AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

1. Tooth with occlusal configuration of Y-shaped development groove is gound in a. Mandibular 2nd premolar b. Mandibular 1st premolar nd c. Maxillary 2 premolar d. Maxillary 1st premolar 2. Sharpest and highest cusp of primary 1st molar tooth is a. Mesiobuccal b. Mesiolingual c. Distobuccal d. Distolingual 3. Which of the following is least mineralized a. Cementoid b. Incremental line c. Cellular cementum d. Acellular cementum 4. Root of the primary and secondary teeth are different in that respect that the primary roots are more divergent and flaring. The other differences is: A. Primary roots show less accessory and lateral canals B. Primary roots resorb more easily C. Primary roots are shorter D. None of the above 13. In extraction of maxillary first premolars, the root anatomy guides the dentist to use a motion that is primarily: A. Buccal-lingual luxation B. Mesiodistal luxation C. Rotation D. All of the above 14. How many teeth (out of 32) in the normal dentition oppose only ONE other tooth? A. None B. 1 C. 2 D. 4 15. Which premolar is considered to be most molar-like in form? A. Maxillary first B. Maxillary second C. Mandibular first D. Mandibular second 16. The distal inclination in roots of the permanent mandibular first molar is: A. More pronounced in either root, depending on the tooth B. Usually more pronounced in the mesial root C. Usually more pronounced in the distal root D. Usually equal in both roots 17. The greatest curvature of the cervical line interproximally is found on the: A. Mesial of the maxillary central B. Mesial of the maxillary lateral C. Distal of the maxillary central D. Distal of the maxillary lateral 18. Which incisor commonly exhibits the most variety in anatomy in both crown form and root form? A. Maxillary central B. Maxillary lateral C. Mandibular central D. Mandibular lateral 19. The mesiobuccal cusp of the maxillary third molar occludes in: A. the mesial marginal ridge of the mandibular second molar B. the distal marginal ridge of the mandibular second molar C. the mesial marginal ridge of the mandibular third molar D. the buccal groove of the third mandibular molar 20. The mesiobuccal cusp of the mandibular second molar occludes with which maxillary tooth surfaces? A. The mesial marginal ridge of the second molar and distal marginal ridge of the first molar B. The distal marginal ridge of the second molar and mesial marginal ridge of the third molar C. The embrasure between the first and second molars D. The central fossa of the maxillary second molar 21. In an ideal arrangement of permanent teeth, the largest incisal embrasure lies between: A. Maxillary central incisor B. Maxillary central and lateral incisor C. Maxillary lateral incisor and canine D. Mandibular central and lateral incisor 22. The most prominent cingulum is found on which incisor? A. Maxillary central B. Maxillary lateral C. Mandibular central D. Mandibular lateral
1

5. Tooth eruption occurs when root formation is completed A. 25%. B. 50%. C. 75%. D. 100%. 6. The most steep cusp inclines are seen in: A. Maxillary 1st premolar B. Maxillary 1st molar nd C. Mandibular 2 premolar D. Mandibular 1st molar 7. The deciduous teeth are differentiated from the permanent teeth by: A. Enamel prismatic arrangement B. Dentinal tubule arrangement C. Primary and secondary dentine D. Mineral content 8. When is the first evidence of calcification of primary teeth? A. 4 month in utero B. 4 and month in utero C. 5 month in utero D. 6 month in utero 9. Relative to primary mandibular incisor permanent mandibular incisor erupt A. Lingually B. Facially C. Measially D. Distally

10. The most common arrangement of canals in the roots of a permanent maxillary first molar is: A. ML, MB, DL, DB B. ML, MB, and DB only C. ML, MB, and palatal D. MB, DB, and palatal 11. In the intercuspal position, the lingual cusp of maxillary 2nd premolar contacts the: A. Distal fossa of mandibular 2nd premolar B. Mesial marginal ridge of mandibular 1st molar C. Distal marginal ridge of mandibular 2hnd molar D. Distal marginal ridge of mandibular 2nd premolar 12. The mesiobuccal cusp of the maxillary first molar occludes in: A. The mesial marginal ridge of the mandibular second molar B. The distal marginal ridge of the mandibular first molar C. The central groove of the mandibular first molar D. The buccal groove of the first mandibular molar

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

23. Which premolar has a lingually inclined occlusal table? A. Maxillary first B. Maxillary second C. Mandibular first D. Mandibular second 24. When viewed from the buccal, the tooth closest to vertical in the mesiodistal angulation of its main axis is A. maxillary central incisor B. maxillary lateral incisor C. maxillary canine D. maxillary first premolar 25. The distobuccal cusp of the mandibular first molar occludes with which maxillary tooth surfaces? A. The mesial marginal ridge of the second molar and distal marginal ridge of the first molar B. The central fossa of the first molar C. The mesial marginal ridge of the first molar and the distal marginal ridge of the second premolar D. The embrasure between the first and second molars 26. At the cervical line, a cross section of the maxillary canine would show: A. a round shape B. an oval shape wider on the lingual than the labial C. a triangular shape with a distinctly wider labial surface D. an oval shape with a slightly wider labial surface 27. An example of a guiding (nonsupporting) cusp is: A. distolingual of #30 B. mesiobuccal of #18 C. distolingual of #14 D. lingual of #5 28. Which incisor is most commonly congenitally missing? A. Maxillary central B. Maxillary lateral C. Mandibular central D. Mandibular lateral 29. A patient is congenitally missing the maxillary lateral incisors and mandibular second premolars. This individual is said to have the condition known as: A. anodontia B. oligodontia C. hypodontia D. hyperdontia 30. Which cusp becomes smaller and less conspicuous as you go from maxillary first to second to third molar? A. Mesiobuccal B. Mesiolingual C. Distobuccal D. Distolingual 31. Cervical bulges are found on which surfaces of primary molar teeth? A. Mesial and distal B. Buccal and lingual C. Lingual only D. Buccal only 32. In rare cases, a permanent mandibular first molar may have a complete supernumerary third root. This root is usually: A. a second mesial root B. a second distal root C. a buccal root D. a lingual root 33. In centric occlusion, the distolingual cusp of the maxillary first molar will contact: A. the mesial marginal ridge of the mandibular first premolar and distal marginal ridge of the second premolar B. the distal marginal ridge of the mandibular second premolar and mesial marginal ridge of the first molar C. the distal marginal ridge of the mandibular first molar and mesial marginal ridge of the second molar D. the distal marginal ridge of the mandibular second molar and mesial marginal ridge of the first molar 34. The mesiolingual cusp of the mandibular second molar contacts: A. the lingual embrasure between the maxillary first molar and second molar B. the distal marginal ridge of the maxillary second molar C. the central fossa of the maxillary second molar D. the lingual groove of the maxillary second molar 35. At the cervical line, a cross section of the maxillary lateral incisor would show: A. a round shape B. an oval shape wider on the lingual than the labial C. a triangular shape with a distinctly wider labial surface D. an oval shape with a slightly wider labial surface 36. Because of the staining effect, tetracycline is not given to children younger than approximately what age? A. 2 years B. 5 years C. 8 years D. 11 years 37. Which structure is involved in pulling the disc of the TMJ forward? A. Stylomandibular ligament B. Medial pterygoid muscle C. Mandibular condyle D. Lateral pterygoid muscle 38. The largest cusp of a maxillary first molar is the: A. mesiobuccal B. mesiolingual C. distobuccal D. distolingual 39. Tooth #B is replaced by tooth #: A. 2 B. 3 C. 4

D. 5

40. The masseteric sling is composed of the masseter & the: A. medial pterygoid B. lateral pterygoid C. anterior digastric D. temporalis 41. Which two molars can be considered to be five-cusped teeth? A. Maxillary first and second B. Mandibular first and second C. Maxillary and mandibular first D. Maxillary and mandibular second 42. The shape of the pulp chamber in cross section cut at the cervical line in the maxillary canine is: A. oval (flattened mesiodistally) B. oval (flattened bucco-lingually) C. round D. figure eight 43. In the maxillary arch, the narrowest incisal or occlusal embrasure is located: A. between first premolar and canine B. between canine and lateral incisor C. between lateral incisor and central D. between central incisors 44. The deepest groove on the occlusal surface of the maxillary 1st molar is: A. Mesiolingual B. Mesiobuccal C. Distbuccal D. Distolingual
2

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

45. Which ligament of the originates from a thin, temporal bone? A. Temporomandibular C. Sphenomandibular temporomandibular joint pointed extension of the B. Stylomandibular D. Lateral 57. Of the following premolars, the one which can never be rotated during extraction is the: A. maxillary first B. maxillary second C. mandibular first D. mandibular second 58. In centric occlusion, the lingual cusp of the maxillary second premolar contacts: A. the mesial marginal ridge of the mandibular first premolar and distal marginal ridge of the second premolar B. the distal marginal ridge of the mandibular first premolar and mesial marginal ridge of the second premolar C. the mesial marginal ridge of the mandibular first molar and distal marginal ridge of the second premolar D. the distal marginal ridge of the mandibular second premolar and mesial marginal ridge of the first molar 59. The maxillary molar most likely to have fused roots is the: A. First B. Second C. Third D. Fused roots are rare for all three molars 60. The distobuccal cusp of the mandibular second molar occludes with which maxillary tooth surfaces? A. The mesial marginal ridge of the second molar and distal marginal ridge of the first molar B. The distal marginal ridge of the second molar and mesial marginal ridge of the third molar C. The embrasure between the first and second molars D. The central fossa of the maxillary second molar 61. Which of the following has bifid root: A. Mandibular lateral incisor B. Mandibular central incisor C. Mandibular canine D. Mandibular 1st premolar 62. Which of the following is NOT considered an important reason for restoring proximal contact in dental restorations? A. Contact protects the periodontal tissue B. Contact prevents food impaction C. Contact increases retention of the restorations D. Contact prevents tooth drifting 63. The anterior tooth with the most pronounced lingual ridge is the: A. Maxillary central incisor B. Mandibular lateral incisor C. Maxillary canine D. Mandibular canine 64. Which tooth below is MOST likely to be caries-resistant? A. Maxillary first premolar B. Mandibular second premolar C. Mandibular lateral incisor D. Mandibular second molar 65. While preparing a class-II cavity on maxillary first molar which of the pulp horn are likely to get exposed: A. Mesiolingual and mesiobuccal B. Distolingual and distobuccal C. Mesiolingual and distobuccal D. Distolingual and mesiobuccal

46. In the mesial outline of the labial aspect of mandibular canine as seen from its am the apex of the root is in shape: A. Convex B. Concave C. Irregular D. Relatively straight 47. In a distal view of a permanent maxillary first molar, how many roots should be visible? A. 1 B. 2 C. 3 D. 4 48. The heights of contour of the mandibular first premolar, when viewed from the mesial, are located within which third? A. buccal in occlusal third, lingual in middle third B. both in middle third C. both in occlusal third D. buccal in cervical third, lingual in occlusal third 49. Which of the following oral muscles is NOT innervated by CN V? A. Masseter B. Buccinator C. Medial pterygoid D. Lateral pterygoid 50. The contact of the permanent mandibular incisor with the canine occurs at which level of the lateral? A. Incisal third B. Junction of incisal and middle thirds C. Middle third D. Gingival third 51. Which cusp on the primary mandibular first molar is highest and sharpest? A. Mesiobuccal B. Distobuccal C. Mesiolingual D. Distolingual 52. Dens-in-dente is most commonly noted in which tooth? A. Maxillary central B. Maxillary lateral C. Maxillary canine D. Mandibular central 53. Which of the following premolar has a mesial marginal ridge more cervical than the distal marginal ridge: A. Maxillary 1st premolar B. Maxillary 2nd premolar st C. Mandibular 1 premolar D. Mandibular 2nd premolar 54. Guiding cusps normally contact: A. mesial marginal ridges B. distal marginal ridges C. central fossae D. embrasures 55. Which premolar, when viewed from the facial, has a longer mesial cusp ridge than distal cusp ridge? A. Maxillary first B. Maxillary second C. Mandibular first D. Mandibular second 56. In centric occlusion, the distolingual cusp of the maxillary second molar will contact: A. the central fossa of the mandibular second molar B. the distal marginal ridge of the mandibular first molar and mesial marginal ridge of the second molar C. the distal marginal ridge of the mandibular second molar and mesial marginal ridge of the first molar D. the distal marginal ridge of the mandibular second molar and mesial marginal ridge of the third molar

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

64. A patient presents for examination with both mandibular first molars distal to the maxillary first molars. This occlusion is known as: A. Class I, distocclusion B. Class II, mesiocclusion C. Class II, distocclusion D. Class III, mesiocclusion 66. The anterior tooth with the most pronounced lingual ridge is the: A. Maxillary central incisor B. Mandibular lateral incisor C. Maxillary canine D. Mandibular canine 67. Oblique ridges are found on which molar teeth? A. Maxillary first and second B. Mandibular first and second C. Maxillary and mandibular first D. Maxilary and mandibular second 68. Leeway space is utilized by: A. Early mesial shift B. Late mesial shift to establish a class- I molar relationship C. To accommodate the large size of canine and premolar D. To compensate for premature loss of 2nd deciduous molar 69. The embrasures which surround the contact points of anterior teeth are: A. mesial, distal, lingual, buccal B. mesial and distal only C. buccal and lingual only D. incisal, cervical, buccal, lingual 70. The distolingual cusp of the mandibular second molar contacts: A. the lingual embrasure between the maxillary first molar and second molar B. the lingual groove of the maxillary second molar C. the central fossa of the maxillary second molar D. the lingual groove of the maxillary first molar 71. The distobuccal cusp of the maxillary second molar occludes in: A. the mesial marginal ridge of the mandibular second molar B. the buccal groove of the mandibular second molar C. the central groove of the mandibular third molar D. the facial embrasure between the mandibular second and third molars 72. The mandibular incisors of a patient are worn down so that dentin is visible on the incisal edge. This is due to grinding of these edges against the natural maxillary incisors. This loss of tooth structure can be termed: A. attrition B. abrasion C. erosion D. internal resorption 73. In centric occlusion, the mesiolingual cusp of the maxillary third molar will contact: A. the central fossa of the mandibular second molar B. the central fossa of the mandibular third molar C. the distal marginal ridge of the mandibular first molar and mesial marginal ridge of the second molar D. the distal marginal ridge of the mandibular second molar and mesial marginal ridge of the third molar 74. In centric occlusion, the lingual cusp of the maxillary first premolar contacts: A. the mesial marginal ridge of the mandibular first premolar and distal marginal ridge of the second premolar B. the distal marginal ridge of the mandibular first premolar and mesial marginal ridge of the second premolar C. the mesial marginal ridge of the mandibular first molar and distal marginal ridge of the second premolar D. the distal marginal ridge of the mandibular second premolar and mesial marginal ridge of the first molar 75. When a fourth canal is found in the permanent maxillary first molar, it is found in the: A. mesiobuccal root B. distobuccal root C. palatal root D. mesiolingual root 76. A mandibular permanent first molar is likely to have a deep root concavity running apically down: A. both roots B. the mesial root C. the distal root D. neither root 77. The distobuccal cusp of the mandibular third molar occludes with which maxillary tooth surfaces? A. The mesial marginal ridge of the third molar and distal marginal ridge of the second molar B. The central fossa of the third molar C. The mesial marginal ridge of the third molar only D. The distal marginal ridge of the third molar only 78. Damage to the right lateral pterygoid results in: A. the mandible turning right on protrusion B. inability to elevate the mandible C. the mandible turning left on protrusion D. none of the above 79. The distal cusp of the mandibular first molar occludes with which maxillary tooth surfaces? A. The mesial marginal ridge of the first molar and distal marginal ridge of the second molar B. The distal marginal ridge of the second molar and mesial marginal ridge of the first molar C. The embrasure between the first and second molars D. The distal triangular fossa of the first molar 80. The mesiolingual cusp of the mandibular third molar contacts: A. the lingual embrasure between the maxillary second molar and third molar B. the distal marginal ridge of the maxillary second molar C. the central fossa of the maxillary second molar D. the lingual groove of the maxillary third molar 81. Based on root morphology, the tooth most likely to be successfully rotated during exodontia is the: A. Maxillary central B. Mandibular central C. Mandibular lateral D. Mandibular canine

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

82. In comparison to those of permanent molars, the common root trunks of primary molars are proportionately: A. larger B. smaller C. relatively equal D. variable, depending on the tooth 83. As compared to the cross section of the maxillary central incisor at the cervical line, the cross section of the mandibular central is: A. more flattened mesiodistally B. more flattened faciolingually C. rounder D. almost identical 84. Growth of the maxilla in the vertical direction is due to: A. Growth of the alveolus B. Growth of the sutures C. Growth of the cranial base D. Growth of the synchondrosis 85. In the Posselt envelope of motion, protruded contact position (PCP) is: A. achieved with the posterior teeth in occlusion B. an extreme border position C. the same as edge-to-edge D. the same as an Angle Class II relationship 86. When compared to the buccal roots of the maxillary first molar, the buccal roots of the maxillary second molar are: A. more parallel, with a pliers-like appearance B. less parallel, lacking a pliers-like appearance C. more parallel, with both having a mesial tip orientation D. more parallel, with both having a distal tip orientation 87. Which of the following permanent teeth is MOST likely to be missing a distolingual cusp? A. Mandibular first molar B. Maxillary first molar C. Mandibular second premolar D. Maxillary second molar 88. The buccal cusp of the maxillary second premolar occludes in: A. the mesial marginal ridge of the mandibular first premolar B. the distal marginal ridge of the mandibular second premolar C. the mesial marginal ridge of the mandibular second premolar D. the facial embrasure between the mandibular second premolar and first molar 89. In occlusion, guiding cusps are defined as: A. lingual cusps of maxillary and mandibular arches B. bucccal cusps of maxillary and mandibular arches C. buccal cusps of the maxillary arch and lingual cusps of the mandibular arch D. lingual cusps of the maxillary arch and buccal cusps of the mandibular arch 90. Protrusive movement causes the condyle of the mandible to move: a. backward and downward b. backward and upward c. forward and downward d. forward and upward 91. As compared to those of the permanent mandibular first molar, the roots of the second molar are: A. more mesially inclined B. straighter C. more distally inclined D. very similar in inclination to the first molar 92. The attrition at the contact point between teeth is known to cause: A. Reduced embrasures interproximally B. Diastemas C. Longer clinical crowns D. Shorter clinical crowns 93. Bifurcated roots may be presents in: A. Maxillary canine B. Mandibular canine C. Mandibular incisor D. Maxillary incisor 94. The mesiobuccal cusp of the maxillary second molar occludes in: A. the buccal groove of the second mandibular molar B. the facial embrasure between the mandibular first and second molars C. the central groove of the mandibular second molar D. the distal marginal ridge of the mandibular first molar 95. The shape of the pulp chamber in cross section cut at the cervical line in the maxillary central incisor is: A. oval (flattened mesiodistally) B. oval (flattened bucco-lingually) C. round D. figure eight 96. The appearance of a second root in a canine is: A. never found B. found more often in the maxillary than the mandibular C. found more often in the mandibular than the maxillary D. found about equally in both arches 97. If the pulp of a single rooted canal is triangular in crosssection with the base of the triangular located facially and apex located lingually with the mesial arm longer than the distal, the tooth most likely: A. Maxillary central incisor B. Maxillary lateral incisor C. Mandibular second premolar D. Mandibular central incisor 98. Dystrophic calcification is seen most commonly in which of the following oral tissues: A. Enamel B. Dentine C. Pulp D. Periodontal ligament 99. In centric occlusion, the distolingual cusp of the maxillary third molar will contact: A. the central fossa of the mandibular second molar B. the central fossa of the mandibular third molar C. the distal marginal ridge of the mandibular first molar and mesial marginal ridge of the second molar D. None of the above 100. Which ligament of the temporomandibular joint inserts into the lingula of the mandible? A. Temporomandibular B. Stylomandibular C. Sphenomandibular D. Lateral

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

1. Ans. A: Ref: Wheelers / 7th edlp-238: Each cusp of the mandibular 2nd premolar has well formed triangular ridges separated by deep developmental grooves. These grooves converges in a central pit and forms a Y-shaped development groove on occlusal surface. Ans. B: Ref: Wheelers/7th edlp-74: The mesiolingual cusp is long and sharp at the tip, more so than any of the other cusp of the mandibular first primary molar and mesiobuccal cusp is having highest pulp horn.

2.

3. Ans. A: Ref Orbans Histology 15th edlp-171, 172, 173 Cementoid: It is a uncalcified organic matrix of the cementum; after calcification or mineralization it forms cementum. Cementum: It is more resistant to resorption than is bone because the cementum is avascular Acellular cementum: It is the first formed cementum and it is called primary cementum. It does not incorporate cells. It covers the root dentine from cemento Enamel junction to the coronal two third of the root. Comparitive Mineralization Incremental line > Acellular cementum > Cellular cementum > Cementoid 4. Ans. Primary roots show less accessory and lateral canals. RefWheeler's 18th edlp-70-71 and Grossman/11th ed/p-149. The root of the deciduous teeth are thinner, slender, and more divergent. Flaring allow the more room to accommodate the developing permanent tooth buds. Accessory canals are more common in permanent teeth in the apical 3rd of the root than the permanent dentition. Among anterior teeth accessory canals are more common in mandibular central incisor while in posterior teeth, accessory canals are more common in mandibular 1st molar teeth at furcation area. 5. Ans. C: RefDatnle/2nd ed/p-108 and 109: Nolla's stages of tooth development: 1.0 Absence of crypt. 7.6 Crown completed. 2.1 Presence of crypt. 8.7 1/3 of root completed. 3.2 Initial calcification. 9.8 2/3rd of root completed. rd 4.3 l/3 of crown completed. 10.9 Root almost completed. 5.4 2/3rd of crown completed. 11.10 Apical end of root completed 6.5 Crown almost completed. Remember that root is not fully formed at the time of eruption and eruption begins at Nolla's stage no-8 of tooth development [2/3rd of root completed] 2/3rd means 66.66% or 67%, which is more than 50% and best near option is 75%. 6. Ans. A: Maxillary1st premolar. RefWheeler's / 7 ed/p-195. The buccal cusp is larger [about 1mm longer, sharper, and more pronounced than lingual] than the lingual cusp Ans. A: Enamel prismatic arrangement. RefOrban's/ 11th ed: Enamel rods or enamel prisms in the cervical and central part of the crown of a deciduous teeth are approximately horizontal. Near the incisal edge and the cusp tips they gradually changes into an oblique direction until they almost vertical in the region of the edge or the tip of the cusp The arrangement of the rods or prism in permanent teeth is similar to that of the primary in the occlusal two third of the crown but deviate from the horizontal in an apical direction in the cervical region. Ans. A. 4 month in utero: RefWheeler's/8th ed/p53. Calcification of primary teeth starts at 4th mounth and completed in 6th month of i.u. Ans. A. Lingually: RefOrban's/11th ed/p-387: At vestibular direction, resorption of the roots of the deciduous incisors and canines begins on their & lingual surface, while in case of deciduous molars resorption often first begins on their inner surface because the early developing bicuspids are between them. The principal direction of movement of tooth during eruption is occlusal or axial. As the deciduous tooth erupts, the permanent tooth germ becomes situated apically and is entirely enclosed by bone except for a small canal that is filled with connective tissue and often contains epithelial remanants of the dental lamina. This C.T mass is termed the "gubernacular cord, and it may have a function in guiding the permanent tooth as it erupt.

7.

8.

9.

10. Ans. D. Most often, the maxillary first molar has three canals: a mesiobuccal, a distobuccal, and a palatal. The palatal is usually largest and widest. Occasionally (30%) the first molar may have a fourth canal,located within the mesiobuccal root, slightly lingual to the mesiobuccal canal. When found, it is the smallest and thinnest of all canals in the tooth. 11. Ans. A. Distal fossa of mandibular 2nd premolar: Wheeler's / 7th ed/p-449: Cusp-Fossa Relation: CUSP FOSA Relation 1 Lingual cusps of premolars - Triangular fossa of mandibular premolars 2. Buccal cusp tip of lower 1st premolar. - Occludes partly with the opposing 1st premolar and canine. nd 3. Buccal cusp tip of lower 2 premolar - Mesial occlusal fossa of opposing second premolar.
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

12. Ans. D. Buccal cusps of maxillary teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for maxillary buccal cusps is that they occlude in the facial embrasure between their mandibular counterpart and the tooth distal to their counterpart, EXCEPT for the mesiobuccal cusps of the molars, which occlude in the buccal grooves of their mandibular counterparts, and the distobuccal cusp of the first molar, which opposes the distobuccal groove of the mandibular first molar. In this uestion we are dealing with the exception of the mesiobuccal cusps of maxillary molars, which occlude with the buccal groove of their mandibular counterpart. In this case, the maxillary first molar mesiobuccal cusp contacts the mandibular first molar buccal groove. 13. Ans. A. One of the best reasons to know standard and unusual root shapes for the various maxillary and mandibular teeth is to use the Correct motion on the forceps when performing extractions. In general, rounded roots are primarily rotated, including the maxillary central incisors and maxillary canines. All double- and triple-rooted teeth cannot be rotated and must be luxated in the buccal and lingual directions. Mesial-distal motion is normally ruled out because of the existence of adjacent teeth. It is used in rare cases where there is no mesial and distal adjacent tooth. The maxillary first premolar is invariably double rooted with a buccal and lingual root, and can never be rotated without breaking the crown off of the root. 14. Ans. D. Because of the shift of the mandibular teeth in a mesial direction due to the smaller size of the anterior teeth, most teeth have two opposing teeth. That is, they oppose their counterpart in the other arch, and a tooth either mesial or distal to that counterpart. There are two classes of exceptions. One of the exceptions is the mandibular central incisors. These two teeth (#24 and #25) oppose only the maxilary centrals (#8 and #9). The other exception is the maxillary third molars (#1 and #16), which oppose only the mandibular third molars. Note that the mandibular third molars oppose both the maxillary second and third molars. 15. Ans. D. The maxillary premolars are considered to be much more alike than are the mandibular premolars. They are most premolar-like in form, with fairly similar sized buccal and lingual cusps and greater overall symmetry. The mandibular premolars, by contrast, are significantly different from each other. The first premolar is very canine-like with a small lingual cusp and relatively large buccal cusp. The mandibular second premolar, while more premolar-like than the first, has attributes of molars as well. The chief molar-like attribute of the mandibular second is the tendency toward three cusps rather than two. The most common form of this tooth has a large buccal cusp with two smaller lingual cusps making up the rest of the crown. The two lingual cusps are the mesiolingual and distolingual and are separated by a lingual groove. There is a less common two-cusped variety which is less molar-like in form. 16. Ans. B. In the mandibular first molar, one of the major distinctions between roots is the greater distal curvature of the mesial root. The distal root, by contrast, is usually more straight, without significant curvature. Another distinction is the deep root concavity seen running the length of the mesial surface of the mesial root. The distal root, by comparison, will have no similar concavity or a very slight depression. This concavity will sometimes express itself as a partial split (bifurcation) of some small section of the apical end of the mesial root into two roots. This feature is rare to unknown on the distal root. 17. Ans. A. When viewed from the proximal, all incisors show a distinct curvature of the cervical line as the line curves markedly upward (toward the incisal). It then returns to a much lower (apical) level on both the facial and lingual. It is most noticeable on the mesial of the central incisor. This is one of those most, biggest, longest, shortest type questions common in this section. 18. Ans. B. It is commonly said that the third molars and the maxillary lateral incisor are the most variable teeth in the mouth. The common forms of maxillary lateral variation include the peg lateral, with an ice cream cone-shaped crown; the deep lingual pit, with a deep (often carious) invagination; and the dens-in-dente, a deep lingual invagination giving a tooth-withina-tooth appearance on x-ray. By contrast, variations in the other incisors are minor and less pronounced. 19. Ans. D. Buccal cusps of maxillary teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for maxillary buccal cusps is that they occlude in the facial embrasure between their mandibular counterpart and the tooth distal to their counterpart, EXCEPT for the mesiobuccal cusps of the molars, which occlude in the buccal grooves of their mandibular counterparts, and the distobuccal cusp of the first molar, which opposes the distobuccal groove of the mandibular first molar. In this question we are dealing with the exception of the mesiobuccal cusps of maxillary molars, which occlude with the buccal groove of their mandibular counterpart. In this case, the maxillary third molar mesiobuccal cusp contacts the mandibular third molar buccal groove. 20. Ans. A. The mesiobuccal cusp of a mandibular molar is a holding (supporting) cusp. The general rule of occlusion of mandibular holding cusps is as follows: the holding cusps of the mandibular teeth occlude on the mesial marginal ridge of their maxillary counterpart, and the distal marginal ridge of the maxillary tooth mesial to their counterpart, EXCEPT distobuccal cusps of mandibular molars occlude with central fossae of their counterparts, the distal cusp of the mandibular
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

first molar occludes with the distal triangular fossa of its counterpart, and the first premolar occludes only with the mesial marginal ridge of its counterpart (but not the canine). In this case, the maxillary counterpart is the maxillary second molar, and the tooth immediately mesial to it is the maxillary first molar. 21. Ans. C. Maxillary lateral incisor and canine: RefWheeler's/6th ed/p-105. Embrasures[spillways]: When two teeth in the same arch are in contact, their curvatures adjacent to the contact areas form spillway spaces called embrasures. Types: [GLOB] 1. Gingival. 2. Labial/lingual. 3. Occlusal. 4. Buccal/labial. The contact area is centered labiolingually on both canine and lateral incisors. The lingual embrasure is similar to that of the central and lateral incisors, but the labial embrasure is changed somewhat by a definite convexity at the mesiolabial line angle of the canine. 22. Ans. B. The maxillary lateral is often the most distinct in almost any anatomical form. Its cingulum is usually more notable relative to its size than that of the central. It should be noted that maxillary cingula are almost always more prominent than their mandibular counterparts. In addition to the prominent cingulum, the maxillary lateral often features a deep lingual fossa, deep lingual pits, and tubercles on the cingulum. 23. Ans. C. The mandibular first premolar is very canine-like in form, with a much reduced lingual cusp, almost resembling a cingulum. The occlusal table thus inclines apically from buccal to lingual, as in a downward slope. This is important in operative dentistry, as the occlusal preparation for this tooth also is slanted to the lingual. All other premolars are essentially flat in their occlusal table, or possibly very slightly lingually leaning if the buccal cusp is slightly higher than the lingual. However, only the mandibular first premolar has this trait so pronounced that it is very different from the other three. 24. Ans. A. Another way of asking the question is: which tooth does not lean toward the mesial or distal? The maxillary central incisor is almost straight vertically, estimated to be about 2 degrees from vertical. The lateral tends to lean slightly mesially, the canine even more in a distal direction, and the first premolar slightly in a distal direction. Do not confuse this leaning with the buccolingual leaning (when viewed from the mesial or distal). These measurements differ significantly for the teeth listed, with the premolar being most vertical. 25. Ans. B. The distobuccal cusp of a mandibular molar is a holding (supporting) cusp. The general rule of occlusion of mandibular holding cusps is as follows: the holding cusps of the mandibular teeth occlude on the mesial marginal ridges of their maxillary counterparts, and the distal marginal ridges of the maxillary tooth mesial to their counterparts, EXCEPT distobuccal cusps of mandibular molars occlude with central fossae of their counterparts, the distal cusp of the mandibular first molar occludes with the distal triangular fossa of its counterpart, and the first premolar occludes only with the mesial marginal ridge of its counterpart (but not the canine). In this case, the maxillary counterpart is the maxillary first molar, and the cusp should occlude in the central fossa of this tooth. 26. Ans. D. The maxillary canine, at the cervix, will have a cross section which is oval and flattened mesiodistally. It is generally slightly wider at the labial end than at the lingual. The pulp cavity at this point is lens-shaped, double convex. It is similar in cross-sectional shape to the mandibula canine. 27. Ans. A. Note that the holding (supporting, occluding) cusps of the posterior dentition are the lingual (palatal) cusps of the maxillary teeth and the buccal (facial) cusps of the mandibular teeth. Buccals of maxillary teeth and linguals of mandibular teeth are guiding cusps. Choice A is the lingual of a mandibular first molar, so it is not a holding cusp, and is a guiding cusp. Choice B is a buccal of a mandibular molar and is a holding cusp. Choice C is a lingual cusp of a maxillary molar and is a holding cusp. Choice D is the lingual of a maxillary premolar and is a holding cusp. 28. Ans. B. The maxillary lateral and the third molars show more variability than any other teeth. Besides a wide variety of unusual morphologies (peg lateral, etc.), the maxillary lateral incisor is fairly commonly congenitally missing. In these patients, the canines drift mesially toward the centrals. Also commonly congenitally missing are third molars and premolars. 29. Ans. C. Anodontia (choice A) refers to the complete absence of tooth formation. In oligodontia (choice B), most but not all teeth are missing. Both of these conditions are often associated with ectodermal dysplasia. Hypodontia refers to a small number of congenitally missing teeth. This is fairly common, and is not sually associated with a systemic disease or disturbance. 30. Ans. D. The MB, ML, and DB cusps of the maxillary molars are the largest, and form the primary cusp triangle, or trigon, of the tooth. The distolingual cusp is the smallest, and is not part of the trigon. It is sometimes referred to as the talon or talon cusp. It is most noticeable in the first molar, less noticeable in the second, and often absent in the third molar. The maxillary
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

third molar therefore often does not have the rhomboid appearance of a maxillary molar, and the occlusal aspect will appear triangular or heart-shaped instead. 31. Ans. D. Cervical bulges are overhangs of the crown sticking out above the cervical line of the primary teeth. In primary anteriors, the cervical bulge is found on both the buccal and lingual surfaces. In the molars, it is found only on the buccal. The most conspicuous cervical bulge in the primary molars is that of the primary mandibular first molar. It is often described as being potbelly when seen from the proximal view. The other molars are not as exaggerated in this area, but still show a pronounced buccal cervical bulge. 32. Ans. B. Despite the fact that the mandibular first molar has a distinct mesial root concavity on the mesial side of the mesial root, and that this root sometimes furcates partially upwards from the mesial, complete additional whole roots are usually second distal roots. Buccal and/or lingual additional roots are not found. 33. Ans. C. The distolingual cusp of a maxillary molar is a holding cusp. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the distal marginal ridge of the mandibular first molar and mesial marginal ridge of the second molar. 34. Ans. A. Lingual cusps of mandibular teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for mandibular lingual cusps is that they occlude in the lingual embrasures between their maxillary counterparts and the teeth mesial to their counterparts, EXCEPT for the distolingual cusps of the mandibular molars, which occlude in the lingual grooves of their maxillary counterparts. In this question we are not dealing with the exception of the distolingual cusps of mandibular molars, so in this case, the mandibular second molar mesiolingual cusp contacts the lingual embrasure between its counterpart (the maxillary second molar) and the tooth mesial to it (the maxillary first molar). 35. Ans. A. The maxillary lateral incisor exhibits an almost round root cross section shape at the cervical line. It is not flattened mesiodistally or labiolingually. The pulp chamber mimics the root shape by being round at this point as well. It is very similar in both root shape and pulp shape to those of the maxillary central. Note that as the pulp enters the coronal section, it will begin to widen mesiodistally (flatten buccolingually) in keeping with the crown shape. 36. Ans. C. This may not seem like dental anatomy, but it is actually a calcification question. In order to avoid tetracycline staining or any other intrinsic stain of enamel, we must avoid all ages where tooth crown calcification is occurring. The last tooth to calcify (and erupt) is the third molar. Most third molars erupt at 17 to 21 years, but calcification of enamel occurs mostly at about age 8. So pregnant mothers and children age 8 and younger are not given tetracycline. 37. Ans. D. The lateral pterygoid connects from the greater wing of the sphenoid and the lateral surface of the lateral pterygoid plate to the mandibular condyle, articular disc, and capsule. It is the only muscle that attaches to these structures. The stylomandibular ligament, sometimes given a vague protective function, extends from the styloid process to the lingula of the mandible. The medial pterygoid muscle is an elevator with no direct attachment to the TMJ. The mandibular condyle is separated from the glenoid (temporal) fossa by the articular (TMJ) disc. The condyle does not pull the disc. The disc is also called the meniscus; they are the same thing. 38. Ans. B. The three largest cusps (trigon, or primitive cusp triangle) of the maxillary first molar are the MB, ML, and DB cusps. The DL cusp is smallest, and is known as the talon cusp (or talon). This cusp is also the one which is even less conspicuous as you go from first to second to third molar. Note also that the DB cusp decreases in relative size as you go from first to second and third molar. The order of size of the cusps in this tooth, then, is from largest to smallest: ML, MB, DB, DL, Carabelli. 39. Ans. D. Remember that primary molars are succeeded by permanent premolars. The permanent molars erupt distal to all primary teeth and do not replace them. So the maxillary replacements are 4 for A, 5 for B, 6 for C, 7 for D, 8 for E, 9 for F, 10 for G, 11 for H, 12 for I, and 13 for J. 1, 2, 3, 14, 15, and 16 do not replace primary teeth. 40. Ans. A. The masseteric sling is a powerful pair of muscles which wrap underneath the angle and ramus of the mandible and act to both support and close (elevate) the mandible. On the lateral surface of the mandible we find the masseter, while on the medial surface we find the medial pterygoid. Although the temporalis (choice D) also strongly elevates, it is not part of this structure. The lateral pterygoid (choice B) attaches to the condyle and TMJ disc, and pulls the condyles forward and laterally. The lateral pterygoid is not part of the masseteric sling.

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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

41. Ans. C. Most maxillary molars are considered four-cusped teeth. However, in some cases, the Carabelli cusp (trait) can be large enough to be considered a fifth cusp on a maxillary first molar. The maxillary second molar is usually four-cusped. The mandibular first molar is normally five-cusped with an ML, MB, DL, and DB cusp and a fifth distal cusp. The mandibular second lacks the distal cusp and is normally a four-cusp tooth. 42. Ans. A. Only maxillary incisors have roundish pulp chamber cross sections when cut at the cervical line. This is true for both maxillary centrals and laterals. In general, mandibular centrals and both arch canines will have ovalish pulp chambers, flattened mesiodistally. (Imagine squashing a round pulp from both the mesial and distal sides at once, resulting in a squashed oval, pointing to the buccal and lingual). Remember that the shape of a pulp chamber is usually related to the shape of the surrounding root. 43. Ans. D. The best way to answer the question is to imagine contact points and proximal-incisal angles for the anterior teeth. A small incisal embrasure will be located wherever the contact points are high (incisal) and where proximal-incisal line angles are almost perpendicular. The best example of this arrangement is the central incisors. Their mesial incisal line angles are very square, and the contact is in the incisal third of the tooth. As you go further distally, the line angles become more rounded, especially for canines. These rounded line angles at the incisal, as well as the more apical contacts, dropping to the middle third as you reach the distal of the canine, ensure much larger incisal embrasures. 44. Ans. A: Mesiolingual: RefWheeler's/7th ed/p-70: In maxillary 1st molars, there is well-defined buccal developmental groove dividing the mesiobuccal cusp and the distobuccal cusp occlusally. 45. Ans. B. The bony origins of the three TMJ ligaments are primarily from three different bones. The stylomandibular ligament originates from a thin, bony extension of the temporal bone, known as the styloid process. The spine of the sphenoid bone is the major origin of the sphenomandibular ligament. The lateral ligament (temporomandibular ligament) has its origin from the zygomatic process. This process is a fusion of the temporal and zygomatic bones. 46. Ans. A: Convex: RefWheelers/7th ed/p-171: In the mesial outline of the labial aspect of mandibular canine as seen from its contact area, to the apex of the root is in convex in shape. 47. Ans. C. This may not be as obvious as it seems. Rule out 4, as the molar only has three roots: the palatal, mesiobuccal, and distobuccal. However, how should they look in a distal view? The palatal root will clearly be visible as the only root on the palatal side. It is massive, and often hooked. On the buccal end, a distal view should easily show the full length of the distobuccal root, so we have two roots so far. What about the mesiobuccal? In this case we can see this root mostly because it is larger than the distobuccal, so some, but not all, of the mesiobuccal root is blocked by the distobuccal. We should, however, see some small sections of it outside of the profile of the distobuccal root. 48. Ans. D. As a general rule, the buccal heights of contour of the premolars are located within the cervical thirds. The lingual heights of contour will normally be more occlusal. On the mandibular first premolar, it is especially occlusal, within the occlusal third. 49. Ans. B. The general rule for innervation by CN V (the trigeminal) is that it innervates the muscles of mastication (temporalis, lateral pterygoid, medial pterygoid, masseter), the mylohyoid, the anterior digastric, and the two tensors (tensor tympani and tensor veli palatini). Note that the buccinator is not included. The buccinator is in the group of muscles of facial expression, which are all innervated by CN VII (the facial nerve). 50. Ans. A. Mandibular incisors are widest near the incisal tip, and their contacts (both central and lateral) are always near the incisal edge. The mandibular canine contact with the lateral incisor is thus in the incisal third. In the canine, the contact is also in the incisal third, but not as incisal as in the lateral. The distal contact of the canine is also in the incisal third, but near the junction of the incisal and middle thirds. 51. Ans. C. The primary first mandibular molar is a highly unusual tooth. It is molar-like in form, with two roots (mesial and distal), but has a very pronounced mesial development of the crown. The mesial section comprises two-thirds of the crown, and the distal portion is much reduced. The mesiolingual cusp is the highest and sharpest, although the mesiobuccal is overall largest as viewed from the occlusal. It is followed in size by the ML, DB, and DL cusps. 52. Ans. B. The maxillary lateral is the most highly variable tooth in the mouth. It can be normal incisor-shaped, peg-shaped, or congenitally missing, or have a wide variety of invaginations, from small pits to deep pits to dens-in-dente, or tooth-within-atooth. This is the case when the invagination is so deep that the radiographic appearance appears to show a small tooth inside the maxillary lateral.
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53. Ans. Mandibular 1st premolar: RefWheeler's/8th ed/p-249: In all the teeth the distal marginal ridge is at a lower level than mesial marginal ridge, except for the mandibular 1st premolar where the distal marginal ridge is at a higher level than mesial marginal ridge. 54. Ans. D. In occlusion, cusps are defined as either holding (supporting) cusps or guiding cusps. Holding cusps, in central occlusion, make contact with the opposing arch, establish vertical dimension of occlusion, and support the forces of occlusion. They are the lingual cusps of the maxillary arch and buccal cusps of the mandibular. When the teeth are in centric occlusion, these cusps are in contact. The other cusps (guiding) are not. The other cusps are either lingual to the contact (lingual cusps of the mandibular arch) or buccal to the contact (buccal cusps of the maxillary arch). Holding cusps generally occlude in the marginal ridge and central fossa areas of the opposing arch. Guiding cusps generally lie in embrasures between teeth, or between cusps of the lingual or buccal surfaces of the opposing arch. 55. Ans. A. The question depends on the fact that the maxillary first premolar has an asymmetric positioning of its two cusps. Rather than having the buccal and lingual cusps in a straight line, the buccal cusp is displaced slightly distally, and the lingual cusp is displaced slightly mesially. This gives the occlusal view of the tooth a slightly twisted appearance. Cusp ridges run from the cusp tip to the proximal edge of the tooth at the marginal ridge. Therefore, if you look facially at the maxillary first premolar, you will see the buccal cusp shifted toward the distal. This makes the cusp tip farther from the mesial, and thus there will be a longer mesial cusp ridge on this tooth. 56. Ans. D. The distolingual cusp of a maxillary second molar is a holding cusp. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the distal marginal ridge of the mandibular second molar and mesial marginal ridge of the third molar. 57. Ans. A. For the most part, rotation of a tooth during extraction works best on teeth with rounded roots, such as the maxillary central incisor and maxillary canine. It can be used in conjunction with buccal-lingual luxation on teeth with single ovalish roots. It can never be used on double-rooted teeth. Of the premolars above, the maxillary first is always double rooted. Of the others, the maxillary second is sometimes double rooted and sometimes single. For the mandibular premolars, the mandibular first is the most likely to have a single ovalish, but close to round, root. It is the MOST likely premolar on which rotation may be part of the extraction. 58. Ans. D. The mesiolingual cusp of a maxillary second premolar is a holding cusp. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the distal marginal ridge of the mandibular second premolar and mesial marginal ridge of the first molar. 59. Ans. C. While all three maxillary molars commonly have three roots, the roots and their arrangement differ distinctively from one to the other. Most notable in the first molar is the pliers-like appearance of the two buccal roots. The mesiobuccal hooks distally and the distobuccal hooks mesially. The second molar does not have this curvature, and the two buccal roots are more parallel, with both roots inclined distally. The third molar often has three fused roots forming a cone-like structure, or sometimes all distally inclined. These factors are important in exodontia of maxillary molars. Maxillary third molars, in particular, can sometimes be elevated out distally in a rotating manner because of the fused cone-like distally facing roots. 60. Ans. D. The distobuccal cusp of a mandibular molar is a holding (supporting) cusp. The general rule of occlusion of mandibular holding cusps is as follows: the holding cusps of the mandibular teeth occlude on the mesial marginal ridge of their maxillary counterpart, and the distal marginal ridge of the maxillary tooth mesial to their counterpart, EXCEPT distobuccal cusps of mandibular molars occlude with central fossae of their counterparts, the distal cusp of the mandibular first molar occludes with the distal triangular fossa of its counterpart, and the first premolar occludes only with the mesial marginal ridge of its counterpart (but not the canine). In this case, the maxillary counterpart is the maxillary second molar, and the mandibular cusp will occlude in its central fossa. 61. Ans. D: Mandibular 1st premolar: RefGrosstnan/11th ed/p-165: In a group of single rooted teeth, bifurcation of roots are more common in mandibular first premolar followed by mandibular incisors and canines. Maxillary anteriors least likely to have bifurcated roots. 62. Ans. C. Contact is re-established in proximal areas when Class II restorations are completed. This restoration of contact at the Correct contact level prevents food from wedging in between teeth and causing buildup of plaque and debris. This, in turn, protects the periodontal ligament, because the chief etiology of periodontal bone loss is calculus and plaque accumulation.
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Stability of the arch is maintained and tooth drifting is also minimized. Without contact, teeth may drift mesially or distally into the space left by the faulty restoration. Proximal contact is NOT considered to be related to filling material retention. This is because each restorations retention is supposed to depend solely on the retentive properties of that individual tooth, tooth preparation, and material. In other words, retention stands alone within the individual tooth. Adjacent teeth are never considered as part of restoration retention. 63. Ans. C. A lingual ridge runs from the incisal edge down the center of the lingual surface of the crown, toward the cervical end of the crown. It splits the lingual surface in half, and usually has a depression on either side (lingual fossae) which separate the lingual ridge from the mesial and distal marginal ridges. Lingual ridges are found on canines, but not on incisors (choices A and B). The lingual ridge is more pronounced on the maxillary canine than on the mandibular (choice D). This is in keeping with a general rule that the lingual anatomy of the maxillary canine is much more pronounced than that of the mandibular. 64. Ans. C. Look for a mandibular anterior tooth to be your answer here. You will often notice clinically that partially edentulous patients often retain mandibular anteriors despite loss of most other teeth. This is due to the following three factors: 1) they have few significant pits or fissures; 2) they are bathed in saliva most of the time, which resists plaque buildup; and 3) they are cleaned by the normal movements of the tongue. Other teeth cannot fit all three of these categories. Note that mandibular canines are often the last teeth left. This is because, although the mandibular incisors are rarely lost to caries, they are often lost to periodontal disease, partially due to their short roots and easy calculus buildup. 65. Ans. A: Mesiolingual and mesiobuccal: RefShobha Tandon/1st ed/p-289: While preparing a class-II cavity on maxillary 1st molar, we should take precaution to avoid the exposure of mesiolingual and mesiobuccal pulp horn; because they are located at higher level. 65. Ans. C. The normal (Class I) jaw relationship will result in the mandibular first molar being located one cusp (one-half tooth) mesial to the maxillary first molar. If the mandibular molar is located distal to the maxillary, it indicates a small mandible (micrognathy) or another problem causing the maxillary teeth to be too far mesial and the mandibular too far distal. This is distocclusion is Angles Class II. Mesiocclusion is Angles Class III, where the mandibular first molar is more than one-half tooth mesial to the maxillary first molar. 66. Ans. C. A lingual ridge runs from the incisal edge down the center of the lingual surface of the crown, toward the cervical end of the crown. It splits the lingual surface in half, and usually has a depression on either side (lingual fossae) which separates the lingual ridge from the mesial and distal marginal ridges. Lingual ridges are found on canines, but not on incisors (choices A and B). The lingual ridge is more pronounced on the maxillary canine than on the mandibular (choice D). This is in keeping with a general rule that the lingual anatomy of the maxillary canine is much more pronounced than that of the mandibular. 67. Ans. A. Oblique ridges are characteristic of maxillary molar teeth. They connect the mesiolingual and distobuccal cusps. The oblique ridge is also considered to be the distal end of the trigon, the major cusp area of the maxillary molar, composed of the ML, MB, and DB cusps. The DL cusp is often reduced and is referred to as the talon (as opposed to the trigon). The trigon is evolutionarily the primitive cusp triangle of the molar crown. Oblique ridges are not found on mandibular molars or on any other teeth. 68. Ans. B: Late mesial shift to establish a class- I molar relationship: RefS.I Bhalajhi/3rd edlp-42. The surplus space is called leeway space of Nance. The amount of leeway space is greater in the mandibular arch than in the maxillary arch. It is about 1.8 mm [0.9 mm on each side of the arch] in the maxillary arch and about 3.4 mm[1.7 mm on each side of the arch] in the mandibular arch. This excess space available after the exchange of the deciduous molar and canine is utilized for mesial drift of the mandibular molars to establish Cass-I molar relation[This occurs in the late mixed dention period and is thus called late shift] while early shift occurs in early mixed dentition period, which utilized primate space to gain Class-I molar relationship. 69. Ans. D The best way to answer the question is to imagine that the embrasures are spaces surrounding a small point of contact between two incisors. This small contact point will have space above it, below it, in front of it, and in back of it. These spaces in dental anatomy will be, respectively, incisal, cervical (gingival), buccal (facial), and lingual (palatal). Note that there is no space mesial or distal to the contact point. Immediately mesial or distal to the contact would be tooth structure. 70. Ans. B. Lingual cusps of mandibular teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for mandibular lingual cusps is that they occlude in the lingual embrasures between their maxillary counterparts and the teeth mesial to their counterparts, EXCEPT for the distolingual cusps of the mandibular molars, which occlude in the lingual grooves of their maxillary counterparts. In this question we are dealing with the exception of the distolingual cusps of mandibular molars, so in this case, the mandibular second molar distolingual cusp contacts the lingual groove of its counterpart (the maxillary second molar).
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

71. Ans. D. Buccal cusps of maxillary teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for maxillary buccal cusps is that they occlude in the facial embrasures between their mandibular counterparts and the teeth distal to their counterparts, EXCEPT for the mesiobuccal cusps of the molars, which occlude in the buccal grooves of their mandibular counterparts, and the distobuccal cusp of the first molar, which opposes the distobuccal groove of the mandibular first molar. In this question, we are NOT dealing with the exception of the mesiobuccal cusps of the maxillary molars or the distobuccal cusp of the maxillary first molar, so this cusp should follow the general rule and occlude with the facial embrasure between its mandibular counterpart (the mandibular second molar) and the mandibular molar distal to it (the mandibular third molar). 72. Ans. A. Attrition is the mechanical wearing of teeth due to physiologic processes, including chewing and bruxism. Abrasion (choice B) is the mechanical wearing away of tooth structure due to some outside object, such as toothbrush abrasion at the cervical lines of teeth due to hard sideways brushing, or from habitually holding bobby pins or nails with the teeth. Erosion (choice C) is the chemical dissolving of tooth structure. It can be caused by a number of factors, including sucking on lemons and other acidic fruit, excessive intake of acidic beverages (cola), or excessive vomiting, as in bulimia. Bulimics often exhibit normal facial surfaces with severely eroded lingual surfaces. 73. Ans. B. The mesiolingual cusp of a maxillary third molar is a holding cusp. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the central fossa of the counterpart, the mandibular third molar. 74. Ans. B. The lingual cusp of a maxillary premolar is a holding cusp. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the distal marginal ridge of the mandibular first premolar and mesial marginal ridge of the second premolar. 75. Ans. A. Note that the three-rooted maxillary first molar does not have a mesiolingual root. The maxillary first molar most often has three roots: mesiobuccal, distobuccal, and palatal. The palatal root is largest, and its canal is largest and widest. In the case of a fourth canal, it is invariably found in the mesiobuccal root. The distobuccal and palatal roots are invariably onecanalled. 76. Ans. B. One of the distinctions between the mandibular first-molar mesial and distal roots is the deep root concavity seen running the length of the mesial surface of the mesial root. The distal root, by comparison, will have no similar concavity or a very slight depression. Other differences include the greater likelihood of the mesial root having a distal curvature, and the greater likelihood of the mesial root being partly split by a partial furcation running partway up from the apical end. 77. Ans. B. The distobuccal cusp of a mandibular molar is a holding (supporting) cusp. The general rule of occlusion of mandibular holding cusps is as follows: the holding cusps of the mandibular teeth occlude on the mesial marginal ridge of their maxillary counterpart, and the distal marginal ridge of the maxillary tooth mesial to their counterpart, EXCEPT distobuccal cusps of mandibular molars occlude with central fossae of their counterparts, the distal cusp of the mandibular first molar occludes with the distal triangular fossa of its counterpart, and the first premolar occludes only with the mesial marginal ridge of its counterpart (but not the canine). In this case, the maxillary counterpart is the maxillary third molar, and the cusp should occlude in the central fossa of this tooth. Remember that the mandibular third molar is located one-half tooth mesial to the maxillary. 78. Ans. A. As a rule, the mandible will move toward the side of injury when the lateral pterygoid is damaged. In this case, the right condyle will not move because of the muscle damage. The left condyle moves forward, but because there is no movement on the right side, the left condyle moves out and rotates to the right, with the nonmoving right condyle acting as a pivot point. Damage to the lateral pterygoid will not affect elevation (closing), because the lateral pterygoid is not an elevator. The elevators are the temporalis, medial pterygoid, and masseter. 79. Ans. D. The distal cusp of the mandibular first molar is a holding cusp. The general rule of occlusion of mandibular holding cusps is as follows: the holding cusps of the mandibular teeth occlude on the mesial marginal ridge of their maxillary counterpart, and the distal marginal ridge of the maxillary tooth mesial to their counterpart, Except distobuccal cusps of mandibular molars occlude with central fossae of their Counterparts, the distal cusp of the mandibular first molar occludes with the distal Triangular fossa of its counterpart, and the first premolar occludes only with the Mesial marginal ridge of its counterpart (but not the canine). Note that mesiobuccal cusps of mandibular molars and buccal cusps of premolars contact marginal ridges.
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

80. Ans. A. Lingual cusps of mandibular teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for mandibular lingual cusps is that they occlude in the lingual embrasures between their maxillary counterparts and the teeth mesial to their counterparts, EXCEPT for the distolingual cusps of the mandibular molars, which occlude in the lingual grooves of their maxillary counterparts. In this question we are not dealing with the exception of the distolingual cusps of mandibular molars, so in this case, the mandibular third molar mesiolingual cusp contacts the lingual embrasure between its counterpart (the maxillary third molar) and the tooth mesial to it (the maxillary second molar). 81. Ans. A. During extraction, rotation can be used on teeth with rounded conical roots. Two primary examples are maxillary centrals (especially) and maxillary laterals. Rotation may also be used somewhat with maxillary canines. If roots are flattened mesiodistally, then buccal-lingual movement is used instead of rotation, as rotation may cause crown fracture. Mandibular centrals, laterals, and canines (choices B, C, and D) are all flattened mesiodistally, and therefore are usually not rotated during extraction. Mandibular canines also may occasionally have two roots (buccal and lingual), which will prohibit rotation. 82. Ans. B. The common root trunk refers to that area of root apical to the crown but coronal to the bifurcation or trifurcation of the roots. It can be viewed as the combined root area from which the individual roots emerge. It is characteristic of primary molars that they have little or no common root trunk. That is, the roots appear to furcate almost immediately below the crown. This is due to the fact that the primary molar roots must flare widely in order to leave room for the developing crowns of the succedaneous premolars. 83. Ans. A. As a general rule, maxillary incisors have round root sections and round pulp chamber cross sections. Mandibular incisors have more oval ones, and are flattened mesiodistally. This is in keeping with the general root shape of each. Maxillary incisor roots are round, and mandibular ones are flattened to a greater degree. Note that in both arches, as the pulp moves coronally it will flatten buccolingually, in keeping with the coronal shape of all incisors. 84. Ans. A: Growth of the alveolus: RefSI. Bhalajhi/3rd ed/p-33: As the teeth start erupting, bone deposition occurs at the alveolar margins. This increases the height in vertical direction and the depth of the palate. 85. Ans. B. The Posselt envelope of motion is a tracing of the extreme border movements of the mandible. It shows how far the mandible can protrude, retrude, open, and close, and all motions connecting these points. Protruded contact position is caused by protruding the mandible as far as possible. This will normally push the mandible past edge-to-edge, until the mandible appears to be in a Class III relationship. As the mandible protrudes, anterior tooth contact causes separation of the teeth out of occlusion. 86. Ans. D. A characteristic curve of the two buccal root tips of the maxillary first molar toward each other is sometimes referred to as a pliers-handled appearance or pincer appearance. In effect, the roots grow apically and then turn toward each other, forming a U shape. This shape helps explain the stability of the tooth, especially when combined with the tripod-like arrangement of the palatal root. Note that the same roots of the second maxillary molar often both point distally, distinguishing one molar from the other. These roots in the second molar are also more parallel than those in the first molar. In buccal view they seem to sway distally, with the palatal root in the midline and slightly mesially tilted. 87. Ans. C. The mandibular first molar is invariably a five-cusped tooth, with MB, ML, DB, DL, and distal cusps. Maxillary first and second molars are normally four-cusped teeth. The distolingual cusp is usually less pronounced on the second molar. It is often absent on the maxillary third molar, but that answer is not listed. The mandibular second premolar is either a two- or three-cusped tooth. The two-cusped variety has a single buccal cusp and a single lingual cusp, while the three-cusped version has a buccal cusp and paired mesiolingual and distolingual cusps. However, both varieties are common, so it is common to find this tooth lacking the distolingual cusp. 88. Ans. D. Buccal cusps of maxillary teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for maxillary buccal cusps is that they occlude in the facial embrasure between their mandibular counterpart and the tooth distal to their counterpart, EXCEPT for the mesiobuccal cusps of the molars, which occlude in the buccal grooves of their mandibular counterparts, and the distobuccal cusp of the first molar, which opposes the distobuccal groove of the mandibular first molar. In this question, the contact is the embrasure between second mandibular premolar (the counterpart) and the first molar (the tooth distal to the counterpart). 89. Ans. C. In occlusion, cusps are defined as either holding (supporting) cusps or guiding cusps. Holding cusps, in central occlusion, make contact with the opposing arch, establish vertical dimension of occlusion, and support the forces of occlusion. They are the lingual cusps of the maxillary arch and buccal cusps of the mandibular. When the teeth are in centric occlusion, these cusps are in contact. The other cusps (guiding) are not. The other cusps are either lingual to the contact (lingual cusps of the mandibular arch) or buccal to the contact (buccal cusps of the maxillary arch).
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AHEAD Test and Discussions DENTAL ANATOMY & OCCLUSION

90. Ans. C. Protrusive movement is defined as moving the mandible outward, away from the head. If you are in centric occlusion, you will protrude to move toward an edge-to-edge position. The lateral pterygoid moves both condyles forward when it contracts, so the initial protrusive movement is forward. When the condyle contacts the articular eminence in the glenoid fossa, it cannot move directly forward anymore and begins to glide downward along the surface of the fossa. 91. Ans. C. In the permanent mandibular first molar, the mesial root is usually slightly curved distally, and the distal root is straighter but pointing toward the distal. In the second molar, both roots are usually significantly inclined toward the distal and curved distally at the end. They tend to resemble each other more than the two roots of the first molar do. They are also closer together. The roots in the first molar are more widely spread. 92. Ans. A. Over time, posterior teeth lose small amounts of enamel as the contact points wear against each other during chewing. The contacts become slightly broader, the teeth themselves become slightly closer, through drifting, and the embrasures between the teeth become slightly smaller. Diastemas (choice B) are not created, because the teeth drift to close any space created by the attrition. The process is at a microscopic level; the wear is very gradual, as is the accompanying drifting, so that contact is not lost. This process does not affect crown length (choices C and D), which is occluso-cervical in direction. It only affects the mesio-distal dimension. 93. Ans. C: Mandibular incisor: RefGrossman/llth ed/p-165: In a group of single rooted teeth, bifurcation of roots are more common in mandibular first premolar followed by mandibular incisors and canines. Maxillary anteriors least likely to have bifurcated roots. .94. Ans. A. Buccal cusps of maxillary teeth are guiding cusps, not holding cusps. Therefore, they do not occlude on marginal ridges or central fossae. The general rule for maxillary buccal cusps is that they occlude in the facial embrasures between their mandibular counterparts and the teeth distal to their counterparts, EXCEPT for the mesiobuccal cusps of the molars, which occlude in the buccal grooves of their mandibular counterparts, and the distobuccal cusp of the first molar, which opposes the distobuccal groove of the mandibular first molar. In this question we are dealing with the exception of the mesiobuccal cusps of maxillary molars, which occlude with the buccal grooves of their mandibular counterparts. In this case, the maxillary second molar mesiobuccal cusp contacts the mandibular second molar buccal groove (its counterpart). 95. Ans. C. Only maxillary incisors have roundish pulp chamber cross sections when cut at the cervical line. Laterals are eggshaped with the widest portion labial, not round. This is true for both maxillary centrals and laterals, which are egg-shaped with the widest portion of the labial not round. In general, mandibular incisors and both arch canines will have oval-shaped pulp chambers, flattened mesiodistally. (Imagine squashing a round pulp from both the mesial and distal sides at once, resulting in a squashed oval, pointing to the buccal and lingual). Remember that the shape of a pulp chamber is usually related to the shape of the surrounding root. 96. Ans. C. Two roots are a fairly rare occurrence in canines, but are occasionally found in the mandibular canine. They are almost unknown in the maxillary. If they are found in the mandibular canine, they will be buccal and lingual, similar to those found in premolars. 97. Ans. Maxillary central incisor: RefGrossman/llth ed/p-151: The occlusal cross-section view of maxillary central incisor is triangular in shape; while the apex located lingually and base of the triangle located facially. 98. Ans. Pulp: Pathologic calcification implies the abnormal deposition of calcium salt in soft tissues. Dystrophic calcification occurs in nonviable or dying tissues in the presence of normal calcium serum levels. 99. The correct answer is D. The distolingual cusp of a maxillary third molar is theoretically a holding cusp, however it is often missing on this tooth. The general rule for maxillary holding cusps is as follows: a maxillary holding cusp contacts the distal marginal ridge of its mandibular counterpart and the mesial marginal ridge of the mandibular tooth distal to its counterpart, EXCEPT FOR THE MESIOLINGUAL CUSPS OF THE MOLARS, WHICH CONTACT THE CENTRAL FOSSAE OF THEIR COUNTERPARTS. This should be the distal marginal ridge of the mandibular third molar and no mesial marginal ridge, because there is no tooth distal to the third molar. So the answer is either the cusp does not exist, or it contacts only the distal marginal ridge of the mandibular third molar. 100. The correct answer is C. The origins and insertions of the TMJ ligaments are as follows: The sphenomandibular ligament arises from a spine on the sphenoid bone and runs forward and downward to insert on the lingula and deep ramus of the mandible. The stylomandibular ligament arises from the spine of the temporal bone known as the styloid process and inserts on the lower ramus and angle of the mandible. The lateral ligament is also known as the temporomandibular ligament. It descends from the lower border and tubercle of the zygoma to the posterior lateral condyle. Its fibers merge with those of the articular capsule.

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