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1. True generalized microdontia may occur in with of the following condition?

A. Hypothyrodism

B. Pituitary dwarfism

C. Hypoparathyroidism

D. Town syndrome

Answer: B

Microdontia is a developmental condition of abnormal small teeth. If all teeth are involved, it is called generalized microdontia. Generally, there are three categories:(1) True generalized microdontia, such as in pituitary dwarfism condition(2) Relative generalized microdontia, such as large jaw bone with normal sized teeth(3) Localized microdontia.The cause of microdontia includes: growth condition, musculoskeletal condition, oral/dental condition, etc.

2. Which tooth is most frequently affected by microdontia?

A. Maxillary lateral incisors

B. Maxillary third molar

C. Maxillary second premolar

D. Mandibular second premolar

Answer: A

Reginal/localized microdontia commonly affects the maxillary teeth, the most commonly affected teeth are maxillary lateral incisors (peg shaped) and third molar, followed by secondary premolars

3. True generalized macrodontia may occur in with of the following condition?

A. Hyperthyrodism

B. Hyperparathyroidism

C. Pituitary gigantism

D. Cushings syndrome

Answer: C

Macrodontia is a condition of having one tooth or teeth abnormally larger than that particular type of tooth/teeth True generalized macrodontia is rare, which affects the entire dentition Regional macrodontia is more common, which is usually caused by the disturbance of morphodifferentiation stage during tooth development

4. Rhizomegaly is most common affecting the roots of:

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A. Maxillary cuspid

B. Mandibular cuspid

C. Maxillary centre incisor

D. Madibular centre incisor

Answer: B

Rhizomegaly, also called radiculomegaly, is an uncommon condition of teeth with extremely long roots. The type of macrodontia in which the root or roots of a tooth are considerably longer than normal. The most commonly affected teeth are mandibular canines

5. All of the followings are characters of hypohidrotic ectodermal dysplasia, EXCEPT:

A. It is an X-linked recessive disorder affecting essentially males

B. Patients lack the ability to regulate body temperature

C. Hypodontia

D. There is defects in the development of salivary gland

Answer: D

Ectodermal dysplasias are heritable conditions with abnormalities of ectodermal structures, such as skin, hair, nails, sweat glands, teeth Hypohidrotic ectodermal dysplasia is an X-linked recessive disorder, which affects only male. People suffer hypohidrotic ectodermal dysplasia lack sweat glands or have functionally impaired sweat glands

6. Which of the following is the correct order of congenital missing teeth from most common to less

common?

A. Maxillary lateral incisor, third molar, second premolar

B. Third molar, maxillary lateral incisor, second premolar

C. Second premolar, third molar, maxillary lateral incisor

D. Third molar, second premolar, maxillary lateral incisor

Answer: B

The most common type of anodontia is hypodontia or oligodontia The most common congenital missing teeth are the third molars, followed by the maxillary lateral incisor and the second premolar

7. Which of the following is the correct order of supernumerary teeth from most common to less

common?

A. Paramolars, mesiodens, maxillary lateral incisor

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B. Maxillary lateral incisor, paramolars, mesiodens

C. Mesiodens, paramolars, maxillary lateral incisor

D. Mesiodens, maxillary lateral incisor, paramolars

Answer: C

Mesiodens, a supernumerary tooth located between the maxillary central incisors, is the most common supernumerary tooth, followed by maxillary fourth molars (paramolars) and maxillary lateral incisor

8. Which of the following is the correct order of impacted teeth from most common to less common?

A. Maxillary canines, third molars, mandibular second premolar

B. Third molars, maxillary canines, mandibular second premolar

C. Third molars, mandibular second premolar, maxillary canines

D. Maxillary canines, mandibular second premolar, third molars

Answer: B

The most common teeth to become impacted are the wisdom teeth (third molars), followed by maxillary canines and mandibular second premolar

9. All of the followings are characters of Taurodontism, EXCEPT:

A. It is the result of late invagination of Hertwigs root sheath

B. It primary affects premolars

C. Affected tooth presents with elongated crown and minimal constriction of cervical region

D. Affected tooth has extremely large pulp chamber

Answer: B

Taurodontism is a developmental disturbance, which primarily affect molars The bifurcation or trifurcation of the affected teeth is very close to the apex, resulting in an abnormally large and long pulp chamber and exceedingly short pulp canals

10. Den Invaginatus most commonly affects:

A. Maxillary central incisors

B. Maxillary lateral incisors

C. Maxillary premolars

D. Mandibular premolars

Answer: B

Den Invaginatus is a developmental pathologic condition of teeth. Its etiology is unclear, probably resulting from infolding of the dental papilla during tooth development

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The affected tooth is usually characterized by the appearance of an invaginated pit extending into the tooth structure with various distances This condition most commonly presents in maxillary lateral incisors, followed by maxillary central incisors, premolars

11. Which of the followings are examples of supernumerary cusps?

(1) Carabelli cusp

(2) Dens evaginatus

(3) Talon cusps

(4) Den Invaginatus

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Occasionally, teeth may present with supernumerary cusps. Carabelli cusp is the most common presentation of this condition, which has an accessory cusp found on the mesiolingual cusp of a maxillary permanent first molar Dens evaginatus is a developmental aberration of a tooth resulting in formation of an accessory cusp Talon cusps, also known as an "eagle's talon", is an extra cusp typically seen on the lingual aspect of maxillary incisors

12. Which of the following statement regarding teeth germination is INCORRECT?

A. It is primarily affects anterior teeth

B. Clinically it resembles teeth fusion

C. It is caused by partial division of a single tooth germ

D. There is one missing tooth present in the arch

Answer: D

Tooth Germination (twin) is a developmental dental anomaly, which is characterized by incomplete splitting of a single tooth germ It happens during the bell stage of tooth development and can affect both primary and permanent teeth It appearances like a fusion tooth, but the difference is there is no missing tooth in the dental arch

13. Which of the following statements regarding hypercementosis are INCORRECT?

(1) It is may seen in patient with Paget disease or hyperpituitarrism.

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(2) Affected tooth is usually nonvital

(3) The lamina dura is intact

(4) Treatment is extracting the involved tooth.

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: C

Tooth affected by hypercementosis appears enlarged and bulbous root. In spite of abnormal amounts of cementum, the affected roots are separated from periapical bone by both a normal-appearing periodontal ligament space and intact lamina dura Hypercementosis does not affect the vitality of teeth and not require treatment

14. Which of the following statement regarding Concrescence is INCORRECT?

(1). It is a type of fusion that occurs before root formation is complete

(2) It may occur before or after tooth eruption

(3) The affected teeth exhibit confluent dentin

(4) It is primarily involves the permanent maxillary molars

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: B

Concrescence is a type of fusion that occurs after root formation is complete The affected teeth exhibit confluent cementum Concrescence can occur before or after tooth eruption and primarily involves the permanent maxillary molars

15. Which of the following is the most significant clinical concern of cervical enamel projections?

A. Development of paradental cyst

B. Periodontal pocket formation

C. Root caries

D. Root sorption

Answer: B

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Cervical enamel projections are focal apical extensions of the coronal enamel beyond the cementoenamel junction and onto the root of tooth They could contribute the periodontal pocket formation and play a role in the development of paradental cyst

16. All of the followings are characters of Turner tooth, except:

A. It is a common form of focal enamel hypoplasia

B. It usually affects only one tooth in the dentition

C. It may result from localized inflammation or trauma during teeth development

D. It may involve both primary and permanent teeth

Answer: D

Turner tooth is enamel hypoplasia involving a single permanent tooth It is usually related to infection in the primary tooth that preceded it or to trauma during odontogenesis It is usually presented as a portion of missing or diminished enamel on permanent teeth

17. If generalized environmental enamel hypoplasia of teeth are formed during the first year of life,

which teeth are often involved?

(1) Permanent incisors

(2) Permanent cuspids

(3) Permanent first molars

(4) Permanent premolars

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

The formation of permeation premolars, second molars and third molars does not begin until a child is 3 years old

18. Neonatal line of teeth can be seen in which of the following teeth?

(1) Primary teeth

(2) Permanent incisors

(3) Permanent first molars

(4) Permanent cuspids

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A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: B

The neonatal lines are formed in Enamel and dentine at the point of birth It can be considered as a mild form of enamel hypoplasia Only teeth that are developing at birth can exhibit neonatal lines All the primary teeth are forming at birth. The first permanent molar is just beginning calcification at or near birth

19. All of the followings are characters of dental fluorosis, except:

A. The risk of fluoride overexposure occurs between the ages of 3 months and 3 years

B. Tooth is no longer at risk of fluorosis after eruption into the oral cavity

C. Regardless of the degree of floride mottling, affected teeth are largely resistance to dental caries

D. The differential diagnosis for dental fluorosis may include Turners hypoplasia and some mild

forms of amelogenesis imperfecta

Answer: A

Dental fluorosis is a developmental disturbance of dental enamel caused by excessive exposure to high concentrations of fluride during tooth development The risk of fluoride overexposure occurs between the ages of 3 months and 8 years. Fluorapatite is more resistant to dissolution by acids (demineralization)

Permanent

tooth

Hard tissue

formation

begins

Enamel

completed

(yrs after birth)

Eruption

(yrs after birth)

Root Completed

(yrs after birth)

Maxillary

Central incisors

Lateral incisors

Cuspid

1st premolar

2nd premolar

1st molar

2nd molar

3rd molar

3-4 month

10-12 month

4-5 month

1.5-2 yrs

2-2.5yrs

At birth

2.5-3 yrs

7-9yrs

4-5

4-5

6-7

5-6

6-7

2.5-3

7-8

12-15

7-8

8-9

11-12

10-11

10-12

6-7

12-13

17-21

10

11

13-15

12-13

12-14

9-10

14-16

18-25

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Mandibular

Central incisors

Lateral incisors

Cuspid

1st premolar

2nd premolar

1st molar

2nd molar

3rd molar

3-4 month

3-4month

4-5 month

1.5-2 yrs

2-2.5 yrs

At birth

2.5-3 yrs

8-10yrs

4-5

4-5

6-7

5-6

6-7

2.5-3

7-8

12-16

6-7

7-8

9-10

10-12

11-12

6-7

11-13

17-21

9

10

12-14

12-13

13-14

9-10

14-15

18-25

20. All of the followings are characters of amelogenesis imperfecta, except:

A. Most cases are inherited in an autosomal dominant pattern

B. It may affect both primary teeth and permanent teeth

C. There are three basic types of amelogenesis imperfecta

D. Hypoplastic type of amelogenesis imperfecta, the enamel is less radiodense than dentin

Answer: D

Type Enamel Quantity Enamel DensityHypoplastic Thinner than normal Radiodensity greater than dentinHypocacified Normal thickness Radiodensity less than dentinHypomaturation Normal thickness Radiodensity about the same as dentin

21. Which of the followings are characters of Dentinogenesis Imperfecta type I?

(1) This condition is inherited in an autosomal dominant pattern

(2) Patients may have blue sclera of the eyes

(3) The affected teeth are opalescent with the color ranging from bluish-gray to brown to yellow

(4) Usually the affected teeth exhibit extremely large pulp chambers by a thin shell of dentin

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Dentinogenesis Imperfecta (DI) is an autosomal dominant hereditary defect This disorder has been classified into three types

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-- Type I is associated osteogenesis imperfecta (OI), patients often exhibit other feature of OI, such as blue sclera of the eyes-- Type II is the most common type and does not associated osteogenesis imperfecta. The infected teeth have similar clinical appearance in both Type I and type II of DI. The teeth may be gray to yellowish brown and exhibit translucent or opalescent hue-- Type III, which is also called Brandywine type, is rare, clinically it is similar appearance as Type I and Type II, but teeth may exhibit extremely large pulp chambers by a thin shell of dentin

22. Which of the followings are characters of Dentin Dysplasia type I?

(1) It is an autosomal dominant inherited disorder

(2) The affected teeth are opalescent with the color ranging from bluish-gray to brown to yellow

(3) The roots of affected teeth are short, blunt or conical

(4) Usually the affected teeth exhibit extremely large pulp chambers by a thin shell of dentin

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: B

Dentin Dysplasia is an autosomal dominant inherited disorder characterized by abnormal dentin formation and abnormal pulp morphology Type I (Radicular DD) : Both dentition may be affected-- The color of teeth is usually within normal range-- The roots of teeth are short, blunt or conical-- In deciduous teeth, teeth often exhibit complete obliteration of the pulp chambers and root canals-- In permanent, theres also pulp obliteration, but may be crescent shaped Type 2: (Coronal DD): -- In deciduous teeth, teeth often exhibit complete obliteration of the pulp chambers and root canals are similar to type I-- In permanent teeth, large pulp chamber is seen in coronal portion of the tooth, pulp calcification may also present-- The roots of deciduous and permanent dentition are of normal shape and length

23. All of the followings are characters of Regional Odontodysplasia, except:

A. It is most commonly seen in permanent dentition

B. Affected teeth present with extremely large pulp chamber

C. The thin enamel and dentin have normal radiodensity

D. Pulp stone may occasionally be visible

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Answer: C

Regional odontodysplasia is an unusual developmental anomaly in which ectodermal and mesodermal tooth components are affected It is most commonly seen in permanent dentition The affected teeth exhibit extremely large pulp chamber with thin dentin and enamel, which exhibit marked decrease in radiodensity On radiographs the teeth are described as "ghost teeth"

24. All of the following conditions are autosomal dominant inherited disorder, EXCEPT:

(1) Dentinogenesis imperfecta

(2) Amelogenesis imperfecta

(3) Dentin Dysplasia

(4) Regional Odontodysplasia

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: B

Amelogenesis imperfecta is inherited in an autosomal recessive pattern Regional Odontodysplasia is a sporadically occurring nonhereditary disturbance of tooth development

25. Which of the following tooth developmental disturbance is(are) not inherited disorder?

(1) Dentin Dysplasia

(2) Turners tooth

(3) Taurodontism

(4) Regional Odontodysplasia

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. Only (4)

Answer: C

Regional Odontodysplasia, also termed ghost teeth, is a sporadically occurring nonhereditary disturbance of tooth development Tuners tooth is a form of focal enamel hypoplasia, which usually caused by localized inflammation or

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trauma during teeth development Dentin Dysplasia is an autosomal dominant genetic disorder of teeth. In some cases taurodontism seems to follow an autosomal dominant type of inheritance

26. Which of the following is(are) dental manifestation of Hypophosphatasia?

(1) Delayed formation and eruption of dentition

(2) Premature loss of primary teeth

(3) Absence of dental cementum

(4) obliteration of the pulp chambers and root canals

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. Only (4)

Answer: A

Hypophosphatasia is a metabolic bone disease caused by alkaline phosphatase deficiency in serum and tissues It may cause delayed formation and eruption of dentition, premature loss of primary teeth, which may be related to the absence of dental cementum There is also spontaneous loss of permanent teeth. Radiographic image reveal that the infected teeth exhibit enlarged pulp chamber and canals

27. Which of the following conditions may associated with macroglossia?

(1) Down syndrome

(2) Beckwith-wiedemann syndrome

(3) Hyperpituitarism

(4) Cretinism

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: D

There are two main causes of macroglossia: congenital and acquired Macroglossia is often seen in cases of Down's Syndrome Hyperpituitarism and hypothyroidism(cretinism) are acquired metabolic disorders which can lead to excessive tongue growth

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Beckwith-Wiedemann Syndrome is an overgrowth disorder characterized by a group of congenital anomalies. The most common manifestations are omphalocele, macroglossia, gigantism, and visceromegaly

28. A patient present with bilateral yellowlish maculopapules ranging from 1mm to 3 mm in diameters

on buccal mucosa, the lesions are painless. And the patient can not tell how long they are last.

Which of the following is the most proper diagnosis?

A. Leuoplakia

B. Fordyce granules

C. Lipoma

D. Candida albicans

Answer: B

Sebaceous glands present in various locations within the oral cavity are called Fordyce granules They are most commonly seen bilaterally on the buccal mucosa and the vermilion of the lip Fordyce granules appear as rice-like, white or yellow-white, asymptomatic papules, ranging from 1-3 mm in width. No treatment is required for Fordyce granules, except for cosmetic removal of labial lesions

29. A eight year old boy presents with an asymptomatic, bilateral, whitish gray, semitransparent

macule on the buccal mucosa, When the cheeks are stretched outward, the lesions disappear, which

of the following is the most proper diagnosis?

A. Leukoedema

B. White sponge nevus

C. Lichen Planus

D. Candida albicans

Answer: A

Leukoedema and white sponge nevus both have onset of lesions in the childhood Leukoedema is characterized by a mild degree of parakeratosis and variable intracellular edema of the epithelium Leukoedema usually presents as an asymptomatic, bilateral, whitish gray, semitransparent macule of the buccal mucosa. When the cheeks are stretched outward, the leukoedema typically disappears. But white sponge nevus will remain visible when the affected mucosa is stretched

30. A 10 year old boy presents with an asymptomatic, well demarcated,whitish corrugated lesions on

the buccal mucosa, his elder brother also has the same lesion. When the cheek is stretched outward,

the lesion does not change, which of the following is the most proper diagnosis?

A. Leukoedema

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B. White sponge nevus

C. Lichen Planus

D. Candida albicans

Answer: B

White sponge nevus is an autosomal dominant hereditary disorder, which almost always presents during childhood The microscopic feature of White sponge nevus includes hyperparakeratosis, acanthosis and intracellular edema of the superficial epithelial cells, predominantly within the spinous layer. Lesions are usually well demarcated from the surrounding normal mucosa, (leukoedema and smokeless tobacco keratosis are poor demarcated) The white lesion of leukoedema tends to diminish or disappear when the mucosa is stretched, while no change is seen in white sponge nevus or other similar lesions

31. Which of the following oral lesions have character of intracellular edema?

(1) Smokeless tobacco keratosis

(2) Frictional keratosis (chronic cheek bite keratosis)

(3) white sponge nevus

(4) leukoplakia

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Intracellular edema is characteristic of several oral lesions: Leukoedema, White sponge nevus, Smokeless tobacco Keratosis, frictional keratosis (chronic cheek bite keratosis), and Witkop's disease Smokeless tobacco keratosis is characterized by surface parakeratosis and may demonstrate pronounced intracellular edema of superficial cells Frictional keratosis, especially chronic cheek bite keratosis is characterized by extensive surface keratosis,,may also present with intracellular edema of superficial epithelial cells leukoplakia is lack of intracellular edema

32. Which of the following is the most common cleft deformity?

A. Unilateral cleft upper lip

B. Bilateral cleft upper lip

C. Cleft palate

D. Combined cleft lip and cleft palate

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Answer: D

Combined cleft lip and cleft palate is the most common cleft deformity, accounting for approximately 50% of all cleft cases

33. Lip cleft is due to the failure of fusion of the ____and ______.

A. maxillary process, medial nasal process

B. maxillary process, lateral nasal process

C. medial nasal process, lateral nasal process

D. None of the above

Answer: A

Lip cleft can be unilateral or bilateral. It is due to the failure of fusion of the maxillary and medial nasal processes The cause of cleft lip involves both hereditary and environmental factors

34. Surgical repair of Cleft lip is usually performed during _____ of patients life, while cleft palate is

repaired approximately ___ of age.

A. 6month, 12month

B. 2-3 month, 12 month

C. 12month, 18 month

D. 18 month, 24month

Answer: B

Often the preferred age to repair cleft lip is at approximately 10 weeks of age, following the "rule of 10s" suggested by surgeons Wilhelmmesen and Musgrave in 1969 (the child is at least 10 weeks of age, weighs at least 10 pounds, and has at least 10g hemoglobin). Cleft palate repair is usually performed between 6 and 18 months35. All of the followings are characters of Stafne cyst are true, except:

A. It is located below mandibular canal

B. Radiographic image reveals a well-defined radiolucent area

C. It is a true cyst with epithelium line

D. No treatment is required

Answer: C

Stafne cyst is a developmental concavity of the lingual cortex of mandible It is usually located in the 3rd molar area, between the mandibular canal and inferior border of the mandible It is a pseudo Cyst, which is not lined by epithelium Radiographically, it is a well-defined, oval-shaped radiolucent image

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36. Which of the followings are oral manifestations of Cleidocranial dysplasia?

(1) Hyperplastic maxilla

(2) Supernumerary teeth

(3) Flat palate

(4) Failure of tooth eruption

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: C

Cleidocranial dysplasia is an autosomal dominant hereditary disorder It has the characters of bilateral partially present or absent clavicles, enlarged frontal and occipital skull plates, under-developed midface, hypoplasitic maxilla, highly arched and narrow palate, supernumerary teeth and failure of tooth eruption

37. Which of the following manifestations may associated with Crouzon Syndrome?

(1) Maxillary hypoplasia

(2) Short upper lip

(3) Widely spaced eyes

(4) Supernumerary teeth

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Crouzon Syndrome is a autosomal dominant genetic disorder characterized by the premature fusion of certain skull bones. It has characters of (1) Wide-set, bulging eyes and vision problems(2) beaked nose(3) Poor vision, hearing deficits(4) Maxillary hypoplasia, teeth crowding(5) Short head, short upper lip(6) Usually of normal intelligence

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38. Which of the following are oral-facial manifestations of Treacher collin syndrome?

(1) Depressed cheeks

(2) Retruded chin

(3) Downward slanting eye

(4) Enlarged tongue

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Treacher collin syndrome is a rare autosomal dominant congenital disorder characterized by craniofacial deformities Affected patients exhibit a characteristic physical features including downward slanting eyes, micrognathis (a small lower jaw), conductive hearing loss,underdeveloped zygoma, drooping part of the lateral lower eyelids, and malformed or absent ears

39. Which of the following are common oral findings of Down syndrome?

(1) Macroglossia

(2) Juvenile periodontitis

(3) Delayed eruption of both primary and permanent teeth

(4) Supernumerary teeth

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Down syndrome has a set of mental and physical symptoms that result from having an extra copy of Chromosome 21. Common oral findings of down syndromes include: (1) Broad lip, fissured lip(2) Macroglossia, fissured tongue(3) Open mouth with protruding tongue(4) Narrow palate(5) Malocclusion(6) Congenitally missing teeth(7) Delayed eruption of both primary and permanent teeth

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(8) Predisposition of periodontal disease

40. Osteogenesis imperfecta has all of the following manifestations except:

A. Bone deformity

B. Blue sclera

C. Amelogenesis imperfecta

D. Dentiogenesis imperfecta often present

Answer: C

Osteogenesis imperfecta (OI) is a genetic disorder. Its typical characteristic includes bone fragility. It may have the following characteristics: Normal or short stature Bone fragility Bone deformity Loose and muscle weakness Blue sclera Dentiogenesis imperfecta Possible hearing loss Quantity and quality change of collagen structure

41. All of the followings are characters of dentinogenesis imperfecta, except:

A. Obliteration of the pulp chamber

B. Teeth are opalescent with the color ranging from bluish to gray

C. Soft enamel tissue

D. Bulb-shaped crowns with constricted cemental-enamel junctions and thin roots

Answer: C

Dentinogenesis imperfecta Autosomal dominant genetic disorder of Affects both primary and permanent teeth Clinical feature-- Teeth present blue or amber brown and opalescent-- Enamel, which is with normal hardness, may split readily from dentin when subjected to occlusal stress -- Severe attrition of teeth-- Soft and easily penetrable dentin -- Pulp chamber obliteration Histologically-- Normal enamel-- Normal mantle dentin-- Severly dysplastic dentin structure (except mantle dentin)

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-- Dentinal tubules irregular and reduced in numbers -- Absence of odontoblastic processes and existing of degenerating cellular debris -- DEJ becomes smooth (flat) instead of scalloped

42. Which type of dentinogenesis imperfecta is associated with osteogenesis imperfecta?

A. Type I

B. Type II

C. Type III

D. Both Type I and Type II

Answer: A

Dentinogenesis imperfecta is an inherited defect of dentin formation This disorder is classified into three types -- Type I is associated with associated osteogenesis imperfecta-- Type II is the most common type and not associated with associated osteogenesis imperfecta-- Type I and type II are similar and present with bulb-shaped crowns with constricted cemental-enamel junctions and thin roots-- Type III (brandywine type) is rare and may present extremely large pulp chamber surrounded by a thin shell of dentin

43. Which of the following cysts are odontogenic?

(1) Dentigenous cyst

(2) Radicular cyst

(3) Odontogenic keratocyst

(4) Nasoplatine cyst

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

CLASSIFICATION OF CYSTS

Odontogenic Cysts

Inflammatory Radicular cystResidual cyst

Developmental

Dentigenous cystEruption cystLaterial periodontalOdontogenic keratocyst (OKC)

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Calcifying odontogenic cyst (COC)

Non-odontogenic Cysts

Nasoplatine cystNasolabial cystDermoid cystThyroglossal duct cystLymphoepithelial cyst

Pseudo Cysts Stafne bone cystSolitary bone cystAneurysmal bone cyst

44. Which of the followings are basic structures of a true cyst?

(1) Lumen

(2) Epithelial lining

(3) Capsule

(4) Fluid or semisolid content

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

The elements of a cyst include Wall or capsule, epithelium lining and lumen

45. Which of the followings are pseudocysts?

(1) Static bone cyst

(2) Traumatic bone cyst

(3) Aneurysmal bone cyst

(4) Residual cyst

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

A pseudocyst is a cystic lesion, but lacks epithelial lining Static bone cyst, traumatic bone cyst, mucocele-extravasation cyst and aneurysmal bone cyst are all

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pseudocysts Residual cyst is an odontogenic cyst that remains in the jaw after the removal of a tooth, it is a true cyst with non-keratinized stratified squamous epithelium

46. Which of the followings are epithelium source of odontogenic cysts?

(1) Rests of Malassez

(2) Reduced enamel epithelium

(3) Remnants of the dental lamina

(4) Epithelium of vestigial ducts, such as nasopalatine duct, nasolacrimal duct

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: A

Odontogenic cysts are derived from three epithelium structure:

(1) Rests of Malassez---remain of Hertwigs epithelial root sheath (HERS) that didn't completely disappear(2) Reduced enamel epithelium--- layers of enamel organ remaining on the tooth surface after completion of enamel formation(3) Remnants of the dental laminapresent as epithelial pearls or islands within the jaw

47. Which one of the following is the most common type of odontogenic cyst?

A. Dentigenous cyst

B. Radicular cyst

C. Nasopalatine cyst

D. Lateral periodontal cyst

Answer: B

Periapical cyst (Radicular cyst) is the most common odontogenic cyst, which is caused by pulpal necrosis

48. Which of the following is the epithelium source of periapical cyst?

A. Rests of Malassez

B. Reduced enamel epithelium

C. Remnants of the dental lamina

D. None of the above

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Answer: A

Periapical Cyst is the most common odontogenic cyst of inflammatory origin It is caused by pulp necrosis following dental caries or trauma The epithelium cyst lining is derived from the Rests of Malassez

49. Which of the following cysts derived from Reduced Enamel Epithelium?

(1) Ridicular cyst

(2) Dentigerous cyst

(3) Odontogenic keratocyst

(4) Paradental cyst

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: C

Cysts derived from Rest of Malassez: Radicular cyst ( periapical cyst), residual cyst Cysts derived from Reduced enamel epithelium: Dentigerous cyst, Eruption cyst, Bifurcation cyst (Paradental cyst) Cysts derived from Dental lamina: Odontogenic keratocyst, Lateral periodontal cyst, gingival cyst of adult, gingival cyst of new bone

50. Radicular cysts most commonly develop from?

A. Inflammation pulp tissue

B. Pre-existing periapical granulomas

C. Periodontal abscess

D. Acute periapical inflammation

Answer: B

Radicular cyst is the most common odontogenic cyst (attributes to about 60% of all jaw cysts) The first periapical defense reaction to pulp necrosis is the formation of a granuloma. Then chronic inflammatory response stimulates the proliferation of epithelium from rests of Malassez and induces the formation of cyst

51. Which of the following statements regarding dentigenous cyst are correct?

(1) It is the outcome of dental inflammation

(2) The most common site is at the mandibular posterior region

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(3) It is usually very painful

(4) It usually associated with an impacted tooth

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: C

Characteristics of dentigenous cyst:(1) It is most commonly found in posterior mandible and around the crown of an unerupted tooth (attached to CEJ)(2) Clinically, it is usually asymptomatic, (may present pain or swelling) (3) Radiographic image shows a well defined unilocular radiolucency lesion(4) Cyst line is non-keratinized stratified squamous epithelium

52. The size of normal follicular space is:

A. 1-2mm

B. 2-3mm

C. 3-4mm

D. 4-5mm

Answer: B

It is difficult to differentiate between a small dentigerous cyst and a hyperplastic follicle. With dentigerous cyst, patient typically has no pain or any discomfort. If there is evidence of tooth displacement or considerable expansion of the involved bone, cyst is suspected Usually, the size of normal follicular space is 2-3mm. If the size of follicular space is more than 5mm, cyst is suspected. Follow up exam is most important

53. Which of the following is not a character of basal cell nevus syndrome?

A. Multiple basal cell carcinomas of the skin

B. Multiple Odontogenic keratocyst

C. Multiple supernumerary teeth

D. Dearly calcification of falx cerebri

Answer: C

Basal cell nevus syndrome Also known as Nevoid Basal Cell Carcinoma Syndrome or Gorlin Syndrome It is an inherited autosomal dominant condition defecting multiple body systems such as the skin, bones, nervous system, endocrine system

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Common clinical findings:(1) Multiple nevoid basal cell carcinomas of the skin(2) Multiple odontogenic keratocysts(3) Congenital skeletal abnormalities: such as early calcification of falx cerebri, bifid ribs, vertebrae anomalies, frontal bossing(4) Hypertelorism(5) Mandibular prognathism(6) Ocular defects: Cataracts, Glaucoma

54. A cyst may be associated with all of the following conditions, except:

A. A necrotic tooth

B. Basal cell nevus syndrome

C. Odontogenic myxoma

D. Ameloblastoma

Answer: C

The periapical cyst (radicular cyst) is associated with pulp necrosis One of the clinical manifestation of Basal cell nevus syndrome is multiple odontogenic keratocyst (OKC) Ameloblastoma can develop from the epithelial lining of a dentigerous cyst. In this condition, it is hard to differentiate ameloblastoma from dentigerous cyst if theres no septa present55. All of the following cysts are derived from reduced enamel epithelium, EXCEPT:

A. Radicular cyst

B. Dentigerous cyst

C. Paradental cyst

D. Eruption cyst

Answer: A

Cysts derived from Rests of Malassez Radicular cyst

Residual cystCysts derived from Reduced Enamel

Epithelium

Eruption cyst

Dentigerous cyst

Paradental cystCysts derived from Dental Lamina Odontogenic keratocyst (OKC)

Lateral periodontal cyst

Gingival cyst

56. All of the followings are characters of dentigerous cyst, except:

A. It is commonly associated with an unerupted tooth

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B. The cyst is attached to the CEJ of the unerupted toth

C. It is usually lined with non-keratinized stratified squamous epithelium

D. Histologically, the cyst presents with irregular bulbous rete ridges

Answer: D

The lumen of dentigerous cyst is lined with non-keratinized stratified squamous epithelium The epithelium and connective tissue interface is flat Radiographically, the cyst appears as a well-defined radiolucency surrounding the crown of an unerupted tooth

57. Which of the following lesion needs most aggressive treatment?

A. Radicular cyst

B. Dentigerous cyst

C. Odintogenic keratocyst

D. Paradental cyst

Answer: C

Odontogenic keratocyst has a remarkable growth potential, greater than the other odontogenic cysts. And it exists a recurrent rate of approximately 30%

58. Which of the following condition is not an inflammatory lesion?

A. Abscess

B. Radicular cyst

C. Fibrous epulis

D. Laternal periodontal cyst

Answer: D

The lateral periodontal cyst is a developmental cyst degenerating from cells of the dental lamina The most common location of the cyst is in mandibular premolar region It is usually asymptomatic and is found accidentally by radiographic images Radiographic image shows a well defined unilocular or multilocular radiolucency lesion Cyst line is non-keratinized stratified squamous epithelium with Focal epithelial thicken plaques

59. Odintogenic keratocyst may be seen together with all of the following clinical manifestations,

except:

A. Multiple basal cell carcinomas of the skin

B. Bifid ribs

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C. Supernumeray teeth

D. Hypertelorism

Answer: C

Nevoid basal cell carcinoma syndrome (GorlinGoltz syndrome) is an autosomal dominant syndrome It involves defects of multiple body systems such as the skin, nervous system, eyes, endocrine system, and bone

The Components of this syndrome include: (1) multiple basal cell carcinomas of the skin(2) multiple Odintogenic keratocyst(3) rib and vertebrae anomalies(4) intracranial calcification(5) skeletal abnormalities, such as bifid ribs, falx cerebri calcification(6) frontal and temporopariental bossing, hypertelorism, and mandibular prognathism

60. Which of the following are histologic findings of odintogenic keratocyst?

(1) non-keratinized stratified squamous epithelium

(2) Corrugated parakeratin on the luminal surface

(3) Bulbous rete ridges

(4) Daughter cysts

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. All of the above

Answer: C

Histologic features of odontogenic keratocysts(1) Parakeratinized / keratinized stratified squamous epithelium(2) Corrugated parakeratin(3) Thin connective wall(4) Epithelium and CT interface is flatlack rete peg(5) Desquamated keratin in lumen(6) Satellite cysts in wall

61. Which of the following lesion(s) has (have) a tendency to growth along the long axis of bone?

(1) Dentigous cyst

(2) Odongenic keratocyst

(3) Aneurysmal bone cyst

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(4) Simple bone cyst

A. (1) (2) (3)

B. (1) (3)

C. (2) (4)

D. Only (4)

Answer: C

Almost all Simple bone cysts are found in the mandible and their boundary is better defined in the alveolar process, giving a scalloped border appearance between the roots of teeth on a radiographic image Simple bone cyst has a tendency to grow along the long axis of the bone, causing minimal bone expansion Odongenic keratocyst also has a tendency to grow along the internal aspect of jaw, causing minimal bone expansion Most of the cysts, such as dentigous cyst are thought to growth solely by osmotic pressure and expansion at all direction from the epicenter Benign lesions grow by displacing adjacent tissues, their growing in bone tend to be round or oval Aneurysmal bone cyst cause diffuse swellings which result in facilal deformity and may perforate the cortex

62. Focal epithelium thicken (plaque) is usually seen in which one of the following condition? (D )

A. Radicular cyst

B. Dentigerous cyst

C. Odintogenic keratocyst

D. Lateral periodontal cyst

Answer: D

Histologic features of lateral periodontal cyst: (1) non-keratinized stratified squamous epithelium(2) Focal epithelial thicken plaques(3) Botryoid variant ---polycystic

63. Which of the following lesions have the similar histological findings?

(1) Lateral periodontal cyst

(2) Lateral periapical cyst

(3) Gingival cyst of adult

(4) Eruption cyst

A. (1) (2)

B. (1) (3)

C. (2) (4)

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D. (3) (4)

Answer: B

Lateral periodontal cyst, Dental lamina cyst of new born and Gingival cyst of adult are all derived from Remnants of the dental lamina Histologic features of the gingival cyst of adult are similar to those of lateral periodontal cyst Some studies conclude that they are the same entity with extraosseous and intraosseous manifestation

64. The epithelium source of nasolabial cyst is:

A. Rests of Malassez

B. Reduced enamel epithelium

C. Remnants of the dental lamina

D. Epithelium remain of nasolacrimal duct

Answer: D

This nasolabial cyst is located superficially in the soft tissues of the upper lip, below the ala of the nose. It is an extraosseous cyst It is considered to originate from remnants of the inferior and anterior portions of nasolacrimal duct

65. Which of the following cyst may not be detected on a radiographic image?

A. Residual cyst

B. Nasopalatine cyst

C. Nasolabial cyst

D. Globulomaxillary cyst

Answer: C

Characteristics of Nasolabial cyst:(1) It is classified as a soft tissue cyst(2) It is now thought to arise from the remnants of the embryonic nasolacrimal duct or the lower anterior portion of the duct(3) It is presented outside the bone in the nasolabial folds below the ala nasi(4) The most common symptom is unilateral swelling, big lesion may cause difficulty in nasal breathing(5) It usually can not be detected by radiographic image unless opacifier is injected

66. A middle-aged woman presents with a movable symptomatic, yellowish superfacial submucosal

mass less tha 1 cm in diameter at the floor of the mouth, which of the following would be the most

possible diagnosis?

A. Lymphoma

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B. Lymphoepithelial cyst

C. Lipoma

D. Ranula

Answer: B

Common

intra-oral site

Clinical findings Histologic faetures Treatment

Lymphoma Buccal

vestibule,

posterior

hard palate,

gingiva

Soft tissue lesions:

Non-tender, diffuse

erythematous swelling

With/without ulceration

Bone lesions:

Vague pain

With/without

paresthesia

Diffused infiltration of

sheets of malignant

lymphoid cells

Malignant cells with

large vesicular nucleus

and small amount of

cytoplasm

Chemotherapy

Radiation therapy

Surgical

management not

usually indicated

Lymphoepithelial

cyst

Floor of

mouth

Post/lateral

of tongue

Asymptomatic

yellow soft superficial

mass

Usually less than 1cm

in diameter

Line: thin para-

keratinized SSE

surrounded by normal

lymphoid tissue

Lumen:

desquamated

parakeratin epithelium

cells

Surgical excision

Lipoma buccal

mucosa and

buccal

vestibule

Asymptomatic

pedunculated/ sessile

swellings

Superficial lesion:

yellow hue

Deeper lesion: normal

in color

Hyperkeratotic

stratified squamous

epithelium

Mature fat cells,

adipocytes

Conservative

surgical excision

Ranula floor of the

mouth

Blue, dome-shaped

fluctuant swelling

May elevate tongue

Well-circumscribed

cavity containing mucin

surrounded by wall of

Marsupialization /

surgical excision

with or without

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compressed fibrous

connective tissue

Dilated salivary

gland duct with

metaplastic change

removal of the

feding sublingual

gland

67. The most common location of oral lymphoepithelial cyst is_______, and the most common

location of cervical lymphoepithelial cyst is_______.

A. anterior floor of mouth, lateral aspect of the neck & posterior to the sternocleidomastoid muscle

B. anterior floor of mouth, lateral aspect of the neck & anterior to the sternocleidomastoid muscle

C. soft palate, lateral aspect of the neck & posterior to the sternocleidomastoid muscle

D. soft palate, lateral aspect of the neck & anterior to the sternocleidomastoid muscle

Answer: B

Approximately half of all intraoral lymphoepithelial cyst are found on the floor of mouth, cervical lymphoepithelial cyst occurs on lateral aspect of the neck, usually anterior to the sternocleidomastoid muscle

68. Which of the following non odootogenic cyst needs the most aggressive surgical treatment?

A. Nasopalatine cyst

B. Lymphoepithelial cyst

C. Thyroglossal cyst

D. Dermoid cyst

Answer: C

Thyroglossal cyst is a rare lesion presenting in the mildline of the anterior neck, usually below the hyoid bone & above the thyroid gland The treatment is surgical excision, because of the high recurrent tendency, it is recommaned that the central portion of the hyoid bone and the remnants of the thyroglossal tract be removed

69. Which of the following are not a common feature of both dermoid cyst and epidermid cyst?

A. Cysts are lined by orthokeratinized squamous epithelium

B. The lumen is generally filled with desquamated keratin

C. Dermal appendages, such as hair follicle, sebaceous glands and sweat glands in the capsule

D. Cyst wall consists of fibrous connective tissue free of inflammation

Answer: C

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The epidermid cyst occurs primarily on skin, occasionally seen intraorally The epidermid cyst closely resemble a dermoid cyst except that epidermid cyst has no dermal appendages

Answer: C60. Which of the following are histologic findings of odintogenic keratocyst?