Masterday2 Con Agregados

MasterDay2
A word from the author: MasterQs and MasterDay2 are helpful only once you have basic
knowledge of your subjects. Both of these files have the best and compile almost all radiographic
images and cases available online. Extensive image/radiographs coverage of each of topic has been
done. Day 2 tests your basic knowledge of the subjects. I sincerely advise you to go through the
mentioned topics properly- as the cases are mostly focussed on these. Know these diseases and
medicines used, contraindications of them and MOA.
What to note/write on the paper provided in the exam ?

You will be given 2 sheets to write on/if anything. Here is what you need to write.
Draw a line in the centre of the first page, and write Generic name on one side and Trade name on
another. During the exam in the first 4-5 cases they mention you both the class/Drug/generic name
and the trade name eg :
Generic Trade
Alendronate (Bisphosphonates) Fosamax
Ethambutol (Anti TB) Abitol
Zoledronic acid (Bisphosphonates) Reclast
By the time you are done with 4-5 cases they will skip the Generic names in few questions because
they presume you should know them as they have been mentioned in the exam only. So If you are
unaware of this, you will have to go back and look for the important information again question by
question, but if u have made this small chart, it saves your time!
Must read topics

1. Hypertension and management
2. Myocardial infarction
3. Stroke
4. Diabetes
5. Syncope
6. Emergency management
7. NSAIDs
8. Antianxiety drugs
9. Osteoarthritis
MasterDay2.zip Version 3.0

May God be with us and help us nail NBDE PART 2 
10. Alzheimer's disease
11. ADHD in child
12. Asthma
13. COPD
14. Bisphosphonates (Follow *Master Bisphosphonates* GIven in the Last section of this file)
15. Local Anesthesia and calculations
16. HIV
17. Hepatitis B
18. Opiods
19. Basal cell carcinoma picture
20. Papilloma picture
21. Prophylactic Antibiotics
22. Endodontic Diagnosis (Given in this file- Last section)
23. Practice Cases (Given in this file- Last Section)
1. Identify
“AOT”
On radiographs, the adenomatoid
odontogenic tumor presents as a
radiolucency (dark area) around an
unerupted tooth extending past the
cementoenamel junction.
It should be differentially diagnosed from a

dentigerous cyst and the main difference is
that the radiolucency in case of AOT
extends apically beyond the
cementoenamel junction.
Radiographs will exhibit faint flecks of radiopacities surrounded by a radiolucent zone.
It is sometimes misdiagnosed as a cyst. And frequently in anterior maxilla!

2. Identify
Dentigerous Cyst
3. Identify Eruption Cyst
4. Identify
Doubtful Answer
Molar appears to have DD and
Premolar – DI

5. Identify?
Amelogenesis Imperfecta:
How to identify?
See the outer boundary n shape.
Compare it with adjacent teeth
moreover i see it like a prepared
tooth for crown to diagnose.
6. Identify
Dentinogenesis imperfecta

7. Identify
External Resorption
8. Identify
Genial tubercle

9. Identify
Mandibular Canal

10. Identify
Ameloblastoma
11. Identify
Fusion

12. Identify
Lateral Periodontal Cyst
13. Identify
Complex Odontoma
It's a complex odontome.

Compound would show enamel
dentin and cementum
separately.

14. Identify
Cementoblastoma
15. Identify
Underexposed / Over Fixed

16. Identify
Intermaxillary Suture
17. Identify
Zygomatic Process

18. Identify
Coronoid Process
19.

20.
21. Identify
Leukoplakia

22. Identify
Herpes Labialis
23. Identify
Stafne’s bone Cyst

24. Identify
Recurrent Caries:

25. Identify
Age and Diagnosis?
Over 7 Years
Diagnosis would be retained deciduous lower incisors and coming to age is would be 7-8 here we have to
consider the development of roots of 6 and roots of upper central incisors and lower lateral incisors. Coming
to loss of D in 3rd arch, ref; Mc Donald pediatric book, if any primary teeth lost before 7 yr there would be
delayed eruption of permanent teeth and if loss of primary teeth after 7 yrs would lead to premature
eruption of permanent teeth. Here premolar is in eruption stage so it should be considered too. So age would
be 7-8 yrs.
26. Learn the fact

Complete craniofacial dysjunction by the Le Fort III osteotomy allows the surgeon to alter the orbital position
and volume, zygomatic projection, position of the nasal root, frontonasal angle, and position of the maxilla
and to lengthen the nose. The Le Fort II osteotomy allows the surgeon to alter the nasomaxillary
projection without altering the orbital volume and zygomatic projection. The Le Fort I osteotomy allows for
correction primarily at the occlusal level affecting the upper lip position, nasal tip and alar base region, and
the columella labial angle without altering the orbitozygomatic region
27. The appearance of the curve of spee on the panoramic suggests that the patients chin was positioned
too:
A. Far forward
B. Far back
C. High
D. Low
Answer is HIGH
28. No answer available
May be lingual tori
29. Identify
Underexposed/Over fixed

+Lower border of mx.sinus
30. Identify
gemination, fusion has just two roots

31. Identify
Answer is below the picture
32. Identify flap

Semilunar Flap

33. Identify
Answer is
below the
Picture

34. Identify
Answer is below the
picture

35. Identify
Answer is below
the picture

36. Identify
we have retained primary 1ts molar in lower right side Missing lower 3rd molar bilateral or extracted
Chin is up means 🙁 frown
Chin is down means 🙂 smile
In this Pano ... Chin down smiling

Pt is 23 years’ old
37. Pt adult male. Present asymptomatic,

necrotic, ulcerated area involving palatal
mucosa.
Histologically presents lobular necrosis of
glandular parenchyma with squamous
metaplasia and hyperplasia of ductal
epithelium. Dx & Tx?
Necrotizing sialometaplasia.
it is caused by ischemic necrosis
of minor salivary glands.
it will heal in 6-10 wks.

38. Identify
8 is angle of Mandible and
9 is Hyoid Bone
39. Identify
Peutz-Jeghers Syndrome.
Intraorally pigmentations
may be located anywhere in the
mucosa.
Most frequently hard palate,
Buccal mucosa and gingiva

40. Identify
1- middle cranial fossa

5- styloid process
17- ear

41. Identify
Dens in Dente

42. Identify
10- glenoid fossa 11- articular eminence 12-
condyle 13-vertebra
43. Identify
Pulp Stone:
Compare with Dens in dente : 42nd Question

44. Identify
2-orbit
3- zygomatic arch
4- hard palate
6- max tuberosity
45. Identify
Eagle’s Syndrome
Elongated Styloid and
calcification of
stylohyoid ligaments.

46. Identify
odontogenic myxoma: non-

encapsulated,
no resorption of teeth,
cortical expansion, honey-
comb appearance
47. Identify
Punched out lesions without sclerotic border...multiple
myeloma
Punched out lesions with or without sclerotic border....
Langerhans cell histiocytosis

48. Identify
The arrow is pointing to alternating

RLs at the level of border of mandible.
This is also known as "onion skin"
and it's seen in
GARRE's Osteomyelitis.
49. Identify – DAY 1

Y is formed between nasal floor and maxillary sinus
Y line of Ennis
The straight line resembles the basal floor and the curved one
for the maxillary sinus.

50. Identify
Answer:
Antral pseudocyst (mucous retention pseudocyst)
51. Identify

52. Identify
Internal Resorption
53. Turner's Hypoplasia***-Frequent

pattern of enamel defects seen in
permanent teeth secondary to periapical
inflammatory disease of the overlying
deciduous tooth.
-The altered tooth is called Turner's tooth.

54. Characteristics of enamel defects
in Turner's Hypoplasia
-Vary from focal areas of white, yellow or brown discoloration
to extensive hypoplasia which can involve the entire crown.
Most frequently noted in permanent bicuspids because of their
relationship to the overlying deciduous molars.
55. In regards to traumatic injury, which teeth are most

affected by Turner's Hypoplasia
Maxillary central incisors
56. Identify problem, cause, treatment

Dental Fluorosis clinical features and treatment -Ingestion of
fluoride results in enamel defects called dental fluorosis.
-Permanent hypomutation of the enamel in which there is an
increased surface and subsurface porosity of the enamel.
-Altered tooth structure presents as areas of lusterless, white
opaque enamel with zones of yellow to dark-brown discoloration.
treatment: composites and full crown coverage

57. Critical years for dental fluorosis
During the 2nd and third years of life when anterior teeth are
forming and fluoride levels are greater than 1 pt per million
ingested.
58. Attrition definition***

Loss of tooth structure caused by tooth to tooth
contact during occlusion and mastication
Destruction accelerated by:
1) poor quality or absent enamel
2) Premature contacts, edge to edge occlusion
3) intraoral abrasives, erosion or grinding habit
59. Abrasion definition Loss of tooth structure

secondary to the action of an external agent.
Most common source is tooth brushing.

60. Erosion definition
Loss of tooth structure caused by chemical reaction (other
than bacteria)
-usually to an acid
external: lemon, vinegar, soft drinks
internal: gastric secretions such as perimylolysis (people
suffering from anorexia or buliema present this)
61. Attrition most often

seen in these teeth
and specific surfaces
-Deciduous and
permanent teeth
-Occlusal and Incisor
region of maxillary
and mandibular teeth
-Lingual of Maxillary
anteriors
-Labial of mandibular
anteriors
62. Abrasion

63. Internal Resorption – Day 1
Destruction of teeth accomplished by cells located in

the dental pulp.-Rare occurence, when injury to
pupal tissue occurs such as
physical trauma or pulpitis.
-Process continues as long as vital pulp tissue
is present. -Uniform well circumscribed symmetric
radiolucent enlargement of the pulp chamber or
canal. Pinktooth of Mummery.
-When it affects the coronal pulp and expands it, the
crown can display a pink discoloration:
64. External Resorption***

-Destruction of teeth accomplished by cells in the periodontal
ligament
-Extremely common, all patients likely to have root resorption
on one or more teeth.
-impacted teeth can hit other teeth and cause damage.
-Presents as a "moth-eaten loss of tooth structure in which
radiolucency is well less-defined.
-Most cases involve the apical or midportions of the tooth.
65. Environmental Discoloration of teeth:

Extrinsic Staining examples
1) Bacterial Stains: cause surface staining of
enamel, dentin and cementum. Seen initially on
labial surfaces of the maxillary anterior teeth in
the gingival 1/3.
2) Tobacco products, tea, coffee: brown discoloration of
the surface enamel. On lingual surface of anterior teeth but
usually widespread and less intense.
3) Medications: Fluoride and chlorhexidine or many other
oral antiseptics like Listerine.

66. Environmental Discoloration of teeth: Intrinsic Staining
Examples:
1) Congenital erythropoietic polyphyria (Gunther's disease)
-Autosomal recessive disorder of porphyrin metabolism
-results in increased synthesis and excretion of porphyrins
and related precursors.
-Diffuse discoloration of the dentition is noted as a result of
the deposition of porphyrin in the teeth.
-Stains teeth red
-eyes are blood shot, show hirutism, sensitive to light, "wear-
wolf disease"
67. Intrinsic staining examples:

2) Hyperbilirubinemia
-During this syndrome, developing teeth may also
accumulate pigment and become intrinsically stained.
-Gallbladder closes, causes bile to accumulate in blood
and cause brown staining in system.
-Deciduous teeth are affected as a result of this
syndrome during the neonatal period.
-teeth extremely dark brown
Two most common causes:
erythroblastosis fetalis
biliary atresia
68. Primary impaction of deciduous teeth is rare

but when it occurs it affects this tooth***
second molars.

69. Ankylosis plays an important role in pathogenesis of
impacted teeth. Permanent teeth most affected by impaction
are*** third molars
(mand then max) and then maxillary
cuspids.
Treatment for impacted teeth include:
orthodontics, long-term watch, surgical removal, assisted
eruption and transplantation.
Ankylosis definition, clinical features and treatment

Cessation of eruption after emergence of teeth
-occurs at any age but most obvious during first 2 decades of
life: 9-18 yrs of age
-occlusal plane of involved tooth is below that of adjacent
teeth.
-A sharp solid sound on percussion of the involved tooth noted if
more than 20% of root is fused to the bone. Absence of
periodontal ligament space may be noted.
-fusion of root into jaw bone is smooth (resorption would show
up ragged on radiograph)
Treatment: Fused to adjacent bone, don’t respond to ortho,
primary molars best treated with extractions and space
maintainers.
70. Hypodontia
lack of development of one or more teeth
Uncommon in deciduous dentition.
Very common in permanent dentition
(pic example of hypodontia during ectodermal dysplasia)
71. Hyperdontia and mesiodens also

increased number of teeth and additional teeth
are called supernumerary

72. Clinical features of Hypodontia
(teeth it most frequently occurs with) (most-> least)
1) third molars
2) second premolars
3) lateral incisors
-More common in females than males
Hyperdontia clinical features

-Single tooth hyperdontia occurs more
frequently in the permanent dentition and
90% present in the maxilla anterior incisor region, followed by
maxillary fourth molars and mandibular fourth molars.
73. Multiple supernumerary teeth (nonsyndromic) occur

most frequently in the:
mandibular premolar region.
The differential diagnosis for multiple supernumerary
teeth are
1) Gardner's syndrome (malignancies in large intestine)
2) Cleidocranial dysplasia
74. Natal teeth

teeth present in newborns
-should be extracted or will cause child severe pain
75. Neonatal teeth

teeth present within the first 30 days of life
(represent pre-maturely erupted deciduous teeth
not supernumerary teeth)
-should be extracted or will cause child severe pain

76. Germination
-A single enlarged tooth or jointed tooth in
which the tooth count is normal when the anomalous tooth
is counted as one.
-1 crown, bifid pulp chamber, 1 root and 1 pulp canal.
-Both primary and permanent dentitions
-High frequency in the anterior maxillary region
77. Fusion
-A single enlarged tooth or joined (double) tooth
in which the tooth count reveals a missing tooth
when the anomalous tooth is counted as one.
-2 crowns, 2 separate pulp chambers, and 1 root.
-Both primary and permanent dentitions
-High frequency in the anterior maxillary region
78. Concrescence
-union of two adjacent teeth by cementum alone
without the confluence of the underlying dentin.
-Presents as two fully formed teeth, jointed along
the root surfaces by cementum.
-Frequently in the posterior maxillary region.

79. Accessory Cusps:
Dens Evaginatus
-Seen in oriental groups
-Cusp-like elevation of enamel located in
central groove or lingual ridge of the buccal cusp of
permanent premolar or molar teeth.
-Usually bilateral, marked by mandibular premolar
predominance.
-results in occlusal problems and prone to fracture
frequently resulting in pupal exposure because the dens
evaginatus contains pupal tissue.
80. Dens Invaginatus****

-Deep surface invagination of the crown or root that is
lined by enamel.
-Due to defect in enamel
-Two forms: coronal or radicular
-Coronal is seen more frequently
-Teeth affected mostly: permanent maxillary lateral
incisors and maxillary central incisors
-Invagination maybe large and resemble a tooth within a
tooth "dens in dente"
-If opening of invagination becomes carious, pupal necrosis may result.
Treatment: small restoration
81. Ectopic Enamel

presence of enamel in unusual locations, mainly the tooth root.
(if u have enamel bud at junction of CEJ...periodontal
defect will result)
ex) enamel pearls
-hemispherical structures of enamel
-most frequent: roots of max. molars, mand molars:
second most frequent.
-majority at furcation area or near CEJ.
-precludes normal periodontal attachment.
-less resistant to breakdown, rapid loss of attachment likely.

82. Taurodontism***
Enlargement of the body and pulp chamber of multi-rooted
tooth with apical displacement of pulp chamber and bifurcation.
-affected teeth are rectangular in shape
-pulp chambers have increased apico-occlusal height and
bifurcation (if present) close to apex.
-Unilateral or bilateral
-Permanent teeth affected more
-Isolated trait or w/
1) Down's
2) Klinefelter's
3) Ectodermal dysplasia
4) Amelogenesis imperfecta
83. Dilaceration***
Abnormal angulation or bend in the root, or less frequently the
crown of a tooth.
-arise following an injury that displaces that calcified portion of the
tooth germ with the remainder of the tooth being formed at an
abnormal angle.
-Permanent maxillary incisors most frequently affected.
84. Supernumerary roots***

increased number of roots on a tooth.
-occurs more frequently on third molar teeth.
85. Hypoplastic Type Generalized: pinpoint pits

Localized: horizontal row of pits in the middle 3rd of facial
surface
Incisal edge or occlusal surface= not affected

Crown prep: like teeth on x-ray! <- amelogenesis Differentiation
86. Hypocalcified
-Matrix laid down normally, abnormal
calcification/mineralization takes place
-SOFT ENAMEL EASILY LOST
-YELLOW-BROWN OR ORANGE ENAMEL
-EASILY STAINED, RAPID CALCULUS FORMATION
X: ray: density of enamel similar to dentin
87. Hypomaturation type

Matrix lad down, mineralizes normally, but crystal
DO NOT form
-teeth normal in shape, OPAQUE,
WHITE-BROWN-YELLOW DISCOLORATION
-Enamel is SOFT AND CHIPS OFF, pierced with explorer
x-ray: enamel looks like dentin (enamel has fallen off DEJ)
88. Ameleogenesis imperfecta picture

no enamel on teeth

89. Dentinogenesis Imperfecta**
-Hereditary disturbance in formation of dentin
-aka "hereditary opalescent dentin"
-May be seen w/ association to osteogenesis imperfecta
-most cases in US traced from whites from English Channel
pic: large bulbous crowns and thinning roots
90. Dentinogenesis Imperfecta clinical description**

-Autosomal dominant
-Severity depends on age
*DECIDUOUS most severely affected
-Followed by perm. incisors and 1st molars
(order of eruption)
-2nd and 3rd molars LEAST AFFECTED
-Exhibit a blue/brown discoloration with translucence
-Enamel strips off easily from underlying dentin
(like amelogenesis!)
**Differentiation: Bulbous crowns (like tulips!), cervical constriction towards roots, thin roots, obliteration of
root canals and pulp chambers.
"shell teeth"= LARGE PULP CHAMBERS, THIN DENTIN
91. Dentinogenesis Imperfecta

broad crowns, thin roots, cervical constriction, pulp chamber
disappear/non-existant, enamel present but easily taken off
(DEJ doesn't hold enamel well)
92. Dentin Dysplasia** (Type 1)

Type 1 or radicular dentin dysplasia (rootless teeth)
-short roots: malformation of root dentin
-Autosomal dominant pattern
-Enamel and Coronal dentin =NORMAL
*x-ray: deci teeth SERVERLY affected with little or no
pulp and very short roots.
*perm teeth: little to no pulp present to
CRESCENT SHAPED PULP CHAMBERS.

93. Dentin Dysplasia (Type 2)**
CORONAL Dentin Dysplasia
-Similar to DI!!!!!
-Autosomal dominant
-Blue/brown translucency of teeth
X-ray: bulbous crown, cervical constriction, thin roots,
early obliteration of pulp chamber
Perm Teeth: classic thristle-tube or flame shape
CANT TELL DIFFERENCE BETWEEN DD TYPE 2 AND DI!
94. Regional Odontodysplasia

"ghost teeth"
-uncommon condition found in both dentitions
-localized non-hereditary developmental abnormality
involving enamel, dentin and pulp. (ALL LAYERS AFFECTED)
-idiopathic
-no racial or sexual predilection
bi-modal peak: eruption of prim teeth 2-4 years
perm dentition: 7-11 yrs
95. Regional Odontodysplasia Clinical Characteristics

-Several contiguous teeth affected usually in maxillary anterior
-Involvement of primary teeth is followed by perm teeth being
affected
-failure of eruption
-teeth that erupt have small irregular, brown
- yellow rough surfaced crowns
x-ray:
-thin enamel and thin dentin surrounding enlarged pulp
-pale wispy image of teeth "ghost teeth"
-densities of enamel and dentin appear fuzzy
-teeth have no shape
-localized

96. Congenital leukokeratosis (White sponge nevus)
It is a rare disorder which is inherited in an autosomal
dominant trait.
Symptoms and signs: present as white, whitish-greyish,

peeling, it is a painless and complication-free disorder on the
buccal mucosa and the mucosal layers of the nose,
oesophagus and the ano-genital region.
These lesions appear first at the time of birth or during
childhood. This disorder occurs mostly on the loose mucous
membrane of the mouth (buccal mucosa, soft palate, the
ventral surface of the tongue, the mucosal surface of the
lips, floor of the mouth, etc.). The gingival and the dorsal
surfaces of the tongue are usually unaffected.
Differential diagnosis: leukoplakia, morsicatio buccarum, lichen oris, fungal infections.
97. Mechanical injuries
The main cause of traumatic ulcers is usually a single

physical damage (for example, fights, sports, epilepsy,
bone, sharp, broken tooth and prosthesis, etc.), which
causes yellowish, painful, soft changes various in
diameter on the affected mucosal tissue. These ulcers
are surrounded by a thin, erythematous halo. They
heal spontaneously in 6–10 days but leave scarring
behind.
Differential diagnosis: specific ulcers (tuberculosis,

lues), aphtha or carcinoma.

98. Epulis fissuratum (denture granuloma)
There are two major factors in the development of a

denture granuloma: the pathologically mobile denture
and the pressure of its edge on the surrounding mucosal
tissue. An epulis fissuratum may most commonly occur
in the middle third of the mandibular bones and is more
common on the buccal surface than on the lingual
surface. The epidermal layer of the mucosa may develop
increased keratinisation. These lesions may become
pale, hard and more flexible to the touch where the
accumulation of connective tissue fibres is more
extensive.
Differential diagnosis: gingival cancer, Hydantoin hyperplasia, epulis.
99. Morsicatio buccarum et labiorum

The cause is that nervous, anxious children and young adults
may repeatedly chew or bite their facial mucosa, lips or
sometimes even their tongue as a bad habit. This constant
mechanical trauma causes white desquamation of the
effected epithelium, with erosions or even ulcers to develop
mainly in the line of dental occlusion and buccal mucosa. This
bad habit is commonly accompanied by bruxism.
Differential diagnosis: leukoplakia, candidiasis, ulcers caused

by inflammations and cancer.

100. Recurrent herpes simplex infection (herpes labialis,
cold sore)
Pathogen: Herpes simplex virus
After the primary infection, the virus becomes latent in the
epithelium and in the ganglia of the trigeminal nerve.
Symptoms: it usually affects the lips or the boundary

between the lips and the skin. Predisposing factors include
exposure to sun, fever (fever blisters), upper respiratory
tract infections, pneumonia, malaria, meningitis, physical or
emotional stress, menstruation, dental treatment, stress,
gastroenteritis, AIDS, pregnancy, trauma, local irritation, etc.
Before the development of blisters, fever and enlargement
of lymph glands may develop. At the onset of the disease an itchy, burning sensation (prodromal) and
redness are present. A few hours later cluster of vesicles are formed, which are 1-3 millimeters in diameter.
Vesicles become coalesced, and after two or three days they rupture and become ulcerated with yellowish
crusts. The surrounding skin is erythematous. Skin lesions usually heal in 8-10 days without scarring. Sites and
frequency of recurrences vary from patient to patient.
Differential diagnosis: Herpes zoster, pemphigus.
101. Verruca vulgaris (common dentino)
Pathogen: human papillomavirus (HPV) – a member of the papovavirus

family.
The wart occurs less frequently in the oral cavity than on the skin, but
more commonly than previously believed.
Symptoms: they usually appear on the lips, tongue and palate, but any
other location in the oral cavity may occur. They appear abruptly and
grow rapidly (viral origin), they are broad based and have a whitish-
grey, papillary surface (usually feel hard on the skin).
Verrucae may appear as multiple and confluent lesions.
Differential diagnosis: Papilloma, verrucous leukoplakia

102. Acute pseudomembranous
candidiasis (thrush)
The commonest Candida albicans-
caused oral disease.
Predisposing factors: inappropriate

oral hygiene, heavy smoking,
xerostomia, radiotherapy, the
administration of antibiotics,
corticosteroids or cytostatic drugs,
diabetes mellitus, chronic systemic
diseases, autoimmune diseases,
leukemia, AIDS, immunosuppression.
It mostly presents in newborns and
children suffering from chronic
illnesses.
Symptoms: the appearance of cream-coloured or pearl-white, bluish-white plaques which leave a slightly
burning, erythematous surface if wiped off is characteristic of this type of candidiasis. Predilection sites
include the buccal, the palate and the tongue. It is common in newborns and infants. In case of acute
pseudomembranous candidiasis in adults, an underlying systemic disease has to be considered.
Differential diagnosis: Lichen, leukoplakia (cannot be wiped off), morsicatio buccarum, allergic stomatitis.
103. Chronic atrophic candidiasis (denture

stomatitis)
It is a common chronic disease of the mucous
membrane especially in patients wearing upper
dentures.
Tight fitting dentures provide favorable
circumstances: they practically function as a
substrate for the growth of Candida.
Symptoms: well-circumscribed, red, edematous,

sometimes eroded mucous membrane
corresponding with the plate of the upper
denture is characteristic of the disease. Chronic
atrophic candidiasis is symptom-free.
Differential diagnosis: contact allergy of the
palate.

104. Recurrent aphthous ulcer (Mikulicz’s aphtha;
minor aphtha)
The etiology is not yet explained. It might be an

autoimmune, viral, bacterial (Streptococci), genetic
(familial) or allergic disease or could be influenced
by mechanical injuries, gastrointestinal diseases
(Crohn’s disease), psychic stress, menstrual cycle
(hormonal factor), walnut or chocolate
consumption, etc., or by hypovitaminosis (B12,
folic acid).
It is the most frequent disease of the oral mucous

membrane. Recurrent aphthae are more frequent
in adulthood and in women. It is rare among
smokers (mucosal hyperkeratinisation).
Symptoms: initially erythema and oedema develops on the corresponding area, accompanied by a nipping,
burning sensation or by paraesthesia. It can be either solitary or multiple. The development of ulcers is not
preceded by vesicle formation. Well-demarcated lenticular (3–10 mm) painful ulcers on erythematous bases,
covered with yellowish fibrous pseudomembranes are present. After 1 or 3 weeks, they heal without leaving
scars. They might persist for years, but their frequency varies from person to person. They might be
accompanied by lymphadenomegaly, too. Predisposed areas are the vestibular surface of the lips, the floor of
the mouth, the ventral surface of the tongue and the cheek (non-keratinized mucosal epithelium). It is rare
on the hard palate, the gingiva and the back of the tongue; these areas are usually affected by
gingivostomatitis herpetica.
Differential diagnosis: herpetic stomatitis, allergic stomatitis.
105. Major aphtha (Sutton’s aphtha)

Recently major aphthae have been
considered to be the rare severe form
of aphthous ulcer.
Symptoms: 1–4 cm in diameter,

usually solitary, but might have
multiple forms, too (giant aphtha).
Very painful crater-like ulcers of
variable depth, covered with
yellowish-grey fibrous
pseudomembranes. The lesion usually
heals with deforming mucosal
scarring after epithelization. Women
are usually more affected.
Predilection areas are the
oropharyngeal region, the soft palate,
the cheeks and the tongue. It causes
severe pain, fever, trismus,

lymphadenitis and difficulties in swallowing or eating. It may persist for several months or even for one or
two years and ends to recur. Biopsy is mandatory
Differential diagnosis: tumorous ulcer, decubital ulcer, specific ulcer: TB lesions
106. Pemphigus vulgaris

Pemphigus vulgaris is a chronic, life-
threatening autoimmune skin, mouth and
other mucous membrane disorder
characterized by blistering of the skin and
oral mucosa. Sometimes pemphigus
appears in reaction to a viral infection,
certain drugs (D-penicillamine,
antihypertensive Captopril), thymoma or
myasthenia gravis.
Symptoms: it usually affects elderly women.
Blistering starts intraepithelially, the
surrounding mucosa is not erythematous.
The thin-walled intraoral bullae easily burst
leaving painful erosions covered with
whitish-grey fibrinous diphtheroid coating.
The erosions may also bleed. Painful
erosions may cause difficulty swallowing
and eating and increased salivation.
Erosions heal without scarring. Sites of
greatest involvement include the buccal mucosa, tongue, palates and the gingiva. Nikolsky’s sign is positive
(when the surface of the unaffected skin and oral mucosa is rubbed, and the skin and mucosa separate
easily).
The diagnosis is established on the basis of skin symptoms and the histopathological examination.
In order to adjust the drug therapy, hospitalization is necessary.
Differential diagnosis: herpetic gingivostomatitis, erosive lichen oris, aphthous stomatitis.
107. Varicosity of the tongue

It is a diffuse dilation of the veins occurring in an elderly
age (varix). The dark blue varicosity on the ventral
surface of the tongue or sometimes on the floor of the
mouth is often called caviar lesion. The varicosity of the
tongue is most common among patients suffering from
cardiopulmonary diseases. Due to its tumour-like
surface, it may cause cancerophobia.
Differential diagnosis: haemangioma, Kaposi’s sarcoma,

malignant melanoma.

108. Angular cheilitis (perlèche)
In children and young adults Staphylococcus or
Streptococcus infection results in pyoderma of the
labial commissure.
109. Median rhomboid glossitis

The disease used to be classified as a
developmental disorder (the persistence of
tuberculum impar), but today the role of chronic
Candida infection and decreased vascularity is
emphasized. It is common among smoking men
and among diabetic patients. The lesion occurs
more frequently in denture-wearing patients.

110. Geographic tongue
The cause of the disease is not clarified; familial predisposition,
psychological factors, vitamin deficiency, malnutrition, exudative
diatheses and endocrine disorders may play a role in the
development of the lesion t can be an accompanying symptom of
psoriasis, reactive arthritis and diabetes mellitus.
111. Lingua villosa (hairy tongue)

The condition is considered to be a multi-aetiological disease,
which presents more frequently in elderly denture-wearing
patients. Hairy tongue is often idiopathic, but it can also be
triggered by antibiotics, corticosteroids, vitamin A or B
deficiency, radiotherapy, chemotherapy, inappropriate oral
hygiene, emotional stress, Candida albicans, heavy smoking,
gastrointestinal disorders or hydrogen peroxide.
Symptoms: the hairy surface is caused by the elongation,

thickening (hypertrophy) and keratosis of the filiform papillae.
The yellowish-greenish, brownish-black colour can be
explained by the presence of pigment-producing bacteria and
Aspergillus species (not Candida albicans), foods,
medications, consumer goods and smoking.
Differential diagnosis: Coated tongue.

112. Xerostomia
Xerostomia is not a disease but a symptom.

Xerostomia may be caused by a wide range of
conditions, the main cause being temporary or
permanent cessation of salivary secretion.
113. Patient with gingivitis due to mouth breathing
114. Pregnancy epulis (If given pt is pregnant

otherwise Epulis

115. Ulcers due to agranulocytosis
116. Gingival enlargement due to calcium-

channel blocker medication
117. Periapical abscess - fistula with opening

118. A lateral periodontal cyst can also show the
signs of a periodontal abscess. In case of infection,
there is shiny, reddish swelling besides the root,
and a fistula may often develop. This disease has
its typical radiographic appearance: sharp edged,
radiolucent picture, wide periodontal space
around the root.
119. Aggressive periodontitis is a term including Local Juvenile Periodontitis and General Juvenile
Periodontitis, also known as Early Onset Periodontitis (EOP).
Typical features are fast progression and vertical bone

resorption starting proximally, resulting in intra-osseal
periodontal pockets. Due to the fast progression and
destructive manner, secondary symptoms
(hypermobility, pocket formation, abscess formation,
changes in position and angulation, hyper eruption)
develop quickly. After thorough questioning, the
presence of the disease in the family is often revealed.
Secondary signs of AgP: tipping, movement, diastema

forming between central incisors, deep bite

120. Peri-implant mucositis: reversible soft tissue
lesion around implants
Peri-implantitis: inflammation affecting

osseointegrated implants in function, resulting in
supporting bone loss
121. Papilloma – Cauliflower appearance
Papilloma is a benign epithelial tumour, which

frequently appears on the oral mucosa. Local
irritation and infection, especially viral infection
(human papilloma virus) may play a role in its
development.
Symptoms: a pedunculated or sessile, white, or

whitish-grey, papillary surfaced tissue growth, which
does not cause any symptoms. A slowly proliferating,
smaller or larger epithelial tumour may also develop.
It occurs mostly in the palates, tongue, gingiva and
lips.
Differential diagnosis: verruca vulgaris, condyloma acuminatum and verrucous carcinoma.

122. Fibroma
Fibromas are benign, slow-growing tumours of
the oral cavity composed of connective tissue.
Fibroma is the most common tumour of the
oral mucosa, which particularly occurs on the
buccal mucosa and on the tongue. In the oral
cavity, fibromas are reactive proliferative
lesions, which develop secondarily to irritation
(by sharp tooth edges, artificial teeth or
calculus) or low grade infection. The lesion feels
solid or soft on palpation. It is sessile or
pedunculated, smooth-surfaced, reddish or
pale and covered with intact mucosa, but as a
result of mechanical irritation it may become
whitish leukoplakia due to keratinization or may
become ulcerated. No other clinical sign or pain
can be observed.
Differential diagnosis: verruca vulgaris, condyloma acuminatum and verrucous carcinoma. epulis, pyogenic
granuloma, granuloma fissuratum and neurinoma.
123. Cavernous haemangioma

This type of haemangioma is a hamartoma (not a
neoplasm), which histopathologically does not
have a capsule. It mostly involves the tongue, lips
and the buccal mucosa, and reaches an extreme
size (macrocheilia, macroglossia), thus hindering
speech and swallowing. It occurs as a flat or
exophytic, painless growth with a raspberry-like
appearance. Its colour ranges from red to dark
blue

124. Pyogenic granuloma
The tumour-like reactive tissue proliferation may
develop in response to trauma or infection, but
it may also occur as a result of hormonal
changes (pregnancy, menopause, or puberty),
the administration of oral contraceptives,
steroid drugs and anti-diabetics. Most frequently
it develops on the gingiva, bucca, lips and
tongue. It is a raised, pedunculated, flat or wart-
like lesion with a dark red or pink colour
depending on the vascularisation of the affected
area. In case of ulceration, it is covered with
yellowish fibrin. Its diameter ranges from a few millimetres to a centimetre. It is a painless tumour, which
easily bleeds.
125. Postextraction granuloma

This reactive, inflammatory tumour-like lesion
develops after tooth extraction as a result of
retained root, broken pieces of bones,
amalgam or other foreign body.

126. Epulis granulomatosa
It is not a real neoplasm, but a reparative tissue
proliferation arising from the mucoperiosteum of the
tooth socket or from the periodontal membrane. The
diagnosis of ”epulis” may be applied only clinically. The
growth is a painless, red lesion, which is prone to bleeding
and occurs mostly on the vestibular surface of the front
and premolar teeth. It is mostly brought about by chronic
inflammation (tartar, excess filling, or crown).
127. Pigmented nevus (intradermalis)
128. Torus Mandibularis

129. Leukoplakia Simplex (Homogenous)
130. Non-homogenous leukoplakia

Verrucous leukoplakia
131. Erythroplakia

132. Lichen Planus
(Reticular Lichen)
133. Cancer of lower lip

134. Cancer of floor of mouth
135. Gingival cancer
The disease develops mostly on toothless alveolar

ridges, where it spreads from the gingiva to the
alveolar mucosa and to the surrounding oral structures.
Gingival cancer accounts for 8–12% of oral cavity
tumours.
Beside smoking and alcohol, mainly chronic irritating

factors (odontolith, prosthesis, etc.) may play a role in
triggering gingival cancer.
The disease destroys the periosteum and the bone if it
reaches them, and loosens the teeth. Gingival cancer is
more frequent on the mandibular gingiva than on the
maxillary, and mandibular gingival cancer metastasizes
regionally more frequently. Metastases occur mainly in
the submandibular region. Similarly to oral cavity cancers located elsewhere, it is mainly the disease of the
elderly (50–70-year-old) men, and histologically most of the cases are squamous epithelial cancers. Incisional
biopsy is necessary.
Differential diagnosis: verruca vulgaris, condyloma acuminatum and verrucous carcinoma. epulis, pyogenic
granulomas.

136. Mucocele
137. Mucous Retention Cyst
138. Periapical Cemento Osseous Dysplasia

lower anteriors commonly involved, middle aged women, vitality
preserved, Radiolucent to Radiopaque

139. Actinomycosis
Normally found in nose and throat.
Symptoms triggering is abscess and surgery
Abscess leads to hard red to reddish purple lump , often on
the jaw from which comes the condition called lumpy jaw
Finally abscess breaks through skin and sinus tract is formed.
Find Actinomyces and sulfur granules in the drained fluid.
140. Strawberry Tongue
Scarlet Fever
Kawasaki Disease
Toxic Shock Syndrome
141. Compound Odontoma

142. Complex Odontoma
143. Recurrent Apthous Ulcer
144. Leukoedema
It will be mentioned that a white / opaque patch, when stretched disappears or it will be A lesion that
blanches, and it’s always “Bilateral”

145. Petechiae, Purpura, Ecchymoses
Difference in size
Petechiae are 1mm -2mm
Slightly larger than them but less than 1cm is Purpura
Largest is Ecchymoses appx 1 cm or more

Radiology Cases
1. Abrasion
2. Abrasion

3. Ameloblastoma
4. Ameloblastoma
5. Ameloblastoma
6. Ameloblastoma

7. Amelogenesis imperfecta
8. Amelogenesis imperfecta

9. Ankylosis

10. Ankylosis
11. Ankylosis

12. Attrition
13. Basal cell nevus syndrome


16. Benign cementoblastoma
17. Benign cementoblastoma

18. Benign cementoblastoma (residual cyst?)
19. Central giant cell granuloma


22. Chondrosarcoma

23. Chronic osteomyelitis with periostitis (Garre's)


27. Calcifying epithelial odontogenic tumor



30. Cleidocranial dysplasia

33. Complex odontoma

34. Compound odontoma


37. Concrescence

38. Concrescence
39. Concrescence

40. Condensing osteitis
41. Condensing osteitis

42. Condensing / sclerosing osteitis
43. Condensing / sclerosing osteitis

44. Dens evaginatus

45. Dens invaginatus



50. Dentigerous cyst

55. Dentin dysplasia


59. Dentinogenesis imperfecta

63. Dilaceration
64. Dilaceration

65. Dilaceration
66. Distodens
67. Distodens

68. Enamel Pearl
69. Enamel Pearl
70. Enamel Pearl
71. Enamel Pearl

72. Enostosis
73. Exostosis
74. Fusion
75. Fusion

76. Fusion
77. Fusion
78. Gardner's Syndrome


84. Gemination
85. Gemination
86. Globulomaxillary cyst


91. Hypercementosis
92. Hypercementosis

93. Hypercementosis
94. Hypercementosis
95. Hypercementosis
96. Hypercementosis

97. Hypodontia
98. Hypodontia
99. Hypodontia

100. Hypodontia
101. Hypodontia
102. Hypodontia
103. Idiopathic osteosclerosis

104. Idiopathic osteosclerosis
105. Idiopathic osteosclerosis (between premolars)
106. Incisive canal cyst

109. Keratocyst (OKC)


113. Lateral periodontal cyst

116. Macrodontia
117. Macrodontia
118. Macrodontia

119. Macrodontia
120. Macrodontia
121. Macrodontia

122. Malignant neoplasm

125. Mesiodens
126. Mesiodens
127. Metastatic neoplasm


133. Microdontia
134. Microdontia

135. Microdontia
136. Microdontia
137. Migration

138. Migration
139. Migration
140. Migration

141. Mucus retention cyst


148. Multiple myeloma

151. Odontodysplasia

154. Odontogenic myxoma

157. Osteosarcoma
158. Osteosarcoma
159. Osteosarcoma (mixed radiopacity)

160. Osteosarcoma (mixed radiopacity)
161. Osteosarcoma (Sunburst)

164. Osteosarcoma (widened PDL)
165. Osteosarcoma (widened PDL)

166. Periapical cemental dysplasia


173. Periapical granuloma/abcess
174. Periapical granuloma/abcess/radicular cyst

175. Periapical granuloma/abcess/radicular cyst
176. Periapical granuloma/radicular cyst
177. Periapical Granuloma (widening of apical PDL)

178. Periapical scar

183. Primordial cyst

187. Pulp calcification

188. Pulp calcification
189. Radicular cyst
190. Residual cyst

191. Residual cyst
192. Root resorption



201. Secondary dentin
202. Socket sclerosis
203. Socket sclerosis
204. Stafne's defect


208. Suppurative osteomyelitis

213. Taurodont

214. Taurodont
215. Taurodont
216. Taurodont

217. Torus
218. Torus
219. Torus
220. Torus

221. Transposition
222. Transposition
223. Transposition

224. Transposition
225. Traumatic cyst
226. Traumatic cyst

227. Turner's hypoplasia
228. Turner's hypoplasia
229. Diagnose (VERY IMPORTANT)

230. Diagnose ( VERY IMPORTANT)
231. Diagnose (Very Important)

Endodontics Diagnosis
(ADA Referred)
Normal Pulp is a clinical diagnostic category in which the pulp is symptom-free and normally responsive
to pulp testing. Although the pulp may not be histologically normal, a “clinically” normal pulp results in a
mild or transient response to thermal cold testing, lasting no more than one to two seconds after
the stimulus is removed. One cannot arrive at a probable diagnosis without comparing the tooth in
question with adjacent and contralateral teeth. It is best to test the adjacent teeth and contralateral
teeth first so that the patient is familiar with the experience of a normal response to cold.
Reversible Pulpitis is based upon subjective and objective findings indicating that the inflammation
should resolve and the pulp return to normal following appropriate management of the etiology.
Discomfort is experienced when a stimulus such as cold or sweet is applied and goes away within a
couple of seconds following the removal of the stimulus.
Typical etiologies may include exposed dentin (dentinal sensitivity), caries or deep restorations. There
are no significant radiographic changes in the periapical region of the suspect tooth and the pain
experienced is not spontaneous. Following the management of the etiology (e.g. caries removal plus
restoration; covering the exposed dentin), the tooth requires further evaluation to
determine whether the “reversible pulpitis” has returned to a normal status. Although dentinal
sensitivity per se is not an inflammatory process, all of the symptoms of this entity mimic those of a
reversible pulpitis.
Symptomatic Irreversible Pulpitis is based on subjective and objective findings that the vital inflamed
pulp is incapable of healing and that root canal treatment is indicated. Characteristics may include sharp
pain upon thermal stimulus, lingering pain (often 30 seconds or longer after stimulus removal),
spontaneity (unprovoked pain) and referred pain. Sometimes the pain may be accentuated by postural
changes such as lying down or bending over and over-the-counter analgesics are typically ineffective.
Common etiologies may include deep caries, extensive restorations, or fractures exposing the pulpal
tissues. Teeth with symptomatic irreversible pulpitis may be difficult to diagnose because the
inflammation has not yet reached the periapical tissues, thus resulting in no pain or discomfort to
percussion. In such cases, dental history and thermal testing are the primary tools for assessing pulpal
status.
Asymptomatic Irreversible Pulpitis is a clinical diagnosis based on subjective and objective findings
indicating that the vital inflamed pulp is incapable of healing and that root canal treatment is indicated.
These cases have no clinical symptoms and usually respond normally to thermal testing but may have
had trauma or deep caries that would likely result in exposure following removal.
Pulp Necrosis is a clinical diagnostic category indicating death of the dental pulp, necessitating root
canal treatment. The pulp is non-responsive to pulp testing and is asymptomatic. Pulp necrosis by itself
does not cause apical periodontitis (pain to percussion or radiographic evidence of osseous breakdown)
unless the canal is infected. Some teeth may be nonresponsive to pulp testing because of calcification,
recent history of trauma, or simply the tooth is just not responding. As stated previously, this is why all
testing must be of a comparative nature (e.g. patient may not respond to thermal testing on

any teeth).
Previously Treated is a clinical diagnostic category indicating that the tooth has been endodontically
treated and the canals are obturated with various filling materials other than intracanal medicaments.
The tooth typically does not respond to thermal or electric pulp testing.
Previously Initiated Therapy is a clinical diagnostic category indicating that the tooth has been
previously treated by partial endodontic therapy such as pulpotomy or pulpectomy. Depending on the
level of therapy, the tooth may or may not respond to pulp testing modalities.
Apical Diagnoses
Normal Apical Tissues are not sensitive to percussion or palpation testing and radiographically, the
lamina dura surrounding the root is intact and the periodontal ligament space is uniform. As with pulp
testing, comparative testing for percussion and palpation should always begin with normal teeth as a
baseline for the patient.
Symptomatic Apical Periodontitis represents inflammation, usually of the apical periodontium,
producing clinical symptoms involving a painful response to biting and/or percussion or palpation. This
may or may not be accompanied by radiographic changes (i.e. depending upon the stage of the disease,
there may be normal width of the periodontal ligament or there may be a periapical radiolucency).
Severe pain to percussion and/or palpation is highly indicative of a degenerating pulp and root canal
treatment is needed.
Asymptomatic Apical Periodontitis is inflammation and destruction of the apical periodontium that is of
pulpal origin. It appears as an apical radiolucency and does not present clinical symptoms (no pain on
percussion or palpation).
Chronic Apical Abscess is an inflammatory reaction to pulpal infection and necrosis characterized by
gradual onset, little or no discomfort and an intermittent discharge of pus through an associated sinus
tract. Radiographically, there are typically signs of osseous destruction such as a radiolucency. To
identify the source of a draining sinus tract when present, a guttapercha cone is carefully placed through
the stoma or opening until it stops and a radiograph is taken.
Acute Apical Abscess is an inflammatory reaction to pulpal infection and necrosis characterized by rapid
onset, spontaneous pain, extreme tenderness of the tooth to pressure, pus formation and swelling of
associated tissues. There may be no radiographic signs of destruction and the patient often experiences
malaise, fever and lymphadenopathy.
Condensing Osteitis is a diffuse radiopaque lesion representing a localized bony reaction to a low-grade
inflammatory
stimulus usually seen at the apex of the tooth.
Diagnostic Case Examples
Practice Case 1

Mandibular right first molar had been hypersensitive to cold and sweets over the
past few months but the symptoms have subsided. Now there is no response to thermal
testing and there is tenderness to biting and pain to percussion. Radiographically,
there are diffuse radiopacities around the root apices.
. Diagnosis: Pulp necrosis;

symptomatic apical periodontitis with condensing osteitis. Non-surgical endodontic
treatment is indicated followed by a build-up and crown. Over time the condensing
osteitis should regress partially or totally (15).
Practice Case 2
Following the placement of a full gold crown on the maxillary right second
molar, the patient complained of sensitivity to both hot and cold liquids; now the
discomfort is spontaneous. Upon application of Endo-Ice® on this tooth, the patient
experienced pain and upon removal of the stimulus, the discomfort lingered for 12
seconds. Responses to both percussion and palpation were normal; radiographically,
there was no evidence of osseous changes.

Diagnosis: Symptomatic irreversible
pulpitis; normal apical tissues. Non-surgical endodontic treatment is indicated;
access is to be repaired with a permanent restoration. Note that the maxillary second
premolar has severe distal caries; following evaluation, the tooth was diagnosed with
symptomatic irreversible pulpitis (hypersensitive to cold, lingering eight seconds);
symptomatic apical periodontitis (pain to percussion)
Practice Case 3
Maxillary left first molar has occlusal-mesial caries and the patient has been
complaining of sensitivity to sweets and to cold liquids. There is no discomfort to
biting or percussion. The tooth is hyper-responsive to Endo-Ice® with no lingering
pain.
Diagnosis: reversible pulpitis; normal apical tissues. Treatment would

be excavation of the caries followed by placement of a permanent restoration.
If the pulp is exposed, treatment would be non-surgical endodontic treatment
followed by a permanent restoration such as a crown.
Practice Case 4
Mandibular right lateral incisor has an apical radiolucency that was discovered during a
routine examination. There was a history of trauma more than 10 years ago and the tooth was
slightly discolored. The tooth did not respond to Endo-Ice® or to the EPT; the adjacent teeth
responded normally to pulp testing. There was no tenderness to percussion or palpation in
the region.

Diagnosis: pulp necrosis; asymptomatic apical periodontitis. Treatment is nonsurgical endodontic
treatment followed by bleaching and permanent restoration.
Practice Case 5
Mandibular left first molar demonstrates a relatively large apical radiolucency

encompassing both the mesial and distal roots along with furcation involvement.
Periodontal probing depths were all within normal limits. The tooth did not respond
to thermal (cold) testing and both percussion and palpation elicited normal responses.
There was a draining sinus tract on the mid-facial of the attached gingiva which was
traced with a gutta-percha cone. There was recurrent caries around the distal margin
of the crown
Diagnosis: pulp necrosis; chronic apical abscess. Treatment is crown

removal, non-surgical endodontic treatment and placement of a new crown
Practice Case 6
Maxillary left first molar was endodontically treated more than 10 years ago.
The patient is complaining of pain to biting over the past three months. There appear
to be apical radiolucencies around all three roots. The tooth was tender to both
percussion and to the Tooth Slooth®.

Diagnosis: previously treated; symptomatic
apical periodontitis. Treatment is nonsurgical endodontic retreatment followed by
permanent restoration of the access cavity.
Practice Case 7
Maxillary left lateral incisor exhibits an apical radiolucency. There is no history of pain and
the tooth is asymptomatic. There is no response to Endo-Ice® or to the EPT, whereas the adjacent
teeth respond normally to both tests. There is no tenderness to percussion or palpation.
Diagnosis:
pulp necrosis; asymptomatic apical periodontitis.Treatment is nonsurgical endodontic treatment

and placement of a permanent restoration.
Master Bisphosphonates and Drug Interactions
The use of bisphosphonates is associated with the production of osteonecrosis of the jaws (ONJ). ONJ is
defined as exposure of the bone of the jaws that does not heal within 8 weeks after identification by a
healthcare worker in a patient taking bisphosphonates. The condition may be asymptomatic or present
with pain, soft-tissue swelling and loosening of teeth in addition to exposure of bone. Bisphosphonates
are inhibitors of osteoclastic activity and their presence in the body may last for years. These drugs are
used in the management of the following:
 Malignancy

o To prevent hypercalcaemia
o To reduce bone loss
 Osteoporosis
 Paget’s disease of bone
 Osteogenesis imperfecta
When used in the management of malignancy the drugs are usually administered intravenously (IV). In
the treatment of osteoporosis, the drug is normally taken orally. Although intravenous bisphosphonates
may be used in the management of osteoporosis, the cumulative dose is lower than that used to
manage the malignancy population. It is the intravenous route that is most commonly associated with
the production of ONJ. The risk of ONJ in patients taking oral bisphosphonates is thought to be low but
has been reported. Concomitant steroid therapy may increase the risk in the latter group. It has been
estimated that the percentage of patients receiving bisphosphonates for management of malignancy
who develop ONF is between 4% and 10%. Around 60% of cases arise after tooth extraction or dento-
alveolar surgery. The mandible is more susceptible than the maxilla. In summary, it appears that the
most at-risk group are patients receiving intravenous bisphosphonates during the management of
malignancy.
The bisphosphonate drugs
o Alendronic acid (Fosavance)

o Disodium etidronate (Didronel)
o Disodium pamidronatea (Aredia) May be administered IV.
o Ibandronic acida (Bondronat, Bonviva) May be administered IV.
o Risedronate sodium (Actonel)
o Sodium clodronatea (Bonefos, Loron) May be administered IV.
o Tiludronic acid (Skelid)
o Zoledronic acid (Zometa) May be administered IV.
Drug interactions and effects of common herbal products:
o -Ginseng:
*Adverse effects:
1.Inhibit platelet aggregation and blood coagulation.
*Drug interactions:
1.May increase effect of hypoglycemic drugs.
2.Increase resistance to loop diuretics.
3.May potentiate bleeding with Wafarin. <<< important
4.May cause mania with MAOI antidepressants.
o ----------------------------------
Garlic:
*Adverse effects:
1. Possible bleeding from inhibition of platelet aggregation.

*Drug interactions
1. Bleeding tendency with antiplatelet drugs (example: asprin) and aticoagulant drugs such as
Warfarin.
2. Could increase hypoglycemia with insulin intake.
----------------------------------------------
o - Ginkgo Bilboa:
*Adverse effects:
1. Could cause bleeding from inhibition of platelet aggregation
*Drug interactions:
1. Possible bleeding with Asprin and Warfarin
o -----------------------------------------
o - Saw Palmetto:
*Adverse reactions:
1.May cause GI disturbances
*Drug interactions:
1. Could cause drug toxicity with sex steroids
o ---------------------------
(important)
- St. John's Wort:
*Adverse reactions:
1. Causes photosensitivity at high doses
2. Increases Cytochrome enzymes CYP: 3A4-1A2 and all CYP2 enzymes (you dont have to
memorize these, just know that it induces Cytochrome P450)
* Drug interactions:
1. Increases phototoxicity with Tetracyclines, Sulfunamides, and proton pump inhibitors.
2. Could cause toxicity of Benzodiazepines, opoids and other CNS depressants.
3. Causes SEROTONIN CRISIS with MEPERIDINE.
4. Decreases effects of:
> Protease inhibitors
> Cyclosporine
> Digoxin
> Warfarin

Master Patient Management
List of VARIABLES:
 Nominal
 Ordinal
 Interval
 Ratio
 Nominal: genotype of names ex: gender

 Ordinal: gingival index
 Kelvin: Ratio ( In the example , 1:5 , 1:3 , True zero)

 Interval: Celsius
 Ratio: BP, Pulse, Height, Weight
Terms used in Dental Insurance Billing
Some of the most commonly used cost containment measures are:
Least Expensive Alternative: (Has never been tested in exam)
Treatment Provision (LEAT) A dental plan may not allow benefits for all treatment options. A
LeastExpensive Alternative Treatment Provision is a limitation found in many plans which reduces
benefits tothe least expensive of other possible treatment options as determined by the benefit plan,
even when the dentist determines that a particular treatment is in your best interest.
For example, the dentist may recommend a fixed bridge, but the plan may allow reimbursement only for
a removable partial denture. The patient may not always understand the payer’s least expensive
treatment policy, and what the out of pocket costs are, until the explanation of benefits (EOB) is
received.
Out-of-pocket costs:
The health insurance definition of out-of-pocket costs is any amount of money that will have to come
from you, hence the term "out of [your]pocket". Two main areas to understand out-of-pocket costs in
insurance are the out-of-pocket costs for services not covered and the out-of-pocket costs you are
expected to pay before your insurance will pay.
Out-of-pocket costs include expenses that your insurance company does not feel are covered services
included in your plan. Some examples would be elective procedures, such as cosmetic surgery or
procedures specifically excluded by your insurance company.

If you don't want to have to pay for something out-of-pocket, you can easily find out what services are
not covered by your insurance company by calling them and asking. Another main out-of-pocket cost in
health insurance are the costs you are expected to pay for covered procedures before your insurance
will pay. The two primary ones are your deductible and co-insurance. The deductible is the amount you
have to pay, out-of-pocket, before your insurance company will start paying. The co-insurance amount is
the percent you are required to pay towards a covered procedure. For example, your insurance
company may cover 80% of your surgery and you have to pay the remaining 20% out-of-pocket. There is
usually an out-of-pocket maximum and once that is reached the insurance company will cover 100% of
the costs and the deductible and co-insurance payments count towards the out of pocket maximum.
Coinsurance:
Most health insurance policies have a coinsurance, or sometimes misspelled as co insurance, clause. This
simply is the percentage amount you are required to pay towards your health insurance bill when you
file a health insurance claim. The coinsurance percentage is usually in addition to the deductible, that
would need to be paid first before the insurance company would pay anything.
Example
Mary Jo had a 20% coinsurance clause on her new health insurance policy. She just got a bill, for her
recent surgery, from her health insurance company. The total of the bill was $2000. Her health
insurance deductible was $200 for the year and none of her deductible was paid yet since this was her
first claim. This means that Mary Jo would need to pay, out of her own pocket, her full deductible

($200), and then 20% of the remaining amount of the insurance bill ($360). So, her total out of pocket
expense for her surgery was $560 ($200+$360).
Copayment:
The copayment is a fixed amount the insured is required to pay to the provider. Some call it the
copayment or copays since there can be different copayment amounts for different services. Copays are
usually what one pays when they visit a doctor or purchase a prescription. The copayment is almost
always required at the time of service or at the time one would purchase their prescription medication.
Then the doctor or pharmacist will bill the insured's insurance company for the remaining amount due.
Sometimes copays are confused with the co-insurance payment. The co-insurance payment is different
as it is a percentage that the insured is required to pay and is usually due for larger procedures such as a
surgery.
Examples: Dean needed to go see his doctor for a lingering cough. When he went to his visit, he was
required to pay a $40 copayment to the doctor at the time of service. The doctor's office then billed the
remaining amount due to Dean's insurance company.

Downcoding:
Downcoding is a practice of third-party payers in which the benefits code hasbeen changed to a less
complex and/or lower cost procedure than was reported except where delineated in contract
agreements.
Predetermination:
Predetermination of benefits is an administrative procedure that may require the dentist to submit a
treatment plan to the third party before treatment begins. The third party usually returns the treatment
plan indicating one or more of the following: patient’s eligibility, covered services, benefit amounts
payable, application of appropriate deductibles, co-payment and/or maximum limitation. Under some
programs, predetermination by the third party is required when covered charges are expected to
exceed a certain amount.
Claims Bundling:
Claims bundling is the systematic combining of distinct dental procedures by third-party payers that
results in a reduced benefit for the patient/beneficiary. The ADA considers bundling of procedures to be
potentially fraudulent.
Bundling: What is often described as bundling is the effort of payers to follow guidelines established in
the Code.
For example,
Payers commonly see claims submitted with the following combinations of services that are not

consistent with the Code: Pins reported as a separate service from a core buildup (the D2950 buildup
code includes pins);
Adhesives, bases or liners as a separate service from the restorations (the Code defines these to be
included as part of the restoration);
Occlusal adjustments and minor adjustments to prostheses as a separate service, when the prosthetic
service includes routine post-delivery care; Suture removal, as a separate service from the extractions,
which include suturing and postoperative care; and X-rays taken during the course of root canal therapy
as a separate service from the root canal, which by definition, includes intra-operative X-rays.
For the examples above, payers will often consider these component services as part of the main
procedure inaccordance with the Code and pay benefits accordingly.
Reinforcement: (Often tested in the exam)
Positive reinforcement occurs when an event or stimulus is presented as a consequence of a behavior

rand the behavior increases.
Example: A father gives candy to his daughter when she picks up her toys. If the frequency of picking up
the toys increases, the candy is a positive reinforcer (to reinforce the behavior of cleaning up).
Negative reinforcement occurs when the rate of a behavior increases because an aversive event or
stimulus is removed or prevented from happening.
Example: A person puts ointment on a bug bite to soothe an itch. If the ointment works, the person will
likely increase the usage of the ointment because it resulted in removing the itch, which is the negative
reinforcer.
Punishment:
Positive punishment occurs when a response produces a stimulus and that responses decreases in
probability in the future in similar circumstances.

Example: A mother yells at a child when he or she runs into the street. If the child stops running into the
street, the yelling acts as positive punishment because the mother presents (adds) an unpleasant
stimulus in the form of yelling.
Negative punishment occurs when a response produces the removal of a stimulus and that response
decreases in probability in the future in similar circumstances.

Example: A teenager comes home after curfew and the parents take away a privilege, such as cell phone
usage. If the frequency of the child coming home late decreases, the removal of the phone is negative
punishment because the parents are taking away a pleasant stimulus (the phone) and motivating the
child to return home earlier.
Pleasant Stimulus Aversive (unpleasant) Stimulus
Adding/Presenting Positive Reinforcement Positive Punishment
Removing/Taking Away Negative Punishment Negative Reinforcement
5 year survival rate
90% in lip cancer
50% in oro pharyngeal cancer
45% in tongue cancer
20% in african American oro pharyngeal cancer whose oral hygiene is bad
Biostatistics in Pt management
* Validity....> should be compared to gold standard and should be high sensitive, specific and unbiased
* Reliability....> should be reproducible and repeatable with same value means produce similar results
* Sensitivity....> % of persons having the disease TP/TP+FN X 100%
* Specificity ....> % of persons not having the disease TN/TN+FP X 100%
* predictive value positive....> TP/TP+FP X 100%
* predictive value negative....> TN/TN+FN X 100%
KNOW IT BY HEART !
1. Highest prevalence of caries = Hispanics

2. Highest DMFT = White (caucasian) (highest amount of restored teeth)
3. Highest untreated primary teeth = Hispanic
4. Highest untreated perm teeth = Black (African American)
5. Moderate periodontitis = Black males ( African American)
6. Class II caries = Whites (caucasian)
7. Class III caries = Blacks (African American)
8. Cleft lip/palate w/ Class III occlusion = Native American

9. Cleft lip alone = Asian
10. Cleft lip in USA = 1:700 to 1:800
11. class 2 malocclusion : whites of northern European descent
12. class 3 malocclusion : Asian
13. Caucasians have more lip cancer while African american have more oropharyngeal carcinoma.
14. Anterior open bite: African American(blacks)
15. Deep bite: cuacasian( whites)
16. Cemento osseous dysplasia - black middle aged women
LEGEND of materials and equipment safety in PT management
*Air born particles
1) Spatter....>large visible particles 50um or larger and its the route of infection of blood borne
pathogens
2) MIST....> settle from air after 10-15 mins and is produced by cough
3) Aerosol....>invisible particles between 5-50um floating in air for hours
* Current OSHA standard for mercury is 0.1mg /m3 over an 8 hours work shift
*Noise inducing hearing loss....> above 90db and protection recommended when noise reaches 85db

(Autism pts are very sensitive to loud sounds,,,,put muffler on ur turbine and work!!!!!!!) –( Concept
commonly TESTED in exam )
* during photopolymerization of composite or any resin material (bridge to operative....> 1-1.5mm from
restoration and use of VLC and alpha diketone with camphor quinone to initiate the polymerization)
always wear eye protector to avoid retinal damage
*before starting any clinic flush all dental instruments including handpiece for several mins to ensure
that the waterline is < 500CFU/mL.
*MSDS is regulated by manufacturers for employees and use colors to notify the employees as
follows:
1) blue....> health hazard
2) red....>fire hazard
3) yellow....>reactivity and stability of chemicals
4)white....> use PPE
LEGEND of Organization in Pt. management
* ACF....> associated with economy and social well being ex.low income children get free food meal in
school
*CMS....> medicaid and medicare
*Medicare....> for elderly and disabled people
*Medicaid.....> for low income people elderly and children
*EPSDT program....> dental services for children

*CHIP program....> offers basic preventive and diagnostic services ex.vaccinations
*HRSA....> offers health care services for uninsured live in rural areas and urban neighborhoods plus
dental services for HIV pts
*CDC....> prevent outbreak of disease and dental infection control ex.community water fluoridation
*FDA....>protecting health against impure and unsafe foods plus temp. of autoclave
*NIH....> deals with supporting medical researches
*NIDCR....> branch of NIH deals with dental researches
*AHRQ....> support health care system and quality
*HHSA.....> provides a broad range of health and social services, promoting wellness, self-sufficiency,
and a better quality of life for all individuals and families
*DEA....> combating drug smuggling and deals and also has sole responsibility for coordinating and
pursuing U.S. drug investigations abroad.
*NHANES.....> a program of studies designed to assess the health and nutritional status .

Q. Through the bloodborne pathogen standard, the occupational safety and health administration
directs activity for each of the following except one. Which one is the exception?
a. Using barrier techniques
b. Using material safety data sheets
c. Obtaining hepatitis B vaccines
d. Communicating hazards to employees
e. Performing housekeeping Ans.B
(material safety data sheets are now called safety data sheets. I was asked this in the exam.)
Q. Stress and illness are often related. The best description of their relationship is which of the
following?
a. Stress is primary cause of illness
b. Illness is adaptation to stress
c. Stress is a psychological reaction
d. They often occur together but are casually unrelated
e. Stress is contributory to illness and illness is usually stressful Ans.E
Q. On the basis of diagnostic test results, a dentist classifies a group of patients as being free from
disease. These results possess high
a. Sensitivity
b. Specificity
c. Generalizability
d. Repeatability Ans.B
Q. In pursuit of what the dentist believes is best for the patient, the dentist attempts to control
patient behavior. This is known as

a. Autonomy
b. Competence
c. Maleficence
d. Paternalism Ans.D
Q. Ans.B
Q. Most epidemiologic studies indicate that gingivitis in children is relatively common. A strong
positive association between specific nutritional deficiencies and the presence of periodontal disease
in children and adults has been demonstrated.
1. both r true
2. both r false
3. 1st true, 2nd false
4. 1st false , 2nd true Ans.3
Q. In assessing patient’s dental fears, the dentist should use each of the following factors except one.
Which one is the exception?
a. Verbal statements
b. Physiological responses
c. Behavior
d. Personality Ans.D
Q. HIPAA was designed to
A) ensure the security and privacy of health information
B) provide insurance coverage for providers
C) increase hospital testing ability
D) encourage employees to stay in their jobs to retain insurance coverage Ans.A
Q. information about subjects in a study included their ethnicity. what level of measurement is
ethnicity?
1. ordinal
2. nominal
3. ratio
4. Interval Ans.B

Q. MOST APPROPRIATE TEST TO DETERMINE THE DIFFERENCES BETWEEN TWO MEANS?(Answer
giving examples on BOTH)
CHI SQUARE TEST
T TEST Ans.B
Q. What's the prophylactic regimen for patients with prosthetic joints.
Ans. Antibiotic prophylaxis guidelines also have been developed for people who have orthopedic
implants such as artificial joints. In 2012, the ADA and American Association of Orthopedic Surgeons
updated the recommendations and no longer recommend antibiotics for everyone with artificial joints.
As a result, your healthcare provider may rely more on your personal medical history to determine when
antibiotics are appropriate for people with orthopedic implants. For example, antibiotic prophylaxis
might be useful for patients who also have compromised immune systems (due to, for instance,
diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk
of orthopedic implant infection.
Q. A patient after extraction says"Thank you,that wasent as bad as i expected,but my sister told me
that the first night after having a tooth pulled is very painful.What if the medication u gave me isnt
strong enough!?Choose the most appropriate answer.
1)Did she make you feel worried about that?
2)It sounds like you are worried that you might not have enough pain relief when ur home.
3)I understand your concern
4)Dont worry i'll give you plenty of pain medication
5)it sounds like your sister had a unusually bad experiance.Dont let other worry you,you'll be just fine.
Ans.B
Q. The most important concept of C.E.A. Winslow’s definition of public health is:
To encourage mental and physical efficiency
Promotion through organized community effort
Individuals acting alone can solve any problem
The science and art of preventing disease Ans.B/D????
( C.E.A. Winslow, characterized public health practice as the science and art of DISEASE PREVENTION,
prolonging life, and
promoting health and well-being THROUGH organized community effort..So Answer is D!)
Q. A moderately mentally challenged 5-year-old child becomes physically combative. The parents are
unable to calm the child. Which action should the dentist take?
Force the nitrous oxide nosepiece over the child’s mouth and nose.

Hand over mouth exercise (HOME).
Discuss the situation with the parents.
Firm voice control. Ans.C
Q. Which of the following is the principal nonverbal cue that two or more people can use to regulate
verbal communication?
eye contact
gentle touch
facial expressions Ans.A
Q. In an experiment comparing the effectiveness of new flouride gel verses an older flouride gel, a null
hypothesis is rejected when
1) a chi square is zero
2) a chi square is high
3) a chi square is low
4) the experimental and control groups have similar results Ans.B
( If you have higher chi-square, there is a high likely chance of your p-value being less than 0.05, so in
that case you reject
your null hypothesis.)
Q. On a prepayment basis, dental patients receive care at specified facilities from a limited number of
dentists. This practice plan is classified as which of the following?
Closed panel
Open panel
Group practice
Solo practice Ans.1
Q. can some one please explain deductible , copayment, coordination of benefits, co insurance??
Ans. A co-payment, is a flat fee that the patient pays at the time of service. The fee is usually small, such
as $10 or $15.
Co-payments are common in capitation plans (e.g. DHMO), and less common in Preferred Provider
Organization
plans (PPOs).
A deductible is a flat amount that the employee must pay before they are eligible for certain benefits.
The deductible may

be an annual or a one-time charge.
co insurance -patients must pay a portion of the services they receive
Q. Which of the following computer databases contain references to dental literature electronically ?
1)LEXUS
2)OVOID-MEDLINE
3)Dental Abstracts
4)Index to dental Literature Ans.B
Q. The measure of the quality of care provided in a particular setting is called:
Quality assurance
Quality evaluation
Quality assessment
Quality inspection Ans.3
( and the steps taken to improve deficiencies is quality assurance)
Q. Which of the following is a social enforcer for a child?
a. Dentist provides toothbrush kit
b. Allows child to watch his favorite tv show
c. Provide the child with stickers of his best cartoons
d. Pat on the back of the child's shoulder Ans.D
Q. Which is not a part of classical conditioning:
1. Acquisition
2. Equilibration
3. Discrimination
4. Generalization
5. Extinction
6. Spontaneous recovery Ans.2
Q. The following were the scores for six dental students in their restorative dentistry exam :
56, 64, 68,46, 82,86.
Therefore the median is_____________
68

64
67
40
66 Ans.66
( whnever thr is even number of figures like here 6 figures are. always take 2 middle, add these 2, and
thn divide it by 2… if
the given set of nos are even then you have to add the two middle numbers and divide by 2. If the given
set is odd then
just pick the middle one. have to order data in an ascending way first, so that will be 46, 56,64,68,82,86,)
Q. Which of the following may be used to disinfect gutta percha points?
1)Glass bead
2)Autoclave
3)Chemical solutions
4)Dry heat Ans.3
Q. Correlation analysis shows that as the income of population increases, the number of decayed
teeth decreases. Therefore, an expected value for this correlation coefficient (r) would be -1, Ans.YES
Q. Which federal agency protects the health of Americans and provides essential human services?
NIH
HRSA
DHHS
AHRQ
None of the above Ans.DHHS
Q. Which is the most important feature of systematic desensitization?
Muscle relaxation
Diaphragmatic breathing
Cognitive restructuring
Exposure
Education Ans.Exposure
Q. Which statement is incorrect about behavior change?

a.Shaping is a behavior change strategy in which the patient learns though demonstration.
b.The behavioral model consists of antecedents, behaviors, and consequences.
c.Goals are long-term targets, whereas objectives are reachable steps along the way.
d.Positive consequences will strengthen a behavior and negative consequences will weaken it.
e.Consequences of today’s behavior will affect behavior tomorrow. Ans.A
Q. network model is often used in
1. D-IPA
2. D-HMO
3. D-PPO Ans.1
( it follows the fee for service plan)
Q. If a dentist is stuck with a needle while treating an HIV-infected patient, which should he perform?
a.Stop work and apply hypochlorite 1:10 to the finger for 5 minutes
b.Stop work, compress the affected area, and apply hypochlorite
c.Antiretroviral therapy
d.Stop work, compress the affected area, and wash with soap and water Ans.C
( its given as C , compressing or squeezing the affected area is not recommended)
Q. The substitution of a relaxation response for an anxiety response using a relaxation strategy such
as diaphragmatic breathing when one is exposed to a feared stimuli is called?
1)Progressive muscle stimulation
2)Habituation
3)Flooding
4)Systematic desensitization
5)Biofeedback Ans.4
(Yup 4 its.. flooding is just a branch from desensitization which works on treating patient by repeating
the fearful response
till he gets used to it.)
Q. When a patient expresses anger about a physician’s colleague, which of the following statements
would be the most appropriate response?
a. Why are you so aggravated over something so trivial?
b. Before I ask any questions, please calm down.

c. What concerns do you have about how you were treated?
d. Why don’t we go talk to Dr. X about your anger? Ans.C????
Q. A patient has difficulty inhibiting the gag reflex during x-ray procedures. The patient is asked to
take an x-ray packets home and practice holding the packet in his mouth for increasingly longer
periods. Which technique is being used?
Graded exposure
Modeling
Reinforcement
Behavioral control
Systematic desensitization Ans.A
Q. Which is not correct about stress?
a. Predictability-less predictability causes more stress.
b. Controllability - less controllability causes the more stress.
c. Familiarity-less familiarity causes more stress.
d. Positive situations are less stressful than negative situations.
e. Imminence-more imminent situations are more stressful. Ans.D
Q. The following component of a scientific article provides the reader with detailed information
regarding the study design:
A. Introduction
B. Background
C. Literature review
D. Methods
E. Abstract Ans.D
Q. Ans.B
Q. incidence of untreated coronal caries is higher in
causcasians or african american or identical for both Ans.African
(Adult untreated caries--- African Anerican
Pediatric untreated caries--- Hispanics)

Q. A patient says that, “Even if there is some pain, it will be brief. I have effective methods of coping.”
The patient reminds himself of this during dental procedures. This patient’s statement exemplifies
which strategy?
Self-efficacy induction
Relaxation statement
Rational response
Imagery
Systematic desensitization Ans.C
Q. Ryan white care act provides dental care to HIV + / AIDS individual. They get their funds via
1. NIH
2. AHRO
3. HRSA
4. NIDCR Ans.3
Q. A student performs a complicated symphony, and he becomes less anxious each time he performs.
Which phenomenon is this?
Systematic desensitization
Habituation
Covert conditioning
Cognitive restructuring
Psychoeducation Ans.B
Q. 5 year survival rate of oropharyngeal cancer is
1-25%
2-50%
3-60%
4-75% ans.2 ( lip.CA...> 90% Tongue CA.....>45%)
Q. OSHA standard for mercury is
1. 1mg per cubic meter for 8 hr work shift
2. 0.1 mg cubic meter for 4 hr work shift
3. 0.5 mg cubic meter for 8 hr work shift
4. 0.05 mg cubic meter for 4 hr work shift Ans.4

(well right value is 0.1 mg percubic meter in 8 hrs of working ... but not in options so next appropriate
will be option 4 )
Q. Percentage of USA with Community water fluoridation
a. 40%
b. 60%
c. 80% Ans.B ( 65-70%...67% is average but nearest option given is 60%)
Q. Prevalance of subgingival calculus in US ADULTS as suggested by surveys is
A-0-0.25
B-0.25-0.5
C-0.5-0.75
D-0.75-1.0 Ans.C
Q. percentage of DFS is more in - cacucasians , hispanics , blacks, asians???
Ans. causacians...(WHite people are more conscious to dental treament and get more caries...the more
caris they get the
more filled it will be...so prevalence and filled surfaces are high in whits or causacians...Black people are
mostly poor and
couldnt afford dental services. So they have high chances of Untreated caries..)
Q. outliers control
mean
median
mode
standard deviation Ans.D
(an outlier is an observation point that is distant from other observations. An outlier may be due to
variability in the
measurement or it may indicate experimental error; the latter are sometimes excluded from the data
set.)
Q. incidence of coronal caries is higher in
causcasian or african american or identical for both Ans.A
Q. Contaminate sharps must be handled in such ways except for
a.The container must be labeled

b.The container has a metal case
c.The container has to be non puncturable
d.The container must be closable. Ans.B (yellow plastic disposable can with lid)
Q. Which is the acceptable CDC water quality in a dental office?
<250 CFU/mL
<500 CFU/mL
<125 CFU/mL
<700 CFU/mL
<1000 CFU/mL Ans.B
Q. Which is the best question to ask a slightly nervous child?
1.Are you worried about pain?
2.Are you nervous?
3."Why can't you be quiet?"
4."Can you tell me what is bothering you?" Are you worried about the needle?" Ans.4
Q. Test result which erroneously assigns an individual to a specific diagnostic or reference group, due
particularly to insufficiently exact methods of testing is known as:
A false negative test
A true negative test
A false positive test
A true positive test Ans.3
Q. Gi index - ordinal , right? Ans.YES
Q. Which term listed below measures the proportion of those without disease who are correctly
identified by a negative test:
Specificity
Sensitivity
Reliabilty Ans.A
Q. A 38-year-old man is fearful of injections. First, you show him the syringe. You talk about the
characteristics of the needle. You then place the needle in his mouth with the cap on and simulate the
procedure with the cap on. You then simulate the procedure with the cap off. Eventually, you proceed
with the injection. What method is being used to reduce fever?

1.Cognitive control
2.Systematic desensitization
3.Habituation
4.Flooding
5.Behavior modification Ans.2
Q. if there is an article and if you want to underatand the definition of Dependent and independent,
which part of the article you look:
Introduction
Method
Body
Result
Summary Ans.A
(its introduction or background in which u describe ur hypothesis definitions of dependant and

independant variables,
innovations, specific aims... define variables in introduction, methods of variable recording is in method
section)
Q. Researches showed to remove plaque from the resident’s teeth more effectively with mechanical
toothbrushes than with manual ones. What is the independent variable in this study?
1) The gingival health of the residents
2) The amount of plaque present on the resident’s teeth
3) The type of toothbrush used
4) Time of day that brushing took place
5) How long teeth were brushed Ans.3
(Independent variable can be changed so tooth brushes design could be changed… 3, independent
variables, 2 is
dependent variable)
Q. 70 percent dentists become anxious with anxious dental patients.
true
false Ans.TRUE
Q. Obtaining informed consent hold true in each of the following cases except:

1. A conscious mentally competent patient.
2. A pregnant patient
3. In emergency cases
4. None of the above Ans.3
(In cases of emergency if the pt. Or legally responsible party is not able to give consent, doctor may
proceed without it.)
Q. do you any idea about minors, under 18, in this regard?
Ans. Under 18 can give implied consent but not actual consent… But under 18 can give consent to their
treatment if : they are living independently, are pregnant, married and an emancipated minor can give
consent for his/her child.
Q. Providing and explaining the informed consent to the patient in understandable terms is
considered a duty of:
1. The office receptionist
2. Dental assistant
3. Resident
4. Attending dentist Ans.4
Q. In the section of a scientific aritcle,the researcher interprets and explains the results obtained in?
1)results
2)summary and conclusion
3)discussion
4)abstract
5)none of the above Ans.3
Q. HOME is an example of:
1. Positive reinforcement
2. Negative reinforcement
3. Positive punishment
4. Negative punishment ans.3
(you add something to decrease the behavior so it should be positive punishment,….. in negative
punishment, you decrease
something to eliminate undesired behavior)

Q. Restoring a carious tooth relieved the toothache in a patient which further motivated him to
perform better oral health care. This is a type of
1. Positive reinforcement
2. Negative reinforcement
3. Positive punishment
4. Negative punishment Ans.B
Q. One of your patient is having a dental problem that is not under your capability and you are
referring that patient to a specialist,this type of behavior comes under which of the following codes?
1)autonomy
2)beneficience
3)veracity
4)nomaleficience Ans.4
Q. what do we watch in a patient during dental dental treatment to find out if he's in pain??
1) saliva
2) hair
3) lips
4) eyes
5) eye brows
Ans.4
Q. Women have a lower survival rate of cancer of the lip..T/F? Ans.T
( Women have higher survival rate then men for oral cancers with exception cancer of the lip..So its
True)
Q. Dental waterline should be flushed at beginning of day for
1.30 sec
2.45 sec
3.60 sec Ans.A (30 according decks 60 according mosby)
Q. 1 L of 1 ppm of NaF contains how many G flouride? Ans.0.5
Q. Statute of limitations- can someone please explain?
Ans. Minimum 2 years of time from Malfunction incident by dentist to patient's sue procedure….. time
starts when dentists

inform the patient about the incident.)
Q. Incidence of cleft lip and palate, 1:1000 and 1:2000, right? Ans.Yes
(1:700 n 1:800 in US)
Q. what is the difference between flooding and systemic desensitization?
Ans. Systemic desensitization uses a hierarchy of slowly increasing the anxiety provoking stimuli like
from least anxiety provoking to most allowing the pt to use his coping skills. In flooding there is a intense
prolonged exposure to a feared stimulus at a time wherein the pt uses coping skills to deal with the
exposure. In simple language systemic desensitization is step by step increase stimulus And In flooding,
it is everything at a single step
Q. What is bundling, unbundling, upcoding, down coding
Ans. upcoding - if you treat tooth with one crown and you get the money for two crown this is upcoding,
downcoding is the reverse of upcodid, you treated two tooth, fixed two crowns but you get the money
for one only.
Bundling is when a dentist submits a claim for two or more procedures performed on a single pt. During
office visit and the
ensurer bundles the services together and only pays for one service.
Unbundling is the practice abused by dentist to get a program to pay more than the actual benefits by
charging a separate
fee for each component. Eg if the service for a crown was unbundled the dentist would send separate
fees for temp. Crown,
tissue prep, occlusal correction etc instead of charging one fee for the crown.
Q. While extracting a maxillary molar, you lose a root down the maxillary sinus which cannot be
retracted
at the moment. You do not inform the patient of the incident. Which code of ethical principle did you
break?
1. Beneficence
2. Non malifecence
3. Patient Autonomy
4. Veracity
5. Justice Ans.4
Q. Which will aid in the cognitive appraisal of a threat?
1.Adaptability, preventability, inevitability, and constancy

2.Controllability, familiarity, predictability, and imminence
3.Interference, adaptability, longevity, and reactance
4.Validity, reliability, adaptability, and predictability
5.Accountability, reliability, validity, and familiarity Ans.2
Q. Can you please clarify that confusion between HMO, PPO,?
HMO -- Health Maintenance Organization. You have one primary care physician through whom all your
health care services
go. If you need to see a specialist you have to first see your primary health care provider, who if can't
help you will provide
you with a referral. Also the visits to doctors outside your network won't be covered by insurance.
PPO- preferred provider organization
You don't need a primary care physician . You can go to any health care provider you want without a
referral - outside or
inside your network
Hmo: Dentist getts fixed monthly amount for each patient or family. They gets paid irespective of the
no. of treatment
provided whether they provide treatment more than the fee they get from insurance or they provide
less valuable treatment
as compared to their fix amount which they get from insurance monthly... dentist will get fixed amount
anyway
Q. Which of the following are necessary for a test to be accurate?
1)specificity
2)reliability
3)validity
4)sensitivity Ans.3
Q. when patient have to pay from his pocket??
deducible
copay
third pary payment Ans.B and C
Q. A dentist is doing research on 5 unrelated patient with different background. He record data ……
etc.dentist is doing what kind of research?

a. clinical trial
b. cohort
c. sectional Ans.Cross sectional
Q. how does parent of special needs child feel most of the time?
a.Hopeless
b.depressed
c.agitated Ans.C
Q. which of the following MOST accurately explains how biofeedback works
a. it reduced cognitive dissonance
b. it stimulates the sympathetic nervous system
c. it relax and to some extent hypnotizes the patient
d. it distracts and engages the patient in an active coping task.
e. it enables the patient to gain control of certain physiological function Ans.e
(Biofeedback therapy involves training patients to control physiological processes such as
muscle tension, blood pressure, or heart rate.
These processes usually occur involuntarily, however, patients who receive help from a
biofeedback therapist can learn how to completely manipulate them at will.
Biofeedback is typically used to treat chronic pain, urinary incontinence, high blood pressure,
tension headache, and migraine headache. )
Q. According to ADA publication entitled principles of ethics and code of professional conduct, a
dentist can announce specialization in which of the following?
a. implantology
b. hospital dentistry
c. aesthetic dentistry
d. dental public health
e. geriatric dentistry Ans.D
Q. What does the Weight and height stand for in recordings?
* Ordinal
* Nominal Ans.A?

Q. where you can find dental literature online?
a. MEDLINE
b. lexus
c. Dental town
d. google Ans.A
Q. Which of the following exhibits the MOST personal behavior by the dentist
A. leaning toward the patient
B. facing directly toward the patient
C. being seated 2 feet from the patient
D. touching the patient gently on the arm Ans.D
Q. which is the acronym for a patient management system?
a. recruit
b. success
c. optimum Ans.C
Q. persistent and repetitions questions asked by an 8 years old patient during treatment are ?
a. attempted to delay treatment
b. medication of hyperactivity
c. sign that child may be autistic
d. expression of the child’s curiosity about the dental treatment Ans.A


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What to note/write on the paper provided in the exam ?

Must read topics

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It should be differentially diagnosed from a

Radiographs will exhibit faint flecks of radiopacities surrounded by a radiolucent zone.

It is sometimes misdiagnosed as a cyst. And frequently in anterior maxilla!

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3. Identify Eruption Cyst

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It's a complex odontome.

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26. Learn the fact

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28. No answer available

May be lingual tori

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32. Identify flap

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In this Pano ... Chin down smiling

37. Pt adult male. Present asymptomatic,

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1- middle cranial fossa

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odontogenic myxoma: non-

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The arrow is pointing to alternating

49. Identify – DAY 1

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53. Turner's Hypoplasia***-Frequent

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55. In regards to traumatic injury, which teeth are most

56. Identify problem, cause, treatment

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58. Attrition definition***

59. Abrasion definition Loss of tooth structure

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61. Attrition most often

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Destruction of teeth accomplished by cells located in

64. External Resorption***

65. Environmental Discoloration of teeth:

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67. Intrinsic staining examples:

68. Primary impaction of deciduous teeth is rare