of suffering from sub acute bacterial endocarditis i permanent 1" molar 2) Removable ) Crown and loop 6) If the primary 2° molar is lst after the eruption of ©) Band and loop) Distal shoe permanent 1° molar (HAN-01) 4d) Loss of primary 1* molar 4, Best space maintainer (PGI -99, KAR -98) 2) Band and loop.) Distal shoe apliance 12, Function of space maintainers ) Space regainer _—_d) None of the above 2) Prevent supra eruption of opposite tooth (MAN 2K) ) Prevent migration of teeth 5 Which of the following al 6) Maintain spaced) Allof the above tnaintaner is incorrect: (01) a) It is an unilateral fixed appliance used in the posterior 13. A space maintainer is least indicated for premature loss of a: segment (BHU-07) a) Primary maxilary frst molar b) Itis a loop soldered with the stainless steel crown >) Primary mandibular first molar ‘c) Stainless steel crown may be banded like any other c) Primary mandibular central incisor natural teth 4) Primary maxilary central incisor 4) This loop is only limited to maintain the space of one (KAR 01) tooth 416, Best space maintainer is (HAN-219 a) Active space maintainer b) Passive space maintainer 6. WI of the following is recommended for bilateral c) Band and loop d) Pulpotomised primary tooth premature exfoliation of mandibular canines (1-02) 5) Nancy appliance b) Lingual arch 15, Which of the following is not a procedure of preventive ) Band and oop) Distal shoe appliance orthodontics: (MAN -98) __) Topical fuoride applications 7. Gennifer,a4 years got her ower 2nd molarextracted due _b) Sei extractions te cares, the possible Line of treatment fs ¢) Lip guar 4) Thumb sucking conection 2) Distl shoe space maintainer (Pct -99) 5) Band and loop between primary 1* molar and permanent 16. The best space maintainer for the early loss of upper Y molar primary incisor i the pin and tube maintainer, because ) Removable partial denture 5) Te is aestheticaly acceptable 4) No active treatment is necessary 5) Te does ot injure the upper ip (MAN -02) ——_c)- Tis easy to fabricate ingual holding arch with loops mesial to 6) Tkallows lateral growth ofthe bone ‘each molar band is used in children for (muse -99) 3) Correction ‘17. Which of the following is a new slow type palatal expander? 5) Regaining space 2) NiTi expander ») Hyrax expander ©) Space maintenance only €) Quad helix 4) Molar otetor 4) Conection ofstally tilted molars «awesc -99) (AN -98, KAR-06) 18. Normal facial index st, a) 65-75% b) 75-80% pe) 8 Bo) 0 BT) 8 OATH 8 By A HE a 0 BLD 14) 0 15) 8 16) D7) A148) € RSS =fa A AAA Dental Pulse Yo ©) 80-90% 4) 100% 31, Extraction of mandibular first molar in an 8 year old (A1°6 04) child known as: 19._ Serial extraction was introduced by 2) Wilkinson's exaction 6) Compensatory extraction 2) Hawley adam 3) Frankel 6) Serial extraction d) Orthodontic extraction ©) Klien 4) Nance (MAN ~02,KAR -95) (HAN-01) 32. A 12-year-old boy was subjected to rapid maxillary 20. Father of serial extraction philosophy in USA fs expansion (RME) forthe correction of bilateral posterior 2) Kjellaren 1) Nancy cross bite, The Maximum separation of the mid palatine ©) Dewet 4) Hotz Suture will occur (MAN -01) a) Inthe molar region —_b)_In the premolar region 24, Serial extraction is contraindicated inall ofthe following __«)_At posterior nasal spine) Between two central incisors except (AlP6 -03) 4) Cine impaction 33. In expansion screws an expansion of 90° causes an 5) Missing premolars snpanaten oft ¢) Class 11 Div T malocclusion 3) 0.20 mm ») 0.10 mm 4) Crowding of deciduous dentition ©) 036 mm 4) 0.09 mm (Han -02) cattns -97) 22. Developing cross bites are treated by using 36, The extraction of upper first molars may be indicated: a) Zspring b) Tongue blade a) When the removal of 4/4 provides insufficient space ) Cross bite elastics) Bite plane b) Where they are rotated (AP-99) _c) When thelr prognosis fs poor 23, In serial extraction procedure if maxillary Ast premolar 4) When 5/5 ae palatally placed ‘is extracted then maxillary canine erupts in direction (KAR -94, 98) 2) ‘Downward 1) Downward-backward 35. Which of the following appliances is not used for slow c) Downward-forward — d) Forward maxillary expansion? (AP-09, KAR-2K) a} ack screw 1) offn spring 24, ‘The term “Serial extraction” was coined by 6) Quad helix appliance) Hyrax appliance 2) Keren 1) Robert Bunon (AIMS 01) 6) seh Fox 4) Hote 36, Quad Helix (KAR-01) " 5) Widens the upper arch b) 15 used in cleft ip 25, Serial extractions are indicated in patients who have 6) Retrats the upper canine 2) Gass IT molar relation b) Excessive overite 4) Tea bite - opening device ©) Class molar relation d) Class Il molar relation cresc -99) (KAR -03) 37. Which of the following permanent tooth is least extracted 26, In serial extraction which isnot a contraindication for orthodontic treatment? 2) Impaction of canine b) Lingual tipping of incisors 2). Canines «) itching 4) Open bite 5) Naxilary first permanent molar (ect-02) «1 molar 4) 2 molar 27. Serial extraction should not be undertaken if there is (coneDx -04) a) Crowding b) Presence of ectopic eruption 38, The arch length preservation can be best carried out by: ©) Deep bite or open bite d) None ofthese a) Placing a tingua arch (AP-02) >) Restoring carious teeth 28, The main reason for replacing premature loss of primary) Placing band and loop space maintainer anterior teeth 4) Placing an acrylic removable space maintainer a) Form and function _b) Speech and esthetics (AlPG-05) «) Space maintenance d) Hone ofthe above 39. Rapid palatal expansion using a Hyrax screw is an (196 -91, 61-96) "example for: 29, Nance methods of serial extraction procedure 2) Extra-ral anchorage b) Intermaxilary anchorage 2) DAC 8) 04 6) Muscular anchorage) Reciprocal anchorage 2 40,C 4) 04,0 40. Raptd maxillary expansion is not indicated after: 30. A substantial increase in maxilary width is usually best a) years 1) 9 years obtained by placing ©) 12 years d) 15 years 2) Lingual arch wire (aP-05) 8) Asutural expansion fixed appliances 41. Premature exfoliation of the primary mandibular ) Posterior inter - maxillary cross elastics canine is the most often the sequelae of which of the 4) face bow with an expanded inner bow following: (HAN-98) a) Caries ) Tau Me ys os He wa He ws Me ws BA ws SA 3) 033) A_34) C35) 036) A_37) A_36) B39) 040) D_ 41) 0a | ©) Serial tooth extraction d) Arch length inadequacy 51, ORTHODONTICS Serial extractions are indicated when there is (KAR-04) a) Nov skeletal discrepancy with dental crowding 42. During mixed dentition stage, which of the following >10 mm appliance should be used as a space maintainer for b) No skeletal discrepancy with dental crowding between missing primary molars in mandibular arch: 5-7 mm 2) Distal shoe b) Nance holding arch ) Skeletal diserepancy >5° }_ Passive lingual arch d) Removable functional acrylic 4) Skeletal discrepancy >10° with dental erowding < Simm {KAR=04) 43, Force required for headgear to restrain maxillary growth is: 52. “Guidance to eruption” is another term for - 2) 50-100 gm per side b) 150-200 gm per side 1) Franket’ appliance —b) Activator ‘)_ 250-500 gm per sided) 750-10009m per side ©) Serialextraction 4). Bionator {COMEDK-07) (COMEDK-09) 44, Typically rapid palatal expansion is done with a jack 53. The tendency for drifting of posterior teeth into screw that is activated at the rate of: extraction space is more in 2) 1.010 2.0 mm/week b) 1.0 to 2.0 mm/day a) Mandible 5) Maxila } 0.5 t0 1.0 mm/week d) 0.5 to 1.0 mm/day )Maxilla and Mandible (COMEDK-07, 14) ) Primary than Permanent teeth 45. An expansion alliance made with an expansion screw is (ComEDK-2011) an example of: 54 Which among the following about removable space 2) Simple anchorage _b) Reciprocal anchorage maintainers are wrong? } Multiple anchorage d) Reinforced anchorage a) Being tissue bor, they impose less stress on the (KcET-07) remaining teeth 46, The ratio of skeletal: dental expansion obtained finally b) By virtue of tissue stimulation they often accelerate the after Rapid palatal expansion ist eruption of teeth between them 2) 4 b) 31 ) They can be functional in the truest sense, hence better oat aa patient co-operation can be expected (COMEDK-07) 4) Easier to fabricate, requiring less chair-side time 47. Treatment objective for serial extraction {KCET-2012) 2) isto intercept a developing arch-length deficiency and 55. the chief disadvantage of a nonfunctional fixed to reduce or eliminate the need for extensive appliance space maintainer? therapy a) Prevent lateral jaw growth 3) Reduce arch-length deficiency b) Difficult to fabricate <)_To plan for extensive appliance therapy )_ Difficulty in maintaining proper oral hygiene 4) To reduce arch-length deficiency & to plan for extensive 4) Continued eruption of opposing tooth appliance therapy (comeo-2012) {COMEDK-08) 56. Space regaining is indicated in all of the following except 48. Crossbites are often seen in the developing dentition in 2) One or more permanent teeth have been lost the molar region, the treatment is b) Some space in the arch has been lost due to mesial drift 1) move bath molars for correction of 1st permanent molar 8) extract one molar ©) Mined dentition analysis shows that once the lost space )_ extract both molars is gained back, there will not be any arch length-tooth 4) possibilty of functional interference considered and material discrepancy shift of mandible to be taken into account 4) 1st molars are in end to end relation due to Class 11 (aP-09) skeletal base and prognathic maxilla 49. Which of the following factors are important when space (kcer-2012) maintenance is considered after the untimely loss of 57. Ideally a malocclusion should be treated between the primary teeth? age of 2) Chronologic age of patient 2) Sand B years b) 8 and 10 years, Skeletal age of patient ©) 10 to 12 years }_ Dental age of patient d) Biologic age of patient 4) The age at which a malocclusion is treated depends on {COMEDK-10) the problem involved 50. In Dewel's method of serial extraction procedure, the (aP-2013) second step involved is to 58. Preventive and interceptive orthodontics is no longer 2). Extract deciduous canine only viable after eruption of ) Extract first premolar 2) Permanent second molars 6), Extract first deciduous molar only ) Primary second molars 4) Extract both deciduous canine and first deciduous molar ) Permanent frst molar d) Permanent lateral incisors (UPSt-09) (aP-2013) mye) c mas) 8 ae) DM) A a) D 49) C SO) 51) A yO 53) 8 BAO 55) 056) 0 57) D 58) & BS)=a A AAA dental Pulse 60. 61, 62. 83. 64, 65. AUL are advantages of removable space maintainers EXCEPT a) Easy to clean ) Permit maintenance of proper oral hygiene ©). They maintain vertical dimension 44) Band construction is necessary. (aP-2013) During arch deficiency, which tooth is most commonly ‘out of arch: a) Ast Premolar b) 2nd Premolar ©) Ist Molar 4) 2nd molar (NeeT-2013) Contraindication of band and loop space maintainer are all except 4) High caries susceptibility ) Single tooth missing in posterior region ©) Moderate to severe space loss 4) Lower anterior crowding (ATIMS Nov-13) Which of the following orthodontic appliance allows “passive expansion”? 4) Transpalatal arch b)- Quad hetix ©) Frankel 4) Rapid maxillary expansion (COMED-14) Which of the following does not function as a space maintainer? 4) Lingual arch b) Stainless steel crown ©) Cass IT restoration d) Palatal expander (GCET-14) Most common unfavourable sequelae of serial extraction 4) Disto-axial inclination of canine »b) Residual space at the extraction site ©) Nesio-axial inclination af second premolar 4) Increase in overbite (COMEDK-15) ‘An example of unilateral fixed space maintainer is ) Crown and loop space maintainer ) Nance palatal arch ©) Lingual arch space maintainer «) Transpalatal arch (KERALA-2015) _ 59) 060) 8 61) B 62) C 63) D 6) 0 G8) Aa | ORTHODONTICS 8. PREVENTIVE & INTERCEPTIVE ORTHODONTICS — ANSWERS °C’ [Bhalajhi 3rd ed 220) In case of premature loss of deciduous second molars, the first permanent molars migrate mesiall. This results in insufficient space for erupting second premolars which may get impacted or deflected and erupt in an abnormal location. Space maintainers are least indicated in maxillary primary incisor area or option (4) 1 [Bhalajhi 3rd 20] ‘D' [Gurkeerat Singh Ast ed 509] [distal shoe space maintainer is indicated when the primary 2° molar is lost before eruption of the permanent 1° molar. Distal sho Patient with heart * Patients with poor oral hygiene © Hemophitc patients ‘D’ [Check Explanation Below] Properly restored deciduous tooth is the best space maintainer ‘8! [Bhalajhi 3rd ed 223) In Band and loop type of space maintainer, the tooth distal to the extraction space is banded and a loop of stainless steel wire is soldered to with its mesial end touching the tooth mesial to the extraction space. ‘The main disadvantage of band and loop space maintainer ‘is that it cannot prevent supra eruption of the tooth in the ‘opposite arch. The crown is used preference to the band ves the abutment tooth is highly carious, exhibiting hypoplasia or pulpotomized, [Bhalajhi 3rd ed 223] oad Bilateral premature exfoliation of teeth jn mandible If the primary 2nd molar is lost before the eruption of. permanent Ast molar Bilateral premature exfoliation of teeth in maxilla Spa ‘© Lingual arch space maintainer, ‘ot fs a bilateral fixed non- functional appliance * Distal shoe space mai ‘Fixed form of distal shoe space ‘maintainer is known as Rocher or intra alveolar appliance. * Palatal arch appliance / ‘Nance palatal arch appliance ce ‘= Band and loop space maintainer ‘©Crown and loop space maintainer. Loss of single tooth ‘in posterior segment 9. 10. a 12. 23. 14, 15. 16. aw. 18, When one side of| arch is intact and several primary teeth fon the other side are missing (unilateral ‘multiple teeth loss) ' Transpalatal arch ‘© Maintains space both anterio- posteriorly and transversely and ‘thus prevents arch collapse ‘Space maintainers are least indicated in maxilary primary ‘neisor area ‘© Pin and tube type of space ‘maintenance is useful when ‘there is early loss of primary incisors. ‘* The advantage of pin and tube ‘ype of space maintainer is that it allows lateral growth of the arch Early loss of primary incisors “K [Bhalajhi 3rd ed 224] “B’ [SHOBHA TANDON ist ed 407] Normal mandibular lingual holding arch is used for space maintenance in mandible, Lingual arch with U-toops mesial to each molar band fs 8 madification of mandibular ingual arch. The loops are opened periodically and this can distalization of molars by 1 to 2 mm. ing about ‘B' [Gurkeerat Singh 1st ed 520] Disking is usually done if the space required for the anterior crowding is not >4 mm. Disking is done on the mesial and distal surfaces of deciduous canine. If more space is required, then mesial surfaces of deciduous 1" molars can be disked, 'N (Bhalajhi 3rd ed 101) Cri appliance is placed palatal to the maxillary incisors. It should be worn at least for a 6 months period, °B [Bhalajhi 3rd ed 226] ‘D' [Bhalajl 3rd ed 220] ‘D' [Bhalajhi 3rd ed 219) 0’ [SHOBHA TANDON Ast ed 383] ‘B' [Bhalajhi 3rd ed 215] Serial extraction is a procedure of interceptive orthadontics y [M.S.RANI 3rd ed 196] “K [Gurkeerat Singh 1st ed 220) 'C [Gurkeerat Singh 1st ed 64] eo == 222A 19. 20. a1. 22. 23. 26. 25. 26. 2. Dental Pulse Martin and Saller give both facial index and cephalic index. Maximum skull width Cephalic Index = Sigur sul length Index values + Mesocephalic (Average) = 76.0 - 81 * Brachycephalic (Broad skull) = 81.0 - 85.5 * Doticocephatic (Narrow skull - 78.9 istance b/w nasion and gnathion Bizygomatic width Facial Index = Bizygomatic width is the distance between two zygoma points Index values + Euryprosopic (Broad) — (79 - 83) + Mesoprosopc (average) — (84 - 88) * Leptoprosopic (long) — (88 - 93) “C [Bhalajhi 3rd ed 228) ‘8 [Bhalajhi 3rd ed 228) Hotz called serial extraction procedute as “active supervision of teeth by extraction’ ‘D [Bhalajhi 3rd ed 228) Indications of serial extraction © Skeletal class-I + Flaring of teeth due to Crowding (AIIMS-09) © Localized gingival recession in lower anterior region Ectopic eruption of teeth © Unilateral or bilateral premature loss of deciduous canines with midline shift Space discrepancy should be atleast § mm in all the four ‘quadrants (extraction case of carey's or arch perimeter analysis) + No skeletal discrepancy should be present. ‘B [Bhalajhi 3rd ed 428) “W [Bhalajhi 3rd ed 231) 'K [Bhalajhi 3rd ed 228] ‘€ [Bhalajhi 3rd ed 228) “B [Bhalajhi 3rd ed 228) * Class-II & ITT malocclusion with skeletal abnormalities (KCET-10) Spaced dentition * Open bite and deep bite cases © Mldline diastema eases *Class-1 malocelusion with minimal space deficiency. 28. 29. 30. 31, 32. 33, 34, 35. _ 1° [SHOBHA TANDON Ast ed 382] {[Bhalajhi 3rd ed 233] Different types of serial extraction procedure: ‘+ Dewel’s method is most commonly used method. In this method the deciduous canines are extracted first at the age of 8-9 years. A year Later the deciduous first molars are extracted so that the eruption of frst premolars is accelerated. This is followed by extraction of erupting fist premolars to permit the permanent canines to erupt in their place.(C, D, 4) ‘+ In modified Dewel's technique, the first premolars fare enucleated at the time of extraction of the first deciduous molars. This is frequently necessary in the ‘mandibular arch where the canines often erupt before first premolars. + Tweed's method, Nance method ~ D, 4, C ‘+ In Nance method, deciduous first molars are extracted around 8 years of age. This is followed by extraction of first premolars and deciduous canines. ial extraction is? (PGI DEC-2011) Most accepted sequence of s a) Cad cos by ogc 4) 064 8! [Bhalajhi 3rd ed 247] 'N (Bhalajhi 3rd ed 267] Wilkinson's extraction methods involves the extraction ofall the four rst permanent molars between the age of 8 J to 9 “years to minimize arch crawding and to provide addition space for euption of third molars. The basic for Wilkinson's extraction is that the first permanent molars ate highly susceptible to cares ‘D' [Bhalajhi 3rd ed 249) The opening of mid-palatal suture is fan shaped or triangular with maximum opening at the incisor region and gradually diminishes towards posterior part of palate. ‘NX [Bhalajhi 3rd ed 254) Opening the expansion screw by % turn or by 90 degree moves the lateral halves by 0.18 mm which is less than the width or periodontal ligament i.e, about 0.20 mm, Pitch of the screws It is the extent to which the two halves of the base plate ‘move, for each full turn of the expansion screw. Normally it 's about 0.8 mm. ‘C (Bhalajhi 3rd ed 267) 1D’ [Bhalajhi 3rd ed 252, 256]ee | 36. 37. 38. 39. ORTHODONTICS = Jack screws Stor + Coffin spring (used in maxilla) expansion | * Quad hex (used in maxilla) appliances |» ni-1i expander (newer type) + Schwarz appliance (used in mandible) 4) Removable appliance incorporating dack screw 2) Fixed tooth and tissue borne “ Rapid appliances expansion |» Derichsweiler type appliances | = Hass type 3) Fixed tooth borne appliances an «Isaacson type + Hyrax type (Winne expander) 4. ‘x [Bhalajhi 3rd ed 257] Both coffin spring and quad helix and used for palatal expansion. Quad helix appliance - In children, it. brings about orthopaedic movement whereas in adults it brings about cthodontie tooth movement oa. ‘X [Bhalajhi 3rd ed 264] For orthodontic purposes, maxillary frst premolars are the most commonly extracted teeth while the maxillary anterior are least extracted 3 [Bhalajhi 3° ed 216) [M.S. Rani 3rd ed 227] athoage ean “ ata moat of ply pcr aig cate chr wit te babe apn Sapa |+ aca movement of rent cng swe cage | sonnce = Rect of ation teeth withthe of a Hawley’s appliance ein css 1 Wemadlny east Ue) os, nea era ae Sttionay | anattlar metas helps revatg| 4g Re racailsryMartaviors iy Mtprimnyiiifars| (COMEDK- 2010). }* Anterior inctined plane cere | Rigid labial bow Beers ot trope ach to nd PN cece eeriate none er nerrecien ee eran = Use ot hedges along with ut Rd mocap zr |> Pape fo o. * Closure of midline diastema by moving two central incisors each other, 1 The use of crossbite elastics. * Atch expansion using a fixed or removable appliance Eg: Quad helix, hyrax, jack screw, ete. Reciprocal anchorage ‘D' [Bhalajhi 3~ ed 268/M.S. Rani 3rd ed 247) Rapid palatal expansion should be carried out prior to ossification of midpalatal suture i.e, before a broad range of ossification time table i.e, between 15 ~ 27 years. “0 [Bhalajhi 3 ed 228] "C [Bhalajhi 3 ed 223, 224) Lingual arch space maintainer i the most effective appliance for space maintenance in the lower arch. This appliance is usually indicated to preserve the spaces created by multiple loss of primary molars. It helps in maintaining the arch perimeter by preventing both mesial drifting of the molars and also Uingual collapse of the anterior teeth, “C [Bhalajhi 3” ed 369] The current recommended force required for headgear to restrain maxillary growth is 350-450 gm per side for a minimum of 12 - 14 hours / day. The recommended duration of head gear wear for restricting excess maxillary growth is (KERALA-2015) 2) Full-time wear 3b) 10-12 hours per day €} 6-8 hours per day) 4-6 hours per day D' [Profit 4° ed 500, 286] Rapid expansion typicaly is done with two turns daily of the ‘ackserew (0.5mm) activation. This creates 10 to 20 pounds of pressure across the mid palatal suture, which is enough to create microfractures of interdigitating bone spicules. In slow palatal expansion, approximately 0.5mm per week is the maximum rate at which the tissues of the midpalatal suture can adopt Y [M.S. Rani 3rd ed 227] “D [Profit 4" ed 286] ‘© According to Profitt, when the rapid palatal expansion was completed, 10mm of total expansion would have been produced by 8mm of skeletal expansion and only 2mm of tooth movement i.e, the ratio of skeletal to dental expansion is 8:2 or 4:1, ‘© Later at & months, the same 10 mm of expansion would still be present, but at that point there would be only 5 mm of skeletal expansion, and tooth movement would account for § mm of the total expansion, making the final ratio of sskeletal to dental expansion is §:5 or ‘+ In slow palatal expansion, the ratio of skeletal and dental expansion fs approximately 1:1 'W (Bhalaji 3rd ed 228] ee ==(222A 48, 49. 50. 51. 52. Dental Pulse ‘D! [Profit 4th ed 436-37] Early correction of dental cross bites in the mixed dentition is recommended because it eliminates functional shifts and wear on the erupted permanent teeth, and possibly dentoalveolar asymmetry. There are three basic approaches to the treatment of moderate posterior crossbites in children: i) Equilibration to eliminate mandibular shift fi) Expansion of a constricted maxillary arch, and iit) Repositioning of individual teeth to deal with intra-arch asymmetries. ‘C [Balaji 4th ed 263] Fs considered for space maintena 4) Time elapsed since loss of tooth As the studies indicated that maximum loss of space occurs within 6 months of extraction of teeth, it is, advisable to place a space maintainer as soon as the primary teeth are removed. »b) Dental age of patient The dental age of the patient should be considered rather than chronological age because of too much variation in eruption of teeth. ©) Thickness of bone covering the unerupted teeth The more the bone covering the unerupted tooth, the ‘more would be the time it would take to erupt, and therefore space maintenance is indicated. 4) Sequence of eruption af teeth The neighbouring dentition can greatly influence the closure of extraction space. gs When the primary 2* molar is lost early, we should study the development of the permanent 2* molar and 2% premolar. In case the 2 molar is ahead of the 2° premolar in its eruption, itis likely to exert ‘a mesial force on the first molar which can move imesially. This may result in insufficient space for 2° premolar. 2) Congenital absence of permanent teeth If the permanent teeth are congenitally missing, the dentist should retain the space until a replacement can be given or allow the ather erupting teeth to drift and close the space. ‘C' [Bhalajhi Gth ed 249/ Ref. Q.No. 29] ‘K’ [Proffit 4th ed 490] Serial extraction is indicated in cases of severe dental crowding. For this reason, itis best used when no skeletal problem exists, and the space discrepancy Is large f.e., > ‘tomm per arch °C! [Bhalajhi th ed 246] 53. 54. 56. 57. 58. 59. 60. 61. 62. 63. _ [ournal of the Indian Dental Associatio Volume 46] It is due to the presence of more cancellous bone, which exerts little resistance to tooth movement, 1974, “C [Bhalaji Sth ed 366) Utmost co-operation of patient is required forthe success of any removable appliance ‘D [Bhalaji sth ed 292] Supra eruption of opposing teeth can take place if pontics are not used i.e. non functional fixed space maintainer is used. Other disadvantages of fixed space maintain ‘© Expert skill and elaborate instrumentation is needed ‘© Decaleification of tooth under bands ‘© IF functional (pontics) space maintainer is used, it ean interfere with vertical eruption of abutment tooth and prevents eruption of replacing permanent teeth if the patient fails to report. 1 [Bhalaji 5th ed 304) [Not required] 'N [Refer Text Below] Preventive and interceptive orthodontics relates to the guidance of eruption and position of permanent teeth during the transition of the dentition, Once the permanent second molars have erupted, it is no longer possible to intercept a developing malocclusion. One must resort at that point to corrective orthodontic measures. ‘D’ [Bhalafi 4th ed 233] Band construction is necessary for fixed space maintainer, [Textbook of orthodontics by Samir E. Bishara Pg 328] Because the maxillary canines and second molars are last teeth to erupt anterior to molars, their displacement out of the arch or impaction is common and is often caused by ‘inadequate space in the dental arch, 8’ [Check Explanation of Q.No.6] roffit Sth ed 351] ‘© Lip bumper as well as removable Frankel appliance allows passive palatal expansion. ‘© Option 1 i.e, Transpalatal arch is a space maintainer © Option 2 i.e, Quad helix allow active palatal expansion ji Sth ed 293/ AAPD guidelines on pediatric ntistry 2012] Fixed space maintainers Band and loop ‘© Crown and loop © Band and Bar Jngual arch space maintainera | 64. 65. Palatal arch appliances (not expander); Eg: Nance holding arch © Transpalatal arch * Distal shoe space maintainer ‘Esthetic anterior space maintainer Stainless Steel crowns and class II restorations act as space maintainer and prevent tipping or rotation of adjacent teeth. ‘D’ [Proffit 5th ed 464 Last paragraph] The most common unfavourable sequel of serial extraction is deepening of bite. Uprighting of incisors and early loss of posterior teeth may result in deep bite. A simple palatal bite plate may correct this problem Advantages of serial extractions * Naturally induced movement and alignment of s crowded anterior teeth. * Improved health of investing tissues. * Improved psychologic state and better patient compliance as a result of improve alignment, + Makes later comprehensive orthodontic treatment easier and quicker, it reduces the duration of multibonded fixed ‘teatment, * Less potential iatrogenic damage, # Cost is minimal. + Itis often within the range of general practitioners iously Disadvantages of serial extractions The most common unfavorable sequel of serial extraction procedure is deepening of overbite, due to uprighting of lingual tilting of incisors. + Treatment time is prolonged as this is carted out in stages spread over 2-3 years ‘It requires the patient to visit the dentist often, thus patient co-operation is needed. * Improper timing of extraction may leads to delay eruption of secondary teeth, + If the procedures are not carried out properly, there is a risk of arch length reducing by mesial migration of the buccal segment, Thus a poorly executed serial extraction program can be worse than none at all. ‘X [Proffit Sth ed 429] ORTHODONTICS RSs=((22FA Dental Pulse _ Sr 9. REMOVABLE AND FIXED APPLIANCES ‘Adams cribs can fracture in use ifthe 411, Force maintained at some appreciable fraction of the 4) Wire is too soft —_b) Tags are high on the bite original from one patient visit to the next is: Base plate is too thick d) Arrowheads are too small a) Continuous force _b) Intermittent force (HAN -94) ) Intemupted forced) None of the above How/where should wire be bent to activate a correctly (Kar-03) made palatal canine retractor? 12, The adams clasp is made of: 4) Between the col and tooth, but close to the ofl 2) 24 mil wire b) 28 mil wire 5) Between the coil and tooth, but close to the tooth ©) 23 mil wire 4) 22 ik wire ©) Between the coil and its insertion into the base of the (KAR -03, AIPG- 14) palate 13, Catlan’s appliance is used for the correction of: 4) By opening out the coil a) Deep bite 'b) Anterior cross bite (AIIMS -93, MAN -94) ) Thumb sucking habit 4) Lip biting habit 3. Anterior bite plane is used in correction of, (KAR -01, ALINS-09, NEET -2013) a) Anterior cross bite b) Deep bite 14, Removable appliances bring about: ©) Open bite 4) All ofthe above 2) Bodily movements b) Translation (MAN -02, COMEDK-08) ) Tipping 4) Derotation correcting (MAN-95, AIPG -03) a) Deep bite b) Anterior open bite 15, Ahelix is placed for: ) Anterior cross bite d) Posterior cross bite 2) Activation (NAN -98, KAR -01) b) Increasing the flexibility and range Example of semifixed orthodontic appliance is «) Esthetics ) Retention a) Kesstings wrap around retainer (KAR -02) 5) Hawley retainer 16, Inclined plane is constructed «Lip bumper 4) Pin and tube appliance 2} 90° to occlusal plane b) 48" to occlusal plane ¢) 30° to occlusal plane 4) 70° to occlusal plane The diameter of labial bow of the maxillary plate (AP -2k) 2) 05-06 mm b) 0.6 -0.8 mm 17, Helix ina finger spring for mesial movement lies <) 07-08 mm €) 0.8~1.0 mm 2) Mesial to the fong axis ofthe tooth (HAN -99) b) Distal to the long axis of the tooth 7. A buccal canine retractor is better than a palatial canine )_ In ine to the long axis ofthe tooth retractor when ) Perpendicular to the long axis ofthe tooth 4) The maxillary canine is distally placed (Pat -2K) +b) The maxillary canine is partially impacted 18, Which of the following clasp is preferable on a partially «)_ The maxillary canine distally placed and rotated erupted tooth for adequate retention of removable 4) The maxillary canine is buccally placed orthodontic appliance? (aN -99) 2) Circumferential clasp b) Adams clasp 8, An anterior bite plate should be trimmed so that: )_ Jacksons clasp 4) South end clasp a) This included at 10° to occlusal plane (AIMS -01) ») This inclined at 30° to occlusal plane 419, Speech problems associated with removable orthodontic «)_ Posterior teeth are 5 mm apart appliances Posterior teeth are 2 mm apart 2), Difficulty with inguo alveolar consonants for a few days (AIINS -01) b) Difficulty with lingual vowel for few days Which of the following is true about Catlan’s appliance: ) Difficulty with both lingucalveolar consonants and a) Ttis used to treat cross-bite of maxillary posterior teeth Lingual vowel for several weeks 8) tis constructed on the lower anterior teeth with an 4) No ditfcuty is found at all Inclined plane ©), Fused for along period it results in anterior deep bite 20. In adams clasp, the angulation of retentive points at the 4) Of constructed on the upper anterior teeth it has a 45 bridge portion of clasp should be degree angulation a) 45° b) 55° (AIINS -01) ©) 75° a) se 410. Anchorage in removable appliances is provided by: 2) Aarylicbase only b) Teeth 21. Which ofthe following clasp is indicated when retention ©) Acrylic base and teeth ad) Retentive clasps {s required for anteriar region (P6195, 97) 4) Southend clasp ——-b) Triangular clasp ye yA De Ye DO De DD) 0 YB Me MA WS BS 1) € 15) 8 16) B17) ¢_18) B 1) A_ BA WEee | ©) Ballend clasp 1) Adams clasp ORTHODONTICS 28. Which ofthe following ae example of fixed active appliances ) ABD a) Begg and straight wire b) Begg and herbst 6) Activator and herbst dl) Activator and frank 22. Which of the following is said to be predecessor of the (MAN -02) adams dasp 29, The main disadvantage of uprighting first molar with 2 2) South end clasp loop tingual arch is 5b) dacksons clasp or full elasp or u clasp 2) Edtrusion of molars )_ Circumferential or three quarter or ‘clasp b) Over conection of molars 4) Schwarz clasp 6) Crozat clasp ) Flaring of mandibular incisors 4) Allof the above 23. Which of the following is correct (MAN -98) 2) Z spring or double cantilever spring is used for labial 30. The first orthodontic appliance devised by angle was movement of incisors and minor rotation of incisors 2) Edgewise ) Pin and tube appliance ) T spring is used for buccal movement of premolars and ©) E~arch «d) Ribbon arch sometimes canines (COMEDK-09) (COMEDK-05) )_ Coffin spring is a removable type of expansion spring _31.__Differential force concept is mainly used in @) Canine retractors are springs that are used to move a) Straight wire appliance canines in a distal direction b) Lingual appliance ©) Allof the above )_ Bega's light wire appliance 2) Frankel appliance 24, Which of the following is not correct (KAR 2K) 2) U~ loop canine retractor is least effective and is used 32, In the III stage of Begg’s treatment: when a minimal retraction of 1-2 mm is required a) Crowding of teeth is comected 5) Helical canine retractor or reverse loop canine retractor b) Ovetbite is corrected is indicated in patients with shallow sulcus and specially «)_ Extraction spaces are closed ‘n mandibular arch 4) Root paralleling is done ) Palatal canine retractor is indicated for retraction of (KAR -2001) palatally placed canines 33. Beta titanium, an excellent choice for auxillary springs 4) Buccal canine retractor is indicated for retraction of is nothing but: buccally placed canines a) Witinol b) THA ©) All ofthe above ©) Stainless steel 4) Sentinol (kar -03) 25. af the following is correct 34, Which of the following is not true of a fixed appliance: 2) High labial bow is used mainly to carry auxillary apron a) Economical springs and is indicated for retraction of anteriors with »b) Rotation and extrusion movements are possible large over jet ) Patient co-operation isnot required ) Roberts retractor is indieated in patients with having 4) Tipping and bodily movement are possible severe enterior proclination (mainly canines) with a over (st -99) jet of 6 mm 35. Coils are incorporated in orthodontic appliances te: «Mills retractor or extended labial bow is indicated in a) Decrease the amount of force patients with large overjet b) Increase the range of movement 4) Fitted labial bow is used as retainer at the completion of _c)_Increase flexibility fixed orthodontic therapy 4) Increase the amount of force ©) All ofthe above (Alps -95) 36. Rotation of teeth is best corrected by 26. Disadvantages of removable orthodontic appliance 8) Hanley appliance). Buccal retractor ) May not be worn by the patient ) Fixed appliance) All of the above 5) Inabitty to control root position (a 2k) c) Hasa failsafe effect d) A&B 37, Lingual fixed appliance is used in a) Bilateral loss of 1 molars 27. Edge wise bonded brackets are used b) Bilateral loss of canines 2) On incisal edges of anterior teeth ) Bilateral loss of laterals 8) To obtain edge to edge occlusion 4) Unilateral loss of premolars )_ With rectangular arch wire (AP -99) 7 mm * Class-II division 18 2 ‘+ Most commonly used frankel appliance FR3_ | © Class-III malocclusion * Open bite FRLA FRB FRI Fre muscle force to the teeth) | 44), inclined plane. Fixed functional appliances | Herbst. appliances, pede eee ee a ae ema at MARS, Jasper jumper ** Bimaxillary protrusion ete, These appliances incorporate headgear Most commonly used fied | Herbst FRS-_ | «used in long face patents with high mandibular funetional appliance plane angle and vertical mailary excess. Removable functional ‘Activator, Bionator, “ee appliances Frankel appliance 8B [Bhaaihi 3rd 08333) oy then term myofunctional therapy was proposed by Lischer Pea ae (COMEDK-08). Best period for myofunctional therapy is the used removable functional ‘Activator late mixed dentition period, appliance —————__________ Te ESSarind aa Tdeally, functional appliance to treat the mandibular al ‘Twin block deficiency of skeletal class II in case of girls should b appliance given during (AP-2013) Group-I appliances (Transmits | Oral screen (AIMS a) Deciduous dentition 'b) Early mixed dentition ©) Late mixed dentition _d) Permanent dentition Group-Ul appliances (reposition | Activator, Bionator the mandible) 7 Group-II appliances Frankel appliance, (ceposition the mandible but _| Vestibular screen ® their area of operation is " vestibule) Removable - fixed functional| lip bumper or Lip appliance or semi fixed| plumber 9. appliance 10. “X [Bhalajhi red 333] Moderate to severe skeletal class-II malocclusion division 11, 1 eases due to a short or retrognathic mandible are ideally suited for functional appliance treatment. 12. Class IL division 2 type of malocclusions may be treated with functional appliances after correcting the axial inclinations 13, cof maxillary anterios. 14 “C [Bhalajhi 3rd ed 338) Class-II and IIT malocclusions, class-I open bite and 45, deep bite malocclusions, children with lack of vertical development in lower facial height, and upright mandibular incisors are indications of activators. Activators may produce moderate mandibular rotation (anteriorly down words), so they are contraindicated in vertical growers, B" [Bhalajhi 3rd ed 338] Lip bumper in maxilary arch isknown as DENHOLTZ appliance “C [Bhalajhi 3rd ed 336) Oral screen was fist introduced by NEWELL. It works on the principles of both force application and force elimination. °C [Bhalajhi 3rd ed 332] [Bhalajhi 3rd ed 336] “K [Bhalajhi 3rd ed 333] “K [Bhalajhi 3rd ed 348) Frankel appliance is a removable myofunctional appliance. Y [Bhalajhi 3rd ed 328] 0 [Bhalajhi 3rd 330] °B [Check Explanation Below] “Twin ~ Block appliance” is the most acceptable functional appliance and was introduced by Wiliam Clark. The appliance consists of a upper and lower appliances with posterior bite blocks. The upper and lower bite blacks interiock at an 70° angle. BS)=((222A 16. 7. 18, 19. 20. a1. 22. 23. 24, 25. 26. 27. 28. 29. Dental Pulse °K [Bhalajhi 3rd ed 363] Herbst appliance is a rigid fixed functional appliance. Jasper jumper isa flexible fixed functional appliance. ‘C [The Art OF The Smite: Integrating Prosthodontics, Orthodontics, Periodontics, Dental Technology, And Plastic Surgery In Esthetic Dental Treatment Pg 130] Herbst appliance is specifically indicated in pre-adolescent patients. Treatment is completed within 6-8 months. Thus it is possible to use the residual growth left in these patients. E(B) shi 3rd ed 338) © ‘D' [Bhalajhi 3rd ed 366, 367) Headgears are the most commonly used oral orthopedic appliances. They are indicated in patients with excessive horizontal ‘growth of maxilla. They are used to distalize the maxillary dentition along with maxilla 'C [BHALATHI 3rd ed No. 368] Cervical headgears cause extrusion of maxillary molars and thus increase the lower facial height. So these are generally indicated in low mandibular angle cases (horizontal rowers) 1s an increase in lower facial height would be beneficial in these patients. ‘D [ph shi 3rd ed 368, 369] “W [Bhalajhi 3rd ed 372) Headgears that cause a forward pull on maxilla are called reverse pull headgear. Facemask is one of the most common reverse pull headgears in use today. wie ht 3rd ed 368), ‘D [Bhalajhi 3rd ed 85, 219] Nilwaukee brace is an orthopedic appliance used for correction of scoliosis. It exerts tremendous force on the mandible leading to retarded mandibular growth. ‘D’ [Bhalajhi 3rd ed 366) “C [Bhalajhi 3rd ed 368) So cervical head gear is used in patients with low mandibular plane angle and deep bite. ‘D' [Bhalajhi 3rd ed 443) Surgery on the hard palate may affect the growth center, inhibiting the forward growth of maxila while the mandible ‘grows normally. This will result in concave facil profile ‘X [Bhalajhi 3rd ed 375, 376] Occipital Pull Chin Cap is most commonly used type. Itis very successful in patients who can bring their incisors close to ‘an edge to edge position at centric relation. OCCIPITAL PULL CCHIN CAP wil results in lingual tipping of the lower inelzors So they are indicated in patients with slightly protrusive 30. 31. 32. 33. _ lower incisors. VERTICAL PULL CHIN CAP is indicated in patients with steep MPA angle and excess anterior facial height. These patients usually exhibit an antecor open bite. “© [Bhalajhi 3rd ed 458,459] Pot Boren Sfeletal_class-II_ with | Sagittal split osteotomy with ‘mandibular retrognathism | mandibular advancement (lass-IE due to manilary | Maxillary segmental anterior) protrusion set hack lass-IT due to Sagittal spit osteotomy with ‘mandibular prognathism_| mandibular set back (lass-I1 due to Lefort-l osteotomy with maxillary retrusion | maxilary advancement * Lefortt with mavillry impaction to correct open Gass Teh skeletal | bite (atPG=14) i ‘* Sagittal split osteotomy for mandibular advancement. Maxillary and mandibular sant jon | segmental osteotomy with Bimanillary protrusion | setback of anterior maxilla and mandible Long face due tomanillary| Lefor-1 with maxillary excess impaction, 8 [Gurkeerat Singh 1st ed 457] High pull head gear or parietal headgear derives supports from the parietal region, ie. front of the head. Tt produces Intrusion of maxillary incisors and is indicated for correction of anterior deep bite, Cervical headgear derives support from nape of neck. It causes extrusion of molars and so indicated in deep bite patients with a low MPA angle, 'N [Bhalajhi 3rd ed 374) C [Bhalajhi 3rd ed 375] Chin cap was introduced by Oppenheim. It delivers a force ‘of 800 ~ 1200 (400 - 600 gms/side). The patient is asked to wear the appliance for 12-14 houts/ day. 35. 36. 37. 38, 8’ [Profitt 4° ed 300, Fig 8-29) 8! [Bhalajhi 3“ ed 397] [Bhalajhi 3° ed 336] Other names of activator ‘© Norwegian appliance ‘+ Functional jaw orthopedics. Bhalaji 4° ed 356]ee | 39. 40. 41. 42 43. 46. 45. 46. an 49. 3 [Bhalajt Sth ed 426] ‘Mechanism of action of working bite: Displaces mandible from its rest position Stretching of the muscles attached to mandible The reflex activity tends to restore mandible to a postural position that was determined by the unstretched muscles. Most construction or working bites are taken at a vertical dimension beyond freeway space. This increases vertical dimension and also displace the mandible in the sagittal and transverse planes, ‘X [Bhalajhi 3% ed 376) ‘D' [Bhalajhi 3° ed 344] 1¢ [Bhalajhi 3" ed 358] BY [Bhalajhi 4th ed 386) ‘C [Bhalajhi 3" ed 336) [Bhalajhi 3 ed 336) “C [Bhalajhi 3% ed 337] ‘8! [Profitt 4th ed 321] In patients with a bilateral cleft, the premaxillay segment is often displaced anteriorly while the posterior maxillary segments are lingually collapsed behind it. IF this distortion is severe, surgical closure of lip, will become extremely difficult. So orthodontic intervention to reposition the segments and to bring the protruding premaxilary segment back into the arch may be needed to obtain a good surgical repair of lip. This is achieved by “infant orthopedics”. Infant orthopedics was pioneered by Burston. In a child with bilateral cleft, the maxillary segment requires. two movements ie. lateral expansion and posterior reposition. This movement is accomplished by a light elastic strap across anterior segment. In infants, the segments can be repositioned surprisingly, quickly and easily, so that the period of active treatment is only a few weeks at most. If pre-curgical movement of maxillary segment is needed, this typically would be done beginning at 3 to 6 weeks of age, 0 that the lip closure could be carried out approximately 10 weeks. A passive plate similar to an orthadontic retainer is then used for a few months after lip closure. Profitt 4th ed 300) °C [Bhalajhi 4th ed 351] Moderate to severe skeletal class II malocclusions are ideally suited for functional appliance treatment. Class II division 1 malacclusion exhibiting a class II skeletal tendency due to a short or retrognathic mandible can be considered functional therapy. ORTHODONTICS 50. 51, 52, 53. 54, Class IE Div. 2 type of malocclusion may be treated with functional appliances after correcting the axial inclinations of the maxillary anterior. Mild class III malocclusions which present with 2 reverse overjet_and an average overbite can be regarded as potentially treatable with functional appliances. Low angle cases (j.e., horizontal growers) respond well as ‘most functional appliances encourage the development of posterior teeth. High angle (vertical growers) class II cases are usualy of 2 categories ~ those with increased overbite and those with some degree of open bite. The deep overbite type of high angle cases are successfully treated using functional appliances while the open bite type of case poses a spacial problem. Most functional appliances allow vertical development ofthe posterior dentoalveolar structures, which may induce unwanted backward rotation of the mandible °C [Bhalaji 4th ed 353, 365] Nance holding arch is a space maintainer. The boy in this case is having class TIT tendency. So a myofunctional appliance is required to correct this. Oral screen is used to intercept habits, to perform muscles exercises and to correct mild anterior proctination. “D’ [Bhalaji 4th ed 374] Indications for Herbst appliance: ‘+ Correction of class I due to retrognathic mandible ‘+ As an anterior repositioning splint, in patients having TMD disorders. ‘= Can be used in mouth breathers. ‘© Ibis fixed, so can be used in uncooperative patients. [Bhalaji th ed 454] Catalans or lower anterior inclined plane appliance is used to treat cross bites. The inclined plane has a 450 angulation, which forces the maxillay teeth in cross bite to a more labial position. It is teeth supported functional appiiance. Expansion screw and Derichsweiler are expansion appliances. °K [Proffit 5th ed 304] The major goal of growth modification is to maximize skeletal changes and minimize dental changes produced by treatment, gs Rapid palatal expansion (RPE) The goal of RPE is to expand maxilla by expansion at mid palatal suture (skeletal) and not just expanding the dental arch by moving the teeth relative to the bone (dental). “B[Proffit Sth ed 46] Distraction osteogenesi: ‘© Distraction osteogenesis is the method of inducing bone ‘to grow at surgically created sites. ‘© Russian Surgeon Ilizarov discovered in 1950's that if cuts were made through the cortex of a long bone of BS)(8) A AAA) dental Putse 55. 56. 37. the Limbs, the arm or leg then could be lengthened by tension to separate bony segments, * Currently it is believed that best results are obtained if this type of distraction starts after a few days of initial heating and callus formation and if the segments are separated at arate of 0.5 ~ 1.5 mm day. * Also this technique is employed for lenathening of ‘mandible and inducing maxillary growth by separating cranial and facial bone at their sutures. “C [Gowri Shankar 1st ed 392 Tab 23.3] Growing patients Non-growing patients Well-aligned dentit Crowded dentition Proclined maxillary Proclined mandibular anterior anterior teeth and teeth upright mandibular teeth Wormal saddle angle and | Increased saddle and gonian acute gonial angle angles (Class-II skeletal (Class-II skeletal with ‘malocclusion with prognathic maxilla tetrognathic mandible Horizontal growth Vertical growth pattern pattern Low angle (low FMA) | High angle (High FMA) cases: ‘cases with tendency | with tendency towards open towards deep bite bite, Decreased lower anterior | Increased lower anterior face face height height Convergent jaw bases | Divergent jaw bases ‘D' [Proffit 5th ed 699) ‘B [Check Explanation Below] ‘According to 2011, January American Journal of Orthodontics Vol.139, Issue 1, page el-e6, the average resting lip Pressure was 24.59 + 2.55q/em"; during swallowing mas 24,87 4 2.45 g/cm? _ee | ORTHODONTICS 11, TREATMENT PLANNING 7-year-old child has normal occlusion except for tingually )_ Surgically removed before initiating orthodontic treatment ‘erupting maxillary central incisor. He should be treated 4) Left alone because the condition will self correct with (a -97) 2) Gioss bite elastic) Tongue blade therapy 9. In correcting an anterior cross bite, the appliance to be }_ Maxillary acrylic inclined plane used is determined by: 4d) Myofunctional therapy a) Amount of overbite (HAN -99) b) Age ofthe patient 2. Mid Line diastema can be corrected by all ofthe following ©) Co-operation ofthe patient except 4) All ofthe above 2) Lingual bow with inter tooth traction (ATMS -89) ») Haley’ appliance with finger springs 10, Ina 10-year-old child the lower canines are trying to «}_ Bonding tooth and inter tooth elastics erupt in 2mm insufficient space. The primary molars 4) Use of steel ligature directly on tooth are large and firmly fixed. The 1st premolars are also (MAN 02, AP -95) ting. The treatment of choice 3. Best retainer advised after the closure of ‘midline a) Remove primary 2 molars dinstema is b) Place a removable bite-opener a) Hawley retainer ), Remove 1" premolars 5b) Hawley retainer with finger spring 4) Mesial stripping of primary 2° molars ) Positioner 4) Bonded retainer (Pot -99) (MAN 01) 14. Shape of the interdental papilla in midkine diastema Which of the following procedure is best suited to correct cases is bimaxillary protrusion 2) Pyramidal ) Round 2) Extraction four premolars and anterior alveolar ) Triangular 4) No spectfc shape repositioning (AP -99) ) Mandibular body osteotomy and posterior maxillary 12. The best time to treat a cross-bite is: osteotomy a) When the roots are fully developed )_ Sub condylar osteotomy b) When the roots are 2/3 developed 4) None of the above ) Permanent dentition has completely erupted (NAN -98) 4) As and when detected 5 The treatment of unilateral buccal cross bite (PSI 2K, 98,97, AIPG -96) 2) Bilateral expansion of maxila 13, The availability for orthodontic treatment depends on 5) Unilateral expansion of maxilla of the effected side 2) Severity & extent of periodontal lesions } Unilateral expansion of masilla of opposite side ) Amount of bone available 4) Unilateral expansion of posterior teeth of involved side ©). Prognosis of periodontal lesions without ortho treatment (MAN-02) 4) Allof the above 6. Inorthodontic treatment, in order to avoid injuries to the (AP -03) tissues, the forces, applied generally should not exceed 14. Bruxism should be treated by night guard using: 2) Capillary blood pressure a) Hawley retainer b) Occlusal splint ') Diastolic ateral blood pressure ) Double occlusal splint.) All of the above )_ Masticatory forces (AIPG -97) «Systolic arterial blood pressure 15, Midline diastema should be corrected (MAN -97, KAR-06) a) As early as possible 7. A patient has a functional shift towards right due to ») Only if protrusion of teeth present cross bite, the indicated treatment is, ©) Only if patients wants it 2) Maxillary expansion bilaterally 4) After eruption of permanent canines +) Expansion of maxilla on the side of functional shift (AIMS -03) c) Expansion of maxilla opposite to the side of 16. The best advantage can be derived if orthodontic functional shift treatment is started 44) None of the above a) After puberty (MAN -99) b) Early adolescent period 8. Ina child, a fibrous maxillary frenum associated with @ )_ At or Just after onset of puberty diastema between central incisors should be 4) None of above 2) Treated by frenectomy (ae -03) 8) Observed until permanent canines erupt De) 0} A OATS) A MATS 8 OD) D MD) 0 GD 14) B15) 016) € Sk= 222A Dental Pulse _ 47. 8 10-year-old child with primary molars in various stages 26. If anterior cross-bite is not corrected with ice-cream of exfoliation has a slight crowding in the lower anterior. spatula, then the appliance indicated is: The clinician should: 2) Inclined plane b) spring 4) Observe him after 1 year ) Fixed appliance) Tongue blade 5) Obtain study costs and perform arch-length analysis, (Pst -99) ©) Observe him after 6 months 27. Iman early mixed dentition case with insufficient space 4) Delay the treatment until all permanent teeth erupt in the anterior segment for erupting permanent lateral (P51 -99) incisors, what treatment is indicated: 18, An B-year old child has end-on-end molar occlusion, The 2) No treatment clinician should: b) Disc the proximal surface of permanent incisors to reduce 4) Observe and wait for the other permanent teeth to erupt the space required ') Do the distal disking of 2* primary molar )_Dise the deciduous cuspids )_Batrat the 1 primary molars ) Extract the deciduous euspids 4) Serial extraction (AIPG -02, Pr -02) (P61-99) 28. Retention appliance should be 19, Anterior bite plane is used to correct: 2) Retentive only ») Passive only ) Anterior cross bite b) Anterior deep bite ) Passive + retentive d) Active + retentive «)_Protrusion of manillay incisors (Pst-97) 44) To depress mandibular anterior teeth in their sockets 29, Extraction of 3rd molar tooth bud in 7-9 yr old child: (AIPG ~94) 2), Improves growth of maxilla 20, Posterior bite planes are used for: 1b) Causes excessive damage to the mandible a) Correcting anterior cross bite ©) Results of future orthodontic treatment are improved 5) Developing anterior cross bite anterior teeth ) Comecting posterior cross bite 4) Results in less crowing 44) Developing posterior cross bite (Alms -96) (AIPG -97) 30. Interceptive and preventive orthodontics cannot be 24. Anterior bite plane incorporated in orthodontic carried out after eruption of appliances functions to: a) Second premolars b). First molars a) Disocclude posterior teeth ¢) Second molars 4) Third molars ) Disocelude anterior teeth (APG -95) )_ Prevent maxillary posterior teeth ftom supra- erupting 34. A deficiency of 6-8 mm usually requires extraction of: 4) Primarily prevent mandibular anterior teeth from 2) First molars 'b) Second premolars supraeruption ©) First premolars 4) Second molars (IPG -95) (KAR -01) 22. not indicated to 32. Overbites must be reduced during the frst stage of class 11/ I treatment to a) Transient class 2 malocclusion a), Prevent traumatic overbite 8) Class 3 malocclusion b) Disengage buccal cusps )_ Thumb sucking habit 4) All of the above ¢) Allow lower space to close (AIIMS -91,94) &) Permit ful overjet reduction 23, A 10-year-old child reports with loss of primary lower (Kar -98) 2nd molar. His occlusion is normal. The clinician should: 33. Anatomic cross bite in contrast to functional cross bite ) Construct suitable RPO usually demonstrates: 8) Place a functional space maintainer a}, Smooth closure to centric occlusion ©) Make a distal-shoe space maintainer b) Deviated closure to centric occlusion 4) Base his choice of treatment upon Xcray findings ) Marked wear facets d) Symmetrical arches (Pot 99) (AIPG -91) 24, The best time to correct a maxillary central incisor cross 34. Single tooth cross bite can be treated by: bite i 2), Removable or fixed appliances 4) After the permanent canines erupt b) Expansion appliance ) After the permanent central incisors erupt ) Extroral elastic d) Head gear «)_ After the ugly duckling stage (AIPG -02) 4d) During the eruptive stage of central incisors 35. Anterior inclined plane should not be used for prolonged (Kar -2K,02) period because it causes 25. Inclined plane is used in the treatment of 8) Growth discrepancy 4) Developing cross bite b) Developed cross bite b) Supra eruption of posterior teeth )_ Deep bite 4) Open bite ) deepbite 4) Cross bite (Pst -99) (Pst -03) i) 818) A io) B 2%) A AYA 2) A B/D %) 0 2) B 6) A ME vc a) 30) € 31) C32) D 33) K-34) A 35) Ba | ORTHODONTICS 36. A major criterion to differentiate between true Angle's ©). Surgery in both maxilla and mandible followed by definite Class TIT and a pseudo Angle's Class III is orthodontic treatment 2) Degree of anterior cross bite 4) Extraction followed by orthodontic treatment b) Presence of bilateral cross bite (KAR -96) ©) Existence of a forward shift of the mandible during 45. A patient of 8years-old attends your clinic he has class closure 1 incisor relation upper and lower incisors shows stight 4) Occlusal relationship between maxilla crowding. Right upper and left lower primary first molars (AP -97, COMEDK -04) recently extracted due to caries Line of treatment is 37. The permanent maxillary first molar of a Byr old child 8) Extraction of left upper and right lower primary frst is to be extracted because of caries. The case can be molars to relieve crowding maintained to prevent malocclusion is by b) Extract all primary canines to relive crowding 2) Placing a space maintainer ©). Fix space maintainers ») Surgically reposition the 2° molar 4) Await until premolar erupt {)_ Let second molar erupt and drift mesillyto close the space (MAN ~98) 4d) Extract first molar on the other side to prevent midline 46. Removal of 7/7 in preference is indicated to shifting a) Mild class IT div. 1 cases (als -92) b) In adult patients 38. Prolonged retention is usually needed in c) When 8/8 are congenitally absent ) Diastema b) Mild crowding ) When 6/6 are inclined distally ) Anterior cross bite d) Deep bite (MAN -96) (PGI-03) 47. The ratio of upper anterior facial height and lower 39. Which of the following indicate extraction of upper first anterior facial height in normal occlusion cases is molars a) 60:40 b) 45355 1) When they are rotated b) When prognosis is poor ©) 55245 4) 40:60 ) For mesial movement of second molars (KAR -95) «) When they are rotated 48. High FMA angle indicates (MAN -96) a) Good prognosis —_b) Bad prognosis 40. If’ are lost due to caries at 8 years in a crowded mouth ©) Good bone growth d) Class II relation ‘5! will probably (KAR 96) 2) Impact b) Deflected palatally 49, Post-normal occlusion is ©) Deflected buccally d) Fail to erupt a) Class I with anterior crowding (MAN - 96) ») Class II malocclusion 41. To regain arch length in anterior segment by moving ) Class IM malocclusion 4) Bimaxillary protrusion incisors labially (KAR -96) 4) Cephalometric analysis have to be made before taking up 50. An example of preadjusted appliance is treatment a) Frankel appliance b) Use tongue blade therapy 20 times 1 day b) Begg’ light wire appliance ) Use of Z spring with Hawley’s retainer ) Angles edge wire appliance 4) Use on anterior bite plane 4) Andrew's stright wire appliance (ATINS -90) (KAR -96) 42. Orthodontic correction is indicated in pre-school age 51. ges best estimated by child for the following except a) History from the patient 8) Anterior cross bite b) Class IT malocclusion b) Xray of the teeth ) Narrow upper arch d) Open bite c) Heredity (KAR -96) @) Kray of the wrist 43. During eruption of Lower lateral incisors left primary (KAR 96) canine is prematurely exfoliated 52. How long should a palatal crib should be worn by a 12) Extraction of right primary canine to prevent midline shift patient being extracted for thumb sucking habit ) No treatment periodic observation only a) One week 'b) One month ) Move the left permanent lateral incisors towards midtine ©) Three months 4d) Six months or longer «é) Move right permanent lateral incisor towards midline (KAR -96) (KAR -96, AP -05) 53. The three land marks which determine skeletal convexity 44. A boy age 8 years came to your dental clinic with no are crowding in both arches. Lateral cephalogram reveals SNA a) Glabella. Prosthion and supramentale angle of 78 and SNB angle of 82 the line of treatment is b) Nasion, sella, articulare 1) Reverse pull head gear with chin cap ©) Nasion, sub spinate and pogonion b) Frankel III (n) reverse activator 4) Orbitale, anterior nasal spine and pogonion 3) © 37) CB) A 39) 8 AO) B Mt) A MB 4) A MA 45) A AA 47) 8 8) B 49) 8 50) 0 5) D 52) 0 53) C SS ==((222A Dental Pulse _ 54, Tooth movement most likely to relapse unless retention 65. Which of the following is the least stable orthodontic {is provided ins correction? a) Tipping b) Rotation 2) Maxillary expansion b) Rotations ©) Extrusion 4) Bodily movements ) Overbite @) Overet (AIIMS -91, P61 -98) (a1P6-05) 55. After correction of rotation of maxillary canine method 66. Which of the following is the important factor to be used to prevent relapse is: considered before attempting to close a midline diastema a) Frenectomy 1b) Over conection using a removable appliance? «) Supracrestal fibrotomy d) None ofthe above a) The size ofthe teeth b) Age ofthe patient (KAR -97, PGI -98, AP - 04) ) Vitality oF the teeth d) Amount of overet 56. Orthodontic correction of which of the following is most (a1PG-06) ‘easily retained? (OR) which of the following orthodontic 67. Rotational changes in the mandible essentially consist, corrections does not require reatiner appliance? of 4) Anterior eross bite b) Crowding a) Matrix rotation 25% and Intramatrix rotation 75% «) Diastema 4) Spacing b) Matrix rotation 50% and Intramatrix rotation 50% (MAN ~95, KAR -98,99,01), )_ Matrix rotation 100% and Intramatrx rotation 0% 57. Relapse after orthodontic tooth movement is due to 4) Matrix rotation 0% and Intramatrx rotation 100% 2) Supracresta gingival fibers (WCET-16) 5) Abnormal pressure habits 68, A5-year old patient with normal posterior occlusion and «)_ Improper angulation of the teeth arch length is sufficient. Midline diastema with rotated 4) All ofthe above teeth is present. How do you manage? (HAN -02) a) Frenectomy 'b) Fixed appliance 58, A corrected anterior cross-bite is retained by: ©). Check for supernumerary teeth 8) Over-correction ——_b). Normal incisor correction 4) Tes normal feature of this age )_ Hawley retentive appliance (aP-06) 4) Palatal acrylic appliance with no labial arch wive 69, Pericision is done for retaining the corrected position of (P61 -99, ALIMS- 2k) the teeth in: 59. The relapse of crowding after orthodontic treatment 2} Rotation ) Cross bite ‘occurs mainly because of: ©) Deep bite 4) Proctined incisors a) Horizontal fibers b) Oblique fibers (aP-05) «) Gingival fibers 4) Transseptal fibers 70. Name the muscle group which opposes the buccinator (AIPG -03, 05) mechanism: 60. Relapse following orthodontic correction of rotation of 2) Medical pterygoid —_b) Lateral pterygoid teeth is associated wit ) Masseter 4) Tongue muscles 8) Supracrestal bers b) Oblique fibers (xceT-07) ©) Horizontal fibers ¢) Diagonal fibers 71. The minimum incidence of cleft palate is seen in which (KAR -02, AIIMS -92, 2012) of the following: 641. Permanent retainer is sometimes needed in cases 2), Mongotoid ») Afghans ) Severe malocclusion b) Anterior eross bite )_ Negroes 4) South Americans «) Severe rotations d) Transposition {AIIMS-07) (KAR -2K) 72, Buccal coil spring used to regain space between 1st 62, According to Tweeds philosophy, the correct placement premolar and 1st molar causes following common post of which teeth is necessary to minimize relaps treatment compticati a) Lower incisors 3) Upper incisors 2) Pain ») Gingival iitation ©) Upper frst molar 4) Lower frst molar ) Tendency of 1st premolar to rotate (KAR -02) 4) Tendency of 1st premolar to intrude 63, Purpose of the post treatment retention of an orthodontic (AIIMS.07) case 73. Bonded retainers are popular in which area of dentition? 4) To allow bony changes b) To prevent tongue thrusting 2) Lower anteriors —_-b)_ Lower posteriors ‘To encourage the space closure ) Upper anteriors 4). Upper posteriors 4) Tolet the patient get used to the new functional position (COMEDK-08) of the teeth 74, Laser weldin (KAR -01) 2} Involves high heat generation 164, The midpalatal suture is most likely to open at which of b) Can be done with pure titanium the following ages of expansion? «)_ Ts not used in dentistry 8) 18 years old b) 13 years old 4) Can be done with pure gold )_ 2 years old 4) 55 years old (COMEDK-08) (AIPG-05) Sa) B55) © 58) A 57) 0 158) B59) C GO) A 6) C yA 6) A HB 65) 8 66) B o7) A 68) C68) A 70) 0 MYC 72) C73) A 7%) Bee | ORTHODONTICS 75. In periodontal compromised tooth, which tooth 4) Oblique direction movement is done carefully: (COMEDK-09) 2) Uprighting ) Intrusion 87. Which of the following drug increases the duration of )_Prociination 4) Retroctination orthodontic treatment? (scer-07) ) Phenytoin ) Aspirin 76. Resistance to torquing is produced by achieving: ©) Paracetamol 4) Vitamin 2), Buccal hook b) Truss effect (ar-10) «}_ Lingual hook 4) Proximal hook 88. The most accepted cause for late incisor crowding is ~ {COMEDK-08) 2) Late mandibular growth 77. Kesting positioner is a b) Pressure from third molar 2) Retainer b) Fixed device €) Lack of normal attrition } Removable appliance d) Functional appliance 4) Lingual eruption of mandibular incisors (MCET-10) (KceT-09) 78. Ideal Time to start an orthodontic treatment is? 89, A 12-year-old boy reported with a class I and div 1 8) Primary Dentition b) Early Mixed Dentition malocclusion with proclined upper incisor and deep )_ Late Mixed Dentition bite, Intraoral examination revealed 2 bilaterally 4d) When the malocclusion frst seen symmetrical face, convex profile, potentially competent (P6-08) lips with normal incisor display during rest and smile. 79. Whip spring is used for correction of. Cephalometric finding showed that the patient had 2) Rotation b) Proclination a horizontal growth direction with CVMI stage Il, <) Grossbite 4) Open bite increased overjet and normal lower incisor inclination {COMEDK-10) (comeo-2012) 80. Centre of resistance of maxilla is at - ‘A) What would be the appliance of choice forthis patient 2) Point A ) Palatal suture a) Twin block b) Activator }_ Above roots of premolar d) Maxillary Tuberosity )Bioator <) Supermarionator (MCET-10) 81. The time duration taken for the periodontal fibers to 58) What is the right time to start deep bite correction realign themselves after orthodontic treatment is with Twin Block Appliance 2) 28 days ) 90 days a) 1 week b) 2 week 6) 120 days 4) 280 days ) 3 week ) 4week {COMEDK-10) 82. Identify the term which indicate teeth or other maxillary ©) What is the best method to prevent proclination of structures too low down in the face lower incisors while treating a case with Twin Block 2) Attraction ) Abstraction appliance )_ Distraction 4) Protraction 2) Inter proximal reduction of lower incisors, (KceT-10) ) Guided eruption 83. Loss of tooth length of Premolar in case of orthodontic ) Tncisor eapping ‘treatment? «) Lip pads. 2) 10mm b) 1.5mm <) 2.0mm @) 25 mm 90. The goals of treatment for class III problems in (P6r-08) adolescents is to establish the correct buccal segment 84, Dontrix gauge is used for occlusion and 2) Measurement of wire strength a) Distal step ») Mesial step ) Measurement of force ©) Overbite ) Overjet Measurement of wire distortion 4) Measurement of wire deformation 91. Fibrotomy to prevent Rotational relapse was advocated (AIPG-10) first by 85. In normal edge and centroid relationship a) Edwards b) Peck and Peck 4) Edge and centroid are in one plane «) Ashley Howes ) Carey 5). Edge isin front of centr (comeo-2012) )_ Edge is behind the centroid 92. Permanent loss of root structure related to orthodontic 4) None of the above treatment occurs primarily at the (AIPG-10) a) Coronal third 1b) Middle third 86. In mandibular 3rd molar region, the grains of bone run ©) Atapex 4) All of the above in- (BHu-2012) 2) Bucco-lingual direction 93. Until lip competence is reached, a 3 mm of incisor ) Vertical direction retraction will reduce lip protrusion by }_Antero-posterior direction a) 1mm 6) 2mm B76) © A) 0 A 8) ¢ eye e) 8 |B) &) 8 eB a) C Be BB) A 89A) A _89B)A _89C)C__90) D1) A _92) C93) 8/A Seo ==(222A 94, 95. Dental Pulse 9 3mm 4) &mm (BHU-2012) The following is not an absolute indication for mounting {an orthodontic study cast on an articulator 4) To record and document any CR-CO discrepancy b) Torecord and document the excursive paths ofthe mandible ©), Surgical treatment planning 4d) Class HI malocclusion with severe tooth material excess cof more than 14mm (KcET-2012) Heat hardening is done in which orthodontic wire 8) Aigiloy b) Stainless steel MA 4) Nits (Pot-2011) Type ‘A’ growth pattern is a) Middle thitd of face grows faster than lower third b) Lower third of face grows faster than middle third ©) Prognosis is poor 4). Equal growth is seen _ 103. Which of the following is not used as an antiflux: 8) Graphite ») Borie acid «) Iron oxide 4) Calcium carbonate with alcohol (auIMs-2012) Which of the following has strong familial inheritance: 4) Functional lass Tb) Class I type T ) Glass IT div ) Class IT div 1. (AIIMS-2012) AA boy of chronologic age 9 years is 125 cm in height. Mean height for the age is 133.71 cm with a standard deviation of 5.49 cm. The skeletal age is assessed as 8 years. The boy may be regarded as. 8) Somewhat physically retarded with the potential to catch up bb) Severely physically retarded with little potential to catch up ) At the right level 4) Destined to be a short-statured individual 106. 105. (a-2013) 97. Minimum time period 106, Among the following which one is considered as treatment in a tooth with root fracture ‘pathologic problem’ which planning treatment in 4) 3 months b) 6 months orthodontics? ©) 9 months ) 12 months 8) Tendency of lower jaw and teeth to be behind upper b) Deep overbite 98. In adults seeking orthodontic treatment with esthetic ©) Minimal attached gingiva in lower anterior region appliances the following may be choices EXCEPT: 4) Decalcification ) Lingual orthodontics b) Ceramic brackets (COMED-14) ) Clear aligner therapy ¢) Titanium brackets 107. Negative space with respect to buccal corridors is an (COMEDK-2013) indication for 99. As a general rule in borderline crowding cases of a broad ttttIntrusion of maxilla b) Distlization of molar facial type ©) Expansion of arches d) Constriction of arches 4) An expansion treatment should be carried out (COMED-14) ) Extraction therapy, should be considered Root shape before and after orthodontic treatment with ©) No treatment required radiographic evidence was first given by 4) Only surgical treatment required. a) Kaley and Phillip -b) Newman and Profit (COMEDK-2013) c)_Ketchman AH ) Malmgren and Levander 100. Adjunctive orthodontics refers to (PGI JUNE-2013) 4) Corrective orthodontics in mild to moderate dental- 109. APDI is? skeletal disharmony a) 78.433.79 b) 81.443.79 ) Mild-maderate orthodontic corrections in patients with ©) 89.344.79 4) 91.243.27 periodontal and/or restorative needs (PGI JUNE-2012) 2) Moderate-severe malocclusions which requires a 110. Molar-incisor hypoplasia in primary teeth at the occlusal combination of orthodontics and orthognathic surgery level is due to developmental defect occurring during? 4) Orthodontics in patients with TM) dysfunction. a) Birth to 12 months (COMEDK-2013) b) th month intra-uterine to birth 101. Which of the following metals shows the property of ©) 22 months to 26 months twinning: 4) 24 months to 48 months 4) Stainless steel b) Nickel-titanium alloy (PGI DEC-2011) ©) Cobalt chromium dA ofthe above 1111, Tooth positioner used as a retainer in posterior teeth. (AIIMS-2012) Most beneficial effect is when? 102. In moyer’s classification of class II type D malocclusion, a) Final setting of occlusion there b) Used in uncooperative patients 4) Orthagnatic maxilla and orthognathic mandible c) Estheties ) Pragnathic maxilla and erthognathic mandible 4) Gingival margin inflammed during orthodontic treatment ©) Orthagnathic maxilla and retragnathic mandible (PI JUNE-2013) 4) Retrognathic maxilla and retrognathic mandible (ATIMS-2012, 2013) 94) 095) A 96) D 97) A 98) D 99) A f00)8 10i)S i02)C 103)8 04)D 105A 0B) 307)¢_108)C__108)B 110) 8 111) DJ ortnovontics horn — 122, Mini esthetics in orthodontics means examination of ') Teeth in relation to each other ) Facial proportions in all three planes ) Facial to body proportions 4) The dentition in relation to the face (aPP6-15) 113, Not a principle of bioprogressive therapy 4) Sectional mechanics b) Muscular and cortical anchorage )_ Over correction of malocclusion 4) All of the above (PL JUNE-2014) 124, The laser used on a crown for debonding orthodontic bracket is known as ) Thermal softening b) Thermal ablation )_ Photoablation 4) Laser debonding (PGT JUNE-2014) 115, Implants used in orthodontics are 4) Endo-osseous implants b) Transosseous implants ©). Micra implants 4) Bioresorbable implants (MHCET-15) TO 13)0 AO 185)CDental Pulse _ 11. TREATMENT PLANNING — ANSWERS =(222A “8 [Bhalph rd ed 428) 17, [Balai 3rd ed 229] Options cos bite east ae uted for conection of / posterior cross bite +R [Bhalajhi 3rd ed 43] «Epon ange Ue they can te wed fr homage oon ron noma of deciduous dention. Int the dita sure of upper ee and lower second deciduous molars are in one vertical plane. of therapy can treat most developing cross bites, For a transition to a class-I molar relation, the permanent © Option ‘C’ maxilary acrylic inclined place is an example first molars drifts mesially by utilizing the physiologic of reinforced or multiple anchorage. ‘spaces and leeway space in the lower arch. + Anterior css bites invlving one or more teeth can be treated by wing Catan apaince (omer anterior 19. ‘8 (Bhalajhi 3rd ed 437] inetned plane) and sing Anterior ite pane shoul be immed so thatthe posterior teeth ate 23.0 apart ‘D’ [Bhalajhi 3rd ed 388) 20. ‘A’ [Bhalajhi 3rd ed 299) 3.0 [Bhat 3d ed 470] 21. ‘A’ [Bhalajhi 3rd ed 437,299) ‘A [Bhaljh rd 48] Anterior bite panes oe vse n treatment of dep over bites by alwng selective eruption of poster teeth ‘5. ‘W [Bhalajhi 3rd ed 430) 2. ‘x (Balj rd 186) ‘The capillary blood pressure is 20-26qm/square cm. 23, ‘D’ [Check Explanation Below] Radiographs ae taken to know whether the second premolar (Ohloh 3d e430) is preset or not Space supervision I eta at ths peed and cae sou beaten seta second premolar ould 8. [Curkeerat singh 2st e254] erupt bef second maa If the dsteme sill persists afer eruption of pemaent ‘canines it is treated by tipping or bodily movement of 24. ‘D’ [Bhalajhi 3rd ed 233] canines followed by frenectomy. 25." [Bhalajhi 3 od ed 429] “Y [Bhaai 3d ed 428) 26. ‘A [Bhalahi 3rd ed 429) 10. ‘D’ [Bhalajhi 3rd ed 239,176] Z springs is ideal for correction of anterior tooth where — ome negative vette ses than 3m and the teeth ae ly tated 2=0.25 mm _| Proximal sining SSS | Etrction of second pense 27. °€ [Ohashi 3rd ed 239,176] = Sum | Estacion of ist premolars 28. [Bhaloh 3rd ed 466) nv : a. 0 “y [ahaa 3 Crowding in Ler anterior region in ate tees and eaty 12. °D [Bhalajhi 3rd ed 233] ‘twenties is common due to eruptive force from the third oy mmol So the extacton of thd molar nea ope ress Ines rowing 14,‘ [Ohalahi are 107] — 15.’ [Bhalajht 3rd ed 48] 31. 'C [Bhalajhi 3rd ed 176] 16. C' [ahalajnt 3rd ed 9, 293] 32. ‘D’ [Bhalajhi 3rd ed 323] Growth modication by meas of fnctional and othodntc *2 OTe rection shuld recede vee redton nde tohavea smooth mover of teeth inte fiona plane Suga conection ong masta mandblestollbe 3 rps 3 wo 425 carried out only after cessation of growth spurs or puberty Option’s is seen in functional cross bite.ee | 34. 35. 36. a7. 38. 39. 40. a 42. 43. 46 [Bhalajhi 3 rd ed 428,429] ‘8 [Bhalajhi 3 wd ed 429) If the appliance is used for more than 6 weeks it can result in anterior open bite due to supra eruption ofthe posterors, [Bhalajhi 3 rd ed 409] ‘C! [Check Explanation Below] Option ‘D' i.e. extraction of first molar on the other side is considered only when the prognosis is not good. The preferred treatment is bodily movement of second molars into the space left by the extracted tooth. [Bhalajhi 3rd ed 466) 3 [Bhalajhi 3rd ed 266, 267] ‘8! [Bhalajhi 3 rd ed 266) Early loss of 'E willecause mesial drifting of first permanent molar leaving inadequate space for second premolar to erupt. In these cases the second premolar erupts palatally, ‘and completely out of the arch. ‘x [Check Explanation Below] Before taking up the treatment, cephalometric analysis should be made to differentiate between skeletal and dental cross bites. ‘8! [Bhalajhi 3 rd ed 9] Transient class-II_ malocclusion willbe self-comected ‘because the growth spurts may change the relation between the jaws. Growth modification by means of functional and orthodontic appliances elicit better response during gronth spurts, Surgical correction of maxilla and mandible should be carried out only after cessation of growth spurts. Option ‘anterior cross bites should be corrected as soon a possible because the lingually locked upper incisors will prevent the forward growth of maxila and may result in true skeletal class-II relation, ‘'X [Bhalajhi 3 rd ed 268) Premature loss of primary canine indicates arch length discrepancy. Following unilateral loss of primary canine, the ‘extraction of same tooth in the opposite side of same arch should be considered to prevent midline shift. This is known ‘5 Balancing Extraction. Some times extraction of teeth in opposite arches are caried ‘out to preserve buccal occlusal relationship. This is known ‘as Compensating Extraction. ‘X [Bhalajhi 3rd ed 410] The SNA and SNB angles of the patient indicate maxillary deficiency and mandibular prognathism. Reverse pull headgear is given for coreection of maxillary deficiency and chin cap is given to retard mandibular growth. ORTHODONTICS 45. 46. 47. 43, 49. 50. 51. 52, Option 'C surgery is indicated after completion of growth period Le, after 20 years. “K [Check Explanation Below] The extraction of diagonally opposite teeth will prevent midline shift and relieves the crowding Ww 'B’ [M.S.RANI 3rd ed 110] Cephalometrically UFH or upper facial height is measured from Nasion to anterior nasal spine while LFH is measured from anterior nasal spine to menton. Ideal proportion of UFH is 45% of total facial height. Ideal portion of LEH is ‘55% of total facial height. Lower facial height is low in (ALIMS-13) © Growing children ‘Skeletal deep bite cases (Anterior bite plane indicated). ‘© Class-II division 2 cases. Lower facial height is increased in ‘= Long face syndrome/Adenoid facies (mouth breathers) ‘+ Skeletal open bite cases ‘B [Gurkeerat Singh 1st ed 111] FMA angle is the angle formed by mandibular plane and Frankfort horizontal plane. Normal value is 25 Degree. Increase FHA angle or high angle cases indicate vertical growth pattern while decreased FMA or low angle cases indicate horizontal growth pattern. ‘+ FHA 16°to 28° ~ prognosis is good Approximately 60% malocclusions have FMA between 16° to 28° ‘+ FMA from 28 ~ 35° ~ prognosis is fat Extractions is necessary in majority of cases. ‘© FIA cbove 35° — prognosis is bad, Extractions frequently complicate problems. “B’ [Check Explanation Below] Post narmal acclusion fs a condition where the lower dental arch appears to lie too far back in relation to the upper arc. Post normal occlusion is due to maxillary prognathism or ‘mandibular retrognathism or both. Pre = normal occlusion is seen in class-IIE malocclusion, ‘D' [Bhalajhi 3rd ed 323] In straight wite technique, the bracket contains fist, second {and third order components so that the wire need not have any complex bending asin edgewise appliance. Hence straight wire technique is known as preadjusted edgewise appliance. D' [Bhalajhi 3rd ed 161] “’ [Gurkeerat Singh 1st ed 548] Palatal crib is basically a reminding appliance that ai the child wha is willing to quit the thumb sucking habit. ists BS)Dental Pulse 53. °C [Bhaljht Sed ed 151] 54, ‘B’ [Bhalajhi 3rd ed 454] 55. 'C [Bholajhi 3rd ed 454, 396] 56. ‘A [Bhaajht Sd ed 465] Cases that | * Anterior cross ite require no | » Posterior cos bite retention * Serial Extraction procedures Vina oe (7 DzPsies Limited or | cass, and elass-tfedraction cases fetention | * Clas pon-estracton cases with dental 21th showing procinatin and spacing + Severe rotation + i ne eastern Prolonged or|* Arch expansion cases without ensuring indefinite | good occasion retention ‘© Expanded arches in cleft palate patients + Patents ehibiting abnormal musculature or tongue habits. 57.0 [Bhalahi 3rd ed 462] 58. ‘BY [Bhalajhi 3rd ed 465] Occlusion will maintain the conected crossite (COMEDK-15). 59, °C [Bhalajh rd ed 62] Relapse is mainly dve to transepal and alveolar cesta sroup of gingival fibers, which remain stitched and do nat ready readapt to the new tooth postion 60. ‘N [Bhalajhi 3rd ed 462) Percsion or creamferential.supracestal botany ts performed to counter the elapse (COMEDK=1) tendency of the stretched gingival bers Person involves surgical setorng of these bers by pasing 2 Sharp narow sage hough the ging ulus around the tooth to a depth oF 2mm apical to the abel cres 61. °C [Ohaljht Sr ed 466] 62. 'K [Bhalajht a ed 462) Tweed hes suggested that post treatment stabitty was increased when mandibular fncsrs are placed upright of Slightly etoctned over the basal bone 63. ‘W [Bhalajhi 3rd ed 460] 64, ‘B’ [Profit 2nd ed 477] Chances of successful opening of midpalatal suture is 100% before the age of 15 years. Note: Natural transvers growth of midpalatal suture continues upto 16 years in girls and 18 years in boys. 65, 66. 67. 69, 70. mn. 72. 7. 15. 76. m _ ‘B [Bhalaj ad 396) [Profitt 4% ed 464), 'N [Profit 4th ed 115] Rotation of mandibular plane relative to core ofthe mandible are called as Intramatrix rotation by Bjork, and External rotation by Profit. For an average individual with normal vertical. facial proportions, however, there is about a -15 degree intemal Rotation (corpal axis) from age 4 to adult life ( Horizontal growth pattern). OF this, about 25 percent results from matrix rotation (Rotation of the mandibular plane relative to cranium) and 75 percent results from intramatrx rotation or body of the mandible rotation, © ‘W [Bhalajhi 3° ed 454] 1D [M.S. Rani 3rd ed 98) “C [Bhalaji 3rd ed 439) Te negroid race has the least incidence while the mangoloids have the highest incidence, Cleft ip is common among males while cleft palate is more common among females. Unilateral clefts account for 20% ofthe incidence while bilateral clefts account for the remaining 20%. Among unilateral clefts, clefts of left side are seen in 70% of the cases. “C [Synopsis Point No. 64] ‘N [Profit 4th ed 626, Fig. 17-10) 'B [Profite 4th ed 674] The potential problem with intrusion in_periodontally involved adults is the prospect that a deepening of periodontal pockets might be produced by this treatment. Intrusion should never be attempted without complete contra of inflammation. © ‘RY [Bhalajhi 4th ed 499) RETAINERS CAN BE CLASSIFIED INTO: AA) Removable retainers ‘+ Hawley’s appliance ~ most commonly used + Begg retainer ‘© Clip-on retainer / Spring aligner ~ also brings about correction of rotations commonly seen in lower anterior region ‘+ Wrap around retainer ~ extended version of spring aligner that covers all the teeth. This type of retainer ‘ig not routinely used in orthodontic practice. Tt finds application in stabilizing a periodontally weak dentition.a | 78. 79. 80. a1. + Kesling tooth positioner -made up of thermoplastic rubber like material and it requires no activation at regular intervals. The drawbacks include diffeulty in speech and risk of TH) problems. + Invisible esthetic retainer ~ made up of ulta thin transparent thermoplastic sheets using 2 Biostar machine, ORTHODONTICS “B [Bhalajhi 4th ed 85) When the dental arch is closer to the Frankfort plane than normal, it is called attraction, when the dental arch or part of it is farther avay from the frontfort horizontal plane (i.e, the maxillary arch position is lower than normal), its called abstraction , . 83. ‘B’ [Proffit 4th ed 350) 8) Fined retainers Average root length change during orthodontic treatments i: * Feed annonce which as used for erthoontic FAIERIGE RCT EIT CHATTEE ‘© Banded canine to canine retainer ~ commonly used joe lower anterior region. Serial] Late | Serial | Late © Bonded lingual retainers ext, plus | ext. | ext, plus | ext, © Band and spur retainer Central inclsor a5 [20] 10 | 25 Lateral incisor 20 [2s 410 | 10 The choice of retention for lower incisors folowing Canine a0 [as] os | a0 orthodontic correction is Second premolar | 0.5 | 25] 05 | -1.8 2) clip-on retainer ©) Spring retainer 8 ant pesitower Fist molar(mesia)| -08 | -10| -05 | -15 4) Bonded canine to canine retainer 84, °B" [Check Explanation Below} “D" [check Explanation Below) Dontrc gauge isa precision instrument designed to measure The ideal te to start the orthodontic treatment depends _‘the forces used in orthodontics (AIIMS MAY- 14). It onthe type of malocclusion, For example, developing cross ‘Measures the forces of cll springs and elastics upto 16 bites should be treated at an early stage so as to prevent ounces. Dontrix gauge (sensitive 4-ounce dontrix gauge) is 4 minor orthodontic problem fiom progressing into a major used to determine the force applied by the elastics, dento-facial anomaly. An old orthodontic maxim states “the. best time to treat a cross bite is the first time itis seen’, 85+ ‘BY [Check Explanation below] Ege is the tip of crown of mast prominent lower incisor A° [SbSjournal.org/2010/volume-22-Number 1/2009- while centroid is the mid-point on root axis of most 21-01-45-50-full html) Prominent upper incisor. Whip spring i a cantilever spring used for rotated maxillary , . Snare Hoditea whip ape reals used for In Class I malocelusion the edge is in advance of centois, ‘© Disimpaction of mild to severe mesially impacted lower 52 overbite is within normal Limits je, 0-2 mm. terminal molars In Class If di. 1 malocclusion, the interincisal angle is © Flaring of anterior teeth. reduced; the edge lies in ine with or behind centroid. °C’ [Bhalajhi 4th ed 381-82} In Class IL div. 2 malocclusion, the interincisl angle is The centre of resistance of the maxilla as a whole should jncreased (AIPG-14), The edge lies behind centroid be considered when planning headgears for the patient. It is belived to exist atthe posterio-superior aspect of 66, -c° zygomatico-maxilary suture (COMEDK-14). Under clinical Conditions the centre of resistance of the dental arch, 28 27, “B? [American Journal of Orthodontics Vol120, Issue 3, whole should be considered. This is located between roots ‘of the premolars. Forces passing through the centre of resistance of the maxilla produce translation of the maxila| in a distal direction while forces passing above or below this point cause rotation of the maxi Not The centre of resistance for a molar is usually at the mid root region. “BW [Profitt 4th ed 628] After orthodontic treatment, the reorganization of periodontal ligament occurs over @ 3 to 4 months period. Pages 364-370] Various promoter drugs: + Prostaglandins * Leucotriens Cytokines + Vitamin D © Osteocalcin + Corticosteroids {enhance bone resorption) ‘Supressor agents: (Reduce bone resorption) + NSAIDS ‘+ Biphosphonates (used in treatment of cancers and osteoporosis)898. Dental Pulse ‘The duration of orthodontic treatment is usually 18 months, which can be reduced by applying promoter agents locally near the moving unit (e., anteriars). Similarly, the suppressor agents can be delivered locally near the anchor unit (ie., molars) to enhance anchorage and retention. Comparative studies on aspirin, acetaminophen and Ibuprofen have concluded that aspirin and Ibuprofen diminished the number of osteoclasts, probably by Inhibiting the secretion of prostaglandins, thereby reducing ‘orthodontic tooth movement. Acetaminophen did not affect orthodontic tooth movements Selective cyclooxygenase-2 inhibitors are tried as an alternative to conventional non-steroidal anti-inflammatory drugs. Multiple animal studies have concluded that celecoxib and parecoxib (but not rofecoxib), are appropriate for discomfort and pain relief while avoiding interference during orthodontic tooth movement. Which of the following drugs effect orthodontic treatment? (PGI Dec-2013) 2) Aspirin ©) Metronidazole by Tetracycline a) Amoxicitin ‘W [Profit 4th ed 126] In modern populations, there is a strong tendency for crowding of the mandibular incisor teeth to develop in the late teens and early twenties. Tree major theories to account for this crowding have been proposed a) Lack of normal attrition in the modern diet. b) Pressure from t ©) Late mandibular growth, molars. The current concept is that late incisor crowding almost always develops as the mandibular incisors, and perhaps ‘the entire mandibular dentition move distally relative to the body of the mandible late in mandibular growth, ‘x [Proffit 4th ed 511, 535] © Class It iv Proclined upper incisors, convex profile Normal lower incisors Deep bite Competent lips Horizontal growth pattern ie, the patient has combined vertical and antero-posterior problem. The two ways to correct this is use of cervical headgear and functional appliance. Functional appliance is preferred ‘as there are mandibular deficiencies. The twin block is the most acceptable functional appliance which can also be fixed to the teeth by bonding. Twin block corrects both deep bite and mandibular horizontal growth pattern. Lips are competent and there is normal incisor display- Indicating maxillayy skeleton is normal and there is deficient mandible, Functional appliance has to be given. —e The thitd stage comesponds to acceleration of growth at peak height velocity. Only 25% to 65% adolescent growth expected, So Twin black has to be given over activator. 'N (Proffit sth ed 535] If class II malocclusion occurs along with deep bite i.e. combined vertical and A-P problems, first deep bite should be addressed then after the anteroposterior correction should be planned. soc. “C [Profft 4th ed 535] 90. ‘0’ [Bhalaji Sth ed 503] 91. " [Proffit 4th ed 615] 92.‘ [Profit 4th ed 349] 93, '8/A [Proffit 4th ed 283] The answer is ‘8 according to Profft 4th ed Pg 283. As a general rule, the lips will move two-thirds of the distance that the incisors are retracted i.e,, 3. mm of incisor retraction will reduce tip protrusion by 2 mm, but only until lip competence is reached, But more authentic book by Ameet and Mc Lauglin has mentioned a ratio of 3:1 and many standard articles mentioned this same ratio. So according to me 3:1 is also a correct option 94, ‘D’ [Profite 4th ed 193) Whether it is necessary or even desirable to mount casts on ‘an adjustable articulator as part of an orthodontic diagnostic evaluation is # matter of continuing debate. There are two reasons for mounting casts on artiulators. The first is to record and document any discrepancy between the occlusal relations at the initial contact of the teeth and the relations at the patients full or habitual occlusion’ The second is to record the lateral and excursive paths af the mandible, documenting these and making the tooth relationships during excursions more accessible for study. In cate of orthognathic surgeries- Using prediction tracings ‘a a guide, a surgical plan i formulated and then the surgery is simulated on articulated working models. 95. 'N' [Profft’s 4th ed 361] Elgiloy (Cobalt-Chromium) alloy is supplied in a softer state and can be heat hardened. After hardening heat treatment, the softest elgilay becomes equivalent to regular stainless steel 96. 'D’ [Ref. Samir E, Bishara (2000) Facial and Dental Changes in Adolescents and their Clinical Implications. The Angle Orthodontist: December 2000, Vol 70, No. 6, Pg 671-483] Tweed differentiated facial growth trends into three basic types: + Type A Balanced growth-middle third and lower third equal growth fs seen horizontally as well as vertically. Both of them proceeds unison. ANS is constantee | 97. 98. 99. + Type 8 - Vertical growth the middle face grows forward with the cranial base and mandible lags behind. Point B cannot catch up the point A. These cases have poor prognosis. ANB increases + Type C = Horizontal growth patterns. Mandible or lower third grows more forward than the maxilla, ANB decreases. He believed that extractions were mandatory in vertical. ‘'X’ [Ref. Susan A. Kindelen Dental Truama Orthodontic Management- Journal of Orthodontics- Vol 35-2008 Pg 68-78] Recommended observation periods prior to orthodontic treatment Crown and erown/roat ORTHODONTICS 100. °B [Carranza 11th ed 505] Orthodontic tooth movement can provide several benefits to the adult perio-restorative patient. This is called as adjunctive orthodontics. Advantage: a) Aligning crowded anterior teeth, permits better access for oral hygiene procedures. b) Vertical orthodontic tooth repositioning can improve certain types of osseous defects and eliminates the need for resective osseous surgery. ©) Improve the esthetics of the maxillary gingival margin levels before restorative dentistry. 4) Forced root eruption of severe fractured maxillary anterior teeth allows crown preparation to have sufficient resistance and retention forms fe) Open gingival embrasures can be corrected with @ ee ea Sas combination of orthodontic root movement, tooth involvement, reshaping and restoration. Crown and _crown/root | Coranol pulpotomy and fractures with pupal wait til raciographie | 101. “B”[orthodontics ~ Curent principles and techniques by ‘avlvement barrier is Formed Graber 4th od 351] (enproximately 3 Twinning: months) Certain metals, when they crystallize in the hexagonal Root fractures with good close packed structure, deformation occurs by twinning heating—without inner year + Ieis a movement that divides the cxystal lattice into 2 position of connective tissue symmetrical parts and these parts are no longer in the Root fractures with good same plane but ata certain angle healing—with inner position + NicTi alloy exhibits twinning throughout the meta af connective. tissue and 2years When these alloys ae subjected toa higher temperature, delayed healing even after a detwinning wil take place, andthe alloy reverts to its endodontic therapy original shape and size. Minor periodontal injuries atten, oneacion titel arr 102. ‘C' [American journal of orthodontics] (Lunation, extrusion, Lateral ‘months Moyer classified class II malocclusion and divided into 2 luxation , subluxation) ? categories, horizontal and vertical types. Tere are subgroups Najor periodontal injuries [= Tdeal fs 1 year -f na in horizontal types of class TI malocelusion. They are (severe lateral uration or | _ sans of ankylosis displacement, Tntsion, | « Atleast of 6 months isa alata pal None eae eee | Re ere T9PeA | protraction with normal mandibular dentition = Prognathic maxilla and normal (orthognathic) Wait root end formation Type B | mandible Immature traumatized teeth | observe at 6 months, 1 mature vaumati ae Type C | Maia as well as mandible are retognathic raion ETRE | RSENS Type D | Retrognathie mandible and orthognathic maxilla caries periapical pathosis Type E | Prognathic maxilla and mandible iy Not well defined group. Less severe than type B, 1 [Bhalasi 4th ed 329] Type F |, D and E. The mandible and the midface may Titanium brackets display metal and are not esthetic, be sal, ‘x [Gurukeerat Singh 2nd ed 68] 303. 'B'[Manappallit 2nd ed 393] ‘The type of facial morphology has a certain relation to the shape and treatment of dental arches + Euryprosopic face types have broad square arches with bordertine crowding. These cases should be treated by expansion, + Leptoprosopic face types have narrow apical base/ arches. Therefore extraction is preferred over expansion, Antiflux is a material used to restrict the flow of solder during the soldering procedure. Eg. Graphite, iron oxide (rouge), calcium carbonate in alcohol hor) —104. 105. 108. 107. 108. 109. 110. Dental Pulse ‘D’ Plournal of Orthodontics 1999;26: 195-203.] © Deep bite (Class II div 2) Class III malocclusion (Skeletal) + Open bite ‘'X (0 child orthop. 2010; 4(5):467-470] ‘The child is retarded to a small extent based on the standard average for his age. But he can definitely eatch up with the mised dentition growth spurt (@- 11 yrs) and adolescent growth spurt (14-16 yrs) {A child with skeletal age (SA) within + 1 year of chronologic ‘age (CA) is generally classified as average or “on time: If SA is in advance of CA by more than 1 year, the child is classified as early maturing or skeletally advanced. If CA is in advance of SA by more than 1 year the child is classified as late maturing or skeletally delayed ‘C [Graber 3rd ed 920] ‘The history, examination and collection of appropriate records are required to identify the problems in any case Tis list of problems helps to formulate a diagnosis. Problems can be divided into pathological problems and developmental problems. Pathological problems are problems related to disease, such as caries and periodontal disease, and shall be addressed before any orthodontic treatment is undertaken, * Developmental problems are those factors related to the malocclusion and make up the orthodontic problem list. “C [Graber 3rd ed 76] Buceal corridor space is defined as visible maxillary dentition vwidth/ Oral aperture width. The buccal corridor is measured from the mesial line angle of the maxillary fist premolars to the interior portion of the commissure of the lips. So negative buccal corridor space indicated mesial-distal width fof teeth is less of oral aperture is wide; so arch needs expansion, 'C [Ketchan AH 19272. A preliminary report of an investigation of apical root resorption of vital permanent teeth. Int. Journal of Orthodontia 13:97-127] 'B! [Check Explanation Below] The APDI (antero-posterior dysplasia indicator) scores the antero-poster skeletal relationship and will be obtained from three angles, the facial angle, the palatal plane angle and A-B plane angle (the facial angle plus or minus the AB plane angle and again plus or minus the palatal plane angle). The mean value of APDI in normal occlusion was found to be 81.623.79, ‘B [Practical Pediatric Nutrition by Poskitt 1998 year ed Pg 161) ‘© The most common dental complication of problems in utero is enamel hypoplasia. The deciduous teeth most effected by hypoplasia are maxillary incisors. They are _ the frst teeth to start calcification, between the 31d-4th ‘months of intrauterine life. Amelogenests of deciduous incisors is nearly completed at term birth. ‘+ Minera is deposited in the matrix formed by ameloblastic activity from the fourth month of intrauterine life to form ‘the enamel of the deciduous teeth (which is nothing but, 10-12 months in ease of molars and incisors). Any severe illness in the mother is likely to be reflected in diminished armneloblastic activity. 111. 'D’ [Proffit Sth ed 596, 615] An alternative to segmental elastics o ight around archwires for final setting is a full arch tooth positioner. A positioner is most effective if itis placed immediately on removal of the fixed orthodontic appliance. 1 i fi 7 archwites has two advantages. ‘+ Teallows the fixed appliance to be removed somewhat ‘more quickly. ‘+ Te serves not only to reposition the teeth but also to massage the gingiva, which is almost always atleast slightly inflamed and swollen after comprehensive orthodontic treatment. The gingival stimulation provided by a positioner is an excellent way to promote a rapid return to normal gingival contours. Disadvantages of using positioners for finishing ‘© The appliances require a considerable amount of laboratory fabrication time and therefore are expensive. ‘+ May increase over bite. ‘© Does not maintain the correction of rotated teeth wel © Good cooperation is essential ‘© Gingival condition with more than the usual degree of inflammation and swelling at the end of active orthodontics. = An open bite tendency, so that settling by mild depression rather than elongation of posterior teeth is needed. Positioners as Retainers: A tooth positioner can also be used as a removable retainer. Positioners are excellent finishing devices and under special circumstances can be used to an advantage as retainers. In fabricating a positioner it is necessary to separate the teeth by 2to 4mm. The advantages of positioner over retainer arez ‘+ Temaintains the occlusal relationships as well as intra arch tooth positions. ‘+ For a patient with tendency toward class-IIl relapse, positioner made with the jaws rotated somewhat downward and backward may be useful.ee | 122. 123. The_major_problems of using a positioner _as_good retainer: The pattern of wear of positioner does match the pattern usually desited for retainers. © Patients will have difficulty in wearing because of its bulk. In fact, positioners tend to be warn less than the recommended 4 hours per day * Positioners do not retain incisor irregularities and rotations as well as standard retainers. * Overbite tends to increase while a positioner is being wor during finishing ‘D' [Proffit 5th ed 241] Macro-esthetic in orthodontics means correction of facial disproportions through camouflage, orthognathic surgery ‘and cosmetic facial surgeries. Mini-esthetic treatment aims {at enhancing the smile by correcting the relationship of the teeth to the surrounding soft tissues on smile, ‘D’ [Check Explanation Below] Biogressive therapy is not strictly an orthodontic technique but, more importantly, it encompasses a total Orthodontic philosophy. Bioprogressive therapy accepts the treatment of the total face rather than the narrower objective of the teeth or occlusion as its mission, Dr Murray Rickets was the man responsible for the development of this approach to ‘orthodontic care. ‘The use of systems approach in diagnosis and treatment by the application of the visual treatment objective in planning treatment, evaluating anchorage, and monitoring results ‘The availability of torque control ‘throughout treatment. ‘Muscular and cortical bone anchorage. Movement of all teeth in any direction with the proper application of pressure (Force per unit area). Orthopedic alteration - Point A control. Managing treatment to unlock the ‘malocclusion in a progressive sequence and establish more normal function and growth ‘Treat the overbite before the overjet correction. Principle #1. Principle #2. Principle #3 Principle #4 Principle #5, Principle #6 Principte #7 Sectional ach therapy with utility arch Principe #8 | mechanics. Principte #9 | Concept of over treatment. Efficiency in treatment with quality Principte #20 | results utilizing a concept of pre- fabrication of appliances. ORTHODONTICS 114.0" 57] Laser bedonding: Debonding of brackets is one of the most important procedures carried out after the active fixed mechanotherapy. Debonding of ceramic bracket is difficult and often results jn fracture of brackets. Studied proved that application of lasers in debonding of brackets not only helps in debonding of metal brackets but also makes easy of ceramic bracket debonding and prevents fracture of enamel. ory of Orthodontics by Basav Raj Phulari 1st ed 115. 'C [Bhalajhi Sth ed 270 last line] Implants can be used as temporary anchorage devices in patients who have lost many teeth or hypodontia. The Implants used for this purpose are known as mini-implant, ortho-implant, microimplant, miniscrens, skeletal anchorage devices or microscrews. (Ss) =Dental Pulse ORTHODONTICS — SYNOPSIS 1, Scientists in orthodontics 8. Thedifference between the amount of space needed fr the accomadation of nisorsand the amountof space available * Father of modern orthodontics, " . See rere ieee is called incisal ability. The incisal bility is roughiy See award about 7rum in maxillary arch and Smm in mandibular ach « Edgewise appliance tangle © E-arch apptonce e 9. Ugly duckting stage is a self-correcting or transient Sa aoe falacisin ee nay ela region a the ge ‘Acid etch technique Buonocore ¥ Straight wire appliance ‘Andrews | 10. Primate spaces or simian spaces oranthropotd spaces are seen mesial to maxillary canines and distal to mandibular Activator ‘Anderson canines these spaces help in placement of te canine cusps Divisions in angles lass-T and » Stim opposion anh, class-IIl occlusion mee Substitution of elssl, and Il of angles 11, The diference between combined mesiodstal width of elassfication with terms neutro occlusion, | Lischer deciduous canines and molars to combined mesiodstal disto occlusion and mesio occlusion width of permanent canines and premolars i called leeway sical removable appliance with acrylic space of Nance, Classical removable appliance with ser | yaytey plate and labial bow 12, The amount of leeway space is about 3.4 mm (1.7 mm on Twin-block aptiance witiam Gar tach side of arch) in mandible while its value fs 1.8 mm Visual treatment objective (VTO) Rickets (0.9 mm on each side of arch) in mail Beta hypothesis to beak oral habits | Dunlop s Split plate for maxillary expansion Schwartz, © The adult human body contains 206 bones. Chin Cap Oppenheim '* The skull at birth contains 45 bones. Term orthodontics was coined by Le foutoun Adult sll is made of 22 bones (14 fecal bones and 8 eerie cranial bones) * Classification of anchorage preparation | ryseg 4 Total vertebrae in human body are 33, (7 cervical + 12 eicentacsccon nasi thoracic +5 lumbar +5 sacral + 4 Coceygeal) * Mandibular incisor school of retention * Total no of cranial nerves - 12 pairs '* Total no of spinal nerves - 31 pairs (8 pairs cervical + Andreason applianceisalso knowns (COMEDK-2033) 12 pairs thoracic + 5 pairs lumbar + 5 pais sacral + 1 ‘Ans. Activator pair coccygeal) ‘ + Total no of ribs ~ 12 pairs (fst seven pairs are true ibs 2. The stains used in vital staining technique (Belchier) are serine costs pancurs fate nish Alzarin, Typton blue, Tetracycline, lead acetate ete ead oai ce tao es Regn ribs 5 The mad denton period cans cases ito tree 34, Grout of face is completed inthe folowing sequence i.e transitional period, second transitional period. 1s width followed by depth and height. 4, First transtional period is characterized by the emergence al Supplemental of first permanent molars and the exchenge of deciduous cee ers incisors with the permanent incisors SSE] SEE sonal peri ie velath + Cinieak + Ocelusograms 5, Inter-transitional period is relatively stable and no change ners ° ¥ 8 ‘examination ‘= Hand wrist radiographs + Study models | « Endocrine tests ©. The second transitional period is characterized by + 102A, Bite |» biagnostic setup replacement of deciduous molars and canines by premolars wing, panoramic | « Electromyographic examination and permanent cuspids. radiographs of muscle activity. + Facial photographs |» Physioprnts. 7. The shift in lower molar from a flush terminal plane to 2 class- relation occurs in two ways early shift occurs by 16, IN CEPHALOMETRY utilizing primate space while later shift occurs by utilizing the leeway space. ‘The exposure parameters are usually 75-80 KVP, 7-8 MA and 0.8 Sec.SEE A ORTHODONTICS SYNOPSIS Wo 107 ) The distance between X-ray film and mid sagittal plane OTe SaCoe 5S of patient head is 18 CM or 7 inches. ae eee are + The distance between X-ray tube and midsagital plane ‘rom nasion to point A and A of patents head is 5 feet /60 inches/162.4 CM. tine from point A to pogonion, + A magnification of 57% is considered normal (PGI 05). “The average value fs 0° while ‘the range is 0+ 10°. Formed by Intersection of the mandibular plane with the FH plane 17. Anatomic landmarks are those that represent actual anatomic structures of the skull. Derived landmarks are those that have been obtained from anatomic structures in cephalogram. ‘+ Value is 22° in Down's analysis, 32° in Steiner's analysis and 25° in tweed analysis. eee * tlasion “+ Anterior nasal spine (ANS) ‘+ Subspinale (Point “®}) + Supramentale (Point ‘B’) + Superior and inferior « Articulare ‘© Angle obtained by joining the prosthion. + Pterygomaxillary sella gnathion line with the FH '* Gonion, pogonion, menton, | fissure plane. Gnathion, condylion + Porion 12 Value is 59° (53 to 66*) f Ration «ey ridge. 18. All anatomic land marks except Gonion and condylion are Unilateral, Gonion and condyiion are bilateral in nature, 19. Derived landmarks are bilateral in nature 20. ‘Average angle is 87.8° while the range is 82° to 95° ‘Formed by intersection of Nasion = pogonion plane with FH plane a Clinical Features * Proctined upper incisors with a resultant increase in over jet «Hyperactive mentalis and buccinator activity and Hypotonic lip * Veshaped narrow upper arch with deep palate ‘Malar process not prominent * Normal path of closure *# Convex profile * Lip trap without lip seal is present Class | © uring assessment ofanterior- posterior elation of upper and lower jaws by two-fngr test the index finger Division-1 is anterior to middle finger and the hand point upwards. (Post marmat | « peep matlab csr ten and he acai angle < 10% Cephalometric features ‘Decreased facial angle (< 88°) ‘Increased angle of convexity or postive angle (> 0°) ‘Increased angle of Y-axis (>59°) + Interincisal angle is reduced due to proctined upper incisors (<135.4°) ‘Increased SNA angle (82°) ‘Increased ANB angle (>2°) + Decreased SNB angle (<80°)SO) AAA dental ese ‘Clinical features + Presence of lingually inclined upper central incisors and lalaly tipped upper lateral incisors. Deep bite or closed bite most consistent and damaging features. «© Squarish, U shaped maxillary arch + Normal lip form, Normal palatal form, Normal muscle activity asst | « Convex profile Division-2 | « Lower factal height is decreased (etter) Malar process is prominent + Backward path of closure is present due to excessively tipped central incisors. + In to finger test, the hand point upwards Cephalometric features ‘+ All are similar to class-II division-1 case except that the interincisal angle (> 135.4*) is greater in class-II division 2. * Narrow upper arch due to lowered tongue position + The lower incisors tend to be lingually inclined + Reduced overbite is the most damaging feature of class-IIT ‘+ In two finger test, the middle finger is ahead of the forefinger or the hand points downwards * Concave profile Cephalometric features Class-I11 : recnormat | ° Facial angle is increased (> 88°) ‘ocelusion) | * Decreased angle of convexity or negative angle (< 0°) is present * Decreased SNA angle (<82*) «= Increased SNB angle (> 80°) ‘Negative ANB angle (<2*) + Increased gonial angle + Positive AB plane angle + The angle of Y-axis is smaller in class-III patients than in class-II patients Class-IV | Presence of class-l on one side and class-LIl on another side Class-1 | » Decreased interincisal angle is seen bimaxillary | 6 shallow mento labial sulcus. protrusion ‘ Increased lower anterior facial height and decreased upper anterior facial height. + Patient may have short upper lip with excessive maxilary incisor exposure + Increased gonial angle with marked antegonial notch * Short mandible ‘Increased mandibular plane angle (High FHA) with vertical growth pattern «Fish mouth appearance. Open bite ‘+ Most of the horizontal planes such as mandibular plane, FH. plane and SN plane are parallel to each other. Deep bite | + Decreased mandibular plane angle (Low FMA or ow angle cases) with horizontal growth pattern «Reduced anterior facial height = Angle of Y-axis is smaller than normal Nevizontal | « oy FMA angle i the Frankfort plane and mandibular planes mest beyond the ociita eon “ * Reduced anterior facial height. * Increased anterior facial etght Vertical | igh tA ange. the wo planes met nit the octal ein «Angle of Y-axis is greater than normalSEE A ORTHODONTICS SYNOPSIS Wee — 22, 23, 2 2. 2. a. 28, a. Saddle angle:- (N-S-Ar) Formed by joining nasion-sella-articulare for assessment of relationships between anterior and posterior cranial bases; thus a large saddle angle signifies a mandible, that is posteriorly positioned with respect to cranial base and maxilla, Large saddle angle cases are difficult to influence with functional therapy. Articular angle (S-AR-GO) is large if mandible is retrognathic but small if mandible fs prognathic Increased gonial angle is seen in class-IIL malocclusion, In patients with large gonial angles, functional appliance treatment are generally contraindicated Curve of spee: It refers to anterir-posterior curvature of the Occlusal surfaces beginning at the tip of the lower cuspid and following the cusp tips of bicuspids and molars continuing as an arc-through the condyle. If the curve is extended it would form a circle of about 4 inch diameter Curve of spee in mandibular posterior is concave. According to Andrews, a normal occlusal plane should be flat with the curve of spee not extending 1.5 mm Curve of Wilson: This is a curve that contacts the buccal and lingual cusp tips of mandibular teeth. It isa crossarch, cross-tooth curve indicating the height difference between supporting and non-supporting cusps in occlusion. Lingual inctination of mandibular molars isthe basis for the curve of Wilson i.e the curvature for the mandibular teeth ive concave and that of maxillary teeth is convex. Curve of Manson: Monson connected the curve of spe and curve of Wilson and suggested that the mandibular arch is adapted itself to the curved segment of a sphere of 4-inch radius. Bennett's Classification ‘Abnormal position of one or more teeth due to local causes ‘Abnormal formation of a part or whole of ‘either arch due to developmental defects ‘of bone ‘Abnormal relationship between upper ‘and lower arches and between either arch ‘and facial contour, due to developmental defects of bone Incisor classification Mandibular incisor edges lie immediately bbelow the cingulum of maxilary central incisors. ‘The mandibular incisor edges lie posterior ‘to cingulum of maxillary centrals. Maxillary central incisors are proclained. 30. a1. 32 33. 34, 35, The mandibular incisor edges lie posterior to cingulum of maxillary centrals. The central incisors are retroclained The mandibular incisor edges tie anterior to cingulum of upper centrals ‘CANINE RELATIONSHIP * Class-1: The mesial incline of upper canine overlaps the distal incline of lower canine, © Class-II: As the masillary arch is placed forward, the distal incline of upper canine contacts the mesial incline of lower canine. © Class-IIl: The lower canine is placed forward to the ‘upper canine and there is no overlapping. MALOCCLUSION INDICES Selects subjects with severe occlusions and dento-facial ‘anomalies + Applicable to permanent dentition only ‘First orthodontic index designed to meet administrator needs of ‘program planners. * Estimates severity of malocclusion « Serves as guide for epidemiological ‘surveys of populations as well as instrument for screening ‘Also known as (IOTN INDEX) ‘Measures treatment need Diagnostic setup was first proposed by Kesling. Diagnostic setup is commonly useful with Bega's technique. + Kesling diagnostic setup + Kesling spring separator + esting tooth positioner + Keslings wrap-around retainer Electromyography is used for recording the electrical activity ‘of the muscles. Kinesiology is the study of movements resulting from action of muscles. Visual treatment objective (VIO) helps in realizing the therapeutic goals and to motivate the patient to co-operate by making the patient to realize the esthetic improvement that could be brought about by the functional appliance therapy. Vogel gesicht is the inhibited growth of mandible due to ankylosis of TMJ which may be due to developmental defects or due to trauma at birth——( 110 AAA 36. 37. 38. Dental Pulse Physioprint is analogous to finger print. The purpose of physioprint is to obtain three-dimensional picture of the face. Physioprint helps in distinguishing one face from the other as the contour and dimensions af no two faces are alike * Ponts index Model analyses of maxillary | * Linder harth index arch * Korkhaus analysis + Arch perimeter. * Careys analysis * Hison-old father * Peck and peck index: * Total space analysis «Staley kerber analysis Model analysis in both | ¢ Bolton’s analysis arches + Ashley Howe's analysis + Huckaba's analysis: * Hixon & old fathers + Nance carey’s analysis * Moyer’s analysis + Tanaka-Johnson analysis * Total space analysis Model analysis of ‘mandibular arch Mixed dentition analysis The best prediction of tooth size in cast analysis is given, by Staley-kerber methods Analysis, which says that ‘malocclusion, occurs as a result of discrepancy between arch length and tooth materia. © Carey's analysis * Arch perimeter analysis Crowding is due to deficiency in arch width rather than arch length Ashley Howe's analysis Many abnormalities are due to abnormalities in tooth size, Bolton’ analysis ns Moyers analysis | L2¥e" incisors width + reference table Required radiographs + reference Hvon and old father | fo" Required casts, radiographs Staley and kerber | and prediction tables used for screening population Required no radiographs and Tanaka and Johnson | A cbtes Nance model nalysis | Required casts and radiographs. Huckaba’s analysis | Total space analysis aa. 40. 41 4 4a 44 4 46 a Peck and peck index:- ©The mandibular incisors in persons with no crowding wil hhave smaller mesiodistal width and large labiolingual width than in persons with incisal crowding. The proportion of the mesiodistal width of each tooth to ‘the labio Uingual thickness is calculated using the formula MOM, x 100 TW ‘Mean value for lower central incisor should be 88 to 92%. Mean value for lower lateral incisor should be 90 to 95% IF the calculated value is greater than mean value, it indicates that the mesiodistal width is more than labiotingual width and hence proximal stripping Is indicated, Total space analysis by Merrifield: Requires study casts and cephalograms * Divides the lower arch into anterior, middle and posterior areas * The discrepancy for each area is calculated and the resultant value is added to yield the total discrepancy of the arch Accepted theories of tooth movement are Pressure tension theory by Schwarz © Fluid dynamic or blood flow theory by Bien Bone bending piezoelectric theory Transpalatal arch, upper inclined plane and orthopedic appliances are examples of reinforced or multiple anchorage. Some of transient malocclusions a Transient skeletal class-I1 + Open bite seen in gum pads © Rush terminal plane * Ualy ducking stage © First deep bite Second deep bite The fixed distal shoe space maintainer (intra-alveolar appliance), which is in practice, now is Roche's appliance. Early loss of deciduous teeth will resut n delay in eruption ‘of permanent successor, Exercise for Clenching of the teeth by the patent massetor muscle _| while counting to ten. © Button pull exercise Lips exercises a + Tug of war exercise * One elastic swallow + Two elastic swallow Tongue exercises ie + Hold pull exercise # swallowa | ORTHODONTICS SYNOPSIS Wo Te 4. 48. 49. 50, 51 52, 53, 34, 55, 56. 57. 58, 59, 60, * Useful in disto occlusion cases ‘The patient is asked to protrude ‘the mandible as much as he can ‘and then retract. This is repeated till the person is tired. Proximal stripping is contraindicated in young patients (due to large pulp chamber) and in patients with high caries index. Proximal stripping should reduce not more than 50% of the enamel thickness Pendulum appliance is an intra-oral distalization appliance used for space gaining. It is mostly used in patients with class I skeletal relationship and class II dental relationship. Rotated posterior teeth occupy more space than normal teeth, Rotated anterior teeth occupy less space than normal teeth, “orthometer” is used to read the ideal arch width in premolar and molar region directly Orthometer was devised by korkhaus. German measles during first trimester of pregnancy can cause cleft lip/clft palate, “Cineflourography" and “payne technique” are used in diagnosis of tongue thrusting. "Salamar structures was the first to classify the underlying skeletal Discrepancybetweencentricrelationandcenticocclusionhas been found tobe the mast common trigger factor for bruxism, The second deciduous molar is the most common toath to get ankylosed, Tongue tie is due to abnormal (ingual frenum or short genioglossus muscle With an optimum force of 20 ~26 gms/sq.cm. of root surface area, the rate of tooth movement should not exceed Imm/ month, joth movement ‘© Initial smal tooth movement ‘© Lag phase where no tooth movement occurs ‘© final large tooth movement The lag phase is directly related to amount of force applied, Tooth movements like rotations require prolonged retention as the supracrestal fibers stretch and undergo readaptation slowly. They take a very long time to 232 days as more for their reorganization. In this case, percision or circumferential supracrestal {fibrotomy (Edward's technique) (KCET-11) is performed, where the gingival fibres are incised to prevent relapse, 61. 62. 53, 64, 65. 66. 67. 68. Percision is performed under local anesthesia with No.1 knife, Orthopedic treatment should be started as early as in deciduous dentition or at about the age of 8 Yk years when the maxillary incisors are erupted and the roots are formed. Reverse pull headgear is also known as Iric and Nakamura appliance. Supernumerary teeth should be differentiated from supplemental teeth, which resemble the adjacent teeth. Supplemental teeth are common seen in premolar and lateral incisor region whereas the supernumerary teeth are ‘commonly seen in the midline followed by 3% molar and premolar regions Class-I malocclusion is ‘the result due to retarded grouth of mandible Extrusion of molar. So indicated in deep patients only Flaring of mandibular incisors Cervical head gear therapy ain disadvantage of Uprighting first molar with a loop lingual arch Undesirable side effect, associated with use of buccal coil spring to regain space for a mandibular 2nd premolar is Disadvantage of the use of laminated arch wire is Tendency for the first premolars to rotate. ‘Abrupiness in response to adjustment Spacing of teeth can be associated with lisping. Lisping associated with interdental spacing is called as interdentat stigmatism. Interdental stigmatism is seen in open bite patients and in class-TT division-1 patients. Overbite is the vertical overlapping of anterior teeth. Normally it is 2 to 3 mm. The expression of overbite in teams of percentage is more important than the absolute value of overbite. overbite sR * 100, Overbite percentage = sap eam Normal overbite percentage is 33.33% Rapid maxilary expansion should be initiated prior to the ossification of the mid-palatal suture. The time of ossification of mid palatal suture is about 16 years in git ‘and 18 years in boys with a broad range of 15-27 years + For patients up to 15 years of age, 90° rotation fone turn) in the morning and evening, In patients over 15 years, 45° activation 4 times a day69, 70. n. 7. 7. 7 Dental Pulse Contraindications of RM 4+ Single tooth eros ites + In adults with severe anteroposterior skeletal discrepancies + Vertical growers ‘© Periodontally weak conditions The retention period following rapid maxillary expansion should not be less than 3 - 6 month. In slow expansion, the maxillary arch is expanded at a rate oF 0.5 ~ mm per week. The forces generated in slow expansion procedures are 2-6 pounds while it is 10-20 pounds (1 pound = 450 gms) in ME. In rapid maxillary expansion, the treatment is completed in 1-2 weeks whereas in slow expansion it may take as much as 2-5 months. Quad helix is used to expand 2 narrow arch as well as to bring about rotation of molars. It brings about orthopaedic movements in children and orthodontic movements in adults Tn angles class-IT cases the upper dental arch {s forwardly placed or the lower arch is placed back. Thus by extracting only in the upper arch itis possible to reduce the abnormal upper proctination and also to discourage the forward development of the upper arch. In angles class-II it is beneficial to avoid extraction in the Upper arch as it may effect the forward development of the maxilla The frst Cephalometric analysis that emphasizes vertical and horizontal relationships is Ssasounf’s analysis. ‘The frst premolars are the most commonly extracted teeth as part of orthodontic treatment (space discrepancy =5 mm). After extraction of premolars, the space will be closed by ‘movement of anteriors and posteriors in the ratio of 60:40, For closure of first premolar extraction space the force requited is 250 gms (Ineizors-150 + canine - 100 gm). The most common congenital defect involving face is cleft lip. The incidence of cleft lip and palate is 1:600. Cleft lip occurs due to disturbances in 6-8 weeks of LU tfe Cleftpalate occursdue to disturbancesin8-10weeksofI.Ulife After surgery patient will develop concave profile due to inhibition of growth centers in maxilla (maxillary retrusion). The patient will have class-ILI malocclusion with bilateral posterior cross bite Obturatoris used to cover the palatal defects while artificial velum is used to cover the sof tissue defects 1 %6. 7” 78. 1 80, a1 82. 83, 8a, 85. 6 87 —e Broadbent cephalostats uses two x-ray sources and two film holders whereas higley's cephalastats uses ane X-ray source ‘and two film holders Down's analysis consists of 10 parameters of which five are skeletal and five are dental Steiner's analysis consists of 11 parameters of which five are skeletal (SNA, SNB, ANB, mandibular plane and Occlusal one plane angles) five are dental and one parameter is for soft tissue analysis, Tweed analysis makes use of three planes that form a diagnostic triangle. The planes are. + Frankfort horizontal + Mandibular plane * Long axis of lower incisor. Decasters line in cephalometry represents the outline of internal surface of anterior cranial base Down's cephalometric analysis is used for diagnosis Steiner's analysis is used for treatment planning. Tweeds analysis establishes diagnostic triangle Tweed developed this analysis as an aid to treatment planning, ‘anchorage preparation, and to determine the prognosis of orthodontic cases. For diagnostic purpose, particularly to identify patients with severe disproportions, careful evaluation of facial proportion both in front and profile views is known as Poor ‘man's cephalometric analysis (Profit 4 ed 179 ) The Wits cephalometric analysis is used to relate the maxilla and mandible in anteroposterior or sagittal plane. The wits appraisal is used in cases where the ANB angle is considered not so reliable DECOSTER'S ine is a line representing the outline of internal surface of anterior cranial base Ballar’s classification of malocclusion is used to know the various skeletal relationships. Tt is use more accurately at the chair side to identity skeletal class, IL and III patients Mandibular second molar is located between two ridges ‘of basal bone and offers greatest resistance to bodily movement than any other tooth, List of teeth in order of diminishing resistance i Mandibular molars # Maxillary cuspids © Mandibular cuspids + Maxillary molars + Maxillary centrals Mandibular bicuspids © Maxillary bicuspids * Maxillary laterals ‘© Mandibular centrals and lateralSEE A ORTHODONTICS SYNOPSIS Ae — 88, 89. 90. o 92. 93. 94. 95. Hypotonic muscles causes flaring and spacing of teeth while the hypertonic muscles causes collapse ofthe teeth lingually The split plate appliance is used for expansion of maxilary arch. It was introduced by SCHWARTZ Ricketts analysis uses visual treatment objectives (VT0) computerized ceghalograms for growth predictions In terms of incidence of malocclusion, supervision of the child's development of occlusion fs most critical between the ages 6-10 years (APPSC -99) CCementum is more resistant to resorption than bone, and it {is for this reason that orthodontic tooth movement is possible. Cementum is avascular while bone is richly vascularsed. Thus degenerative processes are much more easily affected by interference with blood circulation in bone, DIFFERENT ROOT FORMS Canines, maxillary central, and laterals ‘© Mandibular centval and laterals ‘mandibular molars + Buccal roots of maxillary molars * Bicuspids ‘Palatal root of maxillary molars. ‘© Rounded roots resists horizontally directed forces in any direction. ‘© Flatroots have greater resistance to mesiodistal inclination but have little resistance to labiatingual movements, ‘© Triangular roots offers the maximum resistance to displacement compared to round of flat forms The ratio of root surface of anchor teeth to the teeth to be moved should be at least 2:1 without friction, 4:1 with friction, Mes eee © 1 pound, worn for 12-14 hours/day + The force is applied at an angle of 15-20 degrees downward pull to. the occlusal plane to produce foward movement of maxilla 10 to 20 pound 2-3 pounds (900 - 1350 grams) Worn for 14 hrs/day 96 97. 98. 99. ‘= 500 ~ 600 grams/side ‘= Worn for 12-16 hours/day 1150 ~ 500 pounds Components Of Removable Appliance + Retentive components ~ Adams clasp, C clasp ete * Active components _~ Bows, spring, screws lastcs etc. ~ provides anchorage & retention Base plate ‘COMPONENTS OF FIXED APPLIANCES ‘Active components | Separators, elastics, Arch wires, of fixed appliance | Springs. ee ee Pag eee © Elastic chain Closure of space. * Close coil spring. Elastic thread Derotate a tooth Uprighting spring | Move the root in mesio-distal | Se Methods of activation of different components of removable appliances For labial movement of, ‘incisors (COMEDK-15) activation is by opening ‘of both helices. For minor rotation correction, one of the helix is opened pening of coils Closure of the loops or cutting the fee end of active arm by 2 mm and readapting it Elongation of the spring Compression of u-loops ‘Activated by pulling the sides gently apart at the region of coilsDental Pulse —( enh 100. TYPES OF LABIAL BOWS _ Short labial bow (Designed by Hawley) '* Extends from canine to canine and uloops are placed mesial to canine ‘sit s vey stiff and is indicated in case of minar overt reduction and anterior space closure and used for retention purpose ‘Extends ftom first premolar to the opposite first premolar ong labial bow | « Indications are similar to short labial bow. Also used for closure of space distal to canine and ‘guidance of canine during canine retractor ‘Split labial bow / | ° Used for closure of midline diastema Reverse oop labial | + Indications similar to short labial bow ow + The Ustoops are placed distal to canine Roberts retractor, | © Indicated in patients with severe anterior procination with overjet of greater than 4mm Mills retractor High labial bow with | * The apron spring can be designed for retraction of one or more teeth apron spring + Used in cases of large overjet Fitted labial bow ‘= Ustoops are smal ‘Cannot be used to bring about active tooth movement 1 Used as retainers at the end of orthodontic treatment 201, TYPES OF SPRINGS * Used for mesiodistal movement of teeth. Finger spring (Single | + The coil should lie along the long axis oftoth to be moved perpendicular tothe direction of tooth cantilever spring) | movement. + The direction of coils opposite to that of intended tooth movement. eaiersea * Used to move the tooth labially cantilever spring __| + The spring is cranked to keep it clear ofthe other teeth spring (double | Used for labial movement of incisors cantilever spring) | « Also usd for bringing minor rotations T spring Used for buccal movement of premolars and canines ; + Removable type of arch expansion spring aaa + Consists of omega shaped wire place in the mid palatal region Canine retractors | Used to move canines in a distal direction 102. Difference between Beggs and edgewise techniques co Edgewise Introduced by Raymond Begg. It Angle's ribbon arch technique. ‘a modification of | Introduced by Edward H.Angle Ribbon arch brackets with a vertical slot facing th cclusal or gingival direction are used, ge wise type of bracket with a horizontal and rectangular slot facing labially is used, Brackets have single point. Brackets have two point contact Round Buccal tubes and round arch wires are used Rectangular arch wires and round buccal tubes are used. Tipping movements permitted Only bodily movement permitted Three stages in treatment No stages in treatment period is less Light forces are used and the duration of treatment Heavy forces are used and duration of treatment is prolonged Root resorption is less Root resorption is more No anchorage preparation ‘Anchorage preparation is more Wires used have dimension of 0.016, 0.018 and 0.020 inches in different stages Wires used have dimensions of 0.022 x 0.028 ineesFf ortnovontics synorsis BSS — 103. 106. 105. 106. 107. 108. 109. 110. une. un. 16. us. The stage of relatively rapid eruption from the time a tooth first penetrates the gingiva until it reaches the occlusal level is called post emergent spurt (KAR-03). Ligature wires are most commonly used ausillares in fixed appliances. Ligature wires help in securing the arch wire to edgewise type of brackets whereas lock pins ate used to secure atch wire to brackets with vertical slots such as ribbon arch brackets. 16. Elgiloy is cobalt chromium nickel alloy. Root Resorption Index during tooth movements, Inegular root contour Root resorption at apex, less than 2 mm. Root resorption amounting to 2 mms to one-third of root length Root resorption more than one third of root length. Hotz modification of oral screen contains a metal ring projecting between upper and the lower lips. The ring can bee used to carryout various muscle exercises. 18. The modification of activator, which resembles a Bionator, fs eybernator or reduced activator of “Schumth’. us. The appliance that combines the features of both monobloc (activator) and oral sereen is propulsor. The propulsor is devoid of any wire components. The thee types of Bionator are: © Standard appliance © Class-IIT appliance ‘+The open bite appliance Standard appliance is used for treatment of class-I, division-1 and class-T malocclusions having narrow dental arches, In adult patients with mild skeletal class-II and class-II] malocclusion the underlying skeletal discrepancy can be camouflaged by orthodontic tooth movement. This is done by extraction of certain teeth and moving the rest of the teeth into the space created, For correction of cleft tip, ‘Millar’ has suggested the rule of ten, Surgery should be performed at 10 weeks of age, wien the body weight is nat less than 10 pounds and the blood hhemoglabin is not less than 10 grams. The palatal repair should be attempted between 12-26 months of age, Most frequently used retainer appliance is Hawley’ retainer. It consists of Adams clasps and short labial bow Begg wrap around retainer consists of a labial wire that extends till the last erupted molar on both sides. ‘Advantage of Beggs retainer is that there is no crossover wire between canine and premolar, thereby eliminating the tisk of space opening up. Banded retainer, bonded lingual retainer and band and spur retainers are examples of fixed retention appliances Banded canine-to-canine retainer is commonly used in the lower anterior region Band and spur retainer is used in cases where a single tooth has been orthodontically treated for rotation or labiolingual displacement In derotation cases one spur is placed labially andthe other lingually to avoid relapse. In acid etching technique, enamel is etched to a depth of 20-25 microns. Hydrophosphoric acid is used for etching before orthodontic banding, while hydrofluoric acid is used to ‘etch fluorosed teeth before bleaching. (AIPG-14) Brackets are usually fixed on anterior teeth and premolars whereas the buccal tubes or molar tubes are used on molars. Fu age. ‘of mandibular symphysis occurs at 18- 24 months of